The pathophysiology of acute post-stroke hyperglycaemia (PSH) is important as
hyperglycaemia affects the majority of stroke patients, and is consistently associated with
poorer outcome in terms of survival, disability and markers of brain injury such as infarct
expansion. There appears to be an interaction between brain arterial patency and
hyperglycaemia that has not been fully characterised.
This thesis initially reviews the literature on hyperglycaemia and stroke before focusing on
animal models of PSH and clinical trials of insulin treatment for PSH in two systematic
reviews with meta-analysis. The thesis then looks at the relationship between glucose
profiles and clinical outcome in a historical population receiving IV thrombolysis for acute
ischaemic stroke, specifically exploring alternative indices of glycaemic state to compare
the optimal predictive index for functional outcome as measured by the modified Rankin
scale.
The main body of the thesis details a prospective observational clinical study which
recruited 108 patients within 6 hours of acute ischaemic stroke. These patients had careful
monitoring of blood glucose levels over a 48 hour period and detail brain imaging
including CT perfusion scanning to examine the ischaemic penumbra, CT angiography on
admission and at 24-48 hours to document brain arterial patency with follow-up CT brain
imaging to assess outcome infarct volume. The relationship between 48 hour blood
glucose profiles, clinical outcome and imaging findings is then explored.
The main findings of the thesis are summarized below.
· Animal models of PSH have shown that hyperglycaemia exacerbates infarct
volume in MCA occlusion models but studies are heterogeneous, and do not
address the common clinical problem of PSH because they have used either the
streptozotocin model of type I diabetes or extremely high glucose loads.
· Animal models show that insulin has a non-significant and significantly
heterogeneous effect on infarct growth.
3
· Clinical trials of insulin for post stroke hyperglycaemia have shown no benefit in
terms of improved functional outcomes or mortality. Insulin is associated with an
increased risk of hypoglycaemia.
· In a historical cohort mean capillary blood glucose over 48 hours was more
predictive of clinical outcome that admission blood glucose or two consecutive
elevated glucose measurements.
· A high proportion of acute stroke patients have a blood glucose level above
7mmol/L within 6 hours of onset. Different patterns of blood glucose levels define
different populations.
· Higher admission and mean glucose levels correlate with larger infarct volumes.
Larger core perfusion lesion volumes are associated with a greater risk of mortality.
Admission hyperglycaemia is more harmful than hyperglycaemia after 6 hours.
· In patients with angiographic evidence of an arterial occlusion infarct volume
varies significantly with glycaemic status. In some populations late
hyperglycaemia is associated with better imaging outcomes.
· Tandem occlusions are associated with bad outcomes after ischaemic stroke.


Recently a number of new non-destructive diagnostic techniques have been investigated for the reliable condition assessment of the ageing of metal oxide surge arrester (MOSA). Among them polarization/depolarization current and return voltage measurement techniques showed very promising results. This paper presents an insulation polarization model for investigating polarization-based diagnostics for metal oxide surge arrester. The simulations of the proposed model are validated and verified by comparing the data from the polarization/depolarization current measurements. The simulation of return voltage for MOSA is also performed to validate the insulation polarization model. Finally, the usefulness of this model for MOSA diagnostics has been highlighted in this paper.


Two approaches and the subsequent results of approximations for phase velocities in transversely isotropic (TI) media are examined in the context of what has been termed weak anisotropy. What is addressed is the range of anisotropic complexity from general or exact, to mild or weak anelliptic and finally to linearized weak and the limits within which the approximations can be assumed to be applicable. In what follows, the term weak anelliptic anisotropy will not be synonymous with linearized weak anisotropy. The phase (wavefront normal) velocity is the quantity selected for this study, as it is perhaps that which is most often chosen as a candidate for approximation, from which other relevant, associated quantities may be derived or computed – including group (ray) velocity, polarization vectors and intermediate values associated with amplitude computations, reflection and transmission coefficients. The quasi-compressional, qP , and quasi-shear, V qS , are approximated in such a manner that they are dependent on two parameters – ellipticity and anellipticity. Both of these quantities are physically realizable and measurable.


BACKGROUND To lower the burden caused by cancer, the Ministry of Health of the republic of Indonesia requires valid data collection to plan and evaluate cancer programs. This study aimed to evaluate the challenge of developing a cancer registry (CanReg) in Cipto Mangunkusumo Hospital.
METHODS This was an observational study on the implementation of cancer registration from the initial licensing until the creation of valid and accurate data, also the challenges in implementing hospital-based cancer registry (HBCR) in Cipto Mangunkusumo Hospital.
RESULTS Cancer registry was developed in 2016 using the 2013 Indonesian version of CanReg5 program called SriKandI. We identified some problems in this registry implementation, such as legal and human resources, medical records, electronic health records, and the CanReg5 program. Moreover, this team processed 886,086 raw patients' data with fairly good topography and age data completeness.
CONCLUSIONS Several obstacles were encountered upon the establishment of HBCR at Cipto Mangunkusumo Hospital from program to bureaucracy and resources. Nevertheless, CanReg data can be used as a basis for decision making by stakeholders.


An analysis process for break impact loadings to tower, conductors and unfaulted insulators is proposed when one of the composite multi- insulators tension string comes to rupture. A finite element method is used to simulate the break impact process in order to consider the whole structural model of transmission lines and geometric nonlinearity. And a two-step calculation process, form-finding analysis and break impact analysis, is performed. The calculation results are verified by testing data. And an impact influence coefficient is defined to characterize the influence of maximum impact loading to tower, unfaulted insulators, conductors and fittings. A typical example with the structure of three-composite-insulators string and two/three suspension points is presented. The impact loading characteristics are obtained with different fracture locations. The obtained results are beneficial to design composite multi-insulators tension string structure.


The efficient treatment of radioactive waste arising from nuclear accidents and overuse of radioisotopes has become an important issue, and much effort has been devoted to protecting the environment from such toxic radioactive materials. Among them, radioactive iodine in water is regarded as one of the most palpable threats to humans, as it is generated by post-use in medical and industrial applications. Although a few adsorbents and purification processes have been reported, the development of a better desalination method that is able to provide high removal efficiency, ion-selectivity, and reusability is still in demand. Herein, we report a hybrid composite membrane, composed of gold nanoparticles and cellulose acetate membranes, which has the potential to be used for efficient desalination of radioactive iodine. A single filtration process using this membrane provided high removal efficiency with more than two orders of magnitude iodide anion removal within a minute and excellent ion-selectivity. Moreover, the same operation can be applied several times without significant decrease of its performance. Therefore, it is anticipated that our work will be a new avenue for desalination of radioactive iodine in various aqueous media.


Efferent feedback systems provide a means for modulating the input to the central nervous system. The lateral olivocochlear efferents modulate auditory nerve activity via synapses with afferent dendrites below sensory inner hair cells. We examined the effects of dopamine, one of the lateral olivocochlear neurotransmitters, by recording compound and single unit activity from the auditory nerve in adult guinea pigs. Intracochlear application of dopamine reduced the compound action potential (CAP) of the auditory nerve, increased the thresholds and decreased the spontaneous and driven discharge rates of the single unit fibres without changing their frequency‐tuning properties. Surprisingly, dopamine antagonists SCH‐23390 and eticlopride decreased CAP amplitude as did dopamine. In some units, both SCH‐23390 and eticlopride increased the basal activity of auditory nerve fibres leading to an improvement of threshold sensitivity and a decrease of the maximum driven discharge rates to sound. In other units, the increase in firing rate was immediately followed by a marked reduction to values below predrug rates. Because CAP reflects the summed activity of auditory nerve fibres discharging in synchrony, both the decrease in sound‐driven discharge rate and the postexcitatory reduction account for the reduction in CAP. Ultrastructural examination of the cochleas perfused with eticlopride showed that some of the afferent dendrites were swollen, suggesting that the marked reduction in firing rate may reflect early signs of excitotoxicity. Results suggest that dopamine may exert a tonic inhibition of the auditory nerve activity. Removal of this tonic inhibition results in the development of early signs of excitotoxicity.


PURPOSE
Image thresholding and gradient analysis have remained popular image preprocessing tools for several decades due to the simplicity and straight-forwardness of their definitions. Also, optimum selection of threshold and gradient strength values are hidden steps in many advanced medical imaging algorithms. A reliable method for threshold optimization may be a crucial step toward automation of several medical image based applications. Most automatic thresholding and gradient selection methods reported in literature primarily focus on image histograms ignoring a significant amount of information embedded in the spatial distribution of intensity values forming visible features in an image. Here, we present a new method that simultaneously optimizes both threshold and gradient values for different object interfaces in an image that is based on unification of information from both the histogram and spatial image features; also, the method works for unknown number of object regions.

METHODS
A new energy function is formulated by combining the object class uncertainty measure, a histogram-based feature, of each pixel with its image gradient measure, a spatial contextual feature in an image. The energy function is designed to measure the overall compliance of the theoretical premise that, in a probabilistic sense, image intensities with high class uncertainty are associated with high image gradients. Finally, it is expressed as a function of threshold and gradient parameters and optimum combinations of these parameters are sought by locating pits and valleys on the energy surface. A major strength of the algorithm lies in the fact that it does not require the number of object regions in an image to be predefined.

RESULTS
The method has been applied on several medical image datasets and it has successfully determined both threshold and gradient parameters for different object interfaces even when some of the thresholds are almost impossible to locate in the histogram. Both accuracy and reproducibility of the method have been examined on several medical image datasets including repeat scan 3D multidetector computed tomography (CT) images of cadaveric ankles specimens. Also, the new method has been qualitatively and quantitatively compared with Otsu's method along with three other algorithms based on minimum error thresholding, maximum segmented image information and minimization of homogeneity- and uncertainty-based energy and the results have demonstrated superiority of the new method.

CONCLUSIONS
We have developed a new automatic threshold and gradient strength selection algorithm by combining class uncertainty and spatial image gradient features. The performance of the method has been examined in terms of accuracy and reproducibility and the results found are better as compared to several popular automatic threshold selection methods.


