Background Similar to understanding how blood pressure is measured by a sphygmomanometer, physicians will soon have to understand how an artificial intelligence–based application has come to the conclusion that a patient has hypertension, diabetes, or cancer. Although there are an increasing number of use cases where artificial intelligence is or can be applied to improve medical outcomes, the extent to which medical doctors and students are ready to work and leverage this paradigm is unclear. Objective This research aims to capture medical students' and doctors' level of familiarity toward artificial intelligence in medicine as well as their challenges, barriers, and potential risks linked to the democratization of this new paradigm. Methods A web-based questionnaire comprising five dimensions—demographics, concepts and definitions, training and education, implementation, and risks—was systematically designed from a literature search. It was completed by 207 participants in total, of which 105 (50.7%) medical doctors and 102 (49.3%) medical students trained in all continents, with most of them in Europe, the Middle East, Asia, and North America. Results The results revealed no significant difference in the familiarity of artificial intelligence between medical doctors and students (P=.91), except that medical students perceived artificial intelligence in medicine to lead to higher risks for patients and the field of medicine in general (P<.001). We also identified a rather low level of familiarity with artificial intelligence (medical students=2.11/5; medical doctors=2.06/5) as well as a low attendance to education or training. Only 2.9% (3/105) of medical doctors attended a course on artificial intelligence within the previous year, compared with 9.8% (10/102) of medical students. The complexity of the field of medicine was considered one of the biggest challenges (medical doctors=3.5/5; medical students=3.8/5), whereas the reduction of physicians' skills was the most important risk (medical doctors=3.3; medical students=3.6; P=.03). Conclusions The question is not whether artificial intelligence will be used in medicine, but when it will become a standard practice for optimizing health care. The low level of familiarity with artificial intelligence identified in this study calls for the implementation of specific education and training in medical schools and hospitals to ensure that medical professionals can leverage this new paradigm and improve health outcomes.


After more than 300 unlawful alien workers were arrested on criminal charges in the Agriprocessors, Inc. raid in Postville, Iowa, the proceedings used a fast-tracking plea-bargaining system where every defendant pled guilty within two weeks. These defendants were deprived of their liberty without due process of law: all of the defendants were provided with a Spanish interpreter, yet many of them spoke and understood only indigenous South American languages, not Spanish. The civil balancing test of Mathews v. Eldridge provides a useful lens to analyze these criminal proceedings and to understand what the court should have done to ensure these defendants' pleas were "knowing and voluntary." This Note argues that the Agriprocessors defendants, denied adequate interpretation, were deprived of their liberty without due process of law in violation of the Fifth Amendment. I. INTRODUCTION On May 12, 2008, federal officials carried out the largest worksite raid to date at Agriprocessors, Inc., the nation's largest kosher meatpacking plant, in Postville, Iowa. Following the worksite raid led by the Immigration and Customs Enforcement (ICE) officials, federal prosecutors focused on criminally charging several hundred workers for using false documents in their job applications. Many of those arrested were Guatemalans or Mexicans who spoke indigenous South American languages, not Spanish. However, only Spanish interpreters were provided. Without an interpreter who spoke their languages, every defendant pled guilty within two weeks of being arrested. The government's policy of criminalizing illegal immigration, which has only accelerated since the September 11 attacks, represents a shift to a more punitive immigration enforcement strategy. Whereas in the past aliens were merely deported or removed - a civil sanction - under the criminalization policy, aliens are charged with crimes and often face imprisonment before being removed. With increased punishment comes an increased concern about defendants' due process rights. The Due Process Clause of the Fifth Amendment, which applies to unlawful aliens, embodies the constitutional protections for criminal justice procedures.1 However, the hasty Agriprocessors proceedings lacked certain due process protections, especially during the plea negotiation phase, since many of these defendant-aliens were provided interpreters who spoke a language they could not understand.2 The Agriprocessors legal proceedings are particularly appropriate to analyze within the procedural due process context because of the overlap of civil and criminal law found in the immigration context. Because of the criminalization of immigration policy, the government deliberately decided to apply the criminal justice system to these aliens rather than pursuing mere removal. While due process applies in both the civil and criminal context, it is useful in analyzing these criminal proceedings to draw on the civil context, where the tripartite balancing test of Mathews v. Eldridge3 applies, to illustrate how the balancing of government and individual interests in the Agriprocessors cases favored different procedures. This Note argues that providing Spanish interpreters for nonSpanish-speaking defendants during the plea bargaining phase was a violation of the defendants' due process rights and deprived them of their liberty. Initially, it is impossible to determine whether the defendants in the Agriprocessors proceedings could understand Spanish. However, at least one participant in the proceedings with first-hand knowledge, a certified federal court interpreter and Spanish professor, noted that most of the defendants spoke indigenous languages, and understood Spanish, if at all, as a second language.4 While the lack of primary information about the defendants' language abilities makes some of this Note's analysis speculative, it underscores the need to analyze whether these defendants did indeed receive due process and the more general protections of the criminal justice system. …


Artists have been dramatically reshaping the fine art certificate of authenticity since the 1960s. Where traditional certificates merely certified extant objects as authentic works of a named artist, newer instruments purported both to authorize the creation of unbuilt artworks and instruct buyers how to manifest and install them. Such "Permissive Certificates" have fascinated contemporary art historians ever since. Prior scholarship has shown how such documents, essentially blueprints for art creation, force us to confront fundamental ontological questions on the nature of art, the relationship between artist, collector and viewer, and the influence of money and acquisitiveness on art generation. But rarely, if ever, have they been approached as legal instruments.

This Article accordingly fills that gap by construing Permissive Certificates through the complex but potent array of legal rights that they define. It argues that Permissive Certificates are not unitary instruments, but in fact an amalgamation of two distinct legal structures. They couple narrow retrospective warranties on the one hand with prospective copyright licenses and rights of source association on the other. Critically, as with all copyright and source-based permissions, they are conditioned on the owner/licensee complying with use guidelines. Material variations from such terms place the owner/licensee outside the scope of the license, or otherwise in breach, and at risk of claims of infringement by the artist.

This approach to Permissive Certificates yields two important insights. First, they harbor an unappreciated power as a tool for artist control, particularly in jurisdictions such as the U.S. where moral rights remain relatively weak. Second, and more broadly, as art becomes increasingly more dematerialized, digitized, and duplicable, and ever more legalized in turn, Permissive Certificates will grow more and more into the locus of value for such works. Over the long run, museums and other collectors of fine art will become collectors, not of objects, but of permissions. The aura of the artist's hand will be that of a signature and not of a brushstroke.


Dorota Sajewska ponders the significance of the actor/performer's body in art which aims to mediate the experiences of the second and third generation after the Holocaust. Referencing such performance theorists as Peggy Phelan, Jose Esteban Munoz, Rebecca Schneider, and Diana Taylor, she calls attention to the marginalization of work with the body in Western culture, which led to the removal of the body from the archive, and simultaneously from the field of impact on historical narrative and identity politics. Analyzing selected examples of contemporary practices in art (Bozena Keff, Artur Żmijewski, Theater Ramba Zamba), Sajewska demonstrates how, in evading controlled forms of recording and storing history and preserving what is marginal in a culture, the body stresses the partiality, frailty, and fragmentariness of memory and the relative nature of the historical narratives constructed on its basis.


The unlikely Odyssey of George W. Bush. As the principal New York Times reporter assigned to cover George W. Bush's presidential campaign from its earliest stages - and then as a White House correspondent - Frank Bruni has spent as much time around Bush over the last two years as any other reporter. In Ambling Into History, Bruni paints the most thorough, balanced, eloquent and lively portrait yet of a man in many ways ill-suited to the office he sought and won, focusing on small moments that often escaped the news media's notice. From the author's initial introduction to Bush through a nutty election night and Bush's first months in office, Bruni captures the president's familiar and less familiar oddities and takes readers on an often funny, usually irreverent, journey into the strange, closed universe - or bubble - of campaign life. The result is an original take on the political process and a detailed study of George W. Bush as most people have never seen him.


In recent decades there has been a considerable growth in the delivery of professional education in online mode. To support this mode of learning, educators now have at their disposal an array of tools, with recent additions comprising tools for collaborative working and asynchronous learning. Learners undertaking courses in a face-to-face delivery environment typically forge close ties with their peers, and also build rapport with academic staff through lectures, tutorials and one-to-one or small group consultations (Lam, 2004; Singh et al, 2009). These ties tend to lead naturally to opportunities for collaborative working. It is widely acknowledged that this collaboration can have a positive impact on learning performance. By contrast, learning in an online environment can leave some learners feeling isolated from their educators and their peers, leading to a decline in motivation and ultimately performance. Others actively seek to operate in isolation, are reluctant to engage with others, and have to be persuaded of the benefits of forming links with others during their online study. The challenge for the educator is to design online learning programmes in such a way that a spirit of collaborative working is fostered and a productive learning community is established. It was against the backdrop of this challenge that the project presented in this paper was initiated in a UK Higher Education establishment in which there has been a significant increase in the number of professional, vocational and post-experience programmes delivered in online mode. The aims of the project were to explore the approaches being taken, and the tools being used, by colleagues to foster interaction and build learning communities in their online programmes; to gain insights into their students' experiences of online learning; and to capture areas of good practice which could be shared more widely. Following a literature review examining key themes in online learning, an examination of available tools was undertaken. This was followed by an observation study and series of semi-structured interviews with academic staff, relevant support staff and learners. Drawing on activity theory, findings were analysed to identify issues in current practice. These findings highlighted needs for training in online learning design, rather than simply 'technology use' for the academics, and also a need to educate learners about collaborative working and learning. The practical outcomes of the project were twofold: first, using aspects of activity theory, a number of illustrative cases of good practice were constructed for use in training academics. Second, learning guides were devised, again drawing on activity theory, to help students understand the nature and scope of an online learning community and their role as an interacting participant within it. These cases and guides, informed by activity theory, represent an important aspect of the contribution of this project to the wider professional learning community.


