Dante's discourse with the penitent souls in the 'Purgatorio' reveals that these shades are characterised by a tendency towards self-effacement that is radically different from the destructive and self-absorbed attitude of the infernal spirits. Whereas the latter preserve an inner core of obduracy devoid of remorse, the contrite souls in 'Purgatory', through their trusting openness and willingness to communicate information about their private lives and the wider social and political circles of influence in which they once moved, help the Wayfarer to gain immeasurably in courage and inner strength. Throughout his journey, Dante-character is privy to surprising disclosures and, if the souls in Purgatory express amazement at his living presence among them, he is equally astonished by the news they relay to him, which has the potential to alter the destiny of members of the living Christian community and also to advance the spiritual cause of members of the community in Purgatory: "qui per quei di là molto savanza" (Purg. III, 145). Through his encounter with the shade of Pia in 'Purgatorio' V, the Pilgrim Dante is led to a higher level of spiritual cognition, not only as regards the souls in 'Purgatory', whose dialogues move back and forth in temporal and spatial terms as they reconstruct past events, relationships and places on earth, but also in relation to social networks and the interconnectedness of human society at large. URI http://hdl.handle.net/2328/617 Collections Diana Glenn Published Works Flinders Open Access Research DSpace software copyright © 2002-2015 DuraSpace Contact Us | Send Feedback Theme by Of thieves and salvation victories: Purgatorio V, 133 


The paper presents the results of constructing effective relay protection in the power supply system of a mining and processing plant (MPP). A brief description of the MPP is given, the power supply and substitution circuits used to calculate the short-circuit currents are given. A statistical analysis of failures in the electric network of the MPP has been carried out, which makes it possible to draw conclusions about the nature of failures ranges. Analysis of the registered faults shows that a significant part of them are line-to-earth faults, which in most cases turn into multiphase short circuits, which are interrupted by overcurrent protection. In order to improve the efficiency and reliability of the relay protection, the power supply scheme of the MPP was refined and analyzed. The calculation of the short-circuit currents was made, which made it possible to calculate the settings of the relay protection and give recommendations on the place of its installation and adjustment in order to ensure the normal operation of electricity consumers. To reduce the number of failures to the cable insert on the line leaving the administrative and household complex (AHC), and to increase the reliability of power supply to consumers, it is advisable to divide the capacities of the existing 10 kV line into two parallel ones by laying a second line. It is recommended to install a current cut-off on the line outgoing to the AHC, the feasibility of the installation of which was shown by calculations. This will reduce the chance of failures to the cable gland. Data on the setting currents of overcurrent protection and current cut-off are given on the selectivity card.


Knowing the nature of the enzyme–graphene interface is critical for a design of graphene-based biosensors. Extensive contacts between graphene and enzyme could be obtained by employing a suitable encapsulation which does not impede its enzymatic reaction. We have performed molecular dynamics simulations to obtain an insight on many forms of contact between glucose oxidase dimer and the single-layer graphene nano-sheets. The unconnected graphene sheets tended to form a flat stack regardless of their initial positions around the enzyme, whereas the same graphene sheets linked together formed a flower-like shape engendering different forms of wrapping of the enzyme. During the encapsulation no core hydrophobic residues of the enzyme were exposed. Since the polar and charged amino acids populated the enzyme's surface we also estimated, using DFT calculations, the interaction energies of individual polar and charged amino acid residues with graphene. It was found that the negatively charged residues can bind to graphene unexpectedly strongly; however, the main effect of encapsulation comes from the overlap of adjacent edges of graphene sheets.


The management of a pregnancy complicated by uterus myomatosus remains being controversially discussed. Myomectomy early in pregnancy is opposed by exspectative management with myomectomy subsequent to the post partum period. Therapeutic abortion and exstirpation of the gravid uterus represent only hypothetical but not reasonable alternatives. Complications like ureteral obstruction, sepsis, and torsion of the uterus with subperimetrial bleeding as a cause of fever of unknown origin may occur. Rapid growth of a fibromatous uterus in pregnancy may call for a biopsy. Two cases are presented to demonstrate that with intensive pregnancy surveillance exspectative management is justified and may lead to successful confinement of the pregnancy.


OBJECTIVE
To estimate the concurrent use between statins and amiodarone in context with published case reports of drug-interaction-induced rhabdomyolysis.

DESIGN
Retrospective analysis of a longitudinal prescription claims database for concurrent prescriptions of statins and amiodarone dispensed during 2006.

PATIENTS, PARTICIPANTS
The study population includes an unprojected annual number of patients who filled a prescription for an HMG CoA reductase inhibitor or simvastatin-containing products or lovastatin-containing products or Lipitor (atorvastatin) or Caduet (amlodipine/atorvastatin) concurrently with brand and generic forms of amiodarone during 2006. The concurrency analysis was used to provide context for published case reports of rhabdomyolysis/myopathy related to simvastatin and amiodarone concurrent use.

MAIN OUTCOME MEASURE
Episodes of concurrent use between statins and amiodarone.

RESULTS
Findings from this analysis indicate noteworthy amiodarone and statin concurrency (44%) when based on amiodarone patient volume. Atorvastatin had the greatest level of concurrency (23.5%) with amiodarone followed by simvastatin (13.3%). Proportionality based on amiodarone patient volume shows a greater level of concurrency with 20 mg (6%) and 40 mg (5.5%) simvastatin strengths compared with other simvastatin strengths.

CONCLUSION
Clinicians should be vigilant in monitoring the regimens of patients prescribed a statin with drugs that may increase the risk of myopathy. In particular, since nearly half of the patients prescribed amiodarone may also be prescribed a statin, then addition of amiodarone or changes in statin dose should trigger a drug regimen review and patient level monitoring. Clinicians should avoid simvastatin doses greater than 20 mg per day in patients taking amiodarone.


Purpose: Beneficial "4D" treatment planning and delivery methods, most of which are under development, rely on robust characterizations of motion. Implementation of these 4D methods may be hindered by deficiencies in current pre‐treatment imaging. 4D‐CT is the current standard for deriving patient‐specific margins. However, 4D‐CT is sub‐optimal because it represents a single‐cycle "snapshot" motion per slice location which results in slice‐to‐slice inconsistencies for variable breathing. Moreover, 4D‐CT involves ionizing radiation.MRI is not thusly encumbered. We have developed a 2D‐to‐4D sorting technique for dynamic MRI to derive an average‐breathing‐cycle anatomic representation for radiotherapy planning. Methods: Healthy lung and abdominal volunteers were imaged continuously for 10–30 minutes with balanced steady‐state free precession (bSSFP) and/or half‐Fourier single‐shot turbo spin echo (HASTE) on a 1.5T MRI system (MAGNETOM Espree, Siemens). 3D volumes were scanned in sagittal or coronal planes by changing the slice location per frame. Voxels were 2×2×5 mm3 and sequence parameters were adjusted to achieve repetition times of 200–300 ms. Synchronous with image acquisition, an external respiratory trace was collected at 50 Hz. Results: A two‐step sorting technique based on the respiratory trace was developed. In the first step, all frames per slice location and phase bin were averaged, producing an "average 4D‐MRI." From this we derived corresponding "standard deviation 4D‐MRI." Frame averaging resulted in blurring. In the second step, raw frames were compared to the set of images per slice location from the average 4D‐MRI; a normalized cross‐correlation scoring criterion over a user‐selected rectangular ROI indicated the best‐matching respiratory phase anatomically. The subset of best‐matching raw frames per slice location and phase were averaged to produce a final representation with improved contrast. Conclusions: Dynamic MRI shows great promise as a potential standard for motion management. Future efforts will involve modifications to the bSSFP sequence for significant improvements in speed. This work has received research personnel support from Siemens


In Ethiopia, traditional herbal medicine is dominated by plant-focused work, which has been largely driven by an overriding interest in the specific therapeutic properties of individual plants. In search of information on the properties of various Ethiopian medicinal plants, researchers have generally focused their attention on two main sources: (i) the professional traditional health practitioners, and (ii) Ethiopia's ancient medico-religious manuscripts - herbal letters containing elaborate recipes of plant-derived treatments for a wide range of health conditions. Traditional knowledge about medicinal plants and its application are very much taken for granted by both men and women in the communities. Such traditional knowledge and practices constitute routine aspects of daily life and are deeply engrained in the socio-cultural and economic fabric of these rural societies. It is evident that research and development efforts must aim to identify and address the challenges and threats faced by traditional health knowledge systems. The ultimate goal is to strengthen and improve this vast knowledge base for the benefit of the great majority of the developing world who have survived on it for centuries and will continue to do so into the foreseeable future.


Kefir has a sour taste and distinctive aroma. This condition affects the level of consumer acceptance. The level of consumer acceptance of kefir can be improved by adding a sweetener, namely honey. This study aims to determine the characteristics of kefir made from commercial liquid milk to total lactic acid, pH value, viscosity, organoleptic (taste and preference) panelists to kefir with the addition of honey. This study used a completely randomized design (CRD). The treatment of this research was 4 honey concentrations  (5%, 7%, 9% and without the addition of honey (0%) as a control) and was repeated 3 times. Kefir addition of honey is made in the following way: the liquid milk is sterilized at 105oC for 5 minutes and then the sterile milk is cooled down to a temperature of about 40oC. After chilling, sterile milk was inoculated with 3% (v/v) pre-propagated kefir starter and incubated at 37oC for 24 hours. Furthermore, kefir was added with honey treatment with a concentration of 5%, 7% and 9% (v/v) respectively and homogenized. Kefir honey is carried out in a series of tests including total lactic acid, acidity (pH), viscosity, organoleptic (taste and preference). The results showed that the different use of honey kefir did not change the lactic acid content. Increasing use of honey concentration causes pH value, viscosity, sweetness, and preference to increase. The best use of honey concentration in making kefir is 9%.


