AIM
The impact of micronutrient intake and colorectal cancer (CRC) risk is poorly understood. The objective of this study was to evaluate the associations of selected micronutrients with risk of incident CRC in study participants from Newfoundland, Labrador (NL) and Ontario (ON), Canada.

MATERIALS AND METHODS
We conducted a population-based study among 1760 case participants and 2481 age- and sex-matched control participants. Information on diet and other lifestyle factors were measured using a food frequency questionnaire and a personal history questionnaire. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression, controlling for covariables.

RESULTS
Highest compared to lowest quartile intakes of certain micronutrients were associated with lower risk of CRC, including: calcium (from food and supplements (FS), OR=0.59; 95% CI=0.45-0.77, and from food only (FO): OR=0.76, 95% CI=0.59-0.97), vitamin C (FS:OR=0.67; 95%CI:0.51-0.88), vitamin D (FS: OR=0.73; 95% CI: 0.57-0.94, FO: OR=0.79, 95% CI=0.62-1.00), riboflavin (FS: OR=0.61; 95% CI=0.47-0.78, and folate (FS: OR=0.72; 95% CI=0.56-0.92). Higher risk of CRC was observed for iron intake (highest versus lowest quintiles: OR=1.34, 95% CI=1.01-1.78).

CONCLUSION
This study presents evidence that dietary intake of calcium, vitamin D, vitamin C, riboflavin and folate are associated with a lower risk of incident CRC and that dietary intake of iron may be associated with a higher risk of the disease.


Various zinc and cadmium containing metal–organic frameworks using the semi-rigid 1,1′-(anthracene-9,10-diylbis(methylene))bis(pyridin-1-ium-4-olate) ligand (L = AHP) and various sulfonic acid analogs [1,5-naphthalenedisulfonic acid (1,5-NDS), 3-sulfobenzoic acid (3-SBA), 4-sulfobenzoic acid (4-SBA), 5-sulfosalicylic acid (SSA), 5-sulfoisophthalic acid (SIA) and 2,6-naphthalenedisulfonic acid (2,6-NDS)] have been synthesized by a hydrothermal method. They have been characterized by powder X-ray diffraction thermogravimetric analysis and single crystal X-ray diffraction methods. The X-ray studies showed that MOF2, 4, and 8 have two dimensional architectures whereas 1, 3, 5, 6 and 7 have three-dimensional structures. The topological analysis demonstrated that all the zinc-containing MOFs have a hexagonal (hcb) net topology with the point symbol of the framework being {63} whereas cadmium-containing MOF4 has an sql net topology with the point symbol of the framework being {44·62} and MOF5 has a hcb net topology with the point symbol of the framework being {63}. Since all synthesized MOFs have fluorescence properties, they have been used as imaging agents for MCF7 cells. The cytotoxic experiments show that more than 92% cells survive at the dose 100 μg ml−1. The cell imaging results show that the MOF particles were found in the cytoplasm rather than in the nucleus and these can be used further as a conjugate with any known anti-cancer drugs in cellular distribution. The emission properties of these MOFs have been utilized for the detection of a herbicide (simazine) as well as nitroaromatic compounds. The quenching constant for PA (picric acid) in MOF7 was found to be 5.01 × 104 M−1, which may be due to the interaction of picric acid and co-ligands present in MOF7.


A study on the influence of crack widths and type of bars (plain and deformed) on corrosion of steel bars in cracked concrete is presented here. Microcell and macrocell corrosions of plain and deformed steel bars were investigated on 10 3 10 3 40 cm single crack specimens with crack widths of 0.1, 0.3, and 0.7 mm. Water-to-cement ratios were 0.3, 0.5, and 0.7. Electrochemical investigations were also conducted on 15 3 15 3 125 cm multicrack specimens with plain and deformed bars. For these specimens, water-to-cement ratios were 0.5 and 0.7 and crack widths were varied from 0.1 to 0.4 mm. After electrochemical investigations, chloride ions in concrete, corroded areas, weight losses, and pit diameters of the steel bars were investigated. The entire study was carried out in an artificially created chloride ion-induced corrosion environment. The study concludes that the relationship between crack widths and corrosion rate is observed at the very early age of exposure. Water-to-cement ratio and corrosion rate relationship is clearer than crack widths and corrosion rate relationship. Deformed bars are more prone to corrosion than plain bars.


Evaluation of Small Tree and Shrub Plantings on Reclaimed Surface Mines in West Virginia Alexis Monteleone Hundreds of acres of mined land are reclaimed annually in West Virginia (WV) and are planted with hardwood tree species. Forestry and wildlife post-mining land uses require the planting of specific tree species designated by the individual mine permit and planting plan, which generally includes planting of commercially-valuable hardwood species. Establishment and growth of fruitand nut-producing small tree and native shrub species has not been studied for reforestation plantings on surface mines. Though these species are not generally planted as part of forestry reclamation, they are commonly found in forest ecosystems of WV and are often an important component, contributing to both structural and floral species diversity. Survival and growth of 20 species of mastand fruit-producing shrubs and small trees were evaluated to better understand their suitability for reclamation plantings. Seedlings were planted in graded overburden material during 2008 and 2010 on four reclaimed surface coal mines in WV. The selected sites were reclaimed using conventional methods. The experiment was a completely randomized block design with four blocks per site, two east-facing and two west-facing. Each block was comprised of 20 monoculture species plots, and within each plot 25 individuals were planted on 2.4 m x 2.4 m spacing. Initial data on survival and growth of these species was collected in 2008 and 2010 a growing season after establishment. Survival and growth of these species were measured again in 2015 and 2016 to determine individual species performance over time. In general, 18 of the 20 species included in this study were successful in establishing and growing on the reclaimed surface mine sites in West Virginia. The exceptions were pawpaw (Asimina triloba L.) on the sites planted in 2008 and blueberry (Vaccinium corymbosum L.) on the sites planted in 2010. The best performing species overall were black chokeberry (Aronia melanocarpa Michx.) at 56% survival, black cherry (Prunus serotina Ehrh.) at 55%, Washington hawthorn (Crataegus phaenopyrum L. f.) at 54%, nannyberry (Viburnum lentago L.) at 52%, and hazelnut (Corylus avellana L.) at 50%. The two species that experienced the highest mortality were flowering dogwood (Cornus florida L.) at 10% and pawpaw at 9%. Across all species, Elk Run showed the highest survival percentage at 51%, Fola and ICG were between 40 and 45%, while Hobet had the lowest at 25%. Although survival and some height measurements were found to be greater on west-facing aspects when compared with east-facing aspects in this study, the results were not strongly correlated and skewed by a few species that performed particularly well on west-facing aspects at one site. The effect of aspect for the majority of species in this study and at most sites was not significant at the individual species level. Soil properties varied widely among sites with pH ranging from 3.4 at Fola to 7.5 at ICG, fines ranged from 58% at ICG to 82% at Hobet, and elemental concentrations showed large variability. When compared to the growth rates exhibited by these species in horticultural, forestry, or agricultural settings, the growth rates were considerably less in this project with these mine soil conditions. In order to correlate average heights observed with soil properties in the mine soils, stepwise regression, principle component analysis and principle component regression were used. The analysis showed potassium, phosphorus, and aluminum as being the most strongly correlated (R of 0.20) with plant height when all species' average heights at all four sites were considered. Since the mine soil properties were so different at each site, separate regressions were performed. Copper was the most significant soil property for height at Elk Run and ICG, no soil properties were significant at Fola, and EC and Na were important at Hobet. The results of this study demonstrated that several small tree and shrub species have potential for planting on surface mines in West Virginia. Species like black chokeberry, black cherry, Washington hawthorn, and nannyberry, which had greater than 50% survival after 6 or 8 years, are the most likely candidates. Other species which are adapted to better soil conditions did not perform well and should not be considered for plantings.


Background Information Little is known about immigrant children's lifestyles and the uptake of strategies to prevent unintentional injuries. Being an immigrant to Canada can be a risk factor for a child's health because of the cultural differences in the uptake of healthy activities between their country of origin and North America. Objectives To determine the barriers and enablers related to injury prevention strategies such as car seats, bicycle helmet use and participation in formal or informal physical activities. Study Participants Twenty parents from two language groups; Bengali and Spanish, who arrived in Canada within the past 2 years, participated in this study. Participants were recruited with the help of immigrant and settlement organisations. Data Analysis The focus groups were each 2 h and were transcribed and translated into English. Data were analysed using thematic content analysis, which explores emerging themes from interview or focus group data. Result Parents expressed a need for more immigrant friendly injury prevention information. Such information has to be linguistically correct and culturally appropriate for the specific immigrant group. Inadequate information regarding injury prevention and a sense of feeling blamed when their child got hurt were important themes for both groups. Conclusion Immigrant parents want to follow Canadian guidelines for injury prevention, but often do not understand the Canadian cultural context. Healthcare professionals should provide important information programs designed specifically for this growing immigrant population.


