Background Scientific progress and better disease awareness constantly lead to increasing patient numbers in rheumatology which requires optimization of patient care. Objectives The aim of this study was to evaluate and to optimize the procedures of patient care in an university-based outpatient rheumatology setting in Berlin, Germany. Methods One hundred patients with rheumatoid arthritis (80 women, 20 men, mean age 61.2 years, mean disease duration 12.9 years) were independently assessed both by a rheumatologist and via patient-reported self-assessment questionnaires. Current follow-up interval (usually 3 months), patient's perspective on follow-up intervals, signs of disease activity as well as individual patient concerns were recorded. Satisfaction with follow-up intervals was grouped into three categories: too early, just right/optimal, too late. Results Based on the physicians perspective, 46 patients presented at the optimal time point, 51 too early, and three too late. The patients reported the category "just right" in 82 cases, too early follow-up in 10 cases and too late in 8 cases. Of note, 51% (42 individuals) of all patients with self-reported satisfactory follow-up interval were judged to visit the out-patient department too early by the expert rheumatologist. When taking into account the follow-up interval and optimal satisfactory levels, 62% of patients were concluded to visit the department too early in those revisited after 3–4 months (n=65), and in 12% of those who were seen again after 5–6 months (n=17). 82% of patients in the latter group were judged to revisit just right by the physician. Conclusions There was a high proportion of overlap in the views on the satisfaction with follow-up intervals between physicians and patients. Especially in patients who were seen every 3–4 months, a high proportion was deemed to could have come later to the out-patient care unit from a purely medical point of view. Here we see a way to stretch the interval to 5–6 months without risking a long-term deterioration in patient care. However, this measure should be flanked by patient education and good collaboration with the general practitioners. Acknowledgements We thank AbbVie for financial support in the development of measures to optimize out-patient management in patients with rheumatoid arthritis. The sponsor did not influence the scientific results. Disclosure of Interest None declared


Despite going global, LEED certification is essentially a US tailored approach to encourage Green Building businesses and practices. The assumptions of incentive packages and tax breaks, points rewarded for the use of certain types of recycling, weights and points – all these have many local biases for US companies and practices. Before adoption in another country, these assumptions and biases have to be clearly spelled out and checked. In fact, a Green Building certification has to be home-grown to suit economical, cultural and technological conditions. This paper shows how different countries can adopt a customized Green Building Evaluation Code and still be recognized, the case study is Egypt Green Pyramid ranking system. The research aims to evaluate the adoption of the green building systems in Egypt and propose the suitable score and elements to the Egyptian society. Some localized issues for example are the increased encroachment on agricultural land, the abundant desert land, energy crisis and the reduced share of Nile water.


Samples of poly(ethylene terephthalate) with different degrees of crystallinity have been investigated by dielectric spectroscopy in the frequency range 10-2-107 Hz and in the temperature range 60 °C-120 °C. The resulting spectra were evaluated within the A3-scenario of the mode-coupling theory. Quantitative agreement was found between theory and experiment over a frequency range as large as seven decades in the best case. The scaling laws of the theory were also tested and it was found that they were only partially obeyed. We argue that the reason for this is that the limited temperature range and the effect of the activated hopping processes are not taken into account in the present version of the theory.


CONTINUING CUTS TO LOCAL PUBlic health departments' budgets and staff, as well as proposed cuts to the US Prevention and Public Health Fund, are leading to reduced local preventive services and straining the ability of departments to respond to emerging crises, public health leaders and advocates say. A new report from the National Association of County and City Health Officials (NACCHO) found that nearly half of local public health departments cut staff in the first half of 2011 and more than half cut programs during the past year (http://tiny.cc /snu7t). The cuts compound previous losses to such agencies that have occurred in the years since the economic crisis began. Moreover, proposed cuts to the $15 billion in expected funding for prevention efforts included in the health care reform bill may further dampen planned prevention activities, warn more than 100 organizations, including clinician organizations and public interest groups.


Abstract We extend the Boltzmann's ideas that describe the evolution to the equilibrium of many body systems to the multifractal decomposition of the unitary interval 𝕀, in terms of sets Jα conformed by points with the same pointwise dimension, and obtain the D(α) singularity spectrum.


Depending on the level of a spinal cord lesion a person suffering from it has no control over leg and possibly arm movement due to the fact that the motory nerve tracts in the backbone, connecting the movement control centre in the brain with the efferent nerves, are no longer intact. The muscles of a paraplegic patient can possibly still be in good shape, or become likewise through training. The electrical pulses, normally applied to a muscle by the nervous system, can also be generated artificially. The research scope in the field of Functional Electrical Stimulation (FES) of muscles has recently shifted from controlling plain muscle force to controlling the body movement. Ultimately, by application of FES to paraplegics, their movement can be restored. A closed loop PI D-controller, with control parameters chosen according to the ZieglerNichols rules, has recently been developed to have the total knee-angle of a person with a freely moving shank track a predefined reference. Since the rising movement, a sit-to-stand transfer, is an important movement to be restored, as well as from a psychological, a practical and a physiological point of view, the aim now is to apply the PID-controller in helping a paraplegic standing up. Hereto a two Degrees Of Freedom (2-DOFs) model of the lower extremities was derived using Langrange dynamics and taking antropometrical parameters from literature. System stability was analysed and the closed loop performance was considered in simulation as well as in experiment. The Ziegler-Nichols rules do not satisfy to control the body movement in a sit-to-stand transfer. A standing posture is attained when increasing the proportional and derivative action of the 'Ziegler-Nichols'-controller. Since the knee-joints lock near extension the integrative part can be discarded. The suggested parameter changes are desirable also with respect to the system stability. However, the improved parameter set still is not stable according to the Nyquist criterion. Considering also that the PID-parameters need to be tuned anew when the reference trajectory or subject is changed it is therefore recommended to turn to model-based control. A computed torque controller including validated muscle and body dynamics is expected to return satisfying results.


Roller compacted concrete (RCC) is a drier consistency concrete proportioned with dense graded aggregates and has lesser paste content. Primarily owing to its drier consistency, the fresh and mechanical performances of RCC are distinctly different from conventional concretes. The objectives of this work were three fold. The first objective was to explain the anomalous behavior of fresh RCC in terms of different components of workability. The second objective was to explain the mechanisms of strength development in terms of paste quality and quantity. The final objective was to explain the roles of different chemical admixtures (water reducers, retarders, rheology modifiers, air entraining agents, dry cast products, etc.) in influencing the workability and strength performances of RCC. It is observed that the relative volume and quality of the paste, in addition to combined aggregate grading, affect the overall workability of mixtures. The workability of concrete is characterized in terms of cohesion, angle of internal friction, air content, compactibility, and consistency retention over time. Air content plays a decisive role in influencing the performances of concrete. The resulting mobility of the paste influences the compactibility, which in-turn decides the strength as well. RCC shows anomalous behavior in terms of mechanical strength as shown by deviations in the Abrams' law. It is argued that water-binder ratio is not a comprehensive parameter to explain the overall concrete behavior and trends. A significant body of knowledge is added in terms of the use of chemical admixtures in RCC. Atypical behaviors in influencing the fresh and hardened properties are explained by offering plausible mechanisms in terms of binder-admixture interactions. Irrespective of the admixture type, higher than normal dosages are required for RCC.


Cosmic microwave background (CMB) lensing is an integrated effect whose kernel is greater than half the peak value in the range $1<z<5$. Measuring this effect offers a powerful tool to probe the large-scale structure of the Universe at high redshifts. With the increasing precision of ongoing CMB surveys, other statistics than the lensing power spectrum, in particular the lensing bi-spectrum, will be measured at high statistical significance. This will provide ways to improve the constraints on cosmological models and lift degeneracies. Following on an earlier paper, we test analytical predictions of the CMB lensing bi-spectrum against full-sky lensing simulations, and discuss their validity and limitation in detail. The tree-level prediction of perturbation theory agrees with the simulation only up to $\ell\sim 200$, but the one-loop order allows capturing the simulation results up to $\ell\sim 600$. We also show that analytical predictions based on fitting formulas for the matter bi-spectrum agree reasonably well with simulation results, although the precision of the agreement depends on the configurations and scales considered. For instance, the agreement is at the $10\%$-level for the equilateral configuration at multipoles up to $\ell\sim2000$, but the difference in the squeezed limit raises to more than a factor of two at $\ell\sim2000$. This discrepancy appears to come from limitations in the fitting formula of the matter bi-spectrum. We also find that the analytical prediction for the post-Born correction to the bi-spectrum is in good agreement with the simulation. We conclude by discussing the bi-spectrum prediction in some theories of modified gravity.


This paper clarifi es some of the contested ideas put forward by John Stuart Mill by analyzing the reasons and arguments Mill used to support them and demonstrating how these ideas and arguments supporting them are connected into a coherent system. Mill's theory is placed in wider explanatory framework of democratic legitimacy developed by Thomas Christiano, and is portrayed as a typical example of democratic instrumentalism—a monistic position that focuses on the outcomes and results of a decision-making process. Following this move, the focus is shifted on the understanding of political equality in Mill's political thought. I claim that, contrary to some contemporary interpretations, Mill's theory is based on a few fundamentally inegalitarian ideas. Finally, Mill's view on the role of experts in democratic decision-making is analyzed and compared with contemporary theories advocating democratic expertism—Mill's view is again portrayed as inegalitarian, both to the extent of setting political aims and creating methods for achieving these aims.


