Back Ground Data: Far lateral lumbar disc herniation is a unique entity. It needs special care in designing the best surgical approach. Many limited approached have been advocated. We report a case series treated by a minimally invasive approach. Purpose: to evaluate the efficacy and safety of minimally invasive approach in treatment of far lateral lumbar disc herniation. Study Design: Prospective analytic study. Methods: 25 patients suffering from far lateral disc herniation (extra-foraminal) were operated according to this technique. Through a small skin incision (1.5 cm), the paraspinalmuscles are spread by dilators, until a working channel of 11 mm inner diameter and 14 mm outer diameter can be placed. All further steps are performed through this channel under illumination and control of the operating microscope. The mean follow up period was one year, and patients were evaluated by using the Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI). Results: The average surgical time was 49.2 minutes. The ODI improved from 29.96 (preoperative) to 12.12 (post-operative). The VAS of back pain improved from 6.24 (pre-operative) to 3.4 (post-operative).The VAS of leg pain improved from 7.2 (pre-operative) to 2.6 (postoperative). No intra-operative or early postoperative complications occurred. However, only one recurrence happened and could be treated by the same technique. Conclusion: The results from this small series seem to promise that this minimal invasive microscope assisted technique is a practical and valuable alternative to conventional techniques for the treatment of far lateral lumbar disc herniation. The main advantages include: minimal surgical trauma, no effect on the stability of the spine, rapid rehabilitation, short hospital stay and excellent cosmetic outcome. (2012ESJ018)


Objective To evaluate lacrimal sac (LS) pump failure in patients with lower motor neuron facial nerve palsy (FNP) using ultrasound biomicroscopy (UBM). Methods This was a prospective observational case series. Patients with unilateral lower motor neuron FNP of different aetiologies, age groups and gender were enrolled in this study. Anatomical patency was confirmed through irrigation of the lacrimal drainage system. The degree of lagophthalmos and House–Brackmann grade (HBG) were evaluated, and the dye disappearance test performed. UBM evaluation of the LS during opening and closure of the eyelids was performed for both sides; the control side and the side with assumed lacrimal pump failure (attributed to FNP). Any changes in the orbicularis oculi muscle and fluid turbulence within the sac were reported. Results A total of 17 patients with unilateral lower motor neuron FNP were evaluated. The average age (±SD) was 33.2±20.1 years. UBM evaluation of control side LS showed obvious fluid turbulence of different patterns within the sac during opening and closure of the eyelids. Fluid turbulence was absent in the LS with HBG V and VI FNP and reduced in the LS with HBG III and IV FNP. Conclusions UBM can be used as a safe, non-invasive and office-based tool to evaluate the LS pump.


AIMS
To compare the pharmacokinetics of lopinavir/ritonavir (LPV/r) 800/200 mg administered once daily in the morning compared with the evening.

METHODS
This was a randomized, two-way, cross-over study in HIV+ subjects. In each subject the pharmacokinetics of each drug were characterized after 2 weeks of LPV/r 800/200 mg administered once daily at 08.00 h and 19.00 h. On study days, LPV/r was taken with a standardized meal (800 kCal, 25% from fat) after fasting for at least 5 h. LPV/r concentrations were measured by LC-MS/MS, and the data were analyzed by noncompartmental pharmacokinetic analysis.

RESULTS
Fourteen subjects completed the study (all men, mean age/weight 44 year/81 kg). The median (interquartile range) LPV AUC(0,24 h), maximum plasma concentration (C(max)) and concentration at the end of the dosing interval (C(24 h)) after am and pm dosing was, respectively, 143 (116-214) mg l(-1) h, 12.8 (10.3-17.2) mg l(-1), 1.34 (0.58-3.25) mg l(-1), and 171 (120-232) mg l(-1) h, 12.9 (8.22-16.3) mg l(-1), 1.15 (0.59-1.98) mg l(-1). The geometric mean ratio (GMR, am : pm) and 95% CI of the LPV AUC(0,24 h), C(max), and C(24 h) was 0.91 (0.79, 1.06), 1.11 (0.94, 1.32), and 1.19 (0.72, 1.96), respectively. The median ritonavir C(max) after am and pm dosing was 1.05 and 0.90 mg l(-1), respectively. The GMR (95% CI) of the RTV AUC(0,24 h), C(max), and C(24 h) was 0.93 (0.80, 1.08), 1.27 (1.00, 1.63), and 1.04 (0.68, 1.60), respectively. Administration of LPV/r in a once-daily regimen was generally well tolerated.

CONCLUSIONS
No differences were observed in the pharmacokinetics of LPV/r after am or pm dosing with food, which suggests that this once daily combination, can be taken in the morning or evening. Such flexibility in dosing may improve adherence.


Abstract Preventive vaccination is the most successful approach against infectious diseases and has a great impact on world health. Vaccines operate through the activation of innate immunity that helps to stimulate antigen-specific T- and B-lymphocytes. These events are orchestrated by dendritic cells (DCs) that are able to sample foreign structures and concomitantly sense 'danger signals'. Thus, DCs provide a functional link between innate and acquired immunity, and due to their regulatory potential are referred to as natural adjuvants. Human conventional and plasmacytoid DCs express different sets of well-characterized Toll-like membrane receptors (TLRs) that recognize a broad range of conserved molecular patterns of pathogens. The recently discovered cytosolic Nod-like receptors (NLRs) and RIG-like helicases (RLHs) also turned out to participate in pathogen recognition and modulation of immune responses through interacting signaling pathways. As a result of their collaboration, the TLR, NLR and RLH recognition systems induce the secretion of different combinations of cytokines that play a fundamental role in T-cell activation and instruction. Ligands of the innate recognition systems emerge as new adjuvants for vaccine design, whereas manipulation of the signaling pathways mediated by these receptors offers new avenues for fine tuning immune responses and optimizing immunotherapies.


Necrotizing enterocolitis (NEC) is a devastating inflammatory condition of the intestine, which affects premature infants and causes untold damage. Its pathogenesis has to do with how colonizing bacteria interact with the immature newborn intestine. An immature innate immune response with increased TLR-4 on the cell surface and increased signaling molecules, such as NF-κB, can cause excessive inflammation. This is in conjunction with a decrease in the appearance of regulatory molecules which effect the control of innate responses. This condition is so devastating that it must be prevented and not treated. Fortunately, breast milk and probiotics can affect the condition leading to reduced inflammation. How does this effect work? We have shown that breast milk tryptophan and Bifidobacterium infantis result in a metabolite (indole-3-lactic acid) response, which is anti-inflammatory via inhibition of the aryl hydrocarbon receptor transcription factor which stimulates an IL-8 response. We have also shown that breast milk complex carbohydrates interacting with Bacteroides fragilis can cause short-chain fatty acids which exert anti-inflammatory effects on the newborn intestine. These breast milk metabolites could help prevent NEC if shown to be effective clinically.


The recent discovery of electron initiated avalanche photodiodes (e-APDs) using mercury cadmium telluridesemiconductor materials has permitted a significant advance in short-wave infrared imaging. In the visible spectrum,electron-multiplying charge-coupled devices (EMCCDs) improved imaging techniques—especially in the life sciences.And yet, no significant breakthroughs have been made in infrared imagery since the hybridization of III-V or II-VIsemiconductors with low bandgap on complementary metal-oxide semiconductor (CMOS) read-out integrated circuits(ROICs).In 2012, Philippe Feautrier et al.[1] and Gert Finger et al. [2] of the European Southern Observatory (ESO; Garching,Germany) reported successful hybridization of HgCdTe e-APDs on CMOS ROICs with a significant number of pixels(320 × 256). Feautrier et al. [3] also reported the use of a Sofradir/CEA-LETI APD array on the ESO Very Large TelescopeInterferometer (VLTI), called RAPID, demonstrating for the first time the successful operation of this technology in arepresentative environment.First Light Imaging [4] is the first commercial company to make e-APD infrared array technology available in its C-REDOne camera. Using a 320 × 256, 2.5 μm cutoff wavelength HgCdTe e-APD array deeply cooled to 80 K with a highreliabilitypulse-tube cryocooler (mean-time between failure or MTBF of approximately 90,000 hours), the camera has ahigh readout speed of 3500 frames/s (full frame) while exhibiting a readout noise below one electron—thanks to the APDgain in the range of 1 to 60.This paper reports on the results of the Sofradir/CEA-LETI RAPID program [5] and on the development of the C-REDone infrared camera from First Light Imaging based of the SELEX SAPHIRA detector [6]. The interest of ShortWavelengths InfrRed (SWIR) e-APD versus more classical HgCdTe arrays as infrared tilt sensors or pyramid wavefrontsensor like what is currently developed at Keck Observatory is also discussed in this paper.


We present a fully abstract semantica for reai-time distributed computing of the Ada and OCCAM kind in a denotational style. This semantica turns termination, communication along channels, and the time communication takes place, into observables. Yet it is the coarsest semantica to do so which is syntax-directed (this is known as full abstraction). It ·extends the linear history semantica for CSP of Francez, Lehman and Pnueli. Our execution model is based on maximizing concurrent activity as opposed to interleaving (in which only one action occurs at the time and arbitrary delays are incurred between actions). It is a variant of the maximal parallelism model of Salwicki and Müldner.


One of the main features of Drillship or FPSO is a moonpool structure. The moonpool structures have various accuracy tolerances according to their functions and targets. This study is mainly interested in roundness of a circular moonpool structure in FPSO. Because this structure needs abrasion-resistance at which bearing of machine touches on inner wall of moonpool, we should do over-lay welding widely and deeply by using Inconel weld material. But a general over-lay can cause a severe distortion at ship block structure. If we can analyze the roundness by thermal distortion under Inconel over-lay, we can establish a special erection policy by the results. In this study, we designed stress-strain curve for strain-boundary condition analysis by an elasto-plastic material property. The results made us to decide an appropriate ship-block size and policy of crane manipulation will follow for its capacity. If a structure that needs over-lay is not large, solid elements also are not a bad choice for FEM modeling. Therefore we also developed a standard of using strain-boundary method that shell elements are used as over-lay on solid element modeling.


