Breast cancer is a prevalent of tumoregenesis in women and reports for the maximum mortality and morbidity in the global. Ginger (Zingiber officinale) is the mainly widespread spice and herbal remedies used in the world. Since antique periods, ginger has been used in Greece, India and China for the curing of upset stomach, nausea, diarrhea, colds, and headaches. The current work was planned to explore the anticancer properties of zingerone (ZO) toward 7,12‐dimethylbenz(a)anthracene (DMBA)‐treated mammary carcinogenesis in Sprague‐Dawley (SD) rats and MCF‐7 mammary cancer cells. The mammary carcinogenesis was produced through a single dosage of DMBA (20 mg/kg bwt) mixed in soya oil (1 mL) administrated intragastrically with a gavage. We found improved concentrations of lipid peroxidation (LOOH and TBARS), carcinoembryonic antigen, lowered levels of enzymatic (CAT, GPx, and SOD), and nonenzymatic (vitamin E, GSH, and vitamin C) antioxidant in mammary tissues and plasma of DMBA‐induced cancer bearing animals. Moreover, augmented concentrations of phase I (Cyt‐b5 and CYP450) and reduced levels of phase II (GR and GST) detoxification microsomal proteins in mammary tissues were noticed. ZO administrations significantly reverted back to all these parameters in this way, showing efficient of anticancer effect. Furthermore, our in vitro study also supported the anticancer effect of the treatment of ZO were noticed loss of cell viability, improved reactive oxygen species formation, and reduced MMP. Furthermore, the status of apoptosis proteins such as Bcl‐2, Bax, and Bid expressions was determined by using Western blot analysis techniques. Overall, these results proposed the anticancer effect of ZO toward DMBA‐induced mammary cancer in SD animals and Michigan cancer foundation‐7 mammary cancer cells.


Papillary carcinomas account for 85~90% of all thyroid cancer s, with the tumor size considered an important prognostic factor. As the use of high-resolution ultrasonography and fine needle aspiration biopsy have increased, the diagnosis of papillary microcarcinomas of the thyroid gland; defined by the World Health Organization as being less than 1 cm in diameter, has increased. They are generally associated with an excellent prognosis, with distant metastasis being extremely rare. They usually remain clinically silent until their incidental histological diagnosis by autopsy or surgical material. The incidence discovered at autopsy varies between 3 and 36%. Cervical lymph node metastases from papillary microcarcinomas have often been discovered, which may be the first and sole manifestation of the disease, without clinical suspicion of a thyroid tumor. Herein, the case of a papillary thyroid microcarcinoma, diagnosed after a total thyroidectomy due to its first presentation as a contralateral cervical lymph node metastasis, without evidence of a clinical thyroid tumor, is described (J Kor Soc Endocrinol 20:507~512, 2005).


Addressing labor shortages within nursing and allied health professions, which have been exacerbated by the COVID-19 pandemic, requires increasing persistence and equity among community college students pursuing these fields. In this study, we adapted and combined three values-based interventions (values affirmation, goal congruence, and utility values) into one treatment, delivered via interactive text messages, with the goal to support reenrollment among pre-allied health students during the pandemic. Using institutional data from a statewide community college system, we randomized pre-allied health students who were enrolled in Fall 2019 and/or Spring 2020, and who had a valid mobile number on file, into treatment (n = 1,649) or control (n = 1,650) groups. Fully treated students received an average of 17 text messages over 8 weeks of Summer 2020; control students received business as usual support from the college. After adjusting for baseline differences in prior enrollment, the treatment significantly increased reenrollment by 3 percentage points (74% vs. 71%). Examination of individual differences revealed that effects were concentrated among men (+11 percentage points), Black/African American students (+7 percentage points), and students who were not enrolled in Spring 2020 (+13 percentage points). Values-based interventions, therefore, can be an important tool for addressing shortages and inequities in healthcare education and the labor force, an important step toward improving public health. Moreover, community colleges seeking to engage students who withdrew before or during the COVID-19 pandemic should leverage evidence-based practices to boost reenrollment.


ABSTRACT The study on the mechanism of the gas-phase elimination or thermal decomposition kinetics of 2, 2-dimethyl-3-butenal has been carried out by using theoretical calculation at MP2, combined ab initio CBSQB3 and DFT (B3LYP, B3PW91, MPW1PW91, PBEPBE, PBE1PBE, CAMB3LYP, M06, B97d) levels of theory. A good reasonable agreement between experimental and calculated parameters was obtained by using CAMB3LYP/6-311G(d,pd) calculations. The contrasted calculated parameters against experimental values suggested decarbonylation reaction to proceed through a concerted five-membered cyclic transition state type of mechanism, involving the hydrogen transfer from the carbonyl carbon to the gamma carbon, consistent with observed kinetic isotope effect. The breaking of alpha carbon–carbonyl carbon bond to produce carbon monoxide is 50% advanced in the transition state. The reaction mechanism may be described as a concerted moderately non-synchronous process. Examination of the Atoms in Molecules (AIM) analysis of electron density supports the suggested mechanism.


In this paper, we propose a pixel-wise method named TextCohesion for scene text detection, which splits a text instance into five key components: a Text Skeleton and four Directional Pixel Regions. These components are easier to handle than the entire text instance. A confidence scoring mechanism is designed to filter characters that are similar to text. Our method can integrate text contexts intensively when backgrounds are complex. Experiments on two curved challenging benchmarks demonstrate that TextCohesion outperforms state-of-the-art methods, achieving the F-measure of 84.6% on Total-Text and bfseries86.3% on SCUT-CTW1500.


INTRODUCTION :
Sexually transmitted infections (STIs) are a major global cause of
acute illness, infertility, long term morbidity and mortality, with severe medical
and psychological consequences of millions of men, women and infants. STIs
most commonly affect people aged between 15 to 44 years.
In 2006, 1,030,911 Chlamydial infections and 3,58,366 Gonococcal
infections were reported to CDC from 50 states and the districts of Columbia in
United states. Chlamydia trachomatis and Neisseria gonorrhoeae remain the
two most preventable causes of human infertility. Untreated Gonococcal and
Chlamydial infections in women will result in pelvic inflammatory disease in
upto 40% of cases. One in four of these will result in infertility.
Demographic risk factors for the acquistion of gonorrhoeae include
migration of population, unemployment, lack of education, poverty, early onset
of sexual activity, unmarried marital status, past history of gonorrhoeae,illicit
drug use and now commercial sex have been operative universally, but more
severely in certain societies and countries.
AIMS AND OBJECTIVES :
1. To study the prevalence of Chlamydia trachomatis and Neisseria
gonorrhoeae infections in patients attending the Out-Patient Department
of Institute of Venereology, using AMPLICOR CT/NG Polymerase
chain reaction.
2. To study the prevalence of Chlamydia trachomatis and Neisseria
gonorrhoeae infections among HIV positive patients in the study group.
3. To study about the age distribution, socioeconomic background,
educational level and marital status among the patients in the study
group.
4. To compare the sensitivity and specificity of AMPLICOR CT/NG
Polymerase chain reaction with Culture for Gonococci and IgM ELISA
test for Chlamydia trachomatis.

CONCLUSION :
1. Gonococcal infections (males –14.64%, females –13.34%) was more
common than Chlamydia trachomatis (males-3.57%, females –3.70%)
infections. Gonococcal infection was more common in men (14.64%)
compared to women (13.34%). Chlamydial infection was more common
in women (3.70%) when compared to men (3.57%).
2. In HIV positive patients also, gonococcal infections (M-14%, F-
7%),were more common than chlamydial infections (M-3%, F-11%).
3. AMPLICOR CT /NG PCR for urine specimens (M-16, F-15) was highly
sensitive than male urethral (13) and female endocervical swab (13)
specimens in detecting gonococcal infections. In Chlamydial infections,
urine PCR (7) was highly sensitive than urethral swab PCR (2) in males
but in females, endocervical swab PCR(6) was more sensitive than urine
PCR (3).
4. Asymptomatic gonococcal infection was common in affected males
(29.26%) when compared to affected females (27.78%). Asymptomatic
Chalmydial infection was common in affected females (40%) compared
to affected males(20%).Asymptomatic gonococcal (M-57.14%, F-
57.14%) and chlamydial infections (M-66.67%, F-100%) were
common in HIV positive patients compared to HIV negative patients.
5. AMPLICOR CT/NG PCR had 100% sensitivity in detecting gonococcal
infections compared with gonococcal culture and also had 100%
sensitivity in detecting chlamydial infections compared with IgM
ELISA for C. trachomatis.
6. Majority of gonococoal (M-43.90%, F-47.23%) and Chlamydial (M-
50%, F-60%) infection positive patients belonged to 20-29 years age
group. Majority of the affected patients belonged to lower
socioeconomic status.
7. Burning micturition (NG-53.65%, CT-80%) was the main complaint in
affected males and genital discharge (NG-50%,CT-50%) was the main
complaint in affected females. In gonococcal infection positive males,
urethral discharge (14.63%) was the common clinical finding and in
chlamydial infection positive males genital ulcer (30%) was the
common clinical finding .Cervical erosion (NG-58.34%, CT-70%) was
the common clinical finding in affected females.
8. In Chlamydial infection positive patients, gonococcal infection was the
most commonest associated STI (M-30%, F-70%). In gonococcal
infection positive males, C. trachomatis (7.31%) was the commonest
associated STI and in females, Bacterial vaginosis (41.67%) was the
commonest associated STI.
AMPLICOR CT/NG PCR had 100% sensitivity in detecting
gonococcal and chlamydial infections. PCR screening will diagnose
asymptomatic cases of both gonococcal and chlamydial infections.
Since coinfection rate of gonococcal and chlamydial infection
were high, all cases of gonorrhoeae should be treated presumptively for
chlamydial infection as recommended by CDC and WHO.


For LiNbO3 crystals heavily doped with Mg and codoped with Cr a single isotropic ESR line with g=1.971+or-0.002 and a minimal linewidth of 1.8+or-0.2 mT has been observed. With ENDOR it could be shown unambiguously that the new defect is Cr3+ substituting for Nb. The 53Cr hyperfine and quadrupole constants are A/sub ///=50.8+or-0.2 MHz, Aperpendicular to =51.0+or-0.2 MHz and P=0.10+or-0.05 MHz. The crystal field at the chromium site is smaller by more than an order of magnitude than for previously reported Cr3+ centres in LiNbO3, indicating that those centres are not on the Nb site.


