BACKGROUND
People with urothelial carcinoma of the bladder are at risk for recurrence and progression following transurethral resection of a bladder tumour (TURBT). Mitomycin C (MMC) and Bacillus Calmette-Guérin (BCG) are commonly used, competing forms of intravesical therapy for intermediate- or high-risk non-muscle invasive (Ta and T1) urothelial bladder cancer but their relative merits are somewhat uncertain.

OBJECTIVES
To assess the effects of BCG intravesical therapy compared to MMC intravesical therapy for treating intermediate- and high-risk Ta and T1 bladder cancer in adults.

SEARCH METHODS
We performed a systematic literature search in multiple databases (CENTRAL, MEDLINE, Embase, Web of Science, Scopus, LILACS), as well as in two clinical trial registries. We searched reference lists of relevant publications and abstract proceedings. We applied no language restrictions. The latest search was conducted in September 2019.

SELECTION CRITERIA
We included randomised controlled trials (RCTs) that compared intravesical BCG with intravesical MMC therapy for non-muscle invasive urothelial bladder cancer.

DATA COLLECTION AND ANALYSIS
Two review authors independently screened the literature, extracted data, assessed risk of bias and rated the quality of evidence according to GRADE per outcome. In the meta-analyses, we used the random-effects model.

MAIN RESULTS
We identified 12 RCTs comparing BCG versus MMC in participants with intermediate- and high-risk non-muscle invasive bladder tumours (published from 1995 to 2013). In total, 2932 participants were randomised. Time to death from any cause: BCG may make little or no difference on time to death from any cause compared to MMC (hazard ratio (HR) 0.97, 95% confidence interval (CI) 0.79 to 1.20; participants = 1132, studies = 5; 567 participants in the BCG arm and 565 in the MMC arm; low-certainty evidence). This corresponds to 6 fewer deaths (40 fewer to 36 more) per 1000 participants treated with BCG at five years. We downgraded the certainty of the evidence two levels due to study limitations and imprecision. Serious adverse effects: 12/577 participants treated with BCG experienced serious non-fatal adverse effects compared to 4/447 participants in the MMC group. The pooled risk ratio (RR) is 2.31 (95% CI 0.82 to 6.52; participants = 1024, studies = 5; low-certainty evidence). Therefore, BCG may increase the risk for serious adverse effects compared to MMC. This corresponds to nine more serious adverse effects (one fewer to 37 more) with BCG. We downgraded the certainty of the evidence two levels due to study limitations and imprecision. Time to recurrence: BCG may reduce the time to recurrence compared to MMC (HR 0.88, 95% CI 0.71 to 1.09; participants = 2616, studies = 11, 1273 participants in the BCG arm and 1343 in the MMC arm; low-certainty evidence). This corresponds to 41 fewer recurrences (104 fewer to 29 more) with BCG at five years. We downgraded the certainty of the evidence two levels due to study limitations, imprecision and inconsistency. Time to progression: BCG may make little or no difference on time to progression compared to MMC (HR 0.96, 95% CI 0.73 to 1.26; participants = 1622, studies = 6; 804 participants in the BCG arm and 818 in the MMC arm; low-certainty evidence). This corresponds to four fewer progressions (29 fewer to 27 more) with BCG at five years. We downgraded the certainty of the evidence two levels due to study limitations and imprecision. Quality of life: we found very limited data for this outcomes and were unable to estimate an effect size.

AUTHORS' CONCLUSIONS
Based on our findings, BCG may reduce the risk of recurrence over time although the Confidence Intervals include the possibility of no difference. It may have no effect on either the risk of progression or risk of death from any cause over time. BCG may cause more serious adverse events although the Confidence Intervals once again include the possibility of no difference. We were unable to determine the impact on quality of life. The certainty of the evidence was consistently low, due to concerns that include possible selection bias, performance bias, given the lack of blinding in these studies, and imprecision.


Surgical resection or liver transplantation (LTx) are the only available treatments that offer a potential for long-term survival or cure in cases of hilar cholangiocarcinoma. Hilar resection in combination with partial hepatectomy and caudate lobectomy is regarded as the current treatment of choice. Overall 5-year survival rates range from 9% to 28%, and reach as high as 24-43% in R0 resections. Five-year survival rates in the very limited experience with LTx in hilar cholangiocarcinoma are not dramatically worse than those after resection. However, hilar cholangiocarcinoma is not at present an accepted indication for LTx given both the good results of LTx for benign diseases and the dramatic organ shortage. When compared with the prognosis of other gastrointestinal tumours, these survival rates are encouraging in the setting of an otherwise unresectable malignancy. As such, and considering the fact that it may represent the only possibility for cure, the general exclusion of patients with cholangiocarcinomas as candidates for LTx does not seem to be justified. Furthermore, recent advances in multimodal tumour therapy seem to be most promising in combination with LTx. Prospective studies are required to elucidate the influence of better patient selection and the role of multimodal treatments on the outcome of LTx in hilar cholangiocarcinoma. If the encouraging data achieved with neoadjuvant therapy prior to LTx are confirmed by further studies, we foresee that renewed interest in LTx for hilar cholangiocarcinoma could arise.


PURPOSE
To report spectral domain optical coherence tomography (OCT) findings of a patient who experienced bilateral visual loss after a motorcycle accident.

METHODS
A 51-year-old man presented to the emergency department complaining of bilateral visual loss after a motorcycle falling down. A complete ophthalmologic examination and OCT testing were made on the same day of the accident. Follow-up was made at 2 days, 2 weeks, 5 months, and 12 months adding central visual field assessment using Humphrey automated perimetry.

RESULTS
At presentation, best-corrected visual acuity was 20/200 in both eyes, anterior segment was normal, and fundus examination showed a bilateral macular edema confirmed by OCT. After 2 days, visual acuity recovered to 20/25. Optical coherence tomography findings showed foveal detachment, hyperreflective clump below external limiting membrane, and hyperreflectivity of Henle layer nasally to the fovea. After 15 days, visual acuity was 20/20, but vision was altered by a paracentral scotoma and some irregularities of OCT findings persisted. At 1 year of follow-up, best-corrected visual acuity was 20/20, and paracentral scotoma was very tiny in the right eye, whereas larger and deeper in the left eye. Optical coherence tomography was normal in the right eye, whereas some fragmentations of interdigitation zone were still evident in the left eye.

CONCLUSION
We report a case of bilateral whiplash maculopathy from vitreoretinal traction subsequent to road traffic accident. After 1 year of follow-up, visual acuity was restored but paracentral scotoma persisted. Optical coherence tomography appearance of the left eye was still abnormal.


Eosinophilic chronic rhinosinusitis (ECRS) symptoms include massive eosinophilic infiltration into nasal mucosa, nasal polyps, and curative resistance even postoperatively. How so many eosinophils migrate into nasal tissues is unclear, although infiltration is associated with intractability. Two factors considered potentially related are (1) increased eosinophils infiltration from blood vessels into tissue and (2) eosinophil "pools" in tissue due to age. During adherence in local eosinophil infiltration, vascular cell adhesion molecules (VCAM)-1 and alpha 4 beta 1 integrin (VLA-4) bind eosinophils selectivery. Tumor necrosis factor (TNF)-a or interleukin (IL)-4 stimulation increases VCAM-1 expression in vascular endothelial cells, multiplying nasal polyp fibroblasts. This, in turn, stimulates eosinophil infiltration. Eotaxin, a chemokine involved in eosinophil chemotaxis, is expressed significantly more highly in nasal polyp fibroblasts from those with ECRS in TNF-α and IL-4 costimulation than in those without ECRS. mRNA expression of IL-5, a cytokine important in eosinophil survival, is high in the nasal polyps of those with ECRS. The expression of tumor necrosis-factor-related apoptosis-inducing ligand (TRAIL), associated with eosinophil apoptosis, does not differ between those with and without ECRS, whereas that of TRAIL-R3 in peripheral blood eosinophils is higher in those with ECRS. High TRAIL-R3 expression suppresses eosinophil apoptosis. The above factors are, however, associated only partially with eosinophil infiltration, meaning that the mechanism must be further analyzed to clarify ECRS features and determine safe, effective treatment.


The detection of Flat Spectrum Radio Quasars (FSRQs) in the Very High Energy (VHE, E>100 GeV) range is challenging, mainly because of their steep soft spectra and distance. Nevertheless four FSRQs are now known to be VHE emitters. The detection of the VHE γ-rays has challenged the emission models of these sources. The sources are also found to exhibit very different behavior. I will give an overview of what is known about the VHE emission of these sources and about the multiwavelength signatures that are connected to the VHE gamma-ray emission.


BACKGROUND
Sudden, idiopathic sensorineural hearing loss is an acute dysfunction of the inner ear whose cause cannot be determined with the currently available methods of clinical diagnosis.

METHODS
This continuous medical education article is based on a selective review of the literature and on the revised S2 guidelines for acute sensorineural hearing loss of the Association of the Scientific Medical Societies in Germany (AWMF), which were issued on 28 January 2009.

RESULTS
Recent surveys in Germany suggest that the incidence of sudden, idiopathic sensorineural hearing loss may be as high as 300 per 100,000 persons per year. To distinguish this entity from acute hearing loss of other causes, special tests are necessary, including ear microscopy, pure-tone audiometry, and acoustic evoked response audiometry. No clinical trial of the highest evidence level has yet been published to document the efficacy of any type of treatment for sudden, idiopathic sensorineural hearing loss. Nonetheless, there is evidence from trials with lower levels of evidence, post-hoc analyses, and assessments of secondary endpoints of clinical trials indicating that plasma-expander therapy, the systemic and local (intratympanic) administration of cortisone, and the reduction of acutely elevated plasma fibrinogen levels may be beneficial.

