ABSTRACK

Dewi, Shara Ameilia. 2017. "Nilai Moral dalam Film Anime Kuranado (Clannad) Karya Sutradara Osamu Dezaki: Kajian Sosiologi Sastra". Thesis, Study Program of Japanese Literature, Faculty of Cultural Sciences, Diponegoro University. Advisor Nur Hastuti, S.S., M.Hum.

Kuranado (Clannad) the movie anime tells about the main character Okazaki Tomoya who learn about the meaning of family and friends through the main character of a woman named Furukawa Nagisa. In addition to interesting and touching, there is a strong sociological element of social relations between the characters who care for each other, so that moral values are very important in the story that makes the author base to examine the moral values in Kuranado (Clannad) the movie anime. The purpose of this study is to analyze the intrinsic elements and moral values in Kuranado (Clannad) the movie film that directed by Osamu Dezaki.

The author uses three stages in the research method, which is collecting anime film data Kuranado (Clannad) by downloading from the internet at the website named http://lk21.me/Kuranado-2007/, then for Japanese subtitle, the author also download from the internet on the site named akineko.net. After the data analysis, the authors analyzed intrinsic elements that included themes, figures and characterizations, plots, setting, and message with the structural theory and the technical mandates of the division of moral values from the book Teori Pengkajian Fiksi by Burhan Nurgiyantoro. Furthermore, the moral value in terms of sociology of literature, the author uses the book Sosiologi Sastra by Sapardi Djoko Damono. Then last, at the stage of data presentation, the author uses qualitative descriptive method.

The result of this research is the two types of moral values in Kuranado (Clannad) the movie anime. First, the kind of moral values that governs human relationships with oneself. Secondly, the kind of moral values that governs human relationships with other human beings in the social environment.

Keywords: moral values, intrinsic elements, anime, kuranado (clannad) the movie, sociology of literary


Structural clustering is a fundamental graph mining operator which is not only able to find densely-connected clusters, but it can also identify hub vertices and outliers in the graph. Previous structural clustering algorithms are tailored to deterministic graphs. Many real-world graphs, however, are not deterministic, but are probabilistic in nature because the existence of the edge is often inferred using a variety of statistical approaches. In this paper, we formulate the problem of structural clustering on probabilistic graphs, with the aim of finding reliable clusters in a given probabilistic graph. Unlike the traditional structural clustering problem, our problem relies mainly on a novel concept called reliable structural similarity which measures the probability of the similarity between two vertices in the probabilistic graph. We develop a dynamic programming algorithm with several powerful pruning strategies to efficiently compute the reliable structural similarities. With the reliable structural similarities, we adapt an existing solution framework to calculate the structural clustering on probabilistic graphs. Comprehensive experiments on five real-life datasets demonstrate the effectiveness and efficiency of the proposed approaches.


Structural reconstruction of the myocardial arteries seen in congenital heart disease was analyzed and its importance for cardiac activity was defined on the basis of studying case reports, postmortem examinations and morphological data on 127 abnormally formed hearts. It has been established that developmental abnormalities of the heart may be accompanied by myocardial hypertrophy and lesions of the coronary arteries, having an adaptation and pathological character. The former ones lie in hypertrophy and hyperplasia of vascular wall muscles, whereas the latter ones in sclerosis and thrombosis of the arteries, thus creating prerequisites for heart decompensation.


Subduction zones produce some of Earth's most devastating geological events. Recent eruptions of Mount St. Helens and great earthquakes and tsunamis in Japan and Sumatra provide stark examples of the destructive power of subduction-related hazards. In the Cascadia subduction zone, large earthquakes, tsunamis, and volcanic eruptions have occurred in the past and geologic records imply that these events will occur in the future. As the population and infrastructure increase in the region, resilience to these natural hazards requires a detailed scientific understanding of the geologic forces and processes involved, combined with a society motivated to mitigate risks.


A two-order-magnitude increase in the expression of an endogenous retrovirus was found in myocytes from spontaneously hypertensive rats (SHR) relative to Wistar-Kyoto rats (WKY). It has now been demonstrated that the increase in proviral transcripts is not secondary to the effects of pressure overload, as WKY hearts with hypertrophy due to aortic banding do not express the retrovirus. Crossing SHR with WKY results in intermediate levels of blood pressure, hypertrophy and retroviral gene expression, suggesting co-segregation of genotype and phenotype. Findings suggest a possible linkage between an endogenous retrovirus and genetic hypertension in the SHR. A brief overview of endogenous retroviruses is presented and a discussion of their potential for inducing cardiovascular pathology is considered.


One of the criteria for using the pressure-time method is that there is a straight pipe between the measurement cross sections. If the physical influences from a bend were known the method could be expanded for use over bends and hence on more power plants. At the Norwegian University of Science and Technology (NTNU) a test rig suited for experiments on the pressure-time method has been built. In addition to earlier experiments performed on straight pipe and double 90 degree bend, experiments on double 45 degree bend has been performed. This is done in order to try to find out if there is a clear relationship between bend geometry and its influence on the pressure time curve. To further develop the knowledge a full scale test in the field has been conducted on a 5 MW 58 meter head machine with a vertical penstock and a 90 degree bend. In the laboratory a double 90 degree bend caused an underestimation of the flow of about 1 % compared to a straight pipe, while for a double 45 degree bend a conclusion can not be found as the spread around the mean and uncertainty bands is within the range for the straight pipe. The field measurements with a 90 degree bend showed that the underestimation became 8.5%. When measuring pressure difference over bends the resulting calculation will give an underestimation of the flow. This should imply that the measured transient pressure is damped. (Regardless if this is the correct term it is here chosen to call this damping.) The question is if the damping is caused by friction or kinetic effects. The rapid deceleration of the water masses will give transient friction. How transient friction behaves is a topic of interest in hydraulic research. Bends will also cause skewed velocity and pressure profile on inlet and outlet of the bend as well as secondary flows. How this affects the transient pressure is also an interesting parameter.


A quantitative method is proposed to determine of Stone-Wales defects for carbon nanostructures with sp2 hybridization of carbon atoms. The technique is based on the diene synthesis reaction (Diels-Alder reaction). The proposed method was used to determine Stone-Wales defects in the few-layer graphene (FLG) nanostructures synthesized by the self-propagating high-temperature synthesis (SHS) process, in reduced graphene oxide (rGO) synthesized based on the method of Hammers and in the single-walled carbon nanotubes (SWCNT) TUBAL trademark, Russia. Our research has shown that the structure of FLG is free of Stone-Wales defects, while the surface concentration of Stone-Wales defects in TUBAL carbon nanotubes is 1.1×10-5 mol/m2 and 3.6×10-5 mol/m2 for rGO.


Given the high prevalence of unintended pregnancy and early pregnancy failure, family physicians frequently encounter these clinical problems. Early abortion care and miscarriage management are within the scope of family medicine, yet few family medicine residency programs' curricula routinely include training in these skills. Comprehensive reproductive health education for family physicians could benefit patients by improving access to safe care for unintended pregnancy and early pregnancy loss and by improving continuity of care, especially for rural and low-income women. By promoting reflection on conflicts between personal beliefs and responsibility to patients, training in options counseling and abortion care fosters patient-centered care and informed decision making. Managing pregnancy loss and termination also improves skills in patient-centered counseling and primary care gynecology. Multiple studies document the feasibility and success of several training models for abortion and miscarriage management in family medicine. Incorporating comprehensive reproductive health care into family medicine residency training enables family physicians to provide a full range of reproductive health services.


Tuberculosis, one of the oldest diseases of human beings, has still high mortality rates. In this prospective study, 113 HIV seronegative patients with extrapulmonary tuberculosis (EPT) who were admitted to our department between January 2001 and July 2006 have been evaluated and cases with severe or mild forms of EPT have been compared with respect to epidemiological and clinical features, laboratory results and treatment outcomes. The age range of the patients were 16-78 years old (mean age: 46.3 +/- 16.9 years), and 64 of them (56.6%) were female. Severe and mild forms of EPT were diagnosed in 49 (43.3%) and 64 (56.6%) of the patients, respectively. The most frequently involved organ was detected as lymph nodes (43.3%), followed by pleura and vertebrate involvements with the rates of 12.4%. There was an underlying disease in 35 (30.9%) of the patients (diabetes mellitus in 15%; chronic renal dysfunction in 11.5%; malignancy in 4.4%), history of passed tuberculosis infection in 13 (11.5%) and history of contact with a tuberculosis patient in 25 (22.1%). In direct microscopic examination, samples from 19 (16.8) patients were found positive for acid-fast bacilli, and samples cultivated in Lowenstein-Jensen media yielded mycobacterial growth in 25 (22.1%) patients. The diagnosis have been made histopathologically in 89 (78.7%) of the cases. In comparison of the patients with severe and mild forms of EPT, the severe form were detected more frequently in males (p= 0.01), the positivity rates of culture and acid-fast staining were higher in patients with severe form (p= 0.0004 and p= 0.001, respectively). The mortality rate was also found higher in patients with severe form (p= 0.046). The cases who were diagnosed as EPT have been treated by three or four antituberculosis drugs. Izoniazid (300 mg/day, 6-12 months), rifampicin (600 mg/day, 6-12 months), ethambutol (1500 mg/day, 2-4 months), pyrazinamide (2000 mg/day, 2-4 months) and streptomycin (1 g/day, 45-60 days) were used for the therapy. Side effects due to the therapy were observed in 13.3% of the cases (most frequently; gastrointestinal intolerance in 53.3% and hepatitis in 40%), however, there was no necessity to quit the therapy. Surgical treatment has been applied in 14 (12.4%) of the patients. As a result, the investigation of epidemiological and clinical characteristics of extrapulmonary tuberculosis on the large series of cases may be essential for early diagnosis and treatment in endemic countries such as Turkey.


