The achievement of children's quality of life is undoubtedly linked to the development of positive habits that will continue to be practiced in future lives. This can be done by developing awareness and behavior of a balanced clean and healthy lifestyle. The purpose of this study was to determine the increase in the PHBS ability of children. Various efforts have been made so that children with intellectual disabilities can maintain their cleanliness. The efforts made by the teacher are still not maximal so that the delivery of information about PHBS must be completed by another method, namely demonstration. This research was conducted at SDLB 127710 Pematangsiantar5 with an action research method that refers to the Kurt Lewin model. Data collection techniques used purposive sampling and data analysis with the Wilcoxon test. The results showed an increase in understanding of the PHBS of children with intellectual disabilities able to learn SDLB 127710 Pematangsiantar through the demonstration method. This is evidenced by the increase in the score, where the initial assessment was obtained (59%), while in the first cycle, the average score was good (69.9%). In short, the understanding of children with intellectual disabilities being able to learn about PHBS is increased by using the demonstration method.
Keywords: Intellectual Disability Children, PHBS program, Demonstration methods
References
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by virtue of its colonial history in the world capitalist structure. It produces many primary products and trading monopolies have been dominant and manufacture has been absent (relative to say, India or Indonesia). Leadership in recent years has often used socialist rhetoric to take advantage of Cold War but this leadership has seldom had strong local base. As Fitch and Oppenheim (Ghana: End of an Illusion) have shown, even Nkrumah had very narrow popular base in spite of his socialist rhetoric. Economic growth has thrown up new groups with interest in political power and the character of leadership and of ruling groups is changing. (Such a process is even now taking place in India.) Guy Hunter does not discuss or analyse this inter-relationship. He cannot thus predict whether his policy prescriptions will be adopted or if not adopted, what political obstacles will stand in their way. In general one gets the feeling that he hopes for a better aid policy on the part of Western countries as a large part of the solution. However new it may be, this is still paternalism. The liberal, 'new' paternalistic sentiments of Mr. Hunter's book as well as the readable way in which it is written will make it very popular and perhaps influential. It is for this reason that its shortcomings should be pointed out.


Simulated patient care is used in nursing curriculum to facilitate the transition from didactic to practical learning. On the basis of the observations of nurse educators, students frequently struggle when trying to apply the nursing process to simulated scenarios. The author discusses a study that was initiated after faculty observed his use of mind maps as a personal note-taking method.


The leaf miner (Coelaenomenodera elaeidis) is a major pest of the oil palm. It breaks out in epidemic proportions periodically, resulting in severe leaf defoliation and consequently low fresh fruit bunch (FFA) yield. This study analyses temperature, rainfall, relative humidity, and leaf miner abundance records sampled in oil palm fields between 1976 and 1980 in the main station of the Nigerian Institute for Oil Palm Research (NIFOR). Data for temperature, rainfall, and relative humidity were obtained from NIFOR meteorological station. Mathematical relationships between the insect stages (larva, pupa, and adult) and weather factors (rainfall and temperature) were developed indicating that pest predictions can be made for different leaf miner stages using their corresponding model equations giving specific values for rainfall and temperature. Variations in the seasonal patterns of temperature and rainfall are of major significance as a cue to timing leaf miner abundance and would help in making better decisions regarding where farmer action can target pest control interventions, thereby contributing to ensure food security. The need for continuous monitoring has great potential for detection and control of insect pests in oil palm growing areas.


Monocular head pose estimation requires learning a model that computes the intrinsic Euler angles for pose (yaw, pitch, roll) from an input image of human face. Annotating ground truth head pose angles for images in the wild is difficult and requires ad-hoc fitting procedures (which provides only coarse and approximate annotations). This highlights the need for approaches which can train on data captured in controlled environment and generalize on the images in the wild (with varying appearance and illumination of the face). Most present day deep learning approaches which learn a regression function directly on the input images fail to do so. To this end, we propose to use a higher level representation to regress the head pose while using deep learning architectures. More specifically, we use the uncertainty maps in the form of 2D soft localization heatmap images over five facial key-points, namely left ear, right ear, left eye, right eye and nose, and pass them through an convolutional neural network to regress the head-pose. We show head pose estimation results on two challenging benchmarks BIWI and AFLW and our approach surpasses the state of the art on both the datasets.


This study examines whether federal sentencing decisions are influenced by the racial/ethnic composition of federal court districts. Multilevel models of individual cases within federal judicial districts show that Black defendants receive moderately longer sentences than Whites, and that Hispanics and Whites receive similar sentences. These race/ethnicity effects on sentence length are found to vary across federal districts but not as predicted by racial threat theory. In contrast to racial threat predictions, Black sentence lengths are not significantly conditioned by the district Black population. Contrary to racial threat predictions, Hispanic defendants receive the harshest sentences when they account for the smallest share of the population (1 to 3 percent) and the most lenient sentences when they make up more sizable shares of district populations (more than 27 percent). Our results indicate that racial threat theory provides an inadequate explanation of how social contexts influence the federal sentencing of Blacks and Hispanics.


Seaweed farming is among the strategies adopted by the coastalcommunities in Zanzibar in an attempt to alleviate poverty. The study involvedseaweed farmers from the south coast of Unguja. Six shehia3 were purposefulselected and they included Paje, Bwejuu, Jambiani in the south and Bweleo,Dimani and Fumba for the west. Eighty seaweed farmers were randomly selectedfor interview. In addition five businessmen and some government officials who aresupposedly to be working with seaweed farmers were interviewed. Various PRAtools including structured questionnaire, check list, focus group discussion anddirect observation were used to collect the data.It was found out that majority of respondents were aged between 32-55 and 67%were married. 78% have been working as seaweed farmers for the past 6 years andmostly they produce spinosum type of seaweed. Selling of seaweeds is doneindividually and normally they sell semi-processed seaweeds. 90.2% of therespondents showed dissatisfaction with the current offered price of Tsh. 250/kgalthough 74.4% reported positive improvement in their livelihood resulting fromengaging in seaweed farming. There was a general concern that the governmenthave rendered little support to seaweed farmer especially in pricing and provisionof inputs and to a large extent the price is controlled by few private buyers. Despitethese challenges many women have opted to continue with the enterprise owing toabsence of alternative income generating activities. Key words: Seaweed farming, constraints, Zanzibar, marketing, pricing


At present, many countries around the world have significantly invested in sustainable transportation systems, especially for high-speed rail (HSR) infrastructures, since they are believed to improve economies, and regenerate regional and business growth. In this study, we focus on economic growth, dynamic land use, and urban mobility. The emphasis is placed on testing a hypothesis about whether HSRs can enable socio-economic development. Real case studies using big data from large cities in China, namely Shanghai province and Minhang districts, are taken into account. Socio-technical information such as employment rate, property pricing, and agglomeration in the country's economy is collected from the China Statistics Bureau and the China Academy of Railway Sciences for analyses. This research aims to re-examine practical factors resulting from HSR's impact on urban areas by using ANOVA analysis and dummy variable regression to analyse urban dynamics and property pricing. In addition, this study enhances the prediction outcomes that lead to urban planning strategies for the business area. The results reveal that there are various effects (i.e., regional accessibility, city development plans, and so on) required to enable the success of HSR infrastructure in order to enrich urban dynamics and land pricing. This paper also highlights critical perspectives towards sustainability, which are vital to social and economic impacts. In addition, this study provides crucial perspectives on sustainable developments for future HSR projects.


The work collective is a new institution that has developed in the socialist countries of Eastern Europe. It is part of a general effort to establish work and the place of work as a central reference point in people's lives. In an earlier study, which explored the effects of pressures at work on marriage and friendship relations among professional women and men in the United States and two socialist societies,1 quite unsolicited comments of respondents both from the Soviet Union and in the German Democratic Republic made it clear that the work collective was indeed an element of considerable importance in their personal lives. To explore it further promised to reveal important facets of daily life in a socialist country. When I had the chance to do a series of intensive interviews with professional women directly or indirectly affiliated with a university in the German Democratic Republic (GDR),2 I therefore decided to focus my talks on the work collective. I sought to clarify the formal structure and the tasks of the work collective, as well as to understand the actual role of the collective in the lives of the women I spoke with. That I talked mainly with professional women associated with one university is a limitation but one that also yields advantages. I was able to tap a variety of perspectives on the same or very similar work groups and to gain deeper insights into what they really mean for the practicing women professionals participating in them.


This study was conducted under irrigated conditions to determine the effects of seeding rate and harvest stage of pea (Pisum sativum ssp. arvense L. Poir), which was used here as a companion crop, on the hay yield, red clover (Trifolium pratense L.) densities and weed densities. Field studies were conducted as two separate experiments between 20042008. Red clover was sown together with pea at the rate of 20, 40, 60 and 80 seed m -2 . Plots were cut either at the 50% flowering stage for pea or when 70% of pea pods reached at typical lenght. Also, red clover was sown alone as a control and harvested at 50 % flowering stage. In the establishment year, companion crop had increasing effect on hay yield. Regarding total yield at the end of the 3 years, it is suggested that red clover was able to sown with pea at the seeding rate of 40 or 60 seed m -2 and it was harvested at 70% of pea pods reached typical lenght.


