The world is rapidly urbanizing which 68% of its population is expected to live in urban areas by 2050. Likewise, secondary cities of Cambodia are rapidly emerging while the capital is the largest city with a population of more than two million. Improving urban sustainability is, therefore, necessary for the world, as well as Cambodia. Thus, Cambodia has launched clean city standard indicators, proposed sectoral green city indicators, and adapted one target of global sustainable development goal 11 (UN SDG 11), to improve its urban quality and sustainability. However, using these indicators is not sufficient towards achieving urban sustainability because these indicators are limited in social and economic dimensions. Hence, this study aims to develop all dimensional indicators of sustainability based on all targets of UN SDG 11 with the above indicators. This study focused on the priorities of indicators in Cambodia verified and prioritized by Delphi and analytic hierarchy process (AHP) techniques. Then, a priority-based urban sustainability index for Cambodia was formed based on the concept of sustainability in developing countries. Finally, the standard scores were applied to comparatively assess the sustainability of capital and emerging secondary cities of Cambodia based on the 2018 Commune Database. Through this application, the study also sought to find out whether the priority weights of indicators are necessary for the comparative assessment. The results showed that the sustainability levels of Phnom Penh and Sihanoukville were found to be strong in all environmental, social, and economic dimensions. Battambang is also strong although economic sustainability is slightly lower than the average. Siem Reap is low in economic sustainability level while Poi Pet is remarkably low in environmental and social sustainability. Furthermore, the ranks of sustainability levels of the five cities based on weighted scores are different from their ranks based on unweighted scores. Therefore, this study confirms that priority weights of indicators are necessary for the comparative assessment towards improving the accuracy of the comparison.


Inhibition of apoptosis contributes to the pathogenesis of lymphatic malignancies. In particular, the elevated expression of Bcl-2 is considered to be a marker of poor prognosis, since increased levels of Bcl-2 confer longevity as well as chemoresistance. After demonstrating an inverse expressional pattern of Bcl-2 and prostate-apoptosis-response-4 (Par-4) in ex vivo cells of patients suffering from acute lymphatic leukemia (ALL) as well as a deregulated expression of Par-4 in acute and chronic lymphatic neoplasias, the molecular mechanisms underlying these results were investigated. Thus, it was demonstrated that in neoplastic lymphatic cells Par-4 exerts a proapoptotic role augmenting chemosensitivity by down-regulating Bcl-2, promoting disruption of mitochondrial membrane potential and enforcing caspase-activation. Moreover, Par-4 enables cells to circumvent inhibition of the central executioner caspase-3 by alternative activation of caspases following a decrease in expression levels of inhibitors of apoptosis proteins (IAP).


To date, there are three main hypotheses explaining why the human semicircular canals (HSCCs) cannot sense linear accelerations. To further study this issue, we designed a bionic ampulla (BA) instrumented with a symmetrical metal core polyvinylidene fluoride fiber as a bionic sensor, which imitates the structure and function of the human ampulla. The BA was confirmed to have a good sensing ability in experiments with a straight tube. Additionally, we designed a bionic semicircular canal model, a blocking model, and a square model. We compared the perception performance of these three models to test the "density hypothesis," the "closed loop hypothesis," and the "circular hypothesis." The outcomes of these experiments verified the "density hypothesis" and "circular hypothesis," but did not support the "closed loop hypothesis," shedding light on why the HSCC is sensitive to angular acceleration, but not to linear acceleration.


Prephenate dehydrogenase is an enzyme within the TyrA protein family dedicated to tyrosine biosynthesis. It catalyzes the oxidative decarboxylation of prephenate to hydroxyphenylpyruvate (HPP) and CO 2 in the presence of NAD + ; HPP is then transaminated to L-tyrosine, an end product inhibitor of the pathway. Guided by the recently published crystal structures of a monofunctional prephenate dehydrogenase from the hyperthermophilic bacterium Aquifex aeolicus , amino acid residues Trp190, His217, Lys246' and Arg250 were targeted for mutagenesis in order to provide insights into how these side chains might participate in the chemistry of the reaction and contribute to the integrity of the active site. A revised purification protocol afforded excellent yields of variants. We identified Trp190, a completely buried side chain in the NAD + binding pocket, as the source of an unusual fluorescence emission peak at 317 nm. Analysis of variants of Lys246' and Arg250 allowed us to conclude that the two residues participated only in the binding of prephenate and not of NAD + or in catalysis. They are important residues but not essential for binding. In contrast, His217 is critical for prephenate binding and catalysis and for the inhibition of PD activity by tyrosine. Chemical and thermal denaturation studies also suggest that this residue helps to maintain the structural integrity of the active site. Our results are interpreted in light of the crystal structure of the enzyme bound with substrate analogues and tyrosine.


Purpose: The purpose of this study was to explore and describe the process of life adaptation in women with cervical cancer. Method: A grounded theory method with guided data collection and analysis was used. Fifteen women with cervical cancer who had some kind of treatment at the hospital were asked open-ended and descriptive questions with a guideline. All interviews were tape-recorded and transcribed verbatim. Result: The core category that emerged from the comparative analysis was "overcoming cancer" named as a process of life adaptation in the participants. The process of overcoming cancer evolved three stages - "admitting reality", "attempting health-care" and "continuing health-care". Depending on the paradigm model, the central phenomena of the experiences was "powerlessness". The internal factors motivating women to overcome cancer were "denial of cancer" and "desire for life". Strategies of overcoming cancer included "living as a cancer patient," "selective food eating," "steady exercising," "getting rid of stress," and "preparing for death". The intervening conditions, "supportive system," "forms of life," and "burden on family," influenced overcoming cancer. Conclusion: The results of this study could help clinical nurses to understand life adaptation in cervical cancer patients and establish efficient coping strategies in dealing with the problems they face.


OBJECTIVE
To evaluate reproducibility of ejection fraction (EF), myocardial perfusion (MP), and pulmonary transit time (PTT) measured in a group of dogs by use of contrast echocardiography and to examine safety of this method by evaluating cardiac troponin I concentrations.

ANIMALS
6 healthy dogs.

PROCEDURES
2 bolus injections and a constant rate infusion of contrast agent were administered IV. Echocardiographic EF was determined by use of the area-length method and was calculated without and with contrast agent. The PTT and normalized PTT (PTT/mean R-R interval) were measured for each bolus. Constant rate infusion was used for global MP evaluation, and regional MP was calculated by use of a real-time method in 4 regions of interest of the left ventricle. Cardiac troponin I concentration was analyzed before and after contrast agent administration. Intraoberserver and interobserver variability was calculated.

RESULTS
EF was easier to determine with the ultrasonographic contrast agent. For the first and second bolus, mean ± SD PTT was 1.8 ± 0.2 seconds and 2.1 ± 0.3 seconds and normalized PTT was 3.4 ± 0.3 seconds and 3.5 ± 0.3 seconds, respectively. A coefficient of variation < 15% was obtained for global MP but not for the regional MPs. No differences were detected between precontrast and postcontrast cardiac troponin I concentrations.

CONCLUSIONS AND CLINICAL RELEVANCE
Contrast echocardiography appeared to be a repeat-able and safe technique for use in the evaluation of global MP and PTT in healthy dogs, and it improved delineation of the endocardial border in dogs.


Understanding the dynamic response of structures such as storage tanks or pressure vessels due to external chemical explosions is a critical aspect in determining the possible damage resulting from such an event. Furthermore, accurately simulating the overpressure or shock wave associated with a given explosion is equally important in order to achieve accurate results. Assessing the possible damage from an overpressure wave can provide valuable information about protecting structures from external explosions and improving designs. Such analyses become all the more important should the contents of the tank or vessel pose a risk to humans or the surrounding environment. This paper examines multiple computational techniques for simulating the load acting on a structure due to an external blast. In the past, blast parameters such as overpressure amplitude, spatial decay, arrival time, and blast duration had to be defined by the user. Recent development of more advanced computational tools, such as the CONWEP charge property in Abaqus, provides a means to accurately simulate blast loading on a structure, including reflection effects, without having to model the acoustic medium. The explicit computational methods discussed herein provide predictions of blast parameters and permit realistic evaluations of structures due to external explosions.Copyright © 2012 by ASME


In this study, the propagation of electromagnetic waves in one-dimensional plasma photonic crystals (PPCs), namely, superlattice structures consisting alternately of a homogeneous unmagnetized plasma and dielectric material, is simulated numerically using the finite-difference time-domain (FDTD) algorithm. A perfectly matched layer (PML) absorbing technique is used in this simulation. The reflection and transmission coefficients of electromagnetic (EM) waves through PPCs are calculated. The characteristics of the photonic band gap (PBG) are discussed in terms of plasma density, dielectric constant ratios, number of periods, and introduced layer defect. These may provide some useful information for designing plasma photonic crystal devices.


