Background :  Stigma or negative discriminatory attitudes towards psychiatric patients are common in the general public. These attitudes are also demonstrated by medical practitioners and by medical students, which can lead to medical harm to psychiatric patients. This study aimed to improve attitudes of medical students towards psychiatric patients before their clinical rotations. Methods :  Second year preclinical medical students participated in a brief structured early clinical experience which involved introduction to a psychiatric patient in a hospital/clinic setting or in a community vocational setting. Students were randomized to either setting. Data were collected one week before, one week after, and 3 months after the early clinical experience by administering the Medical Condition Regard Scale. Results :  The students' attitudes towards psychiatric patients improved, particularly at follow up. Only male student attitudes improved significantly. Conclusion :  Further study is required to understand and improve medical students' attitudes towards psychiatric patients, perhaps particularly in relation to female students' attitudes.


Meiotin-1 is a protein found in developing microsporocytes of Lilium longiflorum, and immunological assays indicate that cognates exist in both mono- and dicotyledonous plants. Its temporal and spatial expression pattern, coupled with its unusual distribution in chromatin and the properties it shares with histone H1, encourages speculation that it is involved in regulating meiotic chromatin structure. Molecular analyses provide support for the hypothesis that meiotin-1 arose from histone H1 by an exon shuffling mechanism, as meiotin-1 is an H1-like protein that lacks the amino-terminal domain shared by H1 molecules. We have proposed that meiotin-1 serves to limit chromatin condensation in order to foster the unique cytological and molecular events which occur during meiotic prophase. As such, meiotin-1 fits the role of a 'meiosis readiness factor', and its accumulation to a threshold level may commit mitotically dividing progenitor cells to differentiate into meiocytes.


The coke-wastewater contained all the pollutants which are the aromatic compounds and heterocyclic compounds with benzene ring. Under the normal conditions, it is difficult to obtain good results. By the microbial metabolism of the theory , it is easy to microbial degradation. The use of the primary matrix improves the degradation rate of organic matter .we studied some co-metabolism of carbon and nitrogen sources which affect the bacteria in the degradation of coke-wastewater to remove ammonia and COD. At the same kind of reaction conditions, the removal rate of COD and ammonia nitrogen increase the maximum extent by the addition of glucose and NaNO2. Alkaline substances promote the degradation efficiency.


ABSTRACT When was archaeology first practised in the Pacific as a distinct discipline – that is, following a prescribed set of field methods to investigate human change over time, different from those used for other areas such as ethnology, geology, or linguistics? Did Pacific archaeology develop as the application of a metropolitan model, or did it evolve in situ, progressing in fits and starts and communicated only sporadically? We approach these questions by exploring the nature of early archaeological practice in the Pacific from the 1870s to the 1900s, as it was imagined in metropolitan manuals and instructions issued by German and British institutions, and comparing this with the development of actual practices in the field. We also discuss how early archaeological excavations and artefacts (prehistoric material culture) from the Pacific were interpreted, in prescription and in practice, and consider how these interpretations related to European perceptions of Pacific peoples.


The operating environment of the service personnel during the Persian Gulf War involved psychological, biological, and chemical elements including exposure to pesticides such as the insect repellent DEET (N,N-diethyl-m-toluamide) and the insecticide chlorpyrifos (O,O-diethyl O-3,5,6-trichloropyridinyl phosphorothioate) and to pyridostigmine bromide (PB,3-dimethylaminocarbonyloxy-N-methylpyridinium bromide) that was administered as a prophylactic agent against possible nerve gas attack. The present study was designed to determine the toxicity produced by individual or coexposure of hens 5 days/week for 2 months to 5 mg PB/kg/day in water, by gavage; 500 mg DEET/kg/day, neat, sc; and 10 mg chlorpyrifos kg/day in corn oil, sc. Coexposure to various binary treatments produced greater neurotoxicity than that caused by individual exposures and was characterized by severe neurologic deficit and neuropathological alterations. Also, neurotoxicity was further enhanced following concurrent administration of the three chemicals. Severe inhibition of plasma butyrylcholinesterase (BuChE) activity was produced in hens treated with PB (activity 17% of control) compared to those treated with chlorpyrifos (activity 51% of control) or DEET (activity 83% of control). BuChE inhibition was further increased in binary and tertiary treatment groups compared to individual treatment groups. In contrast, a significant inhibition of brain acetylcholinesterase (AChE) was produced in hens administered chlorpyrifos alone (activity 67% of control), while those given chlorpyrifos in combination with other compounds exhibited a significant inhibition of brain AChE activity ranging from 43 to 76%. Brain neurotoxicity target esterase (NTE) was not inhibited in any of the individual treatment groups or PB/DEET, but was significantly inhibited and had activity expressed as a percentage of control in groups administered combined chlorpyrifos with PB of 73% or DEET of 74% and in the tertiary treatment group of 71%. We hypothesize that test compounds may compete for xenobiotic metabolizing enzymes in the liver and blood and may also compromise the integrity of the blood-brain barrier, leading to an increase in their "effective concentrations" in the nervous system to levels equivalent to the toxic doses of individual compounds. This is consistent with the present observation of increases in (1) the inhibition of brain AChE and NTE, (2) the extent of neurologic dysfunction, and (3) the severity and frequency of neuropathologic lesions in the combined treatment groups compared to those administered individual compounds.


Due to the worrying increase in antimicrobial resistance to conventional antibiotics, the search for alternatives is becoming increasingly important. Antimicrobial peptides (AMPs), originating from natural resources, have been recognised as a novel class of antibiotics. An advantage of peptides over antibiotics is that the resistance is more difficult to attain than for conventional antibiotics. With the increasing number of genomes sequenced and available in the public domain, one alternative methodology to obtain novel AMPs is to analyse genes and proteins from genomic databases to predict and identify amino acid sequences that share similarities and molecular features with natural bioactive antimicrobial peptides. In this chapter, we summarise some of our recent results on the production of antimicrobial peptides, particularly, how we managed to identify a family of antimicrobial peptides: cathelicidins, through bioinformatics tools, from the genomes of two lower vertebrates (a reptile and a bird) available in public databases. We hope that our preliminary investigation with these novel peptides could be useful for the design of future strategies that pursue the production of antimicrobial peptides through biotechnology.


Heart failure is an important and ever expanding sub-specialty of cardiology. Many health care professional bodies are now developing specialist expertise in heart failure. This book comprehensively covers all aspects necessary to manage a patient with heart failure. It gives simple, clear advice on the diagnosis, investigation and treatment options available, highlighting the current evidence-base. The chapters provide concise and objective information to guide all health care professionals involved in modern day multi-disciplinary management of the syndrome. The book is set out logically to mirror the patient journey in heart failure.


We present a rare case of squamous cell carcinoma that arose deeply in the abdominal wall, 10 years after abdominal dermolipectomy and wall repair by dermal-adipose graft was performed. The patient presented a 10-cm-diameter subcutaneous tumor that was ulcerated on its superficial aspect, adherent to deep tissues. After histologic examination, we tried to remove the neoplastic mass in a radical way. The surgical defect was repaired with a bilateral tensor fasciae latae flap. The extension, aggressiveness, and deep localization of the malignancy led to the patient's death. In this article, we also analyze a different hypothesis about the origin of squamous cell deep carcinomas and the related literature.


You're no idiot, of course. You know that over the last 100 years, we've seen it all--world war, depression, assassinations, moon landings, an impeachment, and more. But when it comes to really understanding the significance of these events, you feel like you're scaling Mount Rushmore itself. Don't jump off Roosevelt's nose! With The Complete Idiot,s Guide to 20th-Century History, you'll discover the most significant people, ideas, and events that shaped this century--in terms anyone can understand. In this Complete Idiot's Guide, you get:


Social science informs about the ideals and trains experts to deal with the complex social realities. It has a public purpose rooted in what we call dharma (professional and institutional responsibility) as opposed to the arrogance of reason, self-will and self-rationalization intrinsic to contemporary rational choice and modernity. Learning has a synergy - establishing connection between the world of social science theories and the drama of social life. A lack of mutual learning between Nepal's traditional faith intellectuals and modern reason-based social scientists has created a big hiatus and contradiction. The academic life of social scientists in Nepal is completely outside of spiritual, moral and ethical influence experienced by ordinary public. The spiritual blindness of modern social scientists has thus opened multiple gaps between their worldview and those of the citizens on various frontiers--theoretical knowledge and practical experience, technical understanding and composite knowledge and secularity of social science and the vitality of the Hindu-Buddhist scriptures in the popular mind, culture, behavior and practices. This has reinforced a division between the system of knowledge of social scientists and the life-world of people. The proponents of new social movements in Nepal, such as women, Dalits, Janajatis, Madhesis, youths and marginalized population are seeking a structural shift in reason-based knowledge to both reason and feeling in social science knowledge discovery. This movement can open the "captive mind" to social learning of contextual knowledge, conduct research with the citizens, provide inputs to the policy makers and reverse their linear, structure-bound, rationalist and disciplinary thinking into the one that represents what the Nepal mandala, the Nepali space, is really like and how to improve it for the better. The renewal and indigenization of qualitative social science research is important to overcome the spirited challenges posed by social forces in Nepal and contribute to the application of scientific reasoning in public policy and social change. Key Words: social movement, Nepal DOI = 10.3126/dsaj.v2i0.1356 Dhaulagiri Journal of Sociology and Anthropology Vol.2 pp.1-30


Of a series of carbocyclic analogs of adenosine, in which the ribose moiety was replaced by a cyclopentenyl ring, neplanocin A, or (-)-9-[trans-2, trans-3-dihydroxy-4-(hydroxymethyl)cyclopent-4-enyl]adenine proved particularly effective in inhibiting the multiplication of DNA viruses (i.e., vaccinia), (-)RNA viruses (i.e., parainfluenza, measles, and vesicular stomatitis), and double-stranded RNA viruses (i.e., reo) in vitro in cell culture. Depending on the cells used, the MIC of neplanocin A for these viruses ranged from 0.01 to 4 micrograms/ml, and depending on the parameter used to assess toxicity for the host cell, the specificity index of neplanocin A ranged from 50 to 4,000. As postulated before for other adenosine analogs, neplanocin A may owe its antiviral action to inhibition of S-adenosylhomocysteine hydrolase, hence perturbation of transmethylation reactions. In vivo, neplanocin A afforded only marginal protection against a lethal infection of mice with vesicular stomatitis virus.


