We construct in an abstract fashion (without using Gromov-Witten invariants) the orbifold quantum cohomology of weighted projective space, starting from a certain differential operator. We obtain the product, grading, and intersection form by making use of the associated self-adjoint D-module and the Birkhoff factorization procedure. The method extends in principle to the more difficult case of Fano hypersurfaces in weighted projective space, where Gromov-Witten invariants have not yet been computed, and we illustrate this by means of an example originally studied by A. Corti. In contrast to the case of weighted projective space itself or the case of a Fano hypersurface in projective space, a "small cell" of the Birkhoff decomposition plays a role in the calculation.


The goal of our study was to establish the anti- proapoptotic activity of the common in Georgia crops on the Jurkat and MDCK cells. Extracts of various varieties of beans (Tirkmela, Batumi meadow, Shulavera, Udelebi, as well as green peas, Lens Culinaris lentils, soy beans) were added to the intact or incubated under oxidative stress conditions Jurkat and MDCK cells. Cell viability (apoptosis intensity) was determined by a cell proliferative activity test (MTT test). Correlation and statistical analysis of ANOVA was performed using the package (SPSS version 11.0). In the presented study the selective effectiveness of extracts with different antioxidant activity on intact and incubated under oxidative stress Jurkat and MDCK cells was revealed, related with different sensitivity of cells to the oxidative stress. In normal MDCK epithelial cells, resistant to redox-active factors (H2O2), inverse relationship between the intensity of apoptosis and the antiradical potential of the extract was found; in leukemia transformated Jurkat cells, characterized by high sensitivity to oxidants (H2O2), a violation of the redox-dependent anti-apoptotic cell protection mechanisms was revealed, which is manifested by the absence of regularity of the cytoprotective / cytotoxic effects of the extracts on intact and incubated cells under oxidative stress conditions. These results can be used in the development of schemes of anti-tumor and anti-inflammatory therapy.


In this study, a novel adamantanamine-paclitaxel (AD-PTX) incorporated oligochitosan- carboxymethyl-β-cyclodextrin (CSO-g-CM-β-CD) self-assembly macromolecular (CSO-g-CM-β-CD@AD-PTX) micelle was successfully prepared in water through sonication. The formed molecules were characterized by Fourier transform infrared spectroscopy, proton nuclear magnetic resonance (NMR) spectroscopy, two-dimensional NMR, elemental analysis, and liquid chromatography-mass spectrometry, while the correspondent micelles were characterized by dynamic light scattering and transmission electron microscopy. We showed that the macromolecular micelle contained a spherical core-shell structure with a diameter of 197.1 ± 3.3 nm and zeta potential of −19.1 ± 4.3 mV. The CSO-g-CM-β-CD@AD-PTX micelle exhibited a high drug-loading efficacy up to 31.3%, as well as a critical micelle concentration of 3.4 × 10-7 M, which indicated good stability. Additionally, the in vitro release profile of the CSO-g-CM-β-CD@AD-PTX micelle demonstrated a long-term release pattern, 63.1% of AD-PTX was released from the micelle during a 30-day period. Moreover, the CSO-g-CM-β-CD@AD-PTX micelle displayed cytotoxicity at a sub-μM scale similar to PTX in U87 MG cells, and CSO-g-CM-β-CD exhibited a good safety profile by not manifesting significant toxicity at concentrations up to 100 μM. These results indicated that β-CD-based inclusion complexation resulting in biodegradable self-assembled macromolecular micelles can be utilized as nanocarrier, and may provide a promising platform for drug delivery in the future medical applications.


OBJECTIVE
To explore the anatomical features of supratrochlear artery which is related to the blood supply of paramedian frontal flap in nasal reconstruction.

METHODS
10 adult head specimens (20 sides) were used for observation of the course, layer and anastomosis of the supratrochlear artery. The horizontal line of supraorbital rim and the frontal middle line were used as X and Y axis to locate the position of supratrochlear artery.

RESULTS
Supratrochlear artery is directed medially and upward after it gets out from orbit. Some arteries (9/20) have one sharp bend at the beginning. The frontal muscle penetration point of the artery is (15.2 +/- 2.6) mm above the X axis and (12. 1 +/- 1 .4) nun lateral to the Y axis. The artery goes subcutaneously after muscle penetration point. It goes more superficially and is anastomosed to the supraorbital artery and frontal branches of the superficial temporal artery at the same side, and also the contra-lateral supratrochlear artery.

CONCLUSION
The pedicle of the paramedian frontal flap should not be too narrow. The dissection of the pedicle should not be too near to the artery, so as to protect the bend at the beginning. The flap elevation must be performed beneath the frontal muscle, when it is 2-3 cm above the supraorbital rim.


Since its emergence as a discipline in the 1960s, women's history has had a profound effect on the study of the past. Scholarship on women's experiences of and contributions to the Russian revolutionary movement has increased exponentially since the publication of a number of biographies of Aleksandra Kollontai in the 1970s and 1980s and a comprehensive picture has emerged of women's involvement in all the major revolutionary parties, as leading figures as well as rank and file activists. Despite this wealth of historical discovery, remarkably little has found its way into so-called 'general' histories of the revolution. An integrated history, which is the ultimate aim of women's history, has yet to be produced for the Russian revolutionary movement, even though recent prosopographical studies of revolutionary women have made clear the numerous ways in which men and women cooperated and interacted on a daily basis in the underground. This article explores the nature of and reasons for this failure, makes a case for why incorporating women's experiences into the grand narrative of the Russian revolution is important and discusses how this might be achieved.


It is proved that to any electric circuit there correspond two pairs of of conjugate linear vector spaces. One of these pairs is generated by a homological group, while the other by a cohomological one. A new method of analysis of mechanical and electric circuits is proposed, which consists in representing the main variables and matrices of oscillatory circuits in terms of many-dimensional tensor objects. A solution is obtained for the problem of defining eigenvalues of pure-loop and pure-node circuits. It is shown that the latter circuits are pairwise equal to impedances' values of individual branches (to eigenvalues of a primitive circuit). A simple technique of separating roots of characteristic polynomials of many-dimensional systems with concentrated parameters is found. New matrix relations are obtained for loop and node matrices which make it possible to reduce the calculation of determinants of these matrices to the calculation of determinants of matrices of lower orders. A new method is developed for defining a full range of eigenvalues of linear oscillatory systems with a great number of degrees of freedom.


This article describes OAM in MPLS layer 2 transport networks. MPLS networks used to transport layer 2 traffic are referred to as MPLS layer 2 transport networks. They may be used to connect legacy layer 2 networks and/or provide layer 2 service to a user over a MPLS network. As legacy layer 2 networks migrate to use MPLS for transport, the role of MPLS OAM mechanisms is becoming increasingly important. This is because the converged network must offer the same OAM functionality as existing layer 2 networks. This article emphasizes the importance of end-to-end OAM, while emulating existing layer 2 services using MPLS transport. End-to-end fault detection is described in the context of various layer 2 over MPLS transport network models. The article focuses on state-of-the-art MPLS label switched path and pseudo wire OAM mechanisms being developed by the IETF. This includes fault detection and isolation mechanisms such as LSP-Ping, bidirectional forwarding detection, and virtual circuit connectivity verification. The applicability of each of these mechanisms is given. In some cases it may be possible to carry layer 2 OAM cells end-to-end, while in other cases this may not be possible. The relationship between segment-based OAM mechanisms and end-to-end OAM is described for each of these cases.


Until date eLearning environment have only supported or substituted the existing learning environments. However, owing to the improvements in technology over the last decade, it is currently able to support the transition from traditional learning to continuous competent development and to nurture the sustainability and innovativeness of small and medium enterprises. In this study, concept of eLearning was investigated in its general terms and the situation in Turkey was discussed with special emphasis on GIS training. The current state of involvement of eLearning in the field of GIS training was discussed through some approaches and experiences. Finally routes and suggestions for future development and implementation of such applications in the field were presented.


go. In a one try at success condition, prisoners high in n Achievementlow in test anxiety (HL) performed significantly better than those low in n Achievement-high in test anxiety (LH) in a noncontingent but not a contingent path. These results are consistent with previous findings involving prisoners and at variance with results derived from students. Under the two tries at success condition, HL's performed significantly better than Lea's in a contingent but not a noncontingent path and hence are more in line with results obtained from students. The hypothesis as if they were failure threatened is explored. S DEPARTMENT OF HEALTH. EDUCATION WELFARE NATIONAL INSTITUTE OF EDLIEPTION H,, Dr/r APINT BEEN PE PPO 0,..? ED Fick,' tn. A, PF,Fvf r QOM 'HE PflaCiN OP Olar,ANtzAT.oN OPI(,'N AT NC, PO NTS 01 w.F ed oa OP,N.ONS ,,aE 0 DO NOT NFCP,SAia,LY PEPlaF '40.0 NA/ ONAt :NC'7UTE FOnir A ON POS, ON OP POI'Cv PER2ORMANCE OF PRISONERS IN TWO KINDS OZ CONTINGENCY PATHS Elliot E. Entin C©p1, Ohio University


Aim Cognitive impairment is seen in patients with paediatric multiple sclerosis in more than 30% of cases. Altered functions with variable frequency are: attention, language (receptive, verbal fluency, naming), visual-spatial and motor functions, spatial memory, executive functions and abstract reasoning. The aim of this study is to determinate the cognitive functions disorders in children with multiple sclerosis. Methods A total of 21 individuals with paediatric MS (19 girls, 2 boys), ranging from 10–17 years of age (SD=14.90 ± 186) completed initial and follow-up neuropsychological testing at yearly interval. All the patients were given WISC-R, Raven's Standard Progressive Matrices, Wisconsin Card Sorting, Stroop Test, Line Orientation Test and Verbal Fluency Results 55% of the patients had Interferon therapy, First attack age was 12.92 ± 2.36, total number of attacks was 2.68 ± 2.19. IQ assessment was as follows: 19.1% (n = 4) borderline, 47.6% (n = 10) average, 33.4% (n = 7) high average. After interferon therapy; patients showed increased reponse time with less mistakes in Stroop test (p < 0.05), there was an increase of vocabulary scores in Verbal Fluency Test, being is still behind the scores of normal children. Visual-spatial perception impairments became evident right after the attacks. Symptoms of depression have been found in the 25% of the patients. There is a correlation (r: 0.82) between tnumber of attacks, cognitive loss, and depression. Conclusion Cognitive impairment has a negative impact on patient's life limiting social, academic activities. Early treatment with disease-modifying drugs seems to be advisable in order to prevent or delay the development of cognitive impairment.