Mesenteric Panniculitis is a benign fibro-inflammatory process involving adipose tissue of the mesentery. It is characterised by fat necrosis, chronic inflammation and fibrosis, causing thickening and shortening of the mesentery. Patients may present with localised abdominal pain, abdominal mass, intestinal obstruction and ischaemic colitis. We report a case of mesenteric panniculitis causing abdominal pain in a patient with active Primary Sjogren's Syndrome. The rarity of this case makes it of interest. We review the current literature on mesenteric panniculitis and its association with connective tissue disease and inflammatory conditions. A 64-year-old Caucasian male presented in 1994 with dry mouth. A diagnosis of Primary Sjogren's Syndrome (PSS) was made on salivary gland biopsy. In 2010 he presented with an exacerbation of his eye symptoms, muscle pain and fatigue. He complained of abdominal pain and night sweating, but denied any weight loss or change in bowel habit. There was no significant past medical history other than PSS. On examination he had a small right submandibular node and mild synovitis at the right proximal interphalangeal joint and carpometacarpal joint. Examination of the abdomen showed marked umbilical tenderness but no organomegally. Blood tests at this time showed an active inflammation: CRP of 61 (NR 5 mg/L), ESR 39 (NR 20 mm/s), strongly positive ENA Ro and La. IgG was elevated at 18.6 (NR 5.8-15.4), Complement was low at 0.17 (NR 0.18-0.6). An abdominal ultrasound scan demonstrated a 6 × 3 ×3 cmarea of diffuse homogenous fat encasing some mesenteric vessels in the area of focal tenderness. CT abdomen and pelvis showed oedematous mesenteric fat and lymph nodes in the jejunal small bowel mesentery, consistent with mesenteric panniculitis. Laparoscopic biopsy was discussed with the surgical team, but was felt not indicated as risk outweighed potential benefit. The patient was treated with a 9-week reducing course of oral steroids. His abdominal symptoms resolved although CT abdomen showed little improvement in mesenteric panniculitis. A review of the literature suggests that currently there is no standard treatment and management should be guided by patient symptoms. Mesenteric Panniculitis is rare; as a result evidence for treatment is limited to individual case reports. There is no clear link between symptom improvement and radiological resolution of mesenteric panniculitis. It has, therefore been suggested that follow-up imaging should be limited to those with persistent symptoms. Overall the prognosis for mesenteric panniculitis is good, up to half of patients do not require treatment, and recurrence of symptoms is uncommon.


Abstract Deformation in fault zones is commonly characterized by grain-scale microfracturing, with microcrack density typically increasing toward the middle of the zone. The cracks can form under a wide variety of conditions and need to be used with great caution in making tectonic interpretations, particularly in areas with a complex history of fault reactivation. Microcracks may be intragranular (contained within single grains) or intergranular (with a length of several grain diameters). Intragranular cracks formed under dominantly plastic deformation conditions are crystallographically controlled and may not be directly related to regional stresses. Intragranular cracks formed during initial fracturing under cataclastic conditions develop only in grains that are optimally oriented to the deforming stresses. Intergranular cracks form during progressive cataclasis as intragranular cracks grow to join one another: they may develop as transgranular cracks that cut across several grains or as grain-boundary cracks. Once formed, microcracks may be preserved in a variety of ways (e.g. sintering, healing, cementation) depending on post-deformation conditions, and may be distinguished from one another on the basis of microstructural characteristics. Distinguishing between successive generations of microcracks in areas of fault reactivation is particularly important in determining the deformation history and obtaining deformation conditions. For example, Proterozoic quartzites collected from the central Utah Sevier belt have undergone multiple episodes of contractional deformation followed by Basin-and-Range extension. The use of polarized and dark-field optical microscopy and scanning electron microscopy allows microcracks related to the separate episodes of deformation to be distinguished on the basis of morphology, mode of preservation and consistent cross-cutting relationships. Variations in microcrack density and volume of cataclasized rock for the different generations of microcracks are used to establish the patterns of overprinting during fault reactivation. Anastomosing zones of intense deformation formed during successive episodes of faulting may not coincide with one another, as grain-size reduction and cementing during each episode hardens the zones, causing deformation to shift to adjoining weaker rock. However, the fault zone as a whole is a sufficiently large inhomogeneity that it is reactivated during successive faulting events.


Recently, the field of humanoid robotics attracts more and more interest and the research on humanoid locomotion based on central pattern generators (CPG) reveals many challenging aspects. This paper describes the design of CPG for stable humanoid bipedal locomotion using an evolutionary approach. In this research, each joint of the humanoid is driven by a neuron that consists of two coupled neural oscillators, and corresponding joint's neurons are connected by strength weight. To achieve natural and robust walking pattern, an evolutionary-based multi-objective optimization algorithm is used to solve the weight optimization problem. The fitness functions are formulated based on zero moment point (ZMP), global attitude of the robot and the walking speed. In the algorithms, real value coding and tournament selection are applied, the crossover and mutation operators are chosen as heuristic crossover and boundary mutation respectively. Following evolving, the robot is able to walking in the given environment and a simulation shows the result.


OBJECTIVE
To investigate the relationship between the changes of N-methyl-D aspartate (NMDA) receptor activity and brain edema after injury in rats.

METHODS
The brain injury models were made by using a free-falling body. The treatment model was induced by means of injecting AP5 into lateral ventricle before brain injury; water contents in brain cortex were measured with dry-wet method; and NMDA receptor activity was detected with a radio ligand binding assay.

RESULTS
The water contents began to increase at 30 minutes and reached the peak at 6 hours after brain injury. The maximal binding (B(max)) of NMDA receptor increased significantly at 15 minutes and reached the peak at 30 minutes, then decreased gradually and had the lowest value 6 hours after brain injury. Followed the treatment with AP5, NMDA receptor activity in the injured brain showed a normal value; and the water contents were lower than that of AP5-free injury group 24 hours after brain injury.

CONCLUSIONS
It suggests that excessive activation of NMDA receptor may be one of the most important factors to induce the secondary cerebral impairments, and AP5 may protect the brain from edema after brain injury.


Recent neutron diffraction data showing unusual temperature and magnetic-field-induced magnetic reordering in the helical spin-density wave phase of cubic FeFe are analysed in terms of a Landau-type free energy previously used to study related phenomena in isostructural MnSi. The predicted magnetic phase diagrams (H-T) exhibit novel types of first-order and second-order wavevector and spin reorientation phase transitions.


Long a-axes are a particularity of the crystal structures of the N3–-poor lanthanide(III) nitride selenides with the composition M5NSe6 (monoclinic, C2/c, Z = 16; M = La: a = 5177.2(3), b = 1271.58(9), c = 785.49(5) pm, β = 89.386(7)°; M = Ce: a = 5128.4(3), b = 1260.24(8), c = 778.03(5) pm, β = 90.002(7)°; M = Pr: a = 5096.1(3), b = 1252.47(8), c = 772.61(5) pm, β = 90.705(7)°). Two [NM4]9+ tetrahedra sharing a common edge by forming angled [N2M6]12+ double units represent the main structural feature. These edge-shared bitetrahedra reside in between layers of the defect Th3P4- like structure of the C-type lanthanide sesquiselenides (M2Se3). An alternative description of the structure points out the half-occupied cation positions (M10)3+. The discrete [N2M6]12+ units are linked with each others via four different selenide anions building up cationic{[(N2M6)4Se14]20+} slabs. In the [100] direction they are stacked alternatingly with anionic {[(M14Se34)(M10)2]20–} layers formed by Se2– polyhedra about the M3+ cations without any N3– ligands. Furthermore, these anionic layers offer channels filled up with (M10)3+ cations under half-occupation conditions. The site occupation factor of 1/2 for (M10)3+ is plausible, because a full occupation of this site would reveal to high negative valence values for all Se2– anions (Se4, Se10, Se11 and Se13) that show contacts with (M10)3+.


Dye lasers pumped by an N2 laser have been applied to the hook method as the continuum light source of an interferometer, and population measurement with a time resolution of about 5 ns has been made on He and Ne atoms in low-lying excited levels in the pulsed discharge (peak current of about 800 A and current duration of about 3 mu s). The results show a characteristic and rapid change in the population and high population density of the metastable levels, He 23S of 3.0*1013 cm-3 and Ne 1s5 of 1.6*1013 cm-3, in the early stage of afterglow. A short qualitative discussion on the population mechanism is given.


Purpose To examine the intraobserver repeatability of foveal outer nuclear layer (ONL) thickness measurements and evaluate interocular symmetry for patients with achromatopsia (ACHM) and controls. Design Cross-sectional study. Subjects Sixty-four patients with CNGA3- or CNGB3-associated ACHM and 38 patients with normal vision were recruited for analysis. Methods Horizontal line scans through the fovea of each eye were acquired using optical coherence tomography. Three foveal ONL thickness measurements were made by a single observer using custom software to analyze repeatability. Interocular symmetry was assessed using the average of the three measurements for each eye. Main Outcome Measures The main parameter being measured is foveal ONL thickness. Results Mean (± SD) foveal ONL thickness for ACHM patients was 74.86 ± 17.82μm (OD) and 75.30 ± 15.68μm (OS) compared to 110.60 ± 15.67μm (OD) and 110.53 ± 13.91μm (OS) for controls. Foveal ONL thickness did not differ between eyes for ACHM (p = 0.821) or control patients (p = 0.961). Intraobserver repeatability was high for foveal ONL measurements in ACHM patients (ICC = 0.939, OD and 0.915, OS) and controls (ICC = 0.991, OD and 0.984, OS). Conclusions Foveal ONL thickness can be measured with excellent repeatability. While foveal ONL thickness is reduced in ACHM compared to controls, the high interocular symmetry indicates that contralateral ONL measurements could be used as a negative control in early-phase monocular treatment trials.


In this paper, we propose a test to detect the linearity of the dark energy equation of state, and apply it to the SNLS3 Type Ia Supernova (SN Ia) data set. We find that: (a) current SN Ia data are well described by a dark energy equation of state linear in the cosmic scale factor a, at least up to a redshift z = 1, independent of the pivot points chosen for the linear relation; (b) there is no significant evidence of any deviation from linearity. This apparent linearity may reflect the limit of dark energy information extractable from current SN Ia data.


The objective of this research is to study elements of commu-nication signs in the content of Hikaru No Go comics can motivate to inspiring initiative and development of readers that same or different of the assessment of meaning codes under different readers' capital. This research uses a qualitative method, processing data using in-depth interviews with 20 readers through the notions of storytelling, semiology, and inspiration to support the research in the analysis section of the inspiration in the content of Hikaru No Go comics  As the result of the investigation, the inspiration in the content of Hikaru No Go comics can be formulated into 5 types: (1) inspiring initiative to play siege known as the game of Go by means of teaching naturally and creating an attraction with scenes and perspectives; (2) inspiring in create momentum by means of reflect on force towards goals, reflect on force inside oneself and reflect on force from others; (3) inspiring in the two dimensions of culture by means of communi-cate through reality and cultural reflection; (4) inspiring in development of the game of Go by means of giving ideas and perspectives of the game of Go and creating practice; and (5) inspiring in development of creativity by means of hiding special details and showing development by drawing. Decoding of the reader additionally shows development by storytelling and learning from a variety of decoding of meanings in the content of comics.


