IMPORTANCE
A comprehensive meta-analysis of randomized trial data suggests that suicidal behavior is twice as likely when children and young adults are randomized to antidepressants compared with when they are randomized to placebo. Drug-related risk was not elevated for adults older than 24 years. To our knowledge, no study to date has examined whether the risk of suicidal behavior is related to antidepressant dose, and if so, whether risk depends on a patient's age.

OBJECTIVE
To assess the risk of deliberate self-harm by antidepressant dose, by age group.

DESIGN, SETTING, AND PARTICIPANTS
This was a propensity score-matched cohort study using population-based health care utilization data from 162,625 US residents with depression ages 10 to 64 years who initiated antidepressant therapy with selective serotonin reuptake inhibitors at modal or at higher than modal doses from January 1, 1998, through December 31, 2010.

MAIN OUTCOMES AND MEASURES
International Classification of Diseases, Ninth Revision (ICD-9) external cause of injury codes E950.x-E958.x (deliberate self-harm).

RESULTS
The rate of deliberate self-harm among children and adults 24 years of age or younger who initiated high-dose therapy was approximately twice as high as among matched patients initiating modal-dose therapy (hazard ratio [HR], 2.2 [95% CI, 1.6-3.0]), corresponding to approximately 1 additional event for every 150 such patients treated with high-dose (instead of modal-dose) therapy. For adults 25 to 64 years of age, the absolute risk of suicidal behavior was far lower and the effective risk difference null (HR, 1.2 [95% CI, 0.8-1.9]).

CONCLUSIONS AND RELEVANCE
Children and young adults initiating therapy with antidepressants at high-therapeutic (rather than modal-therapeutic) doses seem to be at heightened risk of deliberate self-harm. Considered in light of recent meta-analyses concluding that the efficacy of antidepressant therapy for youth seems to be modest, and separate evidence that antidepressant dose is generally unrelated to therapeutic efficacy, our findings offer clinicians an additional incentive to avoid initiating pharmacotherapy at high-therapeutic doses and to closely monitor patients starting antidepressants, especially youth, for several months.


The development of liver fibrosis is one of the most severe and life-threatening outcomes of chronic liver disease (CLD). For targeted therapy of CLD, it is highly needed to reveal molecular targets for normalizing metabolic processes impaired in damaged liver and associated with fibrosis. In this study, we investigated the morphological and biochemical changes in rat liver models of fibrosis induced by chronic administration of thioacetamide, carbon tetrachloride, bile duct ligation (BDL), and ischemia/reperfusion (I/R), with a specific focus on carbohydrate and energy metabolism. Changes in the levels of substrates and products, as well as enzyme activities of the major glucose metabolic pathways (glycolysis, glucuronidation, and pentose phosphate pathway) were examined in rat liver tissue after injury. We examined key markers of oxidative energy metabolism, such as the activity of the Krebs cycle enzymes, and assessed mitochondrial respiratory activity. In addition, pro- and anti-oxidative status was assessed in fibrotic liver tissue. We found that 6 weeks of exposure to thioacetamide, carbon tetrachloride, BDL or I/R resulted in a decrease in the activity of glycolytic enzymes, retardation of mitochondrial respiration, elevation of glucuronidation, and activation of pentose phosphate pathways, accompanied by a decrease in antioxidant activity and the onset of oxidative stress in rat liver. Resemblance and differences in the changes in the fibrosis models used are described, including energy metabolism alterations and antioxidant status in the used fibrosis models. The least pronounced changes in glucose metabolism and mitochondrial functions in the I/R and thioacetamide models were associated with the least advanced fibrosis. Ultimately, liver fibrosis significantly altered the metabolic profile in liver tissue and the flux of glucose metabolic pathways, which could be the basis for targeted therapy of liver fibrosis in CLD caused by toxic, cholestatic, or I/R liver injury.


The International Planned Parenthood Federation (IPPF), recognizing its responsibility to assist young people in fulfilling their roles as parents, citizens, and leaders, seeks to improve the quality of life of young people by advocating and promoting, especially to governments and other organizations, measures that will respond to their total human needs, including the provision of education and employment opportunities. IPPF, as a family planning organization, can contribute directly to the preparation of young people for responsible parenthood and to meeting their fertility related needs. Family planning associations (FPAs) are encouraged to initiate, strengthen, or support programs which respond to the needs of young people. Priority should be given to meeting the needs of the most disadvantaged groups, with emphasis on out of school and rural youth, slum dwellers, youth in urban industrialized areas, and abandoned adolescents and children, with special attention to the early group adolescent age group. The involvement of young people as active partners in IPPF's work is essential for its efforts to promote and sustain commitment to family planning at policymaking and community levels in the years ahead and to prepare the next generation of leaders within the Federation. Population, family life, and sex education, including family planning and reproductive health management, provide in both formal and nonformal settings, are the cornerstone of youth programs. FPAs should look for ways to remove legal, administrative, and other barriers to the availability of adequate education and services. As pregnancy poses special hazards for adolescents, particularly those under age 16, services should cater to the special circumstances in which adolescent childbearing is taking place. No single contraceptive method can be regarded satisfactory for adolescents as a group, but each method may have a place in adolescent services. Several factors, such as age, parity, and other personal amd medical considerations, need to be carefully assessed in helping the individual adolescent to make a choice. IPPF affirms that meeting the needs of young people is a major objective for the Federation and that priority should be given to meeting the needs of the most disadvantaged young people. Parents have primary responsibility in the preparation of the young for responsible parenthood, and their participation in meeting the fertility related needs of young people as part of an improved quality of family life should be encouraged and supported. Education and counseling should respond to the needs of young people who engage in sex relations and those who do not. Research should be encouraged, particularly at the national and local level, in biomedical, social science, service delivery, and legal and policy areas.


Osteoporosis remains an important cause of morbidity and mortality especially in the elderly. This fact is largely due to fractures of the proximal femur and spine. As recently recognized, vertebral fractures are as much a threat to health and longevity as fractures of the proximal femur. In recent decades, the development of tools to evaluate fracture risk as well as medications to treat osteoporosis has altered the management of people who are at fracture risk. At the same time identification and management procedures concerning spinal fracturing are not very clear. Besides there is not even clear consensus about what exactly constitutes a vertebral fracture, particularly those of minor degree. While height loss is a simple and valuable tool to detect vertebral fractures, it is neither sensitive nor specific enough to replace radiographs. Some 65% of fractures cause no symptoms. Often vertebral fractures are misdiagnosed, especially if they have occurred silently and if the opportunity for diagnosis arises fortuitously. It is to the patient's benefit that radiologists report and physicians identify vertebral fractures evident on a chest or other radiograph, no matter how incidental to the immediate clinical indication for the examination. Technological evolution now allows dual-energy x-ray absorptiometry machines to be used to take spine images while doing a densitometry. The images are adequate, even if not of high radiographic quality, and, more important, the patient undergoes a smaller radiation dose than with conventional spinal radiographs. Such technology may promote fracture recognition. The recognition of vertebral fractures, as well as the prevention and treatment of further fractures, will likely do much to reduce both the burden of osteoporosis-related morbidity and mortality, as well as fracture-related costs to healthcare systems.


The invention relates to a factor process for preparing human von Willebrand from a cryoprecipitated plasma fraction. The method comprises a combination of three chromatographic separation steps. The resulting concentrate exhibits a very high specific activity and a high percentage of high molecular weight multimers. The concentrate is intended in particular for therapeutic use.


Computer-aided language learning (CALL) applications for adult learners are well-established. Tutoring applications for children require special didactic and ergonomic concepts. Except for low functionality (toy-like) products for children and PDA-based solutions, embedded systems seem to be not present in the market yet. The authors currently adapt baseline tutoring technology for adult learners to the special requirements of young children aged 3+ years and they therefore shortly discusses other preliminary studies and the own tutoring system AzAR. The paper introduces didactic and technological concepts of the embedded target system for young children. A German language prototype is still under development. The speech technology and audio components were already tested in comparable application contexts regarding dialogue control, robust recognition and hardware design.


The main objective of this thesis is to analyze and quantify methods for controlling the phenomenon known as Frustrated Total Internal Reflection (FTIR). Several methods of numerical and analytical study of FTIR are presented. A direct solution of the Maxwell equations is shown to be a powerful tool in understanding FTIR. An analytic solution is derived for a specific planar case of FTIR. Results that were obtained in the form of transmission coefficients are compared with the numerical modeling, with favorable results. The numerical modeling results were obtained with a new computer code based on the FDTD algorithm that finds the solution of Maxwell equations in 3 D space with periodic boundary conditions. Several devices based on the active control of total internal reflection (ACTIR) have been proposed, with the most promising being an electrophoretic display cell, in which the frustration of TIR is done by electrostatically charged particles suspended in liquid medium. An analysis is presented from the physical and chemical points of view. An optimization of the electrophoretic display cell surface parameters has been performed by means of ray tracing modeling, and these results and meir implications to the future cell design are presented. Finally a comparative analysis of presented electrophoretic display technology is presented, in the context of alternative existing technologies.


In relation to the Muslim countries or nations, one of the contemporary politico-economic and strategic issues for the United States of America (USA) is a civil democratic Islam. USA has looked for the partners among the Muslim nations but USA has not found a civil democratic Islam in any of the Muslim nations. For USA, the democratic system in the Muslim nations is different from the democratic system in USA. Some of the Muslim nations have accepted the democratic system like Turkey, Egypt, Malaysia, Pakistan, Iran, Sudan, Iraq, and Indonesia. The importance of the existence of a civil democratic Islam in the Muslim nations to USA and the West is undeniable. "Clearly, the United States, the modern industrialized world, and indeed the international community as a whole would prefer an Islamic world that is compatible with the rest of the system: democratic, economically viable, politically stable, socially progressive, and follows the rules and norms of international conduct"(p.ix).


