Introduction Current guidance recommends that all specimens testing positive using a N. gonorrhoeae Nucleic Acid Amplification Test (GC NAAT) be confirmed using a second test with an alternative target, in order to achieve a positive predictive value above 90%. Aim To determine rates of GC NAAT confirmations by primary screening test and specimen site. Methods 994 specimens which were GC NAAT positive at local laboratories were sent for confirmation using an in-house multiplex PCR with PorA and opa gene targets. A correlation between the confirmatory real-time PCR results, specimen site and GC screening NAAT was undertaken. For the purposes of this analysis equivocal results were regarded as positive and inhibited results were excluded. Results Overall, 57% of specimens examined could be confirmed as GC positive using the in-house real-time PCR test (Table 1). Discussion High rates of confirmation can be achieved when examining genital, rectal and urine specimens irrespective of the GC screening NAAT. However >90% confirmatory rates were only achieved when examining male urine specimens which had been screened using the Probetec and Cobas Amplicor tests, although caution should be applied if extrapolating this data to low prevalence settings. Poor confirmation rates from throat specimens is probably due to cross-reactivity with commensal Neisseria, and highlights confirmation is essential when testing these samples. Abstract O24 Table 1 Confirmatory rates by Specimen site and GC NAAT screening test Genital Swab(Female)[n = 119] Urine(Male)[n = 84] Rectal [n = 97] Throat [n = 694] Probetec GC Qx (Becton Dickinson) 78.7% (37/47) 94% (47/50) 85.1% (23/27) 44.2% (248/587) Cobas Amplicor (Roche) 83.3% (50/60) 91.3% (21/23) 79.4% (27/34) 48.2% (27/56) RealTime CT/NG (Abbott) 83.3% (10/12) 72% (8/11)* 80.5% (29/36) 88.2% (45/51) * Small numbers – interpret with caution


A failed Electrical Submersible Pump (ESP) well is generally identified when there is no flow to the surface. The process of reviving well production can take weeks leading to huge unwanted deferment. Through a Proof-Of-Concept (PoC), the objective is to prototype and evaluate the results of an early failure detection for ESP wells using Machine Learning (ML), without reserving focus on implementation. By demonstrating the feasibility of this approach and verifying that the concept has practical potential, the tool can be used to reduce deferment and identify failure prone component to either devise mitigation strategy for extending time-to-failure or work on an improved design before failure.
 The paper details all the work undertaken to develop a Predictive Analytics model based on ML algorithms using field sensor data, real time physics-based model calculated data and well failure history to predict ESP well failure and identify failed component in advance. The approach of database standardization, data pre-processing, machine-learning algorithm selection, supervised training and validation dataset creation shall be discussed. ESP domain knowledge used for Feature Engineering across multiple modeling iterations to consistently improve well and component level model metrics shall be detailed.
 After the evaluation by well owners at Petroleum Development Oman (PDO), refered as Operator's blind test, the prediction of the ML algorithm shows a good accuracy in its ability to capture historical failures ranging between days to months in advance. The Well Level Failure model captures failure prone wells with a precision of 90% and accuracy of 76%. The Component Level Failure model correctly identifies pump failure from other failures with a precision of 92% and accuracy of 88%. These numbers show the reliability of future predictions that could enable users to make high stake workover and operating envelope optimization decisions with confidence.
 Following benefits are estimated from both Well failure and Pump Component failure prediction models metrics respectively: 28.35% savings from total unscheduled ESP deferment1% increase in Overall Mean Time to Failure (MTTF) based on optimization of predicted pump component failure wells.
 In an organization where over thousand ESP wells are managed by limited production engineers, post ESP failure, the effort invested for hoist scheduling, raising new well proposal, rig mobilization, new ESP installation and commissioning utilizes huge time and leads to long undesired oil deferment. Implementation of engineered analytics to predict ESP failures and failed components in advance can support production engineers to plan early for workover operations, increase well run life and minimize oil deferment losses.
 Methodologically assessed by Senior Petroleum Engineers in selected clusters (using historical data and in the context of each failure and non-failure cases), the Predictive Analytics journey has started. It is ready to be operationalized at a small scale to build confidence as an advisory tool for Production Engineers in real-time to evaluate multiple wells' failure probability on a daily basis and generate massive savings from well deferment. This agile journey focused on value generation is achieved with combined efforts between technology, domain knowledge and data.


AIM
Of all the complications of laparoscopic cholectecystomy, bile duct injury (BDI) is the most serious complication. The prevention of injury to the common bile duct (CBD) remains a significant concern in laparoscopic cholecystectomy (LC). Different kinds of methods have been advanced to avoid this injury but no single method has gained wide acceptance. Because of various limitations of current methodologies we began a study using cold light illumination of the extrahepatic biliary system (light cholangiography LCP) to better visualize this area and thereby reduce the risk of bile duct injury.

METHODS
Thirty-six patients with cholelithiasis were divided into two groups. Group I (16 cases) received LCP and group II (20 cases) received methelenum coeruleum cholangiography (MCCP). In group I cold light was used to illuminate the common bile duct by leading an optical fiber into the common duct with a duodenoscope at the time of LC. The light coming from the fiber in the CBD could clearly illuminate the location of CBD and hepatic duct establishing its location relative to the cystic duct. This method was compared with the dye injection technique using methelenum coeruleum.

RESULTS
In group I thirteen cases were successfully illuminated and three failed. The cause of three failed cases was due to the difficulty in inserting the fiber into the ampulla of Vater. No complications occurred in the thirteen successful cases. In each of these successful cases the location of the common and hepatic ducts was clearly seen differentiating the ductal system from surrounding anatomy. In ten cases both the left and right hepatic ducts could be seen and in three only the right hepatic ducts were seen. In four of the thirteen cases, cystic ducts were also seen. In group II, eighteen of the twenty cases were successful. The location of extrahepatic ducts became blue differentiating the ductal system from surrounding anatomy. Two cases failed due to a stone obstructing the cystic duct, and extravisation of the dye turned the entire area blue. LCP showed the common and hepatic ducts more clearly than MCCP.

CONCLUSION
LCP is the only technique that can clearly and directly show the location of the extrahepatic biliary system and may be useful in selecting cases of uncertain anatomy in the prevention of bile duct injury.


We consider a rate control problem for an $N$-particle weakly interacting finite state Markov process. The process models the state evolution of a large collection of particles and allows for multiple particles to change state simultaneously. Such models have been proposed for large communication systems (e.g. ad hoc wireless networks) but are also suitable for other settings such as chemical-reaction networks. An associated diffusion control problem is presented and we show that the value function of the $N$-particle controlled system converges to the value function of the limit diffusion control problem as $N\to\infty$. The diffusion coefficient in the limit model is typically degenerate, however under suitable conditions there is an equivalent formulation in terms of a controlled diffusion with a uniformly non-degenerate diffusion coefficient. Using this equivalence, we show that near optimal continuous feedback controls exist for the diffusion control problem. We then construct near asymptotically optimal control policies for the $N$-particle system based on such continuous feedback controls. Results from some numerical experiments are presented.


The approval of ado-trastuzumab emtansine (T-DM1) in HER2+ metastatic breast cancer validated HER2 as a target for HER2-specific antibody–drug conjugates (ADC). Despite its demonstrated clinical efficacy, certain inherent properties within T-DM1 hamper this compound from achieving the full potential of targeting HER2-expressing solid tumors with ADCs. Here, we detail the discovery of PF-06804103, an anti-HER2 ADC designed to have a widened therapeutic window compared with T-DM1. We utilized an empirical conjugation site screening campaign to identify the engineered ĸkK183C and K290C residues as those that maximized in vivo ADC stability, efficacy, and safety for a four drug–antibody ratio (DAR) ADC with this linker–payload combination. PF-06804103 incorporates the following novel design elements: (i) a new auristatin payload with optimized pharmacodynamic properties, (ii) a cleavable linker for optimized payload release and enhanced antitumor efficacy, and (iii) an engineered cysteine site–specific conjugation approach that overcomes the traditional safety liabilities of conventional conjugates and generates a homogenous drug product with a DAR of 4. PF-06804103 shows (i) an enhanced efficacy against low HER2-expressing breast, gastric, and lung tumor models, (ii) overcomes in vitro- and in vivo–acquired T-DM1 resistance, and (iii) an improved safety profile by enhancing ADC stability, pharmacokinetic parameters, and reducing off-target toxicities. Herein, we showcase our platform approach in optimizing ADC design, resulting in the generation of the anti-HER2 ADC, PF-06804103. The design elements of identifying novel sites of conjugation employed in this study serve as a platform for developing optimized ADCs against other tumor-specific targets.


Arthroscopic labral repair and refixation have garnered much attention over the past several years. Restoration of suction seal and native labral function has been an evolving focus for achieving excellent results in hip preservation surgery. Authors have reported using several labral management techniques: débridement, labralization, looped suture fixation, base stitch fixation, inversion-eversion, and reconstruction. The optimal technique is yet to be determined. Absolute indications for labral repair are symptomatic intra-articular pain, joint space >2 mm, and failed conservative management. Extreme attention is given to identifying and addressing the cause, whether it be acute or repetitive trauma, instability, or femoroacetabular impingement. In this article, we discuss indications for labral repair; describe Dr. Mather's preoperative planning, labral repair technique, and postoperative care; and review published outcomes and future trends in labral repair.


