This report aims in one hand to demonstrate the carried out iterative process of product development including the chosen framework, decision validation, tests and conclusions. On the other hand it intends to be a contribution for the creation of specific standards for surgical illumination. The premise of this project was the insufficient visualization in the deep pelvis during open surgery. The deep pelvis has a complex anatomy because it includes a great number of organs in a particularly small and curved cavity. Shadows, blood obstruction and procedure limitations are permanent challenges a surgeon must face when operating in this region. The available lighting options do not solve the problem since they provide no adequate light focus and are not designer to manoeuvre within space limitations. Other solutions in the market as specific small illuminators are considered to expensive or uncomfortable to use. Chapter 1 introduces the approach undertaken to the claimed problem. This analysis is structured in four main aspects that surround the field of design concerns in order to create a framework around which to work. The context topic is related to the experience of getting in touch with the medical subject for the first time. It is a complex field of specific scientific knowledge and strict rules which are fundamental to understand and be familiar with, in order to properly locate the designed product. Light is the particular domain of this assignment. A study of basic knowledge about light is introduced followed by the characterization of medical lighting. This study revealed its importance not only for the choice of an adequate light technology but also for the fact that the lessons learned in this chapter's topic were decisive for the development of the final design solution. The understanding of the behaviour of light and the working principle of optical fibres allowed a creative move towards a new product, based in a simple theory. In addition the light requirements for medical purpose were found to have few specialized standards. This project started up an inventory of important measurements to contribute for the surgical lighting knowledge necessary to develop good products. An overview of the existing products available in market made possible to understand that mostly optical fibre and LED light sources have potential for lighting a surgical scene. This is basically due to their size, minimal heat emission and light quality. Both technology and associated products have advantages and drawbacks that were considered for the development of this product. The topic about environment makes a call of attention to the problems related with the lifecycle of current products, such as plastic disposables, and their respective waste streams in particular the demanding biomedical waste management. An overview of the available options for the today's products disposal is made with the respective characterization. Solutions can and must be found in strategies of shared responsibility and contribution that start with designers, in collaboration with a network of professional, and end in the final user. The design of a new product must take in account this prior knowledge in order to perform better in the future. Throughout the complete chapter 1 several cross references are made to the appendix report. This document is, especially for the initial approach, an essential complement since it contains all the support information for the learning process in an extensive guide of in depth information. In chapter 2 the previous topics are synthesized in three different design opportunities which are related with the scope of the project. These were important in order to establish and communicate a stepwise decision process with the participation of the user. Additional ideas concerning the functionality of different products are reported, demonstrating that the operating room has space for several design improvements, from the logistic point of view to a technical product level. Chapter 3 reports the idea phase where the chosen design direction was further explored with an additional study of patents and idea generation. The sketch results lead to the development of the two more promising concepts that have integrative functions and don't imply the replacement of surgical tools but rather function together with them. The user is once again involved for a discussion of values for each solution. The choices made in this chapter are based in the main interest of the user. Performance/usability, commercial interest and light adequacy are the three main product characteristics that allow a good comparison between the presented options. Since there are no specific standards to compare the final choice with, a list of requirements of qualitative character is formulated. This list introduces for first time the most relevant evaluation factors used in both, development decisions and later assessment of the product. The factors are: (1) functionality - from ergonomics point of view: efficiency, safety and comfort, - (2) cost and (3) environment. The Extender add on is a concept dedicated to the perineal incision made in a Abdomino-Perineal approach where a rectal self retaining retractor is permanently used. The concept consists of a cordless, user independent device that integrates the illuminating feature with the elongation of the retractor's performance. Chapter 4 initiates the product development in detail. From the previous list of requirements a quantitative criteria is created that relates each qualitative requirement to specific knowledge gathered all through the analysis phase. In this way the product development finds fundament in required tangible features that allow the progress from a rough concept proposal to a final design. Choices are made relative to material, light and power sources and in the end, construction considerations are made defining the final product. This phase required the construction of small models to exemplify the Total Internal Reflection principle, measurements of light and force in context. The main challenges faced during this stage were the dimensioning of the product, the choice of a power source and its sterile use. A battery solution is suggested for current application but an advice is kept for the future application of better solutions, not yet available in market, as the free form Lithium polymer batteries. The product, Indirect, is designed according to manufacturing and to use limitations and is later modelled in Solid Works. Chapter 5 is dedicated to the evaluation of the designed product. This phase is meant firstly to verify that the intended use is accepted by the user. A product prototype is also built for tests related with the involved electronics addressing in particular the heat management of the light source. Finally chapter 6 makes the overview of the project with the most relevant conclusions and recommendations of different nature. The further development of the product is advised, namely with more accurate, perhaps official, tests and also additional research, as the lifecycle analysis of the device for a proper performance evaluation. This report encloses the complete undertaken process, from a first approach to the comprehensive results of a design project. The results are considered fruitful. This project was always faced as a part of a larger project that includes a complete inventory of ideas to improve the OR and the surgeon's profession. At times where high technology is given the highlights it is most important not to forget the backstage design which still moves the people and the world with well designed usable products.


The objective: to present current information about definitions, etiopathogenesis, clinical, laboratory and hemodynamic manifestations of septic cardiopathy, based on published data and the results of our own research.Results: septic cardiopathy is the most important pathogenetic component of sepsis, and cardiac dysfunction makes a significant contribution to its outcomes. It is found out that after staying in the intensive care unit for 3-4 days, the level of the inactive part of the precursor of the B-type natriuretic peptide (NT-proBNP) > 3,450 pg/ml indicates of the risk of death: area under ROC curve (AUC) 0.708 (p = 0.0041), sensitivity 63.6%, and specificity 66.7%. At the same time, NT-proBNP > 5,250 pg/ml is associated with the use of inotropic drugs: AUC 0.769 (p = 0.0007), sensitivity 76.9%, specificity 79.0%. The article describes the detection of septic cardiopathy using transpulmonary thermodilution and calculation of such indices as afterload-related cardiac performance and cardiac function index. Data on the age-related parameters of central hemodynamics and risk of pathological decrease in certain blood circulation indices characteristic of older patients are presented. The article discusses the feasibility of treating septic cardiopathy as a variant of acute heart failure, which can be manifested not only by a decreased systolic function (low left ventricular ejection fraction) but also by increased end-diastolic pressure in the ventricles (diastolic dysfunction) with a normal left ventricular ejection fraction.


The spectrum of fluctuations of the geomagnetic field extends from periods of < 10 years to periods of 106 years. Although cycles of constant period appear to be absent, definite segments of the spectrum may be associated with particular phenomena in the core. Secular variation with periods of 10 to 103 years is associated with changes in the nondipole field. Changes in the orientation and intensity of the main dipole contribute to the spectrum at about 104 years. At periods of 105 to 106 years, there may be a contribution from a random walk of the rotation axis. The more recent reversals of the polarity of the main dipole occur at characteristic intervals of about 106 years. The asymmetry of the nondipole component of the present geomagnetic field also appears in the results of new paleomagnetic studies of secular variation in the eastern Pacific basin. Two models for interpreting these results are presented, one based on lateral changes in the electrical conductivity of the lower mantle, and the other on the control of thermal convection patterns in the core by lateral temperature differences in the lower mantle.


The synthesis, structures, and magnetic properties of monomeric half-sandwich iron and cobalt imidazolin-2-iminato complexes have been comprehensively investigated. Salt metathesis reactions of [Cp'M(μ-I)]2 (1-M, M = Fe, Co; Cp' = η5-1,2,4-tri-tert-butylcyclopentadienyl) with [ImDippNLi]2 (ImDippN = 1,3-bis(2,6-diisopropylphenyl)imidazolin-2-iminato) furnishes the terminal half-sandwich compounds [Cp'M(NImDipp)] (2-M, M = Fe, Co), which can be regarded as models for elusive half-sandwich iron and cobalt imido complexes. X-ray diffraction analysis confirmed the structure motif of a one-legged piano stool. Complex 2-Co can also be prepared by an acid-base reaction between [Cp'Co{N(SiMe3)2}] (3-Co) and ImDippNH. The electronic and magnetic properties of 2-M and 3-Co were probed by 57Fe Mössbauer spectroscopy (M = Fe), X-band EPR spectroscopy (M = Co), and solid-state magnetic susceptibility measurements. In particular, the central metal atom adopts a high-spin (S = 2) state in 2-Fe, while the cobalt complex 2-Co represents a rare example of a Co(II) species with a coordination number different from six displaying a low-spin to high-spin spin-crossover (SCO) behavior. The experimental observations are complemented by DFT calculations.


A novel approach to the quantitative image reconstruction in diffuse optical tomography is proposed. The special structure of the transport equation is used to formulate the iterative image reconstruction algorithm as a process updating the estimates of the optical properties from the solution of an intermediate tomographic problem The ability of the technique to reconstruct simultaneously maps of both absorption and reduced scattering coefficients in 2D geometry is demonstrated using simulated frequency-domain data. The potential advantages of the new approach include its ability to fully retain the non-linear character of the inverse problem while at the same time avoiding either gradient or Jacobian calculations and eliminating the need in an additional regularization mechanism.


Abstract The purpose of this study was to examine high school students' experiences of leading a physical education (p.e.) class. In this qualitative study, data was collected from interviews with six students from the second grade in high school. The collected data has been analyzed using qualitative content analysis as method. Six categories emerged from the analysis: the influence of peer pressure, respect, the benefit of leadership, single or group-leadership, p.e compared to Swedish and advice from students about leadership. The result indicated that the students enjoyed leading p.e classes, that this type of practice was a good element in p.e. The students thought it could be hard to choose activity for the class and peer pressure sometimes affected. They also experienced a difficulty to get attention from other students during the class. The opinion about the leadership assignment as a compulsory part to receive better grades in physical education was questioned by the respondents.