Abstract In many countries, urbanization has seen a rapid increase in demand for mobility in cities. Much of this demand is met by private vehicles, of which conventionally powered two-wheelers significantly contribute to air pollution. The consumer adoption of alternative fuel powered two-wheelers has not been the subject of as much study as passenger cars. In particular, studies of consumer adoption of electric motorcycles, which are a rapidly emerging and an environmentally more sustainable alternative to conventional powered two-wheelers, are few. This study explores the extent of this research gap. The development of motorcycles is analyzed with a focus on Asia, which accounts for 80% of the global fleet. Powered two-wheelers are categorized in terms of regulatory, fuel and technical aspects. Studies of the adoption of electric motorcycles are reviewed. Operational models and deployment in ownership-based or access-based economical models are discussed. An overview of the research methods that are used in existing studies of electric motorcycles is given and the results and their implications are discussed. These findings provide a useful insight for future research, for transportation managers and for policymakers.


Similar case retrieval (SCR) is a representative legal AI application that plays a pivotal role in promoting judicial fairness. However, existing SCR datasets only focus on the fact description section when judging the similarity between cases, ignoring other valuable sections (e.g., the court's opinion) that can provide insightful reasoning process behind. Furthermore, the case similarities are typically measured solely by the textual semantics of the fact descriptions, which may fail to capture the full complexity of legal cases from the perspective of legal knowledge. In this work, we present MUSER, a similar case retrieval dataset based on multi-view similarity measurement and comprehensive legal element with sentence-level legal element annotations. Specifically, we select three perspectives (legal fact, dispute focus, and law statutory) and build a comprehensive and structured label schema of legal elements for each of them, to enable accurate and knowledgeable evaluation of case similarities. The constructed dataset originates from Chinese civil cases and contains 100 query cases and 4,024 candidate cases. We implement several text classification algorithms for legal element prediction and various retrieval methods for retrieving similar cases on MUSER. The experimental results indicate that incorporating legal elements can benefit the performance of SCR models, but further efforts are still required to address the remaining challenges posed by MUSER. The source code and dataset are released at https://github.com/THUlawtech/MUSER.


Background: Hypertension is commonly found in patients with Diabetic Kidney Disease (DKD). Microalbuminuria is the first clinical sign of involvement of kidneys in patients with type 2 diabetes. Uncontrolled hypertension induces a higher risk of cardiovascular events, including death, increasing proteinuria and progression to kidney disease. Objectives: To determine the correlation between microalbuminuria and hypertension and their association with other risk factors in type 2 diabetic patients. Methods: One hundred and thirteen type 2 diabetic patients attending the diabetic clinic of Shaikh Zayed Postgraduate Medical Institute, Lahore, Pakistan were screened for microalbuminuria and raised blood pressure. The study was conducted from November 2012 to June 2013. Results: Patients were divided into two groups. Group 1, those with normoalbuminuria (n=63) and Group 2, those having microalbuminuria (n=50). Group 2 patients showed higher blood pressure values as compared to Group 1. The results were statistically significant and showed poor glycemic control as a contributing risk factor. Conclusion: The study concluded that there is high frequency of hypertension among type 2 diabetics but still much higher among those having microalbuminuria. So, early recognition of renal dysfunction through detection of microalbuminuria and to start treatment without any delay will confer future protection from end stage renal disease as well as hypertension and its complications in type 2 diabetic patients.


Background: Negative regulator molecules are well known essential keys for cell proliferation, survival and homeostasis balance. DUSP6 and SPRY2 are both tumor suppressors' genes which play an important role in RAS feedback signaling pathway by targeting different effector molecules. In this study, we evaluated the mechanisms under RAS hyperactivation scenario driven by BCR-ABL1 and the outcomes of an imbalance feedback signal in a chronic myeloid leukemia (CML) model.

Experimental design: to study the function of DUSP6 and SPRY2 molecules we designed a genetic mouse model of CML. Briefly, bone marrow cells from DUSP6-/- and SPRY2fl/fl mice were cultured with recombinant mouse cytokines (IL-3, IL-6, SCF) and retrovirally transduced with BCR-ABL1 fusion oncogene. For the SPRY2 conditional knockout, cells were transduced with Cre-ERT2 retroviral recombinant vector or empty vector (ERT2) and deletion was induced by a 3-day treatment with 4-Hydroxytamoxifen (4–OHT). Lineage identity of CML-like cells was confirmed by flow cytometry and gene deletion was confirmed by western blot.

Results: In previous gene expression analysis by microarray we showed that DUSP6 and SPRY2 negative regulator molecules are highly expressed in kinase -driven malignancies, including chronic myeloid leukemia. Subsequently, evaluating Dusp6 deficiency we observed a profound signaling imbalance in CML-like cells, resulting in cell cycle arrest in G2/M phase and increased susceptibility to cellular senescence as compared to DUSP6 wild type cells. Absence of this negative regulator molecule also decreased the self-renewal capability of DUSP6-/- CML-like cells, which failed to form colonies in methylcellulose culture. However, when assessing the impact on Erk activation, Dusp6 deletion unexpectedly led to Erk phosphorylation inhibition and Stat5 phosphorylation, suggesting a crosstalk between both pathways. Inducible deletion of SPRY2 surprisingly had opposite effects and once deleted resulted in a significant increase of self-renewal capability observed in colony formation assay. Lack of Spry2 had no major effects in Erk activation and cell growth.

Conclusion: the negative feedback mediators analyzed in our work, showed that feedback signaling is a complex network and distinct molecules acting as negative regulators in the same pathway can actually lead to different outcomes in the same type of leukemia. Overall, we suggest that Dusp6 can play an important role in oncogenic signaling by preventing cellular senescence and maintaining cellular self-renewal. The negative regulator Spry2, however, seems to have an essential function as tumor suppressor gene in CML cells and its deletion can lead to a favorable homeostasis imbalance for leukemic cells.

Citation Format: Vanessa Silveira, Seyedmehdi Shojaee, Markus Muschen. Induced hyperactivation of Ras-MAPK in chronic myeloid leukemia: role of negative feedback signaling. [abstract]. In: Proceedings of the Third AACR International Conference on Frontiers in Basic Cancer Research; Sep 18-22, 2013; National Harbor, MD. Philadelphia (PA): AACR; Cancer Res 2013;73(19 Suppl):Abstract nr A55.


The Coronavirus disease 2019 (COVID-19) pandemic has severely impacted countries around the world with unprecedented mortality and economic devastation and has disproportionately and negatively impacted different communities---especially racial and ethnic minorities who are at a particular disadvantage as they are more likely to be the potential target of COVID-19 infection. Black Americans are especially vulnerable to COVID-19 due to the longstanding history of disadvantage (e.g., long-standing disparities in health outcome). Although some prior research indicates highrisk and vulnerability of the elderly and patients with underlying co-morbidities, little research paid attention to tracing the social and structural health determinants that yield disparities in this pandemic. In this paper, we propose DeepDive to identify diverse determinants (including the structural, social, and constructural determinants) of health disparities in COVID-19 pandemic. We provide a thorough analysis of health disparities based on multiple COVID-19 datasets and examine the structural, social, and constructural health determinants to assist in ascertaining why disparities (in racial and ethnic minorities who are particularly disadvantaged) occur in infection and death rates due to COVID-19 pandemic. Extensive experimental results show the effectiveness of DeepDive. The research provides new strategies for determining these health determinants with a goal to improve pandemic health care.


Humoral hypercalcemia due to parathyroid hormone-related peptide (PTHrP) elevation is a well-known complication of various malignancies, but the situation is rare concerning hematological malignancies except for adult T-cell leukemia/lymphoma. We report a case of Richter's syndrome with humoral hypercalcemia, and demonstrate by reverse transcription polymerase chain reaction (RT-PCR) that peripheral blood PTHrP levels were 2,500-fold higher compared to healthy controls. PTHrP production by tumor cells in chronic lymphocytic leukemia (CLL) and Richter's syndrome has been previously demonstrated by nonquantitative methods such as immunohistochemistry and northern blot analysis, but this is the first report using the RT-PCR method. The presented case did not have hypercalcemia when initially diagnosed as small lymphocytic lymphoma (SLL), and as reported earlier, the development of hypercalcemia may be an indication of the transformation to Richter's syndrome in patients with CLL/SLL.


This paper presents an experimental study of the soft-landing problem in quadrotors using the induced wind modeling approach. The landing phase has been typically one of the critical phases in drone flight. Landing complexity drastically increases when the drone needs to land on sensitive sites, such as platforms or rack of pipes in refineries (for inspection purposes), in which explosive material is running through or there exist flammable/explosive material in the environment. Multirotor unmanned aerial vehicles (UAV s) are usually lightweight platforms and they are significantly disturbed by the aerodynamic ground effect while landing; so, near the ground, those drones are subjected to an external disturbance in proximity to the ground. In this situation, the airflow can be reflected after reaching the ground, disturbing the performance of the rotors significantly. This paper aims to model the induced wind velocity, caused by the propellers to see and consider the ground effect during the landing. The reduction of the total thrust near the ground provides a smooth landing and avoids bumping. The complex wind modeling formulation and limitation of the commercialized autopilots make the implementation a challenging task. Herein we propose how to incorporate the proposed soft-landing algorithm within an existing UA V autopilot. Experimental results show that the proposed approach successfully replicates the wind modeling which leads to a soft-landing.


