INTRODUCTION: Epiphora is a relatively frequent problem encountered in
ophthalmology. It may be due to nasolacrimal sac obstruction following
an acute or chronic inflammation, trauma, tumour, or congenital
malformation. It may be associated with purulent secretion and
swelling of the sac region. Although medical treatment including
antibiotic therapy, may address the symptoms, definitive management
of this problem consists of surgical procedure in which patency of the
lacrimal system is restored. The standard surgery for the blockage of
the lacrimal outflow is dacryocystorhinostomy, in which the lacrimal
sac is connected directly to the nose by removing the layer of bone and
mucosa that separate these two structures. The aim of the surgery is at
draining the tears freely into the nose with sac mucosa forming part of
the lateral nasal wall. AIMS AND OBJECTIVES: To compare the external dacryocystorhinostomy with endoscopic
endonasal surgical dacryocystorhinostomy. To evaluate the outcomes of the two procedure on subjective and
anatomical basis. MATERIALS AND METHODS: A prospective non randomised clinical interventional study was
undertaken at Aravind Eye Hospital and Postgraduate Institute of
Ophthalmology, Madurai; in the department of Orbit and Oculoplasty.
The duration of the study was from May 2004 to June 2006. Fifty three
patients with Primary nasolacrimal duct obstruction with chronic
dacryocystitis were taken up for this study. Patients underwent either
external or endoscopic endonasal surgical DCR depending on their
preference after explaining the two procedures in detail. Consent of the
patient was obtained before including in the study. The ethical
committee in the hospital approved the study.
INCLUSION CRITERIA:
1. Patients with nasolacrimal duct obstruction.
2. Patent canaliculi.
3. Normal eyelid function.
4. No lacrimal sac pathology.
EXCLUSION CRITERIA:
1. Previous lacrimal surgery.
2. Functional nasolacrimal duct obstruction and canalicular
obstruction.
3. Suspicion of malignancy.
4. Post traumatic bony deformity.
DISCUSSION: Epiphora is an annoying symptom embarrassing the patient both
socially and functionally. Lacrimal surgeries continue to evolve with
new technical developments. There has been renewed interest in
performing dacryocystorhinostomy through an intranasal approach
using modern surgical tools such as endoscope and laser. The two
widely accepted modalities of treatment for epiphora resulting from
obstruction of the nasolacrimal ducts are external and endonasal
dacryocystorhinostomy.
The current study was carried out for a period of two years on 53
cases who had nasolacrimal duct obstruction of which 26 cases
underwent external DCR and 27 cases underwent endonasal DCR. Both
the groups were operated by single surgeon. The purpose of the study is
to compare the success rates and complications of these two
procedures.
In our study we have defined success as full success, partial
success and failure based on symptomatic relief of epiphora and
patency of nasolacrimal duct post operatively. In external
dacryocystorhinostomy group, 92.3% (24 cases) had full success and
7.7% (2 cases) had partial success. There was no failure reported in this
group. In endonasal dacryocystorhinostomy group, 74.1 % (20 cases)
had full success, 7.4 % (2 cases) had partial success and 18.5% (5 cases)
had failure. The difference in overall success rate (p value - 0.06) was
not statistically significant. The success rate in our study was
comparable to that of Hartikainen et al86 's who reported a success of
95% in external dacryocystorhinostomy and 71 % in endonasal
dacryocystorhinostomy. CONCLUSION: In our study,
The age distribution of patients were such that maximum
number (35.8%) of patients were in the age group of 31 – 40
years.
Females constituted 69.8% while males constituted only 30.2%.
62.3% of cases presented with nasolacrimal obstruction on left
side
External dacryocystorhinostomy had higher success rate of 100%
while endonasal surgical DCR had a success rate of 81.5%, but
the difference is statistically insignificant.
In external Dacryocystorhinostomy the only complication seen in
our study was prominent scar (15.4%). In endonasal
dacryocystorhinostomy the complications seen in our study were
pyogenic granuloma (3.7%), cheese wiring of canaliculi (7.4%),
tube displacement (7.4%), and failure (14.8%). One patient had
both pyogenic granuloma and failure accounting for 3.7%.
External dacryocystorhinostomy is a standard surgical procedure
for the treatment of nasolacrimal duct obstruction for successful
outcome with minimal risk of disturbing scar. It allows for the
inspection of the lacrimal sac for pathology like tumors and
dacryoliths and easy suturing of the mucosal flaps.
Endonasal dacryocystorhinostomy may be a viable option for the
treatment of nasolacrimal duct obstruction. Disadvantage of this
procedure include the preferred use of general anesthesia by
many surgeons, the need for expensive equipment and
instrumentation, and the relatively steep learning curve for this
procedure. Both the advantages and disadvantages of endonasal
DCR relative to external DCR should be carefully discussed with
patients contemplating endonasal surgery.
8. Future studies comparing DCR techniques should measure the
size of the created soft tissue and bony ostium, and the end point
should include not only improvement in symptoms but more
importantly static and dynamic observation and analysis of the
healed ostium.


The forecast of sales growth rates or slaes trend plays an important role in the evaluation of a business and projection of its future performance. Sales forecasting is a factor in the fundamental analysis and valuation of finance and accounting literature. An analysis of sales, inflation, and personal consumption expenditure data obtained from publicly available sources is the source of some useful suggestions for financial analysts evaluating the sales of a firm or an industry, particularly in emerging market economies burdened with high inflation. The author demonstrates the benefits of expressing sales in real terms (inflation-adjusted sales).


Vertebrate skeleton consists of numerous pieces of bone and cartilage, each placed at the appropriate anatomical site by an elaborate regulatory process in developmental patterning. In this process, mesenchymal cells initially form aggregates at the respective anatomical sites. These aggregates later generate chondrocytes that form a cartilage anlagen and further differentiate into hypertrophic chondrocytes in the growth plate cartilage that is replaced by bone through endochondral bone formation. In an alternative pathway, skeletogenic mesenchymal progenitor cells directly generate osteoblasts through an intramembranous bone formation process. In recent decades, considerable studies have been performed to understand the molecular mechanisms of these processes. By reviewing recent studies, the author attempts to address how the critical transcription factors and secreted factors regulate skeletal tissue formation. Emphasis is placed mainly on the in vivo functions of transcription factors Sox9, Runx2, and Osterix, and signaling exerted by secreted molecules such as Bone morphogenetic proteins (BMPs), Transforming growth factor β (TGF-β), Wnts, Fibroblast growth factors (FGFs), Indian hedgehog (Ihh), and Parathyroid hormone-related protein (PTHrP). Each of these factors is essential for the proper progression of skeletal tissue formation. Elucidation of the mechanisms that govern differentiation of skeletal cells would further contribute to our understanding of maintenance and diseases of skeletal tissue.


30 seconds. On several occasions it was impossible to precipitate the involuntary movements by persistent thumb to finger movements on the right hand; however, on relaxing the right limb and taking up a similar manoeuvre with the left, the right would immediately develop the involuntary movements as described. Passive movement did not precipitate an attack, nor did voluntary movement of either leg. This women demonstrated unilateral paroxysmal kinesigenic dystonic movements only. This dyskinesia was most commonly precipitated by voluntary movement of the affected limb; however, unlike those cases reported by Plant,' it was also possible to evoke similar attacks by voluntary movement of the contralateral hand. This suggests that whatever the specific precipitant of the dyskinesia, whether it be the movement itself or the anticipation of movement2 it does not have to be limited to the limb affected by the choreoathetosis.


Abstract The authors described the general structure of the valley of the Yare, near Norwich, in which the fundamental chalk-rock is covered by the following drift-beds:—1, the Chillesford sand and clay; 2, pebbly sands and pebble-beds; 3, the equivalent of the contorted Drift of Cromer; 4, the middle glacial sand; and, 5, the Boulder-clay. The valley is hollowed out in these beds. Sewer-shafts sunk in the bottom of the valley near Norwich have shown the existence of an abrupt hole or narrow trough in the chalk, having one of its sides apparently almost perpendicular. This is filled up in part by a deposit of dark-blue clay, full of chalk débris, exactly resembling the Boulder-clay at a distance from Norwich, but quite different in character from that occurring in the vicinity (No. 5); and this is overlain in part by a bed of the middle glacial sand (No. 4), and in part by a postglacial gravel. The authors believed that this peculiar hole or trough was excavated by glacial action after the deposition of the bed No. 3, and that it belongs to the earliest part of the middle glacial period. At Somerleyton Brick-kiln, near Lowestoft, a perfectly similar bed occurs between the drift and sand (Nos. 3 and 4).


The charging damage from metal etching and dielectric etching was studied using metal–oxide–semiconductor devices with an oxide thickness of 1.9–6.0 nm, and the impact of the charging on reliability of scaled-down devices, as well as damage monitoring methods appropriate for each plasma process and oxide thickness, were investigated. For metal etching, in which the electron shading effect is a major cause of charging, hot carrier degradation dominated oxide degradation for oxides of 3.5–6.0 nm. For thinner oxides (<3.0 nm), however, a gate leakage failure dominated, but the failure rate decreased with gate oxide thinning below 3.0 nm and became negligibly small below 2.2 nm. For dielectric etching, the gate leakage current was an effective damage monitor. To detect the latent damage accurately, use of a high oxide electric field of 5–9 MV/cm was effective. Like the metal etching damage, the failure rate was lower for a thinner oxide of <3.0 nm. The hot carrier degradation was less sensitive to the dielectric etching damage. To realize a plasma process with low damage and thus to improve the device reliability, time-modulated (TM) plasmas were applied to the electron cyclotron resonance (ECR) metal etcher, the ultrahigh frequency (UHF) dielectric etcher, and the inductively coupled plasma (ICP) polysilicon etcher. These etchers all showed reduced charging damage compared to the conventional continuous-wave plasma. The estimated amount of charges that passed through the gate oxide was reduced to about 1/4 in the ECR metal etcher. The oxide yield improved by about two times in the UHF dielectric etcher. The density of oxide traps decreased in the ICP polysilicon etcher. Thus, an application of the TM plasma for etching is practical and effective for fabricating large scale integrated circuits with high yield and reliability.The charging damage from metal etching and dielectric etching was studied using metal–oxide–semiconductor devices with an oxide thickness of 1.9–6.0 nm, and the impact of the charging on reliability of scaled-down devices, as well as damage monitoring methods appropriate for each plasma process and oxide thickness, were investigated. For metal etching, in which the electron shading effect is a major cause of charging, hot carrier degradation dominated oxide degradation for oxides of 3.5–6.0 nm. For thinner oxides (<3.0 nm), however, a gate leakage failure dominated, but the failure rate decreased with gate oxide thinning below 3.0 nm and became negligibly small below 2.2 nm. For dielectric etching, the gate leakage current was an effective damage monitor. To detect the latent damage accurately, use of a high oxide electric field of 5–9 MV/cm was effective. Like the metal etching damage, the failure rate was lower for a thinner oxide of <3.0 nm. The hot carrier degradation was less sensitive to the dielect...


