This paper investigates the size distribution of the whole population of Spanish commercial, savings and cooperative banks from a dynamic perspective over the 1970 2006 period. To investigate the evolution of the size distribution, we determine whether the data satisfies the Law of Proportionate Effect (LPE) using panel unit root tests. We find that the size-growth relationship is not stable over time but changes depending on the competitive environment of banks (liberalization, deregulation and integration). When Spanish banking was highly regulated, we find that smaller banks grew faster than their larger counterparts. In recent years, however, we find that larger banks grow at the same rate or faster than smaller banks, a result that lends towards LPE acceptance. Thus, our study corroborates the conditioned nature of the size-growth relationship and the size distribution of banks, as emphasized by recent studies for the US banking system. Results imply that the size distribution of Spanish banks will become more skewed in next years, and concentration will tend to increase.


Background: Extra-abdominal desmoid tumor of the head and neck in particular commonly infiltrate vital neurovascular structures. we report a case of a large and recurrent extra-abdominal desmoid tumor causing significant morbidity and who was treated successfully by radiotherapy.
Case presentation: A 34-year-old male patient presented with a history of right neck mass for 15 months, which was gradually increasing in size. Cervical CT scan revealed a large mass of the posterior soft tissues of the neck extended to the soft tissues of the posterior thoracic wall. The CT density of the mass was that of fat tissue. It was measuring 12.4 × 85.9 mm and enhanced after injection of the contrast product. A biopsy was taken. The histopathological findings were suggestive of desmoid tumor.
Discussion: This case was discussed in multidisciplinary oncological team and radiotherapy was planned. The surgery was proposed but not performed due to the recurring character of the tumor and the risk of a high postoperative morbidity. After 4 weeks of treatment, the clinical evaluation showed a good response.
Conclusion: Alternative treatment modalities such as primary radiotherapy may be preferable to mutilating surgery.


This report focuses on the generation of hazardous waste (HW) and the treatment of HW being generated by routine US Department of Energy (DOE) facility operations. The wastes to be considered are managed by the DOE Waste Management (WM) Division (WM HW). The waste streams are to be sent to WM operations throughout the DOE complex under four management alternatives: No Action, Decentralization, Regionalized 1, and Regionalized 2. On-site and off-site capabilities for treatment are examined for each alternative. This report (1) summarizes the HW inventories and generated amounts resulting from WM activities, focusing on the largest DOE HW generators; (2) presents estimates of the annual amounts shipped off-site, as well as the amounts treated by various treatment technology groups; (3) describes the existing and planned treatment and storage capabilities of the largest HW-generating DOE installations, as well as the use of commercial treatment facilities by DOE sites; (4) presents applicable technologies (destruction of organics, deactivation/neutralization of waste, removal/recovery of organics, and aqueous liquid treatment); and (5) describes the four alternatives for consideration for future HW management, and for each alternative provides the HW loads and the approach used to estimate the source term for routine treatment operations. In addition, potential air emissions, liquid effluents, and solid residuals associated with each alternative are presented. This report is supplemented with an addendum that includes detailed information related to HW inventory, characteristics, generation, and facility assessment for the treatment alternatives. The addendum also presents source terms, emission rates, and throughput totals by alternative and treatment installation.


Australia has been an ally of the United States (U.S.) for more than half a century. The Australian alliance with the U.S. began in 1951 with the signing of the ANZUS (Australia, New Zealand, and the U.S.) Pact. Since then Australia adopted a strategy of having military cooperation with both Britain and the U.S. The intensification of the Cold War in the 1950s onward in one way or another strengthened the U.S.-Australian alliance. Australia had significant access to intelligence, training and defence equipment supply from the U.S. Generally, the long period of the Cold War sustained the alliance and its implications on Southeast Asian security were regarded as overall positive. The end of the Cold War did not alter the U.S.-Australian alliance very much. In fact, there were more attempts to beef up defence cooperation between the two to check the rise of China. The two nations were fully aware that beefing up of the security cooperation is vital for long-term peace in Southeast Asia and the Asia-Pacific in general. However, Australia no longer looks to embracing the U.S. in purely military terms. This article, therefore, argues that the impact of the U.S.-Australia alliance in Southeast Asia can no longer be seen in the way it was during the Cold War. The U.S.-Australia alliance also has strong tendencies to shape the character of the region via regional architecture or institutions, including its political and economic direction. The allianceÂ's impact on ensuring Southeast Asia remains within the circle of the West, and not China or Japan for that matter cannot be dismissed.


Humanness is core to speech interface design. Yet little is known about how users conceptualise perceptions of humanness and how people define their interaction with speech interfaces through this. To map these perceptions n=21 participants held dialogues with a human and two speech interface based intelligent personal assistants, and then reflected and compared their experiences using the repertory grid technique. Analysis of the constructs show that perceptions of humanness are multidimensional, focusing on eight key themes: partner knowledge set, interpersonal connection, linguistic content, partner performance and capabilities, conversational interaction, partner identity and role, vocal qualities and behavioral affordances. Through these themes, it is clear that users define the capabilities of speech interfaces differently to humans, seeing them as more formal, fact based, impersonal and less authentic. Based on the findings, we discuss how the themes help to scaffold, categorise and target research and design efforts, considering the appropriateness of emulating humanness.


This book presents an overview and describes experiences in the introduction of remote laboratories for teaching processes. The book provides state-of-the-art evidence on how remote labs can be used by both teachers and students to support the acquisition of lab competencies at the university level. The book consists of 22 chapters grouped into five sections and includes some of the following topics: Historical perspective; remote labs worldwide; experiments; and remote laboratory architecture and networking requirements.


One of the main challenges for cancer patients under treatment is to prevent and tackle malnutrition. The current clinical nutrition market offers different food supplements or oral nutritional support products (mainly milkshakes or modified texture products) for cancer patients under risk of malnutrition. However, it is worth mentioning that these products do not address the pleasure of eating, since they do not meet sensory requirements, such as taste and smell alterations, nor patients' food preferences, leading to a big impact on their quality of life (QOL). Still, controversy remains regarding the specific nutritional requirements for cancer patients during the disease. Several randomized controlled clinical trials yield opposite results when using different bioactive compounds such as omega-3 fatty acids or antioxidants in order to prevent malnutrition or improve QOL. The use of 'omics' technologies in oncology, such as membrane lipidomics, as a powerful tool to provide new insights for the understanding of diet and cancer and their interacting metabolic pathways, will be discussed. The better knowledge of specific requirements (nutrients, sensory parameters and food preferences) for cancer patients provides valuable information for the food industry in the design of customized food products capable of preventing malnutrition, alleviating symptoms and improving QOL. © 2017 Society of Chemical Industry.


Helleborus niger L (HN) is widely used in the treatment of diabetes mellitus in the Indian traditional system of medicine. Therefore, the present study was done to evaluate the antihyperglycemic, antihyperlipidemic and antioxidant activities of ethanol extract of HN root (EHN) in streptozotocin (STZ) - nicotinamide (NC) induced diabetic rats. in vitro α-amylase inhibition assay, normoglycemic study and oral glucose tolerance test were carried out in different root extracts of HN. Antihyperglycemic effect was assessed in EHN using diabetic rats, which was identified as the most effective extract by initial screening. EHN (50, 100 and 200 mg/kg) and glibenclamide (5 mg/kg) orally administered daily for 28 days and the animal was observed in next 14 days. Fasting blood glucose (FBG) and body weight was determined weekly basis up to 42 days. On the 42nd day, various biochemical parameters were estimated. The three doses of EHN shows significantly decrease (p<0.01) in blood glucose levels. The effect was more pronounced in 200mg/kg (71.53%) than 100mg/kg (67.46%) and 50mg/kg (66.63%). In addition, decreased HbA 1 C and improved Hb level were 1 evidenced clearly in diabetic rats. Simultaneously, improvements in serum lipid profile, serum liver profile in diabetic rats were also evidenced clearly. Moreover, body weight and protein levels were increased in diabetic rats. On the other hand antioxidant activity was restored in diabetic rats. Increased glycogen content, glucokinase and decreased glucose - 6 phosphatase, fructose 1, 6 - biphosphatase effects in liver tissues were observed. EHN preserved islet architecture and prevented hypertrophy of β-cells. The EHN is capable of managing hyperglycemia and complications of diabetes in STZ-NC induced diabetic rats. Hence this plant may be considered as one of the potential sources for the isolation of new oral antihyperglycemic agent(s).


Introduction Venous Thromboembolism (VTE) is the leading cause of maternal mortality and morbidity. The risk is increased 60 fold during the first three months postpartum. If postnatal risk scores >2 patients should receive thromboprophylaxis for 7 days or 6-12 weeks depending on history. Aims To review postnatal thromboprophylaxis in high risk women who have recently delivered and are at increased risk of VTE. Methodology Retrospective case note analysis of 50 women from mid September to mid November 2011. Results In the intermediate risk group, there were 3 women with BMI > 40, 3 were intravenous drugs (IVD) abusers and 25 women had emergency LSCS. Among the group with 2 or more risk factors, 7 were aged more than 35 years with other associated risk factors such as 2 with BMI>30, 1 smoker, 1 with prolonged labour and 3 had elective LSCS. There were 7 women with BMI>30 with associated risks such as 1 women was a Para 3, two had prolong labour and 4 had elective LSCS. There was 5 smokers of which 4 had elective LSCS and 1 was a Para 3. Thromboprophylaxis was received by 39 women for 2 days, 8 women received for 3 days and three women for 4 days-this was due to hospital stay for delayed neonatal discharge. In total only 2 patients had a combination of TEDS and Dalteparin. Conclusion Thromboprophylaxis is an integral part of postnatal care and we should be more vigilant in this regard.


