Introduction: Prediction of outcome of based on personal experience is subjective. There is a need for a method of prediction to suit our current state of practice.
Objectives: To evaluate a modified APACHE II system in predicting mortality in acute variceal bleeding.
Patients and methods: Prospective study conducted from June 2005 through September 2006 in the Ibn Sina Hospital Bleeding Centre ICU. Clinical and laboratory data for 102 patients were allotted a modified APACHE II score, a child-Pugh class and fed to SPSS to calculate predicted mortality.
Results: The mean (±SD) age 49.2(± 16.1) years. Male were 79(77.5%). Patients with liver cirrhosis and periportal fibrosis were 75 (73.5%) and 27 (26.5%)) respectively. The mean predicted mortality was 22.8% while the actual mortality was 26.5% (27) patients. The mean modified APACHE II score among the deceased group was 19.04. Rate of
deaths among liver cirrhosis patients was 12 (44.4%) with mean predicted mortality of 27.3%. Deaths among periportal fibrosis occur at mean modified APACHE II score 17.7 and mean predicted mortality of 20%. Seventeen patients had
ICU stay L 4 days. Ten out of them died (58.8%).
Conclusion: Modified APACHE II score is effective in predicting outcome of patients with variceal bleeding. Score of L 15 points and long ICU stay are associated with high mortality.
 Keywords : liver cirrhosis, periportal fibrosis, portal hypertension, schistosomiasis udan Journal of Medical Sciences Vol. 2 (2) 2007: pp. 105-112


Multidistrict litigation (MDL) is exploding. MDL makes up a large and increasing portion of the federal civil docket. It has been used in recent years to manage and resolve some of our largest controversies: opioids, NFL concussions, Volkswagen "clean" diesel, and many more. And, given its growing importance, MDL has come to dominate the academic literature on complex litigation.

At its base, MDL is a tool to coordinate related cases across different courts in service of justice, efficiency, and fairness. These goals are not unique to the federal courts. State courts handle far more cases than federal courts, including the kinds of complex disputes that could benefit from coordination. Yet state MDL procedures are virtually absent from the scholarly literature.

This article offers a systematic study of state MDLs. Surveying the laws of every state, we find that about half the states have developed their own MDL-like procedural devices. What makes MDL consequential is that it allows some official or institution to consolidate cases and to assign them to a hand-picked judge. Therefore, we develop in this article the first taxonomy of state MDLs based on which officials or institutions are given this substantial power. Along the way, we explore the other ways that states have tailored their MDL rules. We also provide case studies of three state MDL systems and report previously unpublished data on how state MDLs work.

Building on these findings, this article offers an institutional analysis of state MDL. We find that state MDLs distribute important cases to courts and judges in ways that depart dramatically from the default rules of judicial administration. These choices have important consequences for litigant control, judicial power, and both inter- and intrastate relations, which can be amplified in states where judges are elected. In these ways, different types of state MDLs—sometimes unwittingly—may tilt the usual balance in favor plaintiffs or defendants, local actors or statewide ones, and voters or government officials.


Human leukemia cell lines were examined for the status of the retinoblastoma (RB) protein by immunoblotting analysis using antibodies raised against the TrpE-RB fusion protein. One of 16 cell lines examined, the T-cell acute lymphoblastic leukemia (ALL) line HSB-2, lacked the 110-Kd RB protein. Southern blot analysis of genomic DNA extracted from HSB-2 cells showed a large homozygous deletion of the RB gene, stretching from exon 18 beyond exon 27. Northern blot analysis showed multiple, abnormal RB transcripts in HSB-2. A truncated protein (72 Kd) was detected with 35S-methionine labeling but not with 32P-orthophosphate labeling of the HSB-2 cells. The genomic deletion of greater than 85 kb DNA at the RB locus (13q14) was not detectable in the karyotype of the HSB-2 cells. Among the 16 human leukemia cell lines examined for the status of the RB gene, only one, the HSB-2 line, showed an abnormal RB protein. Further study of primary leukemia and lymphoma samples appears to be warranted.


Conventional microsurgical reanastomosis was compared with laser microsurgical reanastomosis of the ligated uterine horn in the rabbit. Fourteen virgin female New Zealand white rabbits had both uterine horns ligated and divided at laparotomy. Four weeks later, seven rabbits had conventional microsurgical reanastomosis of the divided uterine horns after the ligated stumps were excised (group 1). The ligated uterine horns of the other seven animals were incised with a carbon dioxide laser with a power density of 637 to 796 W/cm2 followed by conventional microsurgical reanastomosis using polyglactin (Vicryl) 8-0 sutures (group 2). After six weeks, a laparotomy was performed to determine adhesion formation and uterine horn patency by chromopertubation. Adhesion formation was graded 0 (no adhesions) through 3 (extensive, dense adhesions) for each uterine horn. Only one uterine horn in the control group was not patent. Laser microsurgery produced significantly less adhesion (mean +/- SE, 0.79 +/- 0.24) than conventional microsurgery (2.29 +/- 0.13) (P less than .001). The findings indicate that laser microsurgical tubal reanastomosis produces significantly better results with less adhesion than the conventional microsurgical technique.


Apple stem grooving virus (ASGV) is a destructive viral pathogen of pome fruit trees that causes significant losses to fruit production worldwide. Obtaining ASGV-free propagation materials is essential to reduce economic losses, and accurate and sensitive detection methods to screen ASGV-free plantlets during in vitro propagation are urgently necessary. In this study, ASGV was sensitively and accurately quantified from in vitro propagated apple plantlets using a reverse transcription droplet digital polymerase chain reaction (RT-ddPCR) assay. The optimized RT-ddPCR assay was specific to other apple viruses, and was at least 10-times more sensitive than RT-real-time quantitative PCR assay. Furthermore, the optimized RT-ddPCR assay was validated for the detection and quantification of ASGV using micropropagated apple plantlet samples. This RT-ddPCR assay can be utilized for the accurate quantitative detection of ASGV infection in ASGV-free certification programs, and can thus contribute to the production of ASGV-free apple trees.


The paper is concerned with problems of expert evaluation of disability due to ENT diseases including temporary disability, differentiation of temporary and persistent disability, indications for expert examination. Recommendations for experts making the decisions on temporary ENT disability are given. Medical and social factors of ENT disability, especially occupational risks, are analysed.


The first psychotic episode is classically viewed as a critical period which management is important in determining the long-term outcome of the schizophrenia (SCZ). For this reason, the duration of untreated illness (DUI), defined as the interval between the onset of the psychiatric disorder and the administration of the first pharmacological treatment, is a clinical variable that has been increasingly investigated due to its potentially modifiable nature and its value as a predictor of outcome. DUI is poorly applicable and highly unreliable in psychosis. The present critical review examines the impact of DUI and its more operative definition of "duration of untreated psychosis" (DUP) in the course and outcome of SCZ, focusing on its epidemiologic, clinical, prognostic factors. Length of DUP has been identified as positively related to a worst treatment response, symptom control and overall functional outcome in SCZ. Negative symptoms appear to be prominently related to longer DUP. Neuroimaging correlates of DUP have not been clearly outlined: few of the studies considering first-episode patients and DUP showed structural abnormalities. A low proportion of significant associations were found mostly in cerebellum and occipital lobe of patients with longer DUP. Also, evidence of an inverse correlation between cognitive alterations and DUP is not conclusive. DUI and DUP are multidimensional constructs that imply both intrinsic, illness related (e.g. subtle symptoms at onset) and extrinsic factors (e.g. access to mental health services), so that from its study sprouted in the last decades First-Episode Units, aimed at providing secondary prevention in SCZ such as providing a timely diagnosis and treatment to patients experiencing their first psychotic episode. Early intervention seems to ensure a shortened DUP, especially for people presenting with brief limited intermittent psychotic symptoms, and, ultimately, ensure a more favorable prognosis for patients affected


Ciguatera fish poisoning (CFP), one of the most frequently occurring seafood poisonings due to marine finfish consumption, mainly affects the tropical and subtropical Indo-Pacific region and the Caribbean Sea. The principal class of toxins, ciguatoxins (CTXs) from the Pacific, includes more than 20 derivatives and are classified into two groups, CTX1B and CTX3C congeners, based on their skeletal structures. As part of risk management of CFP by the Japanese government, the import of certain species of fish into Japan is prohibited. Additionally, local governments recommend rejecting certain fish species caught in Japan. In this study, we used LC-MS/MS to analyze CTXs from 18 fish specimens belonging to 7 species that had been brought to a wholesale market but were disapproved for sale because of their potential danger of CFP. CTXs were detected in four specimens of Lutjanus bohar and one specimen of Variola louti. It was estimated that the two most poisonous specimens (no. 5: 0.348 μg/kg, no. 8: 0.362 μg/kg) had a toxicity of 0.05 MU/g. Consumption of 200 g of flesh from these fish could cause CFP. Thus, the guidance of the local government to disallow the sale of these fish species in the market contributed to the prevention of CFP.Only CTX1B congeners were detected in L. bohar (specimen no. 5), which had no record of the area where it captured from. It is presumed that the origin of specimen no. 5 was the same as that of the Okinawan L. bohar because the CTX compositions were similar. In two specimens (nos. 6 and 8) from Wakayama, both CTX1B and CTX3C congeners were detected. This is the first report to reveal the CTX profile in fish collected off the Honshu island in Japan.


The rapid rise in cloud computing has resulted in an alarming increase in data centers' carbon emissions, which now accounts for >3% of global greenhouse gas emissions, necessitating immediate steps to combat their mounting strain on the global climate. An important focus of this effort is to improve resource utilization in order to save electricity usage. Our proposed Full Scaling Automation (FSA) mechanism is an effective method of dynamically adapting resources to accommodate changing workloads in large-scale cloud computing clusters, enabling the clusters in data centers to maintain their desired CPU utilization target and thus improve energy efficiency. FSA harnesses the power of deep representation learning to accurately predict the future workload of each service and automatically stabilize the corresponding target CPU usage level, unlike the previous autoscaling methods, such as Autopilot or FIRM, that need to adjust computing resources with statistical models and expert knowledge. Our approach achieves significant performance improvement compared to the existing work in real-world datasets. We also deployed FSA on large-scale cloud computing clusters in industrial data centers, and according to the certification of the China Environmental United Certification Center (CEC), a reduction of 947 tons of carbon dioxide, equivalent to a saving of 1538,000 kWh of electricity, was achieved during the Double 11 shopping festival of 2022, marking a critical step for our company's strategic goal towards carbon neutrality by 2030.


