IntroductionBreast cancer survivors are at risk for late and ongoing problems including cancer recurrence and late effects of treatment. Lack of access to quality follow-up care may affect later mortality, morbidity, and quality of life. This study examines variation in utilization of guideline-based follow-up care separately for four Canadian provinces.
Objectives and ApproachFor our retrospective population-based cohort study of breast cancer survivors diagnosed from 2007 to 2010 in British Columbia (BC), 2007-2011 in Manitoba (MB), 2007-2010 in Ontario (ON), and 2007-2012 in Nova Scotia (NS), we linked provincial cancer registries, clinical and health administrative databases, and followed cases alive at 30 months post-diagnosis to five years from diagnosis. For each province, we calculated percent adherence, overuse, and underuse of recommended follow-up care, including surveillance for recurrent and new cancer, surveillance for late effects, and general preventive care. We also examined variation among provinces and over time.
ResultsSurvivor numbers were 23,700 (ON), 9493 (BC), 2688 (MB), and 2735 (NS). Annual oncologist visit guideline compliance varied provincially (e.g. Year 2 ON=32.7%, BC=15.0%). For most provinces and follow-up years, the majority of survivors had fewer oncologist visits than recommended.  However, survivors had additional annual breast cancer-related visits to a primary care provider.  Surveillance breast imaging guideline compliance was high (e.g. Year 2, ON=81.1%, MB=72.0%, NS=52.8%, BC =49.7%), with rates declining in ON and MB (to approximately 64%), but increasing in NS and BC (to approximately 58%) by Year 5. Overuse of breast imaging was identified in NS (9.1%-20.7% overuse in follow-up years 2-5).  As per the guideline, 72.9%-79.7% (Years 2-5) of BC survivors had no imaging for metastastic disease, highest among all provinces.
Conclusion/ImplicationsProvincial and temporal variations in guideline adherence were identified. Patterns differed by guideline, and both overuse and underuse were observed. These results point to opportunities to improve survivor care and efficiencies in care delivery. In particular, regular care with a primary care physician has been shown to improve follow-up care.


In this work, by using descriptive techniques, the characteristics of the texture of the CT (computed tomography) image of patients with colorectal cancer were extracted and, subsequently, classified in KRAS+ or KRAS-. This was accomplished by using different classifiers, such as Support Vector Machine (SVM), Grading Boosting Machine (GBM), Neural Networks (NNET), and Random Forest (RF). Texture analysis can provide a quantitative assessment of tumour heterogeneity by analysing both the distribution and relationship between the pixels in the image. The objective of this research is to demonstrate that CT-based Radiomics can predict the presence of mutation in the KRAS gene in colorectal cancer. This is a retrospective study, with 47 patients from the University Hospital, with a confirmatory pathological analysis of KRAS mutation. The highest accuracy and kappa achieved were 83% and 64.7%, respectively, with a sensitivity of 88.9% and a specificity of 75.0%, achieved by the NNET classifier using the texture feature vectors combining wavelet transform and Haralick coefficients. The fact of being able to identify the genetic expression of a tumour without having to perform either a biopsy or a genetic test is a great advantage, because it prevents invasive procedures that involve complications and may present biases in the sample. As well, it leads towards a more personalized and effective treatment.


Lignocellulosic substrate is a resource that contains a locked energy reserve that is normally lost during anaerobic digestion. Lignocellulosic substrate is one of the most abundant sources of organic matter available and yet its energy recovery has much room for improvement. Lignocellulosic substrate has cellular properties that are deemed extremely difficult to degrade due to complexity which is why this energy reserve is never unlocked during anaerobic digestion. There are several successful pretreatment methods that are used to degrade this lignocellulosic substrate and unlock this energy reserve. This paper will focus on the methods that include mechanical, irradiation, chemical and combined pretreatment processes. Analysis is conducted on all the studies that are obtained to compare the successes of the different types of pretreatment processes used. Each of the different listed pretreatment processes have different energy requirements, treatment times, and solvent requirement and are acting to enhancing methane production. The improvement in methane production varies from process to process and study to study creating a need to compile all of this valuable data into this research report. This will help future researchers in navigating the available studies of pretreatment of lignocellulosic substrate for improving methane production.


Purpose

The purpose of this research is to explore how current implementation of KM practices, KM processes and KM-centred strategies among Malaysian R&D firms contribute to improving their knowledge quality. In addition, the KM practices investigated are supported by ways of how the R&D firms are motivated to share knowledge and what are the constraints inhibiting such sharing.

Design/methodology/approach

A total of 320 questionnaires were disseminated to Malaysian R&D firms and the response rate was 47 per cent. Descriptive analysis such as percentage, mean values and indexes were used to analyse the data.

Findings

Overall, the findings reflect the nature of R&D firms as knowledge-intensive organisations. KM practices show that there is a very high tendency of implementation of knowledge exploration and knowledge exploitation activities. In all, 90 per cent of more firms have implemented the three KM processes with constructing new knowledge appears to be the most implemented process. Knowledge-centred culture scores the highest overall mean, followed by leadership and HR practices.

Practical implications

This study provides an identification of KM practices that serves as a starting point for R&D managers to determine the gaps and appropriate actions to collectively achieve the desired R&D results and national innovation.

Originality/value

This study serves as a careful examination in exploring the extent to which KM practices, KM processes and KM-centred strategies are implemented in improving the knowledge quality in the Malaysian R&D firms. It helps R&D firms to frame their KM activities to drive the capability of creating and retaining a greater value onto their core business competencies.


Abstract Vibrational spectra of small neutral gold clusters containing up to 8 Au atoms are measured in the far-infrared (46–222 cm–1) via photodissociation of their complexes with krypton atoms. Comparisons with calculated IR spectra for bare Aun clusters using density functional theory allow for structural assignment. For these small sizes, all clusters are found to be planar and of comparably high symmetry. For Au6 no data is available, as this cluster size is not detected in the photoionization mass spectra due to its high ionization energy. The structures assigned are for n = 4: rhombus (D2h); 5: trapezoid (C2v); 7: edge-capped triangle (Cs), 8: 4-fold edge-capped square (D4h).


Unintentional cranial modification derived from archaeological or ethnographic contexts has been extensively documented across the globe. We report tumpline deformations (post-coronal depression) from seven sites dated to the Bronze Age and Early Iron Age of Armenia. This study focuses on the gross anatomy and anatomic relations and meaning of two enigmatic, geographically-patterned, quasi-continuous superstructures of the posterior cranium. Collectively known as occipital superstructures (OSS), these traits are the occipital torus tubercle (TOT) and retromastoid process (PR). In 39 individuals with inadvertent tumpline deformation (post-coronal depression), OSS are present. It is proposed that these are genetically underpinned but triggered by chronic activities related to long-term, strenuous, repetitive muscle use, probably starting at a young age. Co-variation of OSS expression and tumpline deformation is consistent with induction by upper body activity being a proximate cause of these superstructures in genetically predisposed individuals. Although tumpline deformations are expressed more strongly in females, we found that males in Bronze Age and Iron Age groups had more robust muscle markings on the skulls.


In this paper, a novel signal perturbation free transmit scheme is proposed for MIMO channel estimation. A perturbation analysis of the WR-based method is first conducted, showing that the method is subject to a signal perturbation error and therefore, its performance is very poor under the moderate to high signal-to-noise ratios (SNRs). A new transmit structure is then proposed to cancel the signal perturbation error at the receiver in order to improve the performance of the WR-based method in the high SNR case. Computer simulations show that the WR-based method with the proposed signal perturbation free transmit scheme significantly outperforms the original WR-based method as well as the training-based LS method in terms of the MSE of the channel estimate.


Particle Flow Algorithms (PFAs) attempt to measure each particle in a hadronic jet individually, using the detector subsystem that provides the best energy/momentum resolution. Calorimeters that can exploit the power of PFAs emphasize spatial granularity over single particle energy resolution. In this context, the CALICE Collaboration developed the Digital Hadron Calorimeter (DHCAL). The DHCAL uses Resistive Plate Chambers (RPCs) as active media and is read out with 1 × 1 cm2 pads and digital (1-bit) resolution. In order to obtain a unique dataset of electromagnetic and hadronic interactions with unprecedented spatial resolution, the DHCAL went through a broad test beam program. In addition to conventional calorimetry, the DHCAL offers detailed measurements of event shapes, rigorous tests of simulation models and various analytical tools to improve calorimetric performance. Here we report on the results from the analysis of DHCAL data and comparisons with the Monte Carlo simulations.


Hyperostotic bone dysplasias are characterized by progressive hyperostosis and sclerosis of the cranium and facial bones. As a result of progressive bony overgrowth, intracranial pressure may increase and lead to brain and nerve compression, cranial nerve palsies, and an increased incidence of seizures. The long bones often exhibit defective modeling as well as variable degrees of metaphyseal and diaphyseal hyperostosis. In addition, the axial skeleton (including the pelvis) is often hyperostotic and sclerotic. The clinical features of these disorders may have relevance to the outcome of pregnancy; however, there are no reports on the management and pregnancy outcome of patients affected with hyperostotic bone disease. In this report, we describe the course of two pregnancies in a woman with craniodiaphyseal dysplasia (a rare craniotubular dysplasia). Prenatal assessment, method of delivery, choice of anesthesia, and neonatal management are discussed. Although this disorder is rare, the pathophysiologic considerations relevant to pregnancy outcome may be applicable to the management of pregnant women with other hyperostotic bone dysplasias.


Introduction: Radiation effects induced in non-irradiated cells are termed radiation- induced bystander effects (RIBE). The present study intends to examine the RIBE response of QU-DB bystander cells to first, second and third radiation fractions and compare their cumulative outcome with an equal, single acute dose.

