We studied patterns of antenatal care in low- versus high-risk pregnancies in Lebanon comparing 538 women after delivery in urban Beirut with rural Baka'a. Most women had 9 antenatal care visits with an obstetrician, starting in the first trimester. Care for high-risk and low-risk pregnancies was similar in terms of type of provider, number of visits and timing of first visit. More high-risk women had advice about special diets, supplements and laboratory tests. Maternal and fetal outcomes showed that, controlling for area and pregnancy risk, more antenatal visits were associated with fewer preterm deliveries, more caesarean sections and fewer cases of postpartum depression. Overall, differences between risk groups were small.


Background The increase in Rheumatoid arthritis (RA) associated mortality is predominantly due to accelerated coronary artery and cerebrovascular atherosclerosis with increased risk of ischemic heart disease about 50% in patients RA compared to controls1. Objectives To study the pathogenesis of ischemic heart disease in RA, role of inflammatory cytokine interplay, disease activity and rheumatoid factor positivity. Methods Eighty RA patients and 44 healthy controls were included. All subjects were younger than 45 years for females and 55 years for males with exclusion of all traditional risk factors for atherosclerosis. Interleukin (IL) 1,6 and 18 were assessed in all subjects. RA patients fulfilled ACR/EULAR 2010 criteria2 and were subjected to Dobutamine-stress-echocardiography, diseases activity assessement by DAS-283, X-ray hands for Larcen score4 and function assessment by HAQ5. Results RA patients had significantly higher serum IL 1,6 and 18 than controls (p=0.00 in all). Thirty four (42.5%) patients had hypertensive reaction on Dobutamine-stress-echocardiography, four of them had ischemic change, and 46 (57.5%) had normal reaction. All patients with hypertensive reaction had positive RF (p=0.00), 10 had DAS-28>5.1, 20 had DAS-28 from 3.2 to5.1 and 4 were in remission (p=0.001). CRP was higher in patients with hypertensive reaction (p=0.003) while serum levels of IL1,6 and 18 showed no significant difference. In all patients, serum levels of IL1,6 and 18 showed significant positive correlation with VAS, HAQ and DAS-28 (p<0.001 in all). Only IL18 showed significant positive correlation with X-ray score in all patients. Conclusions Disease activity and RF positivity play an important risk factor for ischemic heart disease in RA. Serum levels of IL1,6 and 18 did not help much in detecting patients at risk of ischemic heart disease. Better control of RA disease activity with early remission helps in preventing cardiac complications. More studies on larger number of patients are needed for better understanding of mechanism of ischemic heart disease in RA. References Kaplan MJ. Cardiovascular complications of Rheumatoid Arthritis-Assessment, prevention and treatment. Rheum Dis Clin North Am 2010 May;36(2):405–426. Aletaha D, Neogi T, Silman AJ, et al., 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 201;69(9):1580–8. Prevoo ML, van 't Hof MA, Kuper HH, et al., Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 1995;38(1):44-8. Larsen A, Dale K, Eek M. Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Acta Radiol Diagn 1977;18:481–91. Pincus T, Yazici Y, Bergman M. Development of a multidimensional health assessment questionnaire (MD-HAQ) for the infrastructure of standard clinical care. Clin Exp Rheumatol 2005;23(Suppl.39):S19–28. Disclosure of Interest None declared


This preliminary study evaluated phenoxymethyl penicillin (Penicillin V) as an alternative to parenteral administration of penicillin in horses. Penicillin V was administered orally to five horses at two different doses and plasma levels of the drug were determined at timed intervals. The results were evaluated by regression analysis. Following the administration of penicillin V at a dose of 66,000 IU/kg or 110,000 IU/kg, the mean peak plasma levels obtained were 1.55 micrograms/mL and 2.34 micrograms/mL respectively. A plasma level two to four times above the minimal inhibitory concentration level of Streptococcus equi and Streptococcus zooepidemicus was maintained for 325 minutes at 66,000 IU/kg and 349 minutes at 110,000 IU/kg. Penicillin V given orally was thus shown to be an acceptable alternative to parenteral administration of penicillin in the horse.


The research objective was to determine the criminal liability against misleading advertising and law enforcement efforts against misleading advertising The experiment was conducted in the city of Samarinda, East Kalimantan province for 3 months. Research methods and techniques of research as follows: library research, field studies, and research papers. The results showed that: (1) the error is the principle of criminal responsibility adopted in Indonesia. Without the error on the creator himself, then it can not be criminal to him. Due to convict the perpetrator must be a mistake first. Liability which may be imposed against misleading advertising is to prove that there is an error on the sellers, advertising agencies and the media. So that they can be punished. Evidentiary difficulties faced, the necessary accountability necessary to deviate from the principle of error. With the application of the principle of accountability strict liability, vicarious liability and enterprise liability in the upcoming draft new Penal Code, then to ask the perpetrators to justice will not have problems, and (2) efforts as law enforcement against misleading advertising are: (a) implement the provisions of and sanctions that exist both in the Criminal Code and the law on Consumer Protection, (b) a sanction imposed should be firm and clear to be implemented, and (c) the Law in order to be effective, those who work as law executors should discharge their duty properly -good. They should use the law broadly. They must be interpreted uniformly and with the certainty that fixed.


Introduction: Gastric cancer is a malignant tumour with a fifth position amid all cancers and its mortality rate is third globally. The most common distant mode of metastasis is Peritoneal Dissemination (PD). There is a positive correlation between serum Cancer Antigen 125 (CA125) level and PD in cases of malignant gastric neoplasm. Aim: To study the demographic features, the macroscopic and microscopic features of malignant gastric neoplasm and the relation of serum CA125 level with PD in cases of gastric cancer. Materials and Methods: This cross-sectional observational study was conducted for two years from January, 2018 to January, 2020 on 120 cases at Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal (India). Detailed history taking, clinical examination, routine investigation was done. Peripheral blood sample for CA125 assay was collected. PD was identified through Ultrasonography (USG) or Computed Tomography (CT) or intraoperatively during open surgery. The gastrectomy specimens were sent for gross examination, staging and histopathology. Microsoft excel 2016 and SPSS 18 was used. Chi-square test was used for the comparison between the groups. A p-value of <0.05 was considered significant. The sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) were used for elective assessment. Results: This study comprised 120 cases with mean age of presentation as 54.3 years and male: female ratio of 2.3:1. Fifty cases (41.6%) were identified as tubular (solid)-poorly differentiated adenocarcinoma with 59 cases (49.2%) of stage IIIA and 52 cases (43.3%) of stage IV. The sensitivity and specificity of CA125 was 81.8% and 85.7%. The PPV and NPV were 56.2% and 95.4%. Conclusion: Early detection of peritoneal disease will help the clinicians to stratify the treatment of gastric cancers. Higher sensitivity suggests that preoperative serum CA125 is a promising tool to predict PD which aids in subsequent alternative mode of treatment, lesser morbidity and better survival of patients.


Preantral and small antral follicles may secret anti-Müllerian hormone (AMH) to control gonadotrophin secretion from ruminant gonadotrophs. The present study investigated whether the main receptor for AMH, AMH receptor type 2 (AMHR2), is expressed in gonadotrophs of postpubertal heifers to control gonadotrophin secretion. Expression of AMHR2 mRNA was detected in anterior pituitaries (APs) of postpubertal heifers using reverse transcription-polymerase chain reaction. An anti-AMHR2 chicken antibody was developed against the extracellular region near the N-terminus of bovine AMHR2. Western blotting using this antibody detected the expression of AMHR2 protein in APs. Immunofluorescence microscopy using the same antibody visualised colocalisation of AMHR2 with gonadotrophin-releasing hormone (GnRH) receptor on the plasma membrane of gonadotrophs. AP cells were cultured for 3.5 days and then treated with increasing concentrations (0, 1, 10, 100, or 1000pgmL-1) of AMH. AMH (10-1000pgmL-1) stimulated (P<0.05) basal FSH secretion. In addition, AMH (100-1000pgmL-1) weakly stimulated (P<0.05) basal LH secretion. AMH (100-1000pgmL-1) inhibited GnRH-induced FSH secretion, but not GnRH-induced LH secretion, in AP cells. In conclusion, AMHR2 is expressed in gonadotrophs of postpubertal heifers to control gonadotrophin secretion.


Five methods of dosing vancomycin (Matzke, Moellering, Nielsen, Lake‐Peterson, and manufacturer's) were simulated in 37 patients. Ten serum samples were obtained after a 1–hour intravenous infusion of 6.2–20 mg/kg total body weight. A preinfusion serum sample was obtained from patients not studied on the first dose. Initial estimates of pharmacokinetic values were made using nonlinear iterative least squares regression and serum concentration‐time data. These data were fitted to a two‐compartment, open‐infusion model. Simulations of the peak and trough serum concentrations at steady state for each patient were determined by multiple‐dose simulated pharmacokinetics and each patient's pharmacokinetic values using the regimen suggested by each of the five methods. Steady‐state serum concentrations, predicted systemic clearance by each method (except Lake‐Peterson), and the daily dose for each patient recommended by each method were determined. All the methods underpredicted actual drug clearance, with the Nielsen method having the lowest prediction. The Matzke method recommended the largest dosage. Using each of the methods, only 3–16% of patients would have achieved recommended peak and trough serum concentrations. In the simulation model used, no method performed satisfactorily in attaining the desired vancomycin peak and trough concentrations. We suggest that the Lake‐Peterson method could be used initially, provided that monitoring is also performed to adjust the dosage regimen further.


Quality of life of people with dementia and their family carers is strongly influenced by interpersonal issues and personal resources. In this context, relationship quality (RQ) and sense of coherence (SOC) potentially protect and promote health. We aimed to identify what influences RQ in dyads of people with dementia and their carers and to examine differences in their perspectives.


