Patient satisfaction is a key performance indicator of patient-centered care and hospital reimbursement. To discover the major factors that affect patient experiences is considered as an effective way to formulate corrective actions. A patient during his/her healthcare journey interacts with multiple health professionals across different service units. The health-related data generated at each step of the journey is a valuable resource for extracting actionable insights. In particular, self-reported satisfaction survey and the associated patient electronic health records play an important role in the hospital-patient interaction analysis. In this paper, we propose an interpretable machine learning framework to formulate the patient satisfaction problem as a supervised learning task and utilize a mixed-integer programming model to identify the most influential factors. The proposed framework transforms heterogeneous data into human-understandable features and integrates feature transformation, variable selection, and coefficient learning into the optimization process. Therefore, it can achieve desirable model performance while maintaining excellent model interpretability, which paves the way for successful real-world applications.


Approximately 5% of the Arabidopsis (Arabidopsis thaliana) proteome is predicted to be involved in the ubiquitination/26S proteasome pathway. The majority of these predicted proteins have identity to conserved domains found in E3 ligases, of which there are multiple types. The RING-type E3 is characterized by the presence of a cysteine-rich domain that coordinates two zinc atoms. Database searches followed by extensive manual curation identified 469 predicted Arabidopsis RING domain-containing proteins. In addition to the two canonical RING types (C3H2C3 or C3HC4), additional types of modified RING domains, named RING-v, RING-D, RING-S/T, RING-G, and RING-C2, were identified. The modified RINGs differ in either the spacing between metal ligands or have substitutions at one or more of the metal ligand positions. The majority of the canonical and modified RING domain-containing proteins analyzed were active in in vitro ubiquitination assays, catalyzing polyubiquitination with the E2 AtUBC8. To help identity regions of the proteins that may interact with substrates, domain analyses of the amino acids outside the RING domain classified RING proteins into 30 different groups. Several characterized protein-protein interaction domains were identified, as well as additional conserved domains not described previously. The two largest classes of RING proteins contain either no identifiable domain or a transmembrane domain. The presence of such a large and diverse number of RING domain-containing proteins that function as ubiquitin E3 ligases suggests that target-specific proteolysis by these E3 ligases is a complex and important part of cellular regulation in Arabidopsis.


In code division multiple access (CDMA) systems a significant degradation in detection performance due to multiuser interference can be avoided by the utilization of interference cancellation methods. Further enhancement can be obtained by optimizing the power allocation of the users. The resulting constrained single-objective optimization problem is solved here by means of particle swarm optimization (PSO). It is shown that the maximum number of users for a CDMA system can be increased significantly if an optimized power profile is employed. Furthermore, an extensive study of PSO control parameter settings using three different neighborhood topologies is performed on the basis of the power allocation problem, and two constraint-handling techniques are evaluated. Results from the parameter study are compared with examinations from the literature. It is shown that the von-Neumann neighborhood topology performs consistently better than gbest and lbest. However, strong interaction effects and conflicting recommendations for parameter settings are found that emphasize the need for adaptive approaches.


Laser forming of sheet material has been widely investigated for the last 15 years. While researchers encounter severe problems during the forming of a 3D free form shape, at least one category of surfaces can be made with the process of laser forming, namely the developable surfaces, which are widely used in, for example, ship building. Those surfaces show a zero gaussian curvature and can be unrolled onto a plane without distortion. Until now, the forming of such surfaces has been more or less heuristic, but this paper aims to treat the CAD/CAM issues of this problem in a generic way. Once the surface has been defined, in order to obtain a developable surface, the surface is rebuilt into a number of planar flanges. After collision testing, the unfolding of the surface is calculated. The developable surface is scanned on the boundary between two flanges using laser settings that are determined based on efficiency optimisation considerations, keeping in mind the hardware limitations and the possible surface damage for a too high input energy. In this paper, the proposed CAD/CAM procedure is validated by means of a developable parabolic cylinder.


In this article we use big data methods to analyze the attention paid to the fashion industry on social media. The article argues that for the fashion industry, like many industries, the core product is a form of knowledge that is dependent on gaining and holding people's attention. To understand this attentional economy, social media offers a unique window because it is increasingly a central space within which fashion knowledge is created and shared. Using long-term, geotagged big data from Twitter, we analyze the hitherto difficult-to-explore spaces and places of the global fashion industry. The article suggests that the data confirm the ideas that there are a series of global fashion capitals that are especially important to the industry and that attention paid to fashion is highly uneven and varied across industry functions, national origins, and companies. Evidence is presented that attention to fashion is a global phenomenon that does not always directly link to where fashion products are sold. Attention to fashion is both a market-making mechanism for the industry as well as an indicator of wider social and cultural processes of tastemaking and identity formation within which fashion is entwined. The article concludes by suggesting that such data offer geographers new ways of looking at and linking economic, social, and cultural spaces and geographies and that social media analysis can help bridge boundaries that divide geographers. Key Words: attention economy, big data, economic geography, fashion industry, social media.


