Problem statement: Not all differential equations can be solved analytically, to overcome this problem, there is need to search for an accurate approximate solution. Approach: The objective of this study was to find an accurate approximation technique (scheme) for solving linear differential equations. By exploiting the Trigonometric identity property of the Chebyshev polynomial, we developed a numerical scheme referred to as the pseudo-pseudo-spectral method. Results: With the scheme developed, we were able to obtain approximate solution for certain linear differential equations. Conclusion: The numerical scheme developed in this study competes favorably with solutions obtained with standard and well known spectral methods. We presented numerical examples to validate our results and claim.


Background: Colorectal cancer survivors are not only at risk for recurrent disease but also at increased risk of comorbidities such as other cancers, cardiovascular disease, diabetes, hypertension and functional decline. In this trial, we aim at investigating whether a diet in accordance with the Norwegian food-based dietary guidelines and focusing at dampening inflammation and oxidative stress will improve long-term disease outcomes and survival in colorectal cancer patients. Methods/design: This paper presents the study protocol of the Norwegian Dietary Guidelines and Colorectal Cancer Survival study. Men and women aged 50–80 years diagnosed with primary invasive colorectal cancer (Stage I-III) are invited to this randomized controlled, parallel two-arm trial 2–9 months after curative surgery. The intervention group (n = 250) receives an intensive dietary intervention lasting for 12 months and a subsequent maintenance intervention for 14 years. The control group (n = 250) receives no dietary intervention other than standard clinical care. Both groups are offered equal general advice of physical activity. Patients are followed-up at 6 months and 1, 3, 5, 7, 10 and 15 years after baseline. The study center is located at the Department of Nutrition, University of Oslo, and patients are recruited from two hospitals within the South-Eastern Norway Regional Health Authority. Primary outcomes are disease-free survival and overall survival. Secondary outcomes are time to recurrence, cardiovascular disease-free survival, compliance to the dietary recommendations and the effects of the intervention on new comorbidities, intermediate biomarkers, nutrition status, physical activity, physical function and quality of life. Discussion: The current study is designed to gain a better understanding of the role of a healthy diet aimed at dampening inflammation and oxidative stress on long-term disease outcomes and survival in colorectal cancer patients. Since previous research on the role of diet for colorectal cancer survivors is limited, the study may be of great importance for this cancer population. Trial registration: ClinicalTrials.gov Identifier: NCT01570010.


Current day's pharmacovigilance have been fast evolving sector in the fields of medicine and software technologies. Present insight focuses on major trends of pharmacovigilance in various countries, its importance, use in different drug strategies, future advances. Pharmacovigilance advancing into the major factor of drug safety portions of the drug introduction into market has gained huge response. It has generated into key fields in the Pharmacy profession providing well sophisticated opportunities to Pharmacy professionals around the globe.


During a visit to the Crag district of Suffolk in July 1844, while travelling up the Orwell towards Ipswich, and at a short distance below Holywells, a celebrated Crag locality, I observed a patch of crag on the upper part of a somewhat lofty portion of the bank of the river, and went ashore to examine it. I had not long searched the mass, which consisted chiefly of broken shells, ere I found a heavy nodule, which I soon recognised as the tympanic bone of a Cetacean. It is nearly perfect, having only a portion about an inch in length broken from one end of it. Its fractured extremity exhibits the following characters:—The central portion is of the colour of ferruginous clay; there is next a band of dark ferruginous stain, and exterior to the last a layer of an ochrey colour, somewhat darker than the central portion, and which is easily chipped from the dark-coloured layer; innumerable minute indentations are visible upon its surface, more particularly upon the involuted portion. The colour of the different layers observed in my specimen is undoubtedly derived from a ferruginous infiltration; the texture is that of exceedingly dense bone,—a solidity appropriate to the function of the organ to which it belongs, and very unlike the texture of some coprolitic (?) bodies I possess from the Crag, which exhibit somewhat similar concentric bands, but a decidedly crystalline fracture, particularly in the dark-coloured bands. The long diameter of my fossil is three and a quarter


Objective: To test the expression of miR-1178 in pancreatic cancer and study its clinicopathological significance and mechanism. Methods: The expression of miR-1178 in 87 paired paraffin pancreatic ductal adenocarcinoma specimens and adjacent non- cancerous pancreatic tissue diagnosed by Pathology Department of Peking Union Medical College Hospital was detected by hybridization in situ. The relationship between the expression of miR-1178 and clinicopathological characters was analyzed.miR-1178 mimics and inhibitor were used to further detect the close relationship among miR-1178 and cancer invasion. Establish a nude mice subcutaneously transplanted tumor model, 4 weeks after vaccination for tumor volume and weight measurement.Student t-test, rank sum test, and χ(2) test was used respectively to compare the data between two groups. Cox regression was adopted to improve the single factor and multiple factors analysis. Results: The results of hybridization in situ showed the expression of miR-1178 was increased in 72 cases with pancreatic cancer compared to that in paired normal pancreatic tissues (50/72 vs. 11/72, χ(2)=43.26, P<0.05). miR-1178 expression was positively associated with tumor lymph node stage (χ(2)=4.189, P=0.041). Univariate and multivariate analysis revealed that miR-1178 was an independent adverse prognostic indicator for patients with pancreatic cancer (HR=2.364, 95%CI: 1.114-5.019, P=0.025). Transwell assay indicated the over-expression of miR-1178 increased the number of AsPC-1 cells that penetrated the ECM-coated membrane (177.0±19.8 vs. 119.7±15.9)(χ(2)=8.21, P<0.05). For the in vivo experiment, overexpression of miR-1178 significantly promoted tumor growth, compared with control group (tumor volume: (5 122.4±760.2)mm(3) vs. (1 976.8±601.8)mm(3), t=2.413, P<0.05; tumor weight: (1.55±0.21)g vs. (0.67±0.17)g, t=2.960, P<0.05). Over-expression of miR-1178 down-regulated the expression of Stub1 and elevated the expression of FAK/MMP-9 signal pathway(P<0.05). Conclusions: MiR-1178 is overexpressed in pancreatic cancer, and is effective for predicting patients' prognosis. MiR-1178 regulate Stub1/FAK/MMP-9 signal pathway and promote the invasion of AsPC-1 cells.


1. The metabolism of protein and phospholipid in rat liver plasma membranes isolated by the method of Neville [(1960) J. Biophys. Biochem. Cytol. 8, 413-422] was investigated 3 and 6 h after the injection of D-galactosamine in vivo. During this time, all the biochemical and morphological alterations associated with hepatitis developed. 2. After the injection of D-galactosamine the concentration of sphingomyelin in the plasma membrane decreased to below 60% of the control values. 3. The activity of 5'-nucleotidase (EC 184.108.40.206), which has been purified as a sphingomyelin-protein complex, decreased in the total homogenate as well as in the plasma-membrane fraction of livers of rats treated with galactosamine, to about 60% of the control values. 4. Protein synthesis, as measured by the incorporation of [14C]leucine into plasma membranes, was decreased to 45% of that of the controls. However, only small differences were observed in the amino acid composition of the plasma membrane after D-galactosamine treatment. 5. The protein composition of the plasma membranes was determined by sodium dodecyl sulphate/polyacrylamide-gel electrophoresis. The results showed a change from low- to high-molecular-weight proteins after the injection of galactosamine. 6. These results demonstrate different metabolic processes of the plasma membrane altered during the induction of galactosamine hepatitis.


Male-specific RNA coliphages (F-RNA coliphages) have been proposed as a potential viral indicator of fecal contamination in water and foods because they are easy to culture and are a normal component of the mammalian gut flora. F-RNA coliphage plaque numbers are typically obtained by directly plating a 10-fold dilution o f 1 g offecal material, but the numbers of F-RNA coliphages shed by animals and humans may be too low for direct enumeration. Therefore, the sensitivity of detecting F-RNA coliphages in fecal material was improved by extracting and precipitating F-RNA coliphage from a 10-g fecal sample by use of polyethylene glycol (PEG). The highest recovery of F-RNA coliphage with 10% beef extract, pH 7.2, was obtained in the presence of 1 M NaCl and 10% PEG after 16 h of precipitation, but a pellet was not obtained after a short precipitation time of 2 h. There was no significant difference between eluant-to-fecal-material ratios of 4:1 and 9:1 or homogenization with a stomacher or pulsifier. F-RNA coliphage were detected in 64% (16 of 25 samples) of fecal samples from various sources when the sample size was 10 g but in 36% (9 of 25 samples) of samples when the sample size was 1 g. When F-RNA coliphage were detected in 1-g samples, they


It is crucial to develop electrocatalysts for the oxygen reduction reaction (ORR) for renewable energy applications. Mixed-valence transition-metal oxides with a spinel structure have been explored for this purpose. In this work, we study the influence of the composition of the catalysts (XY2O4, X=Ni, Zn and Y=Co, Mn) on the ORR. The four different types of spinel oxide nanocrystals (NiCo2O4, NiMn2O4, ZnCo2O4, and ZnMn2O4) were synthesized by a simple and scalable method. This allowed for a systematic investigation of the transition-metal influence on the performance of the ORR. Given the general spinel structure of XY2O4, we systematically changed X (Ni, Zn) and Y (Co, Mn). The effects of the presence of different metals in the spinel oxide on the morphology and electrocatalytic properties of the materials toward the ORR were investigated and compared by using scanning electron microscopy, energy-dispersive X-ray spectroscopy, X-ray photoelectron microscopy, and voltammetry. In general, cobalt-based spinel oxides displayed a significant electrocatalytic activity towards the ORR, with Ni-substituted spinel oxides outperforming their respective Zn-substituted congeners. These findings may have great impact in the research field of renewable energy.


