OBJECTIVE
To describe the experiences of women who have learned to live with rheumatoid arthritis (RA), and to explore how women manage this chronic illness and the demands of their everyday lives.

METHODS
Thirty women with a diagnosis of RA were interviewed in their homes. The women were encouraged to "tell their story of living with RA," from the first symptom to the present, using a semistructured questionnaire. Qualitative data were analyzed using a constant comparative analytic process.

RESULTS
Learning to live with RA was characterized by periods of uncertainty, of learning about the illness, discovering strategies that allowed the women to meet the expectations of their roles as women, and the establishment of new patterns of daily life. The women became experts at managing their RA and developed a sense of mastery in coping with their symptoms.

CONCLUSIONS
Persons with RA need support and guidance, beginning with the onset of the disease, to facilitate achieving mastery in living with this chronic illness.


During wet-chemical synthesis, metastable polymorphs frequently nucleate before the stable phase due to a lower nucleation barrier. These metastable polymorphs stabilized at the nanoscale represent some of the technologically most important nanomaterials, e.g., photocatalytic anatase and magnetic maghemite nanoparticles. However, such nanomaterials are not restricted to simple oxides. Here, we present a new polymorph of hexagonal strontium ferrite, i.e., hexaferrite, stabilized in the form of small discoid nanoplatelets. Under hydrothermal conditions the strontium ferrite forms as a result of reactions between Sr and Fe hydroxides in the presence of a high concentration of hydroxyl ions at temperatures below 80 oC. Atomic-resolution scanning-transmission electron microscopy showed that the primary discoid nanoplatelets (2–5 nm thick and a few tens of nm wide) exhibit an incredibly complex crystalline structure with a very large hexagonal unit cell (a= 56.6 A, c=18.0 A) and are weakly ferrimagnetic. With exaggerated growth above 160 oC, the discoid nanoplatelets having the new structure recrystallize to larger hexagonal nanoplatelets with an equilibrium magnetoplumbite structure. The discovery of a new hexaferrite polymorph demonstrates the immense potential of the stabilization of new metastable polymorphs of complex functional materials for the discovery of new nanomaterials.


The European Commission's Action Plan for a Fair and Efficient Tax System within the EU, and the subsequent 'Anti-Tax Avoidance Package' (ATAP), set out a number of short-term initiatives aimed at achieving an optimal corporate tax system and at fighting international tax avoidance within the EU. Pending the desired introduction of the Common Consolidated Corporate Tax Base (CCCTB) as a long-term goal, these initiatives have been considered as capable of stabilizing Member States' revenues and of allowing corporate taxation where profits are really generated. Since specific suggestions made in the academic literature – namely, the suggestions for a 'destination-based corporation tax', for a 'corporation tax 2.0' and for a 'new common consolidated tax base' – have the same objectives, this article critically discusses these suggestions and it analyses whether they can be considered as more consistent or as less consistent with the common objectives than the Commission's initiatives. It also elaborates the hypothesis for a solution capable of both collecting the key input offered by these suggestions and being complementary to the CCCTB.


In this paper the authors have reviewed the carbonation studies which are a vital durability property of concrete. One of the major causes for deterioration and destruction of concrete is carbonation. The mechanism of carbonation involves the penetration carbon dioxide (CO2) into the concrete porous system to form an environment by reducing the pH around the reinforcement and initiation of the corrosion process. The paper also endeavours to focus and elucidate the gravity of importance, the process and chemistry of carbonate and how the various parameters like water/cement ratio, curing, depth of concrete cones, admixtures, grade of concrete, strength of concrete, porosity and permeability effect carbonation in concrete. The role of Supplementary Cementitious Materials (SCMs) like Ground granulated Blast Furnace Slag (GGBS) and Silica Fume (SF) has also been reviewed along with the influence of depth of carbonation.


Abstract. The uniqueness of weak solutions of the primitive equations with Dirichlet boundary conditions at the bottom is an open problem even in the two dimensional case. The aim of this paper is to prove the uniqueness of weak solutions when we replace the Dirichlet boundary condition at the bottom by a friction condition. With this boundary condition at the bottom, we establish an additional regularity result for the vertical derivative of the horizontal velocity which allows us to conclude the uniqueness of weak solutions.


Background: Despite an increase in use of pediatric complementary and integrative health (PCIH), many healthcare professionals still have an inadequate understanding of such practices and consider their use inappropriate, which might thwart implementation processes. In a qualitative interview study we examined the feedback of conventional healthcare professionals about the integrative practices provided to pediatric patients by an integrative team in a pediatric oncological hospital. Methods: Fifteen semi-structured interviews were carried out with various conventional healthcare professionals in an university pediatric hospital in São Paulo, Brazil. The interviews were audio-recorded, transcribed and pseudonymized. DSCsoft® and MAXQDA® software assisted in a profound qualitative analysis using the collective subject discourse and thematic analysis method in order to display participants' perspectives on PCIH and the project in their hospital. Results: Interviewees acknowledged their lack of knowledge about PCIH practices and reflected on the limits of their care as well as on new possibilities PCIH could offer. PCIH was perceived by interviewees as an effective supportive tool of care to promote patients' wellbeing, assist overall compliance, strengthen cooperation between professionals, children and their relatives and hence facilitated general patient care. Since PCIH was implemented in their clinic, perceptions led interviewees to wish for increased PCIH offering and a more profound integration of its therapists into the standard of care. Discussion: The coexistence of integrative and conventional practices in the conventional healthcare setting is important to give visibility to the possibilities offered by the integrative pediatrics field. Regular and constant encounters with integrative practices, as well as information access seem crucial to reach a wider openness for PCIH and subsequently a broader application and dissemination of it.


Oral appliance therapy is emerging as an alternative to continuous positive airway pressure for the treatment of obstructive sleep apnea (OSA). However, its precise mechanisms of action are yet to be defined. We examined the effect of a mandibular advancement splint (MAS) on upper airway collapsibility during sleep in OSA. Ten patients with proven OSA had a custom-made MAS incrementally adjusted during an acclimatization period until the maximum comfortable limit of mandibular advancement was reached. Polysomnography with the splint was then performed. After a 1-week washout period, upper airway closing pressures during sleep (with and without MAS) were determined. Significant improvements with MAS therapy were seen in the apnea/hypopnea index (25.0 +/- 3.1 vs. 13.2 +/- 4.5/hour, p < 0.03) and upper airway closing pressure in Stage 2 sleep (-1.6 +/- 0.4 vs. -3.9 +/- 0.6 cm H2O, p < 0.01) and in slow wave sleep (-2.5 +/- 0.7 vs. -4.7 +/- 0.6 cm H2O, p < 0.02) compared with no therapy. These preliminary data indicate that MAS therapy is associated with improved upper airway collapsibility during sleep. The mediators of this effect remain to be determined.


Inhibition of p-glycoprotein under hyperglycemic conditions has been reported in various barrier tissues including blood-brain barrier, intestine, and kidney, and has been linked to significant clinical complications. However, whether this is also true for the outer blood-retinal barrier constituted by retinal pigment epithelium, or has a role in pathogenesis of diabetic retinopathy is not yet clear. In this study, using cultured human retinal pigment epithelium cell line D407, we found that high glucose exposure induced a significant decrease in p-glycoprotein expression both at mRNA and at protein levels, accompanied by an attenuated p-glycoprotein activity determined by intracellular rhodamine 123 retention. In marked contrast, the expressions of both mRNA and protein levels of inducible nitrate oxide synthase (iNOS) increased, and were accompanied by increased extracellular nitrate/nitrite production by Griess reaction. In addition, mRNA levels of nuclear receptors revealed a decreased expression of pregnane X receptor after the exposure of high glucose. However, the subsequent alterations in production of nitrate/nitrite, functional expression of p-glycoprotein, and mRNA levels of pregnane X receptor were partially blocked when pretreated with S,S′-1,3-phenylene-bis(1,2-ethanediyl)-bis-isothiourea•2HBr (PBITU), a selective iNOS inhibitor. Moreover, the effects of PBITU were antagonized with the addition of L-arginine, a substrate for NO synthesis. Our in vitro results suggest for the first time that iNOS induction plays a novel role in decreased p-glycoprotein expression and transport function at the human outer blood-retinal barrier under hyperglycemic conditions and further support the concept of inhibiting iNOS pathway as a therapeutic strategy for diabetic retinopathy.


The three-dimensional time domain finite-difference (TDFD) method was used to design a 433 MHz circular waveguide applicator for electromagnetic hyperthermia. This applicator has a water-filled lens at one end, providing surface cooling as well as some shaping of the emergent electromagnetic field. An experimental system for scanning the EM field in three dimensions is described. The experimental data were compared with those calculated from the TDFD program and good agreement was found. A realistic three-dimensional model based on an ultrasound scan of a surface tumour was built. Both the EM field and the specific absorption rate (SAR) within the model when irradiated by the applicator were calculated.


OBJECTIVES
Rapid diagnostic tests can screen out negative samples and can save valuable time and money. The study was conducted to assess the usefulness of leukocyte esterase, nitrate reductase and quantitative microscopic unspun urine wet mount examination in rapidly diagnosing urinary tract infections (UTI).

METHODS
Four hundred and fifty samples were tested by semi-quantitative culture on cysteine lactose electrolyte deficient medium, microscopic examination of unspun urine for significant pyuria, dipstick leucocyte esterase test (LET) and nitrite test (NT). Culture was used as gold standard to evaluate the performance of direct microscopy and dipstick tests.

RESULTS
Urine culture examination revealed significant bacteriuria (>10(5) cfu/ml) 98 (21.8%), in urine samples. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and the diagnostic odds ratio (DOR) of the dip-stick LET were 73.5%, 58.5%, 33.0%, 88.8%, and 3.9 respectively; those of the dip-stick NT were 57.1%, 78.7%, 42.7%, 86.8%, and 4.9 respectively; and those for microscopic significant pyuria detection were 68.4%, 60.8%, 32.7%, 87.3%, and 3.4 respectively. Highest sensitivity (95.9%), NPV (97.9%) and DOR (25.7) was obtained on combining microscopy and dip-stick LET and NT (either of them positive). This can potentially cut costs by 79%.

