In the optics of charged particle beams, circular transverse modes can be introduced; they provide an adequate basis for rotation-invariant transformations. A group of these transformations is shown to be identical to a group of the canonical angular momentum preserving mappings. These mappings and the circular modes are parametrized similar to the Courant-Snyder forms for the conventional uncoupled, or planar, case. The planar-to-circular and reverse transformers (beam adapters) are introduced in terms of the circular and planar modes; their implementation on the basis of skew quadrupole blocks is described. Various kinds of matching for beams, adapters and solenoids are considered. Applications of the planar-to-circular, circular-to-planar and circular-to-circular transformers are discussed. A range of applications includes round beams at the interaction region of circular colliders, flat beams for linear colliders, relativistic electron cooling, and ionization cooling.


In 2003, the data from the American Time Use Survey (ATUS) began being published and made available to researchers by the Bureau of Labor Statistics. Data from that survey have been published ever since. Beginning in 2003, ATUS was immediately adopted by Dr. Kurt Krueger as his data source for his annual series Dollar Value of a Day (DVD); the series is published by Expectancy Data. The DVD series was designed to provide data in a manner convenient for use by forensic economists and has been widely cited and used in forensic economic reports for that purpose. This paper looks at problems posed by the ATUS survey itself, by the use of ATUS in DVD, and at a specific criticism leveled at DVD in a paper by Dr. Terrence Clauretie (2010). Clauretie proposes an alternative use of ATUS that he argues is superior. This paper argues that the Clauretie criticism and proposed alternative use of ATUS are without merit and that DVD provides a much more useful basis for valuing loss of household services than the proposed Clauretie method. There are three problems with ATUS and DVD that make that survey and its interpretation in DVD less than perfect instruments for measuring household services of an individual who has been injured or killed. The first problem is that time use in ATUS is based on the age of the youngest child in a family, regardless of the number of children in a household. The second problem is that time use after retirement is not a good proxy for the output of household services by retired persons. The third problem is that DVD shows comprehensive time use for an average person, not just the amount of household services provided by an average person in a demographic category. As such, there may be evidence in the record of a case that shows ways that an individual's time use is not typical of the average that must be accounted for.


A new model of mutational production of alleles was proposed which may be appropriate to estimate the number of electrophoretically detectable alleles maintained in a finite population. The model assumes that the entire allelic states are expressed by integers (…, A −1 , A 0 , A 1 , …) and that if an allele changes state by mutation the change occurs in such a way that it moves either one step in the positive direction or one step in the negative direction (see also Fig. 1). It was shown that for this model the 'effective' number of selectively neutral alleles maintained in a population of the effective size N e under mutation rate υ per generation is given by When 4 N e υ is small, this differs little from the conventional formula by Kimura & Crow, i.e. n e = 1 + 4 N e υ, but it gives a much smaller estimate than this when 4 N e υ is large.


PU.1 is an Ets family transcription factor, which is important for differentiation of both myeloid and lymphoid lineages. In the Friend leukemia model, the failure of PU.1 down-regulation in erythroblasts reportedly results in differentiation arrest, leading to erythroleukemia. In mice conditionally knocked-out of the 3.5 kb length of enhancer region located in14 kb 5′ upstream of the PU.1 gene, PU.1 is down-regulated in myeloid cells and B cells to 20% of that of wild type, and such mice develop acute myeloid leukemia and CLL-like diseases. Since the 3.5 kb enhancer region contains a suppressor region for PU.1 expression in T cells, such mice ectopically express PU.1 in T cells and develop T cell lymphoma. Thus, the failure of proper expression of PU.1 in certain differentiation stages for certain cell lineages appears to result in hematological malignancies. We recently reported that human PU.1 is down-regulated in a majority of myeloma cell lines through the methylation of the promoter and enhancer region located in17 kb 5′ upstream of the PU.1 gene which is homologous to that in14 kb 5′ upstream of murine PU.1 gene. Conditionally expressed PU.1 induced cell growth arrest and apoptosis of two PU.1 low-negative myeloma cell lines, U266 and KMS12PE, suggesting that the down-regulation of PU.1 is essential for myeloma cell growth. We have also reported that PU.1 is expressed in normal plasma cells and PU.1 is down-regulated in myeloma cells of certain myeloma patients, who appear to have poor prognosis. In the present study, to elucidate the mechanisms of the cell growth arrest and apoptosis in PU.1-conditionally expressing myeloma cells, we performed DNA microarray analysis to compare gene expression levels before and after PU.1 expression, utilizing Illumina Sentrix ® Human-6 Expression BeadChip. Of 47,296 genes, 479 genes were up-regulated (>2fold) and 1,697 genes down-regulated ( WAF1/CIP1 was found up-regulated in U266 cells, which was confirmed at protein levels. Among apoptosis related genes, TRAIL was highly up-regulated in both U266 and KMS12PE cell lines. Stably expressed siRNA for TRAIL inhibited apoptosis of PU.1-expressing U266 cells, suggesting that TRAIL may have a crucial role in the PU.1- induced apoptosis. We subsequently examined how TRAIL was up-regulated in such PU.1-expressing myeloma cells. We performed chromatin immunoprecipitation assay and found that PU.1 directly binds to the promoter region of the TRAIL gene in U266 cells. We also determined the PU.1 binding site using electrophoretic mobility shift assays. An introduction of mutations in the PU.1 binding site abolished the binding. We also subcloned the TRAIL promoter and exon1 5′ non-coding sequence into pGL4.26 vector and performed reporter assays. Induction of PU.1 by removal of tetracycline in U266 cells induced 4-fold up-regulation of luciferase activity compared to that without PU.1 expression (28.7-fold compared to that with pGL4.26 vector alone) and mutations in the PU.1 binding site completely abolished the up-regulation. Taken together, we hereby conclude that PU.1 can directly transactivate the TRAIL gene in myeloma cells, leading to apoptosis.


The European recommendations for the management of infective endocarditis have been updated in 2015. The therapeutic modalities depend on both a better prevention in high-risk population, a faster diagnosis through new approaches in medical imaging, and interdisciplinary collaboration by an « endocarditis team. » Treatment involves antimicrobial therapy which can be complex, initially empirical and then targeted, depending on local infectious epidemiology, and whether the infringement affects a native or a prosthetic valve. The surgical indications are identified in the individual patient, based on the response to medical therapy, on complications (heart failure, uncontrolled infection and prevention of embolic events) the germ, the type of valve involved, and of course an integration with the patient's comorbidities.


Pear Valsa canker caused by Valsa pyri is among the most destructive diseases of pear, which causes significant economic loss. The present study was developed to explore the biocontrol efficiency and underlying antagonistic mechanism of Paenibacillus polymyxa strain Nl4 against V. pyri. P. polymyxa strain Nl4, one of the 120 different endophytic bacterial strains from pear branches, exhibited strong inhibitory effects against the mycelial growth of V. pyri and caused hyphal malformation. Culture filtrate derived from strain Nl4 was able to effectively suppress mycelial growth of V. pyri, and was found to exhibit strong protease, cellulase and β-1, 3-glucanase activity. Through re-isolation assay, strain Nl4 was confirmed to be capable of colonizing and surviving in pear branch. Treatment with strain NI4 effectively protected against pear Valsa canker symptoms on detached pear twigs inoculated with V. pyri. Moreover, strain Nl4 promoted enhanced plant growth probably through the solubilization of phosphorus. Comparative transcriptomic analyses revealed that strain NI4 was able to suppress V. pyri growth in large part through the regulation of the expression of membrane- and energy metabolism-related genes in this pathogen. Further transcriptomic analyses of pear trees indicated that strain NI4 inoculation was associated with changes in the expression of genes associated with secondary metabolite biosynthesis, signal transduction, and cutin, suberine, and wax biosynthesis. Together, these data highlighted P. polymyxa strain Nl4 as a promising biocontrol agent against pear Valsa canker and investigated the possible mechanisms of strain Nl4 on control of this devastating disease.


Hematocrit (H) levels can change during hemodialysis, and these changes in H are inversely related to changes in blood volume (BV). The objectives of this study were to determine whether mean arterial pressure (MAP) decreases with decreasing BV and rising H during hemodialysis, and to determine the relationship between dialysis induced intravascular volume depletion and intradialytic morbid events (IME), defined as hypotension, cramping, or lightheadedness that led to dialysis staff intervention. We monitored H continuously using a noninvasive optical technique in 93 hemodialysis sessions in 16 patients. IME occurred in 48 sessions. MAP decreased with increasing H in 10 of 16 patients (P < 0.05), but the relationship between MAP and H varied among the patients. The rate of BV change during sessions without morbidity (5.6 +/- 3.6 [SD] %/hr) was lower (P < 0.001) than that preceding IME in the other sessions (12.2 +/- 5.5 [SD] %/hr). Twelve of 16 patients who exhibited recurrent IME during this study experienced these events when H reached a patient specific threshold. It is concluded that MAP decreases with decreasing BV and increasing H in many patients on hemodialysis, and that a high rate of BV change often indicates that IME are forthcoming. It is further hypothesized that a patient specific H threshold is indicative of a critical BV level below which certain patients experience IME.


The significant real exchange rate appreciation in Armenia and Georgia since 2003, coupled with persistent current account deficits, raises the question of whether real exchange rates have become overvalued. This paper seeks to identify possible exchange rate misalignment by applying the behavioral equilibrium exchange rate approach, complemented by an analysis of the traditional competitiveness indicators. The results indicate an undervaluation of the Armenian dram and no significant misalignment of the Georgian lari in 2006.


This paper reflects on a critique of cosmopolitanism mounted by Tom Campbell, who argues that cosmopolitans place undue stress on the issue of global justice. Campbell argues that aid for the impoverished needy in the third world, for example, should be given on the Principle of Humanity rather than on the Principle of Justice. This line of thought is also pursued by 'Liberal Nationalists' like Yael Tamir and David Miller. Thomas Nagel makes a similar distinction and questions whether the ideal of justice can even be meaningfully applied on a global scale. The paper explores whether the distinction between the Principle of Humanity and the Principle of Justice might be a false dichotomy in that both principles could be involved in humanitarian assistance. It will suggest that both principles might be grounded in an ethics of caring and that the ethics of caring cannot be so sharply distinguished from the discourse of justice and of rights. As a result, the Principle of Humanity and the Principle of Justic...