Active interest by the exploration industry with multi-spectral VNIR-SWIR WorldView-3 (WV-3) imagery has been evident since its launch in August, 2014. Pre-launch simulation studies by Kruse and Perry (2013) and later comparison between resampled AVIRIS and WV-3 by Kruse et al. (2015) demonstrated its mineral mapping potential, using the well published hydrothermal test site at Cuprite, Nevada. Subsequent validation studies by Sun et al. (2017) tested WV-3 for its alteration discriminating within the Pobei area, Xinjiang Uygur, NW China. In this same area, Ye et al. (2017) also undertook a validation WV-3 study using 1:100,000 geological mapping and comparisons with ASTER. Neither study at Pobei undertook field sample spectroscopy. In this current validation study using the Rodalquilar epithermal setting in Spain, WV-3 mineral mapping results were compared with those obtained using resampled HyMap and ASTER imagery. In addition, WV-3 derived spectral signatures were compared with ASD spectrometer field observations of various homogeneous ground sites collected simultaneously with the WV-3 acquisition. Comparison between the WV-3, HyMap, ASTER map products were generated using Cudahy (2012) and Sun et al. (2017) band parameter indices for mineral(group)s including kaolinite, AlOH, MgOH, ferrous iron content in MgOH/carbonate, and jarosite. Compositional results generated with ASTER appeared to be noisy and less intense within the Rodalquilar study area. By comparison, Worldview-3 showed spatially coherent patterns and extents that were more comparable with the lithologies and alteration zonation's published previously by Arribas et al. (1995). Overall, the results show that the combined WV-3 VNIR- SWIR image spatial resolution of 7.5m showed improved discrimination than those derived from equivalent ASTER's spatial resolution of 30m. Compositional products derived from band parameters designed by Cudahy (2012) generally also gave better results than those from Sun et al (2017) at Rodalquilar. Comparison of the WV-3 surface reflectance product and the field spectral signatures showed a close resemblance for the exposed homogeneous car park targets when using a series of multiple transect grid like observations. Other field observations of various beaches, limestone outcrop exposures and mine-site spoil piles were also examined. Ongoing postgraduate Masters studies are currently being undertaken studying such target ASD spectral field observations and comparisons with the results from variable atmospheric processing and modelling of the WV-3 radiance imagery.


The Argument This paper introduces a distinction between two understandings of the pragmatic tradition: domesticated and radicalized pragmatism. The main difference between these two views concerns the feasibility and moral legitimacy of a radical critique of an existing practice such as science, politics, and so on. It is argued that domesticated pragmatism, with its emphasis on local rather than global perspective, has led to trivialization and degeneration of self-reflective critique. Without rejecting pragmatism as such, this paper urges a reinterpretation of this tradition so as to make room for more thorough forms of critique of both science and social practice.


The use of deep neural networks as function approximators has led to striking progress for reinforcement learning algorithms and applications. Yet the knowledge we have on decision boundary geometry and the loss landscape of neural policies is still quite limited. In this paper, we propose a framework to investigate the decision boundary and loss landscape similarities across states and across MDPs. We conduct experiments in various games from Arcade Learning Environment, and discover that high sensitivity directions for neural policies are correlated across MDPs. We argue that these high sensitivity directions support the hypothesis that non-robust features are shared across training environments of reinforcement learning agents. We believe our results reveal fundamental properties of the environments used in deep reinforcement learning training, and represent a tangible step towards building robust and reliable deep reinforcement learning agents.


For safety and robustness of AI systems, we introduce topological parallax as a theoretical and computational tool that compares a trained model to a reference dataset to determine whether they have similar multiscale geometric structure. Our proofs and examples show that this geometric similarity between dataset and model is essential to trustworthy interpolation and perturbation, and we conjecture that this new concept will add value to the current debate regarding the unclear relationship between overfitting and generalization in applications of deep-learning. In typical DNN applications, an explicit geometric description of the model is impossible, but parallax can estimate topological features (components, cycles, voids, etc.) in the model by examining the effect on the Rips complex of geodesic distortions using the reference dataset. Thus, parallax indicates whether the model shares similar multiscale geometric features with the dataset. Parallax presents theoretically via topological data analysis [TDA] as a bi-filtered persistence module, and the key properties of this module are stable under perturbation of the reference dataset.


As pediatricians we are all too aware of our nation's struggle with childhood overweight and obesity. Approximately 1 of every 5 children that we see in the office every day is obese. Despite tremendous efforts to reverse this trend, it is clear we are in this battle for the long haul.


Sufi ideas exerted a great influence on nearly every aspect of traditional Malay literature of the late 16th to the 17th century. Not only Malay literary practice of that age owed much to the Sufi inspiration, equally important is the fact that Sufism brought to life a pre-modern Malay literary theory including, inter alia, fundamental concepts of literary aesthetics. On the basis of a poem by Hamzah Fansuri and Sufi allegories Hikayat Inderaputera and Hikayat Si Burung Pingai the article investigates the Sufi doctrine of imagination as a particular world all of its own, the "aesthetics of light" expressed through specific illumination of portrayed events and "lighting effects", and the "aesthetics of ecstasy" communicated through acoustic and olfactory images. By embodying these aesthetics in the "flesh and blood" of literary works, their creators not only managed to reveal Sufi doctrines with more clarity and beauty, but also let their audience experience them both intellectually and emotionally.


Fiber cut events reduce the capacity of wide-area networks (WANs) by several Tbps. In this paper, we revive the lost capacity by reconfiguring the wavelengths from cut fibers into healthy fibers. We highlight two challenges that made prior solutions impractical and propose a system called Arrow to address them. First, our measurements show that contrary to common belief, in most cases, the lost capacity is only partially restorable. This poses a cross-layer challenge from the Traffic Engineering (TE) perspective that has not been considered before: "Which IP links should be restored and by how much to best match the TE objective?" To address this challenge, Arrow's restoration-aware TE system takes a set of partial restoration candidates (that we call LotteryTickets) as input and proactively finds the best restoration plan. Second, prior work has not considered the reconfiguration latency of amplifiers. However, in practical settings, amplifiers add tens of minutes of reconfiguration delay. To enable fast and practical restoration, Arrow leverages optical noise loading and bypasses amplifier reconfiguration altogether. We evaluate Arrow using large-scale simulations and a testbed. Our testbed demonstrates Arrow's end-to-end restoration latency is eight seconds. Our large-scale simulations compare Arrow to the state-of-the-art TE schemes and show it can support 2.0x--2.4x more demand without compromising 99.99% availability.


This study examined geodemographic factors associated with availability of comprehensive intimate partner violence (IPV) screening services in Miami-Dade County, Florida. We geocoded 2014 survey data from 278 health facilities and created a population-normalized density surface of IPV screening comprehensiveness. We used correlation analysis and spatial regression techniques to evaluate census tract-level predictors of the mean normalized comprehensiveness score (NCS) for 505 census tracts in Miami-Dade. The population-adjusted density surface of IPV screening comprehensiveness revealed geographic disparities in the availability of screening services. Using a spatial lag regression model, we observed that race and ethnicity are associated with mean NCS by census tract after controlling for age, median gross rent, and receipt of Social Security benefits. The percentage of White non-Hispanic residents was positively associated with NCS, Black non-Hispanic was negatively associated with NCS, while Hispanic—the majority ethnicity in Miami-Dade—was not associated with NCS. This exploratory study may be the first to put IPV screening comprehensiveness on the map, and provides a starting point for addressing urban disparities in the availability of IPV screening services that are shaped by race, ethnicity, zoning, and socioeconomic status.


Small scale testing in controlled environments is a key stage in the development of potential wave energy conversion technology. Furthermore, it is well known that the physical design and operational quality of the power-take off (PTO) used on the small scale model can have vast effects on the tank testing results. Passive mechanical elements such as friction brakes and air dampers or oil filled dashpots are fraught with nonlinear behaviors such as static friction, temperature dependency, and backlash, the effects of which propagate into the wave energy converter (WEC) power production data, causing very high uncertainty in the extrapolation of the tank test results to the meaningful full ocean scale. The lack of quality in PTO simulators is an identified barrier to the development of WECs worldwide. A solution to this problem is to use actively controlled actuators for PTO simulation on small scale model wave energy converters. This can be done using force (or torque)-controlled feedback systems with suitable instrumentation, enabling the PTO to exert any desired time and/or state dependent reaction force. In this paper, two working experimental PTO simulators on two different wave energy converters are described. The first implementation is on a 1:25 scale self-reacting point absorber wave energy converter with optimum reactive control. The real-time control system, described in detail, is implemented in LabVIEW. The second implementation is on a 1:20 scale single body point absorber under model-predictive control, implemented with a real-time controller in MATLAB/Simulink. Details on the physical hardware, software, and feedback control methods, as well as results, are described for each PTO. Lastly, both sets of real-time control code are to be web-hosted, free for download, modified and used by other researchers and WEC developers.


Activation of pre-messenger RNA (pre-mRNA) splicing requires 5′ splice site recognition by U1 small nuclear RNA (snRNA), which is replaced by U5 and U6 snRNA. Here we use crosslinking to investigate snRNA interactions with the 5′ exon adjacent to the 5′ splice site, prior to the first step of splicing. U1 snRNA was found to interact with four different 5′ exon positions using one specific sequence adjacent to U1 snRNA helix 1. This novel interaction of U1 we propose occurs before U1-5′ splice site base pairing. In contrast, U5 snRNA interactions with the 5′ exon of the pre-mRNA progressively shift towards the 5′ end of U5 loop 1 as the crosslinking group is placed further from the 5′ splice site, with only interactions closest to the 5′ splice site persisting to the 5′ exon intermediate and the second step of splicing. A novel yeast U2 snRNA interaction with the 5′ exon was also identified, which is ATP dependent and requires U2-branchpoint interaction. This study provides insight into the nature and timing of snRNA interactions required for 5′ splice site recognition prior to the first step of pre-mRNA splicing.


