Support vector machines (SVMs) have been promising methods for classification and regression analysis because of their solid mathematical foundations which convery several salient properties that other methods hardly provide. However, despite the prominent properties of SVMs, they are not as favored for large-scale data mining as for pattern recognition or machine learning because the training complexity of SVMs is highly dependent on the size of a data set. Many real-world data mining applications involve millions or billions of data records where even multiple scans of the entire data are too expensive to perform. This paper presents a new method, Clustering-Based SVM (CB-SVM), which is specifically designed for handling very large data sets. CB-SVM applies a hierarchical micro-clustering algorithm that scans the entire data set only once to provide an SVM with high quality samples that carry the statistical summaries of the data such that the summaries maximize the benefit of learning the SVM. CB-SVM tries to generate the best SVM boundary for very large data sets given limited amount of resources. Our experiments on synthetic and real data sets show that CB-SVM is highly scalable for very large data sets while also generating high classification accuracy.


Shellfish can be a vector for human pathogens. Despite regulation based on enteric bacteria, shellfish are still implicated in viral outbreaks. Oysters are the most common shellfish associated with outbreaks, and noroviruses, which cause acute gastroenteritis, are the most frequently identified pathogen in these outbreaks. Analysis of shellfish-related outbreak data worldwide shows an unexpected high proportion of genogroup I strains. Recent studies performed in vitro, in vivo and in the environment indicate that oysters are not just a passive filter, but can selectively accumulate norovirus strains based on virus carbohydrate ligands shared with humans. These observations may help explain the GI/GII bias observed in shellfish-related outbreaks compared to other outbreaks.


When all you need is a basic understanding of the anatomy of the muscular system, supplemented by current evidence and research, Cram Sessions on Functional Anatomy: Applications and Problem Solving for Real-Life Situations is what you will look to for quick, at-your-fingertips facts. Cram Sessions on Functional Anatomy by Drs. Benjamin, Bechtel, and Conroy is a concise and illustrated quick reference that takes over 60 years of combined clinical experience to provide an understanding of the muscular system and its relation to the fascial and ligamentous systems in the human body, providing benefits for improved patient care and streamlined exercise prescription.


PURPOSE
Dyspnea is one of the most distressing symptoms experienced by terminally ill cancer patients. This study aimed to evaluate the role of interventions for the palliation of dyspnea.

METHODS
We conducted a systematic review of randomized controlled trials assessing all pharmacologic and nonpharmacologic interventions for dyspnea palliation in cancer patients, and searched the Cochrane Library, MEDLINE, conference proceedings, and references. Two reviewers independently appraised the quality of trials and extracted data.

RESULTS
Our search yielded 18 trials. Fourteen evaluated pharmacologic interventions: seven assessing opioids (a total of 256 patients), five assessing oxygen (137 patients), one assessing helium-enriched air, and one assessing furosemide. Four trials evaluated nonpharmacologic interventions (403 patients). The administration of subcutaneous morphine resulted in a significant reduction in dyspnea Visual Analog Scale (VAS) compared with placebo. No difference was observed in dyspnea VAS score when nebulized morphine was compared with subcutaneous morphine, although patients preferred the nebulized route. The addition of benzodiazepines to morphine was significantly more effective than morphine alone, without additional adverse effects. Oxygen was not superior to air for alleviating dyspnea, except for patients with hypoxemia. Nursing-led interventions improved breathlessness. Acupuncture was not beneficial.

CONCLUSION
Our review supports the use of opioids for dyspnea relief in cancer patients. The use of supplemental oxygen to alleviate dyspnea can be recommended only in patients with hypoxemia. Nursing-led nonpharmacologic interventions seem valuable. Only a few studies addressing this question were performed. Thus, further studies evaluating interventions for alleviating dyspnea are warranted.


Faced with a theoretical computing unit with a poor reputation, the author used a process of iterative improvement to address the main concerns. Armed with the informal concept of Caesar theory – bread and circuses – changes were applies across two years and have turned student attitude to the unit around. This paper discusses the iterative process used and the challenges that were faced and (at least partially) overcome. While the process is ongoing, both anecdotal and formal feedback points to a noticeable improvement in student satisfaction without a reduction in the teaching standards.


The classification of protein structures into evolutionary superfamilies, for example in the CATH or SCOP domain structure databases, although performed with varying degrees of automation, has remained a largely subjective activity guided by expert knowledge. The huge expansion of the Protein Structure Databank (PDB), partly due to the structural genomics initiatives, has posed significant challenges to maintaining the coverage of these structural classification resources. This is because the high degree of manual assessment currently involved has affected their ability to keep pace with high throughput structure determination. This thesis presents an evaluation of different methods used in remote homologue detection which was performed to identify the most powerful approaches currently available. The design and implementation of new protocols suitable for remote homologue detection was informed by an analysis of the extent to which different homologous superfamilies in CATH evolve in sequence, structure and function and characterisation of the mechanisms by which this occurs. This analysis revealed that relatives in some highly populated CATH superfamilies have diverged considerably in their structures. In diverse relatives, significant variations are observed in the secondary structure embellishments decorating the common structural core for the superfamily. There are also differences in the packing angles between secondary structures. Information on the variability observed in CATH superfamilies is collated in an established web resource the Dictionary of Homologous Superfamilies, which has been expanded and improved in a number of ways. A new structural comparison algorithm, CATHEDRAL, is described. This was developed to cope with the structural variation observed across CATH superfamilies and to improve the automatic recognition of domain boundaries in multidomain structures. CATHEDRAL combines both secondary structure matching and accurate residue alignment in an iterative protocol for determining the location of previously observed folds in novel multi-domain structures. A rigorous benchmarking protocol is also described that assesses the performance of CATHEDRAL against other leading structural comparison methods. The optimisation and benchmarking of several other methods for detecting homology are subsequently presented. These include methods which exploit Hidden Markov Models (HMMs) to detect sequence similarity and methods that attempt to assess functional similarity. Finally an automated, machine learning approach to detecting homologous relationships between proteins is presented which combines information on sequence, structure and functional similarity. This was able to identify over 85% of the homologous relationships in the CATH classification at a 5% error rate. This thesis was gratefully supported by the Biotechnology and Biological Sciences Research Council.


During Asian financial crisis in 1997, some Indonesian public listed companies suffered by decreasing firm value and poor performance. The dominant factors that contributed to Asian financial crisis are poor corporate governance and lack of transparency. As attempt to improve corporate governance practice of Indonesian corporation, some reforms have been conducted by Indonesian regulatory authorities such as issued the code of good corporate governance with the objective to maximize shareholder and firm value by enhancing transparency, accountability, reliability, responsibility, and fairness. This study examined the relationship between those corporate governance attributes and corporate transparency of indonesian public listed companies By exploring the purposive sampling method, 88 companies were selected as the sample of this study. The finding of this study showed that board size and proportion of independent member on board positively affect corporate transparency. It means the corporate transparency will increase since the companies have large board and higher proportion of independent member on boards. In contrast, the proportion of board of directors who have family relationship is negatively associated with corporate transparency. It implies that family boards tend to advise management to disclose less information to public (less transparent) since they can get the informational benefit by transferring that information to their family. Meanwhile, the influence of family ownership, institutional ownership, management ownership, and foreign ownership on corporate transparency was not be supported by this study.


Modern tropical peats require continuity of precipitation for accumulation, whereas calcretes and calcic vertisols require strongly seasonal conditions. The 20-30-m-thick cyclothems of the Sydney basin, Nova Scotia, Canada, show a systematic alternation of coals and other hydromorphic paleosols with calcretes and calcic vertisols. This implies strong variation in seasonality during the duration of a cyclothem, estimated at 200 ka. In at least one cyclothem, calcic paleosols formed on an interfluve adjacent to a paleovalley cut through marine strata, suggesting that a more seasonal and probably drier climate prevailed during sea-level lowstand. The calcic paleosols are estimated to have formed during periods of 10[sup 4] yr, possibly indicative of partial control by obliquity and precessional cycles. 27 refs., 5 figs., 1 tab.


Alpha-D-Glucopyranosyl fluoride was found to inhibit strongly the action of alpha-glucan phosphorylase b[EC 22.214.171.124] from rabbit muscle, and that of the enzyme from potato tubers rather weakly. The inhibition is highly specific, being competitive with respect to glucose 1-phosphate and noncompetitive with respect to polysaccharide, during polysaccharide synthesis. In the reverse process, it is competitive with respect to Pi. These results have been explained by assuming that the inhibitor binds to the glucose 1-phosphate site of the enzyme, occupying both subsites which normally bind the glucosyl and phosphate moities of the substrate, but does not directly interact with the polysaccharide site. Based on this assumption, the dissociation constants of the enzyme-inhibitor and enzyme-polysaccharide-inhibitor complexes have been evaluated (0.43 and 0.20 mM for the muscle enzyme, respectively; 24 and 23 mM for the potato enzyme, respectively). Glucosyl fluoride also acts as a noncompetitive inhibitor with respect to AMP. A high concentration of AMP causes an inhibitory effect on the action of the muscle enzyme, the effect being menifested in the presence of glucosyl fluoride.


The underlying hallmark of centromeres is the presence of specialized nucleosomes in which histone H3 is replaced by CENP-A. The events that mediate the installation of CENP-A in place of H3 remain poorly characterized. H2A.Z is linked to transcriptional competence and associates with mammalian centromeres. We find that H2A.ZPht1 and the Swr1 complex are enriched in fission yeast CENP-ACnp1 chromatin. Our analysis shows that Swr1, Msc1 and H2A.ZPht1 are required to maintain CENP-ACnp1 chromatin integrity. Cell cycle analyses demonstrate that H2A.ZPht1 is deposited in S phase, coincident with the deposition of placeholder H3, and prior to CENP-ACnp1 replenishment in G2. Establishment assays reveal that H2A.ZPht1 and Swr1 are required for de novo assembly of CENP-ACnp1 onto naïve centromere DNA. We propose that features akin to promoters within centromere DNA program the incorporation of H2A.ZPht1 via Swr1, and mediate the replacement of resident H3 nucleosomes with CENP-A nucleosomes thereby defining centromeres.


