Burns of the head and neck with or without respiratory tract injury remain a serious and complex problem. Care of patients with this injury requires astute frequent clinical examinations, repeated laryngoscopy or flexible bronchoscopy, and serial laboratory investigations. Superb monitoring and care by the entire burn team with frequent dialogue among the individuals with specialized knowledge, mature clinical judgement in regard to therapy, the long-term follow-up help burn victims survive the injury and achieve the best possible functional ability and cosmetic appearance. There are no simple answers or rote decisions in the management of these injuries. The challenge requires the most innovative and creative care coupled with large amounts of hard work. Many of the recent advances in the management of burns of the head and neck have permitted these patients to survive and have helped them to return as functioning members of society.


The composition of serum seromucoid, the protein fraction of serum not precipitated by 0.6 M perchloric acid, has been shown to vary with the technique of preparation. Immunochemical examination revealed that 91.5% of the protein present in the seromucoid fraction of serum was alpha 1 acid glycoprotein, the remainder consisting of alpha 1 antitrypsin, alpha 1 antichymotrypsin, beta 2 glycoprotein, haemopexin, albumin, and pre-albumin. Serum alpha 1 acid glycoprotein concentration determined by radial immunodiffusion correlated well with serum seromucoid concentration although the former was usually 0.4 g/l lower. The determination of serum alpha 1 acid glycoprotein by an immunological method is more precise than the seromucoid method and is not subject to interference from other proteins.


"Electron-doped"; (Nd, Ce)2CuO4 (NCCO) superconductor thin films were prepared by post-annealing of metallic double-layer films of Nd(Ce) and Cu deposited onto (001) surface of SrTiO3 (STO) substrates in air at 600 to 1100°C. Cross-sectional high-resolution transmission electron microscopy (HRTEM) was used to observe the microstructure of the films. The formation of NCCO crystallites was observed at the film/STO interface, when the post-annealing temperature was higher than 700°C In spite of epitaxial growth of NCCO at the interface, thin films annealed at 700 to 900°C were polycrystalline. Single-crystalline NCCO films with epitaxial relation to STO substrate were obtained by postannealing between 900 and 1000°C. However, in the film annealed at 1050°C, many planar faults and also some buffer layers at the interface were observed in the NCCO crystals. The film annealed at 1100°C contained no NCCO crystal and a secondary phase was observed. From these findings the mechanism of the film growth is discussed.


The objectives of this study were to consider the rate of exchange transfusion (ET) in the newborns at King Chulalongkorn Hospital, Bangkok, from 1994 to 2003, and to evaluate its morbidity and mortality. One hundred and sixty five neonates underwent 183 episodes of ET: In-housed fullterm had ET performed at a younger age than the readmitted/referred infants (72.2 +/- 30.9 vs 150.2 +/- 90.7 hours, p < 0.001), and the in-housed preterm neonates (85.4 +/- 36.7 hours, p < 0. 05). They also had lower mean TsB than those of the readmitted/referred infants when ET was initiated (21.8 +/- 2.1 vs.26. 0 +/- 5.1 mg/dL, p < 0.001). Preterm needed phototherapy after ET longer than fullterm neonates (5.3 +/- 3.2 vs 3.3 +/- 1.7 days, p < 0.001). ABO incompatibility (21.3%), G6PD deficiency (13.4%), both conditions (6.7%), and others (22.2%) were identified as causes of hyperbilirubinemia. Unknown causes accounted for 36.4%. There was no mortality in the present study. Overall rate of morbidity was 15.3% of which 67 percent was infection associated conditions. Preterm suffered additional complications of anemia, apnea and cardiac arrest. Sick infants (31.3%) were more likely to develop complications than healthy ones (6.8%). In the healthy group, preterm were more likely to develop morbidity than fullterm neonates (p = 0.0016), while no significant difference was identified between them in the sick group (p = 0.8). ET causes high morbidity, therefore, it should be initiated only when the benefit of preventing kernicterus outweighs the complications associated with the procedure.


The evolution of the diseases which affect the collagen structures of the eye must be oriented in accordance with the study of the membranes richest in connective tissue—that is, the cornea, which contains more than 90%; the sclera and the iris; the ciliary body; the choroid; the retina, and the optic nerve, which are rich in connective tissue. The vitreous is not included, since it consists of a material similar to collagen. The diseases of these various membranes are worth studying in connection with generalized diseases, since careful observation of the ocular status in these diseases permits one to see exactly what occurs in other regions of the connective tissue, less accessible to direct examination. In a large percentage of cases the ocular involvement appears before the general disease becomes evident; hence the discovery of pathological lesions in the collagen structures of the eye, especially when a specific etiologic factor


Marine seismic exploration with ocean-bottom cable technology is able to record P- and S-wave information simultaneously. Elastic full-waveform inversion (EFWI) uses P- and S-waves to invert multiple parameters with adequate amplitude information and complete illumination of the subsurface. To calculate the wavefield within EFWI, we use different formats of wave equations in fluid and solid mediums and an appropriate boundary condition to convert waves on the interface. This partitioned simulation scheme is more stable and efficient than the traditional integrated simulation scheme. However, if the fluid-solid coupled medium has an extremely irregular interface, the conventional finite-difference method with rectangular grids cannot obtain accurate source and receiver wavefields. We use the curvilinear coordinates to overcome this limitation. In the curvilinear coordinates, the irregular interface can be transformed into a horizontal interface. To reduce the crosstalk of inverted P- ([Formula: see text]) and S-velocities ([Formula: see text]), we derive the gradient formulas of [Formula: see text] and [Formula: see text] based on P- and S-wave mode separation in the curvilinear coordinates, and, finally, we develop a 2D curvilinear-grid-based fluid-solid separated-wavefield EFWI (CFS-SEFWI) method. Numerical examples that include an anomaly model and a modified Marmousi II model demonstrate that CFS-SEFWI overcomes the influence of the irregular fluid-solid interface and efficiently reduces crosstalk effects between [Formula: see text] and [Formula: see text]. Our results also demonstrate that this method is less sensitive to noise compared to the conventional CFS FWI method without separating wave modes.


OBJECTIVE
To determine whether the present aesthetic concepts set forth for rhinoplasty in white patients can be applied to the ethnic variations seen in Latino women and, if not, to develop a reproducible means of analysis to serve as a guide for surgical correction.

DESIGN
Cohort analytic study; criterion standard analysis of nasal aesthetics.

PARTICIPANTS
Ninety-seven Latino women and 40 white women.

INTERVENTIONS
Patients were separated according to geographic area of origin, either the Caribbean, Central America, or South America. Anthropometric measurements were obtained and nasal indexes were calculated. Results were compared with previously reported data for African Americans and whites. All patients underwent complete nasal photographic analysis.

RESULTS
Caribbean subjects showed the greatest divergences from whites and resembled African-American anthropometric norms, whereas Central and South American subjects more closely resembled white norms. Two new aesthetic concepts were developed, the dorsal nasal breakpoint and the horizontal nasal axis, which have implications for aesthetic rhinoplasty. The breakpoint is a pivotal point along the nasal dorsum, structurally determined, which was found at different locations in all the groups studied. Caribbean subjects had breakpoints approximately halfway down the dorsum. Central and South Americans had breakpoints about two thirds of the way down the dorsum, and whites had breakpoints three fourths of the way down the dorsum. The horizontal rotation axis is present along a plane that connects the top of the ala with the tip. Rotation of the tip about this axis affects both the characteristics of the dorsal breakpoint and the final appearance of the nose.

CONCLUSIONS
In general, Latino noses can be anthropometrically categorized as mesorrhine. When the geographically derived groups were examined individually, the Latino nose ranged from subplatyrrhine to paraleptorrhine. Surgical correction should be individualized, as each group requires correction of different nasal features. The dorsal breakpoint and the horizontal axis plane can act as nasal profile guides for surgical modifications that would achieve the current concept of the aesthetic nose.


Research on the enlargement conditionality of the European Union sustains opposite positions on the question of whether it represents a means of coercion or an invitation to voluntary adaptation. However, it reveals no dialogue between advocates of these opposed views. In an attempt to replace this gap in communication with a research agenda, this article undertakes a theoretical investigation of the main arguments for regarding compliance with conditionality either as an effect of coercion or as a voluntary choice. It is found that both of these views are worth taking seriously but also that they are premature and in need of further theoretical and in particular empirical clarification. It is suggested, moreover, that coercion and voluntary adaptation are best viewed as complementary rather than competing descriptions of complying with conditionality.


In this study, 11 commercial samples in the Malaysian market consisted of 10 fermented milk beverage and one acidified milk beverage were analysed for their proximate analysis, pH, titratable acidity (TA), brix, viscosity, colour, particle size and sensory evaluation. This study was conducted to get an overview on the physico-chemical properties and sensory evaluation of the fermented and acidified milk beverages in order to produce palm-based acidified milk beverage. Energy content of these samples were ranged between 33.50-73.00 kcal/100 g. Fat, carbohydrate and protein contents were ranged between 0.00-2.54 g/100 g, 7.52-15.75 g/100 g and 1.98-2.10 g/100 g, respectively. All of the commercial samples were observed to be insignificant in sugar and ash content. The pH, TA and brix of the samples varied from 3.50%-4.20%, 0.27%-0.72% and 9.40-18.90°B, accordingly. Colour (L*, a* and b*) varied significantly among the commercial samples. Viscosity and particle size were ranged between 0.022-0.063 Pa.s and 0.45-20.11 μm, respectively. Preferred sample based on sensory evaluation was commercial sample D (fermented). The characteristics of commercial samples B, D and E can be used as guidelines in formulating palm-based acidified milk beverage.


