Spray cooling of hot steel surfaces is an inherent part of continuous casting and heat treatment. When we consider the temperature interval between room temperature and for instance 1000 °C, different boiling regimes can be observed. Spray cooling intensity rapidly changes with the surface temperature. Secondary cooling in continuous casting starts when the surface temperature is well above a thousand degrees Celsius and a film boiling regime can be observed. The cooled surface is protected from the direct impact of droplets by the vapour layer. As the surface temperature decreases, the vapour layer is less stable and for certain temperatures the vapour layer collapses, droplets reach the hot surface and heat flux suddenly jumps enormously. It is obvious that the described effect has a great effect on control of cooling. The surface temperature which indicates the sudden change in the cooling intensity is the Leidenfrost temperature. The Leidenfrost temperature in spray cooling can occur anywhere between 150 °C and over 1000 °C and depends on the character of the spray. This paper presents an experimental study and shows function for prediction of the Leidenfrost temperature based on spray parameters. Water impingement density was found to be the most important parameter. This parameter must be combined with information about droplet size and velocity to produce a good prediction of the Leidenfrost temperature.


BACKGROUND
Endosseous dental implants with rough surfaces have been designed to improve early healing, especially in areas of poor bone or insufficient bone quantity. The aim of this study was to histomorphometrically assess the bone-to-implant contact on 3 different rough-surfaced implants following guided bone regeneration.

METHODS
Mandibular premolars and first molars were extracted in 12 dogs, and healing was allowed for 6 months. Six implant osteotomy sites were prepared, 3 per side, followed by the creation of 7.3 mm wide by 5 mm deep surgical defects in the coronal section of the osteotomy sites. Ten-mm long titanium screw-type implants with titanium plasma-sprayed (TPS), hydroxyapatite-coated (HA), or acid-etched (AE) surfaces were placed; the surrounding defects were filled with canine demineralized freeze-dried bone allograft; implants/grafts were covered with expanded polytetrafluoroethylene membranes; and the tissue was closed. Following a healing period of 4 months, the animals were sacrificed and mandibular blocks were harvested for histomorphometric analysis.

RESULTS
The mean percentage of bone-to-implant contact in the defect and non-defect areas for the different implant surfaces was: AE 16.24% defect, and 28.78% non-defect; TPS 25.08% defect, and 16.96% non-defect; and HA 48.25% defect and 26.60% non-defect. Within the defect, the mean difference in the bone-to-implant contact was significant for HA compared to TPS (P < 0.0001) and HA versus AE (P < 0.0001); TPS versus AE was not significant (P = 0.063). In the non-defect areas, the mean difference in the bone-to-implant contact was significant for AE versus TPS (P = 0.010); all other comparisons were not significant. There were 18 membrane exposures in the 72 implant sites. Data were analyzed again to assess the impact of membrane complications. Using a 1-way analysis of variance, the bone-to-implant contact was compared between the sites with and without membrane complications. No significant differences were seen in the defect areas or in the non-defect areas between the sites with and without membrane complications.

CONCLUSION
In this study, the bone-to-implant contact in regenerated bone was greatest when an HA-coated implant was used.


The oxidation behavior of carbides on Inconel 718 surface was investigated. Oxidation tests were performed at the temperature range of 300 to 650°C. Two types of carbide, NbC and TiC were detected, and the amount of NbC was significantly higher than that of TiC. The oxidation of NbC started at the carbide surface and the matrix interface, and propagated into the interior of the carbide and eruption subsequently occurred with increasing oxidation time. In case of TiC, the oxidation occurred at the outer surface of the carbide and the matrix interface, but did not propagated into the interior of the carbide. Oxides formed on the outer surface of the TiC contained a relatively large amount of elemental Nb. The cross-section of oxidized specimen was investigated. NbC was oxidized more easily due to the significantly lower Gibbs free energy of oxidation than that of TiC. Eruption occurred mainly at the NbC because the Pilling-Bedworth ratio of Nb is higher than the critical value of 2.3 where eruption typically occurs.


Background The purpose of this study was to quantify the cancer support activities that informal carers of head and neck cancer survivors engage in and the relationships between care activities (how comfortable they feel engaging in these tasks and the time that carers spend on these tasks) and psychological wellbeing. Methods This study formed part of project that investigated the post-treatment needs of survivors of head and neck cancer in Ireland. A total of 197 caregivers answered a survey detailing their caring activities, the amount of time that they spent on those activities and how comfortable they felt engaging in them. Psychological wellbeing was assessed by the DASS-21. Multiple logistic regression was used to identify whether aspects of caregiving burden (time and discomfort with one or more head and neck cancer specific tasks) were associated with depression, anxiety and stress, after adjusting for other factors. All analysis was performed using Stata 12. Results In the past month, 45% of carers did not spend any extra hours per week helping their relative/friend with general activities; 31% spent 1–19 h/week and 23% spent 20 or more hours/week doing so. Most carers were comfortable assisting their relative/friend, though more carers felt uncomfortable assisting with cancer specific support tasks (31% uncomfortable helping with medication) compared with general support tasks (7% uncomfortable helping with appointments). In the multivariable analysis the factors significantly associated with having any depression after adjusting for age were: feeling uncomfortable helping with one or more head and neck cancer care tasks OR 6.5 (95% CI [2.2, 19.5]) and being female OR 2.6 (95% CI [0.97, 7.24]). Protective factors were: having private health insurance OR 0.44 (95% CI [0.2, 0.98]) and caring for someone diagnosed 10 years or more ago OR 0.15 (95% CI [0.03, 0.69]). Discussion The findings indicate that it is important that health professionals pay particular attention to carers of people with head and neck cancer who are at risk of poor mental health, such as those with financial issues, those who are older and those with higher burden of care. Healthcare professionals might be able to supply some carers with the support and training that they need to address their discomfort.


The use of nordihydroguaiaretic acid (NDGA)‐polymerized collagen fibers as a novel local drug delivery system is introduced. The drug loading of these biocompatible fibers is illustrated with the anti‐inflammatory agents dexamethasone and dexamethasone 21‐phosphate. Capillary zone electrophoresis was used to measure the amount of drug released from the fibers into phosphate buffered saline with time. From these measurements and the use of a mathematical model, we were able to determine the diffusion coefficients for dexamethasone (D = 1.86 × 10‐14 m2/s) and dexamethasone 21‐phosphate (D = 2.36 × 10‐13 m2/s) in the NDGA collagen fibers. These values have not been previously reported. These fibers can be used to load other agents as well. The diffusion coefficient of any agent loaded in these fibers can be determined using the techniques and mathematical method described. The rate of drug release from the fibers can be controlled using a PLGA coating. The overall importance of this paper is the potential broad application of this novel drug delivery system for the treatment of various human diseases.


The availability of Medical Record Laboratory to support Medical Record education is one that the education provider should prepare. In addition, education providers should also organize the usage, instrument provision, HRD provision and clear planning and objectives. The present research used evaluation topic on the existence of Medical Record Laboratory at the Diploma 3 Program for Medical Record and Health Information, MIPA Faculty, Gadjah Mada University. This topic was used by considering the Government Regulation on education provision, especially Medical Record Education (The Regulation of Minister Health Number 1192/Menkes/Per/X/2004) as thinking base. Data were taken from initial survey that the Laboratory was considered as not maximally performed. Base on instrument availability, this laboratory had no complete instrument, especially manually data processing completeness. Moreover, in fact, the usage and planning on this facility had not been well organized, while there was mostly high demand on the usage. To this end, evaluation was highly required for future progress. Evaluation was gradually performed. First was evaluation on input related technology, human resources, costs, facilities and management. Second was evaluation on process related to whether the planned activities had been completed or not. Third, evaluation on inputs related to attitudes, norms and skill knowledge of those involved in the laboratory (staffs, students, and stakeholder). The present research exploited descriptive method with qualitative approach using single data variable (the existence of Medical Record Laboratory at the Diploma 3 Program for Medical Record and Health Information Gadjah Mada University). Data were collected using source triangulation approach through data cross-checking with fact from other sources. Data analysis was performed by comparing data taken to the existing standard (Government Regulation and theory). To simplify discussion, data were discussed based on principle elements of health services, among others, including: inputs, process, and outputs. Evaluation on the existence of laboratory was presumably exploited to consider future development and management as expected that this Laboratory could be taken as example for medical record management in hospitals.


With the proliferation of internet-based social networks into our lives, new mechanisms to control the release and use of personal data are required. As a step toward this goal, we develop a recommendation system which protects the privacy of user answers while allowing them to learn an aggregate weighted average of ratings. Due to the use of social network connections, the querier obtains a more relevant and trustworthy result than what generic anonymous recommendation systems can provide, while at the same time preserving user privacy. We also give experimental performance results for our solution and several recently developed secure computation techniques, which is of independent interest.


Purpose Wilms tumor (WT) is the most common pediatric renal tumor. Treatment planning under International Society of Paediatric Oncology (SIOP) protocols is based on staging and histologic assessment of response to preoperative chemotherapy. Despite high overall survival (OS), many relapses occur in patients without specific risk factors, and many successfully treated patients are exposed to treatments with significant risks of late effects. To investigate whether molecular biomarkers could improve risk stratification, we assessed 1q status and other potential copy number biomarkers in a large WT series. Materials and Methods WT nephrectomy samples from 586 SIOP WT 2001 patients were analyzed using a multiplex ligation-dependent probe amplification (MLPA) assay that measured the copy number of 1q and other regions of interest. Results One hundred sixty-seven (28%) of 586 WTs had 1q gain. Five-year event-free survival (EFS) was 75.0% in patients with 1q gain (95% CI, 68.5% to 82.0%) and 88.2% in patients without gain (95% CI, 85.0% to 91.4%). OS was 88.4% with gain (95% CI, 83.5% to 93.6%) and 94.4% without gain (95% CI, 92.1% to 96.7%). In univariable analysis, 1q gain was associated with poorer EFS (P < .001; hazard ratio, 2.33) and OS (P = .01; hazard ratio, 2.16). The association of 1q gain with poorer EFS retained significance in multivariable analysis adjusted for 1p and 16q loss, sex, stage, age, and histologic risk group. Gain of 1q remained associated with poorer EFS in tumor subsets limited to either intermediate-risk localized disease or nonanaplastic localized disease. Other notable aberrations associated with poorer EFS included MYCN gain and TP53 loss. Conclusion Gain of 1q is a potentially valuable prognostic biomarker in WT, in addition to histologic response to preoperative chemotherapy and tumor stage.