Venomous snakebite is considered the single most important cause of human injury from venomous animals worldwide. Coagulopathy is one of the commonest important systemic clinical syndromes and can be complicated by serious and life-threatening haemorrhage. Venom-induced consumption coagulopathy (VICC) is the commonest coagulopathy resulting from snakebite and occurs in envenoming by Viperid snakes, certain elapids, including Australian elapids, and a few Colubrid (rear fang) snakes. Procoagulant toxins activate the clotting pathway, causing a broad range of factor deficiencies depending on the particular procoagulant toxin in the snake venom. Diagnosis and monitoring of coagulopathy is problematic, particularly in resource-poor countries where further research is required to develop more reliable, cheap clotting tests. MEDLINE and EMBASE up to September 2013 were searched to identify clinical studies of snake envenoming with VICC. The UniPort database was searched for coagulant snake toxins. Despite preclinical studies demonstrating antivenom binding toxins (efficacy), there was less evidence to support clinical effectiveness of antivenom for VICC. There were no placebo-controlled trials of antivenom for VICC. There were 25 randomised comparative trials of antivenom for VICC, which compared two different antivenoms (ten studies), three different antivenoms (four), two or three different doses or repeat doses of antivenom (five), heparin treatment and antivenom (five), and intravenous immunoglobulin treatment and antivenom (one). There were 13 studies that compared two groups in which there was no randomisation, including studies with historical controls. There have been numerous observational studies of antivenom in VICC but with no comparison group. Most of the controlled trials were small, did not use the same method for assessing coagulopathy, varied the dose of antivenom, and did not provide complete details of the study design (primary outcomes, randomisation, and allocation concealment). Non-randomised trials including comparison groups without antivenom showed that antivenom was effective for some snakes (e.g., Echis), but not others (e.g., Australasian elapids). Antivenom is the major treatment for VICC, but there is currently little high-quality evidence to support effectiveness. Antivenom is not risk free, and adverse reactions can be quite common and potentially severe. Studies of heparin did not demonstrate it improved outcomes in VICC. Fresh frozen plasma appeared to speed the recovery of coagulopathy and should be considered in bleeding patients.


This paper is concerned with the optimization of composite housing in a multi-spectral camera using Kriging algorithm. The effective use of Kriging on physical problems has been expanded to provide global approximations for optimization problems. There are two major strategies to improve efficiency and accuracy of approximate optimization using Kriging. These methods are performed by the stochastic process, stochastic-localization method (SLM), as the criterion to move the local domains and the design of experiment (DOE), the classical design and space-filling design. The proposed methodology is applied to the design of a Multi-Spectral Camera (MSC), as a practical example, which will provide high resolution panchromatic and multi-spectral images and is carried by a satellite designed to fulfill the need for further Earth observation and allowing scientists and communication experts to conduct potentially valuable experiments. When this composite structure is optimized, design constraints are taken for natural frequency and shear stress which should be considered in a launching environment.


The current observed global warming is projected to intensify by the end of the 21st century. According to simulations of the climate system and its impacts on populations, previous studies show significant projected impacts on four main sectors: water, health, energy and agriculture. Concurrent analyses have also focused on the time of emergence (ToE) of future climate modifications to assess when new climate regimes will emerge from a prior reference. Here we propose to investigate the timing and the emergence of global warming impacts on populations over three main vulnerable regions: Western Africa (WAF), Eastern Africa (EAF) and South-eastern Asia (SEA). We propose to analyse multi-sectoral impacts that may affect human being by accounting for (but not limited to) 6 fields: crop failure, water scarcity, health, droughts, floods, and heatwaves. The ISIMIP2b protocol (phase 2b of the Intersectoral Impact Model Intercomparison Project), which provides simulated impacts from 1 to 8 sectoral impact models and four CMIP5 (5th phase of the Coupled Model Intercomparison Project) climate models, is used in this study.

              Preliminary results under the RCP8.5 future climate scenario show a strong acceleration of the decrease of the annual maize yields before 2048 in WAF and EAF according to the CLM45 impact model, suggesting a significant emergence at this time. No particular fluctuation from the long-term trend is shown in SEA. CMIP5 climate forcing (i.e. GFDL-ESM2M, HadGEM2-ES, IPSL-CM5A-LR and MIROC5) responses in maize yields exhibit larger uncertainties over EAF than over WAF and SEA. Drought metrics such as the annual number of consecutive dry days (i.e. daily precipitations < 1mm) and the annual number of periods with more than 5 consecutive dry days show an acceleration of their increases around 2052 in WAF with large climate forcing uncertainties, but no significant emergence over EAF and SEA. Flood metrics from the ORCHIDEE impact model simulations do not exhibit particular fluctuation nor acceleration of the change during the 21st century in the three regions. The next step of our study is to quantify the ToE of the significant fluctuations compared to the long-term trends of the different metrics that cover every impact sectors. The Kolmogorov-Smirnov test (‘KS-test’) method will be applied as the statistical approach to quantify the ToE independently from the signal shape. Impact models uncertainties will also be quantified compared to the climate model uncertainties, in order to assess whether impact or climate modelings is the main driver of the total uncertainties when studying the emergence of the impacts of global warming.


Innovation Education (IE) is a new subject area in Icelandic schools. The aim of the
subject is to train students to identify needs and problems in their environment and to
develop solutions: a process of ideation. This activity has been classroom based but
now a Virtual Reality Learning Environment technology (VRLE) has been designed to
support ideation. This technology supports online communications between students
and teacher and enables them to develop drawings and descriptions of their solutions.
The VRLE is network based and the students work online in the school with their ideas
in real time.
As this learning environment is new it is important to explore and evaluate its use and
value. This paper describes the basic IE pedagogical model and the subsequent
development of the VRLE. These are discussed in relation to constructivist learning
theories. The paper also contains contemplation about future research to develop the
pedagogical understanding for using VRLE to support the development of ideation skills
inside of the innovation process.


The purpose of this thesis is to present information about some of the circumstances experienced by the player in professional football. The writer wishes to present material that will help the general public and the prospective new players to understand more fully the role of the player in professional football. This study contains information pertinent to professional football. An effort has been made to present the facts pertaining to professional football, to the many aspects and ramifications of contractual negotiations, and to the life of professional football players during the football season. The final chapter contains an evaluation of professional football from the standpoint of the player.


In 1860, Queen Victoria sent her eighteen-year-old son, Albert Edward, Prince of Wales, on a goodwill mission to Canada and the United States. The young heir-apparent (later King Edward VII) had not yet gained his reputation as a fashion setter and rake, but he nevertheless attracted enormous crowds both in Canada, where it was the first royal visit, and in the United States. Civic leaders hosted the visitor in princely style, decorating their towns with triumphal arches and organizing royal entries, public processions, openings, and grand balls. In Royal Spectacle, Ian Radforth recreates these displays of civic pride by making use of the many public and private accounts of them, and he analyses the heated controversies the visit provoked. When communities rushed to honour the prince and put themselves on display, social divisions inadvertently became part of the spectacle seen by the prince and described by visiting journalists. Street theatre reached a climax in Kingston, where the Prince of Wales could not disembark from his steamer because of the defiance of thousands of Orangemen dressed in their brilliant regalia and waiving their banners. Contemporary depictions of the tour provide an opportunity to interpret the cultural values and social differences that shaped Canada during the Confederation decade and the United States on the eve of the Civil War. Topics explored include Orange-Green conflict, First Nations and the politics of public display, contested representations of race and gender, the tourist gaze, and meanings of crown and empire. An original and erudite study, Royal Spectacle contributes greatly to historical research on public spectacle, colonial and national identities, Britishness in the Atlantic world, and the history of the monarchy.


In January 2022, the Supreme Court decided two major cases reviewing the legality of sweeping Covid-19 vaccine mandates imposed by the Biden Administration. In National Federation of Independent Business v. Occupational Safety and Health Administration, a 6-3 ruling invalidated a regulation requiring employers with 100 or more workers to compel nearly all of them to get vaccinated against Covid or wear masks on the job and take regular Covid tests. In Biden v. Missouri, decided the same day, a 5-4 Court upheld a Centers for Medicare and Medicaid Services (CMS) policy requiring health care workers employed by institutions receiving federal Medicare and Medicaid funds to get vaccinated. Both cases addressed large-scale policies that were significant in their own right. The two cases also have important implications for the scope of executive power to set regulations (NFIB) and impose conditions on federal grants to state and local governments (Biden v. Missouri). The majority was justified in striking down the OSHA employer mandate because Congress had never clearly authorized it, and also justified in upholding the CMS mandate because it was backed by far more unequivocal statutory authorization. NFIB v. OSHA reaffirmed important constraints on the executive's power to decide a "major question" of policy on its own, while also giving an indirect boost to constitutional nondelegation constraints on the transfer of legislative power to the White House and the administrative state. For its part, Biden v. Missouri makes clear that the executive can exercise reasonable discretion when Congress does clearly authorize it, particularly in the context of attaching conditions to federal grants to state and local governments. Part I of this article provides a brief overview of the history of the two cases and the policies they address. It is particularly notable that both were sweeping emergency measures enacted in response to the Covid pandemic, and both reached the Supreme Court on a heavily expedited basis. I also summarize the Supreme Court's rulings. Part II defends the outcome in NFIB v. OSHA, but also criticizes key elements of the Court's reasoning. Part III assesses Biden v. Missouri. In this case, the Court's statutory reasoning is compelling. But the justices erred in failing to address some crucial issues related to Congress's Spending Clause authority to set conditions on federal grants to state and local governments. Finally, part IV considers some broader implications of the two rulings. Americans across the political spectrum have much to gain from judicial enforcement of limits on executive power. The kind of sweeping unilateral authority the Biden administration claimed in NFIB could easily have been misused by future presidents of both parties. The Court's sensible statutory interpretation in Biden v. Missouri also bodes well for the future.


