Non-alcoholic fatty liver disease (NAFLD) is a broad spectrum liver disorder diagnosed in patients without a history of alcohol abuse. NAFLD is growing at alarming rates worldwide. Its pathogenesis is complex and incompletely understood. The cystathionine-β-synthase (CBS) and cystathionine-γ-lyase (CSE) system regulates homocysteine and cysteine metabolism and contributes to endogenous hydrogen sulfide (H2S) biosynthesis. This review summarizes our current understanding of the hepatic CBS/CSE system, and for the first time, positions this system as a potential therapeutic target in NAFLD. As will be discussed, the CBS/CSE system is highly expressed and active in the liver. Its dysregulation, presenting as alterations in circulating homocysteine and (or) H2S levels, has been reported in NAFLD patients and in NAFLD-associated co-morbidities such as obesity and type 2 diabetes. Intricate links between the CBS/CSE system and a number of metabolic and stress related molecular mediators have also emerged. Various dysfunctions in the hepatic CBS/CSE system have been reported in animal models representative of each NAFLD spectrum. It is anticipated that a newfound appreciation for the hepatic CBS/CSE system will emerge that will improve our understanding of NAFLD pathogenesis, and give rise to new prospective targets for management of this disorder.


The relation between gene body methylation and gene function remains elusive. Yet, our understanding of this relationship can contribute significant knowledge on how and why organisms target specific gene bodies for methylation. Here, we studied gene body methylation patterns in two Daphnia species. We observed both highly methylated genes and genes devoid of methylation in a background of low global methylation levels. A small but highly significant number of genes was highly methylated in both species. Remarkably, functional analyses indicate that variation in methylation within and between Daphnia species is primarily targeted to small gene families whereas large gene families tend to lack variation. The degree of sequence similarity could not explain the observed pattern. Furthermore, a significant negative correlation between gene family size and the degree of methylation suggests that gene body methylation may help regulate gene family expansion and functional diversification of gene families leading to phenotypic variation.


[reaction: see text] The ratio of observed rate constants, k/k', for thermal isomerizations of cis-bicyclo[4.2.0]oct-7-ene and its 2,2,5,5-d(4) analogue to cis,cis-1,3-cyclooctadienes at 250 degrees C is 1.17, indicative of a secondary, not a primary, deuterium kinetic isotope effect. The reaction does not occur through a [1,5] hydrogen shift from the transient cis,trans-1,3-cyclooctadiene intermediate to form the observed cis,cis-diene product.


The President of Iceland was in China during May 16th to 22nd. Coming along with him was a large trade delegation of 200 people from 106 Icelandic companies. Great interest was shown to China, this big market with much potential.Let's hear how the Ambassador of Iceland to China see this.


From June 21 to June 26, 2009, the Dagstuhl Seminar 09261 on Models and Algorithms for Optimization in Logistics was held in the International Conference and Research Center (IBFI),
Schloss Dagstuhl. During the seminar, several participants presented
their current research, and ongoing work and open problems were discussed. Abstracts of the presentations given during the seminar as well
as abstracts of seminar results and ideas are put together in this paper.
The first section describes the seminar topics and goals in general. Links
to extended abstracts or full papers are provided, if available.


To neutralize the waste pickling solutions and rinsing water, resulting from cleaning metal products s surface of rust by acids solutions, lime is used. Being cheap, this method of sewage neutralization has considerable drawbacks. Forming in the technological pipes strong gypsum depositions and low specific productivity of the equipment for sediment dewatering are most significant of them. Characteristic of aggressive industrial sewage, formed at pickling of ferrous metals presented. Methods of elimination of drawbacks of industrial sewage neutralization by lime considered, including stabilization of neutralized industrial sewage and control of properties of the sediment formed. It was noted, that stability of the circulating water can be provided by accelerating of crystallization of the forming gypsum sediments by introducing in it fine priming powder and heating the neutralized water up to 65-70 °С followed by thermal softening of a part of circulating water, removed out of the circulating system. It was shown, that the heating of the water and the ongoing changes of the composition and properties of the sediment result in decrease of filtration resistance 2-3 folds, increase of deposition speed 3-4 folds and decrease the sediment volume 1.5-2 folds comparing with lime neutralization in cold water. Calculated dozes of lime at the heating were taken the same as at the regular lime neutralization. Elimination of the circulating water oversaturation by bi-water gypsum can be reached also by addition into the water of powder-like gypsum pulp - priming powder for microcrystals of the gypsum, followed by aeration during 30-40 min. This method was tested under industrial conditions. Technological properties of the forming sediment can be improved by sediment treatment by flocculants and preliminary heating of the neutralized water up to 65-70 °С. Control of technological properties of the sediment is done by addition of flocculants and heating of the neutralized water. Recommendations for improving operation of the neutralization facilities presented with indicating particular technological parameters of the equipment operation for sewage and sediment treatment.


Recent research has shown the value of social metrics for defect prediction. Yet many repositories lack the information required for a social analysis. So, what other means exist to infer how developers interact around their code? One option is static code metrics that have already demonstrated their usefulness in analyzing change in evolving software systems. But do they also help in defect prediction? To address this question we selected a set of static code metrics to determine what classes are most "active" (i.e., the classes where the developers spend much time interacting with each other's design and implementation decisions) in 33 open-source Java systems that lack details about individual developers. In particular, we assessed the merit of these activity-centric measures in the context of "inspection optimization" — a technique that allows for reading the fewest lines of code in order to find the most defects. For the task of inspection optimization these activity measures perform as well as (usually, within 4%) a theoretical upper bound on the performance of any set of measures. As a result, we argue that activity-centric static code metrics are an excellent predictor for defects.


Literacy in a small, rural, newly literate Papua New Guinean village is analysed by placing it in the context of local notions of Christianity, the self and language. Villagers' interpretations of the relationship between Catholicism and the written word are based on their Cargo-oriented world-view and on their pre-Christian beliefs about language as a powerful means by which individuals could bring about transformations in their world. Local ideas of the self and others are articulated and reinforced through an emphasis on particular dimensions of oral language use. This emphasis has consequences for the uses to which literacy is put, the structure of the writing the villagers produce, and the ways in which they attribute meaning to written texts.


As noted by many scholars, the Wisdom of Solomon contains elements typical of both Greek and Hebrew literature. Numerous studies list specific Greek figures in the book, often making only passing reference to the Hebrew poetic features, referring to them with the single term parallelismus membrorum. But, Wisdom's form is a good deal more complex than these synopses suggest. Parallelism is realized in a number of ways in the Hebrew scriptures and its manifestation in this apocryphal book is a unique combination of different patterns. The present study aims at a detailed description of Wisdom's structure through a close study of the parallelism and verse length of the book's first 15 verses, and through a comparison of these patterns with those in Hebrew poems.


The aim of this research was to find out whether there was a significant difference of students' writing achievement before and after being taught through students' multiple intelligences. The sample of the research was eleventh grade students of Islamic high school in Sekayu, Musi Banyuasin, South Sumatera. The research was conducted by applying quasi experimental in terms of pretest – posttest non- equivalent group design. The sample of this research was 62 science students. The Mean of posttest's score was higher than pre-test. It means that there is an increase of students' writing achievement after being taught through their multiple intelligences.


Language learner strategies, which are closely associated with second language teaching, have experienced great devel?opment in the fields of theory-building and instructional practices since the 1970s. By reviewing previous research, pedagogical enlightenments can be drawn to the current English language teaching.


Abstract Financial inclusion basically indicates the availability of banking services at a reasonable cost to the low income and disadvantaged groups. Thus, financial inclusion is having a savings or current account with any bank. Financial inclusion is an essential driver to accomplish financial development. Therefore, for economic development, there should be enough flow of financial and credit facilities. But this is not possible until and unless financial literacy is achieved in this respect. Financial literacy is the key to the development of financial inclusion in India. In this backdrop, the present study is an attempt to examine the financial literacy initiatives that are taken in the Indian context.Financial inclusion is an important step to reduce poverty in India. Despite significant progress made in financial inclusion through the implementation of various financial literacy initiatives, banks are still fighting to fulfill the dream of 100% financial inclusion.To turn the dream of 100% financial inclusion into reality, the rural poor should get basic education from NGOs/SHGs/etc. about the several benefits of financial products and services offered by the banks and post offices. This will go a long way to tap the untapped potential among the rural poor of our country. Key Words: Financial Inclusion, Financial Literacy, Financial Literacy Centres, National Centre for Financial Education. Cite this Article Sudipta Ghosh. Financial Inclusion Through Financial Literacy: Some Recent Initiatives in India. E-Commerce for Future & Trends . 2019; 6(2): 30–33p


Professional skepticism is considered an essential component of audit quality. Consequently, research has focused on ways to increase skepticism by identifying factors that either limit or encourage its practice. However, research has yet to explore potential negative consequences of professional skepticism. We conduct two experiments to investigate if high levels of skepticism create ill will in audit clients, and how ill will affects the auditor-client relationship and audit quality. In the first experiment, we find that high skepticism creates ill will in the client, which increases the likelihood the client recommends switching auditors and decreases the amount of evidence provided to the auditor. We find that auditors can ingratiate themselves with the client as an intervention to decrease the development of ill will and mitigate its adverse effects. In our second experiment, we examine if client pressure to persuade the auditor of their accounting position mitigates the relationship between high skepticism and ill will. We find an interaction such that if the evidence does not support the accounting treatment the client recommends, a high level of auditor skepticism does not cause clients to experience as much ill will toward the auditor. We contribute to the literature by investigating a new empirical construct, client ill will, and developing a more nuanced perspective of the interactions between auditors and their clients.


