The COVID-19 pandemic that has gripped the world since early 2020 has underscored the need for an effective right to repair medical equipment. As healthcare systems have been pushed to the limit, keeping critical medical equipment (such as ventilators) in working order has become a matter of life and death. Unfortunately, the ability of hospitals and other health care providers to service and fix their medical equipment is often hindered by the tight control that original equipment manufacturers keep over repair of their products. On top of direct contractual restrictions on repair, one of the major difficulties encountered by hospital-based and third-party service providers is the lack of access to service manuals, service keys, schematics, replacement parts, and repair tools. The ability to block access to these critical items is abetted, in large part, by intellectual property laws.In August 2020, a new federal legislation was introduced to address this problem—the Critical Medical Infrastructure Right-to-Repair Act of 2020 (the "Act"). The Act is designed to facilitate repair of critical medical infrastructure during the current COVID-19 pandemic, and to do so, it addresses various relevant intellectual property issues. This Article provides a critical analysis of the Act and examines the extent to which it could serve its prescribed goal. We also investigate the role that courts could play, alongside such legislation, by using policy levers that already exist in intellectual property law to provide relief to hospital-based and independent service technicians and mandate manufacturers to cooperate with them in certain circumstances.


Fistula in ano is tract lined by granulation tissue having internal opening in anal canal and rectum and external opening in the perianal region. The incidence of a fistula-in-ano developing from an anal abscess ranges from 26-38%. The prevalence of non-specific anal fistula has been estimated to be 8.6 to 10/100,000 of the population per year, with a male to female ratio of 8:1.in contemporary sciences Bhagandara  can be correlated with Fistula in Ano. To compare the efficacy of AshwathaKsheer Sutra  and UdumberKsheer Sutra in the management of Bhagandara (Fistula in ano).  The present study is designed as a  Randomized single blind parallel in which 40 patients will be enrolled. Patients will be distributed in two group with 20 patients in each group. In group A AshwathaKsheerSutra and in group B UdumbarKsheerSutra will be changed after 7 days till the cure of fistula. Assessment of the patients will be done on day 1st, 8th, 15th, and 22nd after intervention, follow up will be taken on 29th day.  Results will be drawn from the observations of objective parameters. Conclusion of the study will be drawn on the basis of statistical data calculated from the collected data.


Max Weber has shown that the informing spirit of Western capitalism originated from the Christian Reformation. The capitalist spirit can be regarded as a stand-in of Western modernity as a whole. Western modernity was initially the outcome of the theology of Calvinism. Calvinist modernity inspired political revolutions that since the seventeenth century irreversibly transformed Western feudal societies into bourgeois democratic nation-states. Something comparable happened in India in the nineteenth century with the rediscovery of Vedanta. Rediscovery, reinterpretation and public dissemination of Vedanta constituted the Indian version of a Reformation. In the beginning of the twentieth century this Vedantic Reformation inspired the revolutionary political movement, which sought to free India from foreign domination. Vedanta was regarded as informing the spirit of Indian modernity because Vedanta emphasizes individual emancipation. This same emancipation was to imply collective emancipation from the bonds of colonialism and tyranny. These values of Vedantic modernity remain an important source of inspiration for the socio-political emancipation of the whole of the Indian population.


Intra‐plate volcanism in western Europe shows statistically significant episodicity during the Quaternary period. By comparing the known ages for eruptions in France and Germany, which are compiled here, with a composite oxygen isotope record, we have investigated the link between this episodic volcanism and the climate record over the last two million years. We show that increased volcanism between 415–400 ka and 17–5 ka correlates with warming phases at the end of the last Weichselian (Devensian) and earlier Elsterian (Anglian) glacial stages. The three significant caldera explosions in the eastern Eifel, Germany, are all associated with warming phases at the onset of interglacials. The growth and decay of nearby ice sheets suggest that surface changes in continental mass distribution during glacial Milankovich cycles could provide a mechanism for this correlation by means of the distal effects of flexural loading on the lithosphere. Copyright © 2006 John Wiley & Sons, Ltd.


Multimodal protocols to optimize perioperative care and to accelerate postoperative recovery include abbreviated pre-and postoperative fasting. The aim of this study was to investigate the pre and postoperative fasting period and the factors that influence it in patients who underwent elective operations. We included patients who underwent surgery of the digestive tract and abdominal wall. Data were collected from the patients and from their personal health records. We included 135 patients between 19 and 89 years old. Most were adults (75.55%), female (60.74%) and the most common procedures were hernioplasty (42.96%) and cholecystectomy (34.81%). The preoperative fasting periods for solids and liquids were similar, median 16.50 (5.50-56.92) and 15.75 (2.50- 56.92) hours, respectively. The preoperative fasting period was influenced by the instruction received and surgery time. Postoperative fasting period was 15.67 (1.67-90.42) hours and was influenced by type of surgery and lack of synchrony between the clinical meeting and the nutrition and dietetics service schedules.


Background In the era of precision medicine, it is critical for health communication efforts to prioritize personal health record (PHR) adoption. Objective The objective of this study was to describe the characteristics of patients with heart disease that choose to adopt a PHR. Methods A total of 79 patients with chronic cardiovascular disease participated in this study: 48 PHR users and 31 nonusers. They completed 5 surveys related to their choice to use or not use the PHR: demographics, patient activation, medication adherence, health literacy, and computer self-efficacy (CSE). Results There was a significant difference between users and nonusers in the sociodemographic measure education (P=.04). There was no significant difference between users and nonusers in other sociodemographic measures: age (P=.20), sex (P=.35), ethnicity (P=.43), race (P=.42), and employment (P=.63). There was a significant difference between PHR users and PHR nonusers in CSE (P=.006). Conclusions In this study, we demonstrate that sociodemographic characteristics were not an important factor in patients' use of their PHR, except for education. This study had a small sample size and may not have been large enough to detect differences between groups. Our results did demonstrate that there is a difference between PHR users and nonusers related to their CSE. This work suggests that incorporating CSE into the design of PHRs is critical. The design of patient-facing tools must take into account patients' preferences and abilities when developing effective user-friendly health information technologies.


Abstract In this study, the full section of flexural and shear modulus of molded gratings made of glass fiber reinforced polyester (GFRP) have been statistically and experimentally analyzed. Three different gratings with slab height (h) of 25 mm, 30 mm and 38 mm were taken. The flexural (E) and shear modulus (G) of molded gratings were determined from the three-point bending tests by taking different grating span (L) - slab height (h) ratios ranging from 4 to 20 by four increments. Shear modulus was calculated from the test data by considering Timoshenko's shear deformation beam theory (TBT). The flexural and shear modulus of the molded gratings were determined with a reliability of 99% by Weibull distribution. The results showed that E and G obtained from the Weibull analysis take their maximum values at h38 and h30, respectively. However, maximum mean values of E and G obtained experimentally are at h25 and at h38, respectively.


Abstract : Golden Eagle Lake Dam was inspected by an interdisciplinary team of engineers. The purpose of the inspection was to make an assessment of the general condition of the dam with respect to safety, based upon available data and visual inspection, in order to determine if the dam poses hazards to human life or property. Our inspection and evaluation indicates that the spillways do not meet the criteria set forth in the recommended guidelines for an intermediate dam having a high hazard potential. The Probable Maximum Flood is the appropriate spillway design flood. The spillways will pas the 100-year flood (flood having a one percent chance of being exceeded in any year) without overtopping the dam. The spillways will pass 29% of the Probable Maximum Flood without overtopping of the dam. The Probable Maximum Flood (PMF) is defined as the flood that may be expected from the most severe combination of critical meteorologic and hydrologic conditions that are reasonably possible in the region.


Acute hemiplegia and hemianesthesia is commonly caused by obstruction of major cortical arteries. Such a presentation secondary to a conversion reaction is very rare, especially in the pediatric age group. The authors report an adolescent presenting with acute complete left-sided hemiplegia and sensory loss together with decreased tendon reflexes mimicking an acute arterial stroke. Examination revealed Hoover's sign was present and the patient was oblivious to his stern neurological state. Movement of his paralytic limbs was observed during sleep. Cortical and spinal CT, cortical MRI, motor and somatosensory evoked potentials and a PET study were all normal. As such, the diagnosis of psychogenic hemiplegia was established, apparently within a period that the patient had experienced severe emotional stress while questioning his gender identity. After three days, the adolescent began to move the paralytic limbs along gradual resolution of sensory deficit, leading to complete clinical recovering within two months. Although extremely rare, a conversion reaction should be taken into account in children presenting with acute hemiplegia and anaesthesia, even accompanied with decreased tendon reflexes, when the patient is oblivious to his alleged grave state, and when clinical observations such as Hoover's sign remain intact, substantiated by normal extensive radiological and neurophysiological investigation. Intact motor evoked potentials serve as a key for the diagnosis of psychogenic hemiplegia and, should therefore be performed in suspected cases.


Idiopathic scoliosis (IS) is the most common spinal deformity. Prevalence rates are reported between 0.3% and 13.3% respectively and depend on the screening methods being used. Girls are more likely to be affected than boys. The etiology of IS remains unknown, and its prognosis depends on various factors including age of onset, skeletal and sexual maturity, type and severity of the curve. Non-operative treatments are observation, bracing, physical exercise and electrical muscle-stimulation. Bracing of the adolescent idiopathic scoliosis has been proven to be effective and is indicated in curves between 25 degrees and 45 degrees Cobb and rapidly progredient curves under 25 degrees Cobb. Electrotherapy was promising, but failed to alter natural history of IS. Efficacy of physical exercise training in patients suffering from IS has not been evaluated.