Adenosine is an inhibitory neuromodulator in several brain regions. In the nucleus tractus soUtarius (NTS), however, adenosine exerts excitatory cardiovascular effects. The purpose of the present study was to elucidate the involvement of other endogenous mechanisms that could contribute to the final hemodynamic response to adenosine in this nucleus. In normotensive Sprague-Dawley rats, intra-NTS microinjection of adenosine (23 nmol/60 nl) decreased blood pressure and heart rate. These effects were blocked by prior administration of the specific adenosine receptor antagonist l,3-dipropyl-8-p-sulfophenylxanthine (0.92 nmol) and by the two glutamate receptor antagonists kynurenic acid and glutamic diethylester. The specificity of the adenosine-glutamate interaction in the NTS was demonstrated with adrenergic and angiotensin receptor antagonists that did not affect the adenosine response and by experiments with glutamate receptor antagonists that did not affect nicotine actions in the NTS. Furthermore, an increase in glutamate levels was demonstrated during perfusion of adenosine through a microdiatysis probe in the NTS of anesthetized rabbits. These findings indicate that adenosine increases the release of glutamate in the NTS and, thus, are at variance with the concept of a "universal" inhibitory effect of adenosine in the central nervous system.


Summary and Conclusions 1.Data were collected on the incidence of neural and visceral lymphomatosis and of osteopetrosis in 1,226 chickens inoculated with the filtrable agent of visceral lymphomatosis, 508 chickens in direct contact with inoculated sibs, and 687 isolated chickens. 2.The incidence of visceral lymphomatosis among inoculated groups varied from 33.8 to 95.0 per cent and osteopetrosis from zero to 60 per cent. In the various contact groups visceral lymphomatosis varied from 5.4 to 71.5 per cent. Osteopetrosis did not occur in any contact or isolated group and neural lymphomatosis was present to the extent of less than 3 per cent in any major group. 3.Of the four strains of lymphomatosis, RPL 12, 16, 18, and 20, only strain 12 gave significant contact transmission, and, even with this strain, it did not occur in all inoculations. The reasons for such variations were not determined. 4.High rates of contact transmission that occurred under experimental conditions were reduced to insignificant levels by confining inoculated and noninoculated lots to separate cubicles with solid walls but open tops. 5.Cubicle isolation to 60 days of age did not prevent all contact transmission, whereas cubicle isolation to 90 days in two other experiments resulted in no apparent contact transmission as measured by incidence of gross tumors to 300 days of age. 6.The extent of contact transmission in probits was found to have a direct linear relation to the exposure dosage when in terms of the logarithm of the percentage of the population inoculated. 7.Transmission results indicate that the causative agent of visceral lymphomatosis is different from that causing osteopetrosis and that causing neural lymphomatosis.


The physiological role of peroxisomal ascorbate peroxidases (pAPX) is unknown; therefore, we utilized pAPX4 knockdown rice and catalase (CAT) inhibition to assess its role in CAT compensation under high photorespiration. pAPX4 knockdown induced co-suppression in the expression of pAPX3. The rice mutants exhibited metabolic changes such as lower CAT and glycolate oxidase (GO) activities and reduced glyoxylate content; however, APX activity was not altered. CAT inhibition triggered different changes in the expression of CAT, APX and glutathione peroxidase (GPX) isoforms between non-transformed (NT) and silenced plants. These responses were associated with alterations in APX, GPX and GO activities, suggesting redox homeostasis differences. The glutathione oxidation-reduction states were modulated differently in mutants, and the ascorbate redox state was greatly affected in both genotypes. The pAPX suffered less oxidative stress and photosystem II (PSII) damage and displayed higher photosynthesis than the NT plants. The improved acclimation exhibited by the pAPX plants was indicated by lower H2 O2 accumulation, which was associated with lower GO activity and glyoxylate content. The suppression of both pAPXs and/or its downstream metabolic and molecular effects may trigger favourable antioxidant and compensatory mechanisms to cope with CAT deficiency. This physiological acclimation may involve signalling by peroxisomal H2 O2 , which minimized the photorespiration.


The cardiac L-type Ca(2+) channel plays a key role in cardiac excitation-contraction coupling, action potential duration, and gene expression. Abnormalities in CaV1.2 function, including increased long-opening-mode gating and blunted adrenergic responsiveness, are associated with heart failure and hypertrophy. The increased activation of CaV1.2, in turn, triggers Ca(2+) -responsive signaling pathways, which contribute to the pathogenesis of heart failure and hypertrophy. CaV1.2 in heart is associated with large supramolecular complexes that impact on channel trafficking, localization, turnover, and function. Much of the prevailing dogma relating to mechanisms underlying CaV1.2 trafficking and modulation is derived from studies using recombinant channels reconstituted in heterologous expression systems. However, recent results using knock-in mice indicate that several long-standing "facts" about CaV1.2 regulation derived from heterologous expression studies are not replicated in native heart, emphasizing the critical need for mechanistic studies in the context of actual cardiomyocytes. In this review, we discuss the use of the use of knockin and knockout mice as well as new tools, including doxycycline-induced expression of informative α1C mutants within cardiomyocytes to probe adrenergic regulation of CaV1.2.


become an unwanted child. However, a wanted child is a great asset for parents and society. Therefore, there is a greater need for understanding and promotion of family planning services throughout the world. However, there are benefits and risks attached to all contraceptive methods. Every woman who chooses to use contraception should consult a trained health professional before, during and after using any contraceptive method. Finally, it is noteworthy that the risk of an unwanted pregnancy is far greater than being on the combined pill for one year. Nevertheless, a doctor or a family planning nurse can help a woman to choose an appropriate contraceptive method.


This report examines the current state of knowledge about green growth in cities and outlines the key research questions and protocols that will guide the OECD Green Cities programme. It builds the case for an urban green growth agenda by examining the economic and environmental conditions that have pushed the green growth agenda to the forefront of policy debate and assessing the critical role of cities in advancing green growth. Section 1 lays the context for the paper, examining why green growth is important and how it can be defined in an urban context. Section 2 focuses on policies and tools that enable the transition to green growth in cities. It concludes with a proposal for a policy framework for an urban green growth agenda that is based on a set of hypotheses of desirable economic scenarios. Section 3 examines the main challenges to advancing an urban green growth agenda. It explores the roles that multi-level governance, measuring and monitoring tools and finance must play in delivering green growth in cities. The report concludes with suggestions for future research, including recommendations on how national policymakers responsible for regional and urban policies can advance an urban green growth agenda.


We studied the incidence of gastro‐oesophageal reflux (GOR) during general anaesthesia with the laryngeal mask airway (LMA) in a paediatric population with two ventilatory regimes: spontaneous breathing and controlled mechanical ventilation (CMV). Thirty children between 6 months and 15 years, ASA I‐II, for routine surgery, were randomly assigned in two groups: spontaneous ventilation (n=14), and CMV (n=16). A pH probe was situated in the central third of the oesophagus. Some 66% of the patients breathing spontaneously had GOR episodes vs. 92% of the patients with CMV (P < 0,01). Reflux took place mainly after LMA removal (21% vs. 68%; P < 0,01) and in the Postanaesthetic Care Unit (PACU) (29% vs. 43%; P < 0,05). There was a high incidence of GOR during general anaesthesia and in the PACU in paediatric patients anaesthetized with the LMA. GOR episodes were significantly more evident in the CMV group, mainly after LMA removal, but without clinical significance.


ABSTRACT Background: The World Health Organization recommends a market-ready, urine-based point-of-care diagnostic test for circulating cathodic antigens (CCA) to determine the prevalence of S. mansoni. This study evaluated the performance of the URINE CCA (SCHISTO) ECO TESTE® (POC-ECO), which is currently available in Brazil. Methods: Residents from eight sites with different prevalence estimates provided one urine sample for POC-ECO and one stool sample for Kato-Katz (KK) and Helmintex® (HTX) testing as an egg-detecting reference for infection status. Results: None of the study sites had significantly higher POC-ECO accuracy than KK. Conclusions: POC-ECO is not currently recommended in Brazilian schistosomiasis elimination programs.


The sEMG signals are collected from the vastus lateralis,vastus medialis,biceps femoris,and semitendinosus of lower extremity during level walking among control subjects and knee osteoarthritis (OA) patients,the latter including mild,moderate and severe degree.The 5-fold cross-validation is used to measure the accuracy of the proposed analysis algorithm on collected sEMG recordings.For comparison,the more classical feature vectors of form factor,degree of skewness,kurtosis,and wavelet entropy are also tested.In experiment,the normalized energy ratio and marginal spectrum ratio achieve larger accuracy than the other features for all the four muscular groups.Moreover the accuracy of vastus medialis and biceps femoris are larger than that of vastus lateralis and semitendinosus.These results suggest that the normalized energy ratio and marginal spectrum ratio via the analysis of knee sEMG signals by HHT can server as characteristic parameters to easily classify osteoarthritis with noninvasive method.The more important muscular groups for maintaining the knee joint function are medialis and biceps femoris;as a result of that they should be exercise especially for rehabilitation.


We construct a dynamic epistemic model for extensive form games, which generates a hierarchy of beliefs for each player over her opponents` strategies and beliefs, and tells us how those beliefs will be revised as the game proceeds. We use the model to analyze the implications of the assumption that the players possess common (true) belief in rationality, thus extending the concept of rationalizability to extensive form games.


