Confidence intervals often are recommended as a means of communicating the extent to which individual test scores may be influenced by measurement error. However, test manuals and assessment texts vary widely in their recommendations about how confidence intervals should be constructed, and several contain misinterpretations of classical test theory. The most widely used procedure for constructing confidence intervals misrepresents the likely distribution of true scores, and confidence intervals constructed with it will be inaccurate, especially when extreme scores are involved. The various procedures for constructing confidence intervals that have been suggested in measurement texts are examined in relation to their approximation to the most accurate procedure that uses the estimated true score as the center of the confidence interval and the standard error of estimate to determine the width. In addition, the problems of applying these procedures to norm-referenced scores are discussed—an issue that has been largely ignored in the assessment literature and that leads to further misinterpretations of confidence intervals.


This article puts to the test the ascription of the authorship of the brTsod pa'i de nyid – a short versified Tibetan treatise on debate – to gTsang nag pa brTson 'grus seng ge (?–after 1195). It addresses the issue of its dating and authorship by comparing the central section with the excursus on debate in gTsang nag pa's commentary on Dharmakīrti's Pramāṇaviniścaya and by exploring specific nicknames mentioned in the brTsod pa'i de nyid for arguments by consequence (thal 'gyur).


The attack of dry air or oxygen upon copper becomes appreciable somewhere in the neighbourhood of 200° C. The mechanism of the reaction in this temperature range has been studied by a number of authors but the absence of unanimity in their conclusions is remarkable. It is evident that the oxidation of a metallic surface may result in the formation of a protective oxide film, and that continued oxidation may be controlled by the diffusion of oxygen through the film rather than by factors which are normally described as chemical. Under these circumstances the progress of oxidation is precisely similar to the flow of heat and is subject to the same laws. If c is the concentration of oxygen at a distance y from the oxide—oxygen surface after a time t then D δ2 c /δ y 2 = δ c /δ t .


The current study examined the factors underlying native Hebrew speakers' ability to learn homophonous affix spelling. It takes a novel view in investigating the effect of morpho-orthographic complexity of affix representation on the development of affix spelling across the school years. The role of five morpho-orthographic principles in homophonous affix letter spelling was studied: (i) morpho-orthographic transparency; (ii) affix letter prevalence; (iii) morpho-phonological competition; (iv) overtness of the phonological-orthographic link; and (v) phono-morpho-orthographic consistency. Taken together, these five principles of affix spelling constitute complexity metrics that pinpoint the loci of spelling challenge in homophonous Hebrew affixes. Study participants were 83 monolingual Hebrew-speaking students in four grade levels – 2nd, 4th, 7th, and 10th grades. The research instrument was a spelling task of 244 words containing affix letters in 57 morphological categories. The affixes appearing in the target words represented 56 different affix categories, covering all non-root morphological roles, both inflectional and derivational. While correct spelling increased across grade levels, a hierarchy emerged in interaction with grade level regarding these criteria: Younger spellers were mostly assisted by morpho-orthographic sites, morphological category frequency, and phonological transparency – while spelling in higher grade levels was more affected by morpho-orthographic prevalence. Thus, knowledge of how morphological roles are deployed in the orthography emerges as the most significant factor that affects learning to spell affix letters in Hebrew.


We study the nonequilibrium time evolution of a variety of one-dimensional (1D) and two-dimensional (2D) systems (including SSH model, Kitaev-chain, Haldane model, p+ip superconductor, etc.) following a sudden quench. We prove analytically that topology-changing quenches are always followed by nonanalytical temporal behavior of return rates (logarithm of the Loschmidt echo), referred to as dynamical phase transitions (DPTs) in the literature. Similarly to edge states in topological insulators, DPTs can be classified as being topologically protected or not. In 1D systems the number of topologically protected nonequilibrium time scales are determined by the difference between the initial and final winding numbers, while in 2D systems no such relation exists for the Chern numbers. The singularities of dynamical free energy in the 2D case are qualitatively different from those of the 1D case; the cusps appear only in the first time derivative.


The algorithms based on classical Multidimensional Scaling (MDS) only need 3 or 4 anchor nodes and can provide higher accuracy than other schemes. But it's high computational complexity and large energy consumption cause its shorter lifecycle, so an improved positioning algorithm for Wireless Sensor Networks (WSN) is presented in the paper. It reduces distance matrix involved and fully uses nodes with ranging capability. We conduct simulation studies under square shaped topologies with different communication radius, different connectivity levels and different number of anchors. Simulation results show that improved MDS provides a lower position estimation error than classical MDS and have less running time. In the end, some parameters are suggested, which can make WSN get the optimal network performance.


Has the EU Directive Proposal on CO2 trade been influenced by lobbyism and can it be improved? After hypothesizing how the EU may be vulnerable to lobbyism and why industrial groups have a strong incentive to lobby for favourable environmental regulation, we turn to empirical evidence concerning design. Here, it is possible to measure lobbyism as the difference in proposed design between the Green Paper (before lobbyism) and the final Directive Proposal (after lobbyism). Overall we suggest that this lobbyism affected the design of the EU CO2 market in favour of small-sized and well-organised industrial interest groups at the expense of the EU tax payers. Most critically, allocation of permits and enforcement issues are to be dealt with at the member state level rather than the supranational level allowing member states to favour their domestic industries. A likely market breakdown means less economic growth in the EU because the gains from free trade of greenhouse gas permits among firms in different member states disappear. Therefore, we discuss, based on the US emission trade experience, how the current design proposal can be improved.


PURPOSE OF REVIEW
There is a growing understanding of complications and anomalies associated with infantile hemangiomas. The current review will discuss recent clinical advances in syndromes associated with segmental hemangiomas, including PHACE and LUMBAR syndrome. In addition, the importance of recognizing visceral hemangiomatosis is highlighted.

RECENT FINDINGS
Ongoing longitudinal studies of PHACE and LUMBAR syndromes associated with segmental infantile hemangiomas have led to improved diagnosis and recommendations for screening for associated anomalies. Characterization of a growing spectrum of associated anomalies as well as better classification of at-risk patients will improve diagnosis and outcomes. In addition, visceral hemangiomatosis recognition and understanding of the potential association with consumptive hypothyroidism will improve initiation of appropriate screening.

SUMMARY
Clinicians should be aware of infantile hemangiomas associated with potential syndromic complications and recognize the need to initiate appropriate work-up. Segmental hemangiomas of the head and neck region may indicate a risk of PHACE syndrome and associated developmental anomalies. Although LUMBAR syndrome is the association of lower body segmental hemangioma with developmental anomalies. Visceral hemangiomas most commonly affect the liver and may be associated with complications such as consumptive hypothyroidism and heart failure.


Abstract This paper describes observed changes in surface winds, sea surface temperature (SST), and the volume of water warmer than 20°C (WWV) in the equatorial Pacific Ocean for the period 1980–99. The purpose is to test recent hypotheses about the relationship between variations in WWV and the El Nino–Southern Oscillation (ENSO) cycle. The results confirm inferences based on theory, models, and previous empirical analyses using proxy data (namely sea level) that ENSO involves a recharge and discharge of WWV along the equator and that the cyclic nature of ENSO results from a disequilibrium between zonal winds and zonal mean thermocline depth. The authors also find that the magnitude of ENSO SST anomalies is directly related to the magnitude of zonal mean WWV anomalies. Furthermore, for a given change in equatorial WWV, the corresponding warm El Nino SST anomalies are larger than the corresponding cold La Nina anomalies. This asymmetry between the warm and cold phases of the ENSO cycle implies differences...


Enterprises are increasingly moving their production workloads to the cloud to take advantage of capabilities, such as streamlined provisioning of infrastructure and services, elasticity, scalability, reliability, and security. To leverage such capabilities, monolithic applications typically have to be decomposed to cloud-native architectures, such as microservices. A microservice encapsulates a small and well-defined set of business functionalities and interacts with other services using lightweight mechanisms, often implemented as RESTful APIs. A recent report shows that only 20% of the enterprise workloads are in the cloud, and they were predominately written for native cloud architectures. This leaves 80% of legacy applications onpremises, waiting to be refactored and modernized for the cloud. In this tutorial, we will discuss the motivation---supported by illustrative industrial case studies---for modernizing and migrating legacy applications to cloud. We will then present a detailed tool-supported approach for transforming a monolithic Java application into microservices. This will be followed by a handson virtual lab, where participants will have the opportunity to apply the learned concepts on a real-world enterprise application. Finally, we will conclude the tutorial with a discussion of promising directions for future research more broadly in the area of application modernization.


ABSTRACT: Gin trash and pearl millet stover were used as mulches in the blank rows of a two-planted, two-blank-row (1-m spacing) planting pattern (2×2) for rainfed cotton (Gossypium hirsutum L.) over 4 years. Mulches were applied only one time, April 26, 1982. Gin trash was applied at rates of 7, 23, and 40 Mg/ha (3, 10, and 18 tons/acre), which gave soil coverages of about 30%, 80%, and 95%, respectively. Pearl millet was applied at rates of 10, 20, and 30 Mg/ha (4.5, 9, and 13.4 tons/acre); soil coverages of about 85%, 95%, and 100%, respectively. Check plots were not mulched. Effectiveness of the mulches was ascertained from soil water determinations and lint yields. In 1982, average lint yield on all mulched plots was 53% greater than that on check plots. Insufficient soil water in the planting zone precluded establishment of cotton in 1983 and 1984, but in 1985 cotton was established in the same plots that were used in 1982. Lint yields of mulched plon averaged 13% more than those of check plots. During the 4-year study, plots that had received the greatest amounts of mulch (essentially 100% ground cover initially) consistently had the most soil water. Millet-mulched plots consistently had more stored water than their gin trash counterparts. Producers should be able to significantly increase soil water storage and, hence, increase lint yields and reduce soil erosion losses by the consistent use of mulches of gin trash, millet stover, or comparable organic materials.


