Background Recent studies have revealed structural changes with neovessels in patients with jumper's knee and Achilles tendinopathy, and treatment with sclerosing injections has shown promising clinical results. Purpose To study the prevalence of neovascularization and structural tendon changes on color Doppler ultrasound examination in elite athletes with clinical symptoms of jumper's knee and to examine the ultrasound characteristics of the tendon after sclerosing injection treatment with polidocanol. Study Design Cohort study; Level of evidence, 3. Methods The authors recruited patients among elite athletes with a clinical diagnosis of jumper's knee who participated in a previous randomized clinical trial. The patients recorded knee function using the Victorian Institute of Sport Assessment score. Patients were examined by color Doppler ultrasound at baseline and, for patients with structural changes and neovascularization who received sclerosing treatment, after treatment. Results Sixty-three patients (11 women and 52 men) with 79 symptomatic tendons were studied. The ultrasound examination revealed that neovascularization was present in 48 of the 79 tendons (60%). Of 33 patients (43 tendons) who received sclerosing injections, 29 patients (37 tendons, 86%) were examined 37 (19 to 53) weeks after their final sclerosing injections. Of these, 7 tendons (18.9%) had no change in neovascularization after treatment, 21 tendons (56.8%) had less neovascularization, and 9 tendons (24.3%) had more visible neovascularization. There were no significant differences in the change in Victorian Institute of Sport Assessment score between patients who had less, more, or unchanged neovascularization after treatment (analysis of variance, P = .9). Conclusion About two thirds of patients with jumper's knee can be expected to have structural tendon changes with neovascularization. There was no relationship between changes in ultrasound characteristic and knee function after sclerosing treatment.


INTRODUCTION
Gautier et al. demonstrated that a compression in the left paratracheal region (left paratracheal pressure, LPP) can be used to seal the oesophagus. However, at this level, the left common carotid artery is very close to the carotid that could be affected during the manipulation. This study aimed to assess the hemodynamic effects of LPP on the carotid blood flow.

METHODS
We prospectively included 47 healthy adult volunteers. We excluded pregnant women and people with anomalies of the carotid arteries. The common and internal carotid arteries were preliminarily studied with ultrasounds to exclude atheromatous plaques or vascular malformation. A planimetry of the common and internal carotid arteries was performed. Doppler echography served to measure the peak systolic (PSV) and end-diastolic velocities (EDV) in the common and internal carotid arteries. All measurements were repeated while applying LPP.

RESULTS
Forty-seven participants were enrolled (32 women; mean [SD] age: 42 [13] years). The mean PSV difference [95% CI] in the left common carotid artery before and after LPP at the group level was -15.30 [-31.09 to 0.48] cm s-1 (p = .14). The mean surface difference [95% CI] in the left common carotid artery before and after LPP was 24.52 [6.11-42.92] mm2 (p = .11). Similarly, the same surface at the level of the left internal carotid artery changed by -18.89 [-51.59 to 13.80] mm2 after LPP (p = .58).

CONCLUSIONS
Our results suggest that LPP does not have a significant effect on carotid blood flow in individuals without a carotid pathology. However, the safety of the manoeuvre should be evaluated in patients at risk of carotid anomalies.


Description: Ensure high-quality diagnostic images with this practical scanning reference! Designed to help you plan and acquire MRI images, Handbook of MRI Scanning, by Geraldine Burghart and Carol Ann Finn, includes the step-by-step scanning protocols you need to produce optimal images. Coverage of all body regions prepares you to perform virtually any scan. Going beyond the referencing and recognition of three-lane, crosssectional anatomy, each chapter demonstrates appropriate slice placements, typical midline images of each plane, and detailed line drawings of the pertinent anatomy corresponding to the midline images. With this handbook, you can conceptualize an entire scan and its intended outcome prior to performing the scan on a patient. Keep the book at your console -it's ideal for quick reference!


Abstract It is proposed to combine the traditional method of microscopic assessment of the results of absorption-elution reaction and the gel-filtration technique with the use of the ScanGel immunohematology system (Bio-Rad Laboratories, USA) in blood grouping tests. The study was designed to select monoclonal antibodies suitable for the purpose and optimize conditions of gel filtration. It is concluded that the combined method allows for rapid differential grouping of the large number of blood spots, promotes objectivization of assay results, and lightens the work of the operator carrying out serial analyses.


Using a rich longitudinal database at the plant level, I shed new light on the causal nexus between exports and productivity for Turkey, a middle-income country. I find evidence for both self-selection into exporting and learning-by-exporting. My main focus is on post-entry effects. To test this hypothesis I follow recent empirical literature and I apply the Propensity Score Matching and a Difference-in-Difference estimator. I find a higher labour productivity and TFP growth for exporting firms in the entry year and some years following the entry. Exports seem to place firms on a superior productivity path. My main contribution is to show the strict linkage between export and import activity: export starters often start also importing. Learning by exporting effects hold when I control for the role of imports and I verify larger productivity gains for firms which start exporting and importing at the same time. Finally, in order to verify if post-entry effects are not only scale effects but work through competition channel and/or technology transfers, I look for a heterogeneity according to the sectoral productivity gap between the domestic market and foreign trade partners. I verify a different timing of efficiency improvements between comparative advantage and disadvantage sectors.


Article history: Received: 24, SPE., 2020 Accepted: 14, JAN., 2020 Available Online: 10, JUN. 2020 A conformal antennas are plays an important role due to its multitasking possibilities , which have many opportunities in several applications. In this study, a new design of cylindrical rectangular microstrip antenna(CRMA ) excited at mode, was achieved in order to operate at the frequency of 5.6GHz. The simulation was done by Finite Difference Time Domain(FDTD) method using MATLAB program. The input impedance , return loss and radiation pattern of antenna were calculated and plotted. By using the slots technique and dual-layers substrate technique , the bandwidth(BW) is increased to 88.88% . Also BW is increased as the dielectric constant value is decreased. DOI: http://dx.doi.org/10.31257/2018/JKP/2020/120101 K e y w o r d s : Conformal microstrip antenna


BACKGROUND
In order to reach a clear understanding of minimally invasive approaches in cardiac operations, the authors review clinical experience in using three such approaches: inferior partial median sternotomy, right anterolateral minor thoracotomy, and the right parasternal approach.

MATERIAL/METHODS
Sternotomy and the three different minimally invasive approaches were applied in and 2431 and 323 patients respectively. The approaches were selected according to the circumstances of the individual case. Both external and internal cardiac structures were observed during the operations. The length of the incision, the postoperative drainage, operative time, and cardiopulmonary bypass time were investigated. The postoperative complications occurring after minimally invasive approaches were observed.

RESULTS
In inferior partial median sternotomy, all structures except for the ascending aorta could be exposed well. In right anterolateral minor thoracotomy, only the structures on the right side of the heart could be exposed, but the mitral valve could also be exposed well. The exposure of the right parasternal approach was similar to that of right anterolateral minor thoracotomy. There were statistically significant differences between sternotomy and the minimally invasive approaches in terms of incision length and postoperative drainage, but no difference in operative time and cardiopulmonary bypass time. The postoperative complications of MIAs included air embolism (n = 3), chest pain (n = 9), chest wall malacia (n = 1), rib fracture (n = 2), and sternum fracture (n = 2). The total incidence of complications in minimally invasive approaches was 5.3%.

CONCLUSIONS
The minimally invasive approaches can have satisfactory clinical results if the approaches are correctly chosen and performed.


Houston's pension funds are in financial trouble and pose a significant risk to the financial health of the city. In this paper, public finance fellow John Diamond analyzes a subset of the city's pension plans: the defined benefit plan. A version of the paper appeared as an appendix to a report on the financial state of Houston's pensions by Rice University's Kinder Institute.


The assignment of 13C resonances of nuclei alpha to the haem in horse ferricytochrome c is completed and the Fermi contact shifts are evaluated at 30 degrees C and 50 degrees C using empirical magnetic susceptibility tensors to correct for dipolar interactions. The Fermi contact shifts are fitted to a model of molecular orbitals of eg symmetry, which are subject to a rhombic perturbation. A similar analysis is performed using published data for Pseudomonas aeruginosa cytochrome c551. The relationship between the orientation of the effective g tensor and that of the rhombic perturbation in these proteins is shown to agree with theoretical predictions. A comparison between the orientation of the rhombic perturbations and the crystal structures of horse cytochrome c and P. aeruginosa cytochrome c551 reveals that the orientation of the histidine and methionine axial ligands dominates the rhombic perturbation and that the two ligands have approximately equal influence. The magnitude of the perturbation shows that the orientation of the axial ligands has little effect on the haem redox potential. However, the relationship that is established between the magnetic susceptibility tensor, the partially filled haem molecular orbitals, and the orientation of the haem ligands offers a new source of precise structural information.


Multispectral (MS) pan-sharpening aims at producing high-resolution (HR) MS images in both spatial and spectral domains, by merging single-band panchromatic (PAN) images and corresponding MS images with low spatial resolution. The intuitive way to accomplish such MS pan-sharpening tasks, or to reconstruct ideal HR-MS images, is to extract feature pairs from the given PAN and MS images and to fuse the results. Therefore, feature extraction and feature fusion are two key components for MS pan-sharpening. This article presents a novel MS pan-sharpening network (MPNet), including a heterogeneous pair of feature extraction pathways (FEPs) and a convolutional long short-term memory (ConvLSTM)-based hierarchical feature fusion module (HFFM). Specifically, we design a PAN FEP to extract 2-D feature maps via 2-D convolutions and dual attention, while an MS FEP is introduced in an effort to obtain 3-D representations of MS image by 3-D convolutions and triple attention. To merge the resulting hierarchical features, the ConvLSTM-based HFFM is developed, leveraging intralevel fusion, interlevel fusion, and information exchange within one single framework. Here, the interlevel fusion is implemented with the ConvLSTM to capture the dependencies among hierarchical features, reduce redundant information, and effectively integrate them via its recurrent architecture. The information exchange between different FEPs helps enhance the representations for subsequent processing. Systematic comparative experiments have been conducted on three publicly available datasets at both reduced resolution and full resolution, demonstrating that the proposed MPNet outperforms state-of-the-art methods in the literature.