A substantial volume of research on the psychosocial impact of cancer clearly indicates that patients are likely to experience emotional distress. There is also evidence that psychosocial interventions aimed at decreasing distress provide tangible cost offsets to cancer patients, caregivers and treating institutions. One seemingly major drawback in the setup and delivery of a fully fledged screening program for distress is the extensive pecuniary requirements. Given that the categorical need for distress screening may be confounded by financial limitations, especially in a time of global recession, a cost-effective alternative seems appropriate. The model proposed herein is not a substitute screening program, nor does it eliminate the need to allocate resources to address the identified risks. It does, however, offer a cost-effective alternative to implement a high-risk distress patient identifying process, quite similar to algorithms used in screening for prostate cancer.


Abstract Study advances with a childhood case of partial deletion of the long arm of chromosome 7. The patient is a 36-month-old girl with growth retardation, mild mental retardation and delayed bone age. She showed no signs of hypotelorism, upslanting palpebral fissures, epicanthal folds, low-set ears, or flat and broad nasal bridge. Microarray testing using the Affymetrix CytoScan HD array revealed an approximately 58 kb deletion at 7q31.1 in the girl and her father, suggesting paternal origin. As the patient had no characteristic facial features, 7q deletions had not been considered. This case broadens the range of case presentations for microdeletions of chromosome 7.


Because of the frequent occurrence of cataracts in the general population, the surgical techniques for their removal and the potential associated complications are of widespread interest. The approaches available in general and those used at the Mayo Clinic are described.


Surgical Site infections (SSIs) are a major source of morbidity, mortality and increased medical costs among patients undergoing surgeries. SSIs may be detected during hospitalization following surgery, upon readmission, through Emergency Department or clinic visits. Calling-back patients might be used to detect SSIs in patients who seek medical care in different centres. An active, patient-based, prospective surveillance for SSI following orthopaedic and neurological procedures was conducted between July and September 2016 at the American University of Beirut Medical Centre (AUBMC).
Trained infection control preventionist conducted the surveillance based on the CDC/NHSN (Centers for Disease control and Prevention/National Health Care Safety Network) definition of SSI and the NHSN methodology for data collection by calling-back patients and assessing the signs and symptoms of SSIs at 30 or 90 days after the operative procedure using a standardized checklist. Calling-back patients was initiated following an increase in the SSI rates for particular surgeons in these specialties. Rates were expressed as number of SSI in a designated specialty per 100 operative procedures of the same specialty and were benchmarked with NHSN and the International Nosocomial Infection Control Consortium (INICC) rates.
No SSIs were identified through the phone calls among the 178 patients who were assessed throughout the surveillance period. Whereas, 2 SSIs were identified through the routine surveillance of hospital re-admissions and one SSI was identified from the review of the outpatient clinic records. SSI rates remained unchanged compared to the adopted surveillance methodology and were 3.7% following neurological surgeries and zero following orthopaedic surgeries at the time of the active surveillance.
Call-back programs may be beneficial to obtain additional post-discharge surveillance information. However, patients may have a difficult time assessing their status and the possibility of developing an SSI. Moreover, this process was found to be time consuming, and was not successful in identifying additional SSIs. Re-assessment of this method is essential to examine the value of calling-back patients in detecting SSIs.


Proceedings: AACR 101st Annual Meeting 2010‐‐ Apr 17‐21, 2010; Washington, DC

The cyclin-dependent kinase inhibitor P57Kip2 (Cdkn1c, p57) is a tumor suppressor gene with strong differential expression in both human and murine hematopoietic stem cells (HSC). P57 serves essential roles during embryogenesis, functioning in tissue-specific developmental programs to coordinate proliferation, differentiation and apoptosis. We have identified P57 as an early transcriptional target of the tumor suppressor TGFβ which is required for TGFβ-induced cytostasis of human CD34+ hematopoietic progenitor/stem cells; functions that provide a mechanistic basis for its expression being silenced in many aggressive human myeloid and lymphoid malignancies. To understand the role of P57 in HSC function, we used an engineered mouse strain deficient in P57. Using limiting-dilution HSC transplantation, the gold-standard assay with which to enumerate HSCs, we found that the fetal livers of p57-null mice have ∼4-fold fewer HSCs than their wild-type littermate controls. When we transplanted wt recipient mice with a mixture of p57-wt and p57-null fetal liver mononuclear cells (FLMC), we found that the p57-null hematopoietic cells were underrepresented in the blood of the recipient animals at steady-state. Both the limiting-dilution and competitive repopulation experiments indicate that the absence of p57 compromises HSC development. Strikingly, despite this quantitative deficit, we found that p57-null HSCs are qualitatively superior to p57-wt HSCs. Using serial transplantation, an assay of in vivo HSC self-renewal, we found that p57-null HSCs can be transplanted for two generations beyond which p57-wt HSCs are exhausted and unable to reconstitute hematopoiesis in the recipient animals. This result demonstrates under the tonic strain of serial transplantation, p57 normally serves to restrain HSC self-renewal. Importantly, mice with p57-null hematopoiesis are less sensitive to myelotoxic stress induced by the chemotherapeutics, 5-Fluorouracil (5FU) and cytarabine and have a shallower and shorter nadir following such treatment. Mice with p57-null hematopoiesis also recovered more briskly to the haemolytic agent phenylhydrazine suggesting that p57 serves a critical function restraining the stress-response of hematopoisis. When we administered 5FU to mice transplanted with mixtures of p57-null and p57-wt HSCs, we found that p57-null hematopoiesis contributed disproportionately to hematopoietic recovery and that this enhanced competition was durable. In composite, our findings reveal a novel role of p57 to restrain HSC self-renewal during periods of hematopoietic stress. These results suggest that cells deficient in p57 have an advantage over p57-expressing cells only after hematopoietic stress suggesting that silenced p57 expression can serve to promote malignant hematopoiesis at the expense of normal hematopoiesis and may contribute to chemotherapy resistance.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2548.


"frames" are good but they cannot be combined into a dependable picture of any area. Comparison of potentials among areas as of a given time are even more difficult and are made so by the combination of several SMSA's into SCA's. The real value of this report would be its repetition at annual or biennial periods, if possible increasing the timeliness of some of the data, thus disclosing trends for the statistical items covered. The reviewer's problems and frustrations with Metropolitan Areas, Industrial Areas, and New England "towns"-and the constant conflict between comparability and change-during his years of service with the Bureau of the Census tempers his criticism of this study. It is a good try and repetition should improve both methods and usefulness. VERGIL D. REED Professor Emeritus Columbia University


A large amount of the primary energy consumed in the US is derived from the built environment followed by energy consumed in the transportation and industrial sectors. Consequently, improving the energy efficiency of buildings is an important part of ensuring a more sustainable world for future generations. Of the various techniques employed to improve the energy efficiency of buildings, commissioning and retrofits continue to be the most widely applied solutions. Control optimization, mainly imbedded with continuous commissioning so far, is not applied as widely. Even though there are currently a few applications that integrate all three techniques, no comparison has been made between the integrated process and conventional process. The objective of this research is thus to conduct such a comparison. This thesis begins with a review of the applications for commissioning, retrofits, and control optimization of existing buildings. Then, to compare the conventional commissioning and retrofit process with integrated process, a case demonstration is applied to an existing small commercial building. Study results indicate that in this existing commercial building, conventional retrofits should not be implemented without commissioning because of long simple payback period. The integrated process is more cost effective than conventional process. It can achieve Net Present Value (NPV) of 251,390$ during a 20-years span, which is 2.82 times of commissioning-only process and 1.62 times of combined commissioning and retrofits process.


Human toll-like receptors (TLRs) recognize pathogen-associated molecular patterns (PAMPs) to raise innate immune responses. The human TLR family was discovered because of its sequence similarity to fruit fly (Drosophila) Toll, which is involved in an anti-fungal response. In this review, we focus on the origin of the vertebrate TLR family highlighted through functional and phylogenetic analyses of TLRs in non-mammalian vertebrates. Recent extensive genome projects revealed that teleosts contain almost all subsets of TLRs that correspond to human TLRs (TLR1, 2, 3, 4, 5, 7, 8, and 9), whereas the urochordate Ciona intestinalis contains only a few TLR genes. Therefore, mammals likely obtained almost all TLR family members at the beginning of vertebrate evolution. This premise is further supported by several functional analyses of non-mammalian TLRs. We have summarized several teleost TLRs with unique properties distinct from mammalian TLRs to outline their specific roles. According to Takifugu rubripes genome project, the puffer fish possesses fish-specific TLR21 and 22. Surprisingly, phylogenetic analyses indicate that TLR21 and 22 emerged during an early period of vertebrate evolution in parallel with other TLRs and that the mammalian ancestor lost TLR21 and 22 during evolution. Our laboratory recently revealed that TLR22 recognizes double-strand RNA and induces interferon production through the TICAM-1 adaptor, as in TLR3, but unlike TLR3, TLR22 localizes to the cell surface. Therefore, differential expression of TLR3 and TLR22, rather than simple redundancy of RNA sensors, may explain the effective protection of fish from RNA virus infection in the water. In this review, we summarize the similarities and differences of the TLR family in various vertebrates and introduce these unique TLRs for a possible application to the field of clinical practices for cancer or virus infection.