We design a learning and optimization framework to mitigate greenhouse gas emissions associated with heating and cooling buildings. The framework optimizes room temperature set-points based on forecasts of weather, occupancy, and the greenhouse gas intensity of electricity. We compare two approaches: the first one combines a linear load forecasting model with convex optimization that offers a globally optimal solution, whereas the second one combines a nonlinear load forecasting model with nonconvex optimization that offers a locally optimal solution. The project explores the two approaches with a simulation testbed in EnergyPlus and experiments in buildings on a university campus.


Purpose

The present paper aims to address the description of a numerical optimization procedure, based on mesh morphing, and its application for the improvement of the aerodynamic performance of an industrial glider which suffers of a large separation occurring in the wing–fuselage junction region at high incidence angles.

Design/methodology/approach

Shape variations were applied to the baseline configuration through a mesh morphing technique founded on the mathematical framework of radial basis functions (RBF). The aerodynamic solutions were obtained coupling an RANS code with the mesh morphing tool RBF Morph™. Two shape modifiers were set up to generate a parametric numerical model. An optimization procedure, based on a design of experiment sampling, was set up implementing the fully automated workflow within a high performance computing (HPC) environment. The optimal candidates maximizing the aerodynamic efficiency were identified by means of a cubic RBF response surface approach.

Findings

The separation was significantly reduced, modifying the local geometry of fuselage and fairing and maintaining the wing aerofoil unchanged. A relevant aerodynamic efficiency improvement was finally gained.

Practical implications

The developed procedure proved to be a very powerful and efficient tool in facing aerodynamic design problems. However, it might be computationally very expensive if a large number of design variables are adopted and, in those cases, the method can be suitably used only within the HPC environment.

Originality/value

Such an optimization study is part of an explorative set of analyses that focused on better addressing the numerical strategies to be used in the development of the EU FP7 Project RBF4AERO.


Objective: The HBV genotypes and surface gene mutation among children born after universal HBV vaccination program were not been clearly investigated in Huzhou, China. Thus, the present study was to investigate HBV genotypes and surface gene mutation in vaccinated children in this area.
Methods: Serum samples were collected from 58 children who were chronic HBV infected in Huzhou. The surface gene of HBV were amplified and direct sequencing. Then, the mutations were analyzed.
Results: Fifty-six sample were sequenced successfully. The genotype of HBV was genotype B in 45 children and genotype C in 11 children, respectively. Major serotype was adw (42), followed by adr (11) and ayw (3). Sequence analysis showed that 18 amino acid (AA) substitutions sites in major hydrophilic region (MHR) were identified in children (37.5%, 21/56). Most of the substitutions were associated with vaccine immune escape. The genotypes B had a high mutations frequency in the second loop than genotype C. Of note, eight children with low level anti-HBs were still infected with HBV.
Conclusion: The predominant genotype and serotype were B and adw among children in Huzhou. Genotype B, MHR mutations, and low anti-HBs levels might be related to immunization failure, although the large-scare vaccination program remarkably decreased the infection of HBV in children, strengthen immunization is recommend in children with low level anti-HBs.


Background: Mutation in NPM1 gene has been reported to be the most common genetic mutation in de novo acute myeloid leukemia (AML). AML with NPM1 gene mutation usually presents with higher initial leukocyte and blast cell counts and negative CD34 expression. We aimed to investigate the difference of initial leukocyte counts, bone marrow blast cell counts and expression of CD34 among patients with AML with and without NPM1 mutation. Methods: In this study, 25 de novo patients with AML were investigated for NPM1 exon 12 gene mutation using ASO-RT-PCR. Initial leukocyte counts, bone marrow blast cell counts and expression of CD34 on blasts were examined in all patients. Results: 13 of 25 de novo patients with AML (52%) had NPM1 gene mutation. Initial leukocyte counts in AML patients with NPM1 gene mutation was not significantly higher than patients without this mutation (23.400 /μL versus 16.000 /μL, P=0.53). Blast cell counts were not significantly higher in AML patients with NPM1 gene mutation than patients without mutation. (41% versus 19%, P=0,18). Expression of CD34 was not significantly different between AML patients with and without NPM1 gene mutation (P=0.48). Conclusion: There were no difference in initial leukocyte count, blast cell count and CD34 expression among patients with AML with and without NPM1 exon 12 type A gene mutation.


Abstract Background  Hypertension, persistent high blood pressures (HBP) leading to chronic physiologic changes, is a common condition that is a major predictor of heart attacks, strokes, and other conditions. Despite strong evidence, care teams and patients are inconsistently adherent to HBP guideline recommendations. Patient-facing clinical decision support (CDS) could help improve recommendation adherence but must also be acceptable to clinicians and patients. Objective  This study aimed to partly address the challenge of developing a patient-facing CDS application, we sought to understand provider variations and rationales related to HBP guideline recommendations and perceptions regarding patient role and use of digital tools. Methods  We engaged hypertension experts and primary care respondents to iteratively develop and implement a pilot survey and a final survey which presented five clinical cases that queried clinicians' attitudes related to actions; variations; prioritization; patient input; importance; and barriers for HBP diagnosis, monitoring, and treatment. Analysis of Likert's scale scores was descriptive with content analysis for free-text answers. Results  Fifteen hypertension experts and 14 providers took the pilot and final version of the surveys, respectively. The majority (>80%) of providers felt the recommendations were important, yet found them difficult to follow-up to 90% of the time. Perceptions of relative amounts of patient input and patient work for effective HBP management ranged from 22 to 100%. Stated reasons for variation included adverse effects of treatment, patient comorbidities, shared decision-making, and health care cost and access issues. Providers were generally positive toward patient use of electronic CDS applications but worried about access to health care, nuance of recommendations, and patient understanding of the tools. Conclusion  At baseline, provider management of HBP is heterogeneous. Providers were accepting of patient-facing CDS but reported preferences for that CDS to capture the complexity and nuance of guideline recommendations.


One of the persistent features of historical writing about the sciences in the last twenty years has been the concern of a number of historians who insist on the need for a new awareness of the role of visual images and image making. The author believes that, rather than reducing the analysis of visual culture to a single set of principles, the point of the academic study of scientific images is the recognition of their heterogeneity, the different circumstances of their production, and the variety of cultural and social functions they serve. This essay challenges historians to discover new ways of framing the historical meanings of scientific images within the larger contexts of signifying symbols, images, and mediations that make up culture. The study of nineteenth‐century practices of building collections of scientific photographs provides the background for a discussion of the significance of picture archives in the history of science, of the historical mechanisms that frame some pictures as "scientific" and others as "unscientific," and of the need for further research on how scientific images generate meaning.


Cytosine-rich sequences can form 4-stranded structures called i-motifs. i-Motifs are formed by two duplexes intercalated in an antiparallel direction and held together through the hemi- protonated cytosine-cytosine base pairs, and they are stabilized by acidic conditions, which promote C-C base pairing via hemi-protonation of the N3. i-Motif structure can form in both molecules of DNA and RNA, but RNA i-motifs are less stable than their DNA counterparts. This dissertation describes the study of the stability of RNA i-motifs including characterizing 10 cytosine-rich sequences with variable tract length in [CnU3]3Un at two different pH: 5.5 and pH 7.4. A plant sequence AT5G08230.1 RNA identified in Arabidopsis thaliana was characterized at pH 5.8 by mimicking crowding with PEG 8,000, and drought conditions using KCl. From our knowledge, there are no examples of functional i-motif structures in plants, but they are of particular interest with respect to potential i-motif formation knowing that plants often thrive in acidic conditions where i-motifs are stable. By using some biophysical techniques like Ultraviolet (UV), Circular Dichroism (CD), and thermal difference spectra (TDS), we found all our cytosine-rich sequences were shown to be stable at pH 5.5, except C1U3 and sequences with 5 or more cytosines per tract length fold into stable i-motif structure. Also, we have found the stability of the folded structures increases as the number of cytosines per tract. UV spectroscopy has showed an increase in the melting and annealing temperature for all C-rich sequences when the number of cytosines per tract increase. On the other hand, at pH 7.4 RNA i-motif structure was not observed. We have observed that AT5G08230.1 RNA can form i-motif at pH 5.8 where plants normally thrive, and have confirmed the RNA i-motif can be stabilized at 4°C using PEG 8,000 (40%) and KCl (100 mM and 800 mM).


Typical conductive polymers of poly(3-alkylthiophenes) were synthesized by oxidative polymerization. Alkyl side chains were CnH2n+1 with n=4, 6, 8, 12. The regioregularity with the HT linkage was larger than 99% based on NMR analysis. Completely regioregular head-to-tail (HT) poly(3-alkylthiophenes) were obtained. We have evaluated the effect of side chain size on the thermoelectric properties of Seebeck coefficient and electrical conductivity. The results were as follows: 1) Seebeck coefficient decreased with an increasing electrical conductivity. 2) High Seebeck coefficient >1mV/K was observed at low electrical conductivity <10-2S/cm. 3) The small side chain caused the higher electrical conductivity in the range of electrical conductivity <10- 1S/cm.


