This thesis mainly addresses two issues: 1) to investigate how to perform the lip segmentation without knowing the true number of segments in advance, and 2) to investigate how to select the local optimal observation scale for each structure from the viewpoint of lip segmentation effectively. Regarding the first issue, two number of predefined segments independent lip segmentation methods are proposed. In the first one, a multi-layer model is built up, in which each layer corresponds to one segment cluster. Subsequently, a Markov random field (MRF) derived from this model is obtained such that the segmentation problem is formulated as a labeling optimization problem under the maximum a posteriori-Markov random field (MAP-MRF) framework. Suppose the pre-assigned number of segments may over-estimate the ground truth, whereby leading to the over-segmentation. An iterative algorithm capable of performing segment clusters and over-segmentation elimination simultaneously is presented. Based upon this algorithm, a lip segmentation scheme is proposed, featuring the robust performance to the estimate of the number of segment clusters. In the second method, a fuzzy clustering objective function which is a variant of the partition entropy (PE) and implemented using Havrda-Charvat's structural α-entropy is presented. This objective function features that the coincident cluster centroids in pattern space can be equivalently substituted by one centroid with the function value unchanged. The minimum of the proposed objective function can be reached provided that: (1) the number of positions occupied by cluster centroids in pattern space is equal to the truth cluster number, and (2) these positions are coincident with the optimal cluster ii centroids obtained under PE criterion. In the implementation, the clusters provided that the number of clusters is greater than or equal to the ground truth are randomly initialized. Then, an iterative algorithm is utilized to minimize the proposed objective function. The initial over-partition will be gradually faded out with the redundant centroids superposed over the convergence of the algorithm. For the second issue, an MRF based method with taking local scale variation into account to deal with the lip segmentation problem is proposed. Supposing each pixel of the target image has an optimal local scale from the segmentation viewpoint, the lip segmentation problem can be treated as a combination of observation scale selection and observed data classification. Accordingly, a multi-scale MRF model is proposed to represent the membership map of each input pixel to a specific segment and local-scale map simultaneously. The optimal scale map and the corresponding segmentation result are obtained by minimizing the objective function via an iterative algorithm. Finally, based upon the three proposed methods, some lip segmentation experiments are conducted, respectively. The results show the efficacy of the proposed methods in comparison with the existing counterparts.


CASE HISTORY: 27-year-old male complains of newly worsening left shoulder pain after playing an intense basketball tournament over the weekend. He denies a single incident that caused his pain and was able to finish playing the tournament. Patient is a recreational basketball player and has a daytime desk job. He complains of having pain while trying to sleep on the left shoulder, hence he only slept on his right shoulder. PHYSICAL EXAM: Physical examination revealed a slight loss of motion in the left shoulder. No palpatory tenderness of the left shoulder was identified. However, patient experienced pain with end-range abduction and flexion rotations of the left shoulder. DIFFERENTIAL DIAGNOSES: Glenohumeral subluxation, shoulder impingement, rotator cuff disease, rotator cuff tear, shoulder instability. TESTS & RESULTS: The patient was referred to a magnetic resonance imaging (MRI) by an orthopedic surgeon. The MRI findings revealed a Superior Labrum Anterior and Posterior (SLAP) lesion of the labrum. FINAL DIAGNOSIS: Left shoulder labrum tear. DISCUSSION: SLAP tear of the shoulder is considered relatively rare pathology. Only 6% of shoulder arthroscopies are related to this pathology. The most common SLAP tear is type II tear, which is 55% of all SLAP tears. This type of tear is prevalent in overuse shoulder injuries that occurs mostly in athletes whose sports require repeated external rotation and abduction of the shoulder followed by rapid overhead movement such as throwing and serving. This type of injury is very common in sports, such as baseball, volleyball, swimming, etc. Trends in SLAP repair show higher incidence in men (75%) than in women, and higher incidence in ages 20-29 (29.1 per 10000) then in ages 40-49 (27.8 per 10000). OUTCOME OF THE CASE: After eight weeks of scapular stabilization, scapulo-thoracic mobilization, and soft tissue mobilization treatments the patient showed a small improvement; however, it did not cause significant alleviation of symptoms. The patient was referred to an orthopedic surgeon, specializing in sports injuries. After the MRI revealed the SLAP tear, the treating physician suggested either cortisone or PRP (platelet-rich plasma) injections in addition to 12week rehabilitation program similar to the pre-diagnosis protocols. Patient chose to receive two PRP injections one month apart, which improved his pain level and functionality significantly, and assisted in his adherence to his rehabilitation program. RETURN TO ACTIVITY AND FURTHER FOLLOW-UP: Patient is almost completely symptom free and returned to normal activity.


Introduction: Obesity has become a serious health problem. It is nowadays considered a pandemia nad it is therefore a priority to develop different strategies on its prevention and treatment: lifestyle changes, community interventions as well as pharmacological and non-pharmacological activities. In this way, meal replacement products (energy reduced products designed to replace one or two regular meals providing a supously nutritionally balanced low fat meal) can be an alternative to traditional reduced calorie diet.
Objective: Our aim was to revise the literature on meal replacement and compare the nutritional composition and the different forms of presentation of the main meal replacement products commercialised in Spain.
Methodology: We made a research in pharmacies, weight loss centers and big supermarkets of food products specially designed to replace a meal. We compared the nutritional composition regarding macronutrients and micronutrients of the thirty-two different products founded, including their different form of presentation (bars, powder, drink-shakes and crackers). In order to judge their nutritional composition, we compared one meal replaced with these products with the Recommended Dietary Allowances (RDA).
Results: The most common form of meal replacement products were bars (23 of 32 analyzed products), followed by powder for making shakes (6 products), bricks (2 products) and crackers (1 product). When we analysed a single meal replaced with these products, we founded that the global distribution of macronutrients was: 45% as carbohydrates, 29% as fats, 26% as proteins, and 4.45 grams of fiber. Their average energy was 266 Kcal per meal. Regarding micronutrients (vitamins and minerals), there was a great variability among the different products, but in average their composition was above the 33% of the RDA per meal specially in iron and vitamins B1, B6 and D. Calcium, magnesium, folic acid and vitamin B12 were the micronutrients less plentiful.
Conclusion: Partial meal replacement can be an alternative or a complementary therapeutic option to conventional hipocaloric diets in obesity since they appear to have an easier understanding and follow up. It is therefore important to consider them in weight management programs and more studies are required to establish strict criteria on their nutritional composition by a legal normative.


PURPOSE
To evaluate the reproducibility of liver tumor attenuation measurement performed by using the routinely used manual region-of-interest (ROI) method and that of measurement performed by using a semiautomated volumetric approach at computed tomography (CT).

MATERIALS AND METHODS
This HIPAA-compliant retrospective study had institutional review board approval. The requirement for patient informed consent was waived. Attenuation of colon cancer liver metastases in 208 patients was measured on portal venous phase multidetector CT images by using a single ROI, the average measurement in three ROIs on a single section, and with semiautomated segmentation of the entire tumor volume (volumetric attenuation) to evaluate intermethod agreement. Intraobserver and interobserver reproducibility were evaluated in the first 70 patients. Measurements were repeated after 30 days to assess intraobserver reproducibility. Differences between methods were tested by using repeated-measures analysis of variance. Intermethod, intraobserver, and interobserver agreements were tested by using Bland-Altman analysis and the Lin concordance correlation coefficient (ρc). P < .05 was considered to indicate a significant difference.

RESULTS
A total of 208 pathologically proven colon cancer hepatic metastases larger than 20 mm in diameter in 100 women and 108 men (mean age, 61.6 years ± 11.6 [standard deviation]; range, 28-87 years) were evaluated. Attenuation was significantly different between the three methods of measurement (P < .001 for all). Volumetric measurements had better intraobserver agreement (precision = 3.3%, ρc = 0.996, P < .001) than single-ROI measurements (precision = 12.0%, ρc = 0.947, P < .001) and measurements averaged over three ROIs (precision = 9.3%, ρc = 0.965, P < .001). Volumetric measurements also had better interobserver agreement (precision = 3.6%, ρc = 0.993, P < .001) than single-ROI measurements (precision = 11.3%, ρc = 0.957, P < .001) and the average measurement in three ROIs (precision = 8.5%, ρc = 0.976, P < .001).

CONCLUSION
Measurements of hepatic tumor attenuation at multidetector CT are reproducible. An approach based on the evaluation of whole-lesion attenuation demonstrated better reproducibility than ROI measurements.


This case study has focused on akhlaq of the principals' in primary Islamic School, how they displayed understanding, feeling, and experience of akhlaq in surroundings of four principal's Islamic primary school at Malang Indonesia. This case study utilized the qualitative approach design. Four principals, three from an urban and one from a rural area, were selected. Data were collected over nine months. The inquiry into akhlaq of the principals' through the way caring was displayed in surroundings of four Islamic primary schools, as well as akhlaq acting was carried out by non-participant observation, unstructured interviews, documentation and principals' journals. Data were analyzed using manual qualitative technique where codes were identified and themes were derived in order to answer the research questions.
The findings of this study presented three major themes of understanding, appreciation and experience that has been conducted by the teacher in terms of probation as follows. Moral understanding of the relationship of the teacher understanding and practice, according to mahmudah morality based on al-Quran and as-Sunnah, mazmumah morality in conflict with al-Quran and as-Sunnah. Moral practice that has been emphasized is to appreciate the kindness of others, courtesy, charity, concern for the poor, cleanliness, discipline and honesty. The understanding of the procurement process in the practice of moral habituation; reasoning, research, and religiosity; and development of the mind. While the process of improving the Islamic ethic of goodness, cautious continuously of good practice, muraqabah, struggle, Tazkiyah al-nafs, with good friends, reading the Quran, and religious practices. It is not yet apparent relationship between faith and morality as founded by al-Ghazali. Appreciating moral teacher appreciation that had appeared on a muraqabah like prayer, studying the Quran and other such reflection realized the mistake and others. Experience a great moral teacher of moral experience providing teachers with struggle, demonstrations, uswah hasanah (best example).
The overall findings of this study revealed that understandings, feeling and experience of akhlaq is not integrated, as how caring should be, as propagated by al-Ghazali. The study implied that the principals needed improvement in their understandings, feelings, and experiences in akhlaq acting in the midst of their followers. There should also be a change in the mode of the state and private examination based on Islamic ethics (akhlaq values) as principals need to be developed in a holistic manner, and the need for appropriate professional development on akhlaq values in the preparation, training and selection of principals. Lastly, an integrated and interactive approach that includes akhlaq values in developing principals' competencies holistically is suggested to provide principals opportunities in experiential leading to develop relevant skills, besides acquiring knowledge, to better equip them to face their everyday and Islamic schools future lives.


