Radiofrequency (RF) heating of tissue can be accomplished in two ways. That referred to by Dr Selker is inductive heating, wherein the RF current is converted into a magnetic field by passing it through a coil. The magnetic field induces heat in conductive materials such as electrolyte solutions, metal particles, and wires. Naturally, even temperature sensors with high resistance wires would be heated above ambient temperature and thus interfere with measurements. Our work was done with the other method of RF heating, called dielectric heating. This is accomplished by placing the part to be heated between two plates of a condenser. The current passing between the two electrodes heats only poorly conductive substances and does not heat wires. Nevertheless, the RF current can traverse the wires into the indicating circuits. This is prevented by the interposition of a small, commercially available RF filter. The accuracy of such temperature


There are two reasons why uncertainty about the future yield of investments may not be adequately described by Probability Theory. The first one is due to unique or nearly-unique events, that either never realized or occurred too seldom for probabilities to be reliable. The second one arises when one fears that something may happen, that one is not even able to figure out, e.g., if one asks: "Climate change, financial crises, pandemic, war, what next?" In both cases, simple one-to-one causal mappings between available alternatives and possible consequences eventually melt down. However, such destructions reflect into the changing narratives of business executives, employees and other stakeholders in specific, identifiable and differential ways. In particular, texts such as consultants' reports or letters to shareholders can be analysed in order to detect the impact of both sorts of uncertainty onto the causal relations that normally guide decision-making. We propose structural measures of causal mappings as a means to measure non-probabilistic uncertainty, eventually suggesting that automated text analysis can greatly augment the possibilities offered by these techniques. Prospective applications may concern statistical institutes, stock market traders, as well as businesses wishing to compare their own vision to those prevailing in their industry.


Terahertz spectroscopy, which investigates the electromagnetic spectrum of samples between 0.1 and 10 THz, allows not only for exploration of molecular structures but also of molecular dynamics. One difficulty in performing THz spectroscopy is that the data can be noisy and difficult to interpret. Ab initio molecular modelling has recently become more and more useful in the prediction of, for example, molecular structures, dynamic states and isomeric forms. Since the structure of biomolecules is closely related to their functionality there are broad ranging applications in biomedicine, for example in DNA sensing. An a priori knowledge of the expected THz spectra allows for improved experimentation. There is a growing and recognised need for THz spectroscopic databases to be created and made available along with classifiers that are able to effectively detect a specific substance. We show, for a specific example, the 9-cis and all-trans retinal isomers, how ab initio molecular orbital calculations and quantum chemical modelling programs, such as Gamess, can aid in this endeavour.


Transposable elements (TEs) are middle repetitive DNA sequences classified into families according to their sequence similarities, such elements can playing an important role in the evolutionary process of their host genomes. There are many reports on the distribution of TEs in the fruit fly genus Drosophila, although there is relatively little information relating to the Neotropical mesophragmatica group of Drosophila, probably the most typical cluster of species occurring almost exclusively in the Andes mountains. Dot Blot and PCR analyses was used to study the distribution of some TEs (I, mariner, hobo, gypsy, Tom/17.6, micropia and P elements) within the mesophragmatica group of Drosophila. We found gypsy elements in all the mesophragmatica group species studied and mariner elements were absent only from Drosophila pavani but P element homologous sequences were present only in D. pavani and Drosophila gasici and the other TEs (I, hobo, Tom/17.6, micropia) were not found in any of the species investigated.


Most conventional simulation techniques account for two-point statistics via the modeling of the variogram of the regionalized variable or of its indicators. These techniques cannot control the reproduction of multiple-point statistics or higher order features that may be critical for the performance of the models given the goal at hand (flow simulation in petroleum applications, planning and scheduling for mining applications). Multiple-point simulation is a way to deal with this situation. It has been implemented for categorical variables, yet the demand of large data sets (training images) to infer the multiplepoint statistics has impeded its use in the case of continuous variables. The main problem is that multiple-point statistics are characterized by discretizing the continuous variable by a set of thresholds and coding them as indicators, which results in a loss of resolution between thresholds. We propose a method to incorporate multiple-point statistics into sequential simulation of continuous variables. Any sequential algorithm can be used. The method proceeds as follows. First, the multiple-point statistics are inferred from a training data set or training image with the typical indicator approach. The conditional probabilities given multiple-points data events enable to update the conditional distributions obtained by the sequential algorithm that uses the conventional two-point statistics. The key aspect is to preserve the shape of the conditional distribution between thresholds after updating the probability for the cutoffs used to infer the multiple-point statistics. Updating takes place under the assumption of conditional independence between the conditional probability obtained from the training set and the one retrieved from the conditional probability defined by the sequential method. The algorithm is presented for any sequential algorithm and then illustrated on a real data set using the sequential indicator and Gaussian simulation methods. The advantages and drawbacks of this proposal are pointed out.


shaped hypergranulosis, sawtooth rete ridges, and the presence of colloid bodies at the dermoepidermal junction (Figure 2). The most noticeable aspect from the histological point of view was the intensity of the lymphoid infiltrate, which occupied the whole papillary dermis and reached the upper reticular dermis, obliterating the dermoepidermal junction and also affecting the periadnexal dermis, forming a dense lymphoid accumulation around the sweat glands (Figure 3). These lymphocytes presented no nuclear atypia nor was there a tendency to epidermotropism (Figure 4). Molecular study was performed using the polymerase chain reaction and this detected monoclonal reordering of the TRG gene.


Homogeneous, approximately isotropic turbulence at two Taylor-scale Reynolds numbers, Rλ=50, 190, with a mean transverse temperature gradient is passed through an axisymmetric contraction. The effects of the straining on the velocity field, and on the passive scalar field, are investigated within the contraction as are the effects of releasing the strain in the post-contraction region. Components of the fluctuating velocity and scalar gradient covariance are measured in order to understand their relation to the large-scale anisotropy of the flow. The scale-dependent spectral evolution of the scalar is also determined. A tensor model is constructed to predict the evolution of the fluctuating scalar gradient covariance. The model constants are determined in the post-contraction relaxation region, where the flow geometry does not vary. The model is shown to perform well throughout the flow, even in the contraction in which the geometry varies. Rapid distortion theory is applied to the scalar field in the contraction, and its solutions are compared to the experimental results.


The aim of the study was investigation of association of the rs7574865 polymorphism of STAT4 gene (Signal Transducer and Activator of Transcription 4, a family of signal transduction and transcription activation molecules 4) with very early rheumatoid arthritis (RA) in Russian patients, and the study of the relationship of "phenotype – genotype", particularly of positivity for antibodies to cyclic citrullinated peptides (ACCP), their concentration, the presence of erosive joint damage at inclusion in patients the study with the STAT4 gene polymorphism. Material and methods. The study was conducted in the framework of the program REMARKA (Russian study of Methotrexate and biological drugs in Early active Arthritis). 85 patients with very early RA with a duration of symptoms no more than 6 months, not receiving disease modifying anti-rheumatic drugs (DMARD) and biologicals were included. Results and discussion. The analysis of the distribution of genotypes and alleles of STAT4 rs7574865 polymorphism showed that the frequencies of g/G, G/T and T/T genotypes differ at the level of the prominent tendency to statistical significance between patients with RA and the control group (p=0.05). The frequency of minor allele T in RA is significantly higher than that in the control group, and this allele is associated with a predisposition to RA [odds ratio (OR) 1.7; 95% confidence interval (CI) 1.1–2.8; p=0.03]. In the study of the "genotype – phenotype" relationship, STAT4 gene polymorphism correlated with erosive joint damage (r2=0.289; p=0.008). In carriers of the homozygous genotype TT, the number of erosions at inclusion in the study was significantly higher compared with carriers of genotypes GG/GT (median 5.50 [0.754; 7.5] and 0.00 [0.00; 2.00], respectively; p=0.003). The risk of erosion is also associated with the polymorphism of the STAT4 gene (OR 8.6; 95% CI 1.0–204.9; p=0.03). A difference of the ACCP level depending on STAT4 gene polymorphism was revealed: carriers of at least one minor allele T (G/T+T/T) had significantly higher concentration of ACCP than that in carriers of homozygous GG genotype: 248.97±151.00 and 179.51±147.01 U/ml, respectively; p=0.048). Conclusion. The study showed that in Russian patients with very early RA, the STAT4 gene rs7574865 polymorphism is associated with both predisposition to the disease and prognostically unfavorable manifestations (phenotypes) of the disease, namely, with the development of erosion in the early stages of the disease and an increase of the ACCP level.


Clinical drug resistance to chemotherapeutic agents is one of the major hindrances in the treatment of human cancers. One mechanism by which a living cell can achieve multidrug resistance (MDR) is via the active efflux of a broad range of anti-cancer drugs through the cellular membrane by MDR proteins. Over-expression of multidrug resistance-associated protein 1 (MRP1) is one of the important MDR phenotypes. RNA interference (RNAi) is a fundamental cellular mechanism for silencing gene expression that can be harnessed for the development of new drugs. In our study, by using lipofectamin(TM) 2000 (Invitrogen, Carlsbad, CA, USA) in vitro and electric pulse in vivo to delivery siRNA, we successfully inhibited MRP1 both at mRNA and protein level as determined by reverse transcription-PCR and western blot or immunohistochemistry. Furthermore, the efficacy of chemotherapeutic drugs (epirubicin) to tumour cells dramatically improved both in vivo and in vitro. These studies demonstrate that through efficient delivery siRNA, MRP1-mediated MDR can be reversed and siRNA can be used for further study in clinical cancer therapy.


