Cloud Integrating Nephelometers (CIN) were flown on the U. North Dakota Citation aircraft and the NASA WB-57 aircraft for the purpose of measuring in-situ the optical extinction coefficient and the asymmetry parameter (g) at a wavelength of 635 nm of primarily ice particles encountered during the NASA CRYSTAL-FACE study of large cumulus clouds (Cu) and their anvils found in the southern Florida region. The probes performance was largely successful and produced archived data for vertical profiles of extinction, asymmetry parameter, and effective radius (Re), the latter being obtained by combining CIN and CVI (total water; Oregon State U.) measurements. Composites of the CIN and CVI data describing the average microphysical and optical behavior of the Cu and their anvils showed the following: The extinction increases with height as a result of the size of the particles also decreasing with height as shown by the Re measurements; near the top of anvils the size of the primary ice particles is about 10-um radius; and the value of g does not vary significantly with height and has a mean value of about 0.73 consistent with the idea that ambient ice crystals are primarily of complex shape and reflect solar radiation more efficiently than particles of pristine crystal shape. Other observations include: The g measurements were found to be an indicator of the phase of the cloud permitting identification of the clouds with water droplets, rain, and ice; visual ranges as small as several tens of meters were occasionally found in "extinction cores" that coincided with strong updraft cores; and comparison of the cloud probes on the Citation showed significant disagreement.


In recent years, vision-language research has shifted to study tasks which require more complex reasoning, such as interactive question answering, visual common sense reasoning, and question-answer plausibility prediction. However, the datasets used for these problems fail to capture the complexity of real inputs and multimodal environments, such as ambiguous natural language requests and diverse digital domains. We introduce Mobile app Tasks with Iterative Feedback (MoTIF), a dataset with natural language commands for the greatest number of interactive environments to date. MoTIF is the first to contain natural language requests for interactive environments that are not satisfiable, and we obtain follow-up questions on this subset to enable research on task uncertainty resolution. We perform initial feasibility classification experiments and only reach an F1 score of 37.3, verifying the need for richer vision-language representations and improved architectures to reason about task feasibility.


Technological developments Puzzle games are used in this modern era. It is good if the children's learning media is changed with learning that uses the game especially computer devices for education that can advance the mindset to be more advanced and competitive useful in the world of education more effectively and make someone more positive thinking in everyday life. The purpose of this research to produce game-based learning applications to develop aplikas software-based media learning to make it easier in thinking. This learning media is very well used for elementary school students to help utuk children more widely developed. The stone tool used with MIT Inventor application of this puzzle game is expected to solve the problem. So when children play this game indirectly to learn, with the hope of the spirit of children to learn will be more encouraged and improve the quality of learning children.


Rupture of the Pectoralis muscle tendon is usually rare. And when it does happen, Sports or exercises are most often the culprit. An abducted, extended and externally rotated shoulder is weak and adding tension to it, as happens during a bench press or throwing a ball, is likely to tear off the Pectoral tendon. Sites recognized are: At Tendon attachment, Musculo-tendinous junction and Muscle belly. This is a retrospective case review of three cases of Pectoral tear that underwent Open Surgical repair with fibre-tape and Pec-buttons. No major complications (hematoma, prosthesis failure, persistent pain) witnessed thus far in early postoperative phase (3 months). Notably, MRI imaging did not show any tear in two of the cases despite strong clinical suspicion, prior to surgery. This review has led to the conclusion that, surgical repair for Pectoral tear is a very effective method of treatment, for both complete & incomplete rupture. And MRI imaging, although very sensitive and useful for soft tissues, may not be specific & is best used as an adjunct to aid the Clinical diagnosis only.


The studies related to the coherent structures in the atmosphere, using Doppler wind lidar observations, so far relied on the manual detection and classification of the structures in the lidar images, making this process time-consuming. We developed an automated classification based on texture analysis parameters and the quadratic discriminant analysis algorithm for the detection of medium-to-large fluctuations and coherent structures recorded by single Doppler wind lidar quasi-horizontal scans. The algorithm classified a training dataset of 150 cases into four types of patterns, namely streaks (narrow stripes), rolls (wide stripes), thermals (enclosed areas) and "others" (impossible to classify), with 91% accuracy. Subsequently, we applied the trained algorithm to a dataset of 4577 lidar scans recorded in Paris, atop a 75 m tower for a 2-month period (September-October 2014). The current study assesses the quality of the classification by examining the physical properties of the classified cases. The results show a realistic classification of the data: with rolls and thermals cases mostly classified concurrently with a well-developed atmospheric boundary layer and the streaks cases associated with nocturnal low-level jets (nllj) events. Furthermore, rolls and streaks cases were mostly observed under moderate or high wind conditions. The detailed analysis of a four-day period reveals the transition between the types. The analysis of the space spectra in the direction transverse to the mean wind, during these four days, revealed streaks spacing of 200 to 400 m, and rolls sizes, as observed in the lower level of the mixed layer, of approximately 1 km.


MX2 nanoparticles, with M = Mo, W and X = S or Se, were synthesized via a chemical reaction between molybdenum carbonyl (or tungsten carbonyl) and chalcogen dissolved in para-xylene solution. X-ray diffraction and high-resolution transmission electron microscopy analysis showed that the MoS2, WS2, MoSe2 and WSe2 powders were constituted of rounded amorphous nanoparticles. Upon annealing at 550 °C the nanoparticles crystallized, losing their round shape. The four materials synthesized under similar conditions showed that the annealed selenide nanoparticles (MoSe2 and WSe2) are well crystallized, with aligned stacks of 5–10 layers (002 van der Waals (vdW) planes), while the annealed sulfide nanoparticles (MoS2 and WS2) exhibit curved and tangled 002 planes, randomly distributed in the particle.


The relationship between axillary temperature and postoperative shivering was examined in 302 patients who entered one recovery room in the Derbyshire Royal Infirmary over a one‐month period. No relationship was found between temperature and the occurrence of shivering, or between conscious level and the occurrence of shivering.


In this paper, we address the pilot contamination problem in multi-cell Massive MIMO systems. Particularly, we propose a pilot design scheme that simultaneously minimizes the channel estimation errors of all base stations (BSs) and the total pilot power consumption of all users subject to the transmit power constraint for every user in the network. We decompose the proposed non-convex problem into distributed optimization problems to be solved at each BS, assuming the knowledge of pilot signals of the other BSs. Then, we introduce a successive optimization approach to cast each distributed optimization problem into a convex linear matrix inequality form. Simulation results confirm that the proposed approach significantly reduces pilot power while maintaining the same level of channel estimation error as a recent work in [1].


Abstract Background The effects of cannabis use in vulnerable persons with schizophrenia or schizoaffective disorder, continues to be elucidated. Methods We compared 55 cannabis-only users (Group 1) with 462 non-substance users (Group 2) on measures of length of stay and number of psychiatric hospitalizations with a primary discharge diagnosis of schizophrenia or schizoaffective disorder using the Wilcoxon-Mann-Whitney non-parametric test for non-normal distributions, analysis of variance (ANOVA), and Poisson regression analysis. Results Group 1 had a mean length of stay of 6.15 days (sd = 5.32 days) and Group 2 had a mean length of stay of 8.66 days (sd = 11.14 days) (i.e. Wilcoxon-Mann-Whitney, p = .0347; log-transformed ANOVA, p = .0203). This difference was no longer statistically significant when controlling for three covariates (p = .1543). Poisson regressions for the mean number of admissions (1.84) were not statistically significant. Conclusions Cannabis use may not be a good predictor of length of stay, once covariates are considered, and mean number of hospitalizations in hospitalized patients with schizophrenia or schizoaffective disorder.


ABSTRACT This study aims to design and validate an electronic performance support system that enables educators to use instructional technologies effectively and efficiently. The study was designed and conducted using developmental research methods and with the participation, at different stages, of educators and educational technology and software experts. The tangible product of the designed system is a session plan independent of the content. The system's activity database contains 44 activities. The system works as follows. Based on the learning outcome, student, educator, and environment characteristics, activities not deemed suitable are eliminated, the most suitable activities are presented for the educator to select, and the educator makes a selection. The educator then accesses a session plan produced by the system and can edit this plan as desired. The system has additional features that were created based on the opinions of educators and educational technology experts. These features are tools for supporting academic, technical, administrative, and professional cooperation. To validate the designed system, the views and recommendations of educators and software and educational technology experts were collected. All three groups confirmed the validity of the design. Nevertheless, based on the feedback received, improvements were made before giving the design its final shape.


This study provides insight about the process of top management teams' (TMTs') sensemaking about leadership of middle managers—a process that has so far been neglected by researchers. In a longitudinal case study design, the authors analyzed observational data from 23 TMT meetings and transcripts from interviews with TMT members. Results indicate that TMT sensemaking consisted of images of middle managers, the TMT self-image, and reflection on action and action planning. Furthermore, the importance of TMT unity in actions toward middle managers is highlighted as an important aspect of TMT leadership. It is suggested to incorporate TMT sensemaking about leadership, as well as actual leadership actions toward middle managers, as processes for explaining how TMT composition influences organizational performance.


The study examines education capacity building, challenges, accomplishment, socio-economic implications and prospects of four years of the OlusegunMimiko cum Labour Party led Government in Ondo State. Sample comprised 60 Principal/Head teachers and 160 teachers of both Primary and Secondary schools. Three research questions were generated for the study. Two questionnaires containing 15 items each, based on a 4-point rating scale were used for data collection. Mean scores and standard deviation were used for data analysis. Findings revealed that most Principals/Head teachers appreciated the innovation and the developmental strategies put in place by the Labour Party-led government. The findings equally established that much is still required in the area of education and its proper funding by the state government. Keywords: Education, socioeconomic, development, teachers


This paper presents a hybrid organizational structure chosen by a corporation as a means to combine the benefits of centralization and decentralization. The hybrid structure is the result of a restructuring effort by a coal company in Kentucky under the directive of its parent corporation to ensure maximum resource utilization within a more streamlined organizational structure. Through an observation of the restructuring process, we are able to demonstrate how and why it is important for top-level managers to understand and make the best use of the intricate synergism between information technology and organizational structure. The strategic implications of a hybrid structure and the roles of information technology in organizational changes are explored. We argue that a hybrid structure is a viable and strategically valuable structural alternative, especially for highly diversified conglomerates that grow through mergers and acquisitions of other companies.


