This paper analyses the role of patent-filing fees requested by the member states of the European Patent Convention (EPC). We provide first empirical evidence showing that the fee elasticity of the demand for priority applications is negative and significant. Given the strong variation in absolute fees and in fees per capita across countries, this result indicates a suboptimal treatment of inventors across European countries and suggests that fees should be considered as an integral part of an intellectual property policy, especially in the current context of worrying backlogs. In addition, we show that the transfer rate of domestic priority filings to the European Patent Office (EPO) increases with the duration of membership to the EPO and the GDP per capita of a country, suggesting that member states experience a learning curve within the EPC. The high heterogeneity in the transfer rates casts some doubts on the practice that consists in relying on filings at the EPO or at the United States Patent and Trademark Office to assess the innovative performance of countries.


Author(s): Aldous, David | Abstract: © Institute of Mathematical Statistics, 2018. Plant differently colored points in the plane; then let random points ("Poisson rain") fall, and give each new point the color of the nearest existing point. Previous investigation and simulations strongly suggest that the colored regions converge (in some sense) to a random partition of the plane. We prove a weak version of this, showing that normalized empirical measures converge to Lebesgue measures on a random partition into measurable sets. Topological properties remain an open problem. In the course of the proof, which heavily exploits time-reversals, we encounter a novel self-similar process of coalescing planar partitions. In this process, sets A(z) in the partition are associated with Poisson random points z, and the dynamics are as follows. Points are deleted randomly at rate 1; when z is deleted, its set A(z) is adjoined to the set A(z') of the nearest other point z'.


Companies that own, license, or maintain personal information face a daunting number of privacy and security regulations. Companies are subject to new regulations from one or more governing bodies, when companies introduce new or existing products into a jurisdiction, when regulations change, or when data is transferred across political borders. To address this problem, we developed a framework called "requirements water marking" that business analysts can use to align and reconcile requirements from multiple jurisdictions (municipalities, provinces, nations) to produce a single high or low standard of care. We evaluate the framework in an empirical case study conducted over a subset of U.S. data breach notification laws that require companies to secure their data and notify consumers in the event of data loss or theft. In this study, applying our framework reduced the number of requirements a company must comply with by 76% across 8 jurisdictions. We show how the framework surfaces critical requirements trade-offs and potential regulatory conflicts that companies must address during the reconciliation process. We summarize our results, including surveys of information technology law experts to contextualize our empirical results in legal practice.


Objective: The aim of this studywas to determine the national incidence of facial trauma among toddlers and delineate patterns of injury and their causes. Methods: A retrospective review was designed to explore patterns of maxillofacial trauma within toddler-aged children using the National Electronic Injury Surveillance System from the Consumer Product Safety Commission. The database was searched for emergency department visits involving facial trauma sustained by children 12 months through 3 years of age from 2010 through 2014 and analyzed for patient demographics, primary diagnosis, and associated products/activities. Subset analyses were performed between age groups to determine the relationship between causes of injury and age using extrapolated national incidences. Results: A sample of 45,249 patients extrapolated to an estimated 1.3 million emergency department visits for facial trauma in toddlers from 2010 to 2014, averaging 260,000 annually. Injuries involving foreign bodies and fractures had a higher incidence in toddlers 2 years or older, and fractures comprised fewer than 1% of facial injuries in any age group. Furniture was the most common source of trauma overall, with a higher frequency among toddlers aged 12 to 17 months. Trauma in the setting of sports was more common in toddlers aged 3 years. Conclusions: The low incidence of facial fractures further supports recommendations against routine imaging in toddler facial trauma and suggests that more focus should be placed on investigating for concurrent traumas and soft tissue injuries where fractures are involved. Our findings highlight prevention opportunities, particularly in furniture-related injuries for toddlers aged 12 to 17 months and sports-related traumas in toddlers aged 3 years. Our study also suggests restricting certain toys from 3-year-old toddlers to decrease the risk of aspiration.


In what is generally referred to as Sweden's Age of Greatness (1617–1721), Swedish armies ravaged Europe and Russia. The resulting manoeuvres, battles and sieges have been frequently described by Swedish military historians, yet rarely have the internal relationships within the Swedish armies been a topic of inquiry. This article presents one such analysis, with a focus on the relationship between military commanders and their subordinates in the age of King Charles XII of Sweden (1697–1718). By studying different types of violations of insubordination, my aim has been to identify the various informal rules that determined the nature of the subordinate–superior relationship, with a special focus upon the reasons for insubordination.


Pesticides applied worldwide in conventional agriculture for pest, disease and weed control are critical to increased productivity, but can provide harmful effects on non-target organisms. Given its toxicological, environmental and agricultural relevance, pesticide science comprises an important area of research, not only for scientists working in the field of agriculture, but also for several other professionals, where the subject requires a multidisciplinary approach. Important aspects of pesticides residues in marketed grains in Brazil, contamination of water resources by pesticides, bioaccumulation of pesticides in non-target organisms, are highlighted in this book, in addition to advantages and disadvantages of hormesis to herbicides in agricultural production, and phytoremediation technique to herbicides-polluted soils. We are sure that readers will find a lot of useful information, even if they are only partially interested in a few chapters. In this book entitled "Pesticides in Agriculture and Environment" are covered several topics on current and valuable research on pesticide science.


Objectives To examine inequalities in immunisation and breast feeding by ethnic group and their relation to relative deprivation. Design Cross-sectional study. Setting Manchester, UK. Participants 20 203 children born in Manchester (2002–2007), who had been coded as of white, mixed, Indian, Pakistani, Bangladeshi and black or black British ethnicity in the Child Health System database. Main outcome measures Breast feeding at 2 weeks post partum; uptake of triple vaccine (diphtheria, pertussis and tetanus) at 16 weeks post partum; uptake of the measles, mumps and rubella vaccine (MMR) by the age of 2. Results Black or black British infants had the highest rates of breast feeding at 2 weeks post partum (89%), and South Asian infants had the highest triple and MMR vaccination rates (Indian, 95%, 96%; Pakistani 95%, 95%; Bangladeshi 96%, 95%) after area level of deprivation, parity, parenthood status and age had been controlled for. White infants were least likely to be breast fed at 2 weeks post partum (36%), and to be vaccinated with triple (92%) and MMR vaccines (88%). Within the white ethnic group, lower percentages of immunisation and breast feeding were significantly associated with living in a deprived area and with increasing parity. This was not found within black or black British and Pakistani ethnic groups. Discussion Practices that are protective of child health were consistently less likely to be adopted by white mothers living in deprived areas. Methods of health education and service delivery that are designed for the general population are unlikely to be successful in this context, and evidence of effective interventions needs to be established.


Two extremely significant empirical questions on the relationship between growth, distribution and poverty have remained the focus of attention for researchers and academicians. First, how does a change in aggregate poverty reflect intrasectoral gains/losses versus intersectoral shifts in population? Second, how much of an observed change in poverty can be attributed to the changes in the distribution of income, as distinct from growth in average incomes? Standard inequality measures like the Gini coefficient can be misleading in this context. At any rate, the change in an inequality measure can be a poor guide to its quantitative impact on poverty. Ravallion and Huppi (1991) proposed decomposition formulae to throw light on the contributions of sectoral gains and population shifts (on the one hand) and economic growth and changes in inequality (on the other) to aggregate changes in poverty. They found that both population shifts and gains to the urban and rural sectors alleviated aggregate poverty in Indonesia over the 1984–87 period. In addition, they obtained estimates of the relative contributions of growth and greater equity to poverty alleviation in Indonesia. Datt and Ravallion (1992) extended the analysis to study poverty in Brazil and India during the 1980s. Kakwani (1993) explored the relation between economic growth and poverty for Cote d'Ivoire from 1980–85. He developed his own methodology to measure separately the impact of changes in average income and income inequality on poverty. Kakwani (2000) applied the same methodology to analyse changes in poverty in Thailand covering the period from 1988–94. Recently, Contreas (2003) examined the evolution of poverty and inequality in Chile between 1990 and 1996. Using the "Datt-Ravallion decomposition", he computed that economic growth accounted for over 85 percent of the poverty reduction in Chile.


Martin Amis's 1991 novel Time's Arrow narrativizes two major breaks: a split of consciousness that separates the narrator and protagonist who occupy the same body, and a split in temporality that confuses past and future, so that the narrator attempts to understand the protagonist's life in reverse.1 These schisms within the narrative parallel and invoke two major historical ruptures of the twentieth century: the Holocaust that happened, and the nuclear holocaust that looked likely to occur. Time's Arrow, set within this historical framework,suggests these holocausts jointly destabilized the directionality and flow of time, trapping the post-World War Two generations in a perpetual postmodern apocalyptic condition. Following Fredric Jameson, I understand "postmodern" as a "periodizing concept" (3), referring to the cultural logic underlying late modern socioeconomic formations and the expression of that logic in the aesthetic realm. Jameson's analysis of late modern society's pathological relationship with time and history is particularly relevant to Time's Arrow. The novel is postmodern in its literary style, with its destabilized first-person narrative voice and refusal of conventional linear time, but style here expresses a deeper cultural crisis, including the parallel loss of "a sense of history" and of "the sense of a viable future" (Hollinger 166-167). In the ever-present shadow of two catastrophic crises—one lurking behind and one looming ahead—the narrative points to massive devastation in either direction, undermining, but not negating, the conceivability of a (better) future. Amis's novel most powerfully illustrates the continuity between the 'greatest' crises ofthe twentieth century by portraying apocalypse and rupture as perpetual phenomena, and evoking the difficulty of imagining beyond them.


