Validation of program invariants (a.k.a. correctness witnesses) is an established procedure in software verification. There are steady advances in verification of more and more complex software systems, but coming up with good loop invariants remains the central task of many verifiers. While it often requires large amounts of computation to construct safe and inductive invariants, they are more easy to automatically validate. We propose LIV, a new tool for loop-invariant validation, which makes it more practical to check if the invariant produced by a verifier is sufficient to establish an inductive safety proof. The main idea is to apply divide-and-conquer on the program level: We split the program into smaller, loop-free programs (a.k.a. straight-line programs) that form simpler verification tasks. Because the verification conditions are not encoded in logic syntax (such as SMT), but as programs in the language of the original program, any off-the-shelf verifier can be used to verify the generated straight-line programs. In case the validation fails, useful information can be extracted about which part of the proof failed (which straight-line programs are wrong). We show that our approach works by evaluating it on a suitable benchmark. Supplementary website: https://www.sosy-lab.org/research/liv/


This study examines the impact of alternative telework strategies on professional and personal outcomes. The march design is a longitudinal between-participants field experiment with two manipulated factors: satellite office space available (no, yes) and downtown office space available (no, yes). In all four conditions, participants could telework from home. The design incorporated a fifth (control) condition with no telework, reflecting current company policy. One hundred sixty medical coders from a large health care company participated in the experiment. Archival data recorded work locations, task interruptions, quality adjusted task performance, and employee retention, while the experience sampling method (ESM) captured cognitive and affective responses. The findings help to explain the social dynamics of work location autonomy in the rich ecological settings of employees' organizational and personal environments. Data Availability: Data are available from 'author; however, requests for data should specify the intended use.


A large series of variously substituted amino(pyren-1-yl)methylphosphonic acid derivatives was synthesized using a modified aza-Pudovik reaction in 20–97% yields. The fluorescence properties of the obtained compounds were investigated revealing that N-alkylamino(pyren-1-yl)methylphosphonic derivatives are stronger emissive compounds than the corresponding N-aryl derivatives. N-Benzylamino(pyren-1-yl)methylphosphonic acid displayed strong fluorescence (ΦF = 0.68) in phosphate-buffered saline (PBS). The influence of a series of derivatives on two colon cancer cell lines HT29 and HCT116 was also investigated. The most promising results were obtained for N-(4-methoxyphenyl)amino(pyren-1-yl)methylphosphonate, which was found to be cytotoxic for the HCT116 cancer cell line (IC50 = 20.8 μM), simultaneously showing weak toxicity towards normal lymphocytes (IC50 = 230.8 µM).


PURPOSE OF THE STUDY Rhizarthrosis, a degenerative condition of the carpometacarpal joint of the thumb, affects mainly women. Surgical treatment is indicated once the non-operative treatment fails. Thumb carpometacarpal joint total arthroplasty constitutes one of the surgical treatment options. This study aims to evaluate the short-term functional and radiological outcomes of Touch® prosthesis with a minimum follow-up period, namely two years after surgery. MATERIAL AND METHODS The study presents the outcomes of a group of 56 endoprostheses implanted in 48 patients. The dual mobility Touch® prosthesis is evaluated. The group consisted of 41 women and 7 men, with the median age of the patients being 62 years. The patients were indicated for surgery after the non-operative treatment had failed. All of them suffered from stage II - IV osteoarthritis according to the Eaton-Littler classification. The range of motion - the opposition was assessed using the Kapandji score. The function and the pain were evaluated with the DASH questionnaire preoperatively and at 3 months, 6 months, 1 year and 2 years postoperatively. RESULTS After 24 months, 91.1% (51 patients) were satisfied with the surgical outcome. Altogether 8.9% of patients (5 patients) experienced postoperative exercise-induced pain, limitation of movement of the CMC joint or hand weakness. No dislocation or endoprosthetic loosening occurred in the evaluated group. Primary wound healing was reported in all patients and no superficial or deep infection was observed. The mean DASH score was 65.3 points preoperatively; at the 2-year follow-up, the mean score decreased to 10.8 points. The pain assessed in question 24 of the DASH questionnaire decreased from the mean value of 4.45 points to 1.2 points. After two years, the range of motion of all patients was X/X according to Kapandji. DISCUSSION There are plenty of surgical techniques to manage rhizarthrosis. All types of surgery have their pros and cons. Most endoprostheses used nowadays show good short-term, mid-term, and some of them even long-term outcomes in terms of survival. The Touch® prosthesis, characterized by dual mobility, is the 3rd generation thumb CMC prosthesis and in our study achives comparable short-term outcomes to those reported by international literature. The use of the dual mobility design appears to be effective in reducing the dislocation rate. CONCLUSIONS The Touch® thumb CMC prosthesis achieves very good short-term functional and radiological outcomes. We can recommend the prosthesis provided the patients are followed-up for more than two years after surgery. Key words: rhizarthrosis, osteoarthritis, endoprosthesis of the carpometacarpal joint, dual mobility, Touch®.


The purpose of this study is to critically analyze
existing literature on behavioral finance and to draw
conclusions and recommendations for future studies in this area.
The study is based on a critical review of the literature of
Islamic and conventional behavioral finance. The findings
reveal that investors are affected by psychological and social
factors toward their financial decision-making process with
respect to investment and choosing a particular financial
product. The paper concludes that Islamic behavioral finance is
a relatively new and efforts are needed to advance work in this
area compared with the more advanced conventional behavioral
finance. Behavioral issues are, however, gaining considerable
attention from a broad spectrum of investors, especially those in
the Muslim world.


Abstract Background: Short-latency afferent inhibition (SAI) results when somatosensory afferent input inhibits the corticospinal output from primary motor cortex (M1). The present study examined SAI in the flexor carpi radialis (FCR) muscle in individuals with spinal cord injury (SCI) and uninjured controls. Methods: Short-latency afferent inhibition (SAI) was evoked by stimulating the median nerve at the elbow at intervals of 15, 20 and 25 ms in advance of a transcranial magnetic stimulation (TMS) pulse over M1. SAI was tested with the FCR at rest and also during ~20% of maximum voluntary contraction. Corticospinal output was assessed through measuring both motor thresholds and motor evoked potential (MEP) recruitment curves. The afferent volley was assessed via the N20-P25 amplitude of the somatosensory evoked potential (SEP) and the amplitude of sensory nerve action potentials (SNAP) recorded over the median nerve at the elbow. Results: SAI is reduced in SCI in both the contracted and non-contracted FCR muscle. MEP recruitment curves and thresholds were decreased in SCI only in the active state and not the resting state. N20-P25 amplitude was similar between groups in both the resting and active states although SNAP was significantly reduced in SCI at rest. Conclusions: We conclude that reduced SAI in SCI is likely attributed to neuroplasticity altering the intrinsic M1 circuitry mediating SAI and/or reduced afferent input traversing a direct thalamocortical route to M1. These data provide a new avenue of research aimed at identifying therapeutic approaches to alter SAI to improve upper limb function in individuals with SCI.


Background : Helicobacter pylori( H. Pylori ) is one of the most common pathogens affecting human kind, infecting more than 50% of the world's population. Invasive and non- invasive methods have been used to diagnose H. pylori infection. The polymerase chain reaction (PCR) has been broadly and successfully used to detect Helicobacter pylori virulence genes in gastric biopsies and stool specimen due to its high sensitivity and specificity. Genotyping using H. pylori genes, the cytotoxin associated gene A (cagA) and voculating cytotoxin gene A (vacA), offers one of the best options. Objective : To determine if genotyping of H. pylori cytotoxin associated gene A (cagA) and voculating cytotoxin gene A (vacA) virulence genes in infected patients as well as healthy individuals can be done from stool specimen. Study selection : A Pubmed/Medline search was carried out using specific key words to retrieve all publications on genotyping of H. pylori cagA and vacA from stool specimen between year 2003 to 2012. Data synthesis :Ten different studies from different locations fulfilled the selection criteria and were included in the study. Results : This review summarises different protocol used to successfully detect H.pylori virulence genes cytotoxin associated gene A (cagA) and voculating cytotoxin gene A (vacA) from faecal specimen by PCR from asymptomatic healthy individuals and infected people with Helicobacter pylori infection. Conclusion : this review highlights the use of stool specimen as an alternative test for genotyping of H. pylori cagA and vacA virulence genes as it is non-invasive and easy to collect.


The early people of Uganda derived their livelihood from natural forests by collecting wild fruits for food, fuelwood for domestic heating and metal working, wood for building and making canoes for fishing and warfare, herbs and other plant parts for medicine, and many other social and cultural uses. Subsequently forestry management developed into economic activities to supply both fuelwood and timber for domestic and industrial uses, for export. Forests were also cleared for establishment of plantation crops such as coffee, sugar cane and tea. Early investigations explored the stocking of rubber trees and l'ines in the natural forests and ecological, studies which culminated in the publication of the book "  Indigenous Trees of Uganda" in 1951. This was followed by the development of silvicultural research  involving underplanting of residual forest after logging; and the development of polycyclic selection  method and a monocyclic shelterwood silvicultural system. Plantation forestry research in Uganda was in itiated to iden tify suitable species for increased aid reliable production of timber and ott1er forest  products. This was mainly because the natural forests were incapable of supplying the quantities and  types of timber demanded by the market. Suitable species and provenances for plantation forestry have been identified including the techniques for raising and managing them. This paper gives information on fo rest management research in Uganda from 1898-1998. It also gives highlights on future research in both natural and plantation forests. Key words : Forest management research. natural. plantation, silviculture


This study investigates the differences in parent-related stress, social support, and school adjustment according to self-esteem of children with disabled and non-disabled parents. The data were collected from 176 students between 4th and 6th grade in Chungbuk area. For a data analysis, mean, frequency, percent, three-way ANOVA, and Pearson `s correlation were used. The results show that children`s perceived parent-related stress, social support, and school adjustment are varied according to their self-esteem. Those with higher self-esteem were found to have higher perception level in social support and school adjustment. On the contrary, they were found to have lower level in parent-related stress. The findings indicate further that girls have a closer relationship with their teachers than boys and that children with disabled parents have a closer relationship with their teachers than those with non-disabled parents. However, as opposed to prediction, parental disability itself caused no difference in the level of parent-related stress.