The novel Ni-P/TiO2 composite films with different phosphorus contents were coated to the mild steels using the electroless nickel plating and sol-gel technique, and denoted as Ni-LP/TiO2, Ni-MP/TiO2 and Ni-HP/TiO2, respectively. The structure and chemical composition of Ni-P/TiO2 composite films were investigated using X-ray diffraction (XRD), environmental scanning transmission electron microscopy (ESEM) and energy dispersive X-ray spectrometer (EDX). The anti-corrosion performance of the composite film was characterized by potentiodynamic polarization technique and the polarization resistance measurement. The corrosion resistances of Ni-P/TiO2 composite films are better than that of Ni-P coatings. The corrosion resistance of Ni-P/TiO2 composite film increases with the increasing in phosphous content of Ni-P coating. The Ni-HP/TiO2 composite film possesses more excellent anti-corrosion performance than Ni-LP/TiO2 and Ni-MP/TiO2 films. The self-corrosion current density (icorr) of Ni-HP/TiO2composite film in 0.5 mol/L sulfuric acid is 3.15 μA·cm-2, which is 40% and 62% of that of Ni-LP/TiO2 and Ni-MP/TiO2 composite films, respectively. Its polarization resistance (Rp) is 11.72 kΩ·cm2, about 1.5 and 1.3 times that of Ni-LP/TiO2 and Ni-MP/TiO2 composite films, respectively. Compared to Ni-LP/TiO2 and Ni-MP/TiO2 composite films, it can be seen that Ni-HP/TiO2 composite film has a better corrosion resistance.


This study aimed to develop a practical toolkit to support non-government organizations (NGOs) in tackling health inequalities in the UK and to highlight the challenges and lessons learned. A mixed qualitative methodology within an action research framework was conducted. Semi-structured questionnaires, focus group interviews and discussions with an expert reference group aimed to identify the important themes and produce the toolkit content. A practical guide of information materials for NGOs working on addressing health inequalities was subsequently developed and successfully piloted. The experience of using participatory action research revealed a number of lessons and challenges. The key challenges were lack of training and experience in conducting action research, costs and insufficient resources, slow and time-consuming process, lack of commitment from marginalized groups, and differences in emphasis of goals and vision among participants. The main lessons learned were importance of effective leadership and project management skills, importance of integrating researchers and the researched as equal partners, creation and nurturing of trust, importance of evaluating and piloting processes, importance of engaging with marginalized groups, and use of evidence base in decision making. The lessons and challenges enumerating herein are of value to researchers aiming to implement participatory action research in developing checklists, tools, practical guidance and frameworks, and they offer important areas to consider before starting such projects. In addition, this offers an insight into how the dynamics of participatory action research methodology evolved in the development of the toolkit. Future research and initiatives in this area should focus on ways to improve the toolkit and make it more relevant to a wider community, and methods for evaluating the impact of the toolkit on practice.


Residual networks (ResNets) with an identity shortcut have been widely used in various computer vision tasks due to their compelling performance and simple design. In this paper we revisit ResNet identity shortcut and propose RGSNets which are based on a new nonlinear ReLU Group Normalization (RG) shortcut, outperforming the existing ResNet by a relatively large margin. Our work is inspired by previous findings that there is a trade-off between representational power and gradient stability in deep networks and that the identity shortcut reduces the representational power. Our proposed nonlinear RG shortcut can contribute to effectively utilizing the representational power of relatively shallow networks and outperform much (3 or 4 times) deeper ResNets, which demonstrates the high efficiency of RG shortcut. Moreover, we have explored variations of RGSNets, and our experimental result shows that Res-RGSNet combining the proposed RG shortcut with the existing identity shortcut achieves the best performance and is robust to network depth. Our code and models are publicly available on our website.


The paper serves to place the software (SCROP60) in the public domain. A guide on how to operate it and its hardware requirements is discussed. A neoclassical general equilibrium example using the software is then presented to analyze (1) changes in initial endowments and (2) a corporate income tax problem and the attendant welfare issues involved.


OBJECTIVE
Determine the multiparametric magnetic resonance imaging (mpMRI) appearance of the prostate following focal laser ablation (FLA) for PCa and to identify imaging characteristics associated with recurrent disease.

METHODS
Retrospective analysis of patients who underwent FLA for low-intermediate risk PCa between 2010 and 2014 was performed. Early (median 4 months) and late mpMRI (median 49 months) follow-up were qualitatively assessed for T2-weighted, dynamic contrast enhanced (DCE) and diffusion weighted imaging (DWI) appearances and also compared to corresponding PSA values and biopsy results.

RESULTS
55 cancers were treated in 54 men (mean age 61.0 years). Early mpMRI was performed in 30 (54.5%) patients while late follow-up mpMRI in 42 (84%). Ill-defined scarring with and without atrophy at the treatment site were the most common appearances. In patients with paired MRI and biopsy, one of four patients with clinically significant PCa on biopsy (≥GG2 or≥6 mm GG1) showed hyperenhancement or restricted diffusion at early follow-up. At late follow-up, positive biopsies were seen in 5/8 (63%) cases with hyperenhancement and 5/6 (83%) cases with restricted diffusion at the treatment site. PSA change was not associated with biopsy results at either time point.

CONCLUSION
mpMRI is able to document the morphological and temporal changes following focal therapy. It has limited ability to detect recurrent disease in early months following treatment. Late-term mpMRI is sensitive at identifying patients with recurrent disease. Small sample size is, however, a limitation of the study.

ADVANCES IN KNOWLEDGE
Implementing MRI in follow-up after FT may be useful in predicting residual or recurrent PCa and therefore provide reliable outcome data.


Spoken languages are similar phonetically because humans have a common vocal production system. However, each language has a unique phonetic repertoire and phonotactic rule. In cross-lingual voice conversion, source speaker and target speaker speak different languages. The challenge is how to project the speaker identity of the source speaker to that of the target across two different phonetic systems. A typical voice conversion system employs a generator-vocoder pipeline, where the generator is responsible for conversion, and the vocoder is for waveform reconstruction. We propose a novel Multi-Task WaveRNN with an integrated architecture for cross-lingual voice conversion. The WaveRNN is trained on two sets of monolingual data via a two-task learning. The integrated architecture takes linguistic features as input and outputs speech waveform directly. Voice conversion experiments are conducted between English and Mandarin, which confirm the effectiveness of the proposed method in terms of speech quality and speaker similarity.


There is a desperate need for safe and effective vaccines, therapies, and diagnostics for SARS– coronavirus 2 (CoV-2), the development of which will be aided by the discovery of potent and selective antibodies against relevant viral epitopes. Human phage display technology has revolutionized the process of identifying and optimizing antibodies, providing facile entry points for further applications. Herein, we use this technology to search for antibodies targeting the receptor-binding domain (RBD) of CoV-2. Specifically, we screened a naïve human semisynthetic phage library against RBD, leading to the identification of a high-affinity single-chain fragment variable region (scFv). The scFv was further engineered into two other antibody formats (scFv-Fc and IgG1). All three antibody formats showed high binding specificity to CoV-2 RBD and the spike antigens in different assay systems. Flow cytometry analysis demonstrated specific binding of the IgG1 format to cells expressing membrane-bound CoV-2 spike protein. Docking studies revealed that the scFv recognizes an epitope that partially overlaps with angiotensin-converting enzyme 2 (ACE2)–interacting sites on the CoV-2 RBD. Given its high specificity and affinity, we anticipate that these anti-CoV-2 antibodies will be useful as valuable reagents for accessing the antigenicity of vaccine candidates, as well as developing antibody-based therapeutics and diagnostics for CoV-2.


PURPOSE
To assess the computed tomographic (CT) findings of intrathoracic involvement in multicentric Castleman disease.

MATERIALS AND METHODS
The study comprised 12 patients with lymph node biopsy-proved Castleman disease and multicentric involvement. The patients were aged 23-58 years (mean age, 42.9 years; five men, seven women). Seven patients underwent open lung biopsy (n = 3) or transbronchial lung biopsy (n = 4), which demonstrated lymphocytic interstitial pneumonitis.

RESULTS
All patients had systemic symptoms, polyclonal hypergammaglobulinemia, and bilateral hilar and mediastinal lymph node enlargement. The nodes showed mild to moderate enhancement after intravenous administration of contrast material. At thin-section CT, all 12 patients showed poorly defined centrilobular nodules. Thin-walled cysts were present in 10 patients, thickening of the bronchovascular bundles in 10, and interlobular septal thickening in nine. Less common findings were subpleural nodules, ground-glass attenuation, air-space consolidation, and bronchiectasis.

CONCLUSION
Multicentric Castleman disease is characterized by the presence of systemic symptoms, bilateral hilar and mediastinal lymphadenopathy, and centrilobular nodular opacities. The pulmonary parenchymal findings are due to the associated lymphocytic interstitial pneumonitis.


Purpose of reviewPatients born with congenital adrenal hyperplasia (CAH), the majority of which is 21-hydroxylase deficiency (21OHD), have been studied by pediatric endocrinologists for decades and treated successfully since the pioneering work of Lawson Wilkins. As is the case for other previously fatal diseases of childhood, such as type 1 diabetes mellitus and cystic fibrosis, these children are now surviving into adulthood. This success has created a new clinical entity, for which the natural history and optimal management strategies are not known. Recent findingsLongitudinal and cross-sectional studies of adults with CAH have begun to emerge from a few centers. The major challenges faced by these patients include infertility, neoplasia, and consequences of chronic glucocorticoid therapy. SummaryThe treatment goals of the adult with CAH differ from those for children, and data from specialized centers have identified some of the major issues guiding management. More data and better therapies for these patients are sorely needed.


