Occlusal surface wear scores were examined in a sample of 200 Formative period (1500 bc–ad 500) skeletons from the lower Azapa Valley in northwest Chile. Wear rate and plane (angle) were additionally evaluated using a subsample of paired first and second mandibular molars. The Formative period represents the transition from marine foraging to agro-pastoral dependence in the region, and differences in oral pathology indicate that diet varied by site location (coast vs valley interior) but not by archaeological phase (early vs late). We predicted that occlusal wear would demonstrate similar patterns, resulting from differences in food consistency, and therefore hypothesised that in coastal groups consuming greater quantities of foraged foods, occlusal surfaces should wear faster and exhibit flat molar wear, whereas among valley interior groups consuming greater quantities of agro-pastoral products, these should wear slower but exhibit more angled molar wear. Heavier posterior tooth wear was identified among coastal residents, but rate and angle of molar occlusal attrition did not differ significantly by location. Heavier overall wear and a steeper molar wear plane were identified during the early phase indicating that food consistency varied somewhat over the course of the Formative period. Overall, the results indicate that, although limited differences in tooth wear exist by site location, wear varied more over time likely reflecting a gradual transition from foraging to agro-pastoral dependence in the lower Azapa Valley. Although oral health indicators point to differences in dietary investment by location, maintenance of a mixed subsistence economy likely sustained a comparative consistency of foodstuffs. Copyright © 2011 John Wiley & Sons, Ltd.


The phenomenon of small firms located in industrial clusters is widespread in many countries, particularly in Italy, Brazil, Mexico, Peru and India as well as in some African countries such as Kenya, Tanzania and Ghana. These firms have made significant inroads on the global supply chain for various products such as fashion consumer goods, shoes, garments, precision surgical instruments and construction tiles.

The purpose of this study was to determine the extent and significance of small-firm clustering in Zimbabwe and the factors that contribute to the growth and dynamism of the firms in these clusters with a view to recommending ways in which entrepreneurship among these firms could be nurtured further. The cluster was modeled as an Entrepreneurial Technological Regime wherein it was proposed that the growth and success of the firms depended on the existence of an enabling environment which allowed the constant acquisition and diffusion of knowledge (technological capabilities).

The study used a questionnaire that was distributed to a sample of 608 small furniture manufacturing firms selected from a population of 2 144 firms located in clusters in the five major cities of Zimbabwe. The study also used results from focus group discussions and interviews with owner-managers of firms at the Glenview cluster in Harare.

The study arrived at there conclusions:

- the firms in Zimbabwe"s clusters are micro-enterprises (very small entities) that are "isolated" in that they lack access to new technology and capital;

- the firms are, however, worthy candidates for policy intervention because they possess various collective attributes that place them at an advantage over other SMEs; and

- the clusters possess the characteristics of complex adaptive systems (phenomena with emergent properties), therefore any policy interventions would be more effective if they were directed at the cluster as a whole or groups of firms within the cluster rather than at individual firms.

The study therefore recommended that measures be taken to attract long-term capital (debt and equity) into the cluster by introducing the firms to the capital markets and also bring in new technological capabilities from outside the cluster by forging technical alliances between the firms in the cluster and other firms outside the cluster. This should be done within a framework that fosters a strong private-public partnership in which the private sector takes the leading role and involves the participation of the cluster members and the local authority.


The previously established fact of low activity of Ca, Mg-dependent endonucleolysis of cell nucleus DNA in lymphoproliferative diseases (CME-activity) brought the authors to study intranuclear characteristics of lymphoid cells in childhood acute lymphoblastic leukemia (ALL). The intensity of DNA-endonucleolysis was measured in 0.7% agarose gel using electrophoresis. Peripheral blood and bone marrow samples from 13 untreated ALL patients and 23 children in remission were examined. The age of the patients ranged from 4 to 14 years. CME-activity before treatment appeared to be 2-10 times less than normal in 8 out of 13 patients. In bone marrow cell nuclei CME-activity was universally reduced 3-20-fold. In ALL remission endonuclease activity in blood and bone marrow cells returned to normal.


This case is a detailed account of the planning and execution of the data collection for the Unions in Context study, which is a probability-based survey among lesbian, gay, and heterosexual couples and families in the Netherlands. On one hand, we situate the Unions in Context study in the context of the status quo of the field. We discuss the opportunities and challenges of the different types of pre-existing data sources that allow for the study of same-sex couples and families, such as convenience sample surveys, register and census data, and large-scale social surveys. In this discussion, we highlight the contribution of the Unions in Context data to the field. On the other hand, we outline the practical considerations made during the planning phase; the most commonly faced challenges when studying lesbians, gay men, and bisexuals quantitatively; and the solutions we thought of to address them. Specifically, we explain the steps of how we have succeeded in designing a sampling frame based on population registers to draw a random sample of same-sex and mixed-sex couples. This step-by-step account should enable other researchers interested in studying this difficult-to-reach population to replicate our approach.


Business incubators can help young firms to survive during their first years. They are considered to be an entrepreneurial and economic development instrument that can increase the creativity of new firms including small and mid-sized enterprises and that can support them in the early stage of development which is the most vulnerable stage of their existence. Small and mid-sized enterprises are crucial for enhancing innovation, productivity, competitiveness, social cohesion, and economic development in developed and developing countries. They are also crucial in minimizing unemployment; they create a lot of jobs and significant output in many countries. The economy in many developing countries, especially Arab countries, is in a critical state. The unemployment rate is very high and gross domestic product is very low compared to developed countries. Many types of success models have been proposed and used to measure the success and performance of business incubators in developed countries. However, a limited number of studies and success models have been published on this topic in the case of the developing world. Therefore, the main objective of this paper is to propose a model using a combination of well-known and new success factors for business incubator success in developing countries.


OBJECTIVES
The aim of this study was to evaluate the clinical outcomes of patients undergoing off-pump robotic coronary artery bypass grafting (CABG) with either interrupted nitinol U-Clips in totally endoscopic coronary artery bypass (TECAB) or standard running suture anastomosis in robotically assisted direct coronary artery bypass (RADCAB) over a decade.

METHODS
From January 2007 to December 2017, 280 patients underwent robotic off-pump CABG using the da Vinci S/Si Surgical System in our centre. TECAB with interrupted nitinol U-Clips anastomosis was performed in the left internal mammary artery (LIMA) to LAD grafting in 126 patients and RADCAB (n = 154) of the LIMA to LAD was completed with standard running suture. After discharge, patients were contacted through telephone interview and were invited to attend the outpatient clinic every 6 months or 1 year. The graft patency was assessed by coronary angiography or computed tomography angiography.

RESULTS
All cases were completed without conversion to median sternotomy or cardiopulmonary bypass. A total of 275 single internal mammary artery (IMA) grafts (271 LIMAs, 4 right internal mammary arteries) and 5 bilateral IMA grafts were used as single graft or composite grafts. All the patients were discharged without in-hospital mortality or adverse outcomes. The average follow-up was 89.7 ± 30.4 months (range, 14-143 months). The cumulative survival rates (P = 0.53), the cumulative IMA patency rates (P = 0.83), and the rates of freedom from major adverse cerebrovascular and cardiovascular events (P = 0.41) between TECAB and RADCAB all showed no significant difference in the follow-up.

CONCLUSIONS
Robotic off-pump CABG using IMA grafts is safe and can provide reliable long-term outcomes. Compared with the standard hand-sewn running suture technique in RADCAB, interrupted suture with the nitinol U-Clips in TECAB showed similar long-term clinical results and graft patency in LIMA to LAD bypass grafting.


The author approaches about historical aspects, concepts, ethiology and treament of digestive fistula. The skin care and drainage control are the basis of stomal therapy. So, the author discusses the specific nursing and ET care in this subject, including evaluation, procedures and resources.


Intramedullary signal change (ISC) is a non-specific finding that is frequently observed on magnetic resonance imaging (MRI) examinations of the canine spinal cord. ISC can represent a variety of primary pathological processes such as neoplasms or myelitides or secondary changes such as edema, cysts, gliosis, or myelomalacia. An unusual phenotype of ISC is the "snake-eye" myelopathy (SEM), which refers to bilaterally symmetric T2 hyperintensities preferentially affecting the ventral horn gray matter on transverse MR images, which resemble a pair of snake's eyes. The pathophysiology of SEM is poorly understood in humans, and this imaging finding may be associated with cervical spondylotic myelopathy, spinal cord ischemia, ossification of the posterior longitudinal ligament, amyotrophic lateral sclerosis, and Hirayama disease. Here we describe four dogs with cervical MRI examinations consistent with an SEM-like phenotype. All dogs initially presented with a central cord syndrome or tetraparesis referable to a C6-T2 neuroanatomic localization, which was attributed to disc-associated spinal cord compression in three cases, while one dog had the SEM-like phenotype with no identifiable etiology. Once the SEM-like phenotype was present on MRI examinations, dogs demonstrated insidious clinical deterioration despite therapeutic interventions. Deterioration was characterized by lower motor neuron weakness and neurogenic muscle atrophy progressing to paralysis in the thoracic limbs, while neurological functions caudal to the level of the SEM-like lesion remained largely preserved for months to years thereafter. Neuropathological features of the SEM-like phenotype include multisegmental cavitations and poliomyelomalacia of laminae VI-IX of the caudal cervical spinal cord, although the lesion evolved into pan-necrosis of gray matter with extension into the adjacent white matter in one case with an 8 years history of progressive disease. Although the pathophysiology of SEM remains unknown, the topographical distribution and appearance of lesions is suggestive of a vascular disorder. As the SEM-like phenotype was uniformly characterized by longitudinally and circumferentially extensive neuronal necrosis, results of this small case series indicate that dogs with clinical signs of central cord syndrome and the SEM-like phenotype involving the cervicothoracic intumescence on MR examinations have a poor prognosis for the preservation or recovery of thoracic limb motor function.