Variability of energy intake was examined using data for 73 adult males (17-21 yr) for two different levels of training. The subjects were put on hard physical training costing about 1850 kcal/d (phase I: heavy activity) for the first five months and trades' training involving light physical work equivalent to 900 kcal/d (phase II: moderate activity) in the next five months. All the subjects were observed for five consecutive days of their training for dietary intake, weight, and daily activity pattern in the middle of each activity level. A subsample of nine subjects was also surveyed for five consecutive days every second month during the entire training period to get an estimate of week to week variation within subjects. 'Weigh as you eat' method in combination with proximate analysis was used to determine the habitual energy intake of the subjects. Analysis of variance for intake data showed that a substantial part (55 to 60%) of the total variance was contributed by intra-individual variation. Inter subject variation was found to have a cv of 10 per cent in both the levels of activity. Moreover data of the subsample indicated that variation in mean intake from week to week was significantly larger than the daily variance suggesting nonrandomness of daily energy intake.


This is the first scholarly edition of Apocalypse of Baruch and 4 Esdras according to the Peshitta, the Syriac translation of the Hebrew Old Testament from the second century CE, and up to this day the Bible of the Syriac Churches.


The present study proposed a novel projection display system based on a virtual reality enhancement environment. The proposed system displays stereoscopic images of fractures and enhances the computed tomography (CT) images. The diagnosis and treatment of fractures primarily depend on the post-processing of CT images. However, two-dimensional (2D) images do not show overlapping structures in fractures since they are displayed without visual depth and these structures are too small to be simultaneously observed by a group of clinicians. Stereoscopic displays may solve this problem and allow clinicians to obtain more information from CT images. Hardware with which to generate stereoscopic images was designed. This system utilized the conventional equipment found in meeting rooms. The off-axis algorithm was adopted to convert the CT images into stereo image pairs, which were used as the input for a stereo generator. The final stereoscopic images were displayed using a projection system. Several CT fracture images were imported into the system for comparison with traditional 2D CT images. The results showed that the proposed system aids clinicians in group discussions by producing large stereoscopic images. The results demonstrated that the enhanced stereoscopic CT images generated by the system appear clearer and smoother, such that the sizes, displacement and shapes of bone fragments are easier to assess. Certain fractures that were previously not visible on 2D CT images due to vision overlap became vividly evident in the stereo images. The proposed projection display system efficiently, economically and accurately displayed three-dimensional (3D) CT images. The system may help clinicians improve the diagnosis and treatment of fractures.


We investigate the one-triplet dispersion in a modified Shastry-Sutherland model for SrCu2(BO3)2 by means of a series expansion about the limit of strong dimerization. Our perturbative method is based on a continuous unitary transformation that maps the original Hamiltonian to an effective, energy-quanta-conserving block diagonal Hamiltonian eff. The dispersion splits into two branches which are nearly degenerate. We analyse the symmetries of the model and show that space group operations are necessary to explain the degeneracy of the dispersion at k = 0 and at the border of the magnetic Brillouin zone. Moreover, we investigate the behaviour of the dispersion for small |k| and compare our results to inelastic neutron scattering data.


This is the last complete book published during Levi's lifetime to be translated into English and offers one final look into the mind of one of the most compelling and tragic witnesses of the twentieth century. In THE SEARCH FOR ROOTS, Levi has selected the thirty pieces of prose and poetry most important to him. In doing so, he considers how many of our 'roots' come from the books we've read, and reveals a great deal about both his own tastes and his intellectual preoccupations. Levi's many fans will be fascinated by the pieces he has chosen - with authors selected ranging from Homer, Swift and Melville to Darwin, Marco Polo and a scientist on Black Holes.


Based on the investigation data of damaged vegetations in Karst areas of Guizhou Province during the extreme drought in 2010, an investigation was made on the species composition, floristic composition, life form, leaf characteristics, and environmental conditions of drought-damaged plants at six sampling plots. At these plots, there were 31 plant species drought-damaged, among which, Cunninghamia lanceolata, Celastrus orbiculatus, Rapanea neriifolia, Myrsine semiserrata, Cyclobalanopsis glauca, and Cinnamomum glanduliferum damaged most, and the tropical evergreen arbors with mesophyllous, leathery, and simple leaf suffered more seriously. The damaged plants mainly located on the middle or upper part of steep slopes, and on the thin limestone soils originated from horizontal attitude carbonate rocks. The plants in the microhabitats with soil layer < 30 cm and rock-soil were damaged most, accounting for 87.4% and 40.0% of the total, respectively. It was suggested that the temperate deciduous trees with microphyll could be more planted in Karst areas, and that the microhabitat for the afforestation could be in gully and with thicker soil layer and good site condition.


We present some new techniques for shape approximation with fractals, using iterated function system, a powerful method which allows good control on the resulting fractal. The main point discussed here can be stated as follows : given a grey level image A, find a few number of functions and associated probabilities that approximately generate A. Two directions have been explored : the first uses a gradient method, thus it was necessary to define a smooth error function ; the second one is based upon the ideas of simulated annealing. We then generalize the methods to a broader class of functions, and present some results.


An investigation of the tape medium noise mechanism analyzed the magnetization fluctuation produced by an incremental dc erase process in a variety of modern metal-particle tape media. It examined the wavelength characteristics of the noise and compared the integrated noise during the reverse dc erase process with in situ remanent hysteresis curves. The integrated noise power followed the square of the first field derivative of the remanent hysteresis curve, (dM/dH)/sup 2/, showing that spatial fluctuation of the recording field inside the medium is a major source of the tape medium noise. It excluded spatial fluctuation of the medium coercivity as a possible noise source by comparing results from recording heads with two very different gap lengths. A quantitative analysis of the medium noise spectra at different erase currents indicated that interfacial roughness at the magnetic coating backside in some dual-layer media is a major source of medium noise. The conclusion: The main mechanism of the medium noise in advanced tape media is the head medium spacing fluctuation due to surface roughness.


The N-terminal tails of the four core histones are subject to several types of covalent post-translational modifications that have specific roles in regulating chromatin structure and function. Here we present an extensive analysis of the core histone modifications occurring through the cell cycle. Our MS experiments characterized the modification patterns of histones from HeLa cells arrested in phase G1, S, and G2/M. For all core histones, the modifications in the G1 and S phases were largely identical but drastically different during mitosis. Modification changes between S and G2/M phases were quantified using the SILAC (stable isotope labeling by amino acids in cell culture) approach. Most striking was the mitotic phosphorylation on histone H3 and H4, whereas phosphorylation on H2A was constant during the cell cycle. A loss of acetylation was observed on all histones in G2/M-arrested cells. The pattern of cycle-dependent methylation was more complex: during G2/M, H3 Lys27 and Lys36 were decreased, whereas H4 Lys20 was increased. Our results show that mitosis was the period of the cell cycle during which many modifications exhibit dynamic changes.


Introduction. Nosocomial pneumonia (NP) is the second leading frequency and mortality among nosocomial infections. NP is a frequent complication of severe traumatic brain injury (TBI). The difficulty in diagnosis and monitoring of disease NP on the background of TBI is that the usual signs NP "masked" manifestations of the underlying disease. The aim of our study was to improve the diagnosis and assess the effectiveness of the treatment of nosocomial pneumonia with clarithromycin by studying of serum interleukins in patients with nosocomial pneumonia on the background of traumatic brain injury. Materials and methods. We determined levels of TNFα, IL-4, IL-6, IL-8, IL-10.  We examined 45 patients with isolated TBI, 44 patients with NP (standard treatment scheme), 49  patients with NP, each therapy with clarithromycin. The control group was 33 relatively healthy people. Conclusions. The study revealed a significant increase in the concentration of interleukin TNFα, IL-6, IL-8, IL-10 in the serum of patients with NP on the background of TBI compared with patients with isolated TBI and healthy individuals. Our study found significantly lower concentrations of interleukin TNFα, IL-6, IL-8, IL-10 in the serum of patients after treatment with the addition of clarithromycin compared with patients with standard therapy.


In the summer of 1923, the Sunset Camp Service League of Chicago, a philanthropic organization which maintains a camp ordinarily used for the recreation of Jewish working girls, organized a plan to use the camp during September for the care of a group of girls with chronic heart disease. The project was rather experimental in nature, the object being to determine, if possible, the value of such an experience to the patients treated. The camp used is situated on the shore of a small lake sixty miles northwest of Chicago. It covers five acres of dry and wooded ground which is about from fifteen to twenty feet above the lake level. The buildings include the main house, which has a large porch, living room. dining room, kitchen and lavatories on the first floor and dormitories on the second and third floors; also a smaller cottage with additional sleeping quarters. There


Cognitive development is widely considered to be one of the most important aspects of students' learning. It relates to the identification of patterns, relationships, and the use of language. It concerns with the affective development, which is related to the emotions and the psychomotor development the movement and activities that are associated with the mental process. One of the main issues is the challenges teachers face to address these categories in a specific topic. The standardized assessment tests such as Trends in International Math and Science Study TIMSS and the Program for International Student PISA have three main categories: knowledge, application and reasoning. It is interesting, and important to note, that learning has similar categories: knowledge, skills, and understanding. Considerable attention must be paid in aligning the learning domains to the assessment domains in order to raise students' attainment in the standardized assessments. In order to achieve these results, it is important to understand the kind of knowledge being learned, how memory works, how best to teach for creativity, and how people learn. Interdisciplinary Science, Technology, Engineering and Math STEM is a new reform in education which helps to develop students' 21 century skills and creative thinking. A new framework is being proposed, to develop students' skills through teaching them an interdisciplinary STEM curriculum using authentic tasks (problem-based learning) that leads them to higher-order thinking skills. This paper is presenting a critical reflection on cognitive development, teaching creativity, assessment types, and an interdisciplinary STEM approach, and the relationship between them.