The dependence of the minimum initial electron density necessary to form a volumetric discharge in a high-pressure CO2 laser on the pressure has been estimated. The electron density produced by a sliding discharge at pressures up to 8 atm has been measured. The measured electron density is higher than the minimum value of the initial electron density. The frequency of the channels in a multi-channel sliding discharge at high pressure has also been investigated.


ABSTRACT Links between gun enthusiasm, hypermasculinity, manhood honor maintenance, trait antagonism, and lifetime aggression were examined in this national sample of American men (N = 861). Regression analysis identified honor ideology for manhood and emotion devaluation as the factors that accounted best for gun enthusiasm. Large effect sizes (d > .70 in more than half of the contrasts) were found between cohorts harboring extreme positive versus negative gun attitudes. Gun owners (26.7% of sample) also showed elevations in most of these same trait dimensions, but not lifetime aggression. Gun owners and enthusiasts did not show evidence of childhood maltreatment or current emotional distress. Gun enthusiasts instead seemed to convey a sense of self-assurance and preparedness to respond aggressively to perceived affronts, particularly as they pertained to maintenance of their masculine ideals.


Summary

The encapsulated wasabi flavour prepared from 100% modified starch (HICAP™ 100), HICAP™ 100: maltodextrin (1:1), HICAP™ 100:CAPSUL (1:1) at various flavouring agent concentrations (10, 15 or 20% w/w) was determined for physicochemical properties. All encapsulated treatments were stored at various relative humidity (RH) levels (11%, 33% and 52% RH) and intervally evaluated for encapsulation efficiency (EE) during 60 days of storage. Microcapsules of 20% wasabi flavour derived from the mixture of HICAP™ 100 with maltodextrin and HICAP™ 100 with CAPSUL demonstrated excellent properties including low moisture content, acceptable flowing properties, surface appearance and EE. The release rate of encapsulated flavour increased as the RH increased for most encapsulated treatments. A difference-from-control test was conducted to evaluate the magnitude of wasabi-flavour retention added in the canned tuna spread. The intensity of wasabi-flavour retention in the canned tuna spread with encapsulated flavour agents added was higher than that of the samples without flavour encapsulation.


Summary The toxic lectin abrin increased the survival time of mice inoculated with Ehrlich ascites cells by 43 to 93% and that of mice carrying B16 melanoma by 36%. The best results were obtained when several doses were given. The growth of Lewis lung carcinoma was retarded in abrin-treated mice, but the animals did not survive longer than did untreated animals. Ricin reduced the formation of ascites but increased survival only by 29%. HeLa cells, baby hamster kidney cells, and abrin-resistant variants obtained from these lines all formed solid tumors after injection into nude mice. When the animals were treated i.v. with abrin, tumors derived from parent cell lines sensitive to abrin in vitro were inhibited in their growth, whereas tumors derived from the abrin-resistant variants were unaffected. The data indicate (a) that when the cell lines grow as tumors in nude mice they retain their characteristic sensitivity to abrin and (b) that the inhibition of tumor growth is caused by the action of abrin on the tumor cells as such. Human cancer tissue from a fibrosarcoma humeri, an ovarian carcinoma, an ovarian sarcoma, a melanoma, and an Ewing9s sarcoma was transplanted s.c. into nude mice. When the transplanted tumors had reached an easily measurable size, some of the animals were treated with abrin (3 to 5 injections) or with other cytostatics. In all cases abrin in doses well tolerated by the mice had a strong inhibitory effect on the tumor growth. Abrin and ricin, even when given in nearly lethal doses, did not depress the level of peripheral leukocytes. The finding that abrin and ricin inhibits growth like a number of cytostatics in common clinical use suggests that abrin and ricin may be useful, particularly in combination therapy and under conditions when bone marrow depression rules out further treatment with other cytostatic agents. The data also indicate that studies in nude mice may be of value in assessing the sensitivity of human tumors to cytotoxic agents.


Despite saliva being one fluid with growing interest as a source of biomarkers, both in humans and animal models, f ew studies have been reported that use proteomic approaches for canine saliva analyses. Two-dimensional electrophoresis (2-DE) is considerably used in biomarkers research and their use for dog saliva study may had relevant knowledge about pathology/physiology. The quality of the results obtained using 2-DE greatly depends on sample preparation. Different protein precipitation methods are frequently used for removing interfering compounds and concentrating samples, but their efficiency varies according to sample characteristics.  For dog saliva samples no information was found about the best precipitant and precipitation method for electrophoretic protein profiling. In this study, six different protein precipitation methods were compared. Precipitation of dog salivary proteins with trichloroacetic acid 20% (w/v) resulted in lower protein recovery rate than other methods tested, but allowed protein profiles highly correlated with the ones from original samples. Moreover, this protocol resulted in good protein separation in 2-DE, with the visualization of spots from salivary proteins not observed when samples were treated using other methods. Based on this, we propose the use of TCA for dog saliva whenever precipitation is needed for protein profile analysis.


This article introduces the combined application of vacuum sealing drainage (VSD) and chymotrypsin in the treatment of post-operative mandibular osteomyelitis. The lesion was washed by chymotrypsin (4000U) and saline (500 ml). VSD is effective in the treatment of traumatic mandibular osteomyelitis. This study investigates the effect of VSD combined with chymotrypsin in the treatment of patients with osteomyelitis after mandibular trauma. It is proved that it has a good effect in ensuring drainage, controlling infection and retaining internal fixation, and can create a good environment for fracture healing.


In the intact organism environmental disturbances affecting the circulation often result in simultaneous changes of several groups of peripheral afferents. These elicit characteristic patterns of autonomic activity with distinctive patterns of vagal activity, of regional sympathetic neural activity and of adrenal catecholamine secretion. During simultaneous changes in several groups of afferents the autonomic responses are often non-linear, with the response to one input markedly influenced by the level of the others. When these non-linear interactions involve the central arterial baroreflex pathways the properties of the body's blood pressure system can become greatly altered. With certain combinations of afferents these interactions make it possible for the organism to better withstand large perturbations than it could do through the normal properties of the arterial baroreceptor reflex. The different neuron groups contributing to the CNS autonomic pathways release many different transmitters including noradrenaline or serotonin and changes in reflex properties result from alterations in transmitter release in one or other of the pathways of the particular network. The peripheral arterial baroreceptors become rapidly reset during sustained alterations in blood pressure. Their 'memory' for any given absolute blood pressure is only a few minutes duration. Hence sustained changes in autonomic activity depend on the properties of the CNS either through signals arising from other groups of peripheral receptors, from central 'command' or owing to changes in transmitter release in a given pathway.


AS SCIENTIFIC knowledge has expanded with regard to nutrition, fluid and electrolyte balance, blood volume, and shock, the variety and magnitude of surgical procedures which may be successfully tolerated by patients in the poor-risk category have steadily increased. In recent years our surgical therapeutic efforts have been enhanced by new knowledge gained from defining biologic processes at the cellular and molecular level, thereby enabling us to understand and control physiologic homeostasis on a more sophisticated basis. The eventual outcome following any form of injury, including surgical operations, is directly dependent upon an ability to detect and correct alterations at both macrotissue levels (gross hemorrhage, wound infection, fractures) and microcellular levels (capillary flow, transcellular ion exchange, enzyme activity). The biologic function of magnesium and the trace elements lies at these levels. The physiologic significance of magnesium and zinc is somewhat different than sodium, potassium, and perhaps even calcium, and lies in


The paper considers how new technologies and standards are emerging that are set to have a dramatic effect on the design and implementation of industrial control systems. These technologies will reduce the time to bring new systems on stream, and leverage the integration of business and industrial systems. The fusion of distributed object technology, with function blocks as defined in the new IEC standard 1499, will allow distributed industrial control systems to be created by the interconnection of software components.


Key management poses a main concern for security operation in sensor network. Most existing key management schemes try to establish shared keys for all pairs of neighbor sensors, no matter whether these nodes communicate with each other or not, and causes large overhead. Recent trend of research mainly consider homogeneous sensor network and a few consider heterogeneous sensor network for key management. In this paper, we consider heterogeneous sensor network (HSN) as a model for our proposed novel key agreement protocol based on pairing identity based encryption (IBE). The proposed scheme reduces the key spaces of the nodes, in fact nodes do not need to store any key of the other nodes rather it computes secret sharing key by using pairing and IBE properties. Security analysis shows, it also robust against different attacks such as replay attack, masquerade attack, and integrity attack.


Accepted, March 6, 2002. OBJECTIVE: The anterior lumbar interbody fusion (ALIF) procedure has become an accepted fusion technique for treating patients with degenerative disorders of the lumbar spine. Many consider laparoscopic ALIF to be the least invasive approach. A modification of the open laparotomy—the "mini-open" approach—is an attractive alternative. In this retrospective review, a comparison of these two ALIF approaches is presented. METHODS: We conducted a retrospective review of 98 patients who underwent ALIF procedures between 1996 and 2001 in which either a mini-open or a laparoscopic approach was used. Patient demographics, intraoperative parameters, length of hospitalization, and technique-related complications associated with the use of these two approaches were compared. The subset of patients who underwent L5–S1 ALIF procedures was analyzed separately. Statistical analysis was conducted with 2 and Student's paired t tests. RESULTS: Between 1996 and 2001, a total of 98 patients underwent ALIF. A laparoscopic approach was used in 47 of these patients, and the mini-open technique was used in the other 51 patients. Operative preparation and procedure time were longer with the use of a laparoscopic approach, and significantly greater during L5–S1 ALIF procedures (P 0.05). A marginal but significant increase in length of stay was observed after mini-open ALIF procedures (P 0.05). The immediate postoperative complication rate was greater after mini-open ALIF procedures, 17.6 versus 4.3% (P 0.05); however, the rate of retrograde ejaculation was higher in the laparoscopic group, 45 versus 6% (P 0.05). CONCLUSION: Both the laparoscopic and mini-open techniques are effective approaches to use when performing ALIF procedures. On the basis of the data obtained in this retrospective review, the laparoscopic approach does not seem to have a definitive advantage over the mini-open exposure, particularly in an L5–S1 ALIF procedure. In our opinion, the mini-open approach possesses a number of theoretical advantages; however, the individual surgeon's preference ultimately is likely to be the dictating factor.