Lawyers struggle fiercely with loyalties. We are guided by obligations to our clients, to the legal system, to some concept of justice, to some notion of truth, and by our own moral and ethical compass. And on top of all this, we have to follow the profession's ethical rules. Much has been written about how these loyalties exist - or coexist - in uneasy competition, if not downright conflict; and there is no consensus among scholars or practitioners on how a lawyer can, let alone should, act in trying to balance these competing obligations. Adding complexity to - or maybe in fact simplifying - this debate are the nuanced, complex, multi-faceted experiences our clients share with us. This article introduces some of these stories into the analysis a lawyer undertakes to determine his ethical obligations. Drawing from the experiences of two sets of clients and their lawyers, the piece proposes an approach to ethical regulation that requires the lawyer to engage in a deeply contextual analysis of the specific and particular ethical conflicts presented to him in any particular case; and work with his client to determine how to resolve those conflicts. The first part of the article introduces the stories of these clients as the lawyers came to know them and as the ethical dilemmas unfolded. This section sets the stage for further analysis both of the Rules of Professional Conduct and of the process lawyers undertake to understand and apply those rules. The second part of the paper shifts the focus to the Model Rules of Professional Conduct themselves and tells the stories again, this time in the context of those rules. This second telling reveals that the rules that make up the system of ethical regulation are interpreted to apply to generic, abstract clients in generic, abstract situations. Drawing on critical lawyering and narrative theory, the third part of the paper proposes an alternative approach to interpreting and resolving ethical conflicts. The article suggests that the system of regulation should be interpreted to allow room for the attorney to consider and incorporate the client's narrative context. Such an approach places the client in the center of the inquiry and requires the lawyer and client to engage actively in dialogue and problem-solving. It allows the lawyer and client together to arrive at solutions that both respond to the particular client's needs, and attend to the moral and ethical concerns the lawyer and society might have. By using a critically reflective, intentional process of inquiry around ethical (and other) concerns, the lawyer must focus on this particular client in the context of his life and his legal/non-legal needs in this particular situation. Such an inquiry results in ethical decisions that meet the lawyers' competing obligations of loyalty to the client, to himself, and to the legal system.


Monocytes are a key cell type responsible for the generation of atherosclerosis. Monocytes/macrophages also play key roles in plaque growth and plaque instability. In contrast, recent research has demonstrated that macrophages can also suppress inflammation and promote healing and fibrosis. Some of this complexity relates to the presence of different macrophage subtypes that are induced and activated by different stimuli within the plaque. Macrophage functions include lipid uptake and oxidation with resultant foam cell formation, release of pro or anti-inflammatory cytokines, phagocytosis of dead macrophage and vessel wall cells, release of destructive enzymes such as matrix metalloproteinases, and presentation of antigen to immune cells. Each of these functions is likely to be occurring simultaneously in different subtypes within the complex environment of the plaque. While selective manipulation of monocytes/macrophages has clearly demonstrated their proatherogenic role in early plaque development, their role in advanced plaques has been more difficult to elucidate. Nonetheless, switching of a proinflammatory to an anti-inflammatory/reparative phenotype represents an attractive target for therapeutics in atherosclerosis. Heart Metab; 2013;60:5–8


Detection of mycotoxins, especially aflatoxin M1 (AFM1), in milk is crucial to be able to guarantee food quality and safety. In recent years, biosensors have been emerging as a fast, reliable and low-cost technique for the detection of this toxin. In this work, flexible biosensors were fabricated using dispense-printed electrodes, which were functionalized with single-walled carbon nanotubes (SWCNTs) and subsequently coated with specific antibodies to improve their sensitivity. Next, the immunosensor was tested for the detection of AFM1 in buffer solution and a spiked milk sample using a chronoamperometric technique. Results showed that the working range of the sensors was 0.01 µg/L at minimum and 1 µg/L at maximum in both buffer and spiked milk. The lower limit of detection of the SWCNT-functionalized sensor was 0.02 µg/L, which indicates an improved sensitivity compared to the sensors reported so far. The sensitivity and detection range were in accordance with the limitation values imposed by regulations on milk and its products. Therefore, considering the low fabrication cost, the ease of operation, and the rapid read-out, the use of this sensor could contribute to safeguarding consumers' health.


Objective: This study sought to explore the drug use practices of undergraduate students within the Faculty of Medical Sciences, The University of the West Indies, Mona, Jamaica . Method: This study was a multicentre study carried out in Jamaica and six Latin American countries. The study utilized a cross-sectional design using a survey method of data collection. A list of compulsory classes for first- and second-year undergraduate students in the Faculty of Medical Sciences was retrieved by researchers and then cluster sampling was used to choose lectures to carry out data collection. The instrument utilized for the study was a self-report questionnaire which consisted of 58 questions which enquired about sociodemographic information, psychoactive substance use and associated consequences. Results: A total of 380 students (78 males, 302 females) participated in the study; 115 (30.3%) reported a past year prevalence of psychoactive substance use. Roughly half (50.8%) reported that they first used substances when they were 15 −19 years old. Students also reported a past month prevalence of alcohol use (16.6%), prescription drugs without a prescription (4.5%), tobacco (2.4%) and cannabis (2.1%) use. Conclusion: These preliminary results on substance use patterns among students in the Faculty of Medical Sciences indicate urgent need for further research among this population. Such research should be used to inform prevention and treatment programmes that will directly target this student population.


The nanotechnology field is growing at an unprecedented rate. This is resulting in significant benefits in skin care products and formulations. Likewise, imaging technology is also advancing. The convergence of these fields offers a unique opportunity to observe and quantify the interactions of nanoparticles within cosmetic and skin care formulations. More importantly, imaging technology holds tremendous promise for understanding how formulated nanoparticles interact with our skin. Imaging technologies can be broken into two major groups that include those that require invasive sample collection and processing (e.g., electron microscopy, mass spectrometry, and super-resolution structured illumination microscopy) and those that can be used in non-invasive data collection settings. Fluorescence microscopy, confocal microscopy, coherent anti-Stokes Raman scattering spectroscopy and optical coherence tomography fall into the latter category and are the focus of this review in the context of skin care product and cosmetics testing. Cosmetic and skin care product testing is most informative when carried out in volunteers. This makes invasive or disruptive analysis techniques unfeasible and supports the use of non-invasive imaging technologies. The combination of non-invasive imaging and minimally invasive microbiopsy sampling for combined imaging and molecular data is the future of skin care product testing.


Multi-core techniques are now common even in general computing applications. It is thus critical for our students to be prepared to deal with such systems from both a hardware and software design perspective. In this work, we address the need for multi-core hardware design practice in an undergraduate introductory computer architecture course. Lecture and laboratory materials for a dual-core design sequence were developed in 2007. The new materials have been used each subsequent semester. The yield of functional dual-core designs was 18% for individual students one semester and 56% for student teams of two in another semester. An analysis of student dual-core results indicate that course policies and success on earlier laboratories had a strong impact on the dual-core design yield.


We present a qualitative content analysis of visual-verbal social media posts, where ordinary dog owners pretend to be their canine, to identify meaningful facets in their dogs' life-worlds, e.g. pleasures of human-dog relation, dog-dog relations, food etc. We use this knowledge to inform design of "quantified pets". The study targets a general problem in Animal-Computer Interaction (ACI), i.e. to understand animals when designing "for" them, although lacking a common language. Several approaches, e.g. ethnography and participatory design, have been appropriated from HCI without exhausting the issue. We argue for a methodological creativity and pluralism by suggesting an additional approach drawing on "kinesthetic empathy". It implies to understand animals by empathizing with their bodily movements over time and decoding the realities of their life-worlds. This, and other related approaches, has inspired animal researchers to conduct more or less radical participant observations during extensive duration to understand the perspective of the other. We suggest that dog owners whom share their lives with their dogs already possess a similar understanding as these experts, and thus uphold important experiences of canine life that could be used to understand individual dogs and inspire design.


Traditional morphological examinations are not anymore sufficient for a complete evaluation of tumoral tissue and the use of neoplastic markers is of utmost importance. Neoplastic markers can be classified in: diagnostic, prognostic and predictive markers. Three markers were analyzed.
1) Insulin-like growth factor binding protein 2 (IGFBP2) was immunohistochemically examined in prostatic tissues: 40 radical prostatectomies from hormonally untreated patients with their preoperative biopsies, 10 radical prostatectomies from patients under complete androgen ablation before surgery and 10 simple prostatectomies from patients with bladder outlet obstruction. Results were compared with α-methylacyl-CoA racemase (AMACR). IGFBP2 was expressed in the cytoplasm of untreated adenocarcinomas and, to a lesser extent, in HG-PIN; the expression was markedly lower in patients after complete androgen ablation. AMACR was similarly expressed in both adenocarcinoma and HG-PIN, the level being similar in both lesions; the expression was slightly lower in patients after complete androgen ablation.
IGFBP2 may be used a diagnostic marker of prostatic adenocarcinomas.
2) Heparan surface proteoglycan immunohistochemical expression was examined in 150 oral squamous cell carcinomas. Follow up information was available in 93 patients (range: 6-34 months, mean: 19±7). After surgery, chemotherapy was performed in 8 patients and radiotherapy in 61 patients. Multivariate and univariate overall survival analyses showed that high expression of syndecan-1 (SYN-1) was associated with a poor prognosis. In patients treated with radiotherapy, such association was higher.
SYN-1 is a prognostic marker in oral squamous cell carcinomas; it may also represent a predictive factor for responsiveness to radiotherapy.
3) EGFR was studied in 33 pulmonary adenocarcinomas with traditional DNA sequencing methods and with two mutation-specific antibodies. Overall, the two antibodies had 61.1% sensitivity and 100% specificity in detecting EGFR mutations.
EGFR mutation-specific antibodies may represent a predictive marker to identify patients candidate to tyrosine kinase inhibitors therapy.


Isocyanates are highly reactive chemicals capable of causing a multitude of toxicologic effects including respiratory irritation, dermal irritation, contact sensitivity, and pulmonary hypersensitivity. In order to probe the mechanism(s) underlying these reactions, an animal model has been developed. The guinea pig model reproduces both the respiratory and immunologic effects of isocyanates that have been observed clinically. In experimental animals and in humans, isocyanates induce immunologic reactions with specific antibody formation, including IgE. This finding allows development of diagnostic reagents to assess isocyanate sensitivity. Further characterization of immunologic components in the model is expected to increase understanding of the mechanisms of this immunotoxic disease and develop strategies for treatment and prevention.