: The US failed of the rebalance strategy with Asian features. China has invited Asian countries to join Beijing in framing a security governance model with Asian features. China's formal invite to a neighbour to pursue a regional security doctrine that is led by Beijing. President Xi Jinping called to build consensus and step up dialogue to foster "a security governance model with Asian features." The new model is the latest contribution China has made to regional governance. China-centric collective security architecture in the Asia-Pacific is still work-in-progress. As 'Pivot to Asia' failed". It proved that a U.S.- led alliance system is not the right option to safeguard the peace and stability of Asia. If China's economic, military, and geopolitical influence continues to rise at even a modest pace during this period, the world will witness the largest shift in the global distribution of power since the rise of the United States in the late nineteenth and early twentieth centuries. Moreover, if China surpasses the United States as the world's largest economy in the next 10 to 15 years, it will mark the first time in centuries that the world's economic leader will be non-English speaking, non-Western, and non-democratic. Simultaneously, China is rolling out its One Belt, One Road vision, investing in infrastructure in Central Asia in order to connect China with Europe, as the ancient Silk Road did. China can no longer rely on the old trade and commerce model to produce and export products to the West. China must ignite new markets in a virgin territory, namely, Central Asia. The Belt and Road strategic plan creates better traffic and flow of products in both directions and is good for international trade and commerce. This ambitious strategy carries huge political, financial and social risks. But China is embarking on this hazardous journey because it has to. It is a necessary gamble. The US and China are more focused on achieving maximum benefits in the Asia-Pacific region. The US wants to maintain a friendship with China. Similarly, China wants to maintain a friendship with the US. The two countries are making their policies and positions in view of the changing political scenario in the world. But, the one polar system would decline and emerge multi-polar system would emerge between US, China and Japan in the Asia- Pacific region which will shift to the Centre of Gravity in the Twenty- First Century.


Introduction Oesophageal high resolution manometry (OHRM) is a fast developing area of medicine. Whilst seemingly being at the "cutting edge" of technological advancement, it is a relatively simple procedure to perform and interpret. Its ability to demonstrate functional as well as anatomical abnormalities, has led to a range of new diagnoses and shed light on areas of previous clinical and management dilemma. Despite this, few hospitals outside of the large central teaching hospitals, have embraced this new technology. Objective To assess the demand for OHRM within a district general hospital (DGH). To assess the reasons for referral and the general outcomes from the procedure. Methods The Luton & Dunstable Hospital set up a new OHRM service in July 2009. Prospective procedure related information was stored on a HRM database. This database was analysed to assess total number of procedures performed, the reasons for referral and the diagnostic outcome of those procedures. Results Over the course of the first 2 years, a total of 162 procedures were performed. Patients were referred in with a range of symptoms, often in combinations. Of these 162 patient 9 suffered dental problems, 31 had globus, 32 had persistent sore throat, 27 had chronic cough, 13 had nocturnal cough, 118 had endoscopic negative reflux-like symptoms, 40 had endoscopy negative dysphagia, 30 had atypical chest pains, 1 had persistent nausea, 24 had dysphonia and 2 were for reflux assessment. A wide range of diagnoses were made often in combination, including; - 52 with reduced LOS pressures, 18 with a small LOS, 58 with a hiatus hernia, 52 with acid reflux, 40 with non-acid reflux, 75 with oesophageal dysmotility, 23 with oesophageal spasm, 6 with hypertonic contractions, 19 with hypotonic dysmotility, 5 with achalasia type 2, 4 with achalasia type 3, 15 with a wide transition zone, 17 with transient LOS relaxation, 3 with poor pharyngeal co-ordination, 1 with food bolus, and 20 who were normal. Conclusion OHRM is relatively simple procedure to perform and interpret. With its ability to diagnose both functional and anatomic abnormalities it has become an invaluable part of our DGH gastroenterology unit. Given the clear benefits over standard manometry, we believe that all patients throughout UK should have access to an OHRM service. Disclosure of Interest None Declared.


The first major study of rhythm, metre, and form in North Indian classical music. Time in Indian Music is the first major study of rhythm, metre, and form in North Indian rag , or classical, music. Martin Clayton presents a theoretical model for the organization of time in this repertory, a model which is related explicitly to other spheres of Indian thought and culture as well as to current ideas on musical time in alternative repertories including that of Western music. This theoretical model is elucidated and illustrated with reference to many musical examples drawn from authentic recorded performances. These examples clarify key Indian musicological concepts such as tal (metre), lay (tempo or rhythm), and laykari (rhythmic variation). More generally, the volume addresses the implications of performance practice for the organization of rhythm and metre. Written in a clear and accessible style and illustrated with 102 music examples and diagrams, it will appeal to anyone interested in Indian aesthetic forms and the study of musical time. The book contains a free CD of authentic recorded performances closely referred to in the text.


Current methods for designing cyber-physical systems lack a unifying framework due to the heterogeneous nature of the constituent models and their respective analysis and verification tools. There is a need for a formal representation of the relationships between the different models. Our approach is to define these relationships at the architectural level, associating with each model a particular view of the overall system base architecture. This architectural framework captures critical structural and semantic information without including all the details of the various modeling formalisms. This paper introduces the use of logical constraints over parameters in the architectural views to represent the conditions under which the specifications verified for each model are true and imply the system-level specification. Interdependencies and connections between the constraints in the architectural views are managed in the base architecture using first-order logic of real arithmetic to ensure consistency and correct reasoning. The approach is illustrated in the context of heterogeneous verification of a leader-follower vehicle scenario.


The effect of prestrain on microstructure and mechanical behavior of aged Ti–10V–2Fe–3Al alloy was investigated. The results showed that prestrain caused the tensile strength to decrease by 5%, but the elongation to fracture significantly improved by about 200%, in comparison with the unstrained samples, using a much shorter aging time. Transmission electron microscopy investigations showed that nano-sized alpha (α) particles homogeneously precipitated in the beta (β) matrix, and continuous α films formed along grain boundaries in the unstrained and aged samples. However, in the prestrained samples, the coarse stress induced martensite laths decomposed into α- and β-phases in the form of alternately arranged plates, which suppressed formation of the continuous grain boundary α films during aging. The hardness of the prestrained samples was lower than that of the unstrained samples after the same aging treatments. The enhancement of ductility can be mainly attributed to the suppression of grain boundary α films and the reduced hardness in prestrained samples.


In 1983 the initial results of an IEEE survey on large motors was published and presented at the 1983 I&CPS Conference. This was the first presentation of the results of a survey completed in 1982 of motors larger than 200 hp and no older than 15 years. The results presented here of the 1982 survey are to investigate the data further to address questions generated by the results of the earlier paper, to find additional correlations of the reliability criteria of some of the more interesting categories, and to bring out more results and categories available from the survey data. For information on the overall survey response and the general results of the surveyed categories, refer to the previous paper.


DNA methylation is integral to normal development and disease processes. However, the genomic distribution of methylated sequences – the methylome – is poorly understood. We have recently developed a platform technology for rapid assessment of methylation status throughout the human genome in a high-resolution, high-throughput manner. This is achieved by coupling a methylated DNA immunoprecipitation (MeDIP) method for isolating methyl cytosine rich fragments with array-based comparative genomic hybridization (array CGH). Using a combination of whole genome tiling path BAC arrays and CpG island microarrays, DNA methylation profiles are obtained simultaneously at both genome-wide and locus-specific levels. A comparison between male and female DNA using MeDIP-array CGH revealed unexpected hypomethylation of the inactive x-chromosome in gene-poor regions. Furthermore, comparisons between cancer and non-cancer cell types yielded differential methylation patterns that link genetic and epigenetic instability offering a new approach to decipher misregulation in cancer. Finally, we provide new data showing epigenomic instability in lung cancer cells with concurrent regions of genetic and epigenetic alterations harbouring known oncogenes.


ABSTRACT The objective of this study was to determine the ecological risk of the antifoulant Irgarol 1051 and its major metabolite (GS26575) in United States surface waters by using a probabilistic approach. Distributions of environmental exposure data were compared with the distribution of species response data from laboratory studies to quantify the likelihood and significance of ecological risk. Water monitoring data from both the Chesapeake Bay (2001) and southeast Florida (1999–2001) were used to characterize exposure. Toxicity testing has demonstrated that plants are much more sensitive to Irgarol and GS26575 than animals; therefore, the conservative effects benchmark used to characterize risk was the plant 10th centile for both Irgarol (251 ng/L) and GS26575 (12,500 ng/L). Ecological risk from Irgarol exposure in Chesapeake Bay marinas, a river, and a mainstem area was generally low with the possible exception of the Port Annapolis marina in Annapolis, Maryland. This enclosed marina has a high density of boats, a low flushing rate, and has historically been reported as a "worst case scenario" for other antifoulants such as tributyltin. Ecological risk from GS26575 exposure at Chesapeake Bay sites was judged to be very low as all environmental concentrations were an order of magnitude below the effects threshold for plants. Ecological risk from Irgarol exposure in southeast Florida surface waters was found to be low at various marina, port, river, bay/embayment, channel, and ocean areas. Even the highest Irgarol concentration reported in southeast Florida waters (182 ng/L) was less than the conservative Irgarol effects benchmark of 251 ng/L (plant 10th centile). Ecological risk from GS26575 exposure in southeast Florida waters was also very low.


The electrocardiogram signal is the most important analysis to detect cardiac arrhythmia. Machine learning classification is used as a first step to detect someone's arrhythmia or normal heart. This paper discusses one method for detecting arrhythmia by using digital images of cardiac signals and R-R intervals. The process electrocardiogram digital image is divided into two, first the process of calculating the R-R intervals and second the process of extraction feature using Discrete Cosine Transform, followed by calculating the Euclidean Distance or Cityblock Distance with normal electrocardiogram signal reference. Euclidean Distance results or Cityblock Distance and R-R distance of electrocardiogram signals are then classified using Multiclass Support Vector Machine. The results of accuracy the classification four classes that are cardiac normal, atrial premature beat arrhythmia, atrial flutter arrhythmia, and atrial fibrillation arrhythmia, are 81.9%. The originality is used image to detect cardiac normal or cardiac arrhythmia by combined Discrete Cosine Transform, Euclidean distance or City block distance and Multiclass Support Vector Machine.