ABSTRACT

Monoterpene is a biogenic volatile organic compound commonly found in cleaning products and air fresheners. It can react rapidly with indoor oxidants, such as ozone (O3), to produce secondary organic aerosols (SOAs) in indoor environments, and the reactions are potentially influenced by ammonia (NH3). This study simulated the reactions of O3 and monoterpene with and without the presence of NH3 in an environmental chamber and investigated the surface characterization (elemental components and carbon states) of the PM2.5 generated by these reactions. We found that the generated particles possessed a higher content of nitrogen-containing organic compounds when NH3 was present. Unsubstituted aromatic carbon and aliphatic carbon were the main carbon structures, exhibited by over 60% of the carbon-containing compounds. Additionally, in the presence of NH3, more amide carbon and carboxylic carbon formed during the reactions. We also examined acute lung injury in mice caused by new particle formation under different reaction conditions. Oxidative stress was observed in the bronchoalveolar lavage fluid of the mice, as evidenced by a decrease in antioxidant enzymes (superoxide dismutase) and antioxidants (glutathione) as well as an increase in malondialdehyde. Moreover, the SOAs generated in the presence of NH3 lowered glutathione levels, indicating a rise in oxidative stress. Hence, fine particles formed by indoor oxidative reactions may trigger acute lung injury in humans, potentially causing further respiratory disease.


The yield gap and variability in maize under smallholder systems in two agroecologies in northern Ghana were evaluated using a decision support system for agrotechnology transfer (DSSAT). The model was used to assess (1) the potential yield of maize (YPOT), (2) water-limited exploitable maize yield (YWEX), (3) nitrogen-limited yield (YNI), (4) farmer practice maize yield (YCFP) and (5) proposed enhanced nutrient use yield (enhanced farmer practice; YEFP). Effect of supplementary irrigation was also assessed on YCFP and YEFP conditions. Yield gaps were determined as the difference between YPOT and YCFP or YEFP on the one hand, and between YWEX and YCFP or YEFP on the other hand. The yield gap based on potential yield ranged from 59% to 75% under CFP and narrowed to between 29% and 59% under EFP. With water-limited exploitable yields, the yield gap ranged from 53% to 65% under CFP, reducing to between 22% and 42% under EFP. The use of supplementary irrigation further reduced the yield gap. Improved fertiliser use and supplementary irrigation have the potential to increase yield and hence reduce the yield gap if effective policies and institutional structures are in place to provide farmers with credit facilities and farm inputs.


Abstract Subsurface mixed layers have been observed during three seasons in the area east of the Lesser Antilles to about 50W, between 18N and the South American coast. The thermohaline stratification of this area occurs in the lower part of the thermocline-halocline, between about 200 and 750 m. The approximate life span of many mixed layers was rather short, but some lasted 24 hr. The largest number of occurrences was in the 0–2 and 2–4 hr periods. The vertical heat flux was 3–6 times larger than the salt flux in samples of isopycnal layers with compensating vertical temperature and salinity gradients. Between depths of 200 and 750 m, negative stability occurred in 12% of 5 m vertical intervals.


Biodiesel is a renewable source of global interest and one of the most attractive alternatives to partially replace petroleum fuels. Because of its chemical nature, however, biodiesel quality may be more rapidly degraded (than hydrocarbon-based fossil fuels) because of oxidation particularly during long or inappropriate storage. Herein, we show that a direct, rapid, and easy to implement and perform technique, that is, easy ambient sonic-spray ionization mass spectrometry (EASI–MS), can be successfully applied to monitor biodiesel oxidation. Soybean biodiesel stored under different conditions has been monitored by EASI–MS, and markers of oxidation have been identified. A new oxidation index (Iox) rapidly and easily determined via EASI–MS was proposed.


Background: Different risk factors associated with adolescent suicide attempts have been identified across the globe. Relatively few Indian studies are available on this data. Aims: To study the sociodemographic and clinical variables associated with adolescent suicide attempts. Setting and design: tertiary care hospital, retrospective descriptive study. Materials and methods: Participants: ninety four patients admitted in the pediatric units who had attempted suicide by ingestion. A pretested, semi-open-ended questionnaire was filled for each patient. This data was then compiled and analyzed using statistical methods. Results: Among a total of 94 cases, sociodemographic patient risk factors found were:male to female ratio is 1:3.5. Mean age found was 14.64 years. 58.5% were in age of 15 18 yrs., 54.9% were unemployed and 43.6% were educated only till middle school. Nuclear families with family members more than 5, siblings more than 3, a lower income class, single parents (10.6%), broken homes (9.6%), a history of suicide and alcoholism in family (9.6%) were found as familial risk factors associated with suicide attempts. The interpersonal problems (29%) and depression (19.1%) were the important psychological risk factors. Period prevalence was ≈1 per 1000. Case fatality rate was found to be 2.12 Conclusion: The adolescents used the method of deliberate self-harm only to get attention and had no intention of really dying. This was the distress call used by these adolescents.


Abstract This paper describes the use of conventional and unconventional partial discharge tests by capacitive and inductive coupling in Instrument Transformers (IT). The objective of this work was to evaluate Phase-Resolveld Partial Discharge (PRPD) signatures features obtained during on-site (online) and laboratory (offline) measurements, by comparing results with state-of-the-art patterns and standard recommendations. The analysis of the results showed that is possible to obtain partial discharge (PD) patterns - corona, background noise, internal PD, free potential and surface PD - at on-site measurements but those are compromised by the pulse attenuation, difficulties in performing measuring system calibration and the absence of reference voltage. Suitable range of on-site measuring was above 1 MHz up to 5 MHz. The results reached in on-site measuring can be used as image preprocessing methodology to perform automatic pattern recognition of partial discharge signature. It is also described the parameterization of the HFCT for different frequency filter values though carrying out HFCT parameterization for different types of high voltage equipment was not objective of this work.


The growth of home infusion therapy has been influenced by external forces that have changed the access to and use of health care. As home infusion therapy expands into other alternate care settings, clinicians, regardless of discipline, must be cognizant of how daily clinical practice is affected by regulations, changes in legislation, and consumerism.


quality. The volume is attractively and sensibly designed and is produced to a high standard: clearly the British Museum Press (BMP) is capable of producing work of the very best quality. All of which causes me to wonder increasingly wistfully at its treatment of what should have been a volume in every way complementary to this one, Enlightening the British: Knowledge, Discovery and the Museum in the Eighteenth Century, forming the proceedings of a scholarly conference held to celebrate the word is appropriate the 250th anniversary of the British Museum and produced (on schedule) to coincide with the opening of the Enlightenment Gallery itself. Many of the essays there extend and amplify the themes examined in Enlightenment, but the treatment accorded by BMP to these twin publications could scarcely be more starkly contrasted. As an editor of, and contributor to, this second volume it is not for me to comment on its content, but confronted by the opulence of its handsomely endowed sibling it is impossible not to be shocked by its starveling, limp-backed appearance, drained of all colour and denied even its birthright in the Museum's anniversary year in the Press's own publicity by perversely assigning it a publication date in 2004 (and so it is cited throughout Enlightenment, although the imprint on the volume itself acknowledges its timely appearance), a tactic presumably driven by marketing rather than editorial considerations. Clearly at BMP, to paraphrase a quotation in Kim Sloan's introductory chapter, Enlightenment can still mean whatever you want it to mean.


Introduction Part I: (Mis) Representing Animals: The Limits and Possibilities of Representation 1. What Do We Want from Talking Animals? Reflections on Literary Representations of Animal Voices and Minds Karla Armbruster 2. Our Animals, Ourselves: Representing Animal Minds in Timothy and The White Bone Ryan Hediger 3. Investigations of a Dog, by a Dog: Between Anthropocentrism and Canine-Centrism Naama Harel Part II: Animals in Human Traditions 4. With Dogs and Lions as Witnesses: Speaking Animals in the History of Christianity Laura Hobgood-Oster 5. The Speaking Animal: Non-Human Voices in Comics Lisa Brown 6. Who'll Let the Dogs In? Animals, Authorship, and the Library Catalog Nancy Babb Part III: Animal Self, Human Self 7. Mistresses as Masters: Voicing Female Power Through the Subject Animal in Two Nineteenth-Century Animal Autobiographies Monica Flegel 8. Catster.com: Creating Feline Identities Online Jennifer L. Schally and Stephen R. Couch 9. Identity, Community and Grief: The Role of Bunspace in Human and Rabbit Lives Margo DeMello Part IV: Interspecies Communication and Connection 10. Talking Dogs, Companion Capital, and the Limits of Bio-Political Fitness Merit Anglin 11. If We Could Talk to the Animals: On Changing the (Post) Human Subject Kathy Rudy Part V: Speaking and Knowing: Accessing Animal Subjectivity 13. The Power of Testimony: The Speaking Animal's Plea for Understanding in a Selection of Eighteenth-Century British Poetry Anne Milne 14. "Straight from the Horse's Mouth": Equine Memoirs and Autobiographies Marion Copeland 14. First Friend, First Words: Speaking of/to Talking Dogs Jill Morstad Part VI: The Ethics and Value of Speaking for Animals 15. Horse Talk: Horses and Human(e) Discourses Natalie Corinne Hansen 16. Speaking For Dogs: The Role of Dog Biographies in Improving Canine Welfare in Bangkok, Thailand Nikki Savvides 17. The Elephant Letters: The Story of Billy and Kani G.A. Bradshaw


