In the course of a wordy article which offers no new solution to any problem, R. L. Crocker makes a series of criticisms of articles by us on the subject of Babylonian music. It is gratifying that he, the musicologist who has been most concerned, acknowledges that Gurney's corrections to the system, published in Volume 56 of this journal, are "almost right". However, he accuses us of suffering from and perpetuating methodological and terminological confusions, and of being insufficiently emancipated from modern European musical concepts. It seems to us that there is more confusion in Dr Crocker's paper than in ours, and that in places he is more guilty than either of us of preconception based on modern musical theory. A real step forward in the understanding of the Babylonian tonal systems was made a few years ago when T. J. H. Krispijn produced an improved reading in 1. 12 of the crucial "re-tuning text", UET VII 74. Line 12 rounds off the preceding list of tuning adjustments. In what had previously been read as NU.SU.U[D] "no more" (i.e. "end of sequence"), Krispijn recognized nu-sú-ḫ[u-um], "tightening"; the damaged sign on the edge is compatible with ḫu, and the reading seems secure. This has consequences for readings in all that precedes and follows. Previously, te-[x x] in 1. 15 and te-n[i]-m[a] in 1. 19 had been taken to be from enûm, thus "you alter", and the same verb had been restored in both sections of the document. It was then open to the modern interpreter to decide whether "alter" meant "tighten" in § 1 and "slacken"in §2, or vice versa. With the new reading it became clear that § 1 was about tightenings, and that the verb in § 2 was to be read as te-n[é]-e!-[ma], "you slacken", from nê um, while a different verb was to be restored in § 1, namely [tu-na-sà-ah]. These are the technical terms for re-tuning a string, known from the lexical texts cited by Gurney in his n. 5, and they are both present on UET VII 74. A further consequence of the new reading was that it confirmed the view for which R. Vitale had argued on other grounds,3 that the "front"strings of the instrument played the highest notes, not the lowest as others had supposed.


The aim of this study was to evaluate the status of the native aortic valve in patients operated for acute dissection of the ascending. aorta (ADAA). Between November 1972 and November 1991, 93 patients were operated for ADAA. There were 76 men and 17 women (average age 54 +/- 12 years). The aortic valve was reserved in 80 cases (86%). In 13 patients (14%) aortic valve replacement was associated with replacement of the ascending aorta. The early mortality was 29% (27/93). The global actuarial survival rates at 5, 10 and 15 years were 60.2 +/- 5.2%, 49.7 +/- 6.1% and 26.9 +/- 9.9% respectively. Fifty patients (94%) in whom the native aortic valve was preserved were followed up. Nine patients (18%) died and average of 97 +/- 46 months after surgery. The causes of death were aortic rupture or extension of the dissection (N = 4), ischemic cardiac failure (N = 2), renal failure (N = 1), cerebrovascular accident (N = 1) and sudden death (N = 1). Forty one patients underwent transthoracic echocardiography. Seven patients developed severe aortic regurgitation, 6 of whom had to be reoperated for aortic valve replacement. Echocardiography showed absence of of minimal aortic regurgitation in 22 cases and mild aortic regurgitation with normal left ventricular function in 12 cases (in 2 cases, aortic valve replacement was associated with surgical treatment of another valvular lesion or of coronary artery disease). Therefore, aortic valve replacement was performed in 8 patients 61.5 +/- 51.2 months after the initial operation.(ABSTRACT TRUNCATED AT 250 WORDS)


A rare case of an intrasellar epidermoid cyst with ophthalmologic and endocrinological disorders is reported.<BR>  A 54-year-old male complained of decreased visual acuity and visual field defects. On admission, bitemporal hemianopsia and panhypopituitarism were revealed. Computed tomography (CT) demonstrated a homogeneous low density area in the sellar region. The margin of the low density area was slightly enhanced. The low density area was clearly distinguished from the cerebrospinal fluid space in the metrizamide CT cisternography. The mass lesion was totally removed by the transsphenoidal approach. Histological examination of the surgical specimen showed that the cyst wall consisted of stratified squamous epithelium with keratinization and confirmed the diagnosis of epidermoid cyst.


The density and function of epidermal dendritic cell populations were investigated in aged C57BL/6J mice. The densities of both Langerhans cells (LC) and Thy-1+ dendritic epidermal cells were found to decrease with age. Epidermal cell suspensions from aged mice showed impaired immunologic function as assessed in vitro by the skin-lymphocyte reaction assay and by measuring the ability of epidermal cell suspensions to stimulate the proliferation of sensitized T cells in the presence of the sensitizing antigen. However, the capacity of LC to transport antigen from the skin to the draining lymph nodes was found in vivo to be comparable to that of young mice. Results of transplantation of bone marrow cells from young and old donors into irradiated recipients indicate that the decreased Langerhans cell density found in old mice may result from a deficiency in Langerhans cell bone marrow progenitors.


OBJECTIVE
To describe a patient who presented with hypocalcemia and hypocalciuria as the initial manifestations of celiac disease, despite a normal vitamin D status.

METHODS
We review the diagnostic evaluation, treatment, and biochemical and bone mineral density responses of a patient with asymptomatic celiac disease, which was initially suggested because of a low serum calcium level that became attributable to isolated malabsorption of calcium.

RESULTS
A 36-year-old woman presented with hypocalcemia in the presence of normal serum 25-hydroxyvitamin D and high serum 1,25-dihydroxyvitamin D levels. She had hypocalciuria and secondary hyperparathyroidism that were refractory to pharmacologic calcium and cholecalciferol supplementation. Fecal calcium excretion indicated malabsorption of calcium, and biopsy of the small intestine demonstrated pathologic changes characteristic of celiac disease. Bone mineral density, determined by dual-energy x-ray absorptiometry, was in the osteopenic range at the femoral neck. The initiation of a gluten-free diet resulted in correction of all biochemical abnormalities and a substantial increase in bone mineral density.

CONCLUSION
Primary intestinal malabsorption of calcium without concomitant vitamin D deficiency is possible in celiac disease because of the preferential involvement of the proximal small intestine early in the disease process. Our patient had hypocalcemia caused by celiac disease and values for serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D that were normal and elevated, respectively. Correction was demonstrated after dietary gluten withdrawal.


Abstract 1679

Poster Board I-705

Background Lenalidomide (Revlimid®) is a potent immunomodulatory agent that has recently demonstrated clinical activity in the treatment of relapsed/refractory Multiple Myeloma and low- and int-1 risk Myelodysplastic syndromes with the del (5q) mutation. Laboratory data has shown that lenalidomide enhances T- and NK-cell mediated immune synapse formation and ADCC, and it exerts antiproliferative activity. In relapsed/refractory (R/R) NHL lenalidomide treatment achieved modest responses, although duration of response was >16.5 months (Witzig et al JCO, in press). Synergistic activity between lenalidomide and rituximab has been reported in lymphoma cell and animal models. Here we assess safety and efficacy of the lenalidomide and rituximab combination (R2) in patients with R/R indolent NHL.

Methods Eligible patients had relapsed/refractory indolent NHL with measurable disease, ≥1 prior therapy, and ECOG PS 0-2. Oral lenalidomide was administered once daily on days 1-21 of a 28-day cycle, and was continued until disease progression. Rituximab 375mg/m2 IV was initiated on day 15 of cycle 1, and repeated weekly for a total of 4 doses; if after cycle 2 patient had less than a complete response (CR), 4 additional doses could be administered at discretion of the treating physician. After Gr. 3 tumor lysis syndrome (TLS) developed in 2 of the first 4 patients, the protocol was amended to reduce lenalidomide starting dose from 25 mg to 20mg daily, and TLS prophylaxis was provided with allopurinol in subsequently enrolled patients. Response and progression were evaluated according to IWG criteria (Cheson et al 1999).

Results Of 15 patients currently enrolled on study, 14 received >2 cycles of R2, and 12 are evaluable for response. Median age for evaluable patients is 60 yrs (range: 50-91), 5 pts are female, and histologies include FL (n=9), SLL (n=1), and marginal zone lymphoma (n=2). Median time from diagnosis to treatment on study was 7.5 years (3.3-19), median number of prior therapies was 4 (range:1-11), and 9 patients were considered heavily pretreated (defined as ≥ 3 prior courses of therapy). All patients received prior rituximab, 6 patients had rituximab-resistant disease (defined as no response or relapse ' 6 months after initiating rituximab), and 5 patients had received prior radioimmunotherapy. Of 12 evaluable patients, 10 (83.3%) responded to R2, including 5 patients (41%) with a CR and 4 patients (33%) with a PR. Responses occurred in 4 of 6 patients (66%) with rituximab refractory disease, and in 7 of 9 (77%) heavily pretreated patients. Of 9 patients with R/R FL, 5 (55%) achieved a CR and 3 (33%) had a PR in response to R2, for an 88% ORR. At a median follow-up of 12 months, the median progression free survival has not been reached. Most common grade 3/4 adverse events were fatigue (2/12, 16%), neutropenia (3/12, 25%), lymphopenia (4/12, 33%), and hyponatremia (2/12, 16%). After prophylaxis was initiated, TLS was not observed at the 20 mg dose level.

Conclusion This is the first study to demonstrate that the R2 combination is generally well tolerated and active in patients with R/R indolent NHL. Clinical activity was particularly noted among patients with R/R FL, who achieved 88% OR and 55% CR rate. The tolerability profile of R2 was consistent with other studies of each agent individually in the R/R setting. TLS prophylaxis and monitoring is recommended, particularly during initial cycles of treatment. These data support further evaluation of the potential clinical synergy between rituximab and lenalidomide in larger studies of FL and in earlier lines of therapy.

Disclosures Off Label Use: Lenalidomide for treatment of non-hodgkin's lymphoma. Tuscano: Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees.


