The assurance, or verification, of the level of quality of measurements is essentially a three-step process. First, the acceptable uncertainty must be established, usually on the basis of a published standard or national regulation. Second, a facility must have procedures in place that will lead to performance within the specified uncertainty. Third, the facility must demonstrate its capability of performing measurements within the specified uncertainty. An additional related concept that follows from the third step is a plan for remedial action when a facility fails to perform within this specified uncertainty. Measurement quality can be evaluated using a variety of techniques. Perhaps the simplest method for evaluating the quality of a measurement is the direct comparison to a national standard. For instance, a working-level ionization chamber may be periodically compared with a reference or transfer standard that has in turn been compared with a national standard. If the value measured using the chamber agrees with the value measured using the reference standard chamber to within a specified uncertainty, then the measurement quality is assured. If the difference is greater than the expanded uncertainty (see Section 5.2) the cause of this difference should be investigated and appropriate remedial action taken. Until the discrepancy is resolved, no measurements should be used or disseminated. Any such measurement disseminated, but also affected by the discrepancy, shall be identified and appropriate action taken (e.g., informing the customer).


Chronic pancreatic-fistula rats were given subcutaneously 0.25, 0.5, 1.0 and 2.0 u of insulin after a fast of 12–16 hours. The volume flow and the amylase output were both significantly increased at a dose of 0.5 u. Insulin at a total dose of 1.0 and 2.0 u increased the amylase output but had no significant effect on the volume flow. The effect of insulin on either volume flow or amylase output was abolished by vagotomy. Under repeated secretin injection and urethane anesthesia, weak faradic stimulation of the peripheral end of the vagus also significantly increased the amylase concentration as well as its output. These findings demonstrate that there are vagal 'secretory' fibers for pancreatic secretion in the rat.


Background: Forests have a huge potential to mitigate global warming through CO2 accumulation in their living biomass. Thus, understanding the functioning of these ecosystems is crucial for revealing factors that drive biomass accumulation. Functional diversity helps us understand ecosystem services, including biomass accumulation. Within this context, this work aimed to investigate the role of functional diversity in biomass accumulation for woody vegetation of the Cerradão.
Methods: We estimated above-ground biomass (AGB) of 50 Cerradão stands in Brazil and measured five different functional traits associated with tree species' survival and growth. For each stand, we calculated five community-weighted means (CWMs), based on each functional trait, and three functional diversity metrics. We specifically explored the relationship between CWMs describing functional diversity metrics and AGB. After that, exponential regressions were adjusted, using the variables that presented significant correlation as independent variables and AGB as a dependent variable. Regressions with more than one independent variable were fitted in a way that avoided collinearity. Based on the strongest correlation coefficient (r) and the lowest Akaike value (AIC), we chose the best regression to explain the majority of the variance in AGB.
Results: Our results showed the role of function in determining AGB. In particular, bivariate correlations show that four CWM functional traits and two functional diversity metrics are significantly associated with AGB production, with CWM showing AGB estimation variables. However, multiple regression analyses show that maximum height is the only trait significantly associated with AGB and it alone provides the best model fit.
Conclusions: The accumulation of AGB in Cerradão is explained by the mass ratio theory, and this ecosystem services is directly related to the presence and abundance of species with greater potential tree height (Htmax).


This paper gives an overview of binaries with ultra-short periods, discusses possible ways in which such binaries are formed and estimates the number of such binaries and their relative importance for the space-based gravitational wave detector LISA.


Purpose: This study was done to evaluate the long-term effects of a dementia education program for certified geriatric caregivers (CGCs) caring for elders with dementia in a nursing home. Methods: The research design was one group pretest-posttest design and included 29 CGCs who completed the pre-test, dementia education program, and post-test (immediately after, 1 month after, and 3 months after the completion of the program). The education program was conducted for 3 weeks, and effects of the program were evaluated using measures of knowledge of dementia, care of elders with dementia, work stress, and work satisfaction. Results: Although there was no significant change in the knowledge of dementia, it was significantly improved immediately after the program (Z=-2.03, p=.042). There was a significant change in the care of elders with dementia by the CGCs (x2=13.37, p=.004), but no significant changes in work stress or work satisfaction. Conclusion: The findings indicate that dementia education program is effective in improving knowledge of dementia and care of elders with dementia by CGCs. The results also provide valuable basic data for developing effective dementia education programs for CGCs in nursing homes, but further research is needed using a high quality education programs and research methodology.


A total of 237 rodents was collected in 4 regions of South Carolina from July 1994 through December 1995. Eight species were collected, including cotton mouse, hispid cotton rat, eastern woodrat, marsh rice rat, white-footed mouse, eastern harvest mouse, golden mouse, and black rat. Of the 1,514 ticks recovered from these hosts, Ixodes minor Neumann, including larvae, nymphs, and adults, was the most abundant species, representing 54% of the total. Only immature stages of other tick species were found, including larvae and nymphs of Dermacentor variabilis (Say), Amblyomma maculatum Koch, Ixodes affinis Neumann, and Ixodes scapularis Say. All 5 tick species parasitized cotton mice, cotton rats, and woodrats, which were the most important small mammal hosts for ticks at the localities studied. Rice rats were hosts of A. maculatum, D. variabilis, and I. minor. Amblyomma maculatum was more strongly associated with cotton rats than other rodent species. Ixodes scapularis was most strongly associated with cotton mice, and I. minor was more strongly associated with both woodrats and cotton mice than other species of rodents. Ixodes minor parasitized hosts in the Coastal Zone only, where among spirochete-infected hosts, it was present in significantly greater numbers than other ticks. Furthermore, I. minor was the only tick species that showed a statistically significant positive association with spirochetal infection in rodents. More I. affinis parasitized spirochete-infected hosts than I. scapularis, but fewer than I. minor. The findings discussed herein provide evidence that implicates I. minor as the possible primary enzootic vector of the Lyme disease spirochete Borrelia burgdorferi Johnson, Schmid, Hyde, Steigerwalt and Brenner in the Coastal Zone of South Carolina. They also indicate that the high level of B. burgdorferi infection in rodents from this region may be a function of the combined involvement of I. minor, I. affinis, and I. scapularis in the enzootic transmission of the spirochete.


This article explores the contradictions inherent in the role of "citizen consumer" that emerged for French women in the decades of social and economic change following the Second World War. As inflation wracked the French economy and as planners and modernisers attempted to create a thriving mass-consumer society, the role of citizen consumer answered both the desires of planners and modernisers, and those of organisations hoping to empower women and improve family living conditions. These various groups – though perhaps motivated by different objectives – agreed on several things: that women consumers could have an ameliorative effect on the economy, both by curbing inflation and directing production toward family needs, and that women needed to be educated to assume this role. Thus, the prevailing rhetoric alternated between at once heralding the power of the woman consumer, and pointing to her need for education.


The question is posed whether the bending of sunlight in the Sun's own gravitational field has to be considered when the radius of the Sun is calculated from the observed angle. The general relativistic calculation yields a radius 3.0 km smaller than the standard value calculated by means of Euclidean geometry. The precise numerical calculation employed shows that the exact deflection of light rays observed under large angles differs substantially from the parameterized post-Newtonian (PPN) approximation used for an estimate of the PPN parameter γ.


As in the medical biotechnology area some decades ago, the fast technological development within industrial biotechnology (IB) has caused numerous new ventures. Venture capital (VC) has become a major capital source for these companies and VC investors have particularly allocated financing to research and development (R&D) based companies. Since the early 2000s, the global net stock of VC investments in IB companies has continuously increased over the past 12 years and exceeded 3.5 billion US dollars at the end of 2013. In 2013, the gross amount of VC money was 386 million US dollars distributed to 20 companies corresponding to an average amount of 19.3 million US dollars for each company. The rising capital contribution into the IB sector indicates that it is seen as an attractive investment opportunity for VC investors. Analysing the VC investments by segments shows that there is a strong preference for biofuels and biochemicals. The regional breakdown of VC activities shows that the Americas are the leading region followed by Europe.


In the last several years, in serious consideration of the worldwide economic and environmental issues there has been an increasing research interest in the value of naturally occurring bio-sourced materials. Agro-industrial based biomass comprised of pectin is an inexpensive, renewable, abundant natural resource that could be utilized for large-scale and cost-effective production of natural products i.e., pectinolytics. Pectinolytics are one of the most widely distributed enzymes in bacteria, fungi and plants. From ancient times to date, many methods have been introduced to improve the optimization of pectinolytics to obtain high yields of maximal purity. To expand the range of natural bio-resources the rapidly evolving tools of biotechnology can lower the conversion costs and also enhance target yield of the product of interest. This green biotechnology presents a promising approach to convert most of the agricultural materials into a value-added product with multiple applications. Major advances have already been achieved in recent years in order to obtain high levels of purity with optimal yields. The present review begins with an overview of pectinolytics and their physico-chemical features, and their specific role with classification based on pectic materials. Information is also given on the culture influences and potential sources of pectinolytics, followed by a brief summary of various industrial and biotechnological applications and future considerations.


Non-tuberculous mycobacteria (NTM) infections are increasingly being reported worldwide. They are a major concern for healthcare professionals for multiple reasons, ranging from the intrinsic resistance of NTM to most conventionally utilized antimicrobials to inharmonious diagnostic criteria utilized for evaluation of NTM-infected patients, leading to high morbidity. In this review, we highlight the paucity of drugs having potent anti-NTM activity amongst the new antimicrobials currently under various stages of development for anti-tubercular activity and issue a call for the establishment of a concerted dedicated drug discovery pipeline targeting NTM.