Rhode Island's adoption of the Next Generation Science Standards in 2013 [1] established a pressing need to provide elementary schools with support for integrating engineering in our local district's classrooms. Wind energy was identified as an appropriate instructional topic, both for its relevance to Rhode Island [2], and for its strength as a tool for studying the engineering design process. Education and engineering undergraduates collaborated to educate local fourth graders about engineering design and wind energy. While supporting the need for engineering education in the community, this project also deepened learning for both education and engineering students at Roger Williams University.


Hip adductor spasticity and strength in participants with cerebral palsy (CP) were quantified before and after selective dorsal rhizotomy (SDR) and intensive physical therapy. Twenty-four participants with cerebral palsy (CP group) and 35 non-disabled participants (ND controls) were tested with a dynamometer (OP group: mean age 8 years 5 months, 13 males, 11 females; ND group: mean age 8 years 6 months, 19 males, 16 females). According to the Gross Motor Function Classification System (GMFCS), of the 24 participants with CP, eight were at level I, six were at level II, and 10 participants were at level III. For the spasticity measure, the dynamometer quantified the resistive torque of the hip adductors during passive abduction at 4 speeds. The adductor strength test recorded a maximum concentric contraction. CP group spasticity was significantly reduced following SDR and adductor strength was significantly increased after surgery. Both pre- and postoperative values remained significantly less than the ND controls. Spasticity results agreed with previous studies indicating a reduction. Strength results conflicted with previous literature subjectively reporting a decrease following SDR. However, results agreed with previous objective investigations examining knee and ankle strength, suggesting strength did not decrease following SDR.


Hazard Analysis Critical Control Point (HACCP) is a protective approach alarmed with not only food manufacturing but also storage safety. Now-a-days this system has become vital tool for dealings involving different types and kinds of foodstuffs. This perseverance was to established exact HACCP proposal for Bangladeshi chicken nugget manufacturing plant in a current poultry processing plant in Kishoreganj, Dhaka. A precise broad HACCP model was established to develop consumption security and quality of chicken nugget processed in this manufacturing plant. This study was based on genuine circumstances in the chicken nugget manufacturing plant, HACCP's seven principles and several current general models such as Bangladesh Standards & Testing Institution (BSTI), HALAL, ISO 9001:2015, and ISO 22000, YUM Quality Systems Audit of HACCP utilize through investigation which is also known as qualitative methodology. Under taking the consideration all factors of HACCP such as flow-chart, corrective action, verification procedures, Critical control point monitoring requirements and record-keeping were originated, a HACCP team established in the factory. Three Critical control points (CCP) were acknowledged in the manufacture of chicken nugget in this processing plant. The most important identified CCPs were Supply of ingredients and raw material; packaging material; Proper temperature and time for oil frying and proper examination during packing for foreign and unwanted materials of final product. Therefore, HACCP system should be established in each and every poultry processing facilities, recommended by author. Case Study Asaduzzaman; AFSJ, 20(5): 11-24, 2021; Article no.AFSJ.67061 12


PAGE This dissertation re-conceptualizes the scandals that engulfed the intelligence community in the mid-1970s. The Central Intelligence Agency (CIA) confronted an unprecedented crisis during these years: the Pike hearings in the House of Representatives, the Church Committee in the Senate, and an executive branch commission led by then Vice President Nelson Rockefeller. Historians and political scientists have studied these events before, but I present a nuanced interpretation of the intelligence investigations by placing them in a broader political and cultural context. To fully understand the impact of the so-called "Year of Intelligence," I argue that scholars need to focus on what was happening outside of Congress. The CIA encountered a backlash from both ends of the political spectrum. I provide the first history of Counter-Spy, a left wing magazine founded in 1973 that called for the abolition of covert action. The magazine's editors directly challenged the "culture of secrecy" at the CIA by publishing the names of Agency operatives. At the same time, conservatives embarked on a very different confrontation with the Agency. Like CounterSpy, they charged that the CIA was keeping secrets from the American people, but their concern was with Agency analysis of the Soviet Union, not covert action. I also examine Hollywood portrayals of the CIA in this tumultuous era; rather than simply responding to the Congressional investigations and the Rockefeller Commission, filmmakers actually anticipated the widespread concerns about the complex relationship between espionage and democracy. The events of the mid-1970s badly tarnished the CIA's image. In response to this rapid decline in popular support, the Agency developed an aggressive public relations campaign designed to restore confidence in government secrecy and covert operations. This dissertation contains the first systematic history of CIA public relations. The public relations staff has consistently portrayed the CIA as the most open intelligence agency in the world, heroically protecting national security while accepting the necessity of Congressional oversight. But despite these public statements, Agency officials worked to revitalize the "culture of secrecy." They have dramatically restricted the ability of former employees to write critically about CIA activities; they have successfully lobbied Congress for exemptions to the Freedom of Information Act (FOIA); and they have repeatedly broken promises to de-classify historical records. Agency officials have been obsessed with protecting their image, and this obsession has frequently undermined historical research. Robert M. Gates launched an openness initiative in February 1992, but the culture at the Agency was not fundamentally changed. In fact, George Tenet shut down the voluntary de-classification program at the CIA in 1998. A key conclusion of this study is that the "culture of secrecy" at the Agency remains firmly entrenched. Since the CIA cannot be reformed from within, I argue that outside intervention is required.


We have fabricated Au/n-GaAs Schottky barrier diodes with different surface treatments. Prior to Au evaporation on the n-GaAs(100), the first kind of samples has consisted of dip in the 5H2SO4+H2O2+H2O solution and then H2O+HCl solution, followed by a rinse in de-ionized water (sample AuG1), the second kind of sample has consisted of several steps of anodization in aqueous 4C2H6O2+2H2O+0.1H3PO4 electrolyte with pH=2.02 each followed by a dip in diluted aqueous HCl solution and a subsequent rinse in de-ionized water (sample AuG2), and the third kind of samples one anodization step only (MIS sample AuG3). We have found the lowest values of both the barrier heights and ideality factors for the reference sample AuG1. The anodization, on the other hand, has increased the barrier heights as well as the ideality factors. Furthermore, the barrier heights of approximately 0.80, 0.90, and 1.01 eV for the AuG1, AuG2, and AuG3 diodes, respectively, have been obtained adding the contribution due to image force effect.


Summary: The growth on solid medium of organisms of the pleuropneumonia group as seen in electron micrographs was compared with the growth in liquid media described in a previous paper (Klieneberger-Nobel & Cuckow, 1955). There is no evidence of a rigid cell wall in these organisms, a finding consistent with those electron micrographs of growth in liquid media and in light microscopical preparations. The newly formed minimal reproductive units, hitherto never demonstrated in the light microscope except when they have grown to a larger size, are here demonstrated in large numbers as a uniform phase of small, delicate elements, the diameter of which measures c. 100 mμ. in the electron micrographs.


Two cases of auriculotemporal nerve syndrome (Frey's syndrome) presenting as trigeminal tic douloureux are reported. This condition, characterized by gustatory sweating and facial hyperemia, is occasionally associated with pain, which is usually described as aching or burning, and long-lasting. In these two cases, however, a tantalizing gustatory pain occurred in excruciating brief paroxysms. The pathophysiology of the syndrome, with particular reference to pain, and possible treatment modalities are discussed.


Fiber enhanced Raman spectroscopy is introduced for chemically selective and sensitive monitoring of antibiotics in aqueous media. The bandgap of a hollow core photonic crystal was blue shifted, in order to provide low loss light guidance in the important visible range in a water filled central core of the fiber. Such a sensor fiber provides a spectral window for light guidance for a complete Raman spectrum up to 4000 cm−1 with λexc = 532 nm and enables an extremely strong light–analyte interaction within the liquid-filled fiber core. It was shown that a precise optical coupling must be guaranteed, in order to provide strong analyte signals and to avoid background noise. The fiber itself was used as an optical waveguide and also as a miniaturized sample container for antibiotic solutions. A strongly improved analytical sensitivity could be achieved and it was possible to improve the limit-of-detection for the frequently used broad spectrum antibiotic levofloxacin down to clinically relevant concentrations of 20 μM with only 8 nL sample volume in the fiber core. Fiber enhanced Raman spectroscopy has great potential as a new point of care tool for chemical selective and ultrasensitive monitoring of antibiotic levels, enabling rapid dose adjustment in critically ill patients with severe infections, who require individual dosing due to large inter- and intra-individual changes in pharmacokinetic properties.


