Background This study reviewed epidemiological and experimental evidence on the relationship between egg consumption and cardiovascular disease (CVD) risks among type II diabetes mellitus (T2DM) individuals, and T2DM risk in nondiabetic subjects. Results Four of the six studies that examined CVD and mortality and egg consumption among diabetics found a statistically significant association. Of the eight studies evaluating incident T2DM and egg consumption, four prospective studies found a statistically significant association. Lack of adjustment for dietary confounders was a common study limitation. A small number of experimental studies examined the relationship between egg intake and CVD risk biomarkers among diabetics or individuals with T2DM risk factors. Studies among healthy subjects found suggestive evidence that dietary interventions that include eggs may reduce the risk of T2DM and metabolic syndrome. Conclusion Differences in study design, T2DM status, exposure measurement, subject age, control for confounders and follow-up time present significant challenges for conducting a meta-analysis. Conflicting results, coupled with small sample sizes, prevent broad interpretation. Given the study limitations, these findings need to be further investigated.


Communications technology, many analysts proclaim, heralds a profoundly transformed new world where time and space take on new meanings. As a result, networks of non-state actors proliferate, altering the functions of international organizations and creating new pressures on states. Yet previous eras also witnessed social activists pursuing their agendas through and around national governments. Then as now, social forces and global norms impinged on states with vitality and independence. The experiences of abolitionists and anti-apartheid activists demonstrate how transnational social movements in two different centuries mobilized across national boundaries around issues of race — despite barriers of time, distance and culture. This comparison provides the basis for disaggregating types of non-state actors in world politics and for understanding better the links between social activism and global normative change.


ABSTRACT Three novel donor-acceptor-donor type random copolymers based on benzothiadiazole (BTh) and benzoselenadiazole (BSe) were synthesized via Pd (0) catalyzed Suzuki polycondensation reaction. The two acceptor units were coupled with electron rich moieties which are carbazole (CZ), fluorene (FL) and silafluorene (SiFL). Monomers were characterized using 1H and 13C-NMR spectroscopy. The number and weight average molecular weights of the polymers were calculated using gel permeation chromatography (GPC). All three polymers were electrochemically and spectroelectrochemically characterized. PBThBSeCZ, PBThBSeFL and PBThBSeSiFL showed only p-dopable character and their doping/dedoping potentials were determined as 1.4 V/1.2 V, 1.53 V/1.27 V and 1.8 V/1.3 V, respectively. Corresponding HOMO energy levels were calculated as −5.85 eV, −6.05 eV and −6.15 eV whereas LUMO energy levels were found to be −3.67 eV, −3.84 eV and −3.77 eV, respectively. PBThBSeCZ had lower HOMO level and band gap than PBThBSeFL and PBThBSeSiFL due to its increased electron donating capability of nitrogen atom in carbazole unit.


Stream water was analysed to determine how induced watershed acidification changed the chemistry of peakflow and baseflow and to compare the relative timing of these changes. Two watersheds in north‐central West Virginia, WS3 and WS9, were subjected to three applications of ammonium sulphate fertilizer per year to induce acidification. A third watershed, WS4, was the control. Samples were collected for 8 years from WS9 and for 9 years from WS3. Prior to analyses, concentration data were flow adjusted, and the influence of natural background changes was removed by accounting for the chemical responses measured from WS4. This yielded residual values that were evaluated using robust locally weighted regression and Mann–Kendall tests. On WS3, analyte responses during baseflow and peakflow were similar, although peakflow responses occurred soon after the first treatment whereas baseflow responses lagged 1–2 years. This lag in baseflow responses corresponded well with the mean transit time of baseflow on WS3. Anion adsorption on WS3 apparently delayed increases in SO4 leaching, but resulted in enhanced early leaching losses of Cl and NO3. Leaching of Ca and Mg was strongly tied, both by timing and stoichiometrically, to NO3 and SO4 leaching. F‐factors for WS3 baseflow and peakflow indicated that the catchment was insensitive to acid neutralizing capacity reductions both before and during treatment, although NO3 played a large role in reducing the treatment period F‐factor. By contrast, the addition of fertilizer to WS9 created an acid sensitive system in both baseflow and peakflow. On WS9, baseflow and peakflow responses also were similar to each other, but there was no time lag after treatment for baseflow. Changes in concentrations generally were not as great on WS9 as on WS3, and several ions showed no significant changes, particularly for peakflow. The lesser response to treatment on WS9 is attributed to the past abusive farming and site preparation before larch planting that resulted in poor soil fertility, erosion, and consequently, physical and chemical similarities between upper and lower soil layers. Even with fertilizer‐induced NO3 and SO4 leaching increases, base cations were in low supplies and, therefore, unavailable to leach via charge pairing. The absence of a time lag in treatment responses for WS9 baseflow indicates that it has substantially different flow paths than WS3. The different hydrologies on these nearby watersheds illustrates the importance of understanding watershed hydrology when establishing a monitoring programme to detect ecosystem change. Published in 2002 by John Wiley & Sons, Ltd.


We study the polarization of the vacuum for a scalar field, , on a asymptotically anti-de Sitter black hole geometry. The method we follow uses the WKB analytic expansion and point-splitting regularization, similar to previous calculations in the asymptotically flat case. Following standard procedures, we write the Green function, regularize the initial divergent expression by point-splitting, renormalize it by subtracting geometrical counterterms, and take the coincidence limit in the end. After explicitly demonstrating the cancellation of the divergences and the regularity of the Green function, we express the result as a sum of two parts. One is calculated analytically and the result is expressed in terms of some generalized zeta functions, which appear in the computation of functional determinants of Laplacians on Riemann spheres. We also describe some systematic methods to evaluate these functions numerically. Interestingly, the WKB approximation naturally organizes as a series in such zeta functions. We demonstrate this explicitly up to next-to-leading order in the WKB expansion. The other term represents the "remainder" of the WKB approximation and depends on the difference between an exact (numerical) expression and its WKB counterpart. This has to be dealt with by means of numerical approximation. The general results are specialized to the case of Schwarzschild-anti-de Sitter black hole geometries. The method is efficient enough to solve the semiclassical Einstein's equations taking into account the backreaction from quantum fields on asymptotically anti-de Sitter black holes.


This article discusses the mutual reinforcement effects of IPRs and biotechnology in recent years, and review the development of GURTs and how the major agricultural biotechnology companies behave in that regard. Both proponents and opponents of GURTs made strong arguments based on speculations. We discuss the major arguments by both sides, and argue the possible strategic use of bundling and licensing strategy by the biotech giants, because GURTs make it possible for a seed to be marketed as a vector of trait options. We also examine the validity of two major implicit assumptions held by those opposing GURTs: patenting does not affect the monopoly power of GURTs; and GURTs would take over the GM seed market.


Breast cancer is the most common cancer in women both in developed and developing countries. More than half of all cancer mobile application concern breast cancer. Gamification is widely used in mobile software applications created for health-related services. Current prevalence of gamification in breast cancer apps is unknown and detection must be manually performed. The purpose of this study is to describe and produce a tool allowing automatic detection of apps which contain gamification elements and thus empowering researchers to study gamification using large data samples. Predictive logistic regression model was designed on data extracted from breast cancer apps title and description text available in app stores. Model was validated comparing estimated and benchmark values, observed by gamification specialists. Studys outcome can be applied as a screening tool to efficiently identify gamification presence in breast cancer apps for further research.


PurposeWe investigated the impacts of the COVID-19 pandemic on the modality of formal cognitive assessments (in-person versus remote assessments).Materials and MethodsWe created a web-based survey with 34 items and collected data from 114 respondents from a range of health care professions and settings. We established the proportion of cognitive assessments which were face-to-face or via video or telephone conferencing, both pre- and post-March 2020. Further, we asked respondents about the assessment tools used and perceived barriers, challenges and facilitators for the remote assessment of cognition. In addition, we asked questions specifically about the use of the Oxford Cognitive Screen.ResultsWe found that the frequency of assessing cognition was stable compared to pre-pandemic levels. Use of telephone and video conferencing cognitive assessments increased by 10% and 18% respectively. Remote assessment increased accessibility to participants and safety but made observing the subtleties of behaviour during test administration difficult. The respondents called for an increase in the availability of standardised, validated, and normed remote assessments. ConclusionsWe conclude that the pandemic has not been detrimental to the frequency of cognitive assessments. In addition, a shift in clinical practice to include remote cognitive assessments is clear and wider availability of validated and standardised remote assessments is necessary. Key words: COVID-19, cognitive assessment, remote assessment, video conferencing, telephone conferencing, cognition, teleneuropsychology


Abstract This paper investigates the sources of the substantial decrease in output growth volatility in the mid-1980s by identifying which of the structural parameters in a representative New Keynesian and structural VAR models changed. Overturning conventional wisdom, we show that the Great Moderation was due not only to changes in shock volatilities but also to changes in monetary policy parameters, as well as in the private sector's parameters. The Great Moderation was previously attributed to good luck because the alternative sources of instabilities appear to have offsetting effects on output volatility and therefore were impossible to detect using existing techniques.


OBJECTIVES
To compare 2 laboratory assays commonly used in the evaluation of epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancer (NSCLC).

METHODS
Fifty-three formalin-fixed, paraffin-embedded NSCLC specimens were selected. Extracted DNA was analyzed using the EGFR RGQ Amplification Refractory Mutation System Scorpions probe-based real-time polymerase chain reaction (PCR) assay and the EGFR Pyro pyrosequencing assay.