Background/aim: Ultrasound biomicroscopy (UBM) is an important tool for assessing anterior segment pathology. This study sought to evaluate UBM in the management of anterior segment tumours. Methods: Retrospective analysis of medical records of consecutive patients referred to the ocular oncology unit, University of California San Francisco (UCSF), for suspected anterior segment tumours from 1999 to 2004. Results: 132 eyes from 130 patients were evaluated, including 55 uveal melanomas (UM), 21 iris naevi, 30 iris cysts, and 26 remaining lesions. Of the melanomas, 45 were also evaluated with conventional A/B-scan. There was 29% correspondence between the anatomical structures invaded by melanoma as identified by B-scan v disease extent defined by UBM. Ciliary body and peripheral iris involvement by melanomas was significantly more frequently observed by UBM than B-scan. Seven of 30 benign cysts were diagnosed as cystic before UBM evaluation. In three cases, neuroepithelial cysts were associated with intercurrent pathology including iris naevus (n = 2) and ciliary body melanoma (n = 1). Two ciliary body melanomas showed cavitation, including one patient with a pseudocyst. Histopathological correlation was possible in six cases. Conclusion: UBM is an indispensable tool for the management of anterior segment tumours. This study demonstrates the superiority of UBM v conventional B-scan for the precise localisation of uveal melanoma, especially involving the ciliary body and peripheral iris.


It is well documented that newly arrived immigrants face a significant earnings gap relative to native-born workers. One way for new immigrants to improve their relative labour market position upon arrival in a host country is to improve their educational credentials. According to signalling theory, a host-country credential should provide employers with a proxy for true productivity on the job, leading to higher earnings. Using data from a Canadian longitudinal survey, we employ longitudinal growth-curve techniques to estimate the effect of receiving a Canadian educational credential on the income growth of racial-minority recent immigrants compared to native-born Canadians. The results indicate that the earnings gap between recent immigrants and native-born Canadians is significantly reduced with the attainment of a Canadian educational credential.


Hepatitis B virus is a major health problem worldwide, with approximatively 240 million people living with a chronic HBV infection. HBV chronic infection remains the major cause of hepatocellular carcinoma worldwide, with more than half of HCC patients being chronic HBV carriers, even if underlying mechanisms of tumourigenesis are not totally understood. HBV-related HCC can be prevented by reducing the exposure to HBV by vaccination or by treatment of CHB infection. Current treatment of CHB are Peg-IFN alpha and oral NUCs. Treating HBV infection, either with IFN or NUCs, substantially reduces the risk of HCC development, even if anti-viral therapy fails to completely eliminate HCC risk. Among treated patients, cirrhosis, HBeAg negative at baseline, and failure to remain in virological remission were associated with an increased risk of HCC. The reduction of the risk of developing HCC during anti-viral therapy is largely dependent upon the maintenance of virological remission, since viral load is found to be the most important factor leading to cirrhosis and its complications, including liver cancer development. The question whether Peg-IFN-alpha is superior to NUCs and whether there is a superior agent among NUCs is still controversial. Several studies demonstrated that anti-viral therapy with NUCs could reduce the risk of HCC recurrence after curative treatment of HBV-related HCC.


Neural activity in the human brain starts from the early stages of prenatal development. This activity or signals generated by the brain are electrical in nature and represent not only the brain function but also the status of the whole body. At the present moment, three methods can record functional and physiological changes within the brain with high temporal resolution of neuronal interactions at the network level: the electroencephalogram (EEG), the magnet oencephalogram (MEG), and functional magnetic resonance imaging (fMRI); each of these has advantages and shortcomings. EEG recording with a large number of electrodes is now feasible in clinical practice. Multichannel EEG recorded from the scalp surface provides very valuable but indirect information about the source distribution. However, deep electrode measurements yield more reliable information about the source locations intracranial recordings and scalp EEG are used with the source imaging techniques to determine the locations and strengths of the epileptic activity. As a source localization method, Low Resolution Electro-Magnetic Tomography (LORETA) is solved for the realistic geometry based on both forward methods, the Boundary Element Method (BEM) and the Finite Difference Method (FDM). In this paper, we review the findings EEGLORETA about epilepsy. Keywords—Epilepsy, EEG, EEGLoreta, loreta analysis.


Desert bighorn sheep (Ovis canadensis nelsoni) are a charismatic ungulate native to western North America that live in mountainous regions. In the desert of the southwest United States, populations of bighorn sheep can be isolated by both natural and anthropogenic barriers. Isolation limits gene flow, exacerbates loss of genetic diversity to drift, and thus could affect immune responses to infectious agents. We sought to develop a relatively rapid method for determining MHC class I gene diversity in individual sheep. Both DNA and RNA were isolated from leukocytes collected from 154 adult bighorn sheep from across different mountain ranges in Southern California. Previously identified primers from domestic sheep were used to amplify exons 2 and 3 from OMHC I genes while appending adapters for PacBio circular consensus sequencing. We successfully identified over 40 unique MHC class I sequences expressed by bighorn sheep. Using a combination of phylogenic tree analysis and mapping MHC sequences to the domestic sheep genome, we detect at least 4 unique classical MHC class I regions. Comparison of results using either genomic DNA or mRNA (cDNA) as a template for analysis suggest that certain MHC alleles are expressed at different levels within leukocytes, while many potential pseudogenes were identified when genomic DNA was used as a template. Our data suggests using messenger RNA (cDNA) as a template to identify MHC class I diversity is superior to genomic DNA. Finally, we found clear patterns of MHC class I genotypes differentiated by population, which suggests that both natural and anthropogenic-induced population fragmentation can limit the diversity of MHC genes within a given population.


Accumulation of genetic and epigenetic aberrations leads to malignant transformation of normal cells. Functional studies of cancer using genomic and proteomic tools will help to reveal the true complexity of the processes leading to cancer development in humans. Until recently, diagnosis and prognosis of cancer was based on conventional pathologic criteria and epidemiological evidence. Certain tumors were divided only into relatively broad histological and morphological subcategories. Rapidly developing methods of differential gene expression analysis promote the search for clinically relevant genes changing their expression levels during malignant transformation. DNA microarrays offer a unique possibility to rapidly assess the global expression picture of thousands genes in any given time point and compare the detailed combinatory analysis results of global expression profiles for normal and malignant cells at various functional stages or separate experimental conditions. Acquisition of such "genetic portraits" allows searching for regularity and difference in expression patterns of certain genes, understanding their function and pathological importance, and ultimately developing the "molecular nosology" of cancer. This review describes the basis of DNA microarray technology and methodology, and focuses on their applications in molecular classification of tumors, drug sensitivity and resistance studies, and identification of biological markers of cancer.


Background: Functional ankle instability (FAI) is the primary classification of ankle injuries. Competitive activities have complicated movements that can result in ankle re-injury among patients with FAI. Unanticipated movement state (MS) and mental fatigue (MF) could also happen in these activities, which may further increase their joint injury risk. Objective: This study aimed to clarify the biomechanical characteristics difference of the lower extremity (LE) between the injured side and the uninjured side among patients with FAI when they perform unanticipated side-step cutting after MF. Methods: Fifteen males with unilateral FAI participated in this study (age: 20.7 ± 1.3 years, height: 173.6 ± 4.4 cm, weight: 70.1 ± 5.0 kg). They used the injured side and the uninjured side of LE to complete anticipated and unanticipated side-step cutting before and after MF. The kinematic and kinetics data were evaluated using three-way ANOVA with repeated measures. Results: During patients with FAI performed anticipated side-step cutting, the ankle stiffness of both sides showed no significant change after MF; During they performed unanticipated side-step cutting, their injured side presented significantly lower ankle stiffness after MF, while the uninjured side did not have such change. In addition, after MF, the injured side exhibited increased ankle inversion, knee valgus and LR, but the uninjured side did without these changes. Conclusion: Influenced by MF, when patients with FAI use their injured side of LE to perform side-step cutting, this side LE has a higher risk of musculoskeletal injuries such as lateral ankle sprains and anterior cruciate ligament injury. The ankle stiffness of the injured side will be further reduced when patients with FAI perform unanticipated side-step cutting, which increases ankle instability and the risk of re-injury.


A field experiment was established at the Institute of Grassland and Environmental Research (IGER), Aberystwyth, to compare the seasonal growth and annual yields of two white clovers when grown with each of five perennial ryegrasses. Swards were subjected to two contrasting defoliation managements, namely cutting only and continuous grazing with sheep. In addition to data recorded on dry matter yields of the swards, the effect of management on growth and development of white clover stolons and tillering of ryegrasses was also studied in the third harvest year. The management of the swards had a significant effect on ryegrass tiller number and on the ingress of weed grasses. Differences in persistency and tillering among the ryegrasses were significantly greater when continuously grazed by sheep than when swards were cut. It is argued that ingress of weed grasses under grazing could be used as an indicator of ryegrass persistency. Among those studied, only two of the ryegrasses were able to provide dense persistent swards under continuous sheep grazing. The white clovers included in this experiment differed in leaf size with Gwenda smaller than Ac 3785. Greater differences existed between white clover components when grazed than when under cutting management. Under continuous sheep grazing there were large differences between the clover varieties in stolon length, stolon weight, number of growing points and root weight. The data indicate the importance of the persistence of mixture components under continuous sheep grazing and, since ryegrass is the main component of a clover/grass seed mixture, greater emphasis in breeding and evaluation programmes should be given to persistence, especially under grazing.


