Hypophosphatasia (HPP) is a genetic disease caused by one or more mutations in the alkaline phosphatase (ALP) gene, which encodes tissue-specific ALP and affects the mineralization process. Accordingly, arthralgia, fractures, and dental abnormalities have been reported in adults, and fatal courses in children. This metabolic disorder is commonly misdiagnosed with other more prevalent bone diseases due to its low prevalence and lack of recognition (i.e. chrondrocalcinosis). However, no epidemiological studies on the prevalence of HPP in the rheumatological patient population have been available to date.To identify the prevalence of HPP in rheumatological patients screened for persistent low levels of ALP and association with mutations in the ALP gene.All adult rheumatology patients were screened for pathological low levels of ALP (< 35 IU/L) between January 1, 2017 and June 30, 2019 at the Department of Rheumatology, Clinic of Internal Medicine III, University Hospital Bonn, Germany. Medical files of patients with pathological low ALP levels were then reviewed for clinical signs and symptoms as well as results of genetic testing for HPP (full sequencing using Next Generation Sequencing).In total, 2,289 rheumatology patients were screened for low ALP levels. In 60 patients (2.62 %), pathological low ALP levels were identified, while in 30 of these (1.31 %), persistent low ALP levels were detected. In 19 of the 30 patients, genetic tests for ALPL gene mutations were done. Seven out of 19 patients (36.84 %) had HPP-related symptoms (fracture, dental abnormalities) with normal bone densitometry, while four of these patients (21.05 %) had a history of fracture and three patients (15.78 %) showed dental abnormalities. In addition to the typical HPP signs and symptoms, 13 patients (68.42%) showed mutations in the ALPL gene. One of the ALP mutations was found to be a novel genetic variant, classified as pathological. Interestingly, no association with chondrocalcinosis was detected.In summary, it can be concluded that HPP is an under-diagnosed condition with a higher proportion of affected rheumatologic patients than previously thought (at least 0.56 percent of rheumatologic patients vs. 0,01 percent in a spanish healthy population). If we replicate these numbers for the german population (83 million, 5 percent of whom suffer from rheumatic conditions) the yield is approximately 4.15 million. This possibly indicates that 23,240 potential cases of HPP are currently not diagnosed. Therefore, implementation of a protocol in clinical practice to prevent underdiagnosis of HPP and to treat this disease appropriately is essential.[1]García-Fontana C, Villa-Suárez JM, Andújar-Vera F et al (2019) Epidemiological, Clinical and Genetic Study of Hypophosphatasia in A Spanish Population: Identification of Two Novel Mutations in The Alpl Gene. Sci Rep. https://doi.org/10.1038/s41598-019-46004-2[2]Mornet E, Yvard A, Taillandier A et al (2011) A molecular-based estimation of the prevalence of hypophosphatasia in the European population. Ann Hum Genet 75:439–445. https://doi.org/10.1111/j.1469-1809.2011.00642.xFigure 1.Flow chart of identification of potential hypophosphatasia (HPP) patients from an adult rheumatology population. Threshold alkaline phosphatase < 35 IU/L at 37`C. ALP: alkaline phosphatasePantelis Karakostas: None declared, Ramona Dolscheid-Pommerich: None declared, Moritz Hass: None declared, Peter Brossart: None declared, Valentin Schäfer Speakers bureau: AbbVie, Novartis, BMS, Chugai, Celgene, Medac, Sanofi, Lilly, Hexal, Pfizer, Janssen, Roche, Schire, Onkowissen, Royal College London, Consultant of: Novartis, Chugai, AbbVie, Celgene, Sanofi, Lilly, Hexal, Pfizer, Amgen, BMS, Roche, Gilead, Medac, Grant/research support from: Novartis, Hexal, Lilly, Roche, Celgene, Universität Bonn.


Pressure ulcer (PrU)‐related hospitalisation and mortality are critical issues in medical and surgical patients. Although animal studies have suggested the beneficial effects of sildenafil on wound healing, related clinical data are lacking. This is the first clinical study that has evaluated the effects of topical sildenafil on PrU healing in human subjects. Enrolled patients were randomly allocated to receive topical sildenafil (10%) ointment or placebo daily. Wound healing was assessed visually and photographically by the change in wound score according to two‐digit Stirling scale. Decreases in grades of the PrUs were significantly higher in sildenafil group compared with placebo group (P < 0·001). In addition, surface areas of ulcers in sildenafil group were significantly reduced compared to the control group at day 14 of intervention (P = 0·007). It appears that these effects may be mediated by improvement of microvascular reperfusion in the skin and soft tissue. Further study to emphasise the role of topical sildenafil in the prevention or treatment of PrUs in hospitalised patients is required.


3D printing technology is now frequently employed in many areas of research and development. However, a relatively narrow range of 3D printable materials with a limited spectrum of physico-chemical properties still restricts the true potential of this potentially disruptive technology. There is rapidly increasing interest in the improvement and diversification of properties of generic printing materials via the introduction of fillers with unique properties, and/or by blending materials exhibiting different properties to generate high performance composites. 3D printed composites have already been utilised in a wide range of applications, including biomedical, mechanical, electrical, thermal and optically enhanced products. The increasing popularity of 3D printed composites can be attributed to the ability to fabricate complex geometries, low cost production, and other advantages associated with rapid prototyping. This review covers all the recent reports in which the properties of generic 3D printable materials have been modified either by adding nanoparticles, fibers, other polymers, or by a chemical reaction for fabrication of composites with enhanced biomaterial, mechanical, electrical, thermal, optical and other properties.


Comparing the results of the RADTRANIII calculations with a normalized set of results, both for incident-free transport and vehicular accident cases, the calculated consequences in the current analysis are lower. Even for the High-Activity Shipment, the total expected population dose from either incident-free transport or vehicular accidents is small, and smaller than that estimated in USNRC 1977. The results of the simulation in which parameters were varied randomly and independently indicate that, regardless of the input values assumed, the maximum total population dose from the High-Activity Shipment and the simultaneous occurrence of the least conservative value for each input parameter might be as high as 300 person-rem for a single shipment. The values for either of the other shipments (DOT Exemption or Common Carrier) would be significantly lower. The potential average individual radiation doses from accidents involving multiple Type A package shipments are comparable to the increase in the normal background radiation dose of 0.09 rem/person/year (90 mrem) that an individual would receive by moving from sea level to 5000 ft elevation. The maximum dose to an individual (one very near the accident scene) for the High Activity Shipment would be approximately 0.3 rem (300 mrem) in a maximum severitymore » accident. This is within the individual dose guidelines outlined by NCRP (0.5 rem). Even at the high levels postulated for multiple package shipments under DOT controlled exemptions, the potential risks to the public in terms of expected population dose in the current analysis are below those already found to be acceptable. 4 refs., 3 tabs.« less


Bombyx mori-derived silk fibroin (SF) has recently gained interest for its intrinsic or engineered adhesive properties. In a previous study by our group, the mechanism of the protein's intrinsic adhesiveness to biological substrates such as leather has been hypothesized to rely on hydrogen bond formation between amino acid side chains of SF and the substrate. In this study, the serine side chains of SF were chemically functionalized with substituents with different hydrogen bonding abilities. The effect of these changes on adhesion to leather was investigated along with protein structural assessments. The results confirm our hypothesis that adhesive interactions are mediated by hydrogen bonds and indicate that the length and nature of the side chains are important for both adhesion and secondary structure formation.


A total of 53 bacterial isolates obtained from bovine mastitis and positive to catalase, and 23S rRNA ribotyping tests were analyzed for production virulence factor viz. mannitol fermentation, Coagulase production, lipase activity, DNase activity, slime production assay and haemolysin production. Out of 53 isolates, 53 (100%), 49 (92.45%), 29 (54.72%), 44 (83.02%) and 42 (79.25%) isolates were found positive for mannitol fermentation, Coagulase production, lipase activity, DNase activity and slime production respectively. Out of 53 isolates, alpha, beta, gamma and alpha-beta haemolysin production were observed in 18 (33.96%), 26 (49.06%), 4 (7.55%) and 5 (9.43%) isolates respectively. Further the isolates were subjected to genotypic evaluation of virulence associated Coa and spa genes. Polymorphism was recorded in Coa and spa genes. Amplification of the spa gene revealed 200, 270 and 296 bp size amplicons while 723, 812 and 1000 bp amplicons found in Coa gene amplification. Out of 53 isolates, 36 (67.92%) and 32 (60.38%) isolates were found positive for spa and Coa genes respectively.


Abstract: The risk of additive effects of drugs has remained a continuous concern while prescribing more than one drug to a patient, and it becomes more of a problem when the patient suffers from various diseases simultaneously. In this reasearch the drug taking pattern of elderly patients was kept in mind and the antihyperlipidemic, oral hopoglycemic and antihypertensive commonly prescribed in combinations or as individual agents were given to the rabbits for period of two months and their effects on liver function tests were noted. As compared to control rabbits, Acarbose and Glibenclamide decreased Direct bilirubin (DBR), where as Lisinopril and Amlodipine increased it (P<0.05). Atorvastatin and Amlodipine increased Total bilirubin (TBR) (P<0.05). Acarbose and Metformin increased, where as Atorvastatin decreased Glutamic-Pyruvic Transaminase (GPT) (P<0.05). Metformin and Lisinopril decreased (P<0.05) where as Losartan increased ALP(alkaline phosphatase) (P<0.005). Losartan and Atorvastatin increased Gamma Glutamyl Transferase g - GT (P<0.005).


BACKGROUND
The purpose of this review was to identify critical data and research needs in addressing the following question: What are the primary factors that affect the time lost from work, return-to-work (RTW), subsequent unemployment, and changes in occupation after disabling illness or injury?