The results of solid-phase and deep cultivation of the Siberian strain Fp6-17 Fomitopsis pinicola (Sw.) P. Karst. are presented. Growth parameters were determined on cellulose-containing agarized media and plant substrates with the addition of a solid phase after hydrodynamic activation of fir needles and sawdust of birch. Radial growth rate 3.0–4.3 mm / day; growth coefficient 37–64. Changes in polysaccharides in activated birch sawdust during fermentation noted, despite the low growth coefficient of the fungus. After hydrodynamic activation, the content of easily hydrolysable polysaccharides increased by 9 %, the proportion of hardly hydrolysable polysaccharides decreased by 8%. After further solid-phase cultivation, the content of easily and hardly hydrolysable polysaccharides decreased by 10 and 23%, respectively. The conditions for the deep cultivation of the strain Fp6-17 on a modified Norkrans medium with microcrystalline cellulose selected. At 26 °C and a pH of 4.6 on the seventh day, the maximum activity of carboxymethyl cellulase was 13.6 units / ml; biomass yield – 16.2 g/l. The optimal composition of the solid phase medium was selected after hydrodynamic processing of fir needles and sawdust of birch with enrichment of (NH4)2SO4. The maximum activity of the enzyme was 14.2 u/ml. With high enzymatic activity in the culture fluid, the formation of small globules with a diameter of up to 5 mm and a smaller amount of biomass is noted. At lower enzyme indices, in most cases a greater increase in biomass recorded due to the formation of large ellipsoid pellets with a fringed edge.


ed from Chumakov (1967) Marine deposits of Pliocene age have been discovered in the Nile Valley at a considerable depth below sea-level. These deposits have not only been detected in lower Egypt where the base of the upper Pliocene near Cairo has been established at —300 meters, but more recently in the High Dam area at Aswan. During the course of geological investigation in this area, lower Pliocene marine and estuarian sediments were encountered at —170 (and maybe —200) meters in a narrow incision into the bed of the paleo-Nile River. The overdeepening of this riverbed involved extensive erosion into a crystalline basement of gneiss and granite. The gradient of the bedrock floor of the buried valley of the Nile above Aswan indicates that the Pliocene sea formed a deep estuary in the Nile Valley, which penetrated upstream of Wadi Haifa, in the Sudan, some 1250 miles from the present seacoast. Cross-sections reconstructed from boreholes south of the Aswan Dam are illustrated in Figure 1. The lower part of the Pliocene sequence ( N 2 ^ ) was deposited in a salt water estuary revealing the maximum extent of the Pliocene transgression, which in the Mediterranean region is usually expressed by the Plaisancian. The middle transitional layer (N2 ), dated as Astian, shows a gradual change from oceanic conditions of sedimentation to continental. This series has only been found near the mouths of the east bank wadis. The Upper Series (Villafranchian) is represented by coarse alluvium in isolated patches on both banks of the Nile on the highest erosional surfaces at +160 to 200 meters elevation above the valley bottom of the paleo-Nile. The Quaternary fill (Qj to Q4) is exclusively alluvial and records the encroachment of semi-arid conditions.


Geometric phases are ubiquitous in physics; they act as memories of the transformation of a physical system. In optics, the most prominent examples are the Pancharatnam-Berry phase and the spin-redirection phase. Recent technological advances in phase and polarization structuring have led to the discovery of additional geometric phases of light. The underlying mechanism for all of these is provided by fibre bundle theory. In this colloquium, we review how fibre bundle theory does not only shed light on the origin of geometric phases of light, but also lays the foundations for the exploration of high dimensional state spaces, with implications for topological photonics and quantum communications.


In this paper, the method of the quasilinearization technique in causal differential equations is applied to obtain upper and lower sequences with initial time difference in terms of the solutions of the linear causal differential equations that start at different initial times. It is also shown that these sequences converge to the unique solution of the nonlinear equation in causal differential equations uniformly and superlinearly.


The objective of this study was to analyze the best practices that have to be adopted in implementing ERP. The study further sought to address security challenges faced in ERP implementation. The researcher used content analysis approach of a number of publications on the subject area of ERP implementation. This research makes use of secondary sources like books, academic journals and other online sources that speak about the best practices to be adapted for implementation of Enterprise resource planning systems for conducting the study. The findings showed that before an organization dives in implementing ERP, the following practices for successful implementation have to be considered: developing a plan with clear goals and objectives, gaining internal support and commitment, selecting the right software, allocating sufficient resources and training and change management. The study also established that integrating user management, internal controls, data and information management and reporting, compliance, and protection against internal and external threats associated with a single solution is a big challenge. The paper concludes that even though ERP is important to organisations, its implementation is challenging and organisations must prepare adequately to get it right.


A 74‐year‐old woman was admitted with a dry cough and dyspnea that had persisted for 2 weeks at the beginning of winter. Chest computed tomography revealed bilateral diffuse non‐segmental ground‐glass opacities without centrilobular nodules. Bronchoalveolar lavage fluid revealed a marked increase in the lymphocyte ratio. Her condition and chest radiographic findings improved spontaneously after admission. An additional interview conducted after admission revealed that the patient had started using a contaminated humidifier approximately 2 weeks before the onset of symptoms. Thus, the diagnosis of humidifier lung was established. Humidifier lung is a rare phenotype of hypersensitive pneumonitis that often occurs during dry winter when the use of humidifiers increases. Humidifier lung is an important differential diagnosis of bilateral pneumonia during dry winter, and detailed history‐taking regarding the use of humidifiers, assuming a humidifier lung, is crucial for its diagnosis.


Background: Epidural neuroplasty have emerged as minimally invasive techniques for treatment of low back pain and lower extremity pain due to contained herniated discs when conservative management has failed. A few studies have examined their effects on functional activity and pain medication use. Outcomes of the procedure to treat the ailment were not analyzed over time. Methods: The aim of our study was to evaluate the outcome of epidural neuroplasty in patients with chronic discogenic pain or sciatica due to nerve root compression by a single-level, contained herniated disc. Patients were assessed before and 3, 6, and 12 months after treatment by a blinded investigator. In our retrospective, non-randomized case series, 26 patients with therapy of epidural neuroplasty were included. Patients were evaluated at 3, 6, and 12 months postoperatively, and were asked to quantify their pain using a visual analog scale. Patients were also surveyed in regards to their pain medication use, and Oswestry Disability Index (ODI) was quantified by third-party observers. Data at 3, 6, and 12 months posttreatment were compared to baseline. Results: There was a significant decrease in pain and medication use reported in first three months after the treatment. Functional status also improved at the first 3 months. There were no complications associated with the procedure. Conclusion: Epidural neuroplasty appear to be safe and significantly effective in either early post-treatment periods. Randomized, controlled studies are now required to further evaluate long-term efficacy of the combination therapy.


A Research Thesis Submitted For the Award of the ' Degree of Doctor of Philosophy (Special Needs Education) In the School of Education of Kenyatta University


Abstract The lecture summarized our recent work in the fields of (i) catalytic asymmetric epoxidation and cyclopropanation, (ii) C–C coupling reactions, and (iii) dynamic kinetic resolution (DKR). The first section describes the use of chiral Ru-porphyrins as catalysts for the asymmetric epoxidation and cyclopropanation of nonfunctionalized olefins, and of peptides and alkaloid-based phase-transfer catalysts for the asymmetric epoxidation of enones. The second section highlights the application of the DIANANE-salen ligands (DIANANE: endo,endo-2,5-diamino-norbornane) to the asymmetric Nozaki–Hiyama–Kishi coupling of aldehydes with allylic and vinylic electrophiles, and of N-tosyl proline amides for asymmetric aldol additions. In the final section, bifunctional urea-based organocatalysts for the DKR of azlactones to provide enantiomerically enriched amino acid esters are presented.


