Leukemia in humans arises from the multistep accumulation of mutations. However, the identity of the cell of origin, the nature of the first genetic lesion and the order of subsequent mutations remain poorly understood, as most cases of de novo acute myeloid leukemia (AML) are diagnosed without prior observation of a pre-leukemic clonal expansion. As part of studies to examine intra-tumoral genetic heterogeneity in AML, we carried out deep targeted sequencing (read depth 250×) of 101 commonly mutated leukemia genes on samples from 12 patients at diagnosis. Normal T-cells from each sample were expanded in vitro to provide a non-leukemic hematopoietic tissue for comparison. In 3 of 4 patients, we unexpectedly identified DNMT3a mutation not only in AML cells but also in T-cells at a low allele frequency (1-20%). Other genetic alterations such as NPM1 mutation (mutNPM1) were found only in AML cells and not in T-cells, ruling out contaminating AML cells as the source of the DNMT3a signal in cultured T-cells. To investigate the prevalence of T cell involvement, an additional 71 samples from AML patients at diagnosis were screened by Sanger sequencing for DNMT3a mutations. 17 of 71 AML samples (24%) carried R882 codon mutations (mutDNMT3a), and 15 of 17 (88%) also carried mutNPM1. Mutant allele frequency in freshly isolated T-cells was measured by droplet digital PCR (ddPCR). mutDNMT3a with no evidence of mutNPM1 was detected in T-cells of 12 of 17 patients (70.5%), suggesting that DNMT3a mutation occurs before NPM1 mutation in an ancestral stem/progenitor cell that gives rise to both T-cells and the dominant AML clone present at diagnosis. To directly determine whether phenotypic stem/progenitor cells that carried the mutDNMT3a allele could be identified within the non-leukemic hematopoietic compartment of AML blood and bone marrow samples, we undertook genetic analysis of highly-resolved phenotypically-defined normal stem, progenitor and mature lymphoid cell fractions from 10 patient samples. mutDNMT3a without detectable mutNPM1was present in stem cells and all downstream progenitors, with mean allele frequency among multipotent progenitor (MPP), multilymphoid progenitor (MLP) and common myeloid progenitor (CMP) of 31.7%. mutDNMT3a and mutNPM1 were found together only in granulocyte monocyte progenitor (GMP) and CD33+ blasts. Importantly, even for patients in whom mutDNMT3a was not detected in mature lymphoid populations, mutDNMT3a without mutNPM1 was found in MPP, MLP, CMP, providing strong evidence that mutDNMT3a precedes mutNPM1 during leukemogenesis. Analysis of diagnostic and remission samples revealed similar or higher proportion of cells with mutDNMT3a alone at remission compared to diagnosis. Xenotransplantation of cells from the diagnostic samples of 2 patients with mutDNMT3a and mutNPM1generated predominantly non-leukemic multilineage grafts (18 of 19 mice) with predominance of cells bearing mutDNMT3a without mutNPM1 (mean allele frequency 57%), confirming that mutDNMT3a was present in HSC. Kinetic analysis at 8 and 16 weeks revealed increasing mutDNMT3a allele frequency in multilineage xenografts over time, suggesting that mutDNMT3a confers a competitive growth advantage over non-mutated HSC. Collectively, our results are consistent with the clonal expansion in AML patients of mutDNMT3a HSC that survive chemotherapy. These cells may therefore represent a reservoir for further genomic progression leading to relapse. Our findings now offer the possibility of therapeutic intervention during remission to eliminate these surviving pre-leukemic clones and prevent relapse in a large proportion of AML patients carrying mutDNMT3a. As well, our work provides a framework for the identification of other early events in leukemogenesis and examination of how these changes disrupt normal HSC function and lead to leukemia.

Disclosures: Wang: Trillium Therapeutics/Stem Cell Therapeutics: Research Funding.


T his paper focuses on the issues of coalition formation and cost allocation in a joint replenishment system involving a set of independent and freely interacting retailers purchasing an item from one supplier to meet a deterministic demand. The papers dealing with this problem are mainly focused on supperadditive games, where the cost savings associated with a coalition increase with the number of players in the coalition. The most relevant question addressed then is how to allocate the savings to the players. In this paper, we propose to go further by dealing with a non-supperadditive game, where a set of independent retailers have the common understanding to share the cost savings according to the cost-based proportional rule. In this setting, the global cost optimization is no longer a relevant approach to identify appealing coalitions for any retailer. Here, we provide an iterative procedure to form the so-called efficient coalition structure and we show that this coalition structure has the nice properties of being (i) weakly stable in the sense of the coalition structure core and (ii) strongly stable under a given assumption. An exact fractional programming based solution is also given to generate such efficient coalitions.


We study non-Markovianity and information flow for qubits experiencing local dephasing with an Ohmic class spectrum. We demonstrate the existence of a temperature-dependent critical value of the Ohmicity parameter s for the onset of non-Markovianity and give a physical interpretation of this phenomenon by linking it to the form of the reservoir spectrum. We demonstrate that this link holds also for more general spectra. We unveil a class of initial states for which discord is forever frozen at a positive value. We connect time invariant discord to non-Markovianity and propose a physical system in which it could be observed.


AIM
To observe the dynamic changes and disappearance of three kinds of schistosome circulating antigens(CAgs) in infected rabbits before and after praziquantel treatment.

METHODS
Dot-ELISA assays were developed by using 3 McAbs to determine the dynamic changes of the gut-associated antigen (GAA), membrane-associated antigen (MAA) and soluble egg antigen (SEA) respectively in sera of rabbits infected with S. japonicum.

RESULTS
By the 4th week after infection 39% of the rabbits infected with S. japonicum were GAA positive and only 8.6% were MAA or SEA positive. All the infected rabbits becOme positive with GAA, MAA and SEA by the 8th week after infection. The titers of the GAA, MAA and SEA in sera of the infected rabbits reached their peaks by the 10th week after infection. Titers from rabbits of the untreated group rabbits remained high level until the 27th week after infection. SEA titers were found negative in 10% of the infected rabbits in the treatment group by the 6th week after treatment. The titers of GAA of, MAA' and SEA were found negative in 20%, 80% and 70% of the rabbits in the treatment group, respectively the 8th after treatment. GAA, MAA and SEA in sera except one of the treated rabbits were all negative by the 14th week after treatment.

CONCLUSION
The determination of GAA is useful for the early diagnosis of schistosomiasis, while the determination of, MAA and SEA might be used for the efficacy evaluation.


Abstract We present a case of a 59-year-old woman with a malignant tumor arising within presacral teratoma associated with Currarino syndrome (CS). A characteristic crescent-shaped sacrum was detected on preoperative image examination and the presacral mass was pathologically diagnosed as a malignant tumor associated with CS. To our knowledge, this is the first case report of presacral teratoma associated with CS coexisting with both adenocarcinoma and a neuroendocrine tumor.


This paper presents experimental research on cutting a single stalk of triticale straw for the production of biofuel in the process of its compaction using the piston technique. In the first stage of the experimental study of cutting single triticale straws, the variable parameters were the moisture contents of the stem equal to 10% and 40%, the offset between the blade and the counter-blade g, and the linear velocity of the knife blade V. The blade angle and rake angle were equal to α = 0° and β = 0°. In the second stage, the variables, including the blade angle values α = 0°, 15°, 30°, and 45° and the rake angle values β = 5°, 15°, and 30°, were introduced. Taking into account the analysis of the distribution of forces on the knife edge leading to the determination of the force quotients Fc″/Fc and Fw/Fc, and on the basis of the optimization performed and the adopted optimization criteria, the optimal knife edge angle α can be determined (at values g = 0.1 mm and V = 8 mm/s) at α ≅ 0° and the angle of attack β within the range of 5–26°. What the value will be in this range depends on the value of the weight adopted in the optimization. The choice of their values may be decided by the constructor of the cutting device.


Titles in the Complete series combine extracts from a wide range of primary materials with clear explanatory text to provide readers with a complete introductory resource. This chapter discusses the nature and extent of constitutional conventions, which are political rules that are binding upon those to whom they apply. They apply to the relationships between the Crown, Parliament, the judiciary, the civil service, and the executive, and play a key role in limiting the powers granted to institutions of government by unwritten rules or sources. Constitutional conventions also regulate key parts of the relationship between the institutions of government. The doctrine of ministerial responsibility is one of the most important examples of constitutional conventions regulating the behaviour of the executive. There are two main branches of ministerial responsibility. One is individual ministerial responsibility—that is, a minister's obligation to account to Parliament for his or her words and actions and for those of his or her civil servants. The second branch of ministerial responsibility is collective ministerial responsibility. Amongst other things, collective ministerial responsibility prescribes that decisions reached by the Cabinet or other ministerial committees are binding on all members of the government, regardless of whether or not the individual ministers agree with them.


Dorsocommissural flaps are pedicled flaps with retrograde flow, anastomosed to the dorsolateral vessels of the proximal phalanx of one of the two fingers adjacent to the site of the commissure flap. The authors describe the anatomical basis and operating technique. A clinical case illustrates the simplicity and reliability of the technique. The indications for these flaps are digital skin defects either palmar involving the proximal phalanx and metacarpophalangeal joint, or dorsal involving the middle phalanx and the distal interphalangeal joint.


. This study focuses on the words of the year in German as a comparatively understudied linguistic phenomenon. The article attempts to describe the term "word of the year" in comparison with the close to it term "neologism". In addition to determining the status of words of the year in modern linguistics, special attention is paid to the further fate of words of the year after their publication, their role in adding to the vocabulary of the German language and lexicographical status. The words of the year are comparable to neologisms: most words of the year are the result of word formation, adoption or expansion of the meaning of the word. However, among the words of the year there is a group of lexical units that have long existed in the German language. This group clearly demonstrates the nature of the words of the year. Words the year are lexical units, the meaning of which is particularly relevant. Relevance means the significance of a lexical unit for native speakers of language and culture as a whole in a specific time period, as well as the possible increase in its frequency of use associated with it. The short fixed time existence the status the word the year and its correlation with a specific time period unite words of the year and neologisms. There is also a coincidence of their further life path, which may lead to the fixation of words or their meanings in the language, as well as to their disappearance.The inclusion of words of the year in the dictionary is not determined by high frequency of use, presence of derivative, paradigmatic and syntagmatic activity. These factors are important only for neologisms. The determining criterion for words of the year is their semantics.