ABSTRACT-The U.S. Constitution's separation of powers has its origins in the British idea of the desirability of a Mixed Regime where the King, the Lords, and the Commons all checked and balanced one another as the three great estates of the realm. Aristotle, Polybius, Cicero, St. Thomas Aquinas, and Machiavelli all argued that Mixed Regimes of the One, the Few, and the Many were the best forms of regimes in practice because they led to a system of checks and balances. The Enlightenment killed offthe Mixed Regime idea forever because hereditary office-holding by Kings and Lords became anathema. The result was the birth of a functional separation of legislative, executive, and judicial power as an alternative system of checks and balances to the Mixed Regime. For better or worse, however, in the United States, Congress laid claim to powers that the House of Lords and the House of Commons historically had in Britain, the President laid claim to powers the King historically had in Britain, and the Supreme Court has functioned in much the same way as did the Privy Council, the Court of Star Chamber, and the House of Lords. We think these deviations from a pure functional separation of powers are constitutionally problematic in light of the Vesting Clauses of Articles I, II, and III, which confer on Congress, the President, and the courts only the legislative, executive, and judicial power. The United States badly needs a rebirth of the functional separation of powers idea. INTRODUCTION It is a privilege and an honor for us to write about the legacy of Justice John Paul Stevens with respect to the executive power specifically and the separation of powers more generally. Justice Stevens has had a huge impact on this subject, which all of us care about deeply. Justice Stevens was the author of two of the most momentous and consequential separation of powers opinions of the last thirty years: Chevron U.S.A. Inc. v. NRDC1 and Clinton v. City of New York.2 In the first case, Justice Stevens wrote a seminal opinion for the Court arguing for deference by courts to reasonable executive branch interpretations of law3-a view that he later wisely qualified in subsequent cases when some of his colleagues tried to take it too far.4 In the second case, Justice Stevens limited presidential power by holding unconstitutional a statute that purported to give the President a line item veto by delegating enormous impoundment powers to the President.5 The Chevron opinion and its progeny recognized that the President and his executive subordinates are often functionally lawmakers.6 The Clinton case sets outer limits on Congress's power to delegate its appropriations power to the President.7 Taken together, these two cases suggest that the very idea of the separation of powers is in a state of crisis today. Congress often passes sweeping delegations of legislative power to the Executive Branch,8 thereby placing courts in a quandary when they are called upon to review the legality of agency regulations and orders. Justice Stevens's opinion calling for judicial deference to reasonable executive branch interpretations of law in Chevron recognizes that quandary while his later opinions and votes limiting the scope of Chevron reflect the Justice's desire to preserve as much of the separation of powers as possible by allowing for judicial review.9 Congress also tried with the Line Item Veto Act to surrender part of the traditional legislative prerogative of the power of the purse to the President.10 Justice Stevens, writing for the Court, struck that particular delegation down.11 Chevron and Clinton v. City of New York raise fundamental questions about the separation of powers. How did we get to a world where executive branch agencies routinely make law and where Congress tries by statute to surrender the most ancient of legislative prerogatives? Was Justice Stevens right to create Chevron deference and then to try to confine that deference in subsequent case law? …


Acinetobacter spp. are uncommon etiologic agents of prosthetic valve endocarditis. Two patients with Acinetobacter calcoaceticus subsp. lwoffi prosthetic valve endocarditis are described. The patients were successfully treated with antibiotics (cefotaxime sodium and gentamicin sulfate); thus, we suggest medical treatment rather than early valve replacement in this particular type of infection.


This dictionary provides in-depth coverage of the major historical figures and events of the 20th century. Offering both fact and analysis, Jan Palmowski's reference work should be of interest to a range of readers from students of history, politics, and international relations to anyone with an interest in our modern world. Included are: 2500 entries covering political, diplomatic, and military history; full international coverage with detailed entries for every country in the world; biographical entries on political and military leaders, and leading thinkers who have influenced events; subject entries on international organizations, treaties, religious and political movements, as well as key incidents, places, and battles; and tables including lists of office-holders for countries and organizations and winners of the Nobel Peace Prize.


ABSTRACT The prevalence of Staphylococcus aureus causing prosthetic joint infection (PJI) supports investigation of higher doses of daptomycin in the management of PJI. This was a prospective, randomized controlled trial studying safety and efficacy of daptomycin (6 and 8 mg/kg of body weight) compared with standard-of-care therapy for PJI. This open-label study randomized 75 patients undergoing 2-stage revision arthroplasty to daptomycin at 6 or 8 mg/kg or a comparator (vancomycin, teicoplanin, or semisynthetic penicillin). After prosthesis removal, patients received 6 weeks of antibiotic treatment and a 2- to 6-week antibiotic-free period before implantation of a new prosthesis. Test of cure (TOC) was within 1 to 2 weeks after reimplantation. The primary objective was evaluation of creatine phosphokinase (CPK) levels. Secondary objectives were clinical efficacy and microbiological assessments. Of 73 CPK safety population patients, CPK elevation of >500 U/liter occurred in 4 of 25 (16.0%) (daptomycin, 6 mg/kg) and 5 of 23 (21.7%) (daptomycin, 8 mg/kg) daptomycin-treated patients and 2 of 25 (8.0%) comparator patients. Adverse-event rates were similar among daptomycin and comparator groups. Among modified intent-to-treat patients at TOC, clinical success rates were 14 of 24 (58.3%) for 6 mg/kg daptomycin, 14 of 23 (60.9%) for 8 mg/kg daptomycin, and 8 of 21 (38.1%) for the comparator. Overall microbiological success at TOC was 12 of 24 (50.0%) for 6 mg/kg daptomycin, 12 of 23 (52.2%) for 8 mg/kg daptomycin, and 8 of 21 (38.1%) for comparator patients. In conclusion, daptomycin at 6 and 8 mg/kg given for up to 6 weeks was safe and appeared to be effective in managing staphylococcal PJI using a 2-stage revision arthroplasty technique in a total of 49 patients.


Redistribution of soil, nutrients, and contaminants is often driven by wind erosion in semiarid shrublands. Wind erosion depends on wind velocity (particularly during episodic, high-velocity winds) and on vegetation, which is generally sparse and spatially heterogeneous in semiarid ecosystems. Further, the vegetation cover can be rapidly and greatly altered due to disturbances, particularly fire. Few studies, however, have evaluated key temporal and spatial components of wind erosion with respect to (i) erosion rates on the scale of weeks as a function of episodic high-velocity winds, (ii) rates at unburned and burned sites, and (iii) within-site spatial heterogeneity in erosion. Measuring wind erosion in unburned and recently burned Chihuahuan desert shrubland, we found (i) weekly wind erosion was related more to daily peak wind velocities than to daily average velocities as consistent with our findings of a threshold wind velocity at approximately 7 m s(-1); (ii) greater erodibility in burned vs. unburned shrubland as indicated by erosion thresholds, aerodynamic roughness, and nearground soil movement; and (iii) burned shrubland lost soil from intercanopy and especially canopy patches in contrast to unburned shrubland, where soil accumulated in canopy patches. Our results are among the first to quantify post-fire wind erosion and highlight the importance of accounting for finer temporal and spatial variation in shrubland wind erosion. This finer-scale variation relates to semiarid land degradation, and is particularly relevant for predictions of contaminant resuspension and redistribution, both of which historically ignore finer-scale temporal and spatial variation in wind erosion.


Objectives The aim of the study was to compare between clinical examination, skin scraping, and histopathological examinat ion in the diagnosis of scabies and assess the role of immune cells (CD4+ and CD8+) and transforming growth factor b (TGF-b) to differentiate between scabietic and nonscabietic patients. Background Scabies is a contagious skin infection characterized clinically by nocturnal pruritus and visible burrows. Scabies can occur in epidemic or endemic form. Scabies is still a major public health problem in many resource-poor regions, with prevalence rates reaching up to 10% in the general population and 50% in children. The diagnosis of scabies is challenging, leading to the observation that scabies is at once the easiest and most difficult diagnosis in medicine. Patients and methods Physical examination, skin scraping, and histopathological analysis were carried out for diagnosing scabies. Biopsies were taken from untreated skin lesions of patients 35 with scabies, six with psoriasis, eight with lichen planus and eight normal individuals. T-cell subsets (CD4+ and CD8+) and anti-inflammatory cytokine (TGF-b) were evaluated by immunohistochemical analysis. Results Skin scraping and histopathological examination were highly specific (100%) when compared with physical examination, but the sensitivity of histopathology (88%) was superior to scraping (23%) and clinical diagnosis (85.6%). The highest number of CD4+ T cells was found in scabies and lichen planus but not in psoriasis. In contrast, the highest number of CD8+ T cells was found in psoriasis but not in scabies or lichen planus. There was statistically significant difference between scabietic and nonscabietic patients with regard to CD4+, CD8+, and CD4+/CD8+ ratio. Mild expression of TGF-b was observed in patients with scabies compared with moderate to strong expression in lichen planus and psoriasis. Conclusion Histopathology is an accurate diagnostic method but recommended in suspicious cases only as it is an invasive technique. A high number of CD4+ cells and low expression of TGF-b are characteristic of scabietic lesions.


The influence of qualitatively different nutrition (physiological and that with lysine, methionine, threonine and vitamins A, B, C deficiencies) on certain toxicokinetic parameters of 3H-aflatoxin B1, after single and multiple (every day, during 5 days) intraperitoneal injections of this agent in a dose of 25 micrograms/animal, was studied in two series of experiments on growing male WAG rats with the initial bw 40-50 g. It has been proved that the main parameters of aflatoxin B1 toxicokinetics depend on the injection multiplicity and the nutrition character. It has been established that the qualitative differences in the nutrition character essentially influence the stages of aflatoxin B1 distribution in the body, the sorption and metabolic transformation in the liver, enterohepatic recirculation, the rate and correlation of the main elimination routes. The nutrition character influences the level of persistence and cumulation of firmly bound aflatoxin B1 adducts in the liver and hepatocytic DNA. Possible mechanisms of such effects of different providing of the body with essential nutrients have been discussed. A conclusion has been made that the modifying effect of nutrition on the key stages of aflatoxin B1 toxicokinetics is realized, ultimately, in varying degree of the animal resistance to mutagenic and carcinogenic action of this agent.