Abstract Superplasticity refers to the ability of a polycrystalline solid to exhibit a high elongation, of at least 400% or more, when testing in tension. The basic characteristics of superplastic flow are now understood and a theoretical model is available to describe the flow process both in conventional superplastic materials where the grain sizes are a few micrometers and in ultrafinegrained materials processed by severe plastic deformation where the grain sizes are in the submicrometer range. This report describes the basic characteristics of superplastic metals, gives examples of flow in ultrafine-grained materials, demonstrates the use of deformation mechanism mapping for providing a visual display of the flow processes and provides a direct comparison with the conventional model for superplastic flow. The report also describes the potential for using nanoindentation to obtain detailed information on the flow properties using only exceptionally small samples.


Since 2013, the Instituto Betty e Jacob Lafer has funded projects by civil society organisations in two priority areas: management and innovation in public policies, and reducing inequalities in the justice system. In this article, the author, who is one of the Institute's directors, discusses the social investment scene in Brazil and the reasons that led her family to concentrate their efforts in these two areas.


There is a need in medical and physiological instrumentation for a system that can automatically correct baseline shifts. Some cases where this need arises are discussed. A self-balancing system that can be used as a general-purpose unit has been developed and is described. It consists of a binary counter, a digital to analog converter, and logic circuits. The described system automatically balances dc shifts in signals with a range of 6 V. Balancing time is less than 15 ms. The system is designed to work with tape or chart recorders with input range of ± 1 to ± 3 V. Some design parameters of this system are discussed briefly.


Background: The current manual assessment leads to numerous weaknesses. This study demonstrates the fact that there are many opportunities and challenges that face the introduction of item banking in Kenya. Aim: This study was investigating the possible opportunities and challenges of the introduction of item banking in Kenya. The study focused on the Kenya National Examination Council staff and primary school teachers. Method: This was a descriptive study with data collected using questionnaires, focused group discussions, oral interviews and source documents from the institutions. Validity of the tools was established by piloting the tools to determine their consistency among a few study respondents. This enabled the researcher to get a deeper understanding of the topic and come up with very independent opinion on the area of study. Automatic inclusion, purposive sampling and random sampling were employed in sampling all respondents. The data was analyzed descriptively with the use of SPSS and the findings are presented in figures, tables and percentages. Findings: Two major findings of the study were the lack of adherence to internationally set criteria for item banking by the national examiner in developing KCPE test items. Low skill levels among education practitioners in use of item banking. Conclusion: There is urgent need for the national examiner to embrace technology in assessment of KCPE. This will be in tandem with the changes in assessment practice world over.


Abstract To compare the clinical outcomes of linezolid and vancomycin regimens combined with one-stage surgery in treating traumatic osteomyelitis of the limbs caused by methicillin-resistant Staphylococcus aureus (MRSA) infection. A retrospective study was performed to analyze patients with traumatic osteomyelitis of the limbs attributable to MRSA infection. All of these patients received one-stage surgery to debride their wounds, with subsequent implantation of a vancomycin-loaded calcium sulfate artificial bone. Patients received either intravenous linezolid (study group) or vancomycin (control group) during the perioperative period. The postoperative inflammatory markers, renal function, duration of drainage catheter placement, duration of antibiotic administration, length of hospital stay, adverse events, and recurrence of osteomyelitis in these two groups were compared. The study group had a shorter duration of antibiotic administration and length of hospital stay (p < 0.05). There was a significant difference in the incidences of adverse events between the two groups (5.88% and 17.65% in the study and control groups, respectively, p < 0.05). There was no recurrence in either group during the three-year follow-up period. As of year, five after the surgery, one patient in the control group had a recurrence of osteomyelitis. The linezolid regimen should be preferred to the vancomycin regimen in patients with traumatic osteomyelitis of the extremities caused by MRSA infection because the linezolid regimen showed fewer adverse events, shorter periods of antibiotic use, and shorter hospital stay. However, both treatment regimens achieved satisfactory outcomes and warranted further investigations.


The progress of the network and device technologies enables any device to be connected to the Internet thereby forming an Internet of Things (IoT) architecture. Internet-related activities based on the IoT services can inevitably generate a lot of real-time data which leads a big data phenomenon. To efficiently handle such big IoT data, software-defined networking (SDN) techniques could come into play. Among SDN techniques, P4 is a highlevel language for programming protocol-independent packet processors. This paper presents our preliminary work on how we can use P4 to achieve flexible datapath programming for large scale IoT streaming data streaming. As a case study, we describe the implementation of dynamic MST-based datapath programing for IoT data collection in an arbitrary network topology.


The purpose of this study was to investigate improvement of food habits and eating behavior in children with obesity and precocious puberty by nutritional education monitoring. The results are as follows. Average height and weight of subjects exceeded Korean height and weight standards for children as outlined by The Korea Pediatric Society. Using nutrition education monitoring, meals became more regular, overeating significantly decreased, and eating speed decreased. Further, frequencies of eating-out and night-eating significantly decreased. The most preferred menu item when eating-out was Korean food, and the most preferred menu item for night-eating was fruits, fast food, & processed food. Meat & fish and vegetable intakes all significantly increased. Fruit and milk intakes also significantly increased while bread, snack, and ice cream intakes decreased. Further, fast food & instant food intakes decreased. However, water intake was not significantly affected. The favorite food of children was meat & fish, followed by fast food & processed food. This study may provide information on dietary behavior of children with obesity and precocious puberty and suggests that nutrition education or counseling can improve food habits and eating behavior.


For plants with sensor failures, this paper presents a new design method for a self-repairing control system (SRCS) with the FitzHugh–Nagumo (FHN) model. The FHN equation is well-known as the mathematical model which represents various electrical behaviors in membrane excitation. The proposed SRCS exploits this model as a fault detection filter. By monitoring a spike caused by an abnormal signal from the sensor, the faulty sensor can be detected and replaced with the healthy backup so as to maintain the stability of the control system. Furthermore, to confirm the effectiveness of the proposed SRCS, several numerical simulations are explored.


Background: During they work, mobile population must separate from their spouse in a long time, makes them tending to have extramarital sexual relationship. Objective: To describe the high risk sexual behavior and prevention of STD and HIV among mobile population. Methode: Respondents were 825 in size selected purposively in northern coast of Java and North Sumatra, then interviewed using structure questionnaire, while subsample were questioned in-depthly. They were truck and bus drivers, assistant of truck and bus drivers, fishermen or sailormen. Result: Majority of respondents had middle education level (70%) and were married (75%), while their average monthly income was one million rupiah. Nearly half confessed of having extramarital sexual relationship, although only below 20% used condom recently. This unsafe sex was done with casual partner such as sex worker, girl friends or just friends. Their access to get condom or adequate STD treatment were limited. Easy accessed health facility unit was very few. Information about STD and HIV&AIDS majority was from television. Conclusion: This low knowledge level on STD and HIV&AIDS including its treatment might increase the transmission of these diseases from mobile to general population. Providing health service unit close to shelter or terminal of bus and truck, or sea-port, would improve access to information of STD and HIV&AIDS as well as its treatment, besides disseminating it through popular media such as television. Keywords: mobile population, unsafe sex


Objective: The purpose of the study was to find out the impact of employee empowerment, team work, bank facilities, training, performance appraisal and quality performance upon job satisfaction of employees that how would these factors affect employees' job satisfaction in banking sector of Nepal. Methodology: Data was collected through questionnaire and the questionnaire was distributed among 200 employees of twenty eight commercial banks. Random sampling technique was applied in this procedure. Correlation coefficient and regression were used to analyze and interpret the data. Results and Conclusion: Regression analysis showed that employee empowerment, team work, and bank facilities affect positively whereas training, performance appraisal and quality performance affect adversely on the job satisfaction level of employees. There exists a positive relation overall and boost job satisfaction, which would in turn enhance the productivity of the organization. Article type: Research Paper


This paper attempts to substitute Resource Leveling Problem (RLP) into multi-project environment and construct Resource Leveling Problem of Multi-project (RLPMP) model with the goal of minimizing the sum of weighted mean square deviations of multi-resource requirements. A two-stage hybrid differential evolution particle swarm optimization algorithm is used to solve the model. In the first stage, differential evolution algorithm is used to produce new individuals, and in the second stage, particle swarm optimization algorithm uses a new speed update formula. In the first stage, in order to ensure that the optimal individual will not be destroyed by crossover and mutation, and to maintain the convergence of differential evolution algorithm, we try to introduce Elitist reservation (ER) strategy into differential evolution algorithm. In the second stage, we use a kind of Particle Swarm Optimization (PSO) algorithm with dynamic inertia weight. Through the dynamic change of inertia weight, the global search and local search ability of the algorithm can be adjusted flexibly. The case verification shows that the hybrid differential evolution particle swarm optimization algorithm can effectively solve the RLPMP model, and then effectively improve the balance of multi-project resources.


A new analytical methodology for neutral derivatives of chloroacetanilides made it possible to detect, for the first time in a European groundwater monitoring campaign, three metabolites (hydroxymetolachlor, metolachlor morpholinone and deschlorometolachlor) in addition to ethane sulfonic acid (ESA) and oxanilic acid (OXA) metabolites, which were first detected in 2009. The analytical method involves solid phase extraction and ultra-high-performance liquid chromatography with tandem mass spectrometry (UPLC-MS/MS). Recoveries ranged from 64 to 101%, and limits of quantification were validated at 5, 10 or 20 ng/L, depending on the molecule, in natural water. Most of the chloroacetanilide metabolites were synthesised, as many standards are not commercially available.