Despite the sociological relevance of human mobility between nation-states, our knowledge about its planet-scale structure is still limited. Here, geographic mapping, algorithm-based community detection, network visualization, and conventional line plots are combined to display the network structure of 2.3 billion estimated trips between countries worldwide in 2016, together with information about the (non)evolution of this structure over time. The graph reveals that transnational mobility is highly regionalized: 80 percent of all human movements between countries occur within world regions. Despite strong increases in the absolute amount of transnational mobility, this share remains extremely stable between 2011 and 2016. The community detection algorithm reveals six mobility clusters that clearly correspond to world regions: Africa, Asia and Oceania, the Americas, Eurasia, Europe, and the Middle East. This stable, regionalized structure suggests that a fully globalized "world society" is unlikely to emerge, as social ties remain parochial, even in the transnational sphere.


Step by step operations by which we make a group of objects in which attributes of all the objects are nearly similar, known as clustering. So, a cluster is a collection of objects that acquire nearly same attribute values. The property of an object in a cluster is similar to other objects in same cluster but different with objects of other clusters. Clustering is used in wide range of applications like pattern recognition, image processing, data analysis, machine learning etc. Nowadays, more attention has been put on categorical data rather than numerical data. Where, the range of numerical attributes organizes in a class like small, medium, high, and so on. There is wide range of algorithm that used to make clusters of given categorical data. Our approach is to enhance the working on wellknown clustering algorithm k-modes to improve accuracy of algorithm. We proposed a new approach named "High Accuracy Clustering Algorithm for Categorical datasets".


We demonstrate here the use of high-speed semiconductor lasers and detectors with low loss optical fiber for the transmission of the 500-MHz C-band microwave signal spectrum to and from a satellite antenna. The optical system has low attenuation and large band, width, so the microwave signals can be transmitted directly at the microwave frequency (4 or 6 GHz) over 20 km of fiber without regeneration or qualization. The optical system introduces ≈ 1 dB or less of degradation for both low spectral density QPSK signals and high spectral density FM video signals present in typical satellite transmission systems. For the video signals, the signal to noise after AM conversion was reduced from 56 to 55 dB. The microwave drive level to the laser must be significantly larger (typically > -10 dBm) than the intensity noise of the laser, yet small enough (typically < 10 dBm) to reduce the intermodulation distortion signals to an acceptable level. The laser bias current must be several times threshold so that the resonance frequency is beyond the frequency band of interest (4-6 GHz in this case). A flat modulation response is then obtained, and the intensity noise and intermodulation levels are low.


A total of 50 elderly individuals and 48 college students were tested on several measures of processing speed and of working memory capacity. Language processing was tested with an on‐line measure of sentence processing efficiency, an end‐of‐sentence acceptability judgement task, and a paragraph comprehension test. Elderly individuals performed more poorly than college students on the speed of processing and working memory measures and had longer listening times overall on the sentence processing measures. Elderly individuals did not, however, have overall longer listening times at the most capacity‐demanding regions of the harder sentence types. Correlational analyses failed to establish a relationship between the increase in syntactic processing load at the capacity‐demanding region of the harder sentence type and the measures of working memory capacity, but did establish a relationship between paragraph comprehension and working memory capacity. The data are argued to provide evidence that the WM system used to structure sentences syntactically is separate from that used in other aspects of language comprehension.


Adler's theory was developed between 1912 and 1937. Today those ofus within the Adlerian group, and others who are in sympathy with us, remain impressed with the validity and importance of his contributions. We are aware, too, that originators of recent theories, researchers, and practitioners rediscover and re-apply these revolutionary and fruitful ideas to their own work, without full cognizance of their origin. I should like to elaborate on those Adlerian concepts which have been most useful in the macrocosm of the mental health movement which is presently tending toward community psychiatry, as well as in the microcosm of the psychotherapist's office.


The propagation velocity of sound is often used to measure temperature. The sound probe has the advantage of non-contact sensing and quick response. By combining a sound probe with computerized tomography (CT) and data interpolation, an image of temperature distribution through space can be reconstructed. We have proposed a method for measuring the temperature distribution in two-dimensional space using an acoustic CT (A-CT) method with a very small number of acoustic transducers. The measured object is a circular space with a radius of 1,480 mm. Sixteen transducers are installed on the circular stage. Without a mechanical motion, projection data for the reconstruction is acquired by electronic scanning. We reconstruct the temperature distribution by interpolation from a small number of data set. Electrical heaters create a temperature gradient in space. The temperature profile is measured by 19 thermocouples and used for a computer simulation. Experimentally reconstructed images are in agreement with the simulated images. The measurement system proposed in this paper has advantages for use in atmospheric monitoring, air conditioning and heat management.


The functioning of a living cell is largely determined by the structure of its regulatory network, comprising non-linear interactions between regulatory genes. An important factor for the stability and evolvability of such regulatory systems is neutrality — typically a large number of alternative network structures give rise to the necessary dynamics. Here we study the discretized regulatory dynamics of the yeast cell cycle [Li et al., PNAS, 2004] and the set of networks capable of reproducing it, which we call functional. Among these, the empirical yeast wildtype network is close to optimal with respect to sparse wiring. Under point mutations, which establish or delete single interactions, the neutral space of functional networks is fragmented into ≈ 4.7 × 10 components. One of the smaller ones contains the wildtype network. On average, functional networks reachable from the wildtype by mutations are sparser, have higher noise resilience and fewer fixed point attractors as compared with networks outside of this wildtype component.


BACKGROUND & OBJECTIVE: The aim of this retrospective study was to find the prevalence of coronary artery disease (CAD) in hypertensive patients with or without diabetes mellitus.
METHODOLOGY: Data of patients having essential hypertension (n=931) referred to PINUM from April 2017 to December 2018 for stress/rest cardiac MIBI scan was analyzed. This data was divided into two groups. HD group contains data of patients having hypertension with diabetes mellitus (n=456, 48.98% of total population, M:F=245:211). While data of patients having hypertension without diabetes mellitus was placed in H group (n=475, 51.02% of total population, M: F=254:221).
RESULTS: Prevalence of CAD is higher in HD group than in H group (47.8% vs. 30.1%; p<0.001). CAD is more prevalent in males than females in both groups (53.9 % vs. 40.8% in HD group, and 39.4% vs. 19.5% in H group). This difference in prevalence of CAD in HD and H groups is more marked in females (40.8% vs. 19.5%; p<0.001) than males (53.9 % vs. 39.4%; p=0.001). Prevalence of CAD in patients with typical presentation is not statistically significant in HD and H groups (72.3% vs. 68.4%; p=0.645), while in subjects with atypical presentation prevalence is significantly higher in HD group than H group (40.8% vs. 26.8%; p<0.001).
CONCLUSION: Prevalence of CAD is higher in the group of patients having essential hypertension with diabetes mellitus than the group of patients having essential hypertension without diabetes mellitus.


Scarcity in fossil fuel and other environmental issues forced researchers to search ways to improve in the efficiency of the marine vehicle which is considered the most efficient and economic transport medium now a day. Energy saving device (ESD) is such an implementation to keep dominant impact in this aspect. This paper investigates the effect of aerofoil shape propeller boss cap fin (PBCF) as ESD computationally. Based on Reynoldsaveraged Navier-Stokes (RANS) equations, numerical simulations have been performed to increase propeller efficiency with aerofoil shape propeller boss cap fin in computational fluid dynamic (CFD) approach. In this study, four separate aerofoil shape PBCF with different NACA profile (NACA4412, NACA0012, NACA1412, NACA2412) has been used to find a suitable profile for PBCF. Numerical results shows aerofoil shape PBCF with NACA4412 effectively improves propeller performance by improving the efficiency by approximately 3.52% than parent propeller. The pressure distribution elaborate PBCF (NACA4412) creates a high pressure difference between the pressure side and suction of the propeller as well as high thrust generation. Besides that velocity filed, swirl strength are also studied to get and understand the details of involved flow phenomenon.


Essential hypertension (EH) is a clinically frequent cardiovascular disease, with insidious onset, causing increased pressure load and neuroregulation disorders in patients. Long-term EH can cause left ventricular hypertrophy (LVH), which can lead to arrhythmia and even death. The soluble suppression of tumorigenicity 2 (sST2), matrix metalloproteinase-3 (MMP-3), and galectin-3 (Gal-3) in serum plays an important role in the occurrence, development, and prognosis of cardiovascular diseases. In our study, we divided EH patients into 3 levels and groups with or without LVH, according to their condition. The levels of sST2, MMP-3, and Gal-3 in the serum were measured in different groups of patients. Our results showed that the levels of sST2, MMP-3, and Gal-3 in the serum increased progressively with the level in different EH groups. The levels of sST2, MMP-3, and Gal-3 in the serum of the LVH group were higher than those of the NLVH group, and it is positively correlated with LVH-related indexes. The risk of developing and progressing to LVH in patients with EH can be determined by the method of measuring three indicators.


The effects of artificial aniseikonic errors on the moving-rod type of depth-perception test were studied in two subjects. Aniseikonia in the horizontal meridian produced a constant error in the setting of the movable rod whose direction and magnitude varied with the direction and magnitude of the aniseikonia. In the Howard-Dolman test the constant errors were only one-third to one-half those predicted from the binocular disparity. In a modified test in which opposing monocular cues were eliminated, the settings showed the expected constant errors of about 65 mm for each one percent difference in the size of the ocular images. The mean variation about the average position of subjective equidistance showed considerable day-to-day variation.


Prior research has found that toddlers will form enduring artifact categories after direct exposure to an adult using a novel tool. Four studies explored whether 2- (N=48) and 3-year-olds (N=32) demonstrate this same capacity when learning by eavesdropping. After surreptitiously observing an adult use 1 of 2 artifacts to operate a bell via a monitor, 3-year-olds returned to the demonstrated kind of tool as "for" the task and avoided it for an alternative task over 2 days. Two-year-olds performed similarly after eavesdropping on someone with more discriminable artifacts via the method of a window rather than a monitor. These results demonstrate that toddlers can acquire enduring artifact categories after less than 40 s of surreptitious observation.