BACKGROUND
Several studies have suggested an association between antibody to human heat shock protein 60 (anti-Hsp60) and coronary atherosclerosis, but the results have been inconsistent. The aim of this study was to investigate the association between anti-Hsp60 and coronary heart disease (CHD) and to determine whether anti-Hsp60, hypertension, and diabetes have joint effects on CHD risk.

METHODS
We measured the concentrations of anti-Hsp60 in 1003 CHD patients and 1003 age- and sex-matched control subjects without CHD events.

RESULTS
Concentrations of anti-Hsp60 were significantly higher in CHD patients than in controls. Increasing concentrations of anti-Hsp60 were significantly associated with higher risk of CHD (P for trend <0.0001) and with increasing severity of CHD as assessed by number of diseased vessels detected with angiography [odds ratio (OR) 3.67, 95% CI 1.56-8.64, P = 0.003] after multivariate adjustment for traditional CHD risk factors. There were strong joint effects of high concentrations of anti-Hsp60 and hypertension (OR 5.17, 95% CI 3.95-6.75, P < 0.0001) and diabetes (OR 6.49, 95% CI 4.52-9.33, P < 0.0001) on CHD risk; simultaneous occurrence of high anti-Hsp60 concentrations, hypertension, and diabetes conferred a dramatically higher risk of CHD (OR 20.99, 95% CI 12.50-35.24, P < 0.0001) in multivariate analyses.

CONCLUSIONS
Anti-Hsp60 is independently associated with CHD risk, and a combination of high anti-Hsp60, hypertension, and diabetes is particularly detrimental for CHD risk.


Background: Robot-assisted minimally invasive surgery (RVATS) is a relatively new technique applied for thymectomies. Only few studies directly compare RVATS to the mainstay therapy, open surgery (sternotomy). Methods: A systematic search of the literature was performed in October 2016. The meta-analysis includes studies comparing robotassisted and open thymectomy regarding operation time, length of hospitalization, intraoperative blood loss, and chest-in-tube days, postoperative complications, reoperation, arrhythmic events, pleural effusion, and postoperative bleeding. Results: Of 626 studies preliminary screened, 7 articles were included. There were no significant differences in comparison of operation time (−3.19 minutes [95% confidence interval, 95% CI −112.43 to 106.05]; P = .94), but patients undergoing RVATS spent significantly less time in hospital (−4.06 days [95% CI −7.98 to −0.13], P = .046). There were fewer chests-in-tube days (−2.50 days [95% CI −15.01 to 10.01]; P = .24) and less intraoperative blood loss (−256.84 mL [95% CI −627.47 to 113.80]; P = .10) observed in the RVATS group; due to a small number of studies, these results were not statistically significant. There were also less post-operative complications in the RVATS group (12 complications in 209 patients vs 51 complications in 259 patients); however, this difference was not statistical significant (odds ratio 0.27, 95% CI 0.07–1.12; P = .06). Conclusions: Patients undergoing RVATS spent less time in hospital than patients treated by open surgery (sternotomy). These patients tended to have less postoperative complications, less intraoperative blood loss, and fewer chest-in-tube days. We found evidence for the safety and feasibility of RVATS compared with open surgery, which has to be further confirmed in randomised controlled trials.


The proper handling and disposal of Bio-medical waste (BMW) is very imperative. There are well defined set of rules for handling BMW worldwide. Unfortunately, laxity and lack of adequate training and awareness, in execution of these rules leads to staid health and environment apprehension. In this research paper, awareness about bio-medical waste (BMW) management rules among health care personnel of some important health care facilities in Cuttack is evaluated. In the present study, health care facilities are categorized into four strata i.e. apex Government hospitals, Government and non Government first level referral units (FRU), private health care facilities and corporate health care facilities. Random sampling technique is adopted at all the four different strata mentioned above to have a representative sample. After random sampling technique, total fourteen health care facilities from all strata are taken up. Periodical visits were made to analyze awareness about bio-medical waste management among health care personnel of all the fourteen health care facilities. To make it all embracing and systematic, a written appraisal tool in the form of different questionnaires was prepared for various categories of working personnel in the hospital/nursing home. To increase the sample size best efforts were made to collect data from maximum number of working personnel and their views and sincere suggestions regarding waste management were noted down. The results obtained pointed towards lack of knowledge and awareness towards legislations on bio-medical waste management even among qualified hospital personnel. As a consequence there is inappropriate practice of BMW handling and management, thus exposing themselves and general public to health and environment hazards.


Background: Receding gums, the conundrum among practitioners due to its numerous etiologies and various treatment modalities is found to be an alarming framework in the field of Periodontics. The decision to treat gingival recession is purely influenced by the judgment of the treating, referring dentists, and periodontists.
Aims & Objectives: Currently, there is limited data regarding the approach of an Indian dentist towards the treatment of the gingival recession and their referral to periodontists. Therefore, the purpose of this study is to evaluate the knowledge on diagnosis, treatment strategies, opinions, and interests among the dental professionals with regard to gingival recession.
Material and Methods: An online survey was conducted among 117 dental professionals including interns and postgraduates of various specialties with an age group of 18-30years. This self-prepared questionnaire-based survey was carried out at Mangalore, Karnataka for a period of 2 months.
Results: The study shows 33.3% of the participants (periodontists) were well aware of Cairo's classification of gingival recession and 66.7% did not have any idea.32.5% mentioned malpositioning of teeth to be the primary cause for gingival recession. Regarding the general indication for root coverage procedures, periodontists (58.8%) and non-periodontists (41.1%) answered prevention of further progression of the gingival disease (43.6%) to be the most common reason.
Conclusion: Through our observations made in the present study, we would like to conclude that due to the lack of awareness, knowledge, and professional incompetency, many dentists neglect these perioplastic procedures in their routine practice.


Background
Immunoglobulin M (IgM) nephropathy is an idiopathic glomerulonephritis characterized by diffuse mesangial deposition of IgM. IgM nephropathy has been a controversial diagnosis since it was first reported, and there are few data identifying specific pathological features that predict the risk of progression of renal disease.

Methods
We identified 57 cases of IgM nephropathy among 3220 adults undergoing renal biopsy at our institution. Biopsies had to satisfy the following three criteria to meet the definition of IgM nephropathy in this study: (i) dominant mesangial staining for IgM, (ii) mesangial deposits on electron microscopy (EM) and (iii) exclusion of systemic disease.

Results
The median age was 42 years and 24 patients were male. Thirty-nine per cent of patients presented with the nephrotic syndrome, 49% presented with non-nephrotic proteinuria and 39% had eGFR <60 mL/min. The median post-biopsy follow-up was 40 months and serum creatinine had doubled in 31% by 5 years. Of histological parameters, glomerular sclerosis and tubular atrophy, but not mesangial proliferation, were risk factors for renal insufficiency. Thirty-nine per cent of nephrotic patients achieved complete remission, and outcome was significantly worse in those who did not respond to treatment. Focal segmental glomerulosclerosis was diagnosed in 80% of those undergoing repeat renal biopsy, despite ongoing mesangial IgM deposition.

Conclusions
We propose criteria for a consensus definition of IgM nephropathy.


We study the best arm identification problem in linear multi-armed bandits (LMAB) in the fixed confidence (δ-PAC) setting; this is also the problem of optimizing an unknown linear function over a discrete ground set with noisy, zeroth-order access. We propose an explicitly implementable and provably order-optimal sample-complexity algorithm to solve this problem. Most previous approaches rely on access to a minimax optimization oracle which is at the heart of the complexity of the problem. We propose a method to solve this optimization problem (upto suitable accuracy) by interpreting the problem as a two-player zero-sum game, and attempting to sequentially converge to its saddle point using low-regret learners to compute the players' strategies in each round which yields a concrete querying algorithm. The algorithm, which we call the Phased Elimination Linear Exploration Game (PELEG), maintains a high-probability confidence ellipsoid containing θ∗ in each round and uses it to eliminate suboptimal arms in phases. We analyze the sample complexity of PELEG and show that it matches, up to order, an instance-dependent lower bound on sample complexity in the linear bandit setting without requiring boundedness assumptions on the parameter space. PELEG is, thus, the first algorithm to achieve both order-optimal sample complexity and explicit implementability for this setting. We also provide numerical results for the proposed algorithm consistent with its theoretical guarantees.


Models for Optimum Repair-Level Analysis (ORLA) and Life Cycle Cost (LCC) analysis for Base and Installation Security System (BISS) equipment are described. The ORLA model determines the costs of alternative maintenance approaches for selection of the most economic maintenance approach. The LCC model determines the total cost to the Government for the development, acquisition, initial logistics support, and recurring support of a system over the projected inventory usage period. A unique feature of these models is the marriage of ORLA and ICC which enables LCC to utilize completely the most economic ORLA decision costs. This significantly reduces the overall LCC effort.


The optical isotope shifts in the transition 4f4 5d 6 K9/2 -(23 537)9/2 0 (5702 A) of Nd II by collinear fast-ion-beam laser spectroscopy have been used to deduce for the first time that the mixing probabilities of the configurations 4f3 5d2 , 4f4 6p and 4f3 5d6s of the level (23 537)9/2 0 are 0.84, 0.15 and 0.01 respectively.


