The reaction between Cu(NO3)2.3H2O with bis[(2S,3R)-bicyclo[2.2.2]octane-2,3-dicarbonitrile], (BCODCN) and bis[(2S,3R)-bicyclo[2.2.2]octane-2,3-diamine], (BCODA) produced two new ionic complexes. One of them is bis[(2S,3R)-bicyclo[2.2.2]octane-2,3-dicarbonitrile]copper(ІІ) nitrate, [Cu(BCODCN)2]2+, that is easily synthesized in a nearly quantitative yield using a direct reaction of Cu(NO3)2.3H2O and (BCODCN). Another is bis[(2S,3R)-bicyclo[2.2.2]octane-2,3- diamine]copper(ІІ) nitrate, [Cu(BCODA)2]2+, that has been synthesized by reaction of (BCODA) with Cu(NO3)2.3H2O. These compounds were characterized by IR, UV/Visible techniques. The electronic and vibrational spectra of [Cu(BCODCN)2]2+ and [Cu(BCODA)2]2+ have been measured and studied.


In a period of 18 months the authors performed 359 scrotal ultrasonographies, of which 93 were done because of acute scrotum. The ultrasound-diagnosis failed only in two cases. The ultrasound proved to be a significant aid in the differential diagnostics, and the number of diagnostic explorations decreased especially in traumatic cases. Relying upon the favourable experiences, the authors recommend ultrasonography for more extensive use for the examination of acute scrotum.


Discerning safety from threat and positive or negative outcomes of adversity are fundamental for mental health. Many brain structures have been implicated in both adaptive and maladaptive stress coping, however, how multiple regions function together as a network in the processing of this information is unclear. Here, we recorded local field potentials from seven regions of the mesolimbic-hippocampal-prefrontal cortical network (MLHFC) of male rats during the conditioning of a stimulus (CS) to the absence (safety) and then to the anticipation (fear) of footshocks, and during an approach-avoidance task. We developed a machine learning pipeline to investigate the relevance of specific features of oscillatory activity in the decoding of fear versus safety and approach versus avoidance. We found that decoding performance increased as a function of the number of brain regions included, reaching the best classification if all regions were considered. In addition, the best decoding was obtained from frequencies within the theta range (4-10 Hz). Remarkably, decoder models showed robust generalization within but not between individuals. Nevertheless, we were also able to identify patterns of MLHFC activity that decoded stress coping states from all rats. These patterns were characterized by increased brain-wide theta synchrony during fear and preceding approach. Our results indicate that stress coping information is encoded at the brain-wide level and highlight individual variability in this neural processing. Our findings also suggest that MLHFC network theta activity underlies active stress coping with both aversive and positive motivational valences. SIGNIFICANCE STATEMENT The appraisal of safety versus threat and positive versus negative valence of adversity are core dimensions of emotional experience and stress coping. We developed a new behavioral protocol that discriminates states of fear, safety, approach, and avoidance in a single subject and a machine learning-based method to investigate how neural oscillations can decode such states. Our work provides evidence that stress coping is processed at multiple regions on a brain-wide level involving network oscillations at the theta frequencies, which especially synchronizes during fear and approach. We highlight the potentials of combining artificial intelligence and multi-site electroencephalography to guide therapeutic decisions in precision psychiatry and theta-boosting stimulation therapies for stress-related disorders, especially related to cognitive and motivational deficits.


Teachers' Ethical Responsibilities in a Diverse Society Nathalie Piquemal, University of Manitoba Abstract Recognizing that learning to teach cannot be separated from learning to inquire, I argue that teachers have specific relational and ethical responsibilities to their students, particularly in the context of a diverse society. Using my research experiences with Aboriginal people as examples, I propose an ethical framework based upon four underlying principles: a commitment to difference or to the "relational other" Lévinas (1981); a respect for persons Kant (1956); a commitment to reciprocity Buber (1970); and a sense of care Noddings (1986).


Objectives: To assess knowledge of physicians of tertiary care hospital in Baluchistan about schizophrenia.
Methodology: This cross sectional study was conducted at Department of Psychiatry, Bolan Medical Complex Hospital, Quetta, Pakistan from January 2011 to January, 2012. One hundred physicians were asked to answer a Proforma consisting of two portions namely, general information and knowledge about schizophrenia.
Results: Out of 100 physicians, 96 were males and 4 female. 2% treated more than 10 patients annually, 3% treated 6-9 patients, 12% treated 3-5 patients and 13% treated 1-2 patients annually while 70% physicians didn't treat any case of schizophrenia in two years. 6% diagnosed more than 5 new cases, 18% diagnosed 3-5 new cases and 42% diagnosed 1-2 new cases annually while 34% did not diagnose any new case. 44% of physician had good knowledge about schizophrenia while 56% had poor knowledge.
Conclusion: Most of the physicians in our study area had poor knowledge about schizophrenia. (Rawal Med J 2014;39: ).


In this study we examine a case study of a carve-out for mental health and substance abuse services between a local plan of a national HMO (N=120,213) and a local managed behavioral health care vendor (MBHC). This is one of the first studies which estimates the impact of an HMO carve-out on costs and patterns of MH/SA care. Three years of insurance claims data (1993-1995) were used for the analyses, with a new carve-out contract implemented in May 1994. The new carve-out arrangement included a new vendor, a change in the organizational structure of clinical services, and increased financial risk to the vendor for inpatient care. Descriptive and empirical analyses are reported on a continuously enrolled population (N=49,529). Results from the analyses showed the new carve-out arrangements had a significant impact on spending and utilization of services. Enrollees were 20% less likely to use MH/SA services after the implementation of the new carve-out, and inpatient MH/SA utilization dropped 50% under the new carve-out. Overall, MH/SA spending per enrollee dropped from approximately $4.90 per month to $2.20 per month. Outpatient MH/SA spending per user dropped 35% after the implementation of the new carve-out. Further research should be conducted to evaluate the impact on access and quality of care, given the substantial decrease in utilization and spending.


The evaluation of an inguinal hernia as a result of an accident has to be newly discussed because of new radiologic tools like US, CT and MRI. Therefore an injury of the abdominal wall after an adequate trauma has to be proved. This can also be achieved by radiology, in which signs of injury, as contusion and hematoma, can be detected. Moreover the histological signs of injury and bleeding, i.e. fibrinexudation, capillary granulation tissue, round cells, siderophages, fibrocytes and fibroblast proliferation must be proved.


The cocoa pulp is a slimy layer that surrounds the pieces of seeds, consisting of part of water and a layer of nutritional including sucrose, glucose, and a little starch. The cocoa pulp, the by-product of cocoa production, has been used to avoid environmental pollution as an organic fertilizer. Cocoa shell has been used for livestock feeding, however, utilization of cocoa pulp as livestock feeding is very limited. Therefore, the objective of this study was to determine the performance of male Bali cattle at different ages, fed with concentrate containing cocoa pulp. The experiment was carried out in a completely randomized design consisting of 3 treatments and 3 replications. The treatment consisted of A1 = male Bali cattle 2 years; A2 = male Bali cattle age 3 years; and A3 = Bali cattle male age 4 years, respectively. The parameter was feed consumption, performance, daily body weight gain (DWG), and feed convertion rate (FCR). The results showed that the average feed consumption, DWG, and FCR, showed significantly different (P<0.05) on feed concentrate containing cocoa pulp. The result indicated that concentrate feed containing cocoa pulp showed the best growth performance occurred in 4 years of male Bali cattle


Surfactants of biological origin are in demand both in the food industry and for cosmetic applications. In the present paper the glycosylated nature of a surfactant protein, previously identified in the Acinetobacter radioresistens S13 proteome, was demonstrated. A multiplexed analysis was performed to establish its amino acid sequence homology degree with AlnA, a previously characterized surfactant from A. radioresistens KA53. The amino acid sequence coverage study (N-terminal amino acid sequencing, peptide mass fingerprinting and LC-MS/MS experiments) revealed a 99.97% identity, that is the substitution of one amino acid only. Gly25 of A. radioresistens KA53 AlnA is replaced by Thr in the protein identified in A. radioresistens S13. Such change gives rise to Asn-Asp-Thr N-glycosylation consensus sequon, which is absent in A. radioresistens KA53 AlnA. Actually, Asn23 of the A. radioresistens S13 protein could be identified after N-glycosyl hydrolase treatment only. Asn-Asp-Thr is a peculiar glycosylation consensus sequence since Asp in the central position was shown to decrease the protein glycosylation efficiency in eukaryotes. Our findings provide additional support that glycosylation mechanisms in bacteria differ from those observed in eukaryotic cells. The emulsifying activity of the extracellular protein extracts of A. radioresistens S13 (containing the AlnA-like protein) and a commercial solubilizer widely used in cosmetic preparations, i.e. ethoxylated hydrogenated castor oil (EHCO), were compared. A. radioresistens S13 extracellular protein extracts showed greater emulsifying activity on every tested molecule, especially on peppermint essential oil, with respect to EHCO.


The banded mongoose, Mungos mungo, is a social species that forms multimale and multifemale family groups. Earlier studies suggest these family groups are relatively egalitarian with small differences in reproductive opportunities among individuals of different rank. In contrast, previous studies of other social mongooses have focused on species with more despotic control of reproduction (meerkats, Suricata suricatta, dwarf mongooses, Helogale parvula). In these species, the distribution of reproductive opportunities amongst individuals of different rank has met the predictions of reproductive skew theory: dominant individuals accrue greater reproductive benefits than subordinates, with subordinates breeding less often than dominants. In this paper we test how well two predictions of reproductive skew theory explain variance in measures of reproductive effort, and its correlates, in a wild population of banded mongooses in Queen Elizabeth National Park, Uganda. We measure dominance rank in males and females, and we investigate whether individuals of higher social rank accrue greater benefits than subordinates in terms of survival and reproduction. Banded mongoose dominance hierarchies showed linearity, but low reproductive skew. Rank was not significantly correlated with age. Furthermore, there were only small effects of dominance rank on nutritional levels, and no effects on reproduction and survival, suggesting that banded mongoose societies are indeed relatively egalitarian. No evidence of reproductive suppression was found and other forms of reproductive control were not observed. However, we do not exclude the possibility of increased reproductive competition in circumstances of higher ecological constraints. These findings show that reproductive skew theory is equally useful in explaining variation in reproduction in societies with low reproductive skew, as it is in explaining the allocation of reproductive effort in despotic social systems. Copyright 2001 The Association for the Study of Animal Behaviour.