In previous studies we found that uveal melanoma cells grown in extracellular matrix (ECM)-containing three-dimensional (3D) cultures have increased resistance against herpes simplex virus type 1 (HSV-1)-mediated destruction relative to cells cultured without ECM. Using additional tumor cell types including MB-231 human breast cancer cells, PC-3 human prostate cancer cells, and P19 mouse embryonal carcinoma cells, we show here that tumor cell lines other than melanoma are also more resistant to HSV-1-mediated destruction in 3D cultures than cells grown in 2D. We also demonstrate here that one mechanism responsible for the increased resistance of tumor cells to HSV-1 infection in 3D cultures is an ECM-mediated inhibition of virus replication following virus entry into cells. These findings confirm and extend previous observations related to the role of the ECM in tumor resistance against HSV-1 and may lead to improved strategies of oncolytic virotherapy.


Under the Federal Circuit's current law, the doctrine of equivalents protects only those technologies that arise after the patent issues. This state of affairs creates a curious paradox: the patentee is afforded protection for that which she did not possess, which runs counter to the general view that patents afford protection for the inventor's creation. This paper explores this paradox and offers two possible means of reconciling it based on principles of fairness. First, patentees should only be protected under the doctrine of equivalents for changes in technology that arise from outside their field of technology. While seemingly simple in application, this approach fails to link the scope of protection to the patent's disclosure. The second would provide protection under the doctrine of equivalents if the patent's disclosure would enable the asserted equivalent at the time of infringement. The patent's disclosure is therefore allowed to grow over time, providing insurance against the patent's obsolescence and effectively extending its life span. This approach offers a better theoretical fit in that it ties the right to exclude to the patent's disclosure. It would provide considerable protection to the patentee, however. In order to keep the doctrine of equivalence in check -- either under the status quo or under the Article's proposal -- the author suggests that those who infringe under the doctrine of equivalents should not be subject to permanent injunctions. In other words, the doctrine of equivalents would operate pursuant to a liability rule, not a property rule. This shift is particularly appropriate given the high transaction costs surrounding patent scope, and particularly equivalency. In this way, the interest of the patentee can be protected to some extent, balanced by the interest in third parties in being able to practice their later-developed technologies.


The importance of studying past fire regimes is derived from the need to understand the effects of current Global Change on present and future fire activity. Studying the relationship between long-term fire ecology, ecosystems and climate allows us to understand how vegetation responds to this perturbation and to define the thresholds triggering irreversible changes in the vegetation. This work presents the last 10 000 years of vegetation change and fire activity on a high altitude ecosystem from the Pyrenees range: the mountain lake Basa de la Mora located in the central southern Pyrenees. Holocene fire activity has been inferred through fossil carbon particle identification in the sedimentary sequence obtained in this lake. We observe that the strongest Holocene fire activity in the area occurred between 8.1 and 4 cal Kyr BP. This period was followed by a phase, between 3.2 and 1.7 cal Kyr BP, where almost no fire activity was recorded. These changes seem to be due to biomass availability and fire-conductive climate conditions. Positive correlation has been found between fire activity and Betula, Corylus, as the key fueling taxa and groups of ariditytolerant taxa. Additionally, fire dynamics seems coupled to higher anthropogenic activities after 1.7 cal Kyr BP.


This paper describes our system used in the English Emoji Prediction Task 2 at the SemEval-2018. Our system is based on two supervised machine learning algorithms: Gradient Boosting Regression Tree Method (GBM) and Bidirectional Long Short-term Memory Network (BLSTM). Besides the common features, we extract various lexicon and syntactic features from external resources. After comparing the results of two algorithms, GBM is chosen for the final evaluation.


Digital technologies enable servitization by providing opportunities for the manufacturer to understand the product usage and condition, in customer's operations. The present study seeks to validate the applicability of affordance actualization theory in order to help identify these opportunities. A systematic literature review of the extent servitization research is conducted to identify the key constructs of the theory and their role in enabling servitization using digital technology. The review identified common affordances across the servitization literature along with specific digitalization capabilities required to actualize these affordances. The study contributes further by proposing future research extended to affordance interdependence.


We have investigated the solvent rearrangement process for the excited electron in the iodide–water pentamer using density functional and ab initio calculations. Upon excitation of the iodide–water pentamer, an electron transfers from the iodide anion to the water cluster, resulting in release of the iodine atom and formation of the anionic water pentamer undergoing rearrangement process toward the most stable conformation. Thus, the transformation pathway is elucidated.


In this note, we introduce the concept of Bode Plots, which are piecewise-linear approximations to transfer function plots. These will not only prove useful in plotting a filter's frequency response by hand (as opposed to with a computer or plotting software), but will also help us better understand the behavior of cascaded filters. This note will likely feel like review from the Transfer Function Plotting Note, and much of the later content is optional. Bode Plots are quite useful for performing filter design by hand quickly for various applications. This note will present 2 key ideas, which build on what you've learned about Transfer Functions.


The article is concerned with the critical assessment of the theoretical work of the late Italian economist Claudio Napoleoni (1924-1988). The author reviews some recent works on the subject and underlines his points of consent and dissent from them. The latter relate with the interpretation of the nature of Napoleoni's scientific program of research, with his ideological and methodological position and with his attitude towards Marxism, marginalism, Keynesism and "neo-ricardism". A central point in the discussion is the question of Napoleoni's alleged abandonment, return and final detachment from Marxian economic views. A fairly new portrait of this unconventional figure of social scientist comes out from these pages.


Abstract Guns are central to the comprehension of the racial inequalities in neighborhood violence. This may sound simple when presented so plainly. However, its significance derives from the limited consideration that the neighborhood research paradigm has given guns: they are typically conceived of as a background condition of disadvantaged neighborhoods where violence is concentrated. Instead, I argue that guns belong at the forefront of neighborhood analyses of violence. Employing the logic and language of the ecological approach, I maintain that guns must be considered as mechanisms of neighborhood violence, with the unequal distribution of guns serving as a critical link between neighborhood structural conditions and rates of violence. Furthermore, I make the case that American gun policy should be understood as a set of macrostructural forces that represent a historic and persistent source of disadvantage in poor Black neighborhoods.


This thesis presents four research papers in the field of condensed-matter theory. In all four papers, large-scale Monte Carlo simulations are used to investigate phases and phase transitions in two-component models of superconductors and superfluids with multiple broken symmetries. In Article I, a U(1) × U(1) lattice London superconductor with two different types of intercomponent interactions is investigated with focus on understanding the phases and the phase transitions of the model. Particularly, this model exhibits two different paired phases where proliferation of composite topological defects plays an important role.In Article II and III, a two-dimensional unconventional two-component Coulomb plasma with two distinct Coulomb interactions is investigated. The plasma relates to inner products of Ising-type quantum Hall states as well as to rotating two-component Bose- Einstein condensates with an intercomponent Andreev-Bashkin drag interaction. We investigate the phases and phase transitions of this plasma. Depending on the strength of the attractive intercomponent interaction, the plasma can undergo a Berezinskii- Kosterlitz-Thouless charge-unbinding transition. It can also undergo a two-dimensional melting transition when there is a strong intracomponent repulsion for one of the components. For the parameter values corresponding to the Ising-type quantum Hall states, the plasma is in a screening phase. This can be used to demonstrate that Ising-type quantum Hall states possess quasiparticles with exotic properties.In Article IV, the noncompact CP1 model is investigated. This model is proposed as a critical field theory of the continuous quantum phase transition between the N´eel state and the paramagnetic valence bond solid state in a quantum antiferromagnet. The model exhibits a direct transition line between a fully ordered phase with broken SU(2) symmetry and a fully disordered phase. By going to larger systems, we find that the bicritical point, which terminates the direct transition line, has been overestimated in earlier works. This may have important consequences for the determination of the character of the phase transition along the direct transition line.


Objective: To explore the non-genetic prognostic factors in patients with multiple myeloma (MM).
 Methods: Kaplan-Meier survival curve, Log-rank test and Cox regression model were used to carry out univariate and multivariate analysis on clinical and laboratory parameters of 51 MM patients who were newly diagnosed with MM and had complete follow-up data in the Department of Hematology, Jiangning Hospital Affiliated to Nanjing Medical University, Nanjing From November 2011 to October 2012.
 Results: Of the 51 patients, 29 were male and 22 were female. Followed up to December 2019, 21 died and 30 survived. The univariate analysis showed the prognosis was influenced by factors including age, disease stage, standard treatment, new drugs, maintenance treatment, hypercalcemia, globulin, albumin, hemoglobin. Patients aged <65 years, with ISS stage I and II, with standardized treatment, with new drugs, with normal or below normal blood calcium, with normal or below normal globulin, with albumin ≥ 35g/L or patients with hemoglobin ≥100g/L have longer survival time. The multivariate analysis showed that maintenance treatment, hypercalcemia and hemoglobin were independent risk factors influencing the prognosis of MM patients.
 Conclusion: Patients with blood calcium ≥ 2.6mmol/L, hemoglobin <100g/L and those who do not undergo regular maintenance therapy have a poor prognosis.
 Key words multiple myeloma; overall survival; non-genetic; prognostic factors

 No relevant conflicts of interest to declare.