THE MACROGLOBULINEMIA of Waldenstrom, once considered to be rare, 1 has now been noted with ever increasing frequency. Although 360 case reports have been published, the present report of a single case is noteworthy because of the very unusual and instructive course which it followed. After an apparently typical course for over three years this man's paraprotein began to decrease, and he developed multiple lymphoblastic lymphosarcomatous masses in unusual sites. Two of these masses, in the stomach and prostate gland contributed significantly to the clinical problems encountered in the last months of the patient's life. The evolution of this patient's final illness demonstrates that these unusual masses can, at times, be of vital clinical significance. A brief review of the fifty reported cases of macroglobulinemia with lymphomatous masses is presented, and the significance of this association is discussed. Report of a Case A 66-year-old white man (DVAH A18562) was first


In the past few years, software engineering researchers have adopted social network analysis techniques to understand collaboration patterns in global software teams. In this paper, we investigate current research in global software development where social network theory is used as an analysis technique. We do so through a systematic literature review where we collect and analyze previous work that adopt a social network perspective in distributed software development. We use the 3C collaboration model to classify our results based on the communication, coordination and cooperation aspects of global networks. Our results reveal two main coordination structures used in distributed teams, namely the clustering and the core-periphery structure. The analysis of the cooperation activities of the global networks reveal differences between planning and practice. Finally, several tools have been identified that aim to improve communication patterns among distributed team members.


Background Triage is the correct admission of injured patients to a suitable treatment level. Previously no studies were done for the trauma registry at Odense University Hospital (OUH) in Denmark established in 1996. Aim was to assess level and character of undertriage. Method Retrospective analysis of data collected from OUHs list of patients admitted with ICD S- and T-diagnoses in 2007. Inclusion criteria is ISS>15, treated in intensive care >2 days, dead within 30 days, or proximal penetrating injury. Over-triage was identified on the basis of the trauma registry for patients received by the trauma team, where the severely injured patient was defined as ISS>15 or proximal penetrating injury. In total 747 trauma patients were received in 2007, 21% with ISS>15. Results Undertriage including death within 30 days was 22%, without these, 11%. Women had a higher risk of undertriage than men, and undertriaged patients were significantly older than correctly triaged patients. We discovered a high frequency of falls from low heights in undertriaged patients. 628 patients were admitted by the trauma team, with an over-triage of 82%. Conclusion We found an undertriage proportion comparable to similar studies. Elderly patients and women had a higher risk of being undertriaged, which also has been shown in other studies. We believe further research should be concentrated on the reasons for the high under and over-triage, by investigating current systems and routines, and to research whether the elderly and comorbid would reap benefit from medical participation in early treatment.


The aim of the study was to investigate relationships between the respiratory burst in blood and sputum neutrophils and intracellular enzyme activity in patients with pneumonia. Methods. The study involved 82 patients with moderate to severe community-acquired pneumonia (CAP). The chemiluminescent assay was used to investigate synthesis of primary and secondary reactive oxygen species (ROS). The bioluminescent method was used to examine NAD(P)-dependent dehydrogenase activity in neutrophils. Results. Low-intensity respiratory burst in blood neutrophils and its predominant relations to the state of mitochondrial metabolism and malic enzyme activity were observed in healthy subjects. Blood neutrophils in patients with CAP were activated; the anaerobic respiration and mitochondrial metabolism increased in the cells. Additionally, intensity of the respiratory burst was related to terminal glycolysis reactions and the key reaction of the pentose phosphate cycle. Sputum neutrophils in patients with CAP were also activated. Conclusion. Abnormalities of metabolic support of the respiratory burst, such as decreased production of primary and secondary ROS, could appear under unfavorable conditions. Peroxidation increased in the cells, the intensity of terminal glycolysis reactions decreased, and substrates transferred from the citric acid cycle to amino acid exchange reactions. Under these conditions, malic enzyme remained the only substrate that stimulated the respiratory burst in sputum neutrophils, while substrate transfer from the tricarboxylic acid cycle inhibited synthesis of the secondary ROS.


Ulcerative colitis (UC) is a common inflammatory bowel disease, whose incidence is on the rise worldwide. The drugs commonly used for UC are often associated with a number of side effects. Therefore, the development of effective, food-borne substances for UC is in line with the current needs. Egg yolk phosphatidylcholine (EYPC) is one of the abundant lipids in egg yolk and possesses various biological activities. However, its protective effect against UC has not been clarified. In this study, the anti-UC activity of EYPC was investigated using a dextran sodium sulfate (DSS)-induced colitis model of BALB/c mice. The results showed that EYPC supplementation inhibited DSS-induced colon shortening, the spleen index and disease activity index increase and intestinal structural damage. EYPC could down-regulate the levels of TNF-α, IL-1β, IL-6 and MPO in the colon and restore the number of goblet cells and the level of tight junction (TJ) proteins. Besides, EYPC modulated the composition of the gut microbiota, lowered the relative abundance of the pathogenic bacterium Parabacteroides and upregulated the abundance of the beneficial bacteria Alistipes and Lachnospiraceae_NK4A136_group. These results evidenced that EYPC could attenuate DSS-induced colitis in mice and had the potential to prevent and treat UC.


This study assessed psychoactive substance use in a private institution of learning in Nigeria with emphasis on prevalence and on medically approved substances acquiring an abuse potential. It followed an anecdotal report of the use of a cough mixture (Benylin with codeine) taking a priority attention among substances of abuse within the university community. The university has a total population of about 4,500 students and has seven colleges. Using a structured self report questionnaire, 342 (100%) students were surveyed across 5 randomly selected colleges. 323 candidates complied representing 94% reponse rate. Females 168 (52%) were over represented in the interview. The remaining 155 (48%) were males. An operational definition of abuse was drawn for this purpose to include users of a substance on a daily basis. By so doing social drinkers of alcohol and occasional users of medically approved but unprescribed medicaments for treatment purposes were excluded. For substances that do not enjoy government license to be marketed (eg. Cannabis, Heroine etc.), even a single use is regarded as abuse. Results showed that one of the traditional substances, alcohol 49 (15.2%) retained priority spot in the hierarchy of abused substances. Benylin with codeine 17 (5.3%) was next. This confirmed the verbal and unofficial report of the abuse of such medicament. Other substances of abuse were cannabis 9 (2.8%), cigarette 7 (2.2%), heroine and cocaine (0.003%). In all instances of abuse, (except for heroine which was even) males predominated. The law enforcement agencies like the Nigeria Police Force (NPF), National Drug Law Enforcement Agency (NDLEA) must be sufficiently informed that substances of abuse have gone beyond the conventional substances like alcohol, cannabis, cigarette etc. Efforts must be made to regulate the sales of even some apparently harmless across the counter medications. Key words: psychoactive, students, new challenges, prevalence.


Microcanonical simulations of spectral truncations of the barotropic quasigeostrophic model are utilized to demonstrate systematic departures from Gaussianity in these models. Truncated equations conserve both the energy and the enstrophy, and predictions of the equilibrium statistical theory are Gaussian for all values of geophysical parameters. Nevertheless, nonzero topographic modes induce significant departures from Gaussianity in corresponding Fourier wavenumbers of the stream function. In particular, the distribution becomes asymmetric, resulting in a significant increase of the third moment. This behavior is most noticeable for large-scale topographic components (with small wavenumbers) and intermediate truncation sizes.


*These authors contributed equally to this work Objective: We hypothesize that poor consideration of specialist surgery is due to a lack of exposure to information about careers and practice itself. Ear, Nose, and Throat (ENT) surgery is given little weight in medical school curricula, despite ENT problems being extremely common. Our objective is to assess whether a specialty showcase day was sufficient to boost informed consideration of this career. Design: We designed a half-day course involving an interactive careers workshop exploring ENT as a specialty choice, alongside simulation stations of commonly presenting ENT problems led by ENT doctors. We used preand post-course evaluation sheets to explore factors that encourage and discourage students from surgical careers and perceptions of ENT. Setting: A large proportion of UK medical schools do not offer ENT placements, and of those that do, nearly half are not compulsory. This leaves students unaware of ENT as a career option and unclear about what an ENT career comprises. Our half-day course took place in the simulation suite at St Mary's Hospital, London. Participants: Medical students were mainly in their third year of study and had aspirations towards a variety of surgical and non-surgical careers, with a minority aspiring towards ENT before the course. Results: Our results demonstrate that all students found the session useful and had a much better understanding of ENT practice, with almost all students leaving more likely to consider a career in ENT. Conclusion: We would like to repeat this session in different student year groups and compare their perceptions with our results. We find our results a good case for including informative careers workshops as part of medical school teaching. We pose that interactive workshops exploring specialist surgical careers are a valid way to enable students in making informed career decisions – particularly in specialties that are under-represented at medical school.


Simultaneous support of multiple delay-critical application sessions such as multiuser video streaming require a paradigm shift in the design of ad-hoc wireless networks. Instead of the conventional layered approach, cross-layer optimization is needed for more efficient resource allocation, across the protocol stack and among multiple users. In this work, we extend our previous effort in joint capacity and flow assignment at the MAC and network layers, to include rate allocation at the application layer of each user. The proposed optimization aims to minimize the tradeoff between encoded video quality of all users versus overall network congestion. Compared to a scheme with oblivious layers, where capacity, flow and video rates are assigned individually, simulation results show significant performance gain of our proposed cross-layer approach, in terms of maximum sustainable rate and quality of the video streams.


Risk management has become recognized as a best practice in the software industry. Controlling risks improves essential software development features such as product quality, planning precision and cost-efficiency. For this reason, the inclusion of risk management in software development is an important factor to consider if one wishes to achieve project success.Agile software development models claim to be risk-driven. They state that their iterative approach enables continuous attention to risks and that the risks can be reduced by practices such as continuous software integration and early testing. In reality, however, the agile development models implement few risk management practices.The research problem addressed in this thesis is multi-faceted. The problem concerns the lack of explicit risk management practices in agile development. However, it also concerns the need to address risk management on an organization-wide basis. In addition, it concerns the conflict that emerges from trying to merge the agile process with standard industrial processes, such as risk management, without compromising agility.The goal of this thesis is to explore integration as a solution for addressing the lack of risk management in the agile model based on empirical research. It involves (a) outlining a model integrating the agile and risk management processes on an organization-wide basis, and (b) providing a foundation for its extension.The results show that, within the scope of this research, the proposed solution is a valid candidate for improving the agile situation. However, it is still in its infancy. It does not claim to be complete but needs to be further elaborated and complemented with details. Hence, we outline the model and provide a foundation established in empirical investigation for extending it in future research.