Atrial fibrillation is associated with a fall in cardiac output, and cardioversion to sinus rhythm is frequently attempted. After cardioversion, atrial contractile performance might be depressed. It is, however, unclear whether or not atrial contractile performance is altered following atrial fibrillation periods lasting < 1 wk. Atrial contractile performance after short-term paroxysmal atrial fibrillation was examined in seven barbiturate-anesthetized, open-chest pigs paced at constant ventricular rate after complete atrioventricular block. Percent left atrial systolic shortening (systolic shortening of left atrial diameter in percent of atrial diameter at onset of atrial contraction, %LASS) increased from 100 to 116.2% (107.7-121.8) (median and 95% confidence interval) immediately after cessation of a fibrillation period of 1 min. A brief phase of atrial hypercontractility (%LASS significantly above control) was also demonstrated after fibrillation periods of 5 and 15 min. A subsequent phase of atrial hypocontractility (%LASS significantly below control) was recorded after atrial fibrillation periods of 5, 15, and 30 min. After the 30-min fibrillation period, atrial hypocontractility was most pronounced and reached a nadir of 86.8% (75.1-93.3).


Medical image segmentation is a critical step in computer-aided diagnosis, and convolutional neural networks are popular segmentation networks nowadays. However, the inherent local operation characteristics make it difficult to focus on the global contextual information of lesions with different positions, shapes, and sizes. Semi-supervised learning can be used to learn from both labeled and unlabeled samples, alleviating the burden of manual labeling. However, obtaining a large number of unlabeled images in medical scenarios remains challenging. To address these issues, we propose a Multi-level Global Context Cross-consistency (MGCC) framework that uses images generated by a Latent Diffusion Model (LDM) as unlabeled images for semi-supervised learning. The framework involves of two stages. In the first stage, a LDM is used to generate synthetic medical images, which reduces the workload of data annotation and addresses privacy concerns associated with collecting medical data. In the second stage, varying levels of global context noise perturbation are added to the input of the auxiliary decoder, and output consistency is maintained between decoders to improve the representation ability. Experiments conducted on open-source breast ultrasound and private thyroid ultrasound datasets demonstrate the effectiveness of our framework in bridging the probability distribution and the semantic representation of the medical image. Our approach enables the effective transfer of probability distribution knowledge to the segmentation network, resulting in improved segmentation accuracy. The code is available at https://github.com/FengheTan9/Multi-Level-Global-Context-Cross-Consistency.


Case studies of developing and non-developing tropical depressions in the north-west Australian region during the 1979/80 and 1980/81 cyclone seasons have been constructed using conventional and satellite observations. These show that enhanced low-level winds can occur during the lifetime of non-developing disturbances and are not exclusively associated with cyclogenesis. Both types of system possessed lower-level cyclonic circulations and there was an overlapping such that non-developing storms could have stronger circulations than some developers. At upper levels, development was associated with the subtropical ridge being situated over the surface position of the disturbance. In contrast, the ridge tended to be located southwards of non-developers.

These findings are supported by calculations of area-averaged vorticity at 850 and 200 mb. Cross-sections of zonal winds show that non-developing systems could exhibit weaker vertical wind shears than some developing storms. Developers had only moderate shears at worst and maintained a well organized lower cyclonic circulation.

Such features are consistent with both classes of disturbance existing within the monsoon shearline. Non-development was caused by interactions with large-scale flows in the southern hemisphere that prevented the necessary conditions for cyclogenesis from being all fulfilled. This suggests a need for greater understanding of the influence of mid-latitude events on depressions within the monsoon trough.


Trends and Technology welcomes releases and information about new products, services, Web sites, trends, and upcoming events (give us six months lead time for seminars and meetings). If your company has a Web site that you would like for us to review, please send us news for our Online section, or tell us about sites that would interest clinical laboratory scientists. These sites, as well as the new product information, are offered for reader information only. We cannot vouch for them and their presence here does not constitute an endorsement by CLS or ASCLS. NEW PRODUCTS Kimball Genetics is pleased to announce availability of the One-Day Celiac Disease DNA Test for cheek cell specimens in addition to blood. Cheek cell specimens are popular with both patients and physicians because they eliminate the need for a blood draw and are convenient to collect and ship. Kimball Genetics' unique ability to perform celiac disease testing on cheek cells enables direct-to-consumer marketing of this service. For more information, contact Juli Murphy, (800) 320-1807. American Diagnostica offers an extensive line of clinical laboratory products. Among its most recent offerings are its Imubind®/ELISA-based test kit for the quantitation of activated human factor VII(fVIIa) in plasma, as well as in cell culture supernatants; a line of optimized test kits for the determination of Thrombin Activatable Fibrinolysis Inhibitor (TAFI); and an extensive offering of hemostasis reference, deficient, and control plasmas to support the needs of clinical laboratory scientists. The company also offers a broad line of control…


Purification of the lectin from Phaseolus acutifolius var. escumite was achieved by affinity chromatography on a column containing glutaraldehyzed membranes from blood group O erythrocytes. The lectin is a tetrameric glycoprotein of 121 kDa with 10% of sugar by weight composed by four subunits of 30 kDa as determined by SDS-PAGE. The lectin is composed of four isolectins as determined by ion-exchange chromatography on a mono-S column. The lectin and its isolectins showed identical NH2 terminal residues (ANDLSFNFQR FNETN) with homology to the PHA leucoagglutinin-precursor. Peptide mass fingerprint from each lectin isoform determined from tryptic peptides by MALDI-TOF (matrix assisted laser desorption ionization-time-of-flight) showed differences among subunits, thus suggesting microheterogeneity in their amino acid sequences or different glycosylation patterns. The lectin and its four isolectins agglutinated erythrocytes without serological specificity and showed mitogenic activity on human leukocytes; moreover, the main effect was rather toward CD8+ than to CD4+ human peripheral lymphocytes. The lectin from escumite was not inhibitable by simple sugars; however, the specificity of the lectin and its isoforms was mainly addressed toward galactose residues present in bi- or triantennary N-acetyllactosamine-type glycans.


Identifying differentially abundant microbes is a common goal of microbiome studies. Multiple methods have been applied for this purpose, which are largely used interchangeably in the literature. Although it has been observed that these tools can produce different results, there have been very few large-scale comparisons to describe the scale and significance of these differences. In addition, it is challenging for microbiome researchers to know which differential abundance tools are appropriate for their study and how these tools compare to one another. Here, we have investigated these questions by analyzing 38 16S rRNA gene datasets with two sample groups for differential abundance testing. We tested for differences in amplicon sequence variants and operational taxonomic units (referred to as ASVs for simplicity) between these groups with 14 commonly used differential abundance tools. Our findings confirmed that these tools identified drastically different numbers and sets of significant ASVs, however, for many tools the number of features identified correlated with aspects of the tested study data, such as sample size, sequencing depth, and effect size of community differences. We also found that the ASVs identified by each method were dependent on whether the abundance tables were prevalence-filtered before testing. ALDEx2 and ANCOM produced the most consistent results across studies and agreed best with the intersect of results from different approaches. In contrast, several methods, such as LEfSe, limma voom, and edgeR, produced inconsistent results and in some cases were unable to control the false discovery rate. In addition to these observations, we were unable to find supporting evidence for a recent recommendation that limma voom, corncob, and DESeq2 are more reliable overall compared with other methods. Although ALDEx2 and ANCOM are two promising conservative methods, we argue that those researchers requiring more sensitive methods should use a consensus approach based on multiple differential abundance methods to help ensure robust biological interpretations.


Despite its development several decades ago and several very beneficial properties asynchronous logic design, which is data driven and runs as fast as possible in all situations, is rarely used nowadays. Reasons are of course its disadvantageous properties such as bad testability but also required sophisticated knowledge for designers and missing tools. In this paper we draw a path to tackle the latter points by suggesting a tool/way to generate multiple circuit implementations from a single description. We are aiming to convert specifications written in various input languages, e.g. C or VHDL, to an unified Internal Representation (IR). This IR is composed of building blocks (semantic vocabulary) specified through the Abstract State Machine (ASM) based formal method. The ASM artifact is then used to generate the circuit in the desired (a)synchronous design style. As short term goal we aim to train developers by reading synchronous descriptions and converting them to asynchronous designs however in the long run we hope to establish a unified path for circuit development, which only requires an abstract behavioral description.


Pasteurella multocida is known to cause duck cholera leading to high morbidities and mortalities resulting in huge economic losses. Acute duck cholera is characterized by sever watery diarrhea, anorexia, respiratory manifestations and septicemia, while chronic one leads to localization of the organism in certain organs. This study was undertaken to investigate the prevalence of Pasteurella multocida in ducks in Egypt. Expression of some virulent-genes in the isolated Pasteurella multocida serotypes were examined using the polymerase chain reaction. Finally, antibiotic sensitivity testing of the identified Pasteurella multocida serotypes was also done. Pasteurella multocida could be isolated from 60% of the ducks showing respiratory manifestations and watery diarrhea. 69.8% of the isolated Pasteurella multocida strains followed capsular type A serotype, 20.9% of capsular type D and 9.3% as untypable. Lungs and air sacs had the highest incidence of Pasteurella multocida followed by liver, heart and spleen. Pasteurella multocida serogroups highly expressed virulence-attributes responsible for diarrhea. Pasteurella multocida serogroups showed marked resistance towards some used antibiotics in Egypt.


Background
Various sizes of implants need to be available during surgery. The purpose of this paper is to compare body height and shoe size with implant sizes in patients who underwent total knee replacement surgery to see which biomarker is a better predictor for preoperative planning to determine implant size.

Methods
A total of 100 knees, belonging to 50 females and 50 males, were observed. Participants' body height and shoe size were collected and correlated to implant sizes of a current, frequently used, standard total knee replacement (TKR) implant. The femoral anteroposterior and mediolateral width and the tibial anteroposterior and mediolateral width were correlated with height and shoe size.

Results
The correlation between shoe size and the four knee implant dimensions, femoral AP, ML, and tibial AP and ML were higher than the correlations between height and the same four dimensions.