In his seminal work, Against Method, Paul Feyerabend argued that the scientific method was an inadequate way to gain knowledge.1 Feyerabend preferred anarchistic science—science without rules about how to proceed in the quest for knowledge.2 He argued that the scientific method was too regimented and prescribed to allow for learning about the infinite complexity of the natural world.3 With a nod to this influential work, Bernard Harcourt's Against Prediction: Profiling, Policing, and Punishing in an Actuarial Age challenges the use of actuarial methods in the criminal justice system.4 In this provocative and innovative book, Harcourt argues that prediction has serious flaws and, more importantly, warps society's view of justice by focusing solely on justice that is quantifiable. Against Prediction seeks to redefine the debate in criminal justice from how society uses actuarial methods to whether society should use those methods at all. Harcourt answers this second question, as the title of his book suggests, in the negative—he argues that society should not use prediction in criminal justice. While Against Prediction falls short of redefining the debate, its criticism of actuarial methods provides a compelling critique of criminal justice decision making.


ABSTRACT Background: Fragmented QRS (fQRS) has been shown to be associated with poor outcome in various cardiovascular diseases. Non-dipper hypertension is also associated with increased cardiovascular mortality. The aim of our study is to investigate the relationship between fQRS and non-dipper status in hypertensive patients without left ventricular hypertrophy (LVH). Methods: This study included 106 hypertensive patients without LVH. Patients were divided into two groups: dipper hypertension and non-dipper hypertension. The presence of fQRS was analyzed from surface electrocardiography. Results: Frequency of fQRS (56% vs. 19.6%, p < 0.001) and mean number of leads with fQRS (1.9 ± 1.7 vs. 0.6 ± 1.0, p < 0.001) were significantly higher in patients with non-dipper hypertension compared to dipper hypertension. In addition, the number of leads with fQRS was positively correlated with systolic (r = 0.334, p < 0.001) and diastolic (r = 0.280, p = 0.004) blood pressures (BP). By a multivariate regression analysis, fQRS (OR: 5.207, 95% CI: 2.195–12.353, p < 0.001) was found to be independent predictor of non-dipper status. Conclusion: fQRS is independent predictor of non-dipper status in hypertensive patients without LVH. Also, the higher number of leads with fQRS is associated with higher sleep systolic and diastolic BPs.


Context: The treatment of colorectal cancer has improved considerably in recent years, but it remains the second commonest cause of cancer deaths in men and women in the United States. Better therapies have resulted in prolonged median survival for patients with metastatic disease and a select number of patients can now be cured. Evidence Acquisition: We conducted a computerized search using PubMed and Google Scholar for reports published between January 1993 and August 2009 using mesh headings and key words relating to the treatment of colorectal cancer. If reports identified by these criteria referred to other papers not in the initial search, then these were also reviewed if relevant to metastatic colorectal cancer (MCRC). Results: Seven new chemotherapy agents have been licensed for the treatment of advanced colorectal cancer, with associated improved median survival from 5 months to 2 years. Complete responses are rare with systemic chemotherapy alone, but higher overall response rates to systemic and intrahepatic chemotherapies have enabled initially unresectable patients to undergo potentially curative surgical resection of metastases. Improved surgical expertise together with the adjunctive use of radiofrequency ablation has further expanded the definition of resectability. Advances in the understanding of tumor biology have resulted in the development of clinically useful biomarkers and the emergence of active biological therapies. Conclusions: The multidisciplinary management of MCRC incorporating improved systemic and local therapies continues to improve median survival and enlarge the cohort of patients that can be approached with curative intent. Recent technological advances have facilitated a better understanding of tumor biology that promises continued advancements in patient care.


Upon receiving the output sequence streaming from a sequential encoder, a decoder reconstructs the corresponding input sequence that streamed to the encoder. Such an encoding and decoding scheme is commonly encountered in communication, cryptography, signal processing, and other applications. Given an encoder specification, decoder design can be error-prone and time consuming. Its automation may help designers improve productivity and justify encoder correctness. Though recent advances showed promising progress, there is still no complete method that decides whether a decoder exists for a finite state transition system. The quest for completely automatic decoder synthesis remains. This paper presents a complete and practical approach to automating decoder synthesis via incremental Boolean satisfiability solving and Craig interpolation. Experiments show that, for decoder-existent cases, our method synthesizes decoders effectively; for decoder-nonexistent cases, our method concludes the nonexistence instantly while prior methods may fail. Case studies are also conducted in synthesizing decoders for linear error-correcting codes.


To improve themaneuverability and agility of jumping robots, several researchers have studied steerable jumpingmechanisms. This steering ability enables robots to reach a particular target by controlling their jumping direction. To this end, we propose a novel direction-changing concept for miniature jumping robots. The proposed concept allows robots to be steerable while exertingminimal effects on jumping performance. The key design principles were adopted from the froghopper's power-producing hind legs and themoment cancellation accomplished by synchronized leg operation. These principles were applied via a pair of symmetrically positioned legs and conventional gears, whichweremodeled on the froghopper's anatomy. Each leg has its own thrusting energy, which improves jumping performance by allowing themechanism to thrust itself with both powerproducing legs. Conventional gears were utilized to simultaneously operate the legs and cancel out the moments that they induce, whichminimizes body spin. A prototype to verify the concept was built and tested by varying the initial jumping posture. Three jumping postures (synchronous, asynchronous, and single-legged)were tested to investigate how synchronization andmoment cancelling affect jumping performance. The results show that synchronous jumping allows the mechanism to change direction from –40° to 40°, with an improved take-off speed. The proposed concept can only be steered in a limited range of directions, but it has potential for use inminiature jumping robots that can change jumping directionwith aminimal drop in jumping performance.


The purpose of this report is to review available and emerging antihypertensive treatment options in light of current guidelines and evidence from large clinical trials. The published literature was reviewed for evidence regarding first-line options for antihypertensive agents, including thiazide-type diuretics, as monotherapy or as part of combination therapy. Current guidelines recommend using thiazide-type diuretics as first-line therapy alone or in combination with another agent. Other commonly used antihypertensive agents include calcium channel blockers, β-adrenergic receptor blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and the direct renin inhibitor, aliskiren. These agents are associated with varying degrees of evidence that they may provide protection from cardiovascular or renal disease beyond that associated with blood pressure reduction. Thiazide diuretics are inexpensive and effective but may not be preferable to other classes of antihypertensives that reduce blood pressure to a similar extent with a better safety profile and superior reductions in cardiovascular event rates. However, calcium channel blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and direct renin inhibitors also show promise as initial monotherapy or as part of a combination therapy regimen. In patients requiring additional blood pressure reduction, add-on therapy with a diuretic could provide additional blood pressure-lowering efficacy.


The purpose of this study was to test the direct and moderating effects of job strain variables on the Job Demand–Control–Support model. A total of 422 tourism employees completed a questionnaire. Hierarchical and moderated regression models were employed to test the proposed relationships between job strain variables and work-to-leisure conflict. Results indicated that job demands had a positive relationship with work-to-leisure conflict, whereas the schedule flexibility and the time-off flexibility were negatively related to work-to-leisure conflict. Results also found that supervisor support could moderate the influence of tourism employees' job demands on work-to-leisure conflict. Implications of stress management and job design for human resource department are discussed. Copyright © 2013 John Wiley & Sons, Ltd.


Novel properties of penta-graphene (PG) have stimulated great interest in exploring its potential for device applications. Here, we systematically study the interfacial properties of the heterojunctions constructed by stacking PG on several metal substrates (Ag, Al, Au, Cr, Cu, Pd, and Ti), which are commonly used in field-effect transistors. We consider PG as the channel material because of its semiconducting feature, while treating the metal surfaces as the electrodes. Based on first principles calculations, we show that PG preserves its pentagonal feature with some small distortions when deposited on the metal substrates but undergoes metallization due to the chemical bonding between PG and the metal surfaces. We evaluate the device potential of these PG-metal contacts by studying their tunneling barriers, orbital overlaps, and Schottky barriers. We find that PG forms an n-type Schottky barrier when in contact with Al, Cu, and Ti, but forms a p-type Schottky barrier when supported on Ag, Au, Cr, and Pd...


We study the emerging large-scale structures in networks subject to selective pressures that simultaneously drive toward higher modularity and robustness against random failures. We construct maximum-entropy null models that isolate the effects of the joint optimization on the network structure from any kind of evolutionary dynamics. Our analysis reveals a rich phase diagram of optimized structures, composed of many combinations of modular, core-periphery, and bipartite patterns. Furthermore, we observe parameter regions where the simultaneous optimization can be either synergistic or antagonistic, with the improvement of one criterion directly aiding or hindering the other, respectively. Our results show how interactions between different selective pressures can be pivotal in determining the emerging network structure, and that these interactions can be captured by simple network models.


Great effort has been exerted to redesign the supply chain network as a means to improve corporate competitiveness. In this study, we present a mathematical model and a solution system to help redesign corporate logistics networks. The objective of the model is to minimize total logistics costs. We applied the solution system to real problem cases. We use the model and the concept to develop decision support system that is based on C++ with the use of CPLEX callable library as a solution engine. We tested and verified the DSS for redesigning the network of a large Korean electronics company. Through various scenario analyses. we recommend to redesign their supply chain network that demonstrates the possibility of substantial logistics cost savings.


The substance inducing the production of pigment in the eyes of vermilion brown mutants of Drosophila melanogaster has been shown to be a relatively stable chemical entity possessing true hormone-like activity. A simple method for obtaining hormone solutions has been developed involving extraction of dried wild type Drosophila pupae with ethyl alcohol and water. A logarithmic proportionality has been found to exist between the amount of hormone and the induced eye color. This relationship provides a simple method for the quantitative determination of hormone concentration in given extracts. Larvae and pupae of D. melanogaster contain an intracellular enzyme which inactivates the hormone in the presence of molecular oxygen. The hormone is not oxidized under ordinary conditions with either molecular oxygen or hydrogen peroxide. The hormone has been found to be an amphoteric compound with both acidic and basic groups and with a molecular weight between 400 and 600. The solubility and precipitation reactions of the hormone suggest its amino acid-like nature. However, the instability to heat, acid, and alkali, and its rather restricted occurrence indicate a rather complex specific structure.


