A solid waste audit is designed to determine the quantity and composition of the waste generated in a specific area. The information provided by an audit can help in evaluating waste management practices; such as the efficiency of recycling programs or the feasibility of composting. The literature revealed that many factors complicate a waste audit; the most significant being that waste varies in space and over time. Methodology was developed to address spatial and temporal variation in waste generated at the University of British Columbia for the 1998 year. This methodology was applied to the campus, and resulting data was analyzed to provide recommendations for achieving campus waste reduction goals. To study spatial variability, the campus was partitioned into sixteen different activity areas. Representative samples of waste were collected a minimum of three times from each activity area. Wherever possible, the number of users of the activity area was enumerated during the sample period. Statistically significant differences were found between the waste-per-user values for the sampled activity areas. Existing data on the number of people frequenting activity areas was employed to estimate total waste loads, as the majority of the activity areas (70%) had smaller variations associated with the calculated waste-per-user data sets than with the original waste data sets. The total waste estimated from the experimental design was compared to documented waste values for the year and was found to vary by -18%. Expected differences were attributed to special events, construction waste, and the omission of some activity areas. Other possibilities included spurious events as found in the sampled waste stream, and the under/overestimation of the amount of users for extrapolation. The University has several options available for waste reduction or diversion targets, including enhancing the current recycling program, source reduction of plastic materials, and diverting organic material to composting. The greatest diversion by weight would be accomplished through the diversion of organic material, as it is estimated to make up a substantial 70% of the calculated annual waste stream.


Objective Human immunodeficiency virus (HIV) continues to be a significant public health concern for adolescents and young adults. Since 2006, the Centers for Disease Control and Prevention has recommended more aggressive routine screening for HIV for patients presenting to the emergency department (ED). Our objectives were to design and validate a survey of physician barriers toward the use of rapid HIV testing in the pediatric ED and then to use this validated tool to conduct a national survey of pediatric emergency practitioners' attitudes toward rapid HIV testing in the ED. Methods Survey design and initial validation steps were conducted with a panel of health care practitioners familiar to HIV testing. Several variables were identified as possible barriers toward rapid HIV testing. The survey was sent via electronic software to a national sample of pediatric emergency practitioners over 2 listservs. The previously identified variables were evaluated by factor analysis for internal consistency and homogeneity, and confirmatory factor analysis was conducted via promax and varimax rotation. All factor analyses were conducted using Stata software. Once the validation was complete, the surveys were sent to groups of pediatric emergency practitioners who had previously identified as having rapid HIV testing available in their EDs. Standard descriptive statistics were used, and group differences were evaluated with t test and &khgr;2 test. Results Four factors were identified during the validation process as being the most important barriers for rapid HIV testing in the pediatric ED: self efficacy, familiarity, external barriers, and a previously unidentified factor, which we interpreted as related to barriers to the specific environment of one's own ED. A total of 80 participants returned the final, validated survey. The participants came from 9 different pediatric emergency medicine groups (5 in areas of low rates of HIV infection, 4 in areas of high rates of HIV infection). Self-reported rates of testing were not different based on HIV infection rate in the community or the respondent's level of training. High testing was more common when a guideline was reported (39%) than when it was not (13.3%; difference, 25.7%; 95% confidence interval, 2.9%–48.5%). Of the 4 factors identified, we found statistically significant differences in scores on all 4 factors between high versus low testers, with high testers disagreeing more strongly with the various barrier questions proposed. We found no difference in the factor scores between areas of high versus low HIV infection rates. Conclusions Our results suggest that several factors related to perceived provider barriers are associated with rates of HIV testing in the ED and that personal factors (eg, level of training) and community HIV prevalence were not associated with rates of testing. Our results confirm what has been speculated by numerous authors and provide data to inform efforts to improve compliance with national recommendations for increased testing.


The possibility of correcting free radical oxidation of lipid membranes by the administration of cytoflavin was experimentally studied in rats. It is established that daily cold exposure for 3 h leads to increase in the level of lipid hydroperoxides, diene conjugates, and malonic dialdehyde on the background of decrease in activity of the antioxidant system in the blood of experimental animals. The introduction of cytoflavin (100 mg/kg, i.p.) for 21 day immediately prior to cold exposure leads to reliable (p < 0.05) decrease in the blood level of lipid hydroperoxides (by 13 - 21%), diene conjugates (by 24 - 25%), and malonic dialdehyde (by 20 - 33%) in comparison to rats of the control group. Analysis of the effect of cytoflavin on activity of the antioxidant system components showed that the level of ceruloplasmin and vitamin E in the blood of animals was reliably (p < 0.05) higher by 10 - 33% than analogous indicator in rats of the control group. Thus, the application of cytoflavin under conditions of long-term influence of cold on the organism of animals leads to stabilization of the processes of lipid peroxidation on the background of increased activity of the blood antioxidant system.


OBJECTIVE
To estimate the burden of diabetes mellitus in Manitoba from 1980 to 1984.

DESIGN
Review of the Manitoba Health Services Commission (MHSC) database. The validity of the MHSC data was established through two substudies: one involved self-reports from a survey of elderly Manitobans, and the other involved people with confirmed diabetes enrolled in the provincial diabetes education program.

SUBJECTS
Sample of 100,000 people stratified by age, sex and MHSC health region: 50,000 were aged 25 to 64 years, and 50,000 were aged 65 or more. All MHSC claims containing the ICD-9-CM code for diabetes mellitus or gestational diabetes were identified.

MAIN RESULTS
Of the sample 7627 people were found to have a diagnosis of diabetes, the annual prevalence being 0.8% among those 25 to 44 years of age, 3.5% among those 45 to 64 and 7.6% among those 65 or older. The annual incidence rate among those over 25 years of age was 7.8 per 1000. Of the 4556 pregnant women 25 to 44 years old 85 (1.9%) had diabetes; 23 were believed to have gestational diabetes.

CONCLUSIONS
The incidence and prevalence rates were similar to those determined on the basis of self-reports in Canadian and US national surveys. The use of an administrative database such as that of the MHSC will provide key information for planning health services for diabetic patients and will permit the monitoring of long-term trends in the incidence and prevalence of the disease.


&NA; —Endothelial cell damage is one important pathophysiological step of atherosclerosis and restenosis after angioplasty. Accelerated reendothelialization impairs neointima formation. We evaluated the role of intravenously transfused endothelial progenitor cells (EPCs) on reendothelialization and neointima formation in a mouse model of arterial injury. Spleen‐derived mouse mononuclear cells (MNCs) were cultured in endothelial basal medium. A total of 91.8±3.2% of adherent cells showed uptake of acetylated low‐density lipoprotein (Dil‐Ac‐LDL) and lectin binding after 4 days. Immunostaining and long‐term cultures confirmed the endothelial progenitor phenotype. To determine the effect of stem cell transfusion on reendothelialization, mice received either fluorescent‐labeled spleen‐derived MNCs or in vitro differentiated EPCs intravenously after endothelial injury of the carotid artery. Transfused cells were strictly restricted to the injury site, and lectin binding confirmed the endothelial phenotype. Homing of transfused cells to the site of injury was only detectable in splenectomized mice. Cell transfusion caused enhanced reendothelialization associated with a reduction of neointima formation. Systemically applied spleen‐derived MNCs and EPCs home to the site of vascular injury, resulting in an enhanced reendothelialization associated with decreased neointima formation. These results allow novel insights in stem cell biology and provide additional information for the treatment of vascular dysfunction and prevention of restenosis after angioplasty. The full text of this article is available online at http://www.circresaha.org. (Circ Res. 2003;93:e17‐e24.)


To identify potential vector species of scrub typhus in the Republic of Korea (ROK), chigger mites were harvested from wild rodents captured at nine localities in October 2005. The bodies of the chigger mites were individually punctured with a fine pin, squeezed out internal contents, and examined for Orientia tsutsugamushi DNA by nested polymerase chain reaction. The exoskeleton of associated chiggers was mounted on glass slides with polyvinylalcohol (PVA) medium for identification. Among 830 individuals belonging to 4 genera and 14 species, O. tsutsugamushi was detected from 22 chiggers of six species, with an overall infection rate of 2.7%. The infection rate was highest for Leptotrombidium palpale (5.3%), followed by Neotrombicula japonica (4.3%), Leptotrombidium scutellare (3.7%), Leptotrombidium orientale (3.6%), Eushoengastia koreaensis (1.9%), and Leptotrombidium pallidum (1.5%). This study first reported O. tsutsugamushi infection from N. japonica and E. koreaensis larvae in the ROK. The population densities of L. pallidum (33.4 chiggers/rodent), historically confirmed as a primary vector of scrub typhus in the ROK, were high, whereas its infection rate was relatively low (1.5%). However, E. koreaensis was only collected from 154 individuals at seven collection sites and its infection rate was demonstrated relatively high (mean 1.9%). Additional studies are needed to determine the role of vector species in the epidemiology of scrub typhus.


This study addresses the unique functional features of duckweed via comparison of Lemna gibba grown under controlled conditions of 50 versus 1000 µmol photons m−2 s−1 and of a L. minor population in a local pond with a nearby population of the biennial weed Malva neglecta. Principal component analysis of foliar pigment composition revealed that Malva was similar to fast-growing annuals, while Lemna was similar to slow-growing evergreens. Overall, Lemna exhibited traits reminiscent of those of its close relatives in the family Araceae, with a remarkable ability to acclimate to both deep shade and full sunlight. Specific features contributing to duckweed's shade tolerance included a foliar pigment composition indicative of large peripheral light-harvesting complexes. Conversely, features contributing to duckweed's tolerance of high light included the ability to convert a large fraction of the xanthophyll cycle pool to zeaxanthin and dissipate a large fraction of absorbed light non-photochemically. Overall, duckweed exhibited a combination of traits of fast-growing annuals and slow-growing evergreens with foliar pigment features that represented an exaggerated version of that of terrestrial perennials combined with an unusually high growth rate. Duckweed's ability to thrive under a wide range of light intensities can support success in a dynamic light environment with periodic cycles of rapid expansion.