Twenty four rice genotypes were grown under salt stress conditions, in the artificially salinized
cemented field basins. The correlations between different attributes were computed separately for
each salt stress. Different inevitable correlations were observed, but increased salt stress affected the
magnitude of these correlations. The attributes of number of grains per panicle, total florets per
panicle and panicle fertility showed very highly significant positive correlations with yeild per plant
under the highest salt stress. Such attributes may be utilized as the selection indices for salt tolerance.


In August 2002, a heavy rainfall (445 mm in total for 5 consecutive days) resulted in a catastrophic flood, and it completely washed away the benthic fauna from the mainstream channel of the Gapyeong stream, a typical mid-sized stream in the central Korean peninsula. This study was to investigate the recovery patterns of aquatic insect communities that were damaged by the flood. Aquatic insects were sampled quantitatively using a Surber sampler (50 × 50 cm, 1 riffle and 1 pool/run habitats per site) from three sites (4th-6th order) of the Gapyeong stream prior to 2000 and seasonally after the flood event from 2003 to 2006. Before the flood in the reference year (2000), a total of 77 species of aquatic insects were collected, whereas after the flood 47 species (2003), 51 species (2004), 64 species (2005) and 55 species (2006) were collected from the whole sampling sites. The aquatic insect density decreased to 26.85% (2003), 90.25% (2004), 52.53% (2005) and 54.95% (2006) of that recorded in the reference year. Although approximately 70% of the aquatic insect fauna has recovered since the flood event, the species composition in the most recent year differed substantially (similarity ca. 50%). On the other hand, the compositions of functional groups have not significantly changed. Aquatic insect communities at the riffle sites were affected more profoundly than those at the pool/run sites. The aquatic insect communities at the upstream site recovered more rapidly than those at the downstream sites.


One of the key aims of Higher Education is to develop students' ability to become 'critical reflective thinkers'. This is typically private and ignores the benefits of collaboration. Our project extends innovative reflective techniques to students collaborating at two universities. At Southampton Solent University (SSU), reflective practice is focused on learning, structured in an adaptable spreadsheet via the virtual learning environment (VLE). At Bournemouth University (BU), the VLE Discussion Board facilitates asynchronous online discussion; during which students are encouraged to reflect. This paper describes a project designed to enable users to learn from others' as well as their own reflections. Participants completed a 52-item Metacognitive Awareness Inventory (MAI) and a semi-structured questionnaire on their reflective practice, before being randomly assigned to groups comprising students from a single university or both universities. Via the VLE, participants watched a 20-minute video and then engaged in critical discussion of the content, prompted by four discussion points over a 2-week period. Simultaneously, they recorded reflections on an individual online reflection sheet at least once every other day. At the end of this period, participants were asked to share and discuss their online reflections for a further week. Finally, the MAI and the reflection questionnaire were re-administered. The data are currently being analysed using both quantitative methods (frequency and quantity of posts, changes in scores) and qualitative methods (depth of critical discussion). The results will have both practical and research-focussed outputs.


Background : Kunyit is one of herbal medicine that had been empirically used by Indonesian people since long time ago to treat disease or to maintain their health. Recent studies indicate that dietary kunyit may responsible for anti-inflammatory and antioxidant. Overdose of paracetamol can cause kidney damage. This research was aimed to prove that kunyit extract could protect kidney from appearance change of Balb/c that previously administered by paracetamol.
Method : This laboratoric experimental research applied post test only control group design on 36 mice that were devided into 6 groups. K was only received standart food without any treatment. Treatment group P1 received paracetamol 0,5 ml on 1st – 7th day. Treatment group P2 received kunyit 3mg on 1st – 14th day. Treatment group P3 received kunyit 3mg on 1st – 14th day and paracetamol 3,5 mg on 15th-21th day. Treatment group P4 received kunyit 6mg on 1st – 14th day and paracetamol 3,5 mg on 15th-21th day. Treatment group P5 received kunyit 12mg on 1st – 14th day and paracetamol 3,5 mg on 15th-21th day. P1 and P2 was exterminated on 7th day and 14th day. Respectively, while K, P3, P4, P5 was being exterminated on 21th day. All data were analyzed with One Way ANOVA test and followed with Post Hoc test.
Result : P1 showed the most amount of obstructed tubules from another group. P2 showed less amount of obstructed tubules and insignificantly different statistically (p > 0,05) compared to K group. P3, P4, and P5 tubules proximal showed less obstruction than P1. Significant difference were found in comparison within P1-P3, P1-P4, and P1-P5 (p < 0,05).
Conclusion : Kunyit treatment might salvage kidney from appearance change of Balb/c that previously administered by paracetamol.
Keywords : Histological appearance of mice kidney, Paracetamol, Kunyit.


Foetal membranes are said to be retained when they fail to be expelled within 3-4 hours after parturition. Retained foetal membranes are often complicated by septic metritis and toxaemia within 2-3 days postpartum if not promptly treated. In this case report, a 4 year old female Jamnapuri goat weighing 60kg was presented to the large animal clinic of the Universiti Veterinary hospital, Universiti Putra Malaysia (UPM) with the complaint of difficulty in breathing, coughing, in appetence, dehydration and recumbency a few days after kidding. Following physical examination, haematological and biochemical analysis, a tentative diagnosis of septicemia with concomitant diarrhoea was made. The initial treatment instituted was aimed at stabilizing the patient through intravenous fluid (IVF), non-steroidal antiinflammatory drug (NSAID) and antibiotics therapies. Unfortunately the doe died and necropsy examination revealed a pneumonic lung, mastitis, pin point ecchymotic haemorrhages on the abomasal mucosa with moderately pale and mottled liver and pieces of macerated placenta in an inflamed uterus. The cause of death was fulminant septicemia arising from the retained foetal membranes, with complications of pneumonia, enteritis and mastitis. Prompt implementation of herd health program is paramount in reducing mortalities in goat farms.


This paper examines an environment where original content can be remixed by follow-on creators. The modelling innovation is to assume that original content creators and remixers can negotiate over the 'amount' of original content that is used by the follow-on creator in the shadow of various rights regimes. The following results are demonstrated. First, traditional copyright protection where the original content creators can block any use of their content provides more incentives for content creators and also more remixing than no copyright protection. This is because that regime incentivises original content creators to consider the value of remixing and permit it in negotiations. Second, fair use can improve on traditional copyright protection in some instances by mitigating potential hold-up of follow-on creators by original content providers. Finally, remix rights can significantly avoid the need for any negotiations over use by granting those rights to follow-on innovators in return for a set compensation regime. However, while these rights are sometimes optimal when the returns to remixing are relatively low, standard copyright protection can afford more opportunities to engage in remixing when remixing returns are relatively high.


This paper presents a complete read-out chain for large arrays of X-ray detectors to be used for spectrometry applications in space. The system is fully integrated except for the X-ray detector. It basically consists of a front-end circuit for processing the detector signal, a Wilkinson A/D converter for the analog-to-digital conversion and the digital logic required to ensure the correct handshaking between all the blocks of the read-out chain. The system allows us to process the signal provided by the detector down to the final analog-to-digital conversion. All these functionalities are embedded in a single chip that will be bump-bonded to the matrix of X-ray detectors. The chip, designed in a 0.35 mum CMOS technology, achieves an input-referred noise of 34 erms -, consuming 0.9 mW from a 3.3 V power supply. The on-board A/D converter features 10 bits of resolution with a maximum conversion time of 210 mus. The INL and DNL of the whole read-out channel are equal to plusmn3.3 LSB and plusmn0.2 LSB, respectively.


Child language researchers have often assumed that progress in first language learning depends heavily on language exposure. For example, Hart and Risley (1995) compared children in middle class families with children in lower class families. Based on recordings made across several years in the home, they estimated that by the time the children from lower SES families entered first grade they had heard 30 million fewer words than the middle class children. Researchers and educators have argued that this '30 million word gap' is a primary cause for academic failure of lower SES children in the primary grades in the United States. Researchers in second language acquisition (SLA) research have often postulated a similar linkage between exposure and attainment, both for early and simultaneous bilingual children and later second language learning. Carroll (Carroll) expresses justifiable skepticism regarding such claims regarding the effect of amount of exposure on language attainment. Despite some important differences in conceptualization of the nature of the input, I find her overall analysis compelling and important.


For many years, scholarship on the female gothic has critiqued these works as being essentially conservative and by extension antifeminist. In this essay, Mary Wollstonecraft Shelley's Mathilda is read against such charges in an attempt to demonstrate the ways in which gothic heroines deploy dramatic conventions in order to recuperate their feminist potential. With an eye towards the performative, this essay finds in the character of Mathilda a powerful actress or artist rather than a submissive victim. Whereas previous scholarship has pointed to Mathilda's seeming lack of control throughout the novel, this essay highlights the high degree of control she is invested with by virtue of the very narrative that she creates.


The pharmacokinetics of pyrrolidone in a composition with pyroglutamic acid was studied in white mongrel male rats. The former component exhibits cerebrovascular and neuroprotector activity. Pyrrolidone, detected in the blood plasma and brain for 8 h after peroral and intravenous administration, exhibits a high absolute bioavailability and the ability to penetrate via the blood-brain barrier.


THE FEASIBILITY of bridging experimental arterial defects with vascular grafts preserved by refrigeration in salt solution and in defibrinated plasma was demonstrated by Carrel.1He found that the chances of successful function of the preserved graft, whether arterial or venous, were better when the donor and recipient animals were of the same species. Such grafts he named homografts. Gross and his collaborators2preserved segments of aorta in a mixture of 10% dog serum and 90% "balanced salt solution" and reported satisfactory results in 21 of 24 aortic homografts transplanted into dogs which survived from four days to more than 10 mo. after operation. They attributed a considerable measure of their success to the fact that when the duration of storage was three weeks or less more than 80% of the grafts were shown to have viable cells by tissue culture. Successful implantation of venous segments into arteries as


This guide is a basic overview of Protocol Builder, a resource provided by DML that can help investigators draft research protocols.


