Abstract Six cases of poor sequential bilateral cochlear implant use (partial and complete non-use) were explored through a semi-structured interview, as part of a service evaluation and development audit to improve the quality of a paediatric implant service for sequential users. Themes associated with poor use include: (1) appearance issues, (2) unrealistic expectations of both the benefits and the challenges of adjustment, (3) poor personal motivation for the implant and for engagement in rehabilitation, and (4) dislike of the sound. Feedback from young people highlighted the importance of careful counselling about their expectations of sequential implantation, outcomes and challenges, systemic support and self-directed rehabilitation.


OBJECTIVE
To assess the common presentations of leech infestation in leech endemic areas of Pakistan and to establish its association with unsafe water drinking habits of the individual.

DESIGN
A cohort study.

PLACE AND DURATION OF STUDY
CMH, Kohat, between 1st February 1997 and 30th April 2002.

PATIENTS AND METHODS
Fourteen patients with leech infestation who reported to ENT department of CMH, Kohat, during the above period were selected for study. A specific comparison of their water drinking habits was made with a control group of 42 normal individuals who had come from the same leech endemic area as the first group and belonged to the same socioeconomic class.

RESULTS
Twelve cases (83.4%) in the first group had unsafe water drinking habit i.e. they drank water directly from marshes without seeing its contents substituting cupped palm of hand for a drinking cup. This was in contrast to the control group where only 6 individuals (14%) gave a history of unsafe water drinking habits. Nose was the most common ENT site of leech infestation (71%) with epistaxis being the most prominent symptom. Other sites included hypopharynx (14%), nasopharynx (7 %) and oropharynx (7 %). All the 14 cases with leech infestation were males, 26.09 years being the mean age. The association between patient s unsafe water drinking habits and leech infestation in ENT region was statistically proved with odds ratio being 36.

CONCLUSION
Epistaxis or any other related symptom must be taken with suspicion in leech endemic area. This condition is closely related to unsafe water drinking habits, therefore, the incidence of this infestation can be significantly reduced by educating the individuals to adopt safe water drinking habits.


Here we reported a rare case of misdiagnosed ectopic pregnancy (EP) due to unintended ovulation during controlled ovarian stimulation (COS) in GnRH agonist cycle, resulting in no oocytes harvested and late hyper-stimulation syndrome (OHSS). The patient was a 33-year old primary infertile woman due to male's factors and underwent her second in vitro fertilization (IVF) cycle using GnRH agonist protocol, and no oocytes harvested on ovum picked-up (OPU) day. The start of gonadotropin usage was on day 8th of her period, and the P level increased rapidly and strangely high from day 8th after gonadotropin usage. The E2 level and follicles grew normally but finally no oocytes harvested. She was diagnosed as late ovarian hyper-stimulation syndrome (OHSS) 7 days after OPU. 20 days after OPU, no menstruation come and a positive urine test of hCG were reported. And the patient was diagnosed as EP by laparoscopy. In conclusion, rapidly increased P level, no oocyte retrieval and late onset of OHSS should be very important clues to diagnose this misdiagnosed EP.


Precedent from early in the twentieth century led to the traditionally wide resection margins for primary melanoma, but at that time there was little relevant empirical evidence that substantiated the efficacy of the practice. Later, neither numerous retrospective analyses nor several prospective, randomized trials were able to demonstrate an adverse effect on outcome from melanoma with narrowing of margins to 1 cm. A slightly increased rate of local recurrence was observed in some nonrandomized analyses when margins were less than 1 cm, an effect that may be accentuated with thicker primary tumors. The factual record therefore does not support the use of resection margins greater than 1 cm for invasive melanoma of any thickness.


Five rhesus macaques monkeys surgically prepared with Thiry small intestinal (jejunum) loops and implanted brain electrodes were restrained in primate chairs and kept on 23-hr deprivation-feeding cycle. After being trained to press a lever for sugar pills on an FR 25 schedule of reinforcement, a discrimination training procedure was established. Lever presses were reinforced during the S(D)-a non-aversive mechanical stimulus applied to the internal walls of the Thiry loop by rhythmic inflation-deflation of a small latex balloon by air at the rate of one cycle per sec at 100 mm Hg pressure. The S(Delta) was the absence of the visceral stimulation. The monkeys successfully discriminated between presence and absence of the internal stimulus. A discrimination reversal was attempted and completed on one monkey. The results clearly show operant discrimination based on an interoceptive stimulus. Cortical and subcortical EEG records reflected the onset but not termination of the visceral stimulation.


Controlling healthcare spending and utilization is of significant importance in today's healthcare industry and has public health relevance as the country moves from a system aimed at treating the sick to a system of population health. This goal is only achieved through effective healthcare policy that aligns the needs of a population with the reality of today's healthcare system. Without proper federal and state healthcare policy that can effectively control utilization and thus healthcare spending, our nation faces both budgetary and public health risks, especially in existing unhealthy and rural populations. In order to achieve this goal, lawmakers must evaluate existing policies for effectiveness in controlling healthcare utilization. One of these policies is Certificate of Need; a policy that gained momentum in the 1970's and aims to controls the supply of various healthcare facilities. This essay with examine the effectiveness of Certificate of Need policy in controlling healthcare utilization and spending in an unhealthy and rural population by using the Commonwealth of Kentucky as a case study. I conclude with suggesting alternative methods to Certificate of Need that focus on a health systems approach through utilizing and incentivizing outpatient services.


The present study looks into verbal phrasemes with a verb + it pattern, which have received very little attention beyond the well-established fact that the pronoun there loses some of its referentiality. It focuses more specifically on the role and morphological features of the pronoun in those phrasemes. A corpus-based study shows that the verb + it pattern licenses a number of prototypically intransitive verbs; it is argued that this capacity of the transitive pattern to override individual argument realisations is related to the prototypical semantics associated with the syntactic function of direct object. The study also seeks to determine why personal pronouns are the only type of pronoun licensed in those phrases. They are shown to be the default pronouns in terms of procedural information. Another issue is that of gender: a few phrasemes license alternation between the neuter and the feminine in several varieties of nonstandard English.


The phase information extraction of atrial fibrillation (AF) is significant in medical applications. In this method, atrial activity is decomposed into fundamental and harmonic components. Each component is divided into short blocks for which the amplitudes, frequencies, and phases are estimated. The phase delays between the fundamental and each of the harmonics, here referred to as harmonic phase relationships, are used as features of f-wave morphology. The estimated waves are clustered into typical morphologic patterns. The performance of the method is illustrated by simulated signals, ECG signals recorded from 50 patients with organized AF, and an ECG signal recorded during drug loading. The results show that the method can distinguish a wide variety of f-wave morphologies, and that typical morphologies can be established for further analysis of AF.


Formation of periodic structures in a transverse cross section of the emission of vertical-cavity surface-emitting semiconductor lasers is studied. It is shown that spatial Fourier modes of the emission are selected not only through the well-known mechanism related to the gain dispersion, but also through the dependence of the reflection coefficient of Bragg mirrors on the angle of incidence of the wave. This mechanism gives rise to the selection of standing transverse waves, whose direction is determined by the polarisation vector of the radiation. The effect of the laser cavity symmetry with respect to the active layer on the mode selection is studied.


This paper focuses on online scene learning and fast camera relocalisation which are two key problems currently limiting the performance of wide area augmented reality systems. Firstly, we propose to use adaptive random trees to deal with the online scene learning problem. The algorithm can provide more accurate recognition rates than traditional methods, especially with large scale workspaces. Secondly, we use the enhanced PROSAC algorithm to obtain a fast camera relocalisation method. Compared with traditional algorithms, our method can significantly reduce the computation complexity, which facilitates to a large degree the process of online camera relocalisation. Finally, we implement our algorithms in a multithreaded manner by using a parallel-computing scheme. Camera tracking, scene mapping, scene learning and relocalisation are separated into four threads by using multi-CPU hardware architecture. While providing real-time tracking performance, the resulting system also possesses the ability to track multiple maps simultaneously. Some experiments have been conducted to demonstrate the validity of our methods.


OBJECTIVE
To assess the validity of patient self-reported oral health measures as used in a large multi-country survey for populations aged 50+.

BACKGROUND
Information on people's oral health status is important for assessing oral health needs within populations. However, clinical examination is not always possible. Patient self-reported measures may provide an alternative when time and other resources are scarce.

MATERIALS AND METHODS
Using oral health items from the Survey of Health, Ageing and Retirement in Europe (SHARE), self-reported measures were collected from 186 patients receiving treatment at Heidelberg University Hospital. Self-reports were compared with subsequent clinical examinations. Analyses were conducted for patients of all age groups and separately for patients aged 50+ (analogous to the SHARE study population). Diagnostic accuracy, agreement and correlation of patient-reported information were examined using descriptive statistics and Bland-Altman plots.

RESULTS
Patient-reported presence or absence of a full tooth count was closely related to clinical measurement, both for all age groups (sensitivity: 93%; specificity: 92%) and persons aged 50+ (sensitivity: 100% specificity: 94%). Bland-Altman plots indicate good agreement between patient- and clinical reports of the number of teeth at age 50+ (Concordance Correlation Coefficient = 0.95). Discriminatory power of patient-reporting was good regarding presence vs absence of artificial teeth, but less robust regarding partial vs full replacement of missing teeth.

CONCLUSION
Patient self-evaluations provide reasonable estimates of clinical measures and appear sufficiently accurate for examining variations in the number of teeth, including among populations aged 50+. However, patient reports of the extent of replacement of missing teeth may not constitute reliable reflections of clinical conditions.


Multimedia languages offer us the possibility of connecting our students´ learning with new digital languages while enhancing the processes of knowledge acquisition. We particularly focus on the value of audiovisual narratives in the reflexive teacher training, as a facilitative tool to comprehend and aprehend the eductational reality. In this article we describe the elaboration and use of the portfolio as a bionarrative tool, and its context of use, its formats, its scaffoldings and possibilities, within the Project on Educational Innovation Elkarrikertuz (collaborative inquiry).


