It has been demonstrated that several messenger RNA (mRNA) isoforms have been transcribed from the alpha-fetoprotein (AFP) gene. In rats, it was reported that the novel exon, termed the exon V, exists between the exons 7 and 8, and the novel mRNA isoform (termed AFP-V mRNA) is synthesized using the exon V. In this study, a reverse transcription-polymerase chain reaction was performed and quantitative analysis was done on the AFP mRNA to identify the exon V and the AFP-V mRNA in humans. As a result, 2 novel exons, the exons VA and VB, were identified. Furthermore, 3 novel AFP mRNAs, the AFP-V1, -V2, and -V3 mRNA, were demonstrated to be expressed through alternative splicing. Expression of the AFP-V2 mRNA isoform and the wild-type mRNA was differentially regulated, implying that the AFP-V mRNA isoforms could be used in diagnosis and classification of hepatocellular carcinoma and ovarian carcinoma.


A simple and phenomenological method for the prediction of the performance of piezoelectric beams is studied. It is shown that strong resemblance between flexural, longitudinal and torsional vibrations exists in the piezoelectric case. The important information can, for all three types of vibration, be assembled in three integrals. One of these is normally negligible and the other two are related to each other. One can therefore choose to treat the beam as purely piezoelectric (Poisson's equation) or purely dielectric (Laplace's equation). The piezoelectric behavior, including the values of the well-known piezoelectric equivalent components, can be predicted once the values of the integrals are known. These values can be found using simple mathematical tools.


On-line diagnostics of induction machine faults such as broken rotor bars and shorted stator windings can be accomplished by analysing the anomalies of machine stator current. Defective rotor bars result in twice slip frequency sidebands around the fundamental frequency in the stator current, while stator winding short circuits cause changes in stator current amplitude and the occurrence of negative sequence current. This paper presents an induction machine model based on the Coupled Circuit Approach to simulate both the rotor and stator faults in an induction machine and to test fault diagnostic techniques. This model is realized in Matlab/Simulink and its construction in Simulink is explained with sufficient details. Simulation results of both the rotor and stator fault conditions are presented. A novel high-resolution spectral analysis approach and a technique based on Discrete Fourier Transform (DFT) for the detection of broken rotor bars are tested using the simulated data. The results confirm that the high-resolution method overcomes drawbacks of DFT such as the requirement for long data windows. Copyright © 2009 John Wiley & Sons, Ltd.


The provision of assessment feedback to students is an area which has received much interest in modern education, particularly in the Higher Education context. As current pedagogic practices strongly encourage the provision of feedback and given also the advances in digital technology, feedback mechanisms are becoming ever more sophisticated. However, considering that a great deal of effort is expended on timely, actionable and constructive feedback by tutors, the student perception of the value of the feedback given to them is not as positive as it could be. Currently a multitude of feedback practices have been developed and utilised, though with varying degrees of productiveness. Research in this area is understandably extremely broad as subject disciplines, use of technology, assessment types, methods and tools, educator preferences, student audience and peer and self-assessment capability all have a significant part to play. Given that the approaches to providing feedback are myriad, it is desirable to advance a systematic method of understanding the most constructive feedback types. This paper describes the development of a taxonomical classification which provides structure, order and frame to current popular practices that have evolved during the last decade. The taxonomy is then evaluated with the use of dimensions such as effectiveness/impact, satisfaction, adoption/engagement and quantity of feedback. The main finding of the taxonomical evaluation is the significance of developmental feed-forward guidance with which students are able to self-regulate and evaluate themselves. The paper concludes that this powerful combination should underpin further investigations into how assessment and feedback provision can be optimised for the experiential learning domain in general and to the work-based learning area in particular.


Ovarian tumors and cysts are major problem in women. Rupture and torsion are major damages whic h may lead to abdominal pain and acute abdomen. Cysts are the most prevalent pelvic mass in pregnancy and often associated with function disorders of menstruation which are mostly improved spontaneously. In some cases which are the result of cyst rupture, torsion or bleeding in to the cyst, laparotomy may be needed. This was a prospective - descriptive study that has been performed during 10 years, 155 cases with adnexal torsion were studied from the pathological and clinical point of view. Data was analysed using SPSS, version 16. The most prevalent age was 20 - 30 years, and almost all the cases had abdominal pain. The right ovarian was engaged in 78% of cases, and 1% were bilateral. From pathological point of view, the most prevalent type of functional mass w as follicular and luteal, which luteal was more prevalent followed by dermoid cyst. In 19% of cases, adnexal torsion occurred in pregnant women. One of the important causes for abdominal pain is adnexal torsion, especially during pregnancy and delayed in d iagnosis, may lead to peritonitis necrosis, it should be considered always as an emergency case. Early diagnosis is necessary to preserve adnex. In this study, the most prevalent parts are right adnex, functional mass type and finally dermoid cyst. Key wor d: ovarian cysts, torsion, women,


The article "Misogyny, Misandry and Misanthropy Gender Variations Corpus Analysis in Orwell's 1984" explores the problem immensely present in Society. Corpus analysis is a confirmation of the hypothesized problem. The article is a marker of systematic Misogyny, Misandry and Misanthropy. The need for personal freedom protection is identified and discussed. The problem presented in Orwell's 1984 is the hypothesis of the current state of society and motivation for a "current society" case study, the need for a "gender revisitation". Gender Variations are shown as Misogyny, Misandry and Misanthropy. Gender Variations, interdisciplinary studies trend is the corpus itself presenting Misogyny, Misandry and Misanthropy diversification, not as male, female and humankind unity. Multidisciplinarity is achieved through chosen interdisciplinarity of Language, Gender and Literature via Corpus Linguistics and Statistics. A corpus test sample has been used.


Background Chronic kidney disease (CKD) is an emerging problem worldwide due to the ageing population and increasing prevalence of risk factors, making it necessary to adjust dosage in some commonly prescribed drugs at hospital admission. Purpose To determine the frequency of the need for drug dosing adjustment in patients with CKD at hospital admission to the emergency department (ED), and the pharmacological groups most frequently involved in these adjustments. Material and methods Cross sectional study in a referral area hospital of 330 beds and 275 emergencies/day. In this hospital a medication reconciliation procedure (MRP) was implemented at hospital admission by ED in 2012 that selects patients with higher risk of reconciliation error (RE). We analysed first the frequency of patients with CKD regarding all selected by the MRP during the years 2012 to 2014. Second, we determined the frequency with which the pharmacist made recommendations for dosing adjustment in some of the drugs prescribed in the ED in these patients, and the frequency of acceptance by the emergency physician. Third, the pharmacological groups most frequently involved in these recommendations were noted. Results Of the 424 patients selected by the MRP, 20% were patients with CKD as the underlying disease at hospital admission via the ED. Of these 85 patients with CKD, 36.5% had been prescribed some drug that required dosage adjustment. The pharmacist made 41 recommendations (1.32 recommendations per patient), and 90.2% were accepted by the emergency physician. Anticoagulants, antibiotics and antidiabetic drugs were the three pharmacological groups most frequently involved in recommendations for dosage adjustment, accounting for 26.8%, 19.5% and 17.1% of recommendations, respectively. Finally, the drugs with the most recommendations were enoxaparin (17.1% of recommendations), levofloxacin (12.1%), allopurinol (12.2%) and enalapril (9.8%); these 4 drugs accounted for 51.2% of the recommendations. Conclusion The three pharmacological groups most commonly involved in recommendations for dosage adjustment posed a high risk to the patient in terms of improper dosing. Hence we consider it essential that the pharmacist participates in the patient care team in the ED so that incorrect prescriptions can be avoided. References and/or Acknowledgements Thanks to the ED. No conflict of interest.


1. Three types of experimental trauma to an epiphysis were carried out in rabbits.

2. A small part of the central portion of the epiphysis can be damaged and result in only mild or moderate growth interference.

3. When the entire peripheral portion of an epiphysis is damaged, marked growth limitation and deformity can be expected.

4. Extensive damage to or destruction of the central area of an epiphysis will result in a most marked interference in growth, but with less deformity.

5. It is noted that an osteocartilaginous exostosis may result when a patch of epiphyseal cartilage cells is displaced outside the shaft of the bone.

6. Extreme care to avoid damage to an epiphysis should be taken when bone surgery is necessary in children.


Functional bowel disorders are probably the most common conditions that a gastroenterologist will encounter. Outpatient clinics are frequented by patients with symptoms of dyspepsia, abdominal discomfort, bloating, nausea/vomiting, diarrhoea and constipation. These symptoms are often vague and the cause difficult to determine; in some ways it can be a relief to recognise an abnormality, such as an ulcer or inflammation, that can be treated successfully! However, what happens if there is no abnormality on examination and all the conventional tests, such as blood tests or an endoscopy, are normal? How should one treat these patients? Are the symptoms all in the mind? These patients are often very vulnerable, having already seen a number of gastroenterologists and not received adequate answers. This sadly leads to overinvestigation and often reinvestigation of the patient. The lack of a diagnosis leads to patient dissatisfaction with the medical profession, but also frustration on the part of the clinician. Unfortunately, this is mainly because of the paucity of efficacious treatments for, as yet, an undefined diagnosis and patients are labelled as having ' functional'  problems.


To evaluate the value of 50% reduced-dose cerebral computed tomography (CT)perfusion imaging (CTPI) to show the perfusion abnormalities in Alzheimer's disease (AD), as an attempt to develop a new imaging protocol with lower radiation dose to track the correlation of AD with regional blood flow abnormalities. A total of 52 patients with AD were assigned to the AD group and 28 healthy volunteers served as the control group. All participants were given a 50% reduced-dose cerebral CTPI (current was reduced from 160 to 80 mA) test by a multislice spiral CT scanner. Perfusion parameters of the bilateral frontal cortex, temporal cortex, hippocampus, and basal ganglia were measured, including the cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), and time to peak (TTP). Both the CBV and CBF values of the measured regions were significantly higher in the healthy control group than in the AD group (P < .05), while the MTT and TTP values of these cerebral areas were significantly lower in the healthy control group than in the AD group (P < .05). Four perfusion parameters, namely the MTT of the left frontal cortex, right temporal cortex, right basal ganglia, and right hippocampus, had the greatest sensitivity and a striking correlation with the incidence of AD. The blood flow per unit of time in the regions of interest was significantly lower in the AD group, which provides new evidence for the existence of microcirculation disturbance and ischemia in AD. The 50% reduced-dose cerebral CTPI scan is valuable to show the regional perfusion abnormalities in the patients with AD.


