Pulmonary hypoplasia (PH) is defined as defective or incomplete development of lungs that are immature for gestational age. A prospective study was done to establish practical criteria for the diagnosis of pulmonary hypoplasia and to determine the relative frequency of pulmonary hypoplasia and its associated congenital malformations. Postmortem, formalin-inflated, routinely processed lungs were examined for fresh lung weight, fixed lung volume, radial alveolar count, and tissue maturity. Of these, lung volume was found to be the least useful. However, no single parameter was adequate for diagnosis in every case. Using the remaining three in conjunction, reliable diagnostic criteria were established. In this series of 113 cases, 22% had pulmonary hypoplasia as the primary cause of death, of which one-third had no associated congenital malformations to account for the development of pulmonary hypoplasia. It was found that premature rupture of membranes (PROM) for as short as 5 days could lead to fatal PH. It is concluded that PH is a common problem in neonatal autopsies and can be diagnosed in the average laboratory. Recognizing PH is important because once it has developed, intrauterine intervention in cases of oligohydramnios and postnatal treatment with surfactant inhalation cannot influence the outcome. It remains to be seen whether early fluid replacement in PROM will prevent development of PH.


In their paper at the International Symposium on Multiple-Valued Logic in 2017, C. Moraga, R. S. Stankovi´c, M. Stankovi´c and S. Stojkovi´c presented a conjecture for the number of fixed points (i.e., eigenvectors with eigenvalue 1) of the Reed-Muller-Fourier transform of functions of several variables in multiple-valued logic. We will prove this conjecture, and we will generalize it in two directions: we will deal with other transforms as well (such as the discrete Pascal transform and more general triangular self-inverse transforms), and we will also consider eigenvectors corresponding to other eigenvalues.


The single-crystal X-ray structure of phosphoglycerate mutase from Mycobacterium tuberculosis has been determined at a resolution of 1.70 angstroms. The C-terminal tail of each of the subunits is flexible and disordered; however, for one of the four chains (chain A) all but five residues of the chain could be modeled. Noteworthy features of the structure include the active site and a proline-rich segment in each monomer forming a short left-handed polyprolyl helix. These segments lie on the enzyme surface and could conceivably participate in protein-protein interactions.


An approach to suspected gallstone pancreatitis'based on endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (ES) was adopted in 1976 and was followed in 29 patients. ERCp became the routine method of early biliary tract assessment when gallstone pancreatitis was suspected on clinical and biochemical grounds, and further management was based on ERCP findings. If calculi were detected in the common bile duct (13 cases) ES was performed; when calculi were confined to the gallbladder (12 cases) cholecystectomy was advised; and if no calculi were detected on ERCP (4 cases) investigations were continued. ERCP proved to be a reliable guide to management, while ES provided safe and effective symptomatic relief when choledocholithiasis was present, and prevented recurrence of pancreatitis even when the gallbladder remained in situ .


Partly due to the transdisciplinary agenda of the field, the development of American Studies has been accompanied by intensive debates about methods and theories. This essay relates a—necessarily reductive—narrative about how, throughout its history, German American Studies has intervened into and contributed to these debates; and how, with the emergence of parameters and politics of difference, on the one hand, and poststructuralist thought and notions of differance, on the other, the early debate on methods of American Studies transformed into discussions of theories of American literature, culture, history etc. In the light of what I perceive as the current division within German American Studies—a division between work that refocuses the theoretical discussion on literary studies and questions of aesthetics and analyses that engage other cultural practices and media by way of explicit theoretical perspectives, yet not necessarily in the frame of an American Studies agenda—my argument suggests that we take a more dialectical approach to the plurality of theories American Studies engages. While such an approach can no longer aim at syntheses and needs to allow for incoherencies and contradictions, it seems indispensable if we aim at futures for American Studies.


Objective(s): Bisphenol A (BPA) as a synthetic compound is applied in many plastic industries. BPA has been reported to have endocrine-disrupting feature with cytotoxic effects. The study aimed to evaluate the efficiency of Naringin against testicular toxicity induced by BPA in adult rats. Materials and Methods: The animals were assigned into six groups of control, BPA-treated (50 mg/kg), BPA+Naringin-administrated (40, 80, 160 mg/kg) and Naringin-treated (160 mg/kg) for 30 days. At the end of experiments, testicular weight, total testicular protein, epididymal sperm count, testicular enzymes, serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone and estradiol, testicular enzymatic and non-enzymatic antioxidants and histopathology of testis tissue were evaluated by their own methods. Results: The results showed a reduction in testicular weight, total testicular protein, epididymal sperm count, testicular enzymes (alkaline phosphatase and lactate dehydrogenase) and decrease in the serum TSH, LH, testosterone and estradiol in BPA-administrated rats. Furthermore, BPA reduced the enzyme activities of glutathione peroxidase, superoxide dismutase, and catalase in testis tissue. Also, BPA caused an induction in lipid peroxidation and increase in reactive oxygen species levels, whereas it decreased the glutathione content of testis tissue. Histological findings exhibited seminiferous tubules vacuoles, atrophy and separation of the germinal epithelium in BPA-administrated rats. Oral administration of Naringin along with BPA normalized the biochemical, morphological and histological changes and reduced the testicular toxic condition. Conclusion: These results demonstrated that Naringin significantly managed male reproductive toxicity by antioxidant capabilities, preventing morphological modifications and escalating defense mechanism, thereby reducing oxidative stress from BPA-induced damage.


Leskovec, Kleinberg and Faloutsos (2005) observed that many social networks exhibit properties such as shrinking (i.e. bounded) diameter, densification, and (power-law) heavy tail degree distributions. To explain these phenomena, they introduced a generative model, called the Forest Fire model, and using simulations showed that this model indeed exhibited these properties; however, proving this rigorously was left as an open problem. In this paper, we analyse one of these properties, shrinking diameter. We define a restricted version of their model that incorporates the main features that seem to contribute towards this property, and prove that the graphs generated by this model exhibit shrinking distance to the seed graph. We prove that an even simpler model, the random walk model, already exhibits this phenomenon.


Several brands choose to point out their old age (e.g. "Milka: 111 years of tenderness" in 2015; the painting, tradition and historicity of "La Laitiere" in the 2016 marketing campaign) to show positive aspects that allow them to value their image such as expertise, familiarity or authenticity. Other brands, instead, opt for revitalizing their old age by modifying their logo and color (e.g. Intel in 2013), or their product design or communication (e.g. Fanta in 2017) in order to avoid being perceived as obsolete or old-fashioned. Thus, multiple examples show that managing the perceived brand age corresponds to an actual managerial issue. On the theoretical perspective, the notion of brand aging is addressed in the literature of brand rejuvenation (Huber & al., 2013; Muller & al., 2013). This research stream stipulates that any brand, regardless of its chronological age, risks of being subject to the effects of aging. The latter essentially translates into negative brand associations such as being out-of-date or obsolete. However, other research streams highlight and value positive associations from perceived brand oldness. These mainly include studies of brand heritage (Hakala & al., 2011; Urde & al., 2007; Wiedmann, & al., 2011), or nostalgic brands (Kessous & al., 2015; Merchant & al., 2015). Therefore, it seems that old brands awaken both negative and positive associations. Nevertheless, this ambivalence and these multiple associations have not been covered in the marketing literature and hence deserve to be examined. The exploration of this aspect of the brand is crucial for its management in the long run. Specifically, it would allow brands to evolve with market trends over the years, while maintaining a coherent and relevant image for consumers. In addition, regarding its measurement, no research has opted for an operationalization of the associations that consumers make when exposed to brands perceived as old. Therefore, two main research questions arise: What are the associations attributed to old brands perceived? And how can they be measured? The objectives of this research are twofold. First, we aim at identifying the dimensions of brand oldness associations in the framework of an anthropomorphic approach to consumer-brand relationship (Aaker, 1997; Aggarwal & McGill, 2012; Fournier, 1998). Second, we propose a measurement instrument of brand oldness associations in line with Churchill's (1979) paradigm. This instrument should help managers gage the associations that consumers make with old brands. This research provides the conceptualization of a brand aspect that has been little addressed in the marketing research: brand oldness associations. It provides the identification of its dimensions and proposes a measurement scale. Our findings give new perspectives on brand age; a plethora of other concepts (Decline, Expertise, Maintenance, Reminiscence, Timelessness, and Tradition) results from brand oldness associations. This research presents a substantial managerial interest. In branding, perceived age raises important managerial issues regarding the strategy to adapt for an old brand. Our work provides a lever for action on this aspect of the brand.


Abstract. Since the 1960s, intermittent social conflicts in Nigeria appear mostly linked to
ethnic groups' differences. Considering the importance of regime change in social
and political stability, this article critically analyses the historic and dynamic role
of the core political executive elite in the political system's stability. The article
argues that ethnic politics persist in Nigeria based on the nature of interactions
between political institutions, institution-builders, and society. It asserts a contradictory
link between deep-rooted elite interests and popular preferences in ways
that undermine orientations towards democracy. The empirical focus is on the
composite nature of the core political executive elite analysed through their ethnic
and educational backgrounds. It is observed that, although ethnic shocks are
variously motivated, the atypical shape and inequity in power and role distribution
at the highest levels of executive office-holding stand out as a salient source and
target of antagonism by ethnic groups. This finding has a paradoxical implication:
deep-seated economic and political interests of the elite play a diversionary role
from the real causes of ethnic conflicts in Nigeria.


