Introduction: Pseudo-exfoliation is a complex age related disorder of production and accumulation of fibrillar material in the anterior segment of eye.It is more common as the age advances. It is also associated with serious ocular problems such as cataract and glaucoma. Aims: To find out the prevalence and pattern of clinical presentation in pseudo-exfoliative syndrome in patients visiting ophthalmology outpatient department in a rural area. Materials and Methods: This was a prospective study carried out over a period of one year in the department of Ophthalmology, Mamata Medical College and associated General Hospital, Khammam. In this study 2000 individuals, (1111 male and 889 female) above the age of 40 years, were selected randomly and complete ocular examination was done in these subjects. Results: Ninety (4.5%) out of 2000 individuals screened showed varying degree of pseudo-exfoliation syndrome in one or both eyes. The prevalence rate increased with advancing age. It was 4.5%, at 40 years and above, 5.35 %, 6.35 % and 6.89 % at 50, 60, and 70 years and above respectively. In males the prevalence rate was 5.67% and in females 3.03%. Mean age at which this syndrome was detected is 67.32 SD±8.81 years. In males, it was 68.84 (SD±8.26) years and in females 63.96(SD±9.20) years. Bilateral involvement of the eyes was more common. Frequency of signs of pseudoexfoliation syndrome increased with advancing age and the common signs were pseudoexfoliation material over pupillary border, over anterior capsule of lens, peripheral band, pupillary ruff defects, pigment deposition over trabecularmeshwork and over endothelial surface of cornea, and on anterior surface of lens capsule. Conclusion: Pseudo-exfoliation syndrome is common in hospital visiting population especially in the elderly population in rural South India. Thorough ophthalmologic examination helps to pick up this syndrome. Early detection helps to prevent associated complications such as cataract, glaucoma capsulare and phacodonesis.


The great and rapid development of information technology, Artificial Intelligent, and its daily uses in all areas of our life, requires keeping up with distinguished software tools especially those used in data entry. The handwritten text is an important example to speed up the process of using any software. Researchers around the world provided many techniques to convert handwritten text into an understandable form for the computer system. This paper provides a study about used methods and approaches for Handwritten Text Recognition (HTR), and general overview of the properties of HTR approaches, and the advantages and disadvantages of each one.


The article is dedicated to substantiating the reasons for applying a contextual approach to teaching English for special purposes (ESP) in higher military educational institutions. Even though future officers of the Armed Forces of Ukraine should meet severe requirements as to the level of English language acquisition, when English teachers enter an ESP classroom in a military university, they meet a lot of low-skilled students with a lack of motivation. The students can be afraid of expressing themselves in a foreign language; sometimes they are afraid, stressed, unwilling to speak up because they may not see any necessity in doing so.
That's why at ESP lessons teachers should focus not only on the subject-matter of the course but also increase students' motivation, create a positive atmosphere, develop critical thinking and professional competence, encourage group work for reaching mutual goals. All above mentioned poses a challenge to the teacher, and the solution can be in applying a contextual approach to teaching English for special purposes that implies contextualization of materials to create true-to-life situations and submerge the students into job-related surrounding making them think about their previous experience and ways of its application under different circumstances.
The article generalizes the practical experience of using contextualized materials at the English lessons for special purposes and proves that they help to create a meaningful environment for learners. As the result the students demonstrate an eagerness to express themselves using a foreign language, they are involved in the lesson and ready to work in a team.
So, using contextualized materials at the English lessons for special purposes in higher military educational establishments is an up-to-date issue, as it helps to form necessary language competence of future officers, create additional motivation, and involve students in job-related activities.


In this paper, novel operating and backup channels allocation schemes for IEEE 802.22 system are introduced and their performances are investigated. Interference level and the probability of appearance for incumbent user are taken into account in order to optimally update the backup channels list. Additionally, the operating channel is allocated based on Carrier to Interference and Noise Ratio (CINR) so as to meet Quality of Service (QoS) requirement. Simulation results illustrate that performance is significantly enhanced by employing the proposed channel allocation schemes in the IEEE 802.22 system.


Experience of surgical treatment of 14 patients with bilateral destructive pulmonary tuberculosis by our established methods was generalized. The video-assisted minimally invasive thoracoplastics of 5 – 6 ribs was performed to all patients on the side of massive destruction (presence of large caverns, several caverns, focal dissemination). Second stage of collapse-surgical treatment was performed in 2 – 3 months. Method of extrapleural pneumolysis was used in patients with upper – posterior localization of cavities in the contralateral lung. Patients with inferior lobe localization of cavities in the contralateral lung were operated by the developed method of inferior lobe treatment. The video-assisted extrapleural technique was used in patients with bilateral destructive pulmonary tuberculosis because of impossibility to use resection intervention on the side of a massive destruction, it being surgical operation of choice due to a mild postoperative period course, early activation of patients, less pronounced pain syndrome.


Lundqvist, P. (2008.) Marknad pa vag : den vastgotska gardfarihandeln 1790–1864. [Market on the road : peddling from the province of Vastergotland 1790–1864] 324 pages. Avhandlingar fran Historiska institutionen i Goteborg nr 52. Written in swedish with an english summary. ISBN 91 88614 68 9. This thesis studies the itinerant trade from a small geographical area in southern Sweden, Sjuharadsbygden in the province of Vastergotland. During the studied period, 1790–1864, pedlars from this region distributed goods to practically all of Sweden and also to its neighbouring countries. This study shows the huge extent and the wide geographical scope of peddling – and above all – its importance for the spreading of goods, for the increase in demand and in the prolongation also for the growth of a consumer society and industrialization. The main purpose of the investigation is to explain the strong position the pedlars from this region had in the Swedish textile market during the transition period between feudally-influenced privileged society and market society. The investigation has shown some factors to have been especially important in explaining the strong position of the peddling from Vastergotland in pre-industrial Sweden: lack of competition, access to capital, flexibility, specialization and knowledge. In a greater historical context this study leads to a reconsideration of the earlier view of peddling. Perhaps the most important results of the study show how fluid the limits are between various forms of trade and between urban and rural economy. Peddling, with its connections to proto-industry, factory production, textile processing industry and town merchants all over the country, is a good example of the interaction between various regions and forms of production in the pre-industrial society. The dichotomies between country and town and interior and foreign trade, that the previous commercial historical research used, appear in other words far too simplified. This study has also shown that peddling has had the same importance in Sweden for early consumption chande and increase as well as in the rest of Western Europe. Keywords: Pedlars, Sweden, 18th century, 19th century, internal trade, textile market, distribution, consumer demand, credit networks, institutional change, peasants, households, division of labour


Introduction: Acute Exacerbations of Chronic Obstructive Pulmonary disease (AECOPD) due to Pseudomonas aeruginosa (PA) are associated with worse outcomes. PA antibiotic resistance is important to determine treatment. Objectives: To study clinical characteristics and outcomes in patients with AECOPD due to PA based on their antibiotic resistance. Methods: Prospective observational study including all patients with AECOPD due to PA admitted in a Respiratory ward in a tertiary hospital in Barcelona during 2013-2014. Resistant PA (PA-R) was defined when ≥1 class of antibiotics were resistant on the antibiogram. Results: 401 patients with AECOPD were evaluated. Of them, 53 (13%) had a positive PA sputum culture. 82% were men, median age (± SD) 77 (±7) years old and FEV1 36 (±17) % of predicted. PA-R was isolated in 35 patients (66%).No differences in demographics, lung function and comorbidities among patients with PA-R and PA-sensible (PA-S) were found, except that patients with PA-R had received more prior oral steroids (80% vs 44%, p = 0.009) and antibiotics (65% vs 33%, p = 0.02) PA persistence after adequate treatment was higher in the PA-R group (82% vs 50%, p = 0.04). However, patients with PA-R had lower 30-day and 90-day mortality when compared to patients with PA –S (3% vs 22%, p = 0.02, and 9% vs 33%, p= 0.02, respectively). Conclusions: PA-R affects patients with severe COPD and previous use of steroids and antibiotics. Persistent PA-R strains were found in follow-up sputum samples. However, the presence of sensitive PA is associated with higher mortality. These results may reflect a contrast between acute infections caused by PA-S and chronic colonization with PA-R.


Purpose To evaluate the incremental benefits concerning the implementation of closed-system medical devices for the preparation and administration of chemotherapy agents (integrated or not with traceable workflow), within an Italian clinical practice, in which the use of such technologies is not standardized. Methodology Four Scenarios, implying different levels of technologies introduction, were analyzed, based on the presence and/or absence of closed systems and traceable workflow, in the preparation and in the administration phase. A literature review was conducted, in order to retrieve efficacy and safety measures. Economic and organizational benefits, assuming a hospitals perspective, were assessed by means of health-economics tools, considering 27,660 (±695.86) drugs on average prepared, on an annual basis, by 12 hospitals involved. The typology of medical devices and other devices/equipment used, the human resources involved, and the time spent for the preparation and administration phases were collected. Results Literature stated that the introduction of advanced technologies (CSTDs in the preparation phase, closed-system in the administration phase, both integrated by a traceable workflow) could: i) decrease surface contamination (12.24% vs 26.39%, P<0.001) and ii) improve the capability to identify dosage errors (7% vs 0.096%, P<0.05). The above technologies presented the best trade-off between cost sustained and efficacy gained. Despite marginal investments (ranging from +1% to +6%) being required for their acquisition, an organizational saving equal to more than 1,000 working hours emerged, which could be spent on other hospital activities. Conclusion The implementation of closed systems, integrated with a traceable workflow grounding on gravimetric control, may be considered a valid technological alternative within the investigated setting. The marginal incremental costs could be absorbed already in the first year after their introduction, in particular, because of the potential time saving in using closed systems in both the preparation and administration phases, demonstrating the sustainability and feasibility of such advanced technologies.