The extant economic and marketing literature on product line design mainly addresses firm's product decisions in conventional markets. However, many products demonstrate salient network externalities in their consumption, such as computers, software, telephone, telefax, and Internet routers. To our best knowledge, the role of network externalities in product line design has not been addressed. This paper fills the gap by investigating how the optimal structure and prices of a product line depend on the network externalities in the product market. A fundamental insight we obtain is that, in markets with network effects, the firm has a greater incentive to extend the length (as measured by the number of product varieties) of its product line. In our vertical model, market segmentation is sub-optimal in the absence of network externality. With externality, the monopolist offers two distinct products demonstrating maximum differentiation. The low-end product is used primarily to expand the product network, and is offered below marginal cost when externalities are sufficiently strong.


In this contribution we illustrate some of the quality aspects, as well as a number of organizational and management issues, in relation to the publication of a niche medical journal that since 2000 offers free online access to peer-reviewed articles in the field of Pancreatology.
The journal that today is considered among the three most important international journals in the field, has gained in time a more and more innovative profile through initiatives that, for some aspects, are in countertendency to the normal editorial practice. An example of that is the fact that JOP encourages its authors to publish scientific contributions that concern negative research results. Furthermore the editorial board is engaged in a campaign aimed at convincing author to make their research data available. This grants a greater transparency and enables scientists to check and validate the findings of original authors. Initiatives like virtual round tables and the inclusion of multimedia materials for diagnostic evaluation, comments and discussion among readers, contribute to add value to the journal.
In the course of time JOP has reached such a dimension that from an editorial and publishing point of view the workload required for its management is at risk to become no more sustainable. This is due to the fact that there isn't a true staff of people dedicated to the editorial tasks and those involved are volunteers who do not gain any profit from this activity and who have another main job. All costs involved in the actual publication of the journal have always been covered by contributions from companies in the pharmaceutical and biomedical industry, with a minor contribution coming from one academic Institution. As a matter of fact, funding through sponsorships are decreasing and more occasional than in the past. In this scenario it is clearly emerging the necessity to identify a more sustainable business model that will guarantee the continuation in time of this experience that has proven so positive so far.


A clinical and anatomical analysis comprises pre-commission (dissection), commission, and post-commission stages, each of which is characterized by its tasks, resource costs, and organizational forms. Subjective and objective factors influencing the content and efficiency of dissecting operations have been identified and analyzed; patterns affecting the quality of analyses of fatal outcomes have been established. To enhance the demand for and efficiency of postmortem activities, it is appropriate to reconsider a system for monitoring the results of autopsies, specifically, by excluding the categories "discrepancies" and "iatrogenias" from institutional and federal reports, as well as from the list of the quality indices of the work of healthcare organizations, by increasing attention to the analysis of reasons for defects in medical care. The necessity of improving the analysis of fatal outcomes requires that the level of both primary postgraduate and special training of a modern pathologist should be qualitatively increased so that the growing needs of practical medicine are met.


Background & Objective: Free radicals are highly reactive molecules may cause great damage to cell membranes and DNA and Result in inducing oxidation DNA mutations leading to cancer, degenerative, and other diseases. Plant antioxidant derived may be preventive of free radical damages. Materials & Methods: The Stems and flower sample of plants air-dried, finely ground and were extracted by ethanol: water (70:30) for 48 h. Extracts were filtered and dried under vacuum. The antioxidant activity of five ethanolic extract of medicinal plants (Descurainia Sophia, Plantago major, Trachyspermum copticum L, Coriandrum sativum and Trigonella foenum-graecum) from Iran were analysed by five different methods [1,1-diphenyl-2-picrylhydrazyl (DPPH) radical, 2,2,azinobis-3-ethylbenzthiazoline-6-sulphonic acid (ABTS) radical cation, Ferric-reducing antioxidant power assay (FRAP), phosphomolybdenum (PMB) and reducing power (RP)]. In addition, for determination of antioxidant components total phenolic content was also analyzed. Results: The total phenolic content of medicinal plant ranges from 74 to 154.3 mg Gallic acid/g extract as measured by the Folin–Ciocalteau method. Values of DPPH varied from 15.5 to 19.6 µmol trolex/g. FRAP ranged from 124.2 to 753 µmol of Fe(II)/g extract. Antioxidant activity of the Plantago major was always higher compared to the other plants extracts values of total phenols content and antioxidant capacity by DPPH, ABTS, FRAP, (154.33 mg GAE/g, 1856 µmol trolox, 750 µmol trolox and 1169 µmol of Fe(II)/g, extract respectively). The range of total antioxidant activity by phosphomolybdenum method was 513.3 to 870 µmol trolox/g. The reducing ability of the tested extracts was between 0.31-1.26. Plantago major-was also highest activity in both tests. Conclusion: This study clearly demonstrated that Plantago major crude extract exhibit significant antioxidant activity.


Introduction Monoclonal antibodies (mAb) targeting plasma cells are malignant gammopathy designed and approved therapies. In recent years, these antibodies have also been increasingly introduced for non-malignant conditions such as autoimmune-mediated diseases. The Anti-Phospholipid Syndrome (APS) is an immune-mediated disorder in which autoantibodies against phospholipid associated proteins could elicit the activation of the coagulation cascade in specific situations. Therefore, the mainstream treatment for APS patients is the use of anticoagulant therapy. However, there are refractory patients who would benefit from targeting the antibodies rather than their effects. Rituximab, a B-cell depleting mAb, and intravenous immunoglobulins (IVIG) have been used in APS patients without showing a clear beneficial effect or a significant drop in anti-phospholipid antibody (aPL) levels. Clinical case We present our first APS case treated with daratumumab, an anti-CD38 mAb, in a 21-year-old patient with APS who presented with recurrent venous thromboembolic events despite adequate anticoagulant therapy. She tested positive for lupus anticoagulant, anti-cardiolipin IgG, anti-beta-2-glycoprotein-I IgG and anti-phosphatidylserine/prothrombin IgG and IgM. She was administered one dose weekly of daratumumab for 4 weeks. The treatment showed an adequate safety profile and was well tolerated. The patient was discharged after undergoing a clinically significant improvement. After the therapy, her levels of positive aPL declined significantly and most continued to decrease during the next three months. The patient experienced a new thrombotic episode two years after the therapy associated with poor adherence to antithrombotic therapy. Conclusions The treatment with daratumumab showed an adequate safety profile, was well tolerated and led to a significant clinical improvement. Levels of aPL lowered on therapy and the next three months and then rose again during follow-up. Further investigation is needed to better elucidate the role and optimal timing and doses of daratumumab in treatment of refractory APS.


We present a novel code search approach for answering queries focused on API-usage with code showing how the API should be used. To construct a search index, we develop new techniques for statically mining and consolidating temporal API specifications from code snippets. In contrast to existing semantic-based techniques, our approach handles partial programs in the form of code snippets. Handling snippets allows us to consume code from various sources such as parts of open source projects, educational resources (e.g. tutorials), and expert code sites. To handle code snippets, our approach (i) extracts a possibly partial temporal specification from each snippet using a relatively precise static analysis tracking a generalized notion of typestate, and (ii) consolidates the partial temporal specifications, combining consistent partial information to yield consolidated temporal specifications, each of which captures a full(er) usage scenario.
 To answer a search query, we define a notion of relaxed inclusion matching a query against temporal specifications and their corresponding code snippets.
 We have implemented our approach in a tool called PRIME and applied it to search for API usage of several challenging APIs. PRIME was able to analyze and consolidate thousands of snippets per tested API, and our results indicate that the combination of a relatively precise analysis and consolidation allowed PRIME to answer challenging queries effectively.


Two seismic forces beyond our control the advent of Web 2.0 and the inexorable influx of tech-savvy Millennials on campus are shaping what Roger McHaney calls The New Digital Shoreline of higher education. Failure to chart its contours, and adapt, poses a major threat to higher education as we know it.These forces demand that we as educators reconsider the learning theories, pedagogies, and practices on which we have depended, and modify our interactions with students and peersall without sacrificing good teaching, or lowering standards, to improve student outcomes. Achieving these goals requires understanding how the indigenous population of this new shoreline is different. These students arent necessarily smarter or technologically superior, but they do have different expectations. Their approaches to learning are shaped by social networking and other forms of convenient, computer-enabled and mobile communication devices; by instant access to an over-abundance of information; by technologies that have conferred the ability to personalize and customize their world to a degree never seen before; and by time-shifting and time-slicing.As well as understanding students assumptions and expectations, we have no option but to familiarize ourselves with the characteristics and applications of Web 2.0essentially a new mind set about how to use Internet technologies around the concepts of social computing, social media, content sharing, filtering, and user experience.Roger McHaney not only deftly analyzes how Web 2.0 is shaping the attitudes and motivations of todays students, but guides us through the topography of existing and emerging digital media, environments, applications, platforms and devices not least the impact of e-readers and tablets on the future of the textbook and the potential they have for disrupting teacher-student relationships; and, if appropriately used, for engaging students in their learning.This book argues for nothing less than a reinvention of higher education to meet these new realities. Just adding technology to our teaching practices will not suffice. McHaney calls for a complete rethinking of our practice of teaching to meet the needs of this emerging world and envisioning ourselves as connected, co-learners with our students.