Speckle noise is the main cause of poor optical coherence tomography (OCT) image quality. Convolutional neural networks (CNNs) have shown remarkable performances for speckle noise reduction. However, speckle noise denoising still meets great challenges because the deep learning-based methods need a large amount of labeled data whose acquisition is time-consuming or expensive. Besides, many CNNs-based methods design complex structure based networks with lots of parameters to improve the denoising performance, which consume hardware resources severely and are prone to overfitting. To solve these problems, we propose a novel semi-supervised learning based method for speckle noise denoising in retinal OCT images. First, to improve the model's ability to capture complex and sparse features in OCT images, and avoid the problem of a great increase of parameters, a novel capsule conditional generative adversarial network (Caps-cGAN) with small number of parameters is proposed to construct the semi-supervised learning system. Then, to tackle the problem of retinal structure information loss in OCT images caused by lack of detailed guidance during unsupervised learning, a novel joint semi-supervised loss function composed of unsupervised loss and supervised loss is proposed to train the model. Compared with other state-of-the-art methods, the proposed semi-supervised method is suitable for retinal OCT images collected from different OCT devices and can achieve better performance even only using half of the training data.


This paper presents a new robot localization method in an indoor environment and enters in the development of an assistance robot for disabled people called the ARPH project. The robot developed is composed of two principal parts: a mobile base for displacement and an embedded MANUS arm to handle objects. Each part is equipped with two kinds of sensors: a camera to have the environment structure and the object parameters and an ultrasonic system to recognize environment and object. Our approach to robot localization is based on combination of these two sensors information and uses a 3D/2D matching between environment model and image attributes. The aim is to compute the robot position and orientation in the navigation workspace in a fast way and with a good accuracy, to give to the mobile robot ability to realise different tasks like navigation, tracking and grabbing objects.


The goal of residential load management is to manipulate the electricity demand of a group of consumers to match some desired shape. Effective load management needs two types of controls: systemic and local. Systemic control manipulates the aggregate power by signaling the consumers. Local control determines how the power consumer reacts to the signals. I present a price responsive intelligent thermostat for use in local load management. Further, I explore two types of systemic control using electricity price as the control variable. The first approach is to identify the system using a low order model and apply traditional control techniques. The second approach makes use of game theory to auction the electricity to the consumers. Both methods enable reliable and robust high resolution load management.


The MET receptor tyrosine kinase is an established molecular target for cancer treatment due to the receptor driven uncontrolled cell proliferation, angiogenesis, local invasion and metastasis. Several studies reported that MET signaling may crosstalk with cellular responses to DNA damage and protect tumor cells from cancer treatment with DNA damaging agents including ionizing radiation (IR). In this respect, our group previously demonstrated that MET inhibition in tumor cells with deregulated MET activity results in their sensitization to IR. Recent finding suggests that this radiosensitization is accompanied by the MET inhibition associated downregulation of ATR-Chk1-CDC25 pathway, a major signaling cascade responsible for the intra-S and G2/M cell cycle arrests following DNA damage. Here we hypothesized that further improvement of the efficacy of IR in combination with MET inhibition in p53-proficient cancer cells could be achieved by a p53 knock-down that would disrupt the remaining G1/S checkpoint arrest. Consequently, tumor cells revealing abrogated both G2/M and G1/S checkpoints would enter mitosis carrying substantial DNA lesions and undergo cell death in a greater extent than p53-proficient cells with functional G1/S checkpoint. In order to validate our working hypothesis, GTL-16, a human gastric carcinoma line that reveals MET-dependence and expresses wildtype p53, was used to generate p53-proficient and p53-deficient isogenic cell lines. Following combined treatment of novel selective MET small molecule inhibitor EMD-1214063 and IR, various biological endpoints, such as viability, cytotoxicity, apoptosis, and cell cycle distribution were evaluated in p53 knock-down cells along with their corresponding parental variants. The data suggests that p53-deficient cells are more susceptible to EMD-1214063 and combination treatment than the wildtype-p53 lines as inferred from elevated γH2AX expression and increased cell death. Furthermore, cell cycle distribution profile indicates constantly lower G1 and higher G2/M population as well as up to 3-fold higher expression of a mitotic marker p-Histone H3 Ser10 following MET inhibition combined with IR in p53 knock-down variant as compared to p53 wildtype cells. Interestingly, p53-deficient cells treated by EMD-1214063/IR tend to be rather resistant to apoptosis, suggesting cell death through an alternative mechanism (i.e. mitotic catastrophe). This assumption is supported by imaging analysis that indicates formation of micronuclei in these cells. The concept of MET inhibition-mediated radiosensitization enhanced by p53 deficiency reported in our current work is of high clinical relevance, since p53 is frequently inactivated as a consequence of mutations in numerous types of human cancer and has the potential to overcome the major challenge in cancer treatment due to tumor resistance to conventional chemo- and radiation therapy. Citation Information: Mol Cancer Ther 2013;12(11 Suppl):C218. Citation Format: Kei Mikami, Michaela Medova, Bruno Streit, Mario P. Tschan, Andree Blaukat, Friedhelm Bladt, Daniel M. Aebersold, Yitzhak Zimmer. Relevance of p53 status for the response of tumor cells to MET inhibitors combined with irradiation. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2013 Oct 19-23; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2013;12(11 Suppl):Abstract nr C218.


ence in treatment might have saved. He thougrht that in spite of this indication, there should be no relaxation of efforts-to save those eyes. He would like to hear how far Mr. Browning had thouaht of that danger. He (Mr. Paton) excised an eye the other day on the strength of a report on the blood count. In other circumstances he probably would have persisted in his attempts to save it. With regard to the Wasserrnann test being reliable in not more than 95 per cent. of cases, he adverted to the trypanosome disease, which he spoke of last time, and he understood that some 4 per cent. of cases of scarlet fever also gave a positive reaction.


This thesis contributes to increased knowledge on Holocene climate and environmental variability from two complex and sparsely studied areas. Using a speleothem from Gasparee Cave, Trinidad, as a paleoclimate archive, the local expression of the 8.2 ka (thousand years before 1950) climate event and associated patterns of the inter-tropical convergence zone (ITCZ) and rainfall is provided. Subsequent speleothem studies using multi-proxy analysis of stalagmites from Kapsia Cave and Alepotrypa Cave, Greece, provide records of climate, vegetation and human induced changes in the cave environment during parts of the Holocene.The speleothems from the well-studied Neolithic habitation site, Alepotrypa Cave, have produced a climate and habitation record which covers the period of 6.3-1.0 ka. The cave was inhabited between 8.0-5.2 ka and was closed by a tectonic event, which has preserved the settlement. The stable oxygen record shows the first well-dated and robust expression of the 4.2 ka dry event in the Peloponnese, places the timing of the 3.2 ka dry event within an ongoing dry period, and shows a final dry event at 1.6 ka. The North Atlantic as well as more regional drivers, such as the North Sea Caspian Pattern Index is proposed to, in a complex interplay, govern many of the climate trends and events observed.Trace element variation after the site is abandoned indicate what is interpreted as two volcanic eruptions, the Minoan eruption of Thera (Santorini) around 3.6 ka and the 2.7 ka eruption of Somma (Vesuvius). Variations in trace elements during the habitation period show clear human influence, indicating an association with specific cave activities. One of the most interesting prospects for continued work on Alepotrypa Cave is this successful marriage of speleothem studies and archeology. A framework of dates which constrain some behavior of people living in the cave is only the beginning, and there is great potential to continue finding new clues in the speleothem data.


The paper presents an approach for location-aware communications in ubiquitous computing environments. It is constructed on a symbolic location model, which links everyday objects, including non-smart objects and places, with counterpart objects, which are executable software components that are dynamically organized like a tree based on geographical containment, such as in a user-room-floor-building hierarchy. The approach enables physical entities and places to communicate with one another through their counterpart objects, even when the entities and places are not smart. It supports a mechanism to detect objects and communicate with them according to their locations. This paper presents the design for the approach and describes an implementation of it


This paper argues that ECB credibility in delivering price stability is being progressively eroded; this problem could be overcome by embracing greater transparency especially about the ECB's objectives, macroeconomic forecasts and decision-making. During the ECB's first decade, average inflation in the euro area has been low, but it has failed to meet the ECB's criterion of below but close to 2% over the medium term. Although this could be attributed to unanticipated shocks, the analysis in this paper points to some structural shortcomings. In particular, there has been an upward trend in medium and long term inflation expectations in the euro area, which have even reached over 2%, and the credibility of the ECB achieving price stability in the medium term has gradually eroded to critically low levels. In addition, there is evidence that medium and long term inflation expectations are negatively affected by the inflation experience of the euro area. However, this paper argues that these problems could be overcome embracing by greater transparency, especially about the ECB's objectives, macroeconomic forecasts and decision-making.


This article examines the celebrations organised for the 1916 Shakespeare Tercentenary in three American locations: Wellesley, MA; Atlanta, GA; and Grand Forks, ND. By focusing on these hitherto neglected events, the article extends the investigations, initiated by Thomas Cartelli and Coppelia Kahn, into the ways in which the Tercentenary activities in the U.S. participated in the contemporaneous debates concerning American national identity. These investigations have until recently concentrated almost exclusively on the Tercentenary festivities organised in the metropolitan centre of New York City. An examination of the provincial celebrations in regions as diverse as New England, the South, and the Midwest, indicates that the Shakespeare Tercentenary provided a platform for the negotiation of a complex network of interrelated, and sometimes conflicting, national and local identities.


Anorexia nervosa is a disorder characterized by excessive dieting, a morbid fear of becoming obese, a distorted body image and amenorrhea in women, The condition is seen chiefly in girls and young women but also occurs in men. Death in anorexia nervosa may be sudden, and the mortality rate is the highest of any psychiatric disease.1 Despite investigations of its endocrine and psychiatric manifestations, little has been written about cardiac conduction in this entity. We report a patient with anorexia nervosa who presented with syncope due to a sinus bradycardia. His bundle electrograms were performed during the course of her hospilalization, and revealed that the abnormalities were reversible with food intake.