Abstract Rotational tunnelling and librations of methyl groups in bis(trimethyltin) selenate dihydrate, [(CH3)3Sn]2SeO4 · 2 H2O, have been studied at low temperature using inelastic neutron scattering (INS) technique. Three tunnel transitions at 1.31 μeV, 3.47 μeV, and 21.0 μeV of equal intensity were recorded. In the energy range of phonons a broad, slightly structured intensity distribution is observed. An attempt is made to identify and assign librational modes. The crystal structure of the title compound was determined by single crystal X-ray diffraction. [(CH3)3Sn]2SeO4 · 2 H2O crystallizes orthorhombic, space group D142h-Pbcn with 4 molecules in the unit cell. The lattice constants at room temperature are a = 1142.9(3) pm, b = 1304.6(4) pm, and c = 1084.6(3) pm. According to the molecular symmetry, the two "(CH3)3Sn(H2O)" units in molecule are crystallographically equivalent, but the three methyl groups bound to one Sn-atom are inequivalent. This result coincides well with the observation of three tunnel transitions in INS. A comparison with the related compound, bis(trimethyltin) sulfate dihydrate, is presented. The existence of hydrogen bonding and the role of intermolecular interactions on rotational tunnelling are discussed.


This essay explores the relationship between touching and seeing through the lens of phenomenological experience, framed by the concepts of embodied visuality, haptic and optical images. It argues for the usefulness of the approach for thinking critically about human-animal relationships and the affective mediated experience of other subjectivities. With a focus on 'touch' it uses the 2017 Netflix film Okja to consider the sensual relationship between 'subjective matter' and the onscreen animal body. It discusses the different types of touch present in Okja and the processes of identification in terms of primary engagement with the sense and sensibility of materiality.


Dyspnea or breathlessness is a term primarily used in respiratory medicine. Nevertheless, in the last fifteen years, studies from other fields focus on the affective component of this complex phenomenon due to the frequent observation that psychological states can cause or be caused by dyspnea. Research so far shows that besides the biological component, dyspnea has a strong emotional and psychosocial determinant. This means that apart from its biological factors, dyspnea and its intensity are affected by emotions, personality, anxiety and depression, etc. Individuals with psychiatric disorders, in the same conditions, will evaluate their dyspnea as more intense and disturbing compared to individuals without psychiatric comorbidity. Emotional states in healthy individuals can amplify the sense of dyspnea which is of extreme importance for clinical practice in order to consider the whole person and not just the symptom which is being presented. Also, dyspnea seems to be frequent complaint in some groups of patients with psychiatric disorders (e.g.panic disorder), where the fear of suffocation is presented as clinical symptom. Futher research of dyspnea as a complex, multicomponent phenomenon, can contribute to better treatment options and better differential diagnosis concerning possible psychiatric background of physical symptoms.


Background Adjuvant chemotherapy for colorectal cancer is mainly based on the combination of 5-fluorouracil, folinic acid and oxaliplatin (FOLFOX-4). The pharmacological target of oxaliplatin remains intracellular and therefore dependent on its entry into cells. The intracellular distribution of oxaliplatin is mediated by organic cation transporters 1, 2 and 3 (OCT1, 2 and 3), copper transporter 1 (CTR1) and ATPase Cu2+ transporting beta polypeptide (ATP7B) and may modulate the efficacy of oxaliplatin-based chemotherapy. The aim of this study was to perform a retrospective study to assess the relation between the expression of oxaliplatin transporters in colorectal cancer before chemotherapy and the response to FOLFOX-4 adjuvant chemotherapy in responder and non-responder patients. Methods This retrospective study was conducted at a single center (University Hospital of Clermont-Ferrand, France). The target population was patients with resectable colorectal cancer operated between 2006 and 2013. Inclusion criteria were defined for the responder patients as no cancer recurrence 3 years after the end of chemotherapy, and for the non-responder patients as cancer recurrence within 1 year. Other inclusion criteria were stages IIb–IV cancers, first-line adjuvant FOLFOX-4 chemotherapy, and the availability of resected primary tumor samples. Exclusion criteria were preoperative chemotherapy and/or radiotherapy, a targeted therapy, other anticancer drugs, cancer recurrence between the first and the third year after the end of chemotherapy and follow-up < 3 years. Immunostaining of oxaliplatin transporters (OCT1, 2, 3, CTR1 and ATP7B) and Ki-67 was assessed in tumor samples. Results Retrospectively, 31 patients have been selected according to inclusion and exclusion criteria (15 responders and 16 non-responders). Before FOLFOX-4 regimen, OCT3 expression was significantly lower in responder patients compared to non-responders (p<0.001). According to multivariate analysis, OCT3 remains an independent criterion for adjuvant FOLFOX chemotherapy response (p = 0.039). No significant relation is reported between chemotherapy response and the expression of OCT1 (p = 0.49), OCT2 (p = 0.09), CTR1 (p = 0.45), ATP7B (p = 0.94) and Ki-67 (p = 0.34) in tumors. Conclusions High expression of OCT3 could be an independent factor related to resistance to FOLFOX-4 chemotherapy.


Abstract:The present essay combines the theory of Cultural Memory with ideas about textual repertoires, composite text, and distributed authorship that in recent years have been advanced in studies of early and medieval Chinese literature. In its first part, the essay introduces in detail the historical development and key features of Cultural Memory theory. In its second part, it applies this theory to the study of Qu Yuan 屈原 and the Lisao 離騷, the greatest poem of early China. Through detailed philological analysis, the Lisao is described not as a single text by a single author but as a composite, authorless artifact that participates in a larger Qu Yuan discourse distributed across multiple texts in both prose and poetry. This distributed "Qu Yuan Epic" is an anthology of distinct characteristics attributed to the quasi-mythological Qu Yuan persona—a persona that itself emerges as a composite textual configuration into which are inscribed the nostalgic ideals and shifting aspirations of Han imperial literati. This Han social imaginaire recollects the noble exemplar of the old Chu aristocracy; the dual prophecy of the fall of Chu to Qin and of Qin's subsequent collapse; the religious, historical, mythological, and literary traditions of Chu; the embodied paradigm of the ruler-minister relationship; and the gradual formation of the ideal of authorship through the transformation of poetic hero into heroic poet.


Purpose of review Full nutritional support during the acute phase of critical illness has traditionally been recommended to reduce catabolism and prevent malnutrition. Approaches to achieve full nutrition include early initiation of nutritional support, targeting full nutritional requirement as soon as possible and initiation of supplemental parenteral nutrition when enteral nutrition does not reach the target. Recent findings Existing evidence supports early enteral nutrition over delayed enteral nutrition or early parenteral nutrition. Recent randomized controlled trials have demonstrated that permissive underfeeding or trophic feeding is associated with similar outcomes compared with full feeding in the acute phase of critical illness. In patients with refeeding syndrome, patients with high nutritional risk and patients with shock, early enteral nutrition targeting full nutritional targets may be associated with worse outcomes compared with less aggressive enteral nutrition strategy. Summary A two-phase approach for nutritional support may more appropriately account for the physiologic changes during critical illness than one-phase approach. Further evidence is awaited for the optimal protein amount during critical illness and for feeding patients at high nutritional risk or with acute gastrointestinal injury.


This paper presents the analytical in-plane compliance calculation methods for single axis circular flexure hinges and compares the methods with Finite Element Analysis (FEA). These comparisons are also made for varying geometric parameters not only for "b" (the width of the flexure) but also "t" (the shortest distance of the flexure) parameter. The analyses give us the selectable calculation methods for certain "b" and "t" parameters besides they show which geometric parameter (b or t) have more influence on in which direction of compliances. Thus, while designing a flexure based mechanism this work gives us the advantage of selecting right in-plane compliance calculation methods which are less time consuming and easier than FEA and it also helps us to choose the right geometric parameters by showing the effects of them on the compliances.


In all species reproduction is part of fitness and life. In most reproductive rituals, it is the male that is competing for a female in order to pass on their genes. Are males picky about the females that they mate with? What makes a female attractive? What make the competition worth it? These are questions that scientists wonder while observing streams that are home to guppy ( Poecilia reticulata ) populations. To try and answer these questions, we chose to conduct an experiment testing the female color preference of male guppies. We hypothesized that the male guppies would be more attracted to the bright colored females. In this experiment we observed the behaviors of male guppies and recorded them using a Guppy Data Collector software. Based on our results our hypothesis was supported and the male guppy was more attracted to a bright neon green model instead of a dark sparkly black model.


A cloud platform website, offering a catalog of services, operates under a freemium business model or a free trial business model, aggressively marketing to customers who have previously visited. In such a cloud platform or service business, accurate identification of high profile customers is central to the success for the business. However, there are several limitations of existing approaches because of the following challenges: (1) heavy customer traffic flows, (2) the noise in user behaviors, (3) a lack of collaboration across stakeholders, (4) class imbalanced customer data (few paying customers vs. high numbers of freemium or trial customers), and (5) unpredictable business environments. In this paper, we propose a data-driven iterative sales lead prediction framework for cloud everything as a service (XaaS), including a cloud platform or software. In this framework, from the BizDevOps process we collaborate to extract business insights from multiple business stakeholders. From these business insights, we calculate service usage scores using our RFDL (Recency, Frequency, Duration, and Lifetime) analysis and estimate sales lead prediction based on the usage scores in a supervised manner. Our framework adapts to a continuously changing environment through iterations of the whole process, maintains its performance of sales lead prediction, and finally shares the prediction results to the sales or marketing team effectively. A three-month pilot implementation of the framework led to more than 300 paying customers and more than $200K increase in revenue. We expect our scalable, iterative sales lead prediction approach to be widely applicable to online or cloud business domains where there is a constant flux of customer traffic.