Moisture content of biomass is the most influential factor in biomass storage. Moisture sorption kinetics control the dynamic moisture condition of the biomass, thus affecting biomass storage, processing operations, and final utilization applications. Moisture sorption characteristics of switchgrass, big bluestem, and bromegrass, potential biomass feedstocks for the Northern Great Plains of the U.S., were studied. Study objectives were to determine the moisture sorption kinetics, mathematically model the sorption process using standard models, and evaluate the effect of temperature on moisture sorption. Moisture sorption experiments were conducted at temperatures of 20°C, 40°C, and 60°C and a fixed high relative humidity of 95% using a controlled-environment chamber. Standard moisture sorption kinetics models (exponential, Page, and Peleg) were used to analyze the experimental sorption characteristics of the feedstocks. Bromegrass had the highest moisture sorption rates and final moisture contents, followed by big bluestem and switchgrass. On average, at 20°C, 50% of moisture sorption completion occurred at 1.5, 1.9, and 1.7 h and 90% completion occurred at about 8.5, 13.4, and 12.8 h for switchgrass, big bluestem, and bromegrass, respectively. For the temperatures studied, on average 41% ±3%, 40% ±5%, and 39% ±1% of moisture sorption completion occurred in 1 h and 82% ±2%, 76% ±4%, and 73% ±1% completion occurred in 5 h for switchgrass, big bluestem, and bromegrass, respectively. Moisture sorption rates decreased very sharply during the first hour (≥78%) from their initial values and quickly plateaued thereafter. Increase in temperature increased the moisture sorption rates for all the biomass types tested. Both the Page and Peleg models effectively described the observed sorption characteristics for the selected biomass types (R ≥ 0.96). The Arrhenius equation adequately described the temperature dependence of the model parameters (0.77 ≤ R ≤ 1.00). Based on this study, the Peleg model in combination with the Arrhenius equation is recommended for moisture sorption predictions. Fitted moisture sorption kinetics models, developed nomograms, and combined prediction equations (R ≥ 0.83) form baseline data essential for storage of the selected biomass types and various handling, conditioning, and processing operations.


We present a systematic experimental investigation on visible light collimation by a nanostructured slit flanked with a pair of periodic array of grooves in gold thin film. A wide variety of aspects are considered, such as the polarization state, the transport path of incident light, the groove—groove spacing, the groove width and depth. Our results clearly show that the relationship between the collimation wavelength and the periodicity of the slit-groove structure accords well with the surface plasmon dispersion model proposed by previous researchers. Furthermore, the surface plasmon wave phase retardation effect induced by the surface structure is also verified via the measurement for samples with different groove widths and depths. These results indicate that the detailed geometry of the groove structure has obvious impacts on the collimation effect and the angular distribution of the diffraction light in the subwavelength plasmonic system.


The emergence of a novel coronavirus, SARS-CoV-2, resulted in a pandemic. Here, we used recently released X-ray structures of human ACE2 bound to the receptor-binding domain (RBD) of the spike protein (S) from SARS-CoV-2 to predict its binding to ACE2 proteins from different animals, including pets, farm animals, and putative intermediate hosts of SARS-CoV-2. Comparing the interaction sites of ACE2 proteins known to serve or not serve as receptor allows to define residues important for binding. From the 20 amino acids in ACE2 that contact S up to seven can be replaced and ACE2 can still function as the SARS-CoV-2 receptor. These variable amino acids are clustered at certain positions, mostly at the periphery of the binding site, while changes of the invariable residues prevent S-binding or infection of the respective animal. Some ACE2 proteins even tolerate the loss or the acquisition of N-glycosylation sites located near the S-interface. Of note, pigs and dogs which are not or not effectively infected, respectively, have only a few changes in the binding site have relatively low levels of ACE2 in the respiratory tract. Comparison of the RBD of S of SARS-CoV-2 with viruses from bat and pangolin revealed that the latter contains only one substitution, whereas the bat virus exhibits five. However, ACE2 of pangolin exhibit seven changes relative to human ACE2, a similar number of substitutions is present in ACE2 of bats, raccoon, and civet suggesting that SARS-CoV-2 may not especially adapted to ACE2 of any of its putative intermediate hosts. These analyses provide new insight into the receptor usage and animal source/origin of SARS-COV-2. IMPORTANCE SARS-CoV-2 is threatening people worldwide and there are no drugs or vaccines available to mitigate its spread. The origin of the virus is still unclear and whether pets and livestock can be infected and transmit SARS-CoV-2 are important and unknown scientific questions. Effective binding to the host receptor ACE2 is the first prerequisite for infection of cells and determines the host range. Our analysis provides a framework for the prediction of potential hosts of SARS-CoV-2. We found that ACE2 from species known to support SARS-CoV-2 infection tolerate many amino acid changes indicating that the species barrier might be low. However, the lower expression of ACE2 in the upper respiratory tract of some pets and livestock means more research and monitoring should be done to explore the animal source of infection and the risk of potential cross-species transmission. Finally, the analysis also showed that SARS-CoV-2 may not specifically adapted to any of its putative intermediate hosts.


The aim of this study is to develop an integrated urea-SCR catalytic filter system for reducing soot and NOX emissions simultaneously in diesel engines. In this study, the characteristics of exhaust emissions relative to reactive activation temperature under four kinds of engine loads are experimentally investigated by using a four-cycle, four- cylinder, direct injection type, water-cooled turbo intercooler ECU common-rail diesel engine with the integrated urea- SCR MnO 2-V2O5-WO3/TiO2/SiC catalytic filter system operating at three kinds of engine speeds. The urea-SCR reactor is used to reduce NOX emissions, and the catalytic filter system is used to reduce soot emissions. The reactive activation temperature is very important for reacting a reducing agent with exhaust emissions. The reactive activation temperatures in this experiment is applied to 523, 573 and 623 K. The fuel is sprayed by the pilot and main injections at the variable injection timing between BTDC 15° and ATDC 1° according to experimental conditions. It is found that the NO X conversion rate is the highest as 83.9% at the reactive activation temperature of 523 K in all experimental conditions of engine speed and load, and the soot emissions shown by the average reduction rate of approximately 93.3% are almost decreased below 0.6% in all experimental conditions regardless of reactive activation temperatures. Also, the THC and CO emissions by oxidation reaction of Mn, V and Ti are shown in the average reduction rates of 70.3% and 38% regardless of all experimental conditions.


: A patient is described who developed liver cirrhosis and variceal bleeding. After a continuous infusion of vasopressin rabdomyolysis occurred. Recovery of the clinical picture and of the muscle enzymes occurred 48 hours after cessation of therapy.


In this paper we consider three deeply connected classificational problems on four-dimensional manifolds. First we consider and describe locally regular distributions. Second we give a classification of almost complex structures of general position in terms of distributions. Finally we classify nondegenerate Monge-Ampere equations with two variables in terms of e-structures.


The complexes having the compositions of Eu(L1)(3)2H2O,Eu(L1)3phen,Eu(L2)(3)2H2O,Eu(L2)3phen (phen = 1,10-phenathroline,L1 = Dodecanoic acid, L2 = Stearic acid) were synthesized and characterized by elemental analysis and FTIR spectra. Their fluorescence spectra, UV spectra and TEM (Transmission Electron Microscope) have been investigated. The results show that the 5D0-7F1 and 5D0-7F2 transition of Eu(III) are observed in the emission spectrum of the particles at room temperature. As good photoluminescent materials, they may be useful in the regions of EL (Electroluminescence) or macromolecule composite materials doped with rare earth.


This document describes data structures and API support for Mobile
IPv6 as an extension to the Advanced Socket API for IPv6. Just as the
Advanced Sockets API for IPv6 gives access to various extension
headers and the ICMPv6 protocol, this document specifies the same
level of access for Mobile IPv6 components. It specifies a mechanism
for applications to retrieve and set information for Mobility Header
messages, Home Address destination options, and Routing Header Type 2
extension headers. It also specifies the common data structures and
definitions that might be used by certain advanced Mobile IPv6 socket
applications. This memo provides information for the Internet
community.


ABSTRACT The article invites readers to rethink cities in economic networks against the backdrop of the many ways in which 'gateway cities', serving as brokers, interlink their respective hinterlands globally. It adds logistics, industrial processing and knowledge transmission to the more established gateway dimensions of corporate control and related service provision. This open heuristic is applied to Buenos Aires (Argentina), Cape Town (South Africa) and Singapore, which are vital nodes for the oil and gas industry. In addition to showing how diverse brokerage by cities is, the article calls for qualitative research to complement the insights on city networks generated by quantitative assessments.


Two surveys of biosecurity practices were successfully conducted in August and October of 2017, involving ten national SEACFMD coordinators (pilot survey conducted during the 20th SEACFMD National Coordinators Meeting, 16–18 August 2017, in Pakse, Laos), and 25 OIE Delegates or their nominees (OIE survey conducted by questionnaire for the 3Oth Conference of the OIE Regional Commission for Asia, the Far East and Oceania) respectively. The findings provide important information for leadership personnel responsible for addressing international and national expectations of collaborative transboundary animal diseases control programmes and foot and mouth disease (FMD) in particular. The following findings emerging from this work will be presented at the 30th Conference of the OIE Regional Commission for Asia, the Far East and Oceania, in Malaysia, 20–24 November 2017. As a larger dataset would enable more statistical support for these findings, the conference is an opportunity to encourage participation of the ten countries that have not completed the survey.