RESULTS
Fourteen EGFR mutations were identified in 13 specimens using at least 1 of the assays, with a mutation concordance rate of 92.9%. Using dideoxy sequencing as the gold standard, clinical sensitivity was 73.7% and 68.4% by the RGQ and Pyro assays, respectively, but 100% by both for common drug sensitivity mutations. Performance observations included the following: the RGQ system requires higher DNA input, the RGQ system is a single-step procedure, the EGFR Pyro assay is a 2-step procedure, only the RGQ system can identify exon 20 insertions, the RGQ system is more sensitive, and the Pyro system can specify exact mutations for all interrogated sites.

CONCLUSIONS
Both the RGQ real-time PCR and Pyro assays adequately detect common EGFR mutations; however, the RGQ system is more clinically and analytically sensitive. Performance characteristics should be considered when evaluating these EGFR mutation assays for clinical adoption.


Objective—To compare the concentration of plasma atrial natriuretic peptide in patients with acute myocardial infarction with a healthy population and to determine whether a raised concentration of plasma atrial natriuretic peptide at admission was a predictor of mortality after acute myocardial infarction. Design—Patients with acute myocardial infarction were divided into a group with no congestion (class I) and a group with congestion (class II-IV) according to their highest Killip classification in the first 24 hours after infarction. The concentration of plasma atrial natriuretic peptide was measured at admission. On the basis of the concentration of atrial natriuretic peptide measured in the healthy population, patients were separated into two groups: a group with a high (>200 pg/ml) and a group with a low concentration of atrial natriuretic peptide (≤200 pg/ml). The patients were followed for three years. Patients—55 patients admitted to the coronary care unit within 12 hours of the appearance of symptoms of acute myocardial infarction were compared with 51 healthy individuals. Main outcome measures—Plasma atrial natriuretic pepetide, Killip class, mortality. Results—The patients had significantly higher concentrations of atrial natriuretic peptide than the healthy controls. Furthermore, patients with congestion had a significantly higher concentration of atrial natriuretic peptide than the uncongested group of patients. Total mortality was 34·5%. In the group with a low concentration of atrial natriuretic peptide the mortality was only 13·6%, whereas mortality was significantly higher (48·5%) in the group with a high concentration. Conclusions—The measurement of atrial natriuretic peptide separated the patients into low and high risk groups after acute myocardial infarction.


The results of a calcimetry performed on cuttings from the 3 wells of the Enhanced Geothermal System of Soultz-sous-Forets (France) are compared to other available data (petrography, mineralogy, fracture zones, flow pathways, etc...). The relationship between flow ranking and calcite content for the fracture zones of GPK3 and GPK4 is opposite to the one of GPK2 (the better the fluid flow, the lower the calcite content). This suggests that the fracture zones of GPK2 are different from those of GPK3 and GPK4, and that the connectivity to the fracture network may be different too. The results of this study provide also some explanation for the effects of the chemical stimulations performed in the 3 wells, as well as some information for future chemical stimulations that could be aimed to improve the connectivity between the wells and the fracture network.


A new type of test facility is presented which allows theinvestigation of fluid-structure interactions using a genericflexible model. Rather than modelling the complex geometry of aturbomachine blade passage or blade row, this test facilityuses a two dimensional generic bump located in a straightchannel in order to reach a better understanding of the bendingflutter phenomenon. Thus, experimental campaigns are performedto observe and measure surface pressure fluctuations linked tothe interactions of a shock wave with the boundary layer formedover the oscillating structure. The new test facility modifiesan existing wind tunnel featuring a straight rectangular crosssection. The oscillating model used in the study is oftwo-dimensional prismatic shape and has been investigated inprevious studies, from which base case data are available. Inorder to introduce capabilities for the planned fluid-structureexperimental campaigns, a flexible version of the model hasbeen built. It is moulded of polyurethane at defined elasticityand hardness, and actuated by a novel type of fully integratedmechanical oscillating mechanism. A frequency controlled ACservomotor drives this oscillating mechanism. The whole drivetrain is able to produce an oscillation of the model atvariable amplitude and frequency up to 200Hz. At the same time,a one dimensional laser sensor measures precisely the wholemodel displacement through a top optical window. The flow inthe test section can be set at different operating conditions.Time-resolved pressure measurements are performed on theoscillating surfaceusing Kulite fast response transducerscoupled to an adapted long line probe technique. While theinstantaneous models shape is scanned using laser triangulationtechnique through the top window, unsteady Schlierenvisualization measurement are performed using the accessthrough two side windows. Similar coupling is also performedbetween unsteady flexible geometry measurements and unsteadypressure measurements. The mode shapes of this flexible bumpstrongly depend on the excitation frequency. It is consideredthat a first bending mode shape is obtained for reducedfrequencies up to 0.037. However, for reduced frequencieshigher than 0.037, the mode shapes are interpreted as higherharmonic stripe mode shapes. Thus a second order mode shape isreached for reduced frequencies between 0.037 and 0.074, and athird order mode shape is reached for reduced frequenciesbetween 0.074 and 0.294. In this experimental study, the modeloscillates at reduced frequencies from 0.015 to 0.294 attransonic flow condition characterized by an inlet Mach numberMiso1=0.69 and an outlet Mach number Miso2=0.80. Schlieren pictures as well as unsteadypressure repartitions are obtained for this operating flowcondition. The presented unsteady results demonstrate that thephase of shock wave movement towards bump local motion shows adecreasing trend for third bending mode shapes fluctuating withreduced frequencies higher than 0.074. At the pressure tapslocated after the shock wave formation, the phase of pressurefluctuations towards bump local motion present the samedecreasing trend for the same kind of mode shapes. However noconclusion can be drawn for this range of perturbationfrequencies at a non-fluctuating bending mode shape (a modeshape that remains the same in the whole perturbation frequencyrange). In conclusion, a new version of this generic bump willhave to be manufactured in order to perform similar experimentsat a non-rigid first bending mode shape.


The 23S rRNA nucleotide m2G2445 is highly conserved in bacteria, and in Escherichia coli this modification is added by the enzyme YcbY. With lengths of around 700 amino acids, YcbY orthologs are the largest rRNA methyltransferases identified in Gram-negative bacteria, and they appear to be fusions from two separate proteins found in Gram-positives. The crystal structures described here show that both the N- and C-terminal halves of E. coli YcbY have a methyltransferase active site and their folding patterns respectively resemble the Streptococcus mutans proteins Smu472 and Smu776. Mass spectrometric analyses of 23S rRNAs showed that the N-terminal region of YcbY and Smu472 are functionally equivalent and add the m2G2445 modification, while the C-terminal region of YcbY is responsible for the m7G2069 methylation on the opposite side of the same helix (H74). Smu776 does not target G2069, and this nucleotide remains unmodified in Gram-positive rRNAs. The E.coli YcbY enzyme is the first example of a methyltransferase catalyzing two mechanistically different types of RNA modification, and has been renamed as the Ribosomal large subunit methyltransferase, RlmKL. Our structural and functional data provide insights into how this bifunctional enzyme evolved.


This study was designed to determine the extent to which age and educational level influence adjustment strategies to widowhood stress among widows in Rivers State, Nigeria. Descriptive survey design was adopted for the study. Two research questions and two corresponding hypotheses guided the conduct of the study at 0.05 alpha levels. A sample of 370 widows in Rivers State was drawn from the population through proportional stratified random sampling technique. Two instruments namely; Stress Level Scale for Widows (SLSW) and Questionnaire for Widows Adjustment Strategies (QWAS), both developed by the researcher were used for data collection. Data were analysed with mean, standard deviation and one-way analysis of variance (ANOVA). All hypotheses were tested at 0.05 level of significance and the statistical package known as SPSS for widows was employed for the analyses. Results showed that; widows in Rivers State differ significantly in their adjustment strategies to widowhood stress on the basis of age, educational attainment. Based on the findings of this work, three relevant recommendations were made one of which is that counsellors could systematically use the adjustment strategies studied in this research to help widows to cope with widowhood stress.


Soil erosion leads to washing topsoil, organic matter and soil fertility will decrease eventually. In order to combat erosion and loss of soil, conservation and watershed sediment generation in the NIR region, based on the WSM modeling was performed to estimate the severity of soil deposits. The model with six factors was scored for each work unit. Usually suitable model for certain areas that used them in different situations, needs to model coefficients be calibrated in the study area. For calibration, were measured the amount of precipitation from the model (estimated) and the simulated rain (objective) per work units in this watershed. The results were showed that in some work units the amount of estimated is more than 10 times versus the amount of real data (model with overestimating). The coefficients correction was done by optimizing in the Solver, with convergence (10-4), mutation and forward derivative (0.075) technology, with default values. With using the correction coefficients in the model and establishing a revised model, estimated sediment was closer to the objective values and were increased the correlation between estimate and the observed. Thus the modified model for areas with similar soil and climatic conditions in Yazd province, which has been used with caution. It is suggested to improve the coefficients, with the modified model results in a basin with actual values, to evaluate more confidently be used as local models.


The degree of human health can be influenced by behavior. This behavior factor still becomes a health problem in Indonesia. Unhealthy behavior causes various kinds of infectious diseases and non-infectious diseases. Various efforts to change the behavior of people who do not know, do not want to, and cannot afford it, have been carried out t by the government. However, Clean and Healthy Behavior is still a concern and not optimal yet. Health Belief Model (HBM) is applied as a model in efforts to overcome PHBS. The purpose of this study was to identify the effectiveness of the application of Health Belief Model to PHBS. This research is a quasy experiment with the design of one group pre-post test design. The population in this study was 40 respondents. The method of sampling used was purposive sampling method. The treatment was carried out once per week for 3 weeks. The results showed a difference in the effect of Health Belief Model (HBM) on Clean and Healthy Life Behavior (PHBS). The results of the Wilcoxon test analysis for 3 interventions in 3 weeks showed: the knowledge of PHBS (p ^ 0.00), the attitude of PHBS (0.01) and PHBS Behavior (p ^ 0.00), which means there are differences in the effect of changes in knowledge, attitudes and behavior of PHBS after HBM intervention. Health workers, especially nurses, are expected to make HBM as an effort to promote health and change hygienic and healthy living behavior in families or communities.