The kinetics of oxidation of piperazine and its derivatives, 1-methylpiperazine and 1-ethylpiperazine, by N-sodio-N-bromobenzenesulfonamide or bromamine-B (BAB) in pH 4.0 buffer has been investigated at 303K. The reaction rate shows a first-order each on [BAB]0, and [Piperazine]0, and an inverse fractional-order dependence on[H+]. Additions of reaction product, benzenesulfonamide, or bromide ions and the variation of ionic strength of the medium have no influence on the reaction rate. The reaction has been studied at different temperatures and activation parameters have been calculated. A general mechanism consistent with the preceding kinetic data has been proposed and the rate law derived. The protonation constants of piperazine and its substituted derivatives have been evaluated. The Hammett correlation of substituent effect shows a linear free energy relationship with i² = -0.75 indicating that electron donating centers enhance the rate of reaction. An isokinetic temperature of i¢ = 393 K indicates that enthalpy factors control the reaction rate.


FeSr2YCu2O6+δ compounds with various oxygen contents, 6 + δ = 7.02 ∼ 7.55 and FeSr2Y(Cu0.95Zn0.05)2O7.55 compound were synthesized and studied by the magnetization measurement. FeSr2YCu2O7.55 compound shows superconductivity below TC = 56 K and a broad peak at 20 K, which corresponds to the magnetic ordering of Fe ion, in the magnetization measurement. The Curie constants and the asymptotic Curie temperature strongly depend on the oxygen content. Increasing the oxygen contents, the Curie constants and the absolute values of the asymptotic Curie temperature are increased. Since the asymptotic Curie temperature is negative value, the interaction between Fe ions is mainly antiferromagnetic. A hysteresis is observed in the magnetization curve of non-superconducting FeSr2Y(Cu0.95Zn0.05)2O7.55 compound. It implies that the magnetism of Fe ion is not simple antiferromagnetism.


A new adaptive steganography method based on image contrast to improve the embedding capacity and imperceptibility of the stego images is presented. The method exploits the average difference between the gray level values of the pixels in 2×2 blocks of non-overlapping spatially and their mean gray level in order to select valid blocks for embedding. The method was tested on different gray scale images. Results show that our proposed approach provides larger embedding capacity, while being less detectable by steganalysis methods such as χ2 attack and machine learning steganalysis systems, as compared to some well-known adaptive and non-adaptive steganography algorithms.


IN Dr. Barrs's paper in the BRITISH MEDICAL JOURNAL of March 12th some theories have been advanced which are not considered orthodox and, if true, will disturb the lines of treatment recognised by our best, with some notable exceptions, clinical observers. It is not my intention to discuss Dr. Barrs's able paper in its entirety, but I should wish to argue from clinical experience, as Dr. Barrs does, against some of the points which he has advanced. First, I would point out that there is little or no comparison between the action of the aortic valve and that of the mitral. The strain on the former is, during diastole, much heavier, and more sudden and accentuated, than on the latter during systole. In other words, the closure of the aortic valve is akin to the slamming of a door, the strain commencing from the very moment at which systole ceases, whilst the apposition of the mitral folds is a gradual process, tension on the curtains to any marked extent occurring only at the end of ventricular systole, and is momentary only. And this seems to be more than emphasised by the existence in some of the lower animals not only of one tier but of several tiers of cusps in the aorta to withstand the rebound on the column of blood. The avoirdupois of about the equivalent to 6 inches of mercury has to be considered in the aortic valve, and this is supported not only by the cusps themselves, but as Savory has shown (and notwithstanding the tendency of modern physiology to disturb previously-accepted doctrines, this observation still seems to remain true), by the ventricle muscle itself. There is no such mechanism in the mitral valve, and therefore the incompetence of the two valves rests, to my way of thinking, on totally different physical bases. In the one it is always serious and alarming, in the other it may be, and frequently is, attended by only trivial inconvenience. As Dr. Barrs admits, the danger in aortic incompetence exists from " sudden or gradual "-sudden rather than gladual-"failure of the left ventricle," a failure which, perhaps, is enhanced by a hitherto compensatory hypertrophy expelling a wave of blood with more power than normal into vessels of low tension, and the return of this volume must be accommodated not so much by " hypersystole " as by hyperdiastole of the left ventricle. For here, after all, is the rub. Undoubtedly digitalis increases the length of ventricular diastolic period. The heart, slowed by a course of large doses of digitalis, no longer repeats " one-two, onetwo; " its muscular apparatus, after a more vigorous contraction, is slower in relaxing, and the sounds are converted into "one-two-o-o, one-two-o-o." Let anyone compare the sharp, short aortic obstructive bruit with the long sighing murmur like the noise of a distant blast furnace, and the difference will appear at once; and if this characteristic be further accentuated by digitalis, it is easy to see the risk of the drug. But there are some cases of aortic incompetence in which digitalis may be given with advantage. Dr. Barrs speaks of cases of " uncomplicated double aortic disease which have been under his treatment for breathlessness interfering with work." It is within my experience that breathlessness is a more marked symptom in simple aortic regurgitation than when that condition is complicated by mitral insufficiency. But it is precisely in these latter cases, when cardiac failure begins to develop, that digitalis is of service. So long as the mitral regurgitation is present so as to allow of a " safety 'valve" overflow digitalis may be given with advantage and with safety. In the cases where there is aortic insufficiency alone the ventricle has to bear the strain of the return pressure; but given mitral incompetence in addition the overdistended ventricle is relieved by an expansile auricle, and accommodating pulmonary veins and plexus. It is said that this relief may be dearly purchased by a shortened life. Possibly so; but remembering the uncertain span of life in all cases of aortic insufficiency, remembering that even in the mnost promising cases sudden syncope may close the scene, I do not quite see how we are justified in thinking that comrn parative comfort afforded by the addition of mitral regurgitation is a condition not to be desired. Dr. Barrs's experience and also the experience of other able observers is in favour of digitalis as a remedy in aortic regurgitation. I cannot say that I have been so happy in mine. To quote one example. Some four years ago a young practitioner, who was a careful auscultator, came to me in distress owing to his having prescribed digitalis to three cases of pure aortic regurgitation, which were under his care at an infirmary. The result was disastrous in each case within 48 hours.


The gastrointestinal pathogen, Clostridioides difficile, is the most common cause of hospital-acquired diarrhoea. Bacterial interactions with the gut mucosa are crucial for colonisation and establishment of C. difficile infection, however, key infection events like bacterial attachment and gut penetration are still poorly defined. To better understand the initial events that occur when this anaerobic pathogen interacts with human gut epithelial cells, we employed a dual RNA-sequencing approach to study the bacterial and host transcriptomic profiles during C. difficile infection in a dual-environment in vitro human gut model. Temporal changes in gene expression during infection were studied in the bacterium and the host cells over the course of 3-24 hours. While there were several common differentially expressed bacterial genes across the different times after infection, mammalian transcriptional profiles were quite distinct with little overlap. Interestingly, an induction of colonic receptors for C. difficile toxins was observed, along with the expression downregulation of genes encoding immune response markers. Several cell wall associated proteins were downregulated in C. difficile when in association with host cells, including slpA, which encodes the main S-layer protein. Gene function and pathway enrichment analyses revealed a potential modulation of the purine/pyrimidine synthesis pathways both in the mammalian and the bacterial cells. We observed that proline-proline endopeptidase, a secreted metalloprotease responsible for cell surface protein cleavage, is downregulated during infection, and a mutant lacking this enzyme demonstrated enhanced adhesion to epithelial cells during infection. This study provides new insight into the host and bacterial pathways based on gene expression modulation during the initial contact of C. difficile with gut cells. Importance The initial interactions between the colonic epithelium and the bacterium are likely critical in the establishment of Clostridioides difficile infection, one of the major causes of hospital acquired diarrhoea worldwide. Molecular interactions between C. difficile and human gut cells have not been well defined mainly due to the technical challenges of studying cellular host-pathogen interactions with this anaerobe. Here we have examined transcriptional changes occurring in the pathogen and host cells during the initial 24 hours of infection. Our data indicate several changes in metabolic pathways and virulence-associated factors during the initial bacterium-host cell contact and early stages of infection. We describe canonical pathways enriched based on the expression profiles of a dual RNAseq in the host and the bacterium, and functions of bacterial factors modulated during infection. This study provides insight into the early infection process at a molecular level.


Leonardo's drawings of optical machinery have been used (by David Hockney and others) as evidence for the claim that Leonardo built machines to make concave mirrors with which he could project images. This paper argues that Leonardo's drawings cannot be used as evidence for this claim. It will be shown that Leonardo used the drawings to communicate with his patrons and craftsmen, to experiment on paper, to record trials with models, and to think about 'theoretical' problems in optics. At both the theoretical and the practical level, Leonardo was only concerned with the burning properties of concave mirrors, not with their imaging properties. The paper will conclude that the drawings of optical machinery allowed Leonardo to differentiate himself from the ordinary mirror-makers in his workshop. The same drawings, however, also forced him to remain within the conceptual framework of perspectivist optics.