Successful herbicides, like drugs, have physico-chemical properties that usually fall within certain limits. A recent analysis of 334 herbicides showed similar properties to the 'rule of five' for human orally-delivered drugs, but herbicides diverged from this for proton donors, partition coefficients and molecular weight. To refine rules for herbicides, we exploited the close evolutionary relationship between P. falciparum and plants by screening the Malaria Box, a 400-compound library composed of novel chemical scaffolds with activity against blood stage malaria parasite Plasmodium falciparum. A high proportion (52 of 400) were herbicidal to Arabidopsis thaliana on agar plates. Thirty-nine of these 52 herbicidal compounds were tested on soil and 16 compounds were herbicidal. These data were used to predict whether a herbicidal hit found on agar will work on soil-grown plants. The physico-chemical parameters were weighted to logP and formal charge and used to generate weighted scores to a large chemical library of liver-stage effective antimalarial leads. Of the six top-scoring compounds, one had a potency comparable to commercial herbicides. This novel compound MMV1206386 had no close structural matches among commercial herbicides. Physiological profiling suggested that MMV1206386 has a new mode of action and overall demonstrates how weighted rules can help during herbicide discovery programs.


The authors made a study of the antihistaminic properties of Pipoxizine in 20 subjects with proven histaminic hyperreactivity. The design of the trial consisted in comparing the changes of VC, FEC1, expiratory airway resistance and V50 produced by a histamine aerosol given before and after administration of Pipoxizine. Pipoxizine was given by mouth to 10 patients and intravenously to the other 10 of the group. The statistical analysis of the results demonstrated an antagonist effect of Pipoxizine on the histamine induced bronchoconstriction. The data of this trial are confirmative of the results of other experimenters. It seems therefore reasonable to take into consideration the use of Pipoxizine in the preventive treatment of the paroxystic attacks of the asthmatic disease.


Proc Amer Assoc Cancer Res, Volume 47, 2006

5404

Previous studies have demonstrated that genetic polymorphisms in the estrogen receptor-alpha ESR1 gene are associated with altered risk of breast cancer. Given that ESR1 is an important mediator of hormonal responses in the endometrium, and that estrogen exposure is the prevailing risk factor for endometrial cancer, we hypothesized that genetic variations in the ESR1 gene may modulate the effects of estrogen exposure and thus alter endometrial cancer risk. We tested this hypothesis using data from a large population-based case-control study of endometrial cancer conducted in Shanghai, China, from 1997-2003. Included in this analysis were 1039 cases and 1026 age-matched community controls who had completed an in-person interview and donated a blood or exfoliated buccal cell sample to the study. Genotyping of ESR1 polymorphisms XbaI (rs9340799), and PvuII (rs2234693) in intron 1, and C →G Pro in codon 325 (rs1801132) were performed using the TaqMan method. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate associations between genetic variations of the ESR1 gene and endometrial cancer risk. In addition, ESR1 gene polymorphisms were evaluated for their role in modifying endogenous and exogenous estrogen exposures. Overall, no apparent association between endometrial cancer and the XbaI, PvuII, or Pro325 polymorphism was found. Similarly, haplotype analyses also did not reveal any associations that were statistically significant. Furthermore, we did not find that variants at these sites modify the risk of endometrial cancer associated with various estrogen exposures as measured by menopausal status, waist-to-hip ratio, body mass index, age at menarche and menopause, years of menstruation, history of physical activity, oral contraceptive use, and soy protein intake. Taken together, these data, from one of the largest population-based case-control studies of endometrial cancer, do not suggest a major role of the XbaI , PvuII , and 325Pro polymorphisms in the ESR1 gene in the risk of endometrial cancer.


The 2015–2017 Zika Virus outbreak caused a high increase in patients with Guillain-Barré syndrome (GBS), a post infectious autoimmune disease of the peripheral nerves. The severity of GBS can range from mild impairment with fast recovery to complete paralysis including severe respiratory or autonomic failure. Recovery may take months and even years and may be incomplete despite disease modifying treatment with IVIG or plasma exchange. Therefore, optimal supportive care and effective rehabilitation remain crucial. Multidisciplinary rehabilitation is recommended but may be challenging in the acute phase because of limited patient participation due to profound muscle weakness and severe pain. Inactive denervated muscles will inevitably undergo rapid degeneration resulting in wasting, weakness, and contractures as major long-term complications in severely affected patients. In this chapter, the current evidence of rehabilitation on the short- and long-term motor function in GBS is reviewed, including newly obtained experiences with neuromuscular electrical stimulation (NMES). Rehabilitation remains an area lacking well designed and controlled clinical studies and thus a clear lack of evidence-based guidelines.


Background: Breast arterial calcification (BAC) on mammography correlates with increased cardiovascular risk. Reporting BAC is not standard practice. Our study evaluates the awareness of Canadian radiologists who report mammography of the clinical significance of BAC and their attitudes towards reporting BAC compared to their European and American counterparts. Methods: Following local institutional ethics approval, a 25 question survey (SurveyMonkey) was disseminated to Canadian radiologists via provincial and national society email lists. Responses were collected over 5 weeks (April–June 2022). Results: One hundred and eighty-six complete responses were collected. Sixty percent (112/186) were aware of the association between BAC and cardiovascular risk and 16% (29/186) document its presence in mammogram reports. Thirty five percent (65/186) occasionally document BAC if severe or in a young patient. Four percent (7/186) had local departmental guidelines on BAC reporting and 82% (153/186) agreed there is a need for national BAC reporting guidelines. Fewer Canadian radiologists were aware of the association between BAC and cardiovascular risk compared to European radiologists (60% vs 81%), report the presence of BAC compared to both European (15% vs 62%) and American (15% vs 35%) radiologists, and inform the patient of the presence of BAC compared to European radiologists (1% vs 46%). Conclusion: Canadian radiologists who report mammography were less aware of the association between BAC and cardiovascular risk than their European and American counterparts and were less likely to document the presence of BAC. Given the correlation of BAC with increased cardiovascular event risk, there is increased need for awareness as well as national BAC reporting guidelines. Graphical Abstract


Normal synaptic function and fear learning require glycosylation of the apolipoprotein E receptor Apoer2. This Podcast features an interview with Catherine Wasser and Joachim Herz, authors of a Research Article that appears in the 25 November 2014 issue of Science Signaling, about modifications to an apolipoprotein E receptor that affect synaptic plasticity and learning. Apolipoprotein E (ApoE) is a lipoprotein that helps transport fat-soluble molecules, such as cholesterol, around the body. In the brain, ApoE delivers cholesterol to neurons by binding to ApoE receptors, which triggers endocytosis of the cargo borne by the ApoE aggregates. ApoE receptors can also initiate intracellular signaling in response to binding to other ligands, such as Reelin. Signaling by the ApoE receptor Apoer2 controls neuronal migration during development, affects synaptic plasticity, and helps break down the β-amyloid plaques associated with Alzheimer's disease. Wasser et al. report that differential splicing and posttranslational modification of Apoer2 affects synaptic plasticity and learning in mice.


Particle swarm optimization (PSO) is an evolutionary computation technique developed by Kennedy and Eberhart in 1995 and has been applied successfully to various optimization problems. The PSO idea is inspired by natural concepts such as fish schooling, bird flocking and human social relations. It combines local search (by self experience) and global search (by neighboring experience), possessing high search efficiency. Backpropagation (BP) is generally used for neural network training. It is very important to choose a proper algorithm for training a neural network. In this paper, we present a modified particle swarm optimization based training algorithm for neural network. The proposed method modify the trajectories (positions and velocities) of the particle based on the best positions visited earlier by themselves and other particles, and also incorporates population diversity method to avoid premature convergence. Experimental results have demonstrated that the modified PSO is a useful tool for training neural network


other allergic reactions have occurred from handling the chemicals carelessly. Infections Due To Mosquitoes: The dyeing of the above materials is usually undertaken in sunken pits in the ground or in big earthen pots in or outside the houses. These receptacles provide constant breeding places for mosquitoes that are responsible for yellow and dengue fevers, as well as mosquito borne filariasis. Poisoning: Accidental poisoning of certain illiterate


Introductionthe management of the curriculum in teacher training within the Catholic University of Salta in the School of Education and Teacher Improvement, this thought from a deductive perspective in which theoretical processes are established that allow the explanation of the curriculum in terms of teacher training and its impact on the organizational articulation. Objectiveto specify a strategic articulated intervention device that requires the constitution of a new emancipatory discourse. Materials and methodsWe present a qualitative research that analyzes the problems and variables established in the study. ResultsThe process of rupture leads us to reflect on the teaching position in the face of praxis, on the processes of "learning to teach" which involves continuous training. DiscussionThis perspective points to the development of certain skills that are developed over time of the formation through diverse strategies Conclusionsthe development of the professional competences of the teacher that confront with the disciplinary approach from an innovative glance


Porous silica particles grafted with various stimuli-responsive polymers are investigated with great interest for their use as smart pharmaceutical nanocarriers in advanced drug delivery systems (DDS). In particular, porous silica particles grafted with thermoresponsive polymers that exhibit thermally triggered on/off gating mechanisms have shown improved performance as hybrid DDS capable of controlling the release of different drugs in various mediums which resemble complex biological environments. In addition, the tuning of the drug release profiles as per requirements has proved possible with modifications to the porous core and the grafted thermoresponsive polymers. This highlight presents a brief discussion of basic preparation techniques and some recent significant developments in the field of thermoresponsive polymer grafted porous silica particles as smart pharmaceutical nanocarriers.


During pregnancy, placental vascular growth is associated with marked elevations in blood flow, which is essential for supporting the rapidly growing fetus. These vascular changes take place under chronic physiological low O2 (< 2 to 8% O2 in human, chronic physiological normoxia, CPN) throughout pregnancy. O2 level below CPN pertinent to the placenta results in placental hypoxia. Such hypoxia can cause severe endothelial dysfunction, which is associated with adverse pregnancy outcomes (e.g., preeclampsia) and high risk of adult-onset cardiovascular diseases in children born to these pregnancy complications. However, our current knowledge about the mechanisms underlying fetoplacental endothelial function is derived primarily from cell models established under atmospheric O2 (~21% O2 at sea level, hyperoxia). Recent evidence has shown that fetoplacental endothelial cells cultured under CPN have distinct gene expression profiles and cellular responses compared with cells cultured under chronic hyperoxia. These data indicate the critical roles of CPN in programming fetal endothelial function and prompt us to re-examine the mechanisms governing fetoplacental endothelial function under CPN. Better understanding these mechanisms will facilitate us to develop preventive and therapeutic strategies for endothelial dysfunction-associated diseases (e.g., preeclampsia). This review will provide a brief summary on the impacts of CPN on endothelial function and its underlying mechanisms with a focus on fetoplacental endothelial cells.


