Upadacitinib (UPA) is an oral, reversible, selective JAK 1 inhibitor approved for the treatment of moderate to severe rheumatoid arthritis (RA). The efficacy/safety of UPA has been demonstrated in phase 3 studies, including superiority to adalimumab in patients (pts) with prior inadequate response (IR) to methotrexate.1-4To assess the efficacy/safety of UPA vs abatacept (ABA) in pts with prior IR or intolerance to biologic DMARDs (bDMARDs).Pts were randomized to once daily UPA 15 mg or intravenous ABA (at Day 1, Weeks [Wks] 2, 4, 8, 12, 16 and 20 [< 60 kg: 500 mg; 60-100 kg: 750 mg; >100 kg: 1,000 mg]), with all pts continuing background stable csDMARDs. The study was double-blind for 24 wks. Starting at Wk 12, pts who did not achieve ≥20% improvement from baseline (BL) in both tender and swollen joint counts at two consecutive visits, had background medication(s) adjusted or initiated. The primary endpoint was change from BL in DAS28(CRP) at Wk 12 (non-inferiority). The non-inferiority of UPA vs ABA was tested using the 95% CI of treatment difference against a non-inferiority margin of 0.6. The two key secondary endpoints at Wk 12 were change from BL in DAS28(CRP) and the proportion of pts achieving clinical remission (CR) based on DAS28(CRP), defined as DAS28(CRP) <2.6. Both endpoints were to demonstrate the superiority of UPA vs. ABA. Treatment-emergent adverse events (TEAEs) are reported up to Wk 24 for all pts who received at least one dose of study drug.Of 612 pts treated; 67% of pts had received 1 prior bDMARD, 22% received 2 prior bDMARDs, and 10% received ≥ 3 prior bDMARDs. 549 (90%) completed 24 wks of treatment. Common reasons for study drug discontinuation were AEs (UPA, 3.6%; ABA, 2.6%) and withdrawal of consent (UPA, 1.7%; ABA, 2.6%).Non-inferiority and superiority were met for UPA vs ABA at Wk 12 for change from BL in DAS28(CRP) (-2.52 vs -2.00; -0.52 [-0.69, -0.35]; p <0.001 for UPA vs ABA). UPA also demonstrated superiority to ABA in achieving DAS28(CRP) <2.6 (30.0% vs 13.3%; p <0.001 for UPA vs ABA; Figure 1). Improvements in disease activity and remission rates were maintained through Wk 24. The proportions of pts achieving low disease activity (defined as DAS28(CRP) ≤3.2), ACR20, ACR50, and ACR70 responses were greater with UPA compared with ABA at Wk 12 (nominal p <0.05). More stringent outcome measures – CR, ACR50, and ACR70 responses - remained higher with UPA than ABA through Wk 24 (nominal p <0.05). Incidence of serious TEAEs, AEs leading to discontinuation, hepatic disorders, and CPK elevations were numerically higher with UPA versus ABA (Figure 2). Eight cases of herpes zoster were reported (4 in each treatment arm). No malignancies were reported. One case of adjudicated MACE, two adjudicated cases of VTE (1 pt with DVT and 1 pt with PE; both pts had at least one risk factor for VTE), and one treatment-emergent death were reported with UPA.In RA pts with a prior IR or intolerance to bDMARDs, UPA demonstrated superior improvement in signs and symptoms vs ABA based on change in DAS28(CRP) and in achieving CR at Wk 12. The safety profile of UPA was consistent with the phase 3 RA studies with no new risks identified.[1]Burmester GR, et al. Lancet. 2018;391(10139):2503-12[2]Fleischmann R, et al. Arthritis Rheumatol. 2019;71(11):1788-800[3]Genovese MC, et al. Lancet. 2018;391(10139):2513-24[4]Smolen JS, et al. Lancet. 2019;393(10188):2303-11Andrea Rubbert-Roth Consultant of: Abbvie, BMS, Chugai, Pfizer, Roche, Janssen, Lilly, Sanofi, Amgen, Novartis, Jeffrey Enejosa Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Aileen Pangan Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Ricardo Xavier Consultant of: AbbVie, Pfizer, Novartis, Janssen, Eli Lilly, Roche, Boulos Haraoui Grant/research support from: Abbvie, Amgen, Pfizer, UCB, Grant/research support from: AbbVie, Amgen, BMS, Janssen, Pfizer, Roche, and UCB, Consultant of: Abbvie, Amgen, Lilly, Pfizer, Sandoz, UCB, Consultant of: AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Merck, Pfizer, Roche, and UCB, Speakers bureau: Pfizer, Speakers bureau: Amgen, BMS, Janssen, Pfizer, and UCB, Maureen Rischmueller Consultant of: Abbvie, Bristol-Meyer-Squibb, Celgene, Glaxo Smith Kline, Hospira, Janssen Cilag, MSD, Novartis, Pfizer, Roche, Sanofi, UCB, Nasser Khan Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Ying Zhang Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Naomi Martin Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Mark C. Genovese Grant/research support from: Abbvie, Eli Lilly and Company, EMD Merck Serono, Galapagos, Genentech/Roche, Gilead Sciences, Inc., GSK, Novartis, Pfizer Inc., RPharm, Sanofi Genzyme, Consultant of: Abbvie, Eli Lilly and Company, EMD Merck Serono, Genentech/Roche, Gilead Sciences, Inc., GSK, Novartis, RPharm, Sanofi Genzyme


The analysis of phyllosphere microbiomes traditionally relied on DNA extracted from whole leaves. To investigate the microbial communities on the adaxial (upper) and abaxial (lower) leaf surfaces, swabs were collected from both surfaces of two garden plants, Rhapis excelsa and Cordyline fruticosa. Samples were collected at noon and midnight and at five different locations to investigate if the phyllosphere microbial communities change with time and location. The abaxial surface of Rhapis excelsa and Cordyline fruticosa had fewer bacteria in contrast to its adaxial counterpart. This observation was consistent between noon and midnight and across five different locations. Our co-occurrence network analysis further showed that bacteria were found almost exclusively on the adaxial surface while only a small group of leaf blotch fungi thrived on the abaxial surface. There are higher densities of stomata on the abaxial surface and these openings are vulnerable ports of entry into the plant host. While one might argue about the settling of dust particles and microorganisms on the adaxial surface, we detected differences in reactive chemical activities and microstructures between the adaxial and abaxial surfaces. Our results further suggest that both plant species deploy different defence strategies to deter invading pathogens on the abaxial surface. We hypothesize that chemical and mechanical defence strategies evolved independently for harnessing and controlling phyllosphere microbiomes. Our findings have also advanced our understanding that the abaxial leaf surface is distinct from the adaxial surface and that the reduced microbial diversity is likely a consequence of plant-microbe interactions.


Smart point-of-care mobile solutions integrate with a health system's existing communications and IT infrastructure to achieve the following benefits: Unify data management and communication functions using a single device. Improve accuracy of data collection, medication administration, and blood collection through scanning and cross-matching. Facilitate data accessibility from electronic health records and clinical protocols. Enable better care-team communication while safeguarding personal health information. Increase accuracy and efficiency, thereby improving performance and satisfaction scores.


Background No study have evaluated if there is a correlation between histological pattern of temporal artery biopsy and survival in patients with biopsy-proven giant cell arteritis (GCA). Objectives To investigate the relationship between histological pattern of temporal artery biopsy and survival in patients with biopsy-proven GCA in a defined area of Northern Italy. Methods All patients with incident temporal artery biopsy-positive GCA diagnosed between 1986 and 2012 living in the Reggio Emilia area were identified using pathology register and by reviewing all histopathological specimens. Patients were followed from the time of diagnosis until either their death or until December 31st, 2013. On the basis of the localization of the inflammation, positive TABs were classified into 4 categories: transmural inflammation (TMI), (229 cases, 81.8% of the positive biopsies); inflammation limited to adventitia (ILA), (14 cases, 5% of the positive biopsies); vasa vasorum vasculitis (VVV), (13 cases, 4.6% of the positive biopsies); and small vessel vasculitis (SVV), (24 cases, 8.6% of the positive biopsies). A semiquantitative 4 grade scale was used to describe the severity of mural inflammation (no mural inflammation, 81 cases, 28.9%, mild mural inflammation, 43 cases, 15.4%, moderate mural inflammation, 75 cases, 26.8%, severe mural inflammation, 81 cases, 28.9%). For each case, we identified one control from the same geographic area matched for age and gender. Mortality rates and specific causes of death were reported and compared between cases and controls and between cases with different histological pattern. TAB histological pattern and severity of mural inflammation entered in a Cox proportional regression analysis along with demographical, clinical and laboratory data at disease onset. Results There were 280 incident cases of biopsy-proven GCA (205 women, mean age at disease onset 74.3 + 7.5 y, mean duration of follow-up 95 + 58 months) during the 26-year study period with complete clinical, laboratory and survival data. During the follow- up period 159 (56.8%) patients died (mean survival time from disease onset 101 + 60 months). Patients with histological pattern ILA and VVV had reduced hazard ratio mortality as compared to TMI type (0.38 and 0.12 respectively). Survival of patients with different histological TAB pattern of GCA was not different from controls. The most frequent causes of death were cardiovascular diseases, cancer, and respiratory diseases. No significant differences in causes of death were observed comparing the 4 pattern of histological TAB involvement. Conclusions The histologic spectrum of inflammatory lesions in TAB positive GCA have correlation with survival. Disclosure of Interest None declared


Theoretical models predict that the relative importance of competition and facilitation vary inversely along gradients of abiotic stress, with facilitation dominating under harsh conditions (the so called "stress-gradient hypothesis"). To date, very few studies have tested this hypothesis in the framework of succession. Moreover, the generality of the hypothesis is currently under debate and the necessity to examine responses at the community level and using different stress levels has been emphasized. We evaluate the mechanisms of succession across the emersion gradient in a rocky shore system. After complete clearing of experimental plots at four shore heights, we removed two separate components of the assemblage: ephemeral green algae, early colonists and canopy-forming species, main space holders in undisturbed assemblages. We aimed to test two hypotheses: (a) the net effect of ephemeral algae on canopy-forming species shift along the emersion gradient according to the predictions of the stress-gradient hypothesis and (b) the net effect of the canopy-forming group on associate species change, from neutral/negative to positive, as succession progresses and plants grow, especially at the highest shore heights. Our results did not support the predictions of the stress gradient hypothesis in the framework of succession. We did detect changes through time in the effect of canopy-forming species, from negative to positive, but this was not dependent on the shore height. The outcome of interactions depended on the identity and life-stage of the species. Moreover, indirect interactions among species could also create a less predictable relationship between successional mechanisms and the environmental gradient.


