A 16-year-old young man presented with intensely itchy erythematous dermatitis on the body for 1 week and vesicular lesions on the palms and soles for 4 to 5 days. Lesions on the palms and soles were accompanied by severe burning and itching. The patient gave a history of sore throat and fever, 1 week prior to the onset of lesions. A general physical examination was normal, and cutaneous examination revealed multiple, well-defined erythematous scaly plaques with collaret scaling on the trunk and extremities (Figure 1). Vesicular lesions were seen on the palms and soles (Figure 2). The differential diagnoses we considered were pityriasis rosea and secondary syphilis. The possibility of dermatophytid, vesicular pityriasis rosea, and pompholyx was limited to the palms and sole lesions. Complete blood cell count was within normal limits. Results from antistreptolysin O titer, potassium hydroxide mount, and venereal disease research laboratory were negative. Skin biopsies were taken from the back and left palm. The biopsy specimen from the back revealed focal spongiosis, lymphocyte exocytosis, vacuolar changes in the basal layer, and perivascular lymphocytic infiltrate in the dermis (Figure 3). The biopsy obtained from the vesicular lesion on the left palm revealed an intraepidermal vesicle with no evidence of acantolytic process (Figure 4). A diagnosis of pityriasis rosea was made and the patient was started on clarithromycin 500 mg once a day for 7 days, along with antihistamines and emollients. The lesions faded dramatically in a very short period, and there was significant involution of almost all of the lesions after 7 days of clarithromycin. During the 6 months of follow-up, no recurrence was observed.


The authors analytically investigate and derive the speedup provided by 2-D meshes over hypercubes for several common communication patterns. They take into consideration the difference in channel widths, the communication rates, and the effect of worm-hole routing. The 2-D meshes are shown to provide significant speedups if effects of contentions can be ignored. For large networks having hundreds of nodes, contentions become significant, reducing the speedups. Appropriate mapping and routing may be used to reduce the contentions while retaining the speedups.<<ETX>>


33) This paper presents a mathematical model developed for crop water allocations in a canal command area. The model uses processed data on crop areas obtained from satellite imageries in updating allocation decisions in real time. Water allocations to crops are based on detailed soil moisture balance, competition among crops for available water, crop response to water allocation, rainfall in the command area and amount of available water through canal discharge in an intraseason time period. The model application is demonstrated with the case study of the command area of Distributary No. 36 of the Tunga Bhadra project. Processed data on crop areas for the case study has been obtained from earlier studies carried out by Regional Remote Sensing Service Center (RRSSC), Bangalore.


The main aim of this paper is to depict the sustainability condition of an average subsistence farm in the mid-hill condition of Nepal. For the purpose, a hypothetical farm representing the average condition of the farming system in the area is taken. The analysis is based on the secondary information. For the purpose, only few indicators for the sustainability are analysed including gross profit margin, nitrogen use efficiency and nitrogen balance. The results reflect that an average subsistence farm in the midhill of Nepal earn just NRs 79,449 per annum. The nitrogen balance was negative and nitrogen use efficiency was more than 100% reflecting the system was economically and environmentally unsustainable. The problem behind unsustainability of the system is basically related with poverty and increased population pressure on poorly fertile land. Only a joint venture of public and private sector can address the problem.


Locked nucleic acid (LNA) is a chemically modified nucleic acid with its sugar ring locked in an RNA-like (C3′-endo) conformation. LNAs show extraordinary thermal stabilities when hybridized with DNA, RNA or LNA itself. We performed molecular dynamics simulations on five isosequential duplexes (LNA–DNA, LNA–LNA, LNA–RNA, RNA–DNA and RNA–RNA) in order to characterize their structure, dynamics and hydration. Structurally, the LNA–DNA and LNA–RNA duplexes are found to be similar to regular RNA–DNA and RNA–RNA duplexes, whereas the LNA–LNA duplex is found to have its helix partly unwound and does not resemble RNA–RNA duplex in a number of properties. Duplexes with an LNA strand have on average longer interstrand phosphate distances compared to RNA–DNA and RNA–RNA duplexes. Furthermore, intrastrand phosphate distances in LNA strands are found to be shorter than in DNA and slightly shorter than in RNA. In case of induced sugar puckering, LNA is found to tune the sugar puckers in partner DNA strand toward C3′-endo conformations more efficiently than RNA. The LNA–LNA duplex has lesser backbone flexibility compared to the RNA–RNA duplex. Finally, LNA is less hydrated compared to DNA or RNA but is found to have a well-organized water structure.


In 2005 the federal government decided to establish a National Radioactive Waste Facility in the Northern Territory and in late 2005 legislation to facilitate this process passed into law. In so doing, the government sets aside an existing consensus-based process, established with states and territories, to create a central facility. The government argues that the facility, which will store radioactive waste, is necessary to maintain a continuing domestic nuclear reactor capacity to produce medical radioisotopes in Australia. It also suggests that refusals by states and territories to host radioactive waste, which have frustrated the process of establishing a facility thus far, threaten Australia's ability to service its own requirements for nuclear medicine. Other views, however, question these arguments, and suggest that the facility, as now planned, may not offer the benefits claimed for it under original proposals. On consideration, it becomes clear that these are matters which hold wider implications about the level of Australia's nuclear involvement in the future.


The possible association of human foamy virus (HFV) with human thyroid disorders such as Graves' disease (GD) has been a topic of controversy due to the inconsistent results reported by several groups of investigators. Here we report the investigation of the presence of HFV-related sequences in the Korean population. DNA was obtained from peripheral blood lymphocytes from 24 GD patients and 23 healthy blood donors and subjected to PCR amplification using three sets of nested primers derived from gag, env, and LTR regions of the HFV genome. Contrary to previously reported studies, our analysis identified HFV-related sequences in the genomes of both healthy individuals and the GD patients. However, the nature of the HFV genome present in each group appeared to be different. We detected all 3 regions of HFV-related sequences in 29% of the HFV-positive GD patients, while no samples in the control group amplified all three regions. This suggests that the LTR may be used as a tool for screening for HFV in GD patients. Our data favor the hypothesis of a relationship between GD and the presence of HFV-related sequences, though in a complex way.


Objectives: A multidisciplinary intervention study aimed at reducing quartz exposure in the Dutch construction industry was performed. We aimed to assess the effect of the intervention on exposure level and psycho-social and organisational factors. Method: Eight participating construction companies were randomly allocated to an intervention (n = 4) or control group (n = 4). Following the Intervention Mapping approach, the intervention aimed at engineering, organisational and psycho-social factors. Pre and post-intervention respirable quartz measurements (n = 300) were taken from workers from all eight companies. Questionnaires and observation forms were used to assess pre and post psycho-social and organisational factors. Results: Pre-intervention assessment demonstrated highest respirable quartz levels for concrete drillers, tuck pointers and demolishers (GM respectively 0.20, 0.18 and 0.12 mg/m(3)), exceeding the Dutch occupational exposure limit (OEL) in 62% of the measurements. Identified control measures resulted in 30% reduction in quartz exposure. More social influence was associated with a 1.5 fold increased use of control measures. The post intervention assessments will become available early 2014. Conclusions:High exposure levels exceeding the Dutch OEL were observed. Associations between organisational, psycho-social and use of control measures found during the pre-intervention, were taken into consideration when developing the intervention strategy. A comparison between pre and post intervention outcomes will be presented during the conference. The effect of changes in exposure levels as a result of the intervention will be assessed with a health impact assessment model incorporating population dynamics.


Poses recognition is an important research topic because some situations require silent communication (sign language, surgeon poses to the nurse for assistance etc.). Traditionally, poses recognition requires high quality expensive cameras and complicated computer vision algorithms. This is not the case thanks to the Microsoft Kinect sensor which provides an inexpensive and easy way for real time user interaction. In this paper, we proposed a real time human poses classification technique, by using skeleton data provided by the Kinect sensor. Different users performed a set of tasks from a vocabulary of eighteen poses. From skeleton data of each pose, twenty features are extracted so that they are invariant with respect to the user's size and its position in the scene. We then compared the generalization performances of four machine learning algorithms, support vectors machines (SVM), artificial neural networks (ANN), k-nearest neighbors (KNN) and Bayes classifier (BC). The method used in this work shows that SVM outperforms the other algorithms.


Abstract. Dune height is an important predictor of dune impact during a storm event given that taller dunes have a lower likelihood of being overtopped. However, the temporal dominance of the wave collision regime, wherein significant volume loss (erosion) from the dune will occur through dune retreat without the dune being overtopped, suggests that dune width must also be considered when evaluating the vulnerability of dunes to erosion. We use XBeach, a numerical model that simulates hydrodynamic processes, sediment transport, and morphologic change during a storm, to analyze dune erosion as a function of dune aspect ratio (i.e., dune height versus dune width) for storms of varying intensity and duration. We find that low aspect ratio (low and wide) dunes lose less volume than high aspect ratio (tall and narrow) dunes during longer storms, especially if they are fronted by a narrow beach. During more intense storms, low aspect ratio dunes experience greater erosion as they are more easily overtopped than high aspect ratio dunes. In managed scenarios where sand fences are used to construct a fenced dune seaward of the existing natural dune, we find that the fenced dune effectively prevents the natural dune behind it from experiencing any volume loss until the fenced dune is sufficiently eroded, reducing the magnitude of erosion of the natural dune by up to 50 %. We also find that beach width exerts a significant influence on dune erosion; a wide beach offers the greatest protection from erosion in all circumstances regardless of dune morphology or storm characteristics. These findings suggest that efforts to maintain a wide beach may be effective at protecting coastal communities from dune loss. However, in maintaining wide beaches and dunes, the protection offered in the short-term must be considered against long-term detrimental effects of potentially limiting overwash fluxes, which are critical to maintaining island elevation as sea level rises.