Proper development of nephrons is essential for kidney function. β-Catenin-independent Wnt signaling through Fzd8, Inversin, Daam1, RhoA and Myosin is required for nephric tubule morphogenesis. Here, we provide a novel mechanism through which non-canonical Wnt signaling contributes to tubular development. Using Xenopus laevis as a model system, we found that the cell-adhesion molecule Alcam is required for proper nephrogenesis and functions downstream of Fzd3 during embryonic kidney development. We found alcam expression to be independent of Fzd8 or Inversin, but to be transcriptionally regulated by the β-Catenin-independent Wnt/JNK pathway involving ATF2 and Pax2 in a direct manner. These novel findings indicate that several branches of Wnt signaling are independently required for proximal tubule development. Moreover, our data indicate that regulation of morphogenesis by non-canonical Wnt ligands also involves direct transcriptional responses in addition to the effects on a post-translational level.


The genetic variation among a population of Sclerotinia sclerotiorum collected from oilseed rape fields in the Canakkale Province of Turkey was assessed using molecular and morphological markers. Seven microsatellite primer pairs (out of eight) revealed 32 clear polymorphic alleles among the 36 fungal isolates examined. An unweighted pair-group mean analysis dendrogram was generated using the genetic distance matrix with the 32 microsatellite alleles. The level of similarity was as low as 15% between some isolates indicating a high level of genetic diversity within the fungal population; 23 distinct isolates were found (at a genotypic diversity level of 63%). Among the collection of 36 isolates, 19 mycelial compatibility groups (MCGs) were identified; 10 MCGs included at least two isolates. Molecular and morphological data suggest that most of the isolates within a single MCG were identical; however, the isolates belonging to the MCG2 and MCG4 had variable microsatellite haplotypes and were morphologically dissimilar. The data suggest that there is possibly a high rate of outcrossing as well as evolutionary potential within the population of the pathogen in oilseed rape fields. This is the first report demonstrating the genetic and morphological variation within a population of S. sclerotiorum in Turkey.


The aim of this report is to delineate trends of radicalization in Poland by evaluating specific 'hotspots.' The main source of data are the court files of twelve subjects, which are supplemented with academic literature, as well as offenders' perspectives available in the legal documentation and their (social) media. The study provides rich qualitative evidence about how personal characteristics of the offenders, their direct environment, as well as systemic and structural factors that might have contributed to the offence. The proposed micro, meso and macro factors for the specific hotspots in this report are evidenced with court files, examples of subjects' narratives and supported with findings of well-established criminological research traditions of the past fifty years, while the evidence for facilitating factors is derived from the court files and jurisprudence. The report then situates three purposively sampled participants of the hotspots on the injustice-grievance-alienation-polarization (I-GAP) spectrum. This study reinforces pre-existing research about what contributes and motivates offenders and adds to the understanding of the relationship between radicalization and crime. The absence of criminal records among the subjects indicate that radicalization is not necessarily connected with criminal lifestyle. It also suggests how in the Polish context the type of radical group might impact upon offending patterns, as well as how the normative beliefs about gender acting might be conductive to crime. Moreover, it demonstrates, consistently with the criminological research, that individuals who belong to extreme groups do not always share common traits or trajectories. It indicates that for some hotspot participants just the experience of being subjected to criminal proceedings or secret service supervision has a deterrent effect, while for others rehabilitation and deradicalization might be necessary. Finally, the absence of agreement among scholars and judges regarding hate speech and appropriate criminal justice responses continues to present difficulties.


One of the challenges facing instructional designers is in producing e-learning systems, which take account of individual differences such as nationality, gender and more importantly from an educational perspective, cognitive learning style. Accordingly, it would seem pertinent to investigate such individual difference factors with respect to computer use generally, as a means of informing e-learning instructional design. 170 undergraduate students (103 Chinese and 67 UK) completed the Cognitive Styles Index (Allinson and Hayes, 1996), a computer attitude scale (Smalley, Graff and Saunders, 2001), and also a questionnaire on their knowledge of the Internet and how effectively they used the Internet. The results revealed that Chinese students displayed a more favourable behavioural attitude than the UK students. Also, Chinese participants reported higher Internet usage than UK participants. Nationality also interacted with age on attitude scores, with the greatest variation between age groups in the Chinese sample. The results are discussed in terms of the implications of this research for the design of e-learning systems.


From Christopher J. Rapuano, M.D.: "...The summary is accompanied by brief discussion of the relevance (or irrelevance) of the paper to practicing ophthalmologists. It is what you need to know!" There's no faster or easier way to stay informed! The Year Book of Ophthalmology brings you abstracts of articles carefully selected from more than 500 journals worldwide. Expert commentaries evaluate the clinical importance of each article and discuss its application to your practice.


The multidrug resistance 1 gene (MDR1) encodes P-glycoprotein (Pgp), a member of the ATP-binding cassette (ABC) transporter family that confers tumor drug resistance by actively effluxing a number of antitumor agents. We had previously shown that MDR1 transcription is regulated by epigenetic events such as histone acetylation, and had identified the histone acetylase P/CAF and the transcription factor NF-Y as the factors mediating the enzymatic and DNA-anchoring functions, respectively, at the MDR1 promoter. It has also been shown that MDR1 activation is accompanied by increased methylation on lysine 4 of histone H3 (H3K4). In this study, we further investigated histone methylation in MDR1 regulation and function. We show that the mixed lineage leukemia 1 (MLL1) protein, a histone methyltransferase specific for H3K4, is required for MDR1 promoter methylation, as knockdown of MLL1 resulted in a decrease in MDR1 expression. The regulation of MDR1 by MLL1 has functional consequences in that downregulation of MLL1 led to increased retention of the Pgp-specific substrate DIOC(2)(3), as well as increased cellular sensitivity to several Pgp substrates. Regulation of MDR1 by MLL1 was dependent on the CCAAT box within the proximal MDR1 promoter, similar to what we had shown for MDR1 promoter acetylation, and also requires NF-Y. Finally, overexpression of the most prevalent MLL fusion protein, MLL-AF4, led to increased MDR1 expression. This is the first identification of a histone methyltransferase and its leukemogenic rearrangement that regulates expression of an ABC drug transporter, suggesting a new target for circumvention of tumor multidrug resistance.


ACE-inhibitors and angiotensin receptor blockers (ARB) slow the progression of renal disease in nontransplant patients. A systematic review of randomized trials (n = 21 trials with 1549 patients) was conducted to determine the effect of ACE-inhibitor or ARB use following kidney transplantation. With a median follow-up of 27 months, ACE-inhibitor or ARB use was associated with a significant decrease in glomerular filtration rate (−5.8 mL/min; 95% CI −10.6 to −0.99). ACE-inhibitor or ARB use resulted in a lower hematocrit (−3.5%; 95% CI −6.1 to −0.95), reduction in proteinuria (−0.47 gm/d; 95% CI −0.86 to −0.08) but no change in the serum potassium (0.18 mmol/L; 95% CI −0.03 to 0.40). ACE-inhibitor or ARB use results in clinically important reductions in proteinuria, hematocrit and glomerular filtration rate in renal transplant recipients, but there are insufficient data to determine the effect on patient or graft survival. Randomized trials of sufficient power and duration that examine these hard outcomes should be conducted. Until such trials are completed, this study provides quantitative estimates of the risks and benefits of ACE-inhibitor or ARB use that can be used by clinicians considering prescribing these medications to kidney transplant recipients or to researchers designing future trials.


In ladle refining operations, a plume eye is the area of the bath surface that is not covered with slag, due to bubbling gas, and this area is the most important in slag-metal reactions. In contrast, in vacuum degassers, most of the surface area is not covered with slag, and in this case, the bubble rising area at the bath surface is important for gas-metal reactions. This area is referred to as the "bubble eye area" in this paper. To evaluate the bubble eye size, and its effect on the surface reaction rate, water model experiments were carried out. The plume eye size was measured by changing the thickness of a polystyrene particle layer, which was added to the surface as a slag layer. The bubble eye size was estimated by extrapolating the plume eye size to the value calculated for a polystyrene layer thickness of zero. The volumetric mass transfer coefficient of the surface reaction was measured at various size of plume eye. The volumetric mass transfer coefficient at the bubble eye area was evaluated by extrapolating the mass transfer coefficient at the plume eye area to the value calculated for a plume eye size equal to the bubble eye size. It was concluded that the size of the bubble eye is influenced by the gas flow rate through each nozzle, whereas the volumetric mass transfer coefficient at the bubble eye area is influenced by the bubble eye area and the bubble rising velocity.