According to a Forbes' report published in 2015, cloud-based security spending is expected to increase by 42%. According to another research, the IT security expenditure had increased to 79.1% by 2015, showing an increase of more than 10% each year. International Data Corporation (IDC) in 2011 showed that 74.6% of enterprise customers ranked security as a major challenge. This paper summarizes a number of peer-reviewed articles on security threats in cloud computing and the preventive methods. The objective of our research is to understand the cloud components, security issues, and risks, along with emerging solutions that may potentially mitigate the vulnerabilities in the cloud. It is a commonly accepted fact that since 2008, cloud is a viable hosting platform; however, the perception with respect to security in the cloud is that it needs significant improvements to realise higher rates of adaption in the enterprise scale. As identified by another research, many of the issues confronting the cloud computing need to be resolved urgently. The industry has made significant advances in combatting threats to cloud computing, but there is more to be done to achieve a level of maturity that currently exists with traditional/on-premise hosting. © 2017 The Authors. Published by Elsevier B.V. Peer-review under responsibility of the Conference Program Chairs.


Laser sources offer a potentially low-cost means of improving thelight throughput in tandem-scanning confocal microscopy because oftheir high beam directionality. We measure and compare the opticalsectioning characteristics of the tandem-scanning microscope (TSM)employing (i) the traditional choice of incoherent light from a Xearc lamp and (ii) a cited alternative-coherent light from a He-Nelaser source. In general the laser source is found to result inaxial responses with pronounced sidelobes, the sizes and locations ofwhich are extremely sensitive to the alignment of the pinholearray. The implications of these results for practical TSM systemsare discussed.


Soft tissue sarcomas are rare, heterogeneous tumors of mesenchymal origin with an aggressive behavior. Heparin is a mixture of heavily sulfated, linear glycosaminoglycan (GAG) chains, which participate in the regulation of various cell biological functions. Heparin is considered to have significant anticancer capabilities, although the mechanisms involved have not been fully defined. In the present study, the effects of unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) on B6FS fibrosarcoma cell motility were examined. Both preparations of heparin were shown to both enhance B6FS cell adhesion (p<0.01 and p<0.05), and migration (p<0.05), the maximal effect being evident at the concentration of 10 µg/ml. The utilization of FAK-deficient cells demonstrated that the participation of FAK was obligatory for heparin-dependent fibrosarcoma cell adhesion (p<0.05). The results of confocal microscopy indicated that heparin was taken up by the B6FS cells, and that UFH and LMWH induced F-actin polymerization. Heparitinase digestion demonstrated that the endogenous heparan sulfate (HS) chains did not affect the motility of the B6FS cells (p>0.05, not significant). In conclusion, both UFH and LMWH, through a FAK/actin cytoskeleton axis, promoted the adhesion and migration of B6FS fibrosarcoma cells. Thus, our findings indicate that the responsiveness of fibrosarcoma cells to the exogenous heparin/HS content of the cancer microenvironment may play a role in their ability to become mobile and metastasize.


August 14, 1928. Slight fundus reflex is present, but fundus details are not visible. August 15, 1927. There is no conjunctival injection or proptosis. Although he cannot see, he is feeling well and wishes to be discharged. Having read Dr. Shroff's article in the February number of Brit. Jl. of Ophthal., I am tempted to put on record the above case which is like the one described by him. The points of difference being the long duration of time since the accident happened, till the time when he applied for help, and the conse(tlient iritis with seclusion and occlusion of the ptpil. It is remarkable that with a thorn as long as one inch and a quarter, lying in the orbit right under the lid, which is always in motion, and with the iritis that ensued, the patient, who was a powerful agricultural labourer, did not feel himself out of sorts and only applied for lhelp when, four months after the accident, chemosis set in. Evidentl) the tenonitis whichi was late in appearing had compelled him to seek relief and this was brought on by some sort of interference with the eye, although-he denied it. Repeated letters to him since February have not elicited any response from him. But I shall report it if I hear of any further change in the futture.


ABSTRACT Aminoacyl-tRNA synthetases, catalyzing the first step of protein synthesis, have been shown to involve with multiple additional physiologic responses. Here, we summarize our findings that p300/CBP-Associated Factor and Sirtuin 1 play the reversible acetylation role in regulating the nuclear translocation of Tyrosyl-tRNA synthetase and activating transcription factor E2F1, thus facilitating the repair of damaged DNA.


The aim of this article is to investigate whether there are important differences between the evaluation procedures adopted by the Italian Ministry of Education, University, and Research in the evaluation of scientific research. The two procedures, one for the periodic exercise of the evaluation of scientific research activities and the other to verify the possession of the requisites necessary to be employed as a professor at a university, have different purposes and have been implemented with different evaluation approaches. Analysing sample data extracted from the well-known Scopus database, we replicate the assessment methodologies, obtaining some interesting results. The two procedures identify the same departments of excellence and draw similar rankings. The two evaluation criteria are not so far apart in the identification of the departments of excellence. Through the use of coloured maps, we then identify that the distribution of the departments of excellence in the national territory favours the northern regions.


Volcanic glasses are an amorphous phyllosilicates formed by the fast cooling of the magma. The physicochemical properties of volcanic glasses are directly related to their chemical composition. Thus, the rhyolitic magma, which presents the highest SiO 2 per- centage, displays a high viscosity, which leads to explosive eruptions by the ex-solution of H 2 O, CO 2 , and SO 2 , when the pressure diminishes generates a macroporous structure with interesting applications in construction, as abrasive, acoustic, filter as well as in the agriculture field. The macroporosity of volcanic glass allows to host large molecules as biomolecules, tensoactives, or dyes. On the other hand, the existence of hydroxyl groups in this amorphous aluminosilicate also favors the adsorption of cations and anions, so the volcanic glass is an economical adsorbent to retain heavy metals or radioactive cations.


This paper proposes a novel system-level power estimation methodology for electronic designs consisting of intellectual property (IP) components. Our methodology relies on analytical output and power macromodels of the IP blocks to estimate system dissipation without performing any simulation. We derive upper bounds on the estimation error of our methodology and demonstrate the relation of this error to the sensitivities of the macromodeling functions. For circuits without feedback, we give a sufficient condition for the worst-case power estimation error to increase only linearly with the length of the IP cascades. We also give a tighter sufficient condition that ensures error boundedness in IP systems of any topology. Experiments with signal processing and data encryption systems validate the accuracy and efficiency of our approach. For designs of up to 576 IP blocks, power estimates are obtained within 0.2 seconds. In comparison with switch-level simulation results, the average error of our power estimates is 7.3%.


Lycorine hydrochloride (LH) is an active ingredient sourced from the medicinal herb Lycoris radiata. Previous studies have suggested that LH exerts tumor suppression activity in several human cancers. However, the anti-cancer effect of LH in melanoma and the potential molecular mechanisms still need to be further studied. p21Cip1/WAF1, unlike its traditional cyclin-dependent kinase (CDK) inhibitor role, is believed to act as an oncogene under certain cellular conditions. In this research, an increased expression of p21Cip1/WAF1 was found in human melanoma tissues and positively related to the tumor invasion depth. High level of p21Cip1/WAF1 was found to correlate with bad outcomes of melanoma patients by Kaplan-Meier survival analysis. Functional experiments demonstrated that the proliferation, migration and invasion ability of A375 and MV3 melanoma cells was powerfully inhibited by LH through inducing S phase cell cycle arrest and regulating epithelial-mesenchymal transition (EMT). In NOD/SCID mice model, LH effectively inhibited the xenograft tumor growth and lung metastasis of A375 cells. Further research revealed that LH reduced p21Cip1/WAF1 protein by accelerating its ubiquitination. Importantly, the LH-induced suppression of cell proliferation and metastasis was rescued by p21Cip1/WAF1 overexpression, both in vitro an in vivo. Taken together, LH, which suppresses the proliferation and metastasis of melanoma cells via down-regulating p21Cip1/WAF1, is expected to be developed as an effective medicine for melanoma therapy.


Counter-terrorism measures are often described as pre-emptive, punitive, and afford authorities exclusive and expanded powers. Yet they continue to attract public support. Why is this the case? A consistent finding in traditional crime control research shows a link between perceived threat from racial or ethnic minority groups and their perceived involvement in crime. This perceived relationship results in public support for punitive crime control measures for such groups. Similar connections can be made between terrorism and Muslims. It is thus possible that perceiving Muslims to be threatening may help explain enhanced public support towards harsh counter-terrorism measures. This study draws on survey data of a national sample Australian residents (N = 1199) to test this hypothesis. Findings show the importance of both identity processes and perceptions of Muslims as threatening in shaping support for punitive counter-terrorism strategies. Results also demonstrate how social identity can moderate the effect of perceived threat on support for such strategies. Theoretical and policy implications of this study are outlined.


Exercise on Referral Schemes (ERS) are a widespread community intervention in which health professionals refer patients to a programme of supervised exercise at leisure facilities. National guidance states routine data should be collected and made available for analyses, and that there is a need to better understand what elements of ERS work, for which subgroups of the population. This thesis examines what elements of behaviour change provision within ERS work, for whom and in what circumstances, in order to gain a better understanding of what influences referral to, engagement with, and adherence to such schemes.

First the thesis presents a quantitative evaluation study of 2233 referrals to the 24-week Northumberland ERS in nine leisure facilities between July 2009 and September 2010. Main outcome measures were uptake, 12-week adherence, 24-week completion, and changes in self-reported physical activity, blood pressure, body mass index (BMI) and waist circumference. Two qualitative studies follow, one examining pre-scheme perceptions of 15 referrals and the second following them through the scheme. Data from semi-structured interviews conducted in both studies are presented as three narrative typologies of the referral journey.