Nonconventional luminescent polymers have attracted rapidly growing attention owing to their importance in the fundamental understanding of fluorescence mechanisms and potential practical applications. However, most non-conjugated luminogens exhibit weak blue emission. Incorporating different nonconventional chromophores and adjusting molecular structures of polymers are assumed to enable the formation of more conformations with strong intra- and/or interchain interactions, leading to strong and red-shifted emissions. In this work, we synthesized poly(maleic anhydride-alt-vinyl pyrrolidone) (PMVP) copolymers with different molecular weights through a conventional free radical precipitation copolymerization method. The emissions of PMVPs are significantly red-shifted in comparison to those of the homopolymers poly(maleic anhydride) and poly(N-vinyl-2-pyrrolidone). The PMVPs exhibit aggregation-induced emission (AIE) characteristics, as they are highly emissive in concentrated solutions or in the solid state. The PMVPs also exhibit significant molecular weight-dependent fluorescence (MWDF) and excitation-dependent fluorescence (EDF). The photoluminescence (PL) intensity of their DMSO solutions increases with decreasing molecular weight and their maximal emission wavelength (λmaxex) is red-shifted. Moreover, they can emit a wide range of colours from blue to red under different excitation wavelengths. Very impressively, poly(itaconic anhydride-co-vinyl pyrrolidone) (PIVP) copolymers with a lower chain rigidity emit very strong red emission at about 600 nm in a wide excitation wavelength range, which is rarely reported for non-conjugated luminogens. This study may shed some light on the preparation of nonconventional luminescent polymers with strong and red-shifted fluorescence emission.


Purpose – Continuum-based discrete element method is an explicit numerical method, which is a combination of block discrete element method (DEM) and FEM. When simulating large deformation problems, such as cutting, blasting, water-like material flowing, the distortion of elements will lead to no convergence of the numerical system. To solve the convergence problem, a particle contact-based meshfree method (PCMM) is introduced in. The paper aims to discuss this issue. Design/methodology/approach – PCMM is based on traditional particle DEM, and use particle contacts to generate triangular elements. If three particles are contact with each other, the element will be created. Once elements are created, the macroscopic constitutive law could be introduced in. When large deformation of element occurs, the contact relationship between particles will be changed. Those elements that do not meet the contact condition will be deleted, and new elements that coincide with the relationship will be generated. By the deletion and creation of elements, the convergence problem induced by element distortion will be eliminated. To solve FEM and PCMM coupled problems, a point-edge contact model is introduced in, and normal and tangential springs are adopted to transfer the contact force between particles and blocks. Findings – According to the deletion and recreation of elements based on particle contacts, PCMM could simulate large deformation problems. Some numerical cases (i.e. elastic field testing, uniaxial compression analysis and wave propagation simulation) show the accuracy of PCMM, and others (i.e. soil cutting, contact burst and water-like material flowing) show the rationality of PCMM. Originality/value – In traditional particle DEM, contact relationships are used to calculate contact forces. But in PCMM, contact relationships are adopted to generate elements. Compared to other meshfree methods, in PCMM, the element automatic deletion and recreation technique is used to solve large deformation problems.


In the current study, disgust was induced using a carefully controlled odor manipulation to observe its effect on participants' implicit and explicit responses to homosexuals. Participants were presented with a vial containing an odor that was described as "body odor" (n = 47) that induced a high level of disgust, or "parmesan cheese" (n = 43) that induced a moderate level of disgust, or an odor-free vial (n = 53). Subsequently, participants viewed images of homosexual and heterosexual couples, and their viewing times and ratings of the images' pleasantness were recorded. Additionally, they completed a "feelings thermometer" task, the Attitudes Toward Lesbians and Gay Men scale that assessed feelings toward homosexuals, and the Three-Domain Disgust Scale to measure sensitivity along three dimensions of disgust (pathogen, moral, and sexual). Results indicated that those in the body odor condition viewed images of gay (but not lesbian) couples for less time relative to images of heterosexual couples compared with participants in the other two conditions. With respect to explicit ratings, participants in the body odor condition reported colder feelings for gay relative to heterosexual men on the feelings thermometer compared with those in the no-odor control condition. For pleasantness ratings, the odor manipulation served as a moderator, such that for those in the body odor condition only, higher sensitivity to sexual disgust predicted lower ratings for images of lesbian couples relative to straight couples. Thus, although induction of disgust biases implicit and explicit responses to gay couples, the degree to which this occurs for explicit ratings of lesbian couples depends on levels of sexual disgust. Copyright © 2013 John Wiley & Sons, Ltd.


Purpose: To evaluate the efficacy of a midface seal drape in eliminating fire risk oxygen concentrations from nasal cannulated oxygen delivery compared with a standard open oculofacial surgical field. Methods: Controlled experiment using the SimMan patient simulator and an oxygen detector. Oxygen concentrations were measured at 9 facial surgical locations with nasal cannula flow rates of 2, 4, and 6 l/min of 100% FiO 2 in both the draped and undraped conditions. Results: The mean oxygen concentration in the oculofacial surgical field with the seal drape was 21.4% and 26.3% without (p = 0.0002; paired t test, 2-tailed). The draped condition provided safe oxygen concentration levels at all anatomical landmarks at all 3 flow rates, whereas the undraped condition was associated with suprathreshold oxygen concentration levels at 13 of 27 measurements. There was a direct correlation between oxygen flow rate and surgical field oxygen concentration in the undraped condition. Conclusions: A midfacial seal drape reduced oxygen concentrations from nasal cannula oxygen in the oculofacial surgical field and may reduce fire risk.


The present paper aims to investigate and compare various modalities of migrant entrepreneurship in European countries in order to design a systematic classification of migrant entrepreneurship and to highlight key factors of migrant entrepreneurship in Europe. The paper is based on a comparative assessment of available quantitative data and qualitative information derived from a broad review of findings from previous studies in the literature. Our quantitative evaluation includes the European OECD countries, while our qualitative investigation addresses migrant entrepreneurship experiences in eight European countries: Denmark, Germany, Greece, Italy, the Netherlands, Portugal, Sweden, and the UK. The results of our comparative analysis show that the general picture of European migrant entrepreneurship is determined by some distinct push factors such as high unemployment rates and low participation rates or low status in the labour market as well as by an accompanying factor, namely mixed embeddedness. The results of our comparative evaluation are summarized in a systematic typological table. These show that, while an informal and labour-intensive sector, an underground economy, and small companies and traditional households prompt migrant entrepreneurship in Southern European countries, an over-representation of non-Western immigrants among the self-employed, as well as relatively lower income levels of self-employed immigrants compared to both self-employed natives and employed immigrants are decisive for migrant entrepreneurship in Northern European countries.


Background Maternal exposure to polychlorinated biphenyls (PCBs) is associated with increased proportions of spontaneous abortion and stillbirth in animal studies. In Japan in 1968, accidental human exposure to rice oil contaminated with PCBs and other dioxin-related compounds, such as polychlorinated dibenzofurans (PCDFs), led to the development of what was later referred to as Yusho oil disease. Objective The aim of this study was to investigate the association of maternal PCB and dioxin exposure with adverse pregnancy outcomes in Yusho women. Methods In 2004, we interviewed 214 Yusho women (512 pregnancies) about their pregnancy outcomes over the past 36 years. Pregnancy outcomes included induced abortion, spontaneous abortion, preterm delivery, and pregnancy loss. Results In pregnancy years 1968–1977 (within the first 10 years after exposure), the proportions of induced abortion [odds ratio adjusted for age at delivery (ORadj) = 5.93; 95% confidence interval (CI), 2.21–15.91; two-tailed p < 0.001) and preterm delivery (ORadj = 5.70; 95% CI, 1.17–27.79; p = 0.03) were significantly increased compared with the proportions in pregnancy years 1958–1967 (10 years before the incident). Spontaneous abortion (ORadj = 2.09; 95% CI, 0.84–5.18), and pregnancy loss (ORadj = 2.11; 95% CI, 0.92–4.87) were more frequent (OR = 2.18; 95% CI, 1.02–4.66), but these were not significant (p = 0.11 and p = 0.08, respectively) in pregnancy years 1968–1977. We found no significant increases in the proportions of these adverse pregnancy outcomes in pregnancies occurring during 1978–1987 or 1988–2003 compared with those in pregnancies before 1968. Conclusion High levels of PCB/PCDF exposure had some adverse effects on pregnancy outcome in Yusho women.


Within the European Space Agency's "Commercial In Situ Resource Utilization (ISRU) Demonstration Mission Preparation Phase," we examined two types of lunar sites in preparation for an ISRU demonstration mission. First, we considered poorly characterized potential resource sites. For these so-called characterization sites, precursor missions would investigate the material properties and address strategic knowledge gaps for their use as ISRU feedstock. Regions of interest for characterization missions include the Aristarchus plateau, Montes Harbinger/Rimae Prinz, Sulpicius Gallus, and Rima Bode. Regional pyroclastic deposits at the Aristarchus plateau and adjacent Montes Harbinger/Rimae Prinz exhibit remotely sensed low-Ti, high-Fe2+ compositions. They differ from the high-Ti pyroclastics at Rima Bode and Sulpicius Gallus, which are similar to the pyroclastics northwest of the Taurus Littrow valley (Apollo 17 site). Thus, exploration of the Aristarchus plateau would allow investigation of previously uncharacterized materials, whereas Rima Bode or Sulpicius Gallus would allow comparison to Apollo 17 pyroclastics. Any of these sites would enable evaluation of reported H2O/OH in these deposits. Second, we examined a possible site for a direct ISRU demonstrator mission. For a stand-alone end-to-end (E2E) ISRU demonstrator, a fuller understanding of the physical and compositional characteristics of potential feedstock is required for mission risk reduction. In this case, locations near preexisting sites would allow extrapolation of ground truth to nearby deposits. Because a Ti-rich pyroclastic deposit appears advantageous from beneficiation and compositional perspectives, we examine an example E2E demo site northwest of the Taurus Littrow valley. Hydrogen and methane reduction, as well as the Fray–Farthing–Chen Cambridge process, could be tested there.


Large volumes of interaction logs can be collected from NLP systems that are deployed in the real world. How can this wealth of information be leveraged? Using such interaction logs in an offline reinforcement learning (RL) setting is a promising approach. However, due to the nature of NLP tasks and the constraints of production systems, a series of challenges arise. We present a concise overview of these challenges and discuss possible solutions.


This report addresses two different research problems: (i) It presents a wireless channel model that reduces the complexity associated with high order Markov chains; and (ii) presents energy efficient topology control protocols which provide reliability while maintaining the topology in an energy efficient manner. For the above problems, real wireless sensor network traces were collected and extensive simulations were performed for evaluating the proposed protocols.