Agrobacterium tumefaciens is the main plant biotechnology gene transfer tool with host range which can be extended to non-plant eukaryotic organisms under laboratory conditions. Known medical cases of Agrobacterium species isolation from bloodstream infections necessitate the assessment of biosafety-related risks of A. tumefaciens encounters with mammalian organisms. Here, we studied the survival of A. tumefaciens in bloodstream of mice injected with bacterial cultures. Bacterial titers of 108 CFU were detected in the blood of the injected animals up to two weeks after intravenous injection. Agrobacteria carrying Cauliflower mosaic virus (CaMV) 35S promoter-based constructs and isolated from the injected mice retained their capacity to promote green fluorescent protein (GFP) synthesis in Nicotiana benthamiana leaves. To examine whether or not the injected agrobacteria are able to express in mouse organs, we used an intron-containing GFP (GFPi) reporter driven either by a cytomegalovirus (CMV) promoter or by a CaMV 35S promoter. Western and northern blot analyses as well as RT-PCR analysis of liver, spleen and lung of mice injected with A. tumefaciens detected neither GFP protein nor its transcripts. Thus, bacteraemia induced in mice by A. tumefaciens does not lead to detectible levels of genetic transformation of mouse organs.


Trauma involving the subclavian and axillary arteries is relatively infrequent. However, it can result in devastating functional disability of the upper limb due to significant and permanent associated neurologic deficits. Uncertainty exists in relation to certain aspects of therapeutical management of patients with trauma of the upper limb. Although decision pathway and algorithms have been proposed by several authors, the indications for surgery remain uncertain and not established. Two main points seem to be the most important determinants of the therapeutical strategy; first the viability of the limb and second the accurate determination of the vascular and nerve damage. We present a patient with a traumatic disruption of the subclavian artery and vein and concomitant brachial plexus injury following a road traffic accident. We highlight the role of accurate diagnosis to avoid life and limb-threatening complications from missed diagnosis. Also we review the recent literature emphasizing the therapeutical strategy and the role of conventional surgical repair and endovascular treatment.


Educators and course designers may face great hurdles when designing courses if they include an online setting. Instructional design (ID) has played a vital role as a change agent in facilitating the pedagogical and technological transformation of educators and students. However, some instructors still find ID challenging and there are information gaps regarding instructional design models, categories, educational context, and recommendations for future work. This systematic literature review (SLR) analyzed 31 publications using PRISMA to address this gap. The results of this review suggest combining ID models with broader theoretical frameworks. Investigations and research on ID should include a bigger number of ID types. It is highly recommended that extra frameworks be added to the ID procedure. To explore and grasp all parties engaged in ID, including the role of the instructor, the ID designer, and the student, it is important for additional educational contexts to be amalgamated. For novices in the field, such as graduate students, it is crucial to pay close attention to the several phases and techniques of ID. This review sheds light on the trends, future agenda, and research requirements associated with ID in educational settings. It might serve as a basis for future research on ID in educational contexts.


Progress in the solid-Earth sciences has been remarkable over the past few decades, driven by the availability of new instruments, improved modeling capabilities, reduced barriers to cooperation with scientists in other countries, and increased coordination with other disciplines, such as astronomy and biology. With research advancing on such a wide front, it can be difficult to define the frontiers of scientific inquiry and to convey that information in a way that captures the imaginations of the scientific community, the U.S. Congress, U.S. federal agencies, and the general public.

At the request of program managers at the U.S. Department of Energy, U.S. National Science Foundation, U.S. Geological Survey, and NASA, the U.S. National Academies has assembled a committee of experts to identify the grand research questions driving the solid-Earth sciences. Although other reports have identified research priorities in this area, just a few (such as "Living on a restless planet," 63 pp., NASA Solid Earth Science Working Group, Pasadena, Calif., 2002) have cast them mainly as compelling, fundamental science questions. Such 'big picture' questions may require decades to answer, and research support from many government agencies and organizations. The answers to these questions could profoundly affect our understanding of the Earth.


In this paper, the authors present an evaluation of the electromagnetic fields generated by a static wireless charging system designed for an electric kick scooter on the human biological tissue. The guidelines on the exposure to the electromagnetic fields are previously specified. In this work, a model is designed under COMSOL multi-physics to study the effects of the magnetic field on two possible body parts of a person, which might be exposed to this field, namely the head and the hands is analysed. The magnetic flux density, the induced electrical field, the specific absorption rate, and the resulting increase of temperature of biological tissues are modelled and compared to the limits and guidelines prescribed in the regulation established to limit the exposure of people to electromagnetic fields. Furthermore, the used wireless charging system is modified to operate at higher frequencies to study its effect. The obtained results are below the guidelines and limits of exposure to the electromagnetic fields specified by the International Commission on Non-Ionizing Radiation Protection, European Commission, Institute of Electrical and Electronics Engineers and International Electrotechnical Commission.


Background Pemetrexed-platinum doublet therapy is a standard treatment for stage IIIb/IV nonsquamous non small cell lung cancer (NSCLC). While the regimen is associated with several grade ≥3 toxicities, hyponatremia is not a commonly reported adverse effect. Here we report an unusually high incidence of grade ≥3 hyponatremia in Indian patients receiving pemetrexed-platinum doublet, and the pharmacological basis for this phenomenon. Methods Forty-six patients with advanced NSCLC were enrolled for a bioequivalence study of two pemetrexed formulations. All patients received the pemetrexed-platinum doublet for six cycles followed by single-agent pemetrexed maintenance until progression. Pharmacokinetic blood samples were collected at predefined time points during the first cycle and the concentration-time profile of pemetrexed was investigated by noncompartmental analysis. Hyponatremic episodes were investigated with serum electrolytes, serum osmolality, urinary sodium, and urine osmolality. Results Sixteen of 46 patients (35%) had at least one episode of grade ≥3 hyponatremia. Twenty-four episodes of grade ≥3 hyponatremia were observed in 200 cycles of doublet chemotherapy. Plasma exposure to pemetrexed was significantly higher in patients with high-grade hyponatremia than in those with low-grade or no hyponatremia (P=0.063 and P=0.001, respectively). Pemetrexed clearance in high-grade hyponatremia was quite low compared with normal and low-grade hyponatremia (P=0.001 and P=0.055, respectively). Median pemetrexed exposure in this cohort was much higher than that reported in the literature from Western studies. Conclusion Higher exposure to pemetrexed is associated with grade ≥3 hyponatremia. The pharmacogenetic basis for higher exposure to pemetrexed in Indian patients needs further investigation.


The year 2020 has led the world into a decade of action on the Sustainable Development Goals (SDGs), and the UN calls for a networked and inclusive multilateralism which will not only allow the outpouring of global solidarity to combat COVID-19 crisis, but help overcome the challenges of our current era. 2020 also marks the 15th anniversary of Global Forum on Human Settlements (GFHS) which has been dedicating to make sustainable cities and human settlements for all. GFHS has also issued a statement to extend its strongest support to the latest report launched by the United Nations "Policy Brief: COVID-19 in an Urban World" (hereinafter "Policy Brief").


Biofuels are required to reach the target set out by the European Commission's Transport mandate in the RED II (Renewable Energy Directive) for 2020–2030. To avoid indirect land use change, waste biomass resources such as sunflower husks can be used for advanced biofuel production. A process simulation and technoeconomic assessment of three fast pyrolysis plant scenarios were conducted. The nature of the waste feedstock has an effect on the value chain configuration, fast pyrolysis, and upgrading process design. Considering the difficulties with the transport and storage of biogenic waste due to low bulk density or hazardous and pathogenic content in case of transporting untreated sunflower husks, it is recommended to use a hub-and-spoke type of decentralized value chain configuration. The fast pyrolysis plants are located close to the feedstock, and the fast pyrolysis bio-oil (FPBO) is transported to a single upgrading facility, colocated at an existing refinery. The upgraded FPBO is then cofed into an FCC (fluidized catalyst cracker), where partially green biofuels such as gasoline and diesel are produced. For the fast pyrolysis process design, Scenario 2, treating 10 t/h of dry biomass with electricity and steam as coproducts, has the most favorable economic results with a total capital investment (TCI) of 78 million Euro and operating expenses (OPEX) of 6 million Euro.


Abstract In this study we examine the impact of the strength of the large-scale motions on the amplitude and frequency of the small scales in high-Reynolds-number turbulent boundary layers. Time series of hot-wire data are decomposed into large- and small-scale components, and the impact of the large scale on the amplitude and frequency of the small scales is considered. The amplitude modulation effect is examined by conditionally averaging the small-scale intensity ( ${ u}_{S}^{2} $ ) for various values of the large-scale fluctuation ( ${u}_{L} $ ). It is shown that ${ u}_{S}^{2} $ increases with increasing value of ${u}_{L} $ in the near-wall region, whereas, farther away from the wall, ${ u}_{S}^{2} $ decreases with increasing ${u}_{L} $ . The rate of increase in small-scale intensity with the strength of the large-scale signal is neither symmetric (about ${u}_{L} = 0$ ) nor linear. The extent of the frequency modulation is examined by counting the number of occurrences of local maxima or minima in the small-scale signal. It is shown that the frequency modulation effect is confined to the near-wall region and its extent diminishes rapidly beyond ${y}^{+ } = 100$ . A phase lag between the large- and small-scale fluctuations, in terms of amplitude modulation, has also been identified, which is in agreement with previous studies. The phase lag between large- and small-scale fluctuations for frequency modulation is comparable to that of amplitude modulation in the near-wall region. The combined effect of both amplitude and frequency modulation is also examined by computing conditional spectra of the small-scale signal conditioned on the large scales. In the near-wall region, the results indicate that the peak value of pre-multiplied spectra increases with increasing value of ${u}_{L} $ , indicating amplitude modulation, while the frequency at which this peak occurs also increases with increasing value of ${u}_{L} $ , revealing frequency modulation. The overall trends observed from the conditional spectra are consistent with the results obtained through statistical analyses. Finally, a physical mechanism that can capture most of the above observations is also presented.