Background This descriptive analysis of medication prescribed for frail elderly patients with frequent hospital admissions is the first of such nature in this population group. Hospital readmission in the frail elderly is common and poses increased risks relating to medicines use and transition of care. Purpose To describe the types of medication frequently admitted frail elderly patients are prescribed. Material and methods This study was a retrospective cohort analysis of discharge summaries of 100 patients aged ≥75 years with ≥3 unplanned medical admissions in 12 months into the study site. Results The mean number of admissions for these patients was 4.6 times a year (range 3–13). Of the 100 patients: 5% were taking <5 medications, 23% were taking between 5 and 9 medications, and 72% were taking ≥10 medications. The discharge summaries of the study population showed that 89% of the 100 patients were taking at least 1 high risk medicine1 as regular medications. These high risk medicines were non-steroidal anti-inflammatory drugs (NSAIDs), antiplatelets, antiepileptics, hypoglycaemics, diuretics, inhaled corticosteroids, cardiac glycosides, beta-blockers and anticoagulants (including direct acting oral anticoagulants). The class of high risk medicines are outlined in the figure. Regular medication lists of the 100 patients were examined to identify any potentially inappropriate medicines (PIMs) in accordance with the Beers criteria. 48% of patients were found to be taking at least 1 PIM. The PIMs prescribed includes alpha-blocker, hypnotics, antipsychotics, tricyclic antidepressants and antimuscarinics, high dose diuretics and cardiac glycosides, and some antiarrhythmics (flecainide). This is not exhaustive as the PIM in certain medical conditions, as outlined by Beers criteria, was not assessed as clinical judgement could not be made from just looking at the discharge summary. Conclusion A large proportion of frail elderly patients who had frequent hospital admissions were found to be taking high risk medicines and PIMs. This could facilitate targeted deprescribing of medicines in this patient population. References and/or acknowledgements Howard RL, Avery AJ, Slavenburg S, et al. Which drugs cause preventable admissions to hospital? A systematic review. Br J Clin Pharmacol2007;63:136–47. No conflict of interest


Vascular anomalies (VM) account as one among the most difficult diagnostic and therapeutic enigmas that can be encountered in the practice of medicine. These lesions are the result of an embryonic abnormality of the vascular system. The main characteristic feature of vascular malformations is that they never show signs of involution. It is the most common neoplasm of the infancy. The clinical presentations are extremely protean and can range from an asymptomatic birthmark to life-threatening hemorrhage. Here we present a case of vascular malformation in the upper lip of four-year-old patient.


To exploit the unlicensed band at frequencies around 60 GHz, a certain number of design rules is considered. This paper highlights the difficulties to design a millimeter CMOS power amplifier (PA). A model of a compact inductor and interconnect lines is detailed. This model takes into account substrate and resistive parasitic. A 65 nm CMOS technology from STMicroelectronics has been used. Innovative techniques are implemented in the design of a power amplifier (PA) which is optimized to deliver the maximum linear output power. To obtain good performances in a small surface of silicon, it has been designed, with both lumped and distributed elements. The PA delivers a linear output power of 8.9 dBm with just an area of 0.48 mm*0.6 mm including pads.


Abstract Objectives To describe aspects of delivery of health services after rape, including trade-offs, that would most influence choice of service, and to compare views of patients who had used such services with views of members of the community who may be future users or may have experienced barriers to service use. Design Discrete choice analysis of stated preferences with interviews. Attributes included travel time to the service, availability of HIV prophylaxis, number of returns to the hospital, medical examination, and counselling skills and attitude of the provider. Setting One rural and one urban site in South Africa. Participants 319 women: 155 who had been raped and four carers recruited through health facilities and 160 comparable women recruited from the community. Of these, 156 were from an urban site and 163 from a rural site. Main outcome measures Strength of preferences over a range of attributes through the estimation of a benefit function through random effects probit modelling. Results Factors such as the availability of prophylactic treatment for HIV infection and having a sensitive healthcare provider who could provide counselling are more important in women's decisions to seek care after rape than the travel time necessary to access those services. Conclusion Our findings support the need for holistic rape services.


3D K9: USING QUICKTIME VR TO TEACH VETERINARY ANATOMY By ROBERT MALINOWSKI A well-developed understanding of spatial anatomical relationships is an essential skill for individuals working in the field of veterinary medicine. To aid in the acquisition of this important ability, this multimedia project was created to assist veterinary technology students in learning canine skeletal anatomy in three dimensions. The program will supply the learners with accurate information regarding anatomical landmarks, current nomenclature and proper pronunciation. Students will be able to continue the learning process even after the lab has closed or the gross anatomy portion of their course has ended. The virtual specimens will be distributed to students on CD-ROM. This universal and versatile format will allow them to view the material on any modern personal computer at home, work or school.


This paper studies career mobility of white male doctorates in natural sciences and engineering using the Survey of Doctorate Recipients (1973-2001). The paper focuses on two issues. First, it assesses the relevance of doctoral careers to sciences and engineering (S&E) in general, and research and development in particular. Second, it evaluates participation rates and mobility patterns of doctorates in careers of different types. To analyze how various factors affect mobility, a transition model with competing risks is specified and estimated. The paper finds that only half of doctorates have careers in R&D, and another 8% work in occupations outside the scope of S&E. Employment choices vary throughout a career. Mobility both within- and out of S&E is especially high during the first 16 years on the job. The effects of individual and job characteristics, research productivity, and labor market conditions on transitions are also assessed.


After the 1997 financial crisis, many retrenched workers preferred not to return to provincial homes but remained in Bangkok to establish informal retail businesses in branded and other consumer products. In contrast to traditional street vendors, who specialized in food items primarily catering for low-income customers, and focused on high volume, these 'new generation' street vendors also adopted more formal business practices. Given their greater sophistication and better education, we hypothesized that they would be more organized advocates of vendors' rights and thus more prone to conflicts with municipal authorities. Based on interviews, however, we found that new generation vendors are adaptive to location and business strategy, and prefer a low profile in dealing with officialdom. By contrast, traditional vendors remained more tied to particular spaces, are more likely to stand up for their rights to use public space and, because they expect more from government, are more prone to conflicts with municipal authorities. Our findings relate to ongoing discussion on the rights and needs of street vendors to access urban public space and the responsibilities of authorities to meet and provide for these informal sector livelihoods that make up a significant share of the national economy in Thailand, as elsewhere in the global South.


The History of Education, one of the courses offered at teacher education studies at the University of Szczecin, has been taught since the 1960's. It was then when Teacher Education College in Szczecin was set up as a branch of Adam Mickiewicz University, Poznań. In 1973 Teacher Education College was transformed into an independent unit – Pedagogy Academy. The establishment of the University of Szczecin in 1985 marked a new chapter in the process of the development of the history of education as a course offered at pedagogical studies. History of Education Department was set up in 1992 and professor Danuta Koźmian was chair of the department throughout its existence. Scientific and didactic work of professor Danuta Koźmian first at Teacher Education College, through Pedagogy Academy and the University of Szczecin has been crucial for the development of the history of education as a course taught at teacher education studies in Szczecin. In 2008 professor Danuta Koźmian retired and the Council of the Faculty of Humanities at the University of Szczecin established the Chair for the History of Education appointing professor Wiesław Andrukowicz,  Ph.D its head.


In November 2017 the Tasmanian Institute of Law Enforcement Studies (TILES) released an
Issues Paper on 'Law Enforcement & Public Health' (LEPH). The Issues Paper invited responses
from the Tasmanian community about using Collective Impact (as a possible, among others)
approach for integrated service delivery and collaboration in law enforcement and public health issues (such as mental health, drug and alcohol use or addiction, violence, disease, road trauma, emergency and disaster management).


On 1998 December 12 a new trans-Neptunian object, 1998 XY95, was discovered as part of a deep search. Recent observations of this object have placed it amongst the class of objects known as the scattered trans-Neptunian objects (TNOs). A total of 39 CCD images of 1998 XY95 were taken over two nights, and these were used to search for a light curve, but no significant periodicity was found. An examination of the possible orbital evolution gives no indication of how it may have arrived on its present orbit. The current best-fitting orbit is unstable, but remains within a band of semi-major axis approximately 2 au wide. The bottom of this band is due to 3:1 mean motion resonance with Neptune, while the reason for the top of the band remains unclear.


Abstract In its 2015 judgment in the Costa Rica v Nicaragua case, the International Court of Justice (ICJ) found that Nicaragua's establishment of a military presence in disputed territory violated the territorial sovereignty of Costa Rica. Two judges considered that Nicaragua's actions had constituted a breach of Article 2(4) of the United Nations (UN) Charter, but the majority of the judges chose not to pronounce on the issue. Whilst it has been clarified that the prohibition of the use of force applies to a disputed territory, it seems less clear as to whether such force has to be violent in nature, causing injury to human beings or damage to property, for it to be in breach of Article 2(4). The ICJ's Advisory Opinion on the Legal Consequences of the Construction of a Wall in the Occupied Palestinian Territory case strongly indicated that the construction of the wall breached Article 2(4). If a State establishes a military presence to change the status quo in a disputed territory, it would not be regarded as a 'peaceful' means of settling the territorial dispute. Therefore, such behaviour would violate Article 2(3), under which States shall settle their international disputes 'exclusively' by peaceful means. Furthermore, to constitute an unlawful use of force under Article 2(4), the establishment of a military presence in a disputed territory does not have to be violent but should involve coercion that makes it materially impossible for other claimants to restore the status quo ante without risking human injury or damage to property.


Building English language testing and assessment are one of the key functions of the UK Higher Education institutions from the early process of non-native English speaking student recruitment to the time of in-sessional and pre-sessional English language provision. There have recently been critiques of assessment practice in Higher Education (see, for example, Knight, 2002; Ball et al., 2012; Hamilton, 2014). This begs the question as to the possibility of potential alternatives for the current assessment regime. Accordingly, an interpretive qualitative study was carried out in the UK context to look into the English language lecturers' perceptions of challenges and potentials of dynamic assessment as a potential alternative. The results of the study show that despite ambivalent feelings and concerns about the challenges of implementing dynamic assessment, there are clearly lecturers who are philosophically inclined and open to the potential of dynamic assessment for enabling more personalized learning.