OBJECTIVE
The aim of the study was to evaluate the outcome of elastic ligation in internal haemorrhoids in our out-patient setting.

METHODS
The authors performed elastic ligation of haemorrhoids in 77 patients, and of these 71 (92%) procedures were accomplished in out-patients. The procedure was indicated in second and third-degree symptomatic haemorrhoids and was carried out without local anaesthesia with the aid a Seward Medical applicator. Typically, one haemorrhoidal node was treated per one session. All patients were clinically examined two weeks after completion of treatment.

RESULTS
The success rate of the procedure was 91%. The results were analyzed by a questionnaire. The most common unpleasant symptoms were pain and tenesms. Bleeding occurred in 6 patients. There was no serious life-threatening complication.

CONCLUSION
Based on our observation we consider band ligation as a reliable therapy for symptomatic internal haemorrhoids in out-patients. We suggest reminding patients of possible of complications, unpleasant symptoms sensations restricting their daily activity on the first days after the procedure.


Background: Surgical approach towards greater petrosal nerve has to be done with caution as many surgeons are unfamiliar with the anatomy of the facial nerve. The anatomical landmarks selected must be reliable and above all easy to identify for identification of the greater petrosal nerve so as to avoid injury to the structures in the middle cranial fossa. Observation and Results: The present study is carried out on 100 temporal bones by examining the following measurements of the right and the left sides a) length of the hiatus for grater petrosal superficial nerve b) distance from superior petrosal sinus c) distance from lateral margin of middle cranial fossa d) arcuate eminence and e) distance from exit to the foramen ovale. Discussion: The anatomical landmarks selected must be reliable and above all easy to identify. Bony structures are more suitable than soft tissue or cartilaginous landmarks because of their rigid and reliable location. These anatomical landmarks will definitely help the surgeon while performing vidian nerve neurectomy and also the anatomical relationship of the facial nerve in temporal bone. The middle fossa approach involves a temporal craniotomy in cases of perineural spread of adenoid cystic carcinomas hence these anatomical landmarks will serve as useful guide for the surgeons and radiologists.


Accessory breast is a relatively rare conduction, which is commoner in females than males. Most of them do not cause any discomforting symptoms but cosmetic embarrassment especially to a woman in the presence of her partner. Case Summar y: A 23-year-old postpartum woman is presented who was managed for bilateral accessory breast at a district hospital. The accessory breasts were excised under ketamine anaesthesia. Conclusion : The treatment of accessory breast is excision because all disease conditions that affect normal breast can also affect accessory breast including malignant transformation.


In principle, emerging markets analysts employ the same analytical framework when estimating the value of businesses as their counterparts in developed economies: they forecast future cash flows and discount those to the present with appropriate costs of capital that are estimated using the Capital Asset Pricing Model (CAPM) framework. But in practice, emerging market analysts have a more complicated job because the task of estimating costs of equity in emerging markets is more difficult. Whereas developed economies have an abundance of historical data on overall stock market movements, industry share price behavior, and many individual share price histories, emerging market economies often do not. There may be no comparable local firms that are publicly traded or if there are, their CAPM betas may be unreliable. And if analysts instead use the beta of a U.S. competitor as a surrogate for the emerging market beta, they face the question of whether domestic betas are equivalent across borders. As a consequence, appraisers of emerging market companies confront a beta dilemma. Part of this is a data problem stemming from shorter share price histories in emerging markets and the absence of publicly traded companies in some industries. In such cases, analysts may be inclined to use industry betas calculated with U.S. share prices as a substitute. But this creates an equivalence problem - the possibility, as confirmed by the author's research, that domestic U.S. and emerging market betas are not statistically equivalent for most industries. The author proposes a solution to this problem that involves grouping emerging markets into a single, distinctive asset class that allows for reliable calculations of industry betas. He also suggests ways of testing emerging market industry betas to determine whether they are statistically comparable.


Drawing on recent, critical work dealing with culture theory, ethnicity, and multiculturalism, this article seeks to address the nexus between conflict resolution theory and practice and aims primarily to contribute to the work of practitioners functioning as third parties and intervenors in intercultural and interethnic conflicts and disputes. Two conceptions of culture are proposed and analyzed: a technical, "experience-distant" sense of the term, crucial for conflict analysis (and for education and training); and an affectively laden, often politicized, "experience-near" sense of the term, at the root of so much intergroup conflict and thus implicated in effective and ethical intercultural practice.


By introducing the left and right derivatives, we establish a real structure for the covariant differential calculus on the N-dimensional quantum Euclidean space. The method is also applicable to the quantum Minkowski space.


Malnutrition is one of the major challenges in India. It threatens the long-term human development. In order to reduce the malnutrition problem an effort was made to increase the protein content of the food products, rajma an underutilized legume rich in protein was utilized. Rajma is termed as "king of nutrition". Germination was more effective method in reducing the antinutritional factors of tannins and phytic acid. It was found that tannins and phytic acid were reduced when the germination period increased. The tannin level of rajma flour was 4.3 mg at 24 hours of germination period and it was decreased to 0.35 g at 72 hours of germination period. Hence it was decided to incorporate the rajma flour germinated at 72 hours because of the decrease of antinutritional factors. The phytic acid decreased to 4.50 mg at 24 hours germination period and 1.5 mg at 72 hours germination periods. Hence it was decided to select the rajma flour prepared from the 72 hours germination period for developing food products. The selected rajma flour was incorporated into the food products of chapathi and murukku at 5, 10, and 15 % level by using the replacement method. The developed rajma flour incorporated products were exposed to sensory evaluation by the trained panel members. The overall acceptability of 15% of the selected rajma flour incorporated chapatti and murukku were excellent. The nutrient content of the selected rajma flour was reported as 10% of moisture, 7 g of protein, 5.5 of fiber, 20.2 g of carbohydrate and 4 mg of vitamin C. The incorporation of rajma flour into the chapathi increased the protein content from 12 to 14 g and in murukku it increased from 14 to 19 g. Hence the incorporation of rajma flour into the food products paves way for reducing not only the malnutrition problem but also many of the lifestyle diseases.


Total shoulder arthroplasty has become an accepted treatment for advanced arthritic conditions of the glenohumeral joint1,3. Loosening of the glenoid component has been a complication of the procedure3,5 and, in an attempt to prevent it, a modular glenoid component has been developed. It consists of a polyethylene articular component that snaps into a metal shell that is secured to the glenoid with screws. Although similar designs of modular components have proved to be effective for total joint arthroplasty in the lower extremity, disassembly of the components after implementation has been reported2,6-8,10. We report the case of a patient who had disassembly of the glenoid component after a total shoulder arthroplasty.

A sixty-eight-year-old retired man had a total arthroplasty of the right shoulder for treatment of disabling osteoarthrosis at another institution. The arthroplasty consisted of insertion of a humeral component and a metal-backed two-piece glenoid component without cement. The metal shell of the glenoid component was porous-coated and was secured to the glenoid with two screws.

The operative procedure was uncomplicated and resulted in substantial relief of pain and improvement of function. Three months postoperatively, the patient had an acute onset of pain with an audible pop that occurred when the shoulder was abducted and …


In this study, we investigate patterns in interactions between children with communicative disabilities and their parents. The purpose is to demonstrate how, in play activities at home, parents with varying degrees of success make their children's contributions sensible. A Conversation Analytic approach to interaction underlies our demonstration. We show that parents' actions may be finely tuned and fine-grained, as well as locally situated with regard to treating their children's actions as sensible contributions to an ongoing activity. Finally, we discuss the implications of our findings in relation to early communication intervention.


Background: The purpose of this study was to analyze physician visits associated with inflammatory bowel disease in the United States in order to shed light on the underlying disease time trends in the United States. Methods: The National Diseases and Therapeutic Index of IMS America from 1960 until 2006 was used as the data source. Survey data had been obtained from a representative sample of U.S. physicians 4 times per year during a 48‐hour period and extrapolated to a national level. All physician visits for Crohn's disease and ulcerative colitis were expressed as rates per 100,000 people living in the United States. Results: Physician visits for Crohn's disease increased almost 5‐fold between 1960–1964 and 1990–1994 and have leveled off since then. Except for a slight decrease between 1960–1964 and 1980–1984, physician visits for ulcerative colitis have remained largely unchanged, especially during the most recent 15 years. Similar trends were observed for both men and women. Conclusions: U.S. time trends of physician visits are similar to other previously published time trends of inflammatory bowel disease. It appears that the overall incidence of inflammatory bowel disease has remained stable in the past 15 years.


THE IDYLLIC FREEDOM OF THE CHILD OF NATURE was a popular notion in both the Romantic and Victorian periods. But the wild child, or what we might call the child of nature taken to extremes, stirs the imagination in deeper ways. This is the child represented as radically orphaned, existing outside of language, and alienated from human social bonds; yet it establishes bonds with the natural world that mimic human object relations and thus suggests an oceanic dyadic connectedness with the non-human. Linking the idea of wildness with the idea of child, the nineteenth-century adult imagination generates a figure of "danger and desire" (1.472), to appropriate Wordsworth's evocative phrase, one which represents both impossible connection and irremediable alienation.


The best-known solution to the sequential file update problem is the balanced-line algorithm. Here, the problem is solved using abstract data types and the resulting Cobol program illustrated. It is suggested that the program's modular decomposition aids in the development of the solution.