Studies have shown that knowledge management is an enabler of
organisational processes and helps achieve projected objectives. This
research is aimed at investigating the role of knowledge management in
enabling development project management to achieve the following
objectives; project success, faster completion times, efficiency, innovation,
knowledge sharing and best practices. The research conceptual model (The
CRAI-Codification, Reproduction, Assimilation and Interpretation model)
focused on four types of primary knowledge needed by development projects
for successful execution. These are: -Interpretative knowledge, Assimilative
knowledge, Reproductive knowledge and Codified knowledge.
Using a mixed method approach, qualitative and quantitative data were
collected from over 1000 respondents from development organisations in 8
regions in 11 development project areas. Data were obtained using web
questionnaires, structured interviews and organisational documentation. The
selection of case studies arose as a result of responses to the online survey.
The research used four case studies which exhibited KM 'consciousness and
other criteria which enabled the researcher to identify them as knowledge
generating projects. The cases were drawn from Nigeria, Uganda and
Senegal. The research applied the CRAI model within these case studies and
also compared the results of the survey data with the case study data. The survey achieved a 30.3% (303) response rate. The data gathered were analysed using quantitative analysis tools (SPSS) and techniques (regression, correlation, hypothesis testing, analysis of the model and other general analysis techniques).
The survey and case studies focused on identifying best practices, knowledge
sharing and management practices, knowledge processes in the project management cycle as reflected by the conceptual model, technology and other aspects of Knowledge Management. Some of the findings made by the research are:
(a) No standard best practice exists across the board among development
projects. Each project has a set of practices that represent best
practices for managing their projects;
(b) KM was found to be a factor in speeding up project completion times. It
was also linked to project success, knowledge sharing, innovation and
efficiency; and
(c) The CRAI model was found to be applicable to development projects
and the type of knowledge projects embody. The model positively
correlated with each of the expected outcomes-innovation, completion
times, efficiency, project success and knowledge sharing.
Recommendations made by this research include:
1. Development Projects should begin to design KM strategies as part of
Project Management systems;
2. A development project should begin with mapping essential knowledge
needed by the project;
3. Development PM should pay closer attention to the existence of
communities in the project;
4. KM should be included in the list of critical success factors; and
5. DPs should use PM technologies which integrate KM capabilities.


Introduction A lapse (any smoking) early in a smoking cessation attempt is strongly associated with reduced success. A substantial proportion of lapses are due to urges to smoke triggered by situational cues. Currently, no available interventions proactively respond to such cues in real time. Quit Sense is a theory-guided just-in-time adaptive intervention smartphone app that uses a learning tool and smartphone sensing to provide in-the-moment tailored support to help smokers manage cue-induced urges to smoke. The primary aim of this randomised controlled trial (RCT) is to assess the feasibility of delivering a definitive online efficacy trial of Quit Sense. Methods and analyses A two-arm parallel-group RCT allocating smokers willing to make a quit attempt, recruited via online adverts, to usual care (referral to the NHS SmokeFree website) or usual care plus Quit Sense. Randomisation will be stratified by smoking rate (<16 vs ≥16 cigarettes/day) and socioeconomic status (low vs high). Recruitment, enrolment, baseline data collection, allocation and intervention delivery will be automated through the study website. Outcomes will be collected at 6 weeks and 6 months follow-up via the study website or telephone, and during app usage. The study aims to recruit 200 smokers to estimate key feasibility outcomes, the preliminary impact of Quit Sense and potential cost-effectiveness, in addition to gaining insights on user views of the app through qualitative interviews. Ethics and dissemination Ethics approval has been granted by the Wales NHS Research Ethics Committee 7 (19/WA/0361). The findings will be disseminated to the public, the funders, relevant practice and policy representatives and other researchers. Trial registration number ISRCTN12326962.


This article shows how the modern category of religion largely shapes the horizon of many contemporary theological appropriations of the finality of Christ, and how the influence of this category creates serious problems. Though affirming Christ's finality often seems to pose theological difficulties in religiously pluralistic contexts, I argue that it is not at all a matter of exclusion or denigration of other religions. Quite the opposite: the doctrine at heart expresses the Christian community's hope for universal fellowship.


The intrinsic computational efficiency (ICE) of silicon defines the upper limit of the amount of computation within a given technology and power envelope. The effective computational efficiency (ECE) and the effective computational density (ECD) of silicon, by taking computation, memory and communication into account, offer a more realistic upper bound for computation of a given technology. Among other factors, they consider how distributed the memory is, how much area is occupied by computation, memory and interconnect, and the geometric properties of 3-D stacked technology with through silicon vias (TSV) as vertical links. We use the ECE and ECD to study the limits of performance under different memory distribution, power, thermal and cost constraints for various 2-D and 3-D topologies, in current and future technology nodes.


Proton damage effects on multi-quantum-well (MQW) GaAs/GaAlAs laser diodes are studied using both current vs, voltage (I-V) and optical power vs. current (L-I) characteristics. The lifetime damage factor is calculated from I-V characteristics and compared with the commonly used threshold current damage factor from L-I characteristics. The lifetime damage factor is larger than the threshold current damage factor. This difference is explained by the different values of radiative lifetime when measuring the damage factors in the different operating regions. The two damage factors are compared at proton energies from 70 MeV to 200 MeV.


A refined view of particle stimulated nucleation of recrystallization is presented, which utilizes a combination of advanced modeling tools. FEM simulations were carried out in order to model the evolution of the deformation zone around particles for various particle sizes and shapes. The results of these simulations were complemented by EBSD measurements to determine the number and orientation of nuclei. Finally, this information on particle stimulated nucleation was incorporated into a 3D cellular automaton recrystallization model CORe to model microstructure evolution. From these simulations the dependence of grain size and texture on particles size and shape was derived.


This paper introduces the concept of hydrogel encapsulated interface bilayers as a novel approach for creating durable encapsulated biomolecular materials. The regulated attachment method (RAM) is used to form encapsulated interface bilayers from lipid-encased aqueous volumes contained in a deformable supporting substrate. Physically-encapsulated interface bilayers exhibit increased durability and portability over droplet interface bilayedrs and RAM enables the in situ bilayer formation without the need to dispense and arrange individual droplets. The results presented in this paper demonstrate that poly(ethylene glycol) dimethacrylate monomers (PEG-DMA, Mw = 1000), a photopolymerizable hydrogel monomer, and Irgacure 2959 photoinitiator can be incorporated into the aqueous phase in order to form hydrogel encapsulated interface bilayers. Following bilayer formation, exposure to an ultraviolet (UV) light initiates photopolymerization of the polymer on both sides of the bilayer, creating interface bilayers between solid aqueous phases. Electrical recordings of bilayer formation in the liquid state confirm that interface bilayers formed from photopolymerizable aqueous solutions have both high electrical resistances > 1GΩ necessary for observing transmembrane protein gating and survive the UV curing procedure required to polymerize the hydrogel. Photopolymerization for 60 seconds using a 1W hand held UV spot cure light produced water-swollen solids on both sides of the membrane. Hydrogel encapsulated interface bilayers last for hours to days and retain the fluidity necessary for delivering alamethicin proteins to the interface.Copyright © 2010 by ASME


The T cell-associated CD28 molecule plays a key role in T cell co-stimulation. Its ligation induces the tyrosine phosphorylation of numerous proteins including CD28 itself as well as a restricted set of substrates of 97 and 62-68 kDa which are poorly phosphorylated by the tyrosine kinases induced by CD3-TCR triggering. In this study, we identify these substrates as the product of the vav proto-oncogene and as a 62 kDa protein that could correspond at least in part to p62dok, the 62 kDa adaptor molecule associated to p120 Ras-GTPase activating protein. Both p97vav and p62 are tyrosine phosphorylated upon CD28 ligation by mAb or by its counter-receptor B7-1/CD80. Using CD28 mutants, we also show that Vav and p62 tyrosine phosphorylation is regulated by distinct domains within the CD28 cytoplasmic tail: residues 173-181 for Vav and residues 182-202 for p62. Finally, the phosphorylation of Vav and p62 does not require an intact binding site for Grb-2 or p85 SH2 domains. We thus demonstrate that the CD28 cytoplasmic domain contains at least three functionally independent regions involved in CD28-induced signal transduction, since in addition to the Grb-2 and p85 SH2 domain binding site (Tyr173), residues 173-181 and 182-202 are associated with Vav and p62 tyrosine phosphorylation respectively.


The purpose of this study was to investigate the effect of varying drug load and concentration of a surfactant (sodium lauryl sulfate [SLS]) on the release characteristics of a model peptide (bovine serum albumin [BSA]), and study the net effects of the swelling properties of the hydrogel matrix [poly(vinyl alcohol) (PVA)]. The PVA hydrogel was prepared by a freeze-thaw process in the absence of a chemical crosslinking agent. The effect of protein loading on drug release was examined at three levels (0.65, 1.3, and 2%), whereas the effect of SLS was studied at four levels (0, 0.07, 0.13, and 0.26%). The baseline time for reaching equilibrium swelling was 48 hr for the hydrogel containing 0.65% BSA, and the equilibrium swelling time decreased significantly as the protein load was increased to 2%. The net effect of increased BSA concentrations resulted in faster BSA dissolution from the hydrogel matrix. The equilibrium-swelling ratio decreased from 21 to 10% when SLS was added to the PVA solution, which res...


Within a context of increasing economic pressure in rural America, this study assesses family responses to this change and their consequences from the perspective of the household economy in middle-class families. It draws on the findings of largely separate fields of inquiry, including those on income level and loss, unemployment, and economic adjustments. Using survey and observational data on two-parent families in a midwestern rural county, the analysis shows that (a) adverse income change increases economic pressures and hardship adaptations in ways that match the effect of income level and exceed the influence of unstable work, (b) economic pressures and adaptations mediate the negative effects of economic adversity on emotional health and family relationships, (c) father's negativity in the family represents a stronger link between economic conditions and child behavior than does mother's negativity, and (d) economic pressure and father's negativity increase the risk of aggressive behavior and depressed feelings among boys and girls, especially in the absence of maternal support.