Intravascular thrombus formation and embolization are among the most frequent events leading to a number of cardiovascular conditions with high morbidity and mortality. The underlying causes are stasis of the circulating blood, genetic and acquired coagulation disorders, and reduced antithrombotic or prothrombotic properties of the vascular wall (Virchow's triad). In the venous system, intravascular thrombi can cause venous thrombosis and pulmonary and even peripheral embolism including ischaemic stroke [through a patent foramen ovale (PFO)]. Thrombi in the left atrium and its appendage or ventricle form in the context of atrial fibrillation and infarction, respectively. Furthermore, thrombi can form on native or prosthetic aortic valves, within the aorta (in particular at sites of ulcers, aortic dissection, and abdominal aneurysms), and in cerebral and peripheral arteries causing stroke and critical limb ischaemia, respectively. Finally, thrombotic occlusion may occur in arteries supplying vital organs such the heart, brain, kidney, and extremities. Thrombus formation and embolization can be managed with anticoagulants and devices depending on where they form and embolize and on patient characteristics. Vitamin K antagonists are preferred in patients with mechanical valves, while novel oral anticoagulants are first choice in most other cardiovascular conditions, in particular venous thromboembolism and atrial fibrillation. As anticoagulants are associated with a risk of bleeding, devices such as occluders of a PFO or the left atrial appendage are preferred in patients with an increased bleeding risk. Platelet inhibitors such as aspirin and/or P2Y12 antagonists are preferred in the secondary prevention of coronary artery disease, stroke, and peripheral artery disease either alone or in combination depending on the clinical condition. A differential and personalized use of anticoagulants, platelet inhibitors, and devices is recommended and reviewed in this article.


This study focuses on the theoretical aspect of topographic scattering induced by a shallow asymmetric V-shaped canyon under plane shear horizontal-wave incidence. An analytical approach, based on the region-matching technique, is applied to derive a rigorous series solution, which is more general than that in a previous study. For the wave functions constrained in two angular directions, a novel form of Graf's addition formula is derived to arbitrarily shift the local coordinate system. Barrier geometry, angle of incidence and wave frequency are taken as the most significant parameters in exploring the topographic effects of localized concave free surfaces on ground motions. Both surface and subsurface motions are presented. Comparisons with previously published results and boundary-element solutions show good agreement. Frequency-domain results indicate that, for the high-frequency case at a low grazing angle (corresponding to the potential case in teleseismic propagation), the high levels of amplified motions occur mostly on the illuminated side of the canyon. When the windward slope is steeper, the peak amplitude values, at least 2.4 times larger than those of free-field responses, tend to increase. Time-domain simulations display how a sequence of scattered waves travel and attenuate at regional distances.


Motion estimation is the most critical process in video coding systems. First of all, it has a definitive impact on the rate-distortion performance given by the video encoder. Secondly, it is the most computationally intensive process within the encoding loop. For these reasons, the design of high-performance low-cost motion estimators is a crucial task in the video compression field. An adaptive cost block matching (ACBM) motion estimation technique is presented in this paper, featuring an excellent tradeoff between the quality of the reconstructed video sequences and the computational effort. Simulation results demonstrate that the ACBM algorithm achieves a slightly better rate-distortion performance than the one given by the well-known full search algorithm block matching algorithm with reductions of up to 95% in the computational load.


In this research we present morphologic and immunologic features of uterus scar after cesarean section in inferior segment. We revealed that features of tissue regeneration in seam zone of uteri has depended at allelic implements of gene GPIIIα.


Purpose The American Academy of Pediatric Dentistry (AAPD) recognizes that numerous medical conditions predispose patients to bacteremia-induced infections. Because it is not possible to predict when a susceptible patient will develop an infection, prophylactic antibiotics are recommended when these patients undergo procedures that are at risk for producing bacteremia. This guideline is intended to help practitioners make decisions regarding antibiotic prophylaxis for dental patients at risk.


Steady Euler flows in a periodic square that, for positive vorticity distributions, minimise the entropy at given values of the energy and the circulations are non-confined vortices for optimal values of the circulation, and are confined vortices for certain non-optimal values. An extension of the self-organisation principle for the 2D Navier-Stokes equations is presented which models the dissipative evolution of such confined vortices by changing the values of the constraints in time in accordance with the effect of dissipation. An efficient numerical procedure for calculating these confined states is described and calculations of the dissipative evolution are presented.


Verbal memory deficits remain a major complication of dominant hemisphere temporal lobectomy for epilepsy. The extent of this deficit was assessed preoperatively and 1 month and 1 year postoperatively with the Wechsler Verbal Memory Scale (WMSV) in 14 adults undergoing left temporal lobectomy. Intraoperative localization of language and verbal memory was also performed by electrical stimulation mapping. The WMSV score decreased an average of 22% at 1 month (13 cases), and 11% at 1 year (10 cases), even though in the majority of cases the medial extent of the resections had been significantly modified as a result of preoperative memory changes in response to intracarotid amobarbital perfusion testing. Memory decline was greater in patients who were not seizure-free, and correlated with the lateral (but not the medial) extent of the resection. The memory deficit could be predicted intraoperatively with 80% accuracy from the relationship of the resection to sites identified by electrical stimulation mapping as essential to naming or input or storage aspects of memory. This technique was applied prospectively in two additional cases with left temporal epileptic foci and complete verbal memory loss with left hemisphere amobarbital inactivation. These resections were tailored to avoid the essential naming and memory sites; the WMSV score increased 1 month postoperatively in both cases. This study identifies a lateral cortical component for verbal memory. Sites essential for that component can be localized intraoperatively with stimulation mapping; when they are spared in a resection, verbal memory deficit following dominant hemisphere temporal lobectomy can be prevented even in high-risk cases.


The article deals with the question of the present position of economic history as a theoretical framework of scientifi c specialization and university study branch in the Czech Republic. It focuses on the Central European tradition and analyzes reasons for the connection between economic and social history. It concentrates on the question whether economic history can exist as an autonomous discipline, on which theoretical basis economic history could be built, and from where to derive methodological inspiration. The authors claim that currently the social historians do not consider the connection with economic history as pivotal. They regard the position of economic history as inferior and according to them the dominant role of social history prevents them from dynamic methodological development. They believe that possible alternatives of the future development of economic and social history lie in three potential solutions: a) continuation of the current "defensive" concept of economic and social history; b) separation of economic and social history and their autonomous shaping; c) concept of "offensive" integrating socio-scientifi c approach.


A disintegrin and metalloproteinase 33 (ADAM33) has been identified as an asthma susceptibility gene; however, the role of ADAM33 in the pathogenesis and progression of asthma remains to be elucidated. As ADAM33 is predominantly expressed in airway smooth muscle cells (ASMCs), it is feasible to investigate whether ADAM33 protein expression is correlated with ASMC mechanics that are ultimately responsible for airway hyperresponsiveness in asthma. To determine this, Sprague Dawley rats were sensitized with ovalbumin (OVA) for up to 12 weeks to simulate asthma symptoms. Subsequently, ASMCs were isolated from the rats and cultured in vitro. The protein expression of ADAM33 and cytoskeletal proteins (including F‑actin and vinculin), cell stiffness and contractility, as well as traction force were measured. The results demonstrated that compared with the non‑sensitized rats, the protein expression of ADAM33 in ASMCs from the OVA‑sensitized rats increased in a time‑dependent manner, reaching a maximum level at 4 weeks of sensitization and gradually subsiding as OVA sensitization continued (P<0.001). The cell stiffness, traction force and expression of vinculin and F‑actin changed similarly, resulting in a positive correlation with ADAM33 protein expression (Pearson's correlation coefficient, 0.864, 0.716, 0.774 and 0.662, respectively; P=0.1‑0.3). The in vivo results of OVA‑induced ADAM33 protein expression and its association with the mechanics of ASMCs suggested that ADAM33 is a mediator of ASMC dysfunction in asthma, and may provide a rationale for the therapeutic targeting of ADAM33 in the treatment of asthma.


Malaysia is no exception to the growing trend and severity in Human immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) cases where women are more vulnerable than men. Consequently, the incidence of HIV infections in females is steadily increasing. This study aimed to explore the HIV vulnerability of women and the inequity of HIV infections between males and females in Malaysia over time. Data and necessary information were obtained from the Ministry of Health, Malaysia. The analyses were done by polynomial curve fitting and discriminant function analysis. The fifth degree polynomials were found as useful fitting models for all the cases and almost all the curves explained more than 95% of the variation. The discriminant function analysis identified the discrimination among males and females HIV/AIDS prevalence and AIDS deaths. The current study identified the discrimination between males and females HIV and AIDS prevalence, and AIDS deaths over time and HIV infections among women are gradually rising. The findings suggested that the policies should be aimed at to reduce the major risk factors of HIV transmission, including injecting drug use, needle sharing, and unprotected sex.


The isolation of dysentery bacilli from the stools of children with clinical dysentery or diarrhea has been investigated from several viewpoints. Some authors have been concerned with the elaboration of new methods or mediums, and others, with the separation of the etiologic agents into groups and subgroups. Almost all investigators have noted that the organisms are extremely difficult to isolate in a large percentage of cases, that they die in the stools shortly after passage and that many patients who have clinical dysentery, with mucus and blood in the stools, never have positive cultures. Blacklock and Guthrie1noted, for example, that it became harder to isolate the dysentery bacilli after the acute stages of the disease had passed, but they had been able to obtain a few positive cultures from the intestinal scrapings taken at autopsy. Carter2noted that positive cultures were obtained from 50 per cent of


Piezo1 is the stretch activated Ca2+ channel in red blood cells that mediates homeostatic volume control. Here we study the organization of Piezo1 in red blood cells using a combination of super resolution microscopy techniques and electron microscopy. Piezo1 adopts a non- uniform distribution on the red blood cell surface, with a bias towards the biconcave "dimple". Trajectories of diffusing Piezo1 molecules, which exhibit confined Brownian diffusion on short timescales and hopping on long timescales, also reflect a bias towards the dimple. This bias can be explained by "curvature coupling" between the intrinsic curvature of the Piezo dome and the curvature of the red blood cell membrane. Piezo1 does not form clusters with itself, nor does it co-localize with F-actin, Spectrin or the Gardos channel. Thus, Piezo1 exhibits the properties of a force-through-membrane sensor of curvature and lateral tension in the red blood cell.


