Clinical cardiac electrophysiology also called to as cardiac electrophysiology, arrhythmia assistances or electrophysiology is a branch of the medical specialty of cardiology and is concerned with the study and treatment of rhythm disorders of the heart. Cardiologists with scope in this area are usually mentioned to as electrophysiologists. Electrophysiologists are educated in the mechanism, function, and production of the electrical activities of the cardiac. Electrophysiologists work closely with other cardiologists and cardiac specialists to assist or guide therapy for heart rhythm contractions those are called arrhythmias. They are educated to execute interventional and surgical procedures to treat cardiac arrhythmia.


New linear codes (sometimes optimal) over the finite field with q elements are constructed. In order to do this, an equivalence between the existence of a linear code with a prescribed minimum distance and the existence of a solution of a certain system of Diophantine linear equations is used. To reduce the size of the system of equations, the search for solutions is restricted to solutions with special symmetry given by matrix groups. This allows to find more than 400 new codes for the case q=2,3,4,5,7,9.


In response to concerns raised about the safety of piroxicam, Pfizer Inc. has reviewed three sets of data that constitute the largest body of current evidence regarding the efficacy and safety of piroxicam. First, data from all comparative clinical trials of piroxicam worldwide sponsored by Pfizer Inc. are reviewed with regard to safety issues, with particular attention to gastrointestinal side effects and safety among elderly patients. Second, the principal findings of a large Norwegian multicenter trial of piroxicam and naproxen, comprising 2,035 patients, are summarized. Finally, the worldwide database of more than 77,000 patients monitored in postmarketing surveillance studies is examined to assess gastrointestinal side effects and the relation of age and sex to these adverse events. There is no evidence in any of the comparative clinical data or postmarketing surveillance data to indicate that piroxicam has greater risks of gastrointestinal toxicity than do other nonsteroidal anti-inflammatory drugs, irrespective of patient age.


Tumor microenvironments can promote stem cell maintenance, tumor growth, and therapeutic resistance, findings linked by the tumor-initiating cell hypothesis. Standard of care for glioblastoma (GBM) includes temozolomide chemotherapy, which is not curative, due, in part, to residual therapy-resistant brain tumor-initiating cells (BTICs). Temozolomide efficacy may be increased by targeting carbonic anhydrase 9 (CA9), a hypoxia-responsive gene important for maintaining the altered pH gradient of tumor cells. Using patient-derived GBM xenograft cells, we explored whether CA9 and CA12 inhibitor SLC-0111 could decrease GBM growth in combination with temozolomide or influence percentages of BTICs after chemotherapy. In multiple GBMs, SLC-0111 used concurrently with temozolomide reduced cell growth and induced cell cycle arrest via DNA damage in vitro. In addition, this treatment shifted tumor metabolism to a suppressed bioenergetic state in vivo. SLC-0111 also inhibited the enrichment of BTICs after temozolomide treatment determined via CD133 expression and neurosphere formation capacity. GBM xenografts treated with SLC-0111 in combination with temozolomide regressed significantly, and this effect was greater than that of temozolomide or SLC-0111 alone. We determined that SLC-0111 improves the efficacy of temozolomide to extend survival of GBM-bearing mice and should be explored as a treatment strategy in combination with current standard of care.


Civil society actors engaged in social innovation supporting activities provide crucial services that address unmet social needs and empower communities. Yet, creating a resilient framework that not only supports their activities but helps to sustain them as an organization is often difficult. It necessitates resilience strategies that help them survive and overcome crises even without former institutionalization. The paper identifies three distinct strategies that can be followed: adaptability, diversification and ecosystem building. While all three represent different ways of resilience, the latest provides the most complex safety net, allowing bottom-up organizations and partnerships to share resources, develop complementary services and sustain social innovation. Choosing the time of the first COVID-19 pandemic and the ensuing lockdown for the analysis, the paper illustrates with eight selected case studies how these strategies enfold during a crisis. The paper analyses the activities of different civic initiatives, gauging their capacity to adapt flexibly to radically new situations. While doing so, it brings together the concept of social innovation and resilience and enriches resilience studies with a less frequently found focus on small, civic initiatives.


As we transition away from pandemic-induced isolation and social distancing, there is a need to estimate the risk of exposure in built environments. We propose a novel metric to quantify social distancing and the potential risk of exposure to airborne diseases in an indoor setting, which scales with distance and the number of people present. The risk of exposure metric is designed to incorporate the dynamics of particle movement in an enclosed set of rooms for people at different immunity levels, susceptibility due to age, background infection rates, intrinsic individual risk factors (e.g., comorbidities), mask-wearing levels, the half-life of the virus and ventilation rate in the environment. The model parameters have been selected for COVID-19, although the modeling framework applies to other airborne diseases. The performance of the metric is tested using simulations of a real physical environment, combining models for walking, path length dynamics, and air-conditioning replacement action. We have also created a visualization tool to help identify high-risk areas in the built environment. The resulting software framework is being used to help with planning movement and scheduling in a clinical environment ahead of reopening of the facility, for deciding the maximum time within an environment that is safe for a given number of people, for air replacement settings on air-conditioning and heating systems, and for mask-wearing policies. The framework can also be used for identifying locations where foot traffic might create high-risk zones and for planning timetabled transitions of groups of people between activities in different spaces. Moreover, when coupled with individual-level location tracking (via radio-frequency tagging, for example), the exposure risk metric can be used in real-time to estimate the risk of exposure to the coronavirus or other airborne illnesses, and intervene through air-conditioning action modification, changes in timetabling of group activities, mask-wearing policies, or restricting the number of individuals entering a given room/space. All software are provided online under an open-source license.


OBJECTIVE
to identify whether nursing professionals carry out hand hygiene, how they do it, and what resources are available for this practice during home visits.

METHOD
cross-sectional study conducted in a public Home Care service. The World Health Organization instrument was used to observe the hand hygiene technique, the time of performance, and the product used.

RESULTS
a total of 940 hand hygiene opportunities taking place in 231 home visits were observed. Overall adherence was 14.4%, with the practice of hand hygiene being higher after contact with the patient (53.7%). Before aseptic procedures, after risk/exposure to body fluids, after contact with the patient's environment, and before contact with the patient, adherence was 0.4%. Regarding the quality of the technique, in none of the 135 practices the recommended steps were followed. As for the structure available in the households, 35 (15.2%) had accessible sinks and none had liquid soap and alcohol-based formulation.

CONCLUSION
adherence to hand hygiene by nursing professionals in home care was low, the technique was not performed, and households did not have resources for the practice.


Motivation Single-cell RNA sequencing (scRNA-seq) continues to expand our knowledge by facilitating the study of transcriptional heterogeneity at the level of single cells. Despite this technology's utility and success in biomedical research, technical artifacts are present in scRNA-seq data. Doublets/multiplets are a type of artifact that occurs when two or more cells are tagged by the same barcode, and therefore they appear as a single cell. Because this introduces non-existent transcriptional profiles, doublets can bias and mislead downstream analysis. To address this limitation computational methods to annotate and remove doublets form scRNA-seq datasets are needed. Results We introduce vaeda, a new approach for computational annotation of doublets in scRNA-seq data. Vaeda integrates a variational auto-encoder and Positive-Unlabeled learning to produce doublet scores and binary doublet calls. We apply vaeda, along with seven existing doublet annotation methods, to sixteen benchmark datasets and find that vaeda performs competitively in terms of doublet scores and doublet calls. Notably, vaeda outperforms other python-based methods for doublet annotation. All together, vaeda is a robust and competitive method for scRNA-seq doublet annotation and may be of particular interest in the context of python-based workflows. Availability Vaeda is available at https://github.com/kostkalab/vaeda Contact firstname.lastname@example.com@pitt.edu


E-commerce in these times has become the most important need for the growth of buying and selling via the internet; as it comes to make a faster system to make all kinds of purchases, it is also seen that sales are made by social networks which can not get a control process or improvement and to achieve these strategic objectives and opportunities for each organization, the need to develop e-commerce systems according to the needs of the organization is seen. The objective of this research is to make a systematic review, as well as the methodology that is applied when implementing an E-commerce System. To achieve this objective, a deep research has been done where the scientific evidence related to the case study has been found with a large number of scientific articles and a selection according to the inclusion and exclusion points of view for the search of the information, thus having the research questions.


OBJECTIVE
To observe the changes of angiotensin II (ATII) and ATII type-1 receptor (AT1R) during the development of chronic intermittent hypoxia (CIHO)-induced hypertension in rats, and the effect in the mechanism of CIHO-induced hypertension.

METHODS
Seventy-two male Wistar rats were divided into three groups:intermittent hypoxia group (IH), sham control group (SC) and control group (UC). By using supply of nitrogen (30 s each cycle) followed by compressed air (30 s each cycle) into the exposure chambers (4% - 6% nadir ambient oxygen with return to 21%), IH rats were subjected to intermittent hypoxia every 60 s for 8 h/d during the diurnal sleep period. SC rats were similarly treated but received compressed air instead of nitrogen. UC rats were not treated. Mean arterial pressure (MAP), the levels of ATII and renin activity (RA) in plasma as well as the expression of AT1R mRNA in tissue were measured on day 7, 21 and 42 after experiment.

RESULTS
MAP was significantly elevated in IH rats [(102.2 +/- 6.2) mm Hg, 1 mm Hg = 0.133 kPa] compared with initial MAP [(94.1 +/- 4.3) mm Hg, P < 0.01] and compared with that in SC [(95.7 +/- 3.6) mm Hg], UC [(97.2 +/- 3.6) mm Hg, all P < 0.05] on day 42. The levels of ATII and RA in plasma in IH rats increased gradually over time, and RA started to increase significantly on day 7 [(3.86 +/- 1.25) ng.ml(-1).h(-1)] compared with that in SC [(2.73 +/- 0.98) ng.ml(-1).h(-1)], UC [(2.55 +/- 0.87) ng.ml(-1).h(-1), all P < 0.05], and ATII started to increase significantly on day 21 [(214 +/- 41) ng/L] compared with that in SC [(124 +/- 21) ng/L], UC [(121 +/- 18) ng/L, all P < 0.01]. The RA and ATII levels in plasma showed positive correlation with MAP (r = 0.529, P = 0.008; r = 0.475, P = 0.019 respectively). The expression of AT1R mRNA in heart, kidney and aorta in IH rats showed no differences compared with that in SC and UC group (all P > 0.05). All indices were not different between SC and UC rats at any time point (all P > 0.05).