This article reviews the literature relating to the workplace issues of expecting and new parents within the framework of diversity management. Family status is a secondary dimension of diversity, and organisational responses to pregnant workers, new parents and those returning to work have rarely been explored in the context of diversity management. The concepts of diversity, diversity management and the benefits of effective diversity management are explored in relation to new and expecting parents. The issues of working mothers, pregnancy, breastfeeding, discrimination, industry segmentation, organisational commitment and organisational social responsibility in relation to diversity management are discussed. Recommendations are made regarding maternity leave, paternity leave, return to work strategies, flexible work practices, organisational culture and the role of supervisors.


Previous clinical trials have shown that anti-platelet drugs, such as aspirin and ticlopidine, are approved for prevention of serious cardiovascular events in special populations who are at increased risk of cardiovascular events. Of these trials, the Antithrombotic Trialists' Collaboration (ATT) meta-analysis includes approximately 200,000 patients: Anti-platelet therapy was associated with a 34% reduction in the risk of nonfatal myocardial infarction, a 25% reduction in the risk of stroke, and a 15% reduction in the risk of vascular death. Also in patients with acute coronary syndrome (acute myocardial infarction and unstable angina), both aspirin and ticlopidine have been shown to prevent serious cardiovascular events.


MM-398 is a stable nanotherapeutic encapsulation of the prodrug irinotecan (CPT-11) with longer plasma half-life and higher tumor deposition due to an enhanced permeability and retention effect. Pancreatic cancer has responded poorly to many therapeutics, largely because of inadequate drug penetration due to poor vascularization and the highly aggressive, hypoxic nature of the disease. We sought to better understand how MM-398, a relatively large (100nm) liposomal nanotherapeutic, could be used treat pancreatic cancer. We have tested MM-398 in several pancreatic xenograft models: BxPC3 (KRAS wild type), AsPC-1(KRAS G12D) , Panc-1 (KRAS G12D) and MiaPaCa (KRAS G12C). All models demonstrated complete tumor regression at 20 mg/kg or a human equivalent dose of 60-120 mg/m2. At this same dose, MM-398 suppresses tumor growth in a gemcitabine insensitive AsPC-1 xenograft. MM-398 functionally blocked AsPC-1 tumor cell proliferation as measured by ki-67 staining; however, gemcitabine administered at its maximum tolerated dose did not impact proliferation. MM-398 is currently in multiple clinical trials, including a phase 3 trial for patients with advanced gemcitabine-resistant pancreatic cancer (NAPOLI-1). In order to further understand mechanisms driving response to MM-398, we screened and ranked several cell lines for their ability to convert irinotecan into the active metabolite, SN38. BxPC3 and HT-29 tumors ranked highest in ability to convert irinotecan to SN-38, as measured by HPLC. In a BxPC3 pancreatic orthotopic model which spontaneously metastasizes, 10 mg/kg MM-398 significantly reduced both primary and metastatic tumor load as measured by ex vivo biophotonic imaging of BxPC3luc cells to spleen, lung, liver, diaphragm and GI associated lymph nodes (p In summary, MM-398 induces tumor regression in multiple mouse models of pancreatic cancer, including an orthotopic metastatic model. MM-398 activity may be driven in part by the ability to modify tumor microenvironment parameters, such as hypoxia and vascularization, both of which limit efficacy of chemotherapeutic agents in the treatment of pancreatic cancer. These data support the continued investigation of MM-398 in pancreatic cancer. Citation Format: Nancy Paz, Peter Laivins, Clet Niyikiza, Ulrik Nielsen, Jonathan Fitzgerald, Ashish Kalra, Milind Chalishazar, Stephan Klinz, Jaeyeon Kim, Daryl Drummond, Dmitri Kirpotin, Victor Moyo, Eliel Bayever. MM-398/PEP02, a novel liposomal formulation of irinotecan, demonstrates stromal-modifying anticancer properties. [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Progress and Challenges; Jun 18-21, 2012; Lake Tahoe, NV. Philadelphia (PA): AACR; Cancer Res 2012;72(12 Suppl):Abstract nr A63.


The background of this research was carried out because of the importance of efforts to improve learning achievement in biology through several methods or optimal learning strategies. The purpose of this study was to determine the improvement in the quality of the process and learning outcomes that have an impact on learning achievement in biology after applying the principles of biotechnology with the experiential learning model of class XII IPA2 students of SMA Negeri 1 Pasui. This research is a classroom action research which investigates student factors, teacher factors and the quality of the biology learning process and outcomes. The research location is SMA Negeri 1 Pasui, Enrekang Regency, class XII IPA2, with a total of 21 students in the even semester of the 2016-2017 school year. The implementation of the action consists of two cycles followed by evaluation and reflection activities. The results of the study show that the application of biotics with the experiential learning model can improve the quality of the process and student learning outcomes. Student responses are very positive and student learning outcomes improve each cycle. Keywords : prinbiotech, experiential learning, process quality and learning outcomes


From the methodological perspective, the thesis summarized leisure tea act, judging-time tea act to map translator's style. Through investigations on all these, the thesis succeeded in confirming the translator's styles and pinpointing cultural identity as essential factors influencing their styles. Hopefully, this could help to provide a new angle of view to make research on translator's style. Moreover, the thesis wishes that with analysis of tea culture in Hong Lou Meng the translation of tea relevant acts receive greater priority in the Chinese Classics Translation.


: Industries using conventional fossil fuels have an interest in better understanding the mechanism of particulate formation during combustion since such is responsible for emission of undesired inorganic elements that directly impact the atmospheric pollution level. Fine and ultrafine particulates have tendency to escape the flue gas cleaning devices to the atmosphere. They also preferentially collect on surfaces in power systems resulting in ascending in corrosion inclination, descending in the heat transfer thermal unit, and severe impact on human health. This adverseness manifests particularly in the regions of world where coal is the dominated source of energy for consumption. This study highlights the behavior of calcium transformation as mineral grains verses organically associated inorganic components during pulverized coal combustion. The influence of existing type of calcium on the coarse, fine and ultrafine mode formation mechanisms is also presented. The impact of two sub-bituminous coals on particle size and calcium composition evolution during combustion is to be assessed. Three mixed blends named Blends 1, 2, and 3 are selected according to the ration of coal A to coal B by weight. Calcium percentage in original coal increases as going from Blend 1 to 3. A mathematical model and a new approach of describing constituent distribution are proposed. Analysis of experiments of calcium distribution in ash is also modeled using Poisson distribution. A novel parameter, called elemental index λ, is introduced as a measuring factor of element distribution. Results show that calcium in ash that originally in coal as mineral grains has index of 17, whereas organically associated calcium transformed to fly ash shown to be best described when elemental index λ is 7. As an alkaline-earth element, calcium is considered the fundamental element responsible for boiler deficiency since it is the major player in the mechanism of ash slagging process. The mechanism of particle size distribution and mineral species of ash particles are presented using CCSEM and size-segregated ash characteristics. Conclusions are drawn from the analysis of pulverized coal ash generated from a utility-scale boiler.


Catholics in the liberal pluralism state. Facing secularisation in the monthly Znak (1989–2000): The aim of this paper is to analyse the philosophical, sociological, politological, theological and press articles on the issue of secularisation that were published in the monthly Znak during 1989–2000. A definition of secularisation is employed that was coined by Charles Taylor in A secular age (Taylor, 2007). It is understood as the endurance of religion in a plural society. The paper delineates three stands that the Znak Catholics have taken when facing secularisation: (1) an open catholicity; (2) a liberal faith; and (3) an ambiguous one. (1) The first approach involves confronting one's liberal, secular partners in public debates, with a focus on finding some of their points acceptable according to the Church doctrine. Nevertheless, it is burdened with the anxiety of losing one's own identity. (2) The second approach emphasises some of the connections between liberal and Christian ideas. A particular meaning of liberty and authenticity in human existence is stressed. (3) In the third approach, although it does not admit to its malevolence, the liberal ideas are treated with sharp criticism. Liberalism is accused of limiting the role of religion in a plural society. In the conclusion to the paper, an attempt is made to present the current relations between liberalism and Christianity in Po‑ land. A deep recent transformation is revealed. It is believed that Znak will lose its function as a continuity sustainer in the next few years.


Endodontically treated teeth restored with posts are susceptible to coronal leakage after long-term function. We hypothesize that demineralized collagen matrices (DCMs) created in dentin by acidic zinc phosphate cement within the dowel spaces degrade with time. Forty-two post-restored teeth were extracted after three periods of clinical service and were examined, by means of scanning and transmission electron microscopy, for the status of the DCMs. SEM revealed a progressive degradation of the DCMs, becoming less dense after 3 to 5 years, losing structural integrity after 6 to 9 years, and partially disappearing after 10 to 12 years. TEM revealed evidence of collagenolytic activity within the DCMs, with loss of cross-banding and unraveling into microfibrils, and gelatinolytic activity that resulted in disintegration of the microfibrils. Bacterial colonization and the release of bacterial enzymes and of host-derived matrix metalloproteinases may contribute to the degradation of collagen fibrils in root dentin after clinical function.