Introduction Pharmacists traditionally do not get involved in the long-term management of patients with chronic disease. This service development aimed to integrate pharmacy-lead IBD medication optimisation into the IBD Multi Disciplinary Team (MDT). We report our experience of extending our specialist pharmacist's remit. Method A weekly pharmacist outpatient clinic was established, to initiate immunomodulating drugs and undertake biochemical monitoring. The pharmacist optimised therapy according to blood levels, adverse drug reactions (ADRs) and concordance. Strategic and operational management of the biologics infusion clinic was transferred to the pharmacist. A new blood and therapeutic drug monitoring (TDM) service for immunomodulators and biologics was introduced to optimise therapy decisions. The rapid access (helpline) service was reviewed to see whether the pharmacist could add value. The pharmacist facilitated MDT-approved pathways to initiate and review immunomodulators. A workload and prescription audit was conducted over four months with financial impact assessment. Patient and anonymous colleague feedback was sought. Results In the four months analysed, 14 pharmacist clinics were held, serving 138 patients. 382 patients had blood monitoring, ensuring clinical governance. The biologics infusion clinic expanded to include a cross-speciality services. 65 patients had their immunosupressant therapy adjusted in the TDM service. The pharmacist is gatekeeper for testing and is responsible for optimising therapies (as a non-medical prescriber). The advice sought from the rapid access service was primarily nurse-orientated and the service remains nurse-lead, with pharmacist deputising to maximise resources. In 4 months 142 of 1032 queries were answered by the pharmacist. The MDT reviewed 42 patients on biologics according to the new pathways. The TDM service resulted in a minimum of £60,000 savings for the health economy. 6 of 6 peer-assessors returned overwhelmingly positive reviews of the service and patient feedback was fa. Conclusion Involving the pharmacist in all aspects of the long-term care of patients with IBD enhanced patient safety and standardised treatment and monitoring protocols, whilst individualising therapy. The focus of the MDT shifted to early medicines optimisation, realising considerable cost savings. Interprofessional relationships profited from working closely together / deputising for each other. Embedding pharmaceutical skills into the multidisciplinary team influenced therapeutic decision making, ensuring that services incorporated good medicine management and medicine optimisation principles at conception to guarantee high-quality, compassionate care and strong governance. Disclosure of interest None Declared.


Synthesis of the serotype H3 (SerH3) surface antigen is temperature dependent and responds within 1 h to a change in incubation conditions (G.A. Bannon, R. Perkins-Dameron, and A. Allen-Nash, Mol. Cell. Biol. 6:3240-3245, 1986). Recently, a Tetrahymena thermophila cDNA clone (pC6; D.W. Martindale and P.J. Bruns, Mol. Cell. Biol. 3:1857-1865, 1983) has been shown to be homologous to a portion of the SerH3 mRNA (F.P. Doerder and R.L. Hallberg, personal communication), and it was shown that the cellular levels of this RNA rapidly decreased when cells were shifted from 30 to 41 degrees C (R.L. Hallberg, K.W. Kraus, and R.C. Findly, Mol. Cell. Biol. 4:2170-2179, 1984). These observations indicate that synthesis of the SerH3 protein is highly regulated in response to temperature and led us to initiate studies to determine the mechanism(s) by which SerH3 gene expression is controlled. Using pC6 as a hybridization probe for the SerH3 mRNA, we have determined that (i) the level of SerH3 protein synthesis is directly correlated with the amount of SerH3 message available for translation; (ii) there is, at most, a twofold difference between the relative transcription rates of SerH3 genes at 30 and 40 degrees C; (iii) the SerH3 mRNA half-life in cells incubated at 30 degrees C is greater than 1 h, whereas the half-life in cells incubated at 40 degrees C is only approximately 3 min. These results demonstrate that Tetrahymena SerH3 surface protein expression is regulated by mRNA abundance. Furthermore, the major mechanism controlling mRNA abundance is a dramatic temperature-dependent change in SerH3 mRNA stability.


The article is a report of survey done in range of Tempus Project JEP 1342-98, concerning needs of academic library clients. In the article there was discussed methodology of needs identification, using "Libra" software. There was determined set of needs of various importance hierarchies for users and the satisfaction level with the library services, provided in each of the libraries. There were done comparative analyses of needs among the libraries that took part in the Project. The methodology of analysis of information needs that was presented in the article may be used in the process of library management as a tool of monitoring of library performance.


The present study aimed to evaluate the estimate of reference evapotranspiration (ETo) for the region of Seropedica, RJ, correlating measures obtained with weighing lysimeter and Penman-Monteith - FAO 56 (PMF), Hargreaves-Samani (HS), Camargo (CA), Priestley-Taylor (PT), Makking (MA) and Pan Class A (PCA) methods. The values of ETo estimated by PMF, PT and MA were well correlated to those determined by the weighing lysimeter, whereas the HS and CA methods showed unsatisfactory adjustment with the lysimeter data. The estimated mistakes from the adjusted methods for the region of Seropedica are acceptable for use in design and management irrigation systems. Another interesting alternative is the use of the Pan Class A method, due to the feasible handling and low cost, so that it can be installed near the field.


Anxiety is common in surgical patients, with an incidence of 60% to 92%. There is little information on the incidence and severity of preoperative anxiety in patients scheduled for neurosurgery. The aim of this study was to measure the level of preoperative anxiety in neurosurgical patients and to assess any influencing factors. After the Institutional Review Board approval and informed written consent, 100 patients booked for neurosurgery were interviewed preoperatively. Each patient was asked to grade their preoperative anxiety level on a verbal analog scale, Amsterdam Preoperative Anxiety and Information Scale, and a set of specific anxiety-related questions. The anxiety scores and the responses to the questions were compared between the sex, age, weight, diagnosis, and history of previous surgery. The mean age (±SD) was 50±13 years. The preoperative diagnosis was tumor (n=64), aneurysm (n=14), and other (n=22). Overall verbal analog scale was 5.2±2.7; the score was higher for female (5.8±2.8) than male patients (4.6±2.5) (P<0.05). Amsterdam Preoperative Anxiety and Information Scale anxiety and knowledge scores were greater for surgery than for anesthesia. Questionnaire results showed that the most common anxieties were waiting for surgery, physical/mental harm, and results of the operation. In conclusion, our study showed that neurosurgical patients have high levels of anxiety, with a higher incidence in females. There was a moderately high need for information, particularly in patients with a high level of preoperative anxiety.


This work was supported by Consilider Ingenio 2009 CDS 00050. O.d.l.T. is grateful to the Spanish Ministry of Science and Innovation for a doctoral grant (FPU). We also thank E. Ponce and Dr. D. Penno for discussions and technical assistance.


Archaeogenetic analyses are usually aimed at elucidating the demographic history of small-scale societies, although frequently over large geographic and temporal scales. There has been significantly less attention paid to the analysis of state-level societies, except sometimes as a political framework within which smaller-scale interactions took place. This is curious, because it is widely recognized that state policies can have important demographic consequences (1⇓–3). This relative lack of interest in the genetic impact of states may be associated with an assumption that historical sources provide sufficient information on such processes. In PNAS, the paper by van Dorp et al. (4) on the genetic effects of state formation in central Africa provides an example of such an analysis, indicating some of the likely consequences of state formation and functioning in the Kuba polity.

Over the past 20 y, the archaeogenetic studies that have concerned themselves with state-level societies have done so through a variety of approaches, ranging from straightforward claims of correspondences between haplogroups and state ethnicities (5), to analysis of the demographic consequences of state collapse and regeneration (6), to analysis of different forms of sociopolitical hierarchy often associated with complex societies (7). The relatively small size and recent historical trajectory of the Kuba state allow van Dorp et al. (4) to take a more global approach, comparing variability in autosomal, Y-chromosomal, and mtDNA genetic features for a sample in individuals identifying as Kuba or non-Kuba, the latter from a variety of stateless societies historically situated beyond the boundaries of the Kuba state. These samples were not gathered within the historical territory of the Kuba state, but rather in Kananga, the modern capital of Kasai …

[↵][1]1Email: scott.maceachern{at}dukekunshan.edu.cn.

 [1]: #xref-corresp-1-1


U.S. SCIENCE POLICYWhen House Speaker Newt Gingrich (R-GA) called for a sweeping review of science policy last summer, he gave the job to Representative Vern Ehlers (R-MI), the number two Republican on the House Science Committee. Ehlers, a former physics professor who was recently named one of the three brainiest U.S. House members by Washingtonian magazine, knows he faces a tough sell, because the more detailed the recommendations, the more critics it will attract, including those who may reject it as a partisan document serving the man who requested it. Science interviews Ehlers about his soon-to-be-completed report.


Artificial sugar solutions can be used to disrupt the mutualism between aphids and ants. This provides natural enemies with increased access to aphid populations, thus enhancing biocontrol of hemipteran pests. However, research suggests that artificial solutions should be tailored to specific species in order to maximize the desired result. In this study, we test the effect of an alkaloid, caffeine, and a non-protein amino acid, γ-aminobutyric acid (GABA), on preference for sucrose solutions in two ant species, Lasius niger and Oecophylla smaragdina. These secondary metabolites have been shown to have attractive capabilities in other species of insects, who favor nectars from plants containing these compounds. In our first experiment, both species significantly preferred solutions containing GABA over sucrose-only controls, albeit L. niger favored higher concentrations of the amino acid. Caffeine did not significantly increase preference for sugar solutions in either of the tested species, and ants significantly dispreferred the highest concentration of caffeine offered. When the two metabolites were tested simultaneously against sucrose only, L. niger fed equally from all solutions, while O. smaragdina dispreferred caffeine. Thus, while GABA seems to be a promising ant attractant, caffeine is not an adequate choice, at least at the concentrations tested in this experiment.