CONCLUSION
CIHO can cause the levels of circulating RA and ATII to increase, but has no effects on AT1R mRNA expression in tissue, which suggests that activated renin-angiotensin system may contribute to the pathogenesis of CIHO-induced hypertension.


This paper is to investigated the analysis of performance characteristics of diesel oxidation catalyst (DOC) for diesel vehicle with 2.5L piston displacement. The performance evaluation test of DOC applied to test diesel vehicle was carried out for four kinds of DOCs manufactured from different company. The testing DOCs were randomly selected from the retrofit vehicle and then standard test vehicle that was representative for the application group was equipped with DOC for the test. In this verification test, the reduction rate of particulate matter (P.M.) and the deviation of the performance of the DOC were examined through CVS-75 mode of the standard vehicle and SOF reduction rate of specific DOC was investigated. It was found that some DOCs failed to pass the criteria of the P.M. reduction rate because of the reason seen catalyst aging even if they were same devices. In the result of SOF analysis, the specific DOC showed more PM reduction than SOF of PM. reduction exceptionally.


This study due to the low quality of care by building permit offices Pelalawan Sub Province integrated license service. Phenomenon many homes built without permits, many buildings that do not comply with the license and permit completion time many are not in accordance with the established rules. In this study will be to evaluate the implementation of services with the construction permit should compare with reality (das solen - das sein). Type of research is a descriptive survey method combined qualitative and quantitative. Results of the study concluded, the delivery of services in an office building permits overall unified licensing services are in accordance with standard operating procedures that have been established. Constraints faced was the lack of both quality and quantity of personnel, lack of coordination and the absence of a shared vision of integrated services and support agencies, lack of facilities and infrastructure that one stop service, electricity often die area of office and the absence of public transport lines are cheap to localized office.


A new experimental technique, derived from beam-foil spectroscopy, has been developed for the measurement of long atomic lifetimes in ions. The ions are produced in a standard ion source and then, after a first acceleration step, collisionally excited in the gas or foil stripper of an accelerator. A beam of charge-state selected MeV-ions is transported to and then stored in the clean ultra-high vacuum conditions of a heavy-ion storage ring. This storage has been combined with straightforward optical detection (Fig. 1) to make precise and accurate atomic lifetime measurements in the millisecond range. As any element can be collisionally excited, the method is very versatile and may be used to study a number of cases which are of fundamental atomic structure or astrophysical and terrestrial plasma diagnostic interest. A major advantage of the new technique is that the ion excitation on one hand and the trapping and detection on the other are spatially separated and can be individually optimized. The experiment works in fixed geometry. Thus there are no mechanically moving parts and no explicit dependence of the decay curves on the ion beam velocity. All that is needed to reach high precision are a reliable clock frequency, a measurement of the ion beam storage time (to correct the photon signal for ion beam losses during the measurement cycle), and a photon data rate somewhat higher than the detector dark rate. We employed a solar-blind photomultiplier and an interference filter to suppress possible stray light from ion getter pumps in the vacuum vessel. There is no need for higher spectral selectivity, as the transition of interest is often the only one of extreme longevity of the upper level in a given ionization stage of the element under study. Thanks to this longevity, measurements may begin after higher-lying levels have decayed to the ground state or to the metastable level of interest, and consequently there is practically no cascade problem. No ion-beam related background was detected. Further improvements would be possible by increasing the detection efficiency, for example by using several photomultipliers in parallel.


This article examines the controversial Strategic Withdrawal of Eritrean fighters (EPLF) in the face of Soviet-backed Ethiopian offensives during the Eritrean War of Independence of 1961–91. It highlights the long-term effects of these decisive battles and argues that despite immediate Eritrean setbacks and Ethiopian successes in these encounters, the ultimate strengths and weaknesses of the two adversaries first became apparent during the Withdrawal. Eventually, the Eritrean independence fighters decisively won the war because, as a guerrilla army, they were more adaptable to the fast changing conditions on the ground. Blinded by their belief in armaments and numbers, their far superior foe neglected to correctly appraise the situation and improvise strategy accordingly. This article stops in 1980 when the EPLF went over to the tactical offensive.


In the United States, the library residency (sometimes referred to as a fellowship or internship) is defined as a temporary, entry-level position in a library that targets post-library school graduates as part of a diversity recruitment and/or early career development program. There are fewer than 30 such programs in the USA. We conducted a nationwide survey of library residency programs in the USA. Questions addressed program planning and decision-making, attitudes toward various aspects of libraries and residents, and the effectiveness of residency programs in context. This information will be used to develop a model for libraries that have existing residency programs or that want to start a similar program. Our research will paint a picture of the landscape of library residency programs in the USA. A comprehensive survey of both residency coordinators and residents has not been conducted before. The workshop and companion poster begin with both a theoretical and practical background based on our research. In the interactive portion, participants will be asked to share their individual experiences with early career development in their own countries; to discuss the need for effective early career development programs; and, finally, to design the ideal residency program that can be adapted for their own community needs. This poster and a workshop was presented by Angela Boyd on August 19-20, 2013 at the IFLA World Library and Information Congress 79th IFLA General Conference and Assembly in Singapore, Singapore.


Boulders displaced by the 1984 Western Nagano Prefecture Earthquake (MJMA=6.8) were investigated mainly in the eastern part of the source region which had not been fully surveyed. It was found that numerous boulders were displaced over the large extent of the eastern part of the source region. It is inferred that the boulders were not displaced by high-frequency seismic waves with frequencies between 5-10 Hz, but by low-frequency seismic waves of about 1 Hz, which radiated from the smooth dislocation on the fault plane. The boulder which experienced the largest ground motions was discovered in the eastern part. The ground motions estimated from the displacement of the boulder have a velocity of 5.5 m/s and an acceleration of 3.5 g in the vertical direction, and a velocity of 3.2 m/s and an acceleration of 2.0 g in the horizontal direction.


Introduction: Negative Pressure Wound Therapy (NPWT) is considered as the best treatment for accelerating wound healing, including diabetic ulcer. However, this device is still not available in Indonesia. Therefore, the purpose of this study were to make NPWT by using modifi cation of breast pump, and to elucidate the effect of this device on acceleration of wound healing in diabetic ulcer.Methods: NPWT was made by using digital breast pump. Wounds were divided into two groups; wound-treated by NPWT (experimental group) and wound-untreated by NPWT (control). The negative pressure used for this study was 85 mmHg. Rats were sacrifi ced on day 7, and wound samples and surrounding skin were stained with Hematoxylin and Eosyn. Infl ammation, intensity of necrotic tissue, and wound closure were observed.Results: The device could deliver a negative pressure at a range of 85–140 mmHg. Wound size in the experimental group was smaller than in control group. Infl ammation was also less in the experimental group than control group.Conclusion: The modifi cation of breast pump could be used as a negative pressure therapy for wounds, and has effect on reducing infl ammation and necrotic tissue. Further study is needed to elucidate the effect of this device on human subject.


Confrontation in the form of strong public rhetoric, which led to speculations about possible conflict over Nile water resources has during recent years given way to a spirit of co-operation that is evolving into the Nile Basin Initiative (NBI). While the initiative has made progress, serious challenges that could undermine such co-operation lie ahead.


A theoretical and modulation study of a dipole antenna located in rectangular waveguide is presented. The aim is to determine the nature and dimensions which allow us to attain the simulations in free space. We compare the behavior of a dipole antenna modeled by MOM-GEC with those obtained in free space. A method of moment (MoM) approach combined to the generalized equivalent circuit (GEC) modeling is applied to compute the input impedance of a dipole antenna resonating at 1.8 GHz. A parametric study is conducted to investigate the wall effects on the antenna performances. Also we study the convergence of the input impedance as a function of test function number. The current values with integral method (MOM) are compared with the computed values obtained from numerical methods such as the combined MOM-GEC. The simulated values agree with values obtained from numerical methods.


Proper migration and differentiation of neural crest (NC) cells are required for normal development of craniofacial structures, heart and great vessels, sensory and autonomic nervous systems, and other organs within vertebrate embryos. Seriae‐protease inhibitors reduce NC cell migration in vitro, suggesting the extracellular proteases are important mediators of NC cell migration. While plasminogen activator activity levels are high in NC cells relative to other embryonic tissues, its ability to regulate NC cell migration has not been specifically tested in vivo or in vitro. In this study, we show urokinase‐type plasminogen activator (uPA) regulates NC cell migration in vitro through its ability to convert plasminogen to plasmin. Using a transfilter migration assay, NC cell migration was measured in the presence or absence of plasminogen. Our results showed that plasminogen significantly enhanced NC cell migration. This increase could not be attributed to differences in initial NC cell attachment or cytotoxicity and did not require a chemotactic gradient. The plasminogen‐enhanced NC cell migration was blocked by aprotinin (a plasmin inhibitor) and was mimicked by the direct addition of plasmin to the NC cells, indicating that the plasminogen effect was mediated through plasmin generation. Furthermore, anticatalytic‐uPA anti‐body blocked the plasminogen‐enhanced NC cell migration showing that NC cell‐associated uPA activity was required for this effect. Finally, decreasing NC‐uPA activity by treating cells with transforming growth factor‐β, also blocked the plasminogen‐dependent increase in cell migration. These data show that in vitro, NC cell migration is regulated by NC‐associated uPA activity suggesting that growth factor‐regulation of this activity may play a major role in regulating NC cell migratory capacity in vivo. © 1996 Wiley‐Liss, Inc.


