Purpose/Objectives: High rates of inhaler misuse in patients with chronic obstructive pulmonary disease and asthma contribute to hospital readmissions and increased healthcare cost. The purpose of this study was to examine inpatient staff nurses' self-perception of their knowledge of proper inhaler technique compared with demonstrated technique and frequency of providing patients with inhaler technique teaching during hospitalization and at discharge. Design: A prospective, descriptive study. Setting: A 495-bed urban academic medical center in the Midwest United States. Sample: A convenience sample of 100 nurses working on inpatient medical units. Methods: Participants completed a 5-item, 4-point Likert-scale survey evaluating self-perception of inhaler technique knowledge, frequency of providing patient education, and responsibility for providing education. Participants demonstrated inhaler technique to the investigators using both a metered dose inhaler (MDI) and Diskus device inhaler, and performance was measured via a validated checklist. Findings: Overall misuse rates were high for both MDI and Diskus devices. There was poor correlation between perceived ability and investigator-measured performance of inhaler technique. Frequency of education during hospitalization and at discharge was related to measured level of performance for the Diskus device but not for the MDI. Conclusions: Nurses are a key component of patient education in the hospital; however, nursing staff lack adequate knowledge of inhaler technique. Implications: Identifying gaps in nursing knowledge regarding proper inhaler technique and patient education about proper inhaler technique is important to design interventions that may positively impact patient outcomes. Interventions could include one-on-one education, Web-based education, unit-based education, or hospital-wide competency-based education. All should include return demonstration of appropriate technique.


Clinical treatment response achievable with conventional chemotherapy in high-grade osteosarcoma (OS) is severely limited by the presence of intrinsic or acquired drug resistance, which in previous studies has been mainly addressed for overexpression of ABCB1 (MDR1/P-glycoprotein). This study was aimed to estimate the impact on OS drug resistance of a group of ATP binding cassette (ABC) transporters, which in other human tumors have been associated with unresponsiveness to the drugs that represent the backbone of multidrug treatment regimens for OS (doxorubicin, methotrexate, cisplatin). By using a group of 6 drug-sensitive and 20 drug-resistant human OS cell lines, the most relevant transporter which proved to be associated with the degree of drug resistance in OS cells, in addition to ABCB1, was ABCC1. We therefore evaluated the in vitro activity of the orally administrable ABCB1/ABCC1 inhibitor CBT-1(®) (Tetrandrine, NSC-77037). We found that in our OS cell lines this agent was able to revert the ABCB1/ABCC1-mediated resistance against doxorubicin, as well as against the drugs used in second-line OS treatments that are substrates of these transporters (taxotere, etoposide, vinorelbine). Our findings indicated that inhibiting ABCB1 and ABCC1 with CBT-1(®), used in association with conventional chemotherapeutic drugs, may become an interesting new therapeutic option for unresponsive or relapsed OS patients.


The Mexican regulation NMX-EC-17025-IMNC-2006, establishes that laboratories must have quality control procedures to monitor the validity of tests and calibrations, such monitoring must be planned and reviewed with: a) the regular use of certif ied reference materials or internal quality control of secondary references; b) participation in inter-laboratory comparisons or a prof iciency testing program; c) the repetition of tests or calibrations using the same method or different methods; d) the repetition of the test or the calibration of determined objects; e) the correlation of results for different characteristics of a reference material certif ied by MRC. The quality evaluation of results from the eight laboratories of the Laboratory Network for Analysis, Use, Conservation and Management of Soil (REDLABS) included the elements of sections a), b), c), and d) in order to verify the hypothesis that laboratories emit repeatable, reproducible and unbiased results. In our study, elemental analyzers of different brands were used to measure the total carbon of soil. A certif ied reference material was included in the Inter-comparison Practice. Repeatability and reproducibility of the carbon analyzes were evaluated with samples from the inter-comparison practice; the precision of analyzes from each laboratory was qualif ied with MRC. The results obtained indicate that the laboratories show repeatability in their analyzes with no statistical differences, i.e. reproducibility is detected by inter-comparison. The data issued by the laboratories were unbiased according to their evaluation with certif ied reference material.


This paper intends to design a payload for a Nanosat to record and analyze the Cosmic Microwave Background Radiation (CMBR). Since its discovery in 1965, CMBR has become a much-discussed topic with the speculation that it might hold the key to the birth of our Universe. The big bang theory not only scattered the matter which condensed into galaxies, but also a massive amount of radiation which can be detected by using appropriate instruments, albeit as microwaves due to massive redshift (Redshift is shifting of the wavelength of light or some other form of electromagnetic radiation to the red end of the spectrum. It occurs when a light source moves away from the observer) of our ever-expanding universe. The space missions for detection of CMBR have not been cost efficient, and the Earth-based laboratories deal with too much interference from the surrounding sources. The radiation that was first discovered was of the wavelength 10cm at a reported temperature of 3.5 ± 1 K. The data received about the cosmic microwave background radiation can provide us much information about the anisotropic nature of the observable universe, the cosmic inflation era as well as the recombination era. In the present scenario, CMBR can be detected at a wavelength of about 2 mm. The challenge lies in using a Nanosat in the low earth orbit (LEO) to study CMBR because, being a form of radiation in itself, it is very susceptible to noise from the surrounding sources. The radiation from the sun, the earth as well as the satellite itself will contribute to the noise which needs to be calibrated off since the radiation due to the Cosmic Microwave Background is faint. The interference due to the ambient plasma will also be added to the noise. The antennas are designed with reflectors and calibrated to deal away with all of the aforementioned noises. The use of appropriate rectifiers and amplifiers for selection and amplification of the desired data has also been employed. The whole setup is cooled externally and the orbit selected to minimise the interfering radiation. The spinning of the satellite is controlled to gather desired amount data from a particular region of space. A detailed analysis for noise mitigation and selection of appropriate equipment has been discussed in this paper.


The interaction of the barotropic tide with a tall, two-dimensional ridge is examined analytically and numerically at latitudes where the tide is subinertial, and contrasted to when the tide is superinertial. When the tide is subinertial, the energy density associated with the response grows with latitude as both the oscillatory along-ridge flow and near-ridge isopycnal displacement become large. Where $f\neq 0$ , nonlinear processes lead to the formation of along-ridge jets, which become faster at high latitudes. Dissipation and mixing is larger, and peaks later in the tidal cycle when the tide is subinertial compared with when the tide is superinertial. Mixing occurs mainly on the flanks of the topography in both cases, though a superinertial tide may additionally generate mixing above topography arising from convective breaking of radiating waves.


Abstract The Common Core State Standards for Mathematics have a widespread impact on children's statistical learning opportunities. The Grade 6 standards are particularly ambitious in the goals they set. In this critique, experiences helping children work toward the Grade 6 Common Core statistics expectations are used in conjunction with previous research to identify ways in which the Grades 4–6 standards might be supplemented or revised to help maximize learning. It is suggested that opportunities for children to perceive datasets as aggregates and to draw reasonable conclusions about statistical data by attending to context should be purposefully introduced in Grades 4–5. Currently, the Common Core does not have explicit learning standards for these activities in fourth and fifth grade. It is also suggested that teachers help students question their natural tendencies to focus extensively on the mode when summarizing data. The current standards do not specifically mention the mode. Revising or supplementing the Common Core in the suggested ways holds potential to make the Grade 6 statistical learning standards more attainable for children and to help teachers better anticipate the statistical thinking tendencies that are likely to emerge during classroom discourse.


Sludge are known as waste material or dewatered solid from a commercial or
industrial wastewater treatment plant and potable water treatment plants. It consists
of clay, microorganisms and chemical generated from the use of coagulant material.
The study of sludge is based on municipal treatment plant served by IWK Sdn Bhd.
The objectives of the study are to observe the characteristic of the sludge and
evaluate its potential for recycle or reused. The characteristic observed is physical
properties and chemical properties. In order to meet these objectives the several test
were done in the laboratory material such as sieve analysis, pH value test, moisture
content, classification to soil engineering and heavy metal test. The result from this
study indicates that the sludge is classified as sandy silt according to soil
engineering. The behavior of sandy silt are obtain and used as guide data in recycle
or reused of this sludge. Meanwhile, three elements were carryout from chemical
test. There are Lead Pb, Copper Cu and Zink Zn. The result show those element are
below limit that can harm the environment. Beside that this low content element may
be advantage while recycle or recompose with this sludge. For example, this sewage
sludge can use as raw material to produce lightweight aggregate, absorber for fixbed, and ceramic manufacture.


Objective: To explore experiences, beliefs, and information-seeking behavior around COVID-19 among college students in Oklahoma. Participants: Fifteen college students participated during the pandemic period from April to July 2020. Methods: An exploratory, qualitative research approach method was used to discover students' experiences, beliefs, and information-seeking behaviors around COVID-19. Exploration of beliefs was guided by the Health Belief Model. Results: Students engaged in COVID-19 information-seeking behaviors predominantly through Internet sites, broadcast news, health professionals, and governmental sources. Students experienced emotional burden as a result of COVID-19 misinformation in these sources. While most students perceived a low chance of acquiring the virus due to their lack of underlying medical conditions, they were still concerned about the consequences of becoming infected. Students noted the difficulty of physical distancing while on campus. Conclusions: Colleges/universities should maximize the dissemination of timely, valid health information for the safety of their students and the broader community.