Conclusion
The results indicated that shoe size is a better predictor of component dimensions than is body height.Level of evidence: III.


This article presents the results of an analysis performed in order to determine the feasibility of integrating the generation of wind power plants into the elec tric power system of the Republic of Croatia and their connection to the existing transmission network, for the purpose of providing a basis for the HEP Trans mission System Operator (HEP Operator prijenosnog sustava d.o.o.) to estab lish the upper limits for the construction of wind power plants of 360 MW, which the system is currently capable of integrating.


A diamicton exposed at Deadman Pass in the central Sierra Nevada has been previously described as glacial till and dated at about 3 Ma. If till, the deposit would document an exceptionally old and previously unrecognized glaciation in the Sierra Nevada. The age and glacial origin of the diamicton at Deadman Pass has been widely cited in the geologic literature. Recent work, however, demonstrates that the diamicton is a residual lag and colluvial deposit formed by weathering of poorly consolidated Pliocene pyroclastic rocks that are unusually rich in coarse lithic basement clasts, including granitic and metamorphic rock types.

Evidence that the diamicton at Deadman Pass is not till includes the following: (1) distribution of the diamicton is limited to areas underlain by the distinctive clast-rich lower pyroclastic member of the quartz latite of San Joaquin Ridge, (2) clasts in the diamicton and in the lower pyroclastic member are identical, (3) clast lithologies in the diamicton reflect nearby sources, (4) glacial deposits are absent in well-exposed sections of the lower pyroclastic member, and (5) formation of diamicton from present-day weathering and mass wasting of outcrops of the lower pyroclastic member can be observed locally.


The focus in the search for more reliable predictions in ungauged basins (PUB) has generally been on reducing uncertainty in watershed models (mainly their parameters). More recently, however, we seem to remember that the ultimate objective is not to define the parameters of a specific model but to understand the watershed: What behavior do we expect the ungauged watershed to exhibit? And what behavior should not occur in a particular ungauged watershed? The answers to these questions actually provide additional information that can be assimilated in watershed models for uncertainty reduction in PUB. This extension to hydrologic modeling approaches provides a quantitative link between watershed modeling and statistical hydrology as well as process hydrology that has to be explored. We witness a convergence of approaches—Bayesian, set theoretic, and optimization based—toward utilizing this link. The result is an opportunity for the (quantitative) dialog between modelers, statistical hydrologists, and experimentalists. We close our discussion of this development by presenting new and exciting research questions that we now have to address.


This paper studies the problem of disturbance attenuation with internal stability via output feedback for a family of nonlinear systems. Using a feedback domination design which substantially differs from the separation principle, we explicitly construct a dynamic output compensator attenuating the disturbance's effect on the output to an arbitrary degree of accuracy in the L2-gain sense, and achieving global asymptotic stability in the absence of disturbance.


Introduction: Increasing evidence suggests patients with coronavirus disease 2019 (COVID-19) may develop thrombosis and thrombosis-related complications. Some previous evidence has suggested COVID-19-associated strokes are more severe with worse outcomes for patients, but further studies are needed to confirm these findings. The aim of this study was to determine the association between COVID-19 and mortality for patients with ischaemic stroke in a large multicentre study. Methods: A retrospective cohort study was conducted using electronic medical records of inpatients from 50 healthcare organizations, predominately from the USA. Patients with ischaemic stroke within 30 days of COVID-19 were identified. COVID-19 was determined from diagnosis codes or a positive test result identified with COVID-19-specific laboratory codes between January 20, 2020, and October 1, 2020. Historical controls with ischaemic stroke without COVID-19 were identified in the period January 20, 2019, to October 1, 2019. 1:1 propensity score matching was used to balance the cohorts with and without COVID-19 on characteristics including age, sex, race and comorbidities. Kaplan-Meier survival curves for all-cause 60-day mortality by COVID-19 status were produced. Results: During the study period, there were 954 inpatients with ischaemic stroke and COVID-19. During the same time period in 2019, there were 48,363 inpatients with ischaemic stroke without COVID-19 (historical controls). Compared to patients with ischaemic stroke without COVID-19, patients with ischaemic stroke and COVID-19 had a lower mean age, had a lower prevalence of white patients, a higher prevalence of black or African American patients and a higher prevalence of hypertension, previous cerebrovascular disease, diabetes mellitus, ischaemic heart disease, atrial fibrillation, chronic kidney disease, chronic obstructive pulmonary disease, liver disease, neoplasms, and mental disorders due to known physiological conditions. After propensity score matching, there were 952 cases and 952 historical controls; cases and historical controls were better balanced on all included characteristics (all p > 0.05). After propensity score matching, Kaplan-Meier survival analysis showed the survival probability was significantly lower in ischaemic stroke patients with COVID-19 (78.3% vs. 91.0%, log-rank test p < 0.0001). The odds of 60-day mortality were significantly higher for patients with ischaemic stroke and COVID-19 compared to the propensity score-matched historical controls (odds ratio: 2.51 [95% confidence interval 1.88–3.34]). Discussion/Conclusions: Ischaemic stroke patients with COVID-19 had significantly higher 60-day all-cause mortality compared to propensity score-matched historical controls (ischaemic stroke patients without COVID-19).


We have investigated perforin and granzyme B expression in graft‐infiltrating lymphocytes of patients who underwent heart transplantation. Those proteins are commonly present in the cytoplasmic granules of cytotoxic T lymphocytes and are released upon effector‐target cell interaction. From 28 patients 103 endomyocardial biopsies were obtained and examined by histology and immunocytochemical analysis using relevant monoclonal antibodies. We found that "high" biopsy histological grades were associated with perforin and granzyme B expression in graft‐infiltrating lymphocytes of patients with acute severe rejection crisis. In contrast, these markers were not detected in patients without rejection or during graft stabilization. Interestingly, in patients with mild rejection and "low" histological grades, two groups could be distinguished with a differential expression of the two intracytoplasmic proteins. The presence of perforin and granzyme B‐expressing cells was found to be predictive of rapid progression to severe rejection, so that this situation required additional treatment; in contrast, their absence seemed to correlate with a good graft outcome without additional treatment. Moreover, perforin and granzyme B expression seemed to be down‐regulated by immunosuppressive drugs, which coincided with graft stabilization. In conclusion, our data suggest that detection of granzyme B and perforin in graft‐infiltrating lymphocytes might be helpful for routinely monitoring heart transplant patients.


Pentoxifylline is a methyl-xanthine derivative with many anti inflammatory effects. Pentoxifylline has been found to be effective for many dermatological as well as non-dermatological conditions. It has been used both as primary drug as well as adjuvant and is a safe and relatively cost-effective alternative drug. In this article, we review the literature and highlight various important aspects of pentoxifylline.


Purpose
The purpose of this paper is to present a language-agnostic approach to facilitate the discovery of "parallel passages" stored in historic and cultural heritage digital archives.

Design/methodology/approach
The authors explore a novel, and relatively simple approach, using a character-based statistical language model combined with a tailored version of the Basic Local Alignment Tool to extract exact and approximate string patterns shared between groups of documents.

Findings
The approach is applicable to a wide range of languages, and compensates for variability in the text of the documents as a result of differences in dialect, authorship, language change over time and errors due to inaccurate transcriptions and optical character recognition errors as a result of the digitisation process.

Research limitations/implications
A number of case studies demonstrate that the approach is practical and generalisable to a wide range of archives with documents in different languages, domains and of varying quality.

Practical implications
The approach described can be applied to any digital archive of modern and contemporary texts. This makes the approach applicable to digital archives recording historic texts, but also those composed of more recent news articles, for example.

Social implications
The analysis of "parallel passages" enables researchers to quantify the presence and extent of text-reuse in a collection of documents, which can provide useful data on author style, text genres and cultural contexts.

Originality/value
The approach is novel and addresses a need by humanities researchers for tools that can identify similar documents and local similarities represented by shared text sequences in a potentially vast large archive of documents. As far as the authors are aware, there are no tools currently exist that provide the same level of tolerance to the language of the documents.


The need for more effective interventions to combat the obesity problem has been expressed by many public health experts. While consumer support is important for intervention effectiveness, little is known about why consumers accept or do not accept food choice interventions. The present thesis therefore aims to examine the process underlying acceptance of intervention strategies for healthy food choices. Particularly the role that intervention characteristics (e.g. the source and the location of an intervention) and individual characteristics (i.e. consumers' perceived barriers for behaviour) play in this process is investigated. Three research questions are formulated: 1) What are the drivers of consumer acceptance of intervention strategies for healthy food choices?; 2) How do consumers' barriers for healthy food choices influence both food choices in real-life and acceptance of interventions?; 3) How does intervention intrusiveness influence acceptance and effectiveness of intervention strategies for healthy food choices? General beliefs about the obesity problem and intervention-specific beliefs are identified as the main drivers of intervention acceptance in the food domain ( Chapter 2 ). General beliefs comprised both people's ideas about the magnitude of the obesity problem and the responsibility for food choices that consumers make. Intervention-specific beliefs, on the other hand, concerned people's perceptions of whether an intervention will be effective, both personally and societally, in stimulating healthy food choices (perceived effectiveness) as well as whether the intervention is a fair way of stimulating healthier choices (perceived fairness). Consumers' motivation-related barriers are associated strongest with real-life food choices, with higher levels of motivation to choose healthy foods being related to higher proportions of healthy choices ( Chapter 3 ). Barriers related to the perceived opportunity and ability to choose healthy foods are associated less strongly with real-life choices, with higher levels of opportunity and ability being related to higher proportions of healthy food choices. Three distinct barrier profiles regarding choosing healthy foods are identified: the no-barrier profile (consisting of those who perceive to have no barriers), the lack-of-opportunity profile (consisting of those who perceive to lack opportunity), and the lack-of-motivation profile (consisting of those who report not being motivated). Consumers with a no-barrier profile or a lack-of-opportunity profile perceive interventions to be more effective, more fair, and more acceptable than those with a lack-of-motivation profile ( Chapter 4 and 5 ). Acceptance of less intrusive interventions, such as calorie information provision, is higher than those of more intrusive interventions, such as elimination of unhealthy choices, both in hypothetical ( Chapter 4 ) and realistic ( Chapter 5 ) settings. In the hypothetical setting, the effect of intrusiveness on acceptance is mediated by both the perceived effectiveness and the perceived fairness of interventions: the more consumers perceive an intervention to be effective and fair, the more they accept it ( Chapter 4 ). In the realistic setting, the effect of perceived intrusiveness on acceptance is mediated only by the perceived fairness of interventions ( Chapter 5 ). In a vending machine setting, the implementation of an intervention that eliminates 50% of unhealthy choices leads to higher proportions of healthy choices than the implementation of less intrusive interventions (providing calorie information through labelling and not intervening at all). Since acceptance does not differ between these interventions ( Chapter 5 ), elimination of unhealthy choices appears to be the best way to stimulate consumers to make healthy choices. Overall, this thesis show that consumers' general- and intervention-specific beliefs drive acceptance of intervention strategies for healthy food choices. Intervention intrusiveness partly influences acceptance, depending on the setting in which consumers are confronted with them (hypothetical vs. realistic). Furthermore, barriers that consumers perceive to have in relation to choosing healthy foods impact acceptance of interventions as well. These insights provide implications for policy makers, both in terms of the development and the communication of intervention strategies for healthy food choices.