In current literature, the side-slip angle estimation has been extensively focused due to the importance of the side-slip angle information on the vehicle system control. In this study, the innovative Kalman filter observer for side-slip angle is proposed based on the Takagi-Sugeno (T-S) fuzzy modeling of vehicle non-linear lateral dynamics. Then based on the estimated side-slip angle, the fuzzy logic direct yaw moment controller is proposed to improve the vehicle performance. Finally, simulation results are presented to verify the proposed estimator and controller.


It has been shown by low temperature ESR-spectroscopy that BHT (butylated hydroxytoluene) decreases the content of Fe2+ . . . O2 complexes being active centres of oxygenase type enzymes in loose connective tissue, regenerating liver and also in tumor and liver of tumor bearing mice. This effect is closely related to BHT presence in animal tissues.


Abstract Crowdfunding, a relatively novel internet-based non-banking funding instrument for startups, innovative, creative or prosocial projects, implies that funders (donors or lenders) and fund seekers (project initiators) interact on a crowdfunding platform. The goal of fund seekers is to raise the necessary amount of money to finance their project, while donors are backers of business or research ideas, social causes or start-up companies. Existing research has proven that for a crowdfunding campaign to succeed, one condition is for the crowdfunding platform to provide the adequate technical functionalities that ensure sufficient financial information both during and after the campaign (such as how the money was used and how the money was returned if the project failed) but also the legal framework through a solid contract between the platform and the fund seeker that can prevent moral hazard of the latter. The purpose of this study is to perform a qualitative analysis of the active crowdfunding platforms in Romania in terms of financial information transparency and to determine whether they fulfil the necessary conditions to ensure fair use of donations by project initiators and distribution of reward to donors


In this paper we present the results of an empirical study conducted within small and very small software developing enterprises in Austria. The primary goals of this survey were to find out how they are structured, to learn more about their characteristics, and how they organize software development. Furthermore we evaluate methods, processes, techniques and tools used, persons and roles involved, and finally problems occurring during software development. Additionally we place a special focus on quality management issues and discuss which motivations small and very small enterprises can have to install such a quality management system.


A portable cordless telephone of formula (1), the host telephone (2) combines transceiver apparatus equipped with an antenna (3), a dialing means (4), a microphone (5) and the earphone (6) . Features of this phone that can be worn on the body, hands free.


The idea of having two second messenger pathways in olfaction, one mediated by cAMP and the other by inositol 1,4,5-trisphosphate, is supported by evidence that both second messengers directly activate distinct ion channels in the outer dendrite of lobster olfactory receptor neurons. Evidence that both types of second messenger-gated channels can occur in the same patch of membrane suggests that channels of both types can be expressed in one neuron. Evidence of more than one type of inositol phosphate-gated channel in this highly specialized region of the neuron furthers the idea that the output of individual olfactory receptor cells is regulated through multiple effectors and allows that effector diversity may contribute to functional diversity among olfactory receptor cells.


The effects of emulsion structure and composition of the matrix on the release of linalool (nonpolar) and diacetyl (polar) were studied using sensory evaluation, static headspace gas chromatography, and an electronic nose. The matrices used were water, rapeseed oil, and eight oil-in-water emulsions differing in oil volume fraction (0.05/0.5), emulsifier type (sucrose stearate/modified potato starch), and homogenization pressure (100/300 bar). Fat content strongly affected the release of linalool, but it was not as critical a factor in the release of the more polar compound, diacetyl. A slight effect of the emulsifier type on the release of aromas was observed with sensory and gas chromatographic methods. The reduced droplet size, resulting from higher homogenization pressure, enhanced the release of linalool but had no effect on diacetyl. Sensory and gas chromatographic methods detected aroma changes quite similarly. The electronic nose was capable of detecting only the effect of fat on linalool.


Abstract After four decades of Jose Luis Sert's works, the success and failure of his buildings has now become obvious. Apart from Sert's initial intention of design, his successful buildings attest the outcome of urban naturalization of buildings. It is neither passive adaptation of nor striking contrast to a building's surrounding, but an active and sustaining vitalization which is latent and often assumed. The successful buildings show a concatenate response to the climate, a continuation of praxis, and an architectural contribution to urban environment, while unsuccessful buildings were lacking at least in one of the above points. Three buildings will show the range that Sert intended in accomplishing his tacit approach. First, the Holyoke Center, which was the manifestation of a city with a large building, has proven to be unsuccessful in the recent use of the building. The second building is Peabody Terrace, which expressed environmental adaptation and alternative dwelling to suburbanization through the compact massing and variegated design elements of the building enclosure. The third building is the 44 Brattle Building, which has acted as a catalyst for the enhancement of the building block for more than 40 years. These examples show the range of Sert's initial conception and more over, their actual manifestation in the built environment.


A 68-year-old man with a previous right total hip arthroplasty presented with acute pain in the right hip, and no associated trauma was reported. The previous hybrid arthroplasty consisted of a ceramic femoral head articulating on an ultra-high-molecular-weight polyethylene liner. The unusual diagnosis of fractured ceramic femoral head was made and an urgent revision arthroplasty was performed to remove the ceramic bearing as well as all implants that may have come into contact with the ceramic. This case report highlights the material properties of ceramics in total hip arthroplasties as well as the importance of regular follow-up in these patients.


Background and Objectives Many preclinical studies have been conducted using animal disease models to determine the effectiveness of human mesenchymal stem cells (hMSCs) for treating immune and inflammatory diseases based on the belief that hMSCs are not immunogenic across species. However, several researchers have suggested xenogeneic immune responses to hMSCs in animals, still without detailed features. This study aimed to investigate a xenogeneic humoral immune response to hMSCs in mice in detail. Methods and Results Balb/c mice were intraperitoneally injected with adipose tissue-derived or Wharton's jelly-derived hMSCs. Sera from these mice were titrated for each isotype. To confirm specificity of the antibodies, hMSCs were stained with the sera and subjected to a flow cytometic analysis. Spleens were immunostained for proliferating cell nuclear antigen to verify the germinal center formation. Additionally, splenocytes were subjected to a flow cytometric analysis for surface markers including GL-7, B220, CD4, CD8, CD44, and CD62L. Similar experiments were repeated in C57BL/6 mice. The results showed increased IgG1 and IgG2a titers in the sera from Balb/c mice injected with hMSCs, and the titers were much higher in the secondary sera than in the primary sera. These antibodies were specifically stained the hMSCs. Germinal centers were observed in the spleen, and flow cytometric analysis of the splenocytes showed higher frequencies of centroblasts (B220+ GL7+) and memory T cells (CD62L+ CD44+) both in CD4+ and CD8+ subsets. Similar results were obtained for C57BL/6 mice. Conclusions hMSCs induced a humoral immune response in mice, with characters of T cell-dependent immunity.


Advanced materials for electrocatalytic water splitting are central to renewable energy research. In this study, MoO2 nanobelts@nitrogen self-doped MoS2 nanosheets are produced by nitridation and sulfuration treatments of MoO3 nanobelts. The material structures are characterized by a variety of techniques including scanning electron microscopy, transmission electron microscopy, Raman scattering, X-ray photoelectron spectroscopy, and X-ray diffraction spectroscopy. It is found that because of nitrogen doping and the abundance of exposed active edges, the heterostructures exhibit high electronic conductivity, and more importantly, enhanced and stable electrocatalytic activity in hydrogen evolution reaction (HER), as manifested in electrochemical studies. The onset potential is found to be only −156 mV (vs. RHE), which is 105 mV more positive than that of pure MoS2 under identical experimental conditions. The corresponding Tafel slope is estimated to be 47.5 mV dec−1, even slightly less than that of commercial 10 wt% Pt/C (49.8 mV dec−1), suggesting that the reaction dynamics is largely determined by the electrochemical desorption of hydrogen. This is accounted for by nitrogen doping that leads to an enhanced electronic conductivity of the heterostructures as well as a high density of spinning electron states around the N and Mo atoms in MoS2 nanosheets that are the active sites for HER, as manifested in density functional theory studies of a N-doped MoS2 monolayer.


There is a considerable discrepancy between official rhetoric and reality in the Hungarian higher education system. Based on a series of personal interviews conducted with the actors of Hungarian higher education, this article offers an analysis of the positions and strategies of the key players. Using the Matrix of Alliances and Conflicts: Tactics, Objectives and Recommendations (MACTOR) method, the actors of the higher education system are analysed in terms of direct and indirect reciprocal influences, and their positions with regard to a generic set of possible objectives. It is argued that there is an urgent need for concentrating resources and for re-defining the higher education strategy based on the long-term demands of a globalising world.


In the UK, as in many countries, acid deposition is decreasing but water temperatures are rising and rainfall patterns changing. Disentangling the relative roles of acid deposition and climate change in driving changes in water quality and freshwater biodiversity in the UK is hence now a priority for research. In this poster we describe the use of the Upland Waters Monitoring Network (UWMN), originally designed to track acidification recovery, to identify how climate change might affect upland freshwater ecosystems in the UK. Issues include changes to the thermal regime of lakes and streams, changes in biodiversity and geographical range of taxa, changes in the acidity of surface waters mediated by changes in precipitation and changes in pollutant fluxes related to the accelerated re-mobilisation of legacy pollutants from catchment soils


The main components of the high‐energy BROND library for actinides in the range up to 150 MeV are briefly discussed. The coupled‐channel optical model has been used to calculate the neutron total, elastic, and reaction cross sections. The parameters of the optical model have been determined on the basis of available experimental data including the recent precise measurements of the total cross sections for 232Th and 238U. Evaluations of fission cross sections, secondary neutron multiplicities and spectra, as well as charged‐particle production cross sections are performed in the frame of the statistical model that includes direct, preequilibrium, and equilibrium mechanisms of nuclear reactions. The Kalbach parameterization of angular distributions has been used to describe the double‐differential cross sections of emitted neutrons and charged particles in ENDF/B‐VI format.


