We conducted a critical review of the literature on ketoconazole in preventing acute respiratory distress syndrome (ARDS), a serious disorder associated with high mortality. Two double‐blind, prospective, placebo‐controlled, randomized trials compared ketoconazole with placebo for prophylaxis of ARDS. In one trial, compared with placebo, ketoconazole resulted in a reduced frequency of ARDS (6% vs 31%, p<0.01), lower plasma thromboxane B2 levels (33 vs 75 pg/ml, p<0.05), and shorter intensive care unit stay (7 vs 15.5 days, p<0.05). In the second trial the drug reduced the frequency of ARDS (15% vs 64%, p=0.002), lowered thromboxane B2 levels (83 vs 143 pg/ml), and reduced mortality (15% vs 39%, p=0.05) compared with placebo. Larger multicenter studies are warranted to validate the findings of these two trials.


A 6-year-old child presented with left sinus of Valsalva aneurysm opening in right atrium. Origin of sinus of Valsalva from left aortic sinus and its opening into right atrium is extremely rare. The anomaly was corrected surgically by patch closure at the aortic end. Follow-up echocardiography did not reveal any residual shunt in right atrium.


We report a patient with a rudimentary uterine horn, fallopian tube and ovary in an inguinal hernia. Associated with this abnormality the patient had ipsilateral renal agenesis and a unicornuate uterus.


In this work, we present a radix-10 division unit that is based on the digit-recurrence algorithm and implements binary encodings (Binary Integer Decimal or BID) for significands. Recent decimal division designs are all based on the Binary Coded Decimal (BCD) encoding. We adapt the radix-10 digit-recurrence algorithm to BID representation and implement the division unit in standard cell technology. The implementation of the proposed BID division unit is compared to that of a BCD based unit implementing the same algorithm. The comparison shows that for normalized operands the BID unit has the same latency as the BCD unit and reduced area, but the normalization is more expensive when implemented in BID.


Introduction: In recent years, the health-giving properties of probiotics have attracted the attention of many researchers. Probiotics are vital microorganisms that can play a useful role in improving human health if they are used consistently and adequately. Lactobacillus and Bifidobacterium are the most common probiotic bacteria that are introduced as the normal flora of the body. Probiotics can have a beneficial effect on improving human health by inhibiting or reducing pathogenic microorganisms. They can play an effective role in the treatment and prevention of various diseases such as constipation, oral and dental diseases, cancer, diarrhea, Helicobacter pylori infection and similar diseases. The purpose of this study is to review probiotics and their impact on preventing and improving human health.
Conclusion: Based on the studies, it can be concluded that the continous and sufficient consumption of probiotics can prevent and improve human diseases.


Biofluids as concentrated suspensions exibit (at fixed shear rate gamma) a steady shear viscosity eta which critically depends on (i) the volume fraction of particles phi, and (ii) the ability the particles have to form more or less loose structural units (flocs, aggregates or parts of network). The latter can be quantified by some effective packing volume fraction phi p which reflects the actual compacity of structural units. A special eta-phi relationships which involves such a packing fraction will be discussed. Changes of structural units as shear rate gamma (or shear stress sigma) varies lead to phi p = phi p (gamma) i.e. to non-newtonian viscosity. This shear-thinning behaviour is believed to result from some dynamical equilibrium between formation and destruction of structural units, in the presence of both brownian motions of particles and the shear stresses the suspending fluid exerts on them. A (simple) rate equation (from reaction kinetics) gives a quantitative description of phi p-dependences in gamma and time t. Under steady conditions, the present approach is capable not only to model shear-thinning behaviour but also plastic and shear thickening (dilatant) ones. Time variations under transient shear rate (i.e. thixotropy) can be described with phi p(t) deduced from the same rate equation. Extension to visco-elastic behaviour has been obtained using a Maxwell-model with instantaneous values of viscosity and elasticity which both are functionals of the structural variable phi p(t, gamma).


Introduction: Dental implants are a routine procedure within the therapeutic range of dentists. Many loading protocols are based on techniques and biological times that consider the biology of the host bed. However, early or late complications may occur, such as lack of osseointegration, peri-implantitis, and marginal bone loss. Nowadays, treatments for total or partial failure in osseointegration are often complex and unpredictable. It has recently been postulated that osseointegration is rather an immunomodulated event, which is the result of an equilibrium response to a foreign body reaction. Given this new evidence, there is a need to develop new therapeutic protocols and approaches to improve osseointegration and the prognosis of implant treatments. Hypothesis: Human bone marrow-derived mesenchymal stem cells (HBMMSC), resident in the maxillary and mandibular bones, immunomodulate osseointegration through the bioactivating effect of extracorporeal shock waves therapy (ESWT). Evaluation of the Hypothesis: Local immunomodulation is currently considered one of the main functions of mesenchymal stem cells to maintain tissue homeostasis, and it has been demonstrated that ESWT manages to stimulate the activity of HBMMSC. Clinical and experimental reports demonstrate the therapeutic potential of ESWT in medicine and dentistry. Conclusion: ESWT medical devices could become a new therapeutic strategy to immunomodulate osseointegration. The bioactivating effect of ESWT on resident HBMMSC can have the potential of guiding the tissue response to a more favorable outcome, with the objective of improving clinical success and decreasing the complications of dental implant treatments.


The study determined the carbon budget of the Loboc-Bilar Mahogany (Swietenia macrophylla King.) Plantation in the province of Bohol, Philippines within the months of June to October 2018. The plantation straddles two municipalities, Loboc and Bilar. It is a popular destination for local and international tourists due to its compelling tunnel-like vegetative scenery. Delineation of the plantation boundary was fine-tuned using both image digitization and ground survey. A random sampling method was applied in conjunction with Geographic Information System (GIS) software to spatially distribute sampling plots in the research area. Several carbon pools were assessed, namely: aboveground biomass, necromass or ground biomass, and belowground biomass. Allometric and other mathematical equations were used in the calculation of biomass density, stored carbon and carbon dioxide equivalents. The plantation had 29,428.03 Mg of stored carbon in the biomass distributed over a total land area of 115.21 ha, yielding an estimated stored carbon density of 255.43 Mg ha-1. The monetized value of stored carbon in the whole plantation amounted to US$486,003.96.


Author(s): Thow, Caroline | Advisor(s): Lyon, Bruce E | Abstract: All organisms must allocate limited resources to reproduction and survival, producing life history trade-offs. One such trade-off is maternal care, which balances a female's current reproduction against her future survival. Alternative reproductive tactics have evolved as a way of maximizing lifetime reproductive success by balancing the costs of parental care against the benefits that care provides to current offspring. Conspecific brood parasitism (CBP) is an alternative reproductive tactic where females lay eggs in the nest of a conspecific, providing no further care to those offspring. Some parasitic females may have their own nest in addition to laying parasitically. This results in three possible seasonal reproductive options: nesting and parasitizing, nesting without parasitizing, and parasitizing without nesting. While CBP is taxonomically widespread, it occurs at remarkably high rates in waterfowl. Detecting CBP is challenging, and historically researchers have relied on behavioral and morphological evidence to identify it. Recently, genetic methods of maternity assignment have allowed researchers to detect parasitism directly. However, genetic methods have not been examined under conditions common in waterfowl, where parasitic females may be highly related to their hosts and the candidate parent pool is often incomplete. Additionally, while females can flexibly transition between CBP reproductive options between years, the reproductive success of CBP reproductive options are often quantified by single-season estimates and are rarely considered in the context of the entire lifespan of the females that engage in this behavior. My dissertation focuses on testing accuracy of both genetic and non-genetic methods of detecting CBP and quantifying long-term patterns of CBP in the wood duck (Aix sponsa) in California. In Chapter 1, I assessed the accuracy of detecting CBP using genetic assignments with simulated wood duck populations. Genetic methods of maternity assignment in the context of CBP in wood ducks rarely make assignment errors given a diverse set of microsatellite markers and a largely complete sample of candidate mothers, but the risk of false exclusion and misassignment does increase with related females in the candidate parent pool. In Chapter 2, I compared field-based genetic and non-genetic estimates of CBP. Non-genetic methods produced underestimates of CBP as compared to genetic estimates. However, in combination with genetic estimates of CBP, non-genetic methods uncovered CBP patterns in wood ducks that genetic methods alone would not have revealed. In Chapter 3, I used genetic assignments to quantify the frequency of CBP in wood ducks at the population level over five years, calculated single-season reproductive success of individual females' reproductive options, and determined long-term patterns of CBP behavior of individual and their individual lifetime fitness estimates. The frequency of non-parasitic nesting females declined as density of breeding females and nest sites increased. Females that nested and parasitized had the highest reproductive success by single season measurements, while parasites that did not nest had the lowest reproductive success. Nesting parasitism contributed the most offspring to lifetime reproductive success but parasitism alone or nesting without parasitism could result in large fitness gains. Females nested more frequently as they aged, with or without parasitism, and continued to do so until they exited the population. Collectively, the results of my thesis suggest that genetic methods of maternity assignment are robust in CBP waterfowl, and female wood ducks flexibly transition into nesting reproductive options as they age, which ultimately results in higher reproductive success over the course of their lifetimes. My research is one of the first studies to assess lifetime reproductive success in a CBP system and highlights the importance of taking a long-term perspective in studies of alternative reproductive options to fully understand the costs and benefits of engaging in these behaviors.


The growth of China's population and die veracity of the figures that purport to measure it are both puzzles. Critical in die solutions to both puzzles are die records of an alien dynasty that ruled China from 1644 to 1911. All reconstructions of the growth of the population in recent centuries trace to one or the other of die two Ch'ing series—die local reports ordered by the emperor Ch'ien-lung in 1741, or the survey that began in 1909 and ended with the revolution in 1911. The results of the registration of 1953–1954 are consistent with the first Ch'ing activity. The statistics of the Republic of China had lineal descent from both series, but at a level of total population consistent with the limited results of the 1909–1911 survey.