The Netherlands are situated at what in the Late Bronze Age was an interface between the Nordic, Urnfield and Atlantic interaction zones. However, reconstruction maps for these interaction zones by various authors show different dominant affiliations ( e.g. Atlantic or Urnfield) for the Netherlands. Therefore, this study analyzes the Dutch single-edged socketed Urnfield knives as part of the larger data set on Dutch Late Bronze Age knives, placing them in their wider west-European context. In order to better characterize the distribution of types of socketed knives and their moulds, it is argued that a separate northwest-European production and interaction zone must have existed. Nonetheless, contacts remained with a core area of single-edged socketed knife production in the region of the French/Swiss lake-shore settlements, known as palafittes . In addition, analysis of knife contexts, such as their incorporation in graves, allows to further distinguish areas of different meaning attached to such knives within the larger regions defined by knife typology. Affinity to central-European Urnfield Culture groups is limited to shared decorative traditions. The centre of gravity for the production of single-edged socketed knives is situated decidedly west of the central-European Urnfield area.


Chalcogen bonding (ChB) has emerged as a promising tool in organic synthesis. However, compared with the well-developed selenium- and tellurium-based salt catalysts, the ChB catalysis of sulfonium salts is still unknown. Here, we report a new type of alkynyl-sulfonium salt ChB catalysis for various ionic transformations, including transfer hydrogenation, bromination, bromolactonization, dimerization of 1,1-diphenylethylene, nitro-Michael addition reaction and Ritter reaction. More importantly, the photocapability of ChB was first demonstrated to generate alkynyl radicals for the synthesis of a variety of chalcogenoacetylenes. Mechanistic studies shed light on the mechanism of the photoinduced reactions and confirmed the involvement of alkynyl radicals which are difficult to be generated otherwise.


Thinking about the activism nowadays it is impossible to exclude the power of the visual, of film, cinema, of video, of multimedia platforms and social media extensions that offer a possibility of conveying a message probably stronger than any other tool at our disposal. An emerging form nowadays is the web-documentary or interactive documentary, among the other names it got, which changes the way we see the cinematic narrative and offers another perspective on the engaged audiences. Is there a viable connection between the web-documentary production and social change? Is there a functional form in which the two correspond - an activist project which attained its goal through or with the help of an online documentary film? Can this hybrid art form be used as a tool for social change and how?In this paper I will address these questions, as well as combine different interpretations and suggestions using as a starting point the crossing of documentary cinema and activism practices.


Focus group sessions were held with rural freeway commuters who use Highway 403 from Brantford to Hamilton, Canada, to identify the characteristics of their trip that helped determine their view of the quality of service for the trip. The results from that analysis were then compared with two other types of freeway users who had previously been studied: urban freeway commuters who use Queen Elizabeth Way from Toronto to Hamilton and tractor-trailer drivers. The findings suggest that despite some commonality among the three groups, each group valued a trip characteristic that they did not experience or at least could not be sure of. That characteristic differs across the three groups. Urban commuters were concerned about travel time, rural commuters about maneuverability, and truck drivers about steady traffic flow and physical road conditions. Despite these differences, an argument can be made that density, the service measure for freeways, is a reasonable proxy for most of these concerns. The results also suggest that it is harder to defend by using the same breakpoints on density for different types of freeways or even for different types of drivers. Although operational issues were the primary concern, it may also be appropriate to consider a second rating that addresses the quality of the facility as well as the existing level-of-service method that addresses the quality of operations on it.


A new decoder architecture for nonbinary low-density parity check (LDPC) codes is presented in this paper to reduce the hardware operational complexity and power consumption. Adaptive message control (AMC) is to achieve the low decoding complexity, that dynamically trims the message length of belief information to reduce the amount of memory accesses and arithmetic operations. A new horizontal nonbinary LDPC decoder architecture is developed to implement AMC. Key components in the architecture have been designed with the consideration of variable message lengths to leverage the benefit of the proposed AMC. Simulation results demonstrate that the proposed nonbinary LDPC decoder architecture can significantly reduce hardware operations and power consumption as compared with existing work with negligible performance degradation.


This work presents a new approach to the modelling of planar inductors for microwave and RF applications. The inductance is evaluated by means of analytical expressions based on a full geometry description. Moreover, the model takes into account the ohmic losses, due to conduction current, and the magnetic induced losses, due to Eddy currents by means of a frequency dependent series resistor. Finally, a parallel capacitance is included to match the frequency of the component at its first resonance.


A 56-year-old woman was admitted to our hospital with inspiratory dyspnoea, dry cough, vague right chest pain and right arm pain for 2 months. She denied tobacco use or asbestos exposure and had no significant medical or family history.

A chest radiograph highlighted extensive radiopacity involving the superior right lobe, the lateral view detailed the mass as being located in the posterior mediastinum. Chest …


We present a new algorithm for simulating fireworks animation based on the particle system and physical dynamics principle. The physical processing of fireworks and rendering is full implemented on Graphics Processing Unit(GPU). By using the multiple passages and programmable ability of GPU, it is probable to increase a numerous of particles in the simulation to enhance the reality of the scenes,also improve the running efficiency. Furthermore, making use of the point sprites which supported by the hardware unit for the particle rendering, to render the particles in many ways.Realistic characteristic of fireworks and efficiency of program are achieved and also satisfy the real time running requirement of the system, and can be applied in Virtual Reality System.


Physiologically, with every stroke right and left ventricle ejects the same blood volume. However, due to low resistance of the pulmonary circulation the stroke work is about 75% lower than on the left side resulting in a thinner right ventricular wall. Therefore, the right ventricle shows more compliance and less resistance to an abrupt increase in after load. Acute Right Heart Failure (ARHF) is a clinically complex situation occurring in 10 to 20% of all acute heart failure patients mostly due to right coronary occlusion or secondary pulmonary hypertension [1,2]. It is characterized by an inability of the right ventricle to generate enough cardiac output, thereby resulting in a volume deficit of the left ventricle. In addition, ARHF results in an increase in venous congestion and finally in cardiogenic shock. The prognosis of ARHF is extremely dismissal. Treatment of this life-threatening clinical condition primarily focuses on treating the cause of acute right ventricle failure. In addition, optimization of preload status by volume infusion, reduction of after load, improving contractility by adequate pharmacotherapy, and mechanical circulatory support may be beneficial for patients suffering from ARHF. Figure 1 summarizes the management of acute right heart failure. Since most studies have focused on improving left heart function so far, diagnosis and therapy of ARHF has been rarely in the center of research and innovative developments in medical technology. The right ventricle has therefore been named the "forgotten chamber" [3] (Figure 1).


Countless facial images are generated everyday through digital and cell phone cameras, surveillance video systems, webcams, and traditional film and broadcast video. As a result, law enforcement and intelligence agencies have numerous opportunities to acquire and analyze images that depict persons of interest. Computer-Aided Forensic Facial Comparison is a comprehensive exploration of the scientific, technical, and statistical challenges facing researchers investigating courtroom identification from facial images.


A new species of the Frankliniella cephalica group, from Central Costa Rica, is described under the name "Frankliniella morerai n.sp.". It is closely related to Frankliniella sandovalensis. Both species have translucent bodies, but the new species can be distinguished by these characteristics: setae io II in position 1/2, a complete comb on abdominal segment VIII, antennal segments without coloration and setae po IV longer. It was found in low density in crops of chilli, tomato, lettuce, sweet potato and coriander. A comparative table with other species of this group is included to facilitate diagnosis.


This research aimed to know : (1) the impact of increasing of productivity to food autonomy and the welfare of paddy farmer in 2020; and (2) the impact of increasing of harvested area to food autonomy and the welfare of paddy farmer in 2020. Research covered national scale, using secondary time series data between 1970 – 2004 with descriptive analytic method. Method of analysis  Two Stage Least Square (2-SLS)  by using Statistical Analysis System (SAS) ver 9.2 program as a software. The Result of this research  shows that  : (1) the impact of increasing of productivity and harvested area in 2020 will  increase  food autonomy but decreasing the welfare of paddy farmer; (2) just  increasing  productivity or harvested area in  2020 will not reach save food autonomy; (3) the combination of  reaching productivity until 5 ton/ha  and increasing harvested area until 10% in 2020 will  reach   food autonomy 90,233%  although  decreasing the welfare is the biggest. Key words : Productivity, Harvested area, Food autonomy, Farmer welfare


This exploratory research proposes the concept of instant messaging (IM) addiction and examines (a) whether IM addiction exists among Chinese teenagers and, if so, who the addicts are, what their symptoms are, and to what extent they are addicted; (b) whether psychological variables such as shyness and alienation can predict IM use or addiction among teenagers; and (c) whether IM use or IM addiction can impair the academic performance of teenagers. Using Young's classic definition of Internet addiction, results of a stratified random sample of 330 teenagers in China in 2007 found 95.8% of participants use IM, and 9.8% of them can be classified as IM addicts. Factor analysis identified four major IM addiction symptoms among teenagers: preoccupation with IM, loss of relationships due to overuse, loss of control, and escape. Results also showed that shyness and alienation from family, peers, and school are significantly and positively associated with levels of IM addiction. As expected, both the level of IM use and level of IM addiction are significantly linked to teenagers' academic performance decrement.