This paper proposes a low voltage high current LLC resonant converter for Green PC. Green PC is composed of a lot of blade PCs, and it is a centralized system to manage them in computer center. Green PC should require that its power supplies have several characteristics such as low output voltage, high output current, and high power conversion efficiency. Conventional PSFB (Phase Shift Full Bridge) converter is usually used as DC/DC converter for computer power supply because it has high power conversion efficiency thanks to ZVS (Zero Voltage Switching) operation under middle and high load conditions. However, this converter has some problems such as large switching noise and limitation of ZVS operation under light load condition. In order to improve the performance of power supply for Green PC, a new power supply using popular high efficiency LLC resonant converter for low voltage and high current application is proposed in this paper. The proposed power supply has ZVS capability over the entire load range, thus resulting in good efficiency and high switching frequency. Experimental results verify the performance of the proposed power supply for Green PC using 2[kW] (19[V], 105[A]) rated prototype converter.


Cancer research mainly interests understanding how a normal cell becomes malignant. Here is another question: How does a tumor cell quit the malignant state and return? The answer may be that the reprogramming of tumor cells. In the process of tumor reversion, expressions profiles of many gene can provide reprogramming of tumor cells to the revertants. Recent studies suggested that most strongly downregulated protein in the revertant cells is TCTP. Essentially, TCTP is a house-keeping gene expressed in some cells including not only tumor cells but also erythrocytes, and encodes for a hydrophilic protein of 18–23 kDa. TCTP transcripts accumulate in the resting cells and the cells are rapidly translated, if necessary, into the protein. TCTP protein is expressed at low levels in resting cells and high levels in proliferating cells. Overexpression of TCTP leads to inhibition of etoposide-induced apoptosis, thus reducing TCTP expression either results in apoptosis or reprogramming of cancer cells to the revertants. Additionally, pharmacological studies have shown that agents that reduce TCTP levels kill tumor cells. Other suggested molecular mechanisms in relation to tumor reversion of TCTP are: TCTP is a tubulin-binding protein that associates with microtubules in a cell-cycle; TCTP is directly interact with PLK1 and required for the normal progression of cytokinesis; TCTP binds to the MCL1 protein involved in the programmed cell death; and shows structural similarity to channel-forming helices of the pro-apoptotic protein Bax. In conclusion, TCTP is a key player in the process of tumor reversion and also may provide the new strategies in cancer treatment by identification of new pharmaceutical compounds able to reduce its expression and kill malignant cells.


Free-air carbon dioxide enrichment (FACE) provides a realistic, cost-effective method for evaluating the effects of supraambient CO2 concentrations on growth, development, yield, and water use of agricultural crops and natural ecosystems with very few of the problems normally associated with glasshouse or chamber type research. There are no walls interfering with incident radiation and no artificial constraints on rooting depth. With current FACE technology, CO 2 enriched air is injected around the perimeter of circular plots and natural wind disperses the CO 2 across the experimental area. Under stable, nighttime wind conditions found in FACE wheat experiments at Maricopa, Arizona, the blowers used to inject CO 2 exerted subtle effects on the microclimate in a manner analogous to wind machines used for orchard frost protection. Plots equipped with blowers had nighttime foliage and air temperatures that averaged 0.6–1.0 ◦C warmer than controls without blowers. A secondary effect of these elevated temperatures was that plots equipped with blowers displayed differences in dew duration (time that leaves were wet was reduced 30%), plant development (anthesis occurred 4 days earlier), and senescence [as measured with the normalized difference vegetation index (NDVI)]. Natural wind and turbulence appear to overcome the blower effect during daytime treatments and on some nights. Aerial thermal imagery (8–12 mm) acquired during the 1998 FACE experiment with grain sorghum provided additional evidence of the blower effect on canopy temperatures. Since increased plant tissue temperatures also occur when elevated CO 2 induces partial stomatal closure and reduces transpiration, not all instances of ∗Corresponding author. Tel.: +1-602-379-4356; fax: +1-602-379-4355. E-mail address:email@example.com (P.J. Pinter Jr.) 0168-1923/00/$ – see front matter © 2000 Elsevier Science B.V. All rights reserved. PII: S0168-1923(00)00150-7 320 P.J. Pinter Jr. et al. / Agricultural and Forest Meteorology 103 (2000) 319–333 canopy temperature elevation in CO 2 enriched plots can be ascribed solely to the presence of blowers. It is concluded that proper controls for FACE facilities should have similar air flows to those used in the FACE plots. Advantages and disadvantages to nighttime CO2 enrichment are discussed. © 2000 Elsevier Science B.V. All rights reserved.


Author(s): Crampton, Kevin Thomas | Advisor(s): Apkarian, Vartkess A. | Abstract: Surface-enhanced vibrational spectroscopy has emerged as a powerful tool to probe the (photo)chemistry and (photo)physics of individual molecules, which may be regarded as the primary focus of the field of nanophotonics. Single molecule (SM) sensitivity relies on the excitation of localized surface plasmons which confine far-field radiation to molecular length scales, ultimately enabling submolecular imaging with chemical selectivity. Over the length scales that enable submolecular resolution, localized optical fields cannot be separated from the charge density oscillations that sustain them. As such, the interplay between plasmons, photons and electrons in plasmonic nano-junctions is of critical importance for the development of imaging modalities capable of circumventing the diffraction limit and, more generally, for gaining broader insight into the fundamental mechanisms of surface-enhanced Raman and tip-enhanced Raman scattering (SERS and TERS). In what follows, the SM surface-enhanced parameter space is explored through linear and ultrafast optical measurements utilizing nanometer to angstrom scale plasmonic junctions and non-resonant molecular reporters. SERS measurements carried out on the prototypical gold dimer nano-antenna highlight the interplay between the molecular Raman scattering channel(s) and coherent luminescence of the plasmon itself. Ultrafast studies utilizing 100 femtosecond laser pulses establish the operating principles of the ultrafast analog of surface-enhanced spectroscopy, which are then utilized to demonstrated time and frequency resolved coherent Raman scattering (CRS) in the single molecule limit.The fundamental mechanism of SERS is explored by replacing the continuous-wave excitation source with a picosecond pulse train, which probes the non-equilibrium population dynamics of SM phonon states. The latter are inferred through the observed inverted Stokes/anti-Stokes ratios and verified through stimulated and coherent Raman scattering (SRS and CARS) measurements carried out on the same system. Direct plasmon-molecule energy transfer is dominant over the optically induced and thermal contributions to the vibrational population. Finally, SM TERS measurements utilizing a metalloporphyrin functionalized silver tip are carried out in ultrahigh vacuum and ultralow temperatures (5 K). These measurements directly image the atomic lattice of a copper nitride monolayer with 1.5 A precision. A series of measurements recorded on this system highlight the essential role of photoelectrons in the TERS process.


Follow this and additional works at: http://nsuworks.nova.edu/climate_sustainability_lectures Part of the Energy Policy Commons, Environmental Education Commons, Environmental Health and Protection Commons, Environmental Indicators and Impact Assessment Commons, Environmental Monitoring Commons, Environmental Policy Commons, Natural Resource Economics Commons, Natural Resources and Conservation Commons, Natural Resources Management and Policy Commons, Oil, Gas, and Energy Commons, Other Environmental Sciences Commons, Sustainability Commons, and the Water Resource Management Commons


Objective Vitamin D has many immune benefits and because its deficiency impacts most age groups, it became a nutrient of interest in the coronavirus disease 2019 (COVID-19) era. The objective of this study was to highlight the contribution of vitamin D status to the disease severity of hospitalized pediatric patients suffering from COVID-19 infection.
 Methods This was a cross-sectional study that was conducted on 42 children with documented positive polymerase chain reaction for COVID-19 infection. Detailed history taking and thorough clinical examination were done for each recruited patient. Besides the laboratory and radiological assessment done for COVID-19 patients, 25 hydroxy vitamin D levels [25(OH) D] in the serum were estimated using enzyme linked immunosorbent assay.
 Results Using the cutoff level of 10 ng/mL, only 40% of the patients were below this level and 60% had their vitamin D level more than or equal to 10 ng/mL. Significantly more patients of the first group needed oxygen support (denoting more severe COVID-19 infection and lung involvement). The older the patients, the more evident was vitamin D deficiency among them, and 25(OH) D values were not correlated to weight for length nor weight categories in the studied series of patients suffering from COVID-19.
 Conclusion Vitamin D deficiency affects the severity of pediatric COVID-19 infection in hospitalized patients. It is prudent to advise vitamin D level assessment in such cases and promptly manage the patients accordingly. We recommend further studies to assess the effect of vitamin D supplementation on the clinical outcome of COVID-19 in the pediatric population and other vulnerable groups.


High-throughput sequencing of amplicon libraries is the most widespread and one of the most effective ways to study the taxonomic structure of microbial communities, even despite growing accessibility of whole metagenome sequencing. Due to the targeted amplification, the method provides unparalleled resolution of communities, but at the same time perturbs initial community structure thereby reducing data robustness and compromising downstream analyses. Experimental research of the perturbations is largely limited to comparative studies on different PCR protocols without considering other sources of experimental variation related to characteristics of the initial microbial composition itself. Here we analyse these sources and demonstrate how dramatically they effect the relative abundances of taxa during the PCR cycles. We developed the mathematical model of the PCR amplification assuming the heterogeneity of amplification efficiencies and considering the compositional nature of data. We designed the experiment—five consecutive amplicon cycles (22–26) with 12 replicates for one real human stool microbial sample—and estimated the dynamics of the microbial community in line with the model. We found the high heterogeneity in amplicon efficiencies of taxa that leads to the non-linear and substantial (up to fivefold) changes in relative abundances during PCR. The analysis of possible sources of heterogeneity revealed the significant association between amplicon efficiencies and the energy of secondary structures of the DNA templates. The result of our work highlights non-trivial changes in the dynamics of real-life microbial communities due to their compositional nature. Obtained effects are specific not only for amplicon libraries, but also for any studies of metagenome dynamics.