Investigations were performed to determine whether prostaglandin E1 (PGE1) would cause a favorable change in pulmonary hemodynamics in pediatric patients with congenital heart disease and elevated pulmonary vascular resistance. Twenty-seven patients (ages 0.5 months to 19 years) were studied. PGE1 caused a significant decrease in mean pulmonary artery pressure with 0.05 microgram/kg/min and 0.1 microgram/kg/min infusions (p = .0004). There were significant increases in pulmonary blood flow (p = .0007), and decreases in pulmonary vascular resistance (p = .0001); changes in systemic pressure, resistance, oxygen consumption, and heart rate were minimal. Twenty-three patients underwent heart surgery after catheterization, nineteen of these survived. The four nonsurvivors had higher initial pulmonary resistance (PVR) and less decline in PVR with PGE1 than survivors. This study shows that PGE1 is an effective pulmonary vasodilator in patients with congenital heart disease and elevated pulmonary vascular resistance.


ABSTRACT Atherosclerosis (AS) is one of the main causes of cerebral infarction. Researches on AS mainly focus on the gene level, among which microRNA is the research hotspot nowadays. This study investigated the diagnostic value of aberrant serum miR-488 in AS patients, and further explored the effect of abnormally expressed miR-488 on the biological behavior of vascular smooth muscle (VSMCs) cells by cell transfection. The qRT-PCR was used to investigate the expression level of miR-488 in 125 AS patients and 60 healthy controls. The diagnostic value of miR-488 was analyzed by the receiver operator characteristic (ROC) curve. CCK-8 and Transwell assays were used to detect the ability of miR-488 on the proliferation and migration ability of VSMCs cells. Serum expression of miR-488 in AS patients was higher than that in healthy controls. The expression level of miR-488 was significantly positively correlated with the Carotid Intima-Media Thickness (CIMT) value. The AUC of the ROC curve was 0.892, specificity was 99.3%, and sensitivity was 77.6%. In VSMCs cells, overexpression of miR-488 significantly promoted the proliferation and migration ability. The high expression of miR-488 is a good diagnostic marker for AS. The upregulation of miR-488 promotes VSMCs cell proliferation, and migration, which may provide a new theory for the treatment of AS. Graphical Abstract


Widespread alcohol use by young people in the UK is characterised problematically. Alcohol research has concentrated in three domains, the intra-personal, the inter-personal and the cultural, concentrating upon consumption frequency and quantity as well as resultant risks and harm. A constructionist epistemology and mixed qualitative methods are used to identify discourses surrounding influence on young people's choice to use alcohol or not. Focus and advisory groups and Q method are used with 15-18 year olds.

In focus groups young people continue to use well-understood discourses surrounding alcohol of pleasure and risk. Discourses are dynamic and responsive to context. Deductive analysis provides evidence that individualism and consumerism contribute an epistemological framework and this conflicts with ideas of influence. Q methodology revealed seven discourses after drinkers were separated from non-drinkers during analysis. The primary 'drinkers' factor is the cultural mainstream, with fun and social drinking, followed by additional factors of cultural discordance, being able to 'take it or leave it', cultural indulgence which might be characterised as 'binge drinking' and a cultural tightrope, where there is paradoxical control and intoxication. The primary 'non-drinking' factor is of cultural resistance with 'proscription and abstention', followed by cultural nonchalance, where drinking is viewed positively and abstinence is temporary and finally cultural rationality, where alcohol is refused for practical and rational reasons. The data sets provide insight into discourses of ambivalence and avoidance, indicating although many young people drink frequently and riskily they do not all conform to prevailing views of drinking.

Based on the literature review and data analysis a map has been constructed to illustrate the domains of influence, which affect young people. These results have implications for public health and policy makers. Young people do not easily relate to the influence of their peers, families or wider cultural structures. Nor is drinking based on rational decision making. Although they acknowledge risk, they distance themselves from problematic drinking.


To examine the quantitative performance of three-dimensional atom probe (3D-AP) in steel materials, composition analysis of spherical cementite (Fe3C) formed in an annealed pearlitic steel wire was conducted. It was visualized in three dimensions that manganese and chromium atoms were concentrated in cementite, while silicon atoms were concentrated in ferrite. Phosphor atoms were segregated at the cementite-ferrite interface. By taking all carbon molecular ions into consideration, the carbon concentration in cementite was in the range of 25-27 at%, which approximately coincided with the stoichiometric composition of 25 at%. On the other hand, the iron concentration in cementite was in the range of 70-73 at%, which was a few atomic % lower than 75 at%. The reduction of the iron concentration is caused by the substitution of manganese, chromium and silicon atoms for iron atoms in cementite. It was shown that the 3D-AP enables the quantitative composition analysis with high accuracy. Inhomogeneous distribution of manganese and chromium in cementite was observed, and it was explained by the change in the partition coefficient depending on the interface mobility of spherical cementite growth.


This work arises as a reflection on what it means to be a designer of the future and their greater need for influence and collaboration with the team throughout the product creation cycle. The renewal of a culture of design and business innovation in the area of fashion and textile design is based on the establishment of bridges with different realities that, increasingly dynamic, change the landscape of different products and their creation processes, blurring the boundaries and limits of each area of intervention and its actors. From the small to the big industry we find new needs and professions that project themselves into the future reaching from the past, as in the case of new craft productions that value the identity, artistic and cultural heritage of each geography, supported by new materials and technologies of Industry 5.0. This new dynamic of integrated work, where everyone contributes to enhance the knowledge of each participant, enabling the renewal of knowledge and the development of innovation and social, cultural, and economic inclusion, needs greater support and connection between academia and the creative and productive reality on the ground. The present research group, sustained by the interpretation of the paths of work innovation in the coming decades, intended to provide a contribution to the industry and the culture of national or international design innovation, through research based on the identification of the knowledge and skills necessary for the future training of fashion designers.The adoption of a qualitative and quantitative methodology should allow the collection of data that can indicate trends of needs of future designers and the need to adapt the academy to these new realities. With this study we intend to establish a network of relationships between the different actors in the process of creation and innovation, as well as promote a greater connection between the different forms of creation and production that allow to satisfy the final consumer and their needs around fashion and textiles.


Proceedings: AACR 102nd Annual Meeting 2011‐‐ Apr 2‐6, 2011; Orlando, FL

Background: The immunoproteasome is an alternative form of the constitutive proteasome and it has been increasingly shown to play an important role in a number of diseases including cancer and inflammatory diseases. We have previously developed 'UK-101', a small molecule that selectively inhibits the immunoproteasome catalytic subunit LMP2. In our present study, we investigated the therapeutic potential of the immunoproteasome-targeting approach in pancreatic cancer using UK-101 as a lead compound.

Methods: The expression of LMP2 was assessed in primary pancreatic cancer tissues and established pancreatic cancer cell lines via immunohistochemical (IHC) and immunoblotting analyses. Using pancreatic cancer cells expressing LMP2, we have investigated the effects of UK-101 (an LMP2 inhibitor), general proteasome inhibitors (bortezomib and carfilzomib) and gemcitabine on cell survival, apoptosis and cell cycle progression. We also examined the effects of UK-101 on various molecular markers associated with apoptosis and cell cycle control.

Results: Our immunoblotting and IHC analyses indicated that the LMP2 levels are substantially upregulated in primary pancreatic cancer tissues as well as established pancreatic cancer cell lines compared to nonmalignant pancreatic tissues. The IHC staining on a tumor tissue array demonstrated positive immunostaining for LMP2 in approximately 53% of pancreatic cancer specimens evaluated (n=23 out of 43) while the normal pancreatic duct showed a negative LMP2 staining (n=11). Using Panc-1 (gemcitabine-resistant) and BxPc-3 (gemcitabine-sensitive) cells, we observed that the UK-101 treatment leads to a covalent modification of LMP2, a decreased proteasomal proteolytic activity as well as apoptotic cell death and cell cycle arrest.

Conclusion: Our results show that LMP2 is upregulated in pancreatic cancer and that the targeted inhibition of LMP2 using UK-101 induces apoptotic cell death and cell cycle arrest. Taken together, these results suggest that the immunoproteasome may be a potential therapeutic target that can be exploited for pancreatic cancer where the existing therapy including gemcitabine shows limited efficacy.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2611. doi:10.1158/1538-7445.AM2011-2611


Manufacturing of CIGSe thin film solar modules involves typically one laser structuring step (P1) and two mechanical structuring steps (P2 and P3) for serial interconnection. In our approach, complete laser structuring is successfully demonstrated by application of short nanosecond laser pulses (<10 ns) with a single, visible wavelength of 532 nm. The P1 and the P3 trenches are scribed by induced and direct ablation, respectively. For the P2 scribe, the thermal input of the ns laser pulses is used to transform the CIGSe absorber layer locally into a highly conductive compound to provide proper electrical interconnection. These findings promise further simplification and flexibility to thin film solar cell production.


Nowadays, the studies and researches related to the improvement of the passenger comfort in the car are carried out vigorously. The comfort in the car interior is already become a need for the passengers and the buyers. Due to high competition in car industries, all the car manufacturers are concentrating in improving the interior noise comfort of the car. Vehicle Noise Comfort Index (VNCI) has been developed recently to evaluate the sound characteristics of passenger cars. VNCI indicates the interior vehicle noise comfort using a numeric scale from 1 to 10. Most of the researches are relating the vehicle interior sound quality to psychoacoustics sound metrics such as loudness and sharpness for the frequency between 20 Hz to 20 kHz. In this present paper, a vehicle comfort level indication is proposed to detect the comfort level in cars using artificial neural network. Determination of vehicle comfort is important because continuous exposure to the noise and vibration leads to health problems for the driver and passengers. The database of sound samples from 15 local cars is used. The sound samples are taken from two states, while the car is in stationary condition and while it is moving at a constant speed. Features such as the psychoacoustics criterions are extracted from the signals. The correlation between the subjective and the objective evaluation is also tested. The relationship between the VNCI and the sound metrics is modelled using a feed-forward neural network trained by back-propagation algorithm.