MHD boundary layer flow of Non-Newtonian Power law fluid past a continuously moving flat plate has been considered. The governing equations of continuity and momentum are transformed into ordinary differential equations using similarity transformations. The equation is solved by using method of successive approximations starting with zeroth approximation. For n=1 the results tallies with Corresponding results for Newtonian fluids. Velocity profiles are drawn for different values of parameter n, magnetic parameter M, velocity ratio parameter e shows the behavior of power law fluids. Keywords: - MHD boundary layer, Power law fluids, successive approximations, velocity ratio parameter, velocity profiles.


Ultrafast ultrasound imaging allows total focusing on every pixel, but it uses a non-focusing transmission of the ultrasonic wave into the tissue. Based on plane wave or diverging wave imaging, additional clutter reduces the imaging quality especially in echo-free regions like cysts. Clutter reducing techniques like adaptive beamforming processing compute weighting factors based on measured channel data used for each sample reconstruction. This increases signal and image quality again but adds computational complexity and may result in techniques that are not real-time capable to be implemented in an ultrasound scanner. A fast and accurate phase estimator for real-time applications is needed. Extending the concept of sign coherence factor (SCF) computations using bi-phase estimations, we propose a fast quad phase coherence (QPC) estimator for more accurate phase detection to reduce incoherent clutter. Instead of only using the sign coherence of each of the single channel data, the QPC estimator also includes the monotony of the signal to differentiate into the four classes "positive sign & increasing monotony", "positive sign & decreasing monotony ", "negative sign & decreasing monotony" and "negative sign & increasing monotony". The dominant class of these four is selected and the adaptive weighting is computed as ratio of the absolute frequency of this class to the sum of all other class occurrences. The calculation of the monotony introduces only a small computational overhead compared to other adaptive beamforming techniques. The performance of QPC usage is evaluated using our ultrafast ultrasound research systems at phantom measurements (using "DiPhAS" system with 128 parallel channels) and in-vivo bladder measurements (using "MoUsE" system with 32 parallel channels, 3 MHz phased array transducer). The beamforming reconstruction is computed on the performance-limited integrated PC hardware as OpenCL kernel in real time. Imaging performance is increased compared to sign coherence beamforming (SNR by >3 dB, contrast by 4,4 dB, spatial resolution PSF FWHM by 19%) while computation time still allows real-time usage.


Borrelia crocidurae–associated relapsing fever is endemic to West Africa and is considered benign. We report 4 patients with B. crocidurae–associated neurologic symptoms; 2 of their cases had been misdiagnosed. Frequency and severity of this disease could be underestimated; molecular methods and serodiagnostic tests for Lyme disease might be helpful in its detection.


Background: Malignancies in lymph nodes in our country are predominantly metastatic in nature with an incidence varying from 65.7% to 80.4% and lymphomas range from 2% to 15.3% among lymph nodes aspirated from all sites. Cervical lymphadenopathy accounts for majority of metastatic malignancy.In the present study, 77 cases with cervical lymphadenopathy were included over a period of 1 year ; out of 105 cases of overall lymphadenopathy (73.3 %) & 76.6% of cases turned out to be metastatic in nature . Objectives: 1. To find age & sex incidence of metastatic cervical lymphdenoapathy at TMC & BRAM Teaching Hospital. 2. To study the cytomorphological pattern of malignancy. Material & Methods: All the patients referred to Department of Pathology, Tripura Medical College and Dr. BRAM Teaching Hospital for FNAC of cervical lymph nodes were included in present study. The study design was retrospective and study duration was from June 2014 to May 2015 (1 year) Results: Our study included 77 cases, corresponding to73 % of total number of cases of lymphadenopathy at our hospital. Males were commonly affected (M: F is 2.28:1). Fifth decade was the common age group involved. Metastatic lesions were reported in 23 (29.8%) of total number of cases. Out of 23 cases, 14 were metastatic squamous cell carcinoma (61%), 7 were metastatic adenocarcinoma (30.4%) and 2 were others (8.6%) which include one small cell carcinoma and one undifferentiated carcinoma. Conclusion: Cervical lymph nodes were the commonest sites involved by metastatic malignancy with male preponderance. Peak age of incidence was noted in 5th decade. Squamous cell carcinoma was the most common malignancy reported followed by adenocarcinoma.


H-Ras, N-Ras, and K-Ras are homologous signaling molecules that are able to regulate distinct signaling pathways because they inhabit different compartments within the cell. In their Perspective,
 Meder and Simons
 discuss new work (
 Rocks
 et al .) showing that N-Ras and H-Ras continuously cycle between the plasma membrane and Golgi membranes and that this trafficking depends on whether the Ras isoforms carry a palmitoyl group.


With the fast growth of Internet infrastructure and the use of large-scale complex applications from industries, transport, logistics, government, health and businesses, there is an increasing need to design and deploy multi-featured networking applications. Important features of such applications include the capability to be self-organized, decentralized, integrate different types of resources (PCs, laptops, mobile and sensor devices), and provide global, transparent and secure access to resources. Moreover, such applications should support not only traditional forms of reliable distributing computing and optimization of resources but also various forms of collaborative activities such as business, online learning and social networks in an intelligent and secure environment. In this paper, we present the JXTAOverlay, a JXTA-based P2P platform designed with the aim to leverage capabilities of Java, JXTA and P2P technologies to support distributed and collaborative systems. The platform can be used not only for efficient and reliable distributed computing but also for collaborative activities and ubiquitous computing by integrating in the platform end-devices. The design of an user interface as well as security issues are also tackled. We evaluate the proposed system by experimental study and show its usefulness for massive processing computations and e-learning applications.


A fibre-optic interferometric sensor is described based on a low-coherence source. A novel form of homodyne signal processing is used in which the interferometer is locked to the quadrature point nearest to maximum visibility. This technique avoids the ambiguities which arise from the use of a high-coherence source in interferometers, where the transfer function is periodic.


We introduce a new interpretation of chemical potential and show that holographic entropy is entropy bound, which is supported by two ideal cases discussed in detail. One is sparse but incompressible liquid like a star of uniform density and the other is a screen at infinity in spherically symmetric spacetime. Our work is based on the new scenario of entropy force and holographic thermodynamics, and the Brown—York quasi-local energy.


The author discusses some possible solutions to ASEA (active electronically scanned array) diagnostics in the operational environment using built-in testing (BIT), which can play a key role in reducing life-cycle cost if accurately implemented. He notes that it is highly desirable to detect and correct in the operational environment all degradation that impairs mission performance. This degradation must be detected with low false alarm rate and the appropriate action initiated consistent with low life-cycle cost. Mutual coupling is considered as a BIT signal injection method and is shown to have potential. However, the limits of the diagnostic capability using this method clearly depend on its stability and on the level of multipath for a specific application. BIT using mutual coupling may need to be supplemented on the ground by an externally mounted passive antenna that interfaces with onboard avionics.<<ETX>>


Plasmodium ovale consists of two subspecies - P. ovale wallikeri and P. ovale curtisi. Increased reports of imported malaria ovale in non-endemic regions and mixed infection of P. ovale with other Plasmodium species suggest that P. ovale might be under-detected during routine surveillance. Areas endemic with P. ovale have mostly been reported in African and Western Pacific countries. A recent case report in Indonesia indicated that regions with P. ovale endemicity are not only distributed in Lesser Sunda and Papua, but also in North Sumatra.


BACKGROUND
Protein catabolism and glucose intolerance are prominent in critically injured patients. The objective of this study was to assess if glucose or insulin availability influences the extent of protein catabolism in hypermetabolic patients.

METHODS
Amino acid net balance from the leg was quantitated in 6 severe burn victims. Furthermore, whole body and leg protein kinetics were assessed with 2H5 phenylalanine and 15N alanine. Measurements were obtained after a 9-hour fast, during an IV glucose infusion (30 micromol/kg per minute), and during a hyperinsulinemic (500 mIU/kg per minute) euglycemic clamp.

RESULTS
Compared with fasting values, the administration of glucose resulted in a significantly increased efflux of amino acids from the leg. In contrast, insulin administration significantly decreased the cumulative net efflux of amino acids. During hyperinsulinemia, isotopic measurements demonstrated a significant decrease in alanine appearance and an increase in phenylalanine disappearance into the leg.

CONCLUSIONS
These findings demonstrate that in critically injured patients, acute hyperglycemia increases muscle catabolism despite an endogenous insulin response. In contrast, exogenous insulin given in sufficient amount impedes muscle protein loss. The mechanism for this anabolic effect of insulin may vary between different amino acids.


This article discusses relevant aspects of the psychological situation of being nursed and refers to the psychosocial conception of competence, and its importance in a differential approach to the multidimensional process of developing rehabilitation programs. The report is based on an empirical study of the coping-styles of the chronically diseased elderly and their relatives. Our purpose is to give an expanded definition of competence and to identify some characteristic conditions causing trouble for the diseased and his family. With regard to inter- and intraindividual differences, some ideas of intervention and help are suggested.