This research demonstrated that demographics and other factors related to referral minimally increased ability to predict engagement. Completion resulted in significant increases in self-reported physical activity and significant, but small, reductions in BMI and waist circumference. Participants had complex social circumstances, multiple personal reasons for referral and high expectations of positive health changes. Staff and peer support were influential to success, especially if expectations were not met. The narrative typologies help to identify those for whom ERS currently works well, those for whom ERS works but who may struggle with sustained behaviour change, and those for whom it does not work. This novel approach to classifying likelihood of success is used to discuss potential improvements to ERS.


Aim: While epithelial-mesenchymal transition (EMT) is associated with the complex morphogenetic events during embryogenesis, EMT has also been shown to play an important role in the progression of epithelial cancers. There have been few studies examining ZEB1 and SMAD protein expressions in skin tumor tissues in the literature, and there are no studies evaluating GIT1 protein expression. Materials and Methods: Thirty-seven pieces of squamous cell carcinoma(SCC), 34 pieces of basal cell carcinoma(BCC), 11 pieces of actinic keratosis(AK), 9 pieces of in situ SCC(SCCIS) and 7 pieces of normal skin tissue were included in this study. Results: A statistically significant difference was found between the SMAD1, AREB6 and GIT1 H-scores values of the individuals in the five groups. The levels of SMAD1, AREB6 and GIT1 were higher in SCC than in the control group. In binary comparisons, the SMAD1 H-score values of BCC, SCCIS groups were statistically significantly higher than normal skin. GIT1 H-score values of SCC and BCC groups were significantly higher than normal skin. Conclusion: In skin tumors, EMT is an ever-active mechanism. It is thought that this mechanism is highly controlled in SCC, a more aggressive type of cancer, than in BCC. These results suggest that the investigation of genes related to SMAD1, AREB6 and GIT1 may be useful for research into new molecular targets for the treatment and prevention of metastasis in nonmelanotic skin tumors.


Abstract: This article presents an innovative approach for determining non-product investment in the maintenance of manufacturing facilities using quality-based statistical principles. Degradation of process capability (Cpk) over time with respect to key part specifications is analyzed using a regression model to predict the need for investment. While the preferred approach is to track process capability at all stations in a production line, this becomes prohibitively expensive and impractical in many industries, including engine manufacturing plants. By modeling the trend in Cpk values from only the end of the production line, using subject matter experts (SMEs) when necessary, one can still identify production stations/areas of weakness in a manufacturing facility with reasonable effectiveness. We propose such a method to help plant managers prioritize their limited maintenance resources. The methodology is validated using a case study from an automotive engine plant of Ford Motor Company. It is being disseminated as a "best practice" to other manufacturing facilities at Ford.


Success of the new human papillomavirus (HPV) DNA test for low‐resource settings (careHPV™ test; QIAGEN Gaithersburg Inc., Gaithersburg, MD) requires good test performance when operated by personnel with limited laboratory experience. We evaluated the transferability, reliability, and accuracy of the careHPV test nested within a cervical screening project in a large Nigerian village. CareHPV testing was performed on screen‐positive (n = 345) and screen‐negative (n = 42) women attending colposcopy (68.3% of referred). Biopsies of abnormal‐appearing areas were processed and read in the U.S. CareHPV specimens taken immediately before colposcopy were processed up to four times (in the field) by two secondary school graduates without laboratory experience, trained for this study. Specifically, QIAGEN Gaithersburg trained a laboratory‐inexperienced U.S. researcher, who trained the first local technician who, in turn, trained the second. Residual specimens were sent to the U.S. for MY09/MY11 PCR testing for 13 carcinogenic genotypes (HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) plus HPV66 (included in careHPV). Intrarater agreement was 98.8% (κ = 0.97) and 98.9% (κ = 0.97) for Technicians 1 and 2, respectively, while inter‐rater agreement was 96.3% (κ = 0.90). Agreement with MY09/MY11 PCR (virologic reference standard) was 89.3% (κ = 0.73) with 74.2% sensitivity and 95.7% specificity. The careHPV test detected 12 (80%) of 15 histologically confirmed cervical intraepithelial neoplasia Grade 2 (CIN2) or worse lesions, with an estimated 83.0% specificity to detect


ABSTRACT Introduction: Acute exacerbations in patients with chronic bronchitis are a leading cause of hospitalizations and death. Bacteria contribute significantly to such exacerbations. The aim of this review was to explore the potential role of investigational antibiotics in the treatment of these episodes. Areas covered: The available literature in PubMed database, in websites related to investigational drugs and in websites of the producing companies has been searched. The in vitro activity against pathogens involved in acute exacerbations of chronic bronchitis and the pharmacokinetic profile of antibiotics currently under development were taken into consideration for inclusion in the review. Expert opinion: Several novel antimicrobial agents have completed preclinical and Phase I studies and were well-tolerated. Further investigation is mandatory in order to evaluate their future in treatment of chronic bronchitis exacerbations and discover potential advantages compared to already approved antimicrobials.


Lithotomy, i.e. the surgical method of cutting for stone in the bladder, belongs to the oldest and, due to the high risk, most notorious operating techniques. Records of stone-cuttings date as far back as Ancient Greece. The first detailed description of the procedure and instrumentation of lithotomy is to be found by Celsus (1. century AD). The patient in the lithotomy position, the neck of the bladder is approached by a median incision of the perineum. Celsus is also the first to mention special stone-hooking instruments ("uncus") to aid in extracting the bladder-stones. Medico-historical development lead to constant changes in the technique as well as in the instrumentation, since the lack of analgesia and anaesthesia necessitated quick operations of only a few minutes. A key step in the progress of operation was the introduction of so-called path-finders and directing probes in the 16th century. The opening of the bladder from the perineal incision was now accompanied by the simultaneous admission of a metal catheter into the bladder via urethra, thus providing the "Lithotomist", through manual control of the catheter, with an enhanced orientation towards the position of urethra and bladder. At that time, the dissection was conducted bluntly and without direct view of the situation, i.e. without an exact representation of the structures to be separated. Thanks to the improved instrumentation, the instruments could now be guided along a probe directly into the bladder, thus alleviating the tedious search for the opening after changing instruments, all the while with an agitated, pressing patient. Famous names in the development of the lithotomy with an perineal incision are the medical doctor Mariano Santo (around 1488-1564), the barber-surgeon Frère Jacques de Beaulieu (1651-1719) and later Johann Jakob Rau M.D. (1668-1719). Only later, to avoid injury to the perineum, the suprasymphyseal approach ("Sectio alta") was adopted (primarily by Pierre Franco 1556). Due to the construction of arrow-like probe by the barber-surgeon Frère Come (Jean Baseilhac [1703-1781]), which was pushed through the urethra into the bladder and up and above the symphysis, the danger of damaging or penetrating the peritoneum was greatly reduced. In the 19th century the upper lithotomy prevailed as the standard operating method over the perineal approach, known even by the ancient Greeks, but marked by its high complication rate. Since the end of the 19th century, however, the upper lithotomy in ist turn, has been nearly completely replaced by the cystoscopic transurethral lithotripsy.


In this letter, the problem of pilot contamination in a multi-cell massive multiple input multiple output (M-MIMO) system is addressed using deep reinforcement learning (DRL). To this end, a pilot assignment strategy is designed that adapts to the channel variations while maintaining a tolerable pilot contamination effect. Using the angle of arrival (AoA) information of the users, a cost function, portraying the reward, is presented, defining the pilot contamination effects in the system. Numerical results illustrate that the DRL-based scheme is able to track the changes in the environment, learn the near-optimal pilot assignment, and achieve a close performance to that of the optimum pilot assignment performed by exhaustive search, while maintaining a low computational complexity.


Lankascincus dorsicatenatus is an endemic species of litter-skink distributed throughout the wet zone of Sri Lanka (elevations from 15 to 800 m a.s.l.). The recent resurrection of Lygosoma megalops by the recent description of its neotype designated by Batuwita (2019), presently lost, destabilized the taxonomic status of Lankascincus dorsicatenatus. Amarasinghe et al. (2022) synonymized Lygosoma megalops with Lankascincus fallax, and accepted Lankascincus dorsicatenatus as a valid taxon. Deraniyagala (1953) described Sphenomorphus dorsicatenatus based on a holotype and three paratypes. All the types are lost except one paratype at the National Museum of Sri Lanka, Colombo, Sri Lanka (NMSL), but it is in bad condition. Therefore, with a comparative discussion on the status of 'Lankascincus megalops', here we designate a neotype for Lankascincus dorsicatenatus for clarification of the taxonomic status and stabilize the nomen. A discussion on the distribution and conservation of Lankascincus dorsicatenatus is also provided.


It is shown that a discrepancy and incompatibility persist between basic physics and fusion-literature regarding the radiation losses from a thermonuclear plasma. Whereas the fusion-literature neglects the excitation or line radiation completely, according to basic physics it depends upon the prevailing conditions and cannot be neglected in general. Moreover, for a magnetized plasma, while the fusion-literature assumes a self-absorption or reabsorption of cyclotron or synchrotron radiation emitted by the electrons spiraling along the magnetic field, the basic physics does not allow any effective reabsorption of cyclotron or synchrotron radiation. As is demonstrated, fallacious assumptions and notions, which somehow or other crept into the fusion-literature, are responsible for this discrepancy. In the present work, the theory is corrected. On the grounds of basic physics, a complete energy balance of magnetized and non-magnetized plasmas is presented for pulsed, stationary and self-sustaining operations by taking into account the energy release by reactions of light nuclei as well as different kinds of diffusive (conduction) and radiative (bremsstrahlung, cyclotron or synchrotron radiation and excitation radiation) energy losses. Already the energy losses by radiation make the energy balance negative. Hence, a fusion reactor – an energy producing device – seems to be beyond the realms of realization.


In order to introduce disabled users to the ideas underpinning pervasive technologies, three filmed scenarios were created to illustrate near-future interactions in health, commerce and e-voting domains. These filmed scenarios were used in a focus group session with fourteen participants who had either a visual or auditory impairment. Participants were asked to comment on the scenarios and reflect on the costs and benefits of such technologies. The resultant data was coded in terms of general and disability-specific concerns. Particular issues were raised about the need for disabled individuals to delegate certain tasks to trusted others.