The purpose of this study is to examine and analyze the role of the Prosecutor's Office in handling criminal acts of corruption judicially. In this paper the author uses a normative juridical method. Based on the research, it can be concluded that the duties and functions of the prosecutor as an investigator of criminal acts of corruption are in accordance with the provisions of Article 284 paragraph (2) of the Criminal Procedure Code, the Prosecutor is still authorized to carry out investigations of special crimes in this case corruption. Eradication of corruption is to rely on the consistent treatment of Law on the eradication of corruption. 20 of 2001 concerning amendments to Act No. 31 of 1999 concerning the eradication of corruption. The prosecutor as an investigator concurrently serves as a public prosecutor in handling corruption crimes. Exceptions based on Article 284 paragraph (2) of the Criminal Procedure Code. The Criminal Procedure Code has relinquished the investigative authority from the prosecutor's office, and has been fully assigned to the police


In this paper, we develop a qualitative theory of influence diagrams that can be used to model and solve sequential decision making tasks when only qualitative (or imprecise) information is available. Our approach is based on an order-of-magnitude approximation of both probabilities and utilities and allows for specifying partially ordered preferences via sets of utility values. We also propose a dedicated variable elimination algorithm that can be applied for solving order-of-magnitude influence diagrams.


The simSUNDT software is based on a previous developed program (SUNDT). The latest version has been customized in order to generate realistic synthetic data (including a grain noise model), compatible with a number of off-line analysis software. The software consists of a Windows®-based preprocessor and postprocessor together with a mathematical kernel (UTDefect), dealing with the actual mathematical modeling. The model employs various integral transforms and integral equation and enables simulations of the entire ultrasonic testing situation. The model is completely three-dimensional though the simulated component is two-dimensional, bounded by the scanning surface and a planar back surface as an option. It is of great importance that inspection methods that are applied are proper validated and that their capability of detection of cracks and defects are quantified. In order to achieve this, statistical methods such as Probability of Detection (POD) often are applied, with the ambition to estimate the detectability as a function of defect size. Despite the fact that the proposed procedure with the utilization of test pieces is very expensive, it also tends to introduce a number of possible misalignments between the actual NDT situation that is to be performed and the proposed experimental simulation. The presentation will describe the developed model that will enable simulation of a phased array NDT inspection and the ambition to use this simulation software to generate POD information. The paper also includes the most recent developments of the model including some initial experimental validation of the phased array probe model. © 2010 American Institute of Physics.


Background: For the stabilization of vertebral fractures and luxations are proposed various techniques, with an association of Steinmann pins and bone cement preferred. Implant failure or migration can occur as a late complication of spinal stabilization as well as breaking pins and cerclage wires. The actual incidence of migration of metallic fixation pins and wires is unknown, although the complication has been well documented being sometimes even associated with the death of the patient. The present report aims to describe the use of laparoscopy in removing a Steinmann pin the muscles of the abdominal wall, adjacent to the peritoneal cavity in a dog. Case: A canine mixed breed, female, 1.5 years old, was attended with a history of hit by motor vehicles and after medical and neurological examination was submitted to radiographic examination, evidencing fracture and dislocation of the sixth lumbar vertebra, with cranio-ventral displacement the caudal fragment of the body of the sixth lumbar vertebra. Then underwent surgery to stabilize the spine. For that, was elected segmental spinal fixation modified by applying pins and cerclage wires on spinous processes and facet joints to stabilize the vertebral segments. Two months after the stabilization column radiographic examination control was observed the presence of radiopaque metallic structure, located between L2-L3 in the left flank region. After the placing of three-port laparoscopic, were inspected abdominal cavity and found out adhesion of the omentum in the midline, being obtained adhesiolysis with Kelly forceps and Metzenbaum scissors. The Steinmann pin tip is designed found in the transversus abdominis muscle, requiring therefore the muscle incision for removal of the implant. Once the absence of hemorrhage was verified, the cavity was deflated, and the wounds sutured into muscle and subcutaneous level in Sultan access pattern with 2-0 polyglactin 910. The skin was occluded with a 4-0 monofilament nylon simple interrupted pattern. The surgery had a duration 34 min and there were no trans or postoperative complications associated with the procedure. The animal was discharged 24 h after surgery, and at the end of 10 days, the patient was clinically stable with good wound healing access. Discussion: Migration of orthopedic fixation pins is unusual, but when it occurs, may result in serious consequences. Thus, it is indicated removal of the implant to prevent neurological deterioration or penetration of vital structures. In this report the animal was asymptomatic and the foreign body was an incidental finding of radiographic examination for vertebral stabilization control. Patient in this report, at the moment it was found possible intracavitary implant projection, we opted for the location and removal of it by laparoscopy, since laparoscopic surgery is associated with better and faster postoperative recovery, as well as lower production of painful stimulus, magnification of images and the possibility of wide-ranging exploration of the peritoneal cavity. The patient follow-up with periodic radiographs is essential, confirming the stability of fixation, if any pin migration, removal should be performed urgently, independently of absence of clinical signs. It is concluded therefore that videolaraposcopia can be considered as effective diagnostic and therapeutic tool for removing Steinmann that migrate into the abdominal cavity or surrounding thereof.


454092, Russia Abstract Cardiovascular disease (CVD) and oncological diseases are the leading causes of death in the world. The widespread use of cardiovascular drugs makes it important to study their potential antitumor and carcinogenic effects. The article provides information on the most relevant clinical and experimental studies, which have obtained data on possible antitumor or carcinogenic effects of drugs of basic classes used in cardiology. Current information on the use of acetylsalicylic acid to prevent colorectal cancer is discussed, as well as possible antitumor effects of clopidogrel. The results of studies demonstrating the effect of statins on the risk of cancer development in various localizations are presented. The controversial data on the influence of ACE inhibitors and sartans on the risk of lung cancer and other localizations are discussed. The results of research into beta-blockers as adjuvant therapy for breast cancer are analyzed. The results of studies in which data on possible carcinogenic effects of calcium channel blockers and diuretics were obtained are presented. For each discussed class of drugs, presumed mechanisms of antitumor or carcinogenic action are indicated. The need to develop and introduce drugs to reduce cardiovascular and cancer morbidity into clinical practice by influencing the general pathophysiological mechanisms of CVD and cancer is emphasized. Systemic chronic persistent inflammation is a pathogenetic link between aging, atherosclerosis and carcinogenesis. The results of the CANTOS study opened up new perspectives in the treatment of CANTOS and oncological diseases, and provided a powerful incentive for planning and conducting


This study investigated the effects of climatic changes on temperature, rainfall, and runoff in the Doroudzan catchment in the northeast of Fars province, Iran. Temperature and rainfall changes in three periods including 2011–2030, 2046–2065, and 2080–2099 were downscaled and studied using 15 Coupled Model Intercomparison Project, Phase 3 (CMIP3) climatic models, under three scenarios of greenhouse gas emissions A2, B1, and A1B, from the database of the LARS-WG model. The difference in the amount of changes in temperature and rainfall in these three periods and the observational amounts under the 15 models indicated the uncertainty of the changes values. To reduce this uncertainty and limit the results to the management and planning of water resources, ensemble approach was considered. For the preparation of the ensemble approach, the parameters from the files of the 15-model scenarios were averaged so that a climatic ensemble model could be obtained for each period. Then, the runoffs of the next three periods, under the second approach and three emission scenarios, were produced using the feedforwad neural network. The results indicated an increase in the average monthly maximum temperature and the minimum temperature in all three periods under the three scenarios. The results also showed a decrease in the rainfall in the early months of the year as well as an increase in the rainfall in the spring in most scenarios. Generally, the average annual rainfall in all these three periods under the climatic ensemble model, and three emission scenarios showed a reduction in the average annual rainfall in the three periods. The maximum amount of reduction was in 2080–2099 (101 mm) under the scenario B1. Besides, a reduction occurred in the average runoff of the catchment under three ensemble models and the emission scenario in all three periods, as compared to the average of the long-term observational values in most years.


A silver colloid staining technique for identifying nucleolar organizer region-associated proteins (Ag-NOR's) was applied to 51 human gliomas. These comprised 20 glioblastomas multiforme, 15 anaplastic astrocytomas, and 16 astrocytomas, in which the mean numbers of Ag-NOR's per cell (+/- standard error of the mean) were 2.51 +/- 0.12, 2.01 +/- 0.10, and 1.76 +/- 0.06, respectively. Significant differences among these were recognized, and the mean number of Ag-NOR's paralleled the degree of histopathological malignancy. In 16 cases, studies were performed of the number of Ag-NOR's and the S-phase fraction by in vitro labeling using antibromodeoxyuridine monoclonal antibody. A linear relationship was demonstrated between these two factors (r = 0.857, p less than 0.001), although some scatter was seen. In 32 adult patients, the correlation between the number of Ag-NOR's and the prognosis was estimated. The results demonstrated that the group containing patients with less than 1.80 Ag-NOR's per cell had a better prognosis than the group with 1.80 Ag-NOR's or more. Thus, the number of Ag-NOR's reflected the degree of histopathological malignancy, S-phase fraction, and prognosis. Silver colloid staining for Ag-NOR's is a simple, rapid, and reproducible method for estimating the proliferative potential of human gliomas without requiring a complicated technique.