The application of regularization to ill-conditioned problems necessitates the choice of a regularization parameter which trades fidelity to the data with smoothness of the solution. The value of the regularization parameter depends on the variance of the noise in the data. The problem of choosing the regularization parameter and estimating the noise variance in image restoration is examined. An error analysis based on an objective mean-square-error (MSE) criterion is used to motivate regularization. Two approaches for choosing the regularization parameter and estimating the noise variance are proposed. The proposed and existing methods are compared and their relationship to linear minimum-mean-square-error filtering is examined. Experiments are presented that verify the theoretical results.


The environmental impact assessment was carried out in different five geographical zones of Kwara Central, Kwara North, Kwara South, Kogi Central and Kogi West in two phases. Phase 1 was investigation by observation through questionnaire administration and phase 2 was observation by experiment (sampling and analysis) of 5 farms in each zone making a total of 25 farms. Water quality parameters were measured from site to site where alkalinity and hardness differed significantly ( p 0.05), while water pollution, insecurity as a result of land exposure and wild life displacement were impacted significantly ( p < 0.05). Fish bred and raised were monoculture of family Clariidae of which species of Clarias gariepinus and Heterobranchus longifilis, Heterobranchus bidorsalis and their hybrids were prominent. Poor quality constructions of brood stock ponds, spawning, nursery tanks and fish hatcheries drainage compartments, their effects coupled with uncontrolled discharge of waste water in the hatcheries caused negative residual impacts of pollution, erosion and degradation of farm lands and environment. To prevent the occurrence of these hazards, fish farmers must obtain permits from relevant authorities and contact experts before embarking on pond constructions and fish hatcheries. Keywords: Fish farm hatcheries, impacts, assessments, Kwara state, Kogi state


Federated learning-based semantic segmentation (FSS) has drawn widespread attention via decentralized training on local clients. However, most FSS models assume categories are fixed in advance, thus heavily undergoing forgetting on old categories in practical applications where local clients receive new categories incrementally while have no memory storage to access old classes. Moreover, new clients collecting novel classes may join in the global training of FSS, which further exacerbates catastrophic forgetting. To surmount the above challenges, we propose a Forgetting-Balanced Learning (FBL) model to address heterogeneous forgetting on old classes from both intra-client and interclient aspects. Specifically, under the guidance of pseudo labels generated via adaptive class-balanced pseudo labeling, we develop a forgetting-balanced semantic compensation loss and a forgetting-balanced relation consistency loss to rectify intra-client heterogeneous forgetting of old categories with background shift. It performs balanced gradient propagation and relation consistency distillation within local clients. Moreover, to tackle heterogeneous forgetting from inter-client aspect, we propose a task transition monitor. It can identify new classes under privacy protection and store the latest old global model for relation distillation. Qualitative experiments reveal large improvement of our model against comparison methods. The code is available at https://github.com/JiahuaDong/FISS.


A systematic pre- and postintervention neighborhood observation constituted one component of the evaluation of an initiative to eliminate a street-drug market. Analysis focused on multiple indicators of social and physical order and disorder, as well as physical decay. No noticeable changes were found, but variations in physical and social attributes between the market area and other segments of the neighborhood were revealed. These results suggest lessons that can be learned—and questions that should be considered—with regard to the application of the neighborhood observation methodology to an evaluation of this type of strategic, community-based initiative.


The post-mortem findings of 4 sport divers involved in accidents showed air embolism of the heart as well as 2 subcutaneous emphysemas of shoulder and neck. The lungs were distended and the viscera were hyperaemic. The pleura showed petechiae and small patchy hemorrhages. In microscopic examination foci of alveolar hemorrhages of the lungs and, occasionally, muscosal rupture of small branches of the bronchial tree and of the bronchioli could be determined. The most likely causes for the accidents are discussed and special attention is given to panicking under water. Language: de


: Effect of noradrenaline on activity of Na, K-ATPase from heavy microsomes of rat brain was studied in vitro; the effect of noradrenaline was shown to be dose dependent. The maximal activation of the enzyme was observed at 5.10(-5) M concentration of the catecholamine; an increase of its concentration above 5.10(-4) M inhibited Na, K-ATPase. beta-Adrenolytic drug propranolol /1.10(-5) M/ did not affect the noradrenaline action. At the same time, an alpha-adrenolytic drug phentholamine /1.10(-5) M/ decreased down to zero the activating effect of the catecholamine, but did not affect the inhibitory effect of noradrenaline at high concentrations /1.10(-3) M/. Effects of selective alpha-adrenomimetic compound phenylephrine were also studied. The data obtained suggest that the activating effect of noradrenaline on Na, K-ATPase from rat brain is mediated through alpha-adrenoreceptors.


Background Health outcomes in developing countries continue to lag the developed world, and many countries are not on target to meet the Millennium Development Goals. The private health sector provides much of the care in many developing countries (e.g., approximately 50 percent in Sub-Saharan Africa), but private providers are often poorly integrated into the health system. Efforts to improve health systems performance will need to include the private sector and increase its contributions to national health goals. However, the literature on constraints private health care providers face is limited. Methodology/Principal Findings We analyze data from a survey of private health facilities in Kenya and Ghana to evaluate growth constraints facing private providers. A significant portion of facilities (Ghana: 62 percent; Kenya: 40 percent) report limited access to finance as the most significant barrier they face; only a small minority of facilities report using formal credit institutions to finance day to day operations (Ghana: 6 percent; Kenya: 11 percent). Other important barriers include corruption, crime, limited demand for goods and services, and poor public infrastructure. Most facilities have paper-based rather than electronic systems for patient records (Ghana: 30 percent; Kenya: 22 percent), accounting (Ghana: 45 percent; Kenya: 27 percent), and inventory control (Ghana: 41 percent; Kenya: 24 percent). A majority of clinics in both countries report undertaking activities to improve provider skills and to monitor the level and quality of care they provide. However, only a minority of pharmacies report undertaking such activities. Conclusions/Significance The results suggest that improved access to finance and improving business processes especially among pharmacies would support improved contributions by private health facilities. These strategies might be complementary if providers are more able to take advantage of increased access to finance when they have the business processes in place for operating a successful business and health facility.


The Imperial War Museum houses over 2,000 diaries from:
the First World War alone. This study, with the aid of source
material and interviews, examines why so many men of rank and
officer class kept diaries during the war, when it was against
the King's Regulations to do so.
The diaries utilised range from 1914 - 1918, and illustrate
the change in attitude to the war from the Old Contemptible, the
eager volunteer, to the war-weary recruit. Each diary is represented
as a case study of the soldier,illustrating his family and educational
background. Because these studies range from public schoolboy to
carpenter, differing responses and styles of writing are used to
describe the war.
Hundreds of soldiers have published memoirs and reminiscences
since 1918. Today publishers edit selections, but the purpose of
this study is not to reiterate what has already been written. Memoirs
recall the war years often with fond remembrance of the most important
event of their lives and forget the agony of route marches, hunger
and battle. After 1918 it was easier to recall the esprit de corps,
and forget the Buffering.
Published diaries, like memoirs, cannot be considered a
true record. Editors select what they consider the more interesting
battles and episodes, so that the reader could believe soldiers
spent all of their time in France engaged in battle. These unpublished
selections illustrate battles, but also the monotony of the days 'in
rest', on marches, and on fatigues. Soldiers kept diaries during the war for companionship, to record the great adventure, and to
work out the horrific and inexplicable. They were not, as
published material would often have us believe, describing a
glorified infantryman's picnic.


: From birth to 10 weeks of age, 7 Friesian male calves were fed milk replacers containing 21 p. 100 tallow. The calves were divided into two groups: a control group (4 calves) and a "sorbitol" group (3 calves) receiving sorbitol in the milk replacer (0.6 g/100 g DM). At 2, 3, 5, 7 and 10 weeks of age, plasma concentrations of free cholesterol, cholesterol esters and triglycerides were determined in jugular blood 2 h before the morning meal and 1/2, 2, 3, 5 and 7 h after feeding. No significant variations were observed in the pattern of postprandial estercholesterolemia whatever the age or diet. Average estercholesterolemia was significantly higher (P less than 0.01) at 2-3 weeks of age than at 5, 7 or 10 weeks. Sorbitol supplementation decreased estercholesterolemia significantly (P less than 0.01) when the calves were 2 weeks old, but no effect was observed later. Similar variations in postprandial cholesterolemia were noted for both groups at all ages. Cholesterolemia was significantly higher (P less than 0.05) during the - 2h, + 1/2 hour-period than in the 2-5- hour period and rose significantly at 7 h (P less than 0.05) to the same pre-feeding level. Average cholesterolemia showed the same changes with age as estercholesterolemia in both groups. Changes in postprandial triglyceridemia were similar to those of cholesterolemia in both groups at all the ages studied. The decrease in triglyceridemia (P less than 0.01) 2 h after feeding was probably related to intense lipolysis, and the increase (P less than 0.05) 7 h after feeding was due to the arrival of new feed triglycerides. Triglyceridemia was significantly (P less than 0.05) lower when the calves were 10 weeks old than when they were younger, but no change was observed when sorbitol was added to the diet.