In the medium size tokamak JFT-2M, ferritic steel plates (FPs) were inserted in order to reduce the toroidal field ripple, which caused fast ion losses. A 2D infrared TV (IRTV) system with time and spatial resolutions appropriate for measuring the first wall temperature increment caused by the ripple ion losses was developed. An IR thermal-imaging camera was used in the present study; this device provided a field rate of 60 fields/sec and a detectable temperature range of 0-500oC with a resolution of 0.2oC. The PtSi detector, sensitive to 3˜5 µm IR radiation, was arrayed in 256 × 256 pixels. The optical system consisted of an IR-lens, a turning mirror, and a sapphire vacuum window with a distance from the camera position to the target wall of 3.5 m, resulting in spatial resolution of ˜3 mm. The target wall consisted of ˜9 cm × ˜15 cm carbon tiles. By using this system, local hot spots due to the ripple-trapped and banana drift losses were observed when fast ions were produced by tangential NBI (36 kV, ˜0.5 MW). The peak temperature increment reached ˜75oC and ˜150oC on the ripple-trapped and banana drift loss regions, respectively. In the optimized condition with FP insertion, the temperature increment was reduced to an almost negligible level for the ripple-trapped loss regions. The corresponding increment for the banana drift loss regions was also minimized. These IRTV data clearly demonstrate the efficacy of FPs for the reduction of fast ion losses.


At the recent 16th Party Congress a comprehensive change of the Chinese
leadership was carried through. Even though there was much
speculation as to whether Jiang Zemin and his generation would retire
as scheduled, the change of the old guard took place without much
drama when the congress finally convened in Beijing.
How do we evaluate this development? Does it mean that Chinese
politics have matured in the sense that major decisions now conform to
fixed rules and regulations rather than factional politics? Has the Chinese
political process become more transparent? Have consensual decision-
making processeses finally taken over, relegating patrimonial
policies to a phenomenon of the past? Since the mid-1990s, clear and
detailed regulations for the selection and appointment of leading cadres
have been promulgated. Is the 16th Party Congress the final step in
this process of procedural normativization? Before attempting to answer
these questions, this paper will first deal with the personnel
changes that took place at the 16th Party Congress and the Central Committee
(CC) meeting shortly after the conclusion of the conference.


Computer-aided design (CAD) tools that reduce application-specific integrated circuit (ASIC) development time are examined. The use of hardware description languages to ease the data entry tasks of ASIC designers is discussed. Coupling logic synthesis tools to layout tools is considered. Limitations of logic synthesis are addressed, and some features of intelligent synthesis tools are described. >


This study investigated the relationship between stress management skills and academic achievement of undergraduate students in two Nigerian universities. A total of 800 undergraduate students randomly selected from two universities participated in the study. Three null hypotheses were tested using data generated from research instruments. The instruments included a modified stress management scale adopted from its original form found in Blonna (2005). It has reliability co-efficient of 0.81. Data generated from this instrument were correlated with current students' grade point average scores (G.P.A) using Pearson product moment correlation method. Results showed strong positive relationship between stress management skills and academic achievement. The relationship still exists when the data for each of the two genders were processed separately. It was recommended that stress management skills training should be given prominence in universities' guidance and counselling programmes while concerned authorities should endeavour to provide facilities that may help to reduce academic stress.


In the basic course teaching at undergraduate level, students in the learning of basic courses of painting often meet how to deal with the problems of basic skill training and personal development and how to correctly combine these two things is the important problem to be solved in teaching and learning. Because the relationship between the two is complementary each other, we should pay attention to the training of basic skills, constantly divergent thinking and develop personality, so that one painting work has his own unique style in the accumulation of painting experience.


Respiratory infections are a major health burden in smokers, and contribute to exacerbations, development and progression of chronic obstructive pulmonary disease (COPD). The mechanisms underlying the increased susceptibility of smokers with or without COPD to these infections can be attributed in part to disrupted mucociliary clearance by the airway epithelium. Currently it is incompletely understood how cigarette smoke (CS) affects production of constitutively expressed AMPs, an important contributor to epithelial antimicrobial barrier function. We hypothesized that CS-induced alterations in epithelial differentiation result in a decrease in constitutively expressed AMPs, thus rendering the host more susceptible to infection. To investigate this, primary bronchial epithelial cells (PBEC;n=7) were cultured at the air-liquid interface and daily exposed to CS for 2-3 weeks. Markers of basal and luminal epithelial cells and AMPs were assessed by qPCR, ELISA and immunofluorescence. Results showed that PBEC differentiation into luminal cells was significantly (p Supported by a Marie Curie Intra-European Fellowship (#622815), Galapagos N.V and the Lung Foundation Netherlands (grant # 5.1.13.033).


SummaryTo determine whether canine faecal contamination may represent a source of environmental contamination with Toxocara canis eggs within the urban area of Florence, a total number of 754 dog faeces were collected in 7 public places and examined by routine floatation technique during one-year period. The total prevalence of intestinal nematode eggs was 8.6 %. Trichuris vulpis (4.6 %) eggs were the most prevalent followed by T. canis (3.6 %) and Ancylostomidae (1.7 %) eggs. Mixed infections included T. canis/T. vulpis (0.7 %), Ancylostomidae/T. canis (0.4 %), and Ancylosto-midae/T. vulpis (0.3 %). Total prevalence of intestinal nematode eggs was significantly higher in spring than in winter (OR = 2.06). Our results indicate a low prevalence of T. canis eggs suggesting that dog faeces left on soil are unlikely to cause high environmental contamination with T. canis eggs in the town of Florence.


Two accelerated hot-wet aging tests of glass-reinforced epoxy resin were performed at 45 and 70°C at the same level of relative humidity (RH = 84%). Mechanical and physical properties of "dry" and differently saturated composites are compared. It has been found that the higher the conditioning temperature, the higher the equilibrium moisture content. The glass transition temperature decreases from 138°C (dry) to 108 to 111°C (for both moisture-saturated cases). Moreover, it has been found that moisture absorption reduces the static properties while not modifying the endurance in fatigue tests.


The formation of electrons and ions in the collision between two indium atoms excited to the level is reported. The ionization cross sections and the recombination coefficient for the subsequent electron/ion recombination are measured.


Background Cefotaxime shortage in 2015 led to increased ceftazidime use in the neonatal intensive care unit (NICU). Objective The purpose was to explore whether ceftazidime increases risk for development of resistant gram-negative organisms. Methods Retrospective evaluation of NICU patients with cultures positive for Escherichia coli, Pseudomonas aeruginosa, Klebsiella species, or Stenotrophomonas maltophilia between January1, 2015 and August 31, 2020. Isolates were excluded if obtained from same patient and source within 90 days or if patient ≤7 days of life or admitted from a referring hospital. Data collection included demographics and clinical parameters, and culture/susceptibility data. The primary objective was comparison of pathogens and clinical parameters in those with and without third-generation cephalosporin resistance. The secondary objectives included a comparison between those with and without ceftazidime exposure and identification of factors associated with resistance. Comparisons were made using χ2, Fisher exact tests, or Wilcoxon tests. A logistic regression was used to identify risk factors for resistance. Results Overall, 349 isolates, representing 215 patients, were included. The most common source was endotracheal (n = 192, 55.0%) and pathogens were E coli (31.8%) and P aeruginosa (29.2%). Overall, 12.3% (n = 43) were resistant and these were obtained after longer parenteral nutrition (PN), central line access, and antibiotic days versus susceptible isolates. Higher resistance was noted after ceftazidime exposure versus no exposure, 19.1% versus 6.6%. Each day of ceftazidime was associated with 13% greater odds of P aeruginosa resistance (adjusted odds ratio: 1.13 [95% confidence interval: 1.03-1.23]). Conclusion and Relevance Ceftazidime duration was associated with increased risk for P aeruginosa resistance. Additional studies are needed to confirm these findings.


Zinc finger protein is one of the important transcription factors with zinc finger domain that regulates gene expression in the eukaryotic organisms mainly by specifically interacting with target DNA sequence(cis-acting element). It could be divided into several types of zinc finger proteins, such as C2H2, C2HC, C2C2, C2HCC2C2, C2C2C2C2 etc, based on numbers and positions of Cys and His residues. Of these, C2H2 type zinc finger protein is the most clearly identified zinc finger transcription factor, with the wide existence in human, animals and plants. The characterized plant C2H2 zinc finger proteins are mainly involved in plant growth and development and the responses to environmental stresses. Up to now, more than 50 C2H2 zinc finger proteins have been reported in plants including petunia, Arabidopsis, wheat and rice, and most of them have the plant-specific QALGGH motif in zinc finger domain. This paper briefly introduces the structure, recognition of target-DNA sequence and functions involved in development or environmental stresses of plant C2H2 zinc finger proteins.


Due to the superior performances of nanosilica particles, this research has been designed to study their effects on the mechanical and trigological properties of a PVA/PAM polymer composite by a molecular dynamics simulation method. To realize the research objectives mentioned above, the molecular models of amorphous cells and sandwiched friction models for pure polyvinyl alcohol (PVA)/polyacrylamide (PAM) (component weight ratio is 1:1) and PVA/PAM/nanosilica (component weight ratio is 5.75:5.75:1) polymer composites were constructed and simulated, respectively. The simulation results of the mechanical properties show increases about 31.6% in the bulk modulus, 53.1% in the shear modulus, and 50.1% in the Young's modulus by incorporating a nanosilica particle into a pure PVA/PAM polymer composite. Meanwhile, the changes in Cauchy pressure, B/G ratio, and Poisson's ratio values indicate that incorporating a nanosilica particle into pure PVA/PAM weakened the ductility of the composite. Incorporating a nanosilica particle into a pure PVA/PAM composite also showed a decrease about 28.2% in the abrasion rates and relative concentration distributions of polymer molecules in the final friction models. Additionally, the binding energy and the pair correlation functions between a nanosilica particle and the polymer chains in a cubic cell demonstrate that incorporating nanosilica into PVA/PAM polymer composites improves the internal binding strength between different components through the forming hydrogen bonds. As a result, the mechanical and tribological properties of PVA/PAM polymer composites can be enhanced by incorporating nanosilica particles.