Based on research of ruderal vegetation in the Horna Orava region in the 1980s and in 2005–2007, a list of neophytes was compiled. Thirty-three species of neophytes have been found, representing 6 % of the overall flora. The geographical origin, family, life-history, life-form and status of invasion of these species were as sessed. The biggest proportion of the species was of North American origin (49 %), therophytes (49 %) and members of the family Asteraceae (38 %). Most of the neophytes are garden "escapees" and only few of them may be considered to be of potential hazard to the studied region, most particularly Fallopia japonica, Impatiens glandulifera and Solidago canadensis. Types of plant communities, where particular neophytes were found, and the foci of their distribution were evaluated as well. Neophytes are most abundant in communities of the class Galio-Urticetea, and especially of the alliance Senecionion fluviatilis. Comparing older and present data, trends in the progression of non-indigenous species in the Horna Orava region were predicted. It is apparent that the number of localities of invasive species is increasing and even other species that in the literature from the other regions are mentioned as invasive tend to spread through the area.


The pre-colonial system in South Africa has left the country with many social ills such as inequalities in income distribution, a lack of infrastructure and of critical concern, educational disparities. Since 1994 there have been important efforts made in combating social imbalances through different social programs and various public initiatives in order to redress the societal impacts to build a better life for all. SMEs are thus regarded as engines of growth for emerging countries and as a stimulus of job creation. Women on the other hand, have emerged significantly in the arena and play in the same field as their male counterparts to shape the business landscape in terms of procedures, accounting, sustainability, and  environmental and social responsibility that successful businesses normally follow. With that in mind this paper aims to look at the challenges faced by women operating in Small Medium Enterprises (SMEs) in their daily operations, and also to establish whether they are creating a meaningful contribution to Corporate Social Responsibility (CSR) in their business environment. The findings revealed that women entrepreneurs operating as SMEs in Gauteng still have a long way to go in employing CSR.  Reporting to internal and external stakeholders is still a nightmare. Finally it was observed that women operating as SMEs were not much focussed on CSR. The study used a quantitative method approach and 150 structured questionnaires were administered purposely and respondents were  randomly selected in the three Tshwane Townships. Keywords : Women entrepreneurs, SMEs, Tshwane, CSR, Good Governance, Stakeholders and Local municipality


Abstract: We studied the effects of savanna fires on the structure of local ungulate communities in a West African woodland savanna. The distribution of 11 ungulate species over 9−15 burned sites (the number of which increased as burning activity continued during the dry season) and 7−13 unburned sites was compared with a variety of null models or randomized 'virtual communities'. Five different parameters of community structure were examined: body mass distribution, co-occurrence patterns, species richness, species density and guild dominance. Overall, ungulate species were not randomly distributed over burned and unburned sites. The regular spacing of body masses in the set of species recorded on burned and unburned sites indicated competition, since species similar in body mass are more likely to compete than species of different size. However, co-occurrence patterns on burned sites were random, indicating absence of competition at fine spatial scales due to differential habitat use within the burned landscape. Although the attractiveness of the regrowth on burned sites resulted in higher numbers of ungulates compared with unburned sites, species richness was not different. Grazers were the dominant guild on burned sites, but there were no differences in species richness or species density between grazers and browsers on unburned sites.


This paper derives the probabilistic continuous review inventory model that has the two types of shortage when the order cost is a function of the order quantity. The objective is to minimize the expected annual total cost under a constraint on the expected holding cost when the lead time demand follows Normal distribution by using the Lagrangian method. Some published special cases are deduced and a numerical application with illustrative graphs is added.


Long periods should be considered to characterize the dynamics of regional ecosystems complexes. For the European continent, research is advantaged by the existence of CORINE land cover and use data. This study aims to develop a methodology for using CORINE data (periods 1990-2000 and 2000-2006) to assess long-term environmental changes at a regional scale, consisting of identifying common causes and using ordinary kriging to look at the spatial distribution of changes due to each underlying factor, applied to the Romanian North East Region of Development to answer three questions: what are the characteristic changes and their underlying causes, whether there are different trends in the two periods, and if particular changes form spatial clusters. The results indicate that three types of changes characterize the region: urbanization, abandonment and development of agriculture, and deforestation and afforestation/reforestation. Urbanization tends to increase during the two periods, correlated to the substantial economic growth of the region, and points to the growth pole represented by Iaşi. Even though agricultural abandonment tends to decrease, the very strong decline in the development of agriculture leads to an overall decline of the sector. Finally, while the regeneration of forests tends to slow down, deforestations increase dramatically, suggesting an alarming situation. It appears that the development of agriculture took place at the cost of loosing the forests. The results also indicate differences between the two periods after adjusting for the time difference when all individual changes area accounted for, and cross-matrices suggest that the most important changes occurred in agriculture.


Previous studies have traditionally studied effects of system-initiated message content tailoring to match individual characteristics. Recent work has explored the effectiveness of tailoring to match individual modality preferences and processing styles. Using a web-based experiment, this study investigated the cognitive mechanisms of user-initiated mode tailoring effects on attitudinal and cognitive outcomes in a representative sample of Internet users ( N = 392; 25–86 years). Structural equation modeling showed that mode tailoring – enabling users to self-tailor the presentation mode (via textual, visual, audiovisual information) on a health website – increased users' perceived active control, which in turn contributed to higher perceived relevance and website engagement, and reduced cognitive load. Positive indirect effects of mode tailoring of digital information (vs. no tailoring) through these mechanisms were found for both website attitude and information recall. The findings suggest that perceived active control is the key driver of mode tailoring effects. Implications for theory and message design in digital information environments are discussed.


INTRODUCTION
Recently, there have been growing attention on the modification and optimisation of new extraction and quantification methods, caused by the lack of environmentally friendly methodologies for the extraction of phytochemicals from complex matrices. In the case of pharmaceutical compounds, not only the extraction procedure but also the analysis method should be efficient, precise, fast and easy.

OBJECTIVES
The essential pharmaceutical characteristics and trace concentration of withanolides led us to modify and optimise the previously reported extraction and quantification procedure for withaferin A (WA) as a candidate for withanolides.

MATERIAL AND METHODS
The WA from the air-dried aerial part of Withania somnifera Dunal. was extracted using a microwave-assisted extraction (MAE) technique. Four variables affecting the extraction procedure were optimised using the central composite design approach. The method of high-performance thin-layer chromatography assay was validated and applied for the quantification of each experiment.

RESULTS
The optimum values of factors were: extraction time (150 s), extraction temperature (68°C) and 17 mL of methanol : water in the ratio 25 : 75 as extracting solvent. The solvent system consisted of ethyl acetate : toluene : formic acid : 2-propanol (7.0 : 2.0 : 0.5 : 0.5, v/v/v/v), and densitometric scanning at 220 nm was applied for the analysis. The dynamic linear range, LOD, LOQ and recovery with the inter-day, and intra-day RSDs of the developed method indicated the validity of the method.

CONCLUSION
A pressurised MAE method for extracting WA from the plant's aerial part was optimised using factorial-based design. The net effect of time, temperature, solvent volume and its ratio suggests that the yield of WA increases until each factor reaches its optimum value, and decreases with further increase in temperature or solvent ratio.


The repair of bleomycin-damaged DNA was examined in human fibroblasts isolated from patients having the disease xeroderma pigmentosum (XP). In normal fibroblasts, the appearance of low-molecular-weight DNA was observed in the presence of increasing amounts of the drug. The studies in XP fibroblasts produced results which differed from those obtained in normal cells in two ways. (a) Prelabeled XP cells from most complementation groups contained more low-molecular-weight DNA than observed in the other human fibroblasts examined. (b) When XP cells were exposed to low doses of bleomycin, the low-molecular-weight DNA disappeared, suggesting induction of a repair process. If the XP cells were exposed to bleomycin in the presence of hydroxyurea and 1-beta-D-arabinofuranosylcytosine, the disappearance of low-molecular-weight DNA was not observed; instead, a normal dose response to the drug was observed. Our results suggest that XP cells show an "induced" repair response following bleomycin treatment and that blocking DNA chain elongation uncovers normal incisions in bleomycin-treated DNA.


Background: Helminth and human immunodeficiency virus (HIV) infections have a major effect on the host immune system, and coinfection is widespread. About 17%–66% of the world populations are infected with helminth and approximately 24% of the world's population is infected with intestinal helminth. The majority of this infection occurs in resource-limited settings like sub-Saharan Africa which includes Nigeria. Materials and Methods: Stool samples were collected from 297 participants comprising 150 HIV/acquired immune deficiency syndrome (AIDS)-infected individuals as test group and 147 HIV/AIDS-uninfected individuals as control group attending Aminu Kano Teaching Hospital. The samples were examined using direct wet mount and formol-ether concentration techniques. Results: The overall prevalence of intestinal helminth infection was 18.0% for the test group and 2.7% for the control group. Hookworm was found to be the most prevalent intestinal helminth parasite detected with 7.07%, followed by Ascaris lumbricoides (2.69%) and Fasciola species (0.67%), respectively. Some protozoan parasites were also detected, namely Entamoeba coli (3.4%) and Entamoeba histolytica (2.7%). Six of the participants had multiple infections with hookworm and E. histolytica (3 [1.0%]), A. lumbricoides and E. coli (2 [0.7%]), and A. lumbricoides and E. histolytica (1 [0.3%]). A statistically significant association was observed between the type of toilet used, animal rearing, handwashing, and intestinal helminth infection (P 0.02, 0.003, and 0.000). No statistical association exists between sources of water, walking barefooted, and intestinal helminth infection (P 0.211 and 0.942). Conclusion: This study revealed an increased prevalence of intestinal helminth infection among the test group than the control group, as such stool examination should be part of the routine laboratory investigations for HIV/AIDS patients to have effective and proper management of the patients.