The formation of intricate neural circuits requires that nascent axons navigate the complex environment of the developing embryo and precisely determine the trajectories that would lead them to their final synaptic targets. Although many guidance cues and their receptors have been identified, the intracellular signaling cascades that control and direct axonal growth remained to be fully understood. Developing axons constantly reassess the immediate environment to distinguish between a myriad of guidance molecules that are simultaneously present along their trajectory. Exactly how the axon interpret these signals at a specific time and space are limited, thus understanding how guidance cues work in concert during axonal pathfinding is a major goal in developmental neurobiology and in the regeneration of axonal connections after injury and disease. In this dissertation we studied the pathfinding of spinal cord commissural axons to understand the molecular mechanisms underlying changes in axonal responses from attraction to repulsion during floor plate crossing at the spinal cord ventral midline. Here, we found that chemorepellent signals emanating from floor plate cells of the Slit and class 3 Semaphorin family of proteins synergize in vitro to repel precrossing commissural axons possibly through Neuropilin2 pathways. In addition, we propose that Sonic Hedgehog (Shh) plays a pivotal role in mediating commissural axon repulsive guidance during floor plate crossing. We provide evidence that Shh is a regulator of class 3 Semaphorin signals in precrossing axons and specifically show that knockdown of Shh pathway components, Patched1 (PTC1) and Smoothened (Smo) disrupted proper guidance of commissural axons during floor plate crossing. We also show that both Smo and PTC1 are expressed around the developmental stages we studied and are key determinants of this regulation. The third major finding of this dissertation is that the activation of Semaphorin3 signals by Shh might be induced through the alteration of cAMP/PKA levels via Smo dependent activation of inhibitory G alpha proteins. Together the data presented in this dissertation propose new exciting models in which axon guidance regulatory pathways can induce profound changes in axonal navigational responses by successfully integrating and interpreting signaling inputs from external and internal axon guidance systems


Dental caries is multifactorial disease and is influenced by socio-demographic factors and health beliefs of the individuals. This study aimed to evaluate the relationship of oral health beliefs with caries experience in children of Udupi district. We conducted a cross-sectional survey 13"15 year old school children (n=463). A self-administered kannada version of oral health belief questionnaire was used. Clinical examination was carried out to assess the dental caries among children. Factor analysis revealed a 5 factor structure. Sampling adequacy was also high based on the Kaiser's measure of sampling adequacy (0.813) and communality values of over 0.3 indicated that the variables were reliable. Internal consistency (standardized item alpha) was 0.753. The domains that showed significant higher scores in caries free than carious children were benefits of prevention, barriers, perceived seriousness and seriousness about oral disease (p=0.005, 0.044, 0.018 and 0.019) respectively. The modified version oral health beliefs scale discriminated children with caries from caries free children.


For Networks with t+1 link disjoint spanning trees, we propose a fault tolerant deterministic and adaptive unicast wormhole routing technique which can tolerate up to 100% of all faults involving up to t link faults and high percentage of faults involving more than t links. This technique provides deadlock prevention with message delivery times that is almost identical to the case without fault tolerance. The proposed algorithm consists of two stages. At the first stage, we minimize the set of turns in the network graph, which are prohibited for deadlock prevention and fault tolerance. At the second stage, routing tables are constructed based on the set of prohibited turns that minimize average message path lengths for adaptive routing. Routing tables constructed this way produce a set of output ports sorted in ascending order in terms of the distance to the destination. To route the messages adaptively we select the next available shortest path to the destination. We also present results of simulation experiments for average delivery time for uniform traffic pattern and saturation points.


We consider a collision channel model without feedback based on a time-slotted communication channel shared by K users. In this model, packets transmitted in the same time slot collide with each other and are unrecoverable. Each user accesses the channel according to an internal periodical pattern called protocol sequence. Due to the lack of feedback, users cannot synchronize their protocol sequences, leading to unavoidable collisions and varying throughput. Protocol sequences that provide constant throughput regardless of delay offsets between users are called shift-invariant (SI), they have been studied and characterized in previous work. We propose a new class of SI sequences: Constant Individual Delivery Delay (CIDD) sequences which ensure that the delay between two successfully delivered packets is constant for each user. We present a characterization of CIDD sequences. We also prove that CIDD sequences can achieve the lower bound of SI sequences period but not the optimal throughput.


