BACKGROUND AND OBJECTIVE
Chronic Fatigue Syndrome (CFS) and Multiple Chemical Sensitivity (MCS) are well-defined illnesses that may appear after some toxic exposures.

PATIENTS AND METHOD
We report a consecutive series of 26 patients who developed CFS after exposure to insecticide products. It was associated with MCS in a third of cases.

RESULTS
Toxic exposure was of labour origin after returning to usual work place after a process of fumigation. In 42% of cases there was no fulfilment of fumigation safety rules. The majority of patients were mean-aged women who developed an acute upper airway inflammatory syndrome, without muscarinic or nicotinic manifestations, followed by digestive syndrome, neurocognitive, fibromyalgic and chronic fatigue manifestations. The course of disease was shorter than 1 year in 5 cases (19%), longer than 1 year in 15(58%), and disabling in 6 cases (23%).

CONCLUSIONS
Due to the possible prevention of this toxic exposure, it is very important to carefully follow measures of environment isolation and ventilation after insecticide use in order to avoid the development of these diseases.


Background Pharmacokinetic parameters are altered in critically ill patients, such as an increase in volume of distribution of hydrophillic drugs. Peak plasma levels of amikacin, a concentration-dependent antibiotic, could be reduced in critically ill patients. Therefore, current recommendations include higher doses of amikacin (above 20 mg/kg/day) in critically ill patients in order to achieve therapeutic plasma levels, which means a possible higher incidence of adverse events, such as nephrotoxicity and ototoxicity. Therapeutic drug monitoring (TDM) and pharmacist intervention can be necessary in this type of patient to prevent these adverse effects. Purpose To assess the impact of TDM in critically ill patients receiving high-dose amikacin. ResultsAbstract 4CPS-071 Table 1 N 28 Sex (males) 18 (64.3) Age (years) 76.5 (72–80) Weight (kg) 75 (63.3–85.5) BMI (kg/m2) 27.4 (24.8–32.1) Adjusted weight (kg) 69.2 (60.8–75.1) SOFA score 4 (3–6) Sepsis (n) 20 (71.4) Septic shock (n) 3 (10.7) Dosage (mg/kg/24 hour) 21.5 (20–25) Supratherapeutic peak (>50 mcg/ml) (n) 21 (75) Supratherapeutic trough (>1 mcg/ml) (n) 22 (78.6) SCr (initial) (mg/dL) 0.76 (0.65–0.85) SCr (worst) (mg/dL) 1.1 (0.87–1.23) GFR (initial) (ml/min) 88 (77.9–90.1) GFR (worst) (ml/min) 59 (46–72.8) RIFLE (SCr) (no damage-risk-injury-failure) 17 (60.7)–6 (21.4)–3 (10.7)–2 (7.1) RIFLE (GFR) (no damage-risk-injury-failure) 13 (46.4)–11 (39.4)–2 (7.1)–2 (7.1) Day worst SCr/GFR value (n) 2 (1–4.3) Interval Increase (n): 20 (71.4)Maintain (n): 5 (17.9)Reduce (n): 1 (3.6)Stop (n): 2 (7.1) Dose Reduce (n): 19 (67.9)Maintain (n): 6 (21.4)Increase (n): 1 (3.6)Stop (n): 2 (7.1) Material and methods Retrospective descriptive study performed in a 400-bed tertiary hospital. Data from patients receiving above 20 mg/kg/day amikacin between January 2014 to August 2017 were included. Patients with a glomerular filtration rate (GFR) below 40 ml/min or receiving renal replacement therapy were excluded. An intermediate level (10 hour post-administration) was used to extrapolate almost all peak and trough levels. Peak levels above 50 mcg/ml and trough levels above 1 mcg/ml were considered supratherapeutic. Data collected: demographic, body mass index (BMI), SOFA score (first 24 hours of amikacin therapy), sepsis, dosage, data extraction levels, renal function (values of serum creatinine (SCr) and GFR the first 24 hours of amikacin therapy and worst values during amikacin therapy) and TDM recommendation. Categorical variables were presented as percentages, continuous variables as median and Q1 to Q3 values. Conclusion Greater number of patients with current recommendation of high doses of amikacin presented supratherapeutic plasma levels of amikacin, and about 70% of patients needed a dose reduction or an interval increase. Therapeutic drug monitoring after first dose should be a regular practice in critically ill patients, whom present an early decline in renal function during amikacin therapy. No conflict of interest


Cromakalim (BRL 34915), a novel vasodilator, is used clinically to manage systemic hypertension. Its effects on the intact newborn pulmonary circulation remain unclear. The purpose of this study was to determine the response of both the mean and pulsatile pulmonary hemodynamic parameters to intravenous infusion of BRL 34915 (0.1 mg/kg/min for 10 min) in 48-hr-old open-chest Yorkshire pigs. Animals were divided into two groups: Group I pigs had a high mean baseline pulmonary artery pressure (PAP) (> 17 mm Hg), while Group II pigs had a low to normal baseline mean PAP (< 17 mm Hg). Following instrumentation for high-fidelity recordings of PAP and flow, baseline data were acquired. Employing Fourier analysis, characteristic impedance (Zo), input mean impedance (Zm), impedance harmonic moduli (units in dyn sec cm-5), and phase angles (radians) were determined. Pulmonary vascular resistance (PVR) was calculated and aortic pressure (AP, mm Hg) was also measured. All values = mean +/- SEM. Group I animals ("high tone") underwent a decrease in PAP (17.9 +/- 1.6 mm Hg vs 13.6 +/- 1.9 mm Hg, P = 0.008) and PVR (4310 +/- 816 dyn sec cm-5 vs 3713 +/- 687 dyn sec cm-5, P = 0.04). Group II animals ("low tone") responded with an increase in PAP (11.5 +/- 0.4 mm Hg vs 16.6 +/- 1.8 mm Hg, P = 0.029). AP decreased in Group I (40 +/- 3.8 mm Hg vs 21.5 +/- 2.8 mm Hg, P = 0.008) and Group II (51.2 +/- 10.8 mm Hg vs 31.2 +/- 10.9 mm Hg, P = 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)


Shared Sensor and Actuator Networks (SSAN) represents a new design trend of Wireless Sensor Network (WSNs) that allows the system infrastructure to be shared among multiple applications submitted by different users instead of the original application-specific network design. In this context, we propose a task scheduling algorithm that well utilizes the characteristics of applications with common tasks to improve the system energy efficiency, so as to extend the most concerned performance metric system lifetime. Our proposal is validated by both computer simulations and real sensor nodes tests.


The adsorption properties of CO and H2 on iron-based catalyst with addition of Zr and Ni were investigated using temperature programmed desorption process. It was found that on the carburized iron-based catalysts, molecular state and dissociative state CO existed together. The addition of Zr was preferential for the molecular state adsorption of CO on iron-based catalyst and the presence of Ni was beneficial to the dissociative adsorption of CO. On H2 reduced catalysts, hydrogen mainly adsorbs on the surface iron sites and surface oxide sites. On CO reduced catalysts, hydrogen probably existed as the most stable CH and OH species. The addition of Zr was not benefit to the dissociative adsorption of hydrogen on iron-based catalyst and the presence of Ni was preferential for the dissociative adsorption of hydrogen. Keywords—adsorption, Fischer-Tropsch synthesis, iron-based catalysts


We investigate the photoacoustic effect generated by heat deposition at a point in space in an inviscid fluid. Delta-function and long Gaussian optical pulses are used as sources in the wave equation for the displacement potential to determine the fluid motion. The linear sound-generation mechanism gives bipolar photoacoustic waves, whereas the nonlinear mechanism produces asymmetric tripolar waves. The salient features of the photoacoustic point source are that rapid heat deposition and nonlinear thermal expansion dominate the production of ultrasound.


In this paper we discuss the commonly-used limiting cases, or approximations, for two-point cosmic shear statistics. We discuss the most prominent assumptions in this statistic: the flat-sky (small angle limit), the Limber (Bessel-to-delta function limit) and the Hankel transform (large l-mode limit) approximations; that the vast majority of cosmic shear results to date have used simultaneously. We find that the combined effect of these approximations can suppress power by >1% on scales of l<40. A fully non-approximated cosmic shear study should use a spherical-sky, non-Limber-approximated power spectrum analysis; and a transform involving Wigner small-d matrices in place of the Hankel transform. These effects, unaccounted for, would constitute at least 11% of the total budget for systematic effects for a power spectrum analysis of a Euclid-like experiment; but they are unnecessary.


Objectives: The main objectives of the study were to determine the treatment outcome of tuberculosis (TB) patients in a tertiary care hospital, factors associated with the success of treatment, the adverse drug reactions (ADRs) associated with anti-tubercular drugs, and the causality and severity evaluation of ADRs. Methods: It was a prospective study conducted for 10 months to evaluate the treatment outcome in TB patients in a tertiary care teaching hospital in Kerala, India. A total of 101 patients were studied as per the inclusion and exclusion criteria. Treatment outcome analyzed according to the WHO guidelines, causality and severity assessment was done by Naranjo and HARTWID-SIEGEL scale, respectively. A standardized data collection form was prepared, and necessary data were collected from patient's medical records. Results: A total of 101 patients mostly in the age group of 30–50 years were male population dominates pulmonary TB (PTB) was seen in 57 (56.43%) extra PTB in 44 (43.57%) in which pleural effusion TB was common (34.09%) other types were lymph node TB (15.74%), spine TB, TB meningitis (9.09% each), bone TB (6.481%) treatment outcome found to be success in 85 (84%) 10 (10%)treatment completed 1 (1%) died 4 were defaulters, 1 not evaluated, 82 developed ADR. On causality assessment it was possible and severity of moderate level. Conclusion: By proper management and monitoring TB can be completely cured, and most of them have a favorable outcome with current treatment, and ADR can be managed by providing proper awareness of treatment modalities/disease.


Intestinal microbiota play a crucial role in the development of mucosal tolerance and adaptation. Perturbations in microbiota composition are strongly associated with allergies and asthma in westernized countries. There has been accumulating evidence that the administration of probiotics, "live microbial supplements that exert a beneficial effect on human health," may be effective in the treatment and or prevention of allergic diseases. Although it has been shown that part of the effect of probiotics arises from its interaction with the host immune system, the precise mechanisms remain to be determined. In addition, future studies are necessary to define appropriate species and strains, optimum dose, frequency, and duration for the treatment of allergic diseases.