The poor outlook for gastric cancer in Britain is largely due to late diagnosis. Earlier diagnosis will require both easy access to endoscopy and increased public awareness of dyspeptic symptoms. We used information by personal letter to encourage reporting of potentially significant symptoms in patients over 40 years of age. The aim of this study was to measure the acceptability and effect on gastroscopy rates of home letter information. Patients over 40 registered with 12 general practices were used in the study (practice population 80,000). Patients over 40 from another nine practices (practice population 46,500) acted as controls. A letter encouraging consultation for new dyspeptic symptoms was sent to all study subjects. Gastroscopy rates were compared in both study and control populations. Questionnaires on symptoms were sent to 500 study subjects. The principal outcome measure was the gastroscopy rate in people over 40 in both populations, before and during the intervention. The gastroscopy rate was 23% higher in the study than in the control population during the study (3.32 vs. 2.7%, P = 0.00016, chi 2 = 14.25). Gastroscopy uptake increased by 85% from 1991/2 to 1993/4 in the study group and by 34% in the control group (chi 2 = 14.02, P = 0.00018). Thirty-one per cent of questionnaire respondents had dyspeptic symptoms; only 3% had 'significant' symptoms of between 2 and 52 weeks duration. Home letters are an acceptable and efficient method of increasing gastroscopy uptake in dyspeptic patients over 40.


The importance of local formation of T3 in the feedback effect of the thyroid gland on hypothalamic TRH-producing cells has been established. Primary failure of the thyroid gland results in a fall in circulating T4 and T3 levels, leading to an elevation in the production and release of TRH in the hypothalamic paraventricular nucleus. In contrast, during short term fasting, declining plasma levels of thyroid hormones coincide with suppressed TRH production and release. In the brain, the prevalent enzyme that converts T4 to T3 is type II iodothyronine deiodinase (DII). The present study was undertaken to determine whether a differential hypothalamic expression of type II deiodinase may exist in fasted rats and in animals that are hypothyroid due to the failure of the thyroid gland. Using in situ hybridization, we assessed type II deiodinase messenger RNA (mRNA) levels in the hypothalamus of rats that were control euthyroid, hyperthyroid (T4), hypothyroid induced by propylthiouracil (PTU), and fasted. A group of fasted rats also received exogenous T4. DII mRNA was detected around the third ventricle, including the ependymal layer and adjacent periventricular regions as well as in the arcuate nucleus and the external layer of the median eminence. Quantitative in situ hybridization analysis demonstrated that PTU treatment and short term fasting resulted in significant elevations in DII messenger levels compared with those in euthyroid controls. Three weeks of PTU administration induced a consistent decline in circulating T3 and undetectable T4 levels, whereas 3 days of fasting resulted in only a 50% fall in the concentration of serum thyroid hormones. Interestingly, however, the expression of the DII mRNA was more than 2-fold higher in fasted animals compared with the values in PTU-treated rats. Furthermore, although T4 administration repressed DII mRNA expression in euthyroid animals, the same treatment had no effect on the fasting-induced elevations of DII message. To assess whether DII enzymatic activity is also affected during food deprivation, hypothalami were dissected out, and DII activity was measured in control euthyroid, fasted, and fasted plus T4-treated rats. To determine whether comparable changes in plasma thyroid hormone levels induced by fasting and PTU treatment could have affected DII enzymatic activity in a similar manner, animals were injected ip with PTU for 5 days to decrease plasma thyroid hormones to levels similar to those caused by fasting. DII enzymatic assay showed a significant increase in DII activity in fasted and fasted plus T4-treated animals compared with those in euthyroid controls and PTU-treated rats. No significant changes were found in PTU-treated rats compared with euthyroid animals. These data indicate that during short term fasting, a signal of nonthyroid origin underlies the robust elevation of DII production and activity in the hypothalamus. Thus, we propose that during the initial phase of food deprivation, an increased negative thyroid feedback exists on the hypothalamus due to locally formed T3. This local hyperthyroidism may, in turn, induce the suppression of TRH under these conditions.


Plants generally provide valuable functions in livelihood sustenance and indigenous knowledge on their utilization has been applied over centuries. However society So dependence on plant resources is threatened by rising environmental degradation especially in the tropics and the associated loss of indigenous botanical knowledge cannot be underscored. Traditional markets are useful sources on information on plants. This . paper reports on the ethno botany, availability and consumption trends of economic plants sold on the Kumasi Central market in the Ashanti Region of Ghana, as well as challenges encountered in marketing these resources. Structured questionnaire and inventory sheets were employed in a detailed documentation of information on the vendors and their products. Photographs of the products and specimens were also gathered, prepared and preserved in a herbarium at the Forestry Resarch Institute of Ghana. Information on 150 plant species belonging to 55 families was documented along with a taxonomic identification of new species. Nearly all plant species had multiple uses with approximately 57% and 20% usedfor medicinal andfood purposes respectively. Ninety-seven percent of the plants were non-timber forest products collected from the wild, and 30% of these were reported to have declined in supply as a result of degradation of vegetation. Demand has increased for 60% of the products, attributable to increased recognition and values that consumers currently attach to natural products mainly for medicinal and food purposes. With rising demand and declining supply of some plant species, the sustainability of the natural resource base is possibly threatened. This is because the sources from which these prodcuts are collected are usually unmanaged and harvesting methods, although rudimentary, may be destructive. Management interventions that would enable sustained exploitation of plant species collected from the ,wild, as well as the development of cultivation methods for key threatened species are imperative to aid biodiversity conservation and sustain the livelihoods of people relying on these resources for survival. Keywords: non-wood forest products, natural plant marketing, ethno botany, indigenous knowledge


We provide a comprehensive empirical analysis of the Build America Bonds (BABs) program. We show that the program benefits issuers in the form of lower yields relative to tax-exempt municipal debt for both general obligation and revenue issues. Our analysis suggests no differences in underwriter gross spreads for BABs issues at issuance relative to tax-exempt debt, and that issuance of BABs did not significantly affect prices of other tax-exempt bonds of the BABs issuers. Our analysis also examines characteristics of BABs issuers and factors influencing yields and gross spreads, and suggests that the BABs program was effective in achieving its objectives.


Objectives: To find out the occurrence rate and risk factors of unplanned reoperation (any unscheduled surgery within 30 d after the initial surgery) in patients who have received oral squamous cell carcinoma (OSCC) surgery and vascularized free flap reconstruction. Patients and Methods: We organized a retrospective study of 1058 patients who underwent OSCC resection and reconstruction with vascularized free flaps from 2011 to 2019. Clinical characteristics, reasons for unplanned reoperation, flap types, and previous treatment were compared between the unplanned reoperation group and the control group. Univariate and multivariate analyses were performed to identify perioperative risk factors for unplanned reoperation. The related perioperative factors that may influence perioperative infusion were included in propensity score matching to investigate the independent contribution of intraoperative colloid infusion on unplanned reoperation. Results: The overall rate of unplanned reoperation in OSCC patients was 11% (n=115). Flap necrosis and bleeding were the most common causes. Higher American Society of Anesthesiologists (ASA) grade [odds ratio (OR)=1.709, P=0.009], postoperative anemia (OR=0.983, P=0.011) and excessive intraoperative colloid input (OR=1.55, P=0.037) were identified as risk factors for unplanned reoperation. Propensity score matching was applied, and the difference of unplanned reoperation incidence between the matched groups was statistically significant (14.59% versus 8.54%; P=0.025). The multivariate analyses after propensity score matching confirmed that the intraoperative rate of colloid infusion of more than 2.3 mL/kg/h (OR=1.756, P=0.042) and prior radiotherapy (OR=2.78, P=0.001) are independent risk factors for unplanned reoperation. Conclusion: High intraoperative colloid infusion rate and prior radiotherapy may increase the risk of unplanned reoperation in patients who underwent OSCC surgery and vascularized free flap reconstruction.


Triple negative breast cancer (TNBC) is aggressive with a worse prognosis. We have recently shown that bitter melon extract (BME) treatment was more effective in inhibition of TNBC tumor growth in mouse models as compared to ER positive breast tumor growth. Aberrant dysregulation of lipid metabolism is associated with breast cancer progression, however, anti‐cancer mechanism of BME linking lipid metabolism in breast cancer growth remains unexplored. Here, we observed that accumulation of esterified cholesterol was reduced in BME treated TNBC cell lines as compared to control cells. We next evaluated expression levels of acyl‐CoA: cholesterol acyltransferase 1 (ACAT‐1) in TNBC cells treated with BME. Our results demonstrated that BME treatment inhibited ACAT‐1 expression in TNBC cells. Subsequently, we found that sterol regulatory element‐binding proteins‐1 and ‐2, and FASN was significantly reduced in BME treated TNBC cell lines. Low‐density lipoprotein receptor was also downregulated in BME treated TNBC cells as compared to control cells. We further demonstrated that BME feeding reduced tumor growth in TNBC mammospheres implanted into NSG mice, and inhibits ACAT‐1 expression. To our knowledge, this is the first report demonstrating BME suppresses TNBC cell growth through ACAT‐1 inhibition, and have potential for additional therapeutic regimen against human breast cancer.


Aims: To evaluate human papillomavirus (HPV) infection in whole cervical cone specimens with cervical intraepithelial neoplasia (CIN). In addition, to evaluate the relation between the presence of CIN lesions and HPV infection and the expression of Ki-67, p53, cytokeratins, Gp230 glycoprotein, and simple mucin-type carbohydrates. Methods: Cervical cone specimens from five patients with CIN were studied. For each specimen, serial sections encompassing the whole cone were collected (52 samples). HPV infection and HPV types were detected by the polymerase chain reaction and enzyme immunoassay. The expression of Ki-67, p53, cytokeratins, Gp230, and simple mucin-type carbohydrates was examined immunohistochemically. Results: All cases showed high risk HPV types, namely types 16, 33, 35, and 58. Four of the five patients were infected by multiple viral types. HPV-58 was always seen in CIN III, whereas HPV-35 was more frequent in CIN I. The expression of Ki-67 and p53 was higher in CIN III lesions. The expression of cytokeratins 8 and 17 showed complete or almost complete overlap with CIN III. Altered expression of Gp230, Tn, and sialyl-T was often seen in all grades of CIN. Conclusions: When whole cervical cone specimens are evaluated the rate of multiple HPV infection is very high. The expression of cytokeratins 8 and 17 is a useful marker of CIN III.