Heterogeneous Chip Multi-Processors (heter-CMP) provide suitable resources to various applications and could get more benefits on performance than homogeneous CMP. To fully develop the performance of the heter-CMP system, the applications should be scheduled to the proper cores by the scheduler of the operating system according to their behaviours. Besides, the last level cache (LLC) miss rate is often used as the metric to identify the application features. However, the LLC miss rate could not reflect the application behaviours accurately since the memory access delay, the most important application character is related to patterns of the memory access and many other issues. To improve the accuracy of scheduling on the heter-CMP system, this paper supplies performance counters for the LLC miss penalty to monitor application behaviours. Based on that, the latency-aware scheduling algorithm for asymmetry chip multi-processors (LA-ACMP) is proposed and implemented. Those hardware supports are implemented on the Godson-3 multi-core RTL and simulator and the LA-ACMP algorithm is integrated to the Linux kernel. The performance evaluation on those platforms shows that the LA-ACMP algorithm with LLC miss penalty outperforms the algorithm with LLC miss rate about 32.4%, and outperforms the original schedule algorithm about 18.4%.


We report on a hybrid DWDM-TDM A optical access network that provides a route for integrating access and metro net- works into a single all-optical system. The greatest challenge in using DWDM in optical access networks is to precisely align the wavelength of the customer transmitter (Tx) with a DWDM wave- length grid at low cost. Here, this was achieved using novel tunable, external cavity lasers in the optical network units (ONUs) at the customer's end. To further support the upstream link, a 10 Gb/s burst mode receiver (BMRx) was developed and gain-stabilized erbium-doped fiber amplifiers (EDFAs) were used in the network experiments. The experimental results show that 10 Gb/s bit rates can be achieved both in the downstream and upstream (operated in burst mode) direction over a reach of 100 km. Up to 32 × 50 GHz spaced downstream wavelengths and another 32 × 50 GHz spaced upstream wavelengths can be supported. A 512 split per wave- length was achieved: the network is then capable of distributing a symmetric 320 Gb/s capacity to 16384 customers. The proposed architecture is a potential candidate for future optical access net- works. Indeed it spreads the cost of the network equipment over a very large customer base, allows for node consolidation and integration of metro and optical access networks into an all-optical system.


OBJECTIVES
Women in safety-net institutions are less likely to receive cervical cancer screening. Human papilloma virus (HPV) self-sampling is an alternative method of cervical cancer screening. We examine the acceptability and feasibility of HPV self-sampling among patients and clinic staff in two safety-net clinics in Miami.

MATERIALS AND METHODS
Haitian and Latina women aged 30-65 years with no Pap smear in the past 3 years were recruited. Women were offered HPV self-sampling or traditional Pap smear screening. The acceptability of HPV self-sampling among patients and clinic staff was assessed. If traditional screening was preferred the medical record was reviewed.

RESULTS
A total of 180 women were recruited (134 Latinas and 46 Haitian). HPV self-sampling was selected by 67% women. Among those selecting traditional screening, 22% were not screened 5 months postrecruitment. Over 80% of women agreed HPV self-sampling was faster, more private, easy to use, and would prefer to use again. Among clinic staff, 80% agreed they would be willing to incorporate HPV self-sampling into practice.

CONCLUSIONS
HPV self-sampling was both acceptable and feasible to participants and clinic staff and may help overcome barriers to screening.


The significant economic growth in China has resulted in a better quality of life. In order to cope with the demand for quality eye care, there are plans to increase the number of optometric personnel and to standardise the comprehensive eye-care services. This review aims to update the current educational programs in optometry and the regulations pertaining to the practice of optometry in China. There has been much progress since the publication of a report on the development of optometry in Greater China 15 years ago. China currently has three types of optometry programs: Diploma, Bachelor of Science, and Bachelor of Medicine. Only graduates of the Optometric Medicine program may perform full scope comprehensive eye-care services. Graduates from the other two types of programs may not use diagnostic or therapeutic pharmaceutical agents. The number of practising optometrists in China therefore needs to be planned by the Ministry of Education and the National Health Commission, accordingly.


A thin annular film lining the inside of a rigid tube is modeled as a liquid-lined airway in this study. Due to the capillary instability, the liquid film can form a plug and obstruct the airway once the ratio of the film thickness to tube radius, e, is greater than a critical value ∼0.12. The dynamics of the closure process is simulated for a Newtonian viscous film with constant surface tension and a passive core gas phase. The numerical simulation employs the finite volume approach with a sharp interface method for the free surface. The computational results show that the wall shear stress and normal stress during closure can be strong enough to injure airway epithelial cells.Copyright © 2009 by ASME


Increased production of α-amylase was observed with Bacillus amyloliquefaciens in the present study with wheat flour among the various agro-byproducts tested. The amylase from the bacterium was optimally active at a temperature of 37°C for 72h at pH 4±0.2 by using solid substrate (wheat flour) with the initial moisture of 80% and inoculated with Bacillus amyloliquefaciens of 2×106 cfu ml-1 of inoculum size. Supplementation with 0.04M KH2PO4, 1% maltose as a carbon source, tryptone and ammonium chloride as inorganic and organic nitrogen source in the substrate enhanced the enzyme yield considerably. The α-amylase from Bacillus amyloliquefaciens was partially purified by ammonium sulphate precipitation and ion exchange chromatography. Purification of amylase enzyme yielding a 2.05 fold purified enzyme with a specific activity of 11214.70 IU/mg. Characterization of purified enzyme revealed maximum stability on 65C temperature at pH 6±0.2. The enzyme was stable against Ca+2, Fe+3, Mn+2 metal ions however Cu+2 showed inhibitory effect. The characteristics of the enzyme qualify it as a good enzyme in biotechnological applications.


Recent data suggest that botulinum type-B neurotoxin is a protease which acts on vesicle-associated membrane protein, isoform 2 (VAMP-2). In this report, botulinum type-B neurotoxin is shown to cleave a synthetic fragment (HV62) of VAMP-2, corresponding to the bulk of the hydrophilic domain (amino acids 33-94). The neurotoxin acts at a single site between Gln76 and Phe77. Little or no proteolytic activity by botulinum type-B neurotoxin was observed with peptides containing 7, 10 or 20 amino acids spanning the site of cleavage. The proteolytic action of neurotoxin was strongly inhibited by EDTA and o-phenanthroline whereas captopril and phosphoramidon were ineffective. A series of model peptide substrates were synthesised in order to define the smallest VAMP-2 fragment to be cleaved by botulinum type-B neurotoxin. Data obtained from these substrates suggest that the neurotoxin belongs to a novel class of zinc-endoprotease; more than 12 amino acid residues are required on both the NH2- and COOH-terminal side of the cleavage site for optimal proteolytic activity. The results demonstrate that no other components of cellular vesicles are required for the specific action of the neurotoxin on VAMP-2. The data further show that the highly specific action of the neurotoxin is not dictated solely by the properties of the amino acid residues at the cleavage site but is also dependent on amino acid sequences distal to its site of action.


This research is conducted with the aim to determine the ability of early childhood education teachers to use ICT in the industrial revolution 4.0. The qualitative method is used with data collection techniques in the form of surveys and data analysis using descriptive statistics. The subjects of the study were 26 early childhood education teachers in South Jakarta and Tangerang city. The results showed that early childhood education teachers are able to utilize information and communication technology for the sake of organizing educational development activities quite well. ICTs are used to find references, examples of learning media, look for examples of activities according to themes and sub themes, as well as preparing learning plans and assessments. Improvements need to be made in an effort to operate the computer to be better because there are still teachers who are awkward in interacting with computers because the ability to operate computers is not optimal and the lack of availability of computers in adequate numbers.


Background In the pediatric emergency department, patients are commonly treated with a single dose of oral midazolam for minor procedures. We sought to evaluate the effect of this treatment on procedure completion rates. Methods We conducted a single-center retrospective cohort study of all patients who were treated with pre-procedure oral midazolam between January 2011 and June 2016. The primary outcome was the procedure completion rate. Results During the study period, 1,504 patients were treated with oral midazolam as per department protocol; 1,467 received midazolam and 37 declined midazolam. Oral midazolam was used in 14 different types of emergency department procedures. The procedure completion rates in the treatment and non-treatment groups were 1,402/1,467 (95.6%) and 24/37 (64.8%), respectively (difference 30.7%; 95% confidence interval [CI] 17.3%–46.8%); p<0.0001. Treatment group patients had procedure completion rates of 25/33 (75.8%), 165/188 (87.8%%), 1,154/1,187 (97.2%), and 58/59 (98.3%), in the less than 0.3 mg/kg group, 0.3 to less than 0.5 mg/kg group, 0.5 to less than 0.7 mg/kg group, and 0.7 to less than 0.9 mg/kg group, respectively. Multivariate regression did not demonstrate an association between sex, ethnicity, dosage of 0.5 mg/kg or greater, type of procedure, and failure to complete procedure. Severe adverse events were not recorded. A dose of less than 0.3 mg/kg was significantly associated with an increased risk of failure to complete a procedure (adjusted odds ratio 8.34, 95% CI 3.32–20.9; p<0.0001). Conclusion The findings suggest that oral midazolam in a single dose of 0.5 mg/kg or greater is associated with successful completion of minor pediatric procedures.


BACKGROUND
Neurological deterioration (ND) is common, with nearly one-half of ND patients deteriorating within the first 24 to 48 hours of stroke. The timing of ND with respect to ND etiology and reversibility has not been investigated.

METHODS
At our center, we define ND as an increase of 2 or more points in the National Institutes of Health Stroke Scale (NIHSS) score within 24 hours and categorize etiologies of ND according to clinical reversibility. ND etiologies were considered non-reversible if such causes may have produced or extended any areas of ischemic neurologic injury due to temporary or permanent impairment in cerebral perfusion.

RESULTS
Seventy-one of 350 ischemic stroke patients experienced ND. Over half (54.9%) of the patients who experienced ND did so within the 48 hours of last seen normal. The median time to ND for non-reversible causes was 1.5 days (IQR 0.9, 2.4 days) versus 2.6 days for reversible causes (IQR 1.4, 5.5 days, p=0.011). After adjusting for NIHSS and hematocrit on admission, the log-normal survival model demonstrated that for each 1-year increase in a patient's age, we expect a 3.9% shorter time to ND (p=0.0257). In addition, adjusting for age and hematocrit on admission, we found that that for each 1-point increase in the admission NIHSS, we expect a 3.1% shorter time to ND (p=0.0034).