: Although much is known of the causes and prevention of tail-biting, this continues to be a common vice in pigs. The animals seek diversion by chewing on the tails of their fellows as they feel uncomfortable. This may result in inflammation of the tail. Prevention should be directed towards improvement of the conditions which cause the animal to feel uncomfortable. As this will often not be possible or only in part, efforts are made to prevent tail-biting by docking the tails. When tail-docking is performed according to the rule in one- to three-day-old animals, tail-biting obviously will no longer be possible. However, this does not mean removing the causes of tail-biting. This procedure is therefore undesirable from the point of view of welfare of the animals. Inflammation of the tail may result in metastasis to the spinal column and/or lungs. This is frequently associated with bacteraemia. Moreover, the resulting abscess formation will be highly objectionable from the point of view of hygiene.


Recycling of plastics from screen housing polymers is considered to be helpful to fulfill the requirements of the European waste of electric and electronic equipment directive. However, brominated flame retardants (BFR) and polybrominated dioxins and furans, which are partly limited in marketable products by European and German legislation, have been identified in waste screen housings and need to be eliminated. On application to housing shredder, sink and float was investigated as sorting technology, since BFR-equipped styrene polymers exhibit higher densities compared to corresponding non-BFR types. The feasibility of this concept was proven by database studies and density monitoring of waste screen housing. Laboratory and small-technical scale trials with different mixtures of TV-sets and PC monitor housings revealed that only 5-20% of the original bromine load remained in the target fractions, resulting in bromine levels between 0.18-1.39%. Recycled polymers from fractions rich in HIPSbased TV-set casings did not exceed given threshold limits for PBDD/F and octabromodiphenylether. They were recovered with yields of 52-63% and exhibited mostly virgin-like mechanical properties. In contrast, PC monitor housing fractions were characterized by low yield, high bromine levels in recycled products and brittle recycled polymers. Furthermore, pilot application of another separation approach, the specific swell and float technology, allowed the separation of upgraded HIPS qualities from bromine-reduced TV-set fractions. In contrast, this success has not yet been achieved with waste PC monitors. published in Journal of Applied Polymer Science, Vol. 102, Issue 2, Pages 1262-1273, 15 Oct 2006


Patients subjected to exercise testing following extensive uncomplicated abdominal operations and maintained postoperatively with hypotonic glucose infusions were capable of performing at a mean of 77 +/- 5 per cent of their preoperative maximum work levels. No change was noted in the over-all efficiency or oxygen uptake, of the muscle groups involved. The exercising blood lactate curve can be used to verify the work capacity of large muscle masses and to predict changes in maximum work capacity from submaximal postoperative testing. The maintenance and improvement of the functional integrity of large muscle masses should be one of the primary goals of postoperative surgical nutrition.


Changes in the indices of central hemodynamics and contractility of the heart muscle in the acute period of macrofocal myocardial infarction were studied. In many cases heart ejection and performance of the left ventricle in the first 24 hours of the disease were greater than those in the control group of patients with ischemic heart disease in the period of remission. The increase coincided in time with sharp activation of the sympathico-adrenal and other systems of the organism in myocardial infarction, occurred on a background of deteriorated cardiac contractility, and ended by the third day of the acute period. Such changes in the first day of the disease were less manifest in the group of individuals in whom preceding cardiac failure had been more severe.


Zucchini yellow mosaic virus (ZYMV), genus Potyvirus, infects and causes severe yield losses to cucurbits, including Cucurbita moschata, which is widely grown and consumed in the Indian subcontinent. During 2012-2014, while conducting survey for virus diseases of cucurbits in Tamil Nadu, plants exhibiting mosaic and malformation of leaves and fruits recalling symptoms induced by ZYMV were observed in pumpkin crops at Udumalpet (Tiruppur, isolate TN UDU PUM1) and Anamalai (Coimbatore, isolate TN ANA PUM1) with incidence ranging from 40 to 70%. Ten symptomatic samples (five each from Udumalpet and Anamalai) selected randomly were tested by DAS-ELISA for the presence of ZYMV using a commercial kit (DSMZ, Germany) and ZYMV-specific immunostrips (Agdia, USA). ZYMV was detected only in symptomatic plants. Likewise, RT-PCR using the primer pair (GK ZYMV F/R2) constructed on the coat protein sequence of the virus (Nagendran et al., 2015) amplified a product of ca. 1,000 bp only from symptomatic samples, which was cloned and sequenced in both orientations. Multiple alignment of the nucleotide sequences of both viral isolates (KJ866937 and KJ729043) with comparable sequences from GenBank revealed 98-99% identity with ZYMV isolates from India (HQ529776, KJ866939, KJ729041, KJ729044, JF797206), Iran (JN183062), Israel (EF062582), Syria (KF056805) and Germany (AJ420019) confirming the presence of this virus in symptomatic pumpkin plants. The occurrence of ZYMV in pumpkin has been reported from Germany, Serbia, Korea and Australia (Vucurovic et al. 2012), and in cucumber, gherkins, snake gourd, bottle gourd, zucchini and Amaranthus viridis in India (Nagendran et al., 2015). This is then the first report of ZYMV occurrence in pumpkin in India.


The transitional mucosa adjacent to colorectal carcinoma shows characteristic morphological and histochemical abnormalities that may be indicative of premalignant changes. Sixteen colorectal carcinomas were studied to analyse the proliferative activity and its distribution pattern in tissue samples from transitional mucosa located within 2 cm of the cancer and from uninvolved mucosa 10 cm from the cancer. Proliferative activity was assessed using a monoclonal antibody to proliferating cell nuclear antigen (PCNA). The total labelling index (percentage of labelled cells in a column) of transitional mucosa was not significantly different from that of uninvolved mucosa and normal control mucosa but it was significantly higher in cancer tissue (P < 0.001). An upward shift of the compartment of proliferating epithelial cells towards the bowel lumen was seen in transitional mucosa. The labelling index of the middle compartment (compartment 3) of the crypt in transitional mucosa was significantly higher than that in uninvolved mucosa and control mucosa (P < 0.001). Unstable cytokinetic change may already have started in apparently normal transitional mucosa. Assessment of cell proliferation kinetics by PCNA immunostaining may be useful in screening for heightened risk of the development of colorectal cancer.


One of the most efficient methods to preserve environment is the procedure and method to achieve effective materials and the dual and reapplication of natural sources. In this research, After carrying out a vast study on the growing spot of Iranian oaks , of the 36 species and subspecies already identified, 10 species and subspecies were selected as they cover a vaster surface of Iranian woods in North Alborz Region, Arsabaran region and the western part of Zagros Mountains. 5 samples were collected of each type form diffrenet spots of the country. The effective and usable substances of oak fruit were extracted and isolated by the four methods of maceration, decoction, perculation and soxhlet tannin in one specie show no significant difference; However the amount of tannin in different species show significant differences in statistical term in such a way that the minimum and maximum tannin was found in Q.Brantii, Belangri with 9.7% tannin and Q.Macrantera, with 3.2 percent tannin. This amount was put in contact with wastewater various from plating industries in 20 to 50 mg/L amount. The mentioned wastewaters contained 50 to 750 mg/L heavy metals (chromium, nickel, zinc, copper and silver). The results were analyzed through a biofactor variance analysis model with repetition in each house (Toki) Results showed that the removal output for zinc, copper, nickel and chromium without considering the initial concentration of the metal were 91 to 95 percent, 71 to 83.5 percent, 59 to 90 percent, and 84 to 85 percent, respectively. Also, with repect to the studies carried out with different methods and comparing the percentage of metals removal it was concluded that the removals output through applying 50 mg/L. hydroxide calcium along with 50 mg/L tannin with 82.3 percent average had the most effects in entire metals.


Zinc isotopes have been increasingly applied in cosmochemistry, geochemistry, and environmental sciences. A direct comparison of data obtained in different laboratories is a prerequisite to these applications. The JMC 3-0749L Zn solution is the international primary standard for Zn isotopes, but it is nearly exhausted and no longer available. Thus, it is necessary to calibrate a new reference material for Zn isotope analysis. Herein, we measured the Zn isotope composition and examined the homogeneity of the Standard Reference Material 683 of the National Institute of Standard and Technology (NIST SRM 683, a pure Zn metal nugget of 140 grams) with the double-spike method using Multiple Collector-Inductively Coupled Plasma-Mass Spectrometry (MC-ICP-MS). Five metal nuggets of NIST SRM 683 were intensively sampled by micro-drilling, and they exhibited δ66ZnJMC-Lyon of 0.13 ± 0.06‰ (here and throughout the text, errors are given as two-standard deviation (2SD), N = 32), 0.13 ± 0.04‰ (N = 31), 0.13 ± 0.04‰ (N = 30), 0.13 ± 0.04‰ (N = 30), and 0.12 ± 0.06‰ (N = 30). These values were identical to those of two Zn metal nuggets (0.11 ± 0.02‰ and 0.12 ± 0.02‰) previously reported, which confirmed the accuracy of our data and the isotopic homogeneity of NIST SRM 683. We also digested one whole nugget with δ66ZnJMC-Lyon of 0.12‰ ± 0.04‰ (N = 44), which was identical to that of the drilling samples. Our results indicated that within our analytical precision of 0.04, NIST SRM 683 is homogeneous in Zn isotopic compositions with δ66ZnJMC-Lyon of 0.12 ± 0.04‰ (N = 295) at the 95% confidence level, which is close to the Zn isotope value of bulk silicate Earth. Therefore, we believe that NIST SRM 683 is a good candidate for the next primary standard for Zn isotopes.


Microsatellites are short segments of repetitive DNA sequences distributed throughout the eukaryotic genome and used as molecular markers for various purposes in applied biology. These are tandem repeats of 1-6 nucleotides like di-, tri-, tetra- or hexa nucleotides occurring at high frequency in the nuclear genomes of different taxa including most of the vertebrates. These constitute only a few percent of the genomes depending on their compactness but have become the markers of choice for high-resolution population analysis due to high variability, ease and accuracy of assaying. In modern trends of genetics, molecular biology, biotechnology and genetic engineering pertinent to animal, plant and microbes, these markers have contributed a lot to upgrade the knowledge and information. These are preferred as extremely valuable tools for genome mapping in many organisms over erstwhile markers and are integrated with other morphological features of various organisms helping to identify species or strains accurately. These have been used extensively since last few decades for versatile purposes in various parts of world and are applied to different organisms where fishes are not an exception. As versatile genetic markers, these have been applied in many studies on genetics and resource management of fishes as well as for analyzing pedigree, population structure, genome variation, evolutionary process and fingerprinting. This strengthens management and protection of fish germplasm. These are also integrated with many other tools of recent advancement in biotechnology, molecular biology and genetic engineering vis-a-vis other traditional technologies like captive breeding and fish milt cryopreservation for conserving genetic diversity and rehabilitation of the natural populations of fishes. However, there is still a long way to go before these are applied in each species of fish. The present article reviews a compilation of many references on utilities of microsatellite markers for different purposes applied to various types of fishes and non fishes.