This brief studies distributed containment control for double-integrator dynamics in the presence of both stationary and dynamic leaders. In the case of stationary leaders, we propose a distributed containment control algorithm and study conditions on the network topology and the control gains to guarantee asymptotic containment control in any dimensional space. In the case of dynamic leaders, we study two cases: leaders with an identical velocity and leaders with nonidentical velocities. For the first case, we propose two distributed containment control algorithms to solve, respectively, asymptotic containment control under a switching directed network topology and finite-time containment control under a fixed directed network topology. In particular, asymptotic containment control can be achieved for any dimensional space if the network topology is fixed and for only the 1-D space if the network topology is switching. For the second case, we propose a distributed containment control algorithm under a fixed network topology where the communication patterns among the followers are undirected and derive conditions on the network topology and the control gains to guarantee asymptotic containment control for any dimensional space. Both simulation results and experimental results on a multi-robot platform are provided to validate some theoretical results.


During healthy pregnancy there is a progressive decrease in sensitivity of the mother's cells to insulin signalling, known as insulin resistance, in order to divert glucose towards the growing fetus. To compensate for this, the pancreatic β-cells must adapt through various mechanisms to increase the amount of insulin produced. A failure of the β-cells to sufficiently adapt can lead to gestational diabetes and clinical consequences for both mother and baby.
 The necessary β-cell adaptations are coordinated in large part by the placenta, which acts as an endocrine organ producing and releasing hormones into the maternal blood circulation. Hormones such as prolactin, placental lactogen, and kisspeptin have been identified to play important roles in initiating and maintaining the changes in the β-cells necessary for a healthy pregnancy. Further work towards understanding how the β-cells adapt to pregnancy in humans, the signals underlying these changes, and why these adaptations fail in gestational diabetes is essential in allowing us to address this increasingly prevalent form of diabetes.


Edwin Taylor and John A. Wheeler-one of this century's most distinguished physicists - have completely reorganised this popular and well known book to make it accessible to an even wider audience. New topics, imaginative problems, and exceptionally clever illustrations, combined with a compelling narrative and intellectual authority make this a classic text. It is an ideal text for undergraduate courses in special relativity and modern physics.


Index (NIH-CPSI) and UPOINT domains were evaluated. Patients with negative traditional cultures and positive NGS were offered antibiotic therapy. RESULTS: Urine cultures were negative in all CPPS patients, while 8% (2/25) had a positive EPS culture. NGS identified these organisms in one patient and failed to detect it in the other. In culture negative patients, NGS identified at least one organism in EPS in 70% (16/23), though only 30% (7/23) were for established uropathogens. Patients with positive and negative NGS had similar mean NIH-CPSI scores of 23.3 þ/6.8 and 20.5 þ/6.9, respectively (p[0.44). Organisms of questionable pathogenicity in EPS found by NGS included vaginal flora (Prevotella spp., Sneathia amnii), anaerobes, and fungi. In the subset of 6/25 (24%) men with systemic symptoms suggestive of infection, all had negative EPS cultures but NGS identifying a uropathogen in 50% (3/6). 4 were treated with antibiotics based on the sensitivity gene panel but only 1 patient (25%) resolved their symptoms. CONCLUSIONS: NGS detected a variety of microorganisms not found by conventional culture in urine and EPS. In men with systemic symptoms suggestive of infection, NGS found a pathogen missed by culture in 50%. The presence of vaginal flora, anaerobes, and yeast is novel but the clinical significance is unclear and the value of prolonged antimicrobial treatment of these organisms is not proven. Based on our data, NGS may help identify pathogenic organisms in men with CPPS who have symptoms suggestive of true infection, however men should still be offered multimodal therapy based on their clinical phenotype to maximize the chance for symptom resolution.


In September 2008, the United States government seized mortgage giants Fannie Mae and Freddie Mac. Since that time, the government has pumped $111 billion of new capital into these government-sponsored enterprises. Yet the future of these companies post-bailout is far from clear. As policymakers consider the future of Fannie and Freddie, it is useful to remember that this is not the first significant bailout of a government-sponsored enterprise. The government also rescued the Farm Credit System in the 1980s. This Article examines the historical cycles in which Fannie, Freddie, and the Farm Credit System have funded loans: They fund more loans in good economic times but fund fewer loans in poor economic times. In other words, they fund loans pro-cyclically with business and credit cycles. By repeatedly providing bailouts, however, government officials demonstrate that they want these government-sponsored enterprises to fund loans in a countercyclical manner. This Article considers the advantages and disadvantages of three possible ways to induce countercyclical behavior. It concludes that policymakers should impose countercyclical capital requirements and create an insurance system funded with risk-based premiums to insure the companies' bonds. It further concludes that, even with these measures, occasional government bailouts may be necessary to stimulate lending during severe economic downturns.


We investigate the determinants of the share of insurance frauds over total claims in four different lines of property-liability insurance across 103 Italian provinces and five years. Fraud is framed in terms of rewards and both formal and social costs of crime; either are related to the characteristics of the local socioeconomic system and of the local insurance market. Results are different across lines; fraudulent behaviour in some lines turns out to be more frequent in poorer areas and during weak phases of the economic cycle, or among the younger and less educated, in accordance with the general literature on crime. There is evidence of the negative effect of the density of territorial units (inspectorates and claim handling units of insurers) on fraud frequency. Support is also found for the controlling role of social capital, through social sanctions, on fraudulent behaviour.


Electrodeposition behavior of Zn-Ni alloys was investigated at current densities of 5-500 A•m -2 and a charge of 5 × 10 4 C•m -2 at 308 K in an unagitated zincate solution containing ethylenediamine (EDA), which forms a stable complex with Ni 2+ ions. In the case of the TEA solution, the Zn-Ni alloy exhibited normal codeposition at low current densities, wherein electrochemically more noble Ni deposited preferentially, while it exhibited anomalous codeposition at high current densities, wherein less noble Zn deposited preferentially. In the EDA solution, the alloy exhibited anomalous codeposition at high current densities; on the other hand, even at low current densities, the Ni content in the deposit was almost identical with the composition reference line, showing a behavior similar to anomalous codeposition. In the EDA solution, Ni deposition and H 2 evolution were significantly suppressed over a larger region of current densities, showing the formation of an inhibitor for deposition, which results from Zn 2+ ions in the cathode layer. The dependence of the current efficiency for alloy deposition on the current density was smaller in the EDA solution than in that containing TEA. In the TEA solution, the underpotential deposition of Zn apparently occurred with Ni, while in the EDA solution, the underpotential deposition of Zn never occurred, because Ni deposition was suppressed by the coexistence of Zn 2+ ions even at low current densities. The throwing power of Zn-Ni alloys in the EDA solution was better than that in the TEA solution.


The water diversion project from south to north, which is under construction in the East Diversion Route, and that of the Middle and West Diversion Routes, which are to be started in the near future, will substantially alleviate the acute shortage of water resources in the northern area and will realize the optimal allocation of water resources in China. The Nansi (South Four) Lakes Basin in Shandong Province as the hydraulic hinge of the Eastern Route Project under construction during the period 2001–2010 will receive water downstream of the Yangtze River and divert it to the Tianjin area, Shandong and Hebei provinces. However, the water is heavily polluted at present, rendering it unsuitable as a drinking water source. An integrated water management strategy of around 4 billion Yuan RMB or about US$49 million for the construction of municipal wastewater treatment plants and sewerage systems to combat point source pollution has been drawn up for the Nansi Lakes Basin in China. The scheme pays attention to non-point source pollution control and water reclamation and reuse, to ensure that the project of diverting water from south to north performs adequately, as well as to pave a way for sustainable development.


A total of 227 primary and repeated forensic medical expert conclusions in victims with slight craniocerebral injuries (CCI) are analyzed. Erythrocyte catalase (CTer) activity was analyzed on the basis of the results of computer quantitative morphometry of histochemical analysis of blood smears from 50 victims with slight CCI. CTer activity correlated with the severity of CCI. A new objective method for histochemical diagnosis of slight concussion and contusion of the brain is suggested, which rules out errors in forensic medical expert evaluations in examinations of this category of victims. Language: ru


Two cases of mixed prostatic carcinoma are reported. A 67-year-old man with mixed urothelial and squamous cell carcinoma died 10 months after diagnosis despite hormonal therapy and pelvic irradiation. A 70-year-old man with adenosquamous carcinoma responded well to such treatment.


The COVId19 pandemic is a newly emerging infectious disease that needs to be understood thoroughly in order to be controlled. This study aimed to study the clinical and laboratory characteristics of the COVID19 patient.
Patient and methods: A cross-sectional study was done in Iraq, at Salahadeen general hospital from the period 1st March to the end of May 2020 on patients diagnosed with COVID 19. A total of 75 COVID19 patients enrolled in the study. a full history was taken, a full physical examination was done, computerized tomography, and laboratory tests.
Results: The age distribution of the COVID19 patient were commonly aged (30-50 years) 37(49.3%), and those aged <30 years represented about 6(8%) of the sample. The dominant gender was male 43(57.3%). About 58 (77.3%) of the patient had comorbid disease, coronary vascular disease was 49(65.3%), hypertension was found among 47(62.7%), DM was found among 40(53.3%). Smoking found among 35(46.7%) of the patients.
The commonest symptoms were dyspnea 63(84%), fever 51(68%), Myalgia 46(61.3%), loss of smell 8(10.7%), vomiting 8(10.7%), sputum 8(10.7%), loss of taste 6(8%), diarrhea 6(8%), dry mouth found among 6(8%), cough 6(8%), fatigue 5(6.7%)followed by arthralgia 4(5.3%), and chest pain 3(4%). The mean Spo2% was (88±6.6), heart rate was (103±23.3), the mean respiratory rate was (17.7±4.1), the mean temperature value was (38.1±1.1), and the mean C - reactive protein rate was (49.8±41.2). The CBC shows that Lymphopenia was reported among 34(45.3%) of the patient, leukocytosis reported among 19 (25.3%) of the patient. Chest CT revealed that mean lung involvement was (16.6±14.7%).
Conclusion: The commonest presentation of the patient was dyspnea, followed by fever. Digestive symptoms and myalgia were common. COVID19 maybe became a stigma in our community and educational programs were needed to overcome this problem.
Keywords: COVID19 infection, clinical presentation, CT, Iraq.