On the basis of the improved materials, many factors affecting the concept difficulty were generalized as the following two fundamental factors: attribute saliency (AS) and attribute frequency (AF). The more salient the relevant attribute, or the more frequent it appears in the positive examples, the easier the concept, and vice versa. When the AS or AF of an irrelevant attribute is greater, it will disturb the correct concept formation. In addition, a somewhat strange result was noticed that at least when there are only 2-3 relevant attributes, the number of relevant attributes does not affect the concept difficulty.


In this paper we are concerned with the mean-square exponential stabilization of continuous-time hybrid stochastic differential equations (also known as stochastic differential equations with Markovian switching) by discrete-time feedback controls. Although the stabilization by continuous-time feedback controls for such equations has been discussed by several authors (see e.g. [9,15,17,25,26]), there is so far no result on the stabilization by discrete-time feedback controls. Our aim here is to initiate the study in this area by establishing some new results.


Shakespeare's tragedies are among the most analyzed and discussed literary works. In his tragedies Shakespeare follows the Aristotelian pattern of drama, so it is easy to notice there all the elements of a tragedy presented in Aristotle's Poetics. In this paper I will define what climax in literature is and explore the climax of one of the four great tragedies of Shakespeare, that of King Lear. As a masterfully structured play, the central part of the play is the climax itself. But what is the climax of this play, how is it presented, does it have any impact on the characters, how does it change the course of events, etc? Answers to these questions will be given here. As an example of the interactions between men and weather conditions in Shakespeare's drama, I will explore climate as climax. The climactic moment of the play is the storm, in the 3rd act, when we see the psychological rage of King Lear. Unsurprisingly, Shakespeare exposes the issue of how the local weather durably affects the nature of men as well as by the way their humours are temporarily changed by climate and environment. Yet, I will argue that this issue actually prompts him to reverse traditional points of view in order to show that things also work the other way round. Indeed, in some of his plays, the playwright insists on men's unfortunate capacities to provoke violent climactic disorders and to generate chaos on earth. So, it is not only the weather and climate that affect the behaviour and humour of people, but the way people feel and behave. The case with King Lear is a perfect example of this problem. The storm that Lear finds himself is actually reflected in his inner state, in his psychological rage due to his disappointment with his two daughters, and facing with the harsh reality for a father, but mostly for being unjust to his younger daughter, Cordelia.


Introduction: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common hereditary small-vessel disease. CADASIL is caused by mutations in the NOTCH3 gene on chromosome 19; its global incidence and prevalence are unknown, likely because of under-diagnosis. CADASIL is a multisystemic disease, but its main clinical manifestations are related to the involvement of the brain. Very few controlled studies have been specifically performed on therapeutic interventions for CADASIL and its clinical manifestations. Areas covered: Evidence is reviewed about possible effects of controlling risk factors for the disease, and about treatment of most common clinical manifestations: migraine, TIA/stroke, psychiatric disturbances and epilepsy, cognitive impairment and dementia. Expert opinion: Correction of risk factors, and in particular hypertension, seems to be mandatory for reducing risk of stroke. Antiplatelet agents in secondary prevention in CADASIL might be recommended for secondary but not for primary prevention. Antiepileptic drugs seem to be the best choice for prophylaxis of migraine and MA, when needed. Psychiatric symptoms should be treated with conventional drugs, after reaching correct clinical diagnosis. Treatment of cognitive impairment and dementia with cholinesterase inhibitors may be effective on executive functions, but no conclusive data are available about its usefulness.


This paper shows how order of magnitude reasoning has been Successfully used for troubleshooting complex analog circuits. The originality of this approach was to be able to remove the gap between the information required to apply a general theory of diagnosis and the limited information actually available. The expert's ability to detect a defect by reasoning about the significant changes in behavior it induces is extensively exploited here: as a kind of reasoning that justifies the qualitative modeling, as a heuristic that defines a strategy and as a working hypothesis that makes clear the scope of this approach.


the occurrence of abnorrnal features in higher plants is dealt with—the latter aspect requires more research in respect of lichens. This work will be particularly welcomed by ecologists and environmentalists, and cryptogamic botanists will find it a most valuable soruce of background information. An introduction to the practical use of lichens in the dating of rock surfaces. It describes the basis of the method, sampling and recording procedures, relative and absolute age determination, statistical treatments, applications, and problems of the approach. The work of Drs Andrews and Webber in this field is well-known and this booklet, with its extensive bibliography, will be of interest to all considering using this now well-established technique.


Reconstruction for single sutural synostosis typically involves cranial reshaping to correct for compensatory growth changes. Current remodeling techniques involve obliteration of both pathologic and normal sutures. Presented here is a case report describing a new approach to the treatment of single cranial synostosis. The concept involves excision of the offending suture and transient plating of the remaining functional sutures. Compensatory sutures are then allowed to direct the growth forces to the area of the synostosis, leading to the reversal of the compensatory shape deformity. This more natural approach leaves functioning sutures intact and allows for their active participation in the reshaping process.


Introduction The role of infliximab (IFX) in the salvage treatment of acute severe ulcerative colitis (UC) is well established and both licenced and approved in the UK. Studies have demonstrated that IFX IS effective in the treatment of chronic steroid dependent/refractory UC (1) In the UK IFX is not routinely approved for the treatment of chronic steroid-dependent colitis. Our aim was to assess the long-term outcomes of patients treated with IFX for chronic active UC in a single UK IBD centre. Methods A retrospective single centre review was undertaken of patients with severe active UC who received IFX (5mg/kg) between May 2008 and April 2012. Clinical remission was defined as complete steroid withdrawal, normalisation of bowel frequency and absence of blood with defecation. Treatment with IFX was only continued if steroid free remission was maintained. Results 23 patients were included.10 (43%) of patients were treated with induction therapy only (0, 2 & 6 wks) due to funding constraints. 6 (60%) of this group were not on thiopurines, having been either unresponsive or intolerant. 5 (50%) entered clinical remission-median follow up 18 months (IQR 15–25) & 2 (20%) had colectomy. 13 (57%) were treated with induction and maintenance therapy. Of these 7 (85%) were already established on a thiopurine without clinical response. All 13 (100%) entered clinical remission as defined, median follow up 21 months (IQR 11–26). 1 patient required dose escalation to 10mg/kg. None of the patients in the maintenance group were admitted during this time. No significant side effects were reported in either group. Conclusion In our patients treated with IFX for chronic active UC, IFX maintenance therapy appears to have more sustained steroid free remission rates compared with induction therapy only. All patients treated this way avoided colectomy, hospital admission and had complete steroid free remission during follow-up. Experience of maintenance IFX therapy for UC in the UK is limited due to funding constraints but our data confirms the efficacy of this approach in carefully selected patients the response rate may be higher than in other published series. Disclosure of Interest None Declared. Reference Rutgeerts P, Sandborn WJ, Feagan BG, et al. Infliximab for induction and maintenance therapy for ulcerative colitis. N Engl J Med. 2005; 353:2462–2476.


Abstract The purpose of this study was to explore how a community-based, non-clinical recreational center, called Gilda's Club promotes and contributes to healing and health throughout cancer survivorship. Gilda's Club of Toronto is a not-for-profit venue in Ontario, Canada, that serves as a communal meeting place where people living with cancer, as well as their families and friends, can join with others to build physical, social, and emotional support as a supplement to their medical treatment. Semi-structured interviews with twenty-six members of Gilda's Club revealed three main themes that demonstrate the value of this recreational center to survivorship: (1) Dignity, (2) Hope, and (3) Transcendence. Individually and collectively these themes positively influenced cancer survivorship. The findings demonstrate the importance of therapeutic landscapes to cancer survivorship and the contribution of recreation to a holistic understanding of health.


The first step of the digital processing within a Global Navigation Satellite System (GNSS) receiver is the signal acquisition. The receiver has to detect the satellites in view, and for each of them, has to estimate the Doppler shift and the code phase of the received signal. In order to speed up the acquisition process, modern receivers use fast acquisition technique based on the fast Fourier transform (FFT). This paper presents the complexity evaluation of a FFT-based acquisition technique, suitable for new GNSS signals and for both software and hardware implementations. After the description of the algorithm, the focus will be on the comparison of the results obtained with a Xilinx FPGA board and a software receiver implemented on a general-purpose processor.


The quasi-biennial oscillation is fairly well simulated by use of a T21 60-layer general circulation model with moist convective adjustment. The model is the first version of the Center for Climate System Research/National Institute for Environmental Studies (CCSR/NIES) general circulation model. The vertical resolution is approximately 500m in the upper troposphere and lower stratosphere. The damping time for the maximum wavenumber in the fourth-order horizontal diffusion is 20 days, being about one-order of magnitude less than that in standard general circulation models. The period of the oscillation is 1.5 years, which is slightly shorter than that of the observed quasi-biennial oscillation. The simulated oscillation occurs in the middle stratosphere, being slightly higher than that observed in the equatorial lower stratosphere. The amplitude of the zonal-wind associated with the oscillation is 20 ms−1 which is comparable to the observed value.


The effect of a new GnRH antagonist (ORG 30850 ANT) on FSH, LH, and PRL secretion was studied using male rat pituitary cells in monolayer cell culture. In the absence of GnRH, ORG 30850 ANT did not alter spontaneous FSH and LH secretion into culture medium or the cell content of these hormones. In the presence of GnRH (10(-8) mol/l), ORG 30850 ANT significantly and dose-dependently inhibited FSH and LH secretion into culture medium while increasing their cell content. Conversely, in the presence of a single dose of ORG 30850 ANT, FSH and LH secretion rose significantly when subjected to increasing amounts of GnRH, whereas the hormonal cell content diminished. Furthermore, inhibition of GnRH-induced FSH and LH release by ORG 30850 ANT was not changed by pre-incubation with the GnRH antagonist regardless of the pre-incubation time. The inhibitory effect of the GnRH antagonist was observed early, with its peak occurring within 6 h of culture. These short-term studies indicate that ORG 30850 ANT specifically inhibits GnRH-induced gonadotropin release into culture medium, exerts no effect on the rate of gonadotropin production in the presence or absence of GnRH, competitively and reversibly inhibits the binding of natural GnRH to its receptors, and does not lead to any modifications in PRL secretion.