The densities of a selection of binary mixtures of fused alkali nitrates with alkaline earth nitrates have been measured by means of a manometric densitometer. Within the range of liquid stability all results are expressible as a linear function of temperature. For any pair of salts the isotherms of equivalent volume as a function of equivalent composition have been found to be straight lines. Although decomposition did not permit observations over the whole temperature range, any excess volumes of mixing are sufficiently small to justify extrapolation to determine the theoretical equivalent volumes of the alkaline earth nitrates. The partial equivalent volumes Vm (the volume of melt containing one gram-ion of nitrate ion) of the constituents are thus effectively independent of composition at a given temperature and are given by: NaNO3 Vm = 44.18 + 1.76 x 10-2 (t - 300) KNO3 Vm = 53.25 + 2.29 x 10-2 (t - 300) RbNO3 Vm = 58.37 + 2.62 x 10-2 (t - 300) CsNO3 Vm = 66.25 + 3.06 x 10-2 (t - 300) 1/2Mg (NO3)2 Vm = 38.80 + 1.12 x 10-2 (t - 300) 1/2Ca(NO3)2 Vm = 38.70 + 1.01 x 10-2 (t - 300) 1/2Sr(NO3)2 Vm = 39.55 + 1.02 x 10-2 (t - 300) 1/2Ba(NO3)2 Vm = 41.75 + 1.03 x 10-2 (t - 300) where t is the temperature in degrees Celsius. Vm is correct to ±0.1 % and the expansion coefficient to 1.3%. An interpretation of the effectively ideal behaviour of these systems is discussed on the basis of simple structural models for the packing of nitrate ions.


Information on the energy that is needed to transfer an electron from the valence band of an inorganic compound to a trivalent lanthanide impurity is presented. The energy is a measure of the location of the ground state of the divalent lanthanide relative to the top of the valence band. A variation with type of lanthanide is found that is the same irrespective of the type of compound (fluorides, chlorides, bromides, iodides, oxides, sulfides). The variation is anti-correlated with the known variation in fd transition energies in divalent lanthanides. Because of the anti-correlation, the energy difference between the first 4fn−15d state and the bottom of the conduction band is relatively invariant with type of lanthanide ion. The difference is largest for Eu2+, and decreases gradually towards the end of the lanthanide series by 0.5 eV for Y b2+. Based on the systematic variation in charge transfer energy and fd energy, a three-parameter model is presented to position the energy levels for each divalent lanthanide relative to valence and conduction band states. Using a similar model the levels of trivalent lanthanides are positioned.


AIM
To explore the effect of orthokeratology (OK) fitting on retinal vessel density in low to moderate myopia adolescents by using optical coherence tomography angiography.

METHODS
Children aged 10 to 14y with a cycloplegic spherical equivalent refraction of -0.50 diopter (D) to -5.00 D and astigmatism with more than -1.50 D were recruited. The enrolled adolescents were divided into OK group and spectacle group. During regular follow-up, adolescents were measured respectively at pre-wear, 1, 3, and 6mo after treatment. The follow-up included uncorrected distance visual acuity (UDVA), axial length (AL), superficial capillary plexus density (SCPD), deep capillary plexus density (DCPD), central retinal thickness (CRT), foveal avascular zone area (FAZ-A), foveal avascular zone perimeter (FAZ-P) and foveal vessel density in a 300-µm-wide region around foveal avascular zone (FD-300). The collected data were analyzed using statistical methods.

RESULTS
By one month, SCPD significantly increased in the fovea and superior retina, and DCPD significantly increased inferiorly in OK group compared to spectacle group (P<0.05). By three months, there were significant increases in SCPD in the fovea and inferior retina, and DCPD in the parafovea, superior, and inferior retina in OK group (P<0.05), while the increase in SCPD and DCPD in the fovea were observed by six months (P<0.05). The FD-300 significantly increased at every follow-up in OK group compared to spectacle group (P<0.05). No significant differences in the CRT, FAZ-A and FAZ-P and FD-300 were observed between two groups (P>0.05). OK group showed a significant improvement in UDVA after wearing OK, compared to spectacle group (P<0.01), while the AL did not show a significant difference between two groups (P>0.05).

CONCLUSION
Short-term OK worn can increase local retinal vessel density in adolescents with low-to-moderate myopia.


Objectives: To estimate the prevalence of Helicobacter pylori (H. pylori) and parasites in symptomatic children examined for H. pylori antibodies, antigens, and parasites in Yemen. Methods: A record-based study was carried out at Specialized Sam Pediatric Center in Sana'a, Yemen for 3 years between 2011-2013. Out of the 43,200 patients seen for different causes through that period, 1008 (2.3%) (females: 675 [67%]; males: 333 [33%]) had gastric complaints, and were subjected to an examination of blood and stool for H. pylori and parasites. Data regarding age and gender was also collected. Results: The age of the patients ranged from 3-15 years. The prevalence of H. pylori among children examined for H. pylori was 65%, 30% of them were males, and 35% were females (chi square [I2]=142 p=<0.01]). The prevalence in the 6-8 years age group was 83%, and it was 52% in the age group of 12-15 years. The prevalence of giardiasis was 10%, and amoebiasis was 25%. Conclusion: Prevalence of H. pylori infection among children was high, and was more prevalent in the age group of 6-8 years than in the other age groups. Females were more affected than males. Parasites (amoebiasis and giardiasis) infestation was less prevalent.


rate. In the most favourable circumstances children given the hormone may catch up so effectively that in the end they reach normal adult size. The precise sorts of small children who benefit and the amount and nature of the growth produced are still matters for research. During the past five years the Medical Research Council has obtained contributions of human pituitary glands from departments of pathology throughout the United Kingdom and has made available a limited supply of H.G.H. for clinical trials. This paper reports the first results, so far as growth in small children is concerned, of this co-operative venture. The number of glands received permits the treatment of only about 40 children at present dosage; there are undoubtedly far more children in the country than this who would benefit from treatment. In the light of the findings reported in this paper, therefore, we would urge pathologists and others to send still more pituitaries for extraction (the details of the procedure are given in Appendix I).


A b s t r a c t Maltese honey has been valued for its medicinal properties since ancient times, so much so that the word Malta is derived from the ancient Greek word, Melite, which means honey. in this study, Maltese honey samples (n = 30) from three harvest seasons and different floral sources were analysed to determine their antioxidant/antiradical properties. colorimetric assays were used to determine the polyphenol content, flavonoid content, and colour intensity, and these values were analysed to determine whether they correlated with radical scavenging activity as determined by bioassays. The honey samples varied in their dPPh activity (range, 3.326 - 11.865 mg AeAc/100 g honey), reducing power (ec 50 range: 5.632 - 14.453 mg/ml), total phenolic content (range, 8.114 - 109.765 mg TAe/100 g honey), total flavonoids (range, 0.655 - 212.865 mg Re/100 g honey), and colour intensity (range, 0.000 - 99.581 mm Pfund). The data were subjected to factor analysis using principal components. The antioxidant properties correlated significantly with total polyphenol content and colour (p<0.0001). Principal components analysis revealed three clusters of honey corresponding to the three harvest seasons.


The results of the comparative study of aquatic macrophytes from habitats with different levels and nature of anthropogenic impact phenolic compounds (PCs) and heavy metals (HMs) have been represented in this article. The structural and functional features of Elodea canadensis Michx. photosynthetic apparatus were investigated. Plants material was collected in July, during the flowering period of macrophytes, from the background and impact areas of the Lyala and Revda rivers of Sverdlovsk region, Russia. It was shown that the plants from HMs contaminated habitats characterized by larger sizes of leaves thickness and bigger cells and chloroplasts. Significant changes in elodea sheet thickness and cells dimensions in phenolic polluted area have not been identified. Dimensions of chloroplasts in the impact site decreased. Obviously, this type of resistance to phenol-containing wastewater is due to other security mechanisms. It was shown that chlorophyll content in the Elodea leaves from the polluted water bodies has been increased. Carotenoids content in the impact areas also increased in connection with their antioxidant function, which is particularly evident in stressful conditions.


To the Editor: I read with interest the recent editorial by Dr Barrington regarding international registries for regional anesthesia. Patients have a right to expect a doctor to know their outcomes of any procedure they intend to perform on them, but in reality few of us would be able to provide patients with accurate personal data. As cost and time constraints make postal surveys and phone questionnaires impractical for routine patient follow-up, few patients are questioned after their discharge from hospital about their experience with the block and its success. Is it not time therefore to embrace the modern technology available (text messaging and e-mails) to enable us to collect more practice-changing feedback from our patients? Research data is valuable but it relates to someone else's practice with a different level of experience operating in a different health care system in a different part of the world. A ''virtual department of anesthesiology,'' as described in the editorial, could supply information needed to better inform patients what to expect based on mass data captured in the real world of daily clinical practice, or from our own individual results. Benchmarking one's own performance and results against others in the virtual department would enable a change of practice and retraining for those at the lower end of the performance curve, while giving an opportunity for those at the top end of the curve to share how they work. The Dartmouth registry's follow-up process includes ''ward visits, phone calls, and effective communication with surgical colleagues.'' Ward visits are often not possible, as many patients go home so soon, and effective communication with the surgeons is not a practical way to find out the type of information we need. Phone calls can work and give a personal touch, but they can take a lot of man hours to collect all the information desired from all the patients. At Southampton (United Kingdom), we have developed iPROMS, a highly automated way of collecting this information. iPROMS is powered by an electronic patient record called Cellma, which has been developed by the health software company RioMed. Using iPROMS, we log the fact that we have performed a block on a patient. The software system has been preset with our personal preferences to know what questions we want sent to the patients and at what times after the operation. Our patients are e-mailed on days 2 and 7 postoperatively and asked to click on a link that takes them to our secure Web site. Patients answer questions about their pain, their experience, and complications of the block, as well as their overall satisfaction. Patient answers directly populate databases that automatically produce generic reports at the touch of a button. Bespoke reports can be produced for users wishing to drill down into their information, and benchmarking graphs allow comparisons between clinicians or departments. Automatic reminders are sent to nonresponders, and red-flag alerts are set to immediately inform the clinician should apatient answer a question that raises concern. Dr Barrington states the importance of a uniform data set when setting up a virtual anesthetic department to ensure we end up with comparable data, and I agree to a point, but we should not be too restrictive. Our system is very easy to configure, and so individual users can put in and remove questions that are more applicable to their practice and their institution. This information is just made available to the local user, while other fields in the suggested minimum data set can be uploaded to the virtual department, allowing widespread anonymous viewing of these data. This functionality allows the suggested minimal data set to be collected, while the flexibility to ask what you want remains. With mass users using such an automated system, we would very quickly build up a picture of how anesthetic practice differs around the world, and we could start to answer many of the questions within regional anesthesia to which we do not know the answer.