Neurocysticercosis is the commonest parasitic manifestation of brain and the leading cause of seizure in the developing world. It is caused by the ingestion of Taenia solium eggs through contaminated food and especially pork meat. Computed tomography and magnetic resonance imaging are the modality of choice for diagnosis of neurocysticercosis. We report a case of 65 years old male presented with complaint of seizure, which was diagnosed as diffuse parenchymal neurocysticercosis on computed tomography scan of brain. Health Renaissance 2015;13(3): 177-180


Like rural areas in many countries, Japanese rural society is experiencing decline in all spheres (depopulation, aging, lack of economic opportunity, and so on). Uncertainty in the future viability of agricultural livelihoods coupled with the collapse of the forestry sector has decreased the ecological resilience of the Japanese countryside, increasing overgrown forests, habitat and biodiversity loss, and costly wildlife damage to crops. As these rural crises are compounded by the climate crisis, the need for multifunctional solutions that increase the sustainability of rural society and environment as well as promote a shift to a low-carbon economy is great. Biochar implementation projects have the promise of such a solution, although it is still unclear what role they will play in the actual context of rural socio-ecological systems. Also, little is known about how biochar as a technology and food-related product will be accepted by the public. This study looks at these concerns by illustrating the cases of the "Carbon Minus Project," a multi-actor regional revitalization scheme, and COOL VEGE™, an eco-brand for produce cultivated with biochar in a rural area of Japan (Kameoka City, Kyoto Prefecture). In this paper, the socio-economic impacts of biochar as a soil amendment, eco-brand, and traditional technology are examined through the experiences of vegetable farmers (biochar producers), food retailers, and consumers. The potential economic, social, and ecological impact of the Kameoka project are evaluated and the need for biochar projects to drive multifunctional socio-economic structural change are stressed. Permanent URL: http://hdl.handle.net/2047/d20000347


BACKGROUND
Controversy exists regarding the risk of cardiovascular disease (CVD) associated with androgen deprivation therapy (ADT) in patients with prostate cancer. We sought to evaluate the association between gonadotropin-releasing hormone (GnRH) agonists versus GnRH antagonist and the risk of CVD in patients with prostate cancer with or without prior CVD.

PATIENTS AND METHODS
Using administrative databases from Quebec, Canada, we identified first-time GnRH agonists and antagonist (degarelix) users between January 2012 and June 2016. Follow-up ended at the earliest of the following: first CVD event (myocardial infarction [MI], stroke, ischemic heart disease [IHD], arrhythmia, and heart failure [HF]); switch of GnRH group; death; or December 31, 2016. Inverse probability of treatment weighting (IPTW) based on the propensity score was used to control for potential confounding. IPTW-Cox proportional hazards model accounting for competing risks was used to evaluate the association of interest.

RESULTS
Among 10,785 patients identified, 10,201 and 584 were on GnRH agonists and antagonist, respectively. Median age was 75 years (interquartile range, 69-81 years) for both groups. A total of 4,152 (40.7%) men in the GnRH agonists group and 281 (48.1%) men in the GnRH antagonist group had CVD in the 3-year period prior to ADT initiation. Risk of HF was decreased in the antagonist group compared with the GnRH agonist group among patients with prior CVD (hazard ratio [HR], 0.46; 95% CI, 0.26-0.79). Risk of IHD was decreased in the antagonist group in patients without prior CVD (HR, 0.26; 95% CI, 0.11-0.65). Use of antagonist was associated with an increased risk of arrhythmia among patients with no prior CVD (HR, 2.34; 95% CI, 1.63-3.36).

CONCLUSIONS
Compared with GnRH agonists, the GnRH antagonist was found to be associated with a decreased risk of HF, specifically among patients with prior CVD. Among those with no prior CVD, the GnRH antagonist was associated with a decreased risk of IHD but an increased risk of arrhythmia.


The Chinese wind energy sector has undergone rapid development over the past 30 years, yet its path has differed from that of its European counterparts. There is much discussion in the literature on what the path of innovation is for the Chinese wind energy sector and where this path will lead. This research contributes to the literature by attempting to answer three questions: What is the technological path of innovation in China's wind sector? How did this path of innovation emerge? What are the determinants of this path? To fully understand the Chinese wind energy innovation path, this research first summarises the history of the development of wind energy technology from the perspectives of both core technology innovation and deployment technology. The core technology innovation involved a change in strategy from preferring lower prices to preferring higher quality, from small-turbine to large-turbine technology and from imported technology to indigenous technology, while wind energy deployment experienced a path change from a centralised deployment pattern with a partial production chain to a de-centralised pattern with a whole-production-chain strategy. Against these background features, this paper presents three individual cases of a wind turbine producer, a wind farm and a wind blade producer to illustrate how foreign collaboration and technology, choice of deployment strategy, and government policy have influenced the sector to continually improve its technology. The findings indicate that foreign technology and collaboration have had a significant role in helping wind energy technology to develop in China, and were also key elements in stimulating indigenous innovation when high prices held the domestic wind market back from massive expansion. While public policy has played a key role in many aspects of the development of the innovation path, the long-term, enduring goal of developing the required technology was the essential driver. The development of the wind sector occurred alongside the economic development and social improvement of the nation. Thus, while it may be too soon to predict the future path of innovation for Chinese wind energy technology, an emphasis on research and development and increasing international competition is a trend that is likely to continue.


Diallyl sulfide (DAS) and diallyl disulfide (DADS) were used to determine viability and inhibition of arylamine N-acetyltransferase (NAT) activity in human bladder tumor cells. The NAT activity was measured by high performance liquid chromatography assaying for the amounts of N-acetyl-2-aminofluorene (2-AAF) and N-acetyl-p-aminobenzoic acid (N-Ac-PABA) and remaining 2-aminofluorene (2-AF) and p-aminobenzoic acid (PABA). The viability, NAT activity and 2-AAF-DNA adduct formation in human bladder tumor cells was inhibited by DAS and DADS in a dose-dependent manner, i.e. the higher the concentration of DAS and DADS, the higher the inhibition of NAT activity and cell death. The data also indicated that DAS and DADS decrease the apparent values of Km and Vmax from human bladder tumor cells in both systems examined. This report is the first demonstration to show garlic components did affect human bladder tumor cell NAT activity.


In this work we demonstrate spectrally resolved x-ray scattering from electron-plasma waves in shock-compressed deuterium and proton-heated matter. Because the spectral signature of inelastic x-ray scattering is strongly dependent on the free electron density of the system, it is used to infer ionization in dynamically heated samples. Using 2-6 ns, 500 J laser pulses from LLNL's Janus laser, we shocked liquid deuterium to pressures approaching 50 GPa, reaching compressions of 4 times liquid density. A second laser produced intense 2 keV x-rays. By collecting and spectrally dispersing forward scattered photons at 45 degrees, the onset of ionization was detected at compressions of about 3 times in the form of plasmon oscillations. Backscattered x-rays bolstered this observation by measuring the free electron distribution through Compton scattering. Comparison with simulations shows very close agreement between the pressure dependence of ionization and molecular dissociation in dynamically compressed deuterium.In a second set of experiments, a 10 ps, 200 J Titan laser pulse was split into two beams. One created a stream of MeV protons to heat samples of boron and boron-nitride and the other pumped 4.5 keV K-alpha radiation in a titanium foil to probe the hot target. We observed scattered x-rays 300 ps after heating, noting a strong difference in average ionization between the two target materials at temperatures of 16 eV and very similar mass densities. Comparison with electron structure calculations suggests that this difference is due to a persistence of long-range ion structure in BN resulting in high-temperature band structure.These results underscore the importance of understanding the complex electron structure of materials even at electron-volt temperatures and gigapascal pressures. Our results provide new data to guide the theoretical modeling of warm, dense matter important to understanding giant planets and inertial fusion targets.


The tomato (Solanum lycopersicum) protein kinase Pto confers resistance to Pseudomonas syringae pv. tomato bacteria expressing the AvrPto and AvrPtoB effector proteins. Pto specifically recognizes both effectors by direct physical interactions triggering activation of immune responses. Here, we used a chemical-genetic approach to sensitize Pto to analogs of PP1, an ATP-competitive small molecule inhibitor. By using PP1 analogs in combination with the sensitized Pto (Ptoas), we examined the role of Pto kinase activity in effector recognition and signal transduction. Strikingly, while PP1 analogs efficiently inhibited kinase activity of Ptoas in vitro, they enhanced interactions of Ptoas with AvrPto and AvrPtoB in a yeast two-hybrid system. In addition, in the presence of PP1 analogs, Ptoas bypassed mutations either at an autophosphorylation site critical for the Pto-AvrPto interaction or at catalytically essential residues and interacted with both effectors. Moreover, in the presence of the PP1 analog 3MB-PP1, a kinase-deficient form of Ptoas triggered an AvrPto-dependent hypersensitive response in planta. These findings suggest that, rather than phosphorylation per se, a conformational change likely triggered by autophosphorylation in Pto and mimicked by ligand binding in Ptoas is a prerequisite for recognition of bacterial effectors. Following recognition, kinase activity appears to be dispensable for Pto signaling in planta. The chemical-genetic strategy applied here to develop specific small molecule inhibitors of Pto represents an invaluable tool for the study of biological functions of other plant protein kinases in vivo.


The present volume deals with recent developments in the legal profession in Europe and in the United States of America from a comparative and historical perspective. Apart from discussing the legal profession in general, specific attention is paid to the Latin Notary, the Advocates, the Rechtspfleger, the State Attorney, court experts, and mediators and arbitrators. Topics addressed include the decline of Big Law in the U.S., the classification of court experts as legal professionals in Italy, the demise of anticompetitive measures in the modern legal services market, as well as the question whether mediators should be classified as 'new' legal professionals given the fact that mediation services are currently being offered by many of the 'old' legal service providers. The volume concludes with a contribution on the collaboration of various legal professions in providing for the needs of legal practice.