The Plasimo code is a toolbox that provides support for the numerical simulation of plasma sources of various degrees of equilibrium. It comes with a number of electromagnetic modules, flow solvers, modules for calculating transport coefficients, radiation transport and for the generation of ortho-curvilinear coordinate systems. Plasimo supports transient and steady-state simulations of plasma sources in one-, two and three-dimensional geometries. This paper presents a selection of Plasimo's sub-models. A discussion of the physics behind each module is accompanied by notes about the module's capabilities and limitations and by references to original works and papers in which that particular module was used. As such, it provides a good entry point for people who consider using Plasimo—or parts of it—for their simulation needs.


Between 1959–62 the Wenner-Gren Center in Stockholm was built to promote international cooperation in scientific research. It includes a 25-story tall building, where the steel frame, abandoned in Sweden since before the First World War, was reintroduced as a construction method. Reinforced concrete dominated the Swedish building industry in the post 1945 era. Before constructing the high-rise, building-methods were discussed, evaluated and tested. During construction the building complex was reported in newspapers, described in trade magazines and mediated through a 15 minute long documentary. This puts into focus how aspects of the production of this building extend beyond what is usually thought of as the building site. My paper argues that the building project includes several sites of production where technical know-how, a new project process and the presence of the media created a space of possibility, within which steel was the medium.The steel lattice truss relied on constructional knowledge from the 19th century. However, a building form that narrowed towards the top and a rhombic footprint challenged designers and contractors in matters of precision, statical calculations and prefabrication. The Wenner-Gren Center signifies a modern trend towards the use of highly skilled experts, dealing with new materials and processes, coping with the lack of norms, and with their own inexperience. This draws attention to the non-simultaneity of a project where construction takes place in different modes at several sites. Steel as a material caused architecture to make use of traditional building methods, such as welding while also implementing new methods of assembly. How do we understand the role of material within the frame of non-simultaneity?


Introduction . The article is a brief presentation of the most important general results of the second DAWN study conducted among patients with diabetes, families of people with diabetes and professionals involved in the treatment of diabetes in 17 countries as well as results in Poland in the context of the results obtained in other countries. Material and methods. The study involved more than fifteen thousand participants from 17 countries. The patients and family members were contacted via the Internet, by phone or in person. Medical professionals filled questionnaires sent via Internet. Questionnaires adapted from previous DAWN studies as well as developed specifically for the purpose of this study were used to collect data. Results. The study involved 8596 adult patients with diabetes. The percentage of patients with likely depression [WHO-5 Well-Being Index (WHO-5) score ≤ 28] was 14.8%, with 19.2% in Poland. Diabetes-related distress [questionnaire score Problem Areas in Diabetes Scale 5 (PAID-5) ≥ 40] was declared by 41.1% (in Poland 56.7%) of patients and the negative impact of the disease, in regards to their physical health, was declared by 61.2% of respondents (72.1% in Poland). The family members study group consisted of 2057 subjects among whom an average of 33.7% evaluated the care of the patient as a burden (in Poland 47.1%). Concerns about a person with diabetes reported a significant percentage of family members, most of which, 62.1%, were related to episodes of hypoglycaemia (in Poland 65.2%). Family members declared their desire for higher involvement in the care of patients — 38.7% (in Poland, 31.6%) as well as greater involvement in the patient's emotional problems associated with the disease, 45.6% (41.4% in Poland). The medical professionals study group consisted of 4785 subjects providing medical care for patients with diabetes. In most, an average of 85.4% of respondents believed that shared responsibility increases the efficiency of diabetes treatment (in Poland 86.6%). The most important areas of self-management were: improvement in healthy eating 91.6% (in Poland 94.8%) and increased physical activity — 93.4% (in Poland 95.7%). The organization of healthcare was evaluated as good on average by 27.6% respondents, but only by 8% in Poland. The need for better availability of diabetes nurse specialists was expressed by 66.3% of respondents (in Poland 76.8%); the need of better team communication — 57.6% (in Poland 67.6%); improved access to psychological and psychiatric consultations 59.7% (in Poland 74.7%). Conclusions . There were significant differences between countries observed regarding each parameter, but there was no country which results as a whole were better or worse than others. Research at the international level with the use of psychometric indicators can help identify both the obstacles and opportunities for the effective treatment of diabetes.


The Estacao Biologica de Caratinga is located in the Atlantic dominium, The climate is seasonal with a humid hot season (October-March) and a dry cold season (April-September). The soil is alic Yelowish-Red Latosol. The gap studied is located on the top of a hill, where there are small scattered trees, a large amount of dead bunches of Pteridium aquilinum, herbs, and saplings of tree species. The position of each individual was mapped, and its height and circunference were recorded in a plot of 500m2. Two samples were made by the same method, the first in October 1989, and the second in October 1990. A small variation in density (657 to 668 individuals, respectively) as well as in the composition of the species was verified. Mabea fistulifera (the specie with the highest density in both samples), Bauhinia fusco-nervis, Mikania sp. and a non-identified species of Gramineae increased in density, while Pteridium aquilinum (the second highest density), Ferdinandusa cf. rudgeoides e Vis mia sp. decreased in density. The presence of dead bunches of P. aquilinum, saplings of the species common to the sorrounding forests and the existence of P. aquilinum populations nearby all suggest that the gaps are in an intermediate stage between the decline of the population of P. aquilinum and the occupation of the area by the species od the forest.


Aim of the study The aim of our research was to examine the influence of single whole-body cryostimulation (WBC) on chosen immune system indicators including the heat shock protein HSP-70. Material and methods The study was carried out among ten young and healthy men (mean age 22.4 ±1.65, with a body mass index of 22.91 ±2.39 kg/m2). The participants were subjected to single whole-body cryostimulation (at –130°C temperatures) in a special cryogenic chamber for 3 minutes. Blood samples were collected three times: before cryostimulation, 30 minutes and 24 hours after WBC. Immunoglobulins (IgA, IgG, IgM), interleukins (IL-6, IL-10, IL-1β) and the heat shock protein (HSP-70) were determined in the blood serum. Results As a result of a single exposure to cryogenic temperatures, a significant increase in the level of IL-6 was observed 30 minutes after the WBC (p < 0.05) and a decrease in the level of HSP-70 24 hours after the treatment (p < 0.05). There were no significant changes in the level of interleukins (IL-10, IL-1β) or immunoglobulins 30 minutes after a single WBC treatment or 24 hours later. Conclusions Detailed analysis of the issue shows that a single application of whole-body cryostimulation causes a small, modulating effect on the IL-6 level. Single whole-body cryostimulation treatment has also a slight silencing effect on the HSP-70 level in healthy, young men. Reduction in the concentration of HSP-70 24 hours after WBC may indicate lack of the damaging impact on the spatial structure of the protein due to cryogenic temperatures.

https://www.termedia.pl/Journal/-10/pdf-33409-10?filename=Changes in chosen immune.pdf


Spatio-temporal scene graph generation is an essential task in household activity recognition that aims to identify human-object interactions. Constructing a dataset with per-frame object region and consistent relationship annotations requires extremely high labor costs. Existing datasets sparsely annotate frames sampled from videos, resulting in the lack of dense spatio-temporal correlation in videos. Additionally, existing datasets contain inconsistent relationship annotations, leading to the problem of learning ambiguous temporal associations. Moreover, existing datasets mainly discuss relationships that can be inferred from a single frame, ignoring the significance of temporal associations. To resolve those issues, we created a simulated dataset with per-frame consistent annotations and introduced a range of relationships requiring both spatial and temporal context. Most existing methods explore spatial correlations within single images and do not explicitly consider the dynamic changes across frames. Therefore, we proposed a tracking-based approach that explicitly grasps spatio-temporal human-object interactions while simultaneously localizing humans and objects. Our proposed approach achieved state-of-the-art performance on scene graph generation and outperformed existing methods in scene graph localization by large margins on the proposed dataset. Moreover, the experiments show the efficacy of pre-training on the proposed dataset while adapting to a previous benchmark consisting of real daily videos, indicating the potential of the proposed dataset in real-world scenarios.


Objective The aim of this study is to investigate the value of ultrasound combined with computed tomography (CT) in identifying early low-grade appendiceal mucinous neoplasm and appendicitis. Methods Patients with early low-grade appendiceal mucinous neoplasm and appendicitis from September 2017 to September 2021, including 40 patients with low-grade appendiceal mucinous neoplasm and 40 patients with appendicitis, were collected in this study. Clinical data as well as ultrasound and CT findings of all patients were retrospectively analyzed. Univariate and multivariate logistic regression analyses were applied to establish the ultrasound model, the CT model, and the combined model. Results The nomogram showed that specific characteristics of CT were dilated appendiceal diameter and clear surrounding fat space in the low-grade appendiceal mucinous neoplasm and that specific characteristics of ultrasound were thin or clear layer appendix wall and flocculent echo in the appendix cavity. These four features were used to construct a nomogram for predicting early low-grade appendiceal mucinous neoplasm, and the area under the curve value was 0.839. Conclusion Ultrasound combined with CT for diagnosis of early low-grade appendiceal mucinous neoplasm has a significant value; when found significantly dilated appendix in the lower right abdomen, with thin wall, wall calcification, clear surrounding fat space, and progressive enhancement, especially non-specific symptoms similar to appendicitis, the physician should timely consider the possibility of low-grade appendiceal mucinous neoplasm.


ABSTRACT This study is an attempt to capture the impact on, and sentiments of hotels induced by, COVID-19 pandemic in the Emirate of Sharjah, the third largest emirate of United Arab Emirates (UAE) and also propose plausible strategies to recover from the on-going crisis. The study used critical realism meta-theory as ontological and epistemological assumptions and triangulation in mixed method research design. The data were collected from the General Managers of different categories of hotels operating in the emirate through a questionnaire survey for quantitative analysis and in-depth interviews for interpretative phenomenological analysis. The study finds that managers of 3- and 4-star hotels feel they are more severely affected, have more negative sentiments on the performance of hotels, and will take longer time to recover from the crisis as compared to 5-star and deluxe hotels. This study suggests that building financial capability, brand support and customer base are the promising strategies for the hotels to overcome from such a crisis. Exclusivity of the study lies in the application of pragmatism in its methodology. The findings are valuable for hotels, government and other stakeholders of the hospitality sector to overcome from the crisis.