Abstract Introduction A Variable Rate Intravenous Insulin Infusion (VRIII) is an infusion of insulin at an interchangeable rate. It involves taking regular capillary blood glucose levels, aiming to control the serum glucose levels with in a specific range and an infusion of glucose containing fluid to prevent insulin induced hypoglycaemia (1). A VRIII is used in patients with known diabetes or with hospital related hyperglycaemia who are unable to take oral fluids/food and for whom adjustment of their own insulin regime is not possible (1). The advantage of a VRIII is the fact is that it involves target driven glucose control for specified indications and avoids metabolic decompensation. Aim To test the compliance of the ward medical staff with VRIII protocol against the local trust policy and the Joint British Diabetes Society guidelines (JBDS). Methodology A retrospective audit on sample of 15 patients at Scarborough General Hospital receiving VRIII on medical and surgical wards. Data was collected over a period of a month. Data collection and analysis performed utilising Microsoft Excel. Audits standards based on trust guidelines and JBDS guidelines. Results Most patients were above age of 60 years, female and type 2 diabetic. 100% of patients had daily electrolytes monitoring, 27% had hypoglycaemia, 13% did not have long-acting insulin started before stopping the VRIII. In 40% of patients, blood glucose levels were not maintained between 6-12 mmol/L. Furthermore, in 13% of patients, blood glucose was not monitored hourly. Conclusion This audit showed a good compliance with daily electrolytes measurement, early referral to diabetic team as well as starting the VRIII with dextrose. It is concerning however that integral measures such as ruling out DKA, not prescribing the correct fluid, not checking blood glucose levels and lowering the incidence of hypoglycaemia were not always present. Overall, this audit has identified areas required for improvement to optimise our compliance with VRIII protocol against local and national guidelines. We hope this can be improved via spreading greater awareness of the VRIII protocol, to promote early recognition of DKA and ensure safety checks occur when applying the VRIII protocol. References George, S., 2022. JBDS-IP The use of Variable Rate Intravenous Insulin Infusion (VRIII) in medical patients. Joint British Diabetes Society. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.


We examine the problem of variance components testing in general mixed effects models using the likelihood ratio test. We account for the presence of nuisance parameters, i.e. the fact that some untested variances might also be equal to zero. Two main issues arise in this context leading to a non regular setting. First, under the null hypothesis the true parameter value lies on the boundary of the parameter space. Moreover, due to the presence of nuisance parameters the exact location of these boundary points is not known, which prevents from using classical asymptotic theory of maximum likelihood estimation. Then, in the specific context of nonlinear mixed-effects models, the Fisher information matrix is singular at the true parameter value. We address these two points by proposing a shrinked parametric bootstrap procedure, which is straightforward to apply even for nonlinear models. We show that the procedure is consistent, solving both the boundary and the singularity issues, and we provide a verifiable criterion for the applicability of our theoretical results. We show through a simulation study that, compared to the asymptotic approach, our procedure has a better small sample performance and is more robust to the presence of nuisance parameters. A real data application is also provided.


Sulfonamide resonant biologically active enaminone derivatives 3, 5, and quinolone derivative 8 have been created. Correspondingly, the thiazoloquinazoline derivative 13 was acquired in decent yield via reaction of 2-isothiocyanate derivative 9 with the L-nor ephedrine 10. The assemblies of the prepared amalgams stood established by microanalysis, IR, 1H-NMR, 13C-NMR and mass spectral information. Furthermore amalgams 3 was proved by X-ray crystallographic analysis. The NQO1 inducer activity of the synthesized compounds was assessed by means of a measurable bioassay in Hepa1c1c7 murine hepatoma cells. The thiazoloquinazoline (13) exhibited remarkable activity. Besides, incorporating the thiazol moiety within a heterocyclic ring system (quinazoline) increases the inducer potency. On the other hand, the enaminone derivatives (3 and 5) and quinoline (8) showed weak activity.


The purpose of this study was to find out the parents' hopes for early childhood education during the COVID-19 pandemic in Gunungsari Subdistrict, by using a descriptive qualitative method. The objects were all parents who have children in early childhood education in Gunungsari Sub-district. Data collection was carried out using questionnaires and documentation. Furthermore, the data was analyzed by using the Miles and Huberman flow model. The results showed that distance/online learning was able to improve the quality of learning, specifically in the field of self-proficiency during COVID-19, because it provides guidance and supervision during the learning process, even though distance/online learning cost more. Many parents hope school learning will resume as usual with the consideration that schools need to implement health protocols by limiting the number of children in class, providing hygiene and health facilities, and collaborating with the closest health center regarding health facilities.


The relationship of the El Nino-Southern Oscillation to the contiguous U.S. snowfall was investigated using data from 3841 cooperative observer stations for the period 1951–1997. Snowfall for seven strong El Nino and five strong La Nina events was compared with snowfall occurring during the other 34 winters. The average snowfall for the seven El Nino winters exhibits a coherent large-scale pattern with below-average snowfall across approximately the northern half of the United States and above-average snowfall over the southwestern United States. Application of the t-test indicates that these snowfall anomalies are significantly different (at the 10% level) from the base period snowfall in parts of the mid-Mississippi River basin, the northern Ohio River basin, the western Great Lakes, and the northwestern United States. During strong La Nina winters, above-normal snowfall occurs in the northwest United States and northern Great Lakes. Although these anomalies do not pass tests of statistical significance (at the 10% level), the difference between La Nina and El Nino years is quite notable in the northwest United States. The results suggest that useful long-range outlooks of snowfall anomalies are possible for certain areas of the contiguous United States during strong El Nino events. An analysis of the frequency of strong cyclones (central pressure <992 hPa) shows that the El Nino winters were characterized by above-normal frequency in the extreme southern United States and below-normal frequency along the U.S.-Canadian border, with the pattern approximately reversed in the La Nina winters.


This article aims to recommend a moral reading of the Namibian Constitution, one based on Dworkin's theory of 'constructive interpretation' and 'law as integrity'. To this end, I argue for the application of Dworkin's theory in interpreting the Namibian Constitution. It is submitted that the attainment of social justice for all Namibians is at the heart of Namibia's constitutional project, hence the constitutional promise of 'securing to all our citizens justice, liberty, equality and fraternity'. This paper addresses two concerns: first, the fact that the Namibian Constitution does not include socio-economic rights- the question is how to respond to this problem. I argue that by applying Dworkin's theory of law as integrity and, because the Constitution includes social justice as a broad principle, it would be consistent to use the Constitution to address socio-economic inequality through 'constructive interpretation'. Secondly, the Supreme Court of Namibia has not done too well in 'hard cases' and its approach is inadequate for the realisation of the transformative aims of the Constitution.


Currently, tank wastes are to be characterized by drilling and physically removing core samples. The cores are analyzed in laboratories in a hot cell environment. The purpose of the cone penetrometer is to bring the interrogative methods to the sample in its native environment, providing faster, safer, and more cost effective tank characterization, both in terms of time and effort. Probes currently exist for the physical characterization of tank wastes in terms of porosity, density, temperature, and electrical conductivity. The main tool for chemical analysis in the in-tank cone penetrometer will be a fiber optic Raman spectroscopy probe, which will be used to collect information about the molecular chemical constituents of the tank wastes. This report addresses the design and implementation of a Raman probe with the in-tank cone penetrometer. The scope of this document includes design specifications and recommendations for the following aspects of the in-tank Raman cone penetrometer probe: cone penetrometer probe interface--an unit for the inclusion of a Raman probe in the in-tank cone penetrometer will be described; window materials--chemically resistant and mechanically stable materials for the cone penetrometer probe interface window will be considered; Raman probes--Raman probes for inclusion in the penetrometer will be discussed.


Serotonin (5-hydroxytrytamine (5-HT)) plays an important role in experimental seizures. Recently, we reported the depletion of 5-HT by parachlorophynylalanine (PCPA) in whole brain to enhance 6-Hz psychomotor seizures in mice. In the present work, we investigated the effect of 5-HT depletion in cortex and hippocampus, brain regions relevant for epilepsy, on behavioral and ultra-structural changes following 6-Hz psychomotor seizures in mice. In addition, we studied the effect of sodium valproate (SVP) on behavioral, biochemical, and ultra-structural effects induced by 6 Hz. Behavioral changes induced by 6 Hz stimulation were characterized as the increased duration of Straub's tail, stun position, twitching of vibrissae, forelimb clonus, and increased rearing and grooming. PCPA administration further enhanced while SVP reduced these behaviors in mice. The 6-Hz psychomotor seizure induced ultra-structural changes in both cortex and hippocampus in mice treated with PCPA. Furthermore, PCPA administrations followed by 6Hz-induced seizures were accompanied by reduced hippocampal and cortical 5-HT. SVP attenuated the PCPA-induced ultra-structural changes and alterations of 5-HT content in the mouse brain. The study suggests the involvement of 5-HT in the 6 Hz psychomotor seizures and in the mechanisms of action of SVP against such seizures in mice.


