THE SEAMEN'S HOSPITAL, GREENWICII. TWO CASES OF ADRENAL DISEASE. (Under the care of H. T. GRIFFITHS, M.D.) P. M., a sailor, aged 40, had had no previous illness but ague, and denied any syplilitic contagion. He had been ill for four months with emaciation and diarrhcea. On admission, he presented a sallow cachectic appearance; no pigmentation visible either on skin or mucous membrane, and nothing visible beyond old scarring over the tibioe, so common among sailors. He presented no physical signs beyond very harsh loud breathing at each apex. He had much diarrhoea, the stools being thin and small, which was unchecked by any drug, and had for some weeks a high and irregular temperature, which was attributed to malarial infection, and for which he was given quinine. For many weeks before death his temperature was normal. He lost flesh gradually, but did not deepen in colour, and died seven months after his admission to hospital, and eleven months from the initial feeling of weakness and commencing emaciation. During his stay in hospital he had no special pains; his tongue was always clean, his urine normal, and physical signs practically few. A po8t-mortenm examination disclosed a small cavity at each apex, the lungs tough with increased amount of fibrous tissue, but no tubercle was to be seen; the heart small and healthy, the liver tough and contracted, with one walnut-shaped gumma on the under surface of the right lobe; kidneys tough and cirrhosed, with diminished cortex and adherent capsules, with small gummata scattered throuahout; the right adrenal body was full of small gummata, the largest being the size of a pea, the left adrenal being small aiid healthy. The spleen was pale, and there was ulceration of the colon, chiefly about the splenic flexure, and also about the sigmoid flexure. No lardaceous reaction was obtainable in any organ, and no syphilitic lesions elsewhere. J. Q., sailor, aged 41, had been ill three months with rapid emaciation, night sweats, cough, and pain across the chest, wlth cedema of the legs for six weeks, wlhich persisted chiefly on the left side. I-le was sent up to hospital as a case of pulmonary tuberculosis. On admission, he was much emaciated, had slight cough and high temperature (1020), presenting a thickened left leg with a cold foot, and commencing gangrene of the toes, with a block in the femoral vein; a few rhonchi were audible over the lungs, but no rdles. His skin-elasticity was much diminished, but no tumour was to be felt in the abdomen, and there was no discoloration of the skin or pigmentary depositanywhere. He had no pain except in the left leg, his urine was normal, and his temperature gradually came down to the normal and remained there. The left foot presented more dry gangrene every day, and the patient daily lost flesh, presenting also some fine rales over the lungs, with cough and slight vomiting. He died, somewhat suddenly at the end, on the sixteenth day of admission, and three months and a half after commencing emaciation. On a post-mortem examination, the whole of the left lung was found to be enveloped in a thick membrane closely adherent to the chest-wall and lung. The lungs were cedematous, the bronchial tubes dilated, especially on the lower half of the left lung; the heart presented cnly a few small vegetations on the mitral valve; the liver was enlarged and cirrhotic, the spleen large and diffluent; the kidneys contained some embolic infarcts. Both adrenal bodies were equally large, two inches in their long diameter by one inch and a half in their broadest diameter, their substance cutting firm and close, and consisting of sarcomatous growth, completely replacing the gland-substance, with the exception of a small amount of scirrhus in the glands just above the cardiac end of the cesophagus. There was no other trace of deposit; a large thrombus filled the femoral vein. REMARKS BY DR. GRIFFITHS.-These two cases which presented themselves the same day at the post-mortem table, are alike in their history of emaciation and wvant of pigmentation; but while the first case may be referred to the chronic class, the latter only lasted three months and a half, which is as rapid as the majority of rapidly fatal cases of the true Addison's disease. As regards sarcoma of the adrenal bodies, primary sarcoma (of which the second case is an example) is somewhat rare, cases being reported by Ogle1 in which both adrenals were also involved. Cases are also reported by Hecker, Averbeck, West, Colcott Fox ' (in whose case there was also thrombosis), and others. Gummata in the adrenals are much rarer, Addison never having met with a case, and Greenhow reports none in his admirably collected cases. Baerensprung has described them, however, with some others. With respect to the absence of the usual pigmentation which accompanies adrenal carcinoma, the majority of such cases do not exhibit pigmentary changes, though cases of such bronzing have been reported by Addison, Pitman, and others, while in Greenhow's twenty-two cases of cancer of the adrenals no pigmentation was observed. Virchow, bearing in mind the amount of nervous tissue in the adrenal body, and especially in its medullary portion, is of opinion that the so-called sarcomata are in reality gliomata.


The origins of many of the basic concepts used in the experimental analysis of behavior can be traced to Pavlov's (1927/1960) discussion of unconditional and conditional reflexes in the dog, but often with substantial changes in meaning (e.g., stimulus, response, and reinforcement). Other terms were added by Skinner (1938/1991) to describe his data on the rate of lever pressing in the rat (e.g., operant conditioning, conditioned reinforcement, negative reinforcement, and response induction and differentiation) and key pecking in the pigeon (shaping). The concept of drive, however, has largely disappeared from the current literature.


State of the art neutron detectors lack capabilities required by the fields of homeland security, health physics, and even for direct in-core nuclear power monitoring. A new system being developed at Purdue's Metastable Fluid and Advanced Research Laboratory in conjunction with S/A Labs, LLC provides capabilities the state of the art lacks, and simultaneously with beta (β) and gamma (γ) blindness, high (> 90% intrinsic) efficiency for neutron/alpha spectroscopy and directionality, simple detection mechanism, and lowered electronic component dependence. This system, the Tensioned Metastable Fluid Detector (TMFD) [3], provides these capabilities despite its vastly reduced cost and complexity compared with equivalent present day systems. Fluids may be placed at pressures lower than perfect vacuum (i.e. negative) [4, 5], resulting in tensioned metastable states. These states may be induced by tensioning fluids just as one would tension solids. The TMFD works by cavitation nucleation of bubbles resulting from energy deposited by charged ions or laser photon pileup heating of fluid molecules which are placed under sufficiently tensioned (negative) pressure states of metastability. The charged ions may be created from neutron scattering, or from energetic charged particles such as alphas, alpha recoils, fission fragments, etc. A methodology has been created to profile the pressures in these chambers by lasing, called Laser Induced Cavitation (LIC), for verification of a multiphysics simulation of the chambers. The methodology and simulation together have lead to large efficiency gains in the current Acoustically Tensioned Metastable Fluid Detector (ATMFD) system. This paper describes in detail the LIC methodology and provides background on the simulation it validates.Copyright © 2014 by ASME


BACKGROUND
Some patients have to stop using their air-conduction hearing aid(s) because it causes or exacerbates chronic otitis. Then, a solution is the use of a bone-conduction hearing aid such as the percutaneous bone-anchored hearing aid (BAHA).

OBJECTIVE
To compare patients' performance with their previous air-conduction hearing aid(s) and their BAHA using audiometric tests and a questionnaire.

DESIGN
Prospective clinical evaluation in a single subject design.

PATIENTS
The results of 34 consecutive patients from the Nijmegen, the Netherlands, BAHA series were included. The patients had bilateral conductive or mixed hearing loss and chronic ear problems. Before the BAHA was fitted, the patients used air-conduction hearing aids.

RESULTS
The results of the speech recognition in noise test showed a small but significant improvement with the BAHA. This improvement was related to the size of the air-bone gap. The greater the air-bone gap, the poorer the results with the air-conduction hearing aid(s). The questionnaire demonstrated that the majority of patients preferred the BAHA; diminished occurrence of ear infections played a significant role. The patients did not express an evident preference concerning speech recognition.

CONCLUSIONS
In patients with chronic ear problems a BAHA is an acceptable alternative if an air-conduction hearing aid is contraindicated. Preoperative assessment of the size of the air-bone gap is of some help to predict whether speech recognition may improve or deteriorate with the BAHA compared with the air-conduction hearing aid.


Author(s): Slepian, Z; Eisenstein, DJ; Brownstein, JR; Chuang, CH; Gil-Marin, H; Ho, S; Kitaura, FS; Percival, WJ; Ross, AJ; Rossi, G; Seo, HJ; Slosar, A; Vargas-Magana, M | Abstract: © 2017 The Authors. We present the large-scale three-point correlation function (3PCF) of the Sloan Digital Sky Survey DR12 Constant stellar Mass (CMASS) sample of 777 202 Luminous Red Galaxies, the largest-ever sample used for a 3PCF or bispectrum measurement. We make the first high-significance (4.5σ) detection of baryon acoustic oscillations (BAO) in the 3PCF. Using these acoustic features in the 3PCF as a standard ruler, we measure the distance to z = 0.57 to 1.7 per cent precision (statistical plus systematic). We find DV =2024±29 Mpc (stat)±20 Mpc (sys) for our fiducial cosmology (consistent with Planck 2015) and bias model. This measurement extends the use of the BAO technique from the twopoint correlation function (2PCF) and power spectrum to the 3PCF and opens an avenue for deriving additional cosmological distance information from future large-scale structure redshift surveys such as DESI. Our measured distance scale from the 3PCF is fairly independent from that derived from the pre-reconstruction 2PCF and is equivalent to increasing the length of BOSS by roughly 10 per cent; reconstruction appears to lower the independence of the distance measurements. Fitting a model including tidal tensor bias yields a moderatesignificance (2.6σ) detection of this bias with a value in agreement with the prediction from local Lagrangian biasing.


In this paper we introduce a weighted complex networks model to investigate and recognize structures of patterns. The regular treating in pattern recognition models is to describe each pattern as a high-dimensional vector which however is insufficient to express the structural information. Thus, a number of methods are developed to extract the structural information, such as different feature extraction algorithms used in pre-processing steps, or the local receptive fields in convolutional networks. In our model, each pattern is attributed to a weighted complex network, whose topology represents the structure of that pattern. Based upon the training samples, we get several prototypal complex networks which could stand for the general structural characteristics of patterns in different categories. We use these prototypal networks to recognize the unknown patterns. It is an attempt to use complex networks in pattern recognition, and our result shows the potential for real-world pattern recognition. A spatial parameter is introduced to get the optimal recognition accuracy, and it remains constant insensitive to the amount of training samples. We have discussed the interesting properties of the prototypal networks. An approximate linear relation is found between the strength and color of vertexes, in which we could compare the structural difference between each category. We have visualized these prototypal networks to show that their topology indeed represents the common characteristics of patterns. We have also shown that the asymmetric strength distribution in these prototypal networks brings high robustness for recognition. Our study may cast a light on understanding the mechanism of the biologic neuronal systems in object recognition as well.