This article describes strategies to develop the professional competence of PAI educators or teachers to prepare a quality teaching and learning process (quality). People who play a big role in education are teachers or educators. Indonesia has higher teacher education which creates graduates to become quality educators, transmitting knowledge to students. Thus, when on duty, teachers must have professional competence and attitude in teaching students. Professional teacher competencies are the kinds of skills needed to make you a professional teacher. While quality learning is a series of learning activities that make learning not difficult, not boring, enthusiastic, and able to achieve the desired goals of the teaching and learning process. In the teaching and learning process, teachers need to be trained to develop professional competencies in order to improve the quality of learning. The teacher's professionalism development strategy to achieve the goal of quality or quality learning includes: Always providing examples of personality values, understanding the pedagogical foundations and developing competency skills and skills, designing and making developments on learning practice tools, mastering and implementing teaching and learning process programs, have an academic minimum of Diploma IV or Bachelor's Degree, change the paradigm of bureaucracy, and carry out research.


We present design strategies of high-voltage tolerant I/O circuits for interfaces of 3.3 V or higher. The test vehicle is a USB 2.0-compliant I/O circuit. This is a challenging example because USB 2.0 requires substantial over-voltage tolerance from -IV to 5.25 V. In addition, USB 2.0 requires continuous monitoring of this condition and protection when no power is present. The proposed concept is demonstrated in a 90 nm CMOS process.


In this paper we discuss extending Czech WordNet with verb
synsets coming from the Verbalex database of Czech valency
frames. One of the main tasks involved is linking newly added
verb synsets to their Czech hypernyms and their English
counterparts in Princeton WordNet. To spare the human
lexicographers from tedious work, and to make the task more
efficient, we have developed WordNet Assistant, a software tool
that helps locate the relevant synset(s) in the already
existing structures. According to our experience so far, this
tool is of great advantage when incorporating new synsets to
Czech WordNet, and we regard it as a worthwhile facility when
extending WordNets also for other languages.


Background and Objectives The anesthetic technique used during surgery can affect postoperative length of stay and outcomes, even after controlling for other clinically important factors. This study evaluated the impact of regional anesthesia (RA) compared with general anesthesia (GA) on the amount of time between leaving the operating room and hospital discharge and the odds of in-hospital mortality. Methods Surgical patients admitted after surgery, who received RA, were matched to patients who received GA by propensity score in a 1:4 ratio. We measured the association between anesthetic technique and time to hospital discharge using Kaplan-Meier methods. In-hospital mortality was analyzed using a generalized estimating equation logistic regression model. Results A total of 5870 inpatient surgical cases were analyzed; 1174 cases received RA and 4696 cases received GA. The median time to hospital discharge among patients who received RA was 67.6 hours compared with 71.9 hours among patients who received GA (P < 0.0001). A total of 86 cases died in the hospital after surgery; 7 were in the RA cohort and 79 were in the GA cohort. Receiving RA during surgery was associated with 64% lesser odds of dying in the hospital (odds ratio, 0.36; 95% confidence interval, 0.16–0.75), when adjusting for the number of postoperative days spent in the hospital. Conclusions The study data provide evidence that median time to discharge is shorter when RA is used instead of GA, controlling for other clinically important factors. Additionally, RA use during surgery was associated with a decrease in in-hospital mortality. When an appropriate option, RA may facilitate faster hospital discharge and improve patient outcomes.


The ordered amyloid‐like organization of protein aggregates was obtained using for their formation the rigid fibrillar nanostructures of Congo red as the scaffolding. The higher rigidity of used dye nanoparticles resulted from the stronger stacking of molecules at low pH (near the pK of the dye amino group) because of the decreased charge repulsion. The polylysine, human globin, and immunoglobulin L chain were arranged in this way to form deposits of amyloid properties. The scaffolding was introduced simply by mixing the dye and proteins at a low pH or the dye was used in the preorganized form by maintaining it in the electric field before and during protein addition. The polarization and electron microscopy studies confirmed the unidirectional organization of the complex. The precipitate of the complex was used for studies directly or after the partial or complete removal of the dye. The results suggest that the process of formation of amyloid‐like deposits may bypass the nucleation step. It is possible if the protein aggregation occurs in unidirectionally organized (because of scaffolding) assembly of molecules, arranged prior to self‐association. The recognition of the structure of amphoteric Congo red nanoparticles used for the scaffolding was based on the molecular dynamics simulation.


ABSTRACT In this work, we study the stabilization behavior of micro-diffusion flame of n-heptane formed in a combustor with the inside diameter of 4 mm, in order to elucidate the unique stability mechanism due to miniaturization of diffusion flame downstream porous medium. Effects of incoming Reynolds number and fuel flow rate on overall flame shape, exhaust temperature, and wall temperature are examined experimentally. Furthermore, an energy balance model of the micro combustor is established and optimal working conditions are proposed. Liquid n-heptane is used as fuel and two types of outer tubes are employed in order to examine the role of the heat recirculation. It turns out that the outer tube increases the wall temperature and broadens the flame stability limits. The incoming Reynolds number changes flame position and energy balance in the micro combustors. At low Reynolds number, the outer tube allows the flame to stay close to the porous medium and, accordingly, the porous medium is substantially heated up. Then, the fuel flowing through the porous medium "receives" the heat from the burner (heated by flame) effectively to enhance the reactivity, resulting in improving the stability. At high Reynolds number, the outer tube allows the flame to stay close to the bottom wall of the outer tube and, hence, more radiative heat is transferred through the outer tube, ideal for micro-photovoltaic systems. Additionally, in the case of fixed equivalence ratio, with increasing of the fuel flow rate, combustion releases more heat and the flame is blown toward the bottom of the outer tube. More energy is transferred to the surroundings via the outer tube wall and the maximum value is up to 72.7% of the total combustion heat release.


The main objective of this study was to assess the profiler gain validation technique as an alternative method for validating laser profilers that measure road roughness. The study sought to identify a suitable reference profiler against which other profilers are assessed. A series of field tests were undertaken to address the main objective of this study, where the Walking Profiler (WP) was used as the reference device as a comparison to Laser Profilers A and B in measuring IRI roughness over five test sites with varying roughness and texture. These field tests did not conclusively confirm the profiler gain validation technique. The field test suggests that the profiler gain validation technique should be conducted under a standard test speed for the profiler which can be maintained and allows repeatable tracking of the profiler to minimise variation in the auto-spectral density plots.


Limitations of traditional statistic methods used in weather predicting are analyzed.And the basic theory of k-Nearest Neighbor(k NN) is briefly introduced.Seven factors from high altitude are picked up according to the physic mechanism of hail′s generation.Based on the 248 intact examples of 8 consecutive years,k NN is used to predict hail in Tongchuan in May.Experiment shows k NN′s better performance(the best TS reaches to 0.444).The data in 2005 and 2006 are picked up to do further experiment using the preferred model.Its TS is superior to that of SVM,ANN and the traditional methods which are used by many forecasters.At last,the experiments' results are analyzed,and the applications of k NN in weather broadcasting are further analyzed.


In the last century ice bodies have changed significantly worldwide in response to climatic changes, apparently enhanced during the last decades, presumably owing to anthropogenic influence. Shrinkage of glaciers in the northern latitudes has been extensively documented; however, the behavior of glaciers in tropical or inter-tropical latitudes has been difficult to document. In Mexico, small glaciers are present in the highest mountains: Citlaltdpetl (5675 m), Popocatepetl (5452 m) and Iztaccthuatl (5286 m), all of them volcanoes. The glaciers of Mexico offer important clues about climate change at this latitude. Current inventory and monitoring of Mexican glaciers includes determination of glaciated areas and volumes. A survey has been carried out using ground-penetrating radar in order to get a figure of thickness and a preliminary volumetric estimate of an ice body of IztaccIhuatl volcano named Ayoloco glacier. A radar profile 415 m in length was obtained at a mean altitude of 5000 m with an azimuth of 190°, in a relatively flat area known as La Panza on top of the mountain. 100 Mhz antennas were used in the reflection mode with a separation of 2.5 m and a step-size of 2.5 m. A common mid-point survey was performed comprising 12 stations, at 0.5 m steps, to determine the wave velocity propagation in the ice-rock mixture that constitutes the glacier. Results yield a value of 0. 17 m/ns, which is close to the reported value for ice of 0. 1 6 m/ns. We find a layered structure perturbed by faulting at various inclinations, and an interface between the glacier and the underlying rock along a concave surface, shallow at the profile's extremes. There appears to be a transition at 50 m depth, from brittle to ductile ice. Since Iztaccihuatl volcano has many craters near the summit, we infer that this profile reveals the shape of one of the craters, which has been filled by the glacier's ice and a mixture of rock fragments and volcanic debris. The estimated upper volume of the Ayoloco glacier is 10.04 x 106 m3; this figure will have to be revised when more, perpendicular GPR transects are performed.


Abstract Surfaces of a natural sample of arsenopyrite (FeAsS) were oxidized by a range of inorganic oxidants, and the resultant surface alteration products studied using various spectroscopic techniques. The oxidants used were air during heating to relatively low temperatures (150°C), steam, ammonium hydroxide, hydrogen peroxide, and sulphuric acid. Electrochemical oxidation in water was also undertaken. X-ray photoelectron spectroscopy (XPS), Auger electron spectroscopy (AES), and spectral reflectance measurements, were used to characterize the surface compositions. New data are proposed for the binding energies of core electrons in arsenopyrite based on the fitted XPS spectra: 706.9 eV for the Fe 2p 3/2 level, 161.2 eV for the S 2p level, and 40.7eV for the As 3d level. Spectroscopic analyses of the surfaces following oxidation indicated a range of iron oxides and hydroxides (Fe1−xO, Fe3O4, Fe2O3, FeOOH and Fe(OH)3), arsenic oxides (As2O3 and As2O5), sulphur and iron sulphates (FeSO4, Fe2(SO4)3). The relative proportions of the different phases present in the surface layer are related to the strength of the oxidant employed and, where relevant, the Eh/pH conditions prevalent during oxidation. The conclusions regarding the nature of the oxidation of arsenopyrite are discussed in relation to arsenopyrite extraction by flotation and leaching, and the breakdown of arsenopyrite in natural systems.