In this paper, a semi-analytical method for the analysis of pile-supported embankments is proposed. The mathematic model describes the cooperative behavior of pile, pile cap, foundation soil, and embankment fills. Based on Terzaghi's 1D consolidation theory of saturated soil, the consolidation of foundation soil is calculated. The embankments with two different types of piles: floating piles and end-bearing piles are investigated and discussed. The results of axial force and skin friction distributions along the pile and the settlements of pile-supported embankments are presented. It is found that it takes a longer time for soil consolidation in the embankment with floating piles, compared with the case using end-bearing piles. The differential settlement between the pile and surrounding soil at the pile top is larger for the embankment with end-bearing piles, compared with the case of floating piles.


Changes in mental and physical health, morale and social functioning were assessed in a random sample of elderly women widowed during the course of an 8‐year study, compared with never‐married and still‐married controls. The sample as a whole showed age‐related declines in mental and physical health. As a function of ageing there were increases in personal disturbance and in physical health problems and declines in both morale and social engagement. However, over and above these age‐related changes the widows showed significant changes in mental health. There were decreases in morale after widowhood, followed by slight increases in morale in the longer term. Similarly, there were increases in personal disturbance following widowhood, with slight decreases later. The results confirm that, even after several years, widowhood has differential effects on wellbeing and morale. © 1997 by John Wiley & Sons, Ltd.


Background: Job stress is the most important factor in reducing organizational productivity. Therefore, this study aimed to identify prevalence of job stress among nurses in Iran.Methods: This study was conducted using a meta-analysis. All published articles on prevalence of job stress among nurses in Iran until July 2018 were searched and collected using PubMed, Web of Science, Science Direct, CINAHL, PsychInfo, Scopus, Magiran, IranMedex and SID and Bibliography section of the retrieved papers and related journals. Finally, 22 empirical studies were reviewed using Comprehensive Meta-Analysis software.Results: The overall prevalence of job stress in Iranian nurses was 49.5% (95% CI 41.9%-59.1%). The highest job stress was recorded in Tehran in 2016, 96.4% (95% Cl: 90.3%-98.7%) and the lowest job stress was found in Kashan in 2011, 2.5% (95% Cl: 6.0%-1.0%). Significant statistical correlation was observed between job stress, year and sample size (p<0/05).Conclusion: job stress affects about half of nursing staff in Iran; thus, managers and policymakers should take serious measures to reduce prevalence of job stress among nurses.


Introduction Thyroid cancer (TC) is the most common neck malignancy. However, a large number of publications of TC have not been well summarized and discussed with more comprehensive methods. The purpose of this bibliometric study is to summarize scientific publications during the past three decades in the field of TC using a machine learning method. Material and Methods Scientific publications focusing on TC from 1990 to 2020 were searched in PubMed using the MeSH term "thyroid neoplasms". Full associated data were downloaded in the format of PubMed, and extracted in the R platform. Latent Dirichlet allocation (LDA) was adopted to identify the research topics from the abstract of each publication using Python. Results A total of 34,692 publications related to TC from the last three decades were found and included in this study with an average of 1,119.1 publications per year. Clinical studies and experimental studies shared the most proportion of publications, while the proportion of clinical trials remained at a relatively small level (5.87% as the highest in 2004). Thyroidectomy was the lead MeSH term, followed by prognosis, differential diagnosis, and fine-needle biopsy. The LDA analyses showed the study topics were divided into four clusters, including treatment management, basic research, diagnosis research, epidemiology, and cancer risk. However, a relatively weak connection was shown between treatment managements and basic researches. Top 10 most cited publications in recent years particularly highlighted the applications of active surveillance in TC. Conclusion Thyroidectomy, differential diagnosis, genomic analysis, active surveillance are the most concerning topics in TC researches. Although the BRAF-targeted therapy is under development with promising results, there is still an urgent need for conversions from basic studies to clinical practice.


Fragile X syndrome, the most common heritable form of mental retardation, is caused by silencing of the FMR1 (fragile X mental retardation-1 gene). The protein product of this gene, FMRP (fragile X mental retardation protein), is thought to be involved in the translational regulation of mRNAs important for learning and memory. In mammals, there are two homologues of FMRP, namely FXR1P (fragile X-related protein 1) and FXR2P. Disruption of Fxr2 in mice produces learning and memory deficits, and Fmr1 and Fxr2 double-knockout mice have exaggerated impairments in certain neurobehavioral phenotypes relative to the single gene knockouts. This has led to the suggestion that FMR1 and FXR2 functionally overlap and that increasing the expression of FXR2P may ameliorate the symptoms of an FMRP deficiency. Interestingly, the region upstream of the FXR2 translation start site acts as a bidirectional promoter in rodents, driving transcription of an alternative transcript encoding the ABP (androgen-binding protein) [aABP (alternative ABP promoter)]. To understand the regulation of the human FXR2 gene, we cloned the evolutionarily conserved region upstream of the FXR2 translation start site and showed that it also has bidirectional promoter activity in both neuronal and muscle cells as evidenced by luciferase reporter assay studies. Alignment of the human, mouse, rat, rabbit and dog promoters reveals several highly conserved transcription factor-binding sites. Gel electrophoretic mobility-shift assays, chromatin immunoprecipitation studies and co-transfection experiments with plasmids expressing these transcription factors or dominant-negative versions of these factors showed that NF-YA (nuclear transcription factor Yalpha), AP2 (activator protein 2), Nrf1 (nuclear respiratory factor/alpha-Pal) and Sp1 (specificity protein 1) all bind to the FXR2 promoter both in vitro and in vivo and positively regulate the FXR2 promoter.


In the paper we solve the problem of recognizing the roadbed using information about its possible typical designs. As shown on the paper typical designs can be adequately described by the set of fuzzy features, derived from the polygonal representation of the roadbed cross profile. The recognition is based on the minimization of a functional that takes into account how the polygon representation fits to the geometrical form of a measured profile and how its features obey the fuzzy restrictions. We propose to minimize this functional using probabilistic genetic algorithm. In the paper we also discuss the obtained results of the conducted experiments.


The spinner flask bioreactor has been widely used in in vitro cell culturing processes due to its superiority in providing a homogeneous culture environment compared to traditional culturing methods. However, there is limited understanding of the flow fields in these bioreactors, and optimum culture conditions are yet to be determined. This article presents the experimental characterization of the flow field within a spinner flask at varying speeds (10 RPM to 80 RPM) and impeller positions. An optical, non-invasive measurement technique, Particle Image Velocimetry (PIV), was employed to illustrate the fluid flow and calculate the stresses and vorticity associated with the flow within the flask. The largest recirculation structure was observed in the meridional plane at the highest impeller position while the highest shear stress region was observed at the base of the spinner flask. The study provides an overview of the fluid structure within the spinner flask in the meridional and azimuthal planes. Furthermore, the results presented in this study give an accurate quantification of the range of stresses for the given impeller speeds. These results provide estimates of the biomechanical properties within the type of spinner flask used in many published cell studies.


Through the exploration of a selection of Minerva titles from across the period of the Press's dominance, 1790–1799, focussing on the recurring trope of violence, its varying portrayals by individual authors, and its censure by critics, this thesis argues that the Press makes a unique contribution to the Romantic literary marketplace with regard to its output of violent Gothic fiction. Gothic novels were very popular in the 1790s, but they were much critiqued for their impact on readers, with critics' special concern being female readers' exposure to violent themes, which were said to be unfeminine and immoral.

In this thesis, 'Gothic violence' is interpreted in several ways, extending its meaning beyond the obvious (physical harm inflicted on or by the characters in such novels), to include violence which is verbal, violence as inflicted on the reader, and violence manifested in extreme revolutions of feeling and/or in some peculiarly provocative transgression of social and ethical norms. Minerva authors capitalised on the Gothic's popularity by using its conventions and themes, however their use of violence was not simply to entertain – it was also used to portray the horrors of war and its impact on women and the domestic space; to dramatise a fear of sinister and corrupt institutions supplanting the rightful province of others such as the family, marriage and church; and to explore contemporary concerns surrounding gender roles, parental authority in marriage, and the right ways for children to balance their personal desires with societal and familial duties. In this way, violence was far more than a conventional trope of the Gothic genre for writers at the Minerva Press, rather it was a way of eliciting and exploiting contemporary anxieties and exploring issues pertaining to these. Moreover, through their use of violence, Minerva authors can be seen to deviate from the works of other writers at the time, which this thesis argues ultimately supplants long-standing views of the Press as unoriginal and its works as homogenous.


Multileaf collimators (MLCs) are a valuable tool in modern radiation therapy, offering flexible and convenient field shaping. One disadvantage, however, is the undulation of the dose distribution at the edge shaped by the leaves due to the finite leaf width. An attempt to reduce the effect of this undulation is the objective of the commercial linear accelerator package HD270, which incorporates three-dimensional couch translation together with leaf adjustment to emulate finer leaf widths. In this paper we report on the commissioning and evaluation of this feature, together with the development of a process for quality assurance, as well as description of a clinical application of this technique. It is concluded that this technique could be applied reliably to situations currently utilizing MLC for shielding, with little added cost in treatment time, provided that a comprehensive quality assurance program is in place to monitor the performance of this complicated procedure.