When a plaintiff files a civil lawsuit in federal court, her complaint must satisfy certain minimum standards. Specifically, under the prevailing understanding of Federal Rule of Civil Procedure 8(a), a complaint must plead sufficient factual matter to state a claim to relief that is plausible on its face, rather than mere conclusory statements. Given the significantly higher stakes involved in criminal cases, one might think that an even more robust requirement would exist in that context. But in fact a weaker pleading standard reigns. Under the governing interpretation of Federal Rule of Criminal Procedure 7(c), indictments that simply parrot the language of a statute are often sufficient. As this Article shows, however, that pleading balance is misguided. The drafters of Rule 7(c) designed the Rule to be at least as stringent as Rule 8(a), as demonstrated by the text of Rules 7(c) and 8(a), the history of American pleading, the original Advisory Committee Note to Rule 7(c), and the drafting history of the Criminal Rules. And the drafters' original design should govern today, notwithstanding the Supreme Court's amplification of the civil pleading standard in Bell Atlantic Corp. v. Twombly and Ashcroft v. Iqbal. All of that means that our current pleading regime should be rethought, that criminal defendants should receive more protections and information about the case against them than they presently do, and that policy arguments—which seem to favor a stronger criminal pleading standard—are all the more critical.


Forensic accounting is one of the modern domains of accounting that incorporates special knowledge and a group of skills that are utilized to fight financial corruption and creative accounting, support legal action against such practices and tackle the resulting consequences. The research at hand investigates fundamental perceptions of forensic accounting and discusses methods that forensic accounting uses to detect and curb creative accounting. It also emphasizes the concept of creative accounting, discusses its types and outcomes, and illustrates the techniques of forensic accounting that are used to fight it. A well-structured, five-point Likert style questionnaire was constructed and distributed among a sample of 350 CPAs from the total population of Certified Public Accountants in Mount Lebanon and Beirut Governorates. The researchers used the Statistical Package for Social Sciences (SPSS) to make various statistical tests to analyze the outputs. The research yielded some important findings, mainly that both the integrated and the dimensional audit approaches, which are two forensic accounting methods, lead to curbing creative accounting practices. As a result, the researchers had some recommendations.


CD44 is a glycoprotein that is involved in inflammation and cell-cell/cell-matrix interactions, is upregulated in the kidney upon injury, and leads to fibrosis through enhancement of TGF-beta1 signaling. Absence of CD44 prevents development of renal fibrosis in unilateral ureteral obstruction (UUO). A hallmark of development of renal fibrosis is the degeneration of the capillary network. This study shows that CD44 is upregulated on capillary endothelial cells during UUO. For elucidation of the role of CD44 on peritubular endothelial cells in UUO, capillary network degeneration was compared in CD44+/+ and CD44-/- mice. As expected, degeneration of the capillary network was observed in CD44+/+ mice during UUO, associated with increased endothelial apoptosis. However, in the absence of CD44, degeneration of the network is prevented as a result of a decrease in the rate of apoptosis in endothelial cells. The divergence in endothelial apoptosis is not correlated to differential vascular endothelial growth factor or thrombospondin-1 expression. For further investigation of capillary regression, CD44+/+ and CD44-/- peritubular capillary endothelial cell lines were established. With the use of these cells, it is shown that interaction between CD44 and its ligand hyaluronic acid enhances the proapoptotic effect of TGF-beta1 but not thrombospondin-1 on endothelial cells, contributing to the degeneration of the capillary network. Blocking interaction between hyaluronic acid and CD44 therefore may be a potential therapeutic opportunity to preserve the capillary network and prevent the development of fibrosis in chronic renal disease.


This dissertation aimed at enabling an understanding of the development of the asset-backed security market after the 2007 financial crisis. To reach this objective, the post-crisis ABS market was investigated using an empirical strategy on three secondary and large-scale data sets. In the wake of the financial crisis that began in the summer of 2007 in the U.S. subprime mortgage market, regulations has been strengthen in various steps by governments of major financial markets throughout the world. Non-surprisingly, a particular focus has been on the securitization market, given the dominant role it played in that crisis and, of course, given the course of events in the securitization market during that crisis. This study offers a comprehensive analysis of the effects of the financial crisis on the primary market of Non-U.S. asset-backed securities. Summarized, this thesis finds significant effects on primary market spreads in the ABS market. Furthermore, this study reveals important changes on the risk profiles of the issued securities and concludes that external influences such as the 2007 financial crisis as well as central bank quantitative easing since 2014 affect also primary market yield determinants and important characteristics of the ABS pricing process such as risk monitoring variables.


This study presents a distributed multi-agent-based traffic signal control for optimising green timing in an urban arterial road network to reduce the total travel time and delay experienced by vehicles. The proposed multi-agent architecture uses traffic data collected by sensors at each intersection, stored historical traffic patterns and data communicated from agents in adjacent intersections to compute green time for a phase. The parameters like weights, threshold values used in computing the green time is fine tuned by online reinforcement learning with an objective to reduce overall delay. PARAMICS software was used as a platform to simulate 29 signalised intersection at Central Business District of Singapore and test the performance of proposed multi-agent traffic signal control for different traffic scenarios. The proposed multi-agent reinforcement learning (RLA) signal control showed significant improvement in mean time delay and speed in comparison to other traffic control system like hierarchical multi-agent system (HMS), cooperative ensemble (CE) and actuated control.


We encountered a 38-years-old female patient who was complaining of an unpleasant sensation of the left cervical area due to a recurrent tumor originating from the middle pharynx. She had a history of surgically resected neurofibroma and lipoma from the anterior oropharyngeal wall respectively 5 years and 11 years previously. The preoperative diagnosis of a benign, non-epithelial neoplasm was made based on the imaging studies and surgical treatment was scheduled. An extended surgical resection of the middle pharynx including normal mucosa and a part of the tongue base was successfully accomplished. To cover the pharyngeal defect, a right antero-lateral thigh musculo-cutaneous flap was used for reconstruction. Microscopically, the surgically resected tissue showed a mixed condition of mature cartilaginous, bony and fibroadipose tissue without atypia. The final diagnosis was a benign mesenchymoma which was thought to have developed from pluripotential mesenchymal cells. We considered that the past tumorous lesions had possibly originated in those cells. Because pluripotential mesenchymal cells cannot easily be identified with ordinary histopathological examination, the determination of optimal surgical margins is difficult. In the case of mesenchymoma, substantial marginal tissue should be resected in order to prevent recurrence even in the case of a pathologically-proven benign tumor.


Over the past few years, organizations have faced pressure from stakeholders to implement lean principles in their product development processes. However, the existing methods are not capable of measuring the benefits of adopting lean initiatives in the product development process. This research aims to develop a performance measurement model that can measure the effects of implementing lean in the engineering process. Engineering effort is analyzed in order to identify hidden wastes (e.g. inventory in the form of information about product specifications or engineering errors) in the engineering process. The model has been implemented in a civil design process of an engineering consultant company to validate the general applicability of the new model. The implementation of the model provides visibility on the waste hidden in the engineering process and quantifies that waste. The most significant contribution of this research is the development of new performance metrics and a decomposition chart. Finally, performance metrics are properly linked and the model treats lean as a holistic system, quantitatively measuring performance at different organizational levels.


an analysis of some data from the United States of America. The introduction defines the objectives of the book. These are to examine competition in the ethical (prescription) and O.T.C. (over-the-counter) market segments of the U.K. pharmaceutical industry and to comment on the industry's marketing process. The author also examines the interaction between market share and selected elements of the marketing mix in the ethical market. His claim that this is the first published study of this type in the pharmaceutical industry is undoubtedly accurate. However, it is difficult to believe that established market researchers in the industry have not made similar analyses for in-company reports using the same source data. For the reader with no knowledge of the industry the author provides a good general description in the chapter on selected characteristics of the market. Competition within the industry during the period 1964 to 1973 is discussed and marketing strategies considered, with particular reference to promotional expenditure and pricing strategies. Mr. Slatter courageously attempts the difficult task of looking into the future. This is an interesting and useful chapter. In the final chapter the author deals with competition in the over-the-counter market. This is, in general, a consumer market and the importance of attaining a major market share in at least one product group is emphasised. Acknowledging the need to preserve the confidentiality of the basic market research data it is difficult to understand why the author used two such reports only, and why he used them as he did in his analyses. One may well have doubts concerning the wisdom of using the cash value of sales as a measure of market share throughout the book. This has the disadvantage, when comparing market share percentages, that such comparisons can be distorted by price increases in one or more products or product groups, or by the introduction of a new, high priced, product into a therapeutic class. It would have been helpful had some method been found to incorporate the percentage share of prescriptions written into some of the statistical analyses. In his analysis of marketing strategies the author compares percentage of promotional expenditure with percentage market share in therapeutic groups. Promotional expenditure figures are obtained from the Medical Promotion Index. This data covers expenditure on journal advertising, direct mail and sales representatives only. The data does not include expenditure on samples, convention exhibits, 'give-away' items such as pens, films and doctor meetings or symposia. This is clearly explained in the book. It is, therefore, unfortunate that this partial data is used in making comparisons between manufacturers, and these comparisons in isolation are of


We consider pure mth order subcoercive operators with complex coefficients acting on a connected nilpotent Lie group.We derive Gaussian bounds with the correct small time singularity and the optimal large time asymptotic behaviour on the heat kernel and all its derivatives, both right and left. Further we prove that the Riesz transforms of all orders are bounded on the Lp-spaces with p ∈ (1,∞). Finally, for second-order operators with real coefficients we derive matching Gaussian lower bounds and deduce Harnack inequalities valid for all times.