Hydroacoustics has become a requisite method to assess fish populations and allows to describe the relationships of fish with other elements of the aquatic ecosystem. This nonintrusive method is currently an integral part of the sampling procedures recommended for fish stock assessment by the Water Framework Directive and has been standardized by the European Committee for Standardization [CEN (2014) CSN EN 15910 ‐ Water quality ‐ Guidance on the estimation of fish abundance with mobile hydroacoustic methods, Category: 7577 Water quality. Biological.]. In Europe, hydroacoustic surveys are performed in freshwater using different frequencies. Consequently, there is a need to evaluate if survey results can be compared. This study aimed to carry out in situ comparisons at the 38 kHz frequency (noted f) with two other commonly used frequencies, 70 and 200 kHz. The 38 kHz frequency has seldom been compared with other frequencies in freshwater although it is widely used worldwide, especially in the Great Lakes of North America and in Sweden. In 2016, hydroacoustic data were acquired in Lakes Annecy and Bourget using methods validated in previous studies that compared the frequencies 70, 120 and 200 kHz. This study showed similar density and biomass estimations as a function of frequency, density(f) and biomass(f), between the frequencies studied for low to moderate fish densities. For higher fish densities, the results were more variable and need to be verified. Fish density(f) and biomass(f) estimations sometimes exhibit differences between frequencies, which is not fully in agreement with theoretical calculations. The aim of this study was to evaluate frequency comparisons in practise. However, if the differences on acoustic metrics, density(f) or biomass(f) between frequencies were occasionally statistically significant, the differences were small enough to be considered negligible for fish population management. These analyses led to better knowledge of the responses from fish in temperate lakes for the studied frequencies. Our findings should be considered when revising the CEN standard.


Hypersensitivity to pegaspargase is associated with inferior survival in pediatric patients with acute lymphoblastic leukemia and lymphoblastic lymphoma. In the past year, drug‐supply shortages have led to the lack of an available alternative to pegaspargase. Rather than omit asparaginase from the treatment of acute lymphoblastic leukemia or lymphoblastic lymphoma patients with hypersensitivity to pegaspargase, we continued pegaspargase treatments for nine pediatric patients, utilizing a rapid desensitization protocol. There were no adverse events related to the pegaspargase during desensitization, and all patients who were checked had asparaginase serum levels above the threshold of 0.1 IU/mL at 7 to 14 days after pegaspargase therapy.


PALAVRAS-CHAVES: Mulheres, Diabetes gestacional. The mellitos diabetes is a systemic disease characterized by the dismetabolism of carbohydrates. It can be similar in man and woman. During the pregnancy the woman com be attacked. We identied the feelings of diabetic pregnant, the complications of the disease towards the embryo. The study was done in amaternity in Fortaleza – Ceara –Brasil, with to pregnant during the months August to october of 1999. The interviews were recorded and ranked by types. We concluded that the pregnancy is a period of emotional crisis, herself insecure because of the ignorance about the disease and also concerning to the problems.


Regulatory restrictions have increased in recent years on organisms produced using recombinant DNA and asexual gene transfer, a process commonly called genetic engineering or genetic modification. Regulatory agencies have raised special concerns and required additional scrutiny for perennial grasses and woody plants of interest for biofuels; these plants have incomplete domestication, invasive capabilities, and the ability to mate with wild or feral relatives. Regulations on these plants require extremely stringent containment through all phases of research and development, regardless of the source of the gene, the novelty of the trait, or the plants' anticipated economic or environmental benefits. We discuss the extent to which these requirements conflict with the realities of practical crop breeding, and prevent meaningful agronomic and environmental studies, thus hampering—and in most cases, precluding—the use of recombinant DNA breeding methods for perennial crop improvement. We propose regulatory reforms to better balance benefit and risk and remove unnecessary barriers to agronomic evaluations and environmental studies.


The main characteristics of the companies carrying out and exhibiting interest in trade with Sub-Saharan Africa are identified based on the analysis of a representative survey of Bulgarian enterprises. In order to deepen and streamline the results obtained and to formulate adequate recommendations to the companies and the government for the future development of their policies, a number of companies with real trade relations with countries from the region were identified, with which structured interviews were conducted. The study discusses the results obtained – the first section presents briefly the general features of Bulgarian trade with Sub-Saharan Africa, the second focuses on the identified synthetic profile of Bulgarian companies trading with the region, while the third, main part of the study summarises the attitudes and assessments of Bulgarian business outlined within the structured interviews.


Introduction Mechanical thrombectomy for large vessel occlusion in the anterior circulation has been shown to be beneficial. The question of whether this technique is safe and effective in the distal vasculature remains unanswered. We wanted to compare outcome data from mechanical thrombectomy of M2 branches of the middle cerebral artery (MCA) with those of the M1 segment, and better understand the clinical predictors of these M2 occlusions. Methods A retrospective analysis was performed of data prospectively collected between January 2017 and July 2021 from patients with acute ischemic stroke undergoing mechanical thrombectomy of isolated M1 or M2 branches of the MCA. Results 350 patients were identified, 287 with M1 and 63 with M2 occlusions. Mean age was 70.71 ± 12.55 and 75.21 ± 10.21 years, respectively (p = 0.0083). Baseline Alberta Stroke Program Computed Tomography (ASPECT) score was worse in the M1 cohort (7.68 ± 1.73 vs. 8.32 ± 1.54; p = 0.0079), while there was no significant difference in National Institutes of Health Stroke Scale (NIHSS) scores. No statistical disparity existed in mean procedure duration for each cohort; fewer thrombectomy attempts were required in the M2 cohort (2.01 vs. 1.63; p = 0.0478). There was no statistical difference in total time to recanalization (559.19 vs. 629.97, p = 0.2506). Similar rates of successful reperfusion were observed (Thrombolysis in Ischaemic Stroke score [TICI] ≥ 2b 80.84% vs. 71.43% p = 0.1221). Good outcome (modified Rankin scale ≤ 2) was 56.10 in M1 occlusions and 63.49% on M2 groups. Intracranial haemorrhage rates were similar. Conclusions M2 thrombectomy is safe and a significant proportion of patients achieve a good clinical outcome. Advanced age, atrial fibrillation and previous treatment with anticoagulants were predictors for poor outcome. Good outcome was achieved when effective recanalization was obtained.


Amplification corrections are presented for the finite-fault stochastic ground-motion simulation model; these corrections represent the total effect of the Los Angeles basin on the ground-motion spectra. Spectral amplification ratios were calculated by dividing the observed spectra for the 1994 Northridge and 1987 Whittier Narrows earthquakes, including shear- and basin-generated waves, by the simulated spectra created assuming an average rock-site condition. Smoothed amplification data were plotted above 3D images of the basin revealing a general correlation between the estimated basin depth and total basin amplification for both earthquakes over three frequency ranges: low (0.2-2 Hz), intermediate (2-8 Hz), and high (8-12.5 Hz). The depth-dependent corrections are derived from the regression of the combined data from both earthquakes in order to reduce an uncertainty caused by the azimuth of incoming waves.

Ground-motion duration is defined as the time for 95% of the acceleration spectral energy to pass after the S -wave arrival. Due to ambiguity in defining a basin parameter controlling duration, it was impossible to develop a generic equation that would relate the duration ratio (observed/synthetic) to some characteristic of the basin. Users are cautioned, though, that the durations within the basin may be as much as four times longer than the simulated ones.

The procedure is outlined for potential users who wish to use the results of this study in synthesizing more accurate earthquake ground motions, taking into account complicated basin-geometry and near-surface effects. The results are directly applicable to engineering simulation of strong ground motions in a sedimentary-basin environment.

Manuscript received 21 May 2002.


This experiment was conducted to determine the primary ligamentous restraints to anterior and posterior translation of the sternoclavicular joint. Twenty-four unpaired cadaver specimens were mounted in a custom fixture. Anterior and posterior translations were measured under a sub-failure load in the intact specimen and again after transecting one randomly chosen ligament (anterior capsule, posterior capsule, interclavicular ligament, and costoclavicular ligament; n = 6 for each group). Cutting the posterior capsule resulted in significant increases in anterior translation and posterior translation. Cutting the anterior capsule produced significant increases in anterior translation. Cutting the costoclavicular and interclavicular ligaments had little effect on sternoclavicular joint translation. The posterior capsule is the most important restraint for anterior and posterior translation of the sternoclavicular joint. The anterior capsule is another important restraint for anterior translation. The costoclavicular and interclavicular ligaments have little effect on anterior or posterior translation of the sternoclavicular joint.


I am grateful for Dr. David Hagenbuch's survey of the Bible record on the question of using shocking advertising messages. His article is an example of how Bible study by a business scholar can go deeper than the use of a few Bible texts to prove a point. The article presents an organized method of research into the Bible record. The article has raised my awareness that the volume of biblical data to study for this issue may be greater than we at first thought. It fueled my curiosity regarding what other insights the Bible may offer on this question.