Stromal interaction molecules (STIMs) are endoplasmic reticulum-resident proteins that regulate Ca2+ homeostasis and signaling by store-operated calcium entry (SOCE). The different properties and functions of STIM1 and STIM2 have been described mostly based on work in vitro. STIM2 knockout mice do not survive until adulthood. Therefore, we generated and characterized stim2a and stim2b double-knockout zebrafish. The (stim2a;stim2b)-/- zebrafish did not have any apparent morphological phenotype. However, RNA sequencing revealed 1424 differentially expressed genes. One of the most upregulated genes was annexin A3a, which is a marker of activated microglia. This corresponded well to an increase in Neutral Red staining in the in vivo imaging of the (stim2a;stim2b)-/- zebrafish brain. The lack of Stim2 decreased zebrafish survival under low oxygen conditions. Behavioral tests, such as the visual-motor response test and dark-light preference test, indicated that (stim2a;stim2b)-/- larvae might have problems with vision. This was consistent with the downregulation of many genes that are related to light perception. The periodic acid-Schiff staining of retina sections from adult zebrafish revealed alterations of the stratum pigmentosum, suggesting the involvement of a Stim2-dependent process in visual perception. Altogether, these data reveal new functions for Stim2 in the nervous system.


Several safety prediction models and methods have been developed to eliminate the relationship between the expected accident frequency and various urban intersection geometry and operational attributes. It is generally accepted that accident rates tend to be higher at intersections than on through sections of a road. This is particularly frequent in urban area where roads are characterized by intersections in close succession; moreover, the safe and effective operations of the urban road system can be significantly affected by safety conditions at intersections. In this paper models and methods designed to understand and to predict the accident process at urban intersections are reviewed. In particular, this study intends to show why the statistical modeling approach is useful for accident analysis and how it can be applied to provide some general advice for conducting safety evaluations with accident data. An exploratory example describes how to formulate an accident model for urban intersections by the analysis of significant explanatory variables affecting accident phenomenon and by the modeling of accident and traffic data for urban intersections. Finally, in view of the recent great interest in the safety problems of urban roads with particular regard to intersections, the research intends to summarize the main features of the accident intersection models and their part in developing quantitative safety effectiveness measures for installation design improvements.


Coronavirus 2019 (COVID-19) lockdown periods had a significant negative impact on people's lives and psychological well-being. However, the impact of lockdowns differed between individuals. This study aimed to identify vulnerable groups and investigated the relationship between mood and perceived immune fitness and the number and severity of coronavirus 2019 (COVID-19) symptoms during the first COVID-19 lockdown in the Netherlands. In addition, the impact of emotion regulation and other preventive measures was considered. The aim of the study was to identify possible differences according to sex, age, and the presence of underlying disease. A two-part online survey among N = 1415 individuals of the Dutch population (18 to 94 years old) was conducted in the summer of 2020. N = 541 of these participants also completed part 2 of the survey. A series of questionnaires was completed on mood, quality of life, lifestyle, immune fitness, and the number and severity of COVID-19 symptoms. Retrospectively, the period before the first lockdown (15 January–14 March 2020) was compared with the first lockdown (15 March–11 May 2020). The analysis revealed that the lockdown period was associated with significantly poorer mood, poorer immune fitness, and reduced quality of life. Poorer mood was associated with a significantly reduced immune fitness and a significant increase in the number and severity of COVID-19 symptoms. Mood changes did not differ significantly between men and women. Some mood effects were significantly more pronounced for individuals with underlying diseases (depression, fatigue, and stress) and younger individuals (depression and loneliness). Regarding lifestyle factors, no significant lockdown effects were seen according to underlying disease status. During the lockdown period, women reported a decline in nutrition scores, which was not seen in men, whereas they reported receiving more support from family and friends than men. Regarding age, younger individuals reported a significantly greater negative impact on physical activity and being active than the older participants. No differential effects for the groups were found for health correlates. In conclusion, significant negative lockdown effects on mood, quality of life, and immune fitness were observed across the population. The effects were significantly more pronounced among young individuals and those with underlying disease.


It is well known that massive multi-input multi-output (MIMO) systems rely on highly accurate channel state information (CSI). Given this critical dependence, we present a general downlink model with maximum ratio transmission (MRT) precoding, applied in a realistic cellular system with multiple antenna base station (BS). We take into consideration the aggregate effect of the limited training power, the aged CSI due to user equipment (UE) mobility, and the hardware impairments all contributing to the CSI imperfection at the BS and the UE sides. We provide a tight lower bound on the achievable sum-rate assuming the BS is using MRT precoding to serve multiple single-antenna users. The asymptotic sum-rate as the number of BS antennas becomes very large is studied, and the detrimental impacts of hardware impairment and channel aging are shown.


Artificial intelligence can use real-world data to create models capable of making predictions and medical diagnosis for diabetes and its complications. The aim of this commentary article is to provide a general perspective and present recent advances on how artificial intelligence can be applied to improve the prediction and diagnosis of six significant complications of diabetes including (1) gestational diabetes, (2) hypoglycemia in the hospital, (3) diabetic retinopathy, (4) diabetic foot ulcers, (5) diabetic peripheral neuropathy, and (6) diabetic nephropathy.


The article considers the history of the formation and development of Iran-Russia cultural contacts in the framework of time-consistent political and economic discourses. An important role of Russian and Persian languages and literatures of both countries in this process is noted, and a decisive role of societies of cultural relations between Russia and Iran in the development of bilateral cultural relations is emphasized.Particular attention in this context is paid to the last decades, when cultural cooperation becomes an important factor in the foreign policy strategy of the two countries.The article is devoted to the development of Egypt-Russia relations in the aspect of the inter-civilization dialogue; the dynamics of their development in different historical eras are analyzed, factors that have had a decisive influence on the nature of bilateral interaction are considered.


The objective of this research is to obtain empirical evidence on the influence of firm size ratio, firm age, the ratio of asset turn over, the ratio of asset tangibility, and CEO-Duality toward firm financial performance. The study uses data from manufacturing companies listed on Indonesian Stock Exchange during 2015-2017. The results of this study indicates the ratio of asset turn over, the ratio of firm size and firm age that have a significant influence on firm financial performance, while the ratio of asset tangibility and CEO-Duality has no effect on firm financial performance. To further complement future research, increase the number of samples, by using companies that does not only cover the manufacturing sector, also extends the research period and uses additional variables that can affect the company's financial performance


Several parallel convolution algorithms for array processors with N/sup 2/ processing elements (PEs) connected by mesh, hypercube, and shuffle-exchange topologies, respectively, are presented. The computation time complexity is the same for array processors with different interconnection networks. The communication time complexity, however, varies from network to network, and is the main focus. It is shown that by using inter-PE communication networks efficiently, each PE requires only a small local memory, many unnecessary data transmissions are eliminated, and the overall time complexity (including computation and communication) of algorithms is reduced to O(M/sup 2/). >


Laminated ceramic composite is a new type of material developed in recent years to improve the mechanical properties of structural ceramics. Gel casting and hot-pressure sintering technologies were used to obtain the laminated SiC/BN-Al2O3 composite. Mechanical properties of the laminated composite and monolithic SiC ceramic were compared, and the fracture toughness of the laminated composite is nearly one times higher than that of the monolithic ceramic. Dynamic process of crack propagation in laminated composite was observed in situ by SEM. The interfacial crack initiate first in interlayer near to the notch tip, and then the through layer crack formed in matrix layer at the notch tip. After the through layer crack grows across the first matrix layer, it can be deflected by the interlayer and becomes an interfacial crack again. The through layer crack and the interfacial crack are generated alternately until the failure of the composite. The load / displacement plot of laminated material possess several peaks, and each peak is caused by one propagation of the through layer crack. Toughening mechanisms of the laminated composite include crack deflection, interfacial crack, through layer branch crack and parallel main crack. Copyright © 2001 Society of Automotive Engineers, Inc.


We present the results of a multicenter retrospective study of 35 difficult-to-treat patients with urinary tract infections associated with indwelling urinary catheters (CAUTIs). All patients received oral administration of 3 g fosfomycin trometamol once a day for two days and then with a dose of 3 g every 48 h for two weeks. The most commonly isolated strains were: Escherichia coli (65.7%) and Enterococcus spp. (25.7%); prevalence of Extended-Spectrum Beta-Lactamase strains was 48.5%. Six patients (17.1%) had a clinical response after a single dose of fosfomycin trometamol, 12 (34.2%) after two doses and 13 (37.1%) patients had a clinical response after three or more doses. Four patients (11.6%) failed prolonged antibiotic treatment with fosfomycin trometamol. During the follow-up period, 30 out of 35 (85.7%) patients were without symptomatic infections. No significant side effects were reported. In conclusion, fosfomycin trometamol seems to be a valid treatment option in patients with CAUTIs.