The study is about the assessment of compensation and benefits in selected audit firms in the Kingdom of Bahrain. The research study appraised the current status of compensation and benefits of the firms in terms of remuneration, allowance, promotion and incentives. Also, it endeavored to figure out the perceptions of the employees of the selected audit firms in the Kingdom of Bahrain on the level of effectiveness of compensation and benefits along with the same variables in order to establish a base for enhancement of performance of employees. The study used a descriptive survey method to analyze the perception on compensation and benefits in selected audit firms in the Kingdom of Bahrain. Also, this method is used to analyze the significant relationship of the perception of the employees along with the same variables. The respondents of the study were the 100 employees of the audit firms in the Kingdom of Bahrain. The primary tool in gathering data was the questionnaire. Secondary sources were utilized such as: books, articles, unpublished theses and other printed resources related to the study that were used to support and strengthen the findings of the study. Descriptive statistics were used to analyze and interpret the data gathered such as: weighted mean to identify the average perception of the respondents. T-test was used to calculate the difference in the perception of the respondents. The correlation assessed whether the means of two groups are statistically different from each other. The following were the major findings in the study: 1) The status of the employees' compensation and benefits in audit firms in Bahrain is found to be good as revealed by an overall mean score of 3.93. 2)The effectiveness of the employee performance in audit firms in the light of the four components of compensation and benefits is found to be effective. This is drawn from an overall mean score 3.98. 3) There is a significant relationship between employees' compensation and benefits in audit firms in Bahrain and effectiveness of employee performance. The problems that encountered by employees in relation to compensation and benefits in audit firms in Bahrain include: a) Noncompliance between rises in salaries and rises in prices; b) Non-compliance between salaries of counterparts in other jobs; c) Allowances are not provided on fair criteria; d) Allowances are in accordance unaccepted criteria; e)There are non-clear basis for distribution of allowances such as productivity; f) Vagueness of the applied criteria for promotion; g) Absence of regulations to control the promotion procedures; and h) Lack of transparency in terms of incentives.


The transition from pre-school to Kindergarten is an important part of a child''s learning journey. In the early childhood setting children develop interests, knowledge and learning preferences that often remain unknown in the early days of Kindergarten. We argue that from this young age children can identify and articulate learning preferences as they use their literate practices to communicate their preferences, aspirations and reflections. Digital Stories are short, personal, multimedia presentations created through image (from still and/or video cameras), which are then edited on a computer with video editing software to include a spoken narrative. In this paper we share a project where a cohort of children in transition from pre-school to Kindergarten developed personal digital stories introducing themselves and their learning preferences and interests to their future Kindergarten teacher. Learning events and practices as identified by the children will be shared as we investigate their language choices throughout these experiences. Our analysis reveals implications and makes recommendations for those working with children in the early years of schooling. In presenting the paper we will share examples, the process of construction and our reflections on the children''s use of language.


Microwave and submillimeter molecular transition frequencies between nearly degenerated rotational levels, tunneling transitions, and mixed tunneling‐rotational transitions show an extremely high sensitivity to the values of the fine‐structure constant, α, and the electron‐to‐proton mass ratio, μ. This review summarizes the theoretical background on quantum‐mechanical calculations of the sensitivity coefficients of such transitions to tiny changes in α and μ for a number of molecules which are usually observed in Galactic and extragalactic sources, and discusses the possibility of testing the space‐ and time‐invariance of fundamental constants through comparison between precise laboratory measurements of the molecular rest frequencies and their astronomical counterparts. In particular, diatomic radicals CH, OH, NH+, and a linear polyatomic radical C3H in Π electronic ground state, polyatomic molecules NH3, ND3, NH2D, NHD2, H2O2, H3O+, CH3OH, and CH3NH2 in their tunneling and tunneling‐rotational modes are considered. It is shown that sensitivity coefficients strongly depend on the quantum numbers of the corresponding transitions. This can be used for astrophysical tests of Einstein's Equivalence Principle all over the Universe at an unprecedented level of sensitivity of ∼10−9 , which is a limit three to two orders of magnitude lower as compared to the current constraints on cosmological variations of α and μ: Δα/α <10−6 , Δμ/μ <10−7 .


In recent decades, international organizations have developed initiatives that incorporate lifelong learning as a tool to increase the employability of citizens. In this context, the goal of this research is to test the influence of formal e-learning on estimating employment status. The research made use of a sample of 595 citizens in 2007 and 1,742 citizens in 2011, using microdata from Eurostat's Adult Education Survey (AES) implemented by the Spanish Statistical Office [Instituto Nacional de Estadistica] (INE) in Spain. Controlling for socio-demographics and formal education-level information, multiple binary logistic and ordinal regression models on formal education activities are used to check the separate effects of independent variables and demonstrate that Spanish people who have done formal lifelong e-learning activities are more likely to have an employment contract: i) in 2007, before the start of the economic crisis, for all individuals; ii) in 2011, during the economic crisis, for all individuals; iii) in 2011, for individuals with any level of computer literacy; iv) in 2011, for individuals whose highest education level is primary, secondary, or post-secondary non-tertiary; and v) in 2011, for individuals having more stable employment contracts, understood as a combination of duration (temporary, permanent), and working hours (part-time, full-time). Consequently, after inferential judgements based on the empirical results, it is shown that one of the most important factors for estimating employability in times of economic crisis has to do with lifelong e-learning. Moreover, formal e-learning activities can be a strategy for obtaining better job stability.


Aim: To assess the total cost of direct and indirect materials used in Class III, IV and V composite resin direct restorations. Methods: The calculation of costs was based on the method of variable costing system. A list of the materials was obtained by a panel of experts and based on the excellence standards established in the literature for dental team treatment. The cost considered for each material was obtained from an average of the costs found in the regional supplier market (US$1.0=R$2.12). The repetitions were obtained from Class III, IV and V cavities in artificial premanufactured teeth. The cavities were classified as shallow, medium and deep. The materials were quantified for each type of preparation. Seven brands of composite resins were used and weighed on a precision scale after their insertion in each cavity. The data were analyzed by descriptive statistics and non-parametric Friedman's test (α=0.05). Results: The mean costs were US$7.96 (R$16.88) for Class III restoration, US$8.13 (R$17.24) for Class IV, and US$7.84 (R$16.62) for Class V. There was statistically significant difference in cost between the types of cavities and depth classification. The small cost difference among the different resin brands resulted in no statistically significant differences in the total cost of the restorations. Conclusions: The costs obtained in this survey may be used in the calculation of the final cost of restorative procedures, helping in the management of public or private dental care services.


Background. Clostridium difficile causes diarrhea that ranges from a benign, self-limiting antibiotic use– associated disease to a life-threatening pseudomembranous colitis. Clostridium difficile has rarely been isolated in extraintestinal infections. Our objective was to characterize clinical features and risk factors of these infections. Methods. Extraintestinal C. difficile infections (CDIs) were searched for in an electronic database of all C. difficile–positive isolates found during a 10-year period. The medical records were reviewed retrospectively. Disease severity and comorbidities of the patients were evaluated using Horn disease severity and Charlson comorbidity indexes. Results. Extraintestinal CDI was found in 31 patients who comprised 0.17% of all CDIs. Two patients had bacteremic infections, 4 had abdominal infections without any prior surgery, 7 had abdominal infections after surgery, 4 had perianal abscesses, 13 had wound infections, and 1 had C. difficile in a urinary catheter. In most cases (85%), C. difficile was isolated together with other microbes. Most (81%) patients developed the infection when hospitalized and many had severe comorbidities. Sixteen (52%) had diarrhea. The 1-year mortality rate was 36% and it correlated with the severity of underlying diseases. Conclusions. Extraintestinal CDIs occur mainly in hospitalized patients with significant comorbidities. Extraintestinal CDIs in the abdominal area may result from either intestinal perforation after infection or after intestinal surgery. Wound infections may result from colonization by feces. Clostridium difficile may reach distant sites via bacteremia. Mortality in extraintestinal CDIs is associated with the severity of underlying diseases.


While gender appears to play a role in the incidence of Anterior Cruciate Ligament (ACL) injury, it is unclear if a gender bias in recovery following reconstruction exists. The goal of this investigation was to compare knee strength across gender from pre-operation through six months of rehabilitation following an acute rupture with no associated injuries compromising recovery. All operations were performed by the same surgeon (co-author: RVT) between 1996 and 2002 using the middle 10 mm of the contralateral patellar tendon as the replacement graft. Of the 1,175 ACL patients seen by this surgeon, 102 (57 women and 45 men) fit the inclusion criterion which also required patients to have made every visit (pre-op, 5 wks, 10 wks, 4 months, and 6 months post-op) and completed every test (isokinetic knee flexion and extension at 180 degrees/s as well as isometric leg press). All patients were on the same rehabilitation program allowing for individualized advancement. Strength values were normalized to the uninvolved knee prior to surgery with a flexor/extensor ratio computed from isokinetic strength. There was a significant change (p < 0.05) in each parameter for both sides across time (p < = 0.003) except for the flexor/extensor strength ratio in the men on their involved side (p = 0.119). The only significant differences (p < 0.05) between gender at any time points were in the involved side flexor strength at 5 weeks (p = 0.029), 10 weeks (p = 0.013), and 4 months (p = 0.021) where the men were stronger. In conclusion, since recovery of strength following surgery is not identical between men and women, gender specific rehabilitation protocols may be warranted.