Previous papers have presented algorithms for an EMC expert system used to predict potential electromagnetic compatibility problems in a vehicle early in the design process. Here, the accuracy of inductive and capacitive coupling algorithms are verified through representative measurements of crosstalk within an automobile. Worst-case estimates used by the algorithms are compared to measured values and are compared to values estimated using statistical methods. The worst-case algorithms performed well up to 10-20 MHz, but overestimated measured results by several dB in some cases and up to 10-15 dB in others. An approximate statistical variation of the current expert system algorithms also worked well and can help avoid overestimation of problems; however, worst-case estimates better ensure that problems will not be missed, especially in the absence of complete system information.


This paper challenges the main stream narrative that links the strength and speed of the world trade collapse in 2008-9 to (i) lacking trade finance, (ii) international value chains and (iii) 'murky' protectionism. The paper discusses the emerging literature and points out counteracting forces such as the trade credit and trust that build in commercial relationships. These positive factors are often overlooked by those who blame value chains for the severity of the world trade collapse. The paper offers the theory of trade uncertainty as an alternative explanation focusing on existence of information and/or co-ordination externalities in decentralized market economies that are hit by an unexpected trade shock. A cross section of the depth, duration and steepness of the import decline in 45 countries over the period 2008Q1-2009Q4 finds shorter, but stronger and thus steeper declines for autocratically economies (as suggested by the trade uncertainty hypothesis) and refutes the value chain hypothesis showing that both the share of manufacturing trade and an indicator for the vertical specialization in trade are not (and sometimes negatively) associated with the strength of import contractions. Countries with large shares of manufactures in trade (a proxy for international value chain activity) and/or vertical specialization in trade did not reduce their trade more strongly. This finding suggests that international value chains may very well have had a major dampening effect that reduced the extent to which trade fell.


Bicep2 deployed to the South Pole during the 2009-2010 austral summer, and is now mapping the polarization of the cosmic microwave background (CMB), searching for evidence of inflationary cosmology. Bicep2 belongs to a new class of telescopes including Keck (ground-based) and Spider (balloon-borne) that follow on Bicep's strategy of employing small, cold, on-axis refracting optics. This common design provides key advantages ideal for targeting the polarization signature from inflation, including: (i) A large field of view, allowing substantial light collecting power despite the small aperture, while still resolving the degree-scale polarization of the CMB; (ii) liquid helium-cooled optics and cold stop, allowing for low, stable instrument loading; (iii) the ability to rotate the entire telescope about the boresight; (iv) a baffled primary aperture, reducing sidelobe pickup; and (v) the ability to characterize the far field optical performance of the telescope using ground-based sources. We describe the last of these advantages in detail, including our efforts to measure the main beam shape, beammatch between orthogonally-polarized pairs, polarization efficiency and response angle, sidelobe pickup, and ghost imaging. We do so with ground-based polarized microwave sources mounted in the far field as well as with astronomical calibrators. Ultimately, Bicep2's sensitivity to CMB polarization from inflation will rely on precise calibration of these beam features.


This article presents the development of a junior version of the Spanish (Castilian) NEO Personality Inventory–Revised (JS NEO) suitable for adolescents aged 12 to 18 years. The psychometric properties of the new JS NEO were investigated using two samples of 2,733 and 983 adolescents in Spain. The results showed that the adult NEO-PI-R factor structure was replicated with the junior version of the inventory and that the reliabilities of the scales were adequate. The cross-form correlations between the junior and the adult versions of the questionnaires indicated good equivalence indices. Furthermore, a joint factor analysis of the JS NEO and the Big Five Questionnaire–Children (BFQ-C) provided additional evidence for the construct validity of the JS NEO.


Determining changes in global temperature and precipitation that may indicate climate change is complicated by annual variations. One approach for finding potential climate change indicators is to train a model that predicts the year from annual means of global temperatures and precipitations. Such data is available from the CMIP6 ensemble of simulations. Here a two-hidden-layer neural network trained on this data successfully predicts the year. Differences among temperature and precipitation patterns for which the model predicts specific years reveal changes through time. To find these optimal patterns, a new way of interpreting what the neural network has learned is explored. Alopex, a stochastic correlative learning algorithm, is used to find optimal temperature and precipitation maps that best predict a given year. These maps are compared over multiple years to show how temperature and precipitations patterns indicative of each year change over time.


Teaching art and music is commonly associated with the development of creative skills. Music performance involves distinctive creativities that vary among music traditions and genres. Based on classroom observations and interviews with instrumental and voice professors, this study examined conceptions of creativity in music performance, strategies used to develop students' creative skills that result in original and innovative music performances, and factors that facilitate or inhibit such creative performances. Results of the study suggest a strong emphasis on technical and musical skills as the foundation for creative performance, regardless of musical traditions. However, approaches for the study of technique, devoted time, and how it transfers to actual creative practice differs significantly among traditions. Other aspects that favor an adequate music development are the student-teacher relationships that generate autonomy, flexibility, and freedom, and environments geared towards musical exploration and innovation. Educational implications for the proper development of creativity that result in effective teaching processes for music performance are discussed.


Background A Mediterranean diet is favourable for cardiometabolic risk. Objective To examine the residual effect of a green Mediterranean diet, further enriched with green plant-based foods and lower meat intake, on cardiometabolic risk. Methods For the DIRECT-PLUS parallel, randomised clinical trial we assigned individuals with abdominal obesity/dyslipidaemia 1:1:1 into three diet groups: healthy dietary guidance (HDG), Mediterranean and green Mediterranean diet, all combined with physical activity. The Mediterranean diets were equally energy restricted and included 28 g/day walnuts. The green Mediterranean diet further included green tea (3–4 cups/day) and a Wolffia globosa (Mankai strain; 100 g/day frozen cubes) plant-based protein shake, which partially substituted animal protein. We examined the effect of the 6-month dietary induction weight loss phase on cardiometabolic state. Results Participants (n=294; age 51 years; body mass index 31.3 kg/m2; waist circumference 109.7 cm; 88% men; 10 year Framingham risk score 4.7%) had a 6-month retention rate of 98.3%. Both Mediterranean diets achieved similar weight loss ((green Mediterranean −6.2 kg; Mediterranean −5.4 kg) vs the HDG group −1.5 kg; p<0.001), but the green Mediterranean group had a greater reduction in waist circumference (−8.6 cm) than the Mediterranean (−6.8 cm; p=0.033) and HDG (−4.3 cm; p<0.001) groups. Stratification by gender showed that these differences were significant only among men. Within 6 months the green Mediterranean group achieved greater decrease in low-density lipoprotein cholesterol (LDL-C; green Mediterranean −6.1 mg/dL (−3.7%), −2.3 (-0.8%), HDG −0.2 mg/dL (+1.8%); p=0.012 between extreme groups), diastolic blood pressure (green Mediterranean −7.2 mm Hg, Mediterranean −5.2 mm Hg, HDG −3.4 mm Hg; p=0.005 between extreme groups), and homeostatic model assessment for insulin resistance (green Mediterranean −0.77, Mediterranean −0.46, HDG −0.27; p=0.020 between extreme groups). The LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio decline was greater in the green Mediterranean group (−0.38) than in the Mediterranean (−0.21; p=0.021) and HDG (−0.14; p<0.001) groups. High-sensitivity C-reactive protein reduction was greater in the green Mediterranean group (−0.52 mg/L) than in the Mediterranean (−0.24 mg/L; p=0.023) and HDG (−0.15 mg/L; p=0.044) groups. The green Mediterranean group achieved a better improvement (−3.7% absolute risk reduction) in the 10-year Framingham Risk Score (Mediterranean−2.3%; p=0.073, HDG−1.4%; p<0.001). Conclusions The green MED diet, supplemented with walnuts, green tea and Mankai and lower in meat/poultry, may amplify the beneficial cardiometabolic effects of Mediterranean diet. Trial registration number This study is registered under ClinicalTrials.gov Identifier no NCT03020186.


The Elgar Companion to Neo-Schumpeterian Economics contains a diverse selection of chapters written by some of the most distinguished scholars in their fields. This comprehensive volume is logically divided into micro-, meso- and macroeconomic sections with both theoretically motivated and empirical contributions. In addition, sections on Neo-Schumpetarian social science and policy are included to provide a complete overview of Neo-Schumpetarian economics. This major new Companion is an original work of reference highlighting not only the broad scope but also the common ground between all branches of this prolific and fast developing field of economics.


There is a wide-spread concern that technical change may spur social conflicts, especially if workers are replaced with machines. To empirically analyze whether job destruction drives protests, we study a historical example of a revolutionary new technology: the adoption of electricity. Focusing on the gradual roll-out of the Swedish electricity grid between 1900 and 1920 enables us to analyze 2,487 Swedish parishes in a difference-in-differences framework. Proximity to large-scale water-powered electricity plants is used to instrument for electricity adoption. Our results confirm that the labor saving nature of electricity was followed by an increase of local conflicts in the form of strikes. But displaced workers were not likely to initiate conflicts. Instead, strikes were most common in sectors with employment growth. Similarly, we find that the strikes were of an offensive rather than a defensive nature. Thus, electrification did not result in rebellions driven by technological anxiety. It rather provided workers with a stronger bargaining position from which they could voice their claims through strikes.