Abstract Production networks have been established in many industrial domains with globalized supply structures, sourcing strategies or cooperation environments. Knowledge management in such networks requires a context-oriented approach in order to accommodate for individual and organizational needs when providing relevant knowledge for complex tasks, such as value creation. The focus of this paper is on the procedure by which to determine what actually has to be taken into account as part of the 'context' for establishing context-oriented knowledge management, how to capture this context, and how to use it. The variability of organisational and individual tasks both at design time and at runtime is essential for understanding context in production networks. The main contribution of the present study is a context modelling method, including variability identification. The application of this method is demonstrated by using an example of a production network from automotive industries.


Each ganglion of the plexus Schabadasch is supplied by a specific periganglionic capillary network. Within the plexus Meissner, several ganglia are connected to circulation areas. The communicating branches of the plexus Schabadasch have their own capillary system; as to the plexus Meissner, this is valid for the cat only. The results allow to conclude that the centres of the intramural nervous system of the intestinal wall are equipped with a preferred and self-acting vascularization.


This paper constructs a simple model that can account for both the negative relationship between growth and income inequality observed in the cross-country data and the positive relationship observed within countries over time. The model employs a dual-economy structure with formal and informal sectors. Growth is driven by formal sector human capital spillovers. Restrictive institutions impose barriers to formality that reduce the growth rate and increase inequality. Redistributive taxation lowers inequality but blunts the incentive to accumulate, lowering growth. Institutional structures vary more across than within countries. Consequently, variations in institutional barriers to formality may account for the negative relationship between growth and inequality found in the cross-country data. Variations in the intensity of redistribution may account for the positive relationship observed within countries over time.


The purpose of this study was to understand teacher leaders' role in school improvement program. More specifically, examined how teacher leaders formally or informally lead school improvement; what potential challenges they face when attempting to lead school improvement; and what strategies /mechanisms they employ to improve teacher leadership role in school improvement process were the basic questions of the study. In-depth interviews with five teacher leaders and field notes were used to collect data. The data were tape recorded and then transcribed. Categories themes and patterns from data i.e. inductive analysis were used for data analysis. The findings revealed that, teacher leaders lead school improvement by different methods like collaboration, effective planning, and experience sharing, influencing others by their hardworking habit and, communicating with school community. Besides, teacher leaders face different challenges in leading school improvement such as lack of leadership and management skill, time constraints and absence of recognition and incentive. In sum, the school improvement process is not being led by teacher leaders due to different challenges. Therefore, education leaders should enhance teacher leadership by promoting and supporting teacher leadership role and Policy makers should develop a platform for teacher leadership to enhance teacher leaders' role in school improvement program.


OBJECTIVE
To examine group fitness instructors' knowledge and attitudes toward identification and management of disordered eating (DE).

METHOD
Group fitness instructors representing the three largest fitness center companies in Norway (n = 837, response rate: 57%) completed a questionnaire through Questback (www.questback.com). The questionnaire contained items regarding gender, age, educational background, exercise behavior, and knowledge of recognition and response to DE.

RESULTS
Eighty-nine percent of the respondents reported knowledge about symptoms of DE, 29% was classified with adequate DE knowledge skills. Forty-nine percent of the instructors reported current concern about DE among one or more members, 47% reported knowledge about how to recognize and respond to DE, and 37% reported knowledge about their fitness center's guidelines for approaching DE concerns. The level of formal education in sports and exercise, and a history of self-reported eating disorder, but not fitness instructor experience, were explanatory factors for knowledge about DE symptoms. Both exercise specific educational level and instructor experience were explanatory variables for knowledge about recognition of and response to DE concerns.

DISCUSSION
Implications of the findings include a need for increased confidence among group fitness instructors regarding how to approach DE concerns, increased awareness of excessive/compulsive exercise as a symptom of DE, and enhanced dissemination of existing guidelines for managing DE concerns among members and/or staff.


Edema, as one of common clinical diseases, could be treated by taking medicines and adopting external therapies with traditional Chinese medicines (TCM). In recent years, there have been many clinical and basic studies concerning external therapies with TCM on edema Data showed that the external therapies are mostly composed of such purgating drugs as Rhei Radix et Rhizoma, Natrii Sulfas and Pharbitidis Semen, heat-clearing drug such as Phellodendri Chinensis Cortex and resuscitation-inducing drug such as Borneolum Syntheticum. The study showed that ingredients of external therapies did not pass through hilum and hepatic system, and thus avoided the first pass effect of livers. They enabled effective components of drugs to be rapidly absorbed through pores and skins, strengthened the effect against edema, shortened the treatment course, decreased side effects, and were convenient and inexpensive. External therapies with TCM could play unique advantages in inhibiting edema in the future clinical studies.


The topography of human callosal fibers in the midsagittal corpus callosum (mid-CC), in terms of cortical termination, is inconsistent in the literature. Despite being a high-profile and controversial topic, heterotopic callosal bundles (HeCBs) have not been studied from a whole-brain perspective. Here, we used multi-modal magnetic resonance imaging data from Human Connectome Project Development to explore these two topographic aspects by combining whole-brain tractography based on multi-shell multi-tissue constrained spherical deconvolution, the post-tractography reducing-false-positive-streamline algorithm of Convex Optimization Modeling for Microstructure Informed Tractography 2, and the new cortex parcellation atlas of Human Connectome Project multi-modal parcellation, version 1.0. We proposed that the callosal streamlines would demonstrate a topological arrangement of coronal segments arranged from anterior to posterior, with each perpendicular to the long axis of the mid-CC following its natural curvature, and the adjacent segments overlapping one another owing to the existence of HeCBs. We found that the cortices connected by the coronal segments, from anterior to posterior, corresponded exactly to the cortices from anterior to posterior in the flattened cortical surfaces of this atlas, indicating the original relative positions of the neocortex before curling and flipping during brain evolution. For each cortical area defined by this atlas, the sum strength of the HeCBs was far greater than that of the homotopic callosal bundle. Our findings on the topography of the whole CC would help in further understanding the network between the bilateral hemispheres and preventing disconnection syndromes in clinical settings.


The skin relief influences the exterior aspect of the skin which is very sensitive to aging. It could also be related to the mechanical properties and structure of both dermis and stratum corneum. Consequently, quantitative measurement of the skin surface roughness would seem most useful, as it would permit a quantification of skin aging, an in vivo analysis of mechanical forces acting on the skin structure, and the detection of abnormalities otherwise not visible. The method described comprises three steps: (1) making a silicone rubber negative replica, (2) making an Araldite positive cast, (3) roughness measurement of the cast with a device commonly used in engineering, which provides quantitative parameters: Ra, Rp, Rt, Rmax and others. The reliability of each of these steps was checked, and also the absolute need to locate precisely the site of sampling and to know the angle of the scanning direction with the main axis of the limb or the body. The method seems useful for studying aging, either normal or affected by UV rays and other physiopathological events influencing the skin surface.


Background: The COVID-19 pandemic has caused a sudden shift to distance learning. For many nursing students, distance learning was a new experience. Along with being an essential requirement for retaining students, developing a sense of community is a factor influencing students' success in distance learning. Assessments of the effectiveness of e-learning have been well documented in the literature. However, there is a dearth of research that assessed nursing students' sense of community. This study aimed to assess students' sense of community during e-learning, while determining its impact on their level of satisfaction. Methods: This cross-sectional descriptive study used convenience sampling to collect data via a student satisfaction survey and a classroom community scale. Nursing students were recruited from 13 public and private nursing programs in Saudi Arabia. Results: There was a positive and significant correlation between a sense of community and satisfaction with teaching (r = .269, p < .001), satisfaction with assessment (r = .258, p < .001), satisfaction with generic skills and learning experiences (r = .238, p < .001), and total satisfaction with e-learning (r = .07, p < .001). Students who perceived themselves as working collaboratively with their classmates and being more engaged in their learning were more satisfied with e-learning (p<.01). There were no significant variations in the participants' satisfaction by age (β = −.06, p > .05) and sex (β = −.283, p > .05). However, school level was significantly correlated with satisfaction with e-learning. Specifically, students in lower levels of their nursing school had higher satisfaction rates with e-learning (95% CI [.08, 1.33], [F (3, 99) = 6.96, p < .001, β = −.335, R2 = .174]).Conclusions: Failing to meet student expectations can lead to low levels of student involvement. Thus, students' engagement and satisfaction are good indicators of the quality and effectiveness of online programs. This study calls for further action through seminars and training sessions to introduce innovative teaching techniques and alternative assessment plans for learners in advanced levels. This study helps educational institutions devise strategies to enhance the level of interaction and cooperation among nursing students.


Grasslands play a critical role in the global storage of atmospheric carbon (C). Precise estimation of C contents in different plant components is essential to formulate a strategy for mitigating the atmospheric C. Biomass (B) and C of different herbaceous plant components at species, functional group and site levels from tropical grassland locating on the campus of Banaras Hindu University, Varanasi, India were estimated. For this; 117 herbaceous species just-before flowering were harvested. B and C contents for each species and component were measured and statistically analyzed. The measured C (g plant-1) across the components varied from 0.08 to 31.12. On gm-2 basis; it varied between 29 (leaf) and 49 (root). Plant components, species and functional groups in isolation caused significant differences in the measured C. In the present study; the C content of stem was greater than the leaf and root. The perennial, erect, leguminous and native traits had greater C than the others. Therefore, this observation revealed that the perennial, erect, leguminous and native plants could be a better option for reducing the atmospheric CO2 by capturing it and then converting into B through photosynthesis. Further, the fitted regression equation between the root and shoot for B and C could be used for the extrapolation of B and C of the root component based on the shoot component. The conservative field measurement methods may give precise data on B and C but are destructive to grassland, difficult, time-consuming, and costly to cover at large scale. Hence, the present work could be substantial for the estimation of root C based on shoot component.