Self-management strategies that enhance positive emotions are considered most effective to cope with stress and maintain good mental health and well-being. An artistically designed multisensory environment, The Sensory-Art Space (SAS), was installed in a university in NSW Australia as a new self-management intervention. The design of the SAS was informed by evidence regarding the benefits of viewing art, experiencing nature and accessing sensory rooms. A pilot pre–post intervention study measured changes in affect and perceived stress in 224 participants who spent time in the SAS. Descriptive statistics were completed on the individual affective states, and paired sample t-tests were used to determine changes in Positive and Negative Affect (PANAS-X) and perceived stress (Visual Analogue Scale). The Wilcoxon signed-rank test showed that negative affect reduced, z=−10.23 (p<0.001), and positiveaffect increased, z=−2.57 (p=0.01), following spending time in the SAS. In addition, stress levels reduced after time spent in the SAS, z=−11.29 (p<0.0001). Self-management benefits were found following time in the SAS and future implications for public health and well-being are discussed.


Fc gamma RIII is a family of protein isoforms encoded by at least two distinct, yet highly homologous, genes. Fc gamma RIII on neutrophils is a glycosylphosphatidylinositol-linked protein with an allelic polymorphism (NA1/NA2) while Fc gamma RIII on NK cells (Fc gamma RIIINK) is an exclusively transmembrane protein without the NA polymorphism. The relationship of the isoform of Fc gamma RIII expressed on cultured monocytes (Fc gamma RIIIM phi) to these two forms, however, is unclear because some evidence suggests lowered expression of Fc gamma RIIIM phi in paroxysmal nocturnal hemoglobinuria (unlike Fc gamma RIIINK) and a unique deglycosylated m.w. for Fc gamma RIIIM phi. In this study we demonstrate that, as with Fc gamma RIIINK, Fc gamma RIIIM phi is resistant to the action of phosphatidylinositol-specific phospholipase C and is expressed at normal levels on affected (glycosylphosphatidylinositol-anchor negative) cultured monocytes from patients with paroxysmal nocturnal hemoglobinuria. Fc gamma RIIIM phi is also shed from the cell surface upon incubation at 37 degrees C. However, Fc gamma RIIIM phi and Fc gamma RIIINK have different m.w. as glycosylated proteins despite the same deglycosylated m.w. Thus, each cell type appears to express distinct glycoforms. These differences in glycosylation may influence the functional properties of the receptor.


The number of generations completed by a UK field population of Heterodera schachtiion winter and spring oilseed rape (OSR; Brassica napusL.) during the growing season of 2010/2011 was investigated. The experiments were conducted in pots outdoor using UK OSR winter cultivars (cvs) Flash and Castille and spring cvs Belinda and Heros. The results indicated that temperature was crucial in determining the number of generations completed on OSR during the growing season. At least one generation was completed on cv. Castille, whilst two generations were completed on cvs Flash, Belinda and Heros during the growing season. Development of H. schachtiiwas faster on hybrid OSR cvs Flash and Belinda, suggesting that the hybrids were better hosts of H. schachtiithan the conventional cvs Castille and Heros. Cultivar Flash was more susceptible to H. schachtiiinfection than cv. Castille, while cv. Belinda was more susceptible than cv. Heros. However, no major plant growth differences were observed between the cvs investigated. This is the first report on the number of generations of H. schachtiicompleted on current cultivars of OSR in the UK.


SADH, applied as postbloom sprays to 9 peach cultivars in a series of experiments from 1964 to 1969, accelerated maturation and reduced the number of pickings required for most cultivars. Although SADH did not affect the number of fruits per tree, yield, or fruit size, it advanced the maturity date of 'Ranger' as much as a week; that of 'Blake' 4 days. 'Cardinal', an early cultivar, was not noticeably affected by SADH applied at different stages of development. SADH caused fruit to abscise more readily from the stem and left less fruit remaining on the trees when harvested mechanically. SADH had no detrimental influence on 'Redglobe' peaches stored at 50°F for 3 weeks. These effects support the feasibility of using SADH as an aid in mechanically harvesting freestone peaches intended for fresh market.


UNLABELLED
HIGH PREVALENCE: Several epidemiological studies have shown that the prevalence of bronchial asthma is high in the elderly. It is often difficult to establish the diagnosis of asthma in this population because of the scarcity of symptoms. Pulmonary function tests are widely used to confirm the diagnosis. These tests are possible in most elderly people excepting cases of severe dementia.

MECHANISMS
Pathophysiology of asthma in the elderly may be characterized by superimposition of different factors: 1) the effect of age which is associated with airway adrenoreceptor dysfunction; 2) the impact of chronic pulmonary diseases which may increase airways inflammation; 3) the role of triggers such as infections or various medications.

MANAGEMENT
Management of asthma consists in a specific treatment of trigger(s) associated with anti-inflammatory and bronchodilator medications. Elderly subjects may have difficulty using offinhalators and spacer devices are widely used.


A fundamental frequency (F0) estimator named Harvest is described. The unique points of Harvest are that it can obtain a reliable F0 contour and reduce the error that the voiced section is wrongly identified as the unvoiced section. It consists of two steps: estimation of F0 candidates and generation of a reliable F0 contour on the basis of these candidates. In the first step, the algorithm uses fundamental component extraction by many band-pass filters with different center frequencies and obtains the basic F0 candidates from filtered signals. After that, basic F0 candidates are refined and scored by using the instantaneous frequency, and then several F0 candidates in each frame are estimated. Since the frame-by-frame processing based on the fundamental component extraction is not robust against temporally local noise, a connection algorithm using neighboring F0s is used in the second step. The connection takes advantage of the fact that the F0 contour does not precipitously change in a short interval. We carried out an evaluation using two speech databases with electroglottograph (EGG) signals to compare Harvest with several state-of-the-art algorithms. Results showed that Harvest achieved the best performance of all algorithms.


While the H1N1 pandemic is reaching high levels of influenza activity in the Northern Hemisphere, the attention focuses on the ability of national health systems to respond to the expected massive influx of additional patients. Given the limited capacity of health care providers and hospitals and the limited supplies of antibiotics, it is important to predict the potential demand on critical care to assist planning for the management of resources and plan for additional stockpiling. We develop a disease model that considers the development of influenza-associated complications and incorporate it into a global epidemic model to assess the expected surge in critical care demands due to viral and bacterial pneumonia. Based on the most recent estimates of complication rates, we predict the expected peak number of intensive care unit beds and the stockpile of antibiotic courses needed for the current pandemic wave. The effects of dynamic vaccination campaigns, and of variations of the relative proportion of bacterial co-infection in complications and different length of staying in the intensive care unit are explored.


See video of the presentation. Research Consulting undertook a study for Knowledge Exchange that looked at the relation between open-access policies and services. Drawing on a consultation with funders, institutions and service providers across the five Knowledge Exchange countries and beyond, it identifies the key services needed to successfully implement open-access policies, and suggests priorities for action in support of an open scholarly infrastructure. The study reviewed a wide range of OA policies from public research funders, private research funders and selected high education institutions from the five Knowledge Exchange countries; it finds that although policies vary considerably across countries, they generally share key requirements for green OA, gold OA and monitoring and compliance, with the clearest differences being in the emphasis placed on those requirements. The study also provided a thorough review and classification of OA services, and identified the ones that are indispensable for the successful implementation of all OA policies. In particular, it reviewed the importance for author, institutional and funders' workflows of: (1) underpinning services such as standards, metadata and identifiers (e.g. ORCID and FundREF); (2) abstracting and indexing services, such as the Directory of Open Access Journal; (3) support and dissemination services such as SHERPA; and (4) green OA services encompassing a wide range of repository and related services designed to improve interoperability across the green OA landscape. Finally, we looked at critical challenges facing OA services, including uncertainties over their financial stability and governance models, that hamper – or can hamper in the future – their effective use and continued development, and we highlighted priorities for action from decision makers in the scholarly community. These include both specific recommendations to act in support of critical services, as well as strategic recommendations covering the actions and investments needed to create a coherent OA service infrastructure so as to allow more efficient and effective compliance with OA services.


Fucoidan, a sulfated polysaccharide extracted from brown seaweeds, has been shown to possess various antioxidant, anticoagulant, antiviral, and anticancer functions. In this study, we focused on low molecular weight fucoidan (LMWF) which was extracted from New Zealand Undaria pinnatifida, and investigated its anti-proliferative effects, combined with a quadruplex-forming oligonucleotide aptamer (GroA, AS1411), a powerful cell surface Nucleolin inhibitor, in prostate cancer cells. We examined LMWF (<10 kDa) and compared it with laboratory grade Fucoidan purchased from Sigma (FS), all extracted from the same seaweed species U. pinnatifida. We found that LMWF significantly improved the anti-proliferative effect of GroA, as it decreased cancer cell growth and viability and increased cell death. This research may provide the foundation for LMWF to be used against prostate cancers as a supplement therapy in combination with other therapeutic agents.


We have studied the features of intrinsic Josephson junction stacks in the c-axis direction in highly Pb-substituted (Bi/sub 1-x/Pb/sub x/)/sub 2/Sr/sub 2/CaCu/sub 2/O/sub y/ (with x/spl ges//spl sim/0.2) single crystals exhibiting multiple branches with hysteresis on the I-J characteristics. For the mesa of the single crystal with x=/spl sim/0.2, as the self-field effects on the fluxon motion in the Intrinsic Josephson junctions, the flux flow branch and the zero field step were successfully observed in addition to the supercurrent at zero voltage and the multiple resistive branches. Moreover, their ac Josephson effect was also confirmed by observation of the microwave-induced Shapiro step. These results imply the existence of intrinsic Josephson effects in the single crystals with x/spl ges//spl sim/0.2.


With earthquake prediction appearing now as a possibly unrealizable goal, the contribution that seismologists can make to protecting society against the disastrous effects of earthquakes chiefly revolves around making estimates of likely future levels of earthquake activity that engineers and planners can use in the course of implementing mitigation strategies: seismic hazard analysis. One of the key issues in this field is the treatment of irreducible uncertainty in some of the input parameters, which has been found to defeat simple attempts to produce unique deterministic values for maximum ground motion. Seismologists handle this by modeling uncertainty with a probabilistic approach, referred to as probabilistic seismic hazard assessment (PSHA).