Theories of Decentralization and Local Government brings fresh perspective to the debate and comparative analysis of vertical division of power; i.e. processes of decentralization and relations between central and local (self) governments. The multiple author book is not just one of many similar around the globe, as it encompasses contributions from many different academics from not only different countries, but also different continents and even more importantly, very different political traditions and cultures. This way, the book deepens and strengthens knowledge of the role of local governments in the contemporary world, and brings new value to discussions on the relationship between decentralization and development. Contributors include: Ahmed Mustafa Elhussein Mansour, Hong Pang, Abdulfattah Yaghi, Jose Neftali Recinos, Gariela Miranda-Recinos, Lee Payne, Heather Wyatt Nichol, Ed Gibson, James Newman, Kwame Asamoah, Minerva Cruz, and Alexandra Tsvetkova.


A 45-year-old man was presented at the emergency department with altered neurological status and a 1-day history of diarrhoea and fever. The patient's sexual history revealed multiple male partners. As bacterial meningitis or viral encephalitis was suspected, treatment was started accordingly. Cerebrospinal fluid investigations only showed a slight increase of leucocytes, and microbiological studies remained negative. Stool culture revealed Shigella flexneri, after which Shigella-associated encephalopathy was suspected. The patient recovered quickly with antibiotic treatment. The incidence of Shigella infections in the Western world is rising due to sexual transmission among men who have sex with men. Shigella-induced encephalopathy is a notorious complication among children with a severe form known as the Ekiri syndrome, though rarely seen in adults. This is the second report of encephalopathy in an adult with S. flexneri enteric infection.


Significance Our study is a randomized trial in policing confirming that intensive training in procedural justice (PJ) can lead to more procedurally just behavior and less disrespectful treatment of people at high-crime places. The fact that the PJ intervention reduced arrests by police officers, positively influenced residents' perceptions of police harassment and violence, and also reduced crime provides important guidance for police reform in a period of strong criticism of policing. This randomized trial points to the potential for PJ training not simply to encourage fair and respectful policing but also to improve evaluations of the police and crime prevention effectiveness.


The purpose of this study is to derive COE reduction targets of offshore wind power in Korea. In addition, innovation factors for achieving the COE reduction targets were derived. Also the COE reduction targets of offshore wind power was to improve that national policy, technology, industry and improving regulations would like to help. The results of this study has been created based on the various assumptions, scenarios and experts` discussions. Currently, offshore wind power generation price is 229.72won/kWh in 2012. According to the study, COE of offshore wind power has been proposed 88.8won/kWh at third scenario by 2030. This result has shown competitiveness with fossil fuel power generation.


Passive gamma-ray spectrometers composed of attenuation filters and integrating detection materials provide important advantages for measurements in high-radiation environments and for long-term monitoring. Each of these applications has requirements that constrain the design of the instrument, such as incident energy range of interest, sensor size and weight, readout method, and cost. The multitude of parameters in passive spectrometer design (e.g. attenuation filter material and thickness, integrating sensor type, numbers of pixels, reconstructed energy bin structure) results in a large design space to examine. The development of generalized design optimization tools to interrogate this space and to identify promising spectrometer designs is discussed, particularly the methods used to rapidly calculate system transfer functions and the use of genetic algorithms for design optimization. Specific examples of preliminary design optimization efforts are provided.


To investigate the immune defense mechanisms employed against fungi in the brain, mice were experimentally infected by intracerebral inoculation of Candida albicans or Cryptococcus neoformans. Parameters such as median survival time and numbers of yeast cells in the brains were assessed for naive and immunomodulated mice. We found that no mice survived either C. albicans or C. neoformans challenge at doses of > or = 10(6) yeast cells per mouse. However, when the inoculum size was decreased (< or = 10(5) yeast cells per mouse), C. albicans was no longer lethal (100% survival), whereas 100 and 70% of the mice still succumbed to challenge doses of 10(4) and 10(3) C. neoformans yeast cells, respectively. Pharmacological manipulation and transfer experiments revealed that the myelomonocytic compartment had a minor role against C. neoformans but was deeply involved in the control of intracerebral C. albicans infection. By counting the number of yeast cells in the brains of naive and immunomodulated animals, we established that, unlike C. albicans, C. neoformans remained essentially in the brain, where massive colonization and damage occurred whether naive or immunomodulated defense mechanisms were employed by the host. Overall, these data suggest that the differential role of the myelomonocytic compartment, together with the diverse tropisms of the two fungi, can explain the different development and outcome of intracerebral C. albicans and C. neoformans infections.


Introduction: Dacomitinib (PF-00299804), an irreversible pan-human epidermal growth factor receptor ([HER]-1/EGFR, HER-2, and HER-4) tyrosine kinase inhibitor, demonstrated antitumor activity in Western patients with non–small-cell lung cancer (NSCLC) at a dose of 45 mg once daily. We report data from a phase I/II, multicenter, open-label study of Korean patients with refractory KRAS wild-type adenocarcinoma NSCLC (defined as patients with evidence of disease progression during or within 6 months of treatment with chemotherapy and gefitinib or erlotinib). Methods: The phase I dose-finding portion identified the recommended phase II dose (RP2D) in Korean patients, evaluated safety, and characterized the pharmacokinetics of dacomitinib. In the phase II portion, patients received dacomitinib at the RP2D. The primary end point was progression-free survival at 4 months (PFS4m). Results: Twelve patients enrolled in phase I, and 43 patients enrolled in phase II at the RP2D of 45 mg once daily. In phase II, PFS4m was 47.2% (95% confidence interval [CI], 31.6–61.3; one-sided p-value = 0.0007). Median PFS was 15.4 weeks (95% CI, 9.7–17.6); median overall survival was 46.3 weeks (95% CI, 32.7–not reached); and the objective response rate was 17.1% (95% CI, 7.2–32.1). Common treatment-related adverse events were dermatitis acneiform, diarrhea, and paronychia; there were no treatment-related grade 4 or 5 adverse events. Pharmacokinetic parameters of dacomitinib in Korean patients were similar to those reported in Western patients. By patient report, NSCLC symptoms "cough" and "pain" showed improvement within 3 weeks of initiating treatment. Conclusions: Dacomitinib was well tolerated and had antitumor activity in Korean patients with NSCLC who had previously progressed on chemotherapy and an epidermal growth factor receptor tyrosine kinase inhibitor.


HISTORY AND CLINICAL FINDINGS
A 63-year-old man was admitted to a surgery department with fracture of the acetabulum and luxation of the hip joint. Eight days after intracondylar nail-extension during subcutaneous heparin prophylaxis he developed a dramatic deterioration of his condition with severe abdominal pain and fever and was admitted to our hospital.

INVESTIGATIONS
White cell count was 12,000/microliter, C-reactive protein 7.90 mg/dl. CT-scan, abdominal ultrasound, mesenteric angiography and exploratory laparotomy revealed no pathological findings. At day 13 abdominal ultrasound showed adrenal haemorrhages on the right. Together with a drop in platelet count below 50,000/microliter, adrenal haemorrhage caused by heparin-induced thrombocytopenia (type II; immunological [HIT II]) was suggested.

THERAPY
After discontinuation of heparin and starting therapy with recombinant hirudin and hydrocortisone, a dramatic clinical recovery followed within 24 hours. One year after the initial diagnosis the patient is in a good condition.

CONCLUSION
When abdominal pain, hypotension and fever occurs with a drop in platelet count during heparin therapy HIT II should be considered. An early diagnosis is essential for treatment of this life-threatening complication at an early stage.


Working capital in business is akin to that of heart in human body. Efficient working capital management requires well-balanced funds without which either scarcity of funds will cause obstruction in the smooth functioning of an organization or excess funds will prevent an organization from conducting its operation dexterously. Hence, a great deal of attention must be given to the management of current assets investment in an organization. Management can exercise different sources astutely in financing working capital. In this paper, an attempt has been made to unearth the size of short-term financing pattern used to finance current assets along with the contribution of various sources in the context of the selected five IT sector companies. This paper epitomizes an empirical study of the selected companies in India from diverse perspectives through statistical techniques, tables, secondary data collection strategy accessed through Internet and academic databases viz. literature reviews, website, books, journals, annual reports, etc. from 2012-2013 to 2021-2022. The results of the study show that short-term financing does not meet the full financial requirements of current assets and proportion of various short-term sources in financing working capital requirements has also mixed pattern over the years in the selected units under study.


This paper reviews dynamic light scattering (DLS) of gold nanoparticle-protein interactions for the model protein bovine serum albumin (BSA), as well as in complex biofluids, at the example of mouse serum. DLS data of nanorods of various aspect ratio, of proteins and of mouse serum are discussed in terms of the analysis of their hydrodynamic radii, leading to the distinction of rotational and translational motion as well as to the detection of agglomerates. We address in particular advances obtained by modulated 3D cross correlation dynamic light scattering and recent progress using the CORENN algorithm for analysis of DLS data.


The reason of post-operative introital stenosis in girls with CAH is a poor estrogenization of external genitalia before vaginoplasty. It is possible that the local sensitivity to estrogens can be reduced due to prenatal androgen excess in addition to inadequate compensation, which results to decrease of estrogens production by the ovaries. Objective. To determine the distribution of estrogen and androgen receptors in genital tissue, depending on the form of CAH, the degree of external virilization and serum levels of androgens. Material and methods. The waste surgical tissues obtained during routine feminizing genitoplasty (clitoro- and vaginoplasty) was used for immunohistochemical study of estrogen (α and β) and androgen receptors in girls with CAH (n=13 and n=8, respectively). Results. The expression of estrogen (α, β) and androgen receptors was determined in genital tissues of girls with CAH. There was no significant correlation between the number of immunopositive cells in the tissues of labia minora and vagina and the degree of virilization, as well as between the number of cells expressing the receptors and serum levels of androgens (testosterone, 17-hydroxyprogesterone). There was no difference in the expression of estrogen and androgen receptors between girls with salt-wasting and simple virilizing forms of CAH. The expression of estrogen receptor α in vaginal tissues was reduced in girls who underwent repeated vaginoplasty and were under preoperative local estrogen therapy in comparison to patients in whom the vaginoplasty was performed for the first time (p=0.045). Conclusion. The distribution of estrogen and androgen receptors in the labial and vaginal tissues in girls with CAH doesn't depend on the form of disease, external virilization and serum levels of androgens. Girls undergoing repeated vaginoplasty may have a reduced sensitivity to local estrogen therapy due to decrease of estrogen receptors expression in the vaginal mucosa.