The assessment of piles lateral friction involves the determination of the interface shearing resistance at large displacement. Consequently, the shearing resistance mobilised at large displacements, at the interface between cohesive soils and steel and concrete of varying roughness has been studied in the ring shear apparatus. The latter is known to offer the best mean of studying shearing resistance when soils undergo large displacements. The focus of this work is to highlight the solid material surface roughness effect. Results obtained from soil-soil and soil-interface shearing tests are presented. They indicate that the surface roughness and the average diameter of particles, which are combined into the influence of relative roughness R, have a significant effect on the interfacial shear strength at a given normal stress level. With respect to R, three shearing modes are likely to take place: shearing at the interface, shearing within the soil and an intermediate mode involving these two types of shearing. For the second mode, the shear strength at the interface soil-rough solid materials (steel and concrete) is likely to be greater than the shear strength of the soil, particularly for soils whose major mineral component is montmorillonite.


Background The American College of Surgeons Bleeding Control Basic (BCon) course aimed at teaching hemorrhage control techniques in the USA had not yet been taught in Spain. The purpose of this study is to assess its implementation among students and healthcare employees in the Lozano Blesa University Hospital of Zaragoza, a middle-sized Spanish city. Methods The study was conducted in a University Hospital and at the University of Zaragoza, scheduling four free B-Con sessions from 2017 to 2018. Two groups were identified as forming the population: healthcare employees and medical students. An anonymous questionnaire was completed at the end of the course regarding content, applicability, usefulness, relevance, and satisfaction. Study variables were ranked from 0 to 10: poor (when graded from 0 to 3), fair (4 to 6) and good (7 to 10). Results were compared between the groups, expressed in percentages and χ2 tested to analyze significant differences if any. Results Among the 83 individuals who completed the course, 46 were medical students and 37 healthcare employees; 61% women and 39% men; aged 21 years to 52 years. Attendees evaluated satisfaction with the highest grade (84%), followed by usefulness (73%), applicability (70%), and relevance (66%). There was no variable graded as poor. The comparison of perceptions between groups did not reveal statistical differences based on a 0.05 significance level. Conclusion We concluded that the B-Con course was valued as good for relevance, usefulness, applicability, and satisfaction by the majority of the studied population. Level of evidence Level III.


Metabolic signals are used for imaging and spectroscopic studies of brain function and disease and to elucidate the cellular basis of neuroenergetics. The major fuel for activated neurons and the models for neuron–astrocyte interactions have been controversial because discordant results are obtained in different experimental systems, some of which do not correspond to adult brain. In rats, the infrastructure to support the high energetic demands of adult brain is acquired during postnatal development and matures after weaning. The brain's capacity to supply and metabolize glucose and oxygen exceeds demand over a wide range of rates, and the hyperaemic response to functional activation is rapid. Oxidative metabolism provides most ATP, but glycolysis is frequently preferentially up-regulated during activation. Underestimation of glucose utilization rates with labelled glucose arises from increased lactate production, lactate diffusion via transporters and astrocytic gap junctions, and lactate release to blood and perivascular drainage. Increased pentose shunt pathway flux also causes label loss from C1 of glucose. Glucose analogues are used to assay cellular activities, but interpretation of results is uncertain due to insufficient characterization of transport and phosphorylation kinetics. Brain activation in subjects with low blood-lactate levels causes a brain-to-blood lactate gradient, with rapid lactate release. In contrast, lactate flooding of brain during physical activity or infusion provides an opportunistic, supplemental fuel. Available evidence indicates that lactate shuttling coupled to its local oxidation during activation is a small fraction of glucose oxidation. Developmental, experimental, and physiological context is critical for interpretation of metabolic studies in terms of theoretical models.


The maturation of human stem cell-derived cardiomyocytes (hSC-CMs) has been a major challenge to further expand the scope of their application. Over the past years, several strategies have been proven to facilitate the structural and functional maturation of hSC-CMs, which include but are not limited to engineering the geometry or stiffness of substrates, providing favorable extracellular matrices, applying mechanical stretch, fluidic or electrical stimulation, co-culturing with niche cells, regulating biochemical cues such as hormones and transcription factors, engineering and redirecting metabolic patterns, developing 3D cardiac constructs such as cardiac organoid or engineered heart tissue, or culturing under in vivo implantation. In this review, we summarize these maturation strategies, especially the recent advancements, and discussed their advantages as well as the pressing problems that need to be addressed in future studies.


A number of challenges including instability, nonconvergence, nonuniqueness, nonoptimality, and lack of a general guideline for inverse modelling have limited the application of automatic calibration by generic inversion codes in solving the saltwater intrusion problem in real‐world cases. A systematic parameter selection procedure for the selection of a small number of independent parameters is applied to a real case of saltwater intrusion in a small island aquifer system in the semiarid region of the Persian Gulf. The methodology aims at reducing parameter nonuniqueness and uncertainty and the time spent on inverse modelling computations. Subsequent to the automatic calibration of the numerical model, uncertainty is analysed by constrained nonlinear optimization of the inverse model. The results define the percentage of uncertainty in the parameter estimation that will maintain the model inside a user‐defined neighbourhood of the best possible calibrated model. Sensitivity maps of both pressure and concentration for the small island aquifer system are also developed. These sensitivity maps indicate higher sensitivity of pressure to model parameters compared with concentration. These sensitivity maps serve as a benchmark for correlation analysis and also assist in the selection of observations points of pressure and concentration in the calibration process. Copyright © 2012 John Wiley & Sons, Ltd.


This chapter describes Singaporean perspectives on the Hague Principles. Party autonomy is recognized as a very important principle in the private international law of Singapore. The primacy given to the role of party autonomy is evidenced by the adoption of the New York Convention and UNCITRAL Model Law for international arbitration, the adoption of the Convention on Choice of Court Agreements for international litigation, and the palpable support of the UNCITRAL Convention on International Settlement Agreements Resulting from Mediation. Most of private international law in Singapore is sourced in judge-made law. In the absence of direct Singapore authority, Singapore courts have traditionally looked to English case law for guidance, but increasingly, the courts have looked to the laws of other jurisdictions, and indeed international instruments which do not have binding force in Singapore law. Given the level of sophistication of existing common law contract choice of law rules, it is unlikely that Singapore will engage in radical law reform. However, it is likely that the Singapore courts will continue to look to the Hague Principles for guidance in areas where the common law is unclear or where there is a gap or strong imperative for change.


This book contains contributions to a multidiscip linary workshop organized by the Psychopharm acology Research Branch of the National Institute of Mental Health almost two years ago. Many of the leading clinical and research workers from Europe and the United States made contributions, and these are divided into four sections : Clinical disorders of the basal ganglia, anatomy and physiology, pharmacology and therapy, and neurosurgical procedures. Within these diverse contributions the main intent of the book, and its major interest to psychia trists, are the discussions on tardive dyskinesia. This distressing syndrome of mainly facial and lingual choreoathetoid movements crept surreptitiously into the back wards of mental hospitals after nearly ten years of over-confident drug use. As one clinician contributor sadly remarks : †̃¿ We ar not neurologists, and unless something is very obvious we are going to miss it.' The papers discuss several pertinent (and still unresolved) controversies, including the precise role of drugs and organic deterioration in aetiology, the reversibility of symptoms, the relevance of monkey models, and the pathophysiology of the lesions. The content of the book is slightly marred by its staccato typeface and the fact that several important papers were designed to accompany a filmed presen tation.. This gives the reader a frustrated feeling, likelistening toa soundtrackwhen thelights have fused. It is the fashion nowadays to publish the proceedings of workshops in book form. This may provide a tempting carrot to contributors, but publication delays ensure that the text is outdated for the expert, while the novicecan discoverthe factselsewherein a more easily digested (and often less expensive) form. CLEGHORN et a!.


Influences of diet on tumor growth in man have not yet been observed up to now. Therapeutic results of cancer treatment by surgery, irradiation or drugs can be improved considerably by adequate dietary regimens. Recently it has become more and more clear, that environmental factors, especially nutrition, do influence the formation of cancer. The quantities ingested of some nutrients (fat, cholesterol, fibers) seem to be important, as well as contamination of food with mycotoxins, nitrosamines, and polycyclic aromatic carbohydrates.


Web service composition is a very important task in service-oriented environments. The composition of services has to be based not only on functional but also on non-functional properties. In particular, the selection of the services should be performed at run-time rather than at design-time in order to adjust to changes in the environment that are due to the volatile nature of service-oriented environments. An optimization technique is necessary to perform the composition of web services based on Quality of service (QoS) parameters. Many different methods have been used to address the service composition problem, in particular, many linear programming methods have been used to optimize the process of service composition. The proposed work is different from related work in two aspects: (1) two meta-heuristic methods based on Particle Swarm Optimization (PSO) are introduced to address the optimization problem, and (2) several workflow requests are being processed simultaneously. The experimental results show that the hybrid PSO method in particular performs very well in service-oriented environments.


We used nanopore sequencing and phylogenetic analyses to identify a cosmopolitan genotype of dengue virus serotype 2 that was isolated from a 56-year-old male patient from the state of Goiás in Brazil. The emergence of a cosmopolitan genotype in Brazil will require risk assessment and surveillance to reduce epidemic potential.


Computer networks are now relied on more than ever before for gathering information and performing essential business functions. In addition, cyber crime is frequently used as a means of exploiting these networks to obtain useful and private information. Although intrusion detection tools are available to assist in detecting malicious activity within a network, these tools often lack the ability to clearly identify cyber attacks. This limitation makes the development of effective tools an imperative task to assist in both detecting and taking action against cyber attacks as they occur. In developing such tools, reliable test data must be provided that accurately represents the activities of networks and attackers without the large overhead of setting up physical networks and cyber attacks. The intent of this thesis is to use operation research and simulation techniques to provide both data and data-generation tools representative of real-world computer networks, cyber attacks, and security intrusion detection systems. A simulation model is developed to represent the structure of networks, the unique details of network devices, and the aspects of intrusion detection systems used within networks. The simulation is also capable of generating representative cyber attacks that accurately portray the capabilities of attackers and the intrusion detection alerts associated with the attacks. To ensure that the data provided is reliable, the simulation model is verified by evaluating the structure of the networks, cyber attacks, and sensor alerts, and validated by evaluating the accuracy of the data generated with respect to what occurs in a real network. By providing accurate data with respect to network structure, attack structure, and intrusion detection alerts, the simulation methods used offer considerable support in developing tools that can accurately detect and take action against attacks.


