Understanding disease transmission dynamics in multihost parasite systems is a research priority for control and potential elimination of many infectious diseases. In China, despite decades of multifaceted control efforts against schistosomiasis, the indirectly transmitted helminth Schistosoma japonicum remains endemic, partly because of the presence of zoonotic reservoirs. We used mathematical modeling and conceptual frameworks of multihost transmission ecology to assess the relative importance of various definitive host species for S. japonicum transmission in contrasting hilly and marshland areas of China. We examine whether directing control interventions against zoonotic reservoirs could further reduce incidence of infection in humans or even eliminate transmission. Results suggest that, under current control programs, infections in humans result from spillover of transmission among zoonotic reservoirs. Estimates of the basic reproduction number within each species suggest that bovines (water buffalo and cattle) maintained transmission in the marshland area and that the recent removal of bovines from this area could achieve local elimination of transmission. However, the sole use of antifecundity S. japonicum vaccines for bovines, at least at current efficacies, may not achieve elimination in areas of comparable endemicity where removal of bovines is not a feasible option. The results also suggest that rodents drive transmission in the hilly area. Therefore, although targeting bovines could further reduce and potentially interrupt transmission in marshland regions of China, elimination of S. japonicum could prove more challenging in areas where rodents might maintain transmission. In conclusion, we show how mathematical modeling can give important insights into multihost transmission of indirectly transmitted pathogens.


The purpose of this article is three-fold: (1) to provide an analysis of autoethnography as a method in policing research; (2) to distinguish between policing as a practice and policing as an institution; and (3) to outline the characteristics of policing as a practice. I deploy an autoethnographic method to identify the characteristics of the practice of city policing in democracies. These characteristics—heroic struggle, edgework, absolute sacrifice, and worldmaking—draw attention to a crucial mismatch between policing as a practice and policing as an institution. I conclude by suggesting ways in which the characteristics of the practice can provide a firm foundation for further research into the contemporary problems of policing as an institution.


Background Autologous serum eye drops possess tear-like, antimicrobial and optical properties, and are usually non-allergenic. All these features are responsible for its therapeutic effect. Purpose Describe an adverse reaction attributed to the use of 20% autologous serum eye drops formulated in the hospital's Pharmacy Department. Material and methods 68-year-old female diagnosed with dry eye syndrome. By request of the Ophtalmology Department, a 20% autologous serum eye drops was prepared as magistral formulation. The serum is separated from the rest of the blood components by centrifugation and then diluted with buffered irrigation solution (BSS®). The Pharmacy Department provided the patient with information about preservation and administration method. The causality relationship was determined by applying the Karch–Lasagna algorithm modified by Naranjo. Results Seven days after beginning treatment with autologous serum eye drops, the patient developed palpebral eczema, erythaema, burning sensation and oedema in both eyes. Two weeks' later, the symptoms aggravated, causing treatment discontinuation. Symptomatic treatment with hydrocortisone ointment was started in the oedematised area, one application every 12 hours. In approximately 1 week, symptoms ceased. Within 15 days, the ophthalmologist reintroduced autologous serum eye drops, causing in 3 days' time the same but more severe symptoms than the previous time. The patient attended the emergency service, where eye drops treatment was definitely discontinued, and began treatment with hydrocortisone ointment and carmelose lubricating gel, resolving the symptoms in a few days. The causality relationship following the application of the algorithm turned out to be probable. This adverse reaction was reported to the pharmacovigilance centre and the Ophthalmology Department was contacted to consider conducting a sensitivity test by the Allergy Department, as well as to rule out autoimmune pathology. Conclusion Patients treated with autologous serum eye drops respond with good tolerance and few or no side-effects, although it can produce a slight eye irritation, burning and tearing that often disappears after a few minutes. Some complications have been described such as the deposit of immunoglobulins in the cornea in patients with autoimmune pathology. However, the present case reveals a likely hypersensitivity reaction attributable to its use in the absence of a diagnosed autoimmune pathology. No conflict of interest


In this paper, we summarized our recent efforts toward accomplishing four key goals important for control of microbial population dynamics in nonmixed systems: (1) derivation of a cell population flux model based on individual cell properties; (2) measurement of the population random motility and chemotaxis parameters appearing in this model using a simple experimental assay; (3) quantitative understanding of the effects of cell motility and chemotaxis properties on microbial population dynamics; and (4) manipulation of chemotactic responses by genetic modification.


Leprosy is a catching and chronical disease which caused by leprosy germ (mycobacterium leprae) that infected neural system of skin boundary and another body tissue except central neural system. In our society, there is a stigma said that leprosy is a curse disease, congenital or magic karma that difficult to heal.in this case family plays important role in the main support system of problems and provided knowledge about leprosy. The objective of this study is analyzing correlation between family role and self esteem of patient with leprosy. This study was using cross sectional. The population in a study are one that family's of patient leprosy and all his patient with leprosy in Puskesmas Tanjung Region. The sample in the study is patient with leprosy are 42 people and that one family's of patient with leprosy are 42 people to put using total sampling Technique. The statistical independent variable is family role and the statistical dependent variable is self esteem of patient leprosy. This study was using questionnaire provided to respondent then tabulated using Spearman Rho. Data was collected from responden by questionnaire. The data was presented inform of bars diagram and table. From data collection there are 47,6% respondent possessed low self esteem, 52,4% with high self esteem, 52,4% have enough family role, 47,6% have good family role. ρ count in this study is 0,004 smaller than 0,05. Conclusion of the study is there is a correlation between family role with self esteem of patient leprosy in the Puskesmas Tanjung Region, Sampang. Family is effective channel of reached for the health society effort have used his role with optimals in order to help heal process the family is sick, especially patient of leprosy has physical and psychological health problems


textabstractIn 1888 the French physician Etienne-Louis Arthur Fallot described a "tetrad" of
congenital anatomical defects in a heart, which are now collectively referred to as
tetralogy of Fallot (TF). TF is characterized by a (sub)valvular pulmonary stenosis, a
ventricular septal defect (VSD), dextroposition of the aorta (overriding the VSD) and
concomitant right ventricular hypertrophy (RVH) (Fig. 1.1). The right ventricular
(RV) outflowtract obstruction can be more or less severe, depending on the degree of
malformation as well as the extent of RVH. With an incidence of 1 per 2000 newborns
TF is a frequent cyanotic congenital heart malformation.


This article presents the methodological procedures and results of environmental action in interdisciplinary character, which sought to sensitize and educate Rectory employees of the Federal University of Sao Francisco Valley-Univasf, in Petrolina-PE, on the need to reduce the consumption of cups disposable in the workplace. The action consisted of a Scientific Initiation project and integrated the implementation of the campaign Environmental Program of this institution, prior to its accession in to A3P-Environmental Agenda in Public Administration.


Abstract Submerged macrophytes, as one of the most important primary producers in shallow lakes and streams, have attracted significant research attention, with relevant studies showing dynamic evolution over the past three decades. Here, we investigated the trends and characteristics of 2,836 relevant articles published between 1991 and 2018 based on bibliometric analysis. Our geographic-based results indicated a scarcity of studies on submerged macrophytes in Africa, but strong international collaboration in this field, especially that between Denmark and China. The top two core journal sources (Hydrobiologia and Aquatic Botany) of studies on submerged macrophytes were determined, with another four important sources also identified. In addition, three trends in abstract word dynamics were found over the last three decades: i.e. most frequent word ('lake'); increased words (those related to restoration, ecosystem state, model, and macrophyte community); and decreased words (those related to fish and specific macrophyte genera). Furthermore, our case study on four macrophyte genera showed a close relationship between Hydrilla and Vallisneria and between Potamogeton and Myriophyllum, as verified via the topic-article relationships determined using the topic model. The thematic evolution map of keywords used during the last three decades showed a clear shift in scientific fields; for example, Myriophyllum spicatum was an important keyword during 1999 and 2011 but not in other periods. We found that studies on submerged macrophytes developed with an increase in applied ecology topics, such as lake restoration, and basic scientific topics, such as freshwater ecosystems and plant physiology.


Sorbarod biofilms were investigated for their suitability in establishing a continuous growth for the study of bacterial vaginosis. Important organisms in the condition, Gadnerella vaginalis, Mobiluncus curtisii and Lactobacillus acidophilus were studied. In contrast to growth in broth culture, L. acidophilus and G. vaginalis were maintained for at least 96 hours in steady state on the biofilms. The strict anaerobe M. curtisii was maintained in these biofilms for at least 48 hours an indication that anaerobic conditions do exist in these biofilms. The haemolytic activity of G. vaginalis was consistently maintained in the biofilms in contrast to the short-term activity in the broth culture, which matched the bacterial titre. Gram stains of thin sections of paraffin wax embedded Sorbarods showed the micro-colonies as distinct irregular aggregates of organisms adherent to the cellulose matrix for G. vaginalis while L. acidophilus appeared as large latticed networks that formed between the cellulose fibre matrix. The simple Sorbarod system appears to be suitable for studying the growth of bacteria in continuous culture and has a potential for investigating interactions between micro- organisms. Journal of Tropical Microbiology Vol.1(1) 2002: 36-40


Proof-testing has shown with a high level of confidence that a unique relationship exists between the static strength and the fatigue life or residual strength in unidirectional graphite/epoxy (T300/5208) composite. However, damage, especially visible damage, caused by proof-testing seems to shorten the life and reduce the residual strength. Failure initiation in fatigue is mainly in the form of longitudinal cracking, starting along the edges at lower stresses. Temperature increase follows the same trend as predicted by the solution of a heat conduction equation with a constant rate of heat generation except immediately before the final failure. Although the reason is not clear, the tensile modulus increases after fatigue. For mathematical simplicity and operational ease, a two-parameter Weibull distribution seems adequate for the analyses of scatter in strength and life.