Materials and Methods: This experimental study irradiated three groups of target cells for one, two and three times with 60Co gamma rays. One hour after final irradiation, we transferred their culture media to non-irradiated (bystander) cells. We used the cytokinesis block micronucleus assay to evaluate RIBE response in the bystander cells. The numbers of micronuclei generated in bystander cells were determined.
Results: RIBE response to single acute doses increased up to 4 Gy, then decreased, and finally at the 8 Gy dose disappeared. The second and third fractions induced RIBE in bystander cells, except when RIBE reached to the maximum level at the first fraction. We split the 4 Gy acute dose into two fractions, which decreased the RIBE response. However, fractionation of 6 Gy (into two fractions of 3 Gy or three fractions of 2 Gy) had no effect on RIBE response. When we split the 8 Gy acute dose into two fractions we observed RIBE, which had disappeared following the single 8 Gy dose.
Conclusion: The impact of dose fractionation on RIBE induced in QU-DB cells depended on the RIBE dose-response relationship. Where RIBE increased proportionally with the dose, fractionation reduced the RIBE response. In contrast, at high doses where RIBE decreased proportionally with the dose, fractionation either did not change RIBE (at 6 Gy) or increased it (at 8 Gy).


Dysfunctional mitochondrial activity can lead to a variety of different diseases. As such, there exists a need to quantify changes in mitochondria function as it relates to these specific diseased states. Here, we present the use of resonance Raman (RR) spectroscopy as a tool to determine changes in isolated mitochondrial activity. RR spectroscopy, using 532 nm as the excitation source, specifically provides information on the reduction and oxidation (RedOx) state of cytochrome c, which is determined by the activity of protein complexes in the electron transport chain (ETC). In this model, injection of the substrate succinate into the mitochondrial sample is used to drive the ETC, which causes a subsequent change in cytochrome c RedOx state. This change in RedOx state is tracked by RR spectroscopy. This tool gives real‐time information on the rise and fall of the amount of reduced cytochrome c within the mitochondrial sample, providing a method for rapid assessment of mitochondrial metabolism that has broad applications in both basic science and medical research.


The production of fragments from a broad range of reconstructed quasi-projectiles obtained in the interaction of 32S (45 MeV/nucleon) with 112Sn was studied. A good description of the experimental data on the multifragmentation of these light quasi-projectiles with a model framework based on deep inelastic transfer followed by SMM (statistical multifragmentation model) was obtained. The charge and mass distributions of the observed fragments show that the break-up of a given quasi-projectile source is highly correlated to its isospin composition. The sensitivity of the hot primary fragments to the symmetry energy was investigated in detail. It was found that for the present light systems (A~30), a good description of the experimental data on the charge distributions, the 〈N/Z〉 distributions and the isotopic distributions of the fragments is obtained by the SMM calculations involving the standard (Csym = 25 MeV), as well as, a reduced value of the symmetry energy (Csym = 8 MeV). However, the reduced value of the symmetry energy appears to provide a better description of the isotopic distributions in most of the cases. This is in agreement with an overall reduction of the symmetry energy of primary fragments indicated by a number of multifragmentation studies of heavier systems.


• Describe the differences between rotational and translational kinetic energy • Define the physical concept of moment of inertia in terms of the mass distribution from the rotational axis • Explain how the moment of inertia of rigid bodies affects their rotational kinetic energy • Use conservation of mechanical energy to analyze systems undergoing both rotation and translation • Calculate the angular velocity of a rotating system when there are energy losses due to nonconservative forces


N-isopropyl acrylamide (NIPAM) monomer and N, N' – methylene-bis-acrylamide (BIS) crosslinker were used to synthesize polymer gel dosimeters for a reason that the monomer is lower toxicity which gives a significant advantage over the other polymer gel compositions. The gels were irradiated with Co-60 gamma rays at doses up to 21 Gy and the irradiated NIPAM polymer gels were used to investigate the dose response characteristics based on Raman spectroscopy analysis on the formation of the polymer gels and the consumptions of NIPAM and BIS co-monomers. From the findings, the polymerization was referred to an increment in Raman intensity at 815 cm−1, assigned for C-C stretching mode of NIPAM polymer gel, as the dose increased. The consumptions of the co-monomers were referred to a decrement in Raman intensities at 1025 cm−1 2353 cm−1 for C=C stretching modes of NIPAM and BIS respectively as the dose increased. The increment and decrement in Raman intensities of polymer and co-monomers respectively with increase of dose indicate that there is occurrence of polymerization of NIPAM polymer gels which could be applied in 3D dose distributions for radiotherapy treatment planning. The correlation factor kBIS is greater than kNIPAM showing that the reaction of BIS crosslinker is more efficient than NIPAM monomer to generate 37% of the NIPAM polymer gel.


To the best of authors' knowledge, this paper presents the first work on memory analysis of VLSI architectures for motion-compensated temporal filtering (MCTF). The open-loop MCTF prediction scheme has led the revolution for hybrid video coding methods that are mainly based on the close-loop MC prediction (MCP) scheme, and it also becomes the core technology of the coming video coding standard, MPEG-21 part 13-scalable video coding (SVC). In this paper, the macroblock (MB)-level and frame-level data reuse schemes are analyzed for the MCTF. The MB-level data reuse is especially for the motion estimation (ME), and the level C+ scheme is proposed, which can further reduce the memory bandwidth of the conventional level C scheme. Frame-level data reuse schemes for MCTF are proposed according to the open-loop prediction nature.


INTRODUCTION
Neonatal sepsis is a major cause of morbidity and mortality worldwide especially in developing countries, which justifies early diagnosis and prompt treatment with antibiotics. Antibiotics are the most frequently used medicines in Neonatal Intensive care units. Data regarding rational antibiotic use in neonates is very limited. Hence, it is essential that the antibiotic prescribing patterns be evaluated periodically for its rational use. Therefore, the present study been carried out to identify the prescribing patterns of antibiotics in neonatal intensive care unit of a tertiary care hospital, Western Maharashtra, India.

MATERIALS AND METHODS
A prospective observational study was carried out for 6 months between April to September 2014. The data regarding patient demographics and antibiotic use was collected daily in a structured proforma. Collected data was subjected to statistical analysis.

RESULTS
Out of total 528 neonates with male preponderance (62%), 370 received antibiotics. Mean gestational age and birth weight were 35±3.2 weeks and 2±0.7 kg respectively. Mean length of hospital stay was 14.26±15.36 days (range 1 to 136 days). A total of 1123 antibiotics were prescribed to 370 neonates. The majority of neonates (55.9%) received between 1-2 antibiotics, 37.3% had 3 to 5 antibiotics prescribed, while 6.7% neonates were prescribed more than 5 antibiotics. Number of antibiotics used had statistically significant inverse relationship with gestational age. Among antibiotics; Amikacin, Cefotaxime and Levofloxacin were the drugs most often prescribed. Amikacin and Cefotaxime were given more to term infants whereas other antibiotics like Levofloxacin, Pipercillin- tazobactam and Meropenem were prescribed more to preterm and outborn neonates.

CONCLUSION
The use of a high number of antibiotics is a common practice. Although the indications for use of most antibiotics could be justified, the increased frequency of anbiotics use in some neonates was of concern. Guidelines for the use of antibiotics in neonates are required and larger studies are needed on this issue.


Depolarization of isolated guinea pig vasa deferentia in vitro by either hypertonic KCl or veratridine resulted in a dose-dependent, proportional release of norepinephrine and dopamine β-hydroxylase. The ratio of norepinephrine to dopamine β-hydroxylase activity released by depolarizing agents was similar to that obtained by electrical stimulation of the hypogastric nerve. Thus exocytosis from sympathetic nerve terminals may be elicited by depolarizing drugs as well as by electrical stimulation. Incubation of vasa deferentia in vitro in the presence of reserpine or the sympathomimetic amines tyramine, d-amphetamine, or metaraminol resulted in the dose-dependent release of norepinephrine but not of dopamine β-hydroxylase. When calcium was omitted from the incubation medium, exocytotic release of norepinephrine and dopamine β-hydroxylase induced by depolarizing agents was blocked whereas norepinephrine release induced by sympathomimetic agents was not affected. Tetrodotoxin blocked veratridine but not tyramine-induced release. Colchicine, but not hexamethonium or atropine, blocked exocytotic release. None of these drugs affected tyramine-induced release of norepinephrine. In vasa deferentia from untreated animals, the ratio of supernatant (S2) to particulate (P2) norepinephrine concentration after centrifugation at 100,000 x g for 1 hr was 0.7. In animals treated with reserpine and a monoamine oxidase inhibitor this ratio increased to 1.3, suggesting a release of norepinephrine from vesicular into intraneuronal cytoplasmic stores. The release of norepinephrine by tyramine was enhanced in vasa deferentia from reserpine- and monoamine oxidase inhibitor-treated animals and resulted in a fall in the norepinephrine content of the S2 fraction. This suggests that tyramine may act by displacing norepinephrine from cytoplasmic stores into the synaptic space. After treatment of guinea pigs with reserpine alone or in combination with a monoamine oxidase inhibitor, electrical stimulation of the hypogastric nerve to the guinea pig vas deferens resulted in release of dopamine β-hydroxylase but not of norepinephrine. This suggests that release by exocytosis may occur in the presence of a depleted amine store and that the norepinephrine released by exocytosis is derived predominantly from vesicular reserpine-sensitive stores.


