Agglutinogens of broth cultures vs. saline suspensions. Of primary importance are the results in relation to agglutinogens prepared by cultivation of the microörganism in broth as compared with those prepared by cultivating on plain solid media and suspending the bacteria in saline solution: a general review of the results observed in this study with a single strain of typhoid bacilli, indicate that suspensions in saline solution so prepared as to break up clumps and diluted to proper density, are superior to broth cultures. Saline solutions vs. distilled water. As is well known, sodium chloride exerts an important rôle in the physicochemical phenomenon of agglutination; of agglutinogens prepared by suspending typhoid bacilli in strengths of sodium chloride in sterile distilled water varying from 0.85 to 5 per cent (nos. 17, 18, 19 and 20), best results were observed with the 0.85 and 1 per cent solutions (nos. 17 and 18); agglutinogens prepared with 2 per cent solutions of sodium chloride were less susceptible to agglutination and 5 per cent solutions were decidedly less susceptible. Agglutinogens prepared with distilled water alone (no. 21) were least susceptible to agglutination and yielded some of the lowest titers. Influence of heat. Of primary importance is the effect of heating an agglutinogen upon its susceptibility to agglutination; in the majority of laboratories cultures or suspensions are usually heated at 56° to 60°C. for one-half to two hours. In order to be able to observe the most marked influence of heat, if any, antigens were heated in a water bath at 60°C. for two hours; a general survey of the results of this study indicates that heated antigens are somewhat more susceptible to agglutination than unheated antigens. Influence of chemical germicides and preservatives. In this investigation phenol, tricresol, formalin, mercurophen and glycerin were employed for chemical sterilization and preservation (antiseptic activity); with the exception of formalin in 0.1 to 5 per cent; agglutinogens prepared without preservatives were somewhat superior to those containing phenol, tricresol, mercurophen and glycerin. Kind of chemical germicide and preservative. Of the chemicals employed in the preparation of agglutinogens of B. typhosus, best results were observed with formalin; in fact the addition of 1 to 2 per cent formalin2 to suspensions in isotonic saline solution yielded the best agglutinogens of the series included in this study (nos. 9 and 10). Agglutinogens were prepared with 0.1, 0.5, 1, 2 and 5 per cent neutral formalin; comparative tests have usually shown that those containing 1 and 2 per cent were least likely to show spontaneous agglutination, were most susceptible to specific serum agglutination and were never contaminated. Agglutinogens prepared with phenol in 0.5 per cent and tricresol in 0.5 per cent (nos. 4 and 5) yielded similar results, but they were somewhat inferior to preservative free agglutinogens and decidedly inferior to those containing 0.1 to 2 per cent formalin. Agglutinogens prepared with 1 per cent phenol and tricresol (nos. 12 and 14) were decidedly inferior to those containing 0.5 per cent of these substances and an antigen containing 5 per cent phenol (no. 13) was almost insusceptible to agglutination and proved most unsatisfactory of all. Mercurophen was employed because of its high germicidal activity and freedom of precipitating and coagulating influence upon proteins including bacterial proteins; agglutinogens prepared with 1:1000 mercurophen in physiological saline solution (no. 15) and 1:2000 (no. 6) yielded results similar to those containing 0.5 per cent phenol and tricresol. An agglutinogen containing 1:5000 mercurophen (no. 16) was generally satisfactory and from the standpoints of freedom from spontaneous agglutination, susceptibility to specific agglutination and freedom from contamination ranked next to plain and formalized agglutinogens. The addition of 10 cc. of the best grade neutral glycerin to each 100 cc. of heated agglutinogen containing 0.5 per cent phenol (no. 3) reduced susceptibility to specific agglutination and proved inferior to the same agglutinogen prepared without the addition of glycerin (no. 1). Spontaneous agglutination. Of agglutinogens 1 to 16 preserved over a period of four to eight weeks in a refrigerator, no. 15 containing 1:1000 mercurophen, showed most tendency to spontaneous agglutination and nos. 7, 8, 9 and 10 containing 0.1 to 2 per cent formalin, least spontaneous agglutination; of the freshly prepared antigens, nos. 19 and 20, containing 2 and 5 per cent sodium chloride frequently showed spontaneous agglutination. Macroscopical tests for spontaneous agglutination were conducted with each antigen whenever employed by diluting 1 cc. with 1 cc. of 0.85 per cent saline solution and incubating at 55°C. for twenty-four hours; at the same time microscopical tests were made and occasionally antigens showed small clump of bacilli microscopically, which appeared perfectly homogenous and satisfactory to the closest scrunity with the naked eye.


The aim of the study is to evaluate and compare the soft tissue chin thickness values among adult patients with different vertical growth patterns. A sample size of 180 adults patients (32 males and 148 females), with an average age of 21.42 years (range 17- 32 years), was selected. The sample was divided into three groups according to the vertical growth pattern using SNMP angle (hypodivergent 37°). The soft tissue chin thicknesses in each group were measured at pogonion (Pog), gnathion (Gn), and menton (Me) and analyzed using the one-way analysis of variance and post-hoc Tukey test. The soft tissue chin thickness values were greater in hypodivergent group at Pog (12.71±2.10 mm), Gn (9.72 ± 2.55 mm) and Me (9.13 ± 2.88 mm) and smallest in hyperdivergent group (Pog 8.05 ±1.20 mm, Gn 6.07±1.47 mm, Me 5.91±1.21 mm). The soft tissue chin thicknesses were greater in men than women.  Soft tissue chin thickness was greater in hypodivergent adults than those of normodivergent and hyperdivergent adults. In all the three groups, soft tissue thickness values were greater in men than women.

 Key words: Vertical pattern, soft tissue, thickness, adult, chin.


Latent class models have recently drawn considerable attention among many researchers and practitioners as a class of useful tools for capturing heterogeneity across different segments in a target market or population. In this paper, we consider a latent class logit model with parameter constraints and deal with two important issues in the latent class models--parameter estimation and selection of an appropriate number of classes--within a Bayesian framework. A simple Gibbs sampling algorithm is proposed for sample generation from the posterior distribution of unknown parameters. Using the Gibbs output, we propose a method for determining an appropriate number of the latent classes. A real-world marketing example as an application for market segmentation is provided to illustrate the proposed method.


The main goal of our research was to carry out a comprehensive study on the obligatorily myrmecophilous Maculinea alcon (Denis & Schiffermüller) whose taxonomy has remained highly debated despite the fact that Maculinea Van Eecke species are some of the most intensively studied insects in Europe. We aimed to elucidate the relationship between the different forms exploiting different ecological environments with specific regard to 'Hirschke's rebeli' (M. rebeli (Hirschke)) from the high altitudes of the Styrian Alps which was studied in this respect for the first time. Molecular analyses including multiple gene sequences, microsatellites and allozymes completed with Wolbachia screening, together with geometric morphometry were applied on various sets of samples. Our results showed that 'rebeli' from the type locality differed strongly from all other samples not only at the highly variable microsatellites, but also at standard genes and clearly represents a well‐separated unit (potentially subspecies) within M. alcon. As all individuals were infected with a single Wolbachia strain, this is possibly an ancient infection with high maternal transmission rate. It also suggests that the separation of the topotypic populations was probably a relatively recent event which could have been promoted by genetic drift or specific conditions at high altitudes, and maintained by restricted gene flow. Both the genetic and the morphometric studies supported the proposition that the geographical origin of the populations has a higher effect on the structure of variation than the food plant use. Moreover, we detected more genetic lineages than could be defined by differential host plant usage.


Objective The aim of this study was to determine whether Si-Miao-Yong-An decoction (SMYAD) could protect cardiomyocytes from ischemia/reperfusion (I/R) injury and its underlying mechanisms. Methods C57BL/6 mice were used to establish a model of myocardial infarction by I/R injury and treated by SMYAD for 4 weeks. Then, the cardiac functions of mice were evaluated by cardiac magnetic resonance (CMR). Histopathological analysis for the heart remodeling was detected by H&E and Masson staining. The protein expression of collagen I, MMP9, and TNFα was detected by western blot in the heart tissues. H9C2 cells were used to establish the hypoxia/reoxygenation (H/R) model and SMYAD intervention. MTT assays detected the cell viability of myocardial cells. The expression level of IL-1β was evaluated by ELISA. The expression levels of LC3B-II/LC3B-I, p-mTOR, mTOR, NLRP3, procaspase 1, and cleaved-caspase 1 in H9C2 cells were evaluated by Western blot. Results SMYAD improved cardiac functions such as ventricular volume and ejection fraction of the rats with ischemia/reperfusion injury. Morphological assay indicated that SMYAD reduced the scar size and inhibited fibrosis formation. It was found that SMYAD could regulate collagen I, MMP9, and TNFα protein expression levels in the heart tissues. SMYAD improved the survival rate of H9C2 cardiomyocytes in the H/R injury model. SMYAD elevated the rate of LC3B-II/LC3B-I protein expression, decreased the rate of p-mTOR/mTOR protein expression, and reduced expressions of caspase 1, NLRP3, and IL-1β in H/R cardiomyocytes. Conclusion SMYAD exerted protective effects on ischemia/reperfusion injury in myocardial cells by activating autophagy and inhibiting pyroptosis. This might be the reason why SMYAD protected myocardial tissue and improved cardiac function in mice with ischemia/reperfusion.


Background/Aims: Full-field optical coherence tomography (FFOCT) is a new imaging technology that can provide 3D micron-level resolution and is suited for high-resolution imaging of biological tissue. The aim of this study was to evaluate its capacity and potential for imaging human epidermis and dermis and various skin pathologies in ex vivo and in vivo conditions. Methods: Non-fixed and fixed samples of normal and pathological skin and normal in vivo skin were imaged with a FFOCT system and compared to histological slides. Results: The epidermis and adnexae, the collagen bundles of the dermis and the hypodermis could be identified through architectural and cellular details. The pathological structures were distinguished from the normal structures and corresponded to their histopathological organization. Conclusion: FFOCT is a novel technology in the field of skin imaging that has the potential to be a relevant complement to existing non-invasive imaging modalities for clinical and cosmetic applications.