This study evaluates the reporting of income as taxpayers may attempt to take advantage of the difference between the tax rates on personal and corporate income. In deriving the estimable equation, this analysis models regional economic activity within a dynamic macroecononomic framework with various government revenue sources and multiple expenditure categories. In addition, the model incorporates income shifting with convex adjustment costs. The sample includes the 48 contiguous U.S. states with annual observations ranging from 1977 through 2008. The findings suggest state personal income as a share of output grows the fastest when taxing personal income at a lower top marginal rate than corporate income and as the degree of income tax integration diminishes. The findings are consistent with the hypothesis that tax rate differentials induce economic agents to shift reported income into the relatively low taxed income.


The mouse embryo undergoes compaction at the 8-cell stage and its transition to 16 cells generates polarity such that the outer apical cells are trophectoderm (TE) precursors and the inner cell mass (ICM) gives rise to the embryo. We report here, that this first cell fate specification event is controlled by glucose metabolism. Glucose does not fuel mitochondrial ATP (energy) generation and glycolysis is dispensable for blastocyst formation. Glucose does not help synthesize amino acids, fatty acids, and nucleobases. Instead, glucose metabolized by the hexosamine biosynthetic pathway (HBP) allows nuclear localization of YAP1, and the pentose phosphate pathway (PPP), along with sphingolipid (S1P) signaling, activates mTOR and allows translation of AP-2γ. YAP1, TEAD4 and AP-2γ physically interact to form a nuclear complex that controls TE-specific gene transcription. Glucose signaling has no role in ICM specification, but this cascade of events constituting "Developmental Metabolism" specifically controls the fate of TE cells.


Cognitive reserve (CR) and brain reserve (BR) are protective factors against age‐associated cognitive decline and neurodegenerative disorders. Very limited evidence exists about gender effects on brain aging and on the effect of CR on brain modulation in healthy aging and Alzheimer's Dementia (AD). We investigated gender differences in brain metabolic activity and resting‐state network connectivity, as measured by 18F‐FDG‐PET, in healthy aging and AD, also considering the effects of education and occupation. The clinical and imaging data were retrieved from large datasets of healthy elderly subjects (HE) (225) and AD patients (282). In HE, males showed more extended age‐related reduction of brain metabolism than females in frontal medial cortex. We also found differences in brain modulation as metabolic increases induced by education and occupation, namely in posterior associative cortices in HE males and in the anterior limbic‐affective and executive networks in HE females. In AD patients, the correlations between education and occupation levels and brain hypometabolism showed gender differences, namely a posterior temporo‐parietal association in males and a frontal and limbic association in females, indicating the involvement of different networks. Finally, the metabolic connectivity in both HE and AD aligned with these results, suggesting greater efficiency in the posterior default mode network for males, and in the anterior frontal executive network for females. The basis of these brain gender differences in both aging and AD, obtained exploring cerebral metabolism, metabolic connectivity and the effects of education and occupation, is likely at the intersection between biological and sociodemographic factors. Hum Brain Mapp 38:4212–4227, 2017. © 2017 Wiley Periodicals, Inc.


using the scalp electroencephalogram (EEG) to detect seizure onsets that are not associated with rhythmic EEG activity is challenging. In this paper, we illustrate how supplementing the extracted information from the scalp EEG with the extracted information from electrocardiogram (ECG) can improve the detection of these types of seizures. In this scheme, spectral and spatial features are extracted from EEG and ECG signals by Gabor functions. Then a k-nearest neighbour classifier is used to classify the extracted features from seizure and non-seizure EEG-ECG signals. This algorithm can automatically detect the presence of seizures which can be important advance facilitating timely medical intervention. The performance of algorithm is evaluated on 12 records and recognizes 98.31% expert-labeled seizures with a false detection rate of 11.52%.


The article analyzes the transformative capacity of the Ministry of Social Development and Fight against Hunger (MDS) in shaping structural change in Brazilian municipalities. The study is based on the concepts of organizational and institutional learning, on a combination of analytical categories of the institutional and neo-institutional approaches and on traditional means of government control. As for methodology, this study used process tracing, in-depth interviews, and documentary analysis of regulations, decrees, and resolutions that create direct and indirect incentives to induce agreements and cooperation of municipalities with the Ministry. We identified two important causal mechanisms: a) organizational and institutional learning processes; and b) inter-federative cooperation that, combined, generated significant changes in municipal bureaucratic capacity. The findings show the importance of the Union's transformative capacity in the process of public policy decentralization in Brazil.


In the present communication we report on diastase alpha amylase immobilization at guar gum-silica nanohybrid material (H5). The immobilized amylase (H5-Amyl) showed significantly higher bioactivity (21.62 U mg -1 ) as compared to free amylase (15.59 U mg -1 ) in solution at pH 5 and temperature 40 °C. The kinetic parameters of the free (K m = 10.66 mg L -1 ; V max = 1.36 µmolemL -1 .min -1 ) and the immobilized enzyme (K m = 6.11 mg mL -1 ; V max = 1.45 µmolemL -1 .min -1 ) revealed that the immobilization has increased the overall catalytic property of the enzyme. The immobilized enzyme on recycling could show 87 % of initial activity even in the sixth cycle. Since immobilization did not hamper the enzymatic reaction rate, the biocatalyst may be suitably exploited in food and pharmaceutical industries. Copyright © 2014 VBRI press.


Vascular smooth muscle cells (VSMCs), switching from a differentiated to a proliferative phenotype, contribute to various vascular diseases. However, the role of long noncoding RNA metastasis-associated lung adenocarcinoma transcript 1 MALAT1 in the phenotype switching of VSMCs remains unclear. Here, we report that the knockdown of MALAT1 promotes the transformation of smooth muscle cells from a proliferative phenotype to a differentiated phenotype. MALAT1 knockdown inhibited cellular proliferation and migration, leading to significant cell cycle arrest in the G2 phase. MALAT1 was downregulated in bone morphogenetic protein-7 (BMP-7)-induced cellular differentiation, while MALAT1 was upregulated in platelet-derived growth factor-BB (PDGF-BB)-induced cellular proliferation. PDGF induced the transformation of smooth muscle cells into a proliferative phenotype accompanied by an increase in autophagy. The downregulation of MALAT1 attenuated PDGF-BB-induced proliferation and migration by inhibiting autophagy. MALAT1 could act as a competing endogenous RNA (ceRNA) to regulate autophagy-related 7 (ATG7) gene expression by sponging miR142-3p. The present study reveals a novel mechanism by which MALAT1 promotes the transformation of smooth muscle cells from contraction to synthetic phenotypes.


The need for services targeting fathers in the perinatal period is increasingly apparent. To maximize engagement, such interventions need to be father focused, but men's experiences and needs around support have not been adequately examined. Therefore, the aims of this qualitative study were to explore men's experiences of seeking support for their mental health and parenting in the perinatal period, and identify their specific support needs during this time. Australian fathers (N = 20) who were expecting or parenting an infant less than 2 years of age participated in individual semistructured face-to-face or telephone interviews. Thematic content analysis was used to analyze the data. Five broad themes were explored: experiences of support, support needs, barriers to support, facilitators to support, and timing of support. Several subthemes were identified within each category, illustrating a diverse range of issues that fathers experience across the perinatal period. The findings have implications for our understanding of fathers' help-seeking behaviors, their perinatal support needs and for the development of resources, services, and interventions aiming to engage fathers in maternity health services.


One of the most serious problems of the KEPCO system is a higher fault current than the CB(Circuit breaker's SCC (Short Circuit Capacity). There are so many alternatives to reduce the higher fault current, such as the isolation of bus ties, enhancement of the CB's SCC, and the application of HVDC-BTB (Back to Back) or FCL (fault current limiter). However, these alternatives have drawbacks from the viewpoint of system stability and cost. As superconductivity technology has been developed, the resistive type (R-type) HTS-FCL (High Temperature Superconductor Fault Current Limiter) offers one of the important alternatives in terms of power loss and cost reduction in solving the fault current problem. To evaluate the accurate transient performance of R-type HTS-FCL, it is necessary for the dynamic simulation model to consider transient characteristics during the quenching and the recovery state. Against this background, this paper presents the new HTS-FCL EMTDC (Electro-Magnetic Transients including Direct Current) model considering the nonlinear characteristics on fault current and temperature.


Hainan located in adjacent areas of northeastern Yinggehai Basin,it is one of important sources of sediment to basin filling. In this paper,we analyzed the content,assemblages and index of heavy minerals in sediments which come form the mouth of the seven rivers in western Hainan. The study revealed that heavy minerals content,roundness,assemblages and index are obviously different from the north to south,reflecting the transport distance and parent rocks also different. The northern Zhubijiang mainly for near distance source,including a provenance of acid rocks with some metamorphic and basic-ultrabasic rocks,the dominated heavy minerals are ilmenite,tourmaline,zircon, epidote and tremolite; The northern Changhuajiang river is mainly for the long distance transportation of acid to basic rocks,the dominated heavy minerals are ilmenite,magnetite and zircon; The central Beilihe and Tongtianhe rivers are mainly from near distance source,the acid,basic and metamorphic rocks without long distance transporting,and the dominated heavy minerals are ilmenite,tourmaline,zircon,garnet and tremolite; The central Ganenhe mainly for stable-very stable minerals,they are zircon,ilmenite,titanite,tourmaline and limonite; The southern Wanglouhe and Ningyuanhe are from near transporting parent rocks,including a provenance of acid,basic and metamorphic rocks, the heavy minerals mainly for ilmenite,magnetite,limonite and epidote. Different characteristics of heavy minerals in different rivers are closely related to its source,the areas of transport and the rock types. By studying the different assemblages system of heavy minerals in different rivers,it can help to carry out source-sink comparison and analysis of Yinggehai Basin,to establish the identification signs of different detrital source area of oil and gas reservoir,and has an important geological significance for provenance identification of natural gas in different reservoir.