This study aimed to analyze the effect of the area size and location of openings for natural ventilation on the temperature and relative humidity inside a typological facility for coffee wet processing that have been using in Colombia and some South America Countries as well, with mechanical drying inside, using modeling with computational fluid dynamics modeling, in order to find the best suitable condition for preserve the quality of the coffee parchment. A significant effect was found regarding the area and location of the openings for natural ventilation on the internal hygrothermal environment, but no significant effect was found on the temperature. It was also found that the chimney effect plays a decisive role in the mass transfer of water vapor and heat to the outside of the building, and helping to maintain a suitable internal environment for the preservation of coffee.


ABSTRACT Rhodococcus sp. strain BCP1 cometabolizes chlorinated compounds and mineralizes a broad range of alkanes, as it is highly tolerant to them. The high-quality draft genome sequence of Rhodococcus sp. strain BCP1, consisting of 6,231,823 bp, with a G+C content of 70.4%, 5,902 protein-coding genes, and 58 RNA genes, is presented here.


This work is a review of regenerative beam extraction for synchrocyclotrons and isochronous cyclotrons. The linear and nonlinear theories of the system for synchrocyclotrons are briefly reviewed. The problems for the extraction efficiency and external beam quality are discussed. A theory for isochronous cyclotrons is given. Finally, present operating features of the systems and future prospects are summarized.


Multiple double-pole bright-bright and bright-dark soliton solutions for the multicomponent nonlinear Schrödinger (MCNLS) system comprising three types of nonlinearities, namely, focusing, defocusing, and mixed (focusing-defocusing) nonlinearities, arising in different physical settings are constructed. An interesting type of energy-exchanging phenomenon during collision of these double-pole solitons is unraveled. To explore the objectives, we consider the general solutions of a set of generalized MCNLS equations and by taking the long-wavelength limit with proper parameter choices of single-pole bright-bright and bright-dark soliton pairs, the multiple double-pole bright-bright and bright-dark soliton solutions are constructed in terms of determinants. The regular double-pole bright-bright solitons exist in the focusing and focusing-defocusing MCNLS equations and undergo a particular type of energy-sharing collision for M≥2 in addition to the usual elastic collisions. A striking feature observed in the process of energy-sharing collisions is that the double-pole two-soliton possessing unequal intensities before collision indeed exactly exchange their intensities after collision. Further, the existence of double-pole bright-dark solitons in the MCNLS equations with focusing, defocusing, and mixed (focusing-defocusing) nonlinearities is analyzed by constructing explicit determinant form solutions, where the double-pole bright solitons exhibit elastic and energy-exchanging collisions while the double-pole dark solitons undergo mere elastic collision. The double-pole bright-dark solitons possess much richer localized coherent patterns than their counterpart double-pole bright-bright solitons. For particular choices of parameters, we demonstrate that the solitons would degenerate into the background, resulting in a lower number of solitons. Another important observation is the formation of doubly localized rogue waves with extreme amplitude, in the case of double-pole bright-dark four-solitons. Our results should stimulate interest in such special multipole localized structures and are expected to have ramifications in nonlinear optics.


Quantum-dot cellular automata (QCA) is potentially a very attractive alternative to CMOS for future digital designs. Circuit designs in QCA have been extensively studied. However, how to properly evaluate the QCA circuits has not been carefully considered. To date, metrics and area-delay cost functions directly mapped from CMOS technology have been used to compare QCA designs, which is inappropriate due to the differences between these two technologies. In this paper, several cost metrics specifically aimed at QCA circuits are studied. It is found that delay, the number of QCA logic gates, and the number and type of crossovers, are important metrics that should be considered when comparing QCA designs. A family of new cost functions for QCA circuits is proposed. As fundamental components in QCA computing arithmetic, QCA adders are reviewed and evaluated with the proposed cost functions. By taking the new cost metrics into account, previous best adders become unattractive and it has been shown that different optimization goals lead to different "best" adders.


In no other form of splenomegaly are the indications for splenectomy so definite as in familial hemolytic jaundice. The disease is characterized by increased fragility of the red cells in hypotonic salt solution, reticulocytosis and splenic enlargement, with the presence of jaundice and an indirect positive Van den Bergh test. The underlying defect in red cell metabolism is congenital and hereditary, being transmitted according to mendelian principles. The symptoms are characteristic, recurring in cycles and leading to so-called crises in which there are nausea, vomiting, increased jaundice and a progressive anemia. These symptoms, together with the family history and the laboratory observations, make the diagnosis almost obvious. Splenectomy in these cases is clearly indicated and yields uniformly brilliant results. This is confirmed by our knowledge of the role of the spleen in the destruction of red blood cells. This destruction of red blood cells is a function of the reticuloendothelial


The microfluidic technique has emerged as a promising tool to accelerate the clinical translation of nanoparticles, and its application affects several aspects, such as the production of nanoparticles and the in vitro characterization in the microenvironment, mimicking in vivo conditions. This review covers the general aspects of the microfluidic technique and its application in several fields, such as the synthesis, recovering, and samples analysis of nanoparticles, and in vitro characterization and their in vivo application. Among these, advantages in the production of polymeric nanoparticles in a well-controlled, reproducible, and high-throughput manner have been highlighted, and detailed descriptions of microfluidic devices broadly used for the synthesis of polysaccharide nanoparticles have been provided. These nanoparticulate systems have drawn attention as drug delivery vehicles over many years; nevertheless, their synthesis using the microfluidic technique is still largely unexplored. This review deals with the use of the microfluidic technique for the synthesis of polysaccharide nanoparticles; evaluating features of the most studied polysaccharide drug carriers, such as chitosan, hyaluronic acid, and alginate polymers. The critical assessment of the most recent research published in literature allows us to assume that microfluidics will play an important role in the discovery and clinical translation of nanoplatforms.


A quantum transformation that can diagonalize the Hamiltonian of a ring of N coupled diatomic oscillators is found. By means of the transformation, the dispersion relation of the atomic system is obtained. For large N it turns out that the dispersion relation resembles to the phonon spectrum of the lattice vibration derived by Newton's equation of motion.


This article describes the development of a classification system to measure the expertise levels of practicing paediatric rehabilitation therapists. Seventy‐five therapists from five disciplines (physical, occupational, speech‐language, behaviour, and recreational therapy) were involved, along with 170 peers, and 188 parents of children with disabilities. A cluster analysis of 10 indicators of expertise (derived from a battery of self‐completed, peer‐completed, and parent‐completed measures) indicated three levels of therapist expertise—novice, intermediate, and expert. Expertise level was related to various aspects of experience but not to therapy discipline. The classification system will be useful for the education and professional development of paediatric therapists, and for research on expertise in paediatric rehabilitation.


The sexual swellings of female primates have generated a great deal of interest in evolutionary biology. Two hypotheses recently proposed to elucidate their functional significance argue that maximal swelling size advertises either female fertility within a cycle or female quality across cycles. Published evidence favours the first hypothesis, and further indicates that larger swellings advertise higher fertility between cycles. If so, a male preference for large swellings might evolve, driving females to use swellings as quality indicators, as proposed by the second hypothesis. In this paper, we explore this possibility using a combination of empirical field data and mathematical modelling. We first test and find support for three key predictions of the female-quality hypothesis in wild chacma baboons (Papio ursinus): (i) inter-individual differences in swelling size are maintained across consecutive cycles, (ii) females in better condition have larger swellings and higher reproductive success, and (iii) males preferentially choose females with large swellings. We then develop an individual-based simulation model that indicates that females producing larger swellings can achieve higher mating success even when female–female competition is low and within-female variance in the trait is high. Taken together, our findings show that once sexual swellings have evolved as fertility signals, they might, in certain socio-sexual systems, be further selected to act as quality signals. These results, by reconciling two hypotheses, help to clarify the processes underlying sexual swelling evolution. More generally, our findings suggest that mate choice for direct benefits (fertility) can lead to indirect benefits (good genes).


Since the year 2000, several studies on bounding end-to-end delays in switched Ethernet topologies required in the design of distributed processing systems on board of aerospace vehicles were made public. These studies presented various approaches for dealing with the non-deterministic behavior of non-synchronized network traffic while striving to avoid overestimation. One of them described an effect observed in frame-based network transmissions and named it "serialization". This effect is used in this paper with the objective of constructing a new low-complexity method for estimating the worst case delay experienced by a frame crossing a switched Ethernet. This method results from the combination of two new propositions which inherit concepts originally formulated by schedulability analysis methods for multitask processing systems. Its implementation is shown on a case study using a step-by-step procedure and the results obtained are favorably compared with one previously published work.