Africa is poised for a revolution in the quality and relevance of weather predictions, with potential for great benefits in terms of human and economic security. This revolution will be driven by recent international progress in nowcasting, numerical weather prediction, theoretical tropical dynamics and forecast communication, but will depend on suitable scientific investment being made. The commercial sector has recognized this opportunity and new forecast products are being made available to African stakeholders. At this time, it is vital that robust scientific methods are used to develop and evaluate the new generation of forecasts. The GCRF African SWIFT project represents an international effort to advance scientific solutions across the fields of nowcasting, synoptic and short-range severe weather prediction, subseasonal-to-seasonal (S2S) prediction, user engagement and forecast evaluation. This paper describes the opportunities facing African meteorology and the ways in which SWIFT is meeting those opportunities and identifying priority next steps.Delivery and maintenance of weather forecasting systems exploiting these new solutions requires a trained body of scientists with skills in research and training; modelling and operational prediction; communications and leadership. By supporting partnerships between academia and operational agencies in four African partner countries, the SWIFT project is helping to build capacity and capability in African forecasting science. A highlight of SWIFT is the coordination of three weather-forecasting "Testbeds" – the first of their kind in Africa – which have been used to bring new evaluation tools, research insights, user perspectives and communications pathways into a semi-operational forecasting environment.


Real-world multimedia data is often composed of multiple modalities such as an image or a video with associated text (e.g., captions, user comments, etc.) and metadata. Such multimodal data packages are prone to manipulations, where a subset of these modalities can be altered to misrepresent or repurpose data packages, with possible malicious intent. It is therefore important to develop methods to assess or verify the integrity of these multimedia packages. Using computer vision and natural language processing methods to directly compare the image (or video) and the associated caption to verify the integrity of a media package is only possible for a limited set of objects and scenes. In this paper we present a novel deep-learning-based approach that uses a reference set of multimedia packages to assess the semantic integrity of multimedia packages containing images and captions. We construct a joint embedding of images and captions with deep multimodal representation learning on the reference dataset in a framework that also provides image-caption consistency scores (ICCSs). The integrity of query media packages is assessed as the inlierness of the query ICCSs with respect to the reference dataset. We present the MultimodAl Information Manipulation dataset (MAIM), a new dataset of media packages from Flickr, which we are making available to the research community. We use both the newly created dataset as well as Flickr30K and MS COCO datasets to quantitatively evaluate our proposed approach. The reference dataset does not contain unmanipulated versions of tampered query packages. Our method is able to achieve F-1 scores of 0.75, 0.89 and 0.94 on MAIM, Flickr30K and MS COCO, respectively, for detecting semantically incoherent media packages.


Gestational diabetes mellitus (GDM) and pre-gestational diabetes are known to pose risks to the mother and developing fetus, often related to abnormal fetal growth. One potential mediator of maternal effects on fetal growth is Placental Growth Hormone (PGH). PGH is produced by the syncytiotrophoblast and found predominantly in the maternal circulation. It progressively replaces pituitary growth hormone (hGH) in the human maternal circulation from mid-gestation onwards, peaking towards term. PGH appears to be an important potential regulator of maternal insulin resistance in human pregnancy and may influence fetal growth both by modifying substrate availability and through paracrine actions in the placental bed. The details of PGH regulation remain relatively poorly understood, but current evidence does suggest a central role in growth restricted pregnancies. There is currently less evidence of a pathophysiologic role in production of the macrosomic fetal phenotype commonly seen in response to hyperglycaemia, although our recent in vitro studies do raise the possibility of feto-placental feedback as a mechanism of growth modulation.


Fluorinated greenhouse gases (F-gases) are used for various applications, such as in refrigeration and air conditioning, as substitutes of the ozone-depleting substances. Their utilization has increased drastically over the last few decades, with serious consequences for global warming. The Kigali Amendment to the Montreal Protocol and several national and international legislations, such as the 2014 EU F-gas Regulation, aim to control the utilization and emissions of these gases. In the EU, the phase-down of hydrofluorocarbons (HFCs) is underway, with successive reductions in quotas up to 2050. Under this scenario, efficient strategies for managing the produced and already existing F-gases are of vital importance to guarantee that their effect on the environment is mitigated. Up to now, most of the F-gases recovered from end-of-life equipment or when retrofitting systems are either released into the atmosphere or destroyed. However, in order to put forward a cost-efficient adaptation to the F-gas phase-down, increasing separation and recycling efforts must be made. This critical review aims at providing a revision of the current F-gas management problems and strategies and providing an overview on the innovative strategies that can be applied to contribute to build a sustainable market under circular economy principles.


Based on the overall conclusion of current research results of bed load simulation methods, the bed load simulation method of long reach movable-bed model of the Yellow River is explored in this paper. It deems that, when designing the movable-bed model, it should choose corresponding model similitude law according to the erosion and deposition characteristics of the simulated reach. When simulating the erosion and deposition characteristics of most about deposition and less exchange between suspended load and bed load in reservoirs, the total sediment load model similitude law brought out by Dou Guoren may be adopted into design; when simulating sediment-laden river like the Yellow River with the characteristics of easy scouring and silting, the model similitude law brought out by Zhang Hongwu et al may be adopted. Model practices prove that it is feasible.


Tettigettalna (Hemiptera: Cicadidae) is a genus of small sized cicadas occurring in south-western Europe, which consists of a complex of sibling species that are morphologically difficult to distinguish from each other but their calling songs can be used as the main character for their identification. These sibling species may sometimes occur in sympatry, therefore, this genus is a suitable model for addressing questions on isolation mechanisms and recognition processes. For this study, we selected T. argentata (the species with the broadest distribution) and the three other species of Tettigettalna (T. mariae, T. estrellae and T. josei) that are known to occur in sympatry with T. argentata at some locations in their distribution ranges. Thus, the present study investigates calling song and variation in external morphology in selected sympatric and allopatric populations of four species of Tettigettalna in order to determine whether there are patterns in population divergence that provide evidence of species recognition and reproductive isolation. The interspecific analysis of the calling songs showed that most time domain variables are species-specific although an overlap was found between the maximum and minimum values in T. argentata and T. mariae populations for four time domain variables. When only sympatric popu- lations of T. argentata and T. mariae are compared, time domain variables show less variation leading to a reduced overlap between this pair of sibling species. The morphometric variables showed low interspecific variability and did not allow a complete separation of the four species, both in allopatric and sympatric populations. Sympatric populations of both T. argentata and T. mariae showed lower frequencies and bigger general body sizes than the allopatric ones. The pattern of variation found does not correspond to the pattern expected in species undergoing character displacement.


Abstract Rationale, aims, and objectives This paper examines a remarkable dispute between Dutch insurers, hospitals, doctors, and patients about a set of quality indicators. In 2013, private insurers planned to drastically reform Dutch emergency care using quality indicators they had formulated drawing from clinical guidelines, RCTs, and systematic reviews. Insurers' plans caused much debate in the field of emergency care. As quality indicators have come to play a more central role in health care governance, the questions what constitutes good evidence for them, how they ought to be used, and who controls them have become politically and morally charged. This paper is a case study of how a Dutch public knowledge institution, the National Health Care Institute, intervened in this dispute and how they addressed these questions. Method We conducted ethnographic research into the knowledge work of the National Health Care Institute. Research entailed document analysis, participant observation, in‐depth conversations, and formal interviews with 5 key‐informants. Results The National Health Care Institute problematized not only the evidence supporting insurers' indicators, but also—and especially—the scope, purpose, and use of the indicators. Our analysis shows the institute's struggle to reconcile the technical rationality of quality indicators with their social and political implications in practice. The institute deconstructed quality indicators as national standards and, instead, promoted the use of indicators in dialogue with stakeholders and their local and contextual knowledge. Conclusions Even if quality indicators are based on scientific evidence, they are not axiomatically good or useful. Both proponents and critics of Evidence‐based Medicine always feared uncritical use of evidence by third parties. For non‐medical parties who have no access to primary care processes, the type of standardized knowledge professed by Evidence‐based Medicine provides the easiest way to gain insights into "what works" in clinical practice. This case study reminds us that using standardized knowledge for the management of health care quality requires the involvement of stakeholders for the development and implementation of indicators, and for the interpretation of their results.


Strategy is used by organizations to adjust to emerging challenges and opportunities in the market environment. Due to a more rapidly changing market caused by globalization, strategy has become increasingly important. Organizations often struggle to implement strategy successfully caused by difficulties with the transition from the strategy formulation phase into the realization phase. Fully involving the employees in this phase appears to be challenging, they are often not properly informed or do not understand the strategy. The main objective of this thesis was to create a holistic and practical solution which improves the realization of strategy by motivating employees to contribute. The solution was designed to be usable by Strategiemakers (the client) as well as by organizations themselves. In order to design the solution, a theoretical research and empirical research were conducted to create an holistic understanding of the strategic process and triangulate insights. In literature three main phases of the strategic process were identified: Strategy forming – Guiding policies – Realization. These phases were specified by researching the strategic process of four highly varying organizations, which uncovered six challenges in the realization phase. From these challenges was decided to focus on the troublesome activity of triggering the employee to contribute to the strategy, since a solution for this lied in the reach of this master thesis. Insight into the perspective of the employee on the strategic realization phase provided knowledge on how to improve their motivation for strategy realization. Three parts of this perspective were researched: the influence of the organizational context the employee functions in, the employees' experience of the strategy and general motivators of the employee. With these insights, a holistic and practical solution was designed to facilitate organizations in triggering their employees to adventure in strategy realization. This solution is based on the idea of enhancing the employees' intrinsic motivation by creating a win-win situation for them and the organization. Through six steps the organization is facilitated in linking the personal development of the employee to the strategic objectives which addresses the intrinsic motivation of the employee. In the designed trajectory, the organization is aided in the specification of their strategy by determining which skills and capabilities are needed for the realization. Next, the employees are guided in the discovery of their desired skills and ambitions. Lastly, the canvas kit facilitates the process of making a connection between the employees' desires in development and the skills required for the realization of the strategy.