ABSTRACT Muscle differentiation requires the assembly of high-order structures called myofibrils, composed of sarcomeres. Even though the molecular organization of sarcomeres is well known, the mechanisms underlying myofibrillogenesis are poorly understood. It has been proposed that integrin-dependent adhesion nucleates myofibrils at the periphery of the muscle cell to sustain sarcomere assembly. Here, we report a role for the gene perdido (perd, also known as kon-tiki, a transmembrane chondroitin proteoglycan) in myofibrillogenesis. Expression of perd RNAi in muscles, prior to adult myogenesis, can induce misorientation and detachment of Drosophila adult abdominal muscles. In comparison to controls, perd-depleted muscles contain fewer myofibrils, which are localized at the cell periphery. These myofibrils are detached from each other and display a defective sarcomeric structure. Our results demonstrate that the extracellular matrix receptor Perd has a specific role in the assembly of myofibrils and in sarcomeric organization. We suggest that Perd acts downstream or in parallel to integrins to enable the connection of nascent myofibrils to the Z-bands. Our work identifies the Drosophila adult abdominal muscles as a model to investigate in vivo the mechanisms behind myofibrillogenesis.


High-speed three dimensional imaging based on two-wavelength parallel-phase-shift interferometry is presented. The technique is demonstrated using a high-resolution polarization-based Linnik interferometer operating with three high-speed phase-masked CCD cameras and two quasi-monochromatic modulated light sources. The two light sources allow for phase unwrapping the single source wrapped phase so that relatively high step profiles having heights as large as 3.7 μm can be imaged in video rate with ±2  nm accuracy and repeatability. The technique is validated using a certified very large scale integration (VLSI) step standard followed by a demonstration from the semiconductor industry showing an integrated chip with 2.75 μm height copper micro pillars at different packing densities.


Multispectral microscopy for applications in histology and cytology has attracted much attention in recent years. It has been shown that the unique transmission spectra of biological tissue provides additional information that is potentially useful for better classification of the pathologies. However, irrelevant features in multispectral data may affect results and performance of data analysis methods. In this paper, a fast band selection method is proposed to increase the contrast-to-noise ratio such that relevant information is maximized while reducing the number of spectral bands. The new method obtains an optimal selection of bands by solving a specific objective function with low computational costs. A thresholding criterion is developed to decide on the number of bands to be selected.


IL-10 is a pleiotropic cytokine produced by monocytes and T cells that has potent inhibitory effects on monocyte/macrophage function. Because monocytes and macrophages are capable of releasing the C-C chemokine, macrophage inflammatory protein-1 alpha (MIP-1 alpha), which is a potent chemoattractant for activated T cells, we studied the effects of IL-10 on the expression of MIP-1 alpha in these cells. Low levels of MIP-1 alpha were detectable in resting monocytes and macrophages. Both LPS (1 micrograms/ml) and IL-1 beta (10 ng/ml) induced the expression of MIP-1 alpha mRNA and the release of MIP-1 alpha protein from these cells. The addition of exogenous human rIL-10 inhibited induced MIP-1 alpha mRNA expression as well as the release of MIP-1 alpha protein measured after 24 h. This inhibition was significantly higher in monocytes compared with alveolar macrophages. In monocytes, IL-10-induced inhibition of MIP-1 alpha was only partially accounted for by alterations in mRNA stability and was dependent on de novo protein synthesis. In the presence of an anti-human IL-10-neutralizing Ab, the release of MIP-1 alpha induced by LPS and IL-1 beta was further enhanced in monocytes but unchanged in alveolar macrophages. MIP-1 alpha mRNA was also increased in monocytes. There was no detectable release of IL-10 from alveolar macrophages after LPS or IL-1 beta in contrast to modest amounts released from monocytes. Thus, IL-10 is an inhibitor of the induced transcription of MIP-1 alpha mRNA and of the release of MIP-1 alpha protein, with a greater effect on monocytes as compared with alveolar macrophages. IL-10 may indirectly regulate effects on cells such as activated T lymphocytes partly through the inhibition of MIP-1 alpha expression from monocytes and macrophages.


Hypoxanthine-guanine phosphoribosyltransferase (HGPRT) deficiency is transmitted as an X-linked recessive trait. Female carriers are asymptomatic and the carrier diagnosis is usually performed by determining HGPRT activity in hair roots. This technique does not allow a non-carrier state diagnosis with absolute certainty and has other limitations such as obtaining non-viable hair roots. The knowledge of the genetic mutation in three Spanish families with HGPRT deficiency, enabled us to perform the genetic diagnosis of the carrier state in 10 female subjects at risk and one female fetus. The genetic diagnosis has been performed by analyzing the differences between the mutant and the normal allele with respect to the restriction pattern. When the restriction pattern showed no differences, this has been created by directed mutagenesis. With this methodology we confirmed that a newborn of a known carrier female of HGPRT deficiency was healthy. In all cases the diagnosis could be established with great fiability in a mean time of 24 to 48 hours. We report the first genetic diagnosis of the carrier state for the HGPRT deficiency performed in Spain.


Wide area networks for surveying applications, such as seismic acquisition, have been witnessing a significant increase in node density and area, where large amounts of data have to be transferred in real-time. While cables can meet these requirements, they account for a majority of the equipment weight, maintenance, and labor costs. A novel wireless network architecture, compliant with the IEEE 802.11ad standard, is proposed for establishing scalable, energy-efficient, and gigabit-rate backhaul across very large areas. Statistical path-loss and line-of-sight models are derived using real-world topographic data in well-known seismic regions. Additionally, a cross-layer analytical model is derived for 802.11 systems that can characterize the overall latency and power consumption under the impact of co-channel interference. On the basis of these models, a Frame Aggregation Power-Saving Backhaul (FA-PSB) scheme is proposed for near-optimal power conservation under a latency constraint, through a duty-cycled approach. A performance evaluation with respect to the survey size and data generation rate reveals that the proposed architecture and the FA-PSB scheme can support real-time acquisition in large-scale high-density scenarios while operating with minimal power consumption, thereby enhancing the lifetime of wireless seismic surveys. The FA-PSB scheme can be applied to cellular backhaul and sensor networks as well.


Objective: To characterize sensory symptoms in patients with stroke occurring in the cerebral cortex. Methods: We studied clinical and imaging findings of 24 patients who had prominent sensory symptoms without definitive motor dysfunction. Results: According to the sensory manifestations, patients were divided into dominant impairment of primitive sensation (DIPS) group, dominant impairment of cortical sensation (DICS) group, and paresthesia-only group. DIPS was related to lesions involving the parietal operculum and the insular cortex, whereas DICS was related to the lesions affecting the postcentral gyrus. Patients with paresthesia only had smaller lesions located in the postcentral gyrus. DIPS group patients were more often women (p = 0.013), more often had dysarthria (n = 0.043), and more often developed central poststroke pain or paresthesia (n = 0.005) than the DICS group patients. Restricted sensory changes are common, predominantly involving the perioral or finger areas. Conclusions: Sensory patterns in these patients are generally consistent with the dichotomized (SI and SII) sensory system in the cerebral cortex. Involvement of insular and opercular areas is related to primitive sensory impairment and development of central poststroke pain, whereas postcentral gyrus involvement is related to cortical sensory loss without poststroke pain. The pattern of restricted sensory changes is generally consistent with the Penfield sensory topography.


The tubular handling of sodium in two groups of healthy old people, under the action of indomethacin and aldosterone was studied. Urinary aldosterone elimination was measured. From the results obtained, it is deduced that the elderly lose sodium through incompetence of the distal nephron. The possibility is put forward of a Na-K-ATPase deficit and/or interstitial fibrosis as being related to salt losses.


This thesis examines the wealth of representations of same-sex desire throughout Dickens's literary career, deploying a combination of historicist, feminist and queer theory approaches to challenge the continued silencing of sexually subversive material in current Dickens studies. Without eliding their important differences the project explores both male and female homoeroticism, recognising such articulations as part of Dickens's wider exploration of the socially and sexually disenfranchised who could not be accommodated within the rigid parameters of a respectability exemplified by the institution of marriage. This thesis positions Dickens's fiction as central to queer literary history. Identifying key literary, historical and experiential sources for Dickens's acquisition of sexual knowledge, it is demonstrated that Dickens adapted culturally available representations of same-sex desire to develop influential strategies of homoerotic articulation. Chapter one explores factors that contribute to the received reading of Dickens's work as deeply conservative in terms of gender and sexuality through the case study of Miss Wade. She is retextualised through a recognition of the character's debt to existing models of female same-sex desire and analysis of her relationships' resonance with other female couples in the Dickens canon. The second chapter focuses on the idealisation of alternative patterns of living in Dickens's fiction. The celebration of male bachelorhood and attention to female resistances to marriage militate against critical conceptions of the Dickensian domestic ideal. Chapter three continues the interrogation of the familial ideal, contending that 'in-lawing' (the male homoerotic strategy of marrying a sister of the male favourite) was one of the major strategies through which Dickens and his contemporaries articulated, mediated and transferred same-sex desire. This identification of homocentric strategies demonstrates the fallacy of the dominant critical assumption that the homoerotic emerges most strongly in Dickens's work through violence. Instead, this thesis demonstrates that malevolent manifestations of same-sex desire are part of a wider spectrum of homoerotic representation that also includes highly positive depictions. The final chapters extend the examination of Dickens's career-long commitment to developing pioneering strategies for the positive articulation of same-sex desire. Through attention to Dickens's deployment of homotropical relocation, chapter four argues that Dickens drew upon those sites that were imaginatively sexualised in contemporary culture to re-negotiate the erotically unsatisfying conventional model of domesticity. Chapter five uncovers the highly erotic connotations of gentler ways of touching during the period of Dickens's career, focusing on the Victorian sexualisation of nursing to argue that Dickens deploys this eroticising of nurse/patient roles to develop more affirmative, tender strategies for articulating same-sex desire.


Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the proper treatment plan. The available treatment modalities to replace congenitally missing teeth include prosthodontic fixed and removable prostheses, resin bonded retainers, orthodontic movement of maxillary canine to the lateral incisor site and single tooth implants. Dental implants offer a promising treatment option for placement of congenitally missing teeth. Interdisciplinary approach may be needed in these cases. This article aims to present a case report of replacement of unilaterally congenitally missing maxillary lateral incisors with dental implants.


Quality issues associated with projects in an industrial research laboratory are analyzed. By recognizing the common characteristics of projects in an industrial research laboratory, the problem of identifying the quality priorities is broken down into a series of levels. For each project at the top level are the personnel who play important roles for the success or failure of the project. At the second level are the stages through which the project progresses during its successful completion. At the third level are the factors contributing to the successful completion of the stages above. At the fourth level are the subfactors or the quality metrics that identify the level of success of the factors above. Through the application of this analytic hierarchy process (AHP), a planning and decision-making tool, the quality plan is constructed, and activities of industrial research projects are brought under a common umbrella to identify the most important quality aspects of customers. The scoring mechanism developed here is useful for quality monitoring purposes. It is noted that the way a quality plan is structured can be especially useful for computerizing activities in order to monitor the progress of a large number of projects. >


Abstract:What can an "ethnographic sensibility" contribute to research on climate change governance? With its emphasis on meaning making and understanding what may lie beneath more obvious interactions and processes, ethnographic methodologies, particularly collaborative event ethnography, are increasingly deployed to address complex questions and achieve conceptual leverage on issues related to climate governance. Drawing on literature in climate anthropology, material geography, and political ethnography, and with examples from our own fieldwork experiences, we devise a heuristic typology underpinned by an ethnographic sensibility to help guide the fieldwork phase of a research project. Building on the well-established practice of hanging out, we introduce hanging around, which attends to spatiality and matter; hanging in, which addresses issues of access and trust; and hanging back to guide the practice of reflexivity. We articulate what fieldwork with an ethnographic sensibility entails and discuss its potential and implications for climate governance research.


The interest for spectral color reproduction has increased with the growing field of multispectral imaging and the increasing use of multi-colorant printing systems. Spectral color reproduction, i.e. aiming at reproducing the spectral reflectance of an original, first requires a colorant separation for a multi-colorant printing system, followed by halftoning of each the color channels. Spectral vector error diffusion, sVED, has previously been introduced as a tempting alternative for spectral color reproduction, since the method combines the colorant separation and the halftoning in a single step. Only the spectral properties of the Neugebauer primaries are needed as input, and there is no need to invert a complex printer model for the colorant separation. Previously, spectral vector error diffusion has been positively evaluated for simulated prints, assuming a perfect printer and no dot gain. In this study, we evaluate the performance of sVED in practice, for real prints.Spectral vector error diffusion has been used to reproduce 1000 spectral targets, all within the spectral gamut of the printing system. The resulting color patches have been printed in various print resolutions, using a 10-colorant inkjet printing system. The experimental results reveal a remarkably large difference between the reproduction errors for the printed samples compared to the simulated spectra from the digital halftones. The results show a strong relation between the print resolution and the magnitude of the reproduction error, with lower resolutions giving smaller errors, due to the effect of dot gain in the printing process. The experimental results imply that in its current form, without compensation for physical and optical dot gain, spectral vector error diffusion produces unacceptable spectral and colorimetric reproduction errors, for any print resolutions used in practice.The results further show that the sVED method in many cases produces color patches that appear noisy and visually unpleasant. By replacing the spectral RMS difference with the ΔE94 color difference as criterion in the sVED algorithm, the graininess as well as the resulting color difference was decreased. However, the improvements in colorimetric performance and more visually pleasant reproductions, comes at the cost of an increase in spectral reproduction errors.


We report the use of Time Multiplexing Super Resolution (TMSR) to reduce significantly speckle noise in spectral
imaging microscopy of unstained thin blood smear samples of malaria-infected blood. The method is based on combining
speckle illumination with a moving array serving as an encoding mask. We propose the use of a new encoding mask to
improve the performance of the conventional TMSR method. The new mask is a two-dimensional generalisation of the one-
dimensional Ipatov code. The mask is projected on the object and 13 low-resolution images captured and subsequently
decoded properly using the same array. The low contrast images are added and extracted from the resulting
reconstruction, giving a super-resolved, high-contrast image. The Ipatov filter used in this work performs better than the
Barker filter.


In this paper, a method for the fault section estimation that considers the network topology under the influence of a circuit breaker tripped by the previous fault is proposed. The proposed method uses a three-dimensional (3-D) matrix to represent the network topology and the protection systems. The proposed network matrix describes the sections that are protected by particular protective devices that can be changed according to the network topology. To deal with the uncertainties imposed on the protection systems, the fuzzy set theory was applied to the network matrix in order to examine the relationships between the operated protective devices and the fault section candidates. A systematic method for the fuzzy membership function for each relation is proposed. In the proposed method, the operated time sequences of the protective devices were employed because either the network matrix or the network topology varied whenever the operations of the circuit breakers occur. The efficiency and adaptivity of the proposed method were demonstrated in experimental studies on real power systems in the Korean electric power system, particularly in case of complicated multiple faults.


A simplified method of measuring concrete resistivity, as an index of permeability, has been developed that is similar to ASTM C1202 or the rapid chloride permeability test (RCPT). It is significantly faster and easier to perform, however In this test, cylinders 100 x 200 mm (4 x 8 in.) were cured in 100% relative humidity and tested using the same solutions, test cells, and rubber gaskets as specified in ASTM C1202. To eliminate the problem of the temperature rise of the sample during the test, only one current reading was taken (after 5 minutes) that could be used to calculate the concrete resistivity. Testing was conducted on various different concrete mixtures after 91 days of moist curing using both the new quicker method and the standard ASTM 0202 method. An empirical correlation between the new method and the standard method demonstrates the validity and promise of the new method.


A total of twenty-five monozygotic and dizygotic glucose-tolerant twin siblings of diabetic patients were compared with age-, sex-, and weight-matched groups of glucose-tolerant offspring of two diabetic parents and normal control subjects with regard to glucose, insulin, free fatty acid and growth hormone responses during a five hour oral glucose tolerance test. Few differences in mean levels of glucose, insulin or free fatty acids were found, the trend being a higher insulin level in the twin study groups. Although the numbers of subjects were small, significantly higher insulinglucose relationships were found in monozygotic females compared to normals and in dizygotic females compared to offspring and to normals. The fasting plasma free fatty acid level was highest in the twins among each of the four subgroups, possibly indicating a blunting of the antilipolytic effect of the basal insulin level in the twins. A "paradoxic" type of growth hormone response was seen in both the twin and offspring groups compared to the respective normal groups. It appears that alterations in insulin-glucose relationships and growth hormone response exist in potential diabetic groups that cannot be accounted for by small but important differences in age, weight, or glucose tolerance.


Background: Umbilical artery Doppler reflects the status of placental circulation. Very few studies have reported the outcome of intrauterine growth restriction infants with abnormal Doppler flow pattern. Methodology: This prospective observational study was conducted between February 2014 and December 2014. Antenatal mothers with umbilical artery Doppler abnormality, admitted our labor room were recruited and neonates were followed up till postnatal day 28 or till the date of hospital discharge whichever is later. Results: During the study, 201 antenatal mothers with abnormal umbilical artery Doppler admitted to labor room were included in the study. More than half, 107 (53%) babies were preterm. Of the 184 live babies, 57 (28%) had respiratory distress of which 36 had transient tachypnea of the newborn, 12 had hyaline membrane disease and 8 had meconium aspiration syndrome. Absent or reversal of end-diastolic flow was more in those mothers with preeclampsia. The rate of intensive care unit admissions was significantly higher in absent or reversal of diastolic flow (AREDF) group when compared to forward end diastolic flow (FEDF) group. Preterm small for gestational age babies and perinatal asphyxia were significantly high in pregnancy-induced hypertension (PIH) group. Conclusions: Neonates with absent or reversal of diastolic flow in umbilical artery have significantly higher morbidity and mortality when compared to those with FEDF. Even within the abnormal Doppler group, PIH adversely affects the perinatal and neonatal outcome, indicating that PIH is an independent risk factor in predicting adverse perinatal and neonatal outcome.


Scalable Vector Graphics (SVG) is an XML‐based vector graphics standard developed by the World Wide Web Consortium. The National Archives of Singapore recently launched an online virtual exhibition, Colours in the Wind, which was developed using Macromedia Flash, the most widely used format for animated and interactive vector‐based Web content. The current work reports on the experiences in developing an SVG‐based version of this exhibition as well as the exploration of SVG's potential for developing future virtual exhibitions as an alternative to Flash. Observations from the SVG effort are discussed together with descriptions of techniques used and the limitations and problems that SVG poses to developers. A comparative study involving the usability features of the Flash and SVG versions of the virtual exhibition is also described. Results indicate that users are positive towards SVG and suggest the viability of the technology as a development platform.


This paper uses data from Matlab, Bangladesh to examine the characteristics of female-headed households and estimate the impact of female-headship on children's schooling. Female household-heads in Matlab fall into two broad groups: widows and married women, most of whom are wives of migrants. These women differ from each other not only in their current socio-economic circumstances, but also in their backgrounds and circumstances prior to getting married. To identify the effects of female-headship on children's outcomes, I use a two-stage least squares strategy that controls for the possible endogeneity of both types of female-headship. Results indicate that children residing in households headed by married women have stronger schooling attainments than children in other households, while children of widows are more likely to work outside the home. The hypothesis of exogeneity of female-headship is rejected in most cases.