The Bangladesh government adopted the Domestic Violence (Prevention and Protection) Act in 2010. While the formulation and enactment of the Act was an achievement for the government and the coalition that championed it (the Citizens' Initiative Against Domestic Violence, CIDV), its implementation has been weak. In Bangladesh, dominant social norms have led to stereotyping domestic violence as a trivial, personal matter, which has led to service providers delegitimising and deprioritising the issue. Combined with all the gender biases that operate within the judiciary and other government departments, this has resulted in an unsatisfactory use of the Act for women seeking redress from violence. This paper explores to what extent this lax implementation is due to the weak capacity of implementing agencies versus deliberate/intentional inaction in the form of backlash. It also examines how women's rights organisations have articulated feminist voices in terms of agenda and framing and used collective agency to counter the pushback.


Background: Appropriate resuscitation of hypoxic patients is fundamental in emergency admissions. To achieve this, it is standard practice of ambulance staff to administer high concentrations of oxygen to patients who may be in respiratory distress. A proportion of patients with chronic respiratory disease will become hypercapnic on this. Objectives and methods: A scheme was agreed between the authors' hospital and the local ambulance service, whereby patients with a history of previous hypercapnic acidosis with a Pao2 >10.0 kPa—indicating that oxygen may have worsened the hypercapnia—are issued with "O2 Alert" cards and a 24% Venturi mask. The patients are instructed to show these to ambulance and A&E staff who will then use the mask to avoid excessive oxygenation. The scheme was launched in 2001 and this paper present the results of an audit of the scheme in 2004. Results: A total of 18 patients were issued with cards, and 14 were readmitted on 69 occasions. Sufficient documentation for auditing purposes was available for 52 of the 69 episodes. Of these audited admissions, 63% were managed in the ambulance, in line with card-holder protocol. This figure rose to 94% in the accident and emergency department. Conclusion: These data support the usability of such a scheme to prevent iatrogenic hypercapnia in emergency admissions.


The latest generation of fusion devices needs large superconducting magnets that have to withstand operational voltages of tens of kV. Their insulation typically targets a dielectric strength of about 10 times the operational voltages to cope with degradation during operation resulting from the high electromagnetic loads with cyclic components, thermal stresses due to cycles from 293 K to 4 K, and ionizing radiation. Degradation of dielectric strength is further mitigated by applying solid polyimide overlapped layers in the insulation. The level of Lorentz forces, together with the large superconducting coil sizes, makes high-voltage tests impossible to realize under exact operational conditions. The fact that insulation is very difficult or even often practically impossible to repair in case of electrical fault, requires sound insulation design to reach utmost quality. In this paper, we will discuss the build-up of the electrical insulation in large superconducting magnets both from the manufacturing and operational point of view. In particular, the impact of the insulation design and manufacturing choices on the quality will be discussed in depth. We will also discuss the implementation and the application of insulation systems.


The climate and the urban systems are changing, leading to new challenges and opportunities in the urban environment. Adaptation to these challenges is needed, using the vulnerability assessment areas that are vulnerable can be identified. Vulnerability is the likelihood a system experiences harm and is the combination of both risks and adaptability. Finding adaptability can be hard and is not straightforward, therefor this thesis aims to operationalize adaptability for the current urban environment, focussing on climate change and the physical indicators related to adaptability. Adaptability simply means the ability there is (within a system, society or city) to adapt. A lot of different definitions for adaptability (or adaptive capacity) can be found in literature, which makes talking about, using and comparing adaptability hard. Different fields of interest use different definitions, frameworks and approaches. Most of the definitions and frameworks found in the literature search of this thesis tend to be meant for assessing social adaptability on regional or country scale. They focus on institutions, economy and (technical) knowledge on larger scales. These assessments come down to, the third world countries have bad adaptability while the first world countries have better adaptability. For decision-making on municipality level assessment on smaller scale is needed. For this thesis a lot of indicators have been gathered (a grand total of 38) by literature research and interviews with experts. Indicators are one of the ways of assessing adaptability, so by selecting and combining indicators it is able to determine a measure for adaptability. The used indicators (9 in total) are grouped in so called determinants. There are indicators saying something about space that is available for climate proofing or the type of climate proofing (blue, green or grey solutions) that can be used (space: percentage buildings, percentage water and percentage greening). Furthermore there are indicators that express the underground conditions in an area (underground: soil type and underground infrastructure). There are indicators stressing opportunities regarding climate proofing that may arise (matching: planned works and estimated end of life cycle). There are also indicators that stress the drive for climate proofing (budgets: urgency). Lastly there are indicators related to specific characteristics of an area (function related demands: historical city centre). The indicators are then combined to construct a rapid assessment tool for the municipality of Dordrecht. This tool can be used to prioritize climate proofing in the Dordrecht area, when used side-by-side with a risk map. Quick wins (high adaptability, high risks) can be identified as well as areas that need further attention, research or innovation (low adaptability, high risks). The resulting maps from the tool, show expected behaviour. The historical city centre of Dordrecht shows lower adaptabilities, while harbour, park and nature areas show higher adaptabilities. Assessing and using adaptability adds data and information to your decision-making process. Climate proofing is needed, for it being the least-social-cost strategy, assessing vulnerability helps making good and funded decisions on climate proofing.


To investigate the efficacy and mechanism of action of sodium metavanadate as an oral hypoglycemic agent, five insulin-dependent diabetes mellitus (IDDM) and five noninsulin-dependent diabetes mellitus (NIDDM) patients were studied before and after 2 weeks of oral sodium metavanadate (NaVO3; 125 mg/day). Glucose metabolism measured during a two-step euglycemic insulin clamp was not significantly increased by vanadate therapy in patients with IDDM, but was improved by 29% during the low dose (0.5 mU/kg.min) insulin infusion and 39% during the high dose (1.0 mU/kg.min) in patients with NIDDM. The changes in glucose metabolism were largely accounted for by an increase in nonoxidative glucose disposal, as measured by indirect calorimetry. Basal hepatic glucose production and suppression of hepatic glucose production by insulin were unchanged by vanadate therapy. There was a significant decrease in insulin requirements in the patients with IDDM (39.1 +/- 6.6 to 33.8 +/- 4.7 U/day; P < 0.05). Cholesterol levels significantly decreased in both IDDM (4.53 +/- 0.16 vs. 4.27 +/- 0.22 mmol/L; P = 0.06) and NIDDM (6.92 +/- 0.75 vs. 5.28 +/- 0.46 mmol/L; P < 0.05). After NaVO3 therapy, there was a 1.7- to 3.9-fold increase in basal mitogen-activated protein and S6 kinase activities in mononuclear cells from patients with IDDM and NIDDM that mimicked the effect of insulin stimulation in controls. The most common adverse effect of oral NaVO3 was mild gastrointestinal intolerance. These data suggest that vanadate or related agents may have a potential role as adjunctive therapy in patients with diabetes mellitus.


The article investigates various functions fulfilled by letters exchanged by European scholars and experimenters in the period 1660-1676. The correspondence network taken into consideration is the one coordinated by Henry Oldenburg, who was responsible for a large exchange of letters in that period, particularly when he became the first Secretary of the Royal Society. The analysis shows that this correspondence greatly stimulated the growth of a real community of adepts, as it provided an excellent means for the exchange of views, the conducting of controversies, the corroboration of individual observations and the official recognition of one's own findings. Communal correspondence also fulfilled other important goals linked to socialization purposes, favouring the creation of a new specialized community sharing innovative intellectual interests and professional practices, as well as the adoption of a spirit of solidarity among its members.


DFT calculated barriers for C-H activation of 1,4-cyclohexadiene by nonheme iron(IV)-oxo and iron(III)-superoxo species show that the experimental trends can be explained if the spin inversion probability of the TMC iron(IV)-oxo is assumed to be poor. Also, the TMC iron(III)-superoxo reaction proceeds with an endothermic O(2)-binding energy followed by an intrinsically reactive quintet state.


A 250-km-long east-west geological and geophysical transect has been constructed at about lat 66°40′N, from near the Yukon-Alaska border, across the Eagle Plains foldbelt and Richardson Mountains anticlinorium, to the Interior platform in northwestern Canada. It includes reprocessed industry seismic reflection profiles, regional gravity data, and drill hole information. The north-trending Richardson Mountains anticlinorium is interpreted to be a contractional (pop-up) structure, having a core of Proterozoic and lower Paleozoic rocks; the structure is bounded on the east and west by post-Early Mississippian, pre- or syn-Cretaceous thrust faults. Contractional deformation in the Eagle Plains foldbelt is probably the same age. The location of the pop-up may have been controlled by a preexisting west-facing crustal scale ramp at the top of the crystalline basement. A horizontal displacement of about 33 km is required to accommodate the pop-up; the displacement probably occurs above regional detachment(s) that project westward beneath the Eagle Plains.


It should be emphasized that no fungus grew in culture after the routine autoclaving process used in this hospital for the sterilization of cervical sponges. Thus the organisms were no longer viable and there was there-. fore no danger of causing any infection of the genital tract. In view of the initial difficulty which we experienced in distinguishing this contaminant from a true fungal infection of the genital tract we felt that cytologists should be aware of this potential source of diagnostic confusion and that care should be exercised in diagnosing a fungal infection on smears made from sponges until such time as the fungus in question has been conclusively identified.-We are, etc.,


OBJECTIVE
This report presents selected prevalence estimates of alcohol use, cigarette smoking, leisure-time physical activity, body weight status, and sleep habits among U.S. adults, using data from the 2002-04 National Health Interview Surveys (NHIS). NHIS is conducted annually by the Centers for Disease Control and Prevention's National Center for Health Statistics. Estimates are shown for several sociodemographic subgroups for both sexes combined and for men and women separately. The subgroups are compared in terms of their prevalence of "healthy" and "unhealthy" behaviors.