In this study, we utilized lanthanum to modify vermiculite (RV) targeting at high dye removal and superior reusability. La-modified RV materials were synthesized; followed by detailed characterizations and adsorption studies. Compared with the BET surface area (SBET) of RV (2.98 m2·g−1), those of La-modified RV samples were increased by up to 8 times. Their adsorption performances were investigated by employing Congo red (CR) as the target pollutant in aqueous solution. An increasing loading of La in RV led to enhanced CR removal capacity. The experimental equilibrium data of the La-modified RV were fitted better by using the Freundlich model than the Langmuir model. At the same initial concentration of 100 mg·L−1, the equilibrium capacity of CR was 32.3–80.5 mg·g−1 using the La-modified RV adsorbents, which was 2.5–7.8 times greater than that using RV (9.1 mg·g−1). Meanwhile, the adsorption kinetics was analysed by the pseudo-first-order, pseudo-second-order and intra-particle diffusion models; the kinetics followed the pseudo-second-order model best and the intra-particle diffusion was not the only rate limiting step during adsorption. Superior adsorption capacity of LaRV-0.2, which possessed 29.93 wt% La loading, was observed in the pH range of 3–9; especially the high removal rate (~94%) was observed when pH = 3. The removal rate was increased to ~96.8% in the presence of NaCl compared with 91.6% in the absence of NaCl. The as-synthesized adsorbent maintained a superior adsorption capacity after four adsorption–desorption cycles. The capacity of the regenerated adsorbent in the fourth adsorption–desorption cycle was only 4.2% lower than that of the fresh LaRV-0.2 sample, suggesting great potential in practical wastewater treatment.


An important lesson from the incentive literature is that explicit incentives may elicit dysfunctional and unintended responses, also known as gaming responses. The existence of these responses, however, is difficult to demonstrate in practice because this behavior is typically hidden from the researcher. We present a simple model showing that one can identify gaming by estimating the correlation between a performance measure and the true goal of the organization before and after the measure has been activated. Our hypothesis is that gaming takes place if this correlation decreases with activation. Using data from a public sector organization, we find evidence consistent with our hypothesis. We draw implications for the selection of performance measures.


This study brings together four research lines from different scientific disciplines to expand existing knowledge on the pervasiveness of ethnic discrimination in recruitment and the circumstances under which discrimination is more likely to occur: (1) field experiments on discrimination in recruitment, conducted by economists and sociologists, that have been crucial to our knowledge of the prevalence of discrimination but have taught us less about the sources of discrimination; (2) laboratory experiments on interethnic behavior, mainly conducted by psychologists, that provide the opportunity to closely examine conditions that shape discrimination but have so far neglected behavior related to inequality, like hiring; (3) studies on interethnic attitudes, mainly conducted by sociologists, that have provided valuable insights in the mechanisms that underlie interethnic attitudes but cannot ensure that the same factors influence interethnic behavior; and (4) research on the distinction between explicit and implicit attitudes, developed by psychologists, that has shown that both types of attitudes may influence actions but has so far ignored behaviors related to inequality. The main aim of this study is twofold: (1) assess to what extent ethnic discrimination occurs in recruitment processes via online resume databases in the Netherlands to gain insight in the prevalence of discrimination in recruitment via new channels and provide insight in the role of discrimination in different phases of recruitment procedures; (2) examine under which individual and contextual conditions ethnic discrimination in recruitment is more likely to occur, i.e. when or where ethnic discrimination in recruitment is more likely to arise, who is more likely to discriminate, and who is more likely to be discriminated against. We build upon theoretical approaches from sociology and psychology. First, we draw from two key theoretical approaches within research on determinants of interethnic attitudes to derive expectations on determinants of discriminatory behavior: Ethnic Competition Theory and Contact Theory. Second, we derive predictions on conditions that shape ethnic discrimination from a relatively new line of research within the psychological literature that focuses on the distinction between explicit and implicit attitudes. The key assumption in this literature is that in addition to explicit attitudes that can be controlled and are expressed consciously there are implicit attitudes which can influence actions without intention or awareness. We use a combination of methods: field and laboratory experiments, surveys and reaction time tasks. Results provide strong evidence of discrimination: majority applicants have a 50% higher chance that their resume is viewed on online resume databases and are 60% more likely to receive a positive reaction from employers than (equivalent) minority candidates. Discrimination occurs in all sectors, all occupational levels and hits male and female minority applicants. In economically less prosperous times, employers discriminate more. Those who have more positive interethnic social contacts and those with higher educational achievements or backgrounds are less likely to discriminate; males and those with a religious (Christian) background are more likely to discriminate. Finally, discrimination is not always the result of conscious (explicit) processes; unconscious (implicit) negative associations with ethnic minorities also increases the chances that people discriminate


AIM
To describe new graduate nurses' transition experiences in Canadian healthcare settings by exploring the perspectives of new graduate nurses and nurse leaders in unit level roles.

BACKGROUND
Supporting successful transition to practice is key to retaining new graduate nurses in the workforce and meeting future demand for healthcare services.

METHOD
A descriptive qualitative study using inductive content analysis of focus group and interview data from 42 new graduate nurses and 28 nurse leaders from seven Canadian provinces.

RESULTS
New graduate nurses and nurse leaders identified similar factors that facilitate the transition to practice including formal orientation programmes, unit cultures that encourage constructive feedback and supportive mentors. Impediments including unanticipated changes to orientation length, inadequate staffing, uncivil unit cultures and heavy workloads.

CONCLUSIONS
The results show that new graduate nurses need access to transition support and resources and that nurse leaders often face organisational constraints in being able to support new graduate nurses.

IMPLICATIONS FOR NURSING MANAGEMENT
Organisations should ensure that nurse leaders have the resources they need to support the positive transition of new graduate nurses including adequate staffing and realistic workloads for both experienced and new nurses. Nurse leaders should work to create unit cultures that foster learning by encouraging new graduate nurses to ask questions and seek feedback without fear of criticism or incivility.


Wheat gluten (WG) and its components, gliadin and glutenin proteins, form the largest polymers in nature, which complicates the structural architecture of these proteins. Wheat gluten, gliadin and glutenin proteins in unmodified form showed few secondary structural features. Structural modification of these proteins using heat, pressure and the chemical chaperone glycerol resulted in a shift to organized structure. In modified gliadin, nano-structural molecular arrangements in the form of hexagonal closed packed (HCP) assemblies with lattice parameter of (58 A) were obvious together with development of intermolecular disulphide bonds. Modification of glutenin resulted in highly polymerized structure with proteins linked not only by disulphide bonds, but also with other covalent and irreversible bonds, as well as the highest proportion of β-sheets. From a combination of experimental evidence and protein algorithms, we have proposed tertiary structure models of unmodified and modified gliadin and glutenin proteins. An increased understanding of gliadin and glutenin proteins structure and behavior are of utmost importance to understand the applicability of these proteins for various applications including plastic materials, foams, adhesives, films and coatings.


We assessed the implementation accuracy and fidelity of two board certified behavior analysts (BCBAs) using the open-ended interview from Hanley. Participants interviewed a confederate using the open-ended interview, and were then asked to use information gathered from the interview to create operational definitions of target behaviors as well as test and control condition procedures for a subsequent matched test-control functional analysis as is characteristic of the interview-informed synthesized contingency analysis (IISCA) strategy. Brief behavioral skills training (BST) was then implemented with all participants to increase the accuracy of constructing both target behavior definitions and functional analysis procedures. Preliminary results show moderate rates of accuracy of target behavior definitions and functional analysis procedures prior to BST, and high rates of accuracy following BST. The results also suggest high implementation fidelity on the open-ended interview may not be necessary to achieve high accuracy when constructing target behavior definitions and functional analysis procedures.


In recent years, the choice of prior distributions for Bayesian logistic regression has received considerable interest. It is widely acknowledged that noninformative, improper priors have to be used with caution because posterior propriety may not always hold. As an alternative, heavy‐tailed priors such as Cauchy prior distributions have been proposed by Gelman et al. (2008). The motivation for using Cauchy prior distributions is that they are proper, and thus, unlike noninformative priors, they are guaranteed to yield proper posterior distributions. The heavy tails of the Cauchy distribution allow the posterior distribution to adapt to the data. Thus Gelman et al. (2008) suggested the use of these prior distributions as a default weakly informative choice, in the absence of prior knowledge about the regression coefficients. While these prior distributions are guaranteed to have proper posterior distributions, Ghosh, Li, and Mitra (2018), showed that the posterior means may not exist, or can be unreasonably large, when they exist, for datasets with separation. In this paper, we provide a short review of the concept of separation, and we discuss how common prior distributions like the Cauchy and normal prior perform in data with separation. Theoretical and empirical results suggest that lighter tailed prior distributions such as normal prior distributions can be a good default choice when there is separation.


China, the European Union and Global Governance examines the key determinants of European and Chinese approaches to the restructuring of global governance systems.


The Khatay'namah, or Book of China, a description of Chinese government and society in the mid-Ming period, written by a Central Asian merchant and presented to the Ottoman court in 1516, is evidence that the advent of more rationalized, centralized, and bureaucratic forms of governance in Ming China played a significant role in political developments in the Islamic world. The political ideology of the Ming founder, combining bureaucratic absolutism with a kind of populism that emphasized a direct connection between ruler and subjects, would see a close parallel in the Ottoman Empire in the reign of Suleyman I (1520–66). The Chinese near contemporary of Suleyman, the Zhengde emperor (1505–21), promoted his reign as a continuation of the Mongol Empire, called himself by the title Sheikh 'Alam, and took other measures that engendered speculation of his conversion to Islam. This and other developments in China, including construction of the Great Wall in the late fifteenth century, resonated with millenarian beliefs in the Islamic world. The Khatay'namah's description of China evokes millenarian, utopian ideals but also demystifies China's prosperity, which it attributes to the Chinese people's assiduous adherence to law and system, or qanun. This account of China reflects the importance of cross-border trade, the military, and Muslim Chinese communities as sites of encounter between the Islamic world and the Chinese state. The text's rhetorical strategy of emphasizing similarities between China and the Ottoman Empire may be a reflection of early attempts by Muslim Chinese to negotiate a distinct Chinese Islamic identity.