Objective: To investigate the effect of sleep deprivation on corticospinal excitability in patients affected by juvenile myoclonic epilepsy (JME) using different transcranial magnetic stimulation (TMS) parameters. Methods: Ten patients with JME and 10 normal subjects underwent partial sleep deprivation. Motor threshold (MT), motor evoked potential amplitude (MEP), and silent period (SP) were recorded from the thenar eminence (TE) muscles. Short latency intracortical inhibition (SICI) and short latency intracortical facilitation (SICF) were studied using paired magnetic stimulation. TMS was performed before and after sleep deprivation; EEG and TMS were performed simultaneously. Results: In patients with JME, sleep deprivation induced a significant decrease in SICI and an increase in SICF, which was associated with increased paroxysmal activity. A significant decrease in the MT was observed. No significant changes in any TMS parameters were noted in normal subjects after sleep deprivation. The F wave was unchanged by sleep deprivation in both control subjects and in patients with JME. Conclusions: In patients with JME, sleep deprivation produces increases in corticospinal excitability in motor areas as measured by different TMS parameters.


Objectives In SEKOIA, strontium ranelate 2g/day (SrRan) has shown a structure-modifying activity with significant symptomatic improvement compared to placebo in patients with knee OA. This analysis aimed to determine proportion of patients considered as symptomatic responders as per WOMAC pain sub-score and OMERACT-OARSI-like responders, as well as the number of patients reaching MPCI (Minimal Perceptible Clinical Improvement) and MCII (Minimal Clinical Important Improvement). Methods SEKOIA was a double-blind, placebo-controlled, randomized, 3-year study aiming to demonstrate effects of strontium ranelate on radiographic progression of knee OA. It included men and women over 50 years old, with symptomatic primary knee OA (at least 40 on 100 mm VAS on most days of previous month, Kellgren and Lawrence [KL] grade 2 or 3, and JSW 2.5–5mm). Symptoms were assessed every 6 months using the WOMAC questionnaire. Proportions of patients with at least 20% or 50% improvement from baseline of WOMAC pain sub-score, proportion of OMERACT-OARSI-like responders (calculated without patient's global assessment as it was not assessed in SEKOIA) and percentages of patients reaching MPCI or MCII values, were compared between groups using a chi² test. Patients prematurely withdrawn from the study were counted as non-responding patients. Results ITT population included 1371(82%) patients. Mean±SD age was 63±7years, BMI 30±5 kg/m2, and WOMAC 132±62 mm. 66 % were KL grade II and 69% were female. Over 3 years, a greater percentage of patients treated with SrRan 2g were considered as symptomatic responders compared to placebo: For physical function, MCII and MPCI responders were statistically significantly greater in the SrRan 2g group compared to the placebo group from M12 (p=0.019 and p=0.027, respectively). For pain, the rate of responders was greater in the SrRan 2g group from M6 (p=0.024). Conclusions SrRan treatment is associated with greater number of patients with relevant improvement in symptoms. This can be evidenced from M6 considering MPCI pain responders. Disclosure of Interest O. Bruyère Grant/research support from: IBSA, Merck Sharp & Dohme, Nutraveris, Novartis, Pfizer, Rottapharm, Servier, Theramex, P. Richette Consultant for: Servier, Novartis, Negma, Expanscience. Wyeth Roche, Merck Sharp and Dohme, Genevrier, Ménarini. Ipsen. Pfizer. Sobi. Bioibérica. Fidia. BMS, Paid instructor for: Servier, Novartis, Negma, Expanscience. Wyeth Roche, Merck Sharp and Dohme, Genevrier, Ménarini. Ipsen. Pfizer. Sobi. Bioibérica. Fidia. BMS, N. Bellamy Shareholder of: Registered copyright and trademark holder of the WOMAC® Index, Consultant for: Servier, J. Brown Grant/research support from: Abbott, Amgen, Arthrolab, Bristol Myers Squibb, Eli Lilly, Merck, Novartis, Pfizer, Roche, sanofi-aventis, Servier, Takeda and Warner-Chilcott, Consultant for: Abbott, Amgen, Arthrolab, Bristol Myers Squibb, Eli Lilly, Merck, Novartis, Pfizer, Roche, sanofi-aventis, Servier, Takeda and Warner-Chilcott, Speakers bureau: Abbott, Amgen, Arthrolab, Bristol Myers Squibb, Eli Lilly, Merck, Novartis, Pfizer, Roche, sanofi-aventis, Servier, Takeda and Warner-Chilcott, R. Chapurlat Grant/research support from: Merck, Amgen, Servier, Lilly, Roche, Novartis, X. Chevalier Grant/research support from: Roche for the department association, Consultant for: Expanscience, Negma, Genevriers, Merck Sharp and Dohme, Rottapharm, Fidia, Servier, Pierre Fabre, Smith Nephews, Paid instructor for: Merck Sharp and Dohme, Servier, Expanscience, Ibsa, Genzyme, E. Czerwinski E Grant/research support from: Amgen, Andromeda Biotech Ltd., AstraZeneca, Biotest AG, Eli Lilly, INC Research, Johnson&Johnson, Merck Serono, Novartis, Pfizer, Roche, Servier, Shire Movetis, J. Devogelaer Consultant for: Novartis, Paid instructor for: Merck, Sharpe & Dohme, Servier, Procter & Gamble, Roche, and Amgen, L. March Grant/research support from: Servier, MSD, Pfizer, Abbott, UCB, Paid instructor for: Servier, MSD, Pfizer, Abbott, UCB, K. Pavelka Paid instructor for: BMS, Abbott, Pfizer, MSD, Amgen, L. Punzi Grant/research support from: Abbott SpA, Menarini Spa, Fidia SpA, Sobi SpA, UCB SpA, Consultant for: Abbott SpA, Menarini Spa, Fidia SpA, Sobi SpA, UCB SpA, C. Cooper Consultant for: Amgen, ABBH, Novartis, Pfizer, Merck Sharp and Dohme, Eli Lilly, Servier, J. Reginster Grant/research support from: Bristol Myers Squibb, Merck Sharp and Dohme, Rottapharm, Teva, Lilly, Novartis, Roche, GlaxoSmithKline, Amgen, Servier, Consultant for: Servier, Novartis, Negma, Lilly, Wyeth, Amgen, GlaxoSmithKline, Roche, Merckle, Nycomed, NPS, Theramex, UCB, Paid instructor for: Merck Sharp and Dohme, Lilly, Rottapharm, IBSA, Genevrier, Novartis, Servier, Roche, GlaxoSmithKline, Teijin, Teva, Ebewee Pharma, Zodiac, Analis, Theramex, Nycomed, Novo-Nordisk.


UNLABELLED
Ricin is a potent protein toxin that could be exploited for bioterrorism. Although ricin may be detoxified using heat, inactivation conditions in foods are not well characterized. Two brands of pulp-free orange juice and 2 brands of single-strength apple juice (one clarified and the other unclarified) containing 100 microg/mL added ricin were heated at 60 to 90 degrees C for up to 2 h. With increasing heating times and temperatures the heat-treated juices exhibited decreasing detectability of ricin by enzyme-linked immunosorbent assay (ELISA) and cytotoxicity to cultured cells. Z-values for ricin inactivation in orange juices were 14.4 +/- 0.8 degrees C and 17 +/- 4 degrees C using cytotoxicity assays, compared to 13.4 +/- 1.5 degrees C and 14 +/- 2 degrees C determined by ELISA. Although insignificant differences were apparent for z-values measured for the 2 orange juice brands, significant differences were found in the z-values for the 2 brands of apple juice. The z-values for ricin inactivation in the clarified and unclarified apple juices were 21 +/- 4 degrees C and 9.5 +/- 1.1 degrees C, determined by cytotoxicity assays, and 20 +/- 2 degrees C and 11.6 +/- 0.7 degrees C, respectively, using ELISA. Overall, there were no significant differences between results measured with ELISA and cytotoxicity assays. Ricin stability in orange juice and buffer was evaluated at 25 degrees C. Half-lives of 10 +/- 3 d and 4.9 +/- 0.4 d, respectively, indicated that active ricin in juice could reach consumers. These results indicate that ricin in apple and orange juices can remain toxic under some processing and product storage conditions.

PRACTICAL APPLICATION
Ricin is a potent toxin that is abundant in castor beans and is present in the castor bean mash by-product after cold-press extraction of castor oil. U.S. Health and Human Services recognizes that ricin could be used for bioterrorism. This study reports the stability of ricin in apple and orange fruit juices at temperatures ranging from 60 to 90 degrees C (140 to 194 degrees F).


Abstract A review on the development of climatic scenarios related to policy-oriented assessment of the impact of climatic variations is presented. It seeks to provide background information needed to evaluate the extent to which existing regional scenarios have utility in the above context, and whether and how such utility could be increased in the future. An appraisal of alternative approaches (both GCM and empirically based) that have been used to develop scenarios from the stand-points of their respective motivations, the methods employed, the acknowledged strengths (both present and potential) and weaknesses, the results obtained, and the credibility of those results is given. Types of research needed to make regional climatic scenarios of greater utility for the policy-oriented assessment of the impact of climate variations are suggested.


This article critically evaluates the argument that, if developing countries had better institutions and policies and deeper financial markets, they would receive a boost to growth from capital account liberalization. The existing empirical record is ambiguous and leaves unanswered many of the important questions facing policy-makers. To test some predictions driving the case for capital account liberalization in developing countries, this article investigates the relationship between net capital inflows and medium-term economic growth within a sample of rich, institutionally advanced economies between 1984 and 2004. No evidence of a strong or statistically robust relationship between net capital inflows and future economic growth is found. On the contrary, the evidence suggests that net capital inflows are more strongly associated with past economic growth than with future economic growth. This result implies that capital account liberalization is not likely to boost growth, even among countries with the most appropriate institutions and policies.


For the rapid develop of computer speed, the small calculating advantage of ∞-norm is gone when the nearest points of chaotic time series's reconstructed space are found by 2-norm or ∞-norm. So the right method should be selected on the basis of reconsidered the two methods. By theories analysis, the ratio between ∞-norm distance and 2-norm distance is in an inherent interval. Huanan Zhixin and Lorenz data are used for verified the effect of finding the nearest points by the two norms. The nearest points is partly the same by the two norms and the found same point rate is different between two time series. And the nearest distance calculating by 2-norm between the point pair finding by ∞-norm is equal or great than the point pair finding by 2-norm. So the real nearest point is found by 2-norm.