This thesis explored teacher professional judgement as applied to the final report card process of Ontario Secondary School courses in Business, Humanities, and Social Science. A constructivist grounded theory approach was used. Twenty-four active teachers from various schools participated in semi-structured interviews and follow-up questions. How the respondents understood the use of professional judgement when determining percentage grades was analyzed. The study found that the participants personalized procedures, either independently or at the direction of the local administration, when interpreting policy into practice. These practices, although done with good intentions, were at odds with reliable and valid assessment. This phenomenon was termed Heuristic Assessment.
Ontario's revised assessment and evaluation policy Growing Success (Ontario, 2010a) placed emphasis on informed professional judgement. Although a definition was provided, how the concept works in practice was open to interpretation. Therefore, schools can apply professional judgement in numerous ways and still be in line with provincial policy if what is taught and evaluated correspond with curriculum documents. However, this study found that Ministry instructions are challenging to implement. There are tensions between how the local administration view policy, participant understanding of these guidelines, and the realities of the classroom. Furthermore, school culture consists of both shared, or public, and shadowed, or private practices. Shared and shadowed practices sometimes go with, and sometimes against, provincial policy. Consequently, participants engaged in Heuristic Assessment: they used their professional judgement to adhere to local policy in appearance, while finding ways to evaluate final report cards on their own terms.
This study makes several contributions to the field of knowledge. First, we see the concept of professional judgement in Ontario evaluation practices not as an idealized definition but as teacher-created construct. Second, there was clear evidence that the province still has work to do in order to have better consistency in assessment of learning practices. Understanding gained by the research established proposals on how to further improve reporting of student learning in Ontario and other educational systems. For example, there are easier ways for teachers to explain the meaning of grades to students, parents, guardians, and other stakeholders. If professional judgement is vital to evaluation practices, then the concept should be reified to assist teachers with the assessment process. There is also a methodological contribution, as the study provided an example of how to blend the constructivist grounded theory of Kathy Charmaz with the situational analysis of Adele Clarke to educational evaluation research.


An international relations classic, "The Chinese Calculus of Deterrence" presents a framework for anticipating Chinese political-military behavior in the nuclear era. Through analysis and scholarly research, Allen S. Whiting reconstructs China's response to the perceived threat from India in 1962 and Beijing's secret military participation in the Vietnam War from 1964 to 1968. Comparing these with Chinese actions in the Korean War and Sino-Soviet border clashes, Whiting reveals the patterns in Chinese calculations of deterrence and the use of force.This book throws light on policy divisions at the highest levels in Beijing and on Chinese miscalculations in coping with enemy states. It also suggests ways in which other states can affect Chinese perceptions and behavior to reduce the likelihood of conflict. The analysis presented here strips away the mystery surrounding Chinese behavior and reveals it to be not so far removed from that of other governments. This volume includes a new foreword that considers recent data and developments in the Taiwan Strait.


Stereo vision is the process of recovering 3D spatial information from a pair of 2D images. It is very difficult problem due to the fact that stereo matching problem tends to produce as large number of plausible solutions. Thus we need to restrict the solution space in some manner. Trellis-based stereo matching algorithm places hard constraints on the solution by considering the geometry of stereo imaging and by making assumptions about the real depth shape. In that algorithm, permitting the use of the highly parallel Viterbi algorithm (a special case of dynamic programming), real-time stereo vision system can be realized. However, by using a single scan-line for matching, there are too many stripe noises in the result. In this thesis, a new method which can reduce the stripe noise is proposed. Using the disparity information of the upper scan-line, the proposed algorithm achieves more exact disparity map. The proposed algorithm uses Average of Squared Difference (ASD) instead of Euclidean distance in calculating matching cost in order to alleviate the horizontal stripe noise. The experimental results show more precise disparity map compared with the existing algorithm, especially, at low-to-moderate SNR range. Random dot stereogram (RDS) is used to evaluate the quantitative experiment.


The largest area of local coffee plantation in West Sumatera Province is in the District of Solok, that covers the area around 9,300 Ha, with the annual production of  8,500 Ton. There are two varieties of coffee in this District, arabica and robusta. The area of robusta coffee is around 7,700 Ha that are much larger than arabica  of 1,600 Ha. Although the price of arabica coffee is much higher than robusta, farmers prefer to cultivate robusta coffee mainly due to its resistance to plant diseases, low maintenance cost and higher demand compare to arabica coffee. Since the Robusta coffee is the second largest of local plantation after casiavera in Solok. There is a need for the district government to get a suitable development not only for the benefit of local farmers but also for regional development of Solok district itself. This study applied descriptif qualitative method to analyze the interrelationship of agribusiness sub-systems and its potential aspect. The results shows that the interrelationship of four subsystems of the agribusiness of R obusta coffee agribusiness were not strong enough to face the influences from the external factors of the systems. This, then guided the recommendation to improve the competitiveness of the Robusta coffee , mainly by increasing the quality and appearance of its market form and its dairy products .  Keywords: Robusta coffee, Solok-West Sumatera, Potential Aspect


Basalt fiber reinforced polymers (BFRPs) have been widely used in structures because of their high strength and light weight advantages. The previous research neglected the effect of the bonded anchor which led to overestimated performances of the BFRP tendons. In this study, experiments on the monotonic and hysteretic behaviors were conducted to analyze the mechanics of the BFRP tendons with bonded anchors. After considering the influences of the loading rates and initial prestressed displacements, the anchor colloidal deformations of the BFRP systems were measured and regressed. The results showed that the bearing and elongation capacities of the BFRP tendons, which exceed 3.3% and 140 kN, respectively, were independent of the loading rate and initial prestressed displacement under the monotonic and hysteretic loadings. The colloidal deformations, which accounted for about 20% of the whole deformation of the BFRP tendons, cannot be neglected in the predicted responses of the BFRP tendons. The regressed formulas of the anchor colloidal deformation could effectively anticipate the monotonic and hysteretic responses of the BFRP tendons. Therefore, the BFRP tendons with relatively stable mechanical properties are suitable for further practical application.


In Reducing Toxics, leading experts address industry, technology, health, and policy issues and explore the potential for pollution prevention at the industry and facility levels. They consider both the regulatory and institutional settings of toxics reduction initiatives, prescribe strategies for developing a prevention framework, and apply these principles in analyzing industry case studies. Among the topics considered are: the evolution of, and limits to, current environmental policy incorporating prevention into production planning and decisionmaking do voluntary programs lead to industry greening or greenwashing? case studies of the chemical, aerosols, radiator repair and electric vehicle industries opportunities for and barriers to pollution prevention Reducing Toxics offers an analytic framework for defining and understanding different approaches in the toxics area and describes the basis for a new policy and industrial decisionmaking construct.


" Hyper tableau " is a sound and complete calculus for first-order clausal logic. The present paper introduces an improvement which removes the major weakness of the calculus, which is the need to (at least partially) blindly guess ground-instantiations for certain clauses. This guessing is now replaced by a unification-driven technique. The calculus is presented in detail, which includes a completeness proof. Completeness is proven by using a novel approach to extract a model from an open branch. This enables semantical redundancy criteria which are not present in related approaches.


We propose a method for jointly inferring labels across a collection of data samples, where each sample consists of an observation and a prior belief about the label. By implicitly assuming the existence of a generative model for which a differentiable predictor is the posterior, we derive a training objective that allows learning under weak beliefs. This formulation unifies various machine learning settings; the weak beliefs can come in the form of noisy or incomplete labels, likelihoods given by a different prediction mechanism on auxiliary input, or common-sense priors reflecting knowledge about the structure of the problem at hand. We demonstrate the proposed algorithms on diverse problems: classification with negative training examples, learning from rankings, weakly and self-supervised aerial imagery segmentation, co-segmentation of video frames, and coarsely supervised text classification.


Background Rational antibiotic prescribing, in line with local guidelines, improves patient outcomes and reduces adverse events. The 'Start Smart, then Focus' antimicrobial care bundle provides a framework for rational antibiotic prescribing. Compliance with the care bundle was suboptimal at this tertiary paediatric hospital. A team with representatives from the pharmacy, microbiology and emergency departments collaborated with prescribers to improve the quality of empiric antibiotic prescribing at this institution. Purpose The project aim, using the 'Model for Improvement', was to ensure ≥90% of children admitted to the hospital via the emergency department (ED) and commenced on antibiotic therapy have a documented indication and a choice of therapy in line with local antimicrobial guidelines. Material and methods Results of weekly audits of the first 10 children admitted via the ED and started on antibiotics were fed back to prescribers. Frontline ownership techniques borne from brainstorming sessions with ED staff were used to develop ideas for change. These included: regular antibiotic prescribing discussion at Monday morning handover meeting, an antibiotic 'spot quiz' for prescribers, updates to prescribing guidelines (along with improved access and promotion of prescribing app), colour coded quick reference guideline summary cards which could be attached to prescriber ID badges and reminders and guideline summaries at point of prescribing in the ED. Collection of audit data initially proved challenging, but was resolved through a series of rapid Plan-Do-Study-Act (PDSA) cycles. Presentation of weekly run charts to prescribers fostered considerable support among consultants and non-consultant doctors. Results Documentation of indication and guideline compliance increased from a median of 30% in December 2014/January 2015 to 100% in February–May 2015. Monthly antibiotic expenditure for the hospital decreased from €32 000 in January 2015 to €13 000 in May 2015. Ongoing monthly audits continue to show 100% compliance. Conclusion Prescriber engagement, frequent data feedback and rapid audit cycles resulted in a sustained improvement in the quality of empiric antibiotic prescribing at this hospital. These interventions could easily be adapted by hospital pharmacists in other settings. References and/or Acknowledgements I would like to acknowledge the support of our ED team and hospital prescribers. This sense of ownership contributed to the success of this quality improvement project. No conflict of interest.