Accurate simulation and analysis of wireless networks are inherently dependent on accurate models which are able to provide real-time channel characterization. High-order Markov chains are typically used to model errors and losses over wireless channels. However, complexity (i.e., the number of states) of a high-order Markov model increases exponentially with the memory-length of the underlying channel.

In this report, a novel graph-theoretic methodology that uses Hamiltonian circuits to reduce the complexity of a high-order Markov model to a desired state budget is presented. The implication of unused states in complexity reduction of higher order Markov model is also explained. The trace-driven performance evaluations for real wireless local area network (WLAN) and wireless sensor network (WSN) channels demonstrate that the proposed Hamiltonian Model, while providing orders of magnitude reduction in complexity, renders an accuracy that is comparable to the Markov model and better than the existing reduced state models.

Furthermore, a methodology to preserve energy is presented to increase the network lifetime by reducing the node degree forming an active backbone while considering network connectivity. However, in energy stringent wireless sensor networks, it is of utmost importance to construct the reduced topology with the minimal control overhead. Moreover, most wireless links in practice are lossy links with connectivity probability which desires that a routing protocol provides routing flexibility and reliability at a minimum energy consumption cost. For this purpose, distributed and semi-distributed novel graph-theoretic topology construction protocols are presented that exploit cliques and polygons in a WSN to achieve energy efficiency and reliability. The proposed protocols also facilitate load rotation under topology maintenance, thereby extending the network lifetime. In addition to the above, the report also evaluates why the backbone construction using connected dominating set (CDS) in certain cases remains unable to provide connected sensing coverage in the area covered. For this purpose, a novel protocol that reduces the topology while considering sensing area coverage is presented.


Background: There is a strong association between gout and obesity. Lowering urate is the cornerstone of gout management [1] and urate levels correlate strongly with central obesity. Previous studies suggest that weight loss has a positive effect on serum urate, however, the studies are sparse and small [2]. Objectives: To assess the impact of an initial low-calorie diet-induced weight loss and subsequent randomisation to the body weight-lowering drug liraglutide (a glucagon-like peptide 1 receptor agonist) or placebo on serum urate levels. Methods: In the LOSE-IT trial (NCT02905864), a randomised, double-blinded, placebo-controlled, parallel group, single-centre trial [3], 156 obese individuals with knee osteoarthritis, but without gout, were offered an initial 8-week intensive diet intervention (week -8 to 0) on Cambridge Weight Plan (800-1000 kcal/day) followed by a weight loss maintenance period in which participants were randomised to either liraglutide 3 mg/day or placebo for 52 weeks. We conducted a secondary analysis of blood samples collected at week -8, 0 and 52. The primary outcome measure was change in serum urate. We used paired t-test for the change from week -8 to 0, and for change from week 0 to 52 we used an ANCOVA model adjusted for stratification factors (sex, age category and obesity class), and the level of the outcome at baseline. Data were analysed as observed (i.e. no imputation of missing data). Results: 156 individuals were randomised and 155 had blood samples taken at baseline. In the initial intensive diet intervention period (week -8 to 0) they lost a mean of 12.5 kg (95% CI -13.1 to -11.9, n 156). In the following 52 weeks, the liraglutide group lost an additional 4.1 kg (SE 1.2, n 71) whereas the control group was almost unchanged with a weight loss of 0.2 kg (SE 1.2, n 66). Looking at the main outcome of serum urate levels change, the initial intensive diet resulted in a mean decrease of 0.21 mg/dL (95% CI 0.35 to 0.07, n 155) for the entire cohort. In the following year (week 0 to 52) the liraglutide group exhibited a further mean decrease in serum urate of 0.48 mg/dL (SE 0.11, n 69), whereas the placebo group exhibited a slight decrease in mean serum urate of 0.07 mg/dL (SE 0.12, n 65) resulting in a significant between-group difference of -0.40 mg/dL (95% CI -0.69 to -0.12, n 134) – see Figure 1. Four participants in each group experienced serious adverse events; no deaths were observed. Conclusion: This secondary analysis of the LOSE-IT trial suggests that liraglutide provides a potential novel serum urate lowering drug mechanism in obese patient populations, with potential implication for gout treatment. References: [1]Richette P et al. 2016. Ann Rheum Dis 2017;76:29–42. [2]Nielsen SM et al. Ann Rheum Dis 2017 76(11):1870-1882. [3]Gudbergsen H et al. BMJ 2019. 71–2. Disclosure of Interests: Kristian Zobbe: None declared, Sabrina Mai Nielsen: None declared, Robin Christensen: None declared, Anders Overgaard: None declared, henrik gudbergsen Speakers bureau: Pfizer 2016, Marius Henriksen: None declared, Henning Bliddal Grant/research support from: received research grant fra NOVO Nordic, Consultant of: consultant fee fra NOVO Nordic, Lene Dreyer: None declared, Lisa Stamp: None declared, Filip Krag Knop Shareholder of: Minority shareholder in Antag Therapeutics Aps, Grant/research support from: AstraZeneca, Gubra, Novo Nordisk, Sanofi and Zealand Pharma, Consultant of: Amgen, AstraZeneca, Boehringer Ingelheim, Carmot Therapeutics, Eli Lilly, MSD/Merck, Mundipharma, Novo Nordisk, Sanofi and Zealand Pharma., Speakers bureau: AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, MedImmune, MSD/Merck, Mundipharma, Norgine, Novo Nordisk, Sanofi and Zealand Pharma., Lars Erik Kristensen Consultant of: UCB Pharma (Advisory Board), Sannofi (Advisory Board), Abbvie (Advisory Board), Biogen (Advisory Board), Speakers bureau: AbbVie, Amgen, Biogen, Bristol-Myers Squibb, Celgene, Eli Lilly, Gilead, Forward Pharma, Janssen Pharmaceuticals, MSD, Novartis, Pfizer, and UCB Pharma


National grain reserve is important in terms of responding to disasters and the unbalance between supply and demand in many countries. In China, the government supplements grain supply through online auctions. This study focuses on the auction policy of national grain reserve. We develop an agent-based simulation model of China's wheat market with detail descriptions of different agents, including national grain reserve, grain trading enterprises and grain processing enterprises. Based on this model, the Optimal Computing Budget Allocation (OCBA) simulation optimization method is adopted to analyze the characteristics of optimal decision variables under different scenarios, with an objective to minimize the fluctuation of wheat price. We obtain some insights about operations of national grain reserve. As the first agent-based simulation model about national grain reserve and grain market, this model can be widely used in agricultural economics, and can provide policy supports to the government.


A number of United States cities have applied, or plan to study, automatic computer control technology to urban stormwater management. Several control strategies are compared, from simple set point or reactive control, to stochastic optimal control with full storm forecasting carried out adaptively in real-time. A simulated real-time experiment was conducted which generated storm inflow forecast errors that document the sensitivity of control strategy performance to forecast error. The qualified conclusions of this study are that strategies using limited lead-time forecasts are safer in that they guard against untreated overflows occurring. If the size of the storm indicates that overflows cannot be avoided, then more complete forecasting and sophisticated stochastic control is needed to manage the time and space distribution overflows, overflows so as to minimize adverse impacts on the receiving waters. /Author/


The aim of the present study was to examine the effects of hypothalamo-pituitary-adrenal (HPA) axis reactivity on intelligence test performance in subjects with attention-deficit/hyperactivity disorder (ADHD). We investigated the extent to which an increase or decrease in cortisol after stress was associated with the intelligence test performance in 68 clinic-referred children with ADHD. The mean age of the participants was 8.8 years; 54 of the 68 participants were boys and 14 were girls. ADHD was diagnosed using the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL). Psychological tests, including the Wechsler Intelligence Scale for Children-III and the ADHD diagnostic system (ADS), were administered as a stressor. A saliva sample was collected from each subject before and after psychological testing in order to measure the level of cortisol in the saliva. The cortisol level was measured using a solid-phase radioimmunoassay. Fifty-one of the 68 subjects showed no increase in the level of cortisol after the test. Decreases in the level of cortisol after the test were correlated with poor intelligence performance and the decrease of cortisol in respect to baseline significantly affected the verbal, performance and total IQ (effect sizes, 7.4-9.5%) in subjects who showed blunted responses to stress.


Repairing defects in antitumor immunity has been a longstanding challenge in prostate cancer, and in recent years cellular immunotherapy has emerged as a promising approach for controlling advanced disease. To date, therapies including tumor vaccine and adoptive T-cell immunotherapy have made remarkable headway in solid cancers. Several validated prostate-specific tumor antigens are available as targets for T-cell therapy, including prostate stem cell antigen (PSCA), which is overexpressed in metastatic disease. We are in late-stage preclinical development of PSCA-specific chimeric antigen receptor (CAR)-engineered T cells with plans to initiate a clinical trial early 2019 for the treatment of metastatic castration-resistant prostate cancer. Immune checkpoint pathways, including the programmed cell death protein-1 (PD-1) and the cytotoxic T lymphocyte-associated protein-4 (CTLA4), have emerged as critical drivers of immunosuppression in solid cancers, by limiting both adaptive antitumor immunity as well as adoptive T-cell therapies. Unfortunately in prostate cancer, checkpoint inhibition has led to underwhelming responses, likely due to the low mutational load and immunologically "cold" tumor microenvironment. We hypothesize that antitumor activity of PSCA-CAR T cells will elicit checkpoint pathways that dampen antitumor immune responses and reduce overall clinical outcomes. Herein, we utilize an shRNA approach to knockdown checkpoint receptors as a rational combinatorial strategy that targets checkpoint pathways to improve overall therapy with PSCA-CAR T cells for metastatic prostate cancer. We have successfully developed a multiple shRNA knockdown approach to simultaneously disrupt 3 pathways that may hamper CAR T-cell activity in the tumor. These CAR T cells with shRNA knockdown of checkpoint receptors will be directly compared with checkpoint pathway inhibitor antibody therapies in xenograft models of prostate cancer, with the hope that next generation CARs will resist this break on the immune system in solid tumors.