AIM
Aim of the study was to measure the effect of elastic and inelastic compression on calf muscle pump function in healthy male athletes.

METHODS
This was an experimental study which included 21 healthy male athletes. The ejection fraction (EF) of the venous calf pump was measured comparing the effects of a variety of compression materials: 1) sport compression stockings; 2) light zinc paste bandages; 3) sport compression stockings with additional Velcro® wraps over the calf. The influence of sport stocking and wraps on the venous calibre at the largest calf circumference in the lying and standing position was investigated using MRI.

RESULTS
Inelastic compression exerting a median pressure in the standing position of 37.5 mmHg (zinc paste) and 48 mmHg (loosely applied straps over a sport stocking) achieved a significant increase of EF up to 100%. Sport stockings alone with a standing pressure of 19-24 mmHg did not show a significant change of EF. MRI demonstrated some venous narrowing in the lying but not in the standing position. By wrapping inelastic straps over the stocking an emptying of the veins in the lying and a considerable narrowing in the standing position could be observed.

CONCLUSION
Venous calf pump function in athletes is not influenced by elastic sport stockings, but inelastic wraps either alone or applied over sport stockings lead to a significant enhancement.


Analysis of emergent marine terraces in the San Joaquin Hills, California, and 230 Th dating of solitary corals from the lowest terraces reveal that the San Joaquin Hills have risen at a rate of 0.21–0.27 m/k.y. during the past 122 k.y. Movement on a blind thrust fault in the southern Los Angeles basin has uplifted the San Joaquin Hills and has the potential to generate an M w 7.3 earthquake within this densely populated area. Our structural modeling suggests that the fault dips to the southwest and slips at ∼0.42–0.79 m/k.y., yielding an estimated minimum average recurrence interval of ∼1650–3100 yr for moderate-sized earthquakes. Recognition of this blind thrust extends the known area of active blind thrusts and fault-related folding southward from Los Angeles into coastal Orange County.


Semarang City is a densely populated city with a fairly high mobility. The large number of residents, both natives and immigrants, causes many changes, one of which is the production of waste. Effective waste management is absolutely necessary so that the waste produced can be managed properly. With effective management, it is hoped that Semarang will become a clean city. This problem received a response from the government through the Environmental Service so that it was followed up. One of them is waste management at the Jatibarang TPA. This study uses the theory of effectiveness from several experts and uses the reference to the effectiveness criteria proposed by Gibson. This study uses a qualitative descriptive method conducted through interviews and also documentation. The results of the study indicate that the waste processing at the Jatibarang TPA is quite effective. Adjustment of needs with waste management innovations that are continuously improved so that problems can be resolved. The main obstacle felt was regarding funding for several facilities and infrastructure, the overwhelming need with the funds provided was felt to have not been fulfilled. The advice given is to increase public awareness to reduce waste generation so that waste can be controlled and the burden of the landfill will be reduced.


Eighteen bread wheat (Triticum aestivum L.) and two durum wheat genotypes (Triticum turgidum L.) were used to explore relationship among their morpho-physiological traits. Two separate field experiments were conducted at the Experimental Station, College of Agricultural, Shiraz University. Each experiment was designed as a randomized completed block with three replications. Twenty-five morpho-physiological drought resistance related traits were measured and multivariate statistical techniques were used to consider these relationships. Based on the results of the factor analysis, electrolyte leakage (EL) had the highest positive correlation, while membrane stability index (MSI) had the highest negative correlation with the first factor, canopy temperature depression (CTD). It could be clearly detected that these two variables had high effect on canopy temperature and the genotype with lower EL and higher MSI resulted in lower canopy temperature. This factor also showed that reactive oxygen species (ROS) related traits and plant water relationship related traits had significant effect on CTD. Since yield stability (YS) had the highest coefficient in factor 3, this factor was the most important one showing effective variables on this trait, thus this factor's suggested name was YS. The significant positive correlations with factor 3 were relative water protected (RWP), which is a new index, and cellular membrane stability (CMS). This result clearly shows that new index of RWP can be an efficient indirect criterion to screen higher YS genotypes together with CMS. Cluster analysis grouped variables into three clusters. These results were confirmed by the results of principal and discriminate function analysis. In addition, the results of the factor analysis for considering relationships among measured traits were confirmed through the cluster analysis.


Bathymetric features such as islands and seamounts, as well as dynamic ocean features such as fronts often harbour rich marine communities. We deployed mid-water baited remote underwater video systems on three expeditions in Ascension Island's Exclusive Economic Zone (EEZ), surveying the waters associated with six different bathymetric and dynamic ocean features: Ascension Island, two shallow seamounts (summits ≤ 101 m), one deeper seamount (summit > 250 m), apparent fronts, and haphazardly sampled open ocean areas. At Ascension Island, the pelagic assemblage consisted of a moderate proportion of predators and a diverse range of other taxa, including turtles, dolphins, and large non-piscivores. At the two shallow seamounts, sharks, tunas, billfish, and other large pelagic predators formed the vast majority of the assemblage, contributing > 99.9% of biomass and > 86% of abundance. At the deeper seamount, the pelagic community was comparatively depauperate, however the functional composition of its assemblage indicated some similarities to the shallow seamounts. Apparent fronts did not significantly differ from random offshore sites for metrics such as total abundance and taxonomic richness. However, they harboured assemblages with more abundant sharks, tunas, and large piscivores than random ocean open locations and these differences may be driven by certain front-associated species. Our results illustrate that pelagic assemblages vary markedly among different physical and oceanographic features and that seamounts appear particularly important for pelagic predators. The diversity and abundance of the assemblage, as well as the threatened status of many of the species observed, serve to highlight the conservation value of the Ascension Island EEZ. Our results also provide important baseline information of pelagic wildlife assemblages against which the performance of the recently implemented Ascension Island Marine Protected Area can be evaluated.


Introduction
The objective of this study was to survey 2018-2019 Year III students at the Canadian Memorial Chiropractic College in order explore their perceptions of the components of the revised Jurisprudence, Ethics and Business Management course.

Methods
This study was approved by the Research Ethics Board. A paper survey was distributed to all enrolled students. Using a five-point Likert scale, students were asked if they perceived the course material was (i) well-presented and (ii) important for them to know as future chiropractors. Students were required to sign a consent form to participate.

Results
Survey response rate was 94%. Over 90% of respondents 'strongly agreed/'agreed' lectures, small group session and course assignments were well presented and important for them to know as future chiropractors. Respondents were more critical of the online business modules (on average, 50% 'strongly agreed/agreed').

Conclusions
The information from this survey will enable refinement of future versions of this course.


An actively managed portfolio almost never beats the market in the long term. Thus, many investors often resort to passively managed portfolios whose aim is to follow a certain financial index. The task of building such passive portfolios aiming also to minimize the transaction costs is called Index Tracking (IT), where the goal is to track the index by holding only a small subset of assets in the index. As such, it is an NP-hard problem and becomes unfeasible to solve exactly for indices with more than 100 assets. In this work, we present a novel hybrid simulated annealing method that can efficiently solve the IT problem for large indices and is flexible enough to adapt to financially relevant constraints. By tracking the S&P-500 index between the years 2011 and 2018 we show that our algorithm is capable of finding optimal solutions in the in-sample period of past returns and can be tuned to provide optimal returns in the out-of-sample period of future returns. Finally, we focus on the task of holding an IT portfolio during one year and rebalancing the portfolio every month. Here, our hybrid simulated annealing algorithm is capable of producing financially optimal portfolios already for small subsets of assets and using reasonable computational resources, making it an appropriate tool for financial managers.


We examined specimens from explanted human hearts by two-dimensional electrophoresis. The protocol selected includes: (a) solubilization of the sample in a urea-detergent mix; (b) charge fractionation in the presence of urea and nonionic detergent on a pH 4-10 immobilized pH gradient; (c) size fractionation on a polyacrylamide concentration gradient in the presence of sodium dodecyl sulfate; and (d) staining with silver nitrate. The method is sensitive enough for analysis of biopsies in the 1-3 mg range (wet tissue). We saw, for explanted hearts, variations in the protein pattern with the site of sample dissection. Results are presented for 11 explanted human hearts: one control organ and 10 pathological samples. The recorded pathologies included dilatative cardiomyopathy (six cases), valvulopathy (one case), ischemic cardiopathy (two cases), and graft rejection (one case). The patterns for whole extracts as well as for cytoplasmic proteins and myofibril components are compared. Extensive individual variability was observed both between control and pathological cases and among the abnormal samples.


ABSTRACT This textbook is a comprehensive treatise on virtually all facets of benign enlargement of the prostate. The importance of the subject is indicated by the fact that greater than 80% of men older than 50 years will be affected by this disease.In this text, the subject matter is broken down into ten sections, each with its own section editor. The first three sections deal with the evolution of benign prostatic hypertrophy, the structure and function of the prostate, and endocrine control of the prostate. The next four sections comprise an extensive presentation of the effects of prostatic obstruction and its measurement, both experimental and clinical. Three sections then describe surgical indications, techniques, and results of treatment. Finally, there is an annotated bibliography provided as a concluding section, which, in addition to the references supplied the end of each chapter, serves to compile key references according to their value for


Purpose We evaluated the correlations between visual deficits and patient-reported symptoms in patients with regressed proliferative diabetic retinopathy (PDR) to determine whether there is a psychophysical basis for vision-related impairments. Methods Visual acuity, reading acuity, contrast sensitivity, frequency doubling perimetry (FDP), Humphrey field analyzer (HFA), and dark adaptation assessed visual function. The National Eye Institute Vision Function Questionnaire-25 (NEI VFQ-25) and Low Luminance Questionnaire (LLQ) assessed quality of life. Results We recruited 30 adults who received panretinal photocoagulation (PRP) for PDR and 15 control subjects; 22 diabetic and 11 control participants completed a second evaluation 5 years later. Visual acuity of the worse-seeing eyes tended to correlate better with NEI VFQ-25 and LLQ than did the acuity of the better-seeing eyes. Other vision measures were generally not associated with either questionnaire, especially responses related to driving ability and mental health. Visual acuity only detected subnormal performance in 43% to 45% of patients, while FDP 24-2, HFA 60-4, and LLQ detected abnormal performance in >80% of patients. Conclusions Poor visual acuity may explain some vision-related impairments in daily function. However, many patients with regressed PDR have normal acuity but reduced visual field and poor quality of life. In these patients, their reported symptoms were not fully explained by visual acuity or any psychophysical tests alone. Translational Relevance Visual acuity is a poor indicator of overall visual function in people with regressed PDR. In clinical settings, visual field tests and patient-reported outcomes may provide more comprehensive assessments of their functional deficits than visual acuity.


