Proceedings: AACR 103rd Annual Meeting 2012‐‐ Mar 31‐Apr 4, 2012; Chicago, IL

Introduction: Overall 5-year survival rates of patients with pancreatic cancer remains below 15% due to delay in diagnosis and chemotherapeutic resistance. Combinational therapy has become the mainstay of treatment in patients who have metastatic pancreatic cancer. We hypothesize that 1) vorinostat (suberoylanilide hydoxamic acid), a histone deacetylase inhibitor, will improve efficacy of gemcitabine in gemcitabine-resistant pancreatic tumor cells; and 2) vorinostat works through decreasing the transcription inhibitors of apoptosis proteins (IAPs). Methods: Six different human pancreatic cell lines were treated with various levels of vorinostat with or without gemcitabine. Viability of tumor cells was determined via MTT assay and cytoplasmic levels of IAPs, including survivin, were analyzed via western blot assay. Real-time RT-PCR was performed on cell lysates to determine changes in survivin gene expression. Results: Combinations of vorinostat with gemcitabine significantly inhibited pancreatic cancer cells growth in vitro when compared with either treatment alone (p<0.05). Screening of IAPs expression in tumor cells after exposure to vorinostat revealed variation of their expression in pancreatic tumor cells except survivin, whose expression declined consistently in all cells after vorinostat treatment. Overall cytoplasmic levels of survivin were seen to decline across all cell lines treated. Real-time RT-PCR showed a decrease in survivin gene expression in all cell lines tested as compared to control. Conclusion: We conclude that 1) vorinostat increases the efficacy of gemcitabine on pancreatic cells; and 2) decline of survivin protein levels in after exposure to vorinostat is due to a decrease in gene transcription and indicates that survivin plays an important role in improving the chemotherapeutic effect of gemcitabine. We are currently conducting in vivo experiments to verify our findings using orthotopic pancreatic tumor animal models.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4102. doi:1538-7445.AM2012-4102


I would like to thank Dr. Diana Quiñones for her supportive comments on our article published in the June 2008 issue of the American Journal of Neuroradiology. Diffuse pachymeningeal (dural) hyperintensity on fluid-attenuated inversion recovery (FLAIR) MR imaging (DPMHF) may reflect almost the same dural change as diffuse pachymeningeal enhancement (DPME), but the technique of MR imaging is different. As Dr. Quiñones proposes, if the sign of DPMHF on nonenhanced brain MR imaging, accompanied by other signs of spontaneous intracranial hypotension (SIH; subdural effusions, venous sinus engorgement, brain sagging, etc.), is sufficient to diagnose SIH, the demonstration of DPME by administration of contrast material might not be required. The Table compares the characteristics of DPMHF and DPME. DPMHF has several advantages, such as noninvasiveness and cost, but it is less easily noticed than DPME during the interpretation of MR images. Any observer, including residents and nonspecialists, can detect DPME extremely easily by comparison with the MR imaging before injection of contrast medium. In this case, the detailed MR anatomy of the skull and pachymeninges might be not so important. All other MR signs of SIH, including DPMHF, do not have this ease of detection by image comparison. SIH can be easily and objectively identified on the basis of DPME, and the number of reports in this field has increased rapidly. This is a result of the ease of detection. Physicians in several fields (neuroradiology, neurology, neurosurgery, anesthesiology, emergency medicine, headache) have distinguished the presence of DPME, and the various symptoms and signs have been proven to be the result of SIH. In contrast, the presence of DPMHF remained unnoticed for a long time. Diffuse, linear, uninterrupted, and non-nodular pachymeningeal enhancement is characteristic of patients with SIH. The wave-like appearance may be a characteristic finding in patients with SIH in the frontal and temporal base regions. DPMHF occurs adjacent to the hyperintense appearance of subdural effusion or hematomas in most patients with SIH, so the linear DPMHF can be observed in locations not adjoining the subdural effusion or hematomas. Of course, the observer should be thoroughly knowledgeable about the MR anatomy of the skull and pachymeninges. Therefore, the identification of DPMHF may be relatively more difficult than the identification of DPME. However, FLAIR is the most sensitive sequence for the detection of characteristic thin subdural effusion or hematomas in patients with SIH. A skilled observer may be able to identify diffuse pachymeningeal hyperintensity and thin subdural effusion or hematomas with routine FLAIR MR imaging, thus allowing omission of injection of contrast medium. The diagnosis is then easy to confirm by further MR imaging with contrast medium if necessary.


We investigate and discuss the possibilities and limits of a method for the tunable storage of optical packets called Quasi-Light Storage (QLS). The QLS is simply based on a sampling in the frequency domain. Hence, it is independent of the data rate, the modulation and the wavelength of the optical packets. It works at room temperatures in standard fibers with off-the-shelf telecom equipment. As we will show in theory, the method has the potential to store packets with several thousand Bits of data from Zero to up to 100 ns. In the experiments we have stored several 8 Bit packets with a data rate of 1 Gbps for up to 100 ns, which corresponds to a delay-bandwidth product of 100 Bit.


Artificially dried ryegrass, untreated and ammonia-treated wheat straw were ground and incubated in nylon bags in the rumen of three sheep each fed with diets based on roughage or concentrate. Dry matter degradability, the concentration and the release of the trace elements Cu, Fe, Mn and Zn from the incubated feeds were measured after 0 (washing loss), 6, 12, 24, 48 and 72 h rumen incubation time. Dry matter degradability, trace element concentration and their release were significantly influenced by the kind of incubated feeds, incubation time and feeding of sheep. Cu- (1.8-6.9 mg kg-1 DM) and Zn concentrations (36-103 mg kg-1 DM) of straw residues in the bags were much higher than those of original straw (1.2-1.6 and 8.1-9.9 mg kg-1 DM resp.). The inflow of Cu and Zn in the bags containing straw residues was higher than their release. The Cu-, Fe- and Mn-release from ryegrass was similar to the dry matter degradability, but the Zn-release was much lower.


Background This study is aimed at investigating the changes in relevant pathways and the differential expression of related gene expression after ischemic stroke (IS) at the single-cell level using multiple weighted gene coexpression network analysis (WGCNA) and single-cell analysis. Methods The transcriptome expression datasets of IS samples and single-cell RNA sequencing (scRNA-seq) profiles of cerebrovascular tissues were obtained by searching the Gene Expression Omnibus (GEO) database. First, gene pathway scoring was calculated via gene set variation analysis (GSVA) and was imported into multiple WGCNA to acquire key pathways and pathway-related hub genes. Furthermore, SCENIC was used to identify transcription factors (TFs) regulating these core genes using scRNA-seq data. Finally, the pseudotemporal trajectory analysis was used to analyse the role of these TFs on various cell types under hypoxic and normoxic conditions. Results The scores of 186 KEGG pathways were obtained via GSVA using microarray expression profiles of 40 specimens. WGCNA of the KEGG pathways revealed the two following pathways: calcium signaling pathway and neuroactive ligand-receptor interaction pathways. Subsequently, WGCNA of the gene expression matrix of the samples revealed the calcium signaling pathway-related genes (AC079305.10, BCL10, BCL2A1, BRE-AS1, DYNLL2, EREG, and PTGS2) that were identified as core genes via correlation analysis. Furthermore, SCENIC and pseudotemporal analysis revealed JUN, IRF9, ETV5, and PPARA score gene-related TFs. Jun was found to be associated with hypoxia in endothelial cells, whereas Irf9 and Etv5 were identified as astrocyte-specific TFs associated with oxygen concentration in the mouse cerebral cortex. Conclusions Calcium signaling pathway-related genes (AC079305.10, BCL10, BCL2A1, BRE-AS1, DYNLL2, EREG, and PTGS2) and TFs (JUN, IRF9, ETV5, and PPARA) were identified to play a key role in IS. This study provides a new perspective and basis for investigating the pathogenesis of IS and developing new therapeutic approaches.


BACKGROUND
Cysteine protease Cathepsin L is involved in bone remodeling and expressed in activated macrophages. It is highly expressed in metastatic tumor tissue, especially with bone metastases.

AIMS
We evaluated immunohistochemical expression of Cathepsin L in tumor cells and tumor-associated macrophages (TAMs) in chemo-naive Ewing sarcoma.

SETTINGS AND DESIGN
Retrospective evaluation of archived specimens of Ewing sarcoma.

MATERIALS AND METHODS
Immunohistochemical staining was performed on archived blocks of chemo-naive patients with Ewing sarcoma treated with uniform chemotherapy at our institute between January 2009 and November 2011.

STATISTICAL ANALYSIS
Immunohistochemical expression was co-related with baseline demographics and survival.

RESULTS
During the study period, we had evaluable baseline samples from 62 patients with median age 15 years (range: 2-40); 26 (42%) had metastases. Cathepsin L expression in tumor cells was observed in 8/62 (13%) specimens. None of the baseline clinical characteristics correlated with Cathepsin L expression. Cathepsin L positivity was associated with poor response to neoadjuvant chemotherapy (NACT) (P = 0.05), but did not influence either event-free-survival (EFS) or overall survival. Cathepsin L was expressed in TAMs in all specimens. Grade 3 TAMs (>10 TAMs/high power field) was associated with better response to NACT (P = 0.05). On univariate analysis Grade 3 TAMs predicted superior EFS (median EFS 28.5 months in those with Grade 3 TAMs versus 14.8 months in those with grade ½ TAMs [P = 0.04]).

CONCLUSIONS
Cathepsin L expression by immunohistochemistry was low in our patient cohort, and it did not affect the outcome. In addition, Grade 3 TAMs with Cathepsin L expression was associated with improved EFS.


The following article aims to present the conceptual framework for setting up simple control systems for applications indoor fluorescent lighting. Today such system is of great aim application by the proper use of a natural resource (sunlight) and obtaining substantial economic benefits.