The small saphenous vein (SSV) is an important graft in limb salvage surgery. It is frequently translocated for bypass surgery. Sometimes, the use of the SSV as an in-situ graft for posterior tibial artery or peroneal artery reconstruction offers the advantages of reduced vein graft injury and improved patency. Recently, saphenous vein mapping through computed tomography (CT) volume rendering technique offers a great quality view to the surgeon. We experienced a patient in whom a CT image with volume rendering technique revealed an aberrant SSV connected with the great saphenous vein at the medial malleolus level. This case indicates that an aberrant SSV may be successfully used as an in-situ conduit for bypass to the dorsalis pedis artery. Here, we present the case of a popliteal-to-dorsalis pedis in-situ vein bypass using a LeMaitre valvulotome (LeMaitre Vascular Inc., USA) under mapping of the aberrant SSV by CT volume rendering technique.


A common practice in customer satisfaction analysis is to administer surveys where subjects are asked to express opinions on a number of statements, or satisfaction scales, by use of ordered categorical responses. Motivated by this application, we propose a pseudo-likelihood approach to estimate the dependence structure among multivariate categorical variables. As it is commonly done in this area, we assume that the responses are related to latent continuous variables which are truncated to induce categorical responses. A Gaussian likelihood is assumed for the latent variables leading to the so called ordered probit model. Since the calculation of the exact likelihood is computationally demanding, we adopt an approximate solution based on pairwise likelihood. To asses the performance of the approach, simulation studies are conducted comparing the proposed method with standard likelihood methods. A parametric bootstrap approach to evaluate the variance of the maximum pairwise likelihood estimator is proposed and discussed. An application to customer satisfaction survey is performed showing the effectiveness of the approach in the presence of covariates and under other generalizations of the model which can make a difference in real data situations. Pairwise likelihood inference for multivariate categorical responses with application to customer satisfaction


The rat 9L gliosarcoma brain tumour model has been widely used in brain cancer studies. Intracerebral implantation of the cells in the parietal lobe of the brain has been performed using the stereotactic or freehand inoculation methods. For large numbers of rats, we wished to develop a method more accurate and precise than the freehand method, but less labour intensive than the stereotactic method. A template implantation technique was developed and compared quantitatively with the stereotactic method. Rats were inoculated with either the template or stereotactic method at doses of 1000, 5000, 10 000, 20 000 or 40 000 cells. Results of this comparison showed that the template method is precise and accurate for tumour placement within the brain cortex, and decreases labour requirements. Mean survival rates between groups were not significantly different at doses of 5000, 20 000 or 40 000 cells inoculated. Significance was seen at the low dose of 1000 cells (P < 0.001). This was attributable to an absence of tumour growth in five of six stereotactic rats in this group. Significance was also seen at the 10 000 dose level (P < 0.05) with the stereotactic rats again surviving longer than the template rats. However, in this case all the stereotactic rats had tumour growth. Brain weights did not differ significantly between groups, except at the 1000 dose level where no growth of tumour occurred in five of the six stereotactic animals. Body weight gain within one week following surgery did not differ significantly between any of the groups at α = 0.05. Studies on rat cadavers showed no statistical difference in placement measurements between the stereotactic and template methods. These results indicate that the template method for intra cerebrally implanting tumour cells in rats provides a precise, accurate and rapid procedure that maximizes reproducibility with a significant reduction in labour requirements, when compared with the conventional stereotactic methodology.


Safe injection facilities (SIFs) have shown promise in reducing harms and social costs associated with injection drug use. Favorable evaluations elsewhere have raised the issue of their implementation in the United States. Recognizing that laws shape health interventions targeting drug users, we analyzed the legal environment for publicly authorized SIFs in the United States. Although states and some municipalities have the power to authorize SIFs under state law, federal authorities could still interfere with these facilities under the Controlled Substances Act. A state- or locally-authorized SIF could proceed free of legal uncertainty only if federal authorities explicitly authorized it or decided not to interfere. Given legal uncertainty, and the similar experience with syringe exchange programs, we recommend a process of sustained health research, strategic advocacy, and political deliberation.


We derive the approximate results for two standardized measures of deviation from normality, namely, the skewness and excess kurtosis coefficients, for a class of econometric estimators. The results are built on a stochastic expansion of the moment condition used to identify the econometric estimator. The approximate results can be used not only to study the finite sample behaviour of a particular estimator, but also to compare the finite sample properties of two asymptotically equivalent estimators. We apply the approximate results to the spatial autoregressive model and find that our results approximate the non-normal behaviours of the maximum likelihood estimator reasonably well. However, when the weights matrix becomes denser, the finite sample distribution of the maximum likelihood estimator departs more severely from normality and our results provide less accurate approximation. Copyright © 2009 The Author(s). Journal compilation © Royal Economic Society 2009


In this study, two formulations for the robust optimisation of the size of the permanent magnet in a synchronous machine are discussed. The optimisation is constrained by a partial differential equation to describe the electromagnetic behaviour of the machine. The need for a robust optimisation procedure originates from the fact that optimisation parameters have deviations. The first approach, i.e. worst-case optimisation, makes use of local sensitivities. The second approach takes into account expectation values and standard deviations. The latter are associated with global sensitivities. The geometry parametrisation is elegantly handled thanks to the introduction of an affine decomposition. Since the stochastic quantities are determined by tools from uncertainty quantification (UQ) and thus require a lot of finite element evaluations, model order reduction is used in order to increase the efficiency of the procedure. It is shown that both approaches are equivalent if a linearisation is carried out. This finding is supported by the application on an electric machine. The optimisation algorithms used are sequential quadratic programming, particle swarm optimisation and genetic algorithm. While both formulations reduce the size of the magnets, the UQ-based optimisation approach is less pessimistic with respect to deviations and yields smaller magnets.


Purpose
Given that the Open Government Data (OGD) initiatives of any country are founded on principles of transparency and accountability, it is important that the data sets permit a user-friendly interface for the data sets to be re-used. This paper aims to underline the major drivers and barriers to re-use the data sets in the context of the Philippines.

Design/methodology/approach
In line with the model proposed by Sieber and Johnson (2015), the paper invoked an investigation of the national OGD portal of the Philippines following a documentary analysis research approach.

Findings
The OGD portal of the Philippines permits data search and sharing via social media. Data sets are available in user-friendly formats with a detailed description of the data set itself in the form of metadata. At the same time, the OGD portal of the Philippines has many barriers to re-use. Data sets are not current, and no attempts have been made at updating the records. While the provision of data mapping is provided, the same is not effective as of now. Conducting statistical analysis is not possible online and some of the links are not active. Finally, users' suggestions are acknowledged, but the contribution of users toward the existing data sets is not permitted as of now.

Research limitations/implications
Given that only a single country's OGD initiative has been investigated in the study, further research is warranted to undertake a comparative analysis of OGD institutionalization across different countries.

Practical implications
Government authorities are encouraged to be more proactive in furthering the OGD initiative. Policymakers and practitioners may appreciate the underlying barriers in re-using the data sets and seek to address these concerns.

Originality/value
The OGD initiative of the Philippines has not been investigated so far despite the rising tide of the OGD initiatives across the globe. Given that most of the research on OGD is focused in developed countries, the present study seeks to contribute toward the extant literature by investigating the OGD portal of the Philippines and underlining the major drivers and barriers in re-using the data sets available via the portal.


Delivery of drugs to brain is still a major challenge. Successful delivery across the blood brain barrier has only been achieved in some cases, for example pro-drugs; alternative approach is delivery to the brain by using nanoparticles. Nanotechnology is expected to bring revolutionary changes in the field of life sciences including drug delivery, diagnostics, neutraceuticals and production of biomaterials. Liposomes can also be used for delivery of drug to the brain through the blood brain barrier (BBB). The review focuses on blood brain barrier, nanoparticles and their preparation, and mechanism of nanoparticles mediated drug transfer across blood brain barrier, application of nanoparticles as biomarkers, and liposomes and their manufacturing.


Military manpower policy is often crafted by policymakers without an in-depth understanding of the life experiences and views of junior enlisted personnel. It is plausible to expect that some policymakers attribute the attitudes and experiences of these young soldiers to such features as youth or lack of an advanced education and may thus believe themselves able to empathize with this population group by recalling their own parallel life experiences. However, this approach oversimplifies the life experiences of these families and neglects the reality that most policymakers and professional managers have never experienced the compendium of problems these couples face, such as youth, lack of education, financial difficulties, emotional and physical distance from extended family, and invisibility in a large bureaucracy. At the center of this book are the personal stories of three junior enlisted spouses, told in their own voices and selected to emphasize the dilemmas numerous enlisted families face. The stories provide insight into the experiences and attitudes of other junior enlisted families. Those interested or involved in the military, or those who live a military lifestyle--at any pay grade--will find these stories both useful and engaging.