Selenium, long recognised as an important 'dietary antioxidant', is now known to be an essential component of the active sites of a number of enzymes, including the glutathione peroxidase selenoenzyme family which scavenge hydroperoxides to prevent cellular damage. Dietary selenium deficiency has been linked to diseases as diverse as cancer, heart disease, arthritis and AIDS, and epidemiological evidence is now emerging for the beneficial effects of selenium supplementation. Thus, the pharmacology, biology and biochemistry of selenium metabolism have become subjects of considerable interest, which are spurring efforts to develop synthetic selenium-containing compounds as potential therapeutic agents. Phenylaminoalkyl selenides were developed in the authors' laboratories as novel, selenium-based pharmacological agents. We demonstrated that these compounds exhibited dose-dependent antihypertensive activity in spontaneously hypertensive rats. Biochemical studies established that as a consequence of the redox properties of their selenium moieties, these phenylaminoalkyl selenides possessed the remarkable property of propagating a cycle of turnover-dependent local depletion of reduced ascorbate when processed by the key enzyme of catecholamine metabolism, dopamine-beta-monooxygenase. On the basis of inductively coupled plasma/mass spectroscopic analyses, corroborated by operant behaviour and locomotor activity investigations, an orally-active phenylaminoalkyl selenide with restricted CNS permeability was successfully developed. To our knowledge, this compound--4-hydroxy-alpha-methyl-phenyl-2-aminoethyl selenide--is the first orally active, selenium-based anti-hypertensive compound ever reported. In the future, we anticipate more widespread efforts to incorporate selenium into rationally designed pharmaceutical agents, with the goal of developing novel compounds which may be of therapeutic benefit toward a variety of human diseases.


The structural and electronic properties of clean and hydrogenated diamond (100) surfaces have been investigated via fully self-consistent ab initio calculations. We find that the clean and the monohydrogenated surfaces reconstruct via the formation of rows of symmetric dimers. Further hydrogenation to a coverage of 1.5 monolayers stabilizes a surface with a (1 × 1) periodicity in the C layers, albeit with a low H-desorption energy for the formation of the reconstructed monohydride surface. The electronic properties of the surfaces have been calculated. Surface states within the bulk gap are found for the clean surface and for the strongly hydrogenated surface, but not in the monohydride case.


INTRODUCTION Aortic root (AoR) dilation is associated with cardiac damage and higher cardiovascular risk. Cardiovascular disease is the most common cause of death in patients after kidney transplantation (KTx ). OBJECTIVES The aim of this study was to assess the prevalence of enlarged AoR diameter in KTx recipients. Patients with bicuspid aortic valve, significant valvular disease, or evidence of connective tissue disorder were excluded. PATIENTS AND METHODS A total of 87 KTx recipients were divided into 2 groups depending on immunosuppressive regimen: 41 patients receiving mammalian target of rapamycin inhibitors (mTORi) and 46 patients treated with calcineurin inhibitors (CNIs). In all patients, echocardiography was performed, laboratory and clinical markers of cardiovascular risk were assessed, and the AoR diameter was calculated. RESULTS There were no differences between groups in age, sex, body surface area, body mass index, frequency of diabetes, hypertension, dyslipidemia, time after replacement therapy, creatinine levels, and estimated glomerular filtration rate. In the CNI group, the observed and calculated AoR diameters were similar (P = 0.8). In the mTORi group, the observed AoR diameter was higher than the calculated one (P = 0.002). The concentric and eccentric left ventricular hypertrophy was similar in both groups (P = 0.12 and P = 0.69, respectively). In the stepwise regression analysis, the AoR diameter was associated with body surface area and mTORi treatment. CONCLUSIONS KTx recipients have a high prevalence of AoR dilation. Immunosuppressive regimen based on mTORi increases the incidence of AoR enlargement.


Context In recent years there has been an increase in the availability of 'novel psychoactive substances (NPS)' or 'legal highs'. In turn, there is concern as to the risks these compounds pose as compared to those posed by traditionally misused substances such as illicit diamorphine (heroin), methadone, cocaine, and amfetamines. Methods We reviewed deaths where opiates/opioids, stimulants, hypnosedatives, hallucinogens, or volatile substances were mentioned on the death certificate in England and Wales, 1993–2016 as recorded on the Office for National Statistics drug poisoning deaths database. Deaths were analysed by year of registration of death, age, sex, intent, drug(s) involved, and the presence of alcohol (ethanol). Results There were 68,347 drug-related deaths in England and Wales (includes both licit and illicit substances), of which 15,457 were either coded as, or had mention of, drug dependent/non-dependent substance abuse on the death certificate. Opioids, particularly diamorphine/morphine and methadone, featured in most deaths. Diamorphine/morphine-related deaths (17,402) increased from 155 in 1993 to 981 in 2001, and then remained relatively stable until 2010 (791). Thereafter, annual numbers of deaths fell to 579 in 2012, but have since increased to 1,209 (2016). Deaths in the age group 20–29 years declined from 46% (1993), to 13% (2016), whereas in those aged 40–49 years the percentage of deaths increased from 13% (1993) to 33% (2016). Methadone was mentioned in 7,894 deaths (1993–2016). Annual numbers of such deaths increased from 206 to 437, 1993–7, then declined, but have since increased, reaching 413 in 2016. As to age, a similar pattern as to diamorphine/morphine-related deaths is apparent. Annual numbers of deaths involving cocaine (1993–2016: 3,342), reached 235 in 2008, declined, but have since increased (2011: 112, 2016: 371). Annual numbers of deaths involving methylenedioxyamfetamine/ methylenedioxyethamfetamine/ methylenedioxymetamfetamine ('ecstasy') (1993–2016: 853), have also increased steadily in recent years (2010; 8, 2016: 65). There were relatively few mentions of 'novel stimulants' (1993–2016: 386) on death certificates and such deaths have declined in recent years (2015: 88, 2016: 57). Mephedrone was most frequently mentioned (122), as was para-methoxyamfetamine/para-methoxymetamfetamine (88). Conversely, although synthetic cannabinoids were mentioned infrequently (1993–2016: 37), such deaths have increased recently (2015: 8, 2016: 26). Conclusions Illicit diamorphine (heroin) and methadone continue to be the principal drugs of abuse involved in fatal poisonings in England and Wales. The increase in such deaths in recent years has been largely due to an increase in deaths amongst older users, although the role of potent synthetic opioids such as carfentanil is a cause for concern. Overall, stimulants and related compounds have been implicated in an increasing number of deaths annually. The impact of the plethora of NPS that have appeared in recent years on fatal poisonings may have been mitigated by legislation.


Experimental observations on thermal injury and death of bacteria in the stationary phase can be explained by assuming that death results from inactivation of (XL) of N critical sites. It is assumed: (i) that inactivation of individual sites occurs at random and follows first-order kinetics, (ii) that the critical sites are identical and of equal heat resistance, and (iii) the bacterial population is homogeneous in heat resistance. A method is described for calculating k (the rate constant for inactivation of individual sites), N (sites per cell), and XL (the number which must be inactivated to cause death under the experimental conditions used) from experimental data. Theoretical curves calculated by using this model are identical with experimental curves, providing support for the assumptions used. Calculated values of N and XL were 130 and 21.7 for Pseudomonas viscosa and 175 and 2.7 for Salmonella anatum. There is considerable uncertainty in the absolute values of N, but they are probably > 100. It is predicted that XL will vary depending on the recovery medium used after heating. This theory is consistent with all experimental observations on thermal injury and death of bacteria.


IN THIS NOTE APPEARS AN ADJUSTMENT TO THE POSSIBLE SETTINGS OF THE MEXICAN ECONOMY FOR 2002 BASED ON THE EUDOXIO´S ECONOMETRIC MODEL, CONSIDERING THREE CENTRAL CHANGES DETERMINED BY THE GREATER GROWTH OF THE US ECONOMY, THE EXPECTATION OF A SMALLER NOMINAL DEPRECIATION OF THE EXCHANGE RATE AND THE OIL INTERNATIONAL PRICES.


This paper reports on one particular aspect of a survey conducted in Wales- namely the relation between Christian belief and two of the most characteristic marks of post-Enlightenment modem society. These are (i) personal autonomy or freedom and (ii) egalitarianism or social autonomy in a pluralistic society. The question, therefore, is whether there is any causal-relation, positive or negative, between modernity and current perceptions of God and God's relation to the world. Such a study could illuminate, on the one hand, how contemporary Christians handle a belief in God that has to take account of the pressures of modernity and, on the other hand, whether having religious faith actually affects attitudes.


Understanding and monitoring life history traits is often important in endangered species conservation. Populations of the endangered mussel Cumberlandian combshell Epio blasma brevidens have continued to decline in the Powell River, USA. Understanding and modeling mussel growth is critical for effective reintroduction of this endangered species. In this study, 2 yr old E. brevidens that were produced in our laboratory were released to the Powell River in 2009 to augment this declining population. A mark-recapture monitoring approach using passive integrated transponder (PIT) tags was used to assess the survival and growth of the released mussels. Hierarchical Bayesian growth models incorporating individual growth variations, periodic growth and growth cessations, along with multiple release occasions were developed and compared to the classic von Bertalanffy growth model. Our results showed that the hierarchical model that incorporated individual growth variation gave the best estimates of model parameters, yielding the lowest deviance information criterion value. Mussels exhibited different growth rates (K), including 0.015, 0.026, 0.110 and 0.050 (mo–1), corresponding to the duration of laboratory culture (ages 2, 3 and 4 yr old) and a growth cessation (GC) for 5.98 mo, respectively. The other parameters of asymptotic length (L∞) and age at zero length (t0) were 51.36 mm and −0.648 mo. The flexible structure of Bayesian hierarchical models allowed us to examine growth characteristics of E. brevidens in a changing environment to better understand the details of its growth and lifespan, thus providing useful data for conservation management.