We herein report four patients with desquamative esophagitis that developed one to nine days after peripheral blood stem cell transplantation (PBSCT). Three patients underwent allogeneic PBSCT for leukemia, and the other underwent autologous PBSCT for pineoblastoma. Esophagogastroduodenoscopy revealed mucosal sloughing and fresh blood in the esophagus. Fasting and intravenous proton pump inhibitor therapy in addition to blood transfusion improved the esophageal lesions within five to seven days in three patients. These cases indicate that desquamative esophagitis can occur in patients who receive hematopoietic stem cell transplantation. Although blood transfusions may be required, it can be resolved within seven days.


BACKGROUND
Sentinel lymph node mapping is the standard of care for patients with malignant melanoma and breast cancer. Recently, SLN mapping was introduced to the field of gastric cancer.

OBJECTIVES
To evaluate SLN mapping in patients with gastric cancer.

METHODS
In 43 patients with gastric cancer, open intraoperative subserosal dye injection in four opposing peritumoral points was used. Ten minutes following dye injection, stained LNs were located, marked and examined postoperatively from the surgical specimen.

RESULTS
SLN mapping was performed in 43 patients with gastric cancer; 782 lymph nodes were harvested and evaluated. SLNs were stained in 34 of the patients (79.1%) with a mean of 2.85 SLNs per patient. The false negative rate was 20.9%, the positive predictive value 100%, the negative predictive value 78.6% and the sensitivity 86.9%.

CONCLUSIONS
SLN mapping in patients with gastric cancer is feasible and easy to perform. SLN mapping may mainly affect the extent of lymph node dissection, and to a lesser degree gastric resection. However, more data are needed.


Background: Chlamydial trachomatis infection is the most common cause of tubal infertility among women world-wide. Serological diagnosis of Chlamydial infection that may suggest previous, persistent or on-going infection is now incorporated into routine pre-treatment evaluation of infertile women including assisted conception. Aim: The aim of this study is to determine the prevalence and predictors of asymptomatic Chlamydial infection screening among infertile women and also to compare the screening outcome with findings on hysterosalpingogram (HSG). Subjects and Methods: This was an observational study conducted among 132 infertile women that were attending Adeoyo Maternity Hospital Ibadan. A total volume of 2-3 ml of venous blood was collected for Chlamydia serology using ImmunoComb Bivalent immunoglobulin G kit (Code 50416002) and the results were compared with their HSG. Other information collected was socio-demographics and clinical parameters. Descriptive, bivariate and multivariate tests were performed using Statistical Package for the Social Sciences 15.0 (Chicago, IL USA) and statistical significance was set at (P < 0.05). Results: A total of 130 women were studied with a mean age of 31.6 years (standard deviation = 4.7). Majority - 72.0% (95/132) - had been infertile for 5 years or less. The prevalence of Chlamydial trachomatis was 20.5% (27/132). Bivariate analysis between the biosocial variables and serology result showed a significant association with education (P < 0.01) and religion (P < 0.01). Logistic regression analysis revealed that Muslim women were 3.6 times more likely than Christians to have positive Chlamydial serology result (95% confidence interval odds ratio = 1.18-11.11). Of those with HSG result (64), the accuracy of the test kit showed low sensitivity - 44.2% (19/43) and negative predictive value 40.0% (16/40) (but, high specificity - 76.2%(16/21), and positive predictive value - 79.2% (19/24). Conclusion: Asymptomatic Chlamydial infection is common among infertile women and it positively predict HSG blockage. The serological test may prove invaluable in predicting the presence of tubal blockage; therefore, prophylactic antibiotics may be justified to be included in their care.


Practical experience is crucial in pharmacy education, but it can be difficult to provide pharmacy students with a sufficient level of experience during their education due to a number of challenges. Video games might provide a platform where students can gain positive learning experience in a virtual environment. Serious games have been used successfully across many industries, which suggest that a well-designed serious game can have positive learning outcomes. Increased engagement and motivation are mentioned by experts as some of the main benefits of serious games. Being able to practise skills before utilising them in real-world scenarios is another advantage identified. In this paper, we present a virtual patient simulator which is designed specifically teaching pharmacy students patient communication and administration of drugs. A pilot study and an expert review were carried out to evaluate the effectiveness of the application and its findings are presented.


During citizen-science expeditions to the Ulu Temburong National Park, Brunei, several individuals were collected of a semi-slug species of the genus Microparmarion that, based on morphology and in-the-field DNA-barcoding, was found to be an undescribed species.
 In this paper, we describe Microparmarion sallehi Wu, Ezzwan & Hamdani, n. sp., after field centre supervisor Md Salleh Abdullah Bat. We provide details on the external and internal reproductive morphology, the shell and the ecology of the type locality, as well as a diagnosis comparing it with related species. DNA barcodes were generated for five individuals and used for a phylogenetic reconstruction. Microparmarion sallehi sp. n. and M. exquadratus Schilthuizen et al., 2019 so far are the only Bornean species of the genus that live in lowland forest; other species are found in montane forests.


The cell potential of the cell containing two ion-selective electrodes (ISE), Na-ISE | NaClO4 (m), PEG 4000 (Y), H2O (100-Y) | ClO4-ISE has been measured at temperatures of (288.15, 298.15, and 308.15) K as a function of the weight percentage Y of PEG 4000 in a mixed solvent at a 1 Mpa and the standard state for measured activity coefficients will be a solution of the salt in pure water. Y was varied between (0 and 25) wt.% in five-unit steps and the molality of the electrolyte (m) was between 0.05 mol kg-1 and almost saturation. The values of the standard cell potential were calculated using routine methods of extrapolation together with extended Debye-Huckel and Pitzer equations. The results obtained produced good internal consistency for all the temperatures studied. Once the standard electromotive force was determined, the mean ionic activity coefficients for NaClO4, the Gibbs energy of transfer from the water to the PEG 4000-water mixture, and the primary NaCl hydration number were calculated.


With an incidence of 3–4.5 cases per million, adenoid cystic carcinoma (ACC) of the head and neck is one of the most common tumors of the parotid and sublingual salivary glands. In the clinical course, ACC is shown to have an aggressive long-term behavior, which leads to the fact that radical surgical resection of the tumor with tumor-free margins remains the "gold standard" in treating ACC. Particle radiation therapy and systemic molecular biological approaches offer new treatment options. However, risk factors for the formation and prognosis of ACC have not yet been clearly identified. The aim of the present review was to investigate long-term experience of diagnosis and treatment as well as risk and prognostic factors for occurrence and outcome of ACC.


Large river estuaries experience multiple anthropogenic stressors. Understanding plankton community dynamics in these estuaries provides insights into the patterns of natural variability and effects of human activity. We undertook a 2-year study in the Columbia River Estuary to assess the potential impacts of abiotic and biotic factors on planktonic community structure over multiple time scales. We measured microplankton and zooplankton abundance, biomass and composition monthly, concurrent with measurements of chlorophyll a, nutrient concentrations, temperature and salinity, from a dock in the lower estuary. We then statistically assessed the associations among the abundances of planktonic groups and environmental and biological factors. During the late spring high flow period of both years, the lower estuary was dominated by freshwater and low salinity-adapted planktonic taxa, and zooplankton grazers were more strongly associated with the autotroph-dominated microplankton assemblage than abiotic factors. During the early winter period of higher salinity and lower flow, nutrient (P) availability exerted a strong influence on microplankton taxa, while only temperature and upwelling strength were associated with the zooplankton assemblage. Our results indicate that the relative influence of biotic (grazers) and abiotic (salinity, flow, nutrients and upwelling) factors varies seasonally and inter-annually, and among different size classes in the estuarine food web.


Background: Burnout is considered as a pathological syndrome in which emotional depletion and maladaptive detachment develop in response to prolonged occupational stress. The aim of this study was to measure the degree of burnout and career dissatisfaction among doctors in different stages of their medical careers, and to identify and rank predictive factors. Methodology: A cross-sectional study was performed between December 2016 and June 2017 that involved Saudi physicians from all specialty disciplines at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Questionnaires were electronically delivered to physicians. The survey included the Maslach Burnout Inventory questionnaire. Prevalence of burnout according to different sections of the questionnaire was calculated and predictors of burnout were identified through regression analysis. Results: Seventy seven physicians were included with a mean age of 43.8 years. Almost 90% of participants were married all of which reported having children. 40% of physicians had been practicing for more than 10 years. 83% of participant spent 5 to 8 years in training. The vast majority were academic doctors (91%) and 79% reported having administrative in addition to their clinical duties. Almost half of cohort (48%) reported having only 1–2 hours per day for leisure or family. 61% of physicians reported that they were very satisfied with their choice of becoming a physician. Conclusion: A significant proportion of physicians working at an Academic Medical Center appeared to suffer from burnout. Parenthood and working hours might be predictive of burnout.


Membership to Recording for the Blind & Dyslexic (RFB&D), which creates and lends Talking Books of both textbooks and literature, is now free to individuals with a documented print disability, such as a learning disability, visual impairment, or other physical disability. The books, which are recorded by human narrators, are available in downloadable Digital Talking Book formats, including DAISY (Digital Accessible Information SYstem) and Windows Media Audio. In order to play RFB&D digitally recorded textbooks and literature, members need to use specialized DAISY playback systems. RFB&D offers hardware, software, and accessories that are compatible with the RFB&D Talking Book format. The DAISY players range in price from $259 to $895; the costs for the specialized audiobook software ranges from $55 to $1,289. For more information, contact: RFB&D, National Headquarters, 20 Roszel Road, Princeton, NJ 08540; e-mail: email@example.com ; web site: www.rfbd.org/membership-individual.htm .