Various organizations, such as those active in business or in politics, capture, store, and analyze data gathered from heterogeneous, distributed, and sometimes autonomous information sources including social media, classical and Web databases, multimedia files, localization raw data, etc. Big data is a term used to describe such kind of data having high volume, velocity, and variety features. It involves innovative technologies, such as pervasive and cloud computing ones, used to enhance decision making, provide vision, discovery, and backing to improve business processes and actions on the ground. The latent value of big data analytics is prodigious and clearly recognized by a rising number of studies such as topics related to politics. The tutorial will focus, in general, on big data and related analytics rising topics, and, in particular, on big data studies performed in the modern democracy era. Modeling and analysis approaches will be discussed, and various cases of election big data, including experiences performed in old democracies such in the United States, Canada, and the new ones such in Tunisia, will be presented.


Web-based learning is in its infancy and has the potential to drive immense developments in learning technologies. With advances in videoconferencing software and the move towards a broadband Britain, a new opportunity has arisen for distributed learning to take place whilst retaining synchronous contact with a tutor. De Montfort University's REal time Access to Learning IT (REALITY) is remote, real-time, computer based training in computer applications. It uses a combination of desktop videoconferencing and application sharing to provide remote, distributed, learners with live tuition. The target audience for REALITY are people who, for whatever reason, cannot readily access traditional learning establishments but for whom distance learning is not an option either. The aim is to provide training facilities at a variety of times and locations which are local and familiar and which avoid the potentially negative connotations of traditional educational institutions. With funding from BT, the initial phases of the project are now complete and have been evaluated. The findings indicate that despite technical difficulties and the strain of working at a distance using unfamiliar technology, most of the participants responded favourably to their REALITY experiences.


Abstract Cutaneous, tumor-like nodules were observed on the digits and distal wings in 6 of 52 laughing doves (Streptopelia senegalensis) kept in an aviary. The nodules were surgically removed, and the birds were treated postoperatively with tetracycline. Histopathologic examination of the resected tissue revealed eosinophilic intracytoplasmic inclusion bodies associated with a heavy infiltration of heterophils, lymphocytes, and fewer plasma cells. Electron microscopy revealed pox virions. No additional cases were reported after the birds were surgically treated and quarantined from the remainder of the aviary. The location of lesions on the digits and distal wing tips is unusual for poxvirus. To our knowledge, infection with poxvirus has not previously been diagnosed or reported in wild birds in the Sultanate of Oman.


Sensorimotor adaptation is driven by sensory prediction errors, the difference between the predicted and actual feedback. When the position of the feedback is made uncertain, adaptation is attenuated. This effect, in the context of optimal sensory integration models, has been attributed to a weakening of the error signal driving adaptation. Here we consider an alternative hypothesis, namely that uncertainty alters the perceived location of the feedback. We present two visuomotor adaptation experiments to compare these hypotheses, varying the size and uncertainty of a visual error signal. Uncertainty attenuated learning when the error size was small but had no effect when the error size was large. This pattern of results favors the hypothesis that uncertainty does not impact the strength of the error signal, but rather, leads to mis-localization of the error. We formalize these ideas to offer a novel perspective on the effect of visual uncertainty on implicit sensorimotor adaptation. SIGNIFICANCE STATEMENT Current models of sensorimotor adaptation assume that the rate of learning will be related to properties of the error signal (e.g., size, consistency, relevance). Recent evidence has challenged this view, pointing to a rigid, modular system, one that automatically recalibrates the sensorimotor map in response to movement errors, with minimal constraint. In light of these developments, this study revisits the influence of feedback uncertainty on sensorimotor adaptation. Adaptation was attenuated in response to a noisy feedback signal, but the effect was only manifest for small errors and not for large errors. This interaction suggests that uncertainty does not weaken the error signal. Rather, it may influence the perceived location of the feedback and thus the change in the sensorimotor map induced by that error. These ideas are formalized to show how the motor system remains exquisitely calibrated, even if adaptation is largely insensitive to the statistics of error signals.


Current harmonics caused by nonlinear loads yield major power quality related problems in the utility. Such harmonics are commonly reduced by employing static compensators known as active power filters (APF). APF topologies are of various types, depending on technical and economical requirements; and their performance is intimately related to the applied control algorithm. In this paper, a new constant-frequency linear control scheme is proposed for a shunt three-phase four-leg APF. The APF is used to compensate the current distortion and the reactive power created by a typical industrial load. The elaboration of the control law is based on a small-signal averaged model of the converter, computed in the (d,q,0) synchronous frame. The control scheme consists of multiple-loops PI controllers that ensure voltage regulation at the DC side of the filter, and current wave shaping at the AC side. The control system is implemented numerically using the Matlab/Simulink tool. The performance of the proposed control approach is finally discussed through the obtained simulation results.


The enzyme and antigen activities of aspartate aminotransferase [EC 220.127.116.11] isozymes in several tissues of rats fed on pyridoxine-deficient or control diet for 4 weeks were determined. The enzyme activities in liver (supernate, mitochondria), heart (supernate), brain (mitochondria), and muscle (mitochondria) preparations of the deficient rats were abnormally low, whereas those in other tissue preparations were similar to those of control rats. In liver and heart preparations, the antigen activities of the deficient rats were similar to those in controls, but in brain and muscle mitochondria they were abnormally low. These findings suggest that the activity and the amount of this enzyme are regulated in different ways in different tissues, and suggest that the coenzyme level affects metabolic regulation of the enzyme molecule.


Members of the Eph receptor tyrosine kinase have previously been implicated in cranial neural tube development. Failure of neural tube closure leads to the devastating conditions known as anencephaly and spina bifida. EphA2 and EphA4 are expressed at the tips of the closing spinal neural folds prior and during neural tube closure. We investigated the possible role of murine EphA2 and EphA4 during the last step of primary neural tube closure, which is adhesion and fusion. The individual mouse knockouts of EphA2 and EphA4 per se do not exhibit neural tube defects (NTDs). The embryos generated by the crossing of double heterozygotes Epha2tm1Jrui/+Epha4rb-2J/+ displayed NTDs with a wide degree of severity including close exencephaly and close spina bifida (spina bifida occulta). Interestingly, mutants displaying NTDs had skin covering the underlying lesion. The tissue sections revealed the elevated neural folds had not adhered and fused. The phenotypes seen in Epha2tm1Jrui/+Epha4rb-2J/+ double heterozygous embryos suggest both genes play a compensatory role with each other in the adhesion and fusion of the neural tube. In this study, there exists a >50% penetrance of NTDs in the mouse mutants, which genetically have a single allele each of EphA2 and EphA4 absent.


Rainwater harvesting has been practiced in Kayts (Jaffna Peninsula) since 2016. A consumer preference study conducted in the area by employing a structured questionnaire survey revealed that 97% of the people did not use stored rainwater for drinking as they questioned the quality of water. Thus, the current study was an attempt to investigate into the quality of rainwater harvest in Kayts. It was hypothesised that the quality of rainwater harvested in tanks, varied with time depending on the filling time (rainy season) and consuming time (drought). Selected physical (colour, odour, taste), physicochemical (pH, conductivity, turbidity) and biological (total coliforms) parameters were determined during the rainy season (freshly filled rainwater), early dry season (few months after storage) and peak dry season (several months upon storage) in 2018. Change in colour, odour and taste were evident over time, however, they were within the desirable range of Sri Lanka Standards (SLS) and WHO standards. Turbidity (range: 0.23-1.96 NTU), pH (range: 7.5-8.4) and conductivity (range 68.7-129.6 μS) increased significantly (Kruskal Wallis test: Minitab 17 p<0.05) during the storage time. Total coliforms exceeded the Sri Lankan standard of 10 Cfu /100 ml in two harvest tanks (10 and 14 Cfu/ 100 ml) out of 30 tanks possibly due to contamination by bird excreta. In conclusion, the water quality parameters of securely stored rainwater met the SLS and WHO standards of potable water quality irrespective of the season of sampling. Current research suggests that rainwater in Kayts of Jaffna peninsula is in good quality to be used as drinking water when securely collected. The acceptability of rainwater for consumption was unsatisfactory among consumers due to baseless doubts about water quality. Keywords: Rainwater harvesting, Water quality, Jaffna Peninsula


This study aims to investigate the characteristics of citrus seedlings Village Cingkes consumer, knowing the consumer perception of the marketing mix orange seed Cingkes village, and analyzes the factors that influence consumer purchasing decisions citrus seedlings Cingkes village. Area of research conducted in the village of Cingkes Simalungun by determining the location of the research done purposively. Data used in this study are primary data. Samples were examined as many as 115 respondents. The number of variables studied as many as 25 variables, but only 19 valid variable. Data were processed using factor analysis was 19 variable because it has the MSA is above 0.5. Data obtained from respondents was processed using SPSS 17.0.
Results showed that the characteristics of most of the respondents were male (71.3%), the age group of 20-79 years, the age of most respondents was 30-39 years (33%), with primary school up to undergraduate education, most are high school education (60.9%), with revenues Rp1,000,000 - 44,900,000. Most revenue is Rp 1,000,000 - 4,900,000 (68.7%). According to consumer product factor, factor prices, factor distribution, and promotion of citrus seedlings factor Cingkes village is very important and greatly affect the purchase of citrus seedlings Cingkes village, with 50% of respondents chose agree and strongly agree. The results of factor analysis showed that the results of the 19 variables that influence the purchase of citrus seedlings Village Cingkes form 7 factors. The factor is the price factor with variance value 20,064%,  11,231% social factors, with 9,837% distribution factor, promotion factor by 7,768% to 6,232% psychological factors, factors products by 5,769% and 5,645% of individuals with factor.


This study explores various issues of appearance management behavior for plus-size women in Korea with a focus on clothing. In-depth interviews and focused group interviews were conducted with 24 plussize women. The interviews were recorded and the transcripts were analyzed based on grounded theory. Discomfort was the main phenomenon involving the experience of plus-size women related to appearance management. Psychological as well as physiological/physical discomfort, unmet needs (regarding clothing) and inconvenient shopping experiences were frequently mentioned. Causal conditions for discomfort were obesity, social stigma, and an underdeveloped clothing market for plus-size consumers. Interviewees developed strategies to cope with discomfort (suppressing clothing need, loss of interest in clothing, diversion from clothing needs, sole focus on physical comfort, dress-up and increase in shopping channels, and change in shopping patterns) that depended on contextual conditions (such as duration of obesity and attitudes of people) close to the interviewees. The discomfort of interviewees decreased or continued depending on if they became ambivalent about their obese condition, lost weight, or utilized plus-size specialty stores.