Background: When compared to national averages in Canada, Saskatchewan has one of the highest rates of dental treatment under general anesthesia (GA) and average costs per child. Thus, the purpose of this cross-sectional study is to explore the risk indicators and treatment needs of children receiving dental treatment under GA in Saskatchewan. Methods: In this cross-sectional study, we recruited caregivers of children between 24 and 71 months of age in Saskatoon, Canada. Caregivers completed a 40-item questionnaire, which was supplemented with clinical data and then subject to statistical analysis (independent t-tests and one-way ANOVA). Results: A total of 90 caregiver/child dyads were enrolled with the mean age for children being 49.5 ± 12.3 months. The mean age of a child's first dental visit was 34.7 ± 15.3 months with only 37.9% of children having a dental home. The mean deft index was 11.7 ± 3.4, with an average of 10.9 ± 3.5 teeth receiving treatment. Additionally, location of primary residence (p = 0.03), family income (p = 0.04), family size (p = 0.01), parental education (p = 0.03), dental home (p = 0.04), and body mass index (p = 0.04) had a statistically significant association with a higher mean deft. Conclusions: Our cross-sectional study confirms that children who require dental treatment under GA have a high burden of disease. While individual risk indicators such as diet and oral hygiene play a role in the progression of early childhood caries (ECC), we also demonstrate that children who do not have access to early preventive visits or a dental home are at a higher risk. In addition to improving motivation for oral hygiene at home and nutritional education, improving access to oral health care should be addressed in strategies to reduce ECC.


The article is devoted to the historical experience of interaction between the Main Directorate for Trade and Consumer Cooperation under the Council of Ministers of the USSR (Glavukoop) and subordinate bodies, in particular, as an example of a senior inspector of the Main Directorate for Trade and Consumer Cooperation of the Tyumen Region. On the basis of archival materials introduced into scientific circulation for the first time, organizational and legal issues of creating both central and local governing and control bodies over the activities of cooperative organizations, their structure and composition are considered. The documents used in the work reveal the specifics of the activities of various types of cooperative associations in the Tyumen region, as well as their cooperation with representatives of the controlling authorities of the central government, reflect the psychological and social mood of the workers of these associations. It is noted that the peculiarities of the interaction between the cooperative workers of the region and the staff of the senior inspector were the latent rejection of the former by the state apparatus because of their passivity in work and the open hostility of the cooperative workers in relation to the new state structure. The analysis of the main directions of state regulation in the activities of cooperation is given in the article. The interaction of the senior inspector's apparatus with control bodies is presented, their activities are summarized, and the effectiveness of state policy in relation to cooperative organizations of the Tyumen region and the extent of "shadow" operations in cooperation is assessed.


The correlation of chemical structure, crystalline morphology, and space charge distribution under a dc electrical field was investigated with three kinds of poly(propylene) (PP) with a different chemical structure, that is, homogeneous PP and block copolymer and random copolymer of PP. The space charge distribution of the samples was prominently affected by their chemical sequence structure and crystalline microstructure. Among samples of different PPs, all isothermally crystallized at 140 °C, the sample of random coPP represents the most well proportional space charge distribution and the smallest number of space charges. The effect of thermal history on the space charge distribution was also investigated by the samples of block coPP. The sample thermally treated at 50 °C clearly represents a better proportional distribution than that at higher temperature of 140 and 100 °C. Subsequent experiments indicate that the better proportional distribution attributes to imperfect and fine sperulites with the fine distribution of the "amorphous" region. The imperfect and fine sperulites originate from the random incorporation of ethylene segments or units into PP chains or from the low annealing temperature, and play an important role in the formation of shallow traps and transportation of space charges. © 2002 John Wiley & Sons, Inc. J Polym Sci Part B: Polym Phys 40: 365–374, 2002; DOI 10.1002/polb.10100


Leukocyte diapedesis is an important process in breast cancer etiopathogenesis. Therefore, Junctional adhesion molecule-A (JAMA) and lymphocyte function-associated antigen-1 (LFA-1) genes are among potential candidate genes involved in breast cancer development. In the present study, JAM-A rs790056 (T>C), LFA-1 rs8058823 (A>G) and LFA-1 rs2230433 (C>G) gene variations and their associations with breast cancer risk were investigated in breast cancer patients and healthy subjects. The JAM-A and LFA1 genotypes were determined in 108 breast cancer patients and 63 healthy controls with Polymerase Chain ReactionRestriction Fragment Length Polymorphism (PCR-RFLP) assay. LFA-1 rs8058823 common AA genotype (χ2= 6.062, p= 0.014) and A allele frequency (p= 0.001) and LFA-1 rs2230433 rare GG genotype frequency (p= 0.048) was higher in the patient group compared with controls. The TA haplotype (JAM-A rs790056-T, LFA-1 rs8058823-A alleles) frequency was significantly increased in the patient group compared with controls (p= 0.0173), while the TG haplotype (JAM-A rs790056-T, LFA-1 rs8058823-G alleles) and CG haplotype (LFA-1 rs2230433-C, LFA-1 rs8058823-G alleles) frequencies were significantly lower in the patient group compared with controls (p= 0.0051 and p= 0.002, respectively). In addition, the TCG haplotype (JAM-A rs790056-T, LFA-1 rs2230433-C, LFA-1 rs8058823-G alleles) frequency was significantly lower in the patient group compared with controls (p= 0.0096). Haplotype analysis confirmed that the LFA-1 rs8058823 is more effective in breast cancer risk than LFA-1 rs2230433 and JAM-A rs790056. LFA-1 rs8058823 A allele may be related to breast cancer risk, influencing leukocyte diapedesis. Our findings indicate that functional gene variations associated with leukocyte diapedesis may affect breast cancer risk.


This paper describes a flexible non-Gaussian statistical method used to model polarimetric synthetic aperture radar (POLSAR) data. We outline the theoretical basis of the well-know product model as described by the class of Scale Mixture models and discuss their appropriateness for modelling radar data. The statistical distributions of several Scale mixture models are then described, including the commonly used Gaussian model, and techniques for model parameter estimation are given. Real data evaluations are made using airborne fully polarimetric SAR studies for several distinct land cover types. Generic scale mixture of Gaussian features is extracted from the model parameters and a simple clustering example presented.


The hair cuticle provides significant protection from external sources, as well as giving rise to many of its bulk properties, e.g., friction, shine, etc. that are important in many industries. In this work, atomic force microscopy-infrared spectroscopy (AFM-IR) has been used to investigate the nanometer-scale topography and chemical structure of human hair cuticles in two spectral regions. AFM-IR combines atomic force microscopy with a tunable infrared laser and circumvents the diffraction limit that has impaired traditional infrared spectroscopy, facilitating surface-selective spectroscopy at ultra-spatial resolution. This high resolution was exploited to probe the protein secondary structures and lipid content, as well as specific amino acid residues, e.g., cystine, within individual cuticle cells. Characterization across the top of individual cells showed large inhomogeneity in protein and lipid contributions that suggested significant changes to physical properties on approaching the hair edge. Additionally, the exposed layered sub-structure of individual cuticle cells allowed their chemical compositions to be assessed. The variation of protein, lipid, and cystine composition in the observed layers, as well as the measured dimensions of each, correspond closely to that of the epicuticle, A-layer, exocuticle, and endocuticle layers of the cuticle cell sub-structure, confirming previous findings, and demonstrate the potential of AFM-IR for nanoscale chemical characterization within biological substrates.


This study proposes a Genetic Algorithm (GA) application for the observerbased controller design for discrete multiple time-delay, singularly perturbed systems. The corresponding slow and fast subsystems of the original system are first determined. The GA then derives the observer-based controllers for the D-stability of the slow and the fast subsystems, and a composite observer-based controller for the original system synthesized from the designed subsystems controllers. This study proposes a stability condition dependent upon the singular perturbation parameter ε, to guarantee the stability of the original system under the composite observer-based controller. This study finds the stability criteria of the original uncontrolled system by establishing the stability criteria for its corresponding slow and fast subsystems. If any of the criteria conditions is satisfied, this study uses the condition to find the upper bound ε∗ of ε and can guarantee the stability of the original system by examining the stability of corresponding subsystems, if ε ∈ [0, ε∗). Finally, an illustrative example demonstrates the efficiency of the proposed controller.


Background: Trauma is a leading cause of death worldwide and massive bleeding is the main cause of death in the first 24 hours after injury. Patients with large blood volume loss should undergo the massive transfusion protocol to quickly restore the blood volume and the clotting factors that were lost during bleeding. There are two common strategies regarding transfusion therapy for multiple trauma patients with severe bleeding. The fixed ratio strategy is based on the proportional transfusion of packed red blood cells, fresh frozen plasma and platelets (fixed ratio 1:1:1). The thromboelastometry guide approach is based on the physiopathology of the trauma coagulopathy is a phenomenon that occurs in the early stages of trauma, with hyperfibrinolysis and fibrinogen consumption. Blood products are given based on viscoelastic tests. Methods/design: This study is a prospective, single-center, open-label, randomized trial. Males and females between 18 and 80 years old, with severe trauma and a high Injury Severity Score (ISS- greater or equal than 15) admitted to trauma emergency room are included. To be included, patients require is bleeding actively, with inclusion criteria's to massive transfusion protocol. Patients are randomly allocated to one of the two strategies for massive transfusion (Group A- fixed ratio 1:1:1 or group B- thromboelastometry guided). The primary outcome is the incidence of organ dysfunction on the first, 5th, and 7th day until 28 days post. The secondary outcome are the consumption of blood products within 48 hours, the length of stay in the hospital, days without mechanical ventilation and the financial costs in both groups. Discussion: This trial was proposed to answer questions about the outcomes related to these two strategies of transfusion. This study is important because there is a lack of prospective studies with the subject proposed. Trial registration: Clinical Trial NCT02416817


The purpose of this qualitative descriptive study was to determine Canadian Aboriginal women's perspectives on culturally appropriate HIV counseling and testing. Data were collected through semistructured individual interviews with 7 Aboriginal women, and one focus group, in a western Canadian city. Four major categories were elucidated through thematic content analysis: Aboriginal women's life experiences that may influence their risk of HIV infection and their response to testing; barriers to HIV testing; guiding principles of the ideal HIV testing situation; and characteristics of culturally appropriate HIV testing. The fear of being judged by both the Aboriginal and non-Aboriginal communities and the need for sensitivity to the historical and current context of Aboriginal women's life experiences were pervasive themes throughout the findings.