Background: Trifluridine/tipiracil plus bevacizumab (FTD/TPI + BEV) has shown efficacy and tolerability in refractory metastatic colorectal cancer (mCRC). Because randomized controlled trial (RCT) data comparing FTD/TPI + BEV with FTD/TPI are lacking, this meta-analysis evaluated outcomes with both regimens. Data Sources and Methods: Electronic databases, congress proceedings (past 3 years), trial registries, systematic review bibliographies, gray literature, and guidelines through June 2021 were searched for RCTs, non-RCTs, and prospective observational studies involving >20 previously treated patients with mCRC receiving FTD/TPI + BEV or FTD/TPI. Absolute and relative disease control rate (DCR), progression-free survival (PFS), overall survival (OS), adverse event (AE) rates, and discontinuation rates due to AEs were evaluated using fixed-effects and random-effects models. Study quality, heterogeneity, and publication bias were assessed. Results: In all, 29 of 875 screened publications were selected (26 studies: 5 RCTs, 11 non-RCTs, and 10 prospective observational studies). One RCT compared FTD/TPI + BEV with FTD/TPI. FTD/TPI + BEV versus FTD/TPI had a higher absolute DCR [64% (6 studies; n = 289) versus 43% (10 studies; n = 2809)], median PFS [4.2 (5 studies; n = 244) versus 2.6 (6 studies; n = 1781) months], 12-month PFS [9% (5 studies; n = 244) versus 3% (6 studies; n = 1781)], median OS [9.8 (5 studies; n = 244) versus 8.1 (6 studies; n = 1814) months], and 12-month OS [38% (5 studies; n = 244) versus 32% (6 studies; n = 1814)]. Grade ⩾3 febrile neutropenia, asthenia/fatigue, diarrhea, nausea, and vomiting rates were similar (1%–7%). Grade ⩾3 neutropenia rate was higher with FTD/TPI + BEV than with FTD/TPI [43% (6 studies; n = 294) versus 29% (12 studies; n = 7139)]. Discontinuation rates due to AEs were similar [8% (5 studies; n = 244) and 7% (10 studies; n = 3724)]. Low study quality, heterogeneity, and/or publication bias were detected in certain instances. Conclusion: Despite fewer patients treated with the combination, this meta-analysis consistently suggested that FTD/TPI + BEV provides benefits over FTD/TPI in refractory mCRC and has similar safety, except for more frequent grade ⩾3 neutropenia.


The performance of unsupervised discriminative training has been found to be highly dependent on the accuracy of the initial automatic transcription. This paper examines a strategy where a rela-tively small amount of poorly recognised data are manually transcribed to supplement the automatically transcribed data. Experiments were carried out on a Mandarin broadcast transcription task using both Broadcast News (BN) and Broadcast Conversation (BC) data. A range of experimental conditions are compared for both maximum likelihood and discriminative training using directed manual transcription. For BC data, using fully unsupervised discriminative training, only 17% of the reduction in character error rate (CER) from supervised training is obtained. By automatically se-lecting 18% of the data for manual transcription yields 50% of the CER gain from supervised training. The directed approach to se-lecting data outperforms the use of a random set of data for manual transcription.


This paper aims at extending the notion of thing knowledge put forth by Davis Baird. His Thing Knowledge (Baird 2004) proposes that scientific instruments constitute scientific knowledge and that to conceive scientific instruments as such brings about a new and better understanding of scientific development. By insisting on what "truth does for us," Baird shows that the functional properties of truth are shared by the common scientific instrument. The traditional definition of knowledge as justified true belief would only apply to scientific instrumentation if we were to reject the subjective (and intentional) aspect of it, viz. belief. In consequence, Baird insists that scientific instruments can be seen only as a kind of objective knowledge, that is knowledge maintained by the scientific community but not individually by a given scientist. In this paper, I will argue for a conception of subjective thing knowledge according to which some scientific instruments (especially material models) can be understood as justified true beliefs. By combining Davis Baird's thing knowledge and Clark and Chalmers' hypothesis of extended cognition, I will show that it is possible to derive an analysis of material models as cognitive augmentation of the scientist's mind, and that such scientific instruments are to be understood as a material form of subjective knowledge, i.e. as external-to-the-brain justified true beliefs.


In this work, high density polyethylene (HDPE) incorporation in virgin resin was assessed as to its electrical performance with the use of volumetric resistivity, dielectric strength, and stress tracking measurements. HDPE post-consumer packaging was collected and submitted to a basic process of plastic recovering: washing, grinding, and drying. Formulations containing 0, 25, 50, 75, and 100% of recycled material in the virgin resin were reprocessed by extrusion and injection molding with stabilization. Dielectric strength test results were analyzed by the statistical distribution of Weibull, and the maximum likelihood method. The degree of crystallinity was measured by X-ray diffraction. Atomic absorption spectroscopy was also done to identify metallic residue present in the samples. From the results analyzed, it can be concluded that the HDPE derived from post-consumer packaging can be considered in electrical insulation systems for low voltage (up to 600 V) containing as much as 75% incorporated virgin resin.


Development of real-time fault detection and identification technologies will allow a migration, in the respective theater of operation, from expensive scheduled based maintenance to the more efficient, less costly alternative of condition based maintenance. This paper presents successful initial results applying continuous wavelet transforms coupled with conventional neural networks to the development of a real-time fault detection and classification systems. The approach taken results in a general methodology which is shown to work equally well on fault-seeded, helicopter gear-box data and operational data from Navy shipboard pumps. The family of wavelet basis functions are specifically engineered to allow for real-time implementation. The wavelet basis functions have a time-scale decomposition mathematically inspired from biological systems and provides a clustering in feature space which allows for the development of simplified neural network classifiers. Application to various classes of fault data (helicopter and shipboard pump data) resulted in perfect detection, no false alarms with only modest deferral rates.<<ETX>>


An exploration of in-service public schools teachers' implementation of cooperative learning forms the basis of this article. By means of a qualitative approach to research, two tutors in a teacher development program have studied how a group of English teachers set the conditions to create a cooperative learning environment in their classes. Additionally, they reveal the perceptions that these educators have of themselves as initiators who guide their students in this pedagogical experience. The analysis of information collected provides views about the role that teachers assumed and their concerns when organizing their classroom in order to experience cooperative work. Furthermore, teachers' self-encouragement for professional development emerged as a fundamental issue when they implemented this approach in their institutions.


The effects of erythromycin on myoelectric activity of the spiral colon of dairy cows were investigated in a prospective study. Four Simmental x Red-Holstein crossbred cows of similar body weight and condition with seven pairs of bipolar electrodes implanted in the intestine (one each in the distal ileum, caecum and proximal colon, and four in the spiral colon) were included. Erythromycin lactobionate (1 mg kg(-1)) and 0.9% sodium chloride solution (NaCl) were administered to each cow in a random order. Erythromycin was diluted with NaCl and both treatments were administered slowly intravenously over a period of 5 min 1 h after onset of a phase III of the bovine colonic migrating myoelectric complex (bcMMC). A 3-6-day washout period was scheduled between trials. Significant differences between the results of the treatments were observed for spike duration in phase I as well as for spike duration and duration of spiking activity during phase II of the second bcMMC, which were significantly higher after erythromycin treatment than after NaCl. These findings suggest an indirect effect of erythromycin on colonic motility in cattle.


Matching the resonant wavelength of plasmonic nanoparticles (NPs) and the emission band of organic materials is critical for achieving optimal plasmon-enhanced luminescence in organic light-emitting devices (OLEDs). However, the spectral matching is often unsatisfactory because the interior architecture of OLEDs limits the dimensions of the NPs to support the desired wavelength adjustment. In this article, we proposed a design strategy via AuxAg1-x alloy NPs to enable resonance tuning while preserving the size of the NP to suit the OLED design requirements. The bimetallic NPs, especially for x < 0.6, not only add one more degree of freedom to vary the plasmon wavelength but also provide the benefits of higher scattering and more intense and outspread electric fields over a broader spectrum compared to Au monometallic NPs. These features allow smaller NPs, which are more compatible with OLED interiors, to scatter electric fields more efficiently and increase the density of molecules interacting with the NP plasmons. In the presence of a nearby dipole emitter, the bimetallic NPs can simultaneously increase radiative enhancement and suppress non-radiative losses, which are advantageous for increasing the quantum yield and luminescence efficiency of the emitter. These improvements are associated with lower intraband and interband activities resulting from the higher molar fraction of Ag in the alloy NPs. We provided composition mappings to achieve enhanced luminescence for specified wavelengths at fixed NP sizes. Finally, we theoretically demonstrated that the bimetallic NPs could improve the light-extraction efficiency of OLEDs better than Au monometallic NPs. This work provides essential guidance to enable versatile plasmon-enhanced applications with predefined nanostructural geometries and wavelengths to match the device requirements.


OBJECTIVE: To compare sexual functioning and health-related quality-of-life outcomes of total abdominal hysterectomy (TAH) and supracervical hysterectomy (SCH) among women with symptomatic uterine leiomyomata or abnormal uterine bleeding refractory to hormonal management. METHODS: We randomly assigned 135 women scheduled to undergo abdominal hysterectomy in 4 U.S. clinical centers to either a total or supracervical procedure. The primary outcome was sexual functioning at 2 years, as assessed by the Medical Outcomes Study Sexual Problems Scale. Secondary outcomes included specific aspects of sexual functioning and health-related quality-of-life at 6 months and 2 years. RESULTS: Sexual problems improved dramatically in both randomized groups during the first 6 months and plateaued by 1 year. Health-related quality-of-life scores also improved in both groups. At 2 years, both groups reported few problems with sexual functioning (mean score on the Sexual Problems Scale for SCH group 82, TAH group 80, on a 0-to-100 scale with 100 indicating an absence of problems; difference = +2, 95% confidence interval –8 to + 11), and there were no significant differences between groups. CONCLUSION: Supracervical and total abdominal hysterectomy result in similar sexual functioning and health-related quality of life during 2 years of follow-up. This information can help guide physicians as they discuss surgical options with their patients. LEVEL OF EVIDENCE: I