Abstract We compare various site-response estimation techniques using after-shock data of the 1989 Loma Prieta earthquake collected in Oakland, California. Because of recent interest in comparing results from weak and strong motion (to infer any nonlinearity) and between direct S and coda waves, we pay particular attention to the uncertainties. First, sediment to bedrock spectral-ratio estimates between pairs of sites are compared with those obtained from various generalized-inversion approaches where the source and site effects of multiply recorded events are solved for simultaneously. We find that the site amplification factors are very similar among these approaches, but that the uncertainties can be significantly different depending on how the data are weighted. We also examine and test three site-response estimation techniques that do not rely on a reference site to estimate source and path effects. The first involves a parameterized source- and path-effects inversion. Even when the bedrock data are excluded from consideration, this approach is found to reveal the frequency dependence of site response at each of the sediment sites. The second technique involves taking horizontal- to vertical-component spectral ratios (receiver-function-type estimates) of shear-wave aftershock data. These are also found to reveal the frequency dependence of site response at the sediment sites, and the results for the bedrock site are relatively flat and near unity. the third estimate is formed by taking horizontal-to vertical-component ratios of ambient seismic noise, and these are shown to reveal the fundamental resonant frequency of the sediment sites. Unfortunately, discrepancies exist among all of the site-response estimates (and with one-dimensional predictions) with respect to a frequency-independent scaling factor. Nevertheless, the highly frequency-dependent character of site response is well constrained, and the fact that non-reference-site-dependent methods are capable of revealing this is promising for site-specific hazard assessments in regions that lack adequate reference sites.


There are strong relationships between climate and ecosystems. With the prospect of anthropogenic forcing accelerating climate change, there is a need to understand how terrestrial vegetation responds to this change as it influences the carbon balance. Previous studies have primarily addressed this question using empirically based models relating the observed pattern of vegetation and climate, together with scenarios of potential future climate change, to predict how vegetation may redistribute. Unlike previous studies, here we use an advanced mechanistic, individually based, ecosystem model to predict the terrestrial vegetation response from future climate change. The use of such a model opens up opportunities to test with remote sensing data, and the possibility of simulating the transient response to climate change over large domains. The model was first run with a current climatology at half-degree resolution and compared to remote sensing data on dominant plant functional types for northern North America for validation. Future climate data were then used as inputs to predict the equilibrium response of vegetation in terms of dominant plant functional type and carbon redistribution. At the domain scale, total forest cover changed by ~2% and total carbon storage increased by ~8% in response to climate change. These domain level changes were the result of much larger gross changes within the domain. Evergreen forest cover decreased 48% and deciduous forest cover increased 77%. The dominant plant functional type changed on 58% of the sites, while total carbon in deciduous vegetation increased 107% and evergreen vegetation decreased 31%. The percent of terrestrial carbon from deciduous and evergreen plant functional types changed from 27%/73% under current climate conditions, to 54%/46% under future climate conditions. These large predicted changes in vegetation and carbon in response to future climate change are comparable to previous empirically based estimates, and motivate the need for future development with this mechanistic model to estimate the transient response to future climate changes.


Seventeen weeks old ISA Brown pullets (n=642) were housed into two models of furnished cages. Model A had egg baffles with two claw shortening devices (CSD) per cage, placed in horizontal position (HP). Model B had no egg baffles and two CSD per cage were placed on the rear of feeders, in vertical position (VP). Two types of CSD were used, either abrasive strips or ceramic plates. A third group of birds was housed in conventional cages, with or without strips in VP. Several measures were taken at 18, 35, 49, 62, and 78 weeks of age in a random sample of 10% of hens. The following variables were measured: length of central claw, type and number of feet lesions (FL), and feather cover score (FC). Data were analyzed using a GLM model (SPSS package). The main effects tested were CSD type, CSD position and age. The results suggest that both CSD types were efficient for shortening hen claws and for keeping plumage in good condition, particularly if placed onto egg baffles. However, when placed in such position they may possibly have a negative impact on layers welfare by increasing frequency of toe wounds. KEY WORDS: Claws, furnished cages, layers, toe wounds, welfare.


The relationship between different CA125 parameters and survival in patients with epithelial ovarian cancer was investigated in a prospective study. This involved 161 patients of whom 64 died and 97 remained alive. The established prognostic factors of stage and residual disease were controlled for and the population characteristics (age, follow-up/survival duration, histologic subtype, grade) were comparable in the 'dead' and 'alive' groups. For patients with stage I and II disease preoperative serum CA125, pre-chemotherapy serum CA125, plateau serum CA125 and time to reach the plateau level were all higher in the non-survivors when compared with survivors. In contrast, preoperative serum CA125 and pre-chemotherapy serum CA125 were significantly higher in survivors with stage III and IV disease. A possible explanation for these results includes the suggestion that early- and late-stage ovarian cancer may be different 'diseases' with different natural histories rather than being a continuum. Alternatively, the tumor-associated antigen CA125 being a membrane glycoprotein may have a beneficial, perhaps immunologic role in advanced disease.


The 4-en-3-oxosteroid-5 alpha-reductase from Mycobacterium smegmatis was bound biospecifically on the affinant containing an immobilized testosterone ligand. The enzyme obtained by elution with ethylene glycol and urea in a 32 fold purity has a S. A. of 8.73 X 10(-3) microM androstenedione min-1 mg-1. The coenzyme (FAD) could be separated from the immobilized enzyme substrate complex on the affinity matrix, in the presence of (NH4)2SO4 at pH 3.0. After elution of the apoenzyme 97% of the initial enzyme activity was obtained by incubation with FAD. The reactivated enzyme results in a 40-fold enrichment.


Introduction
This paper addresses the European ICT research regime as an integral part of security research, as it emerged at EU level and also after 9/11. It focuses thereby on the unequal influence certain stakeholders from the high-tech development industry have on the biased directions of the research agenda. The market for civil security has globally grown by a factor larger than 10 since 2001, and, despite the Snowden revelations in 2013, the demand for surveillance ICT by public authorities and private facility operators is rapidly rising. ICT research policy is a core proactive form of public security and social policy, by creating a pool of solutions and measures to be drawn upon in the middle term. In this setting, ICT research success is premised upon a high-tech solutionist, economistic mantra of innovation after which research policy results are measured along econometric indicators. In this respect, reflection upon undesirable side effects of ICT and security-relevant technologies on society is currently methodologically neglected and side-stepped. What is more, the paper questions the capacity of the developed technologies to be "fit-for-purpose", that is, to factually deliver on the comprehensive societal tasks they have been deployed for. The analysis is directed toward ICT function creep, that is, application of the developed technologies other than the originally envisioned, to intended and unintended "dual use" of ICT, that is, the unsolicited transfer of civil technologies to military use. The lack of agreed-upon, rigorous criteria for evidence, which makes (ex-post) evaluations, but also (ex-ante) assessment an arbitrary endeavour, should give place to institutionalization of impact assessment methodologies and practices in the interest of broader segments of society.
Methods
In this paper a threefold methodological approach is pursued: First, a scoping of EU policy documents is done in order to trace legal and policy contexts for ICT (research) policy; Second, a mapping of stakeholders with their diverging agendas within the organizational regime along an influence (power/interest) matrix. The author draws, lastly, on his experience from expert agenda consultations at both German and at EU level, concerning the current and the future ICT/security research programmes.
Results and Discussion
The European Security Research Programme:
Responding to the European Security Strategy (2003) the European Commission launched the mission-oriented research Programme to advance European security through Research and Technology (2004). Budgeted with € 1.4 B under FP7, and with € 1.7 B under Horizon 2020, it is tailored to address four key areas: Fostering Resilience against Disasters and Crises, Fighting against Crime and Terrorism, Border and External Security, and Digital Security. The programme focus is on CBRNE detection, telecommunication data mining technologies, such as DPI, profiling and predictive analytics, biometric identification and pattern recognition, location tracking technologies, as well as surveillance in the form of drones and CCTV. Security research should be mission-driven and serving the five priority areas of the European Union's Internal Security Strategy (ISS): Disrupt international Crime Networks; Prevent terrorism and address radicalisation and recruitment; Raise levels of security for citizens/businesses in cyberspace; Strengthen security through border management; Increase Europe's resilience to crises and disasters. Two major issues have already raised criticism, e.g. by Statewatch, and the European Parliament:
1) The programme is supply-led, promoting industrial interests and not serving the needs of end-users or of the citizens at large.
2) The funded technological research raises serious ethics and fundamental rights questions and is fostering societal insecurity instead of security.
The Challenge:
Security policy and, by default, security research are value-laden, contentious public policy fields. They ought to be informed both by expert evidence and by citizens' values throughout the R&D&I process. Yet, problem definitions, goals, and innovation paths for security research are predominantly shaped by interest groups from the industry. This imbalance in stakeholder participation has, in turn led to a biased "high-tech" understanding of security.
Public concern is growing about how emerging as well as readily available ICT and security technologies, such as biometrics, pattern recognition and detection, risk profiling, and the use of remote sensing and surveillance 'drones', impact on society. What is at stake with such technologies goes beyond issues of data protection and privacy, and poses fundamental questions about the blurring military and civil applications ("Dual Use"), non-intended and non-anticipated consequences of their marketization, such as discrimination of minority social groups, and feasibility and desirability of maximum-security societies. If ethics and societal impacts are to be properly addressed in current and future EU ICT/security research programmes then comprehensive appraisal by experts and citizens themselves is required.
Power asymmetries in the leverage certain actors, such as high-tech Research and Technology Organisations (RTOs), or lobbyists from industry associations have, help them exercise disproportional influence upon the formulation of objectives and the programme of the EU ICT/security policy. c the issue of increasing and streamlining the engagement of civil society actors, being the ultimate beneficiaries of research on security technologies, during the policy cycle of security research in order to enhance both its legitimacy and its effectiveness. The three governance mechanisms recommended below contribute at different stages of the security research policy cycle to make both the process more accountable and responsive to the citizens' needs, and the results more socially and ethically acceptable.
Conclusions
In conclusion, three recommendations of institutional/organizational nature are at hand:     These are meant to make the ICT/security research governance regime more transparent and legitimate, but also more accountable and responsive to the needs and concerns of society, and not merely serve particularistic economic interests. Moreoever, strengthening checks and broadening participation would decisively contribute to minimizing negative non-intended effects of those technologies once applied.
1) Upstream & Streamline CSO Participation
There is a documented need to integrate civil society and its diverse organisations (CSOs) in the early stages of public policy decision making, particularly when the stakes are as high as in the civil security realm. The requirement to engage relevant societal stakeholders beyond organised interests is inscribed both in European Commission's "White Paper on Good Governance" (2002), but also in the "Regulation of the European Parliament and of the Council establishing Horizon 2020" (2012). The implication for security research is that CSOs should not be any longer a "fig-leaf" add-on, promoting "acceptance" for new security technologies, but instead co-define the agenda of security research and make sure that 1) it meets the needs of society, 2) it benefits society, and 3) does not have negative impacts on society.
2) Conduct impact assessments and evaluations
Initiated after 2005 and under update pending for 2014, the European Commission's "Guidelines for Regulatory Impact Assessment" prescribe continuous legitimacy/effectiveness crash tests for policies, such as security research, in order to guarantee that they are 1) fit for purpose (effective), 2) proportional (positive cost-benefit trade-off), 3) informed by scientific evidence, and 4) serving overarching EU values and principles. Specifically, this entails that security research delivers on its primary task, that is, it enhances European citizens' security without infringing civil liberties along the "The Stockholm Programme - An open and secure Europe serving and protecting citizens" (2010), and complies with the EU Charter of Fundamental Rights (2010).
3) Rethink the meaning of Innovation
The current master narrative for innovation in the EU is preoccupied with market-driven, growth-oriented RD Social Innovation in the European Union" pointed towards the huge untapped potential of organisational and institutional innovation for making societies more inclusive, sustainable, and resilient in the spirit of the Lisbon Treaty, by funding non-technological research initiatives.
Acknowledgments
Part of this research has been enabled by the EU FP7 security research project SecurePART (2014-2016), Grant Agreement No. 608039.