A study was undertaken to investigate the effect of hydropriming on the germination of Tongod Wangi upland rice seeds. All experiment were carried out at the Faculty
Sustainable Agriculture, Universiti Malaysia Sabah. Two seed lots: non accelerated aged (non-AA) and accelerated aged (AA) were used. Both lots were hydroprimed for 0, 6, 12, 24 and 48 hours in tap water at 30 ± 2°C. After priming, seeds were air dried. Seed moisture content and germination were determined. The initial moisture content was found to be 8.37 % for non AA seeds and 19.22 % for AA seeds. Seed germination percentage was recorded to be 86.75 % and 84 % for non AA and AA seeds, respectively.
Both AA and non AA seeds displayed the triphasic moisture absorption pattern. Seed germination increased with the increase in hydropriming up to 24 hours. Parameters on
seedling growth and development showed that hydropriming of non AA and AA seeds was beneficial for seeds primed for 6 to 12 hours. However, extending the duration of
priming to 48 hours resulted in deleterious consequences on seedling growth and development.


Despite the plethora of Information and Communication Technologies (ICT) tools and resources available, practitioners are still not making effective use of e-learning to enrich the student experience. This article describes a learning design toolkit which guides practitioners through the process of creating pedagogically informed learning activities which make effective use of appropriate tools and resources. This work is part of a digital libraries project in which teaching staff at two universities in the UK and two in the USA are collaborating to share e-learning resources in the subject domains of Physical, Environmental and Human Geography. As e-learning becomes a standard element in the higher education 'mix', teachers are increasingly expected to be able to create or adapt online learning activities. Digital resources are available from a range of in-house and external sources and can be used to enrich learning environments and student experiences. However, finding, or creating, suitable resources and embedding them in well designed learning activities can be both challenging and time consuming. Sharing and adapting effective designs and solutions is both a stimulant and a time saver. This article describes the background to the specification of a learning activities design toolkit to support teachers as they create or adapt e-learning activities. This uses a model of pedagogical approaches as a basis for developing effective learning design plans, and illustrates its use. Quality and best practice are key considerations. The current debates about learning objects, interoperability, and metadata have informed the design. The authors share their definition of a learning activity and taxonomies for the constituent elements. Real examples are discussed to illustrate their approach. Progress to date on the toolkit is described and future steps outlined.


Designing visualizations of spatial data and 3D terrain is challenging. Usually the designer has to focus on selected relevant aspects of the data, emphasize them, and attenuate less relevant information. Yet, it is not clear upfront if design decisions with respect to emphasis lead to the desired result. Conducting user studies is often infeasible due to their high costs. We propose to utilize saliency maps early in the design phase to help designers assess their visualizations. Saliency maps provide information about the uniqueness of visual features in an images and hence can predict which part of a visualization is likely to attract the user's attention. Our approach is to compute saliency maps in real-time and show them alongside the actual visualization. This provides designers with immediate feedback on the effectiveness of their design decisions.


Solanum nigrum is used in hepatic disorders in folk medicines. The present study was aimed to evaluate the efficacy of S. nigrum on the liver functions in CCl4 induced injuries. Enzymatic activities that are .AST, ALT and ALP, microscopic appearance of liver was used as parameter and hepatocurative studies were performed. In case of hepatocurative study that is post treatment of rats with aqueous extracts of plant (500mg/ orally, two doses with 24 h interval) prevented (p < 0.001) CCl4 induced rise in activity of serum Transaminases (ALT and AST) and ALP and alcoholic extract did not prevent the rise of same enzymes compared to the sham control group in which liver was damaged by CCl4 no treatment given. Histological examination of the liver of treated animals with aqueous extract of plant showed that fatty acids change was less in comparison to the sham control group. In treated group reduction in body weight was minimal and live enlargement was also less compared to the animals in sham control group. Treatment with aqueous extract of S. nigrum effectively attenuated the alteration within the parameter of present study and accredits the hepatocurative role of S. nigrum.

 Key words: Solanum nigrum, hepatocurative, AST, ALT, ALP, histopathology, CCl4induced hepatotoxicity, aqueous extract.


We construct a lower bound of the tensor rank for a new class of tensors, which we call persistent tensors . We present three specific families of persistent tensors, of which the lower bound is tight. We show that there is a chain of degenerations between these three families of minimal-rank persistent tensors that can be used to study the entanglement transformation between them. In addition, we show that these three families of persistent tensors are indeed different generalizations of multiqubit W states within multiqudit systems and are geometrically in the orbit closure of multiqudit GHZ states. Consequently, we show that one can obtain every one of the generalizations of W state from a multiqudit GHZ state via asymptotic Stochastic Local Operations and Classical Communication (SLOCC) with rate one. Finally, we extend the obtained lower bound of the tensor rank to direct sums with persistent summands and to even more general combinations of tensors, which we call block pyramidal tensors . As a result, we show that the tensor rank is multiplicative under the Kronecker and tensor products of minimal-rank persistent tensors with the GHZ tensor.


Electrowetting(E W) has been used sophistically in the fields of biomedical and optical applications. The major problem posing challenge in EW is to reduce its operating voltage. The study consist of understanding the effect of device parameters that affect EW phenomenon to reduce the actuation voltage with optimum velocity. Using EDEW 2.0 simulation tools (8J and Surface Evolver software (9, 11J EW is simulated. By varying the different parameters (electrode length, gap between electrodes, dielectric thickness, shape of electrode edge and dielectric constant) the corresponding energy curves (surface energy versus centroid position) are obtained. The main goal is to reduce the voltage. It is observed that voltage bears inverse relation with the sUrface energy and thus actuation voltage can be reduced by reducing the surface energy. There direct influence of Electrode's parameters in reducing the surface energy. Keywords-Electro


Several scoring systems are used in the field of gastroenterology. Although previous studies have demonstrated the substantial risk of death following gastrostomy insertion and some risk factors have been identified, no previous investigators have described a scoring system for gastrostomy insertion. A prospective unselected dual-centre study was undertaken in order to establish the relative importance of risk factors for mortality after gastrostomy insertion. A simple numerical scoring system to categorize patients' risk of death was then formulated and validated on an independent second cohort of patients. All patients referred for gastrostomy are prospectively included in a database along with demographic, biochemical and outcome data. Gastrostomy insertions from two teaching hospitals from February 2004 to February 2007 were analysed. There were 887 referrals resulting in 837 gastrostomy insertions. The largest cohort was at site A and was used to construct a risk stratification scoring system. Site B was used to validate the scoring system. Site A received 552 referrals and 403 new gastrostomies were inserted (median age 64 years, 268 males). Overall, 30 d mortality rate was fifty-one of 403 (12.7%) with the highest risk in those with dementia (40%) followed by stroke (22.2%). Univariate analysis identified that 30 d mortality was associated with age (OR 3.4), albumin (OR 5.6), cardiac comorbidity (OR 2.0) and neurological comorbidity (OR 1.7). On multivariate analysis only age and albumin remained significant (both P<0.001) and were then modelled and attributed scores, with age scoring 0 or 1 and albumin scoring 0, 1 or 2, giving composite scores from 0 to 3. Scores of 0, 1, 2 and 3 gave 30 d mortalities (%) of 0 (95% CI 0, 2.1), 7 (95% CI 2.9, 13.9), 21.3 (95% CI 13.5, 30.9) and 37.3 (95% CI 24.1, 51.9) respectively. Kaplan-Meier curves stratified by total score showed a significantly increased mortality at 7 (P= 0.0003), 30 (P<0.0001) and 90 (P<0.0001) d. Site B (validation cohort) received 335 referrals and inserted 153 new gastrostomies (median age 77 years, sixty-four males) with a 30 d mortality of twenty-four of 153 (15.7%). Application of the scoring system in this validation cohort gave comparable 30 d mortalities (%) of 0, 7.7, 15.6 and 29.3 for scores 0, 1, 2 and 3 respectively. The Sheffield gastrostomy score can be used to categorize patients being considered for gastrostomy insertion and to calculate risk of death at 30 d. Further external validation is required.


The Delaunay/sup MM/ system supports an interactive, customizable interface for querying multimedia distributed databases, such as digital libraries. Through this interface, users select virtual document styles that cater the display of query results to their needs, while also offering transparent preand post-query refinement and querying. Delaunay/sup MM/'s virtual documents preserve context by maintaining a single customizable interface for result viewing. The advanced transparent query features rely on mediation to provide adept access to information. In this paper, we present the framework for Delaunay/sup MM/, its architecture, the user interface, and results of the first usability study.


Preparing the SUnOSiSVR4 kernel for today's challenges: symmetric multiprocessing, multi-th¡eaded applications, real-time, and multimedia, led to the incorporation of several innovative techniques. In particular, the kernel was re-structured around threads. Threads are used for most asynchronous processing, including interrupts. The resulting kernel is fully preemptible and capable of real-time response. The combination provides a robust base for highly concurrent, responsive operation.


Authigenic calcite and dolomite and biogenic aragonite occur in Holocene pan sediments in a Mediterranean‐type climate on the western coastal plain of South Africa. Sediment was analysed from a Late Pleistocene coastal pan at Yzerfontein and four Holocene inland pans ranging from brackish to hypersaline. The pans are between 0·08 and 0·14 km2 in size. The δ18OPDB values of carbonate minerals in the pan sediments range from −2·41 to 5·56‰ and indicate precipitation from evaporative waters. Covariance of total organic content and percentage carbonate minerals, and the δ13CPDB values of pan carbonate minerals (−8·85 to −1·54‰) suggest that organic matter degradation is a significant source of carbonate ions. The precipitation of the carbonate minerals, especially dolomite, appears to be mediated by sulphate‐reducing bacteria in the black sulphidic mud zone found in the brine‐type hypersaline pans. The knobbly, sub‐spherical texture of the carbonate minerals suggests that the precipitation of the carbonate minerals, particularly dolomite, is related to microbial processes. The 87Sr/86Sr ratios of pan carbonate minerals (0·7108 to 0·7116) are slightly higher than modern sea water and indicate a predominantly sea water (marine aerosol) source for calcium (Ca2+) ions with relatively minor amounts of Ca2+ derived from the chemical weathering of bedrock.