BACKGROUND/PURPOSE
The main objectives of this study were to define the clinical patterns and characteristics of congenital muscular torticollis (CMT) presented in the first year of life and to study the outcome of different treatment methods.

METHODS
This is a prospective study of all CMT patients seen in 1 center over a 12-year period with uniform recording system, assessment methods, and treatment protocol.

RESULTS
From a total of 1,086 CMT infants, 3 clinical subgroups of sternomastoid tumor (SMT; 42.7%), muscular torticollis (MT; 30.6%), and postural torticollis (POST; 22.1%) were identified. The SMT group was found to present earlier within the first 3 months and was associated with higher incidence of breech presentation (19.5%), difficult labor (56%), and hip dysplasia (6.81%). Severity of limitation of passive neck rotation range (ROTGp) was found to correlate significantly with the presence of SMT, bigger tumor size, hip dysplasia, degree of head tilt, and craniofacial asymmetry.

CONCLUSIONS
A total of 24.5% of the patients with initial deficits of passive rotation of less than 10 degrees showed excellent and good outcome with active home positioning and stimulation program. The remaining cases with rotation deficits of over 10 degrees and treated with manual stretching program showed an overall excellent to good results in 91.1% with 5.1% requiring subsequent surgical treatment. The most important prognostic factors for the necessity of surgical treatment were the clinical subgroup, the ROTGp, and the age at presentation (P < .001).


Acne has a complex multifactorial etiology. Inflammatory acne lesions often heal with sequelae. In skin of color the post acne healing phase often reflects post inflammatory hyperpigmentation which is very commonly seen. Though this hyperpigmentation is often transient and fades with time, in certain cases the life of pigmentary marks post acne is prolonged and is not conducive to therapy with topical agents and sunscreens alone. Chemical peels are often used an interventional therapy in dark- skinned individuals for treatment of post acne hyperpigmented marks. This article reviews efficacy, and complications of chemical peels on post acne hyperpigmented marks.


Physicochcmical properties of the Lotus root starch wert investigated. The shape of starch granules was elliptical with the average size of . Starch showed B-type X-ray pattern. The content of amylose was 22.1%. The blue value for starch and amylose were 0.280 and 0.692, respectively. The alkali number was 4.74. By X-ray diffraction examination, gelatinization began at and almost completed at .


For quantificative determination of ERBB2 gene amplification in archival human carcinoma specimens we have developed a rapid, non‐radioactive approach, which is based on the differential polymerase chain reaction (PCR) and fluorescent DNA technique. Sequences from the ERBB2 gene and from a singlecopy reference gene were amplified simultaneously by PCR, in which one of each primer pair was fluorescently labelled. PCR products were separated by polyacrylamide gel electrophoresis in an automated DNA sequencer and directly quantified after laser activation and emission scanning using appropriate software. This fluorescent differential polymerase chain reaction (fd‐PCR) method was used for quantificative determination of ERBB2 gene amplification in 195 formalin‐fixed, paraffin‐embedded breast carcinoma tissues. ERBB2 gene amplification was found in 52 (26%) of these tumors and correlated significantly with tumor size, absence of estrogen receptor (ER) and pS2 expression, but not with absence of progesterone receptor (PR) or presence of epidermal growth factor receptor (EGF‐R) expression, lymph‐node metastases or grading. In univariate analysis, ERBB2 gene amplification showed no significant correlation with clinical outcome, either in the whole population or in the subgroup defined by positive axillary lymph‐node metastases. However, within the node‐negative subgroup, patients with ERBB2 gene amplification had significantly decreased relapse‐free survival and overall survival (p < 0.05). The fd‐PCR assay is a valuable tool for determination of amplification of ERBB2 gene as well as further oncogenes. In this way, more detailed information about individual tumor biology may be acquired by a routine assay. © 1995 Wiley‐Liss, Inc.


N-Acetylcysteine is a natural thiol-containing antioxidant, a precursor for cysteine and glutathione, and a potential detoxifying agent for heavy metal ions. However, previous accounts of the efficiency of N-acetylcysteine (H2NAC) in excretion of lead are few and contradicting. Here, we report results on the nature of lead(II) complexes formed with N-acetylcysteine in aqueous solution, which were obtained by combining information from several spectroscopic methods, including (207)Pb, (13)C, and (1)H NMR, Pb LIII-edge X-ray absorption, ultraviolet-visible (UV-vis) spectroscopy, and electro-spray ionization mass spectrometry (ESI-MS). Two series of solutions were used containing CPb(II) = 10 and 100 mM, respectively, varying the H2NAC/Pb(II) mole ratios from 2.1 to 10.0 at pH 9.1-9.4. The coordination environments obtained resemble those previously found for the Pb(II) glutathione system: at a ligand-to-lead mole ratio of 2.1, dimeric or oligomeric Pb(II) N-acetylcysteine complexes are formed, while a trithiolate [Pb(NAC)3](4-) complex dominates in solutions with H2NAC/Pb(II) mole ratios >3.0.


Extensive possibilities of applications have rendered emotion recognition ineluctable and challenging in the fields of computer science as well as in human-machine interaction and affective computing. Fields that, in turn, are increasingly requiring real-time applications or interactions in everyday life scenarios. However, while extremely desirable, an accurate and automated emotion classification approach remains a challenging issue. To this end, this study presents an automated emotion recognition model based on easily accessible physiological signals and deep learning (DL) approaches. As a DL algorithm, a Feedforward Neural Network was employed in this study. The network outcome was further compared with canonical machine learning algorithms such as random forest (RF). The developed DL model relied on the combined use of wearables and contactless technologies, such as thermal infrared imaging. Such a model is able to classify the emotional state into four classes, derived from the linear combination of valence and arousal (referring to the circumplex model of affect's four-quadrant structure) with an overall accuracy of 70% outperforming the 66% accuracy reached by the RF model. Considering the ecological and agile nature of the technique used the proposed model could lead to innovative applications in the affective computing field.


See related article, Dahlhoff M et al, on page 1585 in Gastroenterology. BACKGROUND & AIMS: We investigated mortality of patients with chronic pancreatitis (CP), compared with the Danish population and sought to determine whether clinical presentations of CP can be used in prognosis. We also investigated clinical factors associated with mortality and causes of death among these patients. METHODS: The Copenhagen Pancreatitis Study is a prospective study of patients admitted from 1977 to 1982 to the 5 main hospitals in Copenhagen with a diagnosis of acute pancreatitis or CP. In 2008, follow-up data were collected from these patients from the Danish Registries; this subcohort comprised 290 patients with probable (n 41) or definite CP (n 249). RESULTS: The mortality of patients with definite CP was 4-fold that of the Danish population and significantly higher than that of patients with probable CP (P .003; 95% confidence interval [CI], 1.21‐2.57); patients with probable CP had a 2- to 3-fold higher mortality rate than the population. In patients with definite CP, factors significantly associated with mortality included non-employment (P .015; 95% CI, 0.53‐0.93), and being underweight (P .020; 95% CI, 0.52‐0.95). Sex, alcohol use, smoking, single versus co-living, exocrine insufficiency, diabetes, pancreatic calcification, CP inheritance, painless CP, acute exacerbation of CP, or surgery for CP had no impact on survival. The most frequent causes of death were digestive diseases (19.5%), malignancies (19.5%), and cardiovascular diseases (11.3%). CONCLUSIONS: Danish patients with definite CP had a 4-fold higher mortality rate compared with the background population and a higher mortality rate than patients with probable CP. Being nonemployed or underweight had significant impact on survival.


The geometry of the pulmonary arterial tree of six adult dogs was measured by a high-speed, volume-scanning, X-ray tomographic technique. After the dogs were anesthetized a catheter was advanced to the right ventricular outflow tract and 2 mL/kg Renovist contrast agent injected rapidly. During the subsequent pulmonary arterial phase of the angiogram the dogs were scanned. Three-dimensional geometry of the pulmonary arterial tree was measured in terms of vessel segment cross-sectional area, branching angles and interbranch segment lengths along axial pathways. The effect of lung inflation and phase of the cardiac cycle on geometry was shown to be most marked on vessel cross-sectional area. The geometric branching patterns in all dogs were similar. The observed, in-vivo branching pattern behaved somewhat like the branching pattern predicted from optimized models proposed by Murray, Zamir, and Uylings.


This paper considers the problem of scaling ad hoc wireless networks now being applied to urban mesh and sensor network scenarios. Previous results have shown that the inherent scaling problems of a multihop ldquoflatrdquo ad hoc wireless network can be improved by a ldquohybrid networkrdquo with an appropriate proportion of radio nodes with wired network connections. In this work, we generalize the system model to a hierarchical hybrid wireless network with three tiers of radio nodes: low-power end-user mobile nodes (MNs) at the lowest tier, higher power radio forwarding nodes (FNs) that support multihop routing at intermediate level, and wired access points (APs) at the highest level. Scalability properties of the proposed three-tier hierarchical hybrid wireless network are analyzed, leading to an identification of the proportion of FNs and APs as well as transmission range required for linear increase in end-user throughput. In particular, it is shown analytically that in a three-tier hierarchical network with nA APs, nF FNs, and nM MNs, the low-tier capacity increases linearly with nF, and the high-tier capacity increases linearly with nA when nA = Omega(radic{nF}) and n A = O(nF). This analytical result is validated via ns-2 simulations for an example dense network scenario, and the model is used to study scaling behavior and performance as a function of key parameters such as AP and FN node densities for different traffic patterns and bandwidth allocation at each tier of the network.