Materials ranging from adhesives, pharmaceuticals, lubricants, and personal care products are traditionally studied using macroscopic characterization techniques. However, their functionality is in reality defined by details of chemical organization on often noncrystalline matter with characteristic length scales on the order of microns to nanometers. Additionally, these materials are traditionally difficult to analyze using standard vacuum-based approaches that provide nanoscale chemical characterization due to their volatile and beam-sensitive nature. Therefore, approaches that operate under ambient conditions need to be developed that allow probing of nanoscale chemical phenomena and correlated functionality. Here, we demonstrate a tool for probing and visualizing local chemical environments and correlating them to material structure and functionality using advanced multimodal chemical imaging on a combined atomic force microscopy (AFM) and mass spectrometry (MS) system using tip-enhanced photothermal desorption with atmospheric pressure chemical ionization (APCI). We demonstrate enhanced performance metrics of the technique for correlated imaging and point sampling and illustrate the applicability for the analysis of trace chemicals on a human hair, additives in adhesives on paper, and pharmaceuticals samples notoriously difficult to analyze in a vacuum environment. Overall, this approach of correlating local chemical environments to structure and functionality is key to advancing research in many fields ranging from biology, to medicine, to material science.


As an American –born –raised -trained psychiatrist who has practiced in the United States and now practicing in Canada, it affords me a unique perspective on the health care debates occurring in my home country. The debate regarding health care reform in the States has been heated on both sides. Even doctors are entrenched in one of the opposing positions, with the majority of U.S. physicians supporting reform with a public option [1]. However, it is difficult to discern fact from propaganda on either side, for or against universal health care. One particular problem is the misinformation and fear-mongering that has been covered regarding Canadian universal health care. In this commentary, I will attempt to make the case for universal health care, and focus specifically on the benefits of universal health care for psychiatry. I want to make the case that corporate medicine is detrimental to psychiatry, and how psychiatry practiced within a universal health care system is substantially different from that practiced within a managed care system.


Air quality in the outflow from urban centers affects millions of people, as well as, natural and managed ecosystems downwind. In locations where there are large sources of biogenic VOCs downwind of urban centers, the outflow is characterized by a high VOC reactivity due to biogenic emissions and low NOx. However most field and chamber studies have focused on limiting cases of high NOx or of near zero NOx. Recent measurements of a wide suite of VOCs, O3 and meteorological parameters at several locations within the Sacramento urban plume have provided a detailed benchmark for testing our understanding of chemistry in a plume transitioning from high NOx to low NOx and high VOC reactivity. As an additional simplification, the strong mountain valley circulation in the region makes this urban plume a physical realization of a nearly idealized Lagrangian plume. Here, we describe a model of this plume. We use a Lagrangian model representing chemistry based on the Master Chemical Mechanism (MCM) v3.1 along with mixing and deposition. We discuss the effects of entrainment of background air, the branching ratio for the production of isoprene nitrates and the effects of soil NOx emissions on the composition of the evolving plume. The model predicts that after 2–3 h of chemical processing only 45% of the peroxynitrates (ΣPNs) are PAN and that most (69%) RONO2 are secondary alkyl nitrate products of the reaction of OH with RONO2. We find the model is more consistent with the observations if: a) the yield of ΣPNs from large and multi-functional aldehydes is close to zero; and b) the reaction between OH and RONO2 produces multifunctional nitrates as opposed to either HNO3 or NO2 as is typical in most currently adopted reaction mechanisms. Model results also show that adding NOx emissions throughout the transect increases the available NOx in the downwind regions, but modeled ozone concentrations were little affected by the increased NOx.


During present study effect of shelter availability on growth performance of Clarias batrachus was evaluated in laboratory conditions. To quantify the growth performance, the change in mass and length over time was evaluated. The competition for shelter among fishes was observed. The fishes were forcing each other for shelter. Availability of shelter affected the growth performance of C. batrachus fish. Decrease in shelter availability was significantly reduced the growth performance of the C. batrachus. Present findings have important implications for habitat restoration. In the habitat assessments or stream restoration programmes, concept of shelter availability should be given attention to improve stream environments to maintain native fish diversity.


A general portfolio of joint life insurance contracts is studied in a stochastic interest rate environment with independent and dependent mortality models. Two types of joint insurance products, namely joint first-to-die and joint last-to-die, are considered in this project. Two methods are used to derive the first two moments of the prospective loss random variable. The first one is based on the individual loss random variables while the second one studies annual stochastic cash flows. The total riskiness of the portfolio is decomposed into its insurance risk and its investment risk. For illustrative purposes, an AR(1) process is used to model the stochastic interest rates. Copula and common shock models are used to model dependence in mortality. The effects of mortality dependence on the riskiness of portfolios of joint life insurances are analyzed.


: Purpose: The purpose of this study is to ascertain consequences of vitamin D3 supplement for the person with over-weight and obese body. Design of Study: Descriptive and cross-sectional. Place and duration: Material for this study was gathered from four different hospitals of Rawalpindi. The time frame of this was from January, 2018 to December, 2018. Methodology and Material: According to the randomized methodology of table, the obese persons are equally distributed two groups, named group A and group B, having 44 persons each. In this study the domination was of male participants having 81 percentage of total patients with 71 males. The persons of group A were treated with vitamin D3 supplementation for the period of three months and named as an involvement group whereas the persons of group B were treated with palliative named as placebo group. The mean ages for the both groups were as former with 38.561±7.282 years and later with 37.852±8.251 years. At the commencement of the study, some typical anthropometric parameters comprising on BMI, waist Hip Ratio, and waist perimeter are measured and recorded on the premeditated forms. At the accomplishment of treatment replication of serum vitamin D3 was done and repeated all parameters measured after three months. Results: Comparative body weight outcomes beforehand and subsequently intervention of involvement group in the persons on the supplement of Vitamin D3 showed the insignificant difference in weight (76.563±11.251 vs. 75.851±10.763) with p-value of > 0.051. Comparativewaist hip ratio outcomes beforehand and subsequently showed insignificant difference of waist perimeter (92.781±7.352 vs. 92.241±7.212) and hip perimeter (107.741±7.452 vs. 106.452±7.121) with p-value of > 0.052. Inconspicuous change is measured in BMI on the reference point 29.652±3.263 and after 12 weeks of intervention 29.38±3.1 kg/m2 which is also insignificant difference statistically. Conclusion: Anthropometric parameters comprising on BMI, Waist Hip Ratio, waist perimeter did not got improvement after the intervention of vitamin D3 supplement for three months. Resultantly alteration of vitamin D3 level for the over-weight and obese persons does not support to minimize the anthropometric parameters. perimeter


Aim To assess the individual and combined effect of 46 type 2 diabetes related risk alleles on incidence of a composite CVD endpoint. Methods Data from the first Danish MONICA study (N = 3523) and the Inter99 study (N = 6049) was used. Using Cox proportional hazard regression the individual effect of each risk allele on incident CVD was analyzed. Risk was presented as hazard ratios (HR) per risk allele. Results During 80,859 person years 1441 incident cases of CVD (fatal and non-fatal) occurred in the MONICA study. In Inter99 942 incident cases were observed during 61,239 person years. In the Danish MONICA study four gene variants were significantly associated with incident CVD independently of known diabetes status at baseline; SLC2A2 rs11920090 (HR 1.147, 95% CI 1.027–1.283 , P = 0.0154), C2CD4A rs7172432 (1.112, 1.027–1.205 , P = 0.0089), GCKR rs780094 (1.094, 1.007–1.188 , P = 0.0335) and C2CD4B rs11071657 (1.092, 1.007–1.183 , P = 0.0323). The genetic score was significantly associated with increased risk of CVD (1.025, 1.010–1.041, P = 0.0016). In Inter99 two gene variants were associated with risk of CVD independently of diabetes; SLC2A2 (HR 1.180, 95% CI 1.038–1.341 P = 0.0116) and FTO (0.909, 0.827–0.998, P = 0.0463). Analysing the two populations together we found SLC2A2 rs11920090 (HR 1.164, 95% CI 1.070–1.267, P = 0.0004) meeting the Bonferroni corrected threshold for significance. GCKR rs780094 (1.076, 1.010–1.146, P = 0.0229), C2CD4B rs11071657 (1.067, 1.003–1.135, P = 0.0385) and NOTCH2 rs10923931 (1.104 (1.001 ; 1.217 , P = 0.0481) were found associated with CVD without meeting the corrected threshold. The genetic score was significantly associated with increased risk of CVD (1.018, 1.006–1.031, P = 0.0043). Conclusions This study showed that out of the 46 genetic variants examined only the minor risk allele of SLC2A2 rs11920090 was significantly (P = 0.0005) associated with a composite endpoint of incident CVD below the threshold for statistical significance corrected for multiple testing. This potential pathway needs further exploration.


The article seeks to explore the contemporary issues of promoting brand integration in a merger process. It is suggested to consider the areas for enhancing the degree of brand integration subject to respective brand integration phases of particular business entities (low integration level – a crisis phase; medium level of integration – the phase of stabilization (verified by the presence of complementary effects from internal and external interaction); high level of integration – the growth phase (verified by the presence of synergistic effects from internal and external self-organization). The proposed pathways to foster brand integration within a merger process are sought to contribute to maximizing the degree of consolidation and diversification of available resources in integrated business structures. The use of an integration effectiveness assessment framework allows for zoning of synergetic effect manifestations, identifying the most probable directions for resource diffusion, boosting the territorial clusters complementarity as well as harmonizing the diverse integration and decentralization interests of business entities. Depending on the phases of business units brand integration, the brand integration principles in the context of a merger process have been specified. Apart from that, the relationship between different types of complementary and synergistic effects has been explored subject to a specific brand structure. The study findings have revealed the major barriers to brand integration within business structures which often trigger negative effects from self-organization, in particular. It is argued that to ensure a balance of the organizational and economic premises of integrated business structures, its baseline institutions, mechanisms and technologies should have a vast integration potential that will link individual elements of the system in such a way as to encourage synergistic and complementary effects to form a kind of a helix that attracts and draws individual brands together into innovation processes.