Neãas, A. , M. Dvofiák: Surgical Treatment of a Saggital Intraarticular Femoral Head Fracture with Coxofemoral Dislocation in Two Mature Dogs. Acta Vet. Brno 2003, 72: 261-265. The surgical treatment of two cases of craniodorsal hip luxation with an associated saggital intraarticular fracture through the femoral head is described. The method of repair consisted of an open reduction via a craniolateral approach to the hip joint and internal fixation of the fracture with a lag screw and a Kirschner wire. One case was complicated by an ipsilateral complex femoral fracture and contralateral luxation of the hip joint with avulsion of a small bone fragment from the femoral head. Both dogs were clinically sound ten to twelve months after surgery. Hip joint, luxation, trauma, fracture Two types of intraarticular femoral head fractures are seen associated with coxofemoral dislocation in mature dogs. Each type presents a challenge to veterinary surgeon to achieve a satisfactory outcome. The more common type involves avulsion of a small portion of the femoral head, which is normally attached to the round ligament. The fragment is too small to be adequately stabilized and its presence may result in failure of attempts at treatment of the dislocated hip by closed reduction. Excision of the fragment is indicated at the time of open reduction of the hip. The second, less common type, is when dislocation of the hip is associated with a much larger saggital fracture through the femoral head. Only a small number of papers have been published, which discuss the methods of treating this more complex injury ( Ve non and Olmstead1983; L ́Eplat tenierand Montavon1997). If the fragment is larger than one-quarter of the femoral head, then the opportunity exists to reduce and stabilize the fracture with lag screws or with a combination of a lag screw and a small pin. Important factors to consider helping to ensure a successful outcome include an atraumatic surgical approach, with due regard to preservation of the blood supply to the fragments and accurate reduction with rigid fragment fixation. The purpose of this paper is to report on the outcome of further two cases. Craniodorsal hip luxation with an associated saggital fracture through the femoral head usually occurs in mature dogs because in the immature dog the proximal femoral growthplate is the weak link. The two common causes of craniodorsal hip luxation are either a car accident or a fall from height ( Wadsworth1993). If the dog is hit by a car from behind, the animal starts to fall toward the hip to be luxated and the rear leg on this side moves into adduction. It is theorised that the centre of gravity of the animal moves lateral to the hip joint and as the hip moves toward the ground, the long lever arm of the adducted femur femoral shaft draws the femoral head out of the acetabulum as far as the joint capsule will allow. When the greater trochanter strikes the ground, the force is transmitted through the femoral neck to the femoral head, driving the head over the dorsal rim shearing the joint capsule and the round ligament. Craniodorsal luxation can also occur when the hind quarters are driven ventrally towards the ground with the leg extended and the foot weight bearing. The pelvis is forced ventrally and the knee and hip flex. At some stage, before the pelvis hits the ground, the knee makes contact with the ground and as the pelvis moves ventrally the hip begins to rotate externally. If the force is of sufficient magnitude the teres ligament and the joint capsule rupture and the tension in the gluteal muscles results in luxation of the femoral head in a craniodorsal direction ( Wadsworth1993). Although the hip is a typical ball-and-socket joint ( Evans1993), it is not well protected against luxation. There are no collateral ligaments and the major stabilising structures of the joint are the joint capsule, the round ligament and the muscles attached to the proximal end of the femur, plus the hydrostatic force exerted by the viscosity of the synovial fluid. In individuals affected by hip dysplasia, the articular and periarticular structures may become stretched and that predisposes the joint to luxation ( Bojrab 1993). The blood supply to the femoral head and neck arises from the lateral circumflex femoral artery, the medial circumflex femoral artery, and to a limited extent from a branch of the caudal gluteal artery (Kader ly et al. 1982). The network from these vessels within the retinaculum penetrates the joint capsule. Clinical observations indicate that, when the femoral head fracture is intracapsular, the ventral joint capsule strips from the femoral neck, leaving intact the retinacular blood supply from the medial circumflex femoral artery to the femoral head (Br inker et al. 1998). Craniodorsal hip luxation with an associated saggital fracture through the femoral head should be treated by open reduction. Closed reduction is not indicated because of the risk of reluxation of the femoral head and the likelihood of developing degenerative joint disease secondary to the damage caused to the articular cartilage and the irritation from the intraarticular fragment. Materials and Methods Two cases of craniodorsal hip luxation with an intraarticular femoral head avulsion fracture were operated on at the Department of Surgery and Orthopaedics, University of Veterinary and Pharmaceutical Sciences in Brno between 1989 and 1997. In each case the fragment of the femoral head was equal to one-quarter the femoral head or more. The first patient was a Bernese Mountain Dog, aged 4 years and weighing 40 kg, diagnosed with a craniodorsal luxation of the left hip joint with an associated fragment in the size of approximately 1/3 of the femoral head (Plate IX, Fig. 1). The fracture was a sequel of a jump from height. The patient was operated on 24 hours following the trauma. The second case was a Schnauzer dog aged 1.5 years and weighing 16 kg, that had been hit by a car and sustained multiple injuries of soft and hard tissues of both pelvic limbs. These injuries comprised of a craniodorsal luxation of the right hip joint and an associated femoral head fracture, a complex diaphyseal fractures of the right femur and a craniodorsal luxation of the left hip joint with an associated small avulsion fracture of the femoral head (Fig. 2). Surgery was delayed for 48 hours so that the patient could be stabilized. The surgical technique used to repair the fracture of the femoral head was the same for both patients. Following the induction of general anaesthesia the affected limb was prepared for surgery from the midline to the hock joint. The patient was positioned in lateral recumbency with the injured leg up. The limb was draped to allow its free manipulation. A craniolateral approach to the hip joint was used which included a partial tenotomy of m. gluteus, profundus and a partial myotomy of m. vastus lateralis (P ierm at te i and Greeley 1979). The round ligament was damaged in both the cases and the remnants of the ligament were debrided and the joint cavity flushed with lactated Ringer's solution. The preoperative plan was to repair the fracture with a lag screw. Prior to the reduction of the fracture of the femoral head, the gliding hole was created in the main fragment. The fracture of the femoral head was then anatomically reduced and held it in position by sharp reduction forceps. The threaded hole in the femoral head fragment was drilled using a drill guide to insure accurate centering. The hole was measured and tapped so that a 2.7 mm cortical lag screw could be inserted. In order to achieve additional rotational stability a Kirschner wire was inserted parallel to the lag screw. The joint capsule was closed with a cruciate suture pattern using non-absorbable monofilament synthetic material (Prolene, USP 2-0). The tendinous parts of m. gluteus profundus and m. vastus lateralis were closed with a Kessler ́s locking-loop suture pattern using Prolene (USP 2-0). The remaining tissues were closed layer by layer in a routine way. 262


Microscopic self-propelled swimmers capable of autonomous navigation through complex environments provide appealing opportunities for localization, pick-up and delivery of micro and nanoscopic objects. Inspired by motile cells and bacteria, man-made microswimmers have been fabricated, and their motion in patterned surroundings has been experimentally studied. We propose to use self-driven artificial microswimmers for the separation of binary mixtures of colloids. We revealed different regimes of separation, including one with a velocity inversion. Our findings could be of use for various biological and medical applications.


Abstract: The purpose of this study is to test the effectiveness of group guidance in improving students' self-esteem SMAN 1 Cariu Bogor. The research method used is quantitative method with quasi-experiment approach. The study population was 148 students of class X. Samples taken by using sample quota samples were 16 students, divided into two groups; experimental groups and control groups. Self-esteem instruments are used to find out the student's self-esteem level by 20 items. Data analysis techniques using percentage of questionnaire results. The conclusion of this research is the effective group counseling service in improving students' self-esteem. Keywords: guidance group, self-esteem.


Background Popular web-based portals provide free and convenient access to user-generated hospital quality reviews. The Centers for Medicare & Medicaid Services (CMS) also publishes Hospital Compare Star Ratings (HCSR), a comprehensive expert rating of US hospital quality that aggregates multiple measures of quality. CMS revised the HCSR methods in 2021. It is important to analyze the degree to which web-based ratings reflect expert measures of hospital quality because easily accessible, crowdsourced hospital ratings influence consumers' hospital choices. Objective This study aims to assess the association between web-based, Google hospital quality ratings that reflect the opinions of the crowd and HCSR representing the wisdom of the experts, as well as the changes in these associations following the 2021 revision of the CMS rating system. Methods We extracted Google star ratings using the Application Programming Interface in June 2020. The HCSR data of April 2020 (before the revision of HCSR methodology) and April 2021 (after the revision of HCSR methodology) were obtained from the CMS Hospital Compare website. We also extracted scores for the individual components of hospital quality for each of the hospitals in our sample using the code provided by Hospital Compare. Fractional response models were used to estimate the association between Google star ratings and HCSR as well as individual components of quality (n=2619). Results The Google star ratings are statistically associated with HCSR (P<.001) after controlling for hospital-level effects; however, they are not associated with clinical components of HCSR that require medical expertise for evaluation such as safety of care (P=.30) or readmission (P=.52). The revised CMS rating system ameliorates previous partial inconsistencies in the association between Google star ratings and quality component scores of HCSR. Conclusions Crowdsourced Google star hospital ratings are informative regarding expert CMS overall hospital quality ratings and individual quality components that are easier for patients to evaluate. Improvements in hospital quality metrics that require expertise to assess, such as safety of care and readmission, may not lead to improved Google star ratings. Hospitals can benefit from using crowdsourced ratings as timely and easily available indicators of their quality performance while recognizing their limitations and biases.


The reliability is one of the serious issues confronted by microelectronics industry as feature sizes scale down to nano-design level. In this paper, we are providing the analysis to find the accurate and efficient method of finding circuit's reliability among the available options. The experimental results provide the reliability evaluation of few probabilistic computation schemes. The comparison will be done on unique platform to choose the best scheme amongst all. The simulations have been conducted on small test digital circuits including LGSynth'93 circuits.


The literature review is devoted to the current radiation methods for studying vertebral hemangiomas. The significance of basic (radiography, computed tomography, and magnetic resonance imaging) and additional (Doppler ultrasound, scintigraphy, and selective angiography) diagnostic techniques is analyzed and their role in determining the indications for surgical treatment is clarified. The priority of computed tomography over other imaging methods for this pathology is established. The use of radiation therapy for vertebral hemangiomas at the present stage of medicine development is highlighted.