Importance Overdiagnosis of cancer—the identification of cancers that are unlikely to progress—is a source of discomfort and challenge for patients, physicians, and health care systems. A major cause of this discomfort is the inability to know prospectively with certainty which cancers are overdiagnosed. In thyroid cancer, as patients have begun to understand this concept, some individuals are independently deciding not to intervene, despite this practice not yet being widely accepted. Objective To describe the current experience of people who independently self-identify as having an overdiagnosed cancer and elect not to intervene. Design, Setting, and Participants In this qualitative study, semistructured interviews were conducted between July 1 and December 31, 2015, with 22 community-dwelling adults aged 21 to 75 years who had an incidentally identified thyroid finding that was known or suspected to be malignant and who questioned the intervention recommended by their physicians. Verbatim transcripts were analyzed using constant comparative analysis. Main Outcomes and Measures The experience of individuals who self-identify as having an overdiagnosed cancer and elect not to intervene. Results Of the 22 people interviewed (16 females and 6 males; mean age, 48.5 years), 18 had elected not to intervene on their thyroid finding and had been living with the decision for a mean of 39 months (median, 40 months; range, 1-88 months). Twelve of the 18 participants reported that they experienced significant anxiety about cancer progression, but had considered reasons for choosing nonintervention: understanding issues of precision in diagnostic testing and the varied behavior of cancer, surgical risks, medication use, and low risk of death from the cancer. Twelve participants described their decisions as met with nonreassuring, unsupportive responses. Medical professionals, friends, and internet discussion groups told them they were "being stupid," "were wrong," or were "crazy" to not intervene. Although 14 individuals said they wished to connect with others about their experiences, only 3 reported success in doing so. Fifteen participants reported that they managed their overall experience through secret keeping. By the time of this study, 5 of the 18 individuals had discontinued surveillance, the recommended alternative to intervention. Despite this, only 7 participants "wished they did not know" about their thyroid finding. Conclusions and Relevance Isolation and anxiety characterize the current experience of patients with thyroid cancer who are living with the decision to not intervene. These patients are at risk of disengaging from health care. Successful de-escalation of intervention for patients who self-identify as having overdiagnosed cancers requires explicit social and health system support and education. We hypothesize that improved support would also promote quality of care by increasing the likelihood that patients could be kept engaged for recommended surveillance.


Abstract In unconfined parts of the Chalk aquifer in southeast England, permeability generally varies laterally with the lowest permeabilities occurring beneath interfluve areas, and the highest beneath river valleys and dry valleys. Furthermore, the Chalk in the river valleys is normally in excellent hydraulic continuity with the overlying highly permeable Quaternary gravels. However, recent field investigations in the Thames Valley have demonstrated the existence of zones of anomalously low Chalk permeability associated with the development of thin discontinuous confining layers of low permeability 'putty chalk' at the gravel-chalk interface. Hitherto putty chalk in the Middle Thames Valley has mostly been reported from interfluve areas where it can occur as a periglacially frost-weathered mantle on the upper surface of the Chalk. The true extent and hydraulic significance of putty chalk in valley bottom positions is only now being realised. Existing models for the lateral variation in Chalk permeability cannot explain these new observations. A new model is therefore proposed in which it is envisaged that, during the Devensian, carbonate dissolution in perennial taliks (unfrozen zones) beneath the major channels of the braided palaeo-Thames caused the high-permeability zones, while permafrost beneath the interfluves restricted dissolution at those sites. Freeze-thaw action in seasonal taliks beneath minor channels would account for the formation of putty chalk at the gravel-chalk interface, and the persistence of permafrost beneath these seasonal taliks would lead to a restriction of dissolution, and thus to a zone of low permeability.


The Noongar people of the South West of Western Australia (WA) continue to seek self-determination and empowerment to ensure their families are able to meet cultural, economic and social needs. Their aspirations, however, are thwarted by a significant number of their members who are incarcerated and the adverse consequences of imprisonment on families. In the meantime, the WA prison system is yet to respond to the unique needs of Noongar prisoners transitioning out of the prison system. The article reviews the literature to develop the idea of a Noongar re-entry peer navigator (PN) model. In this model, select Noongar people who have lived experience of incarceration and who have received training in peer work would be used to support Noongar prisoners during the fraught and lengthy process of re-engaging with families, settling into their communities, and living on Country. The review traces the growth of the PN model in the health system, the prison system, and, more recently, in cross-sector engagements between the prison and service organisations. Consideration is thereafter given to the strengths and limits of the re-entry PN model. The article closes with a discussion on the potential of developing a Noongar re-entry PN to assist Noongar prisoners to achieve re-entry while increasing their prospects for a law-abiding and wholesome life Noongar way.


Biodiversity and Ecosystem Services: Similar but Different In their May Forum piece, Reyers and colleagues (2012) argued that narrow interpretations of biodiversity and ecosystem services have obscured common ground between the two. I am concerned that their narrow interpretation of biodiversity values as largely intrinsic has done the same thing. Although Reyers and colleagues acknowledged that biodiversity conservation occurs for lots of reasons, they claimed that it is often associated with a biocentric, intrinsic-value perspective and that "the concept of biodiversity emerges from an intrinsic context" (p. 503). However, the case for biodiversity conservation equally has its roots in anthropogenic values. For example, the World Conservation Strategy (IUCN 1980), written back when biodiversity was still diversity, strongly promoted conservation to ensure benefits for future generations. It called for conservation of diversity for present and future use. Similarly, McNeely (1988) highlighted the need for a "safety net of diversity." McNeely (1988) linked such anthropocentric values to option values, reflecting the value of biodiversity in providing uses, often unanticipated, for future generations (for a review, see Faith 2007). This broader perspective, based on anthropogenic use values, sheds light on Reyers and colleagues' examples. These examples seem to have focused narrowly on intrinsic, nonanthropogenic, biodiversity values. In their win–neutral example, biodiversity conservation action supposedly has "no apparent human benefit" (p. 506), because no ecosystem services gains are apparent. In their win–lose example, fencing off protected areas, excluding hunting and other current human uses, supposedly makes biodiversity conservation hard to justify because it "will run counter to... human well-being" (p. 506). A narrow intrinsic-values perspective might justify these conclusions, but the broader perspective properly recognizes biodiversity con servation as also offering human-use benefits; it's just that these values may be more about option values and future generations than about the current benefits from those recognized ecosystem services. Biodiversity and ecosystem services share common ground based on anthropogenic use values but may differ in how well they capture current and future uses. They are similar but different. Sustainability depends on finding synergies or efficient trade-offs among the many different needs of society, and a major challenge will be ensuring human well-being for both current and future generations. DANIEL P. FAITH Daniel P. Faith (danfaith8@yahoo. com.au) is a research scientist at the Australian Museum, Sydney, Australia.


The mechanical properties of galvannealed dual phase steels bearing Si were investigated, and then the effect of Si on work hardening behavior during tensile deformation was discussed. Both tensile strength and yield strength were increased with increasing Si content, especially increasing ratio of tensile strength was larger than that of yield strength. On the other hand, the decrease of uniform elongation was very small with increasing Si content. Therefore, tensile strength and total elongation balance was improved by Si addition. High Si (1.2%Si) steel exhibited higher work hardening rate than low Si (0.01%Si) steel in all strain region. Dislocation cell structures were observed at 8% tensile strain in low Si steel, while dislocation cell structures were scarcely observed and instead, tangled dislocations were dominantly observed in high Si steel. Furthermore, high Si steel exhibited higher the increasing ratio of dislocation density in ferrite during tensile deformation than low Si steel. These results indicated that the formation of dislocation cell structure was retarded by Si addition, which led to the increase of work hardening rate and resulted in the improvement of tensile strength and total elongation balance.


This paper presents a white LED backlight driving chip with 3-bit dimming controller and duty-variable power MOS which can be modified with the voltage-mode pulse width modulation (PWM). In the proposed chip, a 3-bit digital-to-analog converter (DAC) and a ramp generator are used to provide eight pulses with variable width through a voltage comparator. Thus, a 3-bit dimming controller can be implemented with those duty cycles for white LED backlight driver. In this paper, the proposed chip is designed and implemented with TSMC 0.35 µm 2P4M CMOS process. The simulation results of the switching DC-DC boost converter show that the output voltage, output current, and chip area are 20 V, 20 mA, and 1.45×1.28 mm2, respectively, at the supply voltage of 3.7 V. The output voltage of 20 V can drive five white LEDs because that a white LED works with a driving voltage of 3.5 V and a driving current of 20 mA.


Intra-guild predation (IGP) – where a top predator (IGPred) consumes both a basal resource and a competitor for that resource (IGPrey) – has become a fundamental part of understanding species interactions and community dynamics. IGP communities composed of intraguild predators and prey have been well studied; however, we know less about IGP communities composed of predators, pathogens, and resources. Resource quality plays an important role in community dynamics and may influence IGP dynamics as well. We conducted a meta-analysis on predator–pathogen–resource communities to determine whether resource quality mediated by the pathogen affected predator life-history traits and if these effects met the theoretical constraints of IGP communities. To do this, we summarized results from studies that investigated the use of predators and pathogens to control insect pests. In these systems, the predators are the IGPred and pathogens are the IGPrey. We found that consumer longevity, fecundity, and survival decreased by 26%, 31% and 13% respectively, when predators consumed pathogen-infected prey, making the infected prey a low quality resource. Predators also significantly preferred healthy prey over infected prey. When we divided consumers by enemy type, strict predators (e.g. wolf spiders) had no preference while parasitoids preferred healthy prey. Our results suggest that communities containing parasitoids and pathogens may rarely exhibit intraguild predation; whereas, communities composed of strict predators and pathogens are more likely dominated by IGP dynamics. In these latter communities, the consumption of low and high quality resources suggests that IGP communities composed of strict predators, pathogens and prey should naturally persist, supporting IGP theory.