The researcher employed the framework of Garrison, Anderson, and Archer (2001) to report the ability of college students to think critically, as displayed in a blended learning strategy that combines discussion in a setting face-to-face with communication through computers, and to explore the impact of class discussion on the outcomes of perceived cognitive and social learning. Twenty-six students, with an intermediate level of English proficiency, participated in this eight-week study. Transcripts of messages among students in the discussion board were analyzed and a questionnaire was administrated at the end of the course to ask students about how they perceived the effect of online discussions on their learning and class interaction. The results show that the distribution of messages into cognitive presence categories is similar to that found previously: most messages belonged to the explorative category with a few integration messages, and few triggering events containing no solution messages. Students engaged in interaction and critical thinking, and demonstrated more profound thinking during discussion inside their class than outside. With regard to perceived learning outcomes of students resulting from blended learning, most students agreed that significant cognitive benefits can be gained from discussions via a computer. Learning outcomes of both social and cognitive nature included sharing views and understanding various perspectives. Students reported that they had more opportunities to work together in a learning community.


Recent developments in next generation disc technology, cameras in mobile phones, zoom-lenses for small digital cameras and camcorders, digital SLRs, and television cameras have amplified the demand for affordable optical systems with outstanding image quality, a combination that can only be achieved using aspheric surfaces. The metrology of aspheric surfaces is a classical problem, but solutions so far have not fulfilled all demands for system cost, TACT (Total Average Cycle Time), minimized tooling, measurement uncertainty, spatial resolution, robustness in a production environment and many more. Zygo Corp. presents here a new method [1,2] for measurement of rotationally symmetrical aspheric surfaces using a new commercial system, which has the potential to fulfill these industry requirements. During measurement, the surface is scanned along its symmetry axis in a Fizeau cavity with a spherical reference surface. The coordinates x,y,z at the (moving) zone of normal incidence are derived from simultaneous phase-measurements at the apex and zone. Phase-shifting Fizeau interferometry and displacement interferometry are combined in the new commercial system to realize this new method. Aspheric departure from a best-fitsphere approaching 800 microns can be measured, and absolute measurement is possible with an absolutely calibrated transmission sphere. A custom parabolic artifact is measured with conventional null Fizeau interferometry and by the new commercial system. Data is reported for each technique along with a difference map achieved by fiducialized data subtract where 32.0 nm peak-to-valley (PV) and 3.6 nm R.M.S. are achieved.


Background:  Popular lay media claim that the aetiology of leukonychia (white spots) on finger nails is due to calcium and/or zinc (McKeith, 2008; Holford, 1998) deficiency. No studies are available in scientific literature to support or refute these claims. Cited causes in dermatology journals include, trophic disturbances, gender, hand dominance, nail trauma and orange stick usage (Mitchell, 1953) although this is dated. This small scale study aimed to establish if there is a correlation between calcium and/or zinc intakes and the presence or absence of leukonychia on finger nails.

Methods:  A cross sectional survey was completed by 82 university undergraduate students. The study was approved by the University ethics panel. A convenience sample was taken from students enrolled on courses within the School of Health Science. A self administered questionnaire collected data on the number of leukonychia present on participant's finger nails, participant's opinions on leukonychia's aetiology, calcium and zinc intakes, age, gender, handedness, supplement usage, activities and orange stick usage. A food frequency questionnaire, adapted from the tool used in the European Prospective Investigation into Cancer (EPIC) (Day et al., 2001), was developed to allot participants calcium and zinc intake scores. Data was coded and analysed using the Statistical Package for Social Sciences (SPSS) version 17. Spearmans Correlation was used to assess the relationship between calcium and zinc intake scores and the number of leukonychia present.

Results:  The majority of participants thought that leukonychia was a result of a singular or multiple nutrient deficiency (51%), mainly either calcium or zinc. Leukonychia was present in 46% of the sample. It was not significantly associated with calcium intake (P = 0.681), zinc intake (P = 0.604), age (P = 0.715), gender (P = 0.089), hand dominance (P = 0.151), multivitamin/mineral usage (n = 62, P = 0.655) or orange stick usage (n = 12, P = 0.961). The majority (63%) of participants reported to take part in activities that knock their hands frequently. A correlation was found between activities that knock participants hands frequently and the number of leukonychia present on finger nails (P = 0.000, t = −4.902, df = 77).

Discussion:  The results showed there was no correlation between calcium or zinc intake scores and leukonychia. Participant's intakes scores followed similar patterns to the actual intakes observed in a survey of the UK general population (Henderson et al., 2003). For both nutrients male intake score where higher than females and intake scores for calcium increased with age. However a limitation of this study is that nutrient intake was estimated using a non-validated tool which provided an arbitrary intake score that could not be quantitatively compared to the National Diet and Nutrition Surveys (Henderson et al., 2003) data. Another limitation was that the number of leukonychia was also gathered using a non-validated tool and all results were self-reported.

Conclusion:  This study suggested that there is no correlation between the presences of leukonychia and calcium or zinc intake scores. Although it would be beneficial if this study was repeated using more robust measures of calcium and zinc intake and leukonychia, and within a larger population known to have low calcium and zinc intakes.

References:  Day, N., McKeown, N., Wong, M., Welch, A. & Bingham, S. (2001) Epidemiology assessment of diet: a comparison of a 7-day diary with a food frequency questionnaire using urinary markers of nitrogen, potassium and sodium. Int. J. Epidemiol. 30, 309–317.

Henderson, L., Irving, K., Gregory, J., Bates, C.J., Prentice, A., Perks, J., Swan, G. & Farron, M. (2003) National Diet and Nutrition Survey: Adults aged 19–64 years. Vol 3:Vitamin and mineral intake and urinary analytes. London: TSO.

Holford, P. (1998) The Optimum Nutrition Bible: The Book You Have to Read if You Care About Your Health. London: Piatkus Books.

McKeith, G. (2008) Food Bible: The Complete A-Z Guide to a Healthy Life. London: Michael Joseph.

Mitchell, J.C. (1953) A clinical study of leukonychia. Br. J. Dermatol. 65, 121–130.


Building benchmarks to systemically analyze different capabilities of video question answering (VideoQA) models is challenging yet crucial. Existing benchmarks often use non-compositional simple questions and suffer from language biases, making it difficult to diagnose model weaknesses incisively. A recent benchmark AGQA [8] poses a promising paradigm to generate QA pairs automatically from pre-annotated scene graphs, enabling it to measure diverse reasoning abilities with granular control. However, its questions have limitations in reasoning about the fine-grained semantics in videos as such information is absent in its scene graphs. To this end, we present ANetQA, a large-scale benchmark that supports fine-grained compositional reasoning over the challenging untrimmed videos from ActivityNet [4]. Similar to AGQA, the QA pairs in ANetQA are automatically generated from annotated video scene graphs. The fine-grained properties of ANetQA are reflected in the following: (i) untrimmed videos with fine-grained semantics; (ii) spatio-temporal scene graphs with fine-grained taxonomies; and (iii) diverse questions generated from fine-grained templates. ANetQA attains 1.4 billion unbalanced and 13.4 million balanced QA pairs, which is an order of magnitude larger than AGQA with a similar number of videos. Comprehensive experiments are performed for state-of-the-art methods. The best model achieves 44.5% accuracy while human performance tops out at 84.5%, leaving sufficient room for improvement.


Major histocompatibility complex (MHC) class In molecules play a vital role in the regulation of T-cell functions in the mammalian immune system. Two key features characterize the polymorphism of MHC haplotypes in humans and non-human primates: the existence of a large number of alleles, and the high degree of genetic diversity between those alleles. Rhesus monkeys and Chimpanzees have been extensively used as relevant models for human diseases and transplantation We have investigated DRB genes in 19 macaques, members of 3 families, using polymerase chain reaction with sequence-specific primers (PCR-SSP) and denaturing gradient gel electrophoresis (DGGE). After amplification PCR products were purified and subjected direct sequencing. Seven animals (Madison #1) were typed by DDGE also. We report that the DRB haplotypes defined by PCR-SSP exhibit a high degree of concordance with the data obtained by DGGE and direct sequening. Our data show prominent variability in the number of DRB1 alleles ranging from 1-4 per genotype within these families. This analysis demonstrated that most of the amplicons were identical to Mamu-DRB alleles that our PCR primers were to amplify. However, 98-99% similarity was noticed in the case of Mamu-DRB1*0303, Mamu-DRB6*0103 and Mamu-DRB*W201 alleles. The observed mismatches were located in non-polymorphic regions. Thus, family studies in rhesus macaques performed by molecular methods confirmed the multiplicity of Mamu-DRB1 alleles per haplotype and the existence of allelic associations published earlier. In addition, we propose 3 more DRB allele associations (haplotypes): Mamu-DRB1*04-DRB5*03; Mamu-DRB1*04-*DRB*W5; Mamu-DRB1*04*W2. The proposed medium-resolution PCR-SSP technique appears to be a highly reproducible and discriminatory typing method for detecting polymorphisms of DRB genes in rhesus monkeys.