In four-day cycling rats studied during the estrous cycle, the levels of circulating norepinephrine (NE) showed a sharp rise concomitant with the LH surge in the afternoon of proestrus. Following the peak, plasma NE fell rapidly to the minimum value by the morning of estrus. The administration of progesterone to ovariectomized estrogen-primed rats resulted in a surge in plasma NE levels 4 h after progesterone treatment. The maximal levels attained were 3-fold greater than baseline values, falling rapidly to reach basal values 8 h after the administration of progesterone. The amine levels remained unaffected 12-20 h later. The LH values attained a maximum 8 h after the injection of progesterone. In rats treated with estradiol benzoate (EB) followed by 0.1 ml of oil instead of progesterone, neither the NE nor the LH peak were observed. These findings are discussed with respect to the significance of increased amounts of plasma NE related to the LH surge.


The writing of this article aims to describe the understanding, process, and role of the teacher in school financial administration. In this article, the authors use the literature study method by collecting literature (material materials) sourced from books, journals, and other sources related to the science of school financial administration and concludes all material or material obtained by developing it in the form of knowledge or insight new. School financial management can be interpreted as a series of activities regulating school finance ranging from planning, accounting, spending, supervision and accountability of school finances. Education funding should be done efficiently. Financial management is one of the substance of school management which helps determine the course of educational activities in schools. As happened in the substance of education management in general, financial management activities are carried out through the process of planning, organizing, directing, coordinating, supervising or controlling. The person responsible for education costs is the principal, however, teachers are also expected to play a role in the school's financial administration.


Several techniques and treatments have been developed for the production of high-performance nylon-6 fibers. The inherent problems of low productivity, high production cost, and high energy consumption, complexity of chemical reaction, mass transfer, and waste recovery systems make most of them inappropriate for industrial application. Horizontal isothermal bath (hIB) is an alternative ecofriendly simple treatment that can be used during melt spinning process for production of technical textile fibers. The efficacy of hIB in improving the mechanical properties of multifilament nylon-6 yarn is studied in this research. The results showed that such treatment can increase the molecular orientation of the amorphous and crystalline functions up to 0.54 and 0.983, respectively, and raised both the amorphous isotropy and fiber birefringence by 67 and 45%, respectively. Hot drawing of the yarn at a very low draw ratio of 1.38, increased the tenacity and modulus up to 10 and 43.9 g/den, respectively, and decreased the elongation to 27%. POLYM. ENG. SCI., 55:2457–2464, 2015. © 2015 Society of Plastics Engineers


Abstract Purpose: Hereditary Spastic Paraplegia (HSP) is an inherited nervous system disorder characterized by development of leg weakness, spasms and stiffness. While generally acknowledged that health and social care services can minimise symptoms and improve quality of life, there is a lack of research exploring this from the perspective of people affected by HSP. This qualitative study explored the users and providers experience of using rural services. Method: Focus groups and interviews were undertaken of people with HSP (n = 14), carers (n = 6) and professionals (n = 12), to describe their experience of service provision and to suggest improvements for care. These were taped, transcribed and analysed. Results: Four themes emerged: (1) Diagnosis, symptoms and finding support; (2) Therapy, treatment and the delivery of care; (3) Managing the disease together; and (4) The way forward. Conclusions: Rehabilitation and support for self-management is valued by those affected with HSP throughout the disease trajectory from diagnosis onwards. Key to this is the development of a partnership approach which includes carers. Single point, well-informed, gatekeepers may enhance the coordination and delivery of care in rural areas. These findings underline current guidance promoting a holistic approach for people with neurological conditions. Implications for Rehabilitation People with HSP see as a high priority the need for additional neuro-physiotherapy services and emotional support services. Single point, well-informed, gatekeepers are essential to coordinate care, especially with rare diseases. Health professionals need more education and training about the disease process and its consequences for people affected by HSP, including the carer burden. People with HSP require better self-management advice, information and support.


During the Second World War aeronautical technology gathered rapid pace. By 1945, bombers had not only greatly increased in engine power and range, but the bombs which they carried rose from 250lbs to 10 tons; the navigator's pencil and rubber of 1939 had been supplemented by infinitely more sophisticated electronic aids. Yet the success or failure of each and every bomber still depended entirely on the efficiency of every member of the crew at his individual position, the interaction and co-operation of all crew members as a body. One member of 617 squadron graphically explained that 'every time we went out, it was seven men against the Reich'. Drawing on letters, journals and diaries, John Sweetman examines the lives the bomber crews lived, from the highs and lows of their missions to the complexities of their friendships and the impact their place in the war had on the families and loved ones they left behind. Part collective biography, part military history, part social history: this will remain the definitive account of the bomber crews of the Second World War for years to come.


A case of Celestin tube obstruction in a 57-year old patient is presented. Obstruction in this case was secondary to three mechanisms: distal mucosal prolapse, intraluminal suture web and food impaction. Prosthetic intraesophageal devices are subject to a number of complications, obstruction being the most frequent. A review of various types of prosthetic tube obstruction are given with emphasis on food impaction. Correct technic on tube insertion and dietary guidance are the best means of insuring tube patency. Guidelines for treating food impaction before endoscopic retrieval are suggested. Papain solution should be taken orally, first. If this is unsuccessful, nasogastric suction over the obstruction and local instillation of papain solution should be the next step. Finally, endoscopic confirmation of the obstruction is performed followed by gentle pulsion on the obstructing particle with a flexible cytology brush.


Numerous efforts have been devoted to capability improvement and cycling stability in the past decades, and these performances have been significantly enhanced. Low initial coulombic efficiency is still a problem in the metal sulfide-based anode materials. This study developed a strategy to achieve high initial coulombic efficiency and superior capacity retention by interpenetrating binary metal sulfides of SnS and MoS2 in a conductive carbon matrix. The synergy ascension of electrochemical performances for the metal sulfides is attributed to their mutual impeding effects on coarsening of metal grains and the capsule-shaped coating structure embedded in the carbon sheet architecture. The SnS/MoS2/C composite was prepared by a simple NaCl template-assisted ball milling method, and showed excellent electrochemical performances in terms of a high initial coulombic efficiency up to 90.2% and highly stable reversibility with a specific capacity of 515.4 mA h g−1 after 300 cycles at 1.0 A g−1. All of these characteristics suggest that the proposed materials are superior among the previously reported metal sulfide-based anode materials for lithium-ion batteries.


Objectives To describe the confidence and training experience acquired during rheumatology training in 21 core competences across the different European countries. Methods As part of a European project to evaluate the differences and similarities in training in rheumatology across Europe, we developed an online survey to assess the training experience. The target population was trainees in rheumatology and rheumatologists certified in the past 5 years. We selected 21 competences, core to rheumatology clinical practice, from the UEMS European curriculum framework (1). For each competence, respondents were asked to assess the confidence in their abilities (0-10 numerical rating scale), the existence of formal education (yes/no), the exposure to patients (0; 1-10; 11-50; 51-100; 101-150; >150) and the existence of an assessment (yes/no) where appropriate. All questions referred to the training period. The survey (June-December 2014) was disseminated in each country by a national PI. Results We gathered 1433 answers to the survey of which 1243 could be included in the analysis (28% of overall target population). Respondents came from the 41 EULAR countries with rheumatology training (30% male, 58% trainees). A summary of the results is presented in Table 1. For any given competence, mean confidence was higher in respondents who had received formal education than in those who had not. Similarly, for all clinical competences and rheumatologic techniques, mean confidence was also higher amongst those who had a higher patient exposure during their training that in those who managed ≤10 patients with that given disease. Mean acquired confidence was also higher in respondents who had a longer training period (internal medicine plus rheumatology) than in those with a shorter training period for all competences except osteoporosis and hand Xray interpretation. The level of confidence was also higher for specialists (vs trainees). Conclusions The acquired confidence in competences during the rheumatology training program considered core for rheumatology practice is variable, but overall reasonably high. Most of the trainees seem to receive formal education and have some patient exposure in all competences, though only around half are assessed in each competence. References European Board of Rheumatology (a section of UEMS). The European Rheumatology Curriculum Framework. www://dgrh.de/fileadmin/media/Praxis_Klinik/european_curriculum_uems_april_2008.pdf Disclosure of Interest None declared


The package-induced stress in a transfer molded piezoresistive pressure sensor has been measured by monitoring the individual piezoresistors in the measuring bridge. Based on measurements on six different samples, the induced difference between longitudinal and transversal stress in the sensor diaphragm has been measured as MPa at room temperature. The induced stress creates thermal zero shift and long term drift of the sensor signal. By covering the sensor chip with a low modulus glob top before molding, the stress and thermal zero shift may be considerably reduced.


The 16S rRNA gene sequences were determined for type strains of 21 Bifidobacterium species. A phylogenetic tree was constructed using the determined sequences and sequences from DNA databases, which contain the sequences of 11 type strains of Bifidobacterium species and 11 strains of related genera. All species of the genus Bifidobacterium and Gardnerella vaginalis ATCC 14018 belonged to a cluster phylogenetically distinct from the other genera. The cluster was divided into two subclusters: subcluster 1 composed of most species of Bifidobacterium and G. vaginalis, and subcluster 2 consisting of two species, B. denticolens and B. inopinatum; both of which were isolated from human dental caries. In the genus Bifidobacterium, four groups of species are known to be moderately to highly related by DNA‐DNA hybridization. The four groups of species exhibited more than 99% similarity among their 16S rDNA sequences within each group. These results indicated that species with around 99% or more similarity in their 16S rDNA sequences should be confirmed for species identities.


In highly constrained settings, e.g., a tentacle-like medical robot maneuvering through narrow cavities in the body for minimally invasive surgery, it may be difficult or impossible for a robot with a generic kinematic design to reach all desirable targets while avoiding obstacles. We introduce a design optimization method to compute kinematic design parameters that enable a single robot to reach as many desirable goal regions as possible while avoiding obstacles in an environment. We focus on the kinematic design of piecewise cylindrical robots, robotic manipulators whose shape can be modeled via cylindrical components. Our method appropriately integrates sampling-based motion planning in configuration space into stochastic optimization in design space so that, over time, our evaluation of a design's ability to reach goals increases in accuracy and our selected designs approach global optimality. We prove the asymptotic optimality of our method and demonstrate performance in simulation for (i) a serial manipulator and (ii) a concentric tube robot, a tentaclelike medical robot that can bend around anatomical obstacles to safely reach clinically-relevant goal regions.