This chapter proposes an analytical framework for studying professional discretion in organisations that provide state-sponsored human services. In general, professional rationality makes claims for more or less autonomous professional discretion shaped by professional knowledge and ethics, and by the license given to each profession by the state. This chapter argues that the discretion of professionals working in formal organisations is further constrained and shaped by rationalities arising through the power relations in that organisational context. In particular, the discretion available within any organisation will tend to be shaped by organisational requirements. These include political, resourcing and accountability requirements, but they also include more structural matters, in particular managing or mitigating conflicts and contradictions that come from the mode of organisation.


Changes in the marine macro- and microfauna, sedimentary geochemistry and surface-water palaeoproductivity through the last 500 000 years of the Cenomanian and first 300 000 years of the Turonian are documented. These are based on the succession at Eastbourne, the thickest and most complete section through the Late Cenomanian and Early Turonian in the Anglo–Paris Basin. Two levels of rapid faunal and geochemical change are identified, one coincident with a significant increase in siliciclastic input at the base of the Plenus Marls Member, and the other with a marked drop in surface water productivity near the top of the same unit. Faunal change is demonstrated to be largely a pattern of immigration–emigration rather than true extinction, and our sequence stratigraphical analysis shows that it was coincident with major sea-level changes. No evidence is found to support the hypothesis that reduced bottom water oxygenation developed and was responsible for extinctions amongst the benthos in mid-shelf environments. The onset of pure chalk facies is interpreted to mark the breakdown of shelf-break fronts and the spread of oligotrophic oceanic waters over much of the continental shelf, initiated by rising sea-level. The Cenomanian–Turonian event, far from recording a mass extinction of shelf fauna, is most probably an artifact caused by a significant switch in the nature of the surviving sedimentary record as a result of a major, but perfectly ordinary, oceanographic change.


We study the constraint on the inflationary energy scale from the recently proposed Trans-Planckian Censorship Conjecture (TCC). We find a universal upper bound on the inflationary Hubble expansion rate $H_\text{inf}$ which is solely determined by the reheating temperature $T_\text{rh}$: $H_\text{inf}/M_\text{Pl}\lesssim T_0/T_\text{rh}$, where $T_0$ is the photon temperature today. The upper limit can be saturated by a post-inflationary oscillatory stage with the critical equation-of-state parameter $w\approx-1/3$, or by an inflation model with multiple stages. In the lowest reheating temperature required for big bang nucleosynthesis, the upper bound on the tensor-to-scalar ratio $r$ at the CMB scales is $r\lesssim10^{-8}$, which can be realized in many string-inspired inflation models.


: The consequences of the Covid-19 pandemic have brought many challenges for the financial sector. Banks are strongly required to introduce stimulus financial, business, and operational implications to prove their value to society. Therefore, this paper aims to discuss the role of transformational leadership and knowledge sharing in boosting banking on innovation in the Covid-19 era. Thirty-two in-depth interviews were conducted with bankers working in 15 leading banks in Lebanon. Content analysis was used to investigate the research aims. The findings highlight that developing a knowledge-sharing culture by leaders exhibiting transformational behavior have a powerful and reinforcing influence on generating new ideas, products, and processes. Leaders allow knowledge sharing on improving and expanding online and digital banking services to further streamline banking operations during the pandemic. Research implications and directions for future research are presented.


Various endoscopic techniques have been developed to overcome the difficulties in biliary or pancreatic access during endoscopic retrograde cholangiopancreatography, according to the preference of the endoscopist or the aim of the procedures. In terms of endoscopic methods, guidewire-assisted cannulation is a commonly used and well-known initial cannulation technique, or an alternative in cases of difficult cannulation. In addition, precut sphincterotomy encompasses a range of available rescue techniques, including conventional precut, precut fistulotomy, transpancreatic septotomy, and precut after insertion of pancreatic stent or pancreatic duct guidewire-guided septal precut. We present a literature review of guidewire-assisted cannulation as a primary endoscopic method and the precut technique for the facilitation of selective biliary access.


The role of thyroid hormone in Xenopus metamorphosis is particularly well understood as it plays an essential role in that process. However, recent evidence suggests that thyroid hormone may play an earlier role in amphibian embryogenesis. We demonstrate that Xenopus thyroid hormone receptor beta (XTR beta) is expressed shortly after neural fold closure, and that its expression is localized to the developing retina. Retinoid X receptor gamma (RXR gamma), a potential dimerization partner for XTR beta, was also found to be expressed in the retina at early stages, and at later stages RXR gamma was also expressed in the liver diverticulum. Addition of either thyroid hormone or 9-cis retinoic acid, the ligands for XTR beta and RXR gamma, respectively, did not alter the expression of their receptors. However, the addition of thyroid hormone and 9-cis retinoic acid did alter rhodopsin mRNA expression. Addition of thyroid hormone generates a small expansion of the rhodopsin expression domain. When 9-cis retinoic acid or a combination of thyroid hormone and 9-cis retinoic acid was administered, there was a decrease in the expression domain of rhodopsin in the developing retina. These results provide evidence for an early role for XTR beta and RXR gamma in the developing Xenopus retina.


The great Swiss mathematician Ludwig Schlafli (1814-1895) left after his death more than three hundred and fifty notebooks. They include mathematical studies and new results, as well as works about classical mathematical texts and a priori more surprising fields like modern European languages, as well as classical and oriental languages, theology and philosophy. Those notebooks were bequeathed to the Swiss National Library where they are still preserved today. Among them, one finds archival fonds No 254, namely two notebooks where Schlafli presents his analysis of Euclid's Elements. Those abundantly illustrated and annotated notebooks show their author's attraction to geometry and how meticulous a copyist he was. Many indices suggest that they go back to Schlafli's youth, when he started his theology studies at the University of Bern. This thesis presents an historical introduction and a critical edition of the two notebooks No 254.


Based on experiences and reflections reported by health professionals, the aim of this study was to critically analyze the actions, situations, and decisions in healthcare services that involve breastfeeding, examining aspects that favor or limit its possibilities. This was a qualitative study based on the conceptual framework of vulnerability and healthcare, using focus groups with 25 healthcare professionals participating in the Committee on Breastfeeding in Londrina, Paraná State, Brazil. The material was produced with a comprehensive format, focusing on questions that involved the breastfeeding process and its approaches and decisions. The study raises issues for understanding how the way mothers and families deal with breastfeeding is linked to organization of the practices and individual and social aspects, requiring integration between practical and technical/scientific knowledge. The article portrays the complexity of healthcare for women and children, allowing an enhanced approach to routine healthcare and the related strategies for breastfeeding.


BACKGROUND: Hurthle cell carcinoma represents approximately 3% of all differentiated thyroid cancers. The terminology is often confusing, and discrimination between Hurthle cell carcinoma and benign Hurthle cell tumors can be unclear. Thus, optimal treatment of patients with these diseases remains unsettled. METHODS: The authors reviewed published evidence on the presentation, biologic behavior, and treatment outcomes for this disease. In addition, they summarized their experience involving a series of 14 patients with Hurthle cell carcinoma. RESULTS: Hurthle cell carcinoma generally produces thyroglobulin and rarely takes up radioactive iodine. It is frequently bilateral or multifocal within the thyroid gland and often presents with local invasion. Hurthle cell carcinoma is associated with a high rate of locoregional recurrence and significant mortality. CONCLUSIONS: The authors advocate total thyroidectomy with central neck dissection as the therapy of choice for patients with Hurthle cell carcinoma.


Despite being designed for performance rather than cognitive plausibility, transformer language models have been found to be better at predicting metrics used to assess human language comprehension than language models with other architectures, such as recurrent neural networks. Based on how well they predict the N400, a neural signal associated with processing difficulty, we propose and provide evidence for one possible explanation - their predictions are affected by the preceding context in a way analogous to the effect of semantic facilitation in humans.


ABSTRACT Teaching English in school is using GBA (Genre Based Approach). GBA is also known as text based teaching. There are twelve kinds of the monolog text can be taught in school by using GBA. One of them is descriptive text. Descriptive text is aim to make the students be able to tell or describe place, person, or thing. There are two aspects that they have to pay attention while describing something, they are appearances and personality. Zodiac description can be used in teaching writing especially in descriptive text. Zodiac description is a media which formed a paragraph that describe about someone traits or characters appropriate with their birth. There are some advantages in teaching writing by using zodiac description. Zodiac description can stimulate students' comprehension toward new words about someone characters, and make them interested to learn. In addition, there are some stages in this teaching, and it include to the four skill lesson especially in teaching writing. By the reason above, the writer is interested to adapt a media of teaching writing by using zodiac description in school to increase the students' comprehension about descriptive text. Key Words : Writin g, Summary Technique , Organize idea.


We deal with the stability problem of the fractional order Black-Scholes model driven by fractional Brownian motion (fBm). First, necessary and sufficient conditions are established for almost sure asymptotic stability and pth moment asymptotic stability by means of the largest Lyapunov exponent and the pth moment Lyapunov exponent, respectively. Moreover, we are able to present large deviations results for this fractional process. In particular, for the first time it is found that the Hurst parameter affects both stability conclusions and large deviations. Interestingly, large deviations always happen for the considered system when 1/2 < H < 1. This fact is due to the long-range dependence (LRD) property of the fBm. Numerical simulation results are presented to illustrate the above findings.