Spatial market equilibrium theory views trade flows as the driving force behind market integration. We assess the price linkages between five major tomato markets in Ghana to ascertain whether spatial price transmission depends solely on direct trade between markets, or whether other forces drive market integration. We analyze a unique dataset of the fresh tomato trade consisting of semi-weekly price and trade flow data. A regime-dependent vector error correction model is proposed and its results are compared with those of a linear model. The analysis reveals that prices in the net producing areas of Ghana (Navrongo and Techiman) adjust quickly to disequilibria, while prices in major consumption areas do not show significant error correction for the most part. Markets are found to be strongly integrated, and some even in periods without direct trade flows. Information exchange among suppliers or third-market effects offer possible explanations to this finding.


In this paper, a novel autonomous data-driven clustering approach, called AD_clustering, is presented for live data streams processing. This newly proposed algorithm is a fully unsupervised approach and entirely based on the data samples and their ensemble properties, in the sense that there is no need for user-predefined or problem-specific assumptions and parameters, which is a problem most of the current clustering approaches suffer from. Moreover, the proposed approach automatically evolves its structure according to the experimentally observable streaming data and is able to recursively update its self-defined parameters using only the current data sample; meanwhile, it discards all the previously processed data samples. Experimental results based on benchmark datasets exhibit the higher performance of the proposed fully autonomous approach compared with the comparative approaches requiring user- and problem-specific parameters to be predefined. This new clustering algorithm is a promising tool for further applications in the field of real-time streaming data analytics.


Structure and histology of the wattle in the male White bellbird (Procnias alba) are described. The proximal two-thirds of the wattle contains only very sparse, frail connective tissue and is isolated both from the respiratory tract and from pneumatic spaces in the skull. The wattle is richly vascularized, with an extensive network of veins, which completely fill the lumen in the distal third. The larger veins possess longitudinal as well as circular muscle. Longitudinal muscle bundles (some associated with feather follicles) are scattered in the loose connective tissue of the periphery. The wattle is compared in structure with the superficially similar frontal process of the turkey (Meleagris gallopavo). The mechanism of extension and retraction is discussed.


Background: Engagement of schools in malaria control is an emerging strategy. Little is known about involvement of students on malaria message developments. This study evaluated message contents of primary school students' malaria poems.Methods: A qualitative content analysis was conducted to explore malaria messages conveyed in poems produced by students. Twenty poems were purposively selected from twenty schools across rural villages in five districts of Jimma Zone. Data were analysed using Atlas.ti version 7.1.4 software. Message contents and metaphors were presented using central themes and categories in supportive quotations. Finally, message contents were quantified in frequency. Results: The ages of the poetic students ranged from 12 to19 years old. A total of 602 specific malaria contents generated. The contents were put into 21 categories under five central themes. Contents about malaria-related knowledge include causation and modes of transmission, mosquito breeding and biting, signs and symptoms, caring for insecticide-treated nets (ITNs), and ways of prevention. The poems conveyed the perception of threats from malaria. Effectiveness of prevention methods was profoundly reported related to adaption of ITNs, environmental cleaning, indoor residual spray (IRS), treatment for fever, and drug adherence practices. Misconceptions, beliefs, and malpractices were mentioned in the poems pertaining to causes and drug-use. Direct calls were present to adopt ITN, IRS, clean surroundings, treatment, and drug use. Message about the severity of malaria, distinguishable signs and symptoms, manifest calls to community participation towards malaria elimination, knowledge of preventive ways, and effectiveness of ITN use were the most commonly conveyed contents. Metaphoric expressions (war and death) were used to convey messages about severity and the need to manage the prognosis of malaria through active ITN utilization, which itself was metaphorically represented 'a trap' to mosquitoes. Conclusion: Poetic content analysis indicated that students in primary schools are considerable malaria messages source, particularly in rural settings. Involving students in malaria programs would effectively communicate knowledge, perceptions, and promote practices by using local metaphors that set learning contexts.


Abstract A series of simulations were performed to determine the sensitivity of a three-dimensional mesoscale model to the spatial variation of surface properties across coastal southern California, including the Los Angeles basin. Properties were allowed to vary one at a time and all at once in the various simulations, and the results were compared to a simulation in which homogeneous surface properties were prescribed. In general, the simulated atmospheric effects of the variations were small, apparently overwhelmed by the large-scale wind and by the diurnal sea-land and mountain-valley winds that occur in the absence of surface variations. Some effects, however, were significantly large. The greatest change in the lowland airflow was a weaker westerly flow in the topographic channel between the western and eastern parts of the basin just south of the San Gabriel Mountains. Quantitative comparison of observed and predicted near-surface winds shows that small but distinct improvements in the model's pred...


BINSWANGER'S disease (BD) is characterized by cerebrovascular lesions in the hemispheral white matter. Interest in BD has been stimulated recently by reports of low density in the periventricular white matter on computerized tomography (CT) and magnetic resonance imaging (MRI) in elderly patients with dementia. This radiographic appearance also is common in asymptomatic patients. To better define the clinical features associated with the characteristic white matter lesions of BD, we reviewed the international literature from 1912 to the present for pathologically verified cases accompanied by relatively complete clinical descriptions. Twenty-one reports with 46 patients were found and, with a case of our own, are summarized in Table 1. The initial symptoms, rate of progression, presence of dementia, and other clinical features were variable. The pathologic features of these 47 cases were, by contrast, uniform and constitute the best basis for defining BD as a disease. The precise cause of the characteristic, presumably ischemic, white matter changes is unknown.


In order to elucidate the prophecies of Ezekiel, especially those against Egypt in Book 29, Jerome reconstructed the siege of Tyre by the Babylonian king Nebuchadnezzar. He seems to have done this not so much on the basis of the predictions recorded in the Bible (to say nothing of accurate records), as by comparison with accounts of Alexander the Great's siege of the same city more than two hundred years later. Jerome seems particularly dependent on the account of Alexander's siege of Tyre given by Quintus Curtius Rufus. The following investigation broadens our understanding of the authors known and used by Jerome, the uses to which he put his historical reading, and the methods of his Biblical exegesis, especially historical reconstruction.


In a double-blind study, 135 inpatients with a diagnosis of chronic schizophrenia were randomly assigned to 8 weeks of treatment with one of six parallel treatments: risperidone (a new central 5-hydroxytryptamine2 and dopamine D2 antagonist), 2, 6, 10, 16 mg/day; haloperidol, 20 mg/day; or placebo, after a single-blind placebo washout period. Doses were increased in fixed increments up to a fixed maintenance dose reached after 1 week. On the Clinical Global Impression-Severity of Illness and Improvement, all active medications were superior to placebo except for risperidone (2 mg) on the Clinical Global Impression-Improvement. On the total Positive and Negative Syndrome Scale (PANSS) score and positive subscale, superiority to placebo was observed for all treatment groups except for haloperidol and risperidone (2 mg), which tended to be superior to placebo on total PANSS and the positive subscale, respectively. On the PANSS negative subscale, only risperidone (6 mg/day) was significantly better than placebo. Risperidone (6 mg) was superior to haloperidol on the total PANSS, General Psychopathology, and Brief Psychiatric Rating Scale subscales. Although there was a linear increase in parkinsonism with increasing risperidone dosage, there were no statistically significant differences between risperidone (2, 6, and 16 mg/day) and placebo. At doses of 6 to 16 mg, risperidone displayed a marked antidyskinetic effect compared with placebo. This effect was more pronounced in patients with severe dyskinesia. By contrast, haloperidol produced significantly more parkinsonism than placebo and risperidone (2, 6 and 16 mg), with no effect on tardive dyskinesia. These data suggest that risperidone, at the optimal therapeutic dose of 6 mg/day, produced significant improvement in both positive and negative symptoms without an increase in drug-induced parkinsonian symptoms and with a significant beneficial effect on tardive dyskinesia.


The Landau-Ginzburg-Wilson theory of phase transitions precludes a continuous transition between two phases that spontaneously break distinct symmetries. However, quantum mechanical effects can intertwine the symmetries, giving rise to an exotic phenomenon called deconfined quantum criticality (DQC). In this Letter, we study the ground state phase diagram of a one-dimensional array of individually trapped neutral atoms interacting strongly via Rydberg states, and demonstrate through extensive numerical simulations that it hosts a variety of symmetry-breaking phases and their transitions including DQC. We show how an enlarged, emergent continuous symmetry arises at the DQCs, which can be experimentally observed in the joint distribution of two distinct order parameters, obtained within measurement snapshots in the standard computational basis. Our findings highlight quantum simulators of Rydberg atoms not only as promising platforms to experimentally realize such exotic phenomena, but also as unique ones allowing access to physical properties not obtainable in traditional experiments.


With the development of molecular targeting therapy, several treatment options for advanced hepatocellular carcinoma (HCC) have become available in cases where curative and other palliative treatments, such as radiofrequency ablation, surgical resection, and transarterial chemoembolization, are not applicable. However, with the detection of a variety of mutations in cancer-related genes in a single tumor, molecular heterogeneity is commonly observed in HCC. Therefore, mutations in the major cellular signaling pathways underlie the development of resistance to molecular targeting agents. On the contrary, immune checkpoint inhibitors have proven effective in patients who are refractory to conventional treatments and molecular targeting therapy. Several clinical trials are currently investigating the efficacy of immune checkpoint inhibitors both individually and in combination with other types of anticancer agents. In this review, we focus on the potential of immune checkpoint blockade in the treatment of human HCC.