The tunneling effect of Bose—Einstein condensate (BEC) in a harmonic trap with a Gaussian energy barrier is studied in this paper. The initial condensate evolves into two separate moving condensates after the tunneling time under certain conditions. The interference pattern between the two moving condensates is given as a comparison and as a further demonstration of the existence of the global phase.


Nucleic acid (DNA) and neurotransmitters integrate together in the brain of organisms to make a powerful information processing systems. Dopamine is an important neurotransmitter whose complexation with DNA in its protonated form has been implemented in several applications such as sensors, antitumor drugs and in bioengineering. However, the molecular level understanding about the binding of protonated dopamine with the different regions of DNA and its effect on the structure as well as stability of DNA is very limited. The nature of binding of protonated dopamine with DNA and its effect on the stability and structural integrity of DNA has been extensively investigated using different spectroscopic and molecular dynamics (MD) simulation techniques. Spectroscopic studies suggest that the multimodal interaction of protonated dopamine with DNA bases in its groove region enhance its stabilization without causing any perturbation in the canonical form of DNA. MD simulation study depicts that protonated dopamine intrudes into the groove region of DNA by replacing the surrounded water and interacts with the bases in the major and minor grooves of DNA in multimodal manner. Electrostatic and dispersion interactions contribute in the stabilization of the interaction of dopamine with the minor groove bases of DNA, whereas, the role of electrostatic interaction is prominent in the case of the major groove. The binding of dopamine with groove region of DNA enhances the hydrogen bond between its Watson-Crick base pairs which results in the higher stabilization of DNA as compared to that in buffer condition. This study provides the molecular level insight about the binding of dopamine with DNA which can be useful in diverse areas ranging from medicines to bioengineering.


The neighborhood context is considered a key institution of inequality influencing individuals' exposure and psychological vulnerability to stressors in the work-family interface, including work-family conflict (WFC). However, experiences of neighborhood context, WFC, and its mental health consequences among minority populations—including foreign-born residents—remain unexplored. We address this limitation and draw on tenants of the stress process model to unpack our hypotheses. We further test whether our focal associations vary for mothers and fathers. Using multilevel data from Toronto, Canada (N = 794), we find that neighborhood disadvantage—measured at the census level—increases reports of WFC among all respondents except foreign-born fathers, who report a decrease in WFC as disadvantage increases. Despite this benefit, the WFC of foreign-born fathers in disadvantaged neighborhoods leads to greater distress compared to other respondents. Our findings highlight important gender differences by nativity status in the impact of neighborhood context on individual-level stressors and mental health.


Manuscript Type: Empirical

Research Question/Issue: Institutional and transaction cost theories highlight the idea that group-affiliated firms outperform unaffiliated firms in emerging economies. However, the persistence of superior performance among group-affiliated firms could be challenged by the recent, quick development of markets and institutions in these countries. This article explores the link between firm performance and the evolution of the institutional environment.

Research Findings/Insights: We analyze how business group affiliation affected firm performance in India in the post-reform era, i.e., from 1990 to 2006. Our findings show that: (1) the performance benefits of group affiliation are evident in the early phase of institutional transition, but level out in the late phase; (2) older group-affiliated firms are better able to cope with institutional transition than younger group-affiliated firms; and (3) group-affiliated service firms are better able to cope with institutional transition than group-affiliated manufacturing firms.

Theoretical/Academic Implications: Our findings support institutional and transaction cost theories, as they show that: (1) when labor, capital, and products markets are characterized by large imperfections and weak supporting institutions business groups outperform independent companies; (2) when markets become more efficient and institutions grow stronger group-affiliated firms fail to show continued superior performance; and (3) heterogeneity among member firms may influence the appropriation of the benefits arising from group affiliation. These findings expand the traditional understanding of the relationship between firm performance and the institutional context in emerging economies, and provide further support for the idea that the relative performance of group-affiliated firms is contingent upon the characteristics of the institutional context and their particular features.

Practitioner/Policy Implications: The article has implications for managers and policy makers. Managers of business groups should adapt the timing of strategies to the evolution of the institutional environment. Policy makers should focus on the consequences of their policies, as they may undermine the efficiency of large national companies.


A mass spectrum will usually be presented as a vertical bar graph, in which each bar represents an ion having a specific mass-to-charge ratio (m/z) and the length of the bar indicates the relative abundance of the ion. The most intense ion is assigned an abundance of 100, and it is referred to as the base peak. Most of the ions formed in a mass spectrometer have a single charge, so the m/z value is equivalent to mass itself. Modern mass spectrometers easily distinguish (resolve) ions differing by only a single atomic mass unit (amu), and thus provide completely accurate values for the molecular mass of a compound. The highest-mass ion in a spectrum is normally considered to be the molecular ion, and lower-mass ions are fragments from the molecular ion, assuming the sample is a single pure compound.


Adolescents and young adults with congenital heart disease are increasingly commonly seen in cardiological practice. Their problems are particular and often unique. Their management requires training and experience in the management of congenital heart disease by the attending cardiologist. In these days of clinical governance, management of ACHD patients must be supervised by clinicians specifically trained in handling congenital cardiac malformation.


Many application specific operating systems based on system on chip are composed of lots of tasks that can generate multi-tasking using preemptive scheduling. Preemptive multi-tasking incurs high preemption switching overheads, and these costs may jeopardize the system schedulability. In this paper, a novel scheduling, named dynamic preemption threshold, is proposed. The scheduling can reduce preemption costs by thread assignment and changing task dynamic preemption threshold at runtime. Because dynamic preemption threshold is based on dynamic algorithm, it can achieve higher processor utilization with relative low costs in context switching and memory requirement. The scheduling perfectly integrates preemption threshold scheduling into EDF algorithm, and accomplishes to transform static model to dynamic algorithm seamlessly.


Trigonocephaly was previously described prenatally in association with severe abnormalities, mostly observed after 18 weeks of gestation. We describe our experience with this finding in early pregnancy, between 14 and 17 weeks of gestation. Our series includes 18 cases of trigonocephaly with several etiologies; trisomy 18, de novo translocation, thanatophoric dysplasia, and open spina bifida without hydrocephalus. Two fetuses had no other significant abnormalities and a spontaneous normalization of the skull shape was observed on follow‐up. Both had normal genetic testing and postnatal outcome. These two cases represent a new phenomenon of an isolated transient form with normal outcome.


The introduction of an online supported, resource based learning environment into a large, multi-modal first year psychology unit led to the spontaneous development of a small, but active, learning community. While off campus students were more active online contributors, many other students "observed" these interactions, not actively contributing but finding the discussion postings valuable to their learning. Overall, use and perceived value of the online communication facilities were related to how confident students were that they had an appropriate study strategy, with off campus and older students reporting greater confidence in their study approach. The results highlight that the nature and function of learning communities for large, multi-modal foundation units are quite different to those typically articulated in the literature and are worth further investigation.


A general solution of sun tracking for an arbitrarily oriented heliostat towards an arbitrarily located target on the earth is published. With the most general form of solar tracking formulae, it is seen that the used azimuth-elevation, spinning-elevation tracking formulae etc. are the special cases of it. The possibilities of utilizing the general solution and its significance in solar energy engineering are discussed.


Background. Relapse of acute myeloid leukemia (AML) after allogeneic hematopoietic stem cell transplantation (HSCT) leaves few therapeutic options, and mechanisms of immune escape of recurring leukemic cells remain poorly understood. Recently, acquired loss of mismatched human leukocyte antigen (HLA) was demonstrated in patients with AML undergoing haploidentical allogeneic HSCT and was suggested not to occur in HLA-matched HSCT. We hypothesized that this mechanism applies to extramedullary AML relapse which occurs frequently after allogeneic HSCT and might also not be restricted to haploidentical HSCT. Methods. DNA from extramedullary AML relapse after HSCT was compared with bone marrow at diagnosis with array comparative genomic hybridization to investigate relapse-specific genomic aberrations in relapsing AML after allogeneic HSCT. Formalin-fixed, paraffin-embedded tissues from the same points of time were assessed for HLA, major histocompatibility complex class I chain-related gene A, and TAP2 immunohistochemistry staining to assess cell surface expression of deleted loci encoded on chromosome 6p. Results. Array comparative genomic hybridization revealed a partial loss of chromosome 6p in extramedullary myeloid sarcoma relapse of AML after sustained complete remission was achieved through matched related allogeneic HSCT. Among others, a deleted region 6p21.32-p21.33, which included several HLA class I genes, was detected. Conclusions. These results suggest that the loss of HLA class I haplotype also occurs in AML relapse after HLA-matched related HSCT. Partial loss of several HLA class I genes and subsequent reduced presentation of minor histocompatibility antigens and reduced ligation of activating natural killer-cell receptors may explain the loss of graft-versus-leukemia response and extramedullary AML relapse in tissue with reduced immunologic surveillance.


Abstract Interestingly, our case presenting with coronary AV fistula firstly reported in the literature with fetal valproate syndrome. Although differential diagnosis is sometimes difficult, it can be diagnosed with detailed history, physical examination and appropriate laboratory tests. Fetal valproate syndrome can be prevented by discontinue of the valproic acid especially during first trimester of pregnancy.


Discusses Marks & Spencer′s application of computer‐based training (CBT) in training its food supervisors. CBT is used to enhance the transfer of learning following training input using workbooks. Argues that the particular application is a very powerful and effective use of CBT, illustrating the real potential of CBT when integrated with other training techniques. Reflects on how such an application may assist in the development of CBT more generally.