With the progress of IT and mobile positioning technologies, various types of location-based services (LBS) have been proposed and implemented. Finding a shortest path between two nodes is one of the most fundamental tasks in many LBS related applications. So far, there have been many research efforts on the shortest path finding problem. For instance, A * algorithm estimates neighboring nodes using a heuristic function and selects minimum cost node as the closest one to the destination. Pruning method, which is known to outperform the A * algorithm, improves its routing performance by avoiding unnecessary exploration in the search space. For pruning, shortest paths for all node pairs in a map need to be pre-computed, from which a shortest path container is generated for each edge. The container for an edge consists of all the destination nodes whose shortest path passes through the edge and possibly some unnecessary nodes. These containers are used during routing to prune unnecessary node visits. However, this method shows poor performance as the number of unnecessary nodes included in the container increases. In this paper, we focus on this problem and propose a new border line-based pruning scheme for path routing which can reduce the number of unnecessary node visits significantly. Through extensive experiments on randomly-generated, various complexity of maps, we empirically find out optimal number of border lines for clipping containers and compare its performance with other methods.


A new type of discrete clamp stretch forming machine based on flexible holding technology was developed to improve the performance of traditional rigid clamp stretch forming machine used for double-curvature metal sheet forming, and its forming characters were illuminated simply. The FE model of flexible discrete clamp stretch forming was set up, and extensive numerical simulations of spherical parts for both the flexible holding mode and the rigid holding mode were carried out by dynamic explicit finite element analysis. The numerical results show that the distribution of stress, strain and thickness were well-proportioned in the flexible holding mode. The larger the spherical radius is, the smaller the minimum transitional length of sheet metal is. The transitional length of 60mm is suitable for flexible discrete clamp stretch forming in the case of considering the forming quality and material utilization. Then, the stretch forming experiment proves that the flexible holding technology is feasible, and the error contrast illustrates the new type of discrete clamp stretch forming machine is practicable.


This paper explores the nature of ongoing relationships between war veterans and spirit mediums in Zimbabwe, as well as the continuing salience of a shared chimurenga legacy of co-operation by these two groups, and how it has been put to use, and acted out by both in the context of Zimbabwe's recent fast track land reform project. In emphasising this continuity, the paper also considers whether a corresponding disparity between the ideology of the ruling political elite and the practices, experiences and performances of guerrillas, spirit mediums and others acting on the ground, which materialised during the liberation struggle, has re-emerged, despite or alongside the recent collaboration of some war veterans with the ruling party's rhetoric of 'patriotic history'. Engaging with Lambek's work on moral subjectivity and Mbembe's 'logic of conviviality' of postcolonial states and their subjects, it argues that war veterans and spirit mediums sometimes share a 'moral conviviality' which appears during bira possession ceremonies, in the shared demands for the return and reburial of the war dead from foreign countries, or for 'national' ceremonies held at Great Zimbabwe and elsewhere to thank the ancestors, as well as in the similar way in which spirit mediums and war veterans subject their agency to that of the ancestors in their narrative performances. It concludes by suggesting that although many war veterans have undeniably been closely complicit in the violent 'authoritarian nationalism' of the state, in this shared war legacy of spirit mediums and war veterans lies the opportunity for radical alternative imaginations of the state.


Reports on a mission to north‐east India undertaken in September 1996 with a view to developing a joint research programme on sustainability of land use in that area. Describes the mission, the travel involved and the nature of the agreement which was reached with members of the North‐East Hill University, Mizoram Campus and with participants of Arunachal University. Identifies priority areas for future research as sustainable agriculture and use of forestry resources with the mission focus of attention being on Mizoram and Arunachal Pradesh. States that the majority of the population in north‐eastern Indian states consists of tribal people, many of whom still engage in shifting agriculture and are still very dependent on forest resources for their livelihood. Explains that, owing to rising populations and the desire for higher incomes, traditional practices in agriculture and forest use in this part of India are no longer sustainable, noting that the incomes of local people and their way of life are therefore threatened and there is urgent need for research to find new alternatives.


BACKGROUND
Skeletal muscle weakness is a prominent problem in many patients with chronic obstructive pulmonary disease (COPD).

OBJECTIVE
The aim of the study was to determine the relation between skeletal muscle function, body composition, and lung function in COPD (emphysema and chronic bronchitis) patients and healthy volunteers.

DESIGN
In 50 patients with chronic bronchitis, 49 patients with emphysema, and 28 healthy volunteers, skeletal muscle function was assessed by handgrip and linear isokinetic dynamometry. Whole-body and subregional fat-free mass (FFM) were assessed by dual-energy X-ray absorptiometry.

RESULTS
Whole-body and extremity FFM were significantly lower in patients with emphysema (P < 0.001) and chronic bronchitis (P < 0.05) than in healthy volunteers, but trunk FFM was significantly lower only in patients with emphysema (P < 0.001). Extremity FFM was not significantly different between the COPD subtype groups, despite significantly lower values for whole-body and trunk FFM (P < 0.05) in patients with emphysema. Absolute skeletal muscle function (P < 0. 001) and muscle function per kilogram of whole-body FFM were significantly lower in both COPD subtype groups than in healthy volunteers (P < 0.05), but no significant difference was found between patients with chronic bronchitis and those with emphysema. Muscle function per kilogram of extremity FFM was not significantly different between the 3 groups and was not associated with forced expiratory volume in 1 s.

CONCLUSION
Skeletal muscle weakness is associated with wasting of extremity FFM in COPD patients, independent of airflow obstruction and COPD subtype.


In Polymer Electrolyte Membrane Fuel Cells (PEMFCs) the structure and morphology of the electrode layer directly affects the value of the electrochemical resistance, which has an impact in the cell performance. These effects become particularly relevant when the cathode catalyst is based on a non-precious metal due to the higher catalyst loadings required to compensate for the lower catalytic activity when compared to Pt based catalysts. In previous experiments performed in our lab, a pyrolyzed iron (III) porphyrin framework (PCPF-Fe) material was characterized, exhibiting a good single cell performance. In this study, the addition of a high surface carbon to the PCPF-Fe was conducted in an attempt to increase the surface area and the electron conductivity and, consequently, improve the activity and stability of the material. For this purpose, as-synthetized PCPF-Fe was mixed with Ketjenblack (KJB) carbon to four different ratios, pyrolyzed and its catalytic activity towards the ORR was evaluated using rotating ring disk electrode (RRDE) experiments. The structure and morphology of the catalyst layer were analyzed through scanning electron microscopy (SEM), and X-Ray Diffraction (XRD). The best performed mixture was 50% PCPF-Fe, and exhibited a higher onset potential (0.868 V in the 100% vs. 1.016 V in the 50%) and limiting current density (-4.6mA/cm 2 in the 100% vs. -6.0mA/cm 2 in the 50%) to that of the pure material. The material was then used as the cathode electrode in a single cell. The maximum current density obtained in single cell test for the 50% PCPF-Fe was only a third of that obtained with a 100% PCPF-Fe (0.25A/cm 2 vs. 0.81A/cm 2 ) cathode with the same catalyst loading, which could be a result of the lower density of catalytic centers in the mixture.


Surrounded by wealth and economically successful communities in California's Huntington Beach area, the Oak View neighborhood has struggled with persistent problems with crime, unemployment, substandard housing, and poverty. Nonetheless, the neighborhood remains resilient and has drawn on the strength of its community ties to support the Oak View Renewal Partnership (OVRP), a place-based nonprofit focused on building and supporting the neighborhood from the inside out. Based on the need for improved employment conditions and more stable incomes in the neighborhood, OVRP has concentrated its efforts on workforce development activities, including job training and placement and small business development. This article discusses the design and operation of OVRP's Micro-Enterprise Development Program model, and presents best practices learned in the incubation and launch of the first neighborhood-based small business developed through this program.


Several model-based techniques have been proposed for characterizing thin layers within multi-layered materials. One problem with these methods is that the models are non-linear with respect to the parameters. Hence, iterative numerical methods must be used estimating the model parameters, i.e. for solving the inverse problem based on measurements. For material structures where the propagation times through the individual layers are shorter than the duration of the transmitted ultrasound pulse, the received waveform will consist of several overlapping echoes. For the parameter estimation to work, good initial guesses of the times of flight are required, which are difficult to obtain due to the severe overlap of the echoes. In this paper we propose a filtering scheme, that compresses the transmitted pulse into a shorter pulse, thus enabling the echoes from within the material structure to be detected. The method is evaluated using simulations on a three-layered material for varying signal-to-noise conditions.


This article has a double objective : to propose a theoretical contribution concerning the problem of performance evaluation in functional departments and to present the results of an empirical field study describing the practices of French companies regarding performance evaluation. The theoretical analysis, built upon a definition of functional departments, which are characterized by a task specialisation, a specific hierarchical position, and the presence of discretionary activities, points out the many problems encountered in evaluating functional departments: confusing goals, poor description of results, paucity of information regarding the means-results relation... The field study shows that the interviewees share a common definition of functional departments, that of service providers. The methods used to evaluate functional departments, though diverse, still focus on costs and neglect measures of results.


Ice cream is a product obtained from controlled raw materials, processed through pasteurization, homogenization, maturation, cooling, freezing, through keeping the air in composition, with or without glazer, and sell in different casseroles or waffle. For every product of ice cream a technical description is made. On this sheet one can find all the ingredients used, the physical–chemical and microbiological characteristics of the final product, the quality control rules applied and the particular analytical methods used for every product. The purpose of this paper is to describe the critical points in which hazard can intervene in the production process, the evaluation and the measures applied to prevent and control these critical points. This method is applied to all the technological processes for obtaining the ice cream based on milk and fruits.