A new method of processing of data obtained using atomic force microscopy (AFM) in the oscil-lating nanoindentation mode is proposed. The model of the AFM probe on elastic beam (canti-lever) interaction with a sample is developed. In addition to the static load, applied on a base of the cantilever, a force modulation, according to a harmonic law, is set. This approach makes possible to take into account not only the force of the probe-material interaction but also the phase shift of the cantilever oscillations with respect to a given harmonic signal on the cantilever base as well as the amplitudes ratio of these oscillations. This information allows the presence of the viscosity in the material evaluating. The advantage of the oscillatory regime over quasistatic indentation was shown. It consists in the possibility to exclude the influence of irreversible pro-cesses (plastic, brittle fracture in the material) on the result of the experiment and to reveal the presence of the time dependent behavior. It is shown that the model contains a small amount of constants; methods for their determination are proposed. The calculations, performed using the developed model, made it possible to make a number of recommendations on choosing the can-tilever stiffness to obtain the most informative experimental results. This approach seems per-spective in studying materials with a high degree of stiffness inhomogeneity, including the deter-mination of the local properties of filled nanocomposites near filler particles.


To assess the contributions of rustic shade cacao plantations to vascular epiphyte conservation, we compared epiphyte species richness, abundance, composition, and vertical distributions on shade trees and in the understories of six plantations and adjacent natural forests. On three phorophytes and three 10 × 10 m understory plots in each of the agroforestry plantations and natural forests, 54 and 77 species were observed, respectively. Individual‐based rarefaction curves revealed that epiphyte species richness was significantly higher on forest phorophytes than on cacao farm shade trees; detailed analyses showed that the differences were confined to the inner and outer crown zones of the phorophytes. No differences in epiphyte species richness were found in understories. Araceae, Piperaceae, and Pteridophyta were less species‐rich in plantations than in forests, while there were no differences in Orchidaceae and Bromeliaceae. Regression analysis revealed that epiphyte species richness on trunks varied with canopy cover, while abundance was more closely related to soil pH, canopy cover, and phorophyte height. For crown epiphytes, phorophyte diameter at breast height (dbh) explained much of the variation in species richness and abundance. There were also pronounced downward shifts in the vertical distributions of epiphyte species in agroforests relative to natural forests. The results confirm that epiphyte diversity, composition, and vertical distributions are useful indicators of human disturbance and showed that while the studied plantations serve to preserve portions of epiphyte diversity in the landscape, their presence does not fully compensate for the loss of forests.


Aims Plants with a history of overgrazing show trait-mediated legacy effects. These legacy effects strongly influence growth dynamics and stress tolerance of grassland plants, thus impacting ecosystem functioning. Long-term overgrazing has strong effects on plant growth and carbon assimilation via asexual propagation. However, the links between nitrogen (N) cycling and grazing-induced plant legacy effects are largely unknown.Methods We tested the strength of legacy effects of long-term overgrazing on N metabolism in the clonal plant Leymus chinensis, and its associated changes at the physiological and molecular levels. These tests were conducted in both field and greenhouse experiments.Results The clonal offspring of overgrazed L. chinensis were significantly smaller than the control offspring, with lower individual N uptake and N utilization efficiency, indicating that the N dynamics were impacted by plant legacy effects. The response ratios of root traits to N patches in the clonal offspring of overgrazed L. chinensis were significantly higher than those of the control, indicating that root nutrient foraging plasticity increased to cope with grazing-induced N heterogeneity. Moreover, the observed plant legacy effects slightly decreased N absorbability in roots but significantly increased N assimilation capacity, by increasing N resorption efficiency in particular, with biotic stress memory activated at the enzymatic and transcriptional levels.Conclusions We propose that multigenerational exposure of perennial plants to herbivore foraging can produce a legacy effect on nutrient uptake, which offers insights into the potential resilience of grasslands to overgrazing.


Stem cells have the surprising potential to develop into many different cell types. Therefore, major research efforts have focused on transplantation of stem cells and/or derived progenitors for restoring depleted diseased cells in degenerative disorders. Understanding the molecular controls, including alternative splicing, that arise during lineage differentiation of stem cells is crucial for developing stem cell therapeutic approaches in regeneration medicine. Alternative splicing to allow a single gene to encode multiple transcripts with different protein coding sequences and RNA regulatory elements increases genomic complexities. Utilizing differences in alternative splicing as a molecular marker may be more sensitive than simply gene expression in various degrees of stem cell differentiation. Moreover, alternative splicing maybe provide a new concept to acquire induced pluripotent stem cells or promote cell–cell transdifferentiation for restorative therapies and basic medicine researches. In this review, we highlight the recent advances of alternative splicing regulation in stem cells and their progenitors. It will hopefully provide much needed knowledge into realizing stem cell biology and related applications.


The miniaturization of ferroelectric devices offers prospects for non-volatile memories, low-power electrical switches and emerging technologies beyond existing Si-based integrated circuits. An emerging class of ferroelectrics is based on van der Waals (vdW) two-dimensional materials with potential for nano-ferroelectrics. Here, we report on ferroelectric semiconductor junctions (FSJs) in which the ferroelectric vdW semiconductor α-In2Se3 is embedded between two single-layer graphene electrodes. In these two-terminal devices, the ferroelectric polarization of the nanometre-thick In2Se3 layer modulates the transmission of electrons across the graphene/In2Se3 interface, leading to memristive effects that are controlled by applied voltages and/or by light. The underlying mechanisms of conduction are examined over a range of temperatures and under light excitation revealing thermionic injection, tunnelling and trap-assisted transport. These findings are relevant to future developments of FSJs whose geometry is well suited to miniaturization and low-power electronics, offering opportunities to expand functionalities of ferroelectrics by design of the vdW heterostructure.


The conventional photographic prints obtained from double crystal x-ray topography are often hard to interprete and reproduce. Photographic enhancement methods require skillful work by an experienced photographer. They are time consuming and the image information is difficult to present quantitatively. Alternatively, image processing methods may be applied by digitization of the original topographic recording. Image processing computer programs may be applied, e.g., for image enhancement and for quantification of image information. This paper's main interest is related to-obtaining a sufficiently high magnification ratio;-correcting for intensity variations within the image;-applying spatial filtering techniques in order to reduce film grain noise;-improving contrast, and-retrieving quantative information on image details.The application of such image processing routines is exemplified on topographs obtained by a double-crystal diffractometer set to the (+, -) asymmetric-asymmetric setting. A silicon single crystal was used as the monochromator, while the sample was a silicon single crystal which had undergone both surface damage and metallic contamination before the application of Rapid Thermal Annealing (RTA). Hence, well-defined microdefects are found within the sample. These computer-processed images are compared with corresponding images enhanced by conventional techniques. The results provide indications of which enhancement procedures should be applied for qualitative image improvement and for quantification of image details within different types of topographic recordings.


Numerical models can be useful for analysis of the ability of structural engineering materials to withstand harsh environmental conditions such as dynamic loading. In the present study, a microstructure-variable-based numerical model for predicting the high strain rate and temperature properties of different microstructures of Ti6Al4V (ELI-Extra Low Interstitial) produced by laser-based powder bed fusion is proposed. The model was implemented in two different subroutines, VUMAT and VUHARD, available in ABAQUS/Explicit for simulating dynamic conditions. The two subroutines were then used to simulate the split Hopkinson pressure bar (SHPB) experiments to study the flow properties of various forms of the direct metal laser sintered Ti6Al4V(ELI) alloy at various conditions of strain rate and temperature. Comparison of the results obtained through simulation and those obtained from experimental testing showed high degrees of correlation and accuracy with correlation coefficients and absolute percentage errors >0.97 and <4%, respectively. The numerical model was also shown to give good predictions of the strain hardening and dynamic recovery phenomena that prevail for deformations at high strain rates and temperatures.


This paper presents design and digital implementation of a fuzzy controller for achieving improved performance of Brushless dc (BLDC) servomotor drive. The performance of fuzzy and PID controller-based BLDC servomotor drives is investigated under different operating conditions such as change in reference speed, parameter variations, load disturbance, etc. BLDC servomotors are used in aerospace, instrumentation systems, space vehicles, electric vehicles, robotics, and industrial control applications. In such applications, conventional controllers like P, PI, and PID are being used with the BLDC servomotor drive control systems to achieve satisfactory transient and steady-state responses. However, the major problem associated with the conventional PID controller is that the tuned gain parameters obtained for such BLDC servomotor drive control systems do not yield better transient and steady-state responses under different operating conditions such as parameter variations, load disturbances, etc. In this paper, design and implementation of fuzzy controller is presented and its performance is compared with PID controller to show its capability to track the error and usefulness of fuzzy controller in control applications.


Background Asthma and chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) is an increasingly recognized phenotype. Few randomized clinical trials have been conducted in patients with ACOS; therefore, scientific evidence concerning ACOS is scarce and a therapeutic approach remains unclear. The aim of this study was to evaluate current treatment trends for patients with ACOS, identified as those with a dual definition of asthma and COPD, in a real-world COPD cohort. Methods Data were analyzed from patients with asthma and COPD in the USA, France, Germany, Italy, Spain, and the UK who participated in the 2012 and 2013 Adelphi Respiratory Disease Specific Programmes (DSPs). Patients with ACOS were identified in the COPD population; these patients had a physician-confirmed, concomitant asthma diagnosis. Physicians completed a patient record form providing information on patient and disease characteristics including prescribed respiratory treatment. Pairwise comparisons were made between the ACOS, asthma, and COPD populations using χ2 tests. Results In total, 9,042 patients with asthma-only, 7,119 patients with COPD-only, and 523 patients with ACOS (a dual diagnosis of asthma and COPD) participated in the study. The most commonly prescribed regimens were inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) + long-acting muscarinic antagonist (LAMA); (ACOS 30%, asthma 1.4%, and COPD 32%), ICS/LABA (19%, 41.5%, and 17%, respectively), and LAMA (6%, 0.4%, and 19%, respectively); 18% of patients with ACOS were not prescribed an ICS. Patients with ACOS had a significantly higher incidence of gastroesophageal reflux disease, diabetes, and obesity and experienced more exacerbations in the past year than those with COPD or asthma. Conclusions The majority of patients with ACOS, as defined in this research, were prescribed similar treatment to those with COPD. There is a need, however, for better treatment for patients with ACOS, as indicated by symptoms and exacerbation levels. A clearer therapeutic approach for patients with ACOS is required.