The paper presents an experimental investigation on the flow-induced vibrations of two tandem circular cylinders for spacing ratio $L/D=1.2{-}6.0$ and reduced velocity $U_{r}=3.8{-}47.8$ , where $L$ is the cylinder centre-to-centre spacing and $D$ is the cylinder diameter. Both cylinders are allowed to vibrate only laterally. Extensive measurements are conducted to capture the cylinder vibration and frequency responses, surface pressures, shedding frequencies and flow fields using laser vibrometer, hotwire, pressure scanner and PIV techniques. Four vibration regimes are identified based on the characteristics and generation mechanisms of the cylinder galloping vibrations. Several findings are made on the mechanisms of vibration generation and sustainability. First, the initial states (vibrating or fixed) of a cylinder may have a pronounced impact on the vibration of the other. Second, alternating reattachment, detachment, rolling up and shedding of the upper and lower gap shear layers all contribute to the vibrations. Third, the gap vortices around the base surface of the upstream cylinder produce positive work on the cylinder, sustaining the upstream cylinder vibration. Fourth, reattachment, detachment and switching of the gap shear layers result in largely positive work on the downstream cylinder, playing an important role in sustaining its vibration.


Efforts are underway to develop and implement nonanimal approaches which can characterize acute systemic lethality. A workshop was held in October 2019 to discuss developments in the prediction of acute oral lethality for chemicals and mixtures, as well as progress and needs in the understanding and modeling of mechanisms of acute lethality. During the workshop, each speaker led the group through a series of charge questions to determine clear next steps to progress the aims of the workshop. Participants concluded that a variety of approaches will be needed and should be applied in a tiered fashion. Non-testing approaches, including waiving tests, computational models for single chemicals, and calculating the acute lethality of mixtures based on the LD50 values of mixture components, could be used for some assessments now, especially in the very toxic or non-toxic classification ranges. Agencies can develop policies indicating contexts under which mathematical approaches for mixtures assessment are acceptable; to expand applicability, poorly predicted mixtures should be examined to understand discrepancies and adapt the approach. Transparency and an understanding of the variability of in vivo approaches are crucial to facilitate regulatory application of new approaches. In a replacement strategy, mechanistically based in vitro or in silico models will be needed to support non-testing approaches especially for highly acutely toxic chemicals. The workshop discussed approaches that can be used in the immediate or near term for some applications and identified remaining actions needed to implement approaches to fully replace the use of animals for acute systemic toxicity testing.


The combination of cryogenic sample temperatures with three-dimensional coherent diffractive imaging for the case of whole frozen-hydrated cells is discussed in the light of theoretical predictions of the achievable resolution.


Globalization as a concept surpasses a mere openness to symbiotic economic relationship. Globalization refers to the level of openness and positive attitude towards the products, values and ideologies of other people and cultures. The study reviews existing literature on the impact of globalization on work ethics across the globe and tries to observe possible trends of convergence of work ethics among several countries. Most of the reviewed studies revealed a significant impact of globalization on work ethics. The more recent studies also showed trends of convergence among some countries that are geographically far apart and initially had different cultural orientations to work. Since globalization is a continuous process, the degree of this convergence may vary as time goes on.

 Key words: Globalization, global openness, capitalist work ethics, Islamic work ethics, socialist work ethics.


[1] The statistical properties of the flow structure in the Yucatan Channel's main section based on 2 years of continuous observations (August 1999 to June 2001) are compared with those simulated by the Ocean Parallelise (OPA) primitive equation model in two different configurations: the ATL6 configuration from the CLIPPER project (the whole Atlantic domain with a 1/6° resolution), and the Prototype Atlantique Mediterranee (PAM) configuration from the MERCATOR project (the North Atlantic domain with 1/12° resolution). While the observed 2-year mean transport into the Gulf of Mexico is 23.06 Sv, ATL6 has a 5-year mean of 27.49 Sv and PAM has a 3-year mean of 29.06 Sv. Apart from this discrepancy in the mean transport both simulations are able to reproduce well, in structure and magnitude, details of the mean current and its variability. Features like the Yucatan Current core and the deep countercurrents in the Yucatan and Cuban sides are both well reproduced, as is the presence of a minimum surface current variability at the center of the channel. The two principal empirical modes of current variability, which are related to the passage of eddies through the channel, are also reproduced by the simulations. The observed and simulated transports above and below the 6°C isotherm show no coherency at any frequency except for a significant coherent peak at a period around 20 days, which we interpret as a first baroclinic Kelvin mode between the two layers. As in the observations, the shedding of eddies by the Loop Current in the simulations is preceded by periods of diminished negative horizontal vorticity flux into the Gulf of Mexico.


We present an image compression algorithm that preserves high-frequency details and information of rare occurrences. Our approach can be thought of as image inpainting in the frequency scale space. Given an image, we construct a Laplacian image pyramid, and store only the finest and coarsest levels, thereby removing the middle-frequency of the image. Using a network backbone borrowed from an image super-resolution algorithm, we train our network to hallucinate the missing middle-level Laplacian image. We introduce a novel training paradigm where we train our algorithm using only a face dataset where the faces are aligned and scaled correctly. We demonstrate that image compression learned on this restricted dataset leads to better GAN network [1] convergence and generalization to completely different image domains. We also show that Lapacian inpainting could be simplified further with a few selective pixels as seeds.


Hepatocellular carcinoma (HCC) is one of the most common cancers and is associated with high mortality worldwide. The current gold standards for HCC surveillance are detection of serum α-fetoprotein (AFP) and ultrasonography; however, non-specificity of AFP and ultrasonography has frequently been reported. Therefore, alternative tools, especially novel specific tumor markers, are required. In this study, cytoplasmic membrane proteins were isolated from phorbol 12-myristate 13-acetate (PMA)-induced invasive HepG2 cells and identified using nano-scale liquid chromatographic tandem mass spectrometry (NLC-MS/MS) with comparison to non-treated controls. The results showed that two proteins, magnesium transporter protein 1 (MAGT1) and A-kinase anchor protein 13 (AKAP13), were highly expressed in PMA-treated HepG2 cells. This up-regulation was confirmed by real-time RT-PCR, western blot analysis, and immunofluorescent staining studies. Furthermore, evaluation of MAGT1 and AKAP13 expression in clinical HCC tissues by immunohistochemistry suggested that both proteins were strongly expressed in tumor tissues with significantly higher average immunoreactive scores of Remmele and Stegner (IRS) than in non-tumor tissues (P ≤ 0.005). In conclusion, the expression levels of MAGT1 and AKAP13 in HCC may be potential biomarkers for the diagnosis and prognosis of this cancer.


Mutagenesis was carried out in human lecithin:cholesterol acyltransferase (LCAT) to generate mutants with stop codons at positions corresponding to amino acids 315, 341, 359, 375, 388, 394, and 398 of the 416-amino acid sequence of the mature enzyme protein. Deletion of the 18 terminal amino acids of the protein was without effect on LCAT phospholipase or acyltransferase activity, or the stability of the protein to denaturation at 37 degrees C. Further deletion led to loss of most of the activity, associated with a 10-fold increase in the rate of denaturation at 37 degrees C. These data indicate that the proline-rich C-terminus of LCAT is not required for effective enzyme activity. The loss of activity that accompanied deletion of residues 394-398 suggests a structural role for these residues, part of a series of predicted beta-sheet sequences in the C-terminal third of the LCAT primary sequence.


The solar updraft tower (also: Solar Chimney) power technology (SUTPT) is simple, robust, sustainable, and a long lasting technology, producing electric power from solar radiation with low maintenance cost and no cooling water. A SUTPT plant will provide electric power over many decades. The feasibility of the SUTPT has been demonstrated successfully by the famous Manzanares Prototype and more recently by a number of project studies. The main goal of the special collection was to gather the current knowledge in thermodynamics, fluid-mechanics, structural engineering, as well as comparison of hybrid or alternative energy concepts. The associated discussions will facilitate exchanges of new ideas and provide a guide for future research directions in the SUTPT area.