Rapidly uplifting coastlines are frequently associated with convergent tectonic boundaries, like subduction zones, which are repeatedly breached by giant megathrust earthquakes. The coastal relief along tectonically active realms is shaped by the effect of sea-level variations and heterogeneous patterns of permanent tectonic deformation, which are accumulated through several cycles of megathrust earthquakes. However, the correlation between earthquake deformation patterns and the sustained long-term segmentation of forearcs, particularly in Chile, remains poorly understood. Furthermore, the methods used to estimate permanent deformation from geomorphic markers, like marine terraces, have remained qualitative and are based on unrepeatable methods. This contrasts with the increasing resolution of digital elevation models, such as Light Detection and Ranging (LiDAR) and high-resolution bathymetric surveys.
Throughout this thesis I study permanent deformation in a holistic manner: from the methods to assess deformation rates, to the processes involved in its accumulation. My research focuses particularly on two aspects: Developing methodologies to assess permanent deformation using marine terraces, and comparing permanent deformation with seismic cycle deformation patterns under different spatial scales along the M8.8 Maule earthquake (2010) rupture zone. Two methods are developed to determine deformation rates from wave-built and wave-cut terraces respectively. I selected an archetypal example of a wave-built terrace at Santa Maria Island studying its stratigraphy and recognizing sequences of reoccupation events tied with eleven radiocarbon sample ages (14C ages). I developed a method to link patterns of reoccupation with sea-level proxies by iterating relative sea level curves for a range of uplift rates. I find the best fit between relative sea-level and the stratigraphic patterns for an uplift rate of 1.5 +- 0.3 m/ka.
A Graphical User Interface named TerraceM® was developed in Matlab®. This novel software tool determines shoreline angles in wave-cut terraces under different geomorphic scenarios. To validate the methods, I select test sites in areas of available high-resolution LiDAR topography along the Maule earthquake rupture zone and in California, USA. The software allows determining the 3D location of the shoreline angle, which is a proxy for the estimation of permanent deformation rates. The method is based on linear interpolations to define the paleo platform and cliff on swath profiles. The shoreline angle is then located by intersecting these interpolations. The
accuracy and precision of TerraceM® was tested by comparing its results with previous assessments, and through an experiment with students in a computer lab setting at the University
of Potsdam.
I combined the methods developed to analyze wave-built and wave-cut terraces to assess regional patterns of permanent deformation along the (2010) Maule earthquake rupture. Wave-built terraces are tied using 12 Infra Red Stimulated luminescence ages (IRSL ages) and shoreline angles in wave-cut terraces are estimated from 170 aligned swath profiles. The comparison of coseismic slip, interseismic coupling, and permanent deformation, leads to three areas of high permanent uplift, terrace warping, and sharp fault offsets. These three areas correlate with regions of high slip and low coupling, as well as with the spatial limit of at least eight historical megathrust ruptures (M8-9.5). I propose that the zones of upwarping at Arauco and Topocalma reflect changes in frictional properties of the megathrust, which result in discrete boundaries for the propagation of mega earthquakes.
To explore the application of geomorphic markers and quantitative morphology in offshore areas I performed a local study of patterns of permanent deformation inferred from hitherto unrecognized drowned shorelines at the Arauco Bay, at the southern part of the (2010) Maule earthquake rupture zone. A multidisciplinary approach, including morphometry, sedimentology, paleontology, 3D morphoscopy, and a landscape Evolution Model is used to recognize, map, and assess local rates and patterns of permanent deformation in submarine environments. Permanent deformation patterns are then reproduced using elastic models to assess deformation rates of an active submarine splay fault defined as Santa Maria Fault System. The best fit suggests a reverse structure with a slip rate of 3.7 m/ka for the last 30 ka. The register of land level changes during the earthquake cycle at Santa Maria Island suggest that most of the deformation may be accrued through splay fault reactivation during mega earthquakes, like the (2010) Maule event. Considering a recurrence time of 150 to 200 years, as determined from historical and geological observations, slip between 0.3 and 0.7 m per event would be required to account for the 3.7 m/ka millennial slip rate. However, if the SMFS slips only every ~1000 years, representing a few megathrust earthquakes, then a slip of ~3.5 m per event would be required to account for the long- term rate. Such event would be equivalent to a magnitude ~6.7 earthquake capable to generate a local tsunami.
The results of this thesis provide novel and fundamental information regarding the amount of permanent deformation accrued in the crust, and the mechanisms responsible for this accumulation at millennial time-scales along the M8.8 Maule earthquake (2010) rupture zone. Furthermore, the results of this thesis highlight the application of quantitative geomorphology and the use of repeatable methods to determine permanent deformation, improve the accuracy of marine terrace assessments, and estimates of vertical deformation rates in tectonically active coastal areas. This is vital information for adequate coastal-hazard assessments and to anticipate realistic earthquake and tsunami scenarios.