The cost reduction of hydrogen refueling stations (HRSs) is very important for the popularization of hydrogen vehicles. This paper proposes an optimized operation algorithm based on hydrogen energy demand estimation for on-site hydrogen refueling stations. Firstly, the user's hydrogen demand was estimated based on the simulation of their hydrogenation behavior. Secondly, mixed integer linear programming method was used to optimize the operation of the hydrogen refueling station to minimize the unit hydrogen energy cost by using the peak–valley difference of the electricity price. We then used three typical scenario cases to evaluate the optimized operation method. The results show that the optimized operation method proposed in this paper can effectively reduce the rated configuration of electrolyzer and storage tank for HRS and can significantly reduce the unit hydrogen energy cost considering the construction cost compared with the traditional method. Therefore, the optimization operation method of a local hydrogen production and hydrogen refueling station proposed in this paper can reduce the cost of a hydrogen refueling station and accelerate the popularization of hydrogen energy vehicles. Finally, the scope of application of the proposed optimization method and the influence of the variation of the electricity price curve and the unit cost of the electrolyzer are discussed.


: Aim: The point of this precise survey and meta-investigation was to assess the clinical utilization of MRI for the assessment of intense a ruptured appendix during pregnancy. Methods: The companies were led by two free analysts (MK, MS) to locate the relevant surveys distributed from 2/3/2019 until the end of 28/2/2020. Our current research was conducted at Sir Ganga Ram Hospital, Lahore from March 2019 to February 2020. We searched the literature distributed in English in MEDLINE via PubMed, EMBASETM via Ovid, The Cochrane Library, and Trip information base. For writings distributed in different dialects, we searched the public information bases, KoreaMed and LILACS. The terms used in the prosecution procedure are Pregnancy [MeSH], Pregnancy in the Operating Room - Magnetic Reverberation Imaging [MeSH] or Appendicitis [MeSH] or Ultrasound, Operating Room, Imaging, MRI [MeSH] or " ، " and Lower Right Quadrant Torment [MeSH]. The predisposition hazard of each item was assessed using QUADAS-2. Based on the results in Tables 2 × 2, the pooled measures of Affectability, Particularity, Analytical Odds Ratio (AOR) and Area Under Elbows (AUC) and their 95% certainty ranges (CI) were determined using the DerSimonian Lair procedure. Results: As numerous as 1164 investigations were chosen. Subsequent to examining the correspondence of the examinations with the required models, 19 examinations were chosen for the last audit. For an infected appendix in pregnancy, the MRI affectability was 91.8% at the 95% certainty time period (CI 87.7–94.9%). At the certainty time period, the particularity was 97.9% (95% CI 0.97.2–100%). The danger of inclination in the investigations directed was estimated utilizing the QUADAS-2 device. Conclusion: MRI has a high affectability and explanatory power (91.8%, 97.9% individually) for the determination of intense rupture of the appendix in pregnant patients whose appendix is clinically presumed to be ruptured. It is an excellent imaging method in many cases, which does not reveal an outbreak, or the mother, of ionizing radiation, making it an incredible choice for pregnant patients with suspected intense rupture of the appendix.


Colloidal Au nanoparticles (NPs) were decorated on stainless steel for surface plasmon enhanced laser ablation. A comparative study of the laser ablation efficiency was carried out on stainless steel samples with and without the Au NPs decoration at a variable pulsed laser fluence and laser pulse number. Higher ablation efficiency was clearly demonstrated in the former as illustrated from the larger diameter, maximum depth and the cross-sectional area of the crater generated by the laser ablation under the same conditions. Additionally, both the maximum depth and efficiency enhancement were found to depend on the laser fluence and pulse number. The maximum enhanced ablation efficiency of 36% based on the cross-sectional area of the crater was obtained at 1 pulse number of laser fluence 1.53 J cm−2. The efficiency enhancement of laser ablation is attributed to the highly enhanced surface plasmon field at the interface between Au NPs and stainless steel.


The electron beam scanlaser (EBS) is a device in which a modified electrooptic light valve is used as a mode selector in the highly degenerate flat-field conjugate laser resonator to provide a scanning light spot. This paper describes improvements in the mode selection portion of the EBS which make the device far more promising. In particular, 1) the charge storage time is now under control, and can be as short as needed, 2) the KDP is protected from the electron beam, 3) the electron gun is protected from the KDP, 4) provision can be made for the needed high-quality optical surfaces in the mode selector, and 5) the transparent conducting coating on the mode selector's KDP crystal has been removed, indicating that the insertion loss of the mode selector can be reduced to less than 1.5 percent.


International terrorism is probably the greatest security challenge America faces today. Policymakers have responded in two ways--going after terrorists abroad and improving security against terrorism at home by boosting homeland security funding. Regarding the latter, total spending directed to homeland security activities will be at least $50 billion for FY2006.Yet, the important question is whether America is getting the maximum level of benefit in exchange for this increase in spending. This paper performs a detailed review of homeland security's spending practices. First, it takes a look at the economics of homeland security spending and contrasts that with the politics of decision-making in this area. Second, it examines the state of homeland security spending. Finally, the paper analyzes how homeland security funds are being allocated and asks whether this is conducive to achieving improved security in the United States. This updated version also includes a review of federal spending to bolster port security. We conclude that a large portion of homeland security-spending decisions are made on a political basis rather than on a sound cost-benefit analysis, leading to the traditional public choice failures that plague government spending more generally. As a result, homeland security funding is likely to be misallocated, resulting in a less than optimal level of security in America.


With aggressive scaling down of feature sizes in VLSI fabrication, process variations have become a critical issue in designs, especially for high-performance ICs. Usually having level-sensitive latches for their speed, high-performance IC designs need to verify the clock schedules. With process variations, the verification needs to compute the probability of correct clocking. Because of complex statistical correlations, traditional iterative approaches are difficult to get accurate results. Instead, a statistical checking of the structural conditions for correct clocking is proposed, where the central problem is to compute the probability of having a positive cycle in a graph with random edge weights. The proposed method only traverses the graph once to avoid the correlations among iterations, and it considers not only data delay variations but also clock skew variations. Experimental results showed that the proposed approach has an error of 0.14% on average in comparisons with the Monte Carlo simulations.


【Objectives : This study was performed to research trends in Korean medicine treatment of diabetes mellitus (DM). Methods : We reviewed 73 studies about diabetes mellitus, which had been published from 2008 to 2013. The article search was performed on the Korean institute of oriental medicine (KIOM) database. Results : 1. Patterns of study design were as follows : 14 review studies, 44 experimental studies, 7 clinical studies, 8 case reports. 2. From the 14 review studies, we noted that literature studies about definition, pathologic mechanism, treatment, pathologic pattern identification of DM and previous study analyses were done. 3. From the 44 experimental studies that are the most common type of DM studies, various Korean medicine treatments such as single medicinal herbs, herbal complexes, diets and pharmacopuncture were used. Anti-diabetic effects were demonstrated in most of the studies. 4. 7 clinical studies about acupuncture, electroacupuncture, herbal medicine, etc. were reported. 5. 8 cases about DM complications and comorbidities were reported. Clinical symptoms improved in all of studies, blood sugar level decreased in four studies. Conclusions : Further clinical and case study based on experimental researches should be performed.】


Al87Ni8Y5 amorphous alloy has been studied by means of X-ray diffraction and X-ray small-angle scattering methods at different temperatures. Scattered intensities and structure factors are analyzed. Structural data are used for calculation of Al-nanocrystalls sizes as well as there mean size temperature dependence. X-ray small angle scattering intensities are interpreted by means of Guinier method. Nanocrystall size distribution function and time dependence of mean size of Al-nanocrystalls during their growth are obtained.


Presents an evaluation of a trade union project to appoint regional health and safety representatives in farm‐working. Outlines the background and development of the scheme and assesses its outcomes. Reviews the problem of health and safety in agriculture and discusses the scheme as a means of improving the health and safety performance of the small enterprises typical of the industry. Identifies factors that have supported or constrained the activities of the regional safety representatives and evaluates their importance. Compares the scheme with analysis of more developed provisions for regional health and safety representatives found in Sweden and identifies and discusses a number of supporting and limiting factors common to both schemes. Concludes the project has achieved very limited success in improving joint consultation on health and safety in agricultural employment. Suggests its limited progress is a result of constraints specific to the industry rather than those of employment in small enterprises in general. Proposes further strategies that the trade union might adopt to increase the chances of success within the industry.


Natural acceleration of charged particles occurs within a variety of physical contexts and through a range of physical processes. "Cosmic" charged particle acceleration can involve particle energies and energy changes from less than one electron Volt (eV),and on through kilovolt (keV) energies,up to 1018 and perhaps 1020 eV These acceleration processes can be in the forms of various types of electric fields directed parallel to the magnetic field lines, which are believed chiefly responsible for the energization of the auroral electrons which bombard the Earth's upper atmospheres at high magnetic latitudes to create auroras.

There are also "collisionless" shock layers in our interplanetary space and well beyond, to energize charged particles in solar and stellar winds. And there may be exotic—and somewhat speculative—processes such as the effect of intense radiation beams associated with non-thermal compact objects, or unipolar electric fields of huge magnitudes near a rotating and accreting black hole. These processes may accelerate particles to even 1020 eV energies. The propagation of such ultra-high energy particles in time and space may be severely modified by quantum gravity effects, which are no longer negligible in these extreme situations.


PURPOSE
To determine the feasibility of adapting confocal scanning laser (CSL) tomography of the optic disc for quantitative evaluation of papilledema in pseudotumor cerebri (PTC).

METHODS
Confocal scanning laser tomography of the optic disc was performed in 11 patients with diagnosed PTC and 12 visually normal control subjects of similar age. In five patients with active papilledema, CSL tomography was performed serially over several months. To quantify optic disc characteristics, surface topography was measured in 0.1-mm steps along the horizontal and vertical meridians and four oblique meridians. Best fit polynomial functions, describing surface topography along each meridian, were derived using linear regression analysis.