To evaluate the efficacy of stress technetium-99m MMI (N-2-methoxy-2-methyl propyl isonitrile) myocardial perfusion scintigraphy (Tc-99m MMI) using intravenous dipyridamole for detection of coronary artery disease (CAD), we collected 66 cases (53 men, 13 women, aged 40-79 years old) between Sept. 1990 and Oct. 1991. The cases were divided into two groups: group I involving 44 patients received coronary arteriography (CAG) examination without previous percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass graft (CABG); group II embracing 22 patients received no CAG examination but all were suffering from old myocardial infarction (MI) evidenced by history and electrocardiography (ECG). All cases underwent Tc-99m MMI planar and single photon emission computed tomography (SPECT) both on intravenous dipyridamole stress and separate day rest tests. Of the 44 group I patients receiving both Tc-99m MMI and CAG, 35 (79.5%) were positive and 7 (16%) were negative by both tests and another 2 (4.5%) were positive by CAG only. Of those positive by both tests, 21 (60%) suffered from identical coronary arterial involvement, including 13 one-vessel disease, 5 double-vessel disease and 3 triple-vessel disease. Of group II patients, 14 suffered from old inferior wall (IW) MI, 6 from old anterior or anteroseptal wall (AW) MI, 1 from old lateral wall (LW) MI and another 1 from combined old anterior and lateral wall (ALW) MI by ECG. Of the 14 patients with IWMI by ECG, all suffered from right coronary artery (RCA) disease but 7 (50%) of them from multivessel disease (MVD) by Tc-99m MMI. 5 of the 6 patients with AWMI by ECG suffered from left anterior descending coronary artery (LAD) disease, but 3 of them from MVD by Tc-99m MMI. Both patients with LWMI and ALWMI by ECG suffered from triple-vessel disease by Tc-99m MMI. The sensitivity of Tc-99m MMI in detecting CAD in group I was 95%, the specificity was 100%. The sensitivity for detection of individual coronary artery disease in LAD, left circumflex coronary artery (LCX) and RCA was 96%, 45% and 89% in this order and the respective specificity was 94%, 100% and 88%. In group II the sensitivity was 95%. The overall sensitivity of intravenous dipyridamole Tc-99m MMI for detection of CAD in groups I and II was 95%; specificity was 100% and accuracy was 95%. In conclusion, stress Tc-99m MMI using intravenous dipyridamole is a valuable method for evaluation and detection of CAD.


Long-term peritoneal dialysis (PD) is associated with alterations in peritoneal permeability and loss of ultrafiltration. These changes originate from increased peritoneal surface area, but the morphologic and molecular mechanisms involved remain unknown. The hypothesis that modifications of activity and/or expression of nitric oxide synthase (NOS) isozymes might play a role in these modifications, via enhanced local production of nitric oxide, was tested in this study. NOS activities were measured by the L-citrulline assay in peritoneal biopsies from seven control subjects, eight uremic patients immediately before the onset of PD, and 13 uremic patients on short-term (<18 mo, n = 6) or long-term(>18 mo, n = 7) PD. Peritoneal NOS activity is increased fivefold in long-term PD patients compared with control subjects. In uremic patients, NOS activity is positively correlated with the duration of PD. Increased NOS activity is mediated solely by Ca(2+)-dependent NOS and, as shown by immunoblotting, an upregulation of endothelial NOS. The biologic relevance of increased NOS in long-term PD was demonstrated by enhanced nitrotyrosine immunoreactivity and a significant increase in vascular density and endothelial area in the peritoneum. Immunoblotting and immunostaining studies demonstrated an upregulation of vascular endothelial growth factor (VEGF) mostly along the endothelium lining peritoneal blood vessels in long-term PD patients. In the latter, VEGF colocalized with the advanced glycation end product pentosidine deposits. These data provide a morphologic (angiogenesis and increased endothelial area) and molecular (enhanced NOS activity and endothelial NOS upregulation) basis for explaining the permeability changes observed in long-term PD. They also support the implication of local advanced glycation end product deposits and liberation of VEGF in that process.


This paper introduces the domestic and international steel ball surface defect detection status, a fiber optic sensor with multi-ring receiving fibers was used for the detection of surface defects on steel ball. According to the different mechanism of defects, the different mathematical models were adopted to compensate the displacement-related defects and roughness-related defects on steel ball, so as to achieve the purposes of accurate judgments and distinguish defects.


Green roofs have been more thoroughly investigated in the last few years due to the potential benefits they offer to ecosystems in urban areas (e.g., carbon sequestration, particle retention, heat island effect attenuation). However, current climate change models predict an increase in desertification, with an increase in temperature and decrease in rainfall, which means there is an increasing demand for green roofs with lower water consumption. Vegetation with very little water requirements, such as desiccation-tolerant mosses, has shown a potential to complement or substitute for vascular species, increasing the sustainability of lower water use in green roofs. In this study, we use chlorophyll a fluorescence imaging to screen for bryophytes with adequate physiology to be used in green roofs placed in at-risk areas with prolonged drought episodes. Apart from Hypnum cupressiforme, all selected species presented a high potential for use in those conditions, particularly Didymodon fallax, Grimmia lisae, Pleurochaete squarrosa, and Targionia hypophylla. Chlorophyll a fluorescence imaging technology proved to be a simple and non-invasive tool for a fast screening of these poikilohydric organisms, to be used in future studies of bryophyte biology, but more importantly in the green roof industry.


Taiwan's export-led industrial development is often presented as a model of how state intervention promotes growth. Others see the same experience as a model of a private enterprise market at work. This study demonstrates that Taiwan policy-makers varied their approach to development as circumstances changed. Export promotion of labour-intensive industries, which predominated in the 1960s, was supplemented by efforts to promote import-substituting heavy industries in the 1970s. In the early 1980s there was a fundamental change in the economic environment as Taiwan government reduced its active intervention in the economy and created a foundation for development based on information and other high-technology products. Taiwan's economy continued to prosper in the 1990s because policies and systems changed along with conditions.


Homework is the focus of many versions of educational reform; yet research on the efficacy of homework as a means of raising student achievement is mixed at best. Even less certain is the impact of homework on the lives of families, particularly family relationships. This study used interviews to examine how a diverse group of parents whose children struggled academically perceived the effects of homework on their families. In general, the presence of homework had a disruptive effect on the lives of these families, reducing the time available for family activities and diminishing the quality of family interactions. In these families, homework was a carrier for school troubles, a means by which "school troubles" were transformed into "family troubles."


A hundred and twenty-five years ago, European infants grew differently from modern infants. We show weight gains of 20 healthy children weighed longitudinally from birth to age 1 year published by Camerer in 1882. The data illustrate the prevalent historic concepts of infant nutrition practiced by German civil servants, lawyers, merchants, university professors, physicians, foresters and farmers. Breastfeeding by the mother was not truly appreciated in those days; children were often breastfed by wet nurses or received bottled milk of various composition. Bottle feeding mainly consisted of diluted cow's milk with some added carbohydrates without evidence that appropriate amounts of oil, butter or other fatty components had been added. French children from 1914 showed similar weight gain patterns suggesting similar feeding practices. The historical data suggest that energy deficient infant formula had regularly been fed in the late 19th and the early 20th century Europe regardless of wealth and social class. The data question current concerns that temporarily feeding energy deficient infant formula may warrant serious anxieties regarding long-term cognitive, social and emotional behavioral development.


Authors in their theoretical report discuss problems of traumatic haemoperitoneum resulting from blunt abdominal injury including diagnostics and therapy. They put the stress on diagnostic-therapeutic algorithm. It is emphasized the necessity of immediate US of the abdomen and at the haemodynamically stable patients helical CT scan. Classification of injured certain abdominal cavity organs is mention and suggested unification of these classifications. It is highlighted conservative treatment of traumatic haemoperitoneum with regular monitoring including monitoring of intralpha abdominal pressure and abdominal compartment syndrome. Damage Control Surgery System, as a new strategy, is discussed in a part regarding operative management.


Complexes of zinc and uranyl ions with L-hydroxyproline (LHP) have been investigated by polarographic method of analysis at 25±1 and 35±1 °C. At pH 4.5, formation of uranyl-LHP complex was observed with metal to ligand ratio of 1: 1 in aqueous and aqueous-methanolic solutions. The stability constant for the complex species is logKc=1.50, 1.30, 1.61, 1.87 in aqueous (25 °C), aqueous (35 °C), aqueous-methanolic (10% v/v) and aqueous-methanolic (50% v/v) media respectively. Between pH 3.0–12.0, zinc–LHP complex has been observed to be reduced irreversibly at DME. Detailed investigations have been reported on the system at 25±1 °C and 35±1 °C at pH 10.0 in varying concentrations of the ligand. Kinetic parameters—the formal rate constant Kf,h° and transfer coefficient α have been calculated.


Graded exercise stress tests performed on 650 consecutive patients with proven or suspected coronary disease undergoing evaluation by cardiac catheterization were correlated with clinical, hemodynamic, and angiographic findings. Among 451 patients with significant coronary stenosis, 332 (74%) had interpretable stress tests and 65% of these were positive (sensitivity). The rate of "false positives' was 8%.The clinical syndrome of typical angina identified significant coronary disease in 89% of the patients, and 58% of that group had a positive exercise test defined by objective electrocardiographic criteria.Patients were not eliminated from this study because of recent digitalis ingestion. Although a higher frequency of uninterpretable exercise tests was found in this group (40%), the test results reflected more severe coronary disease. None of the patients with "false positive' tests were taking digitalis. It is concluded that recent digitalis ingestion should not be considered a contraindication for exercise stress testing.Among the patients with interpretable exercise tests, the angiographic severity of coronary artery disease correlates strongly with the frequency of positive tests (40%, 66%, and 76%, with 70% or greater occlusion of one, two or three vessels respectively). Left main coronary stenosis of 70% or greater was associated with more severe ST segment changes, inability to achieve target heart rate during stress, and a lower maximum heart rate during exercise. The angiographic occurrence of collateral vessels was related to the extent of coronary disease and was associated with a higher percentage of positive exercise tests; no protective effect of collateral circulation could be demonstrated. Patients with abnormal resting hemodynamics or left ventricular asynergy had no significant difference in the frequency of positive tests after adjustment for the angiographic severity of disease.