Synthesis

We investigated how consuming pathogen-infected prey influence important life-history parameters of insect predators. Pathogens are used in a variety of biocontrol programs, especially to control crop pests. We found that true predators (i.e. wolf spiders) have no preference for healthy or infected prey and have reduced fecundity, survival and longevity consuming infected prey. However, parasitoids avoided infected prey when possible. In biocontrol programs with multiple control agents, parasitoids and pathogens would do a better job controlling pests as predators would reduce the amount of pathogen available and have reduced fitness from consuming infected prey. However, theory suggests that true predators, prey and pathogens may coexist long term.


Abstract High-resolution δ18O records from a Geladaindong mountain ice core spanning the period 1477-1982 were used to investigate past temperature variations in the Yangtze River source region of the central Tibetan Plateau (TP). Annual ice-core δ18O records were positively correlated with temperature data from nearby meteorological stations, suggesting that the δ18O record represented the air temperature in the region. A generally increasing temperature trend over the past 500 years was identified, with amplified warming during the 20th century. A colder stage, spanning before the 1850s, was found to represent the Little Ice Age with colder periods occurring during the 1470s–1500s, 1580s–1660s, 1700s–20s and 1770s–1840s. Compared with other temperature records from the TP and the Northern Hemisphere, the Geladaindong ice-core record suggested that the regional climate of the central TP experienced a stronger warming trend during the 20th century than other regions. In addition, a positive relationship between the Geladaindong δ18 O values and the North Atlantic Oscillation index, combined with a wavelet analysis of δ18 O records, indicated that there was a potential atmospheric teleconnection between the North Atlantic and the central TP.


The sex comb on the forelegs of Drosophila males is a secondary sexual trait, and the number of teeth on these combs varies greatly within and between species. To understand the relationship between the intra- and interspecific variation, we performed quantitative trait locus (QTL) analyses of the intraspecific variation in sex-comb tooth number. We used five mapping populations derived from two inbred Drosophila simulans strains that were divergent in the number of sex-comb teeth. Although no QTLs were detected on the X chromosome, we identified four QTLs on the second chromosome and three QTLs on the third chromosome. While identification and estimated effects of the second-chromosome QTLs depend on genetic backgrounds, significant and consistent effects of the two third-chromosome QTLs were found in two genetic backgrounds. There were significant epistatic interactions between a second-chromosome QTL and a third-chromosome QTL, as well as between two second-chromosome QTLs. The third-chromosome QTLs are concordant with the locations of the QTLs responsible for the previously observed differences in sex-comb tooth number between D. simulans and D. mauritiana.


OBJECTIVE: The objective was to describe the characteristics of pediatric discharges associated with long-term mechanical ventilation (LTMV) compared with those with complex chronic conditions (CCCs), and evaluate trends over time in health care utilization for the discharges associated with LTMV. METHODS: The Kids' Inpatient Database, compiled by the Agency for Healthcare Research and Quality, was used. Routine newborn care was excluded. Discharges associated with LTMV were identified by using the International Classification of Diseases, Ninth Revision, code v46.1x and compared with discharges associated with CCCs in 2006 using simple regression and χ2 analyses. Trends in LTMV-associated discharges from 2000 to 2006 were assessed using variance-weighted least squares regression. RESULTS: In 2006, there were an estimated 7812 discharges associated with LTMV. Compared with discharges for children with CCCs, LTMV discharges had significantly higher mortality, longer lengths of stay, higher mean charges, more emergency department admissions, and more discharges to long-term care. From 2000 to 2006, there was a 55% increase in the number of LTMV discharges and a concurrent 70% increase in aggregate hospital charges. The majority of LTMV discharges occurred in children 4 years old and younger, and ∼50% of the aggregate charges were for children younger than 1 year. CONCLUSIONS: Discharges for children associated with LTMV require substantively greater inpatient resource use than other children with CCCs. As the number of discharges and associated aggregate charges increase over time, additional research must examine patterns of care for specific clinical subgroups of LTMV, especially children aged 4 years and younger.


The Dutch polder model has practised secular moderation of bargained wages – 25 years' standstill of purchasing power. Regulatory capture let the minimum wage lag behind and lowered the lowest wage scales, increasing wage inequality. This combined with strong employment growth – mostly in part-time jobs, often low paid and insecure. The household employment rate remained stagnant as single-earner and dual-earner households traded places. The frequent association of higher with lower earnings within dual-earner households mitigated the effects of wage inequality on household income inequality for the persons involved, but also increased inequality as it lifted many of these households higher up the distribution vis-a-vis other households. More than half of all actual aggregate wage growth has accrued to the top decile of the income distribution. Dual-earner world households' joint access to jobs and working hours adds an essential dimension to income inequality that the polder model has missed.


Abstract
This paper outlines our knowledge of the reaction of organophosphorus compounds and carbamates with esterases, examples of particular aspects of the reaction being confined to cholinesterases, although the general principles discussed apply to all B-esterases. Mathematical expressions are given for the different rate constants, and some of the factors that may affect the response of insect and mammalian cholinesterases to organophosphorus compounds and carbamates are discussed.


We investigate the relationship between the Lyapunov exponents of periodic trajectories, the average and fluctuations of Lyapunov exponents of ergodic trajectories, and the ergodic autocorrelation time for the two-dimensional hyperbola billiard. We then study the fluctuation properties of the ergodic Lyapunov spectrum of classical SU(2) gauge theory on a lattice. Our results are consistent with the notion that this system is globally hyperbolic. Among the many powerful theorems applicable to such systems, we discuss one relating to the fluctuations in the entropy growth rate.


The paper reviews the implications of vertical relationships in the fast moving consumer goods markets. Concentration in retailing has changed the balance of power between large brand manufacturers and retailers, making effective the countervailing power that Galbright pointed out in his 1952 book. Through the allocation of space in their stores and selective delisting of products from their assortments, large retailers can obtain lower prices from their suppliers which are then passed on to consumers. Rents obtained by brand manufacturers are reduced and, to improve their margins, they are also lead to dealing more aggressively with their own suppliers. In this way competition in retailing spills over vertically and improves the efficiency of the entire value chain. Moreover, retailers also challenge the market power of their suppliers offering to consumers their own brands. This plays as an indirect stimulus to innovation as manufacturers have to propose new products to make more difficult to retailers to copy existing ones and obtain part of their market. Therefore, it is emphasized how a competitive retail system has widespread implications on the overall efficiency of the economy.


Food selectivity is a common problem for children with autism spectrum disorder (ASD; Schreck, Williams, & Smith, 2004). Behavior-analytic interventions have the most empirical support for feeding disorders (Sharp, Jaquess, Morton, & Miles, 2011). However, there are no randomized controlled trials that have evaluated its effects with a well-defined cohort of children with ASD. In the current investigation, we randomly assigned 6 young children with ASD and food selectivity to either an applied behavior analytic intervention or a wait-list control. We used a crossover randomized controlled trial to evaluate the effects of a multicomponent applied behavior analytic intervention on independent acceptance and mouth clean of 16 novel foods. We subsequently exposed the wait-list control group to the intervention. We also evaluated the effects of the intervention on individual participants with single-case designs. The percentage of independent acceptance and mouth clean increased for the applied behavior analytic intervention group, but not for the wait-list control group until we implemented the intervention.


In this article we introduce an inner parallel cutting plane method (IPCP) to compute good feasible points along with valid cutting planes for mixed-integer convex optimization problems. The method iteratively generates polyhedral outer approximations of an enlarged inner parallel set (EIPS) of the continuously relaxed feasible set. This EIPS possesses the crucial property that any rounding of any of its elements is feasible for the original problem. The outer approximations are refined in each iteration by using modified Kelley cutting planes, which are defined via rounded optimal points of linear optimization problems (LPs). We show that the method either computes a feasible point or certifies that the EIPS is empty. Moreover, we demonstrate how inner parallel cuts can be reversed so that they are valid for the original problem, and we provide bounds on the objective value of the generated feasible points. As there exist consistent problems which possess an empty EIPS, the IPCP is not guaranteed to find a feasible point for the latter. Yet, the crucial advantage of the method lies in the difficulty of each iteration: While other approaches need to solve a mixed-integer linear optimization problem, the IPCP only needs to solve an LP. Indeed, our computational study indicates that the IPCP is able to quickly compute feasible points and reversed inner parallel cutting planes for many practical applications. It further demonstrates that the computed points are generally of good quality and that the reversed inner parallel cuts can help to speed up outer approximation based methods. Christoph Neumann Institute of Operations Research, Karlsruhe Institute of Technology (KIT), Germany E-mail: firstname.lastname@example.com Oliver Stein Institute of Operations Research, Karlsruhe Institute of Technology (KIT), Germany E-mail: firstname.lastname@example.com 2 Christoph Neumann, Oliver Stein


War and migration in the Balkans caused traumatic experiences in great parts of it's population. About four million people living in former Yugoslavia as well as about 100, 000 refugees living in different European countries are estimated to suffer from on-going and severe psychological symptoms of post-traumatic stress. Although in need of treatment, many of these people do not seek treatment. Given the fact that, if untreated, post-traumatic stress reactions tend to persist for many years, often resulting in impairment and disability secondary to the symptom complex, offering appropriate care is a special challenge to health services. With regard to this context, an EC-funded multi-centre study including partners from Belgrade (SCO). Dresden (D), London (UK), Rijcka (HR), Sarajevo (BIH), and Zagreb (HR) aims (a) to provide an empirical basis for designing care programmes for people suffering from post-traumatic stress following war and migration in the Balkans who currently do not seek treatment, and (b) to improve the cost-effectiveness of treatment programmes for those patients who are cared for in specialised treatment centres