The banana weevil, Cosmopolites sordidus (Germar) (Coleoptera: Curculionidae) is an important pest of highland banana in East and central Africa. It causes yield loss of up to 100% in heavily infested fields. Studies were carried out in Uganda to evaluate the efficacy of the the plant base incision trap in attracting C. sordidus and to determine the potential of using the trap in enhancing dissemination of the entomopathogenic fungi, Beauveria bassiana for the pest control. Field experiments were carried out in an established banana field of C. sordidus susceptible East African Highland Banana cultivar, Nabusa (AAA-EA).  There were significantly more weevils recaptured in the incision trap (14.4%) than the conventional pseudostem trap (4.7%). After laboratory incubation, more weevils died due to pathogen infection  from plots where the incision trap was used in combination with B. bassiana (25.9%) compared to where the pathogen was applied around the plant base without the incision (15.9%). Weevils showing signs of mycosis were recovered at 6 and 9 m from the pathogen release point, suggesting that the weevils can pick the pathogen from the aggregation point and disperse it. This data  demonstrates that the incision trap is more attractive to C. sordidus than the conventional pseudostem trap and might be used to enhance dissemination of B. bassiana among adults.

 Key words: Entomopathogenic fungi, horizontal transmission,  pseudostem trap.


Many variables in surveys follow natural orderings that should be respected in estimates of domain means. For instance, the National Compensation Survey estimates mean wages for many job categories, and these mean wages are expected to be non-decreasing according to job level. In this type of situation, isotonic regression can be applied to give constrained estimators satisfying the monotonicity. We combine domain estimation and the pooled adjacent violators algorithm to 10 construct new design-weighted constrained estimators. Under mild conditions on the sampling design and the population, the estimators are shown to be design consistent and asymptotically normal. Confidence intervals for domain means using linearization-based and replication-based variance estimation show marked improvements compared to survey estimators that do not incorporate the constraints. 15


ABSTRACT The purpose of this paper is multifold: (a) to focus awareness on major geologic processes and (b) to present preliminary notions of synergy between processes in deep-water, subsalt, and fan-fold belt environments. With as much as a thousand-fold variation in deposition rates from highstand to lowstand during the Quaternary, and probably during the Neogene, the rates at which processes operate over time are highly variable. Synergy between processes, including those related to specific zones, i. e., subsalt and basement, is connected via the sedimentation rate variation and the rate and extent of Sigsbee Salt migration as the ever-growing, salt-floored subbasin advances basinward through the northern Gulf of Mexico continental margin. Synergistic geologic processes among deep-water, subsalt, and fan-fold belt are compiled: hydrates and hydrodynamics of hydrate stability zones, earthquakes and paleofracture zones with thermal anomalies and contained fluids, fracture development and gas expansion/contraction, fan-fold belt development, subsalt pressure compartments, major deposition rate variations and implications of salt-floored subbasins. Salt has twice to triple the thermal conductivity of alternating sand and shale sediment. Salt massifs, ridges, and diapirs can be as much as 20° to 40° C hotter than surrounding sediments. The advancing salt-floored subbasin can thermally mature organics that have been deposited and make them available for accumulation in reservoirs as commercial hydrocarbons. A passive margin, such as that along the northern Gulf of Mexico, can be characterized by generally high deposition rates, although highly variable in amount and sediment type and made increasingly unstable by containing semiplastic salt. Most deposition occurs along the shelf and slope, overlying the potentially dynamic salt. The entire shelf-slope wedge appears to be leisurely sliding downslope, overriding the finer-grained and more evenly-deposited continental rise and abyssal plain sediments. The rapid prograding of the shelf-slope wedge steepens the overall margin, increasing regional instability. The semiplastic Louann Salt serves as a lubricated surface along which the shelf-slope wedge slides basinward and downslope. The advancing wedge forces creation of fan folds beneath and in front of the advance, advancing compression the causative force. The same advance also may create shear zones that lie above basement and below the salt, pressure compartments, fracture development in front of the advance with gas expansion/contraction, and changes the distribution (laterally and thickness) of hydrates and underlying free gas. Variable deposition rates appear to be the principal driver of the advance. In the case of plate convergence, the relative advance of continental crust accumulates/offscrapes sediments from the subducting oceanic crust to form a critical Mohr-Coulomb-tapered wedge. This tapered wedge is self-sustaining as new sediments accumulate on the "bow" of the wedge with erosion along the wedge base. The dynamic tapered-wedge concept employs the varying geometry of the sedimentary wedge as a way to describe, at least preliminarily, the internal tectonics and sediment budget. The same dynamic tapered-wedge concept may be applied to the above Louann Salt sediments. The advancing shelf-slope wedge, riding above the semiplastic salt, incorporates sediments onto the wedge bow with additional sediments descending from the shelf. Accumulating sediments enlarge the tapered wedge with time. As envisioned, there may be no sediment loss along the wedge base. The changing of the sediment wedge geometry could serve as an index to overall internal tectonics and provide another investigative tool to northern Gulf of Mexico geology. End_of_Record - Last_Page 463-------


The 2013 curriculum has a pattern in which to create a creative Indonesian human being. The creative thinking abilities is important because it makes learners have many ways to solve problems with different perceptions and concepts. Compenents of creative thinking abilities include fluency, flexibility, and novelty. Problem solving can be used to increase motivation and cultivate creative traits. The purpose of this research is to describe the achievement aspect of each level of student's creative thinking ability Program Biology Education of Lambung Mangkurat University in problem solving of plant ecology. This research method using quantitative approach and descriptive research type. Quantitative data from the result of student answers do written tasks that will be analyzed in percentage, then coverted into data description. The result of achievement aspect of each level of student's creative thinking ability student of Biology Education Lambung Mangkurat University in problem solving namely the creative level with fluency aspect is high, flexibility and novelty is medium. The quite creative level with fluency, flexibility and novelty is medium. The less creative level with fluency is medium, flexibility and novelty is low.


An efficient and expedient synthetic protocol is reported for the synthesis of 2,3-diarylquinoline derivatives from readily available aryl amines, aryl aldehydes and styrene oxides using 10 mol% copper(ii) triflate by employing three-component reaction. This approach involves the reaction between the in situ generated imine (derived from the aryl amine and aryl aldehyde) and styrene oxide, which enables the formation of the desired products. The present method has several advantages such as high atom-economy, high regioselectivity, easy handling, consecutive one C-N and two C-C bond formation, shorter reaction time and broader substrate scope with good yields.


Cooperative learning is an instructional model in which students work together toward a common goal. Research has clearly shown that cooperation results in higher levels of achievement. Although students may be a part of a cooperative learning environment, they are also responsible for their own individual achievement. This makes student evaluations a challenge because you are evaluating individual as well as team effort. This paper will review the alternatives for assessing the participation of individual student on a team as well as discuss the cases in which each approach was used. It identifies the positives and negatives of each approach.


Current healing systems in Southern Africa focus on the holistic approach to the health and wellness of patients. Biomedical approaches and traditional healing systems that incorporate spiritual healing, mental healing, physical and social healing play a crucial and significant role in health delivery systems in Southern Africa. An integrative approach has been accepted as a vital component of holistic healing. Often, biomedicine has been criticized for overlooking the relationship of the social and spiritual being to the body and the effect the former has on the latter. Medicine and healing are cultural practices; hence the process of healing and the interpretation of illness reflect and reinforce the cultural definitions of the health problem.  Biomedical technology often determines what is to be taken as authoritative knowledge and, in turn, establishes a particular domain of power. Biomedicine typically extends this privileged position to economics, politics, and class relationships. While the situation of traditional medicine appears to remain weak and marginalized. effort is being made in most African countries to integrate biomedicine and alternative healing paradigms. This paper explores the influence of traditional beliefs and practices and the use of African traditional medicine in the healing process. It further discusses the integration of indigenous healing systems and western medical approaches. The paper concludes that where both biomedical practices and traditional healing systems exist, patients should have a choice of the healing approach and process they prefer, the former or the latter, or a combination of both.

 Key words: Biomedicine, culture, traditional medicine, holistic approach, western medicine.


Importance
Opioids, which carry a high risk for addiction and overdose, are commonly prescribed after corneal surgery. Data are lacking describing opioid prescribing practices and opioid needs by patients after ophthalmic surgery.

Objectives
To quantify opioid use and to assess the association of decreasing the number of opioid tablets prescribed after corneal surgery with postsurgical use.

Design, Setting, and Participants
This prospective cohort study investigated opioid use after corneal surgery using direct interviews of 2 adult patient cohorts separated by an updated opioid prescribing guideline. The first cohort survey assessed the quantity of opioid tablets used after surgery. The cornea division of a tertiary care academic medical center reviewed the use needs and decreased the number of tablets prescribed after routine cases. Simultaneously, a statewide opioid monitoring program began that provided patients with opioid information. A second unique cohort received a more detailed survey to assess use, opioid disposal, and pain control. Data for the first cohort were collected from December 1, 2017, through January 19, 2018; for the second cohort, from June 1 to September 15, 2018. Data were analyzed from October 24, 2018, through September 24, 2019.

Exposure
Corneal surgery.

Main Outcomes and Measures
Differences in use of opioid tablets used by both patient cohorts, assessed using the 2-sample t test.

Results
Of 112 eligible, contacted patients, 82 consented to participate (42 men [51%]; mean [SD] age, 42.5 [17.8] years) and were included in the analysis; 38 of 42 participated in the first cohort and 44 of 70 participated in the second cohort. Of those receiving opioid prescriptions, the first cohort was prescribed significantly more tablets than the second cohort (mean [SD], 18.8 [4.2] vs 6.6 [3.1]; difference, 12.2 [95% CI, 10.4-14.0]; P < .001). The first cohort used significantly more tablets than the second cohort (mean [SD], 8.3 [7.0] vs 4.0 [3.2]; difference, 4.3 [95% CI, 1.4-7.2]; P = .005) and had significantly more leftover tablets (mean [SD], 10.3 [6.9] vs 2.9 [2.7]; difference, 7.5 [95% CI, 4.7-10.2]; P < .001). In the detailed survey for the second cohort, 19 of 27 patients reported pain control as adequate (70% [95% CI, 50%-86%]); 6 of 27, as more than needed (22% [95% CI, 9%-42%]). Twenty of 28 participants (71% [95% CI, 55%-88%]) had leftover tablets; 17 of these (85% [95% CI, 62%-97%]) did not dispose of leftovers, and 3 (15% [95% CI, 3%-38%]) threw away or flushed leftovers.