This paper endeavours to find out how far public and private export credit insurance schemes available in UK to foster international trade, and specially the impact of export credit insurance to UK's SME's. How Export Credit Insurance create and add value to profitable growth of companies in UK.Export credit insurance is financial product/risk management tool used by export oriented businesses to ensure that they receive funds owed to them. Businesses selling their products and services to "international buyers" and take a risk the buyer might not pay or delay the payment. ECI reduce that risk. This research based study will evaluate and examined the fact that ECI supports businesses profitable growth in international trade.


A novel approach for a wireless transmission of MWD and LWD signals in lossy formations has been proposed in this paper. First, the quasi-TEM mode of the extremely low frequency (ELF) near field is excited by a voltage gap on the pipe, guided by and propagated along the metal pipe string in LWD or MWD (logging/measurement while drilling) environment. Once the signal received on the ground is weaker than a certain threshold as the drilling depth increases, a relay segment (transceiver) is installed into the pipe string to receive, amplify, and retransmit the signals to extend the transmission distance and ensure the required propagation range of the ELF wave. In this paper, the details of the transceiver antennas and the relay segment suitable for efficient coupling to quasi-TEM mode have been given first, and then, the numerical simulations of the ELF wave propagation in LWD or MWD environment and the coupling between the guided wave and the relay segment have been made to show the coupling performance of the relay segment to quasi-TEM mode quantitatively. It has been shown that the propagation attenuation of the ELF near field with the guidance of the metal pipe string is much less than that of the space wave in the same lossy media without the guidance of the pipe string, and the scheme of the wireless relay provides an efficient way to extend the propagation range of the EM telemetry evidently and open a new freedom of frequency optimization for wireless transmission systems.


OBJECTIVE
Establishment of investigation of sterile male DNA in AZF region--choice of loci and primers for investigation, optimization of PCR conditions (polymerase chain reaction).

DESIGN
For practice.

SETTING
Department of Medical Genetics and Foetal Medicine, Faculty of Medicine, Palacky University and Faculty Hospital Olomouc.

METHODS
PCR amplification of DNA isolated from blood of sterile men and consequential electrophoresis of synthesized DNA fragments to appoint microdeletions in AZF.

RESULTS
From January to June 2000 were detected the microdeletions in AZF of 3 out of 79 sterile men (3.80%) by means of the Experteam firm kit. From July to December 2000 were tested and optimized conditions of amplification of 10 AZF loci to substitute the kit and they were used for examination of the first 20 sterile men of our collection.

CONCLUSION
In our laboratory was established routine examination male sterility related to microdeletions in AZF. With our collection of loci was substituted the original Experteam firm kit and was widened spectrum of observed loci.


In this paper, we address the problem of detecting an inhomogeneity in shallow water by observing changes in the acoustic field as the inhomogeneity passes between an acoustic source and vertical line array of receivers. A signal processing scheme is developed to detect the perturbed field in the presence of the much stronger primary source signal, and to estimate such parameters as the time when the inhomogeneity crosses the source-receiver path, its velocity, and its size. The effectiveness of incoherent, coherent, and partially coherent spatial processing of the array signals is evaluated using models and data obtained from experiments in a lake. The effect of different bottom types is also considered, and it is shown that partially coherent processing can have a significant advantage depending on the bottom type. Estimates of the minimum input signal-to-noise ratios (SNRs) for which the diffracted signal can be observed are presented.


Philology: The Forgotten Origins of the Modern Humanities, by James Turner. Princeton: Princeton University Press, 2014. 576 pp. In Philology: The Forgotten Origins of the Modern Humanities, James Turner aims to revivify our sense of the importance of philological work by tracking its beginnings in Greece and Rome, its modern intensification in the eighteenth century, and its burgeoning in the nineteenth century. While we may, he observes, associate philology with dry-as-dustness and irrelevance, he aims to present it as the very life force of virtually all contemporary humanistic disciplines, the genetic material that binds "the modern humanities ... as cousins related by branching descent from common ancestors" (381). Turners project thus has a double aspect. First, it seeks to capture the way in which philology involved a distancing of the present from the past; rather than imagining that Oxbridge students, for instance, should learn to think of the Greeks as essentially like themselves, philology taught scholars that they could not simply read texts off but needed to establish the authenticity of those texts, needed to document the various historical moments at which portions of the Homeric texts or the Pentateuch of the Hebrew Bible were written. That process unleashed a consciousness of the distance between any contemporary moment and the historical past. As the notion that nineteenth-century Englishmen were very nearly kin to the Greeks began to go by the boards, Turner thinks, history writing came to coordinate the study of written records--the archive--with accounts of how one might understand the passage of historically distinct knowledge into the present--narrative. The classicism that Matthew Arnold would associate not merely with school subjects but with deeply embedded moral dispositions was itself contested by philological work and the importance of method that it fostered. At the same time that Turner stresses the historicity of philology, its seeming like an archaic scholarly practice, he aims to put it unfailingly into conversation with our present moment. Nineteenth-century English gentlemen may not have been near contemporaries to the ancient Greeks, but we humanists are more directly related to one another and to eighteenth- and nineteenth-century philological scholars than we have realized: "shared background gives all the humanities a collective integrity, even if one not always acknowledged" (382). Moreover, Turner suggests, in an impassioned epilogue, the distinct disciplines which house contemporary scholarship themselves obscure the common feature of their genealogy, interconnections that continue to erupt today in calls for interdisciplinarity. In speaking of ancient philology, Turner separates ancient philology into four areas: "linguistic speculation, rhetoric, textual philology, and grammar," even as he points out that "such partition does not do violence to the facts, but ... serves present convenience more than it reflects ancient practice" (4). That distribution of the topics of ancient philology enables him to speak of various philosophical positions on language--most notably that of Plato's Cratylus with its depiction of language as both naturally expressive and altered by convention. But it also enables him to indicate the supreme importance of writing and published records to philology. Socratic dialogue and the debate structure it instantiates correspond to Turner's categories of linguistic speculation and rhetoric, but the ability to revisit those dialogues and debates rests on Plato's having cast them into writing. Thus, even though Turner recognizes how much of the philological work of historical linguistics revolved around studies of spoken language, he draws attention to the ways in which such work could become comparative only when languages took written form. Turner efficiently surveys the techniques that classical and medieval scholars developed for managing documentary information, and he is warm in his praise of Erasmus's contemporary Beatus Rhenanus as "an accomplished textual philologist" of the early sixteenth century and amusing in his dismissal of others. …


DNA ligases play a pivotal role in DNA replication, repair and recombination. Reactions catalyzed by DNA ligases consist of three steps: adenylation of the ligase in the presence of ATP or NAD+, transferring the adenylate moiety to the 5'-phosphate of the nicked DNA substrate (deadenylation) and sealing the nick through the formation of a phosphodiester bond. Thermus thermophilus HB8 DNA ligase (Tth DNA ligase) differs from mesophilic ATP-dependent DNA ligases in three ways: (i) it is NAD+ dependent; (ii) its optimal temperature is 65 instead of 37 degrees C; (iii) it has higher fidelity than T4 DNA ligase. In order to understand the structural basis underlying the reaction mechanism of Tth DNA ligase, we performed site-directed mutagenesis studies on nine selected amino acid residues that are highly conserved in bacterial DNA ligases. Examination of these site-specific mutants revealed that: residue K118 plays an essential role in the adenylation step; residue D120 may facilitate the deadenylation step; residues G339 and C433 may be involved in formation of the phosphodiester bond. This evidence indicates that a previously identified KXDG motif for adenylation of eukaryotic DNA ligases [Tomkinson, A.E., Totty, N.F., Ginsburg, M. and Lindahl, T. (1991) Proc. Natl. Acad. Sci. USA, 88, 400-404] is also the adenylation site for NAD+-dependent bacterial DNA ligases. In a companion paper, we demonstrate that mutations at a different Lys residue, K294, may modulate the fidelity of Tth DNA ligase.


Grounded in Achievement Goal Theory of Nicholls (1989), the aim of this study was to assess the development of four teaching interventions based on the TARGET areas of Ames (1992) and verify their effect on the perceived motivational climate at situational level in Physical Education (PE) classes. Participants were 580 secondary education students aged between 11 and 15 (12.46±1.15) years. A quasiexperimental design was utilised for four teaching units, each lasting for 10 sessions. The intervention programme was applied in the four experimental subgroups (n=263) by means of motivational strategies to generate a task-oriented climate. In the four control subgroup (n=317), students received conventional PE classes. The perceived motivational climate of each unit was evaluated at the end of the intervention for the different contents. Results showed significantly higher values for the experimental subgroups, in terms of perceived task-oriented motivational climate for the four teaching units, than in the control subgroups. These findings highlight the need to generate specific intervention strategies in order to generate an optimal motivational climate in PE classes. Keywords : Teaching intervention; TARGET areas; Adolescence; Task-oriented climate; Motivational climate; Physical education.


An improved circuit design for a radiotherapy treatment room exit alarm and interlock is described and compared with simpler circuits. The unique self test and fail safe features are discussed. All component values are given for the unit which has been in successful operation for over one year.