The present study was conducted during 2011 to compare the gender participation in decision making regarding crop management in district Swabi of Khyber Pakhtunkhwa province, Pakistan. For this purpose, six union councils i.e Ganduf, Kabgani, Ganichatra, Gabasni, Nara Amazi and Menai were selected. Data were collected from 240 male and 240 female respondents randomly selected for the purpose and analyzed using a paired t-test for comparison of gender participation in decision making regarding crop management. The results indicate that overall level of women participation in decision making was lower as compare to men in the study area.This situation reflects a male dominated society. However, the highest difference of gender participation was recorded in decision making regarding land preparation which ranked 1 st with mean difference 0.71 followed by purchase of inputs and marketing of produce which ranked 2 nd and 3 rd with mean difference 0.60 and 0.56, respectively. Likewise, there existed a highly significant difference in the aspects of insect/ pests' identification followed by controlling insect/ pests with local recipes and manually which ranked 1 st , 2 nd and 3 rd with mean difference 0.55, 0.50 and 0.49, respectively. Similarly, there was a highly significant difference between gender decision making in all weed control measures. However, the highest difference was found in the chemical weed control closely followed by manual and cultural weed control measures which were ranked 1 st , 2 nd and 3 rd with mean difference 0.51, 0.50 and 0.47, respectively.However, women enjoyed sufficient authority in decision making regarding some of the farm activities like harvesting of crops, bringing produce to one place, its threshing and storing grain in domestic godowns. The study concludes that overall women participation in decision making regarding crop management was lower than men which may be enhanced by launching development projects to increase agricultural productivity through exploiting available resources by both genders of the society.


A novel technique for the separation of submitochondrial particles from the external medium, an essential procedure in transport studies, was devised. Very low concentrations of heparin (5-10 micrograms/ml) aggregate the particles and permit their rapid sedimentation in a micro-centrifuge. The transfer of activated fatty acids into mitochondria for oxidation depends on the exchange of matrix carnitine for external fatty-acylcarnitine. To study the matrix face of the carnitine/acylcarnitine translocase, inverted submitochondrial particles were prepared and loaded with L-[14C]carnitine. As found in intact mitochondria, the Km value for L-carnitine was 8 mM, that for palmitoyl-L-carnitine was two orders of magnitude lower, and 11-trimethylaminoundecanoyl-DL-carnitine was a competitive inhibitor. The properties of the carrier exposed to the outer and to the matrix sides of the mitochondrial inner membrane are thus similar.


Myelination, the process by which oligodendrocytes form the myelin sheath around axons, is key to axonal signal transduction and related motor function in the central nervous system (CNS). Aging is characterized by degenerative changes in the myelin sheath, although the molecular underpinnings of normal and aberrant myelination remain incompletely understood. Here we report that axon myelination and related motor function are dependent on BubR1, a mitotic checkpoint protein that has been linked to progeroid phenotypes when expressed at low levels and healthy lifespan when overabundant. We found that oligodendrocyte progenitor cell proliferation and oligodendrocyte density is markedly reduced in mutant mice with low amounts of BubR1 (BubR1H/H mice), causing axonal hypomyelination in both brain and spinal cord. Expression of essential myelin-related genes such as MBP and PLP1 was significantly reduced in these tissues. Consistent with defective myelination, BubR1H/H mice exhibited various motor deficits, including impaired motor strength, coordination, and balance, irregular gait patterns and reduced locomotor activity. Collectively, these data suggest that BubR1 is a key determinant of oligodendrocyte production and function and provide a molecular entry point to understand age-related degenerative changes in axon myelination.


SRAM in the typical microprocessor consumes a substantial amount of on-chip area and significantly contributes to static power dissipation. This study presents a new SRAM architecture with minimum area that utilizes a modified 6T SRAM cell for sub- and near-threshold operation in ultra-low power applications. This new architecture introduces horizontal bit-lines, mitigates half-select disturb, and supports bit-interleaving. The proposed design's stability was thoroughly tested in the presence of process, temperature, and voltage variations and compared to the standard 6T and traditional
8T cells. A 32kb SRAM block implementing the proposed architecture was designed, simulated, and compared to a traditional 8T SRAM cell block. The results show that the proposed design has lower power consumption than the 8T SRAM block, comparable read performance, and better write performance. This was all achieved while only having a 10\% increase in area per bit over the conventional 6T thin-cell layout.


Stresses that the multimedia nature of the next
generation of digital libraries requires the digital librarians
(DL) to be essentially a type of specialist librarian who has
to manage and organize the digital library, handle the
specialized tasks of massive digitization, storage, access,
digital knowledge mining, digital reference services,
electronic information services, search co-ordination, and
manage the archive and its access. The digital librarian
acts as guardian of the information superhighway/the
universal digital library or the global digital library and
acts as a symbiotic human-machine guru. This article also
highlights the roles and functions of a DL in information
retrieval, content delivery, navigation, and browsing. It
envisages the professional education and training for
digital librarians in the management of digital information
systems. It denotes the DL's interface functions, roles,
skills and competencies for the management of digital
information systems in the important areas of imaging
technologies, optical character recognition, markup
languages, cataloguing, metadata, multimedia indexing
and database technology, user interface design,
programming, and Web technology. This paper finally
advocates and targets the task of creating a new job title
± digital librarian ± to take care of digital libraries and to
manage the digital information system


The content of fibrinogen/fibrin, plasma and cellular fibronectin, the 1st type collagen, laminin and skeletal muscle myosin in the zone of experimental myocardial infarction was studied by the immunofluorescent method. The infiltration of the necrotized cardiomyocytes with fibrinogen/fibrin and plasma fibronectin was observed 3 hours and later after coronary artery ligation. Fibrinogen/fibrin and plasma fibronectin form a "primary matrix" of the granulation tissue in which the fibers of the 1st type collagen are being formed. Cellular fibronectin starts to be synthesized 3 days after the infarct development and its content in the extracellular matrix (ECM) of the granulation tissue increases 7-15 days after the infarction. The amount of the fibronectin in ECM of the scar tissue decreases 30 days after the infarct. Fibrinogen/fibrin is always found in the granulation tissue replacing the myocardial infarction but its content in ECM decreases during the scar formation.


In freeze-fracture replicas of rat cheek epithelium structures representing various forms of keratohyalin granules as seen in stained thin sections have been identified. Discrete spherical granules present in nuclei and cytoplasm are represented in replicas by aggregates of 6 nm particles, and composite granules by similar aggregates associated with a homogeneous component. The observations tend to support the concept of the structural heterogeneity of keratohyalin granules.


This paper examines how the venture capital (VC) model is applied to philanthropic venture capital (PhVC). The key aims of the paper are a) to define PhVC and, by transposing its key elements, i.e., "capital" and "advice and engagement", to provide a clear and precise definition of philanthropic venture capitalists (PhVCs); b) to formulate four main hypotheses aiming to test whether, how, and to what extent the typical for-profit VC model, as described by Gompers and Lerner (2001), can be considered as applied to PhVC as well. By analyzing secondary sources we report preliminary results which show that in the screening phase of PhVC investments and during monitoring activities, PhVCs behave like their for-profit counterparts, i.e., the venture capitalists.


We report on two cases of acute liver injury along with the intake of Greater Celandine (Chelidonium majus), a well-known herbal remedy frequently used for irritable bowel syndrome. All other possible causes of acute liver damage were excluded in both patients. In one patient, cholestatic hepatitis recurred rapidly after involuntary re-exposition. Both patients fully recovered after the withdrawal of Greater Celandine. The two cases add to the existing database about the potential hepatotoxicity of drugs containing Greater Celandine and raise the question whether the approval of this drug should be re-evaluated in the light of lacking evidence for a therapeutic benefit.


ECZEMA is a difficult word to define because it has been applied to a heterogeneous group of disorders. From its Greek derivation, eczema means the "result of boiling out or over." Thus, the weeping, vesiculobullous, acute, poison ivy eruption is clearly a type of eczema, but the term is also used to describe a chronic, localized, lichenified plaque of lichen simplex chronicus in which "boiling over" is hardly descriptive. To deal with this dilemma, many dermatologists simply define eczema as "anything that looks like eczema." In other words, "eczema" is a functional term whose meaning, we hope, will become clearer as its clinical manifestations are discussed. Classification Although a number of classifications have been proposed, none has been generally accepted. Perhaps the simplest and most useful is the following: Contact dermatitis includes (1) allergic and (2) irritant forms. Noncontact dermatitis includes (1) atopic dermatitis and (2) nonatopic dermatitis, eg, lichen