Roadside areas are elements intended to reduce the Run-off-road crashes. The hazardousness is an indicator of compliance of this objective. There are few methods to measure hazardousness, which usually depend of the availability of accident data. This paper examines the factors that explain the roadside hazardousness on the basis of existing models and analysis of field data. It was determined that the clearance side next to the barriers of protection, especially in curves with inclined slopes, it is significant to explain the hazards. It was determined that for straights and curves without barriers is relevant the type of object and its position measured position in the roadside.


Summary

1. Organic farming is often promoted as a solution for counteracting the adverse impacts of agricultural intensification on biodiversity. However, it is unclear whether the biodiversity benefits derived from organic farming require an adoption of organic farming in its entirety (i.e. a systems-level approach) or whether the benefits derived are because of just a small subset of the associated management practices.

2. Using bird survey data collected from kiwifruit orchards in New Zealand, we assessed whether orchards managed under an organic system support higher bird densities than those under integrated management systems. To determine whether biodiversity gains might also be achieved on non-organic orchards, we tested whether variation among kiwifruit orchards in the amount of (non-crop) woody vegetation cover, density of shelterbelts and toxicity of pesticide applications are better predictors of bird densities than management systems.

3. Composite measures of breeding season densities of all native species and the subset of native insectivores were higher on organic orchards than integrated management orchards. Densities of introduced bird species were comparable among management systems.

4. Pesticide use and habitat composition variables were better predictors of native bird densities than management system, with native bird densities negatively associated with pesticide toxicity ranking and/or positively associated with woody vegetation cover.

5. Synthesis and applications. A complete conversion to an organic system may not be required to improve biodiversity in agroecosystems. Instead, the transfer of specific land management practices known to benefit biodiversity in organic systems has the potential to enhance biodiversity in other more intensively managed systems (e.g. integrated management). This may be a path towards attaining biodiversity benefits at a larger scale, because such changes may be more straightforward than conversion to an organic system.


We study the design of autonomous agents that are capable of deceiving outside observers about their intentions while carrying out tasks in stochastic, complex environments. By modeling the agent's behavior as a Markov decision process, we consider a setting where the agent aims to reach one of multiple potential goals while deceiving outside observers about its true goal. We propose a novel approach to model observer predictions based on the principle of maximum entropy and to efficiently generate deceptive strategies via linear programming. The proposed approach enables the agent to exhibit a variety of tunable deceptive behaviors while ensuring the satisfaction of probabilistic constraints on the behavior. We evaluate the performance of the proposed approach via comparative user studies and present a case study on the streets of Manhattan, New York, using real travel time distributions.


Increasingly, people will be in situations where there are multiple communicating computing devices that have input / output capabilities. For example, people might carry their handheld computer, such as a Windows CE device or a Palm Pilot, into a room with a desktop or an embedded computer. The handheld computer can communicate with the PC using wired or wireless technologies, and then both computers can be used at the same time. We are investigating many ways in which the handheld computer can be used to extend the functions of existing and new applications. For example, the handheld's screen can be used as a customizable input and output device, to provide various controls for desktop applications. The handheld can contain scroll bars, buttons, virtual knobs and menus. It can also display the slide notes or a list of slide titles for a presentation, the list of current tasks and windows, and lists of links for web browsing. The user can tap on these lists on the handheld to control the PC. Information and control can flow fluidly among all the user's devices, so that there is an integrated environment.