This article presents the results of an interview study carried out with sixteen data-protection authorities in Central and Eastern Europe. The study focuses on the way that data protection authorities reason about the past. The theoretical argument advanced in the text is that data protection in a post-communist context bears a specific historical significance due to the recent experiences with the extensive, coercive state surveillance that was systematized under the communist regimes. The article focuses on the institutional role conceptions of data protection authorities—a theoretical concept that denotes perceptions of the role of an organization within the larger institutional environment. High-level officials from data protection authorities in sixteen countries were interviewed about change and continuity in surveillance. The results show that historical reflectivity is not a dominant feature of the leadership of contemporary data protection authorities and that different countries differ considerably. The respondents least able or willing to discuss the topics of change and continuity are in societies with recent high-level surveillance scandals, such as Bulgaria and North Macedonia.


Herein we study point defects and correlation to photoluminescence in ZnO nanorod. ZnO mirco/nanorod structure was successfully fabricated by co-precipitation method with highly homogeneous characteristics. When ion Mn+2 introduced into ZnO structure, the d-spacing distance of ZnO was increased from 0.248 nm to 0.295 nm due to the larger ionic radius of Mn2+ in comparison to Zn2+. The photoluminescence emission evolution of ZnO through doping and annealing processes hinted the relation of point defect transformations. We found that zinc interstitial, zinc vacancy and its related defects were responsible mainly for photoluminescence emission in annealing and/or Mn2+ doped samples.


The detection of human abnormal action is very important in video surveillance. In order to detecting human abnormal action in different scenarios, we can use a method of double-layer Bag-of-Words model. In this method, the video information is firstly processed using Bag-of-Words, and the information of motion text words and scenarios are included in another bag. A video sequence is represented as a codebook of spatial-temporal words by extracting space-time interest points. An action characteristic is determined by behavior text words in special scenarios. A model of Latent Dirichlet Allocation (LDA) is appLied to automatically learn the distribution of spatial-temporal words and the topics correspond to human action categories. And it also learns the probabiLity distributions of the motion text words in a scenario with supervisor and the intermediate topics corresponding to anomalous or normal action. All of these are achieved by using the Latent Dirichlet Allocation model. Through this method, we can categorize the human action normal or abnormal in a special occasion to a new video. Thus we can advance corresponding security measures.


In the paper a hierarchical overtaking strategy, which is a driver assistance function or rather an autonomous function in electric/autonomous vehicles, is proposed. The solution uses speed and acceleration signals from the surrounding vehicles. These signals are processed with clustering methods in order to achieve probability density functions and predict their expected motion. The strategy includes several additional layers, such as decision making concerning the maneuver, the computation of the required trajectory, and the tracking control of the vehicle. Trajectory generation is formed as an optimization task, which is able to include the prediction model of the surrounding vehicles in the constraints. A robust Linear Parameter Varying (LPV) control design method is proposed to guarantee the tracking of the computed reference. The proposed strategy is able to guarantee the safe motion of the vehicles and handle the interactions with the other traffic participants.


The territory of the Republic of Serbia is vulnerable to various natural disasters, among which forest fires stand out. In relation with climate changes, the number of forest fires in Serbia has been increasing from year to year. Protected natural areas are especially endangered by wildfires. For Nature Park Golija, as the second largest in Serbia, with an area of 75,183 ha, and with MaB Reserve Golija-Studenica on part of its territory (53,804 ha), more attention should be paid in terms of forest fire mitigation. GIS and multi-criteria decision analysis are indispensable when it comes to spatial analysis for the purpose of natural disaster risk management. Index-based and fuzzy AHP methods were used, together with TOPSIS method for forest fire susceptibility zonation. Very high and high forest fire susceptibility zone were recorded on 26.85% (Forest Fire Susceptibility Index) and 25.75% (fuzzy AHP). The additional support for forest fire prevention is realized through an additional Internet of Thing (IoT)-based sensor network that enables the continuous collection of local meteorological and environmental data, which enables low-cost and reliable real-time fire risk assessment and detection and the improved long-term and short-term forest fire susceptibility assessment. Obtained results can be applied for adequate forest fire risk management, improvement of the monitoring, and early warning systems in the Republic of Serbia, but are also important for relevant authorities at national, regional, and local level, which will be able to coordinate and intervene in a case of emergency events.


Cell kinetics in 22 human epidermoid head and neck tumors were studied in vivo using bromodeoxyuridine (BUrD). Patients were infused with 250 mg/m2 of intravenous BUrD in a variety of sites (oral cavity, pharynx, larynx and lip) four/five hours prior to biopsy. BUrD incorporating cells were detected by flow-cytometry using anti-BUrD monoclonal antibodies. Ploidy (DNA index) labelling index (LI%), duration of S-phase (Ts) and potential doubling time (Tpot) could be measured within 12-24 hours from sampling in 77%, 72%, 63 and 63% of cases, respectively. Six failures (few viable cells in biopsy specimen and difficulties in BUrD cell analysis and DNA staining) were recorded. Labelling index values in this study ranged from 2.2% to 28% with a median value of 11%. The median total LI% of diploid tumor (n = 7) was 5% compared to 13% in aneuploid tumors (n = 7). Ts measurement ranged from 6.5 hours to 12 hours, median value being 10.5 hours (euploid tumors: 6.5, aneuploid 12). The calculated potential doubling time ranged from 2.6 to 15 days and the median Tpot was shorter at 5.0 days (euploid tumors: 7 days, aneuploid 4 days). 70% of the tumors had potential doubling time of 5 days or less. Potential doubling time did not correlate with ploidy and tumor or neck nodes status while shorter Tpots were observed in moderate or poorly differentiated tumors. Our data strongly suggest BUrD technique as a useful tool for studying the proliferative behavior of human tumors: the pre-treatment knowledge of individualized potential doubling times for the tumors scheduled for irradiation could help the radiotherapist to choose the more effective fractionation regimen (i.e.: accelerated fractionation for tumors with Tpot less than or equal to 6 days and standard fractionation for tumors with higher values.


This paper presents a method that in real-time determines remedial actions, which restore stable operation with respect to aperiodic small signal rotor angle stability (ASSRAS) when insecure or unstable operation has been detected. An ASSRAS assessment method is used to monitor the stability boundary for each generator in real-time. The ASSRAS boundary represents the condition when a generator reaches the maximum steady state active power injection. The proposed control method exploits analytically derived expressions for the ASSRAS boundary and other characteristic curves in the injection impedance plane to determine an active power redispatch among selected generators to restore stable and secure operation. Since the method is purely based on analytically derived expression, the computation of the remedial actions is fast and well suited for real-time operation. The method was tested on the IEEE 14-bus and the Nordic32 test systems where results show that the method can efficiently determine the required active power redispatch to avoid an imminent instability.


Ontogenetic changes in leaf phenology of a hardwood tree,Acer mono, were investigated in individuals in different size classes in a temperate forest. Leaf emergence was earliest in current-year seedlings, and was increasingly delayed with increasing height of the individual. The shorter the tree, the longer the duration of leaf emergence. Timing of leaf emergence of the dominant heterospecific canopy trees was almost identical to that of conspecific adults; understorey light then gradually decreased with expansion of canopy leaves. These traits indicate that smaller individuals that receive the least light in summer can acquire favourable light for a longer period in spring than taller plants even in a forest understorey, but the advantage decreases with increasing plant height. Changes in the duration of leaf emergence and leaf longevity in response to environmental light regime [sun (forest edge)vs. shade (forest understorey)], were greatest for current year seedlings but decreased with increasing plant height. These results suggest that the plastic response of leaf phenology in juvenile stages may reduce the risk of losing an entire cohort in spatially heterogenous environments in the understorey of temperate forests.


Endophytic root colonisation of the host plant Arabidopsis thaliana by the beneficial root endophyte Serendipita indica is characterised by an initial biotrophic phase followed by a restricted host cell death-associated phase. During colonisation two secreted S. indica effectors synergistically produce the cell death inducer deoxyadenosine (dAdo). Although the mechanism of regulated cell death is important for fungal accommodation, the host molecular pathways that restrict S. indica-induced cell death and allow the maintenance of a mutualistic relationship are largely unknown. Here we show that autophagy, a major degradation pathway plays a key role in the beneficial interaction between S. indica and Arabidopsis. Autophagy restricts fungal colonisation and exerts a protective function against dAdo-induced cell death. Impairment of dAdo uptake in an autophagy mutant background confers resistance to dAdo-induced cell death and precludes the symbiosis-mediated cell death. Taken together, we propose that autophagy-driven pro-survival responses are required to facilitate a long-lasting mutualistic interaction between S. indica and Arabidopsis.