Abstract A novel set of 16 hybrids of bromopyrrole alkaloids with aroyl hydrazone were designed, synthesized and evaluated for antibacterial and antibiofilm activities against methicillin-resistant Staphylococcus aureus (MRSA; ATCC 43866), methicillin-susceptible Staphylococcus aureus (MSSA; ATCC 35556) and Staphylococcus epidermidis (SE, S. epidermidis ATCC 35984). Of the 16 tested hybrids, 14 exhibited equal or superior antibiofilm activity against MSSA and MRSA relative to standard vancomycin. Compound 4m showed highest potency with antibiofilm activity of 0.39 µg/mL and 0.78 µg/mL against MSSA and MRSA, respectively. Thus, this compound could act as a potential lead for further development of new antistaphylococcal drugs.


We investigate the flow of a suspension through a constriction by means of the mesoscopic technique known as dissipative particle dynamics (DPD). The dispersed phase was modeled as a set of soft spheres interacting through a conservative force while suspended and continuum phases interact via DPD forces. It is shown that a Poiseuille steady state is achieved in the presence of bounding walls and under a pressure gradient in a cylindrical pipe. Flow geometry in the laminar regime is explored and discussed for periodic conditions in the presence of a cylindrical narrowing or constriction.


Abstract This research is focused on the analysis of capital mobility indicators in the EU new member states as capital market union is one of the newest initiative in the EU. We found the most integrated countries are Hungary, the Czech R., Croatia and Estonia. Econometric analysis emphasized the main determinants of capital account openness and of FDI inward stock. The analysis indicates that the level of development, intra-EU trade and FDI inward stock have a positive impact on capital account openness (mobility), while inflation has a negative infl uence. The GDP per capita, intra- EU trade and capital account openness have positive impact on FDI inward stock while inflation and gross fixed capital formation have negative influence. Unexpectedly, fiscal variables and interest rates do not have a significant impact on capital openness. The results show that there is room for improvement in all countries that would enable more favorable access to capital.


Citrinin (CTN) and ochratoxin A (OA) were fed alone and in combination to broilers from day of hatch until 3 weeks of age. Dietary concentrations of 300 micrograms CTN/g and 3.0 micrograms OA/g were used. Birds fed CTN had significantly (P less than or equal to 0.05) lower body weights than controls on days 14 and 21 and increased water consumption on days 7, 14, and 21. Birds fed OA had significantly lower body weights than controls on days 7, 14, and 21 and increased water consumption on day 14. Birds fed CTN and OA in combination had lower body weights than controls and increased water consumption during the experiment, but the alterations were intermediate in severity when compared with those in birds fed CTN or OA alone. Birds fed OA alone or combined with CTN had higher liver and kidney weights than controls, but birds fed CTN alone had only higher kidney weights. Birds fed both CTN and OA had concentrations of serum constituents similar to those in birds fed OA alone, except the levels of cholesterol and triglycerides were not significantly different from those in the controls. Histological evaluation of the kidney indicated no lesions in birds fed CTN alone, but birds fed OA, alone or in combination with CTN, had increased tubular casts and tubular hyperplasia compared with controls. These data suggest that there were no additive or synergistic toxic interactions when 300 micrograms CTN/g and 3.0 micrograms OA/g were fed simultaneously to broiler chicks for 3 weeks. However, the severe growth depression resulting from OA and the increased water consumption associated with CTN toxicosis were ameliorated when CTN and OA were fed in combination. These data may be useful in diagnosing field cases of mycotoxicosis where both CTN and OA are involved.


— This study aimed to assess whether there is influence of the Express and VistaScan scanning systems on the optical density of the image of endodontic cements. 36 specimens were used, 6 of each material, and each material was manipulated and inserted into holes in an acrylic plate supported by a glass plate. The radiographic exposure was performed on phosphorus plates together with an aluminum scale of 9 steps with 1 mm each, this being used as the gold standard. After the periapical radiographic acquisitions, the phosphor sensors were scanned by the Express and VistaScan equipment and saved in TIFF. The optical density of each material was measured in shades of gray and in millimeters of aluminum equivalent (mm Al), according to ISO 6876/2001 standards, using the ImageJ software, twice with an interval of 1 week. The optical density of the filling materials was corrected by subtracting the optical density from the glass plate. To compare the average densities according to the different cement brands, the Tukey test was applied for multiple comparisons. All tests were performed at a 5% significance level. There was a strong correlation between optical densities measured at time 1 and time 2, for optical densities measured from the Express scanning system, Pearson's correlation between measurements made at time 1 and 2 was equal to 0.9983 (p < 0.0001) and for measurements made from the VistaScan 0.9998 system (p <0.0001); in both cases the correlations are very close to 1 indicating an almost perfect correlation. In the Express system there was a variation in optical density between 155 and 185, and in the VistaScan system this density varied between 70 and 160. The VistaScan system showed a higher contrast resolution where, through the Analysis of Variance, a greater difference was observed in the densities of the evaluated cements. It was also evident that the measurement via the Express system was numerically superior to VistaScan. There was interaction between the scanning methods and filling cement, mainly in the measurements in the VistaScan system. It was observed that optical density measured in the i-Express system was numerically always higher than the optical density measured in the VistaScan system, and in the Express system, the AH Plus filling cement was the one that obtained the lowest optical density value and the MTA Fillapex reached density larger optics. In the VistaScan system, Sealer 26 cement had the lowest optical density and AH Plus cement had the highest optical density.


The paper presents a novel Three-tier Parallel Genetic Algorithm (TPGA) based on multi-core computer with Threading Building Blocks (TBB). The purpose of a new parallel function is to improve the running efficiency. TPGA is decomposed into three-tier: data coding parallelism, task processing parallelism and data decoding parallelism and it can improve the convergence rate. TBB offers a rich and complete approach to express parallelism in a C++ program. Sequential Genetic Algorithm (SGA) and TPGA are implemented based on TBB with C++ for bin-packing problem. Experiments show that the optimal solutions of TPGA and SGA are Consistent and the running efficiency of TPGA is also sooner than one of SGA.


The CNN (convolutional neural network)-based small target detection techniques for static complex scenes have been applied in many fields, but there are still certain technical challenges. This paper proposes a novel high-resolution small-target detection network named the IIHNet (information interworking high-resolution network) for complex scenes, which is based on information interworking processing technology. The proposed network not only can output a high-resolution presentation of a small target but can also keep the detection network simple and efficient. The key characteristic of the proposed network is that the target features are divided into three categories according to image resolution: high-resolution, medium-resolution, and low-resolution features. The basic features are extracted by convolution at the initial layer of the network. Then, convolution is carried out synchronously in the three resolution channels with information fusion in the horizontal and vertical directions of the network. At the same time, multiple utilizations and augmentations of feature information are carried out in the channel convolution direction. Experimental results show that the proposed network can achieve higher reasoning performance than the other compared networks without any compromise in terms of the detection effect.


Present condition shows that balance and environmental sustainability of mangrove forests in Mahakam Estuary (Delta Mahakam) area has changed which can result negative effect on people activity of coastal communities. Destruction of mangrove forest is caused by intervention and rapid population growth, especially in coastal areas, which result land use change and excessive utilization of natural resources. This condition can lead to degradation of mangrove forest. In order to rehabilitate mangrove forest, active participation from coastal community is needed. In this regard, this research was carried out in order to assess the perception and participation as well as strategies that can be implemented to improve community participation on mangrove forest rehabilitation. The research was conducted in five villages (Saliki, Salo Palai, Muara Badak Ulu, Muara Badak Ilir and Tanjung Limau), Formulation strategies was carried out using SWOT (Strengths, Weaknesses, Opportunities, Threats) method through Focus Group Discussion which combined with Analytical Hierarchy Process to determine the priority of alternative strategies and policies on mangrove forest rehabilitation. The analysis shows that social factor which influences community's participation towards the rehabilitation of coastal mangrove forest is perception variable. Strategy which is expected to improve community participation in mangrove rehabilitation activities is carried out by optimizing the strength factor and take advantage from the opportunities (Strengths Opportunities Quadrant Strategy). Based on formulated strategies, it can be obtained four priority alternatives which can be implemented to improve coastal community participation, i.e.: 1) Development of rural participatory for mangrove nursery; 2) Generates positive perception on the strengthening coastal communities about the advantage and functions of mangrove forests; 3) control upon re-vegetation and restoration of coastal areas resources which suffer from degradation and deforestation; and 4) Accelerate the establishment of Guidance Unit Team and Technical Guidance Unit of Mangrove Forest.


The Domestic Scan Program was developed to highlight innovative practices of high-performing transportation agencies that could be beneficially adopted by other interested agencies. The Scan Program provides the opportunity for technology transfer on a relatively economical basis with significant benefits on a national scale. The Clean Water Act (CWA) places requirements on Departments of Transportation (DOTs) for the discharge of stormwater from their systems through the National Pollutant Discharge Elimination System (NPDES). Non-compliance with NPDES permits can impact project design, engineering and construction schedules and increase construction time and costs. Successful implementation and compliance with NPDES permits requires the appropriate transfer of information and accountability through multiple phases of project delivery. State DOTs that are under NPDES Municipal Separate Storm Sewer System (MS4) Phase I or Phase II permit coverage are anticipating implementation of the total maximum daily load (TMDL) process which poses potential stormwater permitting concerns based upon the method of implementation chosen and the types of receiving water impairments addressed. This paper summarizes a Domestic Scan for stormwater that occurred in July, 2009. Four primary topics were selected as the subject of this Scan. Benefits of this scan include better insight into stormwater requirements during the project delivery process, improved compliance with NPDES permits, and reducing project delays associated with NPDES violations and noncompliance. The Scan provided an excellent opportunity to document lessons learned and share experiences to assist individual DOTs in negotiating, developing, implementing and tracking TMDL programs as part of NPDES MS4 compliance.