THE DRUNKARD'S REVENGE and LOVE'S LABOR. Adapted and directed by Sekine Masaru from William Shakespeare's Twelfth Night. Performed by Roma Kyogen, Japanese National Tour, 2005. This report describes the current attempts by a Japanese no expert to incorporate kyogen techniques into traditional Shakespearean and Italian comedies. Sekine Masaru, drama scholar and no master of the Kanze school, has written about the works of Yeats and Zeami, and directed no style Western drama for international students at the Yeats Summer School Drama Workshop in Sligo and the Drama Center at the University College in Dublin (Sekine 1985, 1990). In 1998, the Japan Foundation sponsored his visit to the Japanese Division of the Faculty of Eastern Studies at the La Sapienza College of the University of Rome. There he trained faculty and students to perform Boshibari (Tied to a Stick) and an adaptation of Kinoshita Junji's Yuzuru (Twilight Crane) in Italian. Since then, Sekine has been melding Italian comedy and kyogen. In 1999, he adapted Carlo Goldoni's Coffee House (1750) into kyogen style, producing it at the Drama Kan Theatre at Waseda University under the title of Wakadanna no Tobaku (The Young Master's Gambling). Around the same time he turned to Shakespearean comedies based on Italian sources, attempting to kyogen-ize them for his classes at Waseda University. Thus his work is a unique project that explores the interface of comic character type, physical theatre, and the cultural capital of Shakepeare in intercultural theatre flows. (1) Sekine returns to Rome every year, using his apartment as a kyogen training studio for Italian students majoring in Japanese studies. The students who volunteer are amateurs in drama, so, although interested in Japanese culture through Japanese animation and popular culture, they had difficulty reading and pronouncing the language. Sekine had to start by instructing them how to read the medieval kanji characters, flatten their dynamic intonation to make their Japanese more natural, and then teach them the undulating rhythms of kyogen declamation. This was the beginning of the Roma Kyogen Ichiza, or Piccola Compagnia di Roma La Sapienza. On 1-2 April 2004, Sekine produced Yopparai no Shikaeshi (The Drunkard's Revenge) and Sakai no Shonin (The Merchant of Sakai) at the Japanese Culture Center in Rome, cast with six students from Roma La Sapienza. The Drunkard's Revenge, an adaptation of Shakespeare's Twelfth Night, was in Japanese, while The Merchant of Sakai was in Italian. In that autumn Roma Kyogen Ichiza toured the National No Theatre in Tokyo, as well as to Saitama, Wakayama, and Kyoto, producing Drunkard's Revenge for Japanese audiences. Nearly three thousand people viewed the touring performances. In March the following year, the troupe produced their new play, Koi no Honeori (Love's Labour), in Rome, touring in autumn to Fukuoka, Nagoya, Kyoto, Osaka, Yokohama, and Tokyo. The 2,500 spectators for the autumn tour and coverage by five different television crews attest to the interest these performances generated. This review covers the 2005 Kyoto production, held at the Kongo No Theatre. The plot of Drunkard's Revenge closely follows a subplot of Twelfth Night. Drawing on some Western slapstick, yet remaining faithful to kyogen style and structure, the actors managed to create an amusing short comedy from Shakespeare. In Drunkard's Revenge, Yamashiro no Kami (the drunkard hero, equivalent to Sir Toby Belch) with his friend Noto no Kami (Sir Andrew Aguecheek), and Kaede (Maria), lady-in-waiting to Princess Ayu (Olivia), gain revenge on insults by Kinoshita Taizen (Malvolio) by having him dress in strange kimonos and engage in fights until Princess Ayu realizes the trick. The play ends with Taizen chasing Yamashiro off stage. Here we see a meeting of kyogen's tricky servants and pompous lord with Shakepeare's plot pattern, topped off by the typical kyogen ending: exit pursued by master. …


In this note, we study communication requirements for decentralized control schemes when sensors and controllers are connected via noiseless digital channels and system noises are bounded. Under various information structures, and within the class of time-invariant encoding and control policies, we quantify achievable rates, and obtain fixed-rate and delayless encoders and decoders that achieve boundedness in the state estimation errors at the controllers. We use distributed coding theoretic approaches to show that when the sensors do not collaborate, it is sufficient for the controllers to share information amongst themselves but not with the sensors. Sensor collaboration, however, leads to improvement in rate performance.


Under a strong magnetic field, the quantum Hall (QH) effect can be observed in two-dimensional electronic gas systems. If the quantized Hall conductivity is acquired in a system without the need of an external magnetic field, then it will give rise to a new quantum state, the quantum anomalous Hall (QAH) state. The QAH state is a novel quantum state that is insulating in the bulk but exhibits unique conducting edge states topologically protected from backscattering and holds great potential for applications in low-power-consumption electronics. The realization of the QAH effect in real materials is of great significance. In this paper, we systematically review the theoretical proposals that have been brought forward to realize the QAH effect in various real material systems or structures, including magnetically doped topological insulators, graphene-based systems, silicene-based systems, two-dimensional organometallic frameworks, quantum wells, and functionalized Sb(111) monolayers, etc. Our paper can help our readers to quickly grasp the recent developments in this field.


oftware radio technology has gained S momentum as engineers everywhere are developing radio architectures that include minimal hardwired analog components. The ability to program intermediate frequency (IF), bandwidth, modulation, coding schemes and other radio functions is the appeal for such widespread interest. Besides providing all these flexibilities, software radio must improve on performance in terms of sensitivity, dynamic range and adjacent-channel rejection. Software radio is still a radio and must perform better than the conventional radio it is replacing. Current advances in field-programmable gate array (FPGA) technology have enabled high-speed processing in a compact footprint, while retaining the flexibility and programmability of software radio technology. FPGAs are popular for high-speed, compute-intensive, reconfigurable applications (fast Fourier transform (FFT), finite impulse response (FIR) and other multiply-accumulate operations). Reconfigurable cores are available from FPGA and board vendors and enable implementation of modulator, demodulator and CODEC functionality in the FPGA. System designers are increasingly looking for front-end acquisition/converter products with integrated FPGA to offload the baseband processing and reduce data transfer rates. Although there has been a huge improvement of the application development tools, FPGA design should be considered as hardware (albeit flexible) development, and it requires a different skill set than software development. This aspect of FPGA design implies that implementing a predesigned core on a commercial off-the-shelf (COTS) front-end data acquisition/converter module is not a simple software development exercise. This needs to be considered during project planning stage to reduce delays down the road. FPGA is important in multimission software radio applications like electronic warfare (EW), radar, communications and RF testing.


The Agreement on the Rescue and Return of Astronauts and the Return of Objects Launched into Outer Space (ARRA) of 1968 deals with the obligation of states toward astronauts in distress or in emergency situations and with the obligation to return space objects. It is the second of the five United Nations space treaties, after the Outer Space Treaty (OST) of 1967 and before the Liability Convention (LIAB) of 1972. The historical development of ARRA and how this agreement reflects the needs and interests of the two important space-faring nations at the time of its entry into force, the United States and the Soviet Union, are important factors for understanding the space race. ARRA is related to the OST and regards the various obligations of states concerning rescue and assistance as well as the return of astronauts, which stand in the middle between a general humanitarian duty and political and national security considerations. The return of space objects and the question of costs of rescue and return operations are important concerns and can be compared to the situation with the law of the sea, the United Nations Convention on the Law of the Sea (UNCLOS) of 1982 and the Convention for the Unification of Certain Rules of Law Respecting Assistance and Salvage at Sea (Salvage Convention) of 1989.
 ARRA has never been applied with respect to accidents or distress of astronauts or cosmonauts but several times with respect to the recovering and returning of space objects. Finally, current challenges, such as the commercialization and privatization of outer space activities need to be addressed. This includes the increased interests of private individuals to enter outer space (so-called space tourism) and the question of the application of the ARRA to suborbital flights. Many legal challenges created by technological progress can be resolved via an evolving interpretation and application of the ARRA. Yet, some issues might warrant a new legal framework.