National economic growth is an aggregate of regional economic growth. Economic growth inboth national and local level is closely related to the performance of the productions of goodsand services, which measured by massive increase in the amount of the Gross Domestic Product(GDP) and Regional Gross Domestic Product (RGDP) for the region. Lampung province'seconomic growth performance is high enough but on the other hand had to be paid by landconversion. This study aims to determine the dynamic of changes in land cover and forest and itsimpact on agriculture, forestry and industrial earnings. Data collected consist of satelitte imageof lampung province RGDP in agricultural sector, RGDP in foresty sector, RGDP in industrialsector and population density data. The result showed that there was a significant relationshipbeetwen changes in private forest cover by 11.055 (p= 0.062), rice field by 7.982 (p= 0.082), andpopulation density by -8.676 (p= 0.000) to the RGDP in agricultural sector. RGDP in theforestry sector is affected significantly by the national forest cover by 1.160 (p= 0.00)and other land use by -0.803 (p= 0.061). RGDP in the industrial sector is influenced significantly byprivate forest -7.434 (p= 0.077), and plantation by 5.471 (p= 0.00).

Keyword : RGDB agriculture sector, RGDB forestry sector, RGDB industri sector


Energy storage is becoming a basic component of modern renewable power plants, especially wind farms. For several considerations, local wind turbine (WT) energy storage is preferred. Flywheel energy storage is among the most promising storage systems regarded for wind applications. This paper proposes a new architecture for flywheel energy storage based on doubly fed induction machine (DFIM) where the open winding stator of the machine is connected in series between the grid and the wind turbine grid side converter. In this architecture, the flywheel-converter is of partial power rating, and is connected to the DFIM rotor. The paper proposes the control concept and thorough simulations test the performance parameters of the system under normal and abnormal operating conditions. Results and analyses indicate smooth dynamic operation, the economic advantage and the improved WT frequency support capability and fault ride through due to the proposed system.


D-Xylose isomerase is a heat-stable enzyme which isomerizes D-xylose into D-xylulose. D-Xylose isomerase from various species also isomerizes D-glucose into D-fructose. This enzyme is used in industry for the production of high-fructose corn syrup. The enzyme is specific for both, xylose and glucose. In most species xylose isomerase is localized intracellularly. However, in a rare actinomycete, Chainia sp. (NCL 82-5-1), xylose isomerase is present in both intracellular and extracellular compartments. We have previously purified and characterized intracellular enzyme from Chainia sp. In the present paper, we describe a procedure for immobilization of intracellular xylose isomerase on INDION 48-R by ionic binding. This method is inexpensive, does not require cross-linking agents and results in firm binding of the enzyme with the resin. The properties of immobilized enzyme such as pH optimum, substrate specificity, Km and inhibition by various metabolites are described and compared with those of purified, nonimmobilized enzyme.


Background: This study is concerned with the comprehension of ambiguous idiomatic statements in schizophrenic and depressive patients. Aims: Using a multiple-choice procedure, we simultaneously tested the presence of concrete and literal elements in the understanding of idiomatic statements. Method: Fourteen schizophrenic and 10 patients undergoing a major depressive episode as well as 14 control subjects completed a questionnaire with 10 idiomatic expressions with two possible interpretations (figurative and literal) of equivalent prominence. The participants had to choose one word linked with the different interpretations of these idioms (figurative, literal, concrete or inappropriate meaning). Results: The main results show that, in all the subjects, the contextual characteristics of the task induced a bias in favor of figurative interpretations despite the equivalent prominence of the literal interpretations of the idioms. The selection of responses relating to the concrete meaning of a single word in the idiom constituted a response mode common to both the schizophrenic and depressed patients. Despite the contextual constraints of the task, the schizophrenics opted for the literal responses more often than the other participants. The descriptive analysis argues in favor of a cognitive and clinical heterogeneity of schizophrenic patients. Conclusion: Results support the idea that literality and concreteness in idiomatic interpretation are possibly due to distinct cognitive impairments, though only some are specific to schizophrenic patients.


The reaction mechanism in the atomic layer deposition of Nb(2)O(5) from Nb(OEt)(5) and deuterated water was studied in situ with a quadrupole mass spectrometer (QMS) and a quartz crystal microbalance (QCM). The responses of these in situ measurement techniques to the characteristics of the ALD processes were thoroughly clarified and the process parameters carefully optimized. Also the effect of the reaction temperature on the extent of decomposition reactions of Nb(OEt)(5) interfering with the ALD process was investigated. Decomposition did occur at 400 degrees C but not at temperatures of 350 degrees C and below. Also the reaction mechanism was studied as a function of reaction temperature and found to be about the same until decomposition of the precursor started. Deuterated ethanol was found to be the most important gaseous byproduct of the ALD process but also some diethyl ether apparently formed. About one of the five ethoxide ligands of Nb(OEt)(5) was released during the Nb(OEt)(5) pulse and the rest during the D(2)O pulse. Finally separate experiments were performed to study the adsorption of ethanol as well as 2-propanol on the surface of Nb(2)O(5). Ethanol was found to adsorb. It could also be stated that water can replace the adsorbed ethanol. On the other hand 2-propanol apparently did not adsorb on the surface of Nb(2)O(5).


In this paper, we propose an approach to explore large texts by highlighting coherent sub-parts. The exploration method relies on a graph representation of the text according to Hoey's linguistic model which allows the selection and the binding of adjacent and non-adjacent sentences. The main contribution of our work consists in proposing a method based on both Hoey's linguistic model and a special graph mining technique, called CoHoP mining, to extract coherent sub-parts of the graph representation of the text. We have conducted some experiments on several English texts showing the interest of the proposed approach.


The afterglow emission from gamma-ray bursts (GRBs) is believed to originate from a relativistic blast wave driven into the circumburst medium. Although the afterglow emission from radio up to X-ray frequencies is thought to originate from synchrotron radiation emitted by relativistic, non-thermal electrons accelerated by the blast wave, the origin of the emission at high energies (HE; ≳GeV) remains uncertain. The recent detection of sub-TeV emission from GRB 190114C by the Major Atmospheric Gamma Imaging Cherenkov Telescopes (MAGIC) raises further debate on what powers the very high energy (VHE; ≳300 GeV) emission. Here, we explore the inverse Compton scenario as a candidate for the HE and VHE emissions, considering two sources of seed photons for scattering: synchrotron photons from the blast wave (synchrotron self-Compton or SSC) and isotropic photon fields external to the blast wave (external Compton). For each case, we compute the multiwavelength afterglow spectra and light curves. We find that SSC will dominate particle cooling and the GeV emission, unless a dense ambient infrared photon field, typical of star-forming regions, is present. Additionally, considering the extragalactic background light attenuation, we discuss the detectability of VHE afterglows by existing and future gamma-ray instruments for a wide range of model parameters. Studying GRB 190114C, we find that its afterglow emission in the Fermi-Large Area Telescope (LAT) band is synchrotron dominated. The late-time Fermi-LAT measurement (i.e. t ∼ 104 s), and the MAGIC observation also set an upper limit on the energy density of a putative external infrared photon field (i.e. ${\lesssim} 3\times 10^{-9}\, {\rm erg\, cm^{-3}}$), making the inverse Compton dominant in the sub-TeV energies.


OBJECTIVES
Cyclosporine has been thought to have a deleterious effect on bone in transplant recipients because of high turnover osteopenia observed in humans after transplantation. However, varying confounding factors such as renal and parathyroid function, cumulative steroid doses and previous exposure to aluminium, also play a role and hinder interpretation of the cyclosporine effect on bone mineral density (BMD).

PATIENTS AND METHODS
A 2-year prospective study was conducted to measure BMD starting 3 months after transplantation and bone remodeling markers from the first post-transplantation day in 52 kidney recipients with no prior exposure to aluminum. None of the patients experienced rejection and at 3 months all had good stable renal function (serum creatinine 137 mumol/l) and mildly elevated parathyroid hormone levels (1.5 times the upper limit of normal). All patients were given the same low dose steroid treatment (10 mg/day) and at 6 months cyclosporine was decreased from 7 to 4.8 mg/kg/day.

RESULTS
BMD measured by double energy X-ray absorptiometry, (DEXA) and expressed in Z score, was moderately decreased at 3 months for the vertebrae (-1.40), the femoral neck (-1.34) and the ultradistal radius (-0.95) which have predominantly cancellous bone and was significantly less decreased (p < 0.05) for the lower third of the radius (-0.6) which is mainly cortical bone. BMD measurements were comparable at 6, 12 and 24 months. When measured by axial computerized tomography (ACT) BMD of the vertebrae showed a non-significant increase of Z score from -1.37 to -1.19 at 2 years. Bone remodeling markers was observed up to month 6 (from month 3 for osteocalcine and from month 1 for total and bone alkaline phosphatase and urinary pyridinoline), then returned to baseline levels at 2 years in parallel with decreased cyclosporine dosage. The increase of vertebral BMD measured by ACT at 1 year was correlated both to cyclosporine dose at 1 year and to bone alkaline phosphatase at 6 months.

CONCLUSION
Our data confirm the presence of moderate osteopenia 3 months after transplantation, predominantly in trabecular bone, logically linked to the initial high doses of corticosteroids. The long-term stability of BMD measured by DEXA and the correlation of vertebral BMD increase measured by ACT with cyclosporine dose and bone alkaline phosphate suggest that cyclosporine had a beneficial immunosuppressor effect by stimulating bone remodeling and thus counterbalancing the suppressive effect of corticosteroids.