Purpose We aimed to restore dose-volume parameters of swallowing-related structures (SRSs) by evaluating long-term swallowing dysfunctions after radiotherapy (RT) in head and neck cancer patients (HNCPs). Materials and Methods Head and neck cancer patients whose pharyngeal region was involved in RT portal and treated with definitive RT/chemoradiotherapy (CRT) were included in the analyses. Patients underwent objective swallowing assessment by flexible endoscopic evaluation of swallowing (FEES). Volumes of SRSs that received 55 Gy (V55) (mean dose [Dmean]) were evaluated according to the dose-volume histograms of each patient. For every SRS, optimal dose-volume cut-off values were determined by receiver operating characteristic curve analysis. Results Fifty-five patients at a median 20 months (range, 12-26 months) after their treatments were evaluated. There was a strong negative correlation between FEES scores and dose-volume parameters of SRS (r ⩽ –0.5, P < .0001). According to our results, middle pharyngeal constrictor (MPC) and inferior pharyngeal constrictor (IPC) had a Dmean > 57 Gy, base of tongue (BOT) Dmean > 50 Gy, supraglottic larynx (SGL) and glottic larynx (GL) Dmean > 55 Gy, and cervical esophagus (CE) Dmean > 45 Gy. MPC V55 > 70%, IPC V55 > 50%, BOT V55 > 65%, CE V55 > 40%, and SGL and GL V55 > 50% were significant predictors for dysphagia. Conclusion It was found that dysphagia correlates strongly with dose-volume parameters of SRSs. IPC, SGL, and CE were found to be structures significantly associated with dysphagia.


This paper proposes a fuzzy-based error correction mechanism (FECM) to improve the precision of an online data-driven fuzzy clustering (ODDFC) used in the maneuvering target tracking and trajectory prediction. In the ODDFC, the observed data are extracted automatically by fuzzy inference mechanism without much computation and training costs. But the improvement performance of ODDFC is slightly due to its parameters limitation and the prediction accuracy can be affected by the trajectory's curvature of moving target. So we propose ODDFC with FECM to solve the problem. In the proposed method, we use fuzzy inference system that has error correction mechanism to reduce the prediction error of ODDFC. ODDFC with FECM can predict maneuvering targets adapt quickly and have better prediction performance than ODDFC. Simulation results show that proposed method can improve the performance of ODDFC


Blended learning has been talked about a lot in contemporary higher education and seen as the perfect solution for improving the quality of learning. In spite of the widespread support of acceptance this approach has gained, it is admitted that there is no single standard formula for a successful blended learning program, and thus more cases of blended learning need to be reported. This paper reports a study of the implementation of blended learning in a paragraph writing course with the aims of taking a closer look at the blended learning activities carried out in the course and revealing the responses of the students about the activities. This case study involved one lecturer and six student participants from the paragraph writing class, which were selected purposively. Data were collected through interviews, observations, and document analysis. The findings showed that there were five main learning activities in face-to-face instructions and five activities online. These activities were intended to maximize the use of classroom time for active and collaborative learning activities, supplemented with online activities to reinforce learning undertaken in the classroom. In general, student responses to blended learning activities in the paragraph writing course were positive.


INTRODUCTION/OBJECTIVES
Depression has shown as the more common mental disorder in elderly community and suicide is it worst consequence. In the Portuguese context suicide rates among the elderly take values higher than in other age groups. The present study aimed to compare elderly institutionalized and not institutionalized in terms of depression, suicidal ideation, dependency and leisure activities.

MATERIAL AND METHODS
The sample was collected in Algarve, Alentejo and Lisbon, in 155 elderly, 85 institutionalized and 71 not institutionalized, with similar proportions between genders. The instruments were The Activity and Leisure Index (IAL), the Geriatric Depression Scale (GDS), The Barthel Index and the Beck Scale for Suicide Ideation (BSI).

RESULTS
The results showed that the elderly institutionalized did not presented higher depression, loneliness, suicidal thoughts or lowest level of activity and leisure, but were less independent. The participants with highest suicidal thoughts had more depression. A self-perception of worse health and more loneliness were related with more depression. A higher activity and leisure was related with less suicidal ideation.

CONCLUSIONS
The data seem to show that the institutionalization of elderly is not related negatively with depression and suicidal ideation.


The large range of deformations of ionic polymer metal composites (IPMCs) has often been proposed as a key advantage of these soft active materials. Nevertheless, many applications in soft robotics still cannot be addressed by current IPMC technology, demanding an even wider deformation range. Here, we empirically demonstrate the feasibility of integrating electrostatic actuation to enhance IPMC deformations. Through the use of external contactless electrodes, an electrostatic pressure is generated on the IPMC, thereby magnifying the deformation elicited by the small voltage applied across its electrodes. A mathematical model is established to predict the onset of the pull-in instability, which defines when electrostatic actuation can be effectively utilized to enhance IPMC performance.The large range of deformations of ionic polymer metal composites (IPMCs) has often been proposed as a key advantage of these soft active materials. Nevertheless, many applications in soft robotics still cannot be addressed by current IPMC technology, demanding an even wider deformation range. Here, we empirically demonstrate the feasibility of integrating electrostatic actuation to enhance IPMC deformations. Through the use of external contactless electrodes, an electrostatic pressure is generated on the IPMC, thereby magnifying the deformation elicited by the small voltage applied across its electrodes. A mathematical model is established to predict the onset of the pull-in instability, which defines when electrostatic actuation can be effectively utilized to enhance IPMC performance.


The design of a photoswitchable homeodomain artificial transcription factor (PATF),
modelled on an engrailed homeodomain, for the purpose of controlling DNA binding
affinity and controlling the transcription process in cells using light has been
investigated. This study was conducted using a 3,3'-bis(sulfo)-
4,4'bis(chloroacetamino)azobenzene crosslinker, alkylated between two cysteine
residues with different spacings (i, i+4, i, i+7 and i, i+11) and either a rigid or flexible
linker domain. In previous studies, basic leucine zipper transcription activators have
been photocontrolled in living cells by incorporating a photoswitchable azobenzene
crosslinker.
Circular dichroism spectroscopy showed the conformation of crosslinked PATF (XLPATF)
peptides (i, i+11 spacing) containing rigid and flexible linkers could be
controlled reversibly by light. Fluorescence anisotropy experiments using labelled DNA
confirmed the in vitro DNA binding affinity of PATF was considerably higher with the
crosslinker in the trans (ground state) configuration than in the cis (photoexcited state)
configuration. Further studies of peptides with i, i+4 and i, i+7 spacings with a semirigid
and rigid linker domains showed increased binding affinity with the crosslinker in
the cis configuration.
Initiation of transcription was investigated by an in vitro transcription assay to measure
the ability of PATF molecules to moderate the production of RNA by irradiation with
UV light. PATF molecules with i, i+11 spacings showed increased transcriptional
activation with the crosslinker in the ground state configuration and i, i+4 and i, i+7
spacings resulted in increased transcription activation with the crosslinker in the excited
state conformation. Control of 50% of transcriptional activity was achieved for i, i+11
v
spacings, and PATFs with a rigid linker domain were more effective switches than
those with flexible linkers. Using i, i+4 and i, i+7 spacings in PATFs resulted in a
lower degree of control but, as anticipated, transcriptional activation was increased after
irradiation.


In this paper, we propose a new information theoretic method for competitive learning, and demonstrate that it can discover some linguistic rules in unsupervised ways more explicitly than the traditional competitive method. The new method can directly control competitive unit activation patterns to which input-competitive connections are adjusted. This direct control of the activation patterns permits considerable flexibility for connections, and shows the ability to detect salient features not captured by the traditional competitive method. We applied the new method to a linguistic rule acquisition problem. In this problem, unsupervised methods are needed because children learn rules without any explicit instruction. Our results confirmed that the new method can give similar results as those by the traditional competitive method when input data are appropriately coded. However, we could see that when unnecessary information is given to a network, the new method can filter it out, while the performance of the traditional method is degraded by unnecessary information. Because data in actual cognitive and engineering problems usually contain redundant and unnecessary information, the new method has good potential for discovering regularity in actual problems.


Abstract: Exopolysaccharide biosynthesis ability of four Lactobacillus fermentum strains isolated from 'Tom Chua', a Hue traditional fermented shrimp was investigated. When comparison with another strains, Lactobacillus fermentum TC21 produced the highest EPS amounts. The EPS yield produced by this strain was obtained were 177.151 µg/mL in the MRS broth added 1% glucose, 2% lactose after 48 h incubation at 37 o C. Therefore, the effects of sugar composition, nitrogen sources, and the culture conditions (initial pH, temperature, initial cell density and time course of incubation) on EPS production by Lactobacillus fermentum TC21 were studied. With the presence 4% sugars added into MRS broth the EPS yields were obtained maximum comparing with another concetrations. The stimulation on EPS synthesis of Lactobacillus fermentum TC21 by lactose was the best (179.752 µg/mL). The replacement of coconut water containing 20% sugar for distilled water in MRS broth significantly affected the EPS production. When 50% of distilled water was replaced by coconut water the EPS yield was the highest (182.638 µg/mL). The effect of nitrogen sources such as peptone, beef extract and yeast extract) on  this strain EPS biosynthesis of this strain was also investigated by supplementating them into MRS containing 4% lactose. All of samples were incubated at 37 o C for 48 h. The EPS amount was 301.988 µg/mL when adding 0.8% (w/v) beef extract into medium. From all of above results, optimal medium for EPS production by Lactobacillus fermentum TC21 contains 0.8% (w/v) beef extract and 4% lactose. Under optimal medium, the EPS yield was reached the highest (405.728 mg/l) after 36 h of incubation with initial pH 6.0 and initial cell density of 10 6 cfu/mL at 35 °C. Keywords: coconut water, cultural conditions, exopolysaccharide, Lactobacillus fermentum, sugar Corresponding author: Tran Thi Ai Luyen


There is a growing tendency to adopt a differential signaling scheme for critical signals. To support differential signaling, differential transmission lines are required. The concept of twisted pair on the cable interconnection can be readily applied to differential transmission lines on printed circuit boards (PCBs), which enables enhanced immunity against crosstalk and radiated emission. The new differential transmission line called twisted differential line (TDL) has been introduced. In this paper the enhanced immunity of TDL against crosstalk and radiated emission is clearly demonstrated with both simulation and measurement. TDL is compared with other differential transmission lines showing its superiority. Moreover several ideas to improve the performance of TDL are proposed and verified to be useful. Offset-TDL (O-TDL) improves crosstalk immunity further and vertical-TDL (V-TDL) enables reduced routing area while maintaining performance.


