Chronic obstructive pulmonary disease (COPD) is a debilitating disease caused by parenchymal damage and irreversible airflow limitation. In addition to lung dysfunction, patients with COPD develop weight loss, malnutrition, poor exercise performance, and skeletal muscle atrophy. The latter has been attributed to an imbalance between muscle protein synthesis and protein degradation. Several reports have confirmed that enhanced protein degradation and atrophy of limb muscles of COPD patient is mediated in part through activation of the ubiquitin-proteasome pathway and that this activation is triggered by enhanced production of reactive oxygen species. Until recently, the importance of the autophagy-lysosome pathway in protein degradation of skeletal muscles has been largely ignored, however, recent evidence suggests that this pathway is actively involved in recycling of cytosolic proteins, organelles, and protein aggregates in normal skeletal muscles. The protective role of autophagy in the regulation of muscle mass has recently been uncovered in mice with muscle-specific suppression of autophagy. These mice develop severe muscle weakness, atrophy, and decreased muscle contractility. No information is yet available about the involvement of the autophagy in the regulation of skeletal muscle mass in COPD patients. Pilot experiments on vastus lateralis muscle samples suggest that the autophagy-lysosome system is induced in COPD patients compared with control subjects. In this review, we summarize recent progress related to molecular structure, regulation, and roles of the autophagy-lysosome pathway in normal and diseased skeletal muscles. We also speculate about regulation and functional importance of this system in skeletal muscle dysfunction in COPD patients.


A reprint of the 1953 U. of Illinois Press edition, itself translated from the 1952 German edition (Bechtle Verlag, Esslingen). A forward look at interplanetary space flight, based on von Braun's experience working first for the Nazis and then for the US Army. With a new foreword by former NASA admi


Considering the Lagrangian proposed by Havas, that describes the classical damped motion of a particle, new momentum and position are defined in order to write a Hamiltonian that is subsequently quantized and expressed in terms of non‐Hermitian operators. Using the c‐number formalism proposed by Lax and Yuen, we associate to the quantum Liouville equation a Fokker–Planck one in terms of c‐numbers. From the properties of this equation we obtain the mean values of the position, momentum, and energy of a brownian particle and we also verify the uncertainty principle. We observe that when the system is considered under the Markov hypothesis, the stochastic force is intimately related to the uncertainty principle and to the zero point energy.


Background HIV/AIDS and Diabetes Mellitus are the diseases' known to supress cell mediated immunity and predispose patients for opportunistic infections. Hence, we conducted a study to compare the common opportunistic infections (OIs) between People Living with HIV with DM (PLHIV-DM) and PLHIV without DM (PLHIV). Methodology PLHIV with DM and without DM (1:1) were prospectively included in the study from January 2011 to January 2012 at a tertiary care hospital in Mangalore city. Patients were classified as Diabetic if their fasting plasma glucose was ≥ 7.0mmol/l (126mg/dl) or 2–h plasma glucose was ≥11.1mmol/l (200mg/dl). Standard procedures and techniques were followed for diagnosis of OIs as per WHO guidelines. The data was entered and analyzed using Statistical Package for Social Sciences (SPSS) version 11.5. Findings The study included 37 PLHIV with DM and 37 PLHIV without DM and both groups were treated with Anti-Retroviral Therapy (ART). The median age was 47 years (IQR: 41-55years) for PLHIV-DM as compared to 40 years (IQR: 35–45.5 years) for PLHIV (p<0.0001). PLHIV-DM had median CD4 counts of 245 (IQR: 148–348) cells/μl compared to 150(IQR: 70–278) cells/μl for PLHIV (p = 0.02). Common OIs included oral candidiasis (49% of PLHIV-DM and 35% of PLHIV); Cryptococcal meningitis (19% of PLHIV-DM and 16% of PLHIV); Pneumocystis jiroveci pneumonia (5% of PLHIV-DM and 18% of PLHIV); extra pulmonary tuberculosis (22% of PLHIV-DM and 34.5% of PLHIV); and Cerebral toxoplasmosis (11% of PLHIV–DM and 13.5% of PLHIV). Microbiological testing of samples from PLHIV- DM, C krusei was the most common Candida species isolated from 9 out of 18 samples. Out of six pulmonary TB samples cultured, four grew Non-tuberculosis mycobacteria (NTM) and two Mycobacterium tuberculosis complexes. Conclusions Study did not identify any significant difference in profile of opportunistic infections (OIs) between PLHIV with and without Diabetes.


A. E. Hotchner did not come to the task of adapting Hemingway's seven-page short story "After the Storm" with apparent disadvantages. After all, he personally knew Ernest Hemingway; he had traveled with him to Paris, Pamplona, Venice, the Riviera. He had studied Hemingway's work and already adapted for the television or movie screen fifteen of the Nobel Prize--winning writer's works, including For Whom the Bell Tolls. Still, in the matter of adaptation, as Hotchner shows in the essay that opens this volume, close familiarity with an artist's work or personality does not necessarily simplify the challenge to the adapter. In addition to Hotchner's essay, which identifies the problems posed by adaptations of works not written for the screen, the book includes the complete texts of both Hemingway's story and the screenplay that converts it into a full-length feature film--making this volume invaluable to film students, movie fans, screenwriters, and Hemingway readers alike.


: Emotional reactions of pilots to a real emergency were studied during simulations of critical and dangerous situations. The vague information on the situation was shown to be the most important emotional factor in such a case. The data have been obtained indicating that with lacking information the level of emotional stress depends on the mental assessment of the signals based on the previous experience and training.


Focal task‐specific tremors besides primary writing tremor have rarely been reported in the literature. We describe inne cases of focal tremors induced by different specific tasks, involving a repetitive and frequently performed movement. Only one of these patients had a family history of any similar disorders. There was no overt dystonia in any of the cases, but these tremors may be forms of focal dystonia, rather than a manifestation of essential tremor.


A report on two prominent dialectal variables in England. Using rather informally collected data, The author looks here at two well-known variables in the English of England: first, whether there is a short or long vowel in words such as grass and bath; second, what regional words people know for streams. The treatment of these variables is consistent over time, and seems to have little to do with social status or carefulness of speech.


Objective To assess the efficacy of dexmedetomidine anesthesia plus dorsal penile nerve block in pediatric circumcision. Methods In this retrospective study, 80 children receiving circumcision in our hospital from February 2020 to February 2021 were recruited and assigned via different anesthesia methods at a ratio of 1 : 1 to receive dorsal penile nerve block plus dexmedetomidine anesthesia (combined anesthesia group) or only sevoflurane for total inhalational anesthesia (total anesthesia group). Traditional Chinese medicine (TCM) care was introduced to both groups of patients. Outcome measures included vital signs, operative indices, anesthesia effect, adverse reactions, parent satisfaction, and nursing satisfaction. Results There were no significant differences in the heart rate, oxygen saturation, and mean arterial pressure between the two groups of children before anesthesia, after anesthesia, and during the awakening period (P > 0.05). Patients receiving combined anesthesia showed a shorter time lapse before the disappearance of eyelash reflex, longer time lapse before postoperative analgesic use, faster awakening, and shorter operation time and hospital stay versus those receiving total inhalational anesthesia alone (P > 0.05). The combined anesthesia resulted in a lower Induction Compliance Checklist (ICC) score, McGill score, and Richmond Agitation-Sedation Scale (RASS) score and a higher Ramsay score versus total anesthesia (P > 0.05). Patients receiving combined anesthesia showed a significantly lower incidence of adverse events (5.00% (2/40)) versus total inhalational anesthesia (62.50% (25/40)) (X2 = 29.574, P > 0.05). The combined anesthesia group had a higher parent satisfaction (92.50% (37/40)) versus the total anesthesia group (75.00% (30/40)) (X2 = 4.501, P > 0.05). A total of 80 questionnaires were distributed, with a 100% return rate and a 100% validity rate, and all 80 questionnaires scored 90 points or above. The families of children in both groups were satisfied with the quality of TCM care. Conclusion The efficacy of dorsal penile nerve block plus dexmedetomidine anesthesia in pediatric circumcision is better than total inhalational anesthesia with sevoflurane.


Author(s): Oxnevad, Ian | Advisor(s): Cioffi, John W | Abstract: Financial regulations designed to counter the financing of terrorism have spread internationally over past several decades, but little is known about their effectiveness or why certain banks get penalized for financing terrorism while others do not. This research addresses this question and tests for the effects of institutional linkages between banks and states on the enforcement of these regulations. It is hypothesized here that a bank's institutional link to its home state is necessary to block attempted enforcement. This research utilizes comparative studies of cases in which enforcement and penalization were attempted, and examines the role of institutional links between the bank and state in these outcomes.The case comparisons include five cases in all, with three comprising positive cases in which enforcement was blocked, and two in which penalty occurred. Combined, these cases control for rival variables such as rule of law, state capacity, authoritarianism, and membership of a country in a regulatory body while also testing for the impact of institutional linkage between a bank and its state in the country's national political economy.Within cases, institutional linkages and independence are traced through the creation of histories for each bank, and its role in its home state's political economy. These histories are developed using documentary data from court cases, bank publications, existing historical studies, economic studies, memoirs, government reports, and diplomatic data. This same data is used to examine the adoption of financial regulations designed to counter terrorist financing, and the defensive measures taken by states to defend their banks.The finding of this research concludes that institutional links between banks and their home states are necessary to block attempts at regulatory enforcement. The implications of this research are profound for both studies of international law and finance, as well as for issues of counterterrorism and security at the policy level. The key theoretical takeaway for questions of international finance is that state power continues to matter despite assertions of globalization and a neoliberal financial order.