. The cryptographic sponge is a popular method for hash function design. The construction is in the ideal permutation model proven to be indifferentiable from a random oracle up to the birthday bound in the capacity of the sponge. This result in particular implies that, as long as the attack complexity does not exceed this bound, the sponge construction achieves a comparable level of collision, preimage, and second preimage resistance as a random oracle. We investigate these state-of-the-art bounds in detail, and observe that while the collision and second preimage security bounds are tight, the preimage bound is not tight . We derive an improved and tight preimage security bound for the cryptographic sponge construction. The result has direct implications for various lightweight cryptographic hash functions. For example, the NIST Lightweight Cryptography finalist Ascon-Hash does not generically achieve 2 128 preimage security as claimed, but even 2 192 preimage security. Comparable improvements are obtained for the modes of Spongent, PHOTON, ACE, Subterranean 2.0, and QUARK, among others.


The notion of cross ratio varieties for root systems is introduced in [7]. Among others, in the case of the root system of type An+2, it was conjectured (cf. Conjecture 2.2 in [7]) that the corresponding cross ratio variety is isomorphic to the n-dimensional Terada model which is a natural compactification of the complement in P of the singular locus of the holonomic system of differential equations for the Appell-Lauricella hypergeometric function FD. The purpose of this article is to prove this conjecture.


In spite of major thrust by research to increase agricultural production through the introduction of and use of scientific agricultural technologies, it is evident that most practices used by peasant yam growers to control and manage natural enemies to yam production consist of indigenous techniques borne of farmers experimentation. Yet, little information is available in an easily understandable form, on these cultural practices of local farmers. In Nigeria, pest constitutes one of the most pressing constraints to crop production, but farmers have built up tremendous knowledge on indigenous ways of controlling pests. The result of the studies conducted among yam farmers in some selected states of Nigeria revealed that the farmers, through their indigenous knowledge had developed botanical pesticides, using extracts of seeds and fruit of trees, wood ashes and other materials to control pests. This paper presents some field results of farmers' experimentation with regard to pests' management under yam cultivation farming systems within the humid ecological zone of Nigeria.


In the summers of 1978 and 1979, an extensive physical oceanographic program was carried out in western Baffin Bay and Lancaster Sound. Data collected include satellite-tracked drifter measurements, CTD profiles and time series of subsurface currents. They indicate that the near-surface circulation of the area is dominated by the southward-flowing Baffh Current. This current, observed to extend at least as far north as Lady Ann Strait (76"N) and south to Cape Dyer (67'N), is largely confined to within 100 km of the coastline. It varies in both intensity and width with the strongest flows occurring where the current follows a cyclonic intrusion into and out of eastern Lancaster Sound; here in the core of the current the median near-surface (4 to 11 m) speeds are 75 cm/s, decreasing to 50 cm/s at 40 m depth and 25 cm/s at 250 m depth. To the east of Devon, Bylot and Baffin islands, the current is well-defined, but generally less intense with typical near-surface speeds of 30 cm/s. Important spatial variations occurred in the circulation of the area. In eastern Lancaster Sound, two distinct and alternating flow patterns were observed in the strong intrusive current in the summer of 1979. Transient large-scale meanders of the circulation were detected in the offshore portion of the Baffin Current off the east coasts of Bylot and Baffin islands. Between the eastern coastline of Bylot Island and the core of the southeasterly flowing Baffin Current, anticyclonic eddies of approximately 20 km diameter occasionally occurred.


We propose a systems analysis framework based on goal modelling and transactions for improved decision-making about security solution architectures - with a specific focus on layered security of physical spaces and assets. The framework assists in defining more complete security strategies as well as analyzing tradeoffs between security and other factors such as cost and privacy. Using the conceptual transaction or requirements-execution-delivery (or RED) Transaction model as the basis, we provide a dynamic virtual structure and methodology for security analysis. The benefit is that the implemented security can be optimized based on the value to the various stakeholders and to minimize the benefit to the attacker.


Anthropogenic habitat conversion through urban sprawl is driving mesocarnivores to modify their behaviour and ecology. Thorough knowledge of their feeding ecology is fundamental in understanding the pressures imposed on mesocarnivores by urbanisation. The diet of the water mongoose Atilax paludinosus has been studied in natural habitats of KwaZulu-Natal, South Africa. However, its urban conspecifics have been mostly overlooked. We used scat analysis to investigate the feeding ecology of water mongooses in the urban greenspace matrix of the Upper Highway Area of eThekwini, KwaZulu-Natal Province. We analysed dietary intake trends using relative percentage of occurrence, based on 105 scat samples collected in 2018–2019. Urban water mongooses opportunistically consumed a wide array of prey items. Their diet was dominated by three main categories: crustaceans 35.9%, rodents 19.6%, and invertebrates 18.4%. Seasonal variation was only detected for crustaceans and rodents. We found chicken bones, plastic particulates and cigarette butts in the scat samples. This indicated that water mongooses in an urban landscape were supplementing their diet by foraging on anthropogenic waste. Our study highlights the generalist and flexible feeding habits of water mongooses in an urban matrix.


Holometabolous insects, including Drosophila melanogaster, undergo complete metamorphosis that includes a pupal stage. During metamorphosis, the Drosophila nervous system undergoes massive remodeling and growth, that include cell death and large-scale axon and synapse elimination as well as neurogenesis, developmental axon regrowth, and formation of new connections. Neuronal remodeling is an essential step in the development of vertebrate and invertebrate nervous systems. Research on the stereotypic remodeling of Drosophila mushroom body (MB) γ neurons has contributed to our knowledge of the molecular mechanisms of remodeling but our knowledge of the cellular mechanisms remain poorly understood. A major hurdle in understanding various dynamic processes that occur during metamorphosis is the lack of time-lapse resolution. The pupal case and opaque fat bodies that enwrap the central nervous system (CNS) make live-imaging of the central brain in-vivo impossible. We have established an ex vivo long-term brain culture system that supports the development and neuronal remodeling of pupal brains. By optimizing culture conditions and dissection protocols, we have observed development in culture at kinetics similar to what occurs in vivo. Using this new method, we have obtained the first time-lapse sequence of MB γ neurons undergoing remodeling in up to a single cell resolution. We found that axon pruning is initiated by blebbing, followed by one-two nicks that seem to initiate a more widely spread axon fragmentation. As such, we have set up some of the tools and methodologies needed for further exploration of the cellular mechanisms of neuronal remodeling, not limited to the MB. The long-term ex vivo brain culture system that we report here could be used to study dynamic aspects of neurodevelopment of any Drosophila neuron.


Reaction of nitrone (V with a, f1 -unsaturated lactone C.4) resulted in the isolation of a single adduct (7). The observed high regiochemical control has encouraged further explorations of natural product synthesis. A route to the synthesis of an interesting member of PyrrolizidineAlkaloid family; (±) -Tussilagin 90/ has been described


Drug-associated hemorrhagic colitis are divided into antibiotic associated hemorrhagic colitis (AAHC) and other drug associated hemorrhagic colitis. AAHC are mainly caused by oral usage of Ampicillin and its derivatives (85%). Initially AAHC are believed to be caused by Klebsiella oxytoca overgrowth. However, these organisum has no exotoxin like Clostridium difficile and pathogenesis of AAHC are still unresolved. Typical AAHC are diagnosed by colonoscopy with diffuse hemorrhage and edema mainly found in descending colon and transverse colon. NSAIDs are also the cause of hemorrhagic colitis like AAHC. Mephenamic acid are famous for this complication. Diarrhea is one of the main complication of oral 5-fluorouracil administration and even causes hemorrhagic colitis. Its histology are characteristic in gland atrophy. Gold colitis are reported 36 cases in rheumatoid arthritis patients. Exact mechanism of bleeding are not understood. NSAIDs may cause collagenous colitis and or lymphocytic colitis in RA patients. Other rare hemorrhagic colitis are associated with azathioprine, methyl dopa, interferon alfa etc. NSAIDs and anticoagulants are well known drugs for complication of GI bleeding making hemorrhagic enteritis.


The authors presented results of the study of antihypertensive therapy for patients of elderly and senile age in the hospital, an assessment of the efficiency of the control of arterial hypertension in a clinical practice is given in the article. The article presents the most effective combinations of antihypertensive agents, their pharmacoeconomic assessment and rational scheme of antihypertensive treatment for the patients of this age category.


Celiac disease (CeD) is an immune-mediated disorder triggered by gluten ingestion that damages the small intestine. Although CeD has been associated with a higher risk for cancer, the role of CeD as a risk factor for specific malignancies, such as enteropathy-associated T-cell lymphoma (EATL), remains controversial. Using two-sample Mendelian randomization (2SMR) methods and the summarized results of large genome-wide association studies from public repositories, we addressed the causal relationship between CeD and eight different malignancies. Eleven non-HLA SNPs were selected as instrumental variables (IVs), and causality estimates were obtained using four 2SMR methods: random-effects inverse variance-weighted, weighted median estimation, MR-Egger regression, and MR pleiotropy residual sum and outlier (MR-PRESSO). We identified a significant causal relationship between CeD and mature T/NK cell lymphomas. Under a multivariate Mendelian randomization model, we observed that the causal effect of CeD was not dependent on other known lymphoma risk factors. We found that the most instrumental IV was located in the TAGAP locus, suggesting that aberrant T cell activation might be relevant in the T/NK cell malignization process. Our findings provide new insights into the connection between immune imbalance and the development of severe comorbidities, such as EATL, in patients with CeD.