The optical Talbot interferometer has been used to explore the topological charges of optical vortices. We recorded the self-imaging of a diffraction grating in the near-field regime with the optical vortex of several topological charges. Our twisted light was generated by a spatial light modulator (SLM). Previous studies showed that interferometric methods can determine the particular orbital angular momentum (OAM) states, but a large number of OAM eigenvalues are difficult to distinguish from the interference patterns. Here, we show that the Talbot patterns can distinguish the charges as well as the OAM of the vortices with high orders. Owing to high sensitivity and self-imaging of Talbot effect, several OAM eigenvalues can be distinguished by direct measurement. We assure the experimental results with our theory. The present results are useful for classical and quantum metrology as well as future implementations of quantum communications.


Abstract Living mulches can provide many sustainability benefits. However, living mulch–cash crop competition and unreliable weed control are major challenges in living mulch systems. In this study, we evaluated the potential of herbicides used at reduced rates in combination with living mulch to suppress weeds, while simultaneously reducing living mulch vigor. Herbicide treatments were a combination of two POST applications, each consisting of a single, different herbicide. Field trials were conducted in Freeville, NY, USA, using: fresh market field tomato as cash crop; sesbania and sunn hemp as living mulch; and the herbicides fomesafen, halosulfuron, metribuzin, and rimsulfuron. In 2015, when water was not limiting, tomato yield and living mulch biomass were positively correlated. This relationship was negative in 2016, likely because of drought during the growing season. Compared with the untreated living mulch check, using the herbicide treatments in combination with living mulch reduced tomato yield losses by up to 71% in 2015 and 51% in 2016. In these herbicide plus living mulch plots, weed biomass was reduced by up to 97%, compared with the weedy check. Living mulch in herbicide treatments generated up to 2500 kg ha–1 of dry matter during both 2015 and 2016, with an average ground cover of 63% in 2015 and 85% in 2016. A predominantly PRE herbicide with residual soil activity (metribuzin), followed by a herbicide with greater POST activity (halosulfuron/rimsulfuron) was the most effective herbicide application sequence. Results from our study indicate that well-designed herbicide applications may enhance the practicability of living mulch systems. Nomenclature: Fomesafen; halosulfuron; metribuzin; rimsulfuron; sesbania, Sesbania sesban (L.) Merr.; sunn hemp, Crotalaria juncea L.; tomato, Solanum lycopersicum L.


Village can implement self- governing community based on the origin and the local custom in order to be democratic, independent and prosperous. Therefore, Indonesia government issues Indonesian Law Number 6, 2014 on the village that provides opportunities for optimizing the Village in rural development. However, rural development should be in a harmony with the local government program, as stipulated in Indonesian Law Number 23, 2014 on Regional Government. Nowadays, Indonesia enters the ASEAN Economic Community. It appears a challenge not only for central government but also for rural urban or administrative village wherein needs to increase human resources development, natural resources finding and rural potency indentifying.  Therefore, the strengthening of administrative village is significant to make administrative village understand toward implementing good governance, making aspirational village regulations and establishing village-owned enterprises. Keyword: Strengthening, Administrative Village, Governance, Regulation


Once one of the most numerous seabirds of the Benguela upwelling system, the population of Cape cormorants Phalacrocorax capensis has decreased by 60% in the past three decades and the species is listed as Near Threatened. Declines in prey availability and/or abundance brought about by recent changes in the distribution of pelagic fish stocks and industrial purse-seine fishing are hypothesised to be a key driver of seabird population decreases in the southern Benguela. We investigated the foraging behaviour of breeding Cape cormorants by deploying GPS and temperature–depth recorders on 24 breeding adults from three islands off the coast of South Africa, two of them to the north of Cape Point and a third farther south on the western Agulhas Bank. This provided the first measures of foraging dispersal by a cormorant in the Benguela system, and enabled a comparison of foraging behaviour between birds from these islands. Foraging trips of Cape cormorants lasted between 17 min and >7 h, at a maximum distance of between 2 and 58 km away from their colony. Foraging effort was significantly greater for birds from farther north off the West Coast in terms of trip duration, distance travelled, number of dives and time spent flying compared to those from the southernmost island (Dyer), which is probably a response to low prey availability in the north. Coastal reserves that exclude pelagic fishing from inshore feeding grounds around Cape cormorant breeding colonies may result in increased local prey availability, which would benefit Cape cormorant populations.


Reactivation of latent JC virus in immunodeficient subjects can lead to a demyelinating disease following lytic oligodendrocyte infection. It is known as idiopathic CD4+ lymphocytopenia and rarely occurs in immunosuppressed patients who are not infected by HIV. We describe a case of persistent idiopathic CD4+ lymphocytopenia in an HIV-negative 65-year-old woman. At autopsy, polymerase chain reaction analysis evidenced JC virus DNA in kidney, brain and liver although there were no signs of progressive multifocal leukoencephalopathy or evidence of oligodendrocyte infection. While her disease was not HIV-induced, it closely resembled AIDS in terms of the nature of the immune derangement and the clinical picture. The case also evidences the reactivation of JC virus infection in non-HIV-related immunosuppression in cerebral and/or extracerebral sites: liver infection seems to be particularly relevant since it has not yet been recognized as a common target of JC virus infection or a source of virus spreading. The absence of any sign of progressive multifocal leukoencephalopathy was remarkable: histological examination failed to disclose demyelination or other progressive multifocal leukoencephalopathy changes, and the search for JC virus DNA with in situ methods also gave negative results. The lack of lytic brain infection in this case would seem to support the hypothesis that the expression of progressive multifocal leukoencephalopathy is directly dependent on the presence of HIV infection.


We consider a new semidefinite programming relaxation for directed edge expansion, which is obtained by adding triangle inequalities to the reweighted eigenvalue formulation. Applying the matrix multiplicative weight update method to this relaxation, we derive almost linear-time algorithms to achieve $O(\sqrt{\log{n}})$-approximation and Cheeger-type guarantee for directed edge expansion, as well as an improved cut-matching game for directed graphs. This provides a primal-dual flow-based framework to obtain the best known algorithms for directed graph partitioning. The same approach also works for vertex expansion and for hypergraphs, providing a simple and unified approach to achieve the best known results for different expansion problems and different algorithmic techniques.


In spring 2011, members at the joint meeting of the Greater Western Library Alliance Resource Sharing/Document Delivery and Collection Development committees discussed the growing "silo-ization" of e-books behind different universities' local databases and access portals. The group formed a subcommittee to investigate the possibility of developing a software system that would allow the interlibrary loan (ILL) of e-books. Two employees of the Texas Tech University (TTU) Libraries explored the question: "What is the simplest way for libraries to lend e-books to each other?" Together, three members—Texas Tech, the University of Hawai'i at Mānoa, and the Greater Western Library Alliance (GWLA)—formed the Occam's Reader Project. Each institution began developing different components of the software. Hawai'i designed the public viewer, and Texas Tech designed the software that would handle the e-book conversion, transmission, and hosting. Occam's Reader offers a unique solution in which the intellectual content of the book is made available for the patron to read, but it is stripped of the additional features and links of the full e-book. The philosophy is similar to offering the level of access of printed books, but with quicker delivery. By spring 2014, the Occam's Reader project entered a pilot program with the publisher Springer to test the Occam's Reader software with other GWLA members. 10 160 | Academic E-Books


OBJECTIVES
Induction of moderate hypothermia in patients with median cerebral artery (MCA) infarction may produce metabolic and nutritional impairments. Currently, we do not know which is the best method to carry out nutritional assessment in this population group. The aim of the present study was to assess the usefulness of nitrogen balance in the follow-up of patients with MCA submitted to moderate hypothermia (32-33 degrees C) by means of intravascular cooling at the Neurocritical Patients Unit at a tertiary hospital.

MATERIAL AND METHODS
We designed a retrospective study including patients with MCA infarction of whom we gathered bio-demographical, clinical, hypothermia, and nutritional variables. Similarly, we carried out a prospective follow-up of a patient with MCA infarction and induced hypothermia, gathering the same variables at different time points of his clinical course.

RESULTS
Six patients with MCA infarction submitted to moderate hypothermia for a mean duration of 12 days (interval 9-15) were included in the retrospective series. We observed that nitrogen losses (mean 9.9 g) were lower than those previously thought for critical patients during the acute phase. During the prospective follow-up of the patient with malignant infarction of the MCA from day 1 to day 22 after the application of hypothermia, low levels of nitrogen losses were similarly observed during the phase of induced hypothermia, which increased later on when the patient recovered normothermia. The mean nitrogen expenditure during the period of hypothermia was 10.7 g and increased up to 27.3 g during the normothermia period (day 17).

CONCLUSIONS
These results suggest that moderate hypothermia-induced metabolic suppression is clinically relevant and thus the determination of nitrogen balance does not seem to be a useful tool in the nutritional followup of this type of patients.


The prevalence of schistosomiasis will soon be controlled to a low level in China. It is therefore imperative to establish a more sensitive and effective early warning system for schistosomiasis, so as to consolidate the achievements of the disease control. By covering four topics including the importance of early warning system for schistosomiasis and its research direction, as well as recent development in big data mining and its application in monitoring and early-warning of schistosomiasis, this review discusses the feasibility of data mining technology for monitoring and early warning of the disease. It is hoped that this technology would increase the efficacy of studies on monitoring and early warning, and promote the elimination of schistosomiasis in China.