: For third-party annotations in the digital edition to be interoperable, we argue they should not be anchored in web pages but in the edition's abstract information structure. We propose an ontology for the editorial domain based on FRBR OO . The ontology distinguishes between the editable domain (works that can be edited) and the edited domain (the result of editing), as well as between the different FRBR levels. The edition's website, with the help of RDFa (RDF triples expressed by means of HTML attributes in the hierarchical HTML structure) can identify fragments of works and expressions and describe their relations. Annotation tools and other clients can use that information to identify the targets of annotation and perform other types of intelligent processing. We discuss what this facility might mean for annotation in the context of digital editions. We also note that the same functionality is desirable in the context of other types of cultural heritage material, such as newspapers and audio-visual archives.


Background The prevalence of ageing HIV infected females continues to increase due to greater survival, delayed diagnosis and new infections; management of specific issues in this group becomes more challenging. Aims/Objective To identify the specific care issues for women at and above 50 years. Method Female patients aged 50 and over were identified from a female cohort of 828 and data collected retrospectively from case notes and electronic patient records. Results and Discussion The sample consisted of 124 (15% of 828) women, mean age 52 y, range 50–75 y; 83% black ethnicity. 40.3% diagnosed at 50 y or over. CD4 counts, mean 217 cells/μl indicating 71% late diagnoses and 42% with advanced/very advanced HIV. 22.6% of the sample had attended hospital before and missed the opportunities for early diagnosis suggesting wider testing even in elderly. 4.5% women had premature menopause compared to <1% in the general population, 7.1% early menopause, 28% had menopausal symptoms, 10% had HRT. On opportunistic testing of BMD tests, 5/8 women had evidence of osteoporosis/osteopenia. 54% of the whole group had vitamin D deficiency. 38% had abnormal cervical cytology, of which 16.5% were high grade. A high degree of obesity (48%) and other co-morbidities (90%) identified. Conclusions Special care for premature/early menopause including early counselling regarding reproductive options, wider HIV testing regardless of age, screening for osteoporosis, breast and cervical cancer, holistic approach in the management of obesity and other co-morbidities. Consideration needed as to how care is provided for this group within current health care settings.


Various closed-cells of plasma display panel were prepared via capillary moldingof paste containing ceramic powders of barrier ribs. The cells include meander, honeycomb, waffle and SDR. In this study, the sintering behaviors of such barrier ribs were investigated. The effects of pre-firing temperature, solid content in the paste, and type of cells on morphologies of the ribs were examined. The results indicated that cells with asymmetric geometry such as SDR and meander results in severe distortion after the sintering. The cells with symmetric geometry such as waffle and honeycomb, on the other hand, the distortion was negligible. Using the waffle type cells, the luminance characteristics of PDP device were evaluated.


Numbers in square brackets refer to chapters: This dissertation studies the relation between myth and demystification in post-revolutionary France, notably in the literary depiction of Paris. I argue that, in this period, the functions of myth in society were being redefined by literature in the light of a new, 'secularised' conception of the sacred. I begin by focusing on the social functions of myth (maintaining social cohesion and identity), particularly through the constitution of 'collective memory' I also examine the downside of this need for social cohesion: alienation [1]. I then look at the framework of modern myth-making that combines poetics, politics, history and myth. I show how new forms of the sacred emerged in the century of rationalism and disenchantment, and how Michelet in particular contributed greatly to the construction of the myth of 1789 [2]. For it is indeed 1789 that explains Paris's unique status. I am focusing on Hugo in this regard to understand the sacralisation of Paris as the capital of the revolution [3]. Hugo also illustrates a general tendency in the post-revolutionary depiction of Paris: its darkness and claustrophobia seem to illustrate the condition of modern man [4]. But beyond a material glance at the city, Hugo's vision sends a more disturbing message: in exile, the poet-seer redefines the march of history and offers new means of demystification [5]. This analysis then extends to looking at Hugo's central character, the People, and its difference from the equally mythical populace. In fact the confusion between the two will lead to the end of Paris as a myth, which coincides with the Commune and the debacle of Paris [6]. That ultimate defeat will prompt Hugo to go back and seek the origins of modern France, focusing this time on 1793 in a last attempt to oppose the seer's parole to that of the state, with the very definition of the republic at stake [7].


An exponential turnpike property for a semilinear control problem is proved. The state-target is assumed to be small, whereas the initial datum can be arbitrary. Turnpike results are also obtained for large targets, requiring that the control acts everywhere. In this case, we prove the convergence of the infimum of the averaged time-evolution functional towards the steady one. Numerical simulations are performed.


A large class of modified theories of gravity used as models for dark energy predict a propagation speed for gravitational waves which can differ from the speed of light. This difference of propagations speeds for photons and gravitons has an impact in the emission of gravitational waves by binary systems. Thus, we revisit the usual quadrupolar emission of binary system for an arbitrary propagation speed of gravitational waves and obtain the corresponding period decay formula. We then use timing data from the Hulse-Taylor binary pulsar and obtain that the speed of gravitational waves can only differ from the speed of light at the percentage level. This bound places tight constraints on dark energy models featuring an anomalous propagations speed for the gravitational waves.


5th Generation (5G) and Industry 4.0 (I4.0) cellular systems have many different use-cases which impose a diverse set of requirements on a candidate Multi-Carrier System (MCS). These requirements demand high flexibility and reconfigurability from any candidate waveform. In this paper we present gr-gfdm a Software-Defined Radio (SDR) implementation of the waveform candidate Generalized Frequency Division Multiplexing (GFDM) in GNU Radio, discuss the details of our implementation and show how the SDR flexibility can be employed for use in simulations and field trials. With a careful design the same implementation can be used in testing, simulation, field trials and interfaces to other programming languages are easily added. Furthermore we facilitate an over-the-air transmission with our implementation in order to demonstrate its capabilities, where we could achieve sample rates of up to 25 MS/s.


We document a novel type of international financial contagion whose driving force is shared financial intermediation. In the London peripheral sovereign debt market during pre-1914 period financial intermediation played a major informational role to investors, most likely because of the absence of international monitoring agencies and the substantial agency costs. Using two events of financial distress – the Brazilian Funding Loan of 1898 and the Greek Funding Loan of 1893 – as quasi-natural experiments, we document that, following the crises, the bond prices of countries with no meaningful economic links to the distressed countries, but shared the same financial intermediary, suffered a reduction relative to the rest of the market. This result is true for the mean, median and the whole distribution of bond prices, and robust to an extensive sensitivity analysis. We interpret this as evidence that the identity of the financial intermediary was informative, i.e, investors extracted information about the soundness of a debtor based on the performance of her financial intermediary. This spillover, informational in essence, arises as the flip-side of the relational lending coin: contagion arises for the same reason why relational finance (in this case, underwriting) helps alleviate informational and incentive problems,


Naturally occurring gaseous by-products of ruminant production-carbon dioxide (CO2 ), methane (CH4 ), and nitrous oxide (N2 O)-can negatively affect the environment. Along with enteric fermentation, manure on pasture is among the most significant contributors to non-CO2 emissions. Condensed tannins, a group of naturally occurring phenolic compounds, can alter the route of nutrient excretion and interact with microbes, suggesting they are a plausible feed additive for reducing excreta gas emissions. We evaluated how quebracho (Schinopsis balansae) tannin extract fed at 0, 15, 30, and 45 g kg-1 of dry matter (DM) within a roughage-based diet affected fecal gas emissions at multiple locations (College Station and Stephenville, TX) during two periods corresponding to winter and spring. During both periods, CO2 , CH4 , and N2 O fluxes were determined using the vented-static chamber methodology over 39 d, and cumulative emissions were calculated. A random coefficients model with animal nested within dietary treatment and period as the random factor was analyzed by location due to the presence of collinearity with soil parameters within periods. Daily CO2 flux was influenced by soil moisture and temperature (r = .34; P < .01), whereas CH4 and N2 O were associated with soil moisture. Cumulative gas production confirmed a dietary effect for CO2 and gross CO2 equivalent at the College Station site (P ≤ .001), demonstrating a linear reduction as quebracho inclusion increased. Variance partitioning indicated that dietary treatment and seasonal period likely influenced animal digestive and metabolic parameters. Within specific environments, quebracho supplementation may assist in reducing fecal gas emissions.


Objectives
The emergence of NDM- and MCR-1-co-producing Escherichia coli has compromised the use of carbapenems and colistin, which are critically important in clinical therapy, and represents a severe threat to public health worldwide. Here, we demonstrate synergism of colistin combined with existing antibiotics as a potential strategy to overcome XDR E. coli co-harbouring NDM and MCR-1 genes.

Methods
To comprehensively evaluate their combined activity, antibiotic combinations were tested against 34 different E. coli strains carrying both NDM and MCR-1 genes. Antibiotic resistance profiles and molecular characteristics were investigated by susceptibility testing, PCR, MLST, S1-PFGE and WGS. Antibiotic synergistic efficacy was evaluated through in vitro chequerboard experiments and dose-response assays. A mouse model was used to confirm active combination therapies. Additionally, combinations were tested for their ability to prevent high-level colistin-resistant mutants (HLCRMs).

Results
Combinations of colistin with rifampicin, rifabutin and minocycline showed synergistic activity against 34 XDR NDM- and MCR-1-co-producing E. coli strains, restoring, in part, susceptibility to both colistin and the partnering antibiotics. The therapeutic effectiveness of colistin combined with rifampicin or minocycline was demonstrated in a mouse model. Furthermore, colistin plus rifampicin showed significant activity in preventing the occurrence of HLCRMs.