Introduction ACOs are seen as an important development in the quest to provide quality care and control health care costs. The pace of ACO adoption has waned after a blistering start. The calculus for ACO adoption has changed and there is little understanding of the reasons for the change. The objectives of this dissertation are to understand physician organizations' motivation to form ACOs, explore physician organizations' ACO readiness, and identification of barriers and facilitators to ACO adoption. The dissertation also proposes an ACO Orientation Conceptual Model and tests the model from case studies of six physician organizations in Orange County, CA. By understanding the reasons physician organizations accept or reject ACO contracts, leaders and administrators can adjust parameters that will influence future accountable care movement. Background ACO is an entity comprised of hospitals and physician organizations who join together to assume responsibility for providing integrated high quality care at a sustainable cost level for a patient population. The idea originated in the medical establishment and entered the policy arena through MedPAC, an agency that advises Congress on Medicare matters. The Dartmouth Institute for Health Policy and Clinical Practice, the Engelberg Center for Health Care Reform at Brookings, and MedPAC pushed ACO onto the national agenda. ACO became a formal part of the health reform movement when the ACA was signed into law. As of October 2013, there were 23 Pioneer ACOs, 35 Advanced Payment ACOs, 220 SSP ACOs, and 235 private sector ACOs. Aims and Objectives The dissertation seeks to understand physician organizations' motivation to form or not form ACOs, proposes and tests an ACO Orientation Conceptual Model, and identifies barriers and facilitators to ACO adoption. Methodology The dissertation uses a qualitative, non-experimental, cross-case study method supplemented by a survey. Six case study participants were selected from a combined list of physician organizations from Cattaneo and Stroud and California Association of Physician Groups (CAPG). Using a semi-structured interview guide, an in-depth interview with an executive in the physician organization and an administration of a Physician Organization ACO Readiness Survey for each organization completed the data collection process. Information from key informant interviews was integrated with publicly available reports, state government agency reported data, information on a physician organization's website, and other Internet resources related to the physician organizations forming the basis for the case studies. Analysis was also performed across the physician organizations to identify common themes and unearth insights. The ACO Orientation Conceptual Model was tested based on the responses to the semi-structured interview questions and the ACO readiness survey. Findings Of the external causal attributes described by the ACO Motivation Conceptual Model, only business rationale, competitor activity, and a policy window were found by case study participants to be applicable. None of the participants cited necessity or timing as an external causal attribute. Of the internal causal attributes described by the ACO Motivaton Conceptual Model, only culture, leadership, and quality care were found by case study participants to be valid. The only internal causal attribute that garnered concensus among all six case study participants was a focus on quality care improvements. Testing of the ACO Orientation Conceptual Model found that along the strategic typology dimension, of the six case study participants in the study, four case study participants were classified as Analyzers and two were classified as Prospectors. None of the case study participants had a Defender classification. Along the ACO readiness dimension, five of the six case study participants had high ACO readiness scores and one case study participant recorded a low ACO readiness score. Using assessments from the case study participants, the model successfully predicted that Analyzers with high ACO readiness scores and Prospectors with low ACO readiness scores would consider becoming ACOs. The model also predicted correctly that Prospectors with high ACO readiness scores would become ACOs.Enviromental barriers identified by case study participants included an ACO's broad scope, intensive resource investment requirements, rules and regulations interpretation and enforcement, and a risk/reward imbalance. Organizational barriers identified by case study participants included physician organization and hospital misalignment of incentives, a lack of infrastructure, a lack of data, difficulties in getting providers to buy-in, and beneficiary inertia. Facilitators identified by case study participants include communication, trust, technology, information exchange, a strong primary care network and network management, scalability, and experience with risk, continuity of care, and managed care programs. Conclusion Understanding physician organization ACO adoption and diffusion may benefit from additional qualitative and quantitative studies. The specific recommendations are to conduct case studies in other geographic areas outside of Orange County, CA, empirically study to see if physician organizations changed strategies due to ACOs, and finally, measure the performance and outcomes of selected ACO strategies. There are three implications for health policy makers. First, for physician groups participating in the Shared Savings Program (SSP), there is a desire to attract Medicare fee-for-service (FFS) beneficiaries into the Medicare Advantage plans. This motivation is different from those of physician organizations serving commercial ACOs. Second, reduce the environmental and organizational barriers to ACO adoption. Finally, healthcare leaders and practitioners should be prepared to address system-wide implications resulting from the massive shifts in the physician organization strategy as a response to ACOs.


Residence in temporary housing is a critical period for the social, economic, and psychological recovery of displaced families following disasters. Temporary housing locations define the displacement distance between families and their essential needs. The objective of this paper is to develop a novel methodology to capture the specific proximity needs and preferences of displaced families. This paper proposes a displacement distance equivalent as an objective metric to evaluate the performance of temporary housing locations in meeting the needs of displaced families. Moreover, the paper describes the development of an integer programming optimization model capable of optimizing temporary housing assignments to minimize total displacement distance equivalent while meeting budget constraints. The main contribution of this paper to the body of knowledge is in transforming the purpose of temporary housing programs from offering general accommodation to providing customized housing solutions tailored to the individual proximity needs of each household using the proposed displacement metric. In addition, the proposed optimization model enables decision makers to set budget constraints to ensure the economic feasibility of identified temporary housing solutions.