It is well known that menopause is associated with an increase of cardiovascular (CV) risk factors, including changes on metabolic profile, body composition, haemdynamic loads and cardiovascular remodelling. The latter starts with an increase of arterial elastance and early concentric left ventricular remodeling, manifested by an increment of the relative wall thickness. We investigated morphological and functional effects of short-term aerobic exercise at moderate intensity without diet restriction on cardiovascular apparatus in post-menopause women. Seventy-six post-menopausal healthy sedentary postwomen (56± 4 yrs) underwent clinical history, physician and anthropometric exam, 12-lead electrocardiography. Echocardiography was used to assess LV geometry and systolic and diastolic functions. Relative diastolic wall thickness (RWT), midwall fractional shortening (MFS) and arterial elastance (AE) were calculated to evaluate the LV concentric remodeling, the intrinsic systolic function and the vascular load, respectively. Data were collected before and after 14 weeks of moderate aerobic exercise training (four time per week). After the intervention program, systolic and diastolic arterial pressure, heart rate and hip circumference were significantly decreased (P = 0,01; P = 0,00; P = 0,00; P = 0,01, respectively). Left ventricular mass/height 2.7, ejection fraction and MFS were higher (p< 0,00; P= 0,00; P =0,00), while relative wall thickness (RWT) and AE were lower (P<0,03;P=0,00). Mitral E wave and E/A were higher (P = 0,001; P<0,0001). Left ventricular mass/height 2.7 was correlated to BMI (P = 0,04), WC (P = 0,034) and waist/hip ratio (P = 0,007). In post-menopause women aerobic exercise improves CV function (concentric remodelling, diastolic and systolic function) acting both on haemodynamic factors and body composition. Our data underline the role of non pharmacological interventions in the CV disease prevention.


The author shows that quantum fluctuations, in particular vacuum polarization, vanish in the background of the spherical shock wave solution of the Einstein field equations, recently found by Nutku (1991). This result is due to the smoothness properties of the new solution.


This paper presents examples of work on the lexical typological profile of Swedish based to a large extent on data from parallel corpora. The lexical typological profile of a language is an account of the distinctive character of its lexical structure in relation to other languages using various approaches to crosslinguistic lexicology which are briefly characterized in the introduction. The bulk of the paper describes the organization of the field of motion verbs in Swedish from a crosslinguistic perspective using data from translations of Swedish novels into English, German, French and Finnish.


Ga-based liquid metal stretchable conductors have recently gained interest in flexible electronic devices such as electrodes, antennas, and sensors. It is essential to maintain electrical stability under strain or cyclic strain for reliable data acquisition and exhibit tough interfacial bonding between liquid metal and polymers to prevent performance loss and device failure. Herein, a highly stable conductor with superior electrical stability and tough interface bonding is introduced by casting curable polymers and a peeling-activated process from liquid metal particles. Based on the compensating effect of liquid metal, similar to the recharge relationship of water between rivers and lakes in nature, the conductor is not only strain-insensitive (ΔR/R0 < 10% for 100% strain) but also immune to cyclic deformation (ΔR/R0 < 7% with 5000 stretching cycles at 50% strain). Embedding liquid metal within the elastomer to create stretchable conductors effectively improves interfacial adhesion properties (the fluid-solid interfacial adhesion force increases from 0.48 to 0.62 mN/mm2). The constructed tough interface could even withstand sonication treatment. Finally, by combining strategies in material design and fabrication, an integrated array composed of vertical interconnect access and robust electrodes is fabricated, which simultaneously holds tough interfacial bonding with the upper and lower layers.


The security of energy supply and sustainable and safe energy production are two main research topics of the Institute for Energy of the Joint Research Center. To lower the risks, for people and the environment, involved in fuel production and petroleum refining, studies and tests are carried out at the Institute on the degradation of low-alloy ferritic steel under petrorefinery service simulated conditions. In this frame, and for industrial purposes, a reliable assessment of damage level by means of non-destructive techniques is a key factor. This paper presents the results of magnetic measurements, in particular the Barkhausen method, on ferritic steels previously exposed to service simulated conditions, and in air. The results show a good potential for this magnetic method to detect changes due to the exposure of the steels to the different environments and, in particular, the degree of damage due to hydrogen attack. A correlation between the results of magnetic and hardness measurements is currently under investigation, but not yet presented in this outline.


The motivations for substantive inclusion of forest carbon in greenhouse gas abatement efforts are strong. For starters, forest carbon projects can be implemented immediately and do not need any new technologies, and the science behind estimating their carbon benefi ts is robust. Secondly, the projects are unique in that they can positively impact the poorest and most disadvantaged people in the world by providing them with needed fi nancial resources. Lastly, forest carbon projects can be used to simultaneously mitigate against and adapt to climate change.


Purpose
Selective laser melting and electron beam melting processes are well-known for the additive manufacturing of metal parts. Metal powder bed fusion (MPBF) is a common term for them. The MPBF process can empower the manufacturing of intricate shapes by reducing the use of special tools, shortening the supply chain and allowing small batches. However, the MPBF process suffers from many quality issues. In literature, several works are recorded for qualification of the MPBF part. The purpose of this study is to recollect those works done for quality control and report their helpful findings for further research and development.

Design/methodology/approach
A systematic literature review was conducted to highlight the major quality issues in the MPBF process and its root causes. Further, the works reported in the literature for mitigation of these issues are classified and discussed in five categories: experimental investigation, finite element method-based numerical models, physics-based analytical models, in-situ control using artificial intelligence (AI) and machine learning (ML) methods and statistical approaches. A comparison is also prepared among these strategies based on their suitability and limitations. Additionally, improvements in MPBF printers are pointed out to enhance the part quality.

Findings
Analytical models require less computational time to simulate the MPBF process and need a smaller number of experiments to confirm the results. They can be used as an efficient process parameter planning tool to print metal parts for noncritical applications. The AI-ML based quality control is also suitable for MPBF processes as it can control many processing parameters that may affect the quality of the MPBF part. Moreover, capabilities of MPBF printers like thinner layer thickness, smaller beam diameter, multiple lasers and high build temperature range can help in quality control.

Research limitations/implications
This study converts the piecemeal data on MPBF part qualification methods into interesting information and presents it in tabular form under each strategy. This tabular information provides the basis for further quality improvement efforts in the MPBF process.

Originality/value
This study references researchers and practitioners on recent quality control efforts and their significant findings for a better quality of MPBF part.


BACKGROUND AND PURPOSE: Brain metastases are a common finding on brain MRI. However, the factors that dictate their size and distribution are incompletely understood. Our aim was to discover a statistical model that can account for the size distribution of parenchymal metastases in the brain as measured on contrast-enhanced MR imaging. MATERIALS AND METHODS: Tumor volumes were calculated on the basis of measured tumor diameters from contrast-enhanced T1-weighted spoiled gradient-echo images in 68 patients with untreated parenchymal metastatic disease. Tumor volumes were then placed in rank-order distributions and compared with 11 different statistical curve types. The resultant R2 values to assess goodness of fit were calculated. The top 2 distributions were then compared using the likelihood ratio test, with resultant R values demonstrating the relative likelihood of these distributions accounting for the observed data. RESULTS: Thirty-nine of 68 cases best fit a power distribution (mean R2 = 0.938 ± 0.050), 20 cases best fit an exponential distribution (mean R2 = 0.957 ± 0.050), and the remaining cases were scattered among the remaining distributions. Likelihood ratio analysis revealed that 66 of 68 cases had a positive mean R value (1.596 ± 1.316), skewing toward a power law distribution. CONCLUSIONS: The size distributions of untreated brain metastases favor a power law distribution. This finding suggests that metastases do not exist in isolation, but rather as part of a complex system. Furthermore, these results suggest that there may be a relatively small number of underlying variables that substantially influence the behavior of these systems. The identification of these variables could have a profound effect on our understanding of these lesions and our ability to treat them.


This retrospective study examines acute unilateral vestibular failure (up to seven days after onset) with modern vestibular testing (caloric irrigation and video-head-impulse test, vHIT) in 54 patients in order to test if the short-term outcome of the patients depends on the lesion pattern defined by the two tests. Patients were grouped according to a pathological unilateral caloric weakness without a pathological vHIT: group I; additional a pathological vHIT of the lateral semicircular canal (SCC): group II; and an additional pathological vHIT of the anterior SCC: group III. Patients with involvement of the posterior SCC were less frequent and not included in the analysis. Basic parameters, such as age of the subjects, days after symptom onset, gender, side of the lesion, treatment, and dizziness handicap inventory, were not different in groups I to III. The frequency of pathological clinical findings and pathological quantified measurements increased from groups I to III. The outcome parameter "days spent in the hospital" was significantly higher in group III compared to group I. The analysis shows that differential vestibular testing predicts short-term outcome of the patients and might be in future important to treat and coach patients with vestibular failure.


: The article analyzes the state of international and domestic competitiveness of US companies in the field of information and communication technologies (ICT). The authors focus on the fact that Artificial Intelligence is increasingly acquiring a leading role in ensuring national competitiveness. The authors consider the federal and local support of the US national competitiveness, which is related to ensuring national security of the country in the conditions of shaping a multipolar world order


Objectives: Everyday correctional officers confront with so many criminals, so this situation could be a bad environment on correctional officer's mental health. But the study about their mental health status and related factors have rarely been focused, and besides, the actual mental health conditions of them have also been rarely investigated. Consequently, this study aimed to identify mental health status and related factors of correctional officers. Methods: Data were collected from July 10 to August 25, 2012. The Participants included 1,496 correctional officers in 50 correctional facilities. Results: The risk factors of mental health problems were living in urban region, 40 ages group, less experience in correctional field, unmarried marital status & not living with their spouse, over nine hours contact with criminals and so forth. On the other hand, stress coping methods were not related with socioeconomic and other factors. Conclusions: Lessening working hours or contact hours with criminals, providing a risk-group management for those who have many risk factors, making selfsupport group will be helpful to manage or promote their mental health status. Besides, employee assistance programs should be developed such as job stress management methods or counselling-communication skills.