187. IV InternationalCongressof PsychiatricEpi demiolog;. Madrid: International Federation of Psychiatric Epidemiology. Is schizophrenia a G-I disease? SIR: I read with interest the paper by Lambert et a! (Journal, November 1989, 155, 619—622) and would like to offer a rather different interpretation of their findings. It may be perhaps that the controls in this study were particularly healthy, in that every one appeared to have a similarly low urinary excretion of 51Cr EDTA. The 24 schizophrenic patients, apart from the two with somewhat raised values, were within the same range and were in fact as normal as the con trols. I do not find this result surprising, as all but one were medicated. The exception had previously been tested when taking neuroleptics. We are not told how long this patient had been off drugs. They could perhaps still have been exerting their effects. Neuroleptic drugs are known to stabilise mem branes, including the gut membrane. P. 5. Guth (pers. comm.) wrote that when he and his colleagues were first studying chlorpromazine it was thought to be inhibiting its own absorption. This drug is pre sently being used as an anti-secretory agent in the treatment of cholera and other diarrhoeral con ditions. It seems very possible that the neuroleptics taken by the patients in this study could have been the reason for their apparently normal gut


Murine cytomegalovirus causes lifelong infections with little pathology in normal host animals. Control of viral replication and prevention of pathology depend on both innate and adaptive immune mechanisms, and cytolytic T lymphocytes play a key role in this process. The virus encodes a number of genes which alter the normal assembly of class I major histocompatability complex proteins, and thus interfere with the ability of infected cells to present antigen to CD8(+)T cells. This review will examine what is known about these viral genes, and present some unanswered questions regarding the role of CTL evasion in the viral infectious cycle.


The effects of seminal plasma (SP), derived from autologous, homologous and heterologous species (stallion, boar and dog) on chilled Asian elephant sperm quality, were determined. Semen was collected from eight males and samples with ≥30% motile spermatozoa were used in the study. Semen was diluted with Tris–glucose–egg yolk extender, supplemented with different SP types and preserved at 4°C for 48 hr. Experiment 1 (n = 31), showed that the presence of SP (autologous) helped to preserve sperm quality in terms of sperm motility and acrosome integrity (p < .05). Homologous SP did not result in better sperm quality than autologous SP. Heterologous SP from stallion provided higher sperm motility and velocities compared to autologous SP (p < .05). Experiment 2 (n = 14) determined the effect of different SP from four stallions. All stallion SP gave higher (p < .05) results for motile spermatozoa and sperm velocities than autologous SP. In conclusion, the presence of SP helps preserve Asian elephant sperm quality and stallion SP supports the motility of Asian elephant spermatozoa during cold storage.


Objective: To investigate the attitudes of health care professionals involved within the coronavirus disease-2019 (COVID-19) pandemic process towards the COVID-19 vaccine in line with their demographic characteristics. Material(s) and Method(s): A questionnaire consisting of 16 questions was conducted to 510 healthcare professionals working in Inegol State Hospital between December 2021-January 2022 and who agreed to participate in the study, to determine their approach to the COVID-19 vaccine. The data were collected with Student's t-test and Mann-Whitney U Test. Chi-square test was used in comparison of categorical variables. Result(s): While 54.3% of the respondents said that they don't want to have the COVID-19 vaccine, 69% answered that "Since there is not any adequate research on the vaccine, the vaccine is not reliable". Were observed that vaccine rejection was most common in the 20-29 age group (72.7%) and pregnant women (100%). In addition, as the education level increased, the number of people considering vaccination increased. The desire to be vaccinated was seen more in married, and it was noted that non-smokers had more COVID-19 (80.3%). Conclusion(s): Healthcare professionals who participated in study were found to have a negative attitude towards COVID-19 vaccine. Although healthcare professionals have hesitations about vaccine, in fact, noteworthy that they're afraid of the disease (43.8%). Despite of the pandemic, more than half (54.3%) of healthcare professionals working in Inegol State Hospital stated that they didn't think about getting a COVID-19 vaccine. Providing hospital staff with more education about the safety, efficacy, and value of currently available COVID-19 vaccines is critical to vaccine acceptance in this population. Copyright © 2022 by Turkiye Klinikleri.


The enhanced ability of melanoma cells to metastasize is reminiscent of the innate propensity of melanoblasts to migrate to distant sites during embryonic development - from the neural crest to their eventual niche in the skin. Once transformed, melanoma cells mimic migratory and growth capabilities similar to those of embryonic melanoblasts. This putative relationship between tumorigenesis and developmental processes was first suggested by Rudolf Virchow more than 150 years ago. While this theory is largely unproven, there are mechanistic links between the processes regulating development and malignancy. Here we investigate this age-old puzzle using a mouse model with melanocyte-specific GFP expression to capture and sequence embryonic melanoblasts. We have, for the first time, isolated and sequenced the transcriptomes of murine embryonic melanoblasts at several key representative developmental stages. To uncover the overall classes of gene expression and to identify and characterize genesets whose expression is common and equally important to melanomagenic and developmental processes, a heat-map of the top 1000 most variable developmental genes was generated, and then shortlisted based on compared levels of expression in human and mouse metastatic melanomas, and on the relationship with melanoma patient survival data. By integrating bioinformatics and functional data we have devised a new cross-species multi-dimensional embryonic-onco-genomics analyses (MEGA) approach and show that late stage melanomas reactivate genes used during embryonic development to achieve a more aggressive metastatic phenotype (which we refer to as metafetal genes). One such identified gene, a KDEL (Lys-Asp-Glu-Leu) endoplasmic reticulum (ER) protein retention receptor (KDELR) family member, was expressed in advanced mouse melanomas relative to normal skin or benign nevi. We confirmed this in human melanoma by showing that this metafetal gene was expressed at high levels in metastatic patient samples relative to benign lesions, and also predicted patient survival. Next, we determined the consequences of RNAi-based knockdown on experimental metastasis in mouse models. We validated the functional significance in human and mouse melanomas by showing that this KDELR plays a key role in melanoma metastasis through adaptation to chronic ER stress for survival by modulating the unfolded protein response (UPR), which can be targeted. We anticipate that this approach will identify a variety of key hardwired pathways associated with melanocyte development that can be co-opted by opportunistic metastatic melanoma cells. This approach also offers a novel perspective on melanoma therapeutics and intervention and offers both mechanistic as well as prognostic insights into our understanding of this fatal disease. Citation Format: Pravin J. Mishra, Theresa Guo, Raza Zaidi, Sean Davis, Aleksandra Michalowski, Helen Michael, William Reinhold, Heinz Arnheiter, Paul Meltzer, Glenn Merlino. Integrated embryonic transcriptome analyses identify key melanoma metastasis regulator. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 994. doi:10.1158/1538-7445.AM2014-994


The derivation of the ponderomotive force due to neutrinos by Hardy and Melrose [Phys.Rev.D 54, 6491 (1996)] is based on a flawed analysis of the ponderomotive force concept. Their conclusions also contain an erroneous physical assumption related to the neutrino emission in supernovae. A correct analysis shows the importance of the ponderomotive force due to neutrinos in type II supernovae explosions.


Infective endocarditis (IE) is a potentially life-threatening disease. Regardless the improvements in IE management, it remains associated with high mortality and severe complications. Staphylococci and streptococci account for 80% of all IE cases. Prevention of IE by appropriate administration of antibiotics before procedures with potential bacteremia in selected patients is recommended according to recent and current guidelines. However, recent studies, have questioned the efficacy of antimicrobial prophylaxis in special situations and in some patient-groups. As a consequence, the guideline of the French working group on IE in 2002, the American Heart Association (AHA) guideline in 2007, the National Institute for Health and Clinical Excellence (NICE) guideline for Great Britain in 2008, and the European Society of Cardiology (ESC) guideline in 2009 restricted the recommendation for antibiotic prophylaxis to high-risk patients only, and only for certain invasive procedures. IE incidence increased in the USA, England and Germany in the last two decades. Study results for the USA, England, France, and Germany were not consistent regarding the influence of the revised guidelines for IE prophylaxis on the IE incidence. Although some study results pointed to an increase of the IE cases after the changes in the guideline recommendations, a final appraisal regarding the impact of the revised guideline recommendations on IE incidence could not be drawn at this time point due to the heterogeneous study results.


Information Technology (IT) is now an integral organization resource that plays a supporting role in most functions. However IT is not the primary business of many organizations. Their core competencies, the areas in which an organization performs best and that represent its competitive advantage is in other functions such as logistics, manufacturing or services. This study analyzed the extent of Information Systems outsourcing adoption within the Kenya Armed Forces. The research looks at the importance of understanding the success factors and the problems associated with planning and implementation of outsourcing strategies in government institutions such as the Security Institutions (Military, Police, National Security Intelligence Service, etc) while ensuring that such institutions perform their core tasks so as to meet the various needs of varying stakeholders. It is also important that the way such institutions handle emerging trends in management of outsourced information systems be understood well. The literature review focuses on specific aspects of adoption relevant to this research in relation to how outsourcing of information systems has been conceptualized, the factors at play plus research into the hurdles of outsourcing adoption within government Security Institutions such as the military. The research methodology used is exploratory in nature and factor analysis is used for data analysis. Data analysis shows that majority of the respondents have worked in the Information Systems department for more than two years, therefore they have an understanding of what happens in the department and also they have the necessary experience to make policy decisions in the military. It is apparent from the findings that the concept of outsourcing has not been clearly articulated and understood by both the Senior Policy Makers and staff working in the department.