Enzymes are characterized by an active site that is typically embedded deeply within the protein shell thus creating a nanoconfined reaction volume in which high turnover rates occur. We propose nanoparticles with etched substrate channels as a simplified enzyme mimic, denominated nanozymes, for electrocatalysis. We demonstrate increased electrocatalytic activity for the oxygen reduction reaction using PtNi nanoparticles with isolated substrate channels. The PtNi nanoparticles comprise an oleylamine capping layer that blocks the external surface of the nanoparticles participating in the catalytic reaction. Oxygen reduction mainly occurs within the etched channels providing a nanoconfined reaction volume different from the bulk electrolyte conditions. The oxygen reduction reaction activity normalized by the electrochemically active surface area is enhanced by a factor of 3.3 for the nanozymes compared to the unetched nanoparticles and a factor of 2.1 compared to mesoporous PtNi nanoparticles that possess interconnecting pores.


The thermal and exercise tolerances of 165 Sudanese cane cutters were measured in the laboratory and related to work performance and productivity in the cane fields. The results showed that the amount of cane cut per minute in the field was significantly correlated with changes in body weight (r = +0-53) during the third hour of work, aerobic energy expenditure (r = + 0-43), and cardiac frequency during work. These variables in turn were associated with predicted maximal power output (VO2 max) measured in the laboratory. The average energy expenditure during cane cutting was 1-66 +/- 0-33 1/min-1 (34-9 kJ/min-1) which represents approximately 60% of the workers predicted VO2 max. This rate of energy expenditure was sustained in the cane fields for at least three hours without significant pauses for rest. The sweat losses measured in 32 cane cutters during the two and three hours of work averaged 637 +/- 221 and 770 +/- 282 g/h-1 respectively, while the mean urine temperature immediately on cessation of effort was 37-74 +/- 0-46 degrees C. Despite the additional environmental heat load of the tropics, it would seem that cane cutters performing a self-paced task demanding heavy physical effort, are able to sustain work levels well in excess of those recommended for most European factory workers without obvious signs of fatigue or heat stress.


This paper aims at outlining the impact of urbanisation on the process of development of the Gabon a country where the last general census of the population (July 1993) showed that close [to two-thirds] of the Gabonese are city-dwellers. Therefore the problems resulting from this situation must be identified and appropriate policies and programs must be established.... (SUMMARY IN ENG AND SPA) (EXCERPT)


Vestibular input to the cerebellum mediates balance and eye movement control. Recent functional MRI studies, however, show midline cerebellar activation during visually induced illusions of self-rotation, thus suggesting that the cerebellum may also contribute to self-motion perception. Here, we investigate self-motion perception directly in patients with vermal (or midline) cerebellar ataxia. Participants were rotated in the dark (90°/s velocity steps) and the time constant of decay of the postrotational angular velocity sensation was measured. The perceptual vestibular time constant in patients was considerably reduced (7.8 s) with respect to control values in this (25.6 s) and several previous studies. In addition to the processing of vestibular signals for motor control, the cerebellar vermis is involved in vestibular processing of self-motion perception.


Segmented labour market and the organization of work the incidence of outwork employers' use of outwork organizing outwork participation in outwork managing two worlds.


The purpose of the study was to formulate liquisolid tablets of Pioglitazone hydrochloride to improve the solubility and dissolution rate. The λmax of Pioglitazone hydrochloride was found to be 234nm in phosphate buffer ph 7.4. The Pioglitazone hydrochloride obeys Beer's law within the concentration range of 5-25 (μg/ml). The solubility studies were observed that the Pioglitazone hydrochloride have highest solubility in Tween 80 compared to other non-volatile liquid vehicles. FT-IR showed that there was no interaction between the drug and excipients. The DSC thermogram of Pioglitazone hydrochloride and liquisolid compacts, the sharpendothermic peak of pure drug appeared at 187oC, whereas no such peak was observed in liquisolid formulation, which indicates that Pioglitazone hydrochloride was molecularly dispersed and in an amorphous form.
Flowable liquid retention potential (Ф-value) was used to formulate liquisolid tablets of Pioglitazone hydrochloride. The twelve formulations were prepared using different concentration of drug in liquid medication, and different ratio of microcrystalline cellulose & aerosil 200 and crospovidone. The directly compressed tablets were prepared using microcrystalline cellulose and aerosil 200 and crospovidone, without addition of non-volatile liquid vehicle.
The results of precompression studies which indicates that the prepared powder blend of all the formulations possess good flow properties. The postcompression evaluations such as hardness, thickness, weight variation, friability, drug content and disintegration test of all the formulated liquisolid tablets were within the acceptable limits. In vitro dissolution studies of all the formulations showed immediate release of drug. Among 12 formulations F12 was selected as a best formulationwhich had the better release of drug (98.74%) and subjected to further studies.
The in vitro release studies revealed that the liquisolid tablets showed a faster drug release compared to the pure drug and directly compressed tablets. The results of the powder X- ray diffraction studies proved that the crystallinity of pure drug was remarkably reduced in the best formulation.
The dissolution rate (DR) in 10 min, increased in linear manner with increasing ratio of drug: Tween 80. The selected formulation showed higher release profile than the pure drug and directly compressed tablets. The selected formulation was found to be stable under the storage condition
CONCLUSION:
The liquisolid tablet technique can be effective way for dissolution rate improvement of water insoluble drugs such as Pioglitazone hydrochloride. Tween 80 was used as a liquid vehicle. The liquid vehicle plays a contributing role in improving the dissolution profiles of a water insoluble drug in the liquisolid formulations, besides choosing a suitable liquid vehicle according to its viscosity and HLB value. Enhanced dissolution rates obtained in the present study in turn indicates increase in oral bioavailability due to increased wetting and surface area available for dissolution. Hence we can conclude that liquisolid tablets of paliperidone was prepared by using Tween 80 (1:1 ratio of drug and Tween 80) and 20 ratio of microcrystalline cellulose and aerosil 200 provide greater release of drug (98.74 % in 60 mins) among all the formulations, and this ratio can be used to enhance the solubility and dissolution rate of poorly water soluble drug pioglitazone hydrochloride. This novel approach to the formulation may be helpful to improve oral bioavailability.


In this work, wood–cement composites (WCC) based on poplar sawdust were developed and fabricated by the extrusion process. The volume fraction of wood particles in the mixes was varied from 23% to 46%. The mechanical properties of these WCC were characterized in compression to determine the maximum compressive strength and the Young's modulus. In the second part, these Young's modulus values were estimated in compression using a 3D numerical homogenization which takes into account the variability in wood particle lengths and the random distribution in the mixes. The obtained results show a good agreement between the experimental data and numerical calculations up to a 35% volume fraction. The model's poor estimation for large volume fractions (over 35%) could be attributed to the experimental sample size, which is not representative for large volume fractions, the percolation of the wood particles into the mixes and the inhibition of the cement setting.


We present the first reduced-dimensional technique to simulate the dynamics of thin sheets of viscous incompressible liquid in three dimensions. Beginning from a discrete Lagrangian model for elastic thin shells, we apply the Stokes-Rayleigh analogy to derive a simple yet consistent model for viscous forces. We incorporate nonlinear surface tension forces with a formulation based on minimizing discrete surface area, and preserve the quality of triangular mesh elements through local remeshing operations. Simultaneously, we track and evolve the thickness of each triangle to exactly conserve liquid volume. This approach enables the simulation of extremely thin sheets of viscous liquids, which are difficult to animate with existing volumetric approaches. We demonstrate our method with examples of several characteristic viscous sheet behaviors, including stretching, buckling, sagging, and wrinkling.


Attitudes are generally regarded as having been learnt. They predispose an individual to action that has some degree of consistency. The experiences of pre-service teachers influence the formation of attitudes and these, in turn, influence their classroom practices. These attitudes and practices may sometimes be at variance with the main direction of their tertiary teaching methods courses. Thus it is crucial in assisting pre-service teachers to understand their own attitudes and practices that these attitudes be made explicit and examined. This paper reports upon part of a larger study that focussed upon pre-service primary teachers in their first mathematics pedagogy subject at the University of Western Sydney. The students completed three data collection instruments: an achievement test of the mathematics they would be expected to teach; a survey of their beliefs about mathematics, mathematics teaching and mathematics learning; and a survey of their attitudes towards mathematics and mathematics teaching. This paper only reports the data from the achievement test and the attitude survey, and investigates the relationships between these data.


Importance Falls are the leading cause of injury-related morbidity and mortality among older adults in the United States. In 2014, 28.7% of community-dwelling adults 65 years or older reported falling, resulting in 29 million falls (37.5% of which needed medical treatment or restricted activity for a day or longer) and an estimated 33 000 deaths in 2015. Objective To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on the prevention of falls in community-dwelling older adults. Evidence Review The USPSTF reviewed the evidence on the effectiveness and harms of primary care–relevant interventions to prevent falls and fall-related morbidity and mortality in community-dwelling older adults 65 years or older who are not known to have osteoporosis or vitamin D deficiency. Findings The USPSTF found adequate evidence that exercise interventions have a moderate benefit in preventing falls in older adults at increased risk for falls and that multifactorial interventions have a small benefit. The USPSTF found adequate evidence that vitamin D supplementation has no benefit in preventing falls in older adults. The USPSTF found adequate evidence to bound the harms of exercise and multifactorial interventions as no greater than small. The USPSTF found adequate evidence that the overall harms of vitamin D supplementation are small to moderate. Conclusions and Recommendation The USPSTF recommends exercise interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls. (B recommendation) The USPSTF recommends that clinicians selectively offer multifactorial interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls. Existing evidence indicates that the overall net benefit of routinely offering multifactorial interventions to prevent falls is small. When determining whether this service is appropriate for an individual, patients and clinicians should consider the balance of benefits and harms based on the circumstances of prior falls, presence of comorbid medical conditions, and the patient's values and preferences. (C recommendation) The USPSTF recommends against vitamin D supplementation to prevent falls in community-dwelling adults 65 years or older. (D recommendation) These recommendations apply to community-dwelling adults who are not known to have osteoporosis or vitamin D deficiency.