As the population increases, the number of motorized vehicles on the roads also increases. As the number of vehicles increases, traffic congestion occurs. Traffic lights are used at road junctions, intersections, pedestrian crossings, and other places where traffic needs to be controlled to avoid traffic chaos. Due to traffic lights installed in the city, queues of vehicles are formed on the streets for most of the day, and many problems arise because of this. One of the most important problems is that emergency vehicles, such as ambulances, fire engines, police cars, etc., cannot arrive on time despite traffic priorities. Emergency vehicles such as hospitals and police departments need to reach the scene in a very short time. Time loss is a problem that needs to be addressed, especially for emergency vehicles traveling in traffic. In this study, ambulances, fire brigades, police, etc., respond to emergencies. A solution and a related application have been developed so privileged vehicles can reach their target destination as soon as possible. In this study, a route is determined between the current location of an emergency vehicle and its target location in an emergency. Communication between traffic lights is provided with a mobile application developed specifically for the vehicle driver. In this process, the person controlling the lights can turn on the traffic lights during the passage of vehicles. After the vehicles with priority to pass passed, traffic signaling was normalized via the mobile application. This process was repeated until the vehicle reached its destination.


Almost every two-year college in the country offers a program for students who will continue their work at a four-year college. The problems of maintaining such a program are fairly straightforward: the two-year and four-year colleges must keep each other posted as to needs, changes, new ideas, etc., if an effective job is to be done. This section provides a place for reports and articles devoted to furthering the exchange of such information. In addition, it should provide some useful information to both two-and four-year institutions about the quality of students now entering post-secondary education.


Dilated cardiomyopathy (DCM) is a common cause of heart failure (HF) and is of familial origin in 20–40% of cases. Genetic testing by next-generation sequencing (NGS) has yielded a definite diagnosis in many cases; however, some remain elusive. In this study, we used a combination of NGS, human-induced pluripotent-stem-cell-derived cardiomyocytes (iPSC-CMs) and nanopore long-read sequencing to identify the causal variant in a multi-generational pedigree of DCM. A four-generation family with familial DCM was investigated. Next-generation sequencing (NGS) was performed on 22 family members. Skin biopsies from two affected family members were used to generate iPSCs, which were then differentiated into iPSC-CMs. Short-read RNA sequencing was used for the evaluation of the target gene expression, and long-read RNA nanopore sequencing was used to evaluate the relevance of the splice variants. The pedigree suggested a highly penetrant, autosomal dominant mode of inheritance. The phenotype of the family was suggestive of laminopathy, but previous genetic testing using both Sanger and panel sequencing only yielded conflicting evidence for LMNA p.R644C (rs142000963), which was not fully segregated. By re-sequencing four additional affected family members, further non-coding LMNA variants could be detected: rs149339264, rs199686967, rs201379016, and rs794728589. To explore the roles of these variants, iPSC-CMs were generated. RNA sequencing showed the LMNA expression levels to be significantly lower in the iPSC-CMs of the LMNA variant carriers. We demonstrated a dysregulated sarcomeric structure and altered calcium homeostasis in the iPSC-CMs of the LMNA variant carriers. Using targeted nanopore long-read sequencing, we revealed the biological significance of the variant c.356+1G>A, which generates a novel 5′ splice site in exon 1 of the cardiac isomer of LMNA, causing a nonsense mRNA product with almost complete RNA decay and haploinsufficiency. Using novel molecular analysis and nanopore technology, we demonstrated the pathogenesis of the rs794728589 (c.356+1G>A) splice variant in LMNA. This study highlights the importance of precise diagnostics in the clinical management and workup of cardiomyopathies.


PurposeUltrafast pulse wave velocity (UFPWV) is an innovative and practical technology that can assess the elastic function of blood vessels. This study aimed to explore the elastic function of the carotid artery using UFPWV and related influential factors in patients with rheumatoid arthritis (RA).MethodsOverall, 120 patients with RA and 60 healthy controls were evaluated. Subjects underwent UFPWV and carotid artery intima-media thickness (cIMT) examination. The patients were divided into a mild activity group (group A) and moderate-to-severe activity group (group B). Differences in clinical indicators among the groups were determined, and the correlation between each indicator and PWV value was analyzed.ResultsThe PWV values were higher in group B than in group A and were higher in group A than in the control group (P < 0.05). The BS and ES n the patient group were positively correlated with age, course of disease, systolic blood pressure (SBP), diastolic blood pressure, body mass index, total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), cIMT, rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) antibody, erythrocyte sedimentation rate, C-reactive protein, and platelets and were negatively correlated with 25-hydroxyvitamin D3 (25[OH]D3) and hemoglobin (P < 0.05). RF, anti-CCP antibody, age, course of disease, SBP, LDL-C, and platelets were risk factors for arteriosclerosis, whereas hemoglobin and 25(OH)D3 were protective factors (P < 0.05).ConclusionUFPWV allows for early and accurate detection of changes in arterial elasticity and enables early intervention to reduce the incidence of cardiovascular events in patients with RA.


Introduction: Health research training is an important component of the medical curriculum. This study was conducted to compare the approach of medical students being taught through an integrated modular curriculum with the students receiving conventional mode of education towards health research.
Materials and Methods: A cross-sectional study was conducted between 3rd-year MBBS students following Lecture Based Learning and Problem Based Learning (groups A and B respectively). A self-designed pretested questionnaire was filled by 153 students of each group (from group A in 2019 and group B in 2020) through a simple randomized sampling technique. Analysis was done using SPSS 21. P-value <0.05 was considered to be significant for all purposes.
Results: Mean knowledge score of PBL students was 50% against a score of 55.5% of LBL students (p-value=0.114). However, the mean attitude score of PBL students was 79.2% against a score of 67.4% of LBL students (p-value< 0.000). Over 49.6% of LBL students and 41.8% of PBL students had satisfactory knowledge. 19.7% of LBL students and 82.3% of PBL students had a satisfactory attitude.
Conclusion: Significantly higher attitude of PBL students was found. However, the level of knowledge was found to be the same in both groups. PBL curriculum has a positive influence on students on their attitudes towards health research.


Facial recognition technology has been used in many fields such as security, biometric identification, robotics, video surveillance, health, and commerce due to its ease of implementation and minimal data processing time. However, this technology is influenced by the presence of variations such as pose, lighting, or occlusion. In this paper, we propose a new approach to improve the accuracy rate of face recognition in the presence of variation or occlusion, by combining feature extraction with a histogram of oriented gradient (HOG), scale invariant feature transform (SIFT), Gabor, and the Canny contour detector techniques, as well as a convolutional neural network (CNN) architecture, tested with several combinations of the activation function used (Softmax and Segmoïd) and the optimization algorithm used during training (adam, Adamax, RMSprop, and stochastic gradient descent (SGD)). For this, a preprocessing was performed on two databases of our database of faces (ORL) and Sheffield faces used, then we perform a feature extraction operation with the mentioned techniques and then pass them to our used CNN architecture. The results of our simulations show a high performance of the SIFT+CNN combination, in the case of the presence of variations with an accuracy rate up to 100%.


The aim of this systematic review and pooled analysis is to determine the effect of enhanced recovery programs (ERP) on clinical outcome measures following esophagectomy. Medline, Embase, trial registries, conference proceedings, and reference lists were searched for trials comparing clinical outcome from esophagectomy followed by a conventional pathway with esophagectomy followed by an ERP. Primary outcomes were the incidence of postoperative mortality, anastomotic leak and pulmonary complications, and secondary outcomes were length of hospital stay and the incidence of 30-day readmission. Nine studies were included comprising 1240 patients, 661 patients underwent esophagectomy followed conventional pathway, and 579 patients underwent ERP. Utilization of ERP was associated with a reduction in the incidence of anastomotic leak (12.2-8.3%; pooled odds ratios = 0.61; 95% confidence interval = 0.39 to 0.96; P = 0.03) and pulmonary complications (29.1-19.6%; pooled odds ratios = 0.52; 95% confidence interval = 0.36 to 0.77; P = 0.001) and length of hospital stay, and no significant change in postoperative mortality or readmission rate. There was significant variation in the design of enhanced recovery protocols, surgical approach, and utilization of neoadjuvant therapies between the studies that are important confounding variables to be considered. This study suggests a benefit to the utilization of ERP following esophagectomy. The pathways provide a template for all medical personnel interacting with these patients in order to provide incremental changes in all aspects of clinical care that translates into global improvements seen in postoperative outcomes.


After the Vietnam war died down, we noticed more and more that we were treating large numbers of injuries associated with motorcycle accidents. We decided to take one year and see what the impact would be on our military manpower. All the cases were collected for 1972 and the figures are only concerned with 1972 as far as hospital days and days lost from full duty. In the Armed Forces in 1971 there were 184 killed and 2,000+ sustained disabling injuries. In the United States Navy in 1971 there were 54 killed with 551 disabling injuries. In 1972 there were 71 killed with 733 disabling injuries. Ten percent of the Navy military personnel are motorcyclists and they accounted for 20.7 percent of privately-owned vehicle accidents. In Hawaii in 1972 there were 4 deaths from motorcycle accidents--3 civilians and 1 Navy. The motorcycle helmet has saved these patients for us and now we have a bumper crop of orthopedic patients. The helmet law was enacted in Hawaii in 1967 and implemented throughout 1968. Deaths from motorcycles in Hawaii in 1965 were 13, 1966 20, 1967 8, 1968 8, 1969 5, 1970 6 and 1971 there were 6 and 1972 there were the four that I have already mentioned. The registration of motorcycles went down during the same period that the deaths went down because at the time the helment law was enacted, a law was enacted requiring a special license for motorcyclists. Registraions in 1965 were 12,016; 1967 10,558; 1969 8,579 and in 1972 10,321. We have not reached the registration mark of 1965 but we are gaining on it rapidly. Disabling injuries decreased along with the registrations but not at the same rate and are now arising rapidly. In 2965 there were 460 non-fatal injuries, 1966 583, 1969 it dropped down to 305 and in 1971 it went back up to 387. The data for 1972 is not available. We do know, however, that within the United States the number of motorcycles registered increased 449 percent from 1960 to 1971. To get down to our study here, the Orthopedic Service at Tripler in 1972 had 45 Navy patients accounting for 3,445 hospitals days and 2,241 light duty days. There were 19 Marine patients, 986 hospital days, 1228 light duty days and the Air Force only had 8 patients with 501 hospital days, 463 light duty days. This was a grand total of 93 patients with 5,740 hospital days and 4,484 days of light duty which accounted for 11,224 mandays lost from full duty. The average hospital days per patient was 58, the average light duty days per patient 59. Four patients were medically retired, four patients received permanent profiles. These men accounted for 139 fractures, 10 major dislocations, 19 major abrasions, 15 major lacerations, 1 man lost his leg and 1 man was rendered quadriplegic. There were 80 lower extremity fractures of which the tibia was the leader with 27. There were 20 metatarsals and 12 femurs. Forty-two percent of these accidents involved another vehicle, that is a car or truck. This is compared with 58 percent in Kentucky and 82 percent in Illinois. One of the major problems with motorcycles is that they seemed to be fair game for anyone with an automobile or truck. One of our men was even hit by a police car and although he is back to duty, he is very limited in what he can do because of his severe foot injury.