Polycations that absorb protons in response to the acidification of endosomes can theoretically disrupt these vesicles via the "proton sponge" effect. To exploit this mechanism, we created nanoparticles with a segregated core-shell structure for efficient, noncytotoxic intracellular drug delivery. Cross-linked polymer nanoparticles were synthesized with a pH-responsive core and hydrophilic charged shell designed to disrupt endosomes and mediate drug/cell binding, respectively. By sequestering the relatively hydrophobic pH-responsive core component within a more hydrophilic pH-insensitive shell, nontoxic delivery of small molecules and proteins to the cytosol was achieved in dendritic cells, a key cell type of interest in the context of vaccines and immunotherapy.


The model predicting quantitatively a dose response for genetic lesions in low dose range is presented. The model is based on the concept of programmed initiation of the genetic damage in the subpopulation of specific cells of "evolutionary reserve" (CER). It is demonstrated that complex shape of dose-response curve results from superposition of processes in different subpopulations within exposed cell population, mainly in CER. The model allows us to explain the minimum observed in the dose-response curve at doses corresponding to one (on the average) event of energy deposition per CER with spontaneous aberrations. The equation for dose-response function for dicentrics describes satisfactory experimental observations. Advantage of proposed equation is that it does not deal with free parameters to fit the data. They are determined independently by using known physical and biological characteristics. The data described allow us to suggest that sensitive body for CER is a cell as a whole. Probably, programmed initiation of genetic lesions in CER requires both two hits at cell membrane and radiation effect on cell nucleus.


Pembrolizumab is a humanized antibody that targets programmed cell death receptor-1. This agent is approved for use in the treatment of several malignancies. While pruritus and papulo-erythematous rash are not uncommon with its use, severe reactions such as Stevens-Johnson syndrome/toxic epidermal necrolysis are very rare. We present herein a case of Stevens-Johnson syndrome occurring in a patient who had previously tolerated pembrolizumab without significant side effects for seven months. Prompt recognition of Stevens-Johnson syndrome/toxic epidermal necrolysis and discontinuation of the offending agent are paramount to ensure a favorable outcome.


A total of 387 isolates of Puccinia graminis f. sp. tritici (Pgt) collected in the central region of the Russian Federation from 2000 to 2009 was analysed with North American differential sets comprising 16 genotypes for samples of 2000–2006 and 20 genotypes for samples from 2007–2009. Forty-five races were identified. The race composition of the local population underwent changes during this period. Race MKBT was the predominant race in the earlier years, but TKNT and TKNTF were in the majority later. During 2000–2009 there were no stem rust epidemics in the region. It was assumed that the local pathogen population cycled on wild grasses (including Elytrigia, Agropyron, Festuca, Dactylis, Phleum and Lolium spp.) and not only on wheat. The existence of host communities of wheat stem rust was supported by random amplified polymorphic DNA (RAPD) markers produced with high-GC primers. The local population of Pgt was considered to be sexual based on the relatively high diversity of races isolated from various hosts and the absence of correlation between virulence attributes and molecular markers.


Specifications for software systems are quite often missing or are obsolete given the evolutionary nature of these systems. Lack of precise software specifications makes the task of debugging and detecting a malfunction of system behavior challenging. Prior works have primarily focused on extracting system specifications in the form of template-based mining frameworks or interactive simulation models. In safety-critical systems where the time of occurrence of events is of prime importance extracting specifications with a quantitative notion of time seems a daunting task. This work presents an unsupervised approach to mine timed temporal properties in the form of deterministic finite state machines with a custom-designed trie data structure. Our frame-work, MINTS learns dominant system specifications from their system traces that are represented as a timed deterministic finite state machine. MINTS is shown to be sound and complete. MINTS scalability and correctness is validated using real-world industry strength traces.


This project is focused on improving Environmental Education in Tallahassee, specifically in regards to the Food and Agriculture System. This paper draws on research about environmental education practices as well as issues within the agriculture system to develop an understanding about not only the need for Food and Agriculture Education, but also the ideal ways to engage students, teachers, and the community. The primary research in this study involved qualitative interviews with local community members and educators who are involved in Environmental Education. Themes and issues of the interviews were discussed as a foundation for an educational framework proposal. The framework involves four key elements 1) an online website of relevant content and lessons 2) a networking initiative to connect farmers and community organizations with teachers and students 3) educational opportunities for teachers and other educators 4) a connection between student's community engagement and classroom success.


words about our paper (1). We wish to point out, however, that we are not proposing PET/MRI fusion as a screening technique. Rather, we encourage that it be used in those cases in which MRI has a specificity of 50% or less (2). Such cases include, but are not limited to, small invasive carcinoma and intraductal carcinoma (ductal carcinoma in situ), which may be missed on MRI; invasive lobular carcinoma, which is difficult to detect by physical examination, mammography, or sonography, and which might be either undetected or underestimated on MRI; tissue changes at a lumpectomy site; occult, multifocal, multicentric, or contralateral breast carcinoma; and patients with otherwise occult cancers who require confirmation of the primary tumor (3–5). MRI is particularly recommended for early detection of breast cancer in women who are at increased risk for breast tumors because of family history, gene mutations such as BRCA1 or BRCA2, or prior radiation exposure or who are difficult to image mammographically, such as young women with dense breast tissue. As was noted in our paper, our patient population consisted of many such cases. Additionally, our method was unique in that we acquired the PET scan with the patient prone to better match the geometry of the MRI scan (6). We noted in our paper that small tumors were harder to detect with PET, and we also noted that for a particular range, the standardized uptake value was an unreliable indicator of whether cancer was present. One outcome of our research is to encourage the clinical development of simultaneous PET/MRI machines that will obviate fusion of separate PET and MR image volumes.


The work presented covers numerical analyses of edge-cracked thin plates of austenitic stainless steel, AISI 316, loaded with transient thermal downshock. Further to this isothermal centre-cracked plates loaded under isothermal biaxial conditions are modelled. Crack growth rates are then applied to the models to determine a correlation between the two geometries. The work presented demonstrates that a correlation exists between thermal downshock and biaxial isothermal crack growth rates. For such a correlation to be determined, the thermal shock and isothermal biaxial loading must be studied with an elastic-plastic material response. It is also determined that biaxiality in thermal shock is a function of the shock localisation due to localised contraction of the specimen in the direction of heat flow, making it necessary to evaluate thermal shock stresses in a two-dimensional sense. The relationship between biaxiality and localisation is found to be non-linear. At shocked regions greater than 25% of the available area maximum stresses remain largely unchanged. Below 25% of the available area maximum stresses drop significantly, by up to 50%. Finally a method is proposed whereby thermal shock crack growth rates can be estimated by the bounding conditions of isothermal biaxial loading. This method uses an estimation of the heat transfer coefficient determined through a thorough analysis of a broad range of thermal shock cycles for AISI 316. Using the defining temperatures and time period of the cycle the h value can be estimated to within 3%. Once known the h value is fed into a simple log function describing maximum thermal stress, which can then be converted for any localisation present. It is also found that the correlating isothermal peak load is approximately equal to that of the thermal stress calculated. From this a modified Paris law is proposed to predict two sets of crack growth rates; one at equibiaxial conditions and the second at a biaxiality determined from the thermal shock load. This is shown to be a minimum of 0.35 at maximum localisation. This will calculate the upper, and lower, bounding limits of the thermal shock crack growth rates, providing a good estimation of the thermal shock crack growth rates.


Dilated Convolution with Learnable Spacings (DCLS) is a recently proposed variation of the dilated convolution in which the spacings between the non-zero elements in the kernel, or equivalently their positions, are learnable. Non-integer positions are handled via interpolation. Thanks to this trick, positions have well-defined gradients. The original DCLS used bilinear interpolation, and thus only considered the four nearest pixels. Yet here we show that longer range interpolations, and in particular a Gaussian interpolation, allow improving performance on ImageNet1k classification on two state-of-the-art convolutional architectures (ConvNeXt and Conv\-Former), without increasing the number of parameters. The method code is based on PyTorch and is available at https://github.com/K-H-Ismail/Dilated-Convolution-with-Learnable-Spacings-PyTorch


In cold climates, wet comminuted wood fuels sometimes freeze to walls and other surfaces during cold storage. This is well known. However, few studies have examined the relationship between the strength of attachment caused by freezing and factors such as temperature, fuel moisture content (MC), and surface type. The freezing ofwood chips to three different surfaces (smoothed concrete, urethane rubber, and coated plywood) was studied on a laboratory scale with equipment designed for the study. Six plastic pipes embedded in thick insulation and filled with wood chips (15% to 155% MC, dry basis) were kept in direct contact with the surfaces that were mounted on a cold wall (-25°C). This allowed the freezing ofwood chips to six circular sections ofthe wall surfaces. The strength of the attachment caused by freezing was defined as the force parallel to the wall needed to loosen the wood chips. The force needed to loosen the wood chips was exponentially related to the MC of the chips. It was 4.3, 17.6, and 40.4 kN per m 2 of contact area at MCs of 50, 100, and 150 percent, respectively. There was no significant difference in attachment between the three wall surfaces. The strength of attachment caused by freezing was influenced by the way the wall was kept cold. Because the study only included three surfaces and used wood chips with a very low proportion of fines and oversized particles, more surfaces and kinds of comminuted wood fuel ought to be studied.


Three cases of postpartum hepatic hemorrhage in the syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP) were diagnosed by Tc-99m sulfur colloid liver-spleen scanning. Two patients had follow-up scans. One showed rapid resolution of the hematoma on the repeat scan performed six days later, while the other showed delayed resolution on the repeat scan four weeks later. All patients received non-surgical supportive therapy with or without blood transfusion after delivery, and recovered well. Usefulness of radionuclide liver-spleen scanning in the diagnosis of peripartum hepatic hemorrhage and monitoring course of the disease is emphasized.