This work was aimed to evaluate milk quality parameters according to three levels of specialization of milk production units in different districts of West Santa Catarina´s State, Brazil. Characterization of milk production units was carried out using a questionnaire in 29 farms as a tool for data collection, applied during a visit to the farm. At the time, 58 milk samples were collected from cooling tanks to determine the levels of fat, protein, lactose, somatic cell count (SCC) and total bacteria count (TBC). Considering the information obtained the milk production units were classified as specialized (E), semi-specialized (SE) and not specialized (NE). The database was subjected to multivariate methods of statistical analysis with the use of Principal Component Analysis (PCA) and Redundancy analysis (RDA). The results indicated that variables that most influence milk quality are: time in the activity, area with perennial pasture, gross income from milk activity, type of milking, teat washing and method of reproduction. Results showed that despite lower percentages of fat and protein, the increased level of specialization provides milk of better quality due to the low rates of SCC and TBC, which leads to higher income from this type of activity. In specialized farms where milk activity has a high economic importance, producers are encouraged to adopt better hygiene practices during milking and herd breeding.


Service oriented device architecture (SODA) is a promising approach for enabling a continuous IT support of medical processes in hospitals. However, there is a lack of specific design patterns for realizing the concept in an effective and efficient way. This paper addresses this research gap by introducing the Standardized Device Service design pattern, as a first fundamental pattern for encapsulating devices as services. The pattern is based on both established Service Oriented Architecture (SOA) best practices as well as latest research in the field of SODA. This paper contributes to a) the extension of the IT support of medical processes by devices, b) the general concept of SODA by addressing the lack of generalized design concepts, and c) the existing catalog of SOA design patterns by introducing a first pattern for device integration.


The article is a deconstructionist reading of women oppression as depicted in the Sesotho folktale, Ngwana ya Kgwedi Sefubeng ("The Child with the Moon on the Chest"). The article argues that folktales embody some intriguing gender and power dynamics, particularly in settings where polygamy is practiced. The article also highlights the dynamics of power among women in a polygamous set up, as well as the contentious subject of gender oppression. The pre-eminence of binary features of good/evil and strong/weak, observed in Ngwana ya Kgwedi Sefubeng justifies the operationalisation of the deconstructionist paradigm. The folktale highlights the struggles and conflicts which women face in their marriages on a daily basis. The selected folktale demonstrates how women oppress each other. In this regard, the folktale not only deconstructs popular and dominant feminist perspectives, but also uses language and orders experiences in a manner that necessitates the use of the deconstructive approach. The selection of this folktale is deliberate. While there are many folktales in this category, Ngwana ya Kgwedi Sefubeng provides us with various ways to interrogate, not just society, but theory as well.


Objective: To determine the frequency of in-stent restenosis in diabetic patients undergoing primary percutaneous coronary intervention (PCI). Study Design: Retrospective/Observational study Place and Duration: Department of Adult Cardiology, Peshawar Institute of Cardiology, Peshawar KPK During the Period from January, 2022 to June, 2022. Methodology: Total 380 patients of either gender with ages 25-70 years underwent primary percutaneous coronary intervention were enrolled. Patients were divided into two groups, diabetic (n=180) and non-diabetic (n=200). Detailed demographics including age, sex, BMI, hypertension, family history of ischemic heart disease and smoking status were recorded after taking informed written consent. Patients were followed to examine the incidence of restenosis. Data was analyzed by SPSS 24.0. Results: There were 140 (77.78%) males and 40 (22.22%) females with mean age 48.26±9.55 years in diabetic group and in non-diabetic group 148 (74%) patients were males and 52 (26%) were females with mean age 47.85±10.66 years. Overall frequency of in-stent restenosis was 28 (7.37%), among them 25 (89.29%) were diabetic and 3 (10.71%) were non-diabetic. There was a significant association between diabetes and in-stent restenosis with p-value <0.05. Conclusion: It is concluded that frequency of in-stent restenosis was high and significantly associated with diabetes in patients undergoing primary PCI. Keywords: Percutaneous Coronary Intervention (PCI), Diabetes, In-stent Restenosis


This letter presents a new auxiliary circuit to achieve transient current commutation (TCC) in dc solid-state circuit breakers (SSCBs). The auxiliary circuit consists of two parts: active injection circuits (AIC) and capacitive couplers. There are two contributions. First, coupling capacitors between AIC and the main branch are introduced to prevent short circuit failures in the auxiliary branch. Second, a boost converter-based resonant circuit is presented for AIC to achieve TCC in the main branch through couplers. The presented AIC tunes the duration time and amplitude of injected countercurrent pulses during dc current interruption. The working principle and design procedure of the auxiliary circuit are presented. The proposed topology is verified by experiments of a 2 kV/100 A dc SSCB prototype under load current interruption. The experimental results show that the injected pulse current through couplers reaches 110 A, and it decays to zero within 12.5 μs. The total reaction time interval including the communication delay and the AIC current rising delay is 108 μs. Meanwhile, the peak voltages across the main branch and the coupler reach 2099 V and 2193 V, respectively.


Some of the methods that are used for noise suppression in cellular telephony are discussed. Noise suppression methods are divided into two groups according to the number of microphones used in the noise suppression system. The first group of methods utilizes a single-microphone and the second group utilizes a number of microphones. Most of the techniques proposed in the single-microphone noise suppression category function in the frequency-domain and use the short-time analysis-synthesis technique. These techniques apply a frequency-dependent gain function to the spectral components of the noisy speech to attenuate the components with greater noise content. The second group of techniques utilize a number of microphones that have the ability to utilize spatial dimension in addition to temporal dimension to suppress the background noise (BGN) effectively.


This Fast Brief provides a general background on the main features of labor regulations in the Middle East and North Africa (MENA) Region. This is part of an effort to understand employability constraints in MENA and to this end a World Bank team gathered information on labor legislation and other legal acts concerning labor regulations in the region. All this rendered more urgent with the ongoing social and political turmoil in the region. Within the broader scope of labor regulations, and in order to assure regional comparability, the information that was collected focused on key issues associated with commencing or terminating employment and during the period of employment (including maternity benefits). This Brief is to provide policymakers and international organizations with a regional analysis of how labor regulation affects labor market outcomes in the region and to inform governments on strategic approaches to employment creation through labor policy and associated reforms. This activity comes as a response to regional priorities in the context of the Arab World Initiative (AWI): one of the six strategic themes of the AWI focuses explicitly on employment creation as a top priority.


Travelling is an important precondition for other occupations, and to support travelling for people with functional limitations in-depth information about usability problems in urban public transport is needed. Therefore, the aim of this study was to explore usability problems in public transport in a travel chain perspective focusing on the physical environment and inherent aspects of it. Service Route travellers were contacted on board buses and a strategic sample of 20 persons participated in focus group interviews. The participants were used to travelling but the results demonstrated that they faced a broad range of usability problems when travelling. By analysing the usability problems in a travel chain perspective, several aspects of the personal, environmental, and occupational components in usability problems were elucidated. The results provide a structure for further analysis of usability problems in urban public transport, in research as well as in practice. Knowledge about the usability problems different groups of people experience when travelling increases knowledge of the environmental impact on occupational performance and how to design supportive traffic environments for people with functional limitations.


The influence of blasting energy on blasting fragmentation and damage of reserved rock is important for safety and schedule of drill-blasting construction in coal mine. This study is aimed at investigating the dynamic mechanical properties of mudstone in coal mine using the energy characterization method, and their quantitative relation formula was also developed. The impact compression experiments of mudstone in Huainan mining area were conducted to study the saturated mudstone dynamic mechanism, crack properties, and energy dissipation law using the diameter 50mm split Hopkinson pressure bar (SHPB). The results show that under the back-and-forth reflection of the stress wave, the saturated mudstone specimens are characterized by circumferential failure and axial splitting damage, which appear in the rock grain interface. By energy analysis, the energy dissipation per volume (EDV), energy dissipation per mass (EDM), and absorption impedance energy ratio (AIER) are used to represent the energy dissipation characteristic of mudstone. And the AIER is the best index. Additionally, there is the quadratic function relationship between three indexes and average strain ratio, showing the dependence of the strain ratio.


Since the establishment of the first minimum retroreflectivity levels in 1993, agencies and researchers have focused on determining the service life of different sheeting type and color combinations. While deterioration curves and measured retroreflectivity are viable methods for maintaining retroreflectivity compliance, they do not ensure the ability of the traffic sign to convey its intended message. Retroreflectivity efficiency only ensures visibility but does not properly describe the legibility of the sign. Therefore, while agencies across the nation are developing and implementing traffic sign maintenance plans, the emphasis should not be solely placed on visibility. In order to evaluate the performance of UDOT's traffic signs, a sample sign population was collected across all four of UDOT's maintenance regions. Analysis on this sample set not only determined the current rate of compliance, but it also identified several issues seen throughout the population. Signs under UDOT's jurisdiction are four times more likely to have substantial damage to the sign face than to fail to meet the minimum retroreflectivity levels. Analysis was conducted on determining contributing factors damage rates and it was determined that precipitation, elevation, seasonal temperature swing, and exposure of the sign all contributed to higher rates of damage. Additional analysis was conducted on determining the service life of different type and sheeting combinations. Hindered by the lack of known installation information, the analysis only identified service life as a significant contributor to sheeting deterioration. Since the majority of new sign installations are prismatic sheeting, the recommended maintenance plan needs to reflect the performance characteristics of this sheeting while continuing to manage the existing sign population. With the combination of UDOT's current sign knowledge and the sheeting deterioration and damage analysis conducted in this thesis, the feasibility of the five preapproved FHWA methods is discussed. This report concludes with the recommendation of a visual nighttime inspection method due to this method's ability to assess both the visibility and legibility of traffic signs. This will ensure that UDOT maintains compliance with the retroreflectivity mandate, while improving safety for motorists.


