Polydatin, one of the natural active small molecules, was commonly applied in protecting and treating liver disorders in preclinical studies. Oxidative stress plays vital roles in liver injury caused by various factors, such as alcohol, viral infections, dietary components, drugs, and other chemical reagents. It is reported that oxidative stress might be one of the main reasons in the progressive development of alcohol liver diseases (ALDs), nonalcoholic liver diseases (NAFLDs), liver injury, fibrosis, hepatic failure (HF), and hepatocellular carcinoma (HCC). In this paper, we comprehensively summarized the pharmacological effects and potential molecular mechanisms of polydatin for protecting and treating liver disorders via regulation of oxidative stress. According to the previous studies, polydatin is a versatile natural compound and exerts significantly protective and curative effects on oxidative stress-associated liver diseases via various molecular mechanisms, including amelioration of liver function and insulin resistance, inhibition of proinflammatory cytokines, lipid accumulation, endoplasmic reticulum stress and autophagy, regulation of PI3K/Akt/mTOR, and activation of hepatic stellate cells (HSCs), as well as increase of antioxidant enzymes (such as catalase (CAT), glutathione peroxidase (GPx), glutathione (GSH), superoxide dismutase (SOD), glutathione reductase (GR), and heme oxygenase-1 (HO-1)). In addition, polydatin acts as a free radical scavenger against reactive oxygen species (ROS) by its phenolic and ethylenic bond structure. However, further clinical investigations are still needed to explore the comprehensive molecular mechanisms and confirm the clinical treatment effect of polydatin in liver diseases related to regulation of oxidative stress.


It is important to determine the impact of global climate change on water resources. In the effective use of water resources, the amount of water required for agricultural irrigation should be planned under these conditions. In this study, the trend analysis of the climate data required for the calculation of reference evapotranspiration (ET0) between 2011 and 2020 for the meteorology station of Tekirdag, Turkey was carried out. Analysis of change in the study was carried out according to the methods of Linear Regression Test, Mann-Kendall Test and Sen T Test. As a result of the change analysis, it was determined that the reference evapotranspiration (ET0) values had a decreasing trend in June and July and this decrease was statistically significant. As a result of the analysis of the changes in the climate parameters used in the calculation of reference evapotranspiration (ET0), it was determined that the values of maximum temperature, average relative humidity and average sunshine duration were in a decreasing trend, while minimum temperature and wind speed values were in an increasing trend. In the study, the change in monthly precipitation amounts during the measurement periods was also examined. As a result of the analysis of the changes, it was determined that the monthly precipitation amounts have a decreasing trend and the changes especially in April, September, October and December are statistically significant. It is thought that the results obtained will contribute to the future agricultural production planning in the regional conditions.


Received: Revised: Accepted: Published online: July 29, 2018 August 26, 2018 September 03, 2018 September 27, 2018 Antimicrobials are excessively used in Pakistan during broiler poultry production, however, status of antimicrobial resistance (AMR) is not known. We report on the frequency of extended spectrum β-lactamase (ESBL) –producing-Escherichia coli recovered from samples obtained from poultry farm environment (n=100) and chicken meat samples (n=100) collected at sales point of live bird market in District Peshawar, Pakistan. Phenotypically confirmed ESBL producers were further investigated for the presence of ESBLand carbapenemase-encoding genes and types of integrons. Our results showed that 38.8% (14/36) and 47.6% (20/42) of E. coli recovered from farm environment and chicken meat, respectively, were found to be ESBL producers. PCR based results showed that 30% (6/20), 10% (2/20) and 20% (4/20) of these E. coli from chicken-meat were harboring blaCTXM, blaCTXM-1 and blaSHV2, respectively, while 20% were carrying blaOXA-48 and blaNDM -1. On the other hands, 28.5% (4/14), 28.5% (4/14) and 14.2% (2/14) of E. coli isolated from chicken farm-environment were harboring blaCTXM, blaCTXM-1 and blaSHV2, respectively, while, 28.5% (4/14) and 14.2% (2/14) were carrying blaOXA-48 and blaNDM -1. Integron 2 was PCR amplified from 17 isolates and integron 1 from 16 isolates, while, integron 3 was absent from all. Finally, insertion sequence ISCR1 was PCR-amplified from 15 isolates (41.6%), which was found associated with blaCTXM among 6 (16.6%) isolates suggesting its role in mobilization. Overall, our results suggest a high rate of occurrence of ESBLand carbapenemase-carrying E. coli in poultry farm environment and chicken meat. ©2018 PVJ. All rights reserved


Summary. Authors present a case of 10 year old girl with spondylometaphyseal dysplasia who had MRI of the hips during acute phase of disease and after 1 year of clinical follow-up in remission stage. MRI was able to pick up significant changes within affected hip during acute phase and then changes after one year of follow-up which explain clinical signs and symptoms. Compare to MRI performed standard plain X-ray was without significant changes in both acute phase and after one year of follow-up.


Ferrous ion-induced lipid peroxidation of the mitochondria isolated from rat liver on the 3rd day after x-ray whole-body irradiation at 650R showed shortening of the lag of induction period and more acceleration of the activity than those of normal mitochondria (Part 1). Further investigations were made on the mitochondria on the 3rd day after irradiation at 650R in regard to fatty acid compositions and Fe(++) -induced peroxidation of total or fractionated mitochondrial lipids. The results are represented as follows. 1) Fatty acid composition of the mitochondria after lipid peroxidation showed the decrease of polyenoic acids (C-20:4, C-22:6), suggesting the polyenoic acids are substrate of the reaction. 2) Changes of fatty acid composition of mitochondria after whole-body irradiation at 650R were shown decreasing of unsaturated fatty acid due to the decrement of C-18:1 and C-18:2, but the component of polyenoic acid increased relatively. These changes are transient, reaching a maximum on the 3rd day after irradiation, and this tendency is parallel to that of lipid peroxidation activity of the mitochondria whole-body irradiated. 3) No difference of the rate of peroxidation observed between total lipids extracted from normal and from whole-body irradiated mitochondria, and the lag of induction period was not seen in both reactions. 4) Peroxidation of the total lipid was seen markedly in the phospholipid fraction and slightly in the simple lipid fractions. Effect of whole-body irradiation on the peroxidation activities of the phospholipid was not observed significantly, despite of the difference seen in their fatty acid compositions. 5) Peroxidation of subfractionated phospholipid by a thin-layer chromatography showed marked activity in the fractions of lecithin and aminophosphatide containing large amounts of C-20:4 and C-22:6: Recovery of the activity of the subfractions increased markedly comparing to the total phospholipid, and effect of whole-body irradiation appeared significantly in these subfractions. However, relationship between activities of the peroxidation and fatty acid compositions of the subfractions cannot seen. It is suggested the mutual interaction of phopholipid subfractions on the peroxidation to decrease the activity, and some of lipid became more sensitive to peroxidation by irradiation. 6) Relative amount of phospholipid to total lipid increased in whole-body irradiated samples. 7) From these findings, it was discussed that the acceleration of Fe(++) -induced lipid peroxidation in mitochondrial level is due to the change of fatty acid composition and association of lipid in the membrane.


The aim of this work is to evaluate the ability of conventional particle detection like SMPS tools calibrated for spherical particles to measure CNTs which present both a nanometre and a micrometre size. Using such conventional measurement tools for the detection of CNTs would be of particular interest. The SMPS gives numbers in terms of concentration and electrical mobility diameter. A theoretical approach is first explored in order to predict the spherical equivalent diameter for CNTs as seen by a SMPS. Experimental measurements were performed in order to validate the theoretical estimations.


The proliferation of street demonstrations that emerge in the Brazilian scenario transform the ways we question the present. The inauguration of a new moment in recent history opens the horizon of possible. It is in this current time that resistances enroll themselves and where social struggles, facing the processes of exploitation, oppression and domination of capitalism, have new territories to fight. This current adjectival repeatedly as new does not appear out of the blue, but from the agencies that were made with the different lines that compound the strata plot of sedimented power in the humanity history, in their cities and in their officers devices. This article seeks to problematize this immediate present by reassembling the history of some hard-lines that define our current institutions, exposing contemporaries strategies of disciplinary and control power exercise. Through insights released by Foucault about a new world order, and the revised concept of Border developed by Mezzadra and Neilson, we look for historical and current events to paint this cartography.


The problem of image interpretation is one of inference with the help of domain knowledge. In this paper, we formulate the problem as the maximum a posteriori (MAP) estimate of a properly defined probability distribution function (PDF). We show that a Bayesian network can be used to represent this PDF as well as the domain knowledge needed for interpretation. The Bayesian network may be relaxed to obtain the set of optimum interpretations.


Recently we proposed an extension to the traffic model of Aw, Rascle, and Greenberg. The extended traffic model can be written as a hyperbolic system of balance laws and numerically reproduces the reverse-lambda shape of the fundamental diagram of traffic flow. In the current work we analyze the steady-state solutions of the model and their stability properties. In addition to the equilibrium flow curve the trivial steady-state solutions form two additional branches in the flow-density diagram. We show that the characteristic structure excludes parts of these branches, resulting in the reverse-lambda shape of the flow-density relation. The upper branch is metastable against the formation of synchronized flow for intermediate densities and unstable for high densities, whereas the lower branch is unstable for intermediate densities and metastable for high densities. Moreover, the model can reproduce the typical speed of the downstream front of wide moving jams. It further reproduces a constant outflow from wide moving jams, which is far below the maximum free flow. Applying the model to simulate traffic flow at a bottleneck we observe a general pattern with wide moving jams traveling through the bottleneck.


The usefulness of measuring beta 2-microglobulin levels in the cerebrospinal fluid (CSF) in neurological diseases is discussed and the relevant literature is reviewed in this article. An elevation of this protein in the CSF is particularly indicative of disease activity in multiple sclerosis, neuro-Behçet's disease, sarcoidosis, acquired immunodeficiency syndrome-dementia complex and meningeal metastasis of malignant tumors, especially the meningeal dissemination of acute leukemia and malignant lymphoma.