METHODS
Data for the U.S. civilian noninstitutionalized population were collected by NHIS using computer-assisted personal interviews. Questions on health behaviors were asked of one randomly selected adult per family in the Sample Adult component of the basic core questionnaire. This report is based on a total of 93,222 completed interviews with sample adults aged 18 years and over, representing an overall sample adult response rate of 73.6% for the 3 years combined. Statistics shown in this report were age adjusted to the 2000 U.S. standard population.

RESULTS
Six in 10 U.S. adults were current drinkers in 2002-04; about 1 in 4 adults were lifetime abstainers. About 1 in 5 adults (21.5%) were current smokers, and over one-half of adults (56.6%) had never smoked cigarettes. About 4 in 10 (42.4%) current smokers tried to quit smoking in the past year. About 6 in 10 adults engaged in at least some leisure-time physical activity, with about 3 in 10 regularly engaging in such activities. About 6 in 10 adults were overweight or obese (BMI is equal to or more than 25), with 4 in 10 adults being of healthy weight. About 6 in 10 adults usually slept 7-8 hours in a 24-hour period.


Numerical responses of the weasel Mustela nivalis to the changes in population density of forest rodents (bank vole Clethrionomys glareolus and yellow-necked mouse Apodemus flavicollis) and predation by weasels were studied in the pristine deciduous forests of Bialowieza National Park, eastern Poland, in 1985 through 1992. The rodents experienced 5 yr of noncyclic (seasonal) fluctuations (autumn density 23-74 rodents/ha) and 2 yr of outbreak and crash (triggered by synchronous heavy crop of oak, hornbeam, and maple seeds). Autumn numbers of rodents exceeded 300 individuals/ha during the outbreak and dropped to 8 individuals/ha in the following autumn. Weasels were censused by livetrapping in summer and by snowtracking on an 11.2-km 2 grid of transects in winter. Radiotracking of 12 weasels in 1990 and 1991 yielded estimates of home ranges and daily movement distances, which were combined with snowtracking and livetrapping data to estimate densities during 7 yr. Estimated winter density of weasels varied from 5.2 to 27.3 individuals/10 km 2 in December and declined to 0-19.1 individuals/10 km 2 by early spring (March). Midsummer (July/August) indices of weasel numbers were extremely variable and corresponded to 41.9-47.6 individuals/10 km 2 in years with moderate density of rodents, 101.7 individuals/10 km 2 during the rodent outbreak and 19.1 individuals/10 km 2 during the crash. Increase of weasel numbers from spring to midsummer was positively related to the spring numbers of rodents. Autumn and winter decline of weasel numbers was not related to rodent density changes. During the outbreak and crash of the rodent population, the numbers of weasels and rodents (both sampled at 2-3 mo intervals) were positively correlated (P < 0.0005) with no time lag. Home ranges of male weasels radiotracked during the rodent outbreak were 11-37 ha (minimum convex polygon), compared to 117-216 ha during the crash year. The predator/prey ratio varied from 0 to 2.5 weasels/1000 rodents. The ratio was highest at low densities of rodents. With increasing numbers of rodents, the ratio declined, since rodent population growth was overwhelmingly faster than weasel population growth. In the 7 autumn-winter seasons (1 October-15 April), weasels removed, on average, 1.6 to 9.5 rodents from each hectare, i.e., from 2 to 28% of autumn numbers of rodents. Winter predation by weasels was heaviest at rodent density of 20 individuals/ha. At lower densities of rodents, the number of weasels was restricted by food shortage and the role of their predation rapidly declined. At high rodent densities, the rodent numbers by far exceeded the predatory capacity of weasels and predation percentage declined again. Weasel predation in relation to rodent density has the same pattern in geographic zones ranging from Turkmen deserts to European farmlands and forests.


Health systems in lower income countries are often not able to provide for the basichealth needs of their populations. The progress of recent initiatives such as the WHO millennium development goals and new funds for disease programs is slowed by the limitations of these health service and systems. Strengthening these health systems has become a priority, but this cannot be achieved immediately, the causes of these limitations are many, complex and with deep historical origins. It is important to ensure that the new resources are used in ways which effectively strengthen these services and systems in both the short and long term. There is some experience and research which has found effective ways to strengthen service delivery and system functioning. However, this research is largely unknown or unused by policy makers and decision makers in ministries, local government, aid agencies and work bank advisors. Although evidence from elsewhere will need to be adapted to the local situation, this research can help avoid expensive mistakes and save time and money in choosing and implementing effective health service strengthening strategies. The purpose of this report is to present some of the first guidance and materials from the world bank 'improving health service program' (WB IHSP). It gives interim guidance based on the best available evidence which was identified in a rapid review of actions for strengthening health services and systems.


Twin Block appliances are simple bite blocks which are designed for full time wear. They achieve rapid functional correction of malocclusions by the transmission of favorable occlusal forces to inclined planes which cover the posterior teeth. One of the authors has successfully completed over 600 cases with the Twin Block appliance and has developed certain modifications which aid in the correction of Class II, division 1 deep bite malocclusion.


Initially, prostaglandins (PGs) were considered to only exist as free acid mediators. Although, formation of PG glycerol esters and PG ethanolamides by cellular cyclooxygenase (COX)-2 has been reported, generation of complex oxidised lipids via COX-1 has not been considered. In this study, formation of sixteen unique PG-containing phospholipids generated by agonist-activated human platelets is demonstrated using lipidomic approaches. Precursor scanning-tandem mass spectrometry identified a group of specific lipids comprising PGE2, PGD2 and two previously undescribed PG-like molecules (named PGb and PGc), attached to four phosphatidylethanolamine (PE) phospholipids (16:0p/, 18:1p/, 18:0p/ and 18:0a/). PGb and PGc were also detected as free eicosanoids and their structures remain to be characterised. These novel lipids formed within 2-5 minutes of platelet activation by thrombin, collagen or ionophore and required activation of several intracellular signalling intermediates, including cytosolic phospholipase A2 (cPLA2), p38 mitogen-activated protein kinase (MAPK), src tyrosine kinases, phospholipase C (PLC) and cytosolic calcium. Unlike free PGs that are secreted, PG-PEs remain cell associated, suggesting an autocrine mode of action. Aspirin supplementation in vivo (75 mg/day) or in vitro (1 mM) blocked their generation, indicating that COX-1 is required. Pharmacological studies using inhibitors of fatty acyl re-esterification significantly reduced formation of PG-PEs. Furthermore, purified COX-1 was unable to directly oxidise PE in vitro. Collectively, these indicate that PG-PEs are initially formed as free PGs via COX-1, and then rapidly esterified into PEs. In summary, this is the first demonstration of acute generation of PG-PEs in agonist-activated human platelets from endogenous substrate via COX-1. These unique lipids may represent additional bioactive molecules from this key platelet enzyme.


The Fedora content management system embodies a powerful and flexible digital object model. This paper describes a new open-source software front-end that enables end-user librarians to transfer documents and metadata in a variety of formats into a Fedora repository. The main graphical facility that Fedora itself provides for this task operates on one document at a time and is not librarian-friendly. A batch driven alternative is possible, but requires documents to be converted beforehand into the XML format used by the repository, necessitating a need for programming skills. In contrast, our new scheme allows arbitrary collections of documents residing on the user's computer (or the web at large) to be ingested into a Fedora repository in one operation, without a need for programming expertise. Provision is also made for editing existing documents and metadata, and adding new ones. The documents can be in a wide variety of different formats, and the user interface is suitable for practicing librarians. The design capitalizes on our experience in building the Greenstone librarian interface and participating in dozens of workshops with librarians worldwide.


We investigate nonequilibrium behavior of driven dissipative systems, using a model we recently presented [Phys. Rev. Lett., 93, 240601 (2004)]. We solve the non-Boltzmann steady state energy distribution and the temporal evolution to it, and find its high energy tail to behave exponentially. We demonstrate that various measures of effective temperatures generally differ. We discuss infinite hierarchies of effective temperatures defined from moments of the nonexponential energy distribution, and relate them to the "configurational temperature," measured directly from instantaneous particle locations without any kinetic information. We calculate the "granular temperature," characterizing the average energy in the system, two different "fluctuation temperatures," scaling fluctuation-dissipation relations, and the "entropic temperature," defined from differentiating the entropy with respect to energy.


Background : Dasatinib (BMS-354825) is a potent SRC inhibitor being studied in several solid tumors including breast cancer. Expression profiling of breast cancer cell lines led to the identification of genes putatively correlated with dasatinib sensitivity. 1,2 Inhibition of Src-family kinases may have complex effects on angiogenesis; circulating levels of VEGFR2 and collagen type IV (CollIV) are related to changes in VEGF signaling. Two Phase 2 single-agent trials of dasatinib 3,4 have been performed in patients with locally-advanced or metastatic advanced breast cancers. Tumor markers may be used to predict clinical benefit and circulating biomarkers may reveal key mechanisms of action. Methods : Biomarker data from two Phase 2 trials including 114 patients were aggregated for this analysis. Archival tumor tissue from most recent prior surgery was collected in both trials; tumor samples were submitted for 38 of 44 patients with triple-negative, 39 of 46 patients with ER/PR+, and 20 of 24 patients with Her2/neu-amplified breast cancer. The initial dasatinib dose of 100 mg BID (n=46) was reduced to 70 mg BID (n=68) to improve tolerability. Based on mRNA results, immunohistochemical (IHC) procedures were developed for caveolin (Cav), phospho-Cav (p-Cav; scored as membrane vs cytoplasmic), EphA2 and IGFBP-2. Staining intensity was expressed on a scale of 0–3. Plasma was collected at baseline and after 2 and 4 weeks of dasatinib treatment and analyzed for VEGFR2 and CollIV by enzyme-linked immunosorbent assay (ELISA). Quantitative biomarker values pre-treatment and at ≥1 on-study time point for 71 of 114 patients were expressed as percent change from baseline. Tumor mRNA expression is being analyzed in all available tissue. Results : Protocol-defined clinical benefit was observed in 13 patients: 4 with triple-negative, 7 with ER/PR+, and 2 with Her2+ (which were also ER+) malignancies. Tumor tissue was prioritized and adequate for analysis in 89 tumors for Cav, 80 for p-Cav, 88 for EphA2 and 84 for IGFBP-2. Positive IHC (2-3+ intensity) was recorded for Cav in 35% of patients, with 11% and 25% positive for p-Cav in cytoplasm and membrane, respectively, and in 27% for EphA2 and 23% for IGFBP-2. No association was detected between clinical benefit and IHC results. Consistent increases in plasma biomarkers were observed in >90% of subjects. Median percent change (at Days 15 & 29, respectively) was 22% & 27% in VEGFR2 and 32% & 46% in CollIV; the mechanism of this change is being further investigated. Increased CollIV on treatment was associated with drug-related Grade 3-4 adverse events in first 4 weeks and with clinical benefit, but not with tumor subtype. Data on mRNA expression will be presented. Conclusions : The selected IHC analytes did not predict clinical benefit in these trials. Consistent early increases in VEGFR2 and CollIV suggest an effect of dasatinib on vascular endothelium which appears related to both safety and efficacy.1. Huang et al. Cancer Res. 2007;67(5):2226-38.2. Finn et al. Breast Cancer Res Treat. 2007;105(3):319-26.3. Finn et al. SABCS 2008;abstract 3118.4. Mayer et al. ASCO 2009;abstract 1011. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 2034.