CONCLUSION
Further clinical trials are needed to validate these preliminary results. Until clear data are available, the predicted benefit and risk of any proposed treatment for sudden, idiopathic sensorineural hearing loss should be discussed in detail with the patient before the treatment is begun.


Pholcid spiders (Araneae: Pholcidae), officially "cellar spiders" but popularly known as "daddy long-legs," are renown for the potential of deadly toxic venom, even though venom composition and potency has never formally been studied. Here we detail the venom composition of male Physocyclus mexicanus using proteomic analyses and venom-gland transcriptomes ("venomics"). We also analyze the venom's potency on insects, and assemble available evidence regarding mammalian toxicity. The majority of the venom (51% of tryptic polypeptides and 62% of unique tryptic peptides) consists of proteins homologous to known venom toxins including enzymes (astacin metalloproteases, serine proteases and metalloendopeptidases, particularly neprilysins) and venom peptide neurotoxins. We identify 17 new groups of peptides (U1–17-PHTX) most of which are homologs of known venom peptides and are predicted to have an inhibitor cysteine knot fold; of these, 13 are confirmed in the proteome. Neprilysins (M13 peptidases), and astacins (M12 peptidases) are the most abundant venom proteins, respectively representing 15 and 11% of the individual proteins and 32 and 20% of the tryptic peptides detected in crude venom. Comparative evidence suggests that the neprilysin gene family is expressed in venoms across a range of spider taxa, but has undergone an expansion in the venoms of pholcids and may play a central functional role in these spiders. Bioassays of crude venoms on crickets resulted in an effective paralytic dose of 3.9 µg/g, which is comparable to that of crude venoms of Plectreurys tristis and other Synspermiata taxa. However, crickets exhibit flaccid paralysis and regions of darkening that are not observed after P. tristis envenomation. Documented bites on humans make clear that while these spiders can bite, the typical result is a mild sting with no long-lasting effects. Together, the evidence we present indicates pholcid venoms are a source of interesting new peptides and proteins, and effects of bites on humans and other mammals are inconsequential.


We propose a new method for measuring the semantic similarity of genes based on path length between their annotation terms in the gene ontology. Our method applies an exponential transfer function to the average path length between two genes to compute their similarity. The non-linear measure ensures that the semantic similarity decreases with distance and proves to be quite competitive when compared to other measures. The advantage of the proposed measure is its simplicity and ease of implementation which gives it a great appeal in this domain. The measure uses only one feature (path length) for computing the similarity between genes. For validation purposes, we computed the similarity of genes from the Saccharomyces genome database (SGD) taking part in various cellular pathways. We analyzed 152 pathways from SGD and compared our similarity results with two of the leading measures. The proposed measure proved to be very competitive in all cases and the clustering results showed that our method is able to surpass the leading methods in certain cases.


In this paper, the system integration of an Advanced Planning and Scheduling (APS) system with Enterprise Resource Planning (ERP) and Manufacturing Execution System (MES) for a Semiconductor Backend Assembly environment is described. The company is one of the worldwide market leaders in semiconductor packaging technology. SIMTech was responsible for the implementation of the Planning & Scheduling functions through its APS application which is called Gintic Scheduling System (GSS). GSS system has been integrated with the other two key manufacturing software systems, namely ERP and MES, with the CIM framework. This paper emphasizes the system integration between the GSS and the customer's existing ERP and MES systems. The paper starts with a broader overview of the APS, ERP and MES systems with the focus on the linkage of APS with ERP and APS with MES. It then introduces the brief background information of the implementation and the integration methodology. Detailed work of the integration is laid out in the fond of integration model structure and illustrated by the system integration mechanism. Various data types that need to be integrated are also elaborated. Further discussions continue with the practical implementation issue like the required frequency of data integration and also the two approaches of data transfer. Finally the paper shares the experiences and lessons the team has learned through the implementation process and concludes the essence of the system integration work.


The main result of our efforts is the development and successful application of the theoretical model of laser induced plasma (LIP) that allows a back-calculation of the composition of the plasma (and the condensed phase) based on the observable plasma spectrum. The model has an immediate experimental input in the form of LIP spectra and a few other experimentally determined parameters. The model is also sufficiently simple and, therefore, practical. It is conveniently interfaced in a graphical user-friendly form for using by students and any laboratory personnel with only minimal training. In our view, the model opens up the possibility for absolute analysis, i.e. the analysis which requires no standards and tedious calibration. The other parts of this proposal (including plasma diagnostics) were somewhat subordinate to this main goal. Plasma diagnostics provided the model with the necessary experimental input and led to better understanding of plasma processes. Another fruitful direction we pursued was the use of the correlation analysis for material identification and plasma diagnostics. Through a number of computer simulations we achieved a clear understanding of how, where and why this approach works being applied to emission spectra from a laser plasma. This understanding will certainly improve the qualitymore » of forensic and industrial analyses where fast and reliable material identification and sorting are required.« less


Studies in healthy volunteers have been legalized since December 20th 1988 in France. The healthy volunteer is employed for a variety of studies in phases I and IV of drug development. This type of research can equally be called nontherapeutic in nature. Every experiment involving healthy volunteers should be approved by the Ethics Committee. Using volunteers within the department, company or other organisation, while offering advantages for the investigator should be prohibited as freedom of concept might not be safeguarded. As well, financial incentives may over-persuade individuals, including students, who have low incomes and promote the "professional volunteer". To avoid this problem, French law planned a national register. The potential benefits of such a disposition are still unknown. Having been given appropriate information concerning the drug trial, his obligations and rights, the healthy volunteer gives his written consent. Specific recommendations for nontherapeutic assessments of drug effects are given concerning prisoners, the mentally handicapped, women with a risk of frequency, children. Ethical considerations concerning research on a healthy population must go beyond the law recently promulgated in France.


We perform a variational analysis of an elastic membrane spanning a curve which may sustain bending and torsion. First, we deal with parametrized curves and linear elastic membranes proving the existence of equilibria and finding first-order necessary conditions for minimizers computing the first variation. Second, we study a more general case, both for the boundary curve and the membrane, using the framed curve approach. The infinite dimensional version of the Lagrange multipliers' method is applied to get the first-order necessary conditions. Finally, a numerical approach is presented and employed in several numerical test cases.


Osteotomies around the knee are traditionally templated on 2D plain X-rays. Results are often inaccurate and inconsistent and multiplanar osteotomies are hard to perform. The aim of this study is to evaluate the feasibility and accuracy of virtual three-dimensional CT-based planning and correct execution of osteotomies around the knee with the aid of patient specific surgical guides and locking plates. Eight consecutive patients with significant malalignment of the lower limb were included in the study. Pre-operative CT scans of the affected limb and the normal contra-lateral side were obtained and 3D models of the patient9s anatomy were created, using dedicated software. The healthy contralateral limb was mirrored and geometrically matched to the distal femur or proximal tibia of the healthy side. A virtual opening wedge correction of the affected bone was used to match the geometry of the healthy contralateral bone. Standard lower limb axes measurements confirmed correction of the alignment. Based on the virtual plan, surgical guides were designed to perform the planar osteotomy and achieve the planned wedge opening and hinge axis orientation. The osteotomy was fixed with locking plates and screws. Post-operative assessment included planar X-rays, CT-scan and full leg standing X-rays. One three-planar, three bi-planar and four single-plane osteotomies were performed. Maximum weightbearing mechanical femoro-tibial coronal malalignment varied between 7° varus and 14° valgus (mean 7.6°, SD 3.1). Corrective angles varied from 7°–15° (coronal), 0°–13° (sagittal) and 0°–23° (horizontal). The maximum deviation between the planned pre-operative wedge angle and the executed post-operative wedge angle was 1° in the coronal, sagittal and horizontal plane. The desired mechanical femorotibial axis on full-leg standing X-rays was achieved in 6 patients. Two patients were undercorrected by 1° and 2° respectively. Conclusion 3D planning and guided correction of multi-planar deformity of femur or tibia is a feasible and accurate novel technique.


In natural forests and manmade protected plantations, nutrient cycling is an important process and it involves various processes within the ecosystem. A considerable amount of nutrients are returned through litterfall in the form of leaves, twigs, bark, flowers, fruits, etc. to the soil and are made available for reabsorption. In order to study the litterfall pattern and the total amount of nutrients returned, a field experiment was conducted in an eighteen years old teak plantation at Forest College and Research Institute, Mettupalayam. The litter was col lected from the tree stands using litter traps of 1 m x 1 m size at monthly intervals for one year from January 2006 to December 2006. Thus collected litter was separated into leaves, twigs, flowers and fruits. Dry weight of each component was determined by drying to constant weight at 600 C and the mean monthly value for each plot was worked out on a unit area basis (kg ha-1). The collected litter samples were analysed for nutrient content and the nutrient returns were worked out. Among the various litter components, leaf litterfall occurred throughout the year with wide variations among different months. The peak leaf fall occurred during February (1,703 kg ha1) and it was higher during January to June contributing 80.0 % to the total annual leaf fall. But flowers, fruits and twig fall occurred only during a particular season. Flowers recorded the highest value during December, while in case of fruits and twigs it was during March. The litterfall was higher during January to June months contributing 77.0 % to the total annual litterfall. The total annual litterfall was found to be 11,255 kg ha-1, of which the leaf litter accounted for 81.9 % to the total litterfall, followed by the twigs (6.5%), fruits (6.3%) and flowers (5.3 %). Contents of Ca and Mg were higher in leaf litter while flowers had higher N and P contents. K content was higher in fruits while the twigs had lowest nutrient contents. The total annual return of various nutrients viz., N, P, K, Ca and Mg from the litter components were 110.26, 17.50, 35.03, 348.97 and 78.46 kg ha-1 respectively. Of the total annual nutrients return, leaf litter contributed a major share of 74.38, 12.51, 27.95, 311.91 and 65.95 kg ha-1 of N, P, K, Ca and Mg, respectively.