People who use sign language to communicate have argued that they are a linguistic minority and not disabled. Rather than being disabled, people in this group have argued that they simply speak a language different than others, such as Spanish or Russian. Labeling a person as disabled attracts negative historical baggage. For this reason, some scholars have argued for the term of "ableism" to replace the term "disability discrimination." Although these debates are extremely important, it is equally important to utilize all available tools to achieve social inclusion for all people regardless of their different abilities. This Article will demonstrate how one such tool can be used to benefit persons with disabilities. In particular, this Article will analyze how the norms and state acceptance of the United Nations Convention on the Rights of Persons with Disabilities ("CRPD") can be used by non-government organization ("NGO") and disability person organization ("DPO") advocates to drive change in their communities and achieve law reforms where appropriate. Persons with disabilities are the world's largest minority group. Persons with disabilities have historically confronted systematic discrimination. The Preamble to the CRPD explains that the United Nations adopted this Convention based on twenty-five key facts including "the fact that the majority of persons with disabilities live in conditions of poverty, and in this regard recognizing the critical need to address the negative impact of poverty on persons with disabilities." The World Bank estimates that persons with disabilities make up twenty percent of the world's poorest people. There have been recent international and domestic commitments to improving the human rights of persons with disabilities. In 2006, the United Nations adopted the CRPD and in 2009 the United States ratified this convention. The rights of persons with disabilities have gained national attention as the result of the Obama administration's express commitment to advancing the rights of persons with disabilities. The adoption of the CRPD by the United Nations and its ratification by the United States have substantially shifted the paradigm that guides domestic laws and policies.Part II of this Article will analyze the paradigm shift inherent in the CRPD. Part II.A analyzes the development of disability policies through the welfare model, to the social model, and finally to the propounding of a human rights agenda. Part II.B then explores how the CRPD has embraced this human rights agenda and how its sweeping human rights agenda can change the lives of persons with disabilities. To emphasize the potential of the rights approach, Part II.C demonstrates what the change means for persons with disabilities exercising their right to work. Part III of this Article then builds upon the sweeping rights agenda to analyze what DPO advocates can do to facilitate the change.Part III.A considers the role of shadow reports and builds on comments of the current chairman of the international committee monitoring the implementation of the CRPD.Part III.B analyzes other steps advocates can take to create a climate of change. This Article then focuses on DPO capacity building.


Chronic ankle instability (CAI) is a common debilitating condition in sports medicine that contributes to dysfunction and disabilities. A significant portion of patients with ankle sprains develops CAI, resulting in recurrent injuries and an increased likelihood to develop a degenerative disease like ankle osteoarthritis. CAI may be due to either mechanical or functional insufficiencies, or both. The mechanical contributing factors are pathologic joint laxity, arthrokinematic restrictions, synovial inflammation and impingements, and degenerative changes. The functional insufficiencies include impairments in proprioception, alpha motoneuron pool excitability, reflex actions, strength, postural control, walking and running mechanics, and jumping and landing mechanics, which indicate alterations in the sensorimotor system. It may be intuitive that mechanical disruptions of the lateral ligaments in the ankle joint following an ankle sprain cause changes in joint mechanics, leading to the joint instability, but it is not clear how sensorimotor deficits arise from mechanical injury to the ankle. Recent evidence showed that deficits in postural control and alpha motoneuron recruitment might be more influential, however, each of the sensorimotor deficits play a role in CAI. Thus, the purpose of this review is to discuss the relevant literature surrounding chronic ankle instability with an emphasis on deficits in postural control and alpha motoneuron pool excitability, and to provide insight into rehabilitation for CAI patients suffering from sensorimotor dysfunction.


Treacher Collins syndrome (TCS) is an autosomal dominant disorder of craniofacial development which affects about 1 in 50 000 live births. It causes symmetrical abnormalities of: (1) the ears, including abnormalities of the external ears, malformation of the middle ear ossicles, and conductive hearing loss; (2) lateral downward sloping of the palpebral fissures, often with colobomata of the lower eyelid; (3) hypoplasia of the mandible and zygomatic complex; (4) cleft palate. Complete non-penetrance is rare, but gene expression is very variable, which can make genetic counselling difficult, particularly as about 60% of cases appear to represent new mutations. The TCS locus was mapped to 5q31-34 in 1991, and positionally cloned in 1996. More recently the 3' and 5' ends have been identified, and the complete genomic organisation of the gene elucidated. Ten mutations were reported initially, and in this paper a further 25 are described, representing an overall mutation detection rate of 60%. The latest 25 mutations are spread across the gene, and all but one of the 35 mutations described so far result in the introduction of a premature termination codon into the predicted protein treacle. Seven different families have a common 5 bp deletion in exon 24, and two families have a recurrent splicing mutation in intron 3, but the remaining 26 families have family specific mutations. Eight of the 35 mutations described are sporadic and each of these is unique. The authors suggest that the mutational spectrum supports the hypothesis that TCS results from haploinsufficiency. They also postulate that other acrofacial dysostoses (such as Nager and Miller syndromes) and hemifacial microsomia/Goldenhar syndrome could result from mutations within the same gene, given that a number of the craniosynostoses have been shown to be allelic. (In the first arch mouse mutant far, the same mutation may result in either bilateral or unilateral features, depending on the genetic background on which the mutation is placed.) the EPM1 site is the first documented example of a large minisatellite expansion associated with a recognised disease phenotype. DAVID 0 ROBINSON


Cardiovascular disease has increased substantially in countries of central and eastern Europe and remains the major cause of premature death in Western populations. Cholesterol plays the major role in the underlying cause of cardiovascular disease, namely atherosclerosis. Epidemiological studies have demonstrated the prospective, strong and dose-dependent relationship between low density lipoprotein cholesterol and cardiovascular disease. In addition, evidence from molecular biology and randomized clinical trials supports the concept that elevated low density lipoprotein cholesterol is both suffi cient and necessary for the development of atherosclerosis. Other risk factors than cholesterol greatly enhance the likelihood of symptomatic disease. Monogenic lipid disorders including familial hypercholesterolemia and familial defective apolipoprotein B illustrate the consequences of the dysregulation of cholesterol metabo-


During the Cretaceous Period, gastropod faunas show considerable differences in their evolution between the Tethyan Realm (tropical) and the Temperate Realms to the north and south. Like Holocene faunas, prosobranch gastropods constitute the dominant part of Cretaceous marine snail faunas. Entomotaeneata and opisthobranchs usually form all of the remainder. In Tethyan faunas the Archaeogastropoda form a consistent high proportion of total taxa but less than the Mesogastropoda throughout the period. In contrast, the Temperate faunas beginning in Albian times show a decline in percentages of archaeogastropod taxa and a significant increase in the Neogastropoda, until they constitute over 50 percent of the taxa in some faunas. The neogastropods never attain high diversity in the Cretaceous of the Tethyan Realm and are judged to be of Temperate Realm origin. Cretaceous Tethyan gastropod faunas are closely allied to those of the "corallien fades" of the Jurassic and begin the period evolutionarily mature and well diversified. Greatest diversity in Tethys occurs in the lagoonal shales associated with the rudist or coral framework environments of the Cretaceous carbonate platforms. Their distribution was pan-tropical, extending in instances across the vast reaches of the Pacific. Three categories of Tethyan gastropods are analyzed. The first group consists of those of Jurassic ancestry. Except for the Nerineacea, these taxa are long ranging but evolutionarily conservative, showing only moderate diversification during the Cretaceous, and becoming extinct with the close of the era. The second group originates mainly during the Barremian and Aptian, reaches a climax in diversification during middle Cretaceous time, and usually declines during the latest Cretaceous, with most not lasting through the terminal event. The third group originates late in the Cretaceous and consists of taxa that manage to either survive the Cretaceous-Tertiary crisis or give rise to forms of prominence among Tertiary warm water faunas. There is a trend among the Tethyan gastropod assemblages for increased provincialism with time. Early and middle Cretaceous taxa are especially widely distributed, but the latest Cretaceous is a time of restricted occurrence for many forms. Temperate Realm gastropod faunas are less diverse than those of Tethys during the Early Cretaceous. Their source is among long lived, extra-Tethys groups, but is increased, especially during major phases of transgression, by immigrants from Tethys. They show a steady increase in diversity, primarily among the Mesogastropoda and Neogastropoda. This trend culminates in latest Cretaceous times when the gastropod assemblages of the clastic provinces of the inner shelf contain an abundance of taxa outstripping that of any other part of the Cretaceous of either realm. Extinction at the Cretaceous-Tertiary boundary is much less pronounced in the Temperate Realm than in the Tethys. Among the Temperate Realm assemblages loss is of generic and species level taxa, unlike the extinction of the family Actaeonellidae or the superfamily Nerineacea and a host of less prominent groups in Tethys. In essence, by the late Maastrichtian, gastropod faunas of the Temperate Realm had attained a modern faunal aspect.


Several articles have focused on the process of innovation acceptance and adoption. Fewer studies have focused on the elements that explain innovation resistance and barriers to technology adoption. This article applies a recent Innovation Resistance Model to measure the attitudes of Brazilian health professionals toward telediagnostics technology. Contrary to what we had expected following a recent backlash from an attempt to modernize telemedicine practices in Brazil by the Federal Council of Medicine, our sample was very receptive to this technology, even though some resistance remains, both in terms of certain functional barriers (complexity, co-dependence, and compatibility), and psychological barriers (social and personal risk, public image, and above all information asymmetries). As a theoretical result, we have validated a scale (based on the model) to measure innovation resistance using the Principal Component Analysis method.JEL Code: I110


The utilization of soybean milk has lasted for past several thousand years, mostly in Orient as a Precious food or as a substitute for cow's milk. There are several hundred varieties in soybean that is called Glycine max Merryl There are three typical varieties, Yellow, Black and Green. However, these are due to pigment in soybean cuticle while their chemical constituents are similar (Table 2). Soybean milk is constituted of protein, fat and carbohydrate of soybean, and these constituents are extracted by hot water. Thus becomes emulsion which is highly digestible and nutritious for human diet. However, it was not found any report on the water extractability comparison between two different varieties Black cuticle soybean which is common in India and Yellow cuticle soybean which is common in Korea. Also there was no report on the comparison on the yield and organoleptic quality derived by varied process. Also several attempts were carried out to improve nutritional value as well as acceptability by use of food additives. A model of continuous soybean milk plant was introduced.