Abstract : In rats exposed to atmospheric hydrazine, the log of blood hydrazine concentration was found to bear a more or less linear relation to atmospheric hydrazine levels. At 20-25 mg hydrazine/cu M, blood concentrations approached 100 nmole/ml, and were about 2 nmole/ml at atmospheric concentrations of about 3 mg/cu M. During exposure, blood concentrations tended to rise rather quickly in the first hour, then oscillated slowly around a generally constant level throughout six hours of exposure. Blood concentration of hydrazine following a single 1 nmole/kg dose decreased with a first phase halftime of about 45 minutes followed by a slower decrease with halftime of 27 hours. Less than one percent of such doses was excreted in bile. In vitro reaction of 5 m molar hydrazine in whole blood proceeded at a rate of about .016 micromole/m1/minute or about 10% in 30 minutes. With higher concentrations turnover becomes more rapid and can exceed the hemoglobin subunit equivalence by many fold. Extensive efforts to locate 15N/labelled urinary metabolities that would account for remaining uninventoried hydrazine have not yet succeeded.


Immigrant students are deeply impacted by the xenophobic dominant narratives about immigration in the United States today, and are at risk of developing a deficit mindset about their own cultures. Our classrooms can serve as spaces of resistance to anti-immigrant and neo-nativist values by intentionally raising student critical consciousness about these oppressive forces, and centering our student's lived experiences and funds of knowledge in the curriculum. This article looks at one high-school arts curriculum unit prompting students to critically analyze the dominant narratives about immigration, interview real immigrants in their lives, and create a counter-narrative art work for public display. The aim for this project was to give immigrant students a space to process, analyze, and counter the xenophobic narratives surrounding them. Summary of the unit plan, student work samples, classroom culture, and alumni testimonials are included.


Background: The study was designed to examine the efficacy and safety of Rhus coriaria L. (Sumac) supplementation in patients who are overweight or obese. Methods: The study was designed as a parallel two-arm, double-blind, randomized placebo-controlled clinical trial conducted in an endocrinology clinical affiliated by Shiraz University of Medical Sciences at 2016. Fifty patients with body mass index (BMI)≥ 25 kg/m were randomly assigned to receive Sumac supplementation (500 mg twice daily) or placebo for six weeks. The patients were evaluated before and after the intervention in terms of their BMI, waist-hip ratio (WHR), leptin, fasting blood glucose, and insulin resistance index (HOMA-IR). Beside clinical adverse event monitoring, liver and kidney function tests were measured before and after the intervention. Results: Statistically significant decrease in weight, waist circumference, and BMI were observed in the Sumac group, which was more prominent as compared to the placebo after six weeks of intervention (1.34 vs. 0.64 P = 0.003; 1.10 vs. 0.54 P = 0.027, and 0.49 vs. 0.24 P = 0.002, respectively). Insulin resistance was also decreased (0.45 vs. -0.14 P = 0.020). No significant change in leptin and fasting blood glucose was observed. No clinical or laboratory adverse event was observed. Conclusions: Sumac supplementation showed to have a potential weight-reduction effect, along with a positive effect on insulin resistance in patients who were overweight or obese.


The purpose of this study is to explore the capacity of the working memory among secondary stage students in Amman second educational directorate and its relationship with their ability to retain information. To explore their level of working memory, listening test period developed by (Daneman & Carpenter, 1980) was used, and the test consisted of 40 items. Moreover, the researcher used retention ability test in biology with 20 items. The sample of the study was selected from eight schools through random clustering total 293 male and female students in the school year 2010/2011. The findings of the study showed that the capacity of the working memory among students was high and their ability to retain was low. There is a positive significant relationship between the capacity of the working memory and the level of the ability to retain information. Based on the findings of the study, the researchers recommended the need of taking careful attention to mnemonics and the strategies that may help working memory in restoring and processing, concentrating in teaching methods that help students to employ more than one sense in addition to the direct experience in teaching to increase the working memory capacity among students and help them to improve information processing strategies. Moreover, they conduct more studies on working memory and its relationship with psychological and cognitive variables in other educational stages.


Background: In elite athletes, training individualization is widely recommended to optimize competitive performance. Previous studies have evidenced the impact of hormonal fluctuations on different performance parameters among female athletes. While consideration of menstrual cycle (MC) phases as a parameter in training individualization strategies is necessary, systematic evidence identifying such impacts in elite athletes should be evaluated. Objective: Systematically review publications that have investigated the link between MC phases and performance in elite female athletes. The overarching aim is to identify whether a consensus across studies exists enabling evidence-based recommendations for training individualization depending on menstrual cycle phases. Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three major scientific publication databases were searched from inception until November 3, 2020. Studies included focused on the influence of physiological or psychological parameters throughout at least one phase of the menstrual cycle of elite athletes. Results: A total of 780 search results were yielded and 26 references from a past bibliography were added manually. About 662 papers were reviewed of which 218 studies were assessed for eligibility. Of these, only seven (1%) precisely investigated the influence of a performance or physical parameter during at least one menstrual cycle phase. These seven studies included a total of 314 elite female participants (20.58 ± 1.91 years). Three used interviews, questionnaires or prospective analyses of reports. Four conducted several performance tests or included physical measures although only two performed tests during training or before/during competition. Among the seven studies, five performed hormonal testing through sampling of blood, saliva, or urine. The remaining relied on athletes' menstruation diaries. The current evidence suggests a variable association between menstrual cycle and a few performance-related outcomes, such as endurance or power resistance, ligament stiffness, decision making skills, psychology, or competitiveness. Conclusion: Different sports performance-related parameters are affected during the menstrual cycle among elite athletes, but the parameters themselves and the magnitude and the direction of the effects are inconclusive. Additional longitudinal and prospective studies to systematically monitor on-field performance parameters are urgently required in order to enable recommendations and training individualization in female elite athletes.


Summary.  Hepatitis C virus (HCV) nonstructural protein 5B (NS5B) is an RNA‐dependent RNA polymerase (RdRp) that is involved in genome replication and virus assembly. NS5B contains a distinct loop (loop Λ2) at the beginning of the nucleoside triphosphate tunnel with a highly conserved lysine (K151). In this study, reverse genetic analysis revealed that substitution of Jc1 NS5B K151 for alanine (K151A) and aspartic acid (K151D) affected genome replication and infectious virus production. However, genome replication and virus production by Jc1 containing NS5B K151R remained unaltered. A major deletion in loop Λ2 abolished RNA replication, suggesting a role for this structural domain in NS5B polymerase activity. In conclusion, this study demonstrated that the conserved K151 modulates infectious virus production; and loop Λ2 is essential for the polymerase activity of NS5B.


In the last decade, diagnosis of caesarean scar (CS) pregnancy and abnormal placental invasion has gone up significantly. It appears that the history of previous caesarean section is the predisposing factor common to both conditions. Until now, these are treated as a separate entity and therefore managed differently. Recent available evidence suggests that these are not a separate entity but rather a continuum of the same condition. If the caesarean scar pregnancy is managed expectantly in the 1st trimester, most likely it evolves into placenta accreta. This leads invariably to peripartum hysterectomy for postpartum haemorrhage (PPH) and severe maternal morbidity. Early diagnosis and intervention may give a favourable outcome.


During the Paleozoic, South America and Africa was part of the same continent, the Gondwana. The land mass was close to the south pole for a while and then migrated northward after the Carboniferous. Due to this common past geological setting, in both areas the Paleozoic formation have numerous similarities. The hot shale of north Africa, Silurian and Devonian in age are well known, and lead to large reserves in Algeria and Libya among others. The synthesis of the south American Paleozoic sources rock presented in this paper shows at the opposite that the richer organic shales are Carboniferous and Permian in age in South America. Silurian and Devonian source rocks exist, are sometime rather thick but never very rich (TOC ~ 2%, initial HI around 500). At the opposite the Lower Carboniferous of the Madre de Dios basins (Peru and Bolivia) and the Permian of the South Peru, North Bolivia and Parana in Brazil are the best Paleozoic SR of SA, with initial S2 up to 80 mg HC/g. Central South America therefore differs from the general trend of the compilation of the source rock richness, worldwide, as in North Africa, Silurian and Devonian show the best values.


In recent years, several highly visible European policies have been more precautionary than their U.S. counterparts. In some cases, the United States has demurred. Morever, Europe has formally adopted the precautionary principle in its treaties and national laws, while the U.S. has not. A close look at the current scenario reveals that greater European precaution is not the whole story. Other cases point in the opposite direction, of greater relative U.S. precaution. In fact, a recent study reveals that it is not the precautionary principle, it is precautionary particularity.


Nowadays, governments are adopting Web 2.0 technologies for interacting with citizens, empowering them to share their views, react to issues of their concern and form opinion. In particular, social media play an important role in this context, due to their widespread use. For governments, a major technical challenge is the lack of automated intelligent tools for processing citizens' opinion in government social media. At the same time, during the last decade, argumentation theory has consolidated itself in Artificial Intelligence as a new paradigm for modeling common sense reasoning, with application in several areas, such as legal reasoning, multiagent systems, and decision support systems, among others. This paper outlines an argument-based approach for overcoming such challenge, combined with context-based information retrieval. Our ultimate aim is to combine context-based search and argumentation in a collaborative framework for managing (retrieving and publishing) service- and policy-related information in government-use social media tools.