The results of the systematic review have the leading place in the hierarchy of clinical data reliability. They allow to extend the conclusions from individual studies to a larger population, minimizing the risk of systematic errors. Meta-analysis is the final step of the review of enough homogenous primary research that allow to quantitatively synthesize their results. In 2018, the Cochrane systematic review and data meta-analysis which assessed the effects of various systemic treatments of metastatic cutaneous melanoma were published. All relevant trials published up to October 2017 were included. This article introduces the assumptions of the meta-analysis and presents its results regarding the effectiveness of the most important systemic treatments of melanoma.


Reserve starch from seeds and tubers is a crucial plant product for human survival. Much research has been devoted to quantitative and qualitative aspects of starch synthesis and its relation to abiotic factors of importance in agriculture. Certain aspects of genetic factors and enzymes influencing carbon assimilation into starch granules remain elusive after many decades of research. Starch phosphorylase (Pho) can operate, depending on metabolic conditions, in a synthetic and degradative pathway. The plastidial form of the enzyme is one of the most highly expressed genes in potato tubers, and the encoded product is imported into starch-synthesizing amyloplasts. We identified that the genomic locus of a Pho1a-type starch phosphorylase is duplicated in potato. Our study further shows that the enzyme is of importance for a normal starch granule phenotype in tubers. Null mutants created by genome editing display rounded starch granules in an increased number that contained a reduced ratio of apparent amylose in the starch.


To date, empirical and conceptual models of relationship marketing have focused almost exclusively on a range of direct antecedents and mediator variables to explain variations in a dependent variable – usually relationship commitment. No attempt has been made to examine under what conditions these various antecedents have a stronger/weaker impact on relationship commitment. This paper extends the relationship marketing literature by testing a contingency model to assess the impact of trust and service satisfaction on relationship commitment under conditions of varying switching costs, alternative attractiveness and experience‐based norms, in the context of a professional consumer service. Employing a sample of 201 clients of financial planning services, we test 11 hypotheses formulated on the basis of a review of the services and relationship marketing literature, and a series of qualitative interviews with clients. The results clearly indicate that the impact of trust and satisfaction vary according to contingency conditions of switching costs, attractiveness of alternatives and client experience.


Absorbable oxidized cellulose hemostatic materials are widely used in hemostasis of veins, capillaries or smaller arteries because of their wide sources, low cost, and high biocompatibility. However, in view of the different application sites, the hemostatic effect of absorbable oxidized cellulose in different surgeries may be different, and its hemostatic effect in patients with colorectal cancer still needs more research to confirm. Therefore, this article explores the in vitro degradation of the absorbable regenerated oxidized cellulose material and its hemostatic effect in colorectal cancer surgery. Explore the in vitro degradation products that can absorb oxidized cellulose. The 44 patients undergoing colon cancer surgery were selected and randomly divided into control group (22 cases, absorbable oxidized cellulose material to stop bleeding) and observation group (22 cases, ordinary Sterile gauze to stop bleeding). The intraoperative blood loss, 3 days postoperative drainage volume, total drainage volume, and operation time of the two groups were recorded. The recovery of intestinal function after operation in the two groups was observed. The in vitro complete degradation time of the absorbable oxidized cellulose material is about 12 days. The degradation products are glucose and cellobiose, which are safe and harmless to the human body. The intraoperative blood loss, drainage volume, total drainage volume, and operation time of the observation group were significantly lower than those of the control group (P <0.05), and the postoperative intestinal function recovery of the observation group was better than that of the control group (P <0.05). In addition, there was no significant difference in the incidence of adverse reactions between the observation group and the control group (P > 0.05). Absorbable oxidized cellulose material has a good hemostatic effect in colorectal cancer surgery, and does not increase the risk of adverse reactions in patients after surgery. It is worthy of popularization and application.


Agricultural Equipment and Machinery Service Business (UPJA) is an area that provides services related to optimizing the use of agricultural tools and machinery to achieve business profits. The purpose of this study was to analyze the business development strategy of the machine tool service business (UPJA) Tentrem, Tegaldlimo District, Banyuwangi Regency. The methodology used is the evaluation of internal and external factors which are then mapped in the IFE EFE matrix, and then followed by a SWOT analysis to generate alternative competitive strategies and implement development strategies. SWOT analysis is used to compile strategic factors in this alsintan service business. The results showed the IFE value with a total score of 3.49 internal indicators, which means that UPJA's business is in the strong or high category. The total score of all external indicators in the EFE matrix is 3.18, which means that UPJA's business is in the strong or high category. Mapping the IFE-EFE matrix followed by a SWOT analysis provides nine alternative strategies and 1 strategy is chosen which has the greatest value, namely maintaining the completeness of the machineries with a value of 1.15. In conclusion, this strategy can be applied to build competitive advantage and business progress of UPJA Tentrem.


Open one of the 179 "drawers" in Professor Stewart's cabinet, and you might find just a one-liner (Why did the chicken cross the Mobius band?") or a seven-page essay on Ferman's last theorem. It features a variety of knots, magic hexagons, square wheels, and topology tricks in which you pretend to slice off your finger. Answers are found at the back of the book and many have URLs for further information. The puzzles require at most a bit of algebra and many should be within the grasp of an intelligent 11-year-old.


: The tremendous increase in the use of internet has lead towards the need of systems that support wide variety of media. As a result of this requirement for large type of media has given rise to many challenges in the storage, retrieval and presentation of such large amount of data. Along with these challenges, the size of data also goes on increasing, it becomes more and more complex and thus increasing the maintenance overhead. In this paper, we present a comparative study of the existing Q uery Retrieval techniques in Multimedia Databases. We analyze briefly the Content based retrieval approach , as well as propose a brief comparison of this technique with the other two retrieval techniques namely Semantic based retrieval and Keyword based retrieval, focusing mainly on audio and video data. This analysis will therefore conclude the better approach towards multimed ia data retrieval.


The interactions between warfarin and antidepressants can have potentially serious consequences resulting from enhanced or reduced anticoagulant activity. Information about such interactions was obtained from a Medline and hand search of the published literature, and by directly contacting manufacturers. The different classes of antidepressants are discussed in turn. The possible mechanisms are considered with particular reference to The cytochrome p450 system. From currently available data on the newer antidepressants our conclusions are that citalopram, nefazodone and sertraline may be relatively less likely to interact with warfarin. Fluoxetine, fluvoxamine, paroxetine and moclobemide appear to have the highest potential of the antidepressants for interactions. There is insufficient data on venlafaxine to make a prediction. The clinical implications of these findings are discussed and specific recommendations for International Normalized Ratio monitoring are suggested.


A universal method of molecular dating that can be applied to all families and genera regardless of their fossil records, or lack thereof, is highly desirable. A possible method for eudicots is to use a large phylogeny calibrated using deep fossils including tricolpate pollen as a fixed (124 mya) calibration point. This method was used to calculate node ages within three species‐poor disjunct basal eudicot genera, Caulophyllum, Podophyllum and Pachysandra, and sensitivity of these ages to effects such as taxon sampling were then quantified. By deleting from one to three accessions related to each genus in 112 different combinations, a confidence range describing variation due only to taxon sampling was generated. Ranges for Caulophyllum, Podophyllum and Pachysandra were 8.4–10.6, 7.6–20.0, and 17.6–25.0 mya, respectively. However, the confidence ranges calculated using bootstrapping were much wider, at 3–19, 0–32 and 11–32 mya, respectively. Furthermore, deleting 10 adjacent taxa had a large effect in Pachysandra only, indicating that undersampling effects are significant among Buxales. Changes to sampling density in neighboring clades, or to the position of the fixed fossil calibration point had small to negligible effects. Non‐parametric rate smoothing was more sensitive to taxon sampling effects than was penalized likelihood. The wide range for Podophyllum, compared to the other two genera, was probably due to a high degree of rate heterogeneity within this genus. Confidence ranges calculated by this method could be narrowed by sampling more individuals within the genus of interest, and by sequencing multiple DNA regions from all species in the phylogeny.


We employ variational Monte Carlo methods to study the transition to strange matter in a simple one-dimensional string-flip model with two flavors and two colors of quarks. The dynamics of the system are described in terms of a many-body potential that confines quarks within hadrons, yet enables the hadrons to separate without generating unphysical long-range van der Waals forces. The model has ''natural'' low- and high-density limits: it behaves as a system of isolated hadrons at low density and as a Fermi gas of quarks at high density. We show that the system exhibits a transition to strange matter characterized by an increase in the length scale for confinement. Yet the small increase at the transition region--of only 10%--suggests that clustering correlations remain strong well into the strange-matter domain. Our results put into question descriptions of strange matter in terms of noninteracting, or weakly interacting, quarks. (c) 1999 The American Physical Society.


Real time fault detection and diagnosis (FDD) is an important area of research interest in knowledge based expert systems. Neurocomputing is one of fastest growing areas of research in the fields of artificial intelligence and pattern recognition. The authors explore the suitability of pattern classification approach of neural networks for fault detection and diagnosis. The suitability of using neural networks as pattern classifiers for power system fault diagnosis is described in detail. A neural network design and simulation environment for real-time FDD is presented. An analysis of the learning, recall and generalization characteristic of the neural network diagnostic system is presented and discussed in detail.<<ETX>>


Road surfaces degrade over time due to heavy traffic and weather conditions, which negatively influences both driving comfort and acoustic properties. In addition, the lifetime of a road surface can be increased by performing cost-effective incremental maintenance and this maintenance
 becomes more expensive when the damages are more severe (cracks, potholes). Current methods such as CPX are performed in a standardized way (using designated equipment and tightly controlled measurement conditions), however budget constraints limit frequent monitoring of surfaces. Therefore,
 continuous monitoring using ordinary passenger vehicles could be helpful to observe trends in rolling noise emissions and road evenness. Hence, we deployed designated sensor boxes in a number of vehicles that are on the road for other purposes. In addition, advances in calibration of different
 devices using de-noising autoencoders alleviate the effect of various measurement conditions such as driving speed, braking, accelerating, and temperature. As our innovative methodology has now been on the road for several years, trend analysis becomes possible.