The possibility to obtain new arylazoenamines endowed with antifungal activity was examined by reacting with acids the arylhydrazones of several keto- and aldo-tert, amines as dimethyl-3-aminoacetone, 3-quinuclidinone, 1-methyl-3-piperidone and 2-formyl-1-methylpyrrolidine. The reaction was successful only in the last two cases. From each 1-methyl-3-piperidone arylhydrazone two isomeric arylazoenamines were formed, which were identical with those obtained from the analogous arylhydrazone of 2-formyl-1-methylpyrrolidine. The structure of these compounds was settled on the ground of UV, IR, NMR and mass spectra and confirmed by means of X-ray analysis. A mechanism is proposed for the formation of arylazoenamines through the contraction of piperidine ring and enlargement of the pyrrolidinic one. The prepared compounds [3-arylazo-1-methyl-delta 2-piperideines 17 and 1-methyl-2(arylazo)methylene pyrrolidines 18 exhibited only a very weak antibacterial activity, but were moderately active against several Candida species and other yeast-like fungi.


Environmental impact assessment (EIA) is implemented in most countries as an administrative procedure. In this context, it is subject to the principles of administrative justice. However, to date, no empirical research has been conducted to determine the extent to which EIA decisions comply with the principles of administrative justice. In this paper, empirical data from 42 EIA cases in South Africa are used to establish EIA compliance with the administrative justice principles of lawfulness, procedural fairness and reasonableness. This is achieved by measuring EIA decisions against specially developed key performance indicators (KPIs). Overall, decisions were found to mostly comply with the principles of administrative justice. However, questions arise with regards to the quality and substance of the information feeding into the decision-making process and on which decisions are ultimately based.


In mechanical design safety assessment of packages for the transport of radioactive material the International Atomic Energy Agency (IAEA) regulations [1, 2] require the use of one of four methods of demonstration of compliance with regulations: tests with prototypes, reference to previous satisfactory demonstrations, tests with scaled models as well as calculation or reasoned argument. In all cases characterization of material behavior is necessary. The need for material characterization can be split into three groups: characterization for material modeling in the design and verification process, determination of assessment criteria and inspections during manufacturing.The paper deals primarily with material characterization for the material modeling in the design phase and authorities approval process. Main package components are discussed: cask body and lids, screws, trunnions, impact limiter and basket (structure holding the content in specified position). Depending on the material used for these components this paper shows exemplary a possible set of material investigations in order to allow modeling in design and assessment during the approval process.Copyright © 2012 by ASME


It is experimentally demonstrated that perfect imaging is possible in disordered wave guiding media, provided that the disorder is off-diagonal, i.e., that only the spacing varies randomly between the otherwise identical lattice sites. On-diagonal disorder or Kerr nonlinearity destroys the imaging.


Elevated serum low density lipoprotein (LDL) cholesterol is a strong risk factor for coronary heart disease; dietary as well as therapeutic regimens target reduction of serum LDL cholesterol to decrease the morbidity and mortality of coronary heart disease. The fatty acid composition of dietary fat has a marked impact on serum LDL cholesterol and other risk factors of diet-related chronic diseases (metabolic syndrome, diabetes and coronary heart disease). Besides fatty acids, which constitute > 95% of their content, fats in foods contain other fat-soluble chemicals collectively called non-glyceride components. Sterols are a major part of the non-glyceride components of fats in plant foods and get concentrated in vegetable oils. Current evidence suggests that properly solubilized plant sterols or stanols incorporated in ester or free form in various food formulations effectively restrict the absorption of both dietary and biliary cholesterol causing 10%-14% reduction in serum LDL cholesterol in normal, hyperlipidaemic and diabetic subjects. The carotenoid-lowering effect of foods enriched with plant sterols can be corrected by increasing the intake of foods rich in carotenoids. The use of foods enriched with plant sterols as a part of a heart-healthy diet is recommended only after consulting a clinician. Recent studies strongly suggest that even smaller amounts of sterols available from natural plant foods and vegetable oils are important dietary components for lowering serum LDL cholesterol. Furthermore, some of the other non-glyceride components of food fats have one or more of the following functions-vitamin activity, serum LDL cholesterol-lowering and antioxidant activity. Since the hypocholesterolaemic and antioxidant effects ofa combination of the non-glyceride components may be more than their individual effects, increasing dietary plant sterols and non-glyceride components from natural plant foods and vegetable oils could provide an additional dietary means for prevention/correction of dyslipidaemia and increasing the antioxidant potential of human diets. The food-based dietary guidelines recommended to ensure an optimal fat quality in the diet of Indians provide high levels of natural plant sterols and other health-promoting non-glyceride components in addition to adequate absolute levels of individual fatty acids and their optimal balance. National policies to promote these dietary guidelines may contribute to the prevention of coronary heart disease and other diet-related chronic diseases.


Abstract : Typestate systems allow the type of an object to change during its lifetime in the computation. Unlike standard type systems, they can enforce safety properties that depend on changing object states. We present a new, generalized formulation of typestate that models the typestate of an object through membership in abstract sets. This abstract set formulation enables developers to reason about cardinalities of sets, and in particular to state and verify the condition that certain sets are empty. We support hierarchical typestate classifications by specifying subset and disjointness properties over the typestate sets. We present our formulation of typestate in the context of the Hob program specification and verification framework. The Hob framework allows the combination of typestate analysis with powerful independently developed analyses such as shape analyses or theorem proving techniques. We implemented our analysis and annotated several programs (75-2500 lines of code) with set specifications. Our implementation includes several optimizations that improve the scalability of the analysis and a novel loop invariant inference algorithm that eliminates the need to specify loop invariants. We present experimental data demonstrating the effectiveness of our techniques.


Of 91 compact-type strains of Staphylococcus aureus in regular serum soft agar (SSA), 82 converted diffuse-type growth in serum soft agar (pH adjusted to 6.0). With the addition of four different rabbit anticapsular sera (anti-type A, B, C, and D sera) in low pH (6.0) SSA, 21 strains of S. aureus showed compact-type colonial morphologies. Eleven, one, and one strains of S. aureus reacted singly with rabbit anticapsular sera types A, B, and C, respectively, and no strain reacted with rabbit anticapsular type D. Eight of the e strains reacted with both rabbit anticapsular sera types A and B. When the ability to absorb the converting activities of the antisera (changes of colonial morphologies of anticapsular sera in SSA) was quantitatively tested, 7- to 27-fold of these organisms were capable of absorbing the activities compared with the Smith diffuse organisms. These results suggest that even unencapsulated S. aureus strains are capable of producing capsular substance, although the capability is quantitatively different from strain to strain.


We consider some simple optimisation problems and employ a non-traditional method to solve them. We try to model both the problem and solution domains as algebraic structures, attempting to characterise the join operations on these domains. In each of the examples chosen, these structures turn out to be monoids and we make use of the homomorphisms between the problem and solution structures to construct recursive programs. We argue that this method employs a particular conceptual model which is easy to use and may produce nice results.


We report here the results of a study on measurements and prediction of laminar-turbulent transition at high free-stream turbulence in boundary layers of the airfoil-like geometries with presence of the external pressure gradient changeover. The experiments are performed for a number of flow cases with different flow Reynolds number, turbulence intensity and pressure gradient distributions. The results were then compared to numerical calculations for same geometries and flow conditions. The experiments and computations are performed for the flow parameters which are typical for turbomachinery applications and the major idea of the current study is the validation of the turbulence model which can be used for such engineering applications.


The increase in the number of medications used may result many negative consequences for patients and health system. Elderly patients are more likely to encounter these health problems associated with polypharmacy. Deprescribing, the process of tapering, withdrawing, discontinuing, or stopping medications, is important in reducing polypharmacy, adverse drug effects, inappropriate or ineffective medication use, and costs. Deprescribing in elderly patients in accordance with the evidence based guidelines has many positive outcomes in older people such as decrease in the risk of falls, improvement in cognition, and improvement in patients' global health status. Therefore, each visit of an elderly patient should be considered as an opportunity to evaluate the unnecessary use or harms of the prescribed or nonprescribed medications. Clinicians should decide to deprescription process by individualized care goals in line with current guidelines. Beers Criteria, STOPP/START and The Medication Appropriateness Index-MAI can be used to assit clinicians to identify unnecessary or potentially inappropriate drugs and reduce the number of medications in older patients. But, a balance is required between over and under prescribing. In conclusion, prevention of polypharmacy and withdrawing unneccesary and inappropriate medications may be the best clinical decision for family physicians who follow the elderly in primary care.


Annular pancreas is an uncommon congenital anomaly associated with duodenal atresia in neonates. Rarely, the condition may manifest later in life. These symptoms include abdominal pain, nausea, and vomiting and usually arise due to obstruction to gastric emptying. Abdominal CT scan with high resolution and angiography protocol and magnetic resonance imaging are useful in confirming the presence of annular pancreas. Operative management involves bypassing the obstructed duodenum. Duodenoduodenostomy is routinely performed in neonates with annular pancreas. In adults, the duodenum is less mobile, and duodenojejunostomy or gastrojejunostomy are recommended. We report two cases of annular pancreas in adults treated with laparoscopic gastrojejunostomy.


Abstract We present EFMARAL, a new system for efficient and accurate word alignment using a Bayesian model with Markov Chain Monte Carlo (MCMC) inference. Through careful selection of data structures and model architecture we are able to surpass the fast_align system, commonly used for performance-critical word alignment, both in computational efficiency and alignment accuracy. Our evaluation shows that a phrase-based statistical machine translation (SMT) system produces translations of higher quality when using word alignments from EFMARAL than from fast_align, and that translation quality is on par with what is obtained using GIZA++, a tool requiring orders of magnitude more processing time. More generally we hope to convince the reader that Monte Carlo sampling, rather than being viewed as a slow method of last resort, should actually be the method of choice for the SMT practitioner and others interested in word alignment.