Birds appear to use their tails during flight, but until recently the aerodynamic role that tails fulfil was largely unknown. In recent years delta–wing theory, devised to predict the aerodynamics of high–performance aircraft, has been applied to the tails of birds and has been successful in providing a model for the aerodynamics of a bird's tail. This theory now provides the conventional explanation for how birds' tails work. A delta–wing theory (slender–wing theory) has been used, as part of a variable–geometry model to predict how tail and wing shape should vary during flight at different airspeeds. We tested these predictions using barn swallows flying in a wind tunnel. We show that the predictions are not quantitatively well supported. This suggests that a new theory or a modified version of delta–wing theory is needed to adequately explain the way in which morphology varies during flight.


A combination of cyclosporine (CSA) and methylprednisolone (MP) was used as graft-versus-host disease (GVHD) prophylaxis in 25 patients age 11-47 years (median 27 years) who received HLA-compatible sibling marrow transplants after myeloablative therapy for leukemia, myelodysplasia or lymphoma. CSA was initiated at 3 mg/kg/day in two divided doses, and the dose was adjusted to maintain a trough whole blood h.p.l.c. concentration between 200 and 800 ng/ml. While on i.v. CSA, the dose of CSA was increased for 10 of the 25 patients. The actuarial rate of grades II-IV acute GVHD was 37%. Those patients who developed moderate to severe GVHD had a significantly higher early mortality than those who did not (56% vs 12%, p = 0.02). There was a significant association between the development of acute GVHD and a mean week 2 CSA trough concentration less than 250 ng/ml. Life threatening regimen-related toxicities in the first 100 days included capillary leak syndrome, acute pancreatitis and small bowel perforation. Although the combination of CSA and MP in this dosing schedule was active in preventing acute GVHD, nephrotoxicity remained a problem, and outcome was limited by the inability to achieve the target CSA trough concentration in a substantial proportion of patients.


Grapevine is a pillar of the California state economy and agricultural identity. This study provides a comprehensive culture-independent microbiome analysis from the sap of grapevine overtime and in a context of a vascular disease. The vascular system plays a key role by transporting nutrient, water and signals throughout the plant. The negative pressure in the xylem conduits, and low oxygen and nutrient content of its sap make it a unique and underexplored microbial environment. We hypothesized that grapevine hosts in its sap, microbes that have a beneficial impact on plant health by protecting against pathogen attack and supporting key biological processes. To address this hypothesis, we chose a vineyard under high Pierce's disease (PD). PD is caused by the xylem-dwelling pathogenic bacterium Xylella fastidiosa. We selected ten grapevines within this vineyard with a range of disease phenotypes, and monitored them over 2 growing seasons. We sampled each vines at key phenological stages (bloom, veraison, and post-harvest) and used an amplicon metagenomics approach to profile the bacterial (16S -V4) and fungal (ITS) communities of the sap. We identified a core microbiome of the sap composed of seven bacterial (Streptococcus, Micrococcus, Pseudomonas, Bacteroides, Massilia, Acinetobacter and Bacillus) and five fungal (Cladosporium, Mycosphaerella, Alternaria, Aureobasidium, and Filobasidium) taxa that were present throughout the growing season. Overall, the sap microbial makeup collected from canes was more similar to the root microbial profile. Alpha diversity metrics indicated a microbial enrichment at bloom and in vines with moderate PD severity suggesting a host-driven microbial response to environmental cues. Beta diversity metrics demonstrated that disease condition and plant phenology impacted microbial community profiles. Our study identified several potential taxonomic targets with antimicrobial and plant growth promoting capabilities that inhabit the grapevine sap and that should be further tested as potential biological control or biofertilizer agents.


Abstract [NiFe] hydrogenases are complex model enzymes for the reversible cleavage of dihydrogen (H2). However, structural determinants of efficient H2 binding to their [NiFe] active site are not properly understood. Here, we present crystallographic and vibrational‐spectroscopic insights into the unexplored structure of the H2‐binding [NiFe] intermediate. Using an F420‐reducing [NiFe]‐hydrogenase from Methanosarcina barkeri as a model enzyme, we show that the protein backbone provides a strained chelating scaffold that tunes the [NiFe] active site for efficient H2 binding and conversion. The protein matrix also directs H2 diffusion to the [NiFe] site via two gas channels and allows the distribution of electrons between functional protomers through a subunit‐bridging FeS cluster. Our findings emphasize the relevance of an atypical Ni coordination, thereby providing a blueprint for the design of bio‐inspired H2‐conversion catalysts.


The entire head and neck of a wild adult male Mongolian gazelle (Procapra gutturosa) was dissected with special reference to its enlarged larynx. Two additional adult male specimens taken from the wild were analysed by computer tomography. The sternomandibularis, omohyoideus, thyrohyoideus and hyoepiglotticus muscles are particularly enlarged and improve laryngeal suspension and stabilization. The epiglottis is exceptionally large. A permanent laryngeal descent is associated with the evolution of an unpaired palatinal pharyngeal pouch. A certain momentary descent seems to occur during vocalization. The high lateral walls of the thyroid cartilage are ventrally connected by a broad keel. The large thyroarytenoid muscle is divided into two portions: a rostral ventricularis and a caudal vocalis muscle. A paired lateral laryngeal ventricle projects between these two muscles. The massive vocal fold is large and lacks any rostrally directed flexible structures. It is supported by a large cymbal‐like fibroelastic pad. Vocal tract length was measured in the course of dissection and in computer tomographic images. Two representative spectrograms, one of an adult male and one of a juvenile, recorded in the natural habitat of the Mongolian gazelle are presented. In the spectrograms, the centre frequency of the lowest band is about 500 Hz in the adult male and about 790 Hz in the juvenile. The low pitch of the adult male's call is ascribed to the evolutionary mass increase and elongation of the vocal folds. In the habitat of P. gutturosa a call with a low pitch and, thus, with an almost homogeneous directivity around the head of the vocalizing animal may be optimally suited for multidirectional advertisement calls during the rut. The signal range of an adult male's call in its natural habitat can therefore be expected to be larger than the high‐pitched call of a juvenile.


Community policing philosophy has become an attractive field within the policing literature, exercised enthusiastically by police forces across England and Wales as a response to police and crime related issues ranging from poor policepublic relations to minor crime and disorder. This paper provides a critical appraisal of community participation and problem solving elements of community policing before moving onto explaining how they have been implemented in England, Wales, and European Union. Finally, this study also highlights that there are stubborn and very serious financial, organisational and cultural challenges regarding the successful application of community policing schemes in England, Wales, and European Union.


In the electricity market environment, charging based on the traditional spot electricity price results in the payment imbalance of electric network, and go against the development of the power system, so it is necessary to modify the spot price. The key of the modification lies in how to calculate the fixed per unit transmission cost of every node, that is how to allocate the fixed transmission cost to the users. In order to solve this problem, power flow tracing is developed to modify the spot price. By making a study of the fundamental principle of power flow tracing, the method of path searching is put forward based on the graph theory. By using the method, downstream tracing algorithm and upstream tracing algorithm according to the proportional distribution principle are given in this paper. Furthermore, in order to improve the computational efficiency of the algorithm, branch expunction method is introduced in the algorithm to optimize the node order. A 5-bus sample system is used to prove this algorithm is feasible and valid. Finally, by using the result of power flow tracing to get fixed node transmission cost and introducing it to modify the spot price, the synthetical price can be achieved.


Income modeling is crucial in determining workers' earnings and is an important research topic in labor economics. Traditional regressions based on normal distributions are statistical models widely applied. However, income data have an asymmetric behavior and are best modeled by non-normal distributions. The objective of this work is to propose parametric quantile regressions based on two asymmetric income distributions: Dagum and Singh–Maddala. The proposed quantile regression models are based on reparameterizations of the original distributions by inserting a quantile parameter. We present the reparameterizations, properties of the distributions, and the quantile regression models with their inferential aspects. We proceed with Monte Carlo simulation studies, considering the performance evaluation of the maximum likelihood estimation and an analysis of the empirical distribution of two types of residuals. The Monte Carlo results show that both models meet the expected outcomes. We apply the proposed quantile regression models to a household income data set provided by the National Institute of Statistics of Chile. We show that both proposed models have good performance in model fitting. Thus, we conclude that the obtained results favor the Singh–Maddala and Dagum quantile regression models for positive asymmetrically distributed data related to incomes. The economic implications of our investigation are discussed in the final section. Hence, our proposal can be a valuable addition to the tool-kit of applied statisticians and econometricians.


In the field of electronic warfare (EW), the development, test, validation, and debugging of radar warning receiver (RWR) hardware and software in the laboratory necessitates the simulation of radar threat signals. This requirement often leads to the development of expensive, high-fidelity, radio frequency (RF) simulators. Because they are expensive, they are scarce. They are also often hard to configure, operate, maintain, and relocate. Moreover, they are frequently in heavy demand, and engineers can rarely utilize them for lower priority, everyday design and debugging tasks. This paper describes the design of a PC-based, low-cost (<$2500 parts cost) radar video signal generator (VSG) circuit card assembly which provides four independent, scan-modulated pulse waveform channels. Each of the four channels is capable of producing a waveform consisting of over 4000 pulses, allowing highly complex waveforms containing stagger and jitter to be defined. Its output signals are in the video domain, not in the RF domain, and although it cannot replace large scale simulators for complete or formal validation testing, it provides an inexpensive, easy-to-use, easily transportable tool capable of supporting engineering and debugging tasks. The VSG card is hosted by a single AT-bus slot of an IBM-compatible PC, and is controlled via a Microsoft Windows-based Graphical User Interface. Run-length encoded pulse and scan waveform data are converted and combined into analog signals compatible with the video input stage of the AN/ALR-69 RWR. This can eliminate the need for RF signal generator hardware entirely, or can allow VSG-generated signals to augment RF-generated signals when RF simulator hardware is available. The VSG hardware and software were designed and are in use at the Georgia Tech Research Institute as part of an effort for Wright Laboratory to improve and enhance test tools available for the evaluation of Radar Warning Receivers.