In this paper, an extensive investigation of hybrid molecular/Si field-effect memories is presented, where redox ferrocene (Fc) molecules play the role of the memory charge storage nodes. Engineering of the organic linkers between Fc and Si is achieved by grafting Fc with different linker lengths. The study shows a clear correlation between results from atomistic computational density functional theory, electrochemical measurements (cyclic voltammetry) and electrical data obtained by a detailed study on capacitors and pseudo-MOS devices. Physical-chemical analyses (atomic force microscopy, high-resolution transmission electron microscopy, and X-ray photoelectron spectroscopy), corroborate the quality of molecular layers on devices.


matched controls. Additionally, the second purpose was to determine the relationship between the placental pathologies and uterine artery (UtA) Doppler findings. Methods: 172 patients with singleton pregnancies between 24 and 35 weeks who presented with signs of preterm labor and 169 healthy pregnant women with correlative properties who admitted for routine pregnancy visits were recruited for the study. UtA blood flows were evaluated with Doppler ultrasonography during uterine inertia for both patients having preterm labor signs and for the control group. Each patient followed until the birth and delivery in 48 hours/7 days/14 days were recorded. The placental pathologies were interpreted (Redline 2007) and the relationship between the Doppler findings and placental pathologies were investigated. Results: Placental pathologies were found to be higher in the study group compared to their controls (P = 0.002). According to placental pathology patterns; the study group had significantly higher subclinical chorioamnionitis (P = 0.014), maternal vascular maldevelopment (P = 0.000) and maternal vascular loss of integrity (P = 0.021) than the control group. In the study group, the patients' who delivered in 48 hours/7 days/14 days, presence of abnormal placental pathologies were also found to be higher (P = 0.001/P = 0.000/P = 0.000) than the patients who did not deliver. The study group with abnormal placental pathologies had substantially higher UtA PI (0.98 ± 0.39) than the patients without placental pathologies (0.74 ± 0.21) (P = 0.001). Conclusions: An underlying abnormal placental pathology was found to be higher in patients showing preterm labor symptoms and in the patients particularly who deliver in early time periods. With this study, it's shown for the first time that the placental lesions prosecuted for preterm delivery were associated with antenatal UtA blood flows.


Drug-induced hepatotoxicity is a worldwide health issue. And diagnosing the injury in the early stage is still a challenge in clinic. In this study, pattern recognition analysis of the ultra high performance liquid chromatography-mass spectrometry (UPLC-MS) of hepatocytes HL7702 was performed to develop differential metabolites related to hepatotoxicity induced by hepatotoxicants, including carbon tetrachloride (CCl4), acetaminophen (APAP), emodin, aristolochic acid (AA) and triptolide. Hepatocytes injuries were induced by 48 h of treatment with CCl4 (4 mmol/L), APAP (6.5 mmol/L), emodin (14 μmol/L), AA (35 μmol/L) and triptolide (18 nmol/L), separately. Global metabolomics profiling, multivariate analysis and database searching were performed to discover common differential metabolites for live injury. The positive hepatoprotective drug, bifendate, was used to repair triptolide induced hepatocytes injury, and bifendate-induced changes of hepatotoxicity-related metabolites were investigated. In the results, fatty acid oxidation and cellular oxidative stress-related metabolites, including nicotinamide adenine dinucleotide and glutathione were significantly changed between the control and hepatotoxicant-treated groups, and after treatment with bifendate, those perturbed metabolites all partly returned to normal level. In conclusion, we discovered potential hepatotoxicity-related metabolites that could be used to evaluate hepatotoxicity induced by chemicals, drugs and traditional Chinese medicines. This study also proved that metabolomics is one of the effective tools to investigate drug-induced hepatotoxicity.


A number of studies have explored the dynamics of opinion change among interacting knowledge workers, using different modeling techniques. We are particularly interested in the transition from cognitive convergence (a positive group phenomenon) to collapse (which can lead to overlooking critical information). This paper extends previous agent-based studies of this subject in two directions. First, we allow agents to belong to distinct social groups and explore the effect of varying degrees of within-group affinity. Second, we provide exogenous drivers of agent opinion in the form of a dynamic set of documents that they may query. We exhibit a metastable configuration of this system with three distinct phases, and develop an operational metric for distinguishing convergence from collapse in the final phase. Then we use this metric to explore the system's dynamics, over the space defined by social affinity and precision of queries against documents, and under a range of different functions for the influence that an interaction partner has on an agent.


Islamic (participation) banks in Turkey are required to apply international accounting standards in their accounting and reporting practices, while their counterparts in Bahrain apply the Accounting and Auditing Organization for Islamic Financial Institutions (AAOIFI) standards. The main objective of this paper is to reveal the relation between Islamic and international accounting standards, discussed in previous studies, by comparing the compliance to AAOIFI accounting standards by Islamic banks in both Turkey and Bahrain. The source of information in this study is secondary data provided in the annual reports of the Islamic banks in Turkey and Bahrain for the year 2017. In order to measure compliance, an unweighted disclosure index was used. The outcomes of this study show that, since AAOIFI accounting standards are compulsory in Bahrain, the level of compliance with AAOIFI standards in relation to general presentation and disclosure in the financial statements of Islamic banks in Turkey is lower than the compliance achieved by their counterparts in Bahrain. Due to the average compliance level achieved by Islamic banks (using the unweighted disclosure index) in Turkey (54.6%), and since all banks in Turkey apply international financial reporting standards and international accounting standards, it is found that there is a relation between AAOIFI and International Accounting Standards Board standards even though they are different. Surprisingly, in the case of Bahrain's Islamic banks, the standard deviation of the total compliance score is 8.66, which indicates an important difference among the Islamic banks in Bahrain in this regard. It is also found that the current practices of participation banks in Turkey do not adequately meet the financial statements and disclosure standards in accordance with the AAOIFI.


Total hip arthroplasty has proven to be a highly successful procedure but with its increased use in elderly patients and in young patients with high physical demands, there are an increasing number of joints requiring revision. Many factors, including loss of bone stock, joint instability, infection, fracture, trochanteric nonunion, and difficulty in implant or cement removal, make revision of the femoral component challenging to the surgeon. To address these factors and to achieve the goals of revision surgery, several key questions should be addressed. What exposure should be used? How can the implant be removed? What type of reconstruction should be used and which implant should be chosen? How can stable fixation be achieved? How can the bone defects be treated? The approach that the authors recommend to the femoral component in revision hip arthroplasty is outlined, taking into consideration each of the questions above. The classification system used by the authors for femoral bone defects present at the time of revision arthroplasty has four categories based on the integrity of the proximal cancellous bone and the cortical tube, which is used to select the technique of reconstruction. The literature on techniques for revision of a failed femoral component is reviewed.


The objective of the present study was to identify and examine the influence of instructional tools, namely, games, songs and stories on young Iranian EFL learners' achievement utilizing a quantitative design. To conduct the study 65 Iranian EFL learners, divided into an experimental group and a control group, learning English at Navid English Institute, Shiraz, Iran, participated in the study. The data were collected through two instruments: a pre/post- achievement test, and audio-recorded interviews, both designed by the researchers. The data obtained from the administration of the test and the interviews were analyzed using independent samples t-tests and paired samples t-tests and the findings were compared to describe the influence of employing instructional games, songs and stories on participants' achievement. Findings drawn from the analysis of data revealed that the implementation of pedagogical tools used in the study can significantly affect the learners' language achievement, realized through their listening, speaking, and writing ability and their vocabulary and grammar.


In this paper, the effects of limited drain current and transistor's on resistance on the performance of an LDMOS inverse class-E power amplifier (PA) are analyzed using a simplified transistor model of piecewise linear dc I-V curves. The minimal magnitude of driving signal, the maximal voltage gain, and the maximal output power of an inverse class-E PA can be defined with the maximal drain kept. The theoretical and simulated results of amplifier performance, such as drain efficiency and output voltage, are compared to verify the analysis, and the nonlinear relation among the drain dc supply voltage, input/output voltage, and phase of an inverse class-E PA caused by limited drain current are presented. The effects on the amplifier performance are further verified by the measured results of a 945-MHz transmission-line inverse class-E amplifier in comparison with the corresponding theoretical and simulated results.


Interactive intelligent systems are increasingly being deployed in safety critical contexts like Space Exploration. For humans to safely and successfully complete collaborative tasks with robots in these contexts, they must maintain Situational Awareness of their task context without being cognitively overloaded -- regardless of whether they are co-located with robots or interacting with them from a distance of thousands or millions of miles. In this paper, we present a novel autonomy design strategy we term Performative Autonomy, in which robots behave as if they have a lower level of autonomy than they are truly capable of (i.e., asking for advice they do not believe they truly need), for the sole purpose of maintaining interactants' Situational Awareness. In our first experiment (n=264), we begin by demonstrating that Performative Autonomy can increase Situational Awareness (SA) without overly increasing workload, and that this is true across tasks with different baseline levels of Mental Workload. In our second experiment (n=318), we consider cases where robots do not believe they need advice, but in fact have faulty perception or decision making capabilities. In this experiment, we only observed benefits to Performative Autonomy for specific types of questions, and only when there was significant cognitive load imposed by a secondary task; yet we observed uniform benefit on task performance for asking these types of questions regardless of task-imposed Mental workload. Our results from these two studies (total n=582) thus provide strong support for using this autonomy design strategy in future safety-critical missions as humanity explores the Moon, Mars, and beyond.


Significant interest has risen in the development of catalytic nanomaterials for the electroreduction of CO2. While extensive studies have been reported on tuning of surface structures to improve the chemical kinetics, less attention has been paid to the mass transfer effects in the CO2 reduction reaction on nanoscale electrocatalysts. We report here a systematic investigation of CO2 electroreduction on highly dense Cu nanowires, with the focus placed on practically relevant high-flux conditions. Mass transfer effects are found to play an important role in this case, giving rise to diffusion-limited CO2 reduction activity and selectivity. By correlating the observed transport phenomena to the CO2 conversion rate calculated from the experimental data and the surface concentration of CO2 on the nanowires derived from transport modeling, an upper limit is revealed for the CO2 conversion rate on the nanostructured electrodes, which also causes the drop in Faradaic efficiency of CO2 reduction at large current densities. Our work emphasizes the necessity of considering mass transfer effects in the design of advanced electrocatalysts for CO2 reduction as well as for understanding their structure–performance relationships.