Cross-project defect prediction is very appealing because (i) it allows predicting defects in projects for which the availability of data is limited, and (ii) it allows producing generalizable prediction models. However, existing research suggests that cross-project prediction is particularly challenging and, due to heterogeneity of projects, prediction accuracy is not always very good. This paper proposes a novel, multi-objective approach for cross-project defect prediction, based on a multi-objective logistic regression model built using a genetic algorithm. Instead of providing the software engineer with a single predictive model, the multi-objective approach allows software engineers to choose predictors achieving a compromise between number of likely defect-prone artifacts (effectiveness) and LOC to be analyzed/tested (which can be considered as a proxy of the cost of code inspection). Results of an empirical evaluation on 10 datasets from the Promise repository indicate the superiority and the usefulness of the multi-objective approach with respect to single-objective predictors. Also, the proposed approach outperforms an alternative approach for cross-project prediction, based on local prediction upon clusters of similar classes.


The modified Laplacian has been used to move unstructured grids in response to changes in the surface grid for a variety of grid movement applications including store separation, aero‐elastic wing deformation and free surface flow simulations. However, the use of the modified Laplacian can result in elements with negative areas/volumes, because it has no inherent mechanism to prevent inversion of elements. In this paper, the use of a modified Laplacian is studied analytically for a two‐dimensional problem of deforming the inner circle of two concentric circles and for a three‐dimensional problem of deforming the inner sphere of two concentric spheres. By analysing the exact solution for this problem, the amount of translation and deformation of the inner circle that maintains a valid mesh is determined. A general grid movement theorem is presented which determines analytically the maximum allowable deformation before an invalid mesh results. Under certain circumstances, the inner circle and sphere can be expanded until it reaches the outer circle or sphere, while remaining a valid grid, and the inner circle and sphere can be rotated by an extreme amount before failure of the mesh occurs. By choosing the exponent to the modified Laplacian appropriately, extreme deformations for single frequency deformations is possible, although for practical applications where the grid movement has multiple frequencies, choosing the optimal exponent for the modified Laplacian may not be practical or provide much improvement. For grid movement simulations involving rigid body translation and rotation or uniform expansion, the modified Laplacian can yield excellent results, and the optimum choice of the modified Laplacian can be analytically determined for these types of motions, but when there are multiple frequencies in the deformation, the modified Laplacian does not allow much deformation before an invalid grid results. Copyright © 2006 John Wiley & Sons, Ltd.


The Full Federal Court decision in the Glencore Case raises very important questions in relation to core concepts underlying Australia's previous and current transfer pricing rules. The case involves the pricing structure that an Australian mining company used for the copper concentrate it sold to its Swiss parent, the largest global trader in copper concentrate. Broadly speaking, the price for copper concentrate is worked out by deducting selecting a copper reference price from a listed metals exchange, like the London Metals Exchange, and deducting an allowance for treatment and copper refining costs (TCRCs). This was the main issue in the case. There were two options realistically available to the taxpayer: the use of market benchmarks that took account of both the prices set by the major mills and those set by the spot market; and, another method known as price sharing where the TCRCs are set at a fixed percentage of the copper reference price, which had the effect of protecting the seller from the risk that copper prices and TCRCs may trend in different directions. In February 2007 when the taxpayer switched to a price sharing formula that set the TCRC rate at 23% of the copper reference price, the benchmark rate set by the Japanese mills was much lower, and the TCRC rate established for the purposes of the mining company's budget, which was approved by its parent around August to September 2006, was 6.5% of the copper reference price. The Appeal Court accepted the taxpayer's argument that the 23% was an arm's length rate because there were contracts between independent parties that used price sharing, and 23% was the midpoint of the rates in those cases, and because the taxpayer's expert witness testified that for such a high cost mine price sharing was "a conservative and reasonable approach to minimising risk". The Court did not consider how independent parties dealing at arm's length (or wholly independently) with each other would have gone about deciding whether or not to hedge the risk, or the comparative benefits of market benchmark pricing relative to price sharing. A question therefore arises as to whether the Appeal Court correctly applied the statutory tests, a matter that would benefit from a High Court review.


Human embryonic stem cells (hESC) can self-renew indefinitely in vitro, and with the appropriate cues can be induced to differentiate into potentially all somatic cell lineages. Differentiated hESC derivatives can potentially be used in transplantation therapies to treat a variety of cell-degenerative diseases. However, hESC differentiation protocols usually yield a mixture of differentiated target and off-target cell types as well as residual undifferentiated cells. For the translation of differentiated hESC-derivatives from the laboratory to the clinic, it is important to be able to discriminate between undifferentiated (pluripotent) and differentiated cells, and generate methods to separate these populations. Safe application of hESC-derived somatic cell types can only be accomplished with pluripotent stem cell-free populations, as residual hESCs could induce tumors known as teratomas following transplantation. Towards this end, here we describe a methodology to detect pluripotency associated cell surface antigens with the monoclonal antibodies TG30 (CD9) and GCTM-2 via fluorescence activated cell sorting (FACS) for the identification of pluripotent TG30Hi-GCTM-2Hi hESCs using positive selection. Using negative selection with our TG30/GCTM-2 FACS methodology, we were able to detect and purge undifferentiated hESCs in populations undergoing very early-stage differentiation (TG30Neg-GCTM-2Neg). In a further study, pluripotent stem cell-free samples of differentiated TG30Neg-GCTM-2Neg cells selected using our TG30/GCTM-2 FACS protocol did not form teratomas once transplanted into immune-compromised mice, supporting the robustness of our protocol. On the other hand, TG30/GCTM-2 FACS-mediated consecutive passaging of enriched pluripotent TG30Hi-GCTM-2Hi hESCs did not affect their ability to self-renew in vitro or their intrinsic pluripotency. Therefore, the characteristics of our TG30/GCTM-2 FACS methodology provide a sensitive assay to obtain highly enriched populations of hPSC as inputs for differentiation assays and to rid potentially tumorigenic (or residual) hESC from derivative cell populations.


"A rich resource for readers interested in the study of American culture."--'South Atlantic Review. '"The essays are noteworthy in their own right, and the collection overall is unified and coherent...'Reading in America' shows a field in its early stages that is attracting a group of extremely talented scholars."--'Journal of American History.


We describe different Bayesian ensemble refinement methods, examine their interrelation, and discuss their practical application. With ensemble refinement, the properties of dynamic and partially disordered (bio)molecular structures can be characterized by integrating a wide range of experimental data, including measurements of ensemble-averaged observables. We start from a Bayesian formulation in which the posterior is a functional that ranks different configuration space distributions. By maximizing this posterior, we derive an optimal Bayesian ensemble distribution. For discrete configurations, this optimal distribution is identical to that obtained by the maximum entropy "ensemble refinement of SAXS" (EROS) formulation. Bayesian replica ensemble refinement enhances the sampling of relevant configurations by imposing restraints on averages of observables in coupled replica molecular dynamics simulations. We show that the strength of the restraints should scale linearly with the number of replicas to ensure convergence to the optimal Bayesian result in the limit of infinitely many replicas. In the "Bayesian inference of ensembles" method, we combine the replica and EROS approaches to accelerate the convergence. An adaptive algorithm can be used to sample directly from the optimal ensemble, without replicas. We discuss the incorporation of single-molecule measurements and dynamic observables such as relaxation parameters. The theoretical analysis of different Bayesian ensemble refinement approaches provides a basis for practical applications and a starting point for further investigations.


Cyst hydatid of the kidney is parasitic condition caused by Echinococcus granulosus and identified in many countries, especially associated with sheep farming. Echinococcal larvae enter the bloodstream using the digestive system and invade any organs in the human body. The urinary system is the third most common area affected by parasitic infection after liver and lungs, but isolated renal involvement is a very rare situation, even in endemic areas. In our case, we aimed to report a 57-year-old female patient with an 18-centimeter isolated renal cyst hydatid treated by retroperitoneal nephrectomy. The diagnosis was based on imaging findings and confirmed by histopathologically. (Turkiye Parazitol Derg 2014; 38: 124-6)


The aging process we are witnessing in the majority of developed countries is raising financial sustainability problems in the pay-as-you-go pension system. The reforms designed to re-establish the financial equilibrium of pension systems may put one of the most important objectives of these systems at risk: to reduce the poverty rate among the elderly. This paper studies the effects that the reforms implemented in the Spanish pension system would have on the poverty rate of the retired population. The two main novelties presented are the following. First, the collective under study is focused on the most vulnerable workers. Second, the effects of the reforms are studied taking into account the labour market situation of the individuals in the years prior to retirement.


Liquid phase deposition (LPD) has been applied for the synthesis of iron phosphate thin films as an example of an effective methodology for the thin film growth of other polyanionic compounds. The prepared films were highly uniform, free of cracks, pure and successfully applied to cover various substrates such as soda-lime glass and stainless steel. The thickness of these films can be easily tailored in the range of 80 nm to 2.7 μm by the deposition time. The chemical equilibria for the hydrolysis of [PF6]− species and the formation of iron phosphate were studied by 19F-NMR and 31P-NMR spectroscopy to get insight into the formation mechanism of iron phosphate thin films. Hydrolysis of [PF6]− occurs very slowly and a longer induction period favors the hydrolysis. The as-prepared FePO4·2H2O films on conductive stainless steel substrates are shown to be electrochemically active for the intercalation of Li+ ions. Two polymorphs of FePO4 with crystal structures identical to hexagonal tridymite AlPO4 and monoclinic FeAsO4 were identified upon heat treatment of the as-prepared powders.