This study is an investigation of the traumatic experiences of Harare women diagnosed with breast cancer. Additionally, the study examines the treatment regimens prescribed for the women and the manner in which they improvise appropriate coping mechanisms to suit their particular circumstances and temperaments. It also investigates the various factors that appear to impact upon the administration and progress of the treatment prescribed for the afflicted women. The study is situated within the structure-agency construct and places greater emphasis on actor-oriented perspectives as embodied in the works of Norman Long (1992). Long's informative work articulates how the notions of structure and agency influence both individual and collective responses as the women undergo breast cancer treatment. This study utilizes a qualitative research methodology and the corresponding research methods. Its findings are based on data collected from a non-probability method using the snow ball sampling technique. The data-collection technique used for the study was the semi-structured in-depth interview with a target group of five (5) Harare women. Indications from the study are that women for whom breast cancer treatment is prescribed are subject to numerous side effects that include physical body image changes, health-related changes and psychological challenges. Other factors under consideration include monetary issues, religious and traditional beliefs, socio-cultural factors, aggressive treatment regimens, factors relating to rejection and institutional factors. The study further shows that different women respond differently to breast cancer therapy and also employ various individualised coping mechanisms including psychosocial support, counselling, religion, acceptance and the use of complementary and alternative medicine. The study also shows that the aggressive treatment regimens lower the women's quality of life with the women often feeling worse than before the prognosis of breast cancer. The study recommends that further investigations into the phenomenon of breast cancer treatment be carried out.


We present an INTEGRAL data analysis of the X-ray transient SAX J2103.5+4545 during two outbursts detected in December 2002. The INTEGRAL coordinates and error circle agree with the position of the recently proposed optical counterpart. A power-law plus cutoff model provided a good fit to the 4–150 keV spectrum yielding a photon index of 1.0±0.1, a cutoff energy E cut = 7.6 ± 2.0 keV and a folding energy E fold = 30.9 ± 2.5 keV. The X-ray luminosity in the 4-150 keV energy range was found to be 6.0×10 36 erg s −1 , assuming a distance of 6.5 kpc. This luminosity, together with the derived photon index, indicate that the source is in a bright state. A 354.9±0.5 second pulse period is measured. This value is significantly smaller than previous measurements, indicating a long-term spin-up episode.


The effects of a thiazolidinedione antidiabetic agent (CS‐045) on diabetic metabolic abnormalities were studied in a double‐blind clinical trial. Fourteen patients with Type 2 diabetes were selected according to study criteria. Eight were treated with oral CS‐045 at 400 mg daily, and six were given placebo. A multi‐step, hyperinsulinaemic, euglycaemic clamp study, with simultaneous plasma free fatty acid study, and glucagon tolerance test were performed before and after administration of drug. Following 3 months of treatment with CS‐045, there were significant decreases in the mean levels of fasting plasma glucose (from 9.18 ± 0.95 to 7.78 ± 0.44 mmol l−1), postprandial plasma glucose (from 11.8 ± 1.23 to 10.36 ± 1.06 mmol l−1), and haemoglobin A1c (from 9.3 ± 0.4 to 6.8 ± 0.4%). Insulin sensitivity also improved (1st step: from 3.12 ± 0.33 to 4.70 ± 0.47 mg kg−1 min−1 (p < 0.01); 2nd step: from 5.61 ± 0.63 to 7.54 ± 0.58 mg kg−1 min−1 (p< 0.01); 3rd step: from 9.21 ± 0.67 to 11.10 ± 0.87 mg kg−1 min−1). The fasting free fatty acid level decreased significantly from 0.28 ± 0.04 to 0.22 ± 0.02 g l−1. The residual free fatty acid level (%) under insulin infusion clamp conditions decreased significantly from 63.7 ± 9.7 to 45.0 ± 9.2%. CS‐045 treatment was associated with decrease in total cholesterol, total triglycerides, and increase in HDL cholesterol. Basal C‐peptide immunoreactivity level decreased, but there was no change in the peak C‐peptide immunoreactivity value. None of these changes was observed in the placebo group. CS‐045 improved hyperglycaemia as well as insulin resistance. CS‐045 appears to have a different mode of hypoglycaemic action from that of the sulphonylureas.


Objective Use of cannabis for medical reasons has increased in Canada since legalisation of recreational cannabis in 2018. The objective of this study was to examine the pattern of use and perceptions about cannabis for menopause in women aged 35 and over in Alberta, Canada. Design Cross-sectional, web-based survey. Setting Online (location of participant residence in Alberta, Canada). Participants Self-selected sample of women recruited through social media (Facebook, Instagram, Twitter) between October and December 2020. Inclusion criteria included: identified as woman, ages 35 and over, living in Alberta, Canada. Primary and secondary outcomes measures Self-reported data were collected on demographics, menopause status and symptoms, cannabis usage and how participants perceived cannabis. Descriptive statistics, comparative analysis and logistic regression explored relations in cannabis use and participant characteristics. Results Of 1761 responses collected, 1485 were included for analysis. Median age was 49 years; 35% were postmenopausal and 33% perimenopausal. Among analysed responses, 499 (34%) women reported currently using cannabis and 978 (66%) indicated ever using cannabis. Of the 499 current cannabis users, over 75% were using cannabis for medical purposes. Most common reasons for current use were sleep (65%), anxiety (45%) and muscle/joint achiness (33%). In current users, 74% indicated that cannabis was helpful for symptoms. Current cannabis users were more likely to report experiencing menopause symptoms compared with non-users. History of smoking and general health status were associated with current cannabis use. Conclusions Some women are using cannabis for symptoms related to menopause. Further research is required to assess safety and efficacy of cannabis for managing menopause and develop clinical resources for women on cannabis and menopause.


On sales transactions in Rubylicious website is lower than the online sales through the instagram on April to September 2017. So that is necessary to do research about the factors that affect on consumer online purchases. The research aims to understand the consumer interest towards website usages in Rubylicious purchases; design the business process model based on identification result and create the new business development strategy; and build the prototype about the puchases on website. Collecting primary data by in-depth interview with Rubylicious owner and 10 Rubylicious customer. This study focuses on analyzing the customer interest in Rubylicious purchase. Indicators in this research is about the understanding the relevance of consumer's attitudes with (1) Consumer Online Behavior, (2) Digital Marketing, And (3) Website Purchasing Decision. The result showed that the respondents were satisfied with the product, price, quality and servicing. There are 5 respondents that interest in purchase repeat order in Rubylicious, 4 respondents doubt in purchase repeat order, that need the support factors that can trigger the repeat purchases. 8 respondents interest in promo when purchasing on the website. Coupon voucher for triggering consumer to make purchases via Rubylicious website. Therefore, the modeling the new business process recommendation system using  Context Diagram / Data Flow Diagram (DFD) focused on coupon voucher features which is equipped with the prototype design using the opensource e-commerce system tools. In this model system there are six entities, they are: Customer, Web Admin, Finance, Bank, Logistic, and courier. There are three datastores in all levels these are: Product, Customer, Order Data.


The crucial physics issues related to fusion burning plasmas and potential fusion reactors can only be studied in a burning plasma experiment. The Ignitor experiment is designed to take the most conservative approach to the near term study of the physics of fusion burning plasmas, using an optimal combination of compact dimensions and high magnetic fields to support high plasma particle densities and high plasma currents. The values of its geometrical parameters, plasma current, and magnetic field have been chosen based on current knowledge of ignition physics, so that ignition is most likely to be achieved. This article presents the most important ideas behind its design.


Abstract Syndrome of the Trephined (SoT) is a severe complication following decompressive craniectomy. Urgent cranioplasty fully reverses the neurologic symptoms of SoT. This article presents a recent case of SoT following inflation of a scalp tissue expander. A review of the literature was performed and case details obtained from the electronic medical record. Our patient had a large craniectomy defect following traumatic brain injury. A scalp tissue expander was used before secondary cranioplasty. The patient suffered severe neurologic decline temporally related to tissue expander inflation, which was fully reversed following expander removal and urgent cranioplasty. SoT can be a neurologically devastating complication which can resolve following urgent cranioplasty. To our knowledge, this is the first description of SoT resulting from inflation of a scalp tissue expander. Familiarity with this syndrome is critical for the plastic surgery provider, who may be called upon to assist with these urgent cases.


Cloud computing is the next generation of technology which unifies everything into one. It is a model for enabling ubiquitous, convenient, on-demand network access to a shared pool of configurable computing resources (e.g., networks, servers, storage, applications, and services) that can be rapidly provisioned and released with minimal management effort or service provider interaction. A new model known as Priority Driven Auction Strategy (PDAS) for Resource Allocation is proposed in this research paper. Resource allocation takes place based on the priority of resources and auction bids between cloud user and datacenters. Load-balancing policy is used for assigning priorities to the resources. Proposed model is implemented in simulation environment and several experimental tests are performed to analyse its performance.


BACKGROUND
The implementation of clinical guidelines in care pathways is being promoted for quality assurance in psychiatry and psychotherapy, as in other medical fields. The achievable benefits are disputed and are generally thought to be small. There have been hardly any studies of the effect of clinical care pathways on the costly inpatient treatment of schizophrenic psychoses.

METHODS
We conducted a prospective, controlled, before and after study in 114 patients with schizophrenia to determine whether the implementation of a pathway would improve diagnosis and treatment in conformity with published guidelines, and whether there would be any associated improvement in outcome. The patients' course was extensively documented with a number of structural, process-related, and outcome-related variables in the years before and after pathway implementation. Moreover, two different intensive methods of pathway implementation were tested. Data were collected from 2003 to 2005. The primary indicators of outcome quality included pharmacotherapy-related variables and assessments of treatment efficacy by the physicians, the nurses, and the patients themselves.

RESULTS
After pathway implementation, some diagnostic tests that had been performed only rarely beforehand were performed much more often. The percentage of over- or undermedicated patients, as defined by the treatment pathway, declined markedly. Surprisingly, however, the patients' multidimensionally documented psychopathological course and their subjective judgments of their condition were worse after pathway implementation than before on all four scales that were used to assess these variables.

CONCLUSION
The implementation of a treatment pathway brought about a robust change in process-related variables. The findings of this study furnish no explanation for the observed decline in treatment efficacy.