7 Aim: To assess the use of chicken manure pellets, partially acidulated phosphate rock (PAPR) and cowpea residues to enhance the fertility and productivity of two Kandiustalfs in Zambia. Methodology: Six treatments; chicken manure, PAPR, cowpea residues, chicken manure with PAPR, cowpea residues with PAPR and no amendment (control) were assigned to 4 m x 4 m plots on each soil. The PAPR was applied at a rate of 40 kg P2O5/ha, chicken manure at 20 kg N/ha and cowpea was planted in rows 45 cm apart. Cowpeas or weeds were allowed to grow on each plot for four months when cowpea pods matured. Plants were cut, incorporated into the soil and left to decompose for six weeks. Soil samples were then collected for analysis of organic matter, N, P, K and greenhouse maize trials. Results: Cowpea residues, chicken manure and chicken manure with PAPR significantly increased levels of organic matter. Cowpea residues and cowpea residues with PAPR significantly increased levels of available N than the control. Available P levels significantly increased with application of cowpea residues and chicken manure with PAPR. Application of cowpea residues, cowpea residues with PAPR and chicken manure significantly increased levels of K than the control. Cowpea residues and cowpea residues with PAPR significantly increased maize dry matter yields than the control. The relative agronomic effectiveness (RAE) of cowpea residues was 66 % on Chakunkula soil and 37 % on Choma soil respectively. Conclusion: Cowpea residues are potential means of improving the fertility and productivity of acidic


Comparison of four pulse shape discrimination (PSD) methods was performed on the same digitized pulses from two different detector configurations. Beta/gamma discrimination of 90Sr and 137Cs was performed using a phoswich detector made of BC400 and BGO scintillators. Alpha/gamma discrimination of 210Po and 137Cs was performed using a CsI:Tl scintillation crystal. The pulse waveforms were digitized with a DGF-4C and analyzed offline with IGOR Pro software. The four pulse shape discrimination methods that were compared include: constant fraction discrimination (CFD), rise time discrimination (RTD), constant time discrimination (CTD), and charge comparison (CC). The CTD method resulted in a spillover of 9.2% (Figure of Merit, FOM=3.9) and 0.25% (FOM=3.2), while the CC method resulted in a spillover of 9.9% (FOM=3.3) and 0.033% (FOM=3.7) for the phoswich and CsI:Tl detectors, respectively. Although the CTD results in the lowest spillover for high signal-to-noise pulses, the optimized CC method, as implemented here, appears to be the best PSD method overall. Analysis of the reciprocal of the pulse shape data typically resulted in a significantly higher FOM than conventional methods with no reduction in spillover. This simple mathematical transformation of the pulse shape data illustrates that the FOM may not be a good scheme for the quantification of PSD


This paper documents a narratively-based interview guide for social work assessments used in Centrelink, a major Australian government department. The questions used in the assessment are illustrated by examples from conversations with the young people and their parents consulting the service, as well as reflections from the team of social workers who trialled the interview guide. The paper shows how working within existing governmental frameworks can still lead to conversations with clients that are respectful, generative, and hopeful.


Regional flood frequency analysis (RFFA) is widely used to estimate design floods in ungauged catchments. Most of the RFFA techniques are based on the annual maximum (AM) flood model; however, research has shown that the peaks-over-threshold (POT) model has greater flexibility than the AM model. There is a lack of studies on POT-based RFFA techniques. This paper presents the development of POT-based RFFA techniques, using regularised linear models (least absolute shrinkage and selection operator, ridge regression and elastic net regression). The results of these regularised linear models are compared with multiple linear regression. Data from 145 stream gauging stations of south-east Australia are used in this study. A leave-one-out cross-validation is adopted to compare these regression models. It has been found that the regularised linear models provide quite accurate flood quantile estimates, with a median relative error in the range of 37 to 47%, which outperform the AM-based RFFA techniques currently recommended in the Australian Rainfall and Runoff guideline. The developed RFFA technique can be used to estimate flood quantiles in ungauged catchments in the study region.


Nonlinear aeroelastic behavior is examined. This research extends the efforts of several recent investigations that address freeplay or piecewise nonlinearities in aeroelastic systems; however, in the studies described herein the authors address continuous nonlinearities such as those found in structural systems that exhibit spring hardening or softening effects. The authors describe a unique e utter test apparatus designed to permit experimental investigations of prescribed nonlinear response. The results of complementary analytical and experimental studies are presented for a nonlinear aeroelastic system limited to two degrees of freedom. Nomenclature


The prophylactic effect of heparin dihydroergotamine, the combination of these two (Heparin-Dihydergot) and acetylsalicylic-acid in the prevention of deep vein thrombosis was investigated in a prospective randomized clinical trial involving 454 patients. Evidence of thrombosis was detected by the 125I-fibrinogen-uptake-test in 22 out of 75 patients (29.3%) in the control group. The application of 2 x 0.5 mgDHE or 2 x 5000 IU of heparin reduced the incidence of deep vein thrombosis to 7%, which is statistically significant. After simultaneous prophylaxis with both drugs the incidence dropped to 2%. The combined use of DHE and heparin may be considered the best prophylactic regimen available for lowering postoperative DVT. After application of 3 x 0.5 g of ASS frequency of DVT decreased only to 15.3% and shows poor prophylactic efficacy.


Among the recently discovered myeloma‐specific gene alterations associated with chromosomal translocations, cyclin D1/PRAD1/Bcl‐1 overexpression caused by t(11;14)(q13;q32) is considered to be the most frequent in myeloma patients and cell lines, and may be a prognostic factor clinically. To elucidate the cellular biological role of overexpressed cyclin D1 in myeloma cells, we examined the mRNA expression levels of cell cycle regulators including three cyclin Ds, cyclin‐dependent kinase inhibitors (CDK‐Is) and accelerators. Cyclin D1 overexpression was clearly demonstrated in the lines with abnormal 11q13 and associated with overexpression of S and G2 accelerator genes. The cyclin D1‐overexpressing lines tended to have a shortened G1 phase compared with the non‐expressing lines. In addition, artificial silencing using antisense oligonucleotides for cyclin D1 suppressed the growth rate of some but not all cyclin D1‐overexpressing cells. These results indicate that overexpression of cyclin D1 caused by cytogenetic abnormalities may make cells progress through the cell cycle rapidly, but it seems that other factors such as cyclin D2 and translocation‐related genes affect the cell cycle progression in myeloma cells.


Mixed (U, Pu) carbides are potential candidate fuels for future IV th generation reactor systems because of their high fissile atom density and their excellent thermal properties. They could contribute to an economical, more compact and efficient core design. Much less studied than oxides, a reassessment of their properties from more recent microanalysis techniques developed for the characterization of uranium oxides could draw benefit. Investigations will focus on UC considered to be a valid surrogate material for R&D studies on (U,Pu)C fuels. UC possesses a similar NaCl type crystal structure and allows larger possibilities for characterization with available techniques. UC is also thought to be a more simple system than uranium-plutonium mixed carbides. The object of this paper is the study of the influence of manufacturing parameters upon the microstructural properties of dense mono-carbides. The narrow range of composition over which the material is stable and its general chemical instability are the cause of many manufacturing difficulties. The carbo-thermic reaction using a mixture of UO 2 and carbon was used as the easiest way to synthetize the carbide powder. Because carbides will slowly oxidize in air, all fabrication stages and equipment required for sample preparation are handled in glove boxes in an argon atmosphere with particularly low oxygen content. Optimized processing conditions have been investigated in order to obtain a high density, single phase material after sintering. The influence of four sintering atmospheres has been investigated such as low vacuum, pure argon, argon/hydrogen and argon/hydrogen/methane. Their influences on sample chemical and physical characteristics are presented.


ABSTRACTWe analyzed the sensitivity of transient step-off responses of shallow-water marine controlled-source electromagnetic configurations, specifically, horizontal electric dipole sources and vertical electric dipole receivers in the near field of the time domain (HED-Ez(t)). The capabilities of this configuration were compared with commonly used configurations, specifically, horizontal electric dipole sources and horizontal electric dipole receivers in the frequency domain (HED-Ex(f)). By examining some simplified models of local hydrocarbon reservoirs representing separate resistive bodies of limited size buried at different depths in the conductive sediments, and an example of a complex 3D geologic structure, the applications of HED-Ez(t) and HED-Ex(f) configurations and their limitations in terms of depth, size, and transverse resistance were evaluated.


Small crack-initiation-arrest events so called Pop-ins often occur at COD tests for welds and COD values at such Pop-ins are usually very small in comparison with those at. the following final fractures. Present assessment regards Pop-in as a critical event because significance of Pop-ins for actual structures hasn't been made clear. Therefore much effort has been made in materials and welding procedures in order to prevent Pop-ins. It is, however, considered to be too conservative to assess Pop-in as initiation of critical brittle fracture if it.is proved that Pop-in makes no influence on the safety of actual structures. And so it is indispensable to clarify the significance of Pop-ins which occur at COD tests and to establish their safety assessment in actual structures.


In the current paradigm, it is believed that the compact VLBI radio core of radio-loud active galactic nuclei (AGNi) represents the innermost upstream regions of relativistic outflows. These regions of AGN jets have generally been modeled by a conical outflow with a roughly constant opening angle and flow speed. Nonetheless, some works suggest that a parabolic geometry would be more appropriate to fit the high energy spectral distribution properties and it has been recently found that, at least in some nearby radio galaxies, the geometry of the innermost regions of the jet is parabolic. We compile here multi-frequency core sizes of archival data to investigate the typically unresolved upstream regions of the jet geometry of a sample of 56 radio-loud AGNi. Data combined from the sources considered here are not consistent with the classic picture of a conical jet starting in the vicinity of the super-massive black hole (SMBH), and may exclude a pure parabolic outflow solution, but rather suggest an intermediate solution with quasi-parabolic streams, which are frequently seen in numerical simulations. Inspection of the large opening angles near the SMBH and the range of the Lorentz factors derived from our results support our analyses. Our result suggests that the conical jet paradigm in AGNi needs to be re-examined by millimeter/sub-millimeter VLBI observations.


One of the known dangerous attacks against wireless sensor networks (WSNs) is node replica. In this attack, adversary captures one or more normal nodes of the network, generates copies of them (replicas) and deploy them in the network. These copied nodes are controlled by the adversary which can establish a shared key with other nodes of the network easily and exchange information. In this paper, a novel algorithm is proposed to defend against this attack in static sensor networks. The proposed algorithm employs a multi-tree architecture to assign ID to the nodes dynamically and prevent attachment of the injected replica nodes to the network by the adversary. The efficiency of the proposed algorithm is evaluated in terms of memory, communication, and computation overheads and the results are compared with other existing algorithms. Comparison results indicate the superiority of the proposed algorithm in terms of mentioned measures. In addition, the proposed algorithm is simulated and its efficiency is evaluated in terms of probability of detecting replica nodes. Experiment results show that the proposed algorithm has favorable performance in detection of replica nodes.