Abstract A geochronological and geochemical study on 10 samples of seafloor massive sulfides (SMS) from the inactive Peterburgskoye hydrothermal field at the Mid-Atlantic Ridge (MAR) was carried out. The 230Th/U ages of the SMS are the oldest for the Quaternary hydrothermal ores ever found at the ocean floor. According to them the hydrothermal activity at Peterburgskoye field started at least 170 ka and continued down to 63 ka. The oldest hydrothermal ores from this field consist mainly of pyrite and chalcopyrite and have geochemical properties typical for SMS associated with basalts.


Neonates are infants who are in their first 28 days of life. The diagnoses of neonatal seizures have been advocated by the use of clinical observations and electroencephalography (EEG). The continuous monitoring of neonatal EEGs in neonatal intensive care units is tedious and involves experts' intervention. The use of clinical decision support systems into the neonatal intensive care units has proved to produce aid to neonatal staff. The neonatal seizures of epileptic origin are more common and we recommend an approach to aid in the classification of the same using EEG signals of the neonates. Daubechies wavelet transform is used for the task of separation of frequency bands and the extraction of features. The theta rhythm of EEG reflects rightly the occurrence of epileptic seizures in neonates. The features taken into consideration for the classification are mean, variance, skewness and kurtosis. The support vector machine (SVM)-based classification is adopted for the development of the system which detects the presence or absence of epileptic seizures. The performance of this diagnostic aid system has been studied and the system has a sensitivity of 94% and specificity of 96%. The receiver operating characteristic curve is also used in the performance assessment.


Aedes aegypti, Aedes notoscriptus, and Aedes albopictus are important vectors of many arboviruses implicated in human disease such as dengue fever. Genetic markers applied across vector species can provide important information on population structure, gene flow, insecticide resistance, and taxonomy, however, robust microsatellite markers have proven difficult to develop in these species and mosquitoes generally. Here we consider the utility and transferability of 15 Ribosome protein (Rp) Exon‐Primed Intron‐Crossing (EPIC) markers for population genetic studies in these 3 Aedes species. Rp EPIC markers designed for Ae. aegypti also successfully amplified populations of the sister species, Ae. albopictus, as well as the distantly related species, Ae. notoscriptus. High SNP and good indel diversity in sequenced alleles plus support for amplification of the same regions across populations and species were additional benefits of these markers. These findings point to the general value of EPIC markers in mosquito population studies.


The relevance of the problem under study is due to the need to monitoring the general situation to respect to human rights. The establishment, provision and realization of human rights is an important indicator in a state, which indicates its democracy, sociality, as well as the fact that such a state is legal. Purpose of the article in the study the issues of legal protection of vulnerable categories of population in the context of formation of active human rights policy of state aimed at increasing the capacity of socially vulnerable groups and reducing the risks of growing social tensions in society. The leading method for studying this problem is the legal sociological method, which allows us to study the effectiveness of state and legal regulation of human rights protection. The article presents an analysis of the results of the European experience in combating intolerance and discrimination. Its types main determined have been. Highlighted the criteria by which discrimination is prohibited. The legal system of human rights protection mechanisms is analyzed. The article presents scientific categories: discrimination, hate crimes, vulnerable groups. The practical significance lies in the development of proposals for improving domestic legislation.


4642 >Background: Up-regulation of the inducible nitric oxide synthase (iNOS) and the cycloxygenase-2 enzyme (COX-2) have been reported to play a role in the process of carcinogenesis and angiogenesis. The aim of this study is to evaluate the possible correlation between iNOS, COX-2 and angiogenesis in ovarian serous carcinoma (OSC) Methods: We identified 118 patients with high-grade, advanced stage OSC from our database. Clinical data including patients' and tumor characteristics and overall survival were collected. Two to 3 paraffin blocks were stained by immunohistochemistry (IHC) with antibodies to COX-2, VEGF and iNOS. For all three markers both intensity and percentage of positive cells were evaluated to give an overall score. Statistical analysis included Chi-square testing to evaluate the correlation between the various markers and the Kaplan-Meier method to evaluate survival Results: Up-regulation of all three markers was noted in a significant number of the cases. The frequencies of overexpression of the specific markers in the study population were: 49% for iNOS, 69% for COX-2 and 77% for VEGF. High iNOS expression strongly correlated with high expression of COX-2 and VEGF. In fact, 98.3% of tumors with high iNOS expression exhibited high COX-2 expression and 98.1% exhibited high VEGF expression. The median survival of patients with high iNOS expressing tumors was 637 days compared to 1107 days for those with low iNOS expressors; this difference did not reach statistical significance Conclusion: High expression of iNOS is noted in a significant number of OSC tumors. This high expression is associated with high expression of COX-2 and VEGF. This suggests a significant role for iNOS in the process of ovarian carcinogenesis and tumor angiogenesis and warrants further investigation


For a high power demand and N+1 redundancy system, this paper presents a digital load share (LS) controller design and its implementation for paralleled phase-shifted full-bridge converters (PSFBC) used in distributed power systems. By adopting the digital control strategy, separately used ICs for both PSFBC and LS control functions in the analog system can be merged into a cost-effective digital controller. To compensate and stabilize PSFBC and LS loops with the direct digital design approaches, a small-signal model of the overall system is derived in the discrete-time domain successively. Then, the steady-state and dynamic load sharing performances are also investigated. Experimental results from two identical 1.2 kW paralleled PSFBC modules are presented to verify the proposed work.


In this Letter, Type IIa Bragg gratings are inscribed into microfibers. The large germanium-doped core region of the multimode fiber provides the necessary photosensitivity to form a Type IIa grating when it is drawn down to the microscale. Reducing the diameter of the microfiber due to lower saturate modulation and the amplified tension-strain transformation effect can accelerate the formation of a Type IIa grating. This provides an efficient method for the fabrication of fiber gratings with 800°C temperature resistance.


A useful tool to construct wavelet decompositions is the lifting scheme. The generalized lifting is an extension of the classical lifting scheme to introduce more flexibility and to permit the creation of new nonlinear and adaptive transforms. However, the design of generalized prediction and update steps is more involved. This letter proposes a generalized prediction design that minimizes the detail signal energy and entropy at the same time. Two algorithm variants are given. The fixed prediction uses the image class statistics to derive the optimal transform. If the statistics are unknown, the adaptive prediction extracts them from the image being coded. The resulting decompositions are applied to lossless image coding, reporting good results. The adaptive algorithm has no bookkeeping or side information requirements, yet its performance is close to the fixed prediction performance.


Forty-nine self-repairs were extracted from a corpus of conversational speech of ten German children (mean age 5;1) with peers. The repairs were analysed using [1]'s classification and compared with his adult data. Children produced fewer appropriateness repairs than adults, but more covert repairs and more phonetic repairs. Like adults, children had a preference to interrupt themselves within-word only for error repairs. Unlike adults, children did not produce editing terms following interruptions.


Nano-ZnS with mixed cubic and hexagonal stacking was synthesized via reaction of zinc acetate with thioacetamide in a weakly acidic solution, while nano-ZnS in primarily the sphalerite phase was synthesized in a basic solution. X-ray diffraction (XRD) and transmission electron microscopy were used to characterize the nanoparticle structures. The formation of nano-ZnS with mixed stacking was simulated numerically by generation of ZnS nanoparticles via random cubic and hexagonal stacking of the close packing layers. The numerically simulated stacking distribution is determined by the ratio of the probability of cubic vs hexagonal stacking. XRD patterns of ZnS nanoparticles with mixed stacking were simulated by using Debye function analysis. The wurtzite (102) peak is absent whereas the wurtzite (103) peak is present in nano-ZnS with mixed stacking, matching features of XRD results for synthesized ZnS. We conclude that crystallization of ZnS nanoparticles with mixed stacking occurs via a growth mechanism in ...


Background and importance The lymphoproliferative autoimmune syndrome caused by cytotoxic T lymphocyte antigen 4 (CTLA-4) insufficiency is characterised by immune dysregulation, haploinsufficiency and multiorgan disorders. This condition is classified as a rare disease and no drugs are yet registered for treatment. Abatacept, an antirheumatic agent that prevents T lymphocyte activation, was proposed. Aim and objectives To report the clinical record of a 15-year-old female patient with autoimmune disorders. Material and methods In 2015, the patient showed Gilbert pityriasis rosea with significant and diffused lymphoadenopathy, and levothyroxine was prescribed for her hypothyroidism. In July 2018, the patient had chronic urticaria and angio-oedema with a low antihistamine response. In April 2019, she showed persistent fever, asthenia and splenomegaly, associated with multiple lymphoadenopathies, compatible with a lymphoproliferative autoimmune syndrome.1 Functional tests evidenced a significant reduction in CTLA-4 expression on T reg lymphocytes. In November 2019, omalizumab was started instead of levocetirizine with benefit. In February 2020, clinicians from the paediatric infections unit proposed to the internal pharmaceutical committee the use of intravenous abatacept as off-label chronic treatment to manage autoimmune disorders related to CTLA-4 mutations. As the patient was suffering from a rare disease, the pharmacists suggested compassionate use of the drug, as for the DM 07/09/2017, also due to the elevated cost of the therapy chosen. Results The use of abatacept has shown a positive outcome to date (after seven doses), with regression in all lymphoadenopathy sites observed. Moreover, because the patient is successfully responding to intravenous administration in hospital, the ethical committee also approved the switch to the subcutaneous form which can be administered at home. Conclusion and relevance Abatacept use in CTLA-4 mutations on T reg may represent a valid chance of positive disease regression. However, eight months of observation of a single patient is not sufficient and more studies and applications are required. Moreover, a literature research and evaluation led the pharmacist to suggest compassionate use to guarantee the patient's therapy and to optimise drug governance, not affecting hospital costs. References and/or acknowledgements Schwab, et al. J Allergy Clin Immunol 2018;142:1932–46. Conflict of interest No conflict of interest


Synthetic thin films such as diamond-like carbon (DLC) and polycrystalline diamond thin films can be used to increase surface flashover voltage of dielectric materials used in HV devices operating in vacuum. This work presents experimental results identifying some surface flashover characteristics of diamond-like carbon (DLC) thin films in space vacuum conditions. The DLC samples used in the experiments are produced by a microwave plasma deposition technique. The electrode material was copper, and a dc voltage was applied between the electrodes. Surface flashover voltage characteristics and the breakdown voltage wave forms of DLC thin film samples were determined. The results showed that DLC thin films may not be suitable materials for HV applications as dielectric materials in vacuum when coated onto semiconductor materials. Additionally, these results were compared with the surface flashover characteristics of polycrystalline diamond thin film and quartz samples.