Proceedings: AACR 102nd Annual Meeting 2011‐‐ Apr 2‐6, 2011; Orlando, FL

Background : Endocrine-therapy resistant HER2 negative luminal-type breast cancer is the commonest cause of breast cancer death but the molecular basis for aggressive clinical behavior is poorly understood. Endocrine therapy resistant cases can be identified early in the course of the disease though the persistant expression of the cell cycle biomarker Ki67 despite neoadjuvant treatment with a potent aromatase inhibitor (JNCI 2008:100;159–61).

Methods : Massively parallel DNA sequencing (Nature 2010; 464:999–1005) was applied to samples from two neoadjuvant endocrine trials ("POL" J Am Coll Surg. 2009; 208: 906–14 and "ACOSOG Z1031" JCO in press ) to define the whole genome sequence of 50 luminal-type breast cancers (PAM50 definition, JCO 2009;27:1160–7) with an average 30 fold coverage. Of these, 24 were defined as resistant (surgical specimen Ki67 > 10%) and 26 sensitive (Ki67 ≤ 10%). Approximately 10 trillion base pairs of sequence were analyzed. Putative somatic mutations were confirmed through targeted sequence analysis and the absence of the variant in matched normal DNA.

Results : The mean number of single nucleotide non-silent variants (SNV) and small deletions (indels) was greater in the resistant group (49 per case) than sensitive cases (23) (p=0.02). The significantly mutated gene list included PIK3CA, TP53, ATR, RUNX1, MYST3, PRSS8, ZNHIT2 and MAP3K1. A large number of structural variations have also been identified with greater than 800 events from 28 patients orthogonally validated to date, mostly deletions but also translocations, although no recurrent translocations have been seen. About 25% of these deletions were paired with an SNV suggesting multiple novel double-hit tumor suppressor events. Extension analysis in 121 POL/Z1031 samples produced the following mutation incidence data PIK3CA (43%), TP53 (15.2%) and MAP3K1 (9.3%). The MAP3K1 mutations were most frequently frame-shift or nonsense, disrupting the C terminal kinase domain, a logical finding in a kinase activated by caspase 7 to promote apoptosis. Only 1 MAP3K1 mutation was observed in 60 basal-like breast cancers (luminal versus basal MAP3K1 mutation frequency p=0.04).

Conclusions : MAP3K1is a novel breast cancer tumor suppressor gene more frequently lost in luminal-type than basal-like breast cancer. Further data analysis will be presented including pathway analyses that place less common mutations into a variety of cancer pathways, including phosphoinositol-3-kinase signaling, cell cycle regulation, metabolism, mitotic spindle regulation and DNA mismatch repair. These analyses suggest a classification of the disease that is not based on individual gene abnormalities but common cancer pathway activation events that ultimately determine outcome for patients with luminal-type disease.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr LB-87. doi:10.1158/1538-7445.AM2011-LB-87


The aim of this study was to examine the correlation between word learning, effort and phonological memory. Twenty college students learned words in Latin through a slideshow. Effort was measured during baseline, word learning and word test, via two values of galvanic skin response: global mean value and numbers of peaks per minute. Phonological memory was measured by repetition of digits and nonwords. An increase in effort was detected between baseline, word learning and word test, except for peaks per minute between word learning and word test. Correlation was not detected for the outcome of word test with the increase in effort from rest to activity, nor with the effort during word learning or word test. Measured effort did not correlate with estimated effort, nor with phonological memory. Further research, with larger study groups, is required to understand the underlying cognitive and psychophysiological mechanisms in novel word learning among adults.


Karl Popper noted that, when social scientists are members of the society they study, they may affect that society. If the individuals to whom a theory initially applies come to understand that theory, then this understanding may affect their behaviour in such a way that the theory ceases to be applicable. This may be called the problem of reflexivity. In this paper, we identify such a problem in an apparently unlikely area: in the area of Condorcet's famous jury theorem. Suppose that each individual member of some decisionmaking body has a greater than 0.5 chance of making a correct judgment, and suppose further that all individuals' judgments are independent from each other. Then the jury theorem states that the majority will make a correct judgment with a probability approaching 1 as the number of individuals increases. We argue that, if the individuals come to understand the jury theorem, then they may cease to make independent judgments, thereby undermining one of the conditions for the application of the theorem. Specifically, we suggest that the individuals may be faced with a temptation to free-ride on the epistemic efforts of others. We first develop the problem in some detail and then ask whether there are any escape routes that can protect the jury theorem against the effect of reflexivity.


Causal therapies for the auditory-pathway and inner-ear diseases are still not yet available for clinical application. Regenerative medicine approaches are discussed and examined as possible therapy options. Neural stem cells could play a role in the regeneration of the auditory pathway. In recent years, neural stem and progenitor cells have been identified in the cochlear nucleus, the second nucleus of the auditory pathway. The current investigation aimed to analyze cell maturation concerning cellular calcium activity. Cochlear nuclei from PND9 CD rats were microscopically dissected and propagated as neurospheres in free-floating cultures in stem-cell medium (Neurobasal, B27, GlutaMAX, EGF, bFGF). After 30 days, the dissociation and plating of these cells took place under withdrawal of the growth factors and the addition of retinoic acid, which induces neural cell differentiation. Calcium imaging analysis with BAPTA-1/Oregon Green was carried out at different times during the differentiation phase. In addition, the influence of different voltage-dependent calcium channels was analyzed through the targeted application of inhibitors of the L-, N-, R- and T-type calcium channels. For this purpose, comparative examinations were performed on CN NSCs, and primary CN neurons. As the cells differentiated, a significant increase in spontaneous neuronal calcium activity was demonstrated. In the differentiation stage, specific frequencies of the spontaneous calcium oscillations were measured in different regions of the individual cells. Initially, the highest frequency of spontaneous calcium oscillations was ascertainable in the maturing somata. Over time, these were overtaken by calcium oscillations in the axons and dendrites. Additionally, in the area of the growth cones, an increasing activity was determined. By inhibiting voltage-dependent calcium channels, their expression and function in the differentiation process were confirmed. A comparable pattern of maturation of these channels was found in CN NSCs and primary CN neurons. The present results show that neural stem cells of the rat cochlear nucleus differentiated not only morphologically but also functionally. Spontaneous calcium activities are of great relevance in terms of neurogenesis and integration into existing neuronal structures. These functional aspects of neurogenesis within the auditory pathway could serve as future targets for the exogenous control of neuronal regeneration.


The name Flavobacterium branchiophila is proposed for a group of 16 bacterial strains that were isolated in Japan (5 isolates), Oregon (10 isolates), and Hungary (1 isolate) from cultured salmonids or sheatfish suffering from bacterial gill disease. These bacteria grow in cytophaga medium at temperatures between 10 and 25°C. The isolates are gram-negative, nonmotile, slender rods measuring 0.5 by 5 to 8 p.m. They utilize gelatin, casein, starch, glucose, fructose, sucrose, maltose, and trehalose. The mean guanine-plus-cytosine content of the deoxyribonucleic acids of three selected strains was 30 mol%. Strain BGD-7721 (= ATCC 35035) is designated the type strain of the new species.


The local sphere is the participatory space par excellence. However, there are few academic studies on citizen participation in urban polities, and even less on the quality of participatory mechanisms. This article analyses two participatory processes of urban reorganisation led by the City of Madrid, based on the development of an analytical framework designed to evaluate its quality, with the objective of knowing which initiative enjoys the higher quality, and of proposing a series of recommendations that would contribute to ensuring the successful development of these processes.


SARS-CoV-2 has caused millions of infections and deaths worldwide and case num-bers continue to rise. Besides the effect of the virus on key organs --- leading to respiratory illness, anosmia, diarrhea, and fever and other complications --- delayed inflammatory reactions to hyaluronic acid dermal fillers, mainly in the face, have also been reported to occur after confirmed SARS-CoV-2 infections and in vaccinated individuals. While delayed inflammatory reactions tend to be self-limiting, they should be diagnosed and treated with corticosteroids, hyaluronidase, and/or antibiotics when necessary. The inflammation is generally not severe, yet these complications are classified as serious adverse events by the US Food and Drug Administration. They appear to be delayed type IV hypersensitivity reactions triggered by the immune system in the presence of SARS-CoV-2 or other viruses, such as those causing influenza, although the underlying mechanisms have not been fully elucidated. Because the longevity of dermal fillers is increasing, while the pandemic continues to evolve and new vaccines are under development, the long-term effects on hyaluronic acid fillers and other bioimplant materials should be studied. Physicians must also be encouraged to report these reactions, however mild, to ensure accurate records.


Go with the flow Enhanced water transport occurs in a number of narrow pore channels, such as biological aquaporins. Tunuguntla et al. thoroughly characterized molecular transport through narrow carbon nanotubes (CNTs) (see the Perspective by Siwy and Fornasiero). In contrast to previous studies, the authors focused on water and ion transport through relatively short (∼10-nm) fragments of CNTs embedded in lipid bilayer membranes. Strong confinement generated highly accelerated water flow compared with that observed in biological water transporters. A key factor in the transport rate was the tunable rearrangement of intermolecular hydrogen bonding. Furthermore, by changing the charges at the mouth of the nanotube, the authors were able to alter the ion selectivity. Science, this issue p. 792; see also p. 753 Small-diameter carbon nanotubes show promising transport properties and selectivity for water purification applications. Fast water transport through carbon nanotube pores has raised the possibility to use them in the next generation of water treatment technologies. We report that water permeability in 0.8-nanometer-diameter carbon nanotube porins (CNTPs), which confine water down to a single-file chain, exceeds that of biological water transporters and of wider CNT pores by an order of magnitude. Intermolecular hydrogen-bond rearrangement, required for entry into the nanotube, dominates the energy barrier and can be manipulated to enhance water transport rates. CNTPs block anion transport, even at salinities that exceed seawater levels, and their ion selectivity can be tuned to configure them into switchable ionic diodes. These properties make CNTPs a promising material for developing membrane separation technologies.