CONCLUSION
Quantitative unspun urine wet mount microscopy and dipstick tests for leucocyte esterase and nitrite test should be added into routine laboratory practices for faster diagnosis of UTI.


Often students of the petroleum engineering programs at the early stage of their studies in institutions of developing countries do not have easy access to the oil and gas industry facilities. Multinational petroleum companies come in with the state-of-the-arts technology, with expatriates who work and leave without technology transfer. Laboratory equipment is very costly to developing institutions of petroleum studies in developing nation. As such, different hands-on models have been developed to simulate different processes of the oil and gas industry in the laboratory. This model captioned "Golden Horse Head" Sucker Rod Pumping model is one of such hands-on models that has been constructed and successfully tested. This model is 88 cm in length, 52 cm wide and 56.5 cm high. It was made using very basic local materials to represent the actual field components, for the purpose of better understanding of how such systems operate. The materials are very affordable and less costly. The overall cost of the model is about 75,000FRS CFA, that is, about US$150.0. This low cost of construction makes the model very affordable to developing institutions of petroleum studies. In this model, there was a reduction from the prime mover speed of 2000 rpm to the pumping speed of 38 rpm, giving a reduction ratio of 52.6:1. It has been tested with a multiphase fluid (water and oil (diesel) simulating crude oil) model, during which 75.4% oil and 97.7% of water were produced.  Its functioning accurately simulates that of a practical oil field sucker rod pumping facility.

 Key words: Developing countries, oil well, model, low-cost, Sucker-rod, pump unit.


The increase in road traffic in the recent years brings into question the complex issue of noise pollution. In numerous surveys carried out on population samples from urban areas, noise pollution or "noise" as it is generically called appears in the forefront of inconveniences and discomfort list. With the use of new techniques developed by acoustics experts, it is possible to study sound propagation and its impact on population in specific urban areas. The purpose of this paper is to compare noise levels in different areas of Timisoara, in order to determine the sensitive buildings in the city. Their identification is essential because on these building facades the noise level resulting from exposure to road noise exceeds or threatens to exceed at least one of the limit values.


If supersymmetric particles are produced at the Large Hadron Collider it becomes very important not only to identify them, but also to determine their masses with the highest possible precision, since this may lead to an understanding of the SUSY-breaking mechanism and the physics at some higher scale. We here report on studies of how such mass measurements are obtained, and how the precision can be optimized.


An increasingly vast segment of the literature examines the relationship between greenspace and pediatric health. However, the bulk of this research continues to use proximate relative greenness as a measure for exposure to the ecosystem services provisioned by natural areas, despite increasing recognition that relative greenness fails to capture the public accessibility, recreation potential, or desirability of natural areas. Thus, this present research demonstrates the use of emerging data sources that can be used in conjunction with traditional greenspace measures to improve modeling as it relates to nature's impacts on pediatric health. Using spatial park and protected area data in concert with mobile phone location data, we demonstrate exploratory analysis on how park and protected area attributes may influence pediatric health in northwest Montana, USA. Suggestive findings concerning how the attributes of park and protected areas (i.e., conservation status, access, recreation demand) influence pediatric health (i.e., attention-deficit/hyperactivity disorder, asthma, and anxiety/mood disorders) lead us to introduce directions for future research beyond greenspace. Importantly, this research does not intend to provide definitive or generalizable findings concerning how parks and protected areas influence pediatric health. Instead, we aim to provide an initial exploration toward a larger, future body of the literature, evaluating parks and protected areas' influence on pediatric health.


This thesis deals with the question, how a pre-development process for technology development could look like. The thesis was written in a company as project, this company is used as a case company. Interviews with relevant employees have been made to analyze the current pre-development process. The current process including responsibilities, goals of pre-development in the company and difficulties are described.The theoretical framework includes a description of the main pre-development models. The first one is the stage gate model, which includes pre-development in the product development process. All stages and gates are clear defined and a given result is expected. The second model, the new concept development (NCD) model is more theoretical it provides methods, tools and techniques for the different steps in pre-development. The (NCD) model defines pre-development as an independent process. Both models are compared to each other.Based on the results of the interviews and the literature review a suggestion for a new pre-development process model is given. This model consists of six steps: Idea collection, idea selection, Concept plan, run pre-development research, evaluating results and use results for new products. The several steps are described in detail and some helpful tools for different activities during the steps are recommended and described. Possible problems and difficulties are also discussed.


Acute pulmonary schistosomiasis affects non-immune individuals returning from endemic areas. Pathogenesis is not well understood. We report a case of acute pulmonary schistosomiasis in which lung biopsy was done 10 weeks after exposure and it identified the presence of schistosomal ovum surrounded by granuloma.


Abstract The equilibrium Rayleigh-Brillouin spectrum for a Maxwell fluid in which heat conduction is governed by the classical Fourier law is computed. This is done by using fluctuating hydrodynamics and by the alternative procedure used by Mountain. It is found that both calculations render the same results only if the fluctuation-dissipation relations in the former are the ones prescribed by Landau and Lifshitz for the case where a dispersive dissipation coefficient is present. This result brings up the question of whether extended irreversible thermodynamics is the proper underlying nonequilibrium thermodynamic framework for the Maxwell fluid. It also suggests that at least the version of fluctuating hydrodynamics based on extended irreversible thermodynamics as introduced by Jou and Casas-Vázquez many years ago [18] must be revised, since it leads to a different form for the fluctuation-dissipation relations.


A method is described for the analysis of taxine alkaloids by liquid chromatography/mass spectrometry. It is applicable to the detection of taxine alkaloids in the stomach contents of horses in which Taxus poisoning is suspected. Analysis of a leaf extract of Taxus baccata revealed unreported alkaloids of the same relative molecular mass as taxine B and isotaxine B.


ABSTRACT:This paper considers the problems that unconscious racial bias and social sin more broadly pose for moral theology's concepts of the erroneous conscience and ignorance. It argues that systemic racism prompts us to reimagine the erroneous conscience and individual culpability for ignorance. I argue that the erroneous conscience is useful in protecting human dignity in the face of error and in acknowledging the many ways we err but also problematic because it equates error with concrete action and conscious decisions and does not account for responsibility for social sin. This paper asserts that people of privilege and white persons cannot be morally innocent, but the erroneous conscience as it has been understood in the theological tradition often implies that innocence is the goal of the moral life and only holds us accountable for conscious moral actions.


Yttrium aluminium garnet scintillators coupled to photo-diode arrays (YAG/PDA) are used extensively in parallel electron energy loss spectrometers (PEELS). The use of uniform illumination spectra acquired with the electron beam spread over a YAG/PDA has been shown to be inadequate for determining the response of YAG/PDA detectors to electrons. The electron response of a YAG/PDA detector depends on the specific operating conditions of both spectrometer and electron microscope and should be determined under the same experimental conditions as used for collecting the spectra for analysis. The response of a YAG/PDA can be conveniently measured by translating the electron beam, with no specimen intercepting the beam, across the detector while acquiring a long-integration-time spectrum. This technique was used to examine the effect on YAG/PDA response of changes in spectrometer energy resolution and entrance aperture size for a particular spectrometer. The technique was also used to examine the effects of incomplete charge collection in the PDA. YAG/PDAS are also shown to exhibit nonlinear response to electron intensity and a phenomenological correction factor is determined for one set of microscope and spectrometer operating conditions. The cause of ripple observed in spectra collected at the highest resolution of the PEELS, while the electron beam was being translated across the YAG/PDA, was investigated and was determined to be due to low level electromagnetic noise deflecting the electron beam across the detector.


We show that the N.N. Bogolubov generating functional method is a very effective tool for studying distribution functions of both equilibrium and non equilibrium states of classical manyparticle dynamical systems. In some cases the Bogolubov generating functionals can be represented by means of infinite Ursell-Mayer diagram expansions, whose convergence holds under some additional constraints on statistical system. The classical Bogolubov idea [1] to use the Wigner density operator transformation for studying the non equilibrium distribution functions is developed and new analytic non-stationary solution to the classical N.N. Bogolubov evolution functional equation is constructed.


Protein folds are built primarily from the packing together of two types of structures: α‐helices and β‐sheets. Neither structure is rigid, and the flexibility of helices and sheets is often important in determining the final fold (e.g., coiled coils and β‐barrels). Recent work has quantified the flexibility of α‐helices using a principal component analysis (PCA) of database helical structures (J. Mol. Bio. 2003, 327, pp. 229–237). Here, we extend the analysis to β‐sheet flexibility using PCA on a database of β‐sheet structures. For sheets of varying dimension and geometry, we find two dominant modes of flexibility: twist and bend. The distributions of amplitudes for these modes are found to be Gaussian and independent, suggesting that the PCA twist and bend modes can be identified as the soft elastic normal modes of sheets. We consider the scaling of mode eigenvalues with sheet size and find that parallel β‐sheets are more rigid than antiparallel sheets over the entire range studied. Finally, we discuss the application of our PCA results to modeling and design of β‐sheet proteins. Proteins 2004. © 2004 Wiley‐Liss, Inc.


We present 0.1-10 keV observations of Her X-1 obtained with the Low-Energy Spectrometer Concentrator instrument onboard the BeppoSAX satellite during the main on-state of the 35 day cycle. We confirm the existence of an intense 0.093 keV blackbody component and a broad emission feature at 0.94 keV. The pulse phase dependence of these components is similar, suggesting a common origin. This is most likely fluorescent excitation of moderately ionized ($\xi\sim$10--100) material located at the inner edge of the accretion disk.