Hemobilia is a disease caused by injury or conditions that cause the abnormal communication between intrahepatic blood vessels and biliary tract, resulting in leakage of blood into the biliary tract. In the past, trauma had been the most common cause of hemobilia. However, with the increasing invasive procedures in the hepatobiliary tract, iatrogenic origin has become the major cause of hemobilia. Also, non-traumatic etiologies of hemobilia include vascular malformation such as aneurysm, gallstone, inflammation, biliary tumor, hepatocellular carcinoma and coagulopathy. Among these non-traumatic etiologies, choledocholithiasis is a rare cause of hemobilia. The authors have experienced two cases of hemobilia caused by choledocholithiasis, which was diagnosed by abdominal ultrasonography, abdominal CT and duodenoscopy. Both patients were treated by the endoscopicsphincterotomy and stone removal with basket.


Main elements concerning the physiology of pain are described, as well as the structures of the nervous system at the origin of the central control of pain: peripheral fibres (small diameter myelinated A delta and unmyelinated C fibres); spinal ascending pathways; cerebral structures relaying nociceptive information (medial and ventro-postero-lateral thalamic relays); SI and SII cortical areas; spinal segmentary and supraspinal excitatory and inhibitory controls; diffuse noxious inhibitory controls (DNIC). Chronic pain is a result of two processes: peripheral and central sensitization, in relation with inflammation and nerve injury at peripheral level and with neuroplasticity at central level. Neurotrophins, mainly NGF and BDNF and their receptors (LNTR, TrkA and TrkB) are involved in these processes. Pain is a result of an unpleasant emotional experience: its various components, mainly the emotional one, may be increased or decreased considering the different characteristics of the stimulus and of the affective state of the patient, as well as the context in which this stimulus is applied. The role of physiological systems, unconnected with those classically involved in the physiology of nociception and pain, such as the motor cortex in phantom limb pain, are described in conclusion, to focus on the extreme complexity of the control systems of pain in humans.


The Ayurveda universities are producing hundreds of native doctors annually. They can practise in different places and branches. Some of them join the Government Ayurveda hospitals, some practise privately and some are based in hotel and tourism industry. The Ayurveda medication has a long history on the island of Sri Lanka, which can be broadly traced in various sources. According to historical events, the advanced health economy was initially spawned through the introduction of Buddhism since the 6th century before Christ (544 BC). Till then, the locals were medically treating each other with the knowledge acquired by experience. Nevertheless, after 544 BC, another phenomenon occurred: there emerged many Kings as native doctors as well. Among such people, we could usually observe those elites who received education in Guru Gedera (school). They were additionally qualified as building engineers, irrigational engineers, artisans and native doctors. The native doctors were called «Vedana» and they were specialized in various fields viz: gynaecologists, veterinary surgeons, general physicians, etc. King Pandukabhaya, King Buddhadasa and King Parakramabahu I are some of famous native doctors in the ancient past. Their work and treatment methods are well-known and worth reviewing in our article. Besides, its contrast is shown to modern treatment techniques and what differences between them consist in. In particular, we see a difference of treatment and prevention approaches. Previously, natural substances were used as healing items; no drugs were engaged at all. From the British colonisation moment, European techniques were brought to improve the Sri Lankan medicine. Also, not only the past health economy evolution is discussed in the article. It is the specialized modern institutions that are focused on. Especially, what are the most relevant hospitals in Sri Lanka, how they are subdivided, what diseases they recover from, how medical aid is provided to specific age or occupation categories. The issue of state and private medical institutions is described as well: what advantages and disadvantages exist for them. Finally, the conclusion is made whether the Sri Lankan health economy system is reliable and resilient in the modern world.


Type-directed certifying compilation and typed assembly language (TAL) aim to minimize the trusted computing base of safe languages by directly type-checking low-level machine code. However, the safety of TAL still heavily relies on its safe interaction with the underlying garbage collector. Based on a variant of foundational proof-carrying code (FPCC), we introduce a general methodology for combining foundational TAL with a certified garbage collector. We demonstrate the practicality of this approach by linking a typical TAL with a conservative garbage collector. This includes proving the safety of the collector, the soundness of TAL, and the safe interaction between TAL programs and the garbage collector. Our work is fully mechanized in the Coq proof assistant and the certified programs can be shipped immediately as FPCC packages.


Tantra is the Hindu-based religion which links ecstatic sexual practice with meditation and direct spiritual experience. It originated in India some 1200 years ago, when the great sacred erotic temples were built. In the West it is best known for its inspiration of tantric yoga, and its associated ritualistic forms of sex. But is tantra just about esoteric sex or does it amount to something more? This lively and original book contributes to a more complete understanding of tantra's mysteries. Without minimising its sexual dimensions, Gavid Flood argues that within tantra the body is more than just a sexual entity. It is a vehicle for the spirituality that is fundamental to people's minds. "The Tantric Body" makes an important and fascinating contribution to the study of South Asian religion, and will have strong appeal to students of South Asian cultures and societies as well as to those of comparative philosophy.


The 17th International Workshop on Mining and Learning with Graphs (MLG) is held in Washington DC, USA on August 15, 2022 and is co-located with the Eighth International Workshop on Deep Learning on Graphs (DLG) as part of the 28th ACM SIGKDD Conference on Knowledge Discovery and Data Mining. This workshop is a forum for exchanging ideas and methods for mining and learning with graphs, developing new common understandings of the problems at hand, sharing of data sets where applicable, and leveraging existing knowledge from different disciplines. In doing so, we aim to better understand the overarching principles and the limitations of our current methods, and to inspire research on new algorithms and techniques for mining and learning with graphs. Topics of interest include, but are not limited to, graph mining, statistical relational learning, social network analysis, and network science. The target audience spans researchers and practitioners across academia, government, and industry.


This study investigated a clicking sound which is often heard when deploying a hydrophone in UK shallow waters. This sound has often been described as being produced by snapping shrimp yet very few snapping shrimp have been found in UK waters. This work has identified the sound of snapping shrimp and shown that a similar sound, while present throughout the year, is not the dominant component of the click field during the summer and autumn. This work has shown that the click sounds are heard in the southern half of the UK only and that click activity has a strong dependence on the annual and diurnal cycles peaking in late summer and during daylight hours. It has also shown that the click activity is dependent on the bottom type with little activity over uniform sand or mud sea beds. Three principal types of click have been identified although it is believed that a greater number of different species contribute to the click field. Localisation of the click sources using one, two and four hydrophone arrays has shown that the majority of the clicks are produced above but close to the seabed. There is also more click activity in the deeper channel than in the inter-tidal shallows at the main study site in the Fleet, Dorset. It has also demonstrated very little click activity over the nearby sand flats. The use of cameras to try and capture pictures of an animal producing the clicks both in the wild and in aquaria and in rock pools has not been successful. This may be due to a number of reasons which are discussed in this report. Although this work has failed to identify the click-producing species it has provided a much better understanding of the characteristics of the clicking sound and recommendations are made for future work that should lead to an identification of the click-producing species.


Mitral valve repair for degenerative mitral regurgitation is nowadays one of the most common valvular procedures. Different technical modifications were added to the original Carpentier's method, trying to maximise the stability of the results and to reduce the incidence of immediate complications and of late failure of the correction. Survival is good, even if recent reports showed that recurrence of mitral regurgitation can be higher than expected. Prolapse of the anterior leaflet remains challenging and is related to higher reintervention rates. Nevertheless, the overall success rate is high, and the increasing experience of the different surgical teams approaching this procedure will help maintain satisfactory and stable long-term results.


The problem of low-power spin decoupling over a broad range of chemical shifts in liquid-state nuclear magnetic resonance (NMR) is addressed through the design of periodic amplitude-modulated irradiation schemes. A principal feature of these is the composition of each decoupling period which contains a single modulated pulse in place of a composite-pulse train of the kind used traditionally. To satisfy the theoretical criterion for decoupling, the pulse amplitude is shaped such that the propagator is made cyclic and broadband, meaning here that it equals the identity matrix over a frequency range which is broad compared to the root-mean-square (RMS) pulse amplitude. The method of design is based on the use of the Floquet formalism to provide insight into the influence of the modulation on the dynamics of the irradiated spin-. Modulation functions formed from simple Fourier series are derived in the first instance using perturbation theory to impose the required cyclicity on the propagator. Broader bandwidth solutions are then obtained by the addition of higher-order Fourier components. Finally, numerical refinement of a selected solution is shown to raise the decoupling quality to the standards acceptable in routine high-resolution NMR.


This paper is concerned with structured machine learning, in a supervised machine learning context. It discusses how to make joint structured learning on interdependent objects of different nature, as well as how to enforce logical con-straints when predicting labels. We explain how this need arose in a Document Understanding task. We then discuss a general extension to Conditional Random Field (CRF) for this purpose and present the contributed open source implementation on top of the open source PyStruct library. We evaluate its performance on a publicly available dataset.


Introduction The response to cardiac resynchronisation therapy (CRT) can be heterogeneous. Most studies aim to improve patient selection in order to achieve better outcomes.However, the adjustment of device timing intervals in conjunction with optimisation of medical therapy may maximise the effectiveness of CRT. This approach provides a new paradigm in the management of advance heart failure where not only medical therapies but also CRT timing intervals are tailored to individual needs. We describe our four years experience with CRT optimisation performed in a consultant-run heart failure (HF) clinic. Methods All patients attending the combined CRT optimisation and HF clinic during the period of 2008–2012 had a clinical assessment followed by echocardiography guided optimisation of their device. A-V optimisation was performed using the Iterative method on a pre-set sequence of paced and sensed AV delays. V-V optimisation was based on the maximal left ventricular outflow tract VTI as a surrogate for stoke volume.The following end-points were used: EuroQol (EQ visual analogue score (VAS)) health questionnaire, 6-minute walk test (6MWT), regional wall motion abnormality scoring (RWMA), left ventricular ejection fraction (LVEF), Yu Index (SD of time to peak systole in a 12 segment LV model as a measure of intra-ventricular dyssynchrony) and the difference between aortic and pulmonary ejection times (IVMD) a marker of inter-ventricular dyssynchrony. Patients were re-assessed after 8–12 weeks at which point optimisations of medical therapy were performed. Results 87 patients underwent CRT optimisation (68 (78%) were males). 92% of patients had NYHA Class II or III. CRT optimisation was performed at a mean 36 weeks post implantation and the follow-up visit took place at a mean of 9 weeks later. Post CRT optimisation there were reduction in intra-ventricular dyssynchrony (Yu Index decreased from 36 to 30ms (p = 0.02)) and inter-ventricular dyssynchrony (IVMD from 20 to 12 ms (P < 0.01). There were improvements in LVEF (from 31 to 34% (p = 0.05)) and RWMA (from 2.1 to 1.9 (P < 0.01)). Clinically there were trends toward an increase in 6MWT (from 274 to 311 m (p = 0.10)), improvement in NYHA from class III to II (p = 0.12) and EQ VAS health questionnaire score (from 60 to 66 (p = 0.07)). Conclusions This study suggests echocardiography guided CRT optimisation results in an improvement in measures of dyssynchrony and LV systolic function with a trend towards clinical improvement. This lends support to the individualisation of CRT timing intervals rather than relying on standard box settings as part of a heart failure service.