Three children, 2 of them siblings, developed a progressive dystonic condition in the first decade of life. The symptoms and signs were milder in the mornings or after a daytime nap but worsened greatly later in the day. One patient became unable to walk by evening. Investigations in 2 patients revealed a reduced concentration of cerebro-spinal fluid homovanillic acid. The 2 more severely affected patients showed dramatic and sustained improvement with levodopa therapy. The condition bears a clinical resemblance to some reported cases of juvenile Parkinson's disease but is probably a separate disorder. Ouvrier RA: Progressive dystonia with marked diurnal fluctuation.


Little has been reported on whether abnormal lipid metabolism affects hydrocephalus, although congenital malformations and infectious diseases are major causal factors for hydrocephalus development. In a study on the pathogenesis of atherogenesis in mice, we unexpectedly discovered that hydrocephalus occurred in partial apolipoptotein E (apoE) and low-density lipoprotein receptor (LDLR) double-knockout (apoE−/−/LDLR−/−) mice fed either chow or a high-fat and high-cholesterol diet between the ages of 4 and 12 weeks. In the 12-week-old high-fat and high-cholesterol group, the incidence rate was as high as 15%. Transcription levels of transforming growth factor-&bgr;1 (TGF-&bgr;1), Smad3, Smad4, and Smad7 in the cortex of the hydrocephalic cerebrum were significant downregulated in 4-week-old mice, but were increased in the 8 and 12-week-old groups compared with that of age-matched nonhydrocephalic mice. The mRNA level of tissue inhibitor of metalloproteinases 1 was significantly increased, whereas matrix metalloproteinase-9 was lower in hydrocephalic mice of all ages. The translation level of TGF-&bgr;1 increased in the hydrocephalic brains of 8 and 12-week-old mice. This study provides primary evidence for the connection between lipid metabolic disorder and hydrocephalus development. This may suggest that both hyperglyceridemia and hypercholesterolemia are harmful factors in hydrocephalus development because of adverse effects on TGF-&bgr;1/Smad signaling in the brain.


The incidence of transurethral resection of the prostate (TURP) and indications for prostatectomy are compared among earlier studies with the preliminary results of a recent national cooperative study of 3,885 patients undergoing transurethral prostatectomies at thirteen health centers in the United States. Clinical evidence indicates that TURP continues to be a successful procedure, with 97 percent of patients doing well in the first four months postoperatively in the most recent study. Although the incidence of TURP-related morbidity has been relatively consistent among three large-scale studies conducted during the past three decades, mortality has steadily declined from 2.5 percent to 0.2 percent.


A method is described for the generation of related natural-language expressions. The method is based on a formal grammar of the natural language in question, specified in the Controlled M-Grammar (CMG) formalism. In the CMG framework the generation of an utterance is controlled by a derivation tree, which is a semantics-oriented prescription of the order in which the components of the grammar have to be used. The method described here uses templates, partial specifications of derivation trees. Related expressions can be generated by filling up a template in various ways. It will be shown that a considerable number of related expressions can be generated by varying only a small number of items. The method is used for the generation of training material in a computer-aided language-learning (CALL) system.


We assessed craving and smoking in response to smoking-relevant cues. Two hundred seven daily smokers viewed images related to 1 of 6 cue sets (cigarettes, positive and negative affect, alcohol, smoking prohibitions, and neutral cues) in separate sessions. Compared with neutral cues, cigarette cues significantly increased craving, and positive affect cues significantly decreased craving. When subjects were then allowed to smoke during continuing cue exposure, cues did not affect the likelihood of smoking or the amount smoked (number of cigarettes, number of puffs, puff time, or increased carbon monoxide). However, craving intensity predicted likelihood of smoking, latency to smoke, and amount smoked, with craving increases after cue exposure making significant independent contributions. Some craving effects were curvilinear, suggesting that they are subject to thresholds and might not be observed under some circumstances.


We report a facile synthesis of ultrathin (2.5 nm) trimetallic FePtPd alloy nanowires (NWs) with tunable compositions and controlled length (<100 nm). The NWs were made by thermal decomposition of Fe(CO)(5) and sequential reduction of Pt(acac)(2) (acac = acetylacetonate) and Pd(acac)(2) at temperatures from 160 to 240 °C. These FePtPd NWs showed composition-dependent catalytic activity and stability for methanol oxidation reaction. Among FePtPd and FePt NWs as well as Pd, Pt, and PtPd nanoparticles (NPs) studied in 0.2 M methanol and 0.1 M HClO(4) solution, the Fe(28)Pt(38)Pd(34) NWs showed the highest activity, with their mass current density reaching 488.7 mA/mg Pt and peak potential for methanol oxidation decreasing to 0.614 V from 0.665 V (Pt NP catalyst). The NW catalysts were also more stable than the NP catalysts, with the Fe(28)Pt(38)Pd(34) NWs retaining the highest mass current density (98.1 mA/mg Pt) after a 2 h current-time test at 0.4 V. These trimetallic NWs are a promising new class of catalyst for methanol oxidation reaction and for direct methanol fuel cell applications.


Many applications rely on the ultra-precise timing of optical signals through fiber, such as fiber interferometers, large telescope arrays, in phase arrayed antennae, optical metrology, and precision navigation and tracking. Environmental changes, specifically those caused by temperature fluctuations, lead to variations in the propagation delay of optical signals and thereby decrease the accuracy of the system's timing. The cause of these variations in delay is the change in the glass properties of the optical fiber with temperature. Both the refractive index of the glass and the length of the fiber are dependent on the ambient temperature. Traditional optical fiber suffers from a delay sensitivity of 39 ps/km/K. We are reducing the temperature sensitivity of the fiber delay through the application of a novel design of optical fiber, Anti-Resonant Hollow Core Fiber. The major improvement in the thermal sensitivity of this fiber comes from the fact that the light is guided in an air core, with very little overlap into the glass structure. This drastically reduces the impact that the thermally sensitive glass properties have on the propagation time of the optical signal. Additionally, hollow core fiber is inherently radiation insensitive, due to the light guidance in air, making it suitable for space applications.


Chronic gastritis is one of the common diseases of the digestive system characterized by many uncomfortable clinical symptoms, and the patient with chronic gastritis has a lower quality of life. Chinese medicine is a branch of medicine in the world, and it has special theory; different methods have been used to treat gastritis for more than 1000 years. We aimed to introduce the special theory and the different methods of Chinese medicine and about its syndrome classification, syndrome differentiation and treatment, diagnosis and treatment process, and criterion of therapeutic effect of chronic gastritis. The mechanism of Chinese medicine on chronic gastritis needs further research.


Antibiotic resistance has become a major public health concern and mathematical models are important analytical tools for the understanding, evaluation and prediction of the resistance problem and related control strategies.The risk of emerging antibiotic resistance and selection has rarely been a concern in the design of antibiotic drug dosing regimens. In the first paper, a selection of antibiotic resistant subpopulations for different antibiotic dosing regimens was studied in vitro. The demonstrated complex relationship was influenced by both the rise of new mutants and a postantibiotic effect (PAE) (continued inhibition of bacterial growth after removal of the antibiotic drug). By constructing a mathematical model that incorporated biologically relevant parameters, we were able to assess the risks of resistance development under different dosing strategies.In the second paper, the model for PAEs is further developed to determine the implications for different dosing regimens. The result challenges the conventional notion that long PAEs promote extended drug dosing intervals and it allows new hypotheses to be tested experimentally based on the findings from the theoretical framework.Since PAE experiments often are time-consuming and laborious, very few studies have been reporting variation for this phenomenon. In the third paper, an extension to capture the stochastic behavior of bacterial population growth under drug exposure is made. The stochastic nature of the model is also an important complement to the existing deterministic models on drug dose drug effect relationships.The last paper describes a controlled clinical intervention study aiming at determining whether the frequency of trimethoprim resistance in E. coli can be decreased by a sudden and drastic reduction in trimethoprim use. In addition to evaluating the intervention effect, the model, given estimated parameters, is also used for predicting other interesting outcomes.