Abstract This study examined the association between intensive board monitoring (IBM) and segment disclosure quality (SDQ). It also investigated whether this association can be moderated by firm's home country investor protection (IP) level. Based on a panel of 271 non-financial European Union (EU) listed corporations covering the 2007–2012 period, this study estimated two multiple regression models including industry and year fixed effects. We found evidence that the segment disclosure quality is higher when a majority of outside directors serve on monitoring committees. We, also, found that the positive association between IBM and SDQ is more pronounced for firms in a weak IP environment and less pronounced for firms in a strong IP environment. Thus, we provided evidence in favor of a substitutive relationship between IBM and IP level with respect to their association with SDQ. Our findings are evidenced by several robustness tests.


Context There are increasing evidences that spleen preservation is of clinical value for patients undergoing distal pancreatectomy. Laparoscopy appears to increase the rate of spleen preservation through both Warshaw and Kimura techniques. Objective To present early and long term outcomes of a consecutive series of laparoscopic distal pancreatectomies with or without splenectomy and to discuss the pros and cons of spleen preservation. Methods All patients undergone laparoscopic distal pancreatectomy were included in the study. Demographic and clinical characteristics were analyzed. Postoperative complications were prospectively recorded in an institutional database. Long term follow up was assessed by outpatient clinic and direct contact. Follow up ended on May 2012. Results In the Surgical Unit B between May 1999 and December 2011, 95 consecutive patients underwent laparoscopic distal pancreatectomy (76 female, mean age 46.8 years). Conversion rate was 3.2%. En bloc splenectomy was associated in 56 patients (59%). Among 39 patients (41%) with spleen preservation, 9 had a Warshaw procedure. Mortality was nil. Postoperative pancreatic fistula developed in 26% while a re-operation was necessary in 10.5%. In three patients splenectomy was performed during the reoperation. In the long term follow up, 19% of spleen preserving subgroup developed asymptomatic gastric varices. Overall 68% of splenectomized patients adhered to vaccine prophylaxis while one patients who did not, developed a severe sepsis; 13% had a more than 2 years persistent reactive thrombocytosis requiring anti-aggregation therapy. None thromboembolic accident was reported. Conclusion Laparoscopy is a good tool to perform spleen preserving distal pancreatectomy. Spleen preservation per se is a "risk factor" for specific early and late complications with or without splenic vessels sacrifice. Splenectomy leads to an increased risk of infectious and vascular accident adequately preventable by vaccination and anti-aggregation therapy.


The paper is aimed at examining relation between factors determining export behavior and propensity to innovate to fill Afghanistan specific literature gap. For this purpose, a number of 236 small and medium manufacturing firms were targeted as statistical unit of analysis. Required data were collected through questionnaire distributed to owner/manager of firms. Descriptive statistics as well as multivariate probit regression were utilized to analyze the data. Findings confirmed no significant relationship between export behavior and propensity to innovate. It further suggests that marketing innovation and technological advancement positively and significantly influence export behavior and propensity to innovate. Furthermore, and unlike result of many other similar studies there was insignificant influence of firm size and firm age on propensity to innovation.


Poor joint proprioception and balance maintenance may lead to sports injuries. Numerous studies have indicated that self-myofascial release (SMR) can improve the function of the proprioception and balance systems. Thus, this study aimed to investigate the effects of acute bouts of SMR on the center of pressure displacements during four stance positions, knee joint position sense at 45° and 90° in open kinetic chain tasks, and dynamic balance during the Y-balance test. Forty-two recreationally active females aged 20–25 years were assigned to either the foam roll group performing 1 min × 3 sets of SMR in the posttest session (N = 22) or the control group (N = 20). Joint position sense at 90° (p = .021), dynamic balance in the anterior (p = .007) and posterolateral (p < .001) directions, as well as the composite score (p = .001), improved significantly in the foam roll group. According to the findings, SMR may improve knee joint position sense at 90° and dynamic balance without any significant impacts on postural sway.


The goal of this research is to see how the Think Pair Share (TPS) cooperative model affects student learning outcomes in integrated theme learning in class V Cluster I, Jurai District IV. This study used a non-equivalent control group design, which is a type of quasi-experimental methodology. This research covered all pupils in class V Cluster I, Jurai District IV. The experimental and control classes were created through purposeful sampling, with class V A acting as the experimental class and class V B functioning as the control class. The hypothesis was evaluated with a t test at a 95% confidence level (α = 0.05), and the results indicated that tcount > ttable (2,434 > 2,045), showing that H1 is correct. As a consequence, using the Think Pair Share (TPS) cooperative learning technique in integrated theme learning in class V of Elementary School had a significant influence on student learning outcomes.


This paper examines the experiences of women with infertility in two Nigerian communities with different systems of descent and historically different levels of infertility. First, the paper focuses on the life experiences of individual women across the two communities and second, it compares these experiences with those of their fertile counterparts, in each community. In doing this, women who are childless are distinguished from those with subfertility and compared with high-fertility women. The research is based on interdisciplinary research conducted among the Ijo and Yakurr people of southern Nigeria, which included a survey of approximately 100 childless and subfertile women and a matching sample of 100 fertile women as well as in-depth ethnographic interviews with childless and subfertile women in two communities: Amakiri in Delta State and Lopon in Cross River State. The findings indicate that while there are variations in the extent to which childlessness is considered to be problematic, the necessity for a woman to have a child remains basic in this region.


This sketch presents a real-time system that aims to bridge a gap between machine listening technology, and self-editing, self-synchronizing video: a movie organizes itself from "listening" to music. In our current demonstration, a series of short video clips of "Cati" dancing, originally shot at different tempi, are arbitrarily sequenced, always in sync with the analyzed beat, i.e., if the music slows down, the dance slows down accordingly. When no beat is found, e.g., the music is mellow, then Cati stops dancing and waits, apparently bored.


Transformer based language models have led to impressive results across all domains in Natural Language Processing. Pretraining these models on language modeling tasks and finetuning them on downstream tasks such as Text Classification, Question Answering and Neural Machine Translation has consistently shown exemplary results. In this work, we propose a Multitask Finetuning methodology which combines the Bilingual Machine Translation task with an auxiliary Causal Language Modeling task to improve performance on the former task on Indian Languages. We conduct an empirical study on three language pairs, Marathi-Hindi, Marathi-English and Hindi-English, where we compare the multitask finetuning approach to the standard finetuning approach, for which we use the mBART50 model. Our study indicates that the multitask finetuning method could be a better technique than standard finetuning, and could improve Bilingual Machine Translation across language pairs.


Here we shall consider the topology and dynamics associated to a wide class of matchbox manifolds, including a large selection of tiling spaces and all minimal matchbox manifolds of dimension one. For such spaces we introduce topological invariants related to their expansions as an inverse sequence of simplicial complexes. These invariants are related to corresponding inverse sequences of groups arising from applying the top--dimension homology to these sequences. In many cases this leads to a computable invariant based on an inverse sequence of matrices. Significantly, we show that when the space is obtained by suspending a topologically transitive action of the fundamental group $\G$ of a closed orientable on a zero--dimensional compact space this invariant at the same time corresponds to the space of Borel measures on the Cantor set which are invariant under the action of $\G$. This leads to connections between the rank of homology groups we consider and the number of invariant, ergodic Borel probability measures for such actions. We illustrate with several examples how these invariants can be calculated and used for topological classification and how it leads to an understanding of the invariant measures.


In this chapter, brief outline is presented about gyro-devices. Gyro-devices comprise of a family of microwave devices and gyrotron is one among those. Various gyro devices, namely, gyrotron, gyro-klystron and gyro traveling-wave tubes (gyro-TWT) are discussed. Gyrotron is the only microwave source which can generate megawatt range of power at millimeter-wave and sub-millimeter-wave frequency. Gyrotron is the most suitable millimeter wave source for the heating of plasma in the Tokamak for the controlled thermoneuclear fusion reactors. This device is used both for the electron cyclotron resonance heating (ECRH) as well as for the electron cyclotron current drive (ECCD). In this chapter, the basic theory of gyrotron operation are presented with the explanation of various sub-systems of gyrotron. The applications of gyrotrons are also discussed. Also, the present state-of-the-art worldwide scenario of gyrotrons suitable for plasma heating applications are presented in details.


In CCS (Carbon dioxide Capture and Storage) operations, the captured CO2 stream from industrial installations is a contaminated CO2: it contains: SO2, NOx, H2S, N2, O2, Ar... This exhausted CO2 may have quite different thermo-physical properties with respect to pure CO2. This may have impacts on the different stages of the CCS chain: capture, transportation, compression, injection and storage [1]. For a global account of these impacts and for a precise specification of maximal amounts of contaminants that can be tolerated in CO2 flues, further investigations are strongly required. Accurate knowledge of the phase equilibrium (Vapor-Liquid equilibrium: VLE) of contaminant-contaminant is part of the required studies in order to assess this problem. In this communication, we have chosen to present VLE of two binary mixtures: SO2/O2 and SO2/N2. Results are obtained using Monte Carlo molecular simulations and an experimental device based on the "static-analytic" method [2]. For these binary systems, data were generated for temperatures between 323 and 413 K and pressures up to 20 MPa. Phase envelopes have been calculated at the same temperatures and for pressures from 5 to 90 MPa. Good agreement is obtained between simulated and experimental data. For mixtures containing SO2, experimental data are scarce and molecular simulations are an interesting tool to overcome limits of experimental devices.