Computer models that predict the rate at which molecular contamination will deposit on optical surfaces typically use outgassing source terms, measured with quartz crystal microbalances, as a basis for the prediction. The American Society of Testing and Materials, Standard Test Method for Contamination Outgassing Characteristics of Spacecraft Materials (Method E-1559), is probably the best know technique used by the aerospace community to measure the outgassing rates or source terms of materials. A simple method for the insitu calibration of quartz crystal microbalances, based on the heat of enthalphy of Adipic Acid, has been developed and demonstrated by the Marshall Space Flight Center, Environmental Effects Branch. The calibration has been demonstrated over a sample temperature range of 25 to 66 degrees Celsius and deposition rates of 2 x 10 -11 grams/cm2-s and greater, for several measurement system configurations. This calibration technique is fully compatible with the American Society for Testing and Materials, Method E-1559, as well as other methodology. The calibration requires no modification of outgassing facilities employing an effusion cell and does not degrade the performance or function of typical vacuum systems.


OBJECTIVE
Recent researches have discovered a class of long noncoding RNAs (lncRNAs), which are dysregulated in various tumors and linked to carcinogenesis. This study aims to uncover the molecular functions of lncRNA CASC15 in non-small cell lung cancer (NSCLC) tumorigenesis.

PATIENTS AND METHODS
Real Time-quantitative Polymerase Chain Reaction (RT-qPCR) was performed to detect CASC15 expression in 55 NSCLC samples and four NSCLC cell lines. Besides, the function of CASC15 was detected through proliferation assay, transwell assay, and wound healing assay in NSCLC cells. Furthermore, the interaction between CASC15 and miR-130b-3p in NSCLC was studied by performing dual-luciferase reporter assay. In addition, tumor formation and metastasis assay were performed in vivo.

RESULTS
CASC15 expression was remarkably upregulated in NSCLC samples compared with that in adjacent samples. Cell proliferation, invasion, and migration in NSCLC were inhibited via knockdown of CASC15 in vitro. Moreover, RT-qPCR results revealed that miR-130b-3p was upregulated via knockdown of CASC15 in vitro. In addition, miR-130b-3p was a direct target of CASC15 in NSCLC. Tumor formation and metastasis were inhibited after CASC15 was knockdown in vivo.

CONCLUSIONS
Our study indicates that CASC15 could promote metastasis and proliferation of NSCLC through sponging miR-130b-3p in vitro and in vivo, which may offer a new therapeutic intervention for NSCLC patients.


Microcomputers can be successfully used to teach the Monte Carlo simulation, a standard tool in statistical mechanics. The authors give BASIC programs for percolation, the Ising model, the structure of hard disc liquids and for the travelling salesman problem.


Background: Chronic kidney disease (CKD) poses substantial clinical, economic, and humanistic burden in patients with type 2 diabetes (T2D). Understanding of how to optimize patient care and slow disease progression is warranted.Objective: To compare the prevalence, clinical characteristics, treatment patterns, and healthcare utilization among patients with CKD, T2D, or CKD associated with T2D.Design: Retrospective cross-sectional analysis. Patients: Adult patients with CKD, T2D, or CKD+T2D in the Cleveland Clinic Health System.Main Measures: Clinical characteristics, laboratory measures, medication utilization, cardiometabolic management and healthcare resource utilization.Key Results: In 2019, 122,276 patients were identified as CKD, 63,643 were identified as T2D, and 35,255 were identified as having CKD associated with T2D. Patients with CKD and CKD+T2D were observed to be older than those with T2D alone, 72.6, 72.2, and 63.0 years, respectively. T2D and T2D+CKD cohorts contained a higher percentage of males vs. those with CKD alone, 49.3%, 50.8%, 43.6%, respectively. ACEi/ARB therapy was observed in 27.7%, 42.4%, and 31.5% patients with CKD, T2D+CKD, and T2D, respectively. SGLT-2i therapy was only prescribed to a minority of patients with T2D (5.8%) and T2D+CKD (4.7%). Emergency department visits and hospital admissions were more prevalent in the group with CKD (26.5%, 52.9%) or CKD+T2D (28.8%, 54.9%) vs. T2D alone (18.6%, 41.8%), respectively. The majority of patients with CKD (90.4%), CKD+T2D (60.0%) or T2D (69.1%) did not have an assessment of urine protein.Conclusions: Patients with CKD+T2D or CKD have higher healthcare resource utilization than those with T2D alone. The majority of patients with CKD, CKD+T2D or T2D do not undergo assessment of urine protein and are under prescribed ACEi/ARB therapy. SGLT-2i therapy was prescribed to only a small minority of patients with T2D or CKD+T2D. An opportunity exists to improve the care of patients with CKD, both with and without T2D.


Abstract In recent years with the various austerity measures put in place by governments, the main providers of welfare, funding of social protection programmes have shrunk. Yet, protecting the less fortunate has never been the preserve of the State; families, communities and civil societies had always contributed in the provisions. One of such contributors are universities, though their core mandate is to educate but in addition many universities have established schemes and scholarships to ensure access to tertiary education for students from low income families. However, as in many social interventions, including Ghana's, there is a gap between policy intent and practice, but often the focus is on the implementors not the beneficiaries. This paper therefore presents findings from a qualitative study exploring the perceptions of participating students in the 'work and study' programme in KNUST using the Social Action theory to unveil the reasons underpinning actions of students who have to work. A case study research design was adopted for this study using a qualitative approach with in-depth interviewing as the method of data collection. Fifteen undergraduates, volunteered to participate in the study. Data collected were qualitatively analysed using the NVivo software. Findings from the study revealed that students had multiple reasons for joining the scheme and it was not based on the sole rational motive of earning an income. The study provides an analytical insight that predicts the behaviours of beneficiaries of social protection initiatives.


The work presented in this thesis focuses on developing a telemedicine system for better management of type1 diabetes in children and teenagers. The research and development of the system is motivated by the inadequate communication in the current system of management of the disease, which results in non-compliance of patients following the regimen. This non-compliance generally results in uncontrolled blood glucose levels, which can result in hypoglycaemia, hyperglycaemia and later life health complications. This further results in an increase in health care costs. In this context, the thesis presents a novel end-to-end, low cost telemedicine system, WithCare+, developed in close collaboration between the University of Sheffield (Electronics & Electrical Engineering) and Sheffield Children's Hospital. The system was developed to address the challenges of implementing modern telemedicine in type 1 diabetic care with particular relevance to National Health Service children's clinics in the United Kingdom, by adopting a holistic care driven approach (involving all stakeholders) based on specific key enabler technologies such as low cost and reconfigurable design. However, one of the major issues with current telemedicine system is non-compliance of the patients due to invasive procedure of the glucose measurement which could be clearly addressed by non-invasive method of glucose measurement.
Hence, the thesis also makes a contribution towards non-invasive glucose measurement using Near Infrared spectroscopy in terms of addressing the calibration challenge; two methods are proposed to improve the calibration of the Near Infrared instrument. The first method combines locally weighted regression and partial least square regression and the second method combines digital band pass filtering with support vector regression. The efficacy of the proposed methods is validated in experiments carried out in a non-controlled environment and the results obtained demonstrate that the proposed methods improved the performance of the calibration model in comparison to traditional calibration techniques such as Principal Component Regression and Partial Least Squares regression.


Background: Tuberculosis is the most important communicable disease world-wide. It is an important cause of morbidity in India. Abdominal tuberculosis mimicks most abdominal diseases and hence is a difficult diagnosis. This study aims to document the epidemiological profile and management strategies of abdominal tuberculosis according to various sites and surgical pathology. Methods: Forty new cases of abdominal tuberculosis were diagnosed and treated over a period of one year (2014-2015) in surgical wards of Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital, Rewa (M.P). The patients were selected after they were diagnosed as abdominal tuberculosis on the basis of clinical history, thorough clinical examination and clinical picture during surgery. Further diagnosis was confirmed by histopathology and tissue culture studies. All the patients diagnosed with abdominal tuberculosis, were put on ATT for a period of 6 month, and they were asked to present themselves for follow up at regular intervals. Results: Out of 40 patients with abdominal tuberculosis, 26 were males (65%) and 14 (35%) were females. male to female ratio was 1.8:1. Adults in their 3rd decade (37.5%) and 4th decade (22.5%) were most commonly affected. Pain abdomen was the most common presenting complaint present in 82.5% cases. Abdomen distension was the most common sign (75%). Pulmonary tuberculosis was associated with in 22.5% cases. 5% cases of abdominal tuberculosis were co infected with HIV infection. 55% cases underwent surgical management followed by ATT, and 45% cases needed only ATT as treatment. In cases explored surgically, ulcero sclerotic type (ileal stricture with perforation) was the most common pathology seen in 31.8% cases. Ileocecal region was the most common site of involvement with 67.3% occurrence. Mortality rate was 5%. Conclusions: Abdominal tuberculosis is predominantly seen in low socio economic group. Adults in their 3rd and 4th decades are most commonly affected, which is the earning age group and hence can have economic implications. Majority of cases were of primary intestinal type and in some it was secondary to pulmonary tuberculosis. Majority of cases underwent surgical management followed by ATT. Anti tuberculosis therapy is still the treatment of choice in abdominal tuberculosis and surgery is only indicated in various complication of abdominal tuberculosis.