In this report we summarize research into new parallel algebraic multigrid (AMG) methods. We first provide a introduction to parallel AMG. We then discuss our research in parallel AMG algorithms for very large scale platforms. We detail significant improvements in the AMG setup phase to a matrix-matrix multiplication kernel. We present a smoothed aggregation AMG algorithm with fewer communication synchronization points, and discuss its links to domain decomposition methods. Finally, we discuss a multigrid smoothing technique that utilizes two message passing layers for use on multicore processors.


Since the onset of the current crisis, numerous intergovernmental organizations made declarations and plans, but only national packages were implemented to minimize adverse effects to real (national) economies. Despite the fact that capital markets have long ago become increasingly complex with a multitude of actors, a state-level approach remains firmly in place. This paper aims to present political responses to the crisis, identifying how politicians envision the future of capital markets and the world economy. The financial crisis might have been a direct motive to start a global political interplay regarding regulation, but it was also a unique opportunity for numerous actors to start pressing for their own agenda vis-A -vis the global economic and political order. Reviewing the responses of several of the most prominent actors on the scene may contribute to understanding how close the world is to having a new financial - or even economic - structure on the global level.


[1] Katla and Eyjafjallajokull volcanoes are situated 25 km apart at the southern tip of the Eastern Volcanic Zone in Iceland. Both have been active in historic time (last 1100 years) and have a history of simultaneous activity. The much more active Katla volcano has erupted at least 20 times, and Eyjafjallajokull's two eruptions were contemporaneous with Katla eruptions. Following a quiet period of several decades, the seismicity beneath Eyjafjallajokull was high in 1994 and again in 1999. The activity culminated in July 1999 when a flash flood occurred from the Mýrdalsjokull ice cap covering Katla, associated with changes in seismicity, bursts of volcanic tremor, and the formation and deepening of ice cauldrons. We report here results of deformation observations of these events, both by GPS geodesy and tilt measurements. The 1999 increase in seismicity at Eyjafjallajokull was associated with significant inflation of the volcano. The deformation data are modeled by a point pressure source at 3.5 km depth beneath the flank of the volcano, about 4 km south of the summit crater. Maximum uplift of the model is 0.35 m. A similar model also explains deformation associated with the 1994 seismic crisis. The deformation field of the Katla volcano is more difficult to ascertain due to the extensive glacier coverage. Movements of points on nunataks on and near the caldera rim indicate inflation and magma movements at shallow level beneath the caldera in connection with the events of July 1999.


B chromosomes are elements extra to the standard (A) chromosomes. Their frequencies in populations are determined by their transmission rates and effects on host fitness. Most B chromosomes are considered to be genomic parasites having transmission drive and being detrimental to their carriers. In some populations of the hermaphroditic planarian Polycelis nigra a small metacentric B chromosome is very abundant. These populations are pseudogamous parthenogenetic, meaning that sperm is needed to activate egg development, but sperm chromosomes are eliminated from the egg after fertilization. Previous transmission studies have shown that paternally inherited B chromosomes occasionally escape expulsion from the egg. Here, we compared a number of phenotypic fitness aspects of worms, with and without B chromosomes, taken from the field. B chromosomes did not significantly affect adult body size, cocoon fertility, cocoon size, hatching time and number of young per cocoon. In one of three samples cocoon production decreased significantly with increasing B number. In one of two populations, young from mothers with B chromosomes grew significantly slower than those of mothers without Bs. The dynamics of this B chromosome appear to conform to the parasitic model: Bs accumulate through occasional paternal inheritance despite being selected against through negative effects on cocoon production and juvenile growth.


IT HAS been established that scleroderma is a generalized disease. The condition usually runs a chronic course, but it may become acute, with fibrinoid change in the connective tissue like that seen in lupus erythematosus and periarteritis nodosa. 1 Therefore, it is not unusual that the following case showed both chronic and acute features of scleroderma, but it is unusual that in this case there was a sudden change from a chronic course to an acute fulminating, fatal course during corticotropin (ACTH) therapy. REPORT OF CASE This 48-year-old white man's illness began in the spring of 1949 with a short episode of involvement of the joints of the right arm and fingers. Following this, he had a nine-month asymptomatic period. In May, 1950, after an eight-week period of stiffness and swelling of the finger joints, wrists, ankles, and balls of the feet, he was admitted to Hines Veterans Administration Hospital.


The treatment of sternoclavicular joint infection is a topic of controversy. This systematic review aims to evaluate the preferred treatment of sternoclavicular joint infections. A literature search using PubMed/MEDLINE®/Embase databases was conducted to identify publications on the surgical management of sternoclavicular joint infections. Case reports and studies without surgical management were excluded. The outcomes of interest included patient demographics, comorbidities, infectious etiologies, radiographic features, surgical management, and complications. Sixteen articles met the inclusion criteria. The mean age of the subjects was 53.4 years; there was a predominance of males (65%), and a minority of the subjects were obese (15%). The most common infectious etiology was methicillin-susceptible Staphylococcus aureus (MSSA) (48%). CT scan was reported in 46% of cases. The most common treatment was surgical resection of the joints (85%), followed by muscle flap closure of the wounds (54.2%). The complication rate ranged from 0-40%. Specifically, recurrence of infection was low with resection of the joint, followed by muscle flap closure. Given the heterogeneity of the methodology and inconsistency in the outcomes, a meta-analysis could not be performed. Overall, the current literature favors the resection of the sternoclavicular joint as the gold standard treatment. Closure of the wound using muscle flap seems to adequately treat this problem without any major untoward events.


This study conducted a preliminary phantom study of MRI-guided vascular intervention, and evaluated the image quality of MR real-time sequences for MR compatible guidewire and balloon imaging with a 3D printed aorta phantom in a 3T MRI scanner. The results showed that the two real-time imaging sequences have sufficient guiding ability to guide the guidewire and balloon to the expected position. After comprehensive evaluation, it was concluded that the FLASH sequence was better than the True FISP sequence.


This article analyses the Francophonie strategy to foster diversity of cultures and multilingualism in a globalised world. The first part of the article provides with the analyses of the historic role of the French cultural and educational model in the diplomatic relations. Then the article refers to the context of the Second World War and the American dominance overshadowing the French model. In this context, the development of the Francophonie strategy is analysed with a particular reference to the political strategies that France has implemented to achieve its goals. One of the most important ones is the pressure that has exerted for the adoption of the Convention on the Protection and Promotion of the Diversity of Cultural Expressions (UNESCO (United Nations Educational, Scientific and Cultural Organization), 2006).


This paper investigates the necessity of cleaning weights before calibration. The conflict between cleaning a weight and breaking the history by cleaning is analyzed. Experience from many hundreds of calibrations with measurements before and after cleaning is reported and analyzed. It is concluded, that weights should be cleaned in order to reach a stable state but should also be calibrated before and after cleaning to gain information about metrological traceability and thus the validity of the results that were produced with the weights.


New York City faces accelerating inundation risk from sea level rise, subsidence, and increasing storm intensity from natural and anthropogenic causes. Here we calculate a previously unquantified contribution to subsidence from the cumulative mass and downward pressure exerted by the built environment of the city. We enforce that load distribution in a multiphysics finite element model to calculate expected subsidence. Complex surface geology requires multiple rheological soil models to be applied; clay rich soils and artificial fill are calculated to have the highest post‐construction subsidence as compared with more elastic soils. Minimum and maximum calculated building subsidence ranges from 0 to 600 mm depending on soil/rock physical parameters and foundation modes. We compare modeled subsidence and surface geology to observed subsidence rates from satellite data (Interferometric Synthetic Aperture Radar and Global Positioning System). The comparison is complicated because the urban load has accumulated across a much longer period than measured subsidence rates, and there are multiple causes of subsidence. Geodetic measurements show a mean subsidence rate of 1–2 mm/year across the city that is consistent with regional post‐glacial deformation, though we find some areas of significantly greater subsidence rates. Some of this deformation is consistent with internal consolidation of artificial fill and other soft sediment that may be exacerbated by recent building loads, though there are many possible causes. New York is emblematic of growing coastal cities all over the world that are observed to be subsiding (Wu et al., 2022, https://doi.org/10.1029/2022GL098477), meaning there is a shared global challenge of mitigation against a growing inundation hazard.


This paper deals with the impact of direct bupati (district head) elections on local politics with regard to land confl icts in the district of Paser, Indonesia. I discuss the position and infl uence of non-governmental organizations (NGOs) in this process and their usage of adat-based land claims. The paper is concerned with the internal political context of government-NGO power relations as well as with the position and profi ling of these parties in Paserese society at large. The subject is approached through a discussion of two 'land' occupations (one in fact being a sea occupation) by groups claiming adat rights, and of the measures taken by the local government and NGOs alike. The new importance of regional politics and local responsibility of those in power in Paser are reviewed against the background of Indonesian political reform. I argue that results are likely to be determined by a specifi c local context and momentum rather than by nationwide developments.


Fixed and wireless convergence service environment is generating a huge amount of traffic, fostering the evolution of the optical network capacity and reach. The greatest portion in the traffic increase is occupied by the video traffic. In order to deal with the traffic increase and improve the network profitability, optical network is evolving towards the smart network. This paper explains about the concept and the direction of the fiber based smart network deployment in Korea.


Graphite nanosheet (GNS) was prepared by physical/chemical method. The polyaniline (PANI)/graphite nanocomposites were synthesized by in situ polymerization of aniline monomer using different amounts (1 to 5 wt%) of graphite nanosheets. The formation of graphite nanosheets was confirmed by Transmission Electron Microscope (TEM) and X-ray Diffraction (XRD). The surface morphology of exfoliated graphite and PANI/GNS nanocomposites were studied by the Scanning Electronic Microscopy (SEM). A device for electrical conductivity measurements was developed in this work and the results show that the conductivity of PANI/GNS is dependent of the GNS contents.