As the deployment of intelligent transportation systems (ITS) technologies moves forward, the issue of sustaining and supporting traffic management systems after they have been constructed becomes increasingly critical. In the midst of limited funding, undocumented costs, competing maintenance needs, aging systems, and institutional barriers, the systems already under operation are struggling to meet the expectations conveyed during implementation. Planning for day-to-day performance and upkeep, despite the necessity, has been an unglamourous and apparently secondary consideration in the ITS implementation process. A well-run and well-maintained system not only serves the transportation system users as intended, but boosts the credibility of the program with the public. Conversely, systems that are plagued with inadequate staffing, persistent software bugs, and inoperable field devices will fail to provide high-performance services and will certainly tarnish the ITS initiative and the credibility of all transportation service providers. Quantifying and securing the funding necessary to operate and maintain ITS and advanced traffic management systems adequately is the first step, yet very little documentation is available to assist system operators. First, a mechanism is provided for estimating the costs required to operate and maintain ITS elements adequately; second, the funding issues are examined and guidelines are provided to address the obstacles that prevent adequate funding of traffic management operations and maintenance. Although the Texas Department of Transportation costs and procedures are examined, the research and recommendations will be useful to other state agencies.


Tribological parameters are dependent upon inter alia, inner component properties which may vary with the temperature-time behaviour of the polymer melt used. This temperature-time behaviour can be influenced by dynamic mould temperature control. The present paper presents a new dynamic tempering concept, which enables a targeted temperature-time control via shifting a mould cavity within two different tempered mould areas at a defined point in time. By influencing the temperature-time development by means of a mould temperature and isothermal holding time variation, micro tensile bars with different inner component properties are produced. To show the influence of inner component properties on tribological parameters, pin-on-disc wear tests are performed. Furthermore, tribological tests with different surface topographies are performed to show the influence of topographical properties on tribological parameters. Results indicate that the tribological properties of microparts are mainly influenced by the nature of the skin near layers, which can be influenced by the application of different mould temperatures. Variations in the isothermal holding time show no significant impact on the material examined. A more distinct roughness of the disc surface topography not only shows higher values for the measured tribological parameters but also different wear behaviour in general.


Cardiac electrophysiological simulations are computationally intensive tasks. The growing complexity of cardiac models, together with the increasing use of large ensembles of models (known as populations of models), make extensive simulation studies unfeasible for regular stand-alone computers. To address this problem, we developed DENIS, a cardiac electrophysiology simulator based on the volunteer computing paradigm. We evaluated the performance of DENIS by testing the effect of simulation length, task deadline, and batch size, on the time to complete a batch of simulations. In the experiments, the time to complete a batch of simulations did not increase with simulation length, and had little dependence on batch size. In a test case involving the generation of a population of models, DENIS was able to reduce the simulation time from years to a few days when compared to a stand-alone computer. Such capacity makes it possible to undertake large cardiac simulation projects without the need for high performance computing infrastructure.


The intergovernmental pillars of the European Union are areas in continuous evolution. Furthermore, this evolution seems to be towards a more institutionalized co-operation. This is especially obvious within the third pillar, where Pupino, for example, seems to be part of a slow trend of approximation to the logic of the Community pillar. Although less pronounced, the same slow shift of perspective can be said to be taking place in the realm of the second pillar or Common Foreign and Security Policy (CFSP). That is arguably why the governments of the Member States were ready to scrap the intergovernmental label, currently attached to both pillars, in the Constitutional Treaty. The necessary political will appears to be there for the CFSP, the main focus of this article, to move into the next phase: one which will necessarily entail less intergovernmentalism and 'more' community method — with judicial oversight as one of its central elements. It is therefore necessary to ask ourselves about the specific role the European Court of Justice should be given. It is with this question in mind that we should approach the changes envisaged by the Constitutional Treaty (hereinafter CT). Even if this document is politically dead, it is the measure of how far the Member States were willing to go in changing the nature of the second pillar and its judicial control. It is foreseeable that a more or less obvious process of cherry-picking will take place in the future; the Member States and institutions, unable to see the CT ratified, will understandably seek to otherwise implement or bring about some of its reforms, if at all possible: those which allegedly deserve to be cherry-picked.This article will consider the role that the ECJ was given within Common Foreign and Security Policy (CFSP) in the Constitution, to decide whether it is good enough to be cherry-picked in the future. Is this the solution we want, or should we set out to find different, more suitable arrangements if the jurisdiction of the ECJ in matters of CFSP is to be reformed in the future? With this in mind, I will examine the changes in the nature of the measures adopted under the CSFP envisaged by the CT (from intergovernmental to Union measures). Consequently, I will turn to the very restricted judicial control foreseen in this area. The jurisdiction of the ECJ is still excluded, save for some exceptions. This article will consider the scope of these exceptions to determine how far-reaching they are, and thus what kind of part they allow the ECJ to play.


This study evaluates the feasibility of a radiation dosimeter that can monitor radiation exposure in real time based on the electro optical modulation of a liquid crystal (LC) cell and the photoconductor cadmium sulfide (CdS). Cadmium sulfide (CdS) is often used in photosensors because of its high reproducibility and sensitivity to light and radiation. As basic research, the electro optical features of a LC cell and a novel CdS photosensor were analyzed from the viewpoint of fabricating a radiation dosimeter. Based on the results, the feasibility of such a detection device was studied by analyzing the efficiency of its electro optical light modulation. The measurement results suggested that the detection system had high resolution and very good reproducibility, with CdS showing excellent X-ray detection efficiency. The results suggest that noise reduction can be achieved by incorporating an LC, given its static electric features. The results of this study could help realize real-time portable radiation dosimeter systems based on optical modulation and using a CdS photosensor.


Background: Management of symptomatic pancreatic pseudocysts poses a unique challenge to minimally invasive surgeons. Despite the predominance of endoscopic management of pancreatic pseudocysts, the laparoscopic approach remains a critical skill in the armamentarium of surgeons. Methods: This report details a laparoscopic intragastric approach to create a pancreatic cystgastrostomy using intraoperative ultrasound and endoscopy. Conclusion: Laparoendoscopic techniques for pancreatic pseudocysts are still required in selective cases when endoscopic management is not available or fails. Using this technique provides patients with same clinical benefits of an endoscopic approach.


In the project of group-reading Collodi's Pinocchio at the second grade of primary school we included Kohlberg's model of moral development stages. We encouraged pupils to respond to a large number of moral dilemmas occurring throughout the text. We have discovered that children's moral judgments slightly exceeded both stages of the pre-conventional level. In some cases, they even reached the fourth conventional stage. Similar results have been observed in some other studies of child's moral development based on Kohlberg's model. However, our main objective was to find those didactical approaches to reading literary texts, which could help one infer the moral issues within the text, thus supporting implicit moral education of pupils. Kohlberg's model was of great help in achieving our objective systematically and on the basis of universal ethics, with righteousness as the highest value, rather than in an anecdotic or moralistic way. We were particularly interested in the so-called permissiveness, a concept that had existed under different formulations already in Collodi's times and had expressed itself through typical misconceptions, such as indulgence means freedom, having no plan enables spontaneity, disobedience is an expression of individuality, messiness stands for art, and confusion is supposed to be a pedagogical concept. Our findings speak in favour of the process-development didactic model of moral education that could be described as a post-permissive approach.


Beneficial effects of silicon (Si) in the plants growth under conditions of drought stress have been associated with to uptake and accumulation ability of element by different species. However, the effects of Si on soybean under water stress are still incipient and inconclusive. This study investigated the effect of Si application as a way to confer greater soybean tolerance to drought stress. The experiment was carried out in 20-L pots under greenhouse conditions. Treatments were arranged in a randomized block design in a 2 × 4 factorial: two water regimes (no stress or water stress) and four Si rates (0, 50, 100 and 200 mg kg–1). Soybean plants were grown until beginning flowering (R1) growth stage with soil moisture content near at the field capacity, and then it started the differentiation of treatments under drought by the suspension of water supply. Changes in relative water content (RWC) in leaf, electrolyte leakage from cells, peroxidase activity, plant nutrition and growth were measured after 7 days of drought stress and 3 days recovery. The RWC in soybean leaves decreased with Si rates in the soil. Silicon supply in soil with average content of this element, reduced dry matter production of soybean under well-irrigated conditions and caused no effect on dry matter under drought stress. The nitrogen uptake by soybean plants is reduced with the Si application under drought stress. The results indicated that the Si application stimulated the defense mechanisms of soybean plants, but was not sufficient to mitigate the negative effects of drought stress on the RWC and dry matter production.


The role of the future navy continues to require higher levels of functionality, performance, and interoperability from shipboard systems. Embedded in the superstructure of future navy ships will be a variety of antenna arrays that will perform different functions such as radar. In an advanced multi-function RF concept (AMRFC), separated Tx and Rx arrays are required to provide the capability to perform a variety of functions [1]. To accommodate multiple functionalities, AMRFC radar systems require advanced antennas operating in multiband and with multi-polarization. In general, a dual-polarized operation can provide more information for radar systems, can increase the isolation between the transmitting and receiving signals of transceivers and transponders, and can double the capacity of communication systems by means of frequency reuses[2]-[3].