In this article, we propose two important measures, quantile correlation (QCOR) and quantile partial correlation (QPCOR). We then apply them to quantile autoregressive (QAR) models, and introduce two valuable quantities, the quantile autocorrelation function (QACF) and the quantile partial autocorrelation function (QPACF). This allows us to extend the Box–Jenkins three-stage procedure (model identification, model parameter estimation, and model diagnostic checking) from classical autoregressive models to quantile autoregressive models. Specifically, the QPACF of an observed time series can be employed to identify the autoregressive order, while the QACF of residuals obtained from the fitted model can be used to assess the model adequacy. We not only demonstrate the asymptotic properties of QCOR and QPCOR, but also show the large sample results of QACF, QPACF, and the quantile version of the Box–Pierce test. Moreover, we obtain the bootstrap approximations to the distributions of parameter estimators and proposed measures. Simulation studies indicate that the proposed methods perform well in finite samples, and an empirical example is presented to illustrate usefulness. Supplementary materials for this article are available online.


Abstract. Sumarmiyati, Handayani F, Sundari. 2019. Insect diversity in rice field crops in Kutai Kartanegara District, East Kalimantan. Pros Sem Nas Masy Biodiv Indon 5: 217-221. Wetland cropping ecosystems has a wide variety of habitats. Plant pest organisms are an inhibitor in increasing rice production in East Kalimantan. Observation of the diversity of insects in the area of agricultural land is very important in supporting the provision of information on pest attacks on crops. The research was conducted in Kutai Kartanegara Regency, East Kalimantan in October-December 2016. The objective of this study was to obtain information about the types of insects in paddy fields. This research was conducted using purposive random sampling. Collection of insect was done using a swing net and insect light traps. Observation data was analised using Shanon (H) diversity / diversity index. To determine the uniformity / diversity of insect types using the Evenes index (E). The results showed 40 types of insects as pests, and 20 types of insects as natural enemies. The most common types of insect pests were found in the district. Marangkayu 28 types, Samboja 15 types, and Tenggarong 13 types. Insects as natural enemies were found in the district Marangkayu 17 types, Tenggarong 14 types and Samboja 13 types.


How do you convert mmol/litre to milligrams/ decilitre? 'Google' it and find an online converter? But we don't always have access to a computer and it could be dangerous to rely blindly on the results of an online converter. Wouldn't it be better to understand the methods of conversion? This is the focus of this drug calculation text book, which has been in print since the late 1970s and has been regularly updated. Previous drug calculation books appeared to have no bearing on actual clinical practice, however, a lot of thought went into this book's presentation. While some of it may seem a bit simplistic—for example, diagrams of syringes showing the correct dose—others are most helpful, for example showing 'real' drug bottle labels and how to interpret and convert to the needed dose. The book takes us through the different calculation methods, with helpful clinical alert sections pointing out potential dangers for specific drug. Calculating drugs is something we do every day and while not every nurse needs a whole textbook on it, this book would be a very useful for a ward library. This fifth edition of Understanding Pathophysiology has been extensively rewritten as our knowledge of diseases has changed enormously over time. An example would be immunological disease, the understanding of which has improved significantly since the publication of the original first edition. What has also changed is the presentation and layouts of textbooks. This edition of Understanding Pathophysiology is clearly indexed allowing quick reference to the piece of interest. The diagrams to explain more difficult aspects are clear and relevant, and there are helpful 'targeted learning' boxes that neatly summarize that chapter. The text starts with the basic concepts of pathophysiology, with a description of the cell and its structure, moving on to the mechanisms of self-defence, and then tackles the difficult subject of immunology. As mentioned, this is an area that has moved forward in leaps and bounds since earlier editions, and the often difficult to understand concepts of immunity are clearly described. Characteristics of human defences are well explained such as level and timing, specificity and cell types, active molecules, and protection. Diagrams show how these different defences work, and there are quickcheck revision boxes alongside the text. Having covered the basic concepts of pathophysiology, the book moves on to the specific body systems including the neurological, haematological, cardiovascular and lymphatic, pulmonary, and then renal and urological systems. The chapter on renal and urinary systems is well written. It has the most up-to-date information such as the latest guidelines on acute kidney injury (AKI) using RIFLE criteria. AKI is well described including possible causes split into, pre-renal, intrarenal or intrinsic, and post-renal AKI. There are clear flow diagrams of the possible reasons for AKI with helpful hints for its evaluation and also treatment. Overall, this textbook is a great example of how well complicated subjects can be described in an easy manner. This is a very interesting book useful for both nursing students and more advanced nurses and I highly recommend it. Understanding Pathophysiology. 5th Edition


Fire poses a continuous threat to forest ecosystems and can dramatically reduce valuable timber species in forest woodland areas. The occurrence of fire in Baikiaea plurijuga woodlands warrants the need of an active and timely fire detection system. Rudimentary methods of detecting fires are still in use in most of Zimbabwe's forest reserves, yet remote sensing has played a pivotal role around the globe in detecting and monitoring both active incidences and post fire burnt areas. Several satellite systems have been validated in different biomes of the world for both MODIS MOD14A1 and MCD14ML.However, there still remains a gap of knowledge in the accurate detection of fires in Baikiaea plurijuga woodlands. In this study we evaluate the accuracy of MODIS fire products using, confusion matrices, kappa statistic, true skill statistic (TSS), remote sensing and Geographical Information techniques where employed to assess the accuracy of MODIS MOD14A1 burnt area product and MCD14ML active fire product in fire detection. This is the first time results of accuracy assessment of fire products are reported in Baikiaea plurijuga woodlands. In both study sites, course resolution 1 km MODIS MOD14A1 burnt area fire product has a continually poor index of agreement with ground data kappa 0 and TSS value is 0. However, for MODIS MCD14ML we found high kappa and true skill statistic values, showing a high. However, we recorded high kappa and TSS values for the MODIS MCDML active fire product. These results, are consistent with the premise that, increase in spatial resolution reduces the sensors ability to detect fires in African Savanna woodlands


WHEN members of the family suspect that a baby is deaf or hard of hearing, they are of course alarmed. They want a diagnosis as early as possible, and this is one of the reasons why it is desirable to examine the child with defective hearing as early in its life as possible. However, there are also other reasons why it is expedient to recognize the presence and to determine the seriousness of a hearing defect early. Normal development of speech depends on whether enough acoustic stimuli reach the acoustic centers and the Wernicke center to train them. Only when these centers are charged often enough (literally innumerable times) with those stimuli, will the motor speech centers be stimulated in turn by them. The latter stimulation is synonymous with the impetus necessary for the development of spontaneous speech. If an examination of the hearing discloses that the distance at which


As pressure to access African resources and explore new market opportunities increases in light of a diminishing Western resource base, saturated markets and troubled economies; it is a priority for African designers to gain a better understanding of the broader and context specific issues of development. This paper explores the disciplines of Development Studies and Industrial Design in order to critically identify approaches to development best suited for African design interventions. Academics and practitioners in Development Studies tend to support one of two camps, the first, a highly critical post-Truman concept of development as a Capitalist agenda to access new markets and the second a more humanitarian approach to an equitable increase in quality of life for all. When exploring industrial design, products regularly become too style focused and fashionable, leading to increased redundancy while forgetting the ethical and political implications of design. Additionally industrial designers have been criticised for their take on development by creating products either designed with a misguided sense of charity, or designed for those in need, but remotely and without an understanding of cultural contexts. Similarly in recent conference proceedings claims of "design trawling" were raised against designers working for big corporates in impoverished communities highlighting possible hidden "Imperialistic agendas". This raises the question of how designers should balance seemingly contradictory good intentions and commercial interests in order to create a more democratic notion of design. Many of the critics of design do not doubt its power to create positive social change and there are many documented accounts of very successful products created for a more equitable society. This paper firstly introduces a history of development and design and then utilises the recent publication Design and Social Impact: A Cross-sectoral Agenda for Design Education, Research and Practice (Smithsonian Institution, 2013) in order to identify gaps and challenges in current approaches to social impact design. This paper then specifically compares some of these issues under the banners of participation, and monitoring and evaluation by utilising literature and case studies drawn from the historically older discipline of Development Studies in comparison to literature and case studies from the discipline of Industrial Design. The aim of this is to identify approaches and methods for development best suited for designers in Africa.


Abstract In the context of modern information systems, security has become one of the most critical quality attributes. The purpose of this paper is to address the problem of quality of information security. An approach to solve this problem is based on the main assumption that security is a process oriented activity. According to this approach, product quality can be achieved by means of process quality - process capability. Introduced in the paper, SPICE conformant information security process capability model is based on process capability modeling elaborated by world-wide software engineering community during the last 25 years, namely ISO/IEC 15504 that defines the capability dimension and the requirements for process definition and domain independent integrated model for enterprise-wide assessment and Enterprise SPICE improvement


In this paper, a facile and environmentally benign method is used to pretreat carbon nanotubes (CNTs) by alkali modification, which decreases the wall thickness, increases the inner diameter, and improves the graphitization degree of CNTs compared to conventional acid treatment. The iron catalyst supported on alkali modified CNTs shows extraordinary Fischer–Tropsch synthesis (FTS) activity and CO conversion (1.78 and 2.41 times, respectively) compared with those supported on either the acid treated or pristine CNTs. Additionally, the diesel (C10‐20) selectivity on Fe/CNTs‐Na is up to 60 %, which is much higher than that calculated from the Anderson–Schulz–Flory distribution (39 %). Similar results are also found by using activated carbon (AC) and N‐doped multiwall carbon nanotubes (NCNTs) as supports for FTS, proving the universal applicability of alkali modification on carbon material. The positive relationship between the C5+ selectivity and C2−C4 olefin/paraffin ratio of iron catalyst can also be achieved irrespective of the support type.