Sixty-one strains of the root-associated nitrogen fixer Spirillum lipoferum exhibited a similar morphology in peptone--succinate salts medium: vibrioid cells having a diameter of 1.0 micrometer. When grown in broth the cells had a single polar flagellum, but when grown on agar at 30 degrees C lateral flagella of shorter wavelength were also formed. The DNA base composition was 69--71 mol% guanine + cytosine when determined by thermal denaturation. DNA homology experiments indicated the occurrence of two distinct but related homology groups: 46 strains were in group I and 15 strains were in group II. Group II strains were distinguished by their ability to use glucose as a sole carbon source for growth in nitrogen-free medium, by their production of an acidic reaction in a peptone-based glucose medium, by their requirement for biotin, and by their formation of wider, longer, S-shaped or helical cells in semisolid nitrogen-free malate medium. The results indicate that two species exist, and on the basis of their characteristics it is proposed that they be assigned to a new genus, Azospirillum. Strians belonging to group II are named A. lipoferum (Beijerinck) comb. nov., while those belonging to group I are named A. brasilense sp. nov. Strain Sp 59b (ATCC29707) is proposed as the neotype strain for A. lipoferum, and strain Sp 7 (ATCC 29145) is proposed as the type strain for A. brasilense.


In this study, generalized projective synchronization (GPS) of two identical and nonidentical time-delayed chaotic systems is presented. Sliding adaptive radial basis function neural network control (SARBFNNC) is applied to synchronize two delayed chaotic systems. The advantages of the adaptive control, neural network and sliding mode control theory are combined in the proposed method. The stability of error dynamics is guaranteed with Lyapunov stability theory. Moreover, supposing that the parameters of the chaotic system are unknown, recursive least square (RLS) method is applied to estimate these unknown parameters. The proposed method has not been used for synchronization of time-delayed chaotic systems yet. Simulation results show that the proposed method is suitable and effective for synchronization of time-delayed chaotic systems.


It is very weak that the reflected signal from the moving shell in gun tubes, due to the multi-mode interference noise. It is very important to eliminate the noise in order to improve the measurement accuracy. A method is presented which can eliminate effectively the noise by using the whitening method and K-L transformation. The mathematical derivation and the program which is designed with Labview8.0 prove the method is correct and effective.


The paper deals with sedimentary evolution of the condensed Ordovician sequence outcropping in Mojcza village, near Kielce (Central Poland), basing on microfacies analysis. The occurrence of fossils, their preservation and mineral composition enabled the author to distinguish five microfacies types. The Mojcza section is generally composed of grainstones and packstones which form the Mojcza Limestone Formation, and calcareous claystones intercalated with wackestones assigned to the Zalesie Formation. The deposition of limestones from the Mojcza section took place on the outer part of drowned isolated carbonate platform of temperate water setting in uniform sedimentary conditions with low accumulation rate. This environment, located in the upwelling currents activity area, was favourable for phosphatization of sediment. Abundance of ferruginous ooids in the upper Llanvirn, L1andeilo and upper Caradoc sediments suggests highstand sea-level conditions during Middle and Upper Ordovician.


In early energy conservation and energy efficiency efforts, implementers and evaluators focused on delivering and analyzing the effects of individual measures. More recently implementers and evaluators have come to understand that measures are embedded in systems and that by taking into account the interactions among measures, through a whole systems or whole buildings approach, even greater energy savings are possible. Even more recently, regional and national market transformation organizations have broadened their scope by undertaking portfolio analysis to optimize the potential savings. In this paper, we argue that while it is important to continue to evaluate programs as we have in the past, we also need to expand our focus to a meta-systems or societal level. Solutions leading to energy efficiency are embedded in a context. The goal of this paper is to discuss issues that arise when taking into account the larger societal context and to discuss the need for evaluators to broaden the scope of their thinking and to bring to bear their skills to influence local, regional, national, and international policies to reduce societal energy use. Our current efficiency efforts may result in more efficient new residential and commercial buildings that reduce the rate of growth in energy consumption. Future efforts may result in net-zero energy buildings. Even with these savings, the geographic placement of such buildings and the nature of designs may result in huge energy expenditures to both construct infrastructure and transport the workforce that uses the building to and from the building. The energy burden imposed by locational decisions may far exceed the energy savings from making a building more efficient. Thus, without analysis of the energy implications of siting and infrastructure development and action to implement more energy efficient policies, we may create a landscape dotted with efficient buildings whose use cause increased use of energy. The authors provide concrete analytic examples from the commercial building sector showing how the energy use from locational and other policy decisions associated with a commercial building can outweigh the energy to be saved from making commercial buildings more efficient. The authors will briefly review some of the existing work that has been done. They also discuss who else might be interested in these issues.


Introduction/Background The standard treatment of locally advanced cervical cancer is the combination of a concurrent radiochemotherapy brachytherapy. The aime of this study was to evaluate the morbidity, also to determine the post therapeutic prognosis and its factors in disease free survival and overall survival at 2 years. Methodology An observational retrospective monocentric cohort concerning 82 patients cared for cervical cancer stage IB2 between 2016–2017 was conducted. All patients included in this study were treated with radiochemotherapy brachytherapy followed by a completion surgery. Results In this study, we had patients with epidermoide carcinoma in 93.90% and adenocaricnoma in 4.88%, with advanced stages, IIB (73.17%), IIIB (9.75%), IIA (12.19%), IB2 (1.22%) and IVA (1.22%). All patients recieved radiotherapy with 93.90% of patientes recieving between 41 and 50 Gy. 33 patients (40.24%) recieved a brachytherapy. 74 patientes (90.24%) recieved a chemotherapy (concomitant for 71 patients). The medium period of time between RCC and surgery was 12.5 weeks. The completion surgery was large (ACHE) in 75.61%, with a laparotomy in 63.41%. A lymphadenectomy was done at the same time in 75.61%. Peroperative difficulties were present in 6.10% of cases. Peroperative complications were observed in 16.63% (2.44% vascular lesion, 1.22% visceral lesion, 8.55% bleeding and 2.44% APO), no reanimation, surgical nor radiological treatment was required. None of the patients died in or after the surgery. Conclusion Our study found a miner and acceptable rate of per and postoperative complications with no gravity. The analysis of complications risk factors and the prognosis factors suggest that the complete response rate, and higher rate of overall survival and disease free survival could be improved. Disclosure Nothing to disclose.


Markov chain Monte Carlo (MCMC) is widely regarded as one of the most important algorithms of the 20th century. Its guarantees of asymptotic convergence, stability, and estimator-variance bounds using only unnormalized probability functions make it indispensable to probabilistic programming. In this paper, we introduce the TensorFlow Probability MCMC toolkit, and discuss some of the considerations that motivated its design.


Mushrooms are known to accumulate radiocesium. To estimate the intake of radiocesium through the eating of mushrooms, about 30 samples belonging to 4 commonly consumed species (Lentinula edodes, Hypsizigus marmoreus, Grifola frondosa, and Tricholoma matsutake), were analyzed for (137)Cs and (40)K. The concentration ranges were 0.060-29 Bq kg(-1) (wet wt) for (137)Cs and 38-300 Bq kg(-1) (wet wt) for (40)K. The geometric mean concentration for (137)Cs was 0.56 Bq kg(-1) (wet wt), and the mean concentration for (40)K was 92 Bq kg(-1) (wet wt). The (137)Cs concentrations in L. edodes cultivated in mushroom beds (sawdust-rice bran media) were lower than those cultivated on bed logs (natural wood with bark). The annual intake of (137)Cs per person through mushrooms was calculated, by using the current analytical results and food consumption data in Japan, to be 3.1 Bq for (137)Cs, which is about 28% of the total dietary intake of this nuclide. The effective dose equivalent of (137)Cs through mushrooms was estimated to be 4.0 currency 10(-8) Sv, which is about the half the value obtained in our previous study. The decrease of the (137)Cs intake through mushrooms is probably related to changes in cultivation methods in recent years, from the use of bed logs to mushroom beds.


People are now making and playing many Renaissance and early baroque instruments which until recently were not even mentioned in standard dictionaries. Praetorius's De Organographia , first published in 1618, can be called the book behind the revival. While it has long been an essential tool for musicologists, it is now exercising a wider, more popular appeal as the growing multitude of instrument makers and players seeks to base its efforts on this documentation Praetorius has provided. No comparable work gives us the wide range, the clarity of description, and above all the scale drawings that we find in Praetorius. This edition of De Organographia , translated and edited by David Crookes, fulfils the need in the present post-revival circumstances for a new translation. Mr Crookes, who is a qualified instrument maker, has added a commentary to help the reader with problems (some literary, but mostly technical) arising from the text. Students of music, performers of early music, and instrument makers.


ABSTRACT This study involves an in-depth examination of Canadian elementary teachers' cognitive processes and metacognitive strategies they used during a self-directed online learning experience. The virtual revisit think aloud, a methodology that combines a retrospective procedure with screen recording technology, was used to capture verbalisations from 13 elementary teachers as they used an online database. Resulting think aloud protocols and post-task interviews were analysed using qualitative methods. An inductive approach to analysis led to six themes related to the types of cognitive processes and metacognitive strategies teachers use during self-directed online learning: connecting to practice, tweaking and adapting, narrowing the focus, skimming through, reading for depth, and source credibility. The teachers in this study demonstrated a non-linear iterative process in which they continuously planned, monitored, and evaluated their learning during the self-directed online learning experience. Implications for teacher learning and research are discussed.


Personalized item recommendation is useful in narrowing down the list of options provided to a user. In this paper, we address the problem scenario where the user is currently holding a basket of items, and the task is to recommend an item to be added to the basket. Here, we assume that items currently in a basket share some association based on an underlying latent need, e.g., ingredients to prepare some dish, spare parts of some device. Thus, it is important that a recommended item is relevant not only to the user, but also to the existing items in the basket. Towards this goal, we propose two approaches. First, we explore a factorizationbased model called BFM that incorporates various types of associations involving the user, the target item to be recommended, and the items currently in the basket. Second, based on our observation that various recommendations towards constructing the same basket should have similar likelihoods, we propose another model called CBFM that further incorporates basket-level constraints. Experiments on three real-life datasets from different domains empirically validate these models against baselines based on matrix factorization and association rules.