CPI invites potential book reviewers who will prepare one of two types of book reviews: A somewhat, long review between 1000-1200 words. A precis of approximately 500-750 words. Each reviewer will be instructed concerning the type of review expected, and given general CPI book review guidelines. Potential reviewers :  If you wish to write a CPI Book Review, please send an email to email@example.com with the following letter of interest: Your name and academic affiliation. Your current land address (to which the book will be mailed). Your email address, telephone number &/or skype address. A professional biography which states:  (i) your academic qualifications; (ii) current academic position; (iii) relevant information which includes: current academic &/or professional interests, previous scholarship, recent publications; (iv) reasons for wanting to write a book review. If possible, suggestions regarding, either recently published or, forthcoming books (in Canada and internationally) that you think are suitable and warrant review.


Abstract For many developing countries such as Uganda, precise gravimetric geoid determination is hindered by the low quantity and quality of the terrestrial gravity data. With only one gravity data point per 65 km2, gravimetric geoid determination in Uganda appears an impossible task. However, recent advances in geoid modelling techniques coupled with the gravity-field anomalies from the Gravity Field and Steady-State Ocean Circulation Explorer (GOCE) satellite mission have opened new avenues for geoid determination especially for areas with sparse terrestrial gravity. The present study therefore investigates the computation of a gravimetric geoid model overUganda (UGG2014) using the Least Squares Modification of Stokes formula with additive corrections. UGG2014 was derived from sparse terrestrial gravity data from the International Gravimetric Bureau, the 3 arc second SRTM ver4.1 Digital Elevation Model from CGIAR-CSI and the GOCE-only global geopotential model GO_CONS_GCF_2_TIM_R5. To compensate for the missing gravity data in the target area, we used the surface gravity anomalies extracted from the World Gravity Map 2012. Using 10 Global Navigation Satellite System (GNSS)/levelling data points distributed over Uganda, the RMS fit of the gravimetric geoid model before and after a 4-parameter fit is 11 cm and 7 cm respectively. These results show that UGG2014 agrees considerably better with GNSS/levelling than any other recent regional/ global gravimetric geoid model. The results also emphasize the significant contribution of the GOCE satellite mission to the gravity field recovery, especially for areas with very limited terrestrial gravity data.With an RMS of 7 cm, UGG2014 is a significant step forward in the modelling of a "1-cm geoid" over Uganda despite the poor quality and quantity of the terrestrial gravity data used for its computation.


This essay examines the postwar fiction of Hotta Yoshie (1918–98), a relatively neglected member of the postwar generation, whose work was shaped by his experience in Shanghai at the end of World War II and his subsequent return to occupied Tokyo. The essay argues that the topos of occupation forms an underlying thematic thread in Hotta's early postwar fiction, one that delineates a historical trajectory moving from the space of Japanese empire to the postwar reconstruction of the nation-state. Through the juxtaposition of wartime and postwar spaces of occupation, Hotta maps the ruptures and repetitions existing between the two periods, providing a key illustration of ways in which memories of empire continued to haunt the postwar literary imagination.


diagnostic and use Abstract The management of trauma-related coagulopathy and haemorrhage is changing from a reactive strategy to a proactive early intervention with blood products and haemostatic agents. Although major haemorrhage and massive transfusion are associated with higher mortality, the pattern of this association with modern trauma care is poorly described. In addition, early predictors of massive transfusion, which might trigger a proactive haemostatic resuscitation strategy, are not currently available. We review recent literature relating to predictors of massive transfusions and the relationship between transfusion and mortality.


This study covers the analysis of temporal change of the land use in Terkos basin which is among the basins, actually the most important one, that were studied within the project of "Analysis of the Land-Use Changes by Using the Satellite Images of the Water Basins of Istanbul" carried out by a group from Istanbul Technical University (ITU), Remote Sensing Division for Istanbul Water Board Authority (ISKI). As the spatial resolution is high, IRS 1C-1D and LISS III satellite images belonging to three different years were used in the project. In the first stage of the study, geometric rectification process of the images were made. In the second stage, land-use classes were determined by applying classification algorithms on the basis of outer border of the long-term conservation area of Terkos basin. From the classification process and its results, area values were calculated and temporal changes were ascertained. In the last stage of the study, accuracy evaluations has been carried out.


Respite/short breaks have been recognized as an important supportive service in paediatric palliative care (Knapp & Contro, 2009; Ling, 2012). In some countries, for example the UK, hospices are key players in this delivery. Despite evidence that supports short break services in hospices (Kirk & Pritchard, 2012) the literature suggests that there is varied access and uptake of such provision (Smith, Graham, & Herbert, 2017; Devanney & Bardley, 2012; Knapp, Shenkman, Marcu et al., 2009). A two-phase grounded theory study was conducted in one region in England, to explore parental experiences and perceptions of children's hospices, the barriers and facilitators to access and the characteristics which parents wanted from hospice services. A two phase grounded theory study (Charmaz, 2014) was conducted: Phase 1 used focus groups to collect data from parents of children already accessing the hospice (n=24) and in Phase 2 semi-structured interviews were conducted with parents of children who did not use the hospice (n=7) and parents who had previous experience of using a hospice (n=7). Analysis of the data identified three main themes: Coming 'Home'; This is Living Now; and Moving Forward. A grounded theory model of place bonding was developed which illustrates the cognitive journey and characteristics which are important for parents of children with life-limiting conditions when considering/receiving hospice care for their child. Finding a place where they belonged and felt at 'home' made the decision to accept help in caring for their child with a life-limiting condition more acceptable.


There is broad consensus across academic disciplines that access to same-race/ethnicity teachers is a critical resource for supporting the educational experiences and outcomes of Black, Hispanic, and other students of color. While theoretical and qualitative lines of inquiry further describe a set of teacher mindsets and practices aligned to "culturally responsive teaching" as likely mechanisms for these effects, to date there is no causal evidence on this topic. In experimental data where upperelementary teachers were randomly assigned to classes, I find large effects upwards of 0.45 standard deviations of teachers of color on the shortand longer-term social-emotional, academic, and behavioral outcomes of their students. These average effects are explained in part by teachers' growth mindset beliefs that student intelligence is malleable rather than fixed, interpersonal relationships with students and families, time spent planning for and differentiating instruction for individual students' needs, and the extent to which teachers lead well-organized classrooms in which student (mis)behavior is addressed productively without creating a negative classroom climate.


The fortunes of signal processors are directly related to progress in integrated circuit technology. This technology has experienced recent advances in logic design density and increased clock rates that will have significant impact on the performance of signal processors for the next 4 to 5 years. The objective of this paper is to develop an architecture that is matched to the computational requirements of a typical RADAR system and show how it can be implemented with these new devices. An analysis has been conducted to determine the relationship between multiplications, additions, and memory accesses for those algorithms requiring the highest data throughput including an adaptive array process. An architecture for a signal processing engine is then developed that is matched to the relative ratios for these functions. This signal processing engine is then sized using configurable gate array integrated circuits to implement each of it's major functions. Finally, an estimate is made of the number of engines required to process these algorithms.


The mobility on stairways is a daily challenge for seniors and people with dyskinesia. Lower limb exoskeletons can be effective assistants to improve their life quality. In this paper, we present an adaptive stair-ascending gait generation algorithm based on a depth camera for lower limb exoskeletons. We first construct a linked-list-based stairway model with the point cloud captured from the depth camera. Then, an optimal foothold point is calculated based on the linked-list stair model for gait generation. Finally, the exoskeleton takes the stair-ascending gait of healthy people as a reference and generates appropriate gait for the stair. The proposed gait generation algorithm is initially validated through holistic simulation analyses. We tested the stairway modeling algorithm on varieties of indoor and outdoor stairways and evaluated the gait generation algorithm on stairs of different height. The subjects' stair walking tests with lower limb exoskeletons show the effectiveness of the proposed stairway modeling and gait generation approaches.


Abstract: This paper draws upon a video ethnography of building care and makes this work available to an investigation of how "non human agency" is sustained in actual cases of repair and maintenance activities. Therefore, the paper homes in on a particular situation of maintenance work, bringing together a caretaker and a couple of tenants, regarding a low water pressure problem (LWPP) at the couple's flat. The paper examines how the participants engage in a situated, temporally unfolding, collaborative and yet distributed inquiry regarding the encountered problem and its candidate solutions. Maintenance routine, in the course of the examined situation, appears to stand in an asymmetrical relationship with repair work due to a prior 'botched job', and the outlined video analysis demonstrates just how the involved participants establish, elaborate and, eventually, suspend this relationship. The expression "reassembling repair" encapsulates this moment of suspension, when the caretaker, upon the tenants' final hint, indeed repairs the LWPP (by reassembling and removing its 'root cause'), instead of sustaining his maintenance routine (to temper only the problem's 'symptoms'). In describing participants' situated inquiry, their practical deliberations and its eventual denouement, the paper offers an apt opportunity to reflect upon socio-material approaches that simplify, simply invoke, or actually "neglect the situation" in favor of renewed epistemologies or generalized ontologies in Science and Technology Studies. Keywords: situated inquiry; respecification; building care; caretaker; maintenance routine; reassembling repair.


An internationally acknowledged requirement is to analyze and provide technical solutions for prevention and safety during the use and maintenance of manure spreader wagons. Injuries statistics data and specific studies show that particular constructive criticalities have been identified on these machines, which are the cause of serious and often fatal accidents. These accidents particularly occur during the washing and maintenance phases—especially when such practices are carried out inside the hopper when the rotating parts of the machine are in action. The current technical standards and the various safety requirements under consideration have not always been effective for protecting workers. To this end, the use of SWOT analysis (Strengths, Weaknesses, Opportunities, and Threats) allowed us to highlight critical and positive aspects of the different solutions studied for reducing the risk due to contact with the rotating parts. The selected and tested solution consists of a decoupling system automatically activated when the wheels of the wagon are not moving. Such a solution prevents the contact with the moving rotating parts of the machine when the worker is inside the hopper. This mechatronic solution allowed us to obtain a prototype that has led to the resolution of the issues related to the use of the wagon itself: in fact, the system guarantees the stopping of manure spreading organs in about 12 s from the moment of the wheels stopping.