The application of ERP platform is the main content of enterprise informatization. This paper from the enterprise user's point of view, using the method of Nolan model and statistical analysis of quantitative analysis of the combination of big data analysis technique based on the proposed ERP project in our country enterprise planning stage analysis of the level of information technology enterprise personnel data feasible BD-- Nolan model the theory of the strategic planning and operation of the technology, based on self-review, also from the perspective of computer system technology gives specific countermeasures to solve the various schemes.


Patients with impaired cell‐mediated immunity have a higher risk of developing histoplasmosis; however, histoplasmosis after solid organ transplantation is rare. In Thailand, histoplasmosis cases are sporadic, and most cases are associated with human immunodeficiency virus (HIV) infection. Herein, we report a case of disseminated histoplasmosis in a kidney transplant Thai recipient diagnosed by fungal staining of fungal culture from bronchoalveolar lavage and bone marrow biopsy. Liposomal amphotericin B was given followed by oral itraconazole. The patient's clinical condition was improved; however, his graft function was irreversibly declined. The majority of histoplasmosis cases after solid organ transplant presented with disseminated disease with pulmonary involvement. Even in a non‐endemic area of histoplasmosis, suspected cases should be early diagnosed and promptly managed in order to reduce morbidity and mortality, especially in cell‐mediated immunity defect patients like solid organ transplant recipients.


This study investigates the influence of family of origin on parental responsiveness toward own child, taking into account gender differences. A total of 110 triads of mothers, fathers, and their first child aged 6–10 months participated in the standardized Free Play procedure. Parental responsiveness was assessed through observational measures (using Ainsworth procedure) and self-reported scales (Parental Responsiveness Scale). Results revealed correlations between objectively assessed responsiveness and self-reported parental styles in the family of origin, separately for mothers and fathers. Among mothers having daughters, parental sensitivity (an important aspect of observationally measured responsiveness) was positively correlated with having had a liberal loving mother and a negative correlation with an autocratic mother. Cooperation (another aspect of observationally measured responsiveness) was correlated positively with having had a liberal loving mother. Meanwhile, having a liberal unloving mother predicted lover sensitivity and cooperation. Similar correlations were not observed for mothers having sons. Among fathers having daughters, both aspects of observed responsiveness were positively correlated with having had a democratic father and negatively with autocratic or liberal unloving parents. Moreover, having a liberal unloving father and autocratic mother predicted their lower responsiveness toward daughters. These findings highlight the role of family dynamics in shaping parental responsiveness and emphasize the importance of understanding these dynamics in promoting responsive parenting.


A rare case study of actinic reticuloid is presented. Analysis of literature, clinical and pathomorphological criteria of I diagnostics are described.


............................................................................................................................................
  iii Copyright
  and
  Access
  Declaration
  .............................................................................................
  v Acknowledgements
  ......................................................................................................................
  vi List
  of
  Abbreviations
  ..................................................................................................................
  viii List
  of
  Tables
  and
  Figures
  ...........................................................................................................
  ix Introduction
  .....................................................................................................................................
  1 Role
  in
  improving
  joint
  range
  of
  motion
  (ROM)
  and
  reducing
  injury
  risk
  ..............................................
  2 Effects
  of
  pre-‐exercise
  stretching
  on
  vertical
  jumping
  performance
  .....................................................
  3 Effect
  of
  stretching
  duration
  ..................................................................................................................
  4 The
  effect
  static
  stretching
  when
  performed
  as
  part
  of
  a
  complete
  pre-‐exercise
  routine
  ....................
  5 Purpose
  of
  the
  study
  and
  research
  hypothesis
  ......................................................................................
  6 Methods
  .............................................................................................................................................
  7 Participants
  ............................................................................................................................................
  7 General
  study
  design
  .............................................................................................................................
  7 Independent
  variables
  ...........................................................................................................................
  9 Dependent
  variables
  ............................................................................................................................
  12 Sit-‐and-‐reach
  score
  ..........................................................................................................................
  12 3-‐m
  running
  vertical
  jump
  height
  ....................................................................................................
  12 Squat
  (SJ),
  countermovement
  (CMJ)
  and
  depth
  (DJ40)
  jump
  heights
  ..............................................
  13 Data
  analysis
  ........................................................................................................................................
  14 Results
  ..............................................................................................................................................
  15 Null
  Hypothesis
  testing
  ........................................................................................................................
  15 Magnitude-‐based
  inferences
  ...............................................................................................................
  17 Discussion
  .......................................................................................................................................
  20 Effect
  of
  warm-‐up
  conditions
  on
  vertical
  jump
  performance
  ..............................................................
  21 Effect
  of
  stretching
  condition
  on
  sit-‐and-‐reach
  scores
  ........................................................................
  24 Effects
  of
  static
  and
  dynamic
  stretching
  on
  vertical
  jump
  performance
  .............................................
  26 Limitations
  of
  the
  study
  .......................................................................................................................
  28 Conclusion
  ...........................................................................................................................................
  29 Practical
  implications
  ...........................................................................................................................
  30 References
  ......................................................................................................................................
  31 Appendix
  A
  .....................................................................................................................................
  40 Appendix
  B
  .....................................................................................................................................
  47 Appendix
  C
  ......................................................................................................................................
  48


The paper explores the efforts of Benazir Bhutto in politicizing her individual distress for cultural trauma in her autobiography The Daughter of the East. It mainly examines how her multiple efforts of transferring personal trauma into social trauma turn out to be Sisyphean attempts. Generally, a never-ending futile endeavour that never gets completed is understood as the Sisyphean attempt. Hence, the paper illustrates the same endless and futile side of Bhutto's exertions in developing cultural trauma through her life writing. Actually, her father Zulfiqar Ali Bhutto, the former Pakistani Prime Minister, was assassinated by the military regime in 1979. On the foundation of the assassination, she became Prime Minister of Pakistan twice. Moreover, that tragic event also provided the major content for the writing of this autobiography. In this context, in this qualitative study of the autobiography, the major insights on the social process of cultural trauma as initiated by Jeffrey C. Alexander are used as the theoretical framework to evaluate the relevant textual evidence. Moreover, the concepts of Sidonie Smith and Julia Watson concerning the culture of writing autobiographies are also borrowed to support the argument. Ultimately, the textual analysis mainly signals that censored media, extreme judiciary and forceful martial law including the government-endorsed faith of Pakistan seem to hinder the social process of cultural trauma.


Two new types of narrow-emitter effects are identified in shallow and narrow-junction polysilicon emitter bipolar transistors. These effects result from a lower doping concentration close to the emitter perimeter of large devices (perimeter depletion effect) or in very-narrow-emitter devices where the polysilicon plugs up the emitter window (emitter plug effect). The consequence is a locally shallower emitter junction which causes a reduced collector current density and a nonideal base current due to a partial overlap of the emitter-base space-charge region with the poly/monosilicon interface. The nonuniform doping in the polysilicon is verified by energy-dispersive X-ray spectroscopy (EDX) measurements. Electrical measurements give a clear indication of the emitter plug effect for two different self-aligned transistor structures, and further evidence is given by a comparison of various poly emitter processes. >


The chromatographic behaviour of molecular species of sphingomyelin on HPTLC was investigated. Sphingomyelin gave a double band pattern on HPTLC plates developed using chloroform/methanol/acetic acid/water (25 : 15 : 4 : 2, v/v) or chloroform/methanol/water (25 : 10 : 1.1, v/v). HPTLC analysis of acyl chain-defined sphingomyelins showed that the Rf values increased linearly with the length of the N-linked acyl chain. A double-banded pattern was therefore seen for natural sphingomyelins with a bimodal fatty acid composition. Racemic sphingomyelins also gave a double band pattern on HPTLC, where the lower band represented the Derythro and the upper band the Lthreo isomer. We also showed that Derythro-N-16:0-dihydrosphingomyelin migrated faster on HPTLC than Derythro-N-16:0-sphingomyelin. The upper and lower band sphingomyelins from two different cell lines (human skin fibroblasts and baby hamster kidney cells) were separately scraped off the HPTLC plates and the fatty acid and long-chain base profiles were studied using GC-MS. The lower bands contained short-chain fatty acids and most of the fatty acids in the upper bands were long. The predominant long-chain base was sphingosine, which was found in both upper and lower bands, but sphinganine was found only in the upper bands. To conclude, there are at least three possible reasons for the sphingomyelin double bands on HPTLC; acyl chain length, long-chain base composition and stereochemistry. These reasons might sometimes overlap and, therefore, HPTLC alone is insufficient for complete analysis of the molecular species of sphingomyelin.


Introduction: Pakistan has suffered from the worst ever natural and artificial disasters in its history since the start of this century. These disasters caused widespread loss of life, property, and resources; moreover, a high level of social and psychological imbalance was also experienced. The only law available in the country to handle disaster situations was response-oriented, and in the aftermath of the Kashmir earthquake in 2005, the government was forced to review its laws dealing with disasters. To provide a complete spectrum of Disaster Risk Management (DRM) at national level, National Disaster Management Ordinance (NDMO) was promulgated in 2006. NDMO was ratified by the parliament naming it as National Disaster Management Act (NDM Act), 2010 of Pakistan with the purpose to reduce the risks and manage the future disaster situations effectively and efficiently. The purpose of this paper is to review in detail the (NDM Act), 2010 of Pakistan and ascertain the limitations with a view to proffer necessary recommendations.
Methods: The study is based on secondary data and detail review of NDM Act 2010, of Pakistan.
Discussion: The detail study of NDM Act, 2010 reveals that the Act was either prepared in haste or by a team lacking the requisite expertise on the subject due to certain glaring ambiguities within the contents of various sections. Initially the Act appears to be reactive in nature as there is no mention of disaster risk reduction measures. Lack of accountability mechanism makes the implementation phase susceptible to deviant workplace behaviors. Details of financial allocations for the lower level disaster management authorities (district, union and town), who are the initial responders have been missed out.
Conclusion: Owing to lack of political and economic constraints supplemented with corruption, the effectiveness of policies and plans formulated under the guidelines of NDM Act, 2010 will always remain doubtful. Thus, the early revision of NDM Act, 2010 of Pakistan is recommended.