Sarcoidosis is a systemic inflammatory disease of unknown etiology that is characterized by the presence of granulomatous inflammation in affected tissues. It can affect essentially any organ system but shows a predilection for the lungs, eyes, and skin. Accurate epidemiological data are not available in the USA, but sarcoidosis is considered a 'rare disease' (prevalence less than 200,000). However, recent epidemiologic studies indicate that regional prevalence is much higher than previously estimated, especially among African American women. Additionally, mortality rates of patients with sarcoidosis are increasing by 3% per year over the past two decades. The most common causes of death are attributed to progressive lung disease and cardiac sarcoidosis, and the health of the patients is further compromised by other systemic manifestations. As such, the management of sarcoidosis requires a collaborative multidisciplinary approach. We aim to discuss the principles of managing sarcoidosis, including standards of care relating to pulmonary disease as well as recent advances relating to the detection and treatment of extrapulmonary manifestations.


The relationship between effusion of the temporomandibular joint (TMJ) and patient-reported disability is poorly researched. This pilot study explored the link between TMJ inflammation as measured by ultrasound and patient disability assessed by the Steigerwald Maher TMD Disability Index (SMTDI). The study design used a prospective correlational approach involving a sample with TMJ dysfunction (TMD). Twenty-four patients were recruited from the European School of Osteopathy and a Kent dental practice. Participants completed the SMTDI to determine the level of TMD (symptomatic score >20). A SonoSite SLA "Hockey Stick" [13-6 MHz] musculo-skeletal transducer was placed over the TMJ in a transverse direction and effusion was calculated indirectly by measuring capsular width. An upper left quadrant protocol was used throughout. A regression analysis was run with participants' gender, age and capsular width as predictor variables modelled against reported SMTDI. Larger capsular widths were found to be significant predictors of SMTDI scores (r = 0.803, p < 0.0001). The patient profile matched with the previous studies and the TMD sufferer population, indicating external validity. Results suggest that the SMTDI could be integrated into practice life as a quick, accessible and easy tool to monitor patients' progress and assess levels of inflammation, without the need for repetitive imaging. The study design proved reproducible and a larger scale study is indicated.


The presence of measurement noise in the data used in empirical modeling can have a drastic effect on the accuracy of estimated models, and thus need to be removed for improved model accuracy. Multiscale representation of data has shown great noise-removal ability when used in data filtering. In this paper, this ability is exploited to improve the prediction accuracy of the Takagi-Sugeno (TS) fuzzy model by developing a multiscale fuzzy (MSF) system identification algorithm. The algorithm relies on constructing multiple fuzzy models at multiple scales using the scaled signal approximations of the input-output data, and then selecting the optimum multiscale model which maximizes the prediction signal-to-noise ratio. The developed algorithm is shown to outperform its time domain counterpart through a simulated example.


This study examines the impact of oil and gas rent on promoting economic growth in Algeria over the period (1980-2010) using Engle-Granger cointegration test and error correction model , findings indicate that both oil and gas rent have a positive impact on enhacing economic growth in Algeria in the long term , error correction model confirms the existence of positive relationship between variables in the long and short term for two models. These results emphasize the great dependece of Algerian economic growth on oil and gaz rent.Thus, Algerian government must carefully lead the process of allocating and monitoring the use of oil and gas revenue and turning it into positive economic growth. Furthermore, policymakers should care more about economic activities diversification in order to reduce the dependence on oil and gas sector, as well as rent seeking activities, especially with the appearance of alternative forms of energy (such as wind, water, and solar power).


The purpose of this research is to analyze the simultaneity between trading volume and order imbalance, the influence of past performance, market risk, market capitalization, tick size totrading volume and the influence of tick size, depth and bid-ask spread to order imbalance of companies were listed on LQ 45 index. Sample in this research were selected by using purposive sampling method with some selected criterias. 55 companies listed on 2014's LQ 45 index were chosen as sample. The results showed that trading volume is simultaneously related to order imbalance; past performance, market risk and market capitalization have a positive and significant effect to trading volume, tick size has a negative and significant effect to trading volume, order imbalance has a negative and not significant effect to trading volume; tick size, depth, bid-ask spread, and trading volume have no significant effect to order imbalance.


XXI century emphasized humanity to embrace the digital era after a reality of Third and Fourth Industrial Revolutions, nowadays dictating new terms of social networking. It is expected that information and communication technologies integrated with value-based medicine will significantly impact healthcare delivery to tremendous number of patients with socially important noncommunicable diseases. Cardiovascular illnesses comprise the greatest part of such pathologies. Hypertension (HTN) being the most prevalent cardiovascular disease is also the key modifiable cardiovascular risk factor yet seems to be an attractive target for both value-based concept and telehealth interventions. Present review addresses up-to-date science on telehealth, sets out the main well-known, but yet unsolved challenges in management of HTN along with the new approaches involving telemedicine programs, digital health outlooks. The main barriers of telehealth implementation are also considered along with the possible solutions.


Primary biliary cholangitis (PBC) is a cholestatic autoimmune liver disease characterized by the gradual destruction of small intrahepatic bile ducts that eventually leads to liver cirrhosis, failure, and even carcinoma. The treatment options for PBC are limited, and the main treatment choices are the US Food and Drug Administration–approved ursodeoxycholic acid and obeticholic acid. However, many patients fail to respond adequately to these drugs and the adverse effects frequently lead to low life quality. For patients with end-stage PBC, liver transplantation remains the only effective treatment. Given their low immunogenicity, prominent immunomodulation property, differentiation potential, and tissue maintenance capacity, mesenchymal stem cells (MSCs) are emerging as new options for treating liver diseases, including PBC. Accumulating evidence from basic research to clinical studies supports the positive effects of MSC-based therapy for treating PBC. In this review, we characterized the underlying roles and mechanisms of MSCs for treating liver diseases and highlight recent basic and clinical advances in MSC-based therapy for treating PBC. Finally, the current challenges and perspectives for MSC-based therapy in clinical application are discussed, which could help accelerate the application of MSCs in clinical practice, especially for refractory diseases such as PBC.


Chronic pelvic pain (CPP) is complex and often resistant to treatment. While the exact pathophysiology is unknown, the pain states resultant from conditions such as interstitial cystitis and the like yield patients with a presentation that bears a striking similarity to neuropathic syndromes that are known to respond to neuromodulation. While there has been past success using the sacral region as a target for spinal cord stimulation (SCS) to treat these patients, there remains to be a consensus on the optimal location for lead placement. In this article, the authors discuss the potential etiology of CPP, examine the current literature on lead placement for SCS as a method of treatment, as well as present several cases where novel lead placement was successfully employed.


The effects of multiple applications of hydrophobic kaolin particle film on apple orchard bug (Heteroptera), beetle (Coleoptera) and spider (Araneae) assemblages were studied in the Netherlands. Insecticide-free orchard plots served as a control. The kaolin applications significantly reduced the abundance and species richness of the communities and also altered their composition and diversity. The treatments disrupted many non-target groups notably mycophagous, predacious and tourist beetles, zoophagous bugs and spiders. Among spiders, wanderer spiders (Thomisidae, Philodromidae) were most affected, whereas web building spiders (Dictynidae) were least affected. After ceasing the applications in July, the between-treatment differences in composition of all communities and diversity of heteropterans and spiders diminished while the differences in abundance and species richness remained for a long time, until the end of September. Many predator species with good colonisation ability recovered slowly after the treatments, mainly due to the scarcity of prey.


The changes of the surface properties of Au, GaN, and SiO x after UV light irradiation were used to actively influence the process of formation of Pseudomonas aeruginosa films. The interfacial properties of the substrates were characterized by X-ray photoelectron spectroscopy and atomic force microscopy. The changes in the P. aeruginosa film properties were accessed by analyzing adhesion force maps and quantifying the intracellular Ca2+ concentration. The collected analysis indicates that the alteration of the inorganic materials' surface chemistry can lead to differences in biofilm formation and variable response from P. aeruginosa cells.


The study explores the psychosocial care-givers knowledge and skills on medical and psychosocial issues in Hemophilia pre-and post participation in the training program conducted in four different North Indian States. The objectives of the study is 1) To approach a cross-section of psychosocial workers and ascertain their views on the psychosocial support in Hemophilia; 2) To critically examine the views/perceptions of the psychosocial workers pre and post training workshop .3) To analyze the responses of the psychosocial workers about medical and psychosocial implications of hemophilia. 4) To identify issues, emerging from empirical evidence, which could be utilized for preparing the guidelines for the psychosocial workers. The findings showed that overall the psychosocial care-givers awareness improved post training on different subsets on the psychosocial awareness questionnaire. This indicates that regular education and updating of knowledge of the care-givers is important. A close perusal of findings suggests that age and experience were closely related to the awareness on the psychosocial issues in Hemophilia. It was found that the young respondents' awareness significantly improved post training whereas there were moderate changes in the responses of the older participants. On the whole, the change in awareness level witnessed after training illustrates that by providing adequate education and information, good results can be achieved, that will benefit PWH and their families, as well as those responsible for giving care to patients suffering from hemophilia.


We begin by developing a baseline quantitative urban model of internal city structure based on Ahlfeldt, Redding, Sturm and Wolf (2015). This model incorporates agglomeration and dispersion forces and an arbitrary number of heterogeneous locations within a city, while remaining tractable and amenable to analytical analysis. We consider a city embedded within a wider economy. The city consists of a set of discrete locations or blocks, which are indexed by i = 1, ..., S. Each block has an e ective supply of oor space Hi. Floor space can be used commercially or residentially, and we denote the endogenous fractions of oor space allocated to commercial and residential use by θi and 1− θi, respectively. The city is populated by an endogenous measure of L̄ workers, who are perfectly mobile within the city and the larger economy, which provides a reservation level of utility Ū . Workers decide whether or not to move to the city before observing idiosyncratic utility shocks for each possible pair of residence and employment blocks within the city. If a worker decides to move to the city, she observes these realizations for idiosyncratic utility, and picks the pair of residence and employment blocks within the city that maximizes her utility. Firms produce a single nal good, which is costlessly traded within the city and the larger economy, and is chosen as the numeraire (pi = p = 1). Markets are perfectly competitive. Blocks di er in terms of their nal goods productivity, residential amenities, supply of oor space and access to the transport network, which determines travel times between any two blocks in the city. Productivity depends on production externalities, which are determined by the surrounding density of workers, and production fundamentals, such as topography and proximity ∗Dept. Economics and SPIA, JRR Building, Princeton, NJ 08544. Email: firstname.lastname@example.com.