The article presents rules for designing a device for fastening tools and machined parts to a CNC machine tool. Suggested tooling was used on machine tools already working in machining industry. Those machine tools can be elements of Flexible Production Systems. Presented solutions facilitate the application of CNC machine tools in low-volume and piece production.


As demands on micro-products increase significantly with raising functional integration and increasing complexity, microfoming attracts a lot of attention in the manufacture of micro-products. Since the conventional big forming systems are not adequate to achieve sufficient tolerances of micro-scale parts, it is necessary to reduce the scale of the forming equipment and devices. In addition, understandings on the size effects, which exist in the material behavior and process characterization of microforming processes, need to be expanded. In this study, a miniaturized forming system based on the ball screw and servo motor actuator was developed for the efficient micro-parts production. In addition, tensile tests and cylindrical upsetting experiments were performed to evaluate the performance of the microforming system and to investigate the flow stress and friction size effects in microforming processes.


Cancer cells adopt a variety of mechanisms to evade the immune system and avoid T-cell recognition. Disruption of human leukocyte antigen (HLA), which may lead to reduced neoantigen presentation, has been proposed as an immune escape strategy in many cancers, including lung cancer. Mutations in HLA class I genes are infrequent in early stage non-small cell lung cancers (NSCLC), suggesting alternative mechanisms of HLA disruption may be common. To date, the polymorphic nature of the locus has precluded copy number analysis and exploration of HLA loss. To investigate the prevalence and importance of HLA disruption, we present LOHHLA (Loss Of Heterozygosity in Human Leukocyte Antigen), a computational tool to determine HLA allele-specific copy number from sequencing data. Building upon previous work imputing HLA haplotypes from sequencing data (Shukla, 2015; Szolek, 2014) and utilizing previously published datasets (Jamal-Hanjani, 2017; Brastianos, 2015), we endeavored to address the prevalence and timing of HLA LOH in lung cancer and its impact on tumor evolution and neoantigen presentation. Using LOHHLA, we find HLA LOH occurs in 40% of NSCLCs and is associated with a high subclonal neoantigen burden, APOBEC mediated-mutagenesis, upregulation of cytolytic activity and PD-L1 positivity. The focal nature of these alterations, their subclonal frequencies, enrichment in metastatic sites, and occurrence as parallel events suggest that HLA LOH is an immune escape mechanism, selected later in NSCLC tumor evolution. Characterizing HLA LOH with LOHHLA refines neoantigen prediction and may have implications for immunotherapeutic approaches targeting neoantigens. Citation Format: Nicholas McGranahan, Rachel Rosenthal, Crispin T. Hiley, Andrew J. Rowan, Thomas B.K. Watkins, Gareth A. Wilson, Nicolai J. Birkbak, Selvaraju Veeriah, Peter Van Loo, Javier Herrero, Charles Swanton. Allele specific HLA loss and immune escape in lung cancer evolution [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2017 Oct 26-30; Philadelphia, PA. Philadelphia (PA): AACR; Mol Cancer Ther 2018;17(1 Suppl):Abstract nr LB-A03.


France ranks third among European countries as regards the level of investment in clinical R&D and, overall, accounts for a contributive effort proportional to the size of its population and pharmaceutical market respectively. However, there is a trend for phase II and III studies to become proportionally fewer than in the past, while the number of phase IV studies is increasing. In a growing proportion of the mega-trials, which are instrumental for establishing evidence-based practice, French experts, investigators and, even more seriously, French patients, are insufficiently represented. Though studies in France are initiated relatively fast due to a clear regulatory framework and perform equally well as far as quantitative and qualitative factors are concerned, compared with most European countries involved in clinical research the costs incurred per completed patient are higher than those recorded in the other countries. Academic research shares most of these constraints and suffers from a lack of financial and human resources, while it faces additional delays in implementing studies because of longer administrative processes. Given the stakes in play, specific solutions should be implemented to maintain and further develop French competitiveness in clinical R&D. At the patient level, positive perception and awareness of the usefulness and safety of participating in clinical trials need to be emphasized. Education at the school level and using the lay media should be developed. Intervention of institutional and government officials is much needed. Direct patient recruitment should be developed through advertisement and the Internet, as well as within doctors' offices and through collaboration with patients' organizations. Patient information and consent forms should be made much simpler than those imposed within the framework of global studies because of FDA requirements. The French health system discourages the recruitment of patients by investigators who are not the family doctor or the usual care provider. Thus, motivation and education of general practitioners and hospital doctors may be increased by involving them during the trial design phase and in the publication process. Specific administrative solutions, within private or public institutions, need to be developed for investigators who do not personally wish to receive investigation fees. Because of lack of availability, investigators need to be assisted with study nurse services and site management organizations, particularly within hospitals and clinics, using the model of the Clinical Investigation Centres. Networks of clinical investigation centres and of individual investigators need to be created. Implementing these solutions should lead to better implications for and reputation of French clinical research.


In this study, correlation dimension analysis was performed on the Doppler signals taken from healthy, mild and serious degree stenosed carotid artery. Correlation dimension is the number of a dynamic system's freedom degrees and is a indicator of the system complexity. Correlation dimension have computed on 8 embedding dimension using the time delay value determined through mutual information function for each Doppler signal, t-test has been performed and a statistically significant difference (p<0.0001) was obtained


Most chapters begin with "Introduction" and conclude with "Bibliography and Reading List." 1.Introduction and Orientation. Anatomical Nomenclature. Cells. Elementary Tissues. Organs. Systems. Speech Production. 2.Breathing. The Respiratory Passage. The Framework for the Breathing Mechanism. The Musculature of the Breathing Mechanism. The Mechanics of Breathing. 3.Phonation. The Supportive Framework of the Larynx. The Cartilaginous Framework of the Larynx. Membranes and Ligaments of the Larynx. The Interior of the Larynx. The Muscles of the Larynx. Methods of Investigation of Laryngeal Physiology. Laryngeal Physiology and the Mechanics of Phonation. 4.Articulation. The Skull. The Cavities of the Vocal Tract. The Articulators and Associated Structures. Contributions of the Articulators. 5.The Nervous System. Tools of the Trade. General Organization of the Nervous System. Functional Anatomy of the Central Nervous System. Functional Anatomy of the Peripheral Nervous System. The Structural and Functional Aspects of Neurons. Neural Pathways. Nervous Control of the Speech Mechanism. An Introduction to the Endocrine System. 6.Hearing. The Nature of Sound. The Ear. The Function of the Inner Ear. 7.Embryology of the Speech and Hearing Mechanism. Early Embryonic Development. Development of the Structures for Speech and Hearing. Development of the Nervous System. Development of the Inner Ear. 8.Circulation. The Circulatory System. General Features of the Cardiovascular System. Blood Supply for the Speech and Hearing Mechanism. Postscript. Glossary. Name Index. Subject Index.


The second of two targets (T2) embedded in a rapid serial visual presentation (RSVSVP) is often missed even though the first (T1) is correctly reported (attentional blink). The rate of correct T2 identification is quite high, however, when T2 comes immediately after T1 (lag-1 sparing). This study investigated whether and how non-target items induce lag-1 sparing. One T1 and two T2s comprising letters were inserted in distractors comprising symbols in each of two synchronised RSVSVPs. A digit (dummy) was presented with T1 in another stream. Lag-1 sparing occurred even at the location where the dummy was present (Experiment 1). This distractor-induced sparing effect was also obtained even when a Japanese katakana character (Experiment 2) was used as the dummy. The sparing effect was, however, severely weakened when symbols (Experiment 3) and Hebrew letters (Experiment 4) served as the dummy. Our findings suggest a tentative hypothesis that attentional set for item nameability is meta-categorically created and adopted to the dummy only when the dummy is nameable.


This paper deals with the development and the evaluation of hybrid ventilation control strategies, using both natural and mechanical modes, in residential buildings using a graphical simulation tool. The description of a library of airflow components and macroscopic pollutants models used to simulate the demand controlled ventilation based on indoor pollutant concentrations is provided. The paper discusses the issue of implementation of ventilation control strategies based on occupancy and indoor air quality using "Stateflow" and integration into thermal-airflow modelling using "Simulink". The case study is a single family dwelling that is used within the European project RESHYVENT. Two demand control strategies have been developed for the hybrid ventilation system. Yearly simulations have been performed in four European climates using the SIMBAD Building and HVAC toolbox, for the evaluation of hybrid ventilation control strategies. The assessment criteria used, are related to indoor air quality, to thermal comfort, to energy consumption and to the stability of control strategies. This work shows the possibility of using a graphical simulation environment for thermal-airflow computation. It is applied to the assessment of hybrid ventilation systems and concludes that the latter can improve indoor air quality and to reduce fan energy consumption with respect to reference system while maintaining the same building energy consumption for heating.


The use of accreditation has been widespread among medical care providers, but accreditation is relatively new to the drug abuse treatment field. This study presents estimates of the costs of pursuing accreditation for methadone treatment sites. Data are from 102 methadone treatment sites that underwent accreditation as part of the Center for Substance Abuse Treatment's evaluation of the Opioid Treatment Program Accreditation Project. The analysis represents the most comprehensive analysis of the costs of pursuing accreditation by a health care provider. Importantly, it is the first analysis of the costs of pursuing accreditation by drug treatment providers. Policy makers and drug treatment providers can use this analysis to plan the labor requirements and costs of future accreditation initiatives.


Every dentist and most dental students and paradental personnel have had experience with the patient whose gag reflex is abnormally active. This article reviews the literature on the gagging problem. The first section considers the normal gag reflex and factors that may be associated with the etiology of gagging, including anatomical and iatrogenic factors, systemic disorders, and psychological conditions. A review of the management of patients with an exaggerated gag reflex


The spherically averaged intracule density I(r) is calculated with minimal and split-valence basis sets in the ground state of the hydrogen molecule. Restricted Hartree-Fock calculations indicate a high probability of interelectronic distances (r) of the order of 1 au as the internuclear separation (R) goes to infinity due to the incorrect dissociation of H2. The inadequacy of the restricted Hartree-Fock I(r) at large R is further illustrated by calculating (1/r) as a function of R. Configuration interaction calculations are shown to yield the correct qualitative form for I(r) at large R and when combined with the Hartree-Fock results yield the approximate Coulomb hole in H2 as a function of internuclear separation. Explicit formulae for the evaluation of I(r) and its moments with s-type Gaussian basis functions are included.