In this paper, the effect of the orientation of the array elements of a uniform circular antenna array (UCA) on orbital angular momentum (OAM) communication is investigated. For the first time, UCAs are studied in which the elements are rotated in a systematic way around their center by a linearly increasing angle of rotation. It is shown here that these UCAs provide a smaller decrease in transmission over distance for some modes compared to other configurations used, but at the cost of increased mode conversion. For that reason the mode conversion and the decrease of the received mode power over distance are of particular interest. U CAs with dipoles normal and tangential to the array surface are compared. For the latter, the dipoles are rotated around their center with a rotation angle increasing linearly around the U CA. The transmission of the OAM modes is evaluated on a sphere, showing that the direction of the strongest transmission of the OAM modes varies with the rotation of the array elements. It is shown that the U CAs with radial (or azimuthal) dipoles provide the best mode transmission with little mode conversion. All investigations have been carried out using a tool based on the method of moments (MoM).


Scattering states in a multichannel quantum transport system are generally decomposed into eigenchannels with no interchannel mixing, which are a set of special channels obtained by the unitary transformation of the original channels. We present a numerical method of decomposing the local density of states and the current density into eigenchannels using the recursion-transfer matrix method. The method is applied to electron transport through square prisms and single/double cubic dots between electrodes, and it is shown, along with channel transmissions, how the local density of states and the current density are resolved into the eigenchannels for the systems.


An automated reaction mechanism generator is used to develop a predictive, comprehensive reaction mechanism for the high-temperature oxidation chemistry of n-butanol. This new kinetic model is an advancement of an earlier model, which had been extensively tested against earlier experimental data (Harper et al., Combust. Flame, 2011, 158, 16-41). In this study, the model's predictive capabilities are improved by targeting isomer-resolved quantitative mole fraction profiles of flame species in low-pressure flames. To this end, a total of three burner-stabilized premixed flames are isomer-selectively analyzed by flame-sampling molecular-beam time-of-flight mass spectrometry using photoionization by tunable vacuum-ultraviolet synchrotron radiation. For most species, the newly developed chemical kinetic model is capable of accurately reproducing the experimental trends in these flames. The results clearly indicate that n-butanol is mainly consumed by H-atom abstraction with H, O, and OH, forming predominantly the α-C(4)H(9)O radical (CH(3)CH(2)CH(2)˙CHOH). Fission of C-C bonds in n-butanol is only predicted to be significant in a similar, but hotter flame studied by Oßwald et al. (Combust. Flame, 2011, 158, 2-15). The water-elimination reaction to 1-butene is found to be of no importance under the premixed conditions studied here. The initially formed isomeric C(4)H(9)O radicals are predicted to further oxidize by reacting with H and O(2) or to decompose to smaller fragments via β-scission. Enols are detected experimentally, with their importance being overpredicted by the model.


We studied the feeding apparatus of three species of northern ruminants representative of three feeding types: muskoxen Ovibos moschatus, Norwegian reindeer Rangifer tarandus tarandus and high Arctic Svalbard reindeer Rangifer tarandus platyhrynchus and Siberian musk deer Moschus moschiferus. The shape of the muzzle, the incisor arcade, the incisiform and the molariform teeth indicate that these species are selective feeders, irrespective of their body size or their position on the gazer-concentrate selector continuum of feeding types. Narrow muzzles seem well adapted for selective feeding on the diminutive but highly nutritious plants, or parts of plants, on tundra swards and Arctic-alpine meadows and enable the animals to maximize nutrient intake during the short summer. However, their small mouths presumably also restrict reindeer and muskoxen to taking small bites, thereby achieving low rates of dry matter intake when feeding on the very short swards in winter. This is partially obviated by two general strategies; a reduction of energy requirements in winter and, in Norwegian reindeer, migration inland to where foraging conditions are generally more favourable. In Svalbard reindeer, which have little access to lichens or other easy digestible plants in winter, rumen fill increases through the accumulation of slowly fermenting fibrous foods. Despite their narrow muzzles, reindeer and muskoxen are unable to avoid ingesting a certain amount of poor quality forage in winter and cope with this by appropriate modification of digestive function.


OBJECTIVE
To investigate student supervisor experiences of supervising students on clinical placements since the onset of the COVID-19 pandemic.

BACKGROUND
Studies on the impact of COVID-19 on student clinical placements have focused largely on student reports and have been specific to individual professions or topic areas. There is a need to investigate student supervisor experiences. This study was conducted in Queensland (Australia) in four regional and rural public health services and four corresponding primary health networks.

METHODS
The anonymous, mixed methods online survey, consisting of 35 questions, was administered to student supervisors from allied health, medicine, nursing and midwifery between May and August 2021. Numerical data were analysed descriptively using chi-square tests. Free-text comments were analysed using content analysis.

RESULTS
Complete datasets were available for 167 respondents. Overall trends indicated perceived significant disruptions to student learning and support, plus mental health and well-being concerns for both students and supervisors. Extensive mask wearing was noted to be a barrier to building rapport, learning and teaching. Some positive impacts of the pandemic on student learning were also noted.

CONCLUSIONS
This study has highlighted the perceived impact of the pandemic on supervisors' mental health, and on the mental health, learning and work readiness of students. This study provides evidence of the pandemic impacts on student clinical placements from a supervisor point of view. Findings can assist in future-proofing clinical education and ensuring that students continue to receive learning experiences of benefit to them, meeting curriculum requirements, in the event of another pandemic.


Many different therapeutic strategies focus on targeting tumor-associated macrophages (TAMs), due to their vital role in creating an immune suppressive tumor microenvironment (TME) with the aim to deplete, repro-gram or target the functional mediators secreted by these cells. Immune modulatory vaccination is an emerging strategy to target immune suppressive myeloid populations in the TME. In contrast to the other clinical strategies that target TAMs, this combines both TAM depletion (through direct killing by cytotoxic T cells) and TAM reprogramming (by introducing pro-inflammatory cytokines into the immune suppressive microenvironment).


Context: In order to preserve the value of Systematic Reviews (SRs), they should be frequently updated considering new evidence that has been produced since the completion of the previous version of the reviews. However, the update of an SR is a time consuming, manual task. Thus, many SRs have not been updated as they should be and, therefore, they are currently outdated. Objective: The main contribution of this paper is to support the update of SRs. Method: We propose USR-VTM, an approach based on Visual Text Mining (VTM) techniques, to support selection of new evidence in the form of primary studies. We then present a tool, named Revis, which supports our approach. Finally, we evaluate our approach through a comparison of outcomes achieved using USR-VTM versus the traditional (manual) approach. Results: Our results show that USR-VTM increases the number of studies correctly included compared to the traditional approach. Conclusions: USR-VTM effectively supports the update of SRs.


Algeria, by its vast terrestrial extent and its climatic variation, has an abundant,
rich and varied flora in which it was counted many aromatic and medicinal species that provide bioactive
compounds characterized by their broad biological activities. In this context, this work is based on
the evaluation of the antimicrobial activity of Quercus robur L. leaves extracts (Family of Fagaceae).

Firstly, the collected plant material was defatted; then, the extraction of tannins and saponins
was carried out according to a standard protocol where the extracts obtained were tested on some uropathogenic
microbial strains by disk diffusion method with the determination of the Minimum Inhibitory
Concentrations (MICs) by broth macro-dilution method.

The extraction yield of the selective extracts was 7.93 and 16.94% for tannins and saponins,
respectively. The antibiotic resistance profile of the tested strains showed a resistance relatively important
to several antibiotics, namely amoxicillin +clavulanic acid and ampicillin for Escherichia coli,
while Pseudomonas aeruginosa showed resistance to amoxicillin+clavulanic acid, amikacin, cefotaxime
and ceftazidime. However, Staphylococcus aureus was susceptible to penicillin, gentamicin, ofloxacin
and chloramphenicol. Antifungal susceptibility testing has been shown that Candida albicans was susceptible
to amphotericin B, econazole and it was clinically categorized as intermediate to miconazole
drug. For antimicrobial tests, the tannins and saponins extracts exhibited a low to strong inhibitory effect
at tested concentrations lower than 30 mg/mL (ranged from no inhibition to an inhibition zone diameter
of 17.5 mm), depending on dose levels and tested microbial strains.

This activity is proportional to the tested concentrations, knowing that tannins extract was
more active compared to saponins extract. For this, Q. robur could constitute an important source for
drug discovery.


Previous studies, predominantly based on increased or decreased plasma levels, have reported conflicting data on a potential functional role of ADAMTS13 in the pathogenesis of liver diseases, including non‑alcoholic steatohepatitis (NASH). The aim of the current study was to evaluate whether ADAMTS13 deficiency affects development of NASH. Therefore, male wild‑type (WT) and Adamts13 deficient (Adamts13‑/‑) mice were kept on a steatosis‑inducing diet devoid of methionine and choline (MCD) or a control diet (MCC) for 4 weeks. Induction of NASH did not affect plasma ADAMTS13 antigen levels of WT mice. MCD as compared with MCC feeding resulted in reduced body and liver weight with no differences between the genotypes. Plasma levels of the liver enzymes AST and ALT were significantly higher for MCD vs. MCC fed Adamts13‑/‑ and WT mice, however were not different between the genotypes. Liver triglyceride levels were also higher after MCD feeding, but were not different between WT and Adamts13‑/‑ mice. Adamts13‑/‑ mice on the two diets exhibited higher insulin sensitivity when compared with WT mice. On the MCC diet, the genotype did not show clear histological abnormalities in the liver, whereas severe steatosis and fibrosis were observed on MCD diet, however were comparable for both genotypes. This was supported by comparably enhanced hepatic expression in the two genotypes on MCD diet of the steatosis marker CD36 and of the fibrosis marker tissue inhibitor of metalloproteinase 1. Thus, the results of the current study do not support a functional role of ADAMTS13 in this murine model of NASH.