During experimental evaluations of RPL on a network with some 20 Zolertia Z1 motes running Contiki version 2.6, inconsistent Packet Delivery Ratios (PDR) and message latencies were frequently observed. Replacing ContikiMAC by NullRDC brought consistency, proving that the problem had to be found in the Radio Duty Cyling (RDC) protocol. Two implementation issues of ContikiMAC were found guilty. The first is the timing of the inter-packet interval related to the interval between two successive Clear Channel Assessment (CCA) probes. The second is the choice of the value of the CCA threshold. These issues will be analyzed in this poster, a satisfactory work-around has been implemented and some to be tested alternatives are proposed. *


In this article the frequency response analysis of curved magneto-electro-viscoelastic functionally graded (CMEV-FG) nanobeams resting on viscoelastic foundation has been carried out. To this end, the study incorporates the Euler-Bernoulli beam model in association with Eringen's nonlocal theory to incorporate the size effects. The viscoelastic foundation in the current investigation is assumed to be the combination of Winkler-Pasternak layer and viscous layer of infinite parallel dashpots. The equations of motion are derived with the aid of Hamilton's principle and the solution to vibration problem of CMEV-FG nanobeams are obtained analytically. The material gradation is considered to follow Power-law rule. This study thoroughly investigates the influence of prominent parameters such as linear, shear and viscous layers of foundation, structural damping coefficient, opening angle, magneto-electrical field, nonlocal parameter, power-law exponent and slenderness ratio on the frequencies of FG nanobeams.


Degeneration and loss of lower motor neurons is the major pathological hallmark of spinal muscular atrophy (SMA), resulting from low levels of ubiquitously-expressed survival motor neuron (SMN) protein. One remarkable, yet unresolved, feature of SMA is that not all motor neurons are equally affected, with some populations displaying a robust resistance to the disease. Here, we demonstrate that selective vulnerability of distinct motor neuron pools arises from fundamental modifications to their basal molecular profiles. Comparative gene expression profiling of motor neurons innervating the extensor digitorum longus (disease-resistant), gastrocnemius (intermediate vulnerability), and tibialis anterior (vulnerable) muscles in mice revealed that disease susceptibility correlates strongly with a modified bioenergetic profile. Targeting of identified bioenergetic pathways by enhancing mitochondrial biogenesis rescued motor axon defects in SMA zebrafish. Moreover, targeting of a single bioenergetic protein, phosphoglycerate kinase 1 (Pgk1), was found to modulate motor neuron vulnerability in vivo. Knockdown of pgk1 alone was sufficient to partially mimic the SMA phenotype in wild-type zebrafish. Conversely, Pgk1 overexpression, or treatment with terazosin (an FDA-approved small molecule that binds and activates Pgk1), rescued motor axon phenotypes in SMA zebrafish. We conclude that global bioenergetics pathways can be therapeutically manipulated to ameliorate SMA motor neuron phenotypes in vivo.


An implicit, stiffly stable numerical integration algorithm is developed and demonstrated for automated simulation of multibody dynamic systems. The concept of generalized coordinate partitioning is used to parameterize the constraint set with independent generalized coordinates. A stiffly stable, Backward Differentiation Formula (BDF) numerical integration algorithm is used to integrate independent generalized coordinates and velocities. Dependent generalized coordinates, velocities, and accelerations, as well as Lagrange multipliers that account for constraints, are explicitly retained in the formulation to satisfy all of the governing kinematic and dynamic equations. The algorithm is shown to be valid and accurate, both theoretically and through solution of an example.


RATIONALE
Multiple Reaction Monitoring (MRM) is a sensitive and selective detection mode for target trace-level analysis. However, it requires the fragmentation of labile bonds which are not present in molecules such as Polycyclic Aromatic Hydrocarbons (PAHs) and their heterocyclic derivatives (PANHs, PASHs).

METHODS
We present the application of an alternative MS/MS mode called "pseudo-MRM" for the GC-MS/MS analysis of Polycyclic Aromatic Compounds (PACs). This mode is based on the monitoring of transitions with no mass loss between the parent and the product ion. Pseudo-MRM peak areas were compared with those of classic MRM on three different mass spectrometers: two Triple Quadrupoles and an Ion Trap.

RESULTS
For all non-polar PACs studied here (PAHs, PANHs and PASHs), the pseudo-MRM transition was always the most intense. The classic MRM transitions exhibited peak areas 2 to 5 times lower. On the contrary, for the functionalized PACs (oxygenated and nitrated PAHs), classic MRM was favored over pseudo-MRM.These observations were confirmed on two Triple Quadrupoles (QqQs), and the real-world applicability of pseudo-MRM on QqQs was validated by the successful analysis of Diesel PM. However, a comparison with an Ion Trap showed that pseudo-MRM was never favored on the Ion Trap, which caused fragmentation of non-polar PACs in MS/MS.

CONCLUSIONS
The results of this study show an important gain in sensitivity when using pseudo-MRM instead of MRM for non-polar PACs on Triple Quadrupole instruments. The selectivity of MRM is preserved in pseudo-MRM by applying non-zero collision energies to which only these non-polar PACs are resistant, not the isobaric interferences. No interference issue was observed when analyzing Diesel PM, a complex matrix, with our pseudo-MRM method. Therefore, we advise for a broader use of this MS/MS mode for trace-level determination of non-polar PAHs.


Computed tomography (CT) provides the most detailed imaging information, hence it is generally used as a routine imaging procedure in the tumour, node, metastasis (TNM)-staging of patients with lung cancer. However, despite the continuously ongoing process of improvement in CT scanning in which today's CT scanners combine fast acquisition, fast data reconstruction and high detail, the technique has important limitations. CT can, in some cases, very accurately show tumour extent within, and predict spread beyond the lung. However, the question of whether the tumour has invaded the chest wall or the mediastinum and, if so, whether it is still potentially surgically curable often remains unanswered. In addition, the only sign for predicting lymph node involvement using CT is enlargement. Many studies have shown that this sign is not very reliable. CT is also, with success, being used to evaluate distant metastases although other techniques such as ultrasound and magnetic resonance imaging can have similar or higher accuracies. Despite these well-known limitations, computed tomography will most likely stay the routine imaging procedure for determining resectability and for assessing intra- and extrathoracic spread of lung cancer. The improvement in technology will probably result a better T‐staging. The role of computed tomography in nodal staging remains important. It offers the surgeon a road map of the lymph nodes and guides towards the nodes that need biopsy. Combining computed tomography with positron emission tomography, when it becomes more widely available, will add functional images to the detail of computed tomography and will not only improve nodal staging but will probably also allow a better evaluation of distant metastasis and reduce the number of unnecessary interventional procedures.


Acrylamide is widely found in baked and fried foods, produced in large amount in Industries and is a prime component in toxicity. This review highlights various toxicities that are induced due to acrylamide, its proposed mode of action including oxidative stress cascades and ameliorative mechanisms using phytochemicals. Acrylamide formation, the mechanism of toxicity and the studies on the role of oxidative stress and mitochondrial dysfunctions are elaborated in this paper. The various type of toxicity caused by Acrylamide and the modulation studies using phytochemicals that are carried out on various type of toxicity like neurotoxicity, hepatotoxicity, cardiotoxicity, immune system, and skeletal system, as well as embryos have been explored. Lacunae of studies include the need to explore methods for reducing the formation of acrylamide in food while cooking and also better modulators for alleviating the toxicity and associated dysfunctions along with identifying its molecular mechanisms.


Abstract The article examines the increasing complexity of the relationship between contemporary architecture and media image by focusing on Office for Metropolitan Architecture (OMA)'s Chinese Central Television Headquarters (CCTV) in Beijing in China, completed in 2012. Here, the CCTV is positioned within a global capitalist system, designed by a brand-architect. It is also deemed an example of productive image-architecture relationships, productive of theoretical discourses, architecture and the construction of architect's brand identity and fame. Considering that architectural historian Aaron Betsky regarded Rem Koolhaas as architect able to produce "a convincing architecture of image" (Patteeuw 2003, 39), this article argues that the very nature of what a convincing architecture of image is is under threat, and contends that at the mercy of media, architecture can be devalued through objectification through media consumption. This article thereby aims to expand the understanding of the productive relationships between architecture and media images.


This study's objective is to solve performance evaluation problem of PC cluster in processing seismic data intensive computing. The objective of performance evaluation is determining the relationship between the number of PC node and the scale of tasks to be processed to decide whether the transaction of seismic data processing should be transformed from mainframe computer to PC cluster platform. In particular, this paper presented a model based on least-squares regression for evaluating the performance of PC cluster. The model begins with the comparison of the computing performance of PC clusters by collecting experiential data, and proceeded by establishing performance evaluation model of PC cluster using least-squares regression, as well as performing error analysis and significance test. To study the effects of the proposed model, a series of experiments based on PC cluster are designed and implemented. The results show that the computational efforts, communication traffic and their relationship play an important role in task processing of PC cluster. This study's conclusions indicate that PC cluster can be substituted for mainframe computer in order to save the expense of processing seismic data.


We study the spontaneous emission rate of a dipole emitter in $\mathcal{PT}$-symmetric environment of two coupled waveguides using the reciprocity approach generalized to non-orthogonal eigenmodes of non-Hermitian systems. Considering emission to the guided modes, we define and calculate the modal Purcell factor composed of contributions of independent and interfering non-orthogonal modes leading to the emergence of cross-mode terms in the Purcell factor. We reveal that the closed-form expression for the modal Purcell factor within the coupled mode theory slightly alters for the non-Hermitian coupled waveguide compared to the Hermitian case. It is true even near the exceptional point, where the eigenmodes coalesce and the Petermann factor goes to infinity. This result is fully confirmed by the numerical simulations of active and passive $\mathcal{PT}$-symmetric systems being the consequence of the mode non-orthogonality.