This paper first portraits Swedish services exporters and services MNEs; second it analyses the determinants of services exports and affiliate sales; and third it studies the choice of mode of entering a foreign market. Emanating from a heterogeneous firm internationalization model, the main contribution of the paper is to explore the interaction between firm characteristics and foreign market characteristics, particularly policy-induced services trade barriers, in shaping services trade and investment patterns. Exploiting a large and very detailed firm-level dataset for the 2008-2013 period, the descriptive analysis finds that most exporting firms export one or two products to a few, most often other Nordic countries. Still, firms that export to 25 or more markets account for more than 80% of total export value. Furthermore, firms that export to 20 countries export more than 60% to their main destination country. Similar patterns are found for affiliate sales. Using a gravity approach we then study the determinants of the extensive and intensive margin of exports and affiliate sales in pooled as well as sector level regressions. We find that trade costs, both natural and policy-induced have the largest impact on the extensive margin of trade, suggesting that trade costs facing services exporters are mainly in the form of fixed entry costs. This is further supported by the finding that incumbency is the most important determinant of future exports and affiliate sales, and incumbents tend to be protected and thrive behind trade barriers.


This article shares personal perspectives and experiences that emerged as a result of 15 years of consulting with athletes representing numerous sports at both Summer and Winter Olympic Games. The importance of listening closely to athletes, respecting their input, and meeting their individual needs is emphasized. Consultants are cautioned against using batteries of standardized personality assessment inventories as these infringe upon the athletes' time without providing practical information. Effectiveness in this field requires firsthand experience with sport, a full understanding of the psychology of excellence, and a willingness to learn directly from the athletes themselves. One-on-one contact, adaptability to individual needs, good interpersonal skills, applied sportpsych knowledge, and persistence in application are also important. It is recommended that registration of consultants in the field of applied sport psychology be contingent upon direct evaluation by athletes.


Atypical cellular disorders are commonly considered part of the gray zone linking oncology to hematology and immunology. Although these disorders are relatively uncommon, they often represent significant clinical problems, provide an opportunity to understand basic disease mechanisms, and serve as model systems for the development of novel targeted therapies. This chapter focuses on such disorders. In Section I, Dr. Arceci discusses the pathogenesis of Langerhans cell histiocytosis (LCH) in terms of the hypothesis that this disorder represents an atypical myeloproliferative syndrome. The clinical manifestations and treatment of LCH in children and adults is discussed along with possible future therapeutic approaches based upon biological considerations. In Section II, Dr. Longley considers the molecular changes in the c-Kit receptor that form the basis of mastocytosis. Based on the location and function of c-Kit mutations, he develops a paradigm for the development of specific, targeted therapies. In Section III, Dr. Emanuel provides a review of the "mixed myeloproliferative and myelodysplastic disorders," including novel therapeutic approaches based on aberrant pathogenetic mechanisms. Taken together, these chapters should provide an overview of the biological basis for these disorders, their clinical manifestations, and new therapeutic approaches.


Introduction: Type 1 diabetes mellitus (T1DM) is a known immune related adverse event (irAE) following treatment with Programmed Death 1 (PD-1) immune checkpoint inhibitors with reported 0.9% incidence. Little is known about such irAEs in individuals with HIV treated with PD-1 inhibitors. Case: A 48-year-old man with HIV on HAART, diagnosed with Hodgkin's lymphoma, initiated PD-1 inhibitor nivolumab. After 6 months, he reported polydipsia and polyuria. Labs revealed glucose 764 mg/dl and A1c 7.1%. Low C-peptide and elevated GAD-65 antibody levels confirmed T1DM, and he started insulin therapy. Nivolumab continued for 12 more months. Despite discontinuation of nivolumab, he remains on insulin therapy. Discussion: While A1c may reflect average glycemia, it alone cannot distinguish T2DM from T1DM progression. C-peptide and autoantibodies for T1DM must be included when screening patients on PD-1 inhibitors. Patients with HIV have higher autoantibody titers in active disease states or following HAART initiation, as seen in immune reconstitution. Moreover, in vitro PD-1 inhibition elevates HIV cell proliferation and immune hyperactivity. The challenge in patients with HIV on HAART and PD-1 inhibitors is unraveling whether autoantibody generation resulting in T1DM is potentiated by pre-existing HIV on HAART and/or provoked by immune response to PD-1 inhibition. Conclusion: Clinicians treating patients with immune checkpoint inhibitors should maintain a high index of suspicion for development of autoimmune disorders. Literature on the use of PD-1 inhibitors in HIV patients is limited and warrants further investigation. To our knowledge, this is the first reported case of T1DM following PD-1 inhibition in a patient with HIV on HAART therapy. Such patients are predisposed to immune reconstitution, and response to PD-1 inhibition may potentiate risk for autoimmune complications. Therefore, higher clinical suspicion for irAEs is merited in patients with HIV on PD-1 inhibitors. Disclosure M.S. Hughes: None. S. Bedrose: None. M. Vasudevan: None. M. Marcelli: None.


A method to approximate the mean value of various performance parameters in distributed database systems using locking for concurrency control is proposed. The main contribution of this approach is its ability to model the interactions between resource and data contention and their effects on system performance. The system performance is evaluated at a point where the interaction between these two factors is in equilibrium. The model involves the solution of a set of simultaneous polynomial equations whose order is dependent on the input parameters, i.e., the size of the network. These equations are solved by an iterative procedure to yield approximate values of relative throughput, utilization of servers and the means as well as higher order moments of the transaction response time. The model has good convergence characteristics and the input parameters can be bounded to determine regions of existence, non-existence and possible existence of a solution. A simulator was used to validate the analytical model and the results agree quite well.<<ETX>>


Phorbol 12-myristate 13-acetate (PMA) decreases the tight junction conductance (TJC) during the reorganization of LLC-PK1A monolayers, but has the opposite effect in LLC-PK1B4, MDCK, and MDCK4 cells. Because no protein synthesis was required for the effects of PMA on the TJC of LLC-PK1A monolayers, we conclude that the regulation of the tight junction by protein kinase C (PKC) is a posttranslational event. In LLC-PK1A monolayers with existing tight junctions, PMA produced an initial increase in the TJC that reverted later to control values despite the continuous presence of PMA and cycloheximide. The inhibitory effect of PMA on the other cell lines was not revertible. A downregulation of total PKC activity and phorbol ester receptors was only observed during the reorganization of LLC-PK1A monolayers. PMA further increases this downregulation. This indicates that the peculiar response to PMA observed in LLC-PK1A monolayers is the result of two concurrent events: 1) the early activation of the enzyme just before the reorganization of the tight junctions begin, and 2) its late downregulation induced after prolonged exposure to phorbol esters. We conclude that PKC regulates the development of the occluding junctions, but through different mechanisms dependent on the characteristics of the cells.


A new acousto-electrical method making use of transient transverse acoustoelectric voltage (TAV) to study solid state structures is reported. This voltage arises after a surface acoustic wave (SAW) generating the signal is switched off. Related measurements consist in detecting the shape of transient voltage and its spectral and temperature dependence. Both theory and experiment show that this method is an effective tool to characterize trapping centers in the bulk as well as at surfaces or interfaces of epitaxial semiconductor structures.


We investigate schemes for achieving service differentiation via weighted end-to-end congestion control mechanisms within the framework of the additive increase/multiplicative decrease (AIMD) principle, and study their performance as instantiations of the TCP protocol. Our first approach considers a class of weighted AIMD algorithms. This approach does not scale well in practice because it leads to excessive loss for flows with large weights, thereby causing early timeouts and a reduction in throughput. Our second approach considers a class of loss adaptive weighted AIMD algorithms. This approach scales by an order of magnitude compared to the previous approach, but is more susceptible to short-term unfairness and is sensitive to the accuracy of loss estimates. We conclude that adapting the congestion control parameters to the loss characteristics is critical to scalable service differentiation; on the other hand, estimating loss characteristics using purely end-to-end mechanisms is an inherently difficult problem.


Freeway traffic was observed over multiple days and was found to display certain regular features. Oscillations arose only in queues; they had periods of several minutes; and their amplitudes stabilized as they propagated upstream. They propagated at a nearly constant speed of about 22 to 24 kilometers per hour, independent of the location within the queues and the flow measured there; this was observed for a number of locations and for queued flows ranging from about 2,000 to 850 vehicles per hour per lane. The effects of the oscillations were not felt downstream of the bottleneck. Thus, the only effect on upstream traffic was that a queue's tail meandered over time by small amounts. (For the long queues studied here, the tails deviated by no more than about 16 vehicle spacings, as compared with predictions that ignored the oscillations). Notably, the character of queued traffic at fixed locations did not change with time, despite the oscillations; i.e., traffic did not decay. There were changes over space, however. New oscillations formed in moderately dense queues near ramp interchanges and then grew to their full amplitudes while propagating upstream, even though the range of wave speeds was narrow. The formations of these new oscillations are strongly correlated with vehicle lane changing. But this pattern of formation and growth was less evident in a very dense queue (caused by an incident), although frequent lane changing occurred near the interchanges. It thus appears that the oscillations were triggered by random lane changing in moderately dense queues more than by car-following effects. Finally, kinematic wave theory was found to describe the propagation of the oscillations to within small errors. For distances approaching one kilometer, and for 2-hour periods, the theory predicted the locations of vehicles to within about 5 vehicle spacings. Further analysis showed that some of these small discrepancies are explained by differences in car-following behavior across drivers.


ABSTRACT In the present study, we established an in vitro system representing the Burkitt's lymphoma (BL)-type Epstein-Barr virus (EBV) infection which is characterized by expression of EBV-determined nuclear antigen 1 (EBNA-1) and absence of EBNA-2 and latent membrane protein 1 (LMP1) expression. EBV-negative cell clones isolated from the EBV-positive BL line Akata were infected with an EBV recombinant carrying a selectable marker, and the following selection culture easily yielded EBV-infected clones. EBV-reinfected clones showed BL-type EBV expression and restored the capacity for growth on soft agar and tumorigenicity in SCID mice that were originally retained in parental EBV-positive Akata cells and lost in EBV-negative subclones. Moreover, it was found that EBV-positive cells were more resistant to apoptosis than were EBV-negative cells. EBV-infected cells expressed the bcl-2 protein, through which cells might become resistant to apoptosis, at a higher level than did uninfected cells. This is the first report that BL-type EBV infection confers apoptosis resistance even in the absence of expression of LMP1 and BHRF1, both of which are known to have an antiapoptotic function. Surprisingly, transfection of the EBNA-1 gene into EBV-negative Akata clones could not restore malignant phenotypes and apoptosis resistance, thus suggesting that EBNA-1 alone was not sufficient for conferring them. Our results suggest that the persistence of EBV in BL cells is required for the cells to be more malignant and apoptosis resistant, which underlines the oncogenic role of EBV in BL genesis.