CONTEXT
Inhibin β-subunits and activin receptors are expressed by human trophoblast cells. Although activin A has been shown to enhance human trophoblast cell invasion, whether two additional activin isoforms, activin B and AB, exert similar effects remains unknown. Moreover, whether the expression of mesenchymal adhesion molecule neural cadherin (N-cadherin) is essential for this proinvasive effect of activin has yet to be determined.

OBJECTIVE
To examine the effects of all three activin isoforms on human trophoblast cell invasion and the involvement of N-cadherin.

DESIGN
HTR8/SVneo immortalized extravillous cytotrophoblast cells and primary cultures of human extravillous cytotrophoblast cells were used as study models. Small interfering RNA-mediated knockdown approaches were used to investigate the molecular determinants of activin-mediated functions.

SETTING
An academic research center.

MAIN OUTCOME MEASURES
Reverse transcription-quantitative real-time PCR and Western blot analysis were used to examine mRNA and protein levels, respectively. Cell invasiveness was assessed by Matrigel-coated transwell assays.

RESULTS
All three activin isoforms produced comparable increases in HTR8/SVneo cell invasion as well as N-cadherin expression. In addition, the up-regulatory effect of activin isoforms on N-cadherin was confirmed in primary cultures of human trophoblast cells. Interestingly, small interfering RNA-mediated down-regulation of N-cadherin attenuated basal and activin-induced invasion of both HTR8/SVneo and primary trophoblast cells. All three activin isoforms induced equivalent phosphorylation of SMAD2 and SMAD3. Importantly, activin-stimulated cell invasion, up-regulation of N-cadherin, as well as activation of SMAD2/SMAD3 were abolished by the TGF-β type I receptor inhibitor SB431542 in HTR8/SVneo cells. Furthermore, knockdown of SMAD2/3 or common SMAD4 abolished the stimulatory effects of all three activin isoforms on N-cadherin expression.

CONCLUSION
Activin A, B, and AB produce comparable increases in human trophoblast cell invasion by up-regulating N-cadherin expression in a SMAD2/3-SMAD4-dependent manner.


Background: Recreational drug use is popular among men who have sex with men (MSM), while there is limited information about polydrug use and its consequent impact on sexual health and human immunodeficiency virus (HIV) acquisition. Methods: Mixed methods were used to recruit MSM from seven cities in China between 2012 and 2013. Participants were divided into four subgroups based on the number of recreational drugs (RDs) used in the past 6 months. "Polydrug use" was defined as simultaneous use of ≥2 types of RDs. Information on demographics and HIV high-risk behaviors (HIV-HRBs) was collected, and blood samples were tested for recent HIV infection by the BED capture enzyme immunoassay. Results: A total of 4,496 Chinese MSM participated, of which 28.4% used RDs, and 5% were polydrug users. Polydrug users commonly took poppers with one or more types of other RDs (e.g. methamphetamine). Polydrug users were likely to be aged 26–30 years, have low educational attainment, be internal migrants, have a high monthly income, use versatile positions during anal intercourse, and have inadequate knowledge about prevention of HIV infection. As the number of RDs used in the past 6 months increased, the prevalence of HIV-HRBs increased ( P <0.05 for all). The odds of recent HIV infection were higher among those who used one type (aOR = 2.2, 95%CI: 1.5–3.0) or two types of RDs (2.3, 1.0–5.2) in the past 6 months compared with those who did not use RDs. Conclusion: The level and pattern of polydrug use among Chinese MSM were different from high-income countries. Polydrug use had a dose-effect relationship with HIV-HRBs. Polydrug users who have higher levels of RDs use are more likely to engage in various sexual risks, thus may be associated with new HIV infections.


This article addresses conflicts and negotiations about gender equality and diversity within the European public sphere (EPS). It aims to explore the specific constraints and possibilities for realizing gender equality and justice from the transnational European context. Research illustrates that the European Union (EU) approach to gender equality has strengthened the transnational space of mobilization and given actors new possibilities to negotiate about multiple inequalities and direct their claims at different levels. This has at the same time led to a diversification of women's claims and conflicts about the meanings and framings of gender equality and diversity within the EPS. This is illustrated by case studies of the framing of gender equality and ethno-national diversity by political actors in the European Women's Lobby and the European Parliament. The article proposes that the multilevel EU polity can be interpreted as a unique case for reframing justice in a globalized world.


In The Growth of Incarceration in the United States, the National Research Council documents the large and persistent racial disparities in imprisonment that accompanied the more than quadrupling of the U.S. incarceration rate since the 1980s. Largely unnoticed by policy makers and opinion leaders in recent years is an unprecedented decrease in the number of African American women incarcerated at the same time that the number of white women in prison has grown to new heights. The result of these recent changes is a near convergence in black-white female incarceration rates from 2000 to 2016. In some states, the changes occurred abruptly and almost instantaneously. In other states, the convergence has been gradual. We find that changes in the population composition—the fraction of the population that is black—was the major contributor to the decline in the disparity among women. We also find that race-specific differences in drug overdose deaths stemming from the recent increases in opioid use lowered the disparity by increasing the white female imprisonment rate and lowering it for black women.


Anatomical studies of the respiratory apparatus of birds show evidences for a gas exchanging tubular system (parabronchi and air capillaries); these exchanging structures are entirely dissociated from the ventilatory drive acting on the air sacs. A "cross-current" gas exchanging system (perpendicular disposition of air and blood capillaries) allow a good wash-out of carbon dioxide (PaCO2 lower than PECO2). The great efficiency of this lung is allowed by its very large diffusive surface (ASa) and by the high values of lung specific oxygen diffusing capacity (DO2/ASa) and of O2 extraction coefficient in inspired air. The ventilatory pattern of birds is characterized by a greater tidal volume and a smaller respiratory frequency than in mammals of same weight. Respiratory centers of birds receive afferences from lung stretch receptors, CO2-sensitive lung receptors and arterial chemoreceptors.


This paper $deaLs$ with the metric maximllm cluustering problem with given cluster sizes and the maximum triangle packing problem. For the former problem, Hassin and Rubinstein gave a randomized polynomial-time approximation algorithm achieving an expected ratio of $\frac{1}{2}-\not\in$ , where $k$ is the size of the $8mallest$ cluster. We improve the ratio to $\iota_{-\frac{2}{k}}2+\frac{1}{k(k-1)}$ and also derandomize it. For the latter problem, Ha.ssin and $R\backslash lbinote\bm{i}$ gave a randomized polynomialtime approximation algorithm achieving an expected ratio of $g_{(1-\epsilon)}88$ we improve the expected ratio of $\frac{187+320n}{347+u\infty}\cdot(1-\epsilon)$ for any constant $\epsilon>0$ . Note that $p$ is clo,ae to 0.27.


We determine the structure of transitive actions of compact Lie groups on spaces which have the dimension and the (rational) homotopy groups of a product 1 ◊ m of spheres. These homogeneous spaces arise in several geometric contexts and may be considered as 1 -bundles over certain spaces, e.g. over lens spaces and over certain quotients of Stiefel manifolds. Furthermore, we show that if a non-compact simply connected Lie group acts transitively on such a space, then the orbits of the maximal compact sub- groups are all simply connected rational cohomology spheres of codimension one and hence classified. We obtain this by giving a short proof of the existence and structure of the natural bundle of Gorbatsevich under these much less general assumptions. In this special case the proof gets considerably shorter by the use of the homotopy properties of the spaces in question and a theorem of Mostert on the structure of orbit spaces of compact Lie groups on manifolds.


• Most commonly used analgesic drugs may be safely administered to lactating dams without adversely affecting the neonates. ■ Introduction The major goal in anesthesia for cesarean section (CS) is to minimize fetal effects of anesthetic drugs in order to minimize fetal respiratory, central nervous system and cardiovascular depression and deliver live, vigorous puppies. Of equal importance is to provide adequate analgesia to the dam and prevent anesthesia-related complications such as hypotension, hypoventilation, hypoxemia, hemorrhage and hypothermia, which will increase morbidity and mortality in both mother and puppies. The physiochemical properties which allow drugs to cross the blood-brain barrier also facilitate crossing of the placenta, therefore the assumption should be made (with very few exceptions) that anesthetics, analgesics and sedatives/tranquilizers all cross the placenta. Prolonged labor prior to delivery causes maternal physiologic compromise, resulting in fetal depression due to decreased placental perfusion, hypoxemia and acidosis. Maternal and puppy mortality is significantly increased during emergent versus planned CS (1,2). Timing and preparation are extremely important for puppy survival for both elective and emergency CS, and a thorough understanding of the maternal physiologic changes and the potential impact of anesthetic drugs is essential to optimize outcomes for both mother and fetus (Figure 1).


Impacts of the interconnect design on the mechanical reliability of Cu/low-k multi-layer interconnects were investigated using Finite Element Analysis. The Chip package interaction (CPI) was analyzed to calculate the energy release rate (ERR). First, impacts of dielectric material properties on CPI were studied using a four metal layer model. Then the study was extended to seven and nine metal layer models were used to investigate the CPI impacts to crack driving forces. Finally, implications on interconnect design rules and reliabilities will be discussed.


This paper focuses on the unique methodology employed in the photographic project '"Under Gods": Stories from Soho Road'. It looks at the photographer as a researcher who sees and draws upon the evolving relationship between themselves, their subjects and the urban environment - in this case the city of Birmingham, UK. This leads to a discussion of the process of fieldwork recently undertaken in Paris, which uses a written phenomenological methodology in contrast to image- and sequence-based commentary mobilized in the Birmingham research. Drawing on everyday 'field' experience, this paper describes the logistics of visual and theoretical research design in complex urban settings, elaborating in particular upon the process of engaging intimately with individuals and communities on the sensitive and ambiguous subjects of faith and religion. The comparative research analyses the environments and experiences of diasporic urban faith communities living within close proximity in small geographical areas in Paris and Birmingham. This paper considers the notions of knowledge and knowledge exchange in terms of both fieldwork experiences and their resulting outputs. In so doing, it demonstrates that while more expressive research methods may encounter obstacles of subjective bias they also have the potential to offer audiences and researchers deeper insights into both the subject matter and the complex process of engaged visual and sensory research. This suggests the need to rethink certain categories of anthropological knowledge in light of understandings that may be accessible through more embodied research methods and expressive data.