Proceedings: AACR 104th Annual Meeting 2013; Apr 6-10, 2013; Washington, DC

Neuroblastoma (NB) is a form of cancer that starts in certain types of very primitive developing nerve cells found in an embryo or fetus. This type of cancer occurs in infants and young children. It is rarely found in children older than 10 years. NB is by far the most common cancer in infants (less than 1 year old). It accounts for about 7% of all cancers in children. There are approximately 650 new cases of NB each year in the United States. The types of treatment used may include surgery, chemotherapy, retinoid therapy, and radiation therapy. In many cases, especially when the cancer has spread too far to be completely removed by surgery, chemotherapy is the main treatment. Most children with NB will need to have chemotherapy. In most cases, treatment involves a combination of anticancer drugs. These therapies by-in-large always have significant side-effects. The goal of all therapies aimed at eradicating cancer, including NB, is to selectively destroy cancer cells while sparing normal tissue. Most chemotherapeutic or radiotherapeutic agents function by damaging DNA or interfering with DNA replication. Rapid advances in recent years have contributed significantly to identifying and understanding the roles of key proteins in DNA damage response pathways. (As a result, the nuclear protein PCNA has been shown to be a component of all DNA replication/repair processes in the human cell). Logically then, it is reasonable to assume that by altering the cellular response to DNA damage, perhaps through manipulating genes or proteins related to DNA repair, cell cycle checkpoint control, damage tolerance or apoptosis, the effectiveness of conventional cancer therapy can potentially be enhanced or used as novel targets for drug discovery. Of course, also selectively sensitizing cancer cells relative to normal tissues should improve the therapeutic ratio for anti-cancer treatment. Our laboratory's recent data indicate that the use of PCNA derived synthetic peptides promote NB cytotoxicity. The hypothesis driving our work is that specific peptides derived from the PCNA protein sequence (caPeptides) have the potential ability to block the binding of several cellular proteins that participate in DNA replication, repair, cell cycle control, transcription, and chromosomal recombination in cancer cells to full length PCNA. By disrupting the naturally occurring interaction between PCNA and the proteins that bind to, or interact, with PCNA, cellular functions that recruit PCNA would be disrupted in the NB cell. These peptides, either alone or in combination with other cancer therapy agents are potentially useful cancer chemotherapeutics or augmentors of the pharmacodynamic effect of specific anti-cancer chemotherapeutics.

Citation Format: Linda H. Malkas, Long Gu, Mingway Li, Shanna Smith, Robert Lingeman, Gerald Wuenschell, Lei Zhang, Robert Hickey. Potential therapeutic peptides for neuroblastoma. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 2039. doi:10.1158/1538-7445.AM2013-2039


Eleven pigeonpea hybrids and 4 inbred cultivars were evaluated to study seed germination and seedling growth parameters using 'Between Paper Towel' (BPT) method. The test was conducted over a period of 10 days at room temperature in a seed germinator. Data were rec orded on test we ight, germination, root length, shoot length, shoot to root ratio, seedling dry weight and seedling vigour index. Significant differences were observed among entries for all the traits studied. Significantly greater values for germination (99.5%), root length (11.6 cm), seedling vigour index (1832), seedling ry weight (4.7 g) and test weight (11.4 g) were recorded for hybrids compared to inbred lines. The presence of longer root in the hybrids resulted in producing lengthier roots and greater tolerance to drought during early growth stages. Thus, greater seedling vigour of the hybrids would also contribute to their higher plant vigour and seed yields.


In the Health field, there is an increasing need to give the Health professional the opportunity to experiment on real situations without necessarily having to be in contact with the patient. In order for this to be achieved, there must be a virtual reality representation via a safe and user friendly system, such as a computer. This means that by using Simulation and modelling techniques new models have to be constructed which will portray the reality. The scope of this paper is to present a Simulation Model and Practical for Educating the General Public for the AIDS Epidemic. The model and the practical were developed by using the tools and applications created under the COAST project.


This study analyses the responsiveness of outpatient care to assess the quality of urban primary health care among all 5 types of health care providers in Bangladesh, namely, the Urban Primary Health Care Services Delivery Project, the NGO Health Services Delivery Project (NHSDP), NGOs, private hospitals, and the Ministry of Health and Family Welfare (MOHFW). Other than some public-private comparisons, there is an absolute knowledge gap regarding responsiveness in urban health systems, particularly in the context of Bangladesh, and this gap motivates this study. The study used primary data collected from 810 randomly selected outpatients. The survey used a structured questionnaire on all 7 domains of responsiveness of outpatient care suggested by the World Health Organization. The estimated mean responsiveness score reveals that overall, approximately 33% of the patients rated the responsiveness of the system as poor. In reported responsiveness, the NHSDP was ranked at the top and the MOHFW at the bottom. The latter is quite expected. Overall, prompt attention and autonomy were the worst-performing domains, and choice of provider, dignity, and clear communication were the better-performing ones. The results suggest the need to improve the degree of responsiveness of all domains, especially those that are more concerned with access to health care, namely, prompt attention, dignity, clear communication, and confidentiality. The Ministry of Health and Family Welfare facilities should give additional consideration to promote prompt attention, autonomy, and quality of basic amenities. Private facilities should also provide additional stress on improving prompt attention and autonomy. The nontherapeutic quality of health care needs to be emphasized in the medical education system. Further research based on household surveys could be worthwhile to measure responsiveness more comprehensively.


We perform population synthesis studies of different types of neutron stars (NSs) (thermally emitting isolated NSs, normal radio pulsars, magnetars) taking into account the magnetic field decay and using results from the most recent advances in NS cooling theory. For the first time, we confront our results with observations using simultaneously the log N-log S distribution for nearby isolated NSs, the log N-log L distribution for magnetars, and the distribution of radio pulsars in the P-P diagram. For this purpose, we fix a baseline NS model (all microphysics input), and other relevant parameters to standard values (velocity distribution, mass spectrum, birth rates, etc.), allowing us to vary the initial magnetic field strength. We find that our theoretical model is consistent with all sets of data if the initial magnetic field distribution function follows a lognormal law with (log (B 0 /G)〉 ∼ 13.25 and σ log B 0 ∼ 0.6. The typical scenario includes about 10 per cent of NSs born as magnetars, significant magnetic field decay during the first million years of a NS life (only about a factor of 2 for low-field NSs but more than an order of magnitude for magnetars), and a mass distribution function dominated by low-mass objects. This model explains satisfactorily all known populations. Evolutionary links between different subclasses may exist, although robust conclusions are not yet possible.


Cooperative spectrum sensing (CSS) alleviates the problem of imperfect detection of primary users (PU)s in cognitive radio (CR) networks by exploiting spatial diversity of the different secondary users (SUs). The efficiency of CSS depends on the accuracy of the SUs in detecting the PU and accurate decision making at the fusion center (FC). This work exploits the higher order statistical (HOS) tests of the PU signal for blind detection by the SUs and combination of their decision statistics to make a global decision at the FC. To minimize energy, a two stage optimization paradigm is carried out, firstly by optimal iterative selection of SUs in the network using Lagrange criterion and secondly optimized fusion techniques achieved by Neyman Pearson. The probability of detecting the PU based on HOS and hard fusion schemes is investigated. The results indicate that the Omnibus HOS test based detection and optimized majority fusion rule greatly increases the probability of detecting the PU and reduces the overall system energy consumption.


This research work studied the effect of global financial crisis on Nigeria economy in Nigeria. The financial crisis ravaging the global economy is naturally a serious cause for concern to policy makers. Secondary data were used in this study, the data were collected from CBN statistical bulletin also data were also gathered from journals and textbook that are related to the research topic. The overall significance of the regression is tested using Fisher's statistics. In this study the calculated F* value of 47.375 is significant at 5%. The result however show that linear relationship exist between the dependent and the independent variables of the model. The evidence established that the independent explanatory variables have individual and combine impact on the market capitalization in Nigeria. There is significant relationship between global financial crisis and capital market in Nigeria. Some of the recommendations made in this study are that. There is an urgent need for the total overhaul of regulations and regulatory framework, in order to enhance both the on-site and off-site examination and supervision of the banks. There is the need for increased and enhanced provisions for consumer protection. Nigerian economy is a mono-economy; any crash on the price of oil internationally will cripple our economy. So it is a matter of urgency for the Nigerian economy to divest into agriculture, manufacturing, information technology etc. Political stability is an important factor that encourages investment in an economy. So our nascent democracy should be nurtured.


Since the 1980s, self-monitoring of blood glucose (SMBG) has allowed easier and improved treatment of insulin-dependent diabetes mellitus (IDDM). SMBG has proved efficient in very selected patients and in conditions such as pregnancy, intensive insulin therapy (CSII and optimal bolus regimen), physical exercise and self-awareness of specific hypoglycaemic symptoms. Through the use of pen insulin injectors, SMBG should improve the autonomy, well-being and metabolic control of most IDDM patients. However, as SMBG is continuing to develop in France, costs are rising (estimated at $170 million per year in 1997), which has led some diabetologists to question its real benefit for all diabetic patients and its cost-effectiveness. Our study of published data indicates that SMBG often fails to be beneficial in non-selected IDDM patients, whether children adolescents or adults. However, educational sessions on SMBG and insulin dose adjustment have demonstrated that SMBG improves well-trained patients. Most authors recommend applying psychosocial scales and suitable educational tools to obtain positive results and justify the human and economic costs involved. In non-insulin-dependent diabetes mellitus (NIDDM), the use of SMBG is increasingly recommended by diabetologists and general practitioners. However, trials investigating the effects of SMBG in NIDDM patients have found no benefit for metabolic control or weight loss. We recommend a moderate use of SMBG in NIDDM patients and the development of clinical research strategies to study the benefit for NIDDM patients of a method which is increasing health costs appreciably.


The paper summarizes a proposed role for error-coding in shaping the composition of the natural nucleotide alphabet. It is argued that as nucleotide replication is essentially an information transmission phenomenon, the evolutionary pressures shaping alphabet composition might not have been confined to physicochemical issues alone, and that error-coding might have had a constraining evolutionary role. Nucleotide recognition features are mapped to 4-digit binary numbers, capturing the hydrogen donor/acceptor patterns (3-bits) and the purine/pyrimidine size motif (1-bit). An error-coding analysis, treating potential alphabets as combinations of 4-bit codewords, suggests that optimal alphabets are composed of nucleotides in which the purine/pyrimidine feature relates to the donor/acceptor pattern as a parity bit. Thus, of sixteen possible informationally distinct nucleotides, a viable alphabet, subject to error-coding constraints, may draw from either one of two sets of eight same-parity nucleotides, but not from both. Chemical considerations such as tautomeric instability, and vulnerability to hydrolysis, render several potential nucleotides unsuitable, reducing the size of the available sets. Two solutions emerge; one corresponds precisely to the natural alphabet of A, C, G and T. A second, less favored solution also appears viable, offering the possibility of life based on an alternative alphabet.