Stability of botulinic toxins of types A, B, C, E and F in drinking water, various solutions, and beverages was studied. The stability of all toxins was the highest in bear, mineral and fruit waters, dessert wine and 40 degrees alcohol, where toxins preserved 50% of initial toxicity during 5-70 days. C-type toxin was the most stable in drinking water. Biological assay and neutralization test on white mice can be used for detection of botulinic toxins.


The onion thrips, Thrips tabaci Lindeman is a major pest of many horticultural crops in many parts of the world. The entomopathogenic fungus Beauveria bassiana (Balsamo) Vuillemin and imidacloprid are used for the control of the onion thrips. The potential interactions between the fungus and the chemical against the onion thrips adults were evaluated in a laboratory and two greenhouse bioassays. The laboratory bioassay was a leaf dip bioassay for a mixture of B. bassiana and imidacloprid. The first greenhouse bioassay was a topical application of a mixture of the fungus and the chemical while the second bioassay was a drenching application of imidacloprid and a topical application of B. bassiana. In all bioassays, the combined application resulted in higher percentage mortalities than either B. bassiana or imidacloprid alone. In the laboratory bioassay, the highest mortality of 97% was achieved by using B. bassiana at the field rate with imidacloprid at 1/10th the field rate relative to 88%, 94%, 21% for B. bassiana alone, imidacloprid alone and the control, respectively. In the first greenhouse bioassay, the highest mortality of 80% resulted from the combined application of B. bassiana and imidacloprid at field rates compared with 55%, 75%, and 22% for B. bassiana alone, imidacloprid alone and the control, respectively. In the second greenhouse bioassay, the combined application of both control agents at field rates resulted in 85% mortality compared with 52%, 83%, and 18% for B. bassiana alone, imidacloprid alone and the control, respectively. The interaction effect between the two control agents was additive except when B. bassiana at 1/2 field rate was mixed with imidacloprid at 1/10th field rate in the laboratory bioassay, where the interaction was antagonistic. The above results indicate that combining imidacloprid with B. bassiana might reduce the rate of the insecticide application while enhancing the efficacy of the biological control agent.


Exercise produces potential influences on physical and mental capacity in patients with neuropsychiatric disorders, and can be made a viable form of therapy to treat Parkinson's disease (PD). We report the chronic effects of a regular physical exercise protocol on cognitive and motor functions, functional capacity, and symptoms in an elderly PD patient without dementia. The patient participated of a program composed of proprioceptive, aerobic and flexibility exercises, during 1 hour, three days a week, for nine months. Patient used 600 mg of L-DOPA daily, and 1 hour prior to each exercise session. Assessment was conducted in three stages, 0-3, 3-6 and 6 to 9 months, using percentual variation to the scales Hoehn and Yahr, Mini-Mental State Examination (MMSE), Parkinson Activity Scale (PAS), Beck Depression Inventory (BDI), and Unified Parkinson's Disease Rating Scale (UPDRS-III). Reassessment showed clear changes in clinical parameters for Hoehn and Yahr (4 to 2.5), MMSE (14 to 22), PAS (13 to 29), BDI (9 to 7) and UPDRS-III (39 to 27) at the end of 9 months. According to our data, exercise seems to be effective in promoting the functional capacity and the maintenance of cognitive and motor functions of PD patients. Regular exercise protocols can be implemented as an adjunctive treatment for reducing the severity of PD.


s 15th World Congress on Disaster and Emergency Medicine sll5 dents have demonstrated that most patients who present at a healthcare facility during a disaster or other major emergency do not necessarily arrive via ambulance. If these reports are accurate, then hospitals and EMS systems should plan differently to prepare for a mass convergence of patients at the healthcare system and consider alternative patterns of patient referral including self-referral when performing major incident planning. Methods: Using numerous search engines and databases, reports of patient care during or after disasters or major emergency incidents were identified. These reports were queried for specific information on how the patients presented to, or were referred to the healthcare location. Results: Almost all case reports identified discuss the importance of the prehospital emergency care system. However, many suggest that only a fraction of the treated patients arrive via ambulance, particularly in the early postevent stages of a disaster. Conclusions: Hospitals should develop emergency plans that consider the alternative referral patterns of patients during a disaster or major emergency. Hospital staff should be proficient in triage, decontamination, and safety and security procedures, in the event that they encounter a patient surge in their facility immediately following the onset of a disaster.


This research aimed to understand how prostitutes are educated in the practice of prostitution. This research is developed with the aim of transforming absences in presence, that is, seeking to understand the experiences of this social group that historically has been impelled to invisibility by the hegemonic order. For to think of education through experience and understand the prostitute in the movement of its existence, we use the theoretical contributions of popular education and phenomenology that strengthened the understanding that the process of educating themselves not only through effective intellection, but it is also true of perception and sensitivity. The phenomenon has been focused on the research is process of educating themselves on the night by women engaged in prostitution in nightclubs in São Carlos / SP. To grasp this phenomenon we used the following instruments: the field approach, coexistence, conversations with prostitutes, observation and field notes. The analysis of research is result of dialogue and coexistence with prostitutes and unveiled that through the availability, distrust and resistance, these women develop different educacional processes, such to facing adversity, weaving bonds of cooperation and solidarity, dealing with diversity, breaking gender conventions, make choices and implement actions to meet their needs, to get fancy, among others. There is much to learn with the prostitutes, but for this it is necessary to surround the phenomenon of prostitution and strip off of stereotypes. Only then can we realize that educating yourself in the night appears as praxis to transform reality, to reveal the prostitutes on the move in search to be more. Refuting the position of the victim these women create and experience new ways of being / living / work and reinvent the world, so the story.


Multiprocessor systems, particularly chip multiprocessors, have emerged as the predominant organization for future microprocessors. Systems with 4, 8, and 16 cores are already shipping and a future with 32 or more cores is easily conceivable. Unfortunately, multiple cores do not always directly improve application performance, particularly for a single legacy application. Consequently, parallelizing applications to execute on multiple cores is essential.
Parallel programming models and languages could be used to create multi-threaded applications. However, moving to a parallel programming model only increases the complexity and cost involved in software development. Many automatic thread extraction techniques have been explored to address these costs.
Unfortunately, the amount of parallelism that has been automatically extracted using these techniques is generally insufficient to keep many cores busy. Though there are many reasons for this, the main problem is that extensions are needed to take full advantage of these techniques. For example, many important loops are not parallelized because the compiler lacks the necessary scope to apply the optimization. Additionally, the sequential programming model forces programmers to define a single legal application outcome, rather than allowing for a range of legal outcomes, leading to conservative dependences that prevent parallelization.
This dissertation integrates the necessary parallelization techniques, extending them where necessary, to enable automatic thread extraction. In particular, this includes an expanded optimization scope, which facilitates the optimization of large loops, leading to parallelism at higher levels in the application. Additionally, this dissertation shows that many unnecessary dependences can be broken with the help of the programmer using natural, simple extensions to the sequential programming model.
Through a case study of several applications, including several C benchmarks in the SPEC CINT2000 suite, this dissertation shows how scalable parallelism can be extracted. By changing only 38 source code lines out of 100,000, several of the applications were parallelizable by automatic thread extraction techniques, yielding a speedup of 3.64x on 32 cores.


P. T. GEACH. Distribution: a last word. The philosophical review, vol. 69 (1960), pp. 396-398. The author considers the doctrine of distribution not as a semantic theory but as a source of rules of inference for conversion, obversion, and inversion. Tn a clear, succinct presentation he shows that by applying the rules generated for conversion and obversion to SaP we may produce S'oP, its inverse, although the rule generated for inversion invalidates the inference from SaP to S'oP. This apparent demonstration of the inconsistency of the rules is dismissed, on grounds that strike the reviewer as insufficient, as "not a decisive argument against the doctrine of distribution." After describing Keynes's attempt to resolve the difficulty over the inversion of SaP by introducing the existential assumption " N o t everything is P" the author presents his version of Jaskowski's interpretation of the four categoricals (XVII 268). This interpretation, though highly unnatural, preserves all the inferences and oppositions of traditional logic while allowing both empty and universal terms. It also contains the Lukasiewicz axioms SaS and SiS. Unlike the Keynes defense of the doctrine of distribution, this interpretation requires no special existential assumption. The author concludes that " the doctrine of distribution is useless" (even if not clearly inconsistent) as a source of rules of inference. NORMAN KRETZMANN


Motor conduction velocity (MCV) alone cannot separate all the cases with types I and II of hereditary motor and sensory neuropathy (HMSN). However, sensory conduction velocity (SCV) in sural nerve distinctly separated types I and II of HMSN (8). As in most of our patients with HMSN sural nerve was unexcitable, we introduced SCV estimation in the distal segments of median and ulnar nerves. So, we studied 124 patients from families with typical and uncomplicated cases of Charcot-Marie-Tooth disease (CMTD): 68 patients had the "hypertrophic" form (type I) and 56 cases the "neuronal" form (type II). In this series, 16 patients had median MCV from 35 to 45 m/s, but SCV in the median and ulnar nerves separated 7 cases with type I and 9 patients with type II of HMSN. In conclusion, the type I and II of HMSN were delimited in most of the studied cases by MCV values in the median nerve. Nevertheless, in cases difficult to be classified either into type I or II of HMSN, i.e. patients with MCV from 35 to 45 m/s, only SCV measurements in distal median and ulnar nerves segments can distinctly separate type I (a slowing over 40% from control values), indicating that this type is underlain by a process of segmental demyelination (SD), which also was confirmed by sural nerve biopsy data. In our cases with HMSN type II MCV was either normal or slightly slowed. By contrast SCV was significantly slowed (a slowing of up to 30%). In addition, we have also a few cases of complicated HMSN forms (rare variants), associated with: 1. Isaacs' syndrome; 2. "denervation-reinnervation" muscle hypertrophy; and 3. Marinesco-Sjögren syndrome. 1. In 3 patients, the clinical features of "neuronal" form of CMTD were associated with fasciculation, cramps, impaired muscular relaxation, and percussion myotonia with respective electromyographic (EMG) accompaniments, which were responsive to valproic acid therapy. 2. On the other hand 3 patients developed in addition to the Isaacs' syndrome a significant "denervation-reinnervation" muscle hypertrophy, confirmed by both morphometric data on muscle biopsy and computed tomography. In these patients there was an increased proportion of type I and a decreased one either of type IIB or of type IIA fibres, without myotonic or dystrophic features.(ABSTRACT TRUNCATED AT 400 WORDS)


The discontinuous character of the exact exchange-correlation $(xc)$ energy functional of Density Functional Theory is shown to arise naturally in the subband spectra of semiconductor quantum wells. Using an \emph{ab-initio} $xc$ functional, including exchange exactly and correlation in an exact partial way, a discontinuity appears in the $xc$ potential, each time a subband becomes slightly occupied. Exchange and correlation give opposite contributions to the discontinuity, with correlation overcoming exchange. The jump in the intersubband energy is in excellent agreement with experimental data.