The corrosion behavior of X70 steel in simulated soil environment under asymmetric dynamic direct current (DC) interference was studied by immersion tests. The experimental results showed that the negatively asymmetric dynamic DC interference would induce localized corrosion. Under the same dynamic period of 160 ±80 s, when the negative half‐wave current density remained stable at −10 mA/cm2 and the positive half‐wave one decreased from 7 to 1 mA/cm2, the equivalent diameters of the localized corrosion zones became smaller and the steel samples demonstrated typical pitting corrosion morphologies. To further explore the effect of asymmetric dynamic DC interference on the localized corrosion behavior of carbon steel, a variety of experimental measurements were carried out including real‐time DC potential monitoring, in‐situ near‐surface pH measurements, cyclic voltammetry, and Mott–Schottky tests. It was found that the localized corrosion behavior was probably related to the breakdown of passive film formed on the metal surface exposed to negatively asymmetric DC current generated high pH conditions.


An adaptive virtual resistor-based controller is proposed to resolve the high-frequency resonance and controller instability issues associated with the integration of plug-in hybrid electric vehicles (PHEVs) with different grid conditions. The issues related to grid integration of PHEVs are presented and analyzed. When connected with different grids, the variety of grid impedance, results in the instability of the controller with fixed compensation gain. The proposed controller uses grid current and filter capacitor current to form a virtual resistor controller. Furthermore, the resonant frequency is extracted and is the criterion used to tune the compensation gain to make the proposed control behave as a controllable virtual resistor. The control-loop modeling, design, and analysis are presented. The adaptive tuning capability is analyzed. The control loop is designed under different grid conditions and the control robustness to the impedance variation is examined. The experimental results verify that the proposed controller can be applied to a wide range of grid conditions stably and can also achieve good performance with regard to total and individual harmonics.


A variety of proteins contributes greatly to the unique nutritional and functional quality of dairy cow milk. Particularly, milk casein content and composition have substantial influence on the processing capa - bilities. In the present study, milk of 23 multiparous Holstein-Friesian cows, grouped as high- (3.49 ± 0.05%; n = 11) and low-protein (3.03 ± 0.05%; n = 12) cows, was sampled approximately weekly during the first 155 days of lactation to determine the course of relative milk protein composition (α-lactalbumin; β-lactoglobulin; α-, β- , and κ-casein). Furthermore, feed restrictions by 30% of dry matter intake in early and mid-lactation as well as experimental tissue biopsies were conducted to observe their effect on milk protein composition. Milk protein composition was relatively stable and displayed similar concentration patterns throughout the experimental period between both groups. Mean relative concentrations of α-, β-, κ-casein, α-lactalbumin, and β-lactoglobulin were 34.2, 31.4, 16.0, 2.1, and 9.7% of total protein, respectively. Feed restrictions did not alter milk protein composition, whereas the season influenced α- and β-casein as well as α-lactalbumin. Further, effects were observed in both groups at times of unfamiliar stressful situations caused by taking liver or muscle biopsies. As a result, the relative concentration of β-casein increased. Therefore, acute stress factors may lead to a deviation in milk protein composition and should be avoided.


I set up in this paper an overlapping generations economy with envi-ronment degrading itself and pollution resulting from both consumption and production to show that there always exists an inter-temporal equi-librium and to determine the competitive steady state. This steady state is compared with the equilibrium steady state in the social benevolent planner's point of view. The paper shows the optimal golden rule allo-cation which maximizes the total utility of all generations, and whenever the capital ratio in the competitive framework is higher than the golden rule capital ratio, the economy stands on the dynamically inecient point. The width of the inecient range of capital ratio depends positively on the environment maintaining technology and depends negatively on the cleanness of production technology. For such any competitive economy, I introduce some combinations of taxes and transfer with purpose of de-centralizing the best steady state attainable through the good and factors markets.


Background: Diabetes mellitus is one of the top diseases leading to morbidity and mortality in Kuwait. There is often a delay in diagnosing patients with type 2 diabetes due to the long asymptomatic pre-clinical stage and complications are commonly present at diagnosis. Screening can identify diabetics and treatment can be initiated earlier to prevent complications. Screening can detect pre-diabetics who may benefit from interventions to prevent or delay progression to diabetes. Objectives: The aim of this study is to estimate the prevalence of risk factors for diabetes in healthy employees and screen those with high risk for diabetes. Method: A cross-sectional study conducted in Jaber Al-Ahmed Hospital from October to November 2012. The Finnish questionnaire for diabetes risk assessment was used to categorize participants into different risk categories for diabetes. Participants considered to be at high risk were screened for diabetes using HbA1c. Results: 647 employees participated in the study. 70.6% of the participants were overweight or obese; more than half had a high waist circumference and 23% were smokers. Kuwaiti employees tended to have more risk compared to non- Kuwaitis (P<0.001) with 27.6% of Kuwaitis belonging to the low risk group compared to 42.4% of the non-Kuwaitis. HbA1c testing showed that out of the 51 participants with high/very high risk, 6 (11.8%) were diabetics and 26 (51.0%) were pre-diabetics. Conclusion: Screening and a diabetic risk assessment for those at high risk should be part of the routine occupational health check program in the hospital.


The currently known point pattern matching algorithms generally performs poorly when the two point patterns to be matched are not isomorphic. To improve the matching performance of the point pattern matching methods for non-isomorphic point patterns, a novel and robust inexact point pattern matching algorithm that combines with the invariant feature and probabilistic relaxation labelling is proposed. A new point-set based invariant feature, Relative Shape Context (RSC), is proposed firstly. Using the test statistic of relative shape context descriptor's matching scores as the foundation of compatibility coefficients, the new support function are constructed based on the compatibility coefficients. Finally, the correct matching results are achieved by using the probabilistic relaxation labelling and imposing the bijective constraints required by the overall correspondence mapping. Experiments on both synthetic point-sets and real image data show that the proposed algorithm is effective and robust.


Contrary to general network, sensor network has many restrictions such as energy recharge. Accordingly, security mechanism used to general network cannot be applied to sensor network. Many researchers propose method of security and energy efficiency separately. To maximize energy efficiency, the methods to support data aggregation and clusterhead selection algorithm are proposed. To strengthen the security, the methods to support encryption techniques and manage a secret key that is applicable to sensor network are proposed. However, energy and security issues are trade-off. This paper is devoted to design secure routing protocol combining conventional routing protocol with security protocol. This new protocol is that encryption algorithm and key management method are applied to specific routing protocol.


This paper describes one possible model for e-learning in undergraduate medical education with an emphasis on supporting and managing curriculum development. The University of Sheffield School of Medicine is undergoing a major revision of its undergraduate medical curriculum, prompted by requirements of the professional regulatory body, the General Medical Council (GMC), and the Quality Assurance Agency for Higher Education (QAA). A computer-based system was developed to provide more efficient administration of the current course and more effective delivery of educational materials to students. The Sheffield Networked Learning Environment (NLE) has been developed in collaboration with other medical schools. A new 'revised' curriculum, due to start in 2003, will be intensively supported by an NLE which has been extensively tested and modified through pilot studies in the current curriculum.


A parallelization of the Day-Stout-Warren algorithm for balancing binary trees. As its input, this algorithm takes an arbitrary binary tree and returns an equivalent tree which is balanced so as to preserve the θ(log(n)) lookup time for elements of the tree. The sequential Day-Stout-Warren algorithm has a linear runtime and uses constant space. This new parallelization of the Day-Stout-Warren algorithm attempts to do the same while providing a speedup which is as near as possible to linear to the number of processing elements. Also, ideally it should do so in an online fashion, without blocking new reads, inserts, and deletes.


Memorizing the Qur'an (Tahfidzul Qur'an) is an activity that is not only done by adults. In the contemporary era, many young childrens who are still in elementary school, memorize the Qur'an both in madrasas and in Islamic boarding schools. However, there are also formal schools that provide Tahfidzul Qur'an Program compared to general subjects. Tahfidul Quran Asukarti Elementary School is a school-based on the Quran and Sunnah. The learning curriculum used is 60% tahfidz lessons and 40% general lessons supported by extracurricular activities. The imbalance of calculations between general lessons and tahfidz is one thing that deserves to be discussed, so this paper focuses on memorization method is used in the learning system. The study was devoted to 2nd grade students as the first batch at SDTQ As-Surkati after further research was carried out on the tahfidz learning method used, namely auditory focusing on hearing. In particular, this paper discusses effectiveness of the memorization method applied at SDTQ As-Surkati, with the interview method with the principal, tahfidz teachers, guardians of students, students, and knowledge literacy about the auditory method. In addition, several factors that influence the success of this method are also presented at the end of this study. This study uses a descriptive qualitative method with scientific analysis. With this research, it is expected to provide good input to the memorizers, especially in SDTQ As-Surkati so that methods that are still considered lacking, can be improved with effective methods of course contributing to the progress of the Tahfidzul Qur'an Program at SDTQ As-Surkati.


– The digital transformation of the construction industry is accelerating with the advances in information technology (IT) and operational technology (OT) and their convergence. While the benefits of such transformation in construction are apparent, cybersecurity aspects are usually overlooked. Cyber-attacks against project information can cause the exposure of confidential project data, intellectual property, and personal information and interruption of project tasks. On the other hand, cybersecurity incidents affecting the OT utilized in the project can lead to misinformation, harm people nearby, or even cause loss of life. Given the criticality of providing robust cybersecurity in construction projects, this study aims to (1) point out the cybersecurity considerations to be taken into account before utilizing autonomous equipment on-site, (2) raise awareness about cybersecurity in construction, and (3) present an example of using vulnerability assessment systems in construction projects. This paper utilizes the Common Vulnerability Scoring System (CVSS) to assess the vulnerabilities and risks of different levels of an autonomous site monitoring system. Four assessors with different backgrounds in cybersecurity and robotic systems performed the assessment. The results revealed the most vulnerable levels of the assessed robotic system, which can be considered as a warning. The assessment suggested in this study can help construction decision-makers identify the levels they need to pay extra attention to before employing a cyber-physical system (CPS) on-site. Utilizing CVSS to conduct a vulnerability assessment for CPSs during the construction phase has not been proposed by any previous study, making this paper novel.