The genus Kaisupeea is established for Boea herbacea, a species long recognised as being out of place in Boea, and two new species closely allied to it. These plants produce annual flowering stems whose basal leaves may be represented by broad foliaceous cataphylls. Kaisupeea herbacea and K. cyanea have spirally twisted fruit-valves, but those of K. orthocarpa are straight. Kaisupeea ranges from Moulmein in Burma [Mawlamyne in Myanmnar] eastwards across Thailand to Bassac on the Mekong river in lower Laos and south to the neighbourhood of Satun on the south coast of Thailand just north of the Malaysian border.


Cemento-ossifying fibroma (COF) is a rare benign tumor which mostly affects the mandible and the most common site is in the premolar-molar region. It is a painless, generally slow-growing, benign lesion which enlarges in an expansive manner. It is usually detected in the third and fourth decade of life and is more common in women. Radiographically, they appear as well-defined unilocular or multilocular intraosseous mass in the premolar-molar region of the mandible. The lesion is invariably encapsulated and with mixed radiolucent density. Its histopathology shows fibrous tissues with calcified structures resembling bone or cementum. This article reports a rare case of a-20-year old male with history of swelling in the anterior mandible region at tooth region 33-43 causing difficulty in occlusion. We have performed marginal resection and put AO plate crossing the bone defect. There was no wound dehiscence and exposed AO plate after six months of close observation. In conclusion, the mass has been succesfully excised and reconstructed using AO plate. Patient has been referred to the prosthodontic department for having a denture.


Human herpesvirus-6 (HHV-6), the etiologic agent of roseola, is ubiquitous, establishes latency in the host, and can infect a variety of immunocompetent cells, with CD4+ T lymphocytes being the targets in which it replicates most efficiently. The present study was undertaken to learn more about specific immunobiologic effects of HHV-6 infection on T-lymphocyte functions. Our data demonstrate that infection of peripheral blood mononuclear cells (PBMC) by HHV-6 results in suppression of T-lymphocyte functions, as evidenced by reduced interleukin-2 (IL-2) synthesis and cellular proliferation. In fact, HHV-6-infected PBMC secreted 50% less IL-2 than mock-infected cells after mitogenic stimulation with OKT3 antibody or phytohemmaglutinin (PHA). The inhibition of IL-2 by HHV-6 was also observed in enriched T-cell cultures, suggesting a direct effect of this virus on this cell type. Messenger RNA (mRNA) analysis by reverse-transcriptase polymerase chain reaction (PCR) indicated that HHV-6 diminishes IL-2 mRNA levels in mitogen-stimulated peripheral blood T cells. These results were also confirmed by Northern blot using the leukemic T-cell line Jurkat. This inhibitory effect of HHV-6 did not require infectious virus, as the use of UV-irradiated HHV-6 produced similar results. Moreover, HHV-6-infected PBMC showed up to an 85% reduction in their mitogen-driven proliferative response, as compared with sham-infected cells. Proliferation of both CD4+ and CD8+ T cells was affected by HHV-6. Taken together, our data show that infection of T cells by HHV-6 results in immune suppression characterized by a downregulation of IL-2 mRNA and protein synthesis accompanied by diminished cellular proliferation.


Transmission at 40 Gbit/s over large mode area photonic crystal fiber (PCF) together with dispersion compensation by optical phase conjugation in a highly nonlinear PCF are demonstrated for the first time.


The paper discusses corruption in public auctions and the role of transparency as a tool to prevent it. First, we analyse where corruption occurs, emphasizing the importance of considering the whole process, from deciding whether to contract-out to implementing the contract. We then analyse the effects of corruption on public auctions and argue that corruption undermines their stated aims. Second, we discuss the ways transparency can mitigate corruption and possible trade-offs regarding competition and efficiency. As an instrument, we focus on the Integrity Pact, a tool developed by Transparency International, and analyse cases in Argentina (school supplies) and Colombia (telecommunications), where transparency helped to prevent corruption and collusion and, furthermore, was able to enhance competition. We conclude with some policy implications. Copyright 2006 The Authors Journal compilation © CIRIEC 2006.


We describe 5 patients who presented with musculoskeletal abnormalities in the neonatal period. All patients were initially suspected to have Larsen syndrome or Beals syndrome but were subsequently diagnosed with a TGFBR2 mutation diagnostic of Loeys-Dietz syndrome. Patients had progressive aortic enlargement, which necessitated surgical intervention for 3 patients and resulted in the death of 1 patient. Delay in diagnosis of Loeys-Dietz syndrome may be associated with adverse prognosis.


Positron emission tomography (PET) is a molecular medical imaging modality which is commonly used for neurodegenerative disease diagnosis. Computer-aided diagnosis (CAD), based on medical image analysis, could help with the quantitative evaluation of brain diseases such as Alzheimer ' s disease (AD). Ranking the effectiveness of brain volume of interest (VOI) to separate healthy or normal control (HC or NC) from AD brain PET images is presented in this book chapter. Brain images are first mapped into anatomical VOIs using an atlas. Different features including statistical, graph, or connectivity-based features are then computed on these VOIs. Top-ranked VOIs are then input into a support vector machine (SVM) classifier. The developed methods are evaluated on a local database image as well as on Alzheimer ' s Disease Neuroimaging Initiative (ADNI) public database and then compared to known selection feature methods. These new approaches outperformed classification results in the case of a two-group separation.


An interesting fluorescence intensity reverse photonic phenomenon between red and green fluorescence is investigated. The dynamic range Sigma of intensity reverse between red and green fluorescence of Er(0.5)Yb(3):FOV oxyfluoride nanophase vitroceramics, when excited by 378.5nm and 522.5nm light respectively, is about 4.32x10(2). It is calculated that the phonon-assistant energy transfer rate of the electric multi-dipole interaction of {(4)G(11/2)(Er(3+))?(4)F(9/2)(Er(3+)), (2)F(7/2)(Yb(3+))?(2)F(5/2)(Yb(3+))} energy transfer of Er(0.5)Yb(3):FOV is around 1.380x10(8)s(-1), which is much larger than the relative multiphonon nonradiative relaxation rates 3.20x10(5)s(-1). That energy transfer rate for general material with same rare earth ion's concentration is about 1.194x10(5)s(-1). These are the reason to emerge the unusual intensity reverse phenomenon in Er(0.5)Yb(3):FOV.


So-called 'hello' nurses, employed by trusts to greet patients as they arrive at A&E departments, have been condemned as a waste of time.


Holoprosencephaly is a congenital anomaly characterized by lack of cleavage of the prosencephalon. Although, relatively rare, it is the most common anomaly that involves both the brain and the face. Prenatal diagnosis of this anomaly using ultrasonography, particularly of the less severe forms, is difficult. Magnetic resonance imaging has recently become an important complement to US in prenatal diagnosis of CNS anomalies. We herein report a patient in whom, at 23 weeks of gestation, US suggested agenesis of the corpus callosum and in whom, at 24 weeks of gestation, MRI correctly diagnosed lobar holoprosencephaly, which was confirmed by a postnatal MRI at 3 weeks of age. Copyright © 2005 John Wiley & Sons, Ltd.


Fire in His HeartBishop Benjamin Tucker Tanner and the A.M.E. ChurchWilliam Seraile"This fine, informative work greatly augments our knowledge of the life of black clergy and periodical editors in the late nineteenth century, by providing us with an insightful biography of Benjamin Tucker Tanner, a man who was one of the greatest in both categories. William Seraile's careful analysis of Tanner's integrationist views regarding race in America can help out present-day Americans who are concerned about overcoming divisions that still persist in our multi-ethnic democratic society." Stephen W. Angell, Florida A&M University"Professor Seraile has written a very well-researched, well-organized biography of Benjamin Tucker Tanner, one of the major leaders of the African Methodist Episcopal Church, who made significant intellectual and pastoral contributions in his roles as minister, editor, and bishop. . . . Seraile highlights the life and work of a very important figure in African American, American, and Methodist religious history." Sandy Dwayne Martin, University of GeorgiaBenjamin Tucker Tanner (1835 1923) distinguished himself in the nineteenth and early twentieth centuries as one of the foremost clergymen and editors in the African Methodist Episcopal (A.M.E.) Church. With depth and insight, he wrote about major events he had witnessed the Civil War, Reconstruction, the rise of Jim Crow, and the Progressive Era, among them and, as part of the A.M.E. Church's educated elite, he helped extend the denomination's reach into the postbellum South as well as into Canada, the Caribbean, and Africa.In Fire in His Heart, William Seraile offers the first full biography of Tanner. As Seraile shows, the Pittsburgh-born churchman struggled in his early years with his own lack of religious zeal. This concern took Tanner from pulpit preaching in 1868 to the editor's desk where, for sixteen years, he edited the Christian Recorder, official organ of the A.M.E. Church, which he molded into a major African American newspaper. He subsequently became founding editor of the AME Church Review, and in 1888 he was made a bishop, serving districts based in Philadelphia, Kansas City, Jacksonville, and Nashville. At about the time he became a bishop, Tanner found the spiritual fire that had been absent in his youth a zeal that was reflected in both poetry and essays.As an editor and bishop, Tanner demonstrated an ardent commitment to human rights and a firm belief in the inclusion of all people into American society. Proud of his African heritage, he wrote books addressing the presence of the African in the Bible and thus was a pioneer in what is now called the Afrocentric school of theology. Even so, he considered himself first and foremost an American, predicting that the United States would eventually become a nation where race and color were unimportant.In its recounting and analysis of Tanner's life, writings, and intellectual contributions, Fire in His Heart underscores the importance of a key figure in the history of the African American church.The Author: William Seraile is a professor in the Department of Black Studies at Lehman College of the City University of New York. He is the author of Voice of Dissent: Theophilus Gould Steward and Black America. "


Its use creates the need for more growth and development in all fields so that the individual can coexist and integrate with the contemporary lifestyle. The use of virtual reality in various disciplines is an inescapable necessity as almost all recent studies are moving towards the technology of virtual reality in an attempt to link the information age systems with multiple interactions and communications. Thus, this research aims to examine the relationship between virtual reality and the art of drawing and painting and its relevance to the development of applied frameworks for this art. This study also aims to investigate the uses of virtual reality and the methods of integrating it within the area of fine arts, especially the field of drawing and painting in the light of this new direction .