The marginal likelihood is a well established model selection criterion in Bayesian statistics. It also allows to efficiently calculate the marginal posterior model probabilities that can be used for Bayesian model averaging of quantities of interest. For many complex models, including latent modeling approaches, marginal likelihoods are however difficult to compute. One recent promising approach for approximating the marginal likelihood is Integrated Nested Laplace Approximation (INLA), design for models with latent Gaussian structures. In this study we compare the approximations obtained with INLA to some alternative approaches on a number of examples of different complexity. In particular we address a simple linear latent model, a Bayesian linear regression model, logistic Bayesian regression models with probit and logit links, and a Poisson longitudinal generalized linear mixed model.


Marek Kacewicz is a research consultant with Chevron Energy Technology Company in Houston, Texas. Prior to joining Chevron, Marek worked as a research geologist for ARCO Exploration and Production Research Center in Plano, Texas, and worked as a basin modeler for Unocal Exploration and Exploitation Technology in Sugar Land, Texas. He has more than 20 years of experience in basin modeling, exploration, and research. His experience covers a wide range of geographic areas worldwide. Some of his professional honors include receiving the 1986 International Association for Mathematical Geology Vistelius Research Award, being selected as an Alexander von Humboldt Fellow (Germany), and receiving the 2005 AAPG Gabriel Dengo Memorial award. He has an M.S. degree in computer science/numerical mathematics and a Ph.D. in earth sciences, both from the University of Warsaw (Poland). Kenneth Peters is a geochemical advisor for Schlumberger. He is the principal author of The Biomarker Guide (2005, Cambridge University Press) and consulting professor at Stanford University where he leads the Basin and Petroleum System Modeling Industrial Affiliates Program. He is a chair of the AAPG Research Committee, AAPG distinguished lecturer for 2009 and 2010, associate editor for AAPG Bulletin and Organic Geochemistry , and editor for the 2009 AAPG Datapages publication Getting Started in Basin and Petroleum System Modeling . He is the recipient of the 2009 Schlumberger Henri Doll Prize for Innovation and the 2009 Alfred E. Treibs Award presented on behalf of the Organic Geochemistry Division of the Geochemical Society. He has a Ph.D. in geochemistry from the University of California, Los Angeles, and spent 15 years with Chevron, 9 years with Mobil and ExxonMobil, and 6 years with the U.S. Geological Society. David Curry is a senior geological advisor on petroleum systems in the Offshore Division at Devon Energy in Houston, focusing primarily on petroleum …


A private healthcare activity follows the same principles that are applicable to any professional activity that interacts with a heterogeneous public. In fact, also for a dental office, knowledge and reputation are fundamental assets for a successful professional activity and need to act in synergy and are mutually reinforcing.1 The graph shows how investing in technology is crucial for the optimisation of a dentist's activity (Fig. 1).


This article presents the latest information about biological functions of basement membranes. It describes all important basement membranes' components and their structure. Schemes showing modular sequence of collagens, nidogen, laminins and other polypeptides and also structural model of basement membranes were included.


The endocardiosis, occasionally worsened by valvular prolapse, has been often described in adult and young pigs. It has been observed that haemodynamics, immunological, genetic and constitutional factors are involved. 48 wild boars were examined. The animals were shot down in hunting season 1992-93 and came from the 4 sardinian districts. All the hearts were grossly examined and the cardiac valves were treated for light microscopy. We didn't observe prominent lesions but small nodular and translucent thickening of the valvulare edge. No valve prolaps was present. Microscopic examination showed mixomatosis, oedema, metachromasia and Alcian-positivityin 27 mitralis (56.25%) and 6 tricuspis valves (12.5%). In 2 wild boars parietal endocarditis was also found.


A pencil-beam radio telescope of the cross type is described; it has a beamwidth of 49 minutes of arc and a sensitivity which approaches, under ideal conditions, 2×10-26 W m-2 (cps)-1, that is, about 1/10,000 the flux density of the strongest radio source. To speed the collection of information the beam may be scanned, presenting information on five separate declinations quasi-simultaneously. Although it is intended primarily as a survey instrument, strong radio sources may be located with high accuracy; the probable errors in the measured positions of the stronger identified sources average less than a 1-foot arc. Methods of calibrating the flux density and temperature scales are described and some examples are given of the use of the radio telescope. The theory of operation and some of the design factors are discussed and it is concluded that, for a given size of antenna and the best snr on a typical radio source, the wavelength is rather well defined. This optimum generally lies in the range 2 m to 4 m, depending on details of the receiver and antenna design; other factors, however, play an important part in the choice of wavelength.


Objective To estimate the burden of diseases in Shandong province by the means of DALY (Disability- adjusted life year) thus to investigate the key public health problems referencing for health policy making. Methods DALYs were calculated following the procedures developed for the Global Burden of Disease (GBD) study to ensure comparability. We measured YLLs using the mortality data of 19 Disease Surveillance Points (DSPs) in Shandong Province during 2000 and 2005. YLDs were estimated based on data for WPRO in the 2002 GBD study published by WHO. Results During this period, the average DALYs loss by all causes for the residents of DSPs in Shandong was 149.74 per thousand persons each year. Noncommunicable diseases accounted for 76.63% of the disability adjusted life years, communicable diseases and other disorders represented 14.13%, and injuries 9.24%. Nearly half of the DALYs (45%) happened among the elderly (60+). Malignant neoplasm was the number one cause of DALYs loss in the male, followed by neuropsychiatric disorder, injury, cerebrovascular disease, heart disease,etc. However, neuropsychiatric disorder possessed the largest single contributor to DALY in the female and followed by heart disease, malignant neoplasm, cerebrovascular disease and respiratory disease. Conclusion Non-communicable diseases such as circulatory diseases, neuropsychiatric disorders and malignant neoplasms were the main causes of disease burden in Shandong province. The importance of neuropsychiatric disorders was more striking and should be recognized properly. The lack of morbidity data is the main limitation of this study. Abstract in Chinese 目的 应用伤残调整寿命年测量山东省居民疾病负担,提出该地区主要卫生问题,为卫生决策提供科学依据. 方法 以山东省2000-2005年19个疾病监测点的死因监测资料为基础,利用世界卫生组织(WHO)提供的方法计算不同疾病在不同性别年龄人群所造成的伤残调整寿命年(DALYs),其中,YIJDs根据WHO公布的亚太区2002年疾病负担数据进行估算. 结果 2000-2005年山东省疾病监测系统居民因为早死和残疾年平均损失149.74个DALYs/千人,其中,76.6%的DALYs损失因慢性非传染性疾病所致,14.1%由传染性疾病等引起,9.2%因为意外伤害造成;接近1/2(45%)的DALYs损失发生在60岁以上人群;恶性肿瘤为造成男性居民DALYs损失的首位原因,其次为精神行为疾患、意外伤害、脑血管病和心脏病等,女性居民则以精神行为疾患为DALYs首位原因,其次为心脏病、恶性肿瘤、脑血管病和呼吸系统疾病. 结论 以循环系统疾病、精神行为疾惠和恶性肿瘤为首的慢性非传染性疾病为造成山东省疾病负担DALYs损失的主要原因.对于精神行为疾患的重要性的认识有待于进一步提高,研究的主要局限性在于发病率资料的缺乏.


Controversy continues regarding the initial management of civilian colon injuries. The main issues are the safety of colostomy versus the desirability of primary repair and the role of exteriorized repair. From 1979 through 1984, 727 patients with injuries to the colon were treated at a large urban trauma center. Ninety-seven per cent of injuries were caused by penetrating wounds. Ten patients died in the operating room prior to repair of the colon wound. For patients who survived long enough to have their injury treated, 52.4% were treated by primary repair, 32.9% were treated with colostomies, and 14.6% were treated with exteriorized repair. Of the factors that have been stated to influence decision making, the extent of the colon injury was the most important. Location, number, and type of associated injuries, fecal contamination, and shock were less important. However, none of these latter factors mandated performance of a colostomy. The overall mortality rate for the series was 9.9%. Forty-one out of 70 deaths occurred within the first 48 hours and were due to shock and hemorrhage. The mortality rate for primary repair was significantly lower than that for colostomies (p less than 0.01). The presence of shock and age greater than 40 were significant factors influencing mortality (p less than 0.01). Mortality also was directly related to the number and type of associated abdominal injuries. Abdominal abscess also occurred significantly less often in patients treated with primary repair than in those with colostomies (p less than 0.01). The use of exteriorized repair was successful in avoiding colostomy in 59% of patients. Primary repair can be performed with minimal morbidity and mortality and should be the mainstay of treatment for civilian colon injuries.


parameterized by θ ∈ R . But we do not expect that the "sum" of two such solutions will again be a solution. However, the special class of soliton equations, the subject of this article, does have a form of nonlinear superposition. An n-soliton solution is a solution that is asymptotic to a nontrivial sum of n solitary waves ∑n i=1 fi(x− cit) as t → −∞ and to the sum of the same waves ∑n i=1 fi(x− cit + ri) with some nonzero phase shifts ri as t →∞. In other words, after nonlinear interaction the individual solitary waves pass through each other, keeping their velocities and shapes but with phase shifts. Equations with multisoliton solutions are very rare (they occur nearly always in one space dimension); these equations are called soliton equations. The Korteweg-de Vries equation