Sustaining watersheds that were developed through community mobilization are a major challenge in Ethiopia despite significant efforts to promote soil and water conservation technologies and approaches. This paper investigates the hypothesis that institutional rationality and functionality play an important role in developing enduring watersheds by comparing the good performing Model research watersheds and adjacent watersheds developed through extensively promoted community mobilization. A semi-qualitative research method was used by applying a multi-stage purposive sampling technique for selecting sample respondents. Based on the new institutional economic theory, twelve effective institutional indicators were devised for the evaluation. Questionnaires were designed and tested to solicit respondents' perceptions on these indicators. Data were analyzed using the Mann-Whitney test. The results showed that significant differences were observed between the two watershed groups in relation to good interaction (p = 0.03) and technical rationality (p = 0.04). Most of the institutional characteristics and rationalities that led to better performance in the case of the Model research watershed were lacking in the community watersheds. In the Model watersheds, effective institutional characteristics and rationalities contributed to enhanced natural resource conservation, increased incomes, improved household food security, and provided additional social benefits. The most important lesson is that close follow-up and informed engagement leads to a speedy recovery and the sustainability of Community watersheds from implementing modest re-orientation of the existing institutional arrangements.


Converting source or unit test code to English has been shown to improve the maintainability, understandability, and analysis of software and tests. Code summarizers identify 'important' statements in the source/tests and convert them to easily understood English sentences using static analysis and NLP techniques. However, current test summarization approaches handle only a subset of the variation and customization allowed in the JUnit assert API (a critical component of test cases) which may affect the accuracy of conversions. In this paper, we present our work towards improving JUnit test summarization with a detailed process for converting a total of 45 unique JUnit assertions to English, including 37 previously-unhandled variations of the assertThat method. This process has also been implemented and released as the AssertConvert tool. Initial evaluations have shown that this tool generates English conversions that accurately represent a wide variety of assertion statements which could be used for code summarization or other NLP analyses.


1. The pressor activities of β-phenylethylamine and eight of its newly synthesized methyl and ethyl derivatives are compared on cats and dogs.

2. None of the derivatives is more active than the parent substance.

3. A methyl group in the para position does not appreciably alter intensity of action although it shortens duration slightly.

4. An ethyl group in the para position moderately decreases both intensity and duration of action.

5. In the group of compounds with methyl substitution on the nitrogen, a second methyl group in either the para or meta position gives a substance slightly less active than phenylethylamine both in duration and intensity. When the second methyl group is substituted in the ortho position, pressor activity is reduced greatly. An ethyl group in the para position is associated with a weak and uncertain pressor action and often a strong tendency to lower blood pressure.

6. The two ethylamine derivatives are depressor regardless of whether a methyl group is substituted in the para or meta position.

7. Both N-ethyl derivatives and also the para-ethyl N-methyl compound cause a reversal of the pressor response normally produced by the other compounds in the series.


Saturated loose sandy ground is easily liquefied and damaged during earthquake shaking. In recent years, seismic design that takes into account liquefaction has become required in various kinds of standard specifications. Some countermeasures for liquefaction have been developed, including soil improvement techniques and seismic reinforcement using piles. This paper reports on liquefaction countermeasure methods using a combination of piles and raft foundations. Raft foundations with sallow soil improvement could reduce the differential settlement of building. The piles could share parts of lateral loading during sand liquefaction and reduce the shear deformation of the ground surrounded by piles. The purpose of this research is to understand the lateral-loading share ratio of piles and shear-deformation reduction rate of ground with different pile spacings. It will attempt to solve engineering questions on designing piles foundations against sand liquefaction, both in simplified terms and in terms of providing a basic understanding for appropriate analytical platforms. The performance of piles in liquefying ground under lateral loading is a complex problem, so to simplify it, our research is two-fold: 1) the lateral-loading share ratio of piles, and 2) shear deformations reduction rate of ground. This paper focuses on the first part: the lateral-loading share ratio of piles.


Our understanding of the physical world has evolved drastically over the last century and the microstructure described by subatomic physics has been found to be far stranger than we could previously have envisaged. However, our corresponding model of experience and its structure has remained largely untouched. The orthodox view conceives of our experience as made up of a number of different simpler experiences that are largely independent of one another. This traditional atomistic picture is deeply entrenched. But I argue that it is wrong.Our experience is extraordinarily rich and complex. In just a few seconds we may see, hear and smell a variety of things, feel the position and movement of our body, experience a blend of emotions, and undergo a series of conscious thoughts. This very familiar fact generates three puzzling questions. The first question concerns the way in which all these different things are experienced together. What we see, for example, is experienced alongside what we hear. Our visual experience does not occur in isolation from our auditory experience, sealed off and separate. It is fused together in some sense. It is co-conscious. We may then ask the Unity Question: What does the unity of consciousness consist in? The second question is the Counting Question: How many experiences does a unified region of consciousness involve? Should we think of our experience at a time as consisting in just one very rich experience, in a handful of sense-specific experiences, or in many very simple experiences? How should we go about counting experiences? Is there any principled way to do so?The third and final question, the Dependency Question, concerns the degree of autonomy of the various different aspects of our unified experience. For example, would one's visual experience be the same if one's emotional experience differed? Is the apparent colour of a sunset affected by the emotional state that we are in at the time? I offer a new answer to the Unity Question and argue that it has striking implications for the way that we address the Counting Question and the Dependency Question. In particular, it supports the view that our experience at a time consists in just one very rich experience in which all of the different aspects are heavily interdependent.


Lactiplantibacillus pentosus 9D3, a prominent gamma-aminobutyric acid (GABA)-producing bacteria isolated from Thai pickled weed was characterized for its safety and probiotic properties via whole-genome analysis and in vitro testing. The whole-genome sequence of L. pentosus 9D3 was determined using a hybrid-sequencing approach, combining PacBio and Illumina technologies. A 3.81-Mbp genome of L. pentosus 9D3 consisting of one 3.65-Mbp chromosome and six plasmids (1.9–71.9 Kbp) was identified with an estimated GC content of 46.09% and 3,456 predicted genes. The strain was confirmed to be Lactiplantibacillus pentosus according to the high average nucleotide identity value of >95% and digital DNA–DNA hybridization scores of >70% to the L. pentosus type strain. Comparative genome analysis with other L. pentosus strains showed that the GABA-producing capability was specific to the strain 9D3. Genes related to GABA biosynthesis and transport were identified on a plasmid, pLPE-70K, indicating the acquired nature of this property. The safety of L. pentosus 9D3 was demonstrated through the lack of genes related to the production of toxins, biogenic amines, and antimicrobial drugs. Although the strain exhibited resistance to ampicillin and chloramphenicol, none of the antimicrobial resistance (AMR) genes were associated with mobile elements, i.e., plasmids and prophages. Therefore, the strain is considered to have low risk of transferring the AMR genes to other, potentially pathogenic bacteria. In addition, L. pentosus 9D3 showed good survivability in the gastrointestinal tract environment and was able to adhere to the intestinal cell in vitro. Therefore, L. pentosus 9D3 is concluded to be safe, with the potential to be used as a probiotic, exerting its health benefit through GABA production in the food system. The GABA-producing capability of the strain in vivo is the subject of further investigation.


The Definition of Death: Contemporary Controversies is the first comprehensive review of the clinical, philosophical, and public policy implications of our effort to redefine the change in status from living person to corpse. It is the result of a collaboration among internationally recognized scholars from the fields of medicine, philosophy, social science, law, and religious studies. Throughout, the contributors struggle to reconcile inconsistencies and gaps in our traditional understanding of death and to respond to the public's concern that, in the determination of death under current policies, patients' interests may be compromised by the demand for organ retrieval.


This paper is devoted to the study, with variational technique, of (p,q)-Laplacian equations in presence of general nonlinearities. Especially we obtain the existence result for the zero mass case, which includes a large class of pure power nonlinearities. More general quasilinear problems of Born-Infeld type are also considered.


Reggio Calabria becomes a metropolitan city with the law n ° 135 August 7, 2012. The new local authority must not only be an automatic replacement of the province, but it has to start processes of sustainable development of the territory, through processes and integrated programs in services and infrastructure. The expectations are starting innovative governance, streamlined and efficient and to provide services and infrastructure to the area of high rank through strategic planning and shared. The theme of port system take on strategic importance in a context that is a candidate to be a reference point in the Mediterranean. The port, many times, has been interpreted as a driving force of development, but it has often been conceived only in its technical - functional. The experiences and analysis of efficient port reality show that, for the construction of a port system, an integrated approach is necessary [3] which considers the aspects of social, economic and financial.


This paper demonstrates a real world case study of a new method for robust simultaneous estimation of two parameters using multiple data sources. The method is used to simultaneously estimate vehicle mass and road gradient. No additional sensors are required beyond those that would normally be found on a vehicle controller network. The estimation algorithm combines components driven by observer state error and also directly by the parameter error using a sliding-mode inspired regressor structure. The algorithm incorporates a novel information fusion method that is integral to the regressor structure and a supervised data-rejection system to limit estimation activity in periods of recognised error-promoting activity. The estimation method has been demonstrated in real time on a modified production passenger car platform. It has been shown to be effective at robustly predicting road gradient and offering more reliable and stable prediction of vehicle mass than existing estimation methods employed in the same multi-parameter estimation context. The estimator allows prediction of vehicle mass whose limiting factor is the bandwidth and accuracy of the available driveline torque information, not the algorithm itself, allowing the identification of a 150 kg change in mass on a 2000 kg vehicle in this case study.