In recent years, numerous methods have been sought for developing novel solutions to counter neurodegenerative diseases. An objective that is being investigated by researchers is to develop cortical implants that are able to wirelessly stimulate neurons at the single cell level. This is a major development compared to current solutions that use electrodes, which are only able to target a population of neurons, or optogenetics, which requires optical fiber-leads to be embedded deep into the brain. In this direction, the concept of wireless optogenetic nanonetworks has been recently introduced. In such architecture, miniature devices are implanted in the cortex for neuronal stimulation through optogenetics. One of the aspects that will determine the topology and performance of wireless optogenetic nanonetworks is related to light propagation in genetically-engineered neurons. In this paper, a channel model that captures the peculiarities of light propagation in neurons is developed. First, the light propagation behavior using the modified Beer-Lambert law is analyzed based on the photon transport through the nervous tissue. This includes analyzing the scattering light diffraction and diffusive reflection that results from the absorption of neural cell chromophores, as well as validating the results by means of extensive multiphysics simulations. Then, analysis is conducted on the path loss through cells at different layers of the cortex by taking into account the multi-path phenomenon. Results show that there is a light focusing effect in the soma of neurons that can potentially help the to stimulate the target cells.


We are living in time where the impact on continuity still grows both on the side our personal lives and business activities. In the same time different international, regional, national, state and private organizations initiated to provide different actions and regulations in order to find the best solutions of this situation. The result is that there exist the whole set of different views over this problem. The main aim of this article is to map this situation, to provide the general framework of business continuity management (BCM) and to discuss its main parts and their mutual relationships. Special impact is given to the integration of the business and IT oriented solutions and ways of assurance initiatives helping managers to assess the implemented solutions and their compliance to the business strategy and other existing regulations.


Background Optimal transition from child to adult services involves continuity, joint care, planning meetings and information transfer; commissioners and service providers therefore need data on how many people require that service. Although attention-deficit hyperactivity disorder (ADHD) frequently persists into adulthood, evidence is limited on these transitions. Aims To estimate the national incidence of young people taking medication for ADHD that require and complete transition, and to describe the proportion that experienced optimal transition. Method Surveillance over 12 months using the British Paediatric Surveillance Unit and Child and Adolescent Psychiatry Surveillance System, including baseline notification and follow-up questionnaires. Results Questionnaire response was 79% at baseline and 82% at follow-up. For those aged 17–19, incident rate (range adjusted for non-response) of transition need was 202–511 per 100 000 people aged 17–19 per year, with successful transition of 38–96 per 100 000 people aged 17–19 per year. Eligible young people with ADHD were mostly male (77%) with a comorbid condition (62%). Half were referred to specialist adult ADHD and 25% to general adult mental health services; 64% had referral accepted but only 22% attended a first appointment. Only 6% met optimal transition criteria. Conclusions As inclusion criteria required participants to be on medication, these estimates represent the lower limit of the transition need. Two critical points were apparent: referral acceptance and first appointment attendance. The low rate of successful transition and limited guideline adherence indicates significant need for commissioners and service providers to improve service transition experiences.


In many questions of signal processing, it is important to use the concepts of instantaneous amplitude or phase of signals. This is especially the case in communication systems with amplitude or frequency modulation. These concepts are often introduced empirically. However, it is well known that the correct approach for this purpose is to use the concept of analytic signal. Starting from this point, we show some examples of contradictions appearing when using other definitions of instantaneous amplitude or frequency that are commonly admitted. This introduces the problem of characterizing pure amplitude-modulated or pure phase-modulated signals. It is especially shown that whereas amplitude modulated signals can be characterized by spectral considerations, this is no longer the case for phase-modulated signals. Furthermore, signals with constant amplitude have very specific properties, which are analyzed in detail. Some consequences and extensions to random signals are finally discussed.


High-occupancy vehicle (HOV) facilities in Virginia have proven to be effective in enhancing mobility. This success, along with the availability of electronic toll collection technology, has led the Commonwealth to expand the HOV system and pursue the implementation of high-occupancy toll (HOT) facilities in the state. Although these facilities hold promise to help address the growing demand for travel in Virginia, a significant challenge in achieving their potential lies in the ability to enforce occupancy requirements in a manner that has minimal impact on the operation of the facilities. This has proven to be a challenge for HOV facilities and will be an even more complex undertaking on HOT facilities. The purpose of this study was to examine occupancy enforcement on HOV and HOT facilities. This examination focused on three areas: assessing the impact of existing manual violation enforcement techniques on HOV violation rates; exploring the feasibility of using new technologies/techniques to improve the effectiveness of violation enforcement; and assessing the impact of violation enforcement techniques on the operations of HOV/HOT lanes. The results of the research indicate that current saturation enforcement techniques are not effective in reducing violation rates. However, no proven technologies are currently available that offer the potential to automate enforcement of occupancy restrictions. Finally, a simulation methodology was developed that may be used to estimate the operations' impacts on current and future enforcement techniques and technologies. The report offers a number of recommendations to address the challenges of HOV/HOT occupancy enforcement in Virginia: (1) the current practice of sporadic saturation enforcement should be discontinued in exchange for regular, continuous enforcement; (2) the HOV Enforcement Task Force should look critically at current HOV policies to identify and recommend specific changes to reduce the likelihood of citations being dismissed in adjudication; and (3) the methodology developed in this research should be used to evaluate new enforcement techniques and technologies before they are implemented.


Nontarget injury from glyphosate drift is a concern among growers using non-glyphosate-resistant (non-GR) cultivars. The effects of glyphosate drift on nitrate assimilation and nitrogen fixation potential, nodule mass, and yield of non-GR soybean were assessed in a field trial at Stoneville, MS. A non-GR soybean cultivar 'Delta Pine 4748S' was treated with glyphosate at 12.5% of use rate of 0.84 kg of active ingredient/ha at 3 (V2), 6 (V7), and 8 (R2, full bloom) weeks after planting (WAP) soybean to simulate glyphosate drift. Untreated soybean was used as a control. Soybeans were sampled weekly for 2 weeks after each glyphosate treatment to assess nitrate assimilation and N2 fixation potential. Nitrate assimilation was assessed using in vivo nitrate reductase assay in leaves, stems, roots, and nodules. Nitrogen fixation potential was assessed by measuring nitrogenase activity using the acetylene reduction assay (ARA). Nitrogen content of leaves, shoots, and seed and soybean yield were also determined. In the first sampling date (4 WAP), glyphosate drift caused a significant decrease in NRA in leaves (60%), stems (77%), and nodules (50%), with no decrease in roots. At later growth stages, NRA in leaves was more sensitive to glyphosate drift than stems and roots. Nitrogenase activity was reduced 36-58% by glyphosate treatment at 3 or 6 WAP. However, glyphosate treatment at 8 WAP had no effect on nitrogenase activity. Nitrogen content was affected by glyphosate application only in shoots after the first application. No yield, seed nitrogen, protein, or oil concentration differences were detected. These results suggest that nitrate assimilation and nitrogen fixation potential were significantly reduced by glyphosate drift, with the greatest sensitivity early in vegetative growth. Soybean has the ability to recover from the physiological stress caused by glyphosate drift.


In this paper we discuss trends in the limits to late childbearing, their determinants and potential implications from an empirical long-term perspective. Although the high levels observed in non-contracepting populations have not been reached, fertility in Europe at ages 40+ and 45+ has increased substantially in recent years. This trend received considerable attention, especially in combination with the emergence of new reproductive technologies and often low levels of general fertility. Nevertheless, physiological studies agree on the fact that age limits to childbearing, at least for women, have not shifted to later ages. Our empirical analyses of high-quality long-term data from Sweden document an increase in the absolute and relative number of births at ages 40+ and 45+, together with an increase in first birth occurrence-exposure rates at ages close to 40. While extreme age at birth seems to move upwards, evidence for a rectangularization of the transition to motherhood is still weak.


Abstract Recently, dramatic progress has been achieved in the study of helical systems with high-beta experiments. Discharges with more than 3% beta plasmas have been achieved in Large Helical Device (LHD) and Wendelstein 7-AS (W7-AS). Although magnetohydrodynamic (MHD) instabilities affect local pressure gradients, the global transport property does not seem to limit the achieved beta value in either device. We summarize the LHD high-beta properties in MHD stability, equilibrium, and transport, and we show the relationship between the experimentally achieved parameters and theoretical predictions. We contrast the LHD results with the W7-AS high-beta properties. In both devices, stationary discharges in the definitely MHD unstable region have not been observed. We mention the key issue for achievement of the beta values >5%.


We consider the effects that a magnetic field has on the observable
properties of an elementary one-fermion state, assumed for simplicity to be
that of one electron. We show that for a weak intensity of the field these
effects can be very simply computed in a quantum field theory theoretical
framework, assuming the minimal form of the electromagnetic interaction and the
validity of the Dirac equation. The effects proceed via preliminary, magnetic
field induced, modification of the four components of the spinor field. These
generate consequent modifications of the various observable properties of the
fermion, which can always be simply expressed in terms of the four spinor field
components. A few general features of the various effects are discussed, and a
number of possible analogies with the fascinating medical description of the
epigenetic process for an organic cell are finally proposed.


Understanding population exposure to precipitation-related extreme events is important for effective climate change adaptation and mitigation measures. We analyze extreme precipitation using indices (EPIs), including consecutive dry days (CDD), annual total precipitation, simple daily intensity, and the number of extremely wet days, under the past and future climatic conditions over East Africa. The exposure of the East African population to these extreme events at 1.5 °C and 2.0 °C global warming levels (GWLs) is analyzed based on Climate Model Intercomparison Project phase 6 models. Exposure is computed from extremely wet and dry days (R95p and CDD, respectively). Under both GWLs, EPIs (except CDD) averaged over East Africa are projected to increase under the Shared Socio-economic Pathways (SSP)2-4.5 and SSP5-8.5 scenarios. The largest increase in wet events will likely occur in eastern and northern Kenya. The results also reveal an intensification of precipitation extremes over Burundi, Rwanda, and some parts of Uganda. However, small changes are expected over most parts of Kenya and Tanzania. Examination of population exposure to EPIs shows that the most prominent and net intense occurrence is over Burundi, Rwanda, and some parts of Uganda. In contrast, less change is noted to occur over vast parts of Kenya and Tanzania. Meanwhile, limiting the warming target to less than 1.5 °C but not more than 2.0 °C has 37% (44.2%) and 92% (4%) less impact on the occurrence of EPIs for R95p (CDD) under SSP2-4.5 (SSP5-8.5) scenarios, respectively. The study establishes that future exposure is predominantly driven by changes in population compared to other factors such as climate or concurrent changes in climate and population (the nonlinear interaction effect). For instance, climate effects are anticipated to contribute ∼10.6% (12.6%) of the total change in population exposure under 1.5 °C (2.0 °C) warming levels, while population and interaction effects are expected to contribute ∼77.4% (71.9%) and 12% (15.5%), respectively, under 1.5 °C (2.0 °C) scenarios. Interestingly, the projected changes in regional exposure due to the interaction effects under SSP2-4.5 are greater than the climate effect, while the reverse pattern is observed under SSP5-8.5. For example, under SSP5-8.5, climate effects for 1.5 °C and 2.0 °C are larger (after population effect) with ∼3.8 × 105 (15.7%) and ∼6.1 × 105 (17.5%) billion person-mm, respectively. The high exposure noted over East Africa calls for a shift in policies to instate suitable adaptation measures to cushion the already vulnerable population.