Introduction: This study investigated the effect of coronavirus disease 2019 (COVID-19) lockdown on the incidence of ocular trauma.Methods: In this retrospective cohort study, we collected data of patients who presented with ocular trauma in the emergency department during the lockdown period (from 22 March, 2020, to 30 April, 2020). In addition, we collected data of patients presenting with ocular trauma during the same period in the previous year. We compared the number of patients who underwent ocular surgery and the number of paediatric patients with ocular trauma between these two periods. A confounding factor may be the absence of patients from different districts who could not travel to the centre due to travel restrictions.Results: Between 22 March, 2019, and 30 April, 2019, a total of 76 patients presented with ocular trauma, of whom 28( 37.2%) required surgery. By contrast, between 22 March, 2020, and 30 April, 2020, a total of 78 patients presented with ocular trauma, of whom 33(42)% required surgery. Furthermore, 9% and 30% of the total patients in 2019 and 2020, respectively, belonged to the paediatric age group. Conclusions: COVID-19 lockdown exerted a significant effect on the incidence of ocular trauma.


Sickle cell disease is a congenital haemoglobinopathy with a high incidence of perioperative complications. Traditional anaesthetic management, based largely on extrapolation from biochemical models, has emphasized avoidance of red cell sickling to prevent exacerbations of the disease. This historical review outlines the evolution of the traditional approach to sickle cell pathology, assesses the validity of this model, describes the emergence of the concept of the disease as one defined by chronic inflammatory vascular damage, and outlines the practical implications of this new approach.


The current debates around censorship are about more than whether or not censorship is desirable. These debates are also about what counts as censorship. The question of what counts as censorship is a relatively new one since the Liberal conception of censorship was taken as given until the 1980s. Since then, a new approach to understanding censorship has gained momentum. What Matthew Bunn calls 'New Censorship Theory' argues that the Liberal conception is far too narrow to properly encompass the vast complexities of censorship. New Censorship Theory does not deny the insights offered by the Liberal conception, but expands upon them. This expansion pushes the notion of censorship out of the censor's office and into the marketplace, politics and social life. New Censorship Theory also recognizes the way that censorship is both prohibitive and productive. In light of this, some authors have argued that New Censorship Theory overstretches the concept of censorship to such a degree that it risks becoming useless and it risks equating all forms of censorship. Beate Müller borrows the notion of family resemblances from the philosophy of the later Wittgenstein to try to avoid getting stuck in the debates around terminology. She does this by trying to identify the essential elements of censorship, distinguishing between its core and periphery characteristics and by mapping censorial actions and reactions systematically. I argue that Müller uses the philosophy of Wittgenstein to make an anti-Wittgensteinian argument. In order to show why I think that this is the case, I will review the censorship debate before providing my own Wittgensteinian contribution.


Although electrophysiologic testing accurately delineates abnormalities in patients with fixed cardiac-conduction defects, its sensitivity in identifying transient rhythm disturbances is unknown. We prospectively studied 21 patients who had electrocardiographically documented intermittent atrioventricular block (n = 13) or sinus pauses (n = 8) causing syncope, but whose cardiac rhythm had reverted to normal by the time of referral. There were 14 men and 7 women, with a mean age (+/- SD) of 63 +/- 13 years. Fourteen patients had organic heart disease, and 8 were taking cardioactive medications. Electrophysiologic testing was performed before the implantation of a permanent pacemaker. Only three of the eight patients with documented sinus pauses had abnormalities during their tests that suggested the correct diagnosis (sensitivity, 37.5 percent), including a prolonged sinus-node recovery time in one and carotid-sinus hypersensitivity in two. Three of the eight patients had abnormalities detected that were unrelated to syncope, including atrial flutter, dual atrioventricular nodal pathways, and sustained monomorphic ventricular tachycardia. Of the 13 patients with documented atrioventricular block, only 2 had abnormalities suggesting the correct diagnosis (sensitivity, 15.4 percent). Additional observations unrelated to syncope among these 13 patients included abnormal sinus-node function, atrial flutter, and atrial fibrillation causing hypotension. These preliminary observations suggest that a negative electrophysiologic test in a patient with a normal cardiac rhythm who has experienced syncope does not exclude a transient bradyarrhythmia as a cause of the syncope. Furthermore, electrophysiologic testing may sometimes reveal unrelated rhythm disturbances that may mistakenly be designated as the cause of the syncope.


We consider the random graph $G_{n, {\bf d}}$ chosen uniformly at random from the set of all graphs with a given sparse degree sequence ${\bf d}$. We assume ${\bf d}$ has minimum degree at least 4, at most a power law tail, and place one more condition on its tail. For $k\ge 2$ define $\beta_k(G) = \max e(A, B) + k(|A|-|B|) - d(A)$, with the maximum taken over disjoint vertex sets $A, B$. It is shown that the problem of determining if $G_{n, {\bf d}}$ contains a Hamilton cycle reduces to calculating $\beta_2(G_{n, {\bf d}})$. If $k\ge 2$ and $\delta\ge k+2$, the problem of determining if $G_{n, {\bf d}}$ contains a $k$-factor reduces to calculating $\beta_k(G_{n, {\bf d}})$.


Many gene products associated with the cdk cell cycle kinases are thought to regulate the active kinase complex and thus regulate the transition points of the cell cycle. Genes encoding these proteins may potentially function as oncogenes or tumor suppressor genes. We describe the chromosomal mapping by FISH of the genes for several cdk-associated proteins including human CCNC (cyclin C) to 6q21, CCNE (cyclin E) to 19q12-->q13, CDKN1 (p21) to 6p21.2 and CDKN3 (KAP to 14q22). Some of these sites are near chromosomal translocations or LOH sites common to a variety of human tumors. The potential role for each of these genes in neoplasia is discussed.


Communication practice is increasingly converging around globally consistent approaches and techniques shaped by both globalisation and globalising communications technologies. However, this paper argues, national and regional practice histories and cultural characteristics have shaped, and continue to shape, practice in individual markets. The paper analyses the extent of that these divergent histories and cultures have shaped the structure and practices of the public relations industry in Australia and other countries. The paper challenges the common assumptions about public relations development and industry practice having developed from a predominantly US-based model progressively disseminated globally. It traces the history of public relations in Australia, counter-pointing its distinctive origins, to the US-origin thesis. It also examines the impact of demography and diverse national culture on industry shape and practice, comparing the Australian industry to that of other industries around the world. It uses mini-case studies of campaigns in specific countries to assess the extent to which they are culturally-bound by historical and cultural differences and the extent to which they are capable of being transferred or adapted to individual markets. For instance, assumptions about globally-consistent brand identities are contradicted by McDonalds' branding practices in markets such as Canada and Japan. The paper also discusses how emerging market PR industries are being shaped by distinctive and divergent cultures and development paths and may create new structural and practice models as the emerging economies becoming dominant internationally. The authors suggest that history and cultural diversity continue, and will continue to, shape national and regional practices.


In this paper, we present a method and a tool to assess the maturity of an enterprise's capability to manage its risks. Akin to the software capability model we rate a firms' risk management capability on a scale from one-to-five. Gaps between the bottom-up reported capabilities and the top-down perceived capabilities, as well as the gaps between organizations are highlighted and provide a useful reality-check for companies in their quest to improve their enterprise risk management (ERM) capabilities and processes. Through an explicit association of ERM capabilities with the organization's business strategy, we provide a more focused assessment and pinpointing of hotspots. The method presented in this paper is supported by a practitioner tool that is currently being piloted in a large IT consulting organization.


Nowadays, strategic flexibility and its effect on organizational performance are crucial to discuss. Moreover, organizations, especially industrial companies, should estimate how flexibility as a mechanism can improve organizational performance. The Hungarian food industry is highly significant in the industrial sector of the Hungarian economy. Therefore, the aim of this paper is to evaluate how the performance of the Hungarian food industry is affected by strategic flexibility, using supply and demand uncertainty as moderators. It is a quantitative and causal study. A survey was conducted to collect the primary data from a proposed sample of managers at the target companies. As a result, 301 valid responses have been analyzed in SPSS. Regression analysis, correlation, and moderation analysis are used as well. The results indicated that strategic flexibility generally enhances the performance of the target companies, and 20.3% of changes in companies' performance are related to strategic flexibility. The flexibility of resources affects only the operational performance, while the flexibility of coordination positively affects company performance; it has a 44.2% influence. The findings also showed that uncertainty does not moderate the relationship between strategic flexibility and target firms' performance. Thus, strategic flexibility is considered as one-effect mechanism in a stable business environment. In all cases, strategic flexibility should be applied in addition to other managerial techniques to enhance company performance.


This bulletin presents various economic time series relating to national, regional, and State farm income statistics. Data series for State-level cash receipts and production expenses by major components from 1949 to 1984 are included as well as other State-level farm income components and off-farm income. U.S. - level information dating back to 1910 (when the income series started) includes cash receipts, production expenses, and capital expenditures by component as well as net farm income and net cash income. A number of related series including prices received and paid by farmers, farm numbers, various interest rate series, and the GNP implicit deflator back to 1910 are included.


Although professional practice in forensic psychiatric environments is, in our opinion, extremely complex and requires the input of different disciplines, conceptual or theoretical models guiding this practice remain rare or poorly adapted. In this article, we propose an interdisciplinary model of practice to correct this deficiency. The objectives of this article are: to report on the literature review conducted; to report, as faithfully as possible, on our general consultation process with employees practicing in a forensic psychiatric institution; and, finally, to propose an interdisciplinary practice model resulting from this general consultation within the organization.