INTRODUCTION:
Pregnancy is one of the miraculous and happiest moments in our life. It is a blessing from above and the joy that brings after all the pain of labour is unmatched. Living birth is the number one factor that brings about a big
change to a women's body. They undergo many postural and biomechanical changes following labour. A number of women experience trouble bringing their abdomen back to its original shape and size after child birth.
After child birth the abdominal muscles are being stretched and elongated and sagging, the split between the two recti abdominal is called diastasis or divarication following labour. As a result the entire abdominal "corset" will be weakened with very little apparent mechanical support. In addition to this there will be increased elasticity of ligament and the back will be more vulnerable to injury resulting from incorrect use.
As a result of overstretched and weak abdominal muscle the patient experience difficulty in initiating micturition and inability to control bladder when she desires to void become apparent there is a leakage when the intraabdominal pressure is raised by coughing, sneezing and laughing. When she walks aware of an almost lack of abdominal control.
STATEMENT OF THE STUDY:
An experimental study to assess the effectiveness of abdominal strengthening exercises in working women following normal delivery.
AIM OF THE STUDY:
The aim of the study is to assess the effectiveness of abdominal
strengthening exercises in working women following normal delivery.
OBJECTIVES:
1. To assess the abdominal muscle strength in working women following
normal delivery.
2. To evaluate the effectiveness of abdominal strengthening exercise in
working women following normal delivery.
3. To determine changes after abdominal muscle training attending the
programme in working women following normal delivery.
METHODOLOGY:
The study is experimental in nature. 20 samples are taken. Pretest
measurement is taken for abdominal muscle strength using dynamic
abdominal endurance scale. After which the abdominal strengthening
exercise was given to the patient. After that posttest measurement is taken in
a similar fashion in a set of pretest measurement.
Setting of the Study: The study was conducted in postnatal wards in Parkkavan Hospital, Trichy.
Population Sample: The samples that fulfill the selection criteria were the population for the study.
Sampling Method:
Purposive sampling method was done in post natal wards.
Criteria for Selection:
1. Mothers who are willing to participate.
2. Mothers who had normal delivery with no other medical complications.
Inclusion Criteria:
1. Mothers of age between 20- 30 yrs,
2. Normal delivery mother's,
3. Working mother's.
Exclusion Criteria:
1. Mother's above the age of 30 yrs,
2. Mother's with Caesarian section,
3. Mother's with severe postnatal problems,
4. House wives.
RESULTS:
This study presented the assessment of effectiveness of
abdominal strengthening exercise program for 20 study samples of working
woman following normal delivery.
Among the selected participants most of them found weak
abdominal muscles. Abdominal strengthening program was given to the
participants.
The study carried out had a correlation with the literature
review. The statistical interpretation of the Mean and Standard Deviation
shows the improvement in abdominal muscle strength. Test statistics for
strength calculated has been compared with tabulated T-test values. It is
found that the calculated test statistics (17.44) from the recorded values is
higher than the tabulated value (2.093). So we rejected the null hypothesis
and accept the hypothesis, saying that there is significant improvement in
strength following strengthening exercise program for working woman
following normal delivery.
CONCLUSION:
The statistical analysis done from the pretest and posttest
values of abdominal endurance test score showed that abdominal
strengthening exercise program had a significant effect in improving the
abdominal muscle strength for working woman following normal delivery.


Information concerning the molecular sorting of G protein-coupled receptors in polarized epithelial cells is limited. Therefore, we have expressed the receptor for thyrotropin-releasing hormone (TRH) in Madin-Darby canine kidney (MDCK) cells by adenovirus-mediated gene transfer to determine its distribution in a model cell system and to begin analyzing the molecular information responsible for its distribution. Equilibrium binding of [methyl-3H]TRH to apical and basolateral surfaces of polarized MDCK cells reveals that TRH receptors are expressed predominantly (>80%) on the basolateral cell surface. Receptors undergo rapid endocytosis following agonist binding; up to 80% are internalized in 15 min. A mutant receptor missing the last 59 residues, C335Stop, is poorly internalized (<10%) but is nevertheless basolaterally expressed (>85%). A second mutant TRH receptor, delta218-263, lacks essentially all of the third intracellular loop and is not coupled to G proteins on binding agonist. This receptor internalizes TRH approximately half as efficiently as wild-type TRH receptors but is nevertheless strongly polarized to the basolateral surface (>90%). These results indicate that molecular sequences responsible for basolateral accumulation of TRH receptors can be segregated from signals for ligand-induced receptor endocytosis and coupling to heterotrimeric G proteins.


This paper presents the first steps of the treatment of a real-world robotic scenario consisting in exploring a large area using several heterogeneous autonomous robots. Addressing this scenario requires combining several components at the planning and execution lev-els. First, the scenario needs to be well modeled in or-der for a planning algorithm to come up with a realistic solution. This implies modeling temporal and spatial synchronization of activities between robots, as well as computing the duration of move activities using a pre-cise terrain model. Then, in order to obtain a robust multi-agent executive layer, we need a robust hierarchi-cal plan scheme that helps identifying appropriate plan repairs when, despite the quality of the various models, failures or delays occur. Finally, we need various algo-rithmic tools in order to obtain flexible plans of good quality.


This article presents a description of the phonemic analysis, as a prerequisite for the formation of the written language, is an analysis of the problem examine disorders of phonemic perception, analysis (simple and complex), disorders of pronunciation phonemes of the pre-school children with delayed mental development


Transmission of nanoscale deformation twins across grain boundaries in nanocrystalline and ultrafine-grained metallic materials is theoretically described. The energy and stress characteristics of twin transmission across grain boundaries in nanocrystalline and ultrafine-grained metals are revealed. It is found that for small twin thicknesses, the critical stress for twin transmission in Cu is close to the typical values of the yield stress, and so twin transmission can actually occur in the course of deformation of nanocrystalline and ultrafinegrained Cu.


Boerhaave syndrome (BS) is frequently reported in cases of esophageal perforation; however, there are relatively few studies on non–Boerhaave syndrome (nBS). This study clarifies the appropriate diagnosis and treatment for patients with nBS among those with esophageal ruptures. Twelve patients with esophageal ruptures who underwent surgery at our department over 14 years were classified into 2 groups: 4 in the nBS group and 8 in the BS group. Patient characteristics, surgical methods, surgical outcomes, and complications were compared between the groups. The chief complaints varied between the groups. The nBS group had significantly higher preoperative C-reactive protein (P = .007) and required 5 days (median) from onset to surgery. Moreover, the perforation diameter was significantly smaller in the nBS group than in the BS group (P = .013). Suturing of the perforation site was performed during the initial surgery in 8 BS group patients (100%) and 1 nBS group patient (25%; P = .018). Only drainage was performed during the initial surgery for 3 nBS group patients (75%). The complications did not significantly differ between the groups (P = 1.000), and no deaths were reported. The chief complaints of patients with nBS are diverse, and esophageal perforation should be cited as a differential diagnosis even in the absence of vomiting or chest pain symptoms. In the initial surgery for patients with nBS, the perforation site does not necessarily need to be closed. It is treatable by second-stage surgery or by natural closing.


Pancreatic ductal adenocarcinoma (PDAC) is the 4th leading cause of cancer-related deaths in the United States with a 5-year survival rate of 6%. Current therapeutic regimens have done little to halt the progression of this disease. This demonstrates an urgent need for novel therapeutic strategies which address the mechanisms underlying the tumor cells' ability to develop resistance to drug treatment. Increased expression of GRP78, a member of the Hsp70 protein family, is associated with poor prognosis in a number of human cancers. This prompted us to explore the role of GRP78 expression in pancreatic tumorigenesis. Our data show that while no GRP78 expression was observed in the ducts of wild-type pancreata, GRP78 expression is significantly increased in the ductal cells of PDACs in our murine models. Moreover, this upregulated GRP78 expression, especially its membrane-associated form, corresponded to P-AKT activation. Our previous results showed that increased P-AKT signaling is significantly associated with distinct pancreatic cancer patient subgroups with more aggressive disease progression. Taken together, these data raised the question of whether GRP78 is essential for pancreatic chemoresistance. GRP78 expression was inhibited in several gemcitabine resistant PDAC cell lines using siRNA. GRP78 knockdown produced no measurable levels of cell death in any cell lines tested. Likewise, treatment with gemcitabine alone produced very little cell death. However, gemcitabine treatment in cells with GRP78 knockdown showed significantly increased cell death. Examination of cells treated with GRP78 siRNA showed decreased P-AKT activation. These data suggest GRP78 could serve as a potential therapeutic target for chemoresistant pancreatic cancers which show PI3K/AKT pathway activation. Citation Format: Katherine Richards, Ellen Gunn, Reginald Hill. Investigating the effect of glucose-regulated protein 78 (GRP78) inhibition in pancreatic cancer chemoresistance. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4038. doi:10.1158/1538-7445.AM2013-4038


A lead-free Bi0.5Na0.5TiO3 (BNT) piezoelectric composite thick film with a thickness of ~11 μm has been fabricated using a modified sol-gel method. Dielectric constant, remnant polarization, and coercive field of the BNT composite film were found to be 1018, 22.6 μC/cm2, and 76.1 kV/cm, respectively. The film was used to fabricate a high-frequency needle transducer and the performance of the transducer was measured. The transducer without a matching layer exhibits a center frequency of 98 MHz and a -6-dB bandwidth of 86%. A wire phantom image acquired using the transducer shows an axial resolution of 15 ¿m and lateral resolution of 68 μm, respectively. Results from this study suggest that the BNT composite film is a promising lead-free piezoelectric material for high-frequency broadband ultrasonic transducer applications.


Microstructural properties and their influence on Jc have been studied in detail on Ag-sheathed (Bi,Pb)2Sr2Ca2Cu3Ox tapes prepared by the powder-in-tube method. The present study centres on two important factors for the achievement of high Jc values: (1) The liquid phase reaction during the (2223) phase formation at 847 degrees C for the composition Bi1.72Pb0.34Sr1.83Ca1.97Cu3.13Ox leads to better connectivity between the (2223) platelets, thus considerably improving Jc (77 K, 0 T): single phase (2223) packing powders formed no liquid during the heat treatment and therefore reached Jc values of only up to 1*104 A cm-2 while multiphase calcined packing powders showed higher Jc values, of 2.6*104 A cm-2. (2) The degree of texturing of the a-b planes in the (2223) platelets varies throughout the oxide layer. The highest degree is found at the Ag/(2223) interface. It gradually decreases towards the centre of the oxide layer. Mixing of Ag powders with the packing powders enhanced Jc up to 3.3*104 A cm-2, due either to the enhanced interface area or to the prevention of cracks during the cooling process. The effect of the powder packing density was also studied: higher packing density (80%) was found to lead to higher Jc values in the oxide layer up to 60 mu m thickness with a regular shape of the cross section.


Advances in wireless communication technology and the proliferation of mobile devices enable the capa-
bilities of communicating with each other even in areas with no pre-existing communication infrastructure.
Traffic and mobility models play an important role in evaluating the performance of these communication
networks. Despite criticism and assumption from various researches on Transmission Control Protocols
(TCP), weaknesses on Mobile Ad Hoc Network (MANET), and Vehicular Ad Hoc Network (VANET).
A simulation was carried out to evaluate the performance of Constant Bit Rate, Variable Bit Rate and
Transmission Control Protocol on MANET and VANET using DSR routing protocol. CBR, VBR, and TCP
have different manufacturer operation mechanisms and these differences lead to significant performance
of CBR and VBR over TCP with better throughput and less average maximal end-to-end delay. DSR
was able to respond to link failure at low mobility which led to TCP's performance in packets delivery.