This paper shows that Frances Burney used language and interaction features in the dialogue of her novels to indicate the moral worth of some of her characters. It also shows how Burney's linking of language and morality allowed her to contribute to stimulating contemporary debates in which three major discourses of the enlightenment intersected: philosophical debates relating to the nature of goodness; consideration of the functions of language, in particular its potential to represent or govern morality; and discussions of the efficacy of spoken language in conversational contexts.In Frances Burney's novels the criteria by which people should be judged are not so much social as moral, and her heroines are located in ethical spaces where predatory opportunists, pretentious egoists, and violent oppressors are to be recognized and spurned. But recognition is not always easy, and sometimes polish and rank can mask unsavoury motives. Conduct books rarely tackled the complex issue of detecting pretence; nor did they offer a nuanced understanding of more complicated and therefore more demanding social contexts. Burney's novels address such omissions, providing narrational schemata for working through diverse situations and relationships, through the various difficulties which the heroines encounter in their educative process. For Burney, speech is the index of morality, offering a reliable code to read an individual's qualities and principles, beyond background, education, and gender. Making flexible use of modern linguistics, this paper shows how Burney encodes interiority in dialogue to signify moral marginality.


Abstract— The age, structure, composition, and petrogenesis of the martian lithosphere have been constrained by spacecraft imagery and remote sensing. How well do martian meteorites conform to expectations derived from this geologic context? Both data sets indicate a thick, extensive igneous crust formed very early in the planet's history. The composition of the ancient crust is predominantly basaltic, possibly andesitic in part, with sediments derived from volcanic rocks. Later plume eruptions produced igneous centers like Tharsis, the composition of which cannot be determined because of spectral obscuration by dust. Martian meteorites (except Allan Hills 84001) are inferred to have come from volcanic flows in Tharsis or Elysium, and thus are not petrologically representative of most of the martian surface. Remote‐sensing measurements cannot verify the fractional crystallization and assimilation that have been documented in meteorites, but subsurface magmatic processes are consistent with orbital imagery indicating thick crust and large, complex magma chambers beneath Tharsis volcanoes. Meteorite ejection ages are difficult to reconcile with plausible impact histories for Mars, and oversampling of young terrains suggests either that only coherent igneous rocks can survive the ejection process or that older surfaces cannot transmit the required shock waves. The mean density and moment of inertia calculated from spacecraft data are roughly consistent with the proportions and compositions of mantle and core estimated from martian meteorites. Thermal models predicting the absence of crustal recycling, and the chronology of the planetary magnetic field agree with conclusions from radiogenic isotopes and paleomagnetism in martian meteorites. However, lack of vigorous mantle convection, as inferred from meteorite geochemistry, seems inconsistent with their derivation from the Tharsis or Elysium plumes. Geological and meteoritic data provide conflicting information on the planet's volatile inventory and degassing history, but are apparently being reconciled in favor of a periodically wet Mars. Spacecraft measurements suggesting that rocks have been chemically weathered and have interacted with recycled saline groundwater are confirmed by weathering products and stable isotope fractionations in martian meteorites.


Infectious disease is frequently cited as a precursor of subsequent autoimmune disease in genetically susceptible hosts. However, the precise mechanisms required for the transition from infection to autoimmunity have not been well defined. We have developed a mouse model of autoimmune myocarditis initiated by infection with Coxsackievirus B3 to trace the cytokine pathways involved. We found that greater production of interleukin-1β (IL-1β) and tumor necrosis factor-α during the early innate response to virus infection is necessary and sufficient to induce a later heart-specific autoimmune disease. Severity of the autoimmune myocarditis is determined by the profile of a number of T helper 1 (Th1) and Th2 cytokines. Th2 responses are especially pronounced in the most severe forms of myocarditis where eosinophils are prominent. The Th1 pathway can lead to infiltration of the heart, but may be dampened by concurrent INF-γ production. Th17 cytokines also contribute to disease, but the signature Th17 cytokine, IL-17A, is not required for cardiac inflammation. Rather, IL-17A is needed for progression to dilated cardiomyopathy. These findings may provide useful markers to identify individuals prone to develop an autoimmune sequel after infection and suggest future early interventions.


Several experiments have demonstrated that rostral segments of the vertebrate lumbar spinal cord produce a rhythmic motor output more readily and of better quality than caudal segments. Here we examine how this rostrocaudal gradient of rhythmogenic capability is reflected in the spike activity of neurons in the rostral (L(2)) and caudal (L(5)) lumbar spinal cord of the neonatal rat. The spike activity of interneurons in the ventromedial cord, a region necessary for the production of locomotion, was recorded intracellularly with patch electrodes and extracellularly with tetrodes during pharmacologically induced locomotion. Both L(2) and L(5) neurons tended to be active in phase with their homologous ventral root. L(5) neurons, however, had a wider distribution of their preferred phases of activity throughout the locomotor cycle than L(2) neurons. The strength of modulation of the activity of individual L(2) neurons was also larger than that of L(5) neurons. These differences resulted in a stronger rhythmic signal from the L(2) neuronal population than from the L(5) population. These results demonstrate that the rhythmogenic capability of each spinal segment was reflected in the activity of interneurons located in the same segment. In addition to paralleling the rostrocaudal gradient of rhythmogenic capability, these results further suggest a colocalization of motoneurons and their associated interneurons involved in the production of locomotion.