Relevance. For the development of the main branch of agriculture in Yakutia — animal husbandry, one of the most pressing problems is the availability of feed. The article presents the results of research conducted at the Yakut Research Institute of Agriculture.Methods. Scientific research on the selection of sunflower mixtures with promising forage crops was carried out at site 30 "A"(on the basis of the laboratory of feed production of the YANIISKH) on the second over-floodplain terrace of the Lena River in 2018-2019.Results. The results of research on the growth and development of forage crops, the formation of yield, chemical composition and nutritional value of sunflower and its mixtures with promising annual crops are presented. High indicators for the development and yield of the tested crops were provided by sunflower mixed with corn 42.7 t/ha of green mass and sunflower mixed with Sudan grass 40.2 t/ha of green mass. The terms of sowing and harvesting of sunflower and its mixtures on permafrost soils are determined — sowing — the first decade of June, harvesting-the second decade of August before early-autumn frosts in the phase of mass flowering and throwing out panicles of the tested forage crops.


Abstract Purpose: To identify the factors associated with disability across many domains using a large powered sample in the activities of daily living (ADL) and instrumental activities of daily living (IADL). Methods: Those aged ≥65 years from the Irish longitudinal study on ageing (TILDA) were included in this cross sectional analysis. Three logistic regression models were used to examine the relationships between 25 health, psychological and sociodemographic variables and difficulties in ADL, IADL and ADL/IADL combined. Results: The proportion of those reporting combined ADL/IADL difficulties was 18%. More individuals reported difficulty with ADLs (13%) than IADLS (11%). The main model showed that after age, the top three factors associated with difficulty in ADL/IADL combined were pain, taking five or more medications and depression. After age, the factors with the highest impact on ADL disability were pain, taking five or more medications and body mass index (BMI); the factors with the highest impact on IADL were being separated or divorced, living with others (non-spouse) and self-rated memory. Conclusions: Awareness of sociodemographics and early interventions for pain and cognitive deficits could reduce ADL/IADL disability and promote successful ageing. Identification of variables that influence ADL/IADLs can be used to inform policy and practice. Implications for rehabilitation After age, pain and taking five or more medications were the strongest factors associated with difficulty in ADL/IADL combined and ADL alone. Practice therefore needs to be cognizant that it is not the disease label but the symptoms of a disease that affect ADL and IADL activities. Given the strong influence of pain on difficulties with ADL and IADL, there is a need for early interventions from a multidisciplinary perspective for pain reduction, control, and self-management. These interventions should include development of pain-coping strategies and exercises to maintain mobility. After age, being separated/divorced or living with non-spouse others are the strongest factors associated with IADL difficulties. Awareness of these social factors can be used to inform support mechanisms, such as development of community services and suitable housing for those with these changing sociodemographics. Unsurprisingly, cognitive impairments were strongly associated with IADL difficulties. Simple cognitive screening assessments could be used for early detection of cognitive changes. In order to maintain optimal cognitive functioning, rehabilitation professionals should facilitate older adults' engagement in activities that are cognitively demanding and socially interactive.


A wind turbine is subjected to a regime of varying loads. For example, each rotor revolution causes a complete gravity stress reversal in the low-speed shaft, and there are varying stresses from the out-of-plane loading cycle due to fluctuating wind load. Consequently, wind turbine blade design is governed by fatigue rather than ultimate load considerations.
Previous studies have adopted many different beam theories, using different techniques and codes, to model the National Renewable Energy Laboratory (NREL) 5 MW offshore wind turbine blade. There are differences, from study to study, in the free vibration results and the dynamic response. The contribution of this study is to apply the code written by the authors to the different beam theories used with the aim of comparing the different beam theories presented in the literature and that developed by the authors. This paper reports the investigation of the effects of deformation parameters on the dynamic characteristics of the NREL 5 MW offshore wind turbine blades predicted by the different beam theories.
The investigation of free vibrations is a fundamental step in the analysis of structural dynamics, and this study cmpares different computational structural methods and investigates their effect on the predicted dynamic response. The modal characteristics of every model examined have been combined with strip theory to determine the dynamic response of the blade.


Malnutrition among children reduces the physical growth, school achievements and future employment opportunities. Present study finds that the incidence of malnutrition among below five age group children in Kutcha slums of Mumbai city is increasing. The incidence of stunting is rising faster whereas the incidence of underweight remains stagnant. The incidence of severe malnutrition is also increasing among children in slums. The deaths related to severe malnutrition are also rising in city. The logit model shows that the incidence of child malnutrition is negatively correlated with per capita income, breastfeeding among children and health care facilities. The policies of recruiting more nurses and doctors in health care facilities, supplementary food coverage by anganwadi workers will work to improve child health. Government must invest more in terms of water supply, sanitation and housing for slum dwellers. Women must be given educational and technical training for self employment.


We present spectral domain polarization-sensitive optical coherence tomography (SD PS-OCT) imaging of peripheral nerves. Structural and polarization-sensitive OCT imaging of uninjured rat sciatic nerves was evaluated both qualitatively and quantitatively. OCT and its functional extension, PS-OCT, were used to image sciatic nerve structure with clear delineation of the nerve boundaries to muscle and adipose tissues. A long-known optical effect, bands of Fontana, was also observed. Postprocessing analysis of these images provided significant quantitative information, such as epineurium thickness, estimates of extinction coefficient and birefringence of nerve and muscle tissue, frequency of bands of Fontana at different stretch levels of nerve, and change in average birefringence of nerve under stretched condition. We demonstrate that PS-OCT combined with regular-intensity OCT (compared with OCT alone) allows for a clearer determination of the inner and outer boundaries of the epineurium and distinction of nerve and muscle based on their birefringence pattern. PS-OCT measurements on normal nerves show that the technique is promising for studies on peripheral nerve injury.


We have previously demonstrated that IgG antibody binding to microfilariae of Dirofilaria immitis increased in the presence of purified C1q. The present study was designed to examine the mechanism of the C1q effect using a system with an antihapten monoclonal antibody (MoAb) and a hapten as an antigen. Microtiter plates were coated with 4-hydroxy-3-nitrophenyl-acetyl (NP)-bovine serum albumin (BSA), and mouse anti-NP MoAb (IgG) was added in the presence of C1q. The amount of IgG which bound to NP-BSA increased with the addition of C1q (p less than 0.01) when the antibody had both specificity to the antigen and ability to fix C1q. The C1q effect, examined using two anti-NP MoAbs with different affinities, was more apparent with the low-affinity antibody (LAMoAb) than with the high-affinity (HAMoAb; percent enhancement of IgG binding was 19 vs. 12%). The C1q effect on LAMoAb binding was doubled when a small amount of HAMoAb was incubated with LAMoAb. The C1q effect on IgG binding might be operative in the early phase of infection, where a small amount of high-affinity antibody and a relatively large amount of low-affinity antibody are produced in the host.


X-rays have been detected from highly ionized swift projectiles of 75As and 80Se passing through thin carbon foils. The investigations have been made at two projectile energies of 55 and 80 MeV for 75As ions and 66 and 90 MeV for 80Se ions. The Kβ/Kα ratios of the ions have been found to be almost half of the free atom values which can be attributed to the sum of the effects caused by vacancies in L and M Shells. In addition to two normal L x-ray peaks a third peak corresponding to LREC (L-shell radiative electron capture) has been observed. All the x-ray lines show a shift towards higher energy due to perturbation of the energy levels. The relative REC cross-section between lower and higher projectile energies shows excellent agreement with the theoretical results obtained under the dipole approximation.


Ocean sunfishes, with their peculiar morphology, large size, and surface habits, are valuable assets in ecotourism destinations worldwide. This study investigates site fidelity and long-range movements of short ocean sunfish, Mola ramsayi (Giglioli 1883), at Punta Vicente Roca (PVR) off Isabela Island in the Galapagos Islands. Five individuals were tracked between 32 and 733 days using ultrasonic receivers and transmitters. Two of the 5 were also tracked with towed pop-off satellite tags. One travelled to the equatorial front covering 2700 km in 53 days, with dive depths in the upper 360 m at temperatures between 9.2°C and 22°C. During its westward travel, dives extended to 1112 m (the deepest depth yet recorded for Molidae) into temperatures ranging between 4.5°C and 23.2°C. The remaining four individuals demonstrated site fidelity to PVR and were detected at the site between 128–1361 times for a total of 3557 reports. Forty-eight percent of the reports occurred during daytime hours and 52% after dark. Presumed cleaning session durations had a median of 15 minutes and a maximum of nearly 100 minutes. No other ultrasonic arrays around Galapagos or in the Eastern Pacific regional network recorded the presence of tagged individuals. These data are combined with tourist vessel sightings and submersible observations to confirm Punta Vicente Roca as an important sunfish hotspot.


Motivation: Human immunodeficiency virus (HIV) and cancer require personalized therapies owing to their inherent heterogeneous nature. For both diseases, large-scale pharmacogenomic screens of molecularly characterized samples have been generated with the hope of identifying genetic predictors of drug susceptibility. Thus, computational algorithms capable of inferring robust predictors of drug responses from genomic information are of great practical importance. Most of the existing computational studies that consider drug susceptibility prediction against a panel of drugs formulate a separate learning problem for each drug, which cannot make use of commonalities between subsets of drugs. Results: In this study, we propose to solve the problem of drug susceptibility prediction against a panel of drugs in a multitask learning framework by formulating a novel Bayesian algorithm that combines kernel-based non-linear dimensionality reduction and binary classification (or regression). The main novelty of our method is the joint Bayesian formulation of projecting data points into a shared subspace and learning predictive models for all drugs in this subspace, which helps us to eliminate off-target effects and drug-specific experimental noise. Another novelty of our method is the ability of handling missing phenotype values owing to experimental conditions and quality control reasons. We demonstrate the performance of our algorithm via cross-validation experiments on two benchmark drug susceptibility datasets of HIV and cancer. Our method obtains statistically significantly better predictive performance on most of the drugs compared with baseline single-task algorithms that learn drug-specific models. These results show that predicting drug susceptibility against a panel of drugs simultaneously within a multitask learning framework improves overall predictive performance over single-task learning approaches. Availability and implementation: Our Matlab implementations for binary classification and regression are available at https://github.com/mehmetgonen/kbmtl. Contact: firstname.lastname@example.com Supplementary Information: Supplementary data are available at Bioinformatics online.