Conclusions
The synergism of colistin in combinations with rifampicin, rifabutin or minocycline offers viable therapeutic alternatives against XDR NDM- and MCR-positive E. coli.


IMPELS is an Individualised Mathematics Planning and Evaluation of Learning Tool for Students with Intellectual Disability. IMPELS was evaluated against 3 number sense tools and subjected to standard validity and reliability assessments. Results obtained indicated that IMPELS correlated strongly with the tools, ranging from 0.70 to 0.91 and 0.45 to 0.70 for Pearson and Spearman's Rho correlation coefficients respectively. Cronbach's alpha and Spilt-Half Reliability (KR-20) was 0.96. IMPELS is useful for the collection of baseline data to inform the development of individual education plans (IEPs) and for monitoring the progress of learning of individual students.


This paper describes position-based impedance control for biped humanoid robot locomotion. The impedance parameters of the biped leg are adjusted in real-time according to the gait phase. In order to reduce the impact/contact forces generated between the contacting foot and the ground, the damping coefficient of the impedance of the landing foot is increased largely during the first half double support phase. In the last half double support phase, the walking pattern of the leg changed by the impedance control is returned to the desired walking pattern by using a polynomial. Also, the large stiffness of the landing leg is given to increase the momentum reduced by the viscosity of the landing leg in the first half single support phase. For the stability of the biped humanoid robot, a balance control that compensates for moments generated by the biped locomotion is employed during a whole walking cycle. For the confirmation of the impedance and balance control, we have developed a life-sized humanoid robot, WABIAN-RIII, which has 43 mechanical d.o.f. Through dynamic walking experiments, the validity of the proposed controls is verified.


We analyse the stability and non-linear dynamics of power-law accretion disc models. These have mid-plane densities that follow radial power laws and have either temperature or entropy distributions that are strict power-law functions of cylindrical radius, R. We employ two different hydrodynamic codes to perform high-resolution 2D axisymmetric and 3D simulations that examine the long-term evolution of the disc models as a function of the power-law indices of the temperature or entropy, the disc scaleheight, the thermal relaxation time of the fluid and the disc viscosity. We present an accompanying stability analysis of the problem, based on asymptotic methods, that we use to guide our interpretation of the simulation results. We find that axisymmetric disc models whose temperature or entropy profiles cause the equilibrium angular velocity to vary with height are unstable to the growth of perturbations whose most obvious character is modes with horizontal and vertical wavenumbers that satisfy vertical bar k(R)/k(Z)vertical bar 1. Instability occurs only when the thermodynamic response of the fluid is isothermal, or the thermal evolution time is comparable to or shorter than the local dynamical time-scale. These discs appear to exhibit the Goldreich-Schubert-Fricke or 'vertical shear' linear instability. Closer inspection of the simulation results uncovers the growth of two distinct modes. The first are characterized by very short radial wavelength perturbations that grow rapidly at high latitudes in the disc, and descend down towards the mid-plane on longer time-scales. We refer to these as 'finger modes' because they display k(R)/k(Z) 1. The second appear at slightly later times in the main body of the disc, including near the mid-plane. These 'body modes' have somewhat longer radial wavelengths. Early on they manifest themselves as fundamental breathing modes, but quickly become corrugation modes as symmetry about the mid-plane is broken. The corrugation modes are a prominent feature of the non-linear saturated state, leading to strong vertical oscillation of the disc mid-plane. In a viscous disc with aspect ratio H/r = 0.05, instability is found to operate when the viscosity parameter alpha < 4 x 10(-4). In three dimensions the instability generates a quasi-turbulent flow, and the associated Reynolds stress produces a fluctuating effective viscosity coefficient whose mean value reaches alpha similar to 10(-3) by the end of the simulation. The evolution and saturation of the vertical shear instability in astrophysical disc models which include realistic treatments of the thermal physics has yet to be examined. Should it occur on either global or local scales, however, our results suggest that it will have significant consequences for their internal dynamics, transport properties and observational appearance.


The cirrhotic patient with acute bleeding from esophageal varices has less than a 50% chance of leaving the hospital alive; the outlook for survival is so poor that even desperate measures are worthwhile. Some traditional nonsurgical methods for the control of the bleeding are either ineffective at worst or temporary at best. Balloon tamponade is not recommended at all, but intravenously administered vasopressin may be helpful in allowing the necessary diagnostic investigations to be completed. Most important at this stage are the measures necessary to improve the general status of the patient--restoration of blood volume with fresh blood, prevention of ammonia intoxication, support of the liver, correction of metabolic alkalosis and treatment of the hyperdynamic state with digitalis and cardiotonic drugs. Controlling the bleeding is not the greatest problem--the greatest problem is achieving survival of a critically ill patient who undergoes a formidable operation (e.g., variceal ligation stops the bleeding, but is itself an operation of considerable magnitude). In our hands emergency shunting is the best treatment providing a definitive procedure with the highest 10-year survival rate and the lowest complication rate.


This paper shows the results obtained from simulation and fabrication process of inspired metamaterial Structure with RMPA 2GHz with rectangular cut shaped structure at 3.2mm layer. To this date, the technology in Left-Handed Metamaterial is best suited for finding beneficial result for our purpose. The metamaterial is the starting point of the analysis and is usually composed of periodic structure of metal and dielectric. We have designed the structure using simulation tools and fabricate them to see how the performance is changing by using inspired metamaterial Structure with respect to fabricated RMPA alone. Simulation results showed that the RMPA return loss is reduced by -26.36 dB and the bandwidth is improved by 5% by incorporating the proposed metamaterial structure. RMPA with Rectangular Cut Shaped Structure at 3.2mm plane is simulated on IE3D Simulation platform, fabricated, and measured on Spectrum Analyzer in the microwave laboratory, Simulation and Measurement results are compiled here.


Currently, patients who undergo total hip arthroplasty want a complete restoration of their hip function and not only pain relief. Templating in THA is essential for accurately predicting the optimal size of the implants required. It also reduces the risk of potential complications. To check the reproducibility of our preoperative planning, to compare the accuracy of templating between orthopedic surgeon (OS), orthopedic resident (OR) and data manager (DM), to determine the learning curve between the different planners and to evaluate the effect of body mass index impact on digital templating for THA. One hundred uncemented Corail ® Hip System using a ceramic on ceramic bearing surface were included into the study. The software used for templating was IMPAX-Orthopaedic-Tools. A calibration marker (28-mm ball) was used for calibration. All the anteroposterior pelvis radiographs were planned by three participants (OS, OR, DM). We systematically collected the precisely planned size measurements as well as the variation by 1 or 2 sizes of prostheses. At +/- 1 size, we did not find any significant difference between the participants with respectively 94%, 96% and 93% concordance for the cup, 88%, 90% and 90% for the stem and 85%, 84% and 83% for the neck. Our preoperative templating was accurate in predicting the required implant size and results were similar to those available in the literature. We did not find any difference between the planners and we were unable to objectivate a learning curve period. We conclude that this essential part of the planning procedure can be performed by the surgeon himself or an orthopedic resident or a data manager who has anatomical knowledge if the surgeon is unable to perform templating himself.


The number of mobile broadband users is increasing. Furthermore, these users have high expectations into the capabilities of mobile broadband, comparable to those in fixed networks. On the other hand, the capacity assignment process on mobile access links is far from transparent to the user, and its properties need to be known in order to minimize the impact of the network on application performance. This paper investigates the impact of the packet size on the characteristics of the oneway delay for the down-link in third-generation mobile networks. For interactive and real-time applications such as VoIP, one-way delays are of major importance for user perception; however, they are challenging to measure due to their sensitivity to clock synchronization. Therefore, the paper applies a robust and innovative method to assure the quality of these measurements. We focus on the down-link as this is still the link that carries the most traffic to the user, and the quality of it will have a significant impact on all IP-based services. Results from measurements from several Swedish mobile operators reveal the possibility to partly control one-way delay and its variability by choosing appropriate packet sizes. In particular, packet sizes leading to the use of WCDMA entail significant but hardly varying one-way delays. On the other hand, we also show that HDSPA networks can deliver large amounts of data at rather high speed, but the cost is a huge variability in the one-way delay.


With respect to full employment migrants still are in a bad position. Despite positive attention for their position, the number of unemployed is very high.One of the problems migrant course-members have to face during their vocational training, is the technical language. This is defined as the language which is used within a certain profession to communicate about the profession.In this article I present the description of an investigation into the use of the technical language, used in textbooks for vocational training within institutes for apprenticeship training and further education. A detailed description is presented in "Een bus is een bus is een bus" (1989).The investigation is based on three theories. The first one describes the relation between learning a second language and language as a communication process. An important aspect here is the "repertoire" the sender and the receiver must have in common in order to be able to communicate with each other. The second theory deals with concepts, their influence on the culture and by that, the assimilation of the data. In this context "concept" means all the meanings, pictures etc,, one can have when reading or hearing a word. The third one gives insight in the relation between the roles a language user has to play, the settings in which he or she has to play that role and the functions of the language activities. All three theories plays their part in vocational training where technical languages are used.Technical language manifests itself in the lexicon (in general technical language, the domain language and in course instruction language) and on text level. Furthermore, technical language has a number of characteristics which can be summarized as "the economical principle". This leads among others to elliptical sentences, composed sentences, passive sentences and changing the word order by placing the clause with the most important information at the beginning of the sentence.It was investigated whether and in which way technical language appears in textbook for learners and what the main problems are for migrant learners. The investigation showed that many texts are a source of problems, because they do not correspond with the knowledge level of the learner.