Growing participation in sports activities over recent years has increased the number of anterior cruciate ligaments (ACL) injuries. Thus, more surgeons became active in this field, leading to a high incidence of transplant failure. In the past 2 1/2 years, 235 patients were treated through navigated ACL reconstruction with semitendinosus-gracilis tendon (STG) autograft. One hundred patients who returned for the follow-up examinations were evaluated. In all cases without concurring injuries, the clinical outcome was excellent or very good. Postoperative radiological examination showed correct positioning of the EndoButton (Smith and Nephew, Mansfield, Mass.) and the Suture Plate (B. Braun-Aesculap, Tuttlingen, Germany) in all patients. The subjective and objective stability assessment did not show any significant difference to the uninjured opposite side.


Multigrid techniques are applied to two‐dimensional indefinite Helmholtz equations, with a standard geometric approach aided by a special treatment of oscillatory near‐kernel components of the Helmholtz operator. The algorithm is a modification of the wave‐ray method by Brandt and Livshits, 1997. Its biggest difference from the original is a more traditional problem formulation: the Helmholtz equations with standard, in applications, Sommerfeld boundary conditions. The new slimmed wave‐ray solver is less technical, and it is easier to implement. The algorithm is tested for a combination of problems and discretization parameters, and in all experiments with constant wave numbers, it shows stable convergence and scalability, all at computational costs comparable to the ones of the V (1,1) multigrid cycle. While not the main focus of the paper, Helmholtz equations with variable coefficients are considered, and some preliminaries are presented, followed by a discussion of the limited applicability of the method for such problems and the ways to expand it. Also briefly outlined is the potential and plans for a parallel implementation. Copyright © 2014 John Wiley & Sons, Ltd.


Introduction Tramadol hydrochloride is a synthetic μ,-opioid agonist. It has been used in the control of moderate to severe pain. Most of the studies on tramadol were related to post-operative pain control. Data on acute pain control in the emergency setting were limited. This study reported on the initial evaluation of tramadol for pain control in an emergency department. Materials and methods It was a prospective observational study. Patients aged 16 years or above attending our emergency department with moderate to severe pain were recruited. Patients with known allergy, current psychiatric medication, intake of alcohol, major systemic illness and opioid dependence were excluded. All patients received 100 mg intramuscular tramadol injection. A 10 cm Visual Analogue Scale (VAS) was used to assess the pain severity before injection, 30 minutes and 60 minutes after injection. Vital signs and side effects were also recorded. Results Forty patients (M: 24, F: 16) were recruited from October to December 2002. Their mean age was 53.5 years. The majority of them suffered from acute musculoskeletal pain or arthritis. Tramadol was shown to be effective in pain control. The VAS decreased by 1.90 (p<0.001) and 3.38 (p<0.001) at 30 minutes and 60 minutes respectively. Four patients reported nausea and three patients vomited. Conclusion Tramadol appeared to be a safe drug to be used in the emergency setting. Only a few insignificant side effects were reported. The comparison of efficacy with other analgesics requires further studies.


The cell line U937, which has been used extensively for studies of myeloid differentiation, bears the t(10;11)(p13;q14) translocation which results in a fusion between the MLLT10 (myeloid/lymphoid or mixed-lineage leukemia [trithorax, Drosophila, homolog]; translocated to 10; alias AF10) gene and the Ap-3-like clathrin assembly protein, PICALM (Clathrin assembly lymphoid myeloid leukaemia). Apart from this translocation, very little is known about the other genetic alterations in this cell line that may represent significant events in disease progression. In this study, conventional G-banding, CGH and M-FISH have been used to characterise fully all of the cytogenetic alterations present in the U937 cell line. M-FISH analysis confirmed the presence of the t(10;11) and an apparently normal copy of both chromosomes 10 and 11. A t(1;5) translocation was observed as well as several unbalanced rearrangements. CGH detected amplifications resulting from duplications of 2q, 6p and 13q. These changes could result in fusion gene products involved in carcinogenesis or the positions of putative oncogenes and tumour suppressor genes. A good correlation between conventional G-banding, CGH and M-FISH was observed.


INTRODUCTION :
A drug may be defined as a chemical substance, or combination of
substances, administered for the investigation, prevention or treatment of
diseases or symptoms, real or imagined. An adverse drug reaction (ADR) may
be defined as an undesirable clinical manifestation resulting from administration
of a particular drug; this includes reactions due to overdose, predictable side
effects and unanticipated adverse manifestations. ADR can also be defined as
'an appreciably harmful or unpleasant reaction, resulting from an intervention
related to the use of a medicinal product, which predicts hazard from future
administration and warrants prevention or specific treatment, or alteration of the
dosage regimen, or withdrawal of the product'. ADRs are underreported and are
an underestimated cause of morbidity and mortality; it has been estimated that
ADRs represent the fourth to the sixth leading cause of death.
Adverse Cutaneous Drug Reactions (ACDRs) are probably the most
frequent manifestations of all drug sensitivity reactions although their incidence
is difficult to determine. Very few published studies have assessed the
epidemiological and clinical features of drug reactions in India and still fewer in
South India. Hence this study was undertaken to assess the pattern and clinical
features of ACDRs and common drugs causing them in South Tamilnadu.
AIM OF THE STUDY :
1. To study the clinicoepidemiological pattern of various adverse cutaneous drug
reactions in patients attending SKIN OPD, Government Rajaji Hospital.
2. To study the common drugs causing adverse cutaneous drug reactions.
MATERIALS AND METHODS :
This study was a prospective, observational study conducted at the skin
OPD, Government Rajaji Hospital, Madurai Medical College, Madurai during
the period from October 2009-September 2011[24 months].
Inclusion criteria:
All consecutive consenting patients diagnosed clinically as a case of
adverse cutaneous drug reaction of all age groups, of all genders, during the
study period were included in the study.
Exclusion criteria:
Non consenting patients, and patients with morphological pattern of
adverse cutaneous drug reaction, but were unable to provide an exact history of
drug intake.
Patients satisfying the criteria were included in the study and demographic
details were recorded. A detailed clinical history including duration, site of
onset, symptoms, drug history, family history were elicited. A complete general
examination, systemic examination and dermatological examination were made.
Digital photographs were taken. The morphology and distribution of skin lesions,
concomitant affection of mucosa, hair, nails, palms, soles, genital involvement
was meticulously recorded and presence of any other associated diseases were
noted.
SUMMARY :
1) Incidence:
Out of all patients attending SKIN OPD during the study period of 24
months 163 patients were diagnosed with ACDR, which constituted to 0.15 %.
2. Occurrence of various clinical types of ACDRs :
Out of the total 163 patients FDE was the most common ACDR seen in 84
cases, Urticaria and Maculopapular rash in 15 cases each, Erythroderma in 11
cases, Urticaria with angioedema in 10 cases, DRESS & SJS in 7 cases, TEN in
6 patients, EMF in 5 patients, Acneiform eruptions in 2 cases and a single case
of phototoxic reaction.
3. Age distribution in various ACDRs:
The maximum no. of cases that is 39.87% of patients were falling between
31-50 years of age group. The youngest patient was 3 months old & oldest
patient was 75 years.
4. Gender distribution in ACDRs:
An almost equal incidence of occurrence in both males & females was
noted, with a slight male predominance.82 cases were males & 81 cases were
females.
5. Site of involvement in various types of ACDRs :
84 patients had only cutaneous involvement.Both cutaneous and mucosal
involvement was seen in 79 out of 163 patients. Out of these 49 had oral
mucosal involvement only, 5 had genital mucosal involvement only, 24 had
both oral and genital mucosal involvement.
6. Recurrent episodes in various types of ACDRs:
Recurrent episodes were seen in 76 patients out of 163. DRESS, TEN,
Erythroderma, Acneiform eruption and phototoxic reaction patients never had
any previous episodes of recurrences.
7. Various drug classes involved in ACDRs:
The commonest drug class involved was antimicrobials with 11 drugs,
followed by NSAIDs with 7 drugs, next common was anticonvulsants with 3
drugs and least common was seen with antidepressants and cancer chemotherapy
with a single drug.
8. Drugs commonly involved in ACDRs:
Cotrimoxazole was the commonest drug causing ACDR which was found
in 37 cases followed by Phenytoin and Doxycycline in 15 cases each,
Amoxycillin in 13cases, Paracetamol in 10 cases, Nevirapine in 9 cases,
Ciprofloxacin in 8 cases, Carbamezapine in 6 cases, Cefixime in 5 cases,
Diclofenac, penicillin and Ibuprofen in 4 cases each, Sodium valproate,
Piroxicam, Aspirin, Metronidazole & Nimesulide in 3 cases each. Tetracycline,
Chloroquine, Isoniazid & Cefoperazone in 2 cases each. Mefenemic acid,
Griseofulvin, Norfloxacin, Dapsone, Phenobarbitone, Imipramine, Imatinib
mesylate & Efavirenz each were incriminated in 1 case each.
9. Drugs and ACDRs caused by them:
Cotrimoxazole was found in 26 FDE cases, 5 cases of urticaria, 3 cases of
urticaria with angioedema, 1 case each of SJS and EMF. Phenytoin in 8 cases of
maculopapular rash , 5 cases of DRESS, 1 case of TEN, 1 case of SJS. Amoxycillin was seen in 9 cases of FDE, 1 case each of urticaria, SJS,
Erythroderma, Maculopapular rash.Nevirapine was implicated in 2 cases of
TEN, 3 cases of erythroderma,4 cases of maculopapular rash. Paracetamol was
seen in 2 cases each of FDE, urticaria, urticaria with angioedema & 1 case each
of TEN & EMF. Carbamezapine was seen in 2 cases each of FDE &
Erythroderma and in 1 case each of TEN & SJS .Cefixime was seen with 3 cases
of FDE, 1 case each of Urticaria, DRESS & maculopapular rash.Diclofenac
sodium & Ibuprofen were associated with 4 cases each of FDE. Sodium
valproate : 1 case of FDE, 2 cases of maculopapular rash, total of 3
cases. Piroxicam : 2 cases of FDE, a case of urticaria .
10. Site of involvement for common individual drugs:
Cotrimoxazole was the most common drug causing cutaneous in 12 and
both involvement in 15 cases, followed by doxycycline and phenytoin each in 6
cases of cutaneous and 9 cases of both. Amoxycillin in 6 cutaneous and both in
7 cases. Paracetamol in 6 cutaneous and both in 4 cases. Nevirapine in 3
cutaneous cases and 6 of both cases. Carbamezapine in 4 cutaneous and 2 case
of both. Ciprofloxacin in 7 cases of cutaneous and 1 case of both, Cefixime in 1
case of cutaneous and 4 cases of both, Diclofenac and Ibuprofen each in 2 cases
in both categories, Sodium valproate and Piroxicam each in 2 cases of cutaneous
and 1 case of both skin and mucosal involvement.
11. Associated diseases in ACDRs:
Maximum number of cases were seen with patients taking drugs for
underlying upper respiratory tract infections; 32 (19.63%), followed by seizure
disorders 24 (14.72%) cases, then followed by fever and headache 18 (11.04%)
cases, HIV was seen in 10 (6.13%) cases, equal no. of patients that is 9 (5.52%)
cases were seen for both lower respiratory tract infections and dental caries &
gingivitis. Among chronic long standing diseases Diabetes mellitus was seen in
7 (4.29%) cases, Hypertension was seen in 6(3.68%) cases, both diabetes and
hypertension were seen in 4 (2.4%) cases. Urinary tract infections were seen in
6 (3.68%) cases, 4 (2.4%) cases each of arthritis and bursitis & acute and chronic
suppurative otitis media were seen.
3 (1.84%) cases each of tuberculous meningitis, malaria, acute diarrhea, myalgia
& typhoid were seen. 2 (1.22%) cases of pyoderma were seen. Single cases each
of leprosy, depression, chronic lymphocytic leukemia, epididymoorchitis &
external hordeolum were seen.
12. Family history in ACDRs:
There was no positive family history in any of the cases.
CONCLUSION :
A total of 163 patients out of 1,03,536 were diagnosed with ACDRs. The
incidence of Cutaneous adverse drug reaction in this study was 0.15% during
this study period of 2 years.
Maximum number of the patients were in the 4thand 5th decade, closely
followed by patients in 1st and 3rd decades.Both the genders were almost equally
involved with a slight predominance of male patients.
Fixed drug eruption was the commonest type of ACDR followed by Urticaria
and Maculopapular rash, next closely followed by erythroderma .
Out of all the ACDRs 84 cases had exclusive cutaneous involvement only. Both
skin and mucosa were involved in rest of the 79 cases. Out of these 79 cases 47
had only oral mucosal involvement, 5 had genital mucosal involvement only and
27 had both the mucosa involved. Recurrent episodes were seen in 76 patients
of all the total cases.
The commonest class of drug causing ACDR was antimicrobials, among
these antimicrobials antibacterials were the commonest subclass involved. Non
steroidal anti-inflammatory drugs were the second commonest followed by
anticonvulsants. Other groups which caused ACDR were antidepressants and
cancer chemotherapy.
Amongst all the drugs Cotrimoxazole was the commonest drug causing
ACDR followed by equal involvement of phenytoin and doxycycline .
Among the individual ACDRs, FDE was most commonly caused by
Cotrimoxazole. Mucosal involvement was most commonly seen with
Cotrimoxazole followed by Phenytoin and doxycycline in succession. None of
the patients had a positive family history of drug reaction.
Upper respiratory tract infection was the most common underlying
systemic disorder following which patients had consumed the drug and
developed ACDR.