Introduction: Diabetic foot ulcers are one of the most serious complications for patients with diabetes mellitus. The use of nutritional supplements such as Diamel® can be considered as an adjunct to conventional treatment in affected patients.
Objective: To evaluate the effectiveness of the product Diamel® in the treatment of diabetic foot ulcers.
Methods: Phase II double-blind, randomized, placebo-controlled clinical trial in a sample of 100 patients of both sexes with type 2 diabetes mellitus (DM) and with Wagner grade I-II-foot ulcers. All of them received conventional therapy, 50 of them combined with the product Diamel® and 50 combined with placebo. They followed up for a period of 1 year. The proportions of healed patients were taken as a response variable to determine efficacy. Other variables are analyzed: body mass index, glycemia, glycosylated hemoglobin, cholesterol, triglycerides, and creatinine, which were compared at the beginning and end of the study. Data analysis was performed according to the intention-to-treat principle.
Results: The Diamel® group showed a 1-year cumulative healing rate of 89.2% (95% CI, 77.4-96.5) vs 72.4% (95% CI, 58.0-85.1) in the placebo group. The average healing time for ulcers in the Diamel® group was 3 months, significantly less than the Placebo group, which took 5 months, p=0.001. At the end of the study, HbA1c and fasting blood glucose had decreased significantly in the Diamel® group. Recurrence rates were lower in the Diamel® group (3 patients, 8%) than in the placebo group (8 patients, 16%), and no major adverse effects were reported in relation to the supplement.
Conclusions: The Diamel® nutritional supplement showed a sufficient degree of efficacy in the treatment of diabetic foot ulcers in patients with type 2 DM, so large-scale studies should be undertaken.


In this paper, a metamaterial structure is presented to lower the mutual coupling between
the closely spaced microstrip patch antenna elements. Two elements Multiple Input Multiple Output
(MIMO) antenna is closely placed with each other at edge to edge separation 0f 0.13of wavelength
isolation improvement of 9dB is achieved by keeping the metamaterial structure in between the
MIMO elements. with the proposed structure, the isolation is achieved by around -24.5dB. Due to
low ECC, high gain, low channel capacity loss and very low mutual coupling between elements, the
proposed antenna is a good candidate for the MIMO applications. The proposed antenna is
fabricated and tested.A reasonable agreement between stimulated and measured results is observed.


The meeting for the researchers who are in charge of tuberculosis (TB) molecular epidemiology in Japan, China and Korea was held. When the databases of IS6110 RFLP in each country were analyzed, the unique K-strain, which constitutes ca. 4% among total TB cases in Korea, was also found in the TB clinical isolates in Japan. Thus, it is very likely that the Mycobacterium tuberculosis, which is characteristic in each country, have already spread out into surrounding nations. It is expected that each country should facilitate the molecular epidemiological research in a concerted way.


This paper will consider the importance of the blend of theory and practice in journalism education. It posits that in order to be equipped for a lifetime in journalism, students need to operate as reflective practitioners, with a well-‐‑formed sense of professional and personal identity. Now more than ever, in a post-‐‑Leveson landscape, they need to know who they are, what they stand for and to have their own individual 'voice'. Drawing on the example set by the BBC College of Journalism and my own doctoral research, for context, I also use a case study from my own teaching to illustrate the point: Professional Perspectives operates a programme of visiting speakers from industry that provides students with differing perspectives on current and key issues in journalism, such as ethics, original storytelling, impartiality. In the final assignment, students address a key challenge, placing quotes and ideas from the practitioners into a theoretical context supported by wider reading. In addition, they reflect on their own sense of self as a journalist. The paper will conclude that active learning from the lived experiences of others can enhance the lifelong education of journalists, informing their self-‐‑understanding and encouraging an ethical approach to their craft.


BACKGROUND
Invasive mold infections (IMIs) are common in individuals who have undergone hematopoietic stem cell transplantation (HSCT). We sought to determine clinical and biological risk factors for different IMIs during each period (early and late) after allogeneic HSCT.

METHODS
Cases of proven and probable IMI diagnosed in HSCT recipients at the Fred Hutchinson Cancer Research Center (Seattle, WA) from 1 January 1998 through 31 December 2002 were included. Survival was estimated with Kaplan-Meier curves, and Cox regression models were used for multivariable analyses.

RESULTS
During the study period, 1248 patients underwent allogeneic HSCT; 163 (13.1%) received a diagnosis of probable or proven IMI. The majority of cases were caused by Aspergillus species (88%). The incidence of IMI caused by other molds remained low (<2%) over the 4-year study period. Risk factors for IMI early after HSCT and late after HSCT differed, with host variables (age) and transplant variables (human leukocyte antigen match) predominating as early risk factors and other clinical complications (graft-versus-host disease and cytomegalovirus disease) predominating later. Biological risk factors that were important during all periods included multiple cytopenias (neutropenia, lymphopenia, and monocytopenia) and iron overload.

CONCLUSIONS
Risk factors for invasive aspergillosis after allogeneic HSCT are multifactorial and differ according to timing after HSCT. Increased attention should be placed on understanding the immunopathogenesis of fungal disease after HSCT.


Abstract This paper gives a detailed description of the Wheeler North Reef at San Clemente, CA. The reef was designed to grow and sustain giant kelp and the associated ecological community. This reef is the largest human-made reef constructed in the United States (70.60 ha, or 174.4 acres). It was constructed in two phases. The Phase 1 Experimental Reef, with a 9.06 ha (22.4 acres) seafloor footprint, was built between 18 August 1999 and 29 September 1999 (35 construction days). The Phase 1 reef consists of 56 modules, sized at 40 m by 40 m, with various hard substrate coverage densities (low, medium, high). The experimental reef was monitored from 1999 to 2005 to assess its performance. The Phase 2 design was based on the results of the monitoring program. Phase 2 construction began on 9 June 2008 and was completed on 11 September 2008 (73 construction days) adding 61.53 ha (152 acres) of reef substrate. The Phase 2 reef consists of 17 polygons varying in area between 0.56 ha (1.4 acres) and 15.74 ha (38.9 acres). The profile of the reef is a single rock layer rising no more than 0.5 m off the existing sand seafloor. This rock configuration was used because previous studies had determined that kelp in the area is most persistent on very low-profile natural outcroppings. The seafloor sand thickness was specified to be no more than 0.5 m with a hard sub-bottom to reduce the probability of the rocks being buried over time.


PROBLEM
In 2001, the ARIA guidelines were published to assist healthcare practitioners in managing allergic rhinitis (AR) according to the best evidence. Very limited information, however, is avail-able on the impact of these guidelines on clinical practice.

METHODS
All Belgian Otorhinolaryngologists were invited to complete a questionnaire, covering demographic and professional characteristics, knowledge, use and perception of the ARIA guidelines and 4 clinical case scenarios of AR.

RESULTS
Of the 258 (44%) Belgian Otorhinolaryngologists who participated, almost 90% had ever heard about ARIA and 64% had followed a lecture specifically dedicated to the ARIA guidelines. Furthermore, 62% stated to always or mostly follow the ARIA treatment algorithms in the daily management of AR patients. In the clinical case section, adherence to the ARIA guidelines raised with increased self-reported knowledge and use of the ARIA guidelines and among participants that considered the guidelines more userfriendly. Of the respondents, 51% were considered as good com-pliers. Younger age was a significant predictor for good compliance.

CONCLUSION
More efforts are required to improve the translation of scientific knowledge into clinical practice and to further identify which factors may influence guideline compliance.


Non-viral delivery is an important strategy for selective and efficient gene therapy, immunization, and RNA interference, which overcomes problems of genotoxicity and inherent immunogenicity associated with viral vectors. Liposomes and polymers are compelling candidates as carriers for intracellular, non-viral delivery, but maximal efficiencies of around 1% have been reported for the most advanced non-viral carriers. Here, we develop a library of dendronized bottlebrush polymers with controlled defects, displaying a level of precision surpassed only by biological molecules like DNA, RNA, and proteins. We test concurrent and competitive delivery of DNA and show for the first time that, while intracellular communication is thought to be an exclusively biomolecular phenomenon, such communication between synthetic macromolecular complexes can also take place. Our findings challenge the assumption that delivery agents behave as bystanders that enable transfection by passive intracellular release of genetic cargo and improve upon coarse strategies in intracellular carrier design lacking control over polymer sequence, architecture, and composition, leading to a hit-or-miss outcome. Understanding the communication that takes place between macromolecules will help improve the design of non-viral delivery agents and facilitate translation of genome engineering, vaccines, and nucleic acid-based therapies.


The purpose of this study was to introduce ethnographic research to students in two graduate-level sport management courses, assess the extent to which the students benefited throughout the duration of the project, and anticipate future benefits as a result of the project. In response to previous calls for a more thorough integration of theory, research, and practice within sport management curricula, a plan to integrate ethnography projects into a sport management human resource management course and a contemporary issues course was developed and implemented. The strengths and weaknesses of the project are discussed relative to student feedback received through journal excerpts and interviews from the students and instructor fieldnotes. Suggestions and guidelines for future uses of ethnography as a teaching tool are offered.


This paper deals with the quality evaluation (validation) of Spoken Language Resources (SLR). The current situation in terms of relevant validation criteria and procedures is briefly presented. Next, a number of validation issues related to new data formats (XMLbased annotations, UTF-16 encoding) are discussed. Further, new validation cycles that were introduced in a series of new projects like SpeeCon and OrienTel are addressed: prompt sheet validation, lexicon validation and pre-release validation. Finally, SPEX's current and future activities as ELRA's validation centre for SLR are outlined.