In most oscine bird species males possess a repertoire of different song patterns. The size of these repertoires is assumed to serve as an honest signal of male quality. The Eurasian blackbird's (Turdus merula) song contains a large repertoire of different element types with a flexible song organisation. Here we investigated whether repertoire size in Eurasian blackbirds correlates with measures of body size, namely length of wing, 8th primary, beak and tarsus. So far, very few studies have investigated species with large repertoires and a flexible song organisation in this context. We found positive correlations, meaning that larger males had larger repertoires. Larger males may have better fighting abilities and, thus, advantages in territorial defence. Larger structural body size may also reflect better conditions during early development. Therefore, under the assumption that body size is linked to overall male quality, our results are in accordance with the hypothesis that repertoire size represents an honest signal in Eurasian blackbirds that has evolved in response to sexual selection.


As an important field of robot research, robot path planning has been studied extensively in the past decades. A series of path planning methods have been proposed, such as A* algorithm, Rapidly-exploring Random Tree (RRT), Probabilistic Roadmaps (PRM). Although various robot path planning algorithms have been proposed, the existing ones are suffering the high computational cost and low path quality, due to numerous collision detection and exhausting exploration of the free space. In addition, few robot path planning methods can automatically and efficiently generate path for a new environment. In order to address these challenges, this paper presents a new path planning algorithm based on the long-short term memory (LSTM) neural network and traditional RRT. The LSTM-RRT algorithm first creates 2D and 3D environments and uses the traditional RRT algorithm to generate the robot path information, then uses the path information and environmental information to train the LSTM neural network. The trained network is able to promptly generate new path for randomly generated new environment. In addition, the length of the generated path is further reduced by geometric relationships. Hence, the proposed LSTM-RRT algorithm overcomes the shortcomings of the slow path generation and the low path quality using the traditional RRT method.


OBJECTIVE
To observe the effects on neural function, living ability and mental state of the patients with acute intracerebral hemorrhage (ICH), as well as aquaporin 4 (AQP4) in the serum after treated with electroacupuncture (EA) on the base of routine therapy of western medicine.

METHODS
Seventy-two acute ICH patients were randomized into an observation group (36 cases, 4 cases dropped off) and a control group (36 cases, 2 cases dropped off). In the control group, the conventional treatment was delivered such as stopping bleeding, preventing re-hemorrhage, controlling blood pressure, mitigating neural edema and reducing intracranial pressure. In the observation group, on the base of the treatment in the control group, EA was supplemented. Acupoints included Shuigou (GV 26), bilateral Neiguan (PC 6) and Sanyinjiao (SP 6) etc. Electric stimulation was operated at Neiguan (PC 6) and Sanyinjiao (SP 6) on the same side, with disperse-dense wave, and 2 Hz/100 Hz in frequency, tolerable current intensity. Electric stimulation was delivered for 30 min in each treatment, once daily and for 6 times per week. The duration of treatment was 2 weeks in the two groups. Before and after treatment, changes of the scores of National Institutes of Health stroke scale (NIHSS), modified Barthel index (MBI) and mini-mental state examination (MMSE), as well as AQP4 content in the serum were observed in the two groups; the efficacy and safety were compared between the two groups.

RESULTS
The NIHSS scores and the serum AQP4 content decreased after treatment when compared with those before treatment in the two groups (P<0.05), while, MBI and MMSE scores increased (P<0.05). In the observation group, NIHSS score and serum AQP4 content were lower than those of the control group (P<0.05), and MBI and MMSE scores were higher (P<0.05). The total effective rate of the observation group was 93.8% (30/32), higher than that of the control group (73.5%, 25/34, P<0.05). The treatment in the two groups was safe, without adverse reactions and events occurring in the patients.

CONCLUSION
Electroacupuncture, on the base of conventional treatment of western medicine, can effectively improve the neural function, living ability, mental state and serum AQP4 content of the patients with acute ICH. It is suggested that the effective treatment by electroacupuncture may be related to the regulation of the serum AQP4 content.


The article presents a comprehensive study of counterion dynamics around a generic linear polyelectrolyte chain with the help of coarse-grained computer simulations. The ion-chain coupling is discussed in the form of binding time, mean-square displacement (MSD) relative to the chain, local ion transport coefficient, and spatiotemporal correlations in the effective charge. We have shown that a counterion exhibits subdiffusive behavior 〈δR^{2}〉∼t^{δ}, δ≈0.9 w.r.t. chain's center of mass. The MSD of ions perpendicularly outward from the chain segment exhibits a smaller subdiffusive exponent compared to the one along the chain backbone. The effective diffusivity of ion is the lowest in chain's close proximity, extending up to the length-scale of radius of gyration R_{g}. Beyond R_{g} at larger distances, they attain diffusivity of free ion with a smooth cross-over from the adsorbed regime to the free ion regime. We have shown that the effective diffusivity drastically decreases for the multivalent ions, while the crossover length scale remains the same. Conversely, with increasing salt concentration the coupling-length scale reduces, while the diffusivity remains unaltered. The effective diffusivity of adsorbed-ion reveals an exponential reduction with electrostatic interaction strength. We further corroborate this from the binding time of ions on the chain, which also grows exponentially with the coupling strength of the ion-polymer duo. Moreover, the binding time of ions exhibits a weak dependence with salt concentration for the monovalent salt, while for multivalent salts the binding time decreases dramatically with concentration. Our work also elucidates fluctuations in the effective charge per site, where it exhibits strong negative correlations at short length-scales.


The majority of rural Appalachian women in jail meet criteria for a drug use disorder and need treatment. Using a latent profile analysis of a random sample of rural women in Appalachian jails (N=400), the current study established groups of women based on criminal history, drug use in the commission of crimes, and role of the partner's drug use in the commission of crimes. Analysis found five distinct profiles of rural women based on involvement of criminal activities as a function of drug use severity. Results suggest that among criminally involved rural women, severity of drug use is a critical factor in the criminal career. Findings can be used to better inform treatment approaches and tailor treatment to meet the needs of this vulnerable population.


Although clinical examination alone or in combination with other techniques is the only ubiquitous method for flap monitoring, it becomes problematic with buried free‐tissue transfer. We present a DIEP flap sentinel skin paddle (SSP) positioning algorithm and its reliability is also investigated using a standardized monitoring protocol. All DIEP flaps were monitored with hand‐held Doppler examination and clinical observation beginning immediately after surgery in recovery room and continued postoperatively at the ward. Skin paddle (SP) position was preoperatively drawn following mastectomy type incisions; in skin‐sparing mastectomies types I–III a small SP (sSP) replaces nipple–areola complex; in skin‐sparing mastectomy type IV, SSP is positioned between wise‐pattern branches while in type V between medial/lateral branches. In case of nipple‐sparing mastectomy SSP is positioned at inframammary fold or in lateral/medial branches of omega/inverted omega incision if used. Three hundred forty‐seven DIEP flap breast reconstructions were reviewed and stratified according to SP type into group A including 216 flaps with large SP and group B including 131 flaps with SSP and sSP. Sixteen flaps (4.6%) were taken back for pedicle compromise, 13 of which were salvaged (81.25%), 11 among 13 from group A and 2 among 3 from group B. There was no statistical difference between the groups concerning microvascular complication rate (P = 0.108), and time until take‐back (P = 0.521) and flap salvage rate (P = 0.473) resulted independent of SP type. Our results suggest that early detection of perfusion impairment and successful flaps salvage could be achieved using SSP for buried DIEP flap monitoring, without adjunctive expensive monitoring tests. © 2014 Wiley Periodicals, Inc. Microsurgery 35:91–100, 2015.


The nuclear shell model calculations are employed to nuclear structure study of the nuclei Ni, Zn and Cu in fpg9/2 model space. The inert core Ni is assumed, with two nucleons outside inert core are considered to describe the binding energy and excited states for both the positive and negative parities of the three nuclei . A computer code were written by Mathematica to perform the configuration mixing and pure shell model calculations by taking the surface delta interaction (SDI) and modified surface delta interaction (MSDI) as residual interactions. The binding energy calculations were in excellent agreement with experimental data. The predicated ground-state and low-lying states (energies, spins and parities) for the Ni, Zn and Cu are compared with the recent available experimental data. Reasonable agreements were obtained by comparing our theoretical work with the experimental data.


The 'PREEpared – Partnering for Remote Education Experience' project (formerly known as Improving Teacher Education for Better Indigenous Outcomes) was a seed-funded initiative by the Department of Education (formerly Office of Learning and Teaching, OLT),
2016-2017, and conducted by the project team from Monash University. Data was collected and resources developed in collaboration with a number of teacher educators across Australia who formed a main interview pool, and several members of a diverse expert reference group, whose experience provided a vital, critical reflection on the project's deliverables.

The guiding principle for this project was to respond to the staffing needs of remote Indigenous schools and ensure graduate teachers are well-equipped and expertly prepared to work and teach inclusively within and for diverse geographic communities. The project has
responded to this aim by providing a central 'go to' website that houses both curriculum and professional experience resources for all initial teacher education providers to access and use.