It is now evident that lymphodepleting cytotoxic regimens augment antitumor immunity. We and others have demonstrated that transfer of naive T cells after sublethal whole body irradiation induces antitumor effector T cells and inhibits tumor progression. We recently reported that CD4 + CD25 + Foxp3 + regulatory T cells (Treg) largely increased after whole body irradiation and suppressed the development of antitumor immune responses during recovery from lymphopenia. Depletion of these radio-resistant Treg following lymphodepletion significantly enhanced antitumor immunity (Baba J, et al. 2012, Blood). The combination of lymphodepletion and transfer of naive T cells seems to be a promising approach for antitumor immunotherapy. But harvesting sufficient number of T lymphocytes from tumor-bearing patients is difficult. To obtain enough number of T cells that were capable of recognizing tumor-antigens, we expanded naive T cells in vitro with culturing in CM containing several cytokines. CD4 or CD8 T cells from naive spleens were activated with immobilized anti-CD3 mAbs for 2 days. Stimulated cells were maintained in CM with the combination of IL-2 (16 U/ml), IL-7 (10 ng/ml), IL-15 (10 ng/ml) and IL-23 (2 ng/ml) for additional 7 days. TCR-Vβ expressions of cultured T cells revealed that they maintained TCR diversity. To evaluate antitumor effects of these cells, mice were irradiated with 500 cGy to deplete lymphocytes and were transferred i.v. with the cultured T cells (4 x 10 7 ). On the same day, mice were inoculated s.c. with MCA205 tumor cells (1 x 10 5 ). We found that expanded CD4 + T cells mediated regression of s.c. tumors. In contrast, CD8 + T cells alone did not have therapeutic effects even combined with depletion of Treg. Next, we examined T cells proliferation by labeling with the CFSE and evaluated IFN-γ production after stimulation with specific tumor cells. Cultured CD4 + T cells proliferated rapidly and developed into tumor-specific effector T cells after transfer into lymphopenic hosts. Because CD4 + T cells from OT-II mice, that recognize Ovalbumin peptide specifically, did not show any antitumor effects after transfer into lymphopenic mice, this antitumor activity of CD4 + T cells is more likely to be tumor-antigen specific. Interestingly, using irradiated Rag-2 knockout mice as recipient abrogated antitumor effects of transferred cultured CD4 + T cells. Our results indicated that the combination of lymphodepletion and transfer of in vitro expanded CD4 + T cells has a potent antitumor efficacy, and recipient cells from irradiated hosts play a role in this treatment model. Citation Format: Tomohiro Tanaka. Appropriate conditioning of CD4 + T cells for antitumor immunotherapy. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3964. doi:10.1158/1538-7445.AM2013-3964


We present a lattice-QCD calculation of the B → πlν semileptonic form factors and a new determination of the CKM matrix element |Vub|. We use the MILC asqtad (2+1)-flavor lattice configurations at four lattice spacings and light-quark masses down to 1/20 of the physical strange-quark mass. We extrapolate the lattice form factors to the continuum using staggered chiral perturbation theory in the hard-pion and SU(2) limits. We employ a model-independent z parametrization to extrapolate our lattice form factors from large-recoil momentum to the full kinematic range. We introduce a new functional method to propagate information from the chiral-continuum extrapolation to the z expansion. We present our results together with a complete systematic error budget, including a covariance matrix to enable the combination of our form factors with other lattice-QCD and experimental results. To obtain |Vub|, we simultaneously fit the experimental data for the B → πlν differential decay rate obtained by the BABAR and Belle collaborations together with our lattice form-factor results. We find |Vub|=(3.72±0.16) × 10–3, where the error is from the combined fit to lattice plus experiments and includes all sources of uncertainty. Our form-factor results bring the QCD error on |Vub| to the same level as themore » experimental error. We also provide results for the B → πlν vector and scalar form factors obtained from the combined lattice and experiment fit, which are more precisely determined than from our lattice-QCD calculation alone. Lastly, these results can be used in other phenomenological applications and to test other approaches to QCD.« less


Caesarean section is the most performed surgical intervention worldwide. A proportion of these caesarean deliveries will necessitate emergency care for maternal and fetal compromise. Anaes-thetic management in these situations can be challenging and a short decision to delivery interval is burning. Current evidence suggests that multidisciplinary communication is essential to support anaesthetic management and optimise team performance. Communication should be supported by using a standardised classification of urgency tool. The four-grade classification scale has increasingly been adopted internationally. While neuraxial techniques are favoured for caesarean sections, gen-eral anaesthesia has an essential role in category 1 caesarean section (defined as a caesarean section in which there is an immediate threat to life for the mother or fetus). The risks and benefits of general and neuraxial anaesthesia for the woman and her baby must be carefully weighed on an individual base. Beyond the delivery of anaesthesia, other practical strategies, such as multidiscipli-nary team training, can contribute to improved maternal and neonatal outcomes.


Stress, the word whenever strikes the mind is usually interpreted in negative terms though in practice stress as a variable can be a good motivator if present only to a certain level (eustress), but when it crosses that minimum required limit and turns into distress, it may cause an employee loose interest in the job and hence reduce the job satisfaction level and hence may result into a lesser commitment to organization. It may even become such a big de-motivator that can even reduce the energy and zeal of an employee to even work any further. Thus this study is an attempt in finding out the relationship that organizational commitment shares with job satisfaction and the impact that occupational stress has on the relationship.


This thesis examines the motivations for and impacts of different channels of adjustment on firm-level productivity. It specifically focuses on how firms systematically choose between different paths of adjustment and the impact of these choices on firm-level productivity.

The first empirical chapter of this thesis examines the determinants of firms' choice of adjustment. Using a multinomial logit model, it considers the role of the following 4 characteristics: firm size, adjustment size, firm-level variables (RD plant closure and plant sale for contracting firms - than small firms. It also shows that firms tend to rely more (less) on external forms of expansion (contraction) when the desired size of adjustment is large. With regards to the firm-level variables considered, this chapter shows that R&D is negatively related to greenfield investment with no/negligible effect on mergers and acquisition, plant closure and plant sale. Age has a negative (no) impact on greenfield investment (mergers and acquisition) and plant closure (plant sale). Multi-plant firms tend to rely more on external forms of adjustment. Lastly, we find that foreign-owned firms are more likely to acquire and close existing plants.

The second empirical chapter studies the impact of alternative forms of adjustment on firm-level productivity. This chapter uses the system GMM approach to tackle two sources of bias: simultaneity of adjustment paths-productivity relationship and endogeneity of factor inputs (and self-selection of firms in and out of an industry) in the production function. This chapter shows that there is no statistical relationship between adjustment paths and the long-run productivity of firms. However, given our choice of appropriate control groups and the fact that we use the system GMM approach to alleviate endogeneity concerns, we view our finding of no long-run adjustment effect as novel.


Rheumatic diseases are a group of chronic autoimmune disorders that involve multiple organs or systems and have high mortality. The mechanisms of these diseases are still ill-defined, and targeted therapeutic strategies are still challenging for physicians. Recent research indicates that cell metabolism plays important roles in the pathogenesis of rheumatic diseases. In this review, we mainly focus on lipid metabolism profiles (dyslipidaemia, fatty acid metabolism) and mechanisms in rheumatic diseases and discuss potential clinical applications based on lipid metabolism profiles.


This paper presents a combined micro- and macro-approach to the fracture of high-strength pearlitic steel bars subjected to multiaxial stress states produced by notches of very different geometries. A fracture criterion based on the distortional part of the strain energy density (or, accordingly, the equivalent stress in the von Mises sense) averaged over a critical distance characteristic of the microstructure of the material is developed towards a more physically sound criterion on the basis of the process zone concept, i.e., the critical domain or fracture region is not constant, but depends on the stress triaxiality in the notched geometry under consideration. Although this combined approach is more difficult due to microstructural considerations, it may also be implemented in a computer, since the size of the aforesaid process zone can also be predicted by numerical analysis.


Over the last decade, microglia have been acknowledged to be key players in central nervous system (CNS) under both physiological and pathological conditions. They constantly survey the CNS environment and as immune cells, in pathological contexts, they provide the first host defense and orchestrate the immune response. It is well recognized that under pathological conditions microglia have both sequential and simultaneous, beneficial and detrimental effects. Cell-specific transcriptomics recently became popular in Neuroscience field allowing concurrent monitoring of the expression of numerous genes in a given cell population. Moreover, by comparing two or more conditions, these approaches permit to unbiasedly identify deregulated genes and pathways. A growing number of studies have thus investigated microglial transcriptome remodeling over the course of neuropathological conditions and highlighted the molecular diversity of microglial response to different diseases. In the present work, we restrict our review to microglia obtained directly from in vivo samples and not cell culture, and to studies using whole-genome strategies. We first critically review the different methods developed to decipher microglia transcriptome. In particular, we compare advantages and drawbacks of flow cytometry and laser microdissection to isolate pure microglia population as well as identification of deregulated microglial genes obtained via RNA sequencing (RNA-Seq) vs. microarrays approaches. Second, we summarize insights obtained from microglia transcriptomes in traumatic brain and spinal cord injuries, pain and more chronic neurological conditions including Amyotrophic lateral sclerosis (ALS), Alzheimer disease (AD) and Multiple sclerosis (MS). Transcriptomic responses of microglia in other non-neurodegenerative CNS disorders such as gliomas and sepsis are also addressed. Third, we present a comparison of the most activated pathways in each neuropathological condition using Gene ontology (GO) classification and highlight the diversity of microglia response to insults focusing on their pro- and anti-inflammatory signatures. Finally, we discuss the potential of the latest technological advances, in particular, single cell RNA-Seq to unravel the individual microglial response diversity in neuropathological contexts.


This paper explores the use of knowledge management with emergency information systems. Two knowledge management systems that were utilized during Hurricane Katrina response are described and analyzed. The systems specified were developed by both federal agencies as well as grass root efforts without the support or mandate of government programs. These programs, although developed independently, were able to share data and interact in life saving capacities, transcending traditional geo-political boundaries. We conclude that emergency information systems are enhanced by incorporating knowledge management tools and concepts.