We propose Pocket Bluff; a novel pocket switched message forwarding protocol that can foil selfish/malicious nodes that deliberately drop data. Pocket Bluff hides the path of a message from intermediary nodes. It employs hook and snake shaped paths so that an intermediary node can `also' be the final destination of a message. By deliberately dropping a message, a selfish/malicious intermediary node risks loosing incoming data. We detail the Pocket Bluff protocol, and its design rational step-by-step.


Ventilatory function, cellular composition in bronchoalveolar lavage (BAL) fluid and release of chemical mediators from leucocytes were examined in 25 older asthmatics (mean age 66.7 years) and 25 younger asthmatics (mean age 45.1 years) in relation to clinical asthma types. 1. Ventilatory function tests showed that the values of ventilatory parameters such as % MMF, % V(50) and % V(25) were lower in older subjects than in younger subjects, and a significant difference was found in the % V(50) value between the two age groups. Regarding clinical asthma types, the values of % MMF, % V(50), and V(25) were significantly lower in both younger and older subjects with type II. 2. In analysis of cellular composition in BAL fluid, the proportion of BAL lymphocytes was significantly lower in type II older subjects than in younger subjects with the same type. A significantly increased proportion of BAL neutrophils was observed in both younger and older subjects with type II. 3. The release of leukotriene C(4) (LTC(4)) from leucocytes was significantly lower in type II older subjects than in younger subjects with the same type, and LTC(4) release in patients with type II was also significantly lower than that in those with other asthma types in both younger and older subjects. The release of histamine and leukotriene B(4) (LTB(4)) from leucocytes was not significantly different between the two age groups. These results demonstrate that ventilatory function, cellular composition in BAL fluid, and the release of chemical mediators from leucocytes are affected by aging and clinical asthma types.


Social welfare problems arise because basic needs are not met due to the relatively small income of the husband. Most of the women who are in the laying hen farm environment choose to become laying hen farm laborers, due to low levels of education, limited employment opportunities, limited skills This study aims to describe and analyze the dual role of wives in improving the family economy. The approach in this research is qualitative with descriptive study research type. The technique of determining informants using purposive sampling with seven main informants and eight additional informants. Data collection techniques include observation, interviews, and documentation. The results of this study describe the dual role of wives in improving the family economy which is divided into three, namely the dual role of wives, factors that influence the dual role of wives, and the role of wives in improving the family economy. The role of wives as laying hen farm laborers is influential in improving the family economy because the income received by the husband is felt to be unable to meet daily, so the wife wants to help earn additional income. With an increase in the family economy by 2.32% from before, the family welfare can be said to have increased.


When trying to change the status quo in their favor, leaders sometimes launch sudden faits accomplis involving the costly, but limited, use of military force. In doing so, they hope that the potential defender accepts the consequences and does not pursue further military conflict. But comparatively little scholarship tries to explain the use of this strategy. I examine the logic for engaging in a fait accompli from within the rationalist bargaining approach to understanding costly military conflict. My analysis identifies informational and commitment problems that can cause a leader to undertake a fait accompli , as well as an informational problem under which the fait accompli can trigger an unwanted war with the potential defender. My model also applies to dilemmas of extended deterrence; it provides some new insights into this area as well. Overall, it helps explain wars that are not preceded by crisis bargaining.


Thank you very much for downloading curious about the internet. As you may know, people have search numerous times for their chosen novels like this curious about the internet, but end up in harmful downloads. Rather than enjoying a good book with a cup of coffee in the afternoon, instead they cope with some infectious bugs inside their computer. curious about the internet is available in our digital library an online access to it is set as public so you can get it instantly. Our book servers hosts in multiple countries, allowing you to get the most less latency time to download any of our books like this one. Kindly say, the curious about the internet is universally compatible with any devices to read.


A porcine model for subarachnoid hemorrhage has been developed to allow the selective application of blood and its components to cerebral arteries. Whole blood was centrifuged to produce two fractions consisting of washed erythrocytes (red blood cells, RBC's) and white blood cells (WBC) plus platelet-rich plasma (PRP); the RBC fraction was subsequently separated into hemoglobin (Hb)-containing cytosol and erythrocyte membranes. Each fraction was selectively applied to the middle cerebral artery (MCA) of pigs for 10 days; after which, vessels were perfusion-fixed and examined by light and transmission electron microscopy and immunohistochemical studies. By morphometric analysis, a marked reduction in the MCA lumen cross-sectional area was observed after selective application of RBC's or Hb/cytosol but not of WBC/PRP or erythrocyte membranes. In both RBC- and Hb/cytosol-treated vessels, luminal narrowing was associated with a differential increase in vessel wall thickness of the ventral (subarachnoid) compared to the dorsal (brain) aspect of the artery, but no significant change in cross-sectional area of the vessel wall. After 10 days of exposure to RBC's or Hb/cytosol, there was a spectrum of ultrastructural changes in the vessel wall comparable to those seen after periadventitial application of whole blood. Selective application of commercially available Hb to MCA produced similar structural and morphometric changes. The degree of luminal narrowing after exposure to whole blood or RBC's was proportional to the volume of the erythrocyte mass adjacent to the vessel at sacrifice. These data suggest that arterial narrowing after SAH is mediated by mechanisms related to prolonged exposure of the vessel wall to hemoglobin or its catabolites from lysing subarachnoid erythrocytes.


Animals perform near-optimal probabilistic inference in a wide range of psychophysical tasks. Probabilistic inference requires trial-to-trial representation of the uncertainties associated with task variables and subsequent use of this representation. Previous work has implemented such computations using neural networks with handcrafted and task-dependent operations. We show that generic neural networks trained with a simple error-based learning rule perform near-optimal probabilistic inference in nine common psychophysical tasks. In a probabilistic categorization task, error-based learning in a generic network simultaneously explains a monkey's learning curve and the evolution of qualitative aspects of its choice behavior. In all tasks, the number of neurons required for a given level of performance grows sub-linearly with the input population size, a substantial improvement on previous implementations of probabilistic inference. The trained networks develop a novel sparsity-based probabilistic population code. Our results suggest that probabilistic inference emerges naturally in generic neural networks trained with error-based learning rules. 1 ar X iv :1 60 1. 03 06 0v 4 [ qbi o. N C ] 2 1 A pr 2 01 7


The accessibility of water is most important component for plant productivity and growth. Water stress is a major threat for the agriculture system of Pakistan. The change in climate causes the change in the patterns of rainfall which may cause the extreme events. The main cause of climate change is the concentration of carbon dioxide in the air and global warming. A change in environment overall takes place by a number of causes but the most important cause of all these changes is isoprene.1 Water scarcity causes high isoprene emission from plants. The dominant volatile organic compound which is released from vegetation is Isoprene (2-methyl-1,3,-butadiene). Isoprene produced by few herbaceous plant species and many woody trees. The emission of these volatiles like isoprene has an indirect effect on climate change and cause smog formation. The examination found that isoprene responds with human made nitrogen oxide to make particulate issue. In light of the presence of nitrogen oxides, it is engaged with creating the negative impacts on climate and human wellbeing. The research investigates current knowledge about the presence of isoprene emissions within the plant kingdom under drought stress conditions. Eucalyptus, Kachnar, Mulberry and Conocarpus are few species which are able to produce isoprene. The pot experiment was designed to identify isoprene emission within these plants. The plants were exposed to decrease Fractional Transpirable Soil Water FTSW. Various VOCs emission was increase under stress conditions. The isoprene emission rate is high under mild drought stress but decline under severe drought stress. Other parameters like stomatal conductance, photosynthesis, internal CO2 were also observed.


