There has been recent interest in the possibility that undiagnosed coeliac disease (CD) might be the cause of diverse clinical symptoms, most particularly "tired all the time".1 A recent study reported a prevalence of three in 100 cases in a primary care environment in which samples were taken from patients with a range of symptoms and signs.2 The second most frequent symptom reported by the endomysial antibody (EMA) positive patients was "being tired all the time". We decided to examine the prevalence of EMA in patients attending our tertiary referral centre with the diagnosis of chronic fatigue syndrome (CFS).

We tested serum from 100 consecutive patients (47 men, 53 women; median age, 40 years; range, 18–57) referred to …


Background: Mouth gag is usually used during Adeno/tonsillectomy surgeries, cleft palate repair, obstructive sleep apnea surgery and intraoral tumor excision. The placement of gag causes hemodynamic changes similar to laryngoscopy. The aim of this study is to evaluate the effect of mouth gag placement on optic nerve sheath diameter (ONSD) of pediatric patients. The secondary aim is to assess the relationship between neck extension for positioning of head and increase in ONSD measurement. Methods: The trial is registered to Australian New Zealand Clinical Trials Registry with Trial ID: ACTRN12618000551291. This prospective, observational study was performed in a tertiary university hospital operating theatre between 01.05.2018-01.07.2018. Thirty-five children aged < 18 years, with ASA I status, and scheduled for adeno/tonsillectomy surgeries were prospectively included in the study. Measurements of ONSD were performed (T0) after induction of anesthesia, (T1) after endotracheal intubation, (T2) after the placement of mouth gag and (T3) 20 minutes after the placement of mouth gag. The degree of neck extension was assessed by the angle between the Frankfort plane and horizontal plane of the operation table in natural position Results: All participants completed the study. There were significant differences in ONSD values according to time (p < 0.001). The maximum increase in ONSD values was detected after intubation (0.69±0.06 mm) and immediately after mouth gag placement (0.67±0.07 mm). ONSD values continued to increase 20 minutes after the gag placement. There was no relation between degree of neck extension and ONSD values (b = 0.63, p=0.715) Conclusions: Mouth gag application causes significant increases in ONSD measurements of children. Therefore, the duration of mouth gag application during surgeries might be limited. Trial registration: The trial is registered to Australian New Zealand Clinical Trials Registry with Trial ID: ACTRN12618000551291.


Author(s): Du, Lawrence | Advisor(s): Rifkin, Scott A. | Abstract: A long-term goal of biology has been to understand how DNA sequences specify complex multicellular living organisms. Understanding this mapping of sequence to form requires identification of cis-regulatory elements and parsing their roles in gene regulatory networks (GRNs). We have tackled this problem experimentally through the study of the C. elegans gut GRN, and by developing machine learning tools for predicting and visualizing cis-regulatory sites.For the C. elegans GRN, we examined the function of \textit{cis}-regulatory GATA motifs upstream of the gut master regulator elt-2. We found that despite similar conservation and binding capability to upstream activators, different GATA cis-regulatory motifs within the promoter of the C. elegans endoderm regulator elt-2 play distinctive roles in activating and modulating gene expression throughout development. By using single copy insertion promoter-reporter constructs and high resolution single-molecule RNA FISH, we determined that a single primary dominant GATA motif located -527 bp upstream of the elt-2 start codon was necessary for both embryonic activation and later maintenance of transcription, while nearby secondary GATA motifs played largely subtle roles in modulating postembryonic levels of elt-2. Mutation of the primary activating site increased low-level spatiotemporally ectopic stochastic transcription, indicating that this site acts repressively in non-endoderm cells. Our results reveal that CREs with similar GATA factor binding affinities in close proximity can play very divergent context-dependent roles in regulating the expression of a developmentally critical gene in vivo. In order to better understand CREs in a context dependent manner, we developed a convolutional neural network (CNN) based tool, DeepNuc, to explore how deep learning techniques can be used to examine cis-regulation. We have used DeepNuc to demonstrate that much of the information needed to define a worm promoter sequence is present in the primary DNA sequence, and we have also applied our tool for exploring miRNAs.


Although wind farms have an undeniable beneficial impact on the environment, certain negative environmental implications do appear as a consequence of their operation. One of them is the production of noise. The wind farm noise values decrease with distance, so that at a certain point they are within the legally prescribed limits. This is the case for individual wind farms noise impact assessments. However, with two or more wind farms in the same area, there is a superposition of noise and a consequential change in the noise value. The focus of the paper is on the results of modeling noise propagation in space in the case of the cumulative impact of two neighboring wind farms. The results are modeled during the process of strategically assessing the environment so as to determine territorial impacts and make informed decisions about future development. The paper presents the strategic answer to the model of the spatial propagation of noise in cases of cumulative impact with a view to including the preventive protection principle in the planning of several adjacent wind farms.


Estimating the age exactly and then producing the younger and older images of the person is important in security systems design. In this paper local binary patterns are used to classify the age from facial images. The local binary patterns (LBP) are fundamental properties of local image texture and the occurrence histogram of these patterns is an effective texture feature for face description. In the study we classify the FERET images according to their ages with 10 years intervals. The faces are divided into small regions from which the LBP histograms are extracted and concatenated into a feature vector to be used as an efficient face descriptor. For every new face presented to the system, spatial LBP histograms are produced and used to classify the image into one of the age classes. In the classification phase, minimum distance, nearest neighbor and k-nearest neighbor classifiers are used. The experimental results have shown that system performance is 80% for age estimation.


Preimplantation stage mouse embryos are known to be highly sensitive to the killing effect of DNA damaging agents such as radiation. Interestingly, however, this stage of development is well protected from radiation induction of malformation and carcinogenesis in postnatal life. In recent years, it has become clear that the stem cells of preimplantation stage embryos undergo extensive apoptosis after DNA damage. It has been postulated that this apoptosis is likely to be responsible for the resistance to malformation, by excluding cells carrying deleterious DNA damage. We have tested the possible role of apoptosis in elimination of gene and chromosome mutations in undifferentiated mouse embryonal carcinoma cell line, F9, transfected with human bcl‐2 cDNA. The colony radiosensitivity of F9 cells was not affected by overexpression of the bcl‐2 gene, but the apoptotic cell death was suppressed, as examined by DNA ladder assay and Hoechst staining. This suppression was accompanied by an increase in the frequencies of hprt mutation and micronucleus formation after X‐irradiation. These results support the idea that maintenance of genomic integrity during early development is likely to be executed by apoptotic elimination of cells at risk.


Basalt filament yarn is a kind of inorganic fiber material made from basalt rocks and has widely been used to produce textile preforms for composite reinforcement. However, most of basalt textile preforms found on the market are made with woven or directionally oriented warp knitted structures. Weft-knitted preforms made of basalt filament yarns are still very limited due to the difficulty of loop formation. This paper presents an experimental investigation of knitting basalt filament yarn using a computerized flat knitting machine. The knitting effects were discussed based on the analysis of the variations of the loop length and yarn damage with different important knitting parameters such as yarn input tension, stitch cam setting and fabric take-down tension. The comparisons with glass filament and wool/acrylic blended yarn under the same knitting conditions were also presented. The study has shown that the basalt filament yarns can be more easily knitted on a flat knitting machine than glass filament due to lower yarn damage effect and larger adjustment scope of stitch cam setting.


Several phosphors without rare-earth elements were synthesized by a simple and practical method. Depending on their wavelength emitting range upon UV excitation, i.e. blue, green or red, they were classified in three groups. The phosphors exhibiting the best performances in optical properties were selected to be incorporated in free-standing silicon films and combined with a 365 nm LED. The thermal quenching of phosphors as well as the photometric parameters of the luminescent composite films were investigated. This white emission of the combination between the rare-earth-free phosphors based silicon film and LED shows a CRI >75 and CCT around 4000 K which can fulfil the requirements for indoor domestic lighting source.


The Authors report the results of a study on the etiology of non-gonococcal urethritis (NGU) carried out on 180 male patients with NGU and on 50 healthy volunteers matched for age and sex. Chlamydia trachomatis infection was proven by culture in 54 (30%) of the NGU-patients and in none of the healthy controls. Ureaplasma urealyticum was recovered from men both with and without urethritis. Bacteria other than C. trachomatis were not found in NGU-patients in a significant percentage. All C. trachomatis-positive NGU-patients presented antibodies against C. trachomatis, by indirect fluorescence, while only 54% of C. trachomatis-negative NGU-patients and 22% of healthy volunteers, were positive. A further serological screening of 78 women with no history of urethritis or cervicitis and 44 children less than 10 years of age was carried out in order to investigate the prevalence of serum antibodies against C. trachomatis in groups of healthy population in Italy.


Abstract We have localized glycine-like immunoreactivity to provide new anatomical detail about glycinergic neurons in the turtle retina. A rabbit antiserum directed against a glycine/albumin conjugate was used with standard fluorescent and avidin-biotin labeling techniques. Some processes in the outer plexiform layer and many processes in the inner plexiform layer, numerous somata in the inner nuclear layer, and isolated somata in the ganglion cell layer were immunoreactive. The vast majority of labeled neurons were amacrine cells. One class of amacrine cells had well-labeled somata near the inner nuclear/inner plexiform layer border, which gave rise to thick primary processes that entered the inner plexiform layer and arborized near the border of strata 1 and 2 and in stratum 3. A second class of glycinergic neurons, consisting of putative interplexiform cells, was unique in that it gave rise to dendritic arborizations in both the outer plexiform layer and the inner plexiform layer. Some of the immunoreactive neurons in the ganglion cell layer were apparently displaced amacrine cells, while others were probably true ganglion cells because they gave rise to labeled axons, and many labeled axons were visible in the ganglion cell axon layer. These results suggested that glycine played an extensive role in the turtle retina, and that it was involved in many diverse synaptic interactions in both the outer plexiform layer and the inner plexiform layer.