Conclusions and Relevance
After an assessment of opioid needs, physicians prescribed fewer opioid pills. However, patients who underwent cornea surgery and received fewer tablets continued to have adequate pain control and used even fewer tablets compared with the initial cohort. Patients with unused opioid tablets did not dispose of them properly.


Aplastic anemia is a rare blood disorder characterized by pancytopenia and hypocellular bone marrow. In patients with aplastic anemia, pancytopenia sometimes worsens during pregnancy, and relapse of aplastic anemia in pregnancy is common. Nevertheless, only supportive care with blood products is the mainstay of treatment of aplastic anemia in pregnancy. Thus, the obstetric management and treatment of aplastic anemia in pregnancy is extremely challenging. We herein report the first case of a pregnant woman complicated with aplastic anemia who was successfully treated with eltrombopag, a thrombopoietin receptor agonist. A 27-year-old primigravida woman who had a history of aplastic anemia refractory to immunosuppressive therapy and was treated with eltrombopag became pregnant. Eltrombopag treatment was continued after weighing the benefits and potential risks. Throughout pregnancy, the woman's pancytopenia did not progress, and she delivered a 2336 g baby vaginally at 38 weeks of gestation. Her postpartum outcome was uneventful, and the neonate did not develop thrombocytosis. Since the efficacy and safety of eltrombopag in pregnancy has not yet been established, its routine use should be avoided. However, if limited to refractory cases and with adequate maternal and fetal monitoring, including neonatal blood examinations, the use of eltrombopag for patients with aplastic anemia during pregnancy may be acceptable and result in favorable maternal and fetal outcomes.


ABSTRACT Purpose There is evidence that childhood adversity is correlated with poor health outcomes across the lifespan. Resilience results when internal and external protective factors in childhood mitigate this relationship. However, among children on the autism spectrum, these relationships are understudied, and little is known about the characteristics and role of adversity and resilience in their in their lives. This study interprets these phenomena as experienced by autistic young adults. Methods Initially, we conducted community engagement with five members of the autism community who advised on the research question, research design, and analysis. Subsequently, four autistic young adults, three women and one non-binary, aged 19–27, were recruited to participate in semi-structured interviews via phone, video conference, and online chat. Credibility checking interviews followed data analysis. Results Through interpretative phenomenological analysis we identified themes related to the negative effects of adversity, including social disconnection, mental and emotional well-being, sense of self, and development into young adulthood. Resilience developed in places of refuge and identity and was evident in their transitions into young adulthood. Conclusion These findings provide direction for decreasing adversity and fostering resilience in children and adolescents on the autism spectrum.


Background: robot-assisted (RATS) thoracic surgery performed in some thoracic centers for over 10 years (Melfi F.M.A.,2002). Nevertheless, the possibility of robotic technology as an alternative to VATS surgery actively discussed. Aim: to compare the results of using RATS and VATS lobectomy for pulmonary diseases. Methods: 117 consecutive patients admitted to hospital for lobectomies: 61 - localized forms of pulmonary TB, 51 - pulmonary tumors, 5 - other lung diseases (bronchiectasis – 2, NMI - 2, pulmonary sequestration - 1). All patients divided in 2 groups: standard lobectomy and lobectomy with lymphadenectomy. CCI was – 1 vs 2, FEV1 was 3,4L vs 2.8L, BMI was 22 vs 27 in the 1 st and 2 nd groups respectively (p>0.05). Results: there were 48 RATS and 21 VATS lobectomies performed in the 1 st group (operative time and blood loss were 186 vs 226min.,90 vs 105ml for RATS and VATS respectively). There were 21 RATS and 27 VATS lobectomies performed in the 2 nd group (operative time and blood loss were 196 vs 260min.,118 vs 190ml for RATS and VATS respectively). Operative time and blood loss were significantly less for RATS lobectomies without lymphadenectomy (P Conclusion: RATS is preferable to perform lobectomy for pulmonary diseases because it provides the best postoperative results, regardless of the performance of lymphadenectomy. Lymphadenectomy increased the rate of postoperative complications, however using of the RATS reduced these disadvantages.


Cyber hackers use email as a tool to trick, inject or drop malicious software into the recipient's device. Everyday users have to face off against, phishing or malicious emails and it would be a huge problem for whole organizations even if only one user clicked on a single link from this malicious email. The difficult issue is how to classify and detect those malicious emails from ordinary, especially spear phishing emails, which are designed for a particular target, or zero-day malicious emails that no one has ever found until now. In this paper, we introduce a way to classify and detect zero-day malicious emails by using deep-learning with data investigated from the email header and body itself, combined with dynamic analysis information as a group of features. Four different language email datasets can be used to train and test the system to simulate real-world diversity and zero-day malicious email attack situations. We succeeded in obtaining a satisfactory accuracy rate for detection results for both zero-day malicious email types and normal spam.


Abstract Conflicts are likely to arise among participants in a collaborative design process as the inevitable outgrowth of the differing perspectives and viewpoints involved. The opportunities for conflict are magnified if many perspectives are brought to bear on a common artifact early in the design process, as in concurrent engineering or integrated engineering. Design advice tools can assist in the process of resolving these conflicts by making critiques and suggestions conveniently available to design participants, and by offering a fair means of evaluating and comparing suggested alternatives for compromise solution. In previous work we introduced a protocol based on notions of economic utility by which design advice systems can recognize conflict and mediate negotiation fairly. This protocol allowed design teams to express the desire to maximize or minimize the values of design parameters over totally ordered bounded domains of values, such as real numeric intervals. In this paper we extend this approach by allowing expressed preferences of design teams to be qualitative as well as quantitative, by allowing teams to express interest in parameters before they actually come into existence, and by relaxing many other of the earlier restrictions on the ways teams may express their preferences.


The ELeGI project focuses on integrating technology-enhanced learning methodologies into a pedagogy-driven and service-oriented architecture based on Grid technology. It aims at a system that is capable of realising personalised, adaptive, and experiential learning. This requires to have available a framework that, on the one hand, allows for representing existing domain knowledge, and, on the other hand, provides a representation of the learner's current state of knowledge. It is shown that a competence-based extension of Knowledge Space Theory provides a representation of the conceptual organization of a domain that not only allows for an adaptive assessment of an individual's knowledge, but also for generating personalised learning paths. The discussion of this framework emphasizes its application within an open distributed service model, and in the context of Virtual Scientific Experiments.


The clinical and laboratory responses to steroid therapy in four patients with sarcoidosis, hypercalcemia, and renal insufficiency are presented. The predominant complaints of these patients were anorexia, nausea, vomiting, and abdominal pains simulating ulcer distress. The diagnosis of sarcoidosis was confirmed in each case by lymph node biopsy. Administration of steroids produced a prompt fall in the level of serum calcium with complete relief of symptoms, despite evidence of persistent mild renal insufficiency in three cases. Long-term steroid therapy has been necessary in these three cases to maintain an asymptomatic and normocalcemic state. The history of a fifth patient is presented to illustrate the difficulties which may be encountered in making the diagnosis of sarcoidosis. In recognized cases of sarcoidosis, studies of the serum calcium and renal function would appear desirable if irreversible renal complications are to be prevented.


Beta‐keratins form a large part of the proteins contained in the hard beta layer of reptilian scales. The expression of genes encoding glycine–proline‐rich beta‐keratins in normal and regenerating epidermis of two species of gecko lizards has been studied by in situ hybridization. The probes localize mRNAs in differentiating oberhautchen and beta cells of growing scales and in modified scales, termed pad lamellae, on the digits of gecko lizards. In situ localization at the ultrastructural level shows clusters of gold particles in the cytoplasm among beta‐keratin filaments of oberhautchen and beta cells. They are also present in the differentiating elongation or setae of oberhautchen cells present in pad lamellae. Setae allow geckos to adhere and climb vertical surfaces. Oberhautchen and beta cells also incorporate tritiated proline. The fine localization of the beta‐keratin mRNAs and the uptake of proline confirms the biomolecular data that identified glycine–proline‐rich beta‐keratin in differentiating beta cells of gecko epidermis. The present study also shows the presence of differentiating and metabolically active cells in both inner and outer oberhautchen/beta cells at the base of the outer setae localized at the tip of pad lamellae. The addition of new beta and alpha cells to the corneous layer near the tip of the outer setae explains the anterior movement of the setae along the apical free‐margin of pad lamellae. The rapid replacement of setae ensures the continuous usage of the gecko's adhesive devices, the pad lamellae, during most of their active life.


This study examines intra- and intercellular trafficking of mesoporous silica nanoparticles along microtubular highways, with an emphasis on intercellular bridges connecting interphase and telophase cells. The study of nanoparticle trafficking within and between cells during all phases of the cell cycle is relevant to payload destination and dilution, and impacts delivery of therapeutic or diagnostic agents. Super-resolution stochastic optical reconstruction and sub-airy unit image acquisition, the latter combined with Huygens deconvolution microscopy, enable single nanoparticle and microtubule resolution. Combined structural and functional data provide enhanced details on biological processes, with an example of mitotic inheritance during cancer cell trivision.


I examine how local municipalities in Denmark and Spain carried out experiments in schooling policy on pupils with immigrant backgrounds, toward improving the process of social integration and academic performance. Policy affecting second generation immigrant children generated conflicts over rights, values, and norms in the public sphere. I analyze local public policy decisions first by confronting two perspectives, local experimentalism and enlightened localism, with one another, and then by identifying various ways in which they are complementary.


We introduce twisted relative Cuntz-Krieger algebras associated to finitely aligned higher-rank graphs and give a comprehensive treatment of their fundamental structural properties. We establish versions of the usual uniqueness theorems and the classification of gauge-invariant ideals. We show that all twisted relative Cuntz-Krieger algebras associated to finitely aligned higher-rank graphs are nuclear and satisfy the UCT, and that for twists that lift to real-valued cocycles, the $K$-theory of a twisted relative Cuntz-Krieger algebra is independent of the twist. In the final section, we identify a sufficient condition for simplicity of twisted Cuntz-Krieger algebras associated to higher-rank graphs which are not aperiodic. Our results indicate that this question is significantly more complicated than in the untwisted setting.