The ongoing COVID-19 pandemic has motivated social workers to reckon with and transform traditions in service delivery. The development, application, and evaluation of technology-enhanced practices have become more vital than ever. Garden on the Balcony (GOB) was an innovative internet-based social work service designed to respond rapidly to the COVID-19 outbreak in Beijing. This paper introduces the underlying perspectives and design of GOB and reports participants' reflections on the program to understand its mechanisms and implications. Interview data from GOB participants were collected 4 months after the program ended. Thematic analysis generated three major themes, suggesting that GOB had (a) promoted individual resilience and family cohesion; (b) built online and offline community bonds; and (c) cultivated a green lifestyle and spiritual reflection on life. This study demonstrates a practical example of the effective use of technology-enhanced practice.


Provides a review of the gap between student's entrepreneurial needs and aspirations and the entrepreneurship education offerings within higher education institutions (HEIs) in Leicestershire, UK. Utilises data from three surveys of university fresher students, held in 2001. Uses the findings as the basis to assess the gap between fresher students' entrepreneurial needs and aspirations and the capability of HEIs to meet them. Draws on multiple surveys from universities in Leicestershire and so will be of relevance to other HEIs with similar student demographics. Fulfils a need to take a strategic review of how HEIs can develop the capability to meet the entrepreneurial needs of new students in supporting their future aspirations.


The purpose of the current scientific work was to study the condition of antioxidant status in sportsmen of different specializations and degree of training during measured physical training and recreational periods. 71 male sportsmen (18-25 years old) were studied. The control group included 15 practically healthy student volunteers of the same age who did not train. Physical loading was a cardiac stress test. Blood was taken by means of venipuncture in the condition of rest 5 and 30 minutes after work on a biological display stand in the volume of 13 500-27 000 kgf×m. Biochemical investigations were performed in blood plasma and erythrocytes. They included measuring of ascorbic acid, α-tocopherol, caeruloplasmin, antiradical activity, intensity of chemiluminescence in consider of general antioxidant activity, enzymatic activity of superoxide dismutase, catalase, glutathione peroxidase, and glutathione reductase. Comprehensive analysis of lipoprotein fractions was performed taking into consideration diagnostic rates. Dependence of the antioxidant status of sportsmen on the degree of training and specializations was determined. Thus, at rest higher content of blood plasma ascorbic acid in well-trained sportsmen (more than 23.2% in acyclic kinds of sports and 11.9% in cyclic kinds of sports) was revealed. In highly qualified sportsmen the content of this vitamin was lower by 19.6%. Also the well-trained sportsmen have lower values of erythrocyte antioxidant enzyme activities. α-tocopherol blood plasma level and glutathione peroxidase activity as well as antioxidant enzyme activity in general corresponded with blood plasma content of ascorbic acid. Blood plasma decrease of ascorbic acid in all studied groups and α-tocopherol in nontrained group was noted after dosage physical loading and recreational periods. At the background of changes of various sorts of activity of enzyme antioxidants and indicators of deep analysis of lipoprotein spectrum protection was stressed. Recommendations on sport nutrition enrichment with vitamins and mineral substances of antioxidant action were developed.


Preparing students for the workforce is a foundational pillar of education. This study sought to assess the perceptions of CTE administrators in [State A] and [State B] on the importance of agricultural educators integrating various employability skills education into their instruction. Traditionally, the relationship between CTE administrators and agricultural educators has been viewed as important. An understanding of the perceptions of [State A] and [State B] CTE administrators that offer agricultural education in their district could be beneficial in determining the importance of employability skills integration into agricultural education. This study utilized the Perkins Collaborative Resource Network Employability Skills Framework to develop the instrument. CTE administrators were asked to rate each individual employable skill on a 1 to 5 Likert scale with 1 = Not Important at All and 5 = Extremely Important. Construct scores for each employability skill category was calculated using the individual employability skills ratings. The results found that participating CTE administrators perceived all employability skill categories to be Very Important or Extremely Important. The employability skills most valued by CTE administrators included Critical Thinking Skills, Personal Qualities, and Communication Skills. A Multivariate Analysis of Variance (MANOVA) was used to ascertain any differences in perception held by CTE administrators in [State A] and [State B]. While the analysis did not return any statistically significant results, it could suggest that CTE administrators in [State A] and [State B] agree on which skills are most valuable for agricultural educators to integrate into their instruction.


In the world of micro- Lithography, several options exist for obtaining features below the 100nm level. Options include a variety of methods which range from additional process steps in etch, multilayer resist systems, or expensive throughput limited direct write E-beam systems. Each comes with a handful of trade offs in uniformity, repeatability and cost. Collimated (LASER) Plasma Lithography (CPL), on the other hand offers a full field exposure with minimal process intervention to obtain resolution below the 100nm barrier. CPL, uses a membrane 1x proximity mask and a collimated light source with energy peaking at 11 A°. By using a mask, an entire 22mm x 22mm field (30mm x 30mm with the next generation) can be exposed at once regardless of chip density, removing any throughput concerns as well as placement, stitching and typical E-beam machine flaw defects. Collimation, provides a predictable flux of energy to ensure minimal global divergence and energy level variation. Energy at 11 A°, allows for a high level of uniformity and penetration within the resist, without introducing resolution compromising scattering or standing wave effects. This Paper will demonstrate the capabilities of CPL as well as the advantages over traditional lithography in obtaining features below 100nm. We will also depict process techniques which take full advantage of improvements in CAR, and experiments which suggest reduction possibilities through variables in mask fabrication.


Little is known about clinical and epidemiological features of Plesiomonas shigelloides-associated diarrhoea in children. We reviewed hospital-based surveillance records of 38 children with diarrhoea having P. shigelloides as the only pathogen isolated from their faecal specimen. Of those 38 children, 29 (76 per cent) were below 2 years of age and 28 (74 per cent) were male. Thirty-two (84 per cent) children presented with watery diarrhoea and six (16 per cent) had dysenteric stools. Vomiting was a feature in 27 (71 per cent) children and clinically significant dehydration was observed in nine (23 per cent) children. Fever was present in three (8 per cent) children and five (13 per cent) had diarrhoea 14 days. Thirty-three (87 per cent) children were successfully treated with ORS alone and only five (13 per cent) required intravenous fluid in addition to ORS. Plesiomonas shigelloides was isolated throughout the year. The findings may be of public health importance for creating awareness among physicians about the clinical profile and management strategy of P. shigelloides-associated diarrhoea in children.


This study focuses on a demonstration of differences between movement-related cortical potentials (MRCPs) during emergency and non-emergency situations. Two paradigms were designed for emergency and non-emergency situations. The necessary pre-processing and Laplacian spatial filter were used in the collected data. Then initial negative phase of MRCPs was extracted from scalp electroencephalogram (EEG) in non-emergency situation and compared with that in emergency situation. Based on the data of non-emergency, a matched filter (MF) algorithm was designed and was used to detect the motor intention in two paradigms. The result shows a significant difference of the initial negative phase of the MRCP in two cases. In addition, if the MF algorithm based on non-emergency situation was used for emergency situations directly, there was a large difference in accuracy. The true positive rate was 60.57±14.79% in nonemergency while 44.29±5.73% in emergency. The result indicates that additional consideration should be given to emergency situation when designing algorithms or collecting data. So, we designed a new algorithm to solve this problem, which works better compared to simple MF. The algorithm effectively improves the true positive rate and reduces the false positive per minute.


We evaluated the effects of long-term treatment with TCV-116, an angiotensin II type 1 receptor antagonist, on endothelial-cell nitric oxide synthase (eNOS) messenger RNA (mRNA) and protein expression in the left ventricle and its relation to myocardial remodeling in Goldblatt hypertensive rats. Two-kidney, one-clip Goldblatt hypertensive rats (RHR) were assigned either to a TCV-116 treatment group (RHR-TCV, n = 8, 3 mg/kg/day, subdepressor dose) or to a group without treatment (RHR-V, n = 7) after their kidneys had been clipped for 4 weeks. TCV-116 was administered to rats in the treatment group for 6 weeks, and age-matched sham-operated rats (ShC, n = 7) served as a control group. Blood pressure in RHR-V and RHR-TCV was similar and significantly higher than that in ShC. The eNOS mRNA and protein levels and NOS activity in the left ventricle was significantly decreased in RHR-V compared with ShC, and significantly increased in RHR-TCV compared with ShC and RHR-V. RHR-V demonstrated a significant increase in fibrosis factor (type I collagen) mRNA expression, perivascular fibrosis, and myocardial fibrosis. These parameters in the microvasculature were improved significantly by TCV-116. Subdepressor dose of TCV- 116 improved pathological myocardial changes in RHR, which may be due in part to an increased eNOS mRNA and protein expression and NOS activity in the left ventricle.


Pseudocolor encoding of holographic images by rainbow holography with no slit is proposed. The pseudocolor holographic image is obtained by white-light reconstruction of the rainbow hologram with no slit. The basic advantage of this technique is the elimination of a narrow slit in the encoding process. The theoretical analysis and experimental results are presented.