AIMS
To test whether a non-stenting anti-thrombotic strategy was still effective at 4-year follow-up in patients enrolled in the EROSION study and to explore potential predictors of long-term prognosis.

METHODS AND RESULTS
Out of 55 patients who completed 1-month follow-up, 52 patients finished 4-year follow-up. The median duration was 4.8 years (4.2 - 5.8 years). The majority of patients remained free from events, and all patients were free from hard endpoints (death, myocardial infarction, stroke, bypass surgery, or heart failure). Only 1 patient had gastrointestinal bleeding, and 11 patients underwent elective target lesion revascularization (TLR). Patients in the non-TLR group had more optical coherence tomography (OCT) thrombus reduction from baseline to 1 month; 95% patients in the non-TLR group versus 45% in the TLR group (p=0.001) met the primary endpoint (thrombus volume reduction >50%). Consistent with the OCT findings, angiographic results showed that the TLR group had less improvement in diameter stenosis (p=0.014) at 1 month compared with non-TLR group.

CONCLUSIONS
Four-year follow-up findings reconfirmed the safety of an anti-thrombotic therapy without stenting for erosion-caused acute coronary syndrome. Patients with better response to anti-thrombotic therapy in the first month were less likely to require stent implantation during the next four years.


ABSTRACT Purpose: The essay is mostly based on the analysis of primary sources (reminiscences) and addresses the question of which currents influenced the number of read books in various periods of modern history and particularly in the age of bourgeoisie in Slovenia. Methodology/approach: The research was carried out in accordance with the paradigms of new cultural history with special emphasis on the history of ideas and mentalities. Results: The mentality of enlightenment and national-awakening looked upon as highly non-elitist and emancipatory in Slovenia, led to efficient ways of spreading books and the circle of their readers. The publishers whose mass production became available to everyone, including the poorest strata of the society, ensured low prices of their book editions. Public and private libraries were an important instrument for the spread and creation of interest groups and national communities. Research limitation: The research is based on available resources; however, the lost or unknown resources could surely offer more answers. It is logical that some assumptions can be confirmed by a detailed analysis or by the review of manuscripts and other similar documents held in Slovenian libraries and abroad. Originality/practical implications: The analysis of reminiscences in the political, economical and historical context offers a new point of view of the social stand and cultural values of the Slovenian bourgeoisie in the early 20th century. The study presents the position of Slovenian people and identity shaped by the reading culture and language identity.


The BVDV eradication program in Lower Austria according to the Swedish model started in 1997 as a voluntary strategy and became obligatory for all herd owners in 2004. In this paper we analyse BVDV isolates found in PI animals of the last infected cattle farms at the genetic level and describe possible risk factors for virus transmission in the final stage of the BVDV eradication program in Lower Austria, where only five infected herds were identified in 2010. Viral isolates from 23 farms on which PI animals had been detected in 2009 (n = 10), 2010 (n = 5), 2008 (n = 5) and in 2006 (n = 3) were analysed at a genetic level at the 5'-UTR. All isolates analysed by phylogenetic analysis fall into five BVDV-1 subgenotypes, i.e., b, e, f, g, and h. No new subgenotypes were identified when compared to isolates analysed at the beginning of the BVDV eradication program. The phylogenetic analysis also revealed three groups of herds with genetically identical isolates; the first group comprised two herds, the second seven herds and the third four herds. Analysis of several factors such as distance between herds, purchase of cattle, work of farmers, veterinarians, assistants of milk recording associations and animal carriers indicated the latter as the most critical factor for transmitting the same viruses. Seven herds of two groups of identical BVDV isolates were served by the same cattle carrier, six herds shared the veterinarian and five herds had the same assistant of the milk recording association who could be the risk factor for the introduction of BVDV into the herd. The analysis helped to stop virus transmission. Therefore, from early 2012 up to now, no new infection has occurred in Lower Austria. The results indicated that biosecurity is a very important factor to prevent the spreading of viruses in the final stage of the BVDV eradication program.


The production of bioethanol, which is one of the alternative fuel, cause the various problem such as agflation in human society. As a substitute for the feedstock, lignocellulosic biomass have a big potential. However, bioethanol production with cellulosic material is not commercialized due to high cost. Thermochemical pretreatment to improve the rate of enzyme hydrolysis and increase the recovery of fermentable sugar, is required in order to achieve the cost down in bioethanol production. In this study, various problems and technologies for pretreatment is introduced. Acid hydrolysis, alkali hydrolysis, steam explosion, organosolv process, ammonia explosion, and wet oxidation pretreatment remove lignin and hemicellulose, and reduce cellulose crystallinity. Optimization of pretreatment process on various sources of lignocellulosic biomass such as softwood, hardwood, and straw should be performed.


Oysters are the living vacuum cleaners of the oceans. There is an exponential decline in the oyster population due to over-harvesting. With the current development of the automation and AI, robots are becoming an integral part of the environmental monitoring process that can be also utilized for oyster reef preservation. Nevertheless, the underwater environment poses many difficulties, both from the practical - dangerous and time consuming operations, and the technical perspectives - distorted perception and unreliable navigation. To this end, we present a simulated environment that can be used to improve oyster reef monitoring. The simulated environment can be used to create photo-realistic image datasets with multiple sensor data and ground truth location of a remotely operated vehicle(ROV). Currently, there are no photo-realistic image datasets for oyster reef monitoring. Thus, we want to provide a new benchmark suite to the underwater community.


ARNHEM LAND, in the vicinity of the Liverpool and Blyth rivers that flow into the Arafura Sea, is a region that most Australians appreciate in a very vague way. A recent book by L. R. Hiatt on the native people who live there' should help remedy this deficiency. It is not long since the Arnhemlanders of the Maningrida region harpooned dugong from dug-out canoes, knocked flying foxes from trees with long sticks and speared wallabies and bush turkeys. They received annual visits from the Indonesians from the sixteenth century onwards. Sailing down in their praus with the October monsoons and returning with the trade winds in March, the Indonesians employed the Australians at collecting and preserving trepang for the Chinese merchants of Macassar. They paid their Australian workers in rice, tobacco, alcohol, cloth and knives; Aboriginal mythology celebrates their coming as a kind of Golden Age.


Background: Asthma is characterized by an increased mass of ASMC which show increased proliferation in vitro. As previously reported, glucocorticoids do not have a significant anti-proliferative effect on ASMC of asthmatics while although their anti-inflammatory efficacy is maintained. Methods: We assessed whether the addition of the long-acting β2-agonist formoterol modifies the anti-proliferative efficacy of glucocorticoids (beclomethasone, budenoside, fluticasone). Primary human ASMC lines from asthmatics and controls were set up from bronchoscopic lung biopsies. Results: Serum deprived sub-confuent cells were stimulated by 5% serum with or without a single drug or combination for a further 48 and 72 hrs. Serum alone increased cell proliferation in healthy control cells by 65% (48 hrs) and 81% (72 hrs); a significantly higher proliferation response was seen in asthmatic ASMC (82% at 48 hrs; 123% at 72 hrs). In the presence of different glucocorticoids alone serum-induced proliferation was significantly reduced in healthy cells (max. 48%) but not in asthmatic ASMC. Treatment with formoterol alone reduced serum-induced proliferation by max. 24% at any time point, with no differences between asthmatic and healthy ASMC. When formoterol was combined with fluticasone a 78% reduction of ASMC proliferation was achieved. Conclusions: Our results show that the β2-agonist formoterol re-establishes the anti-proliferative effect of fluticasone in asthmatic airway smooth muscle cells. This synergistic action may exert an anti-remodeling effect on the asthmatic airway supporting the clinical benefit of combination therapy.


Abstract One of the fundamental means of classifying wheat is through its endosperm texture. It impacts significantly on the milling process affecting among other things flour particle size and milling yield. Hardness in wheat is largely controlled by genetic factors but it can be affected by the environment and factors such as moisture, lipid, and pentosan content. The principal genetic locus controlling endosperm texture in wheat, Ha , is located on the chromosome 5D. At this locus several genes, notably the puroindolines, have been identified. Puroindolines are the major components of the 15 kDa protein band associated with starch granules that is more abundant in soft wheats than in hard. Recently the puroindolines have been shown to enhance grain hardness in rice. In this review we discuss the structure of hard and soft wheat endosperm with particular emphasis on when differences in endosperm texture can be detected in the developing seed. The role of the environment and other factors that may affect the endosperm texture is also examined together with the role of the puroindoline genes at the Ha locus. Finally, we compare endosperm hardness in wheat and in barley.


Type 2 diabetes is on the increase among the Swiss immigrants. The cultural background of patients presents new linguistic and sociocultural barriers and gains in importance for health care. In order to develop patient-centred care, it is necessary to focus on different sociocultural aspects in everyday life and experiences of immigrants from the former republics of Yugoslavia with diabetes who have rarely been studied in Switzerland. Based on these insights the needs for counselling can be identified and nursing interventions can be designed accordingly. Using the Grounded Theory approach, 5 interviews were analysed according to the Corbin and Strauss coding paradigm. The central phenomenon found is the experience to live in 2 different cultures. The complexity arises from the tension living in 2 cultural backgrounds at the same time. It turns out that in the country of origin the immigrants adjust their disease management. The changing daily rhythm and the more traditional role model affect aspects of their disease management such as diet and/or drug therapy. The different strategies impact the person's roles, emotions, their everyday lives and their families. It provides an insight into the perspective of Swiss immigrants from the former republics of Yugoslavia suffering from diabetes. Many questions are still unanswered and further research will be required.


The author discusses the implications of the psychoanalytic concept of insight. He refers to it as an "action-steering utopia of the psychoanalytic process".