We recognize objects even when they are partially degraded by visual noise. We studied the relation between the amount of visual noise (5, 10, 15, 20, or 25%) degrading 8 black-and-white stimuli and stimulus identification in 2 monkeys performing a sequential delayed match-to-sample task. We measured the accuracy and speed with which matching stimuli were identified. The performance decreased slightly (errors increased) as the amount of visual noise increased for both monkeys. The performance remained above 80% correct, even with 25% noise. However, the reaction times markedly increased as the noise increased, indicating that the monkeys took progressively longer to decide what the correct response would be as the amount of visual noise increased, showing that the monkeys trade time to maintain accuracy. Thus, as time unfolds the monkeys act as if they are accumulating the information and/or testing hypotheses about whether the test stimulus is likely to be a match for the sample being held in short-term memory. We recorded responses from 13 single neurons in area TE of the 2 monkeys. We found that stimulus-selective information in the neuronal responses began accumulating when the match stimulus appeared. We found that the greater the amount of noise obscuring the test stimulus, the more slowly stimulus-related information by the 13 neurons accumulated. The noise induced slowing was about the same for both behavior and information. These data are consistent with the hypothesis that area TE neuron population carries information about stimulus identity that accumulates over time in such a manner that it progressively overcomes the signal degradation imposed by adding visual noise.


Leaf Area Index (LAI) is one of the important crop parameters that can be used to assess crop conditions or drought severity. Estimating LAI for arid regions presents challenge due to the high spatial variability in precipitation and in crop canopies found in such regions. In this study, spectral reflectance of pearl millet was computed at various wavelengths and at different times during the cropping season, using a spectroradiometer. Three main indices (Normalised Difference Vegetation Index, Ratio Vegetation Index, and Perpendicular Vegetation Index)were derived from the spectral data. These indices were then correlated with the leaf area index in order to identify the index that gave the strongest relationship. A polynomial relationship, with the coefficient of correlation of 0.70, was found between LAI and NDVI indicating that NDVI is a potential index for estimating LAI for aridregions. Key Words: Arid lands, Leaf area index, vegetation indices


Every day, most of us encounter an environment which holds significant to us beyond our immediate lives: passing a building we used to work in, seeing an image of somewhere we have been on holiday, walking through a city centre we have known all our lives and has changed as we have; but why do we humans feel the need to visit places which are more abstract for us and which become a vicarious experience of something others have lived or framed for us. Much has been discussed and critiqued in terms of the heritage industry we see across the world but in this paper I want to address something of the more specific function of visiting locations which we recognise from imaginary landscapes – not why visit the Tower of London (because we know it's history) but why visit a castle with no name seen distant on a hill? Not why visit the Universal Studios parks in the US or Japan (because it represents and imitation of Hollywood) but why visit some ruins in Ireland because they seem familiar? As such, this paper will drawing upon both the critical context of how we understand landscape as humans within that space but also original data gathered through questionnaires from people around the world in a small study of what we can call 'abstract tourism' and how this is a manifestation of our social-cultural engagements with space, place and identification.


A numerical investigation is presented in this work to study the ballistic performance of Aluminum Oxide (Al203) ceramic plates bonded to a polycarbonate backing subjected to impacts from 7.62 mm diameter calibre projectiles. The ceramic plate measured 102×102 mm with a thickness of 5.8 mm. A numerical model was developed using the explicit finite element code LS-DYNA, which possesses contact, erosion and material failure capabilities particularly suitable for ballistic simulation. The Johnson–Holmquist, Piecewise Linear Plasticity and Plastic Kinematic constitutive material models were used to model the materials behaviors of the, ceramic, projectile materials and backing material, respectively. The residual velocity and depth of penetration (DoP) into the backing material was obtained and compared with the available experimental data. The results showed that when the ceramic plates were impacted by a projectile, damage mechanism of the fragmented ceramic included radial and circumferential crack lines along with a pulverized center and a highly eroded bullet.


Japanese researchers often find it difficult to write up academic reports in English, which may be associated with a perceived "language barrier." However, in fact, it is "emotional barrier" that discourages "potential" researchers from publishing their data. The plain English that we have learnt at school is sufficient to write academic articles in English. What is important is your guts, determination, and perseverance. In this article, tips on how to practically publish your data in English are presented.


In the current work, the tensile properties of semi-crystalline Polyamide 6 are experimentally investigated for varying degrees of crystallinity, temperatures, and loading rates. Based on the experimental results, a phenomenological constitutive framework at finite strains is derived in a thermodynamically consistent manner. To this end, a hyperelastic-plastic intermolecular resistance and viscous molecular network resistance are considered. Non-linear kinematic and isotropic hardening as well as nonlinear relaxation behavior are incorporated, to account for the experimentally observed behavior. It is evident that the mechanical behavior of semi-crystalline polymers exhibits complex dependencies on the degree of crystallinity and the temperature. To capture these experimental findings, both quantities serve as input parameters. A staggered parameter identification scheme is proposed to obtain a unique set of material parameters. Finally, the great capabilities of the proposed framework, to accurately predict the three-dimensional, visco-hyperelastic-plastic material response are demonstrated


Abstract Does information about how other people feel about COVID-19 vaccination affect immunization intentions? We conducted preregistered survey experiments in Great Britain (5,456 respondents across 3 survey waves from September 2020 to February 2021), Canada (1,315 respondents in February 2021), and the state of New Hampshire in the United States (1,315 respondents in January 2021). The experiments examine the effects of providing accurate public opinion information to people about either public support for COVID-19 vaccination (an injunctive norm) or public beliefs that the issue is contentious. Across all 3 countries, exposure to this information had minimal effects on vaccination intentions even among people who previously held inaccurate beliefs about support for COVID-19 vaccination or its perceived contentiousness. These results suggest that providing information on public opinion about COVID vaccination has limited additional effect on people's behavioral intentions when public discussion of vaccine uptake and intentions is highly salient.


Abstract Background and aim: Uric acid elevation has been shown to be an important risk factor for cardiovascular and cerebrobascular disease. QT dispersion (QTd) is a parameter that shows the heterogeneity of ventricular repolarization and can be calculated noninvasively from surface electrocardiography. Increased QTd has been associated with severe arrhythmia and risk of sudden death in many patients and disease groups. In this context, we aimed to investigate the effect of uric acid levels on QTd and the effects of decrease in uric acid levels on QTd. Methods: A total of 225 patients with normal renal function were included in the study; 133 of these patients were hyperuricemic (>7 mg/dL), and the remaining 72 patients were normouricemic (Group 1). The hyperuricemic patients were randomly divided into 2 groups, one group (n = 67) was given placebo (Group 2) for 4 months, and the remaining 66 patients were given allopurinol 300 mg/day (Group 3). Results: Hyperuricemic patients had higher hsCRP and QTd and lower eGFR values compared to the normouricemic control group. After 4 months of treatment, 66 patients treated with allopurinol showed a significant decrease in serum uric acid, systolic and diastolic blood pressure, and hsCRP levels, and a significant increase in eGFR. Although the QTd values in the treatment group did not decrease to the same levels as in the normouricemic control group, a statistically significant decrease was found compared to their baseline values. In hyperuricemic control and normouricemic control patients, there were no differences in the levels of uric acid, hsCRP, eGFR, systolic and diastolic blood pressure, and QTd values compared to baseline values. Conclusions: There was a significant association between elevated serum uric acid and QTd, as well as with inflammatory biomarkers. Also, patients who had received hypouricemic therapy during the follow-up period presented a significant decrease in inflammatory markers as well as QTd. This indicates the beneficial effects of decreasing uric acid levels in decreasing the risk for future major adverse events related to ventricular arrhythmias.


Background: The ankle-brachial index is a simple and effective tool for diagnosing peripheral artery disease, but has not been validated for the diagnosis of coronary artery disease. The aim of this study was to evaluate the ability of the ankle-brachial index to predict coronary artery disease in patients undergoing coronary angiography. Methods: Patients with clinical suspicion of coronary artery disease and indication for coronary angiography were prospectively evaluated. Significant coronary artery disease was defined as the presence of stenosis > 70% of at least one major epicardial coronary artery or any of their major branches. A ROC curve was developed to define the ankle-brachial index cutoff that best predicts coronary artery disease. Results: A total of 312 patients were evaluated: mean age was 57 ± 11 years and 50% were male. One hundred and sixteen (37.2%) patients had significant coronary disease. Ankle-brachial index measurement in these patients was significantly lower than in those without coronary artery disease (0.88 ± 0.14 vs. 0.96 ± 0.87; p < 0.01). Ankle-brachial index < 0.87 showed a sensitivity of 31%, specificity of 95.4%, positive predictive value of 75.9% and negative predictive value of 71.6%. The area under the ROC curve was 0.73 (95% confidence interval of 0.67-0.79). Conclusions: Ankle-brachial index < 0.87 had a high specificity to predict significant coronary disease. Considering its low cost and ease of use, measurement of ankle-brachial index may be incorporated to daily clinical practice to help diagnose significant coronary artery disease.