Carcinoids are neuroendocrine neoplasms. Bronchial carcinoids are unusual, malignant primary neoplasms that characteristically involve the central airways and typically exhibit well-defined margins and bronchial-related growth. Bronchial carcinoids include low-grade typical carcinoids and the more aggressive atypical ones. They usually affect patients in the 3rd through the 7th decade of life who are often symptomatic with cough, hemoptysis or obstructive pneumonia. Rarely, the initial symptoms are related to the secretion of hormones causing carcinoid or other endocrine syndromes. Bronchial carcinoids radiologically manifest as hilar or perihilar masses, with or without associated atelectasis, pneumonia or bronchiectasis. At CT-scan the relationship of these tumors with the bronchial tree is usually seen, and they show contrast enhancement or calcification. Even if the radiological signs may be suggestive for bronchial carcinoid, the definitive diagnosis is reached only by the tissue sampling. Bronchoscopic biopsy is the more effective way to identify the nature of carcinoid tumors because of their frequent central location. The treatment of choice is the surgical resection which should be carried out with maximum respect for the residual lung and bronchial tissues. Endoscopic ablations in well defined cases, bronchotomy and lung resections with or without bronchoplastic procedures have been described. Hilar and mediastinal lymph node sampling and examination should be ever performed during open procedures. Positivity of the nodal tissues could influence the resection procedure and is related with the prognosis, specially for the atypical carcinoids. Chemo- and radiation therapy are not effective in improving the long-term outcome in those patients with advanced disease. The long-term outcome is strictly related with the histological subtype and the lymph node status. Local recurrences and distant metastases are more frequent in the atypical carcinoids which manifest a more aggressive behavior. During the last decade, the importance of the use of somatostatine analogues (octreotide) in the staging, early detection of the recurrent disease and its management such as that of the associated carcinoid syndrome became clear.


The treatment of hepatitis C virus (HCV) infections is essentially known for chronic hepatitis C and is mainly restricted to interferon alpha. Initial trials have indicated that around 50% of the patients with chronic hepatitis C respond to alpha interferon (administered at 3 MU, thrice weekly, during 6 months) by normalizing alanine aminotransferase at the end of therapy, although 25% were found to relapse after therapy. Normalization of biochemical tests is associated with an improvement in liver histological features and with decrease or loss of HCV from serum and liver. Response to therapy is influenced by both duration and dose levels of the treatment. Following studies which showed that higher doses and longer duration were more effective than the current recommendations of 3MU thrice weekly for 6 months have recently conducted to the recent recommendation of a 12 month course of therapy using 3 MU. The outcome of therapy was also shown to be negatively influenced by longer duration of disease and presence of cirrhosis. More recently, the critical role of virological markers has been emphasized with a lower rate of response in patients infected with the genotype 1 b and a high viral load. However, these factors do not certainly predict for an individual patient the quality of the response. Therapeutical goals are: to precisely define pre-treatment scores of response able to give each individual patient the optimal treatment regimen, non responders to interferon alpha and patients with a transient benefit of therapy. Thus, development of new treatments appears critical among which those with other interferons and above all the bitherapy using ribavirin and interferon alpha which may have a marked increase in efficacy in comparison with interferon alpha used as monotherapy.


The purpose of this study is to analyze the results of the test of students' mathematical communication skills on the topic of geometry. This research method is a qualitative research with the participants as many as 25 students in 8 grade of a junior high school in Bandung, then grouped based on early understanding of mathematics. Instrument used in this research are interview and written test with problem which presented refers to indicator of student's mathematical communication skill. The results showed that upper-level students were able to describe the answers correctly, not yet structured in the presentation of the answer, it therefore can cause the skill in using mathematical terms and the presentation of mathematical ideas are still weak. While middle-level students experienced barriers in describing relationships and situations models, and connecting real objects, images, and diagrams into mathematics. In addition, lower-level students have not been able to interpret the problems of communication in correct answers yet. The conclusion is that the mathematical communication skill of students is still lack. So that there needs appropriate learning strategy to improve student's mathematical communication skill.


Implementation of the recommendations from the Organ Donation Taskforce has introduced for the first time into the UK a nationwide framework for deceased donation. This framework is based, in principle, upon a conviction that donation should be viewed as part of end-of-life care and that the actions often necessary to facilitate it become justified when donation is recognized to be consistent with the wishes and interests of a dying patient. The implementation of the Taskforce recommendations across the complex landscape of acute hospital care in the UK represents a challenging programme of change management that has three more or less distinct phases. This programme has involved first creating and communicating the Taskforce's vision for donation in the UK, secondly introducing the structural elements of this new framework into hospital practice, and finally creating the environment in which these new elements can deliver the overall programme goals. Implementation has focused heavily upon areas of practice where significant opportunities to increase donor numbers exist. It is recognized that the greatest challenge is to overcome the societal and clinical behaviours and beliefs that currently create barriers to donation. Although national audit data may point to some of these areas of practice, international comparisons suggest that differences in approach to the care of patients with catastrophic brain injury may have a profound influence on the size of the potential donor pool.


This thesis describes the application of the stochastic-flow-modeling (SFM) approach to represent the quality behavior of a manufacturing system. Initially, a simple, one-product type SFM is discussed and then a more complex multiple-product manufacturing system is developed. This quality SFM-based model has aggregation by station, product, and operational shift. Subsequently, potential supervisory control architectures that could be used in conjunction with this quality-based SFM are discussed and developed. Distribution parameter fitting is explored using static and adaptive approaches and a comparison between these two approaches is given. Then, the accuracy of the SFM modeling technique is demonstrated using two simulation examples. Effective equipment maintenance is essential for a manufacturing plant seeking to produce high quality products. The impact of equipment reliability and quality on throughput have been well established, but the relationship between maintenance and quality is not always clear nor direct. Therefore, after developing a SFM to represent the quality of a manufacturing system, the focus of this work shifts towards identifying correlations between maintenance and quality. This thesis describes a statistical modeling method that makes use of a Kalman filter to identify correlations between independent sets of maintenance and quality data. With such a method, i maintenance efforts can be better prioritized to satisfy both production and quality requirements. In addition, this method is used to compare results from the theoretical maintenance-quality model to data from an actual manufacturing system. Results of the analysis indicate the potential for this method to be applied to preventive, as well as reactive maintenance decisions, since ageing aspects of equipment are also considered in the model.


A new network configuration is introduced which may be used in active RC network synthesis. It uses a voltage-controlled voltage amplifier having negative gain equal to unity and a voltage- or current-inversion negative-impedance convertor. A synthesis procedure is eventually described using the new configuration.


Exploring the genetic basis of heritable traits remains one of the central challenges in biomedical research. In simple cases, single polymorphic loci explain a significant fraction of the phenotype variability. However, many traits of interest appear to be subject to multifactorial control by groups of genetic loci instead. Accurate detection of such multivariate associations is nontrivial and often hindered by limited power. At the same time, confounding influences such as population structure cause spurious association signals that result in false positive findings if they are not accounted for in the model. Here, we propose LMM-Lasso, a mixed model that allows for both, multi-locus mapping and correction for confounding effects. Our approach is simple and free of tuning parameters, effectively controls for population structure and scales to genome-wide datasets. We show practical use in genome-wide association studies and linkage mapping through retrospective analyses. In data from Arabidopsis thaliana and mouse, our method is able to find a genetic cause for significantly greater fractions of phenotype variation in 91% of the phenotypes considered. At the same time, our model dissects this variability into components that result from individual SNP effects and population structure. In addition to this increase of genetic heritability, enrichment of known candidate genes suggests that the associations retrieved by LMM-Lasso are more likely to be genuine.


A fast performance analysis method for NAND flash-based storage devices (NFSDs) is proposed. The method first profiles the operational statistics of an NFSD and then estimates its throughput based on the proposed model. Experimental results show that its accuracy reaches up to 98.7% of the cycle-accurate simulation, while the analysis speedup is more than three orders of magnitude. Also, the generality of the method is shown by applying it to NFSDs with an arbitrary number of channels.


Influenza A virus is a major human and animal pathogen with the potential to cause catastrophic loss of life. Influenza virus reproduces rapidly, mutates frequently, and occasionally crosses species barriers. The recent emergence of swine-origin influenza H1N1 and avian influenza related to highly pathogenic forms of the human virus has highlighted the urgent need for new effective treatments. Here, we describe two crystal structures of complexes made by fragments of PA and PB1, and PB1 and PB2. These novel interfaces are surprisingly small, yet they play a crucial role in regulating the 250 kDa polymerase complex, and are completely conserved among swine, avian and human influenza viruses. Given their importance to viral replication and strict conservation, the PA/PB1 and PB1/PB2 interfaces appear to be promising targets for novel anti-influenza drugs of use against all strains of influenza A virus. It is hoped that the structures presented here will assist the search for such compounds.


Background EBUS is the new gold standard for mediastinal sampling, but is difficult to learn and very operator-dependent. Competency is currently established based on experience (number of performed procedures), self-assessment (the physician9s own judgment), or the subjective opinion of a supervisor. Aims and objectives The aim of the study was to explore to what degree experience, self-assessment, and theoretical knowledge could predict the quality of an EBUS procedure. Our hypothesis was that experience would correlate better with actual performance than self-assessment and theoretical knowledge. Methods Thirty-one international physicians filled out a questionnaire regarding number of performed EBUS procedures and self-assessment of competency. Theoretical knowledge was assessed by administering a validated test with 46 questions. All participants performed an EBUS procedure including two biopsies on a virtual-reality simulator and previously validated simulator metrics were used for objective assessment of quality. Results Surprisingly, the number of correct answers on the theoretical test was the best predictor of technical performance (Pearson correlation=0.52, p=0.004). Experience and self-assessment were weak, insignificant predictors (Pearson correlations=0.01, p=0.59 and 0.18, p=0.35, respectively). Conclusions Caution has to be used when establishing basic competency in endosonography based on number of performed procedures or the perception of the physician. We propose to develop an evidence-based credentialing system consisting of theoretical and practical tests.