University Archives supports scholarship by preserving and providing access to over 300 unique collections that chronicle the history of Washington University from 1853 to today, as well as related St. Louis history and architectural topics.


Na/H exchange regulatory factor-1 (NHERF1) is a PDZ protein that regulates trafficking of several G protein-coupled receptors. The phenotype of NHERF1-null mice suggests that the parathyroid hormone (PTH) receptor (PTH1R) is the principal GPCR interacting with NHERF1. The effect of NHERF1 on receptor recycling is unknown. Here, we characterized NHERF1 effects on PTH1R membrane tethering and recycling by radio-ligand binding and recovery after maximal receptor endocytosis. Using Chinese hamster ovary cells expressing the PTH1R, where NHERF1 expression could be induced by tetracycline, NHERF1 inhibited PTH1R endocytosis and delayed PTH1R recycling. NHERF1 also inhibited PTH-induced receptor internalization in MC4 osteoblast cells. Reducing constitutive NHERF1 levels in HEK-293 cells with short hairpin RNA directed against NHERF1 augmented PTH1R endocytosis in response to PTH. Mutagenesis of the PDZ-binding domains or deletion of the MERM domain of NHERF1 demonstrated that both are required for inhibition of endocytosis and recycling. Likewise, an intact COOH-terminal PDZ recognition motif in PTH1R is needed. The effect of NHERF1 on receptor internalization and recycling was not associated with altered receptor expression or binding, activation, or phosphorylation but involved β-arrestin and dynamin. We conclude that NHERF1 inhibits endocytosis without affecting PTH1R recycling in MC4 and PTH1R-expressing HEK-293 cells. Such an effect may protect against PTH resistance or PTH1R down-regulation in certain cells harboring NHERF1.


Phase-regenerative wavelength conversion is demonstrated experimentally. The simultaneous combination of two nonlinear optical processes, phase conjugation and frequency conversion (Bragg scattering), produces phase-sensitive gain at two new idler wavelengths in addition to the original signal wavelength. This single-stage approach does not require phase-locking of the tunable pump. At maximum pump depletion, amplitude and phase regeneration occur simultaneously.


During the last two decades, numerous studies have focused on the relationships between management compensation, corporate governance and firm performance. Studies on the design of management compensation plan and its effects on firm performance are related to those on agency problems arising primarily from the separation of ownership and control and the misaligned incentives between managers and shareholders. The misalignment of management incentives could lead to dysfunctional behaviour that could affect firm value adversely. Hence, a proper design of management compensation plan is crucial to resolve the manager– shareholder agency conflicts. This study examines the relationships between a certain corporate governance related mechanism and organisational factors and management compensation plan design,and how performance-based management compensation affects firm performance. The examined corporate governance mechanism is the quality of remuneration committee, and organisational factors are composed of ownership structure, and firm leverage. In the main market of Bursa Malaysia, 207 out of 828 companies in different industry sectors from 2008 to 2010 were randomly selected as a sample. This constituted 25 percent of the total listed companies which comprise more than 56 percent of total market capitalisation. The data for performance-based management compensation, the quality of remuneration committee, and ownership structure were collected from the annual financial reports of the sample companies. The data of firm performance, and firm leverage were obtained from Standard and Poor's Capital IQ database. The data were analysed using the regression model.Moreover, the Baron and Kenny (1986) procedure improved by Mathieu and Taylor (2006) was used in order to test the mediating model. Newey-West heteroskedasticity and autocorrelation consistent (HAC) Standard Errors and Covariance were used for the estimation of the ordinary least squares (OLS) regression. Ownership structure variable was represented by four dummy variables, while the other variables were measured as ratio scale. Since senior management compensation constitutes a major component of a firm's total incentive payment, this study on performance-based management compensation helps to evaluate the effectiveness of certain corporate governance related mechanisms in Malaysia. The results of this study have shown that: First, the quality of remuneration committee is found to have a moderately significant positive impact on performance-based management compensation in Malaysian listed companies. This study measures the quality of remuneration committee based on six comprehensive categories with twenty six dimensions. The quality of the remuneration committee is a key factor in enhancing the effectiveness of management compensation plan design. Second, four different types of ownership structure i.e. family ownership, GLC ownership, institutional ownership and dispersed ownership are found to have significant negative impact on performance-based management compensation. These results are consistent with the literature findings; although the finding related to institutional ownership is contrary to expectation. Third, firm leverage is found to have a significant negative effect on performancebased management compensation. This is because high leverage results in higher monitoring. Thus, the high monitoring cost negatively impacted management compensation and performance. Fourth, performance-based management compensation is found to have a significant positive impact on firm financial performance. Effective and performance-based management compensation plan design aligns interest of managers with those of shareholders. Fifth, among the four different types of ownership, institutional and dispersed ownership have significant negative impact on firm performance, whilst family and GLC ownership have moderately significant negative effect on firm performance. Firm leverage is found to have a significant negative effect on firm performance. Finally, performance-based management compensation does not mediate the quality of remuneration committee-performance, dispersed ownership-performance and firm leverage-performance relationships, but it fully mediates family ownershipperformance,GLC ownership-performance, and institutional ownership-performance relationships. Overall, the results of this study indicate that corporate governance related factors such as the quality of remuneration committee, and organisational factors such as ownership structure and firm leverage have a significant influence on the design of management compensation plan, which in turn affects firm performance. Finally, performance-based management compensation mediates the relationship between ownership structure and firm performance. The results of this study show that it is the quality of the remuneration committee rather than the existence of the committee that matters. This research empirically explores aspects of remuneration committee and performance-based management compensation that have, hitherto, not been much examined in the existing literature,especially in developing countries. The majority of reform efforts try to improve transparency and disclosure in the paysetting processes and internal control. However, a little attention gave to the quality of remuneration committee and its potential to discipline the behaviour of the executives. If agency problems are to be sufficiently mitigated via the incentive compensation, then policy makers may have to focus their attention to how the remuneration packages are formulated.


Method: Between May 2012 and September 2014 cluster of five patients with large osteochondral fractures of the lateral femoral trochlea were treated at our institution. These all occurred in high level male athletes, one at a decathlete and the other four soccer players. The MRI scan showed a characteristic appearance of a large subchondral fracture involving most of the lateral femoral trochlea. All patients were symptomatic. The patients were treated with open reduction and internal fixation using headless compression screws. The operative technique and short term results will be outlined. Results: Fixation appears successful in most cases. Conclusion: This appears to be a repetitive trauma related injury that occurs in young high-level athletes.


We present a rationale and method for taking an idiographic approach to study the role religion plays in adolescent development. We theorize that adolescents harness qualitatively different aspects of religion to address idiosyncratic developmental needs. Therefore, analyzing religion's role in adolescent development necessitates a case-by-case holistic analysis. We introduce a systematic method using narratives to identify the personal ways that individuals attribute meaning in general and regarding religion in particular. We present three detailed case studies from a sample of 20 religious Israeli Jewish Orthodox emerging-adult women who provided retrospective narrative accounts of their general and religious development through adolescence. Systematic analysis reveals that religion was significant to these women in diverse and personal ways, addressing markedly different adolescent developmental needs.


The purpose of this article is to discuss about construct measurement in Marketing by summarizing the main considerations about the subject. First, it discusses the origins of the debates about the theme since the 1970s and describes its main consolidated models (the classical Churchill's model, the COARSE model and the formative measurement model). Then it presents current concerns about the classical approach with relevant recommendations (particularly regarding multi-item measurement, single-item measurement, rating scales and cross-cultural aspects). At the end, it presents considerations about measurement trends in Marketing with emphasis on the Item Response Theory (IRT), Bayesian estimators and Partial Least Squares (PLS). The article updates the debate on the theme and contributes to Marketing experts and researchers who demand a current view about measurement and recommendations for research development.


The time profile of a femtosecond pulse propagating in media with a high scattering anisotropy (g≥0.9) is studied in detail. The iteration method based on the expansion of the light field in a series in photon scattering orders with the account for the multiply scattered component is proposed to study analytically the structure of a scattered radiation pulse. The small-angle approximation of the radiation transfer theory used for calculations of low-order scatterings is modified to take into account the spread in the photon delay times. The shape of a scattered ultrashort pulse calculated theoretically well agrees with the shape obtained by the Monte-Carlo simulation. It is shown that the pulse profile in a scattering medium depends on the shape of the scattering phase function with the conservation of the anisotropy factor. A comparative analysis of contributions from different scattering orders to the pulse structure is performed depending on the optical properties of a scattering medium.


Objective To assess the relationship between self-management skills and adherence to follow-up guidelines among gynecological cancer survivors in the Netherlands, Norway, and Denmark, and to assess the relationship between adherence to follow-up programs and use of additional healthcare services. Methods For this international, multicenter, cross-sectional study, we recruited gynecological cancer survivors 1–5 years after completion of treatment. Information on follow-up visits, use of healthcare resources, self-management (measured by the Health Education Impact Questionnaire), clinical characteristics, and demographics were obtained by validated questionnaires. Participants were categorized as adherent if they attended the number of follow-up visits recommended by national guidelines, non-adherent if they had fewer visits than recommended, or over-users if they had more visits than recommended. Results Of 4455 invited survivors, 2428 (55%) returned the questionnaires, and 911 survivors were included in the analyses. Survivors with high self-management most frequently adhered to recommended follow-up. Non-adherent survivors showed lower self-management in the health-directed activity domain (OR 1.54, 95% CI 1.03 to 2.32) than adherent survivors. No other associations between self-management and follow-up adherence were revealed. Non-adherent survivors tended to have endometrial cancer, surgical treatment only, be older, and be Danish residents. Over-users reported more follow-up visits and also used additional healthcare services more frequently than adherent survivors. Conclusion Low self-management appears to reduce the likelihood of adherence to national guidelines for gynecological cancer follow-up. Focusing on patient education for survivors at risk of low self-management to ensure adherence to recommended follow-up may improve personalization of follow-up.