The purpose of this research is to investigate the feasibility of the synthesis of platinum/multi-wall carbon nanotube (Pt/MWNT) catalysts and such catalysts' application in fuel cells. The as-received MWNTs were purified and decorated by pretreatment. Infrared-spectrum indicates the carboxylic (-COOH) and carbonyl (-C=O) groups were introduced on the surface of the MWNTs after pretreatment. These functional groups will act as anchor sites for the Pt deposition. Then the Pt particles in nano scale were deposited on the surface of MWNTs by reduction of a solution of hexachloroplatinic acid. Transmission electron microscopy examination reveals that Pt particles are attached to the surface of MWNTs. If as-received MWNTs are not pretreated in the proper way, the Pt particle aggregates are mostly found on the open end of MWNTs. Occasionally Pt penetrated inside the tube of MWNTs. The relationship between the Pt particle morphology and the conditions of pretreatment and reduction reaction is discussed. After heat treatment, Pt particles recrystallized to form the Pt/MWNT catalysts. The Pt/MWNT catalysts were applied to a single cell and the test result shows a promising future of these catalysts with low Pt loading when applied in proton exchange membrane fuel cells (PEMFCs).


At the Medical Department, Telemark Central Hospital, a project has been going on for five years now to evaluate consultations in lifestyle groups in preference to individual consultations for persons with dyslipidemia. 363 persons were recruited to participate in a series of 5 group consultations at intervals of 3 months, each session to last for 2 hours. Altogether 1469 consultations were of this type. After the first session 79% said they preferred lifestyle group consultations, rather than spending their share of the allotted time on personal consultations, and after the fifth session 81%. The concept has been extended to include patients with chronic disease (asthma and chronic inflammatory bowel disease), with the principal aim of improving the patients' understanding of their disease, and showing them how to control it themselves. The project has attracted much attention, and a consultant in preventive medicine has recently been appointed to the staff. We think it important in terms of impact that the initiative to establish local expertise in preventive medicine emerged from a department that deals with emergency admissions due to lifestyle-related diseases.


Living donor liver transplantation (LDLT) in infants for congenital biliary atresia (BA) poses various challenges nowadays. We aim to investigate independent preoperative risk factors for LDLT in infants. We retrospectively analyzed medical records of infant patients who underwent LDLT surgery for BA from 1 July 2014 to 31 December 2016. Cox regression was used to explore risk factors. The Kaplan‐Meier method was used to calculate the recipient and graft survival, and subgroup analysis was then applied according to the risk factors. Independent t test or Mann‐Whitney U test was applied for comparison of certain factors between survival patients and death. A total of 345 infant LDLT for BA were included in the analysis. In the multivariate Cox‐regression model, 3 factors were determined as independent risk factors for recipient and graft survival, there were neutrophil‐lymphocyte ratio (NLR), pediatric end‐stage liver disease (PELD), and recipient age. The HR (95% CI) of baseline NLR for recipient and graft survival were 1.25 (1.12‐1.38) and 1.25 (1.13‐1.39), with all P < .0001. Kaplan‐Meier curves for NLR using different cut‐offs (1.5; 1, 2) suggested that higher baseline NLR was significantly associated with recipient and graft survival. The subgroup analysis indicated that for infants with elevated NLR, the recipient survival was significantly lower when their age >6 months or PELD >20. Our results indicate that infants with higher baseline NLR value may have lower survival rate 3 years after transplantation. Further investigations about broaden the application of pre‐ and post‐transplant NLR to guide nutrition intervention and immunosuppression therapy are necessary.


Abstract The environmental impact of genetically modified (GM) plants in experimental fields has been examined in several ways, in particular with respect to the dynamics of specific nontarget organisms. The approach of sampling for biodiversity in agroecosystems to compare complex patterns could also be useful in studying potential disruptions caused by GM crops. In this study, we set up replicated field plots of Bt-expressing eggplants and near isogenic untransformed eggplants as a control. We monitored the presence and abundance of herbivore and predator arthropods in weekly visual samplings of the plant canopy for three growing seasons (2001–2003). Insect species were pooled in organismal taxonomic units (OTUs); three multivariate methods were used to compare species assemblage as an estimate of insect biodiversity. This multistep statistical approach proved to be efficient in recognizing association patterns, as evidenced by the data for the target species Leptinotarsa decemlineata Say (Coleoptera: Chrysomelidae) clearly showing a significant association with the control plots. All the analyses indicate a comparable species assemblage between transgenic and near isogenic eggplant areas. Our results suggest that some taxa may warrant more specific study. For example, Alticinae beetles (Coleoptera: Chrysomelidae) were alternatively more abundant in either of the two treatments, and their overall abundance was significantly higher on transgenic eggplants. In light of these results and because of their taxonomic proximity to the target species, these herbivores may represent an important nontarget group to be further studied. Moreover, some sap feeders (e.g., Homoptera: Cicadellidae) were more abundant on Bt-expressing plants in some samples in all 3 yr.


The purpose of this paper is to identify risk factors, analyze and compare their effects on student hygiene behavior at Felix Houphouet-Boigny University. It is a descriptive and analytical cross-sectional study, initially covering 333 students in the second and third year of Training and Research Unit of Biosciences from University Felix Houphouet-Boigny enrolled during the university year in 2015-2016. A total of 318 out of 333 students Interviewed or 95.49% attending the toilets. The majority of the students questioned, 219 (65.76%), had poor hand hygiene practices. There is a non-significant difference between hand hygiene practice and gender (p = 0.16). A staff of 325 students questioned out of 333 or 97.59% denounced a lack of toilets. 95.49% of them are aware of the handwashing procedure. The toilets are also used by girls and boys. We note an insignificant difference between toilet use and sex (p = 0.76). The correct practice of handwashing is not practiced by the students of Training and Research Unit of Biosciences; this was confirmed by direct observation. In the area of toilet surveys, lacks of hygiene equipment and inadequate toilets have been reported. Understanding the challenges of hand hygiene practice in academic may help in the development of hand hygiene promotion strategies for the prevention of infections, especially those that are handled. The promotion of hand hygiene should start with health education.


Deep reinforcement learning has been successfully used in many dynamic decision making domains, especially those with very large state spaces. However, it is also well-known that deep reinforcement learning can be very slow and resource intensive. The resulting system is often brittle and difficult to explain. In this paper, we attempt to address some of these problems by proposing a framework of Rule-interposing Learning (RIL) that embeds high level rules into the deep reinforcement learning. With some good rules, this framework not only can accelerate the learning process, but also keep it away from catastrophic explorations, thus making the system relatively stable even during the very early stage of training. Moreover, given the rules are high level and easy to interpret, they can be easily maintained, updated and shared with other similar tasks.


Regulators have raised concerns about the quality of group audits, particularly where other component auditors are involved. These other component auditors may be affiliated (i.e. part of the principal auditor's network) or unaffiliated with the principal auditor. Using Australian disclosures, we examine these arrangements and their impact on audit quality and fees. Although international auditing standards require the signing auditor to accept responsibility for the entire engagement, we find lower audit quality for group audits involving the principal auditor's network compared to other arrangements, suggesting potential over reliance on the work of network members. Further, we find that fees are relatively higher when other auditors are involved, particularly network auditors. Collectively, our evidence supports the need for closer monitoring of group audits by audit firms and regulators when other auditors, especially network auditors, are involved.


ABSTRACT Introduction: Current medical therapy for glaucoma consists of topical agents that lower intraocular pressure (IOP). Prostaglandin F2α analogues, the most commonly used class of IOP-lowering drugs, bind to prostaglandin FP receptors in tissues of the uveoscleral pathway. This binding increases the expression of matrix metalloproteinases, which degrade the extracellular matrix of the ciliary body, creating inter-muscular spaces allowing aqueous humor to exit the eye. Drawbacks to prostaglandin F2α analogues include cosmetic side effects, especially prostaglandin-associated periorbitopathy (PAP) syndrome. Areas covered: This review describes the novel prostaglandin E2 receptor antagonist, omidenepag isopropyl, which reduces IOP by improving drainage of uveoscleral and trabecular outflow, increasing the facility of outflow. In contrast to prostaglandin F2α analogues, omidenepag does not inhibit adipogenesis or promote eyelash growth. This review describes preclinical studies of omidenepag, published results of phase I–III clinical trials, and preliminary results of phase III trials currently in progress. Expert opinion: Omidenepag appears to provide IOP reductions comparable to those of prostaglandin F2α analogues, but without the cosmetic side effects common to prostaglandin F2α analogues, especially PAP syndrome. The lack of association between omidenepag and PAP suggests that long-term use of this agent may have advantages in patients with glaucoma.


A graph is nonsingular if its adjacency matrix A(G) is nonsingular. The inverse of a nonsingular graph G is a graph whose adjacency matrix is similar to A(G)−1 via a particular type of similarity. Let H denote the class of connected bipartite graphs with unique perfect matchings. Tifenbach and Kirkland (2009) characterized the unicyclic graphs in H which possess unicyclic inverses. We present a characterization of unicyclic graphs in H which possess bicyclic inverses.


Between the American Revolution and the 1840s, silk cultivation was pursued enthusiastically across the United States. Although scorned at first, silk's republican virtues were rediscovered and rearticulated in the antebellum era by a range of proponents. Owing to an evolving infrastructure that integrated the press, the post, and agricultural societies, the appeal of silk drew in farmers and manufacturers of all classes and across many regions. Their disparate circumstances and motivations made a peculiar interest group, but one that secured considerable political and promotional support. More than just an exercise on paper, American silk was widely produced, thanks especially to the labor of women. Eventually, the far-flung community of sericulturists fell prey to environmental and labor-related limitations. But the speed of their downfall, linked to a speculative bubble in mulberry trees, was also due to the distinctive features of their agricultural reformism and its creative relationship with credibility.