Ongoing climate change is affecting the concentration, export (flux), and timing of dissolved organic carbon (DOC) exported to the Gulf of Maine (GoM) through changes in hydrologic regime. DOC export was calculated for water years 1950 through 2013 for 20 rivers and for water years 1930 through 2013 for 14 rivers draining to the GoM. DOC export was also estimated for the 21st century based on climate and hydrologic modeling in a previously published study. DOC export was calculated by using the regression model LOADEST to fit seasonally adjusted concentration discharge (C‐Q) relations. Our results are an analysis of the sensitivity of DOC export to changes in hydrologic conditions over time since land cover and vegetation were held constant over time. Despite large interannual variability, all rivers had increasing DOC export during winter and these trends were significant (p < 0.05) in 10 out of 20 rivers for 1950 to 2013 and in 13 out of 14 rivers for 1930 to 2013. All rivers also had increasing annual export of DOC although fewer trends were statistically significant than for winter export. Projections for DOC export during the 21st century were variable depending on the climate model and greenhouse gas emission scenario that affected future river discharge through effects on precipitation and evapotranspiration. The most consistent result was a significant increase in DOC export in winter in all model‐by‐emission scenarios. DOC export was projected to decrease during the summer in all model‐by‐emission scenarios, with statistically significant decreases in half of the scenarios.


C.difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C.difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents. If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C.difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C.difficile, and surgical evaluation should be instituted as clinically indicated.


The focus of this study is on the financial sector, and it asks two questions: a) what are financial institutions currently doing in terms of assisting in the labour market integration of newcomers? and b) where are the opportunities for improvement within the financial sector with respect to the employment of immigrants? The study examines current achievements regarding the sector's successful labour market integration of immigrants, opportunities for improvement, and recommendations as to how the financial sector can become a leader in this domain as well as the benefits of doing so. Some key findings are that there is a gap in terms of the successful integration and inclusion of immigrants in the labour market despite recognition of the business case for diversity. Ingrained biases and beliefs persist, and the communication patterns and 'rigid' history of the financial sector are not maturing at the same pace as the global economy.


The effect of environmental enrichment on the welfare of stabled horses was estimated on the basis of positive and negative behavioural indicators. Six stabled horses were exposed for seven days to each of two conditions in early spring: i) a window at the back of the loose box was opened, but no horses were within the view of the subject horses (OW) and ii) the window in the loose box was opened and two horses that had been in the same stable as the subject horses were turned out to the paddock next to the stable and were within view of the subject horses (OWH). The window in the loose box had been closed prior to the start of the study for protection against the cold during winter months (CW condition) but horses could see outside the loose box through the grille door. The behaviour of the subject horses was recorded by video camera from 1300 to 1530h, firstly, in the CW condition for the three days prior to treatment as the control condition, and then for the last three days of each week in the OW and OWH conditions. The behaviour was focal- and instantaneous-sampled at 30-s intervals. Significant differences between the effects of the loose box conditions on the mean percentage of time spent in standing behaviour, looking behaviour, and bedding investigation behaviour (which may be an indicator of frustration) were observed but no significant difference in the mean percentage of time spent in standing-sleep behaviour (which may be an indicator of behavioural satisfaction) was observed. When the window was opened, bedding investigation and standing behaviour decreased and, when the conspecifics were within view, bedding investigation behaviour decreased and looking behaviour increased. The results suggested that the OW and OWH treatments suppressed the frustration of stabled horses which did not perform any abnormal behaviour, but may not increase the behavioural satisfaction of stabled horses.


The paper presents the results of experimental studies of the effect of mechanoactivation of the powder, argon shielding gas and the effect of technological modes of melting: the speed of the laser beam, the power of laser radiation, the scanning step, the preliminary temperature of heating the powder material on the surface roughness of the copper powder material obtained by selective laser melting. Experiments on the melting of copper powder are implemented on the installation of layer-by-layer laser melting of the original design, which allows to adjust all technological modes of melting. The surface roughness is determined on the non-contact digital microscope Olympus LEXT OLS4100. The mathematical dependence of the surface layer roughness of copper powder on the technological modes of melting is obtained on the basis of the theory of experiment planning and static processing of the results. The significant parameters of the regime-the power of laser radiation, the speed of the laser beam, the scanning step affecting the roughness of the layer. The positive effect of mechanical activation of powder material and protective atmosphere on the quality of the surface layer is shown.


Classical module systems support well the modular development of applications but do not offer the ability to add or replace a method in a class that is not defined in that module. On the other hand, languages that support method addition and replacement do not provide a modular view of applications, and their changes have a global impact. The result is a gap between module systems for object-oriented languages on one hand, and the very desirable feature of method addition and replacement on the other hand. To solve these problems we present classboxes, a module system for object-oriented languages that provides method addition and replacement. Moreover, the changes made by a classbox are only visible to that classbox (or classboxes that import it), a feature we call local rebinding. To validate the model, we have implemented it in the Squeak Smalltalk environment, and performed experiments modularising code.


Forty nine librarians from the University of Ibadan (UI), University of Lagos (UNILAG) and Obafemi Awolowo University (OAU) were surveyed by employing a structured questionnaire seeking respondents' opinion on quality assurance. The respondents indicated that they fully participated in accreditation exercises of the National Universities Commission (NUC) which is the main body responsible for ensuring quality in Nigerian universities. The importance of accreditation is to improve quality and to maintain standards and guidelines. As regards the impact of accreditation, all the librarians rated improved provision of library services and resources to be the highest impact. Most of the criteria for assuring quality received very high scores with leadership having a score of 100% in the three institutions. It is concluded that the highest impact of accreditation on libraries is the improved provision of library services and resources. The library is the hub of activities during accreditation because each accreditation team is obliged to visit the library to ascertain the quality of library holdings and services in relation to every programme being accredited.


Unipolar depression, estimated to be the leading contributor to burden of disease in middle- and high-income countries, often has an onset in adolescence. The disorder is associated with substantial role impairment and is highly recurrent. This raises questions about both subsequent mental health and social outcome. In order to shed light on this, a community sample of adolescents with depression and non-depressed peers was followed-up after 15 years. In 1991-93, first-year students in upper secondary school (age 16-17) in the town of Uppsala, Sweden, were screened for depression. Adolescents with positive screening and selected peers with negative screening (n=631 in total) were assessed regarding mental health, social situation, and personality. At around age 31, the participants were followed-up in both national registers (n=609) and personal interviews (n=409). Outcome regarding social factors, mental health, and personality was assessed. At follow-up, the former depressed adolescents had completed higher education to a lesser extent than the former non-depressed adolescents. The females with adolescent depression were also at increased risk of subsequent abortion, divorce, single parenthood, and partner violence. Characteristics associated with depression in adolescence (such as poor school performance and disruptive disorders) seemed to contribute to the poor outcome in the social domain. Regarding adult mental health, long-term depression in adolescence was associated with a particularly poor outcome. Compared to adolescents with shorter episodes of depression, those with long-term depression were more likely to report recurrent depression, suicidal ideation, and a range of other mental disorders in adulthood. Measures of personality traits related to neuroticism (a tendency towards negative emotionality) were elevated during ongoing depression and anxiety disorders, but were normalized with remission. However, repeated depressive episodes seemed to leave the individual more vulnerable to stress. It is now important to assess if early treatment can alter the poor outcome depicted in this thesis. Since social adversity, educational difficulties, and interpersonal problems accompany the depressive disorder from adolescence onward, it should also be investigated if interventions aimed at such contextual factors can prevent recurrence and improve quality of life.


The rapid development of high-throughput sequencing technologies poses to transform many aspects of human health. It is without question that within the next decade the ability to rapidly sequence any infection to determine the genetic structure of the etiologic agent will be feasible. To effectively utilize such an approach we must first develop a greater understanding of the genetic variation of clonal microbial pathogens as well as the functional significance of the variation found. To this extent I have focused on three projects. i.) By sequencing 36 community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) from within a defined geographical area we are able to understand how the genome is evolving overtime. Sequence analysis of the strains suggests the population is under diversifying selection for genes related in virulence. In addition, mutational burden of individual isolates correlates with the severity of infection suggesting the CA-MRSA is evolving away from it's hyper-virulent ancestor to become less pathogenic. ii.) Acquiring resistance to the gram-positive antimicrobial daptomycin has previously been shown to be a complicated process that can be achieved through multiple routes. I describe the non-linear multi-allelic acquisition of resistance in a laboratory evolved strain of Bacillus subtilis. Through the use of allelic replacement and transcriptomic analysis three loci (dctP/ ybdI, yvrG, yqeG) are shown to be involved in the resistance phenotype through the alteration of cell wall and cell membrane metabolism pathways. iii.) Finally, I present methods to acquire rare sequences from complex pools of DNA. I demonstrate two such methods, microdroplet PCR and RNA/DNA hybridization to accomplish this. I apply these methods to the capturing of Plasmodium vivax from dried whole blood spots thus alleviating the need to leukocyte filtration. I discuss future application for the integrating all three studies towards the use of clinical sequencing for the detection and monitoring of infectious diseases


With reference to Cameroon English (CamE), this paper proposes another way of analysing non-native English features: differing from the traditional approach which limits itself to surface forms, the paper proposes the tracing of deviations down to the underlying representation (UR) and suggests that RP URs (A) are restructured to autonomous CamE URs (B). While A undergoes RP phonological rules to surface as A', B may fail to undergo these processes; it may also undergo parallel — and quite often divergent — processes and surface as B'. For example, RP UR "s[^]cceed" (A) is restructured to CamE "s[u]cceed" (B). A becomes "s[^]cceed" by Vowel Reduction and B, which does not undergo this process, surfaces unchanged as "s[u]cceed" (B'). This process can be represented on a chart which has three sides: AA', AB and BB'. Hence the name Trilateral Process. It is observed that this model is more illuminating with respect to the dynamics of the differences between native and non-native Englishes than an analysis based solely on surface observation of deviations, for a catalogue of deviations lacks the explanatory insights of a trilateral analysis.