The boundary lubrication and dry friction of plain bearings at different work temperature are unable to be avoided under the start and stop condition. The poor lubrication is one reason of bearing broken. In order to improve the tribological properties and select the best treatment for different bearings used at different temperature, the studies of different treatment technologies are reviewed in this paper. The review shows that the shortages of bonding fiber woven materials, inlaying solid lubricating materials, electro plating and magnetron sputtering are poor temperature resistance, low load capacity, environment pollution and low production efficiencies respectively. Based on the analyses and summaries, the liquid dope spraying and thermal powder spraying are suggested to deposit coating on the surface of bearing which working temperature is lower than 200 and above 800°C respectively. However, the technology processes, the mechanisms of spraying and self-lubrication materials should be studied further and deeply.


Where the government cannot meet wide-ranging health needs of the population and when people are given the opportunity to manage their own affairs and to be involved in decision-making, they can become very efficient. This was demonstrated by an experiment in a senegalese town (450 000 inh.) between 1975 and 1981. A strategy for priority health care with the active participation of the local community was developed to provide a network of acceptable and accessible health services. This was with government support. --The government provides the basic structure of its health services to which the community contributes. It provides the medical staff, technical guidance and logistic support and helps the community volunteers to develop sound accounting procedures. --The community contributes financial and human resources to improve the coverage of the health units. Based on a self-financing system controlled by a health committee per each health unit, communities are in decision making concerning the utilization and management of the community's resources. Procedures to control the community's financial contribution are especially well detailed in the paper. In view of this successful experiment, the minister of public health with the agreement of the government, has recommended that community participation in financing health care services be extended to all regions of the country.


Abstract This article analyses the inter-relationship between political identity, public memory and urban space in South-east Europe through a case study of Parcul Carol I (Carol I Park) in Bucharest, Romania from 1906 to the present. The article analyses how the urban cultural landscape has been reshaped to support the political ambitions of three successive regimes—Romania as a kingdom and liberal constitutional monarchy (1881–1938); state-socialist Romania (1947–1989); and the post-socialist Romanian state from 1989. The article highlights complex continuity from the state-socialist period under post-socialism, rather than destruction of the landscape of state-socialism, combined with the return of pre-socialist landscape elements. The article argues for the need for studies of the fate of state-socialist urban landscapes under post-socialism which consider the complexities introduced by the persistence of landscape elements from the pre-socialist and state-socialist periods and their combination with pre-socialist and post-socialist landscapes to produce hybrid memory-scapes and spaces of the nation.


Declaration This work or any part thereof has not previously been presented in any form to the University or to any other body whether for the purpose of assessment, publication or for any other purpose. Save for any express acknowledgements, references and/or bibliographies cited in the work, I confirm that the intellectual contents of the work are the result of my own efforts and no other person. The right of Adeboye Akanni Akinwunmi to be identified as author of this work is asserted in accordance with ss. 77 and 78 of the Copyright, Designs and Patents Act 1988. At this date copyright is owned by the author.


EurJIC is proud to present a bumper issue on Spin-Crossover Complexes. Our Guest Editors, Keith Murray, Hiroki Oshio and Jose Antonio Real, have worked hard to put together a fantastic issue. With a valuable personal account of the field by Philipp Gutlich and inspiring papers by leading experts, you will not be disappointed.


In this letter we propose a tightly-coupled Extended Kalman Filter framework for IMU-only state estimation. Strap-down IMU measurements provide relative state estimates based on IMU kinematic motion model. However the integration of measurements is sensitive to sensor bias and noise, causing significant drift within seconds. Recent research by Yan et al. (RoNIN) and Chen et al. (IONet) showed the capability of using trained neural networks to obtain accurate 2D displacement estimates from segments of IMU data and obtained good position estimates from concatenating them. This letter demonstrates a network that regresses 3D displacement estimates and its uncertainty, giving us the ability to tightly fuse the relative state measurement into a stochastic cloning EKF to solve for pose, velocity and sensor biases. We show that our network, trained with pedestrian data from a headset, can produce statistically consistent measurement and uncertainty to be used as the update step in the filter, and the tightly-coupled system outperforms velocity integration approaches in position estimates, and AHRS attitude filter in orientation estimates. Video materials and code can be found on our project page: http://cathias.github.io/TLIO/.


Thyristor valve design merits are inherited and new developed high power rating thyristors are used in the valve design. The thyristor control unit (TCU) and snubber circuit are optimized for a high reliability and low loss of thyristor valves. Two 12-pulse converters are connected in series as one converter per pole. The converters use a double valve MVU structure. A careful designed rigorous type test program has been followed to verify the valve and converter design. A single valve is comprehensively dielectric type tested and operational type tested. High voltage valve hanging structure, low voltage valve hanging structure and MVU, plus the series connected valve simulator, are valve supporting structure dielectric tested and MVU dielectric tested. The test results indict that the valve voltage and converter design and protection are proper and there is a substantial margin in operation since, for most of the operational tests, the test parameters were globally more severe than specified.


The National Institute for Health and Care Excellence has published new guidance on the diagnosis and management of varicose veins in the legs.1 The guideline is short but is likely to mark a change in how varicose veins are managed in general practice, and makes recommendations on information for people with varicose veins, criteria for referral, and treatments and management in pregnancy. The guideline uses the Clinical Etiological Anatomical Pathophysiological (CEAP) classification of varicose veins (Box 1),2 which includes information on the clinical severity, aetiology, anatomical location, and pathophysiology of varicose veins and was originally intended for research purposes. Although accepted internationally and used in clinical practice it does have some limitations and is not used as the basis of referral criteria in the guideline. The Guideline Development Group agreed that it was more important for those referring to a vascular service to use clear, key clinical indicators and listen to the patient rather than trying to categorise people using CEAP.


Four men with primary breast cancer were seen between 1972 and 1985 at the Sasebo Municipal Hospital. They were admitted complaining of breast mass and/or bloody nipple discharge. There was no delay between the onset of symptoms and seeking medical advice. They had relatively early stages of disease (three patients had stage I and one had stage II). All patients were treated by modified radical or radical mastectomy. Histopathological study revealed ductal carcinomas and no lymph node metastasis in all patients. Multiple bone metastasis and death occurred in one case. One patient (61 years old) had two separate synchronous primary cancers of the breast and stomach, which is very uncommon.


A recent study suggested that low plasma levels (58-70 ng/ml) of chlorpromazine (CPZ) were achieved by patients concurrently taking lithium, despite ingestion of doses of CPZ (400-1000 MG) which ordinarily produce plasma levels of 100-300 ng/ml or more. We have studied this lithium-chlorpromazine interaction in rats. The plasma and brain levels of [14C]chlorpromazine (CPZ) after an oral dose (5 muCi) were significantly lower (p less than 0.005) in rats treated with lithium, whereas the percent of dose remaining in the stomach (24-30%) was significantly higher (p less than 0.001), than in matched controls. Gastric emptying was measured by [14C]polyethylene glycol and was shown to be inhibited significantly by oral and i.p. lithium. This inhibition of gastric emptying by lithium may be the major cause of the lower plasma levels of CPZ since diminution of plasma drug levels has been shown for L-dopa, chlorpromazine, sulfa drugs, and phenylbutazone in animals and man treated concomitantly with anticholinergics, which also diminish gastric motility.


Abstracts: Frontiers in Cancer Prevention Research 2008

A108

Predictors of hormone receptor status in ovarian cancer: results from the Nurses' Health Study

Background Hormone receptor expression in tumors may offer etiologic information for ovarian cancer, particularly in light of known associations with hormonal and reproductive risk factors.

Methods TMAs were constructed using triplicate core samples extracted from 157 paraffin-embedded blocks of confirmed epithelial ovarian tumors collected from participants in the Nurses' Health Study and stained for estrogen receptor-alpha (ERα) and progesterone receptor (PR). We examined receptor expression by stage, grade and histologic subtype. Multivariate unconditional logistic regression was used to evaluate whether various hormonal, reproductive and anthropometric risk factors differed by ERα and PR expression among cases, and whether these exposures are differentially associated with the risk of developing receptor-positive or receptor-negative ovarian cancer compared to controls.

Results PR expressing tumors were less likely to be invasive ( P = 0.05) and more likely to be of a lower grade ( P < 0.001) compared with PR- tumors. ERα status was not associated with any pathological features of the tumor ( P ≥ 0.76). In the case-control analysis, increasing age, being postmenopausal, and PMH use were associated with an increased risk of developing ERα+, but not ERα-, ( P for heterogeneity = 0.001, 0.06, and 0.06, respectively) and PR-, but not PR+, tumors ( P for heterogeneity = 0.08, 0.003, and 0.40, respectively), while height was only associated with the risk of developing PR- disease ( P for heterogeneity = 0.08). There were no clear differential associations of OC use, parity, adolescent or adult BMI, or physical activity with expression of either receptor. Results were similar in the case-case analysis.

Conclusion Despite limited statistical power, our findings suggest that various risk factors are only associated with certain tumor subtypes based on hormone receptor expression, thus providing mechanistic evidence regarding these relationships in the etiology of ovarian cancer. Given our small sample size, confirmatory studies are required to further delineate these relationships.

Citation Information: Cancer Prev Res 2008;1(7 Suppl):A108.