At present, the attention of specialists is drawn to a new highly pathogenic strain of influenza A (H1N1) 2009, first isolated from cases in late March-April 2009 in California and Mexico, the spread of which led to a pandemic, which was announced by WHO on June 12, 2009. The aim of the study. Conduct a randomized cohort study of therapies for pregnant women with acute respiratory infections. Materials and research methods. To achieve this goal, 45 pregnant women were examined. Pregnant women were included in the examination at 12 weeks of gestation. All patients signed written consent to participate in the experiment. Of the total number of examined 22 pregnant women who did not have somatic pathology made up a comparative group. 23 pregnant women suffered influenza of varying severity in the I-II trimesters of pregnancy. The diagnosis of highly pathogenic influenza A H1N1 was confirmed by virologic testing. Of the 23 pregnant women, the main group consisted of 14 pregnant women who were treated with Viferon the main group and 9 pregnant women who were treated with symptomatic therapy. Research results. However, in 43% of women, ARVI symptoms developed gradually over several days, which was the reason for the later admission of patients to the hospital and was often associated with the development of bacterial complications in the form of sinusitis, otitis media, acute community-acquired pneumonia or complications during pregnancy (threat of termination) ... From the analysis of the case histories, it was found that from the moment the first symptoms of acute respiratory viral infections appeared to hospitalization, it took from 2 to 7 days, on average 3.8 ± 1.2 days. In the 1st group of patients, antiviral therapy was prescribed from the first day of admission to the hospital. The effectiveness of treatment was assessed by the duration of clinical symptoms of the disease, the development of complications and pregnancy outcomes. Typical manifestations of ARVI in pregnant women upon admission to the hospital were: rhinitis in 82% of patients, cough in 64.2% of pregnant women, sore throat in 57.1% of women. Dyspeptic manifestations in the form of nausea, vomiting, diarrhea occurred in 5.2% of patients. Intoxication symptoms in the form of weakness, chills, headache were recorded in 86% (20 women). European Journal of Molecular & Clinical Medicine ISSN 2515-8260 Volume 07, Issue 02, 202


Continued growth in the use of thermoplastic composites for structural components in the aerospace industry due, primarily, to the design flexibility, excellent mechanical properties and low density, combined with the high values of strength and stiffness and low incidence of corrosion meeting the stringent performance requirements of these structures while in service. However, components that requires structural requirements when exposed to harsh environments such as high temperature and moisture, can have their mechanical properties reduced by these environmental factors, and should be carefully evaluated before being placed in service. Although there are several studies in the literature reporting this problem for structural composites, few studies relate in a systematic way, assessing the moisture absorption with the viscoelastic behavior of PPS matrix reinforced with carbon fibers, when the composite is used in aeronautical applications. Thus, the aim of this study is to evaluate the influence of hygrothermal conditioning on the viscoelastic properties of PPS/carbon fiber composites. The results show that the laminates conditioned in a hygrothermal chamber had moisture absorption according to Fick laws, but it was not observed a significant glass transition temperature variation when compared conditioned and not conditioned specimens.


The authors state and prove a theorem solving the problem of commutativity in two dimensions. It is shown under which conditions upsampling and downsampling can be interchanged in two dimensions. This is the generalization to arbitrary two-dimensional lattices of the result that one-dimensional upsampling and downsampling commute if and only if their sampling rates are coprime. Some illustrative examples are given. The result holds for arbitrary sampling lattices. >


By using the mathematical uniform design, a new agglomerated flux for high speed and multi-arc submerged arc welding (SAW) has been developed in this paper, which performs excellently in welding process, and the effects of flux composition on the welding characteristics is analyzed as well. The mechanical tests show that the weld metal obtained in SAW with this flux exhibits high toughness at low temperature, and the other mechanical properties of the weld metal also satisfy the technical specifications for the West to East Pipeline Project in China. The microstructures of the weld metal are also examined. Both optical and TEM microphotoes demonstrate that the weld consists mainly of small-sized and uniformly distributed acicular ferrite. These microstructures can effectively prevent the initiation and propagation of micro cracks, resulting in high notch toughness of the weld metal at low temperature.


Particle nucleation in a thermal plasma reactor occurs as a high-temperature gas undergoes a cooling trajectory. Cooling leads to formation of supersaturated vapours, which causes either homogeneous or ion-induced nucleation. Detailed models have been developed for homogeneous nucleation in a plasma reactor, including discrete-sectional models and moment-type models. The discrete-sectional models are capable of incorporating size-dependent cluster property data as these become available. Calculations in which a one-dimensional cooling trajectory was assumed in a discrete-sectional code indicate that cooling rates play a key role in determining the final particle size. Moment-type models are more computationally efficient, and have been coupled to two-dimensional reactor transport models. A two-dimensional model was compared with experimental results for synthesis of iron particles over a range of conditions in which the volume-mean particle size ranged from roughly 20 nm to 70 nm, with reasonable quantitative agreement for particle size versus reactant feed rate. The major weakness of current models for particle formation in thermal plasmas is the lack of an adequate understanding of ion-induced nucleation. Additionally, there is considerable need for well-characterized experiments in which particle sizes are determined by probe sampling or light scattering.


ABSTRACT Perennial ryegrass (Lolium perenne) was inoculated with urediniospores of Puccinia graminis subsp. graminicola at four stages of reproductive tiller development. All developmental stages, from expansion of the penultimate leaf through anthesis, were equally susceptible to infection measured as number of pustules per total inoculated plant area. However, within each stage from boot through anthesis, there was a negative correlation of susceptibility with age of host tissue, the highest disease severities occurring on expanding or newly expanded leaves or inflorescences. Within-plant spread of the disease from primary lesions on the flag leaf sheath to the elongating stem of the inflorescence was observed and verified. A single primary infection on the leaf sheath can produce an elongated strip of contiguous secondary infections on the inflorescence head and stem, which is a characteristic sign of stem rust. Position and timing of eruption of the secondary pustules on the stem can be explained by assuming that infections occur on the stem slightly distal to the overlying sheath lesion and erupt one latent period later, by which time tiller elongation has moved the stem infection site upward. Repeated infections occur as the stem elongates, producing contiguous lesions. Expansion rate and final lesion area on the stem were correlated with elongation rate of the inflorescence. Microscopic observation of plant tissue sections revealed that the fungus sporulates on the inner surface of the sheath, and germinating urediniospores are attached to the stem surface under the covering sheath starting 1 to 2 cm distal to the location of the sheath infection site.


In the recent years, Robo Advisor, a digital platform that provides automated, algorithm-driven financial planning services, has increasingly received attention from users of different demographics. Many users have taken advantage of its features to automate their saving and investing activities. However, users in an older age group, specifically, those aged fifty or above, have been seen with low adoption of the robo-advisory services. This empirical study is designed to explore the problems associated with older adults' adoption of robo advisors. Specifically, this study intends to examine whether mental health of aging adults affects their intention to use robo advisors. In addition, I hypothesize that perceived usefulness may mediate the effect of mental health on behavioral intention towards using robo advisors, such that it serves to explain why various levels of mental health would result in differences in intention to use (i.e. approach or avoid robo advisors). To explore solutions for non-adoption, I identify three external variables (i.e. social influences, accessibility, and learning support) that could possibly moderate the main effects of mental health hypothesized in the study, so that when either of these variables is present and strengthened, it will enhance likelihood of using robo advisors.


A 34-year-old obese, small-jawed and short-necked woman, had severe obstructive sleep apnea syndrome (OSAS) with bronchial asthma. A surgical removal of a lingual tumor using a laser knife was scheduled under general anesthesia with sevoflurane. A small diameter tracheal tube for laser surgery (internal diameter (ID) of 5.5 mm) was used. The tube was inserted using bronchofiberscopy under spontaneous respiration. Extubation was designed to be performed when the patient resumed adequate spontaneous respiration and was awake. However, her ventilation deteriorated postoperatively as spontaneous breathing continued (PaO2 98 mmHg, PaCO2 88 mmHg at FIO2 1.0). This seemed to have been induced by worsened patient-ventilator synchrony and increased airway resistance due to the use of a small diameter tube. We decided to replace the tube with the one with larger diameter. An ID 7.5 mm tube was inserted with the use of fiberscope through the opening of the vocal cord while the tube for laser surgery was left in space. After confirming that the two tubes were inserted securely, the tube for laser surgery was withdrawn. The patient's ventilation improved significantly afterwards and the extubation was performed successfully. Our method for replacing a tracheal tube seemed to be effective and safe.


Tackling major environmental change issues requires effective partnerships between science and governance, but relatively little work in this area has examined the diversity of settings from which such partnerships may, or may not, emerge. In this special feature we draw on experiences from around the world to demonstrate and investigate the consequences of diverse capacities and capabilities in bringing science and governance together. We propose the concept of coproductive capacities as a useful new lens through which to examine these relations. Coproductive capacity is "the combination of scientific resources and governance capability that shapes the extent to which a society, at various levels, can operationalize relationships between scientific and public, private, and civil society institutions and actors to effect scientifically-informed social change." This recasts the relationships between science and society from notions of "gaps" to notions of interconnectedness and interplay (coproduction); alongside the societal foundations that shape what is or is not possible in that dynamic connection (capacities). The articles in this special feature apply this concept to reveal social, political, and institutional conditions that both support and inhibit high-quality environmental governance as global issues are tackled in particular places. Across these articles we suggest that five themes emerge as important to understanding coproductive capacity: history, experience, and perceptions; quality of relationships (especially in suboptimal settings); disjunct across scales; power, interests, and legitimacy; and alternative pathways for environmental governance. Taking a coproductive capacities perspective can help us identify which interventions may best enable scientifically informed, but locally sensitive approaches to environmental governance.


A majority of the world's cities are situated in or near areas of high biodiversity. Rise in global urban population resulting in rapid urban expansions (larger cities) is a threat to urban biodiversity, which has implications for the ecological health and general well being of humans. The study exploits consistent global land use data to compare 102 cities across the globe on a measure of urban biodiversity, within 15 km and 30 km from the approximate centres of the cities. Cities with high population and higher percentage of land use dedicated to artificial infrastructure recorded lower percentage size reserved for natural habitat, and vice versa. Further testing in regression analysis with birds and plants species as response variables shows a relation with urban extent and size of natural habitat which seeks to promote sustaining ecosystems services. Since urban biodiversity has implications for human ecological health, its indicators must be constantly measured and monitored, while adhering to best practices that conserve nature.


Language use plays a crucial role in the consensualization of stereotypes within cultural groups. Based on an integrative review of the literature on stereotyping and biased language use, we propose the Social Categories and Stereotypes Communication (SCSC) framework. The framework integrates largely independent areas of literature and explicates the linguistic processes through which social-category stereotypes are shared and maintained. We distinguish two groups of biases in language use that jointly feed and maintain three fundamental cognitive variables in (shared) social-category cognition: perceived category entitativity, stereotype content, and perceived essentialism of associated stereotypic characteristics. These are: (1) Biases in linguistic labels used to denote categories, within which we discuss biases in (a) label content and (b) linguistic form of labels; (2) Biases in describing behaviors and characteristics of categorized individuals, within which we discuss biases in (a) communication content (i.e., what information is communicated), and (b) linguistic form of descriptions (i.e., how is information formulated). Together, these biases create a self-perpetuating cycle in which social-category stereotypes are shared and maintained. The framework allows for a better understanding of stereotype maintaining biases in natural language. We discuss various opportunities for further research.