Background: The pulmonary TB patients require prolong treatment along 3 – 6 month.
So they require ability to manage care including compliance to treatment control their
emotional status and ability to live in the normal life. Even though the government has
implemented the DOTs program since several years ago, but there is still problems of the
high prevalence of pulmonary TB in Indonesia that put in number four in the world. The
purpose of this study is to analyze the effects of holistic nursing care nursing "SOWAN"
program toward the independencies of TB patients in physical, psychological, social and
spiritual.
Method: The quasi experimental design was used in this study with quantitative and
qualitative approach. 60 persons was elected as the sample of this study that derived 30
people for control group and 30 other in intervention group. The intervention was done 2
month by using SOWAN program which is abbreviation of supporting, observation, wellbeing,
action and nursing.
The Result: Result of this study showed that there was increasing of independently level
in the intervention group after the intervention with mean from 32.86 before intervention
to 55.33 after the intervention with significant different p value 0.000 and there was
significant different between the intervention group and control group (p= 0.000) that
result also shown in evaluation using self-assessment card after intervention. There is
increasing self-awareness and self-management among the responded from grade 3 to
grade 4.9 (value range from 1 – 5).
Conclusion: As the conclusion, this study provide the significant effect of holistic
nursing care by using SOWAN in increasing the independency level of TB patients in
physical, psychological, spiritual and social. It is recommended the SOWAN can be
implemented in nursing care of chronic diseases in primary care as KIE and AKMS.


This journal published a special report titled "The Cost of Sleep-Related Accidents: A Report for the National Commission on Sleep Disorders Research". The report estimated that sleep-related accidents were annually associated with 23,318 fatalities, between 1,907,072 and 2,474,430 disabling injuries and costs between $43.15 billion and $56.02 billion. This paper reanalyzes the data base and assumptions underlying these estimates and concludes that they greatly overestimated the probable relationship between sleepiness and accidents. A more moderate estimate of this important relationship is proposed.


The constituent documents of the International Criminal Court (ICC) were formulated in the 1990s, at a time when the internet was still relatively new to most of society. In the four years between the signing of the Rome Statute in 1998 and its entry into force in 2002, there was a surge in technological development. The replacement of dial-up connections by home broadband and wireless internet, the commercial launch of 3G, and the introduction of camera phones all took place during that period, followed only a few years later by the founding of Google, YouTube and Facebook. This trend has only continued. Advanced technologies have changed the way in which societies create information and share it, generating an ever-growing volume of data. The availability and accessibility to new sources of information open up opportunities for international criminal investigators, but the task of using them effectively is not without its challenges. Recent cases before the ICC indicate that digital evidence will play an increasingly central role in investigations and prosecutions. In national jurisdictions, digital evidence is now introduced in the majority of criminal cases, and there have been significant reforms in domestic statutes on evidentiary and procedural rules from admissibility to e-discovery. However, such reforms have not yet materialized at the ICC. This article assesses whether the Rome Statute and Rules of Procedure and Evidence, and their current interpretation, remain effective and appropriate in the face of technological change. The authors examine the emerging challenges related to the use and handling of digital evidence, as well as the unique nature of the internet and other dissemination channels. By drawing attention to the main issues with the existing rules and practices, and raising unresolved questions, the authors highlight the importance of reassessing rules based on obsolete assumptions and expectations as we move towards the future.


Introduction: The estrogen receptor (ER) is found in about 60% of epithelial ovarian cancers; however, ovarian cancers are thought to be less estrogen responsive than breast cancers. Previous data has shown that long term estrogen responsive genes in ovarian cancer overlap with breast cancer genes less than 10% of the time. The question remains whether the estrogen receptor regulates the same signaling pathways in ovarian cancer as in breast cancer. Our hypothesis is that a unique set of estrogen responsive genes and proteins are activated by the ER in epithelial ovarian cancer as compared to breast cancer.

Methods: PEO4 cells were cultured in RPMI 1640-phenol red free media at 107 cells/plate and steroid depleted for four days. PEO4 cells were treated with and without 10-7 M 17 β-estradiol (Sigma) for 45min. Ethanol was used as a vehicle and control. Chromatin immunoprecipitation-sequencing (CHIP-seq) was used to determine the DNA-protein interactions of the estrogen receptor in the ovarian cancer cell line. DNA-protein interactions were crosslinked with formaldehyde, sheared and immunoprecipitated with the antibody ERalpha(HC-20):sc-543 (Santa Cruz). DNA was reversed crosslinked and purified. Biological triplicates were done. Library construction and Illumina HiSeq sequencing was done at the Genomics and Microarray Core at the University of Colorado. Reads were mapped using Novoalign. Identifying regions of enrichment, feature characterization, and motif analysis were performed using Homer (UCSD).

Results: 13,000 genes provided unique sequences by computer analysis in the cells treated with estrogen as compared to the ethanol control. 3,500 were uniquely identified as estrogen responsive genes. 2,800 genes were uniquely identified in control cells. Anticipated internal controls such as C-myc were appropriately identified by this analysis. A known estrogen responsive gene, the prolactin receptor, was identified as an estrogen responsive gene in our early timepoint. MicroRNAs 1260B and 3152, CUGBPa Elav-like family member 2, CSP-beta, STAU2 antisense RNA 1 were also seen in our analysis. Another more frequently identified sequence was CAPRIN1 (cell cycle associated protein 1), that is involved with cell proliferation. Additionally, DNA motif analysis of the ER crosslinked DNA revealed known estrogen responsive elements (EREs) and additionally found other DNA binding motifs such as those for p53, C-MYC, and PAX7. FOXA1, a major ER co-factor in breast cancer, was also enriched in our CHIP-seq analysis.

Conclusion: We have identified a unique set of directly ER modulated genes, microRNAs, and binding sites in an ovarian cancer cell line. These represent potential therapeutic targets for novel antiestrogens in ovarian cancer.

Citation Format: Georgina Cheng, Kian Behbakht, Monique A. Spillman. CHIP-seq of the estrogen receptor identifies new targetable estrogen regulated pathways in ovarian cancer. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research: From Concept to Clinic; Sep 18-21, 2013; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2013;19(19 Suppl):Abstract nr A16.


Abstract The first confirmed collection of Aedes japonicus in Maine was in Cumberland County in 2001. Since that initial collection, it has been found in 7 of Maine's 16 counties between 2001 and 2015. These collections include the northernmost collection of Ae. japonicus in the eastern USA, from Madawaska in Aroostook County. Though mosquito surveillance is limited in the state, it is evident that Ae. japonicus is more widely distributed in Maine than previously believed although its role in arboviral transmission in the region is unknown.


The Internet remains an unfinished work. There are several approaches to enhancing it that have been experimentally validated within federated testbed environments. To best gain scientific knowledge from these studies, reproducibility and automation are needed in all areas of the experiment life cycle. Within the GENI and FIRE context, several architectures and protocols have been developed for this purpose. However, a major open research issue remains, namely the description and discovery of the heterogeneous resources involved. To remedy this, we propose a semantic information model that can be used to allow declarative interoperability, build dependency graphs, validate requests, infer knowledge and conduct complex queries. The requirements for such an information model have been extracted from current international Future Internet research projects and the practicality of the model is being evaluated through initial implementations. The main outcome of this work is the definition of the Open-Multinet Upper Ontology and related sub-ontologies, which can be used to describe and manage federated infrastructures and their resources.


Components offer various advantages, such as platform and tool independence but composition languages do not address the same independence. We present a platform independent component composition language called Component Markup Language. CoML offers abstractions for component composition and for meta information. We envision different usage scenarios for CoML as a resource script or input for software engineering tools, such as development tools, GUI builders, architecture visualizer tools etc.


Ground irregularities also known as Defected ground structures (DGS) is a freshly presented innovatory way in designing of patch antennas to boost up the performance of antenna constraints. This study presents a novel proposal of ground irregularities or defected ground structure is proposed for suppression of mutual coupling effects among 2xl multiple input multiple output patch array designed on Roggers Duroid 5880. The two adjacent M shape structures surrounding Dumbbell Shaped structure and sandwiched between Dumbbell shape patterns showed the significant level of surface wave suppression up to −46dB while maintaining the gain of 4.7dB and 5.6dBi of directivity. The patch array operates at 4 to 4.3GHz for Fixed and Radio satellite services (FSS) and (RSS) and radio altimeter application systems.