Background Detection of frailty may be essential to prevent or delay disability in home-dwelling elderly who seek formal assistance for the first time. The prevalence of frailty among elderly, first-time seekers of formal assistance in Norway, is unknown. Simple tests like Short Physical Performance Battery (SPPB) or assessment of gait speed (GS) may identify frailty. The aim of this study was to investigate the prevalence of frailty in this population, and to investigate the test accuracy of GS and SPPB to detect frailty.Methods We conducted a cross-sectional study of 116 home dwelling elderly > 65 years seeking formal assistance for the first time. Frailty was assessed by an adapted version of Fried Frailty Phenotype (FFP), GS was measured over 4 meters, and physical function was assessed by the Norwegian version of SPPB. The test accuracy for frailty (FFP) of GS < 0.8 m/s, SPPB < 10 and SPPB < 10 were assessed.Results 62.1%, 29.3% and 8.6% of the participants were frail, prefrail and non-frail, respectively. No association was found between age and degree of frailty. Both GS and SPPB-scores were significantly lower in the frail group than in the prefrail group, as well as significantly lower in the prefrail group than in the non-frail group (both p < 0.001). Numbers of criteria in FFP were significantly and inversely associated with GS (p < 0.001). GS ≤ 0.8 m/s showed the best test accuracy for frailty, with a sensitivity of 0.99, specificity of 0.37, positive predictive value of 0.76 and negative predictive value of 0.93.Conclusions The present study assessed that over 90% of elderly seeking formal assistance for the first time were either frail or prefrail. This indicates that screening for frailty should be considered for this population in order to enable action to prevent or delay disability. Further, our results indicate that GS with a cut-off at ≤ 0.8 m/s may represent a feasible and easy-to-use screening tool for detecting frailty in this population.


We introduce an algebraic version of the translation algebr a of a group. We prove that a quasi-isometry of two finitely generated groups induc es Morita equivalence of their algebraic translation algebras.


ABSTRACT:Brazil opted for decentralization in the provision of health services at the time of the 1988 Constitution´s promulgation. The municipalities became entirely responsible for primary healthcare provision, sharing financing responsibilities with the central government. The aim of this paper is to evaluate the impact of health spending autonomy on infant mortality rates, using Brazilian local data from 2000 to 2007. As a measure of spending autonomy we used the share (%) of overall health expenditures financed by municipalities' own resources. The larger the share of health expenditures which is not financed by the central government (grants), the greater the autonomy, because local governments can decide how and on what to spend these resources, and most of intergovernmental transfers to the health sector are allocated to predefined specific purposes. The fixed effects estimates, through the use of an instrumental variables approach, show that, on average, greater spending autonomy is not associated with lower infant mortality rates. However, given that local governments and populations are different in many aspects, it is reasonable to expect a heterogeneous response to decentralization. Galiani et al. (2008), for instance, assess the hypothesis that decentralization of high schools in Argentina may have increased the difference in educational outcomes. Could the same have happened to the quality of health in Brazilian municipalities? In well-managed municipalities and in which individuals participate actively and can support their preferences, fiscal autonomy ought to improve the delivery of public services. Using a measure of efficiency in the delivery of health services to split the municipalities in two groups, we got significant results for the more efficient municipalities, implying an increase in inequality. This measure corresponds to efficiency scores estimated using data envelopment analysis (DEA). We also test for heterogeneous impacts of the Family Health Program (PSF), the most important Brazilian basic health care policy, which main expansion occurred until 2007. It is a federal Program that each municipality runs independently. Again, we find evidence of a heterogeneous response, since PSF only reduces infant mortality rates in efficient municipalities. We then confirm Galiani's (2008) hypothesis that decentralization may help only the best to do even better.


Qualitative differences in faecal alpha-1-antitrypsin in patients with Crohn's disease SIR,-The use of faecal alpha-1-antitrypsin (A-1-AT) in the assessment of Crohn's disease (CD) activity remains controversial. In a recent study Fischbach et al found no correlation of faecal A-1-AT with ESR, serum albumin, orosomucoid, activity index of Van Hees, or CDAI.' Conversely, faecal A-1-AT was well correlated with a clinical score, serum orosomucoid, and C-reactive protein in another work by Meyers et al.2 We think that biochemical changes of A-1-AT in the intestine, resulting in an apparent decrease of its faecal concentration, when measured by standard radial immunodiffusion, could explain these discrepancies. We have compared3 the biochemical characteristics of faecal A-1-AT in 14 CD (five men, nine women, mean age 28 years) and in 10 healthy controls (six men, four women, mean age 30 years). The CD location was the ileum in five of 14, the ileum and colon in seven of 14, and the colon in two of 14; the mean duration of disease was 4-8 years (0-2-20). According to CDAI, the disease was active in II of 14 patients and inactive in three of 14. Twenty four hour stools were collected for three days and homogenised. After preparation, sodium dodecylsulphate polyacrylamide gel electrophoresis and immunoblot were applied to analysis of faecal A-i-AT. Two main A-1-AT biochemical forms of respectively 38 000 molecular weight and 51000 mol wt were characterised. Faecal extracts from controls contained only the 38000 mol wt A-1-AT component. Both 38 000 and 51 000 mol wt A-1-AT were found in faeces of patients with CD. Fifty-one thousand mol wt A-1-AT was only recovered in patients with active CD (eight of 11), while 38000 mol wt alpha-I-AT was present in three of 11 patients with active CD and three of three with inactive CD. No relationship was established between the form of faecal A-I-AT and sex or age of the patients as well as duration of CD or its location. Thus different forms of A-1-AT exist in the faeces of patients with CD. This could account for the controversial performances of faecal A-1-AT as a marker of CD activity: when measured by standard radioimmunodiffusion in some faecal samples, concentration of 38000 mol wt A-1-AT was underestimated by almost 20% as compared with native 54 000 mol wt A-1-AT. Further isolation of different A-1AT in faeces (especially 51000 mol wt form) might lead to determination of their relative immunoreactivity. Reassessment of faecal A-1-AT as activity index in CD could then be initiated.


Some fibroangiogenic factors have recently been shown to play potential roles in fibrovascular diseases. The aim of this study was to examine whether there is any relationship between growth factors and pterygium genesis. Twenty-three primary pterygia and 4 normal conjunctiva specimens were analyzed by indirect immunohistochemistry using specific antibodies against basic fibroblast growth factor (b-FGF), platelet derived growth factor (PDGF), transforming growth factor-beta (TGF-beta) and tumor necrosis factor-alpha (TNF-alpha). Positive immunostaining of these growth factors was located in the epithelial cells, endothelial cells of vessels, basement membranes of vessels and epithelium, fibroblasts and infiltrating inflammatory cells in the pterygium. In the normal conjunctiva, positive immunolabeling for TGF-beta and PDGF was much weaker than in the pterygium. We conclude that growth factors may interact directly or indirectly in the pathogenesis of pterygium although proof of this awaits further studies.


Heat shock protein (HSP) 105 is overexpressed in various cancers, but is expressed at low levels in many normal tissues, except for the testis. A vaccination with HSP105‐pulsed bone marrow‐derived dendritic cells (BM‐DC) induced antitumor immunity without causing an autoimmune reaction in a mouse model. Because ApcMin/+ mice develop multiple adenomas throughout the intestinal tract by 4 months of age, the mice provide a clinically relevant model of human intestinal tumor. In the present study, we investigated the efficacy of the HSP105‐pulsed BM‐DC vaccine on tumor regression in the ApcMin/+ mouse. Western blot and immunohistochemical analyses revealed that the tumors of the ApcMin/+ mice endogenously overexpressed HSP105. Immunization of the ApcMin/+ mice with a HSP105‐pulsed BM‐DC vaccine at 6, 8, and 10 weeks of age significantly reduced the number of small‐intestinal polyps accompanied by infiltration of both CD4+ and CD8+ T cells in the tumors. Cell depletion experiments proved that both CD4+ and CD8+ T cells play a critical role in the activation of antitumor immunity induced by these vaccinations. These findings indicate that the HSP105‐pulsed BM‐DC vaccine can provide potent immunotherapy for tumors that appear spontaneously as a result of the inactivation of a tumor suppressor gene, such as in the ApcMin/+ mouse model. (Cancer Sci 2007; 98: 1930–1935)


The role of unsaturated fatty acids in membrane lipids in the tolerance of the photosynthetic machinery to salt stress was studied by comparing the desA-/desD- mutant of Synechocystis sp. PCC 6803, which contained monounsaturated fatty acids, with the wild-type strain, which contained a full complement of polyunsaturated fatty acids. In darkness, the loss of oxygen-evolving photosystem II activity in the presence of 0.5 M NaCl or 0.5 M LiCl was much more rapid in desA-/desD- cells than in wild-type cells. Oxygen-evolving activity that had been lost during incubation with 0.5 M NaCl in darkness returned when cells were transferred to conditions that allowed photosynthesis or respiration. Recovery was much greater in wild-type than in desA-/desD- cells, and it was prevented by lincomycin. Thus, the unsaturation of fatty acids is important in the tolerance of the photosynthetic machinery to salt stress. It appears also that the activity and synthesis of the Na+/H+ antiporter system might be suppressed under high-salt conditions and that this effect can be reversed, in part, by the unsaturation of fatty acids in membrane lipids.


For dealing with traffic bottlenecks at airports, aircraft object detection is insufficient. Every airport generally has a variety of planes with various physical and technological requirements as well as diverse service requirements. Detecting the presence of new planes will not address all traffic congestion issues. Identifying the type of airplane, on the other hand, will entirely fix the problem because it will offer important information about the plane's technical specifications (i.e., the time it needs to be served and its appropriate place in the airport). Several studies have provided various contributions to address airport traffic jams; however, their ultimate goal was to determine the existence of airplane objects. This paper provides a practical approach to identify the type of airplane in airports depending on the results provided by the airplane detection process using mask region convolution neural network. The key feature employed to identify the type of airplane is the surface area calculated based on the results of airplane detection. The surface area is used to assess the estimated cabin length which is considered as an additional key feature for identifying the airplane type. The length of any detected plane may be calculated by measuring the distance between the detected plane's two furthest points. The suggested approach's performance is assessed using average accuracies and a confusion matrix. The findings show that this method is dependable. This method will greatly aid in the management of airport traffic congestion.