Programmed Death-1 (PD-1) is a negative regulator of T cell activation and proliferation that mediates suppressive action by binding to its ligands PD-L1 and PD-L2. The well-established immunosuppressive properties of PD-1/PD-L1 interaction resulting in the re-establishment of peripheral tolerance makes PD-1 an interesting target for therapeutic intervention in cancer patients. In addition to its relevance in tumor-specific immunity, recent studies demonstrate that PD-1 expression on T cells correlates with viral load in HIV and HCV infected patients and further identified PD-1 expression as a marker for exhausted virus-specific CD8+ T cells. In particular, PD-1+CD8+ T cells show impaired effector functions and PD-1 associated T cell exhaustion could be restored by blocking the PD-1/PD-L1 interaction. This results in recovery of virus-specific CD8+ T cell mediated immunity, suggesting that interrupting PD-1 signaling using an antagonistic antibody restores T-cell effector functions. Thus, immunotherapy based on the blockade of PD-1/PD-L1 interaction does not only result in breakdown of effector T-cell tolerance to tumor antigens, but in addition also represents a promising therapeutic strategy for reactivation of virus-specific effector T cells to exert pathogen eradication in chronic viral infections. In this review, we give a comprehensive overview about the immunological functions of PD-1 mediated signaling in T cells with special emphasis on its immune regulatory functions in the context of cancer and chronic viral infections. Moreover, we will summarize recent data obtained in animal models, in-vitro preclinical approaches in patients and their implementation in clinical trials for treating patients with cancer and chronic viral infections.


This guide is designed to help anybody who wants to develop or commission a resilience program to work across a school or local area to support young people at risk of developing mental health difficulties. In her role as advisor to the Big Lottery Fund's HeadStart programme in England, Professor Angie Hart developed the methodological approach outlined below based on her academic research, her work as a child mental health practitioner and her lived experience of supporting children with mental health issues. In addition, the research undertaken and the production of the guide has been supported by the University of Brighton and the Economicand Social Research Council as part of Imagine, an international research project exploring and developing resilience approaches to supporting disadvantaged people. Dr Becky Heaver contributed to researching the different resilience approaches, and appraising them for this guide.


A few years after the demise of communism, it was clear that some postcommunist countries were soaring ahead, while others were stagnant at best. The discrepancy was truly astounding, and it has continued for years. The differences in economic performance are closely related to the economic reform policies pursued.


Can efforts to eradicate inequality in wealth and education eliminate intergenerational persistence of socioeconomic status? The Chinese Communist Revolution in the 1950s and Cultural Revolution from 1966 to 1976 aimed to do exactly that. Using newly digitized archival records and contemporary census and household survey data, we show that the revolutions were effective in homogenizing the population economically in the short run. However, the pattern of inequality that characterized the pre-revolution generation re-emerges today. Almost half a century after the revolutions, individuals whose grandparents belonged to the pre-revolution elite earn 16 percent more and have completed more than 11 percent additional years of schooling than those from non-elite households. In addition, individuals with pre-revolution elite grandparents hold different values: they are less averse to inequality, more individualistic, more pro-market, and more likely to see hard work as critical to success. Through intergenerational transmission of values, socioeconomic conditions thus survived one of the most aggressive attempts to eliminate differences in the population and to foster mobility.


Cyber-physical systems (CPS) is an integration of computation with physical systems and physical processes. It is widely used in energy, health and other industrial areas. Modeling and simulation is of the greatest challenges in CPS research. Modelica has a great potentiality in the modeling and simulation of CPS. We analyze the characteristics and requirements of CPS modeling, and also the features of Modelica in the paper. In respect of information model, physical model and model interface, this paper introduces a unified modeling method for CPS, based on Modelica. The method provides a reliable foundation for the design, analysis and verification of CPS.


Endurance riding is a demanding equestrian discipline that has the potential to present attending veterinarians with challenging medical emergencies. An understanding of the conditions likely to be faced and the carriage of appropriate supplies, especially sufficient intravenous fluids, is essential. This article describes the veterinary inspections performed and advises how veterinary practitioners should manage each medical emergency that may be encountered.


AIM
The study evaluates the efficacy of a set of objective parameters for monitoring facial swelling in a group of patients treated with clarithromycin.

METHODS
Fifty consecutive patients suffering from dental abscesses (22 in the maxillary arch and 28 in the mandibular arch) were enrolled. All these patients underwent antibiotic treatment with clarithromycin in a new formulation as a single daily dose (500 mg/day for 6 days). Pain and changes in facial swelling were evaluated at baseline and each day for 6 days through subjective parameters (visual analogic scale, VAS) and objective parameters (6 different tape measurements on the skin surface above the abscess).

RESULTS
Pain and swelling recorded by patient and dentist (using VAS scores) showed statistically significant decreases (p<0.01) on days 2, 3 and 4, while no further significant variation was observed during days 4, 5 or 6. As regards the objective parameters to quantify facial swelling, the maximum dimensional change (from baseline to final values) in the mandibular arch was obtained with measurement 6 (mean value 2.27+/-0.53 cm); the maximum dimensional change in the maxillary arch was obtained with the sum of the other 5 measurements (mean value 6.34+/-4.09 cm).

CONCLUSION
The use of a single or a combination of linear measurements might provide a sensitive and reproducible method to evaluate facial swelling objectively and could be very useful in monitoring the efficacy of new antibiotics and to compare the results from different studies.


It is a common understanding that identifying the same entity such as module, file, and function between revisions is important for software evolution related analysis. Most software evolution researchers use entity names, such as file names and function names, as entity identifiers based on the assumption that each entity is uniquely identifiable by its name. Unfortunately names change over time. In this paper, we propose an automated algorithm that identifies entity mapping at the function level across revisions even when an entity's name changes in the new revision. This algorithm is based on computing function similarities. We introduce eight similarity factors to determine if a function is renamed from a function. To find out which similarity factors are dominant, a significance analysis is performed on each factor. To validate our algorithm and for factor significance analysis, ten human judges manually identified renamed entities across revisions for two open source projects: Subversion and Apache2. Using the manually identified result set we trained weights for each similarity factor and measured the accuracy of our algorithm. We computed the accuracies among human judges. We found our algorithm's accuracy is better than the average accuracy among human judges. We also show that trained weights for similarity factors from one period in one project are reusable for other periods and/or other projects. Finally we combined all possible factor combinations and computed the accuracy of each combination. We found that adding more factors does not necessarily improve the accuracy of origin detection.


In this paper the development of an experimental test bench to analyze and control the strain of a flexible aluminum beam subjected to external disturbances is described. In the proposed platform, strain-gauges are used to measure the strain of the beam in a single cantilever mode while Ni-Ti-Cu Shape Memory Alloy (SMA) wires are used as force actuators. Data acquisition and control system are implemented with an ADuC microcontroller. The response of the structure in open-loop was used to identify the mathematical model of the system. To find the appropriate controller and to reach the best performance of the system, it was used techniques of direct tuning (pole-zero cancellation) in the identified model. The PI controller has been used to control the strain of the beam for different types of reference signals, as square, sinusoidal and triangular. The frequencies of the reference signals have been varied to observe to which bandwidth the system can respond. Experimental results are used to demonstrate the usefulness of the PI controller in the proposed smart structure.


A thermodynamic simulation model for the 4-stroke cycle of a single cylinder spark ignition engine operating on neat methanol is described in this paper. The development of the model for all the processes is illustrated. It computes the gas pressure, gas temperature and the rate of formation of nitric oxide and carbon monoxide at each crank angle using basic energy equation and reaction kinetic mechanism. A gas exchange model has been formulated by finite difference scheme to evaluate the mass flow rate through valves and the properties in the intake and exhaust systems. The validation of the above model has been carried out by comparing the predicted and experimental data at different operating conditions encompassing changes in fuel-air equivalence ratio, speed, load, spark timing and compression ratio. The special characteristics of methanol such as rapid burning rate, high power output and reduced nitric oxide emissions have been truthfully predicted by the model.


In a previous study (2005 Comput. Phys. Commun.169, 139–143), we clarified the dependence of the phase structure on the hydrophilicity of an amphiphilic molecule by varying the interaction potential between the hydrophilic molecule and water ($a_{\rm AW}$) in a dissipative particle dynamics (DPD) simulation using the Jury model. In the present paper, we perform another DPD simulation using the previous model to investigate the dependence of the interaction potential between adjacent hydrophilic groups on the phase structure. By varying the coefficient of the interaction potential between adjacent hydrophilic groups $a_{\rm AA}$ ($a_{\rm AA}=15,25,40$ and 250) at a dimensionless temperature of $T=0.5$ and a concentration of amphiphilic molecules in water of $\phi=50$%, hexagonal ($a_{\rm AA}=14,25,40$) and micellar ($a_{\rm AA}=250$) phases were observed. In comparison with the previous results, the dependence of the A–B dimer's shape on $a_{\rm AA}$ was determined to be weaker than that on $a_{\rm AW}$. Therefore, it is concluded that the solvent water ${\rm W}$ plays an important role in aggregation of the A–B dimers.