I show how to identify and estimate the average partial effect of explanatory variables in a model where unobserved heterogeneity interacts with the explanatory variables and may be unconditionally correlated with the explanatory variables. To identify the populationaveraged effects, I use extensions of ignorability assumptions that are used for estimating linear models with additive heterogeneity and for estimating average treatment effects. New stimators are obtained for estimating the unconditional average partial effect as well as the average partial effect conditional on functions of observed covariates.


Jammu and Kashmir is the only state in India that has made education free to all its  citizens. Education is the main factor resulting in significant social change in a society. Ever since the beginning of Higher education in India showed that its spread has played a key role in the process of changing the status and social mobility of an individual. It not only adapts an individual to existing or emerging social situation but also has a creative role in the sense that it has the potential of liberating minds from the shackles of the established culture. Various sociological studies have also shown that education is a powerful factor in bringing about change in society. The educational system of a nation is the key to its prosperity and welfare and that no investment is likely to yield greater returns than investment in human resources of which the most important is education. Education in College and Post-Graduate level beyond Primary and Secondary level is important because it needs to meet the challenges of changing demands for advanced knowledge and technologies. However, Expanding higher education is very expensive, but State Government has made many attempts to take it to every nook and corner of the State. This paper analyzes the growth and development of higher education in J & K It aims to suggest some more steps for improvement Quality of higher education in J & K.


In an experimental study of 31 anesthetized dogs the importance of the mitral apparatus for the left ventricular function was investigated. During extracorporeal circulation bileaflet mitral valve prostheses were implanted preserving the mitral subvalvular apparatus. Flexible wires were slung around the chordae tendineae and exteriorized through the left ventricular wall to cut the chordae by electrocautery from the outside when the heart was beating again. External and internal left ventricular dimensions were measured by sonomicrometry, left ventricular stroke volume by electromagnetic flowmeters around the ascending aorta, left ventricular end-diastolic volume by dye dilution technique, and left ventricular pressure by catheter tip manometers. Different preload levels were achieved by volume loading with blood transfusion before and after cutting the chordae tendineae. When the chordae had been divided peak systolic left ventricular pressure did not change. Heart rate only increased at the lowest left ventricular end-diastolic pressures of 3-4 mmHg, but remained unchanged at higher preload levels. Cardiac output decreased significantly up to -9% at left ventricular end-diastolic pressures of 5-10 mmHg, while left ventricular dp/dtmax showed a consistent reduction of up to -15% at any preload level. Significant reductions were also seen in systolic shortening in the left ventricular major axis (by external measurements -27%, by internal recording -43%). Left ventricular end-diastolic dimensions increased in the major axis by +2% when recorded externally, by +10% when measured internally. Systolic and diastolic changes in the minor axis were not consistent and different in the external and internal recordings.(ABSTRACT TRUNCATED AT 250 WORDS)


A psychologic preparation program was developed for use prior to emergency surgery in children. The purpose of this study was to determine whether specific information prior to an emergency operation would reduce anxiety. The effect of the preparation program was evaluated with clinical and laboratory procedures. One group of children who received only general verbal information was compared with another group who received specific information. The subjects were 24 patients and their parents. The children were studied at four different clinical units prior to operation, using the Visual Analogue Scale and pulse rate and blood pressure measurements. Stress hormone levels were measured at three of these clinical units. Visual Analogue Scales were administered to parents three times prior to the child's operation. The results were analyzed for within-group differences from one clinical unit to the next and for between-group differences at the various clinical units. The results indicated less anxiety in the children who received specific information. Catecholamine and beta-endorphin measurements were not greatly different between the groups.


Palliative care is a growing specialty in New Zealand with many well established hospices and a growing number of hospital based advisory services. Palliative care is an element of all healthcare services and the aged care sector is one of those services where many of the residents have palliative care needs. In this setting, care assistants make up a large component of the workforce providing care for residents with increasingly complex needs. This article reports the results of a research study that used semi structured interviews to explore the impact that attending a palliative care course had on care assistants and their practice. Factors identifying the implementation of learning in the workplace were also identified. The results showed that while attending the course had a positive impact on participants; they were restricted in their ability to apply new learning in the workplace. Consequently, recommendations are made to enhance workforce development in the aged care sector and to minimise the barriers to the implementation of learning.


Companies in Lithuania are actively establishing initiatives to improve their social responsibility. At the same time, there is a growing demand for competent managers who can successfully work in an oganisation and take responsibility. The aim of the article is to identify the most important attributes of management by systemizing specific requirements concerning abilties of managing employees of global compact business companies' network, as provided in their work proposals. The activeness of establishing initiatives to improve Lithuanian business companies' social responsibility is analysed. Requirements for competence and abilties of managing employees of global compact network business companies, as provided in their work proposals, are analysed and systemized.


In a telecommunications system such as a global mobile telephone network in which each subscriber unit includes a Subscriber Identity Module (SIM card), each SIM card has fixed memory locations, to which data can be addressed over the air. Some of the locations can not be overwritten from the subscriber unit but can be accessed therefrom on the entry of short simple codes, each associated with one of the locations. Further fixed memory locations can be read over the air only when the subscriber enters a personal identification number. Locking control files are used to control read/write access to the locations respectively.


In cases of suspected non-accidental injury in children, it is vital that a haematologist confirms the presence or absence of a haemostatic disorder so that the child welfare and legal systems can make accurate judgements regarding the cause of isolated injuries. The present paper will discuss commonly used methods for the diagnosis of coagulation disorders in children, and will describe how the investigation of easy bruising and bleeding can be highly problematic. For instance, some frequently used tests for the assessment of haemostasis in children are insensitive, inappropriate, or based on values derived from adult populations. Furthermore, artefact is a frequent problem, and many cases present with a negative family history of bleeding. Therefore, the role played by the haematologist in potential child abuse cases is an essential yet challenging one.


Natural sod culture in orchard is an effective measure to improve the orchard productivity and promote the sustainable production. To explore the effects of inter-row grass ploughing and returning on soil biological cha-racteristics and nutrient contents, we examined the effects of different grass returning to the field on the amount of soil microorganisms, enzyme activities and nitrogen and potassium contents of 0-20 cm soil layer. There are three treatments, cleaning tillage as the control (CK), conventional mowing management (NG), and soil ploughing annually under natural sod culture with conventional mowing condition (NGR) treatments. The results showed that soil microorganisms were dominated by bacteria, followed by actinomycetes, with the least fungi. Compared with CK, both NG and NGR treatments significantly improved the abundance of soil bacteria and fungi, with the strongest effects in NGR treatment, and significantly increased the soil urease, sucrase and catalase activities by 59.0%, 20.7%, 38.3% and 73.5%, 45.9%, 67.8%, respectively. NGR treatment significantly increased soil nitrogen and potassium contents, with the contents of ammonium nitrogen, nitrate nitrogen, particulate organic nitrogen, microbial biomass nitrogen, available potassium and water-soluble potassium being 1.5, 1.8, 1.6, 2.0, 1.3 and 1.4 times of that in CK, respectively. NGR significantly increased soluble sugar content and sugar acid ratio and subsequently improved fruit quality. Overall, NGR increased soil microbial abundance, enzyme activities, nitrogen, potassium contents and fruit quality, which could be a feasible management of inter-row grasses in the natural sod culture apple orchard.


Proc Amer Assoc Cancer Res, Volume 45, 2004

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Lung cancer accounts for a major load (17%) of all cancer related deaths worldwide with more than half of all lung cancer patients in developing countries presenting in advanced stages (Stage IIIB and IV). Multiple studies have shown that new single agents like Vinorelbine are much less toxic but as effective as previously used Cisplatin based combinations. Hence, it is a realistic single drug option for patients with advanced Non Small Cell Lung Carcinoma (NSCLC). Apoptosis is a critical mechanism essential for the action of most chemotherapeutic agents. Thus a better understanding of the molecular mechanisms of apoptosis and augmentation in chemotherapy and chemo-adjuvant therapies are needed. The objective of this study was to investigate whether efficacy of Vinorelbine as an anticancer drug in lung cancer can be enhanced by pretreatment with chemopreventive agent Curcumin. Lung squamous cell carcinoma cells (H520) were cultured in DMEM with 10% FCS. They were treated with a dose of 25μM Curcumin and/or 0.1 μg/ml Vinorelbine for 24 hours each. Apoptosis was detected by morphological examination, TUNEL assay and flowcytometry. Apoptosis and its related proteins were studied by Western blotting and Caspase-3 activity assay. 39% & 24% apoptosis were seen on treatment of H520 cells with Vinorelbine & Curcumin respectively for 24 hours. Priming with Curcumin for 24 hours augmented the Vinorelbine induced apoptosis to 61%. Protein expression analysis revealed that Curcumin & Vinorelbine decreased antiapoptotic Bcl-XL by 34% & 50% respectively, whereas their combination caused a 63% decrease. Proapoptotic Bcl-Xs was increased by 86% by Curcumin & 110% by Vinorelbine and their combination caused a 220% increase. Antiapoptotic Bcl-2 was decreased by 42% and 10% by Curcumin & Vinorelbine alone, while their combination caused a 50% reduction in the same protein. Bax, another pro-apoptotic protein was up-regulated by 64% and 328% by Curcumin & Vinorelbine alone, while their combination caused a 514% upregulation. Cox-2 was decreased by 40% & 8% on Curcumin & Vinorelbine treatments while their combination decreased it by 41%. The uncleaved fragment of Poly-ADP ribose polymerase (PARP) was decreased by 27% and 61% by Curcumin & Vinorelbine alone while their combination caused a 92% decrease. The activity of downstream effector caspase, Caspase-3, corroborated the above results. The findings demonstrate that Vinorelbine induces apoptosis which can be augmented by prior treatment with Curcumin in lung cancer H520 cells. The observations suggest that Bax, Bcl-2, Bcl-XL, Bcl-Xs and Cox-2 are ideal targets for chemotherapy & chemosensitization. It is hoped that less toxic and targeted therapies will provide relief particularly in patients suffering from advanced lung cancer.