The goal of improving adjuvant treatment can be reached in two ways: firstly, by developing more effective drugs and protocols and, secondly, by selecting suitable patients on the basis of clinical and molecular factors. In UICC (Union internationale contre le cancer) stage II, microsatellite instability (MSI) is a strong prognostic factor. Whether it can also be used as a predictive marker is currently a matter of controversy because the available data are contradictory. The question whether or not the MSI status should be checked before treatment decisions are made in stage II patients can therefore not be clearly answered at present. For adjuvant treatment in stage III, with capecitabine/oxaliplatin (XELOX) there is now a new protocol available that is based on the orally administered prodrug capecitabine. With regard to the question of how much older patients in this stage may also benefit from a combination chemotherapy, new--and contradictory--data have emerged recently: firstly, preliminary results of two new studies have given rise to safety concerns and, secondly, an analysis by the 'ACCENT Collaborative Group' indicated lower efficacy of the 'newer' adjuvant protocols in older people. These findings, however, have now been called into question as a result of a new subgroup analysis from the XELOXA study. The expert group therefore recommended that the decision whether to treat patients older than 70 years with an (oral) fluoropyrimidine alone or in combination with oxaliplatin should be based on clinical parameters such as biological age and comorbidities.


What is the issue?

Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by low platelets and an increase in bleeding risk. It has an incidence rate of 3.3 per 100,000 adults per year.
After first-line corticosteroid treatment, there is limited evidence on the best subsequent-line therapies based on evidence of low certainty. Subsequent therapies after failure of corticosteroid use include several treatments, such as rituximab, eltrombopag, romiplostim, fostamatinib, avatrombopag, and splenectomy.
The goal of treatment is to reduce bleeding and prolong life. Increases in platelet count are considered a surrogate to these treatment goals.

What did we do?

We conducted a narrative review of 15 publications (10 randomized controlled trials) found through a systematic literature search.
The review addressed the following policy questions:

What treatment(s) should be used in adult patients with ITP who have failed first-line treatments?
What is the place in therapy of splenectomy in adult patients with ITP?

What did we find?

We found that eltrombopag and romiplostim increased platelet count response and improved ITP symptoms and health-related quality of life compared to placebo.
Interpretation of the effectiveness of avatrombopag, rituximab, and fostamatinib was inconclusive due to the limited availability of evidence and varying risks of bias in the trials.
There was a lack of evidence in specific subgroups of patients and on the role of splenectomy in the sequency of subsequent-line therapies.
Further research is needed to compensate for clinical data gaps to inform an appropriate and relevant economic evaluation.

What does this mean?

CADTH suggests that jurisdictions may consider requesting that an implementation advice panel be conducted to bring together clinical experts to suggest measures (e.g., discontinuation criteria) to manage the clinical and economic uncertainty identified in this report.


A recent published newspaper article commented on the (lack of) quality of Brazilian science and its (in) efficiency. The newspaper article was based on a special issue of Nature and on a new resource for scientometrics called Nature Index. I show here arguments and sources of bias that, under the light of the principle in dubio pro reo, it is questionable to dispute the quality and efficiency of the Brazilian science on these grounds, as it was commented on the referred article. A brief overview of Brazilian science is provided for readers to make their own judgment.


Last year is the year of telomere. The Nobel Prize in physiology or medicine 2009 was awarded to Elizabeth Blackburn, Carol Greider, and Jack Szostak for their seminal discovery of telomere and telomerase. Telomere is a compact DNA-protein structure at the end of chromosome, comprised of TTAGGG repeats in humans and proteins associated with the telomeric sequence. When DNA replication starts, both strands of DNA are synthesized in opposite directions. The leading strand moves continuously, while the lagging strand is generated discontinuously. There is a need of a RNA primer, known as Okazaki fragment, to initiate telomere synthesis on lagging strand. The primer has an intrinsic nature of being degraded, resulting in a loss of some repetitive telomere sequence after the completion of each round of DNA replication. Telomere is one of the key determinants of lifespan, and telomere erosion to a critically short stage limits replicative lifespan of cultured cells, a phenomenon known as Hayflick limit or replicative senescence [1].

Nonetheless, telomere length is not the only contributor to replicative senescence. The length and structure of telomere are tightly controlled by many telomere-associated proteins, mutations in some of which result in premature aging syndromes. In particular, the WRN gene is mutated in Werner syndrome, characterized by accelerated aging phenotypes after puberty. The WRN protein exhibits helicase and exonuclease activities that are critical for DNA metabolism by unwinding or processing DNA substrates. WRN preferentially binds DNA structures reminiscent of intermediates during DNA replication [2], and the WRN helicase activity maintains telomere homeostasis only during DNA replication [3]. A previous study showed that WRN can form a complex with DNA-PK, the key enzyme in the non-homologous end-joining pathway of DNA double strand break repair [4]. Loss-of-function in the catalytic activity of DNA-PK (DNA-PKcs) results in chromosome end-to-end fusion [5]. Strikingly, mice deficient in either DNA-PKcs or WRN alone do not show aging phenotypes unless they are under a short telomere background. Consistent with this notion, Kusumoto-Matsuo et al. have now identified a key link between the WRN helicase and DNA-PKcs at telomeres for the maintenance of telomeric D-loop structure [6]. They provided evidence that DNA-PKcs can specifically stimulate WRN helicase and prevent telomeric D-loop from exonuclease digestion in vitro and in vivo. Moreover, they showed that the telomere repetitive sequence, known as G-tail, is shorter in DNA-PKcs or WRN deficient cells than in normal cells, and these defects can be reversed by overexpressing WRN in DNA-PKcs deficient cells. Altogether, DNA-PKcs can help WRN to unwind telomere D-loop and protect the DNA from exonuclease actions.

The desire of deciphering longevity is likely to drive scientists to continuously explore telomere maintenance. Understanding the cross-talks between the proteins associated with telomere will one day provide the mechanistic basis for telomere-associated aging phenotypes. Of note, Mre11 was found to exhibit a protective role in generating 3' overhang at telomeres to avoid triggering DNA repair mechanisms [7]. The interaction between DNA-PKcs and WRN might act as an upstream event of telomeric D-loop processing and the front line of telomere protection.


To investigate the awareness and improvement requirements of this study was conducted on college students who were the beginnings of adulthood and who were subject to scaling health insurance. Subjects were divided into health and non-health college students to investigate the perception of whether or not to apply scaling health insurance, payroll costs, and the number of benefits. In addition, this study was conducted to provide basic data for the long-term scaling health insurance business to become a social system for improving the quality of life of the people The subjects of this study were to have health and non-health college students respond to the questionnaire from October 10th to October 23rd, 2019 by using the self-assessment writing method and the total of 341 questionnaire was analyzed as the final subject. Cross-analysis was used to verify the difference in perception of the presence or absence of scaling to the general characteristics of the study subjects, and t-test was used to verify the difference in the recognition score for the detailed criteria of scaling insurance. The significance level of the collected data was verified at p<0.05. Recognition of scaling benefits was high in 32.5% of health and 25.7% of non-health college students and the awareness of detail was low in all items. In the improvement requirements, the highest response from both health and non-health sectors were that to increase the number of scaling which is covered in dental insurance in south Korea more than once per year. Looking at the needs of health-related and non-health related college students for the scaling health insurance benefit project, 16.2% of respondents wished to increase the number of times applied per year, 11.7% needed business promotion, 11.2% answered it should included the stain removal (colorants), 9.2% wished age-reduced relief for the business, 6.6% for the cost adjustment in the health-related college student. the importance of oral health through education and promotion on scaling. In order to raise awareness about scaling insurance among college students, it is necessary to recognize the importance of oral health through education and promotion of scaling. Through this study, it is thought that the scaling health insurance reimbursement project will contribute to the improvement of oral health of the people and furthermore to a healthy life. In the future, the government should continue to develop policies to promote oral health by collecting thoughts and opinions of college students and others as well.


Loneliness, sometimes referred to as "perceived social isolation," is defined as a subjective experience of social isolation. Loneliness has been shown to be related more to the quality of social relationships than to the quantity, and is typically characterized by feelings of social disconnection (e.g., being misunderstood by others). It occurs when there is a discrepancy between desired and actual amounts of social interaction. Humans are a social species and have a fundamental need to belong. Feelings of loneliness have been perceived to be early warning signals of potential threats to psychological health (akin to physical pain in physical health problems). Loneliness is associated with an increased risk of various health conditions (e.g., increased inflammation, decreased immunity) and can occur in transient and chronic forms across the lifespan.

In the last few decades, there has been an increase in scientific studies in loneliness and much of this research stemmed from a social neuroscience approach (see work by Cacioppo). The onset of loneliness is thought to motivate an individual to seek connectedness with others; however, symptoms of mental illness often involve withdrawal from the social world. A growing interest in the relationship between loneliness and mental health disorders is therefore not surprising and was first identified as an important relationship in the late 1950s. Psychoanalyst Frieda Fromm-Reichmann highlighted the devastating impact of loneliness on patients with schizophrenia. In more recent times, researchers have used a neuroscience approach to further clarify the relationship between social withdrawal/isolation and positive symptoms of psychosis (see Hoffman's social deafferentation hypothesis).

The psychological consequences of loneliness, however, remain under examined by researchers. It is plausible, but remains unclear, that loneliness is a transdiagnostic factor across different mental disorders that raises the risk of mental health problems, increases the severity of symptoms, maintains diagnostic status, or all of the above. Loneliness is associated with various mental disorders, including depression, social anxiety disorder, and obsessive–compulsive disorder (1), and most of the research on loneliness and mental health has focused on its relationship with depression (2).