Dynamic neural networks can greatly reduce computation redundancy without compromising accuracy by adapting their structures based on the input. In this paper, we explore the robustness of dynamic neural networks against energy-oriented attacks targeted at reducing their efficiency. Specifically, we attack dynamic models with our novel algorithm GradMDM. GradMDM is a technique that adjusts the direction and the magnitude of the gradients to effectively find a small perturbation for each input, that will activate more computational units of dynamic models during inference. We evaluate GradMDM on multiple datasets and dynamic models, where it outperforms previous energy-oriented attack techniques, significantly increasing computation complexity while reducing the perceptibility of the perturbations https://github.com/lingengfoo/GradMDM.


BACKGROUND
Meningiomas are the most common tumors occurring in the central nervous system, with variable recurrence rates depending on World Health Organization grading. Atypical (Grade II) meningioma has a higher rate of recurrence than benign (Grade I) meningioma. The efficacy of adjuvant radiotherapy (RT) to improve tumor control has been questioned.

OBJECTIVE
To investigate clinical and histopathological predictors of tumor recurrence and radio-resistance in atypical meningiomas.

METHODS
This cohort study retrospectively reviewed all patients in St. Michael's Hospital CNS tumor patient database who underwent surgical resection of a Grade II meningioma from 1995 to 2015. Cases with neurofibromatosis type II, multiple satellite tumors, spinal cord meningioma, radiation-induced meningioma, and perioperative death were excluded. Patient demographics, neuropathological diagnosis, tumor location, extent of resection, radiation therapy, and time to recurrence or progression were recorded. Cox univariate regression and Kaplan-Meier survival analysis were employed to identify risk factors for recurrence and radio-resistance.

RESULTS
Among 181 patients, the combination of necrosis and brain invasion was associated with an increased recurrence risk (hazard ratio [HR] = 4.560, P = .001) and the lowest progression-free survival (PFS) relative to other pathological predictors. This trend was maintained after gross total resection (GTR, P = .001). RT was associated with decreased PFS (P = .001), even in patients who received GTR (P = .001).

CONCLUSION
The combination of necrosis and brain invasion is a strong predictor of tumor recurrence and radio-resistance in meningioma, regardless of EOR or adjuvant RT. Our findings question the sensibility of brain invasion as an absolute criterion for Grade II status.


Background The cerebral aqueduct is a central conduit for cerebrospinal fluid (CSF), and non-invasive quantification of CSF flow in the aqueduct may be an important tool for diagnosis and follow-up of treatment. Magnetic resonance (MR) methods at clinical field strengths are limited by low spatial resolution. Purpose To investigate the feasibility of high-resolution through-plane MR flow measurements (2D-PC) in the cerebral aqueduct at high field strength (7T). Material and Methods 2D-PC measurements in the aqueduct were performed in nine healthy individuals at 7T. Measurement accuracy was determined using a phantom. Aqueduct area, mean velocity, maximum velocity, minimum velocity, net flow, and mean flow were determined using in-plane resolutions 0.8 × 0.8, 0.5 × 0.5, 0.3 × 0.3, and 0.2 × 0.2 mm2. Feasibility criteria were defined based on scan time and spatial and temporal resolution. Results Phantom validation of 2D-PC MR showed good accuracy. In vivo, stroke volume was −8.2 ± 4.4, −4.7 ± 2.8, −6.0 ± 3.8, and −3.7 ± 2.1 µL for 0.8 × 0.8, 0.5 × 0.5, 0.3 × 0.3, and 0.2 × 0.2 mm2, respectively. The scan with 0.3 × 0.3 mm2 resolution fulfilled the feasibility criteria for a wide range of heart rates and aqueduct diameters. Conclusion 7T MR enables non-invasive quantification of CSF flow and velocity in the cerebral aqueduct with high spatial resolution.


Background: The most important natural radioactive resource to which people are exposed is Radon gas. Radon gas produced deep in the earth enters into underground waters and dissolves in them. The Radon gas in water supplied for home uses enters the body by either drinking water or inhaling Radon gas released into the air and causes stomach and lung cancers. The purpose of this study is determination of annual effective absorbed dose of Radon gas in Rafsanjan and Anar residents. Material and Methods: This study is experimental and is done on 36 randomly selected resources of drinking and agricultural water in Rafsanjan. Measuring the concentration of Radon gas dissolved in water by the electronic detector RAD7 and statistical analysis of data, the annual absorbed dose of Radon gas by adults and children continually using water of these sources is estimated. Results: The minimum and maximum amount of Radon gas concentration in drinking water are 0.32±0.12 Bq/lit and 13.90±2.45 Bq/lit while the minimum and maximum amount of Radon gas in agricultural resources of water are 3.68±1.25 Bq/lit and 24.51±3.87 Bq/lit, respectively. Therefore, the annual absorbed dose of Radon gas by adults and children using drinking water is between 3.16±1.17 μSv/year and 136.22±24.01 μSv/year and 4.33±1.61 μSv/year and 186.95±32.95 μSv/year, also it is between 36.06±12.25μSv/year and 240.20±37.93μSv/year and 49.49±16.81μSv/year and 329.66±52.05 μSv/year for those using agricultural water Conclusion: it has been concluded that the amount of Radon gas dissolved in the water of this region is approximately high; however, different methods of releasing the existing Radon gas of drinking water along with informing people about the dangers of this gas can decrease the natural exposure caused by Radon gas.


The stability of linear time‐delay systems with point internal delays is difficult to deal with in practice because of the fact that their characteristic equation is usually of transcendent type rather than of polynomial type. This feature causes usually the system to possess an infinite number of poles. In this paper, stability tests for this class of systems are obtained either based on extensions of classical tests applicable to delay‐free systems or on approaches within the framework of two‐dimensional digital filters. Some of those two‐dimensional stability tests are also proved to be useful for stability testing of a common class of linear hybrid systems which involve coupled continuous and digital substates after a slight "ad‐hoc" adaptation of the tests for that situation.


Past research has supported the hypothesis that the relationship between harsh childhood punishment and adult political attitudes is due to the displacement of negative emotions that arise onto punitive public policies, e.g., support for the death penalty (Milburn, Conrad, Sala, & Carberry, 1995). Cognitions associated with childhood punishment may also impact adult political attitudes, yet their effects have not yet been examined, despite research that shows that punitive childhood experiences increase the tendency to attribute hostility to others. Thus, we investigated whether the tendency to make hostile attributions about others' behavior influences a person's authoritarianism, controlling for their parents' political orientation. Respondents completed an online survey concerning their childhood punishment experiences, their parents' political orientation, their trait anger, their level of hostile attribution bias (HAB), and their authoritarianism. Multiple regression analyses and structural equation modeling (SEM) found that higher childhood punishment has a significant direct effect on higher levels of authoritarianism, even after controlling for parents' political orientation, and that trait anger and HAB appear to mediate the effects of childhood punishment experiences on authoritarianism,. These results support the process of affect displacement as an important influence on adult punitiveness and political orientation.


Eugenol and gallic acid have cytotoxic effects in HT-29 colon cancer cells. In this study, we examined cytotoxic effect of esterification of eugenol and gallic acid. Before synthesized process, in silico docking was conduct to eugenol, gallic acid and its esterification products against Bcl-2 protein. After in silico docking, Eugenol and gallic acid were allowed to react by Mitsunobu Reaction to obtain compound (4-5). Proton and carbon NMR spectroscopy, also mass spectra (GCMS) were used to characterize of the structure from products. The products from esterification were tested by cytotoxic activity and showed by IC 50 with navitoclax as positive control. In silico docking result showed compound (5) had the lowest Gibb's Energy. Compound 4 and 5 were successfully synthesized and characterized by spectrometer 1H-NMR, 13C-NMR, and mass spectrometry. In silico docking result related to cytotoxic assay against HT-29 cell line. By replacing hydroxyl group of gallic acid with methoxy groups had increased the lipophilicity and the cytotoxicity. The greatest inhibitor against HT-29 cell line was compounds (5) with IC 50 values of 22.81 μg/ml. The synthesized esterification product, compound (5), had greater cytotoxic activity than eugenol and gallic acid against colon cancer cell line, HT-29. Thus, the esterification products should be considered as a promising candidate for cancer colon drug.


This article contributes to the emergent field of corporate activism by exploring how corporate advertising voices, or is interpreted by the media as voicing, Trump resistance – that is, sympathy with anti-Trump protests and dismay at the politics of the White House incumbent. In so doing, we first situate corporate activism in relation to the more established fields of political corporate social responsibility and corporate social responsibility communication, focusing on discussions concerning the interplay between talk and action as well as the potential of talk to lead to action. On this basis, we propose a conceptual framework that posits talk and action as operating conjointly on the ontological plane of s(t)imulation, a conceptual conjunction of simulation and stimulation that is inspired by Baudrillard's notion of the simulacrum. Empirically, we conduct a qualitative analysis of 20 examples of corporate advertising that has been reported as anti-Trump in the media. We find that the advertising in our sample is characterized by the following three main distinctions: (1) humorous references to Trump, (2) favourable and highly emotional appeals to social justice and (3) dystopian visions of society. We argue that a postmodern perspective on signs and representation may not only nuance our understanding of corporate activism, but also contribute to the conceptualization of the phenomenon by pushing the explanatory framework beyond the dialectic of talk and action.