Importance
Trauma patients have an increased risk of venous thromboembolism (VTE), partly because of greater inflammation. However, it is unknown if this association is present in patients who undergo emergency general surgery (EGS).

Objectives
To investigate whether emergency case status is independently associated with VTE compared with elective case status and to test the hypothesis that emergency cases would have a higher risk of VTE.

Design, Setting, and Participants
This retrospective cohort study used the American College of Surgeons National Surgical Quality Improvement Program database from January 1, 2005, to December 31, 2016, for all cholecystectomies, ventral hernia repairs (VHRs), and partial colectomies (PCs) to obtain a sample of commonly encountered emergency procedures that have elective counterparts. Emergency surgeries were then compared with elective surgeries. The dates of analysis were January 1 to 31, 2019.

Main Outcomes and Measures
The primary outcome was VTE at 30 days. A multivariable analysis controlling for age, sex, body mass index, bleeding disorder, disseminated cancer, laparoscopy approach, and surgery type was performed.

Results
There were 604 537 adults undergoing surgical procedures over 12 years (mean [SD] age, 55.3 [16.6] years; 61.4% women), including 285 847 cholecystectomies, 158 500 VHRs, and 160 190 PCs. The rate of VTE within 30 days was 1.9% for EGS and 0.8% for elective surgery, a statistically significant difference. Overall, 4607 patients (0.8%) had deep vein thrombosis, and 2648 patients (0.4%) had pulmonary embolism. A total of 6624 VTEs (1.1%) occurred in the cohort. As expected, when VTE risk was examined by surgery type, the risk increased with invasiveness (0.5% for cholecystectomy, 0.8% for VHR, and 2.4% for PC; P < .001). On multivariable analysis, EGS was independently associated with VTE (odds ratio [OR], 1.70; 95% CI, 1.61-1.79). Also associated with VTE were open surgery (OR, 3.38; 95% CI, 3.15-3.63) and PC (OR, 1.86; 95% CI, 1.73-1.99).

Conclusions and Relevance
In this cohort study, emergency surgery and increased invasiveness appeared to be independently associated with VTE compared with elective surgery. Further study on methods to improve VTE chemoprophylaxis is highly recommended for emergency and more extensive operations to reduce the risk of potentially lethal VTE.


Eight immunotype lipopolysaccharides (LPSs) of Neisseria meningitidis were prepared by the phenol-water procedure and characterized by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and sugar analyses. By SDS-PAGE and a highly sensitive silver strain. N. meningitidis LPSs from cells grown in tryptic soy broth were shown to contain one or two predominant components and a few minor, somewhat higher-molecular-weight components. The molecular sizes of the two predominant components were approximately the same as those of two E. coli rough-type LPSs, one with a complete core and the other with an incomplete core. The molecular weight of the major LPS component varied somewhat among different immunotypes but was estimated to be in the range of 4,200 to 5,000. By sugar analyses, the eight immunotype LPSs were different in their monosaccharide compositions. All contained glucose, galactose, heptose, glucosamine, and 2-keto-3-deoxyoctonate, but in different molar ratios. The growth of N. meningitidis in tryptic soy broth under different levels of aeration resulted in a change in the two major LPS components seen on the SDS-PAGE gel. High aeration increased the amount of the smaller component, whereas low aeration increased the amount of the larger component. Sugar analyses of LPSs from high and low aeration indicated that the larger LPS component contained more galactose residues per molecule. Use of different media for cell growth may also result in small, but noticeable, variations in the LPS components and in the galactose content of the LPS. The observed heterogeneity of N. meningitidis LPS may explain why many strains of N. meningitidis appear to possess more than one immunotype.


The sendos having been put to practical use in Okayama, Hiroshima and Fukuoka may be divided by their colors into two groups, the greyish and brownish ones. Akashi and Awaji sendos belong to the former and Hiroshima, Kyushu and most of Okayama sendos to the latter. The chemical composition of sendo samples, with special reference to its effects on physical behavior of sendo in mud water and on color of dried rush were studied by the authors. The results obtained are to be summarized as follows: 1)The sendos in water suspension showed reactions within the range pH 5.2 to 9.3. Hiroshima sendos are weak acid, while the others are neutral or slightly alkaline. In most of sendos, the content of soluble salts is very low, while a considerable amount of salts, mostly of calcium sulfate, is contained in Kyu-Akashi sendo. 2)The content of humus and Fe++ in the greyish group is comparatively high, while that in the brownish group is low. The content of HCL-soluble Fe2O3 in the brownish group increases in the following order: coarse sendo<clayey sendo<Kyushu sendo, and that in the greyish group is nearly the same as Kyushu sendo. In the greyish group, the amount of MgO is larger than CaO, while the former is less than the latter in the brownish group. 3)It is found that the base exchange capacity of sendo is closely related to the content of clay, namely, that of clayey sendos are higher than that of coarse sendos. In general, the content of exchangeable cation decreases according to the following order excepting a few samples: Ca>Mg>Na>K. 4)A fairly large amount of oxidizable sulfur is found in Kyu-Akashi sendo and the pH value of soil become extremely acid after oxidation with H2O2, while the content of oxidizable sulfur in Shin-Akashi sendo is much less than in the former. On the contrary, oxidizable sulfur is not found at all in the brownish group. 5)It has been experienced that readiness of changing color is a single, serious drawback of Kyu-Akashi sendo. It is shown that the discoloration is due mainly to the oxidation of Fe++, especially of iron sulfide in Kyu-Akashi sendo. It is concluded that sufficient drying of sendo is an effective measure for preserving the characteristic bluish grey color of Kyu-Akashi sendo, and it is necessary to keep the original color.


efficient and precise genetic modifications Abstract: Plant genome editing tools as Zinc-Finger Nucleases (ZFNs), Trans Activator-Like Effector Nucleases (TALENs), and Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) associated with Cas proteins are offering new possibilities for crop improvement and new insights for functional genomics. In this review, we discuss (i) the new findings in gene editing technologies, (ii) a comparison between them, and (iii) their applications for genetic analysis and manipulation of fruit crops. Different editing technologies, especially the CRISPR/Cas9 system, were successfully used in fruit crops such as apple, banana, cacao, citrus, grape, kiwifruit, and pear. Experimental designs used to analyze the efficiency of the CRISPR/Cas9 genome editor are presented, including manipulating key genes associated with carotenoid biosynthesis that could allow the development of complete albino and variegated phenotypes in some cultivars. The most recent outcomes of the application of genome-editing tools to improve the quality and yields of fruit crops, such as manipulation of juvenile phase and flowering period, gibberellin biosynthesis and generation of dwarf cultivars, ethylene biosynthesis, fruit ripening and parthenocarpy, development of resistant/tolerant cultivars to numerous pests


Across the world, legal education is subjected to a continuous process of change and evolution. This edited collection identifies and explores key contemporary and emerging themes in legal education which are likely to have a significant impact on the law schools, law students and legal academics in the coming years. Each theme is explored by two or more authors from different jurisdictions, allowing for rich comparative dialogue and insights into the current and future directions of legal education.

Key themes explored in this collection include the pressures on law schools exerted by external stakeholders, the fostering of interdisciplinary approaches and collaboration within law schools, the evolution of discourses around teaching and learning legal skills, the continuing development of clinical legal education as a core component of the law degree, the emergence and use of innovative technologies within law teaching and the growing awareness of the need to tackle issues relating to law student wellbeing. Dr Emma Jones' introduction provides a suggested theoretical framework drawing together these themes around the concept of relationality, whilst Professor Anthony Bradney's conclusion provides an incisive comment on the themes explored.

Overall, this edited collection provides an important addition to contemporary debates within legal education by providing a breadth of both national and international perspectives in a format which offers an insight into commonalities and differences between jurisdictions and moves forward the debate on key themes.


Salivary duct carcinoma (SDC) is a subtype of salivary gland cancer with a dismal prognosis and a need for better prognostica-tion and novel treatments. The aim of this national cohort study was to investigate clinical outcome, prognostic factors, androgen receptor (AR) and human epidermal growth factor receptor 2 (HER2) expression. SDC patients diagnosed between 1990 and 2014 were identified by the Nationwide Network and Registry of Histo- and Cytopathology in the Netherlands (PALGA). Subsequently, medical records were evaluated and pathological diagnoses reviewed. Data were analyzed for overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS) and prognostic factors. AR was evaluated by immunohistochemistry (IHC), HER2 by IHC and fluorescent in-situ hybridization. A total of 177 patients were included. The median age was 65 years, 75% were male. At diagnosis, 68% presented with lymph node metastases and 6% with distant metastases. Median OS, DFS and DMFS were 51, 23 and 26 months, respectively. In patients presenting without distant metastases, the absolute number of positive lymph nodes was associated with poor OS and DMFS in a multivariable analysis. AR and HER2 were positive in 161/168 (96%) and 44/153 (29%) tumors, respectively, and were not prognostic factors. SDC has a dismal prognosis with primary lymph node involvement in the majority of patients. The absolute number of lymph node metastases was found to be the only prognostic factor for DMFS and OS. AR expression and—to a lesser extent—HER2 expression hold promise for systemic treatment in the metastatic and eventually adjuvant setting. and distant human epidermal


Agricultural fields naturally have within-field variations that may cause spatial variability in crop yields. Delineating a field into a few management zones (MZ) is therefore a practical management approach for precision agriculture. In this study, some soil properties (clay content, organic matter content and water content measured at different dates) and a multivariate geostatistical approach were used to delineate management zones. The temporal stability of soil water content spatial patterns may be an additional approach in delineating management zones. The present study was conducted on a 120000 m2 durum wheat field in Southern Italy, where soil properties and soil water content were measured at different times over three crop seasons (2005-06, 2006-07, and 2007-08) at 100 locations. The multivariate spatial and temporal data were analysed by Factor Kriging Analysis (FKA). All simple and cross model variograms were calculated by fitting a linear model of coregionalization including the nugget effect and two spatial structures at shorter (70 m) and longer range (500 m). The application of factor kriging allowed us to identify one regionalized factor at longer scale and to partition the field from the point of view of temporal stability of soil water content, into contiguous zones to be submitted to site-specific management. The method showed a great flexibility to combine data from several sources in the delineation of management zones.