THIS publication contains the description of an optical instrument with which it is possible accurately to observe and examine the retina, as well as the images of luminous objects which may be projected upon it in the living eye. To be of value, such an instrument must overcome two important problems. First of all, as we observe the normal eye its anterior appears to be completely dark. The reason for this, as I shall demonstrate, is that under ordinary circumstances the refractive media of the eye prevent us from observing illuminated portions of the retina through the pupil. Therefore, it was necessary to devise a method to illuminate adequately that part of the retina seen through the pupil. Second, only by looking through the refractive media can we visualize the background of the eye. The phenomenon of refraction projects images of retinal structures in such a way that they cannot be visualized. It is necessary to have a special


This talk gives an introduction to some of the basic strong interaction issues we face in η and η decays. It will not cover weak decays. Simple dimensional analysis leads to branching ratios below 10 for weak η-decays and below 10 for weak η decays. These will obviously not be observed in the near future. It is possible to construct models that enhance η and η decays due to beyond the standard model physics to observable rates but these models tend to be ugly in order to avoid the very stringent constraints from kaon decays and other sources, some examples can be found in [1]. Let me remind you of the η-handbook [1] where you can find a series of lectures on the basis of η and η physics. The theory lectures relevant for this talk in there are those by Kroll [2], Bijnens and Gasser [3], Ametller [4], Holstein [5], Shore [6] and Bass [7]. There are also a set of related theory talks in this conference, those by Bass [8], Borasoy [9], Oset [10] and Martemyanov [11], while most of the other talks today are the experimental talks related to η and η decays at KLOE and WASA.


rary police departments into 'political arenas'. The second part explores manifestations of the power struggles in different police organizations. The book concludes with a discussion of new approaches to defining and managing police work and their leadership challenges for police administrators. To illuminate the arguments of the study, the authors give many examples and cases derived from observations during a 3-year study of decision making in police work and further research on institutional racism in law


Even though the number and variety of available configuration management systems has grown rapidly in the past few years, the need for new configuration management systems still remains. Driving this need are the emergence of situations requiring highly specialized solutions, the demand for management of artifacts other than traditional source code and the exploration of entirely new research questions in configuration management. Complicating the picture is the trend toward organizational structures that involve personnel working at physically separate sites. We have developed a testbed to support the rapid development of configuration management systems. The testbed separates configuration management repositories (i.e., the stores for versions of artifacts) from configuration management policies (i.e., the procedures, according to which the versions are manipulated) by providing a generic model of a distributed repository and an associated programmatic interface. Specific configuration management policies are programmed as unique extensions to the generic interface, while the underlying distributed repository is reused across different policies. The authors describe the repository model and its interface and present their experience in using a prototype of the testbed, called NUCM, to implement a variety of configuration management systems.


Purpose
The purpose of this paper is to explore how far plans to "modernize" hospital management in China are converging toward a global model of new public management (NPM) or represent a distinctive pathway.

Design/methodology/approach
This paper draws on a systematic review of available secondary sources published in English and Chinese to describe both the nature and trajectory of hospital management reforms in China.

Findings
In China, while public hospital reforms bear many of the hallmarks of the NPM, they are distinctive in two key respects. First, the thrust of current reforms is to partially reverse, not extend, the trend toward marketization in order to strengthen the public orientation of public hospitals. Second is a marked gap between the rhetoric and reality of empowering managers and freeing them from political control.

Practical implications
This paper develops a framework for understanding the drivers and obstacles to hospital management reforms in China that is useful for managers, clinicians and policy makers.

Originality/value
In China, few authors have considered NPM reform in relation to healthcare. This paper contributes in better understanding current reforms taking place in China's expanding healthcare sector and locates these within broader theoretical and policy debates.


Several nurse researchers do not consistently engage the best rating scale design in developing health research questionnaires thus obscuring the obligatory psychometric properties of the tools as objective rating scales. In response, this paper intends to simplify the Rasch techniques of best rating scale (or questionnaire) validation into four stages. Among researchers and psychometricians, presenting the objective psychometric properties of questionnaires used as rating scales are the cornerstones of the mathematical credibility of any reading generated by the scale. On the contrary, being too reliant on the conventional methods called the classical test theory (CTT), most already "developed" questionnaires rarely display objective indices of the measuring tools. CTT is not the best method for designing questionnaires because its techniques rely on too many unproven mathematical assumptions. Correspondingly in this paper, the Rasch techniques of rating scale design are simplified into four steps for designing questionnaires as objective rating scales. A key contribution of Rasch validation technique is that essential psychometric properties are tested and displayed rather than merely assumed. Therefore, nurse researchers ought to show methodological and mathematical rigours aimed at designing questionnaires as objective measuring tools of health variables. Embracing the four phases of questionnaire design in Rasch techniques provides an easy-to-follow and scientifically robust framework for developing a questionnaire. Finally, the CTT approach to developing questionnaires lack evidence expected of an objective rating scale. Therefore, the four steps in Rasch techniques of questionnaire design, outlined here, present the techniques that researchers may engage in to minimise measurement errors.


abstract:The recent turn to realism in Continental philosophy leaves phenomenology in a precarious position, for it appears that we commit ourselves to a sort of idealism whenever we employ the phenomenological method. I will argue in this article, however, that this appearance is deceptive and that, instead, phenomenology provides support not just for realism but for a position I will call the "new realism," which not only affirms the reality of conditioned, spatiotemporal beings but denies the existence of any type of eternal or unchanging being in which they would ostensibly find their unconditioned condition or source.


Background:The diagnosis of type 1 von Willebrand disease (VWD) presents a diagnostic challenge in children. In fact, 25% or more of children with VWD may be diagnosed only after they experience postoperative bleeding. We previously described a 4-variable composite score that has 92.5% sensitivity and 95% specificity for diagnosing VWD in children with known VWD when 2 of 4 criteria are positive: (1) Tosetto bleeding score ≥1; (2) family history of VWD; (3) personal history of iron deficiency anemia; and/or (4) positive James early bleeding score. The purpose of this study was to prospectively validate a composite score of ≥2 for identifying children with VWD. Procedure:Children without a previously diagnosed bleeding disorder presenting for hematology evaluation were enrolled. Sensitivity, specificity, positive, and negative predictive value of the composite score was determined. Results:A total of 193 subjects were enrolled from 12 participating centers were included in the analysis. Forty-seven children had type 1 VWD, including 11 with von Willebrand Ristocetin Cofactor (VWF):RCo <30 IU/dL, 14 subjects with a VWF:RCo 30 to 39 IU/dL, and 22 with a VWF:RCo 40 to 49 IU/dL. Including all 4 variables, a composite score of ≥2 had a sensitivity of 63.6% to 76.0%, specificity of 33.5% to 35.1%, negative predictive value of 76.9% to 93.8%, and positive predictive value of 5.5% to 25%. Conclusions:The negative predictive value of the composite score was robust, especially at lower VWF:RCo suggesting that VWD testing could be eliminated in nearly a third of children referred for VWD testing.


The limiting total excitation energy of 208Pb is calculated using the nuclear grand partition function. A temperature-dependent shell-model potential and an energy-dependent nucleon-nucleus optical potential are employed to generate the temperature-dependent bound single particle energies epsilon k and the continuum level density rho ( epsilon ) respectively. Levinson's theorem is used to make the relevant change in rho ( epsilon ) due to the T dependence of epsilon k(T). The calculated limiting total excitation energy is about half of the one recently obtained by Dean and Mosel (1985).


This article begins by assessing the ways in which the life and work of Neil MacCormick exemplified a dual commitment to the local and particular - especially through his advocacy of nationalism - and to the international and the universal. It then concentrates on one of the key tensions in his work which reflected that duality, namely the tension between his longstanding endorsement of constitutional pluralism - and so of the separate integrity of different "local" constitutional orders - and his belief in some kind of unity, and so community, residing in the moral and rational properties of all law. The article continues by considering a number of ways in which this tension may be resolved. It concludes, with particular reference to MacCormick's late work on ethics, that the answer may be found through the idea of a general unity of practical reason which undergirds the various special orders of practical reason by which particular legal systems are distinguished.


Testosterone deficiency resulted in increased mortality in men. Our previous work found that hydrogen sulphide (H2S) significantly alleviated the spermatogenesis disorder. To investigate whether H2S could regulate testosterone synthesis and the relative signalling pathways. Disorder model of testosterone synthesis was constructed in vitro and in vivo. The cell viability was detected using CCK‐8 method. The concentration of H2S and testosterone were examined using ELISA kits. The relative mRNA and protein expression of CBS, PDE4A, PDE8A and proteins related to testosterone synthesis were detected by RT‐qPCR and western blotting. PAS staining was used to detect the inflammatory status of testis. The sulfhydryl level of PDE4A and PDE8A was determined by Biotin Switch Technique. CBS overexpression inhibited while knockdown promoted LPS + H2O2 induced injury in testosterone synthesis of MLTC‐1 cells, though regulating the level of H2S. The LPS + H2O2 induced inhibition on cAMP and p‐PKA was recovered by CBS overexpression, while addition of the specific inhibitor of PKA had opposite effects. CBS overexpression alleviated the inflammation status in testis and promoted the expression of StAR, P450scc, P450c17 and 3β‐HSD. CBS could also exhibit its protective role through promoting sulfhydrylation of PDE4A and PDE8A. H2S catalysed by CBS could recover testosterone synthesis in vitro and in vivo through inhibiting PDE expression via sulfhydryl modification and activating cAMP/PKA pathway.