—Due to its popularity and daily active users, social media has become powerful and influential in the last decade. With the nature of a micro-blogging platform, instant messages and the latest short posts are sent throughout the network on Twitter. Therefore, most users utilize Twitter to update breaking news or the latest events. Since a huge volume of tweet messages have been published on Twitter, event evolution has also rapidly developed into related events within similar topics. In this study, we present a novel method to retrieve tweets that relate to a given query term. Not only perfectly matched tweets, but more related tweets will be retrieved. The collected tweet data are processed and constructed as an original network. With the benefits of social network analysis, a simplification-based summarization approach is applied to ignore information that has less importance while preserving significant information in the network based on centrality measurement and clustering coefficient. Using the evolutionary of graph-based representation extends the relationship diffusion to assist related information retrieval. Experiments were performed using Thai news datasets and the framework performance was evaluated by precision, recall, and f-score. The experimental results show that our framework outperformed the baseline methods which derived a similarity score based on the word embedded vector to find relevant documents.


The substantial changes in the business environment are causing the idea of quality to emerge as one of the most important strategic challenges for companies. Still, however, companies in Castilla-La Mancha, much less worker co-operatives, have not yet discovered quality as a prime competitive tool. In this paper we see how trading companies and worker co-operatives show differences as regards how they conceive quality, and the types of benefits and inconveniences that can be obtained from applying quality models. In the same way, the two differ in their application of human resources practices (such as communication, training, creativity, participation and motivation) depending on whether they have implemented a quality system.


We present an approach based on the improved Levenberg Marquardt (LM) algorithm of backpropagation (BP) neural network to estimate the light source position in bioluminescent imaging. For solving the forward problem, the table-based random sampling algorithm (TBRS), a fast Monte Carlo simulation method we developed before, is employed here. Result shows that BP is an effective method to position the light source.


A systematic review was conducted to explore published quantitative and qualitative research describing patient-reported outcomes of palliative telehealth intervention studies. Multiple databases were searched for articles published between January 2006 and May 2016, which met study criteria. Methodological quality was assessed using Cochrane Collaboration's tool for assessing risk of bias for quantitative articles. For studies reporting qualitative outcomes, a checklist was used to evaluate trustworthiness of the methodology. Of the 6 studies reporting quantitative outcomes, 3 studies were rated as having moderate study quality, and 3 studies were rated as having low study quality. Of the 6 studies reporting qualitative outcomes, 3 reported 5 different methods for ensuring trustworthiness, whereas 1 article reported 4 methods, 1 reported 3, and 1 article reported 2 methods. Studies were notably diverse in terms of patient population, technology used, outcomes measures, and methodology. Results across studies were also variable. Methodological factors were major limitations. Recruitment problems, participant attrition, and lack of standardized outcomes measures impacted outcome assessment. Overall, research support for positive patient outcomes in palliative telehealth interventions was weak. However, all studies but one found positive results to support the intervention.


In this work, we propose a new ultrasonic damage inspection method in plate structures. The proposed method employs an OPMT(orientation-adjustable patch-type magnetostrictive transducer) in order to make the ultrasonic waves directed to a specific target point. For experiments, virtual grid points were set up at every 50 mm in an aluminum plate and two OPMTs were used for inspection. If there exists a crack in a plate, the reflected Lamb wave from the crack is measured in addition to the direct waves from the transmitting transducer to the receiving transducer.


The prevalence of spontaneous bacterial peritonitis (SBP) or its variants, bacterascites (BA), and culture-negative neutrocytic ascites (CNNA), may vary depending on the underlying liver disease and protein content of ascites. In this study, we compared the frequency of peritonitis (SBP, BA, CNNA) upon admission in alcoholic (ALD), cholestatic (CLD), and hepatocellular liver disease (HLD); determined the relationship between Child's class and prevalence of peritonitis; and assessed ascitic total protein as a risk factor for peritonitis. Between January 1989 and April 1991, 113 consecutive patients were admitted with chronic liver disease and ascites (49, ALD; 22, CLD; and 42, HLD). All had admission paracentesis. SBP was defined as polymorphonuclear cell count (PMN) > or = 250 mm3 with a positive culture, BA as PMN < 250/mm3 and positive culture, and CNNA as PMN > or = 250/mm3 with negative culture. No patients with obvious intraabdominal source for infection (i.e., secondary peritonitis) were included in the analysis. The prevalence of peritonitis was 8/113 (7%); four patients had SBP, one BA, and three CNNA. The occurrence of peritonitis was independent of the type of liver disease (ALD, 8%; CLD, 9%; HDL, 5%). Neither ascitic fluid total protein nor the severity of liver disease (Child's class) predicted the occurrence of peritonitis. We conclude that the occurrence of peritonitis is unrelated to the type of liver disease, and severity of liver disease did not predict the presence of peritonitis. Also, ascitic fluid total protein < 1.0 g/dl may not be a sensitive predictor of risk of peritonitis.


The effect of workplace incivility on the behavior of individuals has been a widespread concern in recent years. Previous studies have largely linked uncivilized workplaces to discrete emotions such as anger and frustration, as well as negative behaviors such as withdrawal and aggression. However, few studies have focused on the specific role of introverted discrete emotions (i.e., guilt). At the same time, the role of individual differences (i.e., attribution orientation) has not been paid enough attention. Based on the attribution theory, this study examines how coworker incivility influences the organizational citizenship behavior (OCB) of individuals and the moderating role of internal attribution orientation on this process. Using the data of 109 employees for 10 consecutive working days as samples, we employed the PROCESS macro and MPLUS to examine our hypotheses. The results indicated that coworker incivility experience was positively related to the state guilt of employees only when they were high in internal attribution orientation rather than low. State guilt, in turn, was positively related to their OCB. This study expands the research of emotional response to uncivilized experience and provides a new perspective to understand the relationship between workplace incivility and potential positive outcomes. The implications of the general findings are discussed.


Default invariance is the idea that default does not change at any scale of law and finance. Default is a conserved quantity in a universe where fundamental principles of law and finance operate. It exists at the micro-level as part of the fundamental structure of every financial transaction, and at the macro- level, as a fixed critical point within the relatively stable phases of the law and finance cycle. A key point is that default is equivalent to maximizing uncertainty at the micro-level and at the macro-level, is equivalent to the phase transition where unbearable fluctuations occur in all forms of risk transformation, including maturity, liquidity and credit. As such, default invariance is the glue that links the micro and macro structures of law and finance. In this essay, we apply naive category theory (NCT), a type of mapping logic, to these types of phenomena. The purpose of using NCT is to introduce a rigorous (but simple) mathematical methodology to law and finance discourse and to show that these types of structural considerations are of prime practical importance and significance to law and finance practitioners. These mappings imply a number of novel areas of investigation. From the micro- structure, three macro-approximations are implied. These approximations form the core analytical framework which we will use to examine the phenomena and hypothesize rules governing law and finance. Our observations from these approximations are grouped into five findings. While the entirety of the five findings can be encapsulated by the three approximations, since the intended audience of this paper is the non-specialist in law, finance and category theory, for ease of access we will illustrate the use of the mappings with relatively common concepts drawn from law and finance, focusing especially on financial contracts, derivatives, Shadow Banking, credit rating agencies and credit crises.


Hip dislocation associated with Down syndrome is relatively rare. Hip dislocation can progress to severe subluxation or habitual dislocation if the initial therapy is improperly performed. However, definitive treatment guidelines for conservative and surgical therapy for hip dislocation in patients with Down syndrome have not been established. This article describes a case of a 12-year-old girl with Down syndrome with nontraumatic habitual hip dislocation. Her hip joint was associated with acetabular dysplasia and hypoplasia of the posterior acetabular wall. Although conservative therapy was initially performed, no effects were observed. Rotational acetabular osteotomy and capsular plication were performed to reconstruct the posterior acetabular wall. No postoperative redislocation occurred, and the treatment effects were favorably sustained for 2 years. In Down syndrome, few cases of developmental dysplasia and hypoplasia of the posterior acetabular wall have been reported. In previous reports, these morphological abnormalities were rarely taken into consideration when determining the treatment strategy, and to our knowledge, no other reports demonstrate therapy involving rotational acetabular osteotomy for hip dislocation complicated with Down syndrome. Whether the acetabulum had posterior wall deficiency was thought to be important for conservative and surgical therapies in hip dislocation in patients with Down syndrome. Rotational acetabular osteotomy could be an effective surgical procedure for reconstruction of the acetabulum by posterolateral rotation of the osteotomized acetabulum.


We describe a measure quantization procedure i.e., an algorithm which finds the best approximation of a target probability law (and more generally signed finite variation measure) by a sum of $Q$ Dirac masses ($Q$ being the quantization parameter). The procedure is implemented by minimizing the statistical distance between the original measure and its quantized version; the distance is built from a negative definite kernel and, if necessary, can be computed on the fly and feed to a stochastic optimization algorithm (such as SGD, Adam, ...). We investigate theoretically the fundamental questions of existence of the optimal measure quantizer and identify what are the required kernel properties that guarantee suitable behavior. We propose two best linear unbiased (BLUE) estimators for the squared statistical distance and use them in an unbiased procedure, called HEMQ, to find the optimal quantization. We test HEMQ on several databases: multi-dimensional Gaussian mixtures, Wiener space cubature, Italian wine cultivars and the MNIST image database. The results indicate that the HEMQ algorithm is robust and versatile and, for the class of Huber-energy kernels, matches the expected intuitive behavior.