This paper concentrates on techniques for constructing geometric models from data provided by 3-D imaging sensors. Such techniques allow for rapid modeling of sculptured free-form shapes and generation of geometric models for existing parts. Also, the problem of merging images in order to obtain a complete 3-D data set is addressed. The shape representations are closely related to modeling primitives commonly used in computer aided geometric design. In particular, Non-Uniform Rational B-Spline (NURBS), optimal triangulation and superellipsoid surface representations are used in the shape estimation. Computational solutions are provided for shape estimation. The surface approximations are refined by the algorithms to meet a user defined tolerance value. The resulting geometric model is in a procedural form which can convey structural information in addition to low level geometric primitives. Experimental results on view registration and shape estimation are shown.<<ETX>>


A simple, reliable technique of autologous fat grafting for long-lasting rejuvenation of the dorsum of the hand is presented. With this technique, small intact parcels of fatty tissue are harvested with a syringe and a blunt 3-mm cannula. Then, most of the nonviable components are removed from the harvested subcutaneous material by centrifugation, decanting, and wicking. Finally, a 17-gauge blunt cannula places the fat in minuscule parcels of tissue with many passes through five or six tiny incisions in the hand. Separation of the tiny parcels of fat maximizes contact between the surfaces of the transplanted fat and surrounding recipient tissues to encourage integration, anchoring, and long-term survival. Structured, purposeful placement of a thin layer of transplanted fat rejuvenates the dorsal hand by restoring a slight fullness to atrophic subcutaneous tissue, by softening the color and definition of exposed extensor tendons and dorsal hand veins, and by supporting the aging skin.


Why do Cubans convert to Soka Gakkai (SGI)? What factors influence their religious choice? Based on fieldwork conducted in Havana, three main affiliation patterns are identified: the pursuit of practical benefits, spiritual quests and the irreligious paths. At the micro level, these are explained by the converts' perceived congruence between their own (non-)religious worldview and SGI. Next, at the meso level, it is shown that a major institutional factor is SGI's capacity to supply simultaneously a utilitarian religious perspective, an alternative spirituality and a non-theistic humanistic message. Finally, individual and institutional factors are linked to the socio-cultural context.


Background: Tumor suppressor gene (TP53) is considered as the most frequently mutated gene in almost all forms of human cancer. Moreover, genetic variations in the XPD gene affect the DNA repair capacity increasing cancer susceptibility. Polymorphisms within these genes can play a major role in determining individual lung cancer susceptibility. However, several studies have investigated this possibility; but reported conflicting results. Therefore, the objective of this study was to investigate the role of TP53 Arg72Pro and XPD Lys751Gln gene polymorphisms on lung cancer susceptibility in the Bangladeshi population. Materials and Methods: Study subjects comprised of 180 lung cancer patients and 200 healthy volunteers. Genetic polymorphism of TP53 was determined by multiplex PCR-based method, while XPD genotypes were analyzed using Polymerase Chain Reaction-based Restriction Fragment Length Polymorphism (PCR-RFLP) method. Lung cancer risk was estimated as odds ratio (OR) and 95% confidence interval (CI). Results: From the results, no significant association between TP53 Arg72Pro polymorphism and lung cancer risk was observed. Whereas, patients with homozygous mutant variants (Gln/Gln) of XPD at codon 751 were found significantly associated with lung cancer risk when compared to the control (OR=3.58; 95% CI=1.58-8.09; p=0.002). Lung cancer risk was found significantly higher with Gln/Gln variants of XPD among smokers (OR=4.03; 95% CI=1.11-14.63; p=0.026). Significant increased risk of lung cancer was found with Arg/Pro genotypes of TP53, Lys/Gln and Gln/Gln variants of XPD in individuals with family history of cancer (OR=3.44; 95% CI=1.36-8.72; p=0.011; OR=3.17; 95% CI=1.20-8.39; p=0.024; OR=16.35; 95% CI=0.92-289.5; p=0.007, respectively). Conclusion: The findings indicated that homozygous mutant variants (Gln/Gln) of XPD were associated with increased lung cancer risk, whereas TP53 Arg72Pro polymorphism was not associated with risk of lung cancer among Bangladeshi patients.


Engineering analysis and design often uses properties of plane sections in calculations. For example, in stress analysis of a beam under bending and torsional loads, you use the cross-sectional properties to determine the stress and displacement distributions in the beam cross section. In calculating the natural frequencies and shapes of a machine part, you also need to know the area, centroid, and various moments and products of inertia of a cross section or a composed cross section. The centroid, moments and products of inertia of an area made up of several common shapes (rectangles usually), may thus be obtained by adding the moments of inertia of the component areas. However the parallel-axes theorems should be used to transfer each moment of inertia to the desired axis. This procedure is used to calculate the second moments of structural shapes (U-shape, L-shape, C-shape,...) because the determination of their moments of inertia is necessary for design structural members. Many engineering students are introduced to the ideas and concepts of Mohr's Circle when studying stress states due to various loading conditions on structures or machines. Mohr's circle provides a visual representation of what is happening, and the positioning of the stress states on an element relative to a set of coordinate axes. In this paper we propose the use of interactive methods for teaching this part of Mechanics. A set of simulations designed with the Modellus 2.5 software are used for calculating centroids, moment and product of inertia and their properties. Mohr ́s circles are also drawn with interactive simulations to obtain the principal axes and moments of inertia of structural shapes. For solving problems, students can interact in the simulation, by changing shapes, size, angles, etc.


After the Second World War, Japan and its economy were crippled. The industrial power it once had was reduced to rubble, with millions of people left to live in precarious conditions. However, in just a matter of years, the Japanese economy began to re-emerge; local companies became multi-national corporations, and hundreds of high-quality 'Made in Japan' products began flocking Western markets. To the surprise of Western economists, researchers, and politicians alike, Japan began rivaling mature economies without implementing either pure Anglo-American laissez-faire or Soviet-style central planning. This was the work of the "developmental state"', a set of regulatory economic policies oriented towards developing and protecting local industry. Other countries such as South Korea successfully implemented similar industrial policies during the Cold War. But is the "'developmental state"' success story an Asia-only phenomenon? In Latin America, former Ecuadorian President Rafael Correa envisioned a similar plan to develop and modernize the country according to his own, post-neoliberal and environmentally-centered concept of development. The purpose of this article is to compare Ecuador's national development plans from 2007 until 2017 and the policy goals of the Japanese and Korean developmental states.


An optimal control policy applied to multi-level distributed-parameter systems, which provides them with coordinated control, is presented in this paper. This policy adopts a feasible method to control individual subsystems optimally and entire systems coordinately. This policy realizes the overall optimization of the multi-level distributed-parameter systems. This coordinated control method provides composite distributed-parameter systems with a proper control mode, which combines local optimization with global coordination.


Abstract. The alternation of active and break phases in Indian summer monsoon
(ISM) rainfall at intraseasonal timescales characterizes each ISM season.
Both tropical and mid-latitude drivers influence this intraseasonal ISM
variability. The circumglobal teleconnection observed in boreal summer
drives intraseasonal variability across the mid-latitudes, and a two-way
interaction between the ISM and the circumglobal teleconnection pattern has
been hypothesized. We use causal discovery algorithms to test the
ISM circumglobal teleconnection hypothesis in a causal framework. A robust
causal link from the circumglobal teleconnection pattern and the North
Atlantic region to ISM rainfall is identified, and we estimate the normalized
causal effect (CE) of this link to be about 0.2 (a 1 standard deviation
shift in the circumglobal teleconnection causes a 0.2 standard deviation
shift in the ISM rainfall 1 week later). The ISM rainfall feeds back on
the circumglobal teleconnection pattern, however weakly. Moreover, we
identify a negative feedback between strong updraft located over India and
the Bay of Bengal and the ISM rainfall acting at a biweekly timescale, with
enhanced ISM rainfall following strong updraft by 1 week. This mechanism
is possibly related to the boreal summer intraseasonal oscillation. The
updraft has the strongest CE of 0.5, while the Madden–Julian oscillation
variability has a CE of 0.2–0.3. Our results show that most of the ISM
variability on weekly timescales comes from these tropical drivers, though
the mid-latitude teleconnection also exerts a substantial influence.
Identifying these local and remote drivers paves the way for improved
subseasonal forecasts.


Ray matrices are a powerful tool for the analysis of optical systems. This technique is modified to include a diffractive optical element within the optical system. Several research applications are discussed, including optical Fourier transforms and imaging with diffractive optical elements.


The calicivirus agent for rabbit hemorrhagic disease (RHD) escaped from an island quarantine station to the Australian mainland in October 1995. Within 2 wk it was detected at an established field study site where wild European rabbits (Oryctolagus cuniculus) were being monitored in the Flinders Ranges National Park (South Australia, Australia). During November 1995, RHD reduced the rabbit numbers on the site by 95%. Approximately 3% of the population survived challenge by RHD and developed antibodies. Most of the antibody-positive survivors were 3- to 7-wk-old when challenged. Many rabbits died underground, but counts of rabbit carcasses found on the surface indicated that approximately 1 million rabbits had died above ground in the National Park, and that >30 million rabbits may have died in adjacent areas during the November epidemic.


Advanced SOI and strained-SOI (s-SOI) technologies may be an alternative option to integrate Resonant Tunneling Diodes (RTD) in a silicon process. To investigate the expected performances of such technologies, a complete DC and AC compact model of silicon RTD has been proposed, and implemented in a circuit simulator. RTD based RF oscillators have been simulated and compared to more conventional silicon circuits. Even if SOI based RTD offers lower performances than their III-V counterparts, it turns out that extremely low power RF oscillator at 20 GHz can be realized on silicon using this technology.


A total of 73,897 cases of women above 30 years old were screened for their cervical cancer by Pap smear in Niigata prefecture in 1978 and 1979. From them 37 cases of invasive cancer (0.05%) including a case of endometrial adenocarcinoma, stage II, 30 cases of carcinoma in situ (0.04%), and 52 cases of dysplasia (0.07%) were detected. From the correlation between the check up frequency of these patients and the cervical malignancy detected, the following were pointed out: 1) No invasive cancer but carcinoma in situ were detected from those patients who were cytoscreened by successive annual visits. 2) Stage Ia but not more advanced cervical cancer were detected from those patients who were screened at 2 years interval. 3) Stage Ib or farther advanced cervical cancer were detected from those patients who visited at 3 years or more years interval just like from those patients who visited for the first time. To detect cervical cancer in its preinvasive stage, annual Pap smear of adult women over 30 years old should be continued.