Pulmonary autograft, or Ross procedure, is performed by supplanting a diseased aortic valve with the patient's own pulmonary valve. Reconstruction of the right ventricular outflow tract is then completed using a pulmonary homograft. To our knowledge, infective endocarditis occurring decades after the Ross procedure has not been reported. Diligent echocardiographic examination can be crucial to ensure prompt treatment and avoid the 25% mortality rate associated with infective endocarditis. Clinical suspicion should remain high in those with a pulmonary autograft history. In this article, we report the case of a 39-year-old patient with infective endocarditis presenting 22 years after Ross procedure.


Stock market analysis is a very popular area of research. Achieving good prediction in forecasting the stock markets is a very challenging task. The prediction of the future stock markets is done using cascading statistical models. This paper investigates the MCX commodity (Gold) on which the model is applied. Objective: To predict the trend of the gold commodity will remove the uncertainty in the future for the investors. Prediction techniques employed: Multi Variable Linear regression model, Time series models, Skewness and Kurtosis. Finding: The mammoth analysis of the attributes brings up the greater vision about the gold productand its importance to invest in that segment for it keeps the money in harmony with the real time drift in the price and its fluctuations. The data collected consists of commodity prices and volumes over the last 5 years on a monthly basis. The experimental results give us the predicted future values of the commodities. Inference: Prediction can also be valuable to support in planning about viable developments and provides a clear outcome for the future eventual market.


This paper compares three methods to increase validity of case-control studies when two imperfect measurement tools are available to assess exposure. From simulated data, we show that point estimates of the relative risk, using only concordant dual responses, are always less biased than any other estimate. Because of the loss of power due to discarding discordant responses, the concordant response design is not efficient and is expensive. We show that a series response estimation, whereby all information is used but only dual positive responses are considered exposed, can be used to complement the interpretation of the less biased estimates. This approach is more interesting when exposure is rare and measuring it expensive.


Our study aimed to detect the effects of polyphyllin I (PPI) on relieving gestational diabetes mellitus (GDM), and the possible mechanism. A mouse model of GDM was constructed. The effects of PPI on GDM mice were evaluated by detecting blood glucose, insulin level, glucose tolerance test, and insulin tolerance test. The inflammation response in GDM and GDM+PPI group were evaluated by enzyme-linked immunosorbent assay (ELISA). The effect of PPI on the offspring of GDM mice was analyzed. In addition, immunoblot assays were performed to investigate the effects of PPI on the AMPK pathway. We found that PPI improved diabetes-related symptoms and decreased serum inflammatory response in GDM mice. In addition, we also found that PPI reduced the tissue damage of GDM mice. We noticed that PPI alleviated inflammatory injury in GDM mice through targeting AMPK pathway. Our findings showed that PPI has the potential to be explored as the drug for GDM treatment.


DCIM is a Distributed Cache Invalidation Method is used for maintaining cache consistency in wireless mobile network. DCIM is analysed for assessing delay time and bandwidth gain and compared for polling time. DCIM is a client based cache consistency schemes for caching data in wireless mobile network. DCIM is also used as a pull based algorithm for implementing Time to live, piggybacking and prefetching. An adaptive time to live (ATTL) For cache maintenance an adaptive TTL mechanism is used in DCIM that has update rates of data sources to update cache, where expired TTL values is grouped in validation requests rates are prefetched from the server. Existing system has used an adaptive TTL mechanism which contains some limitations like maximum request time, degraded system performance due to which the speed of communication reduces and data received is not reliable. Here the cache maintenance will be doing using EX-ATTL mechanism which will provide hash table for cache invalidation between each 1-hop distance node to data cache node. In this paper all this mechanism will reduce the overhead of the cache node to increase the speed of communication. This proposed mechanism will also reduce the request data delay time due to which the system performance get improved and will provide a reliable data.


The Stac Fada Member (SFM) forms part of the Stoer Group of the Torridonian of NW Scotland. The SFM is unique in the Torridonian, being characterized by the presence of greenish altered glass clasts. Its origin has been debated for decades with several hypotheses being proposed but all invoking some connection with volcanic activity in the region. More recently, Amor et al. suggested that the SFM represents "a chord section through the continuous ejecta blanket surrounding an impact crater". Here, we confirm the presence of shocked material within the SFM and then discuss its origin.


We studied the pregnant women, who requested a '108' ambulance in two Indian states (Andhra Pradesh (AP) and Himachal Pradesh (HP)). We conducted a cross-sectional telephone survey to study the characteristics and outcomes of those who (1) were transported using '108' ambulance, (2) were sent '108' ambulance but did not use it and (3) were not assigned a '108' ambulance. We conducted interviews within 24 hours of clients' call and followed them up at 48 hours, on the 7th and 28th day. 90% of pregnant women callers in AP and only 16% in HP were from poorer socioeconomic circumstances. 22.5% of women who were not provided an ambulance in HP lived in tribal areas. A higher proportion of women who were transported using '108' reported either a high-risk condition (AP, 22%; HP, 27%) or an early complication in pregnancy (AP and HP, 16%), compared with the other groups (AP, 18% and 8%; HP, 19% and 16%). In AP, women who were sent an ambulance but did not use it had higher prevalence of obstetric emergency (9.8%) compared with the other groups (ambulance used, 7.4%; not assigned, 4.1%). One-fifth of women in AP and one-seventh in HP delivered by caesarean section. One woman who called, but was not transported by '108', died in AP. Ten stillbirths and 22 neonatal deaths were reported in AP and 17 and 16, respectively, in HP. Strategies are required to improve '108' service for tribal areas in HP. The '108' services should be improved to reduce non-use of ambulance, especially for women who report obstetric emergencies.


We investigated the hemodynamics of the left gastric vein (LGV) and its association with variceal recurrence using color Doppler endoscopic ultrasonography (CD-EUS). The long-term results of our technique known as combined ligation and sclerotherapy showed that the risk of variceal recurrence decreased after long-term follow-up with timely repeated therapies. On the basis of the hemodynamic background of these results, it was suggested that the posterior branch of the LGV could have developed as an extravariceal shunt, whereas the anterior branch, which directly feeds varices, seemed to disappear through long-term follow-up with repeated treatments. In the study comparing CD-EUS findings between patients with and without variceal recurrence, dominance between anterior and posterior branches and the hepatofugal flow velocity of the LGV were suggested to be important factors contributing to variceal recurrence. We consider that these patients may require more intense therapy, such as the mucofibrosing technique or a technique to obliterate both the varices and their donor vessels.


Inferior vena caval stenosis after liver transplantation is an uncommon complication that may present with lower extremity edema or ascites. Angioplasty and stenting offer a rapid, minimally invasive therapy for inferior vena caval stenosis. A variety of metallic stents have been used to successfully alleviate caval strictures including Wallstents (Boston Scientific, Natick, MA) and Gianturco-Rosch tracheobronchial Z-stents (Cook, Inc., Bloomington, IN).1,2,3 The latter are attractive because they possess high radial strength, exhibit minimal foreshortening and have large interstices.


In brief: There is little evidence that isometric exercise benefits the cardiovascular system, and many physicians believe that it imposes undue demands on the myocardium, so they prohibit such exercises for middle-aged or coronary disease patients. This review article examines the validity of this conclusion by summarizing the effects of isometric exercise on heart rate, blood pressure, myocardial demand, cardiac output, peripheral blood flow, and left ventricular function. Dr. Fardy concludes that isometric exercise is less hazardous than has been presumed and says guidelines should be established according to each patient's history.


A newly developed electrochemical biosensor for the determination of superoxide anions (O(2)˙(-)) released from cancer cells using potassium-doped multi-walled carbon nanotubes (KMWNTs)-1-butyl-3-methylimidazolium hexafluorophosphate ([BMIM]PF(6)) ionic liquid composite gels is demonstrated. The KMWNTs-[BMIM]PF(6) can electrocatalyze oxygen reduction to generate a strong current signal in neutral solution. Compared with KMWNTs without [BMIM]PF(6) or MWNTs-[BMIM]PF(6) composites, the KMWNTs-[BMIM]PF(6) can enhance the oxygen reduction peak current by 6.2-fold and 2.8-fold, which greatly increases the detection sensitivity of oxygen. Then, O(2)˙(-) biosensors are fabricated by mixing superoxide dismutase (SOD) in the KMWNTs-[BMIM]PF(6) gels via monitoring oxygen produced by an enzymic reaction between SOD/O(2)˙(-) without the help of electron mediators. The resulting biosensors show a linear range from 0.04 to 38 μM with a high sensitivity of 98.2 μA mM(-1), and a lower detection limit of 0.024 μM. The common interferents such as hydrogen peroxide (H(2)O(2)), ascorbic acid (AA), uric acid (UA), and metabolites of neurotransmitters, do not interfere with the detection of O(2)˙(-). The proposed biosensor is tested to determine O(2)˙(-) in vitro and from liver cancer and leukemia cells and shows good application potential in biological electrochemistry.


This paper offers a new learning theory-based conceptualization of worry in Generalized Anxiety Disorder (GAD). The authors suggest that the processes that produce GAD symptoms may vary across GAD sufferers and that treatment effectiveness may be enhanced if the process that likely produced symptoms in a given individual is understood. Specifically, they suggest that a "worry as adjunctive behavior" hypothesis be added to the "worry as anxiety" and "worry as avoidance behavior" hypotheses currently considered. This new hypothesis suggests that for some worriers, worry may function as an adjunctive behavior; that is, a way of accessing quick satisfaction when daily living produces too little response contingent reinforcement. The authors explain that life events that give rise to adjunctive behavior are the same as those that contribute to depression and that this might help explain the high comorbidity between GAD and depression. In cases in which worry appears to serve an adjunctive function, treating GAD symptoms as depression would be treated (e.g., with behavioral activation) may be the most successful course of action.