We demonstrate that optically driven two-dimensional lattices of nonlinear metal nanoparticles can support a variety of dissipative localized modes including Faraday ripples, trapped and walking solitons, oscillons, and switching waves connecting different polarization states.


We have studied the early stage dynamics of ripple patterns on Si surfaces, in the fluence range of 1–3 × 1018 ions cm−2, as induced by medium energy Ar+-ion irradiation at room temperature. Under our experimental conditions, the ripple evolution is found to be in the linear regime, while a clear decreasing trend in the ripple wavelength is observed up to a certain time (fluence). Numerical simulations of a continuum model of ion-sputtered surfaces suggest that this anomalous behavior is due to the relaxation of the surface features of the experimental pristine surface during the initial stage of pattern formation. The observation of this hitherto unobserved behavior of the ripple wavelength seems to have been enabled by the use of medium energy ions, where the ripple wavelengths are found to be order(s) of magnitude larger than those at lower ion energies.


With an ageing population in the United Kingdom, atrial fibrillation has become an increasing cause of morbidity and mortality, and a burden on health resources. Drug therapies for the management of atrial fibrillation have a number of roles, including the restoration and maintenance of sinus rhythm and the prevention of thrombo-embolic complications. New anti-arrhythmic drugs are under development and alternatives to warfarin are being investigated. This article examines the current knowledge on the effectiveness of drug therapy in atrial fibrillation and discusses some aspects of the future of drug therapy for atrial fibrillation.


The presented KeyGraph for Files (KGF) helps a user to find timely files and their relationships to their major relevant files. KeyGraph, which was presented as a document indexing algorithm, is applied to a history of files accessed by the user, instead of to a document. This strategy of KGF is supported by analogies between a document and a history of one using files. The occurrences of words in a document and of files used in a sequence have common causal structures, and KeyGraph previously indexes documents taking advantage of the causal structure in a document. As an effect, timely files are obtained from the history of a user using files, in a similar manner to obtaining keywords from a document by KeyGraph.


Multi-photon excitation allows one to use tissue transmitting near-infrared (NIR) light to access excited states with energies corresponding to single-photon excitation in the visible or ultraviolet wavelength ranges. Here, we present an overview of the application of both simultaneous and sequential multi-photon excitation in studies directed towards the photochemical delivery ('uncaging') of bioactive small molecules such as nitric oxide (NO) to physiological targets. Particular focus will be directed towards the use of dyes with high two-photon absorption cross sections and lanthanide ion-doped upconverting nanoparticles as sensitizers to facilitate the uncaging of NO using NIR excitation.


This review article is based on scientific and popular science publications as well as articles from branch magazines that refer to the production of alcohol in Poland based on traditional grain raw materials. New trends in the production of broadly understood alcoholic beverages point to a return to traditional raw materials and production methods, preferably carried out in small, traditional distillery – crafted beers, local wines or spirits. Consumers desire a return to tradition, however, it is equally important to maintain the right quality and efficiency of production. The future of alcoholic beverages based on malted and unmalted cereals in Poland is associated with the search for specific varieties of cereals, their mixtures as well as fermentation and distillation processes that will allow the production of 'craft spirits'.


We investigated the adsorption and the diffusion of alkanes in the sodium-exchanged zeolite Mordenite (Na-MOR) using molecular simulations. MOR-type zeolite consists of main channels (6.5 × 7 Å) oriented along the z crystallographic axis that are connected to small side pockets (3.4 × 4.8 Å). It is well-known that the adsorption of alkanes in Na-MOR strongly depends on the precise location of the framework Al atoms either in the main channel or the side pockets (Calero and co-workers, Angew. Chem. Int. Ed. 2007, 46, 276). We found that this effect can be characterized by a single-order parameter: the number of framework Al in the main channel divided by the number of framework Al in the side pocket (M/S ratio). For any M/S ratio, the adsorption isotherm follows from a linear interpolation between the reference isotherms. This enabled us to predict adsorption isotherms for any distribution of the Al framework atoms or estimate the M/S ratio for a given isotherm. We found that the same model can predict the effect of the M/S ratio on the self-diffusion coefficient, the Maxwell-Stefan diffusion coefficient, and the accessible micropore volume.


Abstract. Acquired digital images are often corrupted by a lack of camera focus, faulty illumination, or missing data. An algorithm is presented for fusion of multiple corrupted images of a scene using the lifting wavelet transform. The method employs adaptive fusion arithmetic based on matrix completion and self-adaptive regional variance estimation. Characteristics of the wavelet coefficients are used to adaptively select fusion rules. Robust principal component analysis is applied to low-frequency image components, and regional variance estimation is applied to high-frequency components. Experiments reveal that the method is effective for multifocus, visible-light, and infrared image fusion. Compared with traditional algorithms, the new algorithm not only increases the amount of preserved information and clarity but also improves robustness.


Background: Studies on humans have revealed the beneficial effects of zinc (Zn) supplementation in patients with type-2 diabetes. Aim: The present study was designed to investigate the effects of zinc supplementation on blood glucose level in type-2 diabetic patients and determine the interaction between age and zinc supplementation on type-2 diabetic patients. Methods: A randomized placebo-control trial conducted in Bashir Hospital of Sialkot, Allama Iqbal Memorial Hospital Sialkot and Civil Hospital of Daska, Sialkot. 144 diabetic patients were selected including an expected drop-out rate of 20%. All the participants were randomly divided into Group 1 (Treatment group with intervention given Zn tablets 20 mg/day) and Group 2 (control group with placebo effect). Each group was further divided into 2 age categories Category 1 (30–50 years of age) and Category 2 (51–70 Years of age). Demographic data, Anthropometric measurements, 24-h dietary recall, serum blood glucose analysis, HbA1C, and serum zinc levels were recorded at the beginning (0 day) and end of the study (60 days). Results: Final fasting serum glucose levels were significantly lowered in group 1 with (p < 0.05) as compared to group 2, but interestingly, results were significant (p < 0.05) in the older age group (51–70 years) as compared to their younger age counterparts (30–50 years) of group2. A similar trend was also found in the HbA1c, serum Zn levels and BMI of the participants. Conclusion: Results implied the possible phenomenon of better response to Zn supplementation among aged patients as compared to younger counterparts, which may suggest higher Zn demands with advanced age.


Transition tracks are an alternative for enhancing the long-term serviceability and durability of concrete track components in railway bridges. The goal of this paper is to investigate the structural behavior for transition track systems of railway bridge deck ends. In this study, the structural behavior of transition tracks such as the variations in static, dynamic, and fatigue behaviors and dynamic properties (natural frequency and damping ratio) are assessed and compared through performing loading tests and finite element analyses using actual vehicle impact loadings. As a result, it is found that the structural behavior of the transition track system is expected to satisfy the actual vehicle impact loading, and the variation in the neutral axis and dynamic characteristics are not affected by the fatigue loading. Therefore, it is inferred that the structural capacity and long-term durability of the transition track system is proven.


Aspirin prolongs the bleeding time in normal subjects and inhibits platelet release and aggregation with connective tissue and other biological agents. We have investigated one of the possible mechanisms by which aspirin prolongs the bleeding time by comparing the effects of aspirin and placebo on the bleeding time and platelet aggregation with connective tissue in normal volunteers. Two separate studies were performed. Both showed prolongation of the bleeding time and inhibition of the platelet connective tissue reaction after aspirin, but only the second study showed a significant correlation between these changes. Both studies are reported in detail because the discrepancy between them illustrates some important principles that require consideration when relating the effects of drugs on platelet function in vitro to their effects in vivo. The findings suggest that when particular care is taken to standardize the measurement of the platelet connective tissue reaction in terms of the stimulus used, subject variability, and analysis of results, the prolonged bleeding time after aspirin can be shown to be related to the defect produced in the platelet connective tissue reaction.


Helicobacter pylori is the main cause of chronic gastritis and peptic ulcer disease in man and is also associated gastric cancer. The spiral shaped H. pylori moves through the gastric mucous layer and colonises the gastric epithelial cells. H. pylori adheres to specific mucosal structures, including mucus molecules, epithelial cells, glycoconjugates and extracellular matrix (ECM) proteins. The ECM is exposed after disruption of the gastric epithelium through the action of the vacuolating toxin A and other mechanisms. The binding of two ECM-proteins, vitronectin and plasminogen to H. pylori was investigated. It was observed that vitronectin binding to H. pylori varies among strains, in a sialic acid dependent manner and correlates to their haemagglutinating ability. The binding was pH dependent, protease and heat sensitive, suggesting that cell surface proteins bind vitronectin. Furthermore, a vitronectin binding protein (57 kDa and a pI of 8.7) of H. pylori CCUG 17874, was identified by two dimensional electrophoresis and Western blot. The amino-terminal amino acid sequence of the vitronectin binding protein was shown to be identical with the NH2-terminal of H. pylori catalase. The binding of plasminogen to H. pylori was a common phenomenon among H. pylori strains, and independent of the morphological state, spiral or coccoid. H. pylori CCUG 17874 interacts with plasminogen at the fifth kringle of the plasminogen molecule, through two cell surface proteins (42 and 57 kDa), distinct from the vitronectin binding protein. H. pylori surface bound plasminogen can be activated to plasmin, in the presence of tissue type plasminogen activator (tPA). The formation of H. pylori surface bound plasmin may be a mechanism to degrade ECM, and could prolong the healing process of gastric ulcers. (Less)


The first two chapters of this thesis describe a study of the kinetics of the gas phase addition of perfluoro-isopropyl and perfluoro-t-butyl radicals to various olefins. The radicals were produced by photolysing the corresponding perfluoroalkyl iodides. Temperature variation data allowed determination of relative Arrhenius parameters. The results are compared with the data available for other simple radicals, and a comparison between the radicals of the series CF3•, CF3CF2•, (CF3)2CF• and (CF3)3C •, in particular, gives valuable information as to the relative importance of steric and other effects in free radical addition reactions. Chapter 3 describes an attempt to determine the absolute rate constant for the recombination of perfluoro- isopropyl radicals. The rotating sector method was used, but, due to a certain amount of thermal initiation and to a first order termination process as well as the more usual bimolecular disappearance of the radicals, the simple mathematical treatment, presented by Shepp, could not be applied to our system. A modified treatment was used and the rate constant was determined at 46°c. The result was taken as evidence for an activation energy different from zero for the reaction. Chapter 4 is a study of the orientation of the addition of monoiodomethyl radicals to various fluorinated olefins, at 150°c Di-t-butyl peroxide was thermally decomposed and the methyl radicals produced initiated the free radical addition by astracting ioding for diiodomethane. The results are compared with the date of some related radicals.