In this paper, we study how to optimally manage the freshness of information updates sent from a source node to a destination via a channel. A proper metric for data freshness at the destination is the age-of-information, or simply age, which is defined as how old the freshest received update is, since the moment that this update was generated at the source node (e.g., a sensor). A reasonable update policy is the zero-wait policy, i.e., the source node submits a fresh update once the previous update is delivered, which achieves the maximum throughput and the minimum delay. Surprisingly, this zero-wait policy does not always minimize the age. This counter-intuitive phenomenon motivates us to study how to optimally control information updates to keep the data fresh and to understand when the zero-wait policy is optimal. We introduce a general age penalty function to characterize the level of dissatisfaction on data staleness and formulate the average age penalty minimization problem as a constrained semi-Markov decision problem with an uncountable state space. We develop efficient algorithms to find the optimal update policy among all causal policies and establish sufficient and necessary conditions for the optimality of the zero-wait policy. Our investigation shows that the zero-wait policy is far from the optimum if: 1) the age penalty function grows quickly with respect to the age; 2) the packet transmission times over the channel are positively correlated over time; or 3) the packet transmission times are highly random (e.g., following a heavy-tail distribution).


Abstract : This research investigated two aspects of the aft wing structure of a joined wing SensorCraft. First, the efficacy of a novel approach for incorporating wing twist for pitch control was analyzed. This design involved adding a spanwise sliding joint into the wing structure at the lower aft spar of the vehicle's aft wing. Second, the joint section where the forward and aft wings connect and form the outboard wing was redesigned and analyzed to improve the load transmission between the wing spars. Using MSC.NASTRAN, linear and non-linear static analyses were performed to examine the efficiency of the wing twist sliding joint and the forces required to achieve sufficient angular deflections for control. MSC.Patran was then used to perform post-processing of the raw data. Several variations of sliding joint location and composite ply angles were conducted. The sliding joint produced marked improvement in angular deflection over the baseline configuration. Surprisingly, however, ply angle did not have a large effect on the resulting deflections. Additional sliding joints incorporated into the wing structure produced no notable improvements in the obtained deflections either. Although the strain induced into the structure by the aft wing twist was on the order of the aerodynamic forces alone, the force required to twist the wing was significantly reduced by adding the slit in all cases. Flutter speed did not differ notably by the addition of the slit into the aft wing, yet some reduction in buckling strength was noted. The redesigned joint planform does appear to recover some of the buckling resistance lost due to the slit.


: If faced with the task of establishing an adult genitourinary outpatient clinic in an already existing ambulatory surgery setting, would you know where to begin? Careful, considered assessment is crucial to a successful outcome.


Although there are currently only a few undergraduate journals in economics, we expect their numbers to increase substantially in the future because of several developments: 1) research and writing activity is increasing in economics programs, 2) online publication is now more feasible and cost efficient than ever, and 3) students are increasingly aware of their on-line identity and desire to project a positive and professional image. Since increasing use of undergraduate journals might benefit a number of students, including potential article authors, article reviewers, and editors, there is a need to begin to assess the educational benefits of participation in journals. This paper reports results from a survey of reviewers who had reviewed articles for two undergraduate journals, The Park Place Economist and The Undergraduate Economic Review. The reviewers generally agreed that they received a range of benefits from the review process and nearly all agreed that reviewing had been a valuable use of their time. Several of the suggested benefits were positively correlated with measures of participation intensity. Nearly half the respondents thought the benefits would have been greater with more, not fewer, articles to review.


Background: A large number of nondigitized electrocardiograph (ECG) strips are routinely collected in larger cohort studies such as the ADDITION study (Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care). These ECG strips are routinely read manually but may contain overlooked information revealing cardiac autonomic dysfunction. The aim of this study was to investigate whether clinical information may be lost using manual R wave to R wave (RR) interval measurements in the calculation of heart rate variability (HRV) in patients with type 2 diabetes mellitus (T2DM). Method: From the Danish part of the ADDITION study, we randomly selected 120 T2DM patients at baseline of the ADDITION study. Analysis of the ECG strips was performed using two different methods: (1) by experienced technicians using rulers and (2) by experienced technicians using a high-resolution computer-assisted method. Calculation of heart rate and time domain HRV [standard deviation of normal-to-normal RR intervals (SDNN) and root mean square of successive differences (RMSSD)] were performed with the same software. Results: When comparing results from the two methods, the following values of Pearson's r are obtained: 0.98 for heart rate, 0.76 for SDNN, and 0.68 for RMSSD. These results indicate that heart rate and HRV measurements by the computer-assisted and manually based methods correlate. However, Bland-Altman plots and Pitman's test of difference in variance revealed poor agreements (p < .01) for both HRV measurements (SDNN and RMSSD); only heart rate showed substantiated agreement (p = .54) between the two methods. Low HRV was statistically significantly associated to high heart rate, systolic blood pressure, and diastolic blood pressure in these screen-detected T2DM patients. Conclusions: Paper ECG strips may contain overlooked clinical information on the status of autonomic function in patients with T2DM. In our study, manual measurements of RR intervals were inferior to the computer-assisted method. Based on this study, we recommend cautiousness in the clinical use and interpretation of HRV based on manual or low resolution measurements of RR intervals from ECG strips. High resolution measurements of RR intervals reveal significant associations between low HRV and high heart rate, systolic blood pressure, and diastolic blood pressure among patients with screen-detected T2DM. It is feasible to use a computer-assisted method to determine RR intervals in patients with T2DM.


The hydrological studies of the Greenland technical Organization in Greenland are being followed up at Copenhagen by hydrological data work as well as hydrological model-simulation. The hydrological regions vary greatly in Greenland, depending on whether the drainage basin is influenced by ablation runoff. To describe a runoff time series from these areas, a hydrological model calibration is made, followed by a simulation. In drainage basins influenced by rain and snow only, a slightly modified version of the precipitation runoff model (NAM) is applied. The parameter transfer for the determination of model input is found by intensive data analysis work here between Nuuk and Kangerluarsunnguup Tasersua (KANG) for temperature and precipitation along with detailed investigations in the basin. This is to ensure that a too short calibration period in connection with the adaption of a hydrological model to the basin data is balanced in the manner that these adapt the hydrological model, and not vice versa. In drainage basins also influenced by ablation runoff it is not possible to use a traditional precipitation runoff model but a hydrological ablation model has been developed in cooperation with The Geological Survey of Greenland. The hydrological ablation model describes the transfer of the temperature after heating and cooling factors as well as snow mobility on the ice, melting density criteria, refreezing etc. The model has been applied to the hydrological basin of Paakitsup Akuliarusersua (PAKI) at Ilulissat where 90% of the drainage basin is covered by the Ice cap. Data evaluation work prior to hydrological model calibration thus allows for a higher degree of simulation rel~ability.


Melanoma, the most threatening form of skin cancer, has a very poor prognosis and is characterized by its very invasive and chemoresistant properties. Despite the recent promising news from the field of immunotherapy, there is an urgent need for new therapeutic approaches that are free of resistance mechanisms and side effects. Anti-neoplasic properties have been highlighted for different disintegrins from snake venom including Lebein; however, the exact effect of Lebein on melanoma has not yet been defined. In this study, we showed that Lebein blocks melanoma cell proliferation and induces a more differentiated phenotype with inhibition of extracellular signal-regulated kinase (ERK) phosphorylation and microphthalmia-associated transcription factor (MITF) overexpression. Melanoma cells became detached but were less invasive with upregulation of E-cadherin after Lebein exposure. Lebein induced a caspase-independent apoptotic program with apoptosis inducing factor (AIF), BCL-2-associated X protein (BAX) and Bim overexpression together with downregulation of B-cell lymphoma-2 (BCL-2). It generated a distinct response in reactive oxygen species (ROS) generation and p53 levels depending on the p53 cell line status (wild type or mutant). Therefore, we propose Lebein as a new candidate for development of potential therapies for melanoma.


The design and prototypal realization of a visual tracking system is presented. The approach to target identification is nonconventional, in that it relies on an architecture composed of multiple standard neural networks (multilayer perceptrons) and exploits the information contained in simple features extracted from images, performing a small number of operations. Therefore, the tracking functions are learned by examples, rather than implemented directly. The system demonstrates that a quite complex task such as visual target tracking can be easily obtained by a suitable neural architecture. The fast tracking algorithm and the parallel structure allow a true real-time operation. The system exploits a two-level neural-network hierarchy with a number of parallel networks and an "arbiter". The training set consists of various geometrical shapes, preprocessed to yield the data vectors. The experimental hardware implementation is based on multiple processing units, implementing the neural architecture, and serves as a prototype for the analysis of the system in practice. A small-sized realization can also be obtained.