Frequency of detection and inoculum production by the conifer shoot blight and canker pathogens Diplodia pinea and D. scrobiculata on cones of red pine (Pinus resinosa) and jack pine (P. banksiana) were studied. Cones were collected from the ground and from canopies of red and jack pine trees in mixed stands at three sites in each of two different locations during two consecutive summers in Wisconsin. Conidia were extracted in water, quantified, germination tested, and the Diplodia species present was determined using molecular methods. At least one pathogen was detected from each tree at each site in both years. Overall, more conidia were extracted from cones from canopies than cones from the ground and from red pine cones than jack pine cones. Both total numbers of conidia extracted and proportions of cones yielding D. pinea or D. scrobiculata varied by location and pine species. Cones from either the ground or canopies can be used for surveys to detect Diplodia spp. at a given site but cones from canopies may be more useful to determine the relative abundance of potentially available inoculum of these pathogens.


OBJECTIVE
To develop guidelines on the suitability of patients for carotid endarterectomy (CEA).

OPTIONS
For atherosclerotic carotid stenosis that has resulted in retinal or cerebral ischemia: antiplatelet drugs or CEA. For asymptomatic carotid stenosis: CEA or no surgery.

OUTCOMES
Risk of stroke and death.

EVIDENCE
Trials comparing CEA with nonsurgical management of carotid stenosis.

VALUES
Greatest weight was given to findings that were highly significant both statistically and clinically.

BENEFITS, HARMS AND COSTS
Benefit: reduction in the risk of stroke. Major harms: iatrogenic stroke, cardiac complications and death secondary to surgical manipulations of the artery or the systemic stress of surgery. Costs were not considered.

RECOMMENDATIONS
CEA is clearly recommended for patients with surgically accessible internal carotid artery (ICA) stenoses equal to or greater than 70% of the more distal, normal ICA lumen diameter, providing: (1) the stenosis is symptomatic, causing transient ischemic attacks or nondisabling stroke (including retinal infarction); (2) there is no worse distal, ipsilateral, carotid distribution arterial disease; (3) the patient is in stable medical condition; and (4) the rates of major surgical complications (stroke and death) among patients of the treating surgeon are less than 6%. Surgery is not recommended for asymptomatic stenoses of less than 60%. Symptomatic stenoses of less than 70% and asymptomatic stenoses of greater than 60% are uncertain indications. For these indications, consideration should be given to (1) patient presentation, age and medical condition; (2) plaque characteristics such as degree of narrowing, the presence of ulceration and any documented worsening of the plaque over time; (3) other cerebral arterial stenoses or occlusions, or cerebral infarcts identified through neuroimaging; and (4) surgical complication rates at the institution. CEA should not be considered for asymptomatic stenoses unless the combined stroke and death rate among patients of the surgeon is less than 3%.

VALIDATION
These guidelines generally agree with position statements prepared by other organizations in recent years, and with a January 1995 consensus statement by a group of experts assembled by the American Heart Association.


Data warehouses are of crucial importance to decision-making in competitive organizations. The fact that they store enormous quantities of data is a challenge in what concerns performance and scalability, as users request instant answers. None of the traditional performance strategies is sufficiently good to make complex aggregation queries take only minutes or seconds. The summary warehouse (SW) achieves such a speedup by storing only general-purpose sampling summaries well-fit for aggregated exploration analysis. The major limitation of SWs results from the tradeoff between accuracy and speed: smaller, faster summaries cannot answer less-aggregated queries. In this paper we present the Bag-of-Summaries approach (BofS) designed to deal effectively with this problem: BofS maintains a set of summaries with varied sizes and chooses the right one to answer a query with the desired accuracy and best possible speedup, based on query granularity considerations. We also present experimental results that show the advantage of BofS.


Abstract A narrowly endemic new species of Glossoloma is described from the Cordillera Oriental of the northern Andes, in the Colombian departments of Caquetá and Huila. Glossolomamagenticristatum J.L.Clark, D.Hoyos & Clavijo, sp. nov. differs from most other congeners by a habit that is usually epiphytic with elongate scandent subwoody shoots, the presence of a magenta corolla tube, and a creased calyx formed by tightly appressed adjacent lobes. A brief summary of Gesneriaceae diversity in the Colombia departments of Caquetá and Huila is discussed with an emphasis on the old highway between Florencia and Guadalupe. The conservation status of G.magenticristatum is assessed as Endangered (EN) based on IUCN Criteria.


Experiments in this dissertation were conducted to characterize the effects of d-fenfluramine on body temperature and the mechanisms by which d-fenfluramine alter body temperature. The experiments were conducted in conscious male Sprague-Dawley rats. Body temperature was measured in all animals using telemetry. The results of the experiments indicated that d-fenfluramine altered body temperature in animals kept 28, 22, 16 and 4 degrees Centigrade. D-fenfluramine produced hyperthermia in animals kept at 28 degrees Centigrade and varying degrees hypothermia at normal and cooler ambient temperatures. Further experiments were conducted to explore the effects of d-fenfluramine on brown adipose tissue (BAT) thermogenesis, cutaneous vascular tone and whole body oxygen consumption. In animals kept at 22 and 4 degrees Centigrade, we found that d-fenfluramine activated BAT, as indicated by a decrease in BAT norepinephrine content, to the same magnitude. Thus, the hypothermia seen at normal and cooler ambient temperature was not due to lack of BAT activation. Also, activation of BAT by d-fenfluramine was mediated through the sympathetic nervous system and through release of central serotonin, since ganglionic blocker pentolinium and serotonin reuptake inhibitor fluoxetine blocked d-fenfluramine-mediated BAT activation. In animals kept at 16 degrees Centigrade, d-fenfluramine increased tail-skin temperature (Tsk), an index of cutaneous vascular tone, indicating that d-fenfluramine produced cutaneous vasodilation. d-fenfluramine-induced increase in Tsk was mediated through withdrawal of the sympathetic vasoconstrictor tone to the tail, since pentolinium blocks this effect. In animals kept at 28 degrees Centigrade, d-fenfluramine produced a decrease in Tsk, indicating vasoconstriction. The effects of d-fenfluramine on the Tsk were mediated through release of serotonin, since fluoxetine blocked these effects. D-fenfluramine increased whole body oxygen consumption, an index of metabolic activity and the increase was due to BAT activation, since pentolinium prevented the increase. Thus, although d-fenfluramine increased metabolic activity through BAT activation, the increase was insufficient to make up for the heat loss produced by cutaneous vasodilation and thus produces hypothermia. The hyperthermia seen at 28oC is due to activation of BAT and the subsequent inability of the animal to lose the excess heat due to cutaneous vasoconstriction produced by d-fenfluramine at 28 degrees Centigrade.


The purpose of this project was to utilize a consumer-directed, care model redesign methodology to develop and evaluate a marketing plan for medication therapy management services (MTMS) provided in community pharmacies. This was accomplished through a six-step process: (1) application of "design thinking" for eliciting consumer input on redesigning MTMS and marketing approaches, (2) exploratory research, (3) focus group analysis, (4) marketing plan development, (5) marketing plan implementation, and (6) marketing plan evaluation.
The findings showed that the application of "design thinking" and focus group analysis was useful for creating a consumer-directed marketing plan for medication therapy management services (MTMS). Implementation and evaluation of the MTMS Marketing Plan revealed that the most successful pharmacies were those that had established business associate agreements with the medical clinics closest to their site of practice, including access to electronic health records. This "virtual electronic presence" of pharmacists in the medical care system was highly consistent with the consumer demand we uncovered for a visible relationship between pharmacists, physicians and other health care providers.

Type: Original Research


ABSTRACT p0071 is an intercellular junction protein of the p120 catenin family. We have identified Rab11a as a novel interaction partner of p0071. p0071 interacted preferentially with active Rab11a. Knockdown experiments revealed an interdependent regulation of both proteins. On the one hand, p0071 depletion induced a perinuclear accumulation of Rab11, suggesting a role of p0071 in the anterograde transport of Rab11 from the pericentrosomal region to the plasma membrane but not in retrograde transport. p0071 as well as Rab11 depletion increased transferrin receptor recycling indicating that p0071-induced Rab11 mislocalization interfered with Rab11 function and shifted recycling from the slow Rab11-dependent pathway to the fast Rab4-dependent pathway. When p0071 or Rab11 depletion was combined with a Rab4 knockdown the effect was reversed. On the other hand, Rab11a depletion increased p0071 recycling to cell contacts thereby identifying p0071 as a Rab11 cargo protein. This correlated with increased intercellular adhesion. Thus, we propose that p0071 has a key role in regulating recycling through the Rab11-dependent perinuclear recycling compartment, and links the regulation of adherens junctions to recycling to allow dynamic modulation of intercellular adhesion.


Journal of Sports Science and Physical Education 5(1): 1-8, 2016 - The purpose of this study was to compare the acquisition of performing the squat technique using visual and verbal feedback among eleven years old children. Thirty standard 5 students from a semi urban
primary school were recruited for this study. Each participant performed the squat without any provision of feedback in the pre-test. Their performance was assessed using the Motion Competency Screen (MCS) scale. The pre-test scores were used to divide the participants randomly into three groups (i.e., visual-, verbal-feedback and control). During the acquisition phase (two weeks), the visual group (video recordings of their performance) received feedback about the correct squat technique by a qualified trainer while the verbal feedback group received verbal instructions and feedback from the same instructor on their performance. The control group did not participate in any trials during acquisition phase. All participants were tested again in the post- and retention test a week after the post-test. A 3 group x 3 tests mixed between-within ANOVA with repeated measures on the second factor was used to measure the between and within group mean differences. There was no significant different between groups for the pre-test. However, both the visual and the verbal feedback groups were significantly better than the control group in the post test. However, in the retention test, the verbal group significantly outperformed the visual group. Again both
groups were significantly better than the control group. In conclusion, both visual and verbal feedbacks were effective in learning a motor skill. Interestingly, verbal feedback showed to be more effective for long term retention (learning).