Fewer than 70 exploration wells have been drilled in Bangladesh (207,000 km2), mostly in the eastern onshore and offshore areas, making it one of the least explored countries in the world. Tectonic developments have controlled the accommodation space available for sediment deposition since the Early Cretaceous. Collision between the Indian plate and Eurasia to the north of Bangladesh and between the Indian plate and the Burma platelet on the east provided favorable conditions for development of Oligocene-Miocene source rocks and Miocene reservoir sands in eastern Bangladesh. The resulting Jenam-Bhuban Boka Bil petroleum system is the most active system identified to date and is dominant in eastern Bangladesh. Hydrocarbons likely also have been generated from the organic-rich shales of the Miocene Bhuban formation. The Jenam-Bhuban Boka Bil petroleum system alone is responsible for the generation of more than 16 tcf of gas in place discovered to date, mostly in the Surma basin of the Chittagong-Tripura fold belt. Several other petroleum systems have been postulated in Bangladesh. Together, the best technical estimate of the total resource base is about 61 tcf, including reserves within the discovered fields, anticipated field growth, and new field discoveries. With the exception of small bacterial contributions in some surface seep gases and two subsurface accumulations, the gases of Bangladesh are thermogenic. Modeling results indicate that the gases and associated condensates are sourced at peak generation depths of at least 6 km. Many of the gas accumulations are associated with retrograde condensates whose compositions are defined by two distinct source facies and by the solution/exsolution effects of vertical migration. Most of the condensates possess molecular signatures that indicate a major hydrogen-rich, angiospermous (flowering land plant) contribution to the organic matter of their source rock(s). The carbon isotope ratios of the methane in the gases and the isotopic and molecular characteristics of the associated condensates indicate a distinct source facies for petroleums of the northern Surma basin relative to those in the south. These isotopic and molecular results, when interpreted in light of the geological framework and our basin models, suggest that the Oligocene Jenam formation is the major contributor north of 24.4 degreesN and that the Miocene Bhuban formation is the major contributor to the south.


The IRAS survey data can be used successfully to produce images of extended objects. The major difficulties, viz. non-uniform sampling, different response functions for each detector, and varying signal-to-noise levels for each detector for each scan, have been resolved. The results of three different image construction techniques are compared: co-addition, constrained leastsquares, and maximum entropy. The maximum entropy result is superior. We present an image of the galaxy M51 with an average spatial resolution of 45 arc seconds, using 60 micron survey data. This exceeds the telescope diffraction limit of 1 minute of arc, at this wavelength. Data fusion is a proposed method for combining data from different instruments, with different spatial resolutions, at different wavelengths. Direct estimates of the physical parameters, temperature, density and composition, can be made from the data without prior image (re-)construction. An increase in the accuracy of these parameters is expected as the result of this more systematic approach.


Soils pollution with crude oil is becoming an ever increasing problem, especially in the light of several breakdowns of oil pipelines and wells reported recently. Due to its toxicity, widespread presence and complex nature, this type of pollution is a serious problem, one reason being that as the modern civilisation, urbanisation and mechanisation develop the use of crude oil products grow. The influence of soil pollution with crude oil depended on the type of soil, crude oil concentration in soil and fertilisation. The study has been undertaken to assay the biodegradation yield of soil polluted with crude oil and treated in different experimental variants. In soil polluted with 5% crude oil, doubling fertiliser dose from 0.25% to 0.5% has exercised the most spectacular effect, causing an increase of yield to 45.7% in absence of bacterial inoculation. Atlow fertiliser dose, inoculation with selected bacteria induced a strong stimulation effect; the bioremediation yield is 24% higher thant hat determined inuninoculated variant. In variants excessively polluted with 10% crude oil, microorganisms with biodegradation capacity of petroleum hydrocarbons have required amore or less period of time to adapt to pollutant presence in excess. Necessary period to adapt to environmental changing, microorganisms was significantly decreased by soil conditioning with Ecosol at 1% concentration.


Fast foods have become very popular among all age groups. The present study is done to assess the consumption pattern of fast foods (western foods, junk foods, instant foods) among adolescents prior to corona virus outbreak. This cross sectional study was done in Hyderabad (Telangana state). The study group consisted of 230 boys and girls studying 10, 11, 12 and intermediate first and second year in the age group of 14-19 years, belonging to middle income and high income groups. Semi structured questionnaire was used to collect information. Frequency of consumption fast foods was recorded. Height and weight was taken using standard scales and BMI calculated. The Consumption of fast foods daily ranged between 4.8 percent to 15.2 percent for French fries, vegetable or chicken Manchuria, and fried rice, and chocolates by 28.3 percent. Among liquid foods, packed fruit juices are taken by 21.7 percent which is a healthy sign. Body Mass Index of boys and girls indicate 44.8 percent boys and 36.8 percent girls are under the normal category, in the overweight category boys are 41.2 percent and girls are 32.2 percent while 11.2 percent boys and 23 percent girls are obese. Girls are more than boys in the obese group which is of great concern and requires planning ameliorative measures. Girls consuming fast food once a day are overweight while boys consuming fast foods once a day are distributed between normal and overweight categories. Among girls bad choice of fast foods or no proper exercise could be the contributing factor to overweight.


D9Arcy Thompson (1942) described the form of antlers as having developed in a two-dimensional pattern which, during growth, may have become more or less distorted depending on the species. In some (e.g. moose, fallow deer), the antlers may exhibit a palmate configuration; in most deer, however, they are branched structures formed by the repeated two-dimensional bifurcation of the original outgrowth. This process gives rise to a series of tines which vary in number according to age and species. In the sika deer, the first set of antlers, produced in yearlings, are unbranched spikes which may grow as much as 6 inches in length. The following year, these are replaced by branched antlers usually having three points each. Mature bucks ordinarily possess 4 points per antler. The annual growth cycle of antlers has been thoroughly documented by Waldo & Wislocki (1951), and Wislocki (1956) in the Virginia deer. In the sika deer it is briefly as follows.


This article responds to a recent critique that the securitization of receivables is a legally shaky financial product that survives only because it is too big to fail. This critique argues that securitization's success in avoiding the costs that the Bankruptcy Code imposes on secured credit, including a bankruptcy trustee's ability to use the cash collateral from the receivables, is a type of fraud that hinders or delays the creditors of the originators of receivables. The critique, however, fails. The cases cited for the author's fraud analysis do not support its thesis. Further, the critique fails to demonstrate that securitization's avoidance of the "Bankruptcy Tax" on secured credit harms the creditors of an originator. The critique also does not refute the strong doctrinal foundation of securitization that combines the form and substance of two long recognized legal devices-(1) a true sale of property to a buyer (2) that is a separate legal entity.


Fragmented and variable perioperative care exposes patients to unnecessary risks and handoff errors. The perioperative surgical home aims to optimize quality, value-based care. We performed a retrospective evaluation of how a preoperative assessment center could coordinate care through e-mails sent to a patient's healthcare team that initiate discussion on critical clinical information. During 100 clinic days on which 8122 patients were evaluated, 606 triggered e-mails, with a potential impact on 19 elements across the perioperative care spectrum. Four cases were canceled, and 42 cases were rescheduled. By fostering information exchange, these communications could advance patient-centered, value-enhanced quality and safety outcomes.


Abstract Pyrrhotite Fe1–xS is the main sulfide component of platinum-group element (PGE) ores and commonly contains from a few tenths to a few dozen ppm of disseminated Pt. Here we report an X-ray absorption spectroscopy investigation into the state of Pt in synthetic pyrrhotite in combination with theoretical spectra modelling. The pyrrhotite crystals were obtained by means of the salt flux technique, using a eutectic mixture of alkali metal halides as the transport media. Analysis of the chemical composition of synthesised crystals showed that an increase of the temperature and sulfur fugacity yields higher concentrations of Pt in pyrrhotite. The Pt content reached 0.6 wt.% at the maximum temperature and sulfur fugacity (t = 720°C, log $f_{{\rm S}_ 2}$ = –0.1) achieved in a Pt-saturated system. X-ray absorption near-edge structure (XANES) analysis of Pt L3-edge spectra revealed that Pt is present in pyrrhotite in the 4+ and 2+ 'formal' oxidation states. Theoretical modelling of XANES and interpretation of extended X-ray absorption fine structure (EXAFS) spectra showed that Pt4+ substitutes for Fe in the crystal lattice of pyrrhotite, whereas Pt2+ forms PtS-like clusters disseminated in the pyrrhotite matrix. Atoms of isomorphous Pt4+ are surrounded by 6 S atoms at a distance of 2.39 ± 0.02 Å. According to theoretical simulations using the FDMNES program, the second coordination sphere of the solid-solution Pt contains one vacancy in the Fe sublattice within the Fe-layer. The Pt2+S-like clusters can be considered as a quench product. High sulfur fugacity stabilises the solid-solution Pt and prevents the formation of the PtS-like clusters during cooling. The maximum content of the solid-solution Pt in pyrrhotite is ca. 50 times lower than in pyrite and can be approximated by a straight line in the log C(Pt) vs. 1/T plot, it increases from 1 ppm at 350°C to 3 wt.% at 900°C.


Trisomy 8 is the most common acquired chromosomal abnormality associated with myeloid malig- nancy. As a constitutional trisomy 8 mosaicism (T8M), it exhibits an extremely variable phenotype. In addition, Behcet disease (BD) has been reported as an unusual complication of myelodysplastic syndrome (MDS). To our knowledge, 12 case reports of various hematologic malignancies in patients with T8M and 18 case reports of MDS with acquired trisomy 8 complicated by BD have been published to date. We report a case of constitutional T8M with MDS complicated by intestinal BD and antithrombin III deficiency. 2005 Elsevier Inc. All rights reserved.


In this paper, we propose a novel approach of fusing the fuzzy control actions of the obstacle avoidance, goal seeking and steering behaviors, in which the steering behavior is derived from motion prediction. As such, the navigator is more capable to steer clear of the zone of high collision probability. Through simulation, it has been confirmed that the navigator having this steering behavior can tackle multiple moving obstacles successfully at much higher speed compared with those without. Furthermore, it does not require any a priori knowledge of the obstacles' motion.