The INFN Tier-1 datacentre provides computing resources to several HEP and Astrophysics experiments. These are organized in Virtual Organizations submitting jobs to our computing facilities through Computing Elements, acting as Grid interfaces to the Local Resource Manager. We are phasing-out our current LRMS (IBM/Platform LSF 9.1.3) and CEs (CREAM) set to adopt HTCondor as a replacement for LSF and HTCondor-CE in place of CREAM. A small instance has been set up to practice with the cluster management and evaluate the feasibility of our migration plans to a new LRMS and CE set. A second cluster instance has been setup to work on production. A number of management tools have been adapted or rewritten in order to integrate the new system with the existing infrastructure. Two different accounting solution for the HTCondor-CE have been implemented, and the more reliable one have been adopted. A python tool has been written to disentangle the management of HTCondor machines from our puppet instance, and to enable a quicker configuration of the cluster nodes. The monitoring tools tied to the old system are being adapted to also work on the new one. Finally, the most relevant setup steps have been documented in a public wiki page and a support mailing has been created to help other INFN sites willing to migrate their LRMS and CE to HTCondor. This document reports about our experience with HTCondor-CE on top of HTCondor and the integration of this system into our infrastructure.


Background and Objective: Renal failure is a major Thai public health problem. Ministry of Public Health and the National Health Security hence have established the peritoneal dialysis (PD) program for all renal failure patients. The main issue of the PD is infection or peritonitis. Surin hospital has been provided PD since January 2009. This study aimed to describe factors associated with infection in PD patients. Methods: This was a descriptive study. We retrospectively reviewed medical records of all PD patients with aged of over 20 who treated at Surin Hospital between January 2009 and December 2015. Baseline characteristics of all patients were recorded including history of infected PD, numbers of infected PD, and gap between recurrent infected PD. Clinical factors were compared between those with and without infected PD. Results : During the study period, there were 407 eligible PD patients. Infected PD was reported in 201 patients (49.39%) and in total 353 times or 0.67 time/patient/year. Those who had infected PD had significantly lower hemoglobin level (9.72 vs 10.23 g/dl; p values 0.016), and lower proportions of diabetes (30.3 vs 41.7%; p value 0.017). Conclusions : Infected PD rate of Surin hospital complied with standard criteria however negative culture result was much higher than the goal criteria. Anemia and being diabetes were two significant factors between those with and without infected PD.


Ultrasound and palpation findings of 17 patients with branchiogenic cysts were studied. Results were compared with operative and histopathologic findings in 13 patients, and to fistulography, cytologic examination and/or CT in 4 patients. Ultrasound findings (appearance, location and extension) were characteristic in 15 of 17 cases. Palpation proved to be incorrect or inconclusive in more than half of the patients. It is concluded that ultrasound examination of the neck may contribute to the correct presurgery diagnosis of branchiogenic cysts.


The increasing sophistication used in the fabrication of semiconductor nanostructures and in the experiments performed on them requires more sophisticated theoretical techniques than previously employed. The philosophy behind the author's exact envelope function representation method is clarified and contrasted with that of the conventional method. The significance of globally slowly varying envelope functions is explained. The difference between the envelope functions that appear in the author's envelope function representation and conventional envelope functions is highlighted and some erroneous statements made in the literature on the scope of envelope function methods are corrected. A perceived conflict between the standard effective mass Hamiltonian and the uncertainty principle is resolved demonstrating the limited usefulness of this principle in determining effective Hamiltonians. A simple example showing how to obtain correct operator ordering in electronic valence band Hamiltonians is worked out in detailed tutorial style. It is shown how the use of out of zone solutions to the author's approximate envelope function equations plays an essential role in their mathematically rigorous solution. In particular, a demonstration is given of the calculation of an approximate wavefunction for an electronic state in a one dimensional nanostructure with abrupt interfaces and disparate crystals using out of zone solutions alone. The author's work on the interband dipole matrix element for slowly varying envelope functions is extended to envelope functions without restriction. Exact envelope function equations are derived for multicomponent fields to emphasize that the author's method is a general one for converting a microscopic description to a mesoscopic one, applicable to linear partial differential equations with piecewise or approximately piecewise periodic coefficients. As an example, the method is applied to the derivation of approximate envelope function equations from the Maxwell equations for photonic nanostructures.


Abstract The aim of this study is to evaluate the infection risk of aircraft passengers seated within and beyond two rows of the index case(s) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A(H1N1)pdm09 virus, and SARS-CoV-1. PubMed databases were searched for articles containing information on air travel–related transmission of SARS-CoV-2, influenza A(H1N1)pdm09 virus, and SARS-CoV-1 infections. We performed a meta-analysis of inflight infection data. In the eight flights where the attack rate could be calculated, the inflight SARS-CoV-2 attack rates ranged from 2.6% to 16.1%. The risk ratios of infection for passengers seated within and outside the two rows of the index cases were 5.64 (95% confidence interval (CI):1.94–16.40) in SARS-CoV-2 outbreaks, 4.26 (95% CI:1.08–16.81) in the influenza A(H1N1)pdm09 virus outbreaks, and 1.91 (95% CI:0.80–4.55) in SARS-CoV-1 outbreaks. Furthermore, we found no significant difference between the attack rates of SARS-CoV-2 in flights where the passengers were wearing masks and those where they were not (p = 0.22). The spatial distribution of inflight SARS-CoV-2 outbreaks was more similar to that of the influenza A(H1N1)pdm09 virus outbreaks than to that of SARS-CoV-1. Given the high proportion of asymptomatic or pre-symptomatic infection in SARS-CoV-2 transmission, we hypothesised that the proximity transmission, especially short-range airborne route, might play an important role in the inflight SARS-CoV-2 transmission.


Microscope-integrated intraoperative OCT (iOCT) allows live cross-sectional imaging concurrent with ophthalmic surgery and dynamic visualization of tissue-instrument interactions. However, limited volumetric data acquisition rates and three-dimensional rendering and display remain critical barriers to iOCT-guided surgical maneuvers. We present a microscope-integrated iOCT system with heads-up display (HUD) and novel semi-transparent ophthalmic surgical instruments. Cross-sectional iOCT imaging of surgical maneuvers using real-time HUD feedback and novel instrumentation is used to demonstrate the utility of real-time cross-sectional imaging for surgical guidance.


Applying Dialogical Methods for Investigations of Happening of Change (DIHC), this study investigated how children who had been diagnosed with an oppositional defiant or conduct disorder participated in a collaborative post-therapy research interview and talked about their experiences of family therapy. The results showed that the children participated as dialogical partners talking in genuine, emotional, and reflective ways. Encountered as full-membership partners, the children also co-constructed meanings for their sensitive experiences. However, their verbal initiatives and responses appeared in very brief moments and could easily have been missed. The collaborative post-therapy interview offered a safe forum for co-reflection by participants on what they had found useful or difficult in the family therapy process. In this interview setting, the family first listens to reflection by the therapists on the therapy process and their thoughts on some of the family's related sensitive issues. The results indicate that when therapists present themselves as not-knowing, receptive and accountable, therapists may facilitate reflection for all family members, including children.


The purpose of this paper has two major aspects. First, it provides an opportunity of presenting an overview of some of the innovations and recent developments in the field of Child Welfare in Victoria. Second, it poses a challenge to make some comment on what these developments might actually add up to; in other words, it begs the question of whether one can make some sort of sense of what is going on. When you are working "in the field", or as we would say with equally telling imagery in the U.K., "at the coal face", you cannot always be aware of the implications and ramifications of what you are doing. True, the managers and the planners of your operations must, and do, give thought to this, but for the majority of us, beset by the problems of everyday work routines, it is hard to lift one's glance beyond the eye-level plane; what is more, one is too exhausted to read the unabating volume of reports and articles and statements that are around.


OBJECTIVE
To analyze the treatment outcomes in patients with spontaneous esophageal rupture (SER).

MATERIAL AND METHODS
The study included 106 patients with SER admitted to the Sklifosovsky Research Institute for the period from 1992 to 2015. The sample also included 91 patients who were referred from other hospitals. All patients were divided into 4 groups depending on surgical procedure: surgical drainage (Group I, n=19); suturing the esophageal defect without antireflux surgery (Group II, n=12); esophageal wall repair with fundoplication procedure (Group III, n=62); resection of the thoracic esophagus (Group IV, n=13).

RESULTS
In the 1st group, complication rate was 100% and significantly exceeded these values in groups II, III, and IV (66.7%, 71%, and 69.2%, respectively; p=0.0318, p=0.0189, and p=0.0413). The length of hospital-stay was the lowest in group IV (mean 42 days) and group I (mean 55 days). Mortality rate in groups I, III and IV was 15-20% lower than in group II. Pneumonia and pleural empyema were significant predictors of poor outcome. Fundoplication improved postoperative outcomes in group III compared to group II. Resection of the thoracic esophagus performed in accordance with strict indications interrupts infectious process and shortens recovery period. Surgical drainage is followed by persistent contamination of mediastinum and pleural cavities that may quickly result a fatal outcome.

CONCLUSION
A differentiated approach to SER treatment can reduce the risk of complications and mortality.


This study examines the effectiveness of a peer counselling program in Hong Kong for the elderly with depression living in the community, and its impact on the peer counsellors. Thirty depressed elderly subjects participated in the program, which was found to have improved their perceived health status and level of depression. As a result of their participation, subjects have also received more social support and adopted more positive coping strategies. As far as peer counsellors were concerned, they benefited in terms of personal growth through helping others, and helped to open a gateway to their own successful aging. Similar programs applied to wider populations and program evaluations utilizing both process and outcome measures are the key recommendations of this study.