A large amount of research results have shown that events exist in many texts. Understanding texts from semantics, texts are composed of events, and events are the basic semantic units for texts. We present a novel approach for computing text similarity, which selects events as the features for documents and computes text similarity from two points of view: event class and event instance. The number of events is usually much fewer than the number of key words in documents. From this side, extracting event characters from documents is a good attempt to solve the high dimension of documents. Keywords-event; text representation; similarity computing


Origanum onites L. of Lamiaceae, is used as a culinary spice and herbal tea; also for its antioxidant, antimicrobial effects among other activities and effects. This research aims to examine the in vitro antimicrobial and antioxidant activities of the infusions and the essential oils (EOs) obtained using different conditions from the aerial parts of the processed and raw of O. onites herbal material. The EOs from O. onites were distilled at different times and characterized both by GC‐FID and GC/MS systems. The resulting main compounds were identified as carvacrol (65.5–91 %), linalool (0.3–17.9 %), γ‐terpinene (2.8–4.6 %), and thymol (0.5–1.5 %), respectively. In addition, Origanum infusions were prepared at four different time intervals, where the volatile compounds of the infusions were analysed using the HS‐SPME‐GC/MS system. Statistical Principal Component (PCA) and Hierarchical Cluster Analyses (HCA) tools were used to demonstrate the composition variations on different times for O. onites infusion and EO samples.


Abstract Objective: To measure and correlate bet-ween elastin expression and elastic fibre thickness in the uterosacral ligaments of women with uterine prolapse. Method: This analytic with cross sectional study was done in January - March 2011. Specimens were obtained from the parafin block of uterosacral ligaments of women having uterine prolapse (prolapse group, n = 16) and the same location in patients with no prolapse having simple hysterectomy, radical hysterectomy or staging laparotomy (control group, n = 16) who came to Dr. Hasan Sadikin hospital and its network. The percentage of elastin-positive tissue and elastic fibre thickness were measured by immunohistochemistry from random field readings per sample. The examiner was unaware of sample identity and the patients' clinical history. Result: The risk factors (age, parity and vaginal delivery) were compared between the control and prolapse groups, and there were no difference of body mass index between the groups. Immunohistochemical staining and morphometric analysis indicated there were significant different beween elastin expression in the prolapse group compare with the control group (p < 0.001). The mean thickness of elastic fibres was 0.938 μm in the group with uterine prolapse and 2.244 μm in the control groups (p = 0.02). Elastin expression was associated with elastic fiber thickness (r = 0.589 and p = 0.016). Conclusion: In this cross-sectional study investigating elastin changes in women with prolapse, there was correlation between elastin expression and elastic fiber thickness in uterosacral ligament of women with uterine prolapse. [Indones J Obstet Gynecol 2011; 35-2: 79-83] Keywords: elastin, uterosacral ligament, uterine prolapse


Fetal Alcohol Spectrum Disorder (FASD) is a preventable, lifelong disability that disproportionately affects Aboriginal and Torres Strait Islander people. This review provides a comprehensive synthesis of the available information on FASD among Aboriginal and Torres Strait Islander people, with reference to the limitations on population-based data and evaluated programs. The review outlines; the harms of alcohol use in the context of colonisation, cultural perspectives on assessment and diagnosis, effective prevention programs and a summary of state and national policies. Health impacts, educational outcomes and the effects of FASD on vulnerable populations such as children in protection and young people in the justice system, are also discussed. Specific perspectives on why women drink during pregnancy and the role of Aboriginal women in preventing FASD are explored. Recommendations include that there be greater focus on the benefits of involving men in the prevention and management of FASD and that future FASD prevention strategies for Aboriginal and Torres Strait Islander people should be community identified, led, and driven. FASD assessment, treatment and public health programs must also consider the history of trauma incurred by Aboriginal and Torres Strait Islander communities as a result of colonisation.


Amikacin is a new aminoglycoside antibiotic which is active in vitro against most isolates of gram-negative bacilli. A dose of 300 mg/m2 intramuscularly produced a highest mean serum concentration of 25.4 μg/ml with a mean serum concentration of 3.1 μg/ml at 8 h. The same dose intravenously produced a highest mean serum concentration of 52.4 μg/ml with a mean serum concentration of 2.1 μg/ml at 8 h. The mean urinary excretion during the first 6 h was 75 and 66%, respectively. When amikacin was administered at a dose of 150 mg/m2 every 6 h, there was evidence of some drug accumulation. A loading dose of 150 mg/m2 administered intravenously over 30 min followed by 200 mg/m2 administered as a continuous infusion every 6 h maintained serum concentrations of 8 μg/ml. No major toxicity was observed with any of these drug regimens.


Autoresuscitation is a phenomenon of the heart during which it can resume its spontaneous activity and generate circulation. It was described for the first time by K. Linko in 1982 as a recovery after discontinued cardiopulmonary resuscitation (CPR). J.G. Bray named the recovery from death the Lazarus phenomenon in 1993. It is based on a biblical story of Jesus' resurrection of Lazarus four days after confirmation of his death. Up to the end of 2022, 76 cases (coming from 27 countries) of spontaneous recovery after death were reported; among them, 10 occurred in children. The youngest patient was 9 months old, and the oldest was 97 years old. The longest resuscitation lasted 90 min, but the shortest was 6 min. Cardiac arrest occurred in and out of the hospital. The majority of the patients suffered from many diseases. In most cases of the Lazarus phenomenon, the observed rhythms at cardiac arrest were non-shockable (Asystole, PEA). Survival time after death ranged from minutes to hours, days, and even months. Six patients with the Lazarus phenomenon reached full recovery without neurological impairment. Some of the causes leading to autoresuscitation presented here are hyperventilation and alkalosis, auto-PEEP, delayed drug action, hypothermia, intoxication, metabolic disorders (hyperkalemia), and unobserved minimal vital signs. To avoid Lazarus Syndrome, it is recommended that the patient be monitored for 10 min after discontinuing CPR. Knowledge about this phenomenon should be disseminated in the medical community in order to improve the reporting of such cases. The probability of autoresuscitation among older people is possible.


Following disasters, a timely and reliable estimation of public demand—the number of individuals having demand—is essential for allocating relief resources properly. However, such an estimation is challenging as public demand varies significantly in dynamic disasters. To address the challenge, this research estimates public demand through proposing a data-driven approach that integrates social media and community demographics. In detail, social media is used to derive the percentage of a population having demand, and demographics are applied to normalize population differences amongst races/ethnicities. The proposed approach is capable of (1) eliminating the social media bias caused by racial disparities on social media platforms, and (2) modeling the uncertainty of social media-derived demand percentage. Hurricane Irma-induced food demand in Florida is studied to prove the feasibility of the proposed data-driven approach. In addition, the research sheds light on the use of partial information for deriving insights for the entire population.


This study examined the effects of training five parents to use Milieu Teaching procedures with their preschool-aged children with disabilities. In a multiple baseline design across families, parents were trained in two conditions: group instruction with home feedback sessions and intensive home feedback sessions. Parents were trained to use seven environmental arrangement strategies and four Milieu Teaching procedures to facilitate their children's acquisition of specific communication targets during eight sessions of group training. The results of the study showed modest levels of performance of the language teaching procedures during the group instruction condition although parents did not reach criterion performance levels during the condition. Intensive feedback and coaching was then implemented in the home which resulted in criterion level performance by most parents and in acquisition of the target skills by the children. These results suggest that parents can learn some basic Milieu Teaching skills in a short-term group instruction format, but intensive practice of these skills will be required before parents reach criterion levels of performance. Also, longer term implementation of the Milieu procedures was required before systematic changes in child learning of targets were observed for most children. Factors contributing to variability in parent and child performance are discussed.


The floppy microcantilever usually exhibits a low quality factor in free air space, because of air damping. Here, the authors present an approach to enhance the quality factor through adding a mass at the free end of the microcantilever. The mass loading effect is theoretically investigated and experimentally validated. Based on the theory, the quality factor of the mass-loaded microcantilever is proportional to (mcan+Δm)1/2, where mcan is the effective mass of the microcantilever and Δm is the added concentrated mass. In the experiments, the silicone grease is added as the mass on a 465×10×0.85 µm3 microcantilever by a micropositioner. Typically, the quality factor is demonstrated increasing from 7.25 to 19.07, when the added mass is 22.82 ng. The mass loading size effect on the quality factor in the experiments has also been discussed. The discipline investigated here is meaningful for the contour design of the microcantilever used in air.


Inefficiency and nonserviceability of the electromechanical disintegrators developed by means of a chromosomal-genetic theory is justified. Conclusions are made about futility of the chromosomal-genetic theory in electromechanical science.


Although Marketing and Science & Technology Management share a common set of themes, there are still few academic exchanges between those areas. This paper discusses some concepts shared by Marketing and Science and Technology, and search to stress that their research agenda is similar or complimentary, no matter they follow different tracks. The study is based upon the literature review about three themes that reveal the greatest potential for integration: innovation, organizational learning and capabilities. The paper concludes that the meaning of the three themes and the problems they aim to discuss are the same in both disciplines. Nevertheless, rarely they gather mutual contributions. A closer approximation could consolidate more consistent theories for the analysis of the problems related to organizational competition through market relationship, hence supporting the creation of practical management models.