Despite mounting evidence of micro-nanoplastics (MNPs) in food and drinking water, little is known of the potential health risks of ingested MNPs, and nothing is known of their potential impact on nutrient digestion and absorption. We assessed the effects of environmentally relevant secondary MNPs generated by incineration of polyethylene (PE-I), on digestion and absorption of fat in a high fat food model using a 3-phase in vitro simulated digestion coupled with a tri-culture small intestinal epithelium model. The presence of 400 μg/mL PE-I increased fat digestion by 33% and increased fat absorption by 147 and 145% 1 and 2 h after exposure. Analysis of the PE-I lipid corona during digestion revealed predominantly triacylglycerols with enrichment of fatty acids in the small intestinal phase. Protein corona analysis showed enrichment of triacylglycerol lipase and depletion of β-casein in the small intestinal phase. These findings suggest digestion of triacylglycerol by lipase on the surface of lipid-coated MNPs as a potential mechanism. Further studies are needed to investigate the mechanisms underlying the greater observed increase in fat absorption, to verify these results in an animal model, and to determine the MNP properties governing their effects on lipid digestion and absorption.


WIN (applied psychology on teaching and technology War Interactive Negotiation) is a highly interactive serious game designed to be used either in educational settings or for on-the-job training for teams wishing to fill in their soft skills clusters gap enhancing creative thinking, problem-solving, negotiating under pressure, time-management skills, team building and leadership skills. The game design is human-focused that is, it works on players' feelings, reasons, vested interests and insecurities to drive them through the game. WIN is also user-centric since content is user-generated and peer-reviewed based on robust pedagogic design and a Computer Supported Collaborative Learning (CSCL) script.
A custom-made environment with thematic buildings and high interaction and display fidelity has been designed in a 3D Virtual World, Second Life (SL). The storyline is based on Thucydides' recount of the Peloponnesian war, dating back to 5th century BC, ancient Greece.
The underlying learning design relies upon mapping Toulmin's argumentation model to De Bono's 6 Thinking Hats creative method for problem-solving. Players are randomly assigned through a custom script to either the Athenian or the Miloan team to negotiate and defend their vested interests. Each team writes an argument which the other rebuts. Each team gets timely feedback for their argument development from the opposing team based on clear criteria set on a scoreboard. The scoring criteria are Toulmin's constituent parts of a good argument (data, claim, warrant, backing, qualifier, rebuttal). The narrative is actually emergent since no one can predict the argument each team will develop. The gamers become a thinking community, collaborating in their teams to achieve a cohesive outcome. Besides enhancement of particular soft skills clusters, the research also revealed a significant correlation between development of the knowledge, skills, attitudes and values most pertinent to the global citizenship mindset and the virtual identities of the players assumed in the game (Athenians-Miloans).
The added value of the dissertation is that 1) there has been no study thus far on virtual identity and competence development (knowledge, skills and attitudes) that mirrors on pro-social behaviour. The existing studies are restricted either to perception of self or change of attitudes, they do not address the whole competence cluster let alone the Global Citizenship Competence. 2) custom tools have been programmed for this serious game, transcending shortcomings of the Linden scripting language to turn Second Life into a collaborative write-and-share platform enabling multiple users to view/edit/write/ at the same time. This way, the exchange of notecards which is the norm in educational interventions in SL and constrains authentic collaboration since each notecard is seen only by one participant at a time, is avoided 3) experiential learning and a practical how-to guide are emphasized moving away from the usual show-and-tell delivery fashion of learning in SL.4) the robust pedagogic design of the WIN is based on its innovative, creative argumentation framework which has been presented as a paper in the Third International Conference on Innovative Computing Technology (INTECH 2013), sponsored by IEEE) 5) αn iterative, agile methodology has been adopted for the design and development methodology of the game. The features of WIN as presented herein, are the result of the third, polished, iterative development cycle of the game (not the final though) which has been playtested and fine-tuned with input from live players/learners…….
As of October 2015, the code that has been written for the tools/features of WIN will be open source.


Strategic management scholars agree firms need to know who they compete with in order to establish and maintain a competitive advantage. Yet we know little about the link between competitor identification and firm performance or the added value of identifying foreign competitors. In this paper we develop and test theory to explain how identifying domestic and foreign competitors can each lead to improved firm performance. Using a unique dataset of Taiwanese manufacturers we find that firms identifying more domestic competitors have higher performance. Additionally, our results indicate that firms identifying high levels of both domestic and foreign competitors have even better firm performance. Thus we contribute to the literature by exploring the importance of identifying domestic and foreign competitors for firm success.


Methylation specific PCR (MS-PCR) is a technology for a sensitive detection of methylation in the gene. This assay was developed for diagnosis of methylation-related diseases including fragile X syndrome (FXS), the most common X-linked mental retardation caused by a CGG trinucleotide repeat expansion. Affected individuals (full mutation, FM) have CGG greater than 200 repeats, while normal individuals and premutation (PM) carriers have 6-54 and 55-200 repeats, respectively. Only FM individuals are correlated with methylation of the gene. The authors tested this assay on known 35 DNA samples (15 normal, 2 PM and 18 FM) and a prospective study of 60 males referred for FXS screening in Songklanagarind hospital. In addition, the authors tested on 2 prenatal cases. All results were corresponded to PCR for CGG repeats and/ or Southern blot analysis. The authors concluded that MS-PCR provides an accurate method for methylation detection of FXS.


RAPD-PCR is a new technique that, starting from genomic DNA allows, with the use of a single primer of "random" base composition to amplify a variable number of sequences that can give important informations if analyzed for linkage studies, gene mapping or phylogenetic purposes. In order to detect the possible application of this simple way of DNA-fingerprinting in individual identification and in cell lineages characterization we analyzed human and non-human Primates DNA. Six different single primers of variable length were used and resulted in individual or specific electrophoretic patterns. As already reported we found a better resolution using "short" primers. The individual electrophoretic patterns obtained by RAPD-PCR can be a simple and reliable approach to DNA analysis.


An increasing number of studies have investigated the neural networks and brain regions activated by different aspects of religious faith or spiritual practice. The extent to which religiousness and spirituality are dependent on the integrity of neural circuits is a question unique to neurological illnesses. Several studies have reported that neural networks and brain areas represent the various components of religious faith or spiritual activity in recent decades. In addition to research in healthy people, another strategy is to observe if neurological abnormalities caused by stroke, tumour, brain damage, or degenerative sickness are accompanied by an alteration in religiosity or spirituality. Similarly, Parkinson's disease (PD), an ailment characterized by dopaminergic neuron malfunction, has been utilized to explore the role of dopaminergic networks in the practice, experience, and maintenance of religious or spiritual beliefs. Case–control and priming studies have demonstrated a decline in spirituality and religion in people with PD due to dopaminergic degeneration. These studies could not adequately control for confounding variables and lacked methodological rigour. Using qualitative and quantitative assessments, a mixed‐method approach might shed additional light on putative religious beliefs alterations in PD. In the current review paper, we discussed the recent research on the impact of PD on spiritual beliefs and spirituality.


Abstract In the article, which is a theoretical and conceptual introduction for the Special Issue of Moravian Geographical Reports on 'New trends and challenges of urban agriculture in the context of Europe', the authors resume and review diverging issues of urban agriculture, exploring and discussing them from a geographical perspective and in a wider context of the transformation of urban and rural spaces, urban regeneration and renewal, agricultural restructuring, multifunctionality, ecosystem services, land-use conflicts and social responsibility. After the introduction that depicts a changing role of agriculture in the context of urban and rural transformations, the current research on urban agriculture in Europe is summarised and reviewed. Then the main trends and concepts of growing and expanding urban agriculture are presented and discussed with a special emphasis on the challenges these pose to geographers.


Steel-concrete composite bridges with two-girders, with long span bridge deck slabs, have been regarded as one of the economical as well as durable bridge types. KHBDC updated in 2005 included new requirements for the thickness of long span bridge deck slabs. However, specifications in KHBDC do not provide detailed information for the minimum thickness of long span bridge deck slabs. Therefore, it is necessary to establish a definite specification for the minimum thickness of long span bridge deck slabs. In this study, 3-D finite element analyses considering orthotropy were performed to derive the minimum thickness formula for long span bridge deck slabs. The formula is proposed as a function of cantilever slabs length and deck slabs span length. From the analytical studies, it was shown that the deck slabs with proposed thickness satisfies serviceability in terms of deflection, crack width and fatigue requirements. Besides, the deflection limit governs the minimum thickness of long span bridge deck slabs and design method for distribution reinforcement in the current specification can underestimate the amount of distribution reinforcement in the long span bridge deck slabs.


Recurrent tracheoesophageal fistula in children is a challenging issue, associated to high morbidity and mortality, due to major scarring and inflammatory changes resulting from previous interventions and the disease itself. Most cases require surgical treatment, but the complexity of the situation may, sometimes, prevent the traditional approach by thoracotomy. We present the clinical case of a 2 year old child with esophageal atresia with proximal and distal fistula, and multiple fistula recurrences. After the fourth recurrence it was decided to use a transternal transpericardic approach to the trachea, with resection of two tracheal rings, ligation of esophageal portion of the fistula, interposition of autologous pericardium and tracheal anastomosis. Although this technique has been used in congenital or acquired tracheal stenosis in children, this is the first report in the literature on its use in recurrent tracheoesophageal fistula.


Blood is a shear-thinning non-Newtonian fluid in which the viscosity reduces with the shear rate. When simulating arterial flow, it is well established that the non-Newtonian nature is important in the smallest vessels; however, there is no consistent view as to whether it is required in larger arteries, such as the carotid. Here, we investigate the importance of incorporating a non-Newtonian model when applying a plaque deposition model which is based on near-wall local haemodynamic markers: the time-averaged near wall velocity and the ratio of the oscillatory shear index to the wall shear stress. In both cases the plaque deposition was similar between the Newtonian and non-Newtonian simulations, with the observed differences being no more significant than the differences between the selected markers. More significant differences were observed in the haemodynamic properties in the stenosed region, the most significant being that lower levels of near-wall reverse flow were observed for a non-Newtonian fluid.