The improvement of student reading skill involves some efforts in
choosing the authentic material. The use of a heroic story, R.A. Kartini
gives moral impacts for students' character building and language skills
improvement. The reading assessment provides some activities which
explores the content of the reading text. The activities are identifying the
good reader behaviors that have been taught and assessed, collecting
evidence that is related to the good reader behaviors, analyzing the
evidence on the good reader behaviors, and making an instructional
decision to improve the reading skill. The advantages of using reading
assessment activities to assessed the student reading comprehension are
students participate in giving opinion, able to attach meaning to words or
sentences, make summary prediction, describe the problem, give relevant
solutions, retell the story in chronological order, and use prior knowledge
in implementing the moral value. The analysis shows that students have
the good reader behaviors as it is proven from their checklist score. The
reading assessment gives result that portfolio is a recommended activity
to improve the student reading comprehension.


Background: Previous studies examined midlife risk factors separately for old-age impaired physical and cognitive functioning. We determined the overlap of risk factors for both domains of functioning within the same setting. Methods: Biological and behavioral risk factors at age 50 years and cognitive and physical functioning were assessed 18 (SD = 5) years later in the Whitehall II study (N = 6,316). Impaired physical functioning was defined as ≥1 limitation on the activities of daily living scale. Impaired cognitive functioning was defined as Mini-Mental State Examination score <27. Two statistical analyses were employed: minimally adjusted analysis (for age, sex, and ethnicity) and mutually adjusted analysis (including all risk factors). Missing data on risk factors were imputed. Results: After confounder adjustment, impaired physical and cognitive functioning at older ages were predicted by hypertension (odds ratios [ORs] 1.80 95% confidence interval [CI] 1.39–2.33 and 1.57 95% CI 1.07–2.31, respectively), poor lung function (1.51 95% CI 1.28–1.78 and 1.31 95% CI 1.08–1.59), and physical inactivity, marginally in the case of cognitive function (1.50 95% CI 1.19–1.90 and 1.27 95% CI 0.99–1.62) at age 50 years. Impaired physical functioning but not cognitive functioning was additionally predicted by depression and higher body mass index (1.72 95% CI 1.46–2.03 and 1.29 95% CI 1.16–1.44, respectively). Conclusions: Several midlife risk factors are associated with impaired physical and cognitive functioning in old age, supporting a unified prevention policy. Analysis of 12 risk factors at age 50 suggests that strategies targeting physical inactivity, hypertension, and poor lung function will reduce impairments in both cognitive and physical functioning in old age.


We extend the effective field theory of inflation to a general Lagrangian constructed from Arnowitt-Deser-Misner variables that encompasses the most general interactions with up to second derivatives of the scalar field whose background breaks temporal diffeomorphism invariance. Degeneracy conditions, corresponding to 8 distinct types -- only one of which corresponds to known degenerate higher-order scalar-tensor models -- provide necessary conditions for eliminating the Ostrogradsky ghost in a covariant theory at the level of the quadratic action in unitary gauge. Novel implications of the degenerate higher-order system for the Cauchy problem are illustrated with the phase space portrait of an explicit inflationary example: not all field configurations lead to physical solutions for the metric even for positive potentials; solutions are unique for a given configuration only up to a branch choice; solutions on one branch can apparently end at nonsingular points of the metric and their continuation on alternate branches lead to nonsingular bouncing solutions; unitary gauge perturbations can go unstable even when degenerate terms in the Lagrangian are infinitesimal. The attractor solution leads to an inflationary scenario where slow-roll parameters vary and running of the tilt can be large even with no explicit features in the potential far from the end of inflation, requiring the optimized slow-roll approach for predicting observables.


Purpose: The purpose of this paper is to understand whether or not the European Foundation for Quality Management (EFQM) Model and the Shingo Model promote and are embedded into the three pillars of sustainability, as well as to propose a conceptual model for excellence in business towards sustainability. Methodology/Approach: Following the PRISMA methodology, 102 articles were included in the review. A bibliometric co-citation network was created based on those publications to understand the link between the topics, using the VOSViewer software. This paper presents a literature review on the topics of the EFQM and Shingo Model, Corporate sustainability (CS), and the relationship between the excellence models and CS. Findings: Findings from the literature review indicate that effectively the new version of the EFQM Model and the Shingo Model guide organisations towards achieving sustainable economic, social, and environmental results. Research Limitation/Implication: There are still a restricted number of articles on the Shingo Model and on the relationship between the Shingo Model and CS, as well as, on the latest version of the EFQM Model and therefore on the relationship between this model version and CS, which presents a limitation to this paper. Originality/Value of paper: This paper contributes to filling the literature gap regarding the lack of studies evolving the EFQM 2020 model version and the Shingo Model, as well as its relationship with CS.


This subject guide provides resources that are useful in the study of intercultural communication in business and the successful completion of this course.


In 1997, the author concluded that living cells use a molecular language (cellese) that is isomorphic with the human language (humanese) based on his finding that the former shared 10 out of the 13 design features of the latter. In 2012, the author postulated that cellese and humanese derived from a third language called the cosmic language (or cosmese) and that what was common among these three kinds of languages was waves—i.e., sound waves for humanese, concentration waves for cellese, and quantum waves for cosmese. These waves were suggested to be the symmetry principle underlying cosmese, cellese, and humanese. We can recognize at least five varieties of waves—(i) electromagnetic; (ii) mechanical; (iii) chemical concentration; (iv) gravitational; and (v) probability waves, the last being non-material, in contrast to the first four, which are all material. The study of waves is called "cymatics" and the invention of CymaScope by J. S. Reid of the United Kingdom in 2002 is expected to accelerate the study of waves in general. CymaScope has been used to visualize not only human sounds (i.e., humanese) but also sounds made by individual cells (cellese) in conjunction with Atomic Force Microscopy (AFM) (unpublished observations of J. Gimzewski of UCLA and J. Reid). It can be predicted that the gravitational waves recently detected by the Interferometer Gravitational-Wave Observatory (LIGO) will be visualized with CymaScope one day, thereby transforming gravitational waves into CymaGlyphs. Since cellese in part depends on RNA concentration waves (or RNA glyphs) and humanese includes hieroglyphs that were decoded by Champollion in 1822, it seems reasonable to use cymaglyphs, RNA glyphs, and hieroglyphs as symbols of cosmese, cellese, and humanese, respectively, all based on the principle of waves as the medium of communication.


Effect of Salinity and Drought Stress on Germination Indices of Two Thymus Species The environmental stress such as, salinity (soil or water) and drought are serious obstacles for medical plants and field crops in further areas of the world, especially arid and semiarid regions. In order to investigate salinity and drought stress on T. daenensis and T. kotschyanus germination indices, an experiment was carried out. To create salinity stress, sodium chloride (NaCl) at the levels of 0 (as control), -3, -6 and -9 bar, and for drought stress, polyetylenglycol 6000 (PEG 6000) in osmotic levels at 0 (as control), -3, -6 and -9 bar were used. Effect of drought and salt levels on investigated traits significant at 0.01. Result showed significance different between evaluated indices. Increasing of stress levels lead to reduction of germination and root and shoot length. Salt stress only in high levels reduced germination rate. Therefore, T. daenensis and T. kotschyanus have relative resistance to salinity in germination stage. Decrease in osmotic potential progressively inhibited seed germination of the two thyme species. In all salt treatments, maximum germination percentage in T. kotschyanus related to West Azerbaijan population and maximum germination rate related to Gazvin population. But in T. daenensis the highest values (both rate and percentage germination) were observed in Arak population. The germination rate of T. daenensis to the drought stress was more than the T. kotschyanus germination rate like the germination percentage. Comparing the two stresses, it appears that drought has more effect than salt in germination indices.


With the Asia-Pacific emerging as the focus of strategic attention from the United States and China, a serious study of conflict management in the region is invaluable. Jacob Berkovitch and Mikio Oishi offer an overview of the region's most contentious conflicts: the perennial Korean Peninsula problem; the issue of independence for Taiwan; tension between India and Pakistan; and the ambiguous status of the Spratly Islands. Although pessimistic about eliminating conflict, the authors provide several examples of effective conflict management in the region. The introductory chapter takes a broad view of trends in global conflict. Quantitative measures provide a sobering view of conflict in the twentieth century by charting the staggering number of fatalities suffered in the Asia-Pacific. The data presented here should give pause to those who think violent conflict is becoming obsolete. It is a shame, however, that the rest of the chapters are not as captivating as the book slips into the trend of being heavily descriptive. Each case study follows the same pattern: a general history of the conflict is given from the post-war period until the present, followed by an outline of the specific attempts made to manage the conflict such as deterrence, external intervention or mutual self-restraint. Commendably, the authors recognise the diverse causes of conflict: territory, ideology, security, independence, resources and ethnicity, and record how each conflict has transformed over time. Nevertheless, the book fails to advance any theoretical framework or introduce new concepts to the literature on conflict management. While the authors offer some brief lessons or glimpses of the future for each case, the lack of a central argument makes the book more like a general guide to conflict in the Asia-Pacific rather than offering a new way to think about resolving conflict in the area. The book also represents a missed opportunity to consider how the shifting balance of power in the region will affect the outcomes of these conflicts in the future – will an increasingly powerful China take a more aggressive stance towardsTaiwan or the Spratly Islands, for instance? Furthermore, the concluding chapter simply recaps each case, only dedicating three pages to extrapolating general trends about conflict in the Asia-Pacific. The book's clarity of prose and structure makes it easy to recommend to those looking for a general introduction to conflict in the Asia-Pacific. For scholars seeking a novel theoretical argument, however, there may be disappointment.