Today's market in micro-wind turbines is in constant development introducing more efficient solutions for the future. Besides the private use of tower supported turbines, opportunities to integrate wind turbines in the built environment arise. The Integrated Roof Wind Energy System (IRWES) presented in this work is a modular roof structure integrated on top of existing or new buildings. IRWES is build up by an axial array of skewed shaped funnels used for both wind inlet and outlet. This inventive use of shape and geometry leads to a converging air capturing inlet to create high wind mass flow and velocity toward a Vertical Axis Wind Turbine (VAWT) in the center-top of the roof unit for the generation of a relatively high amount of energy. The scope of this research aims to make an optimized structural design of IRWES to be placed on top of the Vertigo building in Eindhoven; analysis of the structural performance; and impact to the existing structure by means of Finite Element Modeling (FEM). Results show that the obvious impact of wind pressure to the structural design is easily supported in different configurations of fairly simple lightweight structures. In particular, the weight addition to existing buildings remains minimal.


Invariant NKT (iNKT) cells play an effector/adjuvant function during antimicrobial and antitumoral immunity and a regulatory role to induce immune tolerance and prevent autoimmunity. iNKT cells that differentially modulate adaptive immunity do not bear a unique phenotype and/or specific cytokine secretion profile, thus opening questions on how a single T cell subset can exert opposite immunological tasks. In this study, we show that iNKT cells perform their dual roles through a single mechanism of action relying on the cognate interaction with myeloid dendritic cells (DCs) and leading to opposite effects depending on the presence of other maturation stimuli simultaneously acting on DCs. The contact of murine purified iNKT cells with immature autologous DCs directly triggers the tolerogenic maturation of DCs, rendering them able to induce regulatory T cell differentiation and prevent autoimmune diabetes in vivo. Conversely, the interaction of the same purified iNKT cells with DCs, in the presence of simultaneous TLR4 stimulation, significantly enhances proinflammatory DC maturation and IL-12 secretion. The different iNKT cell effects are mediated through distinct mechanisms and activation of different molecular pathways within the DC: CD1d signaling and activation of the ERK1/2 pathway for the tolerogenic action, and CD40–CD40L interaction and NF-κB activation for the adjuvant effect. Our data suggest that the DC decision to undergo proinflammatory or tolerogenic maturation results from the integration of different signals received at the time of iNKT cell contact and could have important therapeutic implications for exploiting iNKT cell adjuvant/regulatory properties in autoimmune diseases, infections, and cancer.


A separation algorithm for achieving color constancy and theorems concerning its accuracy are presented. The algorithm requires extra information, over and above the usual three values mapping human cone responses, from the optical system. However, with this additional information-specifically, a sampling across the visible range of the reflected, color-signal spectrum impinging on the optical sensor-the authors are able to separate the illumination spectrum from the surface reflectance spectrum contained in the color-signal spectrum which is, of course, the product of these two spectra. At the heart of the separation algorithm is a general statistical method for finding the best illumination and reflectance spectra, within a space represented by finite-dimensional linear models of statistically typical spectra, whose product closely corresponds to the spectrum of the actual color signal. Using this method, the authors are able to increase the dimensionality of the finite-dimensional linear model for surfaces to a realistic value. One method of generating the spectral samples required for the separation algorithm is to use the chromatic aberration effects of a lens. An example of this is given. The accuracy achieved in a large range of tests is detailed, and it is shown that agreement with actual surface reflectance is excellent. >


Kawasaki disease shock syndrome (KDSS) is a newer entity being better recognised recently, which is defined as Kawasaki disease features plus systolic hypotension or clinical signs of poor perfusion. Patients with KDSS typically have more heightened levels of inflammatory markers and greater risks of coronary artery abnormalities, mitral regurgitation and persistent myocardial dysfunction. They also have greater likelihood of intravenous immunoglobulin (IVIG) resistance requiring additional anti-inflammatory treatment. We report two cases of KDSS presenting with shock, both with IVIG resistance and coronary arteries involvement. Clinicians should maintain high index of suspicion for KDSS to avoid delay in diagnosis and to facilitate timely treatment by IVIG.


The purpose of study was to synthesize the focused library of new malononitrile derivative of substituted N-phenylpyrrolidine-2, 5-dione as potential new hybrid antifungal molecules. These hybrid molecules were synthesized in a coupling reaction of substituted N-phenylpyrrolidine-2, 5-dione with dicyanomethane using solvent free ecofriendly microwave assisted method. The 2, 5-diones were prepared by the reaction of succinic anhydride with substituted aryl amines in presence of benzene and acetyl chloride. All the synthesized molecules were persisted and vetted for antimicrobial activities. Most of the molecules showed potential antifungal activity against Candida albicansandAspergillusniger.


This paper details work toward the design of a method for creating auditory displays for the human-computer interface, based on soundtrack composition. We begin with the benefits to this approach before discussing methods for auditory display design and the need for a unification of different design techniques. We then outline our on-going investigation into the tools and techniques employed within the working practices of sound designers and soundtrack composers. Following this we report our observations of the main priorities that influence how composers create soundtracks and propose ways in which our method may support these. We argue that basing the first steps of the method on a 'cue sheet could enable designers to identify actions, objects and events within an HCI scenario whilst taking into account the user and the context of use. This is followed by some initial observations of a preliminary study into whether a participant can successfully use this cue sheet methodology. We conclude by identifying that certain elements of the methodology need to be changed: Further investigation and subsequent design needs to be carried out into ways participants can successfully comprehend and systematically use the cue sheet to identify seen and unseen events, actions and objects within the human-computer interface. Additionally we need to investigate how best categorize and map these elements to sound. We conclude our paper with our plans for future work


Abstract: The extent to which horizontal mergers deliver competitive benefits that offset any potential for competitive harm is a critical issue of antitrust enforcement. This Article evaluates economic analyses of merger efficiencies and concludes that a substantial body of work casts doubt on their presumptive existence and magnitude. That has two significant implications. First, the current methods used by the federal antitrust agencies to determine whether to investigate a horizontal merger likely rests on an overly-optimistic view of the likely existence of cognizable efficiencies, which we label a "standard efficiency credit" that influences market concentration analysis. Second, criticisms of the current treatment of efficiencies as too demanding – for example, that antitrust agencies and reviewing courts require too much of merging parties in demonstrating the existence of efficiencies – are misplaced, in part because they fail to recognize that full-blown merger investigations and subsequent litigation are focused on the mergers that are most likely to cause harm.


We investigated the effect of ATP binding to GroEL and elucidated a role of ATP in the conformational change of GroEL. GroEL is a tetradecamer chaperonin that helps protein folding by undergoing a conformational change from a closed state to an open state. This conformational change requires ATP, but does not require the hydrolysis of the ATP. The following three types of conformations are crystalized and the atomic coordinates are available; closed state without ATP, closed state with ATP and open state with ADP. We conducted simulations of the conformational change using Elastic Network Model from the closed state without ATP targeting at the open state, and from the closed state with ATP targeting at the open state. The simulations emphasizing the lowest normal mode showed that the one started with the closed state with ATP, rather than the one without ATP, reached a conformation closer to the open state. This difference was mainly caused by the changes in the positions of residues in the initial structure rather than the changes in "connectivity" of residues within the subunit. Our results suggest that ATP should behave as an insulator to induce conformation population shift in the closed state to the conformation that has a pathway leading to the open state.


We present empirical tests of the stability of individual differences over the lifespan using a novel methodological technique to combine behavior-genetic data from twin dyads with longitudinal measures of life history-related traits (including health and personality) from non-twin samples.  Using data from The Midlife in the United States (MIDUS) Longitudinal Survey, we constructed a series of "hybrid" models that permitted the estimation of both temporal stability parameters and behavior-genetic variance components to determine the contributions of genetic and environmental influences on individual differences.  Our results indicate that changes in a higher-order factor of life history strategy (Super-K, composed of the K-Factor, Covitality, and Personality) over the study period were very small in magnitude and that this temporal stability is under a considerable degree of shared genetic influence and a substantial degree of non-shared environmental influence, but a statistically non-significant degree of shared environmental influence.  Implications and future directions are discussed.  DOI:10.2458/azu_jmmss_v5i1_figueredo


Experiments were carried out with a household up-draft biomass gasification stove to investigate effects of the air distribution method on the performance of the stove. The temperature distribution along the gasifier, the producer gas composition, the stove power, and the thermal efficiency were investigated. Results showed that in the temperature distribution along the gasifier height, the highest temperature was at the bottom oxidation layer of the gasifier, in the range of 950 to 1050 °C. With increasing air quantity through the burner, the time required to boil the water first decreased and then increased, whereas the stove power and thermal efficiency increased and then decreased. The best stove performance was obtained at an optimum air distribution ratio of 0.333 between burner and gasifier air (0.794×10 m/s·kg). When the burner air increased, the flame length above the burner was remarkably reduced and the flame color gradually changed from yellow-red to blue. At the optimum air distribution ratio of 0.333, the flame was blue and stable. The present study provides references for developing a more efficient biomass gasification stove.