This report highlights information from a survey of Early Head Start programs that examined management structures and program services nationally. The report describes program approaches to service delivery, management and staffing, and partnerships. It also examines the characteristics of communities in which Early Head Start programs operate, the characteristics of enrolled families, and the wide range of services programs provide. The report draws upon qualitative information from in-depth site visits to elaborate and expand on survey findings.


Although sleep duration has been identified as a significant factor in risk for hypertension, there is limited data on the relationship between sleep duration and hypertension control. This study examined the association between habitual sleep duration and hypertension control in United States of America (USA) adults with hypertension. A total of 5,163 adults from the National Health and Nutrition Examination Survey (2015 – 2018) were analyzed. Survey-weighted multivariable logistic regression models were fit to examine the association between habitual sleep duration (coded as <6, 6 - <7, 7 – 9 (reference), and >9 hours) and hypertension control (BP <130/80mmHg versus ≥130/80mmHg), adjusted for sociodemographic, sleep and health characteristics. In the fully adjusted model, habitual sleep duration of <6 hours/main sleep period was associated with reduced odds of hypertension control (OR = 0.66, 95% CI: 0.46 – 0.95, P = 0.027) when compared to 7 – 9 hours. No significant differences were noted in hypertension control between the reference group (7 - 9 hours) and the 6 - <7 or >9 hours groups. These findings suggest that measures to support adequate habitual sleep duration may help improve hypertension control in adults who habitually sleep for <6 hours/day.


OBJECTIVE
This work describes the developmental course of adolescents' weight concerns and examines links with changes in parent-adolescent relationships for girls and boys.

METHOD
Adolescents and parents in 191 families participated in 3 annual home interviews; adolescents rated their weight concerns and their intimacy and conflict with parents. Parental knowledge was measured based on the match between adolescents' and parents' reports of youth's experiences each day during 7 evening telephone calls.

RESULTS
Girls' weight concerns increased from age 11 to 16 and then declined, whereas boys' concerns declined beginning at age 11. Increases in girls' weight concerns were linked to increases in conflict with mothers and fathers and decreases in maternal intimacy and knowledge. At a trend level, declines in boys' weight concerns were associated with declines in father conflict.

CONCLUSION
Mothers and fathers may have unique influences on adolescent weight concerns. Intervention programming should target parent-adolescent relationships.


Cardiac masses are currently studied using multimodality imaging. For diagnosis, different imaging techniques that can provide complementary information are used. Cardiac magnetic resonance imaging (MRI) has become a fundamental tool for this type of pathology owing to its ability to provide tissue characterization, spatial accuracy, and the anatomic relationships of the different structures. This study presents a series of four clinical cases with an initial diagnosis of a cardiac mass. All cases were evaluated at a single center, and patients were aged 57 to 72 years. An etiological study was conducted on all patients using different imaging techniques, including MRI. This study describes the diagnostic and therapeutic procedures of the four cases, which included two intracardiac metastases and two benign tumors. Cardiac MRI was decisive in the diagnostic process, determining the clinical decision-making in all four cases. Cardiac MRI has emerged as a pivotal technique in the diagnosis of cardiac masses. It can provide a highly accurate histological diagnosis without the need for invasive techniques.


Background: Scholarly work is needed to develop the conceptual and theoretical understanding of trust to nursing practice. The transition from hospital care to complex pediatric homecare involves nurses in myriad roles, including management and care provision. Complex pediatric homecare transforms children, families, professionals, and communities, but its exact implications are unclear. Research objectives: To conduct an ethical inquiry into the role and responsibilities of nurses in the qualitative experience of adults involved in the hospital-to-home transition of young, ventilator-dependent children. Research design: We followed methods described by Franco Carnevale. We used a sociologically grounded theoretical orientation—trust—to re-interpret qualitative data for an ethical inquiry into a specific facet of that data. Participants and study context: The participants included 26 adults, including 14 nurses, involved in the hospital-to-home transition in a Canadian province. Participants represented family, hospital, home, and government. Ethical considerations: The Conjoint Health Research Ethics Board at the University of Calgary approved this study. Findings: First, the concept and practice of trust was salient to the experience of transition. For example, responsibilities' allocation between hospital-based professionals to mothers, home-based nurses, and non-professionals necessitated reliance and vulnerability. Second, the consequences of distrust connected to recognized challenges. For example, tensions along rural–urban, medical-family, and professional–personal divide each revealed suspicion and uncertainty that led to isolation and anxiety for all involved. Third, recommendations to improve the experience and mitigate the challenges of transition can be grounded in trust promotion. For example, transition-specific education programs and codes of ethics would promote openness, recognize mutual vulnerability, and advance trust in transition. Conclusions: The challenges to transition evidenced distrust, while trust represents a powerful tool to counter these challenges and their implications. A climate of trust could bridge divides between mothers and professionals; rural and urban professionals; and professionals with differing relationships with the family.


Celebrity endorsement is one of the advertising techniques companies use to create awareness and gain favourable responses about their products and services. This expectation is often not realised as negative image about a celebrity endorser, incongruity of a celebrity endorser with the product being endorsed are all capable of inducing bad responses towards the product rather than the other way round. This study therefore examined the influence of celebrity endorsed advertisement on students' purchase intention employing quasi-experiment as the method of study. Two Pepsi Cola commercials were used with one featuring Osaze Odenwingie as the endorser while the second commercial did not feature any celebrity. Findings of the research suggested that celebrityendorsed advert has a significant influence on students' purchase intention. The study therefore recommends that the various elements involved in producing both celebrity endorsed and non- celebrity endorsed adverts should be carefully mixed together in order to achieve desired results. Likewise, the image of a celebrity before the public should be scrutinized before such a celebrity endorses an advert in order not to cast the product in negative light.


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The adsorption of chromium(VI) from aqueous solutions onto multi-walled carbon nanotubes (MWCNTs) has been investigated under various experimental conditions of initial metal concentration, agitation speed, aqueous pH, temperature and adsorbent dosage to assess the equilibrium and kinetic parameters. It was found that the kinetic data were fitted with the pseudo-first- and pseudo-second-order models, whereas the chromium(VI) adsorption data were fitted with the Langmuir and Freundlich equilibrium models to give the characteristic parameters of each model. According with the evaluation, both isotherm models are useful to represent the measured adsorption data. The adsorption of chromium(VI) is also dependent on the temperature, and the corresponding thermodynamic parameters including Δ H°, Δ G° and Δ S° were estimated from the experimental data, indicating the exothermic and non-spontaneous nature of the metal adsorption onto the MWCNTs. Chromium(VI) desorption was investigated by the use of aqueous hydrazine sulfate solutions.


Recent research in diagnosis (Mcllraith, 1997; Thielscher, 1997; McIlraith, 1998) extends earlier works in diagnosis fi'om first principles by using an action theory instead of a first-order theory to describe the correct behavior of the system in consideration. The action theory allows us to reason about actions and their effects. Thus, when an action does not yield the expected effects something did mMfunction. Using regression, we can identify what is wrong initially. Our position is that in many cases this is not enough. The following example illustrates such a case.


Increasing the number of BSN-prepared nurses at the bedside is directly linked to improved health care outcomes. However, employers are challenged to find enough BSN graduates to meet workforce demands. This article presents an educational model that uses evidence-based practices to increase enrollment, retention, and graduation rates of RN students in a BSN program (RN-BSN) in a resource limited rural community. This exemplar may equip nurse educators with strategies to adopt in their own communities.


Abstract Objective: Lipopolysaccharide (LPS) stimulates the innate immune response in the brain through nuclear factor-kappaB (NF-kappaB) signaling. Since purinergic signals activate NF-kappaB through the P2X7 receptor (P2X7R), we investigated the roles of P2X7R in neuronal NF-kappaB phosphorylation in the mouse hippocampus under basal conditions and P2X7R deletion following LPS treatment in vivo. Methods: We performed immunohistochemical studies for neuronal NF-kappaB phosphorylation in the hippocampi of wild type (WT) and P2X7R knockout (KO) mice under basal conditions and LPS treatment. Results: LPS treatment did not induce neuronal damages in both WT and P2X7−/− KO mice. In WT animals, LPS treatment increased p65-Ser276 and p65-Ser311 NF-kappaB phosphorylations in hippocampal neurons. However, p52-Ser865, p52-Ser869, p65-Ser468, p65-Ser529, and p65-Ser536 NF-kappaB phosphorylations were unaffected by LPS treatment. In P2X7−/− KO mice, neuronal p65-Ser311 NF-kappaB phosphorylation in vehicle-treated animals was higher than that in WT animals. In addition, both p65-Ser276 and p65-Ser311 NF-kappaB phosphorylations were unaffected by LPS treatment in P2X7−/− KO mice. Discussion: These findings indicate that P2X7R may be involved in LPS-induced inflammatory response in neurons, and that p65-Ser311 NF-kappaB phosphorylation may compensate for the loss function of P2X7R by as yet unknown factors.


In this paper, we trace the biases in current natural language processing (NLP) models back to their origins in racism, sexism, and homophobia over the last 500 years. We review literature from critical race theory, gender studies, data ethics, and digital humanities studies, and summarize the origins of bias in NLP models from these social science perspective. We show how the causes of the biases in the NLP pipeline are rooted in social issues. Finally, we argue that the only way to fix the bias and unfairness in NLP is by addressing the social problems that caused them in the first place and by incorporating social sciences and social scientists in efforts to mitigate bias in NLP models. We provide actionable recommendations for the NLP research community to do so.