The authors report the first successful growth by MOVPE of epitaxial thin films of the dilute magnetic semiconductor (Hg, Mn)Te. Epitaxial layers approximately 5 mu m thick were grown directly on (001) GaAs substrates using tricarbonyl (methyl cyclopentadienyl) manganese, di isopropyl telluride and elemental mercury. Deposition took place in a horizontal, atmospheric pressure reactor at temperatures in the range 350-400 degrees C. The layers were shown to be of good crystallinity by RHEED and double-crystal X-ray diffraction, with rocking curve widths of 400-600 seconds of arc. As-grown layers were p-type, with hole mobilities at 79 K of 2000-5500 cm2V-1s-1. Two compositions have been grown, one with x approximately=0.04, which lies below the semiconducting/semimetallic transition and x approximately=0.13, which is semiconducting. Infrared measurements of the latter show it to have a band-gap energy of approximately 0.26 eV at room temperature.


This paper describes the continuities and discontinuities between classification as a practice in archaeology and the development of an on-toterminology in the domain of Islamic archaeology of the al-Andalus. Developing an ontoterminology requires an interdisciplinary approach, which effectively places terminology as a subject matter between linguistics and knowledge representation and reasoning. The example of lighting artefacts shown in this paper demonstrates that the archaeological typologies have information that is implied or conflated in their proposed ordering of artefacts. While the purpose of the typologies is to express the names of artefact types in Islamic archaeology, the development of an ontoterminology requires a formalism in which the essential characteristics of each artefact type are made explicit. This allows for a better understanding of the typologies of artefacts through logical reasoning. Archaeological classification and ontoterminology


Most current tour guiding methods for Taiwanese temples employ graphic webpage frameworks combined with captioned pictures for introduction. This type of tour guiding lacks interactive presence. In addition, the audience may not be able to focus on browsing webpages or learn essential information from the introduction. This study adopted the Delphi method to evaluate the current developed system. This system was aimed at designing VR-based interaction that differs from conventional tour guiding methods to aid users in viewing the display space from their viewpoints. Users cannot only control camera view angles but also select the paths and guiding information as if they were walking in the temple. The analysis results revealed that, in general, the users perceived VR tour guiding as convenient and easy to use. The display and content of the tour guiding system presented clear information to the users, aiding them in gaining further understanding of the introduced item. Finally, the study results can serve as a reference for design research on VR applications in tour guiding.


AdaBoost and support vector machines (SVM) algorithms are commonly used in the field of object recognition. As classifiers, their classification performance is sensitive to affected by feature sets. To improve this performance, in addition to using the classifiers for accurate selection of feature sets, attention must be given to determining which feature subset to use in the classifier. Evaluating feature sets using a margin of the decision boundary of an SVM classifier proposed by Kugler is a solution for this problem. However, the margin in an SVM is sometimes large due to outliers. This paper presents a feature selection method that uses a contribution ratio based on boosting, which is effective for evaluating features. By comparing our method to the conventional one that uses a confident margin, we found that our method can select better feature sets using the contribution ratio obtained from boosting.


An epidemiological study on pancreatic cancer was performed, using for evaluation reports from the Ministry of Public Welfare and the National Pancreatic Cancer Registration Committee and cases experienced at the First Department of Surgery in Kobe University Hospital. The incidence of pancreatic cancer was found to have increased over the lost few decades. Aged subjects with family histories of malignant diseases and cases having past histories of chronic pancreatitis were affiliated with the high-risk group for this disease. Cigarette smoking and beverage consumption were also shown to be increased risk factors for pancreatic cancer. Poor results obtainable with the types of treatment presently available for pancreatic cancer indicated the clinical significance of applying screening methods for subjects in the high-risk group.


Abstract. Previous studies of the motion of patches that comprise patchy pulsating aurora (PPA) have been based on a limited number of events. In this study, we use a large database of PPA patches obtained from the THEMIS all-sky imager at Gillam (66.18° magnetic latitude, 332.78° magnetic longitude) between May 2006 and July 2013 to explore the velocity of the PPA patches. Our results show that PPA patches mainly drift eastward after midnight and westward before midnight. In addition, we found that patch velocities are in the expected range of convection given the magnetic latitude and that the velocities do not seem to depend on auroral electrojet (AE) index. The results suggest that the drifts of auroral patches could be a proxy for the ionospheric convection, and possibly provide a convenient and accurate method to remotely sense the magnetospheric convection.


Stock investing is a high-risk investment, so investors are constantly looking for ways to reduce risk while adapting returns. Lower risk stock groups are represented in Indonesia by the LQ45 index, which includes stocks with high liquidity, large capitalization, and good fundamentals. However, the index contains 45 members with varying risk and return. As a result, the price action analysis of the index's stock members is required to further reduce risk. This study employed principal component analysis to identify the index's various price action groups. PCA was used in Python 3 and produced two groups that explain 70.91% of the variance in the index's price movement. The stock groups derived from PCA were further analyzed, and ANOVA revealed that the groups differed significantly in return but not significantly in risk. The implemented PCA demonstrated potential return for a variety of investors interested in LQ45 stocks.


BACKGROUND
Even though rarely found in Indonesia, the incidence of multiple myeloma (MM) is increasing every year. Bone involvement of MM is the most often a clinical disorder which leads to worsening clinical conditions and low quality of life of patients.

PURPOSE
To determine the clinicopathology profile of bone involvement of MM patients in Indonesia.

MATERIALS AND METHODS
The cross-sectional study of MM conducted at Dharmais National Cancer Hospital (DNCH) by collecting data from medical records of MM patients who came to DNCH in period 2008-2012.

RESULTS
There were 39 MM patients all with age above 60 years. There were 56.4% male and 43.6% female patients. Most were diagnosed at stage III (32.4%), and 41% had obesity. The comorbid conditions were anemia (82.9%), hypoalbuminemia (60%), increased creatinine level (38.5%), increased β2 microglobulin level (94.1%), increased LDH level (23.1%) and plasmocytes above 30% (65%), but only 4.2% patients presented with hypercalcemia. Meanwhile, bone involvement occurred in 76.9% of MM patients with 4 lesions on average and a maximum of 16 lesions. The locations of bone lesions were spine (70%), skull (70%), pelvis (33.3%), humerus (30%), and femur (30%).

CONCLUSIONS
The incidence of MM in Indonesia is increasing annually with bone involvement in more than three-fourths, but interestingly without hypercalcemia.


Many people's social media feeds include posts in languages they do not understand. While previous research has examined bilingual social media users' language choices, little research has focused on how people make sense of foreign language posts. In the present study, we interviewed 23 undergraduate social media users about how they consume and make sense of posts in other languages. Interviewees reported that they often did not pay attention to or engage with foreign language posts, due to a lack of relevance and contextual knowledge. When they did actively engage with foreign language posts, interviewees did not rely solely on machine translation output but instead actively collected and combined various cues from within and outside the post in order to understand what it was about. Interviewees further reported different types of goals for trying to make sense of foreign language posts; some focused on simply extracting and understanding the emotional components of a post while others tried to gain a fuller understanding of a post, including its contextual and cultural meanings. Based on these findings, we suggest design possibilities that could better aid multilingual communication in social media.


Statistical metrology can be defined as a set of procedures to remove systematic and random gauge error from confounded measurement data for the purpose of reducing total uncertainty. We have applied these procedures to the determination of across-chip linewidth variation, a critical statistic in determining the speed binning and average selling price of advanced microprocessors, digital signal processors, and high-performance memory devices. The measurement data was obtained from tow sources: a high- throughput CD-SEM and an atomic force microscope. We found that the high-throughput of SEM permitted the additional measurements required for statistical metrology and heterogeneous gauge matching.


Corn is becoming a major grain source for cattle feeding in the desert southwest. This is due to the increased corn acreages in Arizona and to the fact that cost of corn from the midwest, even with freight charges added, is frequently competitive with locally grown grain. Corn has not been used in the experimental feedlot at the University of Arizona. It appears desirable that certain comparisons be made with corn because its usage is gaining popularity in Arizona.


The sub-Andean thrust belt of the Tarija Basin in South America is undergoing an exploration boom due to interest in the emerging deep, fractured, Devonian gas play. Trap types involve hanging wall anticlines, which formed due to continued thrusting.

The structures were formed by a "rigid beam" type response to compression, with a major thrust fault detachment in the deep Kirusillas shale. A second roof detachment/thrust fault system is often responsible for additional, vertical deformation of younger strata, and for west-to-east displacement with respect to deep Devonian traps. The interplay between these two detachments makes it difficult to predict the geometries of deep Devonian traps.

Acambuco, an area of about 300 000 acres in the extreme northwest of Argentina along the Bolivian border, is operated by the UTE Acambuco partnership which includes Pan American Energy (operator), YPF SA, Oil & Gas (a Shell-Capsa subsidiary), and Apco-NW. Acambuco is part of the southern extension of the Bolivian sub-Andean trend in the Tarija Basin. It spans two mountain ranges, the Sierra de Aguarague in the eastern part of the block and the Sierra de San Antonio in the west; both trends include fields in the multi-TCF range (Figure 1). Figure 1.
The Acambuco area, in the extreme NW of Argentina. This satellite image (SPOT with Landsat in pseudo-color) shows that the area spans two major structural trends; note the surface expression of major structures in the area.

Exploration challenges associated with prospects in the fairway involve defining traps and assessing reservoir quality. These risks can be addressed adequately through the use of integrated 3-D seismic interpretation with horizontal drilling and multilateral completions.