The medical school I (S.M.) attended did not require dissection of a cadaver to fulfill the requirements of the anatomy curriculum. I had "learned" human anatomy through lectures, text books, and an atlas, but did no dissection. Although it was difficult doing anatomy that way, I passed basic science exams with high marks and did well on the board exams (NBME). I graduated from medical school with distinction and thought I was well prepared for residency. To my surprise, dissection of the orbit and periorbital regions and cranial cavity were included in my ophthalmology residency and were to pose a challenge for me. I requested the aid of a medical school anatomist to help me face this challenge. Not only did I learn the art of dissection, I gained considerable knowledge in anatomy (much of it clinically relevant), acquired better skill with surgical instruments and enhanced my logical and critical thinking ability. This viewpoint is based upon a diary I kept during my dissection experience. Clin. Anat. 9:53–56, 1996. © 1996 Wiley‐Liss, Inc.


Among the histories of Medicine that have appeared within the past twenty years there is none more fascinating than "The Story of Medicine" by Doctor Robinson. Written in a most interesting and entertaining manner and touching upon many characters and incidences either omitted or too briefly considered in other works of the kind, this story of Medicine merits a place in the library of every physician and should be read by every medical student. Commencing with a brief discussion of Medicine in the Stone age it considers Medicine in Greece, Alexandria, Rome, in the Middle Ages, in the Renaissance, Seventeenth and Eighteenth Centuries, and concludes with chapters upon the Modernization of Medicine and Medicine in America.
The author possesses a lucid and eloquent literary style, well illustrated in the following paragraph concluding the chapter upon the Modernization of Medicine.


We modify the averaged Lagrangian method for analysing slowly varying nonlinear wavetrains to include cases with small dissipation. To do this, we use a pseudo-variational principle introduced by Prigogine in which the Lagrangian depends on a function to be varied and the solution of the problem; this can be used to describe irreversible processes. Examples of applications to both ordinary and partial differential equations are presented.


In response to the preventable threats posed by poor sanitation and hygiene, the Water and Sanitation Program (WSP) launched two large-scale projects, global scaling up handwashing and global scaling up rural sanitation, to improve the health and welfare outcomes for millions of poor people. Local and national governments are implementing these projects with technical support from WSP. Global scaling up handwashing aims to test whether handwashing with soap behavior can be generated and sustained among the poor and vulnerable using innovative promotional approaches. The primary objectives are to reduce the risk of diarrhea in young children and increase household productivity by stimulating and sustaining the behavior of handwashing with soap at critical times. Overall, the project aims to generate and sustain handwashing with soap practices among 5.4 million people living in Peru, Senegal, Tanzania, and Vietnam, the four countries where the project has been implemented to date. This technical paper presents the findings of the WSP impact evaluation (IE) baseline survey in Peru and is one in a series of papers presenting IE findings from surveys conducted in each project country.


This paper focuses on the comparison of the luminous flux of two dual-remote phosphor structures named flat dual-remote phosphor (FDRP) and concave dual-remote phosphor (CDRP). These two configurations have different luminous flux values due to the disparity in scattering properties in white LEDs. However, the researched results showed that FDRP structure is more lucrative than the CDRP structure when it comes to the luminous flux effectiveness. To support the aforementioned idea, this article also presents the influence of the distance between two phosphor layers (d1) and the distance between the phosphor layer with the LED surface (d2) on the optical properties of the FDRP structure. Specifically, the scattering ability and absorption properties of the remote phosphor layer will vary sharply if d1 and d2 are adjusted into different values, which produces an immense impact on the chromatic homogeneity and illumination capability of WLEDs. Therefore, in order to stabilize the correlated color temperature (CCT) of WLEDs at 8500 K when there is a modification on d1 and d2, the concentration of YAG:Ce3+ phosphor also needs to be varied. Accordingly, the scattering process and absorption phenomenon in the remote phosphor layer will bottom out when d1 = d2 = 0,  leading to the worst color quality and luminous flux. The effect of the spectra generated as these distances are adjusted is obvious evidence for this point. In other words, the larger the d1 and d2, the larger the scattering surface, and thus the blending of blue and yellow light rays will become more homogeneous, yielding the smallest white light deflection and the lowest luminous flux at the same time. The paper's results indicated that the luminous flux will reach a peak at 1020 lm if d1 = 0.08 mm or d2 = 0.63 mm and the chromatic deflection will hit the lowest point as d1 = 0.64 mm or d2 = 1.35 mm. In the end, manufacturers can make their choice for the production of higher-standard WLEDs based on the general knowledge and helpful information that the article has provided and analyzed.


Before antibiotics were available, actinomycosis was the most commonly diagnosed "fungal disease" of the lung because of its morphological similarity to true fungi. At that time actinomycosis presented a fairly typical clinical picture of empyema thoracis and sinus tracts in the chest wall. Nowadays it has become a rare infectious disease that is usually caused by the bacterium Actinomyces israelii and is amenable to treatment by most antibiotics available today. The following report describes the case of a 59-year-old man with an uncommon mediastinal actinomycosis that caused an oesophagotracheal fistula. This complication may develop due to the necrotizing inflammatory process that is typical for actinomycosis. With regard to the literature, the clinical manifestations of the disease and diagnostic and therapeutic considerations are discussed.


BACKGROUND
Artifact reduction or removal is a challenging task when the artifact creation physics are not well modeled mathematically. One of such situations is metal artifacts in x-ray CT when the metallic material is unknown, and the x-ray spectrum is wide.

PURPOSE
A neural network is used to act as the objective function for iterative artifact reduction when the artifact model is unknown.

METHODS
A hypothetical unpredictable projection data distortion model is used to illustrate the proposed approach. The model is unpredictable, because it is controlled by a random variable. A convolutional neural network is trained to recognize the artifacts. The trained network is then used to compute the objective function for an iterative algorithm, which tries to reduce the artifacts in a computed tomography (CT) task. The objective function is evaluated in the image domain. The iterative algorithm for artifact reduction is in the projection domain. A gradient descent algorithm is used for the objective function optimization. The associated gradient is calculated with the chain rule.

RESULTS
The learning curves illustrate the decreasing treads of the objective function as the number of iterations increases. The images after the iterative treatment show the reduction of artifacts. A quantitative metric, the Sum Square Difference (SSD), also indicates the effectiveness of the proposed method.

CONCLUSION
The methodology of using a neural network as an objective function has potential value for situations where a human developed model is difficult to describe the underlying physics. Real-world applications are expected to be benefit from this methodology.


Abstract Discourse like is claimed to be rapidly spreading in urban centres throughout the English-speaking world (see Dailey-O'Cain 2000; Tagliamonte 2005; D'Arcy 2005; Cheshire, Kerswill and Williams 2005). Like is claimed to be particularly pervasive in the speech of adolescents (Andersen 2001). However, comparatively little is known about the distribution of discourse like in the speech of younger age groups. This paper reassesses the claims made by Miller and Weinert (1995), who suggest that discourse like is not acquired until relatively late, after the age of 10. Using a corpus based on the speech of a group of British preadolescents, I argue that not only are new uses of like encountered frequently in preadolescent speech, but that distributional differences between males and females, as well as between different age groups, point to significant aspects of the developmental acquisition of this discourse feature. Furthermore, using data from various languages, cross-linguistic parallels are highlighted between discourse markers that have a similar functional inventory to like in order to show that a number of languages have encoded comparable pragmatic functions using similar lexical sources.


We study a new statistics of wave functions in several chaotic and disordered systems: the random matrix model, band random matrix model, the Lipkin model, chaotic quantum billiard and the 1D tight-binding model. Both numerical and analytical results show that the distribution function of a generalized Riccati variable, defined as the ratio of components of eigenfunctions on basis states coupled by perturbation, is universal, and has the form of a Lorentzian distribution.


This paper aimed to study the adoption of deep learning (DL) algorithm of oral lesions for segmentation of cone-beam computed tomography (CBCT) images. 90 patients with oral lesions were taken as research subjects, and they were grouped into blank, control, and experimental groups, whose images were treated by the manual segmentation method, threshold segmentation algorithm, and full convolutional neural network (FCNN) DL algorithm, respectively. Then, effects of different methods on oral lesion CBCT image recognition and segmentation were analyzed. The results showed that there was no substantial difference in the number of patients with different types of oral lesions among three groups (P > 0.05). The accuracy of lesion segmentation in the experimental group was as high as 98.3%, while those of the blank group and control group were 78.4% and 62.1%, respectively. The accuracy of segmentation of CBCT images in the blank group and control group was considerably inferior to the experimental group (P < 0.05). The segmentation effect on the lesion and the lesion model in the experimental group and control group was evidently superior to the blank group (P < 0.05). In short, the image segmentation accuracy of the FCNN DL method was better than the traditional manual segmentation and threshold segmentation algorithms. Applying the DL segmentation algorithm to CBCT images of oral lesions can accurately identify and segment the lesions.