METHODS
Review of the literature to identify research challenges originating from the multitude of disciplines, data sources, outcome measures, and methodological and analytical problems.

RESULTS
About 100 different determinants of RTW outcomes were identified. Their impact varies across different phases of the disablement process. Recommendations are provided for addressing five selected research challenges.

CONCLUSION
Interdisciplinary research needs to develop a comprehensive conceptual framework. Priority should be given to studies on specific domains of risk factors meeting five selection criteria: amenability to change; relevance to users of research; generalizability across health conditions, disability phases, and settings; "degree of promise" as derived from qualitative exploratory studies; and capacity to improve measurement instruments. Combining qualitative and quantitative research methods is necessary to bridge existing knowledge gaps.


Total colonic aganglionosis (TCA) is an uncommon and severe form of intestinal developmental malformation. The aim of this study is to identify the prognostic factors in children with TCA treated with the Soave procedure. Forty-three children with TCA who were treated with the Soave procedure between February 2008 and August 2013 were included in the study and followed up. Follow-up data were collected regarding growth development, stool frequency and consistency, incontinence, and enterocolitis. Parents of 31 (72.1%) of the 43 patients were followed up. Four patients underwent a primary pull-through procedure, while 27 patients underwent ileostomy and a later definitive operation. The remaining length of the small intestine was 164 ± 53 cm, and pathology revealed 22 cases with mature ganglion cells in the proximal intestine, while there were 9 cases with ecumenical mature ganglion cells in the proximal intestine. Growth development was normal in 19 patients, while mild malnutrition was observed in 8 patients, and moderate malnutrition was observed in 4 patients. Stool consistency was mushy or shaped in 25 patients and mushy or watery in 6 patients. Twenty-eight patients had a frequency of stool ranging between 1-5 bowel movements per day, and 3 patients had more than 6 bowel movements per day. Twenty-five patients suffered from less than 2 bouts of postoperative enterocolitis, and 6 patients suffered from more than 3 episodes of postoperative enterocolitis. Long-term outcomes of children with TCA who are treated with the Soave procedure are satisfactory with good anorectal function and quality of nutrition. The remaining length of the small intestine and the neurodevelopment of the proximal intestine ganglion cells are important prognostic factors.


PurposePrevious research has shown that self-employed workers are more likely than employees to retire late or to be uncertain about retirement timing. However, little is known about the underlying mechanisms. This study aims to fill this gap, by focusing on the explanatory role of various job characteristics – flexibility, autonomy, skills-job match and job security – for explaining differences in retirement preferences between the solo self-employed and employees.Design/methodology/approachData were used of 8,325 employees and 663 solo self-employed respondents (age 45–64) in the Netherlands, who participated in 2016 in the Study on Transitions in Employment, Ability, and Motivation (STREAM). The outcome variable distinguished between early, on-time, late and uncertain retirement preferences. Multinomial logistic regression models were estimated, and mediation was tested using the Karlson-Holm-Breen (KHB) method.FindingsThe solo self-employed are more likely than employees to prefer late retirement (vs "on-time") and to be uncertain about their preferred retirement age. Job characteristics mediate 21% of the relationship between solo self-employment and late retirement preferences: the self-employed experience more possibilities than employees to work from home and to choose their own working times, which partly explains why they prefer to retire late.Originality/valueIn discussions about retirement, often reference is made to differences in retirement savings and retirement regulations between the solo self-employed and employees. The current study shows that differences in job characteristics also partly explain the relatively late preferred retirement timing of solo self-employed workers.


This model showed that nonenhancing T2 high-signal-intensity lesions with relatively low normalized CBV, low volume transfer constant values, and the lowest ADC values could serve as useful prognostic imaging markers for predicting survival outcomes in patients with glioblastoma. BACKGROUND AND PURPOSE: No report has been published on the use of DSC MR imaging, DCE MR imaging, and DWI parameters in combination to create a prognostic prediction model in glioblastoma patients. The aim of this study was to develop a machine learning–based model to find preoperative multiparametric MR imaging parameters associated with prognosis in patients with glioblastoma. Normalized CBV, volume transfer constant, and ADC of the nonenhancing T2 high-signal-intensity lesions were evaluated using K-means clustering. MATERIALS AND METHODS: A total of 142 patients with glioblastoma who underwent preoperative MR imaging and total resection were included in this retrospective study. From the normalized CBV, volume transfer constant, and ADC maps, the parametric data were sorted using the K-means clustering method. Patients were divided into training and test sets (ratio, 1:1), and the optimal number of clusters was determined using receiver operating characteristic analysis. Kaplan-Meier survival analysis and log-rank tests were performed to identify potential parametric predictors. A multivariate Cox proportional hazard model was conducted to adjust for clinical predictors. RESULTS: The nonenhancing T2 high-signal-intensity lesions were divided into 6 clusters. The cluster (class 4) with the relatively low normalized CBV and volume transfer constant value and the lowest ADC values was most associated with predicting glioblastoma prognosis. The optimal cutoff of the class 4 volume fraction of nonenhancing T2 high-signal-intensity lesions predicting 1-year progression-free survival was 9.70%, below which the cutoff was associated with longer progression-free survival. Two Kaplan-Meier curves based on the cutoff value showed a statistically significant difference (P = .037). When we adjusted for all clinical predictors, the cluster with the relatively low normalized CBV and volume transfer constant values and the lowest ADC value was an independent prognostic marker (hazard ratio, 3.04; P = .048). The multivariate Cox proportional hazard model showed a concordance index of 0.699 for progression-free survival. CONCLUSIONS: Our model showed that nonenhancing T2 high-signal-intensity lesions with the relatively low normalized CBV, low volume transfer constant values, and the lowest ADC values could serve as useful prognostic imaging markers for predicting survival outcomes in patients with glioblastoma.


Based on the law of refraction in vector form, an expression is obtained that determines the direction of a ray refracted at two refracting surfaces. As a result of analyzing this expression, represented in matrix form, a form of the expression is proposed that determines the direction of a ray refracted by an arbitrary number of refracting surfaces. The method of mathematical induction is used to prove that the resulting expression is valid for computing the unit vector of a ray refracted by a system of flat, arbitrarily placed refracting surfaces.


This paper describes the geometry and strain characteristics of a complex system of small extensional faults affecting Lower Tertiary mudrock-dominated successions throughout the central North Sea Basin. Structural mapping using three-dimensional seismic data shows that the fault trace geometry is polygonal. The shallow origin of the faults is confirmed by the recognition of growth sequences developed in their hangingwalls. Line balancing techniques were used to measure the extensional strain in two survey areas. This was found to be radially isotropic in the map plane. Extension in any line of section was found to vary from 6 to 19%. Since the deformation is clearly layer-bound and there is no evidence for displacement transfer to basement structures, it is argued that the only explanation for this apparent extension is by layer-parallel volumetric contraction. This is believed to occur in response to fluid expulsion from the mudrocks during early compaction. The conditions for failure may be achieved through increased pore fluid pressure or through tensile stresses generated as a result of pore fluid loss, or a combination of these two processes. Far-field tectonic stresses are not considered to be responsible for the formation of this fault system.


Making decision on which movie to watch is nowadays not an easy process for majority of people. Many people may decide to watch a movie based on the genre attribute of a movie, while for the others, the director can be the attribute that drives them to watch a movie. Hence, people may have di↵erent features, taken into account, when deciding which movie to watch. Recommender Systems can help people in making decision by allowing them to enter the attribute(s), that is the most important to them, and filter the movie catalog accordingly. In this paper we try to investigate the process that results in choosing a movie to watch by people. Hence we present an ongoing work that will ultimately lead to building a dataset (called PoliMovie) that will contain the preferences of users not only on movies but also on attributes of the movies, such as genre, director, and cast., that users selected as the most important attributes when choosing a movie to watch. We report some preliminary results based on the preferences collected from about 400 users, which confirm the di↵erence and complexity of decision making process for di↵erent users.


BACKGROUND
 When studied in community-based samples, the association of physical activity with blood pressure (BP) remains controversial and is perhaps dependent on the intensity of physical activity. Prior studies have not explored the association of smartwatch-measured physical activity with home BP.

 OBJECTIVE
 We aimed to study the association of habitual physical activity with home BP.

 METHODS
 Consenting electronic Framingham Heart Study (eFHS) participants were provided with a study smartwatch (Apple Watch Series 0) and Bluetooth-enabled home BP cuff. Participants were instructed to wear the watch daily and transmit BP values weekly. We measured habitual physical activity as the average daily step count determined by the smartwatch. We estimated the cross-sectional association between physical activity and average home BP using linear mixed effects models adjusting for age, sex, wear time, antihypertensive drug use, and familial structure.

 RESULTS
 We studied 660 eFHS participants (mean age 53 years, SD 9 years; 387 [58.6%] women; 602 [91.2%] White) who wore the smartwatch 5 or more hours per day for 30 or more days and transmitted three or more BP readings. The mean daily step count was 7595 (SD 2718). The mean home systolic and diastolic BP (mmHg) were 122 (SD 12) and 76 (SD 8). Every 1000 increase in the step count was associated with a 0.49 mmHg lower home systolic BP (P=.004) and 0.36 mmHg lower home diastolic BP (P=.003). The association, however, was attenuated and became statistically nonsignificant with further adjustment for BMI.

 CONCLUSIONS
 In this community-based sample of adults, higher daily habitual physical activity measured by a smartwatch was associated with a moderate, but statistically significant, reduction in home BP. Differences in BMI among study participants accounted for the majority of the observed association.