BACKGROUND/AIM
This report aims to present a rare case of ovarian carcinosarcoma and its current, optimal diagnosis and therapy strategy.

DESCRIPTION OF CASE
We report the case of a 70-year-old patient, who presented at the Obstetrics and Gynecology Department of the University Hospital of Mainz, with a short history of increased abdominal circumference.

CONCLUSION
The symptoms, diagnosis, and therapy of carcinosarcoma follow the pattern of a high grade epithelial ovarian cancer, fallopian cancer and primary peritoneal cancer. The rarity of this disease is a barrier to conducting prospective trials and establishing guidelines for high-quality evidence data. Hippokratia 2015; 19 (3): 256-259.


Graphs of bounded degeneracy are known to contain induced paths of order $\Omega(\log \log n)$ when they contain a path of order $n$, as proved by Ne\v{s}et\v{r}il and Ossona de Mendez (2012). In 2016 Esperet, Lemoine, and Maffray conjectured that this bound could be improved to $\Omega((\log n)^c)$ for some constant $c>0$ depending on the degeneracy. We disprove this conjecture by constructing, for arbitrarily large values of $n$, a graph that is 2-degenerate, has a path of order $n$, and where all induced paths have order $O((\log \log n)^2)$. We also show that the graphs we construct have linearly bounded coloring numbers.


Low-frequency nonlinear electrodynamic properties of inhomogeneous magnetoactive plasmas are considered. Using the self-consistent field approximation, the nonlinear material relation between the polarization and the electric field strength in an inhomogeneous magnetoactive plasma is derived. In the case of a weak inhomogeneity of the plasma, the explicit expressions are derived for the linear susceptibility and the nonlinear susceptibilities for quasi-flute plasma motions with the thermal corrections taken into account. The nonlinear interaction of low-frequency oscillations in the inhomogeneous magnetized plasma results in a double cascade of waves in the wave-vector space (i.e., the decay, larger and smaller wave-vector magnitude as compared to that of the pump wave-vector). It is shown this property to be universal as a result of general energy and momentum conservation laws for the nonlinear interaction of waves in the weakly inhomogeneous plasma when the wave phase velocity is anisotropic. The conservation of the energy and the momentum under the nonlinear interaction is related to the symmetry properties of the nonlinear electric susceptibility. The double cascade usually is accompanied with the emergence of the structures in the plasma, strongly elongated in the direction perpendicular to the direction of the plasma inhomogeneity, and the formation of zonal particle flows in the same direction. Therefore the double cascade of waves may be considered as a self-organization process in the plasma. The low-frequency-fluctuation spectra are assumed to be formed under the nonlinear wave-wave interaction and the constant fluxes of nonlinear-interaction integrals corresponding to these spectra. A small-parameter expansion enables one to deduce a wave kinetic equation by regular means and to calculate the fluctuation for weakly turbulent plasma states on the bases of this equation. The stationary wave-intensity distribution are found for the plasma states with zero and non-zero fluxes of nonlinear-interaction integrals over the spectrum. There are considered: long-wave and short-wave convective oscillations, low-frequency drift waves, and electron convective waves. The nonlinear plasma motion in crossed magnetic and gravity fields is investigated. It is shown the phenomenon of a double interchange-wave cascade and the weak-interchange-turbulence spectra is determined. Finally, the nonlinear interaction of the magnetic electron waves is considered which accompanies with the nonlinear electron waves is of large-scale magnetic fields in plasma.


A case of dissecting aneurysm of the vertebro-basilar artery diagnosed angiographically and histologically is reported. A 31-year-old female suddenly developed severe headache and vomiting. On admission, 9 hours later, the patient was somnolent, and signs of diffuse brain stem lesion were manifest. Cerebrospinal fluid, craniogram, and computerised tomography scan showed no abnormal findings. Left vertebral angiography showed intimal separation of the basilar artery as a "double lumen" on lateral projec tion. The patient was given conservative treatment, but died 12 days later of brain stem hemor rhage. Pathological examination showed that the dissection occurred twice: the first subintimal dissection started at the left vertebral artery 15 mm proximal to the vertebral union, and extended to the proximal portion of the left anterior inferior cerebellar artery; the second dissection occurred in the basilar artery and caused the brain stem hemorrhage. The prognosis for dissecting aneurysm of the vertebro-basilar system, especially involving the basilar artery, is very poor, and the authors think that surgical procedure, such as ligation, trapp ing, or anastomosis, in the early stage, based on a correct angiographical diagnosis, is most beneficial.


In recent years increasing attention has been paid to the problems faced by older workers in the UK labour market. In this paper we examine the issue of older workers' participation in vocational training and education, drawing upon data from the Labour Force Survey. Our initial analysis identifies how rates of participation in workrelated education and training differ between age groups. Further exploratory analysis attempts to identify possible reasons for this, analysing the type of training undertaken by various age groups as well as the incidence of self-financed training. We then estimate an ordered-probit model for males and females separately, in an attempt to isolate the extent to which this lower incidence among older workers is due to employer or employee decision making. We find that, when compared to a reference group of prime aged individuals, those aged between 40 and 49 and 50 and 59/64 are less likely to undergo training and, also, less likely to be offered training. We conclude that the lower incidence of training among older workers can be mainly attributed to employer decision making. Finally, we discuss the implications of these findings for public policy.


Although anecdotal evidence and research alike espouse the benefits of service learning, some researchers have suggested that more rigorous testing is required in order to determine its true effect on students. This is particularly true in the case of academic development, which has been inconsistently linked to service learning. It has been proposed that this discrepancy is due to three complications: grades not reflecting higher order thinking skills, self-selection bias, and different grading methods. The study described in this article attempted to circumvent these complications using a test–retest methodology and measuring academic development in three ways: course grades, an assignment that directly tested course-specific comprehension, and self-reported improvement. In addition, improvements in civic responsibility, interpersonal skills, and practical skills were measured via self-report. Although students who participated in service learning self-reported greater improvement in civic responsibility, interpersonal skills, and academic development, they only demonstrated more academic development in terms of concrete course concepts, showing no differences in final examination marks or generation of detailed examples. These findings suggest that academic improvement through service learning may not be adequately assessed by typical methods used to evaluate academic development at universities.


: The Japanese Pharmaceutical Affairs Law distinguishes cosmetics from quasi-drugs, and specifies that they must have a mild effect on the human body and must be safe to use over the long term. Therefore, the safety of cosmetics needs to be thoroughly evaluated and confirmed, taking into account the type of cosmetic, application method, conditions of use and so on. Post-marketing surveys of customers' complaints and case reports of adverse effects are important to monitor and confirm the safety of products. Although manufacturing and marketing of cosmetics are becoming more globalized, the regulations relevant to cosmetics safety still vary from country to country. Thus, compliance with different regulations in various markets is a major issue for producers. In particular, further development of alternatives to animal testing remains an urgent global issue.


Let M be an invariant subspace of the Bergman space L 2 a (D) and S M be the compression of the coordinate multiplication operator M z to the co-invariant subspace L 2 a (D) ⊖ M. The present paper determines when the identity representation of C* (S M ) is a boundary representation for the Banach subalgebra B(S M ). The paper also considers boundary representations on the co-invariant subspaces of L 2 a (B n ).


During fetal development, androgens exert long-term effects which are either organizational on specific organs during a critical phase of morphogenesis (e.g. sexual differentiation of external genitalia), or programming neural functions or enzyme activities expressed later in life. At all stages of development, which extends from fetal and neonatal stages to pubertal accomplishment, androgens also have activational effects that are immediate, multiple, reversible and dose dependent. Both types of actions are intricate during human development. This review will focus (1) on the intricate morphological and activational roles of androgens on sexual differentiation and pubertal development of the genital tract, external genitalia and mammary glands, and (2) on the organizational effects of androgens on four central nervous system functions: pituitary regulation of liver metabolism, gonadotropin secretions, sex dimorphic behavioral patterns, and 'sexualization of the brain'. If the molecular basis of the immediate androgenic action is known, depending of androgen receptor's availability and affinity, little is known of the way androgens exert their influence on either so various morphological processes or neuroendocrine imprinting.


The manner and exact timing of the evolution of the widely used DWDM infrastructure to a transparent optical network is judged on economic circumstances and network performance. In this context this article elaborates on a methodology developed within the Project 1ST NOBEL, for integrating cost functions and other design constraints into the planning of a DWDM network while considering this evolution perspective to a transparent optical network. This systematic approach builds upon the experience of static network design and is substantiated by specific examples in this article


Background: All states have enacted legislation addressing the management of sports-related concussions (SRCs) in adolescent athletes. The effect of these laws on health care utilization is uncertain. Hypothesis/Purpose: The purpose was to evaluate the effects of New York's 2011 Concussion Management and Awareness Act ("Lystedt Law") on emergency department (ED) concussion health care visits (EDCHVs) and brain imaging utilization. It was hypothesized that New York concussion legislation would have a significant temporal effect on EDCHVs. Study Design: Descriptive epidemiology study. Methods: Using the New York State Department of Health Statewide Planning and Research Cooperative System (SPARCS) database, trends in EDCHVs from 2005 to 2015 were identified among 12- to 18-year-old patients, comprising 5,740,403 total ED visits. Results: Overall, 208,024 EDCHVs, including 54,669 for an SRC, occurred during the study period. EDCHVs increased from 13,664 (2.74% of all ED visits) in 2005 to a peak of 21,374 (4.26%) in 2013, with greatest relative increases from 2008 to 2013. SRCs followed a similar trend: 3213 (0.64%) in 2005 to a peak of 6197 (1.24%) in 2013. Brain imaging utilization decreased by 5.3% for EDCHVs and 15.4% for SRCs (all comparisons year-by-year and for trends; P < .001). Conclusion: The period of greatest increases in EDCHVs and decreases in brain imaging utilization for SRCs preceded New York concussion legislation by several years, suggesting a minimal direct effect on emergency care–seeking behavior for concussions. Instead, increased public awareness of SRCs and imaging guidelines may have driven EDCHV trends and imaging practices.