This paper gives an overview of the major research in historical corpus pragmatics on speech acts and texts, adding new suggestions and insights. The section on speech acts deals with corpus-based diachronic descriptions of speech acts in the history of English and the methodological problem of retrieving speech acts in diachronic corpora. The section on texts contains a short overview of corpus-based descriptions of genres in the history of English and addresses the problems connected with the corpus-based analysis of functions and sections in texts. The final section, combining both perspectives, gives suggestions for a history of English as a history of genres and speech acts.


We have been exploring in preclinical models and clinical trials methods to reproducibly provide therapeutic T cell responses by transfer of genetically engineered T cells. Our largest clinical experience is in treating human Acute Myelogenous Leukemia (AML). After identifying that WT1, a gene associated with promoting leukemic transformation, is over-expressed in human leukemic stem cells, and demonstrating in a clinical trial that in vitro expanded WT1-specific CD8 T cell clones can be safely transferred, exhibit anti-leukemic activity, and provide therapeutic benefit to AML patients, we extensively screened normal human repertoires and isolated a high affinity TCR specific for WT1 for genetically engineering CD8 T cells to reproducibly create cells with high avidity for leukemic cells. We have initially pursued this strategy in a 2 Arm trial for leukemia patients either at high risk of relapse (Arm 1) after hematopoietic cell transplant (HCT) or who have already relapsed after HCT (Arm 2). The prophylactic arm is now completed, with very encouraging results- all patients treated with engineered T cells remain alive and relapse free at a median of 38 months, compared to a relapse rate of ~50% in a concurrent matched cohort. Results in relapsed patients (Arm 2) have been less effective, and we have used high-dimensional analyses including single cell RNAseq both to elucidate the reasons for failure to eradicate the leukemia and to design strategies to overcome these obstacles. Our results have identified several mechanisms by which the leukemia escapes, and we have been testing approaches that employ further genetic modification of the T cells to enhance efficacy. The predominant reason for leukemia progression despite targeted therapy with T cells is the inability of the T cells to persist and maintain function in the context of encountering a rapidly proliferating myeloid leukemia. This reflects both engagement of pathways inhibitory to T cells by the leukemic cells, and apoptosis of the T cells from repetitive stimulation. We are addressing this issue by creating immuno-modulatory fusion proteins (IFPs) that have the ectodomain of an inhibitory or death receptor fused to a survival costimulatory domain. Results with two such IFPs will be discussed, a CD200R/CD28 fusion that binds the inhibitory ligand CD200 commonly expressed on leukemic cells but provides a CD28 costimulatory signal and a Fas/4-1BB fusion that binds FasL but rather than induce death promotes proliferation and survival. A more uncommon reason explaining progression is loss of expression of the WT1 epitope being targeted. This has occurred in 2 patients, but for distinct reasons. In one patient this reflected loss of a component of the immunoproteasome, and we have now isolated a TCR that recognizes an epitope not dependent on the immunoproteasome. In a second patient the level of WT1 expression declined- interestingly, this patient was treated with Vidaza, which can increase expression of WT1, and post-Vidaza the transferred T cells persisting in the patient's bone marrow recognized and responded in vivo to the relapsing leukemia. The approaches and technologies we are developing and testing in leukemia are also applicable to solid tumors, and preclinical studies in pancreatic and ovarian cancers will be discussed. Citation Format: Kristin G. Anderson, Dan Egan, Sunil R. Hingorani, Shannon K. Oda, Kelly Paulson, Rachel Perret, Leah Schmidt, Thomas Schmitt, Ingunn Stromnes, Aude Chapuis, Philip D. Greenberg. Utilizing synthetic biology and high-dimensional probing to address therapeutic obstacles and empower engineered T cells with the capacity to eradicate tumors [abstract]. In: Proceedings of the Fourth CRI-CIMT-EATI-AACR International Cancer Immunotherapy Conference: Translating Science into Survival; Sept 30-Oct 3, 2018; New York, NY. Philadelphia (PA): AACR; Cancer Immunol Res 2019;7(2 Suppl):Abstract nr IA17.


This thesis contributes new and unique evidence to the debates surrounding business, management and communication changes and paradigmatic shifts in Western Europe by means of social media (SM) by seeking the answer to how the Facebook platform is actually being used by stakeholders and Western European local governments, and how this usage can be measured and explained. Through the use of existing literature and prior studies this doctoral dissertation first identifies a gap in the knowledge of SM usage (caused by a recent paradigmatic shift from analogue to the digital world). As the next step, it identifies inter-relations of relevant factors towards a continuance use intention or perpetuation of Facebook, and establishes new metrics of corporate Facebook measurement (which may be applicable to most SM). Based on these metrics and avenues it later investigates methods of stakeholders� engagement, transparency, voluntary reporting and Facebook activity in 2012 and 2013. In so doing, it broadens the toolkit of this new research area and provides new evidence of voluntary reporting, transparency and stakeholders� engagement in 15 Western European countries. Importantly, it is the first work to examine this multidisciplinary research field from the aforementioned different perspectives. The establish of new metrics for measuring popularity, commitment, virality and engagement on corporate Facebook and the analyzes of 75 Western European municipalities for scholars contribute valuable interpretations of how social media (most particularly Facebook) may have functioned over the course of the study period and how the identified features and practices responded to the changing business and social environments. Our understanding benefited significantly from these 4 basically independent, but still coherent researches examining: continued use intention of Facebook; establishing metrics for measurement; and combining the content and media types of the posts and the different levels of engagement metrics with stakeholders and local governments behaviors, expectations and changed needs. Patterns were likely to be observed across the examined population detecting differences among different public administration styles. The conclusions from this original project may be placed within the context of the wider social sciences debates. The need for new, relevant and more diverse studies is emphasized to advance the interpretations of current economic and social changes of Western Europe by expanding research to multiple countries and integrating research findings.


Motives: IT is nowadays an effective tool supporting management in many fields, including management of urban greenery. Only a few cities in Poland have launched a dedicated urban greenery management system (UGMS). The need to provide all cities in the country with such a possibility gave birth to the idea of developing a concept using existing Land Administration System (LAS) infrastructure connected with INSPIRE Geoportal which can provide more than 75% of the information for urban greenery management.Aim: The main aim of this study was to propose the functional and database concept of a fit-forpurpose urban greenery management system (UGMS) in Poland as a universal tool for different types of urban greenery management bodies (UGMB) and a consistent information platform covering the entire country based on LAS referred to as the Integrated Real Estate Information System (IREIS), and the INSPIRE Geoportal service. The UGMS concept can be implemented in the other Member States of the European Union and other countries that have LAS and SDI like INSPIRE.Results: This approach develops a cost-effective information system that contains comprehensive information from the existing SDI in Poland and can be used by all Polish cities. The system will provide UGMB with access to data that is required for the performance of their statutory duties. Previous accomplishments, EU recommendations, and national experiences in spatial planning have been taken into account in the design process. In line with the fit-for-purpose concept, the relevant needs were determined during a survey of selected public administration authorities responsible for urban greenery. As a result, the scope of data required to create the UGMS was defined in the context of system functionalities. In addition, potential sources of data for the UMGS and their location in the NSDI were identified.


This revised edition of "Laboratory Outlines in Biology" offers students a variety of exercises on plants - for example, biological co-ordination and plant development. All experiments have been revised to reflect modern usage in biological terminology. Also included are exercises on fertilization and early development in animals, along with two new experiments on molecular biology including one on recombinant DNA.


On orders from the White House, NASA managers last week told Congress they intend to cancel plans for a Pluto flyby and a mission to study the solar wind. The agency is also following orders to make major cuts to the international space station after acknowledging huge cost overruns in the orbiting lab. Meanwhile, the president has called for a blue-ribbon panel of scientists to decide whether the space agency should swallow up the ground-based astronomy program run by the National Science Foundation.


The main features of the future mobile communication systems are the provisioning of high-speed data transmissions (up to 1 Gb/s) and interactive multimedia services. For effective delivery of these services, the network must satisfy some strict quality-of-service (QoS) metrics, defined typically in terms of maximum delay and/or minimum throughput performances. According to this general vision, the integration of different layered network plays one of the most important roles in the next telecommunication systems, for this reason, the paper studies the performance of a routing algorithm, well suited for an integrated Satellite-High Altitude Platform (HAP) system, in terms of network dimension and scalability in order to guarantee an adequate quality of service to multimedia traffic connections.


UNLABELLED
Down syndrome (DS) is an autosomal chromosomal disorder caused by trisomy of all or a critical part of chromosome 21. Individuals with DS have high levels of oxidative stress throughout their lifespan. It has been suggested that levels of antioxidants could be altered in response to an infection or disease.

AIM
To assess the total antioxidant capacity (TAC), nitric oxide (NO), and sialic acid (SA) of saliva in children with DS and its relation to their oral health status.

MATERIALS AND METHODS
Thirty-four noninstitutionalized children in the age group of 7-12 years having DS formed the study group. The control group consisted of 34 normal, healthy children. The W.H.O. criteria were used for diagnosis and recording of dental caries. Oral hygiene status was assessed using the simplified oral hygiene index. Estimation of TAC, NO, and SA levels in saliva was done. Data obtained were subjected to statistical analysis.

RESULTS
In comparison to normal children, DS children showed significantly lower TAC of saliva and significantly higher salivary SA levels. In both groups of children, dental caries was higher in primary dentition when compared to their permanent dentition.