The field experiences of gas foil bearings (GFBs) from the 1960s prove that GFBs offer several advantages over traditional oil bearings and rolling element bearings. They have the potential to be applied in a wide spectrum of turbomachinery. Bump-type foil bearings, which are considered as the best structure for GFBs, can be simply described as a hydrodynamic bearing utilizing the ambient air as the lubricant and a smooth shell supported by a corrugated bump foil as the bearing surface. However, the performance predictions of bump-type foil bearings are difficult due to mechanical complexity of the support elastic structure, especially for the effects of four factors, elasticity of bump foil, interaction forces between bumps, friction forces at contact surfaces, and local deflection of top foil. In this investigation, an analytical model of bump-type foil bearings considering the effects of all above factors is presented. In this model, each bump of the bump strip is simplified to two rigid links and a horizontally spaced spring, whose stiffness is determined from Castigliano' theorem. Then, interaction forces and friction forces can be coupled with the bump flexibility though the horizontal elementary spring. The local deflection of top foil is described using a Finite Element model and added to the film thickness for the pressure prediction with the Reynolds' equation. The bump deflections of a strip with ten bumps under different load distributions are calculated with the presented model and the predictions show consistency with published results. Moreover, the predicted bearing load and film thickness of a full bump-type foil bearing using this model are very close to the experimental data. Also, radial clearance and friction force variations in the foil bearing are noted to change the stiffness of bump significantly. And the predictions from the calculation with a proper selection of radial clearance and friction coefficients show extremely good agreement with the experimental data. The assumption of minimum reachable film thickness is based on experimental data to determine the load capacity of bearing. The results demonstrate that the radial clearance of foil bearing has an optimum value for the maximum load capacity.Copyright © 2009 by ASME


International news, and the technological infrastructures required to collect, distribute, and publish it, have long been battlegrounds of imperial ambition and anticolonial contestation. In the early 1960s, press professionals, engineers, and telecom officials from the global South elaborated a wide-ranging structural critique of the status quo, arguing that developing mass media required decolonizing international networks and global governance practices that perpetuated media inequality. But over the course of the decade, UNESCO began to invite research and expertise from American social scientists and engineers, who came to define UNESCO's approach to satellite-based media development. By redefining the scope of media development to an instrumentalist vision of Westernization, such research eclipsed a broad, structural vision of reform, casting southern experts' more radical designs into shadow. By recovering this history, the article tells a new story of the ideologies and governance practices that helped sustain global news inequality in the satellite age.


With the rapid increase of mobile phone, people's requirements of entertainment have become higher and higher, the demand for the game is the most prominent. Game development based on Symbian platform has higher efficient implementation and powerful function. There is the problem of screen flickering for most games written by beginners. By introducing the problems that encountered in the development of Sudoku game, showing new methods that how to use double buffering and direct screen access technology to solve the problem of screen flashes that exist in the game interface, as a result the fluency of the game's interface has been greatly improved.


Beams are very common types of structural components and it can be classified according to their geometric configuration as uniform or taper and slender or thick. If practically analyzed, the non-uniform beams provide a better distribution of mass and strength than uniform beams and can meet special functional requirements in architecture, aeronautics, robotics, and other innovative engineering applications. Design of such structures is important to resist dynamic forces, such as wind and earthquakes. It requires the basic knowledge of natural frequencies and mode shapes of those structures. In this project work, the equation of motion of a double tapered cantilever Euler beam is derived to find out the natural frequencies of the structure. Finite element formulation has been done by using Weighted residual and Galerkin"s method. Natural frequencies and mode shapes are obtained for different taper ratios. The effect of taper ratio on natural frequencies and mode shapes are evaluated and compared.


ABSTRACTMass concentrations of PM2.5 and PM10 from the six urban/rural sampling sites of Xi'an were obtained during two weeks of every month corresponding to January, April, July and October during 2010, together with the six meteorological parameters and the data of two precursors. The result showed that the average annual mass concentrations of PM2.5 and PM10 were 140.9 ± 108.9 µg m–3 and 257.8 ± 194.7 µg m–3, respectively. Basin terrain constrains the diffusion of PM2.5 and PM10 concentration spatially. High concentrations in wintertime and low concentrations in summertime are due to seasonal variations of meteorological parameters and cyclic changes of precursors (SO2 and NO2). Stepwise Multiple Linear Regression (MLR) analysis indicates that relative humidity is the main factor influencing on meteorological parameter. Entry MLR analysis suggests that SO2 from local coal-burning power plants is still the primary pollutant. Trajectory cluster results of PM2.5 at BRR indicate that the entrained urban pollutants carried by the westerly or winter monsoon forms the dominant regional pollution sources in winter and spring. Ultraviolet (UV) aerosol index verified the source and pathway of dust storm in spring.


The main purpose of this study is to examine the effects of social media addiction on the reading culture of Nigerian students in higher institutions of learning. An online survey was sent to 1500 students of higher institutions in Nigeria during the Lockdown necessitated by the outbreak of the dreaded Corona Virus (COVID-19) Pandemic. A total of 1300 questionnaires were completed and returned. This implies an 86.7% return rate. Data were analyzed using graphical charts. The findings of the study showed that social media mostly used by the student include Facebook, followed by WhatsApp, YouTube, Pinterest, Twitter, Instagram, WordPress, Snapchat, Reddit, respectively; while 75.3% of the students use the social media daily, 92.3% of them access the social media via their mobile phones. The study also found 97% using social media for the purpose of chatting with friends and family. While 79% of the students indicate they read mainly to pass exams, only 43% read books daily. 67.3% indicated that they rarely visit the library. A massive 84.4% strongly agreed that social media has a negative effect on reading habits. The researchers, therefore, concluded that as the world's economy is becoming more knowledge-based, the future of the country is unpredictable except something drastic is done to tackle the decline headlong. It was therefore recommended that lecturers should use social media to teach, give assignments to students, and create reading groups. Libraries should make their services and resources accessible to students through their mobile devices. Seminars to motivate students to read and research should be organized. Parents should monitor their children reading at home and take their children out to libraries instead of shopping malls or cinemas.


Introduction Novel anti-cancer drugs such as targeted cancer therapies and immune check-point inhibitors (ICIs) have adverse events, especially concerning the skin. The aim of this study is to report an overview of the commonly consulted dermatological side effects of ICIs and targeted cancer therapies in clinical practice, along with their management. Methods In this single-center study, we evaluated consecutive oncological patients who were referred from the oncology outpatient clinic to the dermatology outpatient clinic due to skin side effects of ICIs and targeted therapies. All patients were examined and treated at the same day of referral by experienced dermatologists. Patient characteristics, clinical findings, diagnostic workups and treatments were retrieved from outpatient records. Results Sixty three patients were enrolled. Most common diagnoses were lung carcinoma, melanoma and colon carcinoma. Fifty patients (79%) were using targeted therapies while 13 (21%) were using ICIs. Xerosis was the most common side effect (44%), followed by acneiform rash, paronychia, eczema and pruritus. Majority of the side effects were grade 2 and 3. Psoriasis was a common side effect of ICIs. One patient had a newly developed dysplastic nevus on vemurafenib treatment. Oncological treatment was not withheld in any of the patients. Conclusions This study revealed the most commonly consulted skin side effects of novel anti-cancer drugs and their management in daily practice. We underlie the importance of collaborative work of oncology and dermatology professionals as early management of cutaneous side effects of targeted therapies and ICIs improves patient outcomes.


PCBN-inserts have a high potential in the cutting of hardened steel, cast iron and super alloys due to their high hardness and heat resistance. Nevertheless they have a high purchase price, which lowers the economic benefits for the end user compared to other cutting materials. This is caused by the high production costs of the inserts. The grinding of PCBN-inserts causes a major proportion of these costs as a result of the high grinding wheel wear. The primary wear mechanism is grain breakout followed by clogging of the grinding layer. This study shows that the efficiency of the grinding process can be increased significantly by applying low cutting speeds and high feed rates. In this case, splintering of the grinding grain is the main wear mechanism.


The use of system dynamics as a methodology for modeling and testing dynamic behavioural hypotheses in organizational behavioural studies is presented. The system dynamics equivalent of March and Simons' (1958) motivation model is constructed to study its behavioural consequences; it provides an analysis of both the steady-state behaviour and the transient behaviour of the March-Simon motivation model. The methodology yields the dynamic consequences of hypotheses concerning relationships among the variables in the model. Furthermore, it does not necessarily require extensive empirical data for model construction. Rather, it may pinpoint the critical nature of certain variables prior to conducting the actual research. The dynamic behaviour obtained from this approach is identical to the analytical solution of the system of differential equations given in March and Simon's mathematical model. Three distinctive patterns of system behaviour emerge from the numerous experiments conducted with the model. Experimental results leading to these patterns and additional results concerning the time reach equilibrium and levels for the satisfaction variable are discussed.


Copyright: 2014. Virtus Interpress. Due to copyright restrictions, only the abstract is available. For access to the full text item, please consult the publisher's website. The definitive version of the work is published in Journal of Governance and Regulation, Vol. 4, Issue 3 Part 1


In this work, we study the interface traps (ITs) induced electrical characteristic and static noise margin (SNM) fluctuations in 16-nm-gate high-к/metal gate complementary metal-oxide-semiconductor devices and static random asccess memory circuit. Totally random generated device samples with 2D ITs at silicon/HfO2 interface are simulated using an experimentally validated 3D device simulation. Random number and position of ITs and trap's density on fluctuations of threshold voltage, on/off-state current and gate capacitance are explored and compared among process variation effect (PVE), random dopant fluctuation (RDF) and work function fluctuation (WKF). Notably, the position of ITs induces rather different fluctuation in spite of the same number of ITs.


Like direct-to-consumer advertising of prescription drugs undertaken by pharmaceutical companies, client-seeking advertising sponsored by lawyers that highlights the dangers of such products may pose health risks to patients. Unlike the drug industry, whose advertising the federal government subjects to various restrictions, personal injury attorneys face essentially no oversight regarding campaigns that target therapeutic products. Lawyers enjoy no greater rights, however, when engaging in such commercial speech, so the U.S. Constitution would not stand in the way of crafting a sensible response. Nonetheless, because state bar authorities do not seem up to the task of doing so, and tort claims for either negligent misrepresentation or product disparagement would encounter serious obstacles as well, this paper recommends that the federal agency with the greatest stake in the matter — notwithstanding its conceded lack of regulatory jurisdiction over these speakers — take the lead in trying to define what types of attorney drug advertising cross the line. Only then might state officials and courts get the message that some client-seeking advertisements might well mislead patients in ways that threaten their health.