Experimental paradigms are valuable insofar as the timing and other parameters of their stimuli are well specified and controlled, and insofar as they yield data relevant to the cognitive processing that occurs under ecologically valid conditions. These two goals often are at odds, since well controlled stimuli often are too repetitive to sustain subjects' motivation. Studies employing electroencephalography (EEG) are often especially sensitive to this dilemma between ecological validity and experimental control: attaining sufficient signal-to-noise in physiological averages demands large numbers of repeated trials within lengthy recording sessions, limiting the subject pool to individuals with the ability and patience to perform a set task over and over again. This constraint severely limits researchers' ability to investigate younger populations as well as clinical populations associated with heightened anxiety or attentional abnormalities. Even adult, non-clinical subjects may not be able to achieve their typical levels of performance or cognitive engagement: an unmotivated subject for whom an experimental task is little more than a chore is not the same, behaviourally, cognitively, or neurally, as a subject who is intrinsically motivated and engaged with the task. A growing body of literature demonstrates that embedding experiments within video games may provide a way between the horns of this dilemma between experimental control and ecological validity. The narrative of a game provides a more realistic context in which tasks occur, enhancing their ecological validity (Chaytor & Schmitter-Edgecombe, 2003). Moreover, this context provides motivation to complete tasks. In our game, subjects perform various missions to collect resources, fend off pirates, intercept communications or facilitate diplomatic relations. In so doing, they also perform an array of cognitive tasks, including a Posner attention-shifting paradigm (Posner, 1980), a go/no-go test of motor inhibition, a psychophysical motion coherence threshold task, the Embedded Figures Test (Witkin, 1950, 1954) and a theory-of-mind (Wimmer & Perner, 1983) task. The game software automatically registers game stimuli and subjects' actions and responses in a log file, and sends event codes to synchronise with physiological data recorders. Thus the game can be combined with physiological measures such as EEG or fMRI, and with moment-to-moment tracking of gaze. Gaze tracking can verify subjects' compliance with behavioural tasks (e.g. fixation) and overt attention to experimental stimuli, and also physiological arousal as reflected in pupil dilation (Bradley et al., 2008). At great enough sampling frequencies, gaze tracking may also help assess covert attention as reflected in microsaccades - eye movements that are too small to foveate a new object, but are as rapid in onset and have the same relationship between angular distance and peak velocity as do saccades that traverse greater distances. The distribution of directions of microsaccades correlates with the (otherwise) covert direction of attention (Hafed & Clark, 2002).


The objective this study is to determine the effectiveness of mechanical chest compressions on the return of spontaneous circulation on patients suffering a cardiac arrest and the good neurologic outcome when discharged. It was made a systematic review of the studies assessing the effectiveness of using mechanical devices on chest compressions on cardiac arrest patients in a prehospital context. Three RCTs, involving 7208 participants, from which 3027 belonged to the mechanical devices group and 4181 to the control group. The results shows no significant differences on the return of spontaneous circulation or good neurologic outcome when hospital using mechanical devices when compared to manual chest compressions. The mechanical CPR has no influence on return of spontaneous circulation, but presenting benefit with clinical relevance on good neurological outcome at hospital discharge.


Telepresence robots allow users to freely explore a remote space and provide a physical embodiment in that space. However, they lack a compelling representation of the remote user in the local space. We present VROOM (Virtual Robot Overlay for Online Meetings), a two-way system for exploring how to improve the social experience of robotic telepresence. For the local user, an augmented-reality (AR) interface shows a life-size avatar of the remote user overlaid on a telepresence robot. For the remote user, a head-mounted virtual-reality (VR) interface presents an immersive 360° view of the local space with mobile autonomy. The VR system tracks the remote user's head pose and hand movements, which are applied to an avatar. This provides the remote user with an identifiable self-embodiment and allows the local user to see the remote user's head direction and arm gestures.


BACKGROUND Helicopter transport (HT) is an important component of American trauma care, but prospectively identifying patients that would benefit from this resource remains difficult. The objective of this study was to assess the role of the National Trauma Triage Protocol (NTTP) in selecting patients that would benefit from HT. METHODS Subjects transported by HT or ground transport from the scene of injury in 2007 were identified using the National Trauma Databank version 8. Criteria from the stepwise NTTP available in the data set were collected including physiologic data, anatomic injuries identified by DRG International Classification of Diseases—9th Rev. codes, and age. Subgroups of patients who met specific triage criteria were evaluated using logistic regression to determine if transport modality was an independent predictor of survival after controlling for demographics, injury severity, prehospital time, and presence of other NTTP triage criteria. Standard test characteristics were calculated for each criterion to predict trauma center need (TCN). The performance of triage criteria to predict TCN was compared between the groups using independent receiver operating characteristic area under the curve analysis. RESULTS There were 258,387 subjects transported either by helicopter (16%) or by ground (84%). HT subjects were more severely injured (mean [SD], Injury Severity Score, 15.9 [12] vs. 10.2 [10], p < 0.01). Logistic regression identified HT as an independent predictor of survival in subjects with a subset of triage criteria, including penetrating injury, GCS<14, RR<10 or >29 breaths per minute, and age>55 years. Each criterion previously mentioned was significantly more predictive of TCN in the HT group than in the ground transport group (p < 0.01). CONCLUSION Patients who meet certain triage criteria in the field seem to have an independent survival benefit if transported to a trauma center by helicopter. Furthermore, these criteria are highly specific and more reliably predict TCN in the HT group. The specific triage criteria listed previously should be carefully considered when developing policies for scene helicopter use in the trauma setting. LEVEL OF EVIDENCE Prognostic study, level III.


Goal setting is important for everyone to be productive in life. Students particularly need to set aims to be successful in their academic and social life. The present descriptive study was designed to investigate whether the university students have set goals for their future; to what degree they are focused toward their life goals and what are the action plans in form of daily routine to achieve their aims. A sample of 209 students of BS (social sciences; semester I toVIII) was taken conveniently from University of Sargodha; University of Gujrat and University of the Punjab. A questionnaire having short and detailed open ended questions was used to collect the information. The content analysis of data revealed that majority of students even up to semester VIII had no clear aim before them. Students' having targets had very broader and scattered action plans. A greater number of students were wasting their time in activities like using internet and cell phones for other than academic purposes and wandering with friends. However a small number of students had clear targets and were focused enough to achieve them. They had clear and feasible action plans. Majority of such students had got guidance from their teachers at high school, college or university on how to set future goals and prepare action plans. In the light of findings it is suggested that career counseling services should be made available in all institutions to channelize the energies of youth for a better future by directing them to the right destination. Moreover, training must be provided to students on how to select appropriate future goals and how to adopt suitable action plan to achieve the set targets by utilizing their time and sources appropriately. Key words: goal setting, motivation, action plan, university students; future success


Management and biological factors combine to limit litter size in swine herds. With present technology, improving litter size depends upon increasing the number born in the first litter and prolonging sow longevity. Methods for improving size of the first litter rely on increasing the number of eggs ovulated and include flushing (increased feed for at least 10 days before breeding), selecting breeds with high ovulation rates, and delaying breeding until after the pubertal or first estrus. The first two methods are the most cost effective under farm conditions. Because litter size peaks at the fourth or fifth litter, it is also important to increase the proportion of multiparous sows in the herd. This can be accomplished by not culling sows as long as they are productive.; Swine Day, Manhattan, KS, November 19, 1987


OBJECTIVE: To evaluate the effect of alcohol on coronary heart disease (CHD), cancer incidence, and cancer mortality by smoking history.DESIGN/SETTING: A prospective, general community cohort was established with a baseline mailed questionnaire completed in 1986.PARTICIPANTS: A population-based sample of 41,836 Iowa women aged 55–69 years.MEASUREMENTS: Mortality (total, cancer, and CHD) and cancer incidence outcomes were collected through 1999. Relative hazard rates (HR) were calculated using Cox regression analyses.MAIN RESULTS: Among never smokers, alcohol consumption (≥14 g/day vs none) was inversely associated with age-adjusted CHD mortality (HR, 0.40; 95% confidence interval [CI], 0.19 to 0.84) and total mortality (HR, 0.71; 95% CI, 0.55 to 0.92). Among former smokers. alcohol consumption was also inversely associated with CHD mortality (HR, 0.45; 95% CI, 0.23 to 0.88) and total mortality (HR, 0.78; 95% CI, 0.62 to 0.97), but was positively associated with cancer incidence (HR, 1.25; 95% CI, 1.03 to 1.51). Among current smokers, alcohol consumption was not associated with CHD mortality (HR, 1.05; 95% CI, 0.73 to 1.50) or total mortality (HR, 1.07; 95% CI, 0.92 to 1.25), but was positively associated with cancer incidence (HR, 1.30; 95% CI, 1.10 to 1.54).CONCLUSIONS: Health behavior counseling regarding alcohol consumption for cardioprotection should include a discussion of the lack of a decreased risk of CHD mortality for current smokers and the increased cancer risk among former and current smokers.


The complexity of today's hundreds-of-million-transistor microprocessors all but guarantees imperfect first silicon, but leaves unanswered the question of what exactly will go wrong. This article describes features added to the cell broadband engine processor to enable debugging in the presence of such unknown events.


The vital capacity value of the lungs is very influential with the health of the human lungs because with the results the value of the vital capacity of the human lung can be diagnosed as normal or abnormal of the lungs. This study aims to make a means of detecting respiration gas flow rates in humans using an arduino uno-based YF-S201 flow sensor. From the results of data analysis of respiratory gas flow in adult male breathing with ages (20 years 30 years), (30 years 35 years), (35 years 45 years) and (45 years 50 years) as many as 15 users. there is an error of 3.86%, the value is generated from comparing the output of the equipment made by researchers with other tools of the brand Spirolab with as many as 15 users of different height and age. From 15 different users there are 2 users with abnormal lung conditions and 13 other users with normal lung conditions. The result of this error occurred because of the 15 users who were less relaxed when exhaling and breathing.