David Steuart Erskine, 11th Earl of Buchan (1742–1829), is best known for founding the Society of the Antiquaries of Scotland in 1780. In 1786 he reacquired the family's Dryburgh estate, on which stood the ruins of Dryburgh's medieval abbey, which he thereby protected from stone-robbing, enabling it to be enjoyed today. This paper focuses elsewhere, namely on Buchan's architectural interventions in the abbey's landscape, on what motivated him, what he sought to achieve and on what people both at the time and afterwards have made of him and these interventions. It is argued that while Scotland's elites were striving to downplay the independent nation's accomplishments, Buchan instead exploited Scottish history and accomplishment to create a political landscape at Dryburgh, centred on his statue of Sir William Wallace, Guardian of Scotland during the Wars of Independence and executed in 1305. It is argued, too, that the nature of Buchan's politics, as one of the privileged elite who had broken rank from the ruling class, resulted in his reputation being maligned and his creation being generally undervalued by posterity, and in particular by the Scots themselves, the very people to whom he wanted to reach out, to inspire, and to highlight.


With the development of electrified transportation, electric vehicle positioning technology plays an important role in improving comprehensive urban management ability. However, the traditional positioning methods based on the global positioning system (GPS) or roadside single sensors make it hard to meet requirements of high-precision positioning. Considering the advantages of various sensors in the cooperative vehicle-infrastructure system (CVIS), this paper proposes a compound positioning method for connected electric vehicles (CEVs) based on multi-source data fusion technology, which can provide data support for the CVIS. Firstly, Dempster-Shafer (D-S) evidence theory is used to fuse the position probability in multi-sensor detection information, and screen vehicle existence information. Then, a hybrid neural network model based on a long short-term (LSTM) framework is constructed to fit the mapping relationship between measured and undetermined coordinates. Moreover, the fused data are proceeded as the input of the hybrid LSTM model, which can export the vehicular real-time compound positioning information. Finally, an intersection in Shijingshan District, Beijing is selected as the test field for trajectory information collection of CEVs. The experimental results have shown that the uncertainty of fusion data can be reduced to 0.38% of the original level, and the maximum error of real-time positioning accuracy is less than 0.0905 m based on the hybrid LSTM model, which can verify the effectiveness of the model.


Abstract : Since 9/11 much progress has been made by Federal, State and local authorities to prepare for future Catastrophic Incidents. The March 1, 2004 release of the National Incident Management System (NIMS) mandated the use of Unified Command and Incident Management Teams (IMTs) for multi-agency, multi-jurisdictional incidents. These teams have strong potential for improving complex incident management. However, the potential for interagency conflict threatens effectual IMT functioning in the absence of team skills instruction as part of a national training curriculum. The current curriculum teaches technical skills and ICS role responsibilities, and omits skills needed to build healthy team dynamics. Training for IMTs needs to include more than technical skills ("What to do"), and that Department of Homeland Security (DHS) should expand the curriculum to include team dynamics ("How to do it"). Further, DHS need not "re-invent the wheel" when looking for sources of team dynamic theory, but need only look to and adapt the experience of business and academia. Over the past 20-25 years a variety of inter-organizational networks and Work Teams have been studied and field tested. This thesis examines literature lessons on the problems shared by Work Teams and IMTs, with particular emphasis on effectiveness and managing conflict.


Closed-system drug transfer devices (CSTDs) are used to prevent occupational exposure to hazardous drugs in health care providers. They are considered Class II medical devices by the US FDA and are cleared but not approved before marketing. While compatibility tests are conducted by CSTD manufacturers, the procuring institution needs to consider performing its own studies before buying these devices. Herein we tested the compatibility of the components of the Needleless® DualGuard CSTD system (vial access clips, vial access spikes, and administration adaptors) with 10 antineoplastic drugs, under simulated clinical conditions, including compounding and administration, and examined drug potency maintenance, plasticizer migration, and device functionality. All drugs maintained potency within 5%. Diisononyl phthalate leakage was observed from the administration adaptors for paclitaxel and concentrated etoposide solution. In addition, white particles were discovered in CSTDs storing busulfan solution and small cracks were observed on devices which stored melphalan. Thus, it was concluded that even in simulated clinical conditions, instead of extreme conditions, there are still concerns regarding the efficacy and safety of CSTD components. The methodology may be used to implement and detect possible interactions between antineoplastic agents and CSTD components before procurement.


Objective: Negative body image is prevalent in women with rheumatoid arthritis and can affect other areas of well-being. Patients have expressed desire for body image to be addressed in treatment. Yet, it is not routinely addressed and no experimental intervention research has been conducted, until now. This randomized trial evaluated a brief online body image intervention for women with rheumatoid arthritis, with a focus on body functionality (everything the body is capable of doing) as the primary technique. Method: Women with rheumatoid arthritis and who wanted to feel better about their body (N = 84; Mage = 44.82) were randomized to the Expand Your Horizon intervention (comprising 3 writing exercises focusing on body functionality) or a waitlist control group. Primary outcomes concerned body image and secondary outcomes related to rheumatoid arthritis; these outcomes were assessed at pretest, posttest, and at 1-week and 1-month follow-up. Results: Multilevel modeling analyses showed that, relative to control, participants in the intervention experienced improvements in various aspects of body image (functionality appreciation, body appreciation, body satisfaction, body–self alienation) and decreases in depression, with effects persisting at 1-week and 1-month follow-up. No intervention effects were found for body–self harmony, rheumatoid arthritis-specific disability, pain-related disability, and anxiety. Conclusions: Focusing on body functionality can improve body image and reduce depression in women with rheumatoid arthritis. The intervention technique is easy and affordable to deliver and could be a fruitful addition to extant treatments for rheumatoid arthritis.


Spinal cord infarction is uncommon and accounts for only 1% of all strokes in comparison with cerebral infarction. Furthermore, posterior spinal cord infarction is particularly rare because of an anastomotic network of direct penetrating vessels and plexus of pial vessels fed by the paired posterior spinal arteries. We report a case of unilateral posterior spinal artery infarction on lower medulla and upper cervical spinal cord in a patient of 60-year-old woman. She complained of continuous headache for several weeks and suddenly presented right facial paresthesia, slow progression of motor weakness and proprioceptive sensory loss on right extremity, and voiding difficulty. Magnetic resonance and computed tomography imaging studies confirmed acute infarction at the right posterolateral aspect of the lower medulla and upper cervical cord (C1-2 level) with right vertebral artery hypoplasia. Transcranial doppler sonography also showed right vertebral artery hypoplasia rather than stenosis with atherosclerosis.


Abstract In the last decade piled raft foundations have been widely used around the world as intermediate foundation systems between piles and rafts to control the settlement of foundations. However, when those piles are structurally connected to rafts, relatively high axial stresses develop in relatively small numbers of piles, which are often designed to fully mobilize their geotechnical capacities. To avoid a concentration of stress at the head of piles in a traditional piled raft foundation, the raft is disconnected from the piles, and a cushion is introduced between them. Also, to tackle an unfavourable soil profile for a piled raft foundation, the conventional piled raft has been modified into a cushioned composite piled raft foundation, where piles of different materials are used. In the current study the behavior of cushioned foundation components, which transfer the load from the structure to the subsoil, are analyzed in detail, i.e., the thickness of the raft, the length of a long pile and the modulus of a flexible pile.


A new linear complexity algorithm using weighted combining is proposed for multiuser detection (MUD) in macrodiversity for synchronous DS-CDMA. Error probability expression is derived for weighted combining based receivers and a framework for finding optimal weights is proposed. Simulation results show that the performance of the proposed algorithm compares with the optimal maximum-likelihood (ML) MUD under various situations.


Objective Developing and validating a risk assessment tool aiming to identify older adults (≥65 years) at increased risk of possibly medication-related readmission to hospital within 30 days of discharge. Design Retrospective cohort study. Setting The risk score was developed using data from a hospital in southern Sweden and validated using data from four hospitals in the mid-eastern part of Sweden. Participants The development cohort (n=720) was admitted to hospital during 2017, whereas the validation cohort (n=892) was admitted during 2017–2018. Measures The risk assessment tool aims to predict possibly medication-related readmission to hospital within 30 days of discharge. Variables known at first admission and individually associated with possibly medication-related readmission were used in development. The included variables were assigned points, and Youden's index was used to decide a threshold score. The risk score was calculated for all individuals in both cohorts. Area under the receiver operating characteristic (ROC) curve (c-index) was used to measure the discrimination of the developed risk score. Sensitivity, specificity and positive and negative predictive values were calculated using cross-tabulation. Results The developed risk assessment tool, the Hospitalisations, Own home, Medications, and Emergency admission (HOME) Score, had a c-index of 0.69 in the development cohort and 0.65 in the validation cohort. It showed sensitivity 76%, specificity 54%, positive predictive value 29% and negative predictive value 90% at the threshold score in the development cohort. Conclusion The HOME Score can be used to identify older adults at increased risk of possibly medication-related readmission within 30 days of discharge. The tool is easy to use and includes variables available in electronic health records at admission, thus making it possible to implement risk-reducing activities during the hospital stay as well as at discharge and in transitions of care. Further studies are needed to investigate the clinical usefulness of the HOME Score as well as the benefits of implemented activities.