Abstract Weed interference with crop growth is often attributed to water, nutrient, or light competition; however, specific physiological responses to these stresses are not well described. This study's objective was to compare growth, yield, and gene expression responses of corn to nitrogen (N), low light (40% shade), and weed stresses. Corn vegetative parameters from V2 to V12 stages, yield parameters, and gene expression using transcriptome (2008) and quantitative polymerase chain reaction (qPCR) (2008/09) analyses at V8 were compared among the stresses and with nonstressed corn. N stress did not affect vegetative parameters, although grain yield was reduced by 40% compared with nonstressed plants. Shade, present until V2, reduced biomass and leaf area > 50% at V2, and recovering plants remained smaller than nonstressed plants at V12. However, grain yields of shade-stressed and nonstressed plants were similar, unless shade remained until V8. Weed stress reduced corn growth and yield in 2008 when weeds remained until V6. In 2009, weed stress until V2 reduced corn vegetative growth, but yield reductions occurred only if weed stress remained until V6 or later. Principle component analysis of differentially expressed genes indicated that shade and weed stress had more similar gene expression patterns to each other than they did to nonstressed or N-stressed tissues. However, corn grown in N-stressed conditions shared 252 differentially expressed genes with weed-stressed plants. Ontologies associated with light/photosynthesis, energy conversion, and signaling were down-regulated in response to all three stresses. Shade and weed stress clustered most tightly together, based on gene expression, but shared only three ontologies, O-METHYLTRANSFERASE activity (lignification processes), POLY(U)-BINDING activity (posttranscriptional gene regulation), and stomatal movement. Based on morphologic and genomic observations, weed stress to corn was not explained by individual effects of N or light stress. Therefore, we hypothesize that these stresses share limited signaling mechanisms. Nomenclature: Corn, Zea mays L.


The study aimed to evaluate the ability of NBC45, NBC46 and NB40 Microscan (MS) panels, updated to 2010 EUCAST breakpoints, to identify at species level and to correctly define the susceptibility to s-lactams of 61 s-lactamases (BLs) producing Gram-negative isolates. A collection of 73 fully identified strains was analyzed: 21 Klebsiella spp., 17 E. coli, 15 P. mirabilis, 9 A. baumannii (Ab), 7 P. aeruginosa and 4 Enterobacter spp.. 61/73 were BLs and/or carbapenemases producers: 15 were CTX-M-1/-2/-14/-15 positive, and among them two were also VIM-1 positive. Four were TEM-52/-92, 3 PER-1, 2 SHV-12/-18 and 6 CMY-16 producers, while 11 were KPC-2/-3, 9 OXA-51/-58/-23, 8 VIM-1 and 2 IMP-13 positive. One K. oxytoca K-1 iper-producer, 11 non-BL producers/ATCC control strains and a OprD2 porin lacking P. aeruginosa were also included. All isolates were identified by Api-20E and VITEK-2 System and antibiotic susceptibilities were obtained by broth microdilution method. Resistance genes were identified by PCR and sequencing. All 73 isolates were correctly identified and a complete agreement for susceptibility patterns was observed for both ATCC control strains and non-BL clinical isolates. MS failed to detect a BL/Extended-Spectrum-s-Lactamase (ESâL) production in 5/61 cases: any ESsL alert was detected using NBC46 panel for 3/15 CTX-M positive strains and 2 VIM-1/CTX-M-15 producing K. pneumoniae isolates. Intermediate resistance to cefoxitin (MIC 16 mg/L), susceptibility to cefepime (MIC 8 mg/L for ertapenem (ETP), according to previously results. All VIM-1 producers resulted intermediate/resistant to imipenem (IP) and meropenem (MP); decreased MIC values were observed in 2/8 cases. Carbapenem MICs >8 mg/L were detected for IP-13 P. aeruginosa producers; 6/9 OXA carbapenemases- producing Ab showed IP MIC >8 mg/L and 3/6 MP MIC >8 mg/L. 3/9 Ab OXA-58/-51 producers, tested using NB40 panel, were intermediate or resistant to doripenem and meropenem. Regarding the detection of BLs overall agreement between MS and reference methods was 91.9%. Carbapenems MIC values resulted a fold lower than previously determined. Nevertheless using 2010 EUCAST breakpoints for ETP, MP and IP was possible to detect all carbapenemases- producers. MS System represents a useful tool to perform identification of BL- producing Gram negative bacteria.


DNA cloning and mutagenesis are widespread tools in biology. Understanding the structural/functional relationship of the proteins is of great interest, with the aim to clarify the relationships often the researchers used the mutagenic approach. In the last 20 years, several mutagenesis systems have been developed, analyzing them it's possible to observe the "evolution" of mutagenesis. Here, a short description and differences among three methods widely used of mutagenesis are shown.


ABSTRACT Biological Activity of Enzymatically Synthesized Polyphenol Glycoside on Microbial Growth. We have studied an indigenous bacterial strain produced a glycosyl transfer enzyme (CGTase) yielding polyphenol glycosides from a substrate of starch and polyphenol-aglycone. We observed that the CGTase derived from culture filtrate of some microbial strains (Candida rugosa, Bacillus megaterium, B. coagulans and B. polymixa) could synthesize transfer products in the presence of appropriate polyphenol-aglycones as their acceptors. An inhibitory effects of enzymatically synthesized polyphenol glycosides against bacterial growth was furthermore examined. It was found that polyphenol-glycoside, as one of the transfer products, exhibited high antibacterial activity on the growth of Bacillus subtilis and Escherichia coli, no effect when on Bacillus cereus. Key words : Cyclodextrin glucano transferase (CGTase), enzymatic transglycosylation, polyphenol glycoside, antibacterial activity.


The Active Hypermedia Delivery System (AHYDS) within the NACSIS R&D department is an experimental advanced application developed for delivering hypermedia documents over distributed and and heterogeneous systems. The AHYDS is an example of intelligent distributed media information management and multimedia delivery. The evolution of both the technology and the complexity of applications suggests how information systems should be improved and how operating services and multi-agent technology should be integrated inside information engines. We address the concept of the Active Hypermedia Delivery System integrating operating system services (load balancing, fault tolerance), multi-agent support, and database services in order to provide high performance support in distributed and heterogeneous hypermedia management. The user interface framework of AHYDS supports different kinds of data models, content based searching and automatic navigation of hypermedia links for distributed access.


Background Dietary supplements (DSs) may be useful for managing shift work disorder. But the efficiency of outcomes in clinical trials using simulated shift work populations as subjects is controversial. This review explores the potential role of DSs for improving sleep quality, daily functioning, and mood among shift workers in the real world. Methods A related literature search was conducted in PubMed, Web of Science, Embase, and Cochrane Library databases from their inception to July 2021. Information was collected on "shift work," "irregular working hours," "night shift," "dietary supplements," and "nutraceutical research data." Sleep quality-related scales were the primary outcome measures. The meta-analysis was conducted using RevMan 5.4 (Cochrane Collaboration, London, England) and Stata 15.0 (StataCorp, LLC, College Station, TX, USA). Heterogeneity was examined by using I2 statistics, and publication bias was assessed via Egger's regression test. Results Twelve studies, which involved 917 participants, met the inclusion criteria. The DS groups had significant improvement in sleep quality scores (8 randomized controlled trials [RCTs]: p = 0.04; standard mean difference (SMD), −0.45 [−0.88 to −0.03]) and daytime function (7 RCTs: p = 0.02; SMD, −0.50 [−0.92 to −0.08]). The DS groups did not have a significant improvement in psychomotor vigilance (4 RCTs: p = 0.25; SMD, 0.52 [−0.36 to 1.41]), depression (5 RCTs: p = 0.14; SMD, −0.19 [−0.45 to 0.06]), or anxiety (4 RCTs: p = 0.27; SMD, −0.23 [−0.65 to 0.18]). All RCTs suggested a positive safety profile for DSs. Conclusions The findings of this meta-analysis indicated DSs may be beneficial for improving sleep quality and daytime function in shift workers. Although there is a wide range of DSs, the small amount of literature included for each type does not allow for subgroup analysis to be used to eliminate high heterogeneity. We have not yet included literatures on other languages either. Given these limitations of the study, there is still a need for more well-designed randomized controlled trials so that our review can be updated in the future to make the results more conclusive. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=273558, PROSPERO: CRD42021273558.


Multilevel cell (MLC) states with lower threshold voltage endure less cell damage, lower retention error, and less current consumption. Based on these characteristics, it is opportunistic to strengthen MLC flash by introducing bit-flipping that reshapes state proportions on MLC pages. In this paper, we present a holistic study of bit-flipping schemes upon MLC flash in theory and practice. Specifically, we systematically investigate effective bit-flipping schemes and propose four new schemes on manipulating MLC states. We further design a generic implementation framework, named MLC bit-flipping framework, to implement bit-flipping schemes within solid state drives controllers, nicely integrating with existing system-level optimizations to further improve overall performance. The experimental results demonstrate that our proposed bit-flipping schemes standalone can reduce up to 28% cell damages and 53% retention errors. Our circuit-level simulation manifests that the bit-flipping latency on a page is less than 4  $\mu \text{s}$  when using 8K logic gates.