Objective To investigate the effect of minimally invasive video-assisted thoracic surgery on lung bullae with spontaneous pneumothorax.Methods Patients with lung bullae with spontaneous pneumothorax were treated with video-assisted thoracoscopic surgery(VATS).Results The cure rate was 100%.Conclusions There were radical effect,the low rate of relapse,small incision,less pain,shorter hospital stay and quicker recovery to treat ung bullae with spontaneous pneumothorax with video-assisted thoracic surgery(VATS).


With the increase in the demand for sustainable and environmentally-friendly development, Green Building Certification System came into force in 2002, Evaluation parts of Green Building Certification System are divided into land use and transportation, energy, ecological environment, and indoor environment. Alloted point for the part of energy is larger than other part, thus we can say that this part is very important to increase the green building performance. This study aims to analyze the present condition of design and construction for the part of energy in the certificated green school building. Total 40 certificated school buildings were selected and average scoring rate of each item was evaluated. Key particular to be considered were suggested to improve the item of energy consumption.


Targeted therapies utilizing monoclonal antibodies for malignant tumors has been increasingly developed and applied to clinical practice. Trastuzumab (Tmab) is a humanized monoclonal antibody which binds to the human epidermal growth receptor 2 (HER2), which leads to strong antitumor effects by inducing antibody-dependent cell-mediated cytotoxicity (ADCC) and inhibiting HER2 signaling pathway. While Tmab is clinically applied to HER2-positive breast and gastric cancers, there still remain some issues such as low HER2 expression (only 20%) and resistance to Tmab. Recent progress in nanotechnology has brought significant benefits to medical fields. Gold nanoparticles (AuNPs), marked by the in vivo stability and easy surface functionalization, have been developed as therapeutic and contrast agents in the medical field, and some AuNPs reportedly show some cytotoxicity by inducing autophagy and apoptosis, which indicates that AuNPs could be attractive therapeutic agents in combination with tumor-targeting antibodies. In this study, we created Tmab-conjugated AuNPs and evaluated the antitumor effects on HER2-positive but Tmab-resistant gastric cancer cells (MKN7) and HER2-negative gastric cancer cells (MKN74) in addition to HER2-positive and Tmab-sensitive esophagogastric cancer cells (NCI-N87, TE4, OE19) in vitro and in vivo. IC50 dose of Tmab-AuNPs was 6.5 times smaller than free Tmab on NCI-N87 cells. Tmab-AuNPs exhibited stronger antitumor effects on MKN7, NCI-N87, TE4 and OE19, HER2-positive cells, than the other controls on XTT assay, but not such strong effects on MKN74 and NHLF, HER2-negative cells. Notably, Tmab-AuNPs showed potent antitumor effects even on MKN7, HER2-positive but Tmab-resistant cells. Moreover, once HER2 was overexpressed on MKN74 cells by Ad-HER2/ECD, Tmab-AuNPs became effective on artificially-HER2-overexpressed MKN74 cells. More effective intracellular uptake of Tmab-AuNPs was observed by dark field microscopy and transmission electron microscopy on HER2-positive cells, which seemed to cause stronger induction of oxidative stress, autophagy and apoptosis. Finally, stronger antitumor effects of Tmab-AuNPs were also confirmed in mouse subcutaneous xenograft models using HER2-positive cells. In conclusion, Tmab-AuNPs demonstrated potent antitumor effects on Tmab-resistant cells as well as Tmab-sensitive cells, and if combined with HER2/ECD overexpression, Tmab-AuNPs became effective even on HER2-negative cells. These findings suggest that Tmab-AuNPs could be promising HER2-targeted nanodrugs which were able to overcome shortcomings in Tmab-based therapy. Citation Format: Tetsushi Kubota, Shinji Kuroda, Toshiaki Morihiro, Hiroshi Tazawa, Shunsuke Kagawa, Toshiyoshi Fujiwara. Novel HER2-targeted gold nanoparticles; integration of antibody therapy and nanotechnology. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 4747.


The open reading frames of 17 connexins from Syrian hamster (using tissues) and 16 connexins from the Chinese hamster cell line V79, were fully (Cx30, Cx31, Cx37, Cx43 and Cx45) or partially sequenced. We have also detected, and partially sequenced, seven rat connexins that previously were unavailable. The expression of connexin genes was examined in some hamster organs and cultured hamster cells, and compared with wild-type mouse and the cancer-prone Min mouse. Although the expression patterns were similar for most organs and connexins in hamster and mouse, there were also some prominent differences (Cx29 and 30.3 in testis; Cx31.1 and 32 in eye; Cx46 in brain, kidney and testis; Cx47 in kidney). This suggests that some connexins have species-specific expression profiles. In contrast, there were minimal differences in expression profiles between wild type and Min mice. Species-specific expression profiles should be considered in attempts to make animal models of human connexin-associated diseases.


Many studies have demonstrated the importance of the knowledge that interrelates features in people's mental representation of categories and that makes our conception of categories coherent. This article focuses on abstract coherent categories, coherent categories that are also abstract because they are defined by relations independently of any features. Four experiments demonstrate that abstract coherent categories are learned more easily than control categories with identical features and statistical structure, and also that participants induced an abstract representation of the category by granting category membership to exemplars with completely novel features. The authors argue that the human conceptual system is heavily populated with abstract coherent concepts, including conceptions of social groups, societal institutions, legal, political, and military scenarios, and many superordinate categories, such as classes of natural kinds.


Failure mode and effects analysis (FMEA) has been extensively used by wind turbine assembly manufacturers for analyzing, evaluating and prioritizing potential/known failure modes. However, several limitations are associated with its practical implementation in wind farms. First, the Risk-Priority-Number (RPN) of a wind turbine system is not informative enough for wind farm managers from the perspective of criticality; second, there are variety of wind turbines with different structures and hence, it is not correct to compare the RPN values of different wind turbines with each other for prioritization purposes; and lastly, some important economical aspects such as power production losses, and the costs of logistics and transportation are not taken into account in the RPN value. In order to overcome these drawbacks, we develop a mathematical tool for risk and failure mode analysis of wind turbine systems (both onshore and offshore) by integrating the aspects of traditional FMEA and some economic considerations. Then, a quantitative comparative study is carried out using the traditional and the proposed FMEA methodologies on two same type of onshore and offshore wind turbine systems. The results show that the both systems face many of the same risks, however there are some main differences worth considering.


In contemporary knowledge society, the impact of library and information professions has expanded to practical workforce preparation in many adjacent fields, including social work, that heavily rely on information competencies to promote community well-being and public good.This poster adds a practitioner perspective to the ongoing conversation about the need to reimagine LIS education to better align curricular priorities with the demands of the increasingly interconnected information landscape. Through a tale of a subject librarian and Social Work faculty partnership to develop a tailored credit-bearing information literacy course for Social Work pre-majors, the author illuminates the evolving role of librarians who are called upon to educate members of other information-intensive professions in the use of general and subject-specific resources essential for their field. The poster highlights the shared values that inform the practice of both librarianship and social work in response to the issues faced by communities in times of uncertainty and change. Built around the ALA's Core Competences of Librarianship and the Social Work Competencies established by the Council on Social Work Education, the project reflects on the challenges and opportunities associated with integrating information literacy education into a domain where advanced information literacy skills are an indispensable component of the current professional practice. Finally, the project discusses several implications for LIS programs keen on creating a better connection between the LIS foundational values and other professional competency frameworks today's librarians lean on, particularly in such vital areas as user services, lifelong learning and continuing education, and social justice.


We measure the effects of debt dilution on sovereign default risk and study debt covenants that could mitigate these effects. We calibrate a baseline model with endogenous debt duration and default risk (in which debt can be diluted) using data from Spain. We find that debt dilution accounts for 78 percent of the default risk in the baseline economy and that eliminating dilution increases the optimal duration of sovereign debt by almost 2 years. Eliminating dilution also increases consumption volatility but still produces welfare gains. The debt covenants we study could help enforcing fiscal rules.


| In the present communication, an unprecedented and fatal case of Buffo melanostictus intoxication in a German Shepherd dog, presented to Veterinary Medical Teaching Hospital, University of Agriculture Faisalabad Pakistan, for the treatment of profuse salivation, prostration, excessive vocalization, vomiting, hemorrhagic diarrhea and haematuria after accidently chewing a toad (Buffo melanostictus) is put on the record. The clinical examination revealed normal rectal temperature, tachypnea, arrhythmic tachycardia, deep red mucous membranes, elevated capillary refill time and severe neurological signs. Hematological analysis indicated decreased level of hemoglobin, packed cell volume, total red blood cells, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration along with leukocytosis, lymphopenia, neutrophilia, eosinophilia and monocytosis. The significant findings of biochemical panel were including, increased level of blood urea nitrogen, creatinine, liver enzymes, total proteinsand serum potassium. A symptomatic treatment regime was adopted but the patient died on 2nd day post treatment. Diagnosis of toad poisoning was arrived on the basis of pathognomonic clinical signs, hemato-biochemical findings, nevertheless the identification of chewed toad further supported the diagnosis. Additionally, treatment regime, management and known factors influencing toad poisoning along with prognosis are also reviewed.


Summary

Visual and vocal displays of Brown-capped Rosy Finches Leucosticte tephrocotis australis, observed in Rocky Mountain National Park, Colorado, and of Aleutian Grey-crowned Rosy Finches L. t. griseonucha on Adak Island, Alaska, are compared and contrasted with general behaviour among the Fringillidae.