Nowadays, Islamic banking having succeeded in guaranteeing the safety of customer's
wealth worldwide has stepped into tackling the arising issues within the banking sector. The
main objective of the banking system is to ensure the true compliance with the principles of
Islamic commercial jurisprudence through the effective means of supervision. The supervision is
supposed to have been carried out by Islamic experts in a manner which effective and binding
verdicts could be issued but a lot of challenges have been faced. The Islamic advisory board in
an Islamic financial institution has been used for long as a collective fatwa issuing body saddled
with the responsibility of ensuring the shari'ah compliance. However, involvement of
technocrats therein coupled with some bureaucracies; and as well as lack of a suitable legal
framework and enabling environment in support of its operation, have been causing a grievous
injury to the system in recent times most especially in the Modern Muslim countries where
shari'ah is applied side-by-side with other legal systems. In fact, such factors have resulted to
lack of an effective legal framework on Islamic financial activities. It is against this backdrop
that the paper has been jointly looked at the practices in Nigeria and Malaysia with a view to
ascertaining the level playing ground for the performance of their shari'ah advisory bodies. In
the end, the paper revealed that the Malaysian Islamic financial model is a reality compared to
other countries in the world. Hence, the Malaysian model is expected to be suitable and relevant
to the Nigerian system. Thus, the paper suggests among other things that generally, the Federal
Government of Nigeria should adopt the Malaysian model of Islamic financial system;
2
specifically, the paper suggests that the Government in collaboration with Central Bank (CBN)
should facilitate the amendment of the relevant legislation such as the Constitution of Nigeria,
Bank and Other Financial Institution Act (BOFIA) and CBN Act/Regulations in order to pave
way for enacting a suitable Islamic financial regulatory framework; and the Government should
therefore enact a distinctive Islamic financial regulatory framework that can independently
regulate for the Islamic financial activities in the country.


The ISO 9000 standards were first published in 1987. A first, more limited revision was completed in 1994. There is now a more thorough revision underway. A first draft of the suggested new standard has been published in July 1998 and a second draft, expected to be very close to the final version, in February 1999. The changes proposed in these drafts are described and discussed. Summing up, the standard is changing from a technical‐practical tool to a management tool. Four problems with this development are discussed: the sum of demands on management; the comparative strength of the ISO 9000 standard concept; the changed role of the certifying bodies that this change implies; and the implied paradigm of management. The consequences of this may be that the standard turns into a legitimacy seeking management concept alongside other popular "three‐letter acronyms" and thereby adds to the growing amount of hypocrisy in management. This is the year 2000 problem for the ISO 9000 standards.


Background Informing policy and practice with up-to-date evidence on the social determinants of health is an ongoing challenge. One limitation of traditional approaches is the time-lag between identification of a policy or practice need and availability of results. The Right Here Right Now (RHRN) study piloted a near-real-time data-collection process to investigate whether this gap could be bridged. Methods A website was developed to facilitate the issue of questions, data capture and presentation of findings. Respondents were recruited using two distinct methods – a clustered random probability sample, and a quota sample from street stalls. Weekly four-part questions were issued by email, Short Messaging Service (SMS or text) or post. Quantitative data were descriptively summarised, qualitative data thematically analysed, and a summary report circulated two weeks after each question was issued. The pilot spanned 26 weeks. Results It proved possible to recruit and retain a panel of respondents providing quantitative and qualitative data on a range of issues. The samples were subject to similar recruitment and response biases as more traditional data-collection approaches. Participants valued the potential to influence change, and stakeholders were enthusiastic about the findings generated, despite reservations about the lack of sample representativeness. Stakeholders acknowledged that decision-making processes are not flexible enough to respond to weekly evidence. Conclusion RHRN produced a process for collecting near-real-time data for policy-relevant topics, although obtaining and maintaining representative samples was problematic. Adaptations were identified to inform a more sustainable model of near-real-time data collection and dissemination in the future.


Just as Robert Browning repeatedly speaks through other voices in his poems, so does his admirer and critic A. S. Byatt in her fiction, ventriloquizing her characters' poems, stories, letters, and even their academic work. Such writing as Browning's and Byatt's can be understood as mediumistic, a channeling of the voices of the dead or the imaginary. In turn both writers create mediums, Browning in "Mr. Sludge, the 'Medium'" and Byatt in "The Conjugial Angel," one of the two novellas set in Victorian England that form Angels and Insects. Like Browning's Sludge, Byatt's mediums, Sophy Sheekhy and Lilias Papagay, function as figures of the creative writer. Byatt has described Lilias as a "novelist manqué" and Sophy as poet-like. Sludge is critically acknowledged to be a figure of corruption in art, and through him Browning explores the narrative artist's inevitable negotiations between truth, fiction, and lies. Sludge's spiritualist activities are clearly aimed at the greater glory of Sludge. Byatt's mediums, however, are genuinely involved with the mourners and the mourned in the liminal world in which they move. Lilias brings comfort to a bereaved mother, while Sophy transforms the life of Emily Tennyson Jesse, for this novella is based on the most famous case of protracted Victorian mourning, that for Arthur Henry Hallam, the subject of Alfred Tennyson's In Memoriam A.H.H. Browning condemns his character by implication for Sludge's wish that other people should "participate in Sludgehood." Byatt represents Lilias and Sophy as intensely aware of others beside themselves. Thus both through their acts of ventriloquism and through their narratives and characters, Browning and Byatt demonstrate a shared anti-solipsistic aesthetic in texts involving the writer as medium. They turn in imagination to what is outside themselves and represent either negatively (through Sludge) or positively (through Sophy and Lilias) the value of such outward movement.


Autoimmunity plays a role in the development of thyroid dysfunction in human immunodeficiency virus (HIV) infected patients. This study assessed the serum levels of thyroid peroxidise antibody (TPO-Ab) in relation to the various forms of thyroid dysfunction in HIV patients in Kano. Free tri-iodothyronine (fT3), free thyroxine (fT4), thyroid stimulating hormone (TSH) and TPO-Ab were measured using Chemiluminescent immunoassay(CLIA) on the serum of 70 HIV sero-positive patients on Highly Active Antiretroviral Therapy (HAART, as Group I), 70 HAART naïve HIV sero-positive patients (Group II) and 70 apparently healthy HIV negative controls (Group III). The prevalence of thyroid dysfunctions were 55.7%, 42.9% and 2.8% among groups I, II and III respectively. TPO-Ab was elevated in 1 (1.43%) HIV positive patient on HAART, Group I, that also had subclinical hyperthyroidism. Four participants (5.7%) among group III were found to have elevated anti-TPO levels. Thyroid dysfunction was more common among HIV-positive than HIV-negative participants. Thyroid dysfunction among HIV patients was mainly non-autoimmune in origin. However, thyroid autoimmunity appears to play a little role in the development of hyperthyroidism in HIV patients.


The results of static and cyclic axial pile load tests performed on a fully instrumented steel H-pile driven into a glacial till deposit are presented. Cyclic loads were applied through a hydraulic system interfaced with an automated electronic-electromechanical closed loop servo system to achieve a controlled load intensity to the pile in a specific shape (sinusoidal) at specific frequency (0.1 Hz). The load-deflection, load transfer, and configuration of the pile during pile driving and after each load increment was measured through an instrumentation system that consisted of load cells, deflectometers, strain gages, accelerometers, and inclinometers. Data obtained in this investigation indicated that: 1. Axial deformation of the pile remained essentially constant prior to and after cyclic axial load application. The behavior of the pile was essentially elastic during cyclic load application. 2. Within the scope of testing performed, cyclic vertical load increments do not effect the load carrying capacity or load transfer characteristics of the pile. 3. Load transfer characteristics varied with the magnitude of applied axial load. The ratio of point bearing resistance to the applied load increased with the applied load. However, the rate of increase generally decreases with increasing applied load.


Abstract : Research was conducted in the following areas of interest: (1) A paper entitled 'Intra-Plate Seismicity, Reactivation of Pre-Existing Zones of Weakness, Alkaline Magnetism, and Other Tectonism Post-Dating Continental Fragmentation'; In one portion of the paper the tectonics of the French test site in Algeria are investigated. The study shows that the test site is not in the middle of a shield area. Other authors have shown that tectonic setting is significant in estimating yield from seismic amplitude. (2) A study is underway to investigate the possible correlation between P-residuals observed by the New York State Seismic Network and tectonic-structural features. (3) An investigation of anomalous relative residuals for P and PP arrivals from earthquakes with reflection points beneath Tibet. Some residuals are significantly larger (more positive) than those expected for a double crust. (4) Source parameters for earthquakes of relatively small magnitude are being determined using the spectra of Rayleigh waves at about 25 WWSSN stations. (5) Calculation of the reflection and transmission coefficients for Rayleigh waves inpinging upon a vertical discontinuity at oblique angles. (6) Calculation of moment and average shear stress for two earthquakes in the Aleutian subduction zone from strong-motion accelerograph records. (7) Development of more sophisticated tectonic models of the current tectonic processes in the Himalayas, Hindu Kush, Tien Shan, and Pamir Mountains. (8) An analysis of the correspondence between documented teleseismic earthquakes and mapped faults in Pakistan.


Recent advances in adversarial attacks uncover the intrinsic vulnerability of modern deep neural networks. Since then, extensive efforts have been devoted to enhancing the robustness of deep networks via specialized learning algorithms and loss functions. In this work, we take an architectural perspective and investigate the patterns of network architectures that are resilient to adversarial attacks. To obtain the large number of networks needed for this study, we adopt one-shot neural architecture search, training a large network for once and then finetuning the sub-networks sampled therefrom. The sampled architectures together with the accuracies they achieve provide a rich basis for our study. Our ''robust architecture Odyssey'' reveals several valuable observations: 1) densely connected patterns result in improved robustness; 2) under computational budget, adding convolution operations to direct connection edge is effective; 3) flow of solution procedure (FSP) matrix is a good indicator of network robustness. Based on these observations, we discover a family of robust architectures (RobNets). On various datasets, including CIFAR, SVHN, Tiny-ImageNet, and ImageNet, RobNets exhibit superior robustness performance to other widely used architectures. Notably, RobNets substantially improve the robust accuracy (~5% absolute gains) under both white-box and black-box attacks, even with fewer parameter numbers. Code is available at https://github.com/gmh14/RobNets.