It is really a boon for computer users that they get some software free with the operating system. But what if this software was not given free and would have cost thousand dollars. This would have given rise to the bug called "software piracy" but not to worry the bug is still in the market and is the major concern of software developers. The major reasons of piracy include the high cost of software and it is also the business of some unethical people who have chosen piracy as their jobs. Various software companies are inclined towards the research of techniques to handle this problem of piracy. Many defense mechanisms have been devised till date but the hobbyists or the black market leaders so called "software pirates" have always found a way out of it. This paper identifies flaws in the existing defense mechanisms – the static defense mechanisms and identifies the impossibility to prevent the duplication of digital data. The paper presents a dynamic defense mechanism and makes it difficult to pirate. Furthermore it also enables a fine grained control over distributed software. In this methodology the organization can not use the software on the number of computers, exceeding the number of license purchased but it provides an ethical way for optimal uses of that software in the network of the organization by dynamic software and license management which morally and socially build an environment for the prevention of software piracy. KeywordsEnd User License Agreements (EULAs), Electronic software distribution (ESD), Electronic software distribution and Licensing (ESDL), Distributed software and License key management, Byzantine agreement protocol, Election Algorithms


As electricity markets emerge, power exchanges and wheeling transactions become a common operating practice in most power systems. This paper considers an interim system which transfers power between two neighboring systems and presents a methodology to estimate the maximum secure wheeling transaction that the interim system is capable to support. By reactive or active power rescheduling actions, the interim system can significantly increase the size of transfer capability, thus offer support services to accommodate the wheeling transaction. The method utilizes an Optimal Power Flow algorithm, in order to calculate the maximum active power that can be transferred, subject to security constraints, as well as the support services provided by the host system. An AC-OPF model is used and a variety of formulations are examined to model the host system actions. The method is intended for application in real time procedures, utilizing the intra-day electricity market processes. An illustrative study case of the methodology is presented for a 26-bus power system supporting wheeling transaction between two neighboring systems.


The stellar disk of the Milky Way shows complex spatial and abundance structure that is central to understanding the key physical mechanisms responsible for shaping our Galaxy. In this study, we use six very high resolution cosmological zoom simulations of Milky Way-sized haloes to study the prevalence and formation of chemically distinct disc components. We find that our simulations develop a clearly bimodal distribution in the $[\rm \alpha/Fe]$ -- $[\rm Fe/H]$ plane. We find two main pathways to creating this dichotomy which operate in different regions of the galaxies: a) an early ($z>1$) and intense high-$\rm[\alpha/Fe]$ star formation phase in the inner region ($R\lesssim 5$ kpc) induced by gas-rich mergers, followed by more quiescent low-$\rm[\alpha/Fe]$ star formation; and b) an early phase of high-$\rm[\alpha/Fe]$ star formation in the outer disc followed by a shrinking of the gas disc owing to a temporarily lowered gas accretion rate, after which disc growth resumes. In process b), a double-peaked star formation history around the time and radius of disc shrinking accentuates the dichotomy. If the early star formation phase is prolonged (rather than short and intense), chemical evolution proceeds as per process a) in the inner region, but the dichotomy is less clear. In the outer region, the dichotomy is only evident if the first intense phase of star formation covers a large enough radial range before disc shrinking occurs; otherwise, the outer disc consists of only low-$\rm[\alpha/Fe]$ sequence stars. We discuss the implication that both processes occurred in the Milky Way.


Talipes equinovarus (Clubfoot) is the commonest foot deformity with variable incidence across races. Exact etiology remains elusive. The objective of this study is to describe the epidemiology of clubfoot in our centre, looking for predisposing factors. This is a descriptive clinic based epidemiologic study of 106 feet belonging to 69 subjects from January 2014 – December 2015 was conducted. Structured questionnaires were administered to clinically confirmed clubfoot subject's guardian or biologic mothers. Phenotypic data from clubfoot subject were also recorded. Analysis was done using IBM SPSS version 22 for windows. Results revealed the age range of the patients as 3 days to 9 years, with a mean age of 46.17 ± 92.03 weeks. Thirty-seven (53.7%) patients had bilateral deformity while 13 (18.8%) patients had right-sided deformity, and 19 (27.5%) patients had left-sided deformity. Majority 40 (58.0%) of the patients were firstborn out of which 28 were males. Only 2 (2.89%) patients are products of multiple gestations. All mothers were none smokers and there was no reported family history of foot deformities or clubfoot. The mean maternal age was 25.81 years ± 4.99 years. The average length/height of patients at presentation was 64.27 ± 23.93 cm. The average shoulder span of the patients at presentation was 23.93 ± 15.86 cm. The study thus revealed that young maternal age, gender and firstborn are predisposing factors in the etiology of clubfoot.

 Key words: Clubfoot, idiopathic, predisposing factors, epidemiology.


Purpose: Corneal endotheliitis causes endothelial decompensation and is associated with significant visual impairment. The goal of this article is to report a case of corneal endotheliitis associated with coxsackievirus A24 infection after cataract surgery in a patient who had no previous symptoms indicative of conjunctivitis. Methods: A 55-year-old man was admitted for cataract surgery when acute hemorrhagic conjunctivitis was prevalent. Because he did not show any signs of suspected conjunctivitis, the cataract surgery was performed. No intraoperative complications occurred, and he was discharged 1 day after the surgery. Three days later, he visited our clinic with complaints of ocular pain and decreased vision in the left eye. Slit-lamp examination showed corneal stromal edema and mild inflammatory reaction in the anterior chamber. On postoperative day 7, anterior chamber irrigation and viral culture from the aqueous humor sample were performed. Results: Coxsackievirus A24 was detected in the viral culture. Electron photomicroscopic examination with immunohistochemical staining confirmed the presence of viral antigen. Conclusions: This is the first report of corneal endotheliitis caused by coxsackievirus A24 confirmed by viral antigen detection in the aqueous humor of an affected eye.


During summer (JJA) of 2004, a record-high temperature in Korea appeared at Miryang (38.5℃ on July 30). Moreover, Miryang showed the most frequent occurrence (25 days in JJA) of the daily highest temperature among observational sites in Korea. Based on meteorological analysis, it is found that this phenomenon is caused by neither the global warming effect nor the urban climate effect. It is caused by the mesoscale and synoptic and/or global scale atmospheric circulations, as evidenced by several factors described below. Firstly, the hottest areas have normally occurred not at a point but over an area, particularly along an axis connecting Sancheong and Daegu. But in 2004, this axis has moved southward and locates over Namhae-Miryang due to northerlies that were induced by the heating effect related to the low snow-cover on the Tibet Plateau. Secondly, although the maximum temperature was the highest among observational sites in Korea, the daily mean temperature and the number of nights with air temperature over 25℃ were not the highest at Miryang. Thirdly, the downdraft induced by the second circulation of typhoon and abnormal development of the North-Pacific High were found to have exerted an important role.


Erd\H{o}s and Fishburn studied the maximum number of points in the plane that span $k$ distances and classified these configurations, as an inverse problem of the Erd\H{o}s distinct distances problem. We consider the analogous problem for triangles. Past work has obtained the optimal sets for one and two distinct triangles in the plane. In this paper, we resolve a conjecture that at most six points in the plane can span three distinct triangles, and obtain the hexagon as the unique configuration that achieves this. We also provide evidence that optimal sets cannot be on the square lattice in the general case.


Silencing RNA (siRNA) technologies emerge as a promising therapeutic tool for the treatment of multiple diseases. An ideal nanocarrier (NC) for siRNAs should be stable at physiological pH and release siRNAs in acidic endosomal pH, fulfilling siRNA delivery only inside cells. Here, we show a novel application of polyamine phosphate NCs (PANs) based on their capacity to load negatively charged nucleic acids and their pH stability. PANs are fabricated by complexation of phosphate anions from phosphate buffer solution (PB) with the amine groups of poly(allylamine) hydrochloride as carriers for siRNAs. PANs are stable in a narrow pH interval, from 7 to 9, and disassemble at pH's higher than 9 and lower than 6. siRNAs are encapsulated by complexation with poly(allylamine) hydrochloride before or after PAN formation. PANs with encapsulated siRNAs are stable in cell media. Once internalized in cells following endocytic pathways, PANs disassemble at the low endosomal pH and release the siRNAs into the cytoplasm. Confocal laser scanning microscopy (CLSM) images of Rhodamine Green labeled PANs (RG-PANs) with encapsulated Cy3-labeled siRNA in A549 cells show that siRNAs are released from the PANs. Colocalization experiments with labeled endosomes and either labeled siRNAs prove the translocation of siRNAs into the cytosol. As a proof of concept, it is shown that PANs with encapsulated green fluorescence protein (GFP) siRNAs silence GFP in A549 cells expressing this protein. Silencing efficacy was evaluated by flow cytometry, CLSM, and Western blot assays. These results open the way for the use of poly(allylamine) phosphate nanocarriers for the intracellular delivery of genetic materials.