By using the traditional statistical or operations research methods for deciding the product-delivery logistics, the portal companies are not using their competitive advantages on being more e-enabled, informed and computationally able than their traditional counterparts. In this paper, we show some typical characteristics of the portals like their handling of a huge range of goods in terms of transactional values or volumes. Subsequently, we have identified three types of generic product-delivery logistics of the portals with various intermediate entities or trading partners. Then, a completely different approach using an extreme point method rather than the traditional central-tendency-based statistical methods has been suggested. INTRODUCTION E-Business Portals An e-business model, like any other business models, evolves around a basic revenue-generation model, supported by the other necessary business activities like finance, marketing models etc. (Afuah and Tucci 2001; Alt and Zimmerman 2001;Boyle and Ruppel 2006). The business model spells out how a company generates revenue by specifying where it is positioned in the value chain. The revenue generation processes can be direct or indirect and can actually be a multi-level hybrid of other simple models. The web has incorporated radical paradigm shifts in the traditional business models (Bouton et al 2000;Bouwman and Wijngaert 2003;Chen and Dubinsky 2003;Deitel et al 2001), and also has given rise to new kinds of business models. The web has actually complemented or reinvented tried-and-true models and has opened hitherto unseen revenue-earning models ( Jayaraman and Baker, 2003) for companies. Across the four crucial strategic quadrants that were identified in a survey on e-business models (Westland and Au, 1998), i.e. technology, brand, service and market, it was generally found that laggard companies who failed to implement an e-business strategy never made it past the technology quadrant. Leading and mediumperforming organizations, on the other hand, quickly moved their focus from technology to business delivery aspects. They migrated toward a market strategy by concentrating either on a brand strategy or service strategy. Few migrated directly to a market strategy. Leaders like Lufthansa and Motorola etc used Web technologies with a view to harnessing them for leadership in business terms i.e. matching appropriate technology to business strategy and customer requirements, with planned and demonstrated, adequate and appropriate technology capability and capacity either available in-house or through partnering. Innovations in the service strategy worked for a significant proportion amongst the leaders. Over the time, the challenges for these companies graduated from technical ones, e.g. "the complexity of integrating Web sites with legacy systems and business processes," to marketing or service strategies like "sort out channel conflicts," and the need "to include the whole management team and employees in the transformation process." The key learnings were: 1. Being first technology mover is not always a successful strategy even when applied to a viable business model. 2. Information-systems success carries its own risks. In addition to using technology strategically, companies must deploy it in the appropriate organizational and managerial context. (Alt and Zimmerman,2001; Travica, 2005) 3. When technology is treated as an asset with a role in transforming the business, there is much greater likelihood of technology leadership and eventual business payoff. (Bouwman and Wijngaert 2003) T. Bandopadhyay & P. Kumar 2007 Volume 16, Number 1 2 Consequently, many services related to traditional business or e-business models and processes have been e-enabled and have thus become better defined, structured, measurable (Bouwman and Wijngaert 2003; Deitel et al 2001, Lu et al 2005). Some business processes in this context pose bigger challenges than others because of the more number of variables (internal / external: third-party-dependent/ outsourced, can be e-enabled or not) and variants (e.g. with options for in-house/ maintained/ outsourced etc.) involved in them. Efficient, cost-effective logistics and distribution management is one such process which is still seen as the bane of most companies' existence.(EonKyung and Kim, 2001; Fu-ren et al 2002) The distribution network is still seen as a significant bottleneck with many mid-warehouses, intermediaries etc. (Cheung and Liao, 2003; Choi et al 2002; Eon-Kyung and Kim 2001) More emphasis is being placed on product delivery with the explosion of e-tailing and retail stores that require smaller shipments to be made more frequently. In some cases, product delivery performance can be improved with technology, namely in the form of automated sorting systems for e-tailers (e.g., Amazon.com), catalog distributors (e.g., J. Crew), and retailers (e.g. Wal-Mart). Operational decisions must also be answered and economic factors as well as the throughput of the system will be considered. The problem in maximizing the efficiency of logistics networks is that information, applications and processes have been stove-piped. (Cheung and Liao, 2003; EonKyung and Kim 2001) These vertical silos of information have engendered years of disarray and inefficiency in logistics management, customer service and analysis capability. A recent survey presented by Cheung et al shows "demand-side obstacle factors in the form of perceived low e-shopping comparability, e-shopping inconvenience, etransaction insecurity, and poor Internet privacy...translate into...supply-side hurdles." (Cheung and Liao, 2003) In this environment, processes and information systems are separate, uncommunicative parts of the organization that often work at crosspurposes. New solutions are being suggested to address these logistics decision problems. For example, there is the two-part IT model to build, manage and integrate logistics networks; (Choi et al 2002; Fu-ren et al 2002). First model depicts a technical architecture that deploys extraction, transformation and loading (ETL) tools; enterprise application integration (EAI) tools; and business analytic (BA) tools, and second modelthe use of these sophisticated tools to perform complex analysis to enable better distribution decisions and collaboration between trading partners. (Koster, 2003) Collaboration between manufacturers, distribution centers and retailers is now the key to success in ebusiness, with the merging or replacing of old-line, standalone ETL, EAI and BA tools with flexible, scalable, intelligent information networks that route data to and from information-craving entities based on prescribed business rules. But information sharing is not necessarily the panacea for all ills. Choice, design and implementation of the decision making tools and processes based on shared information can actually make the information productive and the decision more effective. In this context, we propose a new approach using Data Envelopment Analysis (DEA) as the method of decision making for B2C horizontal portals' distribution problems based on information sharing of the trading partners involved in the distribution network. We develop the method of using DEA for the decision making process and incorporate a set of decision variables into the process. E-Business Horizontal Portals Horizontal portals in the context of e-business models have a broader user base due to its capability to cater to the versatile areas of interest of the users. Examples include Indiatimes.com, yahoo.com etc. which are often B2C type in nature. On the contrary, the vertical portals serve a particular industry or a user community's supply chain. For example, indiamart.com acts as the e-marketplace for automobile industry i.e. automotive components manufacturers and automobile companies. (Hung et al 2005) For the vertical portals, the supply chains are mainly B2B supply chains which are quite well-defined by traditional business and can be followed in e-business as well, because they can operate using EDI and bulk business. The issue of distribution logistics therefore can be handled and resolved in a much better and elaborate form in vertical portals as compared to the horizontal portals. (Koushik and Joodi, 2000; Mahadevan, 2000) The horizontal portals operate primarily as e-shopping malls wherein a diverse range of products of various companies are available. These portals eliminate mid-warehouses and thereby also eliminate the necessity of an effective inventory management and control system. Instead they handle the orders by acting as in intermediary between the product manufacturers, importers or dealers. They have to cater to the demands of individual customer with small size orders and varied transactional values, which is a unique distribution problem in itself. How the distribution channels can be used optimally and cost-effectively, is a major concern. While minimizing on the cost New Approach using DEA Journal of International Technology and Information Management 3 of distribution, at the same time, the customers have to be satisfied with the speed of order fulfillment and delivery of goods. The key to profitability in the entire E-supply chain (Bouwman and Wijngaert 2003; Deitel et al 2001) can be summed up as under: It has to inspire confidence from supplier to customer It should be more available than possible in the physical world It must protect data integrity to ensure future growth. The first two elements are primarily dependent on the value-chain including procurement and distribution issues. This paper handles these issues relating to the distribution models of e-business portals focusing on speed of delivery and customer satisfaction which reflects the quality of service aspect, customer relationship and cost associated with distribution channels. Business Models of Horizontal Portals Some of the successful business m


This work presents a tool for the additivity test. The additive model is widely used for parametric and semiparametric modeling of economic data. The additivity hypothesis is of interest because it is easy to interpret and produces reasonably fast convergence rates for non-parametric estimators. Another advantage of additive models is that they allow attacking the problem of the curse of dimensionality that arises in non- parametric estimation. Hypothesis testing is based in the well-known bootstrap residual process. In nonparametric testing literature, the dominant idea is that bandwidth utilized to produce bootstrap sample should be bigger that bandwidth for estimating model under null hypothesis. However, there is no hint so far about how to choose such bandwidth in practice. We will discuss a first step to find some rule of thumb to choose bandwidth in that context. Our suggestions are accompanied by simulation studies.


All efforts to help people, however nondirective and permissive in intent, are attempts to exert some type of control over the recipient of the help. Psychotherapeutic and counseling methods exert this control primarily through verbal communications. This book is a fascinating attempt to carry through a consistent view of mental illness and psychotherapy based on this simple fact. It does not claim to offer a complete theory of either illness or treatment, but tenaciously pursues the communicative aspects of both, with illuminating results. The view here advanced, which grows out of the work of a group at Palo Alto directed by Gregory Bateson, maintains that mental illness is best understood as the patient's indirect, self-defeating attempts to control the nature of his relationships with others. These efforts characteristically involve at least two levels of communication. The first is the message itself; the second, one or more qualifying communications signaling how the message is to be interpreted. Communications at the first level are direct and explicit; those at the second are characteristically subtle and indirect. They are conveyed by the total context, by nonverbal signals such as facial expressions, and the like. The neurotic symptom, for example, is seen as an attempt to influence someone else strongly, coupled with a message that the patient is not responsible for what he is doing-as when a wife's anxiety attack makes the husband stay home from work, not because the wife wants him to but because her fear won't let him go. The schizophrenic uses more drastic maneuvers, the purpose of which seems to be to prevent others from forming any type of consistent relationship with him. The schizophrenic not only denies that he is defining a relationship but also denies that he is denying it. For example, a schizophrenic named Tom Jones may say, "My name is Bill Smith," thereby denying his name but also denying that he is denying it by giving himself a name. How does psychotherapy combat these maneuvers? Rejecting self-knowledge or insight as the main source of change, Haley suggests that the essence of the process is the creation of a relationship that the patient cannot control through his neurotic or psychotic behavior and which at the same time encourages more appropriate conduct. Psychotherapy is a struggle between therapist and patient to gain and maintain control of their relationship. Though many readers will bridle at the insistence that all psychotherapeutic methods, including nondirective ones, are efforts to control the patient's behavior-manipulate it, if you will-the case for this is presented convincingly. With neurotics, the therapist's chief weapon is the therapeutic paradox. He uses the same type of maneuver as the patient by confronting him with communications at different levels that contradict each other. For example, the psychotherapeutic situation is defined as benevolent, and yet the patient is put through an ordeal as long as his symptoms continue. The patient could deal easily with a therapist who was only benevolent or only punishing, but he can deal with the paradox of punishment in the context of benevolence only by changing his symptomatic behavior. With a schizophrenic, the therapist's aim is to persuade or force the patient to respond in such a way that he is consistently indicating what kind of relationship he has with the therapist instead of indicating that what he does is not in response to the therapist. "Essentially the patient must be trapped so that he is following directions whatever he does and so is participating in a relationship." This line of thinking, of which the above are fragmentary examples, is applied to neurosis, schizophrenia, hypnosis, directive and psychoanalytic therapies, marital counseling, and family therapy. As in all pioneering efforts, particularly those that try to subsume a wide range of phenomena under a very few principles, the results range from being unconvincing to being brilliant. The reviewer found the discussions of schizophrenia and marital counseling particularly illuminating. Every chapter, however, contains many arresting and thought-provoking observations. This book is heartily recommended to all practitioners of the helping professions, whatever their methods, who dare risk exposure to a cogent challenge to their accustomed ways of thinking and working. JEROME D. FRANK, M.D. Henry Phipps Psychiatric Clinic Johns Hopkins Hospital Baltimore