Multi-way relay networks (MWRNs) allow multiple users to exchange information with each other through a single relay terminal. MWRNs are often incorporated with capacity achieving lattice codes to enable the benefits of high-rate signal constellations to be extracted. In this paper, we analytically characterize the symbol error rate (SER) performance of a functional decode and forward (FDF) MWRN in the presence of channel estimation errors. ConsideringM -ary quadrature amplitude modulation (QAM) with square constellations as an important special case of lattice codes, we obtain asymptotic expressions for the average SER for a user in FDF MWRN. The accuracy of the analysis at high signal-to-noise ratio is validated by comparison with the simulation results. The analysis shows that when a user decodes other users with better channel conditions than itself, the decoding user experiences better error performance. The analytical results allow system designers to accurately assess the non-trivial impact of channel estimation errors and the users' channel conditions on the SER performance of a FDF MWRN withM -QAM modulation.


The potential of the combination of SI nuclease and pseudo-complementary PNA (pcPNA) for site-selective scission of double-stranded DNA has been investigated. Through strand invasion of two pcPNAs, single-stranded portions were formed in both strands of substrate DNA. In the initial stage of the enzymatic digestion, two scission fragments were obtained due to the hydrolysis at these two gap-like sites. On prolonged reactions, however, these products (as well as the substrate DNA) were further digested to smaller fragments. Under the conditions employed here, only Ce(IV)/EDTA is available for the preparation of desired fragments from double-stranded DNA.


One of the intrinsic weaknesses of our historical studies is that we can understand the past only by utilizing analogies to our age. What we comprehend of past events or personalities most readily is the features which they seem to have in common with our own forms of life, and it is from these associations that we take our cue in exploring the past. We know how fallacious this method can be, since a closer study of the historical landscape possibly reveals that what we regarded as a landmark had actually little significance in its own age and what we believed a resemblant factor was nothing but a superficial similarity. So we have very often to burn the bridges over which we entered into the territory of the past.


Approximately 30 % of HIV-infected patients with viral load being suppressed during the course of antiretroviral therapy do not recover their peripheral CD4+T-lymphocyte counts. The reason for this phenomenon, named immunological non-response to treatment, remains unknown. In HIV-positive subjects receiving treatment, interleukin 7 plays a key role in increasing the number and supporting the viability of CD4 + T-lymphocytes. We hypothesized that chronic immune activation, which develops in response to immunological failure during the therapy course, may reduce the susceptibility of CD4 + T-cells to interleukin 7 in HIV-positive subjects. We examined 38 HIV-infected immunological non-responders to therapy; 42 HIVpositive patients with a standard response to treatment; 19 uninfected volunteers. The content of CD4 + , CD4 + CD127 + and activated HLA-DR + CD38 + T-lymphocytes was determined in the peripheral blood of the examined individuals; the concentration of interleukin 7 was established. As a result, it was shown that interleukin 7 concentrations in the blood plasma of HIV positive immunological non-responders to treatment does not differ from the corresponding values of patients who gave a standard response to antiretroviral therapy. At the same time, immunological non-responders to treatment compared with subjects of both control groups were characterized by a deficiency of absolute and relative CD4 + CD127 + T-cell counts capable of responding to interleukin 7. Moreover, the interleukin 7 receptor expression level was reduced on CD4 + T-lymphocytes of immunological non-responders. The higher was the frequency of activated CD4 + T-lymphocytes; the lower was the CD127 + expression density. It should be noted that after excluding the data obtained from patients coinfected with HIV and hepatitis C virus, which are known to have significantly higher levels of chronic immune activation and systemic inflammation, we found no differences in CD127 expression between HIVpositive patients with distinct effectiveness of the immunological response to treatment. Thus, in the present study, we showed that in HIV-infection, poor immunologic response to antiretroviral therapy is associated with a decrease in the CD4 + CD127 + T-cell counts. Moreover, an increase in the level of chronic immune activation is associated with a decrease in CD127 expression density on CD4 + T-lymphocytes.


Based on bottom trawl catches during the years 2002–2017, we present the first large-scale baseline on the spatial distribution and abundance of ice cod Arctogadus glacialis (Peters, 1874) in the fjords and on the shelf in Northeast Greenland (latitudes 70 °N–78 °N). Ice cod abundance peaked in the secluded sill fjords such as Bessel Fjord, Brede Fjord, Clavering Ø fjord system and Kong Oscar Fjord as compared to the offshore shelf. The mean biomass was estimated as 3.9 kg/km2 on the shelf and 49.3 kg/km2 in the fjords. Nearly 45% of the biomass was restricted to temperatures < −1.0 °C and almost 90 % of the biomass occurred within 200–600 m depth. This corresponds well with the deep, subzero fjords along the Northeast Greenland coast which, thus, appear the most suitable habitat for ice cod. Moreover, there was a gradual decrease in ice cod biomass on the shelf over the years 2002–2017. This apparent relocation of ice cod matches the ongoing warming of the Northeast Greenland shelf waters. Given that the overall temperature space of ice cod spans less than 4 ºC in Northeast Greenland, it is likely that the species is particularly vulnerable to climate change as warmer waters before long enter the fjords, i.e., the main habitat for ice cod.


The primary focus of this dissertation was to explore students' perceptions of adopting Web 2.0 applications at the School of Basic Education (SBE) in Kuwait. Although Web 2.0 applications are becoming more popular among the digital generation, there is still no evidence of students' perceptions of adopting the innovation of Web 2.0 technologies in Kuwait. The problem this study addresses is that the current status of Web 2.0 technologies usage by academic students has remained educationally unknown in Kuwait. Therefore, there was a need to investigate the extent to which academic students in SBE are aware of and their usage of Web 2.0 technologies, as well as the factors and obstacles that affect using these technologies. Rogers' diffusion of innovation theory (DoI) is employed in this study to specify the factors that influence student perceptions of adopting Web 2.0 applications as learning tools. Data used in this dissertation was gathered via a survey instrument from 350 students at the SBE and was statistically analyzed to find out the answers of the research questions. This study identified the low rate of Web 2.0 awareness and adoption by the students. Descriptive statistical analysis, such as mean scores and standard deviation, were used to analyze and conclude the findings. In the rates of awareness and adoption of Web 2.0, this study also identified no statistically significant differences between the groups of all the demographic variables except the academic field. The statistically significant differences were identified between the academic variables before and after recoding the academic fields into 5 groups. A t-test and one-way ANOVA were used to determine the statistical significance. Several factors were examined in the study to identify their influence on the rate of adoption. The factors included the rate of awareness, Rogers' attributes of innovations, and the obstacles to adopt Web 2.0. The multiple linear regression technique was used to find out the percentage of variance that was explained by three groups of predictors. The overall research model explained 49% of the variance on the rate of adoption. The implications of the findings, in addition to adding empirical evidence to the body of knowledge, highlight areas for professional development, educational and institutional changes and possibility for future research.


A UDP-glucuronyltransferase isoform glucuronizes phenolic xenobiotics such as 4-nitrophenol, and an isoform glucuronizing 4-hydroxybiphenyl has also been found in rat liver. We purified a UDP-glucuronyltransferase isoform glucuronizing 4-hydroxybiphenyl from bovine liver microsomes by solubilization with 0.7% sodium cholate followed by three column chromatographic separations using DEAE-Toyopearl 650S, UDP-hexanolamine Sepharose 4B, and hydroxyapatite. The purified bovine liver 4-hydroxybiphenyl UDP-glucuronyltransferase (named Bovine 4HBGT) had glucuronidation activities toward 4-hydroxybiphenyl and 4-methylumbelliferone but had little activity toward 4-nitrophenol and 1-naphthol. The apparent molecular mass of Bovine 4HBGT was 54,000 Da on SDS-PAGE, and this was decreased to 50,000 Da by digestion with endo-beta-N-acetylglucosaminidase H. These data suggest that Bovine 4HBGT consists of a 50,000 Da polypeptide and a high mannose type oligosaccharide chain(s) of about 4,000 Da. The NH2-terminal sequence of GT-3 was GKVLVWPVDFSXWINI. These properties of Bovine 4HBGT were very similar to those of rat UDP-glucuronyltransferase glucuronizing xenobiotics. However, the NH2-terminal sequence of Bovine 4HBGT had higher homology with that of rat liver 4-hydroxybiphenyl UDP-glucuronyltransferase than with that of rat liver 4-nitrophenol UDP-glucuronyltransferase.


Providing a small set of promising candidates in place of a single prediction is well-suited for many open-ended classification tasks. Conformal Prediction (CP) is a technique for creating classifiers that produce a valid set of predictions that contains the true answer with arbitrarily high probability. In practice, however, standard CP can suffer from both low predictive and computational efficiency during inference---i.e., the predicted set is both unusably large, and costly to obtain. This is particularly pervasive in the considered setting, where the correct answer is not unique and the number of total possible answers is high. In this work, we develop two simple and complementary techniques for improving both types of efficiencies. First, we relax CP validity to arbitrary criterions of success---allowing our framework to make more efficient predictions while remaining "equivalently correct." Second, we amortize cost by conformalizing prediction cascades, in which we aggressively prune implausible labels early on by using progressively stronger classifiers---while still guaranteeing marginal coverage. We demonstrate the empirical effectiveness of our approach for multiple applications in natural language processing and computational chemistry for drug discovery.


INTRODUCTION
Microvascular tissue serves as the foundation for tissue granulation and remodeling during the wound healing process. Optimal repair of microvascular structure and function is essential for future healing capacity and to minimize tissue breakdown in a newly epithelialized wound.

OBJECTIVE
This case series of 3 patients with nonhealing diabetic foot ulcers (DFUs) refractory to standard wound care demonstrates the ability of processed microvascular tissue (PMVT) to enable wound closure, increase local perfusion and vascular maturity, and improve overall tissue quality.

MATERIALS AND METHODS
Three patients with nonhealing DFUs ranging from 1.1 cm2 to 11.2 cm2 recalcitrant to standard of care were treated weekly with topical PMVT and standard of care. Wound closure was measured weekly using infrared imaging. Fluorescence microangiography was used to perform dynamic quantification of wound microcirculation and assess the perfusion quality. Ingress rates were measured at 5 defined rectangular regions of interest of the wound to evaluate inflammation and microvascular integrity.