A computer model DEPSHIELD for the calculation of shielding factors for gamma radiation at indoor residences in multistory and single-family houses has been developed. The model is based on the exponential point kernel that links the radiation flux density at a given detector point to a point-source strength. The radiation sources considered in the model are fallout radioactivity deposited on roofs, outer walls, and ground surfaces. For any combination of source strength on roof, outer wall, and ground surface, the model calculates shielding factors for specified photon energies. The input data are the dimensions of the house, the thickness of the walls and floors, the window dimensions, and the size of the surrounding ground surface. The fallout source strength on the surfaces is allowed to have different values due to different deposition velocities to these surfaces. This feature of the model also makes it possible to determine the dose reduction effect from a decontamination of the different surfaces. The model has been used in a study of the consequences of land contamination of Danish territory after hypothetical core-melt accidents at the Barseback nuclear power plant in Sweden. The model has also been used to calculate shielding factors for typical housesmore » in the other Nordic countries.« less


Developmental disabilities (DDs) refer to a group of conditions that influence the early development of children and cause changes in their normal developmental pattern affecting their physical, language and mental abilities or behavior. Children with DDs just like normally developing children have health issues that need to be addressed. This special group of children especially those having autism frequently suffer from associated conditions such as gastrointestinal disorders, eating and feeding challenges, seizures, sleep disturbances, attention deficit and hyperactivity disorder, and anxiety among others. These health problems affect the health of these children in different ways and extent. Thus, children with DDs need to access healthcare services and receive quality medical care just like their normally developing peers. However, the health needs of children with DDs particularly autism are not being met as required even though this special population are more likely to seek medical care due to their disabilities and associated conditions. Children with autism and other DDs experience disparities in health and healthcare service utilization. Autism is linked to many health conditions such as epilepsy, gastrointestinal problems and other mental disorders. These health problems affect each individual with autism in a unique way negatively affecting his/her existing social interaction and communication impairments. Again, health facilities and medical equipment are not disability-friendly making it difficult for this special group to effectively have access to quality care. In addition, most healthcare providers do not possess adequate knowledge and skills required to make critical decisions regarding this very special group of persons. Furthermore, due to cultural differences certain diagnosis and treatment regarding autism and other developmental disabilities may not be welcomed. The public health sector of all nations has the duty to promote health and prevent diseases for all including persons with disabilities.


The electric field strength analysis of Czech Republic (CZE) (270 kHz) and Monte Carlo (MCO) (216 kHz) broadcast signals, collected with a 10 min sampling frequency by a receiver located in central Italy from 1996 to 2004, is presented. The distance from transmitter to receiver ranges from 515 km (MCO) to 818 km (CZE). The daytime data and the nighttime data were extracted and then in the daytime data the data collected in winter (21 December to 21 March) were separated from the data collected in summer (21 June to 21 September). Under the hypothesis that the simple addition of the ground wave and sky wave contributions holds, at first, the analysis was focused on the comparison between the experimental and theoretical values of these waves. The theoretical values were calculated by the ground wave (GRWAVE) algorithm and the wave hop theory, respectively. Ratios between the experimental and theoretical values ranging from a few tenths of decibels to some decibels were obtained. Then the analysis of the sunspots' influence on the sky wave propagation mode was performed, and the electric field strength of the two radio signals reveals a reduction of some decibels in sunspot maximum years with respect to the values during the sunspot minimum years. In addition, an influence of the sunspots also was recognized for the ground wave propagation mode.


Sperm chemotaxis, in which sperms are attracted to conspecific eggs via species-specific attractants, plays an important role in fertilization. This phenomenon has been observed in various animals and species-specific sperm attractants have been reported in some species. However, the mechanisms involved in the reception and recognition of the species-specific attractant by the sperms is poorly studied. Previously, we found that the plasma membrane-type Ca2+ /ATPase (PMCA) is the receptor for the sperm-activating and -attracting factor (SAAF) in the ascidian Ciona intestinalis. To determine the role of PMCA in species-specific sperm chemotaxis, we identified the amino acid sequences of PMCAs derived from six Phlebobranchia species. The testis-specific splice variant of PMCA was found to be present in all the species investigated and the ascidian-specific sequence was detected near the 3'-terminus. Moreover, dN/dS analysis revealed that the extracellular loops 1, 2, and 4 in ascidian PMCA underwent a positive selection. These findings suggest that PMCA recognizes the species-specific structure of SAAF at the extracellular loops 1, 2, and 4, and its testis-specific C-terminal region is involved in the activation and chemotaxis of ascidian sperms.


Introduction: Adiponectin is the most abundant adipocytokines secreted from adipose tissues and circulates in considerably high concentration in human plasma. Circulating adiponectin levels are decreased in obese subjects and this decrease has been thought to play a crucial role in the early development of atherosclerosis and cardiovascular diseases. Changes in adiponectin concentration has been reported in dyslipidemic subjects, but the evidence is controversial and no study conducted in north Indian population. Moreover, low molecular adiponectin seems to be linked with a worse lipid profile leading to dyslipidaemic through an association with triglyceride but the exact role of adiponectin in modulating lipid fraction is not well established. Aim: To correlate the level of serum adiponectin with lipid fractions in dyslipidemic male subjects and also to compare them with apparently healthy individuals. Materials and Methods: This case control study was conducted from April 2015 to November 2016 in the Biochemistry department of Rajshree Medical Research institute, Bareilly, Uttar Pradesh, India. A total of 70 non diabetic dyslipidemic male subjects between the age group 35 years to 55 years were selected and all the biochemical parameters (adiponectin, fasting plasma glucose, lipid profile) were evaluated and compared with 70 apparently healthy controls. Statistical analysis was performed by licensed version of Statistical Package for Social Sciences (SPSS) 16.0 software. All the data were expressed in "mean±SD". Student 't' test was also applied to see statistical significance in adiponectin levels between dyslipidemic subjects and healthy controls. Results: The study shows mean±SD of age in dyslipidemic group was 43.61±4.85 years and for control group was 43.53±5.53 years. The mean±SD of BMI in dyslipidemic group 25.72±2.43 was significantly higher than control group 23.42±1.56 with p-value <0.0001. The serum adiponectin concentration was significantly reduced in dyslipidemic subjects 5.11±2.04 μg/mL as compared to healthy control 6.79±1.37 μg/mL with p-value <0.0001. Serum total cholesterol, triglyceride and Low Density Lipoprotein (LDL)- cholesterol were found to be negatively correlated with serum adiponectin (r= -0.89, -0.76 and -0.74) and positively correlated with High Density Lipoprotein (HDL)-cholesterol (r= 0.70). Conclusion: The present study revealed that hypoadiponectinemia is associated with dyslipidaemic in men. The main observation of our present study, however, is that in dyslipidemic subjects, lower levels of adiponectin were associated with high total cholesterol, triglyceride, LDL-cholesterol and reduced HDL cholesterol, though more extensive, multicentric, prospective research with increase sample size could obtain wider insights.


In respect of rock-mass engineering, the detection of planar structures from the rock-mass point clouds plays a crucial role in the construction of a lightweight numerical model, while the establishment of high-quality models relies on the accurate results of surface analysis. However, the existing techniques are barely capable to segment the rock mass thoroughly, which is attributed to the cluttered and unpredictable surface structures of the rock mass. This paper proposes a high-precision plane detection approach for 3D rock-mass point clouds, which is effective in dealing with the complex surface structures, thus achieving a high level of detail in detection. Firstly, the input point cloud is fast segmented to voxels using spatial grids, while the local coplanarity test and the edge information calculation are performed to extract the major segments of planes. Secondly, to preserve as much detail as possible, supervoxel segmentation instead of traditional region growing is conducted to deal with scattered points. Finally, a patch-based region growing strategy applicable to rock mass is developed, while the completed planes are obtained by merging supervoxel patches. In this paper, an artificial icosahedron point cloud and four rock-mass point clouds are applied to validate the performance of the proposed method. As indicated by the experimental results, the proposed method can make high-precision plane detection achievable for rock-mass point clouds while ensuring high recall rate. Furthermore, the results of both qualitative and quantitative analyses evidence the superior performance of our algorithm.


The National Education Act of B.E. 2542 (1999) as well as the Basic Education Core Curriculum of 2008 emphasize the importance of both the acquisition of the English language in present Thai society, as well as the development of 21st century skills for all Thai children. Furthermore, the Thai Ministry of Education supports and encourages cooperative learning as a way to create appealing, motivating, and meaningful learning. Unfortunately, this vision is often not shared by schools in Thailand, which prefer a more traditional instructional method. This comparative study aimed at measuring academic achievement as well as student satisfaction under two instructional methods - traditional instruction and cooperative learning instruction. The research was conducted in science grade four at Sarasas Witaed Bangbon School, Bangkok, Thailand. Science as a school subject is ideal for the implementation of cooperative learning. Indeed, science literacy develops critical thinking, analysis, and cooperative skills. A total of 122 students took part in this study over a period of six weeks during the second semester of the school year 2015. The research included six objectives. Objectives one and two were to determine student academic achievement under traditional instruction and cooperative learning instruction methods. Objectives three and four were to determine student satisfaction under traditional instruction and cooperative learning instruction methods. Finally, objectives five and six were to compare the results between the instructional methods in order to determine if an instructional method was more efficient and/or appealing. The findings of this study suggested that academic achievement of the cooperative learning group did not improve significantly. Student satisfaction was higher for the cooperative learning group than the traditional instruction group. Recommendations for school administrators and future researchers are provided.


The isocoumarins are naturally occurring lactones that constitute an important class of natural products exhibiting an array of biological activities. A wide variety of these lactones have been isolated from natural sources and, due to their remarkable bioactivities and structural diversity, great attention has been focused on their synthesis. This review article focuses on their structural diversity, biological applications, and commonly used synthetic modes.


The calibration of radiocarbon dates by means of a master calibration curve has been invaluable to Earth, environmental and archeological sciences, but the fundamental reason for calibration is that atmospheric radiocarbon content varies because of changes in upper atmosphere production and global carbon cycling. Improved instrumentation has contributed to high‐resolution (interannual) radiocarbon activity measurements, which have revealed sudden and anomalous activity shifts previously not observed at the common resolution of 5–10 years of most of the calibration scale. One such spike has been recently reported from tree rings from Japan and then again in Europe at A.D. 774–775, for which we report here our efforts to both replicate its existence and determine its spatial extent using tree rings from larch at high latitude (northern Siberia) and bristlecone pine from lower latitude (the White Mountains of California). Our results confirm an abrupt ~ 15‰ 14C activity increase from A.D. 774 to 776, the size and now the hemispheric extent of which suggest that an extraterrestrial influence on radiocarbon production is most likely responsible.