Background The original capillary index score publication only included patients that had full digital subtraction angiograms (DSA) before stroke intervention. This CIS was a single center publication with no external validation. Many centers do not perform a full DSA to assess all collaterals before intervention. Hypothesis A modified capillary index score (mCIS) using only the ICA injection can predict outcome in MCA occlusions (only MCA occlusions included). Objective Validate the utility and use of a modified capillary index score (mCIS) to assess outcomes and improvement in acute stroke patients. Methods mCIS was assessed on all consecutive patients with an MCA occlusion with complete database information. NIHSS, recanalization (mTICI), and mRS before and after treatment were assessed. mCIS of 2–3 was considered favorable as per original publication. Correlation between favorable CIS, NIHSS improvement, and mRS (0–3 good) were assessed. Results 33 patients with MCA occlusion with complete data sets where assessed. 63.6% (21/33) had a favorable mCIS (2–3) and 36.4% had a poor mCIS(0–1). Recanalization of TICI 2b or greater was achieved in 42.9% (9/21) of patients with favorable mCIS and 58.3% (7/12) of patients with poor mCIS. Of those with favorable mCIS 28.6% (6/21) had a good mRS of ≤3 at discharge vs those with poor mCIS while those with a poor mCIS 33.3% had a good mRS at discharge. However, mortality was lower in favorable mCIS vs. poor mCIS (9.5 vs. 33.35, p = 0.09). Conclusions A modified CIS is did not predict the functional outcome but may be predictor of mortality. Small sample size, lack of long-term follow up, or the lower rate of recanalization of those with favorable mCIS could have contributed to the negative outcome. A prospective or larger study with long term follow up is needed for validation. References Al-Ali F, Jefferson A, Barrow T, et al. The capillary index score: rethinking the acute ischemic stroke treatment algorithm. Results from the Borgess Medical Center Acute Ischemic Stroke Registry. J Neurointerv Surg. 2013;5(2):139–143. doi:10.1136/neurintsurg-2011-010146 Capillary Index Score, Baseline Characteristics and Outcomes Favorable mCIS Unfavorable mCIS P Value Baseline NIHSS 14 + /-6.9 18.3 + /-3.9 0.051 Age 64.3 + /-16.6 68.8 + /-4.9 0.453 Good Recanalization (2b-3) 42.9% (9/21) 58.3% (7/12) 0.391 NIHSS at Discharge 10.8 + /-7.5 15 + /-2.5 0.099 NIHSS at Discharge in TICI 2b and higher 5.8 + /-4.2 13.4 + /-13.7 0.067 Mortality 2/21 (9.5%) 4/12 (33.33%) 0.093 Good Outcome (mRS < = 3) 28.6% (6/21) 33.33% (4/12) 0.775 Good Outcome in TICI2b or higher 12 mRS < = 3) 5/9 (55.6%) 4/7 (57.1%) 0.0949 Disclosures M. Teleb: None. M. Noufal: None. A. Sattar: None. W. Wazni: None. M. Issa: None. K. Asif: None. A. Gheith: None. A. Castonguay: None. O. Zaidat: 2; C; Penumbra, Stryker, Covidie. 3; C; Penumbra, Stryker, Covidien.


BACKGROUND: Incidence and mortality rates of cervical cancer in Guatemala, as well as many other low- and middle-income countries, are considerably higher than rates in high-income countries. This is most likely due to low rates of cervical cancer screening in these countries, specifically in indigenous and rural populations. Current estimates suggest that less than 40% of women in Guatemala have ever been screened for cervical cancer, with much lower rates in indigenous and rural communities. We therefore proposed that reliance on Papanicolaou (Pap) and visual inspection with acetic acid (VIA) screening are not the most effective methods for controlling and preventing cervical cancer in indigenous and rural communities in Guatemala. Thus we investigated self-collection HPV tests as an alternative primary method of screening. HPV testing can be administered by a woman herself in the privacy of her home, thus mitigating issues of accessibility and privacy, which we believe to be barriers to screening experienced by women in these populations. We hypothesize that an HPV test will increase rates of follow-up care (Paps/VIAs) in these communities. Our prior study showed that HPV testing was highly acceptable in one indigenous group in Guatemala, and this study aims to expand upon those results to determine whether these tests are acceptable in other populations, and if there is an increase in follow-up care after use of these tests. METHODS: A randomly selected group of women (N=1000), ages 18-60, residing in two rural communities (Santiago Atitlan, which is approximately 70 kilometers outside of Guatemala City, and Livingston, which is on the Caribbean coast) will be surveyed June-July 2016 to assess risk factors and knowledge of HPV and cervical cancer. Eligible women (ages 25-56 who are not menstruating or pregnant and have not had a hysterectomy) will be asked to self-collect a vaginal sample to be tested for HPV to assess the prevalence in each community, as well as the acceptability of HPV self-sampling as an option for cervical cancer screening. We have seen that HPV testing is acceptable in Santiago, but are interested to see if the test is acceptable in other populations with different ethnic backgrounds. Women will be given their results from the HPV test within a month after data collection and then be contacted 6 months and 1 year after to determine if they followed-up on their results. RESULTS/FINDINGS: In our pilot study, 93% of women in Santiago were interested in providing a sample and 88% were eligible, showing that the test was highly acceptable in this community. We expect to see similar rates of acceptability in this follow-up study, however this study will be performed in different communities, with varying ethnic compositions, which could alter these rates. Additionally, in our pilot study, 21% of women tested positive for HPV, with 17% testing positive for high risk HPV. We again expect similar results for rates of HPV, but this could differ between communities. We will assess baseline rates of Pap/VIA screening in our surveys and hope to see increased rates of follow-up screening among women who have tested positive for HPV when we contact them at the 6-month and 1-year mark. We may also see increased rates of follow-up care in women who tested negative for HPV, as they have now been exposed to education and information about cervical cancer screening. CONCLUSIONS: Self-collection HPV testing appears to be an acceptable form of cervical cancer screening in at least one, if not more, indigenous and rural communities in Guatemala. This study will help determine if HPV testing increases the rate at which women receive Pap/VIA screening after receiving their HPV test result. With increased screening for cervical cancer in these communities, the incidence and mortality rates of this disease could be greatly reduced. **Data collection will conclude in August and all results will be analyzed prior to this conference. Citation Format: Anna Gottschlich, Audrey Murchland, Kristin Bevilacqua, Andres Pineda, Alvaro Rivera-Andrade, Christian Alvarez, Gina Ogilvie, Carlos Mendoza-Montano, Rafael Meza. Use of HPV self-sampling to increase screening for cervical cancer in indigenous and rural communities in Guatemala. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C64.


Rainfall-induced slope failure is a common problem in areas covered by residual soil in tropical countries. The soil exists in unsaturated condition as ground water table is located well below the ground surface. Rainfall infiltration results in a reduction of matric suction of soil which in turn reduces the soil shear strength, and subsequently triggers the slope failure. Natural formation of the residual soil has lead to the variation of hydraulic conductivity in which soil closer to the ground surface usually has lower permeability as compared to the deeper layer. This condition causes the development of capillary barrier effect at the interface. The water accumulates at the interface and flow for some distance down-slope before it manages to infiltrate into the deeper layer. The distance that the water has to travel before breakthrough is referred as the water diversion length. Numerical simulation using SEEP/W was performed in this study to determine the water diversion length for two cases representing natural slopes i.e. Silty SAND over SAND and Silty SAND over Highly Weathered Granite. Parametric study was performed to study the effect of several variables including hydraulic conductivity of soil, thickness of layers, slope dip angle and the rate of infiltration. Results show that the diversion length is linearly correlated with the difference in the permeability of two soil layers and slope dip angle. The effect of rainfall infiltration depends on the saturated permeability of the upper layer (MRL). The optimum thickness of MRL obtained in this study is 1.5m. Results of numerical analysis are compared with analytical method by Ross model, however good agreement between the two methods was not reached because the difference in saturated hydraulic conductivity of the soils used is not very big. Moreover, under an infiltration rate, the maximum suction existing in the CBL should be as low as possible while the maximum suction attained in the MRL should be as high as possible, which was not the case especially for Silty SAND over Highly Weathered Granite.