The following article looks at the new Flocath quick intermittent catheter, which as been developed with the aim of improving the quality of lives of clients and carers who undertake intermittent catheterization. Teleflex Medical (formerly Rusch UK) provides an extensive range of intermittent catheters in both male and female lengths, as well as a range of indwelling catheters widely used throughout the community, hospitals and private nursing facilities.


AIMS
To utilize the ion-current rectification phenomenon observed for conically shaped nanopores as the basis for designing sensors for drug molecules that adsorb to the walls of the nanopore.

METHODS
The conically shaped nanopore was prepared by the well-known track-etch method in a polyimide (Kapton) membrane. The ion current flowing through the nanopore was measured as a function of applied transmembrane potential in the presence of the analyte drug molecule, Hoechst 33258.

RESULTS
The pore walls in the Kapton membrane are hydrophobic yet have fixed carboxylate groups that give the walls a net negative charge. This fixed anionic surface charge causes the nanopore to rectify the ion current flowing through it. The analyte drug molecule, Hoechst 33258, is cationic yet also hydrophobic. When the membrane is exposed to this molecule, it adsorbs to the pore walls and neutralizes the anionic surface charge, thus lowering the extent of ion-current rectification. The change in rectification is proportional to the concentration of the drug.

CONCLUSIONS
This nanopore sensor is selective for hydrophobic cations relative to anions, neutral molecules and less hydrophobic cations. Future work will explore ways of augmenting this hydrophobic effect-based selectivity so that more highly selective sensors can be obtained.


Bluetooth Enabled Smart Spirometer;Spirometry;Validation;Monitoring;Asthma;Chronic Obstructive Pulmonary Disease, Coronavirus Disease 2019, Respiratory Diseases INTRODUCTION Pulmonary function test (PFT) is a crucial method in diagnosis of respiratory illness and associated symptoms. [5] Even though spirometry is an important tool which helps in respiratory disease diagnosis,[1-3,8] it is still finding a corner place or is unutilized in the primary care settings,[9,10] Some of the reasons for lesser adoption of spirometry by the clinicians could be due its operational attributes such as size of spirometer, cost of procurement, higher maintenance cost with repeated calibration, and dedicated resources or technicians. [11] As the world is moving toward digitalization of health-care services, few portable smart diagnostic devices emerged in the market which includes digital portable spirometers run on mobile phones or tablets. Keeping the same idea at front to develop a highly accurate and low-cost spirometer, Alveoair™ is a fully indigenously developed turbine operated handheld and portable Bluetooth enabled smart spirometer that can be deployed in primary care settings and at family physician offices easily.


This paper introduces a set of collaborative aspects for the teaching-learning process. The goal of this paper is to present a new point of view for the construction of learning object. A methodology named MACOBA is proposed here for the production of collaborative learning objects. These kind of objects conform digital e-resources which are produced (in particularly by teachers) and used (in particular by learners) in collaborative way. The better practices for this process are solved in MACOBA methodology offering the patterns paradigm. At the end we propose a case study in order to prove such methodology.


The key issue in structured P2P (peer to peer) is to locate resources effectively. Chord is a kind of structured P2P system based on overlay network. However, Chord construction doesn't consider the real network situations. At the same time, the clockwise searching scheme of original Chord doesn't make good use of the anti-clockwise neighbors' information. All these increase the latency and cost of locating resources. A bidirectional Chord system based on latency-sensitivity is proposed to decrease the latency and cost of locating resources. This system partitions the nodes according to the latencies among these nodes and the landmarks to decrease the average response time. And by the means of bidirectional query algorithm on Chord, the search path length is reduced. Theoretical analysis and simulations show that the system decreases query-response time greatly


This study is based on qualitative data gathered during 3 years of fieldwork among the Rashaayda Arabic-speaking pastoralists in Sudan. Prior to 1956 every Rashiidy household was linked to other households by 3 types of social relations: 1) patrilineal descent 2) co-residence and 3) incorporation by purchase. After 1956 "slaves" retained membership in the tribe but were not economically dependent on "free owners" and lived apart from "free" Rashaayda. Yet most Rashaayda sought aid from 1) patrilineal kin 2) neighbors and 3) former "owners" or "slaves." If the household were short of workers it could recruit extra help from neighboring households and from households that were not co-resident but were related to it agnatically. Due to rising oil prices in 1974 opportunities for Rashiidy men in oil-exporting countries became available. The 1st Rashaayda to go to the Gulf (in 1975) were men from impoverished households who had lost most of their animals and had abandoned pastoral nomadism. There were jobs in the Gulf for expert camel racers herders livestock brokers and clerks. To buy plane tickets to Mecca the migrants sold their few remaining animals. Once these 1st migrants had found jobs they were allowed to remain in the country as legal workers. When their terms of employment were over most migrants returned to Sudan and transformed their wages into durable wealth. The success of this 1st group encouraged a 2nd group of less impoverished men to consider migration (1977-1980). Like the 1st group the 2nd group had to obtain capital contract extra labor (at home) and investment opportunities to be able to leave. For the 2nd group obtaining these things was more difficult: 1) they had to sell more milk and camels than they would normally 2) they either had to travel to Saudi Arabia as pilgrims and contact employers then or purchase contracts from Rashaayda who had returned to Sudan 3) they had to hire outsiders to work for them while they were away and 4) they invested in jewelry businesses and 2nd wives. Thus the Rashaayda developed mutual trust with some of the other pastoral peoples of the region. Exchanges between rural Rashaayda and urban Sudanese emerged (through business and marriage). The infusion of cash into the Rashaaydas economy has also enabled them to respond productively to worsening ecological conditions in Sudan. Finally economic and political inequalities among still-pastoral Bedouin are today much less pronounced than earlier.


Corporate knowledge management in science and engineering-intensive organizations involves tasks such as standard generation and evaluation, comparison of related cases and experience reuse in their treatment, and the ability to rapidly retrieve all relevant documents around a certain topic or project even if this project has extended over years or decades. No single information retrieval technique is likely to adequately deal with such tasks independent of the specific situation. In this paper, we therefore present a modular approach that allows a variety of techniques from clustering, exploitation of semantic structure knowledge, and visualization to be used in the handling of technical document collections for knowledge management purposes. Usable implementations exist for large parts of the approach. Two real-world usage experiences with projects in the chemical engineering and medical domains provide initial evidence for the value of the approach.


A qualitative survey was conducted in Kawino North location in Kadibo division Kisumu East district with the aim of assessing the role of teachers in implementing play in ECDE center. The objectives that guided the study were to assess the teachers' knowledge and understanding of play, their role in organizing play, how they facilitate play and to find out how and why teachers should get involved in play. The population studied included 24 Teachers from the six ECDE centers which had been randomly selected. The instrumentation employed entailed a critical observation of the learning environment and the formulation of detailed questionnaire for teachers. Findings showed that over half of the teachers lacked relevant knowledge and skills and could therefore not organize play, get involved in children's play as advised by child educationist, and were also unable to facilitate play. It was recommended that these teachers go for more training and that government expenditure should be increased a little bit more in establishing more structures to create more space for children to play and to enrich the ECE teacher training curriculum.


The Kinematic Stabilizer is a posterior-cruciate-substituting design of total knee replacement. We have reviewed 109 primary total knee replacements in 95 patients at a mean follow-up time of 12.7 years (10 to 14). We used survival analysis with failure defined as revision of the implant. This gave a cumulative survival rate of 95% (95% CI +/- 5%) at ten years and (87% +/- 10%) at 13 years. These results from an independent centre confirm the value of an established design of cemented total knee replacement and question the wisdom of the introduction of modifications and new designs without properly controlled trials.


The early phases of a project to design and make operational an ombudsman for humanitarian assistance (HAO) are described in this paper. Beginning with a brief historical overview of the ombudsman concept, it then outlines seven key features of a potential HAO that were identified in the initial feasibility study. The main conclusion from the feasibility study was that, in principle, it is possible to design an HAO by adapting the operational frameworks of existing ombudsman schemes so as to match the needs of the humanitarian sector. Although this seems possible in theory, there still remain some major challenges requiring practical testing in a pilot phase. The most fundamental of these is how to enable the beneficiaries of aid to make their voices heard and register their views on the management of the emergency that is affecting them. Important also, are the issues of ensuring an international jurisdiction and finding sustainable ways of financing the scheme. Finally, the paper alludes to the framework of the pilot itself and how to address the main challenges ahead.


At the first international M-Libraries conference in 2007 it was clear that many libraries were keen to explore the potential of mobile library services, but none of the delegates attending reported having asked library users what sort of library services they might want to access from mobile devices, or which mobile devices they were comfortable using. When I had the opportunity to take part in the Arcadia Programme at Cambridge University Library, I opted to investigate how library users access and interact with information when they are on the move. The key questions posed to students were "Do you use mobile devices?" "What do you use them for?" and "What would you want to access from the library?"


The deposition of compositionally-modulated (Bi/sub 1-x/Sb/sub x/)/sub 2/(Te/sub 1-y/Se/sub y/)/sub 3/ thermoelectric multilayer films by magnetron sputtering has been demonstrated. Structures with a period of 140 /spl Aring/ are shown to be stable to interdiffusion at the high deposition temperatures necessary for growth of single-layer crystalline films with ZT>0.5. These multilayers are of the correct dimension to exhibit the electronic properties of quantum well structures. Furthermore it is shown that the Seebeck coefficient of the films is not degraded by the presence of this multilayer structure. It may be possible to synthesize a multilayer thermoelectric material with enhanced ZT by maximizing the barrier height through optimization of the composition of the barrier.