To determine the minimum effective dose of metronidazole in the treatment of vaginal trichomoniasis, a randomised clinical trial comparing single 1-g and 2-g doses was carried out on 163 patients attending sexually transmitted diseases and family planning clinics. Seventy-two of 86 (84%) patients receiving a single 2-g dose of metronidazole were cured compared with only 42 of 77 (55%) receiving a 1-g dose. The body weight of the patient was a significant variable affecting treatment outcome only in the latter group; 69% of patients weighing more than 57 kg or less when cured compared with only 43% of those weighing more. Patients who failed after either dose regimen were retreated with a single 2-g dose. Eighteen of 21 (86%) and seven of 10 (70%) failures with the initial 1-g and 2-g doses respectively were cured. A single 1-g dose of metronidazole is not recommended as routine treatment for vaginal trichomoniasis.


Many corals (stony corals and octo- corals) rely on their symbiotic algae (zooxanthellae) for survival. Under stress, zooxanthellae are ex- pelled, resulting in coral bleaching. The hypothesis that corals may survive climate change by ex- changing algal types is shown here to be potentially applicable only to a minority of corals. Data on 442 coral species from 43 studies reveal that only a few coral species may be able to change their symbionts. The ability to change symbionts seems to be linked to whether a coral species can host multiple zooxanthella clades, either at different depths on the same reef, on different reefs or at different geographic locations, or concurrently within the same colony. The combined data set shows that only 23% of coral species host multiple zoo- xanthella clades. Most coral species (77%) exhibit fidelity to a narrow subset of a single zooxanthella clade, some even to specific algal genotypes within a clade. These specific algal genotypes in coral species hosting a single algal clade do not change over time. Furthermore, no algal change occurs when a coral colony is either transplanted to differ- ent environments, or subjected to stressors such as disease or increased temperatures. For the majority of corals, therefore, algal switching does not appear to occur. These coral species will survive only if the existing host-symbiont combination withstands the changing conditions. If climate warming con- tinues, coral reefs may undergo a change in bio- diversity such that only a subset of symbiotic corals may persist.


The capacity to prioritize correctly actions in malaria control depends on good knowledge not only of the epidemiology of the disease in the area but also of the behaviour of the people. Health policy makers frequently believe that the people already know enough about malaria and there is no need to commit further resources on finding out what the people actually know and do about the disease in order to modify their wrong habits. One of the pressing priorities for malaria control in Africa is therefore changing the attitude of malaria control policy makers. Considering the constraints to malaria control it is stressed that the health budget is usually below a level sufficient to finance an effective health care system. This is further compounded by inequities in the allocation of funds between health care institutions located in the urban areas compared with those located in the rural areas. Another important constraint is lack of manpower suitably trained to undertake the various elements of the global malaria control strategy. Finally, a very well known constraint is the unavailability of effective drugs at the locations where they are needed.


The Nifty Assignments special session is all about promoting and sharing the ideas and ready-to-use materials of successful assignments. Each presenter will introduce their assignment, give a quick demo, and describe its niche in the curriculum and its strengths and weaknesses. The presentations (and the descriptions below) merely introduce the assignment. A key part of Nifty Assignments is the mundane but vital role of distributing the materials - handouts, data files, starter code, rubrics - that make each assignment ready to adopt. Each assignment presented has complete materials freely available on the Nifty Assignments home page nifty.stanford.edu. If you have an assignment that works well and would be of interest to the CSE community, please consider applying to present at Nifty Assignments.


In this study, the flow profiles of silo that is more important for designing of silos of grain crop (cereals) used in various areas because of nutrient features was taken up. In the study scope, flow profiles for silos were introduced and some flow problems as factors influencing on the flowability of grainy products arching, ratholes (also called pipes) and segregation was explained in detail.


Routing is very fundamental to the implementation of any networking or communications infrastructure. This paper, therefore, examines the conflicts and relevant considerations for implementing autonomous or self-organising unmanned aerial vehicles (UAVs) for communications area coverage, with particular emphasis on the impact of aerial vehicle autonomy algorithms on routing techniques for such networks. UAV networks can be deployed either as ad-hoc or infrastructure-based solutions. The mobility of UAVs introduces periodic topology changes, impacting link availability and routing paths. This work examines the implications of autonomous coordination of multiple UAVs on routing techniques and network architecture stability. The paper proposes a solution where routing techniques and UAV autonomy algorithms are integrated for improved global network efficiency for both ad-hoc and infrastructure-based scenarios. Integrating UAV autonomy algorithms with routing schemes may be an efficient method to mitigate link/topology stability issues and improve inter-UAV communication and network throughput, a key requirement for UAV networks. The implementation of inter-UAV links using optical, microwave or mmWave transmission is examined in the context of this work. The proposed integration may be crucial for communications coverage, where UAVs provide communications area coverage of a community of mobile or fixed users in either ad-hoc or infrastructure-based modes.


Approaches to incarceration vary widely across the globe. As described within and throughout this book, approaches to and definitions of community music also differ in intricate ways. This chapter examines music-making in prisons, specifically led by people coming into U.S. and U.K. prison contexts, suggesting new insights into the values, applications, and meanings of community music. Contrasting approaches toward imprisonment exist not only across the globe, but also within particular countries. In the United States, for example, a wide range of practices within the contexts of imprisonment occur such as incarceration rates, lengths of sentences, use of capital punishment, voting rights for incarcerated people, and quality of legal representation, to name a few. Life behind bars restricts inmates' opportunities for self-expression. Research and practice in music-making in prisons is newly developing and suggests that community music approaches within prisons provides a means toward desistance, improved self-esteem, social support, and a sense of accomplishment. Furthermore, music-making within the complex power dynamics of prison contexts emphasizes the importance of the concepts of the welcome and hospitality within our understanding of community music.


Certain forms of cellular activation lead to immediate early gene (IEGPs) transcription. The biochemical cascade involving IEGPs has been demonstrated to be an important part that cells response to environmental events. The article reviewed the feature of c-Fos expression in vestibular complexes under stimuli. It was considered that c-Fos expression might be a cue parameter in studying the connection of all vestibular complexes, and to reveal the mechanism of motion sickness.


ABSTRACT In this article, I present a previously unexplored verse miscellany, which contains 18 poems and begins with a copy of the Earl of Rochester's "Upon Nothing." The miscellany, held at Staffordshire Record Office, was compiled around 1703 by Sir John Bridgeman, 3rd baronet, a Shropshire gentleman and grandson of the politician Sir Orlando Bridgeman. While many of the contents relate to the political events surrounding the accession to the throne of Queen Anne, the collection reveals a pervasive interest in the turbulent years of the Restoration period. The cultural memory of the Exclusion Crisis casts its shadow over Bridgeman's collection, and many of the topical poems touch upon the ramifications of an unstable line of royal succession. Tracing the political and scribal communities to which Bridgeman might have belonged, I explore the ways in which Rochester, and the Restoration, were being refigured in the earliest years of the eighteenth century.


Summary
1. Sexually selected traits often honestly advertise aspects of individual quality, such as immune function. Such traits have traditionally been thought to reveal real-time information (e.g. current health state), but they may also reflect immunological conditions experienced during ontogeny, which can fundamentally shape survival prospects, adult immune function, and reproductive performance.

2. We tested the effects of immune challenges (injections of sheep red blood cells) during neonatal development on adult immune function and ornamental coloration in male mallard ducks (Anas platyrhynchos). Mallards have a carotenoid-pigmented beak that plays a role in mate choice, and because carotenoids are also associated with immune responsiveness, carotenoid accumulation in body tissues may change as a function of immunological state during development and into adulthood.

3. We found that mallards that received immune challenges at the completion of growth (8–10 weeks old) had a reduced proinflammatory response (as measured by the local swelling response to phytohemagglutinin; PHA) as adults, compared to control birds and those receiving immune challenges at other developmental time points. Mallards that received immune challenges during the acquisition of nuptial plumage (13–15 weeks old) had an increased humoral immune response as adults, as assessed by antibody production to keyhole limpet hemocyanin (KLH). Body mass, adult beak colour, and carotenoid circulation were not affected by immune challenges issued at any point during development.

4. Circulating carotenoid levels prior to adult immune challenge and change in carotenoid titre over the course of the adult immune assessment period were correlated with degree of response to PHA and KLH at adulthood, as well as with nitric oxide production, which is associated with innate immunity. However, the direction of these correlations varied by type of immune assessment. Surprisingly, unlike in several previous studies, we found no link between beak coloration and adult immune function.

5. These findings demonstrate the importance of developmental immune challenges in shaping adult immune response, although the precise mechanisms remain unidentified. Moreover, we found support for the hypothesis that carotenoids are linked to immune function, because of the relationship between multiple immune responses and both initial and change in circulating carotenoid levels.

6. However, our study does not support the hypothesis that sexual signal expression reveals developmental immune history. Taken together, our findings suggest that the relationships between carotenoid physiology, carotenoid-based ornamentation, and immune function are complex.