Dynamic DNA assembly, operated in an autonomous and reconfigurable manner by controlling the kinetics of strand displacement reactions (SDR), is an ideal approach to amplify the fluorescent signals for molecular diagnostic and imaging. Herein, we for the first time have demonstrated an enhancement of fluorescence intensity of DNA/Ag nanocluster-based beacons by the modulation of SDR. This is a new DNA/Ag NCs fluorescence light-up system through the use of the enhancer of G-rich overhang. Such a sensing system can be used to develop a DNA/Ag nanocluster-based beacon for the fluorescent detection of nucleic acid and thrombin with high selectivity and sensitivity, in which the detection sensitivity could be further enhanced through additional Exo III based amplification.


THIS PAPER is the outcome of a study of the case histories of all infants and children with the final diagnosis of a retroperitoneal tumor admitted to the Los Angeles Childrens Hospital during the years 1936 to 1950. Farber 1 and others 2 have recently discussed these tumors collectively, on the basis of the region of origin and certain common clinical findings. The latter aspect of the subject was particularly manifest as this survey progressed. Without the surgical report, or pathological findings, it was impossible to determine accurately the nature of the tumor in a majority of the cases studied. Since retroperitoneal growths form by far the most frequent abdominal tumor of childhood, they are often encountered by the general surgeon. With earlier diagnosis, and improved methods of treatment, cure can be anticipated in about one third of the cases (Wittenborg 3 ; Neuhauser 4 ). These facts have led to a


As the world becomes increasingly interdependent, mutual understanding becomes increasingly important. Therefore, it is essential that people strive for reductions in social distance on an international level. Study abroad is one of the ways to approach internationalization and promote understanding among different peoples and cultures. Prior research has been done on the degrees of social distance between people from different cultures; however, little research has been done regarding changes that cultural immersion produces among those who reside in different cultures. Studies about study abroad programs have focused on cultural sensitivity and adaptability, yet few have combined the study abroad experience with the perceptions of self and other cultural groups. This study presents a framework for understanding people through intercultural activities. It studied social distance and attitude changes brought about in social distance as an artifact of cultural immersion. The study took place both in China and in the United States. It focused on the social distance among American undergraduate students who participated in a China Study Abroad program sponsored by the University of North Texas. The study measured before and after social distance of a group of American students who studied abroad in China. The study abroad program itself was the intervention and lasted for three weeks. A mixed methods research design was used in the study. Social distance data were collected before and after students studied abroad in China. Both inferential statistics and descriptive statistics were used. Qualitative data were also collected and analyzed in the study. Most of the sample population were close to the Chinese people to begin with. Some participants positively changed their social distance and attitudes towards the Chinese people after the study abroad program, even though the changes were not statistically significant. This study merits replication among randomly selected samples. Study abroad programs should be promoted and supported. More research needs to be done that explores the quality of cultural immersion study abroad programs. Studies also need to be done to examine attitude changes among peoples in host countries.


The study on new rheoforming technologies of semisolid alloys has recently been one main subject interesting many professors, experts and industrials, and so many new methods about preparing semisolid alloy slurry and rheoforming process have been put forward. The semisolid slurry of AlSi7Mg alloy was prepared by being poured at a low superheat and stirred by an electromagnetic field at a low power for a short time, and then the slurry was further soaked for proper time and finally rheoformed into a key-shaped die cavity in this paper. The influence of slurry temperature, injection specific pressure and injection speed on the rheoforming process was also studied. The experimental results show that if AlSi7Mg alloy melt is poured at 630°C or 650°C and meanwhile stirred by an electromagnetic field at a low power for a short time, the most primary α-Al grains solidified in the slurry are spherical and only a few are rosette-like. If the slurry after made is then soaked in the liquidus-solidus range for some time, the ripening of primary α-Al grains is developed further and they become more spherical and larger. The experimental results also show that the slurry temperature, injection pressure and speed have a great influence on filling ability. The higher the slurry temperature, injection pressure and speed, the higher the slurry filling ability, and the shorter the core distance from the ingate, the more easily the die cavity is filled. With the given key-shaped casting, if only the slurry temperature should be equal to or more than 585,, or the injection pressure is equal to or more than 20 MPa, or the injection speed should be equal to or more than 1.73m/s, the key-shaped die cavity can be filled completely. The microstructural distribution in the casting is very homogeneous and it shows that the slurry prepared by the new method is very suitable for rheoforming and helpful to obtaining high quality castings.


To cope with sudden changes in the external environment, the budding yeast Saccharomyces cerevisiae orchestrates a multi-faceted response that spans many levels of physiology. Several studies have interrogated the transcriptome response to endoplasmic reticulum (ER) stress and the role of regulators such as the Ire1 kinase and Hac1 transcription factor. However, less is known about responses to ER stress at other levels of physiology. Here, we used quantitative phosphoproteomics and computational network inference to uncover the yeast phosphoproteome response to the reducing agent DTT and the upstream signaling network that controls it. We profiled wild-type cells and mutants lacking IRE1 or MAPK kinases MKK1 and MKK2, before and at various times after DTT treatment. In addition to revealing downstream targets of these kinases, our inference approach predicted new regulators in the DTT response, including cell-cycle regulator Cdc28 and osmotic-response kinase Rck2, which we validated computationally. Our results also revealed similarities and surprising differences in responses to different stress conditions, especially in the response of Protein Kinase A (PKA) targets. These results have implications for the breadth of signaling programs that can give rise to common stress response signatures.


The aim of this study is to present the underlying methodology behind the estimation of the Adequate Living Expenses (ALE) Threshold for the Greek population. The ALE threshold was first introduced in 2014 by the Greek authorities as a benchmark, mainly for protecting over-indebted mortgage holders from foreclosure of the primary residence. In this manuscript, we present alternative methodological approaches and specifications considered to estimate this threshold and we report updated estimates for the year 2017. The ALE threshold is defined through expenditure for the purchase of goods and services and interpreted as the income level that the household should possess in order to cover the level of acceptable living expenses, following the median expenditure pattern of Greek households. By taking into consideration the main categories of the Greek Household Budget Survey, we examined different expenditure specifications, based on the necessity of the needs covered by gradually excluding items that could be considered as "luxury" items (four scenarios were developed). Quantile regression and linear robust regression accounting for the presence of outliers was applied and various model specifications were tested. Our results control for household structure, degree of urbanization and mortgage holding, and interactions among them. In 2017, for a family with two children ALE threshold ranged from 1,196€ to 1,497€ per month, reduced by approximately 11.5% compared to 2012, depending on the expenditure specification. The estimated ALE threshold lies considerably above the poverty line in all cases.


Manguerra-Brainard's fiction is a searching for identity and a realization that this identity is formed not only b y ethnic heritage but b y the tension between this and the American c ulture , which she has also adopted as her own. Asian-American history dates back to almost 160 years ago . But it has only been in the past twenty years that attention has been paid to the veritable trove of literature that the experience of Asians living in America has brought forth .


High entropy alloys (HEAs) and their closely related variants, called multi-principal element alloys (MPEAs), are the topic of a rather new area of research, and so far, the gathered knowledge is incomplete. This is especially true when it comes to material libraries, as the fabrication of HEA and MPEA samples with a wide variation in chemical compositions is challenging in itself. Additive manufacturing technologies are, to date, seen as possibly the best option to quickly fabricate HEA and MPEA samples, offering both the melting metallurgical and solid-state sintering approach. Within this study, CrFeNiTi MPEA samples were fabricated via laser powder-bed fusion (PBF-LB) and solid-state sintering of mechanically alloyed powder feedstock. The main emphasis is on the PBF-LB process, while solid-state sintering serves as benchmark. Within a volumetric energy density (VED) window of 50 J/mm3 to 83 J/mm3, dense samples with large defect-free sections and an average micro-hardness of 965 HV0.1 were fabricated. Clear correlations between the local chemical alloy composition and the related micro-hardness were recorded, with the main factor being the evaporation of titanium at higher VED settings through a reduction in the C14_Laves phase fraction.


Sudden geospatial phenomena, whether natural or technocratic, regional, or global, including pandemics, confront industrial enterprises, including those in the chemical and technological complexes, with a new kind of uncertainty, creating new risks when making operational and strategic management decisions. These risks often have devastating consequences for economic and social agents caught in these geodynamic phenomena. Amongst the many kinds of dangers, the most economically and socially destructive are changes in consumer demand as related to quantitative, qualitative, and temporal parameters. These shockwaves can have dire effects, including the non-functionality of existing logistical systems, unrestrained costs, a terrifying level of unemployment, etc. In these dramatic scenarios, sector management must develop new strategies to deal with changes in the national economy, ensuring their ability to overcome factors that may otherwise destroy the existing socioeconomic parameters. To minimize these negative phenomena, it is necessary to develop a geographic information system (GIS), the elements of which entail dynamic information about all emerging risks, including the ability to ensure complete safety for all personnel, partners and suppliers, relations with government bodies and the public, and optimal use of financial resources. To build such an anti-crisis system, it is advisable to offer a scientific response to these challenges and many other problems associated with the operation of enterprises in such emergencies.