John Donohue and colleagues recently assessed the impact of "right-to-carry" (RTC) laws on crime rates. These laws make it easier to get a carry permit. Donohue et al. claim that their analysis indicates that, contrary to what nearly all other researchers have found, these laws increase violent crime. This paper presents a critical analysis of the research by Donohue et al., and shows that their conclusions are unwarranted.


After reviewing the various etio-pathogenic hypotheses for pterygium in which the discontinuity of the lacrymal film at the corneo-limbic junction appears to play an essential role, the authors discuss the current therapeutic choices. The value and place of lamellar keratoplasty overlapping the limbus are discussed.


Sodium channels are crucial to the ability of sensory neurones to fire action potentials. Modulation of these ion channels can cause neurones to become sensitised leading to a state called hyperalgesia. A recent article by Ostman et al. demonstrates that the decreased inflammatory hyperalgesia observed in NaV1.9 knockout mice is due to the lack of upregulation of a persistent sodium current in sensory neurones by GTP-gamma-S. In neurones from wild type mice this upregulation causes a negative shift in sensory neurone threshold activation: sensitisation. This short article reviews the set of experiments that brought about this finding.


Earth is shielded from the hazardous galactic radiation in the form or cosmic ray ions by the outwardly flow of the solar wind plasma and by the geomagnetic field. Understanding the effects of the global structure of the heliosphere on the transport of energetic charged particles remains an important challenge in space physics. The expanding bubble of the supersonic solar wind cools the populations of GeV ions that penetrate deeply into the interplanetary space. Beyond the solar wind lies the heliosheath that is believed to act as a long-term storage reservoir for the cosmic rays. The heliosheath and its magnetic field topology play an important role in modulating cosmic rays at large heliocentric distances. Understanding this role is crucial for interpreting the the puzzling Voyager spacecraft observations near the edge of the solar system.


OBJECTIVES
To determine the effective dose and CT dose index (CTDI) for a range of imaging protocols using the Sirona GALILEOS(®) Comfort CBCT scanner (Sirona Dental Systems GmbH, Bensheim, Germany).

METHODS
Calibrated optically stimulated luminescence dosemeters were placed at 26 sites in the head and neck of a modified RANDO(®) phantom (The Phantom Laboratory, Greenwich, NY). Effective dose was calculated for 12 different scanning protocols. CTDI measurements were also performed to determine the dose-length product (DLP) and the ratio of effective dose to DLP for each scanning protocol.

RESULTS
The effective dose for a full maxillomandibular scan at 42 mAs was 102 ± 1 μSv and remained unchanged with varying contrast and resolution settings. This compares with 71 μSv for a maxillary scan and 76 μSv for a mandibular scan with identical milliampere-seconds (mAs) at high contrast and resolution settings.

CONCLUSIONS
Changes to mAs and beam collimation have a significant influence on effective dose. Effective dose and DLP vary linearly with mAs. A collimated maxillary or mandibular scan decreases effective dose by approximately 29% and 24%, respectively, as compared with a full maxillomandibular scan. Changes to contrast and resolution settings have little influence on effective dose. This study provides data for setting individualized patient exposure protocols to minimize patient dose from ionizing radiation used for diagnostic or treatment planning tasks in dentistry.


Bluetongue virus serotypes 1 to 24 are transmitted primarily by infected Culicoides midges, in which they also replicate. However, "atypical" BTV serotypes (BTV-25, -26, -27 and -28) have recently been identified that do not infect and replicate in adult Culicoides, or a Culicoides derived cell line (KC cells). These atypical viruses are transmitted horizontally by direct contact between infected and susceptible hosts (primarily small ruminants) causing only mild clinical signs, although the exact transmission mechanisms involved have yet to be determined. We used reverse genetics to generate a strain of BTV-1 (BTV-1 RGC7) which is less virulent, infecting IFNAR(−/−) mice without killing them. Reassortant viruses were also engineered, using the BTV-1 RGC7 genetic backbone, containing individual genome segments derived from BTV-26. These reassortant viruses were used to explore the genetic control of horizontal transmission (HT) in the IFNAR(−/−) mouse model. Previous studies showed that genome segments 1, 2 and 3 restrict infection of Culicoides cells, along with a minor role for segment 7. The current study demonstrates that genome segments 2, 5 and 10 of BTV-26 (coding for proteins VP2, NS1 and NS3/NS3a/NS5, respectively) are individually sufficient to promote HT.


1 in-situ reflectance measurements have been made for carbon dioxide (CO2) frosts formed' on liquid-nitrogen-cooled substrates. The data were obtained spectrally in the wavelength range from 0.5 to 12.0 microns using an infrared integrating sphere. These measurements were made using the hemispherical-angular technique and resulted in the determination of the absolute reflectance. The properties of the CO2 frosts were studied by forming them on black epoxy paint and polished stainless steel substrates. The CÖ2 frosts were found to exhibit an anomalous dispersion reflectance peak at 4.3 microns which was shown to be a very sensitive indication of the presence of solid CO2. In addition, it was found that CO2 scatters short wavelength radiation (X < 1.0 microns) significantly and is semitransparent for much of the wavelength range between 2.0 and 12.0 microns. The application of these results to other problems associated with cryogenically cooled surfaces is discussed.


The present domestic energy situation in Nigeria has made many families to go back to the use of fuel wood/charcoal owing to high prices or scarcity of kerosene and other alternative cooking fuels. Therefore, this study analysed the economic determinants of quantity demanded and supplied, cost and returns and the cost advantages of fuel wood utilization by consumers to other substitutes in Bosso Local Government Area of Niger State, Nigeria. Data were collected from 50 randomly selected fuel wood (charcoal and firewood) producers from Beji and Garatu communities and 60 randomly selected consumers from Maikunkele, Bosso/Maitumbi, Dutsenkura/Kpakungu communities. Analysis of data was done with the use of descriptive statistics, multiple regression analysis, cost and return analysis. Result shows that 72.2% of the variation in quantity demanded by the fuel wood consumers in the study area was explained by the identified determinants, 94.6% of the variation in the quantity the producers supplied. The average return realized by the charcoal producers per quantity produced in bags /month is N 7800.The average return realized by the firewood producers per quantity produced in Dyna truck/month is N 6600. The average return realized by the firewood producers per quantity produced per pickup truck/month is N 1600. A more comprehensive and increased education and enlightenment campaign against deforestation as well as provision of employment for the teeming youth and alternative cheap, eco-friendly energy sources were recommended.


In this paper we outline and demonstrate the critical simulation approach to understanding the data operations of visual social media platforms. We situate this approach within the field of platform studies and position it as a 'hybrid digital method', before describing its application for descriptive, forensic and speculative purposes in two current research projects: one that uses machine vision combined with mixed-methods qualitative research to explore Instagram's algorithmic visual culture; and one that combines automated data donation and machine vision to explore Facebook's ad targeting practices.


Facing the rapidly increasing globalization of world economies and a steadily diversifying domestic consumer base, U.S. corporations have embraced the benefits of hiring more employees with diverse perspectives and experiences. Particularly in industries dependent upon knowledge of science, technology, engineering, and mathematics, recognition has grown that the American work force is seriously constrained by the clear underrepresentation of minority participants. In engineering, the most prevalent attempt to address these issues is through the establishment of multicultural engineering programs (MEPs), often designed as partnerships between universities and major corporate entities. These programs strive to identify, recruit, retain, educate and ultimately employ significant numbers of students of color to strengthen industry innovation and competitiveness. This investigation was initiated to expand the limited research literature on MEPs and the nature of their partnerships with industry. Using qualitative methodology, an exploratory viewpoint, and the lens of the Commitment-Trust Key Mediating Variable Model (KMV) of Relationship Marketing, the relationships of five mature and highly regarded university MEPs and one of their self identified primary industry partners were examined. Leaders of the National Association of Multicultural Engineering Program Advocates, the national representative body for MEPs, identified exemplary MEPs in the organization's five regions; using a selection paradigm, five institutions were chosen for study selected from four of the regions. Each institution then identified a primary industry partner. Participants responded to in-depth interviews (MEPs) and questionnaires (industry) with respect to the nature, benefits, and challenges to both entities in the partnerships. Documents were reviewed for each program and industry. Responses were coded, crosschecked, and analyzed for patterns and themes. In particular, the study explored the issue of how commitment and trust are established in these partnership relationships. Twenty-four patterns and three themes emerged. Clearly, university-industry multicultural engineering partnerships are viewed as engendering important employment opportunities for underrepresented program graduates, promoting a well-developed pipeline of minority employee talent for industry, and increasing funding both for university multicultural programming and minority student support. The study also reports on the broad range of activities these partnerships practice. It suggests avenues for further study to enhance university-industry engagement. INDUSTRY – UNIVERSITY ENGAGEMENT IN MULTICULTURAL ENGINEERING PROGRAMS: AN EXPLORATORY STUDY by JACQUELINE M. GATSON B.A., Grambling State University, 2006 M.S., Kansas State University, 2008


Solid–liquid interdiffusion (SLID) bonding finds a wide variety of potential applications toward die-attach, hermetic encapsulation of microelectromechanical systems (MEMS) devices and 3-D heterogeneous integration. Unlike soft soldering technique, the solidification of intermetallic compound (IMC) formation in SLID bonding occurs during the process isothermally, making it difficult to predict and mitigate the sources of process-dependent thermomechanical stresses. Literature reports two dominant factors for the built-in stress in SLID bonds: volume shrinkage (due to IMC formation) and coefficient of thermal expansion (CTE) mismatch. This work provides a detailed investigation of the Cu–Sn SLID bonding process by finite element (FE) simulations. Specifically, the FE simulation of the SLID bonding process is divided into three steps: ramp-up, hold-time, and ramp-down stages to understand the stresses formed due to each individual step. Plastic material properties for Cu as well as temperature-dependent material parameters for different entities are assigned. Process-dependent thermomechanical stresses formed during the ramp-up and hold-time steps (IMC formation) were found not to be significant. The hold-time step is governed by the reaction and diffusion kinetics, which determines the bond line quality including defects, such as voids. The ramp-down step is the dominant phase influencing the final stress formations in the bonds. The results show an average of >30% decrease in the stress levels in Cu3Sn layer (IMC) when the bonding temperature is brought down from 320 °C to 200 °C, thus demonstrating the importance of low-temperature SLID process.