The current study utilizes mismatch negativity in the phenomenon of phoneme restoration to investigate the critical debate regarding the integration of top down (lexical) and bottom up (acoustic) processing in spoken word recognition. Phoneme restoration, which occurs when phonemes missing from a speech signal are restored by the brain and may appear to be heard, was examined in a multi-standard oddball paradigm. Participants heard stimuli while watching a quiet animated film. Stimuli were divided into word and nonword conditions, with noise added to some stimuli to make them ambiguous. The many-to-one ratio of standards to deviants for generation of mismatch negativity (MMN) was achieved only if the brain could recover the missing phoneme in the ambiguous, noise-spliced stimuli. Both word and nonword conditions were compared to verify that an elicited MMN among words was contingent on involvement of the lexicon in the grouping of standards, and not some more general cognitive grouping procedure. Results from seven participants show preliminary support for the predicted effect: i.e., mismatch negativity for words but not for nonwords. This effect is contingent on phoneme restoration, and thus is consistent with recent literature suggesting that MMN is sensitive to higher information structures such as the mental lexicon.


From 100,000 people in Germany, statistically calculated, 441 males and 350 females suffer from a cancer disease. In about 50 to 80 % of patients with breast or prostate carcinoma bone metastases are registered, which is connected, among others, with a high risk for pathological fractures and other debilitating diseases. The diagnosis of bone metastases is done by conventional X-ray equipment, CT, MRI, and especially with the help of skeletal scintigraphy. For therapy bisphosphonates, anti-hormones and chemotherapeutic agents as drugs are used. Furthermore, radiotherapy, radionuclides, surgery and ablative procedures are applied. A more recent technical method is the STAR™ Tumour Ablation System (RFA), by which minimally invasively an electrode is introduced into the vertebral bodies. The system ensures precise control and thus a targeted ablation of the metastases. Several publications and reports describing a combined application demonstrate the synergistic effectiveness of RFA and radiofrequency kyphoplasty.


Epidermolysis bullosa comprises a group of phenotypically different genodermatosis, hereditary or acquired, characterized by skin fragility and subsequent formation of blisters in response to mechanical trauma, and which may also affect mucous membranes. This study aimed to analyze the relation between the nutritional, hematologic, infectious characteristics and the type of epidermolysis bullosa, through a descriptive case study based on data from medical records of 10 patients with epidermolysis bullosa assisted regularly at the Dermatology Clinic of the Hospital Universitário de Brasília. The old classification of the type of epidermolysis bullosa, weight and height, blood count, white blood cell count, platelet count and description of the type and frequency of secondary infections during the service were considered. We verified a predominance of iron deficiency anemia, chronic leukocytosis, thrombocytosis, chronic malnutrition, low height for age and thinness, and people with epidermolysis bullosa simplex exhibited appropriate relation between height/age and BMI/age. The non-specific skin infection was the most prevalent in both sexes. The severity of the type of epidermolysis bullosa and frequency of secondary infections did not form a directly proportional relation. The absence of direct proportion in all cases between the type of epidermolysis bullosa and the analysis parameters suggest a possible significant interference from other aspects such as the extent of the affected skin area, extracutaneous type of engagement and specific genetic mutation. The inclusion of these factors in the new classification proposed by Fine et al can contribute significantly to a better correlation of clinical parameters and appropriate preventive and therapeutic approaches.


Foreign direct investment (FDI) plays an essential role in the growth of individual economies. Previous research has attempted to explain the wide variance in the amount of FDI that different countries receive by examining such factors as a nation's political stability, the long term economic prospects, ease of doing business, and regulatory environment. This paper examines the impact on inward FDI of three factors that have been largely ignored or only partially studied by previous literature: the level of a country's corruption, its geographic distance from countries that have traditionally been large sources of outward FDI, and a country's sharing of cultural similarities with countries that tend to be large investors abroad. This paper has analyzed data obtained from countries in all areas of the world and over a number of years in order to eliminate potential biases due to exceptionally large investments or divestments that may distort the flow of FDI when a short period of time is studied. Overall, this paper attempts to shed light on the reasons that certain countries receive large amounts of FDI while others do not. Our analysis shows that corruption is the most important variable that determines the flow of inward FDI. These results have important implications for managers and policy makers that want to improve the amount of inward FDI that a country receives.


Highly effective CuZn0.3MgxAlOy (x = 0–0.2) catalysts for the synthesis of chiral L-phenylalaninol derived from Cu-rich hydrotalcite-like precursors were prepared by a co-precipitation method with Na2CO3 as the precipitant, and their physicochemical and catalytic properties were characterized. The results show that the presence of Mg2+ ions can promote the formation of hydrotalcite-like (htl) precursors, and the Mg2+ content would affect the phase purity of the prepared htl precursors. The BET surface area, exposed copper surface area and amount of acid sites of the samples decreased with the increase in the molar ratio of Mg2+/Al3+. Also, the dense layered htl precursors are beneficial to the atomically uniform distribution of the corresponding metal oxides in the prepared catalysts, promoting the stronger interaction between Cu0 and Al2O3 after the catalysts were reduced (SMSI effect). The activity of the CuZn0.3MgxAlOy catalysts is greatly dependent on not only the metallic copper surface area, but also the SMSI effect and the acidity of the catalysts. When Mg2+/Al3+ = 0.1 (mol), a phase-pure htl precursor could be obtained, and after calcination, the prepared CZA-0.1 catalyst exhibited very excellent catalytic performance for the hydrogenation of L-phenylalanine methyl ester to chiral L-phenylalaninol. After 5 h of reaction at 110 °C and 4 MPa H2, 100% conversion of L-phenylalanine methyl ester and 91.1% yield of L-phenylalaninol with an ee value of ~100% were achieved. After recycling 13 times, the L-phenylalaninol selectivity of the CZA-0.1 catalyst only decreased by 7.2%.


The smart transformer (ST), a solid-state transformer with control and communication functionalities, that interfaces medium voltage (MV) and low voltage (LV) grids, enables the control of the frequency in the LV grid independently from the MV one. In a ST-fed distribution grid, the ST can interact with the droop controllers of local generators and loads frequency characteristic to control the LV power demand. However, most of the existing controllers for power converters cannot guarantee good harmonic control under variable frequency condition. To address this issue, a frequency-adaptive control scheme based on the fractional-order repetitive control and the frequency-adaptive phase-locked loop are proposed in this paper. The proposed scheme provides fast online parameter tuning capability in order to be highly adaptive to variable frequencies, and it can be easily implemented in the power converters controllers of a ST-fed distribution grid. Moreover, the stability analysis of the frequency-adaptive system considering the effect of synchronization has been investigated in this paper. Simulation and experiments have been carried out to verify the effectiveness of the proposed scheme as well as the considered scenarios.


We present NEP-PACK a novel open-source library for the solution of nonlinear eigenvalue problems (NEPs). The package provides a framework to represent NEPs, as well as efficient implementations of many state-of-the-art algorithms. The package makes full use of the efficiency of Julia, yet maintains usability, and integrates well with other software packages. The package is designed to be easy to use for application researchers as well as algorithm developers. Particular attention is paid to algorithm neutrality, in order to make performance comparisons between algorithms easier. This paper describes the main functionality of NEP-PACK, as well as design decisions and theory needed for the design.


The subacute and long‐term biochemical effects of methylenedioxymeth‐amphetamine (MDMA) were assessed in homozygous and heterozygous transgenic (Tg) mice that carry the complete sequence of the human copper‐zinc (CuZn) superoxide dismutase (SOD) gene. Non‐transgenic (Non‐Tg) mice showed significant decreased in striatal dopamine (DA) and dihydroxyphenylacetic acid (DOPAC) levels both at 24 h and at 2 weeks after a single injection of MDMA (50 mg/kg). Heterozygous SOD‐Tg mice showed DA depletion only at the 24 h time point. In contrast, homozygous SOD‐Tg mice show no DA or DOPAC depletion at either the 24 h or at the 2 week time points. Moreover, three injections of MDMA (50 mg/kg) given 24 h apart also caused marked reduction of striatal DA and DOPAC in Non‐Tg mice when these substances were measured 2 weeks after the last MDMA injection. That injection schedule also caused small decreases in DA levels in the heterozygous animals but no changes in the homozygous mice; DOPAC levels were not affected in the heterozygous nor in the homozygous SOD‐Tg mice. Furthermore, the multiple injection schedule caused significant decreases in DA and DOPAC in female Non‐Tg mice but not in the two strains of transgenic mice. Neither the single dose nor the multiple dose schedule of MDMA injections affected striatal serotonin (5‐HT) and 5‐hydroxyindoleacetic acid (5‐HIM)levels in any of the three strains of mice. These results support previous observations that MDMA‐induced biochemical effects are observed in the DA systems of mice, whereas these effects are seen in the 5‐HT systems of rats. The present observations also document for the first time a role for the production of superoxide radicals in these effects of MDMA. These mice are an important tool for dissecting pathways involved in drug‐induced neurotoxicity. © 1995 Wiley‐Liss, Inc. 1 This article is a US Government work and, as such, is in the public domain in the United States of America.