RESULTS
Third-order polynomials provided excellent fits (significantly better than the second-order functions) to the surface topography for all meridians in the control subjects and patients with PTC. In control subjects and PTC patients an asymmetry in the slope of the optic disc contours was evident along the horizontal but not the vertical meridian. In patients with active papilledema a significant elevation of the center of the disc was accompanied by a change in overall surface topography. Each of the PTC patients followed up serially had a pronounced posterior deformation of the disc (i.e., a reduction in papilledema) that was initially apparent in the temporal meridian and did not proceed uniformly across all meridians.

CONCLUSIONS
Confocal scanning laser tomography can quantify the magnitude and monitor the resolution of papilledema in PTC. Studies of optic nerve head topography may provide further insight into optic nerve compliance with elevated intracranial pressure.


To improve the seakeeping capability, some devices, such as submerged plates, are often installed on floating structures. The attached plate can not only suppress the motion response but also provide an additional immersed body surface that receives fluid action, aggravating the wave loads. In this study, a theoretical model is developed within the context of linear potential theory to study the hydrodynamic characteristics of a floating column with a submerged plate attached at the bottom. The eigenfunction expansion matching method is applied to obtain the velocity potential, based on which the linear wave force and wave runup can be found immediately. A novel derivation of the mean drift force formulation is developed via the application of Green's second identity to the velocity potential and its derivative in finite fluid volume surrounding the body. Mean drift force formulation that involves control surfaces is then obtained. With the availability of the velocity potential, semi-analytical solution of the mean drift force on the compound column-plate structure is developed based on, respectively, the derived and the classic far-field formulations. After conducting convergence tests and validating the theoretical model, detailed numerical analysis is performed thereafter based on the theoretical model. The influence of the plate size, such as the radius and height, on the wave force and the associated wave runup is assessed.


In designing a fuzzy model and a fuzzy controller, we encounter a major difficulty in the identification of an optimised fuzzy rule base, which is traditionally achieved by a tedious trial and error process. The paper presents an approach to automatic design of optimal fuzzy rule bases for modelling and control using evolutionary programming. Such programming simultaneously evolves the structure and the parameter of fuzzy rule base for a given task. To check the effectiveness of the suggested approach, five examples for modelling and control are examined. The performance of the identified fuzzy models and fuzzy controllers is demonstrated.


Although both strategic management theorists and practicing recruiters endorse selecting applicants on the basis of "fit," precise delineation of fit in a selection context remains elusive. Moreover, the majority of previous work in this area has been based on anecdotes, case studies, or prescriptions rather than empirical evidence. The present investigation examines interviewers' assessments of job applicants in terms of both general and firm-specific employability (i.e., fit). Results suggest that (1) assessments of general employability differ from firm-specific assessments, (2) there is a firm-specific component to interviewers' evaluations of job applicants, and (3) interpersonal skills, goal orientation, and physical attractiveness contribute to assessments of fit (holding general employability constant), while objective qualifications (e.g., grade point average, extracurricular offices, years experience) do not. Suggestions for future research are offered.


Nothing so changed nineteenth-century America as did the railroad. Growing up together, the iron horse and the young nation developed a fast friendship. "Railroad Crossing" is the story of what happened to that friendship, particularly in California, and it illuminates the chaos that was industrial America from the middle of the nineteenth century through the first decade of the twentieth. Americans clamored for the progress and prosperity that railroads would surely bring, and no railroad was more crucial for California than the transcontinental line linking East to West. With Gold Rush prosperity fading, Californians looked to the railroad as the state's new savior. But social upheaval and economic disruption came down the tracks along with growth and opportunity. Analyzing the changes wrought by the railroad, William Deverell reveals the contradictory roles that technology and industrial capitalism played in the lives of Americans. That contrast was especially apparent in California, where the gigantic corporate 'Octopus' - the Southern Pacific Railroad - held near-monopoly status. The state's largest employer and biggest corporation, the S.P. was a key provider of jobs and transportation - and wielder of tremendous political and financial clout. Deverell's lively study is peopled by a rich and disparate cast: railroad barons, newspaper editors, novelists, union activists, feminists, farmers, and the railroad workers themselves. Together, their lives reflect the many tensions - political, social, and economic - that accompanied the industrial transition of turn-of-the-century America.


Information sharing in policing enables proactive and preventative work to enhance
welfare, security and safety for the public; however, achieving these goals requires having
an effective and efficient mechanism for sharing information within and between
organisations. There is currently no systematic approach to specifically analyse the
requirements of an information sharing system, which motivates the need to develop such
an approach. In this research, the Activity Theory was taken as a basis to identify the
requirements of the approach and design a suitable framework, which was then evaluated
through the use of two case studies in the public sector in the United Arab Emirates (UAE).
This research aims to design an information sharing framework that takes proper
account of the actors and their activities to improve the information sharing system. To
this end, it presents the development of the Activity Theory-based Information Sharing
Analysis (AcTIShA) Framework, proposing a mechanism for analysing the information
need and supporting the information sharing. This framework incorporates the concept
of information analysis adopted from the Activity Theory, which is used for understanding
the information. The Activity Theory plays a crucial role in analysing the elements
concerned with the information, such as actors, actions, information artefacts and
purposes within the organisation's activities. To illustrate the application of the AcTIShAFramework, a system design based on its use is demonstrated.
The design science research paradigm is adopted to evaluate the outcomes of the
framework through two case studies. These were carried out in two different public
sectors of the UAE, namely the Ministry of Interior and the Ministry of Health, to evaluate
the AcTIShA-Framework. The focus group method was conducted with a variety of
participants from both sectors to discuss and evaluate the information sharing mechanism. It is demonstrated that the framework provides a systematic and versatile
approach to be utilised to improve the sharing of the information among organisations,
and that it will benefit the development of information sharing systems.
The conclusions, contributions and suggestions drawn from this study are used to
extend the activities of information sharing. Finally, the research provides guidance for
developing information sharing systems.


Background: To evaluate possible causative factors of unsuccessful dacryocystorhinostomy (DCR) surgery, and present the surgical technique and results of revision external DCR in a tertiary referral center. Methods: During 2001–2007, 79 patients (59 female, 20 male, 83 revised DCR sites) underwent revision external DCR for the management of recurrent epiphora after unsuccessful DCR surgery. The possible reasons for unsuccessful DCR surgery were noted according to the preoperative nasal endoscopic and perioperative findings, and revision surgery was performed to address these. Results: The mean age was 43.1 ± 12.0 years, and the mean follow-up was 21.4 ± 12.4 months. At presentation, 58 patients had a history of 1 unsuccessful lacrimal surgery, 16 had 2 unsuccessful surgeries, and 5 had 3 unsuccessful surgeries. The most common preoperative endoscopic finding was nasal mucosal fibrosis and synechiae, and the most common causes of unsuccessful DCR surgery were inappropriate size and location of the bony ostium, fibrosis at rhinostomy site, and canalicular obstruction, respectively. Of the 83 revised DCR sites, 79 sites underwent external DCR with silicone intubation, and conjunctival DCR with Jones tube insertion was performed in 4 sites. Success was achieved in 78 sites (93.9%) with the first revision DCR surgery, and in 81 sites (97.6%) with the second revision. Conclusions: Revision DCR has standard concepts in common with primary DCR surgery; however, for a favorable surgical outcome, the revision surgery should address possible causative factors of failure.


This study is meant to evaluate Civilian gunshot injuries in the city of Nnewi with a view of finding the pattern of injuries and background of affected individual. It is also aimed to bring to the fore the fact that even our easily available plain radiographic studies will localize the pellets, identify some important damages caused by the pellets and help us in planning for management even in the absence of other complex radiological investigative modalities like computed Tomographic scanners, Magnetic Resonance Imaging (MRI), Angiographic studies and interventional techniques /procedures. All gunshot injuries investigated in the Department of Radiology, Nnamdi Azikiwe University Teaching Hospital, Nnewi (NAUTH) between December 1998 – April 2000 were qualified for this work. The films were reviewed as to location of the pellets to enable the surgeon plan for possible extraction. Twenty-five (25) such patients were reviewed in this study. This showed a male/female ratio of 8.1. The age range of subjects was between 18 – 65 years with a mean age of 35years. The model age involved was 20 – 30 years. The commonest site involved as shown by this study was the lower limb ( from pelvic 5 to the foot). The main source of referral was the Accident & Emergency Unit.


Chaucer, Gower and Lydgate were the three poets of their time considered to have founded the English poetic tradition. Gower, like Lydgate, eventually fell victim to changing tastes but is now enjoying renewed scholarly attention. Current work in manuscript studies, linguistic studies, vernacularity, translation, politics, and the contexts of literary production has found a rich source in Gower's trilingual, learned, and politically engaged corpus. This "Companion to Gower" offers essays by scholars from Britain and North America, covering Gower's works in all three of his languages; they consider his relationships to his literary sources, and to his social, material and historical contexts; and they offer an overview of the manuscript, linguistic, and editorial traditions. Five essays concentrate specifically on the Confessio Amantis, Gower's major Middle English work, reading it in terms of its relationship to vernacular and classical models, its poetic style, and its treatment of such themes as politics, kingship, gender, sexuality, authority, authorship and self-governance. A reference bibliography, arranged as a chronology of criticism, concludes the volume. The contributors include: J.A. Burrow, Ardis Butterfield, Nathalie Cohen, E.H. Cooper, Sian Echard, Robert Epstein, John Hines, Edward Moore, Derek Pearsall, Russell Peck, A.G. Rigg, Simon Roffey, Jeremy J. Smith, Diane Watt, Winthrop Wetherbee, Robert F. Yeager. Sian Echard is associate professor, Department of English, University of British Columbia. The Companion can serve as an introduction to Gower and his works for the advanced undergraduate or graduate student, and the essays will also be of interest to experts in Middle English studies and in Gower.