Additional index words. Gardenia jasminoides, light intensity, growth retardant Abstract. The effects of several shading materials on the response of Gardenia jasminoides Ellis to paclobutrazol were investigated under greenhouse conditions. The three main plot treatments were shading (0%, 67%, 98%), and paclobutrazol (0.0, 0.5, 1.0, and 2 mg/ pot) was applied as a soil drench in each main plot after pinching the plants. Both plant size and the number of flower buds per plant decreased as the rate of paclobutrazol increased at all levels of shading. The efficacy of paclobutrazol, however, was generally less under heavy shade, as both translocation of the growth retardant and photosynthe- sis were reduced. Moderate shading (67%) did not affect the size of plants receiving 0.0 or 0.5 mg of paclobutrazol per pot, but plants grown under heavy shade (98%) were 74% as large as similarly treated nonshaded plants. Medium shade reduced the size of plants receiving 1 and 2 mg paclobutrazol 4% and 6%, respectively, relative to that of similarly treated nonshaded plants, whereas heavy shade reduced plant size 11%. The number of flower buds per plant was reduced 30% by moderate shading, 90% by heavy shading. Significant quadratic relationships were observed between the rate of paclobutrazol applied and (1) plant size, and (2) the number of flower buds per plant. Chemical name used: ±-(R * ,R


Behçet's disease (BD) is rare in children. Herein, we report a case of 12-year-old male child with a history of left superficial femoral vein thrombosis and bilateral pulmonary embolism, admitted for multiple thrombosis located in the inferior vena cava, right atrium and ventricle associated with multiple pulmonary artery aneurisms and fissurations concomitant to oral aphthosis, which was suggestive of BD. Despite corticoids and immunosuppressive therapy, the child had a massive hemoptysis resulting in his death. The association between intracardiac thrombosis, pulmonary aneurism and venous thrombosis should raise suspicion of angio-Behçet, which could be lethal.


In order to manage their brand, companies try to control all information about them. this fact can lead to try to change or to delete information available on Internet. In this case, a counterproductive effect called "Streisand" effect can occur. It describes the process leading to a greater diffusion of information that would be kept confidential on Internet in case of no manipulation. the presentation of this effect through three real cases, Ralph Lauren, General Mill and Nestle, demonstrates how a simple desire to brand control on Internet can degenerate into a negative advertising campaign against the company. these cases contribute to note the limitations of communicational and legal responses. they also contribute to a better management of this effect. finally, the impact of the "Streisand" effect on company performance and on its brand image is emphasized. (English) [ABSTRACT FROM AUTHOR]


Analysis of steroid and thyroid hormones is often performed in blood serum. Occasionally though, plasma samples are submitted in lieu of serum for exotic species such as tigers. However, blood tube anticoagulants may affect hormone values. We compared serum and heparin plasma results for 7 hormones in tigers. Serum and plasma samples were collected from 25 tigers and analyzed for progesterone, 17-hydroxyprogesterone, cortisol, androstenedione, testosterone, estradiol, and thyroxine. Using Lin concordance correlation, serum and heparin plasma measures agreed for all hormones except cortisol. However, Passing–Bablok regression only found agreement between serum and heparin plasma measures for androstenedione, testosterone, and estradiol. Median values between the 2 sample types were significantly (p < 0.05) different for progesterone, 17-hydroxyprogesterone, cortisol, and thyroxine. Our results suggest that, for the aforementioned hormones, serum and heparin plasma values may not always be comparable.


In this paper performance study of converter based wind energy conversion system (WECS) has been obtained. The generator used in WECS for this study is a Permanent Magnet Alternator (PMA) coupled to a wind turbine. It is assumed that the wind speed varies widely at the chosen site of WECS. The wide fluctuation of the wind speed produces variable dc voltage across the ac/dc converter stage. A dc-dc buck converter stage has been proposed to be used in such a situation to robustly hold the output dc voltage to the desired constant value needed for the dc link of the PWM inverter. It is shown through the small-signal modeling of the buck converter that the system has sufficient stability margins to control the output voltage and provide insensitivity against variations in the input voltage due to wind speed variations. Both dc output voltage of the buck converter and ac output voltage of the inverter are controlled through a common control strategy. The proposed wind energy scheme has been simulated and analyzed in the MATLAB/SIMULINK platform for different wind speed variations. The experimental verification of the performance of the buck converter to be used for the WECS has been obtained on the laboratory model using a dc motor-synchronous generator set.


The objective of this research was to describe the experience of adolescent mothers with childrearing and studying in non-formal education. The descriptive hermeneutic phenomenological approach was used in the study. Twenties adolescent mothers were selected by purposive sampling with inclusion criteria of looking after their first child and studying in non-formal education simultaneously for more than two months. Their children were healthy babies aged two months to two years old in Songkhla Province, Thailand. In-depth interview was used for data collection, and the data were analyzed by using Colaizzi's method. The study revealed that the experience of adolescent mothers during childrearing and studying in non-formal education was "feeling tried but being happy". Their expressions were classified into three categories 1) feeling tired but being able to get through, 2) having good experiences, and 3) having their life goals. This study provides a guideline in caring for adolescent mothers who are pregnant while studying. Nurses and healthcare providers can use the findings to inform, advise, promote and support these mothers to continue their education or return to educational system after giving birth. In addition, the findings can be used to guide a policy to support a service in order to respond on the basic needs of school-age mothers.


BACKGROUND
Affections of the lacrimal drainage system are often seen by ophthalmologists. Inspection, palpation, diagnostic rinsing and sounding can distinguish anatomical stops before or after tear sac. For final diagnostics however more apparative examinations are necessary. The ultrasonic examination with contrast media is a simple method for diagnostics of affections of the lacrimal drainage system besides the dacryocystography, the scintigraphy and other ones.

PATIENTS AND METHODS
On 12 patients with a dysfunctional lacrimal drainage system and 12 normal controls the ultrasonic examination with instillation of contrast media: silicon oil, glycerine, dispersions of almond oil and viscoelastic substances was performed. All examinations were performed with the 13 B-scan.

RESULTS
The lacrimal drainage way was detectable from the canaliculus to the middle nasolacrimal duc

CONCLUSION
An additional advantage of the ultrasonic examination with contrast-media is the neglect of radiation, the simple and often repeatable examination method, especially the enhancement of the contrast of different valves and stenoses and mucinous deposits in stationary anatomical variations and dynamic defects.


Teaching and training using online video material in science is on the rise. Science students entering universities today are of a "YouTube generation," most likely already having a history of accessing educational videos for learning at school. Here, we report on our experiences with preparing a Massive Open Online Course (MOOC) for the COURSERA platform in the area of computational wave propagation. We describe the complexity of the process but also highlight the opportunities that this form of training offers on state‐of‐the‐art e‐learning platforms. It is foreseeable that in the future universities will promote combinations of direct and supervised online course learning, allowing for more flexibility and variability of training content. We propose that Earth‐Science‐specific databases with links to online courses should be developed, making such courses more accessible to the research community.


Neoliberalism permeates U.S. family law. The law protects negative liberty in family life but denies positive rights to the resources that make family life possible. The law endorses laissez-faire market outcomes and portrays the state as overbearing and incompetent.In this essay, I document how neoliberalism dominates U.S. family law in three legal arenas. The first is federal constitutional law, where the Supreme Court has adopted a thoroughly neoliberal vision of the family. According to the Court, the Federal Constitution grants individuals wide latitude to assert negative liberty — that is, freedom from state intervention — in family life. But individuals have no constitutional right to claim any distribution of resources other than that produced by the marketplace.The second legal arena is state family law, which pursues a limited mission shaped by the contours of constitutional law. When individuals have sweeping rights to negative liberty but no rights at all to challenge market distributions, the primary task of subconstitutional law is simply to create legal space for individuals to exercise negative liberty. Accordingly, state family law pursues no broad mandate to foster family life. Rather, it seeks only to authorize private ordering and to adjudicate private disputes. The third legal arena is federal and state welfare law. One might suppose that welfare would provide a legal vehicle for citizens to challenge market outcomes. However, in the United States today, welfare provision tends to ratify market distributions rather than upend them. The predictable consequence is that individuals and families can suffer dire poverty without any entitlement to state assistance. The entrenched neoliberalism of family law is frustrating for many reasons, not least because it blocks sustained consideration of a more appealing liberalism. Negative liberty, as important as it is, is insufficient for justice. We can imagine — indeed, other countries have adopted — constitutional interpretations that convey positive rights. But so thorough is the neoliberal cast of U.S. family law at all levels that it is difficult to create legal space for consideration of such ideas. Today, constitutional law, family law, and social welfare represent separate legal specialties. To engage the possibilities of liberalism, a necessary, though hardly sufficient, first step will be to draw connections across bodies of law that are, today, treated as separate fields.


This paper reexamines the forecasting ability of Phillips curves from both an unconditional and conditional perspective by applying the method developed by Giacomini and White (2006). We find that forecasts from our Phillips curve models tend to be unconditionally inferior to those from our univariate forecasting models. Significantly, we also find conditional inferiority, with some exceptions. When we do find improvement, it is asymmetric - Phillips curve forecasts tend to be more accurate when the economy is weak and less accurate when the economy is strong. Any improvement we find, however, vanished over the post-1984 period.


Four experiments are reported: 1) Constant arc voltage operation was compared with constant arc current operation over a similar range of plasma density. The higher arc voltage required in the constant arc current operation produced more H−, but it was at the expense of an even larger increase in the accelerated electron current. 2) A comparison of different magnetic filter locations showed the highest accelerated H− and the lowest e− content at the closest filter location. 3) Beam‐forming electrode aperture comparison for round apertures from 2mm to 10mm diameters and an 11×27mm oval slot showed a decreasing H− and e− with increasing aperture area. 4) Increasing accelerator voltage produced an increasing plasma potential and electron temperature and decreasing electron density in the exit chamber of the plasma source.


Information on how biotic factors influence delivery of ecosystem services (ES) in natural systems is important for holistic landscape management. In this study, we assessed the perceived effects of elephants' presence on ES supply in the Pendjari Biosphere Reserve in West Africa. A total of 112 respondents, including riparian communities and reserve officials, were interviewed. First, we used ranking techniques based on stakeholders' perceptions to evaluate differences in perceived importance of ES. Second, we assessed the perceived impact of elephants on ES supply from both direction and intensity perspective. Third, we assessed the economic importance of threatened ESs and elephants' damages related economic losses incurred by households. Twenty-seven ES were enumerated, 13 provisioning ES, 12 cultural ES, and two from the regulating and maintenance ES category. Provisioning ES were perceived as the most important although not significantly different from other categories. PES were also found to be most affected negatively by elephants' impacts. However, elephants' presence increased supply of cultural ES. The average cost of the losses due to elephants' negative impacts ranged from $174.80 to $586.05 per year and per victim household. These results were discussed in relation to management actions necessary to facilitate coexistence between elephant and local populations.