Genome-wide association studies (GWAS) have discovered numerous genomic loci associated with Alzheimer's disease (AD), yet the causal genes and variants remain incompletely identified. We performed an updated genome-wide AD meta-analysis, which identified 37 risk loci, including novel associations near genes CCDC6, TSPAN14, NCK2, and SPRED2. Using three SNP-level fine-mapping methods, we identified 21 SNPs with greater than 50% probability each of being causally involved in AD risk, and others strongly suggested by functional annotation. We followed this with colocalisation analyses across 109 gene expression quantitative trait loci (eQTL) datasets, and prioritization of genes using protein interaction networks and tissue-specific expression. Combining this information into a quantitative score, we find that evidence converges on likely causal genes, including the above four genes, and those at previously discovered AD loci including BIN1, APH1B, PTK2B, PILRA, and CASS4.


or hemolytic anemia, were apparent in any of these patients. We found using the Spearman rank correlation a strong correlation in the 46 patients between CK and aldolase (r = 0.69, p < 0.0001), AST (r = 0.79, p < 0.0001), and LDH (r = 0.66, p < 0.0001). These results indicate that, in agreement with Dr. Carter's statement, when evaluating patients for DM or PM, the initial blood test should be a CK measurement. However, the finding of a high aldolase level as the sole blood marker of muscle damage in PM with or without dermatological signs may not be anecdotal, since we observed this scenario in 4 patients (9.5%) with the disorder. Similarly, Vignos, et al found that 4 out of 20 patients with PM had normal CK. Of these 4 patients, 2 had elevated aldolase levels 6 . Further, the AST and LDH levels may also be normal in this setting, as observed in 3 of 4 patients in our series. We therefore fully agree with Carter, et al and Dr. Mercado's opinion that, in the appropriate clinical setting, normal levels of both CK and AST do not preclude active PM. In patients, particularly (but not only) those with malignancy, whose clinical picture strongly suggests PM, but who are found to have normal CK levels, it may be useful to control aldolase levels. However, whether aldolase may accurately serve to follow the efficacy of treatment in patients with PM and a normal CK level deserves further study. hypertension, but no renal involvement. No study patient had any symptom or sign of secondary renal disease. Our small study indicates that the IIF results did not appear to predict the occurrence of specific ANCA in patients with SSc, in agreement with the findings of Ruffatti, et al 1 . Further studies are needed to determine whether autoantibodies to several neutrophil antigens are present in SSc and whether these antibodies are associated with some clinical features. phosphonates in RA showed a suppression of bone resorption markers 2-4,6 . Whether our findings on the suppression of the cartilage degradation marker CTxII confirm recent suggestions of a chondroprotective effect of bisphosphonates 9,10 or indicate a lack of specificity of the marker remains uncertain. Thus, whether and how bisphosphonates influence RA disease activity remains a question to be answered by studies of sufficient sample size and duration that investigate effects of highly potent bisphosphonates in patients with active RA.


PURPOSE
A dynamic process exists in which hematopoietic progenitor andstromal cells interact to maintain normal hematopoiesis or to adjust to hematopoietic needs under "stress" situations. The effect that tumor-produced growth factors have on hematopoiesis has not been addressed. We postulate that an excess of tumor-produced stimulatory or inhibitory cytokines could impact marrow proliferation and sensitivity to cytotoxic agents.

METHODS
We used two tumor lines (TGP47 and TGP51) taken from a panel of syngeneic murine pancreatic carcinomas, in which each produces a unique array of cytokines, and evaluated their effect in vitro on marrow proliferation and chemosensitivity.

RESULTS
TGP51- and TGP47-conditioned medium increased [3H]thymidine incorporation into cultured marrow cells by approximately 12-fold and 4.8-fold, respectively. The percent of cells in the S + G2-M phases of the cell cycle increased by 110% (TGP51) and 44% (TGP47), and the MCF for proliferating cell nuclear antigen expression increased by 104% (TGP51) and 45% (TGP47). Marrow proliferation of untreated cells could be reduced by interleukin 6 but not by granulocyte macrophage colony-stimulating factor neutralization. Conditioned medium-induced stimulation was unchanged by either interleukin 6alpha or granulocyte macrophage colony-stimulating factor alpha. FLT3-Lalpha reduced marrow proliferation induced by TGP51 medium. Addition of FLT3-L to TGP47 medium additionally enhanced the marrow proliferation. Antitumor necrosis factor alpha additionally increased marrow proliferation induced by TGP47 and TGP51 conditioned medium, whereas addition of tumor necrosis factor alpha reduced marrow proliferation associated with TGP51 medium. The TGP51-induced increase in marrow proliferation resulted in increased marrow chemosensitivity to three myelosuppressive drugs: doxorubicin, cyclophosphamide, and CPT-11, decreasing the IC50 by 46%, 38%, and 95%, respectively.

CONCLUSION
Tumor-produced cytokines can affect marrow proliferative activity and, thus, chemosensitivity to three distinct classes of chemotherapeutics.


Maize (Zea mays L) seed saving among producers in low-income and lesser in developed countries is often prac-ticed. In Mexico, advanced generations of maize hybrids and even mixtures of single-cross (SCs) and double-cross hybrids (DCs) are grown. These populations are expected to perform similar to the synthetic varieties (SVs) . srenibmocd ooge ra, ylbamuserp, tahts dirbyhe htf on oitavirede htn id evlovnis enile htm orfd evirede bd luoct ahtThe derivation of SVs from hybrids seems attractive because would be easier because of the reduced number of potential parents. The frequencies of the genes of the SCs, however, may differ from those of the DCs, may affect the inbreeding coefficient, and thereby the genotypic mean. To address these and related issues, this study was conducted to derive formulae to calculate the inbreeding coefficient (IC) and to predict the genotypic mean (GM) of SVs derived from a mixture of s SCs and d DCs, each represented by m individuals. Formulae for its IC (FSynSC,DC) and GM (YSynSC,DC) were derived. For hybrid parents derived from fully inbred and unrelated lines, FSynSC,DC = [2ms+d(m+1)]/[4m(s+d)2] and, independently of the type of lines, YSynSC,DC = YPS/(s+d)+YPC(s+d−1)/(s+d), where YPS is the genotypic mean of the s + d populations that result from randomly mating the m individuals of each par-ent, and YPC is the mean of all crosses between the s + d parents. From eight lines, three sets of parents (each set involved all eight lines) were considered: 1) four SCs (4SC), 2) two SCs and one DC (2SC+DC), and 3) two DCs (2DC). The SV produced by 4SC shows the lowest IC, although for large m (m > 10) the IC of the SV produced by 2DC is about equal. The largest IC, and thereby the smallest GM, is associated to 2SC+DC because the coances-try between individuals and gene frequencies in SCs are twice those of DCs. What is more noticeable, however, is that 2DC produces the cheapest way of deriving and predicting a SV since only three entries are required (two parents and their cross) and with large m the IC is about the minimum.


Although micelles are commonly used for drug delivery purposes, their long-term fate is often unknown due to photobleaching of the fluorescent labels or the use of toxic materials. Here, we present a metal-free, nontoxic, nonbleaching, fluorescent micelle that can address these shortcomings. A simple, yet versatile, profluorescent micellar system, built from amphiphilic poly(p-phenylenevinylene) (PPV) block copolymers, for use in drug delivery applications is introduced. Polymer micelles made from PPV show excellent stability for up to 1 year and are successfully loaded with anticancer drugs (curcumin or doxorubicin) without requiring introduction of physical or chemical cross-links. The micelles are taken up efficiently by the cells, which triggers disassembly, releasing the encapsulated material. Disassembly of the micelles and drug release is conveniently monitored as fluorescence of the single polymer chains appear, which enables not only to monitor the release of the payload, but in principle also the fate of the polymer over longer periods of time.


Anomia is one of the most frequent manifestations in aphasia. Model-based treatments for anomia usually focus on semantic and/or phonological levels of processing. This study reports treatment of anomia in an individual with chronic aphasia. After baseline testing, she received a training program in which semantic and phonological treatments were contrasted. The semantic treatment resulted in generalization to closely semantically related untreated items. Moreover, this beneficial effect was highly durable and maintained at the immediate posttreatment level for at least 3 months. However, the positive response to the phonological treatment was limited to treated stimuli only. This case study demonstrates that improvement in word-finding abilities may be possible in chronic anomic aphasia, even after a relatively short period of therapy. It also underlines the importance of relying on theoretical models of language processing to adapt treatments to each specific deficit.


The development of thrombotic microangiopathy (TMA) associated with the use of cyclosporine has been well documented. Treatments have included discontinuation or reduction of cyclosporine dose with or without concurrent plasma exchange, plasma infusion, anticoagulation, and intravenous immunoglobulin G infusion. However, for recipients of organ transplantation, removing the inciting agent is not without the attendant risk of precipitating acute rejection and graft loss. The last decade has seen the emergence of tacrolimus as a potent immunosuppressive agent with mechanisms of action virtually identical to those of cyclosporine. As a result, switching to tacrolimus has been reported to be a viable therapeutic option in the setting of cyclosporine-induced TMA. With the more widespread application of tacrolimus in organ transplantation, tacrolimus-associated TMA has also been recognized. However, literature regarding the incidence of the recurrence of TMA in patients exposed sequentially to cyclosporine and tacrolimus is limited. We report a case of a living donor renal transplant recipient who developed cyclosporine-induced TMA that responded to the withdrawal of cyclosporine in conjunction with plasmapheresis and fresh frozen plasma replacement therapy. Introduction of tacrolimus as an alternative immunosuppressive agent resulted in the recurrence of TMA and the subsequent loss of the renal allograft. Patients who are switched from cyclosporine to tacrolimus or vice versa should be closely monitored for the signs and symptoms of recurrent TMA.