This paper is concerned with closed-loop stability analysis and dynamic quantization parameters design of discrete-time networked control systems (NCSs) with noise disturbance. First, based on the Lyapunov function, two state invariant regions of estimation error system and plant system are constructed. The quadratically attractive conditions of the two systems are obtained by using the proposed invariant region sequence, respectively. Second, a quantized control strategy is presented by dynamically adjusting the scaling parameters of logarithmic quantizers. Moreover, the connection of quadratic stability between the plant system and the estimation error system is also given.


Background The ER chaperone GRP78/BiP is a homolog of the Hsp70 family of heat shock proteins, yet GRP78/BiP is not induced by heat shock but instead by ER stress. However, previous studies had not considered more physiologically relevant temperature elevation associated with febrile hyperthermia. In this report we examine the response of GRP78/BiP and other components of the ER stress pathway in cells exposed to 40°C. Methodology AD293 cells were exposed to 43°C heat shock to confirm inhibition of the ER stress response genes. Five mammalian cell types, including AD293 cells, were then exposed to 40°C hyperthermia for various time periods and induction of the ER stress pathway was assessed. Principal Findings The inhibition of the ER stress pathway by heat shock (43°C) was confirmed. In contrast cells subjected to more mild temperature elevation (40°C) showed either a partial or full ER stress pathway induction as determined by downstream targets of the three arms of the ER stress pathway as well as a heat shock response. Cells deficient for Perk or Gcn2 exhibit great sensitivity to ER stress induction by hyperthermia. Conclusions The ER stress pathway is induced partially or fully as a consequence of hyperthermia in parallel with induction of Hsp70. These findings suggest that the ER and cytoplasm of cells contain parallel pathways to coordinately regulate adaptation to febrile hyperthermia associated with disease or infection.


We describe studies aimed at evaluating the physical factors governing the rate of 3'-end proofreading by the Klenow fragment of E. coli DNA polymerase I. Two nonpolar deoxynucleoside isosteres containing 2,4-difluorotoluene (F) and 4-methylbenzimidazole (Z), which are non-hydrogen-bonding shape mimics of thymine and adenine, respectively, are used to investigate the effects of base pair geometry and stability on the rate of this exonuclease activity. Steady-state kinetics measurements show that complementary T.A base pairs at the end of a primer-template duplex are edited 14-40-fold more slowly than mismatches. By contrast, a 3'-end T residue in a T. Z pair is edited at a rate equivalent to that of natural base mismatches despite the fact that it resembles a T.A pair in structure. Similarly, the A in an A.F pair is edited as rapidly as a mismatched pair despite its close structural mimicry of an A.T pair. Interestingly, when the base pairs are reversed and F or Z is located at the 3'-end, they are edited more slowly, possibly implicating specific interactions between the exonuclease domain and the base of the nucleotide being edited. Finally, thermal denaturation studies are carried out to investigate the relationship between editing and the ease of unwinding of the duplex. The rapid editing of bases opposite F or Z residues at the duplex terminus seems to correlate well with the stability of these base pairs when placed in a context resembling a primer-template duplex. In general, the rate of 3'-end editing appears to be governed by the rate of fraying of the DNA terminal pair, and base pair geometry appears to have little effect.


The authors of this Article review the current state of the science of attribu-tion of anthropogenic climate change, with particular emphasis on the meth-odological challenges that are likely to confront any attempt to establish a direct causal link between greenhouse gas emissions and specific damaging weather events. Standard " detection and attribution " analyses, such as those cited by the Intergovernmental Panel on Climate Change (IPCC), are generally sufficient to establish the strength of human influence on large-scale, long-term-average climate, but fall short of quantifying the role of greenhouse gas emissions in almost any conceivable case of actual harm, since nobody is directly exposed to a change in global average temperature alone. The authors argue that it should be possible to agree on a relatively objective approach to quantifying the role of human influence on climate in cases of actual harm. There are, however, a number of questions to be resolved, including: can we apply the concept of Fraction Attributable Risk, developed for population studies in epidemiology , to the analysis of an unprecedented change in a single system such as the world's climate? Can we rely on computer simulation to address counter-factual questions such as " what would the climate have been like in the absence of twentieth century greenhouse gas emissions, " given that we are working with imperfect simulation models? Due to multiple anthropogenic and natural contributions to changing weather risks, it will always be necessary to apply some kind of principle of ceteris paribus to quantify the role of any particular causal agent, such as greenhouse gas emissions. How is this principle to be applied? These questions are not, in themselves, scientific issues, although how they are to be resolved will have a direct bearing on how and whether climate science can inform specific causal attribution claims. In summary, we need the legal community to ask the scientific community the right questions. It is imperative that these issues be resolved as soon as possible, to avoid having them become entwined in the outcomes of specific cases. Thus, this Article serves as a kind of tutorial, going over some material that many will find familiar in order to place it in the context of attribution.


We investigate the electronic structures of the alloyed Bi1-xSbx compounds based on first-principles calculations including spin-orbit coupling (SOC), and calculate the surface states of semi-infinite systems using maximally localized Wannier function. From the calculated results, we analyze the topological nature of Bi1-xSbx, and found the followings: (1) pure Bi crystal is topologically trivial. (2) Topologically nontrivial phase can be realized by reducing the strength of SOC via Sb doping. (3) The indirect bulk band gap, which is crucial to realize the true bulk insulating phase, can be enhanced by uniaxial pressure along c axis. (4) The calculated surface states can be compared with experimental results, which confirms the topological nature. (5) We predict the spin-resolved Fermi surfaces and showed the vortex structures, which should be examined by future experiments.


This section presents a concise overview of the treatments and clinical procedures regularly carried out in the field of cardiovascular care. This 'back-to-basics' article aims to refresh nurses' knowledge on correct practice, as well as introduce students and junior nurses to procedures


Online coding tutorials are increasingly popular among learners, but we still have little knowledge of their quality. To address this gap, we derived several dimensions of pedagogical effectiveness from the learning sciences and education literature and analyzed a large sample of tutorials against these dimensions. We sampled 30 popular and diverse online coding tutorials, and analyzed what and how they taught learners. We found that tutorials largely taught similar content, organized content bottom-up, and provided goal-directed practices with immediate feedback. However, few were tailored to learners' prior coding knowledge and only a few informed learners how to transfer and apply learned knowledge. Based on these results, we discuss strengths and weaknesses of online coding tutorials, opportunities for improvement, and recommend that educators point their students to educational games and interactive tutorials over other tutorial genres.


We present a semiclassical S -matrix study of inelastic collinear electron-hydrogen scattering. A simple way to extract all the necessary information from the deflection function alone without having to compute the stability matrix is described. This includes the determination of the relevant Maslov indices. Results of singlet and triplet cross sections for excitation and ionization are reported. The different levels of approximation - classical, semiclassical and uniform semiclassical - are compared among each other and with the full quantum result.


Introduction The impact of donor specific antibodies on outcomes after liver transplantation remains controversial. We aimed to evaluate the impact of a positive lymphocyte complement dependent cytotoxic (CDC) crossmatch on patient survival and the incidence of complications following liver transplantation (LT). Methods We analysed the outcomes for all patients undergoing LT in our centre over a 6 year period (January 2007–December 2012). All patients transplanted at our centre receive a retrospective CDC crossmatch. We examined the indication for transplantation, patient survival, complications (acute cellular rejection, biliary strictures, chronic ductopaenic rejection) and whether the complications correlated to the presence of a positive crossmatch pre- and post-treatment with dithiothreitol (DTT) for IgM/IgG or IgG antibodies. Results There were 194 liver transplants performed in this period (60% male). A crossmatch was available for 186 patients. The median age of the recipients was 55 years (range 19–71 years). The primary indications for LT were alcoholic liver disease 31%, autoimmune liver disease 18%, hepatocellular carcinoma 11%, viral hepatitis 9%, vascular 7.5%, paracetamol toxicity 7.5%, NAFLD 5% and other 11%. There were 12 deaths (6.5%) in the time period studied. 76 patients had a positive crossmatch and of these 13 were IgG positive (i.e., positive post-DTT treatment). Patient survival did not correlate with the presence of an IgM or IgG positive crossmatch (Fisher's exact test, p = 1.000 for both). Acute cellular rejection (ACR) requiring augmentation of immunosuppression occurred in 38 patients (20%). Neither a positive IgM crossmatch (Chi-square test, p = 0.094) or a positive IgG crossmatch (Fisher's exact test, p = 1.000) correlated with the incidence of ACR. Clinically significant biliary strictures occurred in 14 patients (7.5%). The presence of a positive crossmatch did not correlate with the incidence of strictures (Chi square test, p = 0.124 for IgM antibodies and Fisher's exact test, p = 1.000 for IgG antibodies). Only 1 patient developed chronic ductopaenic rejection in our cohort. Conclusion The presence of antibodies to donor lymphocytes (detectable by the CDC crossmatch) does not affect patient survival or the incidence of acute cellular rejection and biliary anastomotic strictures. Disclosure of Interest None Declared.


STUDY OBJECTIVES
The stress imposed by the COVID-19 pandemic and ensuing social isolation could adversely affect sleep. As sleep problems may persist and hurt health, it is important to identify which populations have experienced changes in sleeping patterns during the pandemic and their extent.