The present thesis argues for heterogeneity and dialogism as inherent strategies at work in novel-writing as praxis. It provides a bifurcated response to the question: how can I write a novel in such a way that it remains true to my sense of form, my sense of language, to the limitations of both, and to my understanding of plural subjectivities?
The first part of the response takes the literary form of a novel, entitled Verses Nature, a postmodern, rebellious conglomerate of genres, in which I put heterogeneity and dialogism to the test. The intention is to sound out the breaking point of the novel, not only to underline
certain limits of the novel as a literary form, but also to explore how this particular literary form positions us as readers.
In order to explore the limits of representation and interpretation, I sought a way to use Verses Nature to break into our coding system to change it from the inside. Codes are not natural, but made. As the title of my work suggests, Verses Nature sets out to interrogate the seemingly natural. What is a novel? What is a genre? What does it mean to read? How do I read? How am I a reader? What do I expect from myself and from the author? I sought to demonstrate that for each of these questions, there is no straightforward answer and that we must first recover from our assumptions. The open-ended structural and semiotic propositions in Verses Nature refuse to play to such assumptions, soliciting instead various levels of surprise. Due to these shattered expectations, readers find themselves having to reposition, to redefine and thus relocate themselves into new narrative/interpretive spaces. Such deliberately loose, at times overlapping, structures render the notion of dialogism and heterogeneity alive. The intention is to agonize the reader so that she accepts that the novel is out of my hands and becomes her responsibility. If the reader fails to see my female protagonist, Carmina, in all her complexity, seeking instead to reduce her to a woman whose racial profile is more pronounced so that she fits ready-made (and white-ordained) notions of blackness, this reader must accept the responsibility for her expectation and hopefully
interrogate why this expectation exists in the first place. If the reader is given no clear point of entry into a text, but must decide for herself where she must place her eyes on the page and where to go from there, this reader must accept responsibility for how she makes meaning from the text. If the reader finds herself constantly rethinking, renaming the place this work occupies – is it a novel? Is it erotica? Is it feminist literature? – then because I have not alleviated her of the responsibility to decide for herself what she wants to see. This reader must acknowledge, by virtue of her doubts, that such classification is not quiet, but always on
the move. Not silent, but noisy. By deliberately writing a work with numerous dynamic interfaces and by testing out the various levels and limits of their co-existence in my mind and in that of the reader, I hope to not only provide initial answers to my research question, but to make a contribution to an ongoing discussion about the properties of the novel. This contribution, like the spirit of my research question, seeks to remain open and dynamic. The second part of the response takes the form of a commentary, by means of which I present and analyse samples of my novel-writing as praxis with a view to demonstrating the routes
and measures taken to expose what I consider the inherent structural heterogeneity of the novel and its dialogical dynamics, as informed by Mikhail Bakhtin and Jacques Derrida. Here, I also examine how a close reading of 'writing in the feminine' as exemplified by a passage in
Nicole Brossard's Fences In Breathing (2007), further refines my understanding of heterogeneity by allowing me to probe a theme that is common to both our work: how the
body interacts with generic structure to create/advocate new reading realities/subjectivities. I come to the conclusion that both Nicole Brossard, a Canadian feminist lesbian writer, and I, make valuable contributions to an on-going discussion about the properties of writing. Neither the potential heterogeneity of the novel nor the multiple reader stances it permits have been sufficiently recognized. The novel, notwithstanding its highly elastic properties, still has room for considerable structural innovation. Verses Nature may be seen to demonstrate something of the immense heterogeneity potentially at work within the novel form. In so doing, it is hoped that this novel may invite readers to renegotiate the borders of the novel as a genre and reanimate an understanding of what the novel may do.


—This paper presents a generic algebraic proof of a recently published theorem [4], on the power conservative equivalent circuit for linear DC networks formed by time- invariant resistors and independent voltage and current sources. As the cited publication states, the internal losses of any network have two components: one variable and dependent on the internal resistances of the actual circuit and the power transferred to the pair of accessible terminals; and the other constant and dependent only on the internal voltage and current sources and the resistances of the actual network. It is also noted that the traditional Thévenin and Norton equivalent circuits are particular cases of the proposed equivalent circuit.


Most Prolog machines have been based on specialized architectures. The authors' goal is to start with a general-purpose architecture and determine a minimal set of extensions for high-performance Prolog execution. They have developed both the architecture and optimizing compiler simultaneously, drawing on results of previous implementations. They find that most Prolog-specific operations can be done satisfactorily in software; however, there is a crucial set of features that the architecture must support to achieve the best Prolog performance. The emphasis in this study is on the authors' architecture and instruction set. The costs and benefits of the special architectural features and instructions are analyzed. Simulated performance results are presented and indicate a peak compiled Prolog performance of 3.68 million logical inferences per second.<<ETX>>


Drought stress is among the most important abiotic factors that contribute to the significant yield reduction of common bean (Phaseolus vulgaris L.). Due to unreliable and poor distribution of rainfall, drought tolerance has become the important train in common bean in bean growing areas. The objective of this study was to evaluate 16 common bean genotypes for drought tolerance under three moisture regimes and identify genotypes with specific traits that improved tolerance to drought that could be recommended for released and become useful parents in the breeding programs. The experiment was conducted in Maruku, Bukoba under screen- house. Based on the drought stress indices which includes drought tolerance index (DTI), Harvest Index (HI) SMC 162, DAB 602, SSIN 1128, DAB 378, DAB 362 and SMR 101 had performed better than other tested genotypes. Also, the results showed that genotypes DAB 582, SRC 59, DAB 602, SSIN 1240, SMC 24, SMR 101 and DAB 362 were drought tolerant with lower and high value of the DSI and YSI respectively. Therefore, the later genotypes can be used in the future breeding programs as the parent for drought tolerance and also can used as a new varieties by farmers.

 Key words: Moisture stress, common bean, seed yield, drought.


Generative adversarial networks (GANs) are able to model the complex highdimensional distributions of real-world data, which suggests they could be effective for anomaly detection. However, few works have explored the use of GANs for the anomaly detection task. We leverage recently developed GAN models for anomaly detection, and achieve state-of-the-art performance on image and network intrusion datasets, while being several hundred-fold faster at test time than the only published GAN-based method.


Intellectual Property ordinarily includes patent, design, trademark and copyright. Due to the technological growth and globalization. Intellectual Property (IP) has acquired an international character. The greater importance on Intellectual Property all over the world can be traced from the concern of different international organization. WIPO and WTO are playing the leading role jointly for the protection of Intellectual property. Under the WTO agreement developing countries and transition economies were given use years to ensure that their laws and practices conform with the TRIPS agreement (1995 to 2000). Least-developed countries had 11 years, until 2006 conform to the TRIPS agreement. At present this period was extended to 2013 in general, and to 2016 for pharmaceutical patents and undisclosed information. This papers describe about Bangladesh that is a member of both the WIPO and WTO. Being a member of WTO, it has also to conform its national law to conformity with the TRIPS agreement within the stipulated time. Presently IP protection is governed by the Patents and Designs Act. 1911, The Trademark Ordinance. 2008 and the Copyright Act, 2000. The law relating to trademark and copyright has been modified to greater extent but patent and design law of our country was not modified yet to cope with the present situation.


This paper summarizes a research project devoted to analyzing the development of outward foreign direct investment (OFDI) and emerging multinational companies from Visegrad countries: The Czech Republic, Hungary, Poland, and Slovakia. After several years of foreign direct investment inflows to central and eastern European countries in recent decades, OFDI has appeared and grown dynamically from these economies. The Visegrad countries are among the leaders in that respect. This type of internationalization is affecting mainly Visegrad neighboring countries and other countries in the region. The concentration of investing companies and transactions is quite high in all four countries, and this determines both the sector and target country composition of OFDI. Intra-Visegrad investments, mainly by pairs of countries, are especially significant.


Two questions have been addressed here: how many logic levels are necessary to synthesise a specific instance of a reversible circuit, and how much better to have large gate libraries, and what gates should be required in libraries. Group theory is applied to 3-bit reversible gate synthesis to create a library useful in hierarchical design. It has been shown that arbitrary 3-bit reversible circuit can be synthesised with four-logic levels, using this new gate library. The respective universal library for the four-level synthesis is constructed and optimised it on the level of nuclear magnetic resonance pulses. A very fast algorithm to synthesise arbitrary 3-bit reversible function to gates from our library is also presented. The algorithm demonstrates dramatic speed benefit and results in a maximum of four-level circuit for arbitrary 3-bit reversible function. The gates are optimised on the level of pulses to decrease their cost and allow for objective comparison with standard CNOT, NOT, Toffoli gates (CNT) circuits. This library guarantees a four-level circuit for any 3-qubit reversible function and is also intended to be used in a hierarchical design of larger circuits.


In this paper, we study ACK/NACK messages detection in the LTE physical uplink control channel (PUCCH) with multiple receive antennas. The LTE PUCCH is typically characterized by high interference variability due to severe inter-user interferences and slot-level frequency hopping. We present detection methods applicable for the cases when the noise variances at the receiver are known and unknown. Noise here may comprise both thermal noise and interference. The proposed detection technique is based on the generalized likelihood-ratio test (GLRT) paradigm. Simulation results show that GLRT-based detector offers a significant gain over the training-based maximum-likelihood detector when the noise variances in two slots are different and unknown. For the case when the noise variances at the receiver are known, the GLRT-based detector has nearly the same performance as the training-based maximum-likelihood detector.


This article develops a postcolonial reading of the sublime by suggesting that aesthetic theories of the sublime were, in their classical philosophical formulations by Edmund Burke and Immanuel Kant, founded on problematic assumptions of racial difference. In the colonial sphere, it is argued, the sublime could discursively manage and contain the contradictions inherent in the aesthetic appreciation and appropriation of contested landscapes. This is particularly evident in the Alan Paton's writing. This article looks at the origins and the influence of rhetoric of the sublime in Paton's work, particularly in his novel Cry, the Beloved Country, and argues that the sublime is a key discursive structure in the shaping of Paton's complex and ambivalent representation of South Africa's politicised and racialised landscape.


In this paper, we present a generalized version of the routing algorithm[l] for a class of 2log2N-stage networks which are made by concatenating two log2Nstage blocking networks. We show that the generalized algorithm can also cover a class of(2log2N — l)-stage networks. It is shown that the inside-out algorithm is a more general algorithm which covers a large class of inherently symmetric rearrangeable networks, in cluding the Benes and its equivalent networks. More over, it is shown that the time complexity of the al gorithm is in O(N), which is superior to that of the looping algorithm. The algorithm is discussed using a graph representation of the network and its connectiv ity properties are shown by a graph describing rule. To show that the algorithm covers a class of 2log2N-stage networks, we introduce the concept of a base-network. These base-networks satisfy some common connectiv ity properties, and we show that any concatenation of two base-networks can be routed by our new algorithm.