Smart home products continue to rise in popularity but have yet to achieve widespread adoption. There is little research on how the general population perceives benefits of different smart home devices beyond general surveys. Using a living laboratory of five solar houses that we equipped with a range of smart home devices, we assessed how university student residents learn about, use, and gain interest in adopting this smart home technology. Analysis of data confirms that users find lifestyle benefits to be the most important motivators for adopting smart home technology. Yet without training in using that technology these benefits do not outweigh the risks associated with learning to operate that technology.


AbstractMaintenance of peripheral tolerance is essential for homeostasis of the immune system. While central tolerance mechanisms result in deletion of the majority of self-reactive T cells, T lymphocytes specific for self-antigens also escape this process and circulate in the periphery. To control the development of autoimmunity, multiple mechanisms of peripheral tolerance have evolved, including T cell anergy, deletion, and suppression by regulatory T (Treg) cells. The pathway consisting of the programmed cell death 1 (PD-1) receptor (CD279) and its ligands PD-L1 (B7-H1, CD274) and PD-L2 (B7-DC; CD273) plays a vital role in the induction and maintenance of peripheral tolerance. This pathway also regulates the balance between stimulatory and inhibitory signals needed for effective immunity and maintenance of T cell homeostasis. In contrast to this important beneficial role in maintaining T cell homeostasis, PD-1 mediates potent inhibitory signals that prevent the expansion and function of T effector cells and have detrimental effects on antiviral and antitumor immunity. Despite the compelling studies on the significant functional role of PD-1 in mediating inhibition of activated T cells, little is known about how PD-1 blocks T cell activation. Here, we will provide a brief overview of the signaling events that are regulated by PD-1 triggering, and we will discuss their implications on cell intrinsic and extrinsic mechanisms that determine the fate and function of T effector cells.


As part of formative and summative assessments in programming courses, students work on developing programming artifacts following a given specification. These artifacts are evaluated by the teachers. At the end of this evaluation, the students receive feedback and marks. Providing feedback on programming artifacts is time demanding and could make feedback to arrive too late for it to be effective for the students' learning. We propose to combine software testing with peer feedback which has been praised for offering a timely and effective learning activity with program testing.
In this paper we report on the development of a Web platform for peer feedback on programming artifacts through program testing. We discuss the development process of our peer-testing platform informed by teachers and students.


We study averaging algorithms, when implemented in large networks of wirelessly connected elements. We extend the notion of ¿increasing correctness¿ (IC) which was defined for cycle-free graphs, to general graphs. An averaging algorithm that is IC has meaningful outputs at each iteration. This makes it possible to stop the algorithm at any time, and use the output values computed up to that time. We prove that the class of IC averaging algorithms is nontrivial. We then present a simple IC averaging algorithm that is based on ideas from graphical models, and study its properties. Finally, we give example applications and simulations of IC averaging algorithms.


Lesions that appear hyperintense in both Fluid Attenuated Inversion Recovery (FLAIR) and T2-weighted magnetic resonance images (MRIs) of the human brain are common in the brains of the elderly population and may be caused by ischemia or demyelination. Lesions are biomarkers for various neurodegenerative diseases, making accurate quantification of them important for both disease diagnosis and progression. Automatic lesion detection using supervised learning requires manually annotated images, which can often be impractical to acquire. Unsupervised lesion detection, on the other hand, does not require any manual delineation; however, these methods can be challenging to construct due to the variability in lesion load, placement of lesions, and voxel intensities. Here we present a novel approach to address this problem using a convolutional autoencoder, which learns to segment brain lesions as well as the white matter, gray matter, and cerebrospinal fluid by reconstructing FLAIR images as conical combinations of softmax layer outputs generated from the corresponding T1, T2, and FLAIR images. Some of the advantages of this model are that it accurately learns to segment lesions regardless of lesion load, and it can be used to quickly and robustly segment new images that were not in the training set. Comparisons with state-of-the-art segmentation methods evaluated on ground truth manual labels indicate that the proposed method works well for generating accurate lesion segmentations without the need for manual annotations.


BACKGROUND
Disturbances of smell and taste are common. About 5% of the general population have anosmia (absence of the sense of smell). Olfactory dysfunction can markedly impair the quality of life.

METHODS
Review of pertinent literature retrieved by a selective search.

RESULTS
In recent years, simple and reliable tests of the sense of smell have been introduced in otorhinolaryngology. Olfactory testing has become a new focus of attention in neurology as well, mainly because many patients with neurodegenerative diseases-including the majority of those with Parkinson's or Alzheimer's disease-have olfactory loss early on in the course of their disorder. Olfactory dysfunction is thus regarded as an early sign of neurodegenerative disease that may allow a tentative diagnosis to be made years before the motor or cognitive disturbances become evident. As for the treatment of olfactory loss, anti-inflammatory drugs and surgery can help in some cases, and olfactory training can lead to significant improvement of post-viral olfactory deficits.

CONCLUSION
Olfactory dysfunction is common and becomes more common with advancing age. It is increasingly receiving attention as an important sign for the early diagnosis and the differential diagnosis of neurodegenerative disorders.


Why does Swaziland remain authoritarian despite the democratic political changes that have occurred in the other parts of the African continent since the 1990s? Does it mean that Swaziland is immune to political change? The answers to these questions are diverse and wide-ranging from the international relations view to the radical perspectives and to the functionalist view. But the tendency of these views is to analyse Swazi politics according to historically constructed and particularised contexts and dynamics without fusing the wide-ranging factors that play various roles in the politics of the country. One of the major assumptions by these views is that the state (royal family) and the nation (subjects) are the same as was the case in the pre-colonial period and that the state has a sole privilege to cultural instrumentalism. These views therefore have a tendency to explain political change in terms of class structure and capital relations without taking the multifunctional dimensions of culture into consideration. This paper brings together the various views to explain political resistance in the country in terms of a cleavage between the state and the nation. It provides a historical overview of the political transformation in the country within a framework of cultural nationalism. The thrust of the paper is to look at how the royal family has survived between a primordial and constructivist perspective to political change from the colonial to the post-colonial period. It subjects both the incumbent and the opposition onto a critical analysis and points out a possible direction for political resolve.


In earlier experiments, exogenous administration of secretory leukocyte protease inhibitor (SLPI) suppressed acute lung injury induced by deposition of IgG immune complexes. In the current studies we examined the mechanism of the protective effects of SLPI in this model. The presence of SLPI in the IgG immune complex-model of lung injury reduced the increase in extravascular leakage of 125I-albumin, the intensity of up-regulation of lung vascular intercellular adhesion molecule-1, and the numbers of neutrophils accumulating in the lung. The presence of SLPI caused greatly reduced activation (ie, nuclear translocation) of the transcription nuclear factor-kappaB (NF-kappaB) in lung cells but did not suppress activation of lung mitogen-activated protein kinase. SLPI did not alter NF-kappaB activation in alveolar macrophages harvested 30 minutes after initiation of lung inflammation. In the presence of SLPI, content of tumor necrosis factor-alpha, CXC chemokines, and C5a in bronchoalveolar fluids was unaffected. In the inflamed lungs, inhibition of NF-kappaB activation by SLPI was associated with elevated levels of lung IkappaBbeta (but not IkappaBalpha) protein in the absence of elevated mRNA for IkappaBbeta. When instilled into normal lung, SLPI also caused similar changes (increases) in lung IkappaBbeta. Finally, in the lung inflammatory model used, the presence of anti-SLPI caused accentuated activation of NF-kappaB. These data confirm the anti-inflammatory effect of SLPI in lung and point to a mechanism of anti-inflammatory effects of SLPI. SLPI appears to function as an endogenous regulator of lung inflammation.


Background and objectives: Department of Pharmacy Service, Srinagarind Hospital has provided 19 types of drug zip bag with different instructions so that the patient can read and understand the instruction for drug use by themselves. This study was aimed to explore the knowledge and understanding of patients about special instructions on drug zip bags. Method: This study was a prospective descriptive study performed in patients who underwent outpatient pharmacy service at Srinagarind Hospital during 15 August to 15 September 2012. Structural questionnaires were used data were analyzed using descriptive statistics and presented in terms of frequency and percentage. Result: There were 400 patients recruited into this study. The respondents were both males (36.2%) and females (63.8%). Before drug use, most of patients (88.0%) read either labels about instruction for use or special instructions on the drug zip bags but 12.0% of patients read only the labels. Most of patients (84.3%) knew that Srinagarind Hospital had many types of drug zip bags and 86.0% of patients knew that different drug zip bags contained different instructions. In part of drug use, 95.3% of patients always read and 95.5% of patients always followed special instructions on the drug zip bags. In part of knowledge and understanding, data were analyzed with 9 types of drug zip bags. Correct answer about how to take medicine were mostly (96.2%) found in patients with label "Take it before bedtime" and correct answer about special instruction were mostly found (25.0%) in patients with drug zip bag P10 (Antithrombotic drug). In part of other recommendation, patients suggested that the drug zip bags should provide informations about indication (52.1%), side effect (18.4%) and expiration date (17.6%). Conclusion : Most patients read the label and special instructions on the drug zip bags and understood how to use drug properly. However, they lack of understanding about detail in special instructions. Most patients were still need more information particularly information about indication of drug. Keyword: Knowledge, Understanding, Special instruction, Drug Zip Bags


Reform of Lebanon's pension system is indispensable. The country already faces fiscal sustainability risks, which will be compounded in the future by significantly higher pension- related spending and liabilities, mainly reflecting adverse demographics. In addition to sustainability issues, the pension system also suffers from equity shortcomings – Lebanon is the only MENA country that does not offer social security for retirees in the private sector. While several reform proposals have been formulated since the early 2000s, none has been implemented to date. Costs mount with every year of delay, so action is required soon to address these challenges.