Abstract In order to answer questions about discrepancies in self-reported tobacco use between youth from different race/ethnic categories, the authors set out to observe and characterize tobacco use among youth in two Florida counties. Their observations and interviews led to identification of a pattern of tobacco use that had not appeared before in the literature on tobacco use, the emergent phenomenon of Black & Mild consumption, especially among African American youth. Teams of field workers conducted direct observations of tobacco use among youths between the ages of 11 and 15, recruiting them and their families into open-ended interviews to determine how youths in that age range initiate and maintain tobacco use. Observational notes and in-depth interviews (all transcribed to word processing files) provided the corpus of data on which the investigators based this study. In addition, information from additional sources, including informal interviews with store owners, rap videos, and queries in other parts of the United States, helped to verify that patterns found in Miami had appeared throughout Florida and in many other parts of the United States. Initial observations took place in the environs of one middle school in southern Miami/Dade County, but additional observations and interviews that contributed to the study took place in sites near other schools, convenience stores, shopping centers, and city streets. African American, Hispanic, and white non-Hispanic young people between 11 and 15 years of age took part in this study, only after field workers obtained informed consent from their parents. Field workers conducted observations of approximately 250 youth in various settings in two counties in Florida, Miami/Dade and Alachua. They elicited 40 in-depth interviews, including one whole family interview and four focus groups. The interviews that contributed to this paper were four in-depth sessions with young African American males recruited at the middle school where key observations took place. Field observations produced a pattern of tobacco use not characterized in the literature, in which a cigarillo called "Black & Mild" that contains between five and twelve times the nicotine of cigarettes has become the product of choice among African American and other youth. Young users of these cigarillos tend not to recognize them as tobacco and believe that they contain no nicotine. Further inquiry revealed that this pattern of smoking was widespread in various parts of the United States. Use of commercial cigarettes has become increasingly expensive, and minority youth with limited money may have sought products that deliver strong nicotine for not much money. Although more research will answer this question definitively, these results suggest that the emergence of Black & Milds and related products may help to explain patterns of response to large-scale studies of tobacco use in which African American youth report less tobacco consumption than other youth. Items on tobacco use in surveys administered among North American youth need reframing in terms of cigar smoking to reflect the cultural significance of Black & Milds and related products among African American youth.


John Henry 'Harry' Iliffe (1903-1960) was a British archaeologist. His significant museum career included posts as head of Classical collections at the Royal Ontario Museum of Archaeology, Toronto (1927-1931); the first keeper of the Palestine Archaeological Museum, now the Rockefeller Museum, in Jerusalem (1931-1948); and Director of Museums in Liverpool (1948-1959). His major interest was Near Eastern archaeology, which is reflected in his work on Sigillata Wares and excavations in Cyprus; from which The RD Milns Antiquities Museum at the University of Queensland holds three artefacts. Iliffe was awarded an OBE in 1948; he died in 1960. The John Henry Iliffe Collection is a collection of photographs, negatives, articles, notes, correspondence, and newspapers cuttings relating to the career and archaeological research of John Henry 'Harry' Iliffe.


The buildup dynamics of diode-pumped passively mode-locked solid-state laser is thoroughly explored using the real-time measurement with temporal sampling rate of up to 40 GHz. A concise cavity is developed to ensure the transient dynamics purely arising from the gain medium and saturable absorber. Experimental results reveal that the laser output in the buildup process exhibits numerous passively Q-switched pulses followed with a damped relaxation oscillation prior to the stable mode locking. Furthermore, it is confirmed that the laser output has already displayed single clean mode-locked pulses inside the first several Q-switched envelopes before stepping into the stage of relaxation oscillation. The present real-time exploration is expected to provide important information for practical applications with temporal modulation of the pump intensity.


Biotherapy including interleukin-2 (IL-2) treatment seems to be more effective outside the central nervous system when compared to the effects obtained when the same tumour is located intracerebrally. Recently published studies suggest that reduced activity of NK cells in tumour tissue can be increased by histamine. The present study was designed to determine whether IL-2 and histamine, alone or in combination, can induce anti-tumour effects in an orthotopic rat glioma model. One group of rats was treated with histamine alone (4 mg kg–1s.c. as daily injections from day 6 after intracranial tumour implantation), another group with IL-2 alone as a continuous subcutaneous infusion and a third group with both histamine and IL-2. The animals were sacrificed at day 24 after tumour implantation. IL-2 and histamine in combination significantly reduced tumour growth. The microvessel density was significantly reduced, an effect mainly affecting the small vessels. No obvious alteration in the pattern of VEGF mRNA expression was evident and no significant changes in apoptosis were observed. Neither IL-2 nor histamine alone caused any detectable effects on tumour growth. Histamine caused an early and pronounced decline in tumour blood flow compared to normal brain. The results indicate that the novel combination of IL-2 and histamine can be of value in reducing intracerebral tumour growth and, thus, it might be of interest to re-evaluate the therapeutic potential of biotherapy in malignant glioma. © 2000 Cancer Research Campaign


The current fast-changing business environment requires workflow management systems to provide the ability of dynamic analysis when processes are edited or updated at both design time and execution time. In this paper, based on model checking we present a new approach of dynamic analysis on temporal properties after changes at design time and execution time. Our approach firstly records and analyzes the patterns by edit operations of processes. Secondly, the processes are automatically maintained by corresponding rules in UPPAAL. Finally, temporal constraints are checked by UPPAAL in background mode, and the results are reported to designers immediately. We apply the approach in a real business scenario to illustrate its advantages: practicable, flexible and efficient.


BACKGROUND: Ovarian granulosa cell tumors (GCT) are hormonally active cancers characterized by indolent growth and late, invasive relapse. GCT are unusual in that they have an unexplained propensity for late recurrence. ~80% of patients with aggressive or recurrent tumors die from their disease. Aside from surgery the therapeutic options are very limited. We have identified the nuclear receptor peroxisome proliferator-activated receptor-gamma (PPARγ) and the X-linked inhibitor of apoptosis protein (XIAP) as potential specific therapeutic targets. PPARγ is a transcription factor that impedes proliferation and promotes terminal differentiation in granulosa cells (GC), is highly expressed in GCT. Its activity however is transrepressed by constitutive activity of the critical pro-survival NF-κB signaling pathway. Constitutive NF-κB signaling is potentially a consequence of a positive feed-forward loop involving XIAP, which is also highly expressed in GCT. As a potent inhibitor of apoptosis, XIAP is an attractive therapeutic target. We have shown in vitro that inhibiting XIAP releases NF-κB transrepression, and together with PPARγ activation, induces apoptosis. We thus hypothesize that XIAP antagonism sensitizes GCT to pro-apoptotic strategies such as PPARγ activation. METHODS AND RESULTS: We have used stable isotope labeling with amino acids in cell culture (SILAC), a proteomic approach to identify differentially expressed proteins after combined PPARγ activation (rosiglitazone) and XIAP inhibition (Smac mimetic). Using two GCT-derived cell lines, KGN and COV434, we identified 52 proteins which were differentially expressed (by 1.5 fold) with the combined treatment. Upregulated proteins included several involved in metabolic processes including acyl-CoA desaturase (4.50-fold), phosphoglycerate kinase 1 (2.87-fold) and α-enolase (1.75-fold). As PPARγ plays a pivotal role in lipid and glucose metabolism, upregulation of these proteins is a consequence of PPARγ activity being restored. Additionally, we observed downregulation of fascin (-1.65 fold), the main actin-bundling protein associated with cell motility and migration. Overexpression has been observed in metastatic tumors and correlated with clinically aggressive phenotypes, poor prognosis and shorter survival. We used the xCELLigence RTCA system to monitor invasion of KGN cells through a Matrigel® basement membrane in real-time. KGN cells treated either with Vehicle, RGZ/RA or SM alone or combined RGZ/RA/SM were plated in the upper chamber of a CIM-Plate 16 and cell invasion through the Matrigel® membrane was monitored. When compared to vehicle treated cells, we observed that the RGZ/RA/SM-treated KGN cells were (i) 30% less invasive and (ii) demonstrated a delayed onset of invasion by 17 hours towards serum-containing media with and without drugs in the lower chamber, respectively. CONCLUSION: We are currently investigating the mechanism involved in XIAP inhibition abrogating transrepression of PPARγ in GCT-derived cells. This study will improve our understanding of the molecular mechanisms in GCT pathophysiology as well as enable identification of new targets for therapeutic strategies. These observations may also translate to ovarian epithelial cell cancers (EOC) as increased apoptosis was observed in serous EOC-derived cell lines expressing both XIAP and PPARγ. We propose that a combination therapy involving the abrogation of XIAP may be of greater efficacy for the treatment of GCT and potentially other ovarian cancer subtypes. Citation Format: Simon Chu, Dilys TH Leung, Maria Alexiadis and Peter J Fuller. PPARγ AGONISTS AUGMENT ANTICANCER EFFECTS OF XIAP INHIBITION ON HUMAN GRANULOSA CELL TUMOR–DERIVED CELLS [abstract]. In: Proceedings of the 11th Biennial Ovarian Cancer Research Symposium; Sep 12-13, 2016; Seattle, WA. Philadelphia (PA): AACR; Clin Cancer Res 2017;23(11 Suppl):Abstract nr NTOC-085.


In this paper, we study the control strategy for connectivity guaranteed trajectory tracking for multi-agent systems using artificial potential based approach. Some agents, called active agents (AAs), which are attracted by the reference point (modeled as the virtual leader), lead the rest of the group to perform the task. Special features of our approach are that the group is not required to be initially connected and the AAs are not fixed as the system evolves. Two control strategies, each of which consists of an AA switching rule and the coupled flocking controller, are proposed to realize different kinds of connectivity as well as other well-known flocking specifications for the multi-agent group.


Background Conventional systemic inflammatory biomarkers could predict prognosis in patients with ischemic stroke (IS) admitted to the intensive care unit (ICU). Acute kidney injury (AKI) is common in patients with IS admitted to ICU, but few studies have used systemic inflammatory biomarkers to predict AKI in critically ill patients with IS. This study aimed to establish a risk model based on white blood cell (WBC)-related biomarkers to predict AKI in critically ill patients with IS. Methods Data were extracted from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) for a training cohort, and data were extracted from the Medical Information Mart for eICU Collaborative Research Database (eICU-CRD) for a validation cohort. Logistic regression analysis was used to determine the significant predictors of WBC-related biomarkers on AKI prediction, and a risk model was established based on those significant indicators in multivariate logistic regression. The receiver operating characteristics (ROC) curve was utilized to obtain the best cut-off value of the risk model. The Kaplan–Meier curve was used to evaluate the prognosis-predictive ability of the risk model. Results The overall incidence of AKI was 28.4% in the training cohort and 33.2% in the validation cohort. WBC to lymphocyte ratio (WLR), WBC to basophils ratio (WBR), WBC to hemoglobin ratio (WHR), and neutrophil to lymphocyte ratio (NLR) could independently predict AKI, and a novel risk model was established based on WLR, WBR, WHR, and NLR. This risk model depicted good prediction performance both in AKI and other clinical outcomes including hemorrhage, persistent AKI, AKI progression, ICU mortality, and in-hospital mortality both in the training set and in the validation set. Conclusion A risk model based on WBC-related indicators exhibited good AKI prediction performance in critically ill patients with IS which could provide a risk stratification tool for clinicians in the ICU.