METHODS
In Study 1, 3,062 responders from 49 countries accessed the survey website voluntarily between March 26-April 26, 2020, and 2,562 (84%; age: 45.2±14.5, 68% women) completed the study. In Study 2, 1,022 adult US responders were recruited for pay through Mechanical Turk, and 971 (95%; age 40.4±13.6, 52% women) completed the study. The survey tool included demographics and items adapted from validated sleep questionnaires on sleep duration, quality and timing, and sleeping pills consumption.

RESULTS
In Study 1, 58% of the responders were unsatisfied with their sleep. Forty percent of the responders reported a decreased sleep quality vs. before COVID-19 crisis. Self-reported sleeping pill consumption increased by 20% (p<0.001). Multivariable analysis indicated that female sex, being in quarantine, 31 to 45-year age group, reduced physical activity and adverse impact on livelihood were independently associated with more severe worsening of sleep quality during the pandemic. The majority of findings were reproduced in the independent cohort of Study 2.

CONCLUSIONS
Changes imposed due to the pandemic have led to a surge in individuals reporting sleep problems across the globe. The findings raise the need to screen for worsening sleep patterns and use of sleeping aids, especially in more susceptible populations, namely, women and people with insecure livelihoods subjected to social isolation.


The Aerofilms company has acquired a remarkable archive of photographs recording the changing face of London generally and the capital's football grounds specifically. For example Aerofilms has been recording the evolution of Wembley Stadium from its original construction in the early 1920s through to the emergence of the new ground. It can also trace the development of Arsenal's Highbury Stadium, showing the building of the classic East and West stands. From this impressive archive, the book shows photographs portraying many of the varied football grounds in the Greater London area. It concentrates on the Metropolis league grounds, both those currently in use and those, which have been lost.


In both mouse models and clinical patients with lupus, autophagy levels were significantly elevated and correlated with disease activity. Furthermore, autophagy can promote the survival of B and T cells, plasma cell differentiation, and antibody production. These results suggest that autophagy may promote the progression of lupus by regulating the survival of autoreactive immune cells. Therefore, we aimed at studying whether suppressing autophagy can modulate lupus progression in vivo. First, we found that the autophagy levels in splenocytes and lymphocytes of peripheral blood (PB) were elevated and positively correlated with disease severity in lupus-prone mice. The shAtg5-lentivirus, which effectively inhibits autophagy in vitro, was then injected into the lupus-prone mice. Autophagy levels in lymph node cells and PB lymphocytes were reduced following Atg5 suppression. We also found that lymphadenopathy and the numbers of plasma cells, CD4−CD8−, and CD4+ T cells decreased in mice treated with the shAtg5-lentivirus. The mice treated with shAtg5-lentivirus exhibited lower levels of proteinuria, serum anti-dsDNA antibody, B-cell activating factor (BAFF), and glomerular immune complex deposition. Therefore, targeting autophagy to moderate overactivated autophagy in immune cells seems to be a novel strategy for combination therapy of lupus.


Due to mechanisms such as proteolytic processing or alternative translation starts, in-vivo proteoforms do not necessarily correspond directly to those encoded in the genome. Therefore, the knowledge of protein termini is an indispensable prerequisite to understand protein functions. So far, sequencing of protein N- and C-termini has been limited to single purified protein species, while the proteome-wide identification of N- and C-termini relies on the generation of single, terminal proteotypic peptides followed by chemical enrichment or depletion strategies to facilitate their detection via mass spectrometry (MS). To overcome the numerous limitations in such approaches, we present an alternative concept that readily enables unbiased ladder sequencing of protein N- and C-termini. The approach combines exopeptidase digestions of the proteome with two-dimensional chromatographic separation and tandem-MS. We demonstrate the potential of the methodology by analyzing the N- and C-terminome of S. cerevisiae, identifying 2,190 N-termini, and 1,562 C-termini. In conclusion, the presented method largely expands the proteomics toolbox enabling N- and C-terminal sequential characterization of entire proteomes.


Our starting point is the difference between an observation and an action. What we see in passive observation is how individuals follow their routine behavior, habits, and natural inclination. Passive observation reflects the state of the world projected to a set of features we chose to highlight. Data that we collect from passive observation show a snapshot of our world as it is. There are many questions we can answer from passive observation alone: Do 16 year-old drivers have a higher incidence rate of traffic accidents than 18 year-old drivers? Formally, the answer corresponds to a difference of conditional probabilities. We can calculate the conditional probability of a traffic accident given that the driver's age is 16 years and subtract from it the conditional probability of a traffic accident given the age is 18 years. Both conditional probabilities can be estimated from a large enough sample drawn from the distribution, assuming that there are both 16 year old and 18 year old drivers. The answer to the question we asked is solidly in the realm of observational statistics. But important questions often are not observational in nature. Would traffic fatalities decrease if we raised the legal driving age by two years? Although the question seems similar on the surface, we quickly realize that it asks for a fundamentally different insight. Rather than asking for the frequency of an event in our manifested world, this question asks for the effect of a hypothetical action. As a result, the answer is not so simple. Even if older drivers have a lower incidence rate of traffic accidents, this might simply be a consequence of additional driving experience. There is no obvious reason why an 18 year old with two months on the road would be any less likely to be involved in an accident than, say, a 16 year-old with the same experience. We can try to address this problem by holding the number of months of driving experience fixed, while comparing individuals of different ages. But we quickly run into subtleties. What if 18 year-olds with two months of driving experience correspond to individuals who are exceptionally cautious and hence—by their natural inclination—not only drive less, but also more cautiously? What if such individuals predominantly live in regions where traffic conditions differ significantly from those in areas where people feel a


This volume rejects the notion that Islam's sacred text is error free and cannot be critically evaluated. The study of the Koran must develop and mature. Scholars of Islam are of course familiar with the book's many errors and contradictions, but these inherent flaws have rarely been revealed to a wider public. "The Origins of the Koran" is an attempt to remedy this deficiency by bringing together classic critical essays which raise key issues surrounding Islam's holy book. Divided into four parts, this important anthology begins with Theodor Noldeke's first truly scientific study of the Koran. Part Two focuses on the difficulty of establishing a reliable Koranic text, while Part Three examines the Jewish, Christian, and Zoroastrian sources of Muhammad's 'revelation'. Part Four is a consideration of the controversial interpretations of contemporary scholar John Wansbrough, who questions the historical reliability of the earliest Islamic sources. This superb collection, which includes additional selections from Leone Caetani, Arthur Jeffery, David Margoliouth, Andrew Rippin, C C Torrey, and more, will prove indispensable to scholars and all those interested in the textual underpinning of one of the fastest growing religions in the world.


Abstract. In the present conditions, especially during a pandemic, higher education requires academic staff to master and implement innovative methods of teaching and learning based on information programs, knowledge transfer systems. The tasks of interactive educational forms are as follows: awakening students' interest; motivating students to solve the problem under study; effective mastering educational material; independent searching for the methods and options how to solve the educational task; interactions between students; teamwork skills; tolerance for any point of view; forming students' own opinion, life and professional skills; reaching the level of student's conscious competence. After analyzing our research, we can state that interactive learning creates an environment of educational communication, which is characterized by openness, equal-footing interaction of participants, accumulation of mutual knowledge, that provides high motivation, strength of knowledge, creativity, sociability, active life position, preservation of individuality, freedom of expression, mutual respect.
          This paper examined the current problems of innovative technologies and teaching methods in modern higher education, as the tendency to humanization and humanitarization of the content of medical education has intensified, new academic disciplines have been introduced and, consequently, the need for academic staff, who could provide an innovative approach to implementing these trends during the educational process, has been increased. It is significant that today teachers are able to create and implement their own innovative methods. In addition, the paper focused on the safety of the educational environment of higher education. Information security is especially important, as nowadays the information media have an extremely big impact on the student environment.


Sequencing genomes with a high frequency of repeat regions is a difficult task.The aim of the project was to develop an algorithm to speed up the sequencing process of highly repetitive genome. By using specific differences between the repeats called defined nucleotide positions (DNPs), cluster DNA sequence reads into contigs. The strategy used in the development of the algorithm resulted in a quite complex algorithm. Test runs of the algorithm showed that there is still work to be done to get a desirable result.


PURPOSE
Oncolytic virotherapy with herpes simplex virus-1 (HSV) has shown promise for treatment of pediatric and adult brain tumors; however, completed and ongoing clinical trials have utilized intratumoral/peritumoral oncolytic HSV (oHSV) inoculation due intraventricular/intrathecal toxicity concerns. Intratumoral delivery requires an invasive neurosurgical procedure, limits repeat injections, and precludes direct targeting of metastatic and leptomeningeal disease. To address these limitations, we determined causes of toxicity from intraventricular oHSV and established methods for mitigating toxicity to treat disseminated brain tumors in mice.

EXPERIMENTAL DESIGN
HSV-sensitive CBA/J mice received intraventricular vehicle, inactivated oHSV, or treatment doses (1x107 plaque-forming units) of oHSV, and toxicity was assessed by weight loss and immunohistochemistry. Protective strategies to reduce oHSV toxicity, including intraventricular low-dose oHSV or interferon inducer polyinosinic-polycytidylic acid (poly I:C) prior to oHSV treatment dose, were evaluated and then utilized to assess intraventricular oHSV treatment of multiple models of disseminated CNS disease.

RESULTS
A standard treatment dose of intraventricular oHSV damaged ependymal cells via virus replication and induction of CD8+ T cells, whereas vehicle or inactivated virus resulted in no toxicity. Subsequent doses of intraventricular oHSV caused little additional toxicity. Interferon induction with phosphorylation of eukaryotic initiation factor-2α (eIF2α) via intraventricular pretreatment with low-dose oHSV or poly I:C mitigated ependyma toxicity. This approach enabled safe delivery of multiple treatment doses of clinically relevant oHSV G207 and prolonged survival in disseminated brain tumor models.

CONCLUSIONS
Toxicity from intraventricular oHSV can be mitigated resulting in therapeutic benefit. These data support clinical translation of intraventricular G207.