Urethral pressure profiles (UPPs) were recorded in ten adult healthy male cats before and after administration of either phenoxybenzamine, diazepam, nifedipine or xylazine. A significant decrease (p less than 0.05) in urethral pressure at the level of the prostate was observed following treatment with all drugs. Xylazine produced a significant decrease in urethral pressure 4 to 7 cm from the tip of the penis in healthy male cats. None of the drugs used decreased urethral pressure in the zones of pure striated muscle or pure smooth muscle in these cats, making current recommendations for pharmacological management of urethral spasm suspect. Further studies are necessary to evaluate clinical cases of urethral spasm and to study the effects of these drugs on the urethral pressure of cats suffering from this spasm.


Background Mucinous cystadenocarcinomas of the pancreas are uncommon tumors. When they affect only the pancreas, surgery usually involves a better prognosis. We describe a case report of a young male patient with mucinous cystadenocarcinomas of the pancreas focusing on the tumor-like mimicking gastric adenocarcinoma. Case report We report the case of a twenty-seven-year-old male with a mucinous cystadenocarcinoma of the pancreas with gastric infiltration and hepatic and intra-splenic metastases. A pancreatic tail resection with total gastrectomy, splenectomy, cholecystectomy, V-VI hepatic segmentectomy and extended D2+ lymphadenectomy was performed. Results After 24 months of follow-up, the patient presented progression of the disease with multiple unresectable hepatic metastases. Conclusion Mucinous cystadenocarcinomas has a better prognosis after surgical resection when it is located only in the pancreas and there are no distant metastasis. The prognosis in patients who are not candidates for surgery or in those in whom metastasis already exists at the time of diagnosis is bleak. However palliative resection may improve survival and quality of life in those cases.


Urban risks and climate change mitigation and adaptation, are new challenges for enhancing the city resilience. City planning plays a fundamental role to cope with these challenges in new settlements design and urban renewal actions, taking into account the socio-ecological complexity of the city. Catchment hydrologic response is influenced by several factors including land use choices and policy tools. Understanding potential effects of urban development is the basis for the implementation of storm‐water control planning actions, along with appropriate mitigation and compensatory measures at the catchment scale. This paper presents a land use planning experience conducted by the University of Catania (Lapta Lab). The focus is on the role of municipal land use planning, a key element of the resilient city. The settlement system of city of Avola, in Sicily, is illustrated as well as the natural characteristics of the site, relevant for the hydrologic response. The main steps of the planning process are described, in order to explain how urban resilience issues were practically addressed. The case presented stimulate several considerations about water sensitive urban planning and the opportunities for the inclusion of nature based solutions, such as sustainable urban drainage systems and regulating services, in land-use planning processes.


Background Underachievement in schools is a global problem and is especially prevalent in developing countries. Indicators of educational performance show that Uganda has done remarkably well on education access-related targets since the introduction of universal primary education in 1997. However, educational outcomes remain disappointing. The absence of school feeding schemes, one of the leading causes of scholastic underachievement, has not been given attention by the Ugandan authorities. Instead, as a national policy, parents are expected to provide meals even though many, especially in the rural areas, cannot afford to provide even the minimal daily bowl of maize porridge. Objective To assess and demonstrate the effect of breakfast and midday meal consumption on academic achievement of schoolchildren. Design, Materials and Methods We assessed household characteristics, feeding patterns and academic achievement of 645 schoolchildren (aged 9–15 years) in Kumi district, eastern Uganda, in 2006–2007, using a modified cluster sampling design which involved only grade 1 schools (34 in total) and pupils of grade four. Household questionnaires and school records were used to collect information on socio-demographic factors, feeding patterns and school attendance. Academic achievement was assessed using unstandardized techniques, specifically designed for this study. Results Underachievement (the proportion below a score of 120.0 points) was high (68.4%); in addition, significantly higher achievement and better feeding patterns were observed among children from the less poor households (p<0.05). Achievement was significantly associated with consumption of breakfast and a midday meal, particularly for boys (p<0.05), and a greater likelihood of scoring well was observed for better nourished children (all OR values>1.0). Conclusion We observed that underachievement was relatively high; inadequate patterns of meal consumption, particularly for the most poor, significantly higher scores among children from 'less poor' households and a significant association between academic achievement and breakfast and midday meal consumption.


Combined oestrogen-progestin oral contraceptives cause venous thromboembolism in women of reproductive age. Healthcare providers typically rely on women's characteristics, medical history and family history to select the most appropriate contraceptives, in an effort to reduce risks of venous thromboembolism. This position paper discusses the use of a new prediction tool (Pill Protect®), available in Switzerland, which adds genetic profiling to clinical characteristics with the aim of predicting individual contraceptive-related thrombotic risks and individualising contraceptive prescription. After reviewing the available data regarding this tool, we believe that its development and validation process may be incomplete and that it is uncertain whether the use of Pill Protect® would lead to better health outcomes. Until we understand the necessarily rigorous scientific validation of this tool, we urge caution to physicians and women who may want to use it.


Most embedded devices are based on heterogeneous Multiprocessor System on Chips (MPSoCs). These contain a variety of processors like CPUs, micro-controllers, DSPs, GPUs and specialised accelerators. The heterogeneity of these systems helps in achieving good performance and energy efficiency but makes programming inherently difficult. There is no single programming language or runtime to program such platforms. This thesis makes three contributions to these problems. First, it presents a framework that allows code in Single Program Multiple Data (SPMD) form to be mapped to a heterogeneous platform. The mapping space is explored, and it is shown that the best mapping depends on the metric used. Next, a compiler framework is presented which bridges the gap between the high -level programming model of OpenMP and the heterogeneous resources of MPSoCs. It takes OpenMP programs and generates code which runs on all processors. It delivers programming ease while exploiting heterogeneous resources. Finally, a compiler-based approach to runtime power management for heterogeneous cores is presented. Given an externally provided budget, the approach generates heterogeneous, partitioned code that attempts to give the best performance within that budget.


The Internet is evolving, both in form and function, at a rate which is becoming increasingly difficult to match. Through constructs such as The Internet of Things, our consumption of digital information and knowledge is slowly moving away from being primarily consumed through screens to one in which we are generators of data by interacting with the objects and spaces which surrounds us. Thus, the Internet is no longer a space we visit but rather the space we live in and experience in our daily lives. The Digital Public Space, a concept based on the democratisation of privately held knowledge, is intrinsically connected to the notions of Internet, especially around its delivery and reach. Whilst the two are arguably separated by different social and political motivational aspirations as the internet evolves so must our consideration of the Digital Public Space. The AHRC Creative Exchange research project was set to explore the myriad of potentials of the Digital Public Space from understanding, facilitation and creation of digital public spaces to privacy and ethical concerns. I approached this space by considering how our own physicality means that there will always be a tangible aspect to the consumption and production of digital information; a duality in existence which needs to be understood in order to design better experiences. In particular, I am concerned with the characteristics and particularities around the creation processes involved in the design of mixed-reality objects and spaces which might contribute to the Digital Public Space in the context imposed by the juxtaposition of the digital and the physical worlds. Therefore, this research presents the methodological framework required for the understanding of such design processes with a clear focus on the interactions and affordances mixed-reality artefacts make use of in their designs. Through the exploration of five different research projects, resulting from collaborative design-led research, conducted in close partnership between academia and the creative industries, I extract, rationalise and present ideas, individually, in order to present research insights for the design and construction of mixed-reality artefacts. The key aspects of which are summarised in a set of guidelines, taking the shape of a manifesto, to serve prospective designers in the production of mixed-reality artefacts.


In this paper we propose an architecture consisting of a particular type of node, namely a communication server that collects and aggregates data, and establishes a link between the users and the sensor nodes through satellite communication. A key challenge with satisfying a lifetime requirement of the communication server is the unpredictability of the sensor data volume arriving at the communication server and the transmission power of the satellite terminal. To provide lifetime predictability we propose an approach that automatically adjusts the quality of the data such that the specified lifetime if achieved. We have shown through an extensive evaluation that the approach manages to provide an actual lifetime within 2% of the specified lifetime despite variations in workload and communication link quality.


Background Suicide is the second most common cause of preventable mortality among Brazilian and French adolescents. The aim of the current study was to compare the main risk and protective factors associated with a suicide attempt (SA) and to highlight differences based on geographical characteristics. Method We compared a Brazilian sample (N = 45) of adolescents admitted to the emergency room of a public hospital in São Paulo for SA to a French sample (N = 320) of adolescents hospitalized for SA across 5 paediatric departments. Then, we ran several multivariate models to examine how each selected variable was related to geographic origin and to the other selected variables linked to geographic origin. Results The two samples presented no significant differences regarding gender, age or schooling. Both samples had high rates of depressive disorders, anxiety disorders, substance use, disruptive disorders, borderline psychopathology, and lifetime SAs. However, the Brazilian sample presented significantly higher levels of psychopathology and had more insecure attachment relationships (fearful and detached), whereas the French sample had a more secure attachment style. Brazilian adolescents had more recourse to spiritual beliefs and spiritual support, whereas the French adolescents had higher scores on the Reasons for Living Inventory and used more help-seeking strategies from their social network, mainly close friends. Multivariate models showed that two productive coping strategies (seeking spiritual support and social action) and the dependence score were significantly associated with membership in the Brazilian cohort, whereas a secure attachment style and depression severity (evaluated by the Beck Depression Inventory) were significantly associated with membership in the French cohort. Conclusion Despite presenting similar psychopathologies, Brazilian adolescents presented a more insecure attachment style and used the religious kind of coping more commonly than their French counterparts. We hypothesize that religion may compensate for the social vulnerabilities present in a middle-income country such as Brazil. More transcultural studies may help to elucidate this phenomenon.