We report on the new technical realization of single-shot color digital holographic microscopy. For this application, we propose to use an original three-wavelength red, green, and blue laser based on the Nd:YAG active element with sequential parametric downconversion and upconversion of optical frequencies into red (634 nm), green (532 nm), and blue (451 nm) spectral intervals. This light source provides high-power short (∼10  ns) pulses and enables simultaneous formation of three color interference patterns in a two-path interferometer. Their registration by a color image sensor provides fast acquisition of phase delay distribution induced by the inspected object at three wavelengths without spectral tuning.


BACKGROUND
Eating behavior is an etiologic factor in the development of lifestyle-related diseases. Knowledge about the stability of eating behavior during the transition from adolescence to early adulthood has implication for dietary interventions for children and young adolescents.

METHOD
Dietary data were collected by means of a short food frequency questionnaire as part of a Norwegian longitudinal cohort study on health behavior, lifestyle, and self-reported health of adolescents. Of 885 14-year-old baseline participants, 521 21-year-olds participated and 40% completed all surveys at each time point.

RESULTS
Mean weekly frequency of consumption of fruit and vegetables decreased by 1-2.5 times per week between ages 14 and 21, whereas that of sugar-containing soft drinks increased by almost 1 time per week between ages 15 and 16. Tracking of consumption patterns into young adulthood was seen for all four foods (P < 0.05 for differences in means between the tracking groups). The proportions of individuals remaining in the same tracking categories at the major transition stages were 50-70%. Yet, some changed in the opposite direction of the observed trends.

CONCLUSIONS
Despite the overall changes in mean weekly frequency of consumption and prevalence of daily consumers, relative ranking by frequency at age 14 indicated some stability of eating behavior into young adulthood.


Abstract : The Air Force Weapons Laboratory attempted to make 100 time-of-arrival measurements on Pre-DIRECT COURSE. With an 88 percent success rate, the detonation wave propagation within the charge was measured. The top and bottom hemispheres detonated at two different rates. However, the detonation velocities were well within the existing data base for Ammonium-Nitrate Fuel Oil charges. One large jet was observed on the charge but its location should not have caused any problems for ground level measurements. Twenty experimental time-of-arrival crystals were also fielded; however, the results are skeptical due to the grounding system of the support structure. (Author)


As a class of porous materials with crystal lattices, metal–organic frameworks (MOFs), featuring outstanding specific surface area, tunable functionality, and versatile structures, have attracted huge attention in the past two decades. Since the first conductive MOF is successfully synthesized in 2009, considerable progress has been achieved for the development of conductive MOFs, allowing their use in diverse applications for electrochemical energy storage. Among those applications, supercapacitors have received great interest because of their high power density, fast charging ability, and excellent cycling stability. Here, the efforts hitherto devoted to the synthesis and design of conductive MOFs and their auspicious capacitive performance are summarized. Using conductive MOFs as a unique platform medium, the electronic and molecular aspects of the energy storage mechanism in supercapacitors with MOF electrodes are discussed, highlighting the advantages and limitations to inspire new ideas for the development of conductive MOFs for supercapacitors.


Users develop habits in relation to information systems (IS) to reduce the cognitive and behavioural efforts needed for using them. However, when these systems have to be discontinued, users face challenges regarding how to stop relying on their legacy habits. Despite their importance, we know little about how legacy habits shape the way users discontinue a legacy system. Through a comparative case‐study approach, in a large mortgage firm and an international telecommunication company, we identify three roles that these habits play during the discontinuance process. We demonstrate that legacy habits not only play an 'inhibiting' role by keeping users attached to legacy systems; they also play a 'bridging' role by acting as a common ground for users to start working with a new system and a 'deterring' role when users resent certain habits of working with the legacy systems, despite their orientation to keep relying on these habits. We contribute to the IS habit literature by extending the roles of legacy habits beyond an inhibiting role. We also enrich the conceptualisation of legacy habits beyond the individual level by showing that the socio‐technical conditions in which the habits are embedded impact the emergence and evolution of their roles during the discontinuance process. We discuss the implications of our findings for theorising and managing IS discontinuance process.


Introduction There is some debate as to what extent epidemiological data for the prevalence of childhood tinnitus can be relied on. While indications are that the prevalence is relatively high, referral numbers for children with tinnitus are reported to be low and many of the studies have a number of methodological difficulties. We describe the protocol of a systematic review aimed at assessing the prevalence of tinnitus and/or hyperacusis in children and young people. Methods and analysis We will include studies of any design (except case reports or case series) comparing the prevalence of tinnitus and/or hyperacusis in children and young people with and without hearing loss, any known external exposure and psychological disorders. We will search the following databases: PubMed, EMBASE and Scopus. No restrictions of language will be applied in the search strategy but during the article selection language is limited to English, German and Scandinavian languages. Primary and additional outcomes will be the prevalence of tinnitus/hyperacusis and the severity, respectively. Ethics and dissemination No ethical issues are foreseen. The results will be published in a peer-reviewed journal and presented at national and international conferences of audiology and paediatrics. Trail registration number This review protocol is registered in the PROSPERO International Prospective Register of Systematic Reviews, registration number CRD42014013456.


This paper presents a position control strategy for a pump-controlled electro-hydrostatic actuator (EHA) using feedforward control with disturbance compensation. As the disturbance observer is used to estimate nonlinear dynamics of EHA, which has valve-opening conditionals, as well as external disturbances, an additional feedforward control is adopted to achieve rapid response. The effectiveness of the proposed control strategy is verified through experiment using an EHA test bench. The proposed controller shows better tracking performance compared with a conventional PID controller.


Abstract Researchers usually query the large biomedical literature in PubMed via keywords, logical operators and filters, none of which is very intuitive. Question answering systems are an alternative to keyword searches. They allow questions in natural language as input and results reflect the given type of question, such as short answers and summaries. Few of those systems are available online but they experience drawbacks in terms of long response times and they support a limited amount of question and result types. Additionally, user interfaces are usually restricted to only displaying the retrieved information. For our Olelo web application, we combined biomedical literature and terminologies in a fast in-memory database to enable real-time responses to researchers' queries. Further, we extended the built-in natural language processing features of the database with question answering and summarization procedures. Combined with a new explorative approach of document filtering and a clean user interface, Olelo enables a fast and intelligent search through the ever-growing biomedical literature. Olelo is available at http://www.hpi.de/plattner/olelo.


INTRODUCTION
Given the increasing number of adoptions from China in countries such as Spain, a study was designed to know and assess the nutritional profile at arrival and its likely implication in global health status, growth, and development of adopted Chinese girls.

PATIENTS AND METHODS
Eighty-five Chinese girls adopted in Spain during the 2002-2003 period and ages ranging 7-33 months of life were studied at the Social Pediatrics Unit of the "Niño Jesús" Hospital, Madrid. Datas regarding institution of origin, nutritional parameters (anthropometrical and biochemical), presence of associated diseases, and developmental retardations (psychomotor/bone age) were gathered.

RESULTS
Waterlow's nutritional index showed a malnourishment rate of 11% based on Chinese reference tables, as compared to 58% based on Spanish tables, of which 82% was acute malnourishment. When comparing the efficacy of both nutritional assessment methods proposed by Waterlow and Gomez, there were no differences in detection of malnourishment in spite of the fact that the latter author gives priority to the weight/age index as a nutritional indicator at ages lower than 2 years. Eighteen percent of the girls were considered at (height/age < p10) of suffering chronic malnourishment, but this was only confirmed in 67% of the group according to Waterlow's criteria. Among assessed plasma parameters, decreased prealbumin, lymphocytes, iron, and transferrin stand out. The predominant pathological findings were thalassemia, dermatitis, psychomotor retardation, and ferropenic anemia.

CONCLUSIONS
These results make us believe in a possible improvement in the conditions at Chinese orphanages. The low age at the time of adoption may justify the low incidence of chronic nutritional deficiencies. As a whole, anthropometrical / nutritional impairments found may be related with the consequences of carelessness and vulnerability of the adoption process. In any case, early diagnosis and implementation of appropriate therapy as soon as possible, as it is being done, is essential to provide appropriate growth and development of these girls.


Chapter V Regulation 9 of the SOLAS Convention, annexed for reference, requirescontracting governments to provide hydrographic services. Many signatories cannotprovide these unaided. This is despite the fact that new cruise ship itineraries and traderoutes are being established in their waters for increasingly larger and deeper draughtvessels. This article reviews a number of chart related casualties. These demonstrate thatno chart, paper or digital, is infallible. This emphasizes the urgent need for new and betterhydrographic data collection in some key oceanic areas. Potential innovative solutions fordata acquisition and hydrographic capacity building strategies are considered.


INTRODUCTION
A growing number of hospitals have implemented the Manchester Triage System (MTS) in their Emergency Department (ED), so as to better prioritize the evaluation of those attending these departments.

OBJECTIVES
To assess whether the MTS was used effectively in patients admitted to the hospital with a diagnosis of acute coronary syndrome (ACS).