In a case where a lot of field devices provided by many different manufacturers are linked by one network, troubles of a distributed system will be difficult to identify. We make the point that software tests of interoperability among these field devices are needed to ensure the system compatibility over a field network. First, we survey the international standards related to the measurement and control domain and point out the necessity of such software tests. Second, we describe an outline of structure of the next generation manufacturing systems and discuss in detail what is required for software tests. Finally, we propose some aspects of software tests and give a framework in the case of function blocks.


Relaxor ferroelectrics of Pb(Zn_1/3Nb_2/3)_0.5(Zr_0.47Ti_0.53)_0.5O_3 (0.5PZN-0.5PZT) were prepared using the conventional oxide mixing method. Both x-ray diffraction analysis and Raman spectroscopy indicate that the amounts of rhombohedral phase are close to tetragonal phase, implying the presence of the morphotropic phase boundary (MPB) in the system of 0.5PZN-0.5PZT, and this result was further confirmed by transmission electron microscopy (TEM) micrographs. At MPB composition, the excellent piezoelectric properties, such as k _p (0.66) and d _33 (425pC/N), were obtained due to the more possible polarization directions of domains and high dc resistivity of 6.5 × 10^10 Ω·cm. Meanwhile, the dielectric studies revealed that the indicator of the degree of diffuseness γ value is 1.73, implying that the relaxor nature of the 0.5PZN-0.5PZT is ceramic. The activation energy related to the dc conductivity was estimated from a linear fitting of the Arrhenius law. The value of 0.09 and 1.04 eV for low and high temperature range corresponds well to the activation energies of migration and first ionization of the oxygen vacancies.


The metallogeny put forward in this paper is the summary report of systematic researches carried out by the author for several decades on basic paradigms of six metallogenic districts at the Yangtze Cratonic Rim by combining the theory of complexity and science of nonlinearity with ore geology. Investigation shows that the ore forming systems are open, far from equilibrium and spatio temporally extended dynamical systems. They possess the inherent fundamental attributes of complexity and self organized criticality, and grow fractally at the edge of chaos. The author takes the natural philosophical reasoning of "geological processes and spatio temporal structures are the essence and crux of geological phenomena" as the fundamental foothold, and sets up a universal framework for the theory. Then it is realized and specified by three major constituent parts, i. e. (1)dynamical attributes of ore deposits,(2)fields of ore geology and (3) evolution of ore forming systems. They embody the integral coupling and intermingling of the trinity of the ore forming processes (the core of which is the dynamics of ore forming processes),the spatial structures (fields of ore geology) and temporal structures (evolution of ore forming systems). Thereby the metallogeny is endowed with comprehensiveness. Furthermore, five determinative criteria for the "Fractal growth of ore forming dynamical systems at the edge of chaos" and ten corresponding characteristics of dynamical behavior are derived on this basis. Finally, the author advances the proposition of "the local activation of ore\|forming materials induces the onset of ore formation", poses its four important scientific problems, and takes "cellular nonlinear networks" (CNN) as paradigms of complexity to reveal quantitively the onset of ore formation, and to localize precisely ore deposits at the edge of chaos. The new metallogeny would thereby be extended, deepened and developed.The new metallogeny raises the conventional ore geology to the level of the science of nonlinearity and complexity with respect to the study of ore genesis and regularity of ore formation.


The transient response of bedrock rivers to a drop in base level can be used to
discriminate between competing fluvial erosion models. However, some recent studies of
bedrock erosion conclude that transient river long profiles can be approximately
characterized by a transport‐limited erosion model, while other authors suggest that a
detachment‐limited model best explains their field data. The difference is thought to be
due to the relative volume of sediment being fluxed through the fluvial system. Using a
pragmatic approach, we address this debate by testing the ability of end‐member fluvial
erosion models to reproduce the well‐documented evolution of three catchments in the
central Apennines (Italy) which have been perturbed to various extents by an
independently constrained increase in relative uplift rate. The transport‐limited model is
unable to account for the catchments'response to the increase in uplift rate, consistent with
the observed low rates of sediment supply to the channels. Instead, a detachment‐limited
model with a threshold corresponding to the field‐derived median grain size of the
sediment plus a slope‐dependent channel width satisfactorily reproduces the overall
convex long profiles along the studied rivers. Importantly, we find that the prefactor in the
hydraulic scaling relationship is uplift dependent, leading to landscapes responding faster
the higher the uplift rate, consistent with field observations. We conclude that a slope‐
dependent channel width and an entrainment/erosion threshold are necessary ingredients
when modeling landscape evolution or mapping the distribution of fluvial erosion rates in
areas where the rate of sediment supply to channels is low.


Diseases of the paranasal sinuses may cause visual disturbances, especially diminished visual acuity and visual field defects, by affecting the optic nerve. We report the unusual case of a female patient with unilateral peripheral, quadrantic scotoma and concomitant chronic ethmoidal sinusitis. Visual acuity was not diminished. Despite extensive diagnostic examinations no other cause of the scotoma could be evaluated. As conservative therapy had been unsuccessful, endonasal pansinus operation was performed. Upon surgery, nearly all ethmoidal cells appeared to be filled with polypous mucosa. The sphenoid sinuses, however, contained air. In contrast, pre-operative CT scans had shown only a slight opacity of the ethmoid bone. Already two weeks after surgery a reduction in size of the scotoma could be noted. In addition to this case report, possible causes of visual field defects due to inflammatory diseases of the paranasal sinuses are discussed. In cases of unilateral visual field reduction associated with symptoms of chronic paranasal sinusitis, early operative exploration of the paranasal sinuses should be considered after exclusion of other possible causes, even if radiological findings do not warrant such a procedure.


BACKGROUND/AIM
We aimed to investigate clinical associations of inflammatory biomarkers neutrophil-to-lymphocyte-ratio (NLR) and platelet-to-lymphocyte-ratio (PLR) in patients with myelofibrosis, myeloproliferative neoplasm with inflammatory background.

PATIENTS AND METHODS
We retrospectively analyzed a cohort of 102 myelofibrosis patients. NLR and PLR were assessed in addition to other disease-specific parameters.

RESULTS
NLR and PLR were significantly higher in myelofibrosis than in healthy controls. Higher NLR was significantly associated with Janus-kinase-2 (JAK2)-mutation, wild-type-Calreticulin (CALR), older age and parameters reflecting increased proliferative potential of disease (higher leukocytes, higher hemoglobin, larger spleen-size), whereas there was no significant association with C-reactive-protein (CRP). Higher PLR was significantly associated with absence of blast-phase-disease, absence of constitutional-symptoms, lower percentage-of-circulatory-blasts, smaller spleen-size and lower CRP. In the Cox-regression-model, higher-NLR (HR=2.76; p=0.004), lower-PLR (HR=1.99; p=0.042) and Dynamic-International-Prognostic-System (DIPSS) (HR=3.26; p<0.001) predicted inferior survival independently of each other.

CONCLUSION
In the context of myelofibrosis, elevated NLR and PLR are more likely to represent myeloproliferation itself and not necessary the extent of inflammation.


In Tunisia, date-palm cultivation and production are of clear strategic importance in terms of economic, social and environmental development. However, the globalization of markets has had a huge impact on the traditional concept of the comparative advantage enjoyed by Tunisia in date exports, highlighting the necessary determinants for competitiveness in the international scenario. In fact, an analysis of the competitive advantage of the Tunisian date industry in the Mediterranean area and Iran over the last 20 years shows that Tunisia is still the main supplier of dates to the EU. The Deglet-Nour variety, in particular, puts Tunisia ahead of traditional competitors such as Algeria and Iran, with average of competitiveness indices as BIS 6405.99, DI 17.38, CMS 41.04 and TBI 99.50 are more stable than those countries during the studied period. But it is currently facing new competitors like Israel and re-exporting countries like France. New business strategies (conditioning, new non-chemical treatments, packing, opening new markets, new distribution channels) would be positive responses to tackle current market limitations, the emergence of new producers and restrictive EU policies.


Synchronous collaboration with large groups in a classroom requires coordination and communication mechanisms that allow students to contribute towards achieving a common goal. This paper presents an application based on an Interpersonal Computer with a shared display that promotes synchronous, non-verbal (silent) collaboration with large groups in a classroom.


In view of evidence linking cholecystokinin-containing neurons with both dopamine system function and Parkinson's disease pathophysiology, the therapeutic effects of the cholecystokinin analog, caerulein, were evaluated in 10 parkinsonian patients stabilized on L-Dopa therapy. Despite substantially elevated plasma caerulein levels immediately following intramuscular injection of this peptide, no consistent change in neurologic status could be discerned. These negative results may be due to the relatively small amounts of caerulein entering the CNS at dose levels that do not induce gastrointestinal toxicity.


In this paper, we present a simple spring-block model for ocean internal waves based on the self-organized criticality (SOC). The oscillations of the water blocks in the model display power-law behavior with an exponent of -2 in the frequency domain, which is similar to the current and sea water temperature spectra in the actual ocean and the universal Garrett and Munk deep ocean internal wave model [Geophysical Fluid Dynamics 2(1972) 225; J. Geophys. REs. 80 (1975) 291]. The influence of the ratio of the driving force to the spring coefficient to SOC behaviors in the model is also discussed.


As we know, "Who can be said to be a conscious being?" is one of the hard problems in present science, and no method has been found to strictly differentiate the conscious being from the being without consciousness or usual matter. In this short paper, we present a strict physical method based on revised quantum dynamics to test the existence of consciousness, and the principle is to use the distinguishability of nonorthogonal single states. We demonstrate that although the dynamical collapse time can't be measured by a physical measuring device, a conscious being can perceive it under the assumed QSC condition, thus can distinguish the nonorthogonal single states in the framework of revised quantum dynamics This in principle provides a quantum method to differentiate man and machine, or to test the existence of consciousness. We further discuss the rationality of the assumed QSC condition, and denote that some experimental evidences have indicated that our human being can satisfy the condition. This not only provides some confirmation of our method, but also indicates that the method is a practical proposal, which can be implemented in the near future experiments.