CONCLUSIONS
We found that despite having similar stroke severity and age, patients with nonreversible causes of ND had significantly shorter median time to ND when compared to patients with reversible causes of ND.


The degree of controllability provided by static convertors is mostly determined by the speed and accuracy of information available from the transducers. This paper discusses the effect of providing fast ON/OFF detection of the silicon-controlled rectifier and describes two novel methods of achieving such information. It is concluded that a method based on continuous monitoring of the gate-to- cathode voltage level provides sufficiently reliable and fast ON/OFF information for the purpose of direct digital control of the convertor plant.


OBJECTIVE
Our aim was to compare perioperative complications between older (≥65 years), middle-age (55-64 years), and younger (<55 years) women after minimally invasive sacrocolpopexy (SCP).

METHODS
This retrospective cohort study included women undergoing SCP from 2006 to 2016 at a single academic center. Our primary outcome was the rate of perioperative complications (intraoperative and postoperative within 6 weeks of surgery), between groups. Secondary outcomes included readmission and reoperation rates.

RESULTS
There were 440 consecutive participants: 159 (36.1%) older, 160 (36.4%) middle-age, and 121 (27.5%) younger women. The overall intraoperative complication rate from SCP was 9.1%, with the most common being cystotomy (5.0%) and vaginotomy (1.8%). There were no differences in intraoperative complications between groups. Urinary tract infection (10.9%) and port-site cellulitis (3.4%) were the most common postoperative complications. For our primary outcome, younger women had a higher rate of postoperative complications compared with middle-age and older women (P < 0.001). There was no difference in postoperative complications between older and middle-aged women. In a multivariate regression controlling for comorbidity, body mass index, diabetes, smoking status, concomitant hysterectomy, and/or sling, younger women retained a higher rate of postoperative complications (odds ratio, 1.7 [1.2,2.2]). Rates of readmission (3.2%) and reoperation (0.7%) were also similar between groups.

CONCLUSIONS
The rate of perioperative complications was low with no difference in intraoperative complications. Women under 55 had a higher rate of postoperative complications compared to women age 55 to 65 years and those older than 65 years. Our results suggest that it is reasonable to offer SCP to women older than 65 years.


This paper describes a system of semi-autoI:":atic storage control which has now been in operation on the Rice University computer for a period of 18 months. Experience in using the system reveals the possibility of a high level of automation in solving storage allocation problems with comparatively simple provisions in machine hardware. Further areas in which machine design may assist in solving these problems are suggested.


It is well known that reading aloud affects children's language and literacy development. Little is known though, about fathers reading to their children. This study examined paternal and maternal bookreading frequency among 430 low-income families and investigated whether paternal bookreading and maternal bookreading predicted children's early language and cognitive development and emergent literacy skills. Results demonstrated that mothers read more frequently to their toddlers than fathers but approximately 55% of fathers reported reading at least weekly to their children. Paternal bookreading at 24 and 36 months significantly predicted children's language and cognitive skills at age 36 months as well as their book knowledge at preK. Maternal bookreading was only a significant predictor of child cognitive skills at 36 months.


Major pipelines across the world transport large quantities of crude oil, natural gas, and petroleum products. These pipelines play an important role in modern societies and are crucial in providing needed fuels for sustaining vital functions such as power generation, heating supply and transportation. If the pipeline carrying these chemicals burst/leaks it results in huge loss of life, money, time, and environmental disaster. To avoid this, proper joining of gas pipelines is needed and it can be done through welding process. Welding is a fabrication or sculptural process that joins materials, usually metals or thermoplastics by causing coalescence. This is often done by melting the work pieces and adding a filler material to form a pool of molten material that cools to become a strong joint, with pressure sometimes used in conjunction with heat, or by itself, to produce the weld.


Biological wastewater treatment methods are being used at an ever increasing extent for the treatment of wastewaters from the Finnish forest industry. Conventional activated sludge processes treating the composite wastewaters from the mill are most commonly used. Present plants may turn out to be inadequate in some cases, or they may not serve the purpose. This can happen for example when 1) the process fails or the running costs become extremely high, 2) the legal regulations concerning the quality of the treated wastewater change or 3) production of the mill expands or is diversified. These situations can be handled by expanding the existing treatment capacity. An alternative is to develop specific additional treatment units more appropriate for the wastewaters in question. In this paper the advantages and disadvantages of some biological process units completing activated sludge treatment plants are studied. In experimental studies a, b and c, a two-stage activated sludge process, a modified activated sludge process and an anaerobic pretreatment, respectively, are examined. The results of these studies show that a selective, highly loaded first stage of a two-stage activated sludge process can efficiently equalize and improve effluent quality, especially when the suspended solids concentration in the influent is high (Study a), that an anoxic/anaerobic unit together with a small aerated contact unit combined with a conventional activated sludge process can reduce phosphorus levels in the effluent (Study b), and that anaerobic pretreatment of concentrated wastewaters efficiently reduces the organic loading, improves sludge settling properties, and reduces sludge yield and phosphorus demand (Study c).


Nowadays Primary dysmenorrhea has become one of the commonest complaints in adolescent girls. Dysmenorrhea is a term which is being used for the condition where women may suffer from pain during menstruation. Studies from India reported the prevalence range from 50 to 87.8%. Aims: It was hypothesized that Ayurveda formulations- Vijayadi-vati and Ashwagandha choorna possesses properties like; Vata-kapha shamak (pacifies Vata and Kapha), Shothahara (anti- inflammatory), and Balya (Potent rejuvenator and antioxidant) can be given as oral therapy in primary dysmenorrhoea. Setting and design: this clinical study was an open randomized controlled study, based on a total of 30 clinically diagnosed patients, with Kashtartava (Primary dysmenorrhoea) in the age group of 16-30years from OPD/IPD of Prasuti & Stree Roga Dept. of National Institute of Ayurveda, Jaipur along with consideration of inclusion and exclusion criteria. Methods and material: there were two groups in this trial; In Group A: patients were treated with Vijayadi Vati and in Group B with Ashwagandha Choorna orally before meals for two consecutive menstrual cycles. The treatment was started seven days before the due date to keep the uniformity. Follow-up was done after the completion of the course of trial drugs fortnightly for 2 consecutive menstrual cycles. This study was approved by the Institutional ethical committee with no. F10(5)/EC/ 2014/7228. Statistical analysis used: Mann-Whitney Test was used for comparison in the effect of trial drug between subjective parameters of two groups. Results and Conclusion: Significant improvement was seen in symptoms in both groups, Comparing the symptomatic improvement in both groups it was found that the Average percentage of relief was higher in 'Group A' i.e., 67.78%, followed by 'Group B' i.e., 60.44%. The result was encouraging with marked relief and No any Adverse Drug reaction was recorded in any group during and in the follow-up period in the present clinical study.


A computer program code was developed to estimate hydraulic behavior of the 2-D connected pipe network system, and implemented to evaluate the effect of joint aperture on hydraulic parameters of fractured rock masses through numerical experiments. A total of 216 stochastic 2-D DFN(discrete fracture network) blocks of 20 m×20 m were prepared using two joint sets with fixed input parameters of joint orientation, frequency and size distribution. Two different cases of joint aperture variation are considered in this study. The hydraulic parameters were estimated for generated 2-D DFN blocks. The hydraulic anisotropy and the chance for equivalent continuum behavior of the DFN system were found to depend on the variability of joint aperture.


Purpose: To describe bilateral corneal endothelial dysfunction in a patient with Parkinson disease who was treated with long-term amantadine. Methods: We employed an A-B-A-B single-subject research design that included clinical history, clinical findings, photographic images, and specular microscopic findings of ocular changes. Results: A 52-year-old woman with Parkinson disease who had taken amantadine for 6 years had bilateral corneal edema for 2 months at baseline. After cessation of amantadine, the edema resolved, and the endothelial cell densities were ≤600/mm2. Corneal edema recurred when the administration of amantadine was resumed. Therefore, amantadine was permanently discontinued and the cornea cleared again. Conclusions: Amantadine can cause reversible corneal edema but can irreversibly reduce the density of endothelial cells.


We show that the quantum Casimir operators of the quantum linear group constructed in early work of Bracken, Gould and Zhang together with one obvious central element generate the entire center of Uq(gln). As a byproduct of the proof, we obtain intriguing new formulae for eigenvalues of these quantum Casimir operators, which are expressed in terms of the characters of a class of finite-dimensional irreducible representations of the classical general linear algebra.


The DNA sequence of the coding region of the mouse thrombospondin (TSP) 3 gene has been determined by analysis of both genomic and cDNA clones. Like TSP1 and TSP2, TSP3 has a homologous COOH-terminal domain and seven type III (Ca(2+)-binding) repeats. However, TSP3 contains four, rather than three, type II repeats and lacks the type I (TSP or properdin) repeats and procollagen homology characteristic of TSP1 and TSP2. In addition, the NH2-terminal domain of TSP3 differs markedly, both in sequence and in exon/intron structure, from that in TSP1 or TSP2. The gene is located on mouse chromosome 3, bands E3-F1, immediately upstream from the Muc1 (episialin) gene and is expressed in the developing mouse in a pattern that also differs from that of TSP1 or TSP2. Based on its structure, we suggest that TSP3 may play both a unique role in cell-matrix interactions and perform functions that overlap with those of TSP1 and TSP2.