The DNA insert of plasmid pK52 contains the fudAB operon coding for the Escherichia coli fatty acid oxidation complex. Studies on the operon's structure and organization revealed that the initiator codon (ATG) of the structural gene for 3-ketoacyl-CoA thiolase, the fadA gene, is located 109 nucleotides 3' to the stop codon (TGA) of the fadB gene that encodes the (rsubunit, a multifunctional polypeptide. The direction of transcription of this operon is thus from fadB to fadA. The orientation of the fadA and fadB genes is the reverse of what had been published previously. The structural gene for thiolase is 1,164 nucleotides long and starts six nucleotides downstream from a ShineDalgarno sequence. 109 nucleotides of 5'-noncoding and 321 nucleotides of 3'-noncoding regions are also reported. The 3-ketoacyl-CoA thiolase &subunit is composed of 388 residues and has a calculated M, of 40,889. The CYand @-subunits were separated by gel filtration in formic acid, and the sequence of the aminoterminal 10 amino acids of the ,&subunit coincided with that deduced from the nucleotide sequence data. Sequence comparisons suggest that Cys-91 of the E. coli enzyme is the active-site cysteine residue and that the consensus sequence of the active sites of 3-ketoacylCoA thiolases is Asn-Arg-XI-Cys-XZ-Ser-X3-X4-Gln. Although the quaternary structure of E. coli 3-ketoacyl-CoA thiolase is different from that of other thiolases, the sequence is homologous to rat and human peroxisomal and rat mitochondrial 3-ketoacyl-CoA thiolases, to the extent of 42, 41, and 37%, identity, respectively. An evolutionary tree of thiolases was constructed; it suggests that the genes of E. coli and peroxisomal 3-ketoacyl-CoA thiolases diverged after the appearance of eukaryotic cells.


If a planned path reaches a dead-end, one can simply stop. Or one can turn around, walk back to the last intersection and take another path, or one can consider taking few paths in parallel. The last scenario is reflective of the journey of remdesivir, the first antiviral for the treatment of COVID-19, that was approved by FDA less than 10 months after the isolation of SARS-CoV-2, the virus responsible for the COVID-19 pandemic. As of January 2022, 10 million COVID-19 patients have been treated with remdesivir worldwide, but the journey of this molecule started more than a decade earlier with the search for a cure of hepatitis C virus. The development path of remdesivir before the emergence of COVID-19 represents a valuable example of a preemptive pandemic preparedness, but the pursuit of this path would not have been possible without sustaining support of John C. Martin, whom we will sorely miss for his piercing vision, uncompromising leadership, and genuine compassion for patients suffering around the world.


ABSTRACT Enterococci account for nearly 10% of all nosocomial infections and constitute a significant treatment challenge due to their multidrug resistance properties. One of the well-studied virulence factors of Enterococcus faecalis is a secreted bacterial protease, termed gelatinase, which has been shown to contribute to the process of biofilm formation. Gelatinase belongs to the M4 family of bacterial zinc metalloendopeptidases, typified by thermolysin. Gelatinase is synthesized as a preproenzyme consisting of a signal sequence, a putative propeptide, and then the mature enzyme. We determined that the molecular mass of the mature protein isolated from culture supernatant was 33,030 Da, which differed from the predicted molecular mass, 34,570 Da, by over 1,500 Da. Using N-terminal sequencing, we confirmed that the mature protein begins at the previously identified sequence VGSEV, thus suggesting that the 1,500-Da molecular mass difference resulted from a C-terminal processing event. By using mutants with site-directed mutations within a predicted C-terminal processing site and mutants with C-terminal deletions fused to a hexahistidine tag, we determined that the processing site is likely to be between residues D304 and I305 and that it requires the Q306 residue. The results suggest that the E. faecalis gelatinase requires C-terminal processing for full activation of protease activity, making it a unique enzyme among the members of the M4 family of proteases of gram-positive bacteria.


Abstract Sarcoidosis is a systemic disease characterized by widespread development of noncaseating epithelioid granulomas. Based on a joint statement by the American Thoracic Society (ATS), European Thoracic Society (ERS), and the World Association for Sarcoidosis and other Granulomatous Disorders (WASOG), the diagnosis of sarcoidosis requires a compatible clinical picture, histologic demonstration of noncaseating granulomas, and exclusion of other diseases that may give a similar histologic or clinical picture. Although to a casual reader these recommendations suggest that making a diagnosis of sarcoidosis is straightforward, a consensus on the diagnostic role of imaging in sarcoidosis remains unclear. First, despite the primacy of chest computed tomography (CT) for evaluating diffuse lung disease, a guideline-based diagnosis of sarcoidosis without biopsy requires specific appearances on chest radiography (Löfgren's syndrome) or 67Ga Scintigraphy (Heerfordt's syndrome). Second, although the literature on CT as a prognostic tool in interstitial lung disease is relatively extensive, very little of this focuses specifically on sarcoidosis. Third, staging of sarcoidosis relies on radiographic appearances at presentation using a system devised by Scadding more than 40 years ago. This is in stark contrast to idiopathic pulmonary fibrosis where significant advances have been made in imaging-based staging and computer-assisted quantification of disease in the past 10 years. In this article, in addition to describing the myriad of imaging patterns seen in sarcoidosis, the impact imaging has on diagnosis, staging, and prediction of outcome will also be discussed. Cardiac-related sarcoidosis and neurosarcoidosis will be discussed in separate articles.


prevent death of bone in many severe cases. Indeed, if you operate early you may withdraw inflammatory exudate only and no pus. In a serious infection it is often difficult to know which part of the bone to attack as there will be no radiological change at this stage; one can even be in doubt as to which bone is involved. We recall a toxic infant, 6 months old, with swelling and maximum tenderness over the lower end of the ulna treated by antibiotics who later developed complete sequestration of the lower half of the radial shaft. We do not know what determines the extent of bone destruction in children. It seems in many cases to be predetermined, and early surgery, at least in our hands, has not lessened this destruction. We believe that the treatment of acute osteomyelitis in its early stages is by chemotherapy. After pus has formed surgical drainage is beneficial as it relieves pain, prevents spontaneous sinus formation, and enables an organism to be cultured and its sensitivity assessed so that the most suitable antibiotic can be used for continuation therapy. We distrust Mr. Harris's timetable regime.-We are, etc., Royal Hospital for Sick Children, N. J. BLOCKEY. Glasgow. T. S. M ANN.


In contrast to time seismic, reliable depth seismic is a good screening tool for petroleum systems analysis. With a constant temperature gradient across the area, the oil and gas windows are parallel to the water depth in a depth seismic section. Inversion of seismic processing velocities can be used to predict lithologies, porosity, pore pressure and uplift / erosion. Our presentation will show how we are using a consistent set of regional depth seismic sections together with Velocity Inversion as tools from the early play screening phase to the beginning of prospect evaluation. This method is especially well adapted to passive margins with deep water and little well control. We will show examples from passive margins in Australia and Norway.


Over the past years the concept of role in distance education has become a promising construct for analysing and facilitating collaborative processes and outcomes. Designing effective collaborative learning processes is a complex task that can be supported by existing good practices formulated as pedagogical patterns or scripts. Over the past years, the research on technology enhanced learning has shown that collaborative scripts for learning act as mediating artefacts not only designing educational scenarios but also structuring and prescribing roles and activities. Conversely, existing learning systems are not able to provide dynamic role management in the definition and execution of collaborative scripts. This work proposes the application of Social Network Analysis in order to evaluate the expertise level of a learner when he/she is acting, with an assigned role, within the execution of a collaborative script. Semantic extensions to both IMS Learning Design and Information Packaging specifications are also proposed to support roles management.


The Guido Music Notation format (GMN) is a general purpose formal language for representing score level music in a platform independent plain text and human readable way. Based on this music representation format, the Guido Lib provides a generic, portable library and API for the graphical rendering of musical scores. This paper gives an introduction to the music notation format and to the Guido graphic score rendering engine. An example of application, the GuidoSceneComposer, is next presented.