A topologically based neural network algorithm is used to conduct an in-depth study and analysis of domino accident risk data in chemical parks, and this is used to construct a prevention and control system applied to the safety prediction of chemical parks. Firstly, the operating model of the flue gas turbine is expanded and analyzed according to the basic theory of topology, and the object element model is constructed to determine the feature vector and potential risk level. Then, the idea of differential evolution is introduced into the topological neural network to solve the problem that the learning rate and weighting coefficients are difficult to determine, and then the complete DE-ENN algorithm is proposed and tested with the UCI standard data set to verify the effectiveness of the algorithm. Finally, the algorithm is applied to the potential risk identification of the smoke machine operation model, and the experimental results show that the method not only has a simple structure, short running time, and high prediction accuracy but also has excellent generalization ability. For the inherent risk and domino effect risk of chemical equipment in chemical fiber enterprises, the accident risk assessment method based on the protection layer analysis method is proposed; combined with the probability of domino accident and personnel vulnerability model based on the comprehensive analysis of the research results of the allowable risk standard, the allowable risk standard applicable to chemical fiber production enterprises in China is proposed. Given the potential accident risk characteristics of chemical fiber production enterprises, the calculation method of firefighting demand and firefighting capacity of firefighting system is given; the index system of firefighting system emergency response capacity assessment is constructed from three aspects of firefighting system integrity, reliability, and effectiveness, and the assessment model and grade classification standard of firefighting emergency response capacity of chemical fiber production enterprises are determined.


A 1.55-/spl mu/m ridge distributed feedback laser and electroabsorption modulator monolithically integrated with a buried-ridge-stripe dual-waveguide spot-size converter (SSC) at the output port for low-loss coupling to a cleaved single-mode optical fiber was fabricated by means of selective area growth, quantum-well intermixing, and dual-core technologies. These devices exhibit threshold current of 28 mA, 3-dB modulation bandwidth of 12.0 GHz, modulator extinction ratios of 25.0-dB dc. The output beam divergence angles of the SSC in the horizontal and vertical directions are as small as 8.0/spl deg//spl times/12.6/spl deg/, respectively, resulting in 3.2-dB coupling loss with a cleaved single-mode optical fiber.


We experimentally demonstrate an active terahertz (THz) resonance switch induced by the polarization conversion in a compound metasurface, which is a LC layer sandwiched by a metallic wire grating and resonance metamaterial (LCGM). Here, the liquid crystal (LC) plays the role of polarization conversion, which can induce the TE resonance. Moreover, there exists a localized resonance between metallic grating and metamaterial layers, and then the excited resonance will be greatly enhanced. The results show that the high extinction ratio of the resonance switch exceeds 30 dB at 0.82 THz. This work will bring new ideas for the research in developing THz phase, polarization, and switch devices with LC and metasurface.


I. Introduction. The main object of this paper is the investigation of the alteration of the sedimentary rocks of the Skiddavian Series by the intrusion of the mass of igneous rock which is commonly known as the Skiddaw granite. One or two cognate subjects will be touched upon, such as the composition and petrographical character of the intrusion, and the general structure and tectonic relations of the sedimentary series; but, in the main, the paper is a study in metamorphism. The Skiddavian Series includes rocks of varying lithological character, grits, flags, shales, and slates, so that the products of metamorphism are not by any means uniform in character; and, in addition to this, the problem is complicated by the occurrence throughout the area of a varying though generally high degree of folding and cleavage. Hence it is necessary to study the effects of thermal metamorphism superposed upon those of a previous dynamic metamorphism. During my examination of the Buttermere and Ennerdale granophyre, I was naturally led to study the effects of this intrusion on the surrounding rocks, which are well-marked. This subject proved to be an unusually difficult one and I then turned my attention to the metamorphism of the Skiddaw intrusion, in the hope that this would throw some light on the puzzling phenomena presented in the former case. It seemed advisable, therefore, to make a complete study of the Skiddaw metamorphism; and since this latter is in itself the more important case, and probably the more instructive from


Introduction: Health insurance is one of the most important components of health care financing to reduce inequality in out-of-pocket payments. Therefore, considering the importance of insurance, increased out-of-pocket payment, and the demand for private insurance, and also the multiplicity of insurance funds, this study aimed to investigate the effects of health insurance on out-of-pocket payments among urban households in Iran. Methods: In this applied, descriptive-analytic study, conducted in 2016, a sample of 17809 urban households in different provinces were recruited from the Center of Statistics of Iran. A household cost-income questionnaire, prepared and completed by the Center of Statistics of Iran, was used to collect data which were then analyzed by using the Stata 14 and double sample selection method. Results: The results showed that the household head's literacy and marital status, the family size, the number of children and elderly, wealth, per capita income and expenditures on education and tobacco had a direct effect on the probability of buying health insurance. Furthermore, households with one type of health insurance had to tolerate more out-of-pocket payments than the other households and finally, households with health insurance, social security insurance and other insurances experienced the highest out-of-pocket payments. Conclusion: The significant difference between the out-of-pocket payments to different insurance types necessitates the establishment of an integrated insurance system which provides the same level of goods and services to all people in the community. On the other hand, the harmonization of health tariffs can reduce the inequality in out-of-pocket payments among the households. Moreover, it is recommended to have a system for monitoring the quality of care.


Corrosion and deposition in Refineries and Petrochemicals is becoming one of the most critical and serious obstacle, and also can cause reduce the efficiency, performance, and analysis accurate of industrial instrument such as turbines, power plants, boilers, and especially sampling tube lines, because of increasing the pressure drop due to build-up deposits. To limit and minimize these deposits in sampling pipe lines would be uses a specially sampling system that design and discuss in this article. This kind of sampling system includes: isokinetic sampling, rapid condensation and cooling, pressure reduction, and process indicators, as well as safety devices to protect online instruments and plant personnel. All in all, by increasing the outer and inner diameter of sampling tube lines, wall thickness, Reynolds number, and required sampling rate, the pressure drop of flowing sample is decreasing and also with increasing the volume annual, the amount of deposits are significantly reduce, because of decreasing the pressure drop.


Contagious mucocutaneous dermatitis is a frequently encountered disease of mountain hares (Lepidus timidus) in Finland. We describe the histopathologic changes and propose an etiologic cause for this disorder. Fifty-three cases collected during 1982–2000 were examined histologically. Transmission electron microscopy was performed in one case. In fully developed lesions, keratinocytes in epidermis and follicular infundibula were swollen and contained large eosinophilic intracytoplasmic inclusion bodies with marked reticular and ballooning degeneration. In later stages, there was marked necrosis and ulceration with severe pyogranulomatous and suppurative inflammation. At this stage, no viral inclusions were detectable, but secondary Staphylococcus warnerii infection was present in most cases. In late lesions, there was dermal fibrosis with epidermal hyperplasia. No spiral-shaped bacteria suggesting treponematosis were detected at any stage. Ultrastructurally, swollen epidermal and follicle infundibular cells contained round intracytoplasmic inclusion bodies with a myriad of virions typical of poxvirus with a biconcave nucleocapsid core, two lateral bodies, and a clearly discernible outer lipoprotein capsule. The findings suggest that contagious mucocutaneous dermatitis in mountain hares is a viral disease caused by a poxvirus. The disease is often complicated by secondary bacterial infection, most commonly S. warneri.


We report on individual wavelength locking of a multiplet of 100-μm broad-area laser diode emitters arranged on a 50% fill-factor bar by means of a single external multi-laser cavity using an ultra-narrowband thin-film filter as a dispersive optical element. The achieved wavelength-locked output power is 216 W, corresponding to an electrical-to-optical conversion efficiency of about 49.7%. The 45 emitters of the laser diode bar are stabilized within a spectral range of about 6.4 nm. Our approach is suited for killowatt-class dense wavelength beam combining of direct diode lasers.


Background: Infections caused by multidrug-resistant bacteria present daily challenges to infectious disease physicians in hospitals throughout the world and these pathogens are spreading into the community. The development of new antibacterial agents to combat worsening antibiotic resistance is still a priority area in anti-infective research. Methods: The experiments were carried out to search for new natural antibiotics through isolation of various Streptomyces strains from different soil samples from Yemen and studying the antimicrobial effects of metabolites that produced. In the same time, the toxicological and biochemical effects of the extracted antibiotic on animals were studied. Results: Streptomyces violaceusniger , was isolated from Yemeni soil sample produced active metabolite that was designated faqihmycin has substantial antimicrobial potential against different microbial species. Investigations into the possible mode of action of faqihmycin revealed that it affects cell wall synthesis and intracellular macromolecule contents of the Gram-positive bacteria Bacillus subtilis . Toxicity studies of faqihmycin confirmed the hepatotoxicity of faqihmycin, there is no strong evidence to suggest that it is nephrotoxic. Conclusions: Further studies with Faqihmycin are needed in order to elucidate its detailed mechanism of action on bacterial cells, as well as studies with Faqihmycin with different doses in order to determine its potential therapeutic use.


This paper considers representations for elementary functions such as polynomial, trigonometric, logarithmic, square root, and reciprocal functions. These real valued functions are converted into integer functions by using fixed-point representation, and they are represented by using binary moment diagrams (BMDs). Elementary functions are represented compactly by applying the arithmetic transform to the functions. For polynomial functions, upper bounds on the numbers of nodes in BMDs and multiterminal binary decision diagrams (MTBDDs) are derived. These results show that for polynomial functions, BMDs require fewer nodes than MTBDDs. Experimental result for 16-bit precision sin(x) function shows that the BMD requires only 20% of the nodes for the MTBDD.