COPE is a new architecture for wireless networks. It uses the concept of network coding in a packet network where data is divided into packets. Network coding is applied to the contents of packets. In addition to forwarding packets, routers mix packets from different sources to increase the information content of each transmission. It inserts a coding scheme between the IP and MAC layers. It show that intelligently mixing packets increases network throughput. Prior work on network coding is mainly theoretical and focuses on multicast traffic. This technique has several important benefits such as an increase in throughput and an improvement in packet delivery ratio, delay, reliability of the network. KeywordsCOPE, Network Coding, Multi-hop Wireless Networks, throughput, delay, packet delivery ratio


Background Most pediatric liver transplantation (LT) centers administer long courses of prophylaxis against cytomegalovirus (CMV) without evidence of benefit and with significant drug exposure and costs. We aimed at evaluating overall outcomes, direct and putative indirect effects of CMV, possible impact of viremia and risk factors for CMV infection in pediatric LT recipients managed with ganciclovir-based preemptive therapy (PET). Methods The records of all the children who underwent LT between 2008 and 2014 were retrospectively analyzed. Results One hundred children were included. Three children had CMV disease; no CMV-related death or graft loss was recorded. The only identified risk factor for CMV infection was the donor/recipient serostatus (odds ratio, 17.23; 95% confidence interval, 1.88-157.87; P = 0.012), while viremia per se did not worsen LT outcomes, such as the incidence of acute rejection, Epstein-Barr virus infection, sepsis, biliary and vascular complications, nor graft dysfunction/loss or death at 3 and 5 years after LT. When compared with a historical cohort of children receiving ganciclovir prophylaxis, PET did not differ from prophylaxis for any of the selected outcomes, but was rather associated with lower antiviral drug exposure (6.4 ± 13 days vs 38.6 ± 14 days, P < 0.0001) and cost per patient (2.2 ± 3.9 k&OV0556; vs 6.6 ± 8.2 k&OV0556;, P = 0.001). Conclusions PET is effective in controlling CMV in children receiving LT, with lower costs and lower exposure to antivirals.


Most of the researchers have been researching algorithm to insert high information in the original medical image but increasing the size of embedded information affects the quality of watermarked medical image severely. This paper presents a new robust image barcode watermarking scheme for medical images that embeds human readable bar-coded watermark image which is generated from corresponding unique patient identification number (PID). Here only PID barcode image is embedded in a medical image for telemedicine applications instead of embedding whole Electronic Patient Record (EPR) data. Further, the presence of PID barcode watermark can be identified with or without manual intervention. A PID sequence watermark is represented as barcoded binary logo image and embedded in the corresponding medical image. This in turn authenticates corresponding medical images and also helps in faster retrieval of whole patient data from the centrally managed hospital database. The proposed scheme first extracts the energy of DCT blocks from the host image and based on these energy values, the blocks are then classified into two clusters named High Energy Blocks (HEBs) and Low Energy Blocks (LEBs) using KMeans clustering technique. To achieve imperceptibility, the watermark bits are embedded only in HEBs leaving LEBs intact. By using the desirable characteristics of proposed technique, the imperceptibility requirements of watermarks are fulfilled along with increased robustness. Experimental results show that the proposed scheme is robust against common attacks and offers both objective as well as subjective watermark detection. The revealed watermark can be easily recognized by human eyes, even if the host image has undergone severe attacks. Due to inherent error detecting capability of the barcode watermark image, the watermark can be fully recovered against various kinds of attacks.


A sophisticated, computer-based, steady-state simulation model has been developed and used to investigate the off-design and phased-construction performance of integrated coal-gasification combined cycle (IGCC) power plants. The ASPEN process simulator was used as the basic framework for the complete systems model; enhanced FORTRAN models were developed for critical components in the plant where the standard ASPEN models were felt to be inadequate. The effects of ambient temperature and part-load operation on a commercial-scale IGCC plant were investigated and strategies to mitigate the off-design performance penalties were examined. Increased ambient temperatures were found to considerably reduce the plant output; this effect could be mitigated through the use of supplemental firing at the expense of increasing the heat rate. Part-load performance could be considerably improved by shutting down one or more gas turbines to enable the other gas turbine trains to operate nearer to full load. The performance of various initial and final plant configurations for the phased-construction operation of IGCC power plants was examined in detail. It was found that if the plant were optimized for operation as a natural-gas-fired combined cycle plant, several critical components would be undersized when the plant was converted to IGCC operation. Similarly, some components wouldmore » be oversized if the plant were designed for IGCC operation but operated as a combined cycle plant. Operating strategies and reconstruction techniques to mitigate these performance penalties were also investigated. 19 refs., 31 figs., 19 tabs.« less


In this work we present the extension of semistochastic heat-bath configuration interaction (SHCI) to work with any two-component and four-component Hamiltonian. The vertical detachment energy (VDE) of AuH2- and zero-field splitting (ZFS) of NpO22+ is calculated by correlating more than 100 spinors in both cases. This work demonstrates the capability of SHCI to treat problems where both relativistic effect and electron correlation are important.


This book provides readers with a vivid picture of how South Asians were perceived by many in Britain in the mid-nineteenth century, as well as of life in Sindh under the Amirs, rulers of the region at that time. McMurdos description indicates the bias and prejudice of an imperialist viewpoint and the political ramifi cations of such perceptions. At the time of Charles Napiers conquest of Sindh in 1843, the British government launched an adverse propaganda campaign aimed at depicting the Amirs as being incapable of looking aft er their own territories. This account can be counted as a part of this campaign. The book refl ects the broad political canvas of that time and prepares the backdrop for the eventual conquest of Sindh.


This paper considers the case of two competing, nested, probability predicting models. The nested model contains traditional factors, and the
larger model contains some expensive, or generally hard to obtain, often genetic, relevant markers. The indices used to compare the respective
predictive ability of the two models are the integrated discrimination improvement (IDI) and the Brier's score improvement (BRI). Estimation of the
models and their relative IDI and BRI are conducted on the same sample, and their respective asymptotic properties are proved. The results are
applied to Alzheimer's disease. The authors conduct two different simulations: one to check the behavior of the estimates of IDI and BRI, and the
other parallel to Gu and Pepe's examples. The three city (3C) study is a cohort study conducted in three cities in France (Bordeaux, Dijon and
Montpellier), aiming to estimate the risk of dementia and cognitive impairment attributable to vascular factors.


ABSTRACT The increasing demand for e-books has led to substantial changes in the book market structure and in the demand for printed books (p-books). In the early market stage, demand side cannibalisation from e-books is potentially underestimated due to two effects: (1) early adopter profiles and (2) different usage context situations for digital and physical products. In two empirical studies, we investigate cannibalisation effects as well as drivers of the cannibalisation potential between e-books and p-books related to consumer needs in different usage situations. We focus on the (early-stage) German e-book market and analyse cannibalisation effects and sources of cannibalisation potential between e-books and p-books in two studies. We do not find empirical support for a cannibalisation of p-book demand in the early market stage of e-books in Germany, even after controlling for potential biases related to early adopter profiles. However, our results indicate a significant cannibalisation potential between e-books and p-books that relates to different consumer needs in different usage situations. Our findings imply that research on cannibalisation effects could substantially benefit from analysing substitution patterns between digital media products and their physical counterparts in early market stages. By this, cannibalisation drivers can be revealed early enough, so that managers can react accordingly. We discuss implications for the early positioning of e-books to reduce potential cannibalisation of p-books.


Ultraviolet sterilizers (UVS) are widely used in restaurants, cafeterias and catering businesses in Korea. The proper application of UVS, however, is still questionable since no studies have clearly identified their efficacy and safety, while regulations and regulatory management systems are yet to be established. In the present study, the efficacy of UVS were investigated by measuring spatial UV intensity inside five commercially operated UVS. The operating safety parameters were also checked by measuring leaked UV intensity. The UV intensities were inversely proportional to distance from the UV lamp within 25 ㎝, and to the square of the distance exceeding 25 ㎝. The UV intensities in commercial UVS varied with the distance from UV lamp and the incident angle, highlighting efficacy and stability concerns. Notable leakage was detected through the door gaps of a studied UVS, which also brought about safety concerns. Allowable working distances for the UV leaking UVS were suggested based on international standards.


It has been necessary recently on several occasions to defend experiences and ideas relative to the Mosher-Toti combined intranasal and extranasal dacryocystorhinostomy. My experiences with this operation have been so satisfactory that some doubt exists as to whether this valuable procedure is receiving its due. I have performed thirty-three operations of this type and have assisted at several more cases extending over a period of about six years. Following one of these, a conversation with an internationally known ophthalmologist resulted in the decision to try to clear up some of the doubt and conjecture connected with the operation. The indications and reasons for recommending it, together with its rationality, should first be considered. Several years ago, while working at the Palo Seco Leper Colony in the Panama Canal Zone on the role of the lacrimal sac in the causation of the ocular complications of leprosy, opportunity arose


We investigate the "negative link" feature of social networks that allows users to tag other users as foes or as distrusted in addition to the usual friend and trusted links. To answer the question whether negative links have an added value for an online social network, we investigate the machine learning problem of predicting the negative links of such a network using only the positive links as a basis, with the idea that if this problem can be solved with high accuracy, then the "negative link" feature is redundant. In doing so, we also present a general methodology for assessing the added value of any new link type in online social networks. Our evaluation is performed on two social networks that allow negative links: The technology news website Slashdot and the product review site Epinions. In experiments with these two datasets, we come to the conclusion that a combination of centrality-based and proximity-based link prediction functions can be used to predict the negative edges in the networks we analyse. We explain this result by an application of the models of preferential attachment and balance theory to our learning problem, and show that the "negative link" feature has a small but measurable added value for these social networks.


AIM
To investigate outpatient consumption of antibiotics during the 2006-2010 period in the City of Zagreb and compare it with other European countries.

METHODS
Data on outpatient consumption of antibiotics were obtained from all pharmacies in the City of Zagreb. Based on the data obtained, the number of defined daily doses per 1000 inhabitants per day (DDDs/TID) were calculated for each ATC subgroup. Drug Utilization 90% (DU90%) method and ratio indicators were used for the assessment of drug prescribing quality.