In this thesis we have examined the spatial and temporal aspects of gene expression and the position induced differences in transgene expression between individual transformants. For this purpose we imaged luciferase ( luc ) gene expression driven by three different promoters that are active throughout a leaf tissue of transgenic petunia plants. The Cauliflower Mosaic Virus (CaMV) 35S promoter, a modified CaMV 35S promoter (m35S) and an Arabidopsis thaliana lipid transfer protein (LTP) were studied. We observed differences in in planta luciferase activity between individual transformants, but also between leaves within a plant and within a single leaf. The luciferase activity within a leaf of a single transformant could differ up to a factor 300. Moreover, the way in which in planta luciferase activity varies within a plant is different in independent transformants expressing the same transgene. The local differences in inplanta luciferase activity cannot be attributed to possible artefacts of the reporter system. Local limitations of luciferin, ATP or oxygen, which are all required for the luciferase reaction, might contribute to these artefacts. Pre-spraying the plants three to five times with luciferin is sufficient to obtain a steady state light production in "undisturbed" luciferase reporter plants, similar to feeding luciferin through the vascular system. We calculated that the ATP consumed by the luciferase reaction in planta is very small compared to the ATP steady state levels within leaf cells, while the cellular ATP concentration is far above the Km of luciferase for ATP. Furthermore, it was shown that oxygen levels could not be limited physiologically, resulting in changes in the local differences in luciferase activity within a leaf. We showed that the in planta activity of accumulated luciferase is rapidly declining after the first application of luciferin, indicating that in planta either no or very little regeneration of luciferase (activity) occurs due to a possible co-reaction with CoA. We also showed that the half-life of the luciferase protein itself is 2.5 hours in planta and that the half life of the active luciferase protein in the presence of luciferin is only 15 minutes or less. We thus conclude that, under the condition of repeated pre-treatment with luciferin, the in planta luciferase activity is closely related to on-going promoter and translational activity. The differences in luciferase activity that we observed within a plant thus truly reflect differences in luciferase gene expression. We thoroughly characterised the spatial differences of luciferase gene expression within a leaf and show that the variegated luciferase activity within a leaf may also vary from day to day. Both the type of spatial expression pattern and the type of temporal expression pattern differed between independent transformants with the same promoter-luciferase construct. This indicates that these differences are related to the different sites of integration in independent transformants. Analysis of local luciferase mRNA levels showed a good correlation with local in planta luciferase activity, indicating that in planta luciferase activity is directly related to luciferase transgene expression. The influence of matrix-associated-regions (MAR elements) on reducing the position induced variation was already known from literature. In plants it had been shown that MAR elements can reduce the variation in activity of the stable s-glucuronidase (GUS) in a population of independent transformants. The luciferase reporter gene allowed a much more precise study of the effect of MAR elements, especially on the spatial and temporal aspects of transgene expression. We analysed the effect of MAR elements on position induced differences in luciferase transgene expression. We noted no change in the level of variegation within leaves, in a population of transformants with a luciferase reporter gene flanked by MAR elements compared to a population of transformants with a luciferase reporter gene not flanked by MAR elements. Also, the presence of MAR elements did not seem to result in a reduction in the variation of in planta luciferase activity within this plant population. The effect of MAR elements on in planta luciferase activity is thus different from that on GUS activity. We concluded that MAR elements probably reduce the position effect of stable gene products by reducing the long-term temporal variation of gene expression. This effect is not visible when real-time reporter genes like luciferase are used. The complicated relation between gene product stability, a reduction in temporal regulation in gene expression by MAR elements, and the potential effects on reducing variation in gene expression were discussed using a model. Analysis of the model system shows that indeed some changes in gene regulation would affect the variance in stable transgene expression with no effect on the variance in unstable transgene expression. Apart from the differences in day-to-day temporal variations in luciferase activity between independent transformants, the variation in short-term temporal regulation of luciferase activity was also investigated. We investigated whether and how the position effect influences the changes in transgene expression in response to wounding. Each of the three promoters that were tested (35S, m35S and LTP) showed a different response to wounding. Although the overall response per promoter type was characteristic, there were also differences in wound response dynamics between independent transformants, carrying the same luciferase construct. This indicated that also the short-term dynamics in transgene expression, like that during the wound response, is affected by the site of integration of the transgene. As it was known from literature that ethylene and jasmonic acid play a role in the wound response, we investigated the effects of inhibition of ethylene synthesis, blocking of ethylene receptors, addition of ethylene, or addition of jasmonic acid on the wound response. None of these treatments showed a consistent and dramatic effect on the wound response. The central question now is: What is the origin of the variegated expression patterns that were observed with in planta activity of luciferase reporter genes? We showed that MAR elements did not reduce the level of variegation of 35S-luciferase activity in leaves, indicating that the variegated luciferase activity is not influenced by the chromosomal organisation of transgene DNA in defined loops of transcriptional activity. The question remained whether the spatial and temporal variation of transgene expression, as shown throughout this thesis, are specific for just the luciferase transgene, or also apply to some endogenous plant genes. We speculated on the possible causes for variegated transgene activity: cell-to-cell differences in chromatin structure, local differences in the level of transcription factor activity or in sensitivity to transcription factors. We showed that the expression of some endogenous plant genes is also variegated in leaves, albeit this variegated activity was different from or opposite to the luciferase expression. As endogenous gene expression does show signs of variegated activity it is not likely that variegated transgene activity is caused by local differences in transgene accessibility for transcription factors and that this is specific for the transgene only. One might further hypothesise, assuming that hormones can influence the level of transcription factor activity, that local differences within a leaf in level or in sensitivity to hormones can result in variegated patterns of gene expression. However, equalising hormone signalling, either by blocking of ethylene receptors, or exogenous application of ethylene or jasmonic acid, had no dramatic effect on either the 35S-LUC, m35S-LUC or LTP-LUC activity in leaves. These hormone treatments neither resulted in a reduction in the level of variegated in planta luciferase activity, indicating that at least these hormones are not (solely) responsible for the observed variegated patterns. The results presented in this thesis show that the luciferase reporter gene allows a much broader analysis of the position induced differences in gene expression than previously shown with more stable reporter genes, like GUS. The results also show that gene expression in a tissue or in a whole plant is more complex than we anticipated, i.e. there are very complex patterns in local promoter activity, both in space and in time.


Objective To examine the effects of a compound Chinese medicine of SanYeXiangChaCai (Rabdosia ternifold, Prismatomeris tetrandra, Panaxpseudo-ginseng) on the treatment of hepatic fibrosis, and to explore its mechanisms in rat model. Methods The rat model of carbon tetrachloride (CCl4)-induced hepatic fibrosis was used to assess the effect of h SanYeXiangChaCai on the treatment offibrosis. Hepatic fibrosis was evaluated by hematoxylin-eosin staining and Masson's trichrome staining. Hepatic hydroxyproline and serum ALT/AST were examined by biochemistry. The expression of α-SMA in liver tissue was examined by immunohistochemistry. The expression of TGF-β1 and CTGF was assessed by RT-PCR and Western blot analyses. Results Histological and hepatic hydroxyproline examination revealed that SanYeXiangChaCai significantly arrested progression of hepatic fibrosis. SanYeXiangChaCai caused significant amelioration of liver injury (reduced activities of serum ALT and AST) and decreased α-SMA expression. Furthermore, SanYeXiangChaCai markedly reduced both mRNA and protein expression of TGF-β1 as well as CTGF. Conclusions These results suggest that SanYeXiangChaCai ameliorates carbon tetrachloride-induced hepatic fibrogenesis in rats via inhibition of TGF-β1 and CTGF expression.


The aim of this study was to evaluate the effects of Codium Fragile(CF) extract on the collagen content and collagen cross-link content of the connective tissues, alkaline phosphatase activity and calcium levels of serum in ovariectomized estrogen-deficient rats. Three groups were surgically ovariectomized. The fourth group was sham operated. Sprague-Dawley female rats were randomly assigned to the following groups : sham-oper-ated rats(Sham), ovariectomized control rats (OVX-CON), ovariectomized rats supplemented with CF at 50 mg/kg body wt and 200 mg/kg body wt, respectively The CF were orally administrated at 1mLa day. The ovariectomy caused a decreasing in collagen content in bone, cartilage, skin and lung tissues. However CF groups, supplementation with Codium Fragile extract, increased in collagen contentin bone and cartilage tissues than OVX-CON group. Fyridinoline content in cartilage collagen was de-creased by ovariectomy but supplementation with the CF extracts was similarly increased to Sham. Alkaline phosphatase activity on serum of CF groups decreased than OVX-CON group. These results suggest that CF supplementation prevents post-menopausal bone loss, thus it may be used possibly to improve the quality of life in menopausal women.


Z. Chair and P.R. Varshney (1986) solved the data fusion problem for fixed binary local detectors with statistically independent decisions. Their solution is generalized by using the Bahadur-Lazarsfeld expansion of probability density functions. The optimal data fusion rule is developed for correlation local binary decisions, in terms of the conditional correlation coefficients of all orders. It is shown that when all these coefficients are zero, the rule coincides with the original Chair-Varshney design. >


Multicellular tumour spheroids (MCTS), the best-described three-dimensional tumour model, offers an excellent in vitro screening system, which to a great extent mimics the microenvironment prevailing in the tumour tissue, supporting studies on such tumour specific processes such as angiogenesis, invasion and metastasis and the assessment of responses to various therapies as well as their underlying mechanisms. Developed as an alternative in vitro model to monolayer cultures, nearly 30 years ago, their role as part of high-throughput cell-based assay system in drug discovery is gaining considerable importance. The distinct possibility of establishing MCTS from primary tumour cells and co-culturing with different normal cells, namely stromal fibroblasts, endothelial cells and cells of hemopoietic as well as immune system lineage, enhance the value of MCTS in cancer research and drug development. Here, the authors present a brief overview on the present status on the application of multicellular spheroids in experimental oncology, particularly from the view point of cancer therapy and drug development.


Deep convolutional networks have demonstrated the state-of-the-art performance on various medical image computing tasks. Leveraging images from different modalities for the same analysis task holds clinical benefits. However, the generalization capability of deep models on test data with different distributions remain as a major challenge. In this paper, we propose the PnPAdaNet (plug-and-play adversarial domain adaptation network) for adapting segmentation networks between different modalities of medical images, e.g., MRI and CT. We propose to tackle the significant domain shift by aligning the feature spaces of source and target domains in an unsupervised manner. Specifically, a domain adaptation module flexibly replaces the early encoder layers of the source network, and the higher layers are shared between domains. With adversarial learning, we build two discriminators whose inputs are respectively multi-level features and predicted segmentation masks. We have validated our domain adaptation method on cardiac structure segmentation in unpaired MRI and CT. The experimental results with comprehensive ablation studies demonstrate the excellent efficacy of our proposed PnP-AdaNet. Moreover, we introduce a novel benchmark on the cardiac dataset for the task of unsupervised cross-modality domain adaptation. We will make our code and database publicly available, aiming to promote future studies on this challenging yet important research topic in medical imaging.