With the tremendous increase in the number of air passengers in the past years, aviation safety has been of utmost importance. At any given point of time, there will be several flights lining up for landing. Landing in good visibility conditions is not a problem. However, the problem arises when we have poor visibility conditions, especially foggy conditions. The pilot finds it difficult to land the flight in poor visibility conditions because of the difficulty to spot the runway clearly. This paper presents a novel method for detecting the runways and hazards on it in poor visibility conditions using image processing techniques. The first step is to obtain the images of a runway on a clear day and compute the smoothness coefficient followed by edge detection, using the SUSAN edge detection algorithm and then finally develop a database of the smoothness coefficients and edge detected images. Now, for the foggy images we compute the smoothness coefficient. Typically, foggy images have low contrast. Hence, before we perform edge detection, we enhance the image using Multi-Scale Retinex (msr). msr provides the low contrast enhancement and color constancy, required to enhance foggy images, by performing non-linear spatial/spectral transforms. After enhancement, the next step is to run the same edge detection algorithm with appropriate thresholds. Finally we determine a hazard by comparing the edge detected images of images taken under clear and foggy conditions. The paper also compares the results of the SUSAN edge detection algorithm with the state of art edge detection techniques.


Ferro- and piezo-electrets are non-polar polymer foams or film systems with internally charged cavities. Since their invention more than two decades ago, ferroelectrets have become a welcome addition to the range of piezo-, pyro-, and ferro-electric materials available for device applications. A polarization-versus-electric-field hysteresis is an essential feature of a ferroelectric material and may also be used for determining some of its main properties. Here, a modified Sawyer-Tower circuit and a combination of unipolar and bipolar voltage waveforms are employed to record hysteresis curves on cellular-foam polypropylene ferroelectret films and on tubular-channel fluoroethylenepropylene copolymer ferroelectret film systems. Internal dielectric barrier discharges (DBDs) are required for depositing the internal charges in ferroelectrets. The true amount of charge transferred during the internal DBDs is obtained from voltage measurements on a standard capacitor connected in series with the sample, but with a much larger capacitance than the sample. Another standard capacitor with a much smaller capacitance—which is, however, still considerably larger than the sample capacitance—is also connected in series as a high-voltage divider protecting the electrometer against destructive breakdown. It is shown how the DBDs inside the polymer cavities lead to phenomenological hysteresis curves that cannot be distinguished from the hysteresis loops found on other ferroic materials. The physical mechanisms behind the hysteresis behavior are described and discussed.Ferro- and piezo-electrets are non-polar polymer foams or film systems with internally charged cavities. Since their invention more than two decades ago, ferroelectrets have become a welcome addition to the range of piezo-, pyro-, and ferro-electric materials available for device applications. A polarization-versus-electric-field hysteresis is an essential feature of a ferroelectric material and may also be used for determining some of its main properties. Here, a modified Sawyer-Tower circuit and a combination of unipolar and bipolar voltage waveforms are employed to record hysteresis curves on cellular-foam polypropylene ferroelectret films and on tubular-channel fluoroethylenepropylene copolymer ferroelectret film systems. Internal dielectric barrier discharges (DBDs) are required for depositing the internal charges in ferroelectrets. The true amount of charge transferred during the internal DBDs is obtained from voltage measurements on a standard capacitor connected in series with the sample, but with...


Background and epidemiology: This past May and June, the US Centers for Disease Control and Prevention and the Public Health Agency of Canada each dedicated a month, respectively, to raising awareness about stroke. Each year in Canada stroke occurs in 50 000 people and accounts for 7% of all deaths. About 5% of men over the age of 65 have been affected by stroke; the proportion is only slightly lower for women. Care for stroke patients accounts for 2.1% of Canadian health care expenditures.1 The burden of this devastating disease can be reduced through a combination of clinical interventions targeted at high-risk individuals and broader population-health initiatives to control chronic diseases.2

The causes and mechanisms of stroke vary. Half of cases are atherothrombotic in origin, with a further 25% attributable to small-vessel lacunar disease and 20% to cardioembolism.1 Common conditions that underlie stroke include atherosclerosis, atrial fibrillation, hypertension, dyslipidemia and diabetes.1

Some risk factors for stroke, such as age, gender, ethnicity and genetic factors, cannot be modified. Others, if moderated, can greatly reduce both the likelihood of stroke and the severity of its outcomes: physical inactivity, hypertension, smoking, dyslipidemia, atrial fibrillation, diabetes and heavy use of alcohol.2

Clinical management: Prevention of stroke in individuals with underlying disease was recently and thoroughly reviewed in CMAJ.1 Highlights of that review are shown in Table 1.

Table 1

Timely access to medical care for thrombolysis (if indicated) and early treatment with ASA can improve stroke outcomes. Individuals at risk of stroke need to be educated that the warning signs of stroke include sudden weakness, trouble speaking, sudden loss of vision and severe unusual headache or dizziness. This must especially be reinforced in patients who experience a transient ischemic attack (TIA), since the risk of stroke is elevated in the first 48 hours after a TIA and the risk of having a stroke within a year of a TIA is 10%–14%.3

Prevention: A stroke-prevention strategy aimed at the general public that involves education and regulatory changes is potentially less costly than and as effective as those that target high-risk populations. For example, about 26% of Canadian adult men and 18% of women have hypertension, defined as a diastolic blood pressure of 90 mm Hg or more, or a systolic pressure of 140 mm Hg or more. About 40% of such people are unaware they have hypertension. Data from large-cohort studies have suggested that a mere 2 mm Hg reduction in a population's mean diastolic blood pressure can decrease the number of new strokes by as much as 14%, which is comparable to targeted medical treatment of all patients with a diastolic pressure of 95 mm Hg or higher.2

Since many of the risk factors for stroke also contribute to the burden of other chronic diseases, there is growing interest in embedding stroke-prevention programs within a broader strategy of control of chronic disease. This includes special attention to those risk factors that contribute to the largest proportion of new stroke cases: physical inactivity, hypertension and smoking.2

Erica Weir CMAJ


This paper presents a decentralized model predictive based load frequency control for multi-area power systems. An MPC controller is designed for each area to decrease the effect of load disturbances and parameter uncertainties owing to variations in power system's parameters. Also to estimate load changes, Fast Output Sampling (FOS) method is used. The estimated signal is defined as a measured disturbance for MPC controller. The MPC method uses feed-forward control strategy for rejecting load disturbance effect in each power system area. A three-area power system has been considered as a test case to evaluate the proposed control scheme's performance. The results have been compared with a recent proposed robust LMI based PI control strategy. This comparison confirms that the proposed method has better performance than the LMI based PI control design in the presence of disturbances and uncertainities so that the frequency deviation and power flow changes between areas are effectively damped to zero with small oscillations in a short time.


This paper was developed with the motivation to design a contemporary approach to the teaching process, as well as to improve and modernize the existing theories and practices, and it is in the function of the necessary reforms of the entire educational system. Generally speaking, the paper is devoted to the methodical concept of the newly proposed model of teaching, which was created within the modification and methodical adaptation of the G. Mayer's former cybernetic model of learning in individualized teaching. Based on the scientific didactic knowledge, an innovative methodological model was constructed – a multimedia teaching strategy, based on the integration of individualization models in educational software. In this paper, certain key segments and implications are presented, as well as the methodical procedure for the preparation and realization of the multimedia strategy that was mentioned.


Abstract As participants in the California Medicaid 1115 waiver, the University of California San Diego Health (UCSDH) used population health informatics tools to address health disparities. This case study describes a modern application of health informatics to improve data capture, describe health disparities through demographic stratification, and drive reliable care through electronic medical record-based registries. We provide a details in our successful approach using (1) standardized collection of race, ethnicity, language, sexual orientation, and gender identity data, (2) stratification of 8 quality measures by demographic profile, and (3) improved quality performance through registries for wellness, social determinants of health, and chronic disease. A strong population health platform paired with executive support, physician leadership, education and training, and workflow redesign can improve the representation of diversity and drive reliable processes for care delivery that improve health equity.


Recurrence and metastasis are the main reasons for failure in the treatment of triple-negative breast cancer (TNBC). Phototherapy, one of the most well-known potent cancer treatment models is highlighted by ablating primitive tumors with immunogenic cell death (ICD) and is associated with endoplasmic reticulum (ER) stress to elicit long-lasting anti-tumor immunity. However, the provoked inflammatory response after phototherapy will stimulate angiogenesis, which provides nutrition for tumor recurrence. Here, an ER-targeted nanoplatform was constructed based on hollow mesoporous Cu2-XS (HMCu2-XS) nanoparticles to suppress recurrence and metastasis of TNBC by combining photo-ablation and microenvironment remodeling. Profiting from the metal ion coordination and large hollow space, HMCu2-XS can be easily modified with p-toluenesulfonamide for ER-targeting and quantitatively loaded celecoxib (CXB) as a vascular inhibitor, thus obtaining ER-HMCu2-XS/CXB. ER-HMCu2-XS showed great photothermal and photodynamic efficiency for ablating 4T1 tumors and inducing ICD under NIR-II laser irradiation. Compared with non-ER-targeted nanosystems, the ER-targeted nanosystem elicited stronger ICDs and recruited more immune cells. Moreover, the thermal-responsively released CXB successfully inhibited angiogenesis after photothermal therapy. The data showed that the ER-HMCu2-XS/CXB mediated the triplicate therapeutic effect of photo-ablation, immune response activation, and vascular suppression effectively, preventing the recurrence and metastasis of TNBC. In conclusion, this work provides a synergistic strategy to enhance therapeutic outcomes in TNBC.