Understanding structural style is paramount to seismic interpretation in the sub-Andean thrust belt. The foothills form a series of laterally extensive folded and thrusted mountain ranges trending NNE. Spacing between the mountain …


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This report is intended to provide an indepth trade area analysis of New Town, North Dakota. Specific analyses included determining New Town's main and greater trade areas, identifying the demographic profile of New Town shoppers, examining important and less important services for patron shoppers of New Town, identifying neighboring cities that area shoppers patronize, determining distances area shoppers traveled to New Town, and listing popular newspapers and radio stations among area residents. Current trade area information for New Town was obtained from a statewide trade area survey conducted by the Department of Agricultural Economics at North Dakota State University in 1989. Recent trends (1980 to 1989) in New Town population, retail sales, per capita income, pull factors, and Mountrail County population and employment were identified and discussed. New Town's population, retail sales, and pull factor, along with Mountrail County population, average annual employment, and per capita income have all decreased throughout the 1980s. Although most demographic and economic measurements have decreased, New Town has fared as well as other North Dakota cities with similar population, and has fared favorably compared to smaller competing trade centers. The economic situation found in New Town and Mountrail County are somewhat typical of the problems found in western North Dakota communities in the 1980s. New Town's trade areas were broken down into main and greater trade areas. A main trade area (MTA) was defined as an area where 35 percent or more of the township residents purchase a majority of selected goods and services in one city. A greater trade area (GTA) was defined as the area beyond the MTA where some township residents purchase some selected goods and services in one city. New Town's MTA increased in size by one township, compared to MTA boundaries determined in 1970. The typical household for survey respondents appears to be a middle-aged married couple, who have completed high school, have few children at home, are primarily employed in agriculture and professional/technical professions, and have resided in the area a large portion of their lives. Main trade area residents traveled an average of 14.0 and 12.8 miles to New Town to purchase selected convenience and specialty goods and services, respectively. Over half (50.6 percent) of the respondents who purchased 50 percent or more of convenience and specialty goods in New Town traveled between 11 to 20 miles to purchase the item. New Town appears to be capturing little of the potential market for two-thirds of the goods and services on the survey questionnaire. New Town's poor market capture can be partially explained by its relative size and close proximity to several larger competing trade centers (Williston, Watford City, and Minot). New Town does appear to be a relatively important source for many of the survey goods and services for respondents shopping for those items in New Town. Minot, Stanley, Watford City, Parshall, and Williston were the most popular cities for the purchase of nonagricultural goods and services by New Town MTA residents who did not purchase a majority of the good or service in New Town. Stanley and Watford City were popular for purchasing agricultural goods and services. Outshopping analysis revealed no substantial demographic or socioeconomic differences between New Town MTA residents purchasing 50 percent or more and those purchasing less than 50 percent of selected goods and services in New Town. Slight differences between groups were evident only in miles traveled and average income. The Minot Daily News was the most popular daily newspaper for both New Town MTA and GTA residents. New Town News and Mountrail County Record were the most popular weekly newspapers for New Town MTA and GTA residents, respectively. The most popular radio stations for New Town MTA residents included KCJB of Minot and KFYR of Bismarck. Although economic times have been difficult, New Town appears to have increased its past trade area and should remain an important trade center for residents in Mountrail County and the surrounding area.


Background and aims: Partial gastrectomy surgeries are conducted frequently due to various reasons but there is no consensus regarding the method of choice for gastrointestinal reconstruction. In this study we aimed to compare billruth II with Braun anastomosis and Roux-en-Y gastrojejunostomy. Materials and methods: This prospective study was conducted on patients presented to surgery clinic at Besat and Taleghani hospital between 2018-2020 who were gastrectomy candidates. Patients undergoing Billruth 2 reconstruction with Braun anastomosis or Roux-en-Y gastrojejunostomy were enrolled in the study. Demographics, operation durative and intraoperative blood loss, early postoperative complications, re-admission within 30 days postoperation, 30-day and 90-day mortality were recorded. at an at least 3-month post-surgery period, patients were followed for late postoperative complications. If necessary, endoscopy was conducted and biopsy was taken. Analysis was performed with SPSS version 22. Results: 84 patients in two 42-patient groups were evaluated. All parameters were the same in two groups except operation duration and intraoperative bleeding (significantly higher in RY group), food residue (significantly higher in RY group) and bile in remnant stomach (significantly higher in B2B group). Conclusion: These two methods of reconstruction are comparable in terms of postoperative complications and mortality rates. Food residue and bile reflux are two determinants which should be kept in mind when choosing the surgery plan by surgeons. Keywords: gastrectomy, reconstruction, Billruth, Braun, Roux en Y anastomosis


Research paper that was published in the Zimbabwe Bulletin of Teacher Education,This article analyses the problem of school dropouts in Zimbabwe during the period 1980 to 2004 with the aim of suggesting how the problem can be eliminated. The discussion is important in view of the fact that the country is experience critical human resource challenges yet the education and training system is releasing large numbers of young boys and girls who have the potential to contribute meaningfully to socio-economic development. The methodology involved the identification and analysis of statistical data on enrolments within schools and colleges from government publications and websites. The analysis showed that the average school dropout rate of about 26% between 1980 and 2004 was rather too high. This was because the dropouts were not being adequately catered for at tertiary level because of strict entry requirements stipulating formal school qualifications. As a solution to this problem, the discussion proposes a paradigm shift within policy makers to address the issues of compulsory school attendance between the ages of six and eighteen, compulsory vocational education and training for all school dropouts, and the generation of local resources and technology for use within the education and training system to reduce costs.


This study aims to compare the effect of intellectual capital, managerial ownership, institutional ownership and corporate social responsibility on the financial performance of coal mining sub-sectors and infrastructure sub-sectors. The samples used are all sub-sector coal mining companies and infrastructure sub-sectors which are listing year 2014-2018 on www.idx.co.id website using nonprobability sampling method with a census technique sampling which is the number of samples used are 37 coal mining and infrastructure subsector companies. The analytical method used is multiple regression. The results of hypothesis testing show that intellectual capital, managerial ownership, institutional ownership and corporate social responsibility have a significant effect jointly on ROA and ROE of coal mining sub-sector companies, but does not significantly affect the company's ROE sub-sector infrastructure. Partially, managerial ownership affects insignificant financial performance in both sectors. Meanwhile, institutional ownership of coal mining companies has significant effect on ROA, but the effect is insignificant to the ROE and has no significant effect on the ROA and ROE infrastructure companies. Corporate social responsibility has a partially insignificant effect on ROA and ROE in the coal mining sub-sector, but has a negative and significant effect on ROA in the infrastructure sub-sector.


BACKGROUND
Heparin remains the drug most commonly used for anticoagulation in continuous renal replacement therapies (CRRTs). However, in patients with hypercoagulability, heparin is insufficient or, in cases with an increased risk of bleeding or thrombocytopenia, it may be contraindicated. Epoprostenol, a potent vasodilator, antithrombotic and antiplatelet agent, could be an alternative.

PATIENTS AND METHODS
We studied the records of patients treated under continuous venovenous hemodiafiltration in an academic tertiary hospital of 900 beds, between January 2000 and June 2003. Epoprostenol was prescribed to patients with (i) filter hypercoagulability, defined as consumption of 2 or more filters in the last 24 hours; (ii) low platelet count; or (iii) recent severe hemorrhage.

RESULTS
Thirty-eight out of 248 (15%) patients who were under CRRT received epoprostenol for more than 72 hours. Epoprostenol was indicated due to filter hypercoagulability in 48%, thrombocytopenia in 68% (7 patients both) and hemorrhage in 3% of cases. The overall time for epoprostenol therapy was 9,749 hours. The mean filter duration previous to epoprostenol was 23 +/- 12 hours and after administering this drug 38.2 +/- 11.9 hours (p = 0.0001). In 6 patients, heparin and epoprostenol were simultaneously administered. The adverse effects were hemorrhage, which presented in 7 patients (18%) and a fall in blood pressure in another 7 (18%), which recovered in the next 24 hour after starting treatment. Cost analysis demonstrates some advantage with epoprostenol in patients with increased tendency to clotting.

CONCLUSIONS
Epoprostenol may be safely used to prevent clotting of the extracorporeal circuits, either alone in patients with thrombocytopenia and/or increased risk of bleeding, or in combination with heparin in states of hypercoagulability.


Journalists as workers and makers of news are a very important stakeholder group for news media companies. It is vital for organizations to acknowledge the needs and expectations of their stakeholders, because fulfilled expectations lead to stakeholder favor and good organizational reputation. Unmet expectations lead to loss of stakeholder trust and bad organizational reputation. The purpose of this master's thesis was to map the expectations and experiences of journalists and freelancer journalists working for major Finnish media companies. The aim was to find out how journalists see the future of media and their own future roles as journalists, how social media has affected journalists' work and what do journalists expect from their employers or clients and the media in general. A total of 16 journalists and freelancers were interviewed for this study. The results were analyzed through qualitative theory-driven content analysis. The results of this study show that Finnish journalists are pessimistic about the future of media. They expect the media business to shrink. Some believe that media will divide into expensive quality media and cheap or free bulk media. Journalists predict that the future journalist must be multi-talented. Most journalists use social media but it hasn't had a big impact on their work yet. Journalists expect social media to become more important in journalistic work in the future. Journalists have various expectations towards their employers. They see the actions of media companies as unfair, because many companies have been reducing journalistic personnel to cut costs while they are making good profits. Journalists expect the media companies to invest in quality of journalism. It means hiring more workers and investing in technological and content development. The results of this study show that journalists' expectations are not fully met by their employers.


Purpose of reviewThe purpose of the review is to provide recommendations to improve clinical decision-making based on the strengths and weaknesses of commonly used hydration biomarkers and clinical assessment methods. Recent findingsThere is widespread consensus regarding treatment, but not the diagnosis of dehydration. Even though it is generally accepted that a proper clinical diagnosis of dehydration can only be made biochemically rather than relying upon clinical signs and symptoms, no gold standard biochemical hydration index exists. Other than clinical biomarkers in blood (i.e., osmolality and blood urea nitrogen/creatinine) and in urine (i.e., osmolality and specific gravity), blood pressure assessment and clinical symptoms in the eye (i.e., tear production and palpitating pressure) and the mouth (i.e., thirst and mucous wetness) can provide important information for diagnosing dehydration. SummaryWe conclude that clinical observations based on a combination of history, physical examination, laboratory values, and clinician experience remain the best approach to the diagnosis of dehydration.