We study finite model reasoning in expressive Horn description logics (DLs), starting with a reduction of finite ABox consistency to unrestricted ABox consistency. The reduction relies on reversing certain cycles in the TBox, an approach that originated in database theory, was later adapted to the inexpressive DL DL-LiteF, and is shown here to extend to the expressive Horn DL Horn-ALCFI. The model construction used to establish correctness makes the structure of finite models more explicit than existing approaches to finite model reasoning in expressive DLs that rely on solving systems of inequations over the integers. Since the reduction incurs an exponential blow-up, we then develop a dedicated consequence-based algorithm for finite ABox consistency in Horn-ALCFI that implements the reduction on-the-fly rather than executing it up-front. The algorithm has optimal worst-case complexity and provides a promising foundation for implementations. We next show that our approach can be adapted to finite (positive existential) query answering relative to Horn-ALCFI TBoxes, proving that this problem is EXPTIME-complete in combined complexity and PTIME-complete in data complexity. For finite satisfiability and subsumption, we also show that our techniques extend to Horn-SHIQ.


In this work, we designed structures based on copper nanosubstrate with graphene and two-dimensional transition metal dichalcogenides (TMDC) in order to achieve an ultrasensitive surface plasmon resonance biosensor. This system contains seven components: SF11 triangular prism, BK-7 glass, Chromium (Cr) adhesion layer, thin copper film, layers of one of the types of transition metal dichalcogenides: MoS2, MoSe2, WS2 or WSe2 (defined as MX2), graphene, sensing layer with biomolecular analyte. Copper was chosen as a plasmonic material because it has a higher conductivity than gold which is commonly used in plasmonic sensors. Moreover, copper is a cheap and widespread material that is easy to produce on a large scale. We have carried out both theoretical and numerical sensitivity calculations of these kinds of structures using the Goos–Hänchen (GH) shift method. GH shift is lateral position displacement of the p-polarized reflected beam from a boundary of two media having different indices of refraction under total internal reflection condition and its value can be retrieved from the phase change of the beam. The SPR signal based on the GH shift is much more sensitive compared to other methods, including angular and wavelength scanning, due to much more abrupt phase change of the SPR reflected light than its intensity ones. By optimizing the parameters of the SPR sensing substrate, such as thickness of copper, number of layers of 2D materials and excitation wavelength, we theoretically showed an enhanced sensitivity with a detection limit 10−9 refractive index unit (RIU).


In modern electronic warfare, it is becoming very important to develop intelligent and adaptive radar anti-jamming methods since jammers can now launch increasingly complex and unpredictable attacks. Besides, in practice, the jamming strategy is usually unknown to the radar. To overcome the limitations caused by the lack of information about the jammer, reinforcement learning is applied to radar anti-jamming in this paper via the adaptation of frequency hopping interval. In reinforcement learning, the sequential decision problem to solve is described as a Markov Decision Process (MDP). To describe the sequential radar anti-jamming decision making process, a detailed radar anti-jamming MDP model is formulated. To balance between integration efficiency and probability of interception, a flexible adjustable tradeoff between them is devised by defining the reward function of the MDP as the weighted sum of the integration efficiency factor and the probability of interception factor. Two properties of the MDP value function are proved. These properties are used to derive the optimal frequency hopping time interval for different pulse widths under the RL framework. Simulation results show that the proposed radar anti-jamming strategy can adapt to the jamming environment well and can control its performance flexibly by adjusting the weights of integration efficiency and probability of interception.


ABSTRACT  Although there is a trend to advocate the use of authentic texts in the foreign language classroom, a consensus regarding the criteria determining textual authenticity has not been reached. Instead, researchers often provide varying, sometimes conflicting definitions as to what comprise authentic materials.

This paper draws on research in discourse analysis in an attempt to determine text authenticity through text type authenticity and provide implications for classroom materials. A text may be considered a spoken or written verbal unit, and a text type may be described as a specific type of spoken or written unit. Thus, for example, the text type "textbook conversation," written by textbook authors for the purpose of teaching specific structures, can probably not be defined as the text type "authentic conversation," in which native speakers engage in speaking for purposes other than to teach their language. In addition a ranking of types of conversational texts, from most to least authentic, provides a scale by which to judge the value of materials used in the classroom.


Capturing the body's mechanical energy from the heart, lungs, and diaphragm can probably meet the requirements for in vivo applications of implantable biomedical devices. In this work, we present a novel contractile cardiomyocyte (CM)-driven biogenerator based on piezoelectric nanofibers (NFs) uniaxially aligned on a PDMS thin film. Flexible nanostructures interact with the CMs, as a physical cue to guide the CMs to align in a specific way, and create mechanical interfaces of contractile CMs and piezoelectric NFs. As such, the cellular construct features specific alignment and synchronous contraction, which realizes the maximal resultant force to drive the NFs to bend periodically. Studies on contraction mapping show that neonatal rat CMs self-assemble into a functional bio-bot film with well-defined axes of force generation. Consequently, the biogenerator produces an average voltage of 200 mV and current of 45 nA at the cell concentration of 1.0 million per ml, offering a biocompatible and scalable platform for biological energy conversion.


With the unusually violent tornado season of 2011, there has been a renewed national interest, through such programs as NOAA's Weather Ready Nation initiative, to reevaluate and improve our tornado warning process. This literature review provides an interdisciplinary, end-to-end examination of the tornado warning process. Following the steps outlined by the Integrated Warning System, current research in tornado prediction and detection, the warning decision process, warning dissemination, and public response are reviewed, and some of the major challenges for improving each stage are highlighted. The progress and challenges in multi-day to short-term tornado prediction are discussed, followed by an examination of tornado detection, focused primarily upon the contributions made by weather radar and storm spotters. Next is a review of the warning decision process and the challenges associated with dissemination of the warning, followed by a discussion of the complexities associated with understanding public ...


Monoclonal antibody-based immunoassays can detect specifically intact human chorionic gonadotropin (hCG), the free alpha-subunit and the free beta-subunit. The differential production of hCG and its free subunits is important in gestational trophoblastic disease. Using well-defined epitope-specific monoclonal antibodies in an immunoradiometric assay format, specific and sensitive assays have been developed. Serum levels of free beta-hCG were abnormally high in patients with gestational trophoblastic disease. In contrast, free alpha-hCG levels in serum were not increased.


Accidental or intentional isoniazid (INH) overdose is not uncommon. Two patients suffering from pulmonary tuberculosis ingested INH (9 g and 12 g respectively) intentionally following acute personal stress. One patient presented with oliguria and coma whereas seizures were the dominant feature in the second case. Serum levels of INH were high in both cases. Satisfactory clinical recovery followed after the administration of intravenous pyridoxine. Literature on the subject was reviewed and the manifestations and recommendations for the management of acute INH toxicity are highlighted.


We analyse in detail a new approach to the monitoring and forecasting of the onset of transitions in high dimensional complex systems by application to the Tangled Nature model of evolutionary ecology and high dimensional replicator systems with a stochastic element. A high dimensional stability matrix is derived in the mean field approximation to the stochastic dynamics. This allows us to determine the stability spectrum about the observed quasi-stable configurations. From overlap of the instantaneous configuration vector of the full stochastic system with the eigenvectors of the unstable directions of the deterministic mean field approximation, we are able to construct a good early-warning indicator of the transitions occurring intermittently.


This paper considers the stabilization of unknown switched linear systems using data. Instead of a full system model, we have access to a finite number of trajectories of each of the different modes prior to the online operation of the system. On the basis of informative enough measurements, formally characterized in terms of linear matrix inequalities, we design an online switched controller that alternates between a mode detection phase and a stabilization phase. Since the specific currently-active mode is unknown, the controller employs the most recent online measurements to determine it by implementing computationally efficient tests that check compatibility with the set of systems consistent with the pre-collected measurements. The stabilization phase applies the stabilizing feedback gain corresponding to the identified active mode and monitors the evolution of the associated Lyapunov function to detect switches. When a switch is detected, the controller returns to the mode-detection phase. Under average dwell- and activation-time assumptions on the switching signal, we show that the proposed controller guarantees an input-to-state-like stability property of the closed-loop switched system. Various simulations illustrate our results.


Several mechanisms contribute to streambank failure including fluvial toe undercutting, reduced soil shear strength by increased soil pore‐water pressure, and seepage erosion. Recent research has suggested that seepage erosion of noncohesive soil layers undercutting the banks may play an equivalent role in streambank failure to increased soil pore‐water pressure. However, this past research has primarily been limited to laboratory studies of non‐vegetated banks. The objective of this research was to utilize the Bank Stability and Toe Erosion Model (BSTEM) in order to determine the importance of seepage undercutting relative to bank shear strength, bank angle, soil pore‐water pressure, and root reinforcement. The BSTEM simulated two streambanks: Little Topashaw Creek and Goodwin Creek in northern Mississippi. Simulations included three bank angles (70° to 90°), four pore‐water pressure distributions (unsaturated, two partially saturated cases, and fully saturated), six distances of undercutting (0 to 40 cm), and 13 different vegetation conditions (root cohesions from 0·0 to 15·0 kPa). A relative sensitivity analysis suggested that BSTEM was approximately three to four times more sensitive to water table position than root cohesion or depth of seepage undercutting. Seepage undercutting becomes a prominent bank failure mechanism on unsaturated to partially saturated streambanks with root reinforcement, even with undercutting distances as small as 20 cm. Consideration of seepage undercutting is less important under conditions of partially to fully saturated soil pore‐water conditions. The distance at which instability by undercutting became equivalent to instability by increased soil pore‐water pressure decreased as root reinforcement increased, with values typically ranging between 20 and 40 cm at Little Topashaw Creek and between 20 and 55 cm at Goodwin Creek. This research depicts the baseline conditions at which seepage undercutting of vegetated streambanks needs to be considered for bank stability analyses. Copyright © 2008 John Wiley & Sons, Ltd.