Wildfire threat is an intrinsic part of life in rural communities in the arid Western U.S. Western U.S. continues to experience a rapid population growth of Wildland-Urban Interface (WUI) areas, an increase in the frequency of wildfire due to increase human-caused ignition (Cardille et al. 2001), and overall fire severity due to over-accumulation of vegetation density on the surrounding public lands. Due to these trends, wildfire tends to have significantly higher economic cost associated with communities located in the WUI relative to wildfires on more remote public lands since WUI residences have an increased chance of damage (NIFC 2004). Fire protection services within these rural areas are scarce however; fire protection can be leveraged by wildfire risk mitigation actions done to both private properties and public lands adjacent to WUI areas. Private mitigation actions include creating a defensible space zone and use of fire resistant construction materials on the house, such as concrete siding or tiled roofing. Defensible space reduces the chance a wildfire will move from the public lands and damage or destroy a house by eliminating the combustible material and vegetation on the landscape within 30 feet of the home and promotes the use of fire resistant landscaping, i.e., well-irrigated lawns, deciduous shrubs and trees, xeriscaping, etc. Fire resistant construction materials reduce the chance a house will catch fire, given it ignites on the property. Public fuel reduction treatments remove strips of the native vegetation around the community creating a barrier between the public lands and the WUI which fire protection services can use to prevent fire from threatening homes. These public actions can be targeted to high priority areas within the community. Private and public provisions to reduce risk can impose considerable costs to residents and the individual risk of damage to a residence from a wildfire is rather low, therefore decisions about investment in these provisions can be seen as a gamble due to the uncertainty regarding the outcome. In one prospect, the resident can pay nothing and face uncertainty about a loss incurred from a wildfire. In another prospect, the resident can reduce the uncertainty by investing in risk mitigating provisions. Financial incentives for WUI residents in areas of elevated fire risk can be imposed in the form of policies and cost-sharing programs such as block grants. Such incentives can relieve some of the burden placed on residents and increase of overall level of defensible space thereby decreasing the level of risk facing WUI residents. Other incentives include educational components that help residents understand the risk they face. We explore how residents' value these provisions when the stakes are high but the chances of loss are low, as well as, how the value changes between public and private risk reduction provisions. Moreover, we explore the welfare loss given exogenous shifts in wildfire risk. Expected Utility Theory, a generally accepted and widely applied normative model of rational choice (Kahneman and Tversky 1979), would suggest rational individual will base investment decisions under uncertainty on comparison of expected utilities between the two prospects (Mongin 1997). The more risk adverse the individual, the more willing the individual is to forego a riskier situation for a more certain outcome. To investigate these issues, we measure the value of wildfire risk reduction to individual WUI residents using an experimental design based on a stated preference framework. We surveyed residents living in rural communities in Nevada that are representative of the different vegetation types, community designs, and population densities found within the Western U.S. We provide the homeowner two means to reduce the risk. The first method is investment in private defensible space on the property to lower the risk to the homeowner's property. The second method is investment is a community-wide fuel treatment program completed on public lands surrounding the community to lower the overall risk to the community and subsequently to the homeowners. In each case the homeowner was asked to state whether they would be attain those provisions at a given dollar amount. For the private provision the respondent was asked to pay a one-time cost. In the public provision, the cost was an annual fee. Within the survey instrument, the risk reduction from investment is explicitly stated to the homeowner. This reduction is explained as a decrease in the probability of damage to the house if provisions are taken. We employed a discrete choice, polychotomous, contingent valuation method that allowed the level of response intensity to be directly incorporated into the response option. The experiment design included 72 versions of the private provision and 24 versions of the public provision, which were randomly assigned to the respondents. For both provisions, there are multiple risk reduction categories that were randomly assigned to the respondents. Similarly, for both there were two year spans for which the risk reduction was valid, e.g, 5 or 10 years. Within the private provision there are three possible loss amounts ($50,000, $100,000, $200,000) to the homeowner, should a wildfire reach the home, which are also varied across respondents. Within the public provision, no loss amount was specified in order to view residents' value for reducing wildfire risk to the community in general. Our results indicate that willingness to pay (WTP) for private provisions of defensible space are higher than public provisions, i.e., $297 for the private provision and $47 per year for the public provision on average. When considering a 5 year time period the two WTP measures are relatively similar. When considering a 10 year period, the WTP for the public provision becomes greater however our models reveal respondents' WTP are not sensitive to the different time horizons. The similarity between the two provisions indicates that the incentives from private or public program would likely have similar outcomes in reducing risk, therefore it should be left to the policy makers to determine the priority each provision has to a given community. Our results for both provisions indicate that as risk reduction increases, so does WTP. For the private provision the average WTP for a 1% reduction is $147 and increases to $450 for a 4% reduction, while the average annual WTP for a 1% reduction is $36 and increases to $51 for a 4% reduction, suggesting people are considering the magnitude of the risk reduction when making decision about investment in fire mitigation provision across the board. From a policy perspective this would indicate people have a higher value for programs that strategically target areas where risk reduction is most effective. Furthermore, educational programs that inform residents about the how effective mitigation actions are from both private property and within the community as a whole can increase support of the provisions. Moreover, because the risk reduction is identical across the two provision but the expected value i.e., the reduction of risk and loss amount, was explicitly stated to the homeowner only for the private provision, the similarity between the two WTP estimates suggest that residents seem more concerned with the overall reduction in risk rather than the actual expected value gained from the provision. Furthermore, within the private provision our results reveal concavity in WTP over expected value which suggests the decreasing marginal value of investment. This finding is consistent with the EUT literature which assumes a diminishing marginal utility of wealth. This notion that marginal WTP incremental declines as expected value increases suggests incentives to increase private levels of defensible space only work up to a certain point. Beyond that, people begin to experience disutility with increased investment. Therefore, incentives to raise levels of defensible space in the most at-risk WUI communities must account for this lower marginal WTP and possible consider cost-sharing programs to offset this diminishing utility.


This paper presented an algorithm to compute the 4x4, 8x8 and 16x16 efficient two-dimensional (2-D) transform for the HEVC standard providing less complexity and its hardware design. As HEVC large transforms suffered from the huge number of computations especially multiplications, this paper presented a proposition of a modified algorithm reducing the computational complexity. The goal is to ensure the maximum circuit reuse during the computation while keeping the same quality of encoded videos. The proposed hardware has been implemented in VHDL. The VHDL RTL code works at 240 MHZ in an Altera Stratix III FPGA. Results showed frequency improvement reaching 96% when compared to an architecture described as the direct transcription of the algorithm. The designed architecture has achieved a throughput reaching 4 Gsamples/s. With these results, the proposed is able to process even HD videos in real time.


The continuing growth of business activities in companies has been in parallel with the increased use of IT to support the basic business processes and assist in generating further commercial advantages for the organization. Business growth has been generated through a natural expansion of the core activities, acquisition of other companies which has often resulted in working practices of geographically separated organizations, divisions and subsidiaries maintained to preserve their successful business culture. The role of the central IT department as the most cost-effective organization to support the business led use of IT is now in question in many companies.In this paper we present the argument that the key to corporate success is associated with the effective management of IT. In many cases, this will require a new style of management with vision and commitment from the CEO. But for those organizations who do not make this change, their corporate prosperity may be at stake.The material described in this paper formed the basis of the 1992 AIT lecture at the City University Business School.


C37 Ovarian cancer is characterized by tumor cell proliferation and metastasis within the peritoneal cavity. It involves a regulated process of ovarian cancer cell adhesion and invasion into the mesothelial surface of all organs within the peritoneal cavity. This process involves integrins, which are cell surface glycoproteins that allow for cell-cell and cell-extracellular matrix interactions. The role of β3-integrin in human ovarian cancer cell metastasis was studied in vitro using a 3-dimensional (3D) cell attachment/invasion model simulating the human omental microenvironment, composed of primary human fibroblasts overlaid with human omental mesothelial cells. SKOV3ip.1 ovarian cancer cells were stably transfected with β3-integrin and higher expression of β3-integrin in transfected cells was confirmed by Western blot analysis. We found that β3-expressing cells were more adhesive and less invasive on full thickness human omentum, peritoneum and the 3D culture compared to control transfected cells. In vivo assessment of relative metastatic potential was carried out in nude mice by intra-peritoneal injection of β3-integrin overexpressing and control transfected cells. Mice were sacrificed 32days after intraperitoneal injection, and the tumors were counted and collected. Tumor weight and number of tumors were significantly less in cells expressing β3-integrin as compared to the control group. To investigate the mechanism involved, we studied the proliferation rate of SKOV3ip.1 cells and found that the control SKOV3ip.1 cells had a higher proliferation rate compared to cells expressing β3-integrin. The effect of β3-integrin expression on cell cycle was studied by staining the cells with propidium iodide (PI) and observing the different phases of cell cycle by flow cytometry. β3-integrin expressing cells were equivalent in number to control SKOV3ip1 cells in S, and G1 phases of cell cycle, however less cells were in the G2 phase. The effect of β3-integrin expression on apoptosis was studied by caspase-3 western blot analysis and we found that caspase-3 was up-regulated in cells expressing β3-integrin. Taken together these results indicate that a reduced growth rate of β3-integrin expressing cells is due to G2/M-phase cell cycle arrest and/or higher rate of apoptosis. These studies suggest that expression of β3-integrin decreases ovarian cancer invasion in vitro and metastasis in vivo through a reduction in cell proliferation.


Nutritional counseling is one of the efforts of the medical nutrition therapy provided to improve the diet and lifestyle of patients of diabetes mellitus.One of the key factors in the treatment of the disease of diabetes mellitus is an improvement of the quality of the diet.The purpose of this research is to know the influence of diet on quality nutrition counselling patients of diabetes mellitus in poly disease in the RSUD dr.M. Yunus Bengkulu year 2018. This type of research is pre-circling with pre and posttest one gorup design.This research was carried out from April to may 2018. The location of the research on poly disease in the RSUD dr.M. Yunus Bengkulu. research Sample is selected by purposive sampling in accordance with the criteria of inclusion and ekslusi.The number of samples that is 20 respondents. The data are tested using the kolmogorov smirnov test, wilcoxon. The results of the research there is a meaningful influence obtained between nutritional counseling to the quality of the patient's diet diabetes mellitus type II in Poly disease in the RSUD dr.M. Yunus Bengkulu Year 2018 with (p = 0.006). Expected to further researchers can continue research on diabetes mellitus patients with more samples to make it more visible variations in the quality of diet of diabetes mellitus patients and researchers can then tried a more educational media varied to seek effectiveness in the media.
Keywords: Diabetes Mellitus, counseling, Diet quality


The time-dependent liquid film thickness and pressure drop were measured by using parallel-wire conductance probes and capacitance differential-preesure transducers. Applying the eddy viscosity theory and an appropriate correlation of interfacial sear stress,a new two-dimensional separated model of holdup and pressure drop of turbulent/turbulent gas-liquid stratified flow was presented. Prediction results agreed well with experimental data.