Perovskite light converting layers optimization for cost-efficient white light emitting diodes (LED) was demonstrated. High excitation independent internal quantum efficiency (IQE) of 80% and weakly excitation dependent PL spectra suitable for white light generation were obtained in the mixed cation CsxMA1−xPbBr3 perovskite nanocrystal layers with optimal x = 0.3 being determined by effective surface passivation and phase mixing as revealed by x-ray diffraction. Enhancement of the PL homogeneity and the external quantum efficiency (EQE) were secured when using 2,2′,2″-(1,3,5-Benzinetriyl)-tris(1-phenyl-1-H-benzimidazole (TPBi) additive in the layer preparation process. Excitation dependent PL intensity, decay time, and IQE revealed that the high emission efficiency of the layers originates from a dominant radiative localized exciton recombination (130 ns) weakly influenced by the nonradiative free carrier recombination (750 ns). Warm and cool white LEDs with correlated color temperature 3000 K and 5600 K, and color rendering index 82 and 74, respectively, were realized by using the optimized perovskite layers, poly[2-methoxy-5-(2-ethylhexyloxy)-1,4-phenylenevinylene] (MEH-PPV) red emitter and a blue LED.


In this paper, Au-modified three-dimensionally ordered macroporous ZnO:In (3DOM Au–ZnO:In) was synthesized by a one-pot method using a PMMA colloidal crystal template. The 3DOM ZnO:In with uniformly dispersed Au had large specific surface areas and highly ordered pore structures. The ethanol-sensing properties of 3DOM Au–ZnO:In were investigated and the sensor based on the 0.050 mol% Au-loaded 3DOM ZnO:In exhibited the highest sensitivity (∼240) to 100 ppm ethanol at the optimum operating temperature of 250 °C. Moreover, the fabricated sensor exhibited excellent selectivity and good stability. Therefore, the Au-modified 3DOM ZnO:In is a promising material for a novel ethanol sensor. The reason for the improvement of the sensitivity was investigated. The large surface area of the 3DOM structure was beneficial for gas adsorption and transfer, and In-doping can increase the electron carrier concentration. Moreover, Au modification enhanced the content of adsorbed oxygen, and thus resulted in a thick depletion layer and high sensitivity.


Opaque and semitransparent dc magnetron-sputtered ZrN films on glass and silicon have been optically characterized with spectral reflectance measurements and ellipsometry. High rate sputtered ZrN has good optical selectivity, i.e., higher than 90% infrared reflectance and a pronounced reflectance step in the visible to a reflectance minimum of less than 10% at 350 nm. The results are comparable with those obtained for single crystalline samples and those prepared by chemical vapor deposition. The complex optical constant (N = n v ik) for opaque films has been determined in the 0.23-25-µm wavelength range with Kramers-Kronig integration of bulk reflectance combined with oblique incidence reflectance for p-polarized light. A variable angle of incidence spectroscopic ellipsometer has been used for determination of the optical constants in the 0.28-1.0-µm wavelength region. The results of the two methods show excellent agreement. The results indicate that ZrN is free electronlike and the Drude model can be applied. The best opaque films had Drude plasma energies (ħω(p) between 6.6 and 7.5 eV and relaxation energies (ħ/τ) between 0.29 and 0.36 eV. Ellipsometer data for the semitransparent films show that the refractive index (n) in the visible increases with decreasing film thickness whereas the extinction coefficient (k) is essentially unchanged. The optical properties are improved by deposition upon a heated substrate.


In Drosophila melanogaster the interactions of the P-M system generate germ-line aberrations (e.g., sterility, mutations) found in certain interstrain hybrids. Two wild populations, from France and Tunisia, were examined in order to determine the distribution of the chromosomal P factor and the extrachromosomal cytotypes. No P factors active for potential GD sterility were found in these populations. But search for the M cytotype, which causes susceptibility to the P factors, and for the P cytotype, which causes resistance to the P factors, showed that both populations are polymorphic for the cytotypes. Such a polymorphism seems to be stable in the wild, at least over a 2-year period. Mutator activity (measured by generated mutations at the sn and ras loci) was found to be present. Some possible interactions between cytotype polymorphism, mutator activity, and the structure of Drosophila populations are discussed.


Aims. We quantify the effect of gravitational redshift on emission lines to explore the transition region from the Newtonian to the Einsteinian regime. With the emitting region closer to the Kerr black hole, lines are successively subjected to a stronger gravitationally induced shift and distortion. Simulated lines are compared to broad, optical emission lines observed in Mrk 110. Methods. We simulate relativistic emission line profiles by using Kerr ray tracing techniques. Emitting regions are assumed to be thin equatorial rings in stationary Keplerian rotation. The emission lines are characterised by a generalized Doppler factor or redshift associated with the line core. Results. With decreasing distance from the black hole, the gravitational redshift starts to smoothly deviate from the Newtonian Doppler factor: shifts of the line cores reveal an effect at levels of 0.0015 to 60% at gravitational radii ranging from 10 5 to 2. This corresponds to fully relativistic Doppler factors of 0.999985 to 0.4048. The intrinsic line shape distortion by strong gravity i.e. very asymmetric lines occur at radii smaller than roughly ten gravitational radii. Conclusions. Due to the asymptotical flatness of black hole space-time, GR effects are ubiquitous and their onset can be tested observationally with sufficient spectral resolution. With a resolving power of ∼100 000, yielding a resolution of ≈0.1 A for optical and near-infrared broad emission lines like Hβ ,H eII and Paα, the gravitational redshift can be probed out to approximately 75 000 gravitational radii. In general, gravitational redshift is an important indicator of black hole mass and disk inclination as recently demonstrated by observations of optical lines in Mrk 110. Comparing our simulated lines with this observations, we independently confirm an inclination angle of 30 degrees for the accretion disk. Redshift deviations induced by black hole spin can be probed only very close to the black hole e.g. with X-ray iron lines.


Compared to refractive index matching in laser optical measurement techniques, magnetic resonance velocimetry (MRV) is assumed to be comparatively robust to changes in fluid composition when the principal components of the mixture provide a measurable MRI signal. In previous studies, MRV measurements were performed with different mixtures of water and glycerol, and no significant errors arose regardless of the mixing ratio. MRV is therefore proposed as a promising method for providing experimental data for a wide range of fluids that may also replicate different viscosity models. However, MRV can suffer from so-called chemical shift artifacts caused by slight variations in resonance frequency of differently bound hydrogen protons. These effects may arise when additional components are added to the flow medium. In this study, the ability of MRV to measure different flow mixtures is investigated. The long-term goal is to provide comprehensive experimental validation data for viscosity models in numerical simulations. Measurements were performed in stationary fluid samples as well as in flow measurements at the sudden expansion of the FDA benchmark nozzel. It is shown that MRV can provide reliable results for a Newtonian fluid and a shear-thinning fluid.


Transmit diversity through multiple transmit antennas is generally regarded as beneficial to the link-level performance. In this paper, we shall investigate the role of transmit diversity with respect to the link level and the system-level performance. We focus on the reverse link analysis, where mobile users are assumed to have independent fading, and they are equipped with multiple transmit antennas (n/sub T/). Each mobile station is assumed to have an average power constraint. The base station is assumed to have n/sub R/ receive antennas. We consider two levels of partial feedback, namely, scalar feedback and per-antenna vector feedback. In both cases, the transmitter does not have full knowledge of the channel matrix. Based on the information theoretical analytical model, it is shown that transmit diversity could enhance link-level performance, but is harmful to the multiuser system performance when there is insufficient feedback information.


This paper investigates and implements conventional and advanced methods for the control of D-STATCOM. The mathematical model of conventional double loop control, Direct-Output-Voltage (DOV) control, Decoupled DOV, Fuzzy-PI and Decoupled Fuzzy-PI based control is studied. The control scheme for the above approaches is implemented using Matlab Simulink platform. The dynamic response of the models are presented and compared.


The liver is the major drug-metabolizing and drug-detoxifying organ. Many drugs can cause liver damage through various mechanisms; however, the liver response to injury includes a relatively narrow spectrum of alterations that, regardless of the cause, are represented by phlogosis, oxidative stress and necrosis. The combination of these alterations mainly results in three radiological findings: vascular alterations, structural changes and metabolic function reduction. Chemotherapy has changed in recent decades in terms of the drugs, protocols and duration, allowing patients a longer life expectancy. As a consequence, we are currently observing an increase in chemotherapy-associated liver injury patterns once considered unusual. Recognizing this form of damage in an early stage is crucial for reconsidering the therapy regimen and thus avoiding severe complications. In this frontier article, we analyze the role of imaging in detecting some of these pathological patterns, such as pseudocirrhosis, "yellow liver" due to chemotherapy-associated steatosis-steatohepatitis, and "blue liver", including sinusoidal obstruction syndrome, veno-occlusive disease and peliosis.


The processes for direct and smelting-reduction of iron ores have, compared to the blast furnace, the advantage of being independent from coke. They will gain importance for mini mills based on the EAF steelmaking route. DRI capacity and production have steadily increased worldwide over the past three decades. DRI production in 2002 was 45 Mt and utilization of installed capacities reached 97%. A further increase in capacity and production is expected. The only smelting-reduction process under industrial application is the Corex process. The four operated plants in the world have in 2002 produced 2.66 Mt hot metal.