Babul Maghfirah Is one Of junior high Schools located in Aceh Besar which gives high attention to Arabic Learning In This Rase, It is one of 13 Junior high Schools In Aceh Besar which still Implements School-Based Curriculum (KTSP) in Teaching learning process. That is why, the write intended to conduct a Research under the title " The Analysis  of Arabic Material in School-Based Curriculum design" The present research was aimed to Find Out : 1) The Obstacle Faced by the Teacher in transferring the material in school-Based Curriculum design, 2) The Strength and weakness Of School-Based Curriculum method, and 3) The analysis of Arabic learning from cognitive, effective and Psikomotor view in School-Based Curriculum design. Descriptive Qualitative design was used in this research so that the writer used Questionnaire, Observation, and Interview to collect the data needed. Furthermore, all students (24 students) of grade VIII were become the sample of this research. After Conducting the research, it was Found that : 1) most of the Teachers had lack understanding toward the School-Based Curriculum it self. It was caused by the Curriculum was not a perfect design and still need a futher development: 2) Lack of  understanding in "Nahwu and Qawai'id" material was one of the weakness of KTSP in cognitive. It made The Students hard to master the method of giving the line, gathering new vocabularies and expression. Thus, it led them to be unable to speak Arabic, Affectively, the Students were more exsited to learn Arabic with School-Based Curriculum design, in psikomotor aspect, the writer found that students had good Capability in Performing " istima'kalamQira'ah and Khitabah". They also tonded to motivate each other. 3) After Conducting observation, Interview and Questionnare, It was also found that the Material of Arabic Language in School-Based Curriculum did not meet to Students need.


Student teachers face a set of complex challenges, particularly in their work in schools, where they have to work closely with associate teachers and the students they teach. The study described in this article sought to examine the teaching experiences of a group of student teachers through their eyes, with a focus on what they thought they had learnt from the students they taught.


We consider the problem of query-focused multidocument summarization, where a summary containing the information most relevant to a user's information need is produced from a set of topic-related documents. We propose a new method based on probabilistic latent semantic analysis, which allows us to represent sentences and queries as probability distributions over latent topics. Our approach combines queryfocused and thematic features computed in the latent topic space to estimate the summaryrelevance of sentences. In addition, we evaluate several dierent similarity measures for computing sentence-level feature scores. Experimental results show that our approach outperforms the best reported results on DUC 2006 data, and also compares well on DUC 2007 data.


We have developed a receiver for low-frequency radio waves using high-temperature superconducting quantum interference devices (SQUIDs). The primary application of such a receiver is to communicate in underground areas where the overburden results in significant losses at the usual radio frequencies. The receiver constructed consists of a SQUID, a small dewar, control electronics, and a battery pack. The SQUID was fabricated in our laboratory using an edge junction technology, discussed in previous publications. For this work we increased the effective area by including a standard galvanically coupled pickup loop. We have investigated background noise spectra and found that the low noise door of the SQUIDs can be fully utilized in the receiver, provided that the signals be encoded with a bandwidth narrower than the 60 Hz spacing between powerline harmonics. The most significant advantage of SQUIDs for this application is that they allow the compact construction of three-axis receivers that are necessary to overcome a dominant source of vibrational or motional noise.


A general variation method is developed for determining: (a) the magnetic shielding of nuclear spin-spin interactions in molecules; (b) the electron-coupled nuclear spin-spin interactions in molecules. Using simple valence-bond and molecular-orbital wave functions calculations have been made for the HD molecule. It is concluded that effect (a) is small compared with (b). Both wave functions lead to values for the zero magnetic field splitting of about 49 c/s, in good agreement with the observed value of 43 c/s.


This paper describes a European Union supported collaborative project called CustomTV based on the premise that future TV sets will provide all sorts of multimedia information and interactivity, as well as manage all such services according to each user's or group of user's preferences/profiles. We have demonstrated the potential of recent standards (MPEG-4 and MPEG-7) to implement such a scenario by building the following services: an advanced EPG, weather forecasting, and stock exchange/flight information.


A new method for obtaining a compact subsumptive general solution of a system of Boolean equations is presented. The method relies on the use of the variable-entered Karnaugh map (VEKM) to achieve successive elimination through successive map folding. It also makes an artificial distinction between don't-care and can't-happen conditions. Therefore, it is highly efficient as it requires the construction of maps that are both significantly fewer and significantly smaller than those required by classical methods. Moreover, the method is applicable to general Boolean equations and is not restricted to the two- valued case. Details of the method are formally justified, carefully explained and further demonstrated via an illustrative example.


In this paper, we deal with two classes of Diophantine equations, $x^2+y^2+z^2+k_3xy+k_1yz+k_2zx=(3+k_1+k_2+k_3)xyz$ and $x^2+y^4+z^4+2xy^2+ky^2z^2+2xz^2=(7+k)xy^2z^2$, where $k_1,k_2,k_3,k$ are nonnegative integers. The former is known as the Markov Diophantine equation if $k_1=k_2=k_3=0$, and the latter is a Diophantine equation recently studied by Lampe if $k=0$. We give algorithms to enumerate all positive integer solutions to these equations, and discuss the structures of the generalized cluster algebras behind them.


WIFO is organising the 7th European Workshop on Applied Cultural Economics (EWACE). This Workshop was founded in 1990 and is intended to provide a forum for the development and dissemination of applications of quantitative methods in cultural economics, as well as cultural-related applications of mathematical economics, experimental economics and other quantitative approaches (e.g., applied micro- and macroeconometric approaches). Possible topics include aspects of industrial organisation of cultural products and services (e.g., pricing, trade), labour market issues of artists (e.g., wages, cultural participation), spillovers and externalities of firms in the cultural sector (agglomeration) and studies on demand elasticities. Participation of interested researchers and policy makers from all countries is welcome. The submission deadline for extended abstracts is 31 May 2015.


The paucity of reports on the vegetational history of the alluvial peatland overlooked the Japan Sea in Tohoku district encouraged us to study it. In this paper the pollen analytical features of the Megata peatland situated at an altitude of above 10m in Akita Prefecture are described with a view to discussion of the vegetational history in the peatland and its surroundings from 3, 500y. B.P.The results are summarized as follows.1. The profile at the north of the peatland from which samples were taken for pollen analysis was mostly composed of autochthonous peat, of which the ages were calculated to be 3, 180±85y. B.P. (N-2003) at the 500cm depth and 2, 080±80y. B.P. (N-2004) at the 300cm depth on the basis of 14C dating.2. Pollen diagram derived from peat profile is characterized by the occurrence of Cryptomeria, Fagus, Quercus and Alnus with a high frequency of pollen and a gradual increasing of Cryptomeria from 3, 000y.B.P. of the initial layer. In pollen diagram three pollen assemblage zones on the basis of the prosperities of these dominant genera are differentiated as follows:I) Fagus-Quercus-Alnus zone (630-420cm)II) Cryptomeria-Fagus-Quercus-Alnus zone (420-70cm)III) Pinus-Cryptomeria-Alnus zone (70-0cm)3. The pollen diagram suggests a gradual change from the forests dominated by Fagus and Quercus, to Cryptomeria-Fagus forests now found locally in Akita Prefecture. An increasing of Pinus and Cryptomeria at the zone III seems to be influenced by plantation in the neighbourhood of the peatland.


This article focuses in all the research, contextualization, definition, analysis and implementation process of the human resources metrics dashboard for an organization in the technology business, using Meta4 technologies. It was developed a business study, some of the key concepts where deepened and defined, metrics were studied and selected, in order to justify the proposed solution. This solution will be the primary support to human resources management, simplifying and justifying the decision making process.


Bonding of Al-Fe-Ce alloy with Zircaloy-4 was carried out using Cu and Zn interlayers. Microstructural characterization was done using scanning electron microscopy and chemical composition of the phases was determined by energy dispersive X-ray spectroscopy. Formation of layered structure was observed in the diffusion zone of bonded structure of Al-Fe-Ce with Zircaloy-4 using Cu as an interlayer. Microhardness of different layers was determined. The results indicate that hardness of the AlZr phase is higher than the Al 2 Zr 3. Microhardness of the bonded alloys also increased due to the small addition of Cu in the lattice. Microhardness of the bonded alloy did not change when the bonding of Al-Fe-Ce with Zircaloy-4 was carried out using Zn coating as an interlayer and a few microcracks were observed in the diffusion zone.


For some critically endangered species, conservation breeding is a vital steppingstone toward re-establishing wild populations. The 'Alalā (Hawaiian crow, Corvus hawaiiensis), currently extinct in the wild, exists today only in a conservation breeding program, which, for many years, utilized successful hands-on husbandry approaches such as separating and resocializing pairs, providing partially manmade nests, artificially incubating eggs, and puppet rearing nestlings. Yet, a top priority of any conservation breeding program is to retain natural behaviors essential to postrelease survival and reproduction, to achieve successful reintroduction and restoration to the wild. We describe how we are adapting 'Alalā husbandry techniques to strengthen pair bonds through full-time socialization, enable pairs to build robust nests, encourage females to incubate eggs to hatch, and provide pairs and their offspring with vital parental rearing experiences. We discuss the use of standardized, data-driven methods to objectively track our progress towards successful parental breeding and to select release candidates based on their likelihood to survive and breed in the wild. The information shared in this report can be applied to other conservation breeding programs, particularly those implementing or transitioning to husbandry techniques geared towards preparing species to thrive in the wild.