Some media have suggested that many youths who have previously completed a gender transition are " detransitioning " . Their experience is often framed around the idea of regrets but rare are the articles that provide a nuanced examination of their journey. This article presents the perspectives of youths who have detransitioned or discontinued a transition regarding their experiences and feelings on their journey from transition to detransition. Semi-structured interviews were conducted with 20 youths between the age of 16 and 25 years who were recruited on social media and who transitioned and detransitioned or discontinued their transition. Data were analysed according to thematic analysis. Regrets and feelings of satisfaction can both coexist. The processes of transition and discontinuation or detransition appear to be non-linear and participants do not necessarily return to a cisgender identity. Ambiguous loss theory is applied to frame youth experiences and feelings and to suggest way forward for intervention


A solid business case is highly dependent upon a strategic and intelligent technology research and development plan, or portfolio, in the early phases of product design. The embodiment of a strategic technology development plan is the identification and subsequent funding of high payoff technology areas that can maximize a company's return on investment, which entails both performance and economic objectives. This paper describes an approach whereby the high payoff technology areas may be identified to quantitatively justify resource allocation decisions and investment opportunities to meet future organizational goals. The approach includes the simulation of the impact of generic technology areas and the degree of difficulty of technological advances within said areas. The approach results in a dynamic forecasting environment whereby rapid trade-offs can be performed in the conceptual phases of design. This environment allows for intelligently building a successful technology portfolio to facilitate a quantitative justification of a solid business case. A proof on concept application was performed on a next-generation supersonic transport.


SUMMARY International Alert has been working with Sri Lanka's diaspora communities for over four years, exploring their potential as an additional peacebuilding actor to those operating within the country. This paper highlights the experiences of both a peacebuilding practitioner and a diaspora partner in implementing cross-community dialogue work in the UK for the objective of long-term peace in Sri Lanka. Although diaspora communities are a unique actor with multiple ties to the country of heritage and residence, they are rarely homogenous by nature, representing many political opinions and experiences. A key challenge therefore for building the peacebuilding capacity of diaspora communities is to acknowledge grievances, respect multiple opinions and harness collective capacity to address the needs of people on the ground. As part of this challenge, it is crucial to advocate for the acceptance and inclusion of all diaspora communities by Sri Lankan state and society.


Murine neural precursor cells and cell lines derived from them are stimulated by members of the heparin-binding fibroblast growth factor (FGF) family. The activity of FGF is regulated by heparan sulfate proteoglycans (HSPGs), and this interaction is an essential prerequisite for the binding of growth factor to the signal transducing receptors. Messenger RNA for FGF-2 was detectable in the neuroepithelium at embryonic day 9, and the HSPGs produced by these cells at this time preferentially bound FGF-2. However, at embryonic day 11, when messenger RNA for FGF-1 was first detectable, there was a switch in the binding specificity of the HSPG to FGF-1. Thus, a single species of HSPG undergoes a rapid, tightly controlled change in growth factor-binding specificity concomitant with the temporal expression of the FGFs.


This volume collects the most important statements on the English language by Samuel Johnson, one of its greatest expositors and speakers. The book includes scholarly, fully annotated editions of Johnson's main writings on the history, structure, and cultural importance of the English language as well as his reflections on lexicography. These texts represent Johnson's thinking as he undertook and completed the major work of his life, the colossal Dictionary of the English Language. The editors set Johnson's writings on the English language in historical context and provide the fullest possible account of their composition. Among the works presented in the volume are Johnson's Plan of a Dictionary of the English Language and the Preface to the Dictionary, both of which are counted among his finest works of prose.


In this paper, we propose a call admission control mechanism for wireless ad hoc networks called interference-based call admission control (iCAC). iCAC is unique in that it does not treat interference uniformly instead classifies interference based on estimates of the position of the interfering nodes. iCAC relies on two novel techniques: (1) estimation of position of the interfering nodes (2) fair allocation using bandwidth acquisition and rate control. By incorporating these techniques, iCAC is able to increase the estimated available bandwidth substantially without overloading the network. We compare iCAC with perceptive admission control (PAC) and IEEE 802.11 without admission control. Simulation results show that iCAC is able to admit substantially more requests than PAC, achieves more than 80% of the throughput of IEEE 802.11 and at the same time maintains very low packet loss rate and average delay comparable to PAC


Bilevel optimization has been successfully applied to many important machine learning problems. Algorithms for solving bilevel optimization have been studied under various settings. In this paper, we study the nonconvex-strongly-convex bilevel optimization under a decentralized setting. We design decentralized algorithms for both deterministic and stochastic bilevel optimization problems. Moreover, we analyze the convergence rates of the proposed algorithms in difference scenarios including the case where data heterogeneity is observed across agents. Numerical experiments on both synthetic and real data demonstrate that the proposed methods are efficient.


The plastic analysis software DEFORM was used to simulate the blanking process of metal plastic without burr. Based on theory of the rigid FEM, the geometry model used for blanking with a negative clearance was established. The facts of influence the quality of the blanking work pieces were analyzed and concluded, at the same time, the parameters were indicated to improve the quality of the blanking work pieces. Through the experiment, the blanking load was measured with different clearance, thickness and material in group. The reciprocity between these facts was analyzed and the clearance was optimized. After the blanking load was regress analysis, the coefficient of the load and these facts were researched. Using quality analysis of the work pieces in the experiment, the thickness and the material were obtained which were suitable for blanking of metal plastic without burr. The reactions which were used to separate the metal were studied, which offered thereunder for proper remaining based on the better quality and smaller blanking load.


Despite the growing digitalization and globalization, the industrial map of the world remains to display high-level concentration of resources and productivity in certain geographical locations called clusters. These locations such as Silicon Valley and Hollywood continue to attract entrepreneurs and large firms, enjoying strong sustainability and competitiveness. As the agglomerate of diverse entities and institutions, clusters play a significant role for improving the overall growth of the industry. This is more evident in the cultural industries where the relatively high unpredictability, expanding scale of investments, and the importance of physical location for consuming cultural contents require firms and participants to cooperate in proximity. In order to examine the importance of clusters in the cultural industries, this study first conducts a theoretical review on the role of clusters in this industry. Then, the paper analyzes the historically meaningful cultural clusters, Italy during the Renaissance and the US Hollywood of modern times, by evaluating the role of four interactive factors: firm, people, education, and government. The analysis of these two cases reveals that the  interactions among the four factors significantly influence the scale and competitiveness of cultural clusters. Ultimately, the paper provides some important options for further development of the Korean wave or Hallyu by utilizing the cluster strategy.


A transmembrane protein serine/threonine kinase, Atr-I, that is structurally related to receptors for members of the transforming growth factor-beta (TGF-beta) family has been cloned from Drosophila melanogaster. The spacing of extracellular cysteines and the cytoplasmic domain of Atr-I resemble most closely those of the recently described mammalian type I receptors for TGF-beta and activin. When expressed alone in test cells, Atr-I is unable to bind TGF-beta, activin, or bone morphogenetic protein 2. However, Atr-I binds activin efficiently when coexpressed with the distantly related Drosophila activin receptor Atr-II, with which it forms a heteromeric complex. Atr-I can also bind activin in concert with mammalian activin type II receptors. Two alternative forms of Atr-I have been identified that differ in an ectodomain region encompassing the cysteine box motif characteristic of receptors in this family. Comparison of Atr-I with other type I receptors reveals the presence of a characteristic 30-amino-acid domain immediately upstream of the kinase region in all these receptors. This domain, of unknown function, contains a repeated Gly-Ser sequence and is therefore referred to as the GS domain. Maternal Atr-I transcripts are abundant in the oocyte and widespread during embryo development and in the imaginal discs of the larva. The structural properties, binding specificity, and dependence on type II receptors define Atr-I as an activin type I receptor from D. melanogaster. These results indicate that the heteromeric kinase structure is a general feature of this receptor family.


Background Childhood arterial ischemic stroke (AIS) is associated with significant morbidity with up to 50% of affected children developing hemiparesis. Hemiparesis is assumed to influence participation within the peer group, but it is unclear to what extent its severity affects participation in different areas of social life. Methods Thirteen children (mean age 9y6m) with AIS (6 without hemiparesis, 7 with hemiparesis) and 21 controls (mean age 9y8m) participated. We scored hemiparesis severity with hand strength asymmetry (pinch and grip strength), measured with a dynamometer. We assessed manual ability (ABILHAND-Kids), socioeconomic status (Family Affluence Scale) and participation (Participation and Environment Measure - Children and Youth). From structural MRI, we measured lesion size. We investigated differences in participation and its relationship with hemiparesis severity using non-parametric partial correlations (controlling for lesion size, manual ability, and socioeconomic status), interpreted as absent (r<0.25), weak (r=0.25-0.50), moderate (r=0.50-0.75) or strong (r>0.75). Analyses were performed in jamovi 1.6.3. Results Children with AIS (with or without hemiparesis) showed reduced participation frequency at school (p<0.001), whilst participation at home and in the community resembled that of their peers. Severity of hemiparesis was moderately related to frequency and involvement at home and to involvement and desire for change in the community, although unrelated to school participation. Conclusion Reduced participation in school life requires close attention in the follow-up of children with AIS - regardless of the severity of hemiparesis. Participation at home and in the community is related to hemiparesis severity and may be improved with participation-focused motor intervention strategies.