In the recently published guidelines of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) for chronic obstructive pulmonary disease (COPD), the staging system included a Stage 0 for subjects without airways obstruction but with respiratory symptoms, denoting these subjects "at risk" for COPD. Our aim was to validate this staging approach using data from three surveys in The Copenhagen City Heart Study, in which a sample of the general population was examined at baseline and in which, after 5 and 15 years, spirometry was performed at all surveys. Criteria for GOLD Stage 0 was fulfilled by 5.8% of the total adult population and 7.2% of smokers. After 5 and 15 years, 13.2 and 20.5%, respectively, of smokers with GOLD Stage 0 had developed COPD fulfilling criteria for GOLD Stage 1 or worse. This was the case for 11.6 and 18.5%, respectively, of smokers without respiratory symptoms. Further analyses using multivariate logistic regression analysis confirmed that GOLD Stage 0 was not identifying subsequent airways obstruction. When analyzing FEV(1) decline, Stage 0 carried a risk of excess decline. GOLD Stage 0 was not a stable feature, which may explain the lack of predictive value. In the Western world, smoking is still in itself the most important indicator of risk of COPD, and alternative markers of susceptibility in the population must be investigated.


Purpose: To study the microscopic anatomic relation of the capsulopalpebral fascia, orbital septum, and tarsus of the lower eyelid in Asians. The anatomic differences between the Asian and non-Asian upper eyelid have been well described by various authors, but the differences of the lower eyelid have not been well characterized microscopically. The microscopic anatomy of the lower eyelid in non-Asians was well studied, but in Asians, despite the presence of gross differences, there were very limited studies on the microscopic anatomy. A thorough knowledge of the Asian lower eyelid anatomy is essential for surgical exploration of the eyelid. It may also explain the higher prevalence of eyelid disorders such as epiblepharon and entropion in Asians. Methods: Ten normal Asian lower eyelids from 10 formalin-fixed cadavers (mean age, 67.5 years) were harvested and studied with light microscopy after staining with Masson trichrome. Results: There was no fusion of the orbital septum and the capsulopalpebral fascia at the lower border of the tarsal plate in 7 specimens and a very limited fusion of these tissues in 3 specimens. The average distance from the inferior tarsal border to the first observable smooth muscle nuclei of the inferior retractors was 1.44 mm. The average tarsal plate thickness was 1.36 mm and the average tarsal plate height was 4.12 mm. Conclusions: The Asian lower eyelid anatomy differs from its non-Asian counterpart. There was no consistent fusion between the capsulopalpebral fascia and the orbital septum inferior to the inferior tarsal border. No extension of the capsulopalpebral fascia to the skin was observed. The average distance between the inferior retractors and the inferior tarsal plate was 1.44 mm in the normal Asian lower eyelid.


Stress-point intervention by Nurses (SPIN) is a research-based intervention that can be used to assist families whose child has a chronic condition and is repeatedly hospitalized. The intervention addresses attendant family stressors, tasks, and concerns. SPIN incorporates parent-nurse contact before admission, during hospitalization, and after discharge. A nurse assists each family to develop their unique set of coping strategies, which are shaped by the family's own concerns and resources and the nurse's expertise. The effectiveness of SPIN has been tested in two intervention studies, one based in the community and another based in ambulatory clinics. Both studies found that families receiving SPIN interventions had better parental coping and family functioning, and there was less developmental regression in the child after hospitalization. SPIN can be used by nurses having experience working with families and children. A self-directed learning program assists with understanding of theoretical and practical aspects of SPIN.


Objectives: To determine the characteristic of auditory perception and cochlear pathophysiology in individuals with long-term occupational noise-exposure. Design: Young workers with occupational noise-exposure from a shipyard were recruited for participation in the current study. Age-matched workers in the same shipyard who had no noise-exposure were enrolled in the control group. The speech-in-noise scores, gap detection thresholds and SP/AP values were tested and compared between the two groups. The correlations of both the speech-in-noise scores and the gap detection threshold with the SP/AP value were calculated and analyzed. Results: Our results demonstrated that even within the normal auditory threshold, individuals with occupational noise exposure showed lower speech-in-noise scores and higher gap detection threshold and SP/AP values. Speech-in-noise score was correlated SP/AP value. The electrocochleography values showed no significant correlation with the gap detection threshold. Conclusion: The result suggested that noise-induced cochlear synaptopathy probably occurs in humans with occupational noise exposure. However, they also implied that the mechanism of auditory dysfunction in humans is more complicated than that in experimental animals.


Experimental research of natural convection and the ways of its suppression in an annular vertical channel to simulate the conditions of cooling the control rod drivers of the reactor protection system (RPS) in its so-called wet design, where the drivers are cooled by primary circuit water supplied due to the system that includes branched pipelines, valves, pump, heat exchanger, etc., is reported. Reliability of the drivers depends upon their temperature ensured by operation of an active multi-element cooling system. Its replacement by an available passive cooling system is possible only under significant suppression of natural convection in control rod channel filled with primary coolant. The methods of suppression of natural convection proposed in the work have demonstrated the possibility both of minimization of axial heat transfer and of almost complete elimination of temperature non-uniformity and oscillation inside the channel under the conditions of free travel of moving element (control rod) in it.The obtained results widen the possibilities of substitution of the active systems of cooling the RPS drivers by reliable passive systems, such as high-performance heat-transfer systems of evaporation-condensation type with heat pipes or two-phase thermosyphons as heat-transferring elements.Copyright © 2013 by ASME


A case of long ureteral polyp with ureteropelvic junction obstruction in a 29-year-old man is reported. He had complained of occasional left flank pain since several years earlier. Excretory urography showed left giant hydronephrosis and no urolithiasis. Retrograde pyelography revealed a mass lesion of the left upper ureter. At exploration, the left ureteropelvic junction was found to be obstructed by an aberrant lower pole renal vessel. At just distal of the junction, a finger-like ureteral polyp, 5 cm in maximal length, was present and accompanied with several little polyps. Partial ureterectomy and pyeloplasty improved the left hydronephrosis. The patient remains symptomless for one year after the operation.


Presents an approach to the vehicle routing problem. The method is based on self-organizing maps with one-dimensional neighborhood, adjustable number of neurons and network training guided by fuzzy rules. The distinctive aspect is the successful application of the algorithm to several instances while keeping parameters unchanged.


In this paper several methods are investigated for feature extraction and classification of mu features from electroencephalographic (EEG) readings of subjects engaged in motor tasks. EEG features are extracted by autoregressive (AR) filtering, mu-matched filtering, and wavelet decomposition (WD) methods, and the resulting features are classified by a linear classifier whose weights are set by an expert using a-priori knowledge, as well as support vector machines (SVM) using various kernels. The classification accuracies are compared to each other. SVMs are shown to offer a potential improvement over the simple linear classifier, and wavelets and mu-matched filtering are shown to offer potential improvement over AR filtering.


This paper addresses the problem of solving nonlinear systems in the context of symmetric quantum signal processing (QSP), a powerful technique for implementing matrix functions on quantum computers. Symmetric QSP focuses on representing target polynomials as products of matrices in SU(2) that possess symmetry properties. We present a novel Newton's method tailored for efficiently solving the nonlinear system involved in determining the phase factors within the symmetric QSP framework. Our method demonstrates rapid and robust convergence in all parameter regimes, including the challenging scenario with ill-conditioned Jacobian matrices, using standard double precision arithmetic operations. For instance, solving symmetric QSP for a highly oscillatory target function $\alpha \cos(1000 x)$ (polynomial degree $\approx 1433$) takes $6$ iterations to converge to machine precision when $\alpha=0.9$, and the number of iterations only increases to $18$ iterations when $\alpha=1-10^{-9}$ with a highly ill-conditioned Jacobian matrix. Leveraging the matrix product states the structure of symmetric QSP, the computation of the Jacobian matrix incurs a computational cost comparable to a single function evaluation. Moreover, we introduce a reformulation of symmetric QSP using real-number arithmetics, further enhancing the method's efficiency. Extensive numerical tests validate the effectiveness and robustness of our approach, which has been implemented in the QSPPACK software package.


Introduction The failure of normal hematopoiesis in myeloid neoplasm could be induced by a variety of mechanism. Regarding myelodysplastic syndrome (MDS)/acute leukemia (AML), aberrant hematopoietic stem/progenitor cells with exhibiting ineffective hematopoiesis and impaired differentiation ability gradually substitute it for normal hematopoietic stem/progenitor cells during a long term as a consequent of replacement of stem cell niche. However, it has not yet been clarified precise mechanism how MDS stem/progenitor cells could replace normal hematopoietic stem/progenitor cells.

Methods In an attempt to analyze the supporting activity of bone marrow (BM) stromal cells, we first established the MDS/AML-derived stromal cells and healthy volunteer (HV)-derived-stromal cells. Next, MDS/AML-derived CD34+ cells or normal CD34+ cells were cocultured with established stromal cells using cytokines including stem cell factor, thrombopoietin, flt3-ligand in the presence of notch ligand (for normal CD34+ cells) or IL-3 (for AML/MDS derived cells). Subsequently, we analyzed clonogenic cells after 2 weeks coculture, 5 week cobblestone area-forming cells (CAFC) and repopulating cells in immunedeficient mice (NSG mice).