Objective Liver fibrosis has been associated with hepatitis C virus (HCV) genotype and genetic variation near the interleukin 28B (IL28B) gene, but the relative contribution is unknown. We aimed to investigate the relation between HCV genotypes, IL28B and development of liver stiffness. Patients and Methods This cross-sectional study consists of 369 patients with chronic hepatitis C (CHC). Liver stiffness was evaluated using transient elastograhy (TE). Factors associated with development of liver fibrosis were identified by logistic regression analysis. Results We identified 369 patients with CHC. 235 were male, 297 Caucasians, and 223 had been exposed to HCV through intravenous drug use. The overall median TE value was 7.4 kPa (interquartile range (IQR) 5.7–12.1). HCV replication was enhanced in patients carrying the IL28B CC genotype compared to TT and TC (5.8 vs. 5.4 log10 IU/mL, p = 0.03). Patients infected with HCV genotype 3 had significantly higher TE values (8.2 kPa; IQR, 5.9–14.5) compared to genotype 1 (6.9 kPa; IQR, 5.4–10.9) and 2 (6.7 kPa; IQR, 4.9–8.8) (p = 0.02). Within patients with genotype 3, IL28B CC genotype had the highest TE values (p = 0.04). However, in multivariate logistic regression, using various cut-off values for fibrosis and cirrhosis, only increasing age (odds ratio (OR) 1.09 (95% confidence interval (CI), 1.05–1.14 per year increment)), ALT (OR 1.01 (95% CI, 1.002–1.011), per unit increment) and HCV genotype 3 compared to genotype 1 (OR 2.40 (95% CI, 1.19–4.81), were consistently associated with cirrhosis (TE>17.1 kPa). Conclusions Age, ALT and infection with HCV genotype 3 were associated with cirrhosis assessed by TE. However, IL28B genotype was not an independent predictor of fibrosis in our study.


Vascular endothelial cells regulate arterial tone through the release of nitric oxide and other diffusible factors such as prostacyclin and endothelium derived hyperpolarizing factors. Alongside these diffusible factors, contact-mediated electrical propagation from endothelial cells to smooth muscle cells via myoendothelial gap junctions, termed endothelium-dependent hyperpolarization (EDH), plays a critical role in endothelium-dependent vasodilation in certain vascular beds. A rise in intracellular Ca2+ concentration in endothelial cells is a prerequisite for both the production of diffusible factors and the generation of EDH, and Ca2+ influx through the endothelial transient receptor potential vanilloid 4 (TRPV4) ion channel, a nonselective cation channel of the TRP family, plays a critical role in this process in various vascular beds. Emerging evidence suggests that the dysregulation of endothelial TRPV4 channels underpins endothelial dysfunction associated with cardiovascular disease (CVD) risk factors, including hypertension, obesity, diabetes, and aging. Because endothelial dysfunction is a precursor to CVD, a better understanding of the mechanisms underlying impaired TRPV4 channels could lead to novel therapeutic strategies for CVD prevention. In this mini review, we present the current knowledge of the pathophysiological changes in endothelial TRPV4 channels associated with CVD risk factors, and then explore the underlying mechanisms involved.


A review of the literature discussing the relationship between mechanical factors and osteoarthrosis (OA) is given. From this review, it is concluded that the impulsive loads experienced at heelstrike during normal level walking are associated with degeneration of the joints of the lower limb. The amount of loading experienced varies between individuals and it is proposed those with higher loading have a greater risk of developing OA. The apparatus and methods used to study the differences in heelstrike impulsive loading (HIL) in a subject population are described. The data from the gait studies is analysed using kinematic and kinetic models. The data confirms that the subject population consisted of two groups, one with a large HIL, the other with a small HIL. These differences are attributed to the kinematics of the swing leg, in particular the vertical velocity of the ankle at heelstrike. A two dimensional simulation model of the swing phase is developed. This model is used, together with an numerical technique, to change the swing phase pattern of a subject with a large HIL to that typical of a subject with a small HIL. The differences in joint moment between these two patterns is evaluated. A sagittal plane model of the patellofemoral joint is developed and described. This model is incorporated into an existing mathematical model of the lower limb. The lower limb model is used to evaluate the differences in muscular control effort required for the two swing phases described above. Differences are found in the phasing of the hip flexor muscles. It is concluded that changes in muscular phasic activity during early swing phase, combined with the dynamics of the swing leg, produce significant changes in the approach velocity of the ankle at heelstrike. Thus, the loading experienced at heelstrike is a function of the timing of muscle activity during swing phase and can be altered by training, so that preventative treatment of OA is possible.


The alloying effects of Nb, Zr, and/or Sn on the phase stability and elastic properties of Ti are investigated by using a first-principles method. Our calculation results indicate that a carefully designed Ti-Nb-Zr-Sn system can be a good candidate for low modulus biomedical materials. We find that the well-known correlation between the e/a ratio and both elastic and phase stabilities for Ti alloyed with transition metal elements breaks down for the Ti-Sn alloy.


Separating mixed distributions is a long standing challenge for machine learning and signal processing. Most current methods either rely on making strong assumptions on the source distributions or rely on having training samples of each source in the mixture. In this work, we introduce a new method---Neural Egg Separation---to tackle the scenario of extracting a signal from an unobserved distribution additively mixed with a signal from an observed distribution. Our method iteratively learns to separate the known distribution from progressively finer estimates of the unknown distribution. In some settings, Neural Egg Separation is initialization sensitive, we therefore introduce Latent Mixture Masking which ensures a good initialization. Extensive experiments on audio and image separation tasks show that our method outperforms current methods that use the same level of supervision, and often achieves similar performance to full supervision.


This paper introduces an embedded control system for cognitive flow management of delay sensitive real-time traffic to improve quality of service (QoS) in Wireless Local Area Networks (WLANs). The management system is based on the fuzzy set theory. It adjusts transceivers' traffic flow(s) for prevailing network conditions to achieve application dependent quality of service requirements by regulating packet size and transmission interval of the source node. The model was validated by simulating voice over IP (VoIP) calls, video phone conversations, and interactive games in OM-NeT++ network simulator. The achieved results demonstrate that the developed control system is able to regulate packet sizes and transmission intervals to the prevailing application dependent optimum level very fast, accurately and with minimal overshoot.


Stream buffers increase the complexity of agroecosystems, providing wildlife habitat, sediment and nutrient sinks to improve water quality, and potentially lignocellulosic feedstock for biofuels. The establishment of stream buffers can be difficult, with weeds competing with desired species and increasing weed pressure in the production fields and contaminating feedstocks. Our objective was to evaluate the success of establishing two different feedstock alternatives, alfalfa (ALF; Medicago sativa L., cultivar Ladak) and tall wheatgrass (TWG; Agropyron elongatum Podp., cultivar Alkar), plus a mix of alfalfa and tall wheatgrass (MIX) at two sites within each of three precipitation zones in the Pacific Northwest (PNW). We evaluated productivity, stand establishment, and weed infestation using a split plot, randomized complete block design. Establishment of targeted species was most successful and productivity was highest in the intermediate precipitation zone. Lignocellulosic feedstock produced by TWG (7.52 ± 2.07 Mg ha−1 [3.35 ± 0.92 tn ac−1]) and MIX (7.45 ± 2.00 Mg ha−1 [3.32 ± 0.89 tn ac−1]) produced significantly more lignocellulosic feedstock than ALF (1.68 ± 0.79 Mg ha−1 [0.75 ± 0.35 tn ac−1]) and SG (2.62 ± 0.99 Mg ha−1 [1.17 ± 0.44 tn ac−1]). The best competition against invasive annual species was obtained in the TWG and MIX treatments, with tall wheatgrass providing the bulk of biomass in either treatment. Productivity was acceptable where naturally occurring subirrigation was present and contributed to crop germination and establishment in the low precipitation zone, but weed pressure was substantial and caused near to complete crop failure in the driest plots. A high level of weed management will be required to produce monocultures of lignocellulosic feedstocks in stream buffers.


Abstract The adjacency matrix of a graph is a matrix which represents adjacent relation between the vertices of the graph. Its minimum eigenvalue is defined as the least eigenvalue of the graph. Let Gn be the set of the graphs of order n, whose complements are connected and have pendent paths. This paper investigates the least eigenvalue of the graphs and characterizes the unique graph which has the minimum least eigenvalue in Gn.


When predicting complex systems one typically relies on differential equation which can often be incomplete, missing unknown influences or higher order effects. By augmenting the equations with artificial neural networks we can compensate these deficiencies. We show that this can be used to predict paradigmatic, high-dimensional chaotic partial differential equations even when only short and incomplete datasets are available. The forecast horizon for these high dimensional systems is about an order of magnitude larger than the length of the training data.


Abstract— Active capture is a new process for the incorporation of large quantities of heavy noble gases into growing surfaces. Adsorption in the conventional sense involves surface bonding by polarization (Van der Waals forces). What is referred to as "anomalous adsorption" of heavy noble gases involves chemical bonds and can occur when other (more chemically active) species are not available to preempt sites with unfilled bonds. Anomalous adsorption has been observed under conditions of fracture, vacuum deposition and ionizing radiation. Active capture depends upon anomalous adsorption to retain noble gases on a surface long enough to be captured in a growing surface film as it is deposited. The fundamental principle may be the impingement onto the growing film with sufficient energy to liberate surface electrons (work function energy of a few electronvolts) so that they are retained by anomalous adsorption long enough to be entrapped in the growing surface. Trapping efficiencies of ˜1% have been observed for Kr and Xe in laboratory experiments, implying a fundamentally new mechanism for the incorporation of heavy noble gases onto surfaces. It may play a role in explaining the large concentrations of planetary noble gases contained in phase‐Q.