Intellectual performance, sensory motor abilities and social adaptation were studied in 41 subjects (2 to 21 years of age) who had severe malnutrition in infancy. A control group consisted of 41 siblings. The mean IQ of 31 parents was 108 (S.D. $$Word$$ 11.3). Socioeconomic deprivation was not present. The results of the Merrill-Palmer test for the malnourished group and the controls revealed significant differences in favor of the controls. No differences were found in the older population for whom the WISC and WAIS were used. The Lincoln-Oseretsky test of motor development and the Vineland scale of social maturity showed no significant differences. These results are consistent with the hypothesis that malnutrition in infancy can affect intellectual development in the first five years of life. Beyond this age, given adequate socioeconomic support, no significant differencces were observed.


Sixteen new anilide derivatives of the natural trioxane artemisinin were prepared and evaluated for antimalarial efficacy in Plasmodium berghei infected mice. Of these 16 new anilides administered orally as one 6 mg/kg dose combined with 18 mg/kg mefloquine hydrochloride, only sulfide 3-arteSanilide 12d was completely curative: on day 30 after infection, all mice in this group had no detectable parasitemia, gained as much weight as the uninfected control mice, and behaved normally.


Ovarian cancer (OC) is an aggressive disease with few valuable biomarkers and effective therapies. In this study, we aimed to elucidate biomarkers associated with OC metastasis into the omentum. We performed comprehensive screening of non-coding RNAs (ncRNAs) between matched primary OC and omental metastasis using the Agilent human lncRNA Array V3.0 microarray. Reverse transcription quantitative polymerase chain reaction (RT-qPCR) was used to validate the microarray results at the mRNA level. Microarray revealed 235 ncRNAs changes, and we validated the top four differential changed genes in an additional 27 paired samples with RT-qPCR. We found that myocardial infarction associated transcript (MIAT) expression increased in the omentum tissue, while small nucleolar RNA, C/D Box 114 cluster (SNORD114) family members SNORD114-10, SNORD114-2 and SNORD114-11 were downregulated when compared with OC tissue. However, there is no significant difference in SNORD114-2 and SNORD114-11 levels. We thus infer that differential expression of MIAT and SNORD114-10 could play an important role during OC metastasis. These ncRNAs might be useful as pre-diagnostic biomarkers at the early stage of cancer metastasis.


This paper investigates the impact of sampling time on Tustin digitization. A Q-matrix representation for the digitized system via Tustin transformation is first proposed. It is shown that Tustin transformation is a special case of the higher-order integrator approaches to digitize a continuous system. Pole-variation loci is then introduced to describe the trajectories of poles of the digitized system using Tustin transformation when sampling time is varied from zero to infinity. With new theorems derived in this paper, the pole-variation loci can be easily sketched. Sampling time of any point on the pole-variation loci of the digitized system can be determined by the angle of the vector drawn from the origin to the designated pole location. System dynamics of the digitized system can then be estimated from the sampling time, which determines the pole locations.


:  This study deals with AC voltage stress imposed on ethylene propylene rubber (EPR) cable. The cable terminal was prepared and installed in different test sets constructed inside the lab. The AC voltage was increased till breakdown of cable. The proper breakdown of cable was achieved by the test set usingde-ionized water as dielectric liquid medium surrounding cable terminal. The electrical breakdown strength Of 5 kV EPR cable under AC voltage has been measured by constructing a suitable test set in JNTUK High Voltage Lab.


Continued investigation of murine leukemia (P-388) active fractions from the African marine worm Cephalodiscus gilchristi has resulted in the discovery of cephalostatins 18 (1b) and 19 (1c). The structures were determined by interpretation of their highfield (500 MHz) 1H, 13C, and 2D NMR and HRMS. Both of these new methoxy steroidal alkaloids exhibited strong activity against the murine P-388 lymphocytic leukemia cell line (ED50 ca. 10(-3) microg/mL), a mini panel of human cancer cell lines (GI50 <10(-3) microg/mL), and the U.S. National Cancer Institute's 60 human cancer cell line panel (mean panel GI50 ca. 10(-9) M).


In this study, we aimed to investigate the removal of basic dyes, including Safranin T (ST), Nile Blue A (NBA), and Brilliant Cresyl Blue (BCB), from aqueous solution with a sulfonated phenol–formaldehyde resin. This sulfonated resin was characterized by Fourier transform infrared spectroscopy and scanning electron microscopy. The adsorption properties of this resin were investigated under different adsorption conditions with different initial dye concentrations, contact times, and pH values. The adsorption equilibrium data were analyzed with Langmuir and Freundlich models. The adsorption behaviors of ST, NBA, and BCB onto the sulfonated resol-type phenol–formaldehyde resin were better described by the Freundlich model. The adsorption capacities of the sulfonated resol resin for ST, NBA, and BCB decreased in the following order: NBA > BCB > ST. © 2008 Wiley Periodicals, Inc. J Appl Polym Sci, 2008


Quantum Machine Learning (QML) has recently emerged as a rapidly growing domain as an intersection of Quantum Computing (QC) and Machine Learning (ML) fields. Hybrid quantum-classical models have demonstrated exponential speedups in various machine learning tasks compared to their classical counterparts. On one hand, training of QML models on real hardware remains a challenge due to long wait queue and the access cost. On the other hand, simulation-based training is not scalable to large QML models due to exponentially growing simulation time. Since the measurement operation converts quantum information to classical binary data, the quantum circuit is executed multiple times (called shots) to obtain the basis state probabilities or qubit expectation values. Higher number of shots worsen the training time of QML models on real hardware and the access cost. Higher number of shots also increase the simulation-based training time. In this paper, we propose shot optimization method for QML models at the expense of minimal impact on model performance. We use classification task as a test case for MNIST and FMNIST datasets using a hybrid quantum-classical QML model. First, we sweep the number of shots for short and full versions of the dataset. We observe that training the full version provides 5-6% higher testing accuracy than short version of dataset with up to 10X higher number of shots for training. Therefore, one can reduce the dataset size to accelerate the training time. Next, we propose adaptive shot allocation on short version dataset to optimize the number of shots over training epochs and evaluate the impact on classification accuracy. We use a (a) linear function where the number of shots reduce linearly with epochs, and (b) step function where the number of shots reduce in step with epochs. We note around 0.01 increase in loss and maximum $\boldsymbol {\sim }4$ % (1%) reduction in testing accuracy for reduction in shots by up to 100X (10X) for linear (step) shot function compared to conventional constant shot function for MNIST dataset, and 0.05 increase in loss and $\boldsymbol {\sim }5$ -7% (5-7%) reduction in testing accuracy with similar reduction in shots using linear (step) shot function on FMNIST dataset. For comparison, we also use the proposed shot optimization methods to perform ground state energy estimation of different molecules and observe that step function gives the best and most stable ground state energy prediction at 1000X less number of shots.


The synthesis of cardiolipin has been investigated following the inhibition of mitochondrial protein synthesis with chloramphenicol. Quantitative measurements of the amount of cardiolipin in the cell during treatment with chloramphenicol as well as pulse-labelling studies using labelled acetate were carried out. The results show that while whole cell phospholipid biosynthesis is depressed by the treatment (probably a reflection of a general cessation of growth), there is no sign of any preferential effect on cardiolipin synthesis. The data also show that as cells are reduced in size as they approach stationary phase there is a six- to seven-fold loss of total cellular phospholipids; however, the amount of cardiolipin is only reduced by four- to five-fold. There is a preferential conservation of cardiolipin as stationary phase is approached with the mole percent cardiolipin phosphorus in the cell rising from 5-7% to 10-12%.


Abstract This synthesis incorporates the 16 most important pollen records available across the North Mediterranean region sensu lato for the last 2.7 Ma. Their location is discussed with respect to the present-day bioclimatic Mediterranean realm. A special effort has been made to redraw, where necessary, the pollen records in terms of modern cyclostratigraphy. The complexity of the evolution of the Mediterranean flora and vegetation as forced by the climatic cycles is evident. The influence of the latitudinal thermic (and xeric) gradient is confirmed, and the superimposition of a longitudinal gradient, forced by the Asian monsoon, is considered. The Mediterranean flora and vegetation were not altered by any important event during the Early-Middle Pleistocene transition between 1.2 and 0.7 Ma.


&NA; Addiction in women is a growing problem in the United States and is recognized as a very serious disease. Today researchers are able to document the neurochemistry of addiction in the brain. It has been found that sexual activity can create a "high" equal to that of crack cocaine. Sexual addiction includes behaviors such as extramarital affairs, compulsive use of pornography, cybersex, compulsive masturbation, exhibitionism, voyeurism, prostitution, child molestation, incest, and rape. Currently there is limited information on the prevalence rate of sexual addiction in women. This is due to the sexualization of women in our culture; sexually addictive behaviors are often masked and misconstrued as expressions of "normal" social and interpersonal conduct, not as indicators of addictive sexual behavior. The purpose of this paper is to increase nurses' awareness and knowledge about sexual addiction, how it manifests in women, how to assess a woman for sexual addiction, and provide some suggestions on how to help these women. Topics covered include: a definition of addiction, the neurochemistry of addiction, elements of sexual addiction in women including barriers to diagnosis, consequences of sexual addiction, and sexual addiction's relevance to nursing. Also included are case studies of women suffering from sex addiction.