Abstract. Spatiotemporal variations of the partial pressure of CO2 (pCO2) were studied during 8 oceanographic cruises conducted between March 2014 and February 2016 in surface waters of the eastern shelf of the Gulf of Cádiz (SW Iberian Península) between the Guadalquivir River and Cape Trafalgar. pCO2 presented a range of variation between 320.6 and 513.6 µatm, with highest values during summer and autumn and lowest during spring and winter, showing a linear dependence between pCO2 and temperature. The distributions of pCO2 were not homogeneous. Spatially, there was a general decrease from coastal to off-shore stations associated with continental inputs and presented an increase in the zones deeper than 400 m due to the influence of the eastward branch of the Azores Current. On the other side, the study area acted as source of CO2 to the atmosphere during summer and autumn and as a sink in spring and winter, with a mean value for the study period of −0.18 ± 1.32 mmol m−2 d−1. In the Guadalquivir and Sancti Petri sections, the CO2 fluxes decreased towards offshore, whereas in the Trafalgar section increased due to the presence of an upwelling. These results highlighted the Gulf of Cádiz as a CO2 sink, with a capture capacity of 14.9 Gg year−1.


OBJECTIVE
The purpose of this study was to investigate the therapeutic effects of combined bumetanide and applied behavior analysis (ABA) treatment in children with autism.

METHODS
Sixty children diagnosed with autism according to the International Classification of Diseases, Tenth Revision (ICD-10) criteria (mean age of 4.5 years) were randomly divided into two groups: A single treatment group (n=28) and a combined treatment group (n=32). The combined treatment group received ABA training combined with oral bumetanide (0.5 mg twice a day). The single treatment group received ABA training only. Autism symptoms were evaluated with the Autism Behavior Checklist (ABC) and the Childhood Autism Rating Scale (CARS), whereas severity of disease (SI) and global improvement (GI) were measured with the Clinical Global Impressions (CGI). Assessment of ABC, CARS, and CGI was performed immediately before and 3 months after initiation of the treatment(s).

RESULTS
Prior to intervention(s) no statistically significant differences in scores on the ABC, CARS, SI, or GI were found between the two groups. Total scores of the ABC, CARS, and SI were decreased in both groups after 3 months (p<0.05) compared with the scores prior to treatment. The total scores of the ABC and the CGI were significantly (p<0.05) lower in the combined treatment group than in the single treatment group. Although the total and item scores of the CARS in the combined treatment group were lower than in the single treatment group after a 3 month intervention, they did not reach statistical significance. No adverse effects of bumetanide were observed.

CONCLUSIONS
Treatment with bumetanide combined with ABA training may result in a better outcome in children with autism than ABA training alone.


The use of X-ray CT images for CT-based attenuation correction (CTAC) of PET data results in the decrease of overall scanning time and creates a noise-free attenuation map (mumap). The linear attenuation coefficient (LAC) measured with CT is calculated at the x-ray energy rather than at the 511 keV. It is therefore necessary to convert the linear attenuation coefficients obtained from the CT scan to those corresponding to the 511 keV. Several conversion strategies have been developed including scaling, segmentation, hybrid, bilinear and dual-energy decomposition methods. The aim of this study is to compare the accuracy of different energy mapping methods for generation of attenuation map form CT images. An in-house made polyethylene phantom with different concentrations of K2HPO4 was used in order to quantitatively measure the accuracy of the nominated methods, using quantitative analysis of created mumaps. The generated mumaps using different methods compared with theoretical values calculated using XCOM cross section library. Accurate quantitative analysis showed that for low concentrations of K2HPO4 all these methods produce acceptable attenuation maps at 511 keV, but for high concentration of K2HPO4 the last three methods produced the lowest errors (10.1% in hybrid, 9.8% in bilinear, and 4.7% in dual energy method). The results also showed that in dual energy method, combination of 80 and 140 kVps produces the least error (4.2%) compared to other combinations of kVps.


This book is intended to be the first of a series of books bridging the gap between basic neuropharmacology and clinical therapeutics. The intention is to include clinical neurophysiology, basic pharmacology and therapeutics with those subjects usually grouped under the heading of clinical pharmacology. It is not said at whom the book is specifically directed, but the emphasis is on the clinical application of the topics discussed. There are nine chapters in the first volume, all written by different authors. The clinical topics discussed range from clinical entities, such as schizophrenia and Gilles de la Tourette syndrome, to neurological conditions such' as spasticity and increased intracranial pressure. The inclusion of these topics reflects more on the promptness of each author in submitting his contribution to the editor rather than in providing a comprehensive review of a particular field. Although some of the topics are not of direct interest to the psychiatrist, this book provides an excellent review of some controversial issues in psychiatry and neurology. There is a comprehensive description of the tardive dyskinesia syndrome by 'Tarsy and Baldessarini, which boasts as many as 192 references. This suffers at times from almost being too detailed. For instance, "Some reports have claimed an association of tardive dyskinesia with advanced age (2 refs.) and female sex (2 refs.). However, other epidemiologic studies have suggested that advanced age (2 refs.) and female sex (3 refs.) are not significantly correlated ..." A reviewer should indicate the credence of the studies he is quoting. The first chapter is by the editor and his colleagues on the pharmacology of schizophrenia. This is a tidily explained hypothesis that the pathophysiology of schizophrenia is due to increased receptor site sensitivity to dopamine. It is writtenjogically and although is


As the world continues towards autonomy, the need for continuous, precise, and robust navigation is becoming increasingly important. A new wave of modernized Global Navigation Satellite Systems (GNSS) signals are currently being implemented on the latest satellite blocks. The focus of this work is on the Global Positioning System (GPS) L5 signal, and while it is not yet fully available there are now windows of time where experimental data can be used to test modified algorithms exploiting the nature of the new signal structures. The GPS L5 signal is a Quadrature Phase-Shift keying (QPSK) signal that has both an in-phase (data) and quadrature (pilot) arm in the signal that are transmitted together. The pilot channel is not modulated with a data message which historically limits the length of coherent integration during tracking. This work adapts a vector tracking algorithm, which has been shown in prior works to provide a more robust navigation solution than scalar tracking architectures, to the GPS L5 signal structure. The traditional vector tracking architecture for both GPS L1 and L5q independently are compared to adapted methods. For the first method, the L5i and L5q discriminator measurements are combined before being added to the Kalman filter to update the Position, Velocity, and Timing (PVT) solution and Numerically Controlled Oscillators (NCOs). For the second method, L5i and L5q are tracked independently and both provide measurements to the same filter for PVT and NCO updates. This second method removes the limit on integration lengths for the L5q channel allowing for varying extended integration lengths on this channel. All methods are post processed on live sky data from only Block IIF and III satellites and evaluated. A covariance analysis is also performed comparing the methods.


The cellular response to heat shock requires massive adaptation of gene expression driven by the transcription factor HSF1, which assembles in nuclear stress bodies together with human satellite III RNA and numerous splicing factors. In this issue of The EMBO Journal, Ninomiya et al demonstrate that nuclear stress bodies serve as a platform for phosphorylation of the SR protein SRSF9 by the CLK1 kinase, which promotes retention of a large number of introns during the recovery phase from heat shock.


We consider a model of licensing of a non-drastic innovation in which the patent holder (an outside innovator) negotiates either up-front fixed fees or per-unit royal- ties with two firms producing horizontally differentiated brands and competing a la Cournot. We investigate how licensing schemes (fixed fee or per-unit royalty) and the number of licenses sold (exclusive licensing or complete technology diffusion) affect price agreements and delays in reaching an agreement. We show that the patent holder prefers to license by means of up-front fixed fees except if market competition is mild and the innovation size is small. Once there is private information about the relative bargaining power of the parties, the patent holder may prefer licensing by means of per-unit royalties even if market competition is strong. Moreover, the delay in reaching an agreement is greater whenever the patent holder chooses to negotiate up-front fixed fees instead of per-unit royalties.


Periventricular tissue damage in multiple sclerosis has been suggested to be mediated by toxic soluble factors in the cerebrospinal-fluid. Magnetization transfer imaging has shown great potential to reveal microstructural tissue changes and has been used to study the association of periventricular normal-appearing white matter (NAWM) changes to the distance from the ventricle. We assessed high-resolution magnetization transfer saturation imaging (MTsat) in equidistant bands around the ventricle of MS patients and compared the resulting MTsat gradient of the thalamus and NAWM. While PV-MTsat values in NAWM are consistent to the literature, MTsat values in the outer thalamic bands were higher than controls, likely caused by increased iron levels.


Purpose
This study aims to analyse the impact on employee productivity of adopting the activity-based working (ABW) a form of new work practices (NWPs). A study of this nature has never been made in Asia.

Design/methodology/approach
A mixed methods design was used, which combined a comprehensive literature review, three interviews with senior professionals and a questionnaire survey with 37 office occupiers all from one international real estate consultancy firm in Hong Kong, as a case study, to analyse the impact of ABW on employee productivity.

Findings
Findings suggest that ABW influences employee productivity to a certain degree. Though both physical and behavioural working environmental factors influence employee productivity in general, the latter factors were relatively more influential. Interestingly, though space-per-employee has been reduced under the ABW, this has not affected employee performance negatively. However, findings indicate that distraction elements (e.g. interruptions, overcrowding and noise) do have a negative influence on employee performance.

Research limitations/implications
The scope of this exploratory study is limited to Hong Kong and to a small sample of respondents representing one international real estate firm. However, the results could be interpreted for critical learning in other similarly expensive real estate rental markets.

Originality/value
The study highlighted the impact of not only physical but also behavioural working environment factors on employee productivity. The maximum benefits of NWPs can only be accomplished by striking a balance between aspects of physical and behavioural working environments.


A summary is given of comparative work carried out within the I.B.P. Tundra Biome at an Arctic station (Greenland) and a sub-Antarctic station (South Georgia). The investigations covered many aspects of plant ecology, primary production and adaptation to polar environments. The work was extended by an international synthesis of results. General conclusions are reported and the current continuation of the studies is discussed.