In recent years, the use of polymers made from renewable materials has been
developed in diverse areas especially in furniture, mattresses, automotive or building
components. Polyurethanes (PU's) made from renewable materials are one of the most
important groups of polymers because of their versatility and they can be manufactured
in a wide range of grades, densities and stiffness. In this project, polymers based on
renewable materials such as rapeseed (RS) and sunflower oil (SF) were synthesized and
cross-linked with methylene di-/>-phenyl diisocyanate (MDI) to form polyurethanes.
Treatment with titanium dioxide (TiCh) was found to affect the physical
properties of the polyurethane in a systematic way. As the loadings of TiOj were
increased (up to 10% of monomer weight), large strain responses were obtained; thus
the stress vs. strain curves plotted by the Instron tensile test showed an increase from
5% to 31%). This study also revealed a remarkable characteristic in the pigmented
polymer exhibiting soft - but - tough behaviour at high TiC>2 loading.
The DMTA test also showed that the properties of the sample loaded with 10 %
TiC>2 increased its tan delta peak (damping factor) from 0.43 to 0.7. The tan delta peak
showed that the damping properties of the material were improved markedly upon
loading with TiC>2. This is useful since noise is radiated by vibration, and the application
of damping materials to the vibrating surface converts the energy into heat, which is
dissipated within the damping materials rather than being radiated as airborne noise.
Increase in TiC>2 loading also gave a progressive increase of hardness (Shore D) for both
RS and SF oil - based polyurethanes.
The effect of prolonged exposure to UVB light, in general promotes
photodegradation for both RS and SF-based polyurethanes, both neat and also material
loaded with TiCh- The photodegradation of the PU's depends on the grade of titanium
dioxide. The addition of 10 % Degussa P25 pigment, gives the greater degradation
while PUs loaded with 5 % Kronos 2220 show the slowest rates of degradation due to
the effect of the coating of this pigment.
The photostabiliser Tinuvin 770 also offers high protection from UVB, while the
combination of Tinuvin 770 and Degussa P25 gave the highest protection from UVB.
Addition of Tinuvin 770 at the stage of preparation of the PUs also greatly reduced the
undesirable yellow colouration prevalent during PU syntheses.


Because so few universities and colleges understand, teach and/or practice the philosophy, concepts and tools of total quality management (TQM), industry practitioners have for many years been providing this much-needed education and training in a variety of venues, both to recent graduates and their more senior colleagues. This paper reviews the intent, content and results of a comprehensive TQM course which has been taught under the sponsorship of the Institute of Industrial Engineers (IIE) and The George Washington University Continuing Engineering Education Program (GWU/CEEP).


Introduction/Aim: Aging of the parahippocampal cortex is accompanied by atrophy. The most common changes include cell number reduction, formation of corpora amylacea in astrocytes, which may represent the basis for the development of cognitive dysfunction. The aim of this study was to detect presence and distribution of corpora amylacea in subpial and subcortical region of parahippocampal cortex during aging process using histochemical analysis as well as to carry out quantification of structural changes in different cortical layers using histochemical and immunohistochemical methods. Material and Methods: Material represents tissue of uncus of parahippocampal gyrus of right cerebral hemisphere of 30 cadavers taken from autopsies carried out at the Forensic Medicine Institute of the Niš Faculty of Medicine. Upon tissue preparation using standard histological procedures, 10 μm thick sections were made and stained with hematoxylin eosin and periodically with acid Schiff's method. The total number of 30 samples, 16 to 93 years of age, was analyzed. Results: During the normal aging process in parahippocampal cortex the number of corpora amylacea localized in subpial region increases, and it is even greater in subcortical white matter, with no significant change in size and shape. Positive reaction to neuron specific enolase, determined by immunohistochemical methods suggests the presence of neural components, while a weaker reaction to glial acid protein and positive one to S100 protein suggests the possibility that the corpora amylacea are astrocyte inclusion. Conclusion: The obtained results indicates that the presence of these structural changes may lead to damage of those brain structures responsible for normal memory function and thus responsible for cognitive changes present in healthy elderly individuals.


Wood anatomical studies in the economically important Apocynaceae or dogbane family are fragmentary. This study represents a first attempt to unravel the phylogenetic significance and major evolutionary trends in the wood of the family, using existing and new microscopic wood observations within the large subfamily Rauvolfioideae. On the basis of LM and SEM observations of 91 species representing all 10 currently recognized tribes, we found that most of the tribes are characterized by a unique combination of wood characters, such as vessel grouping, vessel element length, fiber type, frequency of uniseriate rays, and fused multiseriate rays. Climbing rauvolfioid taxa can generally be distinguished from erect species by their wider vessels, tendency to form paratracheal axial parenchyma, presence of tracheids, and occurrence of laticifers in rays. With respect to the entire family, there is a general phylogenetic trend toward shorter vessel elements, a higher proportion of vessels in multiples and more vessels per multiple, higher tracheid abundance, more paratracheal parenchyma, and fewer cells per axial parenchyma strand in the more derived Apocynaceae. Most of these evolutionary trends are likely to be triggered by drier environmental conditions and/or shifts from an erect to a climbing habit.


Current techniques used to monitor glucose concentration of cell culture media (CCM) require invasive and tedious handling of the sample for sterile media removal and nutrient replacement. In order to optimize cell culture growth in bioreactors, biosensors must be developed that are capable of monitoring the cell culture processes noninvasively and continuously. In this study, on-line, noninvasive determinations of glucose in cell culture media were investigated via near-infrared spectroscopy (NIR) across the 2.0–2.5 μm combination region. A system was developed, using a unique fiberoptic coupling method and a commercial Fourier transform infrared (FT-IR) spectrometer, to characterize glucose single-beam spectra collected from cell culture media. This novel system is the first of its kind and integrates a completely noninvasive optical probe to measure glucose concentrations within cell culture media, in situ. Spectra recorded from a four-day fibroblast culture with this fiber coupled system and an FT-IR spectrometer have been analyzed and compared with standard clinical chemistry techniques. Partial least-squares (PLS) regression has been used to extract the analyte-dependent information and to build a successful multivariate calibration model. A combination of spectra from cell culture media and prepared media mixtures was used to eliminate unwanted correlations in the calibration data. The combined use of this unique fiberoptic system, PLS, and uncorrelated spectra resulted in a true glucose prediction error of 14.8 mg/dL in an independent validation set.


Women's employment patterns changed drastically the last decades. But they are still different across Europe. Welfare state scholars often presume that diversity and change in women's employment across Europe is based on financial (dis) incentive structures embedded in welfare states (Esping-Andersen 1990, 1999, 2002; Sainsbury 1996, 1990; O'Connor et al. 1999; Lewis 1992, 1997). In other words: if childcare is available and affordable. Most mothers will work. If tax and benefit schemes have no financial employment obstructions, most mothers will work.
This book shows, by in depth analyses of women's (and men's) employment and care patterns as well as child care services, taxation, leave schemes and social security in four different welfare states (the UK, the Netherlands, Denmark and Belgium) that this logic does not hold. It is based too much on the misunderstanding that women's decision making is exclusively based on economic self-interest. But a mother is not primarily the homo economicus welfare state scholars tend to presume. 'to work or to care 'is above all a moral predicament. A more suitable understanding is to study what march and Olsen (1989) call 'the logic of appropriateness'. This is also very different point of departure of human behaviour than the 'preference person' which is also used the explain differences in Europe (Hakim 2000, 2003).
What explains better the differences in Europe is the cultural analysis of welfare states. In the case of caring and paid employment, welfare states send culturally-defined moral images of good-enough caring in the form of ideals of care. An ideal of care implies a definition of what is good care and who gives it. These ideals of care are embedded in welfare states and their regulations, laws and implementation processes. Each welfare state promotes specific ideals of care. Cultural explanations (such as Hakim 2000, 2003 and Pfau-Effinger 1998) downplay the role of the state too much. Culture, as is shown, is located within rather than outside the welfare state.
Studying ideals of care not only gives insight into the outcomes of policy, but also into the origins of care policy. Ideals of care are not so much linked to the dominant ideologies that are said to explain the development of welfare states (such as Liberalism, Christian Democracy and Social Democracy) but to what the women's movement (in the broadest sense of the word) proposed, in alliance with more powerful actors, such as a political party in government, professional organisations or women in trade unions.
Five ideals of care are distinguished: full-time motherhood, surrogate motherhood, parental sharing, intergenerational care and professionals care. Each of these ideals has consequences for women's employment patterns and differences between women. In Belgium, for instance, mothers' employment levels have historically been relatively high. The last decades they hardy increased. Many mothers even turn to part-time employment. The study of ideals of care shows that in this country surrogate motherhood is promoted by the welfare state. This ideal means that children are cared for well by someone who closely resembles the real mother, such as a childminder. Even though this gave mothers the moral comfort to enter the labour market, this ideal perpetuates the notion that mothers' care is still best. Childminders are just surrogate. In Denmark, in contrast, the ideal of professional care is dominant: children are cared for best by well-educated professionals, which is even better than when they stay at home with their mother. This ideal of care turns out to be the best guilt-reduction strategy: Denmark has the highest level of women working and nearly all of them work full-time.
This book tries to show, by studying care policy in welfare states, that social policy has an impact on women's and men's division of labour and care. But especially when welfare states are not seen as a financial structures only, but as cultural catalysts.