We present the analysis and suppression of asymmetric modes in a Ku-band Cerenkov-type oscillator numerically and experimentally. The asymmetric modes generated in the initial experiments were identified to be HE11, HE21, and HE31 modes, respectively, by analyzing of the dispersion relationships, the simulation results and the experiment phenomenon. The factors, such as the cathode emission uniformity, the diode voltage, guiding magnetic field, and the concentricity play key roles in the excitation and suppression of these asymmetric modes. In the improved experiments, the asymmetric modes were suppressed effectively. In the improved experiments the asymmetric modes are suppressed effectively, and the designed TM01 mode microwave is generated at a frequency of 13.76 GHz with a power of 1.1 GW, which is in good agreement with numerically predications.


b In American democracy, citizens elect many officials and consider hundreds of referenda, initiatives and bond issues.' The mass media provide citizens with most of the information they have about candidates and issues, and thereby serve as possibly the most important opinion resources for practical political participation.* Citizens may exert the greatest influence through informed participation a t the local level of politics, but low salience of local issues usually reduces local


The ability to demonstrate competence in the modern healthcare arena is becoming increasingly important. Patient safety is of primary importance, but competency documents can also be used to structure professional development and as evidence of practitioners' levels of clinical practice, competence and responsibility. Managing paediatric patients can be highly complex and is surrounded by uncertainty. It requires imagination, advanced decision making and the application of theory and research to practice. Nurses must be able to demonstrate accurate knowledge of physical and psychological development changes of children aged between five and 18 years, and then apply this knowledge to examination and treatment. Nurses must also be able to demonstrate accurate referral to X-ray. Providing good paediatric emergency care has become a high priority and it is hoped that practice standards will improve in line with the national service framework's ten-year plan (DH 2004b). Improving the health and welfare of children is an important investment in our future (Glasper 2005). To this end, all healthcare professionals must strive to deliver high quality, timely and efficient paediatric care.


The monitoring of information on the safety of various drugs is becoming more relevant day by day, as the number of drugs on the  pharmaceutical market increases, generic drugs, bio-analogous drugs appear. Long-term post-marketing use of a  medicinal product allows to accumulate a sufficient evidence base  and experience of application in various population groups, to study  the features of the use of this drug. Information on the safe use of  new drugs can be obtained in selected scientific publications. In  addition to publications in the specialized scientific literature,  regulators of different countries on the basis of new information give opinions on the need to make changes in instructions for medical  use. When analyzing the recommendations of Russian and foreign  regulatory authorities on restricting the circulation of medicines and  / or the need to amend the instructions for their medical use in  connection with the change in the assessment of the safety profile,  we identified 16 administrative decisions of foreign regulatory bodies containing information about the following drugs registered in  Russia. We consider all recommendations to be important  information on the safety of medicines, which is addressed to  specialists in the field of medicine, in particular to persons  authorized by pharmacovigilance in pharmaceutical companies. In  addition, this information may be of interest to physicians of various  specialties who in their practice use buprenorphine, venlafaxine,  gadolinium contrast drugs hydroxyethyl starch, daclizumab,  duloxetine, denosumab, cladribine, clomifene citrate, milnacipran, methotrexate, pemetrexet, radium dichloride, rifampicin,  phoebusostat, flupirtine.


Background Intestinal parasitosis is a major public health problem that affects the health of primary school children in low- and middle-income countries where water, sanitation, and hygiene (WASH) conditions are deficient. Since there is a paucity of information on the prevalence and associated factors of this problem among primary school children in Dessie City in Ethiopia, this study was designed to address these gaps. Methods A school-based cross-sectional study was conducted among 407 stratified-sampled primary school children in five primary schools at Dessie City from April to June 2018. Data were collected using a pretested structured questionnaire, an observation checklist and laboratory analysis of stool samples. Stool specimen from each study participant was collected using clean, properly labeled and leak-proof stool cup. A portion of stool from each study participant collected sample was processed using saline wet mount technique and examined by microscope. The remaining specimens were preserved with 10% formalin and transported to Dessie Comprehensive Specialized Hospital laboratory to be processed by using formol-ether concentration technique. Then, slide smears were prepared from each processed stool specimen and finally, it was microscopically examined with 10x as well as 40x objectives for the presence or absence of intestinal parasites. Factors significantly associated with intestinal parasitosis were determined using binary logistic regression model at 95% CI (confidence interval). Thus, bivariate (COR [crude odds ratio]) and multivariable (AOR [adjusted odds ratio]) logistic regression analyses were carried out. From the multivariable analysis, variables having a p-value of less than 0.05 were declared as factors significantly associated with intestinal parasitosis among primary school children. Main findings The overall prevalence of intestinal parasitosis was found to be 16.0% (95% CI: 12.5–19.4%), of these, 50.8% were positive for protozoa, 32.2% for helminth infections and 16.9% for double co-infections. Entamoeba histolytica was the most prevalent parasite (29.2%), followed by Giardia lamblia (21.5%), Ascaris lumbricoides (18.5%), Hymenolepis nana (9.2%) and Enterobius vermicularis (4.6%). Prevalence rates were similar among government (16.3%) and private (15.7%) school children. Water consumption was less than 5 liters per capita per day in 4 of the 5 schools. Thirty-eight (9.3%) of primary school students reported that they practiced open defecation. About two-thirds (285, 70.0%) said they always washed their hands after defecation. Mother's education (illiterate) (AOR = 3.3; 95% CI: 1.20–9.37), father's education (illiterate) (AOR = 3.9; 95% CI: 1.40–10.82), fathers who could read and write (AOR = 3.3; 95% CI: 1.25–7.86), handwashing before meal (sometimes) (AOR = 2.2; 95% CI: 1.11–4.17) and poor knowledge of WASH (AOR = 9.3; 95% CI: 2.17–16.70) were statistically associated with presence of intestinal parasitic infections. Conclusion We concluded that the prevalence of intestinal parasitosis in the study area among Grades 4–8 primary school children had public health significance. Factors significantly associated with intestinal parasitosis among primary school children's were illiterate mothers and fathers, irregular handwashing of children before meals, and poor knowledge of WASH. Health education to improve students' WASH knowledge and mass deworming for parasites are recommended as preventive measures; and improvements to the quality of WASH facilities in primary schools are strongly recommended to support these measures.


Superconducting quantum circuits are typically housed in conducting enclosures in order to control their electromagnetic environment. As devices grow in physical size, the electromagnetic modes of the enclosure come down in frequency and can introduce unwanted long-range cross-talk between distant elements of the enclosed circuit. Incorporating arrays of inductive shunts such as through-substrate vias or machined pillars can suppress these effects by raising these mode frequencies. Here, we derive simple, accurate models for the modes of enclosures that incorporate such inductive-shunt arrays. We use these models to predict that cavity-mediated inter-qubit couplings and drive-line cross-talk are exponentially suppressed with distance for arbitrarily large quantum circuits housed in such enclosures, indicating the promise of this approach for quantum computing. We find good agreement with a finite-element simulation of an example device containing more than 400 qubits.


Critical shortage of natural aggregate for production of concrete
is developing in many urban areas all over the world. At the same
time increasing quantities of demolished concrete from deteriorated
and obsolete structures are generated as a waste material in the
same areas.
The purpose of this study is to provide and accumulate fundamental
data on the workability and engineering properties of Recycled
Aggregate Concrete used waste concrete, according to the replacement
ratio of fine and coarse aggregate, in the side of not only insuring
resources of aggregate but also disposing and reusing of waste
concrete.


Merthiolate incorporated as a preservative into the agar used for the immunodiffusion analysis of FMDV and an infection-associated antigen caused the degradation of these components. The 140S virus particles were partially degraded to 12S protein subunits of the virus, and the precipitating activity of the infection-associated antigen was markedly reduced. Sodium azide had no deleterious effect on these antigenic components.
 Fractions obtained from the ultracentrifugation of FMDV on CsCl density gradients were analyzed on both Merthiolate and sodium azide agar. Evidence was obtained that particles occurred which were antigenically identical to the virus, but differed with respect to their density and their sensitivity to Merthiolate.


Victory in a basketball game depends on many factors. One of the main factors that determine game performance of the team is the successfulness of basketball shooting. The aim of this study is to determine the influence of the game load intensity on basketball shooting performance. Ten senior female basketball players (2 nd division) participated in this study. Bleep test was used to set the maximal heart rate (HR max ) of each player. The intensity of game load was classified as follows: 95 % of HR max . During the two competitive games and the bleep test the HR was monitored by telemetric device. In the 1 st zone no field goal attempt was recorded. In the 2 nd zone the successfulness of shooting was 60%, in the 3 rd zone 37.5% and in the 4 th zone 45.2%. The relation between the successfulness of shooting and the individual zones was statistically insignificant ( χ 2 =2.786; df =2; p =0.24). Calculated Cramer's contingency coefficient ( V =0.149) shows weak strength of association. Based on the results we may conclude that the shooting performance in basketball game is not dependent on the intensity of game load. Besides the intensity of game load, the shooting performance can also be affected by many other factors. What is relevant for training process is that the 88.1% of all field goal attempts were made with HR over 85% of HR max . This fact should be taken into consideration by coaches when planning shooting practice sessions.


Abstract The study of solar rotation has a 150-year history. Early studies were restricted to looking at the movement of sunspots; much later came studies using other tracers such as supergranules, and spectroscopic measurements using Doppler shifts of spectral lines. These studies also found evidence of other large-scale flows, such as the meridional flows in the north-south direction and the zonal flows, or torsional oscillations, parallel to the equator. However, until the 1980s, the study of solar rotation and large-scale flows was restricted to what could be observed on the solar surface. The advent of good helioseismic data changed that and gave us the means to study flows in the solar interior. Instruments like GONG, MDI and HMI have now collected helioseismic data for two solar cycles and these also allow us to study the large scale flows and their variations with time and solar activity. We review what the long data sets tell us about the these flows and discuss some of the differences between solar cycles 23 and 24.