The tyre-rim bead bond must be broken to carry out repairs on a failed automobile tyre. The use of the locally fabricated manual bead breaking equipment as it is being practiced today by commercial tyre repair artisans in Nigeria is characterized by drudgery. This article reports a study of the local manual bead breaking technology with a view to identifying where engineering design effort could be directed to remove the drudgery involved. The results show that majority (62.5%) of the tyre repair artisans never went beyond elementary primary school education level. Majority (40.82%) of them are of the opinion that the redesign effort should be focused on the bead breaking edge to remove the characteristic drudgery. Furthermore, the bead breaking difficulty and time generally increased with increase in rim size. Specific recommendations were made for the redesign of the local tool to eliminate the drudgery of the bead breaking process.


High-frequency transcranial electrical stimulation was performed in 8 patients undergoing surgery in the sitting position. Following the opening of the dura of the posterior fossa changes in compound muscle action potentials were observed. These changes were not attributable to surgical manoeuvres at the brain stem or spinal cord, or to anaesthetic changes. In all these cases intraoperative fluoroscopy of the skull revealed a subdural air collection underneath the stimulation electrodes. Such a subdural air collection, not infrequent in patients operated on in the sitting position, limits the application of high-frequency transcranial electrical stimulation as a monitoring technique. It remains unclear if this effect is due to the increasing distance between scalp and cortex and the insulating effect of subdural air, or due to displacement of the motor cortex. The practical importance of this report is derived from the increasing application of intraoperative motor pathway monitoring.


The reverse micelle system of sodium di-2-ethylhexyl phosphate was used to extract aminoglycoside antibiotics, neomycin and gentamicin. The aminoglycosides can be efficiently extracted into a reverse micelle solution, and the antibiotics extracted into the micelle phase can readily be recovered back to a divalent cation aqueous solution, such as Ca2+. The transfer efficiency, %E, is heavily dependent on pH and salt concentration in the aqueous feed solution. %E decreases drastically with pH in the pH range 8.5-11, and declines with increasing (NH&SO, concentration. A simple transfer mechanism was proposed which suggests that the antibiotic molecules were extracted into the inner water cores of reverse micelles through attractive electrostatic interaction during forward transfer. In backward transfer, the antibiotics loaded in the micelle phase are released back to an aqueous phase through breaking up of the reverse mi- celles by using divalent cation solutions. The model is supported by the results of dynamic light scattering and infra-red spectroscopy study.


This paper deals with architectural design of the systolic/SIMD DSP processing array called MUS2DAP optimized for the execution of DSP filtering, vector/matrix and linear algebra algorithms. Its main features are architectural support for multithreading, interprocessor communication based on virtual channels and exploitation of instruction level parallelism within each processing cell of the array. Up to four threads can be executed in an interleaved fashion on one processor array. Physical implementation details of the processor network topology are hidden from programmer, since instructions used for interprocessor communication operate on virtual channels. The same algorithm can thus be executed unchanged on multiple physically implemented interconnection network topologies ranging from linear, 2D mesh to hex array. Architecture is optimized to execute algorithms in single precision 32-bit floating-point arithmetic. There are two controllers available, each controlling part of the processing array. This feature is helpful in implementing linear algebra algorithms which usually have processing cells with different functionalities within single array.


Heart failure (HF), the number one cause of death in the western world, is caused by the insufficient performance of the heart leading to tissue underperfusion in response to an injury or insult. It comprises complex interactions between important neurohormonal mechanisms that try but ultimately fail to sustain cardiac output. The most prominent such mechanism is the sympathetic (adrenergic) nervous system (SNS), whose activity and outflow are greatly elevated in HF. SNS hyperactivity confers significant toxicity to the failing heart and markedly increases HF morbidity and mortality via excessive activation of adrenergic receptors, which are G protein-coupled receptors. Thus, ligand binding induces their coupling to heterotrimeric G proteins that transduce intracellular signals. G protein signaling is turned-off by the agonist-bound receptor phosphorylation courtesy of G protein-coupled receptor kinases (GRKs), followed by βarrestin binding, which prevents the GRK-phosphorylated receptor from further interaction with the G proteins and simultaneously leads it inside the cell (receptor sequestration). Recent evidence indicates that adrenal GRK2 and βarrestins can regulate adrenal catecholamine secretion, thereby modulating SNS activity in HF. The present review gives an account of all these studies on adrenal GRKs and βarrestins in HF and discusses the exciting new therapeutic possibilities for chronic HF offered by targeting these proteins pharmacologically.


Background: The prevalence of obstructive sleep apnea (OSA) in the general population ranges from 2 to 6% but the incidence is directly proportional to the age and weight. Few patients with confirmed diagnosis and only 5% receive treatment. The higher prevalence of OSA in the surgical population has been demonstrated in several studies as well as the increased surgical risk. A meta-analysis confirmed the increased complications (postoperative desaturation, acute respiratory failure, cardiac events and the need for transfer to ICU) in this population. When OSA is diagnosed preoperatively, the rate of postoperative pulmonary complications is low and not associated with OSA severity. The beneficial effect of CPAP on patients with OSA is known but its benefit is unknown in patients at high risk of OSA undergoing surgery to prevent these respiratory complications such as post-surgical desaturations.
Objective: To evaluate the effectiveness of CPAP vs ventimask postoperative in patients with high risk of OSA to prevent postoperative desaturations. The secondary objectives are to examine the reduction of postoperative hospital stay of these patients and to evaluate the prevalence of high risk of OSA in surgical population.
Methods: The design is a single-center, randomized, simple blind, and parallel-group trial will be performed between 2017 and 2019 in Dr. Josep Trueta University Hospital of Girona. 682 patients will be recluted during 2 years and randomized into two groups. 341 will receive CPAP therapy with an oxygen concentration of 50% and PEEP 8-10 cm H2O the first 24 hours after surgery and 341 patients will receive ventimask a 50% of oxygen concentration


Gaussian smoothing (GS) is a derivative-free optimization (DFO) algorithm that estimates the gradient of an objective using perturbations of the current parameters sampled from a standard normal distribution. We generalize it to sampling perturbations from a larger family of distributions. Based on an analysis of DFO for non-convex functions, we propose to choose a distribution for perturbations that minimizes the mean squared error (MSE) of the gradient estimate. We derive three such distributions with provably smaller MSE than Gaussian smoothing. We conduct evaluations of the three sampling distributions on linear regression, reinforcement learning, and DFO benchmarks in order to validate our claims. Our proposal improves on GS with the same computational complexity, and are usually competitive with and often outperform Guided ES and Orthogonal ES, two computationally more expensive algorithms that adapt the covariance matrix of normally distributed perturbations.


Abstract The rapid technological changes that have occurred in recent years have become critical for the academic and professional success of novice teachers. This study illuminates the use of digital autonarratives as social transformative pedagogy. The process of telling ones' story—and in the case of our participants, the process of defining and redefining self as teacher through the medium of technology—documents the creation of a bilingual 21st century teacher. Findings indicate the need for pre-service teachers to engage in technologically mediated learning to develop a practical understanding of technology integration. The goals of this research lend additional insight into the direction that teacher preparation programs must take to better serve bilingual teacher candidates in their educational journey to become technologically competent teachers who are prepared to meet the needs of an increasingly culturally and linguistically diverse school-age population.


We describe the specific interaction between high-purity recombinant human immunodeficiency virus (HIV) type 1 p17 and human γ interferon (hIFN-γ) proteins. This interaction was found to be dose dependent and to involve conformational epitopes on both sides. Specificity was confirmed by competition ELISA, using monoclonal antibodies (MAbs) to hIFN-γ as specific reagents. By competition experiments we also identified the epitope(s) on the hIFN-γ molecule involved in p17 binding, very close to the receptor binding site. The kinetic constants were determined by surface plasmon resonance (SPR) analysis. The affinity constant (κA) of the complex was 2.78 × 108 M-1, that is, the ratio between a low dissociation rate constant (κoff)(1 × 10-5sec-1) and a high association rate constant (κon) (3 × 103 M-1sec-1). However, p17 did not displace the binding of hIFN-γ to its cellular receptor, nor did it interfere with the capability of the lymphokine to induce de novo expression of HLA-DR antigens on human monocytic ce...


SUMMARY: A simple and rapid colorimetric test has been developed for the detection of pyrrolidonpl peptidase (PLP) activity in bacteria. Of 2354 strains belonging to various groups of enteric bacteria tested, 451 were PLP-positive. These included Citrobacter, 223 out of 226 strains, Klebsiella (178/188), Enterobacter (49/52), and one strain of Serratia.
Pyrrolidonyl peptidase was not detected in 1146 Shigella strains, 354 Salmonella strains, 333 Escherichia strains, 21 Arizona strains, nor in 33 strains of Proteus, Providencia and Hafnia.
In addition, 56 cultures of various Gram-negative and Gram-positive bacteria were tested for PLP. Enzyme activity was found in strains belonging to the genera Bacillus, Streptococcus, Staphylococcus, Micrococcus, Sarcina, Neisseria and Pseudomonas. The possibility of employing the PLP test for differentiation within the family Enterobacteriaceae is discussed.


This paper describes research with French university graduate student moderators in a Master's program on using technology to teach French as a foreign language and advanced undergraduate students learning French at an American university who used Second Life software and Moodle to carry out oral tasks synchronously. For fall 2011, the researchers designed five tasks (étapes) that paralleled the undergraduates' course curriculum. Transcripts of two of the six groups of moderators and learners show that the unintended different styles of moderator behaviors influenced learner interactions with each other and with the moderators. The authors show that students were less able to engage with each other independently when faced with more rigid questioning behaviors by the moderators.