IN DISCUSSING ARAGORN, Verlyn Flieger notes that: The concept of the king as healer derives from the early Celtic principle of sacral kingship, whereby the health and fertility of the land are dependent on the coming of the rightful king. Where there is no king, or where the king is infirm, the land also will be barren. (50) The fact that Aragorn is a healer, both of his people and of the land, is an important motif of The Lord of the Rings [LotR] and emerges gradually as the narrative progresses. Aragorn tends Frodo after the attack at Weathertop (LotR I:12 192-94), Sam and Frodo after their escape from the mines of Moria (II:6 326-27), Faramir, Eowyn, Merry and others injured in combat, after the battle of the Pelennor Fields (V:8 844-53), and Frodo and Sam after the fall of Sauron (VI:4 931). Similarly, his ascension marks the end of the lands' despoiling, his resolve that Minas Ithil be "utterly destroyed" in order for the cleansing process to begin (VI:5 948), and the imposition of order on his realm (VI:7 971), all symbolized by the blossoming of the White Tree in the Court of the Fountain (VI:5 951). The notion of healing here is broad, and reflects Strathern and Stewart's definition of healing (as opposed to curing), namely that which refers to "the whole person or the whole body seen as an integrated system with both physical and spiritual components" (7). Historically the principle of 'sacral kingship' went beyond the literal and metaphorical healing of lands and people, linking back to ancient fertility rites. The wholeness and health of the realm and its citizens actually required more than just the presence of the 'rightful' king, it required sacrifice from him. This paper will explore the nature of the sacrifice that Aragorn makes, as heir and king, in order to heal the lands of Middle-earth and its people, and how this sacrifice helps him assert his legitimacy as the rightful (or sacral) king. One of Aragorn's most powerful sacrificial acts is not included in the narrative, but is outlined in the Appendices of The Return of the King. It is in the manner and timing of his death. In his definitive work The Golden Bough (first published in 1922), Frazer explores the nature of this type of kingly sacrifice at length. Historically, a broad range of cultures considered it to be extremely dangerous to allow a king to die of disease or old age. Simply put: "if the course of nature is dependent on the man-god's life, what catastrophes may not be expected from the gradual enfeeblement of his powers and their final extinction in death?" (350) It was vital, then, that the king's soul not be weakened by disease; or lost--snatched by sorcerers or demons, or by refusing to return to a dying body. Killing the king ensured that his soul could be caught and transferred to a "suitable successor," before his "natural force was abated," ensuring "the world should not fall into decay with the decay of the man-god" (Frazer 350). In this context, the inter-relationship between the ruler and the continuing fruitfulness of the earth goes beyond the metaphorical; the sacrifice of the ruler or (later) surrogate, was in fact, literal. Mircea Eliade notes that: A regeneration sacrifice is a ritual "repetition" of the Creation. The myth of creation includes the ritual (that is, violent) death of a primeval giant, from whose body the worlds were made, and plants grew. [...] The object in sacrificing a human victim for the regeneration of the force expressed in the harvest is to repeat the act of creation that first made grain to live. (346) Thus the king's death might be self-inflicted, accepted without resistance, or imposed. Frazer outlines an example of a self-inflicted death, the practice of replacing the king in the Indian province of Quilacare, every twelve years: the king has a wooden scaffolding made, spread over with silken hangings: and on that day he goes to bathe at a tank with great ceremonies and sound of music, after that he comes to the idol and prays to it, and mounts on to the scaffolding, and there before all the people he takes some very sharp knives, and begins to cut off his nose, and then his ears, and his lips, and all his members, and as much flesh off himself as he can; and he throws it away very hurriedly until so much of his blood is spilled that he begins to faint, and then he cuts his throat himself. …


Police surveillance has become a problem of governance, not a problem of procedure. The introduction and use of sophisticated surveillance technologies, once reserved for elite central governments, in local policing has raised questions about the sufficiency of existing approaches. Judicial oversight—applying standard Fourth Amendment inquiries—falls short, limited to the facts of and parties to the case, rather than systems of surveillance, and with judges often unaware of or unable to access key technical details of the case. Other alternatives, including legislative guidelines for police technology and local police rulemaking, are lacking in other ways. This Article argues that the proper response to use of sophisticated investigative technologies by local police is local administrative governance by city councils or local administrative agencies. Having an external administrative body make rules about police technology brings with it an ability to consider expanded concerns about technology, timeliness, and an ability to regulate interactions with private actors. There are reasons to be worried about this proposal, too. But, drawing on the nascent literature about local administrative governance, this proposal is most likely to be responsive, accountable, and effective in the local context. In addition to offering a set of legal arguments, this paper contains two novel descriptive contributions. First, where other papers have focused on the legal risks of certain technologies, this paper compiles a comprehensive look at a range of police technologies and systematically analyzes the risks they pose both legally and at the local level. Second, this paper offers the first comprehensive assessment of the current efforts that localities have made towards implementing this kind of local administrative governance for police technology.


Science librarians, as well as other librarians, have seen ample new technologies come and go over the years. Librarians experiment and try to find ways to employ the new tools in our libraries. A driving force in our decision making about what tools to use should always be our patrons and whether the tools can help us do a better job of delivering services. This paper discusses what technologies have proven to be successful, as well as other thoughts to bear in mind as librarians evaluate Web 2.0 tools for science libraries. [ABSTRACT FROM AUTHOR]


To investigate the comorbidity of premenstrual syndrome (PMS) and menstrual migraine, the Menstrual Distress Questionnaire (MDQ) was prospectively administered for two consecutive menstrual cycles to 22 patients with menstrual migraine, 12 cases with migraine without aura and 15 patients with PMS. MDQ scores varied throughout the menstrual cycle in each patient group, the wider changes being shown by patients with PMS. Fourteen menstrual migraine patients and 4 migraine without aura patients achieved diagnostic criteria for PMS over two menstrual cycles. In these patients MDQ scores did not differ from PMS sufferers at any stage of the menstrual cycle. The premenstrual increase of each cluster of PMS symptoms was identical in menstrual migraine and PMS subjects with the exception of negative affect. We suggest that PMS symptoms should be taken into account in the IHS diagnostic criteria for menstrual migraine.


The effect of magnesium addition into a commercial silicon and its leaching refining behavior is studied for producing solar grade silicon feedstock. Two different levels of Mg is added into a commercial silicon and the leaching of the produced alloys by 10% HCl solution at 60 ℃ for different durations is performed. It is shown that the microstructure of the alloy and in particular the distribution of eutectic phases is dependent on the amount of the added Mg. Moreover, the metallic impurities in silicon such as Fe, Al, Ca and Ti are mainly forming silicide particles with different compositions. These silicides are physically more detached from the primary silicon grains and their removal through chemical and physical separation in leaching is better for higher Mg additions. It is observed that the leaching is more effective for the purification of smaller silicon particles produced from each Mg-doped silicon alloy. It is shown that acid leaching by the applied method is effective to reach more than 70% of phosphorous removal. It is also shown that the purity of silicon is dependent on the total Mg removal and effectiveness of leaching on removing the Mg 2 Si phase.


The purpose of this study was to examine the effect of exercise on the rate of protein degradation in rat skeletal muscle. The rates of total and myofibrillar protein degradation were determined by the measurement of the rates of release of tyrosine and 3-methylhistidine, respectively, from the perfused single rat leg. This method measures the rate of protein degradation in the entire lower leg and does not suffer from the limitations inherent in methods that rely on urinary excretion. The rate of total protein degradation was increased by exercise and involved increased flux through the lysosomal pathway, while the breakdown of myofibrillar protein was unchanged. The changes in the rates of protein degradation during the recovery period were greatly influenced by energy intake. Again the rate of myofibrillar protein degradation was unchanged or slightly increased during the recovery period, after either level or downgrade running. Exercise did prevent the increase in the rate of total protein degradation caused by food restriction, which may have important implications in weight reduction diets.


In order to determine the effectiveness of intravesical therapy for superficial bladder cancer, the author critically reviews current data and the methodology upon which such data are based. Included is a discussion of prophylactic versus therapeutic intravesical therapy, the design of clinical trials for intravesical therapy and endpoints of response, biostatistical considerations, a review of randomized clinical trials, and selection of patients for intravesical therapy.


This paper aims to explore the relationship between digital communication and the development of teenagers' identity, focusing on the contribution that philosophy may make to this issue. Digital technologies and the Net have transformed the relational categories of both 'time' and 'space'; therefore, communication has changed beyond our awareness of the devices used to communicate. In particular, young people (i.e. digital natives) find it difficult not to rely on social networks or digital devices (whose two key features are speed and fragmentation) to share information or send messages, thus interacting without ever meeting each other. This framework has contaminated also the learning environment. There is an open debate between those who foster the use of technology because they think it improves students' creativity and students' involvement, and those who warn about the danger of using exclusively technological devices and methods, which could prevent the critical thinking needed to approach the real world holistically. Philosophical thinking can help carry out an anthropological review of these issues; in fact, philosophy 'reads' the reality by reconnecting it with its founding principles. Therefore, it is possible to define how communication and relationships should be in order to stand out as genuine and human. In particular, it is essential to focus on identity, which is the core of adolescence, and investigate the needs concerning identity and relational structure of human beings. It follows that philosophical experience in learning is a chance to change our perception of properties and values which may be considered outdated. However, it is even more important to gain wisdom and knowledge worthy of our historical period and of human needs.


The aim of our article is to inquire into the interconnectedness of local social context, mobility processes and social transformations. We argue that migratory patterns of the local Roma population in ethnically mixed communities are shaped by the degree and modes of maintenance of social distance between the Roma and local majority. While social distance can shape the ways migrant networks develop, it also influences the way remittances are invested at home. The analysis focuses on the comparison of two rural communities from Transylvania where we carried out community studies and a household survey which also included attitude questions related to ethnic groups. Our study revealed that the most visible aspect of the local separation is the housing segregation. While this is present in both cases, in one of the villages Roma use their upward mobility to challenge social segregation and to reduce physical distance (i.e. moving inside the village). Here in spite of physical closeness social distance between the majority and Roma remains high. In the other locality the importance of social ties increase during migration and social distance is reduced, while the ethnic groups maintain their relative residential separation.


The different level of interest in deploying the new Internet address space across network operators has kept IPv6 tardy in its deployment. However, since the last block of IPv4 addresses has been assigned, Internet communities took the concern of the address space scarcity seriously and started to move forward actively. After the successful IPv6 test on 8 June, 2011 (World IPv6 Day [1]), network operators and service/content providers were brought together for preparing the next step of the IPv6 global deployment (World IPv6 Launch on 6 June, 2012 [2]). The main purpose of the event was to permanently enable their IPv6 connectivity. In this paper, based on the Internet traffic collected from a large European Internet Exchange Point (IXP), we present the status of IPv6 traffic mainly focusing on the periods of the two global IPv6 events. Our results show that IPv6 traffic is responsible for a small fraction such as 0.5 % of the total traffic in the peak period. Nevertheless, we are positively impressed by the facts that the increase of IPv6 traffic/prefixes shows a steep increase and that the application mix of IPv6 traffic starts to imitate the one of IPv4-dominated Internet.