Hypoxia-inducible factor 1 (HIF-1) plays an essential role in tumor angiogenesis and growth by regulating the transcription of several genes in response to hypoxic stress and changes in growth factors. HIF-1 is a heterodimeric transcriptional activator and consists of inducible α and constitutive β subunits. In oxygenated cells, intracellular oxygen concentrations are directly sensed by proteins containing the prolyl hydroxylase domain (PHD), which tag HIF-1α subunits for polyubiquitination and proteasomal degradation by prolyl hydroxylation using 2-oxoglutarate (2-OX) and dioxygen. Our recent studies have shown that 2-OX reduces HIF-1α, erythropoietin, and vascular endothelial growth factor (VEGF) expression by hypoxia in the hepatoma cell line Hep3B (Matsumoto K et al.; J. Cell. Physiol., 2006). Similar results were obtained in Lewis lung cancer (LLC) cells in in vitro studies. Here, to address the clinical usefulness of 2-OX, we investigated its antitumor effect using a mouse dorsal air sac (DAS) assay and a murine tumor xenograft model. For the DAS assay, LLC cells suspended in PBS with 0, 7.5, or 15 mM 2-OX per Millipore chamber were implanted subcutaneously into C57BL/6J mice. The values of blood vessel area by LLC cells were 100 ± 20.8, 64.0 ± 9.4, and 45.6 ± 4.4%, respectively, by quantitative analysis with angiogenesis-measuring software. This result indicated that 2-OX clearly inhibited the growth of subcutaneous tumors. To elucidate the effect of 2-OX on tumor growth, 2-OX was administrated to C57BL/6J mice inoculated with LLC cells. LLC cells (1 × 10 6 ) in PBS were implanted into the right flank region of 7-week-old mice. Daily intraperitoneal (i.p.) injections of 2-OX were started on the next day after implantation. From 6 to 12 days after implantation, we measured tumors with calipers and calculated volumes as (length × width 2 ) × 0.5. LLC tumors were removed from mice 12 days after implantation for quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) and immunohistochemical studies. Tumor volumes and weights 12 days after implantation were as follows: PBS alone, 330.8 ± 108.1 mm 3 and 192.6 ± 66.4 mg; 50 mg/kg 2-OX, 128.8 ± 16.4 mm 3 and 111.0 ± 64.5 mg; and 100 mg/kg 2-OX, 78.7 ± 43.7 mm 3 and 88.8 ± 57.5 mg. Quantitative RT-PCR revealed that 2-OX treatment (100 mg/kg) decreased the expression levels of the VEGF gene 0.67-fold in tumor tissues compared with control. We observed quantitative differences in microvessel density (PBS alone, 100 ± 16.5%; 100 mg/kg 2-OX, 46.0 ± 13.5%) using immunostaining for the endothelial cell marker CD31. Intraperitoneal injection of 2-OX significantly inhibited tumor growth and angiogenesis in tumor tissues. Combination therapy is necessary for anti-angiogenic therapy in the human. To examine the effect of 2-OX in combination with 5-fluorouracil (5-FU) chemotherapy, we injected 5-FU i.p. on day 6 and/or 2-OX i.p. on each of days 6–15 in this mouse model. Tumor volumes and weights 15 days after implantation were as follows: PBS alone, 531.2 ± 144.9 mm 3 and 306.3 ± 186.6 mg; 2-OX alone, 324.0 ± 156.5 mm 3 and 308.7 ± 299.0 mg; 5-FU alone, 287.1 ± 155.2 mm 3 and 204.7 ± 108.9 mg; and 5-FU + 2-OX, 98.7 ± 64.9 mm 3 and 130.3 ± 113.5 mg. 5-FU combined with 2-OX significantly inhibited tumor growth in this model, which was accompanied by 53% reduction of VEGF gene expression in tumor tissues removed from mice 15 days after implantation, using quantitative RT-PCR analysis. These results suggest that 2-OX is a promising anti-angiogenic therapeutic agent. To examine whether the inhibitory effect of 2-OX is specific for PHD-containing proteins, an RNAi study will be performed.


OBJECT
The authors studied new and calcified shunt catheters to identify the prevalence of failures caused by aging materials in the shunt. Complications associated with these devices have various origins. Among late complications, fracture or migration of the system is related to the subcutaneous adhesion of the distal tubing in a growing child. A review of a cohort of 64 children who underwent shunt placement in 1980 with barium-impregnated distal catheters showed that 10 of these patients underwent reoperation for complications related to aging of the shunt material. This group represents 15% of the whole series and 30% of those children who were followed for more than 3 years. The true impact of aging of materials on shunt function is probably underestimated.

METHODS
The authors performed physical, chemical, and mechanical analyses of the retrieved aged catheters and also of new catheters, resulting in the following findings: 1) calcifications were observed only on the external surface of the catheter, predominantly in its subcutaneous segment at the level of the neck and anterior chest wall; 2) calcifications contained particles of free silicon and barium sulfate, signifying fragmentation of the polymer; 3) the microstructure of the silicone polymer was modified: microfractures and alteration of the polymeric network were observed; 4) silanol groups were observed on the external surface of the catheter; and 5) the mechanical properties of the silicone rubber were degraded, and the aged catheters were more brittle than the new ones, with ruptures at elongations and fracture energy much lower than that seen in new catheters. Furthermore, in vitro testing with a metastable solution of simulated body fluid demonstrated the critical impact of pH variations in liquid media and surface degradation of the catheters on the precipitation of hydroxylapatite crystals.

CONCLUSIONS
Although most shunt complications can be addressed by better patient management and surgical technique, late complications appear to be partly related to aging of the material. Distal tubing calcifications have been observed in barium-impregnated catheters. The industry recently responded to these observations by introducing plain silicone-coated shunt tubing; further evaluation will show what improvement can be expected.


Waldenström macroglobulinemia (WM) is a rare malignancy in which clonal B cells infiltrate the bone marrow and give rise to a smaller compartment of neoplastic plasma cells that secrete monoclonal immunoglobulin M paraprotein. Recent studies into underlying mutations in WM have enabled a much greater insight into the pathogenesis of this lymphoma. However, there is considerably less characterization of the way in which WM B cells differentiate and how they respond to immune stimuli. In this study, we assess WM B-cell differentiation using an established in vitro model system. Using T-cell-dependent conditions, we obtained CD138+ plasma cells from WM samples with a frequency similar to experiments performed with B cells from normal donors. Unexpectedly, a proportion of the WM B cells failed to upregulate CD38, a surface marker that is normally associated with plasmablast transition and maintained as the cells proceed with differentiation. In normal B cells, concomitant Toll-like receptor 7 (TLR7) activation and B-cell receptor cross-linking drives proliferation, followed by differentiation at similar efficiency to CD40-mediated stimulation. In contrast, we found that, upon stimulation with TLR7 agonist R848, WM B cells failed to execute the appropriate changes in transcriptional regulators, identifying an uncoupling of TLR signaling from the plasma cell differentiation program. Provision of CD40L was sufficient to overcome this defect. Thus, the limited clonotypic WM plasma cell differentiation observed in vivo may result from a strict requirement for integrated activation.


This article sets out to test the hypothesis that differences in fundamental job characteristics (service vs. regulation) affect discretionary street-level decision-making. The hypothesis was tested by examining whether systematic variation could be found in the moral assessments on which street-level bureaucrats performing different types of core tasks base their decisions. The issue was addressed in a comparative case study comprising three institutions, which differ systematically as far as variables of tasks are concerned. Findings showed that differences in core tasks do affect discretionary decision-making, as divergent moral assessments determine and justify decision-making across different core tasks.


Drought frequency and intensity have increased in recent decades and are expected to escalate in future under the changing climate scenario. However, a wide range of uncertainty exists regarding the risk, variability and severity of the drought. This study evaluates the future drought and associated uncertainty over homogeneous regions of India using the suites of CMIP5 global climate models (GCMs) and CORDEX‐SA regional climate models (RCMs). The drought characteristics and its projected future changes are analysed using probability density functions derived from hydroclimatic parameters, including the standardized precipitation index (SPI) and the standardized precipitation‐evapotranspiration index (SPEI). Besides, uncertainties from various sources such as inter‐model variability, indices type, timescale, adapted methods, and time‐slices are explored under the RCP8.5 emission scenario to the end of the 21st century. Our study reveals large biases in the individual model; however, both the multi model ensembles (GCM and RCM) generally demonstrate better performance with respect to observation. In particular, the RCM ensemble showed limitations in capturing the regional precipitation pattern while temperature and potential evapotranspiration (PET) showed considerable enhancement concerning GCMs. SPI (SPEI) generally exhibited enhanced wetness (dryness) derived from increased precipitation (PET), although a few discrepancies were noticed. The regional heterogeneity was also found to exist, although some robust changes were noticed in drought frequency and severity with different return periods. Our finding underscores a wide range of uncertainties in drought projection, with maximum contribution from indices selection followed by model variability whereas other sources have the least contribution. The primary drivers for all these uncertainty sources arise due to variations among models simulated hydroclimatic variables that need to be parameterized more precisely for sustainable drought management.


OBJECTIVE
The involvement of the cervical spine is the most serious skeletal manifestation of rheumatoid arthritis (RA). Instabilities of the upper cervical spine can lead to neurological complications and signs of vertebrobasilar insufficiency. The study investigates the relationship between the course of the RA and the degree of radiological changes in the cervical spine and describes prognostic factors of cervical spine involvement.

MATERIAL AND METHODS
Clinical data were gathered from 205 patients with RA. Standardized X-ray examination of the cervical spine was performed and arthritic changes were assessed by a semiquantitative score. The association of clinical symptoms with defined radiological changes was evaluated.

RESULTS
Radiological changes in the cervical spine related to RA were found in 67.8% of the patients. Anterior atlantoaxial dislocations were detected in 25.4%, subaxial dislocations in 55.6% and a vertical displacement of the dens in 21.5% of the cases. The degree of radiological changes in the cervical spine was not directly correlated with neurological symptoms. Age above 55 years, disease duration of more than 10 years, an onset of cervical pain later than 11 years after the diagnosis of RA, steroid therapy for more than 5 years, bilateral shoulder involvement and the presence of severe erosive changes in at least one peripheral joint were positively associated with the development of severe changes in the cervical spine. In patients with basilar impression, paraesthesia in the upper extremities was significantly more common.

CONCLUSION
Prognostic factors are helpful for the assessment of risk of cervical spine involvement in RA. Since definite clinical hints for cervical involvement are absent, the cervical spine has to be included in the routine examination of patients with RA.


The cost increases for pharmaceuticals obliges our political and health care officials to attempt to contain these costs. One possible measure which must be carefully taken under consideration is to apply a policy using generic medicines which ensures the quality, efficiency and security aspects of generic medicines. In this article, the author reviews the concept and definition of what is the generic pharmaceutical specialty; the requirements necessary to comply with in order for a medication to be classified as generic; the current status of these medications in Spain; the factors regarding their prescription, dispensation and substitution for established medications; and the advantages and disadvantages of their use.


This engaging and accessible book is a must-read for every taxpayer, young and old. It explores the many forms of taxation; how taxes are created, collected, and spent; and why certain aspects of taxation are so controversial.
 "In this world, nothing can be said to be certain, except death and taxes." Benjamin Franklin wrote this now-famous quote more than 200 years ago, and taxation remains just as important (and inevitable) today as then. Taxes are a fact of life for almost everyone, and the public goods and services they pay for are enjoyed by all citizens.
 While taxes are undeniably necessary, the specifics of what should be taxed, who should pay taxes, and at what rate remain hotly debated by economists, government officials, and regular citizens. The first in Greenwood's new Student Guides to Business and Economics series, Taxation gives readers an in-depth yet reader-friendly look at one of economics' foundational concepts. Using simple language and relevant real-world examples, the book explores the different forms of taxation, the necessary components of any tax, how taxes are created and collected, and much more. It also highlights contemporary controversies related to taxation, including whether or not "sin taxes" actually discourage unwanted behaviors like smoking and how best to simplify the tax filing process.