The commercial PowerPlex® Fusion kit is an autosomal STR multiplex kit that has high discrimination power and is more informative in forensic, paternity, and relationship‐testing cases. Key features of this multiplex system are the possibility to direct amplify FTA™ card punches as well as non‐FTA cards and commonly used swabs; optimised inhibitor tolerance and high sensitivity generating full profiles from amount as little as 100 pg of human DNA. This study focused on the optimization of performance variables such as FTA™ punch sizes, reduced reaction volumes, and FTA™ purification reagent aiming to increase the analytical sensitivity, decrease the sample consumption, and cost effectiveness. LOD and LOQ values demonstrated high sensitivity of the PowerPlex® Fusion system. In addition, population databases of Brunei Malay and Chinese from the Brunei Darussalam were established, and parameters of forensic importance were calculated. Overall, the forensic parameters indicated an enhanced utility of the PowerPlex® Fusion kit for forensic evidence analysis and paternity testing in Brunei Malay and Chinese populations.


We employ tertiarybutyl-phosphine (TBP) and tertiarybutylarsine (TBA) as phosphorous and arsenic sources, respectively, for SAG of InP and InGaAsP. These sources enable us to maintain a relatively low V/III ratio of /spl sim/20 even under reduced pressure (76 Torr) MOCVD growth at 640/spl deg/C. With the growth rates which are not extremely low compared to conventional growth, the growth surface profile by SAG using the [110]-stripe is studied and their ultimate limit is presented. Also, the alternative [11_0] direction is investigated and the control of the growth over the SiN/sub x/ adjacent to the selectively opened area is presented. Also, based on the experimental observations, the mechanism leading to the differences in these directions are presented.


One consequence of the trade and technology driven increases in skill premia in the older industrial regions since the 1980s has been a perceived "skill shortage" in those regions, along with freer migration of skilled and professional workers from developing regions. While skilled migration flows remain too small to have large short-run effects on labour markets, a further opening to skilled migrants by the industrialised North could see substantial changes in labour markets and overall growth performance. The links between demographic change, migration flows and economic growth are here explored using a new demographic sub-model that is integrated with an adaptation of the GTAP-Dynamic global economic model in which regional households are disaggregated by age and gender. Skilled migration flows are assumed to be motivated by real wage differences to an extent that is variably constrained by immigration policies. A uniform relaxation of these constraints has most effect on labour markets in the traditional migrant destinations, Australia, Western Europe and North America, where it restrains the skill premium and substantially enhances GDP growth. Skill premia are raised, however, in regions of origin, and particularly in South Asia, although the extent of this is shown to depend sensitively on the responsiveness of skill acquisition to regional skill premia.


The elementary algebra underlying the non local neutrino hypothesis is used to explain discrepancies in the value of Hubble's constant in terms of other physical constants, in the approximation of the R=ct semiclassical cosmology with Mach's principle. It is assumed that quantum gravity breaks the equivalence principle, in conjunction with a quantum Higgs mechanism, and this new view of the electroweak vacuum indicates an absence of dark matter and dark energy. We introduce mass quantisation in the Brannen-Koide scheme in this context.


Surveys were conducted in apricot orchards and gardens in Hatay province of Turkey in 2014 summer season. Apricot plants showing yellowing, wilting and root rot symptoms were collected. Infected plant tissues were surface sterilized and transferred to PDA medium which contains tetracycline. After 5-days incubation period, fungal colonies were identified based on their microscopic and macroscopic characteristics. Totally, 30 isolates were identified as Macrophomina phaseolina. All the isolates were subcultured by single microsclerotia or hyphal tip techniques and kept in +6°C room conditions. Discs of 10mm from each isolate were transferred to PDA medium and kept in 15, 20, 25, 30, 35 and 40°C temperature conditions and optimum growing temperatures were determined as 25 and 30°C. For phenotypical characterizations, all isolates were grown on minimal medium containing 120mM potassium chlorate and 21 of 30 were observed to be dense, 6 were feathery and 3 were restricted, respectively. According to results, there was no correlation between location and phenotype. For the pathogenicity tests, isolates were inoculated onto apricot, peanut, soybean, maize and melon plants and disease severity was measured by using 0-4 scale after 21-days incubation period. The observed disease severity was very high on apricot with the value of 3.87 and moderate on the other plants. There was no difference in disease severity on peanut, soybean, maize and melon seedlings statistically. For molecular characterizations, 14 RAPD primers were used and based on the analysis, 14 of 51 bands were found to be polymorphic. According to phylogenetic analysis, the isolates were grouped into 2 main clusters with many of sub-clusters. No correlation was observed between clusters and locations, temperature responses, chlorate phenotypes or pathogenicity.


Introduction Genome sequencing, a novel genetic diagnostic technology that analyses the billions of base pairs of DNA, promises to optimise healthcare through personalised diagnosis and treatment. However, implementation of genome sequencing faces challenges including the lack of consensus on disclosure of incidental results, gene changes unrelated to the disease under investigation, but of potential clinical significance to the patient and their provider. Current recommendations encourage clinicians to return medically actionable incidental results and stress the importance of education and informed consent. Given the shortage of genetics professionals and genomics expertise among healthcare providers, decision aids (DAs) can help fill a critical gap in the clinical delivery of genome sequencing. We aim to assess the effectiveness of an interactive DA developed for selection of incidental results. Methods and analysis We will compare the DA in combination with a brief Q&A session with a genetic counsellor to genetic counselling alone in a mixed-methods randomised controlled trial. Patients who received negative standard cancer genetic results for their personal and family history of cancer and are thus eligible for sequencing will be recruited from cancer genetics clinics in Toronto. Our primary outcome is decisional conflict. Secondary outcomes are knowledge, satisfaction, preparation for decision-making, anxiety and length of session with the genetic counsellor. A subset of participants will complete a qualitative interview about preferences for incidental results. Ethics and dissemination This study has been approved by research ethics boards of St. Michael's Hospital, Mount Sinai Hospital and Sunnybrook Health Sciences Centre. This research poses no significant risk to participants. This study evaluates the effectiveness of a novel patient-centred tool to support clinical delivery of incidental results. Results will be shared through national and international conferences, and at a stakeholder workshop to develop a consensus statement to optimise implementation of the DA in practice. Trial registration number NCT03244202; Pre-results.


This paper describes the design and VLSI implementation of a highly efficient, single-port SRAM-based deblocking filter. It can achieve 204 cycles/macroblock throughput for H.264/AVC real-time decoding. Several deblocking filter designs in the literature have been compared and the possibility of realizing them in a pipeline is studied. Eventually we came up with a completely new design which has a five-stage pipeline with gated clock to increase system throughput while reducing power. Data hazards and structure hazards, which are the two most critical issues for a pipelined filter, are analyzed and resolved. Efficient memory organization for both on-chip SRAM and transposition buffers is employed. By using innovative hybrid edge filtering sequence and out-of-order memory update scenario, we obtain zero stall cycle in normal pipeline flow, making the best out of a pipelined architecture. Compared with existing designs, our design achieves at least 18% clock cycle reduction, as well as 20% lower power consumption owing to its efficient pipeline and memory architecture. The total gate count is comparable to other designs in literature without using any expensive two-port or dual-port on-chip SRAMs.


We demonstrate numerically that in a three-level Λ-type atomic system, by using two laser pulses, it is able to create arbitrary coherent superposition of the two lower levels via varying the linear chirp rate of the pump pulse in the case of two-photon detunings. The underlying physics of the phenomenon is given by analysing the Hamiltonian of the system on the basis of dressed states. We find that the phenomenon is due to the existence of two anticrossings of the closely spaced dressed states.


This paper pulls from a variety of data sources to estimate the positive and negative impacts of federal policies on state and local finances. For 2004, it finds that a positive federal policy impact of $467 billion is offset by at least $153 billion in negative impacts, representing a one-third reduction in positive impacts. While positive impacts grow only slowly over the next three years, the negative impacts increase rapidly. By 2007, the negative impacts reduce the positive impacts by at least 45 percent. The net value of federal grants and subsidies declines by 18 percent from 2004 to 2007.


Mediation is an ADR which falls within the category of means of self-determination and which presupposes the intervention of a third party a mediator whose function is to bring the parties together in a dispute in order to conclude an agreement between them. In the Portuguese legal system, it is not possible to mediate disputes between taxable persons and the Tax Administration. There are several obstacles to the mediatability of litigation in tax matters. In particular, we are thinking about the principles of legality, the unavailability of the tax credit, and equality. In this paper, it is sought to ascertain if these obstacles are absolute, not allowing any openness to the legality of legal-tax disputes, or if, on the contrary, they are not absolute, making feasible the thinking of creating a relation between Law Taxation and mediation. Adopting a method based essentially on dogmatic analysis, it is believed that it is possible to recognize the legality of legal-tax disputes, albeit within certain limits. The mediation will allow a closer approximation between the parties taxable person and the Tax Administration thus contributing to the creation of a greater ethical-tax awareness and, in this way, to the reduction of litigation.


BACKGROUND
Dipeptidyl peptidase IV (DP IV, CD26), a serine protease with broad tissue distribution and known activity in serum, participates in T cell activation and promotes a Th1 cytokine response, a function in part attributable to its enzymatic activity. We hypothesized that the activity of DP IV in serum and expression of CD26/DP IV in lymphocytes may be altered in patients with inflammatory bowel disease (IBD).

METHODS
Serum DP IV activity and CD26 (DP IV)-positive peripheral blood lymphocytes were measured in 110 patients with IBD (Crohn disease (CD): n = 63, ulcerative colitis (UC): n = 47). Additionally, T cell activation antigens (CD25, CD95) and costimulatory molecules (CD28) were evaluated. The same analyses were carried out in healthy volunteers (HC, n = 28). Thirty-nine patients with CD and 28 patients with UC were reassessed 3-6 months after the first visit.