TOPEX/Poseidon has been collecting altimeter data continuously since October 1992. Altimeter data have been used to produce maps of sea surface height, geostrophic velocity, significant wave height, and wind speed. This information is of proven use to mariners as well as to the scientific community. Uses of the data include commercial and recreational vessel routing, ocean acoustics, input to geographic information systems developed for the fishing industry, identification of marine mammal habitats, fisheries management, and monitoring ocean debris. As with sea surface temperature data from the Advanced Very High Resolution Radiometer (AVHRR) in the late 1980s and early 1990s, altimeter data from TOPEX/Poseidon and ERS-1 and -2 are in the process of being introduced to the marine world for operational maritime use. It is anticipated that over the next few years companies that specialize in producing custom products for shipping agencies, fisheries and yacht race competitors will be incorporating altimeter data into their products. The data are also being incorporated into weather and climate forecasts by operational agencies both in the US and Europe. This paper will discuss these products, their uses, operational demonstrations and means of accessing the data.


The literature describes that the most efficient cell penetration takes place at 200–500 µm depth of the scaffold. Many different scaffold fabrication techniques were described to reach these guidelines. One such technique is solvent casting particulate leaching (SC/PL). The main advantage of this technique is its simplicity and cost efficiency, while its main disadvantage is the scaffold thickness, which is usually not less than 3000 µm. Thus, the scaffold thickness is usually far from the requirements for functional tissue reconstruction. In this paper, we report a successful fabrication of the microporous polyurethane thin layer (MPTL) of 1 mm thick, which was produced using SC/PL technique combined with phase separation (PS). The obtained MPTL was highly porous (82%), had pore size in the range of 65–426 µm and scaffold average pore size was equal to 154 ± 3 µm. Thus, it can be considered a suitable scaffold for tissue engineering purpose, according to the morphology criterion. Polyurethane (PUR) processing into MPTL scaffold caused significant decrease of contact angle from 78 ± 4° to 56 ± 6° and obtained MPTL had suitable hydrophilic characteristic for mammalian cells growth and tissue regeneration. Mechanical properties of MPTL were comparable to the properties of native tissues. As evidenced by biotechnological examination the MPTL were highly biocompatible with no observed apparent toxicity on mouse embryonic NIH 3T3 fibroblast cells. Performed studies indicated that obtained MPTL may be suitable scaffold candidate for soft TE purposes such as blood vessels.


The goal of the present study was to address the various risk factors associated in normolipidemic acute myocardial infarction (AMI) patients admitted to the intensive coronary care unit (ICCU). The study compared serum lipid profiles, lipid peroxidation markers, antioxidants and inflammatory markers in acute myocardial infarction (AMI) patients and age/sex-matched controls. A lipid profile, lipid peroxidation, enzyme antioxidants, endogenous antioxidants, ischemia modified-albumin (IscMA), ceruloplasmin, C-reactive protein (CRP), fibrinogen, lipoprotein (a) and paraoxonase-1 activities were analyzed in 330 subjects, 165 acute myocardial infarction (AMI) patients and 165 age/sex-matched controls. We observed significantly higher (p < 0.0001) total cholesterol and triglyceride levels and lower high-density lipoprotein cholesterol (HDL-C) levels in the AMI patients. The lipoprotein (a), ceruloplasmin, CRP and fibrinogen levels were higher and the bilirubin, ascorbic acid, uric acid, albumin, superoxide dismutase, catalase, glutathione peroxidase and paraoxonase-1 activities were lower in AMI patients than controls. The malondialdehyde (MDA) and conjugated diene (CD) levels were significantly higher (p < 0.0001) in AMI patients.


Who should pay for the money lost by UK and Dutch citizens investing in Icesave accounts? This column presents the dispute's background and argues that the debt burden of Icesave is likely to be closer to 15% of GDP than the 50% often reported. It concludes that Iceland is not too small to repay.


Iread with great interest the article by Darsaut et al on the evaluation of the accuracy of several transcranial Doppler (TCD) flowvelocity values in the diagnosis of severe angiographic vasospasm, which was defined as at least 50% reduction in the diameter of proximal intracranial arteries. In order to achieve this, they performed a retrospective analysis of 221 patients with aneurysmal subarachnoid hemorrhage (aSAH) who underwent TCD within 24hours of conventional angiography and obtained mean flow-velocity threshold values of 164 cm/s for anterior circulation segments and 80 cm/s for the basilar artery (minimal sensitivity of 80% and specificity of 56%–71%). However, these relatively high-threshold values would still unnecessarily refer patients for cerebral angiography 50% of the time and still miss 10%–20% of patients with severe vasospasm, potentially leading to cerebral infarction. I would like to share some thoughts that, hopefully, will add to the previously described results. In patients with aSAH, a delayed phase of brain injury might take place due to delayed cerebral ischemia (DCI), which typically occurs between 3 to 14 days after ictus. Its pathophysiologic process is complex and still under scrutiny; however, it is hypothesized that it might build on a combination of angiographic vasospasm, microcirculatory dysfunction, microthromboembolism, cortical spreading depolarization/ischemia, and capillary transit time heterogeneity. Despite being one of the most widely evaluated parameters during follow-up after aSAH, angiographic vasospasm typically occurs in as many as 70% of patients, whereas DCI usually develops only in 30%. Given that decisions to perform rescue therapies, such as mechanical or chemical angioplasty, are usually based on TCDobtained flow-velocity criteria (which are dependent on the degree of vasospasm), overtreatment (ie, due to false-positives) might occur. Therefore, not surprisingly, CTP has been assessed as a potential diagnostic tool to detect or even predict vasospastic infarction during the first 2 weeks after ictus (ie, vasospasm period). Because this technique assesses directly the brain parenchyma (ie, for ischemia or hypoperfusion), it has the potential to reduce the aforementioned overtreatment of patients with aSAH diagnosed with vasospasm. With this concept in mind, it has been shown that whole-brain CTP performed on day 3 after ictus has sufficient diagnostic accuracy to identify patients at risk for DCI, allowing intensification of antivasospastic therapy. In a more recent study, the authors suggested a standardized CTP protocol for the management of patients with aSAH after finding significantly better outcomes (ie, mRS at 3 months) in patients in whom such protocol was followed compared with another group in which CTP was performed on an individual basis (ie, in a nonstandardized approach). This protocol would potentially reduce excessive radiation exposure by triaging patients on the basis of a daily neurologic assessment and TCD measurement; only comatose and/or sedated patients would systematically undergo CTP at days 3–5, with cases with neurologic deterioration or TCD criteria of vasospasm undergoing CTP on demand. Thus, CTP seems to have the potential to be the main imaging diagnostic tool in the follow-up of patients with aSAH, with TCD having a complementary role in the triage of such patients (mainly based on rising serial values and less on an absolute single one).


BACKGROUND
P-glycoprotein mediates resistance to natural-product anti-neoplastic agents like vinblastine through an active transport process resulting in reduced intracellular concentration of these agents. The triphenylethylene antiestrogen tamoxifen and its major metabolite N-desmethyltamoxifen at concentrations of 4-6 microM enhance the intracellular concentration of natural-product antineoplastics and augment the cytotoxicity of such drugs three-fold to 10-fold in a variety of human and murine cell lines.

PURPOSE
On the basis of these preclinical findings, we conducted a phase I clinical trial of high-dose, oral tamoxifen administered in conjunction with a 5-day continuous infusion of vinblastine.

METHODS
We studied 53 patients with advanced epithelial tumors. Tamoxifen was given orally as a loading dose on day 1, followed by two doses a day on days 2-13. Vinblastine was given as a 120-hour continuous infusion (1.5 mg/m2 per day) on days 9-13 of each tamoxifen course. The starting dose of tamoxifen was 40 mg/m2 administered twice a day following a loading dose of 150 mg/m2. The maximum dose was 260 mg/m2 twice a day following a loading dose of 680 mg/m2. Treatment cycles were repeated every 28 days.

RESULTS
The dose-limiting toxic effects of tamoxifen were neurologic and began within 3-5 days after the start of treatment. They consisted of tremor, hyperreflexia, dysmetria, unsteady gait, and dizziness. One patient experienced a grand mal seizure 24 hours after the last tamoxifen dose. Toxic effects were rapidly reversible. Asymptomatic prolongation of the QT interval on electrocardiogram occurred at doses of tamoxifen of 80 mg/m2 or higher given twice a day. No coagulation or ophthalmologic abnormalities occurred. Tamoxifen did not enhance the toxicity of vinblastine. Mean plasma concentrations of tamoxifen or N-desmethyltamoxifen at 260 mg/m2 tamoxifen given twice a day for 13 days were 6.04 and 6.56 microM, respectively. There was no relationship between plasma antiestrogen content and the development of neurotoxic effects.

CONCLUSIONS
Tamoxifen at 150 mg/m2 given twice a day following a loading dose of 400 mg/m2 results in plasma levels of tamoxifen and N-desmethyltamoxifen of 4 and 6 microM, respectively, without dose-limiting toxicity. We recommend this dose for phase II trials of tamoxifen to modulate P-glycoprotein-mediated drug resistance.

IMPLICATIONS
Our study demonstrates that high-dose tamoxifen can be safely administered and that plasma concentrations that may inhibit P-glycoprotein function can be achieved.


The A V conducting system was examined histologically in 13 selected human hearts (7 control and 6 A V block specimens), focusing attention upon normal His bundle (HB) structure, and upon the histopathologic basis of intrahisian block, with supraventricular QRS configuration. HB revealed a poor morphologic identity, often failing to represent the "undivided stem" of the AV pathway, either due to an early partition into separate longitudinal fascicles, or to varied types and sites of bifurcation, without any definite boundary between nonbranching and branching portions. Split His potentials, the distal component of which has been suggested as arising in the proximal bundle branch system, has been found in a case free of HB histologic abnormality. Supra ventricular QRS configuration in escape rhythm was observed in two cases of AV block, not withstanding destruction of the entire His bifurcation, and in experimental bilateral bundle branch block. Pertinent explanations have been suggested. The overall semantic value and usefulness of the current HB nomenclature do not seem to imply, as yet, a precise and constant anatomoclinical correlation.