PURPOSE
Patients undergoing gastric bypass procedures are predisposed to many vitamin and mineral deficiencies including copper, which can lead to optic neuropathy.

METHODS
A 35-year-old woman complained of progressive vision loss bilaterally 3 years after gastric bypass surgery (GBS).

RESULTS
Ophthalmic examination revealed the presence of subnormal visual acuity and pale optic nerves bilaterally. Laboratory testing showed copper deficiency. Complete improvement in vision was noted after copper was replenished.

CONCLUSION
Nutritional deficiencies occurring after gastric bypass procedures are well reported. They happen and occur due to reduced gastric and enteral absorption and cause many systemic and neurologic manifestations. Optic neuropathy occurring after GBS is often due to vitamin B12 and folic acid deficiency. Copper deficiency causing systemic symptoms is very rare and usually takes decades to manifest. Our case is unique in that copper deficiency was noted as early as 3 years after GBS. Moreover rapid copper replenishment led to a dramatic recovery of vision. Our case underscores the need for maintaining high suspicion when evaluating patients with suspected optic neuropathy occurring after GBS since prompt diagnosis and treatment may lead to reversal of visual loss.


Background Despite greater emphasis on maternal and neonatal health through policy and programming in Nepal, maternal and neonatal health is still not impressive. Health care providers' knowledge assessment on maternal and neonatal care has been well documented elsewhere, but it is very little understood in Nepal. Objective The primary objective of this study was to assess the critical knowledge of primary level nurse- midwives on maternal and newborn care in Kapilvastu District of Nepal. Method This was an Institution based cross-sectional study, conducted in Kapilvastu district, Nepal among sixty eight nurse-midwives. The participants were selected using simple random sampling technique. For collecting the data, health institutions were visited by enumerators for a month from 1st October to 1st November 2012. Data were entered into Microsoft Excel, cleaned and analyzed using SPSS version 17.0. Result More than 3/4th of the nurse-midwives had 10-20 years of experience. Majority of them (89.7%) had poor knowledge in taking action to prevent mother to child transmission for HIV positive women. More than half of them (54.4%) had some knowledge in performing the active management of third stage of labor whereas almost half (51.5%) had poor knowledge to actions needed on post-partum haemorrhage (PPH). Similarly, more than two third (69.1%) had poor knowledge in newborn care. Conclusion Majority of the nurse-midwives were found to have either poor or some level of knowledge in most of the components of maternal and newborn care services. So, greater emphasis should be given to upgrade the knowledge of nurse mid-wives.


Firms in the cloud-computing era are facing the critical issue of integrating on-premises software and cloud-based software services. To date, the software industry has designed two different types of integration methods—an enterprise service bus (ESB) and an integration platform as a service (iPaaS). However, there are conflicting views on when and how to use these different integration methods to fulfill integration needs. This study aims to resolve this confusion through economic modeling. By focusing on the indirect network effect and following a two-product bundling framework, we establish a stylized model to investigate optimal pricing and bundling decisions and the best integration choice. Our findings contradict common perceptions that an iPaaS is the better choice for integration and show that firms can derive higher value by adopting ESB to integrate onpremises software and cloud-based software services. Conceptually, given that the overall network value received from a cloud-based software service is higher, the use of ESB can contribute toward significantly improving the total value of the two software applications. We also find that unbundling is the best marketing strategy for firms because software integration can improve the valuation of individual software. Our findings have important implications for software vendors. They suggest that vendors can leverage a higher network value from the software service by integrating it with onpremises software applications through ESB rather than iPaaS and eventually realize higher profits by extracting more value from consumers. Since integration increases the value of individual products, vendors should sell them separately instead of offering them as a bundle.


Cryopreservation of ovarian tissue is a promising technique to rescue animal species and breeds from extinction and to restore fertility of women after cancer treatment. Establishment of cryopreservation protocols starts by choosing the most efficient cryoprotective agents, the dimension of ovarian fragments, the volume of the cryoprotectant solution, the addition of extra-cellular cryoprotectant, and efficient methods to evaluate follicular quality. Based on these parameters, caprine ovarian tissue was successfully cryopreserved when cortical fragmented in pieces (~ 1mm3) exposed to a low volume (frozen in 1 ml or vitrified in 0.5 ml) of a combination of ethylene glycol and sucrose, according to analysis based on viability markers to assure follicular viability. However, cellular viability after cryopreservation does not guarantee follicular development. It was observed that cryopreserved early-staged follicles show a significant decline in quality after having them in vitro cultured for 24 h. One of the damage effects caused by cryoprotectants is called osmotic stress, because of the high osmolality of the cryoprotective agents. It has been demonstrated that high concentrations of cryoprotectants, e.g. 4.0 M EG (5242 mOsm), are not responsible for osmotic damage. On the other hand, when early-staged follicles were exposed to an ionic solution of 9 % NaCl (2800 mOsm), most of the cells (92 % ) had lost their viability, showing that ions are the cause the cellular damage and not the cryoprotectants (non-ionic solutes). The aim of cryopreservation of early-staged follicles is storage for an undetermined time without viability impairment, followed by further complete development after thawing/warming. Despite the success obtained with the complete in vitro development of cryopreserved early-staged murine follicles, including development of frozen-thawed follicles followed by successful fertilization, embryo development and healthy offspring, similar success is difficult to achieve with large mammals in vitro. There is no protocol for complete in vitro development of early-staged follicles from large mammals. Thus, the importance of transplantation to obtain complete follicular development after cryopreservation. Success of the cryopresevation procedure was demonstrated by the complete follicular development (from primordial to pre-ovulatory stages) after freezing-thawing of ovarian tissue fragments and their re-implantation in ovariectomised donor goats. Thereby, ovarian cortical fragments re-modulated into a new ovarian-like organ, from which blood supply and endocrine function (oestradiol and progesterone production) were restored. The next step before clinical application, consist in evaluate some remaining points related to cryopreservation and transplantation. For example, absence of DNA damage and high survival rate of early-staged follicles after cryopreservation, does not mean that cooling cannot affect DNA by activating genes related to diseases and malformations. Thus, more experiments should be performed in adequate animal models, such as the goat, until data can be satisfactorily repeated and normal offspring can be guaranteed. Finally, although cryopreservation of ovarian tissue should not be promoted to postpone childbearing in healthy women, such a technique may be used in the future for safeguarding maternity for women requiring chemo- or radiotherapy. In addition, it may in the near future be an important technique for the preservation of endangered breeds and species.


The random stirring process is a natural random walk on the set of permutations of the vertex set of a graph. The cyclic time random walk is a self interacting random walk on a graph. It is influenced by its past, in that it is constrained to repeat its past choices if it returns to a previously visited edge after a multiple of some period of time. The two models are fundamentally equivalent to each other as well as to a certain coalescence and fragmentation process.


In the past year, we as a society have made some big steps in gaining gender equality within leadership positions; however, we still have many leaps left to go. Women leaders are still significantly lacking in almost every field, including education, medicine, business, politics, and film. And yet, women have been popularly regarded as just as effective at being leaders as men. Why then do women struggle to get into these high leadership positions? Gender discrimination, unrealistic and unfair expectations for women, and internal doubts are just some of the reasons making it more difficult for women to become powerful lead- ers. So how do we fix this? By listening, learning, observing, and communicating with one another, both women and men can close the gap standing between women and leadership. Both groups have much to do before gender equality is obtained, but that does not mean it is impossible. The barrier seems large and intimidating, but if recent events have proven anything, it is that the barrier is breakable.


The original message on the 'paradigm of prevention', which obliges government to address the emergency from terrorism, was first coined by former US Attorney General John Ashcroft. Soon after, Australian Prime Minister of the day John Howard was to follow Ashcroft's call. The new Labor government in 2007 deployed a fresh strategy: 'the precautionary principle' where government justifies further intrusive measures to confront the emergencies of climate change. This silent messaging as placed in the news media, by inclusion or omission of certain facts, can be traced and exposed to reveal a quietly agreed process to influence the public to imagine the worst without solid evidence. While such hidden messages will continue to shape public opinion and cause obfuscation, journalism educators can develop learning experiences so their students can notice the detail. This paper explores how journalism educators can work with the realities of the news media, which fan public fear of imagined catastrophes on behalf of governments. Students can very quickly learn to join the dots through meticulous discourse analysis coupled with simple computer assisted research - something the compliant mainstream news media seems unable to apply in its normative role as a 'watchdog' of government.


The scene is Ireland. The time, 1916, is the eve of the famous tragic Easter Rebellion in Dublin, which startled Europe even in the midst of the First World War. A single Anglo-Irish family provides the extremely diverse characters. Pat Dumay is a Catholic and an Irish patriot. His relentlessly pious mother pursues her own private war with his step-father, a man sunk in religious speculation and drink. Pat's English-bred Protestant cousin and rival, Andrew Chase-White, an officer in King Edward's Horse, puzzles out his complex emotions about Ireland and Frances, the girl he loves, against a background of the fear of death, while Frances's father, Christopher Bellman, scholar and cynic, finds love of Ireland a more passionate matter than he had bargained for. Weaving these people together into a tragi-comic pattern moves Millie Kinnard: fast, feminist, and only just respectable. As rebellion looms nearer, tension mounts in the sombre rain-soaked Dublin streets; and if, in the end, death disperses most of the people, this is felt to be as inevitable as in a Sophoclean play.