Garnet growth in the early stage of the trachybasalt-eclogite transformation was observed at 2.0 GPa and temperatures of 860°C, 940°C and 1020°C for annealing times of 0.66-13.6 h. The grain size was determined optically to be increased with increasing annealing time. The growth rate decreased with increasing grain size. The garnet growth law was G2.46 = 5.65×10-15texp [-27.40×103/RT], where G represents the average grain size after annealing time t, R is the gas constant and T is the absolute temperature.


This paper aims to characterise and profile subsistence cattle farmers according to selected attributes to establish their influence on the type of cattle breed kept by farmers in Botswana. The development of communal cattle production can be a sustainable way to improve the livelihoods of the rural population in Botswana. However, there needs to be more information or research conducted to characterise and profile communal cattle farmers with a precondition that the farmers can keep any of the three breeds (Tswana, Cross, or Exotic). A logistic regression model was fitted to determine the influence of 11 predictor variables on the type of cattle breed kept by the farmers. Results revealed that female-headed households were 50% more likely to have the Tswana breed of cattle than male-headed households. In contrast, female-headed households were 30% less likely to have cross-breed or exotic-breed cattle than male-headed households. Results further show that resource-poor farmers tend to keep Tswana breed cattle. These are holdings with no farm labour, no other economic activities, female-headed households, and their primary source of income specified as "other".


The herpes simplex virus type 1 encoded ICP8 protein binds single-stranded (ss) DNA and is required for DNA replication in vitro. We have used electron microscopy to examine the ability of ICP8 to promote homologous pairing and strand transfer reactions. Visualization of M13 ssDNA-ICP8 complexes showed that they preferentially bound and enveloped homologous double-stranded (ds) DNA fragments; their deproteinization released ssDNA circles containing dsDNA segments, and an equal number of linear single strands. Optimal transfer required Mg2+ but not nucleoside triphosphates, and showed a fourfold preference for dsDNA fragments with a few bases recessed ends. Gel electrophoretic analysis confirmed the strand transfer activity of ICP8.


Rain attenuation data at 19.5 GHz, obtained in a Japanese satellite wave propagation experiment at a measuring rate of 1 sample per second, are analysed. Short term duration statistics of attenuation and statistics of attenuation occurring in available periods, defined in CCITT are derived. In deriving the attenuation statistics during available periods, the total period is divided into periods of available and unavailable times, for several attenuation threshold levels in accordance with the CCITT definition. >


The exploration of erasure coding has explored consistent hashing, and current trends suggest that the exploration of 802.11 mesh networks will soon emerge. In our research, we prove the refinement of information retrieval systems, demonstrates the essential importance of Bayesian distributed systems. We present a mobile tool for investigating I/O automata, which we call Optime.


Abstract Background Four-dimensional flow magnetic resonance imaging (4D flow MRI) provides volumetric and time-resolved visualization and quantification of blood flow. This review presents an overview of possible applications of 4D flow MRI for non-invasive assessment of abdominal hemodynamics. Method This review is based on the authors' experience and the current literature. A PubMed database literature research was performed in December 2019 focusing on abdominal applications of 4D flow MRI. We illustrated the review with exemplary figures and movies of clinical cases from our institution. Results and Conclusion 4D flow MRI offers the possibility of comprehensive assessment of abdominal blood flows in different vascular territories and organ systems. Results of recent studies indicate that 4D flow MRI improves understanding of altered hemodynamics in patients with abdominal disease and may be useful for monitoring therapeutic response. Future studies with larger cohorts aiming to integrate 4D flow MRI in the clinical routine setting are needed. Key Points:  4D flow MRI enables comprehensive visualization of the complex abdominal vasculature 4D flow MRI enables quantification of abdominal blood flow velocities and flow rates 4D flow MRI may enable deeper understanding of altered hemodynamics in abdominal disease Further validation studies are needed prior to broad distribution of abdominal 4D flow MRI Citation Format Riedel C, Lenz A, Fischer L et al. Abdominal Applications of 4D Flow MRI. Fortschr Röntgenstr 2021; 193: 388 – 398


When preschoolers listen to storybooks, are their eye movements related to their vocabulary acquisition in this context? This study addressed this question with 36 four-year-old French-speaking participants by assessing their general receptive vocabulary knowledge and knowledge of low-frequency words in 3 storybooks. These books were read verbatim to them 7 times over a 2-week interval. At the first and seventh reading, children's eye movements were tracked. Results revealed considerable stability in eye movements, with children spending the vast majority of their viewing time on the illustrations at both time points. Children made modest vocabulary gains on the words in the books, and as expected, these gains were related to their general receptive vocabulary. Most importantly, viewing time during the first reading on depictions of corresponding nouns in the story partially mediated the advantage that overall receptive vocabulary held. As such, this study points to active matching of picture with text during shared book reading and children's processing style when listening to stories as a mechanism for vocabulary acquisition.


A composite membrane of the polymer, chitosan, and the silver-exchanged mineral phase, tobermorite, was prepared by solvent casting and characterised by scanning electron microscopy and Fourier transform infrared spectroscopy. The in vitro bioactivity, cytocompatibility and antimicrobial activity of the composite were evaluated with respect to its potential application as a guided tissue regeneration (GTR) membrane. The in vitro bioactivity was verified by the formation of hydroxyapatite on the surface of the membrane in simulated body fluid and its cytocompatibility was established using MG63 human osteosarcoma cells. The presence of silver ions conferred significant antimicrobial activity against S. aureus, P. aeruginosa and E. coli. The findings of this investigation have indicated that the chitosan-silver-tobermorite composite is a prospective candidate for GTR applications.


Urbanization creates impervious surfaces which reduce natural hydrologic functions and result in channel erosion, loss of property and habitat degradation. Sustainable design and management adopts a more holistic approach to conventional methods. Various techniques for sustainable management are Low Impact Development (LID), Water Sensitive Urban Design (WSUD) and Low Impact Urban Design and Development (LIUDD). Regardless of terminology, the introduction of such concepts to Aotearoa New Zealand reflects a paradigm shift from conventional stormwater management techniques to a more sustainable design philosophy. This paper proposes that the imported concepts of sustainable design run parallel to indigenous values when applied in the Aotearoa New Zealand context. Mātauranga Māori is the indigenous knowledge of the Māori people of Aotearoa. Examples are presented to discuss the parallels between current sustainable design techniques and the contribution of mātauranga Māori through indigenous values.


Modal Analysis is an experimental technique widely used to determine the dynamic response of structures. One of the most critical part is the selection of the actuator that will excite the tested structure. In many cases, traditional exciters, such as hammers and shakers, have been used for this purpose. Nevertheless, these exciters may have the disadvantage of modifying the modal parameters (as reported in some cases) and they are difficult to be used when the structure is not accessible (confined and/or submerged). For these cases PZT-patches, that are very light structures (compared to the tested structure), have been recently used as exciters. Although, in the analyzed studies the natural frequencies of the structure have been determined using PZTs, the rest of parameters that determine the FRF (Frequency response Function) have been not obtained. This could be, because the calibration of PZTs as dynamic force transducers is a complicated task and not an information given by the manufacturers, as in other exciters used for the same purpose. This paper analyzes experimentally and analytically the use of PZT-patches as exciters for modal analysis. For this purpose, a tested structure is excited in different ways with a PZT and its response is compared with a reference case, obtained with a classical exciter. Analyses show how to obtain different modal parameters that determine the FRF of the structure, without previous calibration of the PZT. Finally, and in order to show the potential advantages of these exciters for inaccessible structures, the procedure is repeated for the same structure submerged in water, showing that PZT are much more appropriated exciters in these cases.


INTRODUCTION
Smoking is a stroke risk factor but the most efficient way to promote cessation is unknown. The smoking behavior in patients during the first 2 years post-stroke is studied comparing brief advice and intensive behavioral counseling interventions, taking into consideration biological, psychological, and social factors.

METHODS
Randomized clinical trial of 196 stroke patients, stratified by the presence or not of an insular cortex lesion, with two levels of smoking cessation intervention.

RESULTS
The study retention rate was 85.2%. Abstinence point prevalence at three months after stroke was 50% in the brief advice group and 51.7% in the intensive behavioral counseling group (p =.82) and at 24 months, 48.3% in the brief group and 47.5% in the intensive group (p =.92). Most relapses occurred in the first weeks. After 3 months the curves separated with fewer events in the intensive group and at 24 months the Hazard Ratio was 0.91 (95% CI = 0.61 to 1.37; p =.67).Twenty-four months after stroke, patients with an insular lesion were more likely to be abstinent (OR 3.60, 95% CI = 1.27 to 10.14), as were those who lived with a partner (OR 2.31, 95% CI = 1.17 to 4.55) and those who were less dependent (OR 0.84, 95% CI = 0.73 to 0.97).

CONCLUSIONS
A high percentage of patients gave up smoking in both intervention groups with no significant differences between the two. The effect of the insular lesion on smoking cessation, which is early and continued after two years, is particularly notable.


The essential oil composition of Feronia elephantum Correa (family: Rutaceae) was examined by capillary gas chromatography (GC) and gas chromatography–mass spectroscopy (GC–MS). The analysis revealed the presence of 24 constituents, of which 18 constituents were identified. Trans-anethole (57.73%) and methyl chavicol (37.48%) were the major compounds, while cis-anethole, p-anisaldehyde, (E)-jasmone, methyl eugenol, β-caryophyllene, linalool and (E)-methyl isoeugenol were also present as the minor constituents.