Alvin Schorr, family life specialist on the research staff of the Social Security Administration, believes that there is a fundamental relationship between the housing and the neighborhoods people live in and their ability to overcome or avoid poverty and insecurity. Further, he believes that the primary goal of our government housing policies should be helping to wipe out poverty. From this premise he examines present policies and practices in planning, urban renewal, relocation, public housing, and code enforcement, together with existing patterns of economic and racial segregation. He demonstrates how and why many of these policies aggravate "the syndrome of reinforcing handicaps" that result in poverty and suggests ways in which they should be changed-if, indeed, our goal is the elimination of poverty. This short book, well organized and clearly written, contains a large number of references (271) that will be extremely helpful to anyone wishing to explore particular aspects of housing in more detail than Schorr is able to do in so brief a work. Much of the material is already well known to people interested in housing and in social welfare, but the author's consistent focus on the nature of our housing policies as they affect poverty is unique. He does not imply that merely changing the policies will result in the disappearance of poverty, but he does demonstrate convincingly and effectively that poor housing has a fundamental effect on poverty. Since more than thirty million people in the United States live at or below the poverty line (defined here as an income of about $2,700 for a family of four), anyone deeply concerned with their welfare must hope that this book will be read widely by those who decide our planning and housing policies. In discussing an important omission in the early stages of renewal planning, Schorr makes the astute and significant observation that "the social element has so far chiefly turned up at the point of problem, not of planning." He says, "The poor are the clients of the architect and the city planner," and wonders why efforts at collaboration between physical and social planners--some of which he reviews brietly--are still, for the most part, demonstrations and have not by now been incorporated into programs. With respect to relocation the author says, "The process of change can be hopeful and it can be frightening." About a million persons will be displaced in the next ten years, and half of them will be Negro. Most will be poor and they will be in need of help. Because they will be forced to move, they are likely to be more receptive to help than they would ordinarily be. Schorr recommends that we undertake a mass "prevention of poverty" proaram. with this ready-made caseload. 163


White radish (Raphanus sativus) is a mild-flavoured, very large, white East Asian radish with a wide variety of culinary uses. Osmotic dehydration is a preservation method that offers a high quality product by means of water removal without phase change. This work deals with the studies of osmotic dehydration characteristics of radish in different concentration of osmotic solutions such as salt (3, 6, 9) % and sugar (30, 40, 50)0brix. Radish samples were osmotically dehydrated in osmotic solutions such as salt and sugar with different concentrations at room temperature. Physical, chemical and nutritional analysis was done for the sample and osmotic dehydrated radish. The moisture content, dry matter content, dehydration ratio and rehydration ratio were determined and plotted. From the results it was observed that in the case of moisture content and dry matter content, sugar solution is more effective whereas in the case of rehydration ratio salt solution is best. Therefore applying a combination of these osmotic agents can increase the dehydration effect more. The present study also shows the optimum concentration of osmotic agents at room temperature as 6% for salt solution and 400brix for sugar solution. Also proximate analysis such as moisture content, ash content and ascorbic acid determination were performed for raw and osmotic dehydrated radish and compared it with normal dried radish. Moisture content, ash content and ascorbic acid present in osmotic dehydrated radish was found to be less than that of raw radish and higher than the normal dried radish. This implies that osmotic dehydration retains the nutritive properties of radish than normal drying. Some of these benefits include being able to store radish for longer period of time, maintaining nutritional aspects, flavors and preventing microbial spoilage from occurring.


Although coal plants in some countries are actively being retired ahead of their planned closure dates, there is yet to be sufficient clarity on which business model(s) might help to achieve this at scale. Policy-based and market-led closures, buyout of coal plants, auctioning them off, repurposing them, and swapping coal assets with renewables have all been tried in different parts of the world. In this paper, we first summarize these business models and reflect briefly on the insights gained from these experiences. We then focus on the core questions: How can coal retirements be scaled up? Is there a reason that one model unilaterally works better than others? Do these models need to be crafted specifically to fit the context of each country/system? Can they be combined in some shape or form to carry out retirements at scale more efficiently? We address these issues around some of the country/utility coal fleets where the World Bank team is having active dialogues under the aegis of the Accelerating Coal Transition (ACT) program. The broad conclusions that emerge from the discussion point to the need for a tailored hybrid model that best fits the policy, system, and ownership of a coal fleet.


The study of rainfall time series of two selected weather stations in Malaysia using various statistical methods enabled to analyse the temporal behaviour of rainfall in the study areas. Time-series analysis is an important tool in modelling and forecasting rainfall. SARIMA (1, 1, 2)(1, 1, 1)12, SARIMA(4, 0, 2)(1, 0, 1)12 with constant and ETS state space models based on exponential smoothing were built. All the models proved to be adequate. Therefore, could give information that can help decision makers establish strategies for proper planning of agriculture, drainage system and other water resource applications in Malacca and Kuantan.


Intra-arterial ultrasound is a new real-time imaging technique using a miniaturized transducer in a catheter to image diseased arteries. The small size and close proximity to the structures being imaged allow the use of frequencies from 20-40 MHz, resulting in high resolution images. In addition to the stenotic lumen, it is possible to examine the composition and eccentricity of the plaque, as well as structures outside of the vessel. Such information can be used for planning and evaluating vascular interventions. The addition of Doppler measurements allows the evaluation of function as well as anatomy. Research applications include studies of lesion progression, measurement of arterial elasticity, quantitative blood flow velocities and study of intra-arterial flow patterns. Although this technique is in its infancy, it is highly probable that it will prove to be a useful aid to the vascular surgeon.


Nepalese dairy sector has been showing structural changes with adoption of latest technologies like improved breeds, feeds, cultivated fodder and additives. In the context of these changes, this research was conducted to assess the technical efficiency and its determinants among dairy farms. The study was accomplished with primary data collected through face-to-face interview using semi-structured interview schedule from a sample of 240 dairy farms selected randomly using simple random sampling technique from 8 wards of Bharatpur Metropolitan City, Chitwan. Data were analyzed using descriptive statistics, stochastic production frontier and tobit regression model. Technical efficiency was found to be the highest in mix dairy farms (3.530) followed by cow farms (2.56) and buffalo farms (2.138). Labour was the most contributing factor in all three types of dairy farms. This study had shown that average annual income per farm should be Rs. 542000, Rs. 403225 and Rs. 611400 for getting 90% technical efficiency in milk production at buffalo, cow and mix farms, respectively. Similarly, 57% buffalo farms were operating at efficiency of 30-60%, 46% cow farms were operating at efficiency of 30%, and 67.5% mix farms were operating at efficiency of 30 to 60%. Total investment in dairy farming, training and adopting dairy as primary occupation were positively and significantly affecting technical efficiency on buffalo, cow and mix type of dairy farming system. There is still large scope to increase the annual milk production in the dairy farms of Chitwan through efficient use of available resources with the existing technologies. This is concluded that dairy farming system can be promoted efficiently by increasing total investment in dairy farming through easy access to loan, training on dairy animal production and management, ensuring dairy business as profitable primary occupation, promotion of fodder and pasture production, and securing easy access to medicines and additives.


A technique is presented for verifying the energy calibration of PET tomographs by measuring the energy response spectrum of its detectors. Single scattered radiation provides a continuous energy reference source of coincident photons. The response of the scanner vs. scattering angle, and hence vs. energy is recorded within the sinogram. From these data, the position and resolution of discriminator levels which are set below 511 keV can be extracted. This is shown to be a useful diagnostic of the scanner's energy calibration, and of its response to scatter in 3D acquisitions.


From a gravimetric study done in the Las Salinas basin, situated in the province of San Juan, Argentina, the geometry of the geologic structures that form this sedimentary trough could be determined. The average depth to the basement was found to be about 5 km, and it increases to the north of the basin. The depth values were obtained by applying spectral analysis and Euler deconvolution to the Bouguer anomaly chart. The alineations of the Euler solutions resulted highly consistent with the seismic interpretations and thereby permitted to confirm the existence of a wrench fault system mainly oriented north-south, which flank the sedimentary trough and cuts it off in the middle part. This information, plus densities obtained from logs of two hydrocarbon exploration wells drilled in the basin, permitted the elaboration of a gravity inversion model with variable density, which justifies the Bouguer residual anomaly. The results show that the basin extends over about 5750 km. The sedimentary depths, reachs 5 km, is 1.5 km larger than those obtained with seismic. This leads to the assumption that our results show the depth of the crystalline basement, whereas the seismic ones indicate a shallower presence of a technical basement.


Abstract. The nature of the Ionian Sea crust has been the subject
of scientific debate for more than 30 years, mainly because seismic imaging
of the deep crust and upper mantle of the Ionian Abyssal Plain (IAP) has not
been conclusive to date. The IAP is sandwiched between the Calabrian and
Hellenic subduction zones in the central Mediterranean. A NNE–SSW-oriented
131 km long seismic refraction and wide-angle reflection profile, consisting
of eight ocean bottom seismometers and hydrophones, was acquired in 2014.
The profile was designed to univocally confirm the proposed oceanic nature
of the IAP crust as a remnant of the Tethys and to confute its
interpretation as a strongly thinned part of the African continental crust.
A P-wave velocity model developed from travel-time forward modelling is
refined by gravimetric data and synthetic modelling of the seismic data. A
roughly 6–7 km thick crust with velocities ranging from 5.1 to 7.2 km s−1, top to bottom, can be traced throughout the IAP. In the vicinity of
the Medina seamounts at the southern IAP boundary, the crust thickens to
about 9 km and seismic velocities decrease to 6.8 km s−1 at the crust–mantle
boundary. The seismic velocity distribution and depth of the crust–mantle
boundary in the IAP document its oceanic nature and support the
interpretation of the IAP as a remnant of the Tethys lithosphere with the
Malta Escarpment as a transform margin and a Tethys opening in the NNW–SSE
direction.