In mobile ad hoc networks (MANETs), one essential issue is how to increase channel utilization while avoiding the hidden-terminal and the exposed-terminal problems. Several MAC protocols, such as RTS/CTS-based and busy-tone-based schemes, have been proposed to alleviate these problems. In this paper, we explore the possibility of combining the concept of power control with the RTS/CTS-based and busy-tone-based protocols to further increase channel utilization. A sender will use an appropriate power level to transmit its packets so as to increase the possibility of channel reuse. The possibility of using discrete, instead of continuous, power levels is also discussed. Through analyses and simulations, we demonstrate the advantage of our new MAC protocol. This, together with the extra benefits such as saving battery energy and reducing cochannel interference, does show a promising direction to enhance the performance of MANETs.


Social networking sites are a popular medium of interaction and communication. Social networking sites provide the ability to run applications and games to test users' knowledge. The popularity of social networks makes it an ideal tool through which awareness can be created on existing and emerging security threats. This paper proposes an interactive game hosted by social networking sites with the purpose of creating awareness on information security threats and vulnerabilities. The game applies principles of good game design which includes: the decisions over hypermedia, multimedia and hypertext to achieve perception, comprehension or projection, comprehensive database of questions, weighted system, use of practical data, automation, dynamcis, effort and user acceptance. The aim of the paper is show the effectiveness of using a virtual tool in cyber awareness creation. This paper will thus deal with the proposal of an interactive web-based game which informs and then tests users about potential security threats and vulnerabilities.


This study attempts to develop a pro-poor health care financing system for Eritrea. The study seeks to answer the following question: can the rich and healthy subsidize the poor and sick in Eritrea? This question is directly related to issues of social insurance and universal coverage. This study was conducted in 2016 in six months period from February to August. In this study, both primary and secondary data sources were used. Interviews were conducted with 35 key health officials and stakeholders. In this study, it is found that lack of purchasing power and financial resources; insufficient knowledge of health insurance schemes and high transaction costs; and lack of supply and information about care possibilities are the main problems for the development of a viable healthcare financing system in Eritrea. As the Ministry of Health is embarking on new pricing and cost recovery strategies, a closer look of its effects on consumers is required, particularly on the poor and vulnerable groups. Significant increases in revenues from user fees increases may not be realistic, given the country's high poverty rate. The health care financing policy needs to be assessed in light of current and projected health sector needs.

 Key words: Eritrea, health care financing, Sub-Saharan Africa, health policy, health insurance.


It is commonly believed that renal function rapidly decreases in the vast majority of chronic hemodialysis patients. Three hundred thirty-four patients starting chronic hemodialysis between 1/1/88 and 12/31/92 at six hemodialysis units were prospectively studied. Renal function was determined every 3 months by 68 hr urine collection expressed as weekly fraction urea clearance (L/L total body water/wk). glomerular filtration rate was calculated from the mean of the urea and creatinine clearance. After 3 years, glomerular filtration rate exceeded 4 ml/min in 14% of patients. For a thrice weekly dialysis schedule, it was assumed that a weekly fractional urea clearance of 3 L/L/wk is equal to a dialysis KT/V of 1 and patients need a minimum KT/V of 1.2 per treatment. After 3 years of chronic hemodialysis therapy, residual renal function was found to provide 15% of the dialysis requirement in 19% of patients and 30% of the dialysis requirements in 9% of patients. The occasional patient maintains sufficient residual renal function to provide over 40% of the dialysis requirement for over 4 years. In a retrospective analysis, patients treated only with Cupraphan membrane had a more rapid loss of renal function compared to those never treated with Cupraphan (Besnberg Corp., Germany). The majority of patients with polycystic kidney disease maintained a glomerular filtration rate greater than 2 ml/min for 4 years or longer.


A Voice Excited Predictive Coding architecture (VEPC) has been recently proposed allowing to compress digital speech at bit rates of 9600/7200 bps with a telephone quality. In order to decrease the bit rate down to 4800 bps, while preserving a same level of quality, several improvements of the processing blocks have been considered: · an adaptive pre-emphasis of the predictor coefficients, · a five to one decimation of the residual signal to reduce the residual baseband to 800 Hz, · a parallel implementation of the sub-bands splitting-reconstruction. This paper deals with the improvements as well as the implementation aspects. Taped results will be played at the conference.


Circadian oscillators are known to regulate the timing of cell division in many organisms. In the case of Chlamydomonas reinhardtii, however, this conclusion has been challenged by several investigators. We have reexamined this issue and find that the division behavior of Chlamydomonas meets all the criteria for circadian rhythmicity: persistence of a cell division rhythm (a) with a period of approximately 24 h under free-running conditions, (b) that is temperature compensated, and (c) which can entrain to light/dark signals. In addition, a mutation that lengthens the circadian period of the phototactic rhythm similarly affects the cell division rhythm. We conclude that a circadian mechanism determines the timing of cell division in Chlamydomonas reinhardtii.


The success in reducing the number of children born with HIV is in danger of leaving children who already have the disease with poor access to treatment, experts in HIV and AIDS have warned.

Denis Broun, executive director of Unitaid, a not for profit organisation that purchases drugs for the treatment of HIV and AIDS and other diseases, has welcomed news that the number of new infections in children is falling. But he said that because fewer children are born with the virus, drug companies would no longer have an incentive to manufacture treatments and that childhood HIV might become a neglected disease.

A report by UNAIDS, the joint United Nations programme on HIV and AIDS, released a week before world AIDS day on 1 December, said that the …


Where are we going with curriculum issues? Ernest L. Boyer, in his definitive report on school reform "High School," identifies the second goal of education as promoting student learning through a curriculum based on significant, shared human experiences. The basis for curriculum has changed little since the report, but the landscape of curriculum issues is certainly more varied. When viewing the curriculum landscape, the most significant landmark is that all state education agencies differ in their views on curriculum requirements. Across the country you find varying levels and strengths of state mandates for agriculture, food and natural resources curriculum. Texas provides educators with standards called the essential knowledge and skills (TEKS), which mandate curriculum content for each approved course. This design is to ensure similar course content between districts. Texas does not mandate what courses are taught other than core courses specifically required for graduation. Some states may simply mandate graduation requirements, and allow districts the flexibility to meet those requirements. This scenario may make it challenging for teachers to find curriculum that specifically addresses their state mandates. When aligning curriculum for specific needs, these state mandates must be considered. In some cases, national curriculum content standards may offer needed guidance and direction. The current National Content Standards Initiative, when completed, should be an excellent tool for providing curriculum structure and guidance for some states. Many states allow greater options for local control of curriculum. Certain agriculture, food and natural resources courses may be considered to meet science credit requirements on student transcripts in those states. Avoid the pitfall of equating curriculum with textbooks. Curriculum guidelines provide educational structure; textbooks are content that may or may not be aligned with that structure. Teaching a textbook 'cover-tocover' is not necessarily the same as teaching the curriculum. Some states choose to fund textbooks selected through an extensive approval process at no cost to the individual districts. Other states allow teachers to pick and choose from an approved or suggested textbook list; while still other states allow teachers to pick and choose resources as they see fit, and encourage those teachers to gather whatever resources they can find. Curriculum development is expensive and time-consuming; customizing curriculum resources to meet specific states' standards can be a beneficial option for some entities. Curriculum standards or guides are essential to enable teachers to deliver high-quality instruction using the resources available. Textbooks, laboratory activities, life experiences and other resources are tools that quality teachers use to teach the curriculum. Two distinct issues strongly impacting curriculum development and dissemination are intellectual content and method of delivery. The intellectual content on which our profession focuses is food, agriculture, natural resources and leadership development. Content must be technically accurate and learner-appropriate. Additionally, any curriculum must be with rich with opportunities to reinforce contextual applications of mathematics and science. Materials associated with contemporary curriculum must have sufficient variety between text, images, media content, and other components to have value for individuals with different learning styles. Selection and utilization of appropriate images used in curriculum development is an additional consideration for intellectual content. It can be challenging to capture relevant video footage for curriculum products on a timely basis. Also, curriculum must be delivered in a format technologically appropriate for the campus, teacher and learner. A teacher may wish to utilize online curriculum delivery, but with inadequate computers in the classroom, this creates a challenge. …


High resolution computer tomographic examinations of the petrous bones were performed on 19 patients with confirmed peripheral facial nerve paralysis. High resolution CT provides accurate information regarding the extent, and usually regarding the type, of pathological process; this can be accurately localised with a view to possible surgical treatment. The examination also differentiates this from idiopathic paresis, which showed no radiological changes. Destruction of the petrous bone, without facial nerve symptoms, makes early suitable treatment mandatory.


Inaccurately perceived as niche drugs, antiemetics are key elements of cancer treatment alleviating the most dreaded side effect of chemotherapy. Serotonin 5-HT3 receptor antagonists are the most commonly prescribed class of drugs to control chemotherapy-induced nausea and vomiting (CINV). These antagonists have been clinically successful drugs since the 1980s, yet our understanding of how they operate at the molecular level has been hampered by the difficulty of obtaining structures of drug-receptor complexes. Here, we report the cryo-EM structure of the palonosetron-bound 5-HT3 receptor. We investigate the binding of palonosetron, granisetron, dolasetron, ondansetron, and cilansetron using molecular dynamics, covering the whole set of antagonists used in the clinical practice. The structural and computational results yield detailed atomic insight into the binding modes of the drugs. In light of our data, we establish a comprehensive framework underlying the inhibition mechanism by the -setron drug family.