Scientific Laboratory animals for biomedical research Research on venoms for the development of new therapeutic drugs Venom collection for antiserum production Ecologic Control of rodents and other vertebrates Prey items for several carnivore species (mammals, birds and reptiles) Important components of the food web Ambassadors for environmental education programs and zoological parks Economic Exotic pets Skin and meat production Cultural Popular symbolism, including as the symbol of the medical sciences Mythological symbolism Subjects in public demonstrations and entertainment Religious As a symbol and representation of gods and other religious elements Use in various modern religious cults


Background: Pathway analysis demonstrated associations between deep intracerebral hemorrhage (DICH) and the genetic risk score of complex IV of the oxidative phosphorylation (OXPHOS) pathway in whites. This study investigated the related genetic variations in the DICH population in Taiwan. Candidate variants were selected from the prior report by the following criteria: (1) nuclear genes encoding mitochondria complex IV, (2) genetic effect >1.08, (3) global minor allele frequency >0.01. Six single-nucleotide polymorphisms fitted in the selection criteria, which were mainly involved in Cox assembly, including Cox10, Cox15, and Cox18, and one structural gene, Cox7C. Associations were tested with adjustment of multiple covariables. Permutation testing of 1000 replicates was performed for empirical estimates. Results: This study enrolled 336 patients and 379 controls. Compared with whites, the Taiwan population has higher minor allele frequency (MAF) of rs4308511, rs767844, and rs221592 and lower MAF of rs8079640. There was no variation of rs16949067 in the Taiwan population. When adjusting for the traditional risk factors, rs221592 G allele was associated with DICH risk in women under additive (odds ratio (OR) = 1.5, 95% confidence interval (CI) = 1.02-2.3, P = .04) and recessive models (OR = 2.9, 95% CI = 1.2-6.9, P = .013). In an additive fashion, a poor 30-day outcome was associated with rs4308511 T allele (OR = 1.6, 95% CI = 1.1-2.3, P = .014) and rs9891372 C allele (OR = 1.7, 95% CI = 1.05-2.8, P = .024) in all subjects and in men (rs4308511, OR = 1.8, 95% CI = 1.2-2.7, P = .008; rs9891372, OR = 2.1, 95% CI = 1.1-3.8, P = .02). Conclusions: The results showed ethnic disparities in the complex IV–related genes. COX18-rs221592 G allele was associated with female DICH risks. COX7C-rs4308511 T allele was an independent risk of poor outcome in men.


The necessity to form the integration policy at the subnational level to the existing mechanism of economic integration in the EAEU is shown. The content of the conceptual framework of its elaboration, the features of the object and the subnational level of management as a subject of the policy is disclosed. Taking into account the existing regional restrictions, the directions of the integration policy are justified, including the regional policy aligned at the level of the EAEU member countries, the institutional framework, the measures to deepen interregional and border relations based on the implementation of regional reserves and a closer linkage with the regional development.


Growing evidence shows that exposure to nature and psychological engagement with nature improve health and wellbeing and promote greater proenvironmental engagement. The unprecedented situation created by COVID-related lockdowns seems to have brought both potential distress with household confinements and greater research on experiences in nature. University students may have been particularly impacted as the quality of their home arrangements can vary substantially. The aim of the study was to examine how psychological engagement with nature (nature connectedness and noticing nature), time spent in nature, and household conditions relate to psychological wellbeing and proenvironmental behavior among university students. An online survey was administered to a sample of 566 university students from Italy and Ireland. Hierarchical multiple regressions were performed to investigate the relationships between variables. The results indicate that time spent in nature and psychological engagement with nature in terms of nature connectedness and noticing nature were associated with increased wellbeing and pro-nature-conservation behavior, controlling for demographic covariates. Moreover, the perception of chaos in one's household was related to decreased wellbeing during the prolonged COVID-19 emergency. The findings highlight the need to invest in accessible natural places for students and to focus campus sustainability practices on encouraging nature connectedness to promote wellbeing and proenvironmental engagement.


A new method of matching for radio frequency EPR resonators is proposed. It uses resonant inductive coupling and is particularly suitable for studies with lossy conducting samples. The equivalent circuit of the resonant inductive coupling method is presented and a theoretical analysis of the equations that produce the critical coupling coefficient is discussed. A prototype resonant inductive coupling suitable for loop gap resonators operating at about 200 MHz has been developed and tested. Experimental results obtained with saline solutions show the advantages of resonant inductive coupling in terms of the coupling coefficient, RF magnetic field amplitude and field homogeneity. This matching method has been especially designed for CW EPR applications, in which the adoption of critical coupling is important for optimization of sensitivity. Moreover, resonant inductive coupling should also produce benefits for pulsed EPR studies.


A 78-year-old man with hypertension presented with dry cough and gradually progressive dyspnoea for 3 months. The patient had an audible stridor. Cardiovascular examination was unremarkable. Respiratory system examination revealed both inspiratory and expiratory grunting sound. Laboratory investigations were normal. Electrocardiography showed sinus rhythm with left ventricular hypertrophy (LVH). Chest X-ray showed superior mediastinal widening. Transthoracic echocardiography showed preserved LV functions and dilated aortic arch. Contrast-enhanced computed tomography of the thorax showed a huge aortic arch aneurysm compressing the adjacent trachea. The patient was planned for hybrid aortic arch repair but the patient refused and was discharged on antihypertensive, antiplatelet and statin therapy. The patient continued to have limiting cough, dyspnoea and stridor for 4 months of follow-up until he suddenly died while at home. This case highlights an unusual presentation of a potentially lethal disease. Evaluation of patients presenting with cough and dyspnoea should not be restricted to respiratory diseases. The critical observations made from history.


The unusual properties of metamaterials originate from their artificial metallic structures; however, these materials indeed behave as an effective medium in the operating frequency range. Correspondingly, the unit cell is called a meta-atom, but its relationship with real atoms has not been substantially studied. In this paper, we studied a stacked fishnet metamaterial in the optical frequency range and established a basic relationship between the meta-atom and the real atom. The characteristic frequency of meta-atoms behaves just as the energy level of real atoms, which splits with the stacked meta-atom number, converges with the atom spacing and is sensitive to the features of the center dielectric layer. This work will increase the understanding of metamaterial physics in view of solid-state physics and guide metamaterial design through quantum mechanical methods.


In the struggle for liberation and independence, imagery and visual representations are central to nationalist discourses and to national identity construction. Visual images of the nation become a revolutionary and mobilizing tool with the aim of rallying the nation behind a nationalist goal and shaping its collective identity. This paper aims to examine how Palestine is represented and imagined in various Palestinian visual representations including iconic images, posters and paintings. Based on Kress and van Leeuwen's (2006) visual communication grammar, this social semiotic study analyzes a number of images and posters produced by Palestinian artists in order to look into the constituent elements of Palestinian national identity and the 'homeland' as visually imagined in Palestinian visual discourse. The study shows that conditions of exile, dispossession and national struggle have been predominantly mapped onto Palestinian visual representations which are continually used to advance a grand national narrative and to assimilate individuals into an imagined community by stressing collective national themes. More social semiotic research should be devoted to the analysis of imagery and visual representations as they occupy a central place in the processes of constructing and asserting national identity and memory.


A green strategy was developed for the synthesis of various value-added chemicals using methanol, acetonitrile, acetic acid, acetone and ethyl acetate as the hydrogen source by coupling them with olefins over heterogeneous photocatalysts. A radical coupling mechanism was proposed for the hydrofunctionalization of olefins with methanol to higher aliphatic alcohols over the Pt/TiO2 catalyst as the model reaction. C–H bond cleavage and C–C bond formation between photogenerated radicals and terminal olefins were accomplished in a single reaction at high efficiency. Our approach is atomically economical with high anti-Markovnikov regioselectivity and promising application potential under mild reaction conditions.


Cytochrome P45O (CYP) gene has been known to play one of the most important roles in metabolizing the exogenous materials. In insect, CYP is particularly known to detoxify toxic materials by adding oxygen molecule to the hydrophobic region of the materials. Thus, CYP-dependent metabolism is associated with the adaptation of insect to host plant chemicals. This in turn is known to be one of the driving forces for CYP diversification. In the present study, we cloned seven gene fragments of CYP 4 (CYP4) family from the midgut of the beet armyworm, Spodoptera exigua, through RT·PCT, Sequence analysis of the product showed the gene fragment to contain an open reading frame of ∼150 amino acids, consisted of ∼450 bp. The cloned gene fragments contained typical, conserved regions found in CYP4 family. Pairwise comparison of the deduced amino acid sequences among seven clones ranged in divergence from 0% to 52.86% and resulted in five distinct clones. The other two clones were identical or differ by one amino acid respectively to the corresponding clone, although each differed by ten nucleotides. Analysis of correlation between GenBank-registered, full length CYP4 and the cloned fragments resulted in statistically significant relationship (r² = 0.96085 p