Visual display behaviour of the two subspecies is very similar. Vocal displays, as shown by sonagrams, are by comparison divergent. Most of the sound energy in the flock call of griseonucha is concentrated in a single band of frequencies. The range of these frequencies is small, and the call is whistle-like to the human ear. The flock call of australis, more like that of other finch species, consists of three major bands of frequencies. Based on this difference, it is hypothesized that the flock call of griseonucha may be specialized for penetration of high background noise, which characterizes the windy environment of the Aleutians. In ambient noise that extends across the frequency range of the flock calls, the narrow-range flock call of griseonucha is relatively high in signal/noise ratio. Some divergence in vocal display may also result from social mimicry in the respective habitats. The flight call of australis is click-like, and more like the flight call of the 8ympatric Violet-green Swallow Tachycineta thallasinea than that of griseonucha or of descriptions of the flight call of other finches.

The two races differ also in general breeding habits. The breeding season, from first sexual chasing to fledging of young, in griseonucha spans nearly seven months; the study population was sedentary. In australis, individuals migrate in summer to alpine breeding grounds, and the events of breeding occur within about two months. Males were observed to feed their mates during the nesting period, in both races. Male and female fed the young and removed excreta from the nest, with about equal frequency.

Both australis and griseonucha have marked excesses of males in the mature populations, but both are monogamous. It is considered that the unbalanced sex ratio may have selective effects on the behaviour associated with reproductive activity.


Dividend policy is related to a matter of earning allocation, namely how much of the earning are distributed as dividends and how much of the earning are distributed as retained earnings. Earning matters sometimes result in different desires between management and shareholders, thusly the differences will result in conflicts between both of them and the conflicts will lead to agency cost. The research aimed at analyzing effects of insider ownership and free cash flows on dividen policy partial. The applied data were secondary ones obtained from Jakarta Stock Exchange. Analysis technique applied analysis of multiple linear regression. Research results indicated that insider ownership had no effects on dividend policy, where as free cash flow have effects on dividend policy. Keywords : Dividend Policy, Insider Ownership, Free Cash Flow


The present study was designed to provide information on the relationship between self-reports of health and physicians' ratings in an aged sample, and to determine how both of these measures of health relate to longevity. Subjects were 69 survivors (median age = 84.25 years) of a sample of aged twins who had been followed longitudinally since 1947 to 1949. Self-reports of health were found to be significantly correlated with ratings assigned by a physician on the basis of medical records. Both types of measures were predictive of differences in survival time among the younger subjects in the sample, but neither was significantly related to longevity for older subjects. The results suggest that self-reports could provide a valid, cost-effective means of health assessment in studies in which other forms of health information are lacking.


The well known multiple letter encryption cipher is the Playfair cipher. Here the diagrams in the plaintext are treated as single units and converted into corresponding cipher text diagrams. However because of the drawbacks inherent in the 5*5 Playfair cipher which adversely affects the security we proposed an 8*8 Playfair cipher. For details one can refer to [1]. This paper analyses the new proposed system. For this we have carried out cryptanalysis and through the avalanche effect we find out that the proposed cipher is a strong one.


Unmanned Aerial Vehicles (UAVs) and communication systems are fundamental elements in mission critical services, such as search and rescue. In this article, we introduce an architecture for managing and orchestrating 5G and beyond networks that operate over a heterogeneous infrastructure with UAVs' aid. UAVs are used for collecting and processing data, as well as improving communications. The proposed System Intelligence (SI) architecture was designed to comply with recent standardization works, especially the ETSI Experiential Networked Intelligence specifications. Another contribution of this article is an evaluation using a testbed based on a virtualized non-standalone 5G core and a 4G Radio Access Network (RAN) implemented with open-source software. The experimental results indicate, for instance, that SI can substantially improve the latency of UAV-based services by splitting deep neural networks between UAVs and edge or cloud equipment. Other experiments explore the slicing of RAN resources and efficient placement of virtual network functions to assess the benefits of incorporating intelligence in UAV-based mission critical services.


Foreword ( Clark Spencer Larsen). List of Contributors. 1. Introduction: Changing Paradigms in Our Understanding of the Transition to Agriculture: Human Bioarchaeology, Behaviour and Adaption (Jay T. Stock and Ron Pinhasi). Section A: Subsistence Transitions. 2. Mesolithic-Neolithic Transitions: An Isotopic Tour through Europe (Rick Schulting). 3. The Mesolithic-Neolithic Transition in Eastern Europe: Integrating Stable Isotope Studies of Diet with Palaeopathology to Identify Subsistence Strategies and Economy (Malcolm Lillie and Chelsea Budd). 4. Climatic Conditions, Hunting Activities and Husbandry Practices in the Course of the Neolithic Transition: The Story Told by Stable Isotope Analyses of Human and Animal Skeletal Remains (Gisela Grupe and Joris Peters). 5. Health, Diet and Social Implications in Neolithic Greece from the Study of Human Osteological Material (Anastasia Papathanasiou). 6. Using a Bioarchaeological Approach to Explore Subsistence Transitions in the Eastern Cape, South Africa during the Mid- to Late Holocene (Jaime K. Ginter). Section B: Growth and Body Size Variation. 7. Long Bone Length, Stature and Time in the European Late Pleistocene and Early Holocene (Christopher Mieklejohn and Jeff Babb). 8. Variability in Long Bone Growth Patterns and Limb Proportions Within and Amongst Mesolithic and Neolithic Populations from Southeast Europe (Ron Pinhasi, S. Stefanovic, Anastasia Papathanasiou and Jay T. Stock). 9. Reaching Great Heights: Changes in Indigenous Stature, Body Size and Body Shape with Agricultural Intensification in North America (Benjamin M. Auerbach). 10. Evolution of Postcranial Morphology during the Agricultural Transition in Prehistoric Japan (Daniel H. Temple). Section C: Biomechanics and Indicators of Habitual Activity. 11. The Bioarchaeology of Habitual Activity and Dietary Change in the Siberian Middle Holocene (A.R. Lieverse, Jay T. Stock, M.A. Katzenberg and C.M. Haverkort). 12. 'An External Agency of Considerable Importance': The Stresses of Agriculture in the Foraging-to-Farming Transition in Eastern North America (Clark Spencer Larsen and Christopher Ruff). 13. Mobility and Lower Limb Robusticity of a Pastoralist Neolithic Population from North-Western Italy (Damiano Marchi, Vitale Sparacello and Colin Shaw). 14. Body Size, Skeletal Biomechanics, Mobility and Habitual Activity from the Late Palaeolithic to the Mid-Dynastic Nile Valley (Jay T. Stock, Matthew C. O'Neill, Christopher B. Ruff, Melissa Zabecki, Laura Shackelford and Jerome C. Rose). Section D: Archaeogenetics, Palaeodemography, Cranial and Dental Morphology. 15. The Palaeopopulationgenetics of Humans, Cattle and Dairying in Neolithic Europe (Joachim Burger and Mark G. Thomas). 16. The Genetics of the Neolithic Transition: New Light on Differences Between Hunter-Gatherers and Farmers in Southern Sweden (Anna Linderholm). 17. Palaeodemography of Southern Levantine Pre-Pottery Neolithic Populations: Regional and Temporal Perspectives (Vered Eshed and Ehud Galili). 18. Skeletal Differentiation at the Southernmost Frontier of Andean Agriculture (Marina L. Sardi and Marien Beguelin). 19. Dental Reduction and the Transition to Agriculture in Europe (Ron Pinhasi and Christopher Meiklejohn). Index.


A study has been carried out to determine the value of some standard biochemical tests in the emergency management of 209 acute medical admissions. Of the 678 emergency tests done, only 17.5 per cent showed abnormal results and of these only 12 per cent were helpful in diagnosis although 66 per cent were of value in treating the patients. The tests were most helpful in treating diabetic patients where the blood-glucose level decided insulin dosage in every patient; the pO2 and pCO2 levels were of value in acute on chronic obstructive airways disease; and the serum electrolytes were helpful in managing dehydration due to vomiting and diarrhoea. The possible reasons for the large number of useless tests carried out in diagnosis of these emergency admissions are discussed, and it is suggested that the most important way of avoiding unnecessary tests is better doctor training both before and after qualification. The place of immediacy of tests in the medical out-patient department is also considered. It is concluded that immediacy is of little value in diagnosing and treating out-patients, but would be helpful in reducing unnecessary return visits.


Sustainability or sustainable development as an objective or as a definitions is wirely used since the 1992 Rio Conference on Sustainable Development. There are many attempts to clarify the content of it, most of them covering inter- and intragenerational equity, integration, the different means and methods of long-term thinking. While it is still a controversial question, it is also difficult or even harder to specify the legal content of such a policy matter. The law of sustainable development shall be able to meet the challanges of clarity, enforceability, thus one should try to be more specific then it is acceptabel in the wider the political context. Several international documents, conventions, even EU legislation wants to come closer to the problem. If we wish to translate the content into the legal language, then there are some elements of such a legal system, which we would like to underline: inter-generational equity and right to environment, public participation, cooperation, integration, precaution and subsidiarity. There is also a newly emerging element of the legal understanding – imported from ecology –, which needs greater attention today, that is resilience.


The concept of neutrosophic set was introduced by Smarandache. Atlansov introduced the concept of neutrosophic topological spaces. The main aim of this paper is to introduce the notation πgα–closed sets in neutrosophic topological spaces. We investigate its properties and its relationships are derived. Further πgα-closed mappings are also defined and studied and its properties.


The time-course of rainfall is commonly presented as bar, line or scatter plots, which may sometimes be chaotic, while leading to subjective and vague assertions. More objective criteria quantifying rainfall distribution may therefore be helpful, e.g. when different years are examined concurrently. Here, some practical indices are presented based on the distance between cumulative rainfall curves and the respective theoretical evenness rainfall lines, the line joining the lowest and highest cumulative rainfall values within the considered period. After an introduction to the theory and calculation of the indices, the relationships between the indices and two major crops, maize and sugar beet, are evaluated for a period of 33 years. The results show good correlations between the indices and crop yields, up to r = 0.81, especially when the evenness index was weighted on the mean daily rainfall, i.e. the slope of the evenness line. Significant correlations were also found by recalculating the indices over strategic short-term periods for maize, which indicates how the effectiveness of these indices may be increased by choosing appropriate periods for different crops. Finally, the different indices showed no correlation, indicating little redundancy and thus suggesting a profitable conjoint use of them.