1. Multiply resistant strains of Staphylococcus aureus often harbor one or more extrachromosomal drug resistant factors as well as temperate prophages capable of mediating generalized transduction. 2. Spontaneous transduction occurs in mixed cultures of such staphylococcal strains, and the extrachromosomal resistance factors are involved more frequently than are chromosomal genes. 3. Spontaneous transduction of extrachromosomal determinants of erythromycin resistance and of linked penicillin-erythromycin resistance occurs in the kidneys of mice in which mixed infection has been induced.


Flowers have been a universal cultural object for millennia. They are an important aesthetic element in everyday life worldwide, and have played a highly symbolic role in art throughout the ages. Over the past few years, Makoto Azuma has created a furor in the art world with his floral installations, in which he creates unusual new shapes from plants and flowers and their component parts. Inspired by the Japanese tradition of ikebana - the art of flower arranging - Azuma creates novel and previously unseen aesthetics by bringing together unusual plants that wouldn't usually meet in nature - some of them exotic - in extraordinary arrangements. Shunsuke Shiinoki, who opened the "haute-couture" florists Jardin des Fleurs in Tokyo in 2002 in association with Makoto Azuma, captured these exceptional floral installations in extraordinary photographs.


Background There is limited evidence supporting a replacement interval of infusion sets for continuous subcutaneous insulin infusion (CSII). The aim of this study was to investigate if steel and soft cannula infusion sets can be used in CSII therapy for up to 7 days without negative impact on infusion sites or glycemic control. Methods The insulin infusion sets YpsoPump® Orbit®micro (steel needle) and YpsoPump® Orbit®soft (soft cannula) were each used for up to 7 days by 40 adult subjects with CSII. Each subject used both infusion set types twice. Early replacement reasons were documented and glycemic control was monitored. Results Of 160 inserted insulin infusion sets, 66% were used for 7 days with no obvious difference between steel and soft infusion sets. The mean wearing time was 6.2 ± 1.5 days. Main reasons for early infusion set replacements were occlusions (19%), plaster issues (4%) and accidental pull-out (4%). Comparing glycemic control during day 1-3 and day 1-7, mean glucose was 146 ± 21 mg/dl vs. 148 ± 18 mg/dl, coefficient of variation was 34 ± 7% vs. 33 ± 5% and insulin dose was 40 ± 11 U vs. 41 ± 11 U. Only mild and non-serious infusion site reactions occurred. Conclusions In this study, 7 days indwelling time of insulin infusion sets did not show a clinically relevant impact on glycemic control or insulin requirements and the infectious risk appeared to be low. The replacement interval of infusion sets may be individualized beyond the currently labeled maximum use duration.


Abstract Thomas Piketty's Capital and Ideology (2020) offers a powerful critique of ideological justifications for inequality in capitalist societies. Does this mean we should reject capitalist institutions altogether? This paper defends some aspects of capitalism by explaining the epistemic function of market economies and their ability to harness capital to meet the needs of the relatively disadvantaged. We support this classical liberal position with reference to empirical research on historical trends in inequality that challenges some of Piketty's interpretations of the data. Then we discuss the implications of this position in terms of limits on the efficacy of participatory governance within firms and the capacity of the state to levy systematic taxes on wealth.


Abstract. The development of the railways network in the 19th century represented a significant scenario for the technological advancement of the entire Italian building sector; consequently, it produced a relevant renewal of construction techniques. Icons of this robust infrastructure building program were the railway bridges built over the Po river; their construction represented an arduous technological challenge. Unfortunately, in the years following the proclamation of the Kingdom of Italy the national industry was disorganized and unprepared to face this ambitious challenge; indeed, the first four bridges were built by foreign companies that could guarantee the necessary technological know-how. However, the industrial scenario immediately changed and the last two bridges were designed and built by Italian engineers and steelwork companies. The railway bridges over the River Po are now lost; the changing needs of railway traffic or bombings during the Second World War unavoidably led to their demolition. Their enhancement through 3d modelling and virtual representation is fundamental for the rediscovering of the role they played not only in the construction of the national infrastructural system but also in the life of the young state. To this aim, the paper proposes the outcomes of research that explores the potentialities of 3d software with Visual Programming Language (VPL), in order to create modelling tools useful for the disclosure and dissemination of the historical value of this lost heritage.


There is an increasing quest for sustainable development in the built environmental through the use of alternative construction materials. Basalt fibre is one of those materials that is currently gaining interest in concrete production, because it is environmentally friendly, and also has good mechanical features. The current study evaluates the workability, strength properties, impact resistance and hydration characteristics of high strength chopped basalt fibre-reinforced concrete. Basalt fibre was used in varying proportions, and manufactured sand was used as a total replacement of natural fine aggregate, while other natural materials were kept constant, when casting concrete specimens. The results showed that increasing the cut length of basalt fibre could enhance the strength characteristics and impact resistance of concrete. Overall, the study revealed an improved impact resistance in the tested concrete, which could be traced to be a result of rapid hydration.


The SAGD (Steam Assisted Gravity Drainage) is an enhanced oil recovery process for heavy oils and bitumens. To simulate this thermal process and obtain precise forecasts of oil production, very small-sized cells have to be used because of the fine flow interface. But the use of fine cells throughout the reservoir is expensive in terms of CPU time. To reduce the computation time one can use an adaptive mesh refinement technique which will use a refined grid at the flow interface and coarser cells elsewhere. The first numerical tests of SAGD modelling, using a criterion based on two threshold temperatures, showed that this adaptive-mesh-refinement technique could reduce significantly the number of cells [LLR03]. Nevertheless, the refined zone remains too wide. In this work, we introduce a new criterion for the use of adaptive mesh refinement in SAGD simulation. This criterion is based on the work achieved in [KO00] on a posteriori error estimators for finite volume schemes for hyperbolic equations. It enables to follow more precisely the flow interface. Through numerical experiments we show that the new criterion enables to further decrease the number of cells (and thus CPU times) while maintaining a good accuracy in the results.


This paper describes the implementation of a high-resolution three-dimensional model of the estuary "Sundalagið Norður". This estuary is bound by narrow sills in both ends and has a large semidiurnal tidal variation. The proximity to an amphidromic region, results in a periodically varying difference in sea level height between both ends of the estuary, which generates strong semidiurnal tidal currents across the sills. The available observational data support the model results. The model results verify the dominance of tidal forcing with semidiurnally varying volume fluxes into and out of the estuary. The 5 amplitudes of these fluxes vary in strength with the fortnightly variation between spring and neap tides. More surprisingly, the model also indicates a strong fortnightly variation of net fluxes averaged over 25 hours reducing both diurnal and semidiurnal tidal currents. These variations are caused by fortnightly variations in sea level difference between both ends of the estuary, which are verified by comparison with observed sea level variations. This rather surprising result implies that exchanges within the estuary and with its surroundings vary systematically; typically with one week of net northward flow followed by one week 10 of net southward flow. This variation also appears to affect the mixing processes in the estuary and should be taken into account in planning development or activities. More observational data would be beneficial to validate the model more thoroughly and we recommend that a dedicated experiment with combined observations and numerical modeling is implemented.


Medical historians of the future may look back on the last seventy-five years as a period when accretions of data regarding the mechanisms of many diseases led their excited but often naive devotees on an intellectual bender. Misunderstanding of the whole process of such disorders as infection came about largely through neglect of careful consideration of the host. This neglect, of course, was not confined just to recent times, and in the charming group of essays entitled "The Pedigree of Disease" Jonathan Hutchinson long ago emphasized the person in his striking discourse on disposition, temperament, and diathesis. In fact, these sound concepts constituted the great bulk of what our medical forefathers understood about treating the sick. It should be emphasized again and again that they treated patients wonderfully well, while we treat the disease, well enough but often to the considerable and unhappy neglect of the sick man or woman.


Is there a fair way for policymakers to free the American economy from the specter of never-ending asbestos litigation? Even though the number of cancer deaths attributed to asbestos exposure has been dropping since 1992, some 80 firms linked to asbestos production and use have gone bankrupt, and some $54 billion has been paid out in compensation to sufferers of various asbestos-related illnesses, the number of new asbestos-related claims has begun rising in recent years. Unlike other mass torts, asbestos litigation has no natural ending point because the number of plaintiffs and potential defendants is virtually unlimited - bankrupt asbestos manufacturers are replaced as defendants by firms that sold or installed asbestos-containing products, manufacturers whose products incorporated an asbestos-containing component, or owners of production facilities that had asbestos insulation in their buildings. Needless to say, this litigation and potential future litigation poses a severe threat to the U.S. economy. Is there a way to resolve all this litigation efficiently and, at the same time, fairly compensate plaintiffs and potential plaintiffs?


A simple, sensitive and reproducible reversed phase high performance liquid chromatography (RP-HPLC) coupled with a UV det ector method was developed for the quantitative determination of metaxalone (MET) in pharmaceutical dosage forms. Th e method is applicable to the quantif ication of related substances and assay of drug product. Chromatographic separation was achieved on a BDS Hypersil C-18 (150 mm x 4.6 mm, 5 μ m) column. The optimized isocratic mobile phase consists of a mixture of methanol: water, in the ratio of 90:10 % v/v. The eluted compounds were monitored at 279 nm for MET assay, the flow rate was 1 mL/min, and the column oven temperature was maintained at room temperature. The developed method separated MET from its excipients within 6.0 min. The developed method was validated as per International Conference on Harmonization (ICH) guidelines. The method was validated for specificity, linearity, precision, acc uracy, robustness and system suitability. The method was linear in the drug concentration range of 10-60 μ g/mL. The precision (% RSD) of six samples was 1.67. The mean recoveries were between 100.96%. The proposed method can be used successfully for routine analysis of the drug in bulk and combined pharmaceutical dosage forms.