Phytoremediation is a cost effective and eco-friendly method for cleanup of contaminated soil. This study focused on the assessment of phytoremediation potential of Napier grass (Pennisetum purpureum) and Indian mastered (Brassica juncea) yielding in tannery sludge. Initial characterization of tannery sludge showed a high concentration of chromium, lead, copper and zinc which were 6845.5±50.2, 73±2.5, 93±1.5 and 29±2.5 mg/kg, respectively. Both seeds of these plants were sown on tannery sludge kept in baskets and harvested after 8 and 12 weeks of plantation. Analysis indicated that both Napier grass and Indian mustard accumulated heavy metals in the order of Cr>Zn>Cu>Pb at different parts of these plants. Transfer factor (TF) for both plants were greater than 1 for Cu, Zn, Pb though it was less than 1 for Cr. Indian mustard accumulated highest concentration of Cr, Cu, and Pb whereas Napier grass showed highest Zn uptake and good Cr and Cu accumulation capacity. The uptake rate of Cr increased in Napier grass with the increase of plant age. Moreover, Napier grass is one of the rapid yielding tropical grasses and can retain for a longer period than Indian mustard for that attribute, it may accumulate more heavy metals than Indian mustard within its life span. Both of these plants can be used for remediating heavy metals from contaminated tannery sludge.


Abstract. Important physiological processes, photosynthesis, respiration, carbon allocation and stomatal function are known to be affected by air pollutants. A wide range in sensitivity of photosynthesis both within and between species is evident from the literature for the pollutants sulphur dioxide, ozone, nitrogen oxide and hydrogen fluoride. Some of this variation is clearly due to genetic factors, but much is in response to differences in environmental conditions both prior to and during fumigation. Exposure of plants to mixtures of pollutants generally reduced the threshold at which effects were first detected and increased the level of inhibitory responses. In the majority of studies on stomatal responses to air pollutants, opening occurs at low concentrations, below the threshold for effects on photosynthesis, and closure occurs at injurious concentrations; this latter response often following the inhibition of photosynthesis. Effects on carbon allocation have been reported in response to air pollutants. Changes usually favour leaf development over root growth, which can compensate for a decline in net assimilation rate up to a certain point but may limit water uptake from soils with low moisture content. Future research into physiological effects of air pollutants should incorporate an integrated approach in which both key physiological parameters and growth parameters are measured together with estimates of the effective dose of pollutant. In this way, the underlying mechanisms to changes in growth and development will be more fully understood.


Room temperature vulcanizing fluorosilicone rubbers (FSRs) were prepared from polydimethylsiloxane (PDMS), vinyl fluorosilicone-oil (VFS-oil), and precipitated silica (PDMS/VFS/SiO2). Rheological tests showed appropriate processing condition could be obtained when shear rate > 10 s−1. Mechanical tests indicated that tensile strength and elongation at break were not much affected by VFS-oil and no decline was observed after being aged in 70 °C ASTM 1# oil. The CF3 group could not only increase oil-resistance, but also decrease surface energy, which were proved by ATR-FTIR and contact angle tests. The PDMS oil immersion tests showed that the higher the content of VFS-oil, the better oil resistance can be obtained. The solvent-resistance tests indicated that the VFS-oil improved resistance to nonpolar/low-polar solvent. TGA results showed that the increasing content of VFS-oil could slightly decrease FSRs' thermal stability but increase FSRs' residual mass ratio at 790°C. © 2013 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2014, 131, 39708.


An attempt was made to elucidate whether the hypothalamic paraventricular nucleus (PVN) is involved in carbohydrate homeostasis regulation in rats. The cellular responses to various disturbances of homeostasis were studied in the neuronal subdivisions (subnuclei) of the PVN. The responses were assessed in terms of changes in the sizes of the cell nuclei, nucleoli, and cytoplasm, and by the ultrastructural changes evident in cellular organelles. Significant cellular responses were observed in several subnuclei, with the nature of the responses being determined by the type of homeostatic alteration. The results indicate the possible involvement of the PVN subnuclei in the regulation of carbohydrate homeostasis.


The excretion of uterine estrogens was examined in 61 women: 20 with functional bleedings during climacterium 15 with uterine myoma 16 with cerivcal carcinomas and 10 with ovarian carcinomas. Results showed that there were considerable individual variations in estrogen excretion and anunvanlanced relationship of the fractions with estriol prevailing in all the groups. There was no significant difference in the amounts of estrogen excreted by women with funcional bleedings and those found in women with uterine myoma. Those women with cervical carcinoma did show considerably lower excretions than those of the other groups. The lowest level of excretion was found in those women with ovarian carcinoma. THese examinations did illustrate the considerable disturbances in the biosynthesis of estrogens in the ovaries of afflicted patients. The more advanced the condition the more prominent the disturbances were with imbalance of estriol prevailing.(Authors modified)


To enhance our users' ability to find physical items, University of Oregon Libraries created more precise location information within Primo. Creating an external integration which bypasses Alma location map links, we were able to pass the location code and call number to a mapping front-end service. This allowed us to highlight the specific ranges on each floor in our main library via a responsive tile service map. With the middleware we created, any well-formatted data can be parsed and normalized for use with a mapping front-end. Project goals included: providing sustainable location services that are rendered correctly even with stack shifts, integration into existing workflows in Access Services, and mobile device compatibility. In this presentation we will explain our item location map service, development of the look-up middleware which integrates location codes and call numbers with shelf position in the library, and the creation of the external integration within Alma.


1. Serum albumin levels have been estimated in healthy adult Nigerians. The average level of albumin was 41.4 g/l and there was no sex difference, but the findings differed from that of a previous survey in Ibadan. The importance of serum albumin measurement in relation to the socio-economic and dietary habits of the population has been reviewed. 2. It is concluded that socio-economic, dietary and cultural changes associated with Western education could be responsible for the increased level of serum albumin in this healthy population. 3. It is suggested that similar surveys should be done by locally-practising chemical pathologists.


Aim: Scientometric profile of Indian Journal of Pharmaceutical Research has been carried out in this study to highlight and identify the year-wise growth of publication and citation, authorship pattern, prolific organizations, countries, citation profile, international outreach, two year and five year impact factor trend during year 2007-2018. Materials and Methods: Web of science core collection database of Clarivate Analytics was used to retrieve the data using advance search feature. Search field IS=0019-5464 was used to extract the data. Document type "Correction" was excluded from the study. Software Vosviewer visualizing scientific landscape version 1.6.11 were used for keyword and co-author network analysis. Results: During 2007-2018 there were 997 papers published in Indian Journal of Pharmaceutical Education and Research with total citation 1714 and h-index 14. KLE University is the most contributing organization in Indian Journal of Pharmaceutical Education and Research. 30.2% of the articles published in journal are from foreign countries led by Turkey with 93 publications. Among top 10 highly cited papers, 9 articles published in the year 2011. Conclusion: Indian Journal of Pharmaceutical Education and Research has world-wide coverage with 58 countries other than India and citation rate is showing increasing trend. Two year and Five year impact factor is all time high in year 2018 with 0.445 and 0.425 respectively. This paper highlights its significance in coverage of Pharmaceutical Sciences and allied areas hence useful for students, teachers, publisher and Librarian in formulating policies for journal selection.


Indonesian society who participates in the capital market is still low. The purpose of study specifically to determine signaling hypothesis validity and trading range, which expected with a positive reaction from a market to stock split action can increasing investor base who participating in the capital market, thus increasing community who turned on Indonesia Stock Exchange (BEI) which in turn will increase the role of capital market in Indonesia in order to expand financial access for community this is in line with financial inclusion program. This study uses data 25 companies stock which stock split with event window during 11 days that are 5 days before and 5 days after stock split that occurred during 2007-2012 in IDX. The method used in this study were using paired sample T-test. Changes on the trading volume activity show more liquid stocks, as well as an increase in bid-ask spreads (proxy from retail investors increased) after stock split event proved that stock split policy can expand retail investor base.


The video-based facial expression recognition aims to classify a given video into several basic emotions. How to integrate facial features of individual frames is crucial for this task. In this paper, we propose the Frame Attention Networks (FAN)1, to automatically highlight some discriminative frames in an end-to-end framework. The network takes a video with a variable number of face images as its input and produces a fixed-dimension representation. The whole network is composed of two modules. The feature embedding module is a deep Convolutional Neural Network (CNN) which embeds face images into feature vectors. The frame attention module learns multiple attention weights which are used to adaptively aggregate the feature vectors to form a single discriminative video representation. We conduct extensive experiments on CK+ and AFEW8.0 datasets. Our proposed FAN shows superior performance compared to other CNN based methods and achieves state-of-the-art performance on CK+.


AIMS
The main focus of this follow-up study was to describe how the vision statements were perceived to describe the work in the units and what kind of relationships there were between the vision statements and background factors during the 3-year follow-up.

BACKGROUND
he vision statement gives a competitive advantage to the organization. It helps find the desired direction during a period of transformation in the organization. Satisfaction, empowerment and motivation are challenged in the vision-realization process.

METHODS
he data were gathered by questionnaire from the multidisciplinary team members on three occasions. The response rate was 58% (n = 115, n = 112) for the first and second data sets, and 53% (n = 103) for the third data set. The data was analysed statistically.

RESULTS
The organizational vision was perceived as quite stable during the 3 years. Factors associated with the vision statement at the end of the 3-year period were workload, experience of stress, work motivation, work satisfaction, importance of work independence and general empowerment.

IMPLICATIONS FOR NURSING MANAGEMENT
eaders are able to sustain the vision statement by motivating and empowering the staff. Empowerment especially is worth reinforcing in a vision-realization process.


To investigate the relationship between polyol pathway hyperactivity and altered carnitine metabolism in the pathogenesis of diabetic neuropathy, the effects of an aldose reductase inhibitor, [5-(3-thienyl) tetrazol-1-yl]acetic acid (TAT), and a carnitine analog, acetyl-L-carnitine (ALC), on neural functions and biochemistry and hemodynamic factors were compared in streptozotocin-diabetic rats. Significantly delayed motor nerve conduction velocity, decreased R-R interval variation, reduced sciatic nerve blood flow and decreased erythrocyte 2, 3-diphosphoglycerate concentrations in diabetic rats were all ameliorated by treatment with TAT (administered with rat chow containing 0.05% TAT, approximately 50 mg/kg/day) or ALC (by gavage, 300 mg/kg/day) for 4 weeks. Platelet hyperaggregation activity in diabetic rats was diminished by TAT but not by ALC. TAT decreased sorbitol accumulation and prevented not only myo-inositol depletion but also free-carnitine deficiency in diabetic nerves. On the other hand, ALC also increased the myo-inositol as well as the free-carnitine content without affecting the sorbitol content. These observations suggest that there is a close relationship between increased polyol pathway activity and carnitine deficiency in the development of diabetic neuropathy and that an aldose reductase inhibitor, TAT, and a carnitine analog, ALC, have therapeutic potential for the treatment of diabetic neuropathy.