Introduction: Retinopathy of prematurity (ROP) remains an important cause for preventable blindness. Aside from gestational age (GA) and birth weight, risk factor assessment can be important for determination of infants at risk of (severe) ROP. Methods: Prospective, multivariable risk-analysis study (NEDROP-2) was conducted, including all infants born in 2017 in the Netherlands considered eligible for ROP screening by pediatricians. Ophthalmologists provided data of screened infants, which were combined with risk factors from the national perinatal database (Perined). Clinical data and potential risk factors were compared to the first national ROP inventory (NEDROP-1, 2009). During the second period, more strict risk factor-based screening inclusion criteria were applied. Results: Of 1,287 eligible infants, 933 (72.5%) were screened for ROP and matched with the Perined data. Any ROP was found in 264 infants (28.3% of screened population, 2009: 21.9%) and severe ROP (sROP) (stage ≥3) in 41 infants (4.4%, 2009: 2.1%). The risk for any ROP is decreased with a higher GA (odds ratio [OR] 0.59 and 95% confidence interval [CI] 0.54–0.66) and increased for small for GA (SGA) (1.73, 1.11–2.62), mechanical ventilation >7 days (2.13, 1.35–3.37) and postnatal corticosteroids (2.57, 1.44–4.66). For sROP, significant factors were GA (OR 0.37 and CI 0.27–0.50), SGA (OR 5.65 and CI 2.17–14.92), postnatal corticosteroids (OR 3.81 and CI 1.72–8.40), and perforated necrotizing enterocolitis (OR 7.55 and CI 2.29–24.48). Conclusion: In the Netherlands, sROP was diagnosed more frequently since 2009. No new risk factors for ROP were determined in the present study, apart from those already included in the current screening guideline.


We construct an integrated assessment model with multiple energy sources—two fossil fuels and green energy—and use it to evaluate ranges of plausible estimates for the climate sensitivity, as well as for the sensitivity of the economy to climate change. Rather than focusing explicitly on uncertainty, we look at extreme scenarios defined by the upper and lower limits given in available studies in the literature. We compare optimal policy with laissez faire, and we point out the possible policy errors that could arise. By far the largest policy error arises when the climate policy is overly passive; overly zealous climate policy (i.e., a high carbon tax applied when climate change and its negative impacts on the economy are very limited) does not hurt the economy much as there is considerable substitutability between fossil and nonfossil energy sources.


In a previous paper (1) an observation on the incubation period of Plasmodium vivax was reported, which showed that for several days subsequent to inoculation by sporozoites, the presence of parasites in the peripheral blood stream could not be demonstrated by daily subinoculations of 10 cc. quantities of blood until the eighth day subsequent to inoculation. It appeared desirable to repeat an experiment of this type employing Plasmodium falciparum as the test organism. The results were as follows:
Experiment 109. (a) As a test subject there was selected a Negro male patient (1181) for whom malaria therapy was prescribed. (b) Twelve other Negro male patients requiring malaria therapy were utilized. (c) Anopheline mosquitoes of Lot 729, infected with the Long strain of P. falciparum, were employed for the inoculation of the test patient.
Immediately prior to the inoculation of the test patient 1181, on May 19, 1938, 10 cc. of his blood were removed and injected intravenously into patient B1855.


The microstructure evolution and the growth behavior of intermetallic compounds (IMCs) at Sn-xZn-2Cu/Cu (x=6.5, 8.8, 10 and 12, wt%) interfaces during soldering were investigated. The results indicate that planar Cu5Zn8 layer is formed at each interface of Sn-8.8Zn-2Cu/Cu, Sn-10Zn- 2Cu/Cu and Sn-12Zn-2Cu/Cu couples for all soldering time. However, for Sn-6.5Zn-2Cu/Cu couple, it is Cu5Zn8 phase that formed at the interface within shorter soldering time (1 h and 4 h), but the interfacial reaction products become a double layer structure of Cu6Sn5 phase (near Cu substrate) and CuZn phase (near solder) for longer soldering time (25 h and 49 h). The thickness of IMC layers in all couples increases exponentially with the soldering time. It is also found that for the same soldering time, the thickness of IMC layers increases with increasing Zn content in the solder.


This paper presents a novel technique for reducing time delay and improving the performance of Automatic Link Establishment (ALE) in High Frequency (HF)radios. The techniques proposed for Listen Before Transmit(LBT) based on cognitive radio sensing techniques such as energy detection, matched filter detection and cyclostationary feature detection. ALE is a de facto standard for HF radios through which communication is to be carried out by automatically selecting the channel. Current LBT techniques for ALE work fine for good quality channels but it performs pitiable when the channel quality becomes worst.


Background: Ankylosing spondylitis (AS) is a chronic, progressive, inflammatory disease of the spine and SI joints. Diagnostic criteria and treatments have continued to evolve, necessitating a historical compendium of AS and its management. This paper aims to review the historical context underlying the discovery of AS, as well as the major diagnostic and therapeutic discoveries in the last two centuries. Methods: A scoping review of the literature pertaining to AS was performed via the Pubmed, Scopus, and Web of Science databases. Future directions of AS treatments were assessed by querying the clinicaltrials.gov website. Results: The history of AS can be traced as far back as ancient Egypt (as evidenced by the discovery of its presence in ancient Egyptian mummies) to the late 20th century, when the inherited nature of AS was linked to a genetic factor, HLA-B27. Each discovery made throughout the years led to further investigations into the pathophysiology, diagnosis, and treatment of AS. The criteria to differentiate AS from rheumatoid arthritis were first reported in 1893. Since then, diagnostic criteria for AS have undergone a series of changes before the present-day diagnostic criteria for AS were ultimately determined in 2009 by the Assessment of Spondyloarthritis International Society. Conclusion: As the pathophysiology of AS is better understood, healthcare providers are able to diagnose and treat the condition more effectively. In particular, earlier diagnosis and multiple treatment options have facilitated efficient and more effective treatment.


In this paper we study scheduling problems in unbuffered WDM packet switching networks when the packets have different priorities. The WDM packet switching networks we consider have wavelength conversion ability. We focus on limited range wavelength conversion since it is easier to implement and more cost effective than full range wavelength conversion and also contains the latter as a special case. We formalize the problem of optimal scheduling as a problem of finding an optimal matching in a weighted bipartite graph. The optimal matching is capable of both maximizing network throughput and providing good service differentiation. We give a simple algorithm called the zig-zag path insertion algorithm which solves the problem in O(NKlog(Nk) + NkD) time, where N is the number of input/output fibers of the switching network, k is the number of wavelengths per fiber and D is the conversion degree, as compared to O(N/sup 2/k/sup 2/) time if directly adopting other existing algorithms.


Background Organizational readiness for change is a key factor in success or failure of electronic health record (EHR) system implementations. Readiness is a multifaceted and multilevel abstract construct encompassing individual and organizational aspects, which makes it difficult to assess. Available tools for assessing readiness need to be tested in different contexts. Objective To identify and assess relevant variables that determine readiness to implement an EHR in oncology in a low-and-middle income setting. Methods At the Uganda Cancer Institute (UCI), a 100-bed tertiary oncology center in Uganda,we conducted a cross-sectional survey using the Paré model. This model has 39 indicator variables (Likert-scale items) for measuring 9 latent variables that contribute to readiness. We analyzed data using partial least squares structural equation modeling (PLS-SEM). In addition, we collected comments that we analyzed by qualitative content analysis and sentiment analysis as a way of triangulating the Likert-scale survey responses. Results One hundred and forty-six clinical and non-clinical staff completed the survey, and 116 responses were included in the model. The measurement model showed good indicator reliability, discriminant validity, and internal consistency. Path coefficients for 6 of the 9 latent variables (i.e. vision clarity, change appropriateness, change efficacy, presence of an effective champion, organizational flexibility, and collective self-efficacy) were statistically significant at p < 0.05. The R2 for the outcome variable (organizational readiness) was 0.67. The sentiments were generally positive and correlated well with the survey scores (Pearson's r = 0.73). Perceived benefits of an EHR included improved quality, security and accessibility of clinical data, improved care coordination, reduction of errors, and time and cost saving. Recommended considerations for successful implementation include sensitization, training, resolution of organizational conflicts and computer infrastructure. Conclusion Change management during EHR implementation in oncology in low- and middle- income setting should focus on attributes of the change and the change targets, including vision clarity, change appropriateness, change efficacy, presence of an effective champion, organizational flexibility, and collective self-efficacy. Particularly, issues of training, computer skills of staff, computer infrastructure, sensitization and strategic implementation need consideration.


A synthetic urethane derivative of pladienolide D with potential antineoplastic activity. Pladienolide derivative E7107 is generated from the 12-membered macrolide pladienolide D, one of several macrolides derived from the bacterium Streptomyces platensis Mer-11107. This agent appears to bind to the 130-kDa subunit 3 (spliceosome-associated protein 130; SAP130) of the splicing factor 3b (SF3b), resulting in inhibition of pre-messenger RNA splicing and the arrest of cell-cycle progression. The splicing factor SF3b is a multiprotein complex integral to the accurate excision of introns from pre-messenger RNA; the subunit SAP130 associates with U2 snRNP and is recruited to prespliceosomal complexes.


This thesis investigated kleptoparasitism in mixed-species foraging aggregations of gulls (Laridae). Kleptoparasitism, or food stealing, is a strategy used frequently by gulls. Gull populations are increasing in urban areas despite declining overall. Understanding the role of kleptoparasitism in aiding gulls to invade urban environments was a central aim of this research. A second aim was to develop a model of kleptoparasitism using a compartmental modelling approach from evolutionary game theory and to test this using real foraging data.

Fieldwork was undertaken at two study sites: a coastal site (Brancaster beach, Norfolk, UK) and an urban site (Billingsgate Market, London, UK). The focal species were the Great black-backed gull (Larus marinus), Herring gull (Larus argentatus), Black-headed gull (Chroicocephalus ridibundus), and Common gull (Larus canus), these species forage together but differ in size and competitive ability. Foraging at the sites was recorded and analysed for kleptoparasitic incidents. Three kleptoparasitic strategies were considered: aggressive, stealth and scramble kleptoparasitism.