In zero-shot multilingual extractive text summarization, a model is typically trained on English summarization dataset and then applied on summarization datasets of other languages. Given English gold summaries and documents, sentence-level labels for extractive summarization are usually generated using heuristics. However, these monolingual labels created on English datasets may not be optimal on datasets of other languages, for that there is the syntactic or semantic discrepancy between different languages. In this way, it is possible to translate the English dataset to other languages and obtain different sets of labels again using heuristics. To fully leverage the information of these different sets of labels, we propose NLSSum (Neural Label Search for Summarization), which jointly learns hierarchical weights for these different sets of labels together with our summarization model. We conduct multilingual zero-shot summarization experiments on MLSUM and WikiLingua datasets, and we achieve state-of-the-art results using both human and automatic evaluations across these two datasets.


The object of this paper is to bring together several models of interleaved or parallel memory systems and to expose some of the underlying assumptions about the address streams in each model. We derive the performance for each model, either analytically or by simulation, and discuss why it yields better or worse performance than other models (e.g., because of dependencies in the address stream or hardware queues, etc.). We also show that the performance of a properly designed system can be a linear rather than a square root function of the number of memories and processors.


A general integral formula is analytically derived to represent the wave function of elliptical vortex modes. The derived formula can be straightforwardly employed to take account of spatial damping to explore vortex structure. Spatial damping is found to cause the central degenerate singularity of the circular vortex mode to be split into several singularities with different topological charges. For the non-circular vortex beam, the influence of spatial damping on the distribution of singularities is not significant. Theoretical analyses are confirmed to agree very well with the experimental measurements.


Vector space model is commonly used in the formal representation on text, but this approach would not highlight the features which play a key role in the text contents. An improved feature selection method based on key words was proposed, which uses text structural information and mutual information theory to extract key words on text content. Through using support vector machine (SVM) classifier to test, results showed that classification accuracy has improved significantly.


This study sought to evaluate the change in the perceived self-efficacy in students exposed to a training module with field exercise to conduct an environmental action plan for dengue control. Eighteen education students at a Filipino university participated in the study. A pretest-post-test design was employed. Evaluation was conducted through a nine-point self-efficacy scale. Field exercises were conducted on the grounds of the university campus. The results demonstrated statistically significant increases in perceived self-efficacy scores.


Based on the hazard of thunderbolt on buildings.this paper discusses several lightningproof measures in lightning protection and grounding design of high-story civil buildings.


In the paper, we investigate the lifting of recollements with respect to Gorenstein-projective modules. Specifically, a homological ring epimorphism can induce a lifting of the recollement of the stable category of finitely generated Gorenstein-projective modules; the recollement of the bounded Gorenstein derived categories of some upper triangular matrix algebras can be lifted to the homotopy category of Gorenstein-projective modules. As a byproduct, we give a sufficient and necessary condition on the upper triangular matrix algebra T_{n}(A) to be of finite CM-type for an algebra A of finite CM-type.


Introduction: Chronic renal disease represents a problem of public health in Colombia. Its prevalence has increased in the last decade, with a high prevalence of patients per million (ppm), considering that only 56.2% of the population has access to the health; another condition related is Acute kidney injury (AKI), this common condition is associated with high morbidity and short-term mortality. Genius90 technology is an option for those patients, using Sustained Low-Efficiency Dialysis (SLED) modality and intermittent hemodialysis (HDI). Objective: To present the experience of using SLED and conventional intermittent hemodialysis (HDI) in hospitals in Colombia whit genius®90 technology. To describe the characteristics of the patients who received SLED-type renal replacement therapy in intensive care units and conventional hemodialysis in hospitalization in the last 3 years and to show the experience in a group of patients with COVID-19 infection and AKI that received intermittent and prolonged RRT with the GENIUS® 90 technology in between March and July 2020.


Life in the era of globalization supported by economic, social, cultural, political, technological, and information technology factors today gives birth to many social and cultural phenomena, one of which is the phenomenon of premarital sexual behavior among students. The purpose of this study is, first, to describe and understand the process of premarital sexual behavior, Second, to describe and understand the pattern of premarital sexual behavior interaction, and Third, to understand the meaning of premarital sexual behavior for female students at universities in Malang.
 This research uses the basis of Ira L. Reiss theory, about the theory of sexuality change and the theory of love wheel. The approach of this research is qualitative and the type used is type of phenomenology. Methods of data collection using observation, in-depth interviews, and documentation. The data analysis is using phenomenology analysis model. This study was conducted on female students on several campuses in Malang.
 The results of this study conclude: first, premarital sexual relations among students in general do not always go through the stages as L. Reiss's theory finds about "the wheel of love". Some of the stages to go to premarital sex are traversed but not as Reiss intended. Although in the campus environment begins with dating, but it is only as an entrance only. An important goal to be achieved is to have sex or premarital sex. In the next time, against other couples (not students) do not need to go through dating. Premarital sexual behavior becomes a habit and biological need and also to get financially. This is what Rose and Melati do. However, there are some female students without going through the process. She had premarital sexual intercourse because it started to feel curious and gradually became a habit and biological needs.
 Secondly, in general, the behavior of dating between female students and students continues on premarital sexual intercourse and the act is done repeatedly. The act is done on the basis of awareness to get pleasure and enjoyment. Generally when they have broken up with their girlfriends, premarital sexual needs are channeled / done with others by transactional form.
 Third, a veiled student realizes that premarital sexual conduct both to students and others is great but it is against her religious beliefs. It would be more sinful to be professional in that regard. Because of that condition then every sexual intercourse their pre-married there are feelings of fear, guilt, worries, and regret after doing it. But regret is difficult to stop the act.
 Fourth, based on the results of data analysis obtained, this study found a new theory related to premarital sexual behavior that is named by researchers as a "pyramid of sexuality", a development of existing theories, especially the "wheel theory of love" found by Ira L. Reiss which is used for the basis of this research.


Patent classification is a large-scale, hierarchical, imbalanced, multi-label problem. The number of samples in a real-world patent classification typically exceeds one million, and this number increases every year. An effective patent classifier must be able to deal with this situation. This paper discusses the use of min-max modular support vector machine (M3-SVM) to deal with large-scale patent classification problems. The method includes three steps: decomposing a large-scale and imbalanced patent classification problem into a group of relatively smaller and more balanced two-class subproblems which are independent of each other, learning these subproblems using support vector machines (SVMs) in parallel, and combining all of the trained SVMs according to the minimization and the maximization rules. M3-SVM has two attractive features which are urgently needed to deal with large-scale patent classification problems. First, it can be realized in a massively parallel form. Second, it can be built up incrementally. Results from experiments using the NTCIR-5 patent data set, which contains more than two million patents, have confirmed these two attractive features, and demonstrate that M3-SVM outperforms conventional SVMs in terms of both training time and generalization performance.


Variations in the formation of the brachial plexus and in the course of its branches are not as uncommon as was once thought. A description of the abnormalities and complexities of the anatomy of the upper arm is very important with regard to surgical approaches. This case study reports a combined absence of musculocutaneous nerve associated with a third head of biceps brachii muscle in the left upper arm of an adult male cadaver. Moreover, the left ulnar nerve is entrapped within the substance of the medial head of the triceps muscle. The clinical implications, as well as the possible clinical symptoms resulting from these anomalies are discussed.


Abstract Most people, including many problem drinkers, decrease alcohol consumption as they approach their sixth and seventh decades. Some individuals, however, begin to abuse alcohol in their later years. The same stressors that lead most people to decrease, or stop, the use of alcohol as they near their retirement years actually propel others toward abusing it. The literature on early-onset and late-onset problem drinking in older people is discussed. In addition, later life-cycle theories by Erikson and Peck are used to examine drinking patterns in four elders: one in early-onset recovery, one in early-onset nonrecovery, one in late-onset recovery, and one in late-onset nonrecovery.


This paper reports an investigation on the changing dynamics of marriage and parenting among Africans all over the world. The high divorce rates; increase number of single parent families and "cold wars" in marriages are no joy for the human race. Despite the obvious and regrettably accepted changes in marriage and parenting among circular cultures, little is known about how these dynamics are affecting the views and opinions of Africans in an increasingly global world. Using Facebook – a social media website, as the platform for a focus group discussion, the research gathered views and opinions of Africans all over the world regarding marriage and parenthood education. The findings have been presented and the implications discussed as an eye opener for readers.


Abstract The exact distribution of the Wilcoxon statistic was calculated for five specific cases where both samples contained five observations, some of which were tied. The five specific cases were obtained from an actual experiment. The exact distributions for each of these five cases are compared with some approximations at points near 1, 5, and 10 per cent. Critical values and associated probabilities have been calculated for the exact and approximate distributions.


This paper retraces the steps in the recovery of a capacity for thinking in a boy who was five at the time his mother was tragically murdered by his father and almost 11 years old when he began psychoanalytic psychotherapy. It describes the emotional and technical difficulties of working psychotherapeutically when there seemed to be neither the thoughts nor the words with which to engage and experience the mental pain that lay frozen behind his eyes. I describe in detail the slow unfolding of a process in which Michael appeared to be quite literally rebuilding the structure and internal space of his mind in his play and in the transference. He needed to repair his internal thinking apparatus and recover his capacity for containment before he could house his own traumatic feelings and thoughts and think about them with me. The commensal relationship of container and contained grew out of tolerating unbearable amounts of doubt (W.R. Bion, Learning from Experience, London: Heinemann, 1962) in the transference–countertransference. This was only possible through the triangular space provided by the presence of an analyst and a supervisor in my mind and the generous support provided by colleagues and Michael's dedicated grandparents.


The short term forecasting of wind speed and direction has previously been improved by adopting a cyclo-stationary multichannel linear prediction approach which incorporated seasonal cycles into the estimation of statistics. This paper expands previous analysis by also incorporating diurnal variation and time-dependent window lengths. Based on a large data set from the UK's Met Office, we demonstrate the impact of this proposed approach.