The sequencing of the whole genome of multiple species provides us with the instruction book of how to build an organism and make it work, plus a detailed history of how diversity was generated during evolution. Unfortunately, we still understand only a small fraction, which is locating where genes are and deciphering the proteins they code for. The next step is to understand how the correct amount of gene products are produced in space and time to obtain a fully functioning organism, from the egg to the adult. This is what is known as the regulatory genome, a term coined by Eric H. Davidson. In this review, we examine what we know about gene regulation from a genomic point of view, revise the current in silico, in vitro and in vivo methodological approaches to study transcriptional regulation, and point to the power of phylogenetic footprinting as a guide to regulatory element discovery. The advantages and limitations of each approach are considered, with the emerging view that only large-scale studies and data-crunching will give us insight into the language of genomic regulatory systems, and allow the discovery of regulatory codes in the genome.


Demersal fish assemblages are intimately associated with benthic habitats where they spend a large part of their time feeding and avoiding predators. Bottom fishing activities can degrade seabed habitats and change benthic communities by reducing their complexity. Thereby they can also degrade essential fish habitats such that they can no longer sustain the fish species associated with them. Having established a relationship between cod (Gadus morhua) and whiting (Merlangius merlangus) and specific Irish Sea habitats from consultation with fishers and ground fish surveys we wanted to learn what functional role these habitats play, i.e. as sources of prey and shelter from predators. Habitats complexity of stations with high and medium fish densities was assessed using side scan sonar, QTC ViewTM and underwater photography. Young cod were particularly abundant in a habitat with mixed sediments (low grain size sediments between stones and shells) and emergent epifauna off Belfast Lough (Northern Ireland). Dietary specialism indicates a close association with a particular habitat, while broader diets within and between different areas indicate a weaker association of a fish species with a particular habitat. The availability of prey organisms was assessed by sampling epifaunal and infaunal organisms with a 2-m beam trawl and a Day grab. Demersal fish for condition and stomach contents analysis were collected by otter and beam-trawling. The results from stomach content analysis of cod and whiting are discussed in relation to the prey availability found in the study areas and food niche breadth.


Chromogranin A (CgA) is a neuroendocrine secretory protein that is widely used as a marker for endocrine neoplasms but whose function is not completely understood. In mammals, it is thought that CgA is a precursor for biologically active peptides. Here, we describe the cloning of a complementary DNA encoding CgA from a nonmammalian vertebrate, the frog Rana ridibunda. Sequence analysis revealed that frog CgA exhibits only 40-44% amino acid sequence similarity with its mammalian homologues. The amino acid identity is confined to three regions (70-80% identity) of the protein that are flanked by conserved pairs of basic amino acid residues, suggesting that proteolytic processing at these cleavage sites may give rise to three biologically active peptides whose sequences have been highly preserved during evolution. Tissue distribution analysis by Northern blot and in situ hybridization revealed the widespread expression of frog CgA messenger RNA in the brain and in endocrine tissues, the highest concentration occurring in the distal lobe of the pituitary. Adaptation of frog skin color to a dark background caused a concomitant increase in CgA and POMC messenger RNA levels in the intermediate lobe of the pituitary. Taken together, these data indicate that CgA may function as a precursor to three highly conserved peptides that may exert regulatory functions in the neuroendocrine system.


Reading Spaces – Narrative Dialogue in Art Exhibitions examines the mediation and interpretation of exhibitions through the hypothesis that shows are platforms for narratives. The study of mediation is built on the conception that a curator communicates an exhibition by creating and telling the story of the show. The study of interpretation builds on the notion that each visitor constructs her/his own narrative from her/his interpretation of the exhibition.An examination of the communication of exhibitions brings forth the dialogue created between the artwork, curator and visitor in exhibitions. The examination is conducted through exhibition theory, semiotics and narrative theory, coupled with analyses of individual exhibitions.


Spontaneous preterm birth with preterm delivery (before week 37) and other high prevalence pregnancy-associated diseases, including early-onset preeclampsia, late-onset preeclampsia, and fetal intrauterine growth restriction, form the "Big 4" of pregnancy complications. Until now, truly effective methods to screen, prevent, or manage these complications have been lacking. A major obstacle is the fact that many of these diseases have an early placental origin with late clinical presentation in the mother. Methods that allow presymptomatic screening or diagnosis are urgently needed to overcome the time disparities between disease origin and presentation for the benefit of the mothers and babies involved.

In a recent issue of Science , Quake and colleagues have demonstrated 1 of the first prerequisites to reach this goal (1). Their approach was based on their previous work and that of another pioneering group in the field of noninvasive prenatal screening, both of which clearly showed the possibility of maternal plasma sequencing using circulating cell-free fetal nucleic acids. Applying this approach, they identified by maternal plasma RNA sequencing of 38 women (23 full-term and 15 preterm deliveries) that a set of 7 cell-free fetal RNA (cffRNA) transcripts permitted classification of women who delivered preterm up to 2 months in advance of labor (1, 2). Although these results certainly require validation in larger, blinded clinical trials, their proof of principle indicates the potential of the approach used and generates exciting new perspectives, both for preterm delivery and other diseases of the Big 4.

A …


Why can your brain store a lifetime of experiences but process only a few thoughts at once? In this article we discuss "cognitive capacity" (the number of items that can be held "in mind" simultaneously) and suggest that the limit is inherent to processing based on oscillatory brain rhythms, or "brain waves," which may regulate neural communication. Neurons that "hum" together temporarily "wire" together, allowing the brain to form and re-form networks on the fly, which may explain a hallmark of intelligence and cognition: mental flexibility. But this comes at a cost; only a small number of thoughts can fit into each wave. This explains why you should never talk on a mobile phone when driving.


We assessed the antileukemic activity of 2-deoxy- D -glucose (2-DG) through the modulation of expression of receptor tyrosine kinases (RTK) commonly mutated in acute myeloid leukemia (AML). We used human leukemic cell lines cells, both in vitro and in vivo , as well as leukemic samples from AML patients to demonstrate the role of 2-DG in tumor cell growth inhibition. 2-DG, through N-linked glycosylation inhibition, affected the cell-surface expression and cellular signaling of both FTL3-ITD and mutated c-KIT and induced apoptotic cell death. Leukemic cells harboring these mutated RTKs (MV4-11, MOLM-14, Kasumi-1, and TF-1 c-KIT D816V) were the most sensitive to 2-DG treatment in vitro as compared with nonmutated cells. 2-DG activity was also demonstrated in leukemic cells harboring FLT3-TKD mutations resistant to the tyrosine kinase inhibitor (TKI) quizartinib. Moreover, the antileukemic activity of 2-DG was particularly marked in c-KIT – mutated cell lines and cell samples from core binding factor – AML patients. In these cells, 2-DG inhibited the cell-surface expression of c-KIT, abrogated STAT3 and MAPK – ERK pathways, and strongly downregulated the expression of the receptor resulting in a strong in vivo effect in NOD/SCID mice xenografted with Kasumi-1 cells. Finally, we showed that 2-DG decreases Mcl-1 protein expression in AML cells and induces sensitization to both the BH3 mimetic inhibitor of Bcl-xL, Bcl-2 and Bcl-w, ABT-737, and cytarabine. In conclusion, 2-DG displays a signi fi cant antileukemic activity in AML with FLT3-ITD or KIT mutations, opening a new therapeutic window in a subset of AML with mutated RTKs.


Background & Aim: Restless leg syndrome is a common disorder among hemodialysis patients which decreases the quality of life of these patients. This study aims to determine the effect of stretching exercises on the quality of life of hemodialysis patients with restless leg syndrome. Material & Methods: It was a randomized clinical trial. The sample consisted of 36 hemodialysis patients who were selected from the hemodialysis ward of one of the hospitals of Tehran using restless leg syndrome screening questionnaire. They were randomly assigned to either control (n=18) or experimental groups. Intra dialysis stretching exercises were applied three times a week for eight weeks and each time for half an hour on the patients 'legs. Data was collected by SF-36 before intervention and the end of the fourth and eighth weeks and was analyzed by Fisher, Mann-Whitney and Friedman tests using SPSS-PC (v.16). Results: After eight weeks of intervention, the changes of the mean score of quality of life were significantly different in the intervention group compared with control group (P<0.001). Conclusion: According to the results, applying stretching exercises for eight weeks could increase the quality of life of hemodialysis patients by reducing the symptoms of restless leg syndrome. Accordingly, applying these exercises to improve the quality of life of hemodialysis patients with restless leg syndrome is recommended.


Organizations around the developed world are facing pressure from governments, international agreements, society and various stakeholders, to improve their behavior towards the natural environment. The application of environmental management tools may be an important step towards sustainability and the preservation of environmental values, however marketing could be the key – with the help of information and communication technologies (ICT) – in publicizing and spreading these ideas thus forming customers', stakeholders' attitude in this respect.The aim of this study was to define the concept of environmental consciousness and environmentally conscious behaviour, then to present the shift the traditional marketing philosophy towards the sustainable marketing approach, finally to analyse two top sporting goods manufacturers' (Nike, Adidas) environmental management tools with the help of data gained from their web sites, reports, case studies. Interpreting environmental consciousness is difficult without knowing the attitude to it. In spite of that it is important to distinguish between environmental consciousness and environmentally conscious attitude, because consciousness often appears in attitude influenced by other, outer effects.The environmental conscious attitude of companies in itself is not enough for making use of the advantages deriving from a positive environmental concern. They need to pursue more active communication, to "green" the whole of marketing activities. Thus marketing seems a possible means to naturalize and expand environmental protection both among customers and in company practice. According to the analysed companies, we need to say, that they are commitment with the environmental protection. They are used state-of-theart technologies to make their activity greener and introduce these with full particulars, examples e.g. ColorDry technologies, Better Cotton, The Framaprene ECO heel. Either Nike, Inc., or Adidas Group realised that ICT have the ability to improve efficiency and cut the use of material goods, thus reducing energy demands and the burden upon the environment.