Pericytes, the mural cells surrounding microcirculation, are gaining increasing attention for their roles in health and disease of the central nervous system (CNS). As an essential part of the neurovascular unit (NVU), pericytes are actively engaged in interactions with neighboring cells and work in synergy with them to maintain homeostasis of the CNS, such as maintaining the blood–brain barrier (BBB), regulating cerebral blood flow (CBF) and the glymphatic system as well as mediating immune responses. However, the dysfunction of pericytes may contribute to the progression of various pathologies. In this review, we discuss: (1) origin of pericytes and different pericyte markers; (2) interactions of pericytes with endothelial cells (ECs), astrocytes, microglia, oligodendrocytes, and neurons; (3) physiological roles of pericytes in the CNS; (4) effects of pericytes in different CNS diseases; (5) relationship of pericytes with extracellular vesicles (EVs) and microRNAs (miRs); (6) recent advances in pericytes studies and future perspective.


Tutorials on this page include: How to determine if a journal is peer reviewed; How to search multiple EBSCO databases.


Author(s): Pillai, Minerva Vasudevan | Advisor(s): Kazerooni, Homayoon | Abstract: Lower Extremity Exoskeleton technology has been geared towards benefiting medical and augmentation fields. Functional modularity in exoskeleton design allows practitioners to prescribe exoskeletons which can be geared towards the user's needs and abilities. While most modular knee exoskeleton technology either live in the realm of medicine or augmentation, a stance assistive knee exoskeleton can benefit both able bodied individuals as well as individuals with decreased quadriceps function or knee weakness. Fully passive systems are lower cost but have limited functionality. Powered systems have diverse functionality but are expensive and large. Microcontroller controlled resistive knees are more functionally diverse than fully passive system, but only provide system resistance to motion and can be expensive. Passive microcontroller controlled systems can lead to a low cost and functionally versatile system. By embedding some of the required functionality into the mechanical hardware of the system, the burden on the microcontrollers and need for sensors is reduced. To determine the required functionality the characteristic behavior of the knee during level walking and stair descent were studied. Characteristics for a stance assistive knee joint exoskeleton are derived using biomechanics data. These characteristics are1) The joint provides resistance to flexion during stance2) The joint does not impede extension during stance3) The joint can enter free mode under load at any knee angle4) The joint has very low impedance / is free while extending and flexing during swingA dual jointed architecture with a clutch connected across one joint and a torque generator connected across the other is developed to mechanically achieve requirements 1 and 4. By requiring the clutch or torque generator to provide resistance in one direction but no impedance in the other, characteristic 2 is achieved. By controlling the locking and unlocking of the clutch, characteristic 3 is achieved. The torque generator and clutch requirements can be fulfilled by several passive mechanical components. Several passive mechanical components were analyzed. It was determined that using a wrap spring clutch as the clutch and using a gas spring as the torque generator provides the required characteristics. This combination requires only a small actuator to lock and unlock the clutch. This combination also allows the restoration of energy during extension after it is stored during the resistance phases. This hardware combination results in a stance assistance knee exoskeleton which is relatively small, light and can further help reduce the metabolic cost associated with wearing an exoskeleton. A simplified controller was implemented to gauge system performance. Additional applications for the hardware architecture are proposed. These applications include use of the knee exoskeleton with a modular hip. The hardware is not limited to use as a knee exoskeleton. It can be used to reduce the erector spinae muscles forces in the back, if it is installed at the user's hip. Experiments are proposed to evaluate the effect of the device on the biological joint torque and user's metabolic cost.


Do crackdowns on bribery impact corrupt behavior in the long run? In this paper we observe the long-run impact of a short-term punishment institution (i.e., a crackdown) on bribery behavior in a lab setting. We conduct lab experiments in two countries with cultures that differ in corruption norms, and which experience very different levels of bribery: the US and Pakistan. Bribery is implemented in the laboratory as a repeated three-player sequential game, consisting of a firm, a government official and a citizen. The design contains three phases: pre-crackdown, crackdown, and post-crackdown. Results show that post-crackdown behavior is not significantly different from pre-crackdown behavior in either country. We conclude that short-term crackdowns may impact behavior in the short run, depending on the strength of the existing corruption norms in the country. More importantly, in our setting crackdowns are completely ineffective in the long run, as corrupt behavior rebounds to pre-crackdown levels.


Abstract Objectives To explore older care home residents' experiences of maintaining a sense of purpose in life: a core component of psychological wellbeing. Methods Fifteen residents (9 female; 6 male), aged 60-95 years, from four care homes, were interviewed about their sense of purpose. Interview transcripts were analysed using inductive thematic analysis. Results Theme 1 ('Experiencing Loss') comprises two sub-themes that describe the impact of age-related losses on residents' sense of purpose (sub-theme 1) and the different responses that participants had to these losses (sub-theme 2). Theme 2 ('The Protective Effects of Social Connections') describes how social relationships could provide a sense of purpose, as well as the difficulties participants experienced in forming these relationships. Finally, theme 3 ('The Roles of Activities') describes the types of activities that could help residents to maintain a sense of purpose. Conclusion Care home residents experience losses and barriers that make it more difficult to maintain a sense of purpose. However, with appropriate support and opportunities, residents are able to engage in activities and relationships that provide a sense of purpose. To support residents' mental health and wellbeing, care homes should offer varied opportunities for residents to engage in purposeful activities.


Based on the surveillance data from the contract laboratories of Taiwan Centers for Disease Control, several large outbreaks of enterovirus infection associated with Coxsackievirus A6 (CA6) took place in the years 2009, 2010 and 2013 in Taiwan. In addition, a small CA6 outbreak was also observed, which began by the end of 2014 and continued in 2015. We detected a mutant strain of CA6, which started circulating in Taiwan in 2010. Patients' symptoms associated with this mutant strain were different, predominately hand, foot, and mouth disease (HFMD) with large vesicles, onychomadesis, and desquamation but not herpangina. Although CA6 is not highly prevalent currently, the epidemic occurred a few times in the past several years. Continued monitoring of CA6, especially the mutant strain, is needed to reduce the impact of CA6 epidemic.


This is an evaluative study of the rights in land and forest resources of the Orang Asli communities who are indigenous and minority peoples of Peninsular Malaysia. It argues that justice, fairness, equality and non-discrimination are the basic principles to be used in generating relevant policies and laws and in their interpretation.
It uses mixed methodologies with a law reform oriented approach. Interviews were conducted to understand the law and practices around it, and the perspectives of the relevant actors.
An examination of the communities' custom and related resource rights reveals significant economic and cultural connections with their environment. Although these have some recognition in Malaysian law, there is a significant gap between the law and the practice. Their recognition in common law has strengthened but is yet to have a significant impact on practice. Conflicts over interpretation adversely affect the exercise of existing rights.
Using comparative law methodology, the study considers measures addressing these rights in international law and in selected jurisdictions. The analysis is structured around the framework established: the recognition of rights to natural resources, restorative measures, and procedural and environmental justice.
Autopoietic theory and its concept of legal irritants are used to analyse the potential development of these rights. The exchange of information between common law and international law has contributed to positive changes in Malaysian law and policy. However, resistance to the common law itself and international human rights law may limit their further development or exercise. Factors in the political, economic and social systems are also hostile to their greater recognition. This perpetuates injustice to the Orang Asli.
The thesis suggests that a rights based approach, focused on the basic principles above, be taken in reforming the law. This will be significant not only to the wellbeing of the Orang Asli but the whole society.


We study linear programming and general LP-type problems in several big data (streaming and distributed) models. We mainly focus on low dimensional problems in which the number of constraints is much larger than the number of variables. Low dimensional LP-type problems appear frequently in various machine learning tasks such as robust regression, support vector machines, and core vector machines. As supporting large-scale machine learning queries in database systems has become an important direction for database research, obtaining efficient algorithms for low dimensional LP-type problems on massive datasets is of great value. In this paper we give both upper and lower bounds for LP-type problems in distributed and streaming models. Our bounds are almost tight when the dimensionality of the problem is a fixed constant.


Transmission electron microscopy (TEM) is a scientific research standard for producing nanometer-resolution ultrastructural images of subcellular components within cells and tissues. Mitochondria, endoplasmic reticulum (ER), lysosomes, and autophagosomes are organelles of particular interest to those investigating metabolic disorders. However, there is no clear consensus amongst regarding the best methods for quantifying the features of organelles in TEM images. In this protocol, we propose a standardized approach to accurately measure the morphology of these important subcellular structures using the free program ImageJ, developed by the National Institutes of Health (NIH). Specifically, we detail procedures for obtaining mitochondrial length, width, area, and circularity, in addition to assessing cristae morphology. We further provide methods for measuring interactions between the mitochondria and ER and measuring the length and width of lysosomes and autophagosomes. This standardized method can be used to quantify key features of organelle morphology, allowing investigators to produce accurate and reproducible measurements of organelle structures in their experimental samples. SUMMARY We discuss a standardized method for measuring and quantifying organelle features using transmission electron microscopy and accessing for interactions between subcellular structures; organelles of focus include mitochondria, endoplasmic reticulum, lysosomes, and autophagosomes.


Epitaxial c -axis-orientated HgBa2 CaCu2 O6 (Hg-1212) superconducting thin films with their dimensions as large as ½ inch × ½ inch have been recently achieved using a cation-exchange process. Uniformity of the film was studied by slicing samples into eight pieces, on which uniform zero-resistance Tc values above 120 K were observed. In self-field, Jc values of the film range from 14.6 × 106 to 23.7 × 106 A cm-2 at 5 K, 1.77 × 106 to 3.85 × 106 A cm-2 at 77 K and 0.54 × 106 to 1.38 × 106 A cm-2 at 100 K. The scattering of Jc is found to be within 44% across the film and could be smaller with improvement of processing.