Body mass index (BMI) and waist circumference (WC) have been suggested to be involved in the etiology of hypertension. The present study aimed to determine multiple trajectories of BMI and WC, then examined their associations with the risks of hypertension and high blood pressure in Chinese adults. The study used China Health and Nutrition Survey data from 1991 to 2018. The sample included 9651 adults aged 18 years or older. We used group-based multi-trajectory modeling to identify trajectories. We estimated the relationships between the trajectories and the risks of hypertension with a Cox proportional hazards regression model and the trajectories' relationships with blood pressure levels with a generalized linear model. We identified four trajectories for each gender: low stable BMI, low increasing WC (group 1); medium increasing BMI, medium increasing WC (group 2); increasing BMI to overweight, increasing WC to central obesity (group 3), increasing BMI to obesity, increasing central obesity WC (group 4). Group 1 was the reference group. Among males in groups 2, 3, and 4, the adjusted hazard ratios (HR) and 95% confidence intervals (95% CI) of hypertension were 1.30 (1.15–1.48), 1.86 (1.58–2.18), and 2.60 (2.02–3.34), respectively. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) of males in group 4 increased by 11.90 mm of mercury (mmHg) and 7.75 mmHg, respectively. Among females in groups 2, 3, and 4, the HR and 95% CI of hypertension were 1.35 (1.18–1.54), 1.92 (1.62–2.26), and 2.37 (1.85–3.03), respectively. The SBP and DBP of females in group 4 increased by 8.84 mmHg and 5.79 mmHg, respectively. These data indicated that increases in BMI and WC were associated with unfavorable hypertension risks. Attention to both BMI and WC trajectories has the potential to prevent hypertension.


Large numbers of postlarvae of the bathyal ophiuroid Ophiocten gracilis were collected by two time‐series sediment traps moored on the continental slope of the NE Atlantic for 102 d at 1,000 and 1,400 m deep (469 and 69 mab), respectively. With time, the organisms collected were progressively larger, suggesting that a single cohort was growing within the collection funnel of the traps but above the preservative solution. We believe that specimens from this cohort occasionally lost their grip on the funnel surface and fell into the preservative. This conclusion is supported by (1) the presence of food within the stomachs of postlarvae (these do not feed in their planktonic phase) and (2) the size of specimens (much larger than those previously found in the plankton). The upper trap was well above the benthic nepheloid layer, and suspension of these organisms by ambient currents is highly unlikely. Ophiuroids contributed up to 7% of the total daily flux of particulate organic carbon (POC) in the top trap and almost 30% in the bottom trap, and although they are not normally considered components of downward particle flux, these specimens had been growing on the material entering the traps and so should be included in this portion. Not all of the epifaunal population will have fallen into the collecting cups, but those that fell had requirements for growth and respiration that were a considerable proportion of the daily flux of POC into the traps (up to 16%). If this epifaunal community (a minimum estimate) was distributed evenly within the cone, a high proportion of the settling material would have come into contact with ophiuroids as it slid down the inside walls of the cone. This problem with the sediment trap technique is probably restricted to the continental slope and shelf and will not occur over abyssal depths.


Sperm capacitation is required for fertilization. At the molecular level, this process is associated with fast activation of protein kinase A. Downstream of this event, capacitating conditions lead to an increase in tyrosine phosphorylation. The identity of the tyrosine kinase(s) mediating this process has not been conclusively demonstrated. Recent experiments using stallion and human sperm have suggested a role for PYK2 based on the use of small molecule inhibitors directed against this kinase. However, crucially, loss-of-function experiments have not been reported. Here, we used both pharmacological inhibitors and genetically modified mice models to investigate the identity of the tyrosine kinase(s) mediating the increase in tyrosine phosphorylation in mouse sperm. Similar to stallion and human, PF431396 blocks the capacitation-associated increase in tyrosine phosphorylation. Yet, sperm from Pyk2−/− mice displayed a normal increase in tyrosine phosphorylation, implying that PYK2 is not responsible for this phosphorylation process. Here, we show that PF431396 can also inhibit FER, a tyrosine kinase known to be present in sperm. Sperm from mice targeted with a kinase-inactivating mutation in Fer failed to undergo capacitation-associated increases in tyrosine phosphorylation. Although these mice are fertile, their sperm displayed a reduced ability to fertilize metaphase II-arrested eggs in vitro. Highlighted article: The increase in tyrosine phosphorylation seen during sperm capacitation is mediated by the FER kinase, but this does not seem to be essential for fertilisation in vivo in mice.


1. The role of food in avian reproduction is generally studied from the perspective of the protein and energy demand of birds, This study provides the first experimental evidence that calcium availability may limit reproduction in wild birds as well. 2. Data are presented showing that a large proportion of great tits Parus major on calcium-poor soils in the Netherlands produce eggs with thin and porous shells and desert the clutch before hatching. About 10% of the females do not lay at all. 3. Free-living great tits were supplied with an additional calcium source, i.e. snail shells and chicken eggshells. This treatment reduced the number of females without eggs, the frequency of clutch desertion, the proportion of nests with defective eggshells and the proportion of non-hatched eggs in clutches that produced young. The calcium supplements did not affect clutch size or laying date. 4. We suggest that possible adaptations to a limited calcium supply are not yet evident because the low calcium availability is a recent phenomenon caused by acid deposition and because a large part of the breeding population consists of immigrants from calcium-rich areas. 5. We provide evidence that calcium limitation in avian reproduction may be widespread on calcium-poor soils. 6. The results imply that the costs of egg formation in calcium-poor areas can be much higher than is currently estimated and that food conditions during egg-laying have a greater impact on avian reproduction than is presently believed. [KEYWORDS: eggshell; food availability; limiting nutrients; Parus major L reproduction Brown-headed cowbirds; tit parus-major; great tit; nutrient reserves; quelea-quelea; clutch-size; food; reproduction;birds; limitation]


We consider an infinite, planar, Delaunay graph which is obtained by locally deforming the embedding of a general, isoradial graph, w.r.t. a real deformation parameter $\epsilon$. This entails a careful analysis of edge-flips induced by the deformation and the Delaunay constraints. Using Kenyon's exact and asymptotic results for the Green's function on an isoradial graph, we calculate the leading asymptotics of the first and second order terms in the perturbative expansion of the log-determinant of the Beltrami-Laplace operator $\Delta(\epsilon)$, the David-Eynard K\"ahler operator $\mathcal{D}(\epsilon)$, and the conformal Laplacian $\underline{\Delta}(\epsilon)$ on the deformed graph. We show that the scaling limits of the second order {\it bi-local} term for both the Beltrami-Laplace and David-Eynard operators exist and coincide, with a value independent of the choice of initial isoradial graph. Our results allow to define a discrete analogue of the stress energy tensor for each of the three operators. Furthermore we can identify a central charge ($c$) in the case of both the Beltrami-Laplace and David-Eynard operators. While the scaling limit is consistent with the stress-energy tensor and value of the central charge for the Gaussian free field (GFF), the discrete central charge value of $c=-2$ for the David-Eynard operator is, however, at odds with the value of $c=-26$ expected by Polyakov's theory of 2D quantum gravity; moreover there are problems with convergence of the scaling limit of the discrete stress energy tensor for the David-Eynard operator. The bi-local term for the conformal Laplacian involves anomalous terms corresponding to the creation of discrete {\it curvature dipoles} in the deformed Delaunay graph; we examine the difficulties in defining a convergent scaling limit in this case. Connections with some discrete statistical models at criticality are explored.


Objective : The purpose of this study was to investigate the relationship between type 1 diabetes duration and uncertainty. According to the Reconceptualized Uncertainty in Illness Theory, it was hypothesized that longer duration would be associated with less uncertainty. Research Design and Method : A sample of 379 people with type 1 diabetes recruited from the T1D Exchange completed an online survey. The online survey measured disease duration, uncertainty, and demographic characteristics. Multiple variable linear regression was calculated to test for an association between diabetes duration (in years) and uncertainty in diabetes self-management. Post hoc one-way analysis of variance with Tukey's HSD test was calculated to investigate uncertainty at five and ten-year disease duration intervals. Results : With adjustment for age, gender, and education, diabetes duration was negatively associated with uncertainty (b = -0.15, p= .03; 95% CI = -0.28, -0.01). Uncertainty was lowest among the 64 participants with a duration equal to or greater than 40 years (M=63.53, SD=15.04). In Tukey's HSD post hoc test, the mean difference on the uncertainty scores for 5 to < 10 years diabetes duration (n=38, M=72.66, SD=14.51) and 40 or more years diabetes duration was significant (p = 0.02, 95% CI = 0.81, 17.44). Conclusions : Individuals with longer disease duration reported less uncertainty related to self-management, and uncertainty varied by duration interval. These findings provide preliminary information about where to place behavioral interventions designed to reduce uncertainty among individuals with type 1 diabetes.


The essential definition of the promotion of smart regional growth is local resource, potential, exploration of operational mechanisms. That is in order to develop the understanding of local resource feasibility and the community activities. It is important to develop cross-sectoral cooperation, which is focused on non-technological, social and on the ecological innovation processes in connection with entrepreneurship. Social entrepreneurship is an essential mechanism in economic activity balancing, while creating social values that encourage the local community to participate in many areas and reduce socio-economic disparities. The ''Traditional'' entrepreneur whose main desire is to create a product, find their client and thus, earn money, differs from a social businessman. An entrepreneur who has chosen the social niche, firstly, solves a social problem. In Latvia, social entrepreneurship is becoming more popular. Help and consultation at this point is provided by the Latvian entrepreneurship association (LEA), which has been in operation since the year of 2015. The region of Latgale is also becoming more popular in this field. In order to evaluate social entrepreneurship feasibility and to determine factors in the region of Latgale, cross-disciplinary research has to be carried out. Moreover, research and development in this area involves the involvement of a wide variety of stakeholders: NGO (non-governmental organisation), state, business, representatives of the public.


AIM
To examine the feasibility and validity of electronic generation of quality metrics in the intensive care unit (ICU).

METHODS
This minimal risk observational study was performed at an academic tertiary hospital. The Critical Care Independent Multidisciplinary Program at Mayo Clinic identified and defined 11 key quality metrics. These metrics were automatically calculated using ICU DataMart, a near-real time copy of all ICU electronic medical record (EMR) data. The automatic report was compared with data from a comprehensive EMR review by a trained investigator. Data was collected for 93 randomly selected patients admitted to the ICU during April 2012 (10% of admitted adult population). This study was approved by the Mayo Clinic Institution Review Board.

RESULTS
All types of variables needed for metric calculations were found to be available for manual and electronic abstraction, except information for availability of free beds for patient-specific time-frames. There was 100% agreement between electronic and manual data abstraction for ICU admission source, admission service, and discharge disposition. The agreement between electronic and manual data abstraction of the time of ICU admission and discharge were 99% and 89%. The time of hospital admission and discharge were similar for both the electronically and manually abstracted datasets. The specificity of the electronically-generated report was 93% and 94% for invasive and non-invasive ventilation use in the ICU. One false-positive result for each type of ventilation was present. The specificity for ICU and in-hospital mortality was 100%. Sensitivity was 100% for all metrics.