This article demonstrates symbiotic academic-social enterprise (SASE), a bottom-up approach intertwined with the subsistence marketplace research stream. The SASE approach is unique in coevolving academic and social initiatives in parallel for the express purpose of achieving dual objectives: societally relevant research and social impact over an extended period. Distinct from typical action research approaches, the directionality between research and practice in this approach is circular or mutual rather than linear, the time frame continuous rather than discrete, and the unit of analysis the entire enterprise rather than a single project. Thus, SASE is fundamentally a bottom-up, learning-by-doing approach that developed in contexts characterized by a confluence of uncertainties for communities and a confluence of unfamiliarities for researchers and practitioners. The authors demonstrate this approach in the context of creating sustainability literacy education in Tanzania based on unique climate change impacts in the region. The academic research enterprise provides bottom-up insights about climate change and potential approaches to sustainability literacy education. A sustainability literacy education pilot project demonstrates an initiative in the social enterprise aspect of the approach. Finally, the authors derive public policy and marketing implications of SASE.


Background During the 2009 influenza pandemic, individuals over the age of 60 had the lowest incidence of infection with approximately 25% of these people having pre-existing, cross-reactive antibodies to novel 2009 H1N1 influenza isolates. It was proposed that older people had pre-existing antibodies induced by previous 1918-like virus infection(s) that cross-reacted to novel H1N1 strains. Methodology/Principal Findings Using antisera collected from a cohort of individuals collected before the second wave of novel H1N1 infections, only a minority of individuals with 1918 influenza specific antibodies also demonstrated hemagglutination-inhibition activity against the novel H1N1 influenza. In this study, we examined human antisera collected from individuals that ranged between the ages of 1 month and 90 years to determine the profile of seropositive influenza immunity to viruses representing H1N1 antigenic eras over the past 100 years. Even though HAI titers to novel 2009 H1N1 and the 1918 H1N1 influenza viruses were positively associated, the association was far from perfect, particularly for the older and younger age groups. Conclusions/Significance Therefore, there may be a complex set of immune responses that are retained in people infected with seasonal H1N1 that can contribute to the reduced rates of H1N1 influenza infection in older populations.


Estimates of intangible capital stock are of prime importance for accurate measurement of productivity growth. Aggregate intangible capital stock is usually estimated using the so-called Corrado-Hulten-Sichel (CHS) new growth accounting framework. Yet this framework has not received much academic scrutiny to-date. This article proposes a validity test of two intangible investment series in the CHS framework, namely "brand equity" and "architectural and engineering designs." The test involves assessing the extent to which these intangible investment series explain the demand for trademarks and design rights. The econometric analysis is performed on an unbalanced panel of 32 countries from 1980 to 2010. The results suggest that brand equity investment is a powerful predictor of trademark applications. However, investment in design activity is not correlated with the count of design rights, which I take as evidence that current methodologies do not account well for design activities.


A monoclonal antibody (mAb), sis 1, generated against human c-sis-encoded platelet-derived growth factor (PDGF) BB, was shown by enzyme-linked immunosorbent assay and Western blot (immunoblot) analysis to recognize human PDGF BB and human platelet PDGF AB but not the human PDGF AA. This monoclonal antibody potently inhibited PDGF receptor-binding and mitogenic activities of both human PDGF BB and PDGF AB but had no effect on PDGF AA. Finally, we demonstrated that an immunoaffinity-purified anti-c-sis peptide antibody (anti-V4) which also blocked binding of PDGF BB to its cognate receptor and competed with mAb sis 1 for binding to PDGF BB. All of these results suggest that mAb sis 1 recognizes an epitope of the c-sis gene product, PDGF BB, that spatially overlaps the V4 surface domain of PDGF BB, immunochemically localizing a region of PDGF BB critical for PDGF receptor binding and activation.


The congress theme reflected that landscape ecology is a meeting point - where pattern and process meet people and action - seen as a way of thinking when dealing with European landscapes. We wanted to put emphasis on the integration of pattern and process as a biophysical component of landscape ecology with people and action, bringing in the social and cultural approaches. This requires a true interaction of natural and social sciences, and of science, policy and practice. Therefore the congress was an opportunity to reflect on the state of the art of landscape ecology today. Furthermore, the challenge of the congress was what the future directions are of landscape ecology as a social relevant approach for science, policy and practice.


The renovation of buildings involves multidisciplinary issues and multistakeholder involvement, which makes the process complex to manage. The purpose of this paper is to present a transparent, openly accessible, adaptable framework to ensure a sustainable renovation process, covering the technical, environmental, economic, social, and cultural historical aspects to be considered by the various actors during the renovation process. A framework with an associated process was drawn up, focusing on practical usefulness together with the fundamental idea that sustainability cannot be a sub requirement but must be the overall requirement present in all stages of the process. The framework contains an overview, description of activities, links to external tools and documents, and finally a checklist to be completed after each stage. Depending on which stakeholder uses the framework, there are different examples and suggestions for activities and tools. Contrary to many other assessment schemes, the SIRen process focuses on the renovation process itself, and the self-evaluation gives a numerical value that represents to what extent the actors have considered and implemented different aspects of sustainability in the stages of the renovation process. The SIRen process was partially implemented in four renovation projects during the iterative development of the SIRen framework.


There is a growing interest in the development of new design methods that will allow companies to adapt to a world that is becoming more competitive due to globalization and a rapidly changing global economic landscape. Several new techniques are being developed as a result of this interest that addresses the unique characteristics of product evolution. For example, Otto and Wood presented a new reverse engineering and redesign methodology that focuses on the process steps needed to understand and represent a current product with the combination of various techniques to address the different stages of the design process [1]. In this paper, we present a case study involving the use of augmentation tools such as affinity diagrams and quality function deployment's (QDF) house of quality to augment the systematic design approach originally developed by Pahl and Beitz (P&B) [3] and apply it to an existing process and design issue. While presenting their approach, we apply our augmented approach to a laboratory-scaled fabrication process for the creation of adaptive polymer particles. We demonstrate that this augmented design approach could create a large-scale fabrication method that is low in cost, high in quality, and provides greater efficiency than the original method. According to our results, the process time was reduced by as much as 35.4% which would save thousands of dollars each year. In addition, the quality of the fabricated polymeric samples was improved significantly due to the use of advanced tools and simulation techniques. This augmented P&B method will provide an additional option for businesses and engineering designers to consider when faced with the challenges of sustaining designs and design processes.Copyright © 2009 by ASME


Solitary bone cyst is a benign lesion of unknown origin up to the present date. Its origin is mainly attribute to trauma theory, caused by intra-osseous bleeding which prevents bone repair, causing thus a cystic cavity with serous hematic content lacking epithelial lining. In most cases, the lower jaw is the most affected. It is observed in patients with ages ranging 20-30 years, generally male, it is an asymptomatic, slow-growing entity which progresses toward the cortical plates; it can cause pathological mandible fractures. Its discovery is usually incidental during a radiographic examination. It appears as a radiolucent, unilocular ormultilocular image, with well -defined borders, lacking sclerotic areas. Additional tomography and magnetic resonance studies have revealed that these cavities are not necessarily taken up by fluids: there can be presence of gas, or they could be empty. A differential diagnosis must be established to discard dentigerous cysts, ameloblastoma, keratinizing odontogenic tumor, calcifying epithelial tumor or adenomatoid odontogenic tumor.


This research explores an approach for adaptive reuse to enhance livability and greater connection to place within provincial towns of New Zealand. There are existing buildings which are often left in disrepair or considered too expensive to refurbish or strengthen. They are often demolished with little consideration to the building's significance, therefore adaptive reuse has become a missed opportunity in New Zealand.  Many of our provincial cities have uninhabited large-scale buildings, which need upgrading due to being outdated and no longer fit for purpose. Seismic upgrading is a key factor in why these buildings are left uninhabited. One of the urban areas which this is prevalent is Whanganui. Whanganui has the opportunity to blend the old and the new built form to create a revitalized and timeless street appearance.   The regeneration of Whanganui can be achieved through adaptive reuse to enhance the crafted beauty of the town through its architecture. The revitalization of Whanganui can give guidance to other provincial cities in New Zealand while enhancing the quality of life within the town.  An in-depth analysis of the history of Whanganui, will allow for heritage significance to play a major role in the redesign. This design will be developed at three different scales to demonstrate how the built form can enhance connection to place and livability. These scales are at an urban, a built and a detailed scale.   The main cross roads linking the city of Whanganui to its river is surrounded by character and historical buildings. It will be used as a key area illustrating Whanganui's past to better inform the future.


Two men aged 20 and 18 years complained of transient muscle stiffness of 4 and 2 years' duration, respectively. Symptoms had started in the legs. Gradually, arm muscles and eventually facial and pharyngeal muscles became affected. Neurological examination revealed myotonia without any associated symptoms. Myotonia was confirmed by electromyography. Laboratory investigations, ECG, chest X-rays, slit lamp examination in both patients, and muscle biopsy in one, revealed no abnormalities. History, physical examination and electromyography of family members disclosed no evidence of myotonic dystrophy. Based on the findings mentioned, the diagnosis of autosomal recessive generalised myotonia was made.


anorectal abscess and a fistula in ano. The latter condition, because it communicates with the anal canal, clearly is not suitable for primary closure; but the former condition responds extremely well to this treatment. However, we accept that this diagnostic distinction is not always easy. When reporting the late results of 100 patients treated for anorectal abscess we discovered that seven patients were subsequently found to have a fistula.' We suspect that this was due to errors in the original diagnoses rather than to late complications of the abscess. This same study showed that 15 patients had a recurrent abscess within the succeeding two years and, more important, 78 ' of patients had no recurrence or complication. More recently we have described the details of the operative technique when reporting its efficacy in treating a consecutive series of 150 patients.2 We have also published the results of a randomised trial involving 219 patients with anorectal abscesses.3 This latter study showed that treatment by incision, curettage, and primary sutures was preferable to the conventional treatment as judged by the patient's comfort, healing time, time off work, and the incidence of recurrence. We continue to use it and recommend it for anorectal abscesses and for all other acute pyogenic abscesses. D H WILSON