While recent research has pointed to the importance of regional strategy and the 'interregional liability of foreignness,' critics have pointed out that this argument obscures important differences within regions as well as the similarities across them. Bridging these diverging viewpoints, our research is designed to unpack this debate into cultural, institutional, and regional components. Using a large data set, we find that firms are significantly more dispersed across cultural and, in particular, institutional boundaries, than they are across geographically defined regional boundaries. Further, our results indicate that certain firm-specific resources influence firms' global dispersion; in particular, we find that a nuanced interplay of proprietary capabilities such as technology, marketing, and partnering capabilities has an impact on the location of firm activities.


High resolution NMR spectroscopy, NMR diffusiometry, and NMR cryoporometry have been used to investigate aqueous solution (D2O) of PAMAM_G5.NH2-(Au)(25-100) and PAMAM_G5.NH2-(H2O)1000-(H2O)4000 systems. In the case of dendrimer entrapped gold nanoparticles, the detailed analysis of high resolution NMR spectra has shown that no precursor complex formation happens under the circumstances applied for reduction. Further PGSE results verify that gold nanoparticles of 1.9-2.6 nm size are entrapped in the outermost part of the dendrimers and probably more than one dendrimer molecule takes part in the stabilization process. This system looks like a transition state between dendrimer encapsulated nanoparticles (DENs) and dendrimer stabilized nanoparticles (DSNs), and we deal with it in details for what this means. NMR cryoporometry experiments were performed to detect the encapsulation of water molecules. The results show that, in the swelling PAMAM_G5.NH2 dendrimers, by adding water step by step, there are specific cavities for water with diameters of 3.6 and 5.2 nm. These cavities have a penetrable wall for water molecules and probably exist very close to the terminal groups. The permeability of the cavities is increasing with the increase of the water content. In dilute solution, the formation of nanoparticles is determined by the ratio of the rate of nucleation and aggregation and the latter is affected by the PAMAM_G5.NH2.


Abstract Several soil isolates from 1 g of soil sample were isolated and screened for the production of L-asparaginase. Primary screening was performed using rapid plate assay; dye indicator studies were conducted, and phenol red with 0.005% concentration was found to be optimum. The secondary screening was carried out using the Nesslerization method. The bacteria screened for L-asparaginase production with no glutaminase activity was identified as Bacillus subtilis. Crude L-asparaginase enzyme was partially purified 1.57 folds of purity and 110 U/mg of specific activity. The glutaminase-free L-asparaginase activity was also confirmed using LC-MS analysis. The presence of mass peaks at 147.0 in the reaction mixture suggested an absence of glutaminase activity. An optimized medium obtained comprised of Dextrose 1.5 g/L, K2HPO4 1.2 g/L, L-asparagine 15 g/L, and Tryptone 5 g/L. The highest L-asparaginase activity was observed at 6.0 pH and 30 °C. Kinetic parameters associated with biomass and L-asparaginase production were also studied. The computed values were µm 0.104 h−1, Xm 6g/L P0 1.7U/mL Pm 8.2 U/mL YX/S 4 g-cell/g-glucose µPm 0.35 h−1 qp 5.46 U/g/h YP/x 13.6667 U/g-cell. The novel bacterial isolates showed promise as a potential glutaminase-free L-asparaginase producer, which can prove to be of industrial applications.


Purpose To describe the results of thyroid-related orbitopathy (TRO) treated by ultrasonic deep lateral wall bony decompression with partial rim sparing (DLW-PRS). Methods A review was carried out, from January 2015 to September 2017, of all patients treated with ultrasonic DLW-PRS decompression using a SONOPET® (Stryker, Kalamazoo, MI, USA) ultrasonic aspirator, using a lateral, small triangle flap incision for access. The primary outcome was the change in proptosis (measured by the difference in Hertel exophthalmometry measurements). Other secondary outcomes were changes in visual acuity (VA) (using Snellen scale, decimal fraction), presence of lagophthalmos, eyelid retraction (measured by upper eyelid margin distance to the corneal reflex (MRD1) and lower eyelid margin distance to the corneal reflex (MRD2), and presence of exposure keratopathy). Results A total of 58 orbital decompressions in 35 patients were reviewed, with 23 patients (65.7%) having bilateral decompressions. There was a female preponderance with 26 patients (74.2%), and the mean age ± standard deviation was 52.6 ± 13.9 years. Mean proptosis was 24.51 ± 1.76 mm preoperatively, reduced to 19.61 ± 1.27 mm in final follow-up. The mean reduction was 4.9 ± 1.54 mm. VA improved from 0.8 ± 0.14 to 0.9 ± 0.12, p=0.039. 5 of 13 patients (38.4%) with preoperative diplopia reported improvement or complete resolution after surgery. MRD1 was reduced from 5.25 ± 0.88 mm to 4.49 ± 0.7 mm. MRD2 was also reduced from 6.3 ± 0.88 mm to 5.0 ± 0.17 mm. Presence of lagophthalmos was reduced from 35 eyes (60.3%) to five (8.6%); the presence of epiphora was also reduced from 20 patients (57.1%) to 3 (8.5%) following decompression. Complications of the surgery included zygomatic hypoaesthesia in 14 (40%) patients in the early postoperative period and chewing alterations in 10 (28.5%) of the patients. All of these complications were resolved at the 6-month follow-up visit. We noted no surgical complications such as ocular or soft tissue damage, infection, inflammation, or visual loss. Conclusions The SONOPET® ultrasonic bone curette can be used safely and effectively for DLW orbital decompression surgery. The main benefits were good visualization and handling of tissues and speed and ease of use of the equipment. This trial is registered with ClinicalTrials.gov identifier: NCT04025034.


OBJECTIVEIncidental pituitary adenomas (IPAs) are commonly discovered during cranial imaging evaluations obtained for unrelated indications. The optimal management of IPA remains controversial. The authors investigated the outcomes and safety of the surgical treatment of IPAs at their institution.METHODSClinical outcome data for 1692 patients surgically treated for pituitary adenomas at the Keck Medical Center of USC/USC Pituitary Center over a 17-year period (1999-2016) were reviewed to identify all cases with surgically managed IPAs. Clinical characteristics reviewed in this retrospective analysis included patient demographics, endocrine laboratory data, visual field examinations, and MRI results. Intraoperative data reviewed included requirement for CSF leak repair, surgical complications, and estimated extent of resection. Postoperative data collected included pathology results, length of stay, postoperative complications, endocrine outcomes, readmission rates, and long-term outcomes, including extent of resection noted on postoperative imaging studies and tumor progression and/or recurrence.RESULTSFifty-two patients (3.1% of all cases) underwent transsphenoidal surgery for IPA. The median age at surgery was 61 years (range 31-86 years). The most common reasons for neuroimaging included trauma (19%), stroke/transient ischemic attack (15%), and sinonasal disease (15%). Visual field deficits were present in 15% of bedside examinations, and among the 22 patients sent for formal testing, 54.5% were noted to have deficits. Preoperative endocrine function was normal in 69% of patients, which includes 3 patients (5.8%) having isolated hyperprolactinemia consistent with a stalk effect without other hormonal dysfunction. The average maximal tumor diameter was 20.9 mm (8-50 mm; data available in 35 patients). The most common primary indication for surgery was compression of the chiasm or vision loss (52%); other major considerations included tumor growth, a young patient age, and identified endocrine abnormalities. Intraoperative CSF leak repair was performed in 56% of patients, and 1 patient (2%) developed postoperative CSF rhinorrhea treated with lumbar drainage. The median hospital stay was 2 days. There were no deaths or major complications. Three patients (5.8%) developed transient diabetes insipidus. Over a mean follow-up of 61 months, 4 patients (50.0%) reported improved headaches and 6 (54.5%) reported improvement in their visual deficits. Four patients (25%) had improved endocrine function, including one with resumption of menstruation and another with remission of acromegaly. One patient (2.4%) reported new postoperative headache, and none experienced worsened vision. Four patients (10.5%) developed new single-axis hypopituitarism and 1 (2.6%) developed new panhypopituitarism. The overall recurrence/progression rate on neuroimaging was 9.6% at a mean of 80 months.CONCLUSIONSTranssphenoidal resection of IPAs, when appropriate, can be performed safely at experienced treatment centers. Incidental pituitary adenomas should be evaluated and treated as indicated, especially in younger patients at risk for endocrine or visual dysfunction.


Ectotherms are taxa considered highly sensitive to rapid climate warming. This is because body temperature profoundly governs their performance, fitness and life history. Yet, while several modelling approaches currently predict thermal effects on some aspects of life history and demography, they do not consider how temperature simultaneously affects developmental success and offspring phenotypic performance, two additional key attributes that are needed to comprehensively understand species responses to climate warming. Here, we developed a stepwise, individual-level modelling approach linking biophysical and developmental models with empirically derived performance functions to predict the effects of temperature-induced changes to offspring viability, phenotype and performance, using green sea turtle hatchlings as an ectotherm model. Climate warming is expected to particularly threaten sea turtles, as their life-history traits may preclude them from rapid adaptation. Under conservative and extreme warming, our model predicted large effects on performance attributes key to dispersal, as well as a reduction in offspring viability. Forecast sand temperatures produced smaller, weaker hatchlings, which were up to 40% slower than at present, albeit with increased energy stores. Conversely, increases in sea surface temperatures aided swimming performance. Our exploratory study points to the need for further development of integrative individual-based modelling frameworks to better understand the complex outcomes of climate change for ectotherm species. Such advances could better serve ecologists to highlight the most vulnerable species and populations, encouraging prioritization of conservation effort to the most threatened systems.