The effect of the laser light on the discharge development characteristics in the active medium of an ArF excimer laser is investigated using a one-dimensional fluid model including laser-light-induced photo-ionization and photodetachment processes. These processes are found to have a significant effect at times after the maximum in the laser output signal. For example, the laser-light-driven interactions increase the bulk electron number density by a factor of two and the electric field adjacent to the cathode by a factor of 1.5. Near the anode, the field changes from slightly negative at early times to extremely positive near the end of the laser pulse, resulting in electron drift in the direction of the bulk plasma. This tendency of the field to change sign at the anode is not observed when photon processes are neglected. This strong field enhancement suggests the generation of a filamental instability at the electrodes, as is indicated by experiments.


We analyze equality of opportunity for earnings acquisition in France between 1973 and 1993 conditional on the father earnings in the earnings distribution using two waves of the French data set FQP. First, using stochastic dominance tools, we nd that inequality of opportunity has remained stable when conditioning on the earnings level of the father, while it has diminished when conditioning on his rank in the earnings distribution. The former result is explained by the stable intergenerational earnings elasticity. The latter by the decreasing wage inequality in the previous generation. Then, we decompose the evolution of inequality of opportunity using the mean logarithmic deviation and the results of regressions of descendants'earnings on their parents earnings. It is shown that the main reason beneath the reduction of inequality of opportunity lies in the decrease of earnings inequality taking place in the eighties. JEL Codes: D1, D3, J3


A 30-year-old manual laborer from Karnataka, India presented with intermittent low grade fever and diffuse headache for 1 month. On examination, patient had enlarged supraclavicular and cervical lymph nodes. Patient had positive Kernig′s sign and neck stiffness. Motor, sensory and cranial nerve examinations were within the normal limits. Abdominal, cardiovascular and chest examination did not yield any positive findings. Contrast enhanced computed tomography head was normal. Patient was suspected to have extrapulmonary tuberculosis. Patient was started on antitubercular drugs. Diagnostic lumbar puncture was performed. Wet mount and Giemsa smear preparation of cerebrospinal fluid (CSF) showed trophozoites suggestive of Acanthamoeba. CSF was cultured onto non-nutrient agar with an overlay of Escherichia coli. Wet mount made from the culture media yielded cysts and trophozoites of Acanthamoeba spp. Patient was diagnosed with Acanthamoeba meningitis and was started on specific therapy with Rifampicin 600 mg once a day, Cotrimoxazole 960 mg twice-a-day and Fluconazole 400 mg once daily for 2 weeks. Patient had a complete recovery and was discharged from the hospital.


Waiting time occupies an important position in user's quality-of-service (QoS) evaluation system. However, in conventional overlay cognitive radio networks (CRN), the secondary users are not permitted to transmit any personal information whenever the spectrum is occupied by primary users. It follows that the waiting time of users depends heavily on the primary spectrum occupancy, which, in turn, cannot guarantee the QoS of the secondary users. To remedy this, a game theoretical cooperative waiting-time reducing method (CWTRM) is proposed in a self-generated CRN to meet users' waiting-time demands. The proposed scheme divides the users to temporary primary and secondary groups instead of introducing an extraneous secondary network. Specifically, waiting users are served as temporary secondary users. The cooperation between them and the temporary primary users is proceeded in each frame to make reuse of the unused time fractions, thereby reducing the global waiting time of the network. The optimal relay power, pricing and corresponding cooperating strategies are determined with the utilisation of Stackelberg game and Hungarian method. Finally, the superiority of the proposed CWTRM over non-cooperative schemes is validated through simulations.


Pelvic organ prolapse (POP) decreases quality of life for many women, but its pathophysiology is poorly understood. We have previously shown that Lysyl oxidase‐like 1 knockout (Loxl1 KO) mice reliably prolapse with age and increased parity, similar to women. Both this model and clinical studies also indicate that altered elastin metabolism in pelvic floor tissues plays a role in POP manifestation, although it is unknown if this is a cause or effect. Using Loxl1 KO mice, we investigated the effects of genetic absence of Loxl1, vaginal parity, and presence of POP on the expression of genes and proteins key to the production and regulation of elastic matrix. Cultured cells isolated from vaginal explants of mice were assayed with Fastin for elastic matrix, as well as RT‐PCR and Western blot for expression of genes and proteins important for elastin homeostasis. Elastin synthesis significantly decreased with absence of LOXL1 and increased with parity (p < .001), but not with POP. Cells from prolapsed mice expressed significantly decreased MMP‐2 (p < .05) and increased TIMP‐4 (p < .05). The results suggest changes to elastin structure rather than amounts in prolapsed mice as well as poor postpartum elastin turnover, resulting in accumulation of damaged elastic fibers leading to abnormal tropoelastin deposition. POP may thus, be the result of an inability to initiate the molecular mechanisms necessary to clear and replace damaged elastic matrix in pelvic floor tissues after vaginal birth.


Introduction: Discharge Planning is one of various nursing duty agendas, starting from when patients are admitted to hospital up to being allowed to go home.  The phenomenon of implementation discharge planning for patients today is not optimal whereby nurses just do limited implementation of routine activities in the form of information on re-control. Based on those facts, the author wishes to study the analysis of impedance and enhancement factors in discharge planning implementation at hospitals.Methods: The researcher conducted investigation in February 2020 and involved exploration of some scientific papers journal from ScienceDirect, ProQuest, Scopus, and, PubMed as references with keywords nursing discharge planning, enhancement and impedance factors, implementation, and, hospital. This paper identified15 relevant research articles from 500 original full texts between 2010 and 2018 and analyzed inclusion criterion of enhancement and impedance factors in discharge planning implementation. It involves three RCTs, eight descriptive, and four qualitative research papersResults: As a result, there are found eight enhancement and five impedance factors influencing in discharge planning implementation. Meanwhile, from 3250 research respondents, 2125 persons reports enhanced factors contrary 1.125 samples imply impedance factors.Conclusion: The implementation discharge planning is influenced by some factors that should be given attention by nurses to do discharge planning properly.


Sirs: We do appreciate the interest in our study, stating that there were no statistically significant differences in sensitivities between self-collected vaginal swab (SCVS) and the combined SCVS and first catch urine (FCU) as one sample. Boman and Nylander highlight that different diagnostic methods may give different results. They claim that our study and a Dutch study presented in a poster (but to our knowledge not yet published) in 2007 at the ISSTDR/IUSTI meeting in Seattle, WA, USA indicate a difference in sensitivities according to whether strand displacement assay (SDA) or polymerase chain reaction (PCR) was used as the diagnostic method. We, however, disagree in their conclusion of the studies. In our study the sensitivities for SCVS and the combined SCVS–FCU specimens by PCR were 97.2% (105/108) and 94.4% (102/108), respectively. The corresponding outcome for SDA was 95.2% (60/63) and 96.8% (61/63), respectively. In the Dutch study when using SDA there were only two discordant samples but when using PCR there were nine. The sensitivities for SCVS and the combined SCVS– FCU specimens by PCR were 93.2% (41/44) and 88.6% (39/ 44), respectively, and by SDA were 96% (48/50) and 100% (50/50), respectively. No statistically significant differences or any clear trends were revealed in either study. This may of course have been caused by few positive tests sampled by each method, i.e. low power. Since there may be important differences in feasibility and convenience between SCVS and the combined sampling, due mainly to toilet accessibility, we do believe SCVS is a reliable sampling method and that it is, so far, the one to be recommended in a screening context, irrespective of which nucleic acid amplification test is used. We do agree that there is a need for further studies regarding optimal sampling methods when using common commercially available diagnostic methods, as well as in the necessity of investigating differences between methods for diagnosing genital Chlamydia trachomatis infections in women.


In this study, the production of polymer matrix composite material from prepreg with a hot press, which is a different method from the classical autoclave method, was optimized. The impact behavior of the composite materials produced was investigated. For this, 3mm thick and 90mm diameter aramid reinforced polymer matrix composite samples were produced by hot press method. Impact tests were carried out at 15, 30, 45J energy values. For the impact tests, a 10 mm radius semi-cylindrical steel tip was used. The weight of this tip is 5,045 kg. With the impact tests, the contact force time and energy time curves of the composite samples were obtained and the impact behaviors were interpreted from there. Accordingly, as the impact energy increased, there was an increase in the maximum contact forces of the composite samples and a decrease in the contact times. Considering the energy time graphs, it was determined that there was a decrease in the amount of absorbed energy of the samples as the impact velocity applied to the composite samples increased. Besides, considering the ratio of absorbed energy to applied energy, it was observed that the energy absorption ability dramatically decreased as the impact velocity increased. Finally, the densities of the composite samples produced with the hot press were determined according to the Archimedes principle.