This article describes TRAIL, a model developed within Leicestershire Partnership NHS Trust's City Adult Mental Health Services to facilitate incident reporting and active learning from adverse events. In common with other similar trusts, LeicestershirePartnership NHS Trust has successfully implemented a risk management strategy that has encouraged staff to report adverse events, but this does not guarantee that all staff are aware of why incidents should be reported, and the challenge to move away from the 'blame culture' of old has remained real. As a service, we identified the need to move to the next stage of development that involves learning lessons from these events and engaging staff within clinical services in identifying changes required within their team practices. The TRAIL model has provided the service with a framework for identifying the lessons that could be shared more widely and raising awareness of individual and team responsibilities for maintaining safer services.


It is widely accepted that immunoglobulin (Ig)E triggers immediate hypersensitivity responses by activating a cognate high-affinity receptor, FcεRI, leading to mast cell degranulation with release of vasoactive and proinflammatory mediators. This apparent specificity, however, is complicated by the ability of IgE to bind with low affinity to Fc receptors for IgG, FcγRII and III. We have addressed the in vivo significance of this interaction by studying IgE-mediated passive systemic anaphylaxis in FcγR-deficient mice. Mice deficient in the inhibitory receptor for IgG, FcγRIIB, display enhanced IgE-mediated anaphylactic responses, whereas mice deficient in an IgG activation receptor, FcγRIII, display a corresponding attenuation of IgE-mediated responses. Thus, in addition to modulating IgG-triggered hypersensitivity responses, FcγRII and III on mast cells are potent regulators of IgE-mediated responses and reveal the existence of a regulatory pathway for IgE triggering of effector cells through IgG Fc receptors that could contribute to the etiology of the atopic response.


Aim: To evaluate clinical and radiographic aspects before and after endodontic treatment with an intracanal dressing paste composed of calcium hydroxide, chlorhexidine and zinc oxide in traumatized teeth followed-up for 1 year. Methods: Patients (n=105) treated at the Dental Trauma Service of Piracicaba School of Dentistry, Brazil were enrolled in the study. Two groups of teeth were formed: immature (G1) (n=28) and completely developed teeth (G2) (n=174). All teeth were endodontically treated and received an intracanal dressing with a paste composed by calcium hydroxide, 2% chlorhexidine gel and zinc oxide at a 2:1:2 rate. Clinical and radiographic aspects were evaluated initially, monthly and after 1-year. Results: Most of the immature teeth suffered extrusive luxation (39.3%), whereas intrusive luxation (40.8%) was more common in completely developed teeth. There was a significant reduction in pain on percussion and mobility (p=0.0001) for immature teeth. Mature teeth showed reduction of spontaneous pain, fistula, mobility and pain on percussion (p<0.0001). Radiographic examination showed decrease in all evaluated parameters for both groups, in addition to stabilization of root resorption. Conclusions: This new intracanal dressing paste for traumatized teeth showed promising results in both immature and completely developed teeth, and may prevent posttraumatic complications.


In this research, the output of an arrayed type tactile sensor is simulated by using a finite element method. The information of this output is processed using a neural network, and the 14 types of objects are recognized. This recognition succeeded even if the contact position and the rotation angle of these objects are changed.


Self-supervised learning (SSL) of graph neural networks is emerging as a promising way of leveraging unlabeled data. Currently, most methods are based on contrastive learning adapted from the image domain, which requires view generation and a sufficient number of negative samples. In contrast, existing predictive models do not require negative sampling, but lack theoretical guidance on the design of pretext training tasks. In this work, we propose the LaGraph, a theoretically grounded predictive SSL framework based on latent graph prediction. Learning objectives of LaGraph are derived as self-supervised upper bounds to objectives for predicting unobserved latent graphs. In addition to its improved performance, LaGraph provides explanations for recent successes of predictive models that include invariance-based objectives. We provide theoretical analysis comparing LaGraph to related methods in different domains. Our experimental results demonstrate the superiority of LaGraph in performance and the robustness to decreasing of training sample size on both graph-level and node-level tasks.


Antigen-treated lymphocytes from immune hamsters specifically protected not only macrophages, but also cultured fibroblasts and kidney cells infected with Toxoplasma gondii or Besnoitia jellisoni. Macrophages were not necessary for the protection of fibroblasts and kidney cells. A mediator that inhibited the intracellular proliferation of these microbes was obtained from immune lymphocytes in contact with specific antigen. Again, macrophages were not necessary for the elaboration of this mediator or its activity in kidney cells or fibroblasts. The mediator was microbe and host specific, had a molecular weight between 4,000 and 5,000, was resistant to heating at 56 degrees C for 30 min, and was sensitive to chymotrypsin, but resistant to ribonuclease and deoxyribonuclease. A single injection of Besnoitia mediator afforded better protection to hamsters infected with Besnoitia than did antibody. Whereas antibody lysed extracellular organisms, the microbe-specific mediators conferred immunity not only on macrophages, but also on other cells of the body, apparently the first such demonstration.


Rice is grown abundantly in all of the South Asian countries. About 130 wt% of net rice production is generated as biomass solid waste in the form of rice straw. The biomass solid waste has been characterized to investigate its suitability as feedstock for thermochemical conversion. Considering this availability of rice straw, its favorable volatile content, and elemental and thermal characteristic, an attempt has been made to convert the solid waste into bio-oil. The solid rice straw in particle form was pyrolysed in an externally heated 1443 cm 3 volume fluidized bed reactor with nitrogen as the fluidizing gas and silica sand as the bed material. A renewable energy biomass source cylindrical heater and a gravity feed type reactor feeder were used to heat and to feed the reactor, respectively. The pyrolytic products were oil, char and gas. The product yields were found to be significantly influenced by the process conditions. The physical properties, calorific value, elemental (CHONS) analysis and chemical composition using Fourier Transform InfraRed spectroscopy ( FTIR ) of the product oil were determined. The oil obtained at maximum liquid yield condition was considered for these analyses. The optimum reaction condition was at 450 ° C reactor bed temperature and 31 l/min fluidizing gas flow rate. The results of the analyses showed that the oil was highly oxygenated, acidic in nature with moderate heat value and favorable pour and flash points.


Abstract Coastal vulnerability and its physical, economic and social consequences at national and international scales is of high scientific, political and policy interest. Anthropogenic climate change and coastal erosion threaten the very fabric of a society. Indications, that coastal hazards are impacting diverse coastal areas severely across the world, and it is no longer a vague future threat that can't be ignored. Rising eustatic sea levels synthesized by the growing frequency and scale of coastal hazards like storm surges, coastal erosion and coastal landslides threaten low-lying and unprotected coastal areas in the United Kingdom even if they have coastal defenses. However, there is still significant uncertainty about the degree of vulnerability along different coastal stretches, particularly in England. To fill this uncertainty, the current study estimated the coastal vulnerability of the coastal erosion hotspot Camber, England, by establishing a coastal vulnerability index. This index was developed by compounding various existing parameters and termed as Erosion Coastal Vulnerability Index (ECVI). Results illustrate that 67% of coastal area fall between high and very high vulnerability categories, and current coastal defenses are not strong enough to tackle the severe coastal erosion in Camber. Within the evaluation, thematic maps were generated to enable the intensity of the vulnerability for different coastal stretches to be identified. The evaluated vulnerable hotspot should be treated urgently by regional and national policy organizations to ameliorate the impacts of coastal erosion and other associated risks. Without action, the hotspot is likely to encounter unprecedented new vulnerabilities, disasters and humanitarian catastrophes. The current study results allow for a local, regional and national comparison that may help to evaluate changes in coastal erosion vulnerability.


Abstract

Although cord blood is important in human development, its functions are not well understood. Cord blood shows high potential for use in research studies aimed at maintaining a healthy, long life, as it contains various functional components such as anticancer agents against leukemia. Recently, D-Allose, a stereoisomer of D-glucose, was found in human umbilical cord blood and sera of women. D-Allose has been shown to have anti-cancer activity, reduce reperfusion damage, and have anti-metabolic syndrome effects. Previously, Chen et al. reviewed the production and function of D-Allose but did not discuss its potential as a medical drug based on its presence in women's serum, its safety in humans, its GMP manufacturing, its efficacy in liver injury, its influence on animal lifespan, the biological activity of its derivatives, or its applicability as a diagnostic reagent. In this review, we cite new references and describe the above points of D-Allose and its potential for pharmaceutical applications.


Applying probabilistic models to reinforcement learning (RL) enables the application of powerful optimisation tools such as variational inference to RL. However, existing inference frameworks and their algorithms pose significant challenges for learning optimal policies, e.g., the absence of mode capturing behaviour in pseudo-likelihood methods and difficulties learning deterministic policies in maximum entropy RL based approaches. We propose VIREL, a novel, theoretically grounded probabilistic inference framework for RL that utilises a parametrised action-value function to summarise future dynamics of the underlying MDP. This gives VIREL a mode-seeking form of KL divergence, the ability to learn deterministic optimal polices naturally from inference and the ability to optimise value functions and policies in separate, iterative steps. In applying variational expectation-maximisation to VIREL we thus show that the actor-critic algorithm can be reduced to expectation-maximisation, with policy improvement equivalent to an E-step and policy evaluation to an M-step. We then derive a family of actor-critic methods from VIREL, including a scheme for adaptive exploration. Finally, we demonstrate that actor-critic algorithms from this family outperform state-of-the-art methods based on soft value functions in several domains.