Four studies were conducted: Study 1 investigated differences in the rate of kleptoparasitism between the study sites and assessed the ecological predictors of this difference. The results showed kleptoparasitism was higher at the urban site and higher population density was the best predictor of this. Kleptoparasitism may aid invasion and increase the range of environments a gull can tolerate by helping them meet their energy needs in novel environments.

Study 2 described the patterns of kleptoparasitic behaviour observed at both sites. Large species used aggressive kleptoparasitism against smaller species, and smaller species used stealth kleptoparasitism when stealing from larger species. The use of stealth kleptoparasitism by smaller, subordinate foragers was identified as an empirical example of a Marauder strategy. Kleptoparasitic strategies were used flexibly to compete for resources against opponents of different competitive abilities.

Study 3 examined what strategies, other than kleptoparasitism, subordinate foragers at Billingsgate used to compete for resources. Subordinate gulls foraged for longer, stayed closer to potential food locations, arrived first at patches and took more risks to obtain food than dominants.

Study 4 developed a game-theoretical model and compared this model against the foraging data for Billingsgate. The results indicated the density of different foraging behaviours at Billingsgate may be at an equilibrium, but only 23% of foragers were using evolutionarily stable strategies. This result was attributed to a one-species model being used to describe a population containing three species of differing competitive ability. Further work applying game-theoretical models to field data is needed to assess how effectively gulls use kleptoparasitic strategies, particularly in novel environments such as urban areas.


Preeclampsia is a pregnancy-specific disease characterized by hypertension, proteinuria, and vascular abnormalities; the etiology of which is under active investigation. Utilizing the rat model of reduced uterine perfusion pressure (RUPP), our lab previously demonstrated that induction of hemeoxygenase-1 (HO-1) reduces blood pressure and oxidative stress in placental ischemic rats. While epithelial sodium channel proteins (specifically β-ENaC) are important in maintaining vascular myogenic tone and have been implicated in cytotropholast invasion, the effect of placental ischemia and induction of HO-1 on β-ENaC expression in placentas have not been established. Therefore, the purpose of this study is to test the hypothesis that placental β-ENaC expression is reduced in ischemic placentas and restored by HO-1 induction. Normal pregnant and RUPP rats were treated with the HO-1 inducer, cobalt protoporphyrin (CoPP) (n=4 per group/treatment). Blood pressure was measured and placentas were harvested on day 19 of gestation. Blood pressure increased from 101±1 to 141±4 mmHg (p<0.0001) in response to the RUPP procedure but was reduced by HO-1 induction (117±2 mmHg). RUPP rats also had fewer pups compared to normal pregnant rats (14±1 vs. 4±2 pups). HO-1 induction did not prevent the reduction in pup number. Placental β-ENaC protein expression was reduced by 62% in the RUPPs compared to the normal pregnant rats (p=0.036). HO-1 induction restored placental expression of β-ENaC to the levels of the normal pregnant rats. These findings suggest that HO-1 may exert its protective effects by altering the placental environment through changes in β-ENaC expression.


The traditional view of the morphology–spin connection is being challenged by recent integral field unit observations, as the majority of early-type galaxies are found to have a rotational component that is often as large as a dispersion component. Mergers are often suspected to be critical in galaxy spin evolution, yet the details of their roles are still unclear. We present the first results on the spin evolution of galaxies in cluster environments through a cosmological hydrodynamic simulation. Galaxies spin down globally with cosmic evolution. Major (mass ratios > 1/4) and minor (1/4 mass ratios > 1/50) mergers are important contributors to the spin-down in particular in massive galaxies. Minor mergers appear to have stronger cumulative effects than major mergers. Surprisingly, the dominant driver of galaxy spin-down seems to be environmental effects rather than mergers. However, since multiple processes act in combination, it is difficult to separate their individual roles. We briefly discuss the caveats and future studies that are called for.


Since his death in 1882, if not before, Charles Darwin has been a key icon of the modern era. The bearded sage of Down House has been invoked in a wide range of contexts in the English-speaking world, from eugenics and social policy to debates about the implications of science for religious belief. The essays in this Focus section explore the Darwinian image in an unusual diversity of media, examining portrait photographs, portable sculptures,newspaper caricatures, cartoons, after-dinner drinking songs, and long-playing records. They suggest that Darwin's celebrity needs to be understood not as the outcome of the unique qualities of his life and work, but as an aspect of the emergence of the idea of the scientist, a process closely tied to the developing communication and entertainment industries of the late nineteenth and early twentieth centuries.


The angular momentum (partial wave) reduction of the Lippmann--Schwinger equation describing the interaction of two spin 1/2 particles is extended to the case in which the spin singlet and triplet states are coupled. A straight forward method for obtaining the angular momentum decomposition of the general potential is indicated. The derived formalism is needed to describe the interaction between two nonidentical spin--1/2 particles or between two nucleons when isospin symmetry is violated. The resulting modification of the Stapp phase--shift analysis is given.


OBJECTIVES
Chronic hepatitis C virus (HCV) infection is associated with nonhepatocellular carcinoma malignancies. We aimed to evaluate whether achieving a sustained virological response (SVR, defined as HCV RNA seronegativity throughout posttreatment 24-week follow-up) could reduce the risk of non-hepatocellular carcinoma malignancy in a real-world nationwide Taiwanese Chronic Hepatitis C Cohort (T-COACH).

METHODS
A total of 10,714 patients with chronic hepatitis C who had received interferon-based therapy (8,186 SVR and 2,528 non-SVR) enrolled in T-COACH and were linked to the National Cancer Registry database for the development of 12 extrahepatic malignancies, including those with potential associations with HCV and with the top-ranking incidence in Taiwan, over a median follow-up period was 3.79 years (range, 0-16.44 years).

RESULTS
During the 44,354 person-years of follow-up, 324 (3.02%) patients developed extrahepatic malignancies, without a difference between patients with and without SVR (annual incidence: 0.69% vs 0.87%, respectively). Compared with patients with SVR, patients without SVR had a significantly higher risk of gastric cancer (0.10% vs 0.03% per person-year, P = 0.004) and non-Hodgkin lymphoma (NHL) (0.08% vs 0.03% per person-year, respectively, P = 0.03). When considering death as a competing risk, non-SVR was independently associated with gastric cancer (hazard ratio [HR]/95% confidence intervals [CIs]: 3.29/1.37-7.93, P = 0.008). When patients were stratified by age, the effect of SVR in reducing gastric cancer (HR/CI: 0.30/0.11-0.83) and NHL (HR/CI: 0.28/0.09-0.85) was noted only in patients aged <65 years but not those aged >65 years.

DISCUSSION
HCV eradication reduced the risk of gastric cancer and NHL, in particular among younger patients, indicating that patients with chronic hepatitis C should be treated as early as possible.


OBJECTIVES
Carbapenem-resistant Pseudomonas aeruginosa (CR-PSA) imposes great limitations on empirical therapeutic choices, which are further complicated by metallo-β-lactamase production. This study evaluated in vitro antimicrobial synergy of ceftolozane/tazobactam in combination with aztreonam and fosfomycin against MDR PSA.

METHODS
MICs were determined by broth microdilution and gradient strips. The effect of ceftolozane/tazobactam+aztreonam and ceftolozane/tazobactam+fosfomycin combinations were tested against 27 MDR PSA isolates carrying blaSPM-1 (n = 13), blaIMP (n = 4), blaVIM (n = 3), blaGES-1 (n = 2) and blaCTX-M-like (n = 2), and 3 isolates with no acquired β-lactamase production detected by gradient diffusion strip crossing (GDSC). Six genetically unrelated SPM-1-producing isolates were also evaluated by time-kill analysis (TKA).

RESULTS
All CR-PSA isolates harbouring blaSPM-1, blaGES-1 and blaIMP-1 were categorized as resistant to ceftolozane/tazobactam, meropenem and fosfomycin, with 70% being susceptible to aztreonam. Synergism for ceftolozane/tazobactam+fosfomycin and ceftolozane/tazobactam+aztreonam combinations was observed for 88.9% (24/27) and 18.5% (5/27) of the isolates by GDSC, respectively. A 3- to 9-fold reduction in ceftolozane/tazobactam MICs was observed, depending on the combination. Ceftolozane/tazobactam+fosfomycin was synergistic by TKA against one of six SPM-1-producing isolates, with additional non-synergistic bacterial density reduction for another isolate. Aztreonam peak concentrations alone demonstrated a ≥3 log10 cfu/mL reduction against all six isolates, but all strains were within the susceptible range for the drug. No antagonism was observed.

CONCLUSIONS
In the context of increasing CR-PSA and the genetic diversity of resistance mechanisms, new combinations and stewardship strategies may need to be explored in the face of increasingly difficult to treat pathogens.


The scientific problem of epidemiology of keratoconus in different countries is covered in the article. The results of original studies were analyzed and a conclusion has been drawn that keratoconus is quite a common disease in the world.


This paper presents msIQuant, a novel instrument- and manufacturer-independent quantitative mass spectrometry imaging software suite that uses the standardized open access data format imzML. Its data processing structure enables rapid image display and the analysis of very large data sets (>50 GB) without any data reduction. In addition, msIQuant provides many tools for image visualization including multiple interpolation methods, low intensity transparency display, and image fusion. It also has a quantitation function that automatically generates calibration standard curves from series of standards that can be used to determine the concentrations of specific analytes. Regions-of-interest in a tissue section can be analyzed based on a number of quantities including the number of pixels, average intensity, standard deviation of intensity, and median and quartile intensities. Moreover, the suite's export functions enable simplified postprocessing of data and report creation. We demonstrate its potential through several applications including the quantitation of small molecules such as drugs and neurotransmitters. The msIQuant suite is a powerful tool for accessing and evaluating very large data sets, quantifying drugs and endogenous compounds in tissue areas of interest, and for processing mass spectra and images.