For many years, multiserver1 operating systems have been demonstrating, by their design, high dependability and reliability. However, the design has inherent performance implications which were not easy to overcome. Until now the context switching and kernel involvement in the message passing was the performance bottleneck for such systems to get broader acceptance beyond niche domains. In contrast to other areas of software development where fitting the software to the parallelism is difficult, the new multicore hardware is a great match for the multiserver systems. We can run individual servers on different cores. This opens more room for further decomposition of the existing servers and thus improving dependability and live-updatability. We discuss in general the implications for the multiserver systems design and cover in detail the implementation and evaluation of a more dependable networking stack. We split the single stack into multiple servers which run on dedicated cores and communicate without kernel involvement. We think that the performance problems that have dogged multiserver operating systems since their inception should be reconsidered: it is possible to make multiserver systems fast on multicores.


Introduction:
Probiotic bacteria are live microbial food supplements that beneficially affect the host by improving its intestinal balance. The key event is that nonpathogenic microorganisms, such as strains of lactobacilli or bifidobacteria, can occupy a space in a human biofilm that otherwise would be colonized by a pathogen. Lactobacillus reuteri is an obligately heterofermentative resident in the gastrointestinal tracts of humans ,and it is reported to produce compounds that exhibit antagonistic activity ,i.e., reuterin and reutericyclin, which are water-soluble, broad-spectrum antimicrobials, effective over a wide pH range, and resistant to proteolytic and lipolytic enzymes .
Method: concerning lactobacilli-derived probiotics and oral effects, a search for publications in English was conducted in pubmed , google and medline.
Result: The results of four studies have confirmed that L. reuteri can reduce the counts of salivary streptococcus mutans with statistical significance of reduction (P < 0.05).
Conclusion: Bacteriotheraphy using lactobacilli-derived probiotics can be considered alternative and promising way to get rid of pathogenic members of the oral microflora.


In this paper we propose an algorithm for taxi telematics system. The paper shows how the central call server, call customer, and an empty taxi co-ordinate with one another. With this algorithm, the central call server works efficiently in response to the customer call as well as for an empty taxi. Location history data is required for the central call server to provide a map display of 'needy' customer spots to an empty taxi. Location tracker tracks the location of the taxi and stores it in a memory structure which provides a history of the locations traveled by the taxi in order to use it in future to generate reports which help in post accident analysis. Other mechanisms such as state tracer and pickup pattern provide further analysis information about the location and the speed of the taxi.


We present a new method to estimate three-point correlations in cosmic microwave background maps. Our fast Fourier transform-based implementation estimates three-point functions using all possible configurations (triangles) at a controlled resolution. The speed of the technique depends on both the resolution and the total number of pixels N. The resulting N log N scaling is substantially faster than naive methods with prohibitive N3 scaling. As an initial application, we measure three-point correlation functions in the first-year data release of the Wilkinson Microwave Anisotropy Probe (WMAP). We estimate 336 cross-correlations of any triplet of maps from the eight differential assemblies, scanning altogether 2.6 million triangular configurations. Using Gaussian signal plus realistic noise simulations, we perform a null hypothesis testing with regards to the Gaussianity of the cosmic microwave background. Our main result is that at the three-point level, WMAP is fully consistent with Gaussianity. To quantify the level of possible deviations, we introduce false discovery rate analysis, a novel statistical technique to analyze three-point measurements. This confirms that the data are consistent with Gaussianity at better than the 1 σ level when jointly considering all configurations. We constrain a specific non-Gaussian model using a quadratic expansion of the temperature field in terms of the fNLT parameter, ΔT/T = (ΔT/T)L + fNLT[(ΔT/T) - ⟨(ΔT/T)⟩], for which we construct an estimator from the three-point function. We find that using the skewness alone is more constraining than a heuristic suboptimal combination of all our results; our best estimate is fNLT = -110 ± 150, assuming a ΛCDM concordance model.


Abstract The paper aims to develop and apply a methodological approach that could help to reveal incentives and future strategies of key National Innovation System (NIS) players considering the influence of global social, economic, scientific, technological and ecological trends. To fulfil this aim, a blended foresight methodology was applied, grounded on the platform of economic and classic foresight theory and considering four possible directions for using foresight methods: investigating and building a common vision; supporting evidence-based decisions; promoting communication and participation; inducing transformation and integration into the decision-making process. The main results and findings of the research include a list of 19 global trends, defined from literature analysis and the author's expert knowledge, a short description of their influence on key NIS players, including society, business, infrastructure and institutions, science, education and government; and mapping more than 35 different foresight methods that could be used for revealing incentives and future strategies of key NIS players. The article's theoretical contribution to economic theory consists of several parts. First, a NIS conception is examined through the prism of global trends and a dynamic aspect, whereas it is mostly investigated from statistical and static perspectives. Second, applying foresight as an instrument for researching NIS as a system is a developing academic area with some theoretical gaps, considered in this article by designing a conceptional research framework. Third, blending different foresight methods is always a craft, and the approach applied in this article contributes to it. Finally, the article presents several important trends which will appear in NIS and its key players' transformation in the nearest 5–10 years. From practical implications, this article could be useful for proactive policymakers in the field of science, technology and innovation policy at national and regional levels for designing and providing measures for supporting innovation systems effectively. Foresight practitioners and experts are offered useful, practical ideas of different foresight methods and their possible combinations for everyday activities.


In this study, the effect of the lessons applied in the subject of Inclined Projectile Motion, by taking the 5E Model as basis, in the Physics lesson of GATA Noncommissioned Health Officer Preparation School's 1st grade, on students' academic success and attitude levels was investigated. The study was carried out on 84 students studying in GATA Noncommissioned Health Officer Preparation School's 1st grade on 2004-2005 spring semesters. In the study, multiple choice success test and attitude scale were used. At the analysis made at the end of the application, it was concluded that the experimentation group students on which the 5E Model had been applied were more successful than the control group students on which traditional method had been applied, and that they developed more positive attitudes towards the subject. In light of the findings obtained at the end of the study, recommendations were made.


THE OCCURRENCE of severe shock following myocardial infarction has generally been considered of such grave prognostic import as almost to negate the possibility of effective therapy. It remains true that shock is a grave prognostic indication, but it is encouraging to find more investigators directing their attention to a reasonable therapeutic approach. Inasmuch as the degree of shock is not necessarily in direct proportion to the size of the infarct, it is not unlikely that the resolution of the shock state could lead to recovery in a proportion of the patients who now succumb. Rosenbaum and Levine1reported a 51% mortality rate for cases of infarction complicated by moderate shock and a 93% mortality for those with severe shock. They considered the prognosis grave if the blood pressure remained at 80 mm. Hg or less for any length of time. Katz and Mintz2found that a systolic blood


This study aims to explore the nephrotoxicity due to use of combination of cyclosporine A and hormone in the treatment of nephrotic syndrome. From January 2018 to November 2019, 100 patients with primary nephrotic syndrome were divided into experimental and control groups, with 50 patients per group. The experimental group took oral cyclosporine A and prednisone tablets, while the control group received oral cyclosporine A combined with shock therapy. The contents of white blood cells, triglycerides, urine protein and cholesterol in the experimental group were lower than those in the control group, while their albumin content was significantly higher than the control values. Blood concentrations of cyclosporine A were significantly lower in non-nephrotoxic patients than in nephrotoxic patients. The high blood cyclosporine A level in patients (>200ng/mL) may be a factor for inducement of nephrotoxicity. Basal serum creatinine levels in nephrotoxic patients were significantly higher than those in non-nephrotoxic patients. Therefore, high basal creatinine level may be a contributing factor to nephrotoxicity. The combination of cyclosporine A and hormone is effective in the treatment of nephrotic syndrome. Blood cyclosporine A levels greater than 200ng/ml or elevated basal serum creatinine may be the cause of nephrotoxicity.


We investigated cardiovascular and coronary responses to intravenous infusions of adrenaline, which raised arterial concentrations in a stepwise fashion from basal to about 5-6 nmol.l-1, in 11 non-rejecting heart transplanted patients, and in eight intact innervated subjects. Cardiac adrenaline extraction and noradrenaline release rate were also measured. The transplanted patients showed larger increases in heart rate (36 +/- 11% vs 16 +/- 6%, P < 0.0001) and cardiac index (80 +/- 30% vs 56 +/- 19%, P < 0.05), while stroke volume increments were similar in the two groups (32 +/- 17% vs 35 +/- 13%). The study groups did not differ with respect to changes in arterial pressure, cardiac work or peripheral resistances. Coronary sinus blood flow increased to a greater extent in the transplanted group (75 +/- 35% vs 48 +/- 31%, P < 0.05) and myocardial oxygen consumption also tended to increase more in these patients (78 +/- 42% vs 48 +/- 34%, NS). Myocardial adrenaline extraction was greatly reduced in the transplant patients (-6 +/- 25% vs 64 +/- 18%, P < 0.001), while forearm adrenaline extraction was similar in the two groups (41 +/- 22% vs 40 +/- 23%, NS). Cardiac noradrenaline overflow tended to be lower in the transplanted group (12 +/- 62 vs 48 +/- 43 pmol.min-1, NS). There was a wide range of noradrenaline overflow values (-64 to 147 pmol.min-1) and definite high values in three patients. Cardiac noradrenaline overflow was not correlated to heart rate responsiveness to adrenaline. We conclude that patients with cardiac transplantation respond to adrenaline with exaggerated increases in heart rate and thus in cardiac output. High values of cardiac noradrenaline overflow are seen in some transplant recipients and may suggest reinnervation. Signs of reinnervation are not associated with consistently lower heart rate responses to beta-adrenergic stimulation.