Because listeriosis is one of the deadliest foodborne diseases, controlling and eradicating Listeria monocytogenes biofilms is a serious challenge for food safety. Biofilms (24 h old) formed on polystyrene by a L. monocytogenes strain of food origin were exposed for a further 24 h to 12 different concentrations (from 100 to 1011 PFU/mL) of the bacteriophage P100 (Listex P100). The structural parameters of biofilms were studied by using confocal laser scanning microscopy and digital image analysis. The biovolume in the observation field (14,121 μm2) of control (untreated) biofilms was 237,333.1 ± 2,692.6 μm3. The biomass of treated biofilms ranged from 164.7 ± 89.0 μm3 (biofilms exposed to 1010 PFU/mL) to 231,170.5 ± 15,142.0 μm3 (100 PFU/mL). The lowest biomass was achieved after treatment with 108 PFU/mL, with no further decrease in biovolume when higher phage concentrations were used. A strong ( P < 0.001) correlation was found between phage concentration (log units) and biovolume (-0.965), surface coverage (-0.939), roughness (0.976), maximum thickness (-0.853), and average thickness (-0.965). Findings from this research suggest that bacteriophage P100 at concentrations equal to or greater than 8 log PFU/mL successfully removes L. monocytogenes biofilms from polystyrene surfaces.


Dyshormonogenetic goitre is a rare thyroid entity which occurs due to enzymatic deficiency in the physiological process of thyroxinsynthesis resulting in goitre formation. This has to be differentiated from iodine deficiency goitres for their similarity in clinical presentation, hormonalprofile and on scintigraphy studies. This differentiation is vital for the reason that Dyshormonogenetic goitre (DHGG) needs to be treated with thyroxinwhile Iodine deficiency disorder (IDD)requires simple dietary iodinesupplementation.


The first project undertaken was to develop a currently non-existent forensic technique -- data recovery from damaged SIM cards. SIM cards hold data valuable to a forensic investigator within non-volatile EEPROM/flash memory arrays. This data has been proven to be able to withstand temperatures up to 500°C, surviving such scenarios as house fires or criminal evidence disposal. A successful forensically-sound sample extraction, mounting and backside processing methodology was developed to expose the underside of a microcontroller circuit's floating gate transistor tunnel oxide, allowing probing via AFM-based electrical scanning probe techniques. Scanning Kelvin probe microscopy has thus far proved capable of detecting the presence of stored charge within the floating gates beneath the thin tunnel oxide layer, to the point of generating statistical distributions reflecting the threshold voltage states of the transistors. The second project covered the novel forensic application of AFM as a complimentary technique to SEM examination of quartz grain surface textures. The analysis and interpretation of soil/sediment samples can provide indications of their provenance, and enable exclusionary comparisons to be made between samples pertinent to a forensic investigation. Multiple grains from four distinct sample sets were examined with the AFM, and various statistical figures of merit were derived. Canonical discriminant analysis was used to assess the discriminatory abilities of these statistical variables to better characterise the use of AFM results for grain classification. The final functions correctly classified 65.3% of original grouped cases, with the first 3 discriminant functions used in the analysis (Wilks' Lambda=0.336, p=0.000<0.01). This degree of discrimination shows a great deal of promise for the AFM as a quantitative corroborative technique to traditional SEM grain surface examination.


Summary from only given. Tunable optical filters are important for applications such as DWDM optical networks. Micromechanically actuated filters are desirable because of their wide tuning range, design flexibility and high yield. The device structure consists of epitaxial layers forming a single Fabry-Perot cavity, having two distributed Bragg reflectors (DBRs) and an air gap in-between. We recently reported >100 nm tuning around 1550 nm using a torsional structure. The purpose of this paper is to determine how scalable the various designs are and to establish the design rules. The design flow chart for a MEMS filter using deflection beams is shown.


Software product lines achieve much shorter time to market by system level reuse and code variability. A possible way to achieve this flexibility is to use generic components, including the core system, in different products in alternative configurations. The focus of testing efforts for such complex and highly variable systems often shifts from testing specific products to assessing the overall quality of the core system or potential new configurations. As a complementary approach to feature models and related combinatorial testing methods optimizing for feature coverage, we apply a source code oriented analysis of variability. We present two algorithms that optimize for high coverage of the common code base in terms of C++ preprocessor-based configurations with a limited set of actual configurations selected for testing. The methods have been evaluated on iGO Navigation, a large industrial system with typical configuration support for product lines, hence we believe the approach can be generalized to other systems as well.


Background
Patient safety is of paramount importance in healthcare delivery. Following the inquiry into the Mid Staffordshire Health Trust (Francis 2013, 2015), there has been an increasing demand for nurses and other healthcare professionals to be open and candid in a transparent culture where harm and error are minimised. Despite this drive for openness, there is evidence that health care professionals remain reluctant to raise concerns and this includes student nurses as well as registrants. There is however paucity in research focusing upon the underlying factors which prevent student nurses from raising concerns about suboptimal practice. In an attempt to contribute to the discussion, this study will focus upon student nurses.

Aim
The overall aim of this research is to understand student nurses' perception of what they believe is a patient safety incident in their practice placements and understand the reasons that influence their willingness or reluctance to raise concerns about patient safety.

Findings
Four main themes emerged from analysing the data: the context of patient safety; team culture; hierarchy and fear of retribution.

Analysis and discussion of the data revealed that students were driven to raise concerns as they possessed strong moral and ethical beliefs to uphold patient safety. However, they had an overwhelming desire to fit in with their clinical colleagues and feared retribution and failure if they voiced concerns regarding care. This demonstrated that student nurses were subject to a fluctuating moral compass which was determined by psychological and sociological determinants.

Conclusion
This research study has provided information which contributes to our understanding of student nurses' beliefs about patient safety. It also helps us to recognise the factors that influence student nurses' willingness or reluctance to speak up. This is important because with an increased understanding of their experiences and beliefs, we are better informed to broaden our teaching on this topic and develop effective policies to protect student nurses who raise concerns.


This paper proposes an educational environment in which teacher students and school pupils form a learning community coping with common robotics challenges. The robot prototypes developed by the students are used by the pupils for experiential robotics studies. Our educational research focuses on the analysis of learning behaviors and the effect of the experimentation on development of creative thinking. It is found that collaboration of students and pupils in the common robotics environment is effective for educating both the teacher students and the pupils.


Understanding the geographic linkages among populations across the annual cycle is an essential component for understanding the ecology and evolution of migratory species and for facilitating their effective conservation. While genetic markers have been widely applied to describe migratory connections, the rapid development of new sequencing methods, such as low‐coverage whole genome sequencing (lcWGS), provides new opportunities for improved estimates of migratory connectivity. Here, we use lcWGS to identify fine‐scale population structure in a widespread songbird, the American Redstart (Setophaga ruticilla), and accurately assign individuals to genetically distinct breeding populations. Assignment of individuals from the nonbreeding range reveals population‐specific patterns of varying migratory connectivity. By combining migratory connectivity results with demographic analysis of population abundance and trends, we consider full annual cycle conservation strategies for preserving numbers of individuals and genetic diversity. Notably, we highlight the importance of the Northern Temperate‐Greater Antilles migratory population as containing the largest proportion of individuals in the species. Finally, we highlight valuable considerations for other population assignment studies aimed at using lcWGS. Our results have broad implications for improving our understanding of the ecology and evolution of migratory species through conservation genomics approaches.


Objectives Despite progress made to expand access to health service in Ghana, inequities still exist. Social innovations have been developed as community-engaged solutions to decrease inequities. Methods In partnership with a multistakeholder group, our social innovation team organised a crowdsourcing contest to identify health innovations in Ghana. Informed by a WHO-Special Programme for Research and Training in Tropical Diseases framework, we organised a six-stage crowdsourcing challenge. Results In all, 13 innovations were received in the contest, while 2 innovations were rejected after initial screening. The 11 innovations were reviewed by a panel of four independent expert judges. Inter-rated reliability index (kappa) was 0.86. Following the review of the average score, five top innovations were recognised. These submissions can be put into three main themes: technology and strengthening (eg, mHealth for cervical cancer screening, video directly observed therapy), inclusiveness and reaching the marginalised (people with disability and infertility) and data utilisation for project improvement (seasonal calendar to reduce morbidity and mortality of children under 5 for malaria, diarrhoea and pneumonia). Conclusion In conclusion, this study shows that solutions to local problems exist. Therefore, policymakers, the government and development partners should support the scale-up of such innovations.


Saline extracts from the roots of the pokeweed species. Phytolacca octandra were separated by ion-exchange chromatography into three fractions, Po-1, Po-2 and Po-3. Po-1 contained two monomeric proteins with molecular weights of 36,000 and 29,000 and these were partially purified by gel filtration. Po-2 was purified as a single polymeric protein composed of approximately ten 14,000 mol. wt polypeptides and is a new pokeweed mitogen. Po-3 was purified as a single polymeric protein composed of approximately four 31,000 mol. wt subunits, and apart from its polymeric structure closely resembles commercial pokeweed mitogen (PWM). Po-2 and Po-3 were mitogenic for unseparated human peripheral blood lymphocytes but the degree of mitogenic activity in Po-2 preparations was dependent on storage following purification. Purified B cells were not stimulated by either mitogen. Po-3 was a potent mitogen for T cells but preparations of Po-2 required storage before they stimulated T cells. Higher responses were observed in co-cultures of B and T cells than in separated B and T cell cultures. It is suggested that human B and T lymphocytes show synergy in their responses to Po-2 and Po-3.