Background and Objectives: The health system of China in 1970 was an exemplary model to the world but it began deteriorating after the economic reform in 1980. In order to address the deteriorating health system, government of China implemented the ambitious health reform program in 2009, with the aim to provide "safe, effective, convenient and affordable" health service to all people by 2020. In this study we try gain more insight about the health financing system of China prior to health system reform 2009. Methodology: Secondary data were collected from online data sets of World Health Organization (WHO), World Bank, Economic Co-operation and Development (OECD) and from publicly available reports and documents of related Ministries, and other published sources. Analysis was done with descriptive approach, focused on the three dimensions of health, namely the financing system: total health expenditure, financing source and financing scheme/agents. Results: China's total health expenditure (THE) from 1995 to 2008 remained below 5% of GDP. From 1995 to 2001, the Government share on health expenditure decreased continuously and reached the lowest level of 36.4 % in 2001. Private financing was the primary funding mechanism and sources of revenue for private financing were private insurance and out-of-pocket payments. Household spending on health has increased with an average growth rate of 11.5 % from 2000 to 2008. Health financing scheme was social insurance type with fragmented risk pooling. Conclusions: Low level of public funding and heavy reliance on out-of-pocket payment were the major problem in the past decades. Hence the daunting problem of inadequate health financing ruled the last three decade of China health system. Janaki Medical College Journal of Medical Sciences (2013) Vol. 1 (2): 46-64 DOI: http://dx.doi.org/10.3126/jmcjms.v1i2.9270


One way to address the cost issue of polymer electrolyte membrane fuel cells (PEMFCs) is to reduce the amount of platinum used in the cathode catalyst layers (CLs). The oxygen mass transfer resistance of the cathode CLs is the main bottleneck limiting the polarization performance of low Pt-loading membrane electrodes at high current densities. Pt nanoparticles, ionomers, carbon supports, and water in cathode CLs can all affect their oxygen mass transfer resistance. From the perspective of carbon supports, this paper changed the texture of CLs by adding carbon nanotubes (CNTs) or graphene oxide (GO) into carbon black (XC72) and studied its impact on the oxygen mass transfer resistance. A mathematical model was adopted to correlate total mass transfer resistance and internal diffusion efficiency factor with CL structure parameters in order to determine the dominant textural effect of a CL. The results show that adding 30%CNT or 20GO to carbon black of XC72 improved the electrocatalytic performance and mass transfer capability of the composite carbon-supported Pt catalyst layers during oxygen reduction reaction. The study further reveals that the smaller particle-sized carbon material with tiny Pt nanoparticles deposition can minimize the internal oxygen diffusion resistance. A less dense CL structure can reduce the oxygen transfer resistance through the secondary pores. The conclusion obtained can provide guidance for the rational design of optimal cathode CLs of PEMFCs.


The IEEE 802.11 networks are vulnerable to numerous wireless-specific attacks. Attackers can implement MAC address spoofing techniques to launch these attacks, while masquerading themselves behind a false MAC address. The implementation of Intrusion Detection Systems has become fundamental in the development of security infrastructures for wireless networks. This thesis proposes the designing a novel security system that makes use of metrics from multiple layers of observation to produce a collective decision on whether an attack is taking place.

The Dempster-Shafer Theory of Evidence is the data fusion technique used to combine the evidences from the different layers. A novel, unsupervised and self- adaptive Basic Probability Assignment (BPA) approach able to automatically adapt its beliefs assignment to the current characteristics of the wireless network is proposed. This BPA approach is composed of three different and independent statistical techniques, which are capable to identify the presence of attacks in real time. Despite the lightweight processing requirements, the proposed security system produces outstanding detection results, generating high intrusion detection accuracy and very low number of false alarms. A thorough description of the generated results, for all the considered datasets is presented in this thesis. The effectiveness of the proposed system is evaluated using different types of injection attacks. Regarding one of these attacks, to the best of the author knowledge, the security system presented in this thesis is the first one able to efficiently identify the Airpwn attack.


Radiation losses that occur when bending graded-index polymer optical fibers (POFs) are analyzed as a function of the profile exponent, the light wavelength, the fiber core radius, and the length of the bent section. For this purpose, a ray-tracing model is used, which combines both the generalized Fresnel power transmission coefficients for curved graded-index media and the differential equations that govern the ray paths in highly multimode graded-index fibers. This model is applied to the most recent types of graded-index POF, for which the choice of the core radius and profile exponent is discussed from the point of view of bending losses (the greater the profile exponent and the core radius, the greater the bending losses). The influence of profile exponents different from two is included for the first time.


Approaches to conceptualising 'generation', the meanings invested in the idea and the ways in which these feature in the shaping of identities, relationships and practices, have long been the focus of policy making and academic research. From such work, theorising generation can be understood as clustered around three areas: kinship generations, socio-historical generations and collective generations (Burnett, 2010; Plummer, 2010). These clusters often speak to different disciplinary interests. For example, oral history, human geography and neuroscience research draw on the idea of kinship generations; the social sciences and social history draw on socio-historical generations; and political science and feminist studies focus on collective generations (Stoilova, 2013). However, despite the extent of this theorising and notwithstanding the increasing theoretical and policy interest in the temporal and processual more generally (Thomson, 2011), the concept of 'generation' remains 'slippery' (Newman, 2012). As Biggs (2007) notes, there remains much work to be done in integrating the range of analytical insights that abound in different disciplinary arenas. Compelling arguments have been made similarly for greater multidimensionality in theorised studies of generations (Brannen, 2004; Burnett, 2010; Plummer, 2010). The first aim of this Open Space collection is, then, to bring together some of the ways in which different disciplines conceptualise 'generation' and thereby illustrate their cross-cutting, competing and complementary dimensions.


BACKGROUND
Cancer/testis antigen (CTA) is a class of antigen molecules expressed only in the germinal epithelium of testis and some tumor tissues. As an important CTA molecule, the expression of F-box protein 39 (FBXO39) in breast cancer (BC) and its clinical significance remain unclear. The objective of this study is to explore the value of FBXO39 in the diagnosis, efficacy monitoring, and prognostic evaluation of BC.

METHODS
The expression of FBXO39 mRNA in the serum exosomes of patients with BC before and after the initial diagnosis and treatment was detected by qRT-PCR, and the corresponding ROC curve was plotted. The expression of FBXO39 protein in BC cancer tissues was detected by immunohistochemistry, along with the analysis of the correlation between FBXO39 expression and clinical pathological features as well as prognosis of BC cases.

RESULTS
The serum-derived exosomes were successfully isolated and identified. The positive rate of FBXO39 mRNA in serum exosomes of patients with BC was up to 86%; there was a correlation between the expression level of serum exosomal FBXO39 and clinical staging, HER2, and Ki-67 expression (all with p < 0.05). The sensitivity of serum exosomal FBXO39 in distinguishing BC patients from healthy controls was 88%, with the specificity as 86%, and AUC as 0.9432. The expression change of FBXO39 in serum-sourced exosomes of patients with BC was related to their treatment situation, indicating that the level of FBXO39 decreased significantly after treatment. The expression of FBXO39 in cancer tissue was related to the clinical stage (p = 0.023) and lymphatic metastasis (p = 0.015) of the BC patients. Survival analysis showed that the expression of FBXO39 was negatively correlated with the prognosis of BC patients, with the high expression of FBXO39 indicating poor prognosis.

CONCLUSIONS
Serum-derived exosomal FBXO39 could serve as an important indicator of BC diagnosis and efficacy evaluation; FBXO39 could be rated as an important indicator of BC prognosis evaluation.


New urban infrastructure including lower-carbon energy facilities are increasingly met with community resistance during the public participation phase of planning. Resistance can confound the implementation of government climate change and energy policies. A qualitative case study using social capital and place-attachment analytical lenses is conducted to build knowledge about the social factors involved in a Canberra community's resistance to a gas-fired power station. Analysis reveals that while social capital explains how resistance occurred, a threatened disruption to place attachment explains why. We conclude that public participation processes informed by community social capital and place attachment characteristics would help developers and planners pre-empt resistance.


In this review the single AV lead is revisited in its two actual aspects. The first and more known concerns the capability to "detect" the atrial EGM through floating electrodes free to move in the right atrial blood pool. The characteristics of the atrial signal, processed by the pulse generator sensing amplifier, are at the base of its capability to "detects and discriminates" the cardiac signal from any other kind of interferences. On this selective sensing peculiarity it may be possible develop some specific algorithms for the identification and the characterization of different cardiac arrhythmias. This is an ambitious target but very profitable and with immediate clinical application. To achieve the complete performances of a single A-V lead P-synchronous pacing systems, five stiff rules must be satisfied: a) reliable atrial EGM detection, b) availability of dedicated device systems, c) accurate patient selection, d) optimal implant procedures, e) careful pulse generator programming. Many papers were written and many speculations were made about the possibility to constantly pace the atrium with non contact electrodes, because the idea to realize a DDD pacing using a single A-V lead was very suggestive. This system will simplify implant procedures, allowing the introduction of only one lead in an unique venous approach, will reduce vascular burdening and the correlated clinical complications, and will leave space for many other possible application. Some solutions, the modern technology gives us, are represented not only by the electrode surface modification (the increase of the electrode electrochemical surface improves both pacing and sensing performances) and by modified structure and shaping of the lead (the use of shaped curves in the lead body can promote the electrode contact with the atrial wall, allowing a more constant and reliable pacing), but also by the availability of new pulse morphology and emission methodologies. This, pacing occurring with a lesser dispersion of energy, should avoid the parasitic phrenic nerve stimulation. The rational and optimal exploitation of the mentioned solutions could favor the realization of the "All-In-One Device" we longed for since several years.