PURPOSE
To evaluate the 3-year clinical durability of the flowable bulk-fill resin composite SDR in Class I and Class II restorations.

MATERIALS AND METHODS
Thirty-eight pairs of Class I and 62 pairs of Class II restorations were placed in 44 male and 42 female patients (mean age 52.4 years). Each patient received at least two extended Class I or Class II restorations that were as similar as possible. In all cavities, a one-step self-etching adhesive (XenoV+) was applied. One of the cavities of each pair was randomly assigned to receive the flowable bulk-fill resin composite SDR in increments up to 4 mm as needed to fill the cavity 2 mm short of the occlusal cavosurface. The occlusal part was completed with an ormocer-based nanohybrid resin composite (Ceram X mono+). In the other cavity, only the resin composite CeramX mono+ was placed in 2 mm increments. The restorations were evaluated using slightly modified USPHS criteria at baseline and then annually for 3 years. Caries risk and bruxing habits of the participants were estimated.

RESULTS
No post-operative sensitivity was reported. At the 3-year follow-up, 196 restorations - 74 Class I and 122 Class II - were evaluated. Seven restorations failed (3.6%), 4 SDR-CeramX mono+ and 3 CeramX mono+ only restorations, all of which were Class II. The main reason for failure was tooth fracture, followed by resin composite fracture. The annual failure rate (AFR) for all restorations (Class I and II) was 1.2% for the bulkfilled restorations and 1.0% for the resin composite-only restorations (p > 0.05). For the Class II restorations, the AFR was 2.2% and 1.6%, respectively.

CONCLUSION
The 4-mm bulk-fill technique showed good clinical effectiveness during the 3-year follow-up.


Up to 20% of acute myeloid leukemia (AML) patients present initially with hyperleukocytosis, placing them at increased risk for early mortality during induction. Yet, it is unknown whether hyperleukocytosis still retains prognostic value for AML patients undergoing hematopoietic stem cell transplantation (HSCT). Furthermore, it is unknown whether hyperleukocytosis holds prognostic significance when modern molecular markers such as FLT3‐ITD and NPM1 are accounted for. To determine whether hyperleukocytosis is an independent prognostic factor influencing outcome in transplanted AML patients we performed a retrospective analysis using the registry of the acute leukemia working party of the European Society of Blood and Marrow Transplantation. A cohort of 357 patients with hyperleukocytosis (159 patients with white blood count [WBC] 50 K‐100 K, 198 patients with WBC ≥ 100 K) was compared to 918 patients without hyperleukocytosis. Patients with hyperleukocytosis were younger, had an increased rate of favorable risk cytogenetics, and more likely to be FLT3 and NPM1 mutated. In multivariate analysis, hyperleukocytosis was independently associated with increased relapse incidence (hazard ratio [HR] of 1.55, 95% confidence interval [CI], 1.14‐2.12; P = .004), decreased leukemia‐free survival (HR of 1.38, 95% CI, 1.07‐1.78; P = .013), and inferior overall survival (HR of 1.4, 95% CI, 1.07‐1.84; P = .013). Hyperleukocytosis retains a significant prognostic role for AML patients undergoing HSCT.


ABSTRACT Agricultural land is the preferred form of collateral used by financiers to finance South African farmers. The objective of the paper is twofold; firstly, to determine the valuation methods used by financiers in determining the value of agricultural land used as collateral, and secondly, to determine the correlation between the agricultural land value and the amount of financing provided. Interviews were conducted with five respondents representing the Land Bank, three of the four largest commercial banks and an agricultural company. It was found that the market value approach and the income capitalisation approach are considered to be the most suitable valuation techniques. It was furthermore found that the amount of finance provided is based on varying percentage adjustments made to the value of agricultural land. The practical policy implication is that it is imperative that reliable governmental statistics on agricultural farm values and sales be re-established to encourage conformity among financiers in market value valuations.


The influence of strain aging on the microstructure-property characterization of an X100 pipeline steel was investigated by means of a thermal simulation technique, microscopic analysis method and mechanical properties testing. The experimental steel was prestrained in the tension at 6 pct and then was baked at 150oC, 200oC, 250oC and 300oC for 60 minutes, respectively. The results indicated that the strength and hardeness of test steel X100 increase and the plasticity and toughness decrease with the increasing of strain aging temperature, and it can get a higher ratio of yield to tensile and a lower strain-hardening coefficient which result in lower hardening capacity of X100 pipeline steel. There are two reasons for this strain aging phenomenon. One is the solute atoms of C, N in the α-Fe which Aggregated at the dislocation zones; the other is the compounds precipitation of C, N induced by the dislocations.


Structuring their daily life is an important problem for many individuals with chronic mental disorder. Therefore day structuring services are considered as constituent parts of modern mental healthcare systems. In this paper the theoretical and empirical basis for the implementation and evaluation of day structuring services will be discussed from a social science perspective. Recent work in the field of cultural sociology shows that the social framework of everyday behaviour in modern societies provides a great variety of opportunities to create and practice individual lifestyles. The potential to take advantage of these opportunities is related to individual competencies and resources. The few existing qualitative studies on the everyday behaviour of individuals with chronic mental disorders in the community reveal that increased freedom of choice is often combined with an objective or subjective lack of resources and competencies to make use of this variety of opportunities. Therefore, beyond providing a structure for daily life, day structuring services should help empower individuals with chronic mental disorder to make their choices among behavioural alternatives bearing in mind both illness-related limitations and their strengths and resources.


BACKGROUND
AMD473 (previously ZD0473) is a new-generation platinum compound with activity against a wide range of human tumour cell lines and xenografts, including carboplatin- and cisplatin-resistant lines. To assess its potential combined with a taxane, a phase I study of AMD473 and docetaxel in advanced cancer was initiated by the National Cancer Institute of Canada-Clinical Trials Group.

PATIENTS AND METHODS
Patients with advanced cancer, measurable disease, performance status Eastern Cooperative Oncology Group 0-2, no major organ dysfunction, and one or no previous taxane regimen received escalating doses of AMD473 and docetaxel every 3 weeks, with a starting dose of AMD473 80 mg/m(2) and docetaxel 60 mg/m(2).

RESULTS
Thirty-three patients enrolled on four dose levels were evaluable for toxicity and 25 patients were evaluable for response. The maximum tolerated dose was dose level 4 (AMD473 120 mg/m(2) and docetaxel 75 mg/m(2)), with grade 4 neutropenia in both minimally and heavily pretreated patients causing dose-limiting toxicity. As well at dose level 4, one patient had grade 3 vomiting despite premedication. Dose level three was expanded for both groups of patients and was defined as the recommended phase II dose at AMD473 100 mg/m(2) and docetaxel 75 mg/m(2). Non-hematologic toxicities included fatigue, diarrhoea and other mild toxicities. There was one partial response in a patient with prostate cancer and stable disease in 15 patients. No apparent pharmacokinetic interaction was noted.

CONCLUSION
AMD473 and docetaxel can be combined with a recommended phase II dose level of 100 mg/m(2) and 75 mg/m(2), respectively, given intravenously every 3 weeks. The combination has activity and should be explored in responsive tumour types.


This paper provides a detailed empirical assessment of the evolution of income inequality and the redistributive effects of the tax and transfer system following the 2007-2008 crisis. It focuses on the US case, drawing on data from the Current Population Survey for the period 2007-2012. Contrary to most existing studies, it uses of a wide range of inequality indicators and looks in detail at several sections of the income distribution, allowing for a clearer picture of the heterogeneous consequences of the crisis. Furthermore, it analyses the contribution of different types of taxes and transfers, beyond the overall cushioning effect of the system, which allows for a more refined assessment of its effectiveness. Results show that although the crisis implied income losses across the whole income distribution, the burden was disproportionately born by low to middle income groups. Income losses experienced by richer households were relatively modest and transitory, while those experienced by poorer households were not only strong but also highly persistent. The redistributive system had a crucial role in taming the increase in income inequality in the immediate aftermath of the crisis, and during the GR years, particularly cash transfers. After 2010, however, its effect became weaker and income inequality experienced a new surge. The findings of this paper contribute to a better understanding of the distributional consequences of aggregate crises and the role of tax and transfer policies in stabilising the income distribution in a crisis aftermath.


The relation between dark matter halos and the loci of star formation at high redshift is a pressing question in contemporary cosmology. Matching the abundance of halos to the abundance of infrared (IR) galaxies, we explicit the link between dark matter halo mass (Mh), stellar mass (M*) and star-formation rate (SFR) up to a redshift of 2. Our findings are five-fold. First, we find a strong evolution of the relation between M* and SFR as a function of redshift with an increase of sSFR = SFR/M* by a factor ~30 between z=0 and z= 2.3. Second, we observe a decrease of sSFR with stellar mass. These results reproduce observed trends at redshift z>0.3. Third, we find that the star formation is most efficient in dark matter halos with Mh~5x10^11 Msun, with hints of an increase of this mass with redshift. Fourth, we find that SFR/Mh increases by a factor ~15 between z = 0 and z = 2.3. Finally we find that the SFR density is dominated by halo masses close to ~7x10^11 Msun at all redshift, with a rapid decrease at lower and higher halo masses. Despite its simplicity, our novel use of IR observations unveils some characteristic mass-scales governing star formation at high redshift.


This paper presents a numerical method based on quasilinearization and rationalized Haar functions for solving nonlinear optimal control problems including terminal state constraints, state and control inequality constraints. The optimal control problem is converted into a sequence of quadratic programming problems. The rationalized Haar functions with unknown coefficients are used to approximate the control variables and the derivative of the state variables. By adding artificial controls, the number of state and control variables is equal. Then the quasilinearization method is used to change the nonlinear optimal control problems with a sequence of constrained linear-quadratic optimal control problems. To show the effectiveness of the proposed method, the simulation results of two constrained nonlinear optimal control problems are presented.