Background Quality-assured tuberculosis laboratory services are critical to achieve global and national goals for tuberculosis prevention and care. Implementation of a quality management system (QMS) in laboratories leads to improved quality of diagnostic tests and better patient care. The Strengthening Laboratory Management Toward Accreditation (SLMTA) programme has led to measurable improvements in the QMS of clinical laboratories. However, progress in tuberculosis laboratories has been slower, which may be attributed to the need for a structured tuberculosis-specific approach to implementing QMS. We describe the development and early implementation of the Strengthening Tuberculosis Laboratory Management Toward Accreditation (TB SLMTA) programme. Development The TB SLMTA curriculum was developed by customizing the SLMTA curriculum to include specific tools, job aids and supplementary materials specific to the tuberculosis laboratory. The TB SLMTA Harmonized Checklist was developed from the World Health Organisation Regional Office for Africa Stepwise Laboratory Quality Improvement Process Towards Accreditation checklist, and incorporated tuberculosis-specific requirements from the Global Laboratory Initiative Stepwise Process Towards Tuberculosis Laboratory Accreditation online tool. Implementation Four regional training-of-trainers workshops have been conducted since 2013. The TB SLMTA programme has been rolled out in 37 tuberculosis laboratories in 10 countries using the Workshop approach in 32 laboratories in five countries and the Facility-based approach in five tuberculosis laboratories in five countries. Conclusion Lessons learnt from early implementation of TB SLMTA suggest that a structured training and mentoring programme can build a foundation towards further quality improvement in tuberculosis laboratories. Structured mentoring, and institutionalisation of QMS into country programmes, is needed to support tuberculosis laboratories to achieve accreditation.


Contracting authorities in the public sector are obligated to apply the principles provided for in the Polish law for the evaluation and selection of contractors. In order to analyse the methods of contractors selecting applied in practice by public clients, the notices of contract award results for construction works were analysed. The analysis shows that the procedure selected more and more often is open competitive bidding, where the assessment of the competence of contractors is not very precise, as well as noncompetitive bidding, i.e. single source procurement. The share of procurement procedures, where the only criterion is price, is increasing. The solution to the problems existing here might be the introduction of one of the forms of pre-selection of contractors. The article also briefly discusses verification systems for companies applying for public contracts used in EU countries. Keywords—Certification, contractors selection, open tendering, public investors.


Abstract The objectives of this research are to investigate (1) if a later entrant can reduce an order of entry effect by positioning itself as a low-price brand; and (2) if the type of low-price brand impacts the effectiveness of this strategy. The impact of a low-price strategy on the order of entry effect has been modelled using three categories of over-the-counter medicines. The results indicate that, in a majority of categories and dependent on the type of low-price brand, a low-price strategy can reduce the market share penalty for being a later entrant. In addition, the results provide evidence that leveraging an existing store brand name does not provide a strategic advantage over establishing a new brand name. The implications for managers is that a low-price brand provides a motivating point of difference for consumers, which shifts brand preferences and market share away from the pioneer brand.


The goal of the study was to investigate the impact
of stress on productivity of employees at the Education Training
and Development Practices: Sector Education and Training Authority
(ETDP SETA). According to Dean (2002:38), stress-related illnesses
have been a leading cause for low productivity levels in the
workplace. Immense pressure at work has led to stress, which makes
it the number one factor that has lead to illness. For this study
applied research was utilised, as its main goal was directed
towards shedding light in as far as the impact of stress on
productivity in the organisation was concerned. Thus the study
helped to elucidate descriptive information on the impact of stress
on employees at the ETDP SETA, and gave specific details about the
phenomena in question. Research was conducted within the framework
of a survey. No sampling was done, as the total population was very
small. The respondents in this study were the 51 employees at the
ETDP SETA who were employed during the commencement of the study.
Questionnaires were designed and distributed by delegates, of the
Head of Division Human Resources to all the sections at the ETDP
SETA. From the results obtained it was evident that there were many
stress factors that the employees at the ETDP SETA endured, and the
enquiry proved that the impact of stress affected productivity
negatively. The fact that the majority of the employees thought
that the organisation did not care about them was a reflection of
huge dissatisfaction that undoubtedly lowered
productivity.