The flash method, proposed by Parker, Butler, Jenkins and Abbott from the U.S. Navy Radiological Defense Laboratory in 1961, is the most popular method for measuring the thermal diffusivity of solids. In this method, the front surface of a small sample is subjected to a very short burst of radiant thermal energy. The resulting temperature rise on the opposite surface of the sample is measured and the thermal diffusivity is computed from the temperature rise versus time data. Also, the specific heat can be computed from the measured data, thus allowing for the calculation of the thermal conductivity. Several theoretical models are available for the flash method, which include adiabatic boundary conditions, heat losses, surface coating effects, among other aspects. In this paper, tests were made for the identification of thermo-physical properties of a Ceramic block. The Netzsch Nanoflash LFA 447/1 of LTTC/COPPE/UFRJ was used for the measurements.


Generally, informal small enterprises are still conventional in operating their business in view of some aspects, such as production and marketing, particularly from the side of value chain they create. This applies to small and micro processed food enterprises in Bandung Regency, of which more than 90 percent are informal enterprises with still low product values. Value chain analysis is an analysis of the activities that produce values, originating from both inside and outside the enterprises. The objective of the present research is to map the value chain of the entire activities undertaken by processed food enterprises. This value chain analysis approach is used to enhance the capacity of small enterprises by reviewing the whole value chain as a system. The value chain mapping provides clearness on which activities to enhance internally and externally in relation to other entities like suppliers, distributors, and consumers. The result of value chain map identified detail potential and barrier of SME Food Processing which be utilized as a solution for increased productivity, quality, and local value added as viewed from the entire activities, both internal and external.


Current distributed IR approaches are not readily applicable for P2P scenarios. The high dynamics in these networks and the high cost for building and maintaining indices over Distributed Hashtables make full text indexing and information processing difficult to scale for large P2P networks. My work will propose new approaches for enabling distributed IR over P2P without limiting the network size or mutilating the IR. The basis of these approaches is an innovative distributed clustering algorithm, which can cluster peers in a P2P network based on their content similarity. This clustering enables significant network savings and enables new families of distributed IR algorithms.


Modern pharmacological influence on the pathological changes in cerebral ischemia is actual task of the modern neurology.Aim. To make a comparative assessment of the effectiveness of modern neuroprotectors in conditions of experimental chronic cerebral ischemia. Methods and results. Experimental study of the neuroprotective effects of the citicoline, cortexin and tiocetam on the cognitive functions on the model of the chronic cerebral ischemia was conducted on 75 white rats. Biochemical, immunoassay, pharmacological, statistical methodswere used.Conclusion. Obtained results showed citicoline, cortexin and tiocetam ability to positively influence on the molecular-biochemical changes in the brain cortex with ischemia. This resulted in the glutathione-dependent enzymes activity increase, recover of the thiol-disulfide system balance, nitrotyrosine concentration decrease, improvement of the cognitive function in the experimental animals.


Background

Despite benign overall course, angiogram-negative subarachnoid hemorrhage (AN-SAH) still companies with risk of delayed cerebral ischemia (DCI). Serum glucose was previously found to be related to DCI occurrence in aneurysmal subarachnoid hemorrhage (aSAH), but this has not been confirmed in AN-SAH. The aim of this study was to clarify the significance of serum glucose in DCI prediction in AN-SAH patients.
Methods

We included patients with AN-SAH admitted to our hospital between January 2013 and December 2018. According to different bleeding patterns, patients were divided into perimesencephalic AN-SAH (PAN-SAH) and non-perimesencephalic AN-SAH (NPAH-SAH) patients. DCI was defined as symptomatic vasospasm or/and delayed cerebral infarction. A statistical analysis of the clinical, radiological, and laboratory risk factors of DCI was conducted. Logistic regression analysis was performed to identify the independent predictors of DCI.
Results

A total of 244 AN-SAH patients (mean age 55.7 years, 55.7% men) were included with 164 (67.2%) PAN-SAH patients and 80 (32.8%) NPAN-SAH patients. There were significant correlations between high DCI incidence and high serum glucose levels in the first five days after admission in both PAN-SAH patients and NPAN-SAH patients (p < 0.05). High admission serum glucose was significantly related to higher World Federation of Neurosurgeons Scale (WFNS) (p < 0.05). Multivariate logistic regression analysis showed that admission serum glucose (p = 0.001, OR 1.705, 95% CI 1.232–2.360) and WFNS (p = 0.008, OR 2.889, 95% CI 1.322–6.311) were both significant and independent predictors for DCI occurrence in PAN-SAH patients. Admission serum glucose (p = 0.016, OR 2.307, 95% CI 1.167–4.562), standard deviation (SD) of the serum glucose in the first three days after admission (p = 0.049, OR 5.684, 95% CI 1.006–32.114) and modified Fisher scale (mFS) (p = 0.033, OR 1.859, 95% CI 1.051–3.288) were significant and independent predictors for DCI occurrence in NPAN-SAH patients.
Conclusions

Serum glucose is an early biomarker to predict DCI risk in both PAN-SAH and NPAN-SAH patients, which has an important value in guiding intensive care in AN-SAH patients.


Plants are good source of antimicrobial agents and may be used for alternative drug formation in future. In the present study, comparative antimicrobial analysis of four species of family Asteraceae in southern Rajasthan has been investigated. Acanthospermum hispidum, Pentanema indicum, Sphaeranthus indicus, and Tridax procumbens of family Asteraceae were collected from southern Rajasthan. Antimicrobial activity was carried out of dried leaves extract in methanol and ethyl acetate against Bacillus subtilis, Escherichia coli, Staphylococcus aureus, and Streptomyces griseus bacteria and Aspergillus niger, Candida albicans, Fusarium oxysporium and Trichoderma reesei fungi. Antibacterial and antifungal activities of all four species were measured in the form of zone of inhibition.The highest zone of inhibi-tion was observed on E. coli in S. indicus i.e. 26.00±0.59 mm in ethyl acetate extract and lowest zone of inhibition was observed on B. subtilis in T. pro-cumbens i.e. 5.00±0.21 mm in methanol extract. While the highest zone of inhibition was observed on S. griseus in A. hispidium i.e. 30.00±0.50 mm in ethyl acetate extract and lowest zone of inhibition was observed on C. albicans in A. hispidum i.e. 10.00±0.49 mm in methanol extract. The results of the present study suggest the use of natural antimicrobial agent against studied microorganism.


Purpose: This study aimed to identify falls and related risks of hospitalized patients in order to provide an baseline data to develop effective nursing intervention programs for fall prevention. Methods: The data on 120 patients who experienced falls from 2010 to 2013 during their hospitalization were collected from the patient' electronic medical records of an university hospital. Data were analyzed with descriptive statistics using SPSS/WIN 20.0. Results: Over 60% of the patients who experienced falls during their hospitalization was 65 years or older, and most of them had hypertension. Majority of the subjects needed help to perform daily activities (64%) and complained of general weakness (49.2%). Prior to the falls, the patients were taking average 2.52 medications to treat hypertension. The Fall accident was mostly frequently occurred in their hospital room (59.2%), or in bed (44.2%). The patients aged 70 years and older were significantly less alert than younger group, and taking more cardiovascular medications. Most fall risk factors were not significantly different for age, gender, and department category. Conclusion: The study findings suggest the need to emphasize the nurses to be more actively aware of fall risk factors and to provide aggressive interventions for preventing falls in hospitalized patients.


Active Thermography for Additive Manufacturing Processes Nicholas Jay Wallace Department of Mechanical Engineering, BYU Master of Science The goal of the research conducted for this master's thesis is to understand if active thermography is a suitable technique to detect (identify) and measure (approximate depth and or size) defects in additive manufacturing (AM) processes. Although other non-destructive measurement techniques exist, active thermography is an attractive option for AM applications because of the short measurement times that could be implemented between each layer of a print, and because of the relatively inexpensive equipment required. However, pulse thermography is typically applied to detect larger defects (>1 mm) in materials with high thermal conductivity. It was uncertain if active thermography was sensitive enough to detect the small defects (<100 μm) commonly introduced during AM. Defects of this size are common in AM, and their presence significantly impacts the mechanical properties of the final part. For this reason, the detection limits of active thermography in common AM materials were investigated. Numerical models were created to simulate the heat transfer during active thermography in AM structures (polymer and stainless steel) with defects of varying size. The models included non-ideal conditions such as spectral in-depth absorption of the irradiative pulse and free convection from the object's surface. The spectral properties of acrylonitrile butadiene styrene (ABS), polylactic acid (PLA), and polyamide 12 (PA 12) were measured (see chapter 2) and used in the numerical models. The numerical data indicates that active thermography is sensitive enough to detect the existence of defects smaller than 100 μm in AM materials (see chapter 3). Furthermore, it demonstrates that the defect aspect ratio (defect diameter divided by defect depth) for which traditional 1D thermography models may be used to approximate the depth of defects in 3D systems is approximately 6 (see chapter 4). In addition, the depth of defects with lower aspect ratios (~4) may also be approximated with relatively low error (~10% error). Non-ideal systems (those with convection and spectral in-depth absorption) were simulated, and figures are provided which facilitate the approximation of defect depth using simple, ideal thermography models. Active thermography has shown potential as being an efficient technique for detecting and measuring small defects common in AM.