This paper presents the flow and heat transfer characteristics in a cross-linked silicon microchannel heat sink. The heat sink is composed of 45 channels, 270 μm wide × 285 μm tall in a silicon substrate formed via deep reactive ion etching. A detailed discussion of the pressure drop data reduction is described, including characterization of the channel cross-sections and methods to account for inlet and exit loss coefficients. No significant difference is observed in the pressure drop measurements between the cross-linked and standard heat sinks flowing air and water. The use of un-encapsulated liquid crystal thermography was successfully utilized to obtain local heat transfer data with FC-72 as the working fluid. The heat transfer results show inflections in the thermal profile due to the cross-links.Copyright © 2007 by ASME


Introduction: The reduction of cardiovascular risk by lowering low-density lipoprotein cholesterol (LDL-C) is well documented, and LDL-C remains the main target of lipid lowering therapy. However, not all patients with cardiovascular risk have elevated LDL-C. There is growing recognition that non-high density lipoprotein cholesterol (Non-HDL-C) is strongly related to cardiovascular risk. Aim: This study was done to evaluate the importance of Non-HDL C in predicting cardiovascular risk in type 2 Diabetes Mellitus. Methods: 100 type 2 diabetic patients were taken as subjects. Fasting and post meal blood sugar, lipid profile, and Non-HDL C was analysed in these patients. The patients were divided in two groups depending on their Non- HDL C level; ≤130 mg/dl and > 130mg/dl. Result and discussion: In this study it was seen that, age 25 kg/m2 and LDL cholesterol >100mg/dl were associated with having Non-HDL cholesterol >130mg/dl. Conclusion: The results showed positive correlation between Non-HDL and LDL cholesterol. It also showed significant non achievement of Non-HDL cholesterol targets of ≤130mg/dl even if LDL cholesterol targets were achieved i.e. <100mg/dl suggesting the importance of measuring Non - HDL Cholesterol to predict the risk of cardiovascular disease in type 2 diabetes.


Information hiding controls which parts of a class are visible to non-privileged and privileged clients (e.g., subclasses). This affects detailed design specifications in two ways. First, specifications should not expose hidden class members. As noted in previous work, this is important because such hidden members are not meaningful to all clients. But it also allows changes to hidden implementation details without invalidating correctness proofs for client code, which is important for maintaining verified programs. Second, to enable sound modular reasoning, certain specifications must be visible to clients. We present rules for information hiding in specifications for Java-like languages, and demonstrate their application to the specification language JML. These rules restrict proof obligations to only mention visible class members, but retain soundness. This allows maintenance of implementations and their specifications without affecting client reasoning.


This paper presents the correspondence between the Romanian linguist S. Puscariu, the founder of "the linguistic school of Cluj", and the Swedish Romanist Alf Lombard, who dedicated a great part of his energy and work to the study of the Romanian language, becoming one of the best known specialists in Romanian. There have been preserved eleven letters sent by Pu ș cariu and twelve letters sent by Alf Lombard (between 1935 and 1947). They offer interesting information for the history of linguistics, about their scientific activity and about the political situation in Transylvania during the WWII.


A contribution to management philosophy is made here by the development of a postcolo-nial-storytelling theory, created by drawing together parallel developments in quantum physics and tribal peoples' storytelling. We argue that these developments resituate the hegemonic relationship of discursive representationalism over material storytelling practices. Implications are two-fold. First, this dissolves inherent dualisms presumed in the concept of interaction among entities like actor–structure, subject–object and discursive–nondiscursive in favour of a profound ontology of entanglement and intra-action of materiality and discourse, where storytelling is a domain of this discourse. Second, postcolonial phenomena are understood as results of entangled genealogies in which plural voices are present. This implies an understanding and awareness of the intra-action of imperial narratives and material storytelling and antenarrative resistance, and thus the resistance and contestation to imperial and colonising monologic narratives of spatial and temporal alignment.


This paper reports the development of a new charge amplification approach for photoacoustic tomography (PAT) based on parallel acoustic delay line (PADL) arrays. By using a PADL array to create different time delays, multiple-channel PA signals can be received simultaneously with a single-element transducer followed by single-channel DAQ electronics for image reconstruction. Unlike the conventional voltage amplifiers whose output voltage drops with increasing transducer capacitance, both theoretical analysis and experimental results have shown that the charge amplification can provide almost constant transducer-amplifier gain, which is not affected by the transducer capacitance. Therefore, it allows the use of a large single-element transducer to interface many PADLs without sacrificing the SNR of each channel. This opens the possibility of using large PADL arrays to achieve PAT with a wide field of view and high lateral resolution.


Universities worldwide facing a dilemma in identifying effective models of improving the
quality education to their students at UG and PG levels in order to inculcate employable skills and innovative abilities as per industry requirement. Industries and industry sectors also struggling to identify young graduates who can be innovators to add new ideas and models to add values to their existing products and services to survive, sustain and differentiate in present business competition. This, in turn, developing pressure on Universities to re-define their education models including, suitable subject identification, developing and offering industry related curriculum, effective teaching – learning methodologies including suitable customized pedagogy and use of educational technology to boost the confidence and innovative thinking abilities of graduates. In this paper, we have made an attempt to analyse the present trend in global Higher Education, their effect on Indian University education, technology and its impact on university education model, how research can differentiate campus based university education, Innovations in University research including author centric scholarly publication for copyright based IPR and Student Centric Curriculum for Patent Based IPR. The paper also proposed a model of promoting research at UG and PG levels boosts the Innovative ability of students and faculty members towards excellency. Finally, the authors made some recommendations to reimage the universities towards world-class universities.


formally opened on July 3rd by Lord Provost Sir William L. Sleigh. The first block of the settlement consists of a substantial building containing five houses, eaclh house including a living room and small kitchen downstairs, with two bedrooms and other accommodation upstairs; a generous amount of garden space is allowed to each tenant. Lord Salvesen, chairman of the association, who presided at the opening ceremony, said that in the eleven years since the association had commenced to ask for subscriptions nearly 200 houses for disabled men' and their families hlad beenl provided. These houses were at present inihabited by something like 1,C00 people, so that the association had done something towards both solving the housing probiem and repaying their debt of gratitude to the meni who had suffered most in the war. The Lord Provost, in declaring the settlement open, said that the work of the association had extended all over Scotland, and the present was the eighteenith settlement where disabled men could live in comfort and bring up their families amidst -healthy and pleasant surroundings. Although no actual rent was charged for the houses the occupant was called upon to pay the rates and taxes and other onicosts. He believed that no other country was in possession of a scheme such as this. It was mentioned that the cost of eaclh house was now about £600.


The outcome of Leishmania infections varies substantially, depending on the host and the parasite strain; infection may be asymptomatic or cause mild or severe skin ulcers (cutaneous leishmaniasis [CL]), limited or disseminated lesions, or lethal visceral disease. We previously reported an association between IL-2R mutations and susceptibility to visceral leishmaniasis in children infected with Leishmania donovani. In the present study, we evaluated the possible role of IL-2 signaling in human CL. We first showed that the transcripts of several genes of the IL-2 pathway were abundant in skin lesions caused by Leishmania braziliensis. We then carried out a genetic analysis, focusing on major genes of the IL-2 pathway. We used a family-based approach and found that polymorphisms of several genes appeared to be associated with CL in a Brazilian population. Moreover, two polymorphisms of the IL2RA gene were significantly and independently associated with CL. We confirmed this result in a second Brazilian sample (also exposed to L. braziliensis) and in Iranians infected with Leishmania tropica: IL2RA rs10905669 T (Pcombined = 6 × 10−7) and IL2RA rs706778 T (Pcombined = 2 × 10−9) were associated with greater susceptibility to lesion development. These alleles were also correlated with a poor IFN-γ response and poor FOXP3+ regulatory T cell activation. Thus, IL-2 plays a crucial role in protection against the cutaneous ulcers caused by Leishmania, and the IL-2 pathway is a potential target for strategies aiming to control Leishmania-related diseases.


Mouse thymic stromal cells growing in vitro have been stained with fluorescent antibodies to identify the cells found in these cultures. By means of anti-cytokeratin antibody 35 beta H11, it could be shown that nearly all the cells in the cultures were epithelial. Three other antibodies which bind to specific regions of the thymus were used to detect subpopulations of the epithelial cells. Cells growing as confluent carpets stained with antibody ER-TR5, which is specific for medullary epithelium. Antigens for two other antibodies, MD2 (known to label cells at the medullary side of the cortical-medullary junction) and CDR1 (which reacts with cortical epithelium) were expressed on the cultured cells only after the addition of exogenous signals. MD2 antigen was expressed on a very small percentage of the cells incorporated into networks as well as a few dispersed cells, and seemed related to the activity of fibroblasts. CDR1 antigen appeared on the majority of the cells organized into networks and those dispersed in the cultures. Gamma-interferon (IFN-gamma) and IL-2, lymphokines usually associated with T-cell reactivity, were found to be involved in its expression. It was possible to isolate the CDR1 subpopulation from the cultures by means of the antigen present on the surface of these cells.


Progress in comprehensive utilization of salt lake and related resources in recent years is reviewed in this paper. Production, consumption, and prices of some salts are also concerned. And then, sustainable development and exploitation of the resources are briefly discussed.


Urban green spaces impact the individual and collective health of populations. At the city level, they act as regulators of environmental hazards and constitute collective protective factors. At the individual level, they constitute social spaces for encounters and rejuvenation. But, these functions depend on the use made of these green spaces which can be inequitable. This paper presents the results of the analysis of the use of green spaces in the 6 French cities selected in the WHO French Healthy City Network conducted as part of the GREENH-City research project.

 Based on park profiles, a qualitative survey was conducted among users of 3 different parks in each of the 6 selected cities with both observations and semi-directive interviews. Thematic analyzes were performed. Observed activities were classified into 8 groups (supervised educational, food, activities i.e. calm, commercial, artistic and cultural, physical non-sport, sports) and related to a specific use (professional/ personal, individual/ collective, authorized/ not and conflictual/ not). The uses described by the individuals interviewed were classified into 4 categories: attendance, utility, opinions and activities.

 186 observations and 591 recorded and unrecorded interviews with individuals or groups were conducted in the 18 parks. Overall, calm activities are dominant. However, activities and uses differ between cities and within the city depending on the nature of the parks (ancient, new..), their management, their location (more or less central, located in a deprived area or not) and people expectations.

 Park uses are only partially dependent on amenities within the park. The nature of the park itself, its geographical location and its landscape characteristics seem to be decisive for the uses observed. These data are essential to inform public decision-makers and guide the creation and development of green spaces in cities in a vision of social justice.