This study was conducted to assess the effects of chronic daily spinach supplementation on known markers of muscle damage following half-marathon in well-trained healthy young men. Twenty well-trained men volunteered for this study. Participants were randomized in an open study placebo-controlled fashion into two groups, Spinach (S) (n = 10) and placebo (P) (n = 10). The participants took supplementation or placebo daily for 14 days before running. Participants ran 21 km. The spinach supplementation was prepared at 1 mg/kg body weight. Total Antioxidant Capacity (TAC) was determined as marker of plasma antioxidant capacity. LDH and bilirubin were measured as markers of muscle damage. TAC significantly elevated after supplementation in S group (P<0.05). The plasma level of LDH and bilirubin were significantly higher in P group after exercise (P<0.05). These results suggest that chronic daily oral supplementation of spinach has alleviating effects on known markers of muscle damage following a half-marathon in well-trained healthy young men.


Nonassociative learning is considered simple because it depends on presentation of a single stimulus, but it likely reflects complex molecular signaling. To advance understanding of the molecular mechanisms of one form of nonassociative learning, habituation, for ethologically relevant signals we examined song recognition learning in adult zebra finches. These colonial songbirds learn the unique song of individuals, which helps establish and maintain mate and other social bonds, and informs appropriate behavioral interactions with specific birds. We leveraged prior work demonstrating behavioral habituation for individual songs, and extended the molecular framework correlated with this behavior by investigating the mechanistic Target of Rapamycin (mTOR) signaling cascade. We hypothesized that mTOR may contribute to habituation because it integrates a variety of upstream signals and enhances associative learning, and it crosstalks with another cascade previously associated with habituation, ERK/ZENK. To begin probing for a possible role for mTOR in song recognition learning, we used a combination of song playback paradigms and bidirectional dysregulation of mTORC1 activation. We found that mTOR demonstrates the molecular signatures of a habituation mechanism, and that its manipulation reveals the complexity of processes that may be invoked during nonassociative learning. These results thus expand the molecular targets for habituation studies and raise new questions about neural processing of complex natural signals.


The Hippo signaling pathway is a highly conserved pathway that plays important roles in the regulation of cell proliferation and apoptosis. Transcription factors TEAD1-4 and transcriptional coregulators YAP/TAZ are the downstream effectors of the Hippo pathway and can modulate Hippo biology. Dysregulation of this pathway is implicated in tumorigenesis and acquired resistance to therapies. The emerging importance of YAP/TAZ-TEAD interaction in cancer development makes it a potential therapeutic target. In the past decade, disrupting YAP/TAZ-TEAD interaction as an effective approach for cancer treatment has achieved great progress. This approach followed a trajectory wherein peptidomimetic YAP–TEAD protein-protein interaction disruptors (PPIDs) were first designed, followed by the discovery of allosteric small molecule PPIDs, and currently, the development of direct small molecule PPIDs. YAP and TEAD form three interaction interfaces. Interfaces 2 and 3 are amenable for direct PPID design. One direct YAP–TEAD PPID (IAG933) that targets interface 3 has entered a clinical trial in 2021. However, in general, strategically designing effective small molecules PPIDs targeting TEAD interfaces 2 and 3 has been challenging compared with allosteric inhibitor development. This review focuses on the development of direct surface disruptors and discusses the challenges and opportunities for developing potent YAP/TAZ-TEAD inhibitors for the treatment of cancer.


TJEPKEMA, J. 1978. The role of oxygen diffusion from the shoots and nodule roots in nitrogen fixation by root nodules of Myrica gale. Can. J. Bot. 56: 1365-1371. Nitrogenase activity (acetylene reduction) and oxygen uptake by root nodules of Myrica gale L. were measured before and after removal of nodule roots. There was no significant effect of nodule root removal when respiration was measured in the gas phase (0.05-0.2atm PO, (1 atm = 101.325 kPa)) or acetylene reduction in a stirred aqueous phase at 0.2atm PO,. However, when acetylene reduction was measured in 0.05 atm PO, in an unstirred aqueous phase, there was a 66 to76% reduction in activity. These results indicate that nodule roots are important for oxygen uptake when the nodules are present in an aqueous phase at low PO,, which is probably the normal environmental conditions for many of the nodules. Other measurements showed that diffusion of oxygen from the shoot to the root nodules is not important for nitrogen fixation. These measurements were done on whole plants with the shoots in air (0.20atmp0,) and the roots in water at the desired PO, value. With 0.0atmp0, in the root environment, the rate of acetylene reduction was only 4% of the rate at 0.2atmp0,. Thus, only small amounts of oxygen are transported from the shoot to the nodules.


With the development of smartphones, the use of mobile applications today already covers a lot of everyday life areas and also help us to solve our everyday problems. The objective of the thesis was to create a mobile application for the Android mobile platform, which would help the user in selecting the most suitable parking space. The application includes all public parking places in Ljubljana. At the beginning the Android operating system is presented and the individual component of Android SDK development environment in conjunction with tool Eclipse. Then come presentation of the existing solutions in the area of parking places applications and their comparison with the developing application. The central part is the description of the entire application development from the definition of an idea to final testing. The application list parking places based on the selected search criteria. The user can choose between distance from the parking place, the price and the number of free locations. Selection of parking places is also impacted by the weather. In case of bad weather forecast the use of parking garages is advised. Information's on weather and parking places occupancy are obtained from internet sources. The current location is obtained by the help of GPS receiver. The application can also demonstrate the location of each parking place on the map. In the final section the options for extending application functionality are described.


Background Treating to target (T2T) of remission has proven to be the most efficacy strategy to achieve clinical remission in patients with early rheumatoid arthritis (RA), resulting cost-effective after three years. It involves monitoring disease activity, adjusting drugs to approved protocol and aiming at a predefined target. However there is not enough clinical evidence in established and persistent RA and it has not been established the target treatment strategy. Objectives The objective was to estimate the cost-effectiveness of three strategies in real-life conditions from the Health Service perspective. T2T of remission versus achievement of low disease activity (LDA) and versus satisfactory disease control (SDC) after two years of treatment Methods All patients diagnosed of RA according to the American College of Rheumatology who started biologic therapy between January 2007 and December 2012 were included in the Create registry. A multidisciplinary care team composed by rheumatologists, hospital pharmacists, nurse and statistical personal from a tertiary hospital was the responsible for making the decision about the treatment-choice. A T2T strategy aiming at remission (DAS28<2,6) was applied to all patients. This included standardised and protocolised treatment adjustment. Patients were followed up and evaluated at least every two months. Measurements Effectiveness was evaluated using the DAS28 value. Three different results were compared: Strategy 1 (S1): Clinical Remission (CR). DAS28<2,6 at two years. Strategy 2 (S2): Patients at CR or at least with LDA (DAS28<3,2) at two years. Strategy 3 (S3): Patients from S2 and also those patients with a DAS28>3,2 at two years, but whose disease activity is judged by both the rheumatologist and patient to be low enough not to require switch of treatment (SDC). Care and cost Direct health care costs were assessed from the hospital perspective and included the official drug acquisition costs, diagnostic tests, rheumatologist visits, hospital admission and use of day-care facilities for intravenous drug administration. Data were retrieved from hospital information system and electronic case reports forms. Data of two year follow-up were analysed. Cost-effectiveness It was calculated dividing total direct healthcare mean costs by percentage of patients achieving the target clinical result for each strategy. Results 144 patients were included. After two years, 32,6% of patients achieved target for S1 (DAS28<2,6), 57,6% of patients reached at least DAS28 value<3,2 (S2) and 90,9% of patients reached a SDC (S3). Direct health mean cost after two years was 25,976.05 € (IC95%:23,888.16-28,063.93). T2T of remission was the least cost-effective strategy: 79,681.14€ per clinical remission (SD ±38,880.43€), versus 45,097€/LDA (±22,00.,24€) and 28,545.11€/SDC (±13,958.59€), (p<0,001 in both cases S1 vs S2 and S1 vs S3). Similarly, S2 was less cost-effective than S3 (p<0,001). Conclusions T2T of remission strategy with biologic therapy in established RA and in real-life conditions is less cost-effective than T2T of low disease activity or satisfactory disease control. Disclosure of Interest None declared


Hepatobiliary imaging with Tc-99m-N,alpha-(2,6-diethylacetanilide)-iminodiacetic acid (Tc-diethyl-IDA) was performed in 91 jaundiced patients with documented hepatobiliary damage and serum total bilirubin up to 35 mg/dl. There were 56 patients with obstructive jaundice and 35 with hepatocellular disease. Correct discrimination between hepatocellular and obstructive jaundice was possible with an overall accuracy of 90%. Agreement with the final clinical diagnosis was obtained in 97% of patients with hepatocellular disease, and in 86% of patients with obstructive jaundice. The reliability of the test was inversely related to the serum bilirubin concentration. The incidence of true-positive scans dropped from 93% for bilirubin levels below 10 mg/dl to 83% for bilirubin between 10 and 20 mg/dl. Above 20 mg/dl, the demonstration of a mechanical obstruction was possible in only one out of the four patients with obstructive jaundice. The high predictive values of the test illustrate that Tc-diethyl-IDA imaging constitutes a reliable method to demonstrate an obstructive cause for the jaundice as long as the bilirubin level remains below 20 mg/dl.


A new technique is presented for online test with some garbage lines in reversible circuits. Firstly, testable structures for reversible logic are given. Then, a scan-D Flip-Flops for constructing scan-chains is provided. Using the new scan-D Flip-Flops, test programs for reversible circuits were analyzed. The proposed method was tested on a set of reversible benchmarks. It realized online test.