We have outlined our approach for developing an integrated system for controlling centerline bead temperature in arc welding. An optical thermography system, based on an inexpensive and readily available video camera, was presented. Temperature measurements obtained with this system are within 10% of those measured by a calibrated two-color optical pyrometer. A low-order model describing the centerline temperature dynamics was developed. Two strategies for tuning a simple PI temperature controller were given. We first used off-line sensitivity-based tuning to optimize the controller gains. This method is adequate for systems whose dynamics are time invariant. For GMAW, however, the plant parameters can vary widely due to changes in plate thickness as well as other operating parameters. For this reason we applied a sensitivity-based pseudogradient adaptive algorithm for self-tuning the PI controller. The self-tuning controller is robust to changes in the operating conditions and is therefore more useful than a PI controller with fixed gains. It is also insensitive to the noise present in the GMAW system. The control design presented in this paper makes no attempt to counter the delay between the arc current command and centerline temperature output. Instead, the sample time was deliberately increased so that this delay could be ignored. To increase the bandwidth of the closed-loop system it is necessary to incorporate a Smith predictor or similar mechanism to increase the response time of the closed-loop system. We are currently investigating the design of a predictive controller.<<ETX>>


The Armenian land privatization program is unique among former Soviet Republics in regard to the speed and completeness of its implementation. Armenia is the smallest of the Republics, with a population of 3.7 million, and was left highly dependent on outside sources for energy and raw materials for industries, and grain for its people and livestock. Privatization, began in 1991, was largely completed by 1993. The greatly increased number of individual owners created a need for major restructuring of the industries supplying agriculture and marketing its outputs. Problems in the substructures from technical supplies to storage and marketing are described. Recommendations are for the adoption of policies in the substructural spheres of agriculture that will contribute to the future development of agriculture in Armenia. These policies include improved contractual relations, cooperatives, niche marketing, and restructuring of various service corporations.


The plasma-cholesterol-lowering effects of some dietary legumes are now well established from animal and human studies, but the mechanism is not completely understood. The present study investigated the effect of baked beans (Phaseolus vulgaris) on steroid metabolism of hypercholesterolaemic pigs. Three groups of four pigs were studied: baseline (BL), normal pigs (NP) and those previously prepared with an ileo-rectal anastomosis to nullify the function of the large intestine (IR). All three groups were given a semi-purified control diet, with about 40% energy as fat (polyunsaturated: saturated fatty acid (P:S) ratio 0.3), supplemented with 10 g cholesterol/kg, for 14 d. Then IR and NP pigs were fed for 28 d on a diet supplemented with 10 g cholesterol/kg and 300 g baked beans/kg (dry-matter basis), so that the 40% contribution to energy from fat was maintained (P:S ratio 0.3). Group BL was fed on the control diet throughout. The intact pigs (NP) fed on baked beans showed considerable differences compared with the other groups, as follows: (a) reduced plasma cholesterol (NS); (b) higher concentration of cholesterol in bile (NS); (c) higher concentration of bile acids, especially secondary bile acids, in bile (P < 0.05); (d) reduced elimination of bile acids in faeces, especially secondary bile acids (P < 0.05); (e) higher excretion of coprostanol and lower elimination of cholesterol in faeces (P < 0.05). From these findings it is proposed that a baked-bean-enriched diet potentiates bacterial fermentation and steroid degradation in the large intestine and enhances conservation of bile acids and cholesterol within the enterohepatic circulation. The high concentration of bile acids and cholesterol in bile may thus promote feedback inhibition of hepatic cholesterol synthesis, and hence, reduce plasma cholesterol.


Mobile phone usage while driving is increasing throughout the world. In this paper, we use survey data from 7,268 U.S. drivers to estimate the relationship between mobile phone use while driving and accidents. We hypothesize that drivers who use mobile phones while driving may be more likely to get into accidents than drivers who do not, even when they are not using the phone. We find evidence for the endogeneity of mobile phone and hands-free device usage, and our analysis suggests that individuals who are more likely to use hands-free devices are more careful drivers even without them. Once we correct for the endogeneity of usage, our models predict no statistically significant increase in accidents from mobile phone usage, whether hand-held or hands-free. Our results call into question previous cost-benefit analyses of bans on mobile phone usage while driving, which typically assume that such bans with have a salutary effect.


The article is devoted to research of the actual [рroblem of developing logical thinking of students in conditions of education digitalization. The aim of the research is analysis of the existing state of the problem of developing logical thinking of students and search of the ways of development of logical thinking using digital technologies. The main tasks of the present research are following: to analyze the role and place of logical thinking in a digital society; to analyze the available foreign and Ukrainian digital educational resources for the development of logical thinking of children of all ages; to separate the digital educational resources that could be used in the educational process in the study of mathematics and computer science; to analyze the possibilities of creating logical tasks using digital technologies. The main results of the research are follow: the place and role of logical thinking in the context of education digitalization is investigated; the place of logical thinking in the system of competence approach to studying in the New Ukrainian school is analyzed; the importance of the development of logical thinking for the formation of key competences of the person of the 21st century is established, in particular for mathematical and information-digital competencies; an overview of open e-learning resources for developing logical thinking of children and adults is presented; the digital educational resources that are appropriate to use in the educational process for the development of logical thinking are highlighted and examples of their using are given; there are given outlines prospects for further research in this area, which consist in a detailed analysis of the features of the process of developing digital educational resources and investigating ways of creating digital educational resources by modern creative educators for the development of logical and creative thinking of students.


BACKGROUND
Trastuzumab has been approved for patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic gastric carcinoma; however, relatively little is known about the role of HER2 in the natural history of this disease.

PATIENTS AND METHODS
Patients enrolled in the INT-0116/SWOG9008 phase III gastric cancer clinical trial with available tissue specimens were retrospectively evaluated for HER2 gene amplification by FISH and overexpression by immunohistochemistry (IHC). The original trial was designed to evaluate the benefit of postoperative chemoradiation compared with surgery alone.

RESULTS
HER2 gene amplification rate by FISH was 10.9% among 258 patients evaluated. HER2 overexpression rate by IHC was 12.2% among 148 patients evaluated, with 90% agreement between FISH and IHC. There was a significant interaction between HER2 amplification and treatment with respect to both disease-free survival (DFS) (P = 0.020) and overall survival (OS) (P = 0.034). Among patients with HER2-non-amplified cancers, treated patients had a median OS of 44 months compared with 24 months in the surgery-only arm (P = 0.003). Among patients with HER2-amplified cancers, there was no significant difference in survival based on treatment arm. HER2 status was not a prognostic marker among patients who received no postoperative chemoradiation.

CONCLUSION
Patients lacking HER2 amplification benefited from treatment as indicated by both DFS and OS.

CLINICAL TRIAL
INT-0116/SWOG9008 phase III.


Purpose Apatinib, an oral small-molecule antiangiogenetic medicine, is used to treat patients with advanced hepatocellular carcinoma. However, its systemic toxic side effects cannot be ignored. The ultrasound (US)-targeted nanobubble destruction technology can minimize systemic drug exposure and maximize therapeutic efficacy. The aim of this study was to develop novel GPC3-targeted and drug-loaded nanobubbles (NBs) and further assess the associated therapeutic effects on hepatocellular carcinoma cells in vitro. Materials and methods Apatinib-loaded NBs were prepared by a mechanical vibration method. GPC3, a liver tumor homing peptide, was coated onto the surface of apatinib-loaded NBs through biotin–avidin interactions to target liver cancer HepG2 cells. The effects of different treatment groups on cell proliferation, cell cycle, and apoptosis of HepG2 cells were tested. Results The NBs could achieve 68% of optimal drug encapsulation. In addition, ligand binding assays demonstrated that attachment of targeted NBs to human HepG2 liver cancer cells was highly efficient. Furthermore, cell proliferation assays indicated that the antiproliferative activities of GPC3-targeted and apatinib-loaded NBs in combination with US (1 MHz, 1 W/cm2, 30 s) were, respectively, 44.11%±2.84%, 57.09%±6.38%, and 67.51%±2.89% after 24, 48, and 72 h of treatment. Treatment with GPC3-targeted and apatinib-loaded NBs also resulted in a higher proportion of cells in the G1 phase compared with other treatment groups such as apatinib only and nontargeted apatinib-loaded NBs when US was utilized. Conclusion US-targeted and drug-loaded nanobubble destruction successfully achieved selective growth inhibition and apoptosis in HepG2 cells in vitro. Therefore, GPC3-targeted and apatinib-loaded NBs can be considered a novel chemotherapeutic approach for treating liver cancer in combination with US.


Paronychia and onycholysis are the common nail disorders with similar fundamental pathological findings. Fungi especially yeasts are frequently isolated. Seventy six patients with chronic paronychia and onycholysis attending the dermatology clinic in Tripoli Medical Center (TMC) were enrolled in a one year study. A detailed history and clinical examination was taken. The majority of cases were females (97.4%), with female to male ratio of 37.5:1. A history of chronic exposure to water was obtained in 88.2% of cases. Chronic paronychia was more common on the right hand; the right middle finger was the most commonly affected organ. Nail clippings and debris under nails were collected for direct microscopic examination and culture. Candida albicans was the most frequently isolated organism (37.9%), followed by Candida tropicalis (30%); C.parapsilosis (20%) and other yeasts were isolated less frequently. This study revealed that C. albicans and other yeasts were important causes of chronic paronychia and onycholysis in the country.


Shaking table is a nonlinear system, which is a more nonlinear system with payload. System can be usually as linear system nearby working point in control strategy. 1 H -estimator or 2 H -estimator is used for identifying the Frequency Response Function (FRF) of the system. 1 H -estimator is a lower-estimator and 2 H -estimator is an over-estimator, both have large estimating errors. In this paper, a new estimator, m H -estimator, is used for the identification of the shaking table system's FRF, and whose parameters are estimated by differential evolution (DE) which makes m H closed to the true FRF H . This control strategy can reduce the steps of iterative learning control (ILC) of shaking table system, and the affection of payload characteristic.


Do history and psychoanalysis intersect? It is when a theorization of the historical study of mentalities was attempted that psychoanalysis, in its structuralist formulation, entered history as a discipline. But, if the renewal of historical biography at the beginning of the 1980s marked the return of the actor, the reference to psychoanalysis disappeared from historical reflection. This apparently paradoxical situation reveals the dilemma created by study of the subjectivity of individuals considered as subjects structured by social and historical contexts.