College-educated adults are healthier than other people in the United States, but selection bias complicates our understanding of how education influences health. This article focuses on the possibility that the health benefits of college may vary according to childhood (mis)fortune and people's propensity to attain a college degree in the first place. Several perspectives from life course sociology offer competing hypotheses as to whether the most or the least advantaged see the greatest return of a college education. The authors use a national survey of middle-age American adults to assess risk of two cardiovascular health problems and mortality. Results from propensity score and hierarchical regression analysis indicate that the protective effect of college attainment is indeed heterogeneous. Further, the greatest returns are among those least likely to experience this life course transition (i.e., compensatory leveling). Explanations for this selection effect are offered, along with several directions for future research on the health benefits of completing college.


In a morphological study fibrin-glued tubal anastomoses were compared with classical anastomoses using microsutures. In the isthmic-isthmic anastomoses, whether they were glued or sutured, the opposition of the folds and the continuity of the tubal wall were good. Scanning electron microscope studies of Fallopian tubes subjected to anastomosis using fibrin glue or microsurgical sutures showed a break in the fold structure regardless of the technique used, with formation of polyp-like and tuborous structures in some of the anastomoses in the ampullary region. In one case of an ampullar-ampullar anastomosis with fibrin glue, formation of a fistula was observed and in another case of the same type of anastomosis a hydrosalpinx developed as the consequence of intratubal adhesions and stenosis. In glued anastomoses in particular, intraluminal fibrin deposits were observed. Otherwise our scanning and transmission electron microscope investigations of the region of the anastomoses revealed a normal cell picture with abundant cilia-bearing, structurally unremarkable cells. Fibrin glueing can thus be regarded as a possible alternative to the conventional microsurgical suturing technique for the construction of anastomoses in the isthmic segment of the tube. In the case of wide-lumen ampullary anastomoses, however, the danger of fistula formation, dehiscence, development of intraluminal adhesions and stenosis must be regarded as increased. Fibrin glueing also does not appear to be appropriate for anastomoses requiring approximation of differing luminal widths.


We present stellar population parameters of 12 elliptical and S0 galaxies in the Coma cluster around and including the cD galaxy NGC 4874, based on spectra obtained using the Low Resolution Imaging Spectrograph on the Keck II Telescope. Our data are among the most precise and accurate absorption-line strengths yet obtained for cluster galaxies, allowing us to examine in detail the zero-point and scatter in the stellar population properties of Coma cluster early-type galaxies (ETGs). Recent observations of red sequence galaxies in the high-redshift Universe and generic hierarchical galaxy formation models lead to the following expectations for the stellar populations of local ETGs. (1) In all environments, bigger ETGs should have older stellar populations than smaller ETGs ('downsizing'); (2) ETGs at fixed stellar mass form stars earlier and thus should have older stellar population ages in the highest density environments than those in lower density environments and (3) the most massive ETGs in the densest environments should have a small spread in stellar population ages. We find the following surprising results using our sample. (1) Our ETGs have single-stellar-population-equivalent (SSP-equivalent) ages of on average 5-8 Gyr with the models used here, with the oldest galaxies having SSP-equivalent ages of less than or similar to 10-Gyr old. This average age is identical to the mean age of field ETGs. (2) The ETGs in our sample span a large range in velocity dispersion (mass) but are consistent with being drawn from a population with a single age. Specifically, 10 of the 12 ETGs in our sample are consistent within their formal errors of having the same SSP-equivalent age, 5.2 +/- 0.2 Gyr, over a factor of more than 750 in mass. We therefore find no evidence for downsizing of the stellar populations of ETGs in the core of the Coma cluster. We confirm the lack of a trend of SSP-equivalent age with mass in the core of the Coma cluster from all other samples of Coma cluster ETG absorption-line strengths available in the literature, but we do find from the largest samples that the dispersion in age increases with decreasing mass. These conclusions stand in stark contrast to the expectations from observations of high-redshift red sequence galaxies and model predictions. We suggest that Coma cluster ETGs may have formed the majority of their mass at high redshifts but suffered small but detectable star formation events at z approximate to 0.1-0.3. In this case, previous detections of 'downsizing' from stellar populations of local ETGs may not reflect the same downsizing seen in look-back studies of RSGs, as the young ages of the local ETGs represent only a small fraction of their total masses.


The dynamical cluster-decay model (DCM) is used to calculate the fusion evaporation residue cross-sections σxn for x=1-4 neutron emissions in the fusion reaction 206 Pb+ 48 Ca 254 No * at various incident energies. Considering the multipole deformations up to hexadecapole deformations β4i and configurations with "compact" orientation angles θci (θc=2 0 for 206 Pb), the model is shown to give a good description of the measured individual light-particle decay channels, within one parameter fitting, the neck-length ∆R. Considering 204,206,207,208 Pb-based reactions, the dependence of 2n-emission yields on the isotopic composition of compound nucleus (CN) is also studied within the DCM. Of the four Pb-isotopes considered, at a fixed excitation energy E *~ 20 MeV, ∆R is largest for CN with mass number 256, followed by 255, 254 and smallest for 252, which means to suggest that neutrons emission occurs earliest for 256, then for 255, 254 and finally for 252, in complete agreement with experimental data where 256 No * has the highest cross- section and 252 No * the lowest with 255,254 No * lying in between. This result arises due to the penetrability factor, and is related to double magicity of both target and projectile nuclei.


The analytic structure of non-Gaussian correlators in inflationary cosmologies has recently been proposed as a test of the quantum origin of structure in the universe. To further understand this proposal, we explore the analogous equal-time in-in correlators in flat space and show they exhibit the same features as their cosmological counterparts. The quantum vacuum is uniquely identified by in-in correlators with a total energy pole and no additional poles at physical momenta. We tie this behavior directly to the S-matrix and show that poles at physical momenta always arise from scattering of particles present in the initial state. We relate these flat-space in-in correlators to the probability amplitude for exciting multiple Unruh-de Witt detectors. Localizing the detectors in spacetime, through the uncertainty principle, provides the energy and momentum needed to excite the vacuum and explains the connection to cosmological particle production. In addition, the entanglement of these detectors provides a probe of the entangled state of the underlying field and connects the properties of the correlators to the range of entanglement of the detectors. ar X iv :2 20 3. 10 04 2v 1 [ he pth ] 1 8 M ar 2 02 2


Purpose: To evaluate the MR appearance of bone marrow during and after multiple fractionated and single-dose irradiation using SE sequences, with histopathological correlation. Material and Methods: the left hind limbs of Wistar rats were irradiated with doses of either 2 GyX10 fractions or 20 Gy as a single dose. MR images of the femora were taken on days 0, 1, 3, 5, 7, 10, 15, 20, 25, 30, 40, 50, 60, 90, 120, 150 and 180. T1-, proton-density- and T2-weighted images were obtained with SE sequences. the rats were sacrificed on days 3, 12, 40 and 180 for histological study. Results: No significant change in the T1 relaxation time was observed in the fractionated group during the first 15 days after irradiation. T2 did not change during the initial 7 days. There were significant differences in T1 and T2 between nonirradiated and fractionated, and between fractionated and single-dose irradiated marrows (p<0.01). Sinusoidal dilatation, decrease in cellularity, and hemorrhage were observed on day 3. Fat increased on/after day 12. the fractionated group showed mild changes compared to the single-dose irradiated group. Conclusion: the T1 and T2 relaxation times of bone marrow receiving multiple fractionated irradiation did not change significantly on SE sequences during the early phase. However, dilatation of sinusoids, hemorrhage, decrease in cellularity, and increase in fat content were observed. Single-dose irradiation resulted in marked and early changes in T1 and T2 of the bone marrow.


Abstract. Many populations of Arctic-breeding geese have increased in abundance in recent decades, and in the Canadian Arctic, Snow (Chen caerulescens) and Ross' Geese (Chen rossii) are formally considered overabundant by wildlife managers. The impacts of these overabundant geese on terrestrial habitats are well documented, and more recently, studies have suggested impacts to freshwater ecosystems as well. The direct contribution of nutrients from goose faeces to water chemistry could have cascading effects on biological functioning, through changes in phytoplankton productivity and community composition. We demonstrated previously that goose faeces can enrich ponds with nutrients at a landscape scale. Here, we show experimentally that goose droppings rapidly released nitrogen and phosphorus when submerged in freshwater, increasing the dissolved nitrogen and phosphorus in the water. This resulted in both a decrease in the nitrogen:phosphorus ratio and an increase in cyanobacteria in the goose dropping treatment. In contrast, this pattern was not found when we submerged cut sedge (Carex sp.) leaves. These results demonstrate that geese act as biovectors, causing terrestrial nutrients to be bioavailable in freshwater systems. Collectively, the results demonstrate the direct ecological consequences of ornithological nutrient loading from hyperabundant geese in Arctic freshwater ecosystems.