Standardization in image cytometry involves intensity calibration and shading correction. This unit presents a method using concentrated solutions of fluorophores. A drop of highly concentrated dye solution placed between a slide and a coverslip produces a spatially uniform fluorescent sample with reproducible quantum yield and resistance to photobleaching. The technique has a number of practical features that make it inexpensive, reproducible, and straightforward. Descriptions are given for both wide‐field and confocal scanning fluorescence microscopy.


Due to constant economic, political, educational changes, constant traumatic situations, environmental shocks, everyone falls under the influence of stressors, in non-standard situations that require quick, original solutions. This can be achieved by realizing the creative potential of each individual, maintaining the mental and physical health of a person through a resource of art practices. Therefore, the purpose of the article is to reveal the creative resource of psychological tools. Based on the theoretical analysis of literature sources, surveys of participants in the educational process (research methods), personal experience, competencies formed by the results of advanced training during international and national scientific and practical conferences, based on the genetic and creative approach of Acad. S.D. Maksymenko, we have developed a project of a portable laboratory of creativity «Psychogeometric color art constructor», which contains a set of psychological tools that can be used for psychodiagnostic, corrective, developmental purposes, as well as to optimize mental states. Results: the portable laboratory of creativity has the following advantages: mobility of sets of figures, backgrounds, projective touch «landscape ecodisplays». Psychogeometric art designer can be easily transferred, used, even without a specially equipped cabinet; allows participants to realize their creative potential, create original "creative products"; can be used for psychodiagnostic, corrective, developmental purposes; helps to optimize the mental state of man, can provide psychological relief, used to preserve, strengthen, psychological health, increase stress resistance. We are convinced that art practices should be used in work with both children and adults, because they are based on creativity. We conducted research to reveal the psychological and pedagogical resources of art practices in the modernized educational space. As a result, it was concluded that art tools can be actively used in the educational environment for development purposes to help optimize the mental state of participants in the educational process. Key words: portable laboratory of creativity, psychogeometric color art constructor, metaphorical images, art backgrounds, projective «sensory landscape ecodisplays». Accepted : 12.05.2021 Reviewed : 18.05.2021 Published : 02.06.2021 DOI : https://doi.org/10.31108/3.2021.5.1. 1 2


The Upper Triassic Chinle Formation of the Colorado Plateau contains voluminous volcanic detritus evidently derived from a source to the south. Volcanic rocks exposed in southern Arizona and northern Sonora have been assumed to represent this source terrane, but U-Pb isotopic geochronology and regional stratigraphic correlations indicate that these volcanic rocks are distinctly younger than the Chinle, and thus not a source for the volcanic detritus in the Chinle. Igneous rocks of known or possible Late Triassic age in Nevada, California, or northeastern Mexico are possible sources, but a clearly defined source terrane for the volcanic detritus in the Chinle has not been identified. Tectonic removal of the source terrane by rifting or strike-slip offset, though not proven, is a possibility.


Explicit equations are given for describing the space-time evolution of non-ideal (viscous) relativistic fluids undergoing boost-invariant longitudinal and arbitrary transverse expansion. The equations are derived from the second-order Israel-Stewart approach which ensures causal evolution. Both azimuthally symmetric (1+1)-dimensional and non-symmetric (2+1)-dimensional transverse expansion are discussed. The latter provides the formal basis for the hydrodynamic computation of elliptic flow in relativistic heavy-ion collisions including dissipative effects.


Polycystic ovary syndrome is a heterogeneous endocrine and metabolic disorder associated with abdominal obesity, dyslipidemia and insulin resistance. Since abdominal obesity is characterized by low-grade inflammation, the aim of the study was to investigate whether visceral adipose tissue inflammation linked to abdominal obesity and dyslipidemia could lead to impaired insulin sensitivity in the animal model of polycystic ovary syndrome.Female Wistar rats were treated with nonaromatizable 5α-dihydrotestosterone pellets in order to induce reproductive and metabolic characteristics of polycystic ovary syndrome. Glucose, triglycerides, non-esterified fatty acids and insulin were determined in blood plasma. Visceral adipose tissue inflammation was evaluated by the nuclear factor kappa B intracellular distribution, macrophage migration inhibitory factor protein level, as well as TNFα, IL6 and IL1β mRNA levels. Insulin sensitivity was assessed by intraperitoneal glucose tolerance test and homeostasis model assessment index, and through analysis of insulin signaling pathway in the visceral adipose tissue.Dihydrotestosterone treatment led to increased body weight, abdominal obesity and elevated triglycerides and non-esterified fatty acids, which were accompanied by the activation of nuclear factor kappa B and increase in macrophage migration inhibitory factor, IL6 and IL1β levels in the visceral adipose tissue. In parallel, insulin sensitivity was affected in 5α-dihydrotestosterone-treated animals only at the systemic and not at the level of visceral adipose tissue.The results showed that abdominal obesity and dyslipidemia in the animal model of polycystic ovary syndrome were accompanied with low-grade inflammation in the visceral adipose tissue. However, these metabolic disturbances did not result in decreased tissue insulin sensitivity.


We present the optical INTEGRAL integral field spectroscopy data and Hubble Space Telescope archive images obtained for a representative sample of 22 local Ultraluminous Infrared Galaxies (ULIRGs LIR >1012L⊙). The sample has been designed for fulfilling a program aimed at studying the internal structure and kinematics of this type of galaxies. Taking advantage of the two-dimensional nature of the data, we study the structure of the stellar and ionized gas, the internal ionization state and the gas kinematics. In this contribution we present the sample and the most important results obtained so far.


Heterogeneity of therapeutic Monoclonal antibody (mAb) drugs are due to protein variants generated during the manufacturing process. These protein variants can be critical quality attributes (CQAs) depending on their potential impact on drug safety and/or efficacy. To identify CQAs and ensure the drug product qualities, a thorough characterization is required but challenging due to the complex structure of biotherapeutics. Past characterization studies for basic and acidic variants revealed that full characterizations were limited to the basic charge variants, while the quantitative measurements of acidic variants left gaps. Consequently, the characterization and quantitation of acidic variants are more challenging. A case study of a therapeutic mAb1 accounted for two-thirds of the enriched acidic variants in the initial characterization study. This led to additional investigations, closing the quantification gaps of mAb1 acidic variants. This work demonstrates that a well-designed study with the right choices of analytical methods can play a key role in characterization studies. Thus, the updated strategies for more complete antibody charge variant characterization are recommended.


Abstract. It is essential for accurate image reconstruction to obtain a set of parameters that describes the x-ray scanning geometry. A geometric estimation method is presented for x-ray digital intraoral tomosynthesis (DIT) in which the detector remains stationary while the x-ray source rotates. The main idea is to estimate the three-dimensional (3-D) coordinates of each shot position using at least two small opaque balls adhering to the detector surface as the positioning markers. From the radiographs containing these balls, the position of each x-ray focal spot can be calculated independently relative to the detector center no matter what kind of scanning trajectory is used. A 3-D phantom which roughly simulates DIT was designed to evaluate the performance of this method both quantitatively and qualitatively in the sense of mean square error and structural similarity. Results are also presented for real data acquired with a DIT experimental system. These results prove the validity of this geometric estimation method.


This paper presents the performance and design of a variable frequency 30W, 48V/1.5V voltage regulator module (VRM) for stand-alone high-end servers, laptop computers, and flash memory applications. Self-sustained oscillation control (SSOC) operation is used to achieve voltage regulation and high efficiency for a wide range of load currents. It is a current mode controller for resonant converters, hence offers lower power component ratings than the conventional variable frequency controller and very fast transient response as well. Analytical, simulation and experimental results are presented to offer the proof of concept


Germinated brown rice received great attention as healthy ingredient and can be used as an alternative source in the malting and brewing industry. The germination capacity, physico-nutritional properties, sugars, and diastase enzyme activity of brown rice affected by germination times and temperature were determined and compared with control. Soaking in water increased the moisture content of brown rice. Germination rate of brown rice was also increased by higher germination time and temperature and reached maximum after 48 h of germination at 35 oC. However, dry matter loss, grain weight, and density are affected to a lesser extent. Germination significantly (P<0.05) affects the crude protein, fat, fibre, and ash contents. Total carbohydrates content showed linear relationship with germination time and temperature. During germination, hydrolytic enzymes act on starch, reducing its concentration and resulting in higher total and reducing sugars amounts. Increase in germination time and temperature also increased diastase enzyme activity.


Straight single-line defect optical waveguides in photonic crystal slabs are designed by the plane wave expansion method and fabricated into silicon-on-insulator (SOI) wafer by 248-nm deep UV lithography. We present an efficient way to measure the light transmission spectrum of the photonic crystal waveguide (PhC WG) at given polarization states. By employing the Mueller/Stokes method, we measure and analyse the light propagation properties of the PhC WG at different polarized states. It is shown that experimental results are in agreement with the simulation results of the three-dimensional finite-difference-time-domain method.


Two cases of lower abdominal aortic aneurysm in association with chronic thoracic dissections are reported. These infra-renal aortic aneurysms, superimposed on an abdominal extension of the dissection, always require surgical treatment because of their well known tendency to enlarge and rupture. The authors report their experience and discuss the management of this complication in chronic dissections treated surgically.


Virginia Woolf's literary essays emerge out of an eagerness to communicate a self at odds with its own time, rejecting ideological assumptions present in her contemporaries' critical practice. Woolf's reformulation articulates itself as a return to the humble origins of the essay as form, which she acknowledged to appear embodied in Michel de Montaigne's Essais (1580). The present paper aims to explore the ethics of subversion which underpin Woolf's criticism and her conception of the literary essay, along with the aesthetics which its form presents has promulgated by its "modern" inventor, from Woolf's first reception of the Frenchman's essayist to her own first collection of criticism, The Common Reader (1925).