RESULTS
During the period of five years total antibiotics consumption has declined from 37.38 DDDs/TID in 2006 to 33.28 DDDs/ TID in 2010. The most frequently prescribed subgroup was penicillins (J01C). DU90% segment included 10 out of a total of 32 antibiotics in the year 2006 and 10 out of a total of 23 antibiotics in the year 2010. Leading position in the consumption, in 2006 and 2010, was held by broad-spectrum antibiotics, moreover their consumption increased in 2010.

CONCLUSION
Consumption of antibiotics in Zagreb is still very high and is similar to the consumption in European countries with the highest consumption of antibiotics. Reduced consumption of narrow-spectrum antibiotics and unjustified increase in the consumption of broad-spectrum antibiotics suggess that physicians do not follow clinical guidelines.


28-year-old female received dialysis treatment due to chronic renal failure caused by polycystic kidney disease. Later, she underwent a laparoscopic splenectomy and ABO incompatible living kidney transplantation successfully following bilateral renal contraction therapy with renal transcatheter arterial embolization (renal TAE). A unilateral or bilateral native nephrectomy of a massively enlarged kidney performed at the time of renal transplantation is a common treatment in polycystic kidney patients scheduled for transplantation. On the other hand, when treated with renal TAE, such patients can avoid a laparotomy, which provides several advantages when undergoing peritoneal dialysis in the future or a laparoscopic splenectomy prior to ABO incompatible kidney transplantation. Furthermore, we consider that bilateral renal TAE is necessary for polycystic kidney patients prior to renal transplantation for a variety of reasons, including problems associated with contrast nephropathy if renal TAE for left kidney is remained after renal transplantation.


Three-dimensional (3D) on-chip memory stacking has been proposed as a promising solution to the "memory wall" challenge with the benefits of low access latency, high data bandwidth, and low power consumption. The stacked memory tiers leverage through-silicon-vias (TSVs) to communicate with logic tiers, and thus dramatically reduce the access latency and improve the data bandwidth without the constraint of I/O pin count. To demonstrate the feasibility of 3D memory stacking, this paper introduces a 3D System-on-Chip (SoC) for H.264 applications that can make use of multiple memory channels offered by 3D integration. Two logic tiers are stacked together with each having an area of 2.5×5.0mm2, with a 3-layer 8-channel 3D DRAM stacked on the top. The design flow for this 3D SoC is also presented. The prototype chip has been fabricated with GlobalFoundries' 130nm low-power process and Tezzaron's 3D TSV technology. The 3D implementation shows that the 3D ICs can alleviate the pressure from I/O pin count and allow parallel memory accesses through multiple channels.


This paper studies consensus control for multi-input/multi-output (MIMO) discrete-time multi-agent systems (MASs). It makes use of the novel idea of resource allocation in designing both the communication graph and feedback controller. Explicit consensusability conditions are obtained for MASs over both directed and undirected graphs, which are shown to be the least conservative. Explicit synthesis procedures are also developed. Our results demonstrate the importance of the graph and controller co-design based on resource allocation for MIMO MASs.


The aim of research was to study the effect of different amounts of cobalt citrate produced by nanotechnology on biochemical processes in cows, their productivity and biological value of milk in the first two months of lactation. To achieve this goal the subsequent problems have been solved. We investigated the effect of different amounts of cobalt citrate on biochemical parameters of blood and milk of cows and controlled their average daily yield. The experiment has been conducted in 3 groups of cows (5 cows each) of Ukrainian black and white dairy cattle, analogue by body weight (590–620 kg), performance (6,5–6,8 thousand kg of milk per past lactation) and lactation (3–4 lactation). Unlike the control cows, animals experimental (ІІ) group for two months were fed by mineral supplements in the form of cobalt citrate in an amount of 19 mg Co/kg of dry matter of diet and research (ІІІ) – cobalt citrate in an amount of 34 mg Co/kg of dry matter of diet. Duration of cobalt citrate feeding of cows of research groups was 2 months. In all groups of cows the samples of venous blood were taken in preparation for feeding additives period and during 60 day of additives feeding period in order to determine the concentration of total protein, ceruloplasmin, sialic acids, hexoses bound to proteins and activity of amino transferases. The milk production has been controlled in days of sampling with the definition of daily milk yield per cow and taking an average sample for the determination of milk fat, protein, lactose, inorganic phosphorus and calcium. It has been established that the inclusion in the diet of cows of experimental (ІІ) group of mineral supplements contributed to an increase in animal blood total protein content by 11.9% (P < 0.05), inorganic phosphorus by 15.3% (P < 0.05) and hexoses bound protein by 8.8% (P < 0.05). Under these conditions milk content of inorganic phosphorus increased by 5.6% (P < 0.05) and average daily milk production increased by 4.5%. The use of mineral additives in third experimental group of animals within two months contributed to an increase in blood ceruloplasmin content by 5.1% (P < 0.05) and hexoses bound protein by 11.5% (P < 0.01). Mineral supplements promote 5.4% raise of average daily milk production and increase it to the lactose content by 0.10% (in absolute).


A simple five-port direct receiver achieving broadband performance and high local oscillator to RF isolation is presented. The new circuit comprises three power detectors exhibiting high series impedance, four resistors, and two low-pass and two high-pass phase shifters. It is shown that the phase-shift networks can be designed to optimize receiver operation over a theoretical decade bandwidth. A 300-MHz-2.7-GHz prototype is built and measured to prove feasibility of this proposal.


The letter describes the construction and performance of a S band m.i.c. TRAPATT oscillator. The design utilises a system of sliding lumped-element sections to provide optimum performance from unencapsulated silicon p+?n?n+ chips. Efficiencies of greater than 30% at 2.6 GHz and peak output powers up to 40 W are reported. The oscillator is small and self contained and is suitable for ai borne transmitters.


We characterize the problem of detecting edges in images as a fuzzy reasoning problem. The edge detection problem is divided into three stages: filtering, detection, and tracing. Images are filtered by applying fuzzy reasoning based on local pixel characteristics to control the degree of Gaussian smoothing. Filtered images are then subjected to a simple edge detection algorithm which evaluates the edge fuzzy membership value for each pixel, based on local image characteristics. Finally, pixels having high edge membership are traced and assembled into structures, again using fuzzy reasoning to guide the tracing process. The filtering, detection, and tracing algorithms are tested on several test images. Comparison is made with a standard edge detection technique.


A set of comprehensive evaluation tests were conducted to determine the strength, stiffness and especially durability properties of concrete made with a marine limestone aggregate (Castle Hayne) in comparison with that made with an igneous rock aggregate (Neverson). Standard AASHTO, ASTM and other emerging test methods were used. Tests performed included determination of resistance to rapid freezing and thawing, water-soluble chloride content, concrete chloride permeability, alkali-aggregate reactivity, resistance of aggregate to abrasion and impact degradation, and aggregate soundness. A total of nine concrete mixes of varying strengths were tested. Comparatively, the concrete made with marine limestone aggregate demonstrated (1) good freeze-thaw resistance, (2) slightly higher chloride permeability, (3) little chemical reactivity and (4) very little water-soluble chloride content. As an aggregate, marine limestone wax (1) slightly less resistant to abrasion and (2) significantly less sound. Except for the five cycle sulfate soundness, the marine limestone aggregate and concrete made with marine limestone aggregate, met all applicable AASHTO and NCDOT specifications, including NCDOT special provisions for highly corrosive areas. A direct corrosion investigation is recommended. Pending results of direct corrosion investigation, use of marine limestone aggregate in highly corrosive areas could be provisional. Marine limestone aggregate can be used in all other areas.


The chemopreventive efficacies of selenate, selenite, selenium dioxide, selenomethionine and selenocystine were examined during the promotion phase of carcinogenesis in the 7,12-dimethylbenz[a]anthracene-induced mammary tumor model in rats. Each agent was added to the diet at a final concentration of 3 p.p.m. selenium. In general there was no significant difference in the potency of these five selenium compounds in inhibiting the development of mammary tumors. The interaction of vitamin E (500 p.p.m.) with either selenite or selenomethionine was further characterized in a second carcinogenesis study. Results of this experiment suggested that vitamin E enhanced the protective effect of selenite but not that of selenomethionine. In an attempt to explore the synergistic mechanism of selenium and vitamin E, the effects of these two agents on mitogen-induced blastogenesis and natural killer cytotoxic activity were also investigated. No consistent changes in these in vitro immune functions were detected resulting from supranutritional feeding of either selenite or vitamin E or both. The metabolism of inorganic versus organic selenium was discussed in relation to their role in the control of neoplastic growth as well as to their selective modulation by vitamin E.


This paper reports on a highly-structured Mathematics-Science Partnership (MSP) professional development (PD) program focused on the integration of science, technology, engineering, arts, and mathematics (STEAM) in elementary mathematics and science. With a support system including higher education STEAM education and content faculty, community informal learning partners, an external evaluation team, school administrators, and expert STEAM teachers, twenty-five teachers and five STEAM instructional coaches met together for whole-group PD as they developed and then implemented integrated STEAM problem-based inquiries in their classrooms. This paper describes how the PrimeD framework (Rakes, Bush, Ronau, Mohr-Schroeder, & Saderholm, 2017; Saderholm, Ronau, Rakes, Bush, & Mohr-Schroeder, 2017) guided the STEAM PD program through a collaborative and reflective process.


CD19-targeted chimeric antigen receptor T-cell (CAR-T) therapy has shown promise as treatment of relapsed or refractory B-cell malignancies. However, the clinical utility of early CAR-T monitoring within 1 month after infusion has not been elucidated. In this study, we quantitatively measured CAR-T kinetics in peripheral blood on days 2, 4, 7, 9, 11, 14, 21, and 28 post-infusion using flow cytometry and quantitative polymerase chain reaction in 13 patients with relapsed refractory diffuse large B-cell lymphoma (DLBCL) treated with tisagenlecleucel (tisa-cel). No relationships were identified between bulk CAR-T kinetics and treatment outcomes. Interestingly, the magnitude of CD4+ CAR-T expansion was higher in responders than in nonresponders, while CD8+ CAR-T expansion was minimal in responders. Additionally, CAR-T proliferation was more pronounced in patients with cytokine release syndrome. Our results suggest that CD4+ CAR-T cellular kinetics within 1 month after CAR-T infusion may predict its efficacy after tisa-cel therapy in adult patients with DLBCL.