The Ratu Boko site is a cultural heritage that has a high historical value and located about 30 kilometers to the east of Yogyakarta. Instability of the slope occurred due to the Yogyakarta earthquake in 2006, and it was indicated by the occurrence of cracks in the resto building that built on the top of the hill. The first reinforcement of the columns and foundations of the outside building was used a reinforced concrete that built-in 2012. The similar reinforcement on the inside building column and foundation was finished in 2017. In this research the displacement of the reinforced foundation, and slope stability generally both in safety factor and deformation were evaluated. The deformation and displacement analysis of the foundation were solved using Finite Element Analysis. On the other hand, for the safety factor of the slope, Limit Equilibrium Method was used. The simulation is divided into several stages, starting from the existing condition, after the first and second reinforcement, and also after increasing load due to development plan. Based on the numerical simulation, the horizontal displacement on the foundation of Plaza Andrawina decreases after the first and second reinforcement was installed. The horizontal displacement is significantly decreased in both foundations for 9.44 mm and 8.03 mm. Furthermore, the safety factor of the slope increases after the first and second reinforcement was installed. The slope safety factor using a maximum acceleration of 0.30g is 1.318. These obtained results are relatively safe from slope failures


The relationship between estrogen receptor(R) binding by uterine nuclei and uterotrophic responses was examined. Immature rats received a single injection of estradiol (E2) or estriol (E3) and the following parameters were measured: accumulation and retention of the estrogen receptor by the nuceus of uterine cells; incorporation of 14C-glucose into CO2 lipid, protein and RNA; RNA polymerase activity; water imbibition and increased dry weight. E2 and E3 were of equal potency with regard to the rapid accumulation of R by the nucleus but differed with respect to long term retention of R. The concentrations of nuclear RE2 and RE3 complexes were equivalent between 1 and 3 hr after estrogen injection; however, by 6 hr RE2 remained significantly elevated while RE3 levels had fallen to control values. E2 and E3 were also of equal potency with respect to the stimulation of enhanced glucose utilization, water imbibition, the incorporation of 14C-glucose into lipid, protein and RNA 3 hours following an injection of the hormone. Likewise the activity of RNA polymerase was equally stimulated by E2 and E3 3 hr after injection. Thus all early uterotropic responses (0-3 hrs) that were measured were equally stimulated by E2 and E3. However, E3 failed to stimulate true uterine growth (increase dry weight 24 hr after injection), whereas E2 produced a significant stimulation of true uterine growth. These data suggest that the RE complex is capable of stimulating early uterotrohic events regardless of which estrogen is present; however, in order to produce true uterine growth the RE complex must be retained in the nucleus for long periods of time. This proposal was tested by the administration of repetitive injections of E3. This treatment resulted in an increase in dry weight that was equivalent to the growth that was produced by repetitive injections of E2. These results demonstrate that E2 and E3 elicit early uterotrophic responses with equal facility following a single injection but that only E2 causes true uterine growth. The ability of E2 to stimulate true uterine growth appears to be related to the time of residence of the RE complex in the nucleus.


We have derived the general solution of a wave equation describing the dynamics of two-layer viscoelastic polymer materials of arbitrary thickness deposited on solid (quartz) surfaces in a fluid environment. Within the Voight model of viscoelastic element, we calculate the acoustic response of the system to an applied shear stress, i.e. we find the shift of the quartz generator resonance frequency and of the dissipation factor, and show that it strongly depends on the viscous loading of the adsorbed layers and on the shear storage and loss moduli of the overlayers. These results can readily be applied to quartz crystal acoustical measurements of the viscoelasticity of polymers which conserve their shape under the shear deformations and do not flow, and layered structures such as protein films adsorbed from solution onto the surface of self-assembled monolayers.


Abstract The Nursing Students' Clinical Stress Scale, a Likert-type survey by Whang (2002), translated from Korean into English, was used to identify perceptions of stress in baccalaureate nursing students. Data was collected from a convenience sample of baccalaureate nursing students at a Midwestern university. Students ranked their perceived stress level from clinical situations. One open-ended item asked students to describe their most stressful clinical experience. Rasch Model analysis/diagnostics were used to check the instrument for validity and reliability. Quantitative data were analyzed for descriptive statistics (means). Information from open-ended question was analyzed for themes. Qualitative themes were consistent with results from quantitative analysis and well-aligned with the literature. Students were stressed by incivility by healthcare staff and instructors, inconsistencies and time constraints. Research shows that stress can interfere with learning. It is imperative to determine causes of stress so educators can help decrease stress and improve student learning.


Food prices in Belgium are higher and rise faster than in its neighbouring countries. This can be verified from Eurostat databases, and has been noticed as part of the European Semesters. During the past few years, the phenomenon of price differntials has been studied at the Belgian and the international level. From these studies can be deduced that the causes are manifold, but that there are also factors that work out favourably in Belgium. Four factors that seem to be outstanding in Belgium: the small economic-geographic scale in combination with the bilingualism, wholesale prices, labour cost and the strategy of certain store chains.


A large number of Brain-Computer Interfaces (BCIs) are based on the detection of changes in sensorimotor rhythms within the electroencephalographic signal [1]. Moreover, motor imagery (MI) modifies the neural activity within the primary sensorimotor areas of the cortex in a similar way to a real movement [2]. In most MI-based BCI experimental paradigms, subjects realize a continuous MI, i.e. one that lasts for a few seconds, with the objective of facilitating the detection of event-related desynchronization (ERD) and event-related synchronization (ERS) [3]. Currently, improving efficiency such as detecting faster a MI is a major issue in BCI to avoid fatigue and boredom. In this regards, a recent article showed that a brief intention of movement corresponding to a 2s-MI, leads to more informative ERS features than continuous motor imageries [4]. Thus, in this study, we are investigating differences between continuous MIs and discrete, i.e. simple short, MIs. Material, Methods and Results: 17 healthy subjects carried out real movements, discrete and continuous MIs, in the form of an isometric flexion movement of their right hand index finger. Each subject realized first a session of real movements, and then a discrete and a continuous sessions of motor imageries in a randomized order. Each session is divided into runs for a total number of 100 trials. Beeps were used as go and stop signals. Finally we computed ERD/ERS% for 9 electroencephalographic channels (FC3, C3, CP3, FCz, Fz, CPz, FC4, C4, CP4) using the " band power method " [3] (Fig. 1), topographic and time-frequency representations. Figure 1. Grand average (n = 17) ERD/ERS% curves estimated for the real movement (blue), the discrete motor imagery (red) and the continuous motor imagery (black) within the beta band (18-25 Hz) for electrode C3.


IntroductionEarly in the pandemic, 26% of UK COVID-19 hospitalised patients died, often with high symptom burden. However the needs of non-COVID patients also had to be met. We describe the experiences of one hospital SPCT and lessons learnt.MethodsRetrospective case series review of all patients referred to SPCT (COVID (C) & non-COVID (NC)) in 1st & 2nd pandemic phases. Variables collected: demographic/clinical data, AKPS/POI, outcomes.Semi-structured anonymised online survey of SPCT regarding working experiences/needs during both phases.Summary statistics describe 1st and 2nd phases and compare data between phases (and with same time period year before COVID).ResultsTotal of 1159 (863NC/296C) patients in 2nd phase (Sep 20-Feb 21);this compares with total 956 same time year before and an increase from 904 (856NC/48C) in 1st phase (Mar-Aug 20). SPCT were involved in six times the number of patient episodes in second phase compared with first phase (296 vs. 48) and in 46% of all acute hospital COVID deaths (increase from 30% involvement in first phase). Mean AKPS was 26% in 1st phase, with 80% dying compared with AKPS 18% and 82% dying in 2nd phase. Mean caseload duration 4.1 vs. 2.3 days (1st/2nd phases). Nearly half (5/11, 46%) of team self-isolated during second phase compared with 1/3rd in first phase. Second phase team experience changed with more referrals and more symptomatic dying patients who were rapidly deteriorating. First phase helped second phase with team confidence in managing patients and preparation, but the team highlighted high caseload/symptom burden and personal impact. Improvements instituted include daily cross-site SPCT morning meetings, 7-day CNS service, flexibility using virtual meetings and measures sustaining team wellbeing.ConclusionsSPCT were busy with COVID patients whilst still supporting numbers of Non-COVID patients. Future focus centered on sustaining work flexibility and team wellbeing.


An unprecedented method for the regioselective synthesis of 1,3-diaryl 4-alkyl pyrazoles has been reported. A wide variety of 1,3-diaryl 4-alkyl pyrazoles were synthesized as a single regioisomer via a ring-opening cyclization reaction of unsaturated pyrrolinium ions in the presence of arylhydrazines. This method avoids using additional alkylation steps and hazardous oxidants that generally are essential for the synthesis of 4-alkyl N-arylpyrazoles.