Background The clinical needs of babies, children and young people with life-shortening illnesses continue to change as their care becomes more complex; and the workforce requires to adapt to this. Aim The aim of the project was to design and implement a nursing workforce structure that would meet the current and future needs of the service. The objectives were to analyse the service against workforce establishments; anticipate future needs; identify new roles; and create career pathways. Approach Focus groups involving care staff looked at how the needs of families were supported and what might change in the future. Families were consulted and professional visits to other children's services were carried out. Staff consultation and feedback also informed the model. The successful new structure changed roles for the majority of the nursing workforce and implementation commenced with the most senior nurse managers. Opportunities for internal recruitment were maximised and the number of staff affected overall was then minimised by moving systematically through each tier. Outcomes Nursing is now under a single Director for Children and Families with two Associate Nurse Directors – one leading the nursing teams, the other responsible for quality assurance, service development and clinical learning. New, additionalnursing roles provide leadership at the point of care as well as career pathways. Improved senior nurse cover across seven days, ongoing clinical training and leadership development; has empowered nurses to respond more quickly to deteriorating children. Creative recruitment practices have been used to manage challenges in recruiting registered nurses. Innovative processes have been introduced to support those employees uncertain of the change. Conclusion Other nursing services may wish to learn from our experiences of implementing a new structure that meets the changing needs of patients and has created a career pathway for our staff.


New affordable therapeutic protocols for COVID-19 are urgently needed despite the increasing number of effective vaccines and monoclonal antibodies. To this end, there is increasing attention towards computational methods for drug repositioning and de novo drug design. Here, we systematically integrated multiple data-driven computational approaches to perform virtual screening and prioritize candidate drugs for the treatment of COVID-19. From the set of prioritized drugs, we selected a subset of representative candidates to test in human cells. Two compounds, 7-hydroxystaurosporine and bafetinib, showed synergistic antiviral effects in our in vitro experiments, and strongly inhibited viral-induced syncytia formation. Moreover, since existing drug repositioning methods provide limited usable information for de novo drug design, we extracted and prioritized the chemical substructures of the identified drugs, providing a chemical vocabulary that may help to design new effective drugs.


Reconstructing the evolutionary history of Hox cluster origins will lead to insights into the developmental and evolutionary significance of Hox gene clusters in vertebrate phylogeny and to their role in the origins of various vertebrate body plans. We have isolated two Hox clusters from the horn shark, Heterodontus francisci. These have been sequenced and compared with one another and with other chordate Hox clusters. The results show that one of the horn shark clusters (HoxM) is orthologous to the mammalian HoxA cluster and shows a structural similarity to the amphioxus cluster, whereas the other shark cluster (HoxN) is orthologous to the mammalian HoxD cluster based on cluster organization and a comparison with noncoding and Hox gene-coding sequences. The persistence of an identifiable HoxA cluster over an 800-million-year divergence time demonstrates that the Hox gene clusters are highly integrated and structured genetic entities. The data presented herein identify many noncoding sequence motifs conserved over 800 million years that may function as genetic control motifs essential to the developmental process.


Economic dispatch is an important issue within the electrical system in meeting the lowest cost of the system and is subject to transmission and operating constraints.The power system operation and planning economic dispatch required a reliable technique to achieve minimal cost in economic dispatch otherwise the objective to minimize the generation cost fail. The electrical transmission network does not make complete electricity generation in Single-area economic dispatch. Thus, to complete the economic dispatch for the power transmission system, the multi-area network is proposed. The Multi-Area Economic Dispatch(MAED) connects two or more areas through a tie-line. Each region has a specific cost and load pattern. Tie-lines are used as connectors to enable power switching between regions. 31-Bus test system tested using an algorithm known as Differential Evolution Immunized Ant Colony Optimization (DEIANT) with different case studies with several trials taken to assess the consistency of results. Comparative studies with Pre-Optimization and Newton Rap son revealed that DEIANT technique is more reliable for multi-area power system network.


The Dagstuhl Seminar 13141 "Formal Verification of Distributed Algorithms" brought together researchers from the areas of distributed algorithms, model checking, and semi-automated proofs with the goal to establish a common base for approaching the many open problems in verification of distributed algorithms.
In order to tighten the gap between the involved communities, who have been quite separated in the past, the program contained tutorials on the basics of the concerned fields. In addition to technical talks, we also had several discussion sessions, whose goal was to identify the most pressing research challenges.
This report describes the program and the outcomes of the seminar.


An analytical study is presented of the effectiveness of linear contention window adjustment combined with a long slot duration in the collision avoidance procedures of wireless LAN protocols. A long collision avoidance slot (CAS) duration that includes the beginning of the CTS frame deals with collisions caused by hidden stations. Results indicate that linear backoff minimises empty CASs and reaches a throughput performance very close to maximum. Maximum throughput results obtained by differentiating the throughput equation are compared with similar results in the literature for the IEEE 802.11 protocol.


If you are reading this perspective, chances are that you are curious about the therapeutic potential of yoga and how to build a bridge between your experience and convention-al paradigms of rehabilitation. My intention is to facilitate bridge building between yoga practitioners and the rehabilitation community, including physical, occupational, respiratory, and language therapists and speech and language pathologists. Using a question/answer format, this perspective delineates the many facets of yoga therapy as they relate to rehabilitation. Hopefully the insights offered will inspire you to create your own professional bridges and collaborative partnerships.


Two new hemiterpene glucosides named pubescenosides A and B were isolated from the root of Ilex pubescens. Their structures were elucidated on the basis of spectroscopic and chemical evidence as 2-(trans-caffeoyloxy)methyl-3-hydroxy-1-butene-4-O-beta-D-glucopyranoside and 2-hydroxymethyl-3-caffeoyloxy-1-butene-4-O-beta-D-glucopyranoside, respectively. Pharmacological investigation on pubescenosides A and B indicated that both possess potent anti-platelet aggregation activities.


This study examines how gay and bisexual adolescents identify and access support from their school counselor using a phenomenological inquiry approach. Gay and bisexual adolescents were interviewed regarding their experiences with their school counselors and reported that they believed school counselors should be supportive by virtue of their title. Participants used various methods to determine if their school counselor was supportive including ascertaining political beliefs, relying on the past history of the school counselor-student relationship, observing supportive symbols in school counseling offices, and relying on knowledge gained from other students. Students reported that school counselors are most helpful when they simply listen to students' concerns and state directly that they are willing to discuss LGBT issues. Barriers to accessing support from school counselors included student concerns regarding confidentiality and fears of being judged or treated differently by their school counselor. Th...


Transients have proven to be a specially demanding operation mode for rotor cages in induction motors. The combination of thermal and mechanical stresses causes damage in weak points of the secondary circuit of these machines. A 3-D multiphysics computation may shed some light into the conditions under faults, such as broken bars developing, while taking into account phenomena as interbar currents. With the aim of reducing the computational cost involved, this paper carries out a 3-D simulation of just the rotor during the first 2.5 cycles after a direct-on-line connection, with the tangential component of the magnetic vector potential mapped on its iron surface from the results obtained by the 2-D locked rotor finite-element simulation. The results provide an insight into the skin effect and mechanical loads in the cage, a magnetic coupling between the end ring and the shaft, as well as the limitations of the weakly coupled magnetoelastic analysis.


The conditions under which forecasts from expert judgement outperform traditional quantitative methods are investigated. It is shown that judgement is better than quantitative techniques at estimating the magnitude, onset, and duration of temporary change. On the other hand, quantitative methods provide superior performance during periods of no change, or constancy, in the data pattern. These propositions were tested on a sample of real business time series. To demonstrate how these propositions might be implemented, and to assess the potential value of doing so, a simple rule is tested on when to switch from quantitative to judgemental forecasts. The results show that it significantly reduces forecast error. These findings provide operations managers with some guidelines as to when (and when not) they should intervene in the forecasting process.


Parties to a chapter 13 bankruptcy often contest the status and dischargeability of income tax claims, especially when proofs of claim for these taxes are filed late. Prepetition claims that are filed late may be discharged once the debtor successfully completes a chapter 13 repayment plan. Taxing authorities, however, often allege that these liabilities represent nondischargeable postpetition claims that have "become payable" after the bankruptcy petition was filed. Courts have resolved this issue in conflicting ways: while some have found that taxes "become payable" at the end of the taxable year, most have ruled that the tax return's due date was decisive. This Note observes, however, that this conflict appears rooted in a difference of fact. Courts favoring a tax-return rule have been addressing tax claims in the year the bankruptcy was filed. By contrast, courts that apply a taxable-year rule have been discussing tax claims for the year immediately preceding the bankruptcy filing. Finding this distinction significant, this Note presents an outline for analyzing income tax liability in chapter 13 cases and concludes that both the type of tax claim faced by each court and the petition-filing timeline are as significant to the courts' analyses as their respective interpretations of the phrase "become payable." Applying this framework, this Note illustrates that the taxable-year rule better establishes the critical date upon which taxes should "become payable" to a taxing authority.


Although published literature shows a clear relationship between poor patient compliance with antihypertensive medication and failure to achieve blood pressure control, the association between treatment choices and compliance is less clear. Patient behavior in randomized controlled trials differs from that in actual practice; studies of this difference are therefore required to consider real-world evidence. Studies of actual practice have used a variety of measures of patient behavior, which makes comparisons difficult. In addition, they often have mingled patients receiving antihypertensive treatment for the first time and established hypertensive patients--groups that generally have quite different levels of compliance. This article briefly reviews the literature concerning therapeutic choices and patient compliance with hypertensive medications, including a recent study of persistence using treatment data from the provincial health plan of Saskatchewan, Canada. The Saskatchewan analysis was a rigorous examination of actual practice treatment for hypertension, which demonstrated that angiotensin-converting enzyme inhibitors were associated with the highest 1- and 4.5-year persistence rates and the lowest discontinuation rates among calcium antagonists, beta-blockers and diuretics. These findings may hold important implications for physicians when choosing an initial antihypertensive therapy, and point to the potential importance of the excellent safety and tolerability profiles of new antihypertensive therapies.