Generative adversarial nets (GANs) have generated a lot of excitement. Despite their popularity, they exhibit a number of well-documented issues in practice, which apparently contradict theoretical guarantees. A number of enlightening papers have pointed out that these issues arise from unjustified assumptions that are commonly made, but the message seems to have been lost amid the optimism of recent years. We believe the identified problems deserve more attention, and highlight the implications on both the properties of GANs and the trajectory of research on probabilistic models. We recently proposed an alternative method that sidesteps these problems.


France would seem to be a prime candidate for a vigorous state response to the economic crisis. The country has a long tradition of dirigiste or state-led economic development and its President, Nicolas Sarkozy has been an outspoken critic of laissez-faire capitalism and proponent of more robust regulation. Following the 2008 financial meltdown, the Sarkozy administration announced a series of statist initiatives, ranging from fiscal stimulus, to industrial policy, to financial and economic regulation. Yet this paper will show that the reality of France's response to the crisis has fallen well short of the statist rhetoric. The government has committed few additional resources, displayed little inclination to steer business strategies, and balked at issuing regulations in the absence of pan-European coordination. This paper argues that Sarkozy's neo-statist initiatives have been largely checked by the legacies of shifts in French economic policy a quarter-century ago. In particular, the break with the dirigiste model in 1983 has deprived French authorities of many of the institutions and instruments associated with state-led development, while the massive expansion of social and labor market programs that eased the movement away from dirigisme has left the government without the fiscal capacity to launch expensive new promotional policies. The broader lesson is that a country's response to crisis is shaped by long-term structural factors, not just short-term political calculations, and that even when neo-liberalism is widely believed to have failed, a statist response must be forged, not simply presumed.


A comprehensive investigation was done to evaluate the allergenic algae in the Delhi area. Results of 4,000 skin tests performed on 400 patients suffering from naso-bronchial allergy and 300 skin tests on 30 healthy persons with 10 common algae isolated from the Dehli atmosphere are presented and compared. Positive skin reactions (1+ to 3+) to algae extracts ranged from 25.7% with Lyngbya major extract to 1.7% with Oscillatoria simplicissima extract; in healthy non-allergic volunteers there were no positive skin reactions. The Prausnitz-Küstner (PK), bronchial provocation and conjunctival tests were negative in patients with negative skin reactions; in patients with positive skin reactions PK was positive in 70.9%, bronchial provocation in 50% and conjunctival in 48.5%. Levels of total IgE in patients with naso-bronchial allergy were higher, ranging from 1,225 international units per ml to 1,550 international units per ml, while in healthy volunteers the values were less than 885 international units per ml.


Abstract : The future roles and missions of the military services are inextricably intertwined and together they must maintain the Department of Defense's (DOD) constrained resources, while meeting requirements and preparing for the future. As we strive to operate jointly, commanders will expect and demand a consistent level of support across all spectrums. Transformation must unite unique service capabilities into a seamless joint framework to accomplish the joint force commander's objectives and create a better joint military force. There are many functional similarities across the services, particularly among support occupations. Currently, the services are participating in consolidated training programs and developing common operating systems. Yet, the common support skills and functions that receive this training and will use the common operating systems currently reside separately within each branch of the services. Could these support skills and functions be consolidated into a single joint organization, such as a DOD Support Command? A consolidated support organization could potentially lead to resource savings, more efficient processes, and improved readiness. This paper will examine some existing commonalities within DOD and propose an option for reducing duplication across the services with the intended result of a transformed joint military organization.


In this article, we develop the concept of affective infrastructure as the entanglement of affects, meanings and materiality to analyse protest camps as a specific organisational form of social and political movement. Drawing on two ethnographic research projects investigating an asylum seekers' protest camp in Helsinki, Finland, we argue that affects can be understood as having an infrastructural quality. The article contributes to research on affective politics by empirically studying the affective infrastructure of a protest camp. We distinguish between three interrelated dimensions of the affective infrastructure of a protest camp. First, affects are mobilised to mediate place-related meanings, the alteration of which is crucial to all protest camps. Second, affects are involved in creating the social space and atmosphere necessary to sustain a long-lasting protest. Third, affects impress themselves on abstract objects and ideas that must be managed as a part of the protest's political message. Affects not only join subjects and objects together but also divide them, illustrating that an infrastructure becomes visible when it staggers or fails.


Four Fractional/Integer Order Fuzzy Proportional Integral Derivative controller structures are designed in this study to successfully control a nonlinear, coupled, multi-input, multi-output, three-link rigid robotic manipulator system. The performance of Fractional Order Fuzzy Proportional Integral Derivative and Integer Order Fuzzy Proportional Integral Derivative controllers is evaluated for reference trajectory tracking, changing beginning circumstances, disturbance rejection, and model uncertainty. These controllers' parameters are tuned using a meta-heuristic optimization approach called the most valuable player algorithm for the objective function, which is defined as the integral of the time-squared error. Simulation results show that the suggested Fractional Order Fuzzy Proportional Integral Derivative controllers outperform Integer Order Fuzzy Proportional Integral Derivative controllers for tracking performance, stability, and robustness for all structures. Fractional Order Fuzzy Proportional Derivative Fractional Order Proportional Integral Derivative controller is the best one for trajectory tracking, disturbances rejection, and parameter variation with the least integral of time square error equal to 2.7420×10-6, 3.4×10-3 and 2.0108×10-4 respectively and the response of the angular position for all links for trajectory tracking has minimum settling time which is equal to 0.0290 s for the first link, 0.0160 s for the second link and 0.0050 s for the third link. When the initial condition is changed, the One Block Fractional Order Fuzzy Proportional Integral Derivative controller is the best one, since the integral of time square error is minimum and equal to 1.6253×10-4.

Index Terms— Fractional order controller, Fuzzy logic, Most valuable player algorithm, PID controller, Robotic manipulator.


Electrochemical water splitting by renewable energy resources is an efficient and green approach for hydrogen gas production. However, the anodic oxygen evolution reaction (OER) largely impedes the industrial application due to its sluggish four-electron-transition kinetics. Although various materials have been developed to accelerate the OER rate, still some issues should be addressed to meet the industrial demand: (i) considerable 200~300 mV overpotential as extra onset energy input, (ii) limited survival and performance in acidic electrolyte for the majority of oxide/hydroxide composite materials, (iii) unsatisfying long-term durability and (iv) the need for facile and scalable preparation methods. Here, we emphasize on multi-metallic composites with enhanced OER activity based on both precious and nonprecious elements that outperform the unary and binary composites. And the regulation effect from multi-metal incorporation is also summarized systematically: (i) introducing foreign metal atoms to the host material boosts the physical properties such as conductivity, surface area, defect density, morphology, wettability, etc. (ii) metal doping can synergistically regulate the electronic features of the host material, e.g. oxygen vacancy, eg orbit filling, coordinative number and covalence state, which can optimize the absorption/desorption energy of the M-O intermediate (iii) chaotic impact from the added atoms twists the catalyst lattice into a more aggressive and higher energy state, which is more feasible to transform to an active intermediate with lower required energy supply. This review aims to provide a practical approach to further improve the OER performance via multi-metallic-based catalysts.


Background. The thyrotropin-releasing hormone (TRH) stimulation test is widely used as a screening procedure in subfertile patients to identify subclinical hypothyroidism. However, its usefulness in daily clinical practice has not been proven, despite more than 30 years of use. Material and methods. We analyzed data from a cohort of 371 consecutive female subfertility patients, who were screened with an intravenous TRH test when they came for the first evaluation. All patients with positive thyroid peroxidase antibodies, basal TSH <1.5 mU/l, known thyroid disease or actual thyroid medication were not screened and excluded from the analysis. Results. We found a good correlation between basal and stimulated levels of thyroid-stimulating hormone (TSH). Basal TSH and the difference between stimulated and basal TSH did not correlate with prolactin levels. Definition of a positive TRH test (difference of 15 or 20 mU/l) did not have sufficient sensitivity and specificity, as confirmed by analysis of receiver operating characteristic curves, to identify subclinical hypothyroidism. Conclusion. TRH stimulation testing is not helpful to identify patients with subclinical hypothyroidism and should not be part of initial screening in this group.


Background Research waste is prevalent in many scientific fields despite a number of initiatives to improve research practices. Interventions to improve practice are often implemented without evaluating their effectiveness. It is therefore important to identify the interventions that have been evaluated, assess how they have been evaluated and to identify areas where further research is required. Objectives A scoping review will be undertaken to assess what interventions, aimed at researchers or research teams, to improve research design and conduct have been evaluated. This review will also consider when in the research pathway these interventions are implemented; what aspects of research design or conduct are being targeted; and who is implementing these interventions. Methods Interventions which aim to improve the design or conduct of research will be eligible for inclusion. The review will not include interventions aimed at hypothetical research projects or interventions implemented without evaluation. The following sources will be searched: MEDLINE, EMBASE, ERIC, HMIC, EconLit, Social Policy and Practice, ProQuest theses, and MetaArXiv. Hand searching of references and citations of included studies will also be undertaken. Searches will be limited to articles published in the last 10 years. Data extraction will be completed using a data extraction template developed for this review. Results will be tabulated by type of intervention, research stage, and outcome. A narrative review will also be provided addressing each of the objectives.


Vibrational excitation (VE) of HF by low-energ ye lectrons has been investigated experimentally and theoretically. A new nonlocal resonance model has been constructed based on ab initio calculations of the coupling between a discrete state and continuum states. VE and resonant elastic cross sections have been calculated for a set of initial vibrational states of the molecular target. New high-resolution measurements of VE cross sections for the transitions v = 0 → 1, ... , 4h ave b een carried out. The calculated cross sections are in good agreement with the experimental data, indicating that the mechanisms responsible for the rich threshold structures found in the collision cross sections of HF are well understood.