CONCLUSION
Our study demonstrates excellent accuracy of electronically-generated key ICU quality metrics. This validates the feasibility of automatic metric generation.


Abstract In light water reactors, a helium-filled gap between the fuel and the cladding accommodates fuel swelling and cladding creepdown. However, the low thermal conductivity of helium results in a large ΔT over the gap before closure occurs. To remedy this situation, Wright et al. proposed the use of a liquid metal (LM) bond in the fuel-cladding gap. The LM (33 wt% each of lead, tin, and bismuth) was chosen for its low melting point (~120°C), its lack of chemical reactivity with UO2 and water, and its high thermal conductivity (~100 times that of He). The thermal resistance of the LM-bonded gap is nil. Prior to closure of a helium-bonded gap, the centerline fuel temperature can be hundreds of degrees hotter than that with an LM-bonded gap at the same linear heat rating. Since the diffusion of fission gas atoms depends strongly upon temperature, it is expected that with the high thermal conductivity pellet-cladding gap, the incubation time to fission gas release should be considerably delayed. A modified Booth Sphere model, which takes into account re-solution, is adopted. The amount of fission gas atoms collected at the grain boundary is calculated using realistic time-temperature histories taken from a recent U.S. Nuclear Regulatory Commission review. The saturation value of gas at the grain boundary proposed by Dowling to fission gas release is adopted. The results show that although the temperature in the LM-bonded case is substantially lower than the He-filled case when the gap is open, the temperatures in the two cases equalize when the gap vanishes. Correspondingly, the two cases exhibit a comparable amount of fission gas at the grain boundary. Calculated differences between the times to saturation with LM and He in the gap are as high as ~1 yr and as low as 1 to 2 days.


Abstract This document outlines good measurement practice to be adopted for the determination of flow stress at high temperature in torsion tests on solid metallic materials. The recommendations are applicable to hot (isothermal) tests at medium to high rates of strain (10–3–102 s–1) at temperatures relevant to metal working practice. Guidance is provided on appropriate testpiece geometries and methods of verifying the temperature distribution along the length of the testpiece. Flow diagrams are given showing all the steps that are necessary, including the correction factors that need to be applied for deformational heating and for the determination of true stress. Details are given of the calibration procedures that should be followed to provide traceability to the National Measurement System. Technical input to the document has been provided by the steering group of a European SMT funded project on High Temperature Testing, TESTIFY, that contained representatives of industrial users and producers of a wide range of engineering materials as well as academic modellers. An experimental programme was conducted during the preparation of this document to underpin the procedures in this guide.


BACKGROUND
Statins are among the most commonly prescribed medications worldwide. Although their benefits for cardiovascular disease are well established, the effects of statins on depressive symptoms are unknown.

METHOD
We examined the association between baseline statin use (2000-2002) and subsequent depressive symptoms in a prospective cohort study of 965 outpatients with coronary disease from 12 outpatient clinics in the San Francisco Bay Area. Depressive symptoms were assessed annually for 6 years using the Patient Health Questionnaire (PHQ) (primary outcome measure). We evaluated the cross-sectional association between statin use and risk of depressive symptoms at baseline and the longitudinal association between baseline statin use and risk of depressive symptoms during follow-up.

RESULTS
Of the 965 participants, 629 (65%) used statins. At baseline, statin users had lower mean ± SE PHQ depression scores than nonusers (4.8 ± 0.2 vs 5.9 ± 0.3, P < .01). Statin users were less likely than nonusers to have depression (PHQ score ≥ 10) at baseline (17% vs 24%; P = .02) and during follow-up (28% vs 40%; P < .01). Among the 776 patients without depressive symptoms at baseline (PHQ < 10), statin use was associated with a 48% decreased odds of developing depression during follow-up (odds ratio [OR], 0.52; 95% CI, 0.38-0.73; P < .01). After we adjusted for potentially confounding variables, statin use remained associated with a 38% decreased odds of subsequent depression (adjusted OR, 0.62; 95% CI, 0.41-0.95; P = .02).

CONCLUSIONS
We found that statin use was associated with a decreased risk of subsequent depressive symptoms in patients with coronary heart disease. Whether use of statins prevents depressive symptoms deserves further study.


Foreign peoples lived at the Fair in homes constructed much like those at home.
Many of the building materials for these houses were imported from the native country. Native craftsmen constructed the buildings using their own techniques. For instance, many of the Japanese buildings were constructed with special saws and no nails.
Visitors did not have to walk far to see Eskimo seal tents, Kickapoo domed winter houses, Bedouin tents, Patagonian dwellings made of guanaco skins and delicately painted Japanese homes. The Philippine Reservation included over 100 buildings ranging from thatch-roofed huts balanced in trees to formal homes reflecting Spanish influence like those found in Manila.
St. Louisans marveled at the different types of houses, probably much the same way that the foreign peoples marveled at the Fair's exhibit buildings and pavilions.


The mechanism of functioning of protein C can briefly be presented as follows. Thrombin and factor Xa formed in the blood via coagulation, interact with endothelial thrombomodulin and thereby activate protein C circulating in the blood. The activated protein C inhibits factors V and VIII and, in so doing, blocks the further production of thrombin. In this way protein C intermediates the loop of the negative feedback and prevents excessive thrombin generation. Besides, activated protein C enhances fibrinolysis, causing the release of the tissue plasminogen activator. Activated protein C is inhibited by a heparin-dependent inhibitor and alpha 1-antitrypsin and is then excreted from the organism. Congenital deficiency of protein C gives rise to thromboses; thrombotic diseases of various etiology are accompanied by protein C decline in the blood. Injection of exogenous protein C into the blood increases the anticoagulant activity of the blood and produces an antithrombotic effect.


Dose survival/Lymphocyte/Colony assay/D10 A recently developed dose-survival assay in vitro using human G0 T-lymphocytes from peripheral blood was employed to assess possible interindividual variation of cellular radiosensitivity. Currently lymphocytes from a total of 99 atomic bomb survivors were tested and D10, the X-ray dose required to kill 90% of the cells, was calculated for each test. The mean •} SD of D10 value was 3.35 •} 0.22 Gy for 61 survivors whose DS86 dose is below 0.004 Gy and for 38 survivors of DS86 dose above 1.5 Gy it was 3.31 •} 0.26 Gy. So far, the results do not show any evidence in support of the hypothesis of a selective elimination of a radiosensitive subcohort among the survivors exposed to high doses.


ABSTRACT There has been increasing recognition for the need to reform doctoral training practices to foster students' personal epistemology. This study describes the design and evaluation of a learning experience designed to help students understand the scholarly publication process. Firstly, this study discusses the design of the learning experience, describing the collaborative process of writing an interdisciplinary publication using both online and face-to-face learning. Secondly, this study evaluates the effectiveness of the learning experience by examining students' reflections. We show that participation in the learning experience helped students to develop their academic writing proficiency, collaboration and teamwork, intercultural competence, and ability to engage in reflective practice. Importantly, we show that each student also created more individualised knowledge, gaining insight into how they and others think. This study, therefore, demonstrates that personal epistemology can be fostered through collaboration in a doctoral writing group context.


This paper analyzes the distribution and growth of firm-level employment along two margins: the extensive margin (the number of establishments in a firm) and the intensive margin (the number of workers per establishment in a firm). We utilize administrative datasets to document the behavior of these two margins in relation to changes in the U.S. firm-size distribution. In the cross section, we find the firm-size distribution, as well as both extensive and intensive margins, exhibits a fat tail. The increase in average firm size between 1990 and 2014 is primarily driven by an expansion along the extensive margin, particularly in very large firms. We develop a tractable general-equilibrium growth model with two types of innovations: external and internal. External innovation leads to the extensive margin of firm growth, and internal innovation leads to intensive-margin growth. The model generates fat-tailed distributions in firm size, establishment size, and the number of establishments per firm. We estimate the model to uncover the fundamental forces that caused the distributional changes from 1995 to 2014. The largest contributors to the increase in the number of establishments per firm are the external innovation cost and the decline in establishment exit rate. Classification-JEL E24, J21, L11, O31


Some aspects of Hansen's disease and the health policy for those having it in Maranhão in the 1930s are pointed out. The resolution of the disease in that state followed the precept imposed by the centralizing national health policies developed in the Vargas period: greater sanitary vigilance of those having the disease and the construction of a compulsory isolation colony for the contagiously ill largely characterized the decade regarding the prophylaxis of what was then called leprosy. The discourses of Achilles Lisboa, the doctor who best expressed this period, are highlighted here, since they contributed to aggressively mold the public policies of exclusion directed to those having Hansen's disease in Maranhão.


If terrorism as it is known from history is changing, should the response to it change as well? This paper reflects on the rise and activities of Boko Haram in Northern Nigeria and the hesitation of domestic, regional and international efforts in stemming its spread. It finds that the rise and impact of homegrown terrorist groups like Boko Haram deserve closer attention than they have previously received particularly with regard to legal responses by domestic governments and the international community. The activities of Boko Haram in Nigeria have brought to the fore challenges faced by law and governments in tackling an ideology whose purpose is so far largely misunderstood and whose means of garnering public attention remain as variant and as indiscriminate as their attacks of terror. This paper argues for a reconceptualization; a rethink about the implications for law and social order in the 21st century by examining the lessons to be drawn from, and the responses to be considered, in addressing the emergence of groups such as Boko Haram and their brand of homegrown terror.


An urban medical center has found that participation in cooperative programs with surrounding small rural hospitals meets its own need for a broader geographical base of operations and their needs for access to more and specialized services.