A large body of work suggests that biomolecular condensates ensuing from liquid-liquid phase separation mature into various material states. How this aging process is controlled and if the naive and mature phases can have differential functions is currently unknown. Using Caenorhabditis elegans as a model, we show that MEC-2 Stomatin undergoes a rigidity phase transition during maturation from fluid to viscoelastic, glass-like condensates that facilitate either transport or mechanotransduction. This switch is promoted by the SH3 domain of UNC-89/Titin/Obscurin through a direct interaction with MEC-2 and suggests a physiological role for a percolation transition in force transmission during body wall touch. Together, our data demonstrate a novel function for rigidity maturation during mechanotransduction and a previously unidentified role for Titin homologs in neurons.


IN OCTOBER, THE United States posted a 12-month trade deficit of nearly $600 billion. That figure has been rising steadily and breaking its own record month by month. Each increment adds to the United States' external debt, which is now estimated at over $2.6 trillion. The chart below shows how each has been increasing as a percentage of GDP. Are these increases in the trade deficit and the external debt matters of great immediate concern? No, say a remarkably large number of respected economists, adding that the only imminent danger in these figures is that they might provoke unwise but irresistible calls for protectionism and other equally harmful measures. One of those respected economists is Federal Reserve Board Chairman Alan Greenspan. Addressing a bankers' conference in May, Greenspan acknowledged that the trade deficit, at over 5 percent of GDP, was testing historic limits, especially since it was accompanied by a record budget deficit and record household debt. So why isn't Greenspan alarmed? Because, as the chairman said, the United States is simultaneously benefiting from a "one-time shift in the degree of globalization and innovation." Rapid industrialization and freer trade have lowered the cost of merchandise. The internationalization of investment and banking, coming at a time when America's robust capital markets are so attractive throughout the world, has lowered the cost of credit. The growing flexibility of world financial markets has made it easier for equity prices, product prices, and exchange rates to reestablish global balance without the sort of abrupt impacts on the U.S. economy that create crises. However, Greenspan stressed that one-time shifts don't last forever, and lately his optimistic outlook appears somewhat dampened by the large and ongoing accumulation of dollar assets by Asian central banks. In November, when he told another banking conference that "net claims against U.S. residents cannot continue to increase forever in international portfolios at their recent pace," Wall Street reacted as though it had received new and unpleasant information. At any rate, those massive currency interventions, particularly by China and Japan, have kept the dollar artificially high and Asian imports artificially cheap, and they trouble some economists much more than they do Greenspan. Former Treasury Secretary Lawrence Summers, for one, worries that the United States has found no effective way of preventing these currency transactions. [GRAPHIC OMITTED] In fact, Summers shares little of Greenspan's calm view of the trade deficit, and is especially concerned about the geopolitical implications of the rising external debt. "There is surely something odd," Summers told a group at the International Institute of Economics, "about the world's greatest power being the world's greatest debtor." He has a point. While it isn't easy for other nations to use the threat of calling that debt in order to achieve other political ends, neither is it impossible. The situation of the U.S. today stands in sharp contrast, for example, to that of the British Empire in the nineteenth century, when it was both the world's major power and major creditor. Divided commission IT IS NO SURPRISE that a Federal Reserve chairman and a former secretary of the Treasury from different political parties view a highly charged issue like the trade deficit from dissimilar perspectives. International trade has always been a subject from which professionals can draw vastly different conclusions using the same set of facts. At least Summers and Greenspan do share large areas of agreement, which is more than can be said of some of their colleagues. When Congress established the Trade Deficit Review Commission in 1999, it may have foreseen an end product that would represent bipartisan consensus. The commission's final report was well-researched and thorough, but bipartisan it definitely was not. …


Fibrosarcomas induced in Chinese hamsters and rats by Rous sarcomla virus and 7,12-dimethylbenz(a)anthracene are associated with nonrandom chromosome variation. Although histologically indistinguishable, the tumors induced by the virus or chemical in each host species are characterized by completely different karyotypic patterns.


Form-based visual programming languages, which include commercial spreadsheets and various research systems, have had a substantial impact on end-user computing. Research shows, however, that form-based visual programs often contain faults. We would like to provide at least some of the benefits of formal testing methodologies to the creators of these programs. This paper presents a testing methodology for form-based visual programs. To accommodate the evaluation model used with these programs, and the interactive process by which they are created, our methodology is validation driven and incremental. To accommodate the users of these languages, We provide an interface to the methodology that does not require an understanding of testing theory. We discuss our implementation of this methodology and empirical results achieved in its use.


Institutional settings in which large numbers of participants have the right and in some cases the responsibility to contribute to the proceedings pose particular challenges to the order and allocation of turns. These challenges are organizational, how to enable and order participation between large numbers of people, as well as moral and political—the fair, transparent, and even distribution of access to the floor. In this paper, we address two very different institutional settings—one political and the other economic—and consider how participants are provided opportunities to contribute to the proceedings in a fair and transparent manner. Drawing on ethnomethodology and conversation analysis, we examine the systematic management of turn allocation and demonstrate how multimodality is critical to understanding how particular institutions achieve their principal aims and outcomes. This study is based on the analysis of a substantial corpus of video recordings of public consultations concerned with the discussion of major public and private sector initiatives and auctions of fine art and antiques.


Spatial reasoning is a diverse topic; what might different spatial tasks have in common? One task where substantial progress has been made is qualitative spatial reasoning about motion. Unlike qualitative dynamics, purely qualitative spatial representations have not proven fruitful. Instead, a diagrammatic representation appears to be necessary. This paper begins by outlining the Metric Diagram/Place Vocab. ulary (MD/PV) model of qualitative spatial reasoning, illustrating its power with via two example systems-~FZ0B, a system which reasoned about motion, and CLOCK, a system which analysed fixed-axis mechanisms. We believe this model is applicable beyond simply reasoning about motion. We suspect that (1) some form of metric diagram is a central unifying factor in all spatial reasoning tasks and (2) for human spatial reasoning, the metric diagram is part of, or at least grounded in, our perceptual apparatus. In this spirit, we identify three other kinds of spatial reasoning tasks as research frontiers where substantial progress might also be made, and pose six challenge problems to serve as milestones. The frontiers are (I) deriving system function from concrete structural descriptions (2) representing and reasoning about spatially distributed systems and (3) explicating the role visual perception and recognition in reasoning.


Nowadays, patients are demanding not only enhancement to their dental (micro) esthetics, but also their overall facial (macro) esthetics. Soft tissue augmentation via dermal filling agents may be used to correct facial defects such as wrinkles caused by age, gravity, and trauma; thin lips; asymmetrical facial appearances; buccal fold depressions; and others. This article will review the pathogenesis of facial wrinkles, history, techniques, materials, complications, and clinical controversies regarding dermal fillers for soft tissue augmentation.


[structure: see text]. Macromolecules 1c and 2c bearing multiple redox-active sites are synthesized by an efficient palladium-catalyzed coupling of 2,5-dimethoxytolylmagnesium bromide with readily available hexakis(4-bromophenyl)benzene and tetrakis(4-bromophenyl)methane. These macromolecular electron donors undergo reversible oxidation at a constant potential of 1.15 V vs SCE to yield robust, multiply charged cation radicals that are isolated in pure form using SbCl(5) as an oxidant. These nanometer-size cation-radical salts are shown to act as efficient "electron sponges" toward a variety of electron donors.


Quantifier elimination over the reals is a central problem in computational real algebraic geometry, polynomial system solving and symbolic computation. Given a semi-algebraic formula (whose atoms are polynomial constraints) with quantifiers on some variables, it consists in computing a logically equivalent formula involving only unquantified variables. When there is no alternation of quantifiers, one has a one block quantifier elimination problem. This paper studies a variant of the one block quantifier elimination in which we compute an almost equivalent formula of the input. We design a new probabilistic efficient algorithm for solving this variant when the input is a system of polynomial equations satisfying some regularity assumptions. When the input is generic, involves s polynomials of degree bounded by D with n quantified variables and t unquantified ones, we prove that this algorithm outputs semi-algebraic formulas of degree bounded by D using O((n-s+1) 8t D 3t+2(t+D t) arithmetic operations in the ground field where D = 2(n+s) Ds(D-1)n-s+1(ns. In practice, it allows us to solve quantifier elimination problems which are out of reach of the state-of-the-art(up to 8 variables).


In high speed gearbox systems, the lubrication is generally provided using nozzles to create small oil jets that feed oil into the meshing zone. It is essential that the gear teeth are properly lubricated and that enough oil gets into the tooth spaces to permit sufficient cooling and prevent gearbox failure. A good understanding of the oil behaviour inside the gearbox is therefore desirable, to minimize lubrication losses and reduce the oil volume involved, and ensure gearbox reliability.In order to reach these objectives, a comprehensive numerical study of a single oil jet impinging radially on a single spur gear teeth has been carried out using the Volume of Fluid (VOF) method. The aims of this study are to evaluate the resistant torque produced by the oil jet lubrication, and to develop a physical understanding of the losses deriving from the oil-gear interaction, studying the droplets and ligaments formation produced by the breaking up of the jet as well as the formation of an oil film on the surface of the teeth.URANS calculations have been performed with the commercial code ANSYS FLUENT and an adaptive mesh approach has been developed as a way of significantly reducing the simulation costs. This method allows an automatic mesh refinement and/or coarsening at the air-oil interface based on the volume of fluid gradient, increasing the accuracy of the predictions of oil break-up as well as minimizing numerical diffusion of the interface. A global sensitivity analysis of adopted models has been carried out and a numerical set-up has been defined. Finally several simulations varying the oil injection angle have been performed, in order to evaluate how this parameter affects the resistant torque and the lubrication performances.© 2015 ASME