To the Editor:— Pentecost, Murray, and Brindley are correct in their explanation of the mechanisms of "stress" fractures ("Fatigue, Insufficiency, and Pathologic Fractures," JAMA 187: 1001 [March 28] 1964). Engineering terms can also be used to describe subaudible musculoskeletal sound. The knee joint, while in passive motion, generates compound wave forms, as is shown when this acoustic energy is converted to electric energy and recorded. Under certain circumstances, the knee joint at rest generates a wave motion as a pure sinusoidal wave of simple harmonic motion of 28 or 29 cycles per second. These vibrations are recovered from normal knees as periodic vibrations of the menisci vibrating as a system . Under conditions of injury or disease of the menisci this sine wave is absent or distorted because the meniscus vibrates in parts . The natural frequencies of the menisci are 28 cps medially and 29 cps laterally. Their voltage output varies


This paper describes the design and implementation of a Decentralized Shared Calendar (abbreviated as DeSCal), a distributed application which provides users a decentralized infrastructure to share their calendar events with selected users in a dynamic group. Although being a distributed application, DeSCal is as responsive as a personal calendar. It achieves this high responsiveness by keeping a local copy of the shared calendar at each participating user. Consistency of these replicated copies of the shared calendar is carried out in a decentralized fashion using Operational Transformation (OT) approach. OT allows users to concurrently modify the shared calendar and exchange their updates in any order since it ensures the convergence of copies of the shared calendar in all cases. To prevent unauthorized access by illegal users, DeSCal is endowed with access control mechanism on the local copy of the shared calendar. It employs a flexible access control model based on replicating the access data-structure at each user site to overcome the latency problem. Also, access control on the shared calendar events is dynamic i.e. users are able to change the access rights on their shared calendar events at any point of time after the creation of an event. In short, DeSCal is totally decentralized, scalable and self-configurable i.e., no need of a third party to manage it.


We report on the design and present status of a 1 kJ Nd:Glass laser facility for basic research on quantum engineering at KAERI (Korea Atomic Energy Research Institute). By applying a newly designed spatial filter with a serrated aperture, we improved the diffracted Gaussian spatial profile of an oscillator into a flat-top one. The laser system consists of 4 beam lines, each with the energies of more than 200 J at the nano-second regime. We measured the gain and spatial profiles of each amplification stage. A spectral shaping by a two-stage OPCPA (Optical Parametric Chirped Amplifier) for a pico-second front end was studied to compensate for gain narrowing in multi-stage amplifier chains.


Background: Prostate cancer (PC) is the most common cause of cancer death in men. In advanced PC, many patients suffer chemo-resistance therefore; establishment of a drug-resistant cell model to study the mechanism of action of drug resistance and increase in drug sensitivity is urgently needed. Recently, cancer stem cells (CSCs), and epithelial mesenchymal transition (EMT) have been suggested to play important roles in drug resistance in various cancer types. Green tea polyphenols, particularly the major component epigallocatechin-3-gallate (EGCG), have been shown to have chemopreventive properties in the malignant setting and recent studies have suggested that green tea catechins may enhance the chemo-sensitivity of drug-resistant cancer cells, such as breast cancer, although the mechanism of action is still unclear. Aims: (1) To establish a multi-drug-resistant prostate cancer cell line enriched for CSCs and (2) To investigate whether EGCG can restore drug sensitivity by limiting CSC expansion and/or by reversal of EMT. Experimental procedures: Chemo-resistant (CR) PC3M cells were developed by growth in increasing concentrations of a chemotherapeutic agent. Drug resistance was confirmed using increasing concentrations of doxorubicin (Dox), Taxotere (Tax), 5-fluorouracil (5FU) and cisplatin in fluorometric cell viability assays on resistant and wild-type (WT) cells. Immunofluorescent (IF) staining and flow cytometry were used to identify CSCs. Gene expression was assessed using quantitative real time-PCR. Cell morphology was observed using Nikon invert microscopy. Results: A chemo-resistant variant of WT-PC3M was derived by long-term culture in increasing concentrations of the chemotherapeutic, 5FU. As a result, the IC50 for WT PC3M to 5FU was 30μM as compared to >500μM for CR PC3M. In addition, the CR cells were also shown to be resistant to other chemotherapeutics including Dox and Tax, but not cisplatin. Enrichment for cells with CSC properties was determined in WT and CR cells. In comparison to WT PC3M, gene expression of both CD133 and ATP-binding cassette subfamily G2 (ABCG2), which have been reported as CSC markers in various cancer including prostate cancer, were significantly up-regulated by 10 and 2-folds, respectively in drug resistant cells (p When EGCG was combined with 5FU, the IC50 of 5FU in CR PC3M decreased from 500μM to 100μM in CR PC3M, but it did not show a significant effect in WT PC3M, suggesting that EGCG had restored drug sensitivity in CR cells. It was noted that chemo-resistant PC3M had a more mesenchymal appearance when compared to WT PC3M. The expression of key EMT transcriptional regulator genes such as twist, snail, slug and zeb-1, were up-regulated whereas the epithelial marker gene E-cadherin was down-regulated in CR PC3M. After 48hours treatment with EGCG, all four EMT regulatory genes were significantly down-regulated by up to 3-folds whereas expression of E-cadherin was elevated. Conclusion: Green tea polyphenols restore drug sensitivity in chemo-resistant prostate cancer by reversal of EMT. Citation Information: Clin Cancer Res 2010;16(7 Suppl):A21


In a rare case where the State is mulcted with delictual damages for failure to discharge their constitutional obligations to provide infrastructure in public schools, such as adequate sanitation facilities, the Supreme Court of Appeal awarded damages for emotional shock to the parents and siblings of a Grade-R learner who had drown in a pit-toilet. At the same time, the Court refused to develop the Constitution, 1996, to award separate damages for pure grief and bereavement not accompanied by serious psychological lesions, as well as constitutional damages. The judgment has been widely welcomed by children rights activities and is regarded as heralding a new era in holding the State (education officials) accountable for failure to fulfill their constitutional obligations towards learners, especially regarding the eradication of pit latrines in public schools.
This note gives an analytical review of the judgment and is impact on the (development of) the common law delict, in particular, in the area of emotional shock and psychological injury. In the process, the case note specifically takes interest in the rationality for the SCA's rejection of the Appellants' argument for the development of the common law to award damages for a pure grief and bereavement (in addition to damages for emotional shock and psychological lesions) and constitutional damages. In the end, the case note concurs with the Court that it was unnecessary in the circumstances of the case to develop the common law. In fact, it is asserted in this note that the common law delict of emotional shock, in its current form, adequately compensate victims. Therefore, the SCA was right to reject the argument to develop the common law, as well as the awarding of constitutional damages.


Krieble Library Course Guide for Psychology 1111 (Spring 2015) - Lyme Academy College of Fine Arts campus of The University of New Haven


The magnetic sensor properties of magnetic tunnel junctions (MTJs) with a superparamagnetic (SP) free layer were systematically investigated at low frequencies (<10 Hz). We prepared four varieties of MTJs with various SP properties by changing the annealing temperature. The temperature dependence of magnetoresistance curves and the signal/noise property at 285 K were evaluated. We found that the SP free layer has the advantage of detecting very small and low-frequency AC magnetic fields compared with a ferromagnetic free layer. The SP free layer strongly suppressed magnetic 1/f noise at low frequencies and expressed a very linear response to a small magnetic field. The obtained properties in MTJs with the SP free layer are suitable for detecting biomagnetic fields. The detectivity was 111 nT at low frequencies (from 0.1 to 10 Hz), which is one of the highest values in single-MTJ sensors.


Due to the different historical developments and political traditions of China and Japan, Chinese concepts of legitimacy could not be applied to Japan without major modifications. Tokugawa historians demonstrated a high level of flexibility and creativity in their discussion of political legitimacy. Some Chinese concepts were reinterpreted to fit into the Tokugawa system. For instance, the mandate of heaven was used primarily to discuss the right to govern and denied a Chinese-style "revolution" and dynastic change. Using major Tokugawa historical writings as the main references and highlighting the legitimacy of the Southern or Northern Courts as well as the legitimacy of the Edo bakufu, this study examines the making of Japanized concepts of legitimacy in Tokugawa historiography. It sheds light on understanding how Tokugawa historians creatively modified and appropriated Chinese historical ideas and terms to accommodate Japanese tradition and the Tokugawa political system.


Work fulfills personal values, perhaps differently for males and females. Explored here was the role values play in shaping occupational interests. Study 1 examined children's, adolescents', and adults' (N = 313) occupational values (regarding money, power, family, altruism), occupational interests, and perceptions of values afforded by traditionally masculine and feminine occupations. Results revealed sex differences in occupational values and interests. Furthermore, participants' values predicted their own interests in culturally masculine and feminine occupations. Study 2 used novel jobs and experimentally manipulated prototypical sex of worker and value affordances to disentangle their effects on occupational interests. At all ages, participants' (N = 240) occupational interests were affected by the depicted sex of the workers and by the stated value affordances of the jobs.


Adolescent idiopathic scoliosis (AIS) is a spinal abnormality commonly found in children and adolescents with a prevalence rate of 0.5-5.2%. Data on scoliosis in Indonesia is yet to be available. Our study was aimed at screening and comparing school children with normal posture and with suspected scoliosis (SS). 1059 elementary school students (477 boys, 582 girls) from grade 3 to grade 6 in Jakarta participated in this study. Body mass and height were measured according to the standard technique. Axial rotation of the spine was measured using a scoliometer. Results were classified into two groups: normal if the axial rotation angle was <5° and scoliosis was suspected if the angle was ≥5°. An independent t-test was used to analyze anthropometric differences between the normal and SS group. Statistical significance was set at p<0.05. 74 (7%) of the 1059 students were SS, consisting of 24 (5 %) boys and 50 (8.6 %) girls (OR 1.98, P=0.004). Students at the age of 10 had the highest incidence of scoliosis (27 or 10.1%). Girls with SS were significantly taller and with lower BMI values (138.6 cm vs 134.6 cm, p=0.014; 16.95 kg/m2 vs 18.50 kg/m2, p=0.028). The scoliosis rate in elementary students in Jakarta was about 7 % with higher prevalence in girls.


Two hundred and two intestinal lactobacill strains were obtained and studied in a 30-d experiment with chambered human subjects. Species composition of intestinal lactobacilli varied in the course of the experiment. Species of lactobacilli persisting in organism in the period of isolation were identified.