The yeast Candida oleophila (strain O) presents a high level of protective activity against Botrytis cinerea (gray mold) on postharvest apples. The cDNA-AFLP technique allows the comparison of mRNA populations extracted from cells grown in different conditions. In order to isolate yeast genes potentially involved in biological control properties, that technique was applied on strain O cells growing on apple wounds. The biological control properties of 8 C. oleophila strains and strain O were assessed in order to compare the gene expression of a non antagonistic strain against gene expression of strain O. In the absence of a non-antagonistic strain, an other comparison model was designed. It was based on the growth of strain O in different in situ conditions: strain O applied on apple wounds (O), strain O applied on apple wounds in presence of B. cinerea (B) and B. cinerea alone on apple wounds (F). A recovering technique, based on the washing of cells in the wound and a RNA extraction method followed by a DNase treatment were optimised before cDNA-AFLP application. Thirteen primer pairs were used. Their application resulted in an average of 54 and 55 bands for O and B respectively whereas no bands were observed for F. Among these bands, 8 were expressed more intensely in presence of the pathogen (1.1% of the fragments).


Campaign finance compliance and transparency reveal important non-policy attributes that voters care about. They may signal how the candidate would govern if elected. Using vignette and conjoint survey experiments, I show that voters in primary elections base their candidate selection on transparency considerations, even where the candidate shares the respondents' preferred policy positions. The findings bring campaign finance compliance into the scholarly conversation about candidate valence, and they explain why some primary candidates discourage dark money support only to embrace it in the general election.


Potential products fresh milk from a partners dairy farmers in the area Bendul Merisi Surabaya is still quite favorable, but the technology has not been used in terms of addressing the problem of livestock waste, so the existence of the business partners still largely very simple in handling the waste, which could impact unhealthy society around. The existence of farm businesses that are geographically dense settlements which are urban areas in Surabaya, where villagers are a mixture of local women for newcomers. Required touch technology and knowledge in the group of dairy farmers are still traditional, thus providing added value to the farm business that is expected to have an impact on the surrounding environment healthier. In the implementation of community service (PPM) is made to partners I, namely Mr. Masoud located in the Bendul Merisi, 27 Surabaya and partners II, Mrs. Aslam in the Bendul Merisi, 31 Surabaya, both within the village RW.6 RT.5 Bendul Merisi Wonocolo Subdistrict Surabaya. Priority issues in general partners after advocacy by Tim PPM states have realized the importance of livestock wastewater treatment so as not to impact negatively on the environment and understand the importance of fresh milk production management by developing a broader market access (internet media). The purpose of this devotion 1). provide a good understanding of the handling of liquid waste from the farm; 2). provide a good understanding of marketing management of fresh dairy products; 3). develop household business partners who are economically independent. The method is offered for problems of waste and management are 1) helping to prepare the handling and management of liquid waste effectively is by building bathtub tiered so that the water coming out of the location of the farm is quite clean and does not pollute the environment, 2) help increase the marketing management product by utilizing Internet access. By the conclusion of 2016 IbM have done the steps are 1) the innovation of science and technology in the form of construction of wastewater treatment basin farms in stages; 2) advocacy to partner in improving the understanding of appropriate technology and 3) to facilitate the implementation of Internet technology to expand its internet blog marketing information and business networks. With these steps, the partners feel the positive benefits such as ease of access to fresh milk sales and the emergence of consciousness and moral responsibility for pollution of river water in view of the farm is located in a densely populated urban environment Surabaya.


In this study, we conceptualized perceived combat readiness, an important component of morale, in terms of collective efficacy beliefs and examined some of the anticipated correlates of collective efficacy beliefs as they apply to military combat units. We focused on the following variables: soldiers' experience, leader's tenure, leader's confidence in the unit, soldiers' confidence in the leader, unit discipline, and members' identification with the unit. The study was based on questionnaires given to company leaders (n = 50), staff members (n = 353), and two samples of soldiers (n = 1,197) in 50 Israel Defense Forces companies. Some support was found for all hypothesized correlates. The strongest predictor of perceived combat readiness was identification with the unit. The correlation between aggregated staff members' perceptions and aggregated soldiers' perceptions was only modest, suggesting that the two groups may employ different standards to assess the combat readiness of their units.


The position of the transition from spinel lherzolite to garnet lherzolite in the system CaO-MgO-Al2O3-SiO2 (CMAS) has been determined experimentally at near-solidus temperatures. In reversed experiments, the transition occurs between 18 and 20 kbar at 1200 °C and between 26 and 27 kbar at 1500 °C, corresponding to higher pressures than previously envisaged. A position for the transition deeper within the Earth further complicates the explanation of the so-called garnet signatures in the trace element and isotope patterns of mid-ocean ridge basalts. If melting during adiabatic upwelling beneath a mid-ocean ridge begins at the depth required for the stability of garnet in peridotitic compositions, simple melting models predict that the amount of melt produced should be much greater than the observed thickness of the oceanic crust. A partial solution to the apparent con ̄ict might be that (1) the rather simplistic melting models are in error, (2) that melting begins in garnet pyroxenite veins that are believed to be stable at lower pressures than garnet lherzolite or (3) that melting does not involve garnet at all, but it is clinopyroxene causing the trace element patterns observed in basalts erupted at mid-ocean ridges. A second set of reversal experiments were conducted to investigate the solubility of alumina in both orthopyroxenes and clinopyroxenes at the high temperatures near the solidus in the system CMAS. The results are compatible with most previous studies, and may be used as a starting point to calibrate thermodynamic models for pyroxenes in chemical systems, approximating upper mantle chemistry.


This study is analyzed by the simulation of heat exchanger. As heat conduction happens as contact begins, the temperature increases until 70℃ at the contact part. The displacement increases until 33mm at its maximum and maximum equivalent stress at final stage increases 20 times as much as that of first contact. The expenses about maintenance, repair and management of parts can be reduced largely by applying the simulation about various parts of heat exchanger.


Acute pancreatitis (AP) is the acute inflammation of the pancreas. The morbidity of AP has increased in recent years. Certain patients eventually develop severe AP (SAP), which rapidly progresses to multiple organ dysfunction; the incidence of this occurring in patients with AP is 20-30%. To date, no specific drugs or methods exist to treat this disease. Rutaecarpine relaxes vascular smooth muscle by stimulating calcitonin gene-related peptide (CGRP) release via activation of vanilloid receptor subtype 1 (VR1). It has been demonstrated that rutaecarpine induces a therapeutic effect on SAP. The present study was conducted to characterize the molecular mechanisms underlying the protective effects of rutaecarpine against AP using a rat model of AP. Gross pathological changes of the pancreas, as well as the pancreatic tissue histopathological score, were assessed following treatment with rutaecarpine, capsazepine or a combination of the two. Serum amylase activity was detected using an automatic biochemistry analyzer. Changes in the serum concentrations of interleukin (IL)-6, tumor necrosis factor (TNF-α), IL-10 and CGRP were assessed by ELISA and radioimmunoassay. The results demonstrated that pre-treatment with rutaecarpine markedly decreased pancreatic inflammation and necrosis, reduced the volume of ascites, and significantly increased the plasma concentration of CGRP and the serum concentration of IL-10, an anti-inflammatory cytokine. However, serum concentrations of the inflammatory cytokines IL-6 and TNF-α were decreased. The effect of rutaecarpine treatment markedly improved with increases in the drug dose. Capsazepine, as a competitive vanilloid receptor antagonist, abolished these protective effects of rutaecarpine against AP. Therefore, the results of the present study indicate that rutaecarpine protects against AP in rats by upregulating endogenous CGRP release via activation VR1 of, to improving the microcirculation of the pancreatic tissue and regulate the expression of inflammatory factors.


A model for motion detection is presented. In this approach, motion is viewed as a stable pattern propagating over the image – a technique that makes the model unusually insensitive to noisy input sequences. The model is based on a neural network and requires spontaneous activation of the nodes in order to be operative. The model has been tested in computer simulations with over 300 000 nodes and more than 6 million connections. A compilation of results from these simulations is also presented.


The aim of this study was to evaluate the contribution of gluconeogenesis from amino acids in the development of fasting and absorptive hyperammonemia in cirrhosis. Somatostatin (SRIF), which is known to inhibit the hepatic disposal of gluconeogenic amino acids, was administered in a continuous infusion (500 micrograms/h) for 90 min before and 5 h after a protein meal (240 g of meat) in 11 overnight fasting patients. Plasma glucagon, insulin, gluconeogenic amino acids (GAA: alanine, serine, glycine, and threonine) and ammonia (NH3) were evaluated before the infusion, immediately before, and at 1, 3, and 5 h after the meal. As control study, the same protocol was randomly repeated in a different day with saline infusion. During the latter, a direct correlation was found between fasting glucagon and ammonia (r = 0.68; p less than 0.05). Fasting glucagon, insulin, and NH3 did not change, whereas alanine (p less than 0.05) and the GAA sum decreased (p less than 0.01). When SRIF was infused, fasting glucagon (p less than 0.05), insulin (p less than 0.05), and NH3 (p less than 0.05) decreased. Alanine did not change, and GAA sum increased (p less than 0.02). No correlations were found by plotting changes in glucagon or GAA sum and NH3. After the meal, SRIF infusion abolished the plasma response of glucagon and markedly reduced that of insulin, so that their area under the curve (AUC0-5) were reduced (p less than 0.005, for both), with respect to control study. Moreover, the AUC0-5 of alanine (p less than 0.005) and GAA sum (p less than 0.005) were increased, suggesting a reduced disposal of these compounds. In spite of this, the meal-induced early increase and the AUC0-5 of plasma NH3 observed during SRIF and saline infusion did not differ. Our results do not confirm the importance of gluconeogenesis from alpha-amino-nitrogens in determining the fasting ammonemia of cirrhosis, and suggest that this metabolic pathway does not significantly influence the protein meal-induced exacerbation of plasma ammonia.