This paper presents a dynamically reconfigurable SRAM array for low-power mobile multimedia application. The proposed structure use a lower voltage for cells storing low-order bits and a nominal voltage for cells storing higher order bits. The architecture allows reconfigure the number of bits in the low-voltage mode to change the error characteristics of the array in run-time. Simulations in predictive 70 nm nodes show that the proposed array can obtain 45% savings in memory power with a marginal (~10%) reduction in image quality.


An analytical method for the imaging of cylindrically stratified media is presented. The proposed method is based on the direct problem formulation of cylindrical dielectric objects using the concept of radial transmission line theory. This direct equation is then inverted to obtain a closed-form solution of the radially varying permittivity profile in terms of its value at the interface and the Hankel transform of the reflection coefficient data. A technique to obtain the value of the permittivity at the air-dielectric interface from the multi frequency scattering data is also presented here. A number of examples have been considered and a good agreement between the actual and the reconstructed profiles show that the proposed technique Is suitable for both continuous and discontinuous profiles.


This study aimed to investigate effects of curcumin on high fructose diet (HFD)-induced metabolic syndrome (MetS) in rats and the possible mechanisms involved. MetS was induced in male albino rats (n = 20), over 8 weeks, by 65% HFD. For 8-week experiment period, rats were assigned to 2 equal groups: curcumin-treated rats received curcumin (200 mg/kg, p.o, once daily) along with HFD, and untreated rats were fed with HFD only. We evaluated body mass (BM), systolic blood pressure (SBP), homeostasis model assessment of insulin resistance (HOMA-IR), and serum levels of glucose, insulin, leptin, total cholesterol (TC), triglycerides (TGs), uric acid, malondialdehyde (MDA; lipid peroxidation product), and tumor necrosis factor-α (TNF-α; inflammatory cytokine), and serum catalase (endogenous antioxidant) activity and immunohistochemical expression of nuclear factor κB (NF-κB; inflammation-related transcription factor) in hepatocytes. HFD produced increases in BM, SBP, HOMA-IR, and serum levels of glucose, insulin, leptin, TC, TGs, uric acid, MDA, and TNF-α, a decrease in catalase activity, and strong positive expression of NF-κB in hepatocytes. Curcumin, in presence of HFD, produced significant improvements in all glucose and fat metabolism parameters, and in oxidative stress and inflammation biomarkers. Curcumin may potentially be useful in the treatment of MetS through its ability to modulate oxidation stress status and inflammation cascades.


An adaptive panoramic stereo approach for two cooperative mobile platform is presented. There are four key features in the approach: 1) omnidirectional stereovision with an appropriate vertical FOV, and a simple camera calibration method; 2) cooperative mobile platforms for mutual dynamic calibration and best view planning; 3) 3D matching after meaningful object (human subject) extraction; and 4) real-time performance. The integration of omnidirectional vision with mutual awareness and dynamic calibration strategies allows intelligent cooperation between visual agents. This provides an effective way to solve the problems of limited resources, view planning, occlusion, and motion detection of movable robotic platforms. Experiments have shown that this approach is quite promising.


Purpose of review Enteral nutrition as a treatment for inflammatory bowel diseases is an ongoing area of interest. Even in the era of biologic agents, exclusive enteral nutrition (EEN) offers a unique, drug-free measure for induction of remission in luminal Crohn's disease. The purpose of this review is to discuss the role of EEN in the evolving therapeutic scheme for Crohn's disease, to report on new evidence for short and long-term efficacy and highlight findings on the mechanisms of the anti-inflammatory effects of EEN in light of current understanding of disease pathogenesis. Recent findings Recent clinical studies have suggested that EEN has an established advantage over corticosteroids for inducing remission in children with luminal Crohn's disease with comparable clinical efficacy but superior mucosal healing effect as well as better safety profile. Preoperative EEN therapy can also improve postoperative outcome of intestinal resection. Basic research has demonstrated that EEN has direct anti-inflammatory properties, can correct localization of tight junction proteins, alter micro RNAs expression, and profoundly affect the intestinal microbiota. Summary EEN is an effective treatment for induction of remission in pediatric luminal Crohn's disease and should be offered as a first-line treatment. Accumulating evidence suggest that EEN has direct anti-inflammatory properties with an effect on the intestinal microbiota. However, the relationships between these effects and the specific triggers for these changes have yet to be elucidated.


Cardiac arrhythmias remain common challenges and are associated with significant morbidity and mortality. Effective and safe rhythm control strategies are a primary, yet unmet need in everyday clinical practice. Despite significant pharmacological and technological advances, including catheter ablation and device-based therapies, the development of more effective alternatives is of significant interest to increase quality of life and reduce symptom burden, hospitalizations and mortality. The mechanistic understanding of pathophysiological pathways underlying cardiac arrhythmias has advanced profoundly, opening up novel avenues for mechanism-based therapeutic approaches. Current management of arrhythmias, however, is primarily guided by clinical and demographic characteristics of patient groups as opposed to individual, patient-specific mechanisms and pheno/genotyping. With this State-of-the-Art paper, the Working Group on Cellular Electrophysiology of the German Cardiac Society aims to close the gap between advanced molecular understanding and clinical decision making in cardiac electrophysiology. The significance of cellular electrophysiological findings for clinical arrhythmia management constitutes the main focus of this document. Clinically relevant knowledge of pathophysiological pathways of arrhythmias and cellular mechanisms of antiarrhythmic interventions are summarized. Furthermore, the specific molecular background for the initiation and perpetuation of atrial and ventricular arrhythmias and mechanism-based strategies for therapeutic interventions are highlighted. Current "hot topics" in atrial fibrillation are critically appraised. Finally, the establishment and support of cellular and translational electrophysiology programs in clinical rhythmology departments is called for to improve basic-science-guided patient management.


This paper was presented at the 6th Annual Conference of the Educational Research Association, held in Singapore from 24 - 26 Sep 1992


Occupational stress was studied in 220 police officers through their self-evaluation. The most stressful factors of the examinees' activities were identified. Liability to stress appeared to differ in some factors and depend on the age. The data obtained should be considered in the activities organization and in rehabilitation and prophylactic measures aimed to avoid negative behavioral aspects in police officers and to prevent somatic diseases.


Quality measurement has been slow to make a major impact in health care. Initial measures were too simple to affect outcomes of importance. Incentive programs such as Meaningful Use encourage better measures, but in process may become more complex. We evaluated the measures selected for Meaningful Use in two ways: we counted unique concept identifiers, taxonomies, and aggregated concepts as measures of complexity; and we surveyed informatics professionals to assess difficulty. There were 20,316 unique concept identifiers, 35 taxonomies, and 317 aggregated concepts across the 45 measures. Half the respondents reported measures at least moderately difficult. The number of identifiers was associated with fewer implementations (r=-.37); rating-of-difficulty was associated with more taxonomies (r=.24). The impact on accuracy may be substantial when moving to measures intended to be more relevant to clinical outcomes but requiring the use of more taxonomies, unused structured concept identifiers, or concepts only in free text fields.


Entropic regularization provides a generalization of the original optimal transport problem. It introduces a penalty term defined by the Kullback-Leibler divergence, making the problem more tractable via the celebrated Sinkhorn algorithm. Replacing the Kullback-Leibler divergence with a general $f$-divergence leads to a natural generalization. The case of divergences defined by superlinear functions was recently studied by Di Marino and Gerolin. Using convex analysis, we extend the theory developed so far to include all $f$-divergences defined by functions of Legendre type, and prove that under some mild conditions, strong duality holds, optimums in both the primal and dual problems are attained, the generalization of the $c$-transform is well-defined, and we give sufficient conditions for the generalized Sinkhorn algorithm to converge to an optimal solution. We propose a practical algorithm for computing an approximate solution of the optimal transport problem with $f$-divergence regularization via the generalized Sinkhorn algorithm. Finally, we present experimental results on synthetic 2-dimensional data, demonstrating the effects of using different $f$-divergences for regularization, which influences convergence speed, numerical stability and sparsity of the optimal coupling.


We introduce the problem of risk analysis for Intellectual Property (IP) lawsuits. More specifically, we focus on estimating the risk for participating parties using solely prior factors, i. e., historical and concurrent behavior of the entities involved in the case. This work represents a first step towards building a comprehensive legal risk assessment system for parties involved in litigation. This technology will allow parties to optimize their case parameters to minimize their own risk, or to settle disputes out of court and thereby ease the burden on the judicial system. In addition, it will also help U.S. courts detect and fix any inherent biases in the system.
 We model risk estimation as a relational classification problem using conditional random fields [6] to jointly estimate the risks of concurrent cases. We evaluate our model on data collected by the Stanford Intellectual Property Litigation Clearinghouse, which consists of over 4,200 IP lawsuits filed across 88 U.S. federal districts and ranging over 8 years, probably the largest legal data set reported in data mining research. Despite being agnostic to the merits of the case, our best model achieves a classification accuracy of 64%, 22% (relative) higher than the majority-class baseline.


Fasciola hepatica is the most widely distributed trematode-affecting humans. The Andes Mountains are highly endemic for fascioliasis. We report results of a cross-sectional study evaluating the epidemiology of Fasciola among children in 26 agricultural communities in the Cusco region of Peru. Children 3 to 16 years old were enrolled in preschools and schools. Blood from participants was tested for complete blood counts, transaminases, and Fasciola antibodies. Stool samples were tested for Fasciola and other parasites. A total of 2,515 children were included in the analysis and the mean age was 9.6 years (±3.6). Ten percent (253) of the children had at least one positive test for Fasciola, 6% had chronic infection, and 0.4% acute infection. The rest of the subjects had only antibodies against Fasciola. The prevalence of infection varied from 0% to 20% between communities. Children with evidence of Fasciola exposure were older, lived at higher altitudes, and had a lower socioeconomic status than children without infection. The logistic regression analysis showed that children from Ancahuasi district, older children, and children with higher measures of poverty were more likely to have Fasciola exposure. Fascioliasis is common in the Cusco region and associated with poverty. However, the distribution varies markedly between communities.