Plug-in hybrid electric vehicles (PHEVs) have potential to reduce or eliminate the United States' dependence on foreign oil. Quantifying the amount of petroleum each uses, however, is challenging. To estimate in-use fuel economy for conventional vehicles, the U.S. Environmental Protection Agency (EPA) conducts chassis dynamometer tests on standard historic drive cycles and then adjusts the resulting "raw" fuel economy measurements downward. Various publications, such as the forthcoming update to the SAE J1711 recommended practice for PHEV fuel economy testing, address the challenges of applying standard test procedures to PHEVs. This paper explores the issue of how to apply an adjustment method to such raw PHEV dynamometer test results in order to more closely estimate the in-use fuel and electricity consumption characteristics of these vehicles. The paper discusses two possible adjustment methods, and evaluates one method by applying it to dynamometer data and comparing the result to in-use fleet data (on an aftermarket conversion PHEV). The paper also presents the methodologies used to collect the data needed for this comparison. The predictions using the proposed method are shown to provide close agreement with the in-use observations when the actual fleet charging characteristics are included.


Regarding the fact that huge amount of non-renewable energy is extracted, distributed, converted and consumed for electrical demands in the Building-Integrated Photovoltaic systems, using the rotational photovoltaic panels as a source of energy would be more convenient. Optimization of this system which harvests outdoor natural light and indoor artificial light is an enormous need to maximize the solar panel efficiency. In this paper to achieve the main purpose, an experimental attempt has been made to model the wall and window built PV system as economical as possible. The performance of this model is carried out on the facade of buildings with a Manual switch for rotation. The result of this experiment has shown that the system is more efficient.


The amount of specific antibody present in polyc1onal antiserum, ascites fluid, or hybridoma supernatant can be quantitated by either solid-phase radioimmunoassay (RIA) or by direct enzyme-linked immunosorbent assay (ELISA; ostt 11.4). In the solid-phase assay described here, serially diluted antiserum is incubated in microtiter wells previously coated with the relevant antigen. Bound antibody is detected by employing 125I-Iabeled anti-immunoglobulin antibodies. The amount of specific antibody in the antiserum is then determined from a standard curve generated with a specific antibody of known concentration. The unknown antiserum and the standard antibody are assayed in parallel. The support protocols describe the chloramine T and IODO-GEN procedures for radioiodination of the anti-immunoglobulin reagent. The use of the solid-phase RIA procedure to determine the light-chain (x: and A.) and heavy-chain (y, J.l., a) isotypes present in polyclonal antisera and fluids containing monoclonal antibodies is also described as a basic protocol.


Background: In Switzerland, hospitals are now forced to improve their cost transparency to deal with a tightening financial environment. Decision makers demand benchmark data in order to detect efficiency potential. As part of the supporting services, cleaning services are also affected by that. However, up until now there has been no benchmarking opportunity for cleaning services in hospitals. Purpose: This paper is about the research being applied to develop a benchmark methodology for cleaning services in hospitals. Methodology: Mixed methods design within a traditional qualitative research design, underpinned by the pragmatism paradigm and a primarily inductive approach. The inquiry strategy was a mixed methods case study. Case study entity is seven hospital FM departments where the bounded system of cleaning services was focused on. Data collection methods include document research, semi-structured expert discussions, and a quantitative questionnaire. Data was primarily analysed thematically. Results: 21 clearly defined base numbers leading to informative 12 key figures (KPI's) were developed according to practitioners' needs. Additionally, a detailed catalogue of weighted cleaning tasks was established in order to put the key figures into perspective. Conclusion: The research led to a rigorous method to benchmark cleaning services in Swiss hospitals. However the findings are mostly limited to quantitative figures and do not include qualitative attributes of cleaning services. Nevertheless the results are currently being implemented in practice where a first set of hospitals benchmark their cleaning services with figures of the year 2014.


Total cross sections (TCSs) of electrons scattering from triatomic molecules over the energy range from 30 to 5000 eV are investigated employing a new semi-empirical formula. The TCSs of electrons scattering from triatomic molecules SO2, NO2, and CO2 are calculated. The quantitative TCSs are in good agreement with those obtained by experiments. It is shown that the results derived from the semi-empirical formula are much closer to the measurements than other calculations.


A method for the determination of five aflatoxins (B1 , B2, G1 , G2, M1 ) in Chinese patent medicines and medicinal herbs by immunoaffinity extraction coupled with ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) was developed. The samples were extracted with 80% (v/v) methanol-water solution, followed by stepwise purification using an immunoaffinity column. The target compounds were then eluted with methanol. The extract was filtered then analyzed. With the gradient elution using a binary mobile phase containing of 0.1% formic acid-5 mmol/L ammonium acetate solution and methanol, the five aflatoxins were separated on an UHPLC BEH C18 column, followed by positive electrospray ionization and multi-reaction monitoring (MRM) provided by a triple-quadrupole tandem mass spectrometer. The limits of detection for the standard solution of aflatoxins ranged from 0.05-0.3 microg/L. The linear response was observed in the spiked concentration range of 0.5-100 microg/L with the correlation coefficients higher than 0.99. The spiked recoveries were within 62.3%-82.4% at the spiked levels of 1.0 microg/kg and 5.0 microg/kg for all the five aflatoxins with the relative standard deviations (RSDs) below 10% (n = 6). The developed method is sensitive, accurate, and reproducible with the reasonable recoveries, and can be applied to the determination of the 5 aflatoxins in the Chinese traditional patent medicines, medicinal herbs as well as other similar complex matrices.


The main purpose of this paper is to extract and document the core knowledge of visualization, as an analysis pattern that provides a recurring and viable solution for the problem of visualization in any domain, and in any of its several applications. Now, people use the concept of visualization in every other field of study as an effective communication medium for an easy understanding of the subject. The usage of visualization in different domains or in different applications motivates us to design an efficient pattern shared by the application, as the core concept. The pattern presented in this paper relies on software stability model (Fayad and Altman, 2001), which also helps us to design a stable analysis pattern based on the core concept. The paper also provides a detailed documentation of the proposed pattern, and demonstrates the benefits of the pattern by using it as the core logic in several different applications throughout several case studies.


This workshop will enable participants to actively explore the nature of research data in the visual arts and the essential elements of its appropriate management.

For researchers, the effective management of research data helps validate and contextualise the outputs of artistic research, while at the same time supports the research method by enabling researchers to work more effectively and to mitigate against the risk of data lost. In addition, many funders in the UK now require data management plans to be submitted as part of the funding process.

Funded by the Arts and Humanities Research Council (AHRC), and led by the Centre for Digital Scholarship, a research centre of the University for the Creative Arts, and working in partnership with Falmouth University and the Glasgow School of Art, the VADS4R project is currently developing a series of tailored skills development workshops and materials on research data management in the visual arts. These are focused on the needs of early careers researchers and postgraduate students in the visual arts and will be piloted over the course of the current academic year. Through utilising this emerging knowledge and practice, participants will be given an opportunity to:

> examine the nature of research data in the visual arts and why is it important and to whom;
> learn about the key requirements of good research data management and what to consider when when planning your own approach;
> explore the vital elements of the data management planning to help support your funding proposals.

The workshop will consist of a mixture of presentations and participant led activities. It will be an abridged version of the full program currently being piloted but it will offer an introduction to this vast and complex area, and participants will be able to access to the online toolkits for independent review following the session.


1. Pre-oxyntic cells, arising from a non-mucoid cell, appear on the 20th or 21st day of foetal life. 2. Cells of Twort appear first at the end of the 4th week after birth. 3. Combined oxyntico-peptic cells are occasionally found in the 2nd, 3rd, and 4th weeks after birth. 4. Another type of cell, demonstrated by Wigglesworth9s method, is found in the 4th week after birth.


: An attempt has been made to demonstrate the morphology and haemodynamics of the arteries in the pelvis and lower limbs by means of angiodynography in 20 normal individuals. Problem areas for morphological evaluation are the pelvic vessels, the vessels in the distal adductor canal and the fibular artery in the calf. Haemodynamic studies are successful if the morphology can be adequately shown, but for flow measurements this is true only in the thigh. The results of quantitative haemodynamic analyses are detailed in tabular form (systolic flow -, late systolic reverse and diastolic flow velocity; deceleration; pulsation index; flow values).