This article introduces transition management as a new governance approach for sustainable development. Sustainable development is used here as a common notion referring to those persistent problems in (Western industrialized) societies that can only be dealt with on the very long term (decades or more) through specific types of network and decision-making processes. Based on interdisciplinary research into complex processes of long term, structural change in society, basic tenets for complexity-based governance are formulated. These tenets are translated into a framework that distinguishes between four different types of governance activities and their respective roles in societal transitions. This framework can be used for implementation of governance strategies and instruments. The approach and framework have been developed deductively and inductively in the Netherlands since 2000. This article presents the theoretical basis of transition management and will be illustrated by examples from transition management practice, especially the Dutch national energy transition program.


Although drug combination has proved to be an efficient strategy for clinic gastric cancer therapy, how to further improve their bioavailability and reduce the side effects are still challenges due to the low solubility and untargeted ability of drugs. Recently, newly emerging nanotechnology has provided an alternative for constructing new drug delivery systems with high targeting ability and solubility. In this study, a pH-responsive liposome (Liposome-PEO, LP) loaded with apatinib (AP) and cinobufagin (CS-1) was used for combinational therapy against gastric cancer after coating with a hybrid membrane (R/C). The results indicated that the constructed nanocomplex LP-R/C@AC not only efficiently killed tumor cells in vitro by inducing apoptosis, autophagy, and pyroptosis, but also significantly inhibited tumor invasion and metastasis via the VEGFR2/STAT3 pathway. Moreover, it showed stronger anti-tumor activity in gastric cancer-bearing mouse models, as compared to the sole drugs. A naturally-derived hybrid cell membrane coating bestowed nanocomplexes with enhanced biointerfacing including prolonged circulation time and targeting ability.


This paper reported five kinds of Denmark II lyophilized vaccines produced by 5 different biological production institutes. Through the double blind randomized trial in newborns after 1 year observation, the results demonstrated that all vaccines possessed the stability of heat tolerance and the 12 week tuberculin conversion rates of all group exceeded to 95%, and 1-year positive maintenance rates were in the range of 88.3%-96.1%, and the average diameter of induration was relatively large; the local reaction belonged to normal range; the swollen-lymph node rate was not high; the immune effect was satisfactory.


The authors propose two symmetrically multi-connected optical WAN (wide area network) network architectures which do not require a technology breakthrough but can achieve a high throughput with flexible routing schemes and demonstrate possibility for modular growth. The study has been done with respect to conventional ShuffleNet under the assumption of a uniform traffic pattern. These architectures require the same type of network interface unit as required by the Perfect Shuffle Networks while achieving a better performance for WAN in terms of average number of weighted hops, aggregate throughput, and alternative routing schemes because the local traffic can be distinguished from the remote traffic in these networks.<<ETX>>


Sometimes duplications of the digestive tract are diagnosed not before adulthood. Single cases of malignant tumours in combination with duplications have been described previously. The poor incidence of this entity is documented by less than 20 reports in the last 107 years. There are so far no reports concerning the development of carcinomas within tubulous duplications of the oesophagus. The case of an adult patient having oesophageal duplication with an adenocarcinoma is reported.


The paper deals with two aspects: the public ownership of intellectual property rights and the holding of the title (individuals vs institutions) for the public financed research. A key problem in the past and still now in Europe has been the low transfer of results coming from public research to industrial users. Recently a new trend developed which favours the patenting of the scientific results of public actors. This change partly comes from the modification of the public funding mechanism of allocation and goes with changes in the regulation and regime related to the ownership of intellectual property rights. The paper is built on a pilot study, which controlled if and how the modification in national regulation affected the actors' behaviour. It is based on a survey of public inventors, in two public institutions (Cnr and Roma 1 University) who disclosed their inventions to the institutions in the last three years; on interviews with the responsible persons of the patent offices in the two institutions and on some data from the Cnr 2005 patent portfolio. This pilot study on public patenting in Italy seems to confirm the persistence of the academic incentives in the patenting activities of the public research institutions, even in presence of the 2001 patenting regime, aimed to assign IPR title to the public inventors. Furthermore the results highlight the presence of a relation between public institutions and firms that are not completely captured by the patenting indicators. Patents are only the emerging part of a more large hidden area of relationships between public institutions and industrial firms.


A consistent set of unit cell parameters at various temperatures is not yet available for ordinary ice, but the mean of the most precise measurements leads to a density of 0·9164 g/cm3 at 0°C (atmospheric pressure) with a cubical expansion coefficient of 11 x 10-5, increasing to 0·9414 and 21 x 10-5 at liquid air temperatures. Corresponding figures for heavy ice are 1·0172 g/cm3 and 12 x 10-5 at 0°C, 1·0449 and 18 x 10-5 at -180°C. The hydrogen-bond lengths are not significantly different for ordinary and heavy ice, but in both cases the mirror-symmetric bond (along the principal axis) is about 0·01 Å shorter than the centro-symmetric bond at 0°C. At low temperatures the bond lengths tend to equalize at a value some 1% lower than at 0°C. The hexagonal (tridymite-type) and cubic (cristobalite-type) forms of ice have approximately the same density and hydrogen-bond lengths at —130°C, and both appear to have a statistical randomness of the water-molecule orientation, consistent with there being one hydrogen only (nearly or exactly) along each bond. The thermal vibrations of the hydrogen atoms in hexagonal ice are anisotropic, those of the oxygen atoms nearly spherical. The ranges of stability of hexagonal, cubic and amorphous ice are not exactly known, but cubic ice is only formed at low rates of deposition, low pressures and at temperatures of about -80 to -140°C.


This paper proposes an efficient and computationally fast solution algorithm for distribution system restoration based on a mathematical programming approach. The computation time is improved greatly by dividing the problem into two stages and incorporating restoration strategies, which are derived from an operator's knowledge and experience. It is shown from simulation results that this method is able to obtain an optimal target configuration in all cases. In addition, the computation time has been reduced to within 30% of our previous method.


There is an increasing trend toward student-centred interactive e-learning methods and students' feedback is a valuable tool for improving learning methods. The aim of this study was to explore the attitude of second year pharmacy students at the University of Babylon, Iraq, towards lectures, exams and e-learning. Materials and methods: Ninety pharmacy students were surveyed by paper questionnaire about their preference for lecture format, use of e-files, theoretical lectures versus practical experiments, lecture and lab time. Students were also asked about their predilection for Moodle-based online exams, different types of exam questions, exam time and other extra academic activities. Results: Students prefer to read lectures on paper (73.3%), use of PowerPoint file (76.7%), short lectures of less than 10 pages (94.5%), practical experiments (66.7%), lectures and lab time of less than two hours (89.9% and 96.6 respectively) and intra-lecture discussions (68.9%). Students also like to have paper-based exam (73.3%), short essay (40%) or MCQ (34.4%) questions and also prefer to do extra activities like reports (22.2%), seminars (18.6%) and posters (10.8%). Conclusion: Second year pharmacy students have different attitudes toward traditional and electronic leaning and assessment methods. Using multimedia, elearning and Moodle are increasingly preferred methods among some students. Keywords—Pharmacy, students, lecture, exam, e-learning, Moodle.


With the rapid development of eXplainable Artificial Intelligence (XAI), a long line of past work has shown concerns about the Out-of-Distribution (OOD) problem in perturbation-based post-hoc XAI models and explanations are socially misaligned. We explore the limitations of post-hoc explanation methods that use approximators to mimic the behavior of black-box models. Then we propose eXplanation-based Counterfactual Retraining (XCR), which extracts feature importance fastly. XCR applies the explanations generated by the XAI model as counterfactual input to retrain the black-box model to address OOD and social misalignment problems. Evaluation of popular image datasets shows that XCR can improve model performance when only retaining 12.5% of the most crucial features without changing the black-box model structure. Furthermore, the evaluation of the benchmark of corruption datasets shows that the XCR is very helpful for improving model robustness and positively impacts the calibration of OOD problems. Even though not calibrated in the validation set like some OOD calibration methods, the corrupted data metric outperforms existing methods. Our method also beats current OOD calibration methods on the OOD calibration metric if calibration on the validation set is applied.


and Implications Ten sets of five littermate pigs with a high genetic capacity for lean tissue growth (350 to 370 g/day) and reared via a segregated-early-weaning scheme were used to determine the dietary thiamin needs of pigs exhibiting a high rate of lean tissue growth. Within each litter, pigs were randomly allotted to one of five dietary thiamin concentrations equivalent to 200, 330, 460, 590, and 720% of the current NRC (1988) estimated requirement for 11 to 22 pound pigs. Pigs were penned individually and given ad libitum access to experimental diets and water from 22 to 88 pounds body weight (BW). Pooled across diets, the pigs' body weight gains and feed:gain ratios averaged 1.70 pounds per day and 1.44 pounds, respectively, from 22 to 88 pounds body weight. Dietary thiamin concentration did not alter daily feed intake, rate of body weight gain, or feed:gain ratios. Based on these data, dietary thiamin in a corn-soy-based diet (2.2 ppm) is adequate for optimal rate and efficiency of gain in high lean growth pigs from 22 to 88 pounds body weight.


We examined the hypothesis that rat fatty acid translocase (rFAT) mediates the cellular uptake of T(3) and other iodothyronines. Uninjected Xenopus laevis oocytes and oocytes injected 4 d previously with rFAT cRNA were incubated for 60 min at 25 C in medium containing 0.01-10 micro M [(125)I]T(3) and 0.1% BSA, or 1-100 micro M [(3)H]oleic acid and 0.5% BSA. Injection of rFAT cRNA resulted in a 1.9-fold increase in uptake of T(3) (10 nM) and a 1.4-fold increase in uptake of oleic acid (100 micro M). Total T(3) uptake was lower in the presence than in the absence of BSA, but relative to the free T(3) concentration, uptake was increased by BSA. The fold induction of T(3) uptake by rFAT was not influenced by BSA. By analyzing uptake as a function of the ligand concentration, we estimated a K(m) value of 3.6 micro M for (total) T(3) and 56 micro M for (total) oleic acid. In addition to T(3), rFAT mediates the uptake of T(4), rT(3), 3,3'-diiodothyronine, and T(3) sulfate. The injection of human type III deiodinase cRNA with or without rFAT cRNA resulted in the complete deiodination of T(3) taken up by the oocytes, indicating that T(3) is indeed transported to the cytoplasm. In conclusion, our results demonstrate transport of T(3) and other iodothyronines by rFAT.