Dichloroanilines (DCAs) and dichloronitrobenzenes (DCNBs) are important chemical intermediates in the manufacture of a wide variety of industrial, agricultural, and pharmaceutical agents and have been found to induce nephrotoxicity in vivo and/or in vitro. CAs may also be metabolized to CNBs and vice versa. Among the DCNBs, 3,5-dichloronitrobenzene (3,5-DCNB) was the most potent nephrotoxicant in renal cortical slices. The current study was designed to explore the nephrotoxicity of 3,5-DCNB and its possible renal biotransformation using isolated renal cortical cells (IRCC) as the in vitro model. Briefly, IRCC (~4.0 million cells/ml, 3 ml) from male Fisher 344 rats were treated with DMSO (vehicle control) or 3,5-DCNB (0.5 or 1.0 mM), and cytotoxicity determined over 90 min by measuring lactate dehydrogenase release. In some experiments, a pretreatment was added before 3,5-DCNB (1.0 mM) followed by 60 min incubations. The pretreatments were antioxidants, cytochrome P450 (CYP) inhibitors, a cyclooxygenase inhibitor, a peroxidase inhibitor or flavin monooxygenase (FMO) inhibitors. All antioxidants and metabolizing enzyme inhibitor pretreatments completely or partially attenuated 3,5-DCNB cytotoxicity. These results suggest that the bioactivation of 3,5-DCNB is complex, as inhibition of enzyme systems as different as CYPs, FMOs, cyclooxygenase and peroxidases can provide some cytoprotection. It can also be concluded that free radicals play a role in 3,5-DCNB nephrotoxicity either via participating in the in vitro renal biotransformation of 3,5-DCNB or via being produced as a consequence of 3,5-DCNB biotransformation. Additional studies are needed to ascertain which pathways are critical for 3,5-DCNB nephrotoxicity. Supported by NIH Grant P20GM103434.


The principles of the construction and operation of a digital synthesizer for direct frequency synthesis with acceleration of computational operations by using a residual class system (RNS) are considered. The specifics of the implementation of the operation of direct and inverse transformations from the positional number system to the number system of the residual classes are described. A mathematical model of a synthesizer with a phase accumulator in the system of residual classes is considered. The ways of designing a digital synthesizer of direct synthesis with a phase accumulator in the RNS system and a sinusoidal DAC are considered. In traditional schemes, the conversion of residuals to the value of an analog signal occurs in several stages, where conversion to a binary system is one of the stages. This procedure degrades the speed of the RNS system, adding additional constraints and increasing the waiting time for the conversion result. Methods of converting from RNS to binary number system for basic operations are considered. A DDS design with a phase accumulator in the residual class system and a converter to an analog signal form without using a slow ROM is proposed. The problems of efficient use of the synthesizer crystal area and reduction of delays in the formation of the output signal are considered. A study of one of the main functional blocks of a direct digital frequency synthesizer, a digital-to-analog converter, has been carried out. The architecture of a direct digital frequency synthesizer with a DAC direct conversion from a non-positional number system to an analog signal is proposed. The main sources of noise generation in digital computational synthesizers of the proposed type are investigated. A mathematical model is proposed for calculating the power spectral density of phase noise, which will allow analyzing the noise characteristics in synthesizers built on the indicated principles.


Background : Intraplaque neovascularization in carotid artery plaque was assessed using contrast-enhanced ultrasonography (CEUS) and then the patient underwent carotid endarterectomy (CEA). Significant contrast flow was detected in the plaque and the findings from a pathological specimen are discussed. Case : Asymptomatic severe left-sided carotid stenosis was detected by ultrasonography (US) in a 71-year-old man, and the patient underwent CEA. We assessed the contrast effects of perflubutane over time in CEUS. A pathological specimen of plaque selected during CEA was stained with Masson's trichrome and immunostained using CD34 and CD146. Considerable inflow of contrast from the lumen to the plaque was observed on CEUS, and the plaque was entirely enhanced with contrast agent over time. The pathological findings of the specimen excised by CEA showed a connection between the vessel lumen and nearby neovascularization throughout the plaque. Conclusion : The inflow of contrast agent into the plaque on CEUS corresponded with a histopathological find-ing of the neovascularization.


Aim: To evaluate the bone mineral density at lumbar spine and at femoral neck in a group of young adults in whom Graves' disease developed during childhood and adolescence. Patients and Methods: We examined 28 patients (5 male, 23 female, age 20.9 ± 3.3 years) who were 11.8 ± 2.9 years old at the onset of Graves' disease. They were treated either with methimazole (14 patients) or with methimazole plus l-thyroxine (14 patients). At the time of the investigation, 13 patients were considered cured following antithyroid treatment, 2 were still on antithyroid drugs, 3 were on replacement therapy with l-thyroxine because of hypothyroidism, and 10, treated either surgically or with 131I, were on replacement therapy. The bone mineral density was measured at the lumbar spine (L2–L4) and at the femoral neck, using dual-energy X-ray absorptiometry. Results: The spinal bone mineral density SD score was –0.28 ± 1.02, the femoral neck bone mineral density SD score was 0.36 ± 1.02, and both were not different from zero (NS). We did not find any correlation between the bone mineral density of the femoral neck and that of the lumbar spine and the clinical parameters. Conclusion: Graves' disease, beginning in childhood and adolescence, when appropriately treated, does not affect attainment of peak bone mass.


With the purpose to see what role is played by spleen in experimental thrombocytopenic purpura the author injected anti-platelet serum into the splenectomized guinea pig and studied whether or not such splenectomy would affect the function of megakaryocytes by means of bone-marrow tissue culture. 1. When the guinea pig is subjected to splenectomy, thrombocytes in the peripheral blood tend to increase slightly in number. 2. When the bone-marrow of the splenectomized guinea pig is studied by bone-marrow tissue culture an increase of megakaryocytes in number can be observed but such an operation has no effect on the megakaryocyte function. 3. When the anti-platelet serum is injected into the splenectomized guinea pig, a remarkable decline in number of thrombocytes is recognized, but its degree and the decrease in the function of megakaryocytes are somewhat lesser than those observed in the case of the normal guinea pig injected with the same serum. 4. In the bone-marro tissue culture of the splenectomized guinea pig injected with anti-platelet serum, the number of appearing megakaryocytes somewhat increases and the megakaryocyte function slightly decreases as compared to those in the case of the splenectomized guinea pig without such an injection. 5. Judging from the above results, the spleen might slightly affect the decline in number of thrombocytes and the decreased function of megakaryocytes by anti-platelet serum.


We consider prophet inequalities subject to feasibility constraints that are the intersection of $q$ matroids. The best-known algorithms achieve a $\Theta(q)$-approximation, even when restricted to instances that are the intersection of $q$ partition matroids, and with i.i.d.~Bernoulli random variables. The previous best-known lower bound is $\Theta(\sqrt{q})$ due to a simple construction of [Kleinberg-Weinberg STOC 2012] (which uses i.i.d.~Bernoulli random variables, and writes the construction as the intersection of partition matroids). We establish an improved lower bound of $q^{1/2+\Omega(1/\log \log q)}$ by writing the construction of [Kleinberg-Weinberg STOC 2012] as the intersection of asymptotically fewer partition matroids. We accomplish this via an improved upper bound on the product dimension of a graph with $p^p$ disjoint cliques of size $p$, using recent techniques developed in [Alon-Alweiss European Journal of Combinatorics 2020].


Abstract A growing body of mathematics education research points to the importance of fostering students' mathematical creativity in undergraduate mathematics courses. However, there are not many research-based instructional practices that aim to accomplish this task. Our research group has been working to address this issue and created a formative assessment tool, the Creativity-in-Progress Rubric (CPR) on Proving. This tool is developed to help students evaluate their own proving process, as well as provide instructors insight into students' self-evaluation and process. In this paper, we provide a brief description of the CPR on Proving and explain its implementation in two courses at different institutions. Additionally, we share several students' usages of the CPR and provide some practical implementation suggestions.


Despite significant improvements in clinical management, pancreatic cancer (PC) remains one of the deadliest cancer types, as it is prone to late detection with extreme metastatic properties. The recent findings that pancreatic cancer stem cells (PaCSCs) contribute to the tumorigenesis, progression, and chemoresistance have offered significant insight into the cancer malignancy and development of precise therapies. However, the heterogeneity of cancer and signaling pathways that regulate PC have posed limitations in the effective targeting of the PaCSCs. In this regard, the role for K-RAS, TP53, Transforming Growth Factor-β, hedgehog, Wnt and Notch and other signaling pathways in PC progression is well documented. In this review, we discuss the role of PaCSCs, the underlying molecular and signaling pathways that help promote pancreatic cancer development and metastasis with a specific focus on the regulation of PaCSCs. We also discuss the therapeutic approaches that target different PaCSCs, intricate mechanisms, and therapeutic opportunities to eliminate heterogeneous PaCSCs populations in pancreatic cancer.


The new design of patch antenna with complementary split-ring resonators (CSRRs) and reactive impedance surface (RIS) is presented in this paper. The meta-resonator (CSRRs) and the meta-surface are able to miniaturize the antenna size. This antenna is designed, including a circularly-polarized antenna.


Nowadays the research is focused on ecological friendly catalysts to be used in dyes decolourisation as an important target in the textile industry. In the presented work some copper complexes were prepared by immobilization of Cu (II) on the chitosan matrix. The oxidation of model acid dye ANTD (anthraquinone dye) with hydrogen peroxide catalyzed by these Cu complexes has been investigated and the kinetic of ANTD oxidation was measured. It was found, that the reactivity of catalyst was in the relation with the amount of copper incorporated in the complex. The rate of the oxidative reaction depends also on the concentration of hydrogen peroxide in the reaction solution. Prepared copper complexes were compared in the dye decolourisation efficiency. In the best reaction conditions the anthraquinone dye decolourisation was over 95 %. Obtained results leads us to assume that heterogeneous redox catalysis process could be relatively easy, cheap and useful way to remove textile dyes from wastewater effluents.


In lactating albino mice, the transepithelial mammary transport of Na+, K+ and water was studied during normal and changed intervals between suckles. The formation of ion and water contents of the mice milk usually occurs in 2 stages N first, all Na+, 1/4 K+ and 1/3 water contents in ready milk enter the secret of mammary gland; second, the Na+ in milk is stopped and net flow of K+ and water is 3- and 2-fold higher than during first stage.