Wearable electronics need a number of desirable attributes, such as being compact, flexible, and lightweight. Prior studies on reliability testing have examined the relationship between a flexible electronic and repetitive human body motions (i.e., stretching, bending, twisting, and folding). Such mechanical loads can cause fatigue failure in a wearable electronic. In regard to a wearable band, fatigue failure can be influenced by folding stress. This research study involved the assessment of wearable biometric bands that were calibrated and examined by a test device for folding reliability. The wearable band combines a biometric sensor unit, a micro-controller unit with a wireless connection, and a printed thermistor unit. The sensors have been calibrated by actual temperature and biometric signals. Furthermore, the folding test was conducted utilizing multiple boards. Due to multiple components and printed lines of the PCB, optical images were taken in order to confirm which parts failed and the reasons for the failures. An FEM analysis was conducted in order to understand how stress impacts the PCB and which parts are stressed during the folding process. Throughout the process, an equation was developed to predict the number of cycles necessary for reaching fatigue failure. Throughout this study, the fatigue failure analysis on folding reliability of the wearable biometric band was conducted using experimental analysis, microscopy analysis, and simulating analysis. The study provided further knowledge about the fatigue failure mechanism, which resulted from the prediction of fatigue life developed from the PCB.


The measles‐adherent phenomenon described by Levy in multiple sclerosis was investigated by studying the rosetting effect of blood lymphocytes from multiple sclerosis patients and healthy controls on chronically measles infected heteroploid Hela cells (Lu 106). No significant difference in rosetting was observed, irrespective if a lymphocyte/virus infected Lu cell ratio of 10/1 or 50/1 was used. Therefore, the test is not discriminative for multiple sclerosis.


When a piece of metal is placed above a coil carrying a high frequency current, the induced surface currents in the metal can provide a Lorentz force which can support it against gravity; at the same time the heat produced by Joule dissipation can melt the metal. This is the process of 'levitation melting', which is a well-established technique in fundamental work in physical and chemical metallurgy. Most theoretical studies of magnetic levitation have dealt only with solid conductors and so have a voided the interesting questions of interaction between the free surface, the magnetic field and the internal flow. These fluid dynamical aspects of the process are studied in this paper. A particular configuration that is studied in detail is a cylinder levitated by two equal parallel currents in phase; this is conceived as part of a toroidal configuration which avoids a difficulty of conventional configurations, viz the leakage of fluid through the 'magnetic hole' at a point on the metal surface where the surface tangential magnetic field vanishes. The equilibrium and stability of the solid circular cylinder is first considered; then the dynamics of the surface film when melting begins; then the equilibrium shape of the fully melted body (analysed by means of a general variational principle proved in § 5); and finally the dynamics of the interior flow, which, as argued in § 2, is likely to be turbulent when the levitated mass is of the order of a few grams or greater.


Eleven mineral and trace elements (Mg, Ca, K, Fe, Mn, Al, Zn, Cu, Cd, Ni, and Pb) were determined in the Thymus species growing in Turkey. The total concentrations were measured in samples mineralized with concentrated nitric acid and hydrogen peroxide in a microwave system. The determination of mineral and trace elements in the leaves of the Thymus species was carried out by flame and graphite furnace atomic absorption spectrometry. The accuracy of the method was ensured by using standard reference material (NIST-SRM 1515 apple leaves). The concentration of elements in the Thymus species and their biological activity on humans is discussed.


Ribonucleic acid (RNA) isolated from M. tuberculosis H37Ra was found to be native in nature as determined by hyperchromicity studies using ribonuclease. Mycobacterial RNA-protein (Myc. RNA-P) when injected as RNA-P-FIA complexes induced weak humoral immune responses and strong cell-mediated immune (CMI) responses which were directed against Myc. RNA. Protection comparable to BCG was induced in mice immunized with RNA-FIA complexes against LD50 dose of M. tuberculosis as monitored by increased survival rates, decreased lung density, root specific lung weight (RSLW) and by decreased viable counts of M. tuberculosis in lung, liver and spleen of immunized mice. Enzymatic degradation studies revealed Myc. RNA component to specifically mediate protection while the protein component was found ineffective.


Increasing logic densities and clock frequencies on FPGAs lead to rapid increase in power density, which translates to higher on-chip temperature. In this paper, we investigate the thermal behavior of general applications on fine-grain reconfigurable fabrics and we introduce the pre-mapping sensor insertion problem for thermal monitoring. Our study shows that on average the maximum temperature on the chip is 19.5degC higher than the ambient temperature for a transition density of 0.5 at the primary inputs. For fine-grain reconfigurable devices targeted for general applications it is difficult to predict the locations of potential hotspots a priori. However, programmability presents a unique opportunity for effective thermal monitoring. It would allow us to perform a thermal simulation on a given design first and obtain the locations of potential points of interest in a design. Then, in the pre-mapping stage the design can be updated with insertion of thermal sensors. Given a set of expected hot spots in a design we aim to determine the minimum number of sensors and their locations in order to monitor these locations with a given sensitivity requirement. Since the thermal sensors are implemented using unused CLBs on the fabric it is essential to use the logic resources efficiently. We propose an efficient algorithm to solve the sensor placement problem addressing this optimization goal


Abstract : This report summarizes the work done on Contract F33615-81-C-3227, Superplastic Formed Aluminum Air frame Structures. The scope of this program was to select, design, fabricate, evaluate, and test superplastically formed (SPF) aluminum airframe Parts. The program was conducted in the following five tasks: In Task I several candidate structural components were evaluated for SPF production design, and two parts, namely, Leading Edge Extension (DEX) and avionics deck compartment, showing the most benefits from SPF, were selected. Task II dealt with selection, of suitable alloy for fabrication of structural components. After a detailed evaluation, Reynold's aluminum alloy MD254 was selected for part fabrication.


The field of monolayer and multilayer films of discotic LCs is at its very beginning. The scope and limitations of this preparation method have not yet been explored, and little is known about the structures obtainable. However, the potential access to extraordinary, ordered thin films is fascinating, and will stimulate research in the future.


This paper considers the callback reachability problem --- determining if a callback can be called by an event-driven framework in an unexpected state. Event-driven programming frameworks are pervasive for creating user-interactive applications (apps) on just about every modern platform. Control flow between callbacks is determined by the framework and largely opaque to the programmer. This opacity of the callback control flow not only causes difficulty for the programmer but is also difficult for those developing static analysis. Previous static analysis techniques address this opacity either by assuming an arbitrary framework implementation or attempting to eagerly specify all possible callback control flow, but this is either too coarse to prove properties requiring callback-ordering constraints or too burdensome and tricky to get right. Instead, we present a middle way where the callback control flow can be gradually refined in a targeted manner to prove assertions of interest. The key insight to get this middle way is by reasoning about the history of method invocations at the boundary between app and framework code --- enabling a decoupling of the specification of callback control flow from the analysis of app code. We call the sequence of such boundary-method invocations message histories and develop message-history logics to do this reasoning. In particular, we define the notion of an application-only transition system with boundary transitions, a message-history program logic for programs with such transitions, and a temporal specification logic for capturing callback control flow in a targeted and compositional manner. Then to utilize the logics in a goal-directed verifier, we define a way to combine after-the-fact an assertion about message histories with a specification of callback control flow. We implemented a prototype message history-based verifier called Historia and provide evidence that our approach is uniquely capable of distinguishing between buggy and fixed versions on challenging examples drawn from real-world issues and that our targeted specification approach enables proving the absence of multi-callback bug patterns in real-world open-source Android apps.


Periodic and quasi-periodic structures, printed on a dielectric substrate, can be employed to control the reflection and transmission properties of incident waves as a function of structure geometry. Local variations of the element geometry on a substrate with backside metallization - resulting in respective variations of the reflection phase angle - can be used to design printed reflectarray antennas. The dual-polarization properties of such antennas, together with polarizing grids or slot arrays, can be exploited for the realization of compact, low-profile folded reflector antennas. Examples of some antennas of this type are presented, covering the 60 GHz range for communication and ISM applications, and 76 to 77 GHz for automotive radars.


Gaussian processes are expressive, non-parametric statistical models that are well-suited to learn nonlinear dynamical systems. However, large-scale inference in these state space models is a challenging problem. In this paper, we propose CBF-SSM a scalable model that employs a structured variational approximation to maintain temporal correlations. In contrast to prior work, our approach applies to the important class of unstable systems, where state uncertainty grows unbounded over time. For these systems, our method contains a probabilistic, model-based backward pass that infers latent states during training. We demonstrate state-of-the-art performance in our experiments. Moreover, we show that CBF-SSM can be combined with physical models in the form of ordinary differential equations to learn a reliable model of a physical flying robotic vehicle.


Maximum and minimum
temperatures time series of Congo-Brazzaville are analyzed for trend and discontinuities over the period 1932 to 2010. Temperatures series show an irregular increase. A total of 8 synoptic stations show positive
trends in their annual mean maximum temperature series, and 7 of them are
significant, with higher trends for urban stations. Annual mean minimum
temperature showed 6 stations having positive trends. This increase is in relation with observations at regional scale.
However, the differences are observed between large towns (Brazzaville and
Pointe-Noire), and small or rural towns (Dolisie, Sibiti, Impfondo, Djambala).
Trends in diurnal temperature range (DTR) are large positive trends in maximum
temperature that are mainly observed in cities. The curve of DTR shows a
decreasing trend which indicates the increasing of minimum temperatures. The
effects of urbanization on temperature trends are investigated. Most stations
regarded as urban stations are still useful for trend analysis; being situated
on the suburban of the studied cities, they are therefore, not substantially
influenced by the urban heat island.