Heart‐lung transplant (HLT) is a widely accepted modality for certain patients with advanced and refractory cardiopulmonary disease. Some of these patients are critically ill on the transplant waiting list, and venoarterial extracorporeal membrane oxygenation (VA‐ECMO) can be used as a bridge to transplantation. Although the experience with ECMO as a bridge to lung transplant is promising, there is limited evidence to use ECMO as a bridge to HLT. Femoral cannulation remains a concern for ambulation given the risk of bleeding and cannula complications despite studies reporting its safety. We present a case of a 56‐year‐old male with interstitial lung disease and severe secondary pulmonary hypertension, who was successfully bridged to HLT with ambulatory femoral VA‐ECMO.


Accompany wide area communication has become an intelligent technology, which makes the real-time interaction between the substations and the wide area protection and control system possible. However, the present protection and control system to handle this real-time data has been recognized to be deficient. In this paper begins by reviewing the development history of power system protection, with special attention paid to the recent development in the field of wide-area and integrated protections, in order to look into the future development of protection and control systems. New technique for power system protection and control is proposed. Then the concept of integrated wide area protection and control is introduced, where it can be shown that a hierarchical protection and control system provides the protection and control for wide area or regional power substations/plants and their associated power networks. The system is mainly divided into three levels: the local, the substation/plant, and the wide area/regional. The integrated functions at each level are described in details with an aim to develop an optimal coordination mechanism between each level. The key element in the proposed system is the wide area real-time protection and control information platform, which not only enables the merger of three lines of deface for power system protection and control, but also provides a perfect tool for the application of cloud computing in substations and power networks. ---------------------------------------------------------------------------------------------------------------------------------------


In research on religiosity and prejudice, right-wing authoritarianism (RWA) has been studied alongside variables such as fundamentalism and orthodoxy. Four concerns regarding research on the relationship between RWA and religiosity are identified: (1) the overlap of religiosity and prejudice within the RWA scale; (2) the inflation of relationships by correlating part-whole measures; (3) covariation in the extremes of the construct hiding the possible independence of components within RWA; and (4) statistical artifacts arising in multiple regression from the combination of these factors. We elaborate these four issues and then demonstrate how they can lead to different interpretations of some previously published data. The article concludes with suggestions for the management and resolution of these issues that may allow RWA to continue to be used in religiosity and prejudice research and how it might evolve to become the boon to researchers that they seek.


This article outlines a health care benefits strategy that combines features of the multiple HMO choice approach and the point-of-service approach. Although this plan design may not be appropriate for all employers, it may provide the greatest long-term cost savings for employers with high HMO enrollment, according to the author.


We demonstrate efficient, high-performance format conversion from wavelength-hopping time-spreading (WHTS) optical CDMA to NRZ using a terahertz optical asymmetric demultiplexer (TOAD), with 1 dB power penalty. Schemes for interfacing WHTS and WDM networks are presented.


ABSTRACT Route of administration is an important contributor to the adverse health consequences of prescription medication abuse. The current study examines characteristics associated with non-oral routes of administration among a large sample of prescription opioid abusers and explores needle-related human immunodeficiency virus (HIV) risk behaviors as well. In the study, 791 opioid abusers completed a one-time structured interview, including complete histories of illicit and prescription drug abuse and route of drug administration. The most common method of pill use was oral (91%), followed by intranasal (53.1%), injection (23.8%), and smoking (14.5%). The youngest prescription opioid abusers, ages 18–24, displayed significantly higher odds of using alternate routes of administration and of reusing nonsterile needles for injection. HIV prevention programming should be developed for young prescription opioid injectors.


In this research paper, we present the analysis and the results of the questionnaire about the general and specific uses, the time spent and the possible risks, considering the possible addiction to social networks. We have considered a sample of 182 teenagers, 85 girls and 97 boys, of ages included between 15 and 18 years old of the province of Granada. The most outstanding results indicate a positive correlation between the time of use and the addiction to the social networking sites. They show that a high worry around the dependency exists, revealing the need to develop educational-preventive patterns for a safe use, trying not to fall down in the dependency produced by an excessive use


Abstract Introduction: The aim of the present study was to investigate the association between exposure to fathers' alcohol consumption and offspring's own risk of alcohol-related hospitalization. Methods: Data on circumstances in childhood and adolescence, e.g. fathers' alcohol consumption at different levels (never, rarely, occasionally, often), parental divorce, as well as offspring's own risky use of alcohol, smoking and mental health were collected among 49,321 men (sons), born in 1949–51, during conscription for compulsory military training in 1969/70, i.e. at ages 18–20. Data on alcohol-related diagnoses were collected from the Swedish In-patient Care register 1973–2009. Results: The relative risk of alcohol-related diagnoses among sons after the age of 20 increased with increasing level of alcohol consumption in the fathers. Compared with sons whose fathers never drank alcohol, those with fathers who drank alcohol occasionally or often had an increased hazard ratio (HR) of later hospitalization with alcohol-related diagnoses of 1.77 (95% confidence interval (CI) = 1.57–1.99) and 3.69 (CI 95% = 3.16–4.32), respectively. The associations were markedly stronger when the men were followed from age 40 and onwards compared with follow-up between 20 and 40 years of age. Conclusion: Father's alcohol consumption was associated with an increased relative risk of alcohol-related hospitalization in offspring in adulthood.


Soil fungi are important components of boreal forest ecosystems; for example, saprotrophic fungi regulate nutrient cycling, and mycorrhizal species facilitate nutrient uptake by plants. This study aimed to assess soil fungal communities in a reclaimed area and an adjacent natural mixedwood forest and to identify the distribution of taxa available for seedling colonization. Soil fungal microbiomes were assessed along three transects (from 10 m inside the interior of the undisturbed forest to 40 m inside the reclaimed area) and in the roots of small aspen within the natural forest. Using high-throughput deoxyribonucleic acid (DNA) sequencing of internal transcribed spacer amplicons, a total of 2796 unique fungal taxa were detected across fine roots, forest floor, and mineral soils collected along the transects, whereas 166 taxa were detected in the aspen roots from the natural forest. Within the interior of the forest, ectomycorrhizal fungi were more common, whereas in the reclaimed areas, arbuscular mycorrhizae and saprophytes were more common. This survey showed that natural areas of adjacent undisturbed forest can act as a source of ectomycorrhizal fungi for dispersal into reclaimed areas. Notably, soil fungal taxa colonizing the root systems of small aspen included species that are specifically associated with soils from the undisturbed forest (primarily ectomycorrhizae) or the reclaimed clearing (saprotrophs and plant pathogens).


Knowledge of the epidemiology of visual impairment in children forms one of the cornerstones in paediatric ophthalmology. To gain an overview of the situation in Sweden an epidemiological study was performed. Totally 2373 visually impaired children were found, giving an age-specific prevalence of 10,9/10 000. Childhood blindness (i.e. vision <0,05) was seen in 25%. Male/female ratio was 1,20. Additional impairments were present in 60%. Aetiologies were prenatal in 64%, peri-/neonatal in 20%, infantile/juvenile in 7% and unknown in 9%. The most frequent disorders were cerebral visual impairment, non-hereditary optic atrophy, retinal dystrophy (as a general entity), congenital hypoplasia of the optic nerve and congenital cataract.

To produce a pilot-study regarding visual and social outcome, a study from 1980 was revisited. The same inclusion-criteria as in the nation-wide study were used, which reduced the material from initially 219 to 128 individuals. A comparison to the current findings in the larger study showed only minor differences, with the exception of peri-/neonatal aetiologies, which had increased.

At follow-up 59% were still visually impaired, 23% had improved their vision to 0,3 or above, 13% were deceased. All deceased had additional impairments. The best prognosis was found in albinism and congenital nystagmus. Sociologically was found statistically significant lower frequency of living with a partner, while educational level was significantly higher and rate of employment did not differ regarding the persons without further impairments, diagnosed as visually impaired in their youth, compared to an age-specific control group of 3150.


This study focuses on the decisions of picking, inventory, ripening, delivering, and selling mangoes in a harvesting season. Demand, supply, and prices are uncertain, and their probability density functions are fitted based on actual trading data collected from the largest spot market in Taiwan. A stochastic programming model is formulated to minimize the expected cost under the considerations of labor, storage space, shelf life, and transportation restrictions. We implement the sample-average approximation to obtain a high-quality solution of the stochastic program. The analysis compares deterministic and stochastic solutions to assess the uncertain effect on the harvest decisions. Finally, the optimal harvest schedule of each mango variety is suggested based on the stochastic program solution.


A novel approach towards the realization of all optical Ex-OR gate using all optical NOR gate, based on Semiconductor optical amplifier(SOA), has been presented in this paper, exploiting Four wave mixing(FWM), non linear effect in SOA's. The design and simulation of the circuit has been described with the help of Optiwave software version 7.0 and have been optimized by measuring the output at different values of input parameters like input optical power, injection current and active region length of SOA. Here, in this paper the optimized outpu has been presented. Several approaches have already been suggested for designing all optical logic gates which includes cross gain modulation (XGM), cross phase modulation (XPM) and Machzehender interferometer (MZI) structure etc. In this paper we will use the idea to generate FWM signals by keeping two data pumps(A and b) frequencies fixed at 193Thz and 193.1Thz respectively, which will generate the FWM at 193.2Thz.