The effect of the methyl group on the cooperativity between three types of hydrogen bond (OH···O, CH···O, and OH···π) in cyclic complex involving an acetylene and two waters has been studied on the basis of high-level ab initio calculations. The total interaction energy of three hydrogen bonds increases as the number of methyl group in the complex increases. The binding distances of OH···π and OH···O hydrogen bonds shorten, while that of CH···O hydrogen bond elongates with increasing methyl group. This indicates that addition of methyl group leads to enhancement of OH···π and OH···O hydrogen bonds, and weakening of CH···O hydrogen bond, as also shown in frequency shift, chemical shifts, charge populations, and stabilization energies of orbital interactions. Although the presence of methyl group has a complicated effect on different type of hydrogen bond, the cooperativity of three hydrogen bonds increases in general with the addition of methyl group. © 2007 Wiley Periodicals, Inc. Int J Quantum Chem, 2008


Orientation: Business Rescue Practitioner (BRP) tasks are complex and involve a wide range of knowledge, tacit skills and experience not accessible to novices. Research purpose: Competencies required by business rescue practitioners (BRPs) to navigate a distressed venture were investigated. What BRPs actually 'do' during a rescue guided the development of a competency framework to inform future qualification guidelines for BRP education and accreditation. Motivation for the study: To investigate the research question: 'What are the competencies that underlie the activities of a business rescue practitioner?'. Research design, approach and method: A modified 'interview to the double' (ITTD) process was used to elicit instructions that a BRP would give to an imaginary 'double'. These instructions were analysed and rated for importance, transferability, knowledge requirement and skills requirement; in conclusion, these instructions were ranked and subjected to a content analysis. Main findings: Based on the main activities that were derived from the practices and praxis, one assignment and four supra (higher-level) competencies were consequent to the analysis. A BRP able to successfully navigate a distressed venture towards normal operations should demonstrate a high level of competency in sense-making, decision making and integration, achieved through collaboration as the central competency. Practical implications: Firstly, the study addresses educators' need for a framework of competencies to guide education. Secondly, it paves the way for the Regulator to develop a qualifications framework for accreditation. Contribution : The findings gave structure to the competencies underlying the activities of a BRP to navigate a rescue. Pre-business and financial acumen appears limited without these competencies containing insight, experience, intuition, heuristics, tacit knowledge, perceptive induction and more.


The purpose of this study was to develop sodium reduced foods for 10 representative high sodium foods often served in the food service industry, and to conduct sensory evaluation on the foods. The foods are kimchi, cucumber salad, banquet noodle, seaweed soup, ahuk soup, pork kimchi stew, red pepper paste pork chops, beef bulgogi, grilled mackerel and saury stew selected based on data from the 2010 national health and nutrition examination survey. The sodium contents of chinese cabbage kimchi were 688.1 mg in the control, 587.3 mg in the 15% reduced sodium sample group (level 1), and 486.5 mg in the 30% reduced sodium sample group (level 2). The corresponding sodium contents of cucumber salad were 406.4 mg, 345.5 mg, and 284.6 mg. The sodium contents of banquet noodle were 1080.2 mg, 912.2 mg, and 765.8 mg, respectively. The sodium contents of seaweed soup were 459.4 mg, 392.1 mg, and 333.0 mg, respectively. The sodium contents of ahuk soup were 615.3 mg, 534.9 mg, and 434.4 mg respectively. The sodium contents of pork kimchi stew were 1156.2 mg, 988.3 mg, and 820.2 mg respectively. The sodium contents of grilled mackerel were 624.6 mg, 557.4 mg, and 456.9 mg respectively. The sodium contents of red pepper paste pork chops were 723.7 mg, 615.0 mg, and 505.3 mg, respectively. The sodium contents of beef bulgogi were 678.3 mg, 561.9 mg, and 473.3 mg, respectively. The sodium contents of saury stew were 676.0 mg, 574.6 mg, and 470.9 mg respectively. Sensory evaluation was conducted with a total of 30 samples consisting of 10 control food groups, 15%, and 30% reduced sodium food groups. Results showed sodium reduction up to level 1 or 2 in Chinese cabbage kimchi, cucumber salad, pork kimchi stew, red pepper paste pork chops, beef bulgogi, grilled mackerel and saury stew. However, the soups and noodles showed significant differences between the control and the 15% reduced sodium (level 1) food groups, specifically in banquet noodle, seaweed soup, ahuk soup.


Captive-raised eastern wild turkey (Meleagris gallopavo silvestris) poults were allowed to forage on either recently burned plots or on plots that had not been burned during the previous 3 years. Following a two hour exposure on the study plots, external parasites were recovered from all poults. The louse (Menacanthus stramineus) and the lone star tick (Amblyomma americanum) were the only parasites recovered. Fifty-nine poults exposed to the burned plots had a significantly (P<0.001) lower prevalence of A. americanum infestation than did 57 poults exposed to the unburned plots. Thirty-five percent of the poults exposed to the unburned plots were infested by A. americanum. A single A. americanum was recovered from one poult exposed to burned plots.


Many Native American peoples of the Plains kept oral histories in which periods of time were designated by events. Often pictorial recordings of these events were created as mnemonic devices to assist proper memory, which itself was sometimes recorded in written language. These pictorial calendars occasionally resurface and provide new insights into the histories of Native Americans. A new pictorial calendar of the Mandan Indians has recently reappeared. It and the circumstances of its reappearance are described, and suggestions toward a possible interpretation are offered.


In the existing applications of streaming media, the formats of streaming media contents are multiple. How to effectively protect various-format streaming media contents is a new challenge. A new protection scheme based on online encryption for streaming media is proposed in this paper. It achieves content protection for various-format streaming media by encrypting the data packets. The proposed protection scheme is independent of the streaming media server and format, also can set various security levels according to the streaming media content to achieve personal protection service. Experiments show that the scheme is suitable for copyright protection of various-format streaming media.


This review aimed to investigate the efficacy of integrative medicine (herbal medicine combined with drug therapy) in the treatment of Behcet's disease (BD). Eleven databases were searched from their inception to 7 December 2020, for randomized control trials (RCTs) that reported the effects of integrative medicine in treating BD. The risk of bias was assessed using seven domain criteria from the Cochrane Collaboration tool. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to assess the quality of evidence. The direction of the effect is also shown in the form of an albatross plot. Sixteen trials met the inclusion criteria and were analyzed. The overall risk of bias was determined to be uncertain. The meta-analysis showed a superior response rate with herbal medicine plus drug therapy (relative risk (RR) 1.19, 95% confidence interval (CI) 1.13 to 1.25, n = 1034, p < 0.00001, I2 = 0%, low certainty of evidence (CoE)) compared to drug therapy. Integrative medicine also lowered the recurrence rate after 2 months of follow-up (RR 0.27, 95% CI 0.09 to 0.76, n = 120, p = 0.01, I2 = 0%, low CoE). The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, and skin lesions were also significantly improved using integrative medicine, but equivalent effects were seen for oral ulcers, genital ulcers, and eye inflammation. Minor adverse events were reported in both groups. Our findings suggest that herbal medicine combined with drug therapy is more effective for the treatment of BD than drug therapy alone. Although the type of drug therapy used varied across the studies, integrative medicine was shown to improve the total response rate, skin lesions, the ESR, and the CRP level. However, the overall risk of bias of the studies was concerning, and the CoE was low. Information on adverse events (AEs) was also insufficient. In addition, the number of studies included for data synthesis for most outcomes was small. Future studies with rigorous RCTs may help establish the efficacy of integrative medicine in the treatment of BD.


BACKGROUND Although cystoid macular oedema (CMO) is a rare cause of visual loss in AIDS related cytomegalovirus (CMV) retinitis, nine cases are reported of CMO occurring in HIV infected patients with a prior diagnosis of CMV who were receiving highly active antiretroviral therapy (HAART). METHODS Medical and ophthalmological records of nine AIDS patients with inactive CMV retinitis were retrospectively analysed. Ophthalmic examination data, laboratory findings, and the systemic antiviral treatment were studied. Ophthalmic examination included visual acuity, anterior chamber flare measured with the laser flare cell meter (LCFM), vitreous haze quantification according to the Nussenblatt grading system, and fluorescein angiography. RESULTS Nine HIV infected patients, eight men and one woman, mean age 39 years (range 29–53 years) presented with inactive CMV retinitis and CMO. On fluorescein angiography, CMO was present only in eyes (14 eyes) with signs of previous CMV retinitis. CMV retinitis was inactive in all of them. Visual acuity ranged from 20/200 to 20/30. In 10 eyes with CMV retinitis, anterior chamber flare measured with the LCFM ranged from 18.5 to 82 photons/ms (mean 35.42 ph/ms). A significant vitreous inflammation (1.5+) was observed in eight eyes. All patients had been treated with anti-CMV drugs for a mean period of 18 months (range 12–36 months). All nine patients received HAART with a combination of two nucleotide analogue reverse transcriptase inhibitors and one protease inhibitor for a mean period of 14 months (range 9–18 months). The HIV viral load was below detectable levels (<200 copies/ml) in eight patients and low (3215 copies/ml) in one. At the time of CMO, the median CD4+ lymphocyte count was 232 cells × 106/l (range 99–639). CONCLUSION In AIDS patients, the usual absence of intraocular inflammation in eyes affected by CMV retinitis has been tentatively explained by the profound cellular immunodeficiency. In these patients, treated with HAART, CD4+ counts were increased for several months (mean 14 months). In their eyes, CMV retinitis was associated with significant ocular inflammation and CMO. These findings could be related to the restoration of immune competence after HAART as recently shown.