In order to improve the internal structure of object-oriented software, refactoring has proved to be a feasible technique. Scheduling a refactoring process for a complex software system is a difficult task to do. Refactorings may be organized and prioritized based on goals established by the project management leadership, that shapes a refactoring strategy. The paper presents a multi-objective approach to the Strategy-based Refactoring Set Selection Problem (SRSSP) by treating the cost constraint and the refactoring impact as objectives of a weighted-sum fitness function. The first results of the proposed weighted objective genetic algorithm on a experimental didactic case study are presented and discussed. Keywords— genetic algorithm, multi-objective optimization, refactoring, object-oriented programming, software engineering.


OBJECTIVES
To study the change in asymmetric dimethylarginine (ADMA) in the circulation system of full-term infants with persistent pulmonary hypertension of the newborn (PPHN) and its association with treatment response, as well as the possibility of ADMA as a therapeutic target and a marker for treatment response.

METHODS
A prospective study was performed. A total of 30 full-term neonates who were diagnosed with PPHN within 3 days after birth were enrolled as the PPHN group, and the neonates without PPHN, matched for gestational age and age, who were treated or observed in the department of neonatology were enrolled as the control group. Serum samples were collected on days 1, 7, and 14 of treatment. The high-performance liquid chromatography-tandem mass spectrometry was used to measure the serum concentrations of L-arginine, ADMA, and its isomer symmetric dimethylarginine (SDMA).

RESULTS
For the neonates in the control group, the serum concentrations of ADMA and L-arginine continuously increased and the serum concentration of SDMA continuously decreased within the first 14 days of treatment. On days 1 and 14, there was no significant difference in the serum concentration of ADMA between the control and PPHN groups (P>0.05). On day 7, the PPHN group had a significantly higher serum concentration of ADMA than the control group (P<0.05), while there were no significant differences in serum concentrations of SDMA or L-arginine (P>0.05). Moreover, after 7 days of treatment, the PPHN neonates with a systolic pulmonary arterial pressure (sPAP) of >35 mmHg had a significantly higher serum concentration of ADMA than those with an sPAP of ≤35 mm Hg.

CONCLUSIONS
There are continuous increases in the ADMA concentration and the ADMA/SDMA ratio in the circulation system of full-term infants within the first 2 weeks after birth, and this process is accelerated by the pathological process of PPHN, suggesting that ADMA may be involved in the pathologic process of PPHN. A high level of ADMA is associated with the resistance to PPHN treatment, suggesting that inhibition of ADMA might be a potential target of drug intervention to improve the treatment response of PPHN.


Detailed 3D imaging of Gas Electron Multiplier (GEM) foil hole geometry was realized. Scanning White Light Interferometry was used to examine six topological parameters of GEM foil holes from both sides of the foil. To study the effect of the hole geometry on detector gain, the ANSYS and Garfield ++ software were employed to simulate the GEM detector gain on the basis of SWLI data. In particular, the effective gain in a GEM foil with equally shaped holes was studied. The real GEM foil holes exhibited a 4% lower effective gain and 6% more electrons produced near the exit electrode of the GEM foil than the design anticipated. Our results indicate that the GEM foil hole geometry affects the gain performance of GEM detectors.


Background To assign a course of secondary progressive multiple sclerosis (MS) (SPMS) may be difficult and the proportion of persons with SPMS varies between reports. An objective method for disease course classification may give a better estimation of the relative proportions of relapsing–remitting MS (RRMS) and SPMS and may identify situations where SPMS is under reported. Materials and methods Data were obtained for 61,900 MS patients from MS registries in the Czech Republic, Denmark, Germany, Sweden, and the United Kingdom (UK), including date of birth, sex, SP conversion year, visits with an Expanded Disability Status Scale (EDSS) score, MS onset and diagnosis date, relapses, and disease-modifying treatment (DMT) use. We included RRMS or SPMS patients with at least one visit between January 2017 and December 2019 if ≥ 18 years of age. We applied three objective methods: A set of SPMS clinical trial inclusion criteria ("EXPAND criteria") modified for a real-world evidence setting, a modified version of the MSBase algorithm, and a decision tree-based algorithm recently published. Results The clinically assigned proportion of SPMS varied from 8.7% (Czechia) to 34.3% (UK). Objective classifiers estimated the proportion of SPMS from 15.1% (Germany by the EXPAND criteria) to 58.0% (UK by the decision tree method). Due to different requirements of number of EDSS scores, classifiers varied in the proportion they were able to classify; from 18% (UK by the MSBase algorithm) to 100% (the decision tree algorithm for all registries). Objectively classified SPMS patients were older, converted to SPMS later, had higher EDSS at index date and higher EDSS at conversion. More objectively classified SPMS were on DMTs compared to the clinically assigned. Conclusion SPMS appears to be systematically underdiagnosed in MS registries. Reclassified patients were more commonly on DMTs.


Critically ill patients admitted to hospital following SARS-CoV-2 infection often experience hypoxic respiratory failure and a proportion require invasive mechanical ventilation to maintain adequate oxygenation. The combination of prone positioning and non-invasive ventilation in conscious patients may have a role in improving oxygenation. The purpose of this study was to assess the effect of prone positioning in spontaneously ventilating patients receiving non-invasive ventilation admitted to the intensive care. Clinical data of 81 patients admitted with COVID 19 pneumonia and acute hypoxic respiratory failure were retrieved from electronic medical records and examined. Patients who had received prone positioning in combination with non-invasive ventilation were identified. A total of 20 patients received prone positioning in conjunction with non-invasive ventilation. This resulted in improved oxygenation as measured by a change in PaO 2/FiO 2 (P/F) ratio of 28.7 mmHg while prone, without significant change in heart rate or respiratory rate. Patients on average underwent 5 cycles with a median duration of 3 hours. There were no reported deaths, 7 of the 20 patients (35%) failed non-invasive ventilation and subsequently required intubation and mechanical ventilation. In our cohort of 20 COVID-19 patients with moderate acute hypoxic respiratory failure, prone positioning with non-invasive ventilation resulted in improved oxygenation. Prone positioning with non-invasive ventilation may be considered as an early therapeutic intervention in COVID-19 patients with moderate acute hypoxic respiratory failure.


An air exhaust pressure adjusting type air inlet and exhaust serial connection system belongs to the technical field of mechanical design and comprises an air compressor, an engine, a turbine, connection pipes, through pipes, a volume cavity, a movable body and a spring. The movable body is installed in the volume cavity and is in sealing contact with the inner wall of the volume cavity, a first through pipe and a second through pipe both penetrate through the upper wall and the lower wall of the movable body, two ends of a third connection pipe are respectively communicated with an air exhaust pipe of the engine and the right wall of the volume cavity, and the left wall of the movable body is connected with the left wall of the volume cavity through the spring. When pressure in the air exhaust pipe of the engine is low, the movable body moves towards right, and two boosters can be in serial connection to work. When pressure in the air exhaust pipe of the engine is high, the movable body moves towards left, and only a first booster works. The air exhaust pressure adjusting type air inlet and exhaust serial connection system is reasonable in design, simple in control strategies and suitable for turbine boost systems with the number of the turbines different.


We investigate the relaxation of rectangular wrinkled thin films intrinsically containing an initial strain gradient. A preferential rolling direction, depending on wrinkle geometry and strain gradient, is theoretically predicted and experimentally verified. In contrast to typical rolled-up nanomembranes, which bend perpendicular to the longer edge of rectangular patterns, we find a regime where rolling parallel to the longer edge of the wrinkled film is favorable. A nonuniform radius of the rolled-up film is well reproduced by elasticity theory and simulations of the film relaxation using a finite element method.


Background: There is limited information about the psychosocial (sub-) determinants regarding the use of HIV Testing and Counselling (HTC) services among Tuberculosis(TB) suspected patients in Sudan. This study aimed to assess the psychosocial beliefs related to the intention to use HTC services among TB suspected patients and to establish the relevance of these beliefs for developing behaviour change interventions. Methods: TB suspected patients (N= 383) completed a cross-sectional questionnaire from four separate TB facilities. The questionnaire was based on the Reasoned Action Approach theory. Eligibility criteria included attending Tuberculosis Management Units in Kassala State as suspected TB patients and aged 18-64 years. A Confidence Interval Based Estimation of Relevance (CIBER) analysis approach was employed to investigate the effects of the beliefs on the intention to use the HTC services and to establish their relevance to be targeted in behaviour change interventions. Results: The CIBER results showed the beliefs included in the study accounted for 59% to 70% of the variance in intention to use HTC services. The belief "My friends think I have to use the HTC services" was positively associated with the intent to use HTC, and it is highly relevant for interventions. The belief "If I would fear to be stigmatized if I get HIV positive result" was negatively related to the intention to use the HTC services and highly relevant belief. The belief "If I use HTC services, the health care providers will keep my HIV test result confidential" was strongly associated with the intention to use HTC services. However, it was not a very low relevant belief. Past experience with HTC services was weakly associated with the intention to use HTC services. Conclusion: The intention to use HTC was a function of psychosocial beliefs. The belief investigated varied in their relevance for interventions designed to encourage the use of HTC services. Interventions to intention to use HIV testing and counselling services should address the most relevant beliefs (sub-determinants). Further study is needed to establish the relevance of sub-determinants of the intention to use HTC services.


Unsafe Stool disposal has been linked to high under-five morbidity and mortality in many low and middle-income countries. This paper focuses on examining the prevalence of safe disposal of stools in Nigeria and the factors affecting such behaviour. The most-recent Nigeria Demographic and Health Survey 2018 (NDHS) Child's dataset was used for the analysis in this study. Sample size of 7,834 children under age five was analysed. Percentages and frequencies, chi-square test of association, and binary logistic regression were employed for the statistical analysis. Findings show that a little above half of the women respondents reported safe disposal of stool of their under-five children in the study area (53%). Specifically, the odds of having stool safely disposed increased by 133 percent for children whose household wealth index falls within the richer category (adjusted Odd Ratio (aOR): 2.33; p<0.001), reduced by 17 percent for children whose mothers are working (aOR: 0.83; p<0.05), increased for children whose mothers are residing only in North-East and North-West (p<0.001), increased by 19 percent for children whose mothers were exposed to media exposure to mass media (aOR: 1.19; p<0.05), reduced by 24 percent for women whose children are of first birth order (aOR: 0.76; p<0.05), reduced by 31 percent for women whose children are of small size at birth (aOR: 0.69; p<0.001), increased by 66 percent for women who reported that distance to facility was not a problem (aOR: 1.66; p<0.001), reduced by 19 percent for women who delivered their children at an health centre (aOR: 0.81; p<0.05), and increased by 114 percent for women who used improved toilet facility (aOR: 2.14; p<0.001). This study concludes that a combination of socioeconomic, maternal, child's and environmental factors are the correlates of safe disposal of stool among women with under-five children in Nigeria. It should therefore be prioritised for interventions aimed at reducing high under-five morbidity and mortality in Nigeria.