In this paper, low temperature plasma is used to modify the surface of barium titanate (BaTiO3) nanoparticles in order to enhance the interfacial compatibility between ferroelectric poly(vinylidene fluoride) (PVDF) and BaTiO3 nanoparticles. The results demonstrate that oxygenic groups are successfully attached to the BaTiO3 surface, and the quantity of the functional groups increases with the treatment voltage. Furthermore, the effect of modified BaTiO3 nanoparticles on the morphology and crystal structure of the PVDF/BaTiO3 membrane is investigated. The results reveal that the dispersion of BaTiO3 nanoparticles in the PVDF matrix was greatly improved due to the modification of the BaTiO3 nanoparticles by air plasma. It is worth noting that the formation of a β-phase in a PVDF/modified BaTiO3 membrane is observably promoted, which results from the strong interaction between PVDF chains and oxygenic groups fixed on the BaTiO3 surface and the better dispersion of BaTiO3 nanoparticles in the PVDF matrix. Besides, the PVDF/modified BaTiO3 membrane at the treatment voltage of 24 kV exhibits a lower water contact angle (≈68.4°) compared with the unmodified one (≈86.7°). Meanwhile, the dielectric constant of PVDF/BaTiO3 nanocomposites increases with the increase of working voltage.


To the Editor.— The article by Dr Stern (236:963, 1976) entitled "Roentgenographic Aspects of Narcotic Addiction" states that the observation of gynecomastia in an addict's chest roentgenogram may be a clue to the diagnosis of hepatitis. Although gynecomastia is widely recognized as an occasional physical sign in patients with cirrhosis, it is certainly not frequent in the type of acute hepatitis seen in drug addicts. Inability of the diseased liver to deactivate circulating estrogens would not be an acceptable pathogenetic mechanism for gynecomastia in recently acquired hepatitis, and there is some doubt, too, that it is the real explanation for gynecomastia in cirrhotic patients. The incidence of acute alcoholism and drug addiction is very high in Jersey City. We have seen many patients with hepatitis resulting from heroin use in the past five years, but I cannot recall seeing gynecomastia in the early evolutionary stage of this disease. The occurrence


An attempt is made here to model the complex resistivity effect which is utilized in the geophysical exploration for disseminated sulphide mineralization. A model of a hypothetical mineral grain is developed, and the complex resistivity of a medium loaded with such grains is studied. First, quasistatic electrical conditions (Wait, 1982) are used so that the problem can be solved by using potential fields. The equations are developed in spheroidal coordinates; however, a uniform nonconfocal grain surface impedance is used that does not allow a closed-form solution (Wait, 1958, 1983α). Therefore, approximate solutions are obtained by using numerical techniques (Flanagan, 1983). Sample calculations of complex, frequency-dependent resistivities of a hypothetical pyrite ore are presented. These calculations are based on experimentally determined surface impedance data for pyrite, taken from the literature (Olhoeft, 1982; Collett, 1959).


The arithmetic operations involved in carry select adder (CSLA) and binary to Excess-1 converter (BEC) based CSLA are analysed.CSLA has great scope by reducing area, delay and power consumption. However the regular CSLA is still area consuming due to dual ripple carry adder (RCA) structure, for reducing the area.CSLA can be implemented by using single RCA and BEC converter. In proposed architecture I present and innovated multistage SQRT-CSLA architecture. The substantiation of the proposed design is done through design and implementation of 16-bit adder circuit with multipath carry propagation feature. Simulated results show that the proposed architecture achieves two advantages that is 48% less ADP and 50% less power consumption. Than the CSLA and CSLA with BEC.For simulation Xilinx ISE is used. . In this paper, conventional CSLA is compared with Modified Carry select adder (MCSLA), Regular Square Root CSLA (SQRT CSLA), Modified SQRT CSLA and Proposed SQRT CSLA in terms of area, delay and power consumption. The result analysis shows that the proposed structure is better than the conventional CSLA.


The Amazon is still the center of expansion of the construction of numerous dams for electricity power generation. These enterprises generate major impacts that may alter the spatiotemporal distribution patterns of limnological parameters, as in the phytoplankton community. The objective of this study was to identify the spatiotemporal distribution patterns of the phytoplankton community and their relationship with the limnological variables of the Curuá-Una reservoir. We collected the samples from May 2016 to February 2017. The limnological variables collected were: water transparency, conductivity, turbidity, dissolved oxygen, pH, BOD, nitrate, silica, total phosphorus, chlorophyll a. The samples of phytoplankton were quantified at density expressed in individuals.mL1. To analyze the spatiotemporal variation, a two-way ANOVA and a Canonical Correspondence Analysis (CCA) were performed to evaluate which limnological variables are strongly associated with algal density in the reservoir. The studied community consisted of 214 species were distributed in eight taxonomic groups: 98 Chlorophyta, 70 Bacillariophyta, two Cryptophyta, four Dinophyta, five Cyanophyta, 22 Euglenophyta, 11 Crysophyta and 3 Heterokontophyta. In the ANOVA and CCA analysis, it was very clear that the seasonal distribution pattern is strongly significant, because high dry season density values coincide with higher chlorophyll a and total phosphorus values.


ABSTRACT This paper analyzes fiscal policy from a growth model perspective, with a particular focus on taxation. It argues that tax policies channel resources into specific sectors of the economy and thereby affect the distribution of market incomes. Tax policy can thus be a mid-range form of industrial policy which does not leave resource allocation entirely to the market but does also not seek to "pick winners". To develop policies that help to rebalance existing growth models and to reduce inequality, this understanding of tax policy, and fiscal policy more broadly, needs to return to the agenda of researchers and policymakers.


This work studies sequential assignment match processes, in which random offers arrive sequentially according to a renewal process, and when an offer arrives it must be assigned to one of given waiting candidates or rejected. Each candidate as well as each offer is characterized by an attribute. If the offer is assigned to a candidate that it matches, a reward R is received; if it is assigned to a candidate that it does not match, a reward r ≤ R is received; and if it is rejected, there is no reward. There is an arbitrary discount function, which corresponds to the process terminating after a random lifetime. Using continuoustime dynamic programming, we show that if this lifetime is decreasing in failure rate and candidates have distinct attributes, then the policy that maximizes total expected discounted reward is of a very simple form that is easily determined from the optimal single-candidate policy. If the lifetime is increasing in failure rate, the optimal policy can be recursively determined: a solution algorithm is presented that involves scalar rather than functional equations. The model originated in the study of optimal donor-recipient assignment in live-organ transplants. Some other applications are mentioned as well.


Background: Fibrin as an extracellular matrix feature like biocompatibility, creates a favorable environment for proliferation and migration of cells and acts as a reservoir for storage and release of growth factors in tissue engineering. Methods: In this study, the inner surface electrospun poly (lactic-co-glycolic acid) (PLGA) nanofibrous conduit was biofunctionalized with laminin containing brain derived neurotrophic factor (BDNF) and gold nanoparticles in chitosan nanoparticle. The rats were randomly divided into five groups, including autograft group as the positive control, PLGA conduit coated by laminin and filled with DMEM/F12, PLGA conduit coated by laminin and filled with adipose-derived stem cells (rADSCs) , PLGA conduit coated by laminin containing gold-chitosan nanoparticles (AuNPs-CNPs), BDNF-chitosan nanoparticles (BDNF-CNPs) and filled with rADSCs or filled with rADSCs suspended in fibrin matrix, and they were implanted to bridge a 10 mm rat sciatic nerve gap. Eventually, axonal regeneration and functional recovery were assessed after 12 weeks.Results: After 3months post-surgery period, the results showed that in the PLGA conduit filled with rADSCs without fibrin matrix group, positive effects were obtained as compared to other implanted groups by increasing the sciatic functional index significantly (p < 0.05). In addition, the diameter nerve fibers had a significant difference mean in the PLGA conduit coated by laminin and conduit filled with rADSCs in fibrin matrix groups relative to the autograft group (p< 0.001). However, G-ratio and amplitude (AMP) results showed that fibrin matrix might have beneficial effects on nerve regeneration but, immunohistochemistry and real-time PCR outcomes indicated that the implanted conduit which filled with rADSCs with or without BDNF-CNPs and AuNPs-CNPs had significantly higher expression of S100, MBP and NF200 markers than other conduit implanted groups (p< 0.05).Conclusions: It seems, in this study differential effects of fibrin matrix, could be interfered it with other factors thereby and further studies are required to determine the distinctive effects of fibrin matrix combination with other exogenous factors in peripheral nerve regeneration.


In this work, we study the problem of aggregating a finite number of
 predictors for non stationary sub-linear processes. We provide oracle
 inequalities relying essentially on three ingredients: 1) a uniform bound of
 the $\ell^1$ norm of the time-varying sub-linear coefficients, 2) a Lipschitz
 assumption on the predictors and 3) moment conditions on the noise appearing
 in the linear representation. Two kinds of aggregations are considered giving
 rise to different moment conditions on the noise and more or less sharp
 oracle inequalities. We apply
 this approach for deriving an adaptive predictor for locally stationary time
 varying autoregressive (TVAR) processes. It is obtained by aggregating a
 finite number of well chosen predictors, each of them enjoying an optimal
 minimax convergence rate under specific smoothness conditions on the TVAR
 coefficients. We show that the obtained aggregated predictor achieves a
 minimax rate while adapting to the unknown smoothness. To prove
 this result, a lower bound is established for the minimax rate of the
 prediction risk for the TVAR process. Numerical experiments complete this
 study. An important feature of this approach is that the aggregated predictor
 can be computed recursively and is thus applicable in an online prediction
 context.