Chemically resolved atmospheric aerosol data sets from the largest intercomparison of the Aerodyne aerosol chemical speciation monitors (ACSMs) performed to date were collected at the French atmospheric supersite SIRTA. In total 13 quadrupole ACSMs (Q-ACSM) from the European ACTRIS ACSM network, one time-of-flight ACSM (ToFACSM), and one high-resolution ToF aerosol mass spectrometer (AMS) were operated in parallel for about 3 weeks in November and December 2013. Part 1 of this study reports on the accuracy and precision of the instruments for all the measured species. In this work we report on the intercomparison of organic components and the results from factor analysis source apportionment by positive matrix factorisation (PMF) utilising the multilinear engine 2 (ME-2). Published by Copernicus Publications on behalf of the European Geosciences Union. 2556 R. Fröhlich et al.: Intercomparison of ME-2 organic source apportionment Except for the organic contribution of mass-to-charge ratio m/z 44 to the total organics (f44), which varied by factors between 0.6 and 1.3 compared to the mean, the peaks in the organic mass spectra were similar among instruments. The m/z 44 differences in the spectra resulted in a variable f44 in the source profiles extracted by ME-2, but had only a minor influence on the extracted mass contributions of the sources. The presented source apportionment yielded four factors for all 15 instruments: hydrocarbonlike organic aerosol (HOA), cooking-related organic aerosol (COA), biomass burning-related organic aerosol (BBOA) and secondary oxygenated organic aerosol (OOA). ME-2 boundary conditions (profile constraints) were optimised individually by means of correlation to external data in order to achieve equivalent / comparable solutions for all ACSM instruments and the results are discussed together with the investigation of the influence of alternative anchors (reference profiles). A comparison of the ME-2 source apportionment output of all 15 instruments resulted in relative standard deviations (SD) from the mean between 13.7 and 22.7 % of the source's average mass contribution depending on the factors (HOA: 14.3± 2.2 %, COA: 15.0± 3.4 %, OOA: 41.5± 5.7 %, BBOA: 29.3± 5.0 %). Factors which tend to be subject to minor factor mixing (in this case COA) have higher relative uncertainties than factors which are recognised more readily like the OOA. Averaged over all factors and instruments the relative first SD from the mean of a source extracted with ME-2 was 17.2 %.


Sandor Karacsony (1891 – 1952) is a prominent fi gure in Hungarian pedagogy, in his educational work, and writings; he combined Reformed theology and education science theory. Karacsony interpreted the reform pedagogical responsibility (playfulness, experience-oriented education, etc.) principles, and studied that it referred to the different ages, e.g., the role and prospects of autonomy. However, for example, respecting the other people, placing the individual development into the center, creating benevolent atmosphere, etc., can be explained with his Calvinistic conviction as well (Karacsony, 1995, 2004). According to Karacsony, the joined development of body and soul is recognizable, we always have to look at the whole person. His conception has a lot of similarities with the dialectical conceptualization of Hubert Henz, Ernst Christian Trapp, and Friedrich Daniel Ernst Schleiermacher, furthermore with Dilthey, Nohl, and Wilhelm Flitner ' s pedagogical fundamental relation, communication-centered theory. Examining Sandor Karacsony ' s fi ndings on education, it can be stated that he speaks not so much about education but rather collaboration and a sharing of life. In short, the general aim of the upbringing is the increase and the fi nding of what is possible only with relating and common language.


This report has three sections and a key feature of our empirical analysis is the use of several types of advanced ICT activities such as enterprise resource planning systems, mobile internet access and e-commerce practices. The first section presents new empirical evidence regarding the impact of ICT/E-commerce activities on industry performance in Europe measured as employment and labour productivity growth. The data consists of multi-country industry level data for 14 European countries for the period 2002-2010. The main result of this section is that the increase in ICT/e-commerce activities over time has not lead to a decline in jobs. This holds true for both manufacturing and service industries. In contrast, the different types of ICT activities are significantly related to labour productivity. However, the sign and significance of the relationships vary across different types of ICT activities and also vary over time with lower magnitude for the more recent period. The second section looks at the relationship between several indicators of ICT usage and digitalisation, and the relative demand for highly skilled workers. The data is based on two-digit industry data for seven European countries for the period 2002-2010. For manufacturing industries, our estimates show that broadband connected employees, diffusion of mobile internet, use of enterprise resource planning systems and electronic invoicing are all significantly positively related to the industries' skill intensity. For service industries only mobile internet usage is significant. These estimates indicate that the increase in ERP systems during the period studied accounts for 25% of the increase in the share of workers with a tertiary degree across manufacturing industries and countries. The results are robust with respect to the estimation method and when accounting for endogeneity of ICT. The third section investigates the relationship between technological and organisational innovations, and ICT usage/e-commerce and internet technologies. The data is based on disaggregated data by firm size/industry for 12 European countries for the period 2002-2010. The empirical results show that the sales share of new market products is significantly positively related with both the percentage of workers with mobile internet access and e-procurement activities. Sharing electronic data also contributes to product innovations. We also find that organisational change and enterprise resource planning


A fuzzy legal case-based reasoning system has been developed for CISG (United Nation, Convention on Contract for the International Sale of foods). Since law is adversarial, there are usually at least two opposing viewpoints. Although either side may be quite reasonable, only one side wins in the end. An argument between two agents, such as the plaintiff and defendant, in a legal domain is very useful for classify a vague concept, because it can provide an explanation from the two sides. On the basis of the proposed structural similarity measure approach, a fuzzy legal argument is developed. This approach simulates the cognitive process of human beings in the legal argument. It can be used for students to learn the skill of the legal argument, or provides an advice for the attorneys in practice.


To address drug resistance to influenza virus neuraminidase inhibitors (NAIs), a series of novel boron-containing N-substituted oseltamivir derivatives were designed and synthesized to target the 150-cavity of neuraminidase (NA). In NA inhibitory assays, it was found that most of the new compounds exhibited moderate inhibitory potency against the wild-type NAs. Among them, compound 2c bearing 4-(3-boronic acid benzyloxy)benzyl group displayed weaker or slightly improved activities against group-1 NAs (H1N1, H5N1, H5N8 and H5N1-H274Y) compared to that of oseltamivir carboxylate (OSC). Encouragingly, 2c showed 4.6 times greater activity than OSC toward H5N1-H274Y NA. Moreover, 2c exerted equivalent or more potent antiviral activities than OSC against H1N1, H5N1 and H5N8. Additionally, 2c demonstrated low cytotoxicity in vitro and no acute toxicity at the dose of 1000 mg/kg in mice. Molecular docking of 2c was employed to provide a possible explanation for the improved anti-H274Y NA activity, which may be due to the formation of key additional hydrogen bonds with surrounding amino acid residues, such as Arg152, Gln136 and Val149. Taken together, 2c appeared to be a promising lead compound for further optimization.


Medroxyprogesterone acetate (MPA) is an anti‐cancer drug for mammary carcinomas and an angiostatic steroid. The effects of MPA on the growth and plasminogen activator (PA) activity of bovine endothelial cells were investigated to elucidate the inhibitory mechanism observed in angiogenesis. MPA did not suppress the growth of capillary endothelial cells, even at high concentrations. On the other hand, in bovine endothelial cells of 3 types (adrenal cortical capillary, aortic and pulmonary artery endothelial cells), MPA inhibited extracellular and cell‐associated activity of PA, which might be a protease involved in the neovascular response. MPA also greatly inhibited the high level of PA induced by basic fibroblast growth factor (FGF). The same result was obtained when PA production was induced by 4β‐phorbol‐l2‐myri‐state‐13‐acetate (PMA) in endothelial cells. These findings suggest that one of the points of inhibitory action of MPA in the process of angiogenesis may be the suppression of PA activity, and that inhibition of this protease might be useful for reduction of tumorigenic or excessive angiogenesis in vivo.


ABSTRACT
 The use of simple and economic traps with long lasting lure dispensers is key for implementation of mass trapping strategies against pestiferous fruit flies. Simplicity, cost, ease of assembly, storage and transportation were considered during evaluation of a folding conical trap for mass trapping the Mexican fruit fly, Anastrepha ludens. The application of deltamethrin to the lid of the trap resulted in a cost-effective treatment, which helped retain flies in dry traps for at least 10 wk. However, the conical trap design and the diam, type and disposition of entry-holes, negatively affected performance of the trap under laboratory conditions. High numbers of flies could escape the trap over a short period of time after their release into its interior, although most of them died after escaping because of the delayed effect of exposure to deltamethrin. Under field conditions, no significant differences were observed between orange and yellow traps in capturing either A. ludens or lacewings. In contrast, the folding conical trap model was significantly more efficient in capturing Mexican fruit flies when baited with CeraTrap® lure than when baited either with the conventional hydrolyzed protein or with BioLure®. CeraTrap® lure was also significantly more attractive to beneficial lacewings than the other 2 lures. These results indicated that additional studies on fly population suppression under field conditions will be necessary before deciding to use the folding conical trap as part of a mass trapping strategy to control the Mexican fruit fly.


Between 1995 and 1998 the local authority structure and geography of the United Kingdom was substantially revised. The two-tier system of local government was abolished in Wales, Scotland, and in parts of non-metropolitan England, and replaced with a single-tier system. This involved the creation of a new set of local authority area boundaries which in many places cut across those of the old districts. In addition, many of the local authorities unaffected by the reorganisation nonetheless had experienced small - though demographically significant - boundary changes since the last census. By the time the final phase of the reorganisation came into effect on 1st April 1998 the local government map of the United Kingdom was very different from that of April 1991. There is a need therefore to provide demographic and other geographically based data for the new geography for years prior to 1998. This paper aims to fill a part of this requirement by focusing on two important issues. First, it describes a look-up table detailing exactly how the 1998 local government geography relates to 1991 Census areas, and second, it sets out methods for producing 1991 Census data and mid-1991 population estimates (including single year age detail) for the new geography. A selection of the results produced by the described methods is included in tables and population pyramids.