This paper provides a first assessment of the degree to which public research contributes to innovative entrepreneurship, using data on start-ups and venture capital (VC). It looks at academic start-ups founded by recent undergraduates and doctorate students or researchers. It shows that academic start-ups represent 15% of all start-ups in the specific sample under scrutiny. Their share is higher in science-based technological fields such as biotechnology (23%). Across the majority of countries and technology fields, start-ups created by undergraduate students represent the highest share of all academic start-ups. As to their performance, start-ups founded by researchers are more likely to patent and those founded by students introduce innovations that are more radical compared to other start-ups. While start-ups founded by undergraduate students receive less VC funding and are less likely to exit via IPO or acquisition, those created by researchers are as successful as their non-academic counterparts.


Predictive molecular testing has become an important part of the diagnosis of any patient with lung cancer. Using reliable methods to ensure timely and accurate results is inevitable for guiding treatment decisions. In the past few years, parallel sequencing has been established for mutation testing, and its use is currently broadened for the detection of other genetic alterations, such as gene fusion and copy number variations. In addition, conventional methods such as immunohistochemistry and in situ hybridization are still being used, either for formalin‐fixed, paraffin‐embedded tissue or for cytological specimens. For the development and broad implementation of such complex technologies, interdisciplinary and regional networks are needed. The Network Genomic Medicine (NGM) has served as a model of centralized testing and decentralized treatment of patients and incorporates all German comprehensive cancer centers. Internal quality control, laboratory accreditation, and participation in external quality assessment is mandatory for the delivery of reliable results. Here, we provide a summary of current technologies used to identify patients who have lung cancer with gene fusions, briefly describe the structures of NGM and the national NGM (nNGM), and provide recommendations for quality assurance.


In a strictly theoretical and methodological perspective, the Columbia studies of personal influence—conducted in the 1940s and early 1950s—are today of largely historical interest as particularly self-conscious and sophisticated examples of social-scientific discovery. Yet, there are indications that these studies are once more coming to scholarly attention and their long eclipse, so symptomatic of discontinuity in social-scientific research, may be coming to an end (Scheingold, 1973). There is a growing interest in describing and explaining electoral and related patterns of behavior in terms of the "social networks" to which people belong. The contribution of the Columbia studies to research on the effect of social networks in voting behavior and public affairs seems therefore worthy of retrospection.


Oral dosage form is the physical form of a dose of a chemical compound used as a drug or medication intended for administration or consumption by the oral route. The poor dissolution rate of water insoluble drugs is still a substantial problem confronting the pharmaceutical industry. There are several methods used to increase the solubility of drugs, of those liquid-solid compact (LSC) technique is a new and promising addition towards such a novel aim, that the solubility of the insoluble drug moiety is increased by aid of non-volatile solvents and hence increasing the dissolution and bioavailability. LSC's when compared to all other standard methods used to improve the solubility, have more ability to enhance solubility. Liquisolid compacts were prepared by employing non-volatile solvents like- Polyethylene Glycol and Propylene Glycol, whereas microcrystalline cellulose (MCC) and Aerosil were used as carrier and coating materials, respectively. Disintegrants were used from 2% to 4% to ensure the immediate release of the drug and in turn achieve maximum peak plasma concentration. Magnesium Stearate acted as both glidant and lubricant added prior to compression of tablets. In-vitro drug release results showed that Liqui-solid compacts demonstrated significantly higher drug release rates in less time than those of conventionally made. This was due to an increase in wetting properties and surface of drug available for dissolution.


In this review, we have discussed the different statistical modeling and prediction techniques for various infectious diseases including the recent pandemic of COVID-19. The distribution fitting, time series modeling along with predictive monitoring approaches, and epidemiological modeling are illustrated. When the epidemiology data is sufficient to fit with the required sample size, the normal distribution in general or other theoretical distributions are fitted and the best-fitted distribution is chosen for the prediction of the spread of the disease. The infectious diseases develop over time and we have data on the single variable that is the number of infections that happened, therefore, time series models are fitted and the prediction is done based on the best-fitted model. Monitoring approaches may also be applied to time series models which could estimate the parameters more precisely. In epidemiological modeling, more biological parameters are incorporated in the models and the forecasting of the disease spread is carried out. We came up with, how to improve the existing modeling methods, the use of fuzzy variables, and detection of fraud in the available data. Ultimately, we have reviewed the results of recent statistical modeling efforts to predict the course of COVID-19 spread.


The paper had introduced researches on urban forest park and analyzed its particularity.In terms of elimination of externality during development and tourism consumption process of urban forest park,real estate agent had been introduced and two assumptions had been proposed to eliminate externality.As for elimination of externality during development of urban forest park,right to use planning land for urban forest park and surrounding land for real estate development would be sold to estate agent who would develop urban forest park and commodity house;the management of forest urban park would be undertaken by tourism development companies for which estate agent would make compensation.As for elimination of externality during tourism consumption process,it would control with policies and laws,or establish ticket system.As the study hadn't been conducted on policies about urban land and real estate,the feasibility of the first assumption needed to be further studied by environmental economists.


This paper presents the implementation of a predictive control scheme for an indirect matrix converter. The control scheme selects the switching state that minimizes the reactive power and the error in the output currents according to their reference values. This is accomplished by using a prediction horizon of one sample time and a very intuitive control law. Experimental results with a 6.8-kVA indirect matrix converter prototype are provided in order to validate the proposed control scheme. The converter uses standard digital signal processor operating at a sampling frequency of 20 mus. It is shown that the idea of controlling this converter topology with a predictive approach can be implemented simply and input currents with unity power factor and a total harmonic distortion lower than 5% can be obtained.


We are pleased towelcome you to the 3rd InternationalWorkshop on AI in Networks and Distributed Systems (WAIN). The workshop aims to present high-quality researches leveraging machine learning and data analysis solutions to take full advantage of network systems and infrastructures. In detail, this year WAIN presents innovations for data center scheduling and management and network monitoring and security, using, among the others, node embedding techniques, GNN and federated learning. This year, our technical program is rich and varied, with 1 keynote speech and 6 accepted papers thoroughly evaluated and selected by the 18 members of the Technical Program Committee. All papers received at least 3 reviews, and decisions were made after a vigorous online discussion. In an effort to increase the technical soundness of the contributions, we have increased the papers page limit to 5 pages plus references. For the second year, and hopefully the last one, the workshop is entirely virtual with live streaming presentations to encourage researchers to interact, share their experiences and ideas and discuss the open issues. We would like to thank both the Authors and the Technical Program Committee for their hard work and precious contribution for making WAIN a fruitful workshop.


Initial digital signal processing (DSP) work was aimed at separating deterministic signals from noise and comprised filter design and fast Fourier transform (FFT) based spectral analysis. More recently DSP applications have expanded to include the filtering of random signals in noise. This challenging area of research has united many diverse fields such as astronomy and medicine and has "blurred" the boundaries between signal processing, time series analysis, optimisation theory and topology (in the study of the underlying dynamics of chaotic processes). The focus here is the application of DSP to random (stochastic) signals and complex deterministic (chaotic) signals found in biomedical applications. Optimum processors for filtering these signals assume specific models for the signal and noise sources. If these models are correct then one can achieve guaranteed levels of performance with quantified estimation error statistics. Incorrect models can give misleading results. This is a brief overview of model based DSP illustrated with a heart rate estimation example. (4 pages)


The recent improvements in efficiencies for kesterite (copper zinc tin selenide, CZTS) devices warrant an investigation into how the kesterite device stack can best be capped to minimize losses due to reflection. Additionally, ongoing efforts to replace the cadmium sulfide (CdS) layer in copper indium gallium selenide (CIGS)-based devices, most notably with zinc sulfide (ZnS), need to be accompanied by a similar investigation into how to best finish a CIGS/ZnS stack to minimize reflection losses. An optical analysis of how CZTS/CdS and CIGS/ZnS devices reflect light has been performed for the purpose of optimizing the transparent conducting oxide and antireflection layers for each stack. This research addresses what is similar and what is different between the alternative stacks and the routine CIGS/CdS stack and how to best reduce the reflection losses for each situation.


This paper treats the average mass velocity of laminar free convection inside a heated or cooled vertical tube situated in a large space. A one-dimensional model is proposed by applying the Poiseuille flow and the Graetz solution for forced convection in a tube and by considering both the pressure losses at the tube inlet and exit and in the hydrodynamic developing region. The average mass velocity of air is measured by means of the deflection of a fine quartz fiber in a cross-flow. The agreement between the theory and experiment is very good for the cases where the tube is partly heated and partly adiabatic, where the tube is pertly heated and partly cooled, and with temperature stratification existing in the ambient fluid. At the same time, the effects of tube-to-ambient temperature difference, a reference temperature of the stratified ambient fluid, the tube length-to-diameter ratio and fluid's physical properties in the tube on the average mass velocity are clarified.


Abstract In this paper I defend Max Weber's concept of political legitimacy as a standard for the moral evaluation of states. On this view, a state is legitimate when its subjects regard it as having a valid claim to exercise power and authority. Weber's analysis of legitimacy is often assumed to be merely descriptive, but I argue that Weberian legitimacy has moral significance because it indicates that political stability has been secured on the basis of civic alignment. Stability on this basis enables all the goods of peaceful cooperation with minimal state violence and intimidation, thereby guarding against alienation and tyranny. Furthermore, I argue, since Weberian legitimacy is empirically measurable in terms that avoid controversial value judgments, its adoption would bridge a longstanding divide between philosophers and social scientists


A new large-change sensitivity invariant has been introduced, namely, in the case of a multiport the determinant of a difference of matrices for two values of a single variable element is equal to zero. On the same basis two theorems are proved, showing proportionality of the large- and small-change sensitivities of matrix parameters, as well as of currents and voltages with respect to changes in any single network element. The results obtained can be easily applied to tolerance analysis and design of integrated circult.


A novel concept for ultra-wideband suppression of switching noise in high-speed printed circuit boards (PCBs) is proposed, implemented and tested. This concept consists of using asymmetrical, embedded electromagnetic bandgap (EEBG) structures in conjunction with material with high dielectric constants. The proposed design modifies the classical EEBG structures to achieve a high degree of miniaturization and an unprecedented broadband mitigation of switching noise.