Transcatheter arterial chemoembolization (TACE) is a minimally invasive procedure to restrict a tumor's blood supply, and TACE has an established role in cancer therapy. An embolic material in the form of microspheres (such as drug-eluting beads) and transarterial radioembolization is effective at treating hepatocellular carcinoma (HCC). Endovascular therapy offers promise for the treatment of tumor thrombi in the portal vein. Many researchers are anticipating an era of TACE with microspheres. This review aims to provide an overview of advances in endovascular therapy to treat primary HCC.


A first principles-based model has been developed to simulate the capacity fade of Li-ion batteries. Incorporation of a continuous occurrence of the solvent reduction reaction during constant current and constant voltage (CC-CV) charging explains the capacity fade of the battery. The effect of parameters such as end of charge voltage and depth of discharge, the film resistance, the exchange current density, and the over voltage of the parasitic reaction on the capacity fade and battery performance were studied qualitatively. The parameters that were updated for every cycle as a result of the side reaction were state-of-charge of the electrode materials and the film resistance, both estimated at the end of CC-CV charging. The effect of rate of solvent reduction reaction and the conductivity of the film formed were also studied. © 2004 The Electrochemical Society. All rights reserved.


In a 38-year-old woman, arterial hypertension was diagnosed a few weeks before her death. She died unexpectedly before a diagnostic clarification of the cause was possible. Autopsy revealed an arterial fibromuscular dysplasia with manifestation in both common iliac arteries, both renal arteries, the celiac trunk and the splenic artery. Both renal arteries displayed stenotic dissecant aneurysms which were the cause of the arterial hypertension. As a rare and lethal complication of fibromuscular dysplasia, a ruptured saccular aneurysm was found in the splenic artery. Histologically, the vascular alterations were a combination of medical fibromuscular dysplasia (type II) and periarterial or adventitial fibroplasia (type III). On the basis of the immunohistochemical detection of abundant lysozyme-positive cells, the periarterial fibroplasia appears to be a secondary chronic granulating and cicatricial reaction and not a separate form of fibromuscular dysplasia.


Abstract The quality of a sperm population can be characterized physiologically and its fecundity predicted by its viable : non‐viable sperm ratio. To improve the knowledge of reproductive strategies in two ectoparasitoid hymenopteran species, Eupelmus orientalis Crawford (Hymenoptera: Eupelmidae) and Dinarmus basalis Rondani (Hymenoptera: Pteromalidae), the assessment of sperm viability using the dual fluorescence staining procedure SYBR‐14 : propidium iodide was developed. The aim of the study was to provide a comparative test in vitro applicable to both sexes to study the evolution of sperm quality at various stages of the reproductive processes. The reliability of propidium iodide to detect non‐viable sperm (stained in red) was confirmed in both species on the basis of two stress tests (ethanol and Triton X‐100) but our study also revealed that propidium iodide concentrations must be adequately adjusted for each single species. This experiment also demonstrated the physiological heterogeneity of sperm populations in E. orientalis and D. basalis males and females. In both species, 40% of the sperm in the seminal vesicles was found to be non‐viable. By contrast with E. orientalis, the populations of non‐viable sperm estimated from the seminal vesicles of D. basalis were found to be strongly different from those observed in the spermatheca. From the present results, the population of viable sperm detected in the spermatheca of females from both species proved a reliable predictor of fertilization achieved in ovipositing females.


Introduction: Osteopoikilosis and enchondroma existing together have not been reported in literature, and this is the first report of the management of the same. Case Report: A 26-year-old male presented with dull aching pain with swelling around the knuckle of the left index finger of 1 month duration. On examination, there was a swelling of approximately 1x1 cm on the dorsal aspect. Typical radiographic changes of osteopoikilosis and enchondroma were present. Conclusion: Enchondroma coexistence with osteopoikilosis is rare. Diagnosis is suspected on plain radiographs and confirmed by the histopathologic study. Enucleation of the tumor with bone graft provides good results.


We present a class of Rashba systems in hexagonal semiconducting compounds, where an electrical control over spin-orbital texture is provided by their bulk ferroelectricity. Our first-principles calculations reveal a number of such materials with large Rashba coefficients. We, furthermore, show that strain can drive a topological phase transition in such materials, resulting in a ferroelectric topological insulating state. Our findings can open avenues for interplay between Rashba effect, ferroelectricity and topological phenomena.


CS16-02 The public health and personal implications of a diagnosis of cancer are being increasingly recognized. For this reason, research programs now encompass prevention as well as treatment clinical trials. Quality of life (QOL) is an end point of interest in both treatment and prevention clinical trials. Quality of life is an important outcome measure to monitor when healthy participants are asked to take a chemopreventive agent for a protracted period of time. Chemopreventive agents can have broad impacts on a participant9s functioning as well as specific side effects associated with the agent. Systematic monitoring of participant HRQL also communicates to the participant that the research team is concerned about his well-being, a factor that can affect willingness to enroll in a long-term trial (1). In the primary prevention setting, study participants are healthy individuals and it is important to monitor effects on QOL and functioning, particularly when chemopreventive agents are administered. From a research perspective, participants9 expectations regarding the impact of the chemopreventive regimen will affect their willingness to enroll and participant experience with the prevention intervention will affect adherence to trial requirements (1). Collection of QOL data reinforces that effects on functioning are being monitored by the researchers. Recent trials such as the Postmenopausal Estrogen/Progestion Intervention (PEPI) (2-4), the Breast Cancer Prevention Trial (BCPT) (5), and the Women9s Health Initiative (WHI) (6) have included comprehensive QOL assessments. A comprehensive QOL assessment should also include lifestyle behaviors; these data can serve as important covariates in analyses. For example, physical activity has been found to have a protective effect on the incidence of prostate cancer (7). The prevention context has implications for assessment, design, and statistical considerations for a trial. This presentation will describe HRQL measures that work well for healthy participants (e.g., the SF-36 [8]). An important step in establishing a QOL instrument9s feasibility, reliability, and validity is evaluating its psychometric properties in a broad range of clinical populations (9). Most prevention trials have a goal of enrolling sufficient numbers of minority group participants to be able to evaluate whether or not there are racial/ethnic differences in the efficacy of the preventive agent. The investigators could be faced with low literacy levels (= sixth grade reading level). To compensate for low literacy levels, investigators might need to use a centralized phone bank, interviewer-assessment strategy as an alternative to self-administration of HRQL questionnaire. The feasibility, validity, and reliability of telephone-administered questionnaires have been documented for a group of VA patients (10). In general, little is known about the HRQL of persons who are in lower socioeconomic strata and who have low literacy skills. Potential designs for limited HRQL samples should be discussed because most prevention trials require very large samples, which are not necessary to answer the HRQL research questions. In most cases, based on knowledge about the preventive agent or intervention, the HRQL hypothesis is one of equivalence between the prevention treatment arms; that is, equivalence is a reasonable hypothesis if there are no previous data suggesting that HRQL would be either negatively or positively affected by the study agents. Equivalence can be defined in a number of ways. One possibility is to define it as an effect that is not clinically significant and a method for gauging a meaningful effect is to use the categories proposed by Cohen (11) where a small effect is between .2 and .5 standard deviations. Therefore, we define HRQL equivalence for the treatment arms as any effect less than .2 standard deviations on the primary HRQL continuous measure; on a 0-100 scale, this would be less than a two-point difference. Most prevention trial sample sizes provide more than adequate power to detect these small differences. Depending on resources available for the trial, it may be necessary and scientifically justified to limit the HRLQ assessments to a smaller sample of trial participants. There are several ways to do this. It is better to select institutions and not patients within institutions to reduce complexity. For example, the trial could limit the collection of HRLQ data to Community Clinical Oncology Programs (CCOPs); these institutions could earn cancer control credits for obtaining baseline and follow-up HRQL assessments. Since these institutions are required to obtain cancer control credits in order to retain their CCOP status, the HRLQ study can serve as an incentive. The HRQL study can be conducted with only the first XX number of participants registered to the prevention trial (i.e. the HRLQ study is closed once a specified number of participants have been enrolled). There are potential problems with such methods and these will be discussed in the presentation. Another issue is the length of follow-up period for the HRQL outcome. It should be as long as participants are followed for primary efficacy outcomes but a number of variables will affect the frequency with which the HRLQ are collected during the study period. References 1. Nayfield SG. Roles of government agencies in support and application of quality of life research. Spilker B, editor. Quality of life and pharmacoeconomics in clinical trials. 2nd ed. Philadelphia: Lippincott-Raven; pp. 779-783, 1996. 2. The Writing Group for the PEPI Trial. Effects of estrogen or estrogen/progestin regimens on heart disease risk factors in postmenopausal women. JAMA 1995;273(3):199-208. 3. Espeland MA, Bush TL, Mebane-Sims I (Writing Group for the PEPI Trial Investigators). Rationale, design, and conduct of the PEPI trial. Controlled Clin Trials 1995;16(4 (Suppl)):1S-19S. 4. Miller VT, Byington RL, Espeland MA, et al. Baseline characteristics of the PEPI participants. Controlled Clin Trials 1995;16(4 (Suppl)):54S-72S. 5. Ganz Patricia A, Day Richard, Ware JrJE, Redmond Carol, Fisher Bernard. Base-line quality-of-life assessment in the National Surgical Adjuvant Breast and Bowel Project Breast Cancer Prevention Trial. J Natl Cancer Inst 205;87(18):1372-82. 6. Matthews Karen A, Shumaker Sally A, Bowen Deborah J, et al. Women9s health initiative: Why now? What is it? What9s new? Am Psychol 1997:101-116. 7. Hartman TJ, Albanes D, Rautalahti M, et al. Physical activity and prostate cancer in the Alpha-Tocopherol, Beta-Carotene (ATBC) Cancer Prevention Trial (Finland). Cancer Causes Control 1998;9(1):11-18. 8. Ware JE Jr., Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30:473-483. 9. Nunnally JC. Psychometric theory. New York, NY: McGraw-Hill; 1978. 10. Knight SJ, Chmiel JS, Kuzel T, Sharp L, Albers M, Fine R, Moran EM, Nadler RB, Sharifi R, Bennett CL. Quality of life in metastatic prostate cancer among men of lower socioeconomic status: Feasibility and criterion related validity of 3 measures. J Urol 1998;160:1765-1769. 11. Cohen J. Statistical power analysis for the behavioral sciences. (Edition 2). Hillsdale, NJ: Lawrence Erlbaum & Associates, Publishers, 1988.