Background MDC15 (or ADAM15) is a member of the family of membrane-bound disintegrin-metalloproteinases (a disintegrin and metalloproteinase: ADAM or MDC).1 Some ADAMs are involved in (patho-) physiological important processes such as remodelling of the extracellular matrix (e.g. proteolytic activity of the "aggrecanases")2 and the shedding of membrane-bound cytokines (e.g. TNF-alpha cleavage by TACE).3 By in situ hybridization we could show that MDC15 is markedly up-regulated in osteoarthritic (OA) cartilage.4 However, mRNA expression in normal articular cartilage was below detection level, suggesting an involvement of MDC15 in catabolic processes of the cartilage matrix. Objectives In the present study we examined the expression of MDC15 on protein level in OA cartilage compared to normal articular cartilage. Methods The expression of MDC15 on protein level was analysed on 33 OA cartilage specimens and 14 normal tissue samples using immunohistochemistry. For this purpose a polyclonal antiserum was generated in rabbits by immunisation with a synthetic cyclized peptide (15-mer) derived from the sequence containing the RGD-motive of the disintegrin domain of MDC15. The specificity of the affinity-purified antibody was tested using Western Blot analysis on COS-7 cell lysates that were transfected with a full-length MDC15 cDNA. Immunostaining revealed a single protein band of around 100 kD in the transfected but not in the non-transfected COS-7 cells. Results In OA cartilage MDC15 was strongly expressed in all samples analysed. MDC15 expression did not exhibit any preference for certain zones in OA cartilage. Analogous to the in situ hybridization studies, the protein could be detected already in the early stages of OA (Mankin grades 2–7). Less damaged cartilage of peripheral non-weight bearing areas also displayed strong signals well above those observed in normal aged cartilage. Strong expression of MDC15 was also present in tissues that were severely damaged (Mankin grades >7). In addition, MDC15 was found in secondary formed cartilage of osteophytes as well as metaplastic cartilage in the opened bone marrow (areas of complete cartilage erosion). In contrary, normal cartilage exhibited no or very low expression of MDC15. Conclusion In this work we demonstrate that MDC15 expression is upregulated in OA cartilage not only on mRNA level but also on protein level. Human MDC15 is the only ADAM that contains an RGD sequence in its disintegrin domain by which it can interact with integrins5 thus interfering with cell-cell or cell-matrix interactions. Both its proteolytic potential as well as integrin-binding properties suggest that MDC15 plays an important role in cartilage remodelling in pathophysiological processes. Taken together, the proposed functions of MDC15 and its upregulation in OA, make this interesting multidomain molecule a potential candidate as a new therapeutic target. References Kraetschmar J, Lum L, Blobel CP. J Biol Chem. 1996;271:4593 Tortorella MD, Burn TC, Pratta MA, Abbaszade I, Hollis JM, et al. Science 1999;284:1664 Moss ML, Jin SL, Milla ME, Bickett DM, Burkhart W, Carter HL, et al. Nature 1997;385:733 Boehm B, Aigner T, Gehrsitz A, Blobel CP, Kalden JR, Burkhardt H. Arthritis Rheum. 1999;42:1946 Nath D, Slocombe PM, Stephens PE, Warn A, Hutchinson GR, Yamada KM, et al. J Cell Sci. 1999;112:579


Electronic Medical Record (EMR) system based on the cloud has serious leaks of patient data and private information. Access control and privacy protection are considered to be the keys to ensuring the privacy of patients. Attribute-Based Access Control (ABAC) can realize fine-grained control of cloud medical data, but lacks the corresponding encryption mechanism. Moreover, as the scale of medical data grows, the number of entity attributes and policies required by ABAC is increasing, leading to performance degradation. Most of the existing research schemes focus on security but ignore efficiency, and the encryption scheme does not fit ABAC mechanism well. This paper proposed a retrieval method that enables attribute value, which filtered invalid policies, and improved Ciphertext-Policy Attribute-Based Encryption (CP-ABE), shared attribute set with ABAC to save attribute processing time, thus constructing a secure and efficient SE-ABAC solution in EMR system. Finally, through simulation experiment analysis, the optimizes solution is effective and more efficient than traditional ABAC.


A simple two‐predictor regression model is developed to estimate the relative influence of large‐scale low frequency ocean‐atmosphere dynamics and high frequency atmospheric forcing on peak sea surface temperature (SST) anomalies associated with El Niño/Southern Oscillation (ENSO) variations for the period 1980–2005. One predictor is equatorial warm water volume (WWV), which is an index for the role that upper ocean heat content plays in regulating ENSO variability. The other predictor characterizes high frequency atmospheric forcing in the western Pacific linked to the Madden‐Julian Oscillation (MJO). The two‐predictor model accounts for about 60–65% of peak Nino3.4 SST anomaly variance at 2–3 season lead times and suggests about equal influence (on average) of low frequency dynamical processes and the MJO on peak ENSO SST anomalies over the past 25 years. The implications of these results for ENSO prediction are discussed.


A new design module using an excimer irradiation to assist in micro-electroremoval process as a precise recycle modus for the digital paper of the touch-panel offers a faster performance in removing the Indium-tin-oxide (TCO) thin-films from the surface of the optical PET-diaphragm (PET) of digital paper was developed. The low yield of the TCO deposition is an important factor in optoelectronic semiconductor production. In the current study, the TCO layers proved difficult to remove, the excimer irradiation can be used to help with its removal. During the digital paper recycle processes the use of a 172nm excimer-lamp can remove the stubborn film residues, effectively improving the TCO removal rate. For executing the removal-process of the fabrication, through the excimer irradiation proposed, the stubborn thin-films were easily broken up from the layer's compositions to the nanoparticles and escaped from the PET substrate quickly and cleanly. It is possible to efficiently promote the performance of the designed pillar-form tool striping away the Indium-tin-oxide. The required machining time is shortened by irradiating with an excimer lamp before removal processing TCO layers than that of without the excimer irradiating under similar processing conditions.


The aim of this study was to determin the intensity index of the offensive teamwork. Under observation for this research was the Tallinn University basketball team, that takes part in the championships of the 1. Estonian league. The data was gathered from 600 ball possessions of 8 recorded regular season games. This research has helped to work out the basics of the analytical system of the teamwork aspect. The analysing system of the competition activity of the game, which we have worked out, enables to determine the structure and intensity of the technical and tactical development, and to find interesting models of game activity from the data. On the basis of the received information, the coach can evaluate the activity of the team, find more convenient time laps in the game performance, corrigate the strategy for future games. The analysing system worked out through that, helps to improve the quality of the game. Based on the results of working through the statistical data (T-test, F-test), it was concluded that the average time of successful offence ball possession in the offensive zone (t = 8,75), the number of elements (6,76) and the teamwork intensity index in the offensive zone (0,86) is statistically significantly different from non successful (accordingly t = 10,13; number of elements - 7,52; index - 0,78).


The haemagglutinin (HA) glycan binding selectivity of H1N1 influenza viruses is an important determinant for the host range of the virus and egg-adaption during vaccine production. This study integrates glycan binding data with structure-recognition models to examine the impact of the K123N, D225G and Q226R mutations (as seen in the HA of vaccine strains of the pandemic 2009 H1N1 swine influenza A virus). The glycan-binding selectivity of three A/California/07/09 vaccine production strains, and purified recombinant A/California/07/09 HAs harboring these mutations was examined via a solid-phase ELISA assay. Wild-type A/California/07/09 recombinant HA bound specifically to α2,6-linked sialyl-glycans, with no affinity for the α2,3-linked sialyl-glycans in the array. In contrast, the vaccine virus strains and recombinant HA harboring the Q226R HA mutation displayed a comparable pattern of highly specific binding to α2,3-linked sialyl-glycans, with a negligible affinity for α2,6-linked sialyl-glycans. The D225G A/California/07/09 recombinant HA displayed an enhanced binding affinity for both α2,6- and α2,3-linked sialyl-glycans in the array. Notably its α2,6-glycan affinity was generally higher compared to its α2,3-glycan affinity, which may explain why the double mutant was not naturally selected during egg-adaption of the virus. The K123N mutation which introduces a glycosylation site proximal to the receptor binding site, did not impact the α2,3/α2,6 glycan selectivity, however, it lowered the overall glycan binding affinity of the HA; suggesting glycosylation may interfere with receptor binding. Docking models and 'per residues' scoring were employed to provide a structure-recognition rational for the experimental glycan binding data. Collectively, the glycan binding data inform future vaccine design strategies to introduce the D225G or Q226R amino acid substitutions into recombinant H1N1 viruses.


For decades, the U.S. Air Force has contemplated replacing the A-10 Thunderbolt II "Warthog" with a newer fighter aircraft. However, a quantitative analysis comparing the Warthog's performance and costs with those of its intended replacement, the F-35 Lightning II Joint Strike Fighter, shows that retiring the Warthog would be operationally unsound and fiscally imprudent. The rationale for the replacement is that it would increase airpower capability while controlling costs. That rationale does not withstand scrutiny. An effectiveness analysis based on results from a survey of joint terminal attack controllers indicates that the A-10 vastly outperforms the F-35 in providing close-air support (CAS), a critical requirement for future conflicts against terrorists and insurgents. A cost analysis demonstrates that replacing the A-10 before its service life ends in 2035 would cost at least $20.9 billion. The replacement plan would waste substantial resources and seriously impair U.S. military capabilities. Given that constrained future budgets and low-intensity conflicts requiring precision CAS can be expected, the U.S. air fleet should include the A-10 Thunderbolt II.


Genetic polymorphisms in ERBB4 are thought to be associated with cancer susceptibility. In the present study, we aimed to assess the impact of ERBB4 rs12052398 T>C, rs13393577 A>G, rs13424871 A>T, rs16847082 A>G and rs6147150 (12-bp I/D) polymorphisms on risk of prostate cancer (PCa) in a sample of Iranian population. In a case-control study, we enrolled 169 patients with pathologically confirmed PCa and 182 subjects with benign prostatic hyperplasia (BPH). No significant association was found among ERBB4 polymorphisms and risk of PCa. Subjects carrying TT/AA/AA/AG/ID, TC/AA/AA/AA/II, TT/AA/AT/AA/II and TT/AA/AT/AG/ID genotypes are associated with a decreased risk of PCa. Our findings suggest that haplotypes CAAAI and TAAAD (rs12052398, rs13393577, rs13424871, rs16847082 and rs6147150I) of the ERBB4 polymorphisms are associated with a significantly lower risk of PCa. Further studies with a larger sample sizes and diverse ethnicities are necessary to verify our findings.