In this paper, an improved multiplier architecture, utilizing dual mode logic (DML) targeting single-instruction-multiple-data (SIMD)-like systems is proposed. The design introduces improvements at both the architecture and logic gate levels, by capitalizing on their synergistic combination. At the architecture level, the multiplier design is adapted to accommodate diverse computations based on the level of the input data parallelism. The main novelty is the incorporation of three different acceleration or bypass mechanisms jointly. The configurable multiplier has three variable precision configuration options: a <inline-formula> <tex-math notation="LaTeX">$32\times 32$ </tex-math></inline-formula>-bit, two <inline-formula> <tex-math notation="LaTeX">$16\times 16$ </tex-math></inline-formula>-bit, and four <inline-formula> <tex-math notation="LaTeX">$8\times 8$ </tex-math></inline-formula>-bit multipliers. This bypassing architecture seamlessly integrates DML logic, which supports two modes of operation: a high-performance dynamic mode and a low-energy consumption static mode, with smooth mode switching capabilities. By optimizing the DML mode based on the multiplier's bit-width, the design enhances active computational block utilization, overall performance, and energy efficiency. In the dynamic mode, the DML implementation achieves an average performance improvement of 15% for the 32-bit, 8% for the 16-bit, and 7% for the 8-bit multipliers compared to the CMOS implementation. In the static mode, the DML implementation demonstrates an average energy reduction of 28%. When running in combined mode, where the 32-bit multiplier operates in dynamic mode for acceleration and the 8-bit multiplier operates in static mode for energy savings, the DML implementation exhibits an average overall performance gain of 15% and up to 18% lower energy consumption. The non-trivial semi-automation flow utilized for the complex implementation of the proposed architecture is also presented.


The flowering phenology of five alpine dwarf-tree species was observed in the summit region (3900–3950 m elevation) of Mt. Kinabalu on Borneo Island from March 1998 to November 2001. For each target species, 20–50 individual plants were numbered in two observation plots and the number of inflorescences was monitored at 2–3-mo intervals. The flowering patterns varied among species. Rhododendron buxifolium bloomed extensively every March–May at the main plot but the flowering pattern at the subplot was less predictable. Mass flowering occurred in March 1998 when drought stress was very severe due to an El Niño event. Rhododendron ericoides showed continuous flowering throughout the year and high synchrony between the plots. Extensive flowering of Leptospermum recurvum occurred synchronously within and between plots in the early half of 1999, then flowering activity decreased greatly. Photinia davidiana showed an annual flowering cycle but the timing of the peak flowering differed between the plots. Vaccinium stapfianum showed synchronous flowering between the plots and the flowering peak appeared at longer than 1-y intervals. Plant size was positively correlated with mean flower production in all species, and with the flowering frequency of R. ericoides, R. buxifolium, and V. stapfianum at one of the plots at least. Two fleshy-fruited species, P. davidiana and V. stapfianum, had high selfing ability for fruit production and showed relatively low flowering synchrony among individuals in comparison with the other species. These results indicate that the trigger for initiation of flowering may differ among sympatric species in a tropical-alpine ecosystem at least in normal years.


Purpose: Wilms' tumor is the most common malignant tumor of the kidney during the childhood period. This is a potentially curable disease with an excellent prognosis due to the development of the multimodal treatments, including chemotherapy, radiotherapy and nephrectomy. The aim of this study was 1) to analyze our clinical experiences with of Wilms' tumor at a single tertiary medical center, including the survival rate and recurrence of disease after treatment and 2) to investigate the prognostic factors affecting the survival of patients. Methods: We performed retrospective analysis of the clinicopathologic data of 68 patients who underwent operation for Wilms' tumor during 20 years from March 1986 to March 2005 at Yonsei Medical Center. Results: 40 (58.8%) patients were male and 28 patients (41.2%) were female. The median age at diagnosis was 25 month (range: 2 month to∼10 year 10 month). Preoperative neoadjuvant chemotherapy was given in 27 patients (39.7%), and initial nephrectomy followed by chemotherapy was performed in 41 patients (60.3%). Postoperative adjuvant radiotherapy was performed in 27 patients (39.7%). The median duration of follow-up period was 8 year 2 month (range: 24 day to∼18 year 6 month). The overall 5-year survival rate and 5-year disease free survival rate were 87.0% and 76.9%, respectively. Univariate analysis showed that the significant prognostic factors affecting survival were age at diagnosis (P=0.016), pathologic stage (P=0.032) and, Tumor spillage or rupture during operation (P=0.005) and tumor cell anaplasia (P=0.031). Multivariate analysis showed that tumor spillage or rupture during operation was the most significant prognostic factor (Relative Risk=4.5). Conclusion: Early diagnosis, meticulous surgical technique and proper pre-or postoperative adjuvant chemotherapy and radiotherapy according to the tumor histology significantly increase the patient's survival rates.(J Korean Surg Soc 2006;71:202-209)


We have upgraded IRCAL, the near-infrared science camera of the Lick Observatory adaptive optics system, to add a dual-channel imaging polarimetry mode. This mode uses an optically contacted YLF (LiYF4) Wollaston prism to provide simultaneous images in perpendicular linear polarizations, providing high-resolution high–dynamic-range polarimetry in the near-infrared. We describe the design and construction of the polarimeter, discuss in detail the data reduction algorithms adopted, and evaluate the instrument's on-the-sky performance. The IRCAL polarimeter is capable of reducing the stellar PSF halo by about 2 orders of magnitude, thereby increasing contrast for studies of faint circumstellar dust-scattered light. We discuss the various factors that limit the achieved contrast, and present lessons applicable to future high-contrast imaging polarimeters.


Purpose Doxorubicin/cyclophosphamide followed by docetaxel chemotherapy (AC-D) is an intermediate risk factor (incidence of 10%–20%) for febrile neutropenia (FN) in breast cancer. However, the reported incidence of FN while using this regimen was obtained mostly from Western breast cancer patients, with little data available from Asian patients. This study aimed to assess the incidence of FN in Korean breast cancer patients and to describe clinical variables related to FN. Methods From September 2010 to February 2013, data from the Yonsei Cancer Center registry of breast cancer patients who received neoadjuvant or adjuvant chemotherapy with four cycles of AC-D (60 mg/m2 doxorubicin, 600 mg/m2 cyclophosphamide every 3 weeks for four cycles followed by 75 mg/m2 or 100 mg/m2 docetaxel every 3 weeks for four cycles) were analyzed. The incidence of FN, FN associated complications, dose reduction/delays, and relative dose intensity (RDI) were investigated. Results Among the 254 patients reported to the registry, the FN incidence after AC-D chemotherapy was 29.5% (75/254), consisting of 25.2% (64/254) events during AC and 4.7% (12/254) during docetaxel chemotherapy. Dose reductions, delays, and RDI less than 85.0% during AC were observed in 16.5% (42/254), 19.5% (47/254), and 11.0% (28/254) of patients, respectively. Patients with FN events frequently experienced dose reduction/delays, which eventually led to a decreased RDI. Conclusion The incidence of FN during AC-D neoadjuvant or adjuvant chemotherapy was higher than expected in Korean breast cancer patients. Whether these patients should be classified as a high-risk group for FN warrants future prospective studies.


THERE has been criticism of the quality of care received by patients under the house officer training program. The principal complaint is that some house officers are inconsiderate of their patients' psychological and emotional needs. A second complaint, mostly from physicians, is that patients suffer because the house officers do not possess adequate technical skills and are schooled only in the scientific and theoretical aspects of disease. I am sensitive to these criticisms, especially that of personal inconsideration of the patient, because I spent 15 years as a family doctor, practicing with my father, who was a general practitioner, and made some 8,000 visits to patients in their homes, before joining a faculty of medicine. It is unfair to contrast extremes, but I am certain that sympathetic understanding, combined with medical ignorance, has caused more deaths and unhappiness than has expert scientific knowledge of disease, accompanied by neglect of the


Aim: To report an exceptionally rare case of malignant choroidal melanoma with vitreous seeding, supported by histopathological and field emission scanning electron microscopic (FESEM) studies. Case report: A 58-year-old male with painless diminution of vision in his left eye for past 1 month was found to have a brown retrolental mass lesion on slit lamp examination in the left eye. Detailed fundus examination revealed choroidal melanoma in the left eye with pigmented seeds extending into the vitreous cavity and associated exudative retinal detachment. Ocular imaging was consistent with the diagnosis. Results: The eyeball was enucleated and the tumor was considered as stage IIB (AJCC 8th edition classification). Metastatic workup of the patient was negative. One half of the eyeball was subjected to field emission scanning electron microscopy to further study the nature and appearance of vitreous seeds. Discussion: Vitreous seeding in choroidal melanoma has been reported only in a handful of cases in literature. Histopathological confirmation of vitreous seeds was done in our case and morphological detailing was performed using FESEM study. Conclusions: Treatment naïve choroidal melanoma can very rarely have vitreous seeds. Early enucleation in such cases carries a favorable prognosis.


This study is devoted to the faunal inventory and preliminary ecological analysis of oribatid mite communities in Priazovsky National Wildlife Sanctuary (Krasnodar Krai, Southern Russia), which is included into the Ramsar Convention 'Kuban Delta' Wetland of international importance. We sampled five major habitat types represented in the sanctuary and its environs: liman-reed beds, sandy coasts, elevated coasts, rice paddies, and a salt marsh. In total, 40 oribatid mite species were found. They belonged to 22 families. Most of the species were earlier met in the neighboring regions: Krasnodar Krai, Rostov region and Northern Caucasus. Few species however were found in Krasnodar Krai for the first time, e.g. Ghilarovizetes obtusus Shaldybina, 1969, which was earlier recorded only in the Central and Eastern Caucasus. The most species-rich habitats were liman-reed beds. In rice paddies, oribatid communities were rudimentary and represented only by very few species. The abundance of different oribatid ecomorphs was quite contrasting across the five habitat types. Soil-dwelling mites dominated in liman-reed beds possibly due to stable humidity of soil in this habitat type. The presence of aquatic mites in liman-reed beds was also quite peculiar. In welldrained elevated coasts, non-specialized and surface-dwelling mites were the most numerous because of their better adaptation to drought. In sandy coasts and salt marshes, surface-dwelling mites prevailed. We conclude that salinity and rice-growing seem to reduce considerably abundance and diversity of oribatid mites in the study area. We further assume that the quite high similarity of oribatid fauna in Priazovsky National Wildlife Sanctuary with that in the surrounding regions suggests much closer biogeographic relationship of Kuban lowlands with other regions of North Caucasus, than one would expect.