Background Combining data from different clinical trials (observational studies) is getting more frequent for the analysis of DMARD efficacy (effectiveness) and safety. The underlying objective is plausible: the generation of data with sufficient power for the investigation of rare adverse events or different treatment strategies. However, the approach of simply pooling data from different studies within an analysis has been shown to be prone to bias which applies for both, observational and clinical trial data [1,2]. Objectives To describe the agreement of recommended and applied methods in the analyses of data originating from different studies. Methods A systematic literature review with PubMed and Web of Science was independently conducted by two researchers (RA, CJ) using a common strategy. We included full text publications if: ≥2 different data bases (clinical trial/observational data) with individual patient data were used, efficacy/effectiveness or safety were investigated and if the studies were conducted in patients with rheumatoid arthritis. We excluded studies using claims data, genetic/proteomic association studies and studies of prognostic markers. Outcomes of interest were the number of data bases, the analysis-type (pooled/separated/both) and the illustration and discussion of study heterogeneity. Results After screening 2002 search results, initial consent of the eligibility of each publication for this analyses was found in 58 publications (safety: n=34 (59%), effectiveness: n=20 (34%), both: n=4 (7%)). From these 28 publications (48%) were based on observational data, 24 (42%) on clinical trials and 6 (10%) based on a mixture of study types. The No. of databases in one publication ranged from 2–42 for clinical trial data, 2–10 in observational data and 4–13 if a mixture of databases was investigated. The analysis of pooled data (n=28, 48%) was more frequent in analyses with trials (n=18) than with data from observational studies (n=8). However, the latter studies were primarily conducted in recent years (Table). In only 1/8 publications (13%) from pooled observational data the baseline characteristics were shown separately for each database. Heterogeneity of study populations was discussed in only 2/8 (25%) publications based on pooled analysis, in 8/15 publications (53%) using a separate analysis of observational studies the heterogeneity of patients was discussed. Conclusions Collaborative analyses of several sources of observational data or multiple clinical trials may deliver superior results than individual studies but only if an appropriate analysis is applied. The approach of simply pooling the data neglects existing heterogeneity of patient cohorts, assessment of risk factors/events, missing data and dropouts. The use of individual patient data from multiple clinical trials could be superior to meta-analysis of published results but loses this advantage if the data are simply pooled. Regarding the considerable differences between observational studies, e.g. European register [3], the utility and the recent increase of pooled analyses from observational studies is disputable. References Hammad et al. Clinical Trials 8.5 (2011): 559–570. Van der Steen et al. Palliative medicine 2008;22:750–759. Kearsley-Fleet et al. Rheumatology 54.6 (2015): 1074–1079. Disclosure of Interest None declared


Objective:In 2003, critical care and infectious disease experts representing 11 international organizations developed management guidelines for other supportive therapies in sepsis that would be of practical use for the bedside clinician, under the auspices of the Surviving Sepsis Campaign, an international effort to increase awareness and to improve outcome in severe sepsis. Design and Methods:The process included a modified Delphi method, a consensus conference, several subsequent smaller meetings of subgroups and key individuals, teleconferences, and electronic-based discussion among subgroups and among the entire committee. Pediatric representatives attended the various section meetings and workshops to contrast adult and pediatric management. These are published here as pediatric considerations. Conclusion:Pediatric considerations included a more likely need for intubation due to low functional residual capacity, more difficult intravenous access, fluid resuscitation based on weight with 40–60 mL kg or higher needed, decreased cardiac output and increased systemic vascular resistance as the most common hemodynamic profile, greater use of physical examination therapeutic endpoints, the unsettled issue of high-dose steroids for therapy of septic shock, and greater risk of hypoglycemia with aggressive glucose control.


For improvement quality calculations units and details transmission car is necessary to know loading operating modes of transmission car. The article presents information about variant of the transmission loading control with use of information received with controller of engine management.


An account of the reception of Aristophanes' Lysistrata from the nineteenth through to the twenty-first centuries in terms of gender and sexuality. Particular attention is given to the push and pull of its 'adult content'; its ability to be exploited as a 'sexy' play; and its potential for exploring gender politics. While other cultural traditions and time periods are touched on, too, the focus of this chapter is on the Anglophone reception of Aristophanes -- in translations, adaptations, on the page, on stage and on screen. The piece aims to paint a broad picture of historical developments while examining a series of important case-studies. The first section charts the changing treatment of Aristophanes' sexualized and obscene language. The second section looks at the ways in which those staging and adapting the plays have explored and exploited female sex and sexuality. Finally, the third section examines Lysistrata's legacy, with particular regard not only to how it has been staged as feminist play, but also to how feminism -- seen through the lens of Lysistrata -- has come to be aligned with pacifist and anti-establishment stances.


In this paper we present a method of combining several acoustic parametric spaces, statistical models and distance metrics in speaker diarization task. Focusing our interest on the post-segmentation part of the problem, we adopt an incremental feature selection and fusion algorithm based on the Maximum Entropy Principle and Iterative Scaling Algorithm that combines several statistical distance measures on speech-chunk pairs. By this approach, we place the merging-of-chunks clustering process into a probabilistic framework. We also propose a decomposition of the input space according to gender, recording conditions and chunk lengths. The algorithm produced highly competitive results compared to GMM-UBM state-of-the-art methods.


Although recent high-end interconnection network devices and switches provide a high performance/cost ratio, most of the small to medium sized PC clusters are still built on the commodity network, Ethernet. To enhance performance on commonly used gigabit Ethernet networks, link aggregation or binding technology is used. Currently, a Linux kernel is equipped with a software solution named linux channel bonding (LCB), which is based on IEEE802.3ad Link Aggregation technology. However, standard LCB has the problem of mismatching with the commonly used TCP protocol, which consequently implies several problems of both large latency and instability on bandwidth improvement. The fault-tolerant feature is also supported, but the usability is not sufficient. We have developed a new implementation similar to LCB named RI2N/DRV (redundant interconnection with inexpensive network with driver) for use on a gigabit Ethernet with a complete software stack that is very compatible with the TCP protocol. Our algorithm suppresses unnecessary ACK packets and retransmission of packets even in imbalanced network traffic and link failures on multiple links. It provides both high-bandwidth and fault-tolerant communication on multi-link gigabit Ethernet. We confirmed that this system improves the performance and reliability of the network, and our system can be applied to ordinary UNIX services such as NFS, without any modification of other modules.


The Malawi Social Action Fund is one of the instruments employed by the Malawi government to fight poverty within existing policy frameworks. The third phase of MASAF (MASAF 3) was designed as a platform for the implementation of multi-sectoral community Driven Development (CDD) interventions in the areas of Education, Health, Water, Transport, Communication, Natural Resources, Energy, Agriculture, Irrigation and Community Services. These interventions have been placed in five Community Service Packages (CSP) such that community demands to meet local needs must be within these Service Packages in order to get funding from MASAF. Each of the Service Packages has elements that are meant to address specific Millennium Development Goals (MDGs) and the Malawi Poverty Reduction strategy Paper (MPRSP).The five Service Packages are health, education, water and sanitation, transport and communication and household food security. The major instrument to catalyse demand of projects by communities is communication (development communication). While procedures and processes to access CDD interventions are complex, MASAF 3 has demonstrated that a focused development communication strategy can improve project uptake by communities. CDD operations are bottom up and empowering to communities. Development communication in CDD operations therefore enhances transparency and accountability.


Abstract Multivariate testing is a popular method to improve websites, mobile apps, and email campaigns. A unique aspect of testing in the online space is that it needs to be conducted across multiple platforms such as a desktop and a smartphone. The existing experimental design literature does not offer precise guidance for such a multi-platform context. In this article, we introduce a multi-platform design framework that allows us to measure the effect of the design factors for each platform and the interaction effect of the design factors with platforms. Substantively, the resulting designs are of great importance for testing digital campaigns across platforms. We illustrate this in an empirical email application to maximize engagement for a digital magazine. We introduce a novel "sliced effect hierarchy principle" and develop design criteria to generate factorial designs for multi-platform experiments. To help construct such designs, we prove a theorem that connects the proposed designs to the well-known minimum aberration designs. We find that experimental versions made for one platform should be similar to other platforms. From the standpoint of real-world application, such homogeneous subdesigns are cheaper to implement. To assist practitioners, we provide an algorithm to construct the designs that we propose.


Although 95 percent of the universe is made up of ionized gases or plasma, and although most plasmas exist in magnetic fields, the problem of the behavior of these gases in magnetic fields is a relatively new field of scientific investigation. This article reviews the new findings and speculations on solar dynamics, and concentrates especially on the interactions of the solar wind with the magnetosphere of our earth. Out of the combined efforts of astronomers, physicists, engineers, and geophysicists, a picture of plasmic-magnetic interaction is beginning to emerge.


OBJECTIVE
The objective of this study was to evaluate the psychometric performance of the Acne Symptom and Impact Scale (ASIS) for use in adolescents and adults with acne vulgaris.

METHODS
Psychometric evaluation was performed using both traditional psychometrics in line with proposed US Food and Drug Administration (FDA) criteria and new psychometric methods, Rasch Measurement Theory (RMT). Assessment of equivalence was also evaluated between Caucasians and Non-Caucasians on individual items.

RESULTS
One-hundred fifty subjects completed baseline and follow-up assessments (89 [59.33%] in the Caucasian group and 61 [40.67%] in the Non-Caucasian group). Psychometric analyses demonstrated that the ASIS Sign and Impact domains both performed well. Each domain fulfilled traditional psychometric criteria (Cronbach's alpha=0.79-0.92; test-retest reliability=0.75-0.78) and mostly satisfied Rasch psychometric criteria (person-reliability=0.72-0.93; person-separation=1.61-3.69). Select individual ASIS Items also performed well across all measures and were shown to be reliable and valid as stand-alone items. A similar pattern of results were found for both Caucasian and Non-Caucasian racial subgroups.

CONCLUSIONS
These findings provide empirical evidence that the ASIS is a reliable and valid PRO measure that can accurately assess the severity of symptoms and impacts associated with acne vulgaris.