As a result of deinstitutionalization, currently there are three times as many men and women with mental illness in U.S. jails and prisons than in mental hospitals. Appropriate treatment of this population is critical to safety within correctional institutions, successful integration of offenders into the community upon release and a reduction in recidivism. Dialectical Behavioral Therapy (DBT), originally developed by Linehan for chronically parasuicidal women diagnosed with Borderline Personality Disorder, has been adapted for many other populations over the past decade, including male offenders in correctional institutions. This article presents a rationale for use of DBT in a correctional environment and reviews DBT implementations in correctional settings in North America. Because all of the initiatives thus far have been driven by clinical need, there are no published adaptations of DBT modified for and generalizable to correctional settings.


The objectives of this study were to investigate the effect of dripper discharge and irrigation time on the wetted width in the sandy loam soil with high percentage of gravel and to evaluate previously developed models of estimation of the wetted width in the previous researches. The treatments included three irrigation times (T) of 4, 8 and 12 h and three dripper discharge rates (q) of 2, 4 and 8 l/h, with three replications. The wetted width of each dripper was measured 24 hours after irrigation application. The maximum and minimum wetted widths were 159.8 and 63.5 cm for T12q8 and T4q2, respectively. A linear model was developed as a function of two variables of irrigation time and dripper discharge rate was developed to predict the wetted width in sandy loam soil with high percentage of gravel. The evaluation of recommended models of wetted width for the studied soil showed that only one of six models was accurate enough to estimate wetted width. It can be concluded that the presence of gravels in the soil has a complex effect on width and depth of wetted zone. Thus, it is necessary to measure the wetted width and wetted depth in the field.


Abstract Many crystalline solids have multiple nonequivalent sites among which different atoms show substitutional long-range order-disorder phenomena. The order-disorder kinetics of an atom among any n nonequivalent sites in a crystal can be described by the equation where xi is the site occupancy of the atom at site si, n is the number of nonequivalent sites, λj (λ1 = 0) is constant at a given temperature, pressure, and total composition of the crystal, and cij(t) is constant or polynomial in t. Four theorems governing a multi-site order-disorder process have been proved, requiring that λj must be either zero (only λ1 = 0), a negative real number, or a complex-valued quantity with the real part being a nonpositive number. The kinetic model becomes constrained and naturally complies with crystal-chemical conditions when the mole number per formula unit is chosen as the unit of all site-occupancy variables, or site multiplicities are explicitly incorporated into the model. When the mole fraction is directly used as the unit, the model becomes unconstrained, but it is a valid treatment that is as equally applicable to the multi-site order-disorder kinetics as the constrained model.


Data on reactions of N-silylated amines, carboxamides, amino acids, and their derivatives with trivalent and pentavalent phosphorus acid halides are summarised. The effect of structural factors on the direction of phosphorylation is discussed. The bibliography includes 133 references.


An in vitro system developed for the site-specific mutagenesis of 16S RNA of Escherichia coli ribosomes (Krzyzosiak et al., Biochemistry 26, 2353-2364, 1987) was used to make 10 single base changes around C1400, the residue known to be at the decoding site. C1400 was replaced by U, A, or G, 5 single base deletions at and to either side of C1400 were made, and C or U was inserted next to C1400. Another mutant possessed 7 additional nucleotides at the 3' end of the 16S RNA such that a stem and loop involving the anti-Shine-Dalgarno sequence could form. Another series of 8 mutants tested hypothetical base-pairing between C1404, G1405 and C1496, G1497. The activity of these 19 mutants in A and P site binding, and in initiation-dependent and initiation-independent peptide synthesis was determined. None of the base substitutions of C1400 were strongly inhibitory. The insertions and deletions completely blocked initiation-dependent peptide synthesis but markedly stimulated the initiation-independent reaction. The effects of tRNA binding were variable. The only alteration to block all ribosomal function was the deletion of G1401. The extra stem and loop at the 3'-end blocked initiation-dependent peptide synthesis, but all other assays were normal. The mutants which break and reform the hypothetical base-pairs had a functional pattern that suggest the contiguous base-pairs do exist and are functionally important.


Summary
Complexes consisting of only Dane particles are found frequently in Hepatitis B antigen-positive sera. It is proposed that the reason for their presence is the existence of a third antigen-antibody system involving the Dane coat material but not the small spheres or tubules.


This paper analyses the agrofood system in Navarra (Spain) using the Input-Output data for 1980-1995. The aim is to analyse the evolution and changes taking place between the economic activities in the region. Streit, Chenery-Waanabe and Rasmussen's indicators are constructed. As is usual, we have also calculated the inconme and employment multipliers. This indicators show the very important role of the agriculture and the vegetables canning industry in the regional economy.


Arachidonic acid is believed to be an important and necessary mediator of insulin secretion by beta-cells of islets of Langerhans, and it may regulate intracellular Ca2+ homeostasis. Insulin secretagogues, such as glucose and the muscarinic agonist carbachol, stimulate arachidonic acid accumulation, although the mechanisms involved are controversial: carbachol is believed to stimulate phospholipase A2, while glucose-induced arachidonic acid release is the result of diacylglycerol hydrolysis [Konrad, R. J., et al. (1992) Biochem. J. 287, 283-290]. In insulin-secreting clonal beta-cells RINm5F, HIT-T15, and beta-TC3, Ca(2+)-independent phospholipase A2 was mainly cytosolic, while in islets it was equally distributed between a crude membrane fraction and the cytosol. A membrane-associated Ca(2+)-dependent phospholipase A2 was found to be stimulated by millimolar Ca2+ concentrations, while a cytosolic Ca(2+)-dependent activity was activated by micromolar Ca2+ levels. In order to determine whether phospholipase A2 was activated in insulin secretion, we assessed whether pretreatment of intact islets with secretagogues affected phospholipase A2 activity, which was subsequently measured in membrane or cytosolic fractions. The combination of glucose and carbachol transiently activated Ca(2+)-dependent (but not Ca(2+)-independent) phospholipase A2 activity at 10 min, which corresponded to the peak of arachidonic acid release. No effect was seen with either agonist alone. Our results indicate that activation of Ca(2+)-dependent phospholipase A2 may be due to agonist-induced increases in intracellular Ca2+. We suggest that activation of islet Ca(2+)-dependent phospholipase A2 may be important in a distal process of insulin secretion, such as secretory granule exocytosis.


Tailgut cyst is a rare lesion of developmental origin located in the retrorectal space, which usually presents as a multilocular cystic mass. It is usually found in adults, and neonatal cases are extremely rare. The authors report a tailgut cyst in a neonate that was found by prenatal ultrasonogram, which was like a teratoma in gross appearance.


As the number of low cost computing devices at the edge of network increases, there are greater opportunities to enable novel, innovative capabilities, especially in decentralized cyber-physical systems. For example, in an urban setting, a set of networked, collaborating processors at the edge can be used to dynamically detect traffic densities via image processing and then use those densities to control the traffic flow by coordinating traffic light sequences, in a decentralized architecture. In this paper we describe a testbed and an application framework for such applications.


This study therefore aimed at assessing the pollution level of the soils from the automobile workshop in Lagos and the genotoxic potential of their simulated leachate using Allium cepa . 2 kg of soil samples were collected at a depth of 0 – 15 cm (top soil) using soil auger from five different points at the automobile mechanic workshop in order to get a representative sample (composite sample) and transferred directly into clean, sterile containers. A control soil sample was obtained from the Botanical garden of the University of Lagos, Akoka. The physicochemical analysis of the soil was also carried out using standard methods. The samples were analysed for lead (Pb), chromium (Cr), cadmium (Cd), zinc (Zn), arsenic (As), nickel (Ni), and mercury (Hg) using inductively coupled plasma atomic emission spectroscopy (ICP-AES) after acid digestion. Aliphatic and aromatic hydrocarbons, TPH and oil and grease were determined. Leachate simulation from the soil was carried out according to the American Society for Testing and Materials. The result showed an obvious influence of automobile workshop activities on the physicochemical properties of soil as well as on the root meristem of Allium cepa . Automobile workshop soil contained significantly higher concentrations for all analysed heavy metals (Cd, As, Cu, Pb, Ni and Zn) in comparison to the uncontaminated garden soil. Cd, Cu and Pb levels were higher than specified regulatory standards. All the leachates concentrations showed one form of aberration: sticky chromosomes, C-mitosis, bridges, lagging chromosomes, binucleate, vagrant cells and micronuclei. The highest aberration occurred in 50% concentration of the treatment while the lowest occurred in the control. The aberrations observed varied with exposure time. The results of the present study showed that simulated leachates from an automobile workshop is genotoxic and mutagenic in the bioassays used in this study. The soils contained heavy metals in higher concentrations than the control and standards set by regulatory authorities. Also, higher TPH was observed too. The observed genotoxicity and mutagenicity are believed to be caused by the leachate constituents.


Abstract The impact of retail return policy on consumer behavior has not drawn enough attention from researchers. Lenient return policies insure consumers against having regret after purchasing, so they may increase consumers' likelihood of purchasing. The behavioral theory of endowment effect suggests that consumers may then have a harder time returning purchased goods because people value objects more highly once they own them. We conducted a test of our hypotheses on how return policy and endowment effect influence purchasing tendency and return rate. This experiment proved that endowment effect did affect the returning behavior of consumers. It showed that lenient return policies significantly increased initial purchasing tendency but did not increase return rate. This suggests a potential to increase consumption by adopting lenient return policies.


Fair Trade has spread in developing countries as an initiative aimed at lifting poor smallholder farmers out of poverty by providing them with premium prices, availability of credit, and improved community development and social goods. Fair Trade is also viewed as a niche market for high value products in a context of globalization and trade liberalization policies that affect smallholder farmers in developing countries. The question of whether Fair Trade affects the welfare of rural farmers, however, is particularly contentious. This paper provides a review of the Fair Trade literature, both theoretical and empirical, with a specific focus on the analysis of small-scale producer's welfare in developing countries. Our review shows that while most empirical papers have focused on the impacts of Fair Trade on prices and income, our review highlights the importance of limited market access and changes in productivity. Likewise, little is known about the impacts of Fair Trade on labor markets and human capital investments. Persistent methodological challenges make it challenging, however, to assess the causal impact of this certification and labelling initiative.