The objective of this master thesis is to evaluate the IOR potential for the NorneField's E-segment using low salinity water injection. Sea water/high salinity waterwas injected into this formation in the past. The Norne Field's E-Segment has produced about 40% of the oil in place so far afteremploying the combination of primary and sea water flooding as a secondary recovery technique for a period of 7 years of production (i.e. from 6 November 1997 to 1 December 2004). There is about 60% oil is still trapped as residual oil especially in the Ile and Tofte formations which take hold of about 80% of oil in the reservoir. The oil trapped as a result of high capillary action of water which keeps this oil immobile. Low salinity water injection could be an effective recovery mechanism to extract this residual oil from the reservoir. For the modeling of low salinity water injection for the Norne Field's E-Segment, low salinity water is injected from 1 January 2005 as tertiary recovery method using ECLIPSE 100 reservoir simulator and the simulation is ended on 1 December 2022.Simulation studies using the original wells shown that low salinity water injection with optimal concentration of salinity 1,000 ppm TDS (Total Dissolved Salts) or 1.0kg/m3 revealed substantially higher oil production (34.13 MSCM) compared to seawater/high salinity water injection (32.95 MSCM). Having found that the low salinity water injection is an effective IOR technique for the Norne Field's E-Segment, the next job was to find the different ways to extractmore oil using low salinity water injection. For extracting more oil there are six significant different simulations have been run using different well configurations including base case such as; (1) Base case/sea water injection using the existing or the original wells (i.e. twoinjectors: F-1H & F-3H and two producers: E-2H & E-3AH), (2) Low salinity water injection using the original wells, (3) Low salinity water injection using the original wells in addition to a new producing well PROD-1H, (4) Low salinity water injection using the original wells in addition to recompleted producing well E-3AH, (5) Low salinity water injection using the original wells in addition to a new injection wellINJ-1H, and (6) Low salinity water injection using the original wells in addition to recompleted injection well F-3H.


OF THESIS THE EVERYDAY SPEECH PRODUCTION ASSESSMENT MEASURE (E-SPAM): RELIABILITY AND VALIDITY Purpose: The Everyday Speech Production Assessment Measure (E-SPAM) is a novel test for assessing changes in clients" speech production skills after intervention. This study provides information on reliability and validity for the test and overviews its clinical application. Method & Procedures: E-SPAM, oral reading, and sequential motion rate tasks were administered to 15 participants with motor speech disorders (MSDs). E-SPAM responses were scored using a 5-point system by four graduate students to assess interscorer and temporal reliability and to determine validity for E-SPAM. Results: Findings of this study indicate that the E-SPAM can be scored with sufficient reliability for clinical use, yields stable scores on repeat administrations, and that its results correlate highly with other accepted measures of speech production ability, specifically sentence intelligibility and severity. Conclusions: While the results of this study must be considered preliminary because of the small sample size, it does appear that the E-SPAM can provide information about aspects of speech production such as intelligibility, efficiency, and speech naturalness, that are important when treatment focuses on improving speech. The E-SPAM also appears to be a "clinician-friendly" test as it is quick to administer and score and can be administered to patients across the severity continuum.


The series of tests discussed in this paper was made for the purpose of determining whether or not gate valves or globe valves could be used satisfactorily for regulating releases from irrigation-distribution systems under heads up to about 125 ft. Both types of valves proved unsuitable for making free-flow releases because of the wide dispersion of the jets under throttled conditions. Confinement of the jets to pipelines downstream induced cavitation in and downstream of the valves and a study was made of the pressures in the pipelines upstream and downstream of 6, 8, 10, and 12-in. gate valves, and a 6-in. globe valve to evolve a means of eliminating or minimizing the cavitation. A pressure relationship or "cavitation index" was found to be a useful means of determining the limits of differential head and back pressure to either control the location of, minimize, or eliminate cavitation damage. The design of the water passage immediately downstream from the valves and the pressure within this passage were the two main factors influencing the cavitation characteristics of an installation. One of the most effective means of eliminating cavitation damage below gate valves was the placing of sudden enlargements in the pipe sections immediately downstream. No damage could be detected in the concrete lining of the sudden enlargement under heads up to 150 ft with back pressures of approximately 15 ft, although noise similar to that which accompanies cavitation was present at heads in excess of about 90 ft. A limited number of tests were made to study the resistance of rubber-like products to cavitation-erosion and their use in protecting the downstream pipe wall against this erosion. The conclusion was reached that such protection should not be used except in cases where cavitation will be mild. Some consideration was given to venting the area in the top of the pipe just downstream of the valve, but this was considered objectionable because of the influence of entrained air on flow conditions and measuring devices, particularly propeller meters, placed downstream. Moreover, it was doubtful that air admitted to this region would reach all critical zones of local cavitation. The information obtained from the valve investigation is very useful as design criteria for irrigationdistribution systems where valves are used for regulating the releases.


ABSTRACT To what level are ethnic minority farmers aware of climate change and the importance of their adaptive capacity? This study was conducted in two mountainous districts of Thua Thien Hue province, Vietnam, with the involvement of 246 ethnic households, 15 key informants and a group of provincial and district agricultural representatives. A research framework linking climate awareness and adaptive capacity was adopted for this study. The results highlighted that ethnic minority farmers in the mountainous areas of Thua Thien Hue had relative low awareness of climate change and relative low adaptive capacity. Results also showed that awareness of climate change is an important element for households' adaptive capacity, where farmers who are more aware of climate change have a better adaptive capacity. Strengthening existing formal information channels (from extension and agricultural departments) on climate change with strong interlinkages with local social networks and creating socio-economic incentives to promote individuals' adoption of adaptation measures were key to the building up farmers' adaptive capacity.


1. The effect of external potassium ions on the extrusion of sodium ions by the seawater-acclimated fat sleeper, Dormitator maculatus , was investigated. 2. Removal of external potassium ions reduced the efflux of sodium from the fish by 22% while addition of 10 -4 M ouabain reduced the efflux of sodium ions by 14%. 3. Addition of potassium ions to distilled-water baths into which fish were rapidly transferred stimulated sodium extrusion in a manner which could be described by the Michaelis-Menten equation. The K m of this potassium-stimulated sodium efflux was approximately 2 mM-K/1. 4. The calculated rate of sodium extrusion was 10 times the oral ingestion of sodium ions. 5. Biochemical assays of the levels of the enzyme Na-K-activated ATPase extracted from gill tissue determined that seawater-acclimated fish had 3 times the enzymic activity that fish acclimated to freshwater had. 6. In vitro potassium stimulation of the extracted Na-K-activated ATPase showed Michaelis-Menten kinetics with a K m of approximately 2 mM-K/l. 7. It is concluded that the extrusion of sodium ions by Dormitator maculatus acclimated to sea water is coupled with potassium uptake and is mediated by the enzyme Na-K-activated ATPase.


Flood risk management and flood frequency analysis have relied on the stationary and independence assumptions of random events, whereas the probability associated with a given flood is constant across time. However, climate variability and land use changes may impose significant modifications in the physical processes associated with extreme rainfall-runoff events in a given region which in turn may alter the flood hazard for short or long periods. In this case, identification of the key climate variables associated with the flood hazard variability is particularly important if one wants to assess the impacts of climate change on the flood risk. Here we explore the hypothesis of a time varying flood hazard for several streamflow gauges in leading locations across Brazil by analyzing historical streamflow series and large scale climate teleconnections associated with their interannual variability. Particularly, we define the flood hazard as the probability of the daily flow to exceed some pre-defined threshold value, e.g., the 90 daily streamflow percentile. For each year and gauge, the number of days in which the daily streamflow exceeds the threshold value is then stored. In order to consider only time independent flood events, we decluster the daily streamflow series by taking only flood events in which the inter-arrival time is greater than three days. The interannual variability in the number of flood events for each site is then associated with climate variability in a Poisson regression framework, whose covariates are representative of ENSO, of the meridional position of the Intertropical Convergence Zone (ITCZ) and of the monsoon system over South America. The spatial distribution of the regression estimates are then used to depict a quantitative view of the most sensitive regions in Brazil in terms of flood risk changes due to ENSO, ITCZ and monsoon variability. Finally, the implications of potential future changes of such large scale climate systems on the flood risk in the country are discussed.


Abstract. Particulate organic nitrates (PONs) constitute a substantial fraction of secondary organic aerosols and have important effects on the reactive nitrogen budget and air quality. Laboratory studies have revealed the non-negligible influence of the interactions between anthropogenic pollutants and biogenic volatile organic compounds (BVOCs) on the formation of PONs. In this study, the contents of specific PONs, including monoterpene hydroxyl nitrate (MHN215), pinene keto nitrate (PKN229), limonene di-keto nitrate (LDKN247), oleic acid keto nitrate (OAKN359), oleic acid hydroxyl nitrate (OAHN361), and pinene sulfate organic nitrate (PSON295), in fine particulate matters at four rural and urban sites in eastern China were determined, and the variation characteristics of PONs and the impacts of human activities on PONs formation were investigated. The average concentration of PONs ranged from 116 to 548 ng m−3 at these four sites. PONs were present in higher levels in summer than in other seasons, owing to the high emissions of precursors and intensive photochemical activities in this hottest season. Among the six species of PONs, MHN215 was dominant. In addition, the proportion of OAKN359 in PONs in urban areas was much higher than that in the rural site, indicating that OAKN359 primarily originated from anthropogenic activities. Slight diurnal differences existed in the concentration and secondary formation of specific PONs and varied with locations, seasons, and precursor VOCs. The measurement results showed that PONs in North China were clearly influenced by coal combustion and biomass burning, while meteorological conditions and biogenic emissions were the dominant contributing factors in the South China. Biomass burning significantly enhanced the formation of PONs due to the elevated concentrations of ozone and the released BVOCs. Sulfur dioxide (SO2) emitted from coal combustion was able to react rapidly with Criegee intermediates, the reaction products of BVOCs with ozone, to produce PONs at high rates, suggesting that there is a substantially greater role played by SO2 in organic nitrate chemistry than has previously been assumed.