Omega-3 fatty acids such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are essential fatty acids with numerous health benefits. The main sources of these fatty acids are fish and fish oils. However, fish supply is limited and the availability is uncertain. There are two main problems with regard to fish supply: overfishing and mercury contamination. In addition, food enrichment with fish oil is apparently challenging due to sensitivity of fish oil to oxidation, and fishy smell which make them less attractive to consumers. Based on above problems, alternative sources of EPA and DHA must be found. An alternative for omega-3 fatty acids are microalgae. This research aims to isolate, identify, and find microalgae biodiversity that are able to produce omega-3 fatty acids in their cells. Microalgae were isolated from fallen, senescent leaves of mangrove tree (Kandelia candel) in two locations in Aceh. The colonies were identified morphologically using light and stereo microscopes with 1000x magnifications. The results were compared with those in literatures. This research has isolated and identified some genus of microalgae that were predicted belong to order Labyrinthulida and family Thraustochytriidae. Morphological observations have also confirm identification of one fungi, genus Mortierella. All identified microalgae and fungi are omega-3 fatty acids producers, mainly EPA and DHA


Brownian motions on a metric graph are defined. Their generators are characterized as Laplace operators subject to Wentzell boundary at every vertex. Conversely, given a set of Wentzell boundary conditions at the vertices of a metric graph, a Brownian motion is constructed pathwise on this graph so that its generator satisfies the given boundary conditions.


Microgravity monitoring of active volcanoes can provide evidence of sub-surface mass and/or density changes that precede eruptions. If, in addition, precursory increases in thermal emissions are observed, an integrated mechanistic model for volcanic activity may be developed with the potential for forecasting eruptions. Crater-lake volcanoes provide an interesting target for such studies since thermal output can be monitored simply through lake water calotimetry. Here we summarize 10 years of gravity and thermal data from Poás volcano, Costa Rica. Mass/energy balance calculations demonstrate that, in the steady-state, the large thermal inertia of the crater lake acts as a buffer to short-term changes in the energy input from the cooling magma feeder pipe. Since February 1986, it is postulated that there has been gradual emplacement of a shallow magma intrusion associated with vesiculation and gas loss to the surface. This follows from unambiguous, gravity increases, constrained by elevation control, that are coincident in time with a period of long-term increased energy input to the crater lake. Progressive reduction of the lake volume by evaporation/seepage culminated in an (April 1989) ash eruption providing a good documented record of combined gravity and thermodynamic precursors to volcanic activity.


The thesis describes the first extensive DNA sequence analysis that demonstrated that the tandemly repeated alphoid DNA in the centromere of the human chromosomes consists of distinct subfamilies and in a number equal to or exceeding the number of chromosomes. The expected presence of only one or a few distinct subfamily on individual chromosomes was supported by the characterization of an extremely well-defined subfamily specific for chromosome 7 and represented in the original collection of subfamilies. The pattern of chromosome-specificity breaks down among the acrocentric chromosomes where chromosomes 13 and 21 were found to share one and chromosomes 14 and 22 to share another specific subfamily. By in situ hybridization these subfamilies were shown not to be shared by other chromosomes. The remarkable pairwise pattern of sequence homogenization was present also in the chimpanzee genome raising the question of its biological role. However, the subfamilies on these human and chimpanzee chromosomes are not orthologous but were shown to originate from two evolutionarily different repeat families. It follows that dramatic sequence evolution has occurred in one or both species during or after separation. The sequence evolution might even occur at a higher rate in humans. This possibility was studied in orthologous alphoid sequences on the X chromosome of humans and the great apes. The analysis supports the general view that our closest relative is the chimpanzee and indicates that the rate of recombination is increased in the human repeat DNA. A "molecular clock" running faster in this DNA may have evolutionary implications. Finally, the usefulness of alphoid subfamilies as chromosome-specific markers is illustrated in a cytogenetic dissection of the centromeric region of Robertsonian translocations. The breakpoints were located to satellite III DNA leaving these chromosomes dicentric. The order of the different tandem DNAs on the p-arm of the acrocentric chromosomes could also be established.


Clinical Image:

A 66-year-old female presents with a past medical history of hypertension, chronic back pain from injury following spinal fusion, and a family history positive for paternal grandfather with leukemia. Patient was diagnosed with Acute Myeloid Leukemia (AML) that originated from a background of myelodysplastic features. She initially presented with worsening fatigue and back pain, and was found to have pancytopenia around March 2017. Bone marrow biopsy showed AML 30% blasts with complex cytogenetic abnormalities, including monosomy 7 and p53 mutations. Cerebrospinal Fluid (CSF) studies were negative. She was not considered as an allogeneic stem cell transplant candidate, and instead started on palliative chemotherapy. Patient tolerated well the combination of hypomethylating agents and Venetoclax. She had multiple admissions for neutropenic fever treated empirically with antibiotics. Upon clinic visit on January 2018, she presented with a low-grade fever, and was FLU positive. She was treated with Tamiflu, and completed the therapy by January 9, 2018. She presented again to the clinic on January 15, 2018 complaining of black, painless lesions on the surface of her tongue that were noted upon waking up (Figure 1). Complete Blood Count (CBC) showed White Blood Cell (WBC) 0.5, Hemoglobin (Hgb) 9.2, and Platelet count of 2. Dermatology was consulted, and it was planned to biopsy the lesions after the platelet transfusion were performed, given severe thrombocytopenia due to her chemotherapy regimen. Patient received the platelet transfusions and by the end of the day, upon completion of the transfusion, the lesions on her tongue completely resolved (Figure 2). It is possible, that the lesions were small hemorrhages. Most reported cases of oral hemorrhages have not presented in this manner, as they usually involve a wider area, and are confined to one spot rather than presenting at multiple sites, like in this case. This case is reported due to the rarity of the presentation of these lesions, and their complete, instantaneous resolution upon platelet transfusion. The aim of this article is to increase awareness among our fellow dermatologists and other physicians.


OBJECTIVE
To determine the significance of the selected risk markers in the development of high blood pressure in a relatively short period of time.

DESIGN
Longitudinal or cohort study of a sample of a population from the municipality of Cienfuegos, as a second measurement of the Cienfuegos Global Project.

CONTEXT
Community. Municipality of Cienfuegos; geographic area of the subject-object intervention-investigation of the Cienfuegos Global Project.

SUBJECT
1,369 adults aged 15 years of more (619 men and 750 women; 1,294 alive and 75 dead) were followed from January 1992 to February 1994, which constitutes an alleatory, stratified, equiprobabilistic sample by age and sex. Persons diagnosed as hypertensive in the initial evaluation of Cienfuegos Global Project were excluded, so that the new series for hypertensive patients was constituted by 731 individuals with 125 new patients when the risk markers age, sex, color of skin, family history of high blood pressure, salt consumption, sedentarism, alcoholism and tobaccoism were studied. The association of the risk markers hypercholesterolemia or risky cholesterolemia and obesity was studied with another series formed by a second sample of 417 individuals, this sample introduced 74 new cases of high blood pressure.

MAIN OUTCOME
It was intended to estimate the odds ratio for high blood pressure for the different risk markers studied, in those patients exposed or not to them.

RESULTS
The odds ratio for each of the risk markers was determined. The odds related to age increased from 1.37, to 1.86 in males and decreased to 0.64 in white individuals. These 3 results were statistically significant as risk markers for high blood pressure. The odds ratio for the remaining risk markers had no statistical significance.

CONCLUSION
The age, male sex, and black race, in the comparatively short term--slightly over two years--are the main risk markers that will markedly favor the appearance of high blood pressure.


Mark–recapture methods are a useful population estimation tool, although with many assumptions that cannot always be satisfied for all types of organisms and environments. In the present study, three mark–recapture methods (Petersen, Schnabel and Schumacher–Eschmeyer) were applied in a preliminary trial to estimate the population size of the crab Trichodactylus borellianus and to gain information that would support the use of the methods in the field. The accuracy of these estimates was verified by analysing the percentage of bias, the width of the confidence intervals, and by a chi-square test. The assumptions of equal catchability and closed population were verified, along with assumptions related to the efficiency of marking. The adjusted methodology was applied in a short-term study of a pond on the Parana floodplain. The results showed that the assumptions were satisfied for both the experimental and field studies. The Schnabel was the most accurate method evaluated in both studies. Although the Schumacher–Eschmeyer method also provided accurate results in the field study, it needed large samples to give reliable estimates. The applicability of these methods depends on the stage of the hydrological cycle. The choice of a short-term research design will ensure that the assumption of a closed population is valid for research of this type on an alluvial plain.


In this paper, we report a Schottky ultraviolet photodetector based on poly (3,4-ethylenedioxy-thiophene) poly(styrenesulfonate) (PEDOT:PSS) transparent electrode contacts to Mg0.1Zn0.9O. The I–V characteristic curves of the device are measured in the dark condition and under the illumination of a 340-nm UV light. The device shows a typical rectifying behavior with a current rectification ratio of 103 at ±2 V, which exhibits a good Schottky behavior. The photo-to-dark current ratio is high, which is 1×103 at −4 V. A peak response of 0.156 A/W at 340 nm is observed. The device also exhibits a wide response from 250 nm to 340 nm, with a response larger than 0.1 A/W. It covers the UV-B region (280 nm–320 nm), which makes the device very suitable for the detection of UV-B light.