This special issue of strategies for emerging markets starts with a powerful interview with the CEO and Chairman of the Board of Directors of Caterpillar. Caterpillar is viewed by many analysts as a barometer of the health of the global economy. This interview, which was conducted with CEO Oberhelman, provides insights into how emerging markets may develop in the future. His responses are important because he can tell us how to do business in fully developing markets (e.g., BRIC) and also in developing markets of the future. He discusses not only what markets are emerging but also, more importantly, how and why firms should conduct business in these emerging markets. The person who conducted the interview was Michael Pettus, an Associate Professor of Management at the Tabor School of Business at the Millikin University.


Conidia of Aspergillus nidulans transported the acidic amino acids and some basic and neutral amino acids at very low rates. During germination the rates of transport of these amino acids increased. The rate of permease synthesisllitre of culture increased during germination, reaching a maximum soon after onset of exponential growth; during subsequent growth the rate of synthesis (per litre of culture) was constant. The activity of the acidic amino acid permease, measured in germinated conidia, varied with the nitrogen source in the germination medium. An analysis of the intracellular pool of amino acids has shown no clear correlation between activity of the permease and the intracellular concentration of any amino acid. The acidic amino-acid permease of Aspergillus nidulans is probably regulated by ammonia from within the organism and this regulation is achieved by both inhibition and repression.


A heterologous prime-boost vaccination regime with DNA and recombinant vaccinia virus (rvv) vectors expressing relevant antigens has been shown to induce effective immune responses against several infectious pathogens. In this study, we describe the effectiveness of the prime-boost strategy by immunizing dogs with a recombinant plasmid followed by vaccinia virus, both of which expressed the glutamic acid-rich protein (BgGARP) of Babesia gibsoni. The dogs immunized with the prime-boost regime developed a significantly high level of specific antibodies against BgGARP when compared with the control groups. The antibody level was strongly increased after a booster immunization with a recombinant vaccinia virus. Two weeks after the booster immunization with a recombinant vaccinia virus expressing BgGARP, the dogs were challenged with B. gibsoni parasite. The dogs immunized with the prime-boost regime showed partial protection, manifested as a significantly low level of parasitemia. These results indicated that this type of DNA/rvv prime-boost immunization approach may have use against B. gibsoni infection in dogs.


Abstract An earthquake dataset consisting of 327 records from 67 earthquakes is used to study the frequency‐dependent amplitude decay of seismic coda waves in the Kumaon Himalayas, India. Coda amplitude decays with time t are measured by empirical t − α dependences, with exponent α being variable regionally with frequencies and lapse times. The results show that α varies from 1 to 3, with an average of about 1.93. The lapse‐time dependence of α is noticeable but weak, and no significant azimuthal dependence of α is obtained. Significant regional variations of α are found, ranging from α ≈2.1 for the Lesser Himalaya to α ≈1.76 for the Greater Himalaya. These variations correlate with the geology of the region and crustal structure. The values of α are mostly frequency independent, indicating low intrinsic attenuation within the crust. When interpreted according to the conventional coda‐ Q ( Q c ) model, these values of α lead to Q c ≈78 f 1.06 in the Kumaon Himalaya, Q c ≈90 f 1.09 in the Kumaon Lesser Himalaya, and Q c ≈90 f 0.92 in the Kumaon Greater Himalaya. A frequency‐dependent α is found within a localized area, giving an estimate of near‐surface Q ≈200. Three general conclusions of this study may be significant for coda studies in other areas. First, the values of α are variable regionally, whereas its average level is remarkably constant and correlates with rock types and upper‐crustal structure. Second, the traditionally assumed value of α =1 is much lower than the actual spreading rates, which shows that the coda cannot be viewed as body waves scattered within a uniform crust. Using the value of α =1 causes a systematic underestimation of coda amplitude decays in the data. Third, the dependence of α on frequency is relatively weak and occurs in localized areas. Combined with an underestimated α , this weak frequency dependence may cause biases in the estimation of secondary parameters, such as coda Q .


Two independent nationwide surveys of randomly selected sheep farmers were conducted: in one a questionnaire was mailed to farmers and in the other the farmers were interviewed. The questionnaire was designed to obtain data on the occurrence of scrapie in the national sheep flock of the Netherlands. Farmers owning 30 or more ewes were selected from a database at the Ministry of Agriculture, Nature Management and Fisheries, resulting in 10,000 addresses. Two lists of names were compiled at random. In the postal survey 700 questionnaires were distributed, and 137 farmers were interviewed directly. The response rate in the postal survey was 37 per cent and in the interview survey 100 per cent. The results from the two surveys did not differ significantly. Six per cent of the farmers indicated that they had at some time observed signs of scrapie in their flock. For the total sheep population in the Netherlands, the prevalence of flocks with sheep showing signs of scrapie was between 3.8 per cent and 8.4 per cent (with 95 per cent certainty). In 1989 and 1990 the incidence rate within infected flocks was 1.27 cases/100 ewes/year, and the incidence rate for the total sample population was 0.1 case/100 ewes/year.


In this study we provide insights into the effectiveness of the clearing function concept in a hierarchical planning context. The clearing function is a mathematical representation of the relation between the Work-In-Process (WIP) and the throughput of a production process. We use it in a deterministic order release planning model to anticipate the dynamics of the operational level, which is subject to uncertainties. A multi-period single-item order release and scheduling problem is considered in which the delivery schedule of the orders is determined through the planned lead times, and the capacity loading decisions are separated from the order release decisions in a way so as to plan for on-time deliveries. Early or late delivery of the orders, which are released and delivered in batches, has not been considered explicitly in previous studies on clearing functions, and it significantly affects the inventory costs. Both linear and non-linear clearing functions are tested using a simulation approach. The results indicate that modeling the clearing of WIP by a shop should be based on the short-term operational dynamics of the shop rather than on the long-term average shop behavior, since it improves the consistency between the operational planning and scheduling levels of the hierarchy. The presented methods and results provide valuable information on modeling production characteristics in aggregate production planning and scheduling models.


OBJECTIVE To quantify the effect of metformin on the metabolism of triglyceride (TG)-rich lipoprotein of intestinal origin in patients with non-insulin-dependent diabetes mellitus (NIDDM) who had responded to sulfonylurea but still had fasting hyperglycemia. RESEARCH DESIGN AND METHODS Sixteen patients with NIDDM who had demonstrated a fall in fasting plasma glucose concentration > 2.2 mmol/l in response to glipizide treatment but continued to have fasting plasma glucose concentrations > 8.3 mmol/l were studied. Fasting glucose, GHb, lipid and lipoprotein concentrations were determined, and resistance to insulin-mediated glucose disposal was estimated by measuring the steady-state plasma glucose (SSPG) concentration at the end of a 180-min infusion of somatostatin, glucose, andinsulin. In addition, plasma glucose, insulin, and TG concentrations were measured at frequent intervals from 0800 to 2400, with patients eating breakfast at 0800 and lunch at 1200. Vitamin A was also given at lunch, and the retinyl ester content in plasma and in chylomicron (Svedberg flotation constant [Sr] > 400) and the chylomicron remnant (Sr 20–400) fractions were used to quantify the concentration of postprandial intestinal TG-rich lipoprotein from 1200 to 2400. RESULTS Fasting plasma glucose concentrations (6.8 ± 0.4 vs. 10.5 ± 0.4 mmol/l), GHb levels (7.9 ± 0.3 vs. 10.8 ± 0.5%), and day-long plasma glucose concentrations were all significantly lower after metformin treatment (P < 0.001), which was associated with a significant (P < 0.001) fall in SSPG concentration (11.0 ± 0.9 to 9.6 ± 0.6 mmol/l). In addition, postprandial concentrations of glucose, insulin, free fatty acids, and TG were lower (P < 0.001) following metformin treatment. Postprandial retinyl ester concentrations were also lower in plasma by 33 ± 5.7% (P < 0.001) and in both the chylomicron (32 ± 7.2%, P < 0.001) and chylomicron remnant (26 ± 7.0%, P < 0.005) fractions. CONCLUSIONS Addition of metformin to sulfonylurea-treated patients with NIDDM with less than optimal glycemic control was associated with improved glycemic control, lower postprandial insulin and TG concentrations, and a decrease inpostprandial concentration of TG-rich lipoproteins of intestinal origin. All of these changes might be expected to decrease risk of coronary heart disease.


This paper presents fault attacks against a cellular automata based stream cipher. A fault attack assumes that the adversary is able to physically operate the cryptographic device and insert some errors into it. As a consequence, the adversary can induce faulty results into the device and use them to recover the stored secret key. By using this approach we provide extremely efficient and practical cryptanalytic methods: by injecting n/2 + n2/32 faults we recover the n-bit secret key from a stream cipher based on cellular automaton rule 30. To the best of our knowledge this is the first application of fault attacks against cellular automata based stream ciphers.


Online advertisements are a type of advertisement that is broadcasted on the internet. In contrast to traditional advertising, online advertisements establish an interactive communication. Now-a-days, teenagers are frequently using the internet either for educational purposes or at least for entertainment. When the teenagers come across these online advertisements, their attitude about the advertisements is very important for the success of the advertisements. Hence, the present study analyses the overall attitude of teenagers about online advertisements based on gender, educational qualifications and age. To capture the responses from the teenagers being respondents of the study, a well-structured questionnaire was administered to 2500 respondents with a yielding rate of 80.04 % (2001 usable Questionnaires). The various factors such as general perception, advertising utility, indignity, price perceptions and regulation were captured on a five point scale and further classified into three groups namely favorable, neutral and unfavorable based on the total score. The geographical area of Tamil Nadu State in India was used as the sampling area. The questionnaire was administered in person to students in identified schools and colleges all over Tamil Nadu. Also, Snowball Sampling Technique was used to collect data from respondents who are stationed far away from the researcher. The data used for the purpose of this study were collected for a period of 6 months from 1st July 2014 to 31st December 2014. The collected data were subjected to statistical analysis using Frequency analysis, Chi-Square test, and regression analysis. It was found from the study, that the respondents do not differ in their attitude about online advertisements based on gender, educational qualifications and age.