Background The purpose of this study was to evaluate the feasibility of the virtual clinic for outpatient follow-up care after TKR surgery. Methods A total of 546 TKR surgeries were performed from January 2017 to December 2019. 30 patients were not able to go the hospital for routine follow-up. The data collections were taken for age, gender, year of surgery, functional score (Oxford Knee Score (OKS)), and active range of motion (ROM). The virtual clinic was conducted with the physician assistant and the operating surgeon via WhatsApp video call (WhatsApp Inc., Mountain View, California, USA) or Zoom (Zoom Video Communications, Inc., San Jose, California, USA). Result The average follow-up period was 39.1 months. The earliest follow-up was 20 months, while the longest follow-up was 97 months. The average OKS score was 45. The average consultation time for the virtual clinic is 9 minutes 21 seconds. Most of the patients were satisfied with the online consultation, with only two patients having a satisfaction score below 80%. Conclusion The virtual clinic for TKR surgery showed a high satisfaction rate during the COVID-19 pandemic, which has the potential to extend to the postpandemic era.


What is intellectual disability? And why are people so-labelled excluded in society? How may this be countered and changed? Through a phenomenological methodology that recognised use of self, this work explored narratives in history that have both promoted hegemony and challenged it through 'insider' voice. In this respect it highlighted narrative as a subversive force: both in terms of the empowerment of those oppressed voices and from the perspective of 'logic' that would disparage narrative. From this position ontological questions were raised concerning identity and representation that defy simple either… or… answers and necessitate a narrative approach in place of reductionist objectifications of positivist scientific discourse. It then considered how narrative, as story has traditionally, held an enriching place within the arts. In this way the question crystallised around how the arts may carry the narratives of those so labelled intellectually disabled. This was enhanced with the question of the arts' relationship to hegemonic discourse and thus how their forms may be placed to augment the resistance of insider narratives to it. From here the author sought out examples of insider narratives within the arts, it became clear that this had increased, though was still limited, within the contemporary sphere. Me Too and Heavy Load were found and they resonated with the aim of the work to cross borders and counter their dualistic ontology. This was found to be of great significance to social work given its moorings in the social sciences.


We obtained scanning tunneling microscopy (STM) light emission spectra of a Ni(110)-(2 × 1) O surface. A mosaic of nanoscale bright and dark domains was observed in the STM image. When the tip was fixed over the dark domain, stepwise structures were observed at 100 and 150 meV below the quantum cutoff in the STM light emission spectra. These energies were consistent with the reported vibrational energies of oxygen atoms adsorbed on the Ni(110)-(2 × 1) O surface, and indicated the expected isotope shifts between 16 O and 18O. Therefore, these stepwise structures are induced by the vibrations of adsorbed oxygen atoms. The 100-meV mode corresponded to the vibration polarized parallel to the surface. A theory describing the coupling between the STM light emission and vibration polarized parallel to the surface is proposed. We conclude that the oxygen atoms cover the dark domain and bare Ni atoms correspond to the bright domain. When the exposure level of oxygen was approximately 1/10 of that for Ni(110)-(2 × 1) O, bright-imaged nanostructures were observed in the terrace where bare Ni atoms are exposed. The step structure caused by the vibrations of adsorbed oxygen was observed in the STM light emission spectra of the bright-imaged nanostructures, showing that these structures are covered by oxygen atoms. In other words, the isolated nanostructures covered by oxygen atoms are imaged not as dark, but as bright, unlike in the case of Ni(110)-(2 × 1) O observed by STM.We obtained scanning tunneling microscopy (STM) light emission spectra of a Ni(110)-(2 × 1) O surface. A mosaic of nanoscale bright and dark domains was observed in the STM image. When the tip was fixed over the dark domain, stepwise structures were observed at 100 and 150 meV below the quantum cutoff in the STM light emission spectra. These energies were consistent with the reported vibrational energies of oxygen atoms adsorbed on the Ni(110)-(2 × 1) O surface, and indicated the expected isotope shifts between 16 O and 18O. Therefore, these stepwise structures are induced by the vibrations of adsorbed oxygen atoms. The 100-meV mode corresponded to the vibration polarized parallel to the surface. A theory describing the coupling between the STM light emission and vibration polarized parallel to the surface is proposed. We conclude that the oxygen atoms cover the dark domain and bare Ni atoms correspond to the bright domain. When the exposure level of oxygen was approximately 1/10 of that for Ni(110)-(2 × ...


Resource-constrained project scheduling under a net present value objective attracts growing interest. Because this is an NP-hard problem, it is unlikely that optimum solutions can be computed for large instances. Thus, heuristics have become a popular research field. Up to now, however, tight upper bounds have not been proposed. Therefore, most researchers evaluate their heuristics on the basis of a best known lower bound, but it is unclear how good the performance really is. With this contribution we close this gap and derive tight upper bounds on the basis of a Lagrangean relaxation of the resource constraints. We also use this approach as a basis for a heuristic and show that our heuristic as well as the cash flow weight heuristic proposed by Baroum and Patterson yield solutions very close to the optimum result. Furthermore, we discuss the proper choice of a test-bed, and, by reviewing the literature, emphasize that discount rates must be carefully chosen to give realistic instances.


In this paper, we introduce a method for recognizing a subject complex object in real world environment. We use a three dimensional model described by line segments of the object and the data provided by a three-axis orientation sensor attached to the video camera. We assume that existing methods for finding line features in the image allow at least one model line segment to be detected as a single continuous segment. The method consists of two main steps: generation of pose hypotheses and then evaluation of each pose in order to select the most appropriate one. The first stage is three-fold: model visibility, line matching and pose estimation; the second stage aims to rank the poses by evaluating the similarity between the projected model lines and the image lines. Furthermore, we propose an additional step that consists of refining the best candidate pose by using the Lie group formalism of spatial rigid motions. Such a formalism provides an efficient local parameterization of the set of rigid rotation via the exponential map. A set of experiments demonstrating the robustness of this approach is presented.


Epilepsy occurs in a bimodal pattern with peak incidences during the first year of life and in the ageing population. People aged over 70 have the highest incidence of epilepsy. Physicians, however, are often not aware this prevalence in the elderly. Diagnosis and treatment of epilepsy in the ageing are usually more complicated than in the younger population as there are age-related physiologic changes, multiple pathologies and medical problems as well as polypharmacy. Moreover, older patients are usually vulnerable to adverse drug reactions. This article reviews differences in various aspects of epilepsy between older and younger patients, physiological ageing changes affecting the use of antiepileptic drugs in the elderly and choice of drug treatment in this population.


The main goal of this paper is to analyse recent trends in freight transport volumes as well as their relation to socio-economic and infrastructural variables, in the case of the following major European countries: France, Germany, Italy, Poland, Spain and the United Kingdom. This analysis refers to the period 2005-2016, so that years affected by the global economic crisis, which shows its peak in 2009, are taken into account. This research demonstrated that not all the countries under study show a strong relation between freight traffic and GDP as it could have been expected based on well consolidated experiences and studies. Moreover, other relations are investigated, with mixed results, between the freight traffic volumes and the extension of the rail and road networks as well as oil price data.


The hemodynamic effects of a microcapsule nitroglycerin preparation (Lénitral) were studied in 30 patients. Ten patients received 2 capsules of Lénitral 2,5 mg equivalent to 5 mg nitroglycerin; ten patients received 1 capsule of Lénitral 7,5 mg equivalent to 7,5 mg nitroglycerin, and ten patients received a placebo. Central venous pressure (CVP), systemic arterial pressure (AP) and heart rate (HR) were monitored during 12 hours. In the two groups treated, there was a significant decrease in CVP, starting 30 minutes after administration, lasting until the 8th hour and followed by a gradual increase; HR remained unaltered. AP was only lowered in patients under Lénitral 7,5 mg. There were no changes in these parameters among patients under placebo. In addition, 10 patients were catheterized one hour after oral administration of either 2 capsules of Lénitral 2,5 mg or a placebo. In the patients treated there was a significant decrease in right and left ventricles filling pressure, without changes in HR, AP, cardiac index and peripheral systemic resistances. At the end of the study, administration of 0,6 mg sublingual nitroglycerin produced no further changes in these parameters, in contrast with patients under placebo. The study indicates that Lénitral exerts prolonged hemodynamic effects and that low doses act primarily on preload and higher doses on both preload and afterload. This makes Lénitral a valuable drug for long-term treatment of chronic coronary disease and congestive heart failure.


Purpose: We aimed to assess the efficacy of biofeedback therapy for patients with fecal incontinence (FI) according to the etiology. Methods: Twenty-nine patients with fecal incontinence were treated with biofeedback therapy using a EMG-based system. The efficacy was assessed by using changes in the FI score (Cleveland Clinic, Florida: 0-20) and satisfaction based on a subjective evaluation score from 0 to 100. The median follow up duration was 12 (3-25) months. Results: Ten patients had idiopathic fecal incontinence. Fourteen patients had fecal incontinence due to a sphincter saving operation for rectal cancer. Four cases had spinal cord injury and one patient had a major external sphincter tearing due to trauma. The mean age was 52 (16-78) years. The median number of biofeedback sessions was 10 (3-15) overall. The mean efficacy was 42.8%, and the mean satisfaction score was 56.6. Improvements in the FI score and in the patients' satisfaction varied according to the etiology, 69.5% and 71.5 in the idiopathic group, 28.5% and 49.3 in the postoperative group, and 35% and 24 in the spinal cord injury group. In the idiopathic group, 50% of the patients showed an improvement in the FI score of more than 75%, and 90% of the patients showed an improvement of more than 50%. The number of liquid incontinence episodes was improved 78.3% later in the biofeedback group, and this result was much better than in the postoperative incontinence group (31.8%, p=0.03). Conclusions: The success rate of the biofeedback therapy for fecal incontinence is acceptable. Subjective satisfaction is relatively higher than the improvement in the fecal incontinence score. Idiopathic fecal incontinence may be the best indication for biofeedback therapy.