Results The support of clonogenic cells after 2 weeks coculture and 5 weeks CAFCs was observed after coculture with normal CD34+ cells and HV-derived stromal cells. Furthermore, these cocultured cells engrafted into immunedeficient mice. Interestingly, the number of colony-forming units (CFU) mixed cells (MIXs) and CAFC derived from CD34+ cells was drastically reduced after coculture with MDS/AML-derived stromal cells. Nevertheless, MDS/AML-derived stromal cells support the proliferation of leukemia-initiating cells (L-ICs) and L-ICs were detected after third replating. These results indicate that MDS/AML-derived stromal cells preferentially support leukemia stem/progenitor cells, but not normal CD34+ cells. We compared the mRNA expression between (HV)-derived-stromal cells, MDS/AML-derived stromal cells and 5-aza-dC-treated stromal cells. The expression of several factors including hedgehog-interacting protein (HHIP) was reduced in MDS/AML-derived stromal cells. 5-aza-dC treatment restored the expression in some of genes and the stromal supporting activity for normal CD34+ cells partially recovered.

Conclusion These results suggest that reduction of several gene expressions was detected in MDS/AML stromal cells by changes of methylation status. The epigenetic alteration of stromal genome may be involved in the progression of myeloid disorders.

Disclosures: No relevant conflicts of interest to declare.


The number of people living in slums across the globe has now reached the 1 billion mark 32 percent of the global urban population and the number could double unless governments act swiftly the United Nations said in its first assessment of the worlds slums. The existence of slums is not inevitable says United Nations Human Settlements Program Executive Director Anna K. Tibaijuka. The Challenge of Slums: Global Report on Human Settlements 2003" issued on World Habitat Day Oct. 6 shows that around the world at least 40 percent of settlements which are home to at least 1 billion people can be considered as slums. Seventy-one per cent of city- dwellers in sub-Saharan Africa live in slums compared to 40 percent for Asia and six percent for developed nations. (excerpt)


In various organizations, lean has not only improved procedure, reduced inventory and enhanced ergonomics, but it has also allowed the company to fine-tune its chemistry and keep pace with changes in demand. However, despite its many benefits and continued implementation Safaricom Limited, the company has many times experienced challenges in relation to their service delivery. The study therefore sought to establish the lean procurement practices used in Safaricom Limited; to establish the relationship between lean procurement and supply chain performance at Safaricom Limited and to determine the challenges facing lean procurement in Safaricom Limited. This research study used a case study design. The target population of this study comprised of the staffs working in Safaricom headquarters. This research study used stratified random sampling to select 20% of the target population and the sample size was 37 team leaders. The study used both primary data and secondary data. Secondary data was obtained from the Safaricom annual reports and financial statements. Primary data was collected using questionnaires. The quantitative data in this research was analyzed by descriptive and inferential statistics using Statistical Package for Social Sciences (SPSS version 20). Descriptive statistics includes mean, frequency, standard deviation and percentages. Data was then presented in tables, charts and graphs. Content analysis was used in processing of qualitative data results were presented in prose form. Regression analysis was also used to establish the relationship between lean procurement and supply chain performance at Safaricom Limited. The study established that there is a positive significant relationship between lean procurement and supply chain performance. The study also established that Safaricom was lean procurement practices like involvement and empowerment of employees, supplier-firm relationship, pull system, total quality management, continuous improvement, e-procurement and 5S. The study recommends that telecommunication companies in Nairobi should ensure that they engage services of qualified individuals who have the required expertise in the implementation of lean procurement practices that can assist in making informed lean procurement. In addition, the government of Kenya should also formulate policies to improve e-procurement.


PURPOSE
As a highly heterogeneous group, seniors live in complex environments influenced by multiple physical and social structures that affect their safety. Until now, the major approach to falls research has been person centered. However, in industrial settings, the individuals involved in an accident are seen as the inheritors of system defects. The objective of the present study was to investigate safety deficiencies that contributed to falls in community-dwelling seniors using a systems approach.

DESIGN AND METHODS
The investigations were conducted using the Seniors Falls Investigation Methodology (SFIM), an adapted version of a method used to examine transportation accidents, such as airplane crashes. Fifteen seniors, who experienced a fall or near fall, participated in multiple case studies. A cross-case synthesis was used to summarize findings and identify common patterns of causes and safety deficiencies.

RESULTS
Falls and near falls are a result of latent unsafe conditions, and unsafe acts and decisions combined in a diverse set of circumstances. If not identified and removed, these unsafe conditions can cause falls for other seniors.

IMPLICATIONS
This study provided compelling evidence that causes of falling are systemic and develop over time. It demonstrated that the systems approach is needed to expand the focus from the individual to multilayered organizational and supervisory causes. The SFIM demonstrated capability to identify causes of falls that will allow better prevention and management programs, hence advancing seniors' safety. SFIM shows great potential for implementation in organized settings, such as hospitals and long-term care homes.


As FFT(Fast Fourier Transform) processor is used in OFDM(Orthogonal Frequency Division Multiplesing) system. According to increase requirement about mobility and broadband, Research about low power and low area FFT processor is needed. So research concern in reduction of memory size and complex multiplier is in progress. Increasing points of FFT increase memory area of FFT processor. Specially, SRU(Signal Reordering Unit) has the most memory in FFT processor. In this paper, we propose a reduced method of memory size of SRU in FFT processor. SRU of 64, 1024 point FFT processor performed implementation by VerilogHDL coding and it verified by simulation. We select the APEX20KE family EP20k1000EPC672-3 device of Altera Corps. SRU implementation is performed by synthesis of Quartus Tool. The bits of data size decide by 24bits that is 12bits from real, imaginary number respectively. It is shown that, the proposed SRU of 64point and 1024point achieve more than 28%, 24% area reduction respectively.


Ethics has become the buzzword of the eighties-ethics in pol aics, journalism. business, and health care. There are some inter· esting reasons why ethics is such a popular subject. one of them bell1g the publicity surrounding the Water· gate scandal and the Iran-Contra af fair Ethical issues closer to our pro· fession would be attempts to maintain life by creating a completely sterile environment (the Boy in the Bubble). and the Baby Doe case There are several good reasons for the rise in ethical awareness among health professionals. Brody (983) CItes three: advances in medi· cal technology. changes in SOCIal Clr· cumstances, and shifts 111 moral values. We are all aware that modern technology has made it possible to sustain life artificially, to use machines to perform vital functions for varying periods of time, and to trans· plant organs Questions about when life ends, whether withholding treat· ment is the same as murder, and whether the Individual has a right to die are only a few of those created by technology In addition, sOCIetal changes have created new Issues for consider· ation: Fewer people live in extended families, the elderly have become more Isolated, more women have careers outside of the home, and there are more single-parent homes All of these changes press for a reexamina· tion of our attitudes toward SOCIetal roles, suiCIde, euthanaSia, and abortion. Finally, the increased access to information has added complexity to what at one time were considered to be SImple issue~. Modern medical and technological advances have cre· ated choices that did nOI eXIst 20 to 25 years ago, and, thanks to extensive Ruth Ann Hansen


Spectral data cubes of the interacting pair of galaxies NGC 2535 and NGC 2536 (the Arp 82 system) targeting bright emission lines in the visible band, obtained with the imaging Fourier transform spectrometer (iFTS) SITELLE attached to the Canada-France-Hawaii Telescope (CFHT), are presented. Analysis of Hα velocity maps reveals a bar in $\rm NGC\, 2536$. In $\rm NGC\, 2535$, we find strong non-circular motions outside the ocular ring, in the elliptical arc and tidal tails of $\rm NGC\, 2535$ and a misalignment between the kinematic and photometric position angles. We detect 155 HII region complexes in the interacting pair of galaxies and determine oxygen abundances for 66 of them using different calibrators. We find, regardless of the indicator used, that the oxygen abundance distribution in $\rm NGC\, 2536$ is shallow whereas, in $\rm NGC\, 2535$, it is best fitted by two slopes, the break occurring beyond the ocular ring. The inner slope is comparable to the one observed in isolated normal star-forming galaxies but the outer slope is shallow. We present a numerical simulation of the interaction that reproduces the observed tidal features, kinematics, and metallicity distribution, to investigate the effect of the interaction on the galaxies. The model indicates that the galaxies have undergone a close encounter, strongly prograde for the primary, and are half way in their course to a second close encounter.


The cage occupancy plays a crucial role in the thermodynamic stability of clathrate hydrates and is an important quantity for understanding the CO2-CH4 replacement phenomenon. In this work, the occupancy isotherms of pure CH4, pure CO2, and their mixture in sI and sII hydrates are studied by GCMC + MD simulations. The adsorption of CH4 and CO2 + CH4 in the sI and sII hydrates can be categorized as the one-site Langmuir type. The calculated occupancy ratio θL/θS and the abundance ratio of CO2 to CH4 vary with the temperature and pressure, which provide the prerequisite information for the prediction of CH4 recovery yield at different conditions in the CO2-CH4 gas exchange process. The phase equilibria of clathrate hydrates of pure gases and mixtures are explored and the corresponding heat of dissociation and hydration numbers are determined. The current investigation provides new perspectives to understand the mechanism behind the gas adsorption behavior of clathrate hydrates.