: Ayurveda is not only a medical science but also tells about the ways of living life. In Ayurveda, the most emphasis is given on avoiding diseases; it is given on living a healthy life. In today's era, it has become more important to use the rules of Ayurveda because a person does not pay attention to his health, due to which the person has to face many health-related problems. Today the whole world is suffering from lifestyle disorders i.e., high blood pressure, Includes diabetes, heart disease, depression, etc. Till now no effective treatment of all these diseases is available with modern science, due to which we should avoid these diseases by following the rules of Ayurveda. In this article, we will get brief information about those Ayurveda rules from which these diseases can be avoided.


A 5½-year-old adopted girl was referred to us in view of short stature. After ruling out systemic illness, she was evaluated for growth hormone deficiency (GHD) by stimulation tests. The peak value was 3.47 ng/ml. She was then started on growth hormone (GH). At the end of 6 months of GH therapy, her height velocity was only 3 cm/year. There was a lack of attachment between the mother and the child. She had history of hyperphagia, stealing, and hoarding food. Psychiatry consultation confirmed that the child had appetite disorder, and hence was diagnosed as hyperphagic short stature (HSS). The girl and her parents are undergoing psychiatric therapy for the same. Psychosocial dwarfism seems to originate from serious disturbances in the mother–child relationship. These children mimic patients with GHD, but have poor response to GH therapy. This case underscores the importance of social environment in the growth of the individual.


We conducted a prospective cohort study of 306 HIV-1-infected women, followed from seroconversion for median 6.4 years in Uganda (UG) and Zimbabwe (ZM) to describe the incidence of major clinical outcomes (MCOs), defined as World Health Organization stage 4 conditions and any tuberculosis (TB). In Uganda, 19 MCOs occurred in 13 participants at median 4.6 years and a median CD4 count of 213 cells/mm3. In Zimbabwe, 29 MCOs occurred in 27 participants at median 4.0 years (P < 0.001 versus UG) and median CD4 count of 219 cells/mm3 (P = 0.83 versus UG). MCO incidence was not statistically different (UG: 2.82 cases/100 person-years versus ZM: 2.45; P = 0.64) except for TB (UG: 0.59 versus ZM: 2.02 cases/100 person-years; P = 0.02). This significant difference in TB incidence is primarily due to a TB screening and isoniazid prevention therapy programme that was implemented in Uganda, but not in Zimbabwe, highlighting the importance of integrated TB screening and treatment within HIV programmes.


Chronic myeloid leukaemia (CML) is a clonal hematopoietic stem cell disorder. The annual incidence of CML is 1.5 cases per 100,000 individuals. Multiple myeloma (MM) represents a malignant proliferation of plasma cells derived from a single clone. The co-occurrence of two rare malignancies CML and MM in the same patient is an extremely rare incident, and simultaneous diagnosis of CML and MM is reported in only five cases in the literature. A 75-year-old male presented with complaints of easy fatigability, loss of appetite and unquantified weight loss of four months' duration. On evaluation he was found to have normocytic normochromic anaemia, leucocytosis, elevated serum-calcium concentration and azotaemia. Peripheral blood for the BCR-ABL fusion gene product was positive by fluorescence in situ hybridisation (FISH). However, bone marrow biopsy revealed CD138 positive, 15% plasma cells. Thus the diagnosis of CML and MM was established. Although we can't be certain regarding the cause of CML and MM in our patient, the hypothesis that they evolved from common malignant pluripotent hematopoietic stem cells still holds. However, at the age of 75 years, it might be just due to chance.


In assessing the distributions of trace metals in aquatic environments as a prerequisite to any study of the variation of local toxic metal contamination over space and time, it is tempting to measure dissolved and/or sediment concentrations. A third and preferred alternative, however, is the measurement of accumulated trace metal concentrations in selected organisms, termed biomonitors. Such concentrations are high enough to be easily measured without significant risk of contamination. Most significantly, the accumulated concentrations are time-integrated relative measures of the amounts of metal that have been taken up into the organism via all uptake routes, by definition the bioavailable metal the ecologically significant ambient metal in a habitat given its potential for ecotoxicological effects. To be selected as a biomonitor, an aquatic organism must fulfil several characteristics, and importantly we need an understanding of its accumulation kinetics for a particular metal, as might be described for example by biodynamic modelling. It is preferable to use a suite of biomonitors to investigate the several possible metal sources (solution, suspended material, newly deposited or older sedimented material, etc.) in an aquatic habitat. The choice of this suite should ideally include cosmopolitan biomonitors for which a database of accumulated metal concentrations has been compiled, therefore allowing the identification of trace metal availabilities considered high on an international scale. A major caveat is the need to avoid interspecific comparisons of accumulated metal concentrations, given the wide variation in accumulation patterns between even relatively closely related taxa. Case studies are used to illustrate the principles of the biomonitoring of trace metals in estuarine and marine environments. Threshold accumulated trace metal concentrations in key biomonitors have the potential to be used as simple measures identifying the presence of ecotoxicologically significant trace metal pollution in a coastal habitat.


The performance of a control (CNTR) and information (INF) frame multiplexer which intermixes control and information traffic by accommodating the relatively short CNTR frames between two consecutive INF frames is investigated. It is shown that the delay performance of one class can be improved at the price of degrading the performance of the other. The delay performance of a transaction between two nodes of the communication subsystem can be improved by selecting the parameters of this multiplexer appropriately. The relative importance of CNTR and INF frame delays for a transaction is determined. The results of a simulation study give insight into the behavior of this multiplexer. Based on these results, it is concluded that if the control traffic intensity is high, or the relative importance of control delay is high, then larger values of gap length improve the performance.


Childbirth is one of hardest, parts of Pregnancy and realizing the vision of having a child. The goal of the current study was to explore the mother's experience of child birth. Quantitative approach is implicated in the study which uses an hermeneutic phenomenology based on Van Manen's method. The twelve mother included in the study, who had normal process of child birth by using purposive sampling. Data were collected using 'semi structure interviews'. The thematic analysis followed the method as suggested by Max Van Manen for isolating themes. Seven themes emerged i.e Reasons for choosing this hospital, difficulties faced during admission, care received during labour, information provided regarding the progress of labour , problem faced in labour room, support in labour room and initiation of breast feeding. The findings illuminate the meaning of childbirth as experienced by mother and highlight the need for its management. The generated knowledge can be used by the health care professionals to develop the policy involving male partner actively in child birth process.


Increasing the dose rate offers time saving for IMRT delivery but the dosimetric accuracy is a concern, especially in the case of treating a moving target. The objective of this work is to determine the effect of dose rate associated with organ motion and gated treatment using step-and-shoot IMRT delivery. Both measurements and analytical simulation on clinical plans are performed to study the dosimetric differences between high dose rate and low dose rate gated IMRT step-and-shoot delivery. Various sites of IMRT plans for liver, lung, pancreas, and breast cancers were delivered to a custom-made motorized phantom, which simulated sinusoidal movement. Repeated measurements were taken for gated and nongated delivery with different gating settings and three dose rates, 100, 500, and 1000 MU/min using ion chambers and extended dose range films. For the study of the residual motion effect for individual segment dose and composite dose of IMRT plans, our measurements with 30%-60% phase gating and without gating for various dose rates were compared. A small but clinically acceptable difference in delivered dose was observed between 1000, 500, and 100 MU/min at 30%-60% phase gating. A simulation is presented, which can be used for predicting dose profiles for patient cases in the presence of motion and gating to confirm that IMRT step-and-shoot delivery with gating for 1000 MU/min are not much different from 500 MU/min. Based on the authors sample plan analyses, our preliminary results suggest that using 1000 MU/Min dose rate is dosimetrically accurate and efficient for IMRT treatment delivery with gating. Nonetheless, for the concern of patient care and safety, a patient specific QA should be performed as usual for IMRT plans for high dose rate deliveries.


The Scophony scanner uses the same optical elements as the more familiar flying spot scanner: a rotating polygon mirror, an acoustooptic (A/0) modulator, and a laser light source. The flying spot scanner is designed to construct its image a pixel at a time; no more than one pixel is illuminated at any given instant. The Scophony scanner is designed to image a broad swath of the A/0 modulator's acoustic pulses onto the photoreceptor. Many pixels are illuminated at any given instant in the Scophony scanner. The acoustic pulse image motion is frozen in place by a compensating scanning action. The result is a scanner with a coherent imaging response. This coherent response implies that the optical phase of a given pixel profoundly influences the formation of neighboring pixels. The optical phase at the scanner image plane is driven by the electronic phase of the video signal applied to the A/0 modulator. This coherent response enables electronic manipulation of the video drive signal to have significant impact on the optical imaging performance of the scanner. Two electronic manipulation schemes are proposed for doubling the resolution of the Scophony scanner, one scheme for analog video signals, and one scheme for binary digital video signals. Each scheme gives superior contrast ratio performance compared with the flying spot scanner.


Azo dyes pollution has attracted a major environmental concern due to their color and toxicity. In this study, we investigated a biocatalyzed electrolysis system (BES) with a bio-cathode seeding with enriched inoculum for the decolorization of a model azo dye, alizarin yellow R (AYR). The bio-cathode was inoculated with AYR autotrophic biodegrading consortium. Batch test results showed that the decolorization efficiency (DE) of AYR (100mg/L) reached to 93.2% within 58 hours with 0.5V power supplied and NaHCO3 (840 mg/L) as sole carbon source. Lower DEs of 83.5% and 70.7% were respectively observed in abiotic cathode BESs and bio-cathode BESs inoculated with mixed sludge. The result indicated that the enriched inoculum had a significant effect on the cathode performance. The azo bond cleavage of AYR resulted in the formation of p-phenylenediamine, p-nitraniline and 5-aminosalicylic acid. The decolorization efficiency was further enhanced under the optimized condition of pH (5.2), power supplied (0.5V) and initial AYR concentration (100mg/L), reaching up to 99.2 % within 48 hours with the bio-cathode BESs seeding with the enriched inoculum.