The interdisciplinary approach is recognized as the gold standard for organizing medical care for patients with oncological pathology. It is declared at the normative level in Ukraine, but the forms and methods of work, channels and methods of communication of specialists are not detailed. This requires further research, in particular, when providing surgical care to patients with thyroid pathology. The purpose of the study was to investigate the state of activity organization of multidisciplinary teams in the provision of surgical care to patients with thyroid pathology and to propose approaches for its improvement. Materials and methods: accounting forms No. 003 for 2019 (1208 units), constituent and administrative documents for the institution, department regulations, job descriptions, clinical pathway of patients (15 units in total). The base of research was communal non-profit enterprise "Kiev City Clinical Endocrinological Center". The methods, which were used, are systematic approach, medical and statistical, medical and geographical methods, content analysis, graphic. Results and discussion. Patients of the Department of Endocrine Surgery were from almost all regions of Ukraine. 3.5% of patients were referred by a general practitioner, 55.7% - by an endocrinologist, 40.1% - independently applied. Malignant neoplasm of the thyroid gland was detected in 33.9% of patients, non-toxic multinodular goiter – in 25.2%, benign neoplasm – in 16.3%. In 448 (37.1%) patients, 687 concomitant diseases and complications were identified. Their structure consisted of diseases of the heart and circulatory system – 40.0%, eye diseases – 3.1%, diseases of the nervous system – 2.0%. In order to meet the needs of patients, instrumental and laboratory studies, consultative examinations, consultations and surgical interventions were carried out. The low level of communication between inpatient doctors and outpatient doctors has been shown. This was the reason for the excessive length of stay in bed – 12.6 ± 2.7 days. There is a separate participation of specialist doctors in accompanying patients in the hospital. It was proposed to formalize the official status and develop a typical provision for a multidisciplinary team of specialists; joint discussion, debate, data exchange within the team and with outpatient doctors; afford access to corporate information for the team and coordinate the work of authorized employees. Conclusion. Improving the efficiency of multidisciplinary teams is possible by strengthening collaboration within the team and communication with outpatient doctors


On 9 December 2002 the (Environment) Council of the European Union unanimously agreed on a common position on a Commission's proposal for a Directive establishing a scheme for greenhouse gas emissions allowance trading. This follows the idea that a common European emissions trading system should be preferred above a collection of national emissions trading systems. The European framework for emissions trading needs to be filled in by the Member States. One of their main tasks will be to allocate the greenhouse gas allowances according to a National Allocation Plan. The use of new regulatory instruments as emissions trading will raise new legal questions, which not always can be foreseen before the real application of the instrument in practice. It does not seem to be that the relevant institutions in the European Community already have a clear insight in all the necessary provisions for a well-functioning and just emissions trading scheme. Especially the allocation of the tradable emissions rights can be questioned. With the present criteria, the allocation of the transferable rights will likely be a complicated and probably time-consuming task for the national governments. The European politicians seem to be willing to take this risk with emissions trading in order to build experience with combating the climate change effect.


Abstract Britain has laws and a range of policies which promote the employment of disabled people. The lack of progress to get disabled people into paid work has resulted in huge dissatisfaction for some. Evidence of disability and employment problems is often expressed as hard data, but what of the personal experiences of trying to find employment? This article is based on interviews with 'Nick', a young man with cerebral palsy who wanted to recount his preparation for work, including work experience, through school, the Connexions service and the local Employment Office. He explained how he felt his voluntary work and work experiences were not fully planned and ultimately unsatisfactory. Nick found paid employment, but soon discovered that there were too many problems for him to continue. He reflected on his experiences, including his own initial confidence, his despair at the ending of his paid employment and the realities of what employment means for him.


Abstract The positioning of DNA on nucleosomes is critical to both the organization and expression of the genetic message. Here we focus on DNA conformational signals found in the growing library of known high-resolution core-particle structures and the ways in which these features may contribute to the positioning of nucleosomes on specific DNA sequences. We survey the chemical composition of the protein-DNA assemblies and extract features along the DNA superhelical pathway—the minor-groove width and the deformations of successive base pairs—determined with reasonable accuracy in the structures. We also examine the extent to which the various nucleosome core-particle structures accommodate the observed settings of the crystallized sequences and the known positioning of the high-affinity synthetic '601' sequence on DNA. We 'thread' these sequences on the different structural templates and estimate the cost of each setting with knowledge-based potentials that reflect the conformational properties of the DNA base-pair steps in other high-resolution protein-bound complexes.


Theory and research supports the implementation of cognitive and behavioural interventions (CBI?s) to address social, emotional and behavioural difficulties (SEBD) in children. The literature argues that schools are an ideal place in which to implement such interventions. As part of a county initiative, school staff were trained and offered follow up support by 2 Educational Psychologists (EPs) around the use of school-based CBI to support children who have SEBD. The 10 participants (from 5 schools) in this research were part of this initiative: they received 4 sessions of training followed by either monthly individual supervision, or group supervision, around their use of CBI. Training and supervision targeted implementation of key CB competences, selected from a competency framework recommended by ?Improving Access to Psychological Therapies? (IAPT, 2011). The research explored staff perceptions around the CB competences that they implemented, their methods of implementation and the barriers and facilitators to their implementation. The research used a mixed methodology design. Qualitative data was analysed using thematic analysis and quantitative data was analysed using descriptive statistics. Data was gathered through interviews, supervision sessions, intervention diaries and training evaluations. Exploration of facilitators and barriers to implementation was based on Durlak and DuPre?s (2008) model of intervention implementation. Facilitators/barriers discrete from this model were also identified. Identification and exploration of such factors can assist in ensuring quality implementation of school-based interventions in the future. This study demonstrates how school staff can implement a range of CB competences and through multi-levels of intervention in schools. The potential role of the EP in supporting school staff to implement CBI is also discussed.


Background: While the use of the term "quality" in industry relates to the basic idea of making processes measurable and standardizing processes, medicine focuses on achieving health goals that go far beyond the mere implementation of diagnostic and therapeutic processes. However, the quality management systems used are often simple, self-created concepts that concentrate on administrative processes without considering the quality of the results, which is essential for the patient. For several rheumatic diseases, both outcome and treatment goals have been defined. This work summarizes current mainstreams of strategies with published quality efforts in rheumatology. Methods: PubMed, Cochrane Library, and Web of Science were used to search for studies, and additional manual searches were carried out. Screening and content evaluation were carried out using the PRISMA-P 2015 checklist. After duplicate search in the Endnote reference management software (version X9.1), the software Rayyan QCRI (https://rayyan.qcri.org) was applied to check for pre-defined inclusion and exclusion criteria. Abstracts and full texts were screened and rated using Voyant Tools (https://voyant-tools.org/). Key issues were identified using the collocate analysis. Results: The number of selected publications was small but specific (14 relevant correlations with coefficients >0.8). Using trend analysis, 15 publications with relative frequency of keywords >0.0125 were used for content analysis, revealing 5 quality needs. The treat to target (T2T) initiative was identified as fundamental paradigm. Outcome parameters required for T2T also allow quality assessments in routine clinical work. Quality care by multidisciplinary teams also focusing on polypharmacy and other quality aspects become essential, A global software platform to assess quality aspects is missing. Such an approach requires reporting of multiple outcome parameters according to evidence-based clinical guidelines and recommendations for the different rheumatic diseases. All health aspects defined by the WHO (physical, mental, and social health) have to be integrated into the management of rheumatic patients. Conclusion: For the future, quality projects need goals defined by T2T based initiatives in routine clinical work, secondary quality goals include multidisciplinary cooperation and reduction of polypharmacy. Quality indicators and standards in different health systems will provide new information to optimize patients' care in different health systems.


PCV107 ECONOMIC EVALUATION OF EZETIMIBE COMBINED WITH SIMVASTATIN FOR TREATMENT OF PRIMARY HYPERCHOLESTEROLAEMIA Van Nooten F, Davies GM, Jukema JW, Liem AH, Hu XH United BioSource Corporation, London, UK, Merck and Co, Blue Bell, PA, USA, Leiden University Medical Center, Leiden, The Netherlands, Oosterscheldeziekenhuizen, Goes, The Netherlands, Merck & Co., Inc, West Point, PA, USA INTRODUCTION: Coronary heart disease (CHD) is a leading cause of death in the Western world. Hypercholesterolemia is an important risk factor for CHD. Ezetimibe, a cholesterol absorption inhibitor, can be used in combination with statins to improve cholesterol levels. OBJECTIVES: The aim was to assess cost-effectiveness of ezetimibe combined with simvastatin compared to atorvastatin or simvastatin monotherapy for second line treatment of primary hypercholesterolaemia in the Dutch population. METHODS: A published Markov model (Cook et al 2004) was adapted to evaluate two lipid treatment scenarios in The Netherlands. Baseline patient data from the Dutch EASEGO study were used. The first scenario was based on this study: patients not reaching low-density-lipoprotein cholesterol (LDL-C) goal on atorvastatin 10 mg (A10) or simvastatin 20 mg (S20) were included. These patients were modeled using a doubled dose, or addition of ezetimibe 10 mg to generic simvastatin (eze10/sim20). The second scenario was based on Dutch guidelines. All patients were not meeting their LDL-C goal on simvastatin 40 mg (S40) and were switched to atorvastatin 40 mg (A40), or ezetimibe 10 mg was added to generic simvastatin (eze10/sim40). Key effectiveness measure was change in ratio of total cholesterol to high-densitylipoprotein cholesterol. Model parameters were derived from published literature and guidelines. One-way sensitivity analyses were performed for key model parameters. RESULTS: Based on EASEGO the incremental cost-effectiveness ratio for eze10/ sim20 was a3,497 per quality-adjusted life year (QALY) compared to A20 and a26,417/QALY compared to S40. Based on Dutch guidelines, eze10/sim40 was dominant, and can be seen to be cost-saving compared with A40 ( a3,675/QALY). These results were not very sensitive to changes in input parameters. CONCLUSIONS: Eze/ sim can be considered a cost-effective treatment (EASEGO versus A20 or S40) and in light of the Dutch guidelines (versus A40) even cost-saving. The addition of ezetimibe to simvastatin is a valuable second line treatment option.