Abstract Objective Social media disorder (SMD) is an increasing problem, especially in adolescents. The lack of a consensual classification for SMD hinders the further development of the research field. The six components of Griffiths' biopsychosocial model of addiction have been the most widely used criteria to assess and diagnosis SMD. The Bergen social media addiction scale (BSMAS) based on Griffiths' six criteria is a widely used instrument to assess the symptoms and prevalence of SMD in populations. This study aims to: (1) determine the optimal cut-off point for the BSMAS to identify SMD among Chinese adolescents, and (2) evaluate the contribution of specific criteria to the diagnosis of SMD. Method Structured diagnostic interviews in a clinical sample (n = 252) were performed to determine the optimal clinical cut-off point for the BSMAS. The BSMAS was further used to investigate SMD in a community sample of 21,375 adolescents. Results The BSMAS score of 24 was determined as the best cut-off score based on the gold standards of clinical diagnosis. The estimated 12-month prevalence of SMD among Chinese adolescents was 3.5%. According to conditional inference trees analysis, the criteria "mood modification", "conflict", "withdrawal", and "relapse" showed the higher predictive power for SMD diagnosis. Conclusions Results suggest that a BSMAS score of 24 is the optimal clinical cut-off score for future research that measure SMD and its impact on health among adolescents. Furthermore, criteria of "mood modification", "conflict", "withdrawal", and "relapse" are the most relevant to the diagnosis of SMA in Chinese adolescents.


Alcohol problems are amongst the most stigmatised of conditions, resulting in multiple additional harms for people with alcohol use disorder. Alcohol stigma encompasses widely endorsed negative stereotypes leading to prejudice and discrimination towards people with alcohol use disorder. Self-stigma further harms individuals through preventing and undermining recovery. The persistence of alcohol stigma highlights the limitations of an illness model of alcohol use disorder for stigma reduction; in fact, many groups inadvertently reinforce stigma by emphasising the artificial line between 'normal' drinkers and the pathologised 'alcoholic other'. A public health case for alcohol stigma reduction highlights the need to address this societal false dichotomisation of problem drinkers. Promoting a continuum-aligned model of alcohol use disorder, a dynamic model of responsibility, and other evidence-led approaches such as person-first language by key stakeholders are recommended.


This retrospective study evaluates the impact of GM-CSF and interleukin 3 (IL-3) on bone marrow (BM) and peripheral blood (PB) cell recovery following autologous bone marrow transplantation (ABMT) with mafosfamide-purged BM in patients with lymphoid malignancies compared with a control group receiving no colony-stimulating factor. GM-CSF was administered at 250 micrograms/m2/day (8 patients) as a continuous infusion from day of autologous BMT until the absolute neutrophil count (ANC) reached 0.5 x 10(9)/l for 7 days or until day 30, whichever was first. IL-3 was administered daily starting on the first day of transplant at a dose of 1 microgram/kg/day (6 patients) and 5 micrograms/kg/day (6 patients) for 30 days. CFU-GM and BFU-E were sequentially evaluated in BM and PB at days 7, 14, 21, 28, and 56 post-graft. The neutrophil recovery (ANC > 0.5 x 10(9)/l) was significantly faster in the GM-CSF group compared with IL-3 5 micrograms, IL-3 1 microgram and control group (respectively, days 15, 21, 22, 24) (p < 0.05 to p < 0.01). Similarly, leukocyte recovery was faster in the GM-CSF group compared with control and IL-3 1 microgram groups (p < 0.01 and p < 0.05). No difference was noticed between the two IL-3 groups. Although no difference was observed in platelet recoveries (> 50 x 10(9)/l), it appeared that the GM-CSF group required more units of platelets than either the IL-3 1 microgram or 5 micrograms groups (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)


Introduction The present study aimed to investigate the prevalence and influential factors of thrombocytopaenia in systemic lupus erythematosus (SLE) patients among the Chinese population in order to provide evidence for improving the treatment and nursing of SLE patients. Methods A retrospective analysis of 3140 SLE patients admitted to two large tertiary hospitals was conducted in Anhui, China, from 2011 to 2018. In addition, the influential factors related to SLE with thrombocytopaenia were analysed through univariate and multivariate analysis. Results A total of 804 SLE patients had thrombocytopaenia (25.6%). The top 5 clinical manifestations of SLE inpatients were proteinuria (51.0%), lupus nephritis (45.9%), new rash (38.4%), haematuria (36.7%) and pyuria (32.2%). The incidence of neurological manifestations, oral mucosal ulceration, pleurisy, pericarditis, hyperglycaemia, leucocytopaenia, urinary casts, haematuria, pyuria and high disease activity in the thrombocytopaenia group were higher than those in the non-thrombocytopaenia group (p < 0.05). Multivariate analysis showed age (odds ratio (OR) = 1.009, p = 0.005), neurological manifestations (OR = 1.373, p = 0.048), pericarditis (OR = 1.394, p = 0.048), hyperglycaemia (OR = 1.717, p < 0.001), leucocytopaenia (OR = 2.551, p < 0.001), haematuria (OR = 1.582, p < 0.001), serum C3 level <0.85 g/L (OR = 1.525, p = 0.001), serum C4 concentration <0.10 g/L (OR = 1.287, p = 0.020), serum CRP concentration <8 ng/L (OR = 1.314, p = 0.005), prothrombin time >15.30 seconds (OR = 1.479, p = 0.032), activated partial thromboplatin time >45 seconds (OR = 1.924, p < 0.001) and thrombin time >21 seconds (OR = 1.629, p = 0.015) were associated with thrombocytopaenia. Conclusion Thrombocytopaenia has a high prevalence in SLE patients and is related to some baseline, clinical and laboratory characteristics, affecting multiple organs and systems.


The paper presents the main goals and achievements of the SmartGrids ERA-NET project named "Efficient Identification of Opportunities for Distributed Generation Based on the Smart Grid Technology (SmartGen)" during two years of project realization in Latvia.
 In the paper we proposed the basic principles of optimization of hydro power plant (HPP) working conditions under forecasted electricity prices and probabilistic water inflow values, as well as assessment of the impact of asynchronous generator connection to the existing network taking into account technical limitations.
 The developed model considers the most important technical parameters of HPP and the network, allowing to make HPP generation forecasts and its impact on the network using time-varying and constant input parameters. The mathematical model of a small scale HPP was developed for simulation of HPP electricity production and transient processes.
 The paper also includes the description and results of a case study performed to test the proposed mathematical model. The case study was carried out using the real distribution network part with the connected HPP. Different generation and load scenarios have been modelled. Load-generating interaction scenario modelling was implemented in the Matlab environment.
 The elaborated model can be used for representing a wide range of HPPs in electrical market and assessment analysis of the distribution network, as well as adapted for modelling of other types of power plants that use asynchronous generators.


This analysis demonstrates the application of autoregressive distributed lag (ARDL) models to gauge tax revenue performance in both the short term and the long term, as well as how to incorporate dummies to gauge changes following a popular semi-autonomous tax authority reform. To measure performance, we estimated tax buoyancy, defined as the percentage change in tax revenue in response to the percentage change in the tax base. Using data from 1979 to 2017 from annual economic reports and the United Nations University Government Revenue Dataset, the results show that personal income tax is the most productive of the direct taxes, while VAT is the most productive of the indirect taxes. However, underperforming customs duties estimates were evidence of deep-seated problems, calling for urgent intervention to curb tax evasion, fraud and corruption. Overall, estimates also suggest that tax revenue productivity improved following the tax reform, although the study could not fully credit the improvement to the reform itself.


Diphtheria toxin is a multi-domain protein that invades cells by using their own endocytosis mechanism. In endocytosis, an endosome, a lipid bilayer vesicle, is formed to encapsulate an extracellular molecule. Subsequent acidification of endosome internal solution induces conformational rearrangements and membrane insertion of such encapsulated diphtheria toxin translocation domain (T-domain). In solution at neutral pH, a stand-alone T-domain adopts an all alpha-helical globular structure; however, atomistic details of the pH-dependent conformational changes of the protein are not completely understood. We model structural rearrangements in T-domain in 18 µs long molecular dynamics (MD) simulations of neutral and low pH T-domain models in explicit solvent. At low pH, six histidine residues of the protein were protonated. Two independent MD trajectories resulted in partial protein unfolding at low pH, in which similar regions of the protein conformational subspace were explored. Notably, a pH induced unfolding transition was initiated by partial unfolding of helix TH4 followed by unfolding of helix TH1. Helix TH2 repeatedly unfolds in the low pH T-domain model, which is consequently predicted to be disordered by a consensus of disorder prediction algorithms. Protonation of histidines disrupted a hydrophobic core containing a putative transmembrane helix TH8, which is encircled by hydrophobic surfaces of helices TH3, TH5 and TH9. Afterwards, the low pH T-domain model was reorganized into an ensemble of partially unfolded structures with increased solvent exposure of hydrophobic and charged sites. Thus, MD simulations suggest the destabilizing role of protonation of histidines, in the neutral pH conformation in solution, which may facilitate the initial stages of T-domain membrane binding. The simulation at neutral pH samples conformations in the vicinity of the native structure of the protein. However, significant fluctuations of the protein, including unfolding and refolding of α-helices were observed at these simulation time-scales.