This study explored the impact of the use of prepaid meters on revenue generation of
ZETDC. Quantitative research methods were employed in the study and a random sample
of 108 managers was selected from a population of 120 managers at ZETDC.
Questionnaires were the main instrument of data collection.
It was established in the study that overally the introduction of prepaid electricity meters
aided revenue generation at ZETDC. The prepaid metering system was said to be more
beneficial to the consumer than being of a disadvantage. Major benefits established were
that ZETDC was forced improve consumer welfare as revenue generation depended more
on the consumer's consumption of electricity since there were no more estimates,
increased consumer control over usage, imposed discipline over consumer budgets,
increased consumers' awareness of their energy consumption and easy management of
electricity use and payments. Major benefits to ZETDC included reduced overheads, a
reduction in the cost of importing electricity, improved revenue generation, easy
management of electricity debts and improved servicing of debts by customers.
ZETDC is recommended to reduce its workforce in line with the introduction of
technology. This should start from the metering personnel most of whom are becoming
redundant due to the new technology. This is mainly because the researcher noted in the
study that ZETDC's wage bill was not reduced even after the introduction of the prepaid
system since the company had not implemented any wage bill cutting measures. This
would further reduce overheads and improve the financial position of the company.
The researcher proposes that a further study be conducted to evaluate the prepaid billing
system from a customer's point of view. This would help in identifying the shortfalls of
the system in order to rectify any such challenges.


This paper addresses the use of VR to facilitate design tasks in the early stages of a product design process. A preliminary exploratory study, involving over thirty interviews amongst four industrial partners, revealed only few occurrences of VR being used in the early stages of design. While the potential benefits of the applications are generally acknowledged, product designers lack the appropriate design tools that allow them to quickly and easily create the application. The research presented in this paper applies user-centred design principles to identify requirements for useful, usable and accessible VR design tools. The primary challenge in gathering such requirements is the lack of experience product designers generally have with VR technologies; product designers can not provide reliable requirements for tools they have never seen or used. We present a sequence of three concrete steps that provide product designers with sufficient information to express tool requirements, without developing extensive prototypes. The three methods have been developed and applied in an industrial case study, as part of a larger research project. The paper outlines this research context, the three methods and the lessons learned from the case study.


By spraying the GFP-marked endophytic bacterial strains BS-2-gfp and TB2-gfp, this paper studied their colonization in lychee organs and the functions of the strains in disease control and fruit preservation. The BS-2-gfp and TB2-gfp could colonize and propagate in lychee leaves, flowers, un-matured fruits, and matured fruits, and transfer from the flowers to un-matured fruits. The colonization of BS-2-gfp and TB2-gfp in lychee leaves varied with season and growth stage, being larger in quantity and longer in duration in spring than in autumn. The colonization quantity and duration of the strains also differed in other organs. Both the BS-2-gfp and the TB2-gfp could be isolated and recovered from lychee leaves after 37 d inoculation, the BS-2-gfp could not be isolated from the flowers after inoculation for 10 d, and the BS-2-gfp and TB2-gfp had the largest colonization quantity in matured fruits. The colonization quantity of TB2-gfp in lychee pericarp reached to the maximum (1.90 x 10(6) CFU x g(-1) FM) when the disease index of litchi downy blight had a sharp increase, and, compared with BS-2-gfp, the TB2-gfp had better fruit preservation efficiency, and its colonization quantity in lychee pericarp was also higher. It was suggested that there was a positive correlation between the colonization quantity of test bacterial strains in lychee pericarp and the disease control and fruit preservation effect.


A judgmental sort of 798 items from 7 paper-and-pencil integrity tests produced 23 thematic composites. Patterns of correlations between these composites and the 7 integrity measures and 2 Big Five measures shed light on similarities and differences between different integrity tests. Principal components analysis of 23 composites indicated 4 principal components that further illuminate the content domain of integrity tests. The relationships between 4 integrity principal components and integrity test scores as well as measures of the Big Five dimensions of personality are reported. The findings suggest that integrity tests can differ in their emphasis on various thematic composites, and, yet, be very similar in terms of their standing on the 4 integrity principal components. Different integrity tests can be quite different in terms of surface content, and, yet, assess the same underlying constructs.


Although South Africa' financial sector is well-developed, microenterprise managers see access to finance as a serious problem. Managers of black-owned microenterprises are more likely to see it as a problem - and are less likely to use bank financing - than white-owned microenterprises. Differences in access remain statistically significant and large even after controlling for observable enterprise characteristics. Adding additional variables to control for enterprise productivity, registration, and the presence of audited accounts reduces the size and statistical significance of the difference, but does not eliminate it. This suggests that either other unobserved differences (such as, the availability of collateral) or factors such as discrimination explain part of the difference in access to credit.


The development of a new route to α-aminoboronates using an iridium-catalyzed allylic amination on boronated substrates is described. Unlike the boronate group, the trifluoroborato substituent was found to govern the regioselectivity exclusively in favor of branched products. The transformation of an allylic substitution product into an α-aminoboronic ester in an efficient way validated the implementation of this approach.


The increasing demand for electricity in South Africa has led to a rise in the deployment of solar photovoltaic systems. The integration of these systems requires the installation of power transformers to convert the generated DC power into AC power that can be fed into the grid. However, the high cost of these transformers can hinder the widespread adoption of solar PV systems. Consequently, the primary objective of this work is to introduce a novel service-lifetime loss estimation method that acknowledges the unique requirements of transformers facilitating solar photovoltaic applications. In reality, these transformers are required to facilitate a sporadic energy source, which advocates for an appropriate method to assess the cost of their service-lifetime losses and total ownership cost. Thus far, the energy elements of classical coal-power generation are inadequate, and in conformity with operational and financial considerations of solar PVs, a novel method incorporating the outcomes of a transformer facilitating a solar PV plant is proposed. The proposed approach has been benchmarked with existing methods and the distinction between proposed and existing methods is highlighted. The study further proposes various regression models for estimating the purchase price for transformers specifically intended to exclusively serve in solar PV applications, which are not available in the current South African standards. The percentage errors between the conventional method and the proposed solar PV method are relatively high, ranging from 34.66% to 44.03%. This indicates that the two methods produce significantly different results, and the proposed solar PV method may not be an accurate replacement for the conventional method.


We report a case of von-Recklinghausen's disease presenting with obstructive jaundice and found to have a somatostatin-containing carcinoid tumor in the papilla of Vater and a small neurofibroma in the duodenum. A 42-year-old woman with von-Recklinghausen's disease presented with intermittent jaundice, pruritus, and mild steatorrhea of a two-year duration. Abdominal ultrasonography and computed tomography showed dilated intrahepatic ducts, common bile duct and pancreatic ducts. Duodenoscopy showed a tumor at the papilla of Vater, but a preoperative biopsy failed to provide a definite diagnosis. Laparotomy revealed a yellowish tumor at the papilla of Vater and another nodule on the mesenteric side of the second section of the duodenum. Microscopically, the tumor at the papilla of Vater was found to be a somatostatin-containing carcinoid tumor. The small nodule on the mesenteric side was a neurofibroma. The jaundice, pruritus and steatorrhea disappeared after surgery.


Neuroimaging studies have suggested the involvement of several brain areas in attention‐deficit/hyperactivity disorder (ADHD). Genetic investigations have supported the role of both dopamine D4 receptor gene (DRD4) and dopamine transporter gene (DAT1) in the vulnerability to the disorder. This study evaluates whether the presence of risk alleles at DRD4 and/or DAT1 genes is associated with differences in regional cerebral blood flow (rCBF) in a sample of ADHD boys. The rCBF was compared between ADHD patients with and without risk alleles at DRD4 (7‐repeat allele) and/or at DAT1 (homozygosis for the 10‐repeat allele) genes by single photon emission computed tomography (SPECT) during continuous performance test. Images were analyzed using statistical parametric mapping (SPM‐99). No significant differences in rCBF were found both between ADHD boys with and without the 7‐repeat allele at DRD4 locus, as well as between ADHD boys homozygous for the 10‐repeat allele and ADHD subjects with other genotypes at the DAT1 locus. However, a significantly higher perfusion in the right middle temporal gyrus was found in the group with risk alleles at both DRD4 and DAT1 loci (n = 6) compared to ADHD boys without risk alleles at both loci (n = 28) (P < 0.05). Our findings suggest that a higher recruitment in middle temporal gyrus, an area associated to working memory and selective attention, should exist to compensate a putative effect of the interaction between these dopaminergic genes. © 2004 Wiley‐Liss, Inc.


The Priory Group (2017) suggest that eating disorders are responsible for more loss of life than any other form of psychological illness. UK Sport note that parents of young children are concerned about children taking muscle‐boosting products (including steroids) and being addicted to compulsive fitness. Social media has increased the idealised and unattainable body images which circulate on the internet, influencing both men and women. These images reinforce the internalisation of a 'perfect' body – thin for women and ripped muscular physique for men – and intensify self‐comparison to these images. Consequences include increases in eating disorders (anorexia nervosa, bulimia, orthorexia nervosa), exaggerated focus on fitness training, cosmetic surgery, damaged bodies, low self‐esteem and even death. Long term outcomes can include damaging effects particularly on growing bodies (Hill, 2003; Wells, 2015). Whilst there are numerous websites, Facebook groups, Vloggers, Bloggers, Instagrammers and other social media content that promotes unrealistic bodies, the internet can also be a place where these images are challenged.
 Support groups do exist to deepen self‐esteem that is not associated with images. Similarly, there is also social media content that highlights just how constructed and unrealistic these images are. Media literacy – being able to critique and unravel constructed images and messages – is key for young people to develop self‐esteem that does not depend on comparison to idealised body physiques.