RESULTS
All 3 nonhealing DFUs treated with weekly topical PMVT healed within 12 weeks (average, 6.3 ± 5.5 weeks). Assessment of healed wounds at the time of closure indicated PMVT treatment significantly improved perfusion within the newly healed wounded area and throughout the immediate surrounding tissues. No wound recurrence or tissue deterioration has been observed in more than 9 months of follow-up.

CONCLUSIONS
In this series of patients, the PMVT graft demonstrated improved wound closure, increased local perfusion and vascular maturity, and improved tissue quality. This graft is a promising advanced tissue therapy for nonhealing DFUs and other complex wounds. It is now the subject of a randomized controlled trial.


The association of cavernous hemangioma focal nodular hyperplasia and hemangiomatosis of the liver has not previously been described in the literature. A case report of a patient who presented with these 3 lesions simultaneously is reviewed. The 32-year-old obese woman presented with upper abdominal pain of recent onset. No liver abnormality had been noted at the times of cholecystectomy and cesarean section each performed some years before. She had taken oral contraceptives (OCs) 6 years earlier for about 6 months. Now the liver was enlarged and contained a firm nontender mass that extended to 1 handsbreadth below the right costal margin and across the epigastrium. No bruit was noted. Results of hematologic and biochemical investigations were within normal limits. Ultrasonography revealed a solic mass and selective celiac arteriography showed that the mass occupied the right lobe of the liver and was predominantly avascular with small areas of pooling of contrast material. An operation revealed in addition to the mass many irregular purplish areas 2-4 mm in diameter in both lobes of the liver. Close to the free edge of the left lobe was a yellowish brown and slightly modular firm mass. The pathological report listed a giant cavernous hemangioma of the right lobe several disseminated cavernous hemangiomata multiple disseminated vascular ectasiae (hemangiomatosis) and 1 lesion of focal nodular hyperplasia in the left lobe. 27 days after the operation scintiscanning revealed evidence of good liver regeneration. Another scan 3 years later revealed regeneration of the liver to normal size and no focal abnormalities. Due to the fact that increasing numbers of cases of focal nodular hyperplasia and liver cell adenomas have been reported in association with OCs and in view of the possible association between these drugs and hemangioma caution in prescribing these drugs is recommended.


The nervous, immune, endocrine and integumentary systems are closely related and interact in a number of normal and pathological conditions. Nervous system mediators may bring about direct changes to the skin or may induce the release of immunological or hormonal mediators that cause pathological changes to the skin. This article reviews the psychological mechanisms involved in the development of skin diseases.


The creation of the EU internal electricity market began in the early 1990's. At that time, the EU member states started to organize their electricity sectors in accordance with concurrent political and economical developments since common rules for electricity market were not adopted until 1996 and the first Electricity Directive. This, in turn, formally marked the creation of necessary preconditions for the liberalization of the electricity sector within the EU. From the early phases of the European integration process, electricity has been an important issue and the creation of the internal electricity market still represents a significant objective. Looking back in time, the development of the EU electricity market can be divided into three periods. The first one refers to the introduction of electrical systems on densely populated areas. After that came the expansion and the completion of the electrification of rural areas. The last and still ongoing developmental stage is related to the European electricity sector integration on the supranational level which was initiated with the Single European Act and the introduction of competition on the European market. The latter is progressing slowly and unevenly across the EU which makes it necessary to analyse all the obstacles to the EU electricity market liberalization process, especially when it comes to economic effects that can be expected upon the final creation of the European energy market. Also, Croatia is no exception. Main obstacles to the EU electricity market liberalization process are the ones referring to limited existing and planned generation and transportation infrastructure, deliberate state interference motivated by a desire to support its "national champions", varying electricity price levels among member states for both residential and industrial consumers, price regulation and lack of power of regulatory authorities. There is also a problem of high market concentration and low switching rates which leaves the consumers to choose between only few electricity suppliers. In other words, the general reason lies in the absence of real competition which can be evidenced by the fact that due to improper implementation of the required legislation (which is essential in order to make market opening fully effective) the European Commission initiated, up to now, over 60 infringement procedures. In order to finally achieve a competitive electricity market, new Directive on electricity (Directive 2009/72/EC) together with the Regulation (EC) No 713/2009 represent a possible final step on a way of improving and integrating the electricity market in the EU encompassed with the estimated effects on EU GDP, employment and inflation which are expected upon the final and full opening of electricity (and gas) markets. Restructuring of the electricity sector, in accordance with the overall (economic) interests is also an imperative for Croatia.


This paper describes and analyzes the impacts of economic institutions on the Euro. It analyzes the impact of economic institutions for countries joining the European Union. In order to depict and explain Europe's role in the world economy, this study provides a detailed analysis of the Eurozone trade with the world. The study offers potential solutions to the Financial Crisis of the European Union and details their advantages and disadvantages, with an emphasis on the role and importance of economic institutions.


Up to 10% of children and adolescents in the United States may have asthma and up to 40% may be affected by allergic rhinitis. Most people know that asthma is a serious disease, but "hay fever" is often mistakenly considered trivial. However, hay fever symptoms can significantly influence a patient's quality of life, causing fatigue, headache, and even cognitive impairment. Both asthma and allergic rhinitis can result in lost sleep, many missed school days, and the inability to participate in sports and other recreational activities in which young people engage. An appropriate diagnosis is the first step toward improving quality of life for these young patients. This article reviews diagnostic procedures for allergic disease, and-because compliance is frequently an issue with school-aged patients-it also reviews current thinking on allergen immunotherapy, a treatment that provides effective long-term control in appropriately selected patients.


Because of the lack of design methods and graphic software in the field of production automatized systems (PASs), a design support system which guides in the analysis and PAS design has been developed. This tool, called MACSOOD, is based on a decisional object-oriented method because, at the technical level, the assumptions of an object oriented design and of an object programming are the best known answers to the problem of re-use and flexibility. The design process is discussed, from the construction of hierarchical trees of objects to the verification of coherence.<<ETX>>


This paper presents a novel scalable scheduling architecture for high-performance crossbar-based switches with virtual output queuing (VOQ) scheme. In contrast to traditional switching architectures where the scheduler is implemented by one single centralized scheduling device, the proposed scheduling architecture connects several small scheduling devices in series and the arbitration algorithm is executed in parallel. Thereby the inputs of each single scheduling device establish connections to a group of outputs, by considering both their local transmission requests as well as global output availability information. The advantage of this architecture lies in its ability to implement large schedulers (> 64) with several small scheduling devices as well as in its capability to achieve high-performance scheduling. We first introduce a distributed parallel round robin scheduling algorithm (DPRR) for the proposed architecture. Through the analysis of simulation results on various admissible traffics, it is shown that the performance of DPRR is much better than the performance of other round robin scheduling algorithms commonly used on centralized schedulers. We also prove that under Bernoulli i.i.d. uniform traffic, DPRR achieves 100% throughput. Moreover, we introduce a distributed parallel round robin scheduling algorithm with memory (DPRRM) as an improved version of DPRR to make it stable under any admissible traffic.


This paper reports the results of spectral measurements and a theoretical analysis of the temporal and spatial evolution of laser-produced Cu plasma in vacuum in the range of 8–14 nm. The time dependence of the extreme ultraviolet band spectrum at different positions near the target surface was obtained and found to be dominated by three broad-band features. The 3p and 3d excitations of Cu5+–Cu9+ ions were calculated using the Hartree–Fock theory with configuration interactions. The characteristics of the spectral line distribution for the 3p–nd and 3d–nf transition arrays were analyzed. Based on the steady-state collisional radiation model and the normalized Boltzmann distribution, the complex spectral structure in the band of 13–14 nm is accurately explained through consistency comparisons and benchmarking between the experimental and theoretical simulation spectra, demonstrating that the structure mainly stems from the overlapping contribution of the 3d–4f and 3p–3d transition arrays for the Cu5+–Cu9+ ions. These results may help in studying the radiation characteristics of isoelectronic series highly-charged ions involving the 3d excitation process.


Online sexually explicit material (SEM) is a popular media source, but little is known about its association with body image. This study explored whether perceived realism of SEM mediated the direct association of SEM use on body image while accounting for gender differences. Young adults (N = 393; ages 19 to 30; 53.4% women) recruited through a crowdsourcing Web site completed an anonymous online survey that assessed SEM use, perceptions of the realism of SEM, and body image. Body satisfaction, genital self-image, comfort being nude, penis-/breast-size satisfaction, and self-esteem were used to create the variable of body image. SEM use had a positive indirect association with body image through perceived realism for both men and women. Follow-up analyses revealed this association was due to body satisfaction and self-esteem in men and comfort being nude and self-esteem in women. Findings are discussed in terms of implications for clinical applications and understanding young adults' body image.


Various animals models and several different methods are used in cardiopulmonary resuscitation (CPR) research. The animals used most frequently are dogs and pigs, but in each species thorax configurations, which might be an important factor in the mechanism of blood flow during CPR, are at great variance. The influence of anesthetics on cardiopulmonary and cerebral functions during and following resuscitation are largely unknown, and accordingly there is great variance in the techniques employed by individual researchers. The experimental design chosen with regard to the effect of heparin and epinephrine, induction, form, and duration of cardiac arrest as well as duration of CPR is often very different; comparisons are therefore difficult to make. During CPR ventilation is monitored using ventilatory pressure, frequency, tidal volume, and arterial blood gases. Thorax compressions are characterized by frequency, direction (sagittal, transversal), technique (mechanical, manual), relationship of time between compression and relaxation (50:50, 40:60), and depth of compression (power used, esophageal pressure, arterial blood pressure). Effects of CPR techniques are demonstrated during CPR by cardiovascular parameters. In addition to recording of blood pressure and blood flow, examination of regional perfusion rates using radioactive microsphere techniques is common. 24-h surveillance and extensive neurological tests are carried out during recovery following CPR.


It is no doubt that the gene therapy using recombinant engineering cells provides a novel approach to many refractory diseases. However, the transplant rejection from the host's immune system against heterogeneous cells has been the main handicap of its clinical application. The modern cell micro-encapsulation technique with good immune isolation makes it possible to overcome this problem and has shown potential application foreground in clinical therapies for a lot of diseases such as Parkinson's disease and Hemophiliac disease. This article reviews mainly the relative materials and techniques in processing micro-encapsulation, the host cells used to construct the recombinant genetic engineering cells and application of cell micro-encapsulation technique in the field of gene therapy.