BACKGROUND
Metoprolol (MET) is a β1-adrenoceptor antagonist, which is widely used in the treatment of cardiovascular diseases, and α-hydroxymetoprolol (α-OHM) is its hydroxylated metabolite. Owing to their similar structures, optimization of the condition for the chromatography approach, which is in common use for determination, is both time consuming and laborious.

RESULTS
A new and effective strategy that combines the excitation-emission matrix fluorescence with second-order calibration methods was developed for simultaneous determination of MET and α-OHM in human plasma.

CONCLUSION
Although the fluorescence spectra of MET and α-OHM overlapped and a large number of unknown and uncalibrated fluorescent components coexisted, the developed method enables accurate concentrations together with reasonable resolution of excitation and emission profiles for the analytes of interest. An additional advantage of the proposed method is that there is no need for separation and sample pretreatment, in addition to lower cost than traditional methods.


Taizo Masaki is most prominently mentioned in "Yoshida Torajiro", a short story by Robert Louis Stevenson. After the Meiji Restoration, he was dispatched to Great Britain twice from 1871 to 1881, and became the first president of Tokyo Shokko Gakko (now Tokyo Institute of Technology). He worked earnestly for industrial education for nearly twenty years in the early years of Meiji Era. In 1890, Masaki was transferred to the Foreign Office, and went to Honolulu as consul in Hawaii. After one year, he was promoted to consul general. He stayed in Honolulu for 2 years and a half, however, his activities in Hawaii were not made clear yet. In this article, various kinds of documents between Japanese Foreign Office and Consul Masaki were studied, and the present writers tried to learn from them how he acted as Hawaiian consul.The diplomatic relation between Japan and Hawaii Kingdom began in 1860. It continued only 40 years, because of the Hawaiian revolution in 1893 and the annexation by the U.S.A. The largest pending problem of both countries was the immigration for the sugar beet farms from Japan. As sugar was the main product of Hawaii, the sugar beet farms needed a large number of workers. On the other hand, Japanese agricultural villages were in a long depression after the Meiji Restoration. After short preliminary negotiations, both governments arrived at an agreement that Japan would supply round numbers of immigrants for Hawaiian sugar farms periodically. In 1884, the Japanese consulate was opened at Honolulu, and the first ship "the City of Tokyo" carried 948 emigrants to Hawaii in 1885. This emigration organized by the Japanese government continued for ten years, and 29, 139 Japanese emigrants voyaged to Hawaii as often as 26 times. As the government-sponsored emigration brought about many conflicts, various kinds of troubles occurred.Taizo Masaki made a voyage to Honolulu as the fourth consul in May, 1890. It was the peak period of governmental emigration, and more than twelve thousand emigrants voyaged.There are many documents, and correspondance archives referring to Hawaii in the Diplomatic Record Office. We can infer the activities of Taizo Masaki in Hawaii as consul. The most important business of the Hawaiian consulate was the remittance of immigrants to their family in Japan. Because there was no branch of a Japanese bank in those early years, it was very difficult. Masaki invited a new branch of Yokohama Shokin Bank to Honolulu for Japanese immigrants. The remittance to Japan became easier.Masaki sent many formal annd informal reports which included important information. One of them referred to the suffrage of immigrants. The Hawaiian constitution amended in 1887, approved the right to vote of those other than American or European immigrants. Masaki gave a report on the historical situation and pointed out those problems. The other important reports were referring to the political change of the Hawaiian Government. In those days, the political situation in Hawaii was very unstable; therefore, coups d'etat and reorganizations of the cabinet were done frequently. Masaki's reports described the circumstances of the changes of Hawaiian government and his opinions about them. His final report was dated Nov. 9, 1892, because he returned to Japan in December. It was only one month before the Hawaiian Kingdom collapsed and transferred to the republic form of government.The analysis in this article is not enough; a more detailed examination will be reported in the following articles. The other documents of Taizo Masaki referring to many other items will be introduced, too.In the meantime, Robert Louis Stevenson was making a tour of the islands in the Pacific Ocean, and visited Hawaii at least twice. We have much interest in the question whether the two old friends could meet again or not.


One of the key problems facing the computer industry today is ensuring the integrity of end-user applications and data. Researchers in the relatively new field of software protection investigate the development and evaluation of controls that prevent the unauthorized modification or use of system software. While many previously developed protection schemes have provided a strong level of security, their overall effectiveness has been hindered by a lack of transparency to the user in terms of performance overhead. Other approaches take to the opposite extreme and sacrifice security for the sake of this transparency. In this work we present an architecture for software protection that provides for a high level of both security and user transparency by utilizing field programmable gate array (FPGA) technology as the main protection mechanism. We demonstrate that by relying on FPGA technology, this approach can accelerate the execution of programs in a cryptographic environment, while maintaining the flexibility through reprogramming to carry out any compiler-driven protections that may be application-specific.


During Christmas week in 1995, a fourteen-year-old girl is kidnapped by a bloodthirsty satanic cult. Bob Hightower, the girl's father and a small-town cop, embarks on a desperate mission to find her but his only hope lies with Case Hardin, an ex-cult member and ex-junkie living in a halfway house in Hollywood. Their quest - his for his child, hers to exorcise her demons - becomes a primal hunt-and-chase through a savage sub-culture of drugs and ritualistic violence. But it is Bob who holds the final card to throw into the macabre 'game', the twentieth enigma of the tarot, the angel who signals Judgement . . 'An absolutely stupendous debut novel' Mark Timlin, Independent 'It's a roller-coaster of an experience, noir as a purging metaphysical experience that will take your breath away' Guardian Frightening, ferocious first novel about satanic cults fuelled by drugs and armed to the teeth in the awesome deserts of the American Southwest' Daily Telegraph 'Beautifully written, occasionally creepy and always compelling, it's a striking debut' Dublin Evening Herald


Static displacements were calculated for an earth model which consists of a single layer of thickness H overlying a homogeneous half space. Localized sources simulating earthquake and explosion foci are placed at depths h=H2andh=32H. The ensuing surface deformation is evaluated as a function of the epicentral distance for a typical continental crust model.
 A new technique is used for the quadrature of the displacement integrals. By this method one is able to calculate 1000 layer-integrals of the type
 F m n ( x , t ) = ∫ 0 ∞ y n e − x y J m ( t y ) d y 1 + ( A + B y 2 ) e − 2 y + D e − 4 y ,
 with an accuracy of 0.1 per cent, in less than 2 minutes.
 It is found that for epicentral distances r > 20H the displacements decay like (r/H)−α where 2 < α < 5. For compressional and strike-slip displacements at all depths and for dip-slip source above the layer, 2 < α < 3. For a dip-slip source located below the layer, 3 < α < 5. Maximal displacements for wr, ur, ux, uy and uz occur at approximately r ≃ 0.8h and decay with source's-depth like h−3/2.


Peter Szondis pathbreaking work is a succinct and elegant argument for distinguishing between a philosophy of the tragic and the poetics of tragedy espoused by Aristotle. The first of the books two parts consists of a series of commentaries on philosophical and aesthetic texts from twelve thinkers and poets between 1795 and 1915: Schelling, Holderlin, Hegel, Solger, Goethe, Schopenhauer, Vischer, Kierkegaard, Hebbel, Nietzsche, Simmel, and Scheler. The various definitions of tragedy are read not so much in terms of their specific philosophies, but rather in the way their views assist in analyzing tragedies with an aim to establish a general concept of the tragic. The second part presents exemplary analyses of eight tragedies: Sophocles'Oedipus Rex, Calderons Life Is a Dream, Shakespeares Othello, Gryphius Leo Armenius, Racines Phaedra, Schillers Demetrius, Kleist's The Schroffenstein Family and Buchner's Danton's Death. The readings neither presuppose a concept of the tragic determined by context (as in Hegel's idea of the conflict between two orders of right), nor do they focus exclusively on the texts explicit contents. Instead, they elaborate the dialectical or aporetic structures at the heart of the tragic. The works analyzed represent the four great epochs of tragic poetry: the age of Greek tragedy; the Baroque era in Spain, England, and Germany; French Classicism; and the age of Goethe.


Physical inactivity is a major risk factor in chronic disease and Canadians are insufficiently active. Exercise prescription has been shown to be effective but few physicians prescribe it. The purpose of this study was to determine family medicine residents' perceived importance of exercise prescription, and to assess the factors associated with residents who indicate the strongest conviction to prescribe exercise. All 396 family medicine residents registered in first or second year at the University of British Columbia, during June 2013 August 2013, were eligible to complete the cross-sectional 49-item survey. The outcome measures were (1) the importance of exercise prescription in future practice (2) perception of their training in exercise medicine (3) change of the importance of exercise prescription over the course of residency. The data were analyzed using descriptive and inferential statistics to assess significant relationships between each independent variable, resident physical activity levels, attitudes/beliefs, current counselling/prescribing behaviours, awareness/knowledge of physical activity guidelines, self-perceived competence in exercise prescription, and perception of training received, to their perceived importance of exercise prescription in future practice. The data were analyzed as continuous or categorical variables primarily using bivariate analysis with statistical significance set at the level of 0.05. The response rate was 80.6% (319/396). 95.6% of residents indicated exercise prescription would be important in their future practice with 37.5% strongly agreeing (termed "prescribers"). Prescribers had stronger beliefs in the importance of physical activity in health (p<0.001), physical inactivity in disease (p<0.001), and higher rates of current exercise counselling (p=0.001), exercise prescription (p=0.001), and competence prescribing exercise (p=0.005) compared to their colleagues. There was no difference between prescribers and non-prescribers regarding their levels of physical activity, knowledge, or perception of training. The importance of exercise prescription did not change over the course of residency. Only 18.6% of all residents feel they receive adequate training and 91% desire more training in exercise medicine. Exercise prescription is important


Abstract Purpose To evaluate patient satisfaction with their wheelchairs among Jewish and Arab older adults. Materials and method A cross-sectional study based on personal interviews. Participants were confined to a wheelchair (WC) Level 3. The Quebec User Evaluation of Satisfaction (scales 1–5) evaluated patient satisfaction. T test evaluated differences between continuous variables and or a Fisher's exact test between categorical variables. The contribution of background variables to the overall satisfaction with the wheelchair and related service was evaluated by multivariate regression. Results A total of 74 Jewish and 24 Arab (mean age 78.4 ± 14.1), participated in the study. The overall satisfaction score was moderate/high (3.97 ± 0.8) with no difference between the groups. The most important items for all participants were WC safety, comfort and weight. Participants from the Arab sector were less educated, had higher BMI and were less satisfied with the chair dimensions. Conclusions A WC Level 3 may be effective and meets most of the basic needs of both Jewish and Arab patients at older ages. Higher BMI may result in difficulty to adopt to WC dimensions and can explain the less satisfaction of Arab patients with this component. A routine initial phone call follow-up is recommended to all patients after receiving a wheelchair. Those with problems will be scheduled for home visit. It is recommended to perform a study that will include more types of assistive devices and other groups of patients. Implication For Rehabilitation Apparently, despite lack of home visit follow-up, overall satisfaction with wheelchaires is relatively high. Therefore, initial phone calls may be monitored to all patients and home visits may be scheduled only for those unsatisfied with their chair. Converting a home visit to phone call can reduce the costs associated with routine home visits for all patients as is currently the case in some counties. This counts for both Jewish and Arab patients.