To date, there has been no published study that has developed an evidence-based loneliness intervention in individuals with psychosis. A meta-analytic review of interventions aimed at reducing loneliness in a range of different populations surprisingly included only five studies with individuals with mental health symptoms, and none of the studies were specific to psychosis (3). There is, however, emerging research that highlights the deleterious effects of loneliness in individuals with psychotic disorders. In the second Australian national survey of psychosis (N = 1825), 80.1% of adults aged between 18 and 34 years, diagnosed with a psychotic disorder endorsed perceived loneliness; 37.2% of these adults identified loneliness as a barrier to recovery (4). While many psychosocial interventions are aimed at introducing new social supports (e.g., befriending) or providing social skills training (SST) for people with psychotic disorders, there has been no known study that specifically targets loneliness.


Innovation is necessary to ride the inevitable tide of change. The buzzword of 2009 seems to be "cloud computing" which is a futuristic platform to provides dynamic resource pools, virtualization, and high availability and enables the sharing, selection and aggregation of geographically distributed heterogeneous resources for solving large-scale problems in science and engineering. But with this ever developing cloud concept, problems are arising from this "golden solution" in the enterprise arena. Preventing intruders from attacking the cloud infrastructure is the only realistic thing the staff, management and planners can foresee. Regardless of company size or volume and magnitude of the cloud, this paper explains how maneuver IT virtualization strategy could be used in responding to a denial of service attack. After picking up a grossly abnormal spike in inbound traffic, targeted applications could be immediately transferred to virtual machines hosted in another data center. We're not reinventing the wheel. We have lots of technology and standardized solutions we can already use to engineer into the stack. We are just introducing them in the way least expected.


Background: Tissue factor pathway inhibitor (TFPI) polymorphisms are known to be involved in venous thrombosis; however, any correlation between the TFPI polymorphisms rs8176592, rs10931292, and rs10153820 and venous thrombosis remains controversial. This meta-analysis aimed to elucidate the relationship between these TFPI polymorphisms and the susceptibility to venous thrombosis. Methods: A literature search for relevant studies was conducted in PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Med Online databases. Odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs) were calculated using fixed-effect/random-effect models by the STATA 12.0 software. Sources of heterogeneity were analyzed by subgroup analysis. Results: Eleven case-control studies involving 3740 subjects (1362 venous thrombosis patients and 2378 healthy controls) were included. The TFPI rs8176592 polymorphism was associated with increased risk of venous thrombosis in the whole population, while no significant association was found between rs10931292/rs10153820 and venous thrombosis. In subgroup analysis based on ethnicity, an increased risk was observed with rs8176592 polymorphism in Asians (Recessive model, OR = 1.48, 95% CI = 1.06–2.07, P = .023). An increased risk associated with rs10931292 was identified in non-Asians (Recessive model, OR = 1.42, 95% CI = 1.03–1.97, P = .033). No significant association was found in either Asians or non-Asians with the rs10153820 polymorphism. In subgroup analysis based on source of controls, increased risks were identified in the hospital-based group with rs8176592 polymorphism and in the population-based group with rs10931292 polymorphism, whereas decreased risk was identified in the hospital-based group with the rs10931292 and rs10153820 polymorphisms. Conclusion: Meta-analysis suggested that different TFPI polymorphisms may have different associations with venous thrombosis. TFPI rs8176592 polymorphism may increase the risk of venous thrombosis, especially in Asians and hospital-based patients. The TFPI rs10931292 polymorphism may increase the venous thrombosis risk for both non-Asians and population-based patients. Moreover, rs10931292 and rs10153820 polymorphisms of TFPI may decrease the risk of venous thrombosis for hospital-based patients.


In casting industries with the development of technology there is need to cast complex and intricate parts very accurately in dimension and geometry with the good surface finish. after the development of additive manufacturing technologies the casting industries are able to improve casting by improving pattern making up to certain limit and also some special casting processes like investment casting becomes more easier because of direct manufacturing of wax pattern using 3D printers but due to different joints in complex component manufacturing industries and also automobile industries require Mechanical joint less casting. So, now it becomes necessary for casting industries to make direct mold without the use of pattern. Also, there is development in additive manufacturing technology in material compatibility. This paper reviews the Additive manufacturing technologies for growing patternless casting manufacturing.


The effect of mibefradil, a new nondihydropyridine Ca2+ channel antagonist, was investigated on Y1 cells which exhibited T-and L-type Ca2+ currents. In the great majority of these cells, mibefradil rapidly and selectively blocked T-type Ca2+ current in a dose-dependent manner with a half maximum action at 10-7 M. Furthermore, the specific L-type Ca2+ channel inhibitor, nifedipine, blocked the Ca2+ inward current remaining after the action of mibefradil. Mibefradil does not modify the voltage-dependent characteristics of the current/voltage relationship. However, mibefradil is more effective at depolarized membrane potential.


Background
Inhaled budesonide is a widely used inhaled corticosteroid for asthma.

Objectives
The objectives of this review was to compare the efficacy of budesonide with placebo in the treatment of chronic asthma.

Search methods
The Cochrane Airways Group Trial Register and reference lists of articles was searched. We contacted trialists for additional studies and searched abstracts of major respiratory society meetings (1997-1999).

Selection criteria
Randomised trials in children and adults comparing budesonide to placebo in the treatment of chronic asthma.

Data collection and analysis
Two reviewers independently assessed articles for inclusion and methodological quality. One reviewer extracted data.

Main results
43 studies met the inclusion criteria (2801 paticipants). In non-oral steroid treated asthmatics, budesonide led to significant improvements in a number of measures of airway function. These included FEV1, Weighted Mean Difference (WMD) 3.7% predicted (95% CI 0.1, 7.2%); improvement in morning peak flow (PEF) from baseline WMD 29 L/min (95% CI 22, 36 L/min); improvement in evening PEF from baseline WMD 21 L/min (95% CI 13, 29 L/min). Varying methods of reporting symptoms limited the pooling of studies but all high methodological quality studies demonstrated significant improvements compared to placebo. Health status was not reported. Risk of trial withdrawal due to asthma exacerbation was lower with budesonide compared to placebo, relative risk 0.17 (95% CI 0.09, 0.33). Doses of 500-800 mcg/d appeared to have slightly larger effect sizes than lower doses, but no advantage for high doses were apparent. A single high quality RCT reported significant reductions in daily prednisolone requirement and the number of patients able to discontinue prednisolone completely in budesonide treated subjects compared to placebo. No difference in risk of oropharyngeal soreness/hoarseness or oral Candidiasis was apparent for budesonide compared to placebo. Long-term risk of adrenal insufficiency was not reported.

Authors' conclusions
This review strongly supports use of budesonide in chronic asthma. Consensus guidelines for chronic asthma suggest titrating inhaled steroid dose to individual requirements. Evidence from this review of trials does not present a case for routine dose titration above 800 mcg/d.


Compared to campus-based alcohol interventions for college students, services for emerging adult (EA) risky drinkers who reside off-campus in disadvantaged communities are not well established. This web survey assessed drinking practices, problems, and preferences for professional and lay helping resources spanning digital and in-person formats among community-dwelling EAs to guide services for them and determine whether drinking risk levels varied by preferences for help. Digital respondent-driven sampling recruited EA risky drinkers from disadvantaged communities (N = 356; M age = 23.6 years, 64.0% women, 77.4% employed, 64.9% residing in impoverished areas above the US average, 53.5% income < $20k/year). A web survey assessed participants' drinking practices and problems, including alcohol use disorder symptoms, and help-seeking preferences for smartphone apps; online help; in-person help from doctors, clinics, teachers, and school programs; mutual help groups; and help from friends and family. Preferences were related to participant drinking risks using generalized linear modeling. Modeling results showed that risk levels were related to help-seeking preferences. EAs reporting more negative consequences preferred smartphone apps and help from friends, whereas EAs reporting fewer negative consequences and drinking days preferred professional in-person help (Ps < 0.05). Although >90% fulfilled alcohol use disorder diagnostic criteria, <4% had received an alcohol-related intervention. EAs who are riskier drinkers appear less likely to use professional resources in favor of informal and online resources that allow greater anonymity. Findings can guide services for this underserved population that are responsive to drinker risk levels.


We consider the dynamics of squeeze-out of a molecularly thin confined two-dimensional (2D) liquidlike layer. The squeeze-out is described by a generalized 2D Navier?Stokes equation which is solved exactly for the limiting case where the squeeze-out nucleates at the center of the contact area, and where the (perpendicular) three-dimensional pressure profile is Hertzian. We also present numerical results for the case where the nucleation is off-center. The theoretical results are in good agreement with recent experimental data by two of us for octamethylcyclotetrasiloxane. In light of our theoretical model calculations, we also discuss the spatially resolved diffusion experiments of Mukhopadhyay et al. [Phys. Rev. Lett. 89, 136103 (2002)]. Here, we obtain a puzzling disagreement between theory and experiment which requires more investigation


The hypodermic use of medicaments calculated to make a deep and rapid impression on the blood and the blood-making organs and to combat certain infections is not new. For many years, in the treatment of secondary and tertiary syphilis, it has been the custom, originally amongst the Latins, and more latterly amongst American clinicians, to administer mercury subcutaneously. For rapidity of effect this method of giving the drug is without a peer. Of late years considerable interest has been directed toward the administration in this manner of drugs whose purpose was to overcome diseases essential to the blood itself, blood dyscrasias and blood deterioration dependent on systemic or local infection or toxemia. The old adage "remove the cause" as the primary act to be accomplished has, with reference to the treatment of many diseases, become stale and trite, and, in a vast number of instances, is more easily said than


Eight sublines of C3H mice were tested for their resistance to lethal infection with Rickettsia akari,. strain Kaplan. C3H/HeJ mice were unique in their susceptibility to approximately one plaque-forming unit of rickettsiae. This lack of resistance is apparently due to a mutation in the mouse strain which occurred after 1950.