This collection published by Editorial Katatay, «Onetti out of his mind», carried out by the researchers Teresa Basile and Enrique Foffani, gathers a group of essays that aims to represent the work of the Uruguayan writer taking into account its relationship with other artistic expressions: music, painting, cinema, similarities with other poetic works from Rio de la Plata or unaddressed issues such as old age or gender paradigms. An unlikely Onetti that exceeds the sphere of previous studies and delivers unexpected new readings. This article about Onetti out of his mind deals with all the aspects taking as a thread the different traditions that use of the expression 'out of his mind' throughout time.


Background: Chemotherapy is one of the treatment modalities for cancer. The side effects of treatment, at times, can affect the emotional well-being of patients and their caregivers, thereby leading to distress. This paper aims at screening and identifying levels of distress among patients undergoing chemotherapy and their caregivers. Subjects and Methods: A cross-sectional study design was used. Patients (n = 102) undergoing chemotherapy in the outpatient daycare unit and their caregivers (n = 101) were screened for distress using the National Comprehensive Cancer Network distress thermometer and the problem checklist. Data were analyzed using descriptive and inferential statistics. Results: Patients (53.4%) and their caregivers (22.2%) reported experiencing moderate-to-severe levels of distress. Patients reported significant distress in the areas of physical (P = 0.000) and emotional problems, whereas caregivers reported distress in the areas of family (P = 0.000) and emotional problems. There was no significant difference in emotional problems (P ≥ 0.05) between the patients and their caregivers. There was a positive correlation between physical and emotional problems (r = 0.760, P = 0.000). Majority of patients (85.2%) and caregivers (80.1%) showed interest to avail psycho-oncology services. Conclusions: Distress is prevalent among patients with cancer undergoing chemotherapy and their caregivers. Clinical implications highlight the need to identify and address caregiver distress during routine distress screening for patients using specific psychosocial interventions. Future research warrants the use of administering specific assessments to identify severe psychological issues, such as depression and anxiety for patients reporting severe levels of distress on the screening tool.


Primary objectives of this study were to compare concentrations of pregnancy-associated glycoprotein ( PAG ) before calving, prolactin ( PRL ) after calving, and energy balance indicators before and after calving in cooled cows classified as having high ( HT ) or low ( LT ) core body temperature ( CBT ) during the dry period. Secondary objectives were to investigate associations between dry-period CBT and likelihood of cows developing health disorders, and compare health, productive and reproductive traits of HT and LT cows. Dry Holstein cows ( n = 260) with 250 to 260 d of gestation from three herds were enrolled in the study during summer. Cows were provided evaporative cooling during the dry and lactating period. The vaginal temperature was recorded in 5-min intervals during 7 consecutive days and cows were classified as HT or LT. Blood samples were collected weekly from enrollment until 14 ± 3 d in milk ( DIM ). Additional blood samples were collected within 12 h postpartum from a subgroup of cows ( n = 25) to determine PRL concentration. Cows were monitored for health disorders, productive, and reproductive performance until 13 wk of the subsequent lactation. High temperature cows had shorter ( P < 0.01) gestation length (273.9 ± 0.9 vs. 278.2 ± 0.9 d) and greater ( P < 0.01) incidence of twinning (19.7 vs. 4.2%) than LT cows. Cows classified as HT had greater ( P = 0.02) PAG concentration (134.1 ± 4.9 vs. 117.4 ± 4.9 ng/mL), but postpartum PRL concentration did not ( P = 0.55) differ between HT and LT cows. Primiparous HT cows had greater ( P = 0.05) prepartum nonesterified fatty acids concentration (135, 95% CI = 102 to 178 vs. 104, 95% CI = 75 to 144 mmol/ dL) than primiparous LT cows, but no differences ( P = 0.72) were observed between CBT group in multiparous cows. The concentration of β -hydroxybutyrate was greater ( P = 0.04) for LT compared with HT cows at 7 ± 3 DIM. The quadratic effect of CBT tended ( P = 0.09) to be associated with risk of health disorders within 60 DIM. Milk yield tended ( P = 0.10) to be greater for LT compared with HT cows (49.3 ± 1.9 vs. 46.2 ± 1.6 kg). Pregnancy per AI at first service did not ( P = 0.64) differ between HT and LT cows. In conclusion, HT cows have distinct concentrations of PAG in late gestation and energy balance indicators during the transition period. In addition, CBT assessment during the dry period may be a useful tool to identify cows expected to have impaired health and milk yield in the subsequent lactation. dairy cows classified as LT during the dry period tended to have increased milk yield in the subsequent lactation compared with their HT counterparts. Core body temperature assessment of heat-stressed cows during the dry period may be a useful tool to identify cows expected to have impaired health and reduced milk yield in the subsequent lactation. Further studies are necessary to evaluate management strategies targeted to improve the health and productive performance of cows with increased CBT during the dry period.


Although skirmishes between land-owning farmers and Fulani herders in Nigeria are not uncommon, the dynamics of recent outbreaks, with both cross-border and environmental connotations, call for in-depth scrutiny. Among other factors, the increasing deforestation and steady drop in water levels in the Guinea and Sudan-Sahel savannah of West Africa contribute to Fulani herders' southward migration and, by implication, the perennial violent conflicts between Fulani herders and landowning communities, especially in the North-Central region. As a short-term measure, the Nigerian government should devise a participatory approach, which should provide the necessary platform for an effective peacebuilding process between the herders and land-owning communities. For a more sustainable intervention, however, the proven Gansu-modelled water conservation project in Kano, Nigeria, should be replicated in the increasingly arid Guinea and Sudan-Sahel savannah. Climatic Factors in Nigeria's Farmer–Herder Conflict


Sharing live multimedia content is becoming increasingly popular among mobile users. In this article, we study the problem of optimizing video quality in such a scenario using scalable video coding (SVC) and chunked video content. We consider using only standard stateless HTTP servers that do not need to perform additional processing of the video content. Our key contribution is to provide close to optimal algorithms for scheduling video chunk upload for multiple clients having different viewing delays. Given such a set of clients, the problem is to decide which chunks to upload and in which order to upload them so that the quality-delay tradeoff can be optimally balanced. We show by means of simulations that the proposed algorithms can achieve notably better performance than naive solutions in practical cases. Especially the heuristic-based greedy algorithm is a good candidate for deployment on mobile devices because it is not computationally intensive but it still delivers in most cases on-par video quality compared to the more complex local optimization algorithm. We also show that using shorter video segments and being able to predict bandwidth and video chunk properties improve the delivered video quality in certain cases.


Healthcare has been a matter of concern for centuries as far as diagnostic techniques for human development are concern. These techniques have been evolving through the ages and human beings have become selective towards cheaper and convenient ones (convenient according to that period of scientific development). But in this selection process we suppress the rare scientific techniques which are no more popular but still exist in our society. This paper is a attempt to collaborate our ancestral knowledge with modern science to make diagnostic techniques more efficient, rapid and user friendly. The main idea is to combine IRIDOLOGY and Image processing with its scientific reasons to open up a new research field and healthcare diagnostic technique. Implementing this method practically requires special image processing where iris feature extraction plays a crucial role. In this paper we study Iridology, a branch of medical science and develop a methodology to implement synergy on image processing with it. This paper will explain the work of image processing of the iris image, the effects of various parameters of algorithm, different image acquisition system specifications, various environments and different sizes of images.


The effect of hypoxy on chemotherapy with emoxyl, 5-fluorouracil and bleomycin which are characterized by different affinities with oxygen has been investigated. In an experiment using 96 rats, each weighing 180 g, subcutaneously inoculated with Walker's carcinosarcoma and carcinoma. PC-1, combined use of chemotherapy and hypoxy was followed by a significant inhibition of tumor growth rate, against a background of significant drop in survival due to the increased toxic effect of the drugs. Therefore, hypoxy cannot be recommended for modifying chemotherapy of tumors irrespective of drug affinity with oxygen.


Iontophoretically applied glutamate produces different excitatory postjunctional permeability changes on separate muscle fibers in a single crayfish muslce. At junctions on some fibers glutamate appears to increase the conductance to both sodium and potassium whereas at others its effect is primarily on the sodium conductance. These results obtained by studying the reversal potential for the extracellularly recorded glutamate potential under conditions of varied extracellular sodium and potassium concentrations.


Although draft animals have been playing an essential role in agricultural production worldwide, in recent decades there has been a trend towards replacing draft animals with farm machines. In the areas facing labour shortage due to rural-to-urban migration, the use of farm machines is especially expected to enhance agricultural production and productivity. However, little is known about the extent to which the farm machine use substitutes draft animal use and how the two production activities jointly affect agricultural performance. To fill this gap, this paper attempts to examine the long-run and short-run effects of farm machine use on draft animal use using a pooled mean group estimator, and to estimate the joint effects of farm machine use and draft animal use on agricultural productivity using a panel production function model. The empirical results show that a 1% increase in farm machine use rate tends to decrease draft animal use by 2.82% in the long-run, but it does not have a statistically significant impact on draft animal use in the short-run. In addition, we find that output elasticity of farm machine use has increased from −0.161 in 1978 to 0.170 in 2012, while that of draft animal use has decreased from 0.185 to −0.129 over the same time period. Our findings highlight the importance of government's efforts in promoting an agricultural transition from animal power to machine power in order to increase sustainable agricultural production.