With considerable amount of oil and gas resources, the Arctic zones are becoming more and more attractive for oil and gas exploration and production. However, to be able to produce oil and gas in this region, several new challenges have to be faced. One of these is the heavy ice condition. Thus, to face this challenge, new technologies are required. In drifting ice to heavy ice conditions, a floating stationary unit must withstand the important design ice loadings. Due to these loadings, a safe design of the vessel to seabed connection, however, cannot rely on thrusters' utilization alone. A mooring system needs to be particularly reliable and strong. Eventually, disconnection may be needed in the event of loss of position [Gudmestad et al., 09].
 With regard to these observations, it seems relevant to compute and analyze the loading in the mooring device. The vessel studied in this paper is a moderately sized mono-hull icebreaker suitable as an offloading terminal for deep or shallow water production systems or onshore facilities, as control centre for subsea facilities, as process facility with a small process plant or as an intervention vessel for subsea satellites.
 The Arctic Ocean has a water depth varying from tens of meters (Pechora Sea and Kara Sea as well as parts of the Beaufort Sea) to a couple of thousands meters (Canada Basin). This implies finding different mooring solutions to suit these different water depths.
 Due to weight limitations, it is challenging to design a mooring system for arctic deep water made of chain or wire. The partial use of polyester ropes may be an attractive alternative. Due to its particular features, the polyester rope's behavior is not fully understood and it is needed to be further studied for use with a moored installation in this region with very large mooring forces. This paper aims at presenting the results of ice load calculations on mooring systems composed of different kinds of mooring elements (polyester ropes, wire ropes, chains and buoyant elements) and proposing different geometries according to the water depth.


Because this site is dedicated to free books, there's none of the hassle you get with filtering out paid-for content on Amazon or Google Play Books. We also love the fact that all the site's genres are presented on the homepage, so you don't have to waste time trawling through menus. Unlike the bigger stores, Free-Ebooks.net also lets you sort results by publication date, popularity, or rating, helping you avoid the weaker titles that will inevitably find their way onto open publishing platforms (though a book has to be really quite poor to receive less than four stars).


Exposure-based treatment for threat avoidance in anxiety disorders often results in fear renewal. However, little is known about renewal of avoidance. This multimodal laboratory-based treatment study used an ABA renewal design and an approach-avoidance (AP-AV) task to examine renewal of fear/threat and avoidance in twenty adults. In Context A, 9 visual cues paired with increases in probabilistic money loss (escalating threats) produced increases in ratings of feeling threatened and loss expectancies and skin-conductance responses (SCR). During the AP-AV task, a monetary reinforcer was available concurrently with threats. Approach produced the reinforcer or probabilistic loss, while avoidance prevented loss and forfeited reinforcement. Escalating threat produced increasing avoidance and ratings. In Context B with Pavlovian extinction, threats signaled no money loss and SCR declined. During the AP-AV task, avoidance and ratings also declined. In a return to Context A with Pavlovian threat extinction in effect during the AP-AV task, renewal was observed. Escalating threat was associated with increasing ratings and avoidance in most participants. SCR did not show renewal. These are the first translational findings to highlight renewal of avoidance in humans. Further research should identify individual difference variables and altered neural mechanisms that may confer increased risk of avoidance renewal.


WHEN a solenoid, or cylindrical coil, has no iron core, the magnetic field in the space around it or within it may be come used very precised. Formulas have been published1 which take account of the length and thickness of the coil by algebra terms which have been obtained by an integration over the cross section of the coil. This requires a calculation to be made twice, once for the end of the coil nearer the point for which the magnetic field is being computed, and once for the farther end.


Petrogenetic grids in the system NCKFMASH (Na2O–CaO– K2O–FeO–MgO–Al2O3–SiO2–H2O) and the subsystems NCKMASH and NCKFASH calculated with the software THERMOCALC 3.1 are presented for the P–T range 7– 30 kbar and 450–680 C, for assemblages involving garnet, chloritoid, biotite, carpholite, talc, chlorite, kyanite, staurolite, paragonite, glaucophane, jadeite, omphacite, diopsidic pyroxene, plagioclase, zoisite and lawsonite, with phengite, quartz/coesite and H2O in excess. These grids, together with calculated compatibility diagrams and P–T and T–XCa and P–XCa pseudosections for different bulk-rock compositions, show that incorporation of Ca into the NKFMASH system leads to many of the NKFMASH invariant equilibria moving to lower pressure and/or lower temperature, which results, in most cases, in the stability of jadeite and garnet being enlarged, but in the reduction of stability of glaucophane, plagioclase and AFM phases. The effect of Ca on the stability of paragonite is dependent on mineral assemblage at different P–T conditions. The calculated NCKFMASH diagrams are powerful in delineating the phase equilibria and P–T conditions of natural pelitic assemblages. Moreover, contours of the calculated phengite Si isopleths in P–T and P–XCa pseudosections confirm that phengite barometry in NCKFMASH is strongly dependent on mineral assemblage.


Two alpha-methylene-gamma-butyrolactone--thymine heterodimers 6 and 7 with 5 and 10 carbon alkyl chains, respectively, were prepared to study the photoreactivity of lactone rings toward thymine and the influence of spacer length on photoadduct geometry. Deoxygenated solutions (10(-3) M) of heterodimers 6 and 7 were irradiated at 365 nm in acetone. Irradiation of compound 6 (5 carbons alkyl chain) gave a single photoadduct 8 (70% yield), while irradiation of compound 7 (10 carbons alkyl chain) gave two photoadducts 9a and 9b in a 3/2 ratio (95% yield). Compound 8 was identified as a cis-syn-endo intramolecular [2 + 2] photoadduct involving the 5",6" double bond of the thymine moiety and the 3,6 exomethylenic group of the lactone. Compound 9a was identified as a cis-syn-exo intramolecular [2 + 2] photoadduct involving the 5",6" double bond of the thymine moiety and the 3,6 exomethylenic group of the lactone, and compound 9b as the corresponding cis-syn-endo intramolecular [2 + 2] photoadduct.


Percutaneous dilatational tracheostomy (PDT) is a frequently performed surgical procedure on critically ill patients. This study was designed to compare its two methods: Griggs guide wire dilating forceps (GWDF) technique and the ULTRA-perc single-stage dilator technique Materials and Methods: Thirty Intensive Care Unit (ICU) patients on prolonged mechanical ventilation and requiring tracheostomy were included in our prospective randomized study. The first group (GP-GWDF) underwent PDT by the GWDF technique and the second group by the ULTRA-perc technique (GP-UP). Time for the procedure and early and late procedural complications were recorded and compared in between the two groups. Results: Time taken for tracheostomy was 11.68 ± 6.48 min for GP-GWDF and 13.93 ± 11.54 min for GP-UP (P-value 0.486). Desaturation was noted in two patients in GP-GWDF versus five in GP-UP (P-value = 0.195). Hypercapnea and rise in peak airway pressure occurred in one patient in GP-GWDF versus two in GP-UP (P-value = 0.543). Loss of airway was recorded in two patients in GP-UP and in none in GP-GWDF (P-value = 0.143). Subcutaneous emphysema, pneumothorax and pneumomediastinum occurred in one patient in GP-UP. No major complications were observed in GP-GWDF (P-value = 0.309). Hoarseness of voice was noted in one patient in each group (P-value = 0.659). Conclusion: Both the techniques seem to be equally reliable for carrying out PDT at bedside in the ICU.


Abstract Background In South Africa, overweight/obesity is a public health concern, disproportionally affecting Black females. A contributory role of a lower resting energy expenditure (REE) is suggested for African Americans. The present study assessed the REE of Black and White South African adults aiming to better understand the underlying predictors to overweight/obesity and transform this into locally appropriate recommendations. Methods In 328 (63% female; 39% Black) healthy South African adults, REE was measured with indirect calorimetry and body composition with multifrequency bioelectrical impedance analysis. The REE was estimated with 30 sets of published equations. Black–White differences in REE, as measured and adjusted (analysis of covariance), were determined with quantile regression. Reliability/agreement of estimated (against measured) REE was determined with intra‐class correlations (ICCs) and Bland–Altman analysis. A new equation was developed by median regression followed by preliminary validation. Results Measured REE (adjusted for age along with fat‐free mass [FFM], FFM index, FFM plus fat mass, FFM index plus fat mass index) in White subjects was significantly higher (p < 0.001) than in Black subjects for men and women alike, regardless of obesity class. None of the sets of estimation equations had good agreement with measured REE for Black, White, male and female subjects simultaneously. A new estimation equation, based on whole‐body variables, had good reliability (ICC = 0.79) and agreement (mean difference: 27 kJ) and presents practical opportunities for groups at the local grass‐roots level. Conclusions The REE in Black South African adults is lower than in White adults. Tailored REE equations may improve REE estimation of racially/ethnically diverse South African groups and contribute to improved obesity management.


The author, speaking as a Mozambican researcher living and working in Portugal, examines the different types of knowledge about the history of the colonial relationship and the independence movement produced in the two countries. The colonial project entailed the con- struction of (at least) two divergent narratives on the meanings of the Portuguese presence in Mozambique, narratives that render difficult any possibility of mutual recognition. Colonialism involved much forgetting and silencing; the dominant Eurocentric perspective on colonial his- tory needs to be questioned and problematized. This is not contradictory with a critical question- ing of the official post-colonial narrative of the independent Mozambican state, whose nation- building function caused it to silence the diversity of memories generated by the interaction between colonizers and colonized and to justify the repression of those who questioned the offi- cial version of history. Public narratives, official or otherwise, that construct or reconstruct mem- ories are inevitably in competition with each other and reflect power relations. But the full plurality of memory does not receive public attention; it must be dug out by activist researchers who are able to distinguish subject and object and to produce knowledge in full understanding of the complex relations created by historical legacies.


BACKGROUND
We have previously demonstrated that angiotensin II (Ang II) levels in the interstitial fluid (ISF) space of the heart are higher than in the blood plasma and do not change after systemic infusion of Ang I. In this study, we assess the enzymatic mechanisms (chymase versus ACE) by which Ang II is generated in the ISF space of the dog heart in vivo.