Recent precise determination of the electron anomalous magnetic moment (AMM) adds to the longstanding tension of the muon AMM and together strongly point towards physics beyond the Standard Model (BSM). Here we present a solution to both anomalies via a light scalar that emerges from a second Higgs doublet and resides in the O(10)-MeV to O(1)-GeV mass range. A scalar of this type is subject to a number of various experimental constraints, however, as we show, it can remain sufficiently light by evading all experimental bounds and has the great potential to be discovered in the near-future low-energy experiments. In addition to the light scalar, our theory predicts the existence of a nearly degenerate charged scalar and a pseudoscalar, which have masses of the order of the electroweak scale. This scenario can be tested at the LHC by looking at the novel process ?? → ± ± 9 9 → ;±;± 9 9 + /) via same-sign pair production of charged Higgs bosons. This talk is based on results presented in hep-ph 2003.03386 [1].


As the legal community of the Americas evolves, the role of law schools and legal education must change with it. New realities of globalizing commerce and communication dictate that the legal profession understand and deal with emerging legal relationships. Wherever the future may lead with regard to the various treaties between nations in this hemisphere, like CAFTA, NAFTA, the FTAA, Mercosur, and others, it is obvious that the Americas are drawing irrevocably closer.How will law schools participate and react? There is, in my opinion, an obligation for universities and particularly law schools, to be involved in society and promote social justice. This concept is not alien to Latin America. The challenge is to be in harmony with contemporary society and yet be a force for change at the same time. However, the opinion that colleges should be agents of change is not universal. Some law schools take a more limited view that schools should simply prepare law students to become lawyers, judges, or some other type of legal professional. But even this more limited perspective should recognize the contemporary environment and the coming changes. This article discuss how law schools in our hemisphere can better prepare lawyers for the future, work together more effectively, and promote improvements in the justice systems.


ABSTRACT Social institutions increasingly appear as data-driven entities, with data analytics and information technology transforming social life across health care, education, and criminal justice. Social science scholarship characterizes the political nature of this paradigm by emphasizing technology's role in the governance of life and the sociocultural values embedded within technical design. But little research has examined the intimate work taking place inside these very institutions, resulting in inadequate attention to everyday data practices as they intertwine with evolving technopolitics. Drawing on ethnographic fieldwork of the integration of Electronic Health Records at a large safety-net health system in the United States, in this article I emphasize the intimate work involved in becoming data-driven and how this work shapes the material contours of contemporary data politics. I compare the implementation of two health system initiatives, including a Complex Care Program for an algorithm-defined population and a Disparity Reduction Plan targeting Latinos with Type 2 diabetes, to demonstrate how on the ground actors make intimate decisions about what constitutes the 'right data' in becoming data-driven. As data analytics expands to transform organizational decision-making, redistribute resources, and reconfigure the professional gaze, social science must follow data politics on the move to fully account for the evolving technopolitics of data-driven society.


Most of the Video on Demand (VoD) systems were designed to work in dedicated networks. However, there are some approaches that provide VoD service in nondedicated and best effort networks, but they adapt the media's quality according to the available network bandwidth. Our research activities focus on VoD systems with high quality service on nondedicated networks. Currently, we have designed and developed, to integrate in the VoD server, a network manager that provides: total network control, network state information, and adaptation of the transmission rate in a TCP-Friendly way. The present work describes this network manager, named Network Traffic Scheduler (NTS), which incorporates a congestion control algorithm named "Enhanced Rate Adaptation Protocol" (ERAP). ERAP is an optimization of the well-known protocol denominated "Rate Adaptation Protocol" (RAP). Maintaining the basic behavior of RAP, ERAP increases the efficiency of the NTS by reducing the resources usage (of the server and the network). These components has been extensively evaluated by simulations and real tests in which the resource consumption and the performance were measured. This paper presents the advantages of using ERAP instead of RAP in a VoD server, and its viability to be integrated within the NTS in a VoD server on nondedicated networks.


The rural non-farm micro-entrepreneurial activities in the informal sector hold significance in generating employment, removing poverty, and income inequality. The handloom industry in India holds a distinctive place in the Indian economy as it is the second largest provider of rural employment after agriculture. The North Eastern states of India accounts for more than 65 percent of the total handloom households in India. However, with only 4.26 percent of the total working looms utilized for commercial purposes, the industry is beset with manifold problems such as obsolete technologies, unorganized production system, low productivity, inadequate working capital, and weak market linkages. Therefore, undertaking financial risk plays here a defining role in overcoming these obstacles. Based on the primary data collected from 332 respondents, the present study analyzes determinants of financial risk attitude of the handloom micro-entrepreneurs using the Ordinal Probit model. Education, access to credit, access to training, and individual's income play a crucial role in influencing the risk aversion of the microentrepreneurs. These determinants are found to have a more dominant influence in lowering the risk aversion of female micro-entrepreneurs as compared to the male micro-entrepreneurs. The study suggests for providing vocational education and training programs that focus on entrepreneurship education to the rural female micro-entrepreneurs. Besides, it suggests for the provision and implementation of various financial inclusion programs for easy access to credit with proper follow up programs to ensure the efficient utilization of credit, with a primary focus on the female micro-entrepreneurs. © 2017 College of Management, National Cheng Kung University. Production and hosting by Elsevier Taiwan LLC. All rights reserved.


The salivary microbiota has been linked to both oral and non-oral diseases. Scant knowledge is available on the effect of environmental factors such as long-term dietary choices on the salivary microbiota and metabolome. This study analyzed the microbial diversity and metabolomic profiles of the saliva of 161 healthy individuals who followed an omnivore or ovo-lacto-vegetarian or vegan diet. A large core microbiota was identified, including 12 bacterial genera, found in >98% of the individuals. The subjects could be stratified into three "salivary types" that differed on the basis of the relative abundance of the core genera Prevotella, Streptococcus/Gemella and Fusobacterium/Neisseria. Statistical analysis indicated no effect of dietary habit on the salivary microbiota. Phylogenetic beta-diversity analysis consistently showed no differences between omnivore, ovo-lacto-vegetarian and vegan individuals. Metabolomic profiling of saliva using 1H-NMR and GC-MS/SPME identified diet-related biomarkers that enabled a significant discrimination between the 3 groups of individuals on the basis of their diet. Formate, urea, uridine and 5-methyl-3-hexanone could discriminate samples from omnivores, whereas 1-propanol, hexanoic acid and proline were characteristic of non-omnivore diets. Although the salivary metabolome can be discriminating for diet, the microbiota has a remarkable inter-individual stability and did not vary with dietary habits. Microbial homeostasis might be perturbed with sub-standard oral hygiene or other environmental factors, but there is no current indication that a choice of an omnivore, ovo-lacto-vegetarian or vegan diet can lead to a specific composition of the oral microbiota with consequences on the oral homeostasis.


Children with intellectual disability (ID) are more vulnerable to health conditions than their typically developing peers. Evidence of effective interventions is scarce. A randomized controlled trial was conducted in 30 overweight and obese children with intellectual disability (ID) in China to evaluate a 12-week school-based physical activity intervention for obesity, health-related physical fitness (HRPF), and blood pressure. The intervention consisted of 24 physical activity (PA) sessions (2 sessions/week, 60 min/session), with exercise intensity progressively increasing from a moderate level to a vigorous level. All participants were followed up for 12 weeks after the intervention period to evaluate sustained effects. Outcomes were repeatedly measured at baseline, after the intervention, and after follow-up. The intervention was effective in reducing some obesity-related outcomes (including weight and body mass index) and improving some HRPF-related outcomes (including the 6 min walk test and the 30 s sit-to-stand test), with the significant effects being sustained after the 12-week follow-up. No effect was observed on blood pressure. The findings of this study contribute to the development and implementation of PA interventions to reduce obesity and improve HRPF in children with ID.


Abstract A model is developed to describe the dispersion of pollutants in a coastal area when stable air masses are transported inland. It is assumed that a convective mixed layer develops over land, the height of which increases with distance from the shoreline. The vertical distribution of pollutants is assumed to be homogeneous within the mixed layer and the distribution in the stable layer aloft is assumed to be Gaussian. Pollutant concentrations in the mixed layer are obtained by analytical integration of the mass conservation equation. It is shown that the earlier and much higher estimates of continuous shoreline fumigation by Lyons and Cole (1973) and Meroney et al. (1975) can be derived from our expressions by simplifying substitutions.


In Phaseolus vulgaris, primary roots show gravitational sensitivity soon after emerging from the seed. In contrast, lateral roots are agravitropic during early development, and become gravitropic after several cm growth. Primary and lateral root tissues were examined by polyacrylamide gel electrophoresis, coupled with western blotting techniques, to compare proteins which may contribute to the acquisition of gravitational sensitivity. Root tips and zones of cell elongation were compared for each root type, using immunological probes for calmodulin, alpha-actin, alpha-tubulin, and proteins of the plastid envelope. Lateral roots contained qualitatively less calmodulin, and showed a slightly different pattern of actin-related epitope proteins, than did primary root tissues, suggesting that polypeptide differences may contribute to the gravitational sensitivity which these root types express.


Edited by Christos P Panteliadis, Rudolf Korinthenberg. New York: Thieme, 2005, €99.95 (£70 (approx.); US$125 (approx.)), hardback, pp 973. ISBN 3131415614

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It was Bertrand Russell who said that a stupid man's report of what a clever man says can never be accurate, because he unconsciously translates what he hears into something he understands. Therefore reviewing a book written by so many distinguished neurologists poses a challenge. Added to this is the fact that paediatric neurology is a mystery for many—the more you read the less you seem …

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Building damage accounts for a high percentage of post-natural disaster assessment. Extracting buildings from optical remote sensing images is of great significance for natural disaster reduction and assessment. Traditional methods mainly are semi-automatic methods which require human-computer interaction or rely on purely human interpretation. In this paper, inspired by the recently developed deep learning techniques, we propose an improved Mask Region Convolutional Neural Network (Mask R-CNN) method that can detect the rotated bounding boxes of buildings and segment them from very complex backgrounds, simultaneously. The proposed method has two major improvements, making it very suitable to perform building extraction task. Firstly, instead of predicting horizontal rectangle bounding boxes of objects like many other detectors do, we intend to obtain the minimum enclosing rectangles of buildings by adding a new term: the principal directions of the rectangles θ. Secondly, a new layer by integrating advantages of both atrous convolution and inception block is designed and inserted into the segmentation branch of the Mask R-CNN to make the branch to learn more representative features. We test the proposed method on a newly collected large Google Earth remote sensing dataset with diverse buildings and very complex backgrounds. Experiments demonstrate that it can obtain promising results.