Context. With the introduction of Computer Science (CS) into curricula worldwide, teachers' adoption of CS pedagogical content is essential to ensure the long-term success of reform initiatives. Continuing Professional Development (CPD) programs play a key role in this process. Unfortunately, adoption is seldom evaluated in CS-CPDs or CPDs in general. The result is a dearth of studies (i) modelling teachers' adoption of CS pedagogical content or (ii) investigating factors influencing the uptake of this new discipline. Both aspects are crucial to design and characterize successful CPD programs. Objectives. We thus propose the Teachers' Adoption of CS (TACS) model to investigate factors influencing the adoption of CS pedagogical content by teachers who are following a mandatory CS-CPD program. More specifically, the model proposes that contextual factors (e.g., age, gender, and general teaching experience), prior factors (e.g., experience, and CS perception), and acceptance factors (e.g., interest, and self-efficacy) may impact teachers' adoption of CS pedagogical content. Methods. The study included 180 grades 5 and 6 teachers (students aged 9–11) that were following a mandatory CS-CPD program. The CS-CPD program involved participation in three-day-long sessions distributed over the 2019–2020 academic year. In between sessions, with the support of instructional coaches in the schools, teachers were encouraged, but not required, to adopt the CS pedagogical content. Therefore, during the CPD, and employing surveys based on the TACS model, we evaluated teachers' adoption of the proposed content and investigated how the different factors influenced it. Results. At the PD-level, the results indicate that self-efficacy and interest queried during the CS-CPD are indicative of CS pedagogical content adoption. To shed more light on the relationship between these metrics, a more in-depth analysis was conducted with n = 92 teachers whose responses could be matched between sessions. While interest relates to how teachers adopt CS pedagogical content overall, both interest and self-efficacy are necessary to ensure the likelihood of a specific activity being adopted. Finally, individual teacher characteristics appear to impact adoption, with teachers with low experience with Information and Communication Technologies (ICT) requiring onboarding, while middle-aged teachers require convincing to adopt CS pedagogical content. Conclusion. Three takeaways emerge from the study. First, the analyses confirm the foundation of the TACS model. Second, the findings establish the key role that interest plays in said model. Finally, the results support the relationship between the contextual, prior and acceptance factors on the adoption of primary school CS pedagogical content.


Objectives: To evaluate the effects on quality and efficiency of implementation of the advanced practice provider in critical care. Data Sources: PubMed, Embase, The Cochrane Library, and CINAHL were used to extract articles regarding advanced practice providers in critical care. Study Selection: Articles were selected when reporting a comparison between advanced practice providers and physician resident/fellows regarding the outcome measures of mortality, length of stay, or specific tasks. Descriptive studies without comparison were excluded. The methodological quality of the included studies was rated using the Newcastle-Ottawa scale. The agreement between the reviewers was assessed with Cohen's kappa. A meta-analysis was constructed on mortality and length of stay. Data Extraction and Synthesis: One-hundred fifty-six studies were assessed by full text. Thirty comparative cohort studies were selected and analyzed. These compared advanced practice providers with physician resident/fellows. All studies comprised adult intensive care. Most of the included studies showed a moderate to good quality. Over time, the study designs advanced from retrospective designs to include prospective and comparative designs. Data Synthesis: Four random effects meta-analyses on length of stay and mortality were constructed from the available studies. These meta-analyses showed no significant difference between performance of advanced practice providers on the ICU and physician residents/fellows on the ICU, suggesting the quality of care of both groups was equal. Mean difference for length of stay on the ICU was 0.34 (95% CI, –0.31 to 1.00; I2 = 99%) and for in hospital length of stay 0.02 (95% CI, –0.85 to 0.89; I2 = 91%); whereas the odds ratio for ICU mortality was 0.98 (95% CI, 0.81–1.19; I2 = 37.3%) and for hospital mortality 0.92 (95% CI, 0.79–1.07; I2 = 28%). Conclusions: This review and meta-analysis shows no differences between acute care given by advanced practice providers compared with physician resident/fellows measured as length of stay or mortality. However, advanced practice providers might add value to care in several other ways, but this needs further study.


The issue of gender, as a language variable, has been the focus of study for many years. Knowing about differences between male and female in language use could help teachers and syllabus designers develop better instructions and learning materials for learners. However, it seems that this crucial variable has not gained much attention in the realm of foreign language research, especially in writing skill. Since writing skill in foreign language and especially in academic setting is of significance, much more attention should be paid to the issue of gender. In addition, considering cultural differences between native and foreign language, it can be found that this variable plays a significant role in learning a foreign language. Given the importance of gender in language learning and teaching, this book tries to demonstrate the differences between EFL student's writing and teachers' perceptions of male and female writing. The present book provides valuable information for methodologists, syllabus designers, material developers, teachers and learners.


This paper describes a robust feature extraction technique for continuous speech recognition. Central to the technique is the minimum variance distortionless response (MVDR) method of spectrum estimation. We incorporate perceptual information directly in to the spectrum estimation. This provides improved robustness and computational efficiency when compared with the previously proposed MVDR-MFCC technique. On an in-car speech recognition task this method, which we refer to as PMCC, is 15% more accurate in WER and requires approximately a factor of 4 times less computation than the MVDR-MFCC technique. On the same task PMCC yields 20% relative improvement over MFCC and 11% relative improvement over PLP frontends. Similar improvements are observed on the Aurora 2 database.


Inflammatory bowel diseases (IBD), a heterogeneous group of inflammatory conditions that encompass both ulcerative colitis and Crohn's disease, represent a major public health concern. The etiology of IBD is not yet fully understood and no cure is available, with current treatments only showing long-term effectiveness in a minority of patients. A need to increase our knowledge on IBD pathophysiology is growing, in order to define preventive measures, to improve disease outcome, and to develop new effective and lasting treatments. IBD pathogenesis is sustained by aberrant immune responses, associated with alterations of the intestinal epithelial barrier (IEB), modifications of the enteric nervous system and changes in microbiota composition. Currently, most of the treatments target the inflammation and the immune system, but holistic approaches targeting lifestyle and diet improvements are emerging. As dysbiosis is involved in IBD pathogenesis, pre-, pro-, syn- and postbiotics are used/tested to reduce the inflammation or strengthen the IEB. The present review will resume these works, pointing out the stage of life, the duration and the environmental conditions that should go along with microbiota or microbiota-derived treatments.


Modern processors rely heavily on memory arrays close to the logical processers to have minimal latencies and highest bandwidth for optimal performance. There are memory arrays in the client and server which are configured to different levels based on the size and latency required for the tasks. These memory arrays are separated into bit lines and word lines to address single bits and retrieve required data from the address of the memory location. In any new server validation, a memory access error can happen if the logical to physical memory address is not confirmed. This can lead to corrupt data and operation failure. We have employed here, novel targeted Focused Ion Beam (FIB) milling techniques for Logical to Physical (L2P) memory addressing validation and correction.


Fiber length is an important determinant of fiber quality, and it is a quantitative multi-genic trait. Identifying genes associated with fiber length is of great importance for efforts to improve fiber quality in the context of cotton breeding. Integrating transcriptomic information and details regarding candidate gene regions can aid in candidate gene identification. In the present study, the CCRI45 line and a chromosome segment substitution line (CSSL) with a significantly higher fiber length (MBI7747) were utilized to establish F2 and F2:3 populations. Using a high-density genetic map published previously, six quantitative trait loci (QTLs) associated with fiber length and two QTLs associated with fiber strength were identified on four chromosomes. Within these QTLs, qFL-A07-1, qFL-A12-2, qFL-A12-5, and qFL-D02-1 were identified in two or three environments and confirmed by a meta-analysis. By integrating transcriptomic data from the two parental lines and through qPCR analyses, four genes associated with these QTLs including Cellulose synthase-like protein D3 (CSLD3, GH_A12G2259 for qFL-A12-2), expansin-A1 (EXPA1, GH_A12G1972 for qFL-A12-5), plasmodesmata callose-binding protein 3 (PDCB3, GH_A12G2014 for qFL-A12-5), and Polygalacturonase (At1g48100, GH_D02G0616 for qFL-D02-1) were identified as promising candidate genes associated with fiber length. Overall, these results offer a robust foundation for further studies regarding the molecular basis for fiber length and for efforts to improve cotton fiber quality.


The Saemangeum embankment construction have changed the flowing on the topography of the coastal marine environment. However, the variety of ecological factors are changing from outside of Saemangeum embankment area. The ecosystem of various marine organisms have led to changes by sea surface temperature. The aim of this study is to monitoring of sea surface temperature(SST) changes were measured by using thermal infrared satellite imagery, MODIS and Landsat. The MODIS data have the high temporal resolution and Landsat satellite data with high spatial resolution was used for time series monitoring. The extracted informations from sea surface temperature changes were compared with the dyke to allow them inside and outside of Saemangeum embankment. The spatial extent of the spread of sea water were analyzed by SST using MODIS and Landsat thermal channel data. The difference of sea surface temperature between inland and offshore waters of Saemangeum embankment have changed by seasonal flow and residence time of sea water in dyke.


Goals: To evaluate the significance of osteopontin (OPN) genotypes in the susceptibility to gastric cancer. Background: The expression of OPN has been correlated with development, invasiveness, metastasis, and survival of gastric cancer, but the role of polymorphisms in the OPN promoter has not been investigated. Study: We enrolled 146 gastric cancer patients and 128 controls. DNA was extracted from peripheral blood leucocytes. Single-nucleotide polymorphisms (SNPs) in the OPN promoter (−66, −156, −443, −616, −1748, and −1776) were analyzed by pyrosequencing and direct sequencing methods. Logistic regression analyses were used to evaluate the associations between SNPs and development of gastric cancer. Results: SNP −443 C/C and −616 T/T of the OPN promoter were significantly associated with gastric cancer [odds ratio (OR)=2.88; 95% confidence interval (CI), 1.16-7.12 and OR=1.95; 95% CI, 1.35-2.82, respectively]. Analysis of the combined effect of OPN promoter SNPs revealed that the combination of SNP −443 (T/C or C/C) and SNP −616 (T/T or T/G) had the most significant association with gastric cancer (OR=3.95; 95% CI, 1.58-9.90). Conclusions: Our results suggest that polymorphisms in the OPN promoter are associated with the development of gastric cancer, and the combination of SNP −443 (T/C or C/C) and −616 (T/T or T/G) most significantly increases susceptibility to gastric cancer.