Gestational Diabetic Mellitus is the type of diabetes in pregnancy. It normally shows up in the second 1/2 of pregnancy and numerous impacts fetal development rate and causes moderate foundational improvement. The goal of prevention in pregnancy to change dietary patterns, maintain balanced glucose level and to replace them with a healthy lifestyle for mother. The main purpose of this study to assess the effectiveness of video teaching programme in prevention of gestational diabetic Mellitus among antenatal mothers. Quantitative experimental approach and pre-experimental one group pre-test and post-test design used in this study. The sample size was 60 antenatal mothers. A pre-test was conducted to assess the knowledge on antenatal mothers followed by administration of video teaching programme. After one hour conducted post-test using the same questionnaire. The study finding revealed that after the administration of video teaching programme among antenatal mothers post-test mean score of knowledge was 27.10 with Standard Deviation 2.60 was higher than the pre-test mean score of knowledge was 9.02 with Standard Deviation 2.69. Hence there was a statistically significant difference between pre-test and post-test knowledge scores and the hypothesis was accepted. The calculated paired 't' test value of t=33.64 was found to be statistically highly significant at (P<0.001) association between post-test knowledge scores and socio-demographic variables. This clearly infers there is a significant improvement in the post-test level of knowledge regarding gestational diabetic Mellitus among antenatal mothers.


A gas-fired commercial water heater has been developed which achieves a steady-state efficiency of over 95 percent and can obtain overall service efficiencies above 90 percent in many applications. These high levels of efficiency are obtained by operating in the condensing mode over a substantial portion of the duty cycle. The use of a power burner and a coil-type heat exchanger results in a compact configuration which produces both high efficiency and low emissions. The design, operating principles, and performance characteristics of the water heater are described.


The simulation of quantum Hall physics with rotating quantum gases is witnessing a revival due to recent experimental advances that enabled the observation of a Bose-Einstein condensate entirely contained in its lowest kinetic energy state, i.e. the lowest Landau level. We theoretically describe this experimental result, and show that it can be interpreted as a squeezing of the geometric degree of freedom of the problem, the guiding center metric. This"geometric squeezing"offers an unprecedented experimental control over the quantum geometry in Landau-level analogues, and at the same time opens a realistic path towards achieving correlated quantum phases akin to quantum Hall states with neutral atoms.


We ask whether women's descriptive representation in Congress enhances women's substantive representation through speechmaking on the House floor. Much of the research on women's substantive representation has focused on members' votes for and sponsorship of "women's issues" legislation. We depart from this research by systematically analyzing how members' gender and partisan identities affect gendered rhetoric in their floor speeches. In an era marked by significant increases in the number of congresswomen and partisan polarization, understanding the interactive effect of gender and partisanship on women's representation is particularly important. In an analysis of more than 30,000 speeches from 1993 to 2008, we find that when members speak about issues of their choosing during one-minute speeches, and during specific legislative debates over the most important policies considered on the House floor, congresswomen in both parties are significantly more likely than men to discuss women, enhancing women's representation.


Phobia and prejudice toward Islam in America and Europe are contributed  by a small particular group that name their violence and movement on behalf of  Islam. In fact, Islam is a religion that calls for peace and harmony. But these  impressions are still inadequate to purify the image of Islam. It requires to  systematic effort to show that the truth teaching of Islam that guarantees and supports the universal values of mankind to life in peace and harmony. Fethullah  Gulen, who is scholar, a preacher, a sufi, a teacher and is a Muslim activist from  Turkey, is one of scholars and actors how has done this mission. Currently, Gulen  has tens million followers from around the world that bring about to become one  of the most influential person in contemporary Muslim world. This papers seeks  to see the basic and model of religious social movement that are done by  Fethullah Gulen in his campaign in cosmopolitan society. The campaign strongly  states that Islam is very relevant to modern life. The papers specifically answers  three fundamental questions; how does Gulen interpret scare texts of Islamic  teaching? What model of interpretation that Gulen employs in understanding  various dimensions of Islamic Teaching? How the normative concepts of  Fethulllah Gulen's Teaching used to spread Islamic teaching


OBJECTIVES
To describe the incidence of hypersensitivity to abacavir and frequency of human leucocyte antigen (HLA)-B*5701 in HIV-infected Taiwanese persons.

METHODS
Medical records of 337 HIV-infected Taiwanese in whom abacavir-containing combination antiretroviral therapy (CART) was prescribed from 1 May 2001 to 31 December 2006 were reviewed, and HLA typing of the patients was performed in 320 patients (232 receiving abacavir and 88 not receiving abacavir) with available blood samples. HLA class I and II polymorphisms were determined by PCR with specific primers. HLA-B*5701 was further confirmed by sequence-based typing.

RESULTS
Of the 337 patients, median CD4 count was 166.5 cells/mm3 (range, 1.0-1914.0) and 83 patients (24.6%) had AIDS-defining opportunistic infections. Thirty-eight patients (11.3%) discontinued abacavir within 6 weeks of starting abacavir-containing CART. Among them, 10 patients had successful abacavir re-challenge and another 11 patients had other specific reasons for abacavir discontinuation. Therefore, 14 patients (4.2%) were classified as cases in whom abacavir hypersensitivity could not be excluded, and 3 patients (0.9%) met the criteria of abacavir hypersensitivity. Of the 320 patients undergoing HLA typing, HLA-A02 was the most common allele and only one individual (0.3%) expressed HLA-B*5701. Along with some differences in allele distributions, there was a significant difference in the genetic frequency of HLA-B57 in our patients compared with those of previous studies in other Chinese populations.

CONCLUSIONS
Abacavir hypersensitivity was less frequently encountered in HIV-infected Taiwanese initiating abacavir-containing CART than in Caucasians, which might be explained by the low frequency of the HLA-B*5701 allele.


Since a brief low in 1998, reported cases of syphilis have continued to grow in the US. As primary care providers, NPs are at the forefront of the battle to eliminate syphilis. This article reviews the stages of this infection, diagnosis nuances, and treatment guidelines.


Collaborative resource management has been touted as one of the ways conservation of wildlife resources can be improved, especially in off-protected areas. Three indicators were used to test whether collaboration between the Wildlife Division of the Forestry Commission of Ghana and local communities has any impact on farmers' perspectives on crop raiding. The indicators were: (1) methods used by farmers to reduce raiding, (2) institutions to which farmers report raids, and (3) the kind of assistance needed to reduce raiding. The findings suggest there were no differences between the collaborative indicators and the two chosen study locations. However, on the question of institutions where raiding incidences were reported and location, the difference was significant (X2=14.523; DoF= 5; P=0.01261). In addition, there was a statistically significant relation between location and participants' responses to species that raided their crops (X2=16.988; DoF=4; p= 1.943e-3). Participants from the two locations did not show differences in their responses to preventive methods. Male respondents mentioned the use of traps as their major preventive method, although this is against wildlife hunting regulations in Ghana. Educating and supporting farmers with appropriate preventive methods that reduce their losses to wildlife crop raiding is recommended to improve conservation.


Documentation of the species recorded in biodiversity and inventory projects frequently involves preparation of voucher specimens, which are extremely important for the credibility of such studies (see Chapter 5). In addition, these specimens and their accompanying field notes are valuable sources of scientific information used in systematic, biogeographic, evolutionary, and ecological studies. Most vouchers are preserved specimens from the study site, although photographs of individuals or tape-recorded calls of frogs are sometimes substituted. To be useful as vouchers and to facilitate identifications of species, preserved specimens must be well prepared and well documented. Poorly prepared or improperly documented specimens are of little scientific value and usually not worth the effort of preparation. In this section I review the steps involved in the proper preparation of amphibians as scientific study specimens (for additional discussion, see Pisani 1973; Kams 1986; Simmons 1987).


We studied the secondary succession in semi-natural grasslands (dry grasslands and hay meadows) located in the eastern side of the Tuscan Apennines (Tuscany, Central Italy). We compared these habitats, investigating: (i) the changes in species richness, composition and phylogenetic diversity during the succession; (ii) whether the trends in species loss and species turnover in taxonomic diversity matched those in phylogenetic diversity. We performed a stratified random sampling, in a full factorial design between habitat type and succession stage (60 sampled plots, 10 × 2 types of habitat × 3 stages of succession). We constructed a phylogenetic tree of the plant communities and compared the differences in taxonomic/phylogenetic α- and β-diversity between these two habitats and during their succession. We identified indicator species for each succession stage and habitat. Looking at α-diversity, both habitats displayed a decrease in species richness, with a random process of species selection in the earlier succession stages from the species regional pool. Nevertheless, in the latter stage of dry grasslands we recorded a shift towards phylogenetic overdispersion at the higher-level groups in the phylogenetic tree. In both habitats, while the richness decreased with succession stage, most species were replaced during the succession. However, the hay meadows were characterized by a higher rate of new species' ingression whereas the dry grasslands became dominated with Juniperus communis. Accordingly, the two habitats showed similar features in phylogenetic β-diversity. The main component was true phylogenetic turnover, due to replacement of unique lineages along the succession. Nevertheless, in dry grasslands this trend is slightly higher than expected considering the major importance of difference in species richness of dry grasslands sites and this is due to the presence of a phylogenetically very distant species (J. communis).