Three mirror anastigmats (TMA) are telescopic optical systems with only plane symmetry, that allow for good image quality without any central obscuration. The complexities of manufacturing and alignment can be reduced by fabricating the first mirror and the third mirror in one piece and defining a common axis of all the mirrors. It is attractive to use off-axis used aspheres and to come to an acceptable performance with the smallest number of freeform surfaces. In this paper, different types of freeform surfaces are considered to evaluate their potential. In the performed case study, the correction of spherical aberration and coma is best corrected in the pupil with the second mirror and to select the Zernike representation with remaining x-symmetry is one of the best ways to do this. The use of the Chebyshev polynomials also gives good results. Furthermore it is found, that the first mirror and the third mirror are quite beneficial to be modelled as off-axis aspheres of the Q-type. The result shows that a combination of two Q-aspheres with a Zernike surface at the second mirror is one of the most favorable combinations.


In online social networks, the incomplete or noisy data are usual conditions raising increasingly the need for more accurate methods; especially in user attribute profiling. This work explores the influence of social tie strength in such settings, based on the intuition that the stronger the relationship is, the more likely its members are to share the same attribute values. A Strength-sensitive community-based social profiling process, named SCoBSP, is introduced under this research and the above hypothesis is tested on real world co-authorship networks from the DBLP computer science bibliography. Experimental results demonstrate the ability of SCoBSP to infer attributes accurately, achieving an improvement of 9.18 % in terms of F-measure over the strength-agnostic process.


OBJECTIVES
To characterize variation in pediatricians' telephone referral practices, to identify differences in the types of referrals made during telephone versus office visit encounters, and to examine the impact of referring by telephone on coordination and outcomes of the referral as assessed by physicians.

METHODS
We conducted a prospective study of a consecutive sample of referrals (N = 1856) made from the offices of 142 pediatricians in a national practice-based research network. During 20 consecutive practice-days, physicians completed questionnaires about patients referred during regular business hours. They used office records 3 months later to complete questionnaires about referral outcomes.

RESULTS
Pediatricians made 1 telephone referral every 5 practice-days, which constituted 27.5% of all referrals they made during office hours. Pediatricians who saw more patients per day, saw more patients in gatekeeping health plans, and referred more during office visits made more telephone referrals than their counterparts. Compared with specialty referrals made during office visits, those occurring during telephone encounters were more frequently at the request of parents or because of insurance administrative guidelines. Office visit referrals were more often made for diagnostic evaluation or a surgical procedure. Referrals made during telephone conversations were less well coordinated: office staff or referring physicians scheduled fewer specialty appointments and were less likely to send information to specialists. Three months after referrals were made, specialist feedback and referring physician satisfaction with specialty care were comparable between the two groups.

CONCLUSIONS
Specialty referrals made during telephone conversations with patients are a regular occurrence in pediatric practice. Changes in the health system that lead to greater demands on primary care physician productivity or more patients in gatekeeping health plans will likely increase the number of referrals made during telephone conversations with parents. Pediatricians are less likely to coordinate telephone referrals than office visit referrals. Pediatricians are frequently unaware whether or not referrals are completed.


Strong coupling of molecules to the vacuum field of micro cavities can modify the potential energy surfaces thereby opening new photophysical and photochemical reaction pathways. While the influence of laser fields is usually described in terms of classical field, coupling to the vacuum state of a cavity has to be described in terms of dressed photon-matter states (polaritons) which require quantized fields. We present a derivation of the non-adiabatic couplings for single molecules in the strong coupling regime suitable for the calculation of the dressed state dynamics. The formalism allows to use quantities readily accessible from quantum chemistry codes like the adiabatic potential energy surfaces and dipole moments to carry out wave packet simulations in the dressed basis. The implications for photochemistry are demonstrated for a set of model systems representing typical situations found in molecules.


This paper reports on DC pulse-powered microdischarges in air at atmospheric pressure and their potential utility in chemical sensing. For electrode gaps of 50-100 mum, microdischarges take the form of a glow discharge, an arc discharge, or a hybrid of the two. Arc microdischarges have high optical intensity but suffer from high background emission. Glow microdischarges have low background emission, but the prominent emission is confined in the UV-blue region of the spectrum. The arc-glow hybrid has characteristics that are intermediate between the two and can be tuned by circuitry to suit the chemical sensing application. A handheld system for chemical analysis using synchronized emission spectroscopy of these pulsed microdischarges is demonstrated. The system employs an exchangeable sensor chip (different for gas and liquid samples), a control circuit, and a commercially available portable spectrum analyzer coupled to a handheld computer. A pump and inert carrier gases are not utilized. The system can generate one or a series of single-shot microdischarges per chemical analysis. The gas discharge microchip, which utilizes electroplated copper electrodes on a glass substrate, has an electrode separation of 75 mum and an active area of 300times300 mum2. The handheld system has been used to detect 17 ppm of acetone vapor in air. The liquid discharge microchip also has an electrode gap of 75 mum and an active area of 1times1 mm2. It uses a porous cathode fabricated by micromolding and sintering glass frit slurry in a microchannel. When a microdischarge is initiated between the metal anode and the wet cathode, the liquid is sputtered into the microdischarge and emits characteristic line spectra. In this configuration, the system can detect 2 ppm of aqueous Cr without preconcentration.


In this paper, a highly parallelized Clock & Data Recovery (CDR) architecture with phase feedback at the bit rate is presented. This parallel CDR features demultiplexing directly at the input, which reduces circuit speed requirements and enables extensive use of standard CMOS logic which only draws dynamic power, resulting in excellent power efficiency over a wide range of speeds: power consumption is below 4.6 pJ/bit between 2.4 and 6 Gbit/s. Parallel CDRs have limited loop bandwidth and jitter tolerance due to latency in the phase-feedback loop. Our architecture solves this problem by applying feedback at the bit rate, resulting in jitter tolerance beyond 4.3 UI at 1 MHz.


The use of static system-level simulators is common practice for estimating the impact of re-planning actions in cellular networks. In this paper, a modification of a classical static Long Term Evolution (LTE) simulator is proposed to estimate the Quality of Experience (QoE) provided in each location on a per-service basis. The core of the simulator is the estimation of radio connection throughput on a location and service basis. For this purpose, a new analytical performance model for the packet scheduling process in a multi-service scenario is developed. Model parameters can easily be adjusted with information from radio connection traces available in the network management system. The simulation tool is validated with a large trace dataset taken from a live LTE network.


Serum samples of 746 shot wild boars collected throughout Slovenia during the hunting season of 2005/2006 were examined for the presence of antibodies against rabies virus: 541 samples were collected in areas subjected to yearly antirabies vaccination, and 205 samples were collected in areas where preventive antirabies vaccination was not practised. Using a modified enzyme-linked immunosorbent assay (ELISA), in 209 out of 746 sera (28%) the levels of antibodies against rabies virus were higher than 0.5 IU/ml and deemed positive. A total of 173/541 (32%) and 36/205 (18%) samples were positive in the vaccinated and nonvaccinated areas, respectively. Further analysis of 191 out of the 746 samples using the fluorescent antibody virus neutralisation (FAVN) test revealed the presence of antibodies against rabies virus in 122/191 (64%) samples. This is the first extended research reporting that antibodies against rabies virus that originate from preventive oral vaccination targeting the fox population are present in wild boar.


In current article, results of the determination of
the concentrations of vascular endothelial growth factor (VEGF), and some
interleukins (IL-4, IL-6, IL-10, IL-17А) in the vitreous of patients with
proliferative diabetic retinopathy are presented. We have found that in the
mechanism of development of diabetic retinopathy, significant role plays an activation
of local inflammation process and vascular proliferation. This is evidenced by
a significant increase in the vitreous concentration of IL-4, IL-6, IL-10,
IL-17A and vascular endothelial growth factor. Identified correlations between
VEGF and IL-17A, between VEGF and IL-4, and between IL-17A and IL-4 show the
relationship of inflammation and proliferation processes in the pathogenesis of
diabetic retinopathy.


This paper describes the design, implementation, and performance of the Inversion file system. Inversion provides a rich set of services to file system users, and manages a large tertiary data store. Inversion is built on top of the POSTGRES database system, and takes advantage of low-level DBMS services to provide transaction protection, fine-grained time travel, and fast crash recovery for user files and file system metadata. Inversion gets between 30% and 80% of the throughput of ULTRIX NFS backed by a non-volatile RAM cache. In addition, Inversion allows users to provide code for execution directly in the file system manager, yielding performance as much as seven times better than that of ULTRIX NFS.


James A. Storing has been a student of Norwegian constitutional development and politics for well over twenty-five years. In Norwegian Democracy he has provided the best introduction to Norwegian government available in either English or Norwegian. His emphasis is upon the development, powers, organization and operation of institutions and upon the most prominent areas of public policy. There are chapters on each of the branches of government, on local government, the political parties, the social security system, the role of the state in the economy, and the guiding principles of foreign policy. Storing facilitates understanding by including comparisons to English and American institutions and practices. His book is up-to-date, well-written and admirable for its historical overviews.


As Western society becomes increasingly multicultural in character, schools must reassess the provision of religious education and look at how they might adapt in order to accommodate students' diverse experiences of plurality. This book offers a critical view of approaches to the treatment of different religions in contemporary education, in order to devise approaches to teaching and learning and to formulate policies and procedures that are fair and just to all. Beginning with a contextual overview of the religious, social and cultural changes of the past fifty years, the book goes on to illuminate and assess six different responses to the challenges posed by religious plurality in schools. Conclusions are drawn from the various positions explored in this book, identifying what the character of religious education should be, how it should be taught and addressing the issues raised for policy, practice and research. Rethinking Religious Education and Plurality argues for a plural approach to education and will be a valuable resource for students and researchers studying courses in religious education as well as teachers, education advisers and policy makers.


Abstract The aim of this study was to find out the condition of coral reef coverage and the presence of Chaetodontidae fish in coastal waters of Jayapura City, Indonesia. The observation of coral reef coverage was performed using point intercept transect (PIT) method; meanwhile the observation of the presence of Chaetodontidae fish used visual census method. The result of this study described that coral reef condition in the study site was in severely damage (live coral 0%) in the DOK II site at 6 m depth, moderately damage (live coral 32.00% ± 2.13% to 42.00% ± 13.18%) in Kayu Pulo Island and the DOK II at 3 m depth, and good condition (live coral 56.00% ± 7.48% to 60.00% ± 5.55%) in the Tanjung Kayu Batu. There were 9 Chaetodontidae fish species from Chaetodon genus, Forcipiger genus, and Heniochus genus. The number of Chaetodontidae fish was 95, of which Heniochus acuminatus was the most dominant, as many as 46 individuals.