Social media is gaining popularity nowadays and is increasingly being used by many small and large organisations. Organisations are adopting new social platforms and technologies to achieve their key and effective management strategies. However, there are stillopportunities to explore the role of new technologies in developing useful strategies. In current research, the utilisation of technological tools especially social media was examined to improve the customer value analysis in the organisations. Besides, the research of social media use for crisis management is also increasing and the relevant strategies are still being-investigated. To overcome this gap, this research aims to evaluate the impact of the use of social media on customer value analysis and crisis management. To attain this, a detailed questionnaire was adapted from several different studies. Data were collected from a diverse targeted sample of tourism-related firms from all over Malaysia, including hotels, resorts, travel agencies and transportation companies. The model was tested using Smart PLS software and the results were generalised. Overall, this research will add a noteworthy contribution to the literature by highlighting the significance of social media and recognising its urgency during crisisfor businesses. It will also help in answering questions regarding the role of social media usage towards customer value analysis andcrisis management of organisations in the Malaysian tourism sector. Moreover, the practitioners will use the findings to make strategies for crisis management and build customer value chain.


BACKGROUND
The ageing of the Australian population is placing increasing demand on the nation's healthcare system. This study set out to describe the level of need for multidisciplinary care in an Australian tertiary hospital setting.

METHODS
A cross-sectional audit by case note review of all patients on acute medical and surgical wards in an Australian tertiary hospital. The primary outcome was an identified need for multidisciplinary assessment and intervention.

RESULTS
A total of 60% of the 295 inpatients audited required multidisciplinary care. Of those who were admitted to geriatric and rehabilitation units, 84% required multidisciplinary care. Patients in acute medical and surgical units also had substantial multidisciplinary care needs. Age was a significant influence with 79% of those aged 86 and above having multidisciplinary care needs, whilst only 38% of those aged 55 or less required multidisciplinary care. Difficulties with mobility, need for assistance with self-care, and continence problems were associated with higher requirement for multidisciplinary care.

CONCLUSIONS
In the hospital population, significant multidisciplinary care needs exist. These needs are not limited to inpatients that are elderly or admitted to geriatric or rehabilitation units. This has implications for planning, funding, provision of health care resources, and training of medical and allied health staff.


Todays evidence-based medicine has brought the practicing physician a vast amount of statistical evidence from which various stakeholders in the healthcare system obtain their arguments for and against the use of new therapies. Physicians assume an obligation to prescribe these new treatment options for their patients, firstly because of their eagerness to provide the best medicine, and secondly because of their fear of litigations. On looking at the published data, however, we have observed that the arguments for saving lives with a new treatment are not always supported by the underlying data. Sometimes the data show that the effect of treatment, in real terms, is only a relatively small gain in life-time prolongation. It is concluded that EBM-based concepts such as NNT (number needed to treat), absolute risk and relative risk fall short in ensuring real benefit for the patient. We have, therefore, put forward a mathematic model which takes into account the benefit of a treatment for the individual patient in terms of expected gain in lifetime duration. This model is readily applicable to published results on the clinical effects of a medical therapy and gives the practicing physician a useful tool for deciding whether to administer a medical therapy or not. By looking at the duration of treatment and the individual gain in lifetime expected, we have derived an effectiveness coefficient which can be used to categorize medical treatments into highly effective (close to 100%) and not effective (< 5%), and at the same time arrive at a cost-benefit analysis of the treatment in question. These simple concepts will help physicians and individual patients to make informed decisions based only on those medical therapies which are proven and appropriate. The model we have developed provides a new perspective in therapy for the individual patient using medicines that constitute a rational therapy i.e. a therapy that makes "sense" (sense-orientated medicine = SOM).


We describe a method for approaching the lower cervical and upper thoracic spine, the brachial plexus and related vessels. The method involves the elevation of the medial corner of the manubrium, the sternoclavicular joint, and the medial half of the clavicle on a pedicle of the sternomastoid muscle. We have used this exposure in 17 cases with few complications and good results. Its successful performance requires high standards of anaesthesia, surgical technique and postoperative care.


Background Vilazodone is the latest approved antidepressant available in the United States. Its dual mechanism of action combines the inhibition of serotonin transporters while simultaneously partially agonizing serotonin-1a (5-HT1A) receptors. This combined activity results in serotonin facilitation across the brain's serotonergic pathways, which has been termed by the authors as that of a serotonin partial agonist and reuptake inhibitor, or SPARI. Objective The authors to review laboratory, animal model data, and human trial data to synthesize a working theory regarding the mechanism of antidepressant action of this agent and regarding its potential for additional indications. Methods A MEDLINE and Internet search was conducted and the resultant evidence reviewed. Results Vilazodone has randomized, controlled empirical data which has garnered it an approval for treating major depressive disorder. It combines two well-known pharmacodynamic mechanisms of serotonergic action into a novel agent. Although no head-to-head studies against other antidepressants are published, the efficacy data for vilazodone appears comparable to other known antidepressants, with associated gastrointestinal side effects similar to serotonin selective reuptake inhibitor and serotonin norepinephrine reuptake inhibitor antidepressants, but potentially with a lower incidence of sexual side effects and weight gain. Discussion As a new option for the treatment of major depressive disorder, vilazodone, due to its unique SPARI mechanism of action, may hold promise for patients who cannot tolerate or have not responded to previous antidepressant monotherapies. Additionally, its use may extend to the treatment of other mental health conditions similar to those treated by serotonin selective reuptake inhibitors.


Abstract This study addresses the question: Do second-grade students from low- socioeconomic-status (SES) schools taught with an iteratively designed project-based approach to social studies and content literacy instruction: (a) make statistically significant gains on standards-based social studies and content area literacy assessments, and (b) reach a benchmark on these assessments set by a group of students from high-SES schools? If so, what did the project-based approach entail? Students from 4 classrooms in low-SES schools were assessed before and after experiencing 2 project-based units focused on standards in economics; civics and government; public discourse, decision making, and citizen involvement; and content area literacy. Students from 2 high-SES schools were also assessed, following a year of business-as-usual social studies and content literacy instruction, to establish a benchmark we hoped low-SES students could attain. Results show that low-SES students made statistically significant gains in social studies and content literacy and, at post-test, showed no statistically significant differences from the students in the high-SES schools: Following instruction, there was no SES achievement gap on these assessments. The authors describe the project-based units and strategies that the teachers used to implement these plans, and discuss implications of the study for future research and practice.


The generalized arc consistency (GAC) algorithm is the prevailing solution for alldifferent constraint problems. The core part of GAC for alldifferent constraints is excavating and enumerating all the strongly connected components (SCCs) of the graph model. This causes a large amount of complex data structures to maintain the node information, leading to a large overhead both in time and memory space. More critically, the complexity of the data structures further precludes the coordination of different optimization schemes for GAC. To solve this problem, the key observation of this paper is that the GAC algorithm only cares whether a node of the graph model is in an SCC or not, rather than which SCCs it belongs to. Based on this observation, we propose AllDiffbit, which employs bitwise data structures and operations to efficiently determine if a node is in an SCC. This greatly reduces the corresponding overhead, and enhances the ability to incorporate existing optimizations to work in a synergistic way. Our experiments show that AllDiffbit outperforms the state-of-the-art GAC algorithms over 60%.


Aromatase converts androgens to estrogens. Although third-generation aromatase inhibitors (AIs) are important drugs in hormonal therapy for breast cancer in postmenopausal women, there are concerns about the side effects associated with the estrogen deprivation achieved with AIs. Expression of aromatase in breast cancer tissue is driven by different promoters than those in noncancer tissues; thus, suppression of aromatase expression in cancer tissues through the down-regulation of breast tumor–specific promoters would reduce the side effects associated with whole-body suppression of estrogen biosynthesis by AIs. We report that histone deacetylase inhibitor LBH589 (panobinostat) is a potent inhibitor of aromatase expression (with an IC50 value < 25 nM). LBH589 selectively suppresses human aromatase gene promoters I.3/II, which are preferentially used in breast cancer tissue. Furthermore, using the H295R cell culture model, we found that achieving the same degree of inhibition of aromatase activity required only one-fifth as much letrozole (an AI) in the presence of 25 nM LBH589 as in the absence of LBH589. We also used an H295R/MCF7 coculture model to demonstrate the synergistic interaction of LBH589 + letrozole in suppressing the proliferation of hormone-responsive breast cancer cells. Finally, our results also indicate that LBH589 down-regulates the activity of promoters I.3/II in an epigenetic fashion. LBH589 reduces the levels of C/EBPδ, decreases the binding of C/EBPδ, and increases the levels and binding of acetyl-histones to the promoters I.3/II. These findings provide an important basis for future clinical evaluations of LBH589 in hormone-dependent breast cancer.


Introduction/Background Somatic loss of the wild-type BRCA1 allele is a key event in pathogenesis of BRCA1-driven cancers rendering their pronounced sensitivity to platinum and PARP inhibitors. Methodology We compared the somatic status of BRCA1 and some other genes in serial ovarian cancer (OC) samples, which were obtained before neoadjuvant chemotherapy (NACT), during surgery and at disease relapse from BRCA1 mutation carriers. Results 26/36 (72%) OC had BRCA1 loss of heterozygosity (LOH) before NACT. 15/26 (58%) of the tumors, which had LOH at the beginning of the treatment, showed retention of the normal BRCA1 allele after NACT. The analysis of linked SNPs and FISH assay strongly indicated, that the restoration of BRCA1 function is caused not by the second mutation, but by the selection of pre-existing BRCA1-proficient cells. Tumor relapses were available in 7 patients with BRCA1 LOH in the chemonaive tumor and/or BRCA-proficiency in the residual post-NACT neoplasm; 6 (86%) of these relapses had BRCA1 LOH thus resembling the primary tumor. Secondary open reading frame (ORF) restoring BRCA1 mutation was detected in 1 recurrent OC. Serial samples retained same TP53 mutation during the treatment course. Exome analysis revealed that chemonaive, post-NACT and relapsed tumors had both shared and individual mutations. Conclusion BRCA1 LOH is not the first event in the pathogenesis of BRCA1–driven cancer: gain of TP53 mutation probably precedes BRCA1 inactivation; Treatment–naïve BRCA1–driven tumors contain a small fraction of BRCA1–proficient cells, which rapidly repopulate the tumor lump during the first weeks of therapy; Change of BRCA1 status during NACT may call to reconsider the existing approaches to adjuvant therapy; The balance between BRCA1–deficient and BRCA1–proficient cells is a subject of fluctuations, depending whether therapy is applied or not; Clinical trials on BRCA1–driven OCs need to address the issue of intratumoral heterogeneity of BRCA1 status. Disclosure This work has been supported by the Russian Science Foundation, grant 19-15-00168.