Background—Both acid and duodenal contents are thought to be responsible for the mucosal damage in Barrett's oesophagus, a condition often treated medically. However, little is known about the effect of omeprazole on duodenogastric reflux (DGR) and duodenogastro-oesophageal reflux (DGOR). Aims—To study the effect of omeprazole 20 mg twice daily on DGR and DGOR, using the technique of ambulatory bilirubin monitoring. Methods—Twenty three patients with Barrett's oesophagus underwent manometry followed by 24 hour oesophageal and gastric pH monitoring. In conjunction with pH monitoring, 11 patients (group 1) underwent oesophageal bilirubin monitoring and 12 patients (group 2) underwent gastric bilirubin monitoring, both before and during treatment with omeprazole 20 mg twice daily. Results—In both groups there was a significant reduction in oesophageal acid (pH<4) reflux (p<0.005) and a significant increase in the time gastric pH was above 4 (p<0.005). In group 1, median total oesophageal bilirubin exposure was significantly reduced from 28.9% to 2.4% (p<0.005). In group 2, median total gastric bilirubin exposure was significantly reduced from 24.9% to 7.2% (p<0.005). Conclusions—Treatment of Barrett's oesophagus with omeprazole 20 mg twice daily results in a notable reduction in the exposure of the oesophagus to both acid and duodenal contents. In addition, delivery of duodenal contents to the upper gastric body is reduced.


Contracts are arguably the most important type of business documents. Despite their significance in business, legal contract review largely remains an arduous, expensive and manual process. In this paper, we describe TECUS: a commercial system designed and deployed for contract understanding and used by a wide range of enterprise users for the past few years. We reflect on the challenges and design decisions when building TECUS. We also summarize the data science life cycle of TECUS and share lessons learned.


Modern Well Design Second Edition presents a unified approach to the well design process and drilling operations. Following an introduction to the field, the second chapter addresses drilling fluids, as well as optimal mud weight, hole cleaning, hydraulic optimization, and methods to handle circulation losses. A relatively large chapter on geomechanics follows, presenting methods for wellbore fracture and collapse modeling, including methods to interpret caliper logs.


Whereas modern brain imaging often demands holding body positions incongruent with everyday life, posture governs both neural activity and cognitive performance. Humans commonly perform while upright; yet, many neuroimaging methodologies require participants to remain motionless and adhere to non-ecological comportments within a confined space. This inconsistency between ecological postures and imaging constraints undermines the transferability and generalizability of many a neuroimaging assay. Here we highlight the influence of posture on brain function and behavior. Specifically, we challenge the tacit assumption that brain processes and cognitive performance are comparable across a spectrum of positions. We provide an integrative synthesis regarding the increasingly prominent influence of imaging postures on autonomic function, mental capacity, sensory thresholds, and neural activity. Arguing that neuroimagers and cognitive scientists could benefit from considering the influence posture wields on both general functioning and brain activity, we examine existing imaging technologies and the potential of portable and versatile imaging devices (e.g., functional near infrared spectroscopy). Finally, we discuss ways that accounting for posture may help unveil the complex brain processes of everyday cognition.


Optimal communication/control analysis and design of dynamical controlled systems, when there are finite capacity communication constraints often involve information and control theoretic analysis. This paper, employees information theoretic concepts, which are subject to causality, and thus applicable to control/communication system analysis and design in which encoders, decoders and controllers are causal. The basic mathematical concepts are constructive; they are based on a modified version of Shannon's self-mutual information, known as directed information, which describes how much information a random process conveys to another random process, to account for the causality of the probabilistic channel connecting these random processes, when feedback is used. Following this construction data processing inequalities are derived while the solution to the casual information rate distortion is obtained in which the optimal reconstruction kernel is causally dependent on the source and control. Further, in view of the complexity of the causal rate distortion function, a tight lower bound on the casual rate distortion function is derived which is easy to apply in many control/communication systems. Finally, using the information transmission theorem, the connection between stabilizabilty and observability of the control system is related to the causal rate distortion function and its lower bound.


Landmarks are one of the most effective search heuristics for classical planning, but largely ignored in generalized planning. Generalized planning (GP) is usually addressed as a combinatorial search in a given space of algorithmic solutions, where candidate solutions are evaluated w.r.t. the instances they solve. This type of solution evaluation ignores any sub-goal information that is not explicit in the representation of the planning instances, causing plateaus in the space of candidate generalized plans. Furthermore, node expansion in GP is a run-time bottleneck since it requires evaluating every child node over the entire batch of classical planning instances in a GP problem. In this paper we define a landmark counting heuristic for GP (that considers sub-goal information that is not explicitly represented in the planning instances), and a novel heuristic search algorithm for GP (that we call PGP) and that progressively processes subsets of the planning instances of a GP problem. Our two orthogonal contributions are analyzed in an ablation study, showing that both improve the state-of-the-art in GP as heuristic search, and that both benefit from each other when used in combination.


Using bioenergy systems in architecture provides energy by means of negative emissions technologies (NETs). It plays an important role in stabilizing CO2 emissions at low levels. This depends on options of low life cycle emissions (for instance, a sustainable use of biomass residues), and on outcomes that are site-specific and rely on efficient integrated systems that convert biomass into bioenergy. The objective of this study is to develop self-sufficient systems that generate bioelectricity and offer safety, electricity generation efficiency, cost-effectiveness, waste treatment, integration in domestic use, ease of use, reproducibility and availability. The study also intends to elaborate a general design method of embedding and utilizing microorganisms into architectural elements to achieve design ecology, introducing a multidisciplinary research application through a design theory aspect. The study is based on previous experimental work conducted by the authors. Microbial fuel cell technology was applied to exploit the natural potential of a fungal strain that was identified and optimized to be implemented in microbial fuel cells (MFCs) to generate electricity. The outcomes were included in the self-sufficient cluster design that meets the aforementioned conditions. The novelty of this study is the direct use of a bioreactor of MFCs in a design application for bioelectricity production. It aims to reduce the currently high global CO2 emissions that come from the energy supply sector (47%) and from the building sector (3%), as well as to eliminate the need for large-scale infrastructure intervention. This self-sufficient bio-electricity cluster therefore outweighs other abiotic renewable energy resources such as solar energy or wind power.


Unexpected Pleasures traces a new lineage of modern and contemporary British writers who cast an ironic eye on their genres and make queer use of literary convention. Teasing out the parodic sensibility of writers like Woolf, Bowen, Selvon, Sayers, Stella Gibbons, and Zadie Smith, I take a fresh look at the throwback, the hidebound, the predictable, and the "funny" works that excessively obey the rules of genre and oversupply the pleasurable illusion of power that genre confers. I argue that these excesses weaken the reader's predictive power over the text, and that this shaken expectation exposes and queers a broader set of assumptions about desire, resolution, and futurity that structure social and generic norms. The parodies I examine are queer not only in their liberatory challenge to gendered and sexual norms, but also in the way that their critique resists becoming merely anti-conventional: Rather than eliding the conventions of gender and genre and mocking glibly at both, these works dwell on how conventionality itself accrues meaning, what kinds of expectations we attach to it, and what we might hope for instead.


If Savulescu's (2001, 2009) controversial principle of Procreative Beneficence (PB) is correct, then an important implication is that couples should employ genetic tests for non-disease traits in selecting which child to bring into existence. Both defenders as well as some critics of this normative entailment of PB have typically accepted the comparatively less controversial claim about non-disease traits: that there are non-disease traits such that testing and selecting for them would in fact contribute to bringing about the child who is expected to have the best life. We challenge this less controversial claim, not by arguing deductively for its falsity, but by showing that Savulescu's central argument for this presumably less controversial claim fails. Savulescu offers intelligence as the paradigm example of a testable non-disease trait such that testing and selecting for it would increase the likelihood that the child selected would be the one who is expected to have the best life (or at least as good a life as the others). We provide a series of arguments aimed at demonstrating that Savulescu's argument from intelligence fails. If our arguments are successful, the upshot is not that PB is false, but more modestly, that the burden of proof remains squarely with Savulescu.


AIM
To know the influence of the factors that determine physical exercise in adults and elderly by the analysis of the determinants categories of health-promoting behaviors in the health promotion nursing model (MPS) of Pender.

METHODOLOGY
A descriptive review of the literature was conducted in order to identify the influencing factors in the adoption and maintenance of physical exercise as a health promotes behavior. The databases consulted were PubMed-MEDLINE via RefWorks bibliography manager, CUIDEN and CUIDATGE. The search was conducted in 2010 and 2011, including publications in English and Spanish.

RESULTS
18 articles were reviewed to assess the influence, in adult and elderly population, of the factors: prior related behavior; personal factors; perceived benefits of action; perceived barriers to action; perceived self-efficacy; activity-related affect; interpersonal influences; situational influences; immediate competing demands and preferences; commitment to a plan of action. DEVELOPMENT AND DISCUSSION: Many studies have demonstrated the validity and predictive ability of the model studied in this article (MPS). There are complex biopsychosocial processes that motivate individuals to engage in behaviors to promote health. The MPS variables and their relationship are relevant in the decision to adopt increased physical activity behaviors.