Objective: To determine the frequency of biochemical abnormalities in developmentally normal children presenting with new onset seizures
Methodology: This descriptive cross sectional study was carried out in 131 children presenting in Pediatrics emergency department, Liaquat National Hospital from March 1, to September 30, 2015. Children with very first episode of seizure, aged >1month to less than or equal to 12 years with either active seizures or with history of seizure, as witnessed by the care taker were included in the study. Serum glucose, calcium and magnesium were analyzed and frequency of biochemical abnormalities was determined.
Results: Abnormal serum glucose was observed in 4.5% children and abnormal calcium and magnesium were seen in 18.3% and 2.2% cases, respectively. An overall biochemical abnormality (serum glucose, calcium and magnesium) in children with new onset seizures was observed in 27 (20.6%) children. Both serum glucose and calcium were abnormal in 3(2.2%) cases and both serum calcium and magnesium were abnormal in 3(2.2%) cases.
Conclusion: The diagnosis of biochemical abnormalities is imperative because it alters the therapeutic management of these patients. These tests could be particularly beneficial in children under 1 year, since signs of serum chemistry disturbances are non-specific or are even absent at this age. In older children, these tests should be judiciously advised as guided by history and examination.


Abstract This paper studies the distribution of zeros of certain Epstein zeta functions, associated to positive definite binary quadratic forms with class number 2, in the region of absolute convergence of their Dirichlet series. In particular, one obtains upper and lower bounds for the rate of approach of zeros to the boundary of the zero-free half-plane for such functions. The proof for the lower bound depends on Bohr's method for studying simultaneous diophantine approximations. The upper bound uses instead a deep result on the diophantine type of the ratio of the logarithms of two rational numbers. 2000 Mathematics Subject Classification: 11E45; 11M41.


Something like "global Keynesianism" or "transnational socialism" has been mentioned as a desirable alternative to global neoliberalism (Redmond 1997). However, a definition of this kind of global Keynesianism is hard to find. Many leftists tend to associate Keynesianism with corporate power. However, there are also numerous other leftists who view this differently. For example, a member of parliament for the German Green Party stated in a recent interview that "a reformist party today has to be a left-Keynesian party which contradicts the logic of capital" (Ebermann 1998). A number of scholars from several countries, including Canada, pursue post-Keynesian-ism, in the sense of left-Keynesian economics (e.g., Seccareccia 1991). How-ever, available left-Keynesian literature, as I see it, is lacking a world-system perspective. I am trying in this article to synthesize the two perspectives-namely, left-Keynesianism and world-system theory, leading to a perspective of global left-Keynesianism. This leftist global Keynesianism can, perhaps, be described as an approach to economics which emphasizes responsible public management of economic problems in a world-system context. Common themes in global Keynesianism include the importance of public management, democratic politics, the mixed economy, global income distribution, the management of global demand, investment and money, ecological sustainability and the importance of multiple levels of public management-local, national, regional and global.


Abstract A coupled system of wind, wind wave, and coastal circulation models has been implemented for southern Louisiana and Mississippi to simulate riverine flows, tides, wind waves, and hurricane storm surge in the region. The system combines the NOAA Hurricane Research Division Wind Analysis System (H*WIND) and the Interactive Objective Kinematic Analysis (IOKA) kinematic wind analyses, the Wave Model (WAM) offshore and Steady-State Irregular Wave (STWAVE) nearshore wind wave models, and the Advanced Circulation (ADCIRC) basin to channel-scale unstructured grid circulation model. The system emphasizes a high-resolution (down to 50 m) representation of the geometry, bathymetry, and topography; nonlinear coupling of all processes including wind wave radiation stress-induced set up; and objective specification of frictional parameters based on land-cover databases and commonly used parameters. Riverine flows and tides are validated for no storm conditions, while winds, wind waves, hydrographs, and high wa...


Wireless Sensor Networks (WSNs) are composed of multiple sensor nodes which communicate with each other and one or more base stations wirelessly, and are applied in many fields, including military, ecological and environmental monitoring. However, the wormhole attack problem is a significant security issue in WSNs. The wormhole in the attack consists of one or more pairs of malicious nodes. They will receive and transmit the information of the neighbor node through a special tunnel to other wormhole nodes. This may result in many problems, such as packet routing errors, reduced node lifetimes and even damage the entire network topology. This paper improves a defense method that utilizes the neighbor information collected by mobile nodes without extra hardware, complex calculation or increased resource consumption. A moving average indicator combined with logic operation, the proposed method applies a Quantum-inspired Tabu Search (QTS) algorithm to effectively find combinations enabling the detection of wormholes. Finally, the experimental results show that the proposed method only uses the number of neighbors and can still effectively detect wormhole attacks.


This paper describes the design and application of a new statistical method for real-time syndromic surveillance, used by Public Health England. The Rising Activity, Multi-level Mixed effects, Indicator Emphasis (RAMMIE) statistical method was developed and tested alongside existing methods before being applied to a suite of syndromic surveillance in operation in England. The RAMMIE method has proved to be a reliable, effective method for generating automated alarms for syndromic surveillance. The multi-level models have enabled local models to be created for the first time across all systems and models have proved themselves to be robust across all the signals.


Studies of material objects in the field of memory studies have followed diverse epistemological and disciplinary trajectories, but their shared characteristic has been the questioning of philosophical assumptions concerning human relations with inanimate things and lower-level organic objects, such as plants, within the Aristotelian hierarchy of beings. Rather than accept at face value their categorizations as passive or deficient in comparison to the human subject, critical scholarship has reformulated the place and role of nonhuman entities in culture. This essay examines the nexus of materiality and memory in the work of the French philosopher and art historian Georges Didi-Huberman, with the focus on the questions of mnemonic affordance of things and plants. The essay proposes that Didi-Huberman's project can be approached from the perspective of "undoing" the key binaries of Western historiography of art and material culture: surface/depth, exteriority/interiority, visibility/invisibility, and malleability/rigidity. Focusing on imaginal representations of memory objects in Didi-Huberman's two essays Bark and Being a Skull, the essay situates these texts within the context of his philosophical reading of Aby Warburg's iconology, and argues that Didi-Huberman's undoing of the binaries that have traditionally structured thinking about materiality and memory could be productively approached as a philosophical project of transvaluating surface.


Supplemental Digital Content is available in the text. Introduction. Although pulmonary function testing (PFT) is typically performed for heart transplant evaluation, the prognostic utility of PFTs after transplantation is unknown. We evaluated whether PFT parameters were correlated with outcomes following heart transplantation. Methods. International Society for Heart and Lung Transplantation Thoracic Organ Transplant Registry data were utilized. Survival was assessed using Kaplan-Meier method and compared via log-rank test. Cox proportional hazard modeling was used to evaluate univariate and multivariate predictors of survival. Results. Eight hundred two patients pretransplant PFT data were available for evaluation. Forced expiratory volume in 1 s (FEV1) < 50% predicted (P < 0.0001), and forced vital capacity (FVC) < 50% predicted each had significantly higher mortality (P = 0.001) compared with patients with FEV1 or FVC 50%–80% or >80%. FEV1/FVC < 0.7 was not associated with increased mortality. FEV1 and FVC below 50% both predicted longer lengths of stay (P = 0.028 for FEV1 and P = 0.0075 for FVC). After adjusting for male gender, age, body mass index, smoking history, chronic obstructive pulmonary disease, creatinine, albumin, and total bilirubin, FEV1 < 50% (hazard ratio, 4.91; P < 0.0001; 95% confidence interval, 2.69-8.94) and FVC < 50% (hazard ratio, 2.75; P = 0.003; 95% confidence interval, 1.4-5.4) both remained independent predictors of mortality. Conclusions. Abnormal pulmonary function (FEV1 or FVC below 50% of predicted) pre–heart transplantation is associated with increased mortality and longer lengths of stay posttransplant.


B lymphopoiesis is regulated by multiple signals from stromal cell contact, soluble cytokines, antigen, and T helper cells. In vitro and biochemical experiments have implicated tyrosine kinases as key components of many of these signaling pathways. Genetic analysis of the role of these tyrosine kinases has been facilitated by recent advance in transgenic and gene targeting technology as well as by the identification of the genetic basis of several human and murine immune deficiencies. This review discusses the effect of gain and loss of function mutations of selected tyrosine kinases and their regulators and substrates on B cell development and function.


For those OHPs returning to study at diploma level educational approaches encouraging independent thought can present unexpected new challenges. James Garvey discusses teaching strategies in higher education and argues that it is time to get away from the formal learning situations of the past.


Objective. The relationship between coeliac disease and inflammatory bowel disease (IBD) is controversial. The aim of this study was to determine the prevalence of coeliac disease in IBD and the prevalence of IBD in coeliac disease. Material and methods. Patients were enrolled from specialist IBD and coeliac clinics. Antigliadins, endomysial, tissue transglutaminase antibody and total IgA levels were measured in IBD patients. Patients with positive antibodies were offered a duodenal biopsy. The notes on coeliac patients were reviewed for colonoscopic and biopsy findings. Controls were recruited from the local population. Results. The study included 305 patients with coeliac disease, 354 with IBD and 601 healthy controls. The IBD group comprised 154 ulcerative colitis (UC) cases, 173 Crohn's disease, 18 indeterminate colitis and 9 cases of microscopic colitis. Forty-seven patients had positive antibodies and 3 had villous atrophy on biopsy. All three patients had positive anti-tissue transglutaminase antibodies but only two were endomysial antibody (EMA) positive. Ten coeliac patients had IBD (5 UC and 5 lymphocytic colitis). Five controls had coeliac disease and 2 had IBD (1 Crohn's disease and 1 UC). Stepwise multiple logistic regression showed only antibody positivity as being significant (p<0.0001). Conclusions. The prevalence of IBD in coeliac disease was increased 10-fold compared with that in controls (odds ratio 9.98, 95% CI 2.8–45.9, p=0.0006), while the prevalence of coeliac disease in IBD was comparable with that in controls (odds ratio 1.02, 95% CI, 0.24–4.29, p=1.0).