Community ecologists frequently assume that impacts of invasive species are negative, but this assertion is poorly supported in the literature. To test this, we surveyed 10 sites invaded with the biennial herb Alliaria petiolata (M. Bieb) Cavara and Grande and 3 uninvaded paired sites and tested species diversity between them. We found no significant differences in species diversity between the sites, thereby questioning the hypothesis that invasion causes biodiversity loss. Low biodiversity was instead correlated with human activity, suggesting that niche availability drives invasion in these sites. Nonetheless, invasion "time lag" may be a factor in these sites and long-term, established study is needed to determine effects of the garlic mustard over time.


In Western cultures, the future lies ahead; the past is behind us. It is hard for most Westerners to conceive of other ways of conceptualizing time. But at the Tokyo Evolutionary Linguistics Forum, researchers presented an example of another way of thinking—and gesturing—about time: The Yupno people, who inhabit a remote valley in Papua New Guinea, think of time topographically. No matter which way a speaker is facing, he or she will gesture uphill when discussing the future and point downhill when talking about the past.


In this paper the stability analysis and control synthesis problems for Networked Control Systems (NCS) with bounded transmission delays (constant and unknown or time-varying) are investigated. First, stability conditions for NCS described by ARMA models are established and a method for the determination of admissible delay range is developed. Then, a linear programming method for the design of linear state-feedback controllers guaranteeing the stability of the system for any delay belonging to a prespecified range is developed. Contrary to the usual approaches based on the use of quadratic Lyapunov functions, a polyhedral Lyapunov approach is adopted for both analysis and synthesis. A control synthesis numerical example is given to illustrate the reduction of conservatism of the tolerable delay range when compared to former results.


A brief review of Configuration Interaction (CI) and Correlated calculations is given. New techniques are presented that enhance the precision of CI calculations by several orders of magnitude and match or surpass the best available correlated calculations. These new techniques are based on the uncoupling of all the multi-dimensional integrations typical of these calculations into products of very simple one-dimensional integrals. As a result, not only are the results much more accurate but also the calculations are extremely simple and the computations are numerically very stable.


The decomposition of the cubic perovskite-type oxide Ba(x)Sr(1-x)Co(0.8)Fe(0.2)O(3-delta) (BSCF) into hexagonal and cubic perovskite-type phases has been examined by means of Scanning Electron Microscopy (SEM), Transmission Electron Microscopy (TEM), Selected Area Electron Diffraction (SAED) and X-Ray Diffraction (XRD). SEM and TEM measurements reveal that the new hexagonal phase grows predominantly at the grain boundaries of BSCF ceramics and that the cation composition of the newly formed hexagonal phase differs from that of the starting material. An orientational relationship between the hexagonal and the parent cubic phase was also observed. By means of ex situ XRD the phase fraction of the hexagonal phase was determined as a function of annealing time. A kinetic analysis of the data, based on Avrami-type kinetics, indicates that the decomposition is independent of the initial A-site composition, and the obtained reaction order supports the conclusion that the hexagonal phase grows at the grain boundaries in dense ceramic samples.


The adeno-associated virus type 2 (AAV) genome can be successfully rescued from recombinant plasmids following transfection in adenovirus-infected human cells. However, following rescue, the AAV genome undergoes preferential replication and encapsidation, whereas little replication and packaging of the vector DNA sequences occur. In view of the crucial role in the rescue, replication, and packaging of the proviral genome played by the AAV inverted terminal repeats (ITRs), which consist of a palindromic hairpin (HP) structure and a 20-nucleotide stretch, designated the D-sequence, that is not involved in the HP-formation, we evaluated the involvement of the individual ITRs as well as their components in the selective viral DNA replication and encapsidation. A number of recombinant AAV plasmids that contained deletions-substitutions in different regions of the individual ITRs were constructed and examined for their potential to allow rescue, replication, and/or packaging in adenovirus-infected human cells in vivo. The results reported here document that (ii) two HP structures and one D-sequence are sufficient for efficient rescue and preferential replication of the AAV DNA, (ii) two HP structures alone allow a low-level rescue and replication of the AAV DNA, but rescue and replication of the vector DNA sequences also occur in the absence of the D-sequences, (iii) one HP structure and two D-sequences, but not one HP structure and one D-sequence, also allow rescue and replication of the AAV as well as the vector DNA sequences, (iv) one HP structure alone or two D-sequences, but not one D-sequence alone, allow replication of the full-length plasmid DNA, but no rescue of the AAV genome occurs, (v) no rescue-replication occurs in the absence of the HP structures and the D-sequences, (vi) in the absence of the D-sequences, the HP structures are insufficient for successful encapsidation of the AAV genomes, and (vii) the AAV genomes containing only one ITR structure can be packaged into biologically active virions. Thus, the D-sequence plays a crucial role in the efficient rescue and selective replication and encapsidation of the AAV genome. Furthermore, the D-sequence specifically interacts with a hitherto unknown host-cell protein that we have designated the D-sequence-binding protein (D-BP). These studies illustrate that the D-sequence-D-BP interaction constitutes an important step in the AAV life cycle.


This paper, as its title suggests, introduces some reflections on the importance critical pedagogy as well as awareness-raising practices have in education today, especially in language teacher preparation programs, and how they provide a new opportunity for pre-service teachers to re-think their pedagogical experiences for social transformation. Critical pedagogy (CP) as a philosophy of life helps teachers achieve a better understanding of what teaching really entails and raising awareness fosters reflection regarding our practices in educational settings, starting in the language classroom, exploring on the one hand, what pre-service teachers think and perceive about teaching and learning in the context they are involved in, and on the other hand, how those perceptions might influence their educational practices.


Background: Direct oral anticoagulants (DOACs) are increasingly prescribed for the treatment of venous thromboembolism (VTE). However, little is known regarding pharmacists' practice patterns and preferences in clinical areas of contention, such as initiation dosing, obesity, and renal impairment. Objective: To determine pharmacist trends in practice regarding DOACs for the treatment of VTE overall and within areas of clinical controversy. Methods: An electronic survey was distributed to pharmacists in the United States through national and state pharmacy organizations. Responses were collected for 30 days. Results: One hundred fifty-three complete responses were submitted. The majority of pharmacists preferred apixaban (90.2%) for the oral treatment of venous thromboembolism. When initiating apixaban or rivaroxaban for a new VTE, 76% and 64% of pharmacists surveyed, respectively, state the duration of the initiation dose phases are reduced if the patient received parenteral anticoagulation. Fifty-eight percent of pharmacists used body mass index to evaluate the appropriateness of DOACs in obese patients whereas 42% used total body weight. Preference for rivaroxaban (31.4%) was higher in this population compared to the global population (10%). Apixaban was preferred for patients with renal impairment (92.2%). However, as creatinine clearance as calculated by the Cockcroft-Gault equation (CrCl) reduced to ≤15 milliliters/minute (mL/min), preference for warfarin increased (36%). Conclusion: This national survey of pharmacists demonstrated an overall preference for apixaban and significant variability in practice patterns regarding DOACs for patients with new VTE, patients with obesity, and patients with renal impairment. Further research is warranted to evaluate the efficacy and safety of DOAC initiation dosing phase modifications. Prospective evaluations of DOACs in obese and renal dysfunction populations would confirm the safety and efficacy of DOACs in these populations.


Kr-pok (kidney cancer-related POZ domain and Krüppel-like protein) is a new proto-oncogenic POZ-domain transcription factor. Fatty acid synthase gene (FASN) encodes one of the key enzymes in fatty acids synthesis and is the only enzyme that synthesizes fatty acids in cancer cells. Sp1 and SREBP-1c are the two major transcription activators of FASN. We investigated whether Kr-pok modulates transcription of the FASN. FASN expression is significantly decreased in Kr-pok knockout murine embryonic fibroblasts. Coimmunoprecipitation, GST fusion protein pull-down, and immunocytochemistry assays show that the zinc-finger domain of Kr-pok interacts directly with the bZIP DNA binding domain of SREBP-1. Electrophoretic mobility shift assay, oligonucleotide pull-down, and chromatin immunoprecipitation assays showed that Kr-pok changes the transcription factor binding dynamics of Sp1 and SREBP-1c to the SRE/E-box elements of the proximal promoter. We found that Kr-pok expression increased during 3T3-L1 preadipocyte differentiation and that FASN expression is decreased by the knockdown of Kr-pok. Kr-pok facilitates the SREBP-1c-mediated preadipocyte differentiation and/or fatty acid synthesis. Kr-pok may act as an important regulator of fatty acid synthesis and may induce rapid cancer cell proliferation by increasing palmitate synthesis.


Enhanced electron emission has been observed from lead zirconate- titanate (PZT) surfaces into which arrays of microcavities have been fabricated by nanopowder blasting. Arrays of microcavities, each having an elliptical cross-sectional geometry with major and minor axis lengths of 800 and 600 ?m, respectively, and depths adjustable from 40 to 300 ?m, exhibit a pronounced dependence of the emitter electron current on microcavity depth. For electric field strengths at the emitter surface of ~5-12 V/?m, the RMS current density generated by an array of 250 ?m-deep microcavities with a packing density of 214 + 2 cm -2 ranges from ~3 mA cm -2 to beyond 8 mA cm -2 , or more than a factor of five larger than that produced from a planar PZT surface.