METHODS AND RESULTS
Cardiac microdialysis probes were implanted in the left ventricular (LV) myocardium (3 to 4 probes per dog) of 12 anesthetized open-chest normal dogs. ISF Ang I and II levels were measured at baseline and during ISF infusion of Ang I (15 micromol/L, n=12), Ang I+the ACE inhibitor captopril (cap) (2.5 mmol/L, n=4), Ang I+the chymase inhibitor chymostatin (chy) (1 mmol/L, n=4), and Ang I+cap+chy (n=4). ISF infusion of Ang I increased ISF Ang II levels 100-fold (P<0.01), whereas aortic and coronary sinus plasma Ang I and II levels were unaffected and were 100-fold lower than ISF levels. Compared with ISF infusion of Ang I alone, Ang I+cap (n=4) produced a greater reduction in ISF Ang II levels than did Ang I+chy (n=4) (71% versus 43%, P<0.01), whereas Ang I+cap+chy produced a 100% decrease in ISF Ang II levels.

CONCLUSIONS
This study demonstrates for the first time a very high capacity for conversion of Ang I to Ang II mediated by both ACE and chymase in the ISF space of the dog heart in vivo.


The dehydrogenative α-phosphonation of substituted N,N-dialkylanilines by dialkyl H-phosphonates was achieved under mild conditions by using environmentally benign iron(II) chloride as catalyst and tert-butyl hydroperoxide as oxidant. The reaction proceeded in the presence of electron-donating (methoxy, methyl, benzyl) and electron-withdrawing ring-substitutents (bromo, carbonyl, carboxyl, m-nitro) in moderate to good yields. The X-ray crystal structure of N-(5,5-dimethyl-2-oxo-2λ 5 -[1,3,2]dioxaphosphinan-2-yl-methyl)-N-methyl-p-toluidine was determined. Bis-(4-(dimethylamino)phenyl)methane and bis-4,4'-(dimethylamino)benzophenone underwent bisphosphonation selectively by respective monophosphonation at the remote dimethyl-amino groups. Furthermore, the use of excess dialkyl H-phosphonate and oxidant allowed us to functionalize both methyl groups of N(CH 3 ) 2 in N,N-dimethyl-p-toluidine and N,N-dimethylaminomesidine, respectively, to obtain α,α'-bisphosphonato-amines in high yield.


INTRODUCTION
Disability is a complex phenomenon, and the ways it has been conceived, explained and treated have varied notably throughout history. As the years go by, human beings have evolved and, at the same time, so have medicine and art. And therein lies the extraordinary value, from the ontological point of view, of many works of art, which would never have been produced without the intervention of disease and the practice of the medical art. The aim of this work is to address the study of some deficiencies, disabilities and neurological pathologies that have been represented in paintings at different times in history.

DEVELOPMENT
This article begins with the study of pictures that deal with dwarves and other misnamed freaks of nature that have been represented by painters from Velazquez to Titian or Rubens. The study looks at paintings of cripples, pictures containing the mentally disabled, with examples by Bruegel the Elder or Munch, as well as certain neurological disorders that have been portrayed in paintings, such as Escaping criticism by Pere Borrell or Sad inheritance by Sorolla. Likewise, we also reflect on the trite concept of disease and artistic creativity.

CONCLUSIONS
The artistic representation of deficiency and disability has evolved in parallel to the feelings of men and women in each period of history and, at the same time, their social evolution. Nowadays, this concept continues to advance and some artists no longer represent the sick person, but instead the illness itself.


BACKGROUND & OBJECTIVE
Cyclins overexpress in various tumors, but its expression in hepatocellular carcinoma (HCC) and its correlation to cell proliferation and apoptosis are unclear. This study was to determine the expression of Cyclins, proliferating cell nuclear antigen (PCNA), and cell apoptosis in HCC, and to analyze their interrelations.

METHODS
Tissue microarray technology and SP immunohistochemistry were used to detect expressions of Cyclins A, B1, D1, E, and PCNA in 122 specimens of HCC. In situ terminal deoxyribonucleotide transferase labeling was used to detect cell apoptosis.

RESULTS
In the 122 HCC specimens, positive rate of Cyclin A was 50.0%, of Cyclin B1 was 47.5%, of Cyclin D1 was 42.6%, of Cyclin E was 35.2%. Cyclins levels were significantly higher in HCC tissues of grade II, III, and IV than in HCC tissues of grade I(P 0.05). Densities of apoptotic cells were significantly lower in HCC tissues of grade II, III, and IV than in HCC tissues of grade I(P 0.05); PCNA scores were significantly higher in HCC tissues of grade II, III, and IV than in HCC tissues of grade I(P 0.01). The poorer differentiation, the lower density of apoptotic cells in HCC, the higher PCNA score in HCC. Cyclins levels were negatively related to density of apoptotic cells (r=-0.686, P < 0.01), and positively related to PCNA score (r=0.599, P < 0.01); density of apoptotic cells was negatively related to PCNA score (r=-0.701, P < 0.01).

CONCLUSION
Cyclins overexpress in HCC, which may shorten tumor cell cycle phase, accelerate cell proliferation and decrease apoptosis, and result in increased malignant phenotypes.


SUMMARY This paper outlines some of the differences between preconceptual and Aristotelian methodology and relates the origin of preconcepts to the ordinary conception of Science underlying in textbooks and laboratory manuals. A classroom strategy aimed at changing the prevailing methodology and developing a new basis for conceptual reconstruction is put forward.


ABSTRACT This essay explores the Mothers of East Los Angeles (MELA)—an environmental justice group started and led by older Mexican American women—and the organization's campaign to prevent the construction of a state prison in their neighborhood. The women enact motherwork that protects the well-being of the neighborhood's children, in addition to crafting motherhood into a communal responsibility to look after the neighborhood as a mother would their child. MELA's maternal appeals rely on and eclipse identification with traditional gender categories, suggesting new ways for motherhood to function as an organizing principle to mobilize collectives. More broadly, this essay contributes to scholarly discussions on rhetorical agency by considering motherhood as a means for women's collective resistance and empowerment.


Improving the catalyst stabilities under different conditions (water vapor, SO2, both water vapor and SO2) is important for industrial applications regarding catalytic NO deep oxidation by ozone. In this paper, Ce–Mn/ SA and Fe–Mn/SA catalysts were selected to investigate the stabilities. The results showed that the Ce–Mn/ SA exhibited excellent stability and resistance to SO2, while the Fe–Mn/SA only displayed excellent stability without moisture and SO2. Almost a 50% drop in efficiency was observed after deactivation by water vapor and water vapor together with SO2 for the two catalysts. The Fe–Mn/SA displayed inferior resistance to SO2. After stability testing with water vapor, the surface area, pore volume, and average pore diameter all decreased. The low adsorption energy of the H2O molecule resulted in the superior adsorption of water vapor, which occupied large amounts of active sites. XPS results showed that the ratio of Mn and chemisorbed oxygen decreased after deactivation. Mn favors NO oxidation, while Mn is favorable for ozone decomposition. Therefore, better performance in NO deep oxidation by ozone requires relative balance distribution between Mn and Mn. Interestingly, the TPD results showed that the NO desorption peak was unaffected and even increased a lot after water vapor stability testing. This could be attributed to the nitrates, formed by the N2O5 and H2O in liquid phase, that were adsorbed on the catalyst surface prior to NO, which contributes to a bigger NO desorption peak with lower NO adsorption ability. The trace of sulfate formed after SO2 stability testing was verified from TPD and TGA results, but it was not observed from the FTIR spectra, indicating the sulfate species formed during the ozonation process may not exist on the catalyst surface.


From Pontryagin's Maximum Principle to the Duke Kahanamoku Aquatic Complex; we develop the theory and generate implementable time efficient trajectories for a testbed autonomous underwater vehicle (AUV). This paper is the beginning of the journey from theory to implementation. We begin by considering pure motion trajectories and move into a rectangular trajectory which is a concatenation of pure surge and pure sway. These trajectories are tested using our numerical model and demonstrated by our AUV in the pool. In this paper we demonstrate that the above motions are realizable through our method, and we gain confidence in our numerical model. We conclude that using our current techniques, implementation of time efficient trajectories is likely to succeed. ∗This research is supported by NSF grants DMS-030641 and DMS0608583 †This research is partially supported by ONR grants: N00014-03-10969, N00014-04-1-0751 and N00014-04-1-075


correction of such a reentry when he observed The W olff-Parkinson-White (WPW) syndrome, . . . in a favourable experiment, the vigorous the most common variety of preexcitation, has for some time held a fascination for those circulating wave and its instantaneous arrest by interested in clinical electrophysiology because section of the ring is a sight not easily forgotten. it seems to represent a naturally occurring event which, if adequately understood, would un Courageous is the only way to describe the mask answers to many fundamental questions first attempt to surgically interrupt an accessory concerning mechanisms and treatment of car pathway. The immensity of the feat speaks for diac arrhythmias. Thus, it has been described by itself: Open heart surgery was performed to Scherf and Neufeld [1] as the "Rosetta Stone" divide an invisible stream of electrons! This of electrocardiography. historic event was not anticipated. A fisherman The historic overview of the pre excitation from the coast of North Carolina presented to syndromes will be deferred to Dr. Burchell's Duke University Medical Center in 1968 with authoritative chapter, but a few highlights de refractory supraventricular tachycardia related serve emphasis here because they graphically to the WPW syndrome [2]. Attempts to control portray how elements of serendipity, courage, the tachycardia medically failed. Dr. Andrew and luck played important roles in the unfold Wallace (then Director of the Coronary Care Unit) had recently returned from the NIH ing of the mysteries of preexcitation."