The Australian Health Services Research Institute (AHSRI), University of Wollongong, was commissioned by the Commonwealth Department of Health (the Department) in August 2017 to undertake the 'Resource Utilisation and Classification Study' (RUCS). This is the first of a series of reports that will present the results of the body of work completed as part of the overall RUCS program. This report (Report 1) presents the recommended classification, known as the Australian National Aged Care Classification (AN-ACC). The key elements of the AN-ACC development process, including the sampling methodology, clinical stakeholder consultations, and the data collection and analysis methods are outlined. The final section of this report discusses key classification-related issues that will be critical to the successful implementation of the AN-ACC across the Australian residential aged care sector.


In this paper, a novel method was developed for rapid and quantitative determination of cephalexin on the basis of the fluorescence quenching of L-cysteine capped core–shell CdTe/ZnS nanoparticles (NPs). The functionalized CdTe/ZnS NPs were successfully synthesized in aqueous solution. L-Cysteine capped CdTe/ZnS NPs were characterized by the means of X-ray diffraction (XRD), transmission electron microscopy (TEM) and Fourier transform infrared (FTIR) spectroscopy. Experimental results displayed that the fluorescence intensity of CdTe/ZnS NPs reduced in the presence of cephalexin due to interaction between L-cysteine capped CdTe/ZnS NPs and cephalexin, with the emission wavelength at about 665 nm. Under optimal conditions, the relative fluorescence intensity was linearly proportional to the concentration of cephalexin ranging from 3.4 × 10−6 to 1.0 × 10−4 M with a detection limit of 0.83 × 10−6 M. The L-cysteine capped CdTe/ZnS NPs fluorescence probe showed an obvious and good response to cephalexin, and the result was also satisfactory when it was applied to analyzing cephalexin in a real sample.


The shortest path problem in graphs is fundamental to AI. Nearly all variants of the problem and relevant algorithms that solve them ignore edge-weight computation time and its common relation to weight uncertainty. This implies that taking these factors into consideration can potentially lead to a performance boost in relevant applications. Recently, a generalized framework for weighted directed graphs was suggested, where edge-weight can be computed (estimated) multiple times, at increasing accuracy and run-time expense. We build on this framework to introduce the problem of finding the tightest admissible shortest path (TASP); a path with the tightest suboptimality bound on the optimal cost. This is a generalization of the shortest path problem to bounded uncertainty, where edge-weight uncertainty can be traded for computational cost. We present a complete algorithm for solving TASP, with guarantees on solution quality. Empirical evaluation supports the effectiveness of this approach.


This article clarifies the commonplace assumption that brands make promises by developing definitions of brand promise delivery. Distinguishing between clear and fuzzy brand promises, we develop definitions of what it is for a brand to deliver on fuzzy functional, symbolic, and experiential promises. We argue (a) that brands deliver fuzzy functional promises through encouraging and facilitating courses of actions that are conducive to the promised functionality; whereas (b) brands deliver fuzzy symbolic promises through encouraging and facilitating ways in which consumers can use brands as narrative material to communicate self-identity. Finally, (c) we propose that brands deliver fuzzy experiential promises through effectively motivating consumers to adopt and play a social role implicitly suggested and facilitated by the brand. A promise is an inherently ethical concept and the article concludes with an in-depth discussion of fuzzy brand promises as two-way ethical commitments that put requirements on both brands and consumers.


Male breast cancer is a rare entity and accounts for 1% of all breast cancer cases with an average age of onset 67 years. Several risk factors have been identified, such as genetic and hormonal abnormalities. Even though more data is emerging about this disease, the poor level of awareness often results in late presentation and delayed diagnosis in our country.The present study reported the case of a 63 year old man who was diagnosed with an advanced invasive ductal carcinoma without any important risk factors. The case is presented for the rarity and to discuss awareness, regarding early diagnosis and proper management.


Study Design. A longitudinal cohort. Objective. The aim of this study was to determine the extent of health care resource utilization decrease 2 years after lumbar spinal fusion. Summary of Background Data. Despite the assumption that surgery will minimize the need for ongoing nonsurgical treatment, the impact of lumbar fusion on subsequent health care resource utilization has not been effectively studied. Methods. Patients who had continuous coverage by a major insurer during the year before decompression and posterolateral instrumented spinal fusion, and the 2 and a half years following were identified. All charges processed during this time-period were collected. Charges associated with the index surgery, the 90-day postoperative period, and those unrelated to spinal care were excluded. Associations with Oswestry Disability Index (ODI) score improvement at 2 years after surgery and health care resource utilization were determined. Results. Sixty-six patients were included in the analysis. The mean age was 59 years and 39% were males. There was a decrease in health care utilization costs 1 year after surgery ($3267.59) compared with pre-op ($4246.32), but this was not statistically significant (P = 0.197). There was a statistically significant decrease in costs during the second year after surgery ($1420.97) compared with either pre-op (P = 0.000) or 1-year costs (P = 0.001). No statistically significant correlations could be found between change in ODI scores and costs incurred at either year post-op. Conclusion. Health care utilization decreased at 1 year and significantly at 2 years after lumbar fusion. However, there was no correlation between use of nonsurgical resources and clinical outcome based on ODI scores. This raises the question as to whether these resources were used in a rational manner. This cooperative study between a major insurer and a tertiary spine center provides improved insight into the cost profile of lumbar fusion surgery. Further study is needed to determine whether ongoing post-op treatment is necessary or simply established practice. Level of Evidence: 2


Background Panic disorder (PD) is a devastating illness, with numerous patients experiencing significant functional disability and many not achieving full remission with first-line pharmacologic and psychotherapeutic treatments. Methods A search of PubMed, Cochrane Library, and PsychINFO databases was used to identify publications focused on evidence-based treatment of PD. Results Selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines are standard first-line pharmacologic treatments for PD. Many other antidepressants can be considered as alternatives to SSRIs, including serotonin- norepinephrine reuptake inhibitors, serotonin multimodal agents, tricyclic antidepressants, monoamine oxidase inhibitors, and mirtazapine. Certain anticonvulsants and antipsychotics may be helpful; however, the evidence base is limited. Buspirone, beta blockers, and hydroxyzine can be considered third-line agents. Currently, there is minimal data support the use of electroconvulsive therapy or repetitive transcranial magnetic stimulation (rTMS). There is very little evidence justifying the use of medical cannabis or over-the-counter supplements for PD, and these treatments have risk for adverse effects. Research strongly supports the use of cognitive-behavioral therapy (CBT) for PD. Conclusions Many options exist for the management of PD. Treatments with the strongest evidence include SSRIs, other antidepressants, and CBT. Newer interventions approved for the treatment of depression, such as serotonin multimodal agents, esketamine, and rTMS, merit further investigation for use in PD.


Beardsley, who reported the first American case of hypertrophic pyloric stenosis to be found in the American medical literature, left few other traces behind him. He is mentioned by Bronson in his "Medical History and Biography," referred to by Russell in the "Connecticut State Medical Transactions" for 1892, and Dr. Walter Steiner, of Hartford, gave an account of him before the Connecticut State Medical Society in 1908. He was born in 1748 and lived in Southington, Conn., in Hartford Couty, but he was a member of the New Haven County Medical Society. At one time he had a drug store and practiced medicine as far as his health would permit. In 1789, his health was too poor for him to continue at work and he went to Savannah. He died of consumption on May 10, 1790, at the age of 42. There is an obituary in the Connecticut Journal in


Background: In this study, nanosuspension was prepared to improve the dissolution rate and bioavailability of lipophilic fenofibrate. Method: Melt emulsification method combined with high-pressure homogenization was adapted, and mixture of poloxamer188 and PVP K30 were selected as surfactants. This method consumed less energy and was more efficient than traditional homogenization of drug solid particles suspension directly. Results: The dissolution rate of fenofibrate nanosuspension was increased obviously, and the product was evaluated by pharmacokinetic characteristic in rats. The AUC0–36 h and Cmax of nanosuspensions were increased when compared with the reference formulations. No significant differences were found between the two nanosuspensions A and B, of which the mean particle sizes were 356 and 194 nm, respectively. Therefore, nanosuspensions may be a suitable delivery system to improve the bioavailability of those drugs with poor water solubility.


Purpose
A person with post-stroke lateropulsion pushes their body toward their hemiparetic side and/or resists accepting weight onto their nonparetic side. Research findings regarding long-term persistence of lateropulsion and its association with function are lacking. This study reports associations between lateropulsion severity (Four Point Pusher Score - 4PPS) and functional outcome (Functional Independence Measure - FIM) at three months after discharge.

Methods
This prospective cohort study included 41 consecutive admissions to a stroke rehabilitation unit. Lateropulsion severity and FIM were measured at admission, discharge and three-month follow-up. Lateropulsion status at discharge, stroke laterality, ongoing physiotherapy after discharge, and demographic variables (age and sex) were tested for association with FIM change over the follow-up period.

Results
Complete data were available for 38 participants. Among these, 17 (44.7%) showed lateropulsion (4PPS ≥ 1) on admission, 9 (23.7%) showed persistent lateropulsion on discharge, and 7 (18.4%) showed persistent lateropulsion at three month follow-up. Improved functional status (FIM score) was seen at follow-up in those discharged with lateropulsion who had right-sided lesions but not in those with left-sided lesions.

Conclusions
Lateropulsion can continue to resolve after discharge from inpatient rehabilitation. Larger cohort studies are needed to further explore associations between persistent lateropulsion and long-term outcomes.