RESULTS
In patients with IBD, the DP IV activity in serum was reduced (mean +/- s (standard deviation): 52.8 U/l +/- 16.9 (CD) and 55.7 +/- 15.1 U/l (UC) versus 71.9 +/- 18.4 (HC), P < 0.001). Furthermore, patients with IBD had higher numbers of CD26-positive cells coexpressing CD25 and a higher surface expression of CD26 (DP IV) (mean fluorescence intensity, mean 57.1 (CD) and 59.8 (UC) versus 29.9 (HC), P < 0.001). The DP IV activity in serum showed an inverse correlation with known disease activity scores as well as with the concentrations of orosomucoid in serum.

CONCLUSION
The changes of DP IV in patients with IBD highlight alterations at an interface between immune function and metabolism of peptide hormones, with potential importance for the pathophysiology of IBD. Furthermore, these changes may help to refine the assessment of IBD activity.


In mountain terrains of Himalaya, road and highway networks play a vital role in remote areas for transportation, public network and all kind of socio-economic activities. The stability of rock slopes along the roads and highways is a major concern in these hilly regions. Any kind of slope failure may lead to disruption in traffic, loss of properties and lives/injuries as well as environmental degradation. The unplanned excavations of rock slopes for construction or widening purposes may undermine the stability of the slopes. The present study incorporates the stability analysis of road cut slopes along NH-109 which goes to holy shrine of Kedarnath. Slope failure is not only a phenomenon of rainy season but it has also been encountered even in dry season. The study area experiences high vehicular traffic especially from March to August due to pilgrims since it is the only road to Kedarnath. The distance of about 20 km between Rudraprayag and Agastmuni has been investigated. The continuous slope mass rating (CSMR) technique has been used for slope stability analysis at five different locations. CSMR is modification of original slope mass rating (SMR) proposed by Romana which is based on well established rock mass rating (RMR) technique. Kinematic analysis was also carried out to evaluate these sites for types of failure and its potential failure directions. The potentially vulnerable sites were identified. The results indicate that the CSMR technique may be exploited to assess the stability of rock slopes in the Himalayan territory.


STAT-1 (Signal Transducer and Activator of Transcription-1) is a key signaling component of interferon gamma responses. We present long-term manifestations in siblings with a mutation in the STAT1 gene, which include invasive salmonellosis, recurrent severe respiratory syncytial virus pneumonitis, and hepatosplenic mycobacterial disease, and we summarize all other reported cases with STAT-1 deficiency.


The foodservice industry is among one of the largest industries that contribute significantly to Malaysia's economic growth. The restaurant businesses are operating as a highly competitive market as many food operators are competing with each other in attracting customers. Mamak restaurant is one of the well-established ethnic-based restaurants in Malaysia which is usually seen fully packed with customers most of the time. Despite, the popularity of Mamak restaurant has been acknowledged in many previous studies, there is no attempt done to explore factors that enable the Mamak restaurant to be successful. Therefore, this paper intended to explore success factors of Mamak restaurant in Malaysia based on the customers' perspective and the managerial practices of the Mamak restaurant operators. This paper also aimed to create a business model of success factors of the Mamak restaurant which could be a benchmark by prospective restauranteurs and researchers. The data was collected using an in-depth interview with customers and restaurant operators based on a purposive sampling. The huge data transcription was analyzed in detail to classify codes and categories that summarize and describe the success factors of Mamak restaurant. This study found that location, environment, product, facilities, service, and price of Mamak restaurant have positively contributed to the success of Mamak restaurants. Thus, other food operators can emulate the strategies and practices of Mamak restaurants' management to maximize the potential of their restaurant business.


AIM
Recent studies have demonstrated that netrin-1 plays a vital role in bone metabolism. Previous studies have shown that osteoblasts produce netrin-1 which affects osteoclast differentiation. However, the role of netrin-1 in osteoblast differentiation is not well understood. In this study, we explored the roles of netrin-1 in osteoblasts.

MATERIALS AND METHODS
Quantitative reverse-transcriptase polymerase chain reaction (qPCR), RNA interference for netrin receptors, the generation of netrin-1 plasmid, transfection of plasmids, and cell proliferation assay were performed.

RESULTS
During osteoblast differentiation by ascorbic acid, netrin-1 expression was significantly decreased. Gene expression related with osteoblast differentiation was down-regulated by netrin-1 treatment. We also found that osteoblast differentiation by bone morphogenetic protein-4 (BMP-4) was inhibited in the presence of recombinant netrin-1. Forced expression of both BMP-4 and netrin-1 significantly decreased alkaline phosphatase expression. On the other hand, Unc5b, neogenin, and A2b which belong to netrin receptors were expressed by osteoblasts. Moreover, alkaline phosphatase expression was significantly decreased by knockdown for the combination of two receptors among these receptors.

CONCLUSION
Netrin-1 is involved in the regulation of osteoblast differentiation.


In this paper we propose a novel methodology for analyzing web user behavior based on session simulation by using an Ant Colony Optimization algorithm which incorporates usage, structure and content data originating from a real web site. In the first place, artificial ants learn from a clustered web user session set through the modification of a text preference vector. Then, trained ants are released through a web graph and the generated artificial sessions are compared with real usage. The main result is that the proposed model explains approximately 80% of real usage in terms of a predefined similarity measure.


Road safety is one of the influential factors in reducing road accidents and the resulting injuries and fatalities. The aim of this study is to determine the safety position of the roads of the Bushehr province based on various quantitative and qualitative criteria. For this purpose, a Multi-Criteria Decision Making (MCDM) approach has been utilized. In this approach, first all criteria influencing road safety in the Bushehr province were classified into main and sub-criteria groups and their weights were obtained using Group Analytic Hierarchy Process (GAHP). Then, the rankings of the Bushehr province roads were calculated through the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). The results indicate that during the period of investigation, the roads of Bushehr-Borazjan and Borazjan-Genaveh were the best with minor difference and Deylem-Behbahan road was the worst road of this province. In this regard, the criteria of violations/traffic and road facilities contribute more to the results due to their weights. It is clear that continuous evaluation of road safety will have significant effect on governmental policy-makings for improving roads and safety-related actions.


Surface morphology and defect formation of the prismatic {100} face of ZCTC crystals were investigated by atomic force microscopy (AFM). Both screw-dislocation-controlled growth and two-dimensional nucleation growth occur on the face at a supersaturation of 0.03. Steps advance with strong kinetic anisotropy along the b-axis direction, probably because different parts of the ZCTC molecules are exposed along different crystallographic directions. By comparing heights of elementary steps with the structure of the ZCTC crystal, it is deduced that the growth of ZCTC crystals occurs mostly by direct incorporation of monomers or dimers of ZCTC molecules into the crystal. Defects of hollow channels, negative crystals and cracks that are oriented preferentially along the direction of the b or c axis were observed. The formation of the defects is mainly related to the growth mechanism and structural features of the ZCTC crystal.


The information extraction tasks for the ARPA TIPSTER program center on automatically filling object-oriented data structures, called templates, with information extracted from free text in news stories (for discussion of templates and objects, see "Template Design for Information Extraction" in this volume). With text as input, the TIPSTER systems first detect whether the text contains relevant information. If so, the systems extract specific instances of generic types of information that correspond to each slot in the template and output that information by filling the template slots in an appropriate data representation. These slots are then scored by using an automatic scoring program with templates produced by human analysts that serve as answer keys. Human analysts also prepared development set templates for each domain, which served as training models for system developers (for discussion of the data preparation effort, see "Corpora and Data Preparation for Information Extraction" in this volume).


To investigate the efficacy and safety of laparoscopic internal iliac artery temporary occlusion and uterine repair combined with hysteroscopic aspiration in type III cesarean scar pregnancy. 135 cases of cesarean scar pregnancy in Guangzhou Women and Children's Hospital from November 2017 to November 2020 were collected and 32 cases of type III patients were retrospectively analyzed. They were divided into internal iliac artery temporary occlusion (IIATO) group (21 cases), and bilateral uterine artery embolization (UAE) group (11 cases). The general condition, intraoperative bleeding, postoperative complications, and prognosis of the two groups were analyzed. In the IIATO group, the bilateral internal iliac arteries were temporarily blocked with No. 10 silk thread under laparoscopy. The scar pregnancy clearance and repair of the scar were performed after incision. Subsequently, we performed hysteroscopic aspiration. After the operation, the internal iliac artery ligation thread was removed. In the UAE group, the patients were treated with bilateral uterine artery embolization. Laparoscopic uterine scar repair and hysteroscopy aspiration were performed within 24 hours after embolization. There was no significant difference in age, times of pregnancy, times of cesarean section and gestational weeks between the two groups (P>0.05). No significant differences were observed in the diameter of gestational sac or gestational mass and serum human chorionic gonadotropin (β-hCG) level between the two groups before operation (P>0.05). The operations were successfully completed in 32 patients, and intraoperative blood loss was 67.14±32.78 ml and 71.35±31.56 ml, respectively (P<0.05). The length of hospital stay was 5.14±0.32 day and 4.97±0.21 day, respectively. No peri-procedural bleeding occurred and no secondary surgeries were required. Laparoscopic internal iliac artery temporary occlusion and uterine repair combined with hysteroscopic aspiration is an effective and safe treatment for type III cesarean scar pregnancy, with less postoperative complications and better protection of fertility function for patients.


Ambiguity implies that there are at least two distinct senses ascribed to one sign. It is inherent to language and speech. In this article, I reflect on the types of ambiguity, its typology, production and effect and propose an algorithm for tackling ambiguity in translation. I posit that the choice of a translation strategy and the need for disambiguation in general depend on the type of ambiguity, its sources and character, i. e. whether ambiguity is intended or not. Intended ambiguity occurs when the speaker intentionally does not follow the logic of conceptual clues (primes) and opts for a set of communicative strategies and linguistic means, which allow him/her to offer several possible interpretations of one event or even refer to several different events. I explore a rarely analyzed event-referential ambiguity, which requires additional conceptual information for disambiguation and, consequently, may pose a problem for translation. I argue that problems in disambiguation may occur for a variety of reasons: the translator and\or the recipient may have a wrong reference, have insufficient background knowledge to resolve the ambiguity or make wrong inferences since each recipient bears a different combination of cognitive, axiological, social, professional and gender attributes.