Postoperative cognitive dysfunction (POCD) is a decline in cognitive performance after a surgery with anaesthesia. The exact reasons of surgery and/or anaesthesia resulting in POCD are unclear. The aim of this study is to investigate the effects of different concentration and duration time of isoflurane anaesthesia on cognitive performance and cellular mechanisms involved in learning and memory function. In present work, young adult male C57BL/6 mice (age: 8 weeks) were anaesthetized by different concentration isoflurane in 100% oxygen for different duration time (Mice in group I1 received 0.7% isoflurane 0.5 h, mice in I2 received 0.7% isoflurane 2 h, mice in I3 received 1.4% isoflurane 2 h, and mice in I4 received 1.4% isoflurane 4 h). Non-anaesthetized mice served as control group (I0). Spatial learning was assessed at 10 days post-anesthesia in Morris water maze (MWM). Hippocampal protein expressions of activated caspase 3, NMDA receptor subunit NR2B, and extracellular-signal regulated kinase (ERK) 1/2 were evaluated 24 hours and 2 weeks post anesthesia. Protein expression of activated caspase3 was detected acute elevated in I3 (24 h post-anesthesia) and acute and long-term elevated in I4 (24 hours and 2 weeks post-anesthesia). There was no significant difference between I1, I2 and control group. Protein expressions of NR2B showed an acute and long-term increasement in I1 and I2, decreasement in I4, and an acute decline, then returned to normal in I3 compared to control group. The ratio of phosopho-ERK1/2 to total-ERK showed an acute increasement in I1 and I2, then came to normal 2 weeks post anesthesia compared to control group, meanwhile, we detected an acute and long-term decline in I3 and I4. In MWM test, mice in I1 and I2 showed cognitive improvement, mice in I3 showed similar to control group, while mice in I4 demonstrated cognitive impairment, which were approximately corresponding to the changes of protein expression of NR2B and activation of ERK1/2. The present data suggested the following: (1) Isoflurane may cause neurotoxicity by inducing caspase activation and apoptosis with the anesthetic concentration increased and duration prolonged. (2) Low concentration of isoflurane in 2 hours can induce a hippocampus-specific elevation of NR2B subunit composition and ratio of p-ERK1/2 to total ERK1/2, produce hippocampal-dependent cognitive improvement. While high concentration of isoflurane exceeding 4 hours may induce a decline of NR2B and ratio of pERK1/2 to ERK1/2, then result in cognitive impairment.


Site specific management (SSM) has the potential to improve both economic and ecological outcomes in agriculture. Effective SSM requires strong and temporally consistent relationships between identified management zones, underlying soil physical, chemical and biological parameters defining yield potential, and crop yield. In a farm-scale (250 ha) experiment in semiarid northeastern Colorado, each of eight 31-ha fields was individually mapped for soil apparent electrical conductivity (ECa) and classified into four management zones (ranges of ECa). Soil analyses revealed a strong negative relationship between ECa zones and soil parameters associated with innate fertility (P :::; 0.06). The objective of the present study was to further evaluate ECa as a basis for SSM by examining its relationship to actual yield using two years of yield maps for winter wheat (Triticurn aestivum L.) and corn (Zea mays L.). Withinfield wheat yields were strongly related to ECa, particularly when regressing mean wheat yields within Eea classes against mean ECa within ECa classes (r2 = 0.95 to 0.99). Yield response curves revealed a boundary line of maximum yield that decreased with increasing EC". In this semiarid dryland system, ECa-based management zones can be used in the SSM of wheat for: (1) yield goal determination, (2) soil sampling to assess residual fertilizer concentrations and soil attributes affecting herbicide efficacy, and (3) prescription maps for metering fertilizer, pesticide and seed inputs. Inconsistent relationships were found between EC" and corn yields indicating that, while soil factors controlled wheat yields, corn yields were more influenced by weather.


Intractable conflicts arise when facts and values are deeply intertwined. Involved parties give relevance to different facts or interpret them in different, irreconcilable ways. With this kind of problems, deliberative democracy is increasingly considered as more effective than «strategic» approaches (based on negotiation or aggregation of preferences). The article analyses three «virtues» of deliberative democracy: civic virtue, governance virtue and cognitive virtue. Public deliberation lowers the propensity to and expediency of strategic behaviour, and increases knowledge, raising the quality of decisions. Two interpretations of the cognitive virtue are then examined. The former believes in the unity of Reason. It maintains that a general consensus on the reasons underlying a choice is possible and necessary. The latter believes in the plurality of Reason. It contends that deliberative democracy requires only a fair consideration of all standpoints and proposals. The discussion focuses on Habermas and Rawls. Their «strong» reading of the cognitive virtue implies that solutions to intractable controversies can only consist of strategic compromises. A pluralist conception of Reason can be found in the feminist political thought and in Bohman's analysis of deliberation as social cooperation. However, the plurality of Reason makes deliberative decisions more prone to manipulation, and not easily distinguishable from strategic agreements. The argument developed shows the opportunity of renewing the approach to deliberative democracy, by rethinking its motivational and cognitive elements. Public deliberation is grounded on a pre-political level of cooperation, and while the answers to intractable conflicts suggested by Habermas, Rawls and many others move towards abstraction and generalisation, the opposite way seems more promising.


Angular resolution of the pair radial distribution function in computer simulations of shear induced thickenening in atomic (Lennard-Jones) liquids has revealed the presence of anisotropic local structure which is explained on the basis of group theoretical statistical mechanics. This explains the observed structural asymmetry from the basic assumption that the symmetry of allowed ensemble averages in the steady state in the presence of shear is the same as that of the applied strain rate. The computer simulation results are reproduced from group theory by assuming that the crystal like lattice arrangement of atoms which appear in the simulations under shear can be described by some of the thirty two crystallographic point groups, namely hexagonal, trigonal, and triclinic. The hexagonal lattice symmetries C3h and C6h; the trigonal symmetry S6; and the triclinic symmetry Ci(S2) are found to support the crystal-like structures necessary to explain the observed angular resolution of the pair radial distribution function.


The insurance industry recognises that the products offered by the various insurers are different as each product covers different causes of dread disease at different levels. For this reason, the Association for Savings and Investments SA (ASISA) has proposed a standard grid where there is consistent disclosure on how much each product will pay for the various severities of the main causes of dread disease.


OBJECTIVE
To characterize patterns of dog and cat ownership and veterinary service use among Latino dog and cat owners with various degrees of English-language proficiency. DESIGN :Cross-sectional telephone survey.

SAMPLE
Data from 393 Latino pet owners.

PROCEDURES
Telephone surveys were conducted with Latino dog and cat owners from a random sample of US households to determine the number of dogs and cats owned, factors associated with veterinary service use, and satisfaction with veterinary care.

RESULTS
393 of 1,026 (38.3%) respondents were pet owners. Two hundred fifty-nine of 330 (78.5%) dog owners and 70 of 115 (60.9%) cat owners reported taking their pet to the veterinarian in the past 12 months, most commonly for vaccination or examination or because of illness. Respondents were most satisfied with veterinary care provided, least satisfied with cost, and moderately satisfied with quality of communication. English-language proficiency was not significantly associated with whether owners sought veterinary care. A large proportion of respondents who wanted to receive pet health information in Spanish described themselves as speaking English well or very well.

CONCLUSIONS AND CLINICAL RELEVANCE
Although having limited proficiency in English was not associated with Latino pet owners seeking veterinary care, opportunities exist for veterinary personnel to improve communications with these clients. Personnel can assess their clients' language needs by asking each about the language in which they would prefer to receive their pet's health information.


Observations over 130 patients who underwent radical operation for gastric carcinoma showed that survival is higher among those who received rehabilitation measures and that post-gastroresection complications occurred in them 1.5-2 times less frequently than in the control group; 39.2% of patients who were given rehabilitation therapy and only 15.8% of patients in the control group resumed occupational activity. The authors worked out an optimal plan of restorative treatment according to the character and severity of the postresection complications.


A cytokine storm is an uncontrolled, excessive immune response that contributes to the pathogenesis of coronavirus disease 2019 (COVID-19). Viral infections lead to the loss of negative feedback in immune regulation and an abnormal elevation of the levels of multiple cytokines. In COVID-19, this causes diffuse damage to alveolar functions and may culminate in multiple organ dysfunction. Immunoregulatory therapies target the cytokine storms induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, and include monoclonal antibodies, recombinant granulocyte-macrophage colony stimulating factor, interferon, mesenchymal stem cell-based therapy, thymosin, immunoglobulins and blood purification therapies. These approaches may be effective in the alleviation of COVID-19 symptoms. In this review, cytokine storms caused by SARS-CoV-2 infections are evaluated and discussed, and advances in immunoregulatory therapy strategies for patients with COVID-19 are reviewed.


Background. To determine socioeconomic inequalities in opiates and cocaine related Fatal OverDose (FOD) cases and their implications in terms of prevention. Methods. Cross-examination of healthcare and forensic data in a nested case-control study design. FOD cases (272) were individually matched with 4 controls (1,056) according to sex, year of birth, drug administration route, duration of drug use and compared through conditional logistic regression. Findings. Employment [OR=0.662(95% CI 0.446–0.985)], salary as main income [OR=0.417(95% CI 0.258–0.674)] and educational attainment higher than primary school [OR=0.501(95% CI 0.344-0.729)] revealed to be protective, whereas parental professional status was not associated to FOD. Discussion. Among peers, drug users with lower socioeconomic profiles show increased odds of FOD. However, self-referred socioeconomic characteristics impacting on daily life quality such as education, employment and revenue, were more predictive of FOD than transgenerational factors (e.g. parental social status). Thus, motivational interventions fostering socio-professional integration should be given due attention in dedicated harm prevention policies.


Damage in the corticospinal system following stroke produces imbalance between flexors and extensors in the upper extremity including the fingers, eventually leading to flexion-favored postures. The substitution of the reticospinal tract for the damaged corticospinal tract is known to excessively activate flexors of the fingers while the fingers are voluntarily being extended. Here, we questioned whether the cortical source or/and neural pathways of the flexors and extensors of the fingers are coupled and what factor of impairment influences finger movement. In this study, a total of 7 male participants with hemiplegic stroke conducted isometric flexion and extension at the MCP joints in response to auditory tones. We measured activation and de-activation delays of the flexor and extensor of the MCP joints on the paretic side, as well as, force generation and co-contraction between the flexor and extensor. All participants generated greater torque in the direction of flexion (p=0.017). Regarding co-contraction, coupled activation of the extensor is also made during flexion in the similar way to coupled activation of the flexor made during extension. As opposite to our expectation, we observed that during extension, the extensor showed marginally significantly faster activation (p=0.66) while it showed faster de-activation (p=0.038), in comparison to activation and de-activation of the flexor during flexion. But movement smoothness was not affected by those factors. Our results imply that the cortical source and neural pathway for the extensors of the MCP joints are not coupled with those for the flexors of the MCP joints and extensor weakness mainly contributes to the asymmetry between flexors and extensors.