: This paper presents an improved predictive control of an induction machine fed by a matrix converter using N-switching vectors as the control action during a complete sampling period of the controller. The conventional model predictive control scheme based matrix converter uses a single switching vector over the same period which introduces high torque ripple. The proposed switching scheme for a matrix converter based model predictive control of an induction machine drive selects the appropriate switching vectors for control of electromagnetic torque with small variations of the stator flux. The proposed method can reduce the ripple of the electrical variables by selecting the switching state as well as the method used in the space vector modulation techniques. Simulation results are presented to verify the effectiveness of the improved predictive control strategy for induction machine fed by a matrix converter.


This study concerns the detection and treatment of recurrence after operation for colo-rectal cancer. The recurrences were classified as being in the suture line, peri-colonic, pelvic or distant metastasis. The factors which determine the appearance of recurrence depend on the tumour (development of the tumour and degree of anaplasia), the surgical technique (removal of the metastatic pathway and techniques intended to prevent the implantation of migrating tumour cells) and the patient (age, immunological factors, etc.). Our survey for the detection of recurrence consists of history and clinical examination of the patient, colonoscopy, carcino-embryonic antigen, routine laboratory tests, liver scan and/or ultrasonography, chest X-ray computerised tomography and, in a few special cases, lymphography; arteriography, etc. This group of investigations constitutes a surveillance protocol which should be performed regularly. We present the results of 443 follow-up surveys in 100 patients operated for colorectal cancer.


BACKGROUND
Studies in our laboratory have shown that transforming growth factor beta (TGF beta) induces rodent lens epithelial cells to undergo aberrant growth and differentiation that reproduces morphological and molecular features of human anterior subcapsular cataract and posterior capsule opacification. In addition, features of apoptosis have been described in some forms of human cataract. In the present study we investigated apoptotic changes induced by TGF beta in our rodent models.

METHODS
Lens epithelial explants and whole lenses from rats were cultured with TGF beta. Morphological analysis and TUNEL were used to detect apoptotic changes. Transgenic mice expressing a self-activating form of human TGF beta 1 in the lens were included in the analysis.

RESULTS
TGF beta-induced cell loss in epithelial explants coincided with increased numbers of pyknotic nuclei. Some of these nuclei were TUNEL-positive. Studies on lenses cultured with TGF beta and lenses from transgenic mice showed that the subcapsular plaques that developed contained pyknotic nuclei and that many of these were TUNEL-positive.

DISCUSSION
This study shows that cells develop morphological and molecular features of apoptosis in TGF beta-induced cataract models. This confirms that apoptosis can be included as another TGF beta-induced cellular change that mimics events in human cataract.


In this communication, 3D hierarchical SnO2@Si nanowire arrays on carbon cloth are synthesized by a combination of the chemical vapour deposition (CVD) method for SnO2 nanowires and a subsequent Si thin film coating with a plasma-enhanced CVD (PE-CVD) route. The as-prepared SnO2@Si nanowire arrays are further tested as a flexible and binder-free anode for Li ion batteries. A high areal capacity (e.g. 2.13 mA h cm−2 at a current density of 0.38 mA cm−2) and good cycling performance are demonstrated for the core–shell SnO2@Si nanowire/carbon cloth electrode, which could be attributed to the 3D structural design and a synergistic effect between Si and SnO2.


Location-based services (LBS) are those applications that utilize the position of an end-user, animal or thing based on a given device (handheld, wearable, interwoven into fabric or implanted), executed for a particular purpose. LBS applications range from those that are mission-critical to those that are used for convenience, from those that are mandatory to those that are voluntary, from those that are targeted at the mass market to those that cater for the needs of a niche market. Location services can be implemented using a variety of access mediums including global positioning systems and radio-frequency identification, rendering approximate or precise position details. The introduction of location-based services, which are growing in sophistication and complexity, has brought with it a great deal of uncertainty. Unaddressed topics include: who is accountable for the accuracy and availability of location information, prioritization for location frequency reporting, the user's freedom to opt-in and opt-out of services, caregiver and guardian rights and responsibilities, the transparency of transactions, the duration of location information storage. Some of these controversies are the focus of court cases across the United States, usually between service providers and disgruntled end-users or law enforcement agencies and suspected criminals. While we can wait for the courts to set precedence and then take legislative action to learn about how we should act and what we should accept as morally right or wrong, this is only a small part in considering the emerging ethics of an innovation such as location-based services. Laws, similar to global technical standards take a long time to enact. A more holistic approach is required to analyze technology and social implications. This paper uses scenarios in the form of short stories to summarize and draw out, the likely issues that will arise from widespread adoption of LBS. It is a plausible future scenario, grounded in the realism of today's technological capabilities.


Purpose To assess efficacy and safety of the combination of angle-supported phakic intraocular lenses (IOLs) and photorefractive keratectomy (PRK) for the correction of myopia and astigmatism. Methods Prospective, non-randomized single-surgeon study on 48 patients (76 eyes) undergoing angle-supported phakic IOL implantation with surgical peripheral iridectomy, followed 2 to 3 months later by PRK to correct residual refractive error. Twenty-three patients (33 eyes) achieved good uncorrected visual acuity with IOL implantation alone and did not undergo PRK. Thus, the study was completed by 25 patients (43 eyes) with preoperative mean defocus equivalent (DEQ) of 15.73 D (SD 4.67 D) and mean astigmatism of −2.87 D (SD 1.39 D). Results Eight months after PRK, mean spherical equivalent was −0.08. Mean DEQ was 0.47 D (SD 0.37); 42/43 eyes (98%) were within ±1 D of DEQ, and 33/43 eyes (77%) within ±0.5 D. Mean uncorrected visual acuity was 0.7 (SD 1.9). Safety index was 1.25; efficacy index 1.11. Best-corrected visual acuity improvement (0.16) was statistically significant (95% CI: 1.1 to 2). Halos were moderate in 6/25 patients (24%); severe in 1/25 patients (4%). Endothelial cell density decreased by −6.6%. Pain after PRK was severe in 3/25 patients (12%) and moderate in 13/25 patients (52%). Complications were recurrent iridocyclitis in one eye, transient ocular hypertension in two eyes, and incomplete iridectomy in one eye. Conclusions Angle-supported phakic IOLs followed by adjustment by PRK offer good efficacy, predictability, and safety to manage large refractive myopic errors.


Several common issues are encountered by countries - Germany, Japan, and the United States - that adopted long-term care (LTC) system. First, the demand for LTC and its associated costs have steeply risen following the implementation of the LTC policy. Second, ensuring the quality of services have been difficult. Third, the coordination of services among providers and between LTC and medical care has been inadequate. Learning from their experience, we suggest ways to improve the LTC system in Korea. The basic approach aims for efficiency over equity in the system. This would require promoting provider competition and consumer choice. We propose several policy options according to the major stakeholders. For consumers, cash benefits at fixed rates and personal savings accounts are feasible options to self-contain the demand and cost of services. On the insurer`s side, creating an environment of multiple insurers will engender competition, leading to cost savings and quality care. For providers, delivery of quality services through competition, cost-containment through capitated reimbursements, and coordination of services through integrated delivery system can be achieved. From the assessors` perspective, establishing an information system to monitor the activities of insurers and providers would be important, empowering consumers with information to choose cost-effective service providers. In summary, the suggested approach would provide cost-effective LTC services by guaranteeing consumer choice and promoting major stakeholder accountability. Further studies are needed to test the feasibility of this model in ensuring quality LTC in Korea.


Introduction AVR in patients with calcified aortic valve stenosis relieves the left ventricle from pressure overload. Yet, congestive heart failure (CHF) is one of the complications observed, even years after the operation. The main questions are: why do patients still develop CHF? Which types of CHF can be expected? Which predictors are known? Discussion It has become clear that decrease in ejection fraction, which is the most commonly used parameter, occurs late in the course of aortic valve stenosis, when damage to the left ventricle has already been inflicted on this cardiac cavity. Several more sensitive imaging and Doppler parameters can demonstrate this damage earlier in the course of CAVS. This damage proves to be irreversible, at least in part. This explains the appearance of heart failure after aortic valve replacement. Although this type of heart failure is "diastolic" in nature", a continuum with the systolic type probably exists, at least in patients with aortic valve stenosis. Conclusions Damage to the left ventricle in patients with aortic valve stenosis can go unnoticed if only ejection fraction is used as parameter. Detection of more subtle changes, even in asymptomatic patients with severe aortic valve stenosis might lead to early replacement and hence less postoperative heart failure.


The Toxicologist as Expert Witness is a primer for toxicologists new to expert testimony and consulting. An expert toxicologist may serve in a variety of civil, criminal and regulatory capacities. The author discusses the academic credentials and personality traits that make an effective witness. The toxicologist must be familiar with legal and scientific concepts such as burden of proof, causality and risk. An expert may be retained to serve a variety of disparate functions, everything from consultation to research and investigation. Experts must be capable of explaining complex scientific issues in everyday language. Advice for effective communication during deposition and testimony is included. The witness must be prepared to have their professional judgement, academic history, publications and previous testimony scrutinized by opposing counsel and the experts that they have retained. The spectrum of legal proceedings, from deposition to trial, is described in detail so that even a novice will be completely prepared for the often adversarial legal process. Finally, the chapter addresses practical concerns such as fee structures, professional reputation, ethical obligations and marketing.

Keywords:

expert;
testimony;
burden of proof;
causality;
toxic tort;
admissibility test;
litigation;
forensics