Secondary succession reflects, at least in part, community assembly—the sequences of colonizations and extinctions. These processes in turn are expected to be sensitive to the size of the site undergoing assembly and its location relative to source pools. In this paper we describe patterns of succession over 18 years in an experimentally fragmented landscape created in eastern Kansas, USA, in 1984. The design of the experiment permits one to assess the influence of patch size and landscape position on successional dynamics. The general trajectory of succession follows that typical of succession in much of the eastern United States. In the initial years of the study, there was relatively little effect of patch size or distance to sources. Here we show that spatial effects in this system have become increasingly evident with time, as gauged both by repeated-measures ANOVA and ordination techniques. Woody plants have colonized more rapidly (per unit area) on large and nearby patches. Species richness at a local (within-quadrat) scale in general has increased, with slightly greater richness in large than in small patches later in the study. Temporal stability in community composition has generally been greater in large patches. Spatial heterogeneity in community composition has increased during succession, but with different patterns in large and small patches. This long-term experiment suggests that landscape structure influences many aspects of community structure and dynamics during succession, and that such effects become more pronounced with the passage of time.


Abstract Circulating tumor cells (CTCs) have been shown to be a valuable prognostic marker for different solid cancers. Within the present study we quantified CTCs in thyroid cancer (TC) patients. Special focus was given to disease-free PTC patients with undetectable serum thyroglobulin (Tg) levels. Altogether, 67 TC patients (33 papillary, 20 follicular, 14 medullary) were included in the study. CTC numbers, which were normalized to 3.3×105 peripheral blood mononuclear cells, were correlated with clinical outcome. TC patients had significantly higher CTC numbers compared to controls. The number of CTCs correlated to the initial tumor stage. Importantly, in comparison to controls, differentiated TC patients with serum Tg levels<0.3 ng/ml (no evidence of tumor recurrence) revealed a significantly higher amount of CTCs, also associated to their former tumor stage. Regarding the tumor-free papillary TC (PTC) patients the number of CTCs additionally correlated to the time point of radioiodine (RI) therapy: PTC patients with RI therapies>8 years before CTC measurement had significantly higher CTC numbers compared to those with RI therapy<8 years ago. We found a clear correlation between the number of CTCs and the tumor stage. Importantly, PTC patients who are in remission may still have increased numbers of CTCs. Follow-up analyses in these patients will reveal whether these data will have a clinical impact.


In this paper, X-ray CT image is identified by using a revised GMDH-type neural network with sigmoid functions. The revised GMDH-type neural network algorithm with sigmoid functions proposed in this paper is developed based on the conventional GMDH-type neural network algorithm with a feedback loop. The revised GMDH-type neural networks can identify nonlinear complex systems very accurately because the complexity of the neural networks increase gradually by the feedback loop calculations and the structural parameters such as the number of neurons, the useful input variables and the number of feedback loop calculations are automatically determined so as to minimize the prediction error criterion defined as AIC.


Recently, increasing research attention has been directed toward wireless sensor networks: collections of small low-power nodes, physically situated in the environment, that can intelligently deliver high-level sensing results to the user. As the community has moved into more complex design efforts — large-scale, long-lived systems that truly require self-organization and adaptivity to the environment — a number of important software design issues have arisen. To make software


Patients with progressive or solid food dysphagia should be evaluated for the presence of an esophageal stricture. Barium esophagram and endoscopy can define strictures as benign or malignant. The majority of benign strictures are acid-related. Benign strictures are best managed by esophageal dilation with acid-suppressing medications if a peptic stricture is suspected. If dysphagia recurs, repeat dilation should be performed. There are a variety of interventions for refractory strictures which include injection of intralesional corticosteroids, temporary placement of self-expanding plastic stents and surgery.


The age of proteomics and resulting advances in technology have resulted in an increase in the number of requests for recombinant protein construction, production, and purification projects. One of the mainstays of the Molecular Biology Core Facility (MBCF) at Trudeau Institute is the production of Major Histocompatibility (MHC) Class I and Class II multimeric fluorescently labeled protein-peptide complexes, which allow the tracking of antigen-specific CD8+ and CD4+ T-cells using fluorescence-activated cell sorting (FACS) analysis. In addition, the MBCF has generated fusion proteins to be utilized for immunization strategies and viral coat proteins from influenza and murine gamma herpes virus 68 for detecting epitope-specific antibodies. Another simple but extremely useful and money-saving protein production project is the production and purification of Taq enzyme for a laboratory that uses large quantities of Taq enzyme in a limiting dilution assay for latent viral detection. Requests for milligram amounts of native, endotoxin-free proteins to be used for in vivo vaccination are increasing. The MBCF utilizes a variety of expression systems, but primarily bacterial (using T7 promoter–based plasmids) and the insect cell–based Drosophila Expression System (DES) (Invitrogen). Recently, the Gateway system (Invitrogen) has been introduced into the MBCF to facilitate the whole procedure. Purification schemes are mainly based on size exclusion or affinity chromatography using either protein A, Ni-NTA, or glutathione sepharose.


Partial preferences may occur due to differences in profitability and encounter probability between food types within a patch. In the expanding specialist diet strategy, a forager goes from being partially selective on the preferred, most profitable food, to being opportunistic, after the preferred food has been depleted to a certain critical level. We studied the diet selection strategies of birds foraging on 2 seed types--crushed peanut Arachis hypogaea and husked millet Pennisetum gambiense, in a woodland savannah near Jos, Nigeria. Peanut contains more fat and energy, whereas millet is richer in carbohydrates. We tested 2 hypotheses: 1) energy content will determine seed preference for seeds with relatively similar handling times and 2) diet selection will vary seasonally in response to nutritional demands. We carried out 2 experiments, one with both seed types occurring in a single patch and another with both occurring in 2 separate patches during different seasons. The diet selection strategy of the birds was similar to the expanding specialist. Initially, peanuts seemed to be the preferred food, probably due to their high profitability, but overall millet was preferred. However, the expansion point was not determined by the amount of peanut seeds left, as predicted, but rather by the amount eaten. We propose that a trade-off is created by the fact that peanut has higher energy density but at the same time contains secondary compounds. Selectivity for millet decreased slightly in the wet season when more peanuts were taken possibly due to increasing nutritional demands during breeding. Copyright 2011, Oxford University Press.


Social indicators are a vital tool for the design of social policy especially in the present era of uncertainness and change. Children are among the most affected from these global changes, Thus it is not surprising that recent years have brought a dramatic rise in the number of efforts to measure and monitor the status of children. Yet, despite numerous efforts the field of social child indication is fragmented and lacking a unifying taxonomy, and often the term indicator simply refers to statistical measures, with little elaboration on the theoretical concepts or the relationship between indicators and various other factors. In attempt to create such taxonomy for child indicators, we present circles of five contexts depicted from outside to the inside.


Abstract Aromatic selective polyimide (PI) membrane based voltammetric electrodes were prepared for bupivacaine measurements. Polyimide membranes were synthesized from 4,4′-diaminobenzanilide (DABA) and different aromatic dianhydrides (pyromellitic dianhydride (PMDA), benzophenone-3,3′,4,4′-tetracarboxylic dianhydride (BPDA), 4,4′-oxydiphthalic anhydride (ODPA)) through two-step polycondenzation reactions. The structural properties of the obtained benzanilide based PIs were characterized by various analytical techniques. For the preparation of voltammetric electrodes, these polyimide films were coated with polyimide solution by drop-casting on the surface of a platinum working electrode. Due to the excellent film properties and suitable porosity, the prepared benzanilide based polyimide films were used as the membrane for selective determination of bupivacaine in the presence of interferents that included lactose, glucose and sucrose. For this reason, the selectivity of the modified electrode to bupivacaine obtained from the prepared PI film toward the potential interferences was investigated by differential pulse voltammetry (DPV). The results of voltammetric study showed that polyimide films responded to only bupivacaine at a potential of approximately +0.92 V. The polyimide membrane modified electrode showed a rapid response time, a high R-value of 0.9941, high reproducibility and good selectivity for bupivacaine. The limit of detection (LOD) and the limit of quantitation (LOQ) were determined to be 16.82 µM and 50.46 µM, respectively. Thus, benzanilide based polyimides may be successfully used as selective membranes for preparation of bupivacaine sensors. This structure may be a precursor for the preparation of simultaneous or needle-shaped sensors in the future.