METHODS
We evaluated 114 consecutive patients admitted to the Cardiology Department with a diagnosis of ACS. We recorded the color assigned in the MTS, mean time from arrival in the ED to MTS, mean time from MTS to first medical assessment (1-MA) and mean time from 1-MA to admission. We also analyzed the correlation between the type of ACS and clinical presentation and its relation with MTS.

RESULTS
Of the 114 patients, one was coded red (0.9%), 71 orange (62.3%), 12 green (11%), and two were not assigned a color code according to MTS because they were admitted via a Medical Emergency and Resuscitation Vehicle. Mean time from arrival in the ED to MTS was 5.2 +/- 0.6 min and from MTS to MA was 20 +/- 2.5 min. In patients triaged as orange the time from MTS to MA was 15.1 +/- 1.5 min, as yellow 36.2 +/- 7 min, and as green 35.2 +/- 20.6 min (p = 0.003). Mean time from 1-MA to admission was 144.4 +/- 17 min, with no differences according to triage code or ACS type. Clinical presentation influenced triage and the speed of 1-MA and admission, patients with typical presentation being evaluated and admitted more quickly.

CONCLUSIONS
Most patients admitted for ACS are initially triaged as orange or yellow, an indication for prompt assessment in the ED; this has a positive effect on time to first medical assessment, but has no effect on time to hospital admission.


Precipitation of cinnarizine during in vitro lipolysis of a self-microemulsifying drug delivery system (SMEDDS) was characterized to gain a better understanding of the mechanisms behind the precipitation. During in vitro lipolysis of the SMEDDS with or without cinnarizine, samples were taken at several timepoints and ultracentrifuged. Cinnarizine content in the pellet increased from 4% to 59% during lipolysis. The precipitation of cinnarizine during in vitro lipolysis correlated well with the degree of lipid digestion, determined by sodium hydroxide addition. The pellet from the endpoint of lipolysis was isolated and subjected to dissolution in biorelevant media. Dissolution rate of cinnarizine from pellets containing precipitated cinnarizine was initially 10-fold higher than dissolution from blank pellet spiked with crystalline cinnarizine, reaching more than 50% drug dissolved in the first minute. Pellets were further characterized by X-ray powder diffraction (XRPD) and polarized light microscopy (PLM). Both methods indicated the presence of liquid crystalline phases of calcium fatty acid soaps, but no presence of crystalline cinnarizine in the pellet. Overall, dissolution studies along with XRPD and PLM analysis indicate that cinnarizine precipitating during in vitro lipolysis of this SMEDDS is not crystalline, suggesting an either amorphous form or a molecular dispersion.


The last decade has seen a significant increase in economic and social inequalities, especially in Portugal's inland territories. As a consequence, the increase in social needs is increasingly evident in low-density territories. In this sense, social entrepreneurs have an important role in society, to the extent that, by having more direct contact with their surroundings, they are also more alert to identify needs, which until then have not had the necessary response from public policies. Thus, social entrepreneurship, allied with innovation, can serve as a "tool" to meet social needs, as well as help combat depopulation. Thus, this work shows the social entrepreneurship activities developed within the i3Social project, which aims to clarify the aspects and dynamics of social entrepreneurship to create social businesses. In this sense, this work also seeks to give an overview of what social entrepreneurship involves, i.e., in practical terms, to show that there is a path that should and must be followed for the business idea to become effective and successful in the social intervention market.


Objective To investigate the clinical features and treatment of post-discectomy symptomatic Discal Pseudocyst after percutaneous endoscopic lumbar discectomy.Methods A retrospective analysis of the data of 3 patients with concurrent symptomatic discal pseudocyst after percutaneous endoscopic lumbar discectomy revealed that all patients were female and had unilateral radiculopathy due to single-segmental lumbar disc herniation. Symptoms were alleviated obviously after the first operation, but pains recurred and even worse than before. The mean recurrence time was 5 weeks (2–8 weeks). Post-operative MRI showed quasi-circular occupancy in the original surgical area (low signal on T1-weighted image, high signal on T2-weighted image, same as cerebrospinal fluid), and communicating with the intervertebral disc.Results The symptoms of two patients gradually alleviated after conservative treatment, and the follow-up MRI showed that the cyst had completely absorbed within one year. Another patient underwent percutaneous endoscopic transforaminal cyst excision under local anesthesia again. Round-like tumors were found in the operation, with dark red and viscous contents. Postoperative cyst wall pathology suggested fibrous cyst wall tissue, and postoperative symptoms were relieved immediately. Cystic space occupancy disappeared after 6 months follow-up.Conclusion The concurrent symptomatic discal pseudocyst after percutaneous endoscopic lumbar discectomy are rare and often occur in the early postoperative period, and can be clearly diagnosed by MRI examination. Patients who fail to respond to conservative treatment may require surgical treatment and have a good prognosis.


Objectives To retrospectively evaluate the patients who underwent nasopharyngeal biopsy with imaging and biopsy results, who have or don't have symptoms for nasopharyngeal pathology and to determine the ratio of the nasopharyngeal cancer cases and other pathologic conditions. Methods In this retrospective study, 983 patients who underwent endoscopic nasopharyngeal biopsy for symptomatic nasopharyngeal lesions were included. All pathological results, benign or malign was recorded and classified due to the patients' presenting symptoms such as symptomatic for nasopharyngeal pathology or asymptomatic. Computed tomography (CT) or magnetic resonance imaging (MRI) reports were also recorded separately as group A for malignancy or group B for not malignancy. Results Forty-five (4.6%) of 983 biopsies were malignant. In this group, there is no statistically significant difference between symptomatic and asymptomatic group. For malignant pathologies, the sensitivity of MRI was found 88.2% and CT was 61.5%. Conclusion For early diagnosis of nasopharyngeal cancer, all patients admitted to Ear, Nose and Throat (ENT) referral clinics should be examined endoscopically irrespective of their complaints and suspicious cases should be investigated by imaging especially by MRI. If MRI report clearly indicates Thornwaldt cyst or reactive lymphoid hyperplasia and this result is compatible with endoscopic findings, biopsy may not be necessary. Apart from these cases, all suspected lesions should be biopsied.


The present publication reports about the delay of the rejection by unspecific medicamentous immuno suppression. This is the continuation of our earlier publication about the unaffected primary rejection of xenogenic kidney transplants in the closely related system fox - dog. The combined application of azathioprine and prednisolone leads to elongated function times of the kidney transplants and to the duplication of survival times of the recipients. Lymphocytotoxins, which are immuno-electrophoretic Ig G antibodies, appear two days later than in untreated recipients by hindrance of immunological reactivity. These obtain however then in consequence of the injured formation of antigen-antibody complexes a concentration increase which widely exceeds the increase of the control groups. The influence of azathioprin and prednisolone on the humoral respectively cellular immunity is talked about in the discussion. Morphological differences in the transplants are not observed in comparison with untreated recipients.


Daspone syndrome was noted within six weeks of starting treatment in 1.3% of about 700 leprosy patients on MDT reporting to the skin department of Goa Medical College. Skin rash, photosensitivity, fever, lymphadenopathy, sore throat, hepatosplenomegaly, abnormal liver function tests and raised reticulocyte count were consistent features in all the patients. Other drugs, infectious mononucleosis and viral exanthemata were considered in differential diagnosis. Withdrawal of dapsone and administration of prednisolone controlled the condition within three to four weeks in majority of the patients. One patient died of ischemic heart disease unrelated to dapsone syndrome.


We have recently completed a survey of archival Lyα spectra of cool main sequence stars within 100 pc using data from the Hubble Space Telescope. The H I Lyα absorption lines were analyzed in part to measure properties of the interstellar medium along the observed lines of sight, but the primary goal was to search for evidence of H I absorption from the outer heliosphere and from the analogous astrospheres surrounding the observed stars. The astrospheric absorption is of particular interest because it provides the first method by which one can detect the coronal winds of solar-like stars. We report here 7 new detections of astrospheric absorption, although 2 are marginal, and 4 new detections of heliospheric absorption. This roughly doubles the number of previous astrospheric and heliospheric absorption detections. We report the results of preliminary efforts to use the astrospheric detections to measure mass loss rates for the observed cool stars, and we make some preliminary inferences on what these measurements imply for how mass loss relates to age and activity for solar-like stars.


Purpose: To report clinical features and prognosis of HLA B27 acute anterior uveitis. Methods: 165 patients with recurrent acute anterior uveitis were divided into two groups: HLA B27-positive (group 1, 60 patients) and HLA B27-negative (group 2, 105 patients). A comparison between the two groups was performed. Results: Unilateral involvement was higher in group 1 (p = .046), and more simultaneous bilateral cases occurred in group 2 (p = .004). Group 1 was more correlated to systemic diseases than group 2 (50 versus 17.1%, p < .001), particularly to ankylosing spondylitis (35 versus 3.8%, p < .001). Uveitis was diagnosed before spondylitis in 57% of patients. In groups 1 and 2 an immunosuppressive therapy was administered to 20 and 9.5% of patients but was exclusively given to control uveitis in 1.6 and in 2.8% of cases, respectively. Conclusions: A strong association between HLA B27 uveitis and ankylosing spondylitis was confirmed and usually uveitis preceded rheumatological involvement.