Theology has, also as result of the critique directed at it, undergone an ecologization that takes shape in ecotheology. It is theology's attempt to deliver answers to the ecological crisis. These answers are substantively different compared to approaches in other academic fields and could provide the spiritual foundation that is so urgently needed. For ecotheology to move beyond its academic and theoretical character, it needs a Church that implements and lives according to ecotheological ideas. Only the Church can reach a large number of faithful and influence society at large. By conducting a case study of two Roman Catholic dioceses in Germany, this text analyzes how ecotheology is implemented in an ecclesial context. It finds that there is a huge potential for Christian faith to contribute with relevant answers to today's ecological questions. The investigation shows, however, two major difficulties. Firstly, the Church, that is a vital part of ecotheology, often faces organizational difficulties that prevent stronger progress in the implementation of ecotheological ideas. For abstract ecotheology to become lived reality, it needs to go thru an administrating and practical process that sometimes causes the practical impact to decrease. Secondly, neither the Church nor religion in general are the superior systems in society but rationalized economy and technology. The Church can only act within that framework even though that very framework often prevents a more thorough implementation of ecotheology as there are basic contradictions in the life of Jesus Christ and current economic reasoning. (Less)


As deep neural networks (DNNs) are applied to increasingly challenging problems, they will need to be able to represent their own uncertainty. Modeling uncertainty is one of the key features of Bayesian methods. Using Bernoulli dropout with sampling at prediction time has recently been proposed as an efficient and well performing variational inference method for DNNs. However, sampling from other multiplicative noise based variational distributions has not been investigated in depth. We evaluated Bayesian DNNs trained with Bernoulli or Gaussian multiplicative masking of either the units (dropout) or the weights (dropconnect). We tested the calibration of the probabilistic predictions of Bayesian convolutional neural networks (CNNs) on MNIST and CIFAR-10. Sampling at prediction time increased the calibration of the DNNs' probabalistic predictions. Sampling weights, whether Gaussian or Bernoulli, led to more robust representation of uncertainty compared to sampling of units. However, using either Gaussian or Bernoulli dropout led to increased test set classification accuracy. Based on these findings we used both Bernoulli dropout and Gaussian dropconnect concurrently, which we show approximates the use of a spike-and-slab variational distribution without increasing the number of learned parameters. We found that spike-and-slab sampling had higher test set performance than Gaussian dropconnect and more robustly represented its uncertainty compared to Bernoulli dropout.


High Resolution images can be reconstructed from several blurred, noisy and aliased low resolution images using a computational process know as super resolution reconstruction. Super resolution reconstruction is the process of combining several low resolution images into a single higher resolution image. In this paper we concentrate on a special case of super resolution problem where the wrap is composed of pure translation and rotation, the blur is space invariant and the noise is additive white Gaussian noise. Super resolution reconstruction consists of registration, restoration and interpolation phases. Once the Low resolution image are registered with respect to a reference frame then wavelet based restoration is performed to remove the blur and noise from the images, finally the images are interpolated using adaptive interpolation. We are proposing an efficient wavelet based denoising with adaptive interpolation for super resolution reconstruction. Under this frame work, the low resolution images are decomposed into many levels to obtain different frequency bands. Then our proposed novel soft thresholding technique is used to remove the noisy coefficients, by fixing optimum threshold value. In order to obtain an image of higher resolution we have proposed an adaptive interpolation technique. Our proposed wavelet based denoising with adaptive interpolation for super resolution reconstruction preserves the edges as well as smoothens the image without introducing artifacts. Experimental results show that the proposed approach has succeeded in obtaining a high-resolution image with a high PSNR, ISNR ratio and a good visual quality.


This paper aims at revealing methodological issues referring to the definition and measurement of absolute poverty. The literature on poverty, both relative and absolute, is reviewed and a proposal is put forth for an approach of absolute poverty based on needs and the notion of the value of labour power. The paper presents the results of the applica- tion of this method in the Metropolitan Athens area.


The influence of the excess charge carrier injection mechanism on the excess charge carrier dynamics in ZnO powder is investigated by contactless transient photoconductivity measurements. Excess charge carriers were produced by above bandgap light, subbandgap light and by injection from an adsorbed dye (Rhodamine B) after excitation of this dye. In all these cases the transient photoconductivity decay extends over a large time range but only after band-to-band excitation an appreciable decay is observed in the microsecond time range. The experimental results are discussed in particular with respect to photocatalysis.


Numerous routing algorithms have been proposed for routing efficiently in mobile ad hoc networks (MANETs) embedded in two dimensional (2D) spaces. But, in practice, such networks are frequently arranged in three dimensional (3D) spaces where the assumptions made in two dimensions, such as the ability to extract a planar subgraph, break down. Recently, a new category of 3D position-based routing algorithms based on projecting the 3D MANET to a projection plane has been proposed. In particular, the adaptive least-squares projective (ALSP) face routing algorithm (Kao et al., 2007) achieves nearly guaranteed delivery but usually discovers excessively long routes to the destination. Referencing the idea of hybrid greedy-face-greedy (GFG) routing in 2D MANETs, we propose a local hybrid algorithm combining greedy routing with ALSP Face routing on projection planes. We show experimentally that this hybrid ALSP GFG routing algorithm on static 3D ad hoc networks can achieve nearly guaranteed delivery while discovering routes significantly closer in length to shortest paths. The mobility of nodes is handled by introducing the concepts of active sole nodes and a limited form of flooding called residual path finding to the ALSP GFG routing algorithm. Under mobility simulations, we demonstrate that the mobility-adapted hybrid routing algorithm can maintain high delivery rates with decreases in the average lengths of the paths discovered compared to shortest paths, without generating a large amount of flooding traffic.


The assay method for corticotrophin, in which the involution of the thymus of the nestling rat is measured, can be applied successfully as a quick and simple screening test for biologically active corticosteroids. The sensitivity of the test is such that injection of a standard dose of cortisone acetate produces different results when made up in different media, or injected by different routes. A standard procedure for dispensing and injecting the steroids has therefore been adopted. Of the steroids investigated, it is noticeable that those possessing marked thymolytic activity are also steroids with therapeutic properties.


Abstract Background The patient voice is an important consideration in the availability and choice of pharmaceuticals – however, how to capture this complex area and apply it formally within regulation, health technology assessment and reimbursement remains subject to ongoing debate. Patient preference studies such as discrete choice experiments (DCEs) are being utilised more frequently in healthcare and it is anticipated that patient preference data will be incorporated more frequently into regulatory submissions moving forward. Aim The aim of this review is to provide an overview of DCEs conducted within haemophilia to date and to consider the key issues in response to a rapidly evolving therapeutic pathway. Methods A systematic literature search was undertaken via Ovid MEDLINE and EMBASE CLASSIC + EMBASE. Abstracts were uploaded and analysed via Rayyan systematic review software. Results: Of 478 records identified from the database searches, 12 full text journal articles met the inclusion criteria with a date range from 2005–2021. There have been two published studies exploring haemophilia patient preferences in relation to gene therapy: one DCE and one utilising a threshold technique. Surveyed audiences included physicians, patients, pharmacists, healthcare professionals and caregivers. 50% of the included studies (n=6) were exclusively conducted in the US, whilst 3 recruited participants across multiple countries. The sample size varied considerably between studies with the total sample size ranging from 30 participants to 505 participants. For the studies involving patients and their caregivers, the mean patient age range was 8.2–41.4 years. There was diversity in (a) the scale of the qualitative work undertaken to support the DCEs, (b) the undertaking of pilots, and (c) how extensively these elements were reported in the included studies. There is a notable trend towards using an online web-based format, with 3 out of 4 DCEs since 2019 utilising this approach. The number of attributes observed per DCE ranged from 5–12 with a median of 6 attributes from the included studies. The number of levels per attribute was relatively consistent (range 2–5) with 2–3 (n=4) and 2–4 levels (n=4) being utilised most frequently. Conclusion Patient preferences and the methods for capturing these are likely to be subject to ongoing debate as the haemophilia care pathway evolves to offer more therapeutic options with a range of risks and benefits. Whilst techniques such as DCE are effective at quantifying patient preferences, they tell us little about the reasons driving these decisions and the likelihood that they will change in response to temporal or external factors. DCEs could be particularly useful for estimating the uptake of new products and assessing potential budget impact. Accelerated and reformed regulatory processes are likely to increase demand for patient preference studies. There is therefore an increased requirement to ensure that patient advocacy groups (PAGs) are resourced and have the expertise to support these studies alongside other research commitments, and that manufacturers consider collaborative approaches when formally capturing patient preferences. As more therapeutic options become available in haemophilia care, discrete choice experiment may be a useful means of gauging patient preference © Shutterstock


ABSTRACT Distance education has historically had lower completion rates. Several models of persistence, for on-campus students, indicate that students' financial status affects their decision to persist. This study involved providing distance education students' financial aid in the form of institutional scholarships (N = 545) at Penn State University in the United States. The recipients were students who were not overachievers and not at-risk of failing, but somewhere in the middle. The purpose of the study was to test if receiving financial aid was related to students' persistence. Using logistic regression and Chi-square analysis, this study found that scholarship-receiving students with higher financial need were two times more likely to persist in their studies than those with lower financial need. Results suggest that there is a positive relationship between providing even small financial aid to students with high-financial need and their persistence in their studies.


that make the book worth purchasing. In particular, the chapters on surfactant turnover, respiratory muscles fatigue and structural development of the pulmonary circulation and myocardium are invaluable. Foremost authorities on these subjects have not only produced excellent review articles but have presented the arguments in an original and stimulating manner. These chapters and others are a good source of key references. The book is relevant only to those with special interests in critical care of the newborn. For these, however, at the price, it is a worthwhile addition to their library.