Purpose To evaluate cellular activity in milled versus unmilled surface of the femoral head in 21 patients who underwent robot-assisted total hip arthroplasty (THA). Methods The femoral head of 21 consecutive patients who underwent robot-assisted THA for osteonecrosis was used. 10 cc of trabecular bone from the entire milled surface was obtained using a curette. The same amount of trabecular bone was obtained at least 1 cm away from the milled surface and served as a matched control. Cell morphology, viability, osteocalcin activity, and alkaline phosphatase activity in milled versus unmilled surface were assessed. Results Cell morphology of the milled or unmilled surface was comparable; cells were smaller in the milled surface. Cell viability was a mean of 40% higher in the milled surface (107.4% vs. 67.2%, p<0.001); cell viability at 5 time points was comparable in each group. Osteocalcin activity of cells was slightly higher in the milled surface (1.43 vs. 1.24 ng/ml, p=0.69). Alkaline phosphatase activity of cells was slightly higher in the unmilled surface (150 105 vs. 141 789 U/L, p=0.078). Conclusion The milled and unmilled surfaces of the femoral head were comparable in terms of cell morphology, viability, osteocalcin activity, and alkaline phosphatase activity.


The actions and interactions of independently acting agents in a multi-agent system must be managed if the agents are to function effectively in their shared environment. Norms, which define the obligatory, prohibited and permitted actions for an agent to perform, have been suggested as a possible method for regulating the actions of agents. Norms are local rules designed to govern the actions of individual agents whilst also allowing the agents to achieve a coherent global behaviour. However, there appear to be very few instances of norm-governed multi-agent systems beyond theoretical examples. We describe an implementation strategy for allowing autonomous agents to take a set of norms into account when determining their actions. These norms are implemented using directives, which are local rules specifying actions for an agent to perform depending on its current state. Agents using directives are implemented in a simulation test bed, called Sinatra. Using Sinatra, we investigate the ability of directives to manage agent actions. We begin with directives to manage agent interactions. We find that when agents rely on only local rules they will encounter situations where the local rules are unable to achieve the desired global behaviour. We show how a centralised control mechanism can be used to manage agent interactions that are not successfully handled by directives. Controllers, with a global view of the interaction, instruct the individual agents how to act. We also investigate the use of an existing planning tool to implement the resolution mechanism of a controller. We investigate the ability of directives to coordinate the actions of agents in order to achieve a global objective more effectively. Finally, we present a case study of how directives can be used to determine the actions of autonomous mobile robots.


Anti-swing control is a well-known term in gantry crane control. It is designed to move the payload of gantry crane as fast as possible while the payload swing angle should be kept as small as possible at the final position. A number of studies have proposed anti-swing control using the well-known proportional, integral, derivative (PID) control method. However, PID controllers cannot always effectively control systems with changing parameters. Some studies have also proposed intelligent-based control including fuzzy control. However, the designers often have to face the problem of tuning many parameters during the design to obtain optimum performance. Thus, a lot of effort has to be taken in the design stage. In this paper Fuzzy-tuned PID controller design for anti-swing gantry crane control is presented. The objective is to design a practical anti-swing control which is simple in the design and also robust. The proposed Fuzzy-tuned PID utilizes fuzzy system as PID gain tuners to achieve robust performance to parameters' variations in the gantry crane. A complex dynamic analysis of the system is not needed. PID controller is firstly optimized in MATLAB using a rough model dynamic of the system which is identified by conducting a simple open-loop experiment. Then, the PID gains are used to guide the range of the fuzzy outputs of the Fuzzy-tuned PID controllers. The experimental results show that the proposed anti-swing controller has satisfactory performance. In addition, the proposed method is straightforward in the design.


Based on the quark-gluon contents of nucleon and strongly believing that the force mediators, Pomeron and its counterpart in the conventional approach of Regge theory, for high energy diffractive process would be the tensor glueball and Odderon respectively, we discuss photo-production of vector meson ϕ off the deuteron at energy less than 3 GeV in the QCD inspired model in which the quark gluon degrees of freedom and glueball, Odderon exchange are taken into account. A calculation is performed for γ + D → ϕ + D, and the theoretical predictions of the differential cross section dσγD /dt, are presented and compared with available experimental data. Our QCD inspired model reproduces data quite well in the whole range of the experimental measurements up to |t| ≅ 0.4 GeV. Our results can be used to extract γn → ϕn data, which cannot be measured in experiment.


Intestinal myofibroblasts are alpha-smooth muscle actin-positive stromal cells that exist as a syncytium with fibroblasts and mural cells in the lamina propria of the gut. Through expression and secretion of cytokines, chemokines, growth factors, prostaglandins, and basal lamina/extracellular matrix molecules, as well as expression of adhesion molecules and receptors for many of the same soluble factors and matrix, myofibroblasts mediate information flow between the epithelium and the mesenchymal elements of the lamina propria. With the use of these factors and receptors, they play a fundamental role in intestinal organogenesis and in the repair of wounding or disease. Intestinal neoplasms enlist and conscript myofibroblast factors and matrix molecules to promote neoplastic growth, carcinoma invasion, and distant metastases.


Handover management is one of the most critical issues that mobility management protocols are concerned with. This process becomes even more critical in the case of micro-mobility where the mobile node is expected to encounter frequent handovers. We use the only mobility management protocol that has been standardized by the IETF, namely mobile IP, to identify bottlenecks in the handover process and to determine which of the various micro-mobility management protocols address these bottlenecks. This is achieved by providing detailed delay measurements of the handover process for mobile IPv6 using an OPNET/sup /spl reg// simulation environment. Our results show that the main bottleneck in the handover process is move detection. Further, we show that the only micro-mobility protocol that addresses this bottleneck without suffering from scalability issues is not compatible with mobile IPv6 and, as a result, does not benefit from its many improvements. We conclude that a more appropriate solution would be to use of mobile IPv6 with the addition of move detection optimizations.


Software evolution is an iterative and incremental process that encompasses the modification and alteration of software models at different levels of abstraction. These modifications are usually performed independently, but the objects to which they are applied to, are in most cases mutually dependent. Inconsistencies and drift among related artifacts may be created if the effects of an alteration are not properly identified, recorded, and propagated in other dependent models. For large systems, it is possible that there is a considerable number of such model dependencies, for which manual extraction is not feasible. In this paper, we introduce an approach for automating the identification and encoding of dependence relations among software models and their elements. The proposed dependency extraction technique first uses association rules to map types between models at different levels of abstraction. Formal concept analysis is then used to identify clusters of model elements that pertain to similar or associated concepts. Model elements that cluster together are considered related by a dependency relation. The technique is used to synchronize business process specifications with the underlying J2EE source code models.


The Kamchatka Peninsula lies on the eastern active margin of Eurasia, adjacent to the Kuril-Kamchatka subduction zone. In this study, we provide a geomorphological map of the Central Kamchatka Depression – the largest sedimentary basin in Kamchatka and also in all the island arcs of the North Paci fi c. The depression extends along Kamchatka at latitudes ∼ 44 – 46° N for more than 400 km and is up to 100 km wide. The geomorphological map of the Central Kamchatka Depression is designed at a scale of 1:500,000 and contains ∼ 3000 mapped objects. Volcanic and tectonic landforms have been collected from published sources and generalised to the map scale. Glacial and fl uvial landforms have been mapped using remote sensing data and fi eld geomorphological surveys. Areas of ambiguous interpretation have been outlined. This map is the most detailed geomorphological map published for this region that may guide further geomorphological and paleogeographical investigations.


Since Xi Jinping came to power, new concepts and ideas have come to define China's polity. Of which, Military-Civil Fusion (MCF) is one of the significant concepts added to China's national strategy with the aim to integrate the civilian research and commercial sectors with the military and defence industrial base. The MCF is integral to Xi's vision of the "China Dream" of building a strong country with a strong military by enabling the Military to harness the country's rapid economic growth. Here, the quest lies in building capabilities in 'dual-use' technology and infrastructure to enhance China's overall economic and military capability and secure China's position vis-a-vis the West. The challenge for China is to match the speed and scope of the rapid technological pace to create Fast or lose the ability to compete. In this context, the paper seeks to understand the civil-military integration in China, under its current form as 'MCF'. The key elements examined are the objectives, goals, and policies of the MCFstrategy. It also explores the significance as well as the scepticism attached to China's MCF strategy.


The genetics of heart failure is complex. In familial cases of cardiomyopathy, where mutations of large effects predominate in theory, genetic testing using a gene panel of up to 76 genes returned negative results in about half of the cases. In common forms of heart failure (HF), where a large number of genes with small to modest effects are expected to modify disease, only a few candidate genomic loci have been identified through genome-wide association (GWA) analyses in humans. We aimed to use exome sequencing to rapidly identify rare causal mutations in familial cardiomyopathy cases and effectively filter and classify the variants based on family pedigree and family member samples. We identified a number of existing variants and novel genes with great potential to be disease causing. On the other hand, we also set out to understand genetic factors that predispose to common late-onset forms of heart failure by performing GWA in the isoproterenol-induced HF model across the Hybrid Mouse Diversity Panel (HMDP) of 105 strains of mice. We performed fine phenotyping using serial echocardiograms and controlled for environmental heterogeneity in the experimental setting. As a result, we achieved high heritability estimates of 64% to 84% for all cardiac traits and had superior power for mapping HF-related trait, compared to human studies. Association analyses of cardiac traits, corrected for population structure and multiple comparisons, revealed genome-wide significant loci across the spectrum of cardiac traits. Cardiac tissue gene expression profiling, expression quantitative trait loci, expression-phenotype correlation, and coding sequence variation analyses were performed to prioritize candidate genes and to generate hypotheses for downstream mechanistic studies. Future directions will be to further bridge the gap of understanding between rare Mendelian and common cardiovascular diseases, which together will have wide spread therapeutic implications in delaying or reversing HF progression in human populations.