TGFbeta-Inducible Early Gene (TIEG) and the alternatively-transcribed Early Growth Response Gene alpha (EGRalpha) share a Cys(2)His(2) three-zinc finger region with high homology to Sp1 within its zinc finger region. Three-zinc finger transcription factors bind to GC-rich sequences, with small variations in consensus sequence between subfamilies. In this work, a consensus sequence was identified for TIEG/EGRalpha by expressing and purifying the zinc finger region of the protein, and using this to select a binding site from a random oligonucleotide library by iterative cycles of nitrocellulose filter binding and PCR. A fusion of the TIEG/EGRalpha with the VP16 activation domain supported transcription from this site when cloned in front of a heterologous promoter. Mutational analysis of the binding site identified a GT-rich core (5'-GGTGTG-3') that was necessary for binding, with mutations outside of this region causing only a small to moderate decrease in binding.


Thermal forces drive several nonequilibrium phenomena able to set a fluid in motion without pressure gradients. Although the most celebrated effect is thermophoresis, also known as Ludwig-Soret effect, probably the simplest example where thermal forces are at play is thermo-osmosis: The motion of a confined fluid exclusively due to the presence of a temperature gradient. We present a concise but complete derivation of the microscopic theory of thermo-osmosis based on linear response theory. This approach is applied to a simple fluid confined in a slab geometry, mimicking the flow through a pore in a membrane separating two fluid reservoirs at different temperatures. We consider both the case of an open channel, where the fluid can flow freely, and that of a closed channel, where mass transport is inhibited and a pressure drop sets in at the boundaries. Quantitative results require the evaluation of generalized transport coefficients, but a preliminary check on a specific prediction of the theory has been successfully performed via nonequilibrium molecular dynamics simulations.


This thesis describes the synthesis and crystallisation of a selection of known and novel transition-metal – nitrite complexes and their detailed study using non-ambient X-ray diffraction techniques. These coordination compounds are specifically investigated for their ability to undergo nitro – nitrito linkage isomerisation in the single-crystal, with conversion between isomers achieved on either thermal- or photoactivation. The lifetime of the excited-state isomer is strongly dependent on the experimental temperature and, as such, this thesis is also concerned with time-resolved crystallographic methods. This work relies primarily on the technique of photocrystallography, a growing area of crystallographic research that has enjoyed considerable interest in recent decades. Chapter 1 reviews the seminal progress made in both time-resolved and photocrystallographic research, made possible by dramatic technological advances in the field in recent decades. Chapter 2 outlines the goals of this research project, aiming to obtain a more detailed understanding of the factors that influence the solid-state nitro – nitrito isomerisation. Chapter 3 describes the X-ray methods used in these studies, introducing both fundamental crystallographic principles and detailing the experimental procedures that are undertaken. Chapters 4 and 5 record steady-state photocrystallographic studies conducted for a series of complexes containing bulky, chelating ancillary ligands accompanying a monodentate nitrite group expected to be capable of nitro – nitrito isomerism. The response of these systems to both thermal- and photoactivation is investigated via single-crystal diffraction methods. The analysis focusses on the potential steric and electronic influences from the surrounding crystalline environment, which may have an impact on the progress of the solid-state reaction. Chapter 6 introduces photocystallographic kinetic methods to investigate the progress of nitro – nitrito conversion in real time. These studies are the first of their kind to be conducted on nitrite linkage isomer species and some novel methodology is introduced. Finally, Chapter 7 discusses pseudo-steady-state and trial time-resolved experiments conducted using the new time-resolved diffraction set-up on Beamline I19 at the Diamond Light Source. These early results indicate the power of time-resolved methods for elucidating key information on the nitro – nitrito conversion process and show promise for future experiments.


The spatiotemporal dynamics of the solar photosphere is studied by performing a proper orthogonal decomposition (POD) of line of sight velocity fields computed from high resolution data coming from the MDI/SOHO instrument. Using this technique, we are able to identify and characterize the different dynamical regimes acting in the system. Low-frequency oscillations, with frequencies in the range 20-130 microHz, dominate the most energetic POD modes (excluding solar rotation), and are characterized by spatial patterns with typical scales of about 3 Mm. Patterns with larger typical scales of approximately 10 Mm, are associated to p-modes oscillations at frequencies of about 3000 microHz.


In this study, the limiting maximum drag reduction asymptote for the moment coefficient of an enclosed rotating disk with fine spiral grooves in turbulent flow region were obtained analytically. Analysis which were based on an assumption for a simple parabolic velocity distribution of turbulent pipe flow to represent relative tangential velocity, was carried out using momentum integral equations of the boundary layer. For a certain K- parameter the moment coefficient results agree well with experimental results for maximum drag reduction in an enclosed rotating disk with fine spiral grooves and drag reduction ratio approximately was 15 %. Additionally, the experimental results for drag reduction on a rotating disk can be explained well with the analytical results.


The magnetoresistance of (γ-Fe2O3)xAg100−x (x=50–90), a granular system where insulating magnetic nanoparticles and nonmagnetic metal are intimately mixed, has been studied at room temperature. For high silver concentration (x⩽70), samples are metallic and exhibit ordinary positive magnetoresistance. Below the percolation threshold, which is 11.4 vol % of silver (x=71), samples are insulators. Our data suggest that direct tunneling between silver grains across γ-Fe2O3 barriers dominates at low temperature and variable range hopping becomes the main transport mechanism at high temperature. The variable range hopping within γ-Fe2O3 is believed to be associated with the presence of Fe2+ impurities which is determined by Mossbauer spectroscopy. Negative magnetoresistance up to −2% is found in (γ-Fe2O3)xAg100−x (x⩾72) in an applied field of 10 kOe at room temperature. It is proposed that the observed negative magnetoresistance is due to the field-dependent hopping rate of electrons from Fe2+ to Fe3+ which is e...


Rarely does a humour title come along that is a true gem. Destined to be an instant classic, this is one such book. Containing hundreds of 'new words', it is a marvellous collection of hilarious expressions invented by the extraordinary comic mind of Keith Barker Main. Wry, dry, sly, sometimes rude, but always laugh-out-loud funny, his intelligent brand of humour casts an irreverent look at the age we live in and condenses modern cliches in our society into truly memorable words, some of which have already entered the "Oxford English Dictionary". A comic creation from a cheeky modern wordsmith with superb illustrations throughout, this book is set to take the humour market by storm.


This paper focuses on the impact that the flow and exchange ideas during Continuing Professional
Development (CPD) Workshops has on the professional practice of librarians. Participants in four CPD
workshops were invited to participate in surveys at three and six month intervals after attending CPD
workshops. Most participants implemented the ideas gained from the workshop in ways that benefited
personal practice, library services, and the organisation, transferring the knowledge and skills from the
workshops into their professional practice.


Aqueous humor outflow occurs through the conventional and unconventional pathway. With aging, the latter becomes less active so that the conventional pathway remains the primary mechanism of aqueous humor outflow. An abnormality of this pathway contributes significantly to disordered aqueous humor dynamics and consequent rise in intraocular pressure seen in primary open angle glaucoma and ocular hypertension. Recently, the ocular lymphatics have been implicated in aqueous humor outflow. Additionally, the trabecular meshwork is now understood to be a complex organization of structures, which are controlled by various biomechanical and biochemical mechanisms. Among others, these include the actinomyosin cytoskeletal system, extracellular matrix, intracellular signaling responses mediated by protein kinase C, Rho/Rho kinase, and other biologic factors. This review shall describe the various pathophysiologic mechanisms involved in aqueous humor dynamics.


Urinary tract infections (UTI) in young children have been associated with serious long-term
complications such as renal scarring, hypertension and renal failure. The presenting
symptoms of UTI in children are non-specific. If UTI is not suspected, a urine sample is not
obtained, and without this, UTI cannot be diagnosed. There is evidence that the diagnosis is
often missed.
Most published studies have not systematically sampled urine, and those that have are largely
based in US emergency departments and only include highly selected groups of children. The
true prevalence of UTI in acutely ill children presenting in UK general practice is therefore
unknown.
My thesis consists of a literature review discussing the association of childhood UTI with
long-term complications, the challenges of diagnosis and the evidence that UTIs are being
missed; a systematic review of papers reporting UTI prevalence in children which highlights
the need for a study in UK general practice; a pilot study to determine the feasibility of
recruiting children and obtaining urine samples in UK general practice; and a prospective
cohort study to determine the point prevalence of UTI in 597 presenting children, determine
the predictive value of presenting symptoms, signs and risk factors, and describe the clinical
outcomes for children with UTI.
I found that the prevalence of UTI was 5.9% (95% confidence interval: 4.3-8.0%). This may
be sufficiently high to justify increased urine sampling in general practice. A multi-variable logistic regression model identified younger age range, pain on passing
urine (dysuria) and urinary frequency as being associated with UTI. I propose a urine
sampling strategy for GPs assessing acutely ill children and compare this to suspicion-led
sampling and current guidelines. In my discussion I discuss the limitations, generalisability
and implications of these findings.