Objective: To analyze and summarize the diagnosis and treatment experience of common inherited cardiac arrhythmia syndrome in pediatric patients, and explore the most appropriate therapy. Methods: A retrospective review identified 30 pediatric cases (19 males, 11 females) diagnosed with long QT syndrome (LQTS), Brugada syndrome (BrS), catecholaminergic polymorphic ventricular tachycardia (CPVT), hypertrophic cardiomyopathy (HCM), arrhythmogenc right ventricular cardiomyopathy (ARVC) from January 2008 to December 2018 in the Pediatric Cardiology Department, Guangdong Provincial People's Hospital. Data obtained included the diagnosis, treatment and follow-up outcome. Results: The most common inherited cardiac arrhythmia syndromes were LQTS (n=14) including 1 case with epilepsy, CPVT (n=5), HCM (n=7), ARVC (n=1), and BrS (n=3). Twenty-seven cases were admitted to hospital due to syncope, whereas the remaining 3 cases of BrS had not presented with syncope before admission. The average onset age of inherited arrhythmia was (10.0±3.3) years. Genetic testing was performed on 20 patients. The median follow-up time was 40 months. Among 15 patients who underwent implantable cardioverter defibrillator (ICD) and survived, 2 patients had frequent ICD discharge. One patient underwent radiofrequency ablation, and the other one received left cardiac sympathetic denervation and an increased ICD defibrillation threshold, and the number of ICD discharge was significantly reduced. Among 10 patients who received drug therapy, 4 patients including two patients who discontinued treatment without advices died. Two patients whose parents refused treatment died, 1 case diagnosed with unexplained sudden cerebral death, and the remaining 2 cases without indication for drug therapy survived without any treatment. Conclusions: Mortality rate is high in pediatric patients with inherited cardiac arrhythmia and syncope. The therapeutic effect of drugs are not satisfactory, ICD implantation is the most effective treatment to prevent sudden cardiac death currently, but the postoperative frequent discharge should be brought to the forefront and handled in time.


This paper reconsiders the notion of slack bus in load-flow studies. Instead of determining a priori which bus plays the role of slack bus, it is selected on the fly during the load-flow iterative process in such a way that the system power imbalance is minimized. The problem of selecting the best slack bus, or buses, is first formulated as a nonlinear optimization problem. Then, the results obtained are justified on the basis of the involved equality constraint being a quasilinear function, leading to an LP problem with trivial solution. It turns out that the optimal solution can be easily found from the results of a conventional load flow at a moderate cost. The proposed heuristic procedure is tested on the IEEE test systems.


In the past two years, the issuance of corporate social responsibility (CSR) reports has become an important nonprofit practice of enterprises in China. As of April 2008, over eighty enterprises in China in industries such as biochemical and energy, food and beverage, computers, finance and insurance, and automotive had released CSR (or equivalent) reports. Using SustainAbility's indicator system, the paper evaluates CSR reports issued by enterprises in China between May 2007 and April 2008. The paper finds reports' descriptions of management and performance to be quite good, but that reports failed to give enough information about governance and strategy, data availability, audits, and other aspects. Furthermore, we discovered that the current indicator system, while able to evaluate the quality of reports in form, falls short of truly evaluating their contents. Thus, a new indicator system must be devised to allow an overall assessment of the content of reports.


The Deccan Traps of peninsular India, representing one of the largest flood basalt eruptions on the earth's surface, have been a subject of intensive research in the last three decades because of the attributed link between the Deccan Traps and the Cretaceous-Tertiary boundary mass extinctions. In this context, the biota from the sedimentary beds intercalated with the volcanic flows and underlying the oldest volcanic flow are more important for understanding the faunal diversity and palaeobiogeography of India during the time span of volcanic eruptions. A detailed review of the vertebrate faunal diversity of the Deccan volcanic province is presented here.


The mixed polymer brushes composed of two incompatible polymers, poly(methyl methacrylate) and poly(ethylene glycol), were successfully synthesized via a sequential grafting to method, which was confirmed by water-contact angle and ellipsometric measurements. The resulted mixed polymer brushes could undergo conformational rearrangements upon exposure to different selective solvents, and then the lateral segregation in nonselective solvent and perpendicular segregation in selective solvent happened. As a result, the mixed polymer brushes exhibited the ripple morphology and dimple morphology in corresponding solvent, respectively, and which led to changes in water-contact angle and surface composition as a function of bulk composition of the mixed polymer brushes. Moreover, the switching properties as the surface composition, wettability and topographical images could occur in a controlled and reversible fashion. © 2009 Wiley Periodicals, Inc. J Appl Polym Sci, 2009


The application of techniques to improve the surface finish of pieces obtained by fused deposition modelling, as well as other functional aspects, is of great interest nowadays. Polylactic acid, a biodegradable material, has been considered a possible substitute for petroleum-based polymers. In this work, different chemical post-processing methods are applied to polylactic acid pieces obtained by fused deposition modelling and some characteristics are studied. Structural, thermal, and crystallinity property changes are analyzed according to the treatments applied. This can prevent degradation, eliminate the glass transition phase of the material, and thereby increase the thermal resistance by about 50 °C. An improvement in the roughness of the pieces of up to 97% was also found.


INTRODUCTION
The primary symptom of Clostridioides difficile infection (CDI) is diarrhea of varying severity. Both malnutrition and clinical nutrition increase the risk for contracting Clostridioides difficile (C. difficile) infection and the likelihood of relapses. Moreover, the risk for recurrence is higher if there is infection with a hypervirulent strain (NAP1/BI/027). Hypoalbuminemia predisposes to a severe course of the disease and morbidity.

MATERIAL AND METHODS
Analysis was carried out of the data regarding patients hospitalized at the Regional Hospital for Infectious Diseases in Warsaw from 01 January 2020 to 31 December 2021 who were diagnosed with C. difficile infection. A severe course of infection was diagnosed when a blood test showed a leukocyte count greater than or equal to 15,000/μl and/or a creatinine concentration >1.5 mg/dl (>132.6 mmol/l).

RESULTS
Clostridioides difficile infection was the reason for 185 hospitalizations (involving 108 women and 77 men), of 167 patients aged from 22 to 93 years old. There were 68 (37%) cases of recurrent infection. Seventy-five (41%) infections met the study's criteria for severe CDI, and 12 (7%) patients died. Out of the total number of hospitalizations, 41 (22%) were due SARS-CoV-2 co-infection. PCR tests detecting binary toxin revealed 34 (18%) positive results. Infection with a hypervirulent strain was an independent risk factor for the recurrence of diarrhea which had C. difficile etiology. Overall, during an episode of diarrhea, one antibacterial drug was used in 139 cases (75%), two in 27 (15%), three in 14 (8%) situations, and four - twice (1%). Among these, drugs not recommended for the treatment of CDI were used in 21 (11%) cases. The number of antibacterial drugs administered during an episode of diarrhea was an independent risk factor for the death of the infected person. Clinical nutrition was applied during 19 hospitalizations (10%), out of which 12 (63%) cases showed a severe course of C. difficile infection, while four patients (21%) died. Using clinical nutrition methods was an independent risk factor for a severe course of the disease and patient death.

CONCLUSIONS
Clinical nutrition and the number of antibiotics used during an episode of diarrhea are independent risk factors for the death of a patient with CDI. Infection with a hypervirulent strain increases the risk for relapse.


BACKGROUND
Although balloon pulmonary angioplasty (BPA) improves the hemodynamics and prognosis of patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH), the mechanisms of improvement in oxygenation remain to be elucidated.

METHODSANDRESULTS
From August 2013 to May 2015, we performed a total of 113 BPA procedures in 24 patients with inoperable CTEPH (mean 4.7 procedures per patient). Median age was 70 [60, 74] years and 18 were female (75%). We examined hemodynamics, respiratory functions, and intrapulmonary shunt before and after the BPA procedure. Mean pulmonary arterial pressure (37 [28, 45] to 23[19, 27] mmHg, P<0.01), pulmonary vascular resistance (517 [389, 696] to 268 [239, 345] dyne/s/cm(5)) and 6-min walk distance (390 [286, 484] to 490 [411, 617] m, P<0.01) were significantly improved after BPA therapy. Furthermore, arterial oxygen partial pressure (PaO2, 54.8 [50.0, 60.8] to 65.2 [60.6, 73.2] %, P<0.01) and intrapulmonary shunt (23.4±6.0% to 19.3±5.0%, P<0.01) were also significantly ameliorated. In the multivariate analysis, decrease in intrapulmonary shunt after BPA was significantly correlated with improvement of both PaO2(r(2)=0.26, P<0.01) and SaO2(r(2)=0.49, P<0.01) after BPA.

CONCLUSIONS
These results indicated that BPA improved not only pulmonary hemodynamics but also oxygenation with a resultant decrease in intrapulmonary shunt. (Circ J 2016; 80: 2227-2234).


The method of tensors, as applied to the analysis of electrical systems, has gained favor because of its versatility. The most common application of the method in electrical engineering is the analysis of the dynamics of rotating machinery, but a further application is presented in this paper. The attack includes flexible analyses of the characteristics of triodes, tetrodes, and pentodes, and their use as amplifiers, oscillators, and modulators.


Background and Purpose The recent successes of the DAWN and DEFUSE 3 trials have extended the therapeutic time window for endovascular treatment (EVT). Accordingly, an increased care burden and clinical benefit for patients with acute stroke in the emergency room are expected. It is necessary to evaluate and respond to these changes in order to provide the best care to patients. Methods Data of patients with acute stroke or transient ischemic attack treated at Seoul National University Hospital between October 2010 and September 2016 were reviewed. To estimate the increased workload associated with the revised guidelines, clinical candidates of acute stroke based on the initial history and examination findings and eligible patients for early stroke intervention were selected. Additionally, the data of eligible patients who received EVT more than 6 hours after the onset were reviewed. Results The serial addition of intravenous thrombolysis, EVT within 6 hours, and EVT beyond 6 hours to the guidelines resulted in 506 (19.8%), 588 (23.0%), and 718 (28.0%) clinical candidates, respectively, and 329 (12.8%), 365 (14.3%), and 389 (15.2%) eligible patients out of 2,561 patients with stroke. Compared to applying the previous stroke guidelines, the number of clinical candidates increased by 130 (22.1%), whereas the number of eligible patients for early stroke intervention increased by only 24 (6.6%). Seven of the 24 eligible patients received off-label EVT and showed significantly improved neurological outcomes at discharge. Conclusions Notwithstanding the small number of subjects in this study, providing EVT to eligible patients beyond 6 hours may improve their neurological outcomes.