Toll-like receptors (TLRs) recognize components of microbes and initiate host responses in sepsis. TLR2, the receptor for microbial lipoproteins, is important in the inflammatory effects of bacteria and fungi. Endothelial cell (EC) activation, coagulopathy, and vascular leak contribute to sepsis-induced lung injury. We previously found that bacteria shed TLR2 agonists into the blood in sepsis models, that TLR2 activation increases EC expression of inflammatory markers and EC PMN trafficking, modulates EC expression of coagulation factors, increases EC monolayer permeability, and causes lung inflammation and decreased arterial blood oxygenation in mice. We hypothesized that TLR2 activation by the lipopeptide, Pam3Cys, causes lung vascular leak and coagulopathy. Treatment of human lung microvascular EC with Pam3Cys led to increased plasminogen activator inhibitor 1 levels in culture supernatants, and increased monolayer permeability to albumin (p<0.05). Intratracheally administered Pam3Cys also significantly (p<0.05) increased albumin levels in lung homogenates and bronchoalveolar lavage fluid, and increased lung fibrin deposition. The alterations that we observed in lung microvascular EC function closely resemble those that occur in patients with sepsis. Our studies here suggest that TLR2 activation contributes to sepsis-induced EC dysfunction, coagulopathy, and respiratory failure, and suggest that EC TLR2 pathways could potentially be targeted for sepsis interventions.


An azimuth pattern reconfigurable antenna has been developed to scan a hemispherical space on a wide metal surface. The reconfigurable pattern was created by using a magnetic dipole antenna with a wide elevation angle on a large metal ground and by controlling the magnetic current direction. A feeding network supplies three different type signals to the port to make four patterns. The antenna was fabricated and measured. Each far-field beam pattern was measured half-power beam width(HPBW) about 150° in the elevation pattern. The proposed antenna radiates in all directions of hemispherical shape when using four modes since the antenna can cover 90° in azimuth plane in each mode.


Bulk glass of composition Se70Te28Cd2 was prepared by the melt quenching technique. Differential Scanning Calorimetry were performed under isothermal conditions and the results have been analysed using the transformation kinetics theory developed by Johnson-Mehl and Avrami. The results indicate that the crystallization process is a three dimensional growth process. The calculated value of the effective activation energy, EG, for crystal growth, was 173 ± 0.5 kJ/mol for this glass.


Nevus anemicus (NA) is a cutaneous anomaly characterized by pale, well‐defined patches with limited vascularization after rubbing. They are largely known to be associated with neurofibromatosis 1 (NF1) and have received little attention in the literature until recently. We sought to characterize the prevalence and clinical features of patients with NA and NF1. We conducted an observational prospective study of 99 children with NF1 at the Hospital Niño Jesús, Madrid, Spain, from January 1, 2012, through July 31, 2013, and reviewed three other series of patients with NF1 and NA recently reported. The prevalence of NA in children with NF1 ranged from 8.8% to 51%, being much more prevalent at younger ages. Prospective studies yielded a higher prevalence than retrospective studies. NA was located most commonly on the trunk, particularly on the anterior chest wall, and was often multiple. Patients with segmental NF1 or isolated café au lait spots rarely had NA, and NA was absent in other genodermatoses. The collection of data was not homogeneous in all studies. NA has a high prevalence in individuals with NF1 patients but seems to be absent in connection with other genodermatoses, therefore its presence can assist in the diagnosis of suspected cases of NF1. The subtle clinical appearance of NA makes its detection difficult, and physicians involved in the care of children with NF1 must be aware of its possible presence and significance.


Non-O1/non-O139 vibrios refer to all vibrios except toxin producing Vibrio cholerae serogroups O1 and O139. The prevalence of illness caused by non-O1/non-O139 vibrios steadily increases all over the world in the last 20 years, which is very probably related to global warming. These infections are reported year-round from tropical and subtropical climate zones, but they were also detected in the mild climate zone of the United States of America and Europe. In mild climate, they have markedly seasonal occurrence, typically peaking in May to October. A human can be infected after ingestion of contaminated food, especially seafood and fish, or water or while bathing. In Europe, non-O1/non-O139 vibrios were detected in the Baltic Sea, North Sea and Mediterranean Sea but also in ponds and rivers. Depending on the pathogen entry route, the clinical manifestation may appear as gastroenteritis, otitis, wound infection or severe up to fatal illness, predominantly in immunocompromised patients. There is no specific prevention. Non-specific prevention includes good personal and food handling hygiene practices and avoiding contact of unhealed wounds with sea or surface swimming water. Given the severity and increasing frequency of infections caused by non-O1/non-O139 vibrios, they should be considered in differential diagnosis of gastrointestinal and wound infections, especially in patients with a history of consumption of fish and seafood or with a history of contact of unhealed wounds with sea or other open swimming water.


Objective The aim of this study was to estimate the direct medical cost per episode and the annual cost for acute diarrhea (AD) in children under five years of age in Ambulatory Care Centers of the Ministry of Public Health (MOPH) of Ecuador. Methods A cost of illness study with a provider perspective was carried out through a micro-costing of health resources and valuated in international dollars. Medical consultations and laboratory tests were valued using the tariff framework of services for the National Health System and for the prescribed medications, a reported cost registry of pharmacy purchases made in the year of study was used. Results A total of 332 electronic health records of children under five years of age were included in the analysis. Laboratory tests were performed on 37.95% (126/332), medications were prescribed to 93.67% (311/332) of the children, and antimicrobials were prescribed to 37.35% (124/332) of the children, representing an antibiotic prescription rate of 26.51% (88/332) and an antiparasitic prescription rate of 10.84% (36/332). The mean cost of the MOPH per child per episode of AD was US$45.24 (2019 dollars) (95% CI:43.71 to 46.76). Conclusion The total estimated cost of AD in children under five years of age for the MOPH in 2019 was about US$6,645,167.88 million (2019 dollars) (95% CI: 6,420,430.77 to 6,868,436.12). A high proportion of the direct medical cost of AD in children under five years of age in outpatient settings is due to unnecessary laboratory tests.


In this paper a novel directive TMo surface wave launcher for integrated planar leaky wave antennas is presented. As proof of concept the launcher is designed for a frequency modulated continuous wave radar at 120 GHz. Simulations for launcher and antenna are presented, as well as verification measurements of a prototype. Being well matched over the whole WR6 band from 110 GHz to 170 GHz, the designed launcher covers a large bandwidth. The antenna prototype incorporating the new launcher scans over a range of 18° when fed from 110 GHz to 130 GHz.


In humans, inhibitory jaw reflexes can be depressed by painful stimulation of remote parts of the body. The underlying mechanisms may involve diffuse noxious inhibitory controls (DNIC). Animal experiments have shown that the neurons which may mediate DNIC show spatial encoding (i.e. their responses vary in relation to the size of the body area being stimulated). The aim of this study was to investigate whether the modulation of an inhibitory jaw reflex shows similar spatial dependency. Electromyographic recordings were made in 9 subjects, from a masseter muscle that was activated to a level equivalent to 10% of that obtained during a maximum voluntary contraction. Reflex inhibitions were evoked by electrical stimuli to the upper lip, either alone (controls) or during the application of conditioning stimuli (47 degrees C water) to the fingers, the hand, the half forearm or the whole forearm. Conditioning stimuli applied to the larger but not to the smaller areas resulted in significant modulations of the reflex. There was a significant correlation between stimulus area and reflex magnitude. These results demonstrate a spatial dependency for the modulation of an inhibitory jaw reflex by painful stimuli -- a further parallel with DNIC as studied on single neurons in animals.


Optimization is a crucial step in the analysis of experimental results. Deterministic methods only converge on local optimums and require exponentially more time as dimensionality increases. Stochastic algorithms are capable of efficiently searching the domain space; however convergence is not guaranteed. This article demonstrates the novelty of the hybrid genetic algorithm (HGA), which combines both stochastic and deterministic routines for improved optimization results. The new hybrid genetic algorithm developed is applied to the Ackley benchmark function as well as case studies in food, biofuel, and biotechnology processes. For each case study, the hybrid genetic algorithm found a better optimum candidate than reported by the sources. In the case of food processing, the hybrid genetic algorithm improved the anthocyanin yield by 6.44%. Optimization of bio-oil production using HGA resulted in a 5.06% higher yield. In the enzyme production process, HGA predicted a 0.39% higher xylanase yield. Hybridization of the genetic algorithm with a deterministic algorithm resulted in an improved optimum compared to statistical methods.


Introduction Damage control laparotomy is a widely accepted practice in trauma surgery. We applied this approach selectively to severely ill patients requiring open pancreatic debridement. We sought to evaluate outcomes associated with this novel, staged approach to operative pancreatic debridement. Methods Retrospective review evaluating 75 consecutive patients (12 DCD, 63 single-stage debridement) undergoing open pancreatic debridement by a single surgeon (2006-2016). Damage control debridement was compared to single staged debridement only as a point of reference and not to evaluate the technique as potentially superior. Results Patients treated by damage control debridement were more severely ill globally with increased preoperative organ failure (83% DCD vs. 43% SSD), intensive care unit admission (83% vs. 48%), and mean APACHE II (12.0 vs. 7.3). Indications for damage control debridement included: hemodynamic compromise (n=4), medical coagulopathy (n=4), or a combination (n=4). Six of 12 damage control debridement patients required three or more debridements prior to definitive abdominal closure (mean number of total debridements=2.6; range 2-4). Length of stay (43.8 vs. 17.1 days) and intensive care unit stay (20.8 vs. 5.9 days) was longer in damage control debridement patients. However, readmission (42% vs. 41%) and repeat intervention (58% vs. 33%; endoscopic: 17% vs. 11%; percutaneous drain: 42% vs. 19%; repeat operation after abdominal closure: 0% vs. 13%) were similar. Overall mortality was 2.7%; mortality was similar between damage control debridement (8%) and single staged debridement (2%). Conclusions Despite more severe acute illness, necrotizing pancreatitis patients treated with damage control debridement had similar morbidity and mortality as those undergoing elective single stage pancreatic debridement. Damage control debridement is an effective technique with which to salvage severely ill necrotizing pancreatitis patients.