The effect of a magnetic field on adhesion of cultured muscle cells to the culture plate has been studied in vitro. An experimental system was manufactured to apply a magnetic field to muscle cell culture. The system consists of a couple of solenoid coils, a culture dish of 52 mm internal diameter, and an inverted phase-contrast microscope. The solenoid coil generates the alternating magnetic field of 13 mT of the effective value at a period of 0.01 s with the electric current of the rectangular pulses. C2C12 (Mouse myoblast cell line originated with cross-striated muscle of C3H mouse) cells were suspended in Dulbecco's Modified Eagle's Medium. The suspension was poured into the plastic dish placed on the stage of the microscope. The culture dish was exposed to the magnetic field between the solenoid coils at 29 degrees Celsius. For comparative study, a part of the suspension was poured into the same kind of dish without exposure to the magnetic field at 29 degrees Celsius. The number of cells, which adhered to the bottom of the culture dish, was traced according to the time (<130 min) during exposure to the alternating magnetic field. The experimental results show that adhesion is accelerated with alternating magnetic field of 13 mT.


Quantitative evaluation of lesion load in multiple sclerosis (MS) from magnetic resonance imaging (MRI) scans is becoming important in understanding and monitoring the progression of the disease. Methods of MS lesion segmentation based on intensity thresholding offer one of the most robust and easily‐implemented means of computing the total lesion volume. This study evaluated the effects of slight changes in the choice of intensity threshold on computed lesion volumes in 20 patients with MS using such a technique. After judging the optimum choice of threshold value, the threshold value was increased and decreased by 3% in 1% steps around this value; we observed a mean change of 15% in computed lesion volumes for 1% changes of threshold value. Larger changes in lesion volume were found when the threshold was changed by larger amounts. On the other hand, the amount of time required for manual review decreased, and the confidence with which manual review could be performed increased when using lower thresholds. This study shows that the choice of threshold is a crucial factor in measuring lesion volumes in MS when using intensity‐based techniques. It also suggests that in multicenter and/or longitudinal studies, criteria for choosing the threshold should be developed whereby the threshold level should be set such that all MR visible lesions are above it, in order to minimise the human interaction and, consequently, the reproducibility of the results.


Background/introduction Standard methods of teaching sexual history taking are heavily reliant on role-play which many students find threatening. We took a fresh look at this with particular reference to the learning environment and learner diversity. Aim(s)/objectives To develop a new resource as an alternative to role-play which allows students to practice the key components of sexual history taking in a fun and memorable way. Methods The concept of 'find your mate' grew through brainstorming sessions with a medical student and an F2 trainee. The idea of a 'party atmosphere' with background music allows those with 'musical intelligence' to create a link whilst also masking individual conversations and reducing embarrassment. Provision of party snacks and soft drinks addresses players' basic physiological needs. Results An interactive game was developed with flexibility to accommodate any number of participants from 6–30. Feedback was universally positive with players reporting marked improvement in confidence scores in sexual history taking. Discussion/conclusion Students often find terminology used in sexual history taking unfamiliar or uncomfortable. They come from a variety of social, ethnic and religious backgrounds and may carry judgmental attitudes. Some may have had negative sexual experiences. Providing a psychologically and physically safe environment for them to develop this important skill is of paramount importance. I am confident that giving students a framework of standard questions and phrases and then allowing them the combined privacy and space to practice the use of such in a safe learning environment will improve their confidence in sexual history taking.


This dissertation takes its departure from the methodology of German Begriffsgeschichte and sets out to explore the use of the concept of happiness in Swedish chapbooks (skillingtryck).The period considered, 1750-1850, frames the transition from early modern to modern society, a time that has often been labeled Sattelzeit or Schwellenzeit. The aim of this thesis is to study how the concept of happiness was used in the chapbooks and how it changed during this period. The empirical analysis of the first fifty years shows that the concept of happiness was firmly rooted in Lutheran cosmology and anthropology. In this worldview happiness (lycka) was a central concept alongside providence, world/worldlyness and heavenly bliss. The concept of happiness was first and foremost used to illustrate the ups and downs of worldly life.The dichotomy between worldly happiness (lycka) and eternal bliss (lycksalighet) was often a theme in the songs of the 18th century chapbooks, where the the eternal life in heaven was depicted as the total absence of pain and misery and worldly happiness, although sometimes pleasurable, was seen as mixed with misfortune, grief and calamity. The organizing principle of 18th century cosmology was time. Time was understood through the salvation history where everything proceeded towards eschaton, the ultimate days. The cosmology underwent considerable changes in the chapbook songs and texts of the early 19th century. It was increasingly seen as a more subjective and emotional phenomenon. The sharp distinction between happiness (lycka) and bliss (lycksalighet) faded and happiness gradually became synonymous with well-being (vallust), felicity (sallhet) and blessedness (salighet). Happiness was now associated with emotion and with the human psyche and thereby lost its previous importance within the frame of cosmology. Central concepts can be identified that show a shift towards a more neoplatonic cosmology, often associated with Romanticism. The allure of truth and beauty is for example apparent in the 19th century chapbooks. Happiness and felicity became temporaly secularized and were seen as a goal for the worldly future, while eternity gradually lost its significance. Happiness transformed from being an external circumstance, impervious to man, into something emotional and subjective and became something for the individual to search for within him- or herself. The collective perspective of eternity that characterized the old order disappeared and in its place we can distinguish a new secularized and individualized concept of happiness. (Less)


Abstract. This study discusses how much of the biases in top-of-atmosphere (TOA) radiation and clouds can be removed by parameter tuning in the present-day simulation of a climate model in the Coupled Model Inter-comparison Project phase 5 (CMIP5) generation. We used output of a perturbed parameter ensemble (PPE) experiment conducted with an atmosphere–ocean general circulation model (AOGCM) without flux adjustment. The Model for Interdisciplinary Research on Climate version 5 (MIROC5) was used for the PPE experiment. Output of the PPE was compared with satellite observation data to evaluate the model biases and the parametric uncertainty of the biases with respect to TOA radiation and clouds. The results indicate that removing or changing the sign of the biases by parameter tuning alone is difficult. In particular, the cooling bias of the shortwave cloud radiative effect at low latitudes could not be removed, neither in the zonal mean nor at each latitude–longitude grid point. The bias was related to the overestimation of both cloud amount and cloud optical thickness, which could not be removed by the parameter tuning either. However, they could be alleviated by tuning parameters such as the maximum cumulus updraft velocity at the cloud base. On the other hand, the bias of the shortwave cloud radiative effect in the Arctic was sensitive to parameter tuning. It could be removed by tuning such parameters as albedo of ice and snow both in the zonal mean and at each grid point. The obtained results illustrate the benefit of PPE experiments which provide useful information regarding effectiveness and limitations of parameter tuning. Implementing a shallow convection parameterization is suggested as a potential measure to alleviate the biases in radiation and clouds.


About 25 km northwest of Hannover at Mellendorf a former sand pit was filled with industrial waste between about 1960 and 1980. The contents is mainly magnesium drosses. In 1987 the top of the site was sealed with a 1.5 m thick cover to avoid penetration of water into the waste. This was important because the bottom of the disposal at a depth of about 15 m below surface was not sealed. 1996 and 1997 TEM- (Transient Electromagnetic) and RMT-(Radio Magnetotelluric) measurements were carried out over the deposit. Goal of the combined use of RMT and TEM was a complete investigation of the vertical and horizontal resistivity distribution within the deposit and the directly surrounding area. The RMT measurements covered the deposit with a 10 m by 10 m grid, using four frequencies between 16 kHz and 200 kHz. For each frequency a pair of transmitters was chosen perpendicular to each other and located in the directions of the long and short axis of the deposit. For the TEM measurements the Protem 47 unit (Geonics) was used in an inloop configuration, the receiver being located at the centre of 50 m * 50 m transmitter loops. The interpretation of the data was performed in three steps. In a first step a one-dimensional inversion of the TEM data was used based on a three layer starting model. In the same step the interpretation of the RMT-data was based on a two-dimensional model. Secondly, for a further explanation of the RMT and the TEM data three-dimensional models were applied, based on the results of the preliminary interpretation of each method separately. Finally a three-dimensional model fitting both data sets was developed. The basic principle for determining the optimum model for both methods was to use the RMT-results for the top layers down to a depth of approximately 17 m and below that the results from the TEM data. This led to a final model combining the high resolution of the RMT method for the top layers and the better resolution at greater depth penetration of the TEM system. This model was further optimized, using trial and error, the only possible way at the moment. Figure 1a shows the combined model, which uses two different resistivity distributions for the western and eastern part of the deposit. The interesting result is that the high conductivity of the deposit extends to a greater depth than that of the former sand pit. The most likely explanation of the extension of the low resistivity below the known deposit depth is a leakage of waste water from the deposit into the ground below. To prove the validity of this result, modeling tests were undertaken with a reduced depth extend of the conducting layers for both sections of the deposit, the western (fig. 1b) and the eastern part (fig. 1c). Both models could not satisfactorily explain the measured data. This verifies with increased reliability the resistivity distribution of the optimized model shown in fig. 1a.


This thesis is a continuation of my previous work `Supporting Notetaking with Digital Writing System: the case of teacher education'. The main goal of this thesis is to design a customized digital pen and paper based note taking system for the practice based teacher education, PPE. This thesis work has further performed a literature review to state the pedagogical objectives of PPE. Literature review on state-of-the-art has also been carried out. Together, these researches have informed the development of deployment scenarios and requirements for the system design. The system design is based on the Logitech io2 system deployed in my previous work. The system design extends the original system with a specialized paper design and a functionality to invoke storing of notes to specified folders at note taking time. The system has been evaluated by both experts and users, and has received positive feedback from both groups. The feedback is presented in this thesis to inform possible further work with this system


It is well known that the color of many natural and man-made objects is often very similar to that of human skin, such as sand, brick, to name a few. For the task of skin detection, it is often a very challenge task to identify the right skin locations while being robust against the distraction of these objects. In this paper, we present an on-line learning approach to model human skin by utilizing the similarity between neighboring pixels, and then combine it with region growing technique to accurately segment skin regions. By assuming the colors of neighboring skin pixels in YCbCr color space follows conditional Gaussian distributions, an on-line learning update is devised to efficiently estimate the parameters of these Gaussian distributions. For the inference stage, our algorithm first evaluates the color distance map in RGB space to reliably place the seeds of skin regions, then segment the skin regions by iterative seed growing based on the learned skin models. Empirical evaluations demonstrate the efficacy of the proposed approach.