For the purpose of gaining a deeper understanding of the relationship between external training load and health in competitive alpine skiing, an accurate and precise estimation of the athlete's kinematics is an essential methodological prerequisite. This study proposes an inertial sensor-based method to estimate the athlete's relative joint center positions and center of mass (CoM) kinematics in alpine skiing. Eleven inertial sensors were fixed to the lower and upper limbs, trunk, and head. The relative positions of the ankle, knee, hip, shoulder, elbow, and wrist joint centers, as well as the athlete's CoM kinematics were validated against a marker-based optoelectronic motion capture system during indoor carpet skiing. For all joints centers analyzed, position accuracy (mean error) was below 110 mm and precision (error standard deviation) was below 30 mm. CoM position accuracy and precision were 25.7 and 6.7 mm, respectively. Both the accuracy and precision of the system to estimate the distance between the ankle of the outside leg and CoM (measure quantifying the skier's overall vertical motion) were found to be below 11 mm. Some poorer accuracy and precision values (below 77 mm) were observed for the athlete's fore-aft position (i.e., the projection of the outer ankle-CoM vector onto the line corresponding to the projection of ski's longitudinal axis on the snow surface). In addition, the system was found to be sensitive enough to distinguish between different types of turns (wide/narrow). Thus, the method proposed in this paper may also provide a useful, pervasive way to monitor and control adverse external loading patterns that occur during regular on-snow training. Moreover, as demonstrated earlier, such an approach might have a certain potential to quantify competition time, movement repetitions and/or the accelerations acting on the different segments of the human body. However, prior to getting feasible for applications in daily training, future studies should primarily focus on a simplification of the sensor setup, as well as a fusion with global navigation satellite systems (i.e., the estimation of the absolute joint and CoM positions).


INTRODUCTION: Chorioamnionitis can initiate fetal lung injury and result in neonatal chronic lung disease (CLD). Although neonates with CLD have higher amniotic fluid concentrations of proinflammatory cytokines, overexpression of transforming growth factor β (TGF-β) also seems to be important in the pathogenesis of neonatal CLD. OBJECTIVE: Our goal was to investigate how TGF-β is related to fetal lung injury induced by chorioamnionitis. METHODS: Forty-four amniotic fluid samples were obtained at delivery from preterm infants (median gestational age: 28 weeks; median birth weight: 908 g). TGF-β and interleukin 6 (IL-6) concentrations in amniotic fluid were measured with enzyme-linked immunosorbent assays. RESULTS: TGF-β concentration in amniotic fluid correlated with IL-6 concentration (P < .0001). Both TGF-β and IL-6 concentrations in amniotic fluid increased with increasing histologic severity of chorioamnionitis (each P < .0001). Coexisting presence of neonatal CLD and histologic chorioamnionitis was associated with significantly higher amniotic fluid TGF-β and IL-6 concentrations than presence of neonatal CLD without histologic chorioamnionitis or absence of both (mean TGF-β level: 454.3 vs 119.2 vs 151.8 pg/mL [P < .0001]; mean IL-6 level: 5.14 vs 0.99 vs 1.64 ng/mL [P = .0005]). Both TGF-β and IL-6 concentrations in amniotic fluid correlated with duration of neonates' need for oxygen administration (each P < .0001). CONCLUSIONS: Amniotic fluid TGF-β may be important in chorioamnionitis-induced fetal lung injury that results in neonatal CLD.


Image quality models usually include a mechanism whereby artifacts are masked by the image acting as a background. Scientific study of visual masking has followed two traditions: contrast masking and noise masking, depending primarily on whether the mask is deterministic or random. In the former tradition, masking is explained by a decrease in the effective gain of the early visual system. In the latter tradition, masking is explained by an increased variance in some internal decision variable. The masking process in image quality models is usually of the gain-control variety, derived from the contrast masking tradition. In this paper we describe a third type of masking, which I call entropy masking, that arises when the mask is deterministic but unfamiliar. Some properties and implication of entropy masking are discussed. We argue that image quality models should incorporate entropy masking, as well as contrast masking.


"The humanitarian policy that the Canadian government implemented in response to the 1989 Tiananmen Square crackdown changed a migration system primarily based on personal networks into a brain drain. Post-Tiananmen mainland Chinese immigrants (MCIs) were better educated than those arriving in Canada previously. Among the post-Tiananmen MCIs, those who landed under the policy were better educated than those landing in other categories. The analysis suggests that post-Tiananmen MCIs represented a brain-drain rather than a refugee flow, that the humanitarian policy implicitly contained ideological and human capital concerns in addition to humanitarian concerns, and that Canada benefited from the policy by obtaining human capital as well as satisfying its humanitarian obligations and ideological aspirations."


A nagging feeling of great expectations turned sour is in the air, at least at this end of the globe. The illusion appears to have been twofold. Those liberals who after the Cold War had imagined finally to see the Western city win over competing forms of self-regulation, self-reproduction, and homeostasis can no longer fail to see how, by the time the twenty-first century has commenced, democracy and the rule of law, the West's own blueprint for living together, have lost some of their lustre, when they have not been bluntly rejected. Those amongst the poets who, by contrast, had argued all along that another world was possible or, alternatively, that democracy and the rule of law could at most be promised or tendered rather than fully achieved or imposed, sometimes today worry whether in the process they may not have become somewhat problematically if unwittingly fixated with what in the age of mass culture and information technology some argue might be a potentially self-defeating aesthetics of the Other. Alain Badiou's Platonism of the multiple and, specifically, his ethics of truths invite us to consider whether the widespread sense of disappointment and closure which follow from such an unsatisfactory situation should not be grasped as a figure of nihilism, specifically as a figure of 'betrayal', and whether, on the other hand, what is required may not be discernment, courage, and caution and to remain alert to the possible occurrence of new signal events. Thus to a poetics of illusion and of consequent disappointment Badiou prefers an ethics of truths which starts from the obvious existence of certain generic truths and yet is never closed-off to the invention of new ones. As presented, Badiou's ethical proposal is far from being fully developed and it is bound to be contentious. And yet it does contribute to a unique and powerful critique of current events as they ceaselessly appear on the horizon of a more interconnected world, specifically a critique which purports to offer a more affirmative, and even optimistic, message than many competing analyses of democracy and the rule of law.


Background: Regarding the association of osteoporosis with various fractures and its disabilities, high cost of treatment and rehabilitation, asymptomatic majority of patients and revealing after serious disability and preventable disability and its complications, this study was conducted to determine the prevalence of osteoporosis and its association with demographic factors and body mass index (BMI) in patients referred to Sanandaj densitometry center.
Methods: This cross- sectional descriptive- analytic study was carried out on 250 patients referring to Sanandaj densitometry center from September 2017 to September 2018. For the subjects, BMD was determined by dual-energy X-ray absorptiometry method at two bone segments, ie the hip and spine. Data were analyzed using independent t-test, fisher exact test, chi- square test and logistic regression test using SPSS V.23 software.
Results: In 250 studied subjects, there were found 68 cases (27.2%) osteoporosis in spine region and 38 cases (15.2%) in hip region. There was a significant correlation between age and incidence of osteoporosis in the spine and hip (P-value < 0.001), with the increase in age, the prevalence of osteoporosis increased. Despite the prevalence of osteoporosis in females, there was no significant relationship between sex and osteoporosis in spine and hip (P-value > 0.05). Despite the higher prevalence of osteoporosis in the study population living in the city, there was no significant relationship between residence and osteoporosis in spine and hip (P- value > 0.05). There was a significant relationship between education level and osteoporosis in spine and hip (P- value < 0.001), so that with the increase in education, the prevalence of osteoporosis decreases. There was a significant correlation between BMI and osteoporosis in spine and hip (P- value < 0.05), with an increase in BMI, the prevalence of osteoporosis decreases.
Conclusion: This study revealed a high prevalence of osteoporosis. Therefore, considering the increased risk of fracture, the morbidity and mortality due to osteoporosis and their costs, increasing awareness of people about complications, how to reduce the risk factors and timely treatment, it seems necessary.


Hospital infection control measures are crucial to tuberculosis (TB) control strategies within settings caring for human immunodeficiency virus (HIV)–positive patients, as these patients are at heightened risk of developing TB. Pyrazinamide (PZA) is a potent drug that effectively sterilizes persistent Mycobacterium tuberculosis bacilli. However, PZA resistance associated with mutations in the nicotinamidase/pyrazinamidase coding gene, pncA, is increasing. A total of 794 patient isolates obtained from four sites in Lima, Peru, underwent spoligotyping and drug resistance testing. In one of these sites, the HIV unit of Hospital Dos de Mayo (HDM), an isolation ward for HIV/TB coinfected patients opened during the study as an infection control intervention: circulating genotypes and drug resistance preand postintervention were compared. All other sites cared for HIV-negative outpatients: genotypes and drug resistance rates from these sites were compared with those from HDM. HDM patients showed high concordance between multidrug resistance, PZA resistance according to the Wayne method, the two most common genotypes (spoligotype international type [SIT] 42 of the Latino American-Mediterranean (LAM)-9 clade and SIT 53 of the T1 clade), and the two most common pncA mutations (G145A and A403C). These associations were absent among community isolates. The infection control intervention was associated with 58–92% reductions in TB caused by SIT 42 or SIT 53 genotypes (odds ratio [OR] = 0.420, P = 0.003); multidrug-resistant TB (OR = 0.349, P < 0.001); and PZA-resistant TB (OR = 0.076, P < 0.001). In conclusion, pncA mutation typing, with resistance testing and spoligotyping, was useful in identifying a nosocomial TB outbreak and demonstrating its resolution after implementation of infection control measures.


The purpose of this study was to evaluate the capacity of pulsed bilateral electric fields to control bacterial attachment on stainless steel plates. Previously sterilized circular metal plates of stainless steel were submerged in a liquid medium with a known concentration of Staphylococcus epidermidis and incubated for 1 hour at 36oC while a 200 Hz pulsed electric field of 18 V/cm was applied for 2.5 μseg and then sonicated for 5 minutes in 10 ml of saline. Three different models were cultured and compared: 1) negatively-charged plate, 2) positively-charged plate, and 3) control plate without electric current. A total of 39 metal plates were processed. The median adherence in the control group and the electric field group was 312 CFU/mm2 and 16,2 CFU/mm2 respectively (p < 0.001, reduction of 95% of bacterial attachment). Bilateral pulsed electric field is able to reduce bacterial attachment on stainless steel plates in in vitro conditions.