This dissertation contains two chapters on law and economics and one chapter on international trade.

An important but under-researched issue for medical malpractice (med-mal) litigation is how physicians' previous medical malpractice experiences affect their behaviour. Using Florida data on closed med-mal claims, I find that if physicians have prior paid claims, their current litigation is resolved faster and is associated with less cost. Having a prior payout does not significantly predict the likelihood or the amount of the current payout. This suggests that ``learning'' occurs as a result of prior med-mal experience. As a theoretical motivation, I developed a dynamic version of the divergent expectations (DE) litigation model. The model predicts, consistent with the data, that physicians have a more realistic analysis of med-mal litigation if they have prior experience. Many robustness checks are carried out to test the results, including using a fixed effect framework, to which the results are robust.

In the second chapter, we investigate the impact of ``duty to settle'' rule in predicting patterns in data. Prior models and studies of settlement ignore the insurer's ``duty to settle''  – the obligation to settle within policy limits if it would be unreasonable to refuse a within-limits settlement offer. We incorporate the duty to settle into a structural model of settlement of medical malpractice claims, and then estimate the model using maximum likelihood methods applied to a Texas closed claims database. Both the data and our model predict: a mass of cases with a settlement demand by the plaintiff exactly at limits; a smaller but still sizeable mass of cases with settlement exactly at limits; very few above-limits payments by insureds; and when above-limits payments are made, they are often by insurers. The model does a reasonable job in predicting data moments, including fractions of cases settled at limits, settled above limits, and tried. Using the model in counterfactual analysis, we predict: (i) with no duty to settle, more cases will be tried; (ii) with strict insurer liability for not settling within limits, there will be fewer trials and more above limits payments by insurers; and (iii) the duty to settle will rarely cause insurers to pay more than the expected value of claims.

The third chapter of this dissertation is on international trade. There is a well established literature on the impact of sovereign debt renegotiation on bilateral trade, including Rose (2005) among others. However, there is no study that disentangles impacts of renegotiation on the intensive and extensive margins, where the former is the trade volume of established bilateral trading relationships and the latter is the number of established relationships. This study employs the UNComTrade dataset and debt renegotiation data from the Paris Club for over 150 countries in order to address the impact of a debt renegotiation on the extensive margin of trade. This paper finds that bilateral trade volume declines…


The authors of the original paper (see ibid., vol.52, no.5, p.1433-42, May 2004) thank Lu and Huang for their useful comments (see ibid., vol.54, No.7, p.3155, July 2006) and apologize for any confusion that their errors may have caused.


Testing is the process of evaluating a system or its components intended to find that whether it satisfies the specified requirements or not. Testing is executing a system in order to identify any gaps, errors or missing requirements in contrary to the actual desire or requirements. In this scenario test suites are generated it is also known as Validation suite which is a collection of test cases that are intended to be used to test a software program. But the problem is targeting one coverage goal at a time is not feasible and code coverage is also high. In order to overcome this problem generating new testsuites with the help of Evosuite tool which covering all coverage goals as well as coverage code is small.It meausured using code coverage and fundamental problemwith common apporach is coverage the goals and how an of them are feasible.In this whole test suites are evovled covering all goals at same time.Its effectiveness not added by number of infeasible targets in code.It has a novel approach in approach Evosuote Tool and it achieved upto 188 times branch coverage in traditional approach targeting single branch strategy with upto 62% samaller test suites.In software testing many testsuites are used to debug a program to over come the testsuites Evosuite Tool was implemented to coverage goals as well as But the problem is targeting one coverage goal at a time is not feasible and code coverage is also high.In order to overcome this problem generating new test suites with the help of Evosuite tool which is covering all coverage goals as well as coverage code is small. KeywordsBranch coverage, Search based software engineering,infeasible goal, collateral coverage Genetic Algorithm.


The present study was conducted to find out the etiology and clinical profile of children with liver disease as seen at a tertiary care teaching hospital in Uttaranchal. The study included 117 patients with ages ranging between 1.5 months to 18 years. Loss of appetite was found to be the predominant presenting feature (95.7%) followed by nausea and vomiting (90.6%). Twenty four (20.5%) cases had cirrhosis of liver with portal hypertension. Acute hepatitis was seen in 28 (23.9%) cases. Fifteen (12.8%) cases had hepatic failure out of whom 9 died. Chronic hepatitis was present in 11(9.4%) cases. On the whole hepatotropic viruses were responsible for 43 (36.8%) cases of liver disease. A total of 13 (11.1%) deaths occurred. Hepatic failure with encephalopathy was the leading cause of death.


We often seek to identify co-occurring hidden features in a set of observations. The Indian Buffet Process (IBP) provides a non-parametric prior on the features present in each observation, but current inference techniques for the IBP often scale poorly. The collapsed Gibbs sampler for the IBP has a running time cubic in the number of observations, and the uncollapsed Gibbs sampler, while linear, is often slow to mix. We present a new linear-time collapsed Gibbs sampler for conjugate likelihood models and demonstrate its efficacy on large real-world datasets.


This report was prepared by Cesar Environmental Economics Consulting under awards CRI-3, 4 and 5 from the US Department of the Interior and National Oceanographic and Atmospheric Administration. The statements, findings, conclusions, and recommendations are those of the author(s) and do not necessarily reflect the views of the Department of Interior, NOAA, or the government of the CNMI.


With reference to Dar es Salaam, this paper examines experience to date with the concept of urban environmental planning and management (EPM), an approach promoted by the UN agencies concerned with human settlements (UNCHS) and environment (UNEP) to enhance the capacity of local governments to manage rapid urban growth and development in partnership with key stakeholders. The paper highlights the opportunities EPM provides to revitalise urban management, particularly in capacity-starved contexts such as those seen in Tanzania. Militating against sustained partnership between local governments and key stakeholders are constraints including weak political will, overemphasis on short-term physical outputs, reluctance to share power, and the protracted nature of the EPM process. Changing entrenched attitudes and habits of the political and administrative e´lites (e.g. conservatism or inflexibility, mystification of urban planning and management, and the monopolisation of power) is imperative if EPM is to be institutionalised within Tanzania. Other issues include how to sustain consensus among diverse stakeholders, the balancing of long-term strategies with immediate or shortterm expectations in poverty-stricken environments, in addition to problems of dialogue with substantive participation by civil society in immature multi-party democracies.


This study aims to describe several aspects of Javanese tradition, Islamic values and modernity influencing young Javanese women in taking up trendy veils. This research is a qualitative study conducted on Javanese female students wearing trendy veils from four universities in Surakarta. Data were collected through observations, questionnaires and interviews in focus group discussion. The findings show some cultural values derived from Javanese tradition, Islam, and modernity influencing and determining the practice of wearing trendy veils among female Javanese Muslim students. From the perspective of modernity, it was found that the practice of trendy veiling among these female students is influenced by the idea of practicality, freedom and autonomy. While traditional Javanese values such as etiquette, relationships and honor also find its relevance to their practice of veiling, it is Islamic religious orientation, the intention for self-improvement based on sharia that becomes the determinant factor in the decision of taking up trendy veils.


In this paper a transfer matrix method is developed to solve for bending vibration of beam with linearly reduced width, and subsequently used to determine the exact natural frequencies for such problems. The differential equation, shear force, and bending moment are derived from Hamilton's principle, and the roots of the differential equation are computed using the power series solution of the Frobenius method. The effect of various taper ratio for bending vibration of beam with linearly reduced width is investigated in detail, and to validate the accuracy of the proposed method the results computed are compared with those given from commercial software(ANSYS).


This study attempts to define the degrees of lexicalization and grammaticalization of the Finnish converbs ending in Ten, TUA, TessA, TAkse, mAllA and -mAttA. The study is based on a corpus of Finnish newspaper texts from the 1990s. The approach is fundamentally functional-typological and cognitive. The productive use of the six Finnish converbs is compared to their lexicalized and grammaticalized instances and to some less prototypical non-finite adverbial verb constructions. In this study lexicalization is seen as a process from transparent and productive, to opaque and unproductive. It also stands for the lexical strength of an item, i.e. how often an item or a co-occurrence of items is repeated in discourse. Grammaticalization, in contrast, is seen as a process from less grammatical to more grammatical. The more grammaticalized an item is, the more it resembles the most prototypical items in the target category. The types of lexicalized converb forms that this study focuses on are adverbs (e.g. yllattaen 'suddenly, unexpectedly') and phrasal adverbs (e.g. juurta jaksain 'thoroughly, root and branch'); the types of grammaticalized converbs analyzed are adpositions (e.g. huolimatta 'despite, notwithstanding'), conjunctions (e.g. olettaen etta 'supposing') and sentence adverb markers (e.g. sanoen 'saying' in rehellisesti sanoen 'frankly'). A three-way model is suggested to the degrees of lexicalization on the one hand, and the degrees of grammaticalization on the other. When determining the degrees of lexicalization and grammaticalization of individual items, their syntax, form, semantics and frequency are taken into consideration. The analysis consists of determining the weight of these criteria in each individual instance, exemplifying the productive and lexicalized/grammaticalized uses of the converb forms from the corpus, and providing frequency data on the various uses in the chosen corpus material.


We report the results of an experimental investigation of segregation in a binary mixture of dry particles subjected to horizontal oscillatory excitation. The thin layer of particles was driven by the stick-slip frictional interaction with the surface of a horizontal tray. As the packing fraction of the mixture was increased, the evolution of distinct phases was observed. We identified them as a binary gas, segregation liquid and segregation crystal and provide both microscopic and macroscopic measures to identify their properties. Finally, we draw some analogies between segregation in our granular system and self-assembly in binary colloidal mixtures.