Objective: To study the impact of Kerala floods of 2018 in the Micro, Small, and Medium Business Enterprises of Kerala. Method/ analysis: The study was conducted with the primary data obtained from the ground response of the entrepreneurs by the method of questionnaire. A comprehensive study was undertaken utilizing the competence of advanced statistical tools and software that provided clear insights on the socio-economic aftermaths of the calamity. Findings: The customer arrival has declined in the flood affected urban areas while rural localities remained same. Purchasing capacity of customers decelerated in the rural localities whereas in urban localities approximate to normal. The expenditure incurred for the entrepreneurs as the result of the devastation was enormously hiked at the same time the employment generation experienced a significant dip in the sector. The overall function of the sector is slowly approaching the normalcy. The rural localities suffered extremely from the disruption of transportation due to extensive damages on roads and highways whereas urban localities have relieved from the disruption of movement of goods. It was found that insurance coverage has not helped them to recover from the losses incurred due to flood. The enterprises functioning in ecologically sensitive areas were the worst affected by the flood. The distribution of income was found to have significant divergence among the urban and rural localities. Applications and improvements: Mandating the inclusion of insurance policy reforms with specific consideration for employment generation and enhancement of rural economy is necessary. Strict implementation of environmental norms should be constituted.


The development of a hydrogen-fueled engine using external mixture injection (e.g., using port or manifold fuel injection) with high efficiency and high power is dependent on the control of backfire. This work has developed a method to control backfire by reducing the valve overlap period while maintaining or improving engine performance. For this goal, a single-cylinder hydrogen-fueled research engine with a mechanical continuous variable valve timing system was developed. This facility provides a wide range of valve overlap periods that can be continuously and independently varied during firing operation. By using this research engine, the behavior of backfire occurrence and engine performance are determined as functions of the valve overlap period for fuel-air equivalence ratios between 0.3 and 1.2. The results showed that the developed hydrogen-fueled research engine with the mechanical continuous variable valve timing system has similar performance to a conventional engine with fixed valve timings, and is especially effective in controlling the valve overlap period. Backfire occurrence is reduced with a decrease in the valve overlap period, and is also significantly decreased even under operating conditions with the same volumetric efficiency. These results demonstrate that decreasing the valve overlap period may be one of the methods for controlling backfire in a hydrogen-fueled engine while maintaining or improving performance.


The effects on marketing margins and Texas what producers of shifting from a period with stable prices to a period without stable prices were investigated using both econometric and simulation techniques. Empirical evidence reveals wheat export firms are risk averse and that either futures markets were unable to absorb increased price risk or futures markets absorbed increased price risk at a cost of $0.054 per bushel. Increased variability in prices and reduced farm program benefits substantially reduced the probability of Texas wheat producers receiving a reasonable return on equity and a reasonable rate of asset accumulation.


Quantitative clearance of aerosolized Escherichia coli from the trachea, lung, and air sacs was measured in turkeys infected with Bordetella avium. Clearance of E. coli in turkeys with B. avium-induced tracheitis was minimally affected early in infection. Sixteen to 23 days after infection with B. avium, sporadic, mild depressions in clearance of E. coli were observed in the tracheas, which had large areas of deciliated tracheal epithelium or replacement of normal epithelium by immature hyperplastic epithelium or metaplastic squamous epithelium. Clearance of E. coli from the lung and air sacs was minimally affected in turkeys infected with B. avium.


Remodeling of tissue, such as airway smooth muscle (ASM) and extracellular matrix, is considered a key feature of airways disease. No clinically accepted diagnostic method is currently available to assess airway remodeling or the effect of treatment modalities such as bronchial thermoplasty in asthma, other than invasive airway biopsies. Optical coherence tomography (OCT) generates cross-sectional, near-histological images of airway segments and enables identification and quantification of airway wall layers based on light scattering properties only. In this study, we used a custom motorized OCT probe that combines standard and polarization sensitive OCT (PS-OCT) to visualize birefringent tissue in vivo in the airway wall of a patient with severe asthma in a minimally invasive manner. We used optic axis uniformity (OAxU) to highlight the presence of uniformly arranged fiber-like tissue, helping visualizing the abundance of ASM and connective tissue structures. Attenuation coefficient images of the airways are presented for the first time, showing superior architectural contrast compared to standard OCT images. A novel segmentation algorithm was developed to detect the surface of the endoscope sheath and the surface of the tissue. PS-OCT is an innovative imaging technique that holds promise to assess airway remodeling including ASM and connective tissue in a minimally invasive, real-time manner.


: We report a new case of congenital lumbar hernia. This is first case reported of congenital lumbar hernia and bilateral renal agenesis. We review literature and describe associated malformations reported that would be role out in every case of congenital lumbar hernia.


This paper proposes a face recognition system that can be used to effectively match a face image scanned from an identity (ID) document against the face image stored in the bio-metric chip of such a document. The purpose of this specific face recognition algorithm is to aid the automatic detection of forged ID documents where the photography printed on the document's surface has been altered or replaced. The proposed algorithm uses a novel combination of texture and shape features together with subspace representation techniques. In addition, the robustness of the proposed algorithm when dealing with more general face recognition tasks has been proven with the Good, the Bad & the Ugly (GBU) dataset, one of the most challenging datasets containing frontal faces. The proposed algorithm has been complemented with a novel method that adopts two operating points to enhance the reliability of the algorithm's final verification decision.


For several months, there have been ongoing protests in Hong Kong against the Chinese government. The democratic pressure does not seem to be diminishing and could have political consequences in the elections later this year. To understand the evolution of the situation, we must also take into account the economic transformation of the region as a whole, of which Hong Kong is no longer necessarily at the forefront.


How do Jains, adherents of one of the oldest minority religions in India, maintain their identity and protect their way of life when surrounded by non-Jain religions? Even more striking, how do Jains in the United States, where they constitute a minority within the Indian minority, maintain their traditions amidst a multi-cultural American society? Seeking upward mobility, Jains in post-independence India, have migrated locally, regionally, and internationally and these migrations have disrupted their social, religious, and cultural practices. My thesis looks at the ways in which Jains have addressed these disruptions. I analyse how they have restructured their traditional religious education, transforming it in a variety of ways, producing a range of contemporary Jain religious schools for children, both in India and the United States.  I argue that these new religious schools serve an important function in maintaining ancient Jain traditions, but have, at the same time, initiated significant structural as well as curricular changes that have transformed some of those traditions: widening the gap between Jain children and Jain mendicants, and reallocating authority within the Jain community by enabling laywomen to shape the curriculum and to teach in part-time religious schools, to name a few. The thesis pays attention to these changes, the reasons for the changes, and their consequences.  Using in-depth curriculum analysis and formal interviews, I examine contemporary Jain religious schools for children in the image-worshipping Digambar tradition and the non-image worshipping Shvetambar Terapanth tradition in India, and in mixed traditions in the United States. These Jain schools are growing exponentially in number and popularity within India and America, but have largely remained unexamined. This study aims to fill an important gap by closely analysing the rituals, leadership, and curricula of these new religious schools and their role in shaping modern Jain traditions.


The NAEP Validity Studies (NVS) Panel was formed in 1995 to provide a technical review of NAEP plans and products and to identify technical concerns and promising techniques worthy of further study and research. The members of the panel have been charged with writing focused studies and issue papers on the most salient of the identified issues.


Trace elements in soils depending on the pathways, mode of exposure and concentrations can be essential or non-essential to human-life developments. However there are some that are potentially toxic. Mobilization of the trace elements can be influenced by environmental conditions. Whilst others cause depletion others contributes to metal-ion enrichments that generally depends on surface processes and the prevailing human activities in the area. The 18 trace elements analysed from the 154 soil samples collected and studied; 2 chalcophile elements As and Cd listed among the potentially toxic elements (PTEs) were identified to be extremely and moderated polluted. Enrichment factors (EF) of 42.3 and 1.45 were computed for these 2 PTEs. On the contrary the essential elements Cu, Ni and Zn required for human metabolism rather showed depletions of 10.5, 24.0 and 21.0 respectively. Copper, Ni and Zn had computed geoaccumulation indeces (Igeo) of 0.17, 0.14 and 0.14 representing no-pollution. The quantities of these essential trace elements may not be enough for human and animal metabolisms and the non-essential PTEs may be detrimental to human health. Average concentrations of trace elements, essential and non-essential elements alike have not been published for the District. Besides the relationships between trace elements and health had not been thoroughly investigated so there is the need for geoscientists to intensify research on trace elements in the environment and together with professionals in public health so as to identify health issues arising from trace elements in the environment..