Nutlin-3 is a small-molecule antagonist of murine double minute 2 (MDM2) that blocks its binding to p53, leading to an increase in p53 protein levels. The tumor suppressor p53 induces growth arrest or apoptosis in response to genotoxic stress. Along with its growth-suppressive effect, it has been reported that p53 stimulates the mitogen-activated protein kinase (MAPK) pathway via the upregulation of heparin- binding epidermal growth factor-like growth factor (HB-EGF), an epidermal growth factor receptor (EGFR) ligand, and discoidin domain receptor 1 (DDR1), a tyrosine kinase receptor, at the transcription level. In this study, we propose a novel mechanism involved in the p53-induced MAPK activation. Nutlin-3 induced the phosphorylation of EGFR, MAPK/ERK kinase (MEK)1/2 and extracellular signal-regulated kinase (ERK)1/2 in U2OS human osteosarcoma cells harboring wild-type p53. This phosphorylation was completely inhibited by p53 siRNA, but not by pifithrin (PFT)-α, an inhibitor of the trans-criptional activity of p53. While the nutlin-3-induced EGFR phosphorylation was prevented by the inactivation of ERK1/2, the nutlin-3-induced MEK1/2-ERK1/2 phosphorylation was still observed in the cells in which EGFR phosphorylation was inhibited using EGFR siRNA and AG1478, an inhibitor of EGFR tyrosine kinase. Of note, nutlin-3 caused the accumulation of mitochondrial reactive oxygen species (ROS) and this correlated with the mitochondrial translocation of p53. 2,2,6,6-Tetramethyl-1-piperidinyloxy (TEMPO), a ROS scavenger, prevented the phosphorylation of ERK1/2. PFT-μ, which prevented the mitochondrial localization of p53, suppressed ERK1/2 phosphorylation, as well as ROS accumulation. Finally, we analyzed the effect of ERK1/2 activation on nutlin-3-induced apoptosis. The knockdown of MEK1/2 and ERK1/2 activity using U0126, a MEK inhibitor, or siRNAs, resulted in the enhancement of nutlin-3-induced apoptosis. In addition, TEMPO and PFT-μ also promoted nutlin-3-induced apoptosis. Taking the above findings into account, it can be concluded that nutlin-3 activates ERK1/2 prior to EGFR phosphorylation via ROS generation following the mitochondrial translocation of p53 and that nutlin-3-induced ERK1/2 activation may play a role in protecting U2OS cells from p53-dependent apoptosis, constituting a negative feedback loop for p53-induced apoptosis.


The flexible maneuvering of microliter liquid droplets is significant in both fundamental science and practical applications. However, most current strategies are limited to the rigid locomotion on confined geographies platforms, which greatly hinder their practical uses. Here, we propose a magnetism-actuated superhydrophobic flexible microclaw (MSFM) with hierarchical structures for water droplet manipulation. By virtue of precise femtosecond laser patterning on magnetism-responsive poly(dimethylsiloxane) (PDMS) films doped with carbonyl iron powder, this MSFM without chemical contamination exhibits powerful spatial droplet maneuvering advantages with fast response (<100 ms) and lossless water transport (∼50 cycles) in air. We further performed quantitative analysis of diverse experimental parameters including petal number, length, width, and iron element proportion in MSFM impacting the applicable maneuvering volumes. By coupling the advantages of spatial maneuverability and fast response into this versatile platform, typical unique applications are demonstrated such as programmable coalescence of droplets, collecting debris via droplets, tiny solid manipulation in aqueous severe environments, and harmless living creature control. We envision that this versatile MSFM should provide great potential for applications in microfluidics and cross-species robotics.


This chapter explains the concept of abusive judicial review: the use of courts by regimes to achieve anti-democratic constitutional change. Abusive judicial review involves abusive constitutional borrowing in two distinct senses: first, regimes lean on captured or cowed courts as a strategy to legitimate or advance authoritarian goals, and second, those courts often draw upon liberal democratic doctrines in abusive ways. It develops a typology of two different forms of the phenomenon—a weak form where courts uphold authoritarian moves by political actors, and a strong form where they act more directly to remove obstacles to authoritarian programs. Finally, it draws out two main examples: the Venezuelan Supreme Court's repression of the opposition-held legislature using a doctrine of 'legislative omission' and other tools, and the wielding of militant democracy doctrines by the Cambodian and Thai apex courts to ban parties for authoritarian ends.


To analyze the temporal evolution of HIV-related stigma in Spain between 2008 and 2012. We interviewed a representative sample of the Spanish population (N = 1619) through computer-assisted telephone interviews. The survey measures diverse facets of stigma and other-related variables. We compared the data of the 2012 survey with the result of the survey carried out in 2008. The degree of discomfort concerning people with HIV decreased significantly in 2012. Avoidance intention, negative feelings, the number of people who agreed with the implementation of harsh discriminatory policies, and the number of people who blame people with HIV were also lower in 2012. However, there are still misconceptions about HIV transmission. Attitudes of the Spanish population toward people with HIV have improved in the last four years. However, some attitudes and beliefs still need to be changed.


During the period between 1930 and 1970 more than 17,000migrants were drawn to Louisville, challenging us to rethink the centralityof rural to urban migration narratives during the era of the Second GreatMigration. African American migration in Louisville, Kentuckydemonstrates the necessity of recognizing the distinctiveness of theSecond Great Migration as well as the need to turn our attention to Blackmobility within the South. Between 1935-1940, the largest Southerncities witnessed an influx of Black population; many of these migrantsoriginated in the urban, not rural South. That Kentucky's Blackpopulation was primarily urban stood in stark contrast with much of theSouth; however, Blacks in Tennessee, Alabama, Florida and NorthCarolina were also predominantly urban. Not only does examining urbanto urban migration patterns offer a more complex view of AfricanAmerican migration, it also offers a more nuanced view of AfricanAmerican urbanization as a process. African American migration inLouisville, Kentucky challenges us to rethink the centrality of rural tourban migration narratives during the era of the Second Great Migration.


The 1999 Ineson Lecture 1999 was given by Stephen Foster, Assistant Director of the British Geological Survey with overall responsibility for various areas of geoscience including hydrogeology and engineering geology.⇓

Fig. 1.

Stephen Foster graduated from Kings College in the University of London in 1965, starting his career in geotechnical engineering but moving into hydrogeology at an early stage when he joined the Institute of Geological Sciences (IGS). By 1974 he became Groundwater Pollution Research Leader at the IGS, shortly to be re-styled the British Geological Survey (BGS). During 1986–89 he was seconded to the World Health Organization/Pan-American Health Organization as Groundwater Advisor for the Latin American & Caribbean Region. On return to the BGS he became Chief Hydrogeologist and was promoted to Assistant Director in 1991.

Dr Foster is the author of some 125 published papers, reports and manuals. His earlier work focused on the geological and hydraulic controls on …


We assessed 27 indicators of plant diversity, stand yield and individual crop tree responses 25 years post-treatment to determine long-term trade-offs among conifer release treatments in boreal and sub-boreal forests. This research addresses the lack of longer-term data needed by forest managers to implement more integrated vegetation management programs, supporting more informed decisions about release treatment choice. Four treatments (untreated control, motor-manual brushsaw, single aerial spray, and complete competition removal) were established at two jack pine (Pinus banksiana Lamb.) sites in Ontario, Canada. Our results suggest that plant diversity and productivity in boreal jack pine forests are significantly influenced by vegetation management treatments. Overall, release treatments did not cause a loss of diversity but benefitted stand-scale yield and individual crop tree growth, with maximum benefits occurring in more intensive release treatments. However, none of the treatments maximized all 27 indicators studied; thus, forest managers are faced with trade-offs when choosing treatments. Research on longer term effects, ideally through at least one rotation, is essential to fully understand outcomes of different vegetation management on forest diversity, stand yield, and individual crop tree responses.


Background It is important to study new potential markers of response to treatment in rheumatoid arthritis (RA), because up to 40% patients don't achieve remission even using biological therapy. DNAse activity of the blood serum and antinuclear antibody may be useful in this context. Changes of serum DNase activity in the RA treatment by biological agents previously have been not investigated. Objectives The aim of this work is to study the dynamics clinical and laboratory parameters, DNAse serum activity and ANA during the RA treatment by infliximab (INF) and assess the prognostic potential of them in prediction of response to INF. Methods 24 RA patients were involved in the study. All patients fulfilled the EULAR/ACR 2010 RA criteria. 22/24 patients received 6 infusions of INF at a dose of 3 mg/kg according to standard protocol: at 0th, 2th, 6th and then every 8 week. 2/24 patient received 4 infusions of INF. All patients received synthetic DMARDs therapy by metotrexate (10–17,5 mg weekly), 18/24 patients received glucocorticoids (methylprednisolone 4–8 mg daily) and non-steroidal anti-inflammatory drugs. Prior to treatment by INF patients did not receive any biological agents. All patients had high disease activity before INF treatment (DAS28<5,1). ANA determination was performed by indirect immunofluorescence on Hep-2 cells using digital system AKLIDES. ANA was measured in serum samples before 1st INF administration, at 22–30 weeks after the 1st INF administration. To determine the DNAse activity of serum the method of rivanol clot was used. DNase activity was measured in serum samples before 1st INF administration, at 6 weeks after the 1st INF administration, at 30 week of treatment. Results At week 30, ACR70 improvement reached 5/22 of the patients, ACR50 - 10/22 of the patients, ACR20 – 4/24 of patients. At 30 weeks of treatment by INF 2/22 of patients achieved remission (SDAI<3,3), 10/22 - a low disease activity (3,3 0,05). For assessment prognostic value of laboratory signs for INF response prediction logistic regression was used. Prognostic model, which included changes in ANA (Δ ANA) and DNAse serum activity level (Δ DNAse serum activity), anti-CCP- and RF-negativity was better (p=0,02) (area under ROC-curve =1,0; 95% CI 0,844–1,00 p=0,0001) than the model, which included only anti-CCP- and RF-negativity (area under ROC-curve =0,795; 95% CI 0,597–0,924, p=0,0141). Conclusions The study confirmed the efficacy of RA treatment by INF for anti-CCP and RF negative patients. DNAse serum activity and ANA may be used as additional prognostic biomarker of INF response. For the assessment DNAse activity as marker of response to therapy is needed futher investigations with more number of patients. Disclosure of Interest None declared


Background: Dengue is the most widespread mosquito-borne viral infection, found in tropical and subtropical climates worldwide. The World Health Organization has included dengue as one of the 10 threats to global health in 2019 with rapidly evolving epidemiology. Aims and Objectives: Given the limitation of data in regard to dengue burden, we have planned the present study with the objectives to provide a comprehensive overview of the seroprevalence, clinicoepidemiological profile, and serotype of dengue virus in Agra region of Uttar Pradesh. Materials and Methods: We conducted an observational study at viral diagnostic and research laboratory, Sarojini Naidu Medical College, Agra, Uttar Pradesh, from August to December 2021. Our study included all blood specimens received at virology laboratory from clinically suspected cases of dengue infection. For the identification of serotype, NS1-positive samples were sent to King Georges Medical University, Lucknow. For clinical-epidemiological profile of dengue positive patients, data were obtained from records of 203 patients from our hospital. Results: We received total of 5457 serum samples from suspected patients for dengue serology during the study period. In total, positivity rate was 27.29% (1489/5457) and peak of cases was reported in month of October. Median age of dengue positive cases was 17 years. Dengue hemorrhagic fever (DHS) was diagnosed in almost 41% of patients of 203 patients admitted in our hospital. DEN-2 was reported to be most common serotype (97.1%). In our analsyis, we found that in most patients fall in platelets levels below 50,000 happened during the 5 th and 6 th day in Dengue fever. Conclusion: We conclude that our study showed higher seroprevalence of dengue in Agra region with the age group of 0–20 years being infected most. DEN-2 was most prevalent circulating strain, which leads to more severe dengue infection.