Orientation: Diversity management, focusing on developing and appreciating diverse ideas and building relations among diverse employees, and new electronic human resource management (e-HRM) approaches to employees, often leave employees feeling disrespected and indignant. Thus, instead of human resource practitioners, harnessing the strategic role of e-HRM towards value creation for people and organisation, e-HRM has taken a dehumanising turn.Research purpose: This research questioned how technological changes affecting e-HRM could optimise and enable diversity.Motivation for the study: Current literature does not adequately address this e-HRM dilemma impacting on HRM.Research approach/design and method: A qualitative exploratory case study was used to determine how and to what extent the application of e-HRM technology implementation impacted on diversity management. The human niche and ecological model theories help explain the nature of employees' interactional relationships and coping mechanisms when intervening factors such as e-HRM are introduced respectively.Main findings: The research revealed disconnectedness between e-HRM, individuals and groups, affecting efficiency. Further research is required to improve humanistic approaches for e-HRM implementations.Practical/managerial implications: Application of human niche theory may guide a more participative approach from the onset. Leaders and managers who follow a pure transactional approach may fuel employee isolationism and hamper diversity management through technology in e-HRM.Contribution/value-add: Our findings provide insight into the unintended consequences of diversity. We indicated how e-HRM systems can lead to relational breakdown in a developing country context. Technology should be integrated in managing diversity, and not just focused on operational efficiencies.


Responses to sprint interval exercise (SIE) are hypothesized to be perceived as unpleasant, but SIE protocols are diverse, and moderating effects of various SIE protocol parameters on affective responses are unknown. We performed a systematic search to identify studies (up to 01/05/2021) measuring affective valence using the Feeling Scale during acute SIE in healthy adults. Thirteen studies involving 18 unique trials and 316 unique participant (142 women and 174 men) affective responses to SIE were eligible for inclusion. We received individual participant data for all participants from all studies. All available end-of-sprint affect scores from each trial were combined in a linear mixed model with sprint duration, mode, intensity, recovery duration, familiarization and baseline affect included as covariates. Affective valence decreased significantly and proportionally with each additional sprint repetition, but this effect was modified by sprint duration: affect decreased more during 30 s (0.84 units/sprint; 95% CI: 0.74–0.93) and 15–20 s sprints (1.02 units/sprint; 95% CI: 0.93–1.10) compared with 5–6 s sprints (0.20 units/sprint; 95% CI: 0.18–0.22) (both p < 0.0001). Although the difference between 15–20 s and 30 s sprints was also significant (p = 0.02), the effect size was trivial (d = −0.12). We observed significant but trivial effects of mode, sprint intensity and pre-trial familiarization, whilst there was no significant effect of recovery duration. We conclude that affective valence declines during SIE, but the magnitude of the decrease for an overall SIE session strongly depends on the number and duration of sprints. This information can be applied by researchers to design SIE protocols that are less likely to be perceived as unpleasant in studies of real-world effectiveness. Systematic Review Registration Open Science Framework, https://osf.io/sbyn3.


Embracing the whole of ancient history and literature over more than two thousand years, the three volumes of A Dictionary of Greek and Roman Biography and Mythology provide a wealth of information on every significant figure mentioned by the Greek and Roman writers in the areas of history, philosophy, mathematics, the Arts, medicine, law, geography, architecture, etc. A full account of the works as well as the lives of the Greek and Roman writers is included. Painters, sculptors, and architects are treated at considerable length and an account is given of all their works extant or of which there is any record in the ancient writings. Care has been taken to separate articles on mythological subjects from those of an historical nature. Greek divinities are given under their Greek names and Italian divinities are given under their Latin names. The final volume contains chronological tables of Greek and Roman history, genealogical tables and a list of kings. With contributors drawn from amongst the most distinguished scholars of the day the reissue of these scarce volumes makes available once more an important and valuable work of classical scholarship.


In pervasive healthcare systems, WSNs provide rich contextual information and alerting mechanisms against odd conditions with continuous monitoring. Furthermore, they minimize the need for caregivers and help the chronically ill and elderly to survive an independent life. In this paper, we propose an outdoor monitoring environment and evaluate the capabilities of video sensor networks for healthcare monitoring in an outdoor setting. The results exhibit that their capabilities are limited. For this reason, we proposed several enhancements for reducing the traffic load on the network for better performance. RFID is a very mature technology that has already been used in many areas. The RFID-enhanced video sensor networks reduce the network traffic load. Moreover, the proximity of the healthcare professionals who are also moving in the surveillance area is also used for better balancing the network load. Finally, for assuring the reporting of the emergency events with low latencies, we propose an emergency frame based queuing mechanism and evaluated its performance through simulations.


Cupping therapy has been popular in elite athletes in recent years. However, the effect of cupping therapy on reducing muscle fatigue has not been investigated. The purpose of this study was to investigate the immediate and delayed effects of cupping therapy on reducing biceps brachii fatigue during biceps curls. Twelve healthy untrained participants were recruited for this repeated-measures study. Cupping therapy (–300 mmHg pressure for 5 min) and sham control (no negative pressure for 5 min) were applied after biceps fatigue induced by performing repeated biceps curls at 75% of the 10 repetitions of maximum of the non-dominant hand. Surface electromyography (EMG) with spectral analyses [mean frequency (MNF), median frequency (MDF), and spectral moments ratio (SMR)] were used to assess muscle fatigue during the fatigue task. EMG signals during the first 10 repetitions and the last 10 repetitions of biceps curls were used to assess neuromuscular fatigue. There were significant decreases in MNF and MDF and a significant increase in SMR immediately and 24 h after the sham control (no intervention). When comparing the MNF, MDF, and SMR after cupping therapy to the sham control, there was no significant immediate effect on reducing muscle fatigue. However, there was a significant delayed effect on improving recovery following fatigue for the cupping therapy compared to the sham control (MNF changes: sham 0.87 ± 0.02 vs. cupping 0.91 ± 0.02, p < 0.05; MDF changes sham: 0.85 ± 0.03 vs. cupping: 0.91 ± 0.02, p < 0.05; SMR changes: sham 1.89 ± 0.15 vs. cupping 1.58 ± 0.13, p < 0.05). The findings of this study demonstrate that there is a time effect of cupping therapy for reducing muscle fatigue. Cupping therapy is effective on reducing biceps brachii muscle fatigue after 24 h.


Purpose: To evaluate the role of umbilical cord serum (UCS) and autologous serum (AS) therapy in reepithelialization of corneal graft after keratoplasty in a randomized controlled trial. Methods: A total of 105 eyes with epithelial defect (ED) after keratoplasty (penetrating keratoplasty—67 and anterior lamellar keratoplasty—38) on the first postoperative day were included in the study. The eyes were randomized into three groups: UCS (n=35), AS (n=35), and artificial tears (AT) (n=35). All patients received standard postoperative medical therapy. The primary outcome measure was time to epithelialization, and secondary outcome measures were best-corrected visual acuity and graft clarity. Results: The ED healed completely in 103 eyes. The mean time for complete reepithelialization was 2.5±2.1, 3.1±2.2, and 4.5±1.4 days in UCS, AS, and AT groups, respectively. The mean percentage decrease in the size of the ED was significantly better in the UCS and AS groups as compared with the AT group (P=0.001). The rate of reepithelialization was comparable between the AS and UCS groups (P=0.3). On bivariate analysis, significant correlation was found between the mean size of postoperative ED, grade of the donor cornea (P=0.001), and the presence of preoperative ED (P=0.001). No complications were associated with the use of serum therapy. Conclusion: Most of the cases of postkeratoplasty corneal ED can be managed with AT only. The serum therapy (AS/UCS) helps in the faster reepithelialization of postkeratoplasty ED as compared with AT and may be considered as a treatment option for early epithelial healing.


De Bruijn and Erdos proved that every noncollinear set of n points in the plane determines at least n distinct lines. Chen and Chvatal suggested a possible generalization of this theorem in the framework of metric spaces. We provide partial results in this direction.


Conjunctivocorneal involvement in systemic lupus erythematosus (SLE) is quite infrequent.1–3 We report the impression cytological (IC), immunohistochemical (IHC), and transmission electron microscopic (TEM) features of a case with unusual keratoconjunctival epitheliopathy refractory to medical treatment.

A 76 year old woman was referred with a long history of bilateral foreign body sensation. She had been on topical antibiotics, artificial tears, corticosteroids, hyaluronate, and aciclovir without improvement. At initial examination, biomicroscopy revealed diffuse, translucent, disseminated peripheral corneal intraepithelial coin lesions with a cystic appearance (fig 1A, B), also in the bulbar conjunctiva over the limbus (fig 1C). Fluorescein staining revealed increased permeability with negative staining. Schirmer's test was normal in both eyes. The patient had systemic and dermatological features diagnosed as SLE and had been taking prednisolone 7.5 mg/day for 1 year. Conjunctival cultures were negative for infectious processes. A thorough systemic evaluation for other systemic diseases and serum antibodies for herpes simplex virus (HSV-1, HSV-2), varicella zoster …


Austin and colleagues1 offer an opinion that the recent BSG guidelines on adult coeliac disease are regressive for not considering a biopsy avoidance strategy in patients with positive serological findings.2 The authors cite a positive predictive value (PPV) of up to 100% for serological testing, however studies reporting these findings are from highly selected populations where coeliac disease prevalence is high (six studies, coeliac disease prevalence between 21% and 100%). The most important data that clearly refutes Austin and colleagues' suggestion is a study of 2000 patients attending endoscopy, where coeliac disease prevalence was 3.9%.3 In this study the PPV of anti-tissue transglutaminase antibody (tTG) was only 28.6%, despite sensitivity and specificity of greater than 90%, which only increased to 71.7% when combined with a positive endomysial antibody (EMA). In simple terms if we follow the approach advocated by Austin and colleagues 3 out of 10 patients would be placed on a …