Private View, an installation performance by A2 Company / London, was performed in 2004 by 17 people, (including a 90yr old woman & 3yr old child) at the Institute of Contemporary Arts, London.
The installation-performance attempted to explore cause and effect: how the least insignificant action can have an effect on the human body's sensory system and in our lives, & how the consequences of our actions are rarely considered.
Staged in inter-joining gallery rooms, Private View created a space of enactment, of memory, of witnessing, of interconnectedness for performer & audience alike.
In one room under the title you've cheated again, in front of a microphone, a man on a chair randomly 'pops' bubble wrap in his hands. The audio is amplified resulting in the sound of gunfire. His actions are filmed. People lie on the floor & jolt impulsively to the 'popping' sound. Audience members are encouraged to lie down & follow.
Under the title when I die I would like to take the telephone with me just in case there is one more thing I would like to say, a woman lies under a mound of earth with only one arm revealed holding a mobile phone, which rings intermittently.
In another room under the title and I remember that I hadn't stopped moving on, I had actually been moving non-stop and quite fast, without really paying attention to the fact that soon I was going to be very old, an old lady sits in an armchair, her look fixed on a television screen, broadcasting bubble wrap 'popped' between finger & thumb. Desensitized through repeated exposure she falls asleep. A bowl of nuts sit untouched by her side.
A2, Anton Mirto & Alit Kreiz, create experimental performance projects exploring new personal, social & emotional language forms. A defining feature of their practice is to represent & engage people from different ages, cultures & backgrounds. Future show: the future of death at WUK in Vienna- April 08 For further information or to contact the company visit www.A2company.org


The principal results of the present study are: (a) the failure to find an antibody subset that binds a cross-reacting ligand better than the comparable homologue in spite of the use of isolation methods that select for such antibody molecules; (b) the isolation of antibody subsets with virtually indistinguishable average intrinsic association constants for homologous and cross-reacting ligands, but which nevertheless have physical properties (Qmax and relative fluorescence coefficient) that readily distinguish these subsets according to their origin in response to antigenic stimulation with DNP- or with TNP-protein; (c) the demonstration, by precipitin reaction and measurement of association constants for homologous and cross-reacting haptens, of generally greater cross-reactivity among high affinity anti-DNP and anti-TNP antibodies, i.e. low affinity antibodies are generally more discriminating; (d) the selection of anti-DNP and anti-TNP antibody subsets that are distinctive in their ability to show spur formation in gel diffusion reactions with homologous and cross-reacting antigens. These results suggest that in the initial cellular response to antigenic stimulation, DNP-BγG and TNP-BγG stimulate virtually nonoverlapping sets of antigen-sensitive cells, despite the great similarity of these two immunogens. With prolonged stimulation this specificity wanes, giving rise to a more degenerate response evident in the greater cross-reactivity of the antibodies produced later in immunization.


Teleost fin rays are able to regenerate, when they are cut, restoring the whole structure in a few weeks. Following the formation and growth of an apical blastema, deposition of lepidotrichial matrix occurs. We have histo and immunochemically analyzed the maturation process of the lepidotrichial hemisegment, pointing out the interactions between their components and likewise the temporal and spatial distribution of some extracellular matrix components during regeneration. Lepidotrichial matrix is rich in sulfated glycosaminoglycans (GAGs), most of which are forming proteoglycans. Collagen is abundant and it strongly interacts with GAGs, as the tissue differentiates. The use of specific digestions with papain and collagenase suggests that some mannose rich glycoproteins may be also implicated in lepidotrichial maturation before mineralization. In each hemisegment a central band (CB) can be observed. In spite of the histochemical similarities between the CB and the subepidermical basement membrane, neither collagen IV nor laminin are present. This CB could be the result of a transient transdifferentiation of the outer lepidotrichial synthesizing cells.


The purposes of this study are to develop a computer-assisted instructional material, which involves animations, virtual lab and educational computer applications, based on 7E learning model towards the methods of Mohr and Volhard in the unit "precipitation titrations" delivered in some quantification chemistry courses and to identify the effects of this material on student achievement. The study employs the design of quasi-experimental with control and experiment groups to which pre- and post-test were administered. The participants of the study includes 89 vocational high school students. The data were collected through the administration of the test which was used as both pre- and post-test. The Cronbach alpha coefficient of the achievement test was found to be 0.756. The findings obtained were analysed through t-tests. The findings indicate that post-test scores of experiment group and control group on the achievement test were statistically significant different. This difference indicates that the software has positive effects on student achievement.
Key words: chemistry education, 7E learning model, animation, precipitation titrations, virtual lab, educational computer games.


Plant breeders shape breeding and seed increase programs, in part, according to the percent outcrossing in the species. Previous reports indicated that aeschynomene, L., was almost entirely self-pollinated. The objective of these experiments was to determine percent outcrossing under greenhouse and field conditions. A completely dominant trait, glabrousness, was used to determine percent outcrossing in a pubescent line of aeschynomene in the presence of honey bees, spp., in the greenhouse and natural pollinators in the field. Mean percent outcrossing during two seasons in the greenhouse was 24%. Mean percent outcrossing was 30% at two Florida locations separated by 450 km. This level of outcrossing suggests that more rigorous isolation requirements than those currently used may be needed in breeding programs and seed increase fields where two or more lines are grown nearby.


This paper examines the influence of market size on foreign direct investment to Nigeria for the period 1970 – 2011. It answers the question: do multinational enterprises consider market size in the allocation of their foreign direct investment (FDI) to Nigeria? Unlike similar previous studies on Nigeria, this paper examines market size in terms of economy size and population size. Autoregressive Distributed Lag (ARDL) model and Granger Causality Tests were estimated. The results show that economy size and population size has positive and significant effect on foreign direct investment to Nigeria. Market size also Granger causes FDI to Nigeria. This paper, therefore, concludes that multinational enterprises consider Nigerian market size in the allocation of their foreign direct investment (FDI) to the country.


BACKGROUND
the visits to the paediatric emergency department for mental problems are increasing exponentially, but the emergency department team in not ready enough to manage them, due to the lack of adequate training. This study aimed to evaluate how the Italian Society of Paediatric Emergency Medicine and Urgency triage system was able to estimate urgency in patients accessing the paediatric emergency department for a mental health problem.

METHODS
We conducted a retrospective study at the emergency department of the Institute for Maternal and Child Health, IRCCS Burlo garofolo of Trieste (Italy), from December 2015 to April 2017. During the study period, we identified all the patients undergoing an urgent psychiatric consultation. We collected demographic variables, triage code, diagnosis, and outcomes of each patient. Subsequently, we have assigned a degree of psychiatric urgency, based on Gail and Rosenn's classificationwhich is a specific tool to evaluate psychiatric urgency. The primary study outcome was the comparison between the degree of urgency assigned using the triage system and the Gail and Rosenn's classification.

RESULTS
In this series, 567 patients underwent an urgent psychiatric consultation, and 280 of them received a diagnosis of a mental health problem. The degree of urgency assigned at the triage was: emergency for 5 cases (2%), urgency for 96 (34%) and non-urgency for 179 (64%). Instead, the degree assigned with GRC was: emergency for 95 cases (34%), urgency for 112 (42%) and non-urgency for 73 (26%). The number of patients, detected as emergency and urgency by the two tools, was significantly different (p = 0.0001).

CONCLUSIONS
In this study, we demonstrated that the Italian Society of Paediatric Emergency Medicine and Urgency triage system underestimated the urgency of patients with mental health problems compared to a specific tool to assess the degree of psychiatric urgency.


In this paper, a sensor fusion technique is proposed for autonomous underwater vehicles (AUV) to track underwater cables. The focus of this paper is to solve the two practical problems encountered in optical vision based systems in underwater environments; namely 1) navigation of AUV when cable is invisible in the image, and 2) selection of the correct cable (interested feature) when there are many similar features appearing in the image. The proposed sensor fusion scheme uses dead reckoning position uncertainty with a 2D position model of the cable to predict the region of interest in the image. This reduces the processing data increasing the processing speed and avoids tracking other similar features appearing in the optical image. The proposed method uses a priori map of the cable for AUV navigation when the cable features are invisible in the predicted region in the image. An experiment is conducted to test the performance of the proposed algorithm using the AUV "Twin-Burger 2". The experimental results presented in this paper show how the proposed method handles the above-mentioned practical problems.


A modified angular spectrum algorithm is presented for the diffraction calculation of partially coherent beams propagating in optical systems. The proposed algorithm can directly calculate the cross-spectral density of partially coherent beams at each surface of the optical system and possesses much higher computational efficiency for low coherent beams compared with that of the common modal expansion methods. Then, a Gaussian-Schell model beam propagating in a double-lens array homogenizer system is introduced to carry out a numerical simulation. Results show that the proposed algorithm can obtain an identical intensity distribution as the selected modal expansion method but with a much higher speed, thus verifying its accuracy and high efficiency. However, it's worth noting that the proposed algorithm is only suitable to the optical systems in which the partially coherent beams and optical components have no coupling effects in the x and y directions and can be dealt with individually.


OBJECTIVES. The objective of this study was to calculate sensitivity values for the detection of major respiratory viruses of childhood by using combined nose-throat swabs and nasopharyngeal aspirates. METHODS. Children who had symptoms and presented to a pediatric teaching hospital and had a diagnostic respiratory specimen collected were enrolled, and paired nose-throat swab and nasopharyngeal aspirate specimens were collected. Parents were asked to collect the nose-throat swab specimen in the first instance but could defer to a health care worker if unwilling. Nose-throat swab collectors were asked to rate perceived quality of collection. All nasopharyngeal aspirates were collected by a health care worker by using a standard protocol. Real-time polymerase chain reaction for 8 respiratory viruses was performed in our hospital's diagnostic laboratory. RESULTS. Paired nose-throat swab/nasopharyngeal aspirate specimens were collected during 303 illnesses, with at least 1 respiratory virus identified in 186 (61%). For the major pathogens of childhood, influenza A virus and respiratory syncytial virus, collection by using the nose-throat swab had a sensitivity of 91.9% and 93.1%, respectively. A health care worker collected 219 (72%) of the nose-throat swab specimens; concordance with the nasopharyngeal aspirate was not related to health care worker collection or perceived quality of collection. CONCLUSIONS. Nose-throat swab specimens, in combination with sensitive molecular testing, are a less invasive diagnostic respiratory specimen with adequate sensitivity for use in the clinic and hospital outpatient settings and large-scale community studies through parent collection. For children who present to a hospital in which an avian or pandemic strain of influenza virus is reasonably part of the differential diagnosis, nasopharyngeal aspirates or a similar collection technique (eg, nasal washes) should continue to be used.