A method is presented for the efficient optimization of microwave filters and multiplexers designed from an ideal prototype. The method is based on the estimation of a rational function adjusted to a reduced number of samples of the microwave device response obtained either through electromagnetic analysis or measurements. From this rational function, a circuital network having the previously known topology of the microwave device is synthesized and compared to a circuital network with the desired response but including nonidealities. All of the process of analysis and model extraction can be seen as a model function that relates the physical parameters of the microwave device with the extracted circuital network parameters. Then, the error vector of the circuital parameters is used to generate a correction vector of the physical parameters through an estimation of the inverse of the Jacobian matrix of the complete model function. The Jacobian estimation is updated at each iteration of the optimization process with no need for additional evaluations of the model function. Two numerical examples of the proposed technique corresponding to the synthesis of a filter and a diplexer are presented, demonstrating the increased efficiency of the proposed technique with respect to direct electromagnetic optimization.


The combined ANOVA analysis for grain yield of ten wheat genotypes at 12 environments showed that bread wheat grain yield was significantly affected by environment, which explained 75.01% of the total treatment (genotype + environment + genotype by environment interactions) variation, whereas the G and GEI were significant and accounted for 9.48 and 15.5%, respectively. The additive main effects and multiplicative interactions (AMMI) analysis indicated that three principal component analysis (PCA) were significant (P < 0.01). PCA 1, 2 and 3 accounted for 65.49, 17.10 and 10.11% of the genotype + environment (GE) interaction, respectively. Graphical display of genotype by environment interaction (GGE-biplot) based on genotype-focused scaling was depicted in order to detect the locations of genotypes, whereas the wheat genotypes were divided into four groups based on their scores of PCA 1 and 2: Three stable and high yielding genotypes (G2, 10 and 6), two unstable high yielding genotypes (G4 and 1), three stable low yielding genotypes (G5, 7 and 8) and two low yielding unstable genotypes (G9 and 3). The correlation coefficients among the twelve test environments and the vector view of the GGE-biplot provided a succinct summary of the interrelationship between the environments whereby only 38 of the 67 correlation coefficients were significant. All environments were positively correlated except the environment E5 which was negatively correlated with E9, 12 and 10. The G10 (Giza 168) is adaptable for a wide range of environment conditions.


Purpose: Monocarboxylate transporter 4 (MCT4) can influence the amount of lactate in the tumor microenvironment and further control cancer cell proliferation, migration, and angiogenesis. We investigated for the first time the expression of MCT4 in circulating tumor cells (CTCs) derived from early stage Non-Small Cell Lung Cancer patients (NSCLC) and whether this is associated with clinical outcome. Experimental Design: A highly sensitive RT-qPCR assay for quantification of MCT4 transcripts was developed and validated and applied to study MCT4 expression in CTC isolated through the Parsortix size-dependent microfluidic device from 53 and 9 peripheral blood (PB) samples of NSCLC patients at baseline (pre-surgery) and at relapse, respectively, as well as the "background noise" was evaluated using peripheral blood samples from 10 healthy donors (HD) in exactly the same way as patients. Results: MCT4 was differentially expressed between HD and NSCLC patients. Overexpression of MCT4 was detected in 14/53 (26.4%) and 3/9 (33.3%) patients at baseline and at progression disease (PD), respectively. The expression levels of MCT4 was found to increase in CTCs at the time of relapse. Kaplan-Meier analysis showed that the overexpression of MCT4 was significantly (P = 0.045) associated with progression-free survival (median: 12.5 months, range 5–31 months). Conclusion: MCT4 overexpression was observed at a high frequency in CTCs from early NSCLC patients supporting its role in metastatic process. MCT4 investigated as clinically relevant tumor biomarker characterizing tumor aggressiveness and its potential value as target for cancer therapy. We are totally convinced that MCT4 overexpression in CTCs merits further evaluation as a non-invasive circulating tumor biomarker in a large and well-defined cohort of patients with NSCLC.


Static random access memories (SRAMs) built on carbon nanotube field effect transistors (CNFETs) are promising alternatives to conventional CMOS-based SRAMs, due to their advantages in terms of power consumption and noise immunity. However, the nonideal carbon nanotube (CNT) fabrication process generates metallic-CNTs (m-CNTs) along with semiconductor-CNTs, leading to correlated faulty cells along the growth direction of the m-CNTs. In this paper, we propose a novel low-cost test solution to detect such faults. Instead of using conventional March test to test each and every SRAM cell, we selectively test certain SRAM cells and judiciously skip testing other SRAM cells between the selected cells. To ensure high fault coverage, we propose three jump test algorithms for different CNFET-SRAM layouts. Moreover, we model m-CNT-induced SRAM faults and characterize their distribution in the SRAM array. Experimental results show that the proposed solutions are able to achieve high fault coverage with low test cost.


The vasodilatory properties of nitric oxide (NO) are well documented, but its direct effects on myocardial contractility are somewhat controversial. The present report follows a series of articles in which we reported the translocation of NO synthase isoforms both after myocardial infarction in aged rats and in human heart failure (HF). This redistribution is due to nNOS1 translocation from the sarcoplasmic reticulum to the caveolae in the outer membranes. Translocation is determined by strong interactions between the enzyme and caveoline-3 (a marker of caveolae). It suggests a regulatory role of nNOS1 in both normal inotropism and HF. The physiological consequences of this translocation were studied in a well-documented experimental model of myocardial infarction with HF in adult rats. Myocardial function was analyzed before and after adrenergic activation, both ex vivo on isolated hearts and in vivo with a Millar probe.--In rats, as in humans, the level of nNOS1 is enhanced, and this is associated with translocation to the caveolae. Such a process is seen in both humans and rats with HF.--In HF, ventricular elastance (E(s), in mmHg/microL: a load-independent measure of contractility) is reduced, and the time constant of relaxation, tau, is prolonged. In basal conditions, in non HF controls, specific nNOS1 inhibition by L-VNIO induces a 33% increase in E(s) and a 17% increase in the time constant of relaxation. The response to an adrenergic stimulation is attenuated in HF. The main result of this work is that pharmacological inhibition of nNOS1, either ex vivo with L-VNIO, or in vivo with SMTC, normalizes the adrenergic response of failing hearts. nNOS1 translocation is thus a major contributor to the autocrine regulation of contractility in HF, and is probably responsible for hampering the adrenergic response in HF.


Deficiency of the enzyme D-glycerate dehydrogenase (D-GDH) which also has glyoxylate reductase (GR) activity, is believed to be the underlying cause of primary hyperoxaluria type 2 (PH2). We have established the reaction kinetics of this enzyme in human liver and using these parameters have developed a microassay for the measurement of D-GDH and GR on needle liver biopsies obtained from patients with suspected primary hyperoxaluria. Tissue distribution studies of the two enzyme activities suggest that more than one enzyme with D-GDH activity is present in human tissues and the one with associated GR activity is mainly confined to the liver. The clinical significance of these findings for diagnosis and treatment is discussed.


Background In 2011 The Early Breast Cancer Trialists9 Collaborative Group (EBCTCG) reported that five years of adjuvant tamoxifen (TAM) significantly reduces the 15-year risks of breast cancer recurrence and death. Moreover, the estrogen receptor (ER) was considered the clinically most relevant predictive factor for efficacy of TAM treatment. In premenopausal patients participating in a randomized trial of 2 years of adjuvant TAM, we have previously reported on increased recurrence free survival in patients with ER- and PR-positive disease and a trend for increased overall survival in patients with PR-positive tumors. The median follow-up time was 13.9 years for patients without events. Since the effect on mortality may increase beyond year 10, we investigated more mature of data. Aims To investigate the long-term effect of 2 years adjuvant TAM in premenopausal patients choosing cumulative mortality (CM) and cumulative breast cancer mortality (CBCM) as end-points. Methods Premenopausal patients (n=564) with stage II breast cancer were included in a Swedish randomized multicenter trial between 1986-1991 and allocated to 2 years of TAM (n=276) or no treatment (n=288). The hormone receptor status of the tumor was known for 541 (96%) of the patients included, determined by immunohistochemistry or cytosol-based methods. Less than 2% were treated with adjuvant chemotherapy and they were equally distributed between the two groups. Median follow-up time was 26.3 years (22.7-29.7). Mortality data was obtained from the Swedish Cause of Death Register. Results Death from any cause was recorded among 312 (55%) of the patients, and 265 (47%) of the deaths were due to breast cancer. Two years of TAM decreased CM and CBCM in all patients irrespective of hormonal receptor status (n=564) (CM: HR 0.81; 95% CI: 0.65-1.02, p=0.070; CBCM: HR 0.79; 95% CI: 0.61-1.01, p=0.058), as well as in patients with ER-positive disease (n=346) (CM: HR 0.77; 95% CI: 0.57-1.03, p=0.077; CBCM: HR 0.72; 95% CI: 0.52-1.01, p=0.051), however not strictly significant. Importantly, in patients with PR-positive tumors, TAM significantly reduced CM and CBCM (CM: HR 0.73; 95% CI: 0.55-0.98, p=0.037; CBCM: HR 0.68; 95% CI: 0.49-0.94, p=0.020). Moreover, in patients with ER- and PR positive tumors TAM decreased CM (HR 0.74; 95% CI: 0.55-1.01, p=0.057) and CBCM (HR 0.69; 95% CI: 0-49-0.97, p=0.033), whereas there was no effect of TAM in patients with ER-positive and PR-negative tumors (p=0.97 and p=0.99, respectively). Conclusions The present study demonstrates that 2 years of adjuvant TAM as monotherapy significantly reduced CM and CBCM in premenopausal women with PR-positive tumors as well as CBCM in ER- and PR-positive tumors, after > 25 years of follow-up. Five years of adjuvant TAM have been proven to reduce mortality rates at 15 years, but we herein show that also 2 years of TAM yields a survival benefit at 25 years. In the latest meta-analysis from EBCTCG, PR did not add predictive information in patients with ER-positive tumors, but according to our results the significance of PR, as a predictive factor for TAM efficacy, should be re-emphasized in premenopausal women. Citation Format: Maria Ekholm, Par-Ola Bendahl, Marten Ferno, Bo Nordenskjold, Olle Stal, Lisa Ryden. Mature data (> 25 years) on 2 years adjuvant tamoxifen treatment in premenopausal women with breast cancer: Time to re-emphasize the progesterone receptor as predictive factor? [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-12-17.