The novel polyethylene glycol-grafted multiwalled carbon nanotube/sulfur (PEG-CNT/S) composite cathodes with nest-like structure are fabricated through a facile combination process of liquid phase deposition and self-assembly, which consist of the active material core of sulfur particle and the conductive shell of PEG-CNT network. The unique architecture not only provides a short and rapid charge transfer pathway to improve the reaction kinetics but also alleviates the volume expansion of sulfur during lithiation and minimizes the diffusion of intermediate polysulfides. Such an encouraging electrochemical environment ensures the excellent rate capability and high cycle stability. As a result, the as-prepared PEG-CNT/S composite with sulfur content of 75.9 wt % delivers an initial discharge capacity of 1191 and 897 mAh g(-1) after 200 cycles at 0.2 C with an average Coulombic efficiency of 99.5%. Even at a high rate of 2 C, an appreciable capacity of 723 mAh g(-1) can still be obtained.


In this work the multiply-differential cross section for electron-impact ionization is considered. A coplanar, equal-energy, fixed-relative angle kinematics is chosen and the particular case where the scattered and ionized electrons emerge perpendicular to each other is emphasized. It is shown how new structures arise in the spin non-resolved cross sections due to an interplay between single-binary collisions and the ratio of singlet to triplet scattering. We deduce that the angular behaviour of these structures in the spin non-resolved cross sections gives a direct hint as to the spin states occupied by the escaping electrons.


We report a computer simulation study of an electroneutral mixture of oppositely charged oblate ellipsoids of revolution with aspect ratio A=1/3. In contrast with hard or soft repulsive ellipsoids, which are purely nematic, this system exhibits a smectic-A phase in which charges of equal sign are counterintuitively packed in layers perpendicular to the nematic director.


Most communities of the world acculturate their own identity by the inculcation of art cultures into the spines of citizenry education. Right from the pre-school stage to higher level education, it has been observed that the Art knowledge contents have skewed away from the gate keepers' (Accreditation bodies) expectations and requirements in most schools today. The aim of this study is to evaluate the current art knowledge contents in the selected Universities' curricula in order to integrate the relevant art-knowledge ingredients into the architecture curricula in southwest Nigeria. The methodology employed qualitative-content analysis on the secondary data retrieved from the curriculum of schools, Community Charrette guidelines and art-oriented pedagogic activities. The results yielded pedagogic indices from Art-based curriculum integration, Tenets from hidden curriculum, Gestalt Acculturation experiences and architectural design studio exhibitions of works. The study recommended that relevant pedagogic knowledge Art-culture content (PKC) should be integrated pragmatically into the curricula of schools to preserve the art cultures in architectural Identity and design practices of the future professionals.


Abstract May Measurement Month (MMM) is an international screening campaign for arterial hypertension initiated by the International Society of Hypertension and endorsed by the World Hypertension League. Its aim is to raise the awareness of elevated blood pressure (BP) in the population worldwide. The goal of the present analyses is to assess the results obtained during three years of this campaign in Switzerland. Swiss data from MMM17 to MMM19 campaigns were used. BP and a questionnaire for basic demographic and clinical information were recorded for each participant. BP measurements and definition of arterial hypertension followed the standard MMM protocol. To assess BP control, European Society of Hypertension 2018 thresholds of <140/90 mmHg were used. Overall, 3635 participants had their BP measured, including 2423 women (66.7%) and 1212 (33.3%) men. More than half of the data came from pharmacies during MMM18 and MMM 19 campaigns. The difference in BP between pharmacies and other screenings sites was small. Overall, prevalence and awareness rates were 32.7% and 72.3%, respectively. Of those on medication, 60.9% were controlled, and of all hypertensive patients, 39.4% had controlled BP. In Switzerland, the prevalence of hypertension based on a 3-year awareness campaign was similar to previous epidemiological data within the country. One third of the population screened had hypertension, two thirds were aware of it, and less than half had controlled BP.


AIM
to study rates and possible causes of detecting "clean" coronary arteries at elective coronary angiography.

MATERIAL AND METHODS
Medical records of 711 patients who had undergone elective coronary angiography (ECAG) between 01/04 and 31/05 2014 were retrospectively reviewed. Four groups were distinguished: group 1 - patients with normal coronary arteries (n=234), group 2 - patients with coronary artery stenoses (CAS) <60% (n=94), group 3 - patients with 60-69% CAS (n=22), group 4 - patients with CAS more or equal 70% (n=361).

RESULTS
Most patients were men (p<0.001), except group 1, where women prevailed (p<0.05). Patients in groups 3 and 4 were older than in groups 1 and 2 (p=0.019). Symptoms of angina were less likely to be found in group 1 (p<0.001). History of myocardial infarction (MI) prevailed in group 4 (p<0.001). Arrhythmias were detected more frequently in group 1 (p<0.001); there were less diabetics in this group (p=0.010). Group 1 contained more patients examined before cardiac valve surgery (p<0.001). Typical angina was more often found in group 4, whereas atypical angina - in group 1 (p<0.001). Cardialgia prevailed in groups 1 and 2 (p<0.001). Holter ECG monitoring was used more frequently in group 1 (p<0.001). Symptoms of latent coronary insufficiency were mainly reported in group 1 (p=0.006). The pretest probability of ischemic heart disease (IHD) was higher in groups 2 and 4 compared to group 1 (p<0.001).

CONCLUSION
Among patients who had undergone ECAG 32.9% had no CAS. Younger females without history of MI and diabetes as well as patients with atypical angina or cardialgia prevailed in this group. This group of patients had the lowest pretest probability of IHD (58%). Patients without CAS were more often scheduled for EGAG before valvular heart surgery and because of cardiac arrhythmias.


the importance of mining by engaging in a more sustained discussion on how the Chinese experience of mining and appropriation of geology contribute to our understanding of broader issues such as labor-intensive industrialization. Despite these comments, Wu's account is one of the most important works to date to put German and Chinese history into conversation since William Kirby, Germany and Republican China , 1984. This is especially important given the tendency to overlook continental European perspectives in works on nineteenth-century Chinese history, and the growing historiography on German capitalism in the global context. The author's adept handling of the institutional complexities of nineteenth-century Germany combined with her sound knowledge of late imperial Chinese intellectual trends is a great strength of the work, and makes this a valuable contribution to the history of Asia-Europe relations and global business history.


Interacting and coordinated auxin transporter actions in plants underlie a flexible network that mobilizes auxin in response to many developmental and environmental changes encountered by these sessile organisms. The independent but synergistic activity of individual transporters can be differentially regulated at various levels. This invests auxin transport mechanisms with robust functional redundancy and added auxin flow capacity when needed. An evolutionary perspective clarifies the roles of the different transporter groups in plant development. Mathematical and functional analysis of elements of auxin transport makes it possible to rationalize the relative contributions of members of the respective transporter classes to the localized auxin transport streams that then underlie both preprogrammed developmental changes and reactions to environmental stimuli.


This report presents the analytical results of 2727-S NRDWS facility closure verification soil sampling and compares these results to clean closure criteria. The results of this comparison will determine if clean closure of the unit is regulatorily achievable. This report also serves to notify regulators that concentrations of some analytes at the site exceed sitewide background threshold levels (DOE-RL 1993b) and/or the limits of quantitation (LOQ). This report also presents a Model Toxics Control Act Cleanup (MTCA) (WAC 173-340) regulation health-based closure standard under which the unit can clean close in lieu of closure to background levels or LOQ in accordance with WAC 173-303-610. The health-based clean closure standard will be closure to MTCA Method B residential cleanup levels. This report reconciles all analyte concentrations reported above background or LOQ to this health-based cleanup standard. Regulator acceptance of the findings presented in this report will qualify the TSD unit for clean closure in accordance with WAC 173-303-610 without further TSD unit soil sampling, or soil removal and/or decontamination. Nondetected analytes require no further evaluation.


Foamy oil flow is commonly encountered in heavy oil production from homogeneous or heterogeneous (after cold heavy oil production with sands - CHOPS) reservoirs. This can be due to a drive mechanism in the primary production (depletion of methane saturated heavy-oil) and secondary stage (gas injection after primary production). In the primary stage, among other important parameters, pressure depletion rate has been reported to be the most critical characteristic to control this type of flow. In the secondary stage, gas amount and type (sole injection of methane, carbon dioxide, propane, or combination of these) and application conditions (soaking time on cyclic solvent injection durations, depletion rate) are critical. The cornerstone of the foamy oil behavior relies on its stability, which depends on parameters such as oil viscosity, temperature, dissolved gas ratio, pressure decline rate, and dissolved gas (solvent) composition. Although the process has been investigated and analyzed for different parameters in the literature, the optimal conditions for an effective and more economical process (mainly foamy oil stability) has not been thoroughly understood, especially for the secondary recovery conditions. In this study, air has been used as an ameliorative to improve foamy oil stability. Five pressure depletion tests divided into two cases were performed. Each pressure depletion test included eight independent pressure recordings obtained from pressure transducers distributed along a sandpack holder for 48 hours. In order to reach the optimal conditions of the applications, three different pressure depletion rates were tested at 0.23 psi, 0.51 psi/min, 1.53 psi/min, and air were tested as an ameliorative for foamy oil stability. We observed that increasing pressure depletion rates increase the formation of foamy oil, however, when pressure depletion rates were too high, it may cause a negative effect in the final oil recovery factor. We also observed that injecting air into the sandpack caused an increase in the heavy oil viscosity, and the subsequent injection of methane as a solvent became more effective in generating more stable foamy oil, which resulted in obtaining a higher oil recovery factor. This novel approach is expected to improve the understanding and the use of foamy oil mechanics and to achieve a higher foamy oil stability aiming to increase the final heavy oil recovery factor.