Glucose and glutamine are two principal nutrients in mammalian cells that provide energy and biomass for cell growth and proliferation. Especially in cancer cells, glutamine could be a main alternative for energy and biomass supply once glucose metabolism is suppressed. Therefore, single inhibition of enzymes in either glucose metabolism or glutaminolysis, though maybe efficient in vitro, is far from being satisfactory for efficient in vivo cancer therapy. Here, we proposed a new strategy for dual inhibitions on both glucose and glutamine metabolisms concurrently by silencing mutated gene Kras and glutaminase 1 (GLS1) via nanomaterial-based siKras and siGLS1 delivery, rather than conventional highly toxic chemodrugs. Such a combination therapy could overcome the challenge that glucose and glutamine are alternatives to each other in the biosynthesis and energy production for cancer cells, resulting in much elevated treatment efficacy. In addition, layered double hydroxide (LDH), the siRNA carrier, enables an enhanced gene delivery efficiency compared to the commercial transfection agent Lipofectamine 2000. Briefly, Mg-Al LDH nanosheets, loaded with siKras and siGLS1 onto their surfaces by electrostatic adsorption, could release siRNA from lysosomes into the cytoplasm via the proton sponge effect of LDH, favoring the siRNA stability and gene silencing efficiency enhancements. The thus released siRNA could downregulate the expressions of Kras, GLS1, and other enzymes involved in glucose metabolism, resulting in the downregulations of ATP and other metabolites. Such a biosafe LDH/siRNA nanomedicine is able to efficiently suppress the growth of xenografts through cancer cell proliferation suppression, displaying its great potential as a simultaneous glucose/glutamine metabolism coinhibitor for treating pancreatic cancer.


BACKGROUND
The Government of Nepal has implemented safe abortion policy since 2002. There are 245 approved sites providing safe abortion services to women across the country. Family planning counselling is one of the components of the safe abortion policy, which is important to reduce unwanted pregnancy, maternal morbidity and mortality due to the consequences of unsafe abortion and the service burden.

OBJECTIVES
This study explains the perceptions, practices and factors affecting the use of family planning among abortion clients attending safe abortion services in Nepal.

METHODS
A cross sectional study was carried out on September, 2008 enrolling 58 women who were waiting in the dressing room for safe abortion services in Paropkar Maternity Hospital, Nepal. All women attending hospital clinic for receiving safe abortion services were approached for interview till the targeted number was fulfilled. A convenience sampling was applied to reach the sample size.

RESULTS
Of the 58 respondents, majority of the respondents were Hindus (83%), residing in Kathmandu district (76%); of the age group 20-29 years (69%); and 98% were married. One fifth (20.68 %) of the respondents had previous history of spontaneous or induced abortion. The main reason for abortion did not want any more babies/ complete family (45%). The knowledge of modern contraception was high (98.27%). The knowledge of emergency contraception was low (25.9%). Side effects was the main reason (48%, n=31) for discontinuation of contraceptives. Intention to use some modern family planning methods after the abortion was expressed by 83% clients. The major enabling factor for continued contraceptive use was the absence of side effects. The family planning counselling was acceptable for 91% clients.

CONCLUSION
Knowledge, acceptance of counselling service and intention to use family planning measure was high in the study participants. There is need to provide skills on adapting with the adverse effect of family planning measure through continuous education and reinforcement.


Aid is not generally aimed at the poorest people, though most multilateral or bilateral agencies would like to think they get included. However, donors´ strategies are generally blind to differentiation among the poor, and have not improved in this respect. The special provisions for the least developed countries, where many of the poorest people live, have not worked well. Aid to conflict-affected countries is itself in crisis. Much greater and more integrated aid is called for in both cases. Middle-income countries are themselves becoming donors, but the poorest populations of these countries have benefited from international partnerships which draw attention to the poorest and help foster innovative policy responses. Equity is far from being a strong principle of aid givers UNICEF is the exceptional agency. The human rights based approach to development, which would give much greater weight to the poorest, in practice languishes at the margins of development, though where this has been taken up in middle-income countries (e.g., India) donors have stood on the sidelines. Explanations of this fairly dismal state of affairs are offered in terms of political economy and organizational and profession incentives. Finally the paper sketches a set of issues which need to be incorporated into the post 2015 framework and its preparation if poverty is to be taken more seriously by donors.


The adsorption of oxygen on a reduced SrTiO3 (111) surface occurs in two distinct phases. At low exposures (less than 1 L), the adsorption leads to the incorporation of O = ions into the vacant lattice oxygen sites. At higher exposures a second different oxygen species adsorbs.


1. Bacterial filtrates were prepared by the methods described by Besredka, but these never developed any specific growth-inhibiting factors. 2. Such filtrates produced a strictly local immunity of the areas of the skin infiltrated but such protection was never greater than that produced with the broth from which they were prepared. This immunity was manifest within 8 hours and persisted at least 15 days. 3. Transcutaneous treatment by moist dressings soaked in either filtrate or broth were entirely ineffective. 4. Sites of healed cutaneous lesions show a strictly local and nonspecific immunity for a period of 5 to 6 weeks. 5. Repeated intracutaneous infection with virulent staphylococci failed to produce a general cutaneous immunity.


The additional power demand caused by cold load pickup (CLPU) condition restricts the simultaneous restoration of all the loads of a network due to excessive loading on the network elements and violation of limits. Therefore, step-by-step restoration is the most adopted approach. However, it requires long time for the complete restoration. The main cause of CLPU problem is the loss of diversity amongst the loads which causes the enduring phase of CLPU condition. The conservation of load diversity reduces the demand during restoration. In the proposed approach, the diversity is conserved by using distributed generation (DG) for quick restoration and the reduction of additional power demand caused by CLPU condition. The capacity required for DG is evaluated on the basis of the required additional power demand and the load-diversity preserved. The proposed approach utilizes the genetic algorithm for determination of the optimal size and location of the required DG. The approach is demonstrated on a 33-bus, 12.66-kV primary distribution network.


It is generally accepted that the bicuculline-resistant responses to GABA are mediated through the activation of GABAB receptors that mediate a slow IPSP. However, a number of reported observations are difficult to reconcile with this model. Specifically, GABAB antagonists only partially block bicuculline-resistant GABA responses, and both 4- aminopyridine (4-AP) and carbachol have been reported to block responses to the selective GABAB agonist baclofen, but not GABA itself. Thus, it has been argued that baclofen and GABA increase potassium conductance through separate receptor mechanisms. This suggestion is not easily reconcilable with the postulated physiological role of GABAB receptors in mediating the slow IPSP. We have addressed these discrepancies by using the new GABAB antagonists 2-hydroxy-saclofen (2- OH-SAC) and CGP 35348 in the presence of the GABA uptake inhibitor SKF 89976A. The weak antagonism of 2-OH-SAC against the bicuculline- resistant GABA response was improved when the GABA uptake was inhibited with SKF 89976A, allowing for the application of lower GABA concentrations. Under these circumstances, 2-OH-SAC and CGP 35348 strongly antagonized GABA and baclofen responses, but did not have any effect on outward currents evoked by 5-HT. The slow IPSP evoked in the presence of glutamate antagonists was reversibly inhibited by CGP 35348 (IC50 = 14 microM), without affecting the fast IPSP. Carbachol (0.3–20 microM) had no effect on outward currents evoked by either baclofen or GABA. 4-AP (5 microM to 1 mM), despite causing a large increase in cell excitability, did not change baclofen responses. Higher concentrations of 4-AP (5 mM) induced inward current, and reduced both baclofen and GABA outward currents to a similar extent.(ABSTRACT TRUNCATED AT 250 WORDS)


The purpose of the present study was to identify the effect of using current event teachi9ng method on the achievement of primary 10 grade students in the patriotic and Social Studies and their attitudes. Sample (N=81) consisted of all students attending the primary 10th grade level at AL Hussein Comprehensive Boy Secondary School within Amman First Directorate of Education during the academic year( 2011-2012). Participants were randomly assigned to control and experimental groups. For statistical treatment, the researcher used means, standard deviations, and T-test to verify valence of the two groups in the study. In addition, multiple ANCOVA, and Kuder-Richardson (KR-20) to calculate reliability of the achievement test. Results showed statistically significant differences attributed to group effect on all posttest levels in favor of the experimental group, with high mean estimate score. The researcher recommends motivating teachers to use current events in their teaching by holding training courses for them supervised by specialists from the education colleges at the Jordanian universities.


The history of land settlement programs in the Philippines from 1900 to 1975 is reviewed from secondary sources, including three case studies. A few similarities are noticed among all of the resettlement movements: (a) a small number of families that are directly resettled by government programs and (b) the large proportion of spontaneous migrants that are attracted by the government stimulus. One conclusion is that while land settlement increased total production of the country as a whole, it had unintended side effects such as increased cultural conflicts. Neither land settlement can be expected to permanently solve agrarian problems although the presence of frontier land can temporarily delay acute conditions.


AIM AND OBJECTIVES
Defining the components of emotional competence in caring for older people in Iranian hospitals.

BACKGROUND
People of older age are the largest recipients of healthcare services in hospitals. Thus, it is essential to establish what characteristics of emotional competence are required for nursing older people.

DESIGN
This qualitative descriptive-exploratory study was conducted in Iran from September 2015 to April 2016.

METHODS
Semi-structured interviews were conducted with 25 participants (nine nurses, 12 nurse managers, four clinical instructors), chosen by purposive and snowball sampling based on saturation. Data were analysed by content analysis method.

RESULTS
Qualitative content analysis identified two core categories and seven subcategories from the data: (a) Individual emotional competence with five subcategories of positive attitude, spiritual maturity, emotional self-control, adherence to professional ethics and creativity and innovation, and (b) social emotional competence with two subcategories of relationship management and compassionate care.