Abstract Objective  Three primary neuraxial techniques reduce labor pain: epidural, dural puncture epidural (DPE), and combined spinal-epidural (CSE). This study aims to determine whether neuraxial analgesia techniques changed after the onset of the coronavirus disease 2019 (COVID-19) pandemic. Given that a dural puncture confirms neuraxial placement, we hypothesized that DPE was more frequent in women with concerns for COVID-19. Study Design  A single-center retrospective cohort study comparing neuraxial analgesia techniques for labor and delivery pain management before and after the onset of the COVID-19 pandemic and in patients with and without SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) at a maternity hospital in Dallas, Texas, with a large delivery service. Statistical analyses included the Chi-square test for categorical and Kruskal–Wallis test for nonparametric ordinal comparisons. The Cochran–Mantel–Haenszel test was used to assess the association between neuraxial technique and accidental dural puncture or postdural puncture headache. Results  Of 10,971 patients who received neuraxial analgesia for labor, 5,528 were delivered in 2019 and 5,443 in 2020. Epidural analgesia was the most common neuraxial technique for labor pain in 2019 and 2020. There was no difference in the frequency of neuraxial analgesia techniques or the rates of accidental dural puncture or postdural puncture headaches comparing all deliveries in 2019 to 2020. Despite a significant increase in DPEs relative to epidurals in the SARS-CoV-2-positive group compared with the SARS-CoV-2-negative group in 2020, there was no significant difference in postdural puncture headaches or accidental dural punctures. Conclusion  The advantages of a DPE, specifically the ability to confirm epidural placement using a small gauge spinal needle, likely led to an increase in the placement of this neuraxial in SARS-CoV-2-positive patients. There was no effect on the frequency of postdural puncture headaches or accidental dural punctures within the same period. Key Points Epidural analgesia was the most common neuraxial technique for labor pain management. Dural puncture epidural placements increased in SARS-CoV-2-positive patients. Rates of postdural puncture headaches and accidental dural puncture after neuraxial placement did not change.


We present further development of our analysis algorithm for Multi-Filter Rotating Shadowband Radiometer (MFRSR) data. The new additions include techniques allowing us to retrieve spectral aerosol single scattering albedo (SSA) and column amount of precipitable water vapor (PWV). The SSA retrievals employ MFRSR measurements of both direct normal and diffuse horizontal irradiances. We present a sensitivity study indicating dependence of SSA retrievals on optical thickness and other aerosol parameters. Influence on the retrievals of a possible error in separation of the direct and diffuse irradiances by the instrument is discussed. The algorithm has been tested on a long-term dataset from the local MFRSR network at the DOE Atmospheric Radiation Measurement (ARM) Program site in Southern Great Plains (SGP). Our results are compared to AERONET's almucantar retrievals of SSA from CIMEL sun-photometer co-located with the MFRSR at the SGP Central Facility. A constrained variant of the algorithm (assuming zero nitrogen dioxide column values) is used for this comparison and to study the influence of the uncertainty associated with this atmospheric gas on the retrieved aerosol absorption properties. Precipitable water vapor column amounts are determined from the direct normal irradiances in the 940 nm MFRSR spectral channel. HITRAN 2004 spectral database has been used to model the water vapor absorption, while a range of other databases (HITRAN 1996, 2000, ESA) is used in the sensitivity study. The results of the PWV retrievals for SGP's MFRSR network are compared with correlative measurements by Microwave Radiometers (MWR), GPS stations, AERONET, and MODIS satellite product. In the latter case an interpolation technique has been used to determine spatial structure of water vapor field from the network data and to create a 2D dataset comparable with satellite data.


Accounting for stock options is a controversial issue. The FASB recognized that the "intrinsic value" method, which had been used for years, failed to adequately account for the costs involved. To rectify the problem they suggested the use of a "fair value" method. Their proposal met with strong objections from companies, which were concerned with the impact of the proposed standard on their reported profits. Consequently, the board relented and allowed the use of either method. Unfortunately, both the intrinsic value and fair value approaches have deficiencies, particularly in regard to how they measure compensation expense and gains and losses over time. This paper addresses these shortcomings by developing two alternative cost measurement approaches that apply an option‐pricing model on an iterative basis over the life of the option. Both approaches represent specific ways to implement exercise‐date measurement techniques for stock options. The paper argues that both approaches provide more relevant and reliable measures of an option's cost than either intrinsic or fair value methods.


The establishment of the International Criminal Court represents a major milestone in the international community's fight against impunity at the international level. International prosecution by the ICC represents a direct contribution to the fight against impunity for international crimes under the Rome Statute regime. However, international justice mechanisms, whether permanent or ad hoc, are not intended to supplant States where they have organized criminal justice systems which are willing and able to ensure that there is accountability for the crimes concerned. Indeed pursuant to the principle of complementarity, the Rome Statute provides ample room not only for the exercise of national jurisdiction, but also for the development of international criminal law at the national level. While encouraging the use of and explaining the avenues available under the Rome Statute to its State Parties to undertake domestic prosecutions, this article argues that national prosecutions should remain the primary option, wherever feasible, because they can handle many more cases and are usually preferable from the perspectives of victims and local justice systems.


ABSTRACT Judicial reform has been part and parcel of democratization process among countries preparing for European Union accession. The literature on EU enlargement, political conditionality conceptualizes the EU's role in promoting rule of law and judicial reforms in its external neighbourhood, especially in the candidate states as largely positive. However, in the Turkish case, the EU's political conditionality in judicial reform presents a mixed picture. This paper provides a qualitative case study with the aim to assess the conditions under which backsliding occurs. The paper's main proposition is that this backsliding in judicial reforms and rule of law is due to the interplay of the relative weakness of the EU's political anchor and the relative strength of the domestic struggles facing political elites. Judicial reforms emerge as a visible aspect of backsliding as it has become a key priority area for the EU. This paper assesses to what extent the changing pace and direction of judicial reforms have been driven by a mix of factors; the EU's political conditionality as well as the domestic costs of adaptation.


Two new bis-bidentate imidazole-substituted nitronyl nitroxide biradicals, BNITIm-C2 (BNITIm-C2 = 1,1'-(1,2-ethanediyl)bis(1H-imidazole-2-4,4,5,5-tetramethyl-4,5-dihydro-1H-imidazol-1-oxy-3-oxide)) and BNITIm-C4 (BNITIm-C4 = 1,1'-(1,4-butanediyl)bis(1H-imidazole-2-4,4,5,5-tetramethyl-4,5-dihydro-1H-imidazol-1-oxy-3-oxide)), and two series of lanthanide complexes, namely [(BNITIm-C2)Ln(NO3)3](MeOH) (Ln = Gd (1Gd) and Tb (2Tb)), (BNITIm-C2)Dy(NO3)3 (3Dy) and (BNITIm-C4)[Ln(hfac)3]2(C7H8)2 (Ln = Gd (4Gd), Tb (5Tb) and Dy (6Dy), hfac = hexafluoroacetylacetonate), have been prepared and characterized structurally and magnetically. Single crystal X-ray crystallographic analyses revealed that complexes 1Gd-3Dy exhibit 1D chain structures where the Ln(NO3)3 units are bridged by the BNITIm-C2 bis-bidentate biradical, while complexes 4Gd-6Dy exhibit binuclear structures with two Ln(hfac)3 units bridged by the BNITIm-C4 biradical. The bulky hfac anions prohibit the further coordination of LnIII to another NIT ligand and the formation of a similar 1D chain structure. Due to the very long intra- and intermolecular distances of the spin centers, complexes 1Gd-3Dy can be magnetically regarded as an isolated 2p-4f-2p tri-spin system while complex 4Gd-6Dy can be regarded as an isolated 2p-4f bi-spin system. Magnetic analyses on the two GdIII compounds revealed the ferromagnetic GdIII-NIT interactions and antiferromagnetic NIT-NIT interactions through the GdIII ion in 1Gd. Alternating-current (ac) magnetic susceptibility investigations revealed that complex 5Tb exhibits the typical SMM behavior under a zero dc field while complex 6Dy was proved to be a field-induced SMM. Ab initio calculations were performed on complexes 2Tb and 5Tb to understand their magnetic anisotropy together with their different magnetic dynamics.


UNLABELLED
The use of ocular ultrasonography for the evaluation of emergency patients has recently been described in the emergency medicine (EM) literature. There are a number of potential uses that may greatly aid the emergency physician (EP) and avoid lengthy consultation or other diagnostic tests.

OBJECTIVE
To examine the accuracy of bedside ultrasonography as performed by EPs for the evaluation of ocular pathology.

METHODS
This prospective, observational study took place in a high-volume, suburban community hospital with an EM residency program. All patients arriving with a history of eye trauma or acute change in vision were eligible to participate in the study. A 10-MHz linear-array transducer was used for imaging. All imaging was performed through a closed eyelid, using water-soluble ultrasound gel. Investigators filled out standardized data sheets and all examinations were taped for review. All ultrasound examinations were followed by orbital computed tomography or complete ophthalmologic evaluation from the ophthalmology service. Statistical analysis included sensitivity, specificity, and positive and negative predictive values.

RESULTS
Sixty-one patients were enrolled in the study; 26 were found to have intraocular pathology on ultrasound. Of these, three had penetrating globe injuries, nine had retinal detachments, one had central retinal artery occlusion, and two had lens dislocations. The remaining pathology included vitreous hemorrhage and vitreous detachment. Emergency sonologists were in agreement with the criterion standard examination in 60 out of 61 cases.

CONCLUSIONS
Emergency bedside ultrasound is highly accurate for ruling out and diagnosing ocular pathology in patients presenting to the emergency department. Further, it accurately differentiates between pathology that needs immediate ophthalmologic consultation and that which can be followed up on an outpatient basis.