The present study exemplifies the method of quantitative reverse transcriptase-polymerase chain reaction (cRT-PCR) by quantifying, in bovine tissues, the specific mRNAs for the two key proteins which regulate cellular cholesterol metabolism, the low density lipoprotein (LDL)-receptor and the 3-hydroxy-3-methylglutaryl-Coenzyme A (HMG-CoA) reductase. Our data reveal a broad range of expression for both mRNAs. The LDL-receptor mRNA expression was highest in the adrenal gland (6.7 x 10(4) molecules/micrograms cellular RNA) followed by the corpus luteum of the ovary, intermediate in the liver (8.6 x 10(2) molecules/micrograms cellular RNA) and not detectable in the large intestine. Expression of the HMG-CoA reductase almost paralleled LDL-receptor values. It was found to be highest in the ovary (6.1 x 10(6) molecules/micrograms cellular RNA) followed by the adrenal gland, intermediate in the liver (3.1 x 10(5) molecules/micrograms cellular RNA) and lowest in the large intestine (9.9 x 10(4) molecules/micrograms cellular RNA). These data are consistent with other reports concerning the quantitative analysis of the expression of both proteins as determined by other experimental approaches. Thus cRT-PCR is a valuable tool for the quantitative analysis of the LDL-receptor and the HMG-CoA reductase.


The yield and work hardening behavior of a small-scale initial-boundary value problem involving dislocation plasticity in an idealized particle strengthened system is investigated using micropolar single crystal plasticity and is compared with results for the same problem from dislocation dynamics simulations. A micropolar single crystal is a work-conjugate higher-order continuum that treats the lattice rotations as generalized displacements, and supports couple stresses that are work-conjugate to the lattice torsion-curvature, leading to a non-symmetric Cauchy stress. The resolved skew-symmetric component of the Cauchy stress tensor results in slip system level kinematic hardening during heterogeneous deformation that depends on gradients of lattice torsion-curvature. The scale-dependent mechanical response of the micropolar single crystal is dictated both by energetic (higher-order elastic constants) and dissipative (plastic torsion-curvature) intrinsic material length scales. We show that the micropolar model captures essential details of the average stress–strain behavior predicted by discrete dislocation dynamics and of the cumulative slip and dislocation density fields predicted by statistical dislocation dynamics.


A 38 years old woman without any cardiovascular risk was admitted to the Emergency Room of our Hospital symptomatic for chest pain and dyspnoea. She referred a recent holiday in Tunisia; she was excellent health until a week before when she developed flue–like symptoms, such as fever, fatigue, abdominal pain, diarrhea and myalgia, like all the family members; the night before the access to the ER, she suffered from weakness of breath. Physical examination revealed venous engorgement and sinus tachycardia with a rate of 102 bpm, blood pressure was about 85/50 mmHg, oxygen saturation in 3L nasal cannula was 92%. The EKG showed a sinus tachycardia without any ST elevation or depression and generalized low voltage. A transthoracic echocardiography revealed circumferential pericardial effusion (3,5 cm) and both right atrium and right ventricle collapse in the setting of cardiac tamponade; EF was 35% (GLS=6%). Our first clinical suspicion was viral pericarditis with pericardial effusion (early cardiac tamponade), in consideration of the anamnestic data, the holiday in Tunisia and the general symptoms. However, an urgent pericardiocentesis was performed and one liter of sero–sanguineous pericardial fluid (exudate) was drained; therefore, there was an immediate haemodynamic improvement. A pigtail was placed using the Seldinger technique. While the first sample of cytology on sero–sanguineus pericardial fluid was negative, the second sample resulted positive for malignancy. Chest CT showed bilateral pleural effusion and a mass which was compatible with a lung cancer. Lung nodule biopsy revealed a lung adenocarcinoma. Immunohistochemistry (IHC) and molecular testing for epidermal growth factor receptor (EGFR) were positive. The patient was affected by metastatic non small cell lung cancer with EGFR mutation, which was responsive to Osimertinib. Three days later, another echo was performed showing almost complete resolution of pericardial effusion and normal LV function (EF= 55%). The patient was transferred to the Oncology Department and then discharged from the Hospital. Before starting Osimertinib, she was suggested to undergo a baseline cardiovascular stratification, EKG and transthoracic echocardiogram, three–monthly echocardiography surveillance with monitoring of GLS (which guides the management of potentially cardiotoxic drugs); close monitoring of magnesium levels is also recommended to minimize the risk of QTc prolongation.


cruelty, lack of objectivity and potential abuse. Furthermore, it has often been argued that non-animal alternatives can be effectively used as substitutes. However, results of toxicity rarely conform to a predetermined pattern. In a recent report,' toxicologists from a major chemical manufacturing company shared an unpredictable finding made in the course of evaluating one particular substance according to the 1989 guidelines of the United States Environmental Protection Agency.' These guidelines required acute oral and dermal tests, which revealed slight toxicity by the oral route (LO .. between 200 and 2000 mglkg body weight) and practically no toxicity by the dermal route (LO,. greater than 2000 mglkg body weight). A completely different picture emerged from the Draize test.' When 100 mg of material was placed in the conjunctival sac of rabbit eyes for assessment of irritant properties, each animal "exhibited a sequence of clinical systemic signs indicative of severe neurotoxicity, commencing within 6 min of application and ending in death of the animals in 12 min". The only conclusion can be that a proper initial hazard evaluation of this chemical required not just an animal test but the actual Draize-lype test; otherwise, the profound toxicity observed would have remained undetected no matter whether conventional LO .. tests, LO .. tests, or alternative non-animal tests were used. A ban on the Draize test (as exists in Victoria, for example), although clearly desirable for ethical and other reasons, would appear to have been premature on scientific grounds. The message is clear we do not yet know how to predict the results of tests used to assess the hazards of chemical substances. If we did, the toxicologist need only be armed with insight and a computer and a massive product liability insurance package. Donald G MacPhee, PhD, MEIA, FASM, FAIBlol Reader Microbial Mutagenesis laboratory La T robe University, Bundoora, VIC 3083 blood alcohol levels considered in most States as dangerous for driving; on such occasions they consume amounts of alcohol well in excess of limits currently recommended by health authorities. While lowering very high levels of consumption on licensed premises should lead to a reduction of alcohol-related harm and offences, this situation is unlikely to be achieved without public debate and clear enforceable guidelines as to the responsibility of licensees in serving a legal but potentially lethal psychotropic drug. Despite community support for police enforcement of existing liquor licensing laws,' very little enforcement activity has been apparent in recent years.' There is a need for a much clearer message regarding the service of alcohol to intoxicated patrons to be conveyed to licensees. At the same time, responsible server training programs should be expanded and barstaff supported through increased public awareness campaigns outlining the responsibilities of servers of alcohol. Phil Rydon, BA(Hons) Tim Stockwell, PhD National Centre for Research into the Prevention of Drug Abuse Curtin University of Technology. GPO Box UI987 Perth, WA 6001


We present a loadless CMOS four-transistor cell for very high-density embedded SRAM applications. Using 0.18-/spl mu/m CMOS technology, the memory cell size is 1.9344 /spl mu/m/sup 2/ (1.04 /spl mu/m/spl times/1.86 /spl mu/m), which is 35% smaller than a six-transistor cell using the same design rule. The newly developed CMOS 4T cell operates with high stability at 1.8 V, even though its designed cell ratio is 1.0 to minimize the area. A pair of pMOS transfer transistors is used to store and retain full-swing signals in the cell without a refresh cycle. The fabrication process is fully compatible with high performance CMOS logic technologies, because there is no need to integrate a poly-Si resistor or a TFT load.


High prevalence of poverty diseases such as diarrhoea, respiratory tract infection, parasitic infections and dental caries among children in the developing world calls for a return to primary health care principles with a focus on prevention. The 'Fit for School' program in the Philippines is based on international recommendations and offers a feasible, low-cost and realistic strategy using the principles of health promotion outlined in the Ottawa Charter. The cornerstone of the programme is the use of school structures for the implementation of preventive health strategies. 'Fit for School' consists of simple, evidence-based interventions like hand washing with soap, tooth brushing with fluoride toothpaste and other high impact interventions such as bi-annual de-worming as a routine school activity for all children visiting public elementary schools. The programme has been successfully rolled-out in the Philippines covering 630,000 children in 22 provinces and it is planned to reach 6 million children in the next three years. The programme is a partnership project between the Philippine Department of Education and the Local Government Units with support for capacity development activities from the German Development Cooperation and GlaxoSmithKline.


CREG1 is an endosomal-lysosomal protein which is highly expressed in the liver. Hepatocyte-specific deletion of Creg1 in mice causes insulin resistance and elevated glycemia. To test if CREG1 is nutritionally regulated, we fed mice for 10 weeks with a high-fat diet (HFD) which progressively downregulated CREG1 in the liver at both protein and mRNA levels. The CREG1 expression was restored after switch back to a standard chow diet for two weeks. The diet-induced CREG1 changes negatively correlated with blood glucose levels. Sequence analysis revealed enrichment of CpG islands in exon 1 of both human and mouse CREG1 genes. To test if methylation of these CpG islands contributes to HFD-induced CREG1 reduction, we fed mice with a HFD for 10 weeks and treated them with the DNA methyltransferase inhibitor 5-aza-deoxycytidine, which reversed HFD-induced CREG1 downregulation in the liver. At the cellular level, overload of cultured human hepatocytes with fatty acids reduced CREG1 expression, and this was reversed by inhibiting DNA methylation. Furthermore, removal of all CpG islands in the first exon with sense mutations abolished lipid overload-induced CREG1 downregulation. These results suggest that HFD downregulates CREG1 via DNA methylation of the CpG islands in the first exon. It would be interesting to test if CREG1 reduction mediates HFD-induced insulin resistance.