Our aim is to examine the size, kinematics, and geometry of the broad-line region (BLR) in the double-lensed quasar Q 0957+561 by analyzing the impact of microlensing on various rest-frame ultraviolet broad-emission lines (BELs). We explore the influence of intrinsic variability and microlensing on the C IV, C III], and Mg II emission lines through multiple spectroscopic observations taken between April 1999 and January 2017. By utilizing the line cores as a reference for no microlensing and correcting for the long time delay between the images, we estimate the sizes of the regions emitting the broad-line wings using a Bayesian approach. Our study of the microlensing amplitudes between the lensed images of the quasar Q 0957+561 reveals differing sizes of the regions emitting the three prominent BELs C IV, C III], and Mg II. The strength of the differential microlensing indicates that the high-ionization line C IV arises from a compact inner region of the BLR with a half-light radius of $R_{1/2} \gtrsim 16.0$ lt-days, which represents a lower limit on the overall size of the BLR and is comparable to the size of the region emitting the r-band continuum in this system. A somewhat larger size of $R_{1/2}\gtrsim 44$ lt-days is obtained for the semi-forbidden line C III]. Microlensing has a weak impact on the lower-ionization line Mg II, which is emitted from a region with a half-light radius of $R_{1/2} \gtrsim 50$ lt-days. These findings suggest that the BEL regions may have distinct geometries and kinematics, with the more extended ones being spherically symmetric, and the most compact ones being nonspherical, with motions likely confined to a plane.


Trusted insiders that betray an organization can inflict substantial harm. In addition to having privileged access to organization resources and information, these users may be familiar with the defenses surrounding valuable assets. Computers systems at the organization need a mechanism for communicating suspicious activity that is difficult for a malicious insider (or even an outsider) to detect or block. In this work, we propose a covert channel in the Ethernet frame that allows a computer system to report activity inside other, unrelated network communication. The covert channel leverages the differences in the framing approaches used by Ethernet and IP packets to append hidden information to IP packet and transmit it to an organization's administrator. This stealthy communication is difficult for even advanced attackers and is challenging to block since it opportunistically uses unrelated communication. Further, since the transmission is tied to the Ethernet frame, the communication cannot traverse network routers, preventing security information from leaving the organization. We introduce the covert channel, incorporate it into a working prototype, and combine it with an intrusion detection system to show its promise for security event reporting.


Abstract:  The need for evidence‐based practice guidelines requires high quality, carefully controlled clinical research trials. This multidisciplinary conference attempted to: identify urgent clinical and research issues, identify obstacles to performing clinical trials, develop concepts for organ‐specific and all‐organ research and generate a report that would serve as a blueprint for future research initiatives. A few themes became evident. First, young children present a unique immunologic environment which may lead to tolerance, therefore, including young children in immunosuppression withdrawal and tolerance trials may increase the potential benefits of these studies. Second, adolescence poses significant barriers to successful transplantation. Non‐adherence may be insufficient to explain poorer outcomes. More studies focused on identification and prevention of non‐adherence, and the potential effects of puberty are required. Third, the relatively naive immune system of the child presents a unique opportunity to study primary infections and alloimmune responses. Finally, relatively small numbers of transplants performed in pediatric centers mandate multicenter collaboration. Investment in registries, tissue and DNA repositories will enhance productivity. The past decade has proven that outcomes after pediatric transplantation can be comparable to adults. The pediatric community now has the opportunity to design and complete studies that enhance outcomes for all transplant recipients.


We present a device model for the hydrazine processed kesterite Cu2ZnSn(S,Se)4 (CZTSSe) solar cell with a world record efficiency of ∼12.6%. Detailed comparison of the simulation results, performed using wxAMPS software, to the measured device parameters shows that our model captures the vast majority of experimental observations, including VOC, JSC, FF, and efficiency under normal operating conditions, and temperature vs. VOC, sun intensity vs. VOC, and quantum efficiency. Moreover, our model is consistent with material properties derived from various techniques. Interestingly, this model does not have any interface defects/states, suggesting that all the experimentally observed features can be accounted for by the bulk properties of CZTSSe. An electrical (mobility) gap that is smaller than the optical gap is critical to fit the VOC data. These findings point to the importance of tail states in CZTSSe solar cells.


In view of the economic liberalization process taking place with great speed in a large number of developing countries, the question of attracting foreign direct investment (FOI) has come into sharper focus. In fact, policy makers now consider FDI inflows as an index of the effectiveness of their international business regimes. This paper examines and analyses evidence pertaining to FOI in some low-income emerging economies of Asia. It is argued that the process of opening up of an economy creates external pressures to enhance competitiveness. This kind of pressure is actually in the interest of the country seeking to compete in international markets. Based on evidence, the paper goes on to identify the determinants of FDI in some oft-quoted low-income countries of Asia. While most of the determinants identified in the paper are in line with conventional wisdom, it is argued that their hierarchical importance is context specific.


Background: In terminal cancer patients (TCPs), one of the most important things is to define the survival to help the main responsible physicians, patients, and main caregivers make decisions, set goals, and work across the end-of-life strategies. Patients and Methods: We retrospectively reviewed the medical files of TCPs, who died during September 2011 and December 2017, to recognize the correlation between prognostic nutritional indices (PNIs) and survival in those subtypes of patients. The receiver operating characteristic (ROC) curve was used to identify the cutoff value of PNI. Results: A total of 858 TCPs were eligible and included, the median age was 62 years (range: 18–107). The most common primary cancer sites were colorectal cancer in 151 patients (17.6%), hepatobiliary in 129 (15%), lung cancer in 115 (13.4%), breast cancer in 114 (13.3%), and genitourinary in 80 (9.3%). The mean value of PNI for all cancer types was 32.9 ± 6.7. The values showed different levels across cancer types. For patients who lived >2 weeks, PNI was 36.7 compared with that who died within 2 weeks was 29.3, which was a statistically significant (P < 0.001). By the ROC curve, the cutoff value of PNI was 32.3 and area under the curve was 0.888. The sensitivity, specificity, positive predictive value, and negative predictive value were 91.28% (95% confidence interval [CI]: 88.2–93.8), 71.09% (95% CI: 66.5–75.4), 76.5% (95% CI: 73.7–79.2), and 88.8% (95% CI: 85.3–91.5), respectively. Conclusion: The PNI is an easy and an applicable biomarker to estimate life expectancy in TCPs.


Sweet Dreams: The World of Patsy Cline. Edited by Warren R. Hofstra. Music in American Life. (Urbana and other cities: University of Illinois Press, 2013. Pp. [xvi], 198. Paper, $25.00, ISBN 978-0-252-07930-6; cloth, $85.00, ISBN 978-0-252-03771-9.) There are few voices in American music as iconic as Patsy Cline's, and her work with producer Owen Bradley defined the Nashville Sound just as that city centralized and rationalized the country genre in the late 1950s and early 1960s. Warren R. Hofstra's edited collection Sweet Dreams: The World of Patsy Cline gives that voice a rich historical context. "Insofar as this book is an examination of the world of Patsy Cline," Hofstra writes, "she is the agent through which we can view certain aspects of American life and culture from the post-World War II era to today" (p. 7). Most popular music studies start with a similar premise, but few live up to its promise as Sweet Dreams does. Sweet Dreams centers on the urbanization of the post-World War II South and the rise of a consumerist middle class forged through a national media culture, two revolutions that upended traditional southern verities of race, class, and gender. Cline's biography reflects these developments. The book follows her from her agrarian roots to the northern Virginia town of Winchester and her career from Washington, D.C., to the country music capital of Nashville. In dropping rural fiddle for melodious strings and barn dance hokum for sensuous pop chanteuse, her music also reflected these changes in postwar American life. The smooth Nashville Sound did not betray country's agrarian audience, in this reading, but served as a logical soundtrack to the aspirations of Cline's southern generation. The range and quality of authors are impressive. Bill C. Malone sets the stage by elaborating on the broad transformations in southern life and culture framed in the introduction. Hofstra and the late Mike Foreman then move to the particulars with a history of Cline's hometown of Winchester. The case study locates the collection's argument in a specific geography, detailing Winchester's evolving political economy from agricultural to industrial to service work in the years of Cline's upbringing. Cline's colleague George Hamilton IV contributes a brief reminiscence about her vibrant character as a strong woman on the Washington, D.C., circuit that also nurtured Roy Clark and Jimmy Dean. Beth Bailey interprets Cline's story as a lesson on the changing meanings of respectability and success in the postwar moment. Cline's raucous reputation and social climbing may have offended the patrician hierarchies of the South, but these elements mattered less as prosperity and cultural norms carved out a space for those formerly marginalized. …