Evaluation of health services is a regular and systematic process to compare between an achieved result and standard criteria. A laboratory is one of health services which it must continually evaluate and integrate a technology within its services to improve quality for achieving customers' satisfaction. The objective of this research was to result health laboratory information system which could be used to support the evaluation of the laboratory services at the Health Laboratory of Purbalingga Distric. Development of the system was based on the FAST "Framework for the Application of Systems Techniques" methodology. Design of this research was pre experimental one group pretest and posttest. Number of subject was seven respondents. The research variables were accessibility, accurateness, completeness, and clarity of information. The result of this research showed that the new system could overcome the problems of data accessibility, accurateness, completeness, and clarity of information to support the evaluation of the laboratory services. The considered average on the new system (3.92) was higher than the considered average on the old system (1.55). Based on the statistical analysis, it showed that there was any differences of information quality between the old and the new system (p value = 0.0001). The hospital management should maintain the new system, recruit a specific officer, and evaluate the system for sustaining and repairing it.
Keywords; information system; health laboratory; evaluation of the laboratory services


Introduction: C-reactive protein (CRP) is the most widely used biomarker of infection in critically ill patients and some data are available on the morbidity and mortality in obese patients in the medical intensive care setting, but it is widely held that their outcomes are poor. Aim of the work: This study aimed to evaluate the impact of CRP and BMI on the outcome of patients admitted in the respiratory ICU (RICU) in Abbassia Chest Hospital. Materials and methods: This prospective study was carried out on 71 patients admitted to the RICU at Abbassia Chest Hospital from January 2011 to July 2011. A full assessment of history, a thorough clinical examination, length of stay (LOS), and need for mechanical ventilation were assessed, and BMI and CRP were measured. Results: There was a highly significant correlation between BMI categories and outcome in which the mortality rate was high among underweight patients; there was also a significant correlation with complications, wherein septicemia was more common in underweight patients. Complications of mechanical ventilation were more common in morbidly obese patients and nosocomial infection was more common in obese patients. The results showed an insignificant correlation between smoking, need for mechanical ventilation, duration of MV, LOS in ICU, and outcome in terms of the CRP level. Conclusion: The study concluded that CRP exerted an independent effect on the duration of mechanical ventilation (MV) and LOS in RICU. The mortality rate was high in underweight patients, but not in overweight, obese, or severely obese patients.


In partial discharge detection of transformer, supersonics detection method is applied widely. In the paper, a model of supersonics is established by MATLAB. Meanwhile, analyses about the relation between amplitude of sound pressure and discharge capacity and ultrasonic signal spectrum are implemented based on the model. By analyzing the partial discharge characteristics of ultrasonic signals, a suitable ultrasonic receiving sensor can be selected that meets the performance requirements. Therefore, detection band of sensor is determined. Meanwhile, the structure of the sensor and the selection of piezoelectric crystals are introduced in details.Finally,the design of ultrasonic receiving sensor is determined.


BACKGROUND: Generic self-report measures do not reflect the complexity of a person's pain-related behaviour. Since variations in a person's fear of movement and avoidance behaviour may arise from contextual and motivational factors, a person-centred evaluation is required-addressing the cognitions, emotions, motivation and actual behaviour of the person. CLINICAL QUESTION: Most musculoskeletal rehabilitation clinicians will recognise that different people with chronic pain have very different patterns of fear and avoidance behaviour. However, an important remaining question for clinicians is "how can I identify and reconcile discrepancies in fear of movement and avoidance behaviour observed in the same person, and adapt my management accordingly?". KEY RESULTS: We frame a clinical case of a patient with persistent low back pain to illustrate the key pieces of information that clinicians may consider in a person-centred evaluation (i.e., patient interview, self-report measures and behavioural assessment) when working with patients to manage fear of movement and avoidance behaviour. CLINICAL APPLICATION: Understanding the discrepancies in a person's fear of movement and avoidance behaviour is essential for musculoskeletal rehabilitation clinicians, as they work in partnership with patients to guide tailored approaches to changing behaviours.


Tin oxides with high theoretical capacities as anodes for lithium-ion batteries always suffer from the electrical disconnect issue of active materials owing to huge volume changes. In this work, flexible mats composed of ultra-small SnOx nanoparticles, graphene, and carbon fibers are synthesized by reducing graphene oxide with stannous ions at room temperature following treatments. SnOx nanoparticles, including SnO and SnO2, with diameters of approximately 4 nm are embedded in the matrix composed of carbon fiber and graphene to form composite fibers that are woven into flexible mats without any binders. As binder-free anodes for lithium-ion batteries, SnOx–graphene–carbon fiber mats can deliver a high reversible capacity of 545 mA h g−1 after 1000 cycles at a current density of 200 mA g−1, which is much better than those of SnOx–carbon fiber mats. The improved performance of SnOx–graphene–carbon fiber mats can be attributed to the ultra-small size of SnOx nanoparticles and the double protection of both graphene and carbon fibers.


Vulnerability is a multifaceted phenomenon brought about over time. Simplified interpretations based upon selective representation of current conditions serve to deny overdue attention to its root causes. As disasters themselves ignore boundaries of place and time, so also must their exploration, as exemplified by the long history of vulnerability reduction research and practice. Descriptions of the causes of vulnerability, therefore, necessarily transgress conventional disciplinary and sectoral boundaries; not to do so would disregard the very nature of the subject. Accordingly, this paper seeks to go beyond some assumed practice—such as viewing vulnerability as a contemporary snapshot of a group of people in a specific place—in an attempt to demonstrate evidence of vulnerability and to begin to reveal its causes, so that national and local, multidisciplinary and multi-sectoral applications from the past and the present might assist its long overdue reduction, now and in the future.


The thermal rheological state along with the depth to the Curie isothermal surface have been investigated in this thesis in order to provide a solid and a consistent subsurface image of the crust under Yellowstone caldera. This latter well-known caldera represents a unique geological and geophysical laboratory, where complex geodynamic processes in a continental hotspot are manifested, and it has been the center of interest for decades monitored since the fifties.
In the first part of this manuscript, I started by mapping the distribution of the depth to the Curie isothermal surface. To this end, I assume that the bottom of the magnetic crust corresponds to the depth of the iso-Curie surface where the magnetic minerals lose their magnetization due to the increase of temperature. Comparing with previous findings, our outcomes are computed with new aeromagnetic dataset with higher resolution, which play a key role in the improvement of the final results. I used two techniques based on spectral analysis of the magnetic anomalies: the first approach is the modified centroid method assuming a statistical ensemble of blocks of varying depth, width, thickness, and magnetization, each one uniformly distributed. It is simple to argue that this kind of distribution is not uncorrelated but it is instead a correlated distribution of magnetic sources, with a sloping exponent of about 3 that is within the fractal range. The misunderstanding may be explained in this way: even though the magnetization spectral factor is constant (a white power spectrum), the magnetization distribution must instead be defined by the product of spectral factors related to the prism size, magnetization and thickness, which is a red power spectrum, as discussed above. The second approach is the fractal distribution of magnetic sources, for which a spectral factor exists with a sloping exponent within the fractal range (from 2 to 4).
The application of the two methods to our dataset suggest that in both cases, a shallow Curie isothermal surface ranging from 1 km to 5 km is retrieved.
The second part of the thesis is focused on building a 3D thermal model. It was constructed through solving a 3D finite element problem of heat transfer in a conductive system using Comsol Multiphysics software involving a trial and error optimization of the density, velocity models jointly with the geothermal heat source parameters. The previous obtained depth to the Curie isothermal map was a key constraint parameter to check the validity of the thermal model.
Subsequently, a 3D rheological model was built using the 3D temperature model as an input along with the geological and the geophysical information from literature. The most part of earthquakes epicentres were found to be concentrated in the brittle zone of the volume while the ductile zone is not totally homogeneous confirming the sandwich theory of the crust suggested by different authors which states that the ductile zone contains some brittle stratification. This brittle-ductile volume is the first 3D mapping of the rheological features of the crust under Yellowstone caldera.
The results obtained from this work can be considered as a new valuable information that provide a new insights into Yellowstone caldera, improve the monitoring of the volcanic evolution and assess the risk of its hazard.


Background: Sickle cell disease is the commonest inherited hemoglobinopathy. There are few reports point towards decrease incidence of diabetes mellitus in sickle cell disease patients. Materials and Methods: This cross-sectional study was conducted in VIMSAR, Burla, Odisha between Nov 2014 to Oct 2016. FBS and 2 hours OGTT reports of adult sickle cell disease patients were compared with the same reports from equal no of adult persons without sickle cell disease (controls) to found out any significant difference in prevalence of diabetes mellitus in sickle cell disease patients versus controls. Results: A total of 137 adult patients of sickle cell disease out of which males were 94 (68.61%) and females were 43 (31.38%) with an average age of (26.7 ± 10.9) years and an equal number of controls [males 87 (63.8%) and females 50 (36.5%)] with an average age of (47.6 ± 13.6) years were included in the study. We found diabetes mellitus in 2 (1.46%) out of 137 sickle cell disease patients with an average BMI 18.5 kg/m2 versus 12 (8.76%) in equal number of controls with an average BMI of 22.6 kg/m2. Conclusion: This study concludes that prevalence of diabetes mellitus in sickle cell disease patients is significantly lower than non-sickle cell disease persons. This may be due to less longevity and low BMI in sickle cell disease patients.


The existence of asteroidal meteoroid streams capable of producing meteorite-dropping bolides has long being invoked, but evidence is scarce. Recent modelling of previously reported associations suggests that the time-scales to keep the orbital coherence of these streams producing meteorites are too short. We present an unequivocal association between near earth object (NEO) 2002NY40 and at least one bright fireball detected over Finland in 2006 August. Another two additional fireballs recorded from Spain and Finland seem to be related, together producing a fireball-producing stream (β Aquarids). On the basis of historical data, the 2006 finding suggests the existence of a meteoroid complex capable of producing meteorites. Taking into account present time-scales for orbital decoherence, if 2002NY40 has large meteoroids associated with it, such behaviour would be the consequence of a relatively recent asteroidal fragmentation. Supporting our claim, the heliocentric orbits of two recently discovered NEOs, 2004NL8 and 2002NY40, were found to exhibit a good similarity to each other and also to the orbits of the three bolides. The fireball spectra of the two Finish bolides showed that the chemical abundances of these objects are consistent with the main elements found in chondrites. This result is consistent with the probable Low iron, Low metal (LL) chondritic mineralogy of asteroid 2002NY40. Consequently, this asteroid may be delivering LL chondrites to the Earth. Additional fireball reports found in the literature suggest that the associated β Aquarid complex may have been delivering meteorites to the Earth during, at least, the last millennium.


Results of clinical examination and surgical treatment of 1022 patients with tumors of the hypophysis were analyzed. All the patients were operated upon by transsphenoidal endoscopic approach during the recent 10 years. Complications were observed in 76 (7.4%) patients. Most serious of them were: intraoperative mechanical injury of the right internal carotid artery and contact rupture of a large aneurysm of the internal carotid artery falsely diagnosed as craniopharyngioma. In both cases urgent intravascular interventions were necessary which resulted in relief of symptoms and recovery of the patients.