Low power wide area network (LPWAN) technologies are increasingly catching the attention of the Internet-of-Things market and have brought the need for reliable knowledge about the performance of such networks. This paper is concerned with the performance and scalability of LoRa networks, a leading LPWAN technology. Several recently published articles have analyzed the ability of LoRa networks to scale, i.e., their ability to support increased traffic and number of nodes. This paper proposes to employ message replication and gateways with multiple receive antennas to achieve, respectively, time and spatial diversity. The paper presents the proposed schemes and evaluates them through theoretical analysis and computer simulations. Results show that LoRa networks are highly sensitive to the increase in user and traffic density, but both message replication and multiple antennas can enhance performance. Message replication has an optimum number of message copies for each network configuration, and its utilization is more beneficial in low-density networks, while the use of multiple receive antennas at the gateway is always beneficial.


Fetal growth restriction (FGR) is one of the major contributors to adverse perinatal outcome. However, the diagnostic tools used for the assessment of fetal well-being are limited due to the great variability among fetuses. The purpose of this study was to estimate the dynamics of fetal circulation during the advanced stages of the gestational period. A methodology for estimating fetal hemodynamic parameters is presented. The method combines a mathematical model of the fetal circulation, optimization algorithm, and measurements of power-Doppler ultrasound. The model estimates fetal indices of the fetal circulation that are not accessible for direct measurement, aimed at the identification of the degree of circulatory compromise in fetuses diagnosed as FGR. The method was tested on a cohort of 20 normal and 22 growth-restricted fetuses. Model predictions indicated significant changes in the circulation of FGR fetuses compared to normal fetuses. Cardiac output was significantly lower in the FGR group compared to the control group (330 ± 52 mL min−1 kg−1 compared to 396 ± 52 mL min−1 kg−1, p < 0.001). Furthermore, placental blood flow was lower for the FGR group (145 ± 49 mL min−1 kg−1 compared to 181 ± 31 mL min−1 kg−1, p < 0.01). In the FGR fetuses with adverse outcome, both indices were reduced even further (297 ± 56 mL min−1 kg−1, p < 0.001 and 97 ± 46 mL min−1 kg−1, p < 0.001, respectively). In the adverse outcome group the model indicated also significant increase in cardiac output distribution towards the brain (9.6 ± 0.7%, compared to 8.0 ± 1.6%, p < 0.01) and an increase in the ratio of blood shunted by the ductus venosus (60.6 ± 17.7%, compared to 39.7 ± 14.8%, p < 0.01), indicating a severe brain sparing effect in these fetuses. In conclusion, patient-specific modeling may provide a reliable estimate of the important hemodynamic indices of the fetal circulation which may be clinically relevant for the management of FGR pregnancies.


In addition to traditional video-surveillance applications, the use of acoustic surveillance is becoming increasingly important. The acoustic clues are appropriate for detecting target that are hidden or in a dark location and assumed to make a sound. In the conventional acoustic surveillance systems, the false alarms tend to frequently occur because the conventional acoustic surveillance systems are not robust against the interferences of other sounds. In this study, in order to overcome the conventional difficulty, we apply the Hidden Markov Model (HMM) based robust recognizer with feature compensation to the detection of glass destruction sounds. Experimental results confirmed that the feature compensation method is effective not only to speech signals but also to the material sounds like the glass destruction sound.


For the last 12 years then has been a series of headlines in which Nobel laureate David Baltimore and his colleague, Thereza Imanishi-Kari, were variously accused, convicted, or exonerated of scientific fraud by a bewildering number of scientific panels, Congressional committees, and government agencies. Some scientists passionately attacked him, while others defended him with equal intensity. A brief description is given of the case leading to the exoneration of Baltimore and Imanishi-Kari and an assessment of its meaning.


Although neither blame nor responsibility is a term capable of precise definition, blame is a concept with particular resonances - both moral and emotional. Blame evokes a highly personal expression of the wrongdoer's attitudes or emotions toward the victim, whereas responsibility connotes a professional violation of shared, externalized norms. This article identifies an increasingly pronounced tendency to premise government liability on a demand for blameworthy behavior of a type in which entities rarely engage, rather than on standards of responsibility better suited to measuring the behaviors and duties of governmental entities. It argues that the tendency has had unfortunate consequences for the scope of municipal liability jurisprudence.


Nowadays, the Web is experiencing a continuous change that is leading to the realization of the Semantic Web. Initiatives such as Linked Data have made a huge amount of structured information publicly available, encouraging the rest of the Internet community to tag their resources with it. Unfortunately, the amount of interlinked domains and information is so big that handling it efficiently has become really difficult for the final users. DBPedia, one of the biggest and most important Linked Data repositories, is a perfect example of this issue. In this paper, we propose an approach to provide the users with different domain views on a general data repository, allowing them to perform both keyword and navigational searches. Our system exploits the knowledge stored in ontologies to 1) perform efficient keyword searches over a specified domain, and 2) refine the user's domain searches. We focus on the case of DBPedia, as it mirrors the information stored in the Wikipedia, providing a semantic entry to it.


BACKGROUND
This section is under preparation and will be included in the next issue.

OBJECTIVES
To assess the effect of prophylactic application of emollient ointment in preterm infants.

SEARCH STRATEGY
Searches were made of the Oxford Database of Perinatal Trials, Medline (MeSH terms: ointment; limits: age groups, newborn infant; publication types, clinical trial), previous reviews including cross references, abstracts, conference and symposia proceedings, expert informants, and journal handsearching in the English language.

SELECTION CRITERIA
Randomized controlled trials which compared the effect of prophylactic application of emollient ointment to routine care or as needed topical therapy in preterm infants are included in this review.

DATA COLLECTION AND ANALYSIS
Data regarding clinical outcomes including transepidermal water loss, skin condition, fluid intake, suspect infection and proven nosocomial infection were excerpted from the reports of the clinical trials by the reviewers. Data analysis was done in accordance with the standards of the Cochrane Neonatal Review Group.

MAIN RESULTS
Two randomized trials which compared prophylactic application of ointment to routine skin care or as needed topical ointment therapy were identified. Lane (1993) noted improved skin condition in infants receiving topical application of emollient ointment. In the study of Nopper and coworkers (1996), prophylactic application of ointment significantly decreased transepidermal water loss during the first six hours after initial application. Skin condition was noted to be improved during the first 1-2 weeks. Surveillance cultures demonstrated less bacterial colonization during the two week study. A significant decrease in suspect and proven infection was noted. Fewer infants were evaluated for sepsis among the group who received prophylactic application of ointment (relative risk 0. 50, 95% CI 0.27, 0.93; risk difference -0.30, 95% CI -0.54, -0.06). Both studies reported on the incidence of proven nosocomial infection. A trend towards a decrease in the risk of proven nosocomial infection was noted in infants who received prophylactic application of emollient ointment (typical relative risk 0.29, 95% CI 0.07, 1.16, typical risk difference -0.13, 95% CI -0.25, -0.01).

REVIEWER'S CONCLUSIONS
In two small studies, prophylactic application of emollient ointment decreased transepidermal water loss, decreased the severity of dermatitis, and decreased the risk of suspect sepsis and proven sepsis. Further clinical studies are warranted to validate these results.


We use the hydrodynamic, cosmological EAGLE simulations to investigate how the hot gas in haloes condenses to form and grow galaxies. We select haloes from the simulations that are actively cooling and study the temperature, distribution and metallicity of their hot, cold and transitioning 'cooling' gas, placing these in the context of semi-analytic models. Our selection criteria lead us to focus on Milky Way-like haloes. We find that the hot-gas density profiles of the haloes form a progressively stronger core over time, the nature of which can be captured by a β profile that has a simple dependence on redshift. In contrast, the hot gas that will cool over a time-step is broadly consistent with a singular isothermal sphere. We find that cooling gas carries a few times the specific angular momentum of the halo and is offset in spin direction from the rest of the hot gas. The gas loses ∼60 per cent of its specific angular momentum during the cooling process, generally remaining greater than that of the halo, and it precesses to become aligned with the cold gas already in the disc. We find tentative evidence that angular-momentum losses are slightly larger when gas cools on to dispersion-supported galaxies. We show that an exponential surface density profile for gas arriving on a disc remains a reasonable approximation, but a cusp containing ∼20 per cent of the mass is always present, and disc scale radii are larger than predicted by a vanilla Fall & Efstathiou model. These scale radii are still closely correlated with the halo spin parameter, for which we suggest an updated prescription for galaxy formation models.


Seventy two patients admitted to a medical department with dyspepsia but without a previous diagnosis of peptic ulcer disease or chronic pancreatitis were studied consecutively. A pancreatic function test (Lundh meal test) and an upper endoscopy was made in all patients. There was no difference in age, sex ratio, occurrence of upper abdominal pain or chronic alcoholism between the groups of patients with reduced pancreatic function (20) and the group with normal function (52). Seven duodenal ulcers were found, two in patients with normal pancreatic function (2/52 = 3.8%; 95% conf lim: 0.5-13.2) and five in patients with reduced pancreatic function (5/20 = 25%; 95% conf lim: 8.7-49.1). This difference was statistically significant (p less than 0.01). Duodenitis occurred with equal frequency in the two groups.


In this paper, we use the common structural break test suggested by Bai et al. (1998) to test for a common structural break in the stock prices of the US, the UK, and Japan. On the basis of the structural break, we divide each country"s stock price series into sub-samples and investigate whether or not the structural break had slowed down the growth of stock markets. Our main findings are that when stock markets are modeled in a trivariate sense the common structural break turns out to be 1990:02, with the confidence interval including several episodes, such as the asset price bubble when housing prices and stock prices in Japan reached a peak in 1988/1989, the early 1990s recession in the UK, the business cycle peak of July 1990, the August 1990 Iraqi invasion of Kuwait and the March 1991 business cycle trough. Annual average growth rates suggest that the structural break has slowed down the growth rate of the US, UK and Japanese stock markets.