Although the vision-and-language pretraining (VLP) equipped cross-modal image-text retrieval (ITR) has achieved remarkable progress in the past two years, it suffers from a major drawback: the ever-increasing size of VLP models restricts its deployment to real-world search scenarios (where the high latency is unacceptable). To alleviate this problem, we present a novel plug-in dynamic contrastive distillation (DCD) framework to compress the large VLP models for the ITR task. Technically, we face the following two challenges: 1) the typical uni-modal metric learning approach is difficult to directly apply to the cross-modal tasks, due to the limited GPU memory to optimize too many negative samples during handling cross-modal fusion features. 2) it is inefficient to static optimize the student network from different hard samples, which have different effects on distillation learning and student network optimization. We try to overcome these challenges from two points. First, to achieve multi-modal contrastive learning, and balance the training costs and effects, we propose to use a teacher network to estimate the difficult samples for students, making the students absorb the powerful knowledge from pre-trained teachers, and master the knowledge from hard samples. Second, to dynamic learn from hard sample pairs, we propose dynamic distillation to dynamically learn samples of different difficulties, from the perspective of better balancing the difficulty of knowledge and students' self-learning ability. We successfully apply our proposed DCD strategy to two state-of-the-art vision-language pretrained models, i.e. ViLT and METER. Extensive experiments on MS-COCO and Flickr30K benchmarks show the effectiveness and efficiency of our DCD framework. Encouragingly, we can speed up the inference at least 129$\times$ compared to the existing ITR models.


Buried ground water is very indispensable because it is major sources for the uses of humans, animals, industry and domestic purposes. The presence of pathogenic bacteria in drinking water is one of the great issues now-adays. The present article summarizes the dangerous effects, common methods of detection, recent outbreaks and possible plan to control the contamination of various common bacteria in drinking water to alert general public to be safe and healthy.


Performance of calves fed milk replacer until 56 days of age Thirty male Holstein calves were designed to two groups, kept in pasture since they were five days, and they were fed with commercial pelleted starter concentrate, and whole milk (control group) or milk replacer made with soy protein, wheat milk and whey (treatment group), in one hour a day, until 56 days. The calves had access ad libitum to water and mineral salt. Everyone was weighted weekly, and measured. The stature development didn't differ between treatments, but the weight gains were minor for the calves fed with milk replacer , what reflected on their body scores. The body weight gain was affected by the consume of concentrate, and by the dry matter of the liquid diet, because of the decantation of this product occurred during the supply.


Abstract Introduction  Pediatric traumatic brain injury (TBI) is a significant cause of death and long-term disability. There is a paucity of data on quality of life in survivors of pediatric TBI. The aim of this study is to determine the factors affecting the quality of life after TBI in children. Methods  Consecutively admitted 104 of 156 patients to the pediatric intensive care unit (PICU) with TBI between 1 month and 18 years were included in the study. Demographics were obtained from electronic records. Injury severity and mortality scores were calculated. The Pediatric Quality of Life Inventory (PedsQL) scale and Glasgow Outcome Scale (GOS) score were evaluated by interview with patient or the caregiving parents. The Rotterdam computed tomography (CT) score was calculated from the radiology images taken within the first 24 hours after admission to the emergency service. Results  Severe TBI, multiple trauma, intracranial hemorrhage from multiple sites, convulsions, high intracranial pressure, emergency operation on admission, and hypotension on admission were associated with low PedsQL values according to results of univariate analysis ( p  < 0.05). There was a negative correlation between PedsQL and GOS, mechanical ventilation duration, PICU length of stay (LOS), and hospital LOS. In the linear regression model made by considering the univariate analysis results, it was shown that Rotterdam CT score and PICU LOS are independent variables that determine low PedsQL score. PedsQL scores were lower in children ≥ 8 years of age and in those evaluated within the first year after discharge ( p  = 0.003). Conclusion  In pediatric TBI, Rotterdam CT score and PICU LOS were found as independent variables determining PedsQL score after discharge.


Previously, we have shown that thin-film freeze-drying can be applied to prepare dry powders of bacteria such as Lactobacillus acidophilus. Herein, we tested the viability of L. acidophilus in thin-film freeze-dried powders (TFF powders) filled in delayed-release vegetarian capsules in a simulated gastric fluid (SGF) consisting of 0.1N hydrochloric acid and sodium chloride. Initially, we determined the water removal rate from frozen thin films on relatively larger scales (i.e., 10–750 g). We then prepared and characterized two TFF powders of L. acidophilus with either sucrose and maltodextrin or sucrose and hydroxypropyl methylcellulose acetate succinate (HPMC-AS), a pH-sensitive polymer, as excipients and evaluated the viability of the bacteria after the TFF powders were filled in delayed-release vegetarian capsules and the capsules were incubated in the SGF for 30 min. On 10–750 g scales and at the settings specified, water removal from frozen thin films was faster than from slow shelf-frozen bulk solids. When the L. acidophilus in sucrose and HPMC-AS TFF powder was filled into a delayed-release capsule that was placed into another delayed-release capsule, the bacterial viability reduction after incubation in the SGF can be minimized to within 1 log in colony forming unit (CFU). However, for the L. acidophilus in sucrose and maltodextrin TFF powder, even in the capsule-in-capsule dosage form, bacterial CFU reduction was > 2 logs. TFF powders of live microorganisms containing an acid-resistant material in capsule-in-capsule delayed-release vegetarian capsules have the potential for oral delivery of those microorganisms.


An open labeled randomized clinical study on 'VALI AZHAL KEEL VAYU' with reference to its Aetiology, Pathogenesis, Clinical features, diagnosis, investigations and treatment were conducted at Department of Pothu Maruthuvam, Government Siddha Medical College and Hospital, Palayamkottai.
This clinical study of Vali Azhal Keel Vayu is done on the basis of reference in Sabapathi manuscript in Noinadal, Noi mudhal naadal Thiratu Part-II, Pg. No. 623. The disease is correlated with Rhematioid arthritis.
The trial drug chosen for the clinical study – AKKINI CHOORANAM Dosage of 4.2 gms twice a day with sugar after food (Ref. Koshayi Anuboga Vaithiya Bramma Ragasiyam Part – II, Pg. No. 104).
The aetiology, pathology, pathogenesis, clinical features, classification and prognosis of the disease were collected from a number of literatures both in Siddha system as well as in modern system of medicine.
For this study, Out of 40 patients, 20 patients were diagnosed clinically and admitted in the In patients ward and treated with trial medicines. Another twenty patients was treated Out patients department.
The selection of patients and management of patients during admission and after treatment is carried out under the supervision of Professor, Associate Professor, Lecturers of Department of Pothu Maruthuvam.
A case sheet proforma is prepared with particulars focus on Siddha and Modern clinical parameters.
Separate cases sheets were maintained for each patient in In-patient ward and their vital signs and symptoms were monitored and recorded daily. The patients were treated with the trial drug AKKINI CHOORANAM.
Routine blood examinations, Urine analysis, other specific investigations and radiological investigations were done by modern scientific methods and were considered for diagnosis and to follow the progress of the patients.
Siddha diagnosis is made up with the help of Ezhu Udal Kattugal and Envagai Thervugal.
Since Vali Azhal Keel Vayu is a chronic disease, it requires treatment for minimum thirty days to minimize the severe pain, tenderness and swelling with slight disappearance of stiffness. The patient is advised to follow up the treatment in Out patient Department.
From this study the following datas were clear that disease was more common in female than male. Maximum incidence was in Pitha Kaalam. Clinically marked reduction in the symptoms along with increase sense of well being, decrease in ESR, decrease in symptoms, decrease in the DISEASE ACTIVITY PAIN SCORE OF 28 JOINTS was noted.
The patients were observed for a period of 3 months during and after the course of treatment. No signs of complications were observed. Clinically no toxic effects were noticed during the treatment period. The pharamacological evaluation of AKKINI CHOORANAM showed significant anti inflammatory and analgesic activity. No acute toxicity, side effects were noted.
Bio chemical analysis of AKKINI CHOORANAM showed the presence of calcium, sulphate, chloride, ferrous iron, starch, tannic acid, amino acids and unsaturated compound.
CONCLUSION:
In Sabapathy Manuscript was described under Vali Azhal Keel Vayu explains the clinical conditions as rheumatoid arthritis. The lines of this version are well analysed under Siddha and modern parameters and the cases are thoroughly examined with clinical and bio chemical report.
Treatment is given on the basis of Mukkutra Theory. The deranged kutrams are made to normal by the trial medicine.
The trial medicine, AKKINI CHOORANAM has the taste of kaarupu, inippu according to the taste of individual ingredients.
Kaarpu suvai - Has its function of relieving indigestion, flatulence and constipation.
Inippu suvai - Regulates the vitiation of Vatham and Pitham.
Thus the trial drug based of its suvai acts as an effective anti-arthritic drug.
Almost all the cases treated with the trial drug shows considerable improvements.
Further follow up of all patients showed a significant relief of their symptoms.
1. 50% of Out patients and 60% of In patients showed Good response.
2. 30% of Out patients and 20% of In patients showed Moderate response.
3. 20% of Out patients and 20% of In patients showed Poor response.
I conclude that, this trial drug 'AKKINI CHOORANAM' has improved the clinical symptoms of the patients and assured them a better standard of living.


As a complex and critical cyber-physical system ( CPS ) , the hybrid electric powertrain is significant to mitigate air pollution and improve fuel economy. Energy management strategy ( EMS ) is playing a key role to improve the energy efficiency of this CPS. This paper presents a novel bidirectional long short-term memory ( LSTM ) network based parallel reinforcement learning ( PRL ) approach to construct EMS for a hybrid tracked vehicle ( HTV ) . This method contains two levels. The high-level establishes a parallel system first, which includes a real powertrain system and an artificial system. Then, the synthesized data from this parallel system is trained by a bidirectional LSTM network. The lower-level determines the optimal EMS using the trained action state function in the model-free reinforcement learning ( RL ) framework. PRL is a fully data-driven and learning-enabled approach that does not depend on any prediction and predefined rules. Finally, real vehicle testing is implemented and relevant experiment data is collected and calibrated. Experimental results validate that the proposed EMS can achieve considerable energy efficiency improvement by comparing with the conventional RL approach and deep RL.