While cases of syphilis innocently acquired are not of very infrequent occurrence, and the number of reported cases is increasing rapidly, the following recent instances in private practice are thought to be of sufficient interest to warrant placing them on record. They serve to call attention to the dangers which arise from the disease on every side, and to illustrate the diverse locations where the initial lesion of syphilis may be found, as well as the modes by which the poison may enter the system: Case 1.—Chancre of the Cheek. Mrs. W., aged 24, was sent to my office in consultation May 28, 1894, on account of a sore on the right cheek, just below the zygoma, which had refused to heal. It had begun six weeks previously, as a small pimple like a mosquito bite, which had soon broken down, leaving a raw surface, which increased in size to


We have characterized the reactivities of a panel of V4‐34‐encoded human IgM monoclonal antibodies (mAb) which bind the erythrocyte Rh D antigen, derived from an immunized individual. These were compared with the specificities of V4‐34‐encoded autoantibodies with I/i reactivity produced from patients with cold agglutinin disease (CAD), and other V4‐34‐encoded autoantibodies. The antibodies were evaluated for cold agglutinin activity using haemagglutination tests, immunofluorescence microscopy for reactivity with tissue components, and in solid phase radiobinding assays with purified antigens. We found that (i) cold agglutinin activity was a property of all the V4‐34‐encoded mAb (ii) the cold agglutinins from CAD patients were generally monospecific for I/i whereas most of the anti‐D and the other V4‐34‐encoded mAb displayed multireactive properties, frequently binding to strongly acidic antigens (iii) computation of the net charge of the heavy‐chain V regions showed that the multireactive mAb were generally more positively charged than the monospecific cold agglutinins, which could contribute to their multireactive phenotype. The involvement of charge interactions was further indicated by the effects of pH and ionic strength on the immunofluorescence staining patterns.


Abstract. The tropical cyclone (TC) track and intensity predictions over Bay of Bengal (BOB) using the Advanced Research Weather Research and Forecasting (ARW) model are evaluated for a number of data assimilation experiments using various types of data. Eight cyclones that made landfall along the east coast of India during 2008–2013 were simulated. Numerical experiments included a control run (CTL) using the National Centers for Environmental Prediction (NCEP) 3-hourly 0.5 × 0.5° resolution Global Forecasting System (GFS) analysis as the initial condition, and a series of cycling mode variational assimilation experiments with Weather Research and Forecasting (WRF) data assimilation (WRFDA) system using NCEP global PrepBUFR observations (VARPREP), Atmospheric Motion Vectors (VARAMV), Advanced Microwave Sounding Unit (AMSU) A and B radiances (VARRAD) and a combination of PrepBUFR and RAD (VARPREP+RAD). The impact of different observations is investigated in detail in a case of the strongest TC, Phailin, for intensity, track and structure parameters, and finally also on a larger set of cyclones. The results show that the assimilation of AMSU radiances and Atmospheric Motion Vectors (AMV) improved the intensity and track predictions to a certain extent and the use of operationally available NCEP PrepBUFR data which contains both conventional and satellite observations produced larger impacts leading to improvements in track and intensity forecasts. The forecast improvements are found to be associated with changes in pressure, wind, temperature and humidity distributions in the initial conditions after data assimilation. The assimilation of mass (radiance) and wind (AMV) data showed different impacts. While the motion vectors mainly influenced the track predictions, the radiance data merely influenced forecast intensity. Of various experiments, the VARPREP produced the largest impact with mean errors (India Meteorological Department (IMD) observations less the model values) of 78, 129, 166, 210 km in the vector track position, 10.3, 5.8, 4.8, 9.0 hPa deeper than IMD data in central sea level pressure (CSLP) and 10.8, 3.9, −0.2, 2.3 m s−1 stronger than IMD data in maximum surface winds (MSW) for 24, 48, 72, 96 h forecasts respectively. An improvement of about 3–36 % in track, 6–63 % in CSLP, 26–103 % in MSW and 11–223 % in the radius of maximum winds in 24–96 h lead time forecasts are found with VARPREP over CTL, suggesting the advantages of assimilation of operationally available PrepBUFR data for cyclone predictions. The better predictions with PrepBUFR could be due to quality-controlled observations in addition to containing different types of data (conventional, satellite) covering an effectively larger area. The performance degradation of VARPREP+RAD with the assimilation of all available observations over the domain after 72 h could be due to poor area coverage and bias in the radiance data.


This paper surveys the emergence and transformation of Vietnamese studies in Russia and the former Soviet Union from the late nineteenth century until the present. It demonstrates how writings by Russian explorers and geographers developed into a professional academic field during the Soviet era, one that was strongly shaped by ideological affinities and international connections within the communist world. Although Vietnamese studies in Russia has retained some intellectual and institutional legacies from the Soviet era, it also reflects transformations in academic life in Russia since the 1990s as well as the changing relationship between the two countries.


Spatial and temporal resolution of NOGA are superior to CTA and transesophageal echocardiography. NOGA provides direct images of both intimal and subintimal images. Aortic angioscopy using non-obstructive general angioscopy (NOGA) is a novel, video-based technique that allows visualization of the inner aorta. Dual infusion method improves the visual field and the use of an Ikari-L guiding catheter allows easy access to the aorta, enabling NOGA of not only the coronary artery but also aorta. Imaging techniques such as computed tomography angiography (CTA), magnetic resonance, and transesophageal echocardiography have been used to evaluate the aorta and the findings are usually confirmed based on pathology. NOGA has a spatial and temporal resolution superior to these techniques, detecting various types of spontaneous ruptured aortic plaques (SRAPs) and injuries. SRAPs detected using NOGA are not comparable to those detected using CTA. NOGA can also demonstrate subintimal changes and blood flow through the aortic wall. Although aortic angioscopy is yet at its dawn, several case reports have showed its ability to decode aortic dissection pathogenesis and to evaluate the merits and demerits of stent graft implantation. NOGA is a unique invasive modality to visualize the inner aorta and to sample SRAPs. NOGA is an epoch-making modality that can be used to simultaneously evaluate the arterial and venous systems.


With the explosive growth of online sales, multi-channel retailers are increasingly focused on finding ways of integrating the online channel with traditional retail stores. The need for the development of effective multi-channel strategies is strongly felt by the retailers. The present research normatively addresses this issue and using a game theoretic approach, derives optimal strategies that maximize profits under different competitive market structures. Managerial implications are discussed and probable paths of future research are identified.


Total blood and plasma free amino acids and plasma urea levels were studied in fed and 24 h fasted Zucker rats. In fed animals there were no differences between obese and lean rats in the overall essential and non essential blood free amino acids. However, starvation reduced blood amino acid levels in the obese animals compared to the lean group, mainly due to changes in the plasma compartment. The reduction of available amino acids from plasma in the obese rats during starvation affected most of the amino acids, including the branched chain amino acids, which showed higher levels in the fed situation than in lean rats. Of particular interest is the opposite response to starvation in lean and obese Zucker rats concerning the plasma ratio of tryptophan (Trp) to the large neutral amino acids (LNAA) which could be implicated in the alteration of food intake and energy expenditure characteristic of obesity.


* The influence of carbohydrate availability to mycorrhizal roots on uptake, metabolism and translocation of phosphate (P) by the fungus was examined in axenic cultures of transformed carrot (Daucus carota) roots in symbiosis with Glomus intraradices. * 14C-labelled carbohydrates, 33P-phosphate and energy dispersive X-ray microanalysis were used to follow the uptake and transfer of C and P in the arbuscular mycorrhizal (AM) symbiosis. * The uptake of P by the extraradical mycelium (ERM) and its translocation to the mycorrhizal roots was stimulated and the metabolic and spatial distribution of P within the fungus were altered in response to increased carbohydrate availability. Sucrose supply resulted in a decrease of polyphosphates and an increased incorporation into phospholipids and other growth-related P pools and also caused elevated cytoplasmic P levels in the intraradical mycelium (IRM) within the root and higher cytoplasmic P levels in the root cortex. * These findings indicate that the uptake of P by the fungus and its transfer to the host is also stimulated by the transfer of carbon from plant to fungus across the mycorrhizal interface.


The gastrointestinal (GI) hormone, gastrin, promotes cancer progression and its down-regulation has been linked to reduced cancer stem cell numbers. Gastrin acts through the cholecystokinin-2 receptor (CCK-2R) and its biological effects are blocked by CCK-2R inhibitors. We investigated the regulation of the CCK-2R and its potential role in promoting survival of cancer stem cells (CSC).

A panel of cancer cell-lines, including GI, glioblastoma and lung, with CCK-2R-transfected cells as a positive control, were grown either as monolayers, or, to provide a 3D in vitro tumour model, as spheres. Linear-after-the-Exponential (LATE)-PCR was used to quantify CCK-2R gene expression and this was validated using siRNAs. Flow cytometry was used to investigate receptor protein expression. Activity of CCK-2R promoter reporters was quantified using luciferase assays.

LATE-PCR for CCK-2R gene expression is 10,000-fold more sensitive than the Taqman-based assay, and provides a highly precise method for detection of genes which have important biological functions but low expression. This assay showed that primary non-small-cell lung tumours have significantly more expression than normal lung tissue, indicating a potential therapeutic marker. CCK-2R siRNAs resulted in up to 97% (p<0.05) knockdown of the receptor in cancer cells, confirming the specificity of LATE-PCR and offering a therapeutic possibility.

The CCK-2R promoter constructs were active in lung, glioma and colorectal cancer cell-lines, demonstrating a potential drug target; however, transcriptional activity did not correlate with gene expression suggesting post-transcriptional or translational regulation is a factor affecting CCK-2R expression.

Flow cytometry suggests the presence of a small population of cells within each of these cell-lines which expresses CCK-2R very highly, which was not correlated to CSC markers. However, CCK-2R expression was enriched when cells were grown as spheres, and inhibition caused a delay in sphere-forming, implying that the CCK-2R may play a role in tumour, and CSC, expansion. Thus, CCK2R provides a potential target for therapeutic intervention in cancer.


The year 2009 marked the 40th anniversary of a ground-breaking paper that appeared in the UK journal Nature that presaged the advent of successful IVF procedures, and much else. This was the subject of a conference held under the title "In vitro human embryos: Interdisciplinary reflections on the first four decades". My paper was simply called "The view from social anthropology", the basic "work" of the paper being in the accompanying bibliography. It concerns developments in the English-speaking world, but hopefully is of wider interest.