What do children know about communication? In the increasingly globalized world we live in, nowadays children more often come into contact with multiple languages at different ages and in variable contexts. Consequently, children may at times be required to communicate in situations in which they lack sufficient understanding of the language used. These situations of communication are characterized by an uneven proficiency of the language used and can lead to breakdowns in communication if there is not a sufficient willingness to bring forth the exchange and make use of communication strategies. Knowing about communication, that is, being aware of the interaction, of the potential obstacles and of different strategies to overcome them, is essential to bring exolingual situations of communication to a successful end. Understanding how children perceive, control and handle exolingual situations of communication is essential in order to help teachers and children cope with these situations and more specifically, in order to help all bilingual children have access to the school's knowledge. This thesis was carried out to explore the extent to which the learning of an additional language at an age when the child can be conscious of this learning process may influence the course of exolingual interpersonal communication. Children's perceptions and treatment of exolingual situations of communication are measured through the identification of the children's willingness to communicate and of their strategy use. Reactions of children who learned a new language at an age and in a context in which they were able to be conscious about and reflect upon their learning (abbreviated LLE, i.e. Language Learning Experience) are compared to those of children who learned a new language in a less conscious way, from birth onwards (abbreviated, nLLE, i.e. without a Language Learning Experience). In each chapter a different approach is adopted to evaluate the child's metacognitive awareness, assessing different outcome measures and using different exolingual situation test paradigms. The perspectives range from a focus on the perception that children have of this particular communicative scenario to an analysis of their capacity to consider the outcome of the exchange. LLE children outperformed the nLLE children on these various measures of metacognitive awareness, thus suggesting that children may benefit from a Language Learning Experience regardless of whether they are already bilingual or not. The learning of a new language at an age that children may be conscious of the learning process helps to improve their metacognitive awareness and may enhance their confidence in exolingual situations of communication


. Regressions trained to predict the future activity of social media users need rich features for accurate predictions. Many advanced models exist to generate such features; however, the time complexities of their computations is often prohibitive when they run on enormous data-sets. Some studies have shown that simple semantic network features can be rich enough to use for regressions without requiring complex computations. We propose a method for using semantic networks as user-level features for machine learning tasks. We conducted an experiment using a semantic network of 1037 Twitter hashtags from a corpus of 3.7 million tweets related to the 2022 French presidential election. A bipartite graph is formed where hashtags are nodes and weighted edges connect the hashtags reflecting the number of Twitter users that interacted with both hashtags. The graph is then transformed into a maximum-spanning tree with the most popular hashtag as its root node to construct a hierarchy amongst the hashtags. We then provide a vector feature for each user based on this tree. To validate the usefulness of our semantic feature we performed a regression experiment to predict the response rate of each user with six emotions like anger, enjoyment, or disgust. Our semantic feature performs well with the regression with most emotions having R 2 above 0.5. These results suggest that our semantic feature could be considered for use in further experiments predicting social media response on big data-sets.


The chemical composition and degradation of dissolved amino acids and glucose by bacteria were investigated in the northern Sargasso Sea. Multiple pools of amino acids were discerned based on microbial reactivity. Concentrations of dissolved free amino acid (DFAA) were highest in the surface waters, where rapid utilization of DFAA accounted for <20% of the measured bacterial growth requirements for C and N. Dissolved combined amino acid (DCAA) and protein (using the BCA assay) concentrations were 10to 25-fold higher than that of DFAA. In surface waters, DCAA was largely identifiable as protein (-loo%), but most of the DCAA at depth (2100 m) did not respond to the protein assay (<50%). In surface waters, protein was the dominant form of organic nitrogen used to support bacterial growth, supporting 20 to 65% of the calculated bacterial N demand. In deeper waters, utilization of a modified form of protein (glucosylated protein) accounted for the highest portion of the bacterial growth demands. Free and combined amino acids did not meet the full bacterial N demand at depth, and other, unrneasured nitrogen sources were required. Similar to trends in utilization, maximum uptake rate (V,,) for protein was highest in surfaces waters. Modified protein had higher V,,,,, in deep waters, consistent with the longer turnover time of this pool of DCAA and the likelihood that it is produced in the surface and transported to depth each winter during mixing events.


Despite advances in treatment, multiple myeloma (MM) remains incurable. Here we propose the use of STK405759, a novel microtubule targeting agent (MTA) and member of the furan metotica family for MM therapy. STK405759 inhibited tubulin polymerization in a cell-free system and in myeloma cells. This molecule had potent cytotoxic activity against several MM cell lines and patient-derived MM cells. Moreover, STK405759 demonstrated cytotoxicity against drug-resistant myeloma cells that overexpressed the P-glycoprotein drug-efflux pump. STK405759 was not cytotoxic to peripheral blood mononuclear cells, including activated B and T lymphocytes. This compound caused mitotic arrest and apoptosis of myeloma cells characterized by cleavage of poly (ADP-ribose) polymerase-1 and caspase-8, as well as decreased protein expression of mcl-1. The combination of STK405759 with bortezomib, lenalidomide or dexamethasone had synergistic cytotoxic activity. In in vivo studies, STK405759-treated mice had significantly decreased MM tumor burden and prolonged survival compared to vehicle treated- mice. These results provide a rationale for further evaluation of STK405759 as monotherapy or part of combination therapy for treating patients with MM.


Abstract In this article, a method for identification of equivalent stiffness was proposed based on a genetic algorithm by studying the stiffness characteristics of autoeliminating clearance auxiliary bearing devices (ACABDs) in static condition. Subsequently, the equivalent stiffness damping model and the Hertz contact theory were combined to establish the theoretical equations of the ACABD. Moreover, the linear equivalent model of the ACABD was established to eliminate the influence of contact of the revolute pair on mode shape and mode frequency of the rotor. In addition, simulations and experiments were carried out to verify the effectiveness of the genetic algorithm–based stiffness identification method. The results indicated that the relative errors between the equivalent stiffness in the X and Y directions identified by the linear equivalent model and the theoretical values were 6.22 and 7.19% respectively, demonstrating the feasibility of this identification method.


The area of parallel and distributed computing has grown very fast in the past few decades with the aim of offering vast computational capabilities that applications can tap into. Applications from the various areas of science and engineering can perform large-scale, high-accuracy computations and simulations with the advent of new machines and architectures. Run-time libraries, operating systems software, performance analysis tools, support for compilers and data base systems are aimed at increasing the productivity and usability of these machines in the hands of applications programmers. Efficient application design and performance analysis and the fine tuning of applications have become an absolute necessity.
In this thesis we focus on applications that are highly data intensive and require large amounts of storage and extensive data processing capabilities. As the I/O devices have very high latencies, such applications use many useful processor cycles waiting for disk accesses to complete. This problem is exacerbated in parallel machines since there are many processors with the result that there are multiple high-volume requests to the I/O subsystem, making I/O a troublesome bottleneck. Because of this problem parallel machines require both systems support and the fine tuning of application to achieve efficient implementations.
We optimize the I/O activity of some large production applications as well as some small scientific applications and synthetic workloads, and we evaluate and analyze the performance of optimizations on these applications using I/O performance tools. Some of the applications that we study spend around 60% of their execution time performing I/O operations. Optimizations such as prefetching, caching/buffering, collective I/O influence the I/O performance of these applications. In addition, systems attributes such as the number of processors and I/O nodes, the stripe unit and the stripe factor affect the performance. We study the relative impact of all the different factors on the application performance and the best-fitting optimizations based on the nature of the applications.


Minimal perfect hash functions have been shown to be useful to compress data in several data management tasks. In particular, order-preserving minimal perfect hash functions [12] have been used to retrieve the position of a key in a given list of keys: however, the ability to preserve any given order leads to an unavoidable Ω(n log n) lower bound on the number of bits required to store the function. Recently, it was observed [1] that very frequently the keys to be hashed are sorted in their intrinsic (i.e., lexicographical) order. This is typically the case of dictionaries of search engines, list of URLs of web graphs, etc. We refer to this restricted version of the problem as monotone minimal perfect hashing. We analyse experimentally the data structures proposed in [1], and along our way we propose some new methods that, albeit asymptotically equivalent or worse, perform very well in practise, and provide a balance between access speed, ease of construction, and space usage.


Salmonella enterica serovar Typhimurium (STM) is a major cause of food-borne gastroenteritis. Recent outbreaks of infections by STM are often associated with non-animal related food, i.e. vegetables, fruits, herbs, sprouts and nuts. One main problem related to consumption of fresh produce is the minimal processing, especially for leafy salads such as corn salad, rocket salad, or lettuce. In this study, we focused on lettuce (Lactuca sativa) which is contaminated by STM at higher rates compared to corn salad, resulting in prolonged persistence. We previously described the contribution of Saf fimbriae, type 1 secretion system (T1SS)-secreted BapA, intact LPS, and flagella-mediated motility to adhesion to corn salad leaves. We systematically analyzed factors contributing to adhesion of STM to lettuce leaves. We used the previously established reductionist, synthetic approach to identify factors that contribute to the surface binding of STM to leaves of lettuce by expressing all known adhesive structure by the Tet-on system. The analyses revealed contributions of Lpf fimbriae, Sti fimbriae, autotransported adhesin MisL, T1SS-secreted BapA, intact LPS, and flagella-mediated motility to adhesion of STM to lettuce leaves. In addition, we identified BapA is a potential adhesin involved in binding to corn salad and lettuce leaf surfaces. Importance Gastrointestinal pathogens can be transmitted by animal products, as well as by fresh produce of non-animal origin. The numbers of outbreaks by fresh produce contaminated with gastrointestinal pathogens are increasing, and underline the relevance to human health. The mechanisms involved in the colonization of, persistence on, and transmission by fresh produce are poorly understood and have to be part of further research. Here, we investigated the contribution of adhesive factors of STM in the initial phase of plant colonization, i.e. the binding to the plant surface. Usage of a reductionist, synthetic approach including the controlled surface expression of specific adhesive structures of STM, one at a time, allowed the determination of relevant fimbrial and non-fimbrial adhesins, the O-antigen of lipopolysaccharide, the flagella, and chemotaxis to binding to lettuce leaves.


Reaction of the diphosphanylamine 2,6-{(Ph2P)(2)N)(2)C5H3N with four equivalents of Au(tht)Cl (tht = tetrahydrothiophene) affords the tetragold complex 2,6{(ClAuPh2P)(2)N)(2)C5H3N in high yield. Decomposition of the tetragold compound results in the formation of the digold complex 2,6-{(ClAuPh2P)HN}(2)C5H3N and colloidal gold. A trigold intermediate, which contains a Au-Au interaction [2.9886(5) Angstrom] has been isolated, and while ultimately unstable, it is thought to be partially stabilised by virtue of the aurophilic nature of gold. ((C) Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2004).