We analyse the patterns and determinants of technology alliance formation with partner firms from emerging economies with a focus on European firms' alliance strategies. We examine to what extent European firms' alliance formation with partners based in emerging economies is persistent – that is, to what extent prior collaborative experience determines new alliance formation – and we compare this pattern with alliance formation with developed country partners. Second, we examine to what extent prior engagement in international alliances with partners from developed countries increases the propensity to form technology alliances with partners based in emerging economies, and vice versa (interrelation). We find that both persistence and interrelation effects are present, and that they are generally not weaker for emerging economy alliances. Alliance formation with Indian and Chinese firms is significantly more likely if firms have prior alliance experience with Japanese firms. The findings suggest that building on their prior international alliance experience firms extend their alliance portfolios across both developed and emerging economies, increasing the geographical diversity of their alliance portfolios.


Radioactive 204Tl+ was found to diffuse in potassium chloride up to three times more rapidly than stable Tl+. The difference is attributed to the 204Pb2+ daughter element produced by β–emission. A theoretical model accounts satisfactorily for the discrepancy and indicates that internal sources of cation vacancies are effective in maintaining electroneutrality at all but low temperatures.


Single-cell analyses of secretory proteins are essential to fully understand cellular functional heterogeneity and unravel the underlying mechanisms of intercellular signaling and interactions. Retrieving dynamic information of protein secretion at single-cell resolution reflects the precise, real-time functional states of individual cells in physiological processes. Such measurements remain very challenging in single-cell analysis, which requires highly integrated systems capable of performing on-chip single-cell isolation and subsequent real-time protein detection. Here, recent advances in microfluidics-based single-cell manipulation and emerging approaches for label-free single-cell biosensing are reviewed. The advantages and limitations of these technologies are summarized and challenges to establish the integrated microfluidic biosensing systems for real-time single-cell secretomics are discussed. Recent efforts on integrated platforms for on-chip single-cell protein assays are highlighted and some perspectives on future directions in this field are provided.


This is a review of the results related to generalizations of the notion of $\tau$-function and integrable hierarchies and to their interpretation within the group theory framework that admits an immediate quantization procedure. Different group theory structures underlying integrable system are discussed in detail as well as their quantum deformations.


Aim Compare the value of ambulatory EEG and video telemetry in Diagnosis and Classification of seizures. Method The EEG department database was interrogated retrospectively for children having both ambulatory EEG and video telemetry recording during the period March 1998 to August 2011. Only patients referred for purposes of diagnosis of attacks and classification of epilepsy were included. Patients admitted for pre-surgical evaluation of epilepsy were excluded. 48 patients were included in the study; M:F ratio 0.7:1, mean age 11.5 years, range 2 to 21 years. All patients had only 1 telemetry but 9 patients had more than 1 ambulatory recording. For the purposes of the study the result from the ambulatory recording preceding the video telemetry was used. Information regarding reason for referral and result of the long term EEG investigations was obtained. Results The reason for request was for Diagnosis of attacks in 77% of ambulatory EEGs and 52% of video telemetries. Classification of epilepsy in 16% of ambulatories and 43% of telemetries. Recording length for ambulatory EEG was: 24 h (68%) 48 h (25%) and 72 h (6%). Recording length for video telemetry was 1–3 days (60%) and 4–5 days (40%). Typical attacks were recorded in 68% of ambulatory EEGs and 56% of telemetry recordings. The EEG helped in Diagnosis in 66% of ambulatory EEG's and 62% of telemetries. The EEG helped in Classification in 21% of ambulatory EEG's and 56% of telemetries. 62% of patients where ambulatory EEG was inconclusive (21% of the total) went on to have a valuable telemetry. The combined yield of the investigations was 89%. Conclusion Ambulatory EEG is an effective tool for diagnosing seizures in two thirds of children. Where ambulatory EEG is inconclusive, videotelemetry improves the diagnosis in a further fifth. Video telemetry is superior to ambulatory EEG in classifying seizures.


Understanding the nature and extent of climatic impacts on agricultural productivity under a variety of scenarios is extremely important for developing countries, where a sizable portion of the population relies on agriculture for life and livelihood. Thus, this paper presents evidence of heterogeneity in climatic impacts on crop yield in Assam, India. In particular, applying the non-parametric quantile regression technique to district-level data from 1978 to 2005, this study examined heterogeneity in the impacts of temperature and rainfall across seasonal rice varieties (autumn, winter, and summer), agroclimatic (AC) zones, and the distribution of rice yield. The results suggested that, in general, the effects of temperature on yield were not statistically significant for any of the three seasonal rice varieties. However, these effects were not uniform in their magnitudes, signs, and statistical significance across AC zones and yield distribution for each variety of rice. Similarly, there were wide variations in the effects of total precipitation across seasonal varieties, AC zones, and yield distribution. The results also suggested that an increase in temperature variability is beneficial and that rainfall variability is harmful to autumn and winter rice yield. For summer rice, the effects of these two climate variables were positive but statistically insignificant. Given the importance of rice yield for food security and poverty alleviation in Assam, these results could inform the design of appropriate adaptation strategies and public policies to counter the adverse impacts of climate change on agriculture in Assam. Furthermore, since most people in rural areas are engaged in agriculture, these results are important for the sustainability of rural economies.


On the night of June 28, 2014, near the village of Arshan in Tunkinsky district, Republic of Buryatia in eastern Siberia, two types of debris flows were formed as a result of intense storm precipitation: 1) debris floods along the river Kyngarga; 2) debris flows along the valleys originating from the cirques of the southern slope of the Tunkinsky Goltsy range, which went in the south-west direction towards the village. A year later, July 14, 2015, in the village of Arshan a debris flood occurred in the river Kyngarga. During the Holocene debris flows have occurred repeatedly, traces of which are seen in the sections of loose deposits. Their age was defined with the help of radiocarbon analysis of buried soil horizons. A historical analysis of debris flow activity on the territory for more than a century was made using published scientific works. Natural factors for the formation of debris flow situation were considered (synoptic and climatic conditions, hydrology, geology and landscape structure were evaluated). Reasons for the most recent debris flows were defined. A detailed analysis was given of the valleys of a number of rivers where results of debris flows were the most destructive. As a result of the debris flow along the river Kharimta, realignment of the river network took place. Consequences of debris flows for the natural environment and infrastructure of the village of Arshan were evaluated. It is considered that the partial destruction of the village of Arshan is a distinct possibility in the near future due to debris flows from cirque #1.


We report the measurement result of the degree to which X-rays from a conventional X-ray generator in the energy range up to 60 keV are linearly polarized. The X-ray generator we used in which the accelerated electrons hit the water-cooled metal head is widely used commercially. We measured the degree of linear polarization by employing a Thomson scattering process. We found that the degree of linear polarization depends only on the ratio between the X-ray energy from 20 keV to 60 keV and the applied voltage to the electron. The higher the ratio is, the higher the degree of linear polarization we obtain, whereas the weaker the X-ray intensity is. By selecting an appropriate combination between the applied voltage and the X-ray energy, we confirmed that we would obtain a mono-energetic highly linear polarized X-ray beam with enough intensity for practical use.


Abstract. This paper presents a pipeline that aims at illustrating the procedure to realize a 3D model of a complex building integrating the UAV and terrestrial images and modifying the 3D model in order to publish to Google Earth in an interactive modality so as to provide better available models for visualization and use. The main steps of the procedure are the optimization of the UAV flight, the integration of the different UAV and ground floor images and the optimization of the model to be published to GE. The case study has been identified in a building, The Eremo di Santa Rosalia Convent in Sicily which hash more staggered elevations and located in the hills of the hinterland and of which, the online platform only indicate the position on Google Maps (GM) and Google Earth (GE) with a photo from above and a non-urban road whose GM path is not corresponding with the GE photo. The process highlights the integration of the models and showcases a workflow for the publication of the combined 3D model to the GE platform.


This study aimed to investigate some main factors affecting secondary students' choice of high school in Tra Vinh province. A group of 777 participants including 440 urban and 337 rural secondary students in Tra Vinh city and some districts of Tra Vinh province was selected to answer the questionnaire. The results from the questionnaire revealed that three groups of factors (educational environment, school distinction and personal conditions) had nearly equal overall mean scores and influenced students more than the three remaining factors (social network, extra activities and location-transportation) in choosing their high school. In addition, no significant difference was found between urban and rural secondary students in choosing their high school. Based on the findings above, some possible recommendations were suggested to the executive boards of high school, secondary school teachers and secondary school students in order to assist them in choosing their appropriate high school.


Following the US Civil War, newly freed Black Americans had significantly poorer health than Whites. Founded in 1865, the Freedmen's Bureau offered a range of support (eg, food, health care, shelter, legal aid) to try to improve health among the newly freed. The COVID-19 pandemic has exposed the persistence of racial health inequity in American life. Ethical obligations to address it exist now, just as they did in 1865.