STUDY OBJECTIVES
Obstructive sleep apnea (OSA) is an independent risk factor for hypertension (HTN). Increasing evidence from animal and human studies suggests that HTN exacerbates OSA. We performed a systematic review and meta-analysis of studies evaluating the effect of anti-hypertensive medications on the severity of OSA.

METHODS
A literature search of PubMed and Embase was done using search concepts of OSA, HTN, and drug classes used to treat HTN. Studies that reported changes in the severity of OSA objectively by using apnea-hypopnea index (AHI) or respiratory disturbance index (RDI) were included. Pooled mean difference estimates were calculated. Tests for heterogeneity, publication bias, and subgroup sensitivity analysis were conducted.

RESULTS
Of 27,376 studies screened, only 11 met inclusion criteria, including 5 randomized controlled trials and 6 single-arm prospective trials. The pooled mean difference estimate (95% confidence interval [CI]), based on a random-effects model, was -5.69 (95% CI -10.74 to -0.65), consistent with an overall decrease in AHI or RDI attributable to antihypertensive medications. The effect size was even more pronounced, -14.52 (95% CI -25.65 to -3.39), when only studies using diuretics were analyzed. There was no significant heterogeneity or publication bias among the studies. Meta-regression indicated neither age, baseline AHI, nor change in systolic/diastolic blood pressure influenced the results.

CONCLUSIONS
Collectively, findings from these relatively small, short-term studies tend to support the contention that treatment with antihypertensive agents confers a statistically significant, albeit small, reduction in the severity of OSA, which may be more pronounced with the use of diuretics.


Angiosarcomas rarely involve the female genital tract. There have only been sporadic case reports of angiosarcomas of the cervix, uterus, vagina, parametrium, broad ligament and pelvis, and only 11 well-documented case reports of primary ovarian angiosarcoma in the English language literature to date. We present a case of primary pure ovarian angiosarcoma with lung metastasis that had partial response after chemotherapy with adriamycin and ifosfamide. But pulmonary hemorrhage and respiratory failure resulted in her death 7 months after initial diagnosis.


The U.S. Geological Survey (USGS) has begun the development of operational, 30-m resolution annual thematic land cover data to meet the needs of a variety of land cover data users. The Continuous Change Detection and Classification (CCDC) algorithm is being evaluated as the likely methodology following early trials. Data for training and testing of CCDC thematic maps have been provided by the USGS Land Cover Trends (LC Trends) project, which offers sample-based, manually classified thematic land cover data at 2755 probabilistically located sample blocks across the conterminous United States. These samples represent a high quality, well distributed source of data to train the Random Forest classifier invoked by CCDC. We evaluated the suitability of LC Trends data to train the classifier by assessing the agreement of annual land cover maps output from CCDC with output from the LC Trends project within 14 Landsat path/row locations across the conterminous United States. We used a small subset of circa 2000 data from the LC Trends project to train the classifier, reserving the remaining Trends data from 2000, and incorporating LC Trends data from 1992, to evaluate measures of agreement across time, space, and thematic classes, and to characterize disagreement. Overall agreement ranged from 75% to 98% across the path/rows, and results were largely consistent across time. Land cover types that were well represented in the training data tended to have higher rates of agreement between LC Trends and CCDC outputs. Characteristics of disagreement are being used to improve the use of LC Trends data as a continued source of training information for operational production of annual land cover maps.


Objective: The aim of this study is to determine if health professionals in our hospital insert objects in their ears and the complications which follow.

Methodology: In this prospective cross-sectional study, validated questionnaires were filled by health professionals working in our Teaching Hospital and analyzed.

Results: One hundred and forty one questionnaires were analyzed involving subjects aged 25 to 59 years with a mean of 42 years (SD = +/- 12.5). There were 94 males and 47 females with a male to female ratio of 2:1. Thirty four (24.1%) nurses participated in the study followed by Resident doctors (n = 22, 15.6%) and Intern doctors (n = 20, 14.2%). One hundred and twenty nine (91.5%) individuals 'clean' their ears with majority of them (n = 48, 37.2%) doing so occasionally. Multiple objects were inserted into the ears by 32 (24.0%) subjects and single objects by 98 (76%). The commonest object inserted into the ears to effect 'cleaning' was cotton buds in 115 cases. Twelve (9.3%) subjects recorded ear injuries in the process. Seven (53.3%) subjects with injuries inserted objects into their ears daily. Seven subjects recorded injuries with the use of match sticks. Sixty three (44.7%) subjects had accumulation of cerumen. Cotton buds (n = 29) were the commonest method for cerumen removal. Complications recorded from the removal of cerumen were otalgia (n = 2) and vertigo (n = 1).

Conclusion: Health professionals in our centre have a practice of inserting various potentially dangerous objects into their ears.


Recent work has demonstrated the importance of addressing bone loss in the surgical management of anterior shoulder instability. Multiple options exist for reconstituting the glenoid articular surface to include: anatomic versus non-anatomic techniques and utilizing autograft versus allograft material. Anatomic restoration via an arthroscopic approach with distal clavicle osteochondral autograft (DCA) is the senior author's preferred technique when bone grafting is indicated for instability cases. This technique offers a low cost, readily available, and reproducible means of obtaining autograft material. Moreover, the distal clavicle graft provides an anatomic restoration of the glenoid radius with an articular cartilage cap comparable in thickness to that of the native glenoid. Along with a summary of the pertinent literature, this review article outlines the rationale, indications, and technical notes for this procedure.


Hamartomas are tumours composed of mesenchymal tissues such as cartilage, fat, connective tissue and smooth muscle and can be found in virtually any organ system. These masses commonly develop sporadically, but are also seen in certain syndromes such as tuberous sclerosis or Carney triad. While their imaging appearance varies depending on the organ they arise from, findings are usually unique and a diagnosis can be confidently made. Radiologists must be aware of the clinical and imaging presentations of these lesions with the particular goal of avoiding unnecessary studies or invasive procedures. Furthermore, knowledge of common syndromic entities is crucial, as the radiologist may be the first to suggest the diagnosis.


BACKGROUND
Data is lacking about long-term impact of JJ stents (JJst) on renal parenchyma. The aim of the study was to assess the evolution of renal parenchyma in patients with JJst indwelling for more than two years, and to find predictive factors for the development of renal atrophy.

METHODS
Consecutive patients with JJst indwelled for more than 24 months, with a history of cancer, were retrospectively included. Replacements of JJst were scheduled every six months, or earlier in case of premature obstruction. Patient characteristics at the time of insertion of JJst, history of indwelling JJst and most recent data (serum creatinine, cancer status, definite JJst removal, renal volume (RV) with3D software) were recorded.

RESULTS
With a median follow-up of 4 years, 73 patients were included. The indication of JJst insertion was mostly external compression (65.8%). CT scans were available to assess RV evolution in 66 patients (90.4%). Median shrinkage of RV was higher when JJ stenting was unilateral versus bilateral: -40% (-63; -15) versus -16% (-36; -3), P<0.001. The duration of indwelling JJst was the only statistically significative predictive factor of renal shrinkage in multivariate analysis (OR [CI 95%]: 1.35 [1.10-1.66] P=0.004). Median relative change from baseline in eGFR was -22% (-45%; -5%.). No statistically significant predictive factors of eGFR evolution were found in univariate and multivariate analysis.

CONCLUSIONS
Unilateral JJst for more than 2 years was associated with a significant shrinkage of renal parenchyma, especially since the duration of the indwelling stent was long.


This article shows how a philanthropic organization, Open Society Foundations (OSF), contributes to building the fight against discrimination as an organizational field within the European institutional sphere. OSF operates according to a strategy already studied in the case of other foundations : through "enrolling" different grantee organizations into a collective project. However, OSF is a specific case because of its direct intervention as a protagonist of the field, either as part of coalitions with NGOs, or in its own name as a lobby in the EU arena. OSF is indeed a hybrid actor : it is a grant-maker with considerable resources in a time of increasing scarcity of public funding, but it also acts as a think tank and a lobby, basing its public policy proposals on both the expertise of highly qualified employees and on the knowledge provided by its grantees. Therefore, OSF differs from the model described in the literature of philanthropic organizations which indirectly and "subtly" shape social movements and their organizational fields.


The total synthesis of the pentacyclic tetrahydroisoquinoline alkaloid quinocarcin, which possesses intriguing structural and biological features, has been achieved through a gold(I)-catalyzed regioselective hydroamination reaction. It is noteworthy that the regioselectivity of the intramolecular hydroamination of an unsymmetrical alkyne could be completely switched through substrate control. Other key features of this synthesis include the highly stereoselective synthesis of 2,5-cis-pyrrolidine through the intramolecular amination of the bromoallene and the Lewis acid mediated ring opening of dihydrobenzofuran.


Electronic publishers can be simply but plausibly divided into 'stylists' and 'structuralists'. Structured document formatting systems are used widely. Implicitly, they present a particular and potentially attractive view of documents, where form and content are divorced. This view also suggests that authors simply write, while the formatting software does the work of rendering he structured text into a suitable visual form.This paper informally examines some of the forces which encouraged the development of such systems (in particular TeX/LaTeX), and of such a view. Examples are cited which contest the view that form and content can be separated completely, and which suggest that the world of documents and formatting is altogether more demanding.