Intracortical brain-machine interfaces have shown promise for restoring function to people with paralysis, but their translation to portable and implantable devices is hindered by their high power consumption. Recent devices have drastically reduced power consumption compared to standard experimental brain-machine interfaces, but still require wired or wireless connections to computing hardware for feature extraction and inference. Here, we introduce a Neural Recording And Decoding (NeuRAD) application specific integrated circuit (ASIC) in 180 nm CMOS that can extract neural spiking features and predict two-dimensional behaviors in real-time. To reduce amplifier and feature extraction power consumption, the NeuRAD has a hardware accelerator for extracting spiking band power (SBP) from intracortical spiking signals and includes an M0 processor with a fixed-point Matrix Acceleration Unit (MAU) for efficient and flexible decoding. We validated device functionality by recording SBP from a nonhuman primate implanted with a Utah microelectrode array and predicting the one- and two-dimensional finger movements the monkey was attempting to execute in closed-loop using a steady-state Kalman filter (SSKF). Using the NeuRAD's real-time predictions, the monkey achieved 100% success rate and 0.82 s mean target acquisition time to control one-dimensional finger movements using just 581 $\mu$W. To predict two-dimensional finger movements, the NeuRAD consumed 588 $\mu$W to enable the monkey to achieve a 96% success rate and 2.4 s mean acquisition time. By employing SBP, ASIC brain-machine interfaces can close the gap to enable fully implantable therapies for people with paralysis.


Aims: There is limited data on the occurrence of E. Coli O157: H7 in water. Therefore, this study aims to detect E. Coli O157: H7 in the Water Treatment Plant (WTP). Materials and Methods: This cross-sectional study was conducted in Isfahan WTP, central of Iran. Immunological methods were implemented with anti-serum kits and the molecular method of reverse transcription-polymerase chain reaction (RT-PCR) was used to detect E. Coli O157: H7 in eight locations of the WTP; the sludge of the sedimentation basin and filter backwash water were also monitored. The survival of E. Coli O157: H7 in the sludge samples of the sedimentation basin was indicated by the formation of agglutination particles using the immunological method, and through indicator probes using the RT-PCR method. Results: E. Coli O157: H7 was not detected in the water samples from the WTP units. The removal percent of total coliforms (TC), fecal coliforms (FC), and Heterotrophic Plate Count (HPC), respectively, were as follows: 59.5, 49, and 54.8% in the sedimentation basin; 66, 45.8, and 57% in the ozonation system; 98.8, 98, and 78.8% in the filtration system; and 96, 100, 91% in the disinfection system. Conclusions: This study revealed the existence of the pathogenic coliform of E. Coli O157: H7 in the sludge of the sedimentation basin. The absence of E. Coli O157: H7 in the finished water indicated that the WTP units were able to eliminate these pathogenic bacteria before reaching the final units of the plant, including the filtration and disinfection systems.


No electronic medical record (EMR) system is ready to use out-of-the-box. Vendors provide rudimentary clinical content with the expectation that physicians will want to modify it to meet the needs of their individual practice style. This article discusses some key factors involving our experience with customizing our EMR system that, in hindsight, are thought to be valuable points of knowledge.


When DNA replication stalls at a fork-blocking lesion, cells use damage tolerance pathways to continue replication. One pathway, "translesion synthesis," involves specialized DNA polymerases that can use damaged DNA as a template. Translesion synthesis can result in mutations (i.e., can be error-prone), but it can also be error-free. An alternative pathway has been hypothesized (sometimes called "damage avoidance"), by which cells make temporary use of an undamaged copy of the blocked sequence as a template, i.e., the newly synthesized daughter strand of the sister duplex or the allelic copy. This pathway is error-free. Evidence of the use of the daughter strand of the sister duplex as a template in intact mammalian cells has not been available heretofore. To determine whether hMms2, a ubiquitin-conjugating enzyme-like protein, plays a critical role in such damage avoidance, a human fibroblast cell strain in which both error-prone translesion synthesis and error-free damage avoidance can be detected and quantified simultaneously, and several derivative strains in which expression of hMms2 protein had been eliminated or greatly decreased, were compared for their ability to avoid translesion synthesis past UV254nm-induced DNA photoproducts. Loss of hMms2 protein eliminated the ability of the latter strains to use an allelic copy of a target gene for damage avoidance, i.e., to produce a wild-type gene from two nonfunctional allelic copies of that gene. Molecular analysis of the wild-type gene showed that this process involves gene conversion unassociated with crossing-over. That the loss of hMms2 also eliminated use of the daughter strand of the sister duplex as a template for damage avoidance could be inferred from the fact that the frequency of mutations induced by UV in the single copy HPRT gene of the derivative strains was significantly higher than that observed in the parental strain. These data indicate that hMMS2 is essential for human cells to carry out damage avoidance by using either type of homolog, and that damage avoidance and translesion synthesis are alternative pathways for tolerating fork-blocking photoproducts.


Cave environment provides special ecosystems for evolution of lives distant from surface environments. We investigated bacterial and archaeal communities of wall biofilm obtained from of a volcanic cave (Daesubee) in Jeju, Republic of Korea. Bacterial and archaeal 16S rRNA genes were PCR-amplified and sequenced using pyrosequencing technologies. Unique prokaryotic communities with low diversities were observed. The main bacterial sequences (ca. 83% of total reads) were affiliated with Pseudonocardia mongoliensis of phylum Actinobacteria and clustered with clones obtained from various caves. Reflection of light on the wall surface of cave might be caused by formation of beads of water caused by hydrophobic filaments of actinobacterial colonies. Main archaeal sequences (ca. 65.7% of total reads) were related with those of I.1a-Associated group of phylum Thaumarchaeota. The sequences were related with that of Candidatus Nitrosotalea devanaterra which was known to oxidize ammonia under acidic condition (ca. pH 5.0). Nutrients leached through volcanic soils contribute formation of unique microbial communities of wall biofilm of cave Daesubee.


ABSTRACT Cyanobacteria produce numerous volatile organic compounds (VOCs), such as β-cyclocitral, geosmin, and 2-methylisoborneol, which show lytic activity against cyanobacteria. Among these compounds, only β-cyclocitral causes a characteristic color change from green to blue (blue color formation) in the culture broth during the lysis process. In August 2008 and September 2010, the lysis of cyanobacteria involving blue color formation was observed at Lake Tsukui in northern Kanagawa Prefecture, Japan. We collected lake water containing the cyanobacteria and investigated the VOCs, such as β-cyclocitral, β-ionone, 1-propanol, 3-methyl-1-butanol, and 2-phenylethanol, as well as the number of cyanobacterial cells and their damage and pH changes. As a result, the following results were confirmed: the detection of several VOCs, including β-cyclocitral and its oxidation product, 2,2,6-trimethylcyclohexene-1-carboxylic acid; the identification of phycocyanin based on its visible spectrum; the lower pH (6.7 and 5.4) of the lysed samples; and characteristic morphological change in the damaged cyanobacterial cells. We also encountered the same phenomenon on 6 September 2013 in Lake Sagami in northern Kanagawa Prefecture and obtained almost the same results, such as blue color formation, decreasing pH, damaged cells, and detection of VOCs, including the oxidation products of β-cyclocitral. β-Cyclocitral derived from Microcystis has lytic activity against Microcystis itself but has stronger inhibitory activity against other cyanobacteria and algae, suggesting that the VOCs play an important role in the ecology of aquatic environments.


This research was intended to investigate on child abuse (physical and sexual) among selected public secondary school students in Nairobi Province. Its objective included the following: to find out the types of physical and sexual abuses they experienced, who among the two genders experienced most abuse, the psychological effects of the abuse, what were the perceived causes of the abuse, what action the abused students had taken and how the abuse had affected their lives as students. The data from the students was collected using stratified sampling and then simple random sampling while from the teachers, interview schedules was used after selecting them using purposive sampling. Then, to analyze, descriptive research design was be used. The findings of the research revealed that: 1. Physical and sexual abuse was prevalent among the secondary school students. 2. The major perpetrators of the abuses were people well known to the victims. 3. A large percentage of the abuses took place at home 4. Most of the abuses remained unreported. 5. Most of the victims did not seek medical treatment. The recommendations of the research include the following: 1. Care should be taken in the discipline of children. 2. Home safety shouldbe ensured to avoid children getting physically hurt. 3. Children need proper counseling on growth and development. ---"c 4. Parents should cultivate a more open relationship with their children. 5. There is need to sensitize, educate and empower children on various ways of handling and reporting cases of abuse. It is hoped that this research will be of help to the Guidance and Counseling teachers in schools, parents who need to understand what is going on with some of their teenagers, the Ministry of Education and to add to what the gender based organizations have researched on previously. CONTENTS (i) Declaration (ii). (ii) Dedication (iii) (iii) Acknowledgements (iv) (iv)Abstract. (v) (v) Table of contents (x). (vi) List of figures, charts and tables (ix) 1. CHAPTER