The purpose of this study was to evaluate the microbial community (MC) composition as it relates to salivary metabolites and periodontal clinical parameters in a 21-d biofilm-overgrowth model. Subjects (N = 168) were enrolled equally into 5 categories of periodontal status per the biofilm-gingival interface classification. Microbial species within subgingival plaque samples were identified by human microbiome identification microarray. Whole saliva was analyzed by liquid chromatography–mass spectrometry and gas chromatography–mass spectrometry for metabolite identification. Phylum was grouped into MCs according to principal component analysis. Generalized linear and regression models were used to examine the association among MC, species, periodontal clinical parameters, and salivary metabolome. Multiple comparisons were adjusted with the false discovery rate. The study population was distributed into 8 distinct MC profiles, designated MC-1 to MC-8. MC-2 explained 14% of the variance and was dominated by Synergistetes and Spirochaetes. It was the only community structure significantly associated with high probing depth (P = 0.02) and high bleeding on probing (P = 0.008). MC-2 was correlated with traditional periodontal pathogens and several newly identified putative periodontal pathogens: Fretibacterium fastidiosum, Fretibacterium sp. OT360/OT362, Filifactor alocis, Treponema lecithinolyticum, Eubacterium saphenum, Desulfobulbus sp./OT041, and Mogibacterium timidum. Synergistetes phylum was strongly associated with 2 novel metabolites—cyclo (-leu-pro) and cyclo (-phe-pro)—at 21 d of biofilm overgrowth (P = 0.02). In subjects with severe periodontitis (P2 and P3), cyclo (-leu-pro) and cyclo (-phe-pro) were significantly associated with increased changes in probing depth at 21 d of biofilm overgrowth (P ≤ 0.05). The analysis identified a MC dominated by Synergistetes, with classic and putative newly identified pathogens/pathobionts associated with clinical disease. The metabolomic discovery of 2 novel cyclodipeptides that have been reported to serve as quorum-sensing and/or bacteriocidal/bacteriostatic molecules, in association with Synergistetes, suggests a potential role in periodontal biofilm dysbiosis and periodontal disease that warrants further investigation.


The paper analyzes the current state and prospects of development of the mechanism of compensation of harm in criminal proceedings. It is noted that with a steady trend of growing discontent of the majority of victims with the state's activities to restore their rights violated because of the crime, the courts properly resolve civil claims in criminal cases. The reasons why article 52 of the Constitution of the Russian Federation remains declarative are revealed. The conclusion about the inadmissibility of expanding the subject and grounds of civil claims in criminal proceedings is substantiated. It is indicated that the foreign practice of compensation for harm to victims, including through the formation of compensation funds, the use of mediation procedures, funds of non-governmental organizations, faces many problems that remain unresolved. In this regard, it is proposed to use only the institutions of restitution and voluntary compensation of harm in the criminal process, actively using the possibilities of pre-trial stages, as well as to consider claims that clearly arise from the substance of the criminal law dispute and (or) recognized by civil defendants. The remaining civil law issues directly or indirectly related to the committed or impending crime should be resolved in civil proceedings, where the burden of proof of the asserted claims is placed on the person recognized as the victim in the criminal case, his heir or representative. An important role is given to the improvement of the system of execution of court decisions, including through the development of programs based on the achievements of modern digital technologies.


A retrospective study was performed in an Italian tertiary hospital to evaluate trends in candidaemia between 1992 and 2001, and to compare the characteristics of episodes of fungaemia between 1992--1997 and 1998--2001. In total, 370 episodes of candidaemia were identified, with an average incidence of 0.99 episodes/10 000 patient-days/year (range 0.49--1.29 episodes). On an annual trend basis, the overall incidence was essentially stable in surgical and medical wards, but decreased in intensive care units (ICUs) (p 0.0065). The average use of fluconazole was 37.9 g/10 000 patient-days/year (range 21.4--56.1 g), and did not change significantly during the 10-year period. Nearly two-thirds of patients were in ICUs at the onset of candidaemia, but none was neutropenic in either study period. Candida albicans remained the predominant species isolated (53.8% vs. 48.1%), followed by Candida parapsilosis, Candida glabrata and Candida tropicalis, the distribution of which did not change significantly. The 30-day crude mortality rate was essentially similar (44% vs. 35%) in both study periods. Thus the incidence of nosocomial candidaemia, although high in this institution, decreased among critically-ill patients during the 10-year period. This finding seemed to be related to an improvement in infection control practices, particularly regarding the prevention of intravascular catheter-related infections in ICUs. Although the overall use of fluconazole was considerable, no increase in azole-resistant non-albicans Candida spp. was detected.


High erosivity induced by high rainfall volume and high intensity in the tropical climate of Malaysia has rendered soil being easily eroded during rainfall. With an annual rainfall depth of more than 2000 mm, rainfall intensities exceeding 100 mm in 24 h regularly occur. Stream suspended solid concentrations immediately after a high intensity storm often exceed 5000 mg 1 -1 , with high variations over space and time. Soil loss and sediment yield in virgin forest is usually low. However, logging activities with high intensity of roads and skid trails drastically changes the fundamental characteristics of the forest floor with regard to sediment generation, storage and transport causing soil loss and sediment yield to increase by an order of magnitude or more. This paper presents a review of data on sediment yield and stream suspended solid concentration due to logging in Malaysia to assess the potential impact of logging on water quality in the Ulu Muda forest. Some soil loss simulation results are presented to highlight the potential risk posed by logging within water catchment areas.


In the last twenty-five years, there have been significant advances in the spatial resolution of most geophysical sets of data. Whereas geophysical data were once commonly acquired along widely spaced profiles, it is now more usual to obtain geophysical data along numerous closely spaced traverses. As a result, the spatial sampling is now comparable in both horizontal directions and the greater resolution has greatly improved the interpretation of geological features. A major benefit of high resolution geophysical data sets, is the ability to generate pseudo-geological maps. The geological map traditionally has been a one of the most important domains for visually summarizing geological information. The broad objective of this study was to use seismic refraction methods to map in detail a faults zone and shear zone, which there was no evidence of subsurface faults in study area. Seismic refraction methods were selected because of their potential ability to provide greater lateral resolution of the narrow vertical shear zone, than is currently the norm with electrical or electromagnetic methods. The results of the seismic refraction surveys show that the hidden faults occur as a narrow region with low seismic velocities and increased depth of weathering.


BACKGROUND
The preferred treatment of malignant distal bile duct strictures is endoscopic stent insertion. When this fails, percutaneous drainage is an alternative to surgery. The purpose of this study was to evaluate the success and complication rate of temporary percutaneous treatment.

MATERIAL AND METHODS
20 patients (12 men, 8 women, mean age 62 years) with obstructive jaundice secondary to pancreatic carcinoma (14 patients), metastases of colorectal carcinoma (3 patients) and cholangiocarcinoma (3 patients) underwent percutaneous treatment after 2 unsuccessful attempts of endoscopic cannulation. Puncture of the intrahepatic bile duct system was done under US and direct radiological monitoring using a 22-gauge needle.

RESULTS
In 11 patients bile was drained internally-externally using multiple side holes catheters placed percutaneously via the bile ducts and Vater's papilla into the duodenum. In 4 patients bile was drained internally by percutaneous stent insertion. In all other patients bile was drained externally. The internal-external bile drainage was temporary. 14 days after this procedure in all patients endoscopic sphincterotomy was performed and endoprosthesis was placed. In the group with percutaneous internal bile drainage further endoscopic treatment was successful in 2 patients and in remaining patients the next stent had to be inserted percutaneously. In the group with percutaneous external bile drainage stent placement during ERCP was possible in 2 patients. The overall success rate for bile drainage was 100%. In 15 patients (75%) further endoscopic retrograde procedures were thus made possible. Complications occurred in 2 of the 20 patients (10%). None were life-threatening and surgical intervention was not necessary. One patient developed cholangitis and one another--bacteraemia.

CONCLUSION
Temporary, percutaneous bile drainage is an alternative with a high success rate when endoscopic cannulation fails. Surgery can be avoided in nearly 75% of cases.


We take here a broad view of model engineering as encompassing different approaches such as the OMG MDA/spl trade/ proposal as stated in R. Soley (2000), the Microsoft Software Factories view based in J. Greenfield (2004), and many others. We distinguish the three levels of principles, standards and tools to facilitate the discussion. We proposed the idea that there exist a common set of principles that could be mapped to different implementation contexts through the help of common standards. We illustrate our claim with AMMA, a lightweight architectural style for a model-engineering platform that is currently mapped onto the eclipse modeling framework according to F. Budinsky et al. (2004).


: The major known health problems from roofing occur from the use of coal-tar pitch products. This article examines the severe eye and skin irritations prevalent among roofers and also explores other issues, such as the potential carcinogenicity of roofing material.


Background: In Pakistan, Chronic Obstructive Pulmonary Disease(COPD)is still underdiagnosed.We conducted this study to see utility of GOLD screening questionnaire for quick identification of COPD patients and to identify the risk factors frequency for COPD. Methodology: Global obstructive lung disease(GOLD) copd screening questionnaire was used to screen patients in COPD camp at Khyber Teaching Hospital, Peshawar, followed by spirometry for confirmation & their demographics, risk factors& treatment details were entered on a structured questionnaire. Results : Total of 500 patients were screened on 5 item COPD screening questionnaire.270 patients screened of having suspicion of COPD were further worked up.Among them,73% and 27% were males and females with mean age 42± 17yrs.Tobacco was consumed by 50% & out of these 27% used niswar.Other risk factors such as exposure to logfire and passive smoking were found in 42 and 41% of the study participants. Risk factors for COPD at workplace such as exposure to visible dust, smoke, irritating chemicals and fumes were found in 67,47,24 and 10% of the respondents respectively. Past history of Tuberculosis & asthma were present in 10 & 25% of patients.Mean FEV1,FVCand PEFR of the study population was 2.4± 0.97 L(73%predicted),2.9 ± 1.1 L(74% predicted)& 415 ± 140 L/min(86% predicted) respectively.Almost 50% were either asthmatic or at risk of having COPD due to exposure to risk factors. Conclusion: GOLD COPD screening questionnaire is helpful in identifying patients and even those with normal spirometry have risk factors for COPD like tobacco use, exposure to log fire, passive smoking and workplace exposure to visible dust, smoke, irritating chemicals and fumes.