Objectives: The aim of this study was to determine whether immature hemodialysis fistulas undergo flow-induced adaptive remodeling after successful percutaneous angioplasty. Background: Approximately 50% of radiocephalic fistulas remain immature after surgery and cannot be used for hemodialysis. Small fistulas with anastomotic inflow stenoses may undergo salvage angioplasty, but the time course of outward remodeling after successful treatment has not been defined. Methods: Thirty-two of 39 patients (82%) with inaccessible, hypoplastic radiocephalic fistulas underwent attempted salvage angioplasty of inflow stenoses involving the arteriovenous anastomoses. Twenty patients experienced salvage of their fistulas and successfully underwent hemodialysis (51%). Results: Eleven patients had serial angiographic procedures, which allowed paired sequential quantitative angiographic measurements of the fistulas to be made during a median follow-up of 200 days (range 5–2,298 days). Fistula diameters increased from 4.5 6 1.3 mm to 8.0 6 2.5 mm (mean 6 S.D.). The mean growth of the fistulas was 1.0 6 0.9 mm per year. Conclusions: The mechanism of adaptive remodeling transforms nonmaturing hypoplastic autogenous fistulas into functioning accessible dialysis accesses after successful percutaneous transluminal angioplasty of inflow anastomotic stenoses. VC 2009 Wiley-Liss, Inc.


Background: Iron deficiency is the most common nutrient deficiency in the world, however, patients with severe iron deficiency generally have normal cardiac function. This suggests that a mechanism exists in the heart that maintains cardiac iron levels despite systemic iron deficiency, however, the mechanism for this adaptation of the heart to iron deficiency is not known. We recently discovered an mRNA-binding protein tristetraprolin (TTP) to mediate iron utilization within an iron-deprived cell independently of the canonical iron regulatory proteins (IRPs). Here, we hypothesized that TTP protects the heart against iron deficiency through intracellular conservation of iron, and that disruption of this pathway will make the heart vulnerable to low-iron states. Results: Consistent with the above hypothesis, we demonstrated that hearts of TTP knockout mice have normal baseline function, yet deteriorate when subjected to iron deficiency. On contrary, iron-deficient TTP WT mice show no decline in cardiac function in spite of significant reduction in iron levels. Since TTP is known to reduce protein expression through mRNA degradation, we hypothesized that it halts expression of iron-consuming proteins, reducing overall cardiomyocyte's iron requirements. We identified three mitochondrial iron-requiring proteins to be negatively regulated by TTP: NDUFS1 (part of complex I), UQCRFS1 (part of complex III), and mitochondrial aconitase (part of the TCA cycle). Specifically, we showed that TTP binds to and degrades mRNAs of these targets. This is based on data that the steady state level of the mRNAs for these proteins are decreased with iron chelation, but do not change with TTP deletion. Additionally, mRNAs of these proteins are protected against after actinomycin-D treatment with TTP deletion. RNA co-immunoprecipitation studies confirmed TTP binding to the mRNAs of these proteins. Thus, in the absence of TTP, these proteins continue to be expressed and act as "iron sinks" in a cell that is already iron deficient. Conclusions: Our results, for the first time, provide the mechanism of cellular adaptation to iron deficiency, and demonstrate a major role for TTP in this process by regulating mitochondrial proteins.


This paper studies Hamel's formalism for simple hybrid mechanical control systems and explores the role of time-reversal symmetries and hybrid zero dynamics to predict the existence of periodic orbits in these control system. A time reversal symmetry in the phase-space permits us to construct a time reversible hybrid Hamiltonian system. If the Hamiltonian function describing the continuous dynamics and the impact map are invariants under a time reversal symmetry on the zero hybrid dynamics, under some mild conditions, we find sufficient conditions for the existence of periodic solutions for the class of simple hybrid Hamiltonian control systems.


The Swedish welfare state has been subject to a substantial re-organization in recent decades, not always recognized in the international literature. Almost every area of social policy have changed, often in the downward direction and with potential far-reaching consequences for the social sustainability of the Swedish welfare state. In this research note, I discuss significant changes to Swedish social policy and place the reorganization of the Swedish welfare state in an international perspective. Focus is on old-age pensions and unemployment benefits. Both areas are characterized by significant changes.


Nurses have been involved in the management of sexually transmitted infections (STIs) well before the era of Florence Nightingale. Their role has varied from that of the technician, almoner, counsellor, and doctor's assistant, to one in which they are able to provide first line management of STIs in nurse led clinics. However, changes to the role of the nurse have not been entirely through choice. It appears that nurses have often been called upon in times of crisis and need—their role often evolving only through demand for services and personnel. Barriers to developing the role of the nurse continue to exist as we move into the 21st century. From Lock hospitals to specialised genitourinary medicine clinics, this historical review looks at how the role of the nurse has evolved over the past 150 years and suggests how past lessons can help enhance the contribution nurses will make to the future of STI management and control.


In recent decades a large community of scholars has intensively investigated the theoretical bases of concurrency, driven both by scientific curiosity and by the fact that concurrent features appear in many different fields, such as biology, economics, medicine, and the social sciences. Many mathematical models have been developed for formalizing the behavior of concurrent systems, i.e., systems composed of agents that not only compute in isolation, but also by exchanging information with each other. Particularly relevant is therefore the representation of the interactions, or process, that may occur in these concurrent systems, which are hosted in an open environment. Roberto Gorrieri and Cristian Versari have been leading scientists in the field, and have great experience in teaching the topics covered. The reader of this book is gently lead through the fascinating area of concurrency from very basic results to increasingly complex issues, always with great clarity and analytical rigor. A large number of examples and exercises help in uncovering and understanding the many subtleties of the presentation. This monograph is therefore an excellent textbook for introducing undergraduate and graduate students, as well as people developing or using concurrent systems, to the theories of concurrency. Some aspects of concurrent systems are not considered here, those typical to more advanced models, like mobility of agents. After a course based on this book, however, a student will have all the knowledge and the techniques to face this intriguing and challenging topic, and many others. The starting point of the intellectual journey proposed by the authors is the semantic structure, namely labelled transition systems, which provides us with the means and the tools to express processes, to compose them, to prove properties they enjoy, typically equality of syntactically different systems that behave the same. The rest of the book relies on the Calculus of Communicating Systems proposed by Milner. Tailored versions of this calculus are used to study various notions of equality between systems, and to investigate in detail the expressive power of the models considered. Warm thanks are due to the authors of this book, for their successful work in bringing together the fundamentals of concurrency theory in an accurate, uniform and enjoyable volume.


The moving block bootstrap, the stationary bootstrap, and the threshold bootstrap are methods of simulation output analysis, which are applicable to autocorrelated data. These bootstrap methods assume the stationarity of data. However, bootstrap methods cannot work if the stationary assumption is not guaranteed because of seasonality or trends in data. In the simulation output analysis, threshold bootstrap method is the best in describing the autocorrelation structure of original data set. The threshold bootstrap makes the cycle based on threshold value. If we apply the bootstrap to seasonality data, we can get similar accuracy of the results. In this paper, we verify the possibility of applying the bootstrap to seasonal data.


Public health authorities recommend that isolation precautions for influenza should be continued for 7 days after illness onset or until 24 h after the resolution of symptoms, whichever event lasts longer. However, little data are available regarding the duration of isolation for patients with 2009 pandemic H1N1 (pH1N1). We recruited patients with confirmed pH1N1 virus infection at a 2,000-bed tertiary care center. Influenza viral loads from oropharyngeal swab specimens were serially determined by reverse transcriptase quantitative polymerase chain reaction every other day, and the risk factors for prolonged viral shedding were investigated. To evaluate the current recommendations for isolation precautions, we measured the intervals between symptom onset and the last viral RNA detection, and that between the last viral RNA detection and the point at which the patient was symptom-free for 24 h. From November 2009 to January 2010, 26 patients were enrolled, and viral RNA was detected in more than half of the eligible patients (10 of 19, 52.6%) for ≥7 days after symptom onset. While evaluating the policy for lifting quarantine, we found that viral RNA was detected in 4 of 15 patients (26.7%) beyond the recommended duration of isolation. In conclusion, viral RNA was detected in a substantial proportion of hospitalized patients even when they fulfilled the recommended conditions for lifting quarantine, and we believe that more prudence is required in this aspect.


Contents Section 1: Fluid structure interaction Nonlinear diffraction of water waves: a classical perturbation method Design and testing of wind deflectors for roof-mounted solar panels PIV measurements of laminar flow around a hemisphere Oil squeezing power losses in gears: a CFD analysis Complete Francis turbine flow simulation at Derbendikan power station The characteristics of open cavity flow with a length to depth ratio of 4 Section 2: Computational methods On gauge fields in fluid turbulence Preconditioned HLLC scheme for incompressible viscous flow simulation An immersed boundary method for simulating compressible viscous flow in complex geometries Computational design of the flow properties of foams Assessment of two pressure-velocity coupling strategies for local meshless numerical method Numerical investigation of swirl flow inside a supersonic nozzle Numerical study of battle damaged two-dimensional wings Simulation of fluid-structure interaction for an elastic cylinder in an axial flow Numerical simulation of vortex-induced vibration of a pivoted cylinder using the spectral element method Droplet interaction and dynamic wettability of advanced materials used in aeronautics Section 3: Multiphase flow On radiation absorption effects and air humidity influence on evaporating water droplets and vapour condensation intensity Emulsion compression and coalescence under enhanced gravity studied with in-situ microscopy Steady state numerical model for critical two-phase flow in a nozzle Experimental and numerical investigation of boiling flow in a vertical pipe with phase change using a multi-fluid modelling approach Validation of the CFD model for prediction of flow behaviour in fluidized bed reactors Study of a fluidized bed reactor for gasification of biomass Liquid - gas interface under hydrostatic pressure Multifield hybrid approach for bubble to slug flow transition modelling Development of a computationally efficient bubble column simulation approach by way of statistical bubble micro-flow modelling Computational and experimental analysis of the churning power losses in an industrial planetary speed reducer Section 4: Environmental fluid mechanics Water and contaminant flux estimation from multi-layer passive flux meter measurements Meridional flow of grounded abyssal currents on a sloping bottom in spherical geometry The Italian Data Buoy Network (RON) Section 5: Turbulent flow PIV measurements on the formation of the flow field and aerosol particle distribution in a turbulent square duct flow Numerical simulation of coaxial turbulent jet with and without discrete particles Three-dimensional mixture theory simulations of turbulent flow over dynamic rippled beds Validation of a stochastic droplet breakup model applied to a liquid jet in turbulent crossflow Section 6: Bubble and drop dynamics Air - water: two phase flow behavior in a horizontal pipe using computational fluids dynamics (CFD) Isenthalpic oscillations with quadratic damping in saturated two-phase fluids Study of the application of Acoustic Emission technology for on-line monitoring of bubble phenomena and flow patterns in two-phase gas-liquid flow Acoustic frequency for bubble size correlation using acoustic emissions A microfluidic study of oil-water separation kinetics Section 7: Heat and mass transfer The role of natural convection and density variations in the solidification process of water in an annular enclosure Benard convection with rotation and a periodic temperature distribution Research on the heat transfer law of gas-liquid two-phase flow in a deepwater wellbore On the exact solution of incompressible viscous flows with variable viscosity Hybrid synthetic jet actuator with a novel fluidic diode Section 8: Hydrodynamics Superquadratic fluidic restrictors and their applications Numerical analysis of the circulation variability in the Zadar channel area (east Adriatic) Vortices in micro/nano channel flows A turbulence closure based on the maximum entropy method Section 9: Applications in biology Use of heart blood flow analysis in clinical practice Application of statistical methods in human airway flow analysis