 Urban green spaces can improve population health but their uses may be inequitable. Study of population use of urban green spaces may help to shape local policies towards more equity.


An adaptive IIR filter in ANC(Active Noise Control) systems is more effective than an adaptive FIR filter when acoustic feedback exists, in which cause an order of an adaptive FIR filter must be very large if some of poles of the ideal control filter are near the unit circle. But the IIR filters may have stability problems especially when the adaptive algorithm for adaptive filters is not yet converged. In this paper, a stabilized multi-channel recursive LMS (MCRLMS) algorithm for an adaptive multi-channel IIR filter is presented. RLMS algorithms usually diverge before the algorithm is not yet converged. So, in the beginning of the ANC system, the stability of the RLMS algorithms could be improved by pulling the poles of the IIR filter to the center of the unit circle, and returning the poles to their original positions after the filter converges. Computer simulations and experiments for dipole ducts using a TMS320C32 digital signal processor have performed to show the effectiveness of a proposed algorithm.


Future college graduates will need to know how to function effectively within international work groups. One noteworthy characteristic of many older, working students at metropolitan universities is that they are already engaged in such efforts. Their knowledge and skills may be invaluable in the classroom, but are they being tapped? Perhaps these students can team with faculty members as "learner experts" who complement the instructor s content expertise. Partnering with these students in developing course content, or in delivering innovative curricular experiences, may go a long way toward keeping courses up-to-date, relevant, and exciting.


Summary Tualang honey is obtained from large honeycombs produced by Asian bees (Apis dorsata) in gigantic Tualang trees. It has been used traditionally by local communities to treat wounds. However, unlike manuka honey its medicinal uses are not well researched. An open, prospective study into the efficacy of wound healing in full thickness wounds in rats, was designed to compare two honey impregnated dressings with silver-impregnated hydrofibre dressings. A full-thickness wound was created on the dorsum of Sprague-Dawley rats (n=45). Tualang honey impregnated paraffin tulle (P-honey) and tualang honey impregnated hydrofibre dressings (H-honey) were compared with silver-containing hydrofibre dressing (positive control; H-Ag). The wounds were inspected on days 4, 7, 14, 21 and 28. The dressings and wounds were assessed for adherence, ease of removal, fluid accumulation, dryness of skin and exudates, rate of epithelization, healing and wound contraction. Three rats treated with each dressing were sacrificed on the days that wounds were inspected. The wounds and scars were histologically analysed for inflammatory parameters. Tualang honey impregnated dressings were comparable to the commercially available silver impregnated hydrofibre dressing in terms of adherence, ease of removal, fluid accumulation, dryness of surrounding skin and exudates; p > 0.05 for non-parametric Kruskal-Wallis tests and post hoc corrections with a Mann-Whitney test. The rates of wound healing, wound contracture and subsequent histological analysis of inflammatory reaction by each dressing were also comparable. Tualang honey impregnated dressings were as effective as silver impregnated hydrofibre dressings in terms of dressing properties, promotion of wound healing and inflammatory reaction.


In this paper we study the home marking problem for Petri nets, and some related concepts to it like confluence, noetherianity, and state space inclusion. We show that the home marking problem for inhibitor Petri nets is undecidable. We relate then the existence of home markings to confluence and noetherianity and prove that confluent and noetherian Petri nets have an unique home marking. Finally, we define some versions of the state space inclusion problem related to the home marking and sub-marking problems, and discuss their decidability status.


This paper reviews some of the challenges related to understanding constraints to agricultural productivity improvements in developing countries. It takes a micro-level approach to shed light on the complexity of farmers' adoption of new technologies and practices and of climate change adaptation decisions. The main arguments are illustrated using an example from the evaluation of a randomized pilot program in Nicaragua. The paper also highlights open questions for future research.


ITo, K. Morphological Analysis of Yolk Sac Tumor. Tohoku J. Exp. Med., 1993,171(1), 53-63 Morphological analysis of imprint histology and cytology was performed in 7 patients with yolk sac tumor (YST). As a result, histological figures of YST were classified into 4 patterns. Endodermal sinus pattern was most frequently identified, followed by polyvesicular vitelline pattern. Imprint cytology findings of YST were also classified into 4 patterns. Cuboidal cells were most frequently observed ; cells and nuclei were both cuboidal in shape and 25-40 p and 20-25 p in diameters, respectively. The chromatic showed fine to coarse granular patterns. The nuclear cytoplasmic (N/C) ratio was 50-70%, and each nucleus contained one to four nucleoli. Next to cuboidal cells, spindle-shaped cells were frequently noticed; 20-40 p in size with spindle-shaped nuclei 10-20 p in diameter and fine to coarse granular chromatic pattern. Naked cells and bizarre cells were also noticed. It was postulated that cuboidal cells and spindle-shaped cells were originated from the endodermal sinus pattern and the loose reticular pattern of YST, respectively. When utilized with rapid-frozen specimens, imprint cytology of YST is sufficient for rapid diagnosis during operations. ovary; cytology; yolk sac tumor; embryonal carcinoma


The impact of Enterovirus Real Time-Polymerase Chain Reaction assay (EV RT-PCR) on hospitalization lengths of patients with aseptic meningitis has been investigated but the impact of early EV RT-PCR results released on time before patient discharge remains unclear during Echovirus meningitis outbreaks.

 To assess a potential correlation between EV RT-PCR turn-around time and hospitalization lengths during an Echovirus meningitis outbreak.

 Eighteen patients demonstrating a positive EV RT-PCR assay performed on Cerebrospinal Fluid (CSF) samples collected between October 1st 2014 and December 31st 2014 were retrospectively included. Viral protein 1 (VP1) gene region was amplified and sequenced using a classical Sanger sequencing reaction. Clinical data were retrospectively collected from patient's records. Quantitative variables expressed as median values and ranges were compared using Mann Whitney U test. Correlations were performed using simple regression analysis.

 Phylogenetic VP1 sequence analyses identified that the outbreak was related to an Echovirus 30 strain in 7 out of the 10 cases with available sequencing data. The three remaining sequences analyses evidenced Echovirus 14, 9 and 7 strains. Hospitalization length was statistically shorter in children without comorbidity (n=5) than in adult patients (n=10) or neonates and children with comorbidity (n=3) (p=0.003 and 0.01 respectively), whereas EV RT-PCR turnaround time was not statistically different between these groups. Correlation between hospitalization length and EV RT-PCR turnaround time was poor (R2=0.06), especially in adults (R2=0.01)

 Our data indicated that EV RT-PCR turnaround time was not correlated to hospitalization length during a short Echovirus meningitis outbreak.


Merging binary neutron stars are thought to be formed predominantly via isolated binary evolution. In this standard formation scenario, the first-born neutron star goes through a recycling process and might be rapidly spinning during the final inspiral, whereas the second-born star is expected to have effectively zero spin at merger. Based on this feature, we propose a new framework for the astrophysical characterization of binary neutron stars observed from their gravitational wave emission. We further propose a prior for the dimensionless spins of recycled neutron stars, given by a gamma distribution with a shape parameter of 2 and a scale parameter of 0.012, extrapolated from radio pulsar observations of Galactic binary neutron stars. Interpreting GW170817 and GW190425 in the context of the standard formation scenario and adopting the gamma-distribution prior, we find positive support (with a Bayes factor of 6, over the nonspinning hypothesis) for a spinning recycled neutron star in GW190425, whereas the spin of the recycled neutron star in GW170817 is small and consistent with our prior. We measure the masses of the recycled (slow) neutron stars in GW170817 and GW190425 to be $1.34_{-0.09}^{+0.12}$ $(1.38_{-0.11}^{+0.11})$ $M_{\odot}$ and $1.64_{-0.11}^{+0.13}$ $(1.66_{-0.12}^{+0.12})$ $M_{\odot}$, with $68\%$ credibility, respectively. We discuss implications for the astrophysical origins of these two events and outline future prospects of studying binary neutron stars using our framework.


Volume 1 [546 pp]: Mathew Carey, "Essays on Political Economy" (1822). Volume 2 [406 pp]: Francis Wayland, "Elements of Political Economy" (1837). Volume 3 [238 pp]: George Tucker, "Political Economy for the People" (1859). Volume 4 [496 pp]: Amasa Walker, "Science of Wealth - A Manual of Political Economy" (1867). Volume 5 [206 pp]: William Graham Sumner, "Problems in Political Economy" (1884) and "Political Economy and Political Science" (1884). Volume 6 [415 pp]: Francis A. Walker, "Political Economy" (1892).


Radix Puerariae is the dried root of Pueraria lobata (Willd.) Ohwi, which releases a variety of isoflavones. The objective is to investigate the extraction process of total flavonoids in Radix Puerariae and to examine their effects on blood glucose MDA in alloxan-diabetic mice. Solvent extraction and column chromatographic isolation were used to extract the total flavonoids in Radix Puerariae, and colorimetry was used to determine the content of total flavonoids. Mouse model (persistent hyperglycemia) was established by intravenous injection of alloxan to observe the effects of Radix Puerariae total flavonoids in these diabetic mice. MDA level was also determined. Colorimetric determination showed that the content of total flavonoids in Radix Puerariae, the main active constituents in the extraction product, averaged 47.65%. Serum glucose level reduced significantly in animals following the use of Radix Puerariae total flavonoids of high- and medium-dose.The extraction process of total flavonoids in Radix Puerariae and quality control methods established in this study are feasible and cost effective. Radix Puerariae total flavonoids have a significant hypoglycemic effect, and can reduce lipid peroxidation.