CONCLUSION
Emotional competence was identified as one of the main components of nursing skills when caring for older people. Gerontological nurses should demonstrate emotional competence in caring for older people and include a positive attitude, spiritual maturity, emotional self-control, adherence to professional ethics, creativity in care, successful relationship management and compassionate care in their practice.

IMPLICATIONS FOR PRACTICE
These findings can be used to guide development of emotional competencies for nursing older people.


ABSTRACT From May 1997 to December 2001, a serotype O:6 multidrug-resistant strain of Pseudomonas aeruginosa colonized or infected 201 patients in the University Hospital of Besançon (France). The susceptibility profile of this epidemic clone to fluoroquinolones and aminoglycosides was relatively stable during the outbreak but showed important isolate-to-isolate variations (up to 64-fold) in the MICs of β-lactams. Analysis of 18 genotypically related isolates selected on a quaterly basis demonstrated alterations in the two DNA topoisomerases II and IV (Thr83→Ile in GyrA and Ser87→Leu in ParC) and production of an ANT(2")-I enzyme. Although constitutively overproduced in these bacteria, the MexXY efflux system did not appear to contribute significantly to aminoglycoside resistance. β-Lactam resistance was associated with derepression of intrinsic AmpC β-lactamase (with isolate-to-isolate variations of up to 58-fold) and sporadic deficiency in a 46-kDa protein identified as the carbapenem-selective porin OprD. Of the 18 isolates, 14 were also found to overproduce the efflux system MexAB-OprM as a result of alteration of the repressor protein MexR (His107→Pro). However, complementation experiments with the cloned mexR gene demonstrated that MexAB-OprM contributed only marginally to β-lactam and fluoroquinolone resistance. Of the four isolates exhibiting wild-type MexAB-OprM expression despite the MexR alteration, two appeared to harbor secondary mutations in the mexA-mexR intergenic region and one harbored secondary mutations in the putative ribosome binding site located upstream of the mexAB oprM operon. In conclusion, this study shows that many mechanisms were involved in the multiresistance phenotype of this highly epidemic strain of P. aeruginosa. Our results also demonstrate that the clone sporadically underwent substantial genetic and phenotypic variations during the course of the outbreak, perhaps in relation to local or individual selective drug pressures.


With much advancement in healthcare and technology, physicians use an electronic medical record (EMR) system to document patient encounters. Tele health is a growing phenomenon, allowing physicians to either be in a clinic or home setting when it comes to the patient encounter. The main purpose of this type of encounter is to allow wider access to patient care for people who are not able to see a physician. Examples of this are individuals residing in retirement homes, as physical or mental disability can become a limiting factor. The main goal of this study is to get a better understanding of tele healthcare with regards to access, patient satisfaction and everyday usage of this form of technology. More precisely, it is an in-depth look at how various methods, such as telemedicine can increase an individual's accessibility for seeking healthcare needs while attempting to increase patient satisfaction with healthcare services provided.


The Loire River in Central France is approximately 1010 km long and drains an area of 117 800 km2. Upstream, the Loire river flows south to north from the Massif Central to the city of Orleans, 650 km from its source. The Loire River is one of the main European riverine inputs to the Atlantic Ocean. We have chosen to analyze the isotope composition of copper (Cu), zinc (Zn) and lead (Pb), because many compagnies and industries such as nuclear power plants, food processing industries release directly in the Loire liquid effluents that are very rich in Cu, Zn and Pb (several hundreds of tons per year). Industrial sources responsible for the release of Cu-Zn-Pb within the Loire basin were sampled and analysed for their concentrations and corresponding isotope compositions. We also analyzed river waters (upstream to downstream) and suspended solids samples. Cu-Zn-Pb isotope compositions were measured using a Neptune MC-ICPMS at the BRGM. In order to analyse Cu and Zn, we carried out a two-steps analytical development: 1) a chromatographic separation, followed by 2) analysis on the MC-ICPMS. The first results for Zn and Pb isotopes in dissolved load show a very homogeneous Pb and Zn signature from upstream to downstream (0.2 variations in 206Pb/204Pb ratio and 0.15‰ in 66Zn/64Zn value). Moreover, the Pb isotopic signature is close to geogenic domain. For Zn, the characterization of the geogenic signature is in progress. These results suggest the absence of substantial anthropic pollution in the Loire river waters. On the contrary, preliminary measurements on suspended matter suggest a more substantive anthropic contribution. Noteworthy, suspended matter is known to play a significant role in the riverine transport of heavy metals. As a consequence, precise studies of the interaction between the suspended and dissolved load will be necessary to assess the importance of the anthropic input within the Loire river.


Frequency-modulated continuous-wave (FMCW) synthetic aperture radar (SAR) is a lightweight cost-effective high-resolution airborne imaging radar. In squint case, the frequency scaling algorithm, which is suitable for processing nonchirped raw data, cannot be used directly in FMCW SAR data processing because of low system sampling frequency. On the other hand, the continuous antenna motion of FMCW SAR can cause serious distortions in the reconstructed images. In this letter, an improved algorithm called the chirp transform algorithm is proposed. When the effects of the residual video phase are negligible, the algorithm uses a chirp transform to perform the time scaling operation to alleviate the sampling frequency problem. It requires only fast Fourier transforms and multiplications. The range cell migration introduced by the continuous motion is also compensated completely in range-Doppler domain. The algorithm performances are analyzed and are supported by point target simulation experiments.


MEETING BRIEFSALTA, UTAH-- More than 1000 scientists gathered here from 5 to 10 July for an unusual joint conference of the International Society of Developmental Biologists and the Society for Developmental Biology. At the meeting, researchers reported that [onychophorans][1], primitive, wormlike creatures believed to be the closest living relatives of the organisms that gave rise to the arthropods, including insects, have the same eight homeobox ( Hox ) genes as insects themselves. This indicates that the diverse body segments of insects did not evolve as a result of Hox gene duplication as previously thought, but may instead have arisen as a result of changes in Hox gene regulation. In another session, researchers reported that by studying the control of a gene believed to be key to the formation of [ommatidia][2], the independent photoreceptor units that make up the compound fly eye, they have gained a better understanding of how the ommatidia form the eye's extremely regular hexagonal pattern. And by treating cells taken from a part of the amphibian embryo called the animal cap with proteins known to influence [organ development][3], other researchers have been able to induce the formation of organs, such as the heart and liver, in culture. If a similar feat can be accomplished for mammalian cells, it might aid efforts to construct replacement human organs.

 [1]: http://www.sciencemag.org/cgi/content/full/277/5326/639#hox
 [2]: http://www.sciencemag.org/cgi/content/full/277/5326/639#fly
 [3]: http://www.sciencemag.org/cgi/content/full/277/5326/639#organ


To date, the factors significantly reduces the tolerance of the liver against the development of NAFLD and GSD. At the stage of biliary sludge cholelithiasis is found in more than half of the patients suffering from NAFLD. BS violates jelchnokamennouu and releaxation activity of hepatocytes, thereby slowing the passage of bile through the intrahepatic and extrahepatic bile ducts that aggravate the course of NAFLD. The reasons for the formation of sludge is not completely understood. To date there are no accepted tactics of conducting and treatment of patients with HB in the background of NAFLD. In our work we demonstrate one possible way to tackle this important problem.


The digital era has changed the human lifestyle of social media use. Social media has become a platform not only to show "who one is" in cyberspace but also a platform for the capitalist industry to promote consumerism. As one of the most popular social media platforms, Instagram is utilized by the capitalist industry to achieve its goals of sales and growth. This study aims to determine how posts from Instagram with the hashtag. #cowokmilenial used by the capitalist industry build a metrosexual side. The researchers employed the qualitative approach with the semiotic method on Instagram through the hashtag #cowokmilenial during 2019. The findings in this study indicate that the capitalist industry constructs the meaning of metrosexual men among Indonesian millennials through skincare products (especially facial care/Rodeos soap) which promise to help them look handsome with a clean, bright, and acne-free face.


Purpose: To review prevalence, long-term progression, and prognosis of vitreoretinal interface modifications in pathologic myopia with posterior staphyloma and investigate foveal sensitivity and fixation stability. Methods: Retrospective single-institution series of 214 eyes (116 patients) with pathologic myopia, axial length >30 mm, and posterior staphyloma. Exclusion criteria included follow-up less than five years, incomplete records, and/or less than three optical coherence tomography or microperimetry. Patients were divided into 5 groups according to optical coherence tomography: 1) epiretinal membrane without schisis (ERM); 2) macular retinal schisis (Schisis); 3) partial thickness macular hole (PTMH); 4) full-thickness macular hole (FTMH); and 5) posterior retinal detachment (PRD) with or without macular hole. Disease progression was defined as a visual acuity decrease of two or more lines associated to objective worsening of the optical coherence tomography and/or microperimetry. Results: Vitreoretinal abnormalities at baseline were present in 116 of 204 patients (56.8%) and 214 of 408 eyes (52.4%); 98 of 116 patients (84.4%) showed bilateral involvement. Baseline visual acuity and foveal sensitivity varied significantly with ERM performing better and PRD worse than others; PTMH and FTMH did not differ. During the 66 months of average follow-up, 33 of 214 eyes (15.4%) required surgery and 13 of 33 eyes (39.3%) needed reintervention. Surgery rate significantly differed among groups: 2% for ERM, 20% to 25% for Schisis, PTMH, and FTMH, and up to 50% for PRD. Progression rate of Schisis and FTMH was the same, regardless of symptoms, while macula-off PRD always required surgery. Decrease of fixation stability and foveal sensitivity correlated to need for surgery, while baseline foveal sensitivity and fixation did not. Conclusion: Vitreoretinal interface pathology in pathologic myopia with posterior staphyloma encompasses a spectrum of conditions whose baseline functionality, prognosis, rate, and amount of progression vary significantly. Customized treatment for each different condition should be considered.