BACKGROUND:
Venous ulcers (ulcus cruris) are wounds in legs due to malfunctioning of venous valves. Among leg ulcers they are the major contributors nearly 79- 83%. Approximately 24-30% of patients are of the age of 42-45 and 60-70% are between age of 60-64.They are otherwise healthy individuals losing their productive period of living because of these ulcers.
The pathophysiology of venous insufficiency may be due to valvular reflux, destroyed valves, or perforator paucity. Leucocytes cause inflammation, and later the platelets adhere form a pericapillary cuff of fibrin, leading to tissue hypoxia, cell death and ulceration.
More common cause 75% of venous ulcer being superficial, perforator or deep venous reflux rather than obstruction which is a less frequent cause 1-3%. Trauma are in 23% of cases, and congenital anomaly in 1-2%.
Color Duplex scan is the investigation of choice, which gives information about patency and reflux.
The treatment options for venous problems are conservatively by limb elevation and a compression bandage. Medically managed with drugs like pentoxifylline, aspirin and micronized flavinoids. Once the patient does not respond to conservative management, surgical intervention becomes mandatory, both for the underlying cause and a cover for ulcer should be instituted. The various surgical option available for superficial venous system reflux are ligation and stripping of superficial varicose veins, endoscopic subfascial perforator ligation, foam sclerotherapy, endovenous laser or radiofrequency ablation. The medical cost incurred towards treating these is much their financial burden of lost work is huge for the patient and the government as these venous ulcers are either neglected or managed inappropriately.
METHODS:
Between December 2012 to November 2013, the patients who had presented to the general surgery and vascular surgery outpatient department of inclusion criteria were admitted evaluated using duplex, ulcer was documented on visitrak treated and periodically observed.
RESULTS:
In this study we observed majority of patients 69.6% belonged to age group of 40-59. Men 92 % were affected more. Right lower 48% limb slightly predominates left 40%. The patients have recalcitrant ulcer ranging from 12- 38 weeks duration peeks between 20-22 weeks. On duplex the SFJ reflux 56.5% dominated followed by the SFJ along with perforators 28.9%. Most common anatomic presentation was incompetence in the SFJ (grade II reflux 69. 7% dominates over grade III 30.3%). Among perforator's leg perforators are most common site. CEAP 4 heals earlier then its counterparts approximately by 12 weeks followed by CEAP 5 which takes 22 weeks and then CEAP 6 which takes 28-30 weeks' time. Finally The SFJ are the first to heal majority heal by 16 weeks. Perforators as pathology took longer duration to heal 28 weeks. When all three the SFJ, SPJ and Perforator are present it takes the maximum time of around 30 weeks to heal.
CONCLUSION:
This study clearly suggest that as far as pigmentation and ulceration are concerned the underlying pathophysiology and reflux in the SAPHENOFEMORAL JUNCTION and PERFORATOR are more harmful and if left untreated take longer time to heal. They are statistically significant with the p value being 0.029 and .007 for saphenofemoral junction and perforator reflux respectively. As ever, the reality is more complicated as there is much still to be discovered as in this study the sample size was small and more number of cases will be needed for precious conclusions. In the meantime a working knowledge of the underlying process can help these ulcer patients heal faster.


Background: Asthma is a complex inflammatory disorder of the airways, and research on alternative therapeutic strategies has attracted attention. This study aimed at hypersusceptibility and toxicity of recombinant human phospholipase D2 (rhPLD2) in guinea pigs. We determined the behavioral responses in the model of immediate hypersensitivity animals and changes of eosinophil levels following use of the drugs. Special attention was given to the effects of rhPLD2 in vivo on the guinea pig with chronic persistent asthma and the mechanism involved. Methods: To investigate the effect of rhPLD2 on the expression of protein kinase C (PKC), and to examine the activity of signal transducer and activator of transcription 1 and 5a in the lung of the guinea pig with chronic asthma. Guinea pigs with chronic asthma were divided into five groups: a saline group, a dexamethasone 5.0 mg group, and rhPLD2 (1.5, 2, or 3 mg) groups. Non-sensitized animals were as normal control group. PKC expression was measured by immunohistochemistry, alterations of STAT1 and STAT5a were detected by TransAM transcription factor assay kits. Results: rhPLD2 (3.0 mg) decreased PKC expression to baseline and inhibited STAT1 activity compared with that of the saline group (p < 0.01). Conclusion: The rhPLD2 may suppress the chronic inflammatory reaction through down-regulating PKC expression and STAT1/STAT5a activity in the lung. The rhPLD2 may be a suitable therapeutic target for asthma.


The present study reports on the observation of dipolar solvent relaxation in phospholipid membranes using multifrequency phase and modulation fluorometry. We measured the time-resolved emission spectra of 6-propionyl-2-(dimethylamino)naphthalene (PRODAN) in artificial bilayer membranes of chemically defined acyl-, alkyl-, and alkenyl-substituted phospholipids at 15 degrees C. 1-Palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine, 3-O-hexadecyl-2-oleoyl-sn-glycero-1-phosphocholine, or 1-O-hexadec-1'-enyl-2-oleoyl-sn-glycero-3-phosphocholine (plasmalogen) were used as matrix lipids. The chemical structures of these lipids differ only with respect to the type of linkage (carboxyl ester, ether, or enol ether bond) between glycerol and the hydrophobic chain linked to the primary hydroxyl of glycerol. At 15 degrees C, all the lipids are in the liquid crystalline state. PRODAN probably localizes at the hydrophobic-hydrophilic interface of the phospholipid bilayer [Chong, P. L. (1988) Biochemistry 27, 399-404]. We found faster solvent relaxation of PRODAN in membranes composed of the ether lipid compared to that in the ester lipid membranes. On the other hand, the fluorescence anisotropies of the label were very similar, showing that the motion of the label itself is similar in ether and carboxyl ester lipids. We conclude that the spectral differences observed for PRODAN in ether and ester lipids could be due to different dipolar relaxation of the immediate surroundings of the label, i.e., reorientation of lipid dipoles in the glycerol region and of water molecules residing therein.


: The daily exposure of the body to various biological and chemical agents, as well as to atmospheric (climate) changes, contributes to the deterioration of general health, ie the decline of the immune system as a whole or of certain organs. Due to the relatively rapid lifestyles, not always controlled use of medicines, and especially antibiotics, many causes of diseases (bacteria, viruses, parasites) undergo a transformation and develop resistance to the drugs given in the treatment of a particular disease. As such, the causative agents can be isolated from different regions and biological substances (blood, urine, cerebrospinal fluid, swab, amniotic fluid, faeces, etc.) from the human body, depending on the type that manages to settle in the given environment. This imposes the need for more detailed and specific identification of the cause, for better diagnostics, enabling better therapy and successful healing. Our research is based on the qualitative identification of the DNA molecule in sexually transmitted diseases, more precisely the detection of Chlamydia trachomatis intracellular bacteria with the Polymerase Chain Reaction - method, introduced in July 2019 in microbiological laboratory of PHI Public health center Stip - R. Macedonia. The type of Chlamydia trachomatis causes a sexually transmitted disease of the genito-urethral tract in both sexes, with the highest risk and percentage in reproductive and sexually active periods. As one of the most common culprits for sterility, the bacterium can be isolated from urine and swabs from a particular region (cervical in female patients). This study was performed using the in vitro RT-PCR method of ELITe InGenius® CE-IVD over a four-month period from July to October 2019, which included a total of 94 patient swabs, 2 conjunctival smears on both eyes of them and 92 cervical. For the qualitative proof of Chlamydia infection, can be used chromatographic so-called quick tests too, but the result is far less-specific. In our research 2 of the cervical smears were initially tested by rapid tests and yielded positive results, but with the polymerase chain reaction of ELITe InGenius® CE-IVD, they were negative. From all the possibilities offered by the menu, combining in real-time 43 different PCR assays from all disease panels (for transplant pathogens, antibiotic resistance testing, sexually transmitted diseases, respiratory infections, meningitis, gastro-infections, genetic disorders), to detect Chlamydia we used the STI ELITe MGB® Panel, and the Chlamydia ELITe MGB® Kit, as well as the appropriate calibrations and controls. According to the referral diagnosis of patients and/or gynecological pathology, by the assessment of the gynecologist or urologist, of all cervical swabs in the study period, three gave a positive result for the DNA molecule identification of Chlamydia trachomatis. The patients whose samples were examined were aged from 20 to 45 years, the same sexually active and with pre-treated infections, infertility and pathological pregnancies, but with different geographical origin from rural to urban areas in the eastern region of R. Macedonia. The three positive Chlamydia detections by ELITe InGenius® RT-PCR method were reported in patients aged 25-30 years, two of whom were from urban and one from less developed socio-economic environment, expressing the fact of the large availability and highest quality in detection to the cause of infection with this kind of analysis. In this way, patients have the opportunity to get the most accurate result in the shortest time possible and thanks to modern medicine to be successfully cured, improving their health as well.


High Altitude Platforms (HAP) are currently considered as an alternative solution for providing reliable multicast and broadcast services. The major problem limiting the scalability of such systems is Feedback Implosion, a problem arising whenever a large number of users transmit their feedback messages. In the present Letter, a novel scheme is proposed which takes into account rain attenuation being the dominant factor impairing link performance. The proposed scheme is based on the selection of an Area Representative (AR) which is responsible for providing quick feedback messages to the HAP, thus suppressing feedback messages sent by other users. The proposed scheme is assessed both through analytical modeling and simulation with very satisfactory results.