We investigate the emission of electric current from a polarized dielectric whenever the matrix dilates. The thermal volume expansivity, the isothermal bulk modulus, its temperature and pressure derivatives and the rate of temperature or pressure variation would determine the shape and the magnitude of the electric signal. We emphasize the permanent dipole polarization and the ionic (induced) polarization. Numerical estimates of the current density, which would be recorded in polarization or depolarization experiments in a model system with cubic symmetry, such as sodium chloride doped with a small amount of divalent cation impurities, are obtained.


Double minute chromosomes are acentric extrachromosomal DNA artifacts that are frequently observed in the cells of numerous cancers. They are highly amplified and contain oncogenes and drug resistance genes, making their presence a challenge for effective cancer treatment. Algorithmic discovery of double minutes (DM) can potentially improve bench-derived therapies for cancer treatment. A hindrance to this task is that DMs evolve, yielding circular chromatin that shares segments from progenitor double minutes. This creates double minutes with overlapping amplicon coordinates. Existing DM discovery algorithms use whole genome shotgun sequencing in isolation, which can potentially incorrectly classify DMs that share overlapping coordinates. In this study, we describe an algorithm called " HolistIC" that can predict double minutes in tumor genomes by integrating whole genome shotgun sequencing (WGS) and Hi-C sequencing data. The consolidation of these sources of information resolves ambiguity in double minute amplicon prediction that exists in DM prediction with WGS data used in isolation. We implemented and tested our algorithm on the tandem Hi-C and WGS datasets of three cancer datasets and a simulated dataset. Results on the cancer datasets demonstrated HolistIC's ability to predict DMs from Hi-C and WGS data in tandem. The results on the simulated data showed the HolistIC can accurately distinguish double minutes that have overlapping amplicon coordinates, an advance over methods that predict extrachromosomal amplification using WGS data in isolation. Availability Our software is available at http://www.github.com/mhayes20/HolistIC.


Background: The high morbidity and mortality associated with microbial infections and the ineffectiveness of conventional antibiotics due to inappropriate use and resistance warrant alternative stratagems. Aim: We investigated the antimicrobial, cytotoxicity, and qualitative phytochemical composition of the aqueous and methanolic leaf extracts of Physalis peruviana L. (Solanaceae) based on its ethnomedicinal information. Methods: The antimicrobial activity of the extracts was investigated using the disk diffusion technique. The brine shrimp lethality assay method was used to determine the cytotoxicity of the study extracts on brine shrimp nauplii. Qualitative phytochemistry of the study extracts was performed using standard procedures. Results: The two extracts did not possess antimicrobial activity against P. aeruginosa and were either inactive or slightly inactive against the other microbes at concentrations of ≤ 50 µg/ml. Notably, the aqueous extract exhibited high to very high activities against E. coli and S. aureus and very high to remarkable activities against B. cereus. The methanolic extract showed remarkable activity at concentrations of ≥200 µg/ml against E. coli, moderate to very high against S. aureus, high to very high against B. cereus, and moderate to high against C. albicans. The aqueous extract's minimum inhibitory concentrations (MICs) were 50 μg/ml (E. coli and B. cereus), 100 μg/ml (S. aureus), and 200 μg/ml (C. albicans). The minimum bactericidal concentration concentrations (MBCs) of the aqueous extract were 100 μg/ml (E. coli and B. cereus), 200 μg/ml (S. aureus), while the minimum fungicidal concentration (MFC) for C. albicans was 400 μg/ml. The MICs of the methanolic extract were 25 μg/ml for E. coli, S. aureus, and B. cereus and 100 μg/ml for C. albicans, and the MBCs were 100 μg/ml for E. coli, S. aureus, and B. cereus, and the MFC for C. albicans was 200 μg/ml. The aqueous was non-toxic, while the methanolic extract was slightly toxic to brine shrimp nauplii, indicating their relative safety. Various phytochemicals were detected in the study extracts, depicting broad pharmacologic activity, including antimicrobial activity. Conclusion: The aqueous and methanolic leaf extracts of P. peruviana may serve as a source of efficacious and safe novel antimicrobial agents upon further evaluation.


Increased serum levels of IL-15 are reported in type 1 diabetes (T1D). Here we report elevated serum soluble IL-15Rα levels in human T1D. To investigate the role of IL-15/IL-15Rα in the pathogenesis of T1D, we generated double transgenic mice with pancreatic β-cell expression of IL-15 and IL-15Rα. The mice developed hyperglycemia, marked mononuclear cell infiltration, β-cell destruction, and anti-insulin autoantibodies that mimic early human T1D. The diabetes in this model was reversed by inhibiting IL-15 signaling with anti-IL2/IL15Rβ (anti-CD122), which blocks IL-15 transpresentation. Furthermore, the diabetes could be reversed by administration of the Janus kinase 2/3 inhibitor tofacitinib, which blocks IL-15 signaling. In an alternative diabetes model, nonobese diabetic mice, IL15/IL-15Rα expression was increased in islet cells in the prediabetic stage, and inhibition of IL-15 signaling with anti-CD122 at the prediabetic stage delayed diabetes development. In support of the view that these observations reflect the conditions in humans, we demonstrated pancreatic islet expression of both IL-15 and IL-15Rα in human T1D. Taken together our data suggest that disordered IL-15 and IL-15Rα may be involved in T1D pathogenesis and the IL-15/IL15Rα system and its signaling pathway may be rational therapeutic targets for early T1D.


Background and aim. Insulin resistance is a main feature, and possibly a pathogenic factor, of non-alcoholic fatty liver disease. It is usually measured on glucose metabolism; the effects on amino acid regulation have never been assessed. In particular, no data are available on insulin-dependent branched-chain amino acid metabolism, which is under insulin control. Materials and methods. We measured amino acid disappearance from plasma during an euglycemic glucose clamp in 39 biopsy-proven non-alcoholic fatty liver disease patients and in ten control subjects. A primed-constant infusion of insulin (constant rate, 2 40 mU / m per min for 2 h) was used to raise plasma insulin to |100 mU / l. Euglycemia was maintained by a variable glucose infusion, a measure of tissue insulin sensitivity. Plasma amino acids were assayed during the clamp after ninhidrin derivatization. Results. Fasting plasma amino acids were similar in the two groups. Steady-state insulin levels were significantly higher in non-alcoholic fatty liver disease patients, whereas tissue sensitivity to insulin was reduced by 50%. The plasma disappearance of branched-chain amino acids, as well as the disappearance of the sum of glutamine and glutamate and that of serine were significantly reduced in non-alcoholic fatty liver disease. Differences were maintained after adjustment for steady-state insulin, and correlated with reduced tissue sensitivity to glucose. Conclusion. Insulin resistance in non-alcoholic fatty liver disease patients also affects amino acid metabolism, especially for amino acids involved in peripheral muscle nitrogen exchange. The metabolic effects of altered protein / amino acid metabolism must be considered.


We report the intraoperative courses of 2 consecutive Berlin Heart Excor® Pediatric Ventricular Assist Device implantations, in which transcranial Doppler ultrasonography helped to detect macroscopically undetected residual air bubbles captured in the pump after air removal had been correctly performed according to manufacturer's specifications. Our experience with these cases suggests that a beat-to beat deairing maneuver guided by transcranial Doppler is a useful strategy for reducing cerebral exposure to perioperative gaseous microembolism.


Background The Disease Activity Score in 28 joints (DAS28) is a scoring system used to measure the disease activity in patients with Rheumatoid Arthritis (RA). A complex calculation based on four parameters: Swollen and tender joint counts, C-reactive protein (CRP) and patient global assessment (VAS Global) result in the DAS28 value. In daily clinical practice DAS28 is used to guide treatment decisions. According to the EULAR DAS28 >5.1 indicate high disease activity, whereas a value <3.2 is indicative of low disease activity. If DAS28 is lower than 2.6 the patient is considered to be in remission. Response criteria have also been based on the DAS28 value, so when comparing a patient's DAS28 score over two time points a DAS28 improvement >1.2 is considered as a good response to the treatment [1]. We will focus on the parameter CRP. The intraindividual biological variation of CRP in healthy subjects is about 42 % [2], while the analytical variation is below 10%. Intraindividual biological variability of CRP in patients with RA is unknown, however it must be expected to be at least in the same order of magnitude as for healthy individuals, and then it might have significant impact on DAS28 score and therefore on the overall treatment. This is becoming increasingly relevant as so called high-sensitivty C-reactive protein (hs-CRP) tests are available on routine basis in many hospitals [3]. Objectives The aim of this study was to investigate the theoretical influence of the variability in CRP at low/normal values on the DAS28 score Methods We used Microsoft Excel to calculate DAS28 score by using following formula: DAS28=0.56*√(tender joints) + 0.28*√(swollen joints) + 0.36*ln(CRP+1) + 0.014*VAS Global + 0.96 Results Changes in CRP results below app. 10 mg/l that might be caused by biological variation can result in disproportionately great change in the DAS28 score and misclassification of patients. An example: A patient with five tender joints, one swollen joint, VAS 10 and CRP 1mg/l, DAS28 score is 2,9; if the CRP instead is tested to 7 mg/l which is possible if the patient's true CRP-level is 4 mg/l DAS28 is calculated to 3,4. A figure with (non uploadable) DAS28 on the Y-axis and CRP mg/l on the X-axis shows a steep increase in the DAS28 at CRP values lower than 20mg/l, then the curve flattens significantly. Conclusions The intraindividual biological variation of CRP in patients with RA with low disease activity is unknown, but if it is similar to the variation in healthy subjects you should be cautious to interpret the DAS28 score when CRP <10 mg/l because biological variation of CRP might cause relatively large fluctuations on the final DAS28 score, with consequences on patient classification and treatment. References G. Wells et al, Validation of the 28-joint Disease Activity Score (DAS28) and European League Against Rheumatism response criteria based on C-reactive protein against disease progression in patients with rheumatoid arthritis, and comparison with the DAS28 based on erythrocyte sedimentation rate, Ann Rheum Dis. 2009 June; 68(6): 954-960 Clark GH, Fraser CG. Biological variation of acute phase proteins. Ann Clin Biochem 1993; 30: 373-6 Rojo-Martinez G. et al, Factors determining high-sensitivity C-reactive protein values in the Spanish population. firstname.lastname@example.com study, Eur J Clin Invest 2013;43(1):1-10 Disclosure of Interest None Declared