Concerning climate change Antarctica is a very sensitive region. Those changes are
relevant for synoptic systems, the humidity coupled with them and precipitation. In this
study measurements of relevant climatic variables like mean sea level pressure, temperature
and humidity are analysed together with results of the regional climate model HIRHAM.
This way the model results are validated and changes in the recent past can be monitored.
HIRHAM is a regional climate model consisting of model dynamics from HIRLAM and
model physics from ECHAM. It is run with boundary conditions from ERA40 (1994 to
1999) and ERAinterim (1996 to 2009). Measurements are provided by radiosondes and
GPS-retrieval. HIRHAM data has been compared to reanalyses and measurements at
station sites. It shows that the steep antarctic orography leads to di�erences between
measurements and model. Nevertheless HIRHAM provides a good performance simulating
the relevant variables on decadal time scales in general but also concerning the specialities
of the continent like for example katabatic winds. The systemic di�erences between both
measurement methods GPS-retireval and radiosonding have been analysed. While GPS
measures humidity in a volume of air, the radiosonde integrates humidity on a path, which
leads to di�erent results in total water vapour.
After the validation of the model, its data has been analysed concerning synoptical pat-
terns. It could be shown, that in the HIRHAM grid area the most active region is the
Ross- and Amundsen-Sea region. The MSLP standard deviation shows that the main
cylone tracks are north of the East Antarctic Coast stations. This is one reason for the
humidity being lower in this region. In Antarctica the humidity is low and has a strong
humidity gradient around the coast. This is because of the di�erent humidities over land
and over and the steep orography in Antarctica. For a �ner analysis of pressure patterns,
a �lter tool developed at the HZ Geesthacht has been used. Over the continent there is a
high pressure zone, over the seas around it, especially in latitudes of ca. 60� mostly low
pressure structures can be found. These patterns, reaching from Ross Sea to Amundsen
Sea and the Peninsula, are synoptically active.
To �nd AAO-positive and AAO-negative seasons for an analysis of the synoptical behaviour
in di�erent AAO-phases, the �rst EOF of the Antarctic region has been calculated with
ERA-interim data of the years 1996 to 2009. In AAO-positive phases the pressure is lower
than in AAO-negative phases, especially in the region around West Antarctica. This e�ect
is coupled to a higher humidity in this region on AAO-positive seasons. For a seasonal
mean of daily P-E-budgets, the precipitation is stronger in AAO-positive phases. which is
also consistent with the higher humidity and stronger lows in these seasons.


IMPORTANCE
Opioid-dependent patients often use the emergency department (ED) for medical care.

OBJECTIVE
To test the efficacy of 3 interventions for opioid dependence: (1) screening and referral to treatment (referral); (2) screening, brief intervention, and facilitated referral to community-based treatment services (brief intervention); and (3) screening, brief intervention, ED-initiated treatment with buprenorphine/naloxone, and referral to primary care for 10-week follow-up (buprenorphine).

DESIGN, SETTING, AND PARTICIPANTS
A randomized clinical trial involving 329 opioid-dependent patients who were treated at an urban teaching hospital ED from April 7, 2009, through June 25, 2013.

INTERVENTIONS
After screening, 104 patients were randomized to the referral group, 111 to the brief intervention group, and 114 to the buprenorphine treatment group.

MAIN OUTCOMES AND MEASURES
Enrollment in and receiving addiction treatment 30 days after randomization was the primary outcome. Self-reported days of illicit opioid use, urine testing for illicit opioids, human immunodeficiency virus (HIV) risk, and use of addiction treatment services were the secondary outcomes.

RESULTS
Seventy-eight percent of patients in the buprenorphine group (89 of 114 [95% CI, 70%-85%]) vs 37% in the referral group (38 of 102 [95% CI, 28%-47%]) and 45% in the brief intervention group (50 of 111 [95% CI, 36%-54%]) were engaged in addiction treatment on the 30th day after randomization (P < .001). The buprenorphine group reduced the number of days of illicit opioid use per week from 5.4 days (95% CI, 5.1-5.7) to 0.9 days (95% CI, 0.5-1.3) vs a reduction from 5.4 days (95% CI, 5.1-5.7) to 2.3 days (95% CI, 1.7-3.0) in the referral group and from 5.6 days (95% CI, 5.3-5.9) to 2.4 days (95% CI, 1.8-3.0) in the brief intervention group (P < .001 for both time and intervention effects; P = .02 for the interaction effect). The rates of urine samples that tested negative for opioids did not differ statistically across groups, with 53.8% (95% CI, 42%-65%) in the referral group, 42.9% (95% CI, 31%-55%) in the brief intervention group, and 57.6% (95% CI, 47%-68%) in the buprenorphine group (P = .17). There were no statistically significant differences in HIV risk across groups (P = .66). Eleven percent of patients in the buprenorphine group (95% CI, 6%-19%) used inpatient addiction treatment services, whereas 37% in the referral group (95% CI, 27%-48%) and 35% in the brief intervention group (95% CI, 25%-37%) used inpatient addiction treatment services (P < .001).

CONCLUSIONS AND RELEVANCE
Among opioid-dependent patients, ED-initiated buprenorphine treatment vs brief intervention and referral significantly increased engagement in addiction treatment, reduced self-reported illicit opioid use, and decreased use of inpatient addiction treatment services but did not significantly decrease the rates of urine samples that tested positive for opioids or of HIV risk. These findings require replication in other centers before widespread adoption.

TRIAL REGISTRATION
clinicaltrials.gov Identifier: NCT00913770.


Immune modulation has been recognized as an effective anti-osteoporosis strategy since the pivotal role of the RANK/RANKL/OPG signaling in bone metabolism and remodeling was discovered. To investigate the potential preventive and/or therapeutic effects of immune modulator protein Ling Zhi-8 (LZ-8) on osteoporosis, the osteoporosis animal model was established in Wistar rats by intramuscular injection of dexamethasone (DEX), namely glucocorticoids-induced osteoporosis (GIOP) rat model. To investigate the potential preventive effect of rLZ-8 on GIOP, we co-treated the rats with DEX and rLZ-8 intraperitoneally during the GIOP modeling stage and analyze the bone mass measured by bone mineral content (BMC) and bone mineral density (BMD), as well as levels of phosphorus (Pi), calcium (Ca2+) and hydroxyproline (HOP) in femur of GIOP rats. Consistently, all results suggested that rLZ-8 could prevent bone loss in the femurs of GIOP rats. Through analyzing the trabeculae morphology and the trabeculae amount by H&E staining, we found rLZ-8 could also improve the structural deterioration in femurs of GIOP rats. In order to further verify the results and its mechanism obtained from bone analysis, multiple biomarkers, including minerals metabolism (Pi and Ca2+), bone formation markers (osteocalcin, ALP and IGF-1), bone resorption markers (TRACP5b, CTX-1 and HOP), cytokines (IL-1β, IL-6 and TNF-α), oxidative stress indicators (GSH-px, SOD and MDA) and hormone molecules (testosterone, estradiol, calcitonin and parathyroid hormone) have been detected in serum or urine of rats. Results of these biomarkers in serum or urine confirmed rLZ-8's protective effect in GIOP. Through analyzing the relative expression level of OPG and RANKL in femurs via western blot, we foundrLZ-8 could increase OPG/RANKL ratio which could impede osteoclastogenesis process. To test the potential therapeutic effect of rLZ-8 on successfully generated GIOP rats, we administrated rLZ-8 to rats for three weeks starting from the ending day of 7 weeks treatment of DEX. We found rLZ-8 could also reverse the bone loss in GIOP rats. Through the BWs and organ coefficient analysis, we found rLZ-8 has little toxicity to the rats. Our results suggested that rLZ-8 may be developed into promising anti-osteoporosis drug with both preventive and therapeutic properties.


In his second paragraph Professor Oliver reacts strongly to a single brief paragraph in the text and one sentence of the summary that included speculation about the possible importance of the results. In each of the four sentences in question use of the subjunctive clearly implies caution, and the reader is referred back to our original paper, in which the speculations may be viewed in perspective. The paper contains no dietary recommendations, and, indeed, the only recommendations that I have espoused are those of the Committee on Medical Aspects of Food Policy panel on diet and heart disease' and the study group of the European Atherosclerosis Society,2 of which Professor Oliver and I were both members.


Purpose: Novel physical activity (PA) monitoring technologies can accurately capture the various dimensions of PA that are important for health. Presenting complex multi-dimensional PA feedback is potentially challenging. In this study, we generated personalised PA profiles and explored the impact of receiving rich visual informational feedback in terms of educational and motivational properties and cognitive-affective responses. Methods: Healthcare Professionals (HCPs: GPs, nurses and health trainers; n=15) and 40-70 year old male and female patients considered at risk of future chronic disease (as identified by the NHS Health Check; n=30) were provided with visual feedback depicting their personalised PA data. One-to-one semi-structured interviews were conducted to explore their attitudes towards physical activity and their responses to seeing personalised feedback. Thematic analysis was used to identify main themes and interpret the data. Results: Both HCPs and patients found that personalised PA profiles were both informative and motivational. Patients highlighted that the feedback enhanced their understanding of their own PA and in many cases were surprised by the discrepancy between their perceived and objectively measured PA levels. Participants who observed low activity levels, high sedentary time and missed PA recommendations generally expressed disappointment upon seeing their data and an instant desire to positively change their behaviour. Participants that were shown to have surpassed PA recommendations expressed feelings of pleasure and reassurance. Conclusions: Technology-enabled personalised visual PA feedback and profiles appear to be informative and motivational for Patients and Healthcare Professionals. This approach represents a promising tool for behaviour change interventions targeting physical activity.


In this paper, the orange peel defect in the surface range of the st14 steel sheet has been investigated using the electron backscattered diffraction (EBSD) technique. It has been found that the orange peel defect in the st14 steel sheet was resulted from the local coarse grains which were produced during hot-rolling due to the critical deformation in dual-phase zone. During deep drawing, the coarse grains with {100}001 microtexture can slip on the {112}111 slip system to form bulging and yields orange peel defects, while the coarse grains with {112}110 orientation do not form the defect as the Schmid factor of {112}111 slip system in it equals zero.