Introduction: Violence has been declared a problem of public health by the World Health Organization since 1996. In the last years, an alarming increase of violence involving adolescents has been seen, reflected in several indicators like the number of homicides. Objective: To explore risk factors for juvenile violence and homicide based on a review of the literature with emphasis in Colombian information. Material and Methods: A narrative review of the literature was made searching biomedical databases, including studies made with adolescents, both genders, published in English and other languages from 1966 to 2006. Results: 107 studies were identified that study different risk factors for homicide and juvenile violence. The use of guns, the use of illegal drugs and alcohol, intrafamilial violence, history of conduct disorder, suicide attempts, convicted parents, gang membership and beliefs that favor violent acts as a solution to problems were found to be the most important factors. Conclusions: Adolescents are both perpetrators and victims of violent acts, homicide being the second cause of death between the ages of 15 to 19 years old. Risk factors associated with violence and juvenile homicide are similar, making their study of extreme importance. Colombia does not escape this phenomenon. Many studies find that the main risk factor is to have been a victim of violence.


Presented in this paper are some preliminary ideas on the role of actuator saturation in linear systems that are under study. Real actuators have limited bandwidth and they saturate upon receipt of overly large inputs. Such actuator saturation can have catastrophic consequences especially in feedback control of open-loop unstable plants. It is well known that even when used with stable plants, actuator saturation can lead to undesirable limit cycle behavior. Actuator saturation can also easily occur when integrations are used within a control loop. Integrator anti-windup schemes have been proposed for overcoming that situation. One obvious but almost unresearched idea for eliminating wind up would be to get rid of the need to use integral action inside the feedback loop. So the crucial question is whether or not it is possible to get good steady state accuracy without using integral control? One idea could be to delegate the tracking responsibility to a carefully designed pre-filter.


In the early 1950s, anodising was an infant industry. It was a fi rmly established process in the aircraft industry, but otherwise it was associated with small scale industries such as nameplates, cosmetics, fancy goods and giftwares, shop fi ttings, etc. Aluminium is now the second most widely used metal and anodising has become the most widely used fi nish in a range of major industries and applications. It has become a worldwide multibillion dollar industry. It is not generally realised that this status has been largely the result of the application of marketing theory by the major aluminium companies worldwide. This contribution records its evolution as far as the UK is concerned. It examines how the application of the marketing theory prevalent at the time affected the development and diffusion of the technology required to bring about the growth of output of anodised aluminium products in large scale industries, such as motor and related bright trim applications and a range of architectural products.


Amorphous solid dispersions (ASDs) are among the most popular and widely studied solubility enhancement techniques. Since their inception in the early 1960s, the formulation development of ASDs has undergone tremendous progress. For instance, the method of preparing ASDs evolved from solvent-based approaches to solvent-free methods such as hot melt extrusion and Kinetisol®. The formulation approaches have advanced from employing a single polymeric carrier to multiple carriers with plasticizers to improve the stability and performance of ASDs. Major excipient manufacturers recognized the potential of ASDs and began introducing specialty excipients ideal for formulating ASDs. In addition to traditional techniques such as differential scanning calorimeter (DSC) and X-ray crystallography, recent innovations such as nano-tomography, transmission electron microscopy (TEM), atomic force microscopy (AFM), and X-ray microscopy support a better understanding of the microstructure of ASDs. The purpose of this review is to highlight the recent advancements in the field of ASDs with respect to formulation approaches, methods of preparation, and advanced characterization techniques


We studied the formation of style scheme (identification of the style that characterizes an artist) presenting 100 participants aesthetic visual stimuli. Participants were Spanish university students who volunteered: 72 women, 28 men of mean age 22.8 yr. Among those 50 were enrolled in History of Art and 50 students in Psychology. Stimuli belonged to different categories—High Art (pictures of well-known artists, like Van Gogh)/Popular Art (decorative pictures like Christmas postcards) and Representational (pictures with explicit meaning content, like a landscape)/Abstract (pictures without explicit meaning content, like Pollock's colored stains). Analysis using Signal Detection Theory techniques focused on how participants discriminate representational and abstract pictures. With High An stimuli, participants can better discriminate representational paintings than abstract ones. However, the difference in discrimination between representational and abstract pictures diminishes among participants studying History of Art. It seems that prior education in art favors forming style schemes and to some extent enables the participant to detect the "meaning" in High Art abstract paintings.


Glory lily, the state flower of Tamil Nadu is being commercially cultivated in Tamil Nadu. Field experiments were conducted to study the arthropod biodiversity and to develop eco-friendly management strategies. Results of the studies on insect biodiversity in gloriosa ecosystem revealed that the lepidopteran pests viz., lily caterpillar, Polytela gloriosae, semilooper, Plusia signata and tobacco cutworm, Spodoptera litura and a sucking pest viz., Thrips tabaci were recorded to be the major pests. Early instar lily caterpillars fed on chlorophyll of the leaves but the later instars fed voraciously leaving only the hard stem of the plant resulting in complete devastation. Eggs were small, round and dorsoventrally flattened. Egg period varied from 3 to 6 days. The larval period lasted for 14 to 18 days and the larvae underwent five moults to become pupa. The eggs of tobacco cutworm were small, round and were laid in clusters of several hundreds, usually on leaf surfaces. The egg period varied from 3 to 4 days. The larval period varied from 15 to 18 days with five larval instars. Pupation took place inside the soil. Eggs of semilooper were laid singly on underside of the leaves. The egg period varied from 2 to 3 days. Larval period lasted for 14 to 17 days with five instars. Thrips infesting Gloriosa superba was identified as Thrips tabaci. Body of the adult thrips was recorded to be 1.0 to 1.2 mm long and yellowish-grey to dark-grey in color. Wings have single longitudinal vein with a fringe of hairs. Dark blotches are observed on the thorax and abdomen. Female laid 30 to 80 whitish eggs. There were two nymphal stages that lasted up to 14 days, after which the larva entered quiescence. This pre-pupal stage (1-2 days) was followed by the pupal stage. Adult females lived for 10 to 13 days. These thrips were identified as vectors in transmitting necrosis, a viral disease. Virus infected plants developed a bronze or purple discoloration. Leaves curled downwards and were distorted. Affected leaves wilted and died. Dark streaks appeared on stems near the growing point, led to death of the plant. Based on the results of field experiments conducted for the management of lepidopteran pests of G. superba, flavonoids were adjudged as the best alternative to the chemical pesticides in gloriosa eco-system and for the management of thrips and gloriosa necrosis, foliar application of fipronil at 1.25 mL L(-1) was recommended.


ObjectivesSeveral studies have indicated changes in sensation and/or pain sensitivity among women across the menstrual cycle, but the pattern of the changes varies considerably. One reason for the reported discrepancies could reside in lack of biochemical definition of menstrual cycle phase. The aim was to quantify temperature and temperature pain thresholds at biochemically defined stages of the menstrual cycle. MethodsNineteen healthy women were included in the study. Temperature and temperature pain thresholds were evaluated by quantitative sensory testing, performed at 3 occasions during the menstrual cycle (early follicular phase, late follicular phase, and mid-luteal phase). At each test session, serum concentrations of estradiol and progesterone were assessed. ResultsThermal cold perception threshold at the mammilla was significantly lower in the late follicular and mid-luteal phases, compared with the early follicular phase (P<0.05, respectively). For the remaining test sites, no cycle related differences in thermal perception or thermal thresholds could be documented. ConclusionsThe present study has indicated no major changes in thermal pain thresholds related to phase of the menstrual cycle for the tested locations, although thermal cold perception threshold at the mammilla was a significantly lower in the late follicular and mid-luteal phases, compared with the early follicular phase. The findings of the present study further underlines the need for strict criteria for menstrual cycle phase when studying pain sensitivity in relation to hormonal events in women.


An apparent epidemic of diabetes is occurring in adults worldwide. This trend seems to be associated with socioeconomic and lifestyle changes. The population of developing countries and some communities within developing countries are at higher risk. Diabetic eye disease and its complications, especially diabetic retinopathy, are a leading cause of blindness and visual dysfunction in adults in economically developed societies. Epidemiological studies of the impact of diabetic eye disease in developing countries are scarce. Risk factors for the development and progression of diabetic retinopathy include, among others, hyperglycemia, genetic factors, race, duration of the disease, arterial hypertension, and proteinuria.


This article aims to determine the relationship of employer educational assistance with organizational commitment in terms of affective commitment, continuance commitment, normative commitment to turnover intention, thought of quitting, and job alternatives. Many organizations offer the benefit of educational assistance to their employees. However, it seems that many of them are not sure whether the expenditure is harmonious with the benefits they receive in return. This is particularly true when organizations offer general rather than specific educational benefits that are not tied to job-related tasks. This has lead many organizations to ask what benefit if any, they receive from providing tuition assistance programs. While most of the previous research has been tied to tangible returns on this investment in employee capital, with varying conclusions, this study examines two of the intangible benefits that are proposed to accumulate to an organization providing educational assistance; increased organizational commitment and decline in turnover intention. The focal organization, a large corporation, is one of the leaders in the information and communication technologies sector in Thailand. The study focuses on 90 retail staff members. The method used is both quantitative in the form of surveys and qualitative in the form of action research. The process of ODI is based on employer educational assistance and its effect on organizational commitment and turnover intention. The research findings provide evidence that leads to the conclusion that there is a significant difference between pre- and post-ODI on organizational commitment and turnover intention. Continuance commitment has the most significant result after the intervention. Moreover, the results show a significant negative relationship between turnover intention and organizational commitment.