We analyze a threshold contact process on a square lattice in which particles are created on empty sites with at least two neighboring particles and are annihilated spontaneously. We show by means of Monte Carlo simulations that the process undergoes a discontinuous phase transition at a definite value of the annihilation parameter, in accordance with the Gibbs phase rule, and that the discontinuous transition exhibits critical behavior. The simulations were performed by using boundary conditions in which the sites of the border of the lattice are permanently occupied by particles.


FADN: Buttress for Farm Policy or a Resource for Economic Analysis? We argue that the Farm Accountancy Data Network (FADN) is capable of much more than it currently achieves and that it has been greatly under-utilised for policy analysis by economic researchers. We illustrate graphically some of the wider possibilities offered by FADN beyond its traditional role as a buttress for farm policy Farm incomes differ enormously between farms and differences within a member state are often more important than differences between member states. The dataset allows us to make differences explicit. It is possible to analyse the composition of farm incomes, for example the significance of subsidies amongst different farm types and farming systems. Some national FADN datasets also permit classification of farm households according to the relative importance of farm and non-farm incomes and allow us to examine the impact of income composition on, for example, investment behaviour, FADN data can be used for ex-ante as well as ex-post policy evaluations and we illustrate with an example of the impact of different models for implementing the Single Farm Payment in Germany. We believe that certain enhancements to the dataset are possible to improve further its potential for research support, for example by including more non-agricultural income sources in the European FADN.


The study aims to assess the cytotoxic activity of the methanolic extract (CME) and various fractions from the bark of Dillenia indica L (Family: Dilleniaceae) using brine shrimp lethality bioassay and sedative activities using hole cross, open field, and elevated-plus maze (EPM) test in Swiss albino mice. In brine shrimp assay, the LC50 for CME, pet-ether (PETF), chloroform (CHF) and aqueous (AQF) fraction were found to be 110, 24.55, 85 and 14.45 μg/ml, respectively, indicating significant cytotoxicity of PETF and AQF when compared to the standard vincristine sulfate (7.5 μg/ml). In open field test, the number of movements per min (after 120 min) was 40.90, 12.43, 5.45, 3.66, and 29.74 for control, standard diazepam, CME, CHF and AQF, respectively, indicating strong activity of the chloroform soluble fraction compared to the other test samples of D. indica. Similar data was observed in hole cross test where the number of movements per minute after 120 min were 3.60, 5.56, 4.77, and 7.99 for the standard, CME, CHF and AQF, respectively. In EPM test, the CME showed a significant decreased percentage of entries of mice into the open arms of EPM as well as the percentage of time spent in the open arms. The result indicates that the CHF significantly suppressed the locomotor activity than that of methanol and aqueous fractions. These findings will be helpful for bioassay-guided isolation of active principles responsible for cytotoxicity and sedative activities.
Bangladesh Pharmaceutical Journal 24(2): 105-110, 2021


The goal of this study is the discovery of biomarkers reflecting the pharmacodynamic action of sulforaphane (SFN), initially using normal human mammary epithelial MCF10A cells and then in tissue obtained from healthy patients undergoing reduction mammoplasty. The isothiocyanate SFN is formed by the hydrolysis of glucoraphanin, a water soluble glucosinolate found in cruciferous vegetables with especially high levels measured in 3 day old broccoli sprouts. Chemoprevention by SFN is achieved in part through the upregulation of cytoprotective enzymes via the Keap1/Nrf2 pathway. Preliminary dose response and time course studies in MCF10A cells established that SFN upregulated cytoprotective enzymes as indicated by increased levels of NQO1 transcripts, protein and activity. NQO1 induction was dependent on the Keap1/Nrf2 pathway since NQO1 transcripts, protein and activity were enhanced by KEAP1 siRNA knockdown in MCF10As. For the biomarker discovery phase SFN treated and KEAP1 knockdown MCF10A cells were analyzed by microarray to determine transcriptomic changes in response to pharmacological and genetic stimulation of the Keap1/Nrf2 pathway. The two experimental approaches were analyzed independently and then compared. The predominant class of upregulated genes common to both SFN treatment and KEAP1 knockdown were xenobiotic metabolism and antioxidant genes including NQO1, heme oxygenase (decycling) 1, sequestosome 1, thioredoxin reductase 1 and peroxiredoxin 1. The most highly upregulated genes in this class were the aldo-keto reductase family members including AKR1B1, AKR1B10, AKR1C1 and AKR1C3. Other classes of genes with overlapping regulation were glutathione metabolism genes such as GCLC and GCLM, molecular transport, cell growth and cell death regulation genes. Some members of the xenobiotic metabolism, molecular transport, cell growth and cell death regulation classes of genes were also regulated exclusively by SFN. Additionally histone cluster and chromatin remodeling genes were downregulated by SFN. Potential biomarker genes from the microarray study include NQO1, GCLC, SQSTM1 and AKR1C1. An accompanying proteomic study for biomarker discovery using Stable Isotopic Labeling with Amino Acids in Cell Culture (SILAC) is underway. The transcriptomic and proteomic changes in response to SFN treatment and KEAP1 knockdown will be compared to determine if the changes seen on the transcriptomic level are translated to the proteomic level. Candidate biomarkers identified from microarray and SILAC studies reflecting the pharmacodynamic action of SFN in human cells will be analyzed by Western blot, qRT-PCR and enzyme assays in tissue from reduction mammoplasty patients. These women have been randomized in a clinical trial to receive either a broccoli sprout preparation containing 100 micromole SFN or a placebo beverage daily for 10 days prior to surgery. Supported by DOD grant BC073262 and NIH grants P50 CA088843 and U54 RR020839. Citation Information: Cancer Prev Res 2010;3(12 Suppl):A47.


In this paper, we propose a high speed built-in self-test (BIST) design which can support the at-speed testing for DDR or DDR2 SDRAM. We use the pipeline strategy together with several special design techniques to achieve the high speed requirement. A scheme is developed which can efficiently solve the problem of different execution cycles of DDR or DDR2 SDRAM's commands and can generate a compact test sequence for the desired March algorithm(s). Our BIST can support single or multiple March algorithms. With the single algorithm design extremely high speed around 833 MHz is achieved using the TSMC 0.18/spl mu/m technology. For the multiple-algorithms design, our design can still satisfy the speed requirement of DDR2 memory even with the 3 most complex March algorithms. Our experiment also shows that if only DDR memory testing is required, then more than 30 March algorithms can be integrated into our BIST design.


A set of online feedback tools has been developed in the learning portal that supports an ICT-based Chinese Language teaching and learning programme implemented in some Singapore schools. The tools are an integral part of an ICT-based peer assisted learning environment that contributes to pupils' self-directed learning and formative assessment processes. This paper discusses the design principles, affordances and functionalities of the feedback tools. In particular, there is a tool that allows pupils to provide suggested edits to their peers' online written work. The decision to accept or reject the suggestions lies with the young authors themselves, thereby cultivating them to be responsible and reflective learners who constantly seek to improve the quality of work. Other avenues of feedback in the environment include facilities that allow pupils to post their comments and rate the written work of their peers.


Background and aims The shoulder joint is one of the pivotal joints for day to day activity. Chronic shoulder pain is a major musculoskeletal pain problem affecting significant functional disability and incidence is as high as 67%. Currently the main treatment modalities are oral analgesics, physiotherapy, intra articular steroid injection and suprascapular nerve block. These modalities offer only partial or no pain relief. the author has developed a new treatment modality- ultrasound guided superior trunk percutaneous neuromodulation and block for chronic shoulder pain management. Methods After local research and development departmental approval a retrospective data collection who had the procedure was done Retrospective– 55 patients from mid–2016 until end of 2017. Data obtained from 49. Age, sex, laterality, original pathology, pre procedure NRS, post procedure NRS at 6–8 weeks, patient reported outcome of functionality and QoL improvement, details of physiotherapy sessions and it's outcome were recorded. Results Average pre procedure pain score was – 9/10 and post procedure pain score was –3.3/10. Average 63% reduction or 5 points in the NRS reduction 80% reported Quality of life and functional improvement. Majority of patients had Osteoarthritis and rotator cuff pathology. Second most common cause was persistent post surgical pain. Conclusions Ultrasound guided STBPB provided average 63% improvement in NRS scoring and 80% improvement in functionality and QoL across the board.


Elevated remnant cholesterol is associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD). We aimed to evaluate the concentrations and general distribution of remnant cholesterol at admission in patients hospitalized for acute coronary syndrome (ACS), and those in patients who reached the low-density lipoprotein cholesterol (LDL-C) target or non-high-density lipoprotein cholesterol (non-HDL-C) target. Patients with ACS who were enrolled in the Improving Care for Cardiovascular Disease in China—ACS project from 2014 to 2019 were included. Elevated remnant cholesterol concentrations were defined as ≥1.0 mmol/L. Among 94,869 patients, the median (interquartile range) remnant cholesterol concentration at admission was 0.6 mmol/L (0.4–0.9 mmol/L) and 19.2% had elevated remnant cholesterol concentrations. Among patients with LDL-C concentrations < 1.4 mmol/L, 24.4% had elevated remnant cholesterol concentrations, while the proportion was 13.3% among patients with LDL-C concentrations between 1.4 and 1.7 mmol/L. Among patients with non-HDL-C concentrations < 2.6 mmol/L, 2.9% had elevated remnant cholesterol concentrations but 79.6% had LDL-C concentrations ≥ 1.4 mmol/L. Even among patients with LDL-C < 1.4 mmol/L and non-HDL-C < 2.6 mmol/L, 10.9% had elevated remnant cholesterol. In conclusion, one fifth of patients with ACS have elevated remnant cholesterol concentrations at admission. Elevated remnant cholesterol concentrations are present in patients with LDL-C or/and non-HDL-C concentrations within the target, which represents an unmet need to add remnant cholesterol as a target for the secondary prevention of ASCVD.