This dissertation studies the modern migration of Spaniards to the United States and the process of identity formation among the Spanish immigrant communities in America from the U.S.-Mexican War to the aftermath of World War II. The starting point underscores one of its main arguments: the impetus for the development of a Spanish ethnic identity among Spaniards in nineteenth- century America was U.S. expansionism in Mexico and the Caribbean. Confronted with American and Cuban nationalism, Spanish immigrant elites in some cases invented national traditions even before they were embraced in the homeland. Using a transnational framework that foregrounds the complex historical relationships between Spain, Latin America, and the United States the thesis highlights the singularity of the Spanish immigrant experience in America, rooted in the legacy of the Spanish discovery and colonization of the Americas. This legacy offered Spanish immigrant elites the symbolic tools they needed to forge a Spanish ethnic identity in the United States. The idea of Spain and Spanish identity favored by these nineteenth- century elites, however, held less appeal for the increasing numbers of immigrants from Spain arriving at American shores in the twentieth century. Sub-national and supra-national loyalties defined many of these newcomers, some of whom espoused anarchism or supported separatist movements in Catalonia and the Basque Country. Their anticlericalism and their repudiation of Spain's colonial wars in Morocco countered the elite's imperial image of monarchic, Catholic Spain. This analysis helps us understand the diaspora's enthusiasm for the proclamation of the Spanish Republic in 1931, as well as the immigrants' overwhelming response when the Republic was attacked by General Franco's military uprising in 1936. The unprecedented mobilization of the Spanish diaspora during the Spanish Civil War charted a singular path to Americanization. Most immigrant narratives point to World War II as one of the key moments in this process, but I argue that, in the Spanish case, the war in Spain played the crucial role. The circumstances of the war, however, complicated this process. For many Spaniards becoming American was not a voluntary choice, but one born of their transformation, after Franco's victory, from emigrants into exiles


Introduction: Cathepsin K is being targeted for the treatment of various human disease including osteoporosis and cancer. In the present study, a compound, which contains a 2-cyanopyrimidine scaffold with optimal substituents that can interact with S2 and S3 subsites of cathepsin K, was derivatized. Objective: To determine the in silico binding affinity, the toxicity and physicochemical properties of 1-[2-(3-biphenyl)-4-methylvaleryl)] amino-3-(2pyridylsulfonyl) amino-2propanone and its derivatives. Methods: UCSF chimera was used for macromolecule preparation and Autodock Vina was used for calculating binding affinities. PyMOL and UCSF Chimera were used to analyze the postdock binding interactions of the derivatives. Osiris property explorer was used to predict the toxicity and certain selected physicochemical properties of the derivatives. Results: The substitution of the phenoxy moiety with lipophilic substituents was found to increase the binding affinity, unlike substitutions made on the cyanopyrimidine moiety. The derivatives were found to have high binding affinity and were non-toxic, but showed low drug likeness and drug scores.


This essay complicates the notion that the German Wars of Liberation brought about renewed conservatism regarding the gender stereotypes that restricted women to their "natural" calling in the domestic realm. An examination of homosocial bonding in Theodor Körner's patriotic poetry leads to an analysis of Caroline de la Motte Fouqué's novels about the French Revolution, and Henriette Frölich's Virginia, oder die Kolonie von Kentucky. Although the two women writers differ sharply in their political viewpoints, both use their fiction to explore the limits of permissible behavior for women and to intervene into the public sphere. (TK)


Tumor- or cancer-associated fibroblasts (TAFs or CAFs) are active players in tumorigenesis and exhibit distinct angiogenic and tumorigenic properties. Adrenomedullin (AM), a multifunctional peptide plays an important role in angiogenesis and tumor growth through its receptors calcitonin receptor-like receptor/receptor activity modifying protein-2 and -3 (CLR/RAMP2 and CLR/RAMP3). We show that AM and AM receptors mRNAs are highly expressed in CAFs prepared from invasive breast carcinoma when compared to normal fibroblasts. Immunostaining demonstrates the presence of immunoreactive AM and AM receptors in the CAFs (n = 9). The proliferation of CAFs is decreased by anti-AM antibody (αAM) and anti-AM receptors antibody (αAMR) treatment, suggesting that AM may function as a potent autocrine/paracrine growth factor. Systemic administration of αAMR reduced neovascularization of in vivo Matrigel plugs containing CAFs as demonstrated by reduced numbers of the vessel structures, suggesting that AM is one of the CAFs-derived factors responsible for endothelial cell-like and pericytes recruitment to built a neovascularization. We show that MCF-7 admixed with CAFs generated tumors of greater volume significantly different from the MCF-7 xenografts in nude mice due in part to the induced angiogenesis. αAMR and AM22-52 therapies significantly suppressed the growth of CAFs/MCF-7 tumors. Histological examination of tumors treated with AM22-52 and aAMR showed evidence of disruption of tumor vasculature with depletion of vascular endothelial cells, induced apoptosis and decrease of tumor cell proliferation. Our findings highlight the importance of CAFs-derived AM pathway in growth of breast carcinoma and in neovascularization by supplying and amplifying signals that are essential for pathologic angiogenesis.


This article analyses the reasons for the continuation of the Norwegian consensual model of capitalism with its strong focus on collective bargaining and a universal public sector. Two main causes are identified. First, capital in Norway is characterized by the predominance of small and medium-sized companies and, as a result, is comparatively weak. Second, the agency of labour has been decisive and trade unions are still able to balance the structural power of Norwegian employers. Prior to the 2005 elections, trade unions adopted a more independent position from the Labour Party, and the Campaign for the Welfare State broadened the social basis for the maintenance of the public sector by bringing together trade unions and social movements. As a result, the Labour Party moved towards the left and continued to support traditional social democratic achievements such as the universal public sector and a strong role for trade unions in economic and social policy making.


The unparalleled Coronavirus disease 2019 (COVID-19) outburst has ushered a radical change in the conventional healthcare industry in India. The unprecedented lockdown and the ongoing COVID crisis has reincarnated telemedicine practice for the unforeseeable future. The Indian government was quick to realise it and laid guidelines for its practice across video, audio, or text. The teleconsultation is basically doctor-patient interaction bridged by information technology over an online platform to receive essential health-care services. All doctor-patient relationships thrive on mutual trust which is hardly established over first time virtual consultation considering the emotions of the majority of Indian population and its inertia to change. The medical fraternity though initially uncomfortable with these changes are slowly adapting to this new reality over the last one and half years. The recent guidelines, 2020 have bestowed full onus on the doctor as to decide whether tele-consultation is sufficient or is in-patient evaluation required based on patient complexities. But if any untoward event, delay to urgent care or malpractice happens out of this, will the doctor be held responsible and if yes, is it going to be covered under medical indemnity? Moreover, telemedicine platform being a mix of medical sciences and information technology is governed by laws of both making it complicated, with a steep learning curve for all concerned. Besides the right to privacy is fundamental in medical ethics and stands undebated in telemedicine too. The responsibility of harbouring and protecting the information rests primarily on the doctor. But there is till date no regulatory body that authorises the tech platforms with specific legislations and regulations making seepage of sensitive and personal data and information (SPDI) a certain possibility. In the western world any platform that deals with protected health information (PHI) must be Health Insurance Portability and Accountability Act (HIPAA) compliant ensuring data security, unlike India. The more telemedicine gains traction and computerised operations are being used to keep tag of digital health records, radiology, pharmacy and laboratory systems, security concerns will proportionately increase. Additionally, the technology platforms have been given the rights to analyse the credibility of the doctors and regulate consultation fees with no government monitoring inviting probable disastrous consequences. They at times act as middlemen between the doctor, pharmacies, laboratories and patients serving their own vested interests. They often advertise promotional offers to lure in patients flouting all moral ethics for business/to increase their market share. Additionally their terms and conditions and grievance section are framed mostly in a way that the doctor eventually becomes the scapegoat in any untoward development. Apprehending these potential loopholes, the U.S.A has passed The Health Information Technology for Economic and Clinical Health (HITECH) Act (2009) to maintain vigilance over ePHI security, offsite backup in IT failure, methods of data storage and transfer as per HIPAA standards and to penalise in case of defaulters. On the other hand currently there is no formalised policy for insurance reimbursement like most developed nations. The current pandemic push has bolstered the telemedicine growth and the market share is expected to cross $5.5 billion by 2025 in India. But for successful integration of telemedicine with normal practice in future one needs to define and compartmentalise the role of doctors and tech platforms with comprehensive legislations so that medical decisions are taken not based on personal interests but for optimal patient care. Otherwise in the quest for a new avatar in Indian healthcare system we might just end up creating another Frankenstein's monster.


By Kai Erikson Current scholarship is based on the review of books no older than one or two years. No matter the contests or even the importance of the material, this kind of ill-fashioned dispositions impinge on the advance of Science; they don't allow for a broader re-discovery of other relevant projects which have been ignored for a considerable lapse of time. This is the case of the book authored by Kai Erikson, lecturer at Yale University. His valuable but contradictory work focuses on the exploration of trauma and social pathologies after-disasters. In a moment in which mankind is fraught with natural or made-man disasters, a project of this nature is fundamental in order for readers to understand the convergence of uncertainty with fear.


Housing affordability is a major problem in New Zealand and it has escalated following unprecedented increases in residential property values over the last five years. The issue is extremely complex with a wide assortment of variables that have an influence. This paper has focused on New Zealand's property taxation policies
The tax structure in New Zealand is inappropriate as it relies heavily on taxing the productive sectors of the economy. A major hole in the tax base exists concerning the taxation of capital, particularly around property where subjective legislation and susceptible exemptions almost encourage speculation.
This paper has reviewed the impact of foreign investment, a land transfer duty instrument and the bright line test on housing affordability. It is recommended that data collected on foreign investment is revised to deem non-permanent New Zealand residents as foreign buyers. It is also recommended that foreign buyers are restricted from buying existing residential property stock. The low-rate and broad based land transfer duty scheme described in this report should be implemented to correct distortionary investment choices while simultaneously generating significant revenue. The revenue should be used to significantly reduce income taxes, creating a tax switch. The main home exemption should be removed from the bright line test to create more equitable outcomes and improve the tests effectiveness.
It is hoped this reform package would steer people away from the pursuit of tax-free capital gains from residential property and encourage investment in productive sectors of the economy that actually stimulate economic growth.