SER virus is a member of the family Paramyxoviridae, genus Rubulavirus, which has been isolated from pigs. It is very closely related to SV5 virus serologically, in protein profile, and in nucleotide sequence. However, unlike SV5, SER induces minimal syncytium formation in infected CV-1 or BHK cells. Fluorescence transfer experiments between labeled erythrocytes and infected MDBK cells revealed that SER also induces hemifusion and pore formation with reduced efficiency. The virion polypeptide profiles of SER and SV5 are very similar, except that the SER F1 subunit shows an apparent molecular weight that is about 2 kDa higher than that of SV5. Comparison of the deduced amino acid sequences revealed the SER F (551 aa) to be longer than SV5 F (529 aa) by 22 residues in the cytoplasmic tail (CT) domain. The HN and M gene sequences of the viruses were found to be very similar. The SER F showed minimal fusion activity when coexpressed with either SV5 or SER HN. In contrast, SV5 F was highly fusogenic when coexpressed with either HN protein, indicating that the restricted fusion capacity of SER virus is a property of its F protein. Truncation in the CT of SER F by 22 residues completely rescued its ability to cause syncytium formation, whereas other truncations rescued syncytium formation partially. These results demonstrate that an elongated CT of a paramyxovirus F protein suppresses its membrane fusion activity.


In today's business a close operation is necessary to decrease the joint total inventory cost. According to Simchi-Levi et al (2000) several international companies have demonstrated that integrating the supply chain has improved the company's performance and market share. This paper considers an inventory vendor-buyer integrated system in a fuzzy situation by employing the type of fuzzy numbers which are trapezoidal. This model have been developed by using different optimization methods. A full fuzzy model is by using different optimization methods. A fully fuzzy model is developed where the input parameters and the decision variables are fuzzified. The optimal policy for the developed model is determined are fuzzified. The optimal policy for the developed model is determined by using the Lagrangean conditions after the defuzzification of the cost function with the graded mean integration method. The proposed method finds the optimal lotsize for both the vendor and buyer in an integrated two stage supply chain. Numerical examples are provided to highlight the difference between crisp and the fuzzy cases.


T measures suggested by Jacques Genest and colleagues for the prevention of vascular diseases, both cardiac and neurologic, indicate the magnitude of the problem of overweight in the United States and Canada. Here in Brazil, we observe a paradoxical situation: many people are afflicted with poverty and famine, yet they also have risk factors for cardiovascular problems. It thus appears that vascular risks have no regard for a country's economic status. The new left-wing federal government in Brazil is making strong efforts in the area of social benefits, for example through the Fome Zero (Zero Hunger) program. However, public health doctors have no particular preoccupation with vascular disease, and suboptimal nutrition may occur among Brazilians even in the presence of adequate caloric intake, as evidenced by abnormal levels of C-reactive protein, apolipoprotein, homocysteine and other compounds. Although Brazilian physicians apply evidence-based guidelines in the modern facilities that are available in our large cities, elsewhere they have adopted a system of what might be called "blind prevention," whereby patients are given acetylsalicylic acid, a statin, folic acid and vitamin E (unpublished manuscript). Physicians in the developed world tend to disapprove of this approach because it does not take into account individual patient factors such as microalbuminuria or gastric problems. This issue was recently the subject of heated debate in the "rapid responses" section of the BMJ after Wald and Law proposed a "Polypill." Despite the differences in medical systems and patient populations in Canada and Brazil, the guidelines presented by Genest and colleagues will be an important reminder to Brazilian health authorities that vascular disease also requires their attention.


Presowing seed treatments used to enhance the rates of germination and afterward seedling emergence have not occasionally shown the same rate in indoor and field. The treatments considering germination mechanism and factors affecting germination must be totally included in indoor experiments so that the results drawn can be reproduced in the field. Seed germination is controlled by Phytochrome-mediated action changed with composition rates of red and far-red lights. Sunlight can penetrate soil into depth, which in turn means that seeds having in their width may receive the light if soil was covered 3 times over them. The penetrating light, moreover, turns to more far-red light than red light reverse to the sunlight. For germination tests after the artificial presowing seed treatments, therefore, seeds of smaller than 2 mm (, and larger than 3 mm (> 3 mm) must be done with incandescent lamp (IL) having more far-red light, with IL or in darkness, and in darkness, respectively. The 96 papers published in 13 Korean scientific journals up to the end of 2003 were analysed on the basis of the above explanation. 91 species were used 147 times as experimental materials; 101 times for seeds and 22 times for > 3 mm seeds. If they were analysed as the light sources used for germination tests, correct applications reached more and less than 60% in both and > 3 mm seeds but 23% in


The agar culture method was used to state that colony-forming units responsible for cell structures of a hemopoietic series remained undamaged after cryopreservation (-196 degrees) in a suspension of mouse and human donor bone marrow. Cultivation of cryopreserved bone marrow revealed the inhibition of proliferative activity of cells growing in agar as compared with native ones. The inhibition of DNA synthesis was the basis of this process.


Abstract In this paper, the baroclinic-barotropic instability of the Gulf Stream is studied numerically. The quasigeo-strophic potential vorticity equation is linearized around the mean flow, which is modeled using data from field measurements in the Gulf Stream off Cape Hatteras. The perturbation around the mean flow is decomposed into waves along the streamwise direction using a Fourier transformation in space and a Laplace transformation in time. For each wave, an eigenvalue problem is obtained, which is solved numerically to yield the frequency as a function of the wavenumber. The instability is of the convective type, in the sense that any localized perturbation will propagate out of any fixed region in space in finite time. External noise can, however, drive the instability creating spatially growing waves. The spatial growth rates of the waves are computed as a function of their frequency using an iterative procedure and are found to be in good agreement with growth rates from field measurements. V...


Abstract Health promotion practice is characterised by a diverse workforce drawn from a broad range of disciplines, bringing together an extensive breadth of knowledge, skills, abilities, attitudes and values stemming from biomedical and social science frameworks. One of the goals of the CompHP Project was to ensure that higher education training would not only reach competency-based standards necessary for best practice, but also facilitate mobility within the EU and beyond through the accreditation of professional practitioners and educational courses. As a result, higher education institutions in Italy and elsewhere are requested to shift the focus from the definition of learning objectives to the identification of teaching strategies and assessment measures to guarantee that students have acquired the competencies identified. This requires reflection on the pedagogical models underpinning course curricula and teaching–learning approaches in higher education, not only to meet the competency-based standards but also to incorporate overarching transversal competencies inherent to the profession and, more specifically, to the online accreditation procedure. Professionals applying for registration require competence in foreign languages, metacognition and be digitally literate. The article provides a brief overview of the development and structure of the International Union for Health Promotion and Education online accreditation system and proposes a pedagogical reflection on course curricula.


Britain has high rates of crime, compared to other Western European Countries (Morgan and Liebling, 2007, p1104). The Governments latest polices are seeking alternative solutions to fight crime outside of the expensive criminal justice system. The voluntary and community sector are being encouraged to play an increasing role in 'fixing Britains broken society' as part of the 'Big Society initiative (Alcock, 2012, p4), whilst facing funding cuts and increased demand for their services. This dissertation discusses whether crime prevention is the responsibility of the voluntary and community sector, it evaluates the various crime prevention strategies which provide a solution to the root cause, or reduce the opportunity, of crime. These strategies are already incorporated into interventions offered by the voluntary and community sector or could be easily adopted by them. There is no conclusive evidence as to the effectiveness of these projects, however the small scale research undertaken for this dissertation will provide qualitative data to show the success of two voluntary and community based organisations in crime prevention.


The following exploratory study addresses the country's digital learning efforts by reviewing the effectiveness of remote learning during the COVID-19 pandemic. This includes challenges and implications that arose during the implementation process. Conducting semi-structured interviews, the analysis acquired perspectives from the classroom level to the policy-making level. This included perspectives about the country's education system and the participants' experiences implementing digital learning strategies. Through these interviews, the analysis identified issues such as lack of priority in teaching and infrastructural problems. As a result, low-income and rural students had little access to digital tools. The findings suggest that remote learning placed a strain on the government's abilities to provide quality education for all students.


A chromosome C-banding protocol using Wright's stain was employed to compare chromosomes in cultivars and wild accessions of several hexaploid oat taxa (Avena spp.). This technique permits the identification of each of the 21 somatic hexaploid oat chromosomes. Digital images of C-banded cells were captured on computer and used to construct karyotypes of several oat accessions. Polymorphisms for C-bands among oat cultivars and wild accessions are described. These banding polymorphisms can be used to trace introgression of chromosomes from wild sources and to provide physical markers on the genetic map for oat. Although C-banding permits the identification of likely C-genome chromosomes based on comparisons with C-banding patterns in diploid and tetraploid Avena species, the A and D genomes cannot be readily differentiated based on their banding patterns.


In addition to providing crucial insights, the rebel-to-party literature exhibits an unacknowledged conceptual tension: despite remarkable agreement on what 'rebel-to-party transition' should capture, there are nearly as many definitions and measures as there are studies of it. I demonstrate that conceptual imprecision has an analytic ripple effect—compromising the validity of the concept, the quality of the measure, the validity of inclusion criteria, and the results of analyses. Across four existing rebel-to-party variables, scholars only agree with regard to eight transitions (out of 161) and five failures (out of hundreds). To address these limitations, I propose a novel conceptualization and measure of rebel-to-party transition—distinguishing between failures, nominal participants (the conventional benchmark for transition), and seated participants. I demonstrate that some definitions of 'failure' induce selection effects into samples, and that minimalist indicators of 'transition' introduce problematic heterogeneity into 'successes'. My analyses reveal that nominal participants are statistically indistinguishable from failures on key traits predicting transition and, moreover, seated participants consistently drive results. As such, the new conceptual framework advances the literature on conceptual and empirical grounds.