The problem of isolated angioedemas is a difficult problem of clinical allergology, their prevalence needs further studies. Hereditary angioedema occurs rarely and makes not more than 2% of all angioedema cases, in the total population hereditaty angioedema is detected with the rate of 1:10000-1:1500000 persons. There are three forms of this disease: type I hereditary angioedema, type II hereditary angioedema and estrogen-dependent edemas (type III). The first two forms are conditioned by genetically deterministic absolute or relative deficit of C1-inhibitor, in the third form its concentration and function are not changed. Hereditary angioedemas, unfortunately, are incurable for today in spite of achievements of current medicine. However, in case of full anamnesis available, target diagnosis and timely onset of treatment it is possible to have a significant positive dynamics in the course of disease. In medical science there is a poor experience regarding this nosology that motivated us to publish a report on such a rare clinical case.


Introduction: Oxidative stress is largely implicated in a molecular mechanism involving initiation, development and progression of leukaemogenesis. Trévo® supplement is a multiherbal formula produced from various phytonutrients with antioxidant potential. We investigated the antioxidant activities of Trèvo® supplement as a prospect for leukaemia treatment. Materials and Methods: The study was carried out on 36 Wistar rats weighing between 140 g and 160g. They were randomly divided into six groups. Group 1 (positive controls) were induced with 0.2 ml benzene chromosolv solution 48 hourly for 4 consecutive weeks and fed with rat pellets without Trévo® supplement. Group 2 (negative controls) received only rat pellets. Group 3 received only normal dose of Trévo® supplement with rat pellets. Groups 4, 5 and 6 were induced for 4 weeks followed with low-, moderate- and high-dose Trévo® supplement for 3 weeks with rat pellets, respectively. Glutathione (GSH), catalase (CAT), malondialdehyde (MDA), total protein (TP) and gamma-glutamyltransferase (GGT) plasma concentrations were assayed simultaneously. Results: Induction of leukaemia was evidenced in positive controls by elevated total white blood cell counts (marked with lymphocytosis) and mild anaemia with reduced haemoglobin counts. Furthermore, GSH, CAT and TP levels for graded dosages of Trévo®-treated groups (following benzene induction) showed statistically significant elevations (P < 0.05) compared to the benzene-induced positive controls, whereas MDA and GGT levels with high-dose Trévo® treatment showed statistically significant reductions (P < 0.05) compared to the positive controls. Conclusions: Trévo® supplement exhibited profound antioxidant potential indicated by improvement from leukaemia after oral administration. This amelioration is believed to be associated with the nutritional supplement in a dose-dependent manner.


Abstract: Photosensivity disorders in childhood frequently can be diagnosed and managed in the general dermatology clinic. Occasionally, when diagnostic doubt exists, referral to a specialist unit is required for diagnostic phototesttng. Light testing equipment is fickle by nature, making such units uncommon. Phototesting using monochrometor or provocation systems takes approximately 45 minutes. Immediate and delayed readings over the following 48 hours as appropriate are required to cover the diagnostic possibilities. Individual diseases are characterized by particular patterns of wavelength dependency and evolution of the abnormal response. Other investigations that may be required are autoantibodies to exclude lupus erythematosus, a porphyrin scan leading to full studies and, on occasion, cell mutation or survival, and chromosome studies for the rarer genophotodermatoses. Good investigative data frequently help clarify the common clinical variants.


An inverse methodology is used to reconstruct the absorption coefficient distribution in a plane-parallel, absorbing–emitting medium with gray-diffuse walls, from the knowledge of exit intensity over the walls. The discrete transfer and conjugate gradient methods, respectively, are used to solve the direct and inverse problems. The sensitivity problem is solved by an efficient approach. The results show that the absorption coefficient distribution can be recovered well even for noisy data.


With recent climate changes, Scots pine (Pinus sylvestris L.) forests have been affected by die-off events. Assisted migration of adapted provenances mitigates drought impacts and promotes forest regeneration. Although suitable provenances are difficult to identify by traditional ecophysiological techniques, which are time consuming and invasive, plant water status can be easily assessed by infrared thermography. Thus, we examined the stress responses of 2-year-old potted Scots pine seedlings from six provenances (Bulgaria, France, Germany, Italy, Poland, and Spain) based on two thermal indices (crop water stress index and stomatal conductance index). Both indices were derived from infrared images during a 6-week drought/control treatment in a greenhouse in the summer of 2013. The pines were monitored during the stress and subsequent recovery period. After controlling for fluctuating environmental conditions, soil moisture or treatment-specific water supply was the most important driver of drought stress. The stress magnitude and response to soil water deficit depended on provenance. Under moderate drought conditions, pines from western and eastern Mediterranean provenances (Bulgaria, France, and Spain) expressed lower stress levels than those from both continental provenances (Germany and Poland). Moreover, pines from continental provenances were less resilient (showed less recovery after the stress period) than Mediterranean pines. Under extreme drought, all provenances were equally stressed with almost no significant differences in their thermal indices. Provenance-specific differences in drought resistance, which are associated with factors such as summer precipitation at the origin of Scots pine seedlings, may offer promising tracks of adaptation to future drought risks.


To enable the development of an automated coloring process, dental zirconia is examined in terms of porosity, pore size and shrinkage during sintering. The properties of commercially available metal ionic inks such as viscosity, density and surface tension are investigated. Droplet impact on the zirconia surface and the absorption into the pores is analyzed with a high speed camera. The color result after sintering is investigated and compared to tooth samples.
 A method is developed to achieve a realistic, smooth color transition on flat zirconia samples. This is achieved by mixing the single inks directly on the zirconia through sequential application. Consequently, the number of different inks required to reproduce the full dental color scale can be reduced. Additionally, three dimensional tooth replacements are colored with the developed method.


Several important chemical reactions of alcohols involving the O-H bond or oxygen-hydrogen bond only and leave the carbon-oxygen bond intact. An important example is salt formation with acids and bases. Alcohols, like water, are both weak bases and weak acids. The acid ionization constant (Ka) of ethanol is about 10~18, slightly less than that of water. Ethanol can be converted to its conjugate base by the conjugate base of a weaker acid such as ammonia {Ka — 10~35), or hydrogen (Ka ~ 10-38). It is convenient to employ sodium metal or sodium hydride, which react vigorously but controllably with alcohols:


An ever-increasing number of web-based repositories aimed at sharing content, links or metadata rely on tags informed by users to describe, classify and organize their data. The term folksonomy has been used to define this "social taxonomy", which emerges from tagging carried by users interacting in social environments. It contrasts with the formalism and systematic creation process applied to ontologies. In our research we propose that ontologies and folksonomies have complementary roles. The knowledge systematically organized and formalized in ontologies can be enriched and contextualized by the implicit knowledge which emerges from folksonomies. This paper presents our approach to build a "folksonomized" ontology as a confluence of a formal ontology enriched with social knowledge extracted from folksonomies. The formal embodiment of folksonomies has been explored to empower content search and classification. On the other hand, ontologies are supplied with contextual data, which can improve relationship weighting and inference operations. The paper shows a tool we have implemented to produce and use folksonomized ontologies. It was used to attest that searching operations can be improved by this combination of ontologies with folksonomies.


Abstract The efficacy of dendritic cell vaccine for newly diagnosed glioblastoma remains controversial. We conduct a systematic review and meta-analysis to explore the influence of dendritic cell vaccine on treatment efficacy for newly diagnosed glioblastoma. We search PubMed, EMBASE, Web of science, EBSCO, and Cochrane library databases through December 2019 for randomized controlled trials assessing the efficacy and safety of dendritic cell vaccine for newly diagnosed glioblastoma. This meta-analysis is performed using the random effect model. Three randomized controlled trials are included in the meta-analysis. Overall, compared with control group for newly diagnosed glioblastoma, dendritic cell vaccine shows no substantial effect on median overall survival [standard mean difference, 0.11; 95% confidence interval (CI), −0.18 to 0.41; P = 0.45], median progression-free survival (standard mean difference, 0.12; 95% CI, −0.24 to 0.48; P = 0.50), progression-free survival rate [risk ratio (RR), 1.29; 95% CI, 0.82–2.04; P = 0.27], overall survival rate (RR, 1.29; 95% CI, 0.61–2.72; P = 0.50), or nervous system disorders (RR, 0.80; 95% CI, 0.59–1.08; P = 0.14). Dendritic cell vaccine may provide no obvious benefits for the newly diagnosed glioblastoma.


Deep learning has become the mainstream methodological choice for analyzing and interpreting whole-slide digital pathology images (WSIs). It is commonly assumed that tumor regions carry most predictive information. In this paper, we proposed an unsupervised clustering-based multiple-instance learning, and apply our method to develop deep-learning models for prediction of gene mutations using WSIs from three cancer types in The Cancer Genome Atlas (TCGA) studies (CRC, LUAD, and HNSCC). We showed that unsupervised clustering of image patches could help identify predictive patches, exclude patches lack of predictive information, and therefore improve prediction on gene mutations in all three different cancer types, compared with the WSI based method without selection of image patches and models based on only tumor regions. Additionally, our proposed algorithm outperformed two recently published baseline algorithms leveraging unsupervised clustering to assist model prediction. The unsupervised-clustering-based approach for mutation prediction allows identification of the spatial regions related to mutation of a specific gene via the resolved probability scores, highlighting the heterogeneity of a predicted genotype in the tumor microenvironment. Finally, our study also demonstrated that selection of tumor regions of WSIs is not always the best way to identify patches for prediction of gene mutations, and other tissue types in the tumor micro-environment may provide better prediction ability for gene mutations than tumor tissues.