Scientific works of recent years have shown that neurogenic and non-neurogenic hyperactivity of the bladder is largely a consequence of detrusor ischemia, which is accompanied by structural and functional rearrangement of myocyte cell membranes. Against this background, proteins endogenous activators of contractility of myocytes, which are not neurotransmitters, contacting with extra-synaptic receptors, initiate spasm and clinically manifests idiopathic hyperactivity of the bladder. With further increase in ischemia, the membranes become even stiffer. The phase of hypoactivity or detrucrality of detrusor is coming. The bladder is outside the zone of neurohumoral management, which is clinically manifested by a drop in the capacity of the bladder and an increase in detrusor pressure.


We consider the problem of a seller who faces a privately informed buyer and only knows one moment of the distribution from which values are drawn. In face of this uncertainty, the seller maximizes his worst-case expected profits. We show that a robustness property of the optimal mechanism imposes restrictions on the seller's ex-post profit function. These restrictions are used to derive the optimal mechanism. The optimal mechanism entails distortions at the intensive margin, e.g., except for the highest value buyer, sales will take place with probability strictly smaller than one. The seller can implement such allocation by committing to post prices drawn from a non-degenerate distribution, so that randomizing over prices is an optimal robust selling mechanism. We extend the model to deal with the case in which: (i) M goods are sold and the buyer's private information is multidimensional and (ii) the seller and the buyer interact for several periods. In the case of multiple goods, there are several optimal mechanisms. With multiple goods full bundling is optimal, as well as selling the goods in a fully separable way. In the dynamic model, we show that repetition, period by period, of the static-optimal mechanism is optimal.


This chapter examines the use of biometrics techniques within forensic science. It discusses the historic connections between the subjects and then examines face and ear biometrics in detail. The detailed examination starts from one of the most common and familiar biometric features face and then introduces a new biometric feature ear into forensics. Face is the natural means for human beings to recognise each other. Face biometric applications are widely used in our daily lives. However, currently no fully automatic face recognition system is accepted by the judicial system. This chapter introduces the manual and computer-aided forensic face recognition, explains the differences between automatic face recognition system (biometrics) and forensics and outlines the current progress towards addressing the challenges existing in face recognition. Ear biometrics is a potentially important biometric feature, and there has been much research progress. The current state of formal validation of ears as a forensic tool is discussed and a set of morphological features along with an analysis of their discriminatory powers are presented. These features are important in deciding whether there is enough information available for identification in case of missing features. The terminology associated with these features may also assist with communicating ear comparison results to juries, an important step in making such evidence effective at trial.


Purpose To evaluate the safety and efficacy of combined intracorneal ring segments (KERARINGS) insertion and corneal collagen cross-linking (CXL) performed in one session or two sessions and to present the refractive outcomes. Setting Magrabi Eye Hospital, Cairo, Egypt. Methods This prospective comparative study included 16 eyes of 10 patients with progressive mild to moderate keratoconus that were randomly divided into two groups. Group 1 included nine eyes that underwent KERARINGS insertion followed by CXL 6 montsh later; group 2 included seven eyes that underwent the two procedures at the same day. In both groups channel creation was performed using the femtosecond laser (Intralase FS 60). Results There was statistically significant improvement in both groups' uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), with significant reduction in refractive error and keratometric values (p<0.05). There was no statistically significant difference between both groups regarding the changes in UDVA, CDVA and refractive error (p>0.05). However, group 2 revealed more statistically significant reduction of keratometric values on topographical examination (p=0.046). The stromal haze that developed in both groups was more marked and persistent in group 2 than in group 1. Conclusion Combined KERARINGS insertion and CXL can be performed safely in one or two sessions. However, the same-session procedure appears to be more effective regarding the improvement in the corneal shape.


This review primarily examines the hermeneutical principles Nurnberger uses to bridge the gap between biblical theology and systematic theology. It argues that Nurnberger correctly identifies the task and problems facing theologians who wish to construct a critical, contextual theology without abandoning the biblical witness completely. He offers a suggestive metaphor, but his hermeneutical principles do not quite establish his conclusions. Instead, the review suggests, the conclusions owe their plausibility to the metaphor – and to the considerable wisdom and faith Nurnberger brings to the project. Perhaps we have no better resources when we deal with intractable problems.


Fuzzy Fingerprints have been successfully used as an interpretable text classification technique, but, like most other techniques, have been largely surpassed in performance by Large Pre-trained Language Models, such as BERT or RoBERTa. These models deliver state-of-the-art results in several Natural Language Processing tasks, namely Emotion Recognition in Conversations (ERC), but suffer from the lack of interpretability and explainability. In this paper, we propose to combine the two approaches to perform ERC, as a means to obtain simpler and more interpretable Large Language Models-based classifiers. We propose to feed the utterances and their previous conversational turns to a pre-trained RoBERTa, obtaining contextual embedding utterance representations, that are then supplied to an adapted Fuzzy Fingerprint classification module. We validate our approach on the widely used DailyDialog ERC benchmark dataset, in which we obtain state-of-the-art level results using a much lighter model.


The 2011 Occupy Movement has taught us that in seizing space, we can seize the imagination. In the name of austerity, public services and public spaces are under assault, our current political and economic moment is characterized by the privatization of the public. If enclosure is a fundamental aspect of our contemporary moment, then occupation—a reclaiming of public space—is its countermovement. The Occupy encampments became a metonym for the larger struggle over privatization and austerity, public access and public demonstrations, and even for the embattled concept of "The Public" itself. Occupation as a tactic against privatization and austerity revealed the depths to which the supposed Public was already privatized, revealing the depth to which spaces, institutions, and the very conception of the public itself had already been enclosed, had become privately operated public spaces. It demonstrated the way in which the democratic possibilities of these supposedly common resources had already been foreclosed upon.


We report on a 60 year old patient with peripheral neuropathy, neurogenic muscular atrophy, skin ulcers, arthritis and weakness. Detection of cryoglobulins in association with typical clinical symptoms, exclusion of hepatitis C and any other disease led to a rare diagnosis: essential cryoglobulinemic vasculitis. The case demonstrates not only the difficult diagnostic process but also the problems of an adequate and effective therapy. Since the usual immunosuppressive treatments such as methotrexate, high dose corticosteroid and intermittent intravenous pulse cyclophosphamide therapy (Austin's scheme) failed, we performed plasmapheresis (cascade filtration), which brought about an immediate and long-term remission. Besides discussing various types of plasmapheresis procedures and potential pathophysiological mechanisms, we point out that this therapy could find an early use in severe essential cryoglobulinemic vasculitis because of its excellent risk/benefit ratio.


This study presents a framework for the enhancement of parameter estimation issues by computing the time average of several quantum observables measured under the evolution of the Hamiltonian system. These time-cum-quantum averages are expressed as a quadratic function of the orthogonal projections on the eigen subspaces of the system. Estimation of the parameters is done using the approximate time-independent perturbation theory assuming the other parameters to be small with respect to one of the parameters that is normalised to unity in the presence of noise. The study also proves that the derived expression for the mean square parameter estimation error attains the quantum limit. When the measurement noise is classical and for general positive operator-valued measure successive time, the authors derive an expression for the quantum Cramer–Rao lower bound.


32 squamous lung carcinoma, 18 lung adenocarcinoma and 45 healthy individuals were included. let-7b and miR-126 expression were detected by real-time RT-PCR. 3 tissues of lung cancer patients (tumor, tumor surroundings and healthy lung tissue) were compared. Expression of anti-angiogenic let-7b and miR-126 were significantly lower in tumor tissue and surroundings compared to both healthy lung tissue of diseased patients and control. There was no difference between tumor and tumor surrounding tissue. High let-7b expression and miR-126 expression were highly associated with both better progression-free and overall survival. High micro-vascular density was negatively associated to let-7b and miR-126 expression and highly associated with poor overcome. Our results confirm a possible role of those two miRNas in lung cancer angiogenesis and suggest the potential new target angiogenic lung cancer therapy.


Objectives To evaluate and to compare the levels of compassion of students throughout the Integrated Master's in Medicine (MIM) in Portuguese Universities and relating them to University's formal curriculum.Methods Cross sectional study of the levels of compassion of 1st, 3rd and 5th year students (3rd, 4th and 5th years in the University of XX) by electronically appliance of the Jefferson Scale of Medical Empathy (student version), between October and November 2018. Curricular plans of each University was searched on the institutional sites. The percentages of Credit Units (CU) and EUROPEAN CREDIT TRANSFER SYSTEM (ECTS) were calculated for the concept and/ or pillars of compassion. Adequate descriptive and inferential statistics were defined with difference definition for p <0.03.Results Mean levels of compassion are numerically far from their maximum value (49), being different between sexes p<0.001, year of attendance, p=0.022 and university, p=0.026). The percentage of CU related to the compassionate approach is significantly different between faculties (p <0.001), but the percentage of ECTS is not different (p = 0.031).Discussion This is the first comparative study between Portuguese medical schools. The reduction in the levels of compassion of future physicians is a matter of concern for medicine schools.Conclusion There are differences in the levels of compassion among the students of the var universities according to the year attended. There are no differences between the percentage values of ECTS, according to the institutional websites. The measured value is generally favourable to student´s Compassion. Differences between Universities deserves future studies.