It is paramount that research relevant to Indigenous communities be conducted in partnership with them through free and prior informed consent. Historically, much research was extractive in nature, performed without Indigenous community consent, and often applied a deficit-framing. Some academic professional societies have developed guidelines for ethically conducting research with Indigenous communities to avoid these unethical practices. However, missing from these ethical research declarations are the specifics on research implementation or how research can be enriched through an ethical research approach. In 2010, the Association of American Geographers' (AAG, now known as the American Association of Geographers) Indigenous Peoples Specialty Group (IPSG) wrote a Declaration of Key Questions About Research Ethics with Indigenous Communities outlining several questions that researchers should ask themselves when collaborating with Indigenous communities. We selected the AAG's ethical principles for this study as it was one of the first environmentally oriented professional societies to make such a declaration. It is also among the world's largest professional societies with over 10,000 members across 100 countries, with nearly upward of 7000 in attendance at its annual conference. The IPSG's Declaration organizes their key questions around several elements: (1) Formulating the Project, (2) Identities of the Researchers, (3) Partnerships, (4) Benefits, (5) Findings, and (6) Deepening Relationships. This article discusses how each of the elements in the IPSG's Declaration can be addressed for a wide range of research projects, providing specific examples from the Global Citizenship and Sustainability (GCS) program, a community-based partnership between Cornell University, the Institute of Social Informatics and Technological Innovations at the Universiti Malaysia Sarawak, and Penan village leaders in Long Lamai, Malaysia. This article argues that GCS' research was enhanced through a non-extractive, community-based, and collaborative research mindset and further describes questions based on the IPSG's Declaration that researchers can ask themselves throughout their research processes. This article serves as a foundation for researchers collaborating with Indigenous communities to think about their research to give agency to those communities while conducting innovative research. This article has been written in consultation with a community-chosen representative of Long Lamai, Borneo.


In this letter, a planar monopole UWB antenna with dual band-notched characteristics is proposed. The band-stop characteristics is realized by embedding the 1st/3rd order Hilbert-curve slots on the patch. With the dimension adjustment of each Hilbert-curve slots, the band rejection from 3.3 to 3.7 GHz and from 5.3 to 6 GHz can be accomplished easily. The VSWR and radiation pattern of the fabricated antenna are measured, and the proposed antenna would be adequate to a UWB applications.


In this paper we study the Nash equilibrium in a smooth public goods economy, described as a non-cooperative game, where the set of players is a mixed measure space of consumers. We assume a finite number of private goods. We show that under certain conditions there exists a unique Nash equilibrium in the economy, where the public goods are produced with a linear technology. Moreover, we discuss the difference in market power between an atomless sector and an atom with the same utility function, and an atom with its split atomless sector, both in a pure exchange economy and a public goods economy.


The use of advanced signal processing approaches for improving the performance of secure wireless communication systems utilizing Smart Antennas and Spread Spectrum (SS) signaling is overviewed in this paper,. Emphasis is placed on research results obtained by the author and his research group in the last decade. Using advanced signal processing is shown to highly improve the performance of Smart Antennas and SS techniques in interference limited and wideband multi-user wireless communication systems. The considered advanced signal processing techniques include Artificial Neural Networks (ANN), Wavelets, Higher Order Statistics (HOS) and the related constant Modulus Algorithms (CMA), Genetic Algorithms (GA) and Fractals. In the presentation, the following enhancements of Smart Antenna using modern signal processing techniques are briefly described: i. Using ANN to shape the Array factor, reduce the side-lobe level and affect steerable interference nulling. ii. The use of HOS for blind beamforming and detection of multi-Source multipath signals with general antenna array structures. iii. The use of CMA for mitigating multipath and fading effects. iv. The use of Wavelets in the design of blocking matrix for sidelobe cancellers and for broadband beamforming. v. Using GA for smart and wideband array design. vi. The design of Fractal Arrays for multiband operation On the other hand, the following enhancements of SS signaling using modern signal processing approaches will be highlighted in the presentation: i. The use of ANN for the design of Matched filters (NMF) for efficient code acquisition and in the design multi-user receivers for ii.


Three-dimensional neutron diffusion calculations are routinely performed in support of various NRC-sponsored reactor fuel testing programs conducted in the Power Burst Facility test reactor at the Idaho National Engineering Laboratory. The calculations are done with the PDQ-7-II program. ENDF/B Version IV data provide the basic cross section information used to generate few-group neutron diffusion theory constants used in the calculations. Reactor operating data have been employed to validate the three dimensional PBF diffusion theory model. Results obtained to date show that criticality is quite accurately predicted at various steady-state power levels. In addition, for one reactor configuration considered measured axial power distributions at three different radial locations compare well with the predicted distributions.


RATIONALE
Several mycobacterial species can produce serious infections in humans, and the treatment required depends on the infecting species. Fast identification, ideally with minimal manipulation of the infecting species, is therefore critical; here, we propose a method potentially allowing cultures to be identified by headspace analysis and use it to screen for differences between mycobacterial species based on the volatiles released during growth.

METHODS
Short-chain volatile organic compound emissions from two non-tuberculosis slow growing mycobacterial species, Mycobacterium avium and Mycobacterium kansasii, and a non-pathogenic fast growing species, Mycobacterium smegmatis, in Middlebrook M7H9 culturing media were followed online with a proton transfer reaction quadrupole mass spectrometer.

RESULTS
Measurable differences between the headspace of the two slow growing mycobacteria M. kansasii and M. avium were found, as well as differences with respect to the faster growing mycobacteria M. smegmatis. Three compounds, attributed to sulfur-containing volatiles--dimethyl sulfide, propanethiol and dimethyl disulfide--were found to be specific to M. avium.

CONCLUSIONS
Clear differences were detected in the low molecular weight volatile emissions compounds of the mycobacterial species under study, without the need for sample manipulation. Further studies with other mycobacterial species will reveal if the differences observed are specific to the species studied here. Furthermore, the use of an ion trap as a mass analyzer with the same ionization technique, allowing molecular detection over a wider molecular range, could allow the detection of additional biomarkers thus capturing a wider molecular range.


The degree of symptomatology of a patient with peripheral arterial disease dictates the kind of treatment. Despite the known therapies, some patients continue to have pain with ambulation, which affects their quality of life. The therapeutic implications of the angiogenic growth factors were identified by the pioneering studies of Folkman et al. 2 decades ago. Further investigations established the possibility of the use of formulations of recombinant angiogenic growth factors, with the objective of developing or increasing the network of collaterals in animal models of chronic myocardial or limb ischemia. Researches suggest that primitive stem cells with whole bone marrow possess greater functional plasticity, capable of contributing to regeneration of ischemic limb muscle and vascular endothelium by adult stem cells. Local autologous marrow stromal cells implantation induces a neovascular response resulting in a significant increase in blood flow to the ischemic limb. In this article we review the studies that have established how the implantation of bone marrow cells into ischemic limbs increases collateral vessel formation.


Objective: Computer and Internet literacy helps student nurses to achieve their learning goals. Increasing number of Saudi nurses is entering to work in the health care settings. It is vital that they have the abilities to use enhanced electronic means to find and utilize research findings throughout their career. There are limited numbers of nursing students' information technology usage and no studies of Saudi nursing students' computer and Internet utilization in their education were ring the literature review. The aim of this study is to investigate located du how student nurses use Computer and Internet for their studies in the College of Nursing, Jeddah. And the objectives are: To describe nursing students' use of computer and Internet during their education in College of Nursing, Jeddah. Materials and Methods: A relative frequency survey was conducted. The self-administered instrument's validity was tested by using expert evaluations and by conducting a pilot study. A convenient sample of 100 female nursing students was used and response rate was 89%. Results: The average age of the respondents was 22.3 years. Most of the students, 95.5% had their own computer and 68% had Internet connection at home. Only 41, 6% used Blackboard and 77.5% used e-mail in communication with their instructor. 80.9% of respondents searched nursing journals from the internet and only 12 students (n=89) used database(s) for information search. 82% of students found relevant nursing information for their studies from the Internet. Conclusion: This study shows that nursing students are not using systematic ways to retrieve evidence based information from the databases. National Guard Health Affairs Universities have a good and relevant collection of databases for nursing students. Nursing students also need further training in using Blackboard, Word processor, Excel, and reference managers.


Puccini's Madama Butterfly (1904) was a notorious failure at its world premiere: condemned by Italian critics for its "decorative" surfaces and apparent repetition of earlier Puccinian tropes. The first of the composer's two operas based on works by American playwright David Belasco, the opera was soon revised and received its belated New York Metropolitan Opera premiere in 1907 as part of a festival of the composer's works organized in his presence. The decision to visit New York was timely: not only had Belasco's source play been premiered there in 1900, but New York was by then emerging as the global center of the operatic gramophone industry, with recordings of Puccini's works made in Camden, New Jersey, frequently featuring performers from the Metropolitan Opera. This development echoed wider operatic power shifts between Italy and the United States at this time, which informed evolving attitudes to new sound reproduction technology on both sides of the Atlantic.
 This article re-examines Madama Butterfly from the perspective of Puccini's 1907 tour. In particular, it focuses on the composer's interactions with the U.S. gramophone industry during and before his New York visit, examining them in relation to broader questions of the Italian operatic future and ideas of Italian vocality. While Madama Butterfly has long been addressed in relation to its Orientalist depiction of Japan, reframing Puccini's Belasco-inspired opera within this transatlantic context can illuminate the fraught cultural politics of the gramophone industry, as well as their intersection with the wider musical dramaturgy of Puccini's opera. Ultimately, I argue, Madama Butterfly emerges as a vital document of a changing auditory culture ca. 1900, as well as of an ambivalent colonial imagination.


This report concerns a case of an 80-year-old man with progressive dysphagia and stridor. Patient's clinical and radiological evaluation revealed a mass of the hypopharynx and a large cervical osteophyte. Microlaryngoscopy under general anaesthesia demonstrated the presence of a hypopharynx abscess that was drained. A tracheotomy was performed in order to secure the airway, and 6 weeks later, the patient was decannulated and returned to full consistency diet.


1.Introduction The spread of the Covid-19 pandemic is unfortunately accompanied by the equally rapid one of unfair commercial practices in Italy. A worrying scenario, also for potential, serious…