The behavior of embedded hardware and software systems is determined by at least three dimensions: control flow, data aspects, and real-time requirements. To specify the different dimensions of a system with the best-suited techniques, the formal language CSP-OZ-DC (Hoenicke and Maier, 2005) integrates communicating sequential processes (CSP) (Hoare, 1985), Object-Z (OZ) (Smith, 2000), and duration calculus (DC) (Zhou and Hansen, 2004) into a declarative formalism equipped with a unified and compositional semantics. In this paper, we provide evidence that CSP-OZ-DC is a convenient language for modeling systems of industrial relevance. To this end, we examine the emergency message handling in the European train control system (ETCS) as a case study with uninterpreted constants and infinite data domains. We automatically verify that our model ensures real-time safety properties, which crucially depend on the system's data handling. Related work on ETCS case studies focuses on stochastic examinations of the communication reliability (Hermanns et al., 2005; Zimmermann and Hommel, 2005). The components' data aspects are neglected, though


Infectious diseases have caused historical pandemics in the world. Three strategies, including
sanitation programs, antimicrobial drugs, and vaccines are considered for the prevention and treatment
of infectious diseases. Today, some infectious diseases cause millions of mortalities universally.
Due to the emergence of antibiotic-resistant pathogens, as well as some limitations of traditional vaccines,
focusing on novel strategies is essential. Multi-Epitope Vaccines (MEVs), as a novel strategy,
have been designed based on immunoinformatics methods; epitope prediction by authentic servers,
attachment of epitopes using proper linkers, physicochemical, immunological and structural evaluation
by bioinformatics tools that are basic stages in MEVs designing. Advantages such as cost-effective,
high safety, less time consumption in designing, the application of natural adjuvants, and satisfactory
preclinical evaluation outstand MEVs than other types of vaccines. Therefore, MEVs are promising
vaccines against resistant diseases such as lower respiratory infection and diarrhea.


Carboplatin is one of the most useful and well tolerated cytotoxic drugs for gynecologic malignancies. Hypersensitivity to carboplatin is not rare among patients receiving multiple recurrent treatments with this drug. The aim of the current study was to offer a safe and convenient carboplatin desensitization strategy to patients with a proven allergic reaction to this drug.


Semiempirical Calculations on the Proton Affinity of Unbranched Primary Aliphatic Amines The experimental gasphase proton affinities of some alkylamines are found to correlate with the Mulliken charges on the NHr groups of the corresponding ammonium-cations as calculated by the semiempirical MINDO/3and MNDO-method rather than with the electron density at the nitrogen-atom or the NH2-group of the corresponding Amines. As can be seen from the charges of the NH2-groups of the amines, the alkyl-chains do not exhibit a general positive inductive effect. It is found that the amount of electron density transferred to an attacking proton increases with the length of the alkyl-chains. This effect is similar to the so-called inductomeric effect introduced by Ingold.


In this paper, we consider the problem of finding the MEDLINE articles that describe functions of particular genes. We describe our experiments using the mg system and the partitioning of a graph of biological sequences, structures and abstracts. We participated in the primary task of the TREC 2003 Genomics Track.


The study of Christianity in universities and research institutes is nothing unusual. It is rather remarkable, however, that Christian studies have become established in the cultural and educational system of communist China and have been developing rapidly since the late 1980s. A considerable number of scholars are now pursuing the serious academic study of Christianity and publishing their findings, and are doing so not in seminaries or other ecclesiastical settings but in institutions of the social and human sciences run and financed by the state. Their research includes not only studies of Christianity from historical and sociological perspectives, which may often be considered value-neutral from a religious point of view, but also the production of confessional theology, although the latter is much smaller in quantity than the former. Some scholars who are interested in religion even become committed Christians. In this article I introduce the phenomenon of the production of theology in these circumstances, articulating the factors that make it possible, analysing the nature of the theology produced in this situation and making a theological reflection on the orientation of theology relevant for Asian countries.


Examines budget planning; implementation and performance evaluation practices by utilizing a questionnaire survey of 54 medium and large sized companies located in Bahrain. Most of the companies prepare long‐range plans and operating budgets, and they follow a definite budget procedure and implementation methodology. Uses budget variances to measure a manager's ability, for timely recognition of problems, and to improve the next period's budget. While both the listed and non‐listed companies have reported many similar budget practices, the main differences were specific purposes served by budgets, degree of budget participation, periodicity of variance reporting, and purposes and authority to evaluate budget variance reports. In certain cases, firm size influences budgeting practices. Contributes toward filling a gap in the literature on the use of budgets as a planning and control tool in developing countries. Most prior studies were mainly confined to advanced countries. The study findings suggest the need for research on attitudes held by the budgetees towards the use of budget variances in the context of advanced management accounting techniques.


Objective: In this study, a quality-by-design (QbD) approach was used to develop a betamethasone suspension for injection formulation and to investigate the possible effects of formulation and process variables on the critical quality attributes (CQAs) of the formulation.
Material and Method: It was determined that the CQAs of the formulation were particle size distribution, viscosity, sedimentation time, density and assay of active substances and preservatives, considering the quality target product profile (QTPP). Potential risk factors that may affect the CQAs of the formulation were identified using an Ishikawa diagram, and a six-factor, two-level Plackett-Burman experimental design was used to statistically investigate the effects of selected formulation and process variables. The prepared formulations were tested, and variance and multiple linear regression analyses were performed with the acquired data
Result and Discussion: As a result of the one-way analyses of variance (ANOVA) and multiple linear regression analyses, the established statistical models for the assay of methyl parahydroxybenzoate and propyl parahydroxybenzoate, and viscosity were found to be significant, the established models for other independent variables were not significant. The concentration of carmellose calcium and filter type was found to be the most significant formulation and process variables. In conclusion, this study showed that understanding the formulation and process variables that may affect the CQAs of injectable suspension formulations with a QbD approach could be useful for formulation development and optimization.


Self-scaled barrier functions are an important tool in the study of conic linear programming problems over symmetric cones. They are also closely related to Euclidean Jordan algebras. In the first part of this article we show that every self-scaled barrier function defines a Euclidean Jordan algebra. In the second part we use this algebra to obtain a complete classification of self-scaled barrier functions. In particular we show that the barrier function with the smallest possible self-concordance parameter is unique up to an additive constant and can be written in terms of the determinant of the associated Jordan algebra.


Reproduction is important for sustainable lamb production in Merino sheep. Data from a Merino flock maintained at Elsenburg Research Farm in the Western Cape, South Africa, were used to investigate the genetic parameters for ewe reproduction traits and their relationship with objectively measured wool traits. Traits included number of lambs born during the first lambing opportunity (NLB1), number of lambs weaned during the first lambing opportunity (NLW1), total weight of lamb weaned during the first lambing opportunity (TWW1), number of lambs born during a ewe's lifetime (NLB3), number of lambs weaned during a ewe's lifetime (NLW3), and total weight weaned per ewe's reproductive life (TWW3) Fixed effects of selection line, birth type, sex, age of the dam in years, year of birth, and the sex*birth year interaction had significant effects on all bodyweight and objectively measured wool traits. Only year of birth and selection line affected ewe reproduction traits. Heritability estimates amounted to 0.10 ± 0.03 for NLB1, 0.07 ± 0.02 for NLW1, 0.10 ± 0.04 for TWW1, 0.25 ± 0.04 for NLB3, 0.12 ± 0.03 for NLW3, and 0.18 ± 0.04 for TWW3. Wool traits were moderately heritable at 0.28 ± 0.05 (staple strength) to 0.60 ± 0.03 (clean yield (CY)) and coefficient of variation of fibre diameter (CVFD). Relationships among ewe reproduction traits were high, ranging from 0.74 between TWW1 and NLB3 to 1.00 between NLW1 and TWW1. The genetic relationships of ewe reproduction traits with wool weights and staple length were positive. Fibre diameter (FD) and CY were unfavourably related to ewe reproduction traits. It seems possible to improve ewe reproduction when selecting on NLB, NLW, and TWW in Merino sheep without unwanted correlated response to selection in wool traits, with the exception of FD and CY. Keywords : Bodyweight, heritability, relationships


Abstract This is a retrospective study. Prior studies have characterized the deleterious effects of narcotic use in patients undergoing primary total knee arthroplasty (TKA). While there is an increasing revision arthroplasty burden, data on the effect of narcotic use in the revision surgery setting remain limited. Our aim was to characterize the effect of active narcotic use at the time of revision TKA on patient-reported outcome measures (PROMs). A total of 330 consecutive patients who underwent revision TKA and completed both pre- and postoperative PROMs was identified. Due to differences in baseline characteristics, 99 opioid users were matched to 198 nonusers using the nearest-neighbor propensity score matching. Pre- and postoperative knee disability and osteoarthritis outcome score physical function (KOOS-PS), patient reported outcomes measurement information system short form (PROMIS SF) physical, PROMIS SF mental, and physical SF 10A scores were evaluated. Opioid use was identified by the medication reconciliation on the day of surgery. Propensity score–matched opioid users had significantly lower preoperative PROMs than the nonuser for KOOS-PS (45.2 vs. 53.8, p < 0.01), PROMIS SF physical (37.2 vs. 42.5, p < 0.01), PROMIS SF mental (44.2 vs. 51.3, p < 0.01), and physical SF 10A (34.1 vs. 36.8, p < 0.01). Postoperatively, opioid-users demonstrated significantly lower scores across all PROMs: KOOS-PS (59.2 vs. 67.2, p < 0.001), PROMIS SF physical (43.2 vs. 52.4, p < 0.001), PROMIS SF mental (47.5 vs. 58.9, p < 0.001), and physical SF 10A (40.5 vs. 49.4, p < 0.001). Propensity score–matched opioid-users demonstrated a significantly smaller absolute increase in scores for PROMIS SF Physical (p = 0.03) and Physical SF 10A (p < 0.01), as well as an increased hospital length of stay (p = 0.04). Patients who are actively taking opioids at the time of revision TKA report significantly lower preoperative and postoperative outcome scores. These patients are more likely to have longer hospital stays. The apparent negative effect on patient reported outcomes after revision TKA provides clinically useful data for surgeons in engaging patients in a preoperative counseling regarding narcotic use prior to revision TKA to optimize outcomes.