Note: The following is the notation used in this paper: ( . ) for decimals and ( ) for thousands. Summary National, state/provincial and municipal legislation regulating stormwater runoff in the United States and Canada have provided increased incentives for using permeable pavements. In addition, regulatory frameworks for implementation of sustainable design have embraced permeable pavement solutions. These regulations are often called low impact development (LID) or sustainable urban drainage systems (SUDS). A logical and technically sound design process using design software can support design professionals and help permeable pavement achieve full potential in North America. In 2008, the Interlocking Concrete Pavement Institute (ICPI) introduced a non-proprietary software program called Permeable Design Pro that integrates hydrological and structural design solutions for permeable interlocking concrete pavement. The hydrological analysis determines if the volume of water from user-selected rainfall events can be stored and released by the pavement structure. User defined parameters determine how much water infiltrates into the soil subgrade, enters pipe subdrains or flows from the pavement surface. The structural capacity of PICP is determined using the American Association of State Highway and Transportation Officials [AASHTO, 1993] structural design equations for base/subbase thickness to support vehicular traffic. This paper describes the development of the structural and hydrological design methodology with an example of its use.


We review research that provides a sociocultural perspective on proenvironmental support. Despite the increasing volume of psychological research on proenvironmental action, there has been a relative dearth of consideration of sociocultural contexts, which poses critical theoretical and practical limitations to understanding and fostering proenvironmental actions across diverse populations. The sociocultural perspective posits that the primary motives driving action are context dependent. Building on this perspective, our research examines significant divergence in key determinants of proenvironmental support, focusing on several sociocultural variables, including national culture (individualism-collectivism), socioeconomic status, and religion. This program of research shows that personal environmental beliefs more directly lead to proenvironmental support in sociocultural contexts that prioritize personal motives over social motives. In contrast, in contexts that prioritize social motives, social influence becomes a more important predictor of proenvironmental support. Solving environmental challenges requires leveraging psychological diversity to motivate people across the globe.


Summary

Physical characteristics of precrystallised binary mixtures of cocoa butter (CB) and 5, 10, 15, 20, 25 and 30% (w/w) cocoa butter replacer (CBR) or cocoa butter substitute (CBS) were determined. The lipid composition was obtained by chromatography and the solid fat content (SFC) by nuclear magnetic resonance. Tempering was carried out using a lab-scale agitated jacket vessel reactor. Bars made with tempered samples were submitted to X-ray diffraction and rupture tests. Snap values of crystallised mixtures decrease with an increase in the amount of alternative fat. X-ray diffraction patterns confirmed the predominant formation of the beta polymorph habit for CB and beta prime form for CBR and CBS. Mixtures of CB and CBR exhibit chemical compatibility. The knowledge of the snap values and of the variation of SFC with temperature proved to suffice to adequately anticipate the influence of the addition of alternative fats on chocolates physical attributes.


Summary: Synchronized akinete differentiation occurred following the transition from exponential to non-exponential (linear) growth, the major trigger being energy limitation. Young akinetes first accumulated cyanophycin, then developed a multilayered extracellular envelope and a thickened wall. The dry weight, chlorophyll a, glycogen and carbon contents of mature akinetes were greater than those of vegetative cells, while their contents of DNA, RNA, protein, phycocyanin and nitrogen were similar to those of vegetative cells. Akinetes were resistant to desiccation and low temperatures, but not to temperatures above the maximum for vegetative cell growth.
In N2-grown cultures heterocyst differentiation ceased at the end of exponential growth, while cell division continued, and akinetes first appeared in a regular pattern at a fixed distance (9 cells) from the nearest heterocyst. Exogenous NH4
+ inhibited the differentiation of heterocysts and, in their absence, akinetes developed in irregular positions. The regular spatial pattern imposed on akinete differentiation by heterocysts was, like the heterocyst spatial pattern itself, independent of N2 fixation. Similar changes in both patterns induced by 7-azatryptophan suggested that they share a common mechanism of control.


Patients with high-risk prostate cancer who undergo 18 months of androgen blockade live as long as those who have 36 months of treatment, according to results of a recent phase III study.


Density functional theoretical calculations are used to elucidate the epoxidation mechanism of styrene with a cytochrome P450 model Compound I, and the formation of side products. The reaction features multistate reactivity (MSR) with different spin states (doublet and quartet) and different electromeric situations having carbon radicals and cations, as well as iron(III) and iron(IV) oxidation states. The mechanisms involve state-specific product formation, as follows: a) The low-spin pathways lead to epoxide formation in effectively concerted mechanisms. b) The high-spin pathways have finite barriers for ring-closure and may have a sufficiently long lifetime to undergo rearrangement and lead to side products. c) The high-spin radical intermediate, (4)2(rad)-IV, has a ring closure barrier as small as the C--C rotation barrier. This intermediate will therefore lose stereochemistry and lead to a mixture of cis and trans epoxides. The barriers for the production of aldehyde and suicidal complexes are too high for this intermediate. d) The high-spin radical intermediate, (4)2(rad)-III, has a substantial ring closure barrier and may survive long enough time to lead to suicidal, phenacetaldehyde and 2-hydroxostyrene side products. e) The phenacetaldehyde and 2-hydroxostyrene products both originate from crossover from the (4)2(rad)-III radical intermediate to the cationic state, (4)2(cat,z(2) ). The process involves an N-protonated porphyrin intermediate that re-shuttles the proton back to the substrate to form either phenacetaldehyde or 2-hydroxostyrene products. This resembles the internally mediated NIH-shift observed during benzene hydroxylation.


INTRODUCTION :
Gastroesophageal Reflux disease (GERD) is a condition that arises
from reflux of gastric contents into the esophagus through the lower
esophageal sphincter causing symptoms and/or injury to esophageal or
extraesophageal structures. While normal people may experience reflux
symptoms once in a while, say for example after a heavy meal these are
usually infrequent and do not interefere with patients quality of life
nor do they cause significant esophageal injury. Pathological reflux
occurs when the esophageal defense mechanisms including acid
clearance and mucosal resistance are overwhelmed by the injurious
refluxate such as acid, pepsin, bile, duodenal contents. Lower Esophageal
Sphincter(LES) is the most important component of antireflux barrier
and is a tonically contracted smooth muscle of length 3-4cm located
at the gastroesophageal junction. Resting LES pressure varies between
10-30 mm Hg and its reserve is high since even a pressure of 5-10mmHg
can prevent reflux. Resting tone of LES is a function of both myogenic
and neurogenic components. Acetyl choline released from muscarinic
system is the predominant neurotransmitter in maintaining resting
LES tone. In addition the diaphragmatic contractions augment LES
pressure during inspiration. LES is designed naturally to prevent
reflux while at the same time it provides air venting through belching
mechanism by relaxing transiently, especially postprandially, called as
TLOSRs-Transient Lower esophageal Sphincter Relaxations. But, this
natural mechanism of belch which when severe and frequent causes
pathological reflux. TLOSRs are the predominant cause of GERD in
most cases of GERD while in 20% cases LES incompetence is the
causative factor.
Esophageal syndromes include syndromes which are typically not
associated with esophageal injury such as typical reflux syndrome,
reflux chest pain syndrome and syndromes associated with esophageal
injury such as endoscopic esophagitis, esophageal strictures, barretts
metaplasia, adenocarcinoma. extraesophageal syndromes with
established associations include reflux cough syndrome, laryngitis,
asthma, Dental erosions.
AIM :
To study the prevalence of gastroparesis in GERD patients and
assessment of the same by gastric scintigraphy and correlate it with
gastroparesis cardinal symptom index.
MATERIALS AND METHODS :
The study was conducted at Department of Medical
Gastroenterology Rajiv Gandhi Government General Hospital-Chennai
and Advanced Nuclear Medicine Research Institute-Chennai from Feb
2012 to Feb 2013 .In all patients history was taken and physical
examination done. Then they underwent baseline investigations
including complete blood count, fasting and post prandial blood sugar,
renal function test, ultrasound abdomen, upper gastrointestinal endoscopy
with grading of esophagitis when present, biopsy of lower esophagus
was taken if showing severe esophagitis or suspicious for baretts
esophagus. Two patients had already undergone 24h ambulatory pH
monitoring as part of evaluation outside. GERD was diagnosed by
symptomatic criteria – montreal definition(28/28), with the predominant
symptoms being heartburn, regurgitation, endoscopic criteria-LA
classification (3/28), biopsy criteria (2/28),24hpH criteria /Demeester
scoring (2/28).
CONCLUSIONS :
1. There is a significant prevalence of gastroparesis in gastroesophageal
reflux disease (10.7%).
2. All cases of gastroparesis detected in GERD patients were of mild
grade.
3. Fundal retention predominated over antral retention in cases with
gastroparesis (66.7% versus 33.3% ).
4. Gastroparesis was found predominantly in female patients (66.7%
vs33.3%).
5. The Correlation between gastroparesis Cardinal symptom index
and scintigraphic gastroparesis was not significant.


The present work had evaluated the efficiency of the pasteurization and the use of preservatives in mangos pulps (Mangifera indica L.) refrigerated. Before carrying out the treatments, the fruits had been cleaned in solution of sodium hypochlorite (NaOCl) at 100 mg. L-1, for 10 minutes. After the processing, it was carried out through the adjustment of pH of pulps for 3.0 and the adjustment of the water activity (Wa) at 0.95. The used variable had been the branching (hot water at 95 ± 5 oC, for 0 and 1 minute), the addition of sodium benzoate in the concentrations of 0; 200 and 500 mL.L-1 and, sulfite dioxide (SO2 ) in 0, 100 and 200 mL.L-1. Then the pulps had been packed in low density polyethylene (LDPE) bags of 0,060 mm (0.10 x 0.12 m - without free space and content of 500g of pulp) and, conditioned in at 20 ± 1 oC e 80 ± 3% of R.H, for 28 days. At the end of the experiment, the treatments not submitted to the branching had shown the biggest ascorbic acid levels. However, in these same treatments had been noticed intense microbiological activity and raised levels of pH. There aren't significant differences between the tested treatments in the titratable acidity (TA) and soluble solids (SS) analyses. Due to the absence of black spot in the pulps used during all the experimental period, it couldn't be detected the differences between the application of the SO2 and the use of the branching. The lower index of microbiological contamination and the preference of the judges in the sensorial panel had been attributed to the submitted treatments to the branching, addition of 500mL.L-1 of sodium benzoate and addition of 200mL.L-1 of sulfite dioxide.