It is my purpose in this address to review the development of carotid artery surgery as it relates to the problem of cerebrovascular insufficiency caused by extracranial atherosclerotic occlusive disease. We are indebted to many members of this organization for numerous advances in this field during the past two decades. History The word "carotid" is derived from the Greek term meaning to stupefy or to plunge into deep sleep. According to Rufus of Ephesus (circa 100 AD) the term was applied to the arteries of the neck because compression of these vessels produced stupor or sleep. Ambroise Pare has recounted this phenomenon as follows: "[The] two branches which they call carotides or soporales, the sleepy arteries, because they being obstructed, or any way stopt we presently fall asleep." 1 According to Dandy, 2 Hippocrates and Galen were aware that hemiplegia resulted from a lesion in the opposite side of the


In this paper, a nonlinear parabolic variational inequality in noncylindrical domain is considered. Using extended Rothe's method recently achieved in [11] an approximate solution is constructed. Existence and uniqueness results are proved. Also, we present some further results and comments related to the main result. Mathematics subject classification (2010): 65N40, 35K20.


AIM. To investigate the relation of prooxidant and antioxidant systems with adverse effects of antiviral alpha interferon treatment in chronic hepatitis C. METHODS. The study included 67 patients with chronic hepatitis C aged 19 to 45 years [males 28 (41.8%), females 39 (58.2%)] who were receiving antiviral treatment. Prooxidant (diene ketones and diene conjugates, malon dialdehyde) and antioxidant (catalase, superoxide dismutase, glutathione and glutathione-dependent enzymes) systems indicators were measured. According to the severity of side effects, patients were distributed to two groups. The first group consisted of 19 (28.4%) patients with transient passing adverse effects, usually manifesting as short-term flu-like syndrome after the medication injection, lasting no longer than 2-3 weeks of treatment. The second group consisted of 48 patients (71.6%) with prolonged side effects, registered throughout the whole treatment period. Results: Flu-like syndrome with intense myalgia and asthenic syndrome were the most frequent side effects (89.5 and 83.3% of cases, respectively). Dyspepsia, psychopathy and arthralgia were less common (79.2, 72.9 and 68.7%, respectively). Over than a half of the patients lost weight (7-9 kg compared to baseline weight), and also had alopecia and autoimmune thyroiditis. Most of the patients could not tolerate the treatment, 33 (49.2%) patients aborted the treatment. In patients with long-term side effects, low baseline levels of glutathione reductase, glutathione peroxidase, glutathione transferase were revealed (p CONCLUSION. Examined patients with chronic hepatitis C had diverse activity of antioxidant system. Long-term side effects were seen in patients with low levels of parameters of antioxidant protection at the baseline.


Recombinant interferon-alfa (Intron A, Roferon-A) has been under investigation as a therapeutic agent for non-Hodgkin's lymphoma (NHL) for 25 years. It has antitumor efficacy in a number of histologic subtypes but has not been accepted as a clinically useful agent by the majority of oncologists/hematologists. A total of 10 prospective, randomized trials of interferon-alfa have been conducted in patients with follicular lymphoma. A survival benefit associated with interferon-alfa has been demonstrated in three of these trials, which used an anthracycline-based combination chemotherapy induction regimen, primarily in patients with bulky symptomatic disease. In this article, we review these trials, as well as the use of interferon-alfa in other NHL subtypes. Based on these data, we support the recommendation that interferon-alfa be added to an anthracycline-based induction regimen in the treatment of patients with clinically or histologically aggressive follicular lymphoma. This agent also appears to be effective in patients with diffuse large B-cell lymphoma and in patients with cutaneous T-cell lymphoma. Preliminary clinical data support the need for prospective, randomized phase III trials evaluating the role of interferon-alfa in these disorders.


We describe a successful case of surgical treatment for anomalous left coronary artery from the pulmonary artery (ALCAPA) syndrome with severe left ventricular dysfunction. Because of the severe left ventricular dysfunction, we planned to use an extracorporeal membrane oxygenation for heart support until a satisfactory recovery had been established. The left ventricular function significantly recovered in a few days, and the patient could be discharged without any complications.


OBJECTIVE
To summarize the clinical features, electrophysiological and neuropathological characteristics of peripheral nerves in patients with primary Sjögren's syndrome (SS).

METHODS
We retrospectively analyzed the clinical, electrophysiological and neuropathological characteristics of 5 female SS patients with neuropathy complications undergoing electrophysiology and sural nerve biopsy at our department from January 2011 to June 2013.

RESULTS
They had an age range of 20-75 years. The course of peripheral neuropathy ranged 0.5-60 months and the whole course 12-240 months. pSS-associated neuropathy included multiple mononeuropathy (n = 1), symmetrical axonal sensorimotor polyneuropathy (n = 1) and sensory ganglioneuronopathy (n = 3). All biopsies showed varying degrees of myelinated fiber loss. Three biopsies had axonal degeneration associated with demyelination. However, there was no formation of onion bulb regeneration or plexus. Necrotizing vasculitis was diagnosed in 2 cases.

CONCLUSION
The manifestations of peripheral nerve n pSS include multiple mononeuropathy, axonal symmetric sensorimotor polyneuropathy and sensory gangioneuronopathy. Sural biopsy shows typical necrotizing vasculitis in some cases and myelinated fiber loss and axonal degeneration in others. The pathogenic mechanisms of neurological involvement in pSS remain unknown. However, vasculitis, ischemic and immunological insults resulting in sensory gangioneuronopathy have been described.


Introduction Evidence concerning the effectiveness of non-pharmacological interventions that are applied to people with dementia living in long-term care facilities is inconsistent. The purpose of this protocol is to describe the methodological considerations that will guide the completion of a scoping review that will inventorise and assess the effectiveness of the various non-pharmacological interventions that are documented in literature for improving quality of life of people with dementia living in long-term care. Methods and analysis This scoping review will combine the methodology outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews and Guidance for conducting systematic scoping reviews by Peters et al. PubMed; MEDLINE; CINAHL; Embase; Cochrane Database of Systematic Reviews; Cochrane Central Register of Controlled Trials; Emcare; Sociological Abstracts and PsycINFO databases will be searched. Grey literature databases will also be explored. A two-stage screening process consisting of a title and abstract scan and a full-text review will be used to determine the eligibility of studies. Studies, irrespective of design, will be included that quantitatively assess quality of life of long-term care residents who receive non-pharmacological interventions for dementia. A pair of reviewers will independently assess all articles for eligibility, and all eligible articles will be abstracted and charted using a standardised form. The extracted data will undergo a 'narrative review' or a descriptive analysis of the contextual or process-oriented data and quantitative analysis reflecting the objectives of this scoping review. Ethics and dissemination Research ethics approval is not required for this scoping review. This review started off in October 2018, anticipated end date is June 2020. We plan to disseminate this research through publications, presentations at relevant national and international conferences and meetings with relevant stakeholders. This scoping review protocol has been registered at Open Science Framework (https://osf.io/tupbv).


Objectives The mesothelium, the surface layer of the heart, lung, bowel, liver, and tunica vaginalis, is a complex tissue implicated in organ-specific diseases and regenerative biology; however, the mechanism of mesothelial repair after surgical injury is unknown. Previous observations indicated seeding of denuded mesothelium by free-floating mesothelial cells may contribute to mesothelial healing. In this study, we investigated the prevalence of mesothelial cells in pleural fluid during the 7 days following pulmonary surgery. Study design Flow cytometry was employed to study pleural fluid of 45 patients after lung resection or transplantation. We used histologically validated mesothelial markers (CD71 and WT1) to estimate the prevalence of mesothelial cells. Results The viability of pleural fluid cells approached 100%. Leukocytes and mesothelial cells were identified in the pleural fluid within the first week after surgery. The leukocyte concentration was relatively stable at all time points. In contrast, mesothelial cells, identified by CD71 and WT1 peaked on POD3. The broad expression of CD71 molecule in postoperative pleural fluid suggests that many of the free-floating non-leukocyte cells were activated or proliferative mesothelial cells. Conclusion We demonstrated that pleural fluid post lung surgery is a source of mesothelial cells; most of these cells appear to be viable and, as shown by CD71 staining, activated mesothelial cells. The observed peak of mesothelial cells on POD3 is consistent with a potential reparative role of free-floating mesothelial cells after pulmonary surgery.


Today's consumers are increasingly concerned about how their food is produced. In some cases, consumers also want to know where their food was produced, who produced it, and when it was sent to the market relative to when and where they are purchasing and consuming the product.


12 Microplastic represents a rising proportion of marine litter and is widely distributed throughout 13 a range of marine habitats. Correspondingly, the number of reports of species containing 14 microplastics increases annually. Nephrops norvegicus in the Firth of Clyde have previously been 15 shown to retain large aggregations of microplastic fibres. The potential for N. norvegicus to retain 16 plastic over an extended time period increases the likelihood of any associated negative impacts 17 to the individual. This study represents the longest observation of the impacts of microplastic 18 retention in invertebrates. We exposed N. norvegicus to plastic over eight months to determine 19 the impacts of extended exposure. Over this period we compared the feeding rate, body 20 mass, and nutritional state of plastic-fed N. norvegicus to that of fed and starved control 21 groups. Following the experimental period, the plastic-fed langoustine contained microplastic 22 aggregations comparable to those of small individuals from the Clyde Sea Area. Comparisons 23 between fed, unfed and plastic-fed individuals indicated a reduction in feeding rate, body mass, 24 and metabolic rate as well as catabolism of stored lipids in plastic contaminated animals. We 25 conclude that N. norvegicus exposed to high levels of environmental microplastic pollution may 26 experience reduced nutrient availability. This can result in reduced population stability and may 27 affect the viability of local fisheries. 28 Capsule: Long term retention of microplastic aggregations reduces the nutritional state of 29 langoustine. 30


Clinch River-Environmental Restoration Program (CR-ERP) personnel and Tennessee Valley Authority (TVA) personnel conducted a pilot study during the week of April 22--29, 1993, prior to initiation of CR-ERP Phase 2 Sampling and Analysis activities. The organisms specified for testing were larval fathead minnows, Pimephales promelas, and the daphnid, Ceriodaphnia dubia. Surface water samples were collected by TVA Field Engineering personnel from Clinch River Mile 9.0 and Poplar Creek Kilometer 1.6 on April 21, 23, and 26. Samples were split and provided to the CR-ERP and TVA toxicology laboratories for testing. Exposure of test organisms to these samples resulted in no toxicity (survival, growth, or reproduction) to either species in testing conducted by TVA. Attachments to this report include: Chain of custody forms -- originals; Toxicity test bench sheets and statistical analyses; Reference toxicant test information; and Personnel training documentation.