BACKGROUND
Prolonged labour is associated with increased risk of postpartum haemorrhage (PPH), but the role of active pushing time and the relation with management during labour remains poorly understood.

METHODS
A population-based cohort study from electronic medical record data in the Stockholm-Gotland Region, Sweden. We included 57 267 primiparous women with singleton, term gestation, livebirths delivered vaginally in cephalic presentation in 2008-14. We performed multivariable Poisson regression to estimate the association between length of second stage, pushing time, and PPH (estimated blood loss >500 mL during delivery), adjusting for maternal, delivery, and fetal characteristics as potential confounders.

RESULTS
The incidence of PPH was 28.9%. The risk of PPH increased with each passing hour of second stage: compared with a second stage <1 h, the adjusted relative risk (RR) for PPH were for 1 to <2 h 1.10 (95% confidence interval (CI) 1.07, 1.14); for 2 to <3 h 1.15 (95% CI 1.10, 1.20); for 3 to <4 h 1.28 (95% CI 1.22, 1.33); and for ≥4 h 1.40 (95% CI 1.33, 1.46). PPH also increased with pushing time exceeding 30 min. Compared to pushing time between 15 and 29 min, the RR for PPH were for <15 min 0.98 (95% CI 0.94, 1.03); for 30-44 min 1.08 (95% CI 1.04, 1.12); for 45-59 min 1.11 (95% CI 1.06, 1.16); and for ≥60 min 1.20 (95% CI 1.15, 1.25).

CONCLUSIONS
Increased length of second stage and pushing time during labour are both associated with increased risk of PPH.


Primary objective: To assess the prevalence of and risk factors for sleep disturbances in the acute post-traumatic brain injury (TBI) period. Research design: Longitudinal, observational study. Methods and procedures: Fifty-four first time closed-head injury patients were recruited and evaluated within 3 months after injury. Pre-injury and post-injury sleep disturbances were compared on the Medical Outcome Scale for Sleep. The subjects were also assessed on anxiety, depression, medical comorbidity and severity of TBI. Main outcomes and results: Subjects were worse on most sleep measures after TBI compared to before TBI. Anxiety disorder secondary to TBI was the most consistent significant risk factor to be associated with worsening sleep status. Conclusions: Anxiety is associated with sleep disturbances after TBI. Further studies need to be done to evaluate if this is a causal relationship.


The focus of this review is to examine the importance of quantifying total HIV DNA to target the HIV reservoir and the clinical implications and challenges involved in its future application in clinical practice. Despite intrinsic limitations, the quantification of total HIV DNA is currently the most widely used marker for exploring the HIV reservoir. As it allows estimating all forms of HIV DNA in the infected cells, total HIV DNA load is the biomarker of the HIV reservoir that provides most of the insights into HIV pathogenesis. The clinical role of total HIV-DNA in both untreated and treated patients is extensively supported by important lines of evidence. Thus, predictive models that include total HIV DNA load together with other variables could constitute a prognostic tool for use in clinical practice. To date, however, this marker has been primarily used in experimental evaluations. The main challenge is technical. Although the implementation of droplet digital PCR could improve analytical performance over real-time PCR, the lack of standardization has made cross-comparisons of the data difficult. An effort by investigators to compare protocols is needed. Furthermore, the main effort now should be to involve the biomedical industry in the development of certified assays for in vitro diagnostics use.


Proceedings: AACR 103rd Annual Meeting 2012‐‐ Mar 31‐Apr 4, 2012; Chicago, IL

Purpose: The PI3K/Akt/mTOR pathway is an attractive target in HER2 positive breast cancer refractory to anti-HER2 therapy. The hypothesis is that suppression of this pathway results in sensitization to anti-HER2 agents. However, this combinatorial strategy has not been comprehensively tested in models of trastuzumab and lapatinib resistance. Experimental Design: We analyzed in vitro cell viability and induction of apoptosis in five different cell lines resistant to trastuzumab and lapatinib. Inhibition of HER2/HER3 phosphorylation, PI3K/Akt/mTOR and ERK signaling pathways was evaluated by western blot. Tumor growth inhibition following treatment with lapatinib, INK-128 or the combination of both agents was evaluated in three different animal models: two cell-based xenograft models refractory to both trastuzumab and lapatinib and a xenograft derived from a patient who relapsed to trastuzumab-based therapy. Results: The addition of lapatinib to INK-128 prevented both HER2 and HER3 phosphorylation induced by INK-128, resulting in inhibition of both PI3K/Akt/mTOR and ERK pathways. This dual blockade synergistically enhanced cell death in five different HER2 positive cell lines resistant to trastuzumab and lapatinib. In vivo, both cell line-based and patient-derived xenografts showed exquisite sensitivity to the antitumor activity of the combination of lapatinib and INK-128, causing durable tumor shrinkage in the absence of any sign of toxicity. Conclusions: The simultaneous blockade of PI3K/Akt/mTOR and ERK pathways achieved by combining lapatinib with INK-128 acts synergistically in inducing cell death and tumor regression in breast cancer refractory to anti-HER2 therapy.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 1811. doi:1538-7445.AM2012-1811


A multi-input multi-output (MIMO) recurrent neural network (RNN) is used as a versatile tool for the high-speed phasor detection and the adaptive identification of control and protection signals in power systems. For the application as a phasor detector, a fast pseudo-gradient training is performed off-line to estimate the time-invariant weights of the RNN. This network is then operated in real-time, in recall mode only, to behave as a nonlinear fixed-coefficient filter. For the application as an adaptive identifier of nonlinear components, training is performed off-line for initializing the connection weights, but subsequently, they are continuously updated in real time. This results in an adaptive identifier suitable for detecting abrupt changes in complex nonlinear systems. Following an initial evaluation on synthetic signals, these two proposed RNNs are then validated using realistic waveforms generated from a series-compensated power system model.


New tools to educate immunization managers in developing countries are needed to keep these health policy makers current on the latest vaccines and procedures, and to provide support in decision making. The goal of the AIM e-Learning Project is to deliver up-to-date and engaging web-delivered media, with solid instructional design, to an audience relatively new to web-based learning. Accuracy of information and accessibility drive our design. Our ultimate objective is to aid immunization managers in developing timely, effective and sustainable policy.


Effectiveness of hyperbaric oxygen therapy in crush injury due to earthquake is not reported yet. In this study, the patients, who developed compartment syndrome as a result of crush injury after the Marmara earthquake on August 17, 1999, and who were treated with firstly decompressive fasciotomy and then hyperbaric oxygen therapy, were evaluated retrospectively. After examination and prior treatment on admission, the patients, who had sustained injuries by being compressed under collapsed buildings, were diagnosed with the crush syndrome. On admission, arterial blood gas analysis, whole blood count, biochemical assays, and radiographic and neurological examinations were done. All patients underwent decompressive fasciotomy. Wound cultures were collected from patients and antibiotherapy was started if necessary. Wound cleanings were maintained daily and surgical debridement was performed if needed. Hyperbaric oxygen therapy was performed twice daily at 2,5 Absolute Athmosphere (ATA) by two-hour sessions in postoperative period. Total number and the duration of sessions of hyperbaric oxygen therapy were noted. Fifty two patients were treated with hyperbaric oxygen therapy in postoperative period. Hyperbaric oxygen therapy was provided to all patients in 946 sessions, varying between 3 to 70 sessions per patient. Forty five of 52 patients were recovered without any complication or any sequels. Hemodialysis was performed to 7 patients for acute renal failure, and two of them died during the hyperbaric oxygen therapy due to acute respiratory distress syndrome and sepsis. Hyperbaric oxygen therapy should be considered in the treatment of crush injuries due to earthquakes.


This paper is a report of qualitative and quantitative research on "continuing bonds" between the bereaved and the deceased in the areas affected by the Great East Japan Earthquake. The disaster victims recount that it is normal for them to have conversations with the deceased, and that maintaining continuing bonds with the deceased makes them feel better. Communities of grief, within which stories about the deceased are shared, have emerged among the bereaved. There appear to be two types of representation of, and relationship with, the dead: namely, as "familiar spirits" and "unfamiliar spirits." The closeness of relationships within a community decides which type is dominant. Many victims consider their connection to the deceased to be stronger than their connection to the priests who facilitate these bonds. Finally, based on these findings, this paper examines how religious specialists have been engaged in spiritual care, and whether such care will be successful as a post-secular activity under the conditions of "recovery secularism."


Operative vaginal delivery has been maligned since the days of W.J. Little with the word "forceps" becoming nearly synonymous with "Birth Injury" and "Cerebral Palsy." However in his presentation to the Obstetrical Society of London in 1861, Little's emphasis was on difficult labors being the culprit in subsequent disabilities in the offspring. Instrumented deliveries in that era were the end result of a long, obstructed labor performed for maternal benefit and to avoid a destructive procedure to the fetus thus allowing a chance at life. If there had been a normal progress in labor, operative assistance for delivery would not have been needed. Thus, was it the instrument or the obstructed labor that led to fetal injury? In this article, we will review what injuries to the fetus and the mother can be directly attributable to the instrument. We will explore the processes of labor, conduct of labor management, and concurrent fetal factors that can modulate the occurrence of birth trauma. Evidence regarding inexperience and improper use as contributing to injury will also be explored.