Purpose To investigate the glycated albumin (GA) introduction implications, as an add-on strategy to traditional glycemic control (Hb1Ac and fasting plasma glucose – FPG) instruments, considering insulin-naïve individuals with type 2 diabetes mellitus (T2DM), treated with oral therapies. Methods A Health Technology Assessment was conducted in Italy, as a multi-dimensional approach useful to validate any innovative technology. The HTA dimensions, derived from the EUnetHTA Core Model, were deployed by means of literature evidence, health economics tools and qualitative questionnaires, filled-in by 15 professionals. Results Literature stated that the GA introduction could lead to a higher number of individuals achieving therapeutic success after 3 months of therapy (97.0% vs 71.6% without GA). From an economic point of view, considering a projection of 1,955,447 T2DM insulin-naïve individuals, potentially treated with oral therapy, GA introduction would imply fewer individuals requiring a therapy switch (−89.44%), with a 1.06% in costs reduction, on annual basis, thus being also the preferable solution from a cost-effectiveness perspective (cost-effectiveness value: 237.74 vs 325.53). According to experts opinions, lower perceptions on GA emerged with regard to equity aspects (0.13 vs 0.72, p-value>0.05), whereas it would improve both individuals (2.17 vs 1.33, p-value=0.000) and caregivers quality of life (1.50 vs 0.83, p-value=0.000). Even if in the short term, GA required additional investments in training courses (−0.80 vs 0.10, p-value = 0.036), in the long run, GA could become the preferable technology (0.30 vs 0.01, p-value=0.018) from an organisational perspective. Conclusion Adding GA to traditional glycaemic control instruments could improve the clinical pathway of individuals with T2DM, leading to economic and organisational advantages for both hospitals and National Healthcare Systems.


A two-stage process was developed by serial inter-connection between CSTR (Continuously Stirred Tank Reactor) and UASB (Upflow Anaerobic Sludge Bed) to produce high-rate biogas from waste textiles. Most of the textiles contain cellulose, which could be a potential substrate for biogas production. Blue jeans textile (pretreated and untreated) was used as waste textile in this process to investigate biogas production under semi-continuous conditions. Jeans was pretreated using 85% NMMO (N-Methyl-Morpholine-Oxide), an environmental friendly solvent at 120 °C for 3 h. OLR (Organic Loading Rate) was increased in the order of 2, 2.7, and 4 gVS/L/day respectively. Pretreatment had a significant effect on the biogas production. NMMO pretreatment doubled the biogas yield, during an OLR of 2 g VS/L/day compared to untreated jeans. The OLR could successfully be increased to 2.7 g VS/L/day resulted in 91% and 96% theoretical yield for untreated jeans and pretreated jeans respectively. However, further increase in OLR did not increase the methane production. For the complete process, COD (Chemical Oxygen Demand) efficiency was high for untreated jeans with 65.1% followed by treated jeans with 39.5% in the UASB. CSTR possessed the major share of biogas production for both textiles. Considering the fact that, textile is one of the largest consumer products, a proper way of disposal or treatment is necessary. By biogas production, waste textile could also be treated and a value-added product was obtained.


This paper suggests that new approaches are required to communicate with communities affected by flooding and coastal erosion. In post-modern society, communities question the validity of the message. They have expectations of the medium of the message. They receive the message through the frameworks of their multiple stories and identities. The personal narratives and experiences within a local community seek recognition and voice alongside the official statements and claims of the engineering and scientific community. Objectivity and reliability are challenged.

The authority of the formal written word, communicating at a cognitive and rational level, takes its place alongside new oral and visual traditions. Technology allows individual stories to reach a wider and more immediate audience. A single, general story is replaced by a multiplicity of particular stories from local communities and individuals. NGOs have followed the media in becoming adept at using all these aspects of communication.

Effective approaches to communication acknowledge the different cultures of the professional and citizen communities (e.g. residential, fishing farming sailing) involved in interacting with FCERM. The paper will examine the way in which stories and storytelling can be used as a bridge between different cultures, creating communities of practice in which knowledge may be shared and sense made of common problems. It suggests some devices which can be used in effective storytelling to help us put our own messages across. Drawing on recent experiences (for example during recent major disasters such as Boscastle), the paper also explains how stories can work for us as we uncover the information buried in the stories of others.

Story telling may also be important in establishing shared fields of experience with communities. This needs to be in the context of effective dialogue that seeks to hear and understand what each community is trying to communicate, based on mutual respect or humility. This humility recognises the value of both the practical knowledge, lodged in the experiences and stories within communities, and the analysis and judgement of professionals as they reflect on and contextualise that experience for future decision making.


the operationi for it kinows more or less that his life has been saved, and would almost inevitably return to the surgeon lhe supposed had saved hiis life if at any future date he required treatment for symptoms whicill le knew preceded hiis former catastroplhe. Furtlher, patients who lhave been'finally discharged lhave always been told to report themselves immnediately for any symptoms of "indigestion"; a few, but only a few, lhave done so. I am convinced, explain it lhow one may, tllat far tlle majority of patients who have perforations simply closed are cured finallv of their ulcers. If that is so the correct treatment would seem to be to suture only at the timne of perforation, reserving for furtlher operation those patients who slhow evidence, clinical or radiooraplhic, or botlh, that tlheir ulecrs lhave not healed. It will then be found that nearly all of tllem require no further surgical treatment.I am, etc., Portsmoutli, April 17tb. CHARLES P. CHILDE, F.R.C.S.


This paper presents a 95 mV startup-voltage step-up DC-DC converter for energy harvesting applications. The capacitor pass-on scheme enables operation of the system from an input voltage of 95 mV without using additional off-chip components. To compensate for the die-to-die process variation, post-fabrication threshold voltage (VTH) trimming is applied to reduce the minimum operating voltage (VDDMIN) of the oscillator. Experimental results demonstrate the 34% VDDMIN reduction of the oscillator by post-fabrication VTH trimming. The proposed step-up converter achieves the lowest startup voltage in standard CMOS without using a mechanical switch or large transformer.


A majority of today's adolescents and young adults are constant social media users. Social media allows individuals to express themselves, communicate with peers and meet new people. Peer support is crucial for adolescent development and disease management. Young people with chronic conditions may not know someone in their offline life with a similar condition. A majority of young people with chronic conditions are interested in finding peers with similar conditions through social media. There is a gap in the literature regarding how young people with chronic conditions use their social media in relation to their condition. The purpose of this commentary is to discuss social media use in adolescents and young adults with connective tissue disorders (CTDs) and to explore future avenues for social media research in this population.


BACKGROUND
A mass spectrometry-based assessment of methicillin resistance in Staphylococcus aureus would have huge potential in addressing fast and effective prediction of antibiotic resistance. Since delays in the traditional antibiotic susceptibility testing, methicillin-resistant S. aureus remains a serious threat to human health.

RESULTS
Here, linking a 7 years of longitudinal study from two cohorts in the Taiwan area of over 20 000 individually resolved methicillin susceptibility testing results, we identify associations of methicillin resistance with the demographics and mass spectrometry data. When combined together, these connections allow for machine-learning-based predictions of methicillin resistance, with an area under the receiver operating characteristic curve of >0.85 in both the discovery [95% confidence interval (CI) 0.88-0.90] and replication (95% CI 0.84-0.86) populations.

CONCLUSIONS
Our predictive model facilitates early detection for methicillin resistance of patients with S. aureus infection. The large-scale antibiotic resistance study has unbiasedly highlighted putative candidates that could improve trials of treatment efficiency and inform on prescriptions.


Lung donation is the most risky transplant procedures. With low survival rates, and poor acceptance of donated lungs, those in need of a lung transplant are at high risk of dying. One reason for poor outcomes is the lack of optimal match between donor and recipient when it comes to lung size and shape. Lungs that do not properly fit in the recipient's chest cavity can fail to inflate fully and quickly start to deteriorate. In such patients, lung contusions can form, edema occurs in healthy lung tissue, and overall lung function declines. To improve patient outcomes after lung transplant, we describe here a developed a computational pipeline which enables donor lungs to be properly matched to recipients. This tool uses CT scans from both the donor and potential recipients to calculate how anatomically different the sets of lungs are, and therefore provide improved matches in both size and shape for the donor lungs.


The aim of the article is to explore and explain some of the controversies around home uterine monitoring, using a socio-technical interaction networks (STIN) approach. A Cochrane systematic review identified 15 included studies. A critique of these studies, using the eight components of the STIN framework, illustrated very clearly the different assumptions made about the purpose of home uterine monitoring, and helped to explain the different outcomes. The final mapping stage suggested that systems architecture choices included that of the role of monitoring support, to complement patient education or to enhance education for provider and patient. A similar choice concerned the type and extent of patient—care-provider contacts to be used. Using the STIN framework provided a useful perspective on the telemedicine aspects of home uterine monitoring, providing value beyond the systematic review conclusions alone.


The process of magnetization reorientation in a ferromagnetic semiconductor GaMnAs films was investigated using planar Hall effect measurements. In addition to the well-known two-step switching behavior that occurs during this process, we have observed two additional distinct features in field scan data of the planar Hall resistance (PHR). First, the region of the external field required to begin and complete the reorientation of magnetization from one easy axis to another strongly depends on the direction of the applied field. And second, the maximum amplitude of PHR is significantly reduced during magnetization reversal when the applied field is oriented near one of the easy axes of the GaMnAs film. We provide an explanation of these phenomena using the magnetic field dependence of the free-energy density and assuming the coexistence of multiple domains with three different directions of magnetization in the sample.


A new MLC NAND page architecture is presented as a breakthrough solution for sub-40-nm MLC NAND flash memories and beyond. To reduce cell-to-cell interference which is well known as the most critical scaling barrier for NAND flash memories, a novel page architecture including temporary LSB storing program and parallel MSB program schemes is proposed. A BL voltage modulated ISPP scheme was used as parallel MSB programming in order to reduce cell-to-cell interference caused by the order in which the cells are programmed. By adopting the proposed page architecture, the number of neighbor cells that are programmed after programming a selected cell in BL direction as well as their amount of T/th shift during programming can be suppressed largely without increasing memory array size. Compared to conventional architecture it leads to a reduction of BL-BL cell-to-cell interference by almost 100%, and of WL-WL and diagonal cell-to-cell interferences by 50% at the 60 nm technology node. The proposed architecture enables also to improve average MLC program speed performance by 11% compared with conventional architecture, thanks to its fast LSB program performance.