Background: The objective of the study was to investigate the histological distribution of collagens in the healthy rat's tympanic membrane. Methods: Immunohistochemical analysis of collagen type I, II, III, and IV in the tympanic membranes in healthy adult female Sprague-Dawley rats. The staining was semiquantified using light microscopy in a blinded fashion, not knowing what type of collagen the slide had been stained for. Results: The pars tensa of the tympanic membrane was mainly stained for collagen type II and IV. The fibrous annulus could on immunohistochemistry be subdivided into an inner and an outer portion. The inner portion of the fibrous annulus was mainly stained for collagen type II, whereas the outer portion was most strongly stained for collagen type III and collagen type IV. The test-retest reliability of the semiquantative method was 81%. Conclusion: Collagen type II and IV are the major collagen constituents of the pars tensa of the tympanic membrane. The outer portion of the fibrous annulus has collagen type III and IV as its major constituents, whereas the inner portion is made up of collagen type II.


This article reports the views of managers and tutors on the role of policy 'levers' on teaching, learning, and inclusion in colleges of Further Education (FE) in our research project, 'The impact of policy on learning and inclusion in the Learning and Skills Sector (LSS)'. Using data from five research visits conducted over two years in eight FE learning sites, we explore the processes by which colleges 'mediate' and 'translate' national policy levers and how this affects their ability to respond to local need. The paper tentatively develops three related concepts/metaphors to explain the complexity of the policy/college interface—'the process of mediation', 'acts of translation' and 'local ecologies'. We found that policy levers interacted with a complex set of national, local and institutional factors as colleges responded to pressures from the external environment and turned these into internal plans, systems and practices. We conclude by suggesting that national policy‐makers, who design national policy levers, may not be fully aware of these complexities and we make the case for the benefits of greater local control over policy levers, where these interactions are better understood.


A growing body of evidence highlights the close association between nutrition and human health. Fat is an essential macronutrient, and vegetable oils, such as palm oil, are widely used in the food industry and highly represented in the human diet. Palmitic acid, a saturated fatty acid, is the principal constituent of refined palm oil. In the last few decades, controversial studies have reported potential unhealthy effects of palm oil due to the high palmitic acid content. In this review we provide a concise and comprehensive update on the functional role of palm oil and palmitic acid in the development of obesity, type 2 diabetes mellitus, cardiovascular diseases and cancer. The atherogenic potential of palmitic acid and its stereospecific position in triacylglycerols are also discussed.


They Stand Apart. A Critical Survey of the Problems of Homosexuality. Edited by His Honour J. Tudor Rees, D.L., J.P. and Harley V. Usill, B.A. Contributors: The Viscount Haiisham, Q.C.; W. Lindesay Neustatter, M.D., B.Sc., M.R.C.P.; H. A. Hammelmann, M.A., D.Phil., LL.D.; and the Rev. D. S. Bailey, Ph.D. (Pp. 220+xii. 21s.) London: William Heinemann Ltd. 1955. At a time when public attention has been directed to the problems created by the existence in the community of a considerable number of homosexuals, there is need for an impartial and authoritative statement of the facts so far as they are known. The influence of homosexuals as a group, whether they differ from their fellows only in point of sexuality or whether the difference is part of a more generalized failure of normal adaptation in the emotional sphere, has been seen in relation to treason, to the corruption of youth, to character formation in the undergraduate student, and to the recognition of worth in music and the arts, in a series of recent court cases and public controversies. The present pressure of interest has reached the point when a Royal Commission has been formed. It is probable not so much that there are more homosexuals at the moment, but that homosexuality is discussed freely, and homosexual practices, while they give rise to surprise in our generation, are not regarded with such repugnance and prejudice as they have been at other times. That homosexuals equally with others can make valuable contributions to knowledge and culture is generally agreed, and we are grateful, for instance, for Leonardo da Vinci's gifts to posterity. On the other hand, history shows that more than once the stability of a kingdom has been rocked by a clique of homosexuals, and that such groups, among others, gain ascendancy in times of national decadence. While statutory recognition is needed of the fact that homosexuality may threaten the interests of the community, it is clear that at present the law may often inflict punishment on a type of individual who does not otherwise find himself in conflict with society. The deterrent effect of penal sanctions on such personalities is much open to question. Everyone is entitled to his opinion on this issue, and if his attitude is a civilized one he will wish it to be based on reason and fact rather than on emotion and prejudice. The medical man in particular should know something of the points of view of the Church, the legal profession, and the medical psychologist, and also something of the attitude of other countries and of other times to a problem which has been restated so often. The contributors to They Stand Apart have made a most creditable attempt to place the facts before the responsible reader, and each has made, from the mass of information available to him as a specialist, a sensible summary, while keeping to his own province. The legal aspects are summarized by the senior editor, and this, his last published work, contains a wealth of experience and knowledge. The social aspects are discussed by Viscount Hailsham, and the Christian standpoint is explored by the Rev. D. S. Bailey, study secretary of the Church of England Moral Welfare Council. The medical aspects are admirably dealt with by Dr. Lindesay Neustatter, who presents with remarkable fairness the views of the different schools of thought on the aetiology of homosexuality. It is a pity, in a book which is as well conceived, presented, and edited as this one is, that his section should contain an irritating number of misspellings of proper names and misuses of words; " predisposition " for " predilection," " depravation " for "deprivation," " perpetrate " for " perpetuate," are examples. There are 24 serious errors of the kind which can be eliminated only by a proof-reader who knows something of the author's use of words. These errors mar a section which brings great clarity to a subject of which much loose thinking has been evident in the psychiatric literature. In particular the writer does not fall into the common error, seen in recent reports, of dismissing female homosexuality as unimportant. In view of the possibility of a change in the law, great interest attaches to an account of the law in other countries given by H. A. Hammelmann. The text -is supported by appendices giving statistics and excerpts from parliamentary debates and official reports. The writers have presented their aspects of the problem in such a way as to be most useful to a citizen inquiring whether the present law should be altered and whether the community should set up some means of dealing with the problems of the maladjusted homosexual and of the protection of youth. The individual contributors achieve a high standard, and the book, which deserves to be widely read, could do much to reduce some of the misunderstanding which exists between the Church, the Law, and Medicine on this subject. ALEXANDER KENNEDY.


This paper describes a concept of a novel webbased CAD software for gear shaper cutters, including its core implementation aspects. Web-based system is proposed as a better alternative to traditional desktop CAD systems based on case study of Dathan Tool & Gauge Co. Ltd. One of the main issues in the development of a web-based CAD system is the need to process and, subsequently, visualise a lot of technical product drawings and sketches. Conventional web-oriented design systems are either integrated with specialised CAD software for processing technical drawings or use dedicated graphics visualisation tools. The proposed web-based CAD software tool for gear shaper cutters relies on technologies supported by regular web browser programs with no need for additional client software and is based on the freely available components and standards.


Aneja, Donohue, and Zhang (2014) recently released a report addressing efforts to estimate the impact of right-to-carry (RTC) laws on crime rates. These laws make it easier to acquire permits that allow their possessors to legally carry concealed weapons in public places. They address studies by Lott and Mustard that indicated there were crime-reducing effects, supposedly due to the deterrent effects of potential crime victims possessing guns, as well as reanalyses of Lott and Mustard's data by a panel of the National Research Council (NRC). While Aneja et al. generally agree with the NRC panel that the data do not permit firm conclusions about the impact of RTC laws, and even make their own contributions to the demonstration of the sensitivity of key estimates to a variety of methodological variations, the authors cannot resist repeatedly suggesting that the passage of RTC laws increases aggravated assaults and possibly other violent crime rates as well. The authors seem to want to eat their cake and have it too – that is, to accurately note how questionable estimates of RTC laws' effects on crime are, yet still tell readers that the laws were a bad idea because they increased violent crime. This note primarily focuses on this aspect of the Aneja et al. report. This paper serves as an object lesson of what can happen when scholars narrowly focus solely on statistical issues without regard to either theory or prior research, as if statistical estimates could interpret themselves. The authors were solely concerned with refuting the conclusions of Lott and Mustard by noting flaws in their data and statistical analyses, and doing the same to a lesser extent with regard to the NRC report, so they did their own reanalyses of data without reference to a large body of prior research that directly contradicted their premises.


Objective: The aims of this study were to evaluate the etiology and predisposing factors of patients with Fournier's gangrene (FG) and to compare the results and efficacy of vacuum-assisted closure (VAC) treatment with conventional dressings and debridement method. Methods: The data of 52 patients diagnosed with FG and treated at our clinic between January 2013 and October 2018 were analyzed. Patients diagnosed with FG based on physical examination findings and anamnesis were analyzed. Patients with VAC applied (Group I) and not applied (Group II) were analyzed for demographics, etiology, wound culture results, predisposing factors, FG severity index, visual analog scale (VAS) for pain, number of debridements, requirement for analgesia, colostomy, length of hospital stay, and complications. Results: Group I included 37 patients treated with conventional daily dressings, and Group II included 15 patients who were treated with VAC. No significant difference was determined between the groups with respect to etiology, microorganism type, or predisposing factors. Length of hospital stay was similar in both groups. Statistically significant differences were observed between the groups with respect to the number of debridements, VAS values, mean number of daily dressings, and use of analgesia (P<0.001). Conclusion: VAC treatment does not decrease treatment duration, but less pain is felt during dressing changes as fewer dressings are used. Patient tolerance to treatment is also improved. It may be considered that the use of VAC treatment in wound care for patients with FG could increase patients' tolerance to treatment and quality of life.