Research on the mouse genome lurched into the fast lane last week, as private donors joined the U.S. government to step on the gas. A public-private consortium announced on 6 October that it's kicking $58 million into a new fund that will pay to sequence the DNA of the "black six" (C57BL/6J) strain of laboratory mouse. The consortium aims to produce a draft version of the genome by the end of February.


(1) Aspecies of "Eleutheria" is found in fair abundance at certain times and places at the Cape of Good Hope. (2) It can readily be kept in confinement, and some of its habits are noted. (3) The chief characteristics of the species are described and compared with those of other southern species. (4) Its hydroid form has been found, and proves to be very similar to that of Cladonema (Stauridia), not of Eleutheria (Clavatella). (5) It differs, however, from Cladonema chiefly in the absence of oral tentacles, and a, new genus (Cnidonema) is proposed for the reception of this and probably all the other southern Eleutheria, the hydroid forms of which, however, are not yet known.


We consider a finite-range spin glass model in arbitrary dimension, where the strength of the two-body coupling decays to zero over some distance gamma(-1). We show that, under mild assumptions on the interaction potential, the infinite-volume free energy of the system converges to that of the Sherrington-Kirkpatrick one, in the Kac limit gamma-->0. This could be a first step toward an expansion around mean-field theory, for spin glass systems.


Since 2020, the world has been facing a global pandemic of the infectious disease COVID-19 caused by the coronavirus SARS-CoV-2. It has a negative impact not only on the economy of individual countries, but also on the financial and property situation of business entities, and thus on the lives of hundreds of millions of people around the world. The aim of this article is to present the results of the study and an assessment in terms of the impact of the COVID-19 pandemic on the development of the financial situation of hospitals in Europe after the first year of the pandemic in relation to the situation several years before the pandemic. The study covered the period from 2017 to 2020. An economic analysis based on basic statistical characteristics was conducted using the financial data of a survey population of 8,995 private and public hospital operating companies in Europe, including 2,769 from Western Europe and 6,226 from Eastern Europe. The research hypothesis was confirmed only for operating income (turnover), current ratio and solvency ratio, while it was not confirmed for asset situation. For the other analyzed economic quantities, heterogeneous results were obtained depending on the region of Europe in which the hospital is located.


Chickens infected with the malarial parasite Plasmodium gallinceum produced green droppings: the predominant pigment was biliverdin. Droppings of identical appearance were produced by chicks injected with phenylhydrazine, a haemolytic agent: it is concluded that the catabolism of haemoglobin resulting at least in part from malarial haemolysis produces excess bile pigments which appear in the droppings. Other chicken diseases in which green droppings are "a characteristic objective symptom are fowl typhoid, Newcastle disease (Doyle's form), spirochaetosis and fowl cholera. The correlation of this symptom with haemolytic or other secondary anaemia is discussed and its value in field outbreaks of avian malaria as an indicator of the need for immediate therapy is emphasised.


The systems of spit bars that crop out in the area of linkage Atlantic-Mediterranean began to accumulate around 6,900 yr BP during the maximum of the Present Interglacial. From the morpho-sedimentological study of these spit bar systems, the study of littoral dynamics (particularly the littoral drift and interchange of "superficial Atlantic water" (SAW) and Mediterranean water), and the results of 14 C measurements, we have deduced that (a) the maximum of the Present Interglacial took place ca. 6.500 yr BP, (b) the progradation of spit bar systems relates to climate; anticyclonic conditions increase the entrance of "superficial Atlantic Water" into the Mediterranean, and enhance littoral drift favouring progradation. In contrast, the entrance of SAW decreases under low-pressure conditions causing reduced littoral drift, no progradation and, as a consequence, generation of the very large swales or erosional surfaces separating successive spits. (c) In the most complete case, four large prograding bodies called H 1, H 2 , H 3 and H 4 , can be distinguished, but more 14 C measurements are required to deduce more precise periodicities.


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Credit: Carlos Ortiz/Democrat and Chronicle

The name Seymour Schwartz became synonymous with surgery after his five fellow editors of Principles of Surgery , published by McGraw Hill in 1969, voted him editor in chief. Schwartz edited the next seven editions of the seminal textbook, later re-named Schwartz's Principles of Surgery . The first edition ran to 1850 pages and 52 chapters.

The 11th edition was published last year, when Schwartz was in his 90s. In a characteristic visionary foreword, Schwartz noted, "The 'science of surgery' has gained dominance over the 'art of surgery.' Diverse technologies have been incorporated to expedite diagnosis and improve surgical excision or repair. It is as if today's surgeons have adopted a new language, new rules, new protocols—and anticipate new outcomes."

In 2018 he told the Rochester Democrat and Chronicle newspaper, "I was happiest in the operating room. I prepared for every operation. I have an ego. And I felt I could operate as well, if not better than, most of the surgeons I was around."

But Schwartz was much more than a leading surgeon, once described as "sharp as a tack." He was also a …


This is a book on the process of state-building in Myanmar. Myanmar is now under the reform processes undertaken by the new government formed in 2011. The reforms include both political and economic reforms. Politically, Myanmar is heading towards a new political system that will ensure the perception of its framers who want to build an international identity of the state of Myanmar. Economic development is also the focus of the new government. With such changes in the country, there is a need of literature focusing on Myanmar and this book fulfills this need partially. Although the study focuses on the state-building process of Myanmar between 1988 and 2010, it actually traces the politics of development in Myanmar since independence in 1948. It is a study of state-led development process of Myanmar in line with the developmental state theory and in comparison with the state-led development of Indonesia under Suharto's regime. This book will help readers including politicians, policy makers, international donors, academics, foreign investors, etc. to understand the process of state-building in Myanmar.


In order to provide reliable connections across metropolitan and wide-area optical networks, the network operator must provide some degree of redundancy so that traffic can be switched from damaged working paths to backup paths that are disjoint from the working paths that they are protecting. In the most general form of path protection, N working paths between two client edge nodes are protected by M backup paths. The set of working and protection paths forms a M:N protection group. In the near future, optical transport networks (OTNs) will use an automated control plane to set up, tear down, or modify connections between client edge nodes. If protection groups are allowed to evolve over time, with working and backup paths being set up or torn down individually, it may be necessary to modify other working and backup paths in addition to those that are being created or destroyed, in order to maximize network utilization. In this paper, we examine the mechanisms that can support adaptive M:N protection group management and describe how existing Generalized Multi-Protocol Label Switching (GMPLS) signaling protocols allow this capability to be deployed in the OTN.


The concept of Petri net controllers is extended to include automatic error recovery and adaptive design. In the Petri net controller considered, a place that represents an operation or a state of a machine is attached to two functions and a constant so that it can represent a system working with both normal states and abnormal states. In addition, it is possible to detect an error with the controller using watchdog timers. Four basic Petri net augmentation methods for error recovery are investigated: input conditioning, alternate path, feedback error recovery, and forward error recovery. The authors demonstrate that when these methods are used to augment the Petri net controller, some important properties of the controller are guaranteed to be preserved. These properties include boundedness or safety, liveness, reversibility and the essentially decision-free property. An example of augmentations for error recovery for a piston insertion cell with two robots is given. >


Woman, aged 52 1.1.68: Referred with rectal pain, her doctor having found a cystic mass the size of a walnut behind the lower part of the rectum. Previous history not significant. Blood pressure 150/80. Hb 12-5 g/100 ml. Abdominal examination negative. Rectal examination revealed a large cystic swelling behind the rectum and extending upwards in the curve of the sacrum. Biopsy of rectal wall in the region of the cyst was normal.


Chronic inflammatory demyelinating polyneuropathy and the neuropathies associated with monoclonal gammopathies represent a significant proportion of initially undiagnosed neuropathies. Over the past year, a number of publications have provided information on the clinical characteristics, mechanisms, and possible relationships between these neuropathies. This review summarizes this recent information, with an emphasis on the relevance to therapy.


Linguistic landscape research has been administered in different parts of the world by several researchers. However, linguistic landscape research in Indonesia is still limited in number. To respond to the scarcity of linguistic landscape study in Indonesia, the present research discusses the visible languages, proportions of top-down and bottom-up signs in Sidoarjo City. The functions of the signs are also identified.Data were collected from signs in some public places and along the main streets of Sidoarjo City.The results of the study show that the linguistic landscape is dominated by Indonesian. English is used more often than Arabic. Javanese as the mother tongue for the majority of the society of Sidoarjo is rarely used. Some other Asian languages are also apparent in the shopping centers. Description and explanation of the functions of the signs are also presented.


The reciprocity theorem is used to derive expressions for the short-circuit current at the terminals of a receiving antenna and the input impedance of an antenna. The source-field Situations in the reciprocity statement are chosen so as to make the derivations straightforward to carry out and easy to interpret.


Human rights are inalienable and inviolable fundamental entitlements. The right of self-determination is one of such rights. It is the individual and collective right of the people, and especially of the indigenous peoples. Integrating indigenous knowledge systems is one of the tools to enforce the rights of self-determination to also ensure self-determined development. Starting from this perspective, this book presents the findings of a research work, which the author carried out on the actual enforcement of rights of self-determination and integration of indigenous knowledge systems of Gamo People of Ethiopia in light of the international legal instruments, policies of organizations of UN System such as International Fund for Agricultural Development (IFAD) and fundamental local laws and policy documents of Ethiopia. One of the aims of this study is to raise awareness on the indigenous knowledge systems and legal documents recognizing the rights of indigenous peoples. The author hopes that this study can add value to the development initiatives of Ethiopia and contribute its part to researchers, academic communities, policy makers, development partners and Gamo people.