This article reconstructs the printing history of Hugo Grotius's Mare liberum ( The Free Sea , 1609). It examines the political circumstances which prompted the pamphlet's publication, but then seemed to conspire against it, and relates these to Grotius's revision of chapter 12 of Ms. BPL 917 in Leiden University Library, the one surviving copy of De iure praedae ( The Commentary on the Law of Prize and Booty , 1604-1608). While preparing chapter 12 for the press, he made a serious effort to tone down its bellicose rhetoric, erasing, for example, all references to the Spanish claims to the Americas. His aim was to placate the French envoy Pierre Jeannin and his own political patron Johan van Oldenbarnevelt, the driving forces behind the negotiations for the Twelve Years' Truce (1609-1621). In the context of these negotiations, Grotius was at pains to downplay his radical rights theories. The subjective right of punishment only received a mention in the conclusion of Mare liberum , for example. Yet a discarded outline for the pamphlet's preface shows that the argument of De iure praedae remained uppermost in his mind, witness the outline's denunciation of the 'poisonings, perfidy and crimes of the Portuguese'. Both De iure praedae and Mare liberum had been commissioned by the Dutch East India Company (VOC) for the express purpose of influencing political developments in its favour. Yet neither treatise had the impact originally intended by Grotius and the VOC directors. Ironically, these occasional writings became classics of international law instead.


The authors consider the dynamics of a defect tunnelling between two trap sites in a metal. The interaction with conduction electrons is shown to influence strongly the defect motion at low temperatures. They calculate the structure factor for inelastic neutron scattering. The inelastic scattering peaks found at very low temperatures are shown to merge into a single quasi-elastic peak at higher temperatures. The width of the quasi-elastic peak narrows as the temperature is increased further. This behaviour results from the damping of the defect motion through the non-adiabatic response of the screening cloud. The present paper extends the authors previous results for symmetric two-state systems to the asymmetric case.


It is shown that the non-additive part of the Casimir - Polder potential between three neutral isotropic ground-state atoms or molecules can be obtained in a simple way by generalizing a method that has recently been used for two-body forces. The electric field correlations of vacuum fluctuations in the presence of one atom are evaluated at the position of the other two atoms. This fluctuating field induces and correlates the dipole moments of these two atoms, such that their correlation function contains a term depending on the presence of the first atom. When the dipolar interaction between the induced dipoles is evaluated, this term yields the correct expression of the non-additive three-body Casimir - Polder potential. It is argued that this method prompts a new physical interpretation of three-body forces in terms of dressed vacuum field correlations.


A new solid-phase extraction technique has been developed for the speciation of trace dissolved Fe(II) and Fe(III) in environmental water samples with a microcolumn packed with crosslinked carboxymethyl konjac glucomannan (CCMKGM) prior to its determination by flame atomic absorption spectrometry (FAAS). Various influencing factors on the separation and preconcentration of Fe(II) and Fe(III), such as the acidity of the aqueous solution, sample flow rate and volume, and eluent concentration and volume, have been investigated systematically and optimized. Fe(III) could be quantitatively retained by CCMKGM in the pH range of 3.0–7.0, then the retained Fe(III) on the CCMKGM was eluted with 5.0 mol L−1 HCl after cleaning with 0.01 mol L−1 HCl to eliminate Fe(II) and determined by FAAS. Total Fe was determined after the oxidation of Fe(II) to Fe(III) by H2O2, and Fe(II) concentration was calculated by subtracting Fe(III) from total iron. The adsorption capacity of CCMKGM for Fe(III) was found to be as high as 162.3 mg g−1. The detection limit (3σ) for Fe(III) was 1.5 μg L−1 and the RSD was 3.5% (n = 11, c = 20 μg L−1) with an enrichment factor of 50. The proposed method has been applied to the speciation of iron in water samples with satisfactory results. © 2009 Wiley Periodicals, Inc. J Appl Polym Sci, 2009


For ethical, medical, financial as well as legal reasons scientific evaluation is mandatory in the field of public health or rehabilitative medicine. We prototype a fictive randomised and controlled study, taking into account numerous concerns against such a type of statistical analysis in the special field. The theoretical benefits of the study design do well balance its modest cost.


Recently, two special photonic jets, photonic hooks and twin photonic jets, have been proposed to deal with complex conditions in nanoscale manipulation. Photonic hooks are generated by a single light plane wave and an asymmetric microparticle, while the twin photonic jets are produced by two incident light beams. In this letter, we presented and demonstrated a method to combine photonic hooks and twin photonic jets. A single light plane wave and a symmetric microparticle, twin-ellipse microcylinder, are used in this research. The curvature degree, length and maximum E2 field enhancement of twin photonic hooks are varied significantly, with the change of refractive indices and shape of twin-ellipse microcylinder. And a liquid-immersed core-shell is built to achieve a flexible tunability.


Blood pressure monitoring with sphygmomanometers became common in anaesthesia in the early part of the 20th century, but it presented some challenges for the anaesthetist. Measurement by palpation was difficult as the anaesthetist often needed both hands for the administration of the anaesthetic and maintenance of the airway. Similarly, there was often insufficient access for auscultation with a stethoscope. In 1950, C.T.Barry published a paper entitled "Oscillometry during Anaesthesia" in which he "hoped to show ... that simple oscillometers are suitable for use in the theatre, and also have advantages of their own. The oscillometric index is a useful guide, the sensitivity of these instruments allows readings to be obtained when the pressure is too low to produce audible Korotkov sounds, and the recognition of cardiac irregularities is greatly facilitated"1. Oscillometry had its origins in 1876 with the work of Marey who noted oscillations were produced when measuring blood pressure. His work was hampered by mercury manometers which responded slowly and dampened the oscillations. While the Americans and the English continued using mercury manometers, the French and Germans introduced and improved anaeroid manometers2. These were based on the principle of barometers and utilised a Bourdon Tube, a hollow metal tube with a sealed distal end. This is shaped into an arc and connected to a system of levers which ultimately move a needle over a scale. Heinrich von Recklinghausen, the German physiologist, popularised the anaeroid manometer for blood pressure measurement. Heinrich was the son of Friedrich Daniel, the famous pathologist who described von Recklinghausen's neurofibromatosis. He made significant contributions to the field of blood pressure measurement and published a lengthy and comprehensive textbook on the subject in 19403. In particular, he noted the need for a wider arm cuff, unlike the very narrow cuff that was first proposed by Riva-Rocci. Oscillometry required the use of a suitable instrument to magnify the oscillations produced in the cuff by the pulsations of the artery. Many instruments were designed; all involved the use of a sensitive membrane or capsule, the movements of which were amplified. The most successful instruments were derived from the work of von Bernd who placed the capsule in an airtight box, but his instrument was too sensitive to have commercial application. Pachon produced a simple and practical modification of von Bernd's oscillometer in an airtight box with a glass window. The box contained a very sensitive anaeroid capsule which communicated with a rubber arm cuff enclosed in canvas; the apparatus also had a pump, an escape valve and an anaeroid manometer to indicate the pressure. It was popular in Britain prior to 1950 and was still used in Europe at that time. It did have some limitations as the systolic pressure reading was very inaccurate and practitioners relied more heavily on the 'oscillometric index'. This index was devised by Pachon and consisted of a scale of graduations which allowed measurement of the swing of the needle. The significance of the index was widely debated and was thought to be governed by two factors: the pulse pressure and the tone of the peripheral arteries. In Barry's study of 204 cases, the index was seen to be a more accurate indication of problems developing during anaesthesia: "In sixteen ...cases, however, it was noted that although the systolic remained unchanged or actually rose, the oscillometric index showed a definite fall, sometimes associated with a deterioration in pulse and colour"1. The accuracy of oscillometers was improved by the use of a double cuff, first suggested for use in blood pressure measurement by Amblard in 1908 and popularised by Gallavardin2. The double cuff allowed the upper cuff to be deflated while the lower cuff partially occluded the artery and thus provided further amplification of the pressure wave. Some early experiments were performed with double cuffs placing the lower cuff on the forearm, but these were never as popular as the more practical and accurate double, overlapping cuffs on the upper arm. The more sophisticated oscillotonometer developed from these early oscillometers and is widely attributed to von Recklinghausen. The device, which was extensively used in anaesthesia, consists of two cuffs, the upper black 5 cm cuff overlapping the lower red 10 cm cuff4. Both are connected to a single inflation bulb. The case contains a control lever, a release valve and two tambours, one connected to the atmosphere and the other to the lower sensing cuff. There is a mechanical amplification system connected to an oscillating needle and dial. Both cuffs and the airtight box are pressurised above systolic pressure and the control lever is then activated to produce a sustained leak from the upper cuff and the casing. The size of this leak is controlled by the release valve. When the needle oscillations show a definite increase, the lever is released and the needle stops at a point assumed to be the systolic pressure. Further activation of the lever allows observation of a definite decrease in the oscillations; release of the lever will again stop the needle and allow a reading of the diastolic pressure. There were two models of the von Recklinghausen oscillotonometer, the Scala Alternans and the later Scala Alternans Altera. In the earlier model the control lever had to be pushed intermittently and did not allow for a sustained leak during deflation. Hutton and Prys-Roberts' extensive study of the Alternans oscillotonometer in clinical practice concluded that the systolic and mean arterial pressures could be ascertained with some accuracy but that the readings were influenced by both the patient and the operator. They found the oscillotonometer "useless" for the determination of diastolic pressure5. The von Recklinghausen oscillotonometer was manufactured in Germany but the English instruction booklet was poorly translated and extremely complicated6. Reading it, there is no doubt that the operation of the device was open to a great deal of individual interpretation, a problem that was eventually solved by the development of the microprocessor and the creation of automatic blood pressure machines. C. Ball, R. N. Westhorpe Geoffrey Kaye Museum of Anaesthetic History REFERENCES Barry CT. Oscillometry during anaesthesia. Anaesthesia. 1950; 5:26-35. 1. Naqvi NH, Blaufox MD. Blood pressure measurement. An Illustrated 2. History. New York: The Parthenon Publishing Group; 1998. von Recklinghausen H. Blutdruckmessung und Kreislauf in den Arterien 3. des Menschen: Geschichte und heutige Lage der Probleme, neue Losungsversuche. Dresden; Leipzig: Steinkopff; 1940. Corall IM, Strunin L. Assessment of the Von Recklinghausen 4. oscillotonometer. Anaesthesia. 1975; 30:59-66. Hutton P, Prys-Roberts C. The oscillotonometer in theory and practice. 5. Br J Anaesth. 1982; 54:581-590. Instructions for the use of the Oscillotonometer "Scala alternans". 6. Geoffrey Kaye Museum of Anaesthetic History. von Recklinghausen oscillotonometer