Composite system of Profiled Steel Sheet Dry Board (PSSDB) is a system composed of profiled steel sheet (PSS) and dry board (DB), attached together by self-tapping or self- drilling screws. PSS, the most significant structural component of this system is currently sourced from the available profiles in local markets. Yet, it is apparent that manufacturing specific PSS for this system can result in a more economical system. This paper investigates the effect of varying cross-sections of PSS on the PSSDB system regarding ultimate load carrying capacity (strength) and (weight) of the system.


The spatial structure of a stilbenoid dendrimer is investigated by small-angle X-ray scattering (SAXS) and small-angle neutron scattering (SANS) in dilute solution. All measurements are performed in toluene. The dendrimer consists of a stilbenoid scaffold with appended hexyloxy chains. SAXS is mainly sensitive to the dendrimer scaffold whereas SANS intensity, measured in fully deuterated toluene, derives from the solute molecules. The resulting SAXS and SANS intensities are analyzed by comparison with various models. It is found that the model of a circular disk gives the best description of the data. SAXS data demonstrate that the stilbenoid scaffold is flat as expected for benzene rings conjugated through vinylene units. Thus, it can be described by a circular disk with a radius of 1.6 nm and a thickness of 0.7 nm. SANS, on the other hand, shows that the hexyloxy chains are not confined in the plane defined by the core. This is derived from modeling the SANS data with a much thicker circular disk (radius: 2.4 nm, thickness: 1.8 nm). The structure factor S(q), describing the interaction of the dendrimers at higher concentrations, is modeled quantitatively with the "polymer reference interaction site model" (PRISM) integral equation formalism for hard plates such as particles. Here the structural data obtained from the analysis of the SANS data are used so that no new adjustable parameter is necessary for this description.


The non-financial benefits of Corporate Social Responsibility (CSR) initiatives remain an understudied controversy in the literature. We draw on elements of stakeholder theory to investigate the effect of multiple CSR initiatives on job satisfaction for a widespread set of medium-sized Canadian companies. We explore this relationship further by focusing on the moderating effects of governance control structures. Data on these variables is captured through the lens of CFO/controller perceptions because of their intimate governance gatekeeping over firms' control structure/systems. In this respect, we assume that CFOs are among the instrumental drivers in advancing an organization's unfolding social consciousness. Research findings in this study reveal the criticality of examining this linkage within the context of the performance-based versus conformance-based dimensions of an organization's corporate governance control structure – two governance dimensions championed by the International Federation of Accountants (2009). Results for low/high levels of performance-based control structures manifest different interaction configurations of statistically significant CSR variables that heighten job satisfaction. However, significant interaction effects under low/high levels featuring compliance-based control structures are not forthcoming, despite the presence of significant main effects in the CSR/job satisfaction relationship. These findings offer firms a more comprehensive practical understanding of benefits associated with investments in particular CSR strategies while grooming specific control structures, as well as offering researchers new control variables to model in the CSR domain.


Open Neural Network Exchange (ONNX) is an open format to represent AI models and is supported by many machine learning frameworks. While ONNX defines unified and portable computation operators across various frameworks, the conformance tests for those operators are insufficient, which makes it difficult to verify if an operator's behavior in an ONNX backend implementation complies with the ONNX standard. In this paper, we present the first automatic unit test generator named Sionnx for verifying the compliance of ONNX implementation. First, we propose a compact yet complete set of rules to describe the operator's attributes and the properties of its operands. Second, we design an Operator Specification Language (OSL) to provide a high-level description for the operator's syntax. Finally, through this easy-to-use specification language, we are able to build a full testing specification which leverages LLVM TableGen to automatically generate unit tests for ONNX operators with much large coverage. Sionnx is lightweight and flexible to support cross-framework verification. The Sionnx framework is open-sourced in the github repository (this https URL).


One of the main obstacles, hampering method development and comparative evaluation of named entity recognition in social media, is the lack of a sizeable, diverse, high quality annotated corpus, analogous to the CoNLL'2003 news dataset. For instance, the biggest Ritter tweet corpus is only 45,000 tokens – a mere 15% the size of CoNLL'2003. Another major shortcoming is the lack of temporal, geographic, and author diversity. This paper introduces the Broad Twitter Corpus (BTC), which is not only significantly bigger, but sampled across different regions, temporal periods, and types of Twitter users. The gold-standard named entity annotations are made by a combination of NLP experts and crowd workers, which enables us to harness crowd recall while maintaining high quality. We also measure the entity drift observed in our dataset (i.e. how entity representation varies over time), and compare to newswire. The corpus is released openly, including source text and intermediate annotations.


Abstract The purposes of this research were (1) to investigate the business status of Home Bakery business ofSuan Dusit Rajabhat University; (2) to study behaviors of Home Bakery business customers; (3) to study strengths,weaknesses, opportunities, and threats of Home Bakery business; and (4) to present guidelines for developmentof Home Bakery business with the Blue Ocean Strategy. This research employed the mixed method of studycombining the qualitative and the quantitative research methodologies. In the qualitative research study, theresearcher conducted in-depth interviews of main informants including 40 university administrators, instructors,Home Bakery business administrators, personnel and customers; while in the quantitative study, the researcherused a questionnaire as the research instrument to collect research data from 364 Home Bakery businesscustomers, and analyzed the data statistically using the percentage, mean, standard deviation, one-way analysisof variance, and chi-square test. Research findings were as follows: Regarding business status of Home Bakery business, the productswere outstanding with being delicious and fresh, but the packaging were not attractive; the prices were cheapand sanitary without profit seeking. As for the place, there was only one place for selling the products withinsufficient parking slots. As for marketing promotion, there was still no marketing promotion. By contrast,the bakery business outside of the university was highly competitive, with attractive packaging, high prices,attractively decorated places, and selling through sales distributors. Motivating factors for buying Home Bakeryproducts were ranked as follows: deliciousness, freshness, reputation of Home Bakery, product quality,cleanliness and sanitation, confidence in Suan Dusitus products, variety of products, and attractiveness ofpackaging. The majority of customers bought the products for their own consumption. Results of SWOTanalysis showed that the strength was in having a good production system; the weakness was the lack ofmarketing strategy; the business had opportunity for expansion due to the fact that Thai peopleus way of lifehad changed toward consuming more bakery products; and the identified threats were up-to-date productiontechnology being expensive, the trends for consuming healthy food, and the economic crisis. Guidelines for development of Home Bakery business of Suan Dusit Rajabhat University with the BlueOcean Strategy were the creation of valuable innovation with efficient management of production costs; theincrease of values for customers via good services; development of health foods and application of marketing strategy; and creation of marketing network in order to increase incomes. As for synthesis results, the researcherpresented the IDENTITY Model to enhance outstanding identity of Home Bakery. The Model had the followingdetails: I: Innovation (creating innovation); D: Differentiation (creating difference); E: Efficiency (efficiency andeffectiveness in cost management and customer values); N: Network (creating marketing network); T: Tasty(tastiness of bakery products); I: Improvement (improvement and development); T: Taking care (taking care ofcustomers); and Y: Yields for all (benefits for all sections of the public). Keywords: Home Bakery, Suan Dusit Rajabhat University, Blue Ocean Strategy


Species of the Lamiaceae family have enjoyed a rich tradition of use for flavoring, food preservation, and medicinal purposes, due to their curative and preventive properties. Cultivated winter savory ( Satureja montana L.), sage ( Salvia officinalis L.) and hyssop ( Hyssopus officinalis L.) are produced for seed, herb, and essential oil. Dominant compounds in S. montana essential oil were carvacrol (43.2%) and thymol (28.4%), while cis -thujone (27.1%) and camphor (19.3%), followed by trans -thujone and 1,8-cineole were the major compounds in S. officinalis essential oil. As for H. officinalis essential oil, cis - and trans -pinocamphone (41.1% and 20.5%, respectively) were the most abundant compounds, followed by β-pinene. The highest antimicrobial properties, as well as antioxidant capacity, showed S. montana essential oil compared to other tested essential oils. Furthermore, H. officinalis essential oils showed higher antioxidant activity than that of S. officinalis . The aim of this investigation was to determine the composition and bioactivity of essential oils of mentioned varieties. Presented results show that S. montana essential oil could be proposed as a valuable source of natural preservatives.


Recent experiments have shown that human bronchial epithelial cells (i.e., BEAS-2B) release pro-inflammatory cytokines (i.e., IL-6 and TNFalpha) in a receptor-mediated fashion in response to the neuropeptides, substance P (SP), calcitonin gene-related protein (CGRP), and the prototype botanical irritant capsaicin. In the present experiments, we examined the relevance of these receptors to particulate matter (PM)-associated cellular inflammation. BEAS-2B cells, exposed to residual oil fly ash particles (ROFA), responded with an immediate (<30 s) increase in intracellular calcium levels ([Ca2+]i), increases of key inflammatory cytokine transcripts (i.e., IL-6, IL-8, TNFalpha) within 2 h exposure, and subsequent release of IL-6 and IL-8 cytokine protein after 4 h exposure. Pretreatment of BEAS-2B cells with pharmacological antagonists selective for the SP or CGRP receptors reduced the ROFA-stimulated IL-6 cytokine production by approximately 25 and 50%, respectively. However, pretreatment of these cells with capsazepine (CPZ), an antagonist for capsaicin (i.e., vanilloid) receptors, inhibited the immediate increases in [Ca2+]i, diminished transcript (i.e., IL-6, IL-8, TNFalpha) levels and reduced IL-6 cytokine release to control levels. BEAS-2B cells exposed to ROFA in calcium-free media failed to demonstrate increases of [Ca2+]i and showed reduced levels of cytokine transcript (i.e., IL-6, IL-8, TNFalpha) and IL-6 release, suggesting that ROFA-stimulated cytokine formation was partially dependent on extracellular calcium sources. A final set of experiments compared the inflammatory properties of the soluble and acidic insoluble components of ROFA. BEAS-2B cells, exposed to ROFA or ROFA that had been filtered through a 0.2-micrometer pore filter, produced equivocal IL-6. BEAS-2B cells exposed to pH 5.0 media for 15 min released moderate amounts of IL-6, 4 h later. This cytokine release could be blocked by amiloride, a pH receptor antagonist, but not by CPZ. BEAS-2B cells, pretreated with amiloride before ROFA exposure, showed a partial (approximately 25%) reduction of IL-6. Together, these data indicate that the acidic, soluble components of ROFA initiate cytokine release in BEAS-2B cells through activation of both capsaicin- and pH-sensitive irritant receptors.