This study sought to determine the potential of sedimentary cladoceran assemblages for inferring changes in shallow lake ecological structure and function. The first stage of the study aimed to isolate and quantify the main structuring forces of the contemporary zooplankton community. Zooplankton populations were sampled from 39 mesotrophic to hyper-eutrophic shallow lakes (<3 m average depth) in the U.K. and Denmark. Additionally, a suite of environmental variables, including: fish, macrophytes, algal crop, nutrient concentrations and water transparency were analysed. A variety of numerical techniques including constrained ordination and logistic regression were employed to determine whole community and individual species response to the environmental variation within the data set. The sedimentary remains of zooplankton were then enumerated from the surface sediments of the 39 'training set' lakes. These data were compared with the contemporary counts. Despite differential preservation of sedimentary remains, the main factors structuring the assemblages were the same in both data sets, zooplanktivorous fish density (ZF) and submerged macrophyte abundance (MA). Furthermore, these factors displayed a similar degree of influence on both assemblages. A multivariate regression tree (MRT) was used to calibrate sedimentary cladoceran assemblage response to ZF and MA. The resultant model places a site in one of five groups based on cladoceran assemblage and corresponding to a range of values of ZF and MA. These groups represent distinct forms of ecosystem structure and function varying from sites with clear water, abundant macrophytes and low ZF to turbid, phytoplankton dominated systems with high ZF. Sedimentary cladoceran assemblages from dated cores for two sites, Felbrigg Lake (Norfolk, England) and Kenfig Pool (Glamorgan, Wales) were analysed. The cladoceran inferred ZF and MA indicated that both sites have undergone dramatic changes in ZF and MA. Comparison with plant macrofossil data and historical records at both sites indicated the veracity of the model.


The aim of this study was to analyze nutritional compositions of rapeseed pollen granules and to determine the possible usage of pollen granules as a yeast culture medium. Rapeseed pollen granules (per 100 g) were consisted of carbohydrate 58.9 g, protein 20.8 g, fat 4.1 g, ash 2.5 g and water 13.7 g. And fructose (13.7 g), glucose (11.1 g), and sucrose (6.6 g) of sugars and K (606.7 mg) and P (603.3 mg) of minerals were highly contained. In addition, free amino acids such as glutamic acid (2,482.4 mg), aspartic acid (2,136.5 mg), lysine (1,648.3 mg), and leucine (1,631.1 mg) were present at a higher level. When liquid medium, which was made from cracked pollen granules (5, 10, 15, 20, 25, 30, and 40 g/L), was tested for yeast culture, liquid medium containing pollen granules over 15 g/L showed higher yeast growth than YPD medium (control). Liquid medium containing both cracked pollen granules (15 g/L) and NaCl (1 ~ 20 g/L) improved yeast growth than the liquid medium without NaCl. In addition, when yeast growth was tested on solid medium made from pollen granules (15 g/L) at 30℃ for 2 days, yeast colonies were equally well-formed like those grown on YPD medium. Overall, rapeseed pollen granules have potential properties on yeast growth and could be used as a primary source for yeast culture.


The LIM homeodomain transcription factor Lmx1a is a very potent inducer of stem cells towards dopaminergic neurons. Despite several studies on the function of this gene, the exact in vivo role of Lmx1a in mesodiencephalic dopamine (mdDA) neuronal specification is still not understood. To analyse the genes functioning downstream of Lmx1a, we performed expression microarray analysis of LMX1A‐overexpressing MN9D dopaminergic cells. Several interesting regulated genes were identified, based on their regulation in other previously generated expression arrays and on their expression pattern in the developing mdDA neuronal field. Post analysis through in vivo expression analysis in Lmx1a mouse mutant (dr/dr) embryos demonstrated a clear decrease in expression of the genes Grb10 and Rgs4, in and adjacent to the rostral and dorsal mdDA neuronal field and within the Lmx1a expression domain. Interestingly, the DA marker Vmat2 was significantly up‐regulated as a consequence of increased LMX1A dose, and subsequent analysis on Lmx1a‐mutant E14.5 and adult tissue revealed a significant decrease in Vmat2 expression in mdDA neurons. Taken together, microarray analysis of an LMX1A‐overexpression cell system resulted in the identification of novel direct or indirect downstream targets of Lmx1a in mdDA neurons: Grb10, Rgs4 and Vmat2.


Abstract. It has been suggested that mines other than octopamine may be involved in the pathogenesis of hepatic encephalopathy. Plasma phenylethanolamine has been determined by a radioenzymatic method in twenty‐six biopsy‐proven cirrhotics with or without encephalopathy and in seven normal adults. Phenylethanolamine plasma levels correlated statistically with the presence of liver cirrhosis and severe coma. These results are consistent with the false neurotransmitter hypothesis of hepatic encephalopathy.


Proceedings: AACR Annual Meeting 2014; April 5-9, 2014; San Diego, CA

Background: Weight change may influence breast cancer prognosis. The aim was to investigate whether weight change between the preoperative and 1-year postoperative visit was associated with risk of early breast cancer events in a population-based cohort of breast cancer patients in Sweden.

Methods: Weight was measured by research nurses at the preoperative and the 1-year follow-up visits from 849 primary breast cancer patients operated between 2002 and 2011 in Lund, Sweden. Tumor characteristics, clinical data, and date of death were obtained from pathology reports, patient charts, and population registries.

Results: The median follow-up was three years and 79 early breast cancer events occurred during the follow-up period. In all patients, there was a non-significant tendency towards decreased risk of early events with weight loss (Ptrend = 0.11). Weight loss was significantly associated with lower risk of early events compared to stable weight or weight gain in patients with axillary nodal involvement (Ptrend = 0.012), but not in patients without axillary nodal involvement. Further analysis showed that weight loss was only significantly associated with lower risk of early events among patients younger than 70 years with axillary nodal involvement, while patients who had gained more than 5% of the preoperative weight had significantly earlier events compared to those with stable weight. The results remained significant after adjustment for age at diagnosis, natural logarithm of the preoperative weight, invasive tumor size, axillary nodal involvement, and ER status. Further adjustments for smoking and alcohol abstinence, ever use of hormone therapy, or for treatments did not materially change the result.

Conclusion: Weight loss was associated with significantly lower risk for early breast cancer events in patients younger than 70 years with axillary nodal involvement compared to stable weight or weight gain. If these results are confirmed, weight management may be incorporated in post-diagnosis management of breast cancer patients with axillary nodal involvement and have a significant beneficial impact on short-term prognosis.

Citation Format: Xuyian Kenez, Andrea Markkula, Maria Simonsson, Christian Ingvar, Carsten Rose, Helena C. Jernstrom. Weight change in relation to early breast cancer events in breast cancer patients. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2171. doi:10.1158/1538-7445.AM2014-2171


The most critical and controversial input parameter to a seismic hazard analysis is generally the regional ground-motion relations, which define the peak ground motion and response spectral parameters as functions of earthquake magnitude and distance. For seismic hazard applications in California, these relations have been derived by regression analysis of recorded strong-motion data ( e.g., Boore et al., 1997; Abrahamson and Silva, 1997; Sadigh et al., 1997). For regions beyond California, such as eastern North America (ENA), regional ground-motion relations cannot be reliably derived from direct regression of strong-motion data, because these data are too sparse in the magnitude-distance range of engineering interest ( M 5 to 8 at distances less than 200 km). For this reason, alternative methods of deriving ground-motion relations have been employed.

In eastern North America, nearly all recently published ground-motion relations have been derived using the stochastic method ( e.g., Atkinson and Boore, 1995; Frankel et al., 1996; Toro et al., 1997). The stochastic method is a simple and effective tool for developing ground-motion relations, whereby earthquake ground motions are treated as bandlimited Gaussian noise, whose amplitude spectrum is given by a seismological model of earthquake source and propagation processes. The model has been shown to reproduce successfully the sparse ENA database (Atkinson and Boore, 1995, 1998), and has also been demonstrated to fit the more extensive California database (Boore, 1983; Boore and Joyner, 1997; Atkinson and Silva, 2000). Nevertheless, there is significant uncertainty involved in using ground-motion relations that are based largely on a model whose accuracy for large-magnitude earthquakes can be truly known only after many more years of gathering ground-motion data in ENA.

Uncertainty plays a major role in seismic hazard analysis, and the evaluation of uncertainty is an important product of such an analysis ( e.g., EPRI, 1993 …


Acute respiratory infection (ARI) ranks first in the ten most frequent diseases occurring in Allakuang Village during the last five years. The physical conditions and the density of pollution inside houses are risk factors that cause ARI. Homemakers are particularly vulnerable to ARI because most of their time is spent inside their houses. The aim of this study is to determine the factors that affect the incidence of ARI among homemakers, including the physical condition of the house (temperature, humidity, lighting, ventilation, ceiling condition, floor, walls, and the location of the kitchen), the pollutants inside the house (PM10, cooking fuel, tobacco smoke, and smoke mosquito coils), and the number of occupants. The sample used in this cross-sectional study comprised 103 homemakers. The analysis was conducted using chi-square and multiple logistic regression tests. The results showed that several factors had significant correlations with ARI, such as PM10 concentration, the type of cooking fuel, and the use of mosquito coils. Furthermore, the results of the multivariate analysis showed that the most influential factor that caused ARI was the type of cooking fuel. Homemakers who used firewood and kerosene as their cooking fuel were47times more at risk of suffering ARI compared with those who used gas fuel. Hence, people are recommended to reduce the use of cooking fuel that produces smoke, to the kitchen from the family room, and to eliminate the use of mosquito coils.


Ongoing environmental changes in the Arctic will affect the exchange of natural volatile organic compounds between the atmosphere and the Arctic Ocean. Among these compounds, natural halocarbons play an important role in atmospheric ozone chemistry. We measured the distribution of five major natural halocarbons (methyl iodide, bromoform, dibromomethane, methyl chloride, and methyl bromide) together with dimethyl sulfide and tetrachloroethylene in the atmosphere over the Arctic Ocean (from the Bering Strait to 79°N) and along the cruise path to and from Japan. Methyl iodide, bromoform, and dibromomethane were most abundant near perennial sea ice in air masses derived from coastal regions and least abundant in the northernmost Arctic, where the air masses had passed over the ice pack, whereas methyl chloride and methyl bromide showed the opposite distribution pattern. Factors controlling those distributions and future prospects for natural halocarbons in the Arctic are discussed.