At present, malaria rapid diagnostic tests (RDTs) are widely available and used in
parts of Asia and Latin America. In Africa, their use has been limited mainly to private health facilities. With the adoption of artemisinin combination therapies (ACTs) by most African countries as first line treatment for malaria, an effective, but expensive treatment is available, and the case for an expanded role for rapid diagnostics in the fight against malaria is clear. Despite this perceived potential role for RDTs, some challenges hinder their introduction and scale-up in the public health sector. Among the requirements are significant investments in policy development, training, infrastructure, and supply chain and quality assurance systems. African Journal of Health Sciences Vol. 14 (3-4) 2007: pp. 114-117


Integration support is a rather new professional field, and it is common for paraprofessionals (PPs) with personal migration experiences as their main qualification to perform the work without having a job description, education or ethical principles to follow. In previous research, migration experiences have been contested as a professional competence and criticism has been raised about a lack of professionalism. Organisational professionalisation directed from above – such as education, guidelines and standardisation – has been requested. This study raises questions about occupational professionalisation from within, from the working group itself. Based on workplace learning theory, the study explores how a working group of 30 PP integration workers in Civic Orientation are enhancing occupational capacities jointly. They identified a lack of client responsiveness as a problem and developed an explanatory model where their own biographical experience of migration (themselves as former migrants or their family members and recollections of their former 'home country') play a crucial role. Thus, the results indicate that one's own migration experience can be a part of and a motivator for occupational professionalism of PPs if it is allowed to be collectively reflected on, critically scrutinised and contextualised.


This thesis used a qualititave research approach to explore the causes, manifestations and consequences of tuberculosis (TB) stigma in an urban district in Ghana. It examined reasons why TB is stigmatised and elucidated how TB stigma manifests within the community setting and the healthcare system. It also explored the feelings and experiences of TB patients, to highlight how the fear of stigmatisation may affect case finding and treatment adherence.

Twenty eight focus groups (6 with patients, 6 with health workers and 16 with community members) and 121 individual interviews (66 with community members, 34 with patients and 21 with health staff) were conducted. Data were analysed using Grounded Theory techniques and procedures.

Eleven causes of TB stigma were identified: fear of infection; physical frailty of TB patients; association of TB with HIV/AIDS; perceived causes and spread of TB; outdated societal practices about TB; public health practice and discourse; attitudes of healthcare workers towards TB patients; health staff's own fear of TB; self-stigmatisation by TB patients; judgement, blaming and shaming TB patients; and past experiences with TB. Elements of physical and moral threats were identified in all these causes of TB stigma. The threat the disease poses to community members led to imposition of socio-physical distance, participatory restrictions and rules for unexpected interactions on those suffering from TB in society. Within the healthcare system, the threat of TB affected the attitudes and behaviours of healthcare workers towards TB patients and TB work. Health managers also sited TB units/wards in isolated parts of the hospital, and failed to provide adequate tools and equipment, support and supervision to enable the provision of quality TB services. The fear of stigmatisation made the patients deny the obvious symptoms of the disease, and report to the hospital only after prolonged period of self-medication in the community. When diagnosed, they cried, questioned how they got the disease, contemplated committing suicide and were mostly isolated within the family and community.

For everyone, the threat of TB underlies their beliefs, attitudes, actions and behaviours when interacting with TB patients. It also forms the basis of avoidance of social interactions, and attitudes and practices of healthcare workers towards TB patients.

The TB control programme should encourage open discussion about TB in the community and tailor health education messages to the community's understanding of the disease. TB services should be completely integrated into the general healthcare system and community members involved in activities of the TB control programme. Regular refresher courses in TB control and management should be organised for health professionals and a national guideline for the prevention of TB in health workers developed.


The viscoelasticity of myristic acid monolayers has been investigated through light-scattering techniques. The authors obtain information on the modulus of compressibility, and dilational surface viscosity. The existence of a relaxation phenomenon associated with monolayer vertical motion has been observed. The authors have measured a new surface viscosity coefficient, associated with this effect. A comparison is made between these data and other light-scattering experiments on myristic acid monolayers by Byrne and Earnshaw (1979), who do not take this viscosity into account.


With the recent progress in deep learning (DL), DL inversion, which reconstructs subsurface physical properties from geophysical data using DL techniques, has been widely applied. For decision-making and risk management related to the application of DL inversion, assessing the reliability of a prediction is essential, and such assessment can be achieved through uncertainty estimation. However, most geophysical studies have focused on deterministic prediction that does not provide uncertainty estimates. In this letter, a practical uncertainty estimation method based on the Bayesian framework is introduced for DL inversion of electromagnetic data. More specifically, iterative estimation by a convolutional neural network with dropout provides epistemic and aleatoric uncertainties as well as a resistivity model. Using numerical tests, we observed that aleatoric uncertainty indicates the nonuniqueness of the inverse problem, showing which parts of the resistivity model are less sensitive to the data. In addition, we proposed an empirical criterion for determining whether new data are similar to training data using estimated epistemic and aleatoric uncertainties. Based on this criterion, out-of-distribution data were identified; these data showed larger data misfit, indicating that the predictions would be unreliable. The applicability of uncertainty estimation and the empirical criterion derived from uncertainties were demonstrated using field data. Bayesian uncertainty estimation and the criterion established here may help to achieve more reliable prediction via DL inversion.


While attending the AGU/ASLO (American Society of Limnology and Oceanography) Ocean Sciences meeting in New Orleans, La., I fell to contemplating the variety of acronyms that occur in geophysical research. As we all know, a catchy acronym is a n essential ingredient of any large research project. While a good start has been made by ingenious colleagues, much more could be done in this direction. I respectfully submit a list of proposed acronyms for future projects in the ocean sciences. Perhaps members of other sections might like to contribute equivalents in their own fields.


OBJECTIVE Low health-related quality of life (HRQoL) has been consistently reported to be associated with poor prognosis for a variety of health outcomes in various settings. We aimed to evaluate whether HRQoL in patients presenting with new diabetic foot ulcers (DFUs) has prognostic significance for ulcer healing, major amputation, and death. RESEARCH DESIGN AND METHODS We followed 1,088 patients with new DFUs presenting for treatment at one of the 14 centers in 10 European countries participating in the Eurodiale (European Study Group on Diabetes and the Lower Extremity) study, prospectively until healing (76.9%), major amputation (4.6%), or death (6.4%) up to a maximum of 1 year. At baseline, patient and ulcer characteristics were recorded as well as EQ-5D, a standardized instrument consisting of five domains and a visual analog scale for use as a measure of HRQoL. The prognostic influence of the EQ-5D domains was evaluated in multivariable Cox regression analyses on the time-to-event data, adjusting for baseline clinical characteristics of the ulcer and comorbidities. RESULTS While predictive effects of HRQoL, adjusted for possible confounders, were absent for healing, decreased HRQoL, especially in the physical domains, was statistically significant for major amputation (mobility, self-care, usual activities) and death (self-care, usual activities, pain/discomfort). CONCLUSIONS Low HRQoL appears to be predictive for major amputation and death, but high HRQoL does not increase healing. Future studies into the influence of HRQoL on ulcer outcome are important in attempts to decrease treatment failure and mortality.


We study efficient nonlinear taxation of labor and capital in a dynamic Mirrleesian model incorporating political economy constraints. Policies are chosen sequentially over time, without commitment. Our main result is that the marginal tax on capital income is progressive, in the sense that richer agents face higher marginal tax rates.


Power losses (PL) are one of the most—if not the most—vital concerns in power distribution networks (DN). With respect to sustainability, distribution network reconfiguration (DNR) is an effective course of action to minimize power losses. However, the optimal DNR is usually a non-convex optimization process that necessitates the employment of powerful global optimization methods. This paper proposes a novel hybrid metaheuristic optimization (MO) method called the chaotic golden flower algorithm (CGFA) for PL minimization. As the name implies, the proposed method combines the golden search method with the flower pollination algorithm to multiply their benefits, guarantee the best solution, and reduce convergence time. The performance of the algorithm has been evaluated under different test systems, including the IEEE 33-bus, IEEE 69-bus, and IEEE 119-bus systems and the smart city (SC) network, each of which includes distributed-generation (DG) units and energy storage systems (ESS). In addition, the locations of tie-switches in the DN, which used to be considered as given information in previous studies, are assumed to be variable, and a branch-exchange adaption is included in the reconfiguration process. Furthermore, uncertainty analysis, such as bus and/or line fault conditions, are studied, and the performance of the proposed method is compared with other pioneering MO algorithms with minimal standard deviations ranging from 0.0012 to 0.0101. The case study of SC is considered and the obtained simulation results show the superiority of the algorithm in finding higher PL reduction under different scenarios, with the lowest standard deviations ranging from 0.012 to 0.0432.


Introduction. Chronic pain is a prevalent medical condition in the general population and is one of the most common reasons patients visit their primary care doctors. When the pain is resistant to the common treatment modalities, it presents a challenge for the physician and may have profound consequences for the quality of life of the patient. Methods. We present four case reports in which subcutaneous peripheral nerve stimulation was successfully used to treat chronic neuropathic pain after all other treatment efforts had failed. Results. In all cases, the patients underwent a trial of peripheral nerve stimulation with good results. The patients reported decreased use of pain medications, increased quality of life, and high satisfaction with the procedure results. Conclusion. The use of subcutaneous peripheral nerve stimulation as a viable treatment alternative in certain cases of chronic neuropathic pain should continue to be rigorously evaluated.


This paper discusses the dark reactions and photoreactions that occur with transfer of an electron from a donor to an acceptor in polymer matrices under electron tunnelling conditions and when forming change-transfer complexes. The main emphasis is on an analysis of the factors that determine the rate of electron transfer, which, in accordance with the advanced theory of electron transfer, are the magnitude of the exchange interaction, the free energy of the process, and the reorganisation energies of the medium and the reacting donor and acceptor molecules. The existing models for the movement of charge carriers between single-type transport sites are discussed. The limits of applicability of the different models have been determined. The reorganisation energy of a polymer matrix is shown to have a considerable effect on the rate of movement of charge carriers on introduced transport molecules. The effect of the dielectric properties and free volume of polymer matrices on the characteristics of electron phototransfer in donor-acceptor complexes is discussed. The bibliography includes 126 references.