Dual arm work machine that consists of hydraulic excavator is expected for transportation of long objects such as steel stocks and destruction of concrete walls by cooperating dual arm. However, cooperation of two or more arms generates overload in a work object and arms. Because the arms form closed-loop through the work object, refuge of internal force disappears. In this paper, a nondestructive dual manipulation technique for reducing working load is designed using indirect force control that applies in a part of one arm. Operator's positioning accuracy in transportation of long object is measured by a front structure of the hydraulic excavator. From the results, permissible positioning error in nondestructive dual manipulation is clarified. Moreover, load of working object is reduced by indirect force control by using hydraulic circuit with accumulator. Target mechanical impedance is maintained by combining hydraulic circuit with adaptive control in hydraulic system that changes the load characteristic while working. Transportation work experiment of long object is conducted by using the lifter that corresponds to positioning control manipulator and the hydraulic excavator that applies the force control system. Working load has decreased to 20% of maximum working load of the front structure of the construction machinery. Usable range of nondestructive manipulation is clarified by a chart that shows relations between expected load decrease and target mechanical impedance characteristic decided with the work object. Therefore, nondestructive dual arm manipulation of the construction machinery can be achieved by using the mechanical impedance adjustment with combination of the hydraulic circuit and the adaptive control.


OBJECTIVE
To determine how graduating medical students perceive instructional settings, materials, and teachers as to importance or influence upon their education and how they would change curriculum and allocate educational resources based on their experience.

MATERIALS AND METHODS
One hundred thirty-nine graduating medical students at the University of Wisconsin, Madison were offered five dollars to complete and return the survey. Students were asked to rate the importance or influence (1 = most important or influential, 5 = least important or influential) of more than forty educational settings, materials, teachers, and which aspects of the curriculum should be emphasized or preserved when educational resources become more limited. Open-ended responses were also allowed. Ratings were analyzed determining a mean and standard deviation. One way analysis of variance was used to determine whether there were differences among groups. When statistically significant differences existed, the Tukey HSD test was used to compare subsets of the group. In the only group with a dissimilar number of responders, T tests were used for comparison.

RESULTS
Sixty-four of 139 (46%) surveys were correctly completed and returned. Students rated the most important and influential parts of their education as experiences in years 3 and 4 of medical school. The most highly rated group of teachers were resident physicians (mean rating = 1.64, F (df = 343) = 12.55, p < .0001) during years 3 and 4 of medical school, followed by full time clinical faculty in years 3 and 4 (mean = 1.78), full time basic science faculty in years 1 and 2 (mean = 1.98), community physicians in years 3 and 4 (mean = 2.15), and teaching assistants in years 1 and 2 (mean = 2.75). Students rated the preservation of teaching efforts in years 1 and 2 (mean = 3.06), developing objective structured clinical examinations (mean = 3.21), and administering "board type" end of course examinations (mean = 3.42), as the lowest priority items for receiving educational resources. Coordination of the basic science and clinical years of medical school (mean = 2.03), problem based learning (mean = 2.08) and preserving teaching effort of years 3 and 4 clinical faculty (mean = 2.09) were the highest priorities for receiving resources. Open-ended comments indicated years 1 and 2 should be condensed and coordinated with years 3 and 4, making learning more clinically oriented.

CONCLUSIONS
Students at the end of their medical school education at the University of Wisconsin rate the clinical portions of their training as most important to their medical education and residents as their most important teachers. When asked how best to change medical education, their most common responses were to 1) make years 1 and 2 more clinically oriented, both by including patient care earlier and more often during those years, 2) take the repetitiveness out of the years 1 and 2 curriculum and 3) prepare students for years 3 and 4 with transitional classes.


In various countries, offset policies allow economic developments to proceed on condition that proponents undertake agreed actions that offset the resulting losses of environmental values. Although ecological and environmental benefits are the main concern of a conservation agency when assessing an offset proposal, it is also important to be aware of the full cost of implementing the offset. However, there is currently a lack of understanding of the costs of implementing offsets, including which costs are relevant and what their magnitudes are. To address this knowledge gap, we developed a typology of costs that are relevant to offset schemes. We searched the publicly available information on costs of offset activities for thirty-four threatened species and communities in Australia to apply our cost framework. The results indicate that cost information is lacking in many cases. Information about some of the cost categories is not available for any of the species (e.g., induced costs to other areas or sectors). It is not clear whether the unreported cost categories are not considered during negotiation or whether it is just a case of lack of reporting.


The Punden of Mbah Sentono is a sacred landscape that is used frequently by people to increase their spirituality. It is recognized as a sacred place to perform rituals such as tahlilan, slametan and ruwatan desa. The main issue I raise in this paper concerns the social-political significance of the rituals. The three main questions are, first, how is ruwatan practiced in the Punden of Mbah Sentono? Second, how have political actors used the ritual in the punden as a political tool in an election? The last, how have people also used the ritual in the punden to counter the political actors' use the ritual? I will show that the rituals do have social-political significance and argue that both political actors and people in society have mutual relations through the rituals. From this point of view, I state that ritual in the Punden of Mbah Sentono is divided into two time periods, "during election period" and "after election period". "The ritual during election period" are tahlilan and slametan which are handled by the candidates of the local election to build political support, whereas "the ritual after election" is ruwatan desa which is also used by the winner for negotiation and reconciliation to ease the negative impacts of the competitions during the local election, which affect people. On the other hand, people also use the rituals to ask for financial support from the candidates for holding big ruwatan desa and kirap. In the years before and after the election, ruwatan desa is held as small events. In this research, I analyze the social-political significance of ritual, using a theoretical framework informed by Kertzer.
[Punden Mbah Sentono adalah tempat sakral yang sering digunakan sebagai tempat spiritual oleh orang-orang untuk meningkatkan spiritualitas mereka. Punden tersebut diakui sebagai tempat sacral untuk melakukan tahlilan, slametan dan ruwatan desa. Isu utama yang saya angkat didalam tesis ini adalah siknifikansi social-politik pada ritual. Ada tiga pertanyaan utama; yakni, pertama,  bagaimana ruwatan desa ritual dipraktekkan di punden Mbah Sentono? kedua, bagaimana actor politik menggunakan ritual didalam punden sebagai alat politik didalam pemilihan? Terakhir, bagaimana masyarakat menggunakan ritual di punden untuk keluar dari actor politik? Saya akan menunjukkan bahwa ritual mempunyai siknifikansi social-politik dan beranggapan bahwa actor politik dan masyarakat mempunyai hubungan timbal balik melalui ritual.]


This thesis has three main objectives; first, it assesses and evaluates cost and profit efficiencies of the European Union banking system by employing the stochastic frontier analysis (SFA) over the period 2004-2010. It divides the EU region into four groups; the entire EU region, the old and the new EU countries as well as the GIIPS countries. Second, this study investigates the determinants of bank cost and profit inefficiencies with the focus mainly being on the role of banking risks and the world financial crisis (2007-2009) in affecting banking efficiency. Third, this thesis evaluates the impact of different variables on bank stock returns, with the emphasis on bank efficiency, risk and the world financial crisis, over the period 2004-2010. The empirical findings show that commercial banks in the EU improve their cost and profit efficiencies on average between 2004 and 2010. Also, banks in the old EU countries appear to be more cost efficient but less profit efficient compared to banks in the new EU countries. Interestingly, the empirical analysis concludes that overall insolvency, credit and liquidity risks have significant and positive effects on bank cost and profit inefficiencies during the world financial crisis, suggesting that banks that maintain less risk outperform their counterparts during crisis time. The world financial crisis appears to affect negatively both cost and profit efficiencies of EU banks; however, it has stronger negative effect on banks in the old EU member states than in the new EU countries. Finally, the results show that changes in cost and profit efficiencies along with capital and size variables appear to have a positive and significant influence on bank stock performance in the EU and that bank stock returns are significantly sensitive to market and interest rate risks.


This paper presents performance of Quasi-Cyclic low-density parity-check (QC-LDPC) codes on a flat Rayleigh fading channels by employing DPSK modulation scheme. The BER curves show that large girth and diversity level robust the system performance. Moreover, Prototype architecture of the LDPC codes has been implemented by writing Hardware Description Language (VHDL) code and targeted to a Xilinx Spartan-3E XC3S500E FPGA chip. Simulation results show that the proposed QC-LDPC codes achieve a 0.1dB coding gain over randomly constructed codes and perform 1.3 dB from the Shannon-limit at a BER of 10−6 with a code rate of 0.89 for block length of 1332.


We introduce a novel algorithm for solving learning problems where both the loss function and the regularizer are non-convex but belong to the class of difference of convex (DC) functions. Our contribution is a new general purpose proximal Newton algorithm that is able to deal with such a situation. The algorithm consists in obtaining a descent direction from an approximation of the loss function and then in performing a line search to ensure sufficient descent. A theoretical analysis is provided showing that the iterates of the proposed algorithm admit as limit points stationary points of the DC objective function. Numerical experiments show that our approach is more efficient than current state of the art for a problem with a convex loss function and a non-convex regularizer. We have also illustrated the benefit of our algorithm in high-dimensional transductive learning problem where both loss function and regularizers are non-convex.