CONCLUSIONS
The Health Promotion Model facilitates the evaluation of the elements that influence behavior and helps nurses to identify how willing a person to exercise, what are their difficulties and can decide what interventions are most seek to promote physical activity.


We analyse the impact of Fair Trade and organic farming on a sample of Fair Trade organic rice producers in Thailand. We find that per capita income from agriculture is positively and significantly affected by organic certification and FT affiliation years. Such effect does not translate into higher productivity due to a concurring increase in worked hours. FT and organic certification contributions are however downward biased if we do not take into account the relatively higher share of self- consumption of affiliated farmers. Our main findings are robust when we control for selection bias and endogeneity with instrumental variables, propensity score matching and by restricting the sample to affiliated producers only. We also test which of the two (organic and FT) effects is stronger and find that the latter prevails.


The purpose of this contribution is to make the idea of modeling as theory-building operational. We conceive the modeling process as a theory-building process, thereby opening up a new perspective on the methodology of modeling in the social sciences. By reconceptualizing the notion of modeling, we hope to convey the advantages of more conceptual thinking in management. Practitioners could gain effectiveness in dealing with external complexity if they would espouse the modeling task as a disciplined reflection and communication geared toward the elaboration of theories. This contribution is based on projects in which System Dynamics models for real-world issues were constructed together with corporate partners. To clarify the isomorphic nature of theory-building and formal modeling and illustrate the approach to modeling as theory-building, one of these modeling ventures is described in detail.


This study aims to identify the factors that the Qatari government can contribute to Qatar's internationalization of Small-Medium Enterprises (SME). In addition, it highlights the current role played with a variation of the future proposed programs. The obstacles faced by entrepreneurs also have been identified, and was accompanied by counterparts' views from the country's officials.
 This study involved an online survey shared with 100 business owners and people working in the private sectors targeted through different mediums with help from Qatar Development Bank and their subsidiaries. The overall conclusion from the data analyzed is that there are still missing factors that the country lacks regulations, facilities, and education. However, there is evidence that the Qatari regulator moves in the right direction with the different initiatives and programs. Therefore, even though there are existing facilities, the programs offered do not fit the entrepreneurs' needs. The entrepreneurs lack the managerial and marketing skills and the power in bargaining and negotiation with external stakeholders.
 The main recommendation is to set national private sector/SME advancement techniques within the broader national advancement translated in a centralized portal based on the overall conclusion. Different recommendations have been proposed to provide proper training programs' implementation plan. The proposals include the capacity of the Qatari government to actualize sound macroeconomic arrangements. The training programs to involve the teachers' development expand the learner's ranks, content sharing facility, and instructional methods redesigning. In addition, accessibility to loans and advanced finance equity, mainly to medium and long-term opportunities to grow SMEs' exchange and venture capacity align with the Qatari National Vision 2030, whereas keeping up sound government accounts will offer assistance to the accessibility of finance for improvement purposes.


African swine fever (ASF) is currently the most important challenge for domestic pig production worldwide. The virus reached Eurasia in 2007, and is today affecting more than half of European Union member countries. Among Western Balkan countries, Serbia suffered the first case of ASF in a backyard holding in 2019. Since then, numerous outbreaks in domestic pigs and wild boar have been reported throughout the country despite the efforts of the veterinary authorities to control the disease. The lack of an effective vaccine is one of the main constraints, and the only currently available option to prevent further ASF infections is the application of strict biosecurity measures. Regarding biosecurity, backyard pig producers and smallholding farmers in Serbia have substantial gaps in the knowledge and fail to comply with safe production behaviour that favours the spread of ASF virus. In the currently prevailing smallholder and backyards farming systems, farm biosecurity is largely non-existent. The aim of this review was to identify specific ASF-risks factors in the current pig production system and gaps in biosecurity measures related to the human activities recognised as social and cultural identity in Serbia. Moreover, the main risk factors for ASF spreading and transmission at the domestic/wild boar interface, biosecurity practices in different production systems, and possible future control measures and awareness campaigns are discussed.


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ABSTRACT Despite their benefits, technological devices such as cell phones may also have deleterious effects on human health. Considerable debate continues concerning the effects of the electromagnetic field (EMF) emitted during cell phone use on human health. We investigated the effects of exposure to 900 megahertz (MHz) EMF during mid to late adolescence on the rat liver. Control (ContGr), sham (ShmGr) and EMF (EMFGr) groups of female rats were established. We exposed the EMFGr rats daily to 900 MHz EMF on postnatal days 35−59. ShmGr rats underwent sham procedures. No procedure was performed on ContGr rats. Rats were sacrificed on postnatal day 60 and the livers were extracted. One part of the liver was stained with Masson's trichrome or hematoxylin and eosin. The remaining tissue was used to measure oxidative stress markers including malondialdehyde, glutathione, catalase, superoxide dismutase, 8-hydroxydeoxyguanosine (8-OHdG) and nitrotyrosine. Total antioxidant status and total oxidant status were used to calculate the oxidative stress index. We found normal hepatic morphology in the ContGr and ShmGr groups. The EMFGr group exhibited occasional irregularities in the radial arrangement of hepatocytes, cytoplasmic vacuolization, hemorrhage, sinusoid expansion, hepatocyte morphology and edema. Biochemical analysis revealed that 8-OHdG and SOD levels in EMFGr decreased significantly compared to the ContGr and ShmGr groups. Exposure to a continuous 900 MHz EMF for 1 h daily during mid to late adolescence may cause histopathological and biochemical alterations in hepatic tissue.


In this paper we consider Markov analysis of models of complex software and hardware systems. A Markov analysis tool can be used during verification processes of models of avionics systems. In the introduction we enumerate main advantages and disadvantages of Markov analysis. For example, with Markov analysis, unlike other approaches, such as fault tree analysis and dependency diagram analysis, it is possible to analyze models of systems that are able to recovery. The main drawback of this approach is an exponential growth of models size with number of components in analyzed system. It makes Markov analysis barely used in practice. The other important problem is to develop a new algorithm for translating a model of a system to a model suitable for Markov analysis (Markov chain), since the existing solutions have significant limitations on the architecture of analyzed systems. Next we give a brief description of the context - AADL modeling language with Error Model Annex library, MASIW framework, and also give an explanation of Markov analysis method. In a main section we suggest an algorithm for translating a system model into a Markov chain, partially solving the problem of exponential growth of Markov chain. Then follows a description of further steps, and some heuristics that allow to extremely reduce running time of the algorithm. In this paper we also consider other Markov analysis tools and their features. As a result, we suggest a Markov analysis tool that can be effectively use in practice.


The accessory genome of the human pathogen Klebsiella pneumoniae is large, variable and highly mobile. This reservoir of genes leads to the emergences of hospital outbreak strains with enhanced virulence and multidrug resistance, such as ST258, and acts as a source for transfer of these traits to other Gram negative pathogens. One such mobile genetic element, ICEKp, is prevalent in isolates of invasive disease where it enhances iron acquisition by the siderophore yersiniabactin. Yersiniabactin is also a virulence factor in pathogenic Escherichia coli and Yersinia species. Similarities between siderophore transporters and drug efflux pumps led us to postulate that the yersiniabactin transport proteins could contribute to antimicrobial resistance. We determined the effect of loss and gain of ICEKp, or the transporters alone, on iron acquisition and drug sensitivity of K. pneumoniae and Escherichia coli. Deletion of ICEKp impaired iron acquisition of clinical isolate K. pneumoniae HS11286 due to reduced siderophore secretion and reduced ability to acquire iron from siderophores. A simultaneous increase in sensitivity to a broad range of antimicrobials could be complemented by reintroduction of the ybtPQ ABC transporter. Furthermore, transfer of ICEKp to E. coli occurred efficiently by conjugation and conferred a similar decrease in sensitivity to antimicrobials.


We measure one aspect of how access to emergency care through ambulance services changes for patients when a hospital closes. We empirically estimate the time needed to transport a patient to an emergency department in an ambulance in the period immediately after the hospital closes. We find urban patients in zip codes where a hospital closes have a small change in transportation time, where rural patients average an estimated 15.7 additional minutes – a 46% increase compared to the year before the closure. This increase is primarily the result of an almost 100 percent increase in the time it takes to transport a patient from the location of the incident to the hospital. The impact on rural Medicare-eligible patients is even larger. We find no change in the time it takes ambulances to arrive at an incident and only a small change in the time spent at the scene.


Abstract Transcranial Doppler sonography has become widely used in assessing cerebral vasomotor reactivity which provides information regarding cerebral autoregulation and collateral circulation. Cerebral vasomotor reactivity is defined as a shift between cerebral blood flow or cerebral blood velocity before and after administration of a potent vasodilatory stimulus test. Three such tests are currently used for this purpose: the apnea test, CO2 inhalation and the Diamox test (i.v. acetazolamide), all of which are based on the dilatatory response of cerebral blood flow to hypercapnia. Certain advantages of the Diamox test were described, but each of the three tests has its strong and weak points, and this will be the topic under discussion. There are several practical applications of the combined TCD and the vasodilatory tests in assessing of cerebral vasomotor reactivity: 1. To evaluate the intracranial hemodynamic status in patients with carotid occlusive disease with the intent of predicting the occurrence of ischemic brain events. 2. To compare intracranial hemodynamics before and after carotid endarterectomy. 3. To compare autoregulation and collateral circulation in the different parts of the circle of Willis. 4. To predict dementia after stroke. In summary, the potential clinical usefulness of combined TCD and provocative vasodilatory tests has been clearly shown. Further large scale studies are needed in order to augment the applications of cerebral vasomotor reactivity assessment in the clinical setting.