This article explores the concept of self-awareness and describes how it can be beneficial to nurses on a personal and professional level. Practical tools such as the Johari Window are presented to assist the reader in this process. The authors discuss portfolio development, which provides the opportunity to document personal and professional growth. Authors


Abstract Intersectionality is a useful method (Lutz, 2015) for interdisciplinary long-term care (LTC) research to advance a more critical understanding of how experiences of quality are shaped by mutually reproducing social divisions, identities and relations of power that shape LTC. This paper discusses insights from the "Mapping Care Relationships" stream of the Seniors – Adding Life to Years (SALTY) project, a pan-Canadian program of research examining clinical, social and policy perspectives on quality in LTC. "Mapping Care Relationships" mapped how promising approaches to care relationships are organized and experienced in LTC. From January 2018-August 2019 our team of nine researchers conducted rapid ethnographies in eight nursing homes, two in each of four provinces across Canada. We purposively observed and interviewed workers from a wide variety of positions and backgrounds, informed by an intersectionality approach. We traced how promising approaches in person-centred dementia care (PCDC) in particular may reify the subordinated status of care workers (some more than others) and reinforce inequities within LTC systems. In multiple LTC homes, front-line care workers described experiencing physical and emotional harm in care relationships with residents which caused them distress. However, consistent with a PCDC approach, the harm was attributed to 'behaviours' clinically symptomatic of dementia. In framing power differentials from a medical perspective, PCDC makes it possible to interpret harmful experiences as 'part of the job' and something workers should know to expect, prevent, avoid, redirect, or ignore. Lutz, H. (2015). Intersectionality as method. DiGeSt. Journal of diversity and gender studies, 2(1-2), 39-44.


This research report assesses the level of maturity of formal service review processes used and the outcomes achieved. It also identifies how these processes can be supported and enhanced, as a future direction. Local government service provision has transformed significantly over recent decades. Australian councils have moved beyond the traditional narrow emphasis on 'roads, rates and rubbish' towards broader objectives to promote the social, economic, environmental, and cultural wellbeing of communities. Over a similar period, community expectations of local government have increased while other levels of government have devolved various functions. While some council services have experienced higher demand from the community (such as sporting and cultural facilities), others have been subject to increased legislative requirements (such as asset management and strategic planning). The overall effect is that councils must provide a greater range of services while endeavouring to meet higher standards.


Mycetoma, formerly known as Madura foot, is a chronic, localized, gradually increasing in size, granulomatous exogenous infection of the skin and subcutaneous tissue with risks of bone and visceral involvement. It is unevenly found worldwide but it is endemic in tropical and subtropical countries. Two groups of mycetoma exist with similar clinical presentation; eumycetoma due to true fungi, and actinomycetoma due to aerobic bacteria from actinomycomycetes species. Mycetoma is difficult to treat and can lead to serious sequelae including disability, deformity and even death, so early diagnosis and treatment can elicit good results. The diagnosis is made based on a clinical picture of a triad of painless tumefaction, draining sinuses and granules of the causative micro-organism along with direct microscopic examination and histological study. It is very important to distinguish between actinomycetoma and eumycetoma for selecting the therapy. Actinomycetomas generally respond well to antimicrobials compared with eumycetomas, which respond poorly and need a combination of medical and surgical therapy. Bone involvement makes treatment more difficult, keeping surgical amputation as the only choice of treatment. Despite the possibility of a cure with medical treatment alone, treatment failure may occur even with long-term therapy, which necessitates adding surgical intervention to achieve cure. We report a case of gluteal actinomycetoma in an Omani man, treated successfully by combined medical treatment and surgical excision with graft reconstruction after failure of different regimens of antimicrobials.


40 patients with diabetic gastroparesis. Results of a 3-wk double-blind study indicate that metoclopramide at a dosage of one 10-mg tablet four times daily reduced nausea, vomiting, fullness, and early satiety and improved meal tolerance better than placebo. Statistically significant differences were noted for nausea and postprandial fullness. Mean gastric emptying assessed by radionuclide scintigraphy was significantly improved in the metoclopramide-treated group when compared with their baseline result. Metoclopramide is an effective agent for improving the upper gastrointestinal motor function in diabetic patients with gastroparesis.


When rival Zillow Group, Inc., went public in July 2011, it was only a matter of time before Trulia, Inc. (Trulia), followed suit. In late 2011, Trulia's board of directors was intent on going public when it hired Sean Aggarwal as its CFO to see the firm through the initial public offering (IPO) process. In late May 2012, he is considering when to go public, in the wake of Facebook's disappointing IPO earlier in the month, which had stalled the IPO market. Also, in April 2012, the Jumpstart Our Business Startups (JOBS) Act was passed into law, bringing new regulations that affected the IPO process for emerging growth companies (EGC), or companies with less than $1 billion in revenue in their most recent fiscal year. Trulia would qualify as an EGC, and therefore was eligible to avail itself of the reduced disclosure and public on-ramp provisions of the law. This case examines an IPO that follows in close proximity to the passage of the JOBS Act. Aggarwal must determine what provisions of the new law to adopt with few precedents to go by. The case includes a simple valuation exercise of Trulia's preliminary price range for instructors who wish to cover this topic. It also covers two other controversial issues about IPOs: the high costs of going public and the disappearance of small IPOs in the United States from 2001 to 2011, as motivation for the JOBS Act. A brief review is given of each topic and the controversy surrounding it to allow instructors flexibility in exposing students to these issues. This case was written for Darden's second-year MBA elective focusing on financing arrangements, but would be useful in undergraduate or graduate courses covering investment banking, capital raising, or corporate finance.
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The Brazilian fermentation process has unique characteristics, such as the utilization of acid yeast cell recycling. The difficulty to sterilize large volumes of water and sugarcane juice enables the presence of indigenous yeasts. Occasionally, those yeast strains are better adapted and exert dominance over the commercial strains employed in the fermentation process. This study explored the prevalence of indigenous yeast strains in an ethanol producing unit in Brazil. The samples, ranging from beginning to late stages of the harvest season, show the presence of indigenous yeast. This can be observed by the divergence in PCR banding patterns from the samples, when compared to the commercial yeast strain PE-2 utilized by this particular ethanol producing unit. The results obtained point to the dominance of indigenous yeasts in the fermentation system that surpass in occurrence the commercial strain in all stages of the harvest season.


An amylolytic strain was collected from rotten potato and its activity evaluated. The isolated strain was cultivated for amylase production in shake flasks at 35±2 o C and the fermentation pattern was studied. Optimum temperature for maximum enzyme synthesis was observed at 35°C, when initial pH of fermentation medium was adjusted to 5.5. Maximum extracellular amylase activity of 7.9 U/mL and the maximum intracellular activity of 320 U/mL was recorded. Although maximum biomass was present at 12.6 g/L but highest growth rate was observed between 08 to 40h with maximum at 36h. The extracellular amylase present in the broth was partially purified with an overall yield of 44% through purification procedure of ammonium sulphate precipitation. After completed extraction and partial purification and stabilization, the stability of enzyme was observed in a range of temperature and pH between 60°C-90°C and 2-8 pH respectively. Maximum enzyme activity was demonstrated at 90°C, and pH of 5.5 and 6.5. The thermo stability of the amylases of this Bacillus species was comparable to that of amylases from other microbial sources. Int J Appl Sci Biotechnol, Vol 3(3): 427-430


Apioideae is the biggest and the most diverse of four subfamilies recognised within Apiaceae. Except for a few, likely derived, woody clades, most representatives of this subfamily are herbaceous. In the present study, we assessed stem anatomy of 87, mostly therophytic and hemicryptophytic, species from at least 20 distinct lineages of Apioideae, and juxtaposed them with 67 species from our previous anatomical projects also focused on this subfamily. Comparing our data with the literature, we found that wood anatomy does not allow for a distinction between apioids and their close relatives (Azorelloideae, Saniculoideae), but more distantly related Mackinlayoideae differ from Apioideae in their perforation plate type. Vessel element and fibre length, and vessel diameter were positively correlated with plant height: phenomena already reported in literature. Similar pattern was retrieved for vertical intervessel pit diameter. Wood ground tissue in apioids ranges from entirely fibrous to parenchymatous. The shortening of internodes seems to favour the formation of parenchymatic ground tissue, whereas the early shift to flowering promotes the deposition of fibrous wood in monocarpic species. These results support a hypothesis on interdependence among internode length, reproductive strategy, and wood ground tissue type.


The purpose of this study was to investigate the viscoelastic properties of tendon structures in humans. Elongation of the tendon and aponeurosis of medial gastrocnemius muscle (MG) was directly measured by ultrasonography, while subjects (N=12) performed ramp isometric plantar flexion up to the voluntary maximum, followed by a ramp relaxation. The relationship between estimated muscle force (Ff) and tendon elongation (dL) was fitted to a linear regression, the slope of which was defined as stiffness of the tendon structures. The hysteresis was calculated as the ratio of the area within the Ff-dL loop (elastic energy dissipated) to the area beneath the load portion of the curve (elastic energy input). The resulting Ff-dL relationship was non-linear in form, as previously reported on animal and human tendons in vitro. The mean stiffness was 24.0•}5.6 N/mm. However, there was a considerable inter-subject variability (15.8 to 36.8 N/mm). The Young's modulus, i. e., the slope of the stress-strain curve, was 280 MPa, which tended to be lower than the previously reported values for human tendons. It was also found that the strain of the tendon structures was homogeneously distributed along its length. The mean hysteresis (energy dissipation) was 23.4•}12.4%. However, again there was a considerable inter-subject variability (8.7 to 39.3%). The present results indicated that the tendon structures of human MG was considerably compliant and its hysteresis was in accordance with previously reported values. (Jpn. J. Phys. Fitness Sports Med. 1999, 48 : 597•`606) key words : stiffness, hysteresis, human tendon, ultrasonography


The effects of S-(3,3-Dimethyl-i -triazeno)imidazole-4-car boxamide (DTIC), 1-(2-chlomoethyl)-3-(4-methyhcyclohexyl)1-nitrosoumea (MeCCNU), and L-phenylahanine mustard (L PAM) have been compared by using three i.p. transplanted mouse melanomas: the Bi6 melanoma in CS7BL/6 mice; the Harding-Passey (HP) melanoma in BALB/c x DBA/2 F1 (hereafter called CD2F,) mice; and the Cloudman 591 mel anoma in DBA/2 mice. HP melanoma responds well to all three drugs. S91 responds only to L-PAM and MeCCNU. DTIC may accelerate death in mice bearing this tumor. Bi6 responds well to L-PAM and moderately well to MeCCNU and to multiple injections of DTIC. The best response to DTIC and MeCCNU is given by HP, while the best response to L-PAM is given by 591 . Tumor cell-doubling times were found to be 1.5 days for Bi6, 2 days for HP, and 3 days for S9i . HP would seem to be the most responsive melanoma with respect to the 3 agents studied. This may be due to an interaction between the chemotherapeutic agents and the host immune response, since the HP tumor arose in a noninbmed mouse and is thus nonsyngeneic with the CD2F, host. All three tumors appear to be interesting biological models for studying drug combinations and combined therapeutic modalities against melanoma.