: Laparoscopic retropubic urethropexy by Birch was followed by chemotherapy with m-cholinolytics in 30 women with mixed urinary incontinence. 15 patients received trospium chloride in a daily dose 30-45 mg and the other 15--oxibutinin hydrochloride in a daily dose 10-15 mg. A comparative analysis of the treatment results after 36 months of follow-up demonstrated higher safety of trospium chloride which showed the same efficacy with oxibutinin hydrochloride.


Recent techniques in Question Answering (QA) have gained remarkable performance improvement with some QA models even surpassed human performance. However, the ability of these models in truly understanding the language still remains dubious and the models are revealing limitations when facing adversarial examples. To strengthen the robustness of QA models and their generalization ability, we propose a representation Enhancement via Semantic and Context constraints (ESC) approach to improve the robustness of lexical embeddings. Specifically, we insert perturbations with semantic constraints and train enhanced contextual representations via a context-constraint loss to better distinguish the context clues for the correct answer. Experimental results show that our approach gains significant robustness improvement on four adversarial test sets.


I. BACKGROUND: EUROPEAN SOCCER AND EUROPEAN UNION FREE MOVEMENT OF WORKERS LAW The United European Football Association ("UEFA") is the governing body responsible for regulating soccer throughout Europe. UEFA, working closely with the globally-oriented FA©dA©ration Internationale de Football Association ("FIFA"),1 promulgates rules and regulations regarding all aspects of the play of soccer within Europe.2 Regulation under both FIFA and UEFA extends to rules of play, rules of player transfer, rules of contract and arbitration, and rules of player eligibility. UEFA has authority to regulate competition on both the European national and club team levels. National teams represent European countries in international competition, whereas club teams compete within one country's private league in a manner similar to competition in the NFL or the NBA. The best club teams from each country's private league also compete against one another in the UEFA Cup and UEFA Champions League. These interleague competitions showcase the best private teams in European soccer and do not take place under color of any national flag.3 The propriety of selecting players based on nationality when composing a national team is not an area of dispute-it is at the private, club team level that nationality selection issues arise. In DonA v Mantero, the Court of Justice of the European Communities ("ECJ") recognized that international sports competition, in which countries are represented by their national teams, does not fall within the category of economic activity regulated by the Treaty Establishing the European Community ("EC Treaty").4 Because EU antidiscrimination labor law under the EC Treaty applies only to economic activity, nonnationals can be excluded from national teams without violating EU free movement regulations.5 Freedom of movement under the EC Treaty "entailfs] the abolition of any discrimination based on nationality between workers of the Member States as regards employment" by prohibiting barriers on free movement of EU workers between EU nations.6 The free movement regulations were enacted for economic reasons-"to free up the labour market with migrant workers who were regarded as 'human capital' or factors of production within the common market."7 Because club sports within nations qualify as economic in nature, free movement and antidiscrimination requirements apply to club team player selection.8 Prior to 1991, UEFA mandated that club teams could only have two noncitizens on their starting lineup (not including assimilated foreigners).9 In 1991, as a result of negotiations between UEFA and the European Commission, this rule was relaxed. UEFA implemented new quotas for club teams: three players on each team's starting lineup had to be citizens of the country in which the club was located and two could be foreigners that had lived in the country for a certain number of years. This policy became known as the "3+2 Rule."10 In Union Royale Belge des SociA©tA©s de Football Association ASBL v Bosman, however, the ECJ held these nationality quotas to be in violation of the EC freedom of movement requirement.11 UEFA reluctantly complied with the ECJ opinion and revoked its nationality quotas.12 Because there is no longer a nationality quota, and because premier club teams have their pick of the best players in Europe, many national club teams are now composed primarily of foreign players.13 In England, for example, two of the most popular club teams (Arsenal and Chelsea) typically start each game with only two or three English players out of eleven.14 UEFA leaders believe that the low number of domestic players has a negative impact on both fan morale and the development of high-quality national players.15 UEFA has therefore proposed a new rule ("Homegrown Rule") under which club teams will be required to employ a specific number of players (the current proposal is four) that have been trained within the club's development program, as well as a specific number (again four) who have been trained by any club within the national league. …


Article II of the 1967 Outer Space Treaty prohibits the extension of territorial sovereignty to celestial bodies and prevents sovereigns from supporting private citizens' property rights in such bodies, resulting in celestial anarchy. This paper argues that such anarchy poses no problem for sustaining enforceable private property rights in outer space. Economic theory and reality demonstrate that privately enforced property rights can and do emerge under terrestrial anarchy, suggesting that private enforcement can also sustain a property rights regime under celestial anarchy. Economically, at least, celestial anarchy is no threat to flourishing outer-space commerce.


Gut microbiota, the largest symbiont community hosted in human organism, is emerging as a pivotal player in the relationship between dietary habits and health. Oral and, especially, intestinal microbes metabolize dietary components, affecting human health by producing harmful or beneficial metabolites, which are involved in the incidence and progression of several intestinal related and non-related diseases. Habitual diet (Western, Agrarian and Mediterranean omnivore diets, vegetarian, vegan and gluten-free diets) drives the composition of the gut microbiota and metabolome. Within the dietary components, polymers (mainly fibers, proteins, fat and polyphenols) that are not hydrolyzed by human enzymes seem to be the main leads of the metabolic pathways of gut microbiota, which in turn directly influences the human metabolome. Specific relationships between diet and microbes, microbes and metabolites, microbes and immune functions and microbes and/or their metabolites and some human diseases are being established. Dietary treatments with fibers are the most effective to benefit the metabolome profile, by improving the synthesis of short chain fatty acids and decreasing the level of molecules, such as p-cresyl sulfate, indoxyl sulfate and trimethylamine N-oxide, involved in disease state. Based on the axis diet-microbiota-health, this review aims at describing the most recent knowledge oriented towards a profitable use of diet to provide benefits to human health, both directly and indirectly, through the activity of gut microbiota.


A compositional approach to air quality index (AQI) based on a log-contrast of pollutants over non-polluted air fraction was recently developed. This approach let to three open questions about consistency and formalization of such index. First question is to find out the conditions under which the approximation of the log-contrast by the logarithm of the geometric mean of pollutants concentrations, are reliable. Second, is to examine a way to define a reasonable scale for express air quality, taking into account the effects of air pollution on population health and on social or economic activity. The third one is to find out the properties of this kind of index with respect to the addition of a new set of air pollutants in the composition. To deal with these open questions, a decision making tree should be designed in order to select suitable weights on the air pollutants. A preliminary application study of air pollutants composition distribution in some cities is presented. In addition, the approach of the log-contrast by the logarithm of the weighted geometric mean is described for these cities.


This paper deals with damping modeling for transformer energization studies for system restoration purposes. A review of some of the literature recommendations for these studies is presented. Then, several damping models for generators, lines and transformers are benchmarked by means of simulation vs. field test measurements comparison. For the field test case considered, results show that simple models are as accurate as the more sophisticated frequency- dependent ones. A technique for automatized benchmark has been used that could be applied to other field test cases in order to draw general conclusions.


Strategies to promote implementation of school-based health promotion (HP) programmes should be designed to suit determinants of implementation and continuation. This study explored determinants of completeness of teachers' implementation of a healthy diet promotion programme and of their intention to continue the programme. Strategies for promoting complete and continued implementation of school-based HP programmes should be designed to suit such determinants. Teacher logbooks were used to assess completeness. Additionally, the teachers completed questionnaires before and after implementation on user-, programme-, context- and dissemination strategy-related determinants and their intention to continue the programme in the next school year. Non-parametric tests and logistic regressions were used to assess baseline-posttest changes in determinants and differences in determinants between teachers with levels of completeness and of intention to continue the programme. Variability in teachers' completeness of using the programme was best predicted by their perception of 'relative advantage' and 'compatibility' of the intervention programme. Teachers' intention to continue could be explained by 'perceived personal benefits', their perception of 'programme outcome feasibility' and on 'subjective norm from students'. Our explorative study indicates that HP professionals should target various user-, programme- and context-related determinants in their implementation strategy to improve completeness of programme implementation and continuation. Close collaboration with the users and members of the target group during the programme development phase is essential.