Reconstruction of spatial layout of indoor scenes from a single image is inherently an ambiguous problem. However, indoor scenes are usually comprised of orthogonal planes. The regularity of planar configuration (scene layout) is often recognizable, which provides valuable information for understanding the indoor scenes. Most of the current methods define the scene layout as a single cubic primitive. This domain-specific knowledge is often not valid in many indoors where multiple corridors are linked each other. In this paper, we aim to address this problem by hypothesizing-verifying multiple cubic primitives representing the indoor scene layout. This method utilizes middle-level perceptual organization, and relies on finding the ground-wall and ceiling-wall boundaries using detected line segments and the orthogonal vanishing points. A comprehensive interpretation of these edge relations is often hindered due to shadows and occlusions. To handle this problem, the proposed method introduces virtual rays which aid in the creation of a physically valid cubic structure by using orthogonal vanishing points. The straight line segments are extracted from the single image and the orthogonal vanishing points are estimated by employing the RANSAC approach. Many scene layout hypotheses are created through intersecting random line segments and virtual rays of vanishing points. The created hypotheses are evaluated by a geometric reasoning-based objective function to find the best fitting hypothesis to the image. The best model hypothesis offered with the highest score is then converted to a 3D model. The proposed method is fully automatic and no human intervention is necessary to obtain an approximate 3D reconstruction.


In this study, magnetic resonance imaging techniques have been used to examine the geometry of arterial curvature and branching in casts and in vivo, and to measure the distribution of axial velocity in the associated flow. It is found, contrary to a widely held view, that the geometry is commonly non-planar. Moreover, relatively small values of the parameters which render the geometry non-planar appear significantly to affect the velocity distribution. The findings suggest that non-planarity is an important factor influencing arterial flows, including wall shear. The implications are not restricted to vascular biology, pathology and surgery, but may extend to the design of general piping systems.


: Intravenous injection of Cowdria ruminantium infected blood produced no sings of disease in four impala, Aepyceros melampus; three blue wildebeest, Connochaetes taurinus; a buffalo, Syncerus caffer; a kudu, Tragelaphus strepsiceros; a giraffe. Giraffa camelopardalis and a warthog, Phacochoerus aethiopicus. a control sheep injected with the same blood reacted severely and showed typical lesions of heartwater at autopsy.


We explore the landscape of HRM in North American MNCs which have been for long characterized as having an express preference for institutionalizing aspects of the home business system when operating aboard. Drawing upon institutional theory, both the USA and Canada are identified as liberal market economies. Building on this, we examine the HR preferences of subsidiaries originating in North America and operating in diverse liberal and coordinated market economies in order to test the extent to which the host context influences the pattern of HR policies and practices pursued, referring predominantly to the literature on USA firms. The results indicate that the pattern of HR practices pursued by North American owned MNCs varies widely depending on whether these North American owned MNCs are operating in liberal or coordinated market economies, lending support to the importance of context as a determinant of the likelihood of, and limits to, the transfer of HRM practices and preferences.


Sir,

A 56-year-old post-menopausal lady was evaluated as a liver donor for her daughter who had fulminant liver failure. Her medical history was unremarkable, and post-menopausal state and age above 50 years were the only associated risks. A 12-lead electrocardiogram and two-dimensional echocardiography were both normal. We identified her as intermediate surgical risk[1] with clinical cardiopulmonary reserve of six metabolic equivalents. Standard protocols for anaesthesia for hepatectomy were performed; however, an epidural catheter was abandoned in view of technical difficulty and analgesia was provided with an intravenous fentanyl infusion. The procedure lasted for 6.5 h with blood loss of 600 ml and the patient was extubated at the end of procedure. Continuous analgesia was provided with an intravenous infusion of fentanyl targeting a pain score <4 on the visual analogue scale. On the 1st post-operative day (POD), the patient was pain-free, ambulant and haemodynamically stable. Her heart rate averaged 65/min, central venous pressure 7–8 mmHg, haemoglobin 10.8 g/dL, serum aspartate aminotransferase 684 IU/L, serum alanine aminotransferase 565 IU/L and international normalised ratio (INR) 1.46. On the second POD, the patient developed sudden hypotension with cardiac arrest. There was no evidence of hypovolaemia or bleeding at the surgical site.

Standard cardiopulmonary resuscitation was initiated with successful return of spontaneous circulation after two cycles. The blood pressure was then maintained with infusions of adrenaline and dopamine. A 12-lead electrocardiogram suggested an inferolateral wall ST-elevation myocardial infarction [STEMI, Figure 1]. A coronary angiogram showed 80% stenosis of the distal right coronary artery with normal flow in all other vessels. Percutaneous coronary intervention was performed with a bare metal stent that was exchanged for a covered stent following perforation at the site of stenting. A pigtail catheter was inserted into the pericardial sac [Figure 2]. Infusion of eptifibatide and intravenous heparin were administered at the time of intervention. The patient bled 1.8 L from the abdominal drain and 330 ml from the pericardial sac, for which she was transfused two units of packed red blood cells and two units of fresh frozen plasma (INR was 4.23). She was weaned off the ventilator on the 4th day following intervention and was discharged on the 16th POD.

Figure 1

Electrocardiogram showing inferolateral wall ST-elevation myocardial infarction

Figure 2

Pigtail catheter in the pericardial sac

Despite guidelines for donor selection,[2] emotional factors and donor availability confound the selection in life-threatening situations. Donor deaths range from 0.5% to 2% in right hepatectomy, and myocardial infarction has also been one of the causes.[3] As history suggested a good cardiopulmonary reserve with a revised cardiac risk index[1] score of 0.9%, we did not consider the need for stress testing. An exercise stress testing, dobutamine echocardiogram or assessment of anaerobic threshold may have been predictive of major adverse cardiac events (MACE) in this patient.[1] In contrast to the American College of Cardiology guidelines,[1] the European Society of Cardiology[4] guidelines classify liver resection surgery as high surgical risk for MACE.

It is possible that stress of surgery pre-disposed the STEMI following plaque rupture.[4] Percutaneous intervention was the treatment of choice as surgical revascularisation or thrombolysis is associated with increased bleeding post-operatively.[1] Although coagulation disturbances are known after major hepatectomy, epidural analgesia is considered acceptable if performed judiciously.[5]

Living donation is a viable option for fulminant liver failure, and marginal donors are accepted in the background of restricted donor availability as a life-saving measure. As the donor undergoes surgery that is not indicated for his well-being, rigorous adherence to standard protocols in donor evaluation[6] even in emergent situations and communication of potential life-threatening complications is necessary for living donor transplants. In the light of our report, exercise stress testing or pharmacological stress testing for prediction of MACE should be considered in high surgical risk procedures including donor hepatectomy.

Financial support and sponsorship
Nil.

Conflicts of interest
There are no conflicts of interest.


Mitral valve prolapse (MVP) is a common condition present in 1–3% of the population. There has been evidence that a subset of MVP patients is at higher risk of sudden cardiac death. The arrhythmogenic mechanism is related to fibrotic changes in the papillary muscles caused by the prolapsing valve. ECG features include ST-segment depression, T wave inversion or biphasic T waves in inferior leads, and premature ventricular contractions arising from the papillary muscles and the fascicular system. Echocardiography can identify MVP and mitral annular disjunction, a feature that has significant negative prognostic value in MVP. Cardiac MRI is indicated for identifying fibrosis. Patients with high-risk features should be referred for further evaluation. Catheter ablation and mitral valve repair might reduce the risk of malignant arrhythmia. MVP patients with high-risk features and clinically documented ventricular arrhythmia may also be considered for an ICD.


This research article assesses the implications of using lean manufacturing for universities' educational, scientific, financial and economic activities. The research methods include comparative analysis, trend analysis, Wilcoxon T-test, Fisher's exact test, and correlation analysis. In retrospect, when comparing data on universities that are members of the «Association of Lean Universities», there comes to be a positive effect of lean manufacturing on the indicator «Income from all sources per one scientific and educational worker» and, in less degree, on research and development work (R&D), inflation taken into account. No statistically significant relationship between lean manufacturing and the average Unified State Examination (USE) score of the students admitted to the budgetary form of education was found. A comparative analysis of lean medical schools with their «non-lean» peers showed that lean manufacturing has a positive effect on the growth of R&D, taking inflation into account. Consequently, the use of lean manufacturing allowed universities to maintain average income growth rates per one scientific and educational worker. In addition, lean universities differ from their peers in terms of R&D amount dynamics. The study is to some extent limited by lacking quantitative information on the scale of lean manufacturing implementation, as well as by the dissimilar structure of the lean universities as such, medical schools predominating among them. The research results can be useful for university management and for the lean technologies implementation partners, who are interested in making decisions on the use of lean manufacturing.