Exact general relativistic observation equations for the GAIA concept were derived for a static sphere, i.e., with only stellar angular coordinates as unknowns. These equations were then put to test in an end-to-end simulation of the current baseline mission. Although the applicability of the present model is limited to the case of an observer in the gravitational well of a spherical non-rotating Sun, the results show that, despite cumbersome formalism, measurements of angular distances among stars good to 100 arcsec (as expected for stars of V = 16 mag) can be modeled to yield estimates of the relativistic astrometric parameters with errors of 20 arcsec after only one year of satellite operations.


87 malignant colorectal polyps were removed in 81 patients by endoscopic polypectomy from 1972 until 1987. Thereafter 34 of these patients had a surgical resection of the colon. Surgical resection was performed for incomplete excision of the polyp (20 x), for tumor invasion of the lymphics in the polyp stalk and for moderately/poor differentiated carcinoma. In 6 patients a residual carcinoma was detected in the removed colon specimen, but lymph-node metastasis only in one with moderate-differentiated carcinoma. Our results demonstrate that colorectal polyps with invasive well-differentiated carcinoma and tumor free base do not need a surgical resection. Patients of the high-risk-group (moderately/poor-differentiated carcinoma, invasion of blood vessels and lymphatics, incomplete excision), should be referred to further surgical resection. With regard to the low rate of metastatic spread even in patients with high-risk-polyps accurate differentiation seems to be necessary. In 19 out of 52 (36.5%) patients endoscopic control examinations after surgical or endoscopic resection revealed recurrent pathological findings. On the base of the presented data we conclude that there is a need for short-term endoscopic controls over a period of five years.


Causal inference explores the causation between actions and the consequent rewards on a covariate set. Recently deep learning has achieved a remarkable performance in causal inference, but existing statistical theories cannot well explain such an empirical success, especially when the covariates are high-dimensional. Most theoretical results in causal inference are asymptotic, suffer from the curse of dimensionality, and only work for the finite-action scenario. To bridge such a gap between theory and practice, this paper studies doubly robust off-policy learning by deep neural networks. When the covariates lie on a low-dimensional manifold, we prove nonasymptotic regret bounds, which converge at a fast rate depending on the intrinsic dimension of the manifold. Our results cover both the finite- and continuous-action scenarios. Our theory shows that deep neural networks are adaptive to the low-dimensional geometric structures of the covariates, and partially explains the success of deep learning for causal inference.


Inflatable structures used in soft robotics applications exhibit unique characteristics. In particular, the tip-extension structure, which grows from the tip, can grow without friction against the environment. However, these inflatable structures are inferior to rigid mechanisms in terms of their load-bearing capacity. The stiffness of the tip-extension structure can be increased by pressurization, but the structure cannot maintain its curved shape and compliance. In this study, we proposed a mechanism that combines a skeleton structure consisting of multi-joint links with functions to increase rigidity while keeping low pressure and realizing the functions of bending and shape fixation. We devised a design method for rigid articulated links and combined it with a membrane structure that utilizes the advantages of the tip-extension structure. The experimental results show that the payload of the designed structure increases compared to that of the membraneonly structure. The findings of this research can be applied to long robots that can be extended in the air without drooping and to mechanisms that can wrap around the human body. Keywords—Soft Robot Materials and Design, Mechanism Design, Compliant Joint/Mechanism


Choline kinase (CK) is the first enzyme in the CDP-choline pathway for the synthesis of phosphatidylcholine, the most abundant phospholipid in the mammalian cell membrane. This enzyme exists as three isozymes (α1, α2 and β) and the CKα isozyme has been implicated in cancer pathogenesis. Inhibition of CK activity has been proposed for cancer therapies. MicroRNAs (miRNAs/miRs) are non‑coding RNAs that serve important roles in diverse biological pathways and human diseases, including cancer. However, the regulation of CKα gene expression by miRNAs has never been investigated, to the best of the authors' knowledge. In the present study, two miRNA mimics, miR‑876‑5p and miR‑646, were transfected into the HepG2 cell line and the effect of these miRNAs on the levels of CKα mRNA were determined by reverse transcription‑quantitative polymerase chain reaction. Cells transfected with 25 nM miR‑876‑5p for 48 h exhibited significantly lower levels of CKα mRNA. Following optimization, miR‑876‑5p caused four times lower levels of CKα mRNA compared to the negative control. Effects of the miRNAs on HepG2 cell viability and cellular morphology were additionally analyzed using an MTT cell viability assay and scanning electron microscopy, respectively. HepG2 cells that were transfected with the optimum concentration of miR‑876‑5p for the optimum duration exhibited 25% lower viability than negative control and signs of apoptosis in electron micrographs. The results suggested miR‑876‑5p as a potential miRNA modulator of CKα expression in the cells, and may be relevant for the design of more effective anticancer strategy targeting CK.


Importance
Opioid-related mortality and national prescribing guidelines have led to tapering of doses among patients prescribed long-term opioid therapy for chronic pain. There is limited information about risks related to tapering, including overdose and mental health crisis.

Objective
To assess whether there are associations between opioid dose tapering and rates of overdose and mental health crisis among patients prescribed stable, long-term, higher-dose opioids.

Design, Setting, and Participants
Retrospective cohort study using deidentified medical and pharmacy claims and enrollment data from the OptumLabs Data Warehouse from 2008 to 2019. Adults in the US prescribed stable higher doses (mean ≥50 morphine milligram equivalents/d) of opioids for a 12-month baseline period with at least 2 months of follow-up were eligible for inclusion.

Exposures
Opioid tapering, defined as at least 15% relative reduction in mean daily dose during any of 6 overlapping 60-day windows within a 7-month follow-up period. Maximum monthly dose reduction velocity was computed during the same period.

Main Outcomes and Measures
Emergency or hospital encounters for (1) drug overdose or withdrawal and (2) mental health crisis (depression, anxiety, suicide attempt) during up to 12 months of follow-up. Discrete time negative binomial regression models estimated adjusted incidence rate ratios (aIRRs) of outcomes as a function of tapering (vs no tapering) and dose reduction velocity.

Results
The final cohort included 113 618 patients after 203 920 stable baseline periods. Among the patients who underwent dose tapering, 54.3% were women (vs 53.2% among those who did not undergo dose tapering), the mean age was 57.7 years (vs 58.3 years), and 38.8% were commercially insured (vs 41.9%). Posttapering patient periods were associated with an adjusted incidence rate of 9.3 overdose events per 100 person-years compared with 5.5 events per 100 person-years in nontapered periods (adjusted incidence rate difference, 3.8 per 100 person-years [95% CI, 3.0-4.6]; aIRR, 1.68 [95% CI, 1.53-1.85]). Tapering was associated with an adjusted incidence rate of 7.6 mental health crisis events per 100 person-years compared with 3.3 events per 100 person-years among nontapered periods (adjusted incidence rate difference, 4.3 per 100 person-years [95% CI, 3.2-5.3]; aIRR, 2.28 [95% CI, 1.96-2.65]). Increasing maximum monthly dose reduction velocity by 10% was associated with an aIRR of 1.09 for overdose (95% CI, 1.07-1.11) and of 1.18 for mental health crisis (95% CI, 1.14-1.21).

Conclusions and Relevance
Among patients prescribed stable, long-term, higher-dose opioid therapy, tapering events were significantly associated with increased risk of overdose and mental health crisis. Although these findings raise questions about potential harms of tapering, interpretation is limited by the observational study design.


Tracheal cross-sections can be measured by means of computerised tomography with hitherto unparalleled accuracy. Among the patients examined by the authors (43) women following tracheopexy because of tracheomalacia), computerised tomography yielded approximately 3 times as many pathological findings as was possible by conventional x-ray diagnosis. Over and above this, it is always possible to calculate the flow resistance, a fact which can be of great importance for therapy planning and control. Hence, in all cases where accurate visualisation of the tracheal cross-section is necessary, computerised tomography appears to be the method of choice at the present time.


A three-year research program for the development of novel XUV spectroscopic diagnostics for magnetically confined fusion plasmas is proposed. The new diagnostic system will use layered synthetic microstructures (LSM) coated, flat and curved surfaces as dispersive elements in spectrometers and narrow band XUV filter arrays. In the framework of the proposed program we will develop impurity monitors for poloidal and toroidal resolved measurements on PBX-M and Alcator C-Mod, imaging XUV spectrometers for electron density and temperature fluctuation measurements in the hot plasma core in TEXT or other similar tokamaks and plasma imaging devices in soft x-ray light for impurity behavior studies during RF heating on Phaedrus T and carbon pellet ablation in Alcator C-Mod. Recent results related to use of multilayer in XUV plasma spectroscopy are presented. We also discuss the latest results reviewed to q{sub o} and local poloidal field measurements using Zeeman polarimetry.


A theory as the basis for solving nonlinear boundary value problems is described in this article. Based upon a careful discussion on nonlinear propagation characteristics of bulk acoustic waves (BAWs) in anisotropic solids, we present an original analysis for the nonlinear reflection of a pure-mode plane wave at an interface of two anisotropic solids, which reveals that the interface may generate freely-propagating second-harmonic waves, and that the reflective and the refractive second-harmonic waves increase two-dimensionally in the bulk. This technique can also be applied to wave reflection problems at other kinds of planar boundaries