THis question is too wide and vague to admit of a direct answer; but it may be usefully debated by those who have had much study and experience in connexion with the subject. Holding, as I do, that consumption in its widest sense-including not only cases of distinct tuberculosis, but those also of caseous pneumonia and chronic inflammation, which are only different forms and degrees of the same malady-is a disease of degeneration and decay, it can hardly be supposed that I should generallyrecommend consumptives, with the seeds of decay in them, either to waste their remaining stamina by sexual indulgence, or to incur the risk of unhealthy propagation from their own decaying stock; and yet I have advised many a consumptive to marry, and in numerous instances the result has been happy and fruitful. For a patient in co;zqr;ned or active consumption to marry, could never be advised by any rational physician, on either physical or moral grounds. Both reason and experience forbid such a step, as fraught with perils and penalties, present and future. It is different with many of the now numerous class of cases of arrested or limited disease, in whom the bodily functions are active and vigorous, and in whom there is a probability of life for many years under favourable circumstances. Among these favourable circumstances may-often be counted the increased social and domestic comforts and the %thivening communion and sympathy of a well assorted and well regul,1*&4married life. To those who have not the gift of continence, and whbZS ections have been already engaged with the hope of marriage, a sitge life is one of unnatural restraint and disappointment, injurious to health, and likely enough to accelerate disease and decay. To such, a judicious marriage and the moderate exercise of the sexual functions become a source of bodily health, as well as of mental happiness, the beneficial influence of which can hardly be overestimated. To such, the new life seems to have a regenerating influence, with increased vitality and energy, extending even to the organic functions of assimilation and nutrition. I believe that these remarks apply to both sexes, in,iuding childbearing and lactation in the female. So long as all these processes go on normally, with good and regular feeding and digestion, the maternal organism receives fresh vigour from the quickening influence of foetal and infantile life; and processes of degeneration and decay are retarded or suspended. So far is correct the common belief that pregnancy and lactation retard the progress of phthisis. But such remarks do not apply to sickly pregnancies, to severe and exhausting confinements, and to excessive or disordered lactation. Such unfortunate contingencies, which cannot always be foreseen, pretty surely impair the vital powers and hasten the progress of decay. Further, there is a considerable number of consumptive individuals for whom, although the disease be limited and not active, marriage is not desirable. To say, in general terms, that these are weakly individuals, does not sufficiently characterise them. Weak they are, both in body and mind; but there is also a nervousness which aggravates the weakness and adds to sensibilities and sufferings. The weakness extends to the sexual function; and although, unfortunately, it does not extinguish desire, it renders the exercise of that function harassing and exhausting. To such persons, married life would prove a perpetual snare and worry; and their safest course is to cultivate the grace of continence in single blessedness. The apprehension of procreating unhealthy children is an objection more valid with physicians and friends than with the consumptive himself when his affections are engaged; and we are bound to consider that its weight varies also with circumstances. In predicating anything concerning a future generation, it must be borne in mind that we can deal only in terms of probability; and to give them numerical value would require larger statistics than any yet available. Although our experience abounds in examples of children born of consumptive parents being unhealthy, and sooner or later falling victims to some form of the disease, yet the exceptions are numerous also, and prove the power of young life to countervail any inherited proclivity to decay. I could cite many cases, but it would take more time and space than can be given here. Guided by general principles and experience, we may well warn all consumptives born of one or both consumptive parents, or having several blood-relatives consumptive, that there will be great risk of their own children proving consumptive also, and that the risk is further increased when a consumptive marries into another consumptive family; and on this consideration, as well as for their own sakes, we cannot sanction the union of such consumptive persons. On the other hand, consumptives whose malady originated in an inflammatory attack, without any clear history of family taint, and whose present condition is that of arrested disease, with good general health, need have no unusual solicitude as to the healthiness of their progeny, if due care be taken with their hygienic and dietetic management. In this respect, as well as in the general treatment of consumptives, the affluent might have a better chance than those in straitened circumstances; for change of air, a salubrious residenc.e, and a variety in the best kinds of food, are potent but expensive means for the restoration and preservation of health. But the indocility and caprices of the affluent often deprive them of their advantages; and, even when they seek advice, they too commonly are guided by their own inclinations as to how far they will follow it. Whilst I was writing these lines, a gentlemnan entered my consulting-room, saying that he wished for my advice about the propriety of his marrying. Eight years ago, he had been sent home from India, condemned as a consumptive, having spit blood daily for several weeks, and lost much flesh. However, he so far recovered as to be able to return to his milftary duties in India, from which he again returned invalided two months ago, with a renewal of pectoral symptoms. It is needless to enter into details; but I found signs of limited disease in one lung, which, as I told him, was probably inflammatory, and might be removed with proper treatment and care, and then he might entertain his marrying project. "0 !" said he, " I am going to be married the day after to-morrow."


Virtually all modern contracts are standard forms. Although courts have long interpreted ambiguities in such agreements strictly against the drafter, they have struggled to explain why they do so. Under sustained academic fire, states are beginning to abandon the strict against-the-drafter doctrine. Recent cases have even refused to certify class actions on the grounds that a corporate defendant's non-negotiated, unilaterally-dictated contract is ambiguous and thus cannot be construed without individualized extrinsic evidence. This Article claims that the rejection of the strict against-the-drafter rule stems from confusion about its normative foundation. Judges and commentators have offered three rationales for the doctrine: that it discourages ambiguity, corrects unfairness, and redistributes wealth. These theories share the goal of improving the quality and legibility of standard form terms. But even if they succeed, the resulting gains are unclear: most consumers ignore the fine print, and those that do not are cognitively biased and thus cannot value terms accurately. Thus, this Article contends that the doctrine is better understood as encouraging uniformity of meaning in mass-produced contracts. Firms cannot reap the benefits of standardization - institutional, informational, and agency savings - if homogeneous terms lack a single, overarching meaning. At the same time, firms have powerful incentives to use ambiguity strategically and retain confusing terms. The strict against-the-drafter rule counterbalances these enticements. In addition, it prevents the absurd consequences that would result if the meaning of identical terms could fluctuate with the particulars of each transaction.


Cationically modified chitosan derivatives exhibit a range of appealing characteristics, with a particular emphasis on their antimicrobial potential across a broad spectrum of biomedical applications. This study aimed to delve deeper into quaternary chitosan (QC) derivatives. Through the synthesis of both homogeneously and heterogeneously dual-quaternized chitosan (DQC), utilizing AETMAC ([2-(acryloyloxy)ethyl]-trimethylammonium chloride) and GTMAC (glycidyl trimethylammonium chloride), a permanent charge was established, spanning a wide pH range. We assessed structural differences, the type of quaternary functional group, molecular weight (Mw), and charge density. Intriguingly, an upper critical solution temperature (UCST) behavior was observed in AETMAC-functionalized QC. To our knowledge, it is a novel discovery in cationically functionalized chitosan. These materials demonstrated excellent antimicrobial efficacy against model test organisms E. coli and P. syringae. Furthermore, we detected concentration-dependent cytotoxicity in NIH-3T3 fibroblasts. Striking a balance between antimicrobial activity and cytotoxicity becomes a crucial factor in application feasibility. AETMAC-functionalized chitosan emerges as the top performer in terms of overall antibacterial effectiveness, possibly owing to factors like molecular weight, charge characteristics, and variations in the quaternary linker. Quaternary chitosan derivatives, with their excellent antibacterial attributes, hold significant promise as antibacterial or sanitizing agents, as well as across a broad spectrum of biomedical and environmental contexts.


As the number of percutaneous coronary interventions increase annually, patients with intracoronary stents (ICS) who present for noncardiac surgery (NCS) are also on the rise. ICS is associated with stent thrombosis (STH) and requires mandatory antiplatelet therapy to prevent major adverse cardiac events. The risks of bleeding and ischemia remain significant and the management of these patients, especially in the initial year of ICS is challenging. The American College of Cardiologists guidelines on the management of patients with ICS recommend dual antiplatelet therapy (DAT) for minimal 14 days after balloon angioplasty, 30 days for bare metal stents, and 365 days for drug-eluting stents. Postponement of elective surgery is advocated during this period, but guidelines concerning emergency NCS are ambiguous. The risk of STH and surgical bleeding needs to be assessed carefully and many factors which are implicated in STH, apart from the type of stent and the duration of DAT, need to be considered when decision to discontinue DAT is made. DAT management should be a multidisciplinary exercise and bridging therapy with shorter acting intravenous antiplatelet drugs should be contemplated whenever possible. Well conducted clinical trials are needed to establish guidelines as regards to the appropriate tests for platelet function monitoring in patients undergoing NCS while on DAT.


The recent come-back of master narratives illustrates the political turn in the historical discipline. Poststructural and postmodernist theoretical approaches to history in the past decades have resulted in plural or even fragmented views on the past that are not considered helpful in the search for a coherent national identity. In response to the call for grand and coherent views on the Dutch and their history, a new historical canon was presented in 2007. This canon illustrates the central role of Christian religion in the grand narrative of the Dutch past – a past that is definitely over in a country that profiles itself as secularized. Although this view on religion fits in smoothly with the – by now discredited – secularization thesis it reflects only a partial view on religion and does not account for expressions and meanings of religion beyond the church-based institutions. Historians, historians of religion in particular, have to come to terms with the often capricious role of human agency in religion, in past and present. Contemporary literature, I argue in this article, provides 'small stories' of belief and faith that help to re-conceptualize religion as dynamic, lived religion that defies the existing master narrative.