Prevention is better than cure is the right phrase to express how important sand production monitoring and surveillance to protect well integrity which consequently help securing environment, people, asset and also reputation without causing unnecessary restrictions to the production performance. This paper showcases the benefits gained from utilizing an automated Digital Integrated Operations System, or "IO" to enhance the existing Sand Monitoring and Management (SMM) workflow.
 Sand production will impose significant impact and key failure are mostly related to erosion and sand accumulation. Reactive management approach can be implemented in a faster manner should we have good surveillance. The IO was designed to provide critical information on the historical and current status and operating conditions of wells, production and injection equipment, as well as daily production and injection volumes based on data fed from the thousands of transmitters installed at the plant. The system is used for different applications related to production surveillance and optimization, and also includes sand management as a core module. For this purpose, it utilizes the SMM workflow by enabling visual monitoring of well sand count data and compliance to well sampling plan in the IO platform, and by performing daily computation of erosional rates together with remaining wall thickness on surface flowlines - achieved by combining live well parameters with latest sand count data, latest well test and erosion rate.
 Upon stringent monitoring, two (2) wells were identified by IO to be under high risk and quick action was taken to manage the risk. From IO, number of times that each well had been categorized under severity were then be validated by checking in the input data. From well monitoring and surveillance, flowing tubing head pressure (FTHP) were seen lower than trending and bean size had been fully opened. Knowing that the well is prone to be producing high amount of sand and expose to downhole integrity issue, the sand production must be controlled before it reaches to the surface.
 The immediate action was to choke down the well, monitor the FTHP, evaluate well test performance trending and most importantly increase the frequency of sand count. After doing so, the team observed that erosion rate has been reduced below the limit and sand count was also reduced. Simple action can be taken if we know what is the root cause in a timely manner. All this will be possible through IO. Visualization had been transparent, communication was enhanced, and collaboration boosted towards safe operation.


The renin-angiotensin system (RAS) has two different axes, the classical one with the effector peptide angiotensin II and the new one with the effector peptide angiotensin (1-7). Both peptides have been shown to be involved in the pathogenesis of diabetes mellitus and its consequences, nephropathy, retinopathy and cardiomyopathy in animal models and patients. In diabetes, angiotensin II acts mostly deleterious and angiotensin (1-7) protective. In this review we summarize the knowledge about the role of the different RAS axes in diabetes mellitus and the use of drugs interfering with the RAS in the therapy of the disease.


Eating disorders affect all ethnic and socioeconomic groups. However, currently available assessment instruments, which were developed and validated for exclusively
Caucasian populations. With the purpose to develop a culturally sensitive framework for the eating disorders treatment in Latinos/as, the objectives of this work were: 1) identify and describe some of the relevant cultural elements for eating disorders in the Latino population and, 2) to draft a culturally sensitive intervention model for eating disorders in Latino population in the United States. Providing culturally sensitive treatments for Latinos with psychiatric disorders is essential to reverse public health disparities


Recently, simulation of Chemical Mechanical Polishing (CMP) is becoming more important because planarity and uniformity which are dependent on many dynamic factors are difficult to control. In this paper, a profile simulation environment based on the linear elastic material and nonlinear contact analysis that considers equipment parameters, such as pad hardness, thickness and down pressure is presented. In transient CMP simulation using the elastic model, the contact stress on the wafer surface is the dominant factor in polishing rate during the CMP process. The profiles of CMP simulation agree well with the measured data. This simulation can be used to optimize the CMP process and to generate design rules for filling dummy patterns which are used to improve planarity.


Introduction: The soaring incidence of gout in the United Kingdom suggests that medical practitioners should be increasingly aware of optimizing management of gout, which is aimed at pain relief, preservation of joint function and preventing recurrent attacks. Recent guidelines published by the British Society of Rheumatology (BSR), have provided clinicians with a framework for achieving these aims. Aims: To evaluate the management of gout in a primary care centre in North West England against recognized standards. Methods: An electronic search on EMIS Web using the Read codes "gout" and "gouty arthritis", with a specified period of 2010–2013, generated a cohort of patients who were categorized into 2 groups: those prescribed urate-lowering therapy (allopurinol) and those not. Patients on febuxostat were excluded. Clinical data from the patients were extracted and retrospectively audited. Results: A total of 112 patients were identified, of which only 46% (n = 52) of patients were reviewed after an acute attack. Among those who were prescribed allopurinol, only 19% (n = 12) achieved target serum urate levels while only 67% (n = 42) had their serum urate levels checked regularly and 31% (n = 20) had dosage adjustments. Comparatively, in patients not prescribed allopurinol, a few indications for initiating allopurinol were detected: 29% (n = 12) had more than one attack of gout in a year, 27% (n = 11) suffered from renal insufficiency, 2% (n = 1) presented with tophi, and 17% (n = 7) were on diuretics. Conclusion: Gout management in this primary care centre is not fully concordant to the BSR guidelines. Clearly, there is a need to improve adherence, particularly in the tight monitoring of serum uric acid levels, medications review, appropriate use of allopurinol, where indicated, and patient follow-up.


Understanding constellations in large data collections has become a common task. One obstacle a user has to overcome is the internal complexity of these repositories. For example, extracting connected data from a normalized relational database requires knowledge of the table structure which might not be available for the casual user. In this paper we present a visualization framework which presents the collection as a set of entities and relations (on the data level). Using rating functions, we divide large relation networks into small graphs which resemble ego-centered networks. These graphs are connected so the user can browse from one to another. To further assist the user, we present two views which embed information on the evolution of the relations into the graphs. Each view emphasizes another aspect of temporal development. The framework can be adapted to any repository by a flexible data interface and a graph configuration file. We present some first web-based applications including a visualization of the DBLP data set. We use the DBLP visualization to evaluate our approach.


Today, state-of-the-art computational methods and programs for quantum theory for electron correlation may not be developed entirely manually. They are often constructed with the essential aid of symbolic algebra systems automating lengthy and error-prone mathematical derivation and computer implementation, inevitable in these developments. Recent progress in this new paradigm of chemical theory development—complete automation—is reviewed.


The novel 3-nitro-2-pyridinesulfenyl (Npys) group, which is useful for the protection and the activation of amino and hydroxyl groups for peptide synthesis, is reported. The Npys group is readily introduced by treatment of amino acids with 3-nitro-2-pyridinesulfenyl chloride. The Npys group is easily removed by treatment with very dilute HCl, e.g. 0.1-0.2 N HCl in dioxane, but is is resistant to trifluoroacetic acid and 88% formic acid. Npys is also selectively removed under neutral conditions using triphenylphosphine or 2-pyridinethiol 1-oxide without affecting benzyloxycarbonyl (Z), tert-butyloxycarbonyl (Boc), 2-(4-biphenylyl)propyl(2)oxycarbonyl (Bpoc), 9-fluorenylmethyloxycarbonyl (Fmoc), benzyl (Bzl) or tert-butyl (tBu) protecting groups. The N-Npys and O-Npys groups when activated in the presence of RCOOH by the addition of tertiary phosphine form peptide or ester bonds via oxidation-reduction condensation. The important features of the Npys group are demonstrated through the synthesis of peptides in solution and by solid phase methodology without a formal deprotection procedure. In solid phase synthesis, 4-(Npys-oxymethyl) phenylacetic acid is used as the key intermediate for the introduction of the trifluoroacetic acid resistant 4-(oxymethyl) phenylacetamido linking group to the resin.


Online advertising has exceeded television, to became the largest revenue advertising category in the United States [146], [147]. Some of the reasons for this success are online advertising's unique capabilities for measurement and personalized ad delivery. However, this success also presents new challenges for society. The same technology used for selling products can be employed as a tool for mass persuasion. This paper examines three aspects of this problem: data privacy, information bubbles, and false information. The paper offers some thoughts on addressing each problem.


The American Gastroenterological Association (AGA) standards for office-based gastrointestinal endoscopy were written in response to market changes in physician reimbursements for many endoscopic procedures that will continue to drive their performance into unregulated physician offices. The AGA believes that patient safety is best protected if these standards are adopted by sites that also comply with state/federal laws for licensure or are certified as an ASC and/or are accredited by a nationally recognized accreditation program (e.g., the Joint Commission on Accreditation of Healthcare Organization's [JCAHO] new Office-Based Surgery Standards). Heretofore, relevant practice standards for the performance of endoscopic procedures in these settings have not been available, a situation that the AGA believes puts patients at risk. These standards have been developed to reduce that risk.


At present, the methods of mathematical modeling of real objects and processes play an important role in developing systems, aimed at processing geometric information. Such systems are based on mathematical models of real world objects, optimization methods and theory of building intelligent systems. The research is focused on the applied aspects of interval mathematical modeling in a geometric design. The classification of implementations of the interval mathematical model of the basic interval optimization placement problem, many implementations of which covers a broad class of scientific and applied placement problems, according to the type of classification of mathematical programming problems was performed. Various types of interval mappings of interval mathematical models in Euclidean space for the transition from the optimization problem in interval space to an equivalent optimization problem in Euclidean space were constructed. The method for solving the interval optimization problem in  as the two-criteria optimization problem in Euclidean space  was further developed. New science-based developments in the theory of geometric design and interval geometry provide a solution to the important applied problem of accounting errors in modeling and solving optimization problems of geometric design. The proposed tools for mathematical modeling and solving interval optimization placement problems were used in developing computer programs: "PackingofIntervalParallelepipeds", "PackingofIntervalPolygons", "Simulation of alloy properties".


This thesis examines the discursive construction of housing for asylum seekers in Sweden. Housing accommodations for asylum seekers are located within the confines of the nation state, whilst their inhabitants simultaneously are excluded from the nation state figured as political community. This illustrates the ambiguous position of stateless individuals within the international system of nations states and in relation to Sweden specifically.
 By discussing the relationship between discourse and material spatiality and by framing this discussion within theoretical conceptions of inside/outside and the border separating the two, I argue that asylum seekers defies this very division. Their housing accommodations are discursively framed as both outside and inside the sphere of the nation. This reflects an inability of our political language to make sense of the asylum seeker and the places constructed for this group. Simultaneously, precisely this ambiguity enables the housing of asylum seekers to be controlled by the state.