 Y.Qi: None. J.Liu: None. J.C.Chao: None. S.A.Rahimi: None. L.Y.Lee: Speaker's Bureau; Abbott. S.Li: None.

 Rutgers Biomedical and Health Sciences


PURPOSE
To compare the effects of education only and exercise training combined with education on fall knowledge, fall efficacy, physical activity, and physical function in adults aged 70 years or older residing in elderly residential facilities.

METHODS
A three-group pre- and post-test design was utilized: education only (EO; n = 23), education and TheraBand (ET; n = 22), and education and walking (EW; n = 22). Fall education was provided for all three groups. In addition, TheraBand exercise training was provided for the ET and a walking exercise for the EW. Data were collected from November 1st, 2017 to February 15th, 2019 and analyzed with χ² test, paired t-test, and one-way ANOVA using IBM SPSS/WIN ver. 22.0.

RESULTS
Compared with the EO, the ET and the EW were more effective in terms of fall efficacy, physical activity, and lower extremity muscle strength. The EW showed higher improvement in walking abilities than the EO and the ET.

CONCLUSION
Exercise training combined with education is more effective in preventing falls among community-dwelling adults aged 70 years or older. When considering fall prevention programs for older adults, both TheraBand and walking exercise training combined with education can be chosen based on the participant's physical status. Aggressive strategies to improve daily walking are required to maintain walking abilities among community-dwelling adults aged 70 years or older.


We propose adding a third, intermediate, verdict to the two-verdict system used in criminal trials. We show that the additional verdict can be used to distinguish between convicted defendants, based on the residual doubt regarding their guilt at the end of the trial, in a way that improves welfare and does not increase the set of innocent defendants who are wrongly convicted. It can also be guaranteed that wrongfully convicted defendants do not serve longer sentences, provided that the sentence in the two-verdict system was not too inefficiently low. Since even acquitted defendants may face a social stigma, we also consider using the additional verdict to distinguish between acquitted defendants, and provide conditions under which this improves welfare. Generalizations to multi-verdict systems with a larger number of verdicts are also explored. We also consider plea bargains, and show that a properly chosen plea in a two-verdict system leads to higher welfare than any multi-verdict system, and is in fact the optimal mechanism. Finally, we consider the impact of multiple verdicts on the incentives to gather evidence, and show that the effect is generally positive. ∗We thank Robert Burns, Eddie Dekel, Fuhito Kojima, Adi Leibovitz, Paul Milgrom, and Jean Tirole and seminar participants at UC Berkeley, Seoul National University, and the NBER Summer Institute Law and Economics Workshop for helpful comments. David Rodina provided outstanding research assistance. Strulovici gratefully acknowledges financial support from an NSF CAREER Award (Grant No. 1151410) and a fellowship form the Alfred P. Sloan Foundation. Siegel: Department of Economics, The Pennsylvania State University, University Park, PA 16802, email@example.com. Strulovici: Department of Economics, Northwestern University, Evanston, IL 60208, firstname.lastname@example.com.


The microstructure, critical current density and relaxation behaviour of a YBCO sample fabricated by the powder melting process technique have been studied by using a transmission electron microscopy and SQUID magnetometer. It is found that many 211 particles are very small with diameter of submicrometre size. Also, some 211 particles with 250 nm in diameter exist in this sample. A high density of stacking faults and dislocations is observed. In the low field region, Jc decreases with the field according to a power law at temperatures above 60 K. An exponential temperature relationship between the critical current density (Jc) and temperature is established in the high field region. In addition, the field and temperature dependence of the relaxation rate exhibits a plateau over a temperature region from 30 K to 65 K, illustrating the collective pinning nature of the pinning centres.


Using state of the art Monte Carlo simulations of a bead-spring model we investigate both the equilibrium and the nonequilibrium behavior of the homopolymer collapse. The equilibrium properties obtained via multicanonical sampling recover the well-known finite-size scaling behavior of collapse for our model polymer. For the nonequilibrium dynamics we study the collapse by quenching the homopolymer from an expanded coiled state into the globular phase. The sequence of events observed during the collapse is independent of the quench depth. In particular, we focus on finding out universal scaling behaviors related to the growth or coarsening of clusters of monomers, by drawing phenomenological analogies with ordering kinetics. We distinguish the cluster coarsening stage from the initial stage of primary cluster formation. By successful application of a nonequilibrium finite-size scaling analysis we show that at all quench temperatures, during the coarsening stage, the cluster growth is roughly linear and can be characterised by a universal finite-size scaling function. In addition, we provide evidence of aging by constructing a suitable autocorrelation function and its corresponding dynamical power-law scaling with respect to the growing cluster sizes. The predicted theoretical bound for the exponent governing such scaling is strictly obeyed by the numerical data irrespective of the quench temperature. The results and methods presented here in general should find application in similar phenomena such as the collapse of a protein molecule preceding its folding.


Currently, there is a discrepancy among the available guidelines on the usefulness of nuclear medicine techniques in medullary thyroid cancer (MTC) diagnosis and treatment. Aim of this review is to provide an update on diagnostic and therapeutic nuclear medicine techniques in this setting. Evidence-based data clearly demonstrates the usefulness of PET/CT with different radiopharmaceuticals in recurrent MTC (in particular when serum calcitonin is higher than 150 pg/mL or calcitonin doubling time is shortened) and 18F-FDOPA should be the preferred PET radiopharmaceutical. If 18F-FDOPA PET/CT is negative or unavailable, 18F-FDG PET/CT or 68Ga-DOTA-peptides PET/CT could be performed for MTC restaging. There is currently insufficient evidence to recommend PET/CT with several radiopharmaceuticals for MTC staging. Clinical experience on PET/MRI with different radiopharmaceuticals in MTC is still limited. Several investigational nuclear medicine therapeutic options are currently under evaluation in metastatic MTC. More data are needed to evaluate the efficacy, toxicity, and role of these therapeutic options in the management of MTC patients.


The formation of 3D objects composed of shape memory polymers for flexible electronics is described. Layer-by-layer photopolymerization of methacrylated semicrystalline molten macromonomers by a 3D digital light processing printer enables rapid fabrication of complex objects and imparts shape memory functionality for electrical circuits.


The essence of providing patient care revolves around the process of medical decision making (MDM). For most health care providers, this process flows smoothly from diagnosis to treatment planning. Practitioners typically become aware of this complex process only when questions arise. Occasionally, a health care provider will seek some secondary source of information, a book, a colleague, or a website to reach clarity. Only very occasionally, will the patient come into this inner sanctum of health care practitioners: treatment planning. It is hoped that all will routinely engage the patient in a discussion to arrive at informed consent, so that treatment may begin. This process of MDM is at the core of what makes up health care. In the last 20 years, evidence-based medicine (EBM) has made huge inroads into medical training in an effort to instill sound reasoning about efficacy and effectiveness in all medical graduates. In this article, the terms eff icacy (demonstration of benefit under ideal conditions, typically in randomized controlled trials [RCTs]) and effectiveness (demonstration of benefit in real-life conditions) are used very carefully, and not interchangeably. The value of efficacy lies mainly in its ability to indicate potential for effectiveness accurately. Sadly, in the drive to emphasize the importance of delineating clearly sound measures of clinical effectiveness, modern medicine has come to equate RCTs as the final arbitrators of clinical decision making. As discussed below, RCTs are but one tool to sort out these complex questions. In integrative medicine (IM), particularly, with its emphasis on patient variables and practitioner participation, evaluation of efficacy is not sufficient. For some time, IM has functioned like a stepchild to conventional care in MDM as the research base and number of large RCTs remains imbalanced. Almost all decision making based on the primacy of large RCTs creates a strong preference for the conventional care options, given the primacy of pharmaceutical funding, which drives the vast majority of large RCTs. In fact, overdependence on RCTs has been fostered by the need for conventional pharmaceuticals to meet Food and Drug Administration (FDA) requirements for marketing. Gradually, the influence of EBM has been misinterpreted to embrace RCTs as the only form of evidence considered to be valid. It is also important to note that some of the assumptions upon which RCTs gained favored status over observational data have now been shown to be without merit. 1 This article describes the process of MDM from the perspective of IM. First, the article reviews why RCTs are but one approach to sorting out the issue of efficacy and effectiveness. This article proposes an amended scale of effectiveness that includes alternative criteria. Second, the article examines why treatment benefit is but one of the two crucial questions that we need to ask about every treatment that we consider. Maizes et al. 2 and others in IM have argued that risk issues must be an increasing part of the discussion about treatments plans. This article proposes a scale for risk concerns aimed to create a needed dialectic process to balance every discussion of effectiveness. Finally, the importance of patient variables is discussed in the context of IM.


Sand is a type of soil with high porosity and a tendency toward a high permeability rate and low shear strength, which often causes problems in terms of piping and low slope stability. Permeability and shear strength have a very close relationship with soil stability. In this paper, we analyzed the addition of the bacterial producer exopolysaccharide on sandy soil for increased instability. The addition of this bacterial producer is expected to improve soil stability by reducing its permeability and increasing its shear strength. To find an alternative approach to overcome the problems of low permeability and shear strength, experiments were conducted using five types of non-pathogenic inoculated bacterial producer, namely, Lactobacillus sakei, Agrobacterium tumifaciens, Bacillus subtilis, Pseudomonas sp, and Nitrobacter sp, added to five samples of river and beach sand. After 30 days of bacterial inoculation, the permeability of the sand samples was tested using a constant head test, and the shear strength was tested using a direct shear test, which was confirmed through scanning electron microscopy (SEM). Based on the permeability test, the permeability of the sand samples inoculated with Bacillus subtilis was reduced the most at 74.43%. Based on the direct shear test, the highest increase in shear strength, i.e., about 58.91%, was in the samples inoculated with Lactobacillus sakei. SEM photographs with 10,000 x magnification showed the presence of bacteria and the formation of extracellular polysaccharides in the walls of the sand, which affected the permeability reduction rate and increased the shear strength of the sand samples. Based on the permeability and shear strength results, it can be seen that the correlation between the two is weak, and thus when the shear strength of the sample increases, the permeability does not necessarily decrease; the correlation depends on the type and characteristics of the bacterial producer.