A series of polypropylene (PP) nanocomposite fibres containing respectively 0, 0.5, 1, 3, and 5 wt% ZnO nanoparticles (NPs) were prepared by melt spinning. The antimicrobial activity of these fibers against Staphylococcus aureus (ATCC 6538) as a Gram-positive bacterium and Klebsiella pneumoniae (ATCC 4352) as a Gram-negative bacterium was evaluated. It was confirmed by scanning electron microscopy that the dispersion of the NPs within the PP matrix was homogeneous. Although such homogeneity the fibers are unable to exhibit antimicrobial activity. The absorption properties of the fibers was then investigated and found to be inadequate, so cold plasma and chemical finishing were applied to improve their absorptivity. After this treatment the PP/ZnO nanocomposite fibers exhibited increasing antimicrobial effectiveness with filler content. In addition, mechanical and thermal characterization tests showed that increasing concentration of ZnO–NPs improved the mechanical properties of the fiber due to the interface between the matrix and the nanoparticles sharing the stress. The crystallinity of the fibers was found to decrease by about 7% as the level of ZnO increased to 5%. This was attributed to the more rapid cooling experienced in the presence of ZnO particles of high thermal conductivity.


The purpose of this paper is to develop a mathematical optimization model that can be used as a decision support tool for the supply chain planning at Perstorp Oxo AB, a global company in the process industry. At their site in Stenungsund, Perstorp Oxo AB produce chemicals to customers in a variety of branches and for further refinement at other Perstorp sites in Gent, Castellanza and Perstorp. The customers are mainly in branches such as food and feed, leather and textile, plastic and safety glass production. Since Perstorp Oxo sells products to customers worldwide, two large inventory facilities are located in Antwerp (Belgium)and Tees (United Kingdom) for five product types each and two smaller facilities in Philadelphia (USA) and Aveiro (Portugal) for one type respectively. The developed model is a mixed-integer linear program, where the objective function maximizes the profit margin, that is, the difference between the selling price and the cost of production, transportation, inventory carrying and outsourcing. A solution to the model shows the quantities to be transported between the different sites, production rates, inventory levels, setups and purchases from external suppliers, each with its respective cost. The results of a baseline scenario show that there is a potential to increase profit margin by using a decision support tool based on an optimization model.


The most common connection in historic green oak framing
vernacular architecture is the all-timber pegged mortice and
tenon joint. This paper outlines a series of tests completed to
investigate the pull-out, bending and shear behaviour of the
mortice and tenon joint. Initially strength and stiffness
characteristics of different peg types subject to pull-out (joint
tension) loading and the effect of fit tolerance on pull-out
performance of mortice and tenon joints are reported.
Thereafter joint moment resistance and shear capacity tests
are reported and links between the pull-out performance and
rotational stiffness discussed. Finally, a series of braced subframe
tests are reported, to which upper-bound plasticity
theory is successfully applied to predict collapse load.


Coastal lagoons where salinity varies within a wide range during the year are colonized by euryhaline macrophytes which can develop extensive beds. Seasonal changes in biomass of Ruppia cirrhosa and Potamogeton pectinatus were studied in Tancada Lagoon (Ebro Delta, NE Spain) in order to reveal the environmental factors controlling their population development. Ruppia cirrhosa occupy a larger area of the lagoon than Potarnogeton pectinatus. Their maximum above ground biomasses are also different (495 g m-2 and 351 g m-2 ash free dry weight, respectively). Below ground biomass of Ruppia cirrhosa is between 9 and 53 % of the above ground biomass, while it is 3-40 % for Potamogeton pectinatus. Chlorophyll a contents show fluctuations similar to biomass. Low salinity and high turbidity caused by freshwater inflows favour Potamogeton expansion, while Ruppia development is favoured by high salinity and transparent water.


This article utilizes economies of visibility to interpret how two UK women political leaders' bodies are constructed in the press, on-line and by audience responses across several media platforms via a multimodal analysis. We contribute politicizing economies of visibility, lying at the intersection of politics of visibility and economies of visibility, as a possible new modality of feminist politics. We suggest this offers a space where feminism can be progressed. Analysis illustrates how economies of visibility moderate feminism and tie women leaders in various ways to their bodies; commodities constantly scrutinized. The study surfaces how media insist upon femininity through appearance from women leaders, serving to moderate power and feminist potential. We consider complexities attached to public consumption of powerful women's constructions, set up in opposition, where sexism is visible and visceral. This simultaneously fortifies moderate feminism and provokes feminism. The insistence on femininity nevertheless disrupts, through an arousal of audible and commanding feminist voices, to reconnect with the political project of women's equality.


A curious type of nonlocal phenomenon known as one-way quantum steering has been demonstrated experimentally for the first time by two independent groups of physicists. This phenomenon is similar to quantum entanglement but applies when one of the two parties sharing a quantum state does not trust the source of quantum particles. The researchers say their work could help to broaden applications of quantum cryptography. [12]


Public administration scholars have argued the need for a 'general theory' linking strategic management to the context in which public organizations operate. Understanding the interplay between organizational contexts and strategic management responses to urban sprawl and greenhouse gas (GHG) emissions remains an underexplored avenue for empirical advancement of this goal. Using 2015 survey data, we employ a novel Bayesian item response theory (IRT) approach to test how land use policy comprehensiveness, organizational capacities, leadership turnover, and environmental complexities affect the strategic management of smart growth policy in local governments. We find that public organizations harness political, administrative, and community capacities in varied combinations to better achieve their policy objectives, but these influences may not be complementary. Also, policy comprehensiveness generally relates to more strategic activity, while municipal executive turnover offers opportunities and threats to some smart growth strategies. Implications of this research are discussed.


Financially rewarding farmers is an unconventional approach to agricultural extension. We evaluate an extension program, primarily delivered through farmer discussion groups, which rewarded farmers with conditional payments. Combining a matching model with a difference-in-difference estimator to data from the Irish National Farm Survey, we found that there was no significant impact on farm performance from the extension program over a four year period. The results align with previous research and would suggest that financial incentives in the form of conditional payments are not an ideal strategy for agricultural extension or technology adoption.


Overview: Ziauddin Yousafzai is a man who was born and raised in Pakistan. He is a devout Muslim and takes pride in two things – his family and education. He is responsible for the building and running of multiple schools in the Swat Valley – for both boys and girls. His daughter has won multiple awards in school for her work and speeches. Their nation is not perfect, and that certainly needs reform, but Ziauddin believes that education can solve these problems. His life and the lives of his family and friends move on until one word stops everything – Taliban. Suddenly, radicalization is spread throughout his home. This group who is spilling over from Afghanistan gains a substantial amount of support at the very beginning – but who can blame them? The Pakistani government is corrupt and does nothing for its people. Change is something anyone would want. Besides, to Ziauddin and many other people of Pakistan, the Taliban does not seem like a severe threat at first. They preach a return to more focused practices of the teachings of the Quran. While fear is still there, no one in Pakistan is able to predict what might happen next. Suddenly, as if overnight, he is forced to watched as schoolhouses are bombed, people are executed in the streets the Taliban has taken over Swat Valley. He remains adamant about all of his children, including his daughter, receiving education and does what most are too afraid to do – he speaks out publicly against the Taliban. While his efforts are valiant, they prove to be useless as the government does little to rescue his home from the invading extremists. Tensions rise, and the violence escalates until he finds himself on a one-way flight to Birmingham, England to stay with his daughter, Malala, as the entire world reacts in shock that even the Taliban would shoot a fourteen-year-old girl simply for going to school. Situations such as the one told above have almost become the norm within not only Pakistan, but Afghanistan as well. Unfortunately, not as many people are lucky and survive the onslaughts as Malala and her father did. For decades, the Taliban has been rising to power in these two Middle Eastern nations. Their extremist views have gained international attention and condemnation and are also responsible for the deaths of thousands of innocent citizens during the War in Afghanistan and their invasion of Pakistan. While they have been around since the Cold War, it seems to most the Taliban has exploded into power and influence, especially during the late 20th century and into the 2000s. When the mountainous geography of both nations and the amount of power and influence the Taliban held over people is explored, it is easy to see how a small militia of a few hundred grew so quickly and became one of the largest terrorist threats in the world.


Anesthesiologists' perspectives on US health care finance reform are increasingly germane to recent policy reforms. The aim of this follow-up survey was to examine how anesthesiologists' views of health care costs and future practice roles have changed since 2014. Six thousand randomly chosen active members of the American Society of Anesthesiologists were again surveyed and were also asked several new questions regarding specialties and perioperative management. Results showed an increase in self-reported understanding of the perioperative surgical home. Government, insurance companies, and pharmaceutical companies saw an increase in perceived "major responsibility" for cost reduction. Respondents vastly preferred that patient care under the perioperative surgical home be multidisciplinary.


Abstract This paper sheds light on some unexpected consequences of health insurance regulation that may pose a big challenge to insurers' risk management. Because mandated uniform contributions to health insurance trigger risk‐selection efforts, risk adjustment (RA) schemes become necessary. A good deal of research into the optimal RA formula has been performed. A recent proposal in Switzerland has been to add 'Hospitalization exceeding three days during the previous year' as an indicator of high risk. Applying the new formula to an individual Swiss health insurer, its payments into the RA scheme are predicted to increase substantially, reaching up to 13% of premium income. Its mistake had been to implement Managed Care successfully, resulting in low rates of hospitalization. The expected risk management response is to extend hospital stays beyond three days, contrary to stated policy objectives.


Three cyclin cDNA clones (Ntcyc25, Ntcyc27, Ntcyc29) have been isolated from tobacco (Nicotiana tabacum) using the PCR cloning method. The encoded Ntcyc cyclins were highly homologous to mitotic cyclins. In synchronized tobacco suspension cultured cells, the mRNA levels of Ntcyc25 and Ntcyc27 were detectable through S, G2 and M phases, while the Ntcyc29 mRNA was detected from G2 to M phase. These expression patterns classified the Ntcyc25 and Ntcyc27 into A-type cyclin and Ntcyc29 into B-type cyclin. The three genes were expressed in growing tobacco cultured cells but ceased to be expressed when cells entered the stationary phase, indicating that the expression of these cyclin genes was well correlated with cell growth. The N-terminal truncated Ntcyc25 and Ntcyc29 cDNAs were able to rescue G1 cyclin mutant of Saccharomyces cerevisiae, while the full-length of Ntcyc27 protein could also partially perform G1 cyclin functions.