The interest for international development partnerships has increased within the discipline of cultural anthropology hand in hand with growing globalisation. Through the study of how actors that have engaged in a Ugandan-Swedish Municipal Partnership experience, express and utilise cultural difference, this thesis aims to make a contribution to this research by examine activities that took place in a specific context of cultural intersection. In addition, it aspires to link these experiences in the everyday life to general socio-political discourses. The material that the thesis builds upon was gathered during a total of four months of fieldwork in Manafwa district, Uganda, and the municipality of Amal, Sweden. The main informants that were consulted during the fieldwork were civil servants, politicians and actors that in other ways had engaged in the partnership or in the several side-projects that were linked to it. In the analysis of their narratives, as well as of observations collected in the two field sites and of official documents that concerns the partnership, inspiration was drawn from previous research in the discipline of applied development anthropology as well as the institutionalised anthropology of development. Theories of intercultural interaction and the work of hegemonies have been used in order to examine development through the study object of cultural difference.The thesis has its starting point in two issues that were high on the agenda during my stay in Manafwa district; the 2014 Anti-homosexuality Act and corruption within the partnership. Through the study of the way that the engaged actors' experiences are used in order to create coherence in relation to these issues, the aim is to reach an understanding of how their world views are simultaneously shaped by and reshaping intercultural encounters. The ways in which claims of universal truths are used in order to install feelings of belonging and to motivate certain actions will be presented. Furthermore, the thesis will show how hegemonies in many ways are used in order to maintain hierarchies within development partnerships that in their official outlines claim that they intend to be equal.


There are multiple concepts, in the study of psychology, about the factors that determine the psychological development and the formation of one's  personality. After a lot of theoretical, experimental and practical research about the participation of students in diverse mathematical olympiads and contests along the years, as a generalisation of the results of our analysis, we elaborated and formulated the concept of the resultant. This concept is our guideline in the theoretico-methodological approach to the training of gifted students for these olympiads and contests.


One new alkaloid, 4-geissoschizine N-oxide methyl ether (1), was isolated from the EtOH extract of the hook-bearing branch of Uncariarhynchophylla, together with 10 known alkaloids, 3-epi-geissoschizine methyl ether (2) isolated from U.rhynchophylla for the first time, geissoschizine methyl ether (3), 4-hirsuteine N-oxide (4), hirsuteine (5), hirsutine (6), 3α-dihydro-cadambine (7), 3β-isodihydro-cadambine (8), cadambine (9), strictosamide (10), and akuammigine (11). The structures were elucidated by spectroscopic methods including UV, ESI-QTOF MS, NMR, and circular dichroism experiments. Neuroprotective effects of 1–9 were investigated against 3 mM glutamate-induced HT22 cell death. The activity assay showed that 2, 3, 5, and 6 exhibited potent neuroprotective effects against glutamate-induced HT22 cell death. However, only weak neuroprotective activities were observed for 1, 4, 7, 8, and 9.


Proust's most famous critic claims that he didn't have "even a vague or confused idea" of how his novel was going to hang together. Others tell us that every statement in the novel is a "transient hypothesis," that Proust has "made up his mind about nothing," or even that Proust thinks he himself is "mad" for believing that art has the power to transfigure reality. This paper will explain why none of that is true. As is clear from his essays, his letters, and even his actions, Proust was not an "essayist," in the Musil sense: not someone, that is, whose assessments were always tentative and provisional, ready to be relinquished at any moment. At least when it comes to the relationship between selfhood, style, and art, Proust had a set of pretty robust beliefs; and those same letters, along with elements of the novel itself, also show that he wasn't flying without instruments. So why have some critics thought otherwise? Perhaps, in part, it's because they have assumed the narrator always speaks for Proust. If so, their foundational assumption isn't just mistaken; it's also likely to prevent the novel from doing some of its most important work on us, a work not of deconstruction, and not simply of didacticism, but of self-understanding, formal modeling, and habit cultivation, all in the service of a better life.


: In the 1990s, operational strategies to assure survival will be crucial for all healthcare providers. All will face an accelerating rate of change, and the paramount change will be an intensified competitive marketplace. How does this impact rehabilitation? Like acute care hospitals, rehabilitation facilities will diversify into alternative delivery systems. This paper examines the course one provider--Casa Colina, Inc.--has taken, the pitfalls and problems along the way, and the implications for other rehabilitation providers. Strategies used to strengthen various areas of rehabilitation are considered, including ambulatory care, skilled nursing, traumatic brain injury, medical and vocational rehabilitation, residential programs, joint ventures, rehabilitation hospitals and outpatient services. A strong consensus exists today among healthcare experts concerning where we are headed and operational strategies for survival in 1990. How does this consensus impact rehabilitation? Before dealing with rehabilitation, let us review essential agreements. For HOSPITALS, the experts agree that: multi-hospital systems will continue to grow and will be best positioned to implement and take advantage of the strategies of choice in the new competitive market; money spent nationally on healthcare services will continue to grow; new types of providers will erode acute care inpatient hospitals' share of healthcare expenditures; emphasis in healthcare will shift to ambulatory services and delivery systems; and hospitals may be at a disadvantage in attracting capital financing and many will have to create new corporate structures and business ventures to compete in the capital market.(ABSTRACT TRUNCATED AT 250 WORDS)


Foreign functions have been considered in the advanced database systems to support complex applications. We consider optimizing queries with foreign functions in a distributed environment. In traditional distributed query processing, selection operations are locally processed before joins as much as possible so that the size of relations being transmitted and joined can be reduced. However, if selection predicates involve foreign functions, the cost of evaluating selections cannot be ignored. As a result, the execution order of selections and joins becomes significant, and the trade-off for reducing the costs of data transmission, join processing, and selection predicate evaluation needs to be carefully considered in query optimization. A response time model is developed for estimating the cost of distributed query processing involving foreign functions. We explore the property of the problem and find an optimal algorithm with polynomial complexity for a special case of it. However, finding the optimal execution plan for the general case is NP-hard. We propose an efficient heuristic algorithm for solving the problem and the simulation result shows its good quality. The research result can also be applied to the advanced database systems and the multidatabase systems where the conversion function defined for the need of schema integration can be considered a type of foreign functions.


We aim to review the imaging findings of Klippel-Trenaunay syndrome. This disorder characterized clinically by a triad of capillary malformations manifesting as a port-wine stain, venous varicosities typically along the lateral aspect of the lower extremities, and bone and/or soft tissue hypertrophy. Imaging of extremities shows unilateral venous varicosities, persistent embryonic veins, anomalous of the superficial and deep venous system, low-flow venolymphatic malformations, and bony and soft tissue hypertrophy. Other findings include neurospinal as cavernoma, aneurysm, and hemimegalencephaly, pulmonary as pulmonary thromboembolism and pulmonary hypertension and visceral as gastrointestinal and genitourinary vascular anomalies. Imaging may detect associated lesions and differentiate from simulating lesions.


The work conducted in this project is an extension of the developments itemized in DE-FG-36-04GO14236. This program is designed to help the development of a biorefinery based around a raw sugar mill, which in Louisiana is an underutilized asset. Some technical questions were answered regarding the addition of a biomass to ethanol facility to existing sugar mills. The focus of this work is on developing technology to produce ethanol and valuable by-products from bagasse. Three major areas are addressed, feedstock storage, potential by-products and the technology for producing ethanol from dilute ammonia pre-treated bagasse. Sugar mills normally store bagasse in a simple pile. During the off season there is a natural degradation of the bagasse, due to the composting action of microorganisms in the pile. This has serious implications if bagasse must be stored to operate a bagasse/biorefinery for a 300+ day operating cycle. Deterioration of the fermentables in bagasse was found to be 6.5% per month, on pile storage. This indicates that long term storage of adequate amounts of bagasse for year-round operation is probably not feasible. Lignin from pretreatment seemed to offer a potential source of valuable by-products. Although a wide range of phenolic compounds were present inmore » the effluent from dilute ammonia pretreatment, the concentrations of each (except for benzoic acid) were too low to consider for extraction. The cellulosic hydrolysis system was modified to produce commercially recoverable quantities of cellobiose, which has a small but growing market in the food process industries. A spin-off of this led to the production of a specific oligosaccharide which appears to have both medical and commercial implications as a fungal growth inhibitor. An alternate use of sugars produced from biomass hydrolysis would be to produce succinic acid as a chemical feedstock for other conversions. An organism was developed which can do this bioconversion, but the economics of succinic acid production were such that it could not compete with current commercial practice. To allow recovery of commercial amounts of ethanol from bagasse fermentation, research was conducted on high solids loading fermentations (using S. cerevisiae) with commercial cellulase on pretreated material. A combination of SHF/SSF treatment with fed-batch operation allowed fermentation at 30% solids loading. Supplementation of the fermentation with a small amount of black-strap molasses had results beyond expectation. There was an enhancement of conversion as well as production of ethanol levels above 6.0% w/w, which is required both for efficient distillation as well as contaminant repression. The focus of fermentation development was only on converting the cellulose to ethanol, as this yeast is not capable of fermenting both glucose and xylose (from hemicellulose). In anticipation of the future development of such an organism, we screened the commercially available xylanases to find the optimum mix for conversion of both cellulose and hemicellulose. A different mixture than the spezyme/novozyme mix used in our fermentation research was found to be more efficient at converting both cellulose and hemicellulose. Efforts were made to select a mutant of Pichia stipitis for ability to co-ferment glucose and xylose to ethanol. New mutation technology was developed, but an appropriate mutant has not yet been isolated. The ability to convert to stillage from biomass fermentations were determined to be suitable for anaerobic degradation and methane production. An economic model of a current sugar factory was developed in order to provide a baseline for the cost/benefit analysis of adding cellulosic ethanol production.« less


Background and aims: Performance assessment of the HSE-MS in the contractors is a key step in the contractor's management process and it forms the basis of continuous improvement. Therefore, the present study aims to develop a practical model for the performance assessment of Health, Safety and Environment Management System (HSEMS) of construction contractors. Methods: In this analytical-practical study, after determining the main factors and indicators related to each of them, the questionnaire was built and then, the process of its validity and reliability were conducted. The importance of the main factors and their indicators were identified by using the questionnaire along with a poll of three groups of HSE experts in a holding company. Afterward, the results of the expert opinions were investigated and the corresponding formulas were used for calculating of the relative importance of main factors and their indicators. The performance indicators score in order to build the model was calculated. At the end, in order to validate the presented model, HSE performance of three large construction contractors in a holding company was evaluated. Results: developed model was composed of seven main factor and 123 indicators. Total score of contractor performance assessment in the project level can be a range between 80 (very poor performance) and 400 (very good performance) from the perspective of the HSE. The result of performance assessment in project level of three contractors shows that the HSE performance of first contractor was good and both second and third contractors were moderate. Conclusion: The proposed model can be used by employers of the large organizations to assess their HSE performance of contractors in level project. In addition, with regards to the output of assessing the contractors' performance, the contractors can be graded according to their HSE performance and was used as an input in the selection of contractors for the future


Non-destructive test is the best method for evaluate the different parameters of the pavements. In destructive testing taking core or make destruction to the pavement is time consuming. And difficult to carried out in heavy traffic area. Non-destructive test are carried out on various pavement to determine the test parameters. Modulus of Elasticity, Poissons's ratio and deflections of pavements are evaluated by using NDT instrument. Determination of strength of pavement and revised loading criteria for design of pavement. Test equipment use for to carry test on rigid pavement is Rebound Hammer and for flexible pavement is Falling weight Deflectometer. Test data collected from the tests for various pavement is used to evaluate, maintain and upgrade existing pavement systems to meet today's traffic demand for higher magnitudes of loading and frequencies.