This paper proposes a control-oriented pressure wave model, utilizing outputs of a reaction-based two-zone engine combustion model developed earlier, to accurately predict the key knock characteristics. The model can be used for model-based knock prediction and control. An in-cylinder pressure wave model of oscillation magnitude decay is proposed and simplified to describe pressure oscillations due to knock combustion, and the boundary and initial conditions of the pressure wave model at knock onset are provided by the two-zone reaction-based combustion model. The proposed pressure wave model is calibrated using experimental data, and the chemical kinetic-based Arrhenius integral (ARI) and maximum amplitude of pressure oscillations (MAPO) are used as the evaluation criteria for predicting knock onset and intensity, and the knock frequency is studied with the fast Fourier transform (FFT). The calibrated model is validated for predicting knock onset timing, knock intensity and frequency. Simulation results are compared with the experimental ones to demonstrate the capability of predicting engine knock characteristics by the proposed model.


SIR,-Dr John Ashton's editorial gives an excellent picture of the modern approach to public health.' His list of topics with which it is concernedhousing, sanitation, education, transport, etcillustrates the fields into which health now has an input. But it is also worth while to emphasise the other side of the coin and point out that the professions concerned-architecture, town planning, education, engineering, and agriculture -also have an important input into health. One exemplary multidisciplinary field that needs the cooperation of health professionals with many of these other professionals is accident prevention. This is, by a long way, the most important public health problem affecting children, adolescents, and young adults. It is therefore somewhat ironic that in the same issue of the BMJ there is a note on the establishment of a Trauma Foundation, whose resources will be devoted to research, postgraduate education, and providing hospital facilities for injured people.2 Regrettably, no mention is made of resources devoted to the prevention of such accidents. The irony is further heightened by the accompanying illustration of a cyclist who seems to have a head injury after being struck by a car-but no cycle helmet is in evidence. We urge that all such initiatives, in the spirit of the orientation described by Dr Ashton, recognise fully the proportions of the problem of injuries resulting from accidents, especially as it affects young people.


The multi-disciplinary methods used to investigate early agriculture at Kuk Swamp in the Highlands of New Guinea are outlined. Methods adopted during the original investigations in the 1970s (directed by Jack Golson, with Philip Hughes from 1974), as well as during renewed investigations at the site (directed by Tim Denham from 1997 under Golson's supervision) are considered. Three methodological contributions to the study of early agriculture and plant exploitation are highlighted: X-radiography, biostratigraphic markers, and the integration of macrofossil and microfossil analyses. One outstanding methodological problem is considered, the representativeness of different components of a feature fill for reconstructions of past cultivation practices. Thoughts on an integrated method (macrofossil, microfossil and molecular) for future research on early agriculture and arboriculture in the region are presented.


The work presented in this thesis concerns the dynamics of shoreface-connected ridges and tidal sand ridges. These large-scale bedforms are observed on the inner and outer shelf of coastal seas in water depths of 10-20m. The motivation of this work is to improve the understanding of the mechanisms related to their formation and the processes that determine their main characteristics. This is done with the use of idealised morphodynamic models. The basic assumption underlying these models is that large-scale sand ridges can solely form as free instabilities on a flat sea bottom. Mathematical methods based on a stability analysis are applied, whereas analytical and numerical methods are used to solve the equations. Existing models are extended with new physical processes, in particular including the role of grain sorting. An important part of this thesis concerns the unresolved question about the origin of the observed mean grain size pattern over the ridges. It explores the hydrodynamic processes that can lead to sediment sorting and the formation of large-scale sand ridges. The model results indicate that the dynamics for different forcing conditions strongly differ. Shoreface-connected sand ridges mainly form during storm conditions, whereas if fair weather conditions prevail the more offshore located tidal sand ridges develop. A probabilistic formulation of these two realisation of the model is used to find conditions for which both types of large-scale bedforms occur simultaneously, as is the case in the southern North Sea. These conditions turn out to be a low storm fraction and the presence of both tidal and storm-driven currents. The transport of non-uniform sediment is described by formulations for both bed load and suspended load, both of which account for dynamic hiding effects. A one-layer model for the bed evolution is used and two grain size classes (fine and coarse sand) are considered. The results of the model for storm conditions indicate that the observed phase shift between bed topography and mean grain size for shoreface-connected ridges (finest sand on seaward flanks) is due to the selective transport via suspended load of grains with different sizes. Parameter values are based on the sand ridges along the Atlantic coast of North America. A net stabilising effect on the initial growth and an enhanced migration is predicted. A physical explanation for the model results is given. During fair weather or tidally dominated conditions, when bed load transport of sediment is dominant, the results indicate an increase in initial growth and migration rates of tidal sand ridges for a bimodal sediment mixture. A symmetrical tidal current results in a grain size distribution, with the coarsest sand found at the crest of the ridges. Results are compared with the tidal ridges on the Belgian coastal shelf. The investigation of the long-term evolution of shoreface-connected ridges focuses on storm-dominated micro-tidal shelves. It is shown that, starting from an initial state without bedforms, a pattern of ridges with a finite height develops. The evolution of the spatial patterns in the mean grain size and bottom topography are shown and discussed in terms of physical mechanisms.


Further progress in the development of polymer gel dosimetry using MRI is reported, together with examples of its application to verify treatment plans for stereotactic radiosurgery and high dose rate brachytherapy. The dose distribution image produced in the tissue-equivalent gel by radiation-induced polymerization, and encoded in the spatial distribution of the NMR transverse relaxation rates (R2) of the water protons in the gel, is permanent. Maps of R2 are constructed from magnetic resonance imaging data and serve as a template for dose maps, which can be used to verify complex dose distributions from external sources or brachytherapy applicators. The integrating, three-dimensional, tissue-equivalent characteristics of polymer gels make it possible to obtain dose distributions not readily measured by conventional methods. An improved gel formulation (BANG-2) has a linear dose response that is independent of energy and dose rate for the situations studied to date. There is excellent agreement between the dose distributions predicted using treatment planning calculations and those measured using the gel method, and the clinical practical utility of MRI-based polymer gel dosimetry is thereby demonstrated.


In this work, a novel micoropump actuated by EO (electroosmotic) actuators toward biomedical systems and drug delivery systems. The classical structure, which consists of an actuating unit, chambers and rectifiers, has been employed in the design. The EO actuators with the impulse input make the polydimethylsiloxane (PDMS) diaphragm which separates the two chambers reciprocate. So the working liquid can be pumped from inlet to outlet. Due to the large deflections of the PDMS diaphragm, the device is completely self-filling and able to pump liquid even operated in vertical situation. By using the indirect pumping mechanisms, the EO actuator can be used more widely without considering the properties of the working liquid. And a maximum flow rate of 133μl/min (using top water as working liquid) was obtained by an input voltage of 30V and an exciting frequency of 1.4Hz. In order to find the characteristic of the micropump, the Bouc-Wen model was used to model it. And some experiments were manipulated to show the characteristics of the PDMS diaphragm and the check valve. These experiments results demonstrate the diaphragm micropump performance and ability to deliver the fluid and drugs to biomedical systems.


Introduction: Nasal fractures are common injuries, frequently considered to be minor. Nevertheless, they may cause significant damage, from both a functional and aesthetic perspective. Methods: Medical records of 144 patients admitted for nasal fracture treatment between February 2002 and October 2008 to the Plastic Surgery Area of the Unicamp Clinical Hospital were analyzed. Results: Patients were predominantly male (75.7%), with a male to female ratio of 3.1:1. The most number of cases was observed in 21 to 30 year olds, and the majority of fractures (31.8%) were caused by physical aggression. Closed reductions were performed on all patients under local and topical anesthesia after an average of 8 days. Among the studied patients, 31 experienced residual deformity. Conclusions: Patients typically affected by nasal fractures are young male adults. Closed reduction surgical treatment yields acceptable results, with correct injury evaluation and treatment timing.


Until recently the onset of labour was considered to be due to changes in maternal hormone levels which were represented by a drop in the progesterone and a rise in the oxytocin levels. Recent work has shown that onset of labour is associated with several phenomena which take place parallel to one another, and they are immunological, haemodynamic, biochemical, mechanical, psychological and hormonal. The last of these are far and away the most important and have three sources: a placental source; a maternal source of sex steroids, oxytocin and prostaglandins and; of fetal origin, adrenal and posterior pituitary hormones. It seems that the prostaglandins and the maturation of the fetal brain are at present considered to be all-important. Better knowledge of the physiology of the onset of labour has led to greater success in pharmaco-dynamically induced labour, but this is not yet truly physiological. Therefore except in cases of pathology it does not seem right to undertake the risks of inducing labour more or less systematically.


Foot problems are commonly involved in diabetes, and the most common presentation of diabetes is an ulcer. Diabetic foot ulcer is a complex problem caused by reduced blood supply, nerve damage, or infection. But unfortunately in most of cases, these three factors have played a role for impairment of diabetic feet. Sometimes nerve damage or neuropathy is an initial insult, and multiple times ischemia is the leading factor for ulcer formation. After certain period, infection finally supervenes and makes a sterile ulcer to infected leads to loss of limb or foot. This becomes more complicated because of less pronounced ischemic symptoms in diabetic than non-diabetics. Furthermore, the healing of a neuroischemic ulcer is slowed down by microvascular dysfunction. Therefore, some ulcers can get better by revascularization, but pure ischemic ulcers rarely respond to revascularization. Many guidelines have largely ignored these specific demands related to ulcerated neuroischemic diabetic feet. Any diabetic foot ulcer should always be considered to have vascular impairment unless otherwise proven. This chapter highlights the best way to diagnose and treat these patients with diabetic foot ulcer. Most of the studies dealing with neuroischemic diabetic feet are not comparable in terms of patient populations, interventions, or outcomes. Therefore, there is an urgent need for a paradigm shift in diabetic foot care, that is, a new approach and classification of diabetics with foot ulcer in regard to clinical practice and research.