BACKGROUND
Prostate cancer is the most common noncutaneous malignancy in men in the United States. Patients with metastatic castration-resistant prostate cancer (mCRPC) may be treated with secondary hormonal therapy or with chemotherapy, and potentially with concomitant corticosteroids. Corticosteroids can help manage the side effects of chemotherapy and secondary hormonal therapy and ameliorate prostate cancer-related symptoms, although corticosteroids are also associated with adverse effects. With an increasing number of available treatment options for mCRPC, evaluating the real-world concomitant use of corticosteroids in this patient population is important.

OBJECTIVE
To evaluate the utilization patterns of corticosteroids for the treatment of patients with mCRPC based on real-world data from 2 large claim databases.

METHODS
This retrospective analysis included medical and pharmacy claims from 2 large publicly available healthcare claims databases covering more than 31 million individuals to identify treatment patterns in adult patients with mCRPC. A total of 2593 patients with mCRPC were identified in data set 1 and 626 patients in data set 2 between 2005 and 2011. The appropriate treatment for castration-resistant prostate cancer (CRPC) was defined as chemotherapy, an antiandrogen, an adrenal androgen blocker, or estrogen. The index date was the date of the first CRPC treatment or the first metastasis diagnosis, whichever occurred later. The observation period spanned from the index date to the end of health insurance eligibility. Study end points included population characteristics, the distribution of mCRPC therapies, and corticosteroid utilization patterns.

RESULTS
The study population came from the 2 data sets and included 3219 men who were treated for mCRPC. Bone and lymph nodes were the predominant metastatic sites. Bicalutamide was the most common secondary hormonal therapy, and docetaxel was the most common chemotherapy used for these patients. Overall, 73.4% of the patients in data set 1 received concomitant corticosteroids, as did 71.6% of patients in population 2 during the entire period from the index date to the end of eligibility date. In addition, 62.8% and 60.4% of patients, respectively, received concomitant corticosteroids during the secondary hormonal therapy period, and 93.8% and 95.1% of patients, respectively, received concomitant corticosteroids during the chemotherapy period. Similar patterns of corticosteroid use were observed across geographic areas of the United States.

CONCLUSION
This study shows consistently similar utilization patterns of corticosteroids in patients with mCRPC in 2 large national databases. Using real-world data to inform concomitant corticosteroid use in the treatment of patients with mCRPC may assist healthcare providers with treatment selection and with sequencing decision. Future research is warranted to investigate evolving treatment options for patients with mCRPC.


We conducted a survey to evaluate a previously proposed mechanism for explaining Belief-Desire-Intention (BDI) agents using folk psychological concepts (belief, desires, and valuings). We also consider the relationship between trust in the specific autonomous system, and general trust in technology. We find that explanations that include valuings are particularly likely to be preferred by the study participants. We also found evidence that single-factor explanations, as used in some previous work, are too short.


A supplement to the Climate Change Scenarios for Nepal report published by the Ministry of Forests and Environment for the National Adaptation Plan (NAP) Process, this manual provides detailed information about the processes through which the assessment highlighted in the report can be carried out. They include – selection of the general circulation/climate models (GCMs), downscaling of the GCM dataset, assessment of changes in precipitation and temperature, and assessment of change in climate extremes. The manual downscales climate datasets for the Koshi River basin, the Kabul River basin, and the Kailash Sacred Landscape to analyse future scenarios in these basins and the landscape.


In a previous paper Barcroft and Hill [1910] gave evidence to show that in dialysed solution haemoglobin has its smallest possible molecular weight, contains, namely, one atom of iron. In a later communication Hill [1910] suggested that the dissociation curves of oxyhaemoglobin in the presence of salts and carbon dioxide can be calculated from the hypothesis that these bodies tend to aggregate the large haemoglobin molecules into larger molecules, which then combine with oxygen according to the equation


Fault dictionaries for the stuck-at fault model are not appropriate for diagnosing CMOS bridging faults. This paper shows that for CMOS circuits containing bridging faults, either IDDQ or the voting model is needed for correct diagnosis. However, a technique based upon the voting model that uses stuck-at fault dictionaries to diagnose bridging faults is described. When the traditional stuck-at fault technique is used, between 30-50% of the bridging faults resulted in a misleading diagnosis which indicated the presence of the failure on a fault-free node. In addition, as the stuck-at fault diagnostic ability of a test increased, the bridging fault diagnostic ability decreased.<<ETX>>


A nonlinear Duffing-type dynamical system, in which the stability of equilibria is modulated in a time-dependent manner, is investigated both experimentally and numerically. This is a low-order dynamical system with some interesting available choices in the coordinate system. The system is found to exhibit a variety of interesting nonlinear behavior including ultrasubharmonic resonance. Frequency content is used to characterize periodic and chaotic behavior and their relation to the parameter space.


The concept of quality factor enhancement in a two dimensional rectangular dielectric resonator (RDR), based on the phenomenon of edge diffraction suppression by a plasma, is presented. This phenomenon occurs when the plasma exhibits the specific negative permittivity, which makes the RDR separable, i.e., analytically solvable by means of the separation of variables. The Rotman plasma, constituted of metal thin wires is proposed as a practical implementation of this ideal plasma, and the diffraction suppression concept is demonstrated with this plasma by an SIE/MoM approach verified by using a finite element method solver, HFSS. It is shown that a relatively small number of wires (4 times 4) in the plasma is sufficient to mimic a close-to-ideal plasma medium, which suggests a potential for practical applications. This study reveals that the utilization of this plasma allows a strong (high-Q) resonance even for low-permittivity dielectrics otherwise improper to act as resonators.


Optimized Water Filling scheduling (OWF) has been studied previously \cite{p2p:Ezovski2009} for no peer leaving Peer-to-Peer (P2P) network, where the problem of efficiently delivering a common set of data from a single base station to multiple users that have heterogeneous uploading capacity was examined. In the absence of peer leaving, it has been demonstrated that OWF can achieve significant performance improvement by exploiting the optimal tradeoff between augment of last finish time and reduction of average finish time. However, peer leaving is a typical behavior of P2P file sharing network, and minimizing average finish time combined with the effects of peer leaving necessitates a more complex scheduling policy. In this work, we extend their studies to P2P networks with users are subject to leave when they complete the data gathering. A simple scheduling method, named reversed water filling method (RWF) is proposed to adapt problem of peer leaving. We also examine the finish time and total network access time of peers under different file distribution strategies. The results show that RWF method yields significant shorter average finish time and total network access time than its predecessors and all other known file delivery methods under peer leaving condition. The results provide fundamental insights of scheduling for improving performance of P2P systems.


Glycosaminoglycans heparin and heparan sulfate are biologically active polysulfated carbohydrates that are among the most challenging biopolymers with regards to their structural analysis and functional assessment. Fragmentation of oligosaccharides and sulfate loss are important hindrance to their analysis by mass spectrometry (MS), requiring thus soft ionization methods. The recently introduced soft ionization method desorption electrospray ionization (DESI) has been applied here to heparin and heparan sulfate oligosaccharides, showing that DESI-MS is well suited for the detection of such fragile biomolecules in their intact form. Characterization of complicated oligosaccharides such as synthetic heparin octadecasulfated dodecasaccharide was successfully achieved. The use of water for a spray solvent instead of denaturing organic solvents allowed the first DESI-MS detection of noncovalent biomolecular complexes between heparin oligosaccharides and the chemokine Stromal Cell-derived Factor-1. The hyphenation of the DESI ion source with the high-resolution LTQ-Orbitrap MS analyzer led to high accuracy of mass measurement and enabled unambiguous determination of the protein-bound sulfated oligosaccharide.


Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a nonprofit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to patients and support to caregivers while encouraging the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum in which caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members. Increasingly, cancer patients are subjected to advertisements related to oncologic therapies and other cancer-related products in the popular media. Such direct-to-consumer advertising is controversial: while it may inform, educate, and perhaps even empower patients, it also has the ability to misinform patients, and strain their relationships with oncology providers. The U.S. Food and Drug Administration requires that direct-to-consumer advertising provide a balanced presentation of a product's benefits, risks, and side effects, but this can be difficult to achieve. Through a discussion of this topic by an oncology fellow, ethicist, cancer survivor, and senior oncologist, the role of direct-to-consumer advertising and its often subtle effects on clinical practice in oncology are explored. Although sparse, the medical literature on this increasingly prevalent type of medical communication is also reviewed.


Energy sensitive photon counting x-ray detectors (PCXD) [1] have many advantages over energy-integrating x-ray detectors (EIXD) in x-ray computed tomography (CT), such as the ability to measure the spectrum of x-ray beams. When such PCXDs are operated under a high count rate in clinical scanners, coincident photons would distort the recorded energy spectrum due to the limited speed of the detector. To compensate for the spectrum distortions, we have developed analytical models for them [3] and integrated one such model into an image reconstruction process using a sinogram restoration framework [6]. In this method, the attenuation of the object was modeled as a sum of line integrals of N basis functions, where N was fixed at 3 for the entire sinogram when a contrast agent is involved. The method allowed us to reconstruct accurate images, compensating for the effect of spectrum distortion of PCXD; however, the contrast-to-noise (CNR) of the images were only comparable to that obtained by EIXDs. We believe the main reason is an increased statistical uncertainty in the estimated line integrals introduced by the 3rd basis function. In this paper, we propose a method to improve the CNR by employing the fewest number of basis functions Nm (≤ N) as necessary for an individual sinogram ray. Our simulation studies indicate that the CNR achieved for a Gd-based contrast agent by PCXDs could be 12% better than the conventional method of [6], and 28% better than EIXDs for scans with similar number of x-ray photons, which points to a dose reduction of 20% and 39% respectively.