Improved performance in speech applications using deep neural networks (DNNs) has come at the expense of reduced model interpretability. For consumer applications this is not a problem; however, for health applications, clinicians must be able to interpret why a predictive model made the decision that it did. In this paper, we propose an interpretable model for objective assessment of dysarthric speech for speech therapy applications based on DNNs. Our model aims to predict a general impression of the severity of the speech disorder; however, instead of directly generating a severity prediction from a highdimensional input acoustic feature space, we add an intermediate interpretable layer that acts as a bottle-neck feature extractor and constrains the solution space of the DNNs. During inference, the model provides an estimate of severity at the output of the network and a set of explanatory features from the intermediate layer of the network that explain the final decision. We evaluate the performance of the model on a dysarthric speech dataset and show that the proposed model provides an interpretable output that is highly correlated with the subjective evaluation of Speech-Language Pathologists (SLPs).


The aim of this study was to determine the lactose absorption capacity and possible existence of bacterial overgrowth in the small bowel in asymptomatic school children of low social economic level in Marilia, a city located in the interior of Sao Paulo state. Eighty three children aging 7 to 15 years old without any gastrointestinal manifestations at least 30 days prior to the tests were studied. All the patients had fasted for at least 8 hours before the tests were performed. Lactose absorption was evaluated by breath hidrogen test after an overload of lactose 18 g in 10% aquous solution. Lactose intolerance was determined by the occurrence of clinical symptoms, such as diarrhea, abdominal pain, flatulence, etc in the following 24 hours after the test was performed. Bacterial overgrowth was evaluated by the breath hidrogen test after a 10 g lactulose load in aqueous solution. Lactose malabsorption was detected in 19 (22.9%) children and lactose intolerance was observed in 10 (12%) children. Lactose intolerance was more frequently observed in children who showed lactose malabsorption (6/19; 31.6%) than in those who presented a normal test (4/64; 6.3%) (P = 0.008). Bacterial overgrowth was detected in six (7.2%) children and showed no statistical relationship with lactose malabsorption. Ontogenetic lactose malabsorption verified in this group of school children is similar to the reported for Caucasian populations. Presence of bacterial overgrowth confirms the existence of asymptomatic environmental enteropathy in children of low social economic level.


Type V collagen is a quantitatively minor fibrillar collagen comprised of different chain compositions in different tissues. The most widely distributed form, an alpha1(V)2alpha2(V) heterotrimer, regulates the physical properties of type I/V heterotypic collagen fibrils via partially processed NH2-terminal globular sequences. A less characterized alpha1(V)alpha2(V)alpha3(V) heterotrimer has a much more limited distribution of expression and unknown function(s). We characterized the biosynthetic processing of pro-alpha1(V)2pro-alpha2(V) procollagen previously and showed it to differ in important ways from biosynthetic processing of the major fibrillar procollagens I-III. Here we have successfully produced recombinant pro-alpha1(V)pro-alpha2(V)pro-alpha3(V) heterotrimers. We use these, and mouse embryo fibroblasts doubly homozygous null for the Bmp1 gene, which encodes the metalloproteinase bone morphogenetic protein-1 (BMP-1), and for a gene encoding the closely related metalloproteinase mammalian Tolloid-like 1, to characterize biosynthetic processing of pro-alpha1(V)pro-alpha2(V)pro-alpha3(V) heterotrimers, thus completing characterization of type V collagen biosynthetic processing. Whereas pro-alpha1(V) and pro-alpha2(V) processing in pro-alpha1(V)pro-alpha2(V)pro-alpha3(V) heterotrimers is similar to that which occurs in pro-alpha1(V)2pro-alpha2(V) heterotrimers, the processing of pro-alpha3(V) by BMP-1 occurs at an unexpected site within NH2-terminal globular sequences. We also demonstrate that, despite similarities in NH2-terminal domain structures, pro-alpha2(V) NH2-terminal globular sequences are not cleaved by ADAMTS-2, the metalloproteinase that cleaves the N-propeptides of the major fibrillar procollagen chains.


PURPOSE
To optimize small vessel delineation on non-contrast enhanced susceptibility weighted MRI protocol for MRI guided intervention in the brain.

METHODS
Multiple 5mm slices of the brain in a healthy volunteer were acquired with a 16-echo gradient echo sequence and a 32 channel head coil on a 3T scanner. K-space was under-sampled by a factor of 2. Images were reconstructed using 1) the vendor ASSET algorithm, 2) sparsity enforcing TV regularization applied to each slice and echo individually, and 3) group sparse reconstruction on each slice individually but all echoes simultaneously. The group sparse reconstruction increases the signal-tonoise ratio SNR of later echoes by utilizing the shared edges of brain structure between the echoes, which include the blood vessels. Quantitative PPM maps are computed from the complex images and are post processed by a method that removes background off-resonance effects. Magnitude images and corrected PPM maps are compared.

RESULTS
PPM maps show blood vessels with high contrast. The magnitude images and ppm maps using method 1 appear blurry compared to methods 2 and 3 because of anti-ringing filters. While small vasculatures appear very sharp in the ppm maps of methods 2 and 3, method 3 appears to have less smoothed magnitude images.

CONCLUSION
To obtain useful blood vessel delineation, low noise susceptibility weighted images are needed. Standard methods like SWI or SWAN require the combination of several slices using a minimum intensity projection to delineate vessels. The method considered here delineates vasculature with high spatial resolution and high SNR in a single slice. Iterative reconstruction methods have superior image quality but also require much more computation time. By reconstructing all echoes simultaneously, group sparse reconstruction produces the sharpest and clearest images.


Gastric syphilis in the setting of HIV is rare in the literature with only one other case reported. Herein, we present a case of a 40-year-old HIV-infected man with gastric syphilis. Evaluation revealed a rapid plasma reagin (RPR) of 1:2056, and cerebrospinal fluid with evidence of neurosyphilis. An esophagogastroduodenoscopy (EGD) was performed revealing nodular masses, which resolved after appropriate therapy with penicillin.


Cancer is a major disease, affecting people globally. Breast cancer specifically, is one of the primary types of cancer affecting women between the ages of 50 and 70. Many treatments have been developed for this disease, but for certain types of tumour, current treatments are failing. Therefore, there is an urgent need for new treatments.
An example of a new type of treatment is the use of magnetic nanoparticles. These particles are nanoscale crystals of iron oxide such as magnetite. They can be magnetically driven to specific targets in vivo using a magnetic field external to the body. Drug molecules can be attached to them for magnetic drug delivery at lower doses. The particles can generate heat when an alternating magnetic field is present. This is known as magnetic hyperthermia, and it is capable of killing tumour cells. The particles can also be used in MRIs for cancer diagnosis.
For these applications, the particles must have a narrow size distribution, high purity, be biocompatible and stable, and have specific magnetic properties. Achieving all of these requirements is difficult using synthetic methods. However, magnetotactic bacteria use biomineralisation to produce precise size and shape particles of magnetite, which are known as magnetosomes.
This study aimed to test and enhance the leading magnetosomes for cancer treatment. Magnetosomes were synthesized with varying concentrations of Mn2+, Co2+ and Cu2+ in order to optimise their magnetic properties for magnetic hyperthermia in cancer cell lines, where Co-doped magnetosomes displayed the highest coercivity (420 Oe) compared to native magnetosomes (125 Oe). This cobalt doping produced the highest apoptotic cell death in vitro (26.4%) and following the in vivo, testing confirmed that the presence of special magnetosomes with Co-doped magnetosomes within a tumour caused cell death around the sites of magnetosome localisation, compared to areas where there are no magnetosomes. In addition, for their MRI response, Mn doping enhances the T2 relaxation with increasing concentration of manganese, whereas in native magnetosomes, the Mn doping showed the highest saturation magnetisation of Ms 112 emug-1 and the highest value of relaxivity 434 mM-1S-1, which indicates the high degree of sensitivity in MRI. Furthermore functionalising the magnetosome surface with streptavidin has confirmed cell uptake by fluorescence microscopy and flow cytometry for some future applications with bioactive substances. The cell uptake was highest at 0.18 mg/ml concentration with low toxicity, as evidenced by the flow cytometry, MTT, and Endotoxin assays.
The outcome of this work is optimised concentrations of magnetosomes for cell uptake and cytotoxicity. The magnetic properties of magnetosomes have been enhanced through Co2+ and Mn2+ doping, and cell uptake has been investigated using TEM and fluorescence microscopy of functionalised magnetosomes. The more promising magnetosomes for magnetic hyperthermia have been tested in tumours in mice.