Context. X-ray emission from active galactic nuclei (AGN) is dominated by the accretion disk around a supermassive black hole. The radio luminosity, however, has not such a clear origin except in the most powerful sources where jets are evident. The origin (and even the very existence) of the local bi-modal distribution in radio-loudness is also a debated issue. Aims. By analysing X-ray, optical and radio properties of a large sample of type 1 AGN and quasars (QSOs) up to z > 2, where the bulk of this population resides, we aim to explore the interplay between radio and X-ray emission in AGN, in order to further our knowledge on the origin of radio emission, and its relation to accretion. Methods. We analyse a large (∼800 sources) sample of type 1 AGN and QSOs selected from the 2XMMi XMM-Newton X-ray source catalogue, cross-correlated with the SDSS DR7 spectroscopic catalogue, covering a redshift range from z ∼ 0. 3t oz ∼ 2.3. Supermassive black hole masses are estimated from the Mg ii emission line, bolometric luminosities from the X-ray data, and radio emission or upper limits from the FIRST catalogue. Results. Most of the sources accrete close to the Eddington limit and the distribution in radio-loudness does not appear to have a bimodal behaviour. We confirm that radio-loud AGN are also X-ray loud, with an X-ray-to-optical ratio up to twice that of radio-quiet objects, even excluding the most extreme strongly jetted sources. By analysing complementary radio-selected control samples, we find evidence that these conclusions are not an effect of the X-ray selection, but are likely a property of the dominant QSO population. Conclusions. Our findings are best interpreted in a context where radio emission in AGN, with the exception of a minority of beamed sources, arises from very close to the accretion disk and is therefore heavily linked to X-ray emission. We also speculate that the radio-loud/radio-quiet dichotomy might either be an evolutionary effect that developed well after the QSO peak epoch, or an effect of incompleteness in small samples.


Digital twins relevant for the climate sector are complex, coupled, multi-scale models, which often entail real-world data assimilated onto physical equations. Classifying the predictions of these models, and in particular identifying any rare or atypical outcome, is a formidable challenge which needs to be overcome if digital twins are to achieve their full predictive potential. Here I outline the technical details connected to this challenge and discuss a possible direction forward.


The South African grain-producing regions have suffered severe fluctuations as regard national yields, resulting in measures being taken in respect of certain cereals to bring the supply in line with the national demand. The Swartland is one of the more stable wheat producing regions and the drastic cut in wheat prices during the 1988/89 season caused large-scale dissatisfaction amongst the producers, which in turn led to an investigation into restructuring possibilities in the Swartland. The point of departure was the creation of a representative farming model for the Middle Swartland subregion. Information was gathered by means of postal questionnaires. The dynamic linear programming technique was applied to this model over a twelve year period. The risk factor was then incorporated by applying the Target MOTAD programming technique to the model. A single cash injection of R130 per hectare was necessary to get the DLP model to function successfully. In the DLP model the solution stabilised after a five year period, while the risk model stabilised after eight years. Different cropping and livestock patterns were derived from the models. The general conclusion is that the restructuring of farming patterns in the Swartland has definite potential.


Find adequate or inadequate according to the income level of employees' organizational stress to study the effects of Press and Public Relations Directorate of the Parliament on a survey of employees, distributed by Vos-D Organizational Stress Measurement Survey data were collected. Research data, 14 were evaluated on the basis of the stress factor. T-Test were used for this study. Competence of personnel involved in the study group scores were examined by income level, income level, to have sufficient staff, excessive workload, role ambiguity, responsibility, will attend job-related uncertainty in decision-making process, lack of job satisfaction factors were measured stress score higher than the average for other personnel.


Characterising tidal hydrodynamics in the vicinity of submerged features can be demanding given the hostility of the marine environment. Logistical challenges in the measurement of such flows has promoted research on wake studies through physical and numerical modelling. In this study, site measurements and modelled data are combined to provide an insight into the regional hydrodynamics within a macrotidal strait, namely Ramsey Sound in Pembrokeshire, Wales, UK. The site has received interest from tidal energy developers but is characterised by various steeply inclined bathymetric features, including a semi-submerged pinnacle known as Horse Rock. Understanding how prominent submerged features impact on flow conditions can be crucial for the feasibility and deployment of marine (energy) infrastructure. Observational bedand vessel-mounted acoustic Doppler current profiler (ADCP) data are used to calibrate a coastal ocean model. The depth-averaged model is generated using Thetis, a coastal flow solver based on the finite-element engine Firedrake. Hydrodynamic characteristics are examined at different stages of the spring-neap tidal cycle, highlighting the local and regional influence of prominent bathymetric features. In particular, this study focuses on how common assumptions in tidal stream resource assessment models could hinder model calibration. A variable Manning coefficient field is utilised to represent differences in seabed roughness; this is an approach not generally undertaken in similar modelling studies where a uniform constant coefficient is typically calibrated. Also highlighted is the effect of mesh resolution on capturing certain wake structure characteristics, which points to the need to locally refine the mesh around key bathymetric features to a level that is also not typically applied in modelling studies used for tidal resource assessment.


As an evolutionarily conserved RNA-binding protein, LIN28 is known to be involved in the regulation of the translation and stability of a large number of mRNAs and the biogenesis of certain miRNAs. Increasing evidence indicates that LIN28 regulates many cellular processes, such as embryonic stem cell proliferation, cell fate succession, developmental timing, and oncogenesis. However, the expression and function of LIN28 after intracerebral hemorrhage (ICH) are still unclear. In this study, we performed an intracranial hemorrhage model in adult rats and western blot, immunohistochemistry, as well as immunofluorescence showed that LIN28 was obviously up-regulation in neurons adjacent to the hematoma after ICH. Besides, the transitory increase of LIN28 expression was paralleled with the up-regulation of proliferating cell nuclear antigen (PCNA) as well as GFAP. Hence, LIN28 might play an important role in astrocyte proliferation after ICH.


Disturbances of sleep and night‐time behaviours are amongst the most disabling symptoms of dementia. They often increase carers' burden and the risk of institutionalization. The causes are complex and are difficult to investigate because of a lack of acceptable methods for monitoring behaviours in the home. Here we show that a passive under‐mattress can be used to track changes in night‐time behaviour and physiology, and that a range of digital biomarkers produced are informative in understanding the effects of medication changes, disease progression and intercurrent illness in patients living with dementia (PLWD).


Anatomical segmentectomy is the complete resection of an area supplied by a segmental portal branch. Among segmentectomies, isolated segmentectomy 4 is a technically demanding procedure because there are two transection planes: on the left side along the umbilical fissure and, on the right side, along the middle hepatic vein. Although there are several reports on anatomic segmentectomies, only few regard the anatomic segmentectomy 4a. We report here the case of a 60‐year‐old man who underwent anatomical segmentectomy 4a en bloc with the caudate lobe to resect a colorectal liver metastasis located in segment 4a and involving the paracaval portion of the caudate lobe. This type of procedure was planned in order to maximize the postoperative functional hepatic reserve, thereby reducing the risk of postoperative liver failure and ultimately allowing the possibility for future repeat hepatectomy in case of recurrence. J. Surg. Oncol. 2016;113:665–667. © 2016 Wiley Periodicals, Inc.


This work reformulates the complete electrode model of electrical impedance tomography in order to enable more efficient numerical solution. The model traditionally assumes constant contact conductances on all electrodes, which leads to a discontinuous Robin boundary condition since the gaps between the electrodes can be described by vanishing conductance. As a consequence, the regularity of the electromagnetic potential is limited to less than two square-integrable weak derivatives, which negatively affects the convergence of, e.g., the finite element method. In this paper, a smoothened model for the boundary conductance is proposed, and the unique solvability and improved regularity of the ensuing boundary value problem are proven. Numerical experiments demonstrate that the proposed model is both computationally feasible and compatible with real-world measurements. In particular, the new model allows faster convergence of the finite element method.


Abstract We present analyses of the noise wave field in the vicinity of Virgo, the Italian–French gravitational wave observatory located close to Pisa, Italy, with special reference to the vibrations induced by a nearby wind farm. The spectral contribution of the wind turbines is investigated using (1) onsite measurements, (2) correlation of spectral amplitudes with wind speed, (3) directional properties determined via multichannel measurements, and (4) attenuation of signal amplitude with distance. Among the different spectral peaks thus discriminated, the one at frequency 1.7 Hz is associated with the greatest power, and under particular conditions it can be observed at distances as large as 11 km from the wind farm. The spatial decay of amplitudes exhibits a complicated pattern, which we interpret in terms of the combination of direct surface waves and body waves refracted at a deep (≈800 m) interface between the Plio-Pleistocenic marine, fluvial, and lacustrine sediments and the Miocene carbonate basement. We develop a model for wave attenuation that allows determining the amplitude of the radiation from individual turbines, which is estimated on the order of for wind speeds over the 8–14 m/s range. On the basis of this model, we then develop a predictive relationship for assessing the possible impact of future wind farm projects.


In the Big Data computing, improving performance with memory computing is one of hot spots. In the memory computing, the data deployment directly affects load balance and task efficiency. In the scene of memory computing of electric power data, two unsolved problems are: (1) only memory space, without the CPU frequency and nuclear number, could be considered for load balance and improving performance, (2) there are so many manual operations that it is difficult to complete data deployment automatically. This paper provides an electric power data deployment solution for distributed memory computing to solve the above challenges. In the solution, according to business logic and hardware configuration of cluster nodes, the data deployment strategy can be established. Then, the deployment scheme can be implemented with interface operation. Lastly, cluster nodes load data according to the deployment scheme. The solution has been applied to the Objectification Parallel Computing (OPC). The application result shows that OPC can achieve the best performance which can meet the demand of system efficiency and the operation of data deployment is simple.