The Pacific Rim has become a high-value geostrategic region because of the growing interdependence in its dynamics of political and economic cooperation. The international and regional cooperation systems continue their transformation since the early twenty first century, therefore it is quite relevant to be attuned with these processes. In recent years, Colombia has designed various strategies for international integration in the Asia-Pacific region within its Trans-Pacific foreign policy. It is essential for actors and interest groups to make a diagnosis to establish a forward-looking strategy to diversify the agenda of relations with this region. The purpose is to ensure a better understanding of the next transpacific cooperation schemes.


A promising method to introduce H into Si solar cells in order to passivate bulk defects is by the post-deposition annealing of an H-rich, SiN/sub x/ surface layer. It previously has been difficult to characterize the small concentration of H that is introduced by this method. IR spectroscopy has been used together with marker impurities in the Si to determine the concentration and depth of H introduced into Si from an annealed SiN/sub x/ film.


The fetus develops inside of a sac that is surrounded by a membrane called the amnion. The sac contains amniotic fluid, which surrounds the developing fetus and protects the fetus from injuries. Polyhydramnios ( Garbhodhaka vriddhi ) is a condition that occurs when there is too much accumulation of liquor amnii. The exact cause is unknown, but it may be the result of deficient absorption & excessive production of liquor amnii. Liquor amnii exceeds 2000ml, AFI is more than 25cm. It probably occurs in 1 in 1000 pregnancies. Susrutha described one characteristic of Garbha vriddhi as Jataraabhi vriddhi (increase in size of the abdomen). That increase may be due to variation in Sankya (multiple pregnancies), size (big baby) or fluid (hydromnios) of Garbha . Bhavamisra adds further that labour is much difficult. Abnormal amniotic fluid volume can be associated with increased maternal risk as well as perinatal morbidity and mortality. Successful management depends upon appropriate diagnostic evaluation. Prolongation of the pregnancy for further fetal maturation may be achieved with timely therapeutics. This article describes the case report of a 23 year old woman who is a primi complicated by polyhydramnios, which developed between 26 & 28 weeks of pregnancy. Ayurveda being an eternal medicine many treatments are described by Acharyas. The background of the study is Jalodara chikitsa. It is concluded that Ayurveda is useful for treating polyhydramnios, as an alternative to Diuretics, Indomethacin & amniocentesis.Â


The high-Tc superconductor YBa2Cu3O7-x has been found to become more 'metallic' as the maximum sintering temperature is increased from 1187 to 1234 K. The superconducting transition width also becomes narrower and smoother with a slight increase in the transition temperature. These improved electrical characteristics have been found to be associated with larger particle size and better long-range ordering of the Cu-O linear structure. On the basis of the effective-medium approximation, the authors also argue that the observed behaviour of the logarithmic temperature derivative of normal state resistivity is not controlled by densification or preferential orientation of the c axis perpendicular to the disc surface of the sintered pellets.


The authors review the different procedures used today to resolve female bladder instability and analyse the most modern trends regarding therapeutic strategy.


Age-related delays in the uptake of norepinephrine (NE) by the rat myocardium were observed after subcutaneous injection of NE (Gey, Burkard, and Pletscher, 1965). We report here that in vitro uptake of 3H-NE by myocardial slices from healthy C57BL/6J male mice is not impaired by aging (8-28 mo.) at 0.1 ng/ml, 2.0 ng/ml, 1000 ng/ml of NE. Additionally, no age-related changes of inulin space in myocardial slices were observed. Hence, the delayed uptake observed in vivo by Gey et al. may be attributed to age-related changes in the absorption from the subcutaneous site.


The article presents data on the state of the Digital Substation technology in Russia. Also voiced the advantages and disadvantages of this technology. Since the main disadvantage is the economic inexpediency of introducing digital substations, the article proposed a method to improve the reliability of electricity supply to regional areas.


A genetic algorithm has been developed for the inversion of seismic traveltime data and
applied to a tomographic investigation of central-eastern Tasmania. The investigation
used four shots and twelve stations across a 100 km east-west section of the post
Devonian cover of the Tasmania Basin. This area lies across the inferred but poorly
understood contact between the Eastern and Western Tasmanian Terranes, which has
proven difficult to image in previous geophysical studies.
The genetic algorithm developed in this project is portable across all parallel and
non-parallel Unix-based computing platforms, and interfaces with an existing, ad-
vanced, fast marching forward model code. The algorithm was applied both at low
resolution with subsequent model refinement by a subspace inversion method in a two-
step approach, and at higher resolution to directly invert the data using a one-step
approach. The one-step implementation yielded superior exploration of the model
space, and sufficient exploitation of the possible solutions when applied to the sparse
noisy data acquired during the controlled source investigation. This demonstrates the
viability of a one-step Monte-Carlo approach to seismic traveltime tomography in cases
of sparse data coverage.
The results of the inversions show a high velocity anomaly at 6 km depth and
147.4 degrees longitude, coincident with a long-wavelength magnetic anomaly, and is
interpereted as an ultramafic unit of possible oceanic crustal affinity. This supports
both thick and thin-skinned tectonic models with oceanic crust beneath the Eastern
Tasmanian Terrane, though the thin-skinned scenario is preferred on the basis of ex-
isting gravity data. A model is suggested in which this oceanic unit is part of the
allochthonous boninite-tholeiite stack overlying the Western Tasmanian Terrane.


MAYOR is a real-time player of the popular simulation game SimCity. Since SimCity is a complex, dynamic world, players must make do with a partial understanding of how the world works. MAYOR contends with an incomplete world model by using a case-based planner which repairs plans on expectation failures, and with experience can improve its case library. SimCity players must also be able to quickly prioritize many tasks, which range from short to long-term. MAYOR uses utility estimates based on historical observation of the success of past tasks. This paper describes these approaches, and provides an overview of the MAYOR architecture.


Aesthetic nurses will often take before and after photographs of their patients to document their clinical practice and show the patient the extent of the aesthetic effects that have been achieved following treatment. However, to make the most of this opportunity and remain cost-effective, it is beneficial for practitioners to have guidance on what makes a good photograph, and what tools are needed for this. In this article, the author outlines the important and valuable functions of today's vast range of cameras.


Inflammatory pseudotumor is a rare, benign lesion of various organs and tissues, characterized by proliferating fibrovascular tissue admixed with inflammatory cells of etiology and pathogenesis that are largely unknown. We report a case of a 55-years-old woman with acute pancreatitis with a retroperitoneal mass in Morrison's space detected by tomography. Aspects concerning incidence, etiology, clinical, and histopathologic characteristics are discussed.


In 42 cases of trisomy 13 at 10–14 weeks of gestation, compared with 947 controls, the median multiple of the median (MoM) of maternal serum free β‐human chorionic gonadotrophin (β‐hCG) and pregnancy associated plasma protein A (PAPP‐A) was significantly decreased (0.506 MoM and 0.248 MoM respectively), whilst fetal nuchal translucency was increased (2.872 MoM). In 38% and 71% of cases of trisomy 13 maternal serum free β‐hCG and PAPP‐A was below the 5th centile of the appropriate normal range for gestation and in 62% of cases the nuchal translucency was above the 95th centile. When combined together in a multivariate algorithm with maternal age, 90% of cases of trisomy 13 could be detected at a 0.5% false positive rate or 84% at a 0.1% false positive rate. We conclude that specific trisomy 13 risks should be part of developing risk algorithms combining maternal serum biochemistry and nuchal translucency for use in first trimester screening alongside those for trisomy 21 and trisomy 18. Copyright © 2000 John Wiley & Sons, Ltd.


A BSTRACT . We present in this paper the new Branch and Bound method with new quadratic approach over a boxed set (a rectangle) of R n . We construct an approximate convex quadratics functions of the objective function to fined a lower bound of the global optimal value of the original non convex quadratic problem (NQP) over each subset of this boxed set. We applied a partition and technical reducing on the domain of (NQP) to accelerate the convergence of the proposed algorithm. Finally,we study the convergence of the proposed algorithm and we give a simple comparison between this method and another methods wish have the same principle.


Beta 2 microglobulin (B2M) has been identified as a major component of amyloid deposits. This study was designed to determine whether changes occur in the synthesis of B2M in dialysis patients. Mononuclear cells (MNC) were isolated in peripheral blood from healthy volunteers, patients on hemodialysis (HD) and on continuous ambulatory peritoneal dialysis (CAPD). MNC were cultured in a medium of RPMI 1640 with or without interleukins IL-1, IL-2 or interferon INF-r. B2M in the cultured cells and supernatant was measured by enzyme immunoassay. IL-2 or INF-r stimulated B2M synthesis 'was significantly lower (25%) in patients on HD than in normal controls regardless of the type of dialysis membranes used, with no change in basal B2M synthesis. No differences were detected between healthy volunteers and CAPD patients. Preincubation of MNC with complement - activating or non-complement - activating membrane had no influence on B2M synthesis. The basal B2M synthesis of MNC significantly increased after a 4-hour HD regardless of the membranes used, and IL-2 and IFN-r stimulated synthesis were both essentially the same before and after HD. It was thus concluded that maximum capacity for B2M synthesis of MNC decreases in hemodialysis patients. This low responsiveness of MNC may be partially the cause for the reduction in cell-mediated immune response in HD patients.


High resolution fluid simulations are commonly used in the visual effects industry to convincingly animate smoke, steam, and explosions. Traditional volumetric fluid solvers operate on dense grids and often spend a lot of time working on empty regions with no visible smoke. We present an efficient sparse fluid solver that effectively skips the inactive space. At the core of this solver is our sparse pressure projection method based on unsmooth aggreggation multigrid that treats the internal boundaries as open, allowing the smoke to freely move into previously-inactive regions. We model small-scale motion in the air around the smoke with a noise field, justifying the absence of reliable velocities in the inactive areas.