Many topics have been touched in this thesis. I would like to conclude with some answers to the questions raised in the initial problem description and point out further challenges in some cases. We have seen that there exist several approaches for CALL, with virtual learning communities as one example. The community presented here, moodle.org, is an open source framework and let any user register for free and manage a course. In that way may this framework be used by school institutions, professional language course providers and other users who feel free to organize a course. This environment is quite formal in nature, because most of the use at the portal is related to a registered course. Another portal, italki.com, offers language learning after the tandem method and users are free to search among all (visible) profiles on the sites to find a match. This is a more informal framework as the users are not connected to any established educational institution, they do not necessarily follow a curriculum and the learning is not instructed to follow any pedagogical principles. These portals may be accessed both in stationary and mobile environments (by mobile browsers). In the case of mobile environments there exist many challenges: Developers of the site are requested to take special considerations of how some material is to be structured to fit the interface at the user's terminal. One of the considerations at moodle.org was for instance to limit graphical content (illustrated in chapter 5.2.1), as this takes up much space on the screen and uses quite a bit bandwidth to download. Other challenges can be related to media richness and context awareness discussed in chapter two. One example could for instance be a video conference lecture held at a moodle course. If some of the users are in a mobile environment without the possibility to transfer video (because of terminal or bandwidth limitation), they should still be given the option of following the lecture by audio transmission. This will reduce the richness of the lecture, but they will be able to catch up the most essential things. BBC offers another kind of framework which is typically meant for beginner learners in a language. The material in 'Language steps' is instructional and interactive, as it requires response and apprehension from the users. This makes it most suitable for stationary environments, but the content could be presented in a mobile environment to. The 3 "Rearranging the dialogue" task will probably be suitable for a touch screen handheld. The content in the different modules could also be categorized to fit the current response flexibility of the user. An example of different categories was given in chapter 2. Another framework presented from the BBC portal was their show "The Flatmates". This is an internet based soap show where the episodes can be followed by downloadable tracks or simply be read. The users may contribute to the show with discussion about the characters and give feedback about how the show should continue. This is a good example of how the Internet can be used as a platform for participation among users. There also exist mobile applications like KODI's dictionary and Coolgorilla's audio phrase books. These can be categorized as referential tools and can be used in many settings, remarking that the audio phrase books in most cases are suited for beginners on vacation in the target language country. Chapter 6 discussed general possibilities and challenges related to technology and market trends. Web 2.0 was presented as the future trend of Internet usage and web design with key words as creativity, information sharing and collaboration between users (and companies). A survey, held by the Norwegian institute ITU has showed that Norwegian teenagers at average participate in 3,4 'network societies'. Facebook was the most popular. The biggest reason to participate in the networks was to meet friends. Only 8 percent answered that the networks provided help for school related topics. This shows that most of the interaction in these networks are informal among the teenagers. Could we still expect more participation in school related topics in such networks? The answer is yes, and no. The technology exists to promote school related subjects in these networks, but it would be a challenge to mix the pupils' (and the teacher's) roles in such a situation, as depicted in chapter 6.3. Hans Christian Arnseth also points out in [46] that the question about using more web 2.0 applications in the school system is much about ideology – "What do we regard as proper learning and how can/should technology be used in the education?". At last were some general challenges related to technology presented, with issues around convergence, human aspects, business models and policy as the main issues. Copyright policy and business models can be even more complicated in the evolution of web 2.0 interfaces, where content sharing and user participation goes hand in hand.


Marine mussels Mytilus edulis (L.) from 3 different age/size groups were exposed for 24 h to combined hypoxia and hyperthermia (28 k 1°C) and subsequently reimmersed in seawater at 10 k 1°C. Exposure to the physical stressor induced lysosomal destabilisation and enlargement in the digestive cells of mussels of all ages. Recovery of lysosomal integrity was demonstrated after 24 h in seawater by the youngest mussels (2-4 yr) only. Levels of unsaturated neutral lipids increased in all mussels followlng exposure and was associated with enlarged lysosomes No consistent pattern or significant change was observed in lipid levels in mussels of any age during the recovery period. Levels of lipofuscin (stress pigment) in mussels exposed to hypoxia and hyperthermia and in those subsequently reunmersed in seawater did not follow any consistent pattern, but were generally much higher in the youngest n~ussels than in the older age groups. Recovery of metabolic rates to control levels was observed 12 h after reimmersion in seawater in the youngest mussels only. Metabolic rates of the 6-8 and 210 yr mussels remained elevated relative to the controls after this time. These findings indicate that the stress reaction is independent of age but that the potential for recovery of lysosomal integrity and metabolic rate is age-related.


High level architecture (HLA) establishes a common simulation technology framework, which supports the linkage between different simulation models, and represents the latest development direction of the distributed simulated. Considering the unity and telescopic expandability of the network linkage interface, the simulation linkage engine development tool was designed and realized. Firstly, the basic characteristic of simulation linkage platform were analyzed, and then the solution of simulation linkage engine was provided during the design and development, finally, the viewable and general development tool supporting the distributed simulation linkage was designed, which provided a high-effective, flexible and shortcut integration platform.


At the molecular level, metal coordinates are crucial for stabilizing an appropriate electronic configuration for high-efficiency oxygen reduction reaction (ORR) electrocatalysts. In this work, an excellent platform to realize the decoration of Fe coordinates at the subnanometer scale into nitrogen-doped carbon networks (designated as Fe–Fe@NC) is provided. X-ray absorption spectroscopy confirmed the precise configuration of Fe coordinates with Fe–Fe and Fe–N coordinations at the molecular level. As a cathode catalyst, the newly developed Fe–Fe@NC exhibited superior ORR performance and a higher peak power density of 175 mW cm−2 in Zn–air batteries. Unlike most reported pristine Fe-based catalysts, Fe–Fe@NC also showed good oxygen evolution reaction (OER) activity, with a low operating potential (1.67 V vs. RHE) at a current density of 10 mA cm−2. Calculations based on density functional theory revealed that the Fe–Fe coordination in Fe subclusters favored the 4e− transfer pathway and, thus, achieved highly active catalytic performance. This work reveals that iron clusters at the subnanometer scale provide an optimized electronic structure for enhanced ORR activity.


This paper presents a neural network based scheme for human face detection and eye localization in color images under an unconstrained scene. A self-growing probabilistic decision-based neural network (SPDNN) is used to learn the conditional distribution for each color classes. Pixels of a color image are first classified into facial or non-facial regions, then pixels in the facial region are followed by eye region segmentation. The class of each pixel is determined by using the conditional distribution of the chrominance components of pixels belonging to each class. The paper demonstrates a successful application of SPDNN to face detection and eye localization on a database of 755 images from 151 persons. Regarding the performance, experimental results are elaborated. As to the processing speed, the face detection and eye localization processes consume approximately 560 ms on a Pentium-II personal computer.


Agribusiness, farm business and agricultural-environmental decisions which varied in their characteristics were used to evaluate multiple criteria decision making (MCDM) in an agricultural context. This paper discusses differences between the case studies, strengths and weaknesses of the methods used, and the success of the MCDM process based on participants' expectations and experiences. While MCDM can help identify the best decision, the main benefits identified in using MCDM included better understanding of their own and other's perspectives, a means to explain the decision and a structured way to work through the decision process. Key problem areas identified included time limitations, understanding and ownership.


ABSTRACT Analogous to observations in RNA viruses such as human immunodeficiency virus, genetic variation associated with intrahost dengue virus (DENV) populations has been postulated to influence viral fitness and disease pathogenesis. Previous attempts to investigate intrahost genetic variation in DENV characterized only a few viral genes or a limited number of full-length genomes. We developed a whole-genome amplification approach coupled with deep sequencing to capture intrahost diversity across the entire coding region of DENV-2. Using this approach, we sequenced DENV-2 genomes from the serum of 22 Nicaraguan individuals with secondary DENV infection and captured ∼75% of the DENV genome in each sample (range, 40 to 98%). We identified and quantified variants using a highly sensitive and specific method and determined that the extent of diversity was considerably lower than previous estimates. Significant differences in intrahost diversity were detected between genes and also between antigenically distinct domains of the Envelope gene. Interestingly, a strong association was discerned between the extent of intrahost diversity in a few genes and viral clade identity. Additionally, the abundance of viral variants within a host, as well as the impact of viral mutations on amino acid encoding and predicted protein function, determined whether intrahost variants were observed at the interhost level in circulating Nicaraguan DENV-2 populations, strongly suggestive of purifying selection across transmission events. Our data illustrate the value of high-coverage genome-wide analysis of intrahost diversity for high-resolution mapping of the relationship between intrahost diversity and clinical, epidemiological, and virological parameters of viral infection.


The objective of this study was to determine whether methylcobalamin inhibits the ototoxic action of gentamicin. Fourteen pigmented guinea pigs were randomly divided into experimental and control groups. Each animal in the experimental group was given a large single dose of gentamicin (125 mg/kg i.m.), followed by immediate administration of methylcobalamin (1 mg kg i.m.). In the control group, the animals received gentamicin only, at the same dose as the experimental group. The compound action potentials (CAPs) in the right ears of animals were measured using a signal processor before and 15, 30, 45, 60 and 75 min after injection of the drugs. The sound stimulus was presented by means of clicks and tone pips at 2, 4 and 8 kHz. Following the electro-physiological tests, the animal was sacrificed and prepared for scanning electron microscopic observation. There was prolongation of latency and diminution of amplitude of CAPs N1 and N2 15 min after injection of gentamicin. Although the N1-N2 intervals increased as the time after injection of gentamicin increased, the variations were still within normal ranges. In contrast, there was no prolongation of N1 latencies or N1-N2 intervals 30 min after injection in the experimental group. There were no marked changes in N1 or N2 amplitudes, compared with the results before injection, in the experimental group. The firing mechanism of the inner ear may be affected by a single dose of gentamicin. This suggests that the transient ototoxic action of gentamicin hardly affected the conductive function of the nerve fibres, even though the firing function of the inner ear was influenced. Methylcobalamin may inhibit the ototoxic side effects of gentamicin.


Despite the fact that grade retention is now seen as controversial in many quarters, it remains common practice in numerous countries. Previous research on the effects of grade retention on student development has, however, generated ambiguous results, particularly in terms of motivational outcomes. This ambiguity has been attributed in part to a lack of high-quality studies including a longitudinal design, a suitable comparison group, and adequate statistical control of preretention differences. Based on longitudinal data of N = 3,288 German students over 3 years of secondary school, we examined differences in their academic self-concept, scholarly interests, learning motivation, and achievement motivation between those being retained in the 6th grade (n = 61) and those of the same age being promoted annually. To account for confounding variables, we applied full propensity score matching on baseline measures of the dependent variables, as well as various other covariates that have been found to be associated with the risk of retention (e.g., cognitive ability, academic performance, and family background variables). Results reveal a steep decline in students' academic self-concept, interests, and learning motivation during the last months spent in the original class, just before retention. For those measures that were available, negative effects were still partly significant after 1 year, but had diminished 2 years after grade retention. Contrary to predictions suggested by the big-fish-little-pond effect, we found no positive effects of retention on students' academic self-concept. (PsycINFO Database Record (c) 2019 APA, all rights reserved)