In June 2007, the Supreme Court of Canada expressly overruled 20 years of jurisprudence that interpreted the freedom of association as excluding collective bargaining. This about-face by the Supreme Court was unexpected. What gave rise to this remarkable decision and what does it portend for the role of the courts in labour relations in Canada and beyond? The recent successes before courts have led some observers to suggest that it may now be a propitious time for a coordinated and proactive litigation strategy to vindicate labour's collective rights. This article offers some preliminary answers to these broader questions and issues by focussing on the Supreme Court's decision in the Health Services and Support case.


In the last decade, much of the attention is made towards introducing the smart systems and appliances to meet the requirement of the century and make life comfortable. During the same period, electric power sector also made the necessary innovation to compensate the demand of today's electric supply and to make use of electric resources effectively by introducing "Smart-Grid". The smart grid is a part of transformation and reformation in the power industry sectors. The smart grid is a future modern power system that utilizes internet of thing to monitor, control and create various intelligent communications in the electrical system. In this paper, the author first presents the fundamental architecture of Internet of Things (IoT). They then outline the key technologies of IoT for Smart Grid. Finally, the ideas of applied communication and framework of transmission and distribution monitoring based IoT for Smart Grid is discussed. The deployment of IoT technologies in Power System infrastructures would accelerate the smart grid development and enhance the electricity delivery services becoming more robust, attractive, responsive and communicative.


With the explosion of results in molecular biology there is an increased need for IE to extract knowledge to support database building and to search intelligently for information in online journal collections. We aim to build information extraction systems from biology papers and their abstracts available from the MEDLINE database[1, 3]. As a part of a project on information extraction from the research papers in biology domain, we are creating an expert-tagged corpus of MEDLINE abstracts, which will be used for training and testing the information extraction systems. In this paper, we outline the features of this new corpus, its ontological basis, our annotation scheme, and statistics of its annotated objects. We also show the tagging and tag management tools.


Background: Cachexia is a condition characterized as a loss in body mass or metabolic dysfunction and is associated with several prevalent chronic health conditions including many cancers, COPD, HIV, and kidney disease, with between 10 and 50% of patients with these conditions having cachexia. Currently there is little research into cachexia and our objective is to characterize cachexia patients, their healthcare utilization, and associated hospitalization costs. Given the increasing prevalence of chronic diseases, it is important to better understand cachexia so that the condition can be better diagnosed and managed. Methods: We utilized one year (2009) of the Nationwide Inpatient Sample (NIS). The NIS represents all inpatient stays at a random 20% sample of all hospitals within the United States. We grouped cachexia individuals by primary or secondary discharge diagnosis and then compared those with cachexia to all others in terms of length of stay (LOS) and total cost. Finally we looked into factors predicting increased LOS using a negative binomial model. Results: We estimated US prevalence for cachexia-related inpatient admissions at 161,898 cases. Cachexia patients were older, with an average age of 67.95 versus 48.10 years in their non-cachexia peers. Hospitalizations associated with cachexia had an increased LOS compared to non-cachexia patients (6 versus 3 days), with average costs per stay $4641.30 greater. Differences were seen in loss of function (LOF) with cachexia patients, mostly in the major LOF category (52.60%), whereas non-cachexia patients were spread between minor, moderate, and major LOF (36.28%, 36.11%, and 21.26%, respectively). Significant positive predictors of increased LOS among cachexia patients included urban hospital (IRR=1.21, non-teaching urban; IRR=1.23, teaching urban), having either major (IRR=1.41) or extreme (IRR=2.64) LOF, and having a primary diagnosis of pneumonia (IRR=1.15). Conclusion: We have characterized cachexia and seen it associated with increased length of stay, increased cost, and more severe loss of function in patients compared to those without cachexia.


Background and objectives In Rheumatoid arthritis (RA), anti-citrullinated protein antibodies (ACPA) represent highly disease-specific biomarkers found in the majority of patients. As ACPA have been implicated in disease pathogenesis, it is of crucial relevance to understand the underlying B cell response. In this context, visualisation of citrullinated antigen-specific B cells would allow for a detailed characterisation of the immune response to better understand its development and maintenance. Unfortunately, visualisation of autoreactive B cells in humans has proven extremely difficult. Materials and methods Using the CCP2-antigen and its arginine control variant, we developed a multicolour tetramer-based staining method to visualise citrullinated antigen-specific B cells in peripheral blood of RA patients by flow-cytometry. Specificity of the staining was verified by culturing tetramer-positive and -negative B cells isolated by FACS. Citrullinated antigen-reactive B cells were further phenotyped using cell surface markers associated with developmental and functional B cell characteristics. Finally, the frequency of citrullinated antigen-reactive B cells was correlated to ACPA serum levels and in vitro ACPA production. Results The staining procedure successfully separated citrullinated antigen-reactive B cells from non-specific background signals. Already fourteen FACS-sorted tetramer-positive B cells produced detectable amounts of ACPA, whereas no ACPA production was observed in cultures of up to 5000 tetramer-negative B cells. The majority of citrullinated antigen-reactive B cells had a post-germinal centre memory or plasmablast phenotype. Up to 1 in 200 memory B cells were directed against citrullinated antigens, and their frequency correlated with spontaneous ACPA production in culture and ACPA serum titres in vivo. Conclusions We show, for the first time, the specific and reliable identification of citrullinated antigen-specific B cells in high frequencies in peripheral blood of RA patients. The majority of this population has a memory phenotype and closely reflects the dynamics of the in vivo ACPA response. These data provide the basis for a detailed characterisation of this disease-specific immune response on a single cell level and could lead to the identification of novel therapeutic targets.


Purpose: To uncover potential diagnostic biomarkers for endocervical adenocarcinoma (EAC) and adenocarcinoma in situ (AIS). Experimental design: Quantitative label-free liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS) peptidomics strategies were employed to profile 8 cervical mucus (CM) samples, including 3 EAC cases, 2 AIS cases and 3 normal controls (Ctrl). Results: Among the 3721 exclusive peptides identified, 12 (5 up-regulated and 7 down-regulated) endogenous peptides were significantly expressed in EAC compared to healthy controls (EAC/Ctrl); 10 (7 up-regulated and 3 down-regulated) endogenous peptides were significantly expressed in AIS compared to healthy controls (AIS/Ctrl); 11 (6 up-regulated and 5 down-regulated) endogenous peptides were significantly expressed in EAC compared to AIS (EAC/AIS) (absolute fold change ≥1.5, Benjamini-Hochberg adjusted p-value ≤0.05). Among these identifications, annexin A1 (ANXA1) was found to be down-regulated both in EAC and AIS, and its unique peptide (FIENEEQEYVQTVK) may be promising indicators for cervical glandular epithelial lesions. Conclusion: This is the first study to utilize CM peptidomics in cervical glandular malignancies, which may reveal the novel noninvasive biomarkers for EAC and AIS.


Decentralisation has the potential to address one of the most deep-rooted causes of conflict in Liberia. Yet, as the planning continues, a myriad challenges have emerged.
Liberia has long been characterised by a deeply entrenched centralism. This was created by the American Colonisation Society (ACS) in 1847 for freed and repatriated slaves - known as Americo-Liberians - who became the ruling minority for over a century, largely suppressing indigenous Liberians. Attempts at decentralisation prior to the war were limited and never fully materialised under either presidents William V.S. Tubman (who introduced an integration strategy) or William R. Tolbert, Jr (with his Rural Development Taskforce). During the reign of Samuel K. Doe, no decentralisation was provided for - despite introducing a new constitution in 1986 - largely due to the politicised nature of the reform consultations.


Learning new skills isn't only for the benefit of passing the exam but being able to apply those skills in a productive way. One cannot learn before one understands which is why student understanding is a priority for facilitators. This becomes especially important in threshold concepts where a student will be unable to progress to the next stage before the threshold concept is mastered, but facilitators do not focus on pedagogy as they rely on the support of instructional designers. This explorative paper looks at student perceptions of their understanding of the threshold concept in electrical engineering, logic gates, after completing a lesson designed using the proposed ten-step activity plan. The activity plan is derived from the learning theories of Gagne, Biggs, Vygotsky and Gibson. A sample of 18 students completed an online survey that focused on their acquiring of skills relating to logic gates, truth tables and Boolean algebra. Results showed a positive experience with 88.89% of participants indicating that they left the lesson with a good understanding of the threshold concept. This ten-step activity plan can assist to close the gap between instructional designer and facilitator to design threshold concept lessons based on sound learning theory.


The authors performed the comparative analysis of radiographs of two groups of patients with severe dysplastic coxarthrosis who underwent total hip replacement with osteotomy of T. Paavilainen and without it. The study revealed significant differences in the results: the degree of leg lengthening and the degree of displacement of the greater trochanter with the restoration of the anatomical center of rotation using osteotomy on T Paavilainen significantly greater than with a standard prosthesis. The average limb lengthening without osteotomy was 29.1 mm, 95% confidence interval (from 24.5 to 33.6), and using osteotomy - 45.7 mm (from 41.8 to 49.6) (p 0.0001). The average displacement of the greater trochanter without osteotomy was 27.2 mm, 95% confidence interval (from 22.8 to 31.6), and with osteotomy - 61.4 mm (from 54.4 to 68.4) (p 0, 0001).