Pearson Skills: Science and Inquiry 2 Student Book is an essential tool that students use in their classroom and at home to learn and understand the skills required. The full-colour presentation makes it engaging and accessible for all students. Written specifically to meet the requirements of the Australian Curriculum, the student book acts as a guide for both student and teacher.

Science inspires curiosity and encourages us to ask questions and seek answers about our world. To be able to investigate, research, answer questions and communicate your findings as a scientist, you need a diverse set of skills. Pearson Skills: Science and Inquiry 2 Student Book has been written to address the Science Inquiry Skills of the Australian Curriculum, as well as other skills that underpin good science understanding and have shaped science as a human endeavour. The student book consists of eight chapters and includes skill outcome summaries at the start of each chapter, each skill packaged into an achievable one-lesson page spread, supported by a literacy focus, a glossary for each chapter, and solutions for checkpoint and skill review questions.


-----Electricity demand, air pollution and greenhouse gases are increasing by 10% per year or more in many of the developing countries. The corresponding increase in infrastructure systems to provide the generating capacity is often beyond the means of most countries especially those with large, often isolated rural populations. Thus, decentralized or distributed generation (DG) using a variety of locally available fuels is often the only attractive solution to insure sustained economic growth and reduction in air pollution. The future technical leadership in developing the DG capacity can be provided by foreign-born graduate students currently enrolled in the M.S. in Environmental Technology or M.S. in Energy Management programs at NYIT. A graduate level course, Power Plant Systems, taught by the author, requires that each student submit a feasibility study for DG in their home country. The results of the feasibility studies including a variety of techniques using different fuels that can reduce air pollution and greenhouse gases and are incorporated into the syllabi of several courses.


Low dietary energy and decreased intake of herbage have been attributed to the reduced performance of grazing dairy cattle. We hypothesized that grasses with inherently greater energy would interact in a complementary way with condensed tannins (CT) in birdsfoot trefoil to increase herbage intake by grazing dairy heifers. Eight pasture treatments comprising high-sugar perennial ryegrass (Lolium perenne L.), orchardgrass (Dactylis glomerata L.), meadow bromegrass (Bromus riparius Rehmann), and tall fescue [Schendonorus arundinaceus (Schreb.) Dumort] were established in Lewiston, Utah as monocultures and binary mixtures with birdsfoot trefoil (Lotus corniculatus L.; BFT). Pasture treatments were rotationally stocked by Jersey heifers for 105 d in 2017 and 2018, and herbage samples were collected pre- and postgrazing for each 7-d grazing period and analyzed for herbage mass, nutritive value, and apparent herbage intake. We observed differences among pasture treatments in herbage quantity and nutritive value, as well as differences in herbage intake by grazing Jersey heifers. On average, grass-BFT mixtures had greater herbage intake than grass monocultures, and every grass-BFT treatment individually had greater herbage intake than their respective grass monocultures. Using multivariate analyses, we determined that approximately 50% of the variation in herbage intake was due to nutritive and physical herbage characteristics, with the most explanatory being characteristics related to fiber and energy, followed by those related to the percent of BFT in the herbage. Grass monocultures exhibited a range of inherent dietary energy, but there was indication that an imbalance of energy to crude protein (e.g., protein deficient) reduced intake of grass monocultures. Moreover, there was some evidence of a complementary effect between increased dietary energy and CT; however, low CT levels made it impossible to determine the effect of CT on herbage intake per se. This study confirmed that chemical and physical characteristics inherent to different pasture species have a large effect on herbage intake by grazing cattle. Pastures planted to binary mixtures of nutritious grasses and birdsfoot trefoil increase herbage intake of temperate pastures by grazing Jersey heifers.


Plants are used by humans in daily life in many different ways, including as food, herbal medicines, and cosmetics. Unfortunately, many natural plants and their chemical constituents are photocytotoxic and photogenotoxic, and these phototoxic phytochemicals are widely present in many different plant families. To date, information concerning the phototoxicity and photogenotoxicity of many plants and their chemical constituents is limited. In this review, we discuss phototoxic plants and their major phototoxic constituents; routes of human exposure; phototoxicity of these plants and their constituents; general mechanisms of phototoxicity of plants and phototoxic components; and several representative phototoxic plants and their photoactive chemical constituents.


BACKGROUND
The implementation of the National Health Insurance System (NHIS) in Indonesia has been changing the primary care physician (PCP) work condition and their job satisfaction.

OBJECTIVE
This research aimed to explore the reasons behind PCPs' satisfaction and dissatisfaction with job satisfaction's aspect under the NHIS reform.

METHODS
We conducted an exploratory qualitative study within two areas in Central Java, Indonesia, using semi-structured in-depth interviews with 34 PCPs and 19 triangulation sources. We conducted both inductive and deductive analyses by the NVivo 11.

RESULTS
Most PCPs felt dissatisfied with the following aspects of the NHIS: referral system, NHIS health services standard, NHIS programmes, performance evaluation and pay-for-performance, relationship with patient and workloads. PCPs felt constrained with the referral regulation and non-specialist diagnoses, which led to dissatisfaction with performance evaluation and the pay-for-performance implementation. Furthermore, an increase in workload and conflict with patients resulted from patients' misunderstanding the NHIS health service procedures. However, PCPs felt satisfied with the chronic disease management programme and patients' appreciation.

CONCLUSIONS
This study presents the reasons behind PCPs' satisfaction and dissatisfaction with job satisfaction's aspect under the NHIS reform. There is a need for additional discussion among all stakeholders (Ministry of Health, Social Security Agency for Health/SSAH, primary health care and physician's professional organizations about the non-specialist diagnoses list, performance evaluation and pay-for-performance). The government and SSAH need to improve the communication and socialization of the NHIS procedures/regulations.


During the past five years, randomized, controlled trials and clinical guidelines provided data for making evidence-based decisions about blood transfusion. In light of this new information, we monitored transfusion practices/variations among hospitals in our region. We sought to determine whether hospitals actively involved in addressing transfusion utilization and best practices in 1999 (hospitals 1–3) experienced changes when re-surveyed in 2003. As a "control" group, we determined transfusion patterns at 9 hospitals in 2003 (hospitals 4–12), that did not participate in the 1999 survey. We compared autologous transfusion practices involving orthopedic surgery patients at 3 hospitals participating in both surveys and at 8 hospitals contrasting 2003 survey data and 1999 hospital data (no data was available for comparison from one hospital). Data comparisons involved transfusions between Oct.–Dec.1999 vs. Oct–Dec. 2003. In addition we compared transfusion practices involving cardiovascular surgery patients (DRG's 104–107, 109–111) at 2 hospitals participating in the 1999 and 2003 surveys and 5 hospitals joining the survey in 2003. Among the hospitals participating in 1999, the number of patients donating autologous units for orthopedic surgery declined 68%(88 to 28 patients), the number of patients transfused decreased by 58% (55 to 23patients), and the number of units collected was 68% lower (151 to 49 units). In contrast, at hospitals participating in the survey for the first time in 2003, there was only a 7% decline in the number of autologous units collected (274 to 255); the number of patients donating was unchanged (156 and 157). Of note, hospitals 10 and 12 were affiliated with hospital 3 and followed the same transfusion protocols. The average number of units transfused per patient in 1999 and 2003 in both groups (~1.5 and 1.8) was essentially unchanged. The relatively low number of units infused further questions the need for autologous donations in these patients. At 2 hospitals participating in both the 1999 and 2003 surveys, the percentage of cardiovascular surgery patients transfused with red blood cells decreased (40% to 29% and 60% to 44%). This compares to a higher percentage of patients receiving transfusions (range 46–80%) at hospitals participating only in 2003. A similar difference appears in the average number of units infused per transfused patient (2.2–3.6 vs. 2.9–4.7). No differences in patient outcomes were attributed to changes in transfusion practices. Blood utilization patterns improved at hospitals and their affiliates committed to transfusion practice benchmarking compared to hospitals not utilizing this monitoring modality. We conclude that utilization variation analysis remains an effective methods for influencing transfusion practice.


Abstract The effects of growth hormone and/or thyroxine treatments on antibody production, primary lymphoid organ development, and general body growth were examined in two dwarf strains (sex-linked dwarf—SLD, and autosomal dwarf—ADW) and in a normal-growing strain (K) of White Leghorn chickens. One-day-old male chicks were assigned to experimental groups and were treated either with thyroxine (T4) feed supplements or daily mammalian growth hormone (GH) injections or a combination of these treatments (T4/GH). Within the SLD strain, GH treatments resulted in a significant enhancement (P < 0.005) of humoral immune responsiveness and bursal growth while T4 treatments significantly (P < 0.05) stimulated thymic growth. Overall growth in the SLD was also stimulated by T4 treatments. GH and/or T4 treatments had no specific effects on primary lymphoid organ growth in the ADW strain but either treatment separately resulted in a significant (P < 0.05) increase in overall body size. None of the treatments significantly (P > 0.05) affected any of these parameters in the K-strain controls. Supplementation with T4 significantly elevated serum T4 levels within all strains. There were, however, no significant differences in the serum levels of T4 between strains within any of the treatment groups. Serum triiodothyronine (T3) levels were significantly lower in all treatment groups of the SLD as compared to the K-strain control. ADW serum T3 levels were significantly lower than the K-strain only in the T4-treated group. No differences (P > 0.05) were found between the dwarf and control strains in endogeneous GH levels, although mammalian GH treatments did produce significant changes in serum T3 and T4 levels within the K-strain. These results provide evidence that hormonal manipulations can significantly affect body growth, primary lymphoid organ development, and immune function in the dwarf strains studied and suggest these strains may be useful models for future studies on hormonal interactions and immune function.