The interactions in vitro of LY307640 with the cytochromes P450 (P450s) were studied using human liver microsomes, specific inhibitors of the P450s, and cDNA expressed enzymes. The kinetics of formation of the two major oxidative metabolites, desmethyl LY307640 and LY307640 sulfone, were determined using two human liver microsomal samples. The kinetic data indicated that high and low affinity sites were present for the production of both metabolites of LY307640. The Km(apparent) and Vmax(apparent) for desmethyl LY307640 formation by microsomes from human liver E (HL-E) for the high affinity site were 18.8 +/- 4.4 microM and 402 +/- 52 pmol product/min/mg protein. The high affinity site Km(apparent) and Vmax(apparent) for LY307640 sulfone formation by microsomes from HL-E were 4.4 +/- 2.1 microM and 81.8 +/- 18 pmol product/min/mg protein. The rates of desmethyl LY307640 and LY307640 sulfone formation by the high affinity site were determined using 14 human liver microsomal samples characterized for P450 marker catalytic activities and immunoquantified levels of the P450s. Rates of formation of desmethyl LY307640 significantly correlated with the immunoquantified levels of CYP 2C19 and the ability of the microsomes to 4'-hydroxylate S-mephenytoin. LY307640 sulfone formation significantly correlated with the immunoquantified levels of CYP 3A and the ability of the microsomes to 1'-hydroxylate midazolam. Inhibition studies and use of expressed cytochrome P450 systems confirmed the correlation data demonstrating that CYP 2C19 catalyzed the formation of desmethyl LY307640 and CYP 3A and catalyzed LY307640 sulfone formation. Further, LY307640 competitively inhibited S-mephenytoin 4'-hydroxylation and midazolam 1'-hydroxylation as did the structurally related compound, omeprazole. For the inhibition of S-mephenytoin 4'-hydroxylation and midazolam 1'-hydroxylation, LY307640 had higher Ki(apparent) values than that of omeprazole. These studies demonstrate that the high affinity enzymes which catalyze the formation of the desmethyl and sulfone metabolites of LY307640 are, respectively, CYP 2C19 and CYP 3A. In addition, the inhibition data suggest that LY307640 has less potential to inhibit the metabolism of CYP 2C19 substrates compared to omeprazole, and that LY307640 and omeprazole have a similarly low potential to inhibit the metabolism of CYP 3A substrates.


Five hundred fifty-six samples representing 24 species of small mammals (two species of marsupials and 22 rodents) were collected in Panama between February 2000 and July 2002. The samples were examined for antibodies to hantaviruses by means of enzyme-linked immunosorbent assay or immunoblot assays. The serologic results indicated that several rodent species might act as hantaviral reservoirs in Panama: Costa Rican pygmy rice rat (Oligoryzomys fulvescens costaricensis), four positive of 72 tested (5.6%); Cherrie's cane rat (Zygodontomys brevicauda cherriei), five of 108 (4.6%); Mexican deer mouse (Peromyscus mexicanus), one of 22 (5%); Mexican harvest mouse (Reithrodontomys mexicanus), one of seven (14%); Chiriquí harvest mouse (Reithrodontomys creper), one of two (50%); and Sumichrast's harvest mouse (Reithrodontomys sumichrasti), three of four (75%). Hantavirus infection in Peromyscus mexicanus and the three species of Reithrodontomys was caused by Rio Segundo hantavirus, a species of virus not previously reported from Panama. At least three hantaviruses, therefore, are known to infect populations of wild rodents in the country. However, given the total number of animals tested, the role of these rodent species in the epidemiology and epizootiology of hantavirus infections remains unclear.


The conventional semi-active variable damping (VD) device can only dissipate the vibration energy, which inherently limits its performance in vibration control. This paper proposes a novel semi-active inerter concept and develops a prototype with magnetorheological (MR) dampers, which can store the vibration energy in a flywheel and then release it to suppress vibration. The new idea is inspired by a variable inertance (VI) device, which has a VD device and a passive inerter in serial, and a passive mechanical motion rectifier (MMR), which can convert the reciprocating input into a unidirectional output. The controllable MMR (CMMR) applies two VD devices to replace the two one-way roller clutches in the MMR. By equipping the CMMR, the semi-active inerter gets more controllability than the original VI device because it can switch the torque and motion transmitting routes between the device terminals and the flywheel in it. The frequency-domain analysis validates the versatile of the semi-active inerter, which can work in VD and VI modes. The test results of the semi-active MR inerter prototype are used to identify the device parameters, which are applied for the control simulation. The semi-active MR inerter in CMMR mode has the best torque tracking performance with a given test condition, and it has a 20.13% improvement than in the VD mode. Then, a seat suspension with the semi-active MR inerter is applied to validate the effectiveness of the device in vibration control. The results show that the vibration reduction of the seat suspension in the CMMR mode is 39.3% higher than in the VD mode, which indicates a significant improvement of ride comfort. The new concept of the semi-active device has excellent potential in vibration control and is promising in practical applications.


In this article, we analyze the impact on hotels of the ISO 14001 environmental certification system from the customers' perspective. Based on a comparison of customer ratings of 6,850 hotels in Spain with and without ISO 14001 certification, overall guests rate the hotels with ISO 14001 certification higher than those without the certification. These results are stronger for hotel comfort and hotel services compared with other hotel attributes. Moreover, the most significant differences were found in the upscale four-star hotels. While the study does not reveal causes for these findings, the implication is that the highest end five-star luxury hotels do not gain distinctive differentiation by having the ISO 14001 certification, while for three-star hotels, guests' price sensitivity overrides environmental concerns. At the four-star level, however, hotels seem to be able to gain a distinct market advantage from environmental certification. For all hotels, the management discipline provided by ISO 14001 can provide a competitive advantage.


Protein-disulfide isomerase (PDI) has been proposed to exhibit an "unfoldase" activity against the catalytic A1 subunit of cholera toxin (CT). Unfolding of the CTA1 subunit is thought to displace it from the CT holotoxin and to prepare it for translocation to the cytosol. To date, the unfoldase activity of PDI has not been demonstrated for any substrate other than CTA1. An alternative explanation for the putative unfoldase activity of PDI has been suggested by recent structural studies demonstrating that CTA1 will unfold spontaneously upon its separation from the holotoxin at physiological temperature. Thus, PDI may simply dislodge CTA1 from the CT holotoxin without unfolding the CTA1 subunit. To evaluate the role of PDI in CT disassembly and CTA1 unfolding, we utilized a real-time assay to monitor the PDI-mediated separation of CTA1 from the CT holotoxin and directly examined the impact of PDI binding on CTA1 structure by isotope-edited Fourier transform infrared spectroscopy. Our collective data demonstrate that PDI is required for disassembly of the CT holotoxin but does not unfold the CTA1 subunit, thus uncovering a new mechanism for CTA1 dissociation from its holotoxin.


BACKGROUND: APRI and Forns (IF) index are noninvasive models consisting of routine laboratory data for the prediction of liver fibrosis in patients with chronic hepatitis C. The aim of our study was to confirm the value of these models to predict significant fibrosis in these patients and if they may decrease the need for performing liver biopsy specimens in coinfected and HIVnon-coinfected. PATIENTS AND METHOD: We included 60 patients with chronic hepatitis C and histologic data, 33 were coinfected with HIV. Mild fibrosis (F0-F1) was found in 73% patients, severe fibrosis (F3-F4) in 23% and cirrhosis in 18.3%. We calculated and compared APRI and IF with the stage of liver fibrosis. RESULTS: The APRI score 1.5 and IF 6.9, as predictors of mild or severe fibrosis, were only available in 53% and 49%. Neither laboratory nor APRI and IF were associated with liver fibrosis in non-coinfected patients. We only found association in HIV coinfected patients: severe fibrosis (F3-4) whit higher gammaglobulins [24.5% vs. 30% (p < 0.05)] and Gamma-GT levels [77 (46.5) vs. 32 (48.5) (p < 0.05)], and lower prothrombin time [72% vs. 91% (p < 0.05) ] and platelets.109 count [129 (40) vs. 170 (78) (p < 0.05)]; APRI was lower than 0.5 in 41.6% patients with mild fibrosis (F0-1) against none with severe (F3-4) (p < 0.05); specifity (E) of APRI < 0.5 for predicting mild fibrosis was 100%, but sensivity (S) was very low (41%), with a positive preditive value (VPP) of 100%, but a negative predictive value (VPN) also very low ( 36.3%). CONCLUSIONS: Our study showed that these models don t avoid the need for liver biopsies. More than a half of patients are not appropriately classified according to findings on liver biopsy and S and VPN are very low. The combination of these index with gammaglobulins, Gamma-GT, AST, ALT and platelet levels and protrombine time, only may be an approach to degree of fibrosis or inflammation liver in HIV co-infected patients.


This study uses content analysis methodology to analyse a professional journal and open-ended interviews with two Australian nurse practitioner candidates (NPCs) over the 12- month period in implementing a dialysis nurse practitioner (NP) model to identify conceptual categories best describing the transitional experience. Four themes with various sub-themes were identifi ed: 'Finding a balance', 'The public face', 'Finding a personal version of the NP role' and 'Nurturing'. These themes were also consistent with the United States (US) and United Kingdom (UK) experience. However, unlike early international NPs, NPs in the current study were well supported by key stakeholders and encountered fewer political and organisational barriers. The key themes identifi ed in the study were used to make recommendations to assist role transition for future NPs in Australia. Exploring the experiences of pioneer NPs in Australia begins to fia literature gap and equip nurses with knowledge to assist them in their professional and personal challenge to become an NP.


The term posterolateral rotatory instability (PLRI) was coined in 1991 by O'Driscoll to describe the instability of the elbow caused by injury to the lateral ulnar collateral ligament (LUCL). This condition, which is usually preceded by a traumatic dislocation of the elbow, is the most common type of chronic instability of the elbow. In this type of instability, the radius and ulna rotate externally in relation to the distal humerus, leading to posterior displacement of the radial head relative to the capitellum. lateral elbow pain, clicking, popping and snapping are possible symptoms. The diagnosis of PLRI relies on a high index of suspicion and on a detailed physical examination. Several tests have been described including apprehension tests and examination under anesthesia. Surgical treatment with reconstruction of the lateral collateral ligament complex yields successful results. In this review we summarize the current knowledge of the pathoanatomy, presentation, physical examination, diagnostic tests and management of chronic posterolateral rotatory instability of the elbow.