The in-flight pattern measurements of a sub-millimeter space telescope may be improved by determining the actual reflector anomalies, and then including the knowledge of these in the final pattern determination. The pattern measurements with a celestial object as a source often have an insufficient signal-to-noise ratio for pattern prediction outside the main lobe. Repeated measurements may improve this, but even better is the possibility of extracting data from different detectors operating at different frequencies. With the Planck Space Telescope as an example, simulations of a displaced and distorted reflector were carried out for noise-contaminated amplitude measurements of Jupiter by five and 10 different detectors, respectively. First, the main beams of the antenna patterns were retrieved in a regular grid. Here, the accuracy was limited by the noise level. By a Physical Optics optimization, the actual distortions of the telescope's reflector were then determined, so that the calculated radiation patterns of the antenna were correlated to the measured main beams. The patterns for the optimized and retrieved reflector geometry were shown to be precise at levels far below the noise floor in the direct measurements.


Quora is a popular Q&A site which provides users with the ability to tag questions with multiple relevant topics which helps to attract quality answers. These topics are not predefined but user-defined conventions and it is not so rare to have multiple such conventions present in the Quora ecosystem describing exactly the same concept. In almost all such cases, users (or Quora moderators) manually merge the topic pair into one of the either topics, thus selecting one of the competing conventions. An important application for the site therefore is to identify such competing conventions early enough that should merge in future. In this paper, we propose a two-step approach that uniquely combines the anomaly detection and the supervised classification frameworks to predict whether two topics from among millions of topic pairs are indeed competing conventions, and should merge, achieving an F-score of 0.711. We also develop a model to predict the direction of the topic merge, i.e., the winning convention, achieving an F-score of 0.898. Our system is also able to predict ~ 25% of the correct case of merges within the first month of the merge and ~ 40% of the cases within a year. This is an encouraging result since Quora users on average take 936 days to identify such a correct merge.


An exploration of Thornton's work reveals an attempt by a woman to push the boundaries of her own creativity, as well as the limitations and restrictions embedded in a society that sought to delineate the space between aboriginal and Euro-Canadian people along racial lines. Her written and visual material read together provide an example of an alternative to traditional iconography and stereotypical representations of Native people. Yet, her work cannot be removed from the context of art production by Euro-Canadian artists of the early 20th century, who were interested in "salvaging" aboriginal traditions and customs through their brushes and palettes, sometimes with total disregard for the actual people. This multi-faceted and conflicting process is what defines Thornton's work, and provides an opportunity to explore issues of cultural appropriation as well as the complexity of human relations.


Roots are essential organs for a plant's ability to absorb water and obtain mineral nutrients, hence they are critical to its development. Plants use root architectural alterations to improve their chances of absorbing nutrients when their supply is low. Nine root traits of a Brassica napus association panel were explored in hydroponic-system studies under low potassium (K) stress to unravel the genetic basis of root growth in rapeseed. The quantitative trait loci (QTL) and candidate genes for root development were discovered using a multilocus genome-wide association study (ML-GWAS). For the nine traits, a total of 453 significant associated single-nucleotide polymorphism (SNP) loci were discovered, which were then integrated into 206 QTL clusters. There were 45 pleiotropic clusters, and qRTA04-4 and qRTC04-7 were linked to TRL, TSA, and TRV at the same time, contributing 5.25–11.48% of the phenotypic variance explained (PVE) to the root traits. Additionally, 1360 annotated genes were discovered by examining genomic regions within 100 kb upstream and downstream of lead SNPs within the 45 loci. Thirty-five genes were identified as possibly regulating root-system development. As per protein–protein interaction analyses, homologs of three genes (BnaC08g29120D, BnaA07g10150D, and BnaC04g45700D) have been shown to influence root growth in earlier investigations. The QTL clusters and candidate genes identified in this work will help us better understand the genetics of root growth traits and could be employed in marker-assisted breeding for rapeseed adaptable to various conditions with low K levels.


A canonical flat-plate turbulent boundary layer with Reθ = 4590 is exposed to a favourable mean streamwise pressure gradient sufficient to cause relaminarization. The favourable pressure gradient is generated by a linear contraction, yielding a peak value of the acceleration parameter of K = 4.4 × 10−6 which is sustained for approximately 13 local boundary layer thicknesses. The relaminarization process is characterized by an extensive series of mean flow and turbulence measurements obtained at several representative streamwise locations. In anticipation of the loss of standard log-law behaviour, the local wall shear stress is directly measured using the oil-film interferometry technique. Mean flow measurements show a systematic variation in the Kármán and additive constants with applied streamwise strain rate. The series of measurements also indicate an apparent decoupling of the outer and near-wall regions of the accelerating boundary layer. In accord with this, conditional measurements show that fourth-quadrant sweep events are virtually eliminated, while much less frequent but larger-amplitude near-wall second-quadrant ejection events remain. The reduction in fourth-quadrant sweep events is matched by an observed increase in near-wall third-quadrant events. The consequent reduction in near-wall Reynolds stress correlation and associated cross-stream momentum transport results in a large reduction in cf for the relaminarized flow.


Recent observations of two unusual Z Cam systems, V513 Cas and IW And have shown light curves that seem to contradict the disc-instability model for dwarf novae: outbursts are appearing during standstills of the system when according to the model, the disc is supposed to be in a hot quasi-equilibrium state. We investigate what additional physical processes need to be included in the model to reconcile it with observations of such anomalous Z Cam systems. We used our code for modeling thermal-viscous outbursts of the accretion discs and determined what types of mass-transfer variations reproduce the observed light curves. Outbursts of mass transfer (with a duration of a few days, with a short rise time and an exponential decay) from the stellar companion will account for the observed properties of V513 Cas and IW And, provided they are followed by a short but significant mass-transfer dip. The total mass involved in outbursts is of the order of 10$^{23}$g. We studied the possible origins of these mass transfer outbursts and showed that they most probably result from a giant flare near the secondary star surface, possibly due to the absence of star spots in the $L_1$ region.


Abstract We assessed how many US deaths would have been averted each year, 1933–2021, if US age-specific mortality rates had equaled the average of 21 other wealthy nations. We refer to these excess US deaths as "missing Americans." The United States had lower mortality rates than peer countries in the 1930s–1950s and similar mortality in the 1960s and 1970s. Beginning in the 1980s, however, the United States began experiencing a steady increase in the number of missing Americans, reaching 622,534 in 2019 alone. Excess US deaths surged during the COVID-19 pandemic, reaching 1,009,467 in 2020 and 1,090,103 in 2021. Excess US mortality was particularly pronounced for persons under 65 years. In 2020 and 2021, half of all US deaths under 65 years and 90% of the increase in under-65 mortality from 2019 to 2021 would have been avoided if the United States had the mortality rates of its peers. In 2021, there were 26.4 million years of life lost due to excess US mortality relative to peer nations, and 49% of all missing Americans died before age 65. Black and Native Americans made up a disproportionate share of excess US deaths, although the majority of missing Americans were White.


BackgroundCoronavirus disease-19 (COVID-19) was declared by the World Health Organization (WHO) as a global pandemic on March 2020. Several measures have been attempted to contain the spread of the virus including school closures and lockdown. These measures have resulted in children staying at home with potential hazard exposure such as accidental drug or foreign body ingestions. In this study, we want to investigate the impact of COVID-19-related measures on admissions of children with accidental foreign body or drug ingestion. Methods All accidental ingestion admissions to pediatric wards at Al-Amiri hospital during the pandemic from March 2020 till February 2021 were retrospectively reviewed. They were compared with admission data from the pre-pandemic period from March 2019 till February 2020. Results There were 90 admission with accidental ingestion during the Pandemic compared to 138 admissions in the pre pandemic period. The mean age of admission during non-COVID-19 period was 3.9 ± 2.6 years, and 4.1 ± 2.9 years during pandemic period. The most common cause of accidental ingestion in children in both periods was medication ingestion. Coin ingestion was the second common cause during the pandemic compared to detergent in the pre-pandemic period. ConclusionsDespite children's stay at home during COVID-19 pandemic, there was a reduction in hospitalization with accidental ingestion. This emphasizes the significance of family availability and constant observation of children at home as an important safety measure.


Abstract A shipboard acoustic Doppler current profiler, in its bottom-track mode, estimates the radial velocity of the transducer relative to the bottom and the range from the transducer to the bottom for each beam of each ping. These data, along with attitude data (pitch, roll, and heading), can be used to map the X, Y, and Z positions of the beam/bottom intercepts. This paper shows how these intercepts can then be used to characterize the size, shape, and orientation of small-scale bathymetric features. The method is applied to data collected over a field of sand waves located 40 km east–northeast of Cape Hatteras, North Carolina, in 30 m of water. Forty-five sand waves were crossed. The sand waves were oriented in an east–west direction, had characteristic heights of 3 m, wavelengths of 230 m, and northern slopes steeper than southern slopes (e.g., 3.8% versus 2.4%). Some sand waves were sampled repeatedly and extended for several kilometers.


containing :o g bromide per 200 ml, as a †̃¿ nerve tonic'. Her general practitioner had prescribed this for her, and she had taken it twice a day for over twenty years. There was no family or personal history of mental illness. Her mixture was dis continued and she was encouraged to drink a lot of water.Her serumbromideslowlyfell and shewas discharged after two months. No reason was found for the onset of her bromide intoxication to have occurred at this particular time.