Videos are commonly used to support learning of new skills, to improve existing skills, and as a source of motivation for training. Video self-modelling (VSM) is a learning technique that improves performance and motivation by showing a user a video of themselves performing a skill at a level they have not yet achieved. Traditional VSM is very data and labour intensive: a lot of video footage needs to be collected and manually edited in order to create an effective self-modelling video. We address this by presenting FakeForward – a method which uses deepfakes to create self-modelling videos from videos of other people. FakeForward turns videos of better-performing people into effective, personalised training tools by replacing their face with the user's. We investigate how FakeForward can be effectively applied and demonstrate its efficacy in rapidly improving performance in physical exercises, as well as confidence and perceived competence in public speaking.


Rotenone, a commonly-used piscicide, interferes with the cellular respiration of aquatic vertebrates and invertebrates by preventing the uptake of oxygen. While dose-response relationships have been developed for fish, there are limited comparative data available on aquatic insects that respire either with tracheal gills or with a plastron – a thin layer of air trapped by hairs on the exterior of the body. This study assesses the temperature-dependent toxicity of rotenone to gill-respiring aquatic insects, family Coenagrionidae, and plastron-respiring aquatic insects, family Corixidae, at concentrations that are lethal to Mozambique tilapia Oreochromis mossambicus. Both groups of insects were found to be differentially susceptible to rotenone, with survival decreasing as functions of both increased concentration and temperature. The dose-response relationship of Mozambique tilapia was found to be similar to that of other fishes, with 100% mortality achieved at 0.025 mg l-1 at both 20 °C and 28 °C. At this concentration, mortality in gill-respiring insects after 48 h was 10% at 20 °C and 28% at 28 °C, which was higher than that of plastron-respiring insects, being 2% and 7% at the same temperatures. At higher concentrations (0.05–0.10 mg l-1), however, mortality of both gill- (>50%) and plastron-respiring (>10%) insects became substantial.


The generation of S-curves for the extinction of counterflow sooting flames has been accomplished by implementing a flame-controlling continuation method inclusive of soot model. The code can generate solutions for augmented flamelets databases, including soot scalars, useful for Flamelet Progress Variable (FPV) tabulations for sooting turbulent simulations. Indeed, the inclusion of all S-curve's branches brings substantial improvements in the reproduction of extinction/re-ignition regimes or flame/acoustic interactions. In this context, developing a reliable tool for S-curve generation, with coupled reproduction of gas-phase and soot characteristics, is of great importance. The algorithm calculates the flamelet states through a 2-point flame-controlling continuation method with control on species mass fractions. Soot calculation is coupled with gas kinetics at every continuation so that flamelet states are inclusive of soot formation effects on precursors' consumption and flame temperature. The flame and soot features can be correctly predicted along the whole curve with smooth transitions between branches. A brief introduction on general S-curve properties is given, using the implementation on hydrogen flames with different oxidizer's inlet temperatures. Besides, soot characteristics are thoroughly investigated on ethylene flames at different pressures.


The present dissertation examines whether the heterogeneity of co-residence experiences and the nest-leaving process have consequences for later parent-adult child relationships in Italy and Sweden. Three aspects of intergenerational linkages are analyzed: residential proximity, the frequency of parent-child contact, and the downward flow of economic resources from parents to their adult children. By devoting particular attention to these three dimensions of intergenerational solidarity, the first chapter presents an overview of the literature on parent-adult child relationships and describes long-standing cultural differences between Italy and Sweden.
In the second chapter, I ask whether in Italy the time spent in the parental home promotes the frequency of contacts between generations, and whether violating social norms regarding the socially accepted time for leaving home is related to less frequent interactions with parents in later life. The findings show that the longer the time adult children spent in their parents' home, the higher the propensity to reside near, and maintain frequent interaction with parents in later life is. In addition, spending longer time in the parental home appears to provide much less benefit for Italian daughters than for sons. Age norms appear to prescribe the socially accepted 'age deadline' for fulfilling expectations for normal adult development. Considering the reasons for leaving home, marriage continues to be the normative occasion to leave the parental family, particularly among adult daughters, who are subject to greater cultural expectations about family ties.
The third chapter devotes particular attention to union dissolution and family conflict during childhood and adolescence as possible mechanisms behind the relationship between nest-leaving processes and later parent-child relationships. The findings reveal that the duration of co-residence is likely to foster family interactions also in Sweden, and this positive relationship is only marginally explained by childhood family experiences. However, late home leavers tend to maintain frequent contacts with parents in part owing to having moved shorter geographical distances, and this is more evident for adult daughters than for sons. In addition, adult daughters who stay at home for longer have more opportunities to form binding relationships with mothers than with fathers.
The fourth study aims to extend the findings of the previous two chapters, by analyzing intergenerational financial transfers and using a within-family approach (or a sibling design). The findings show that in Italy and other southern European countries late home leavers are more likely to receive economic support from their parents, compared to their siblings who move out of the family nest at an earlier age. But this effect is completely mediated by the time since leaving the parental home, indicating that parents tend to facilitate the transition to independence of their young adult children.
The last chapter discusses the findings in the light of previous research. The results of the present dissertation supports the idea that family members' life courses are deeply interconnected, and that previous family history has important long-term consequences for later intergenerational relationships. I provide new insights into how co-residence experiences and events in early adulthood shape later family relations throughout the life course.


It is claimed sedentariness is as much a threat to long- term health as smoking or unhealthy eating, and is not mitigated by bursts of physical activity. Desk bound office workers are particularly vulnerable to this risk, given the inherently sedentary nature of their roles. To tackle this problem in HCI, we have focused largely on smartphones apps whilst embracing a general trend towards automating data collection of behavior. We argue that placing technologies in the environment, leveraging ambient displays and Tangible User Interfaces (TUIs), can offer a more effective approach for tackling sedentary behaviors in an office environment. We include a brief design of a device we intend to use to evaluate these ideas.


Adverse drug reactions are not unusual during Anti-Tubercular Therapy (ATT). One of the common complications of anti-tubercular treatment is drug induced hepatitis and renal insufficiency has also been reported. Renal failure and/or hepatitis encountered during treatment of tuberculosis can have varied aetiologies: drug induced, concomitant viral infection, pre-existing co-morbidities or a combination of these. Since, hepatitis and/or renal insufficiency can be life threatening a prompt diagnosis is warranted, where drugs should be kept as one of the important cause. Identifying the drug helps in treating hepatitis and/or renal insufficiency along with helping the physician to change the combination of ATT regimen. Rifampicin is one of the most important first line drugs in the treatment of tuberculosis. Hepatitis, epigastric distress, anaemia, thrombocytopenia, and interstitial nephritis are reported adverse drug reactions to rifampicin. As per literature rifampicin induced renal toxicity is usually seen on rifampicin re-exposure, or rifampicin administration on alternate days, both being present in this case. Here we are reporting a case of ATT induced renal failure with concomitant hepatitis where rifampicin was suspected to be the cause.


A method is presented for producing long-cone-distance spiral bevel gears using CNC machining center. Due to long-cone-distance, these spiral bevel gears are very difficult to produce, because machine-tool settings exceed the outermost limits of the available dedicated machines. The method removes the limits of the dedicated machine tool. This paper consists of (a) geometric modeling of the long-cone-distance spiral bevel gears, (b) process planning for NC machining based on CAM software. Experimental cuts were made to ascertain the validity and effectiveness of the presented method with a CNC machining center.


There is considerable uncertainty surrounding the future availability of hardwood timber from state-owned native forests in southern Queensland. The timber industry is becoming increasingly reliant on private native forests, where much is on properties primarily managed for beef cattle grazing. Historically, these forests have been periodically high-grade harvested without silvicultural treatment or cleared to increase pasture production where landholders have the right to do so. This study compares these traditional forest management practices at four case study properties against silvopastoral system alternatives. Merchantable timber, pasture and cattle production was estimated for each management scenario with a native forest silvicultural treatment response model. The net present value of each scenario was estimated over a 20-year management period. For all case study properties, the worst-performing forest management scenario was to clear forest for grazing. Investment in silvopastoral systems in southern Queensland was found to be financially attractive, particularly when silvicultural treatments were implemented in year zero to increase timber production. Silvicultural treatments increased the mean annual increment of merchantable timber over 20 years by an average of 1.3 m3/ha/year relative to the scenario where no management was performed in year zero. Forest management scenarios with silvicultural treatments had better financial performance than scenarios without silvicultural treatment. However, long payback periods and sovereign risk are serious impediments to silvopastoral system adoption in southern Queensland. If these concerns can be overcome, private native forests have the potential to be sustainably managed to improve the financial performance of farms, improve regional employment and income generation, supply Queensland's future hardwood timber needs, and increase carbon sequestration and biodiversity conservation on private land.


Background/context Teaching in clinical simulations potentially supports students to develop varied skills sets including teamwork, therapeutic communication, critical thinking and clinical judgment.1 Research into understanding the effectiveness of clinical simulations to develop clinical judgment is growing.2,3 However, little is known about students' experiences of developing clinical judgment skills in clinical simulations and how such skills are likely to translate to making clinical judgments in a clinical setting. The purpose of this research was to understand how students develop clinical judgment skills in clinical simulation-based learning environments. Methodology To explore how undergraduate students develop clinical judgment skills a case study was used to pursue the research goal. Data was collected from March to June 2015. Twelve clinical simulations were observed and twelve participants interviewed twice; once after clinical simulations and again after clinical practice. Permission was given to record video for six of the observed clinical simulations. Additional data included crelated to clinical simulations. Anticipated outcomes An understanding of the opportunities and challenges associated with acquiring clinical judgment skills in simulation-based learning environments in undergraduate nursing education An understanding of how a simulation learning context influences students development of clinical judgment skills An understanding of how to design simulations to influence students development of clinical judgment skills Potential impact A contribution to the knowledge and theory to inform teaching practices in clinical simulations in undergraduate nursing programs. Implications for policy makers grappling with issues surrounding possible substitution of clinical hours with clinical simulations. References Jeffries PR. Simulation in nursing education: from conceptualization to evaluation: National League for Nursing, 2012 Hayden JK, Smiley RA, Alexander M, Kardong-Edgren S, Jeffries PR. Supplement: The NCSBN national simulation study: a longitudinal, randomized, controlled study replacing clinical hours with simulation in prelicensure nursing education. J Nurs Regul. 2014;5(2):C1–S64 Kelly, MA. Investigating the use of simulations in enhancing clinical judgement of students to practice as registered nurses. Sydney: Faculty of Arts and Social Sciences, University of Technology, 2014