The local compositional heterogeneity associated with the short‐range ordering of Mg and Nb in PbMg1/3Nb2/3O3 (PMN) is correlated with its characteristic relaxor ferroelectric behavior. Fully ordered PMN is not prepared as a bulk material. This work examines the relaxor behavior in PMN thin films grown at temperatures below 1073 K by artificially reducing the degree of disorder via synthesis of heterostructures with alternate layers of Pb(Mg2/3Nb1/3)O3 and PbNbO3, as suggested by the random‐site model. 100 nm thick, phase‐pure films are grown epitaxially on (111) SrTiO3 substrates using alternate target timed pulsed‐laser deposition of Pb(Mg2/3Nb1/3)O3 and PbNbO3 targets with 20% excess Pb. Selected area electron diffraction confirms the emergence of (1/2, 1/2, 1/2) superlattice spots with randomly distributed ordered domains as large as ≈150 nm. These heterostructures exhibit a dielectric constant of 800, loss tangents of ≈0.03 and 2× remanent polarization of ≈11 µC cm−2 at room temperature. Polarization–electric field hysteresis loops, Rayleigh data, and optical second‐harmonic generation measurements are consistent with the development of ferroelectric domains below 140 K. Temperature‐dependent permittivity measurements demonstrate reduced frequency dispersion compared to short range ordered PMN films. This work suggests a continuum between normal and relaxor ferroelectric behavior in the engineered PMN thin films.


The author focuses on the legal aesthetics dilemma, which appears in the dominant sense that the legal content prevails over the legal form. Some possible reasons and consequences of the aesthetical crisis are considered. The article offers the way to overcome that crisis. To this end the author outlines the new interdisciplinary field of legal studies called legal aesthetics. According to the author's opinion the aesthetical criteria shall be applied primarily to the legal text and also to all the tools, such as visualisations, which make it more comprehensible. The key issues of the new discipline are scrutinized, such as objectives, subject, method and relations with other legal studies, such as legal technique. The author shows the connection between the legal aesthetics and legal design, arising within philosophy of design-thinking.


Cryptocurrencies such as bitcoin are breakthrough financial technologies that promise to revolutionize the digital economy. Unfortunately, their long-term adoption in the business world is imperiled by the lack of stability that manifests as dramatic swings in transaction fees and severe participant dissatisfaction. To date, there has been little academic effort on studying how system participants react to volatility in fee movements. Our study addresses this research gap by conceptualizing the bitcoin platform as a data space market and studying how market equilibrium forms between users who demand data space while trying to avoid transaction delays and miners who supply data space while trying to maximize fee revenues. Our empirical analysis based on past bitcoin transactions reveals the existence of a relatively flat downward-sloping demand curve and a much steeper upward-sloping supply curve. Regarding users, the inelastic nature of demand signals the utility of bitcoin as a niche platform for transactions that are otherwise difficult to conduct. This result challenges the belief that users may easily abandon the bitcoin technology upon rising transaction costs. We also find that the use of bitcoins as a trading asset is associated with higher levels of tolerance to fees. Regarding miners, the comparatively elastic nature of supply indicates that higher fees stimulate mining by a larger magnitude than suppressing demand. This finding implies that, ceteris paribus, the bitcoin system turns to self-regulate transaction fees in an efficient manner. Our work has implications for the management of congestion in blockchain-based systems and more broadly for the stability of cryptocurrency markets.


After careful lysis the nucleoid of Pseudomonas testosteroni can be isolated in three different forms with compact and unfolded DNA structures. The released nucleoids contain endogenous DNA-dependent RNA-polymerase activity using the chromosomal DNA as a template. RNA synthesis is proportional to duration of RNA-polymerase reaction and amount of DNA-protein-complexes. The sensitivity towards ionic strength and rifampicin indicates that a part of RNA-polymerase activity is tightly bound to the chromosomal DNA.


When we see beautiful, long hair, well-dressed young daughters and mothers standing side by side with their husbands and all surrounding the tall, massive wide-faced elegant man, with red tie around his neck, all facing the camera eye, it's the Trumps. The media convergence in image society phenomenon reached broader meaning and brought international consequences after last presidential election in USA. Contemporary visual culture links with politics and consists of not only the present, but also the past visual codes skilfully reinterpreted by the public relations specialist. It's the visual channel, official presidential family pictures used in the media that is analysed in our study, e.g. "Time" cover. The primary question asked is: whether the contemporary recipients prefer the truth and the new or the beauty and the old in the messages that they perceive every day in their newsfeed. It is argued that the Trump family is new incarnation of The Kennedy's, especially when the visual representation of them both is analysed in the eye-tracking experiment. The heat-maps of the family photographs are compared and the areas of interests represent the symbolic depiction of group leaders strength and white, male domination, are described. Biometrics meets the media images.


Ad hoc networks such as Wireless Sensor Networks (WSN) are characterized by the scarcity of energy resources (among other resource types). Their intelligent design can extend their lifetime without compromising the operation of network nodes and the applications running on them. To this end we propose an adaptive epidemic scheme that helps reduce energy expenditure through intelligent tuning of the infection (forwarding) rate. Redundant communications and experienced error rate drive the adaptation of the forwarding rate. Simulation results show that significant energy gains can be obtained through the proposed scheme.


Viridans group streptococci form the major part of the commensal flora of the human upper respiratory tract. However, these organisms are also the leading cause of infective endocarditis and an increasing source of bacteremia in neutropenic patients (1). Beta-lactam agents are the treatment of choice for these infections, but macrolides and related drugs are recommended for prophylaxis and alternative treatment in allergic patients (1). The two presently recognized mechanisms of resistance to macrolide antibiotics in streptococci are (i) target site modification mediated by erythromycin resistance methylases (Erm), which confer cross-resistance to macrolides, lincosamides, and streptogramin B components (MLS phenotype), and (ii) active-drug efflux pumps, encoded either by the mefAE genes or by the mreA gene (3, 4, 11). The efflux systems encoded by the mef genes cause resistance to 14- and 15-membered macrolide compounds only, and this phenotype is designated M (10). Phenotype M is widespread among beta-hemolytic streptococci and Streptococcus pneumoniae in a number of countries (6, 7, 10). During a survey of antimicrobial resistance in viridans streptococci, strains with the M phenotype were investigated.

A total of 90 consecutive strains of viridans group streptococci were isolated from 90 patients hospitalized in a French hospital (Haut-Leveque, Pessac), between 1988 and 1995. These strains were identified with two commercial kits, API20 STREP and Rapid ID32 (Biomerieux): 57 isolates belonged to the Streptococcus mitis group, 24 to the Streptococcus milleri group, and 9 to the Streptococcus salivarius group. By the disk diffusion method, the strains were classified in three categories with regard to their MLS behavior: (i) 55 strains (61.1%) were susceptible, 27 (30%) had the MLS phenotype, and 8 (8.9%) had the M phenotype. The latter strains (five S. mitis strains, two Streptococcus oralis strains, and one S. salivarius strain) were susceptible to all other antibiotics, except for three which were additionally penicillin resistant. MICs of MLS antibiotics were determined by the agar dilution method on Mueller-Hinton medium supplemented with 5% horse blood. The eight isolates with the M phenotype exhibited low-level resistance to erythromycin and other 14- and 15-membered macrolides, although the intrinsically more active new ketolide HMR 3647 retained significant activity; in contrast, they remained fully susceptible to 16-membered macrolides, lincosamides, and streptogramins (Table (Table1).1). The DNAs of the eight isolates were amplified with primers specific to the mefAE genes (2). The PCR protocol consisted of a 5-min melt at 94°C, followed by 35 cycles (1-min melt at 94°C, 1-min primer-annealing step at 50°C, and 1-min extension step at 72°C), with a final extension step of 10 min at 72°C. All strains except for one (S. mitis 4) yielded a PCR product of the expected size (1.2 kb), whether no amplification was obtained with the DNAs of negative-control strains (sensitive or MLS phenotype strains). The amplicons were analyzed by restriction using four endonucleases designed to differentiate mefA and mefE (ClaI, HindIII, AccI, and HhaI) (2). The results showed that six strains carried a mefE gene, while the remaining one (S. oralis 6) possessed a mefA gene (Table (Table1).1). Thus, mefE appears to be predominant in viridans streptococci with the M phenotype, as previously observed for S. pneumoniae (6) and Streptococcus agalactiae (2). With specific primers for ermA, -B, -C (9), ermTR (8), and mreA (4), no PCR amplification was obtained with S. mitis 4 under the above conditions (Table (Table1).1). These results suggest the existence of a novel erythromycin resistance gene or mechanism in these species.

TABLE 1

MICs of MLS antibiotics correlated with the presence of mef genes in streptococci

The erythromycin resistance rate in viridans group streptococci was similar to those reported recently (around 40%) (1, 5), but the incidence of the M phenotype was lower than that reported elsewhere (about 20%) (1, 12). This is consistent with a lower incidence of beta-hemolytic streptococci and pneumococci with mef genes in France (<1%) (2). Commercially available 14- and 15-membered macrolides appear to be of limited value for chemoprophylaxis and therapy in viridans streptococcal infections.


In this paper, the generation of a magnetic field-free line (FFL) along a constant direction is investigated. It is shown that an FFL gradient field can be generated by two perpendicular Maxwell coil pairs. These coils can be used for imaging distributions of superparamagnetic nanoparticles with high sensitivity applying the magnetic particle imaging technique. To this end, the FFL has to be rapidly moved back and forth while either the object or the coil assembly rotates slowly. The field quality of the proposed coil setup is assessed by manufacturing a prototype and measuring the magnetic field using a Hall-effect sensor.