Kerala has always been known for its remarkable development in medical and educational sector and has also witnessed many social reform movements. Despite high indices of development in education and health, gender-related indices of development continue to be low in Kerala. Paradoxically patriarchal forces are still prominent in the state despite aspirations towards modern 'western' lifestyles, and this is an issue that demands to be explored in detail. Gender is one of the topics which is widely debated in social media by the youth in Kerala, especially in recent times. This study finds its relevance by locating itself at the intersection of the interdisciplinary field of gender studies, anthropology and the emerging perspective of critical social psychology. The broad research objective of this study is to map the qualitative shifts in the social landscape of Kerala, with respect to gender.
The methods used for the study are online ethnography (where I followed discussions on gender-related topics in Facebook for four months), and focus group discussions (six FGDs were conducted among college students in three colleges in Kochi). The methods of analysis used are discourse analysis and thematic analysis. The findings show that people tend to take a 'progressive tag' when discussing gender, while at the same time rejecting the term 'feminism'. People explicitly identify themselves with particular political and religious categories/ideologies (e.g. 'liberal', 'atheist', 'religious', etc.) and seek to demonstrate that the category or community they belong to is 'progressive'. The discussions on gender are determined by the need to protect one's patriarchal privileges and are driven by religious and political motivations. Finally, in the context of Kerala where the requirement for women's involvement in the salaried work force is increasing, given the rising financial burdens on unemployed and underemployed men, it becomes important to project the society as a 'progressive' one, one that is conducive for
women's participation. By inscribing ethnicity, culture, and nationalism into women's identity and body through the notions of gendered nationalism, men seek to benefit from women's work involvement, without compromising on the patriarchal privileges.


OF THESIS FREQUENCY TRACKING AND PHASOR ESTIMATION USING LEAST SQUARES AND TOTAL LEAST SQUARES ALGORITHMS System stability plays an important role in electric power systems. With the development of electric power system, the scale of the electric grid is now becoming larger and larger, and many renewable energy resources are integrated in the grid. However, at the same time, the stability and safety issues of electric power system are becoming more complicated. Frequency and phasors are two critical parameters of the system stability. Obtaining these two parameters have been great challenges for decades. Researchers have provided various kinds of algorithms for frequency tracking and phasor estimation. Among them, Least Squares (LS) algorithm is one of the most commonly used algorithm. This thesis studies the LS algorithm and the Total Least Squares (TLS) algorithm working on frequency tracking and phasor estimation. In order to test the performance of the two algorithms, some simulations have been made in the Matlab. The Total Vector Error (TVE) is a commonly used performance criteria, and the TVE results of the two algorithms are compared. The TLS algorithm performs better than LS algorithm when the frequencies of all harmonic components are given.


also due to the lowering of blood viscosity. Charm et al reported that plasma viscosity in joggers is lower than that in those who do not jog.6 The Munich group headed by Ernst has published several studies showing that exercise increased red cell deformability and reduced blood viscosity.78 Several studies also show that many factors, including cholesterol and noradrenaline, reduce red cell deformability. Exercise lowers plasma cholesterol and noradrenaline concentrations,2 and these changes seem to be shown by improved red cell deformability, which lowers blood viscosity. This concept provides a basis for understanding why both increased physical activity and appropriate dietary changes may lower blood pressure. Therefore those who by choice, or because of disability, do not exercise regularly can obtain haemorrheological benefits through diet alone that are similar to those induced by exercise.


For several years, UNICORE and Globus have co-existed as approaches to exploiting what has become known as the ``Grid''. Both offer many services beneficial for creating and using production Grids. A cooperative approach, providing interoperability between Globus and UNICORE, would result in an advanced set of Grid services that gain strength from each other. This paper outlines some of these parallels and differences as they relate to the development of an interoperability layer between UNICORE and Globus. Given the increasing ubiquity of Globus, what emerges is the desire for a hybridised facility that utilises the UNICORE work-flow management of complex, multi-site tasks, but that can run on either UNICORE- or Globus-enabled resources. The technical challenge in achieving this, addressed in this paper, consists of mapping resource descriptions from both grid environments to an abstract format appropriate to work-flow preparation, and then the instantiation of work-flow tasks on the target systems. Other issues such as reconciling disparate security models and file transfer support are also addressed.


ABSTRACT The Prevent Duty mandates education providers to address young people both as vulnerable to radicalisation and as (potentially) resilient. This paper argues that interventions designed to address vulnerability are problematic, as they tend to adopt the logic of safeguarding – a familiar mindset for professionals working with young people – while also extending practices of surveillance. As well as this safeguarding/surveillance nexus, however, the Duty offers openings for resilience-focused school-based interventions, which can assist young people's development into active citizenship. Drawing on Chantal Mouffe's distinction between "agonism" and "antagonism", I will argue that the Duty endorses interventions to build resilience grounded in the effective capacity for citizenship, understood as enabling individuals both to take sides in ("agonistic") political