ECOSYSTEM RECOVERYWith six military bases, four national park areas, sprawling suburbanites, and off-road riders, there's considerable jostling for elbow room in the Mojave Desert. One unassuming neighbor, in particular, has been the focus of many real estate fights: the desert tortoise. And the shell-slinging is starting again.


During the research of the history of the Baroque pharmacy of the Merciful Brethern at the Kuks Hospice (Eastern Bohemia), established in 1743, and its professional standard, pharmaceutical literature was found at the preserved hospice library. The present author first focused on the existence of basic, obligatory literature: dispensatories, tariffs of medicaments, and juridical literature (pharmaceutical laws). There survived a small number of these books because many books were destroyed during various wars. The following dispensatories (pharmacopoeias) were found: Dispensarorium pharmaceuticum Austriaco-Viennense 1729/1738, Dispensatorium Regium et Electorale Borusso-Brandenburgicum 1744, Dispensatorium pharmaceuticum Pragensae renovatum 1750, Pharmacopoea Austriaco-provincialis 1774, 1775, 1790, 1794 (including a critical commentary by Z. G. Huszty 1797), The Military Dispensatory 1795, Pharmacopoea Austriaca 1812, 1814 and 1855. There are a few books of the tariffs of medicaments (only from 1795, 1816 and 1866) and juridical literature. These dispensatories (and their occurrence) will be useful for an analysis of laboratory preparation and supplying this pharmacy. A few illustrations of pharmaceutical literature, found bookplates, and a print of a painting of Count F. A. Sporck are attached.


As we studied in our literature, the recent method was presented for blocking of misbehaving user in the Tor networks called as Nymble. However the limitation which we identified for Nymble is that if the Nymble manager fails, then whole security system is fails. And hence this approach is heavily vulnerable for failure risks. Thus in this paper we are presenting the new extended method for overcoming above said problems. In this paper we propose a secure Misben system, where users acquire an ordered collection of Misbens, a special type of pseudonym, to connect to Websites. Without additional information, these Misbens are computationally hard to link and hence, using the stream of Misbens simulates anonymous access to services. Web sites, however, can blacklist users by obtaining a seed for a particular Misben, allowing them to link future Misbens from the same user. Servers can therefore blacklist anonymous users without knowledge of their IP addresses while allowing behaving users to connect anonymously. Our system ensures that users are aware of their blacklist status before they present a Misben, and disconnect immediately if they a0072e blacklisted. For the risk free and reliability of proposed approach we also proposed architecture with details that if first misben manager failed to generate seed when it get complaint from server, in previous systems in that condition system get collide and then anonymizing network in trouble ,so provide solution to this problem we introduced new 2 misben manager.


Objective. The purpose of this study was to explore professional practices for monitoring aided audibility for children who are deaf or hard of hearing (DHH). Design. A cross-sectional survey design was used to identify providers' self-reported practice patterns for monitoring aided audibility for children who use hearing aids, cochlear implants, and bone-conduction hearing aids. Three surveys were used. Study Sample. Practicing audiologists, speech-language pathologists, and deaf educators providing services to children birth to six years of age who use hearing technology were recruited to participate. A total of 184 surveys were included in the analysis (96 hearing aid; 47 cochlear implant; 41 bone conduction hearing aid). Results. Practice gaps were identified, including infrequent use of parent questionnaires to explore how children are hearing at home and in other environments, lack of loaner equipment for some children when hearing devices were being repaired, and inconsistent monitoring of data logging to identify challenges with hearing aid use. Conclusion. Children who are DHH and their parents rely on professionals to provide evidence-based practices. This study revealed practice gaps related to monitoring audibility, suggesting opportunities for training to address provider confidence and consistent implementation of monitoring practices.


The measurement of vehicle magnetic moments and the results from use of a fluxgate magnetic sensor to actuate a lighting system from the magnetic fields of passing vehicles is reported. A typical U.S. automobile has a magnetic moment of about 200 A-m2(Ampere-meters2), while for a school bus it is about 2000 A-m2. When the vehicle is modeled as an ideal magnetic dipole with a moment of 200 A-m2, the predicted results from an analysis of the sensor-vehicle geometry agree closely with observations of the system response to automobiles.


Abstract. Ground surveys and remote sensing are integral to establishing fair and equitable property valuations necessary for real property taxation. The International Association of Assessing Officers (IAAO) has embraced aerial and street-view imaging as part of its standards related to property tax assessments and audits. New technologies, including unmanned aerial systems (UAS) paired with imaging sensors, will become more common as local governments work to ensure their cadastre and tax rolls are both accurate and complete. Trends in mapping technology have seen an evolution in platforms from large, expensive manned aircraft to very small, inexpensive UAS. Traditional methods of photogrammetry have also given way to new equipment and sensors: digital cameras, infrared imagers, light detection and ranging (LiDAR) laser scanners, and now synthetic aperture radar (SAR). At the University of Alaska Fairbanks (UAF), we work extensively with unmanned aerial systems equipped with each of these newer sensors. UAF has significant experience flying unmanned systems in the US National Airspace, having begun in 1969 with scientific rockets and expanded to unmanned aircraft in 2003. Ongoing field experience allows UAF to partner effectively with outside organizations to test and develop leading-edge research in UAS and remote sensing. This presentation will discuss our research related to various sensors and payloads for mapping. We will also share our experience with UAS and optical systems for creating some of the first cadastral surveys in rural Alaska.


Introduction: The emergency department (ED) is often the first point of access to the health care system for patients with an acute mental health crisis. Outpatient resources are limited, typically do not operate after hours, and patients and their families often lack sufficient information on where and how to access mental health services within their communities. The objective of this study was to determine which community healthcare resources patients attempted to access for their mental health condition prior to presenting to the ED. Methods: Between April 2016 to June 2017, a convenience sample of adult ( 18 years) patients presenting to an academic ED (annual census 65,000) with a mental health complaint were invited to complete a 23-item, paper-based survey. The questionnaire was pilot-tested and peer-reviewed for feasibility and comprehension. Results: Of the 200 patients who completed the survey, mean (SD) age was 37 (16) years and 96 (48%) were male. 20 (10%) patients were brought to the ED involuntarily by police services. 175 (88%) had been previously diagnosed with a mental health condition, the most common being depression and/or anxiety (n=134, 67%). 47 (24%) patients indicated they were currently only connected to a primary care provider, while 94 (47%) patients indicated they had existing relationships with multiple mental healthcare providers. 117 (59%) patients attempted to see an alternative healthcare provider prior to coming to the ED. 78 (39%) patients had a pending scheduled appointment with a healthcare provider for their mental health condition, 44 (56%) of which were within 7 days of their ED visit, but chose to seek care in the ED. 38 (19%) patients either had a referral with no appointment date set, or had an impending mental health appointment scheduled more than 30 days from their ED visit. Conclusion: These findings suggest that most patients seeking ED care during a mental health crisis do so despite being connected to alternative healthcare providers and outpatient services. Future studies should attempt to determine reasons why patients with mental health conditions seek care in the ED, and examine barriers to mental health care in the community and outpatient setting.


India's livestock sector is one of the largest in the world and plays an important role in economy of India. The major problem in health sector is diseases and the lack of rapid detection systems for their diagnosis. Treatment of a disease condition is based on the diagnosis of the etiology /cause; hence diagnosis plays a pivotal role in devising a control strategy. Syndromic management as a first line of therapeutic practice have shown to be effective in various approaches but may inevitably results in overtreatment, resulting in wasted resources and, potentially, increased antimicrobial resistance. So the next generation of therapeutic management depends largely on evolving rapid point of care techniques for targeted management of diseases. The point of care test will prove to be a potential tool not only in diagnosis and control of emerging and dreaded diseases of human and animal significance but also detection of biological warfare agents. The current era in the field of point of care has come way far beyond detection of non infectious conditions like blood glucose monitoring, pregnancy diagnosis etc and has plunged into a sea of avenues. So this review is a brief overview on salient aspects on the transformation taken in this field for benefit of both the sectors.


The Book of Aneirin, which contains all the verses that go to make up the Gododdin, is a manuscript written on vellum about the year 1250. It is incomplete, ending at the bottom of folio 38 and at least three or four folios are missing. The condition of the manuscript suggests that the existing folios have been re-arranged. The various later copies of the poem on paper are not worth further study, for they are not evidence of better texts, but of the carelessness of copyists. The manuscript is in two different handwritings, which may be called-A and B. The body of the work is in A and was written first. As well as the Gododdin verses, it contains four other poems, the last of which is attributed to Taliesin. The verses in the second handwriting B were added afterwards on the empty pages of the manuscript, and are nearly all variant versions of ones already given in A.


The colony and cluster forming capacity of bone marrow cells (BM CFC and CluFC) in agar culture, was studied from 20 oligoblastic patients. 13 patients had a leukemic growth pattern and 12 of these died within one year after diagnosis. 7 patients had no leukemic growth and 4 are alive 16 to 90 months after diagnosis. Both the determination of the proportion of abnormally light buoyant density of CFC and CluFC and the study of their suiciding index were used to characterize more precisely the leukemic or nonleukemic status of patients. Because of the small number of patients involved in the later preliminary study, the prognostic significance cannot be valuated. Serial studies of individual patients showed different types of evolution in the growth pattern of BM CFC and CluFC. Either the increase of BM CFC and CluFC paralleled that of the myeloblasts, or there was a change in the growth pattern before AML transformation suggesting clonal evolution.