The design of modern steam turbines for power plant applications is steering for higher effi- ciencies. A considerable contribution to this aim is expected from a reduction of flow losses in turbine intakes and exhausts. The present study therefore deals with the optimization of the exhaust of a high pressure (HP) turbine. In the first part of this study a numerical model is presented which allows for a precise representation of the exhaust flow. This computational fluid dynamics (CFD) model has been validated with a fair amount of experimental data from a test rig. For the second part of the study comprehensive numerical investigations have been carried out, considering the major geometrical parameters of such a geometry. In order to minimize the effort in design time and preprocessing a fully parametric 3D model of the geometry is created to prepare the different design variations. The results of these simulations allow to assess the performance differences of given exhaust designs in the early design phase without the need for expensive CFD simulations. Finally the potential for improvement is shown by means of a comparison of an optimized design to the baseline geometry.


Computed tomography (CT) colonoscopy is a well-established technique for evaluation of colorectal cancer. Significant advances have been made in the technique of CT colonoscopy since its inception. Excellent results can be achieved in detecting both colorectal cancer and significant sized polyps as long as a meticulous technique is adopted while performing CT colonoscopy. Furthermore, it is important to realize that there is a learning curve involved in interpreting these studies and adequate experience is essential to achieve high sensitivity and specificity with this technique. Indications, contraindications, technique and interpretation, including potential pitfalls in CT colonoscopy imaging, are reviewed in this article. Recent advances and the current role of CT colonoscopy in colorectal cancer screening are also discussed.


ABSTRACT An ion-induced templatization strategy was used to prepare crosslinked polymeric pseudocrown ethers (PCEs) in situ during a one-step free-radical polymerization. These studies bring to a conclusion the fundamental studies on the templatization process reported in the first two papers of this series. For the PCEs, with nickel as the templating ion and hydroxyethyl methacrylate as the monovinyl comonomer, the ion-binding studies revealed a significant enhancement in the ion-binding capacity associated with the inclusion of the template ion during synthesis. For example, a PCE synthesized with a monomer-to-solvent ratio of 20/80 exhibited an ion-binding capacity that was 7.5 times higher than a control polymer produced under identical conditions except for the absence of the template cations. A PCE synthesized with a monomer-to-solvent ratio of 20/80 exhibited a capacity of 0.3 mg/g polymer for Ni2+ cations. Finally, it was observed that the column could be fully regenerated by elution with a small ...


The blockchain 2.0 age, marked by smart contract and Ethereum, has arrived couple years ago. Its technologies have expanded the application scenarios of blockchain technology and driven the boom of decentralized Finance. However, smart contract vulnerabilities and security issues are also emerging one after another. Hackers have exploited these vulnerabilities to cause huge economic losses. In recent years, a large amount of research on the analysis and detection of smart contract vulnerabilities has emerged, but there has been no common detection tool and corresponding test dataset. In this paper, we build GSVD dataset (Generalized Smart Contract Vulnerability Dataset) consisting four offline datasets using smart contracts on two chains, Polygon and BSC: two small Solidity datasets consisting of 153 labeled smart contract source codes, which can be used to test the performance of vulnerability mining tools; two large Solidity datasets consisting of 52,202 un labeled real smart contract source codes that can be used to verify the correctness of various theories and tools under a large number of real data conditions. At the same time, this paper integrates the scripting framework accompanying the GSVD dataset, which can execute a variety of popular automated vulnerability detection tools on top of these datasets and generate analysis results of contracts and potential vulnerabilities. We tested the Minor dataset under GSVD using three tools (Slither, Manticore, Mythril) that are kept up to date and found that the combined use of all tools detected 61.1% of labeled vulnerabilities, of which Mythril has the highest detection rate of 42.6%. It is not difficult to conclude that there`re still ample room for advancement for current smart contract vulnerability mining tools because of their underlying methods. Besides, our dataset can contribute to the ultimate target greatly by providing mining tools plenty real contracts information.


Designing oxygen cathodes with both high energy density and excellent cycling stability is a great challenge in the development of lithium–oxygen (Li–O2) batteries for energy storage systems. Herein, we design a novel structure of hierarchical NiCo2O4 nanosheets on porous carbon nanofiber films (denoted as NiCo2O4@CNFs) as an oxygen cathode for lithium–oxygen batteries. The NiCo2O4@CNFs cathode delivers a high specific discharge capacity of 4179 mA h g−1, a high energy density of 2110 W h kg−1 and superior cycling stability over 350 cycles. The excellent electrochemical performance of the NiCo2O4@CNFs cathode can be attributed to the rational design and engineering of catalysts and porous conductive electrodes. These results indicate that the NiCo2O4@CNFs electrode is a promising candidate for high energy density and long-life Li–O2 batteries. Additionally, the rational design of the hierarchical catalyst constructed low-dimensional nanostructure and the lightweight porous carbon nanofiber electrode can be also used for other metal–oxygen batteries, such as zinc–oxygen (Zn–O2) batteries, aluminum–oxygen (Al–O2) batteries, and sodium–oxygen (Na–O2) batteries.


Work in the construction industry is mainly fieldwork with workers being highly mobile. Information flows between construction sites can be facilitated by the use of mobile technologies. Although several studies have investigated the use of mobile technology (mICT) and how it can be used to improve business processes in the construction industry (e.g. Bowden, Dorr, Thrope & Anumba, 2006; Zou, Ye, Peng, & Chen; 2006; Vilkko, Kallonen, & Ikonen, 2008), the amount of mICT use in the construction industry continues to be low compared to other sectors due to several factors such as financial constraints and the lack of techniques for evaluating ICT benefits (ABS, 2012). This research is intended to inform users and future researchers about obstacles that could hinder the adoption and use of mobile technologies in Libya. The major aims of this thesis are: 1) to investigate the factors that affecting the intention of stakeholders to adopt and use this technology in the Libyan construction industry, 2) to explore the benefits that could be gained from adopting and using mICT and 3) to investigate the current uses and the future prospects regarding adopting and using this technology.

A research model based on the broader technology acceptance literature was developed to provide a framework for this research. The model was designed to provide a better understanding of the inter-relationships between constructs proposed as likely to have a significant role in mICT technology acceptance in the construction industry. The research model includes a set of constructs believed to influence the intention to adopt and use mICT in the construction industry. These are: perceived usefulness of mICT, perceived ease of use of mICT, perceived credibility of mICT and perceived high cost of technology, perceived mICT self-efficacy and facilitating conditions.

The research strategy for this study was survey research and combined both quantitative and qualitative research. Questionnaires and semi-structured interviews were used for collecting the data. A sample of 202 respondents representing the main types of stakeholders in the construction industry was obtained from construction companies in three Libyan cities and 25 of them were also interviewed.

The model was tested using Partial Least Square and the results were used to address the first research question, "What are the factors that could influence the intention to adopt and use of mICT by stakeholders in the Libyan construction industry?". To answer the other two research questions, a qualitative analysis approach was used which was mainly based on the procedures used by Silverman (2006).

The study found that the intention to adopt and use mICT in the Libyan construction industry was directly affected by perceived usefulness of mICT and perceived ease of use of mICT and indirectly by perceived mICT self-efficacy and facilitating conditions. The study also showed that mICT is very beneficial to the stakeholders in the construction industry in numerous areas such as reduction of work time, cost and effort. Moreover, mICT was found to be important to stakeholders for interacting, monitoring, exchanging information and organising and completing work. In addition, the study has also identified the construction industry stakeholders' perspectives on what the future holds for mICT adoption and use in the construction sector, and the necessity for government support in increasing the number of mobile service providers, establishing investment contracts with international mICT technology suppliers and adopting training programs for stakeholders.


OBJECTIVE
To discuss the effectiveness of improved interosseous dorsal artery reversed island flap to repair dorsal skin and soft tissue defect of the hand.

METHODS
Between March 2009 and September 2012, 29 cases of dorsal skin and soft tissue defects were treated with improved interosseous dorsal artery reversed island flap. Of 29 cases, there were 17 males and 12 females, aged 23-71 years (mean, 47 years); and the left hand was involved in 12 cases and the right hand in 17 cases. There were 11 cases of avulsion injury, 9 cases of crushing injury, 5 cases of strangulation injury, and 2 cases of traffic accident injury; the interval of injury and admission was 1-7 hours (mean, 4 hours). Two patients had scar contracture. The locations of soft tissue defects were dorsal hands in 21 cases, first webs in 5 cases, and dorsal thumb in 3 cases. The size of soft tissue defects ranged from 4 cm x 3 cm to 10 cm x 8 cm. One-stage repair was performed in 11 cases, and two-stage repair in 18 cases. The size of flaps ranged from 5.5 cm x 4.5 cm to 12.0 cm x 10.0 cm. The donor sites were sutured directly or repaired by skin grafting.

RESULTS
All flaps survived, and wounds healed in first stage. And the grafted skins at donor sites all survived, and incisions all healed in first stage. Twenty-six patients were followed up 3 months-3 years (mean, 19.5 months). Bulky flap was observed in 3 cases, and defatted operation was performed after 6 months; the other flaps had good appearance and texture, and wrist function was normal. According to total angle of motion (TAM) systematic evaluation, the results were excellent in 17 cases, good in 6 cases, and fair in 3 cases at 3 months after operation.

CONCLUSION
Improved interosseous dorsal artery reversed island flap has the advantages of easy-to-obtain, simple operation, and high survival rate of flaps, so it is an effective method to repair dorsal skin and soft tissue defect of the hand.