We investigated the optical properties of stacking faults (SFs) in cubic silicon carbide by photoluminescence (PL) spectroscopy and mapping. The room-temperature PL spectra consisted of a 2.3 eV peak due to nitrogen and two undefined broad peaks at 1.7 eV and 0.95 eV. On the PL intensity mapping for the 2.3 eV peak, SFs appeared as dark lines. SFs which expose carbon atoms (SFC) and silicon atoms (SFSi) on the surface appeared as bright lines and dark lines, respectively, in PL mapping for the 1.7 eV and 0.95 eV peaks. We believe the two undefined peaks are associated with SFC. This technique allows us to detect SFs nondestructively and to distinguish between SFC and SFSi. We further suggest the presence of inhomogeneous stress around SFCs based on the broadening of the 2.3 eV peak.


In this work, T-shaped mould design was used to generate hot spot and the effect of Sr and B on the hot tearing susceptibility of A356 was investigated. The die temperature was kept at 250 o C and the pouring was carried out at 740 o C. The amonut of Sr and B additions were 30 and 10 ppm, respectively. One of the most important defects that may exist in cast aluminium is the presence of bifilms. Bifilms can form by the surface turbulence of liquid metal. During such an action, two unbonded surfaces of oxides fold over each other which act as a crack. Therefore, this defect cause many problems in the cast part. In this work, it was found that bifilms have significant effect over the hot tearing of A356 alloy. When the alloy solidifies directionally, the structure consists of elongated dendritic structure. In the absence of equiaxed dendrites, the growing tips of the dendrites pushed the bifilms to open up and unravel. Thus, leading to enlarged surface of oxide to become more harmful. In this case, it was found that these bifilms initiate hot tearing.


IMPORTANCE
Chronic tinnitus negatively affects the quality of life for millions of people. This clinical trial assesses a potential treatment for tinnitus.

OBJECTIVES
To determine if repetitive transcranial magnetic stimulation (rTMS) can reduce the perception or severity of tinnitus and to test the hypothesis that rTMS will result in a statistically significantly greater percentage of responders to treatment in an active rTMS group compared with a placebo rTMS group.

DESIGN, SETTING, AND PARTICIPANTS
A randomized, participant and clinician or observer-blinded, placebo-controlled clinical trial of rTMS involving individuals who experience chronic tinnitus. Follow-up assessments were conducted at 1, 2, 4, 13, and 26 weeks after the last treatment session. The trial was conducted between April 2011 and December 2014 at Portland Veterans Affairs Medical Center among 348 individuals with chronic tinnitus who were initially screened for participation. Of those, 92 provided informed consent and underwent more detailed assessments. Seventy individuals met criteria for inclusion and were randomized to receive active or placebo rTMS. Sixty-four participants (51 men and 13 women, with a mean [SD] age of 60.6 [8.9] years) were included in the data analyses. No participants withdrew because of adverse effects of rTMS.

INTERVENTIONS
Participants received 2000 pulses per session of active or placebo rTMS at a rate of 1-Hz rTMS daily on 10 consecutive workdays.

MAIN OUTCOMES AND MEASURES
The Tinnitus Functional Index (TFI) was the main study outcome. Our hypothesis was tested by comparing baseline and posttreatment TFIs for each participant and group.

RESULTS
Overall, 18 of 32 participants (56%) in the active rTMS group and 7 of 32 participants (22%) in the placebo rTMS group were responders to rTMS treatment. The difference in the percentage of responders to treatment in each group was statistically significant (χ(1)(2) = 7.94, P < .005).

CONCLUSIONS AND RELEVANCE
Application of 1-Hz rTMS daily for 10 consecutive workdays resulted in a statistically significantly greater percentage of responders to treatment in the active rTMS group compared with the placebo rTMS group. Improvements in tinnitus severity experienced by responders were sustained during the 26-week follow-up period. Before this procedure can be implemented clinically, larger studies should be conducted to refine treatment protocols.

TRIAL REGISTRATION
clinicaltrials.gov Identifier: NCT01104207.


Dexamethasone (Dex) is widely used to treat chronic inflammatory diseases in the clinic. Increasingly, there is more attention being paid to the side effect of Dex. In this study, we investigated the involvement and mechanism of Dex exposure in accelerating mineralization during long bone formation. We first determined that Dex exposure could accelerate long bone mineralization in vivo, but there was no apparent difference between control and Dex-treated in the phalanges model in vitro. Next, we established that Dex exposure promoted angiogenesis in the chick yolk sac membrane model. In addition, it increased human umbilical vein endothelial cell proliferation and migration in culture. We found that Dex could enhance angiogenesis when phalanges were cultured on chick chorioallantoic membrane and correspondingly increased the expression of angiogenesis-related genes in the phalanges. Furthermore, we also revealed that Dex exposure reduced the number of osteoblasts and simultaneously increased the number of osteocytes in ex vivo-cultured phalanges. Runx-2 and Col10α1 expressions were up-regulated by Dex exposure, indicating that Dex exposure accelerated the terminal differentiation of osteoblasts. Lastly, we demonstrated that MC3T3-E1 cells cultured in the presence of Dex accelerated their mineralization. In summary, we have shown that the ability of Dex to initiate angiogenesis is the mechanism that allows it to accelerate mineralization during long bone formation.


Over the last decades, argumentation has become increasingly central as a frontier research within artificial intelligence (AI), especially around the notions of interpretability and explainability, which are more and more required within AI applications. In this paper we present the first prototype of Arg-tuProlog, a logic-based argumentation tool built on top of the tuProlog system. In particular, Arg-tuProlog enables defeasible reasoning and argumentation, and deals with priorities over rules. It also includes a formal method for dealing with burden of proof (burden of persuasion). Being lightweight and compliant to the requirements for micro-intelligence, Arg-tuProlog is perfectly suited for injecting argumentation into distributed pervasive systems.


Many surgeons will already be familiar with the Companion to Specialist Surgical Practice series of books and the publishing of the third edition this year is a welcome revision of this popular and useful resource. The Oesophagogastric Surgery book at last has its correct title (changed from Upper Gastrointestinal Surgery in the previous two editions) and is aimed at surgeons in higher training and practising consultants in keeping with the overall aim of the series. The editors have added to the existing list of contributors, the majority of whom are established experts in the current management of oesophageal and gastric conditions to provide up-to-date evidence-based information on both benign and malignant disease.

There are three completely new chapters in this third edition that cover the management of early oesophagogastric cancers, gastrointestinal stromal tumours and motility disorders. Comprehensive literature reviews on the first two topics provide an excellent summary of current management including areas of controversy and uncertainty, and highlight these two areas of increasing interest. The difficult and often marginalised subject of motility disorders is approached clearly with very practical suggestions albeit in the shortest chapter of the book; though some of the detail regarding definitive procedures (present in other chapters) is lacking.

The other 15 chapters have been revised and rewritten in varying degrees to ensure their subject matter is as up-to-date and relevant as possible. Some topics, such as the treatment of complications of previous upper GI surgery, have changed little since the second edition was published in 2001 and this chapter has received only cosmetic alterations. In other areas, such as radiotherapy and chemotherapy in treatment of oesophageal and gastric cancer and the surgical management of morbid obesity, there have been important advances that are incorporated into the new text to represent current practice.

All of the chapters are easy to read and address their subject matter comprehensively. In addition, the new style of double-column pages, clearer headings and subheadings, and generally smarter tables is more user-friendly than before. The addition of a 'Key Points' summary at the end of each chapter is excellent, and provides a good summary. The Companion series stresses the importance of evidence-based practice and this book uses extensive referencing throughout to support points that are discussed. Important references are highlighted in the main text with a 'scalpel code' which is very helpful for those interested in key papers and the long list of references at the end of each chapter will provide a useful resource for those looking for even more reading. Some of the black-and-white photographs have been reproduced in colour in the middle of the book but these are not clearly indexed to the original text and it is a shame that more colour could not have been used throughout.

A new feature for the Companion series is the link to an e-learning website designed for trainees to perform self-assessment. The site is easy to access, free of charge and provides basic and advanced levels of assessment in an intuitive format. At the time of review there were only the oesophagogastric assessments available but these appeared useful and I suspect will see heavy use immediately prior to examinations.

I like the Companion series of books, and this particular book achieves its aims in an excellent fashion. General surgical trainees will find more than they need to know about oesophagogastric surgery here, while oesophagogastric trainees and consultant surgeons can rely on it as a good knowledge base. By bridging the gap between more basic general textbooks and large 'reference' texts, this book has a niche and by regular updates it remains relevant. I would recommend it to all who have an interest in the specialty.


Aeromonas and Pseudomonas diseases are responsible for mortalities of some farmed catfish in Nigeria. The objective of the study is to investigate the efficacies of extracts of some plants against Aeromonas and Pseudomonas diseases of Heterobranchus longifilis . Ethanol extracts of Phyllanthus amarus, Allium sativum, Artemisia annua, Citrus limon , Moringa oleifera , Allium cepa and Azadirachta indica were tested against Aeromonas hydrophila and Pseudomonas flourescens of H. longifilis by disc diffusion assay. Extracts of P. amarus, A. sativum, A. annua and C. limon were significantly (P<0.05) more sensitive to A. hydrophila and P. flourescens than M. oleifera , A. cepa and A. indica which were effective against P. flourescens . Minimum inhibitory concentrations (MIC) of the extracts were 25mg/ml for P. amarus and A. annua ; 25 and 100mg/ml for C. lemon and A. cepa respectively and 50mg/ml for A. indica .  Alkaloid was demonstrated in all plants except A. annua by qualitative methods. Moderate amount (++) of cardiac glycosides was demonstrated in A. sativum , M. oleifera and P. amarus . Saponin (+++) was present in M. oleifera and A. indica while, tannin (++) was present in M. oleifera , P. amarus and A. indica respectively. Phlobatanins and Anthraquinones (++) were present in P. amarus and M. oleifera respectively.  Extracts of aforementioned plants have potentials as therapy against Aeromonas hydrophila and Pseudomonas flourescens of farmed catfish.