ABSTRACT Human papillomaviruses (HPVs) are small DNA tumor viruses that are the causative agent of warts and are associated with many anogenital cancers. The viral gene encoding the E6 protein has been found to be involved in HPV oncogenesis. E6 is known to inactivate the cellular tumor suppressor, p53. In addition, E6 has been shown to bind to a variety of other cellular proteins. The focus of this study was to determine what role the interactions of E6 with a subset of cellular proteins which contain a common α-helical domain in their E6 binding region (α-helix partners) play in E6-mediated phenotypes. We generated transgenic mice expressing a mutant of E6, E6I128T, which is defective for binding at least a subset of the α-helix partners, including E6AP, the ubiquitin ligase that mediates E6-dependent degradation of the p53 protein, to determine whether binding of α-helix partners plays a role in E6-mediated activities in vivo. Unlike mice expressing the wild-type E6 (strain K14E6WT), the mice expressing E6I128T lacked the ability to alter the radiation-induced block to DNA synthesis and promote the formation of benign skin tumors in conjunction with chemical carcinogens. Additionally, they displayed reduced levels of skin hyperplasia, spontaneous skin tumors, and tumor progression activity compared to those of the K14E6WT mice. From these results, we conclude that a domain in E6 that mediates α-helix partner binding is critical for E6-induced phenotypes in transgenic mice.


The aim of this study is to describe the experience and expectations of Chinese cancer patients with regard to the favorable and unfavorable words conveyed by their social support providers. In-depth interviews were conducted with 20 patients with cancer using a qualitative approach, and the data obtained were analyzed using content analysis. The findings indicated that favorable words inspired patients with cancer and raised their hopes. Such words included words expressing positive confirmation of patients' physical condition and mental status, words of encouragement and consolation, discussions of successful cases, information about advanced medical techniques and developments, practical instructions, emotional support from close relatives, confirmation about previous achievements for the family and about one's career, as well as small talk to distract the patient. Unfavorable words were those that weakened the patients' hopes and self-esteem. They included words expressing negative information and pessimistic attitudes, those indicating an overprotective attitude on the part of close relatives, as well as words expressing commiseration, advice, and an underestimation of the patients' suffering without empathy. The findings provide guidelines for nurses to communicate with patients with cancer verbally in a Chinese cultural context, and outline strategies for communication to meet psychologic needs of patients.


In this work, a novel, efficient, simple and green solid phase extraction (SPE) method based on a pipette tip filled with zirconium nanoparticles (Zr-NPs) was developed for the sensitive determination of cobalt in soil samples via slotted quartz tube-flame atomic absorption spectrophotometry (SQT-FAAS). Zirconium nanoparticles providing repeatable and reproducible signals of the analyte were synthesized via a practical method and used as adsorbents. Extraction and preconcentration steps were performed in a customized pipette tip loaded with zirconium nanoparticles. All parameters having significant effects on the analyte signal (pH and volume of the buffer, amount of nanoparticles, type, concentration and volume of the eluent, sample volume and sample flow rate) and instrumental conditions were optimized to obtain the best experimental outcomes. Under the optimum conditions, the linear range of the developed method was found to be between 7.5 and 75 μg L−1 with a correlation coefficient of 0.9998. The SPE method offered 56-fold enhancement in the detection power of FAAS with the limits of detection and quantification (LOD/LOQ) calculated as 2.2 and 7.2 μg L−1, respectively. The developed method was applied to soil samples in order to test both its applicability and accuracy for real samples. The percent recoveries obtained were in the range of 90–101%, indicating the method's accuracy and applicability for complex matrices such as soil samples.


Background and Objectives:The optimal AV delay should allow for the completion of the atrial contraction prior to the ventricular contraction, and provide for the longest diastolic filling and maximal stroke volume. This study evaluated the effects of the AV delay on the changes in heart functions, in patients with a DDD pacemaker and normal systolic function. Subjects and Methods:Nineteen patients were enrolled. The pacing rate was set at 70 beats/min. The AV delay was lengthened in 20-25 msec step, from 100 to 250 msec. The stroke volume and diastolic parameters were measured by echocardiography for each AV delay. Results:The changes in the stroke volume associated with the changes in the AV delay were not statistically significant. However, when viewing each individual patient, the optimal AV delay for each patient could be found. When comparing the stoke volumes obtained just before, just after, and during the maximal AV delay, a statistically significant difference was found (p<0.05). The absolute value of the E/A ratio was less than 1. The pulmonic vein flow pattern was dominated by the systolic flow, but the changes were not statistically significant. There was a tendency for the E wave propagation slope to decrease. However, the absolute value was less than 40 cm/s, and the E/E' absolute ratio was more than 8, but neither showed any significant differences. Conclusion:In patients with a DDD pacemaker and normal systolic function, the diastolic parameters were abnormal, and the stroke volume affected by the change in the AV delay. (Korean Circulation J 2003;33 (8):701-708)


Background There is a widening care gap in Canada between patients who need Rheumatology care and the capacity of the system to deliver that care in a timely manner. At Rheumatology Health Team Hamilton we have developed several models of team-based care with trained rheumatology nurses. One successful team -based model has been a nurse managed injection clinic treating patients with inflammatory arthritis or soft tissue pain. All patients fill out a health check questionnaire and authorize their consent before receiving injections, ensuring patient safety. Nurses use a set of directives written by the rheumatologist as guidelines for the clinic with a Rheumatologist always present on site. This clinic allows immediate access and assessment of patients with flares or potentially needing steroid injections. Currently this clinic administers nearly 100 injections per week. The purpose of this study was to assess patient perspectives on how they view this team -based model as compared to a traditional MD model which historically would cause a delay of treatment by 8-10 weeks before an assessment of their disease was possible. Objectives To determine patients satisfaction with a nurse led corticosteroid injection clinic to manage symptomatic flares. Methods A cross-sectional study sampling 217 consecutive patients who attended the injection clinic was conducted at Dr. Bensen's Rheumatology Practice in Hamilton, Canada from May 2013 to June 2013. Patients were given a structured self-administered questionnaire to determine their satisfaction with the steroid injection clinic run by the nurses. Those that have English as a second language were excluded as well as anyone who wasn't able to understand and follow directions on the questionnaire. Efficacy and relevance was assessed by patients answering eight qualitative questions. Results The results of this study indicated that patients were offered timely access to care at critical times when they were experiencing a flare of disease symptoms. 83% of patients responded that their pain was better managed in this clinic. 96% of patients affirmed that they were able to be seen within 2 weeks of their onset of symptoms. All patients surveyed felt comfortable discussing their health issues with the nurse and felt confident in the nurse's assessment and injection techniques. Overall the patients reported that because of this nurse led injection clinic model their quality of life living with a rheumatologic condition improved. Conclusions Our results show that a nurse run steroid injection clinic is both valued by patients for pain and inflammation management and is readily available. This demonstrates a high degree of satisfaction with the nurse run program and they feel very strongly that without this clinic their pain management would not be optimal. Without this clinic, patients indicated that they would seek treatment elsewhere, mostly with their family doctors, emergency rooms, or walk-in clinics, resulting in further congestion in an already overwhelmed healthcare system. This study determined that nurse run steroid injection clinics are both needed and valued by our patients in Hamilton, Canada. Disclosure of Interest : None declared DOI 10.1136/annrheumdis-2014-eular.3012


Conventional biological treatments used in most Indonesian landfill sites are mostly ineffective in treating stabilized landfill leachates to meet the standard regulation. Thus, a combination of biological and electrochemical process is offered to successfully treat leachates containing a high concentration of organic and nitrogenous compounds. In this study, a moving bed biofilm reactor (MBBR) was applied prior to electrochemical oxidation by using boron-doped diamond (BDD), Ti/IrO2, and Ti/Pt anodes with applied current of 350, 400 and 450 mA. The objectives were to investigate the effect of anode type and the applied current on the removal of organics as well as total nitrogen from the MBBR-treated leachate with electrochemical oxidation. The optimum removal of chemical oxygen demand (COD) observed on the Ti/Pt anode was 78% by applying 400 mA, with an estimated energy of 56.7 Wh g L-1. In the case of Ti/IrO2 and BDD anodes, the optimum removal of COD was 76 and 85% with an energy consumption of 58.9 and 36.9 Wh g L-1, respectively, both achieved at 350 mA. Although all anodes showed less-satisfactory performances for total nitrogen reduction, around 46-95% removal of nitrogenous compounds was achieved by MBBR, with their partial conversion to nitrates.


This report investigates the effects of noise on a speaker dependent, isolated word recognition system. Correct word recognition in a noise-free environment exists in a variety of present-day applications. However, when the acoustic environment includes noise, the problem of correct word recognition becomes more difficult. The noise interferes with the accurate location of the word boundaries and also distorts the spectral representation of the speech waveform. A series of experiments were performed to determine (1) the effects of using an energy-based endpoint detector and a conventional isolated word recognition system when the input speech is noisy and (2) the effects of placing a noise suppression prefilter in tandem with the word recognizer in an attempt to remove the noise prior to recognition. It was found that the system consisting of the prefilter working in tandem with the word recognizer increased word recognition accuracy. *This report is based on a thesis of the same title submitted to the Department of Electrical Engineering and Computer Science at the Massachusetts Institute of Technology in February 1983 in partial fulfillment for the degrees of Bachelor of Science and Master of Science.


Pigmented cosmetic dermatitis1–4 is a new name for melanosis faciei feminase designated after the mechanisim and causative allergens of this pigmentary disorder were greatly clarified. In Japan, a large number of pigmented cosmetic dermatitis patients were noted in the 1960s and 1970s; however, the number of patients has decreased remarkably since 1978, when major cosmetic companies began to eliminate strong contact sensitizers from their products. This review is concerned with the way this pigmentary disorder was overcome through the use of patch testing and allergen control.