Eph receptor tyrosine kinases and their ligands, ephrins, are membrane proteins coordinating a wide range of biological functions both in developing embryos and in adult multicellular organisms. Numerous studies have implicated Eph receptors in the induction of opposing responses, including cell adhesion or repulsion, support or inhibition of cell proliferation and cell migration, and progression or suppression of multiple malignancies. Similar to other receptor tyrosine kinases, Eph receptors rely on their ability to catalyze tyrosine phosphorylation for signal transduction. Interestingly, however, Eph receptors also actively utilize three kinase-deficient receptor tyrosine kinases, EphB6, EphA10, and Ryk, in their signaling network. The accumulating evidence suggests that the unusual flexibility of the Eph family, allowing it to initiate antagonistic responses, might be partially explained by the influence of the kinase-dead participants and that the exact outcome of an Eph-mediated action is likely to be defined by the balance between the signaling of catalytically potent and catalytically null receptors. We discuss in this minireview the emerging functions of the kinase-dead EphB6, EphA10, and Ryk receptors both in normal biological responses and in malignancy, and analyze currently available information related to the molecular mechanisms of their action in the context of the Eph family.


Background and Objectives: One of the most frequent genetic alterations reported to date in prostate cancer (PC) is aberrant methylation of glutathione transferase P1 (GSTP1). Taking into consideration the involvement of oxidative stress in PC pathogenesis and recent advances in scientific understanding of the role of GSTP1*Ala114Val rs1138272 polymorphism in carcinogenesis, we hypothesized that this single-nucleotide polymorphism (SNP) influences the risk of PC independently of, or in combination with, other GST polymorphisms, including GSTP1*IIe105Val rs1695 or GSTM1 and GSTT1 deletion polymorphisms. Materials and Methods: Genotyping was performed in 237 PC cases and in 236 age-matched controls by multiplex polymerase chain reaction (PCR) for deletion of GST polymorphisms and by quantitative PCR for SNPs. Results: We found that carriers of either GSTP1*Val (rs1138272) or GSTP1*Val (rs1695) variant alleles had a PC risk compared to individuals with both referent alleles (OR = 4.93, 95%CI: 2.89–8.40, p < 0.001 and OR = 1.8, 95%CI: 1.19–2.73, p = 0.006, respectively). Additionally, in a haplotype analysis we found that individuals with GSTP1*C haplotype, represented by both variant alleles (GSTP1*Val rs1695 + GSTP1*Val rs1138272), had a 5.46 times higher risk of PC development compared to individuals with the most frequent haplotype (95%CI = 2.56–11.65, p < 0.001), suggesting a potential role of those variants in PC susceptibility. A regression analysis on the number of risk-associated alleles per individual (GSTM1*active, GSTT1*null, GSTP1*Val rs1695 and GSTP1*Val rs1138272) showed a significant increase in the risk of developing PC, from 3.65-fold in carriers of two risk alleles (95%CI = 1.55–8.61, p = 0.003) to an approximately 12-fold increase in carriers of all four risk alleles (95%CI = 3.05–44.93, p < 0.001). Conclusion: Prostate cancer may be influenced by multiple glutathione transferase (GST) polymorphic genes, especially GSTP1, highlighting the role of gene–gene interactions in human susceptibility to this cancer.


Current management of construction projects, regardless of their individual characteristics, is heading decidedly to process-based schemes. These issues should be well studied and therefore analyzed by the design team and project control. Moreover, there are designer or projects construction companies that have yet to implement efficiently the principles of the process approach, thereby excluding them from management efficient technical service quality, an issue that directly affects the construction processes and building of new infrastructure. This time it takes to revision of this situation in the organizations responsible of the design and execution of civil engineering projects in Cuba, so that reflection serves to enhance the implementation of the approach to process management in their daily activities, an important aspect to demonstrate competitiveness, efficiency and quality in the domestic and international markets.


Motor skills and movement-related functioning significantly shape how children experience and interact with the world around them. Among infants and young children, developmental motor disorders contribute to delays with motor, cognitive, and psychosocial development. Early and accurate identification of these disorders is necessary to facilitate timely access to therapeutic interventions that minimize the long-term effects of disability on everyday activities and participation. In the United States, motor assessments commonly used among children 0 to 3 years focus on completion of specific motor skills at a single point in time, which provides only a part of the greater picture that is a child's motor and movement-related functioning. Video-capture methods, like the General Movements Assessment (GMA) and the Infant Motor Profile (IMP), offer greater accuracy and predictive power to (1) identify motor deficits in young children and (2) facilitate early access to supportive, therapeutic intervention.


OBJECTIVE
Agents which promote increased interstitial adenosine levels may be cardioprotective. The aim of this study was to evaluate the ability of 5-amino-1-beta-D- ribofuranosylimidazole-4-carboxamide (AICAr), an adenosine regulating agent, to limit infarct size when given before ischaemia, before coronary reperfusion, or postreperfusion in a rabbit preparation of ischaemia-reperfusion injury.

METHODS
The left coronary artery was occluded for 30 min and subsequently the ischaemic bed was reperfused for 180 min. Infarct size and risk zone size were delineated by tetrazolium staining and microsphere autoradiography, respectively. Four groups were studied: controls (n = 13), AICAr (2.5 mg.kg-1.min-1 intravenously for 5 min followed by 0.5 mg.kg-1.min-1 for 60 min) beginning either 5 min before coronary occlusion (n = 11), 5 min before coronary reperfusion (n = 11), or at 25 min coronary reperfusion (n = 10). Lignocaine was not given in these experiments.

RESULTS
Infarct size, normalised to risk zone, was significantly reduced with AICAr given 5 min before coronary reperfusion, at 35.0(SEM 4.4)% v 51.8(3.9)% in controls; p = 0.03. Cardioprotection was not observed when AICAr was given either 5 min before coronary occlusion [44.2(4.8)%] or 25 min postreperfusion [45.9(3.2)%].

CONCLUSIONS
These findings support the hypothesis that adenosine regulating agents, such as AICAr, can modulate infarct size in this rabbit preparation of ischaemia-reperfusion injury.


Determining theoretically the respective contributions of cations and anionic groups in inorganic crystals to their linear and NLO effects is meaningful when searching for new NLO materials. In the past we used a theoretical model called anionic group theory to evaluate the relationship between microstructure of the oxide NLO crystals and their macro-optical properties, and calculate their n/sub i/, /spl Delta/n and d/sub ij/ coefficients. The investigations of the band energy calculation method confirm that anionic group theory is successful for the oxide series NLO crystals. In the case of refractive index and birefringence in particular, the results are consistent with experiments. For calculating d/sub ij/ coefficients, the theory is basically successful. Its major shortcoming is that it is unable to consider the effect of cations on the d/sub ij/ coefficients.


An amino-truncated variant form of the epidermal growth factor receptor (EGFRvIII) has been identified in human brain, breast, lung and ovarian tumors. We have found that overexpression of this mutant EGF receptor in NIH3T3 cells results in transformation as a result of the activation of the receptor kinase via ligand-independent dimerization. Transformation was correlated with tyrosine phosphorylation of only a subset of the proteins observed in cells overexpressing the normal EGF receptor. This suggested that further studies on cells expressing the EGFRvIII might provide insights into the pathways most relevant to transformation. In clones expressing high levels of mutant EGF receptor, the levels of both Grb2 and SHC were decreased. Despite this decrease, much of the endogenous Grb2 immunoprecipitated with EGFRvIII. Interestingly, no increase in ras-GTP loading was found in clones expressing the EGFRvIII and MAP kinase assays indicated only a small increase in activity. These results indicate that high-level expression of the EGFRvIII induces down-regulation of the ras-MAP kinase pathway and that other components involved in EGF receptor signal transduction may play a greater role in neoplastic transformation by the EGFRvIII.


The fabrication of electrical interconnects to provide power for and communication with computers as their component complementary metal oxide semiconductor (CMOS) devices continue to shrink in size presents significant materials and processing compatibility challenges. We describe here our efforts to address these challenges using top-surface imaging and hybrid photoresist/self-assembled monolayer patterning approaches, in conjunction with selective electroless metal deposition, to develop processes capable of fabricating appropriate submicron and nanoscale metal features useful as electrical interconnects, as well as plasma-etch-resistant masks and metal diffusion barriers. Our efforts focus on the development of cost-effective methods compatible with a manufacturing environment that satisfy materials and process constraints associated with CMOS device production. We demonstrate the fabrication of approximately 50-nm-width features in metal with high fidelity and sufficient control of edge acuity to satisfy current industry design rules using our processes and discuss the challenges and opportunities for fabrication of analogous sub-10-nm metal features.


We examine the stability properties of the ground state of two-component Bose-Einstein condensates as a function of the interspecies interactions. A stability criterion is identified from the curvature matrix of the Gross-Pitaevskii energy functional subject to the normalization conditions. By analyzing the stability signature, the characteristic features of the spontaneous spatial symmetry breaking are verified in various types of traps. The details of the differences between the continuous symmetry breaking and discrete symmetry breaking are discussed.


The purpose of this review is to provide an up-to-date report on the molecular and physiologic processes involved in the role of thyroid hormone as an epigenetic factor in brain maturation. We summarize the available data on the control of brain gene expression by thyroid hormone, the correlation between gene expression and physiologic effects, and the likely mechanisms of action of thyroid hormone on brain gene expression. In addition we propose a role for unliganded thyroid hormone receptors in the pathogenesis of hypothyroidism. Finally, we review recent data indicating that thyroid hormone receptors have an impact on behavior.