IF THE world chooses to seek a solution to the energy dilemma through nuclear energy, the element plutonium will become an article of commerce to be handled in quantities of thousands of tonnes annually. Plutonium is a uniquely potent inhalation carcinogen, the potential induction of lung cancer dwarfing other possible toxic effects. For reasons to be presented here, it is my opinion that plutonium's carcinogenicity has been very seriously underestimated. If one couples the corrected carcinogenicity with the probable degree of industrial containment of the plutonium, it appears that the commercialization of a plutonium-based energy economy is not an acceptable option for society. Sagan's statement1that "the experience of 30 years supports the contention that plutonium can be used safely" is manifestly indefensible. No meaningful epidemiological study of plutonium-exposed workers for that 30-year period has ever been done. Since thousands of those possibly exposed have left the industry and are


Cloud storage usages are becoming increasingly popular on mobile devices. Through an extensive motivation study, we find that cloud storage accesses from mobile apps suffer from several notable problems that undermine usage experiences. The root cause is that the way of cloud storage providers deploying their services onto mobile devices relies on app developers for the correct and appropriate implementations and lacks the ability of monitoring and servicing client-side cloud storage accesses. We propose StoArranger, a practical system framework that solves the problems by coordinating, rearranging, and transforming cloud storage communications on mobile devices. We have prototyped the proposed system using two different implementation approaches. We discuss our experiences of the implementations in the paper. The real-app evaluation experiments show that StoArranger can significantly improve mobile cloud storage access efficiency with little overheads.


Introduction: Allogeneic hematopoietic cell transplantation (HCT) offers a potentially curative therapy in patients (pts) with hematologic malignancies; however, treatment-related mortality (TRM) remains a concern. Strategies to improve post-HCT neutrophil recovery (NR) and immune reconstitution (IR) to decrease TRM need to be explored. Murine models of allogeneic HCT suggest that fractionated hematopoietic progenitor cell (HPC) infusion may improve engraftment through improved access of HPCs to a viable hematopoietic niche ( Felfly et al., 2010 ; Bhattacharya et al., 2009 ). The impact of fractionated HPC infusion on NR, IR and overall survival (OS) has not been prospectively studied in humans.

Objective: Determine the impact of bulk vs. fractionated HPC infusion on NR after allogeneic HCT, as defined by the time to achieve an absolute neutrophil count (ANC) of > 500. Secondary objectives included evaluations of OS, TRM, relapse and additional parameters of IR.

Methods: In this randomized phase 2 study of bulk vs. fractionated HPC infusions, pts with hematologic malignancies < 75 yrs underwent HCT, receiving unmodified or CD34 selected allografts from HLA-matched or mismatched related or unrelated donors ([NCT01596257][1]). Patients were randomized to receive HPC infusion as a bulk (Bulk Arm) or in fractions (Fractionated Arm): 4x10E6 CD34+ cells/kg recipient weight infused on day 0, with the remaining HPCs CD34+ cell selected then infused on days 2, 4 and 6 post-HCT, in equally distributed aliquots. Randomization was stratified by allograft type (unmodified vs. CD34 selected). Patients whose donor failed to collect at least 7x10E6 CD34+ cells/kg recipient weight received bulk HPC infusions regardless of randomization, for safety. These pts continued HCT on study, but were replaced until each arm reached a target accrual of 36 pts. Per protocol, these pts were not included in this modified intent to treat analysis (ITT). Patients with at least 100 days of follow up on 6-30-15 were included in the current analysis.

Results: Of 124 pts enrolled between 2012 and 2015, 109 are evaluable. Patient and transplant characteristics are outlined in Table 1. Median age was 60 yrs. Donors of 41 pts (38%) failed to mobilize the minimum CD34+ cell dose and were not included in the analysis. Of 68 pts 33 were randomized to the Bulk Arm and 35 to the Fractionated Arm. Median CD34+ cell doses were 9.8x10E6/kg recipient weight in the Bulk Arm and 7.6x10E6/kg recipient weight in the Fractionated Arm. All pts engrafted. Median time to ANC of > 500 was 11 days in both arms (Figure 1). Day +180 median CD4+ cell count was 173.5 cells/µl in the Bulk Arm and 168 cells/µl in the Fractionated Arm. With a median follow up of 19 months in surviving pts, the estimated 2-yr OS was 78% and 70% for pts in the Bulk vs. Fractionated Arms, respectively (Figure 2). The estimated 2-yr cumulative incidences of TRM were 9% and 7% in pts in the Bulk vs. Fractionated Arms, respectively. The estimated 2-yr cumulative incidences of relapse were 27% and 26% in pts in the Bulk vs. Fractionated Arms, respectively. The cumulative incidences of grades II-IV (grades III-IV) acute GVHD were 30% vs. 14% (6% vs. 0%) in pts in the Bulk vs. Fractionated Arms, respectively.

Conclusion: In this randomized modified (ITT) analysis, fractionated infusion of HPCs in pts undergoing allogeneic HCT did not statistically significantly impact NR or OS when compared to pts receiving bulk HPC infusion. In addition, CD4+ cell count on day 180, TRM and relapse rates were similar between the two groups. We also observed that with current mobilization techniques it was unlikely that more than 60% of normal donors would be able to collect more than 7x10E6 CD34+ cells/kg recipient weight for adult recipients.

![Table 1.][2]

Table 1.
KEY-HCT-hematopoietic stem cell transplant, Flu-Fludarabine, Mel-Melphalan, Bu-Busulfan

![Figure 2.][2]

Figure 2.
Neutrophil recovery in patients receiving bulk vs. fractionated infusions of hematopoietic progenitor cells

![Figure 3.][2]

Figure 3.
Overall survival in patients receiving bulk vs. fractionated hematopoietic progenitor cell infusions.

Disclosures Off Label Use: We discuss off-label use of busulfan, melphalan, cyclophosphamide, fludarabine, thiotepa, total body irradiation, tacrolimus and methotrexate. We also discuss off-label use of CD34 selected progenitor cell infusion. . Perales: Merck: Honoraria; Amgen: Honoraria; NMDP: Membership on an entity's Board of Directors or advisory committees; Astellas: Honoraria; Takeda: Honoraria. Giralt: Celgene: Honoraria, Research Funding; SANOFI: Honoraria; TAKEDA: Honoraria; JAZZ: Honoraria; MILTENYI: Honoraria; Johnson and Johnson: Research Funding.

 [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT01596257&atom=%2Fbloodjournal%2F126%2F23%2F3095.atom
 [2]: pending:yes


The main purpose of this paper is to investigate the relationship between ageing and the development in the aggregate health care expenditure in EU countries on a macroeconomic level when economic and institutional variables are included. The results of the model will be used to extrapolate the total health care expenditure for the next 10 years.


Across a species range, spatially-varying environments can drive the evolution of local adaptation. Multiples sources of environmental heterogeneity, at small and large scales, draw complex landscapes of selection which may challenge adaptation, particularly when gene flow is high. Because linkage opposes gene flow but also limits the efficiency of natural selection by contrasting pressures, the key to multidimensional adaptation may reside in the heterogeneity of recombination along the genome. Structural variants like chromosomal inversions are important recombination modifiers that form massive co-segregating genomic blocks linking together alleles at numerous genes. In this study, we investigate the influence of chromosomal rearrangements on genetic variation to ask how their contribution to adaptation with gene flow varies across geographic scales. We sampled the seaweed fly Coelopa frigida along a bioclimatic gradient of 10° of latitude, a salinity gradient and across a range of heterogeneous, patchy habitats. We assembled a high-quality genome to analyse 1,446 low-coverage whole-genome sequences, and we found large non-recombining genomic regions, including putative inversions. In contrast to the collinear regions depicting extensive gene flow, inversions and low-recombining regions differentiated populations more strongly, either along an ecogeographic cline or at a fine-grained scale. Those genomic regions were disproportionately involved in associations with environmental factors and adaptive phenotypes, albeit with contrasting patterns between the different recombination modifiers. Altogether, our results highlight the importance of recombination in shaping the selectionmigration balance and show that a set of several inversions behave as modular cassettes facilitating adaptation to environmental heterogeneity at local and large scales.


It has long been assumed that all normal cells have the same capacity to engage homologous recombination (HR) and non-homologous end joining (NHEJ) to repair DNA double-strand breaks (DSBs), a concept exploited for DNA-damaging chemotherapeutics. We show that mammary epithelial lineage dictates the DSB repair pathway choice. Primary mammary proteomes and DSB repair enumeration by γ-H2AX, Rad51 and DNA-PKc foci reveal that NHEJ operates in all epithelial cells, but high-fidelity HR is restricted to the luminal lineage. This translates to divergent poly (ADP-ribose) polymerase inhibitor (PARPi) vulnerability of mammary epithelial progenitor activity in both mouse and human, irrespective of the BRCA1/2 status. Proteome-defined lineage-specific signatures correlate to breast cancer subtypes and predict PARPi response of triple-negative human breast cancer xenografts. These intrinsically divergent HR characteristics of mammary cell types underpin a new strategy for identifying PARPi responders.