ABSTRACT MisL is a Salmonella enterica serotype Typhimurium fibronectin binding protein whose expression is induced during infection of mice. T-POP transposon mutagenesis identified marT as a positive regulatory element controlling expression of a misL::lacZYA transcriptional fusion. Gel shift analysis identified MarT as a transcriptional activator of the misL promoter.


798 The molecular basis for the generation of genetic diversity in cancer cells has emerged as an important focus of investigation. We have previously shown that homologous recombination (HR), required for a variety of normal cellular processes, is dysregulated in cancers and leads to the progressive accumulation of genetic variation over time. Moreover the inhibition or stimulation of HR activity in cancer cells, by altering components of the HR pathway, concordantly affects the acquisition of new genetic. Consistent with this, an elevated frequency of cancer is observed in patients whose cells have elevated rate of recombination. A dysregulated expression of HsRAD51 recombinase, a key player in HR can cause an increase in HR activity, leading to increased rate of mutations, telomere elongation, and development of cancer. We have previously demonstrated that siRNAs targeting hsRAD51 can completely inhibit acquisition of new mutation in cancer cells. Based on these data, we hypothesized that hsRAD51 promoter activity may be a target of carcinogenic agents and ability to measure the hsRAD51 promoter activity may provide a method to assess carcinogenic potential of a test agent. To this end we constructed a mammalian expression vector containing firefly luciferase gene downstream of hsRAD51 promoter. This plasmid was introduced into normal human diploid fibroblasts and 24 hrs later the transfected cells were exposed to carcinogens or the control vehicle. Following 2 hrs exposure, cells are lysed and luciferase activity assayed. Although exposure to a non-carcinogen, Sodium azide did not induce hsRAD51 promoter activity or HR activity in normal fibroblasts, exposure to agents with known transforming ability, Mitomycin C and Nickel chloride, led to a significant induction of hsRAD51 promoter activity (2.5 and 3.5-fold respectively) in normal fibroblast. In these cells we have also confirmed an associated elevation in HR activity following treatment with these chemicals. These agents were also able to further induce hsRAD51 promoter in myeloma cells, with known over-expression of hsRAD51. We have further evaluated the effects of anti-oxidants on hsRAD51 promoter activity. In myeloma cells with elevated hsRAD51 expression, the anti-oxidant tocopherol and cannabinol were able to reduce hsRAD51 promoter activity by 3- and 8-fold respectively while vitamin C and Selenium had minimal effects. These preliminary results provide us with an ability to measure potential of known carcinogens to induce HR. Validation of this test is underway prior to its application to screen agents with ability to transform cells or inhibit HR activity.


Background: Since their initial use in the 1980s, IFNs have become an essential component of the therapy for many diseases such as hepatitis and multiple sclerosis. Although they have been extremely useful in conditions that pose therapeutic challenges, complications associated with their use have been widely reported including emerging reports of several autoimmune diseases. Many of these reports have shed light on the pathogenesis of autoimmune disorders and helped to highlight not only the critical role of type I IFNs in defense against viral infections but also the pivotal role they occupy in the interface between innate and adaptive immunity. Many patients with autoimmune disease have increased responsiveness to type I IFNs (α/β), and therapy with these cytokines has induced or unmasked autoimmune disease in many additional patients. Objective: The objective of this paper is to discuss the role of type I IFNs in autoimmunity. Methods: The literature regarding type I IFNs and autoimmunity was reviewed using the Medline database from 1950 to 2009. Search terms included 'interferon alpha' and 'autoimmune disease' and 'interferon beta' and 'autoimmune disease'. Case reports, case series, reviews and prospective studies were included in the analysis. Results/conclusions: In the literature a variety of autoimmune disorders have reportedly been induced by the use of type I IFNs, being used, although these are primarily in the form of case reports and case series. Nevertheless, there is a growing body of molecular evidence to support the clinical association. The role of IFNs in the induction of autoimmunity is complex with interplay of many genetic and environmental factors that influence the balance between normal and aberrant immune responsiveness, ultimately leading to the observed clinical manifestations.


Child marriage is a fundamental violation of human rights. It hinders progress towards development and public health goals. In this study, we argue that armed conflict plays an important role in the occurrence of child marriages; it influences the supply of and demand for young brides. We argue that in conflict settings, families are more willing to marry off their young daughters for protection. Armed conflict can also influence the demand: marriage in general declines due to an imbalance in sex ratio. However, in cases where belligerents use war tactics specifically focused on harming girls, such as sexual violence and girl recruitment, early marriage might increase as the result of armed conflict. To empirically examine these linkages, we combine the Demographic and Health Surveys of West Africa with information on the location of armed conflict. Our study shows that armed conflict generally reduces the occurrence of child marriage with 13% to 18%. However, we observe that when conflict actors use war tactics that specifically harm young girls there is a significant increase of 12% to 18% in the probability of a girl getting married before the age of 18. This research has important implications for our understanding of the relationship between armed conflict, gender inequality, and their impact on children.


Alport syndrome is a progressive multisystem disease associated with variants in genes COL4A3, COL4A4, COL4A5.The syndrome is an important genetic cause of kidney failure, including women with X-linked disease. Given the unfavorable natural history of Alport nephropathy and benefit from early treatment with angiotensin-converting enzyme inhibition, it is necessary to change our diagnostic approach in patients with persistent glomerular hematuria and management of patients with Alport syndrome. This review presents the ethiology, pathogenesis, genotype and phenotype heterogeneity of the syndrome and expert clinical practice recommendations to enhancing early diagnosis and achieving optimal outcomes in Alport syndrome.


The present article gives an overview of sociocultural approaches to creativity and advances a particular theory of the creative process grounded in the notions of difference, position, perspective, dialogue, and affordance. If sociocultural psychology challenges old dichotomies between mind and body, individual and society, then creativity is ideally placed to demonstrate their interdependence. While sociocultural thinking in creativity research has traditionally emphasized the social or collaborative nature of creative processes, recovering old scholarship and reviewing it in light of current empirical developments shows how socio-materiality can properly inform psychological theory in this area. The article starts with an outline of sociocultural principles before considering their application to creativity. It then formulates four propositions regarding the creative process: (a) differences of perspective increase creative potential; (b) exchanging positions and perspectives, within and between individuals, fosters creative processes; (c) these exchanges result in perspectives that reveal previously unperceived affordances; and (d) oftentimes, it is the affordances of material objects or of unique idea combinations that guide the development of novel perspectives in creative work. Evidence supporting these key hypotheses of the perspective-affordance theory of creativity (PAT) comes from research conducted in a variety of areas within psychology and in related fields. In the end, the methodological and practical implications of considering creativity as a process of recognizing differences, exchanging positions, developing perspectives and discovering affordances will be discussed, as well as the broader implications of building theories that bring together, rather than keep separate, the social, the material, and the psychological.


The development of continental-scale fire mapping using AVHRR since the early 1990s and, more recently, MODIS imagery, is transforming our understanding of Australian fire regimes—particularly the national significance of savanna burning. The savannas of northern Australia are the most fire-prone part of a fire-prone continent. The savanna region comprises 1,898,562 km2 (24.7% of the Australian landmass), of which 21% has been burnt on average each year, over the period 1997–2005. Savanna fires currently contribute about 68% of national fire extent annually—the remainder comprising mostly fire in central Australia (associated in recent years with decadally high rainfall, hence high fuel loads), with just 2% in relatively densely populated southern Australia. At finer scales of resolution employing LANDSAT imagery, northern Australian studies since the early 1980s are providing novel landscape-scale assessments including monitoring of fire regime heterogeneity and biomass burning emissions. While seasonality has been shown in a number of studies to be correlated with fire intensity, remote sensing studies of fire severity are just commencing. The paper particularly addresses recent north Australian studies that explore the importance of spatial and temporal patchiness in fire extent and severity.


OBJECTIVE: To compare the clinical efficacy and tolerance of didanosine (ddl) monotherapy with low-dose zidovudine/didanosine (AZT/ddl) therapy among HIV-infected patients previously treated with AZT. METHODS: A randomized controlled trial was carried out of ddl 400 mg daily versus AZT/ddl 300/200 mg daily among patients with CD4 cell counts </=350 mm3 and prior AZT treatment for at least 16 weeks. Fifty eight patients received ddl monotherapy and 66 combined treatment. RESULTS: Patients were similar with respect to demographic, clinical and laboratory characteristics, and prior AZT treatment. Median duration of follow-up was 17.3 months. In the ddl group, 20 patients (34%) discontinued treatment because of toxicity, compared to 19 (29%) in the AZT/ddl group (p=0.38). There was no statistically significant difference in CD4 change between the two groups. In the ddl group, 16 patients (28%) developed a clinical endpoint (death or AIDS-defining opportunistic infection), compared to 33 (50%) in the combined therapy group (relative risk 1.8; 95% confidence interval 1.1-2.9; p=0.01). CONCLUSIONS: For fairly advanced AZT-pretreated patients, monotherapy with ddl was clinically and statistically superior to the low-dose AZT/ddl combination in preventing AIDS-defining illness and death. When access to drugs is limited, e.g. in under-resourced countries, combining available drugs and reducing dosage may be less effective than a single drug at the conventional dosage.