The literature shows that economic policy uncertainty affects corporate cash holding. Nevertheless, there is no literature involving the moderating effect of executives' background and the corresponding economic consequence. China is in the stage of economic transition with weak property rights protection. Therefore, executives' government working experience helps enterprises to obtain all kinds of benefits. However, different ownership structures may affect the role of executives' government working experience. Enterprises can establish the connection with the government through controlling shareholders, board of directors and managers. Unlike state owned enterprises, the actual controllers of private owned enterprises are nature persons or non-governmental economic subjects, which are not inherently connected with the government. The government working experience from the board of directors and managers may play a more important role in private owned enterprises. Based on the sample of China listed firms in 1999-2015, the result indicates that when the degree of economic policy uncertainty increases, firms tend to increase their cash holding; the greater the change in the uncertainty is, the greater the change in cash holding is. Executives' government working experience could mitigate the relation between uncertainty and cash holding in private owned enterprises. Nevertheless, executives' government working experience could not affect the relation in state owned enterprises. Furthermore, we isolate the part of the impact of economic policy uncertainty and executives' government working experience on cash holding, and examine how the part of cash holding affects corporate value. We find that cash holding to deal with uncertainty could improve corporate value of the next year; extra cash holding to deal with uncertainty from private owned enterprises whose executives have no government working experience could have a significant positive effect on corporate value. Moreover, our results are robust to different measurement for economic policy uncertainty and cash holding. Our study could provide two suggestions in practice. Firstly, it helps to enhance the understanding of liquidity demand behavior of Chinese enterprises, by providing new evidence for the determinants of cash holding from economic policy uncertainty and executives' background. Secondly, it helps the government realize that economic policy uncertainty affects the resource allocation of micro-entities, especially private owned enterprises whose executives have no government working experience. In order to strengthen private capital's confidence in the market, the government should try to maintain the continuity of economic policies and improve their predictability.


Academic libraries support teaching, learning and research functions of their institutions. Such libraries are found in universities and middle-level colleges including Kenya Medical Training Colleges (KMTC). Public libraries like Kenya National Library Services (KNLS) also support such functions in addition to their core functions like Preservation and conservation of national imprint, enhancement of reading and information seeking habits of the public. This study aimed at comparing strategies used for marketing library services in KMTC and KNLS for information utilization. A descriptive survey research study design was conducted at KMTC and KNLS in Kakamega County.Study participants were recruited using stratified sampling technique. 563 out of a population of 1738 from KMTC and KNLS was sampled using Krecie and Morgan's sample size determination. A pre-tested questionnaire and interview were used for data collection. Comparison of the marketing strategies; Exhibitions and displays, User Periodic Orientation, Suggestion Box, Library extension services, Through Friends and Tutors were significantly different between KMTC and KNLS P <0.001. Majority of those who accepted that the strategies above were used were from KNLS. However, majority of the participants disagreed about the use of library extension services. The User Periodic Orientation (OR,2.00;95% CI, 1.34, 2.98; p< .001), Suggestion Box (OR, 0.35; 95% CI, 0.24, 0.51; p< .001), Library extension services (OR, 3.05; 95% CI, 1.95, 4.78; p< .001), Through Friends (OR, 9.00; 95% CI, 10.04, 35.95; p< .001), Through tutors (OR, 7.00; 95% CI, 4.43, 12.25; p< .001) were associated with better marketing strategy. Conclusively, librarians in both libraries were knowledgeable in marketing library services. However, the study established that KMTC librarians needed to be proactive in marketing in order serve clients appropriately. The study recommended that managers of the two libraries review their policies to make marketing a mandatory exercise and train librarians in marketing for satisfactory service delivery


Even though manufacturing establishments are dispersed throughout the Quebec metropolitan area, many of them are concentrated in what may be called industrial zones. The principal characteristics of these various zones are examined in this paper, with particular emphasis on the location factors. Four of these factors appear to have been responsible for the selection of most of the various industrial sites: 1. The transport facilities ; 2. Cheap land ; 3. The possibility of extension ; 4. The proximity of labour.


Fusing the IgG1 constant region (Fc-domain) to therapeutic proteins increases their plasma half-life via neonatal Fc receptor (FcRn) binding. However, potential interactions with other Fc-binding molecules including complement C1q and Fc gamma receptors (FcγR) can have immunological consequences. Our previous studies in a mouse model suggest that engagement of the Fc-Factor IX (FIX) to FcγR on APC and NKT cells could alter the immunogenicity of the FIX moiety. Here, we conducted a comparative study of FDA-approved Fc-fusion proteins to assess their potential for C1q binding as well as FcγR binding and signaling. Binding of soluble drug to C1q was measured by ELISA, and FcγR binding and signaling was evaluated using BW5147:FcγR-ζ reporter cell lines. We demonstrate that rFIXFc and rFVIIIFc bound C1q as well as activating and inhibitory FcγRs (I, IIA, IIB, IIIA). These therapeutic proteins also signaled via FcγRIIIA, and to a lesser extent via FcγRI and FcγRIIB. Other Fc-fusion drugs (TNFR-Fc; CTLA4-Fc) bound FcγRI (TNFR-Fc also bound FcγRIIIA), but did not result in FcγR signaling. As predicted, a control anti-CD20 monoclonal antibody modified for enhanced FcγRIIIA engagement, bound and signaled via FcγRIIIA, while the parent molecule did not; supporting our use of BW5147: FcγR-ζ reporter cells for the assessment of Fc:FcγR interactions. Our studies show that Fc-fusion drugs have distinct C1q/FcγR binding and signaling properties. Moreover, FcγR binding does not predict signaling. Our studies suggest that Fc-FcγR engagement can influence the immunogenicity to Fc-fusion drugs as both fusion partners influence this interaction. Future investigations will elucidate the underlying molecular mechanisms.


Proceedings: AACR Annual Meeting 2014; April 5-9, 2014; San Diego, CA

Background: Epithelial Ovarian Cancer (EOC) is the most lethal female reproductive tract malignancy with nearly 200,000 new cases and > 125,000 deaths attributable to the disease each year worldwide. Most patients present with advanced stage disease and the cornerstone of treatment is surgical debulking followed by platinum-based chemotherapy. The major contributor to the high fatality-to-case ratio is chemoresistant disease. In fact, while 80% of patients have a complete clinical response to their primary therapy, the majority will die from disease recurrence within 5 years. The underlying tumor biology that distinguishes between platinum sensitivity and resistance is largely unknown. We sought to identify candidate biomarkers/pathways which could distinguish between these two states and test their prognostic ability.

Methods: Ovarian tumor samples from patients with primary high-grade serous ovarian cancer were divided into two groups based on response to platinum status. Transcriptome analysis was performed using RNA-Seq and Ingenuity Pathway Analysis (IPA) was used to explore differences between these two sets of samples. Findings were validated using qtRT-PCR. Survival analysis was performed in two independent sample sets. The largest set consisted of the gene expression data and relapse free and overall survival information downloaded from GEO (Affymetrix microarrays only), EGA and TCGA, representing more than 1400 samples.

Results: IPA highlighted that Interferon regulatory factor 1 (IRF1) was differentially expressed between the two clinical groups and that IRF1 expression was upregulated in the platinum-sensitive group. Validation studies performed on 31 patient tumor samples demonstrated a significant difference in PFS between the low and high IRF1 groups (P = 0.027) as well as a distinct difference in the probability of recurrence. High levels of IRF1 strongly correlated with increased overall survival in late-stage disease regardless of debulking status and grade in those patients who received platinum therapy.

Conclusion: The goal of this study was to identify candidate genes/pathways which might play a role in distinguishing between different platinum states of EOC. Using an RNA-Seq / pathway based approach, we identified differential levels of IRF1 as a predictor of both PFS and OS in patients treated with platinum agents - the gold standard of treatment. Future studies will evaluate the clinical utility of these findings.

Citation Format: John A. Martignetti, Samantha Cohen, Rebecca Mosig, Richard Halpert, Jean-Noel Billaud, Peter Dottino. Transcriptome and pathway analysis identifies IRF1 as a predictor of progression free and overall survival in ovarian carcinoma. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 5593. doi:10.1158/1538-7445.AM2014-5593


Diagnosis may be established in obscure conditions occasionally, and permanent relief given to the patient, with only a negligible risk, by a digital exploration of the heart sac. Philadelphia has been interested in the surgery of the heart and pericardium for years. In 1876 an intern of the Pennsylvania Hospital made a search in its library for literature on pericardial tapping. Some results of this study were incorporated in journal articles 1 and later in Pepper's System of Medicine, 1885, in which an improved form of pericardial aspirating trocar was illustrated. This instrument has proved a useful device. It was described in 1877 and 1881. In October of the latter year, an article, read in Brooklyn, suggested the employment of pericardiotomy to permit the suturing of cardiac wounds. 2 A suggestive article on cardiac suture by Block 3 appeared in 1882, which I mentioned before the College of Physicians of