Purpose – This research aims to analyze the differences in the bid-ask spread, depth, and trading volume after a new tick size and minimum trading unit policy were imposed by the Indonesian Stock Exchange (IDX) on January the 6th, 2014.

Design/Methodology/Approach – This research is exercised on the three variables of liquidity, i.e. the bid-ask spread, the depth, and the trading volume. This research used a paired difference test to measure the impact before and after the policy was imposed.

Findings – The results showed that the smaller the tick size, the greater the average decrease of the bid-ask spread, ask depth, and bid depth, but the trading volume did not show a significant average difference.

Research Implications – The tick size reduction was consistent and supported the previous research from different countries. The bid-ask spread, ask depth, and bid depth significantly decreased, and the trading volume had a tendency to increase as well, although it was not significant.

Results are aimed at the IDX and Bapepam as additional information related to the changes that occurred as a result of the implementation of the new policy in stock trading. Investors can use the information from this study to make investment decisions.


Introduction This study was performed in order to find out the relevant factors of the recurrence of hepatoblastoma .Materials and Methods 28 patients that presenting with recurrent hepatoblastoma in our hospital from 2012 to 2015 were included in the investigation. The pathological subtype,clinical stage, serum levels of alpha fetoprotein (AFP), the change trend of the tumor volume and AFP value of each case after they received neoadjuvant chemotherapy and after surgical resection were recorded. The χ2 test was used to analyze the relationship between tumor recurrence and the aforementioned factors.Results The results showed that in the recurrence group, the patients were in higher clinical stage than that in the non-recurrence group. In the patients with recurrent tumors, the rate of tumor volume reduction, the extent of AFP level decrease and the proportion of those in the group whose AFP level fell to normal range in one month after tumor resection were all apparently lower than those in the non-recurrence patients.Conclusion The main risk-altering factors involved in the recurrence of hepatoblastoma were: clinical stage, reduction in tumor size after neoadjuvant chemotherapy, and the rate of descent of AFP levels to within normal range after tumor resection. These indicators can be used as important biomarkers for personalized treatment, assessment of treatment efficacy and prognostic indicators.


The phosphatidylcholine exchange protein and bee venom phospholipase A2 were used to estimate the phosphatidylcholine accessibility in proteoliposome-containing cytochrome P-450. Without cytochrome P-450 phosphatidylcholine was only partly accessible for the both membrane probes. Incorporation of cytochrome P-450 into the liposomes resulted in a complete accessibility of phosphatidylcholine for the phosphatidylcholine exchange protein and phospholipase A2. On the other hand, phosphatidylcholine was only partly available for the membrane probes in cytochrome b5 containing proteoliposomes. It was concluded that cytochrome P-450 induces rapid transmembrane translocation of phosphatidylcholine with tau 1/2 less than 20 min. It is proposed that cytochrome P-450 may be responsible for rapid flip-flop of phosphatidylcholine in rat liver microsomes.


We described in this paper a computer program for Automated Mathematical Modelling and Simulation (AMMS) for Bacteria growth control in the food industry using Artificial Intelligence (AI) techniques. This computer program is an implementation of a new method for AMMS using Expert Systems technology and Fractal Theory developed by the authors. We show in this paper mathematical models expressed as differential equations, for the simulation of bacteria growth for several types of food. The goal of constructing this models is to capture the dynamics of bacteria population in food, so as to have a way of controlling this dynamics for Industrial purposes. Controlling the growth of bacteria is very important in industrial microbiology in obtaining the food products with the desired chemical and microbiological properties. The goal of controlling the growth of bacteria population can be achieved, by computer simulations and application of the theory of dynamical systems. We also use the fractal dimension as a tool for the identification of bacteria by measuring the geometrical complexity of the colonies. This method of the identification is based on the experimental fact that different types of bacteria have colonies of different geometrical form and complexity.


INTRODUCTION :
World Health Organisation has defined a drug as "a substance or
product that is used or intended to be used to modify or explore
physiological system or pathological state of the recipient".
Adverse drug reaction is defined by WHO as "a response to a drug
that is noxious, unintended and undesired and occurs at doses used in
man for modification of physiological function". ADRs affect upto 7% of
the general population and constitute upto 8% of hospital admissions.
Cutaneous ADRs are among the more commonly observed adverse
reactions to medications. Among the various morphological drug reaction
patterns encountered, Fixed Drug Reactions account for upto one third of
cases. According to many Indian studies, Fixed drug eruption is the most
common cutaneous adverse drug reaction pattern, constituting 25-40% of
cases. In the western world, it is next only to maculopapular rash as
the common cause of CADR. Several studies analysing the
epidemiological, pathophysiological, pharmacological and clinical
aspects of FDE are available in literature. Though clinically less severe,
FDE causes cosmetic embarrassment in many patients.
AIMS OF THE STUDY :
 To find out the incidence, age and sex distribution of Fixed Drug
Eruption among patients attending the Department of
Dermatology, Government General Hospital, Chennai.
* To find out the proportion of FDE cases among various cutaneous
adverse drug reactions.
* To find out the common offending drugs and study the drug
specific clinical patterns and sites of involvement in the FDE cases.
* To study the different parameters of fixed drug reaction - Number
of episodes in a patient and mean length of time from drug
exposure to the development of FDE lesions during initial and
subsequent episodes.
* To confirm the drugs responsible for causation through patch
testing.
* To study the various histopathological characteristics of fixed drug
eruptions.
* To ascertain the role of CD8+ T-cells in causation through
Immunohistochemistry.
CONCLUSION :
1. The incidence of Fixed Drug Eruption among Dermatology OPD
attendees from Aug 2008 to Aug 2010 was found to be 0.54%.
2. The main age group affected was 21 – 30 years.
3. An almost equal sex incidence. was observed with the male to
female ratio being 1.23:1.
4. The incubation period observed during the first and subsequent
episodes was 13.4 days and 4.6hrs respectively.
5. The most common offenders were fluoroquinolones especially
ciprofloxacin seen in 14.5% of cases and levofloxacin in 10.5% of
cases. The next common offender was cotrimoxazole inducing
FDE in 11.8% of cases. Nonsteroidal antiinflammatory drugs were
the causative drugs in 19.73% of cases with diclofenac being the
main inducer followed by paracetamol.
6. Classical presentation was seen in 81.57% of cases. The other two
morphological patterns encountered were Bullous FDE(18.42%)
and Nonpigmenting FDE(1.33%).
7. Multifocal pattern was the most common pattern of distribution of
lesions. Solitary and generalised patterns were also encountered.
8. Extremities were the most frequently involved sites seen in 44.73%
of cases, followed in decreasing order of frequency by trunk, face,
oral mucosa, genital mucosa, lips and palms and soles.
9. There was no statistically significant difference between males and
females regarding the site of involvement . Clinically mucosal
lesions and lesions on the palms and soles were more commonly
encountered in males. Involvement of the lip was commonly seen
in females.
10. Though statistically insignificant, clinically significant associations
were observed regarding drug specific site of involvement.
Phenytoin induced FDE exclusively on the trunk. Paracetamol was
observed to induce bullous FDE preferentially on palms and soles
Ciprofloxacin induced lesions mainly on the extremities.
11. The rate of occurrence of associated local and systemic symptoms
was 78.95% and 14.47% respectively which is relatively high when
compared to previous studies.
74
12. Drug patch tests done to establish the causality of offending drugs
revealed positivity in 32.9% of patients. The testing was found to
be positive when done on lesional skin when compared to
nonlesional skin.
13. Histopathological examination of biopsy specimens produced
consististent findings in all the 33 cases in whom biopsy was
performed.
14. Immunohistochemical analysis done using antibodies to CD8
revealed positivity in both acute and chronic cases, establishing the
role of these cells in causation of FDE.
In the current study, the number of patients observed was less
when compared to the previous studies. So statistical analysis did not
reveal any significance regarding the sex specific and drug specific site
of involvement.


Preceptor orientation is a well identified need. Less often identified is the critical role the staff development specialist plays in the ongoing support and development of preceptors. In this article, the authors explain activities of coaching, facilitating, mentoring, and consulting. These role components are essential in the ongoing development of preceptors. This support also may help retain preceptors.


Edward Teller reportedly once proposed that nuclear detonations be used to close the Strait of Gibraltar. His idea was that as the Mediterranean rose and became fresher, the water could be used to bring the Sahara to life. He acknowledged, of course, that the cost of such progress would be the loss of Venice and other Mediterranean sea-level cities.' Ironically, we find today that, rather than Tellerite fantasies, the more banal and prosaic day-to-day activities of a growing world population threaten to change the climate of the world and flood coastal cities, not only in the Mediterranean but around the globe. The Intergovernmental Panel on Climate Change has concluded that overall global temperatures will rise in the next century and that this global warming will have tremendous effects on the environment. 2 This


A Machine Learning and Data-Driven Prediction and Inversion of Brittleness: A Case Study in Southwest Pennsylvania, Central Appalachian Basin Tobi Ore In unconventional reservoir sweet-spot identification, brittleness is an important parameter that is used as an easiness measure of production from low permeability reservoirs. In shaly reservoirs, production is realized from hydraulic fracturing, which depends on how brittle the rock is–as it opens natural fractures and also creates new fractures. A measure of brittleness, brittleness index, is obtained through elastic properties of the rock. In practice, problems arise using this method to predict brittleness because of the limited availability of elastic logs. To address this issue, machine learning techniques are adopted to predict brittleness at well locations from readily available geophysical logs and spatially using 3D seismic data. The geophysical logs available as input are gamma ray, neutron, sonic, photoelectric factor, and density logs while the seismic is a post-stack time migrated data of high quality. Support Vector Regression, Gradient Boosting, and Artificial Neural Network are used to predict the brittleness from the geophysical logs and Texture Model Regression to invert the brittleness from the seismic data. The Gradient Boosting outperformed the other algorithms in predicting brittleness. The result of this research further demonstrates the application of machine learning, and how these tools can be leveraged to create data-driven solutions to geophysical problems. Also, the seismic inversion of brittleness shows promising results that will be further investigated in the future.