This is a case study of a patient with the clinical diagnosis of meningoencephalitis. It demonstrates the in vivo development of plasma cells in the central nervous system. All the stages of in vitro mitogen-induced lymphocyte transformation previously described by light and electron microscopy are recapitulated in this analysis of cerebrospinal fluid. It is postulated that this represents a local humoral immune reaction in the central nervous system and provides morphologic support for the concept that the gamma globulin in cerebrospinal fluid is produced locally in part, in addition to its origin from the plasma proteins.


Multiple myeloma is a cancer of the plasma cells that is characterized by multiple localized lesions in the marrow, particularly of the spine, skull, and pelvis, although soft tissue lesions also occur. It is the second most common blood cancer, affecting approximately 45,000 people in the US. Most preclinical modeling of myeloma employs SC xenografts that mimic the less common plasmacytoma form of the disease. Systemic (IV) implants are also used, but studies typically are based on a single survival endpoint, limiting knowledge about the progression and response of the disease under treatment. In order to more quantitatively monitor disseminated disease progression and response to treatment, we have characterized two human (JJN3 and MM1S) and one murine (5TGM1) myeloma models that have been modified to express luciferase. All models were characterized by 100% tumor take rate and focal dissemination of the disease to the spine and skull that mimic clinical experience. These models showed individual and reproducible patterns of spread to other sites, and differed in their sensitivities to standards of care. Analysis of tumor doubling times, tumor titrations, luminescence-based growth delay, and survival all indicated that the bioluminescence signal was a reliable quantitative indicator of viable tumor burden, even under treatment with clinical standard of care agents. Luciferase labeling and the tight correlation between luminescence signal and viable tumor burden raises the possibility of differential real-time tracking of tumor progression and response at individual sites. Citation Format: Meridith Baugher, Jenifer Baranski, Deepa Balagurunathan, Christopher Bull, Noah Winchell, Darren Shaw, Erin Trachet, Deanne Lister, Patrick McConville, Wilbur R. Leopold. Characterization of imaging-enhanced models of disseminated multiple myeloma. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3859. doi:10.1158/1538-7445.AM2013-3859


A calculation model was developed to forecast and assess the effect of global climate change on the future of energy use, water sufficiency and agricultural production in Jordan. For the purpose of this study, the world is divided into three regions: Jordan, Arab League countries and the rest of the world. Interaction between these regions is assumed to take place in the form of agricultural products exchange. Considering the sectors of energy, water and agriculture in Jordan from the viewpoint of systems' concepts, the future behaviors of their quantities are formulated under conditions of climate change. These quantities are: energy consumption, water supply and demand, and the production and consumption of agricultural products. An example calculation is made and the behavioral features of those quantities from the year 2000 to 2100 are derived under the constraint that the total amount of the worldwide production of a certain agricultural product is equal to the total amount of its consumption. The results show that the amounts of energy, water and agricultural products required for Jordan will become remarkably high, especially in the second half of this century. This strongly emphasizes the need for appropriate policies to tackle the deficits. The developed model appears suitable for assessing the adequacy of the policies that should be implemented in future Jordan regarding the management of the sectors of energy, water and agriculture.


The aim of this study was to determine the effects of coenzyme Q10 Supplementation on Footsal competitioninduced changes in serum neutrophil in male players. Therefore, Twenty four male footsal player of league(age23/5±1year, height174/75±5.2cm,body mass 71/3±3.5 kg and BMI 22/72±1) were selected and randomly assigned in four groups:( coenzyme Q10, competition + coenzyme Q10,competition + placebo and (placebo) . Based on research design, players took coenzyme supplement (100 mg coenzyme Q10) or placebo three times daily .The players accomplished three successive footsal competitions in time period of 4-6 p.m. The blood samples were collected for analysis of serum neutrophil at the rest status before, immediately and 24 hours after the final session of competitions. data were analyzed by repeated measure ANOVA,LSD post hoc test at P<0/05. Results showed that effect of supplementary consumption of coenzyme Q10 on neutrophil levels during three consecutive matches in competition group with supplement was significantly (p=0/0001) different from other groups. Post hoc test revealed that, this difference was significant in the second and third stages. Results of within group comparison in ANOVA analysis showed that the level of neutrophils in competition group with coenzyme Q10 was significant (p=0.010) in three stages of measurement. The post hoc test indicated that level of significance were increased (p=0.001) in second stage and decreased in third (p=0.027).Based on the results consumption of coenzyme Q10 supplement at the time of successive footsal competitions can reduce serum neutrophil of male footsal players, so can have a beneficial effect on players' immune system. It is suggested that, Footsal players use coenzyme Q10 supplement during consecutive matches.


This investigation examined social support available to Euro- and Mexican-American children (N = 88), as reported by children residing in single- and two-parent homes. Mothers provided descriptions of their own social networks and of their child's adjustment. Child reports of network size and composition varied by ethnicity and maternal marital status, with children from intact, Euro-American homes reporting the fewest network members and those from intact, Mexican-American families reporting the most. No significant group differences emerged in child reports of the amount of, or satisfaction with, support received. The children's reports of total frequency of receiving support were associated with lower rates of externalizing behaviors. Similarly, children whose mothers reported more supportive networks were rated as lower in externalizing behavior, regardless of marital status or ethnicity. In regression analyses, both the mothers' reports of support and the children's reports of support contributed significantly to the prediction of externalizing behaviors.


Background: Chronic kidney disease (CKD) is a significant public health problem. Dialysis is the mainstream method of treatment in these patients. This causes the patients to have a monotonous and restricted daily life, joint pain, limiting their activities after treatment onset. Hence this study was carried out to find the prevalence of common musculoskeletal disorders in patients undergoing haemodialysis in a tertiary care hospital.
Method: 50 participants undergoing dialysis in a tertiary care hospital under the age group of 18-70 years diagnosed with stage V CKD were included using convenient sampling. They were assessed using Nordic Questionnaire to locate the different areas of pain.
Result: The first group consisted of 41 participants who underwent dialysis from 2- 41 months. Body regions commonly affected in the last 7 days were low back 25(60.97%); neck 21(51.21%); shoulder 15(36.58%); elbow 14(34.14%) in the extremity with arteriovenous fistula; upper back 14(34.14%); hips/thighs, knees 9(21.95); wrist/hands 7(17.07%) in the extremity with arteriovenous fistula; ankle/feet 6(14.63%). The second group consisted of 9 participants who underwent dialysis from 42-84 months. Body regions commonly affected in the last 7 days were low back 8(88.88%); upper back 7(77.77%); hip/thigh 6(66.66%); neck, knee 5(55.55%); elbow 4(44.44%) in the extremity with arteriovenous fistula; shoulder, ankle/feet, wrist/hands 3(33.33%).
Conclusion: The study concluded that the highest prevalence of musculoskeletal disorders in the participants undergoing haemodialysis was low back pain (66%) followed by neck (52%), upper back (42%), shoulder (36%), elbow (36%), hips/thighs (30%), knees (28%), wrist/hands (20%) and ankle/feet pain (18%).


This paper is an attempt to empirically investigate the industrial risk premium and realized return relationship by extending hybrid CAPM of Bodnar, Dumas, and Marston (2004). The inclusion of the industry risk premium offers more sophisticated results. Fama and Macbeth (1973) methodology are applied to test this relationship. The results indicate that there is a positive and significant relationship of the industry risk premium for Pakistan, India, and Brazil, whereas, it is insignificant for China, Russia, and South Africa. It is also seen that other risk premiums are insignificant for the said countries if industry risk premium is considered. The results also indicate that industry risk premium is only significant for those countries where the firms are mostly operated through the family business environment like Pakistan, India, and Brazil. This may lead to conclude that the industry risk premium can be used as the agency cost of minatory shareholders and controlling shareholders. This study provides an insight for the global investors, FPI holders, local and global mutual fund managers, to incorporate this industry risk premium into the existing CAPM framework especially for the countries where the business is managed as a family environment.


We examined age differences in the effort required to perform the basic cognitive operations needed to achieve a specified objective outcome, and how hypothesized increases in effort requirements in later life are related to intrinsic motivation associated with enjoyment of and participation in effortful cognitive activities. Young (N = 59; 20-40 years) and older (N = 57; 64-85 years) adults performed a memory-search task varying in difficulty across trials, with systolic blood pressure responsivity-calculated as the increase over baseline during task performance-used as a measure of effort expenditure and task engagement. Consistent with expectations, older adults exhibited greater levels of responsivity (i.e., effort) at all levels of objective task difficulty, and this increase was reflected in subjective perceptions of difficulty. Older adults also exhibited greater levels of disengagement (i.e., effort withdrawal) than younger adults at higher levels of task difficulty, conceivably reflecting the disproportionately greater effort required for successful performance in the former group. We also found that, relative to younger adults, older adults' engagement was more sensitive to the importance attached to the task (i.e., motivation to do well). Finally, we also obtained evidence that increased costs associated with cognitive engagement in later life were negatively associated with intrinsic levels of motivation to engage in effortful cognitive activity. The results support the general conclusion that the costs of cognitive activity increase with age in adulthood, and that these costs influence individuals' willingness to engage resources in support of demanding cognitive activities.


Folate, a B vitamin found almost ubiquitously in foods, is required for de novo nucleotide synthesis and methylation reactions in our body. A shortage of folate can lead to macrocytic anemia, however, extra folic acid, the synthetic form of folate, is considered to be a modern day panacea for a variety of diseases, specifically vascular disease. This review summarizes the evidence from randomized controlled trials and illustrates the weak foundation on which health claims regarding the possible beneficial effect of extra folic acid for vascular disease are based. It is prudent for public health policy makers to await trials--the conventional golden standard by which to test causality--before deciding on folic acid fortification for the general population.