Phytoremediation is a recent approach that employs the use of plants for the removal of pollutants from the environment. This approach is cost effective and environment friendly in comparison of other conventional remediation techniques. A greenhouse experiment was conducted in pots to evaluate the lead phytoremediation potential of Rumex dentatus. Pots were divided into six groups and seeds of the plant were grown in them. Plant parts were analysed for the concentration of Pb. The highest concentration of Pb (423.33 mg/kg) was found in the root of group D plants (grown in 250 ppm Pb-contaminated soil) while the minimum concentration of Pb (296 mg/kg) was found in the root of group C plants (grown in 100 ppm Pb-contaminated soil). The maximum concentration of Pb (467.33 mg/kg) in the shoot of the plants was found in group D plants while its minimum concentration (85.33 mg/kg) was found in the shoot of group A plants. Bioconcentration factor (BCF) of the plants for Pb was found higher (18.39) in control group while minimum (0.61) in the plants of group E (0.61). The calculated translocation factor (TF) value of the plants for Pb was found maximum (1.10) grown in group D pots while its minimum value (0.25) was found in the plants grown in group A soil. The maximum bioaccumulation coefficient (BAC) was 6.74 for the Pb in the plants of control group while its minimum value (0.50) was found in the plants grown in group E soil. Only the plant of the R. dentatus grown in 270.77 ppm Pb-contaminated soil showed BCF, BAC and TF values ˃ 1 for Pb. Based on BCF, BAC and TF values, R. dentatus was found feasible for the phytoextraction of Pb from contaminated soil having Pb concentration up to 270.77 mg/kg.


In the course of reviewing publications on Lauraceae, several nomenclatural problems were found. Solving these problems led to the proposal of new names for Litsea pseudoelongata Kosterm. (L. siamensis van der Werff), Cryptocarya lancifolia Kosterm. (C. stenophylla van der Werff), and C. pauciflora Lauterb. & K. Schum. (C. oligantha van der Werff). Beilschmiedia velutinosa Kosterm. is a synonym of B. lanatella Kosterm., and Lindera spicata Kosterm. (1992) is a later homonym of L. spicata Kosterm. (1973). Nectandra roberto-andinoi (C. Nelson) C. Nelson is transferred to Damburneya Raf., and Ocotea ligulata van der Werff is transferred to Mespilodaphne Nees & Mart.


Agency and communion constitute two fundamental dimensions of social perception. Universal dimensions of mate preferences represent both agentic and communal content, but a direct test of mate preferences toward agency and communion is lacking. The present study examined preferences toward agentic and communal traits in mate preferences among 206 heterosexual individuals (112 females), analysing the role of the target's sex and actor's sexual strategy. Results showed that women demonstrated higher expectations toward agentic and communal traits in a potential partner than men. Preference for agency in short-term relationships did not differ from preferences toward agency and communion in long-term relationships, but preferences toward communion of partner in short-term relationships was significantly lower. These results were discussed in light of the signaling role of agency and communion in human mating behavior.


The experience of transport systems users, in terms of comfort, reliability, safety and above all convenience, is critical in determining demand for transport services, at least when there is a choice of alternative ways to travel. Convenience is one of the strongest attractions of the private car for passenger transport. For users of public transport, convenience is also clearly important but not always clearly defined and not often measured in designing transport systems or monitoring their operating performance. In many situations, an increase in public transport convenience reduces the unit costs of travel (euros/dollars per hour or cents per minute) and so provides benefits equivalent to an increase in travel speed. This report focuses on convenience and its importance to the user experience. It reviews operational definitions of convenience, evidence for the willingness of users to pay for convenience and the use of indicators to assess and improve the convenience of public transport, with a view to making it more effective and more competitive.


Effects of titanium addition on as-cast austenite grain size in 0.2 mass% carbon steel cooled at 0.03°C/s has been studied. The average austenite grain size was reduced from 4.3 to 1.9 mm by increasing the titanium concentration from 0 to 0.13 mass%. Two different shapes of Ti(C, N) particles were observed in the solidified samples; one was a facet shape which were dispersed over the whole observation area and the other was a filmy shape, most of which were located on the austenite grain boundary. Thermodynamic calculations and EPMA analyses showed that the facet shaped Ti(C, N) particles crystallize at relatively high temperatures, while the filmy shaped ones form from the last solidifying liquid in the inter-dendritic regions at lower temperatures. The latter Ti(C, N) is considered to provide the grain refinement effect of austenite grain structure. The grain refinement effects of titanium are further discussed by comparing the results of 0.2 mass% carbon steel with those of 0.45 mass % one, which supports the substantial effect of the filmy shaped Ti(C, N) on the as-cast austenite grain structure.


Anthocyanin biosynthesis in plants is influenced by a wide range of environmental factors, such as light, temperature and nutrient availability. In this study, we revealed that the potassium-repressed anthocyanin accumulation in radish hypocotyls was associated with altered sugar distribution and sugar signaling pathways rather than changes in oxidative stress status. Sugar-feeding experiments suggested a hexokinase-independent glucose signal acted as a major contributor in regulating anthocyanin biosynthesis, transport and regulatory genes at the transcriptional level. Several R2R3-MYBs were identified as anthocyanin-related MYBs. Phylogenetic and protein sequence analyses suggested that RsMYB75 met the criteria of subgroup 6 MYB activator, while RsMYB39 and RsMYB82 seemed to be a non-canonical MYB anthocyanin activator and repressor, respectively. Through yeast-one-hybrid, dual-luciferase and transient expression assays, we confirmed that RsMYB39 strongly induced the promoter activity of anthocyanin transport-related gene RsGSTF12, while RsMYB82 significantly reduced anthocyanin biosynthesis gene RsANS1 expression. Molecular models are proposed in the discussion, allowing speculation on how these novel RsMYBs may regulate the expression levels of anthocyanin-related structural genes. Together, our data evidenced the strong impacts of potassium on sugar metabolism and signaling and its regulation of anthocyanin accumulation through different sugar signals and R2R3-MYBs in a hierarchical regulatory system.


Abstract 193 We have previously reported on the adverse prognostic implications of CA, independently contributing to clinical outcome prediction even in the era of gene expression profiling (GEP). The presence of hypodiploidy/deletion13 (CA13/hypo) was associated with a particular poor prognosis, whereas the absence of CA (no CA) imparted superior outcome; the remainder (other CA) had an intermediate prognosis. Here we provide an update of overall survival (OS) and progression-free survival (PFS) with TT1, TT2 control arm (TT2-), TT2 thalidomide arm (TT2+), TT3a, TT3b, TT4-light (TT4-L, fractionated melphalan + VTD), and TT4-standard (TT4-S). The backbone of protocols was tandem transplantation with melphalan 200mg/m2 (MEL-200). TT2 employed thalidomide during all phases of the protocol in a randomized fashion. TT3a introduced bortezomib and 3-yr maintenance with VTD for year 1 and TD for years 2 and 3; TT3b applied VRD with lenalidomide in all 3 years of maintenance; TT4-S used standard MEL-200 as conditioning, whilst in TT4 MEL-50 for 4 consecutive days was given. In addition, TT4L applied 1 instead of 2 cycles of induction and consolidation therapy. Both OS and PFS were consistently superior with "no CA" followed by "other CA" and "CA13/hypo" in all trials including TT4-S (Figure 1). However, there was a striking reversal of the benefit order with TT4-L: "no CA" fared worst, and both "CA13/hypo" and "other CA" had equally superior OS and PFS. The analyses were repeated for TT3 and TT4, limiting TT3 to the ∼85% of patients with GEP-defined low-risk MM, since TT4 was designed specifically for GEP70 low risk MM (Figure 2). In the "no CA" group, 2-yr OS and PFS were >90% in TT3a/b and TT4-S, compared to 75% in TT4-L (p=0.007 and 0.01 for TT3 and TT4-s, respectively). TT4-L patients had ∼90% 2-yr OS and PFS in case of "CA13/hypo" and "other CA", contrasting with ∼60–80% 2-yr OS and PFS for the other protocols. It could be speculated that patients with "no CA" have more slowly cycling micro-environment dependent disease in which the well-recognized MEL dose response relationship is crucial. Conversely, the more genomically unstable "CA13/hypo"-type MM may benefit from the synergistic effect of repeated application of MEL and bortezomib, which could be related to the ability of bortezomib to disrupt protein metabolism required for repair of MEL-induced DNA damage. The basis for these finding is under investigation, but do support the need for further studies investigating novel conditioning regimens and their exact beneficiaries, which could further personalize myeloma care and may be related to bortezomib9s presence in the fractionated melphalan transplant regimen in TT4-L. Disclosures: No relevant conflicts of interest to declare.


Objective: To evaluate the effect of monosialoganglioside (GM-1) in spinal cord trauma patients seen in our service who have not been treated with methylprednisolone. Methods: Thirty patients with acute spinal cord trauma were randomly divided into two groups. In Group 1, patients received 200 mg GM-1 in the initial assessment and thereafter received 100 mg intravenous per day for 30 days and Group 2 (control) received saline. Patients were evaluated periodically (at 6 weeks, 6 months, one year and two years), using a standardized neurological assessment of the American Spinal Injury Association / International Spinal Cord Society. Results: The comparative statistical analysis of motor indices, sensitive indices for pain and touch according to the standardization of ASIA / ISCOS showed that the assessments at 6 weeks, 6 months and 2 years, GM-Group 1 patients had higher rates than the control group regarding sensitivity to pain and touch, with no statistically significant difference from the motor index. Conclusion: The functional assessment showed improvement in the sensitive indices of patients treated with GM1 after post-traumatic spinal cord injury compared to patients who received placebo. Level of Evidence IV, Prospective Case Studies Series.