Background Studies of mortality after cataract surgery have reported conflicting results: initial studies reported increases, while subsequent studies reported excess in the younger patients only. These studies compared mortality after cataract surgery with that after other operations, or with population rates. Neither comparison group is likely to be representative of patients having cataract surgery. Previously we have shown that plotting temporal profiles of mortality in successive periods after operation can show whether or not an operation is associated with excess postoperative mortality; and expressing mortality relative to that in the general population that is, as standardised mortality ratios (SMRs), can highlight the effects of selection as 'fit for surgery' and case-mix. We aimed to do this for cataract surgery. Methods Records of all day cases and inpatient hospital admissions for cataract surgery in England, 1999–2010 linked to death records up to 2011 for patients aged 45 years and over. Death rates were calculated for consecutive months in year after operation and expressed as SMRs. Results There were 2,538,835 operations followed by 4492 deaths (0.2%) within 30 days and 110,703 (4.4%) within one year of operation. The corresponding SMRs were 39 (95% confidence interval (CI) 37.5–39.8) and 78 (95% CI 77.8–78.8), both lower than the rates in the general population. SMRs were inversely related to age with the 45–54 age group having a one-year SMR of 333 while those aged 90+ years having a SMR of only 57. Plotting the SMRs for consecutive months after surgery showed that the first month had the lowest value, the values increased for the next two months and then stabilised for the rest of the year. This pattern was found for all the individual subgroups analysed – age-group, sex, with and without diabetes – though the actual values of the SMRs differed. The one month SMR was, on average, 45% that of the 4–12 month SMR. Conclusion If cataract surgery was associated with excess postoperative mortality then a cluster of deaths occurring shortly after operation would be expected. No such cluster was found. The relatively low death rate in the first month after surgery is likely to be due to selecting patients as 'fit for surgery'. The inverse relationship between SMR and age shows the effect of case-mix with the younger patients being relatively less healthy and the older patients being healthier than the general population.


An important issue in diagnosis research is design methods for residual generation. One method is the Chow-Willsky scheme. Here, the Chow-Willsky scheme is extended as it becomes universal in the sense that, for both discrete and continuous linear systems, it is shown to be able to generate all possible parity functions. This result means it can also be used to design all possible residual generators. It is shown that previous extensions to the Chow-Willsky scheme are not universal, which is the case when dynamics controllable from faults exist, but not from the inputs or disturbances. Also included here are two conditions on the process for fault detectability and strong fault detectability.


The tensile properties of an S304H austenitic stainless steel processed by large strain cold rolling were studied. Cold rolling was accompanied by the deformation twinning and martensitic transformation. The fraction of strain-induced martensite comprised 0.65 after cold rolling to a total strain of 4. The transverse grain size progressively reduced to about 200 nm in both the austenite and martensite phases. The deformation microstructures were characterized by large internal distortions, which were attributed to high dislocation density well above 10 15 m −2 . Cold rolling resulted in significant strengthening. The yield strength increased from 290 MPa in the initial annealed state to 2 050 MPa in the sample subjected to cold rolling to a total strain of 4. The strengthening could be adequately explained by increasing the dislocation density. In the framework of dislocation strengthening model the austenite and strain-induced martensite provided equal fractional contribution to the overall strength of the rolled steel.


Primary aldosteronism is common and contributes to adverse cardiovascular, kidney, and metabolic outcomes. When instituted early and effectively, targeted therapies can mitigate these adverse outcomes. Surgical adrenalectomy is among the most effective treatments because it has the potential to cure, or attenuate the severity of, pathologic aldosterone excess, resulting in a host of biochemical and clinical changes that improve health outcomes. Herein, we review the role of surgical adrenalectomy in primary aldosteronism while emphasizing the physiologic ramifications of surgical intervention, and compare these to other targeted medical therapies for primary aldosteronism. We specifically review the role of curative adrenalectomy for unilateral primary aldosteronism, the role of non-curative adrenalectomy for bilateral primary aldosteronism, and how these interventions influence biochemical and clinical outcomes in relation to medical therapies for primary aldosteronism.


It was in 1935 when Henry Wheeler Robinson presented his later much questioned thoughts on the Hebrew conception of corporate personality. The main goal of the conception was to provide a framework to alleviate - or perhaps even to remove - the tension between individual and collective aspects that can be found side by side in texts from the Old Testament. The book of Ezekiel provides examples - used by Wheeler Robinson - of the tension mentioned. So, texts taken from the book of Ezekiel can be used to put Wheeler Robinson's conception to the test. Chapters 18 and 20 are classical examples of such texts. Chapter 18 appears to be oriented towards the individual, while chapter 20 is collective oriented. After stating the view on the book of Ezekiel the MT of chapters 18 and 20 is reviewed at a text-critical as well as at a structural level. Chapters 18 and 20 (with some marginal emendations) provide a sound basis for further inquiry.
The analysis of the Hebrew conception of corporate personality shows a heavy dependency on the anthropological theories of Levy-Bruhl, especially concerning the primitive mentality and its 'law of participation'. Wheeler Robinson formulates four basic aspects of the conception: 'extension', 'realism', 'fluidity' and 'individuality within the corporate conception'. The core of the conception is the third one: the fluidity. The fluidity facilitates rapid and unmarked transitions from the one to the many, and from the many to the one. The fluidity is highly influenced by the theories of Levy-Bruhl, especially the 'law of participation'.
Discussion on the conception however was forthcoming, while it was being used in different fields of inquiry. A pivotal role in the discussion can be ascribed to Rogerson (1970). Rogerson is focusing on the basic principles of the conception. He concludes his examination by proposing to abandon the use of the conception completely because of its ambiguity and its outdated anthropological principles. While Rogerson's conclusions relating to the ambiguity of the conception and the outdated basic principles are to be followed, his proposal to abandon the use of the conception categorically is too far-reaching in my opinion. A new anthropological theory, such as the 'multimodal framework' by Samuel, offers the possibility of preserving the valuable aspects of the conception while obviating its shortcomings. Ezekiel 18 and 20 will be described from this perspective.
Ezekiel 18 and 20 are described with the relation between individual and collective in view from the internal logic of these ideas in the texts. Other scholarly disciplines such as anthropology, sociology and psychology are used besides to obtain a fuller insight into the relation between individual and collective, as reflected in these texts.


A mail survey of practicing hospital pharmacists in British Columbia who graduated since the introduction of hospital residency programs was conducted to determine the influence of a hospital pharmacy residency program on career advancement and satisfaction. Respondents included 33 past residents and 38 non residents. Career advancement was measured by union grade level. Professional and employment satisfaction were assessed using a five-level satisfaction scale. Percentage time allocated to each of administrative, clinical, distributional and research activities was determined for each group. Past residents were also requested to estimate residency program time allocation devoted to these activities which would best prepare them for their present employment. The results of this study indicate that in the ten years the program has been in operation, no difference can be demonstrated between past residents and non residents with respect to career advancement, professional satisfaction or employment satisfaction. Past residents recommend that a hospital residency should consist of approximately 40% clinical activities, 30% distributional activities and the remainder time allocated equally to administrative and research activities. Further research is recommended to evaluate the impact of a hospital pharmacy residency program in a location independent of union grade restrictions and later in the career of past residents to determine the influence of these factors on career advancement and satisfaction.


BACKGROUND
Total thyroidectomy is recommended as a line of management of thyroid cancer in many cases. Our aim was to compare postoperative analgesic effect of local ketamine 1 mg/kg instilled in the wound to that of intramuscular (IM) ketamine and placebo after total thyroidectomy.

METHODS
A total of 90 patients aged 18 to 60 years, American Society of Anesthesiologists (ASA) class I to II, with a body weight of 50 to 90 kg, scheduled for total thyroidectomy were enrolled after ethics committee approval in this prospective, randomized, double-blind, controlled study and divided randomly into 3 groups to receive treatment after hemostasis. Group (I) received 1 mg/kg ketamine in a total volume of 10 mL normal saline instilled in the wound. Group (II) received 1 mg/kg of IM ketamine. Group (III) received 10 mL of normal saline instilled in the wound. Total amount of morphine consumption, first request of analgesia, and side effects were recorded. Visual analog scale at rest and movement and hemodynamics were assessed immediately, 1, 2, 4, 6, 12, and 24 hours postoperatively.

RESULTS
Total morphine consumption was reduced and first request of analgesia was delayed in group I compared with that in groups II and III, and in group II compared with that in group III (P=0.000). Visual analog scale at rest and movement were decreased immediately postoperatively in groups I and II in comparison with their values in group III; group II had higher sedation scores.

CONCLUSIONS
Local wound ketamine instillation provided superior postoperative analgesia with lower incidence of side effects in comparison with IM ketamine and placebo following total thyroidectomy.


In the past decade, some major improvements have been achieved in the management of the European Endangered Species Programme (EEP) for the Western lowland gorilla Gorilla gorilla gorilla. To assess the achievements of the current management approach, data on 225 births, 96 deaths and 154 transfers were collected from the most recent international studbook and analysed. Compared with the preceding decade, neonatal mortality and hand-rearing rates have decreased, resulting in a lower but acceptable birth rate. Transfers in most cases proved to be successful: almost all gorillas were integrated into their new groups and most animals introduced to a breeding group had their first offspring within 2 years. The results show that the current management approach is successful, and that the population is sustainable and has good genetic health. Several aspects of gorilla management are presented and discussed. One of the major challenges for both the Gorilla EEP Species Committee (GEEPC) and the holders is to find a solution for the increasing problem of ♂♂ not needed for the breeding programme at any given time.


In this paper illustration of the influence of input machining parameters on the surface roughness and Tool wear rate are determined along with regression analysis. This experiment was conducted on High Carbon High Chromium Steel (HCHCR) with Copper as tool electrode. The data collected during experimentation has been used to yield responses in respect of surface roughness and tool wear rate (TWR). The objective of this paper is to study the influence of operating input parameters of copper electrode on surface roughness of HCHCR and tool wear rate of copper followed by optimization. The effectiveness of EDM process with copper electrode is evaluated in terms of surface roughness and tool wear rate. In this work the parameters such as current, spark gap, flushing rate pulse on time, pulse off time were selected. Analysis is carried using the Anova analysis.