Background A number of studies have shown that susceptibility to several infectious diseases is related to the patient's blood group. Although the relationship between blood group and susceptibility to malaria has been studied by several researchers, the results have been contradictory. Since malaria has re-emerged as a major problem in India during the past few years, it would be useful to know whether there is any relationship between blood group and infection. Objectives The study will be undertaken to correlate the blood groups and clinical presentations in malaria patients and to understand the differential host susceptibility in malaria. Method Over a period of 4 years malaria positive samples identified by peripheral smear (thin and thick smears) will be evaluated in this study. Haemoglobin, total leucocyte count, differential leucocyte count and platelet count of each patient done on an automated cell counter will be retrieved from the data. Blood group was determined by forward and reverse method. The demographic details of the patients and clinical details were obtained from case records of the patients. Malarial species and the severity of clinical course were correlated with blood groups Results A total of 205 patients were included in the study, of which 123 cases were positive for plasmodium falciparum and 78 cases were positive for P. vivax infection and 4 patients had mixed infection. The results of blood groups showed 33 -'A' group, 84 -'B' group, 70 -'O' group and 18 were 'AB' group. When the clinical courses between different groups were compared using the following parameters for severe infectiona parasitic load of > 10/1000 RBCs, severe anemia with haemoglobin <6gm%, platelet count of <10,000/mm, hepato or splenomegaly or clinical signs of severe malaria such as fever >101 F and the other organ involvement, it was observed that there was no significant relationship between ABO blood group and malaria in our population, this could be due to various demographic reasons. Conclusions The present study indicate that individuals of blood group A and B are more susceptible to malaria infection as compared with individuals of blood group O, however the severity of infection differs due to differential host susceptibility.


33 Background: Receptor tyrosine kinase fusion (RTK+) has been identified in colorectal carcinoma (CRC). Tumor agnostic treatment has been approved in NTRK fusion ( NTRK+) and RET fusion ( RET+) positive solid tumor. However, overall response rate (ORR) was the lowest among entrectinib-treated NTRK+ CRC (20%, 2/10) and selpercatinib treated RET+ CRC (20%, 2/10) among all NTRK+ and RET+ solid tumors respectively. Methods: We surveyed all 58 human RTKs to identify RTK fusions in CRC and RET and NTRK fusions in other solid tumors using AACR GENIE cbioportal public version 13.0. We abstracted and compared the tumor mutation burden (TMB) of these fusions from the cbioportal database. Patient and tumor characteristics were also abstracted. Results: Among the 14812 unique CRC patients identified in the AACR GENIE cbioportal, a total of 153 unique RTK fusions were identified (44 with known fusion partners, 109 with intragenic rearrangement) in 27 out of the total 58 human RTKs. The most common RTK fusions in CRC were in FGFR1 (N = 23), EGFR (N = 21), ERBB2, NTRK1, RET, FGFR2 (N = 10 each), FLT1 and FLT3 (N = 9 each), FLT4 and ALK (N = 7 each). Considering only samples with identified fusion partners, the mean TMB was 66.6 +/-15.8 (mt/MB) for NTRK+ CRC (N = 9), and 35 +/-11.5 for RET+ CRC (N = 4), which were significantly higher when compared to mean number of 6.2 +/- 5.4 of TMB for all other RTK+ CRC (ALK, EGFR, FGFR1/2, ERBB4, FLT1/3/4, LMKT2, MET, NTRK2, PDGFR-b, ROS1) (N = 30, P< 0.05). Furthermore, NTRK+ CRC harbored significantly higher TMB than RET+ CRC (P = 0.003). The mean TMB was 4.0 +/- 1.9 for RET+ NSCLC (N = 65), 2.6 +/- 1.6 for RET+ Thyroid cancer (N = 52), which were both significantly lower than RET+ CRC. Mean TMB was 3.1 +/- 1.7 for NTRK+ glioma (N = 21), 3.3 +/- 1.7 for NTRK+ thyroid cancer (N = 21), 6.5+/-5.1 for NTRK+ Melanoma (N = 8), 5.9 +/- 3.4 for NTRK+ NSCLC (N = 7), 5.1 +/- 1.2 for NTRK+ breast cancer (N = 7) all of them were significantly lower than the mean TMB of NTRK+ CRC. 1482 (10.0%) patients with CRC had their MSI status reported. 3 out of 3 NTRK+ CRC patients with known MSI status were all MSI-H (100%). 12 out of 12 non-NTRK/non-RET RTK+ CRC patients were MSI-S. Conclusions: In this comprehensive survey of human RTK fusions in CRC, NRTK+ and RET+ CRC harbor significantly higher TMB compared to other RTK+ CRC or to other NTRK+/RET+ solid tumors. Limited data showed NTRK+ CRC were all MSI-H. NTRK+ and RET+ CRC are distinct molecular subtypes of CRC with unique pathogenesis from all other NTRK+ or RET+ solid tumors. We hypothesize that NTRK+/RET+ CRC may benefit from pembrolizumab that has been approved for histologic agnostic high TMB tumors rather than RET or NTRK tyrosine kinase inhibitors (low ORR in CRC) that also have histological agnostic indications.


Infection with Schistosoma causes aberrant expression of host microRNAs (miRNAs), and normalizing the levels of dysregu-lated miRNAs can attenuate pathology. Here, we show that the host miRNA, miR-96 , is markedly upregulated during the progression of hepatic schistosomiasis. We demonstrate that elevation of miR-96 induces hepatic fi brosis in infected mice by suppressing the expression of its target gene, Smad7 . We show that infection with Schistosoma induces the expression of transforming growth factor b 1 (TGF- b 1), which in turn upregulates the expression of miR-96 through SMAD2/3-DROSHA-mediated post-transcriptional regulation. Further-more, inhibition of miR-96 with recombinant adeno-associated virus 8 (rAAV8)-mediated delivery of Tough Decoy RNAs in mice attenuated hepatic fi brosis and prevented lethality following schistosome infection. Taken together, our data highlight the potential for rAAV8-mediated inhibition of miR-96 as a therapeutic strategy to treat hepatic schistosomiasis.


Background: SARC-F and Mini Sarcopenia Risk Assessment (MSRA) questionnaires have been proposed as screening tools to identify patients at risk of sarcopenia. The aim of this study is to test the use of SARC-F and MSRA, alone and combined, as a pre-screening tool for sarcopenia in geriatric inpatients. Methods: 152 subjects, 94 men and 58 women, aged 70 to 94, underwent muscle mass evaluation by dual energy X-ray absorptiometry (DXA), muscle strength evaluation by handgrip, and completed the MSRA, SARC-F and Activity of daily living (ADL) questionnaires. Results: 66 subjects (43.4%) were classified as sarcopenic according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. The 7-item SARC-F and MRSA and 5-item MSRA showed an area under the curve (AUC) of 0.666 (95% confidence interval (CI): 0.542–0.789), 0.730 (95% CI: 0.617–0.842) and 0.710 (95% CI: 0.593–0.827), respectively. The optimal cut-off points for sarcopenia detection were determined for each questionnaire using the Youden index method. The newly calculated cut-off points were ≤25 and ≤40 for MSRA 7- and 5-items, respectively. The ideal cut-off for the SARC-F was a score ≥3. Applying this new cut-off in our study population, sensitivity and specificity of the 7-item MSRA were 0.757 and 0.651, and 0.688 and 0.679 for the 5-item MSRA, respectively. Sensitivity and specificity of SARC-F were 0.524 and 0.765, respectively. The combined use of the 7-item SARC-F and MSRA improved the accuracy in sarcopenia diagnosis, with a specificity and sensitivity of 1.00 and 0.636. Conclusion: 7-item SARC-F and MSRA may be co-administered in hospital wards as an easy, feasible, first-line tool to identify sarcopenic subjects.


Although human pluripotent stem cells (hPSCs) can theoretically differentiate into any cell type, their ability to produce hematopoietic cells is highly variable from one cell line to another. The underlying mechanisms of this heterogeneity are not clearly understood. Here, using a whole miRNome analysis approach in hPSCs, we discovered that their hematopoietic competency was associated with the expression of several miRNAs and conversely correlated to that of miR-206 specifically. Lentiviral-based miR-206 ectopic expression in H1 hematopoietic competent embryonic stem (ES) cells markedly impaired their differentiation toward the blood lineage. Integrative bioinformatics identified a potential miR-206 target gene network which included hematopoietic master regulators RUNX1 and TAL1. This work sheds light on the critical role of miR-206 in the generation of blood cells off hPSCs. Our results pave the way for future genetic manipulation of hPSCs aimed at increasing their blood regenerative potential and designing better protocols for the generation of bona fide hPSC-derived hematopoietic stem cells.


Abstract The sugar content of California wine grapes has increased significantly over the past 10–20 years, and this implies a corresponding increase in the alcohol content of wine made with those grapes. In this paper we develop a simple model of winegrape production and quality, including sugar content and other characteristics as choice variables along with yield. Using this model we derive hypotheses about alternative theoretical explanations for the phenomenon of rising sugar content of grapes, including effects of changes in climate and producer responses to changes in consumer demand. We analyze detailed data on changes in the sugar content of California wine grapes at crush to obtain insight into the relative importance of the different influences. We buttress this analysis of sugar content of wine grapes with data on the alcohol content of wine. (JEL Classification: Q54, Q19, D12, D22)