In recent years there is a search for inexpensive alternate materials as a source of adsorbent to remove the heavy metal in aqueous solution; in the present study coconut shell and shale are used as adsorbents for the removal of cobalt. The study also aims to find the suitable pH, temperature and dosage for the removal of Co (II) ions.


A patient with chronic schizophrenia had two hemodialyses and two sham dialyses in a single-blind design. There was no change in the patient's affect after either procedure, but her auditory hallucinations disappeared after both hemodialysis and sham dialysis, with hemodialysis inducing a much longer partial remission.


Author(s): Hawkins, Byron | Advisor(s): Demsky, Brian | Abstract: Remote code execution (RCE) exploits are considered among the more destructive intrusions in today's software security landscape because they allow the adversary to execute arbitrary code with the permissions of the victim process. Today's leading software defense systems are able to eliminate significant portions of this attack surface, but many of these approaches such as control flow integrity (CFI) and intrusion detection systems (IDS) address a limited scope of attack vectors, while others like diversification have not received wide user adoption. Consequently, user applications remain vulnerable to RCE attacks. One limitation that is common among these approaches is an overcommitment to preventing the adversary's takeover strategy. Since the domain of potential attack vectors may be infinite, the adversary may always be able to devise a new takeover strategy that cannot be detected or prevented by any of the existing takeover-oriented defenses. After an attack, current monitoring systems often do not provide sufficient information about how the adversary took control or what vulnerability was compromised. Forensic tools can derive this information from an instance of the attack, but it may take multiple days or even weeks to isolate an instance for analysis. Motivated by the need for a program monitor that is equally effective against unforeseen takeover strategies as well as an exploit payload, Introspective Intrusion Detection (IID) combines the advantages of traditional intrusion detection and CFI by distinguishing anomalies in execution without making absolute judgments about malicious intent. This approach begins with a profiling phase that distills observed execution paths into a compact data representation called a trusted profile that constitutes a "ground truth" of safe application behavior. When deployed for online monitoring, IID reports any deviation from the Trusted Profile as a potential intrusion. Software developers can benefit from IID as a complement to deployed defenses by gaining visibility into unforeseen malicious behaviors or evasive variations of known attacks. Debugging of field failures and error reports can also benefit from the deep introspective logging provided by IID. Where deployed software has ample performance headroom and sufficient technical support, IID can also be deployed as a comprehensive realtime monitor to detect advanced persistent threats (APT) and other evasive intrusions.Experimental evaluation of IID prototypes for x86 binary executables and PHP applications show that this technique (a) identifies unforeseen takeover strategies along with exploit payloads, (b) accurately distinguishes benign anomalies from those associated with real attacks, (c) incurs low overhead with minimal false positives during normal execution of server applications such as Microsoft IIS and web applications such as WordPress, and (d) incurs moderate overhead for desktop applications such as Microsoft Office, Google Chrome and Adobe PDF Reader with a false positive rate suitable for expert analysis.


The structure of H+ (H2O)6 is investigated by examining selected low-lying minima with several first principle methods to benchmark the performance of these methods employed in the previous theoretical studies. Interestingly, we found that DFT methods with a moderate basis set follow the trends of MP2 with a large basis set very closely. In additional to the conventional zero point energy estimated with harmonic oscillator approximation, the contribution of vibrational anharmonicity is also investigated via first principle calculations. We found the anharmonicity contribution to the zero point energy varies between 2.7 to 5.0 mhartree and with that two kinds of tree structures (simple and branched tree) are found to be the most stable forms with nearly the same energy. The effects of Ar-attachment on the relative stability of these two tree structures are also examined and we found that the Ar-attached branched tree is more stable than the Ar-attached simple tree by about 1.4 mhartree. We shall also discuss the relevance of our findings with the recent experimental spectra on both bare and Ar-attached species.


Colorectal cancer (CRC) is the third most common cancer in the world. There are two major distinct precursor lesion pathways: the traditional adenoma–carcinoma pathway leading to most cases CRC, and the serrated neoplasia pathway. SMAD4 gene is involved in adenoma–carcinoma pathway. The protein encoded by the SMAD4 gene is a key downstream signaling mediator in the TGFβ pathway. This pathway has tumor-suppressor functions, including cell-cycle arrest and apoptosis. Its activation in late-stage cancer can promote tumorigenesis, including metastasis and chemoresistance. This study aimed to evaluate the effect of 5-fluorouracil (5-FU) on viability of advanced colorectal cancer cells and establishing whether the test compound may have an effect on the expression level of the SMAD4 gene, DNA damage and apoptosis. Chemotherapy based on 5-FU is used as an adjuvant treatment in most colorectal cancer patients. The results obtained in the study showed that the use of 5-FU in low concentrations may not have a therapeutic effect, and may also influence drug resistance in cancer cells. Moreover, it has been shown that by using 5-FU at higher concentrations and prolonging the exposure time, SMAD4 gene expression is significantly increased which may have an impact on the effectiveness of the therapy.


Background Noise in the operating room (OR) is a stressor with far-reaching negative consequences. The Silent Operating Theatre Optimisation System (SOTOS) suppresses the noise level in the OR and improves the communication of the OR-staff. This study investigates whether SOTOS has a positive impact on the OR-staff's perceived stress, exhaustion, activity and concentration. Methods Data were collected in a quasi-experimental study design of 32 radical prostatectomies using the da Vinci robotic-assisted system. Sixteen randomly chosen surgeries were carried out with SOTOS and 16 without. A total of 34 OR-staff-members took part, each 32 surgeries involving five planned OR-staff-members. Two points of measurement, before and after each surgery, were carried out, with a final sample of n=143 repeated measurements data. Before and after surgery, OR-staff-members completed a concentration test and a questionnaire concerning their perceived stress, exhaustion and activity levels. Results The OR-staff felt significantly less stressed, less exhausted and more active during and after surgery when operating with SOTOS. Especially the primary surgeons, assisting surgeons and circulating nurses profited from SOTOS. SOTOS did not reveal a significant impact on the OR-staff's concentration in this study. Conclusion For urological surgeries using the da Vinci system SOTOS constitutes a technical resource which significantly reduces perceived noise stress and exhaustion and improves the activity of primary surgeons, assisting surgeons and circulating nurses. These efficiencies likely lead to positive changes in their health and job satisfaction and are hence beneficial to the patient safety and hospital resources.


OBJECTIVE
To explore the predicting performance of renal resistive index (RRI), semi quantitative power Doppler ultrasound (PDU) score and serum cystatin C (Cys C) for acute kidney injury (AKI) in patients with cardiac failure or sepsis.

METHODS
A prospective, observational study was conducted. Critically ill patients with acute cardiac failure or sepsis admitted to the emergency intensive care unit (ICU) of Cangzhou Central Hospital from January 1st to December 31st in 2018 were enrolled. In addition to the demographic data, serum Cys C, RRI, and PDU score were measured within 6 hours after admission to ICU. Renal function was assessed on day 5 according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Patients who proceeded to AKI stage 2 or 3 within 5 days from admission were defined as the AKI 2-3 group; other patients were classified into the AKI 0-1 group. The differences of each index were compared in all patients, cardiac failure patients and sepsis patients between the two groups. Multivariate binary Logistic regression was carried out to identify the independent risk predictors of AKI 2-3. Receiver operator characteristic (ROC) curves were plotted to examine the values of Cys C, RRI, PDU score, and RRI+PDU in predicting AKI 2-3.

RESULTS
Thirty-seven patients with cardiac failure (11 with no AKI, 10 with AKI stage 1, 3 with AKI stage 2, and 13 with AKI stage 3) and 26 patients with sepsis (8 with no AKI, 2 with AKI stage 1, 7 with AKI stage 2, and 9 with AKI stage 3) were recruited. In all patients as well as the subgroup of cardiac failure, compared with the AKI 0-1 group, acute physiology and chronic health evaluation II (APACHE II) score, sequential organ failure assessment (SOFA) score, rate of continuous renal replacement therapy (CRRT), 28-day mortality, serum creatinine (SCr), Cys C and RRI were higher in AKI 2-3 group, and urine output, PDU score were lower; in the subgroup of sepsis, rate of CRRT, SCr, and Cys C were higher in AKI 2-3 group, and urine output was lower. Multivariate Logistic regression analysis found that Cys C and PDU score were independent risk factors for AKI 2-3 in all patients [Cys C: odds ratio (OR) = 11.294, 95% confidence interval (95%CI) was 2.801-45.541, P = 0.001; PDU score: OR = 0.187, 95%CI was 0.056-0.627, P = 0.007]; RRI and PDU score were independent risk factors for AKI 2-3 in patients with cardiac failure [RRI (×10): OR = 6.172, 95%CI was 0.883-43.153, P = 0.067; PDU score: OR = 0.063, 95%CI was 0.007-0.584, P = 0.015]; Cys C was the independent risk factor for AKI 2-3 in patients with sepsis (OR = 22.830, 95%CI was 1.345-387.623, P = 0.030). It was shown by ROC curve analysis that: in the subgroup of cardiac failure, the predictive values of RRI, PDU score and Cys C were well [area under the curve (AUC) and 95%CI was 0.839 (0.673-0.942), 0.894 (0.749-0.971), 0.777 (0.610-0.897), all P < 0.01]. RRI+PDU performed best in predicting AKI (AUC = 0.956, 95%CI was 0.825-0.997, P < 0.01), and the predictive value was higher than Cys C [AUC (95%CI): 0.956 (0.825-0.997) vs. 0.777 (0.610-0.897), P = 0.034]. In the subgroup of sepsis, the predictive value of Cys C was well (AUC = 0.913, 95%CI was 0.735-0.987, P < 0.01), however, the predictive value of RRI, PDU, RRI+PDU were poor.

CONCLUSIONS
RRI and PDU score effectively predict AKI stage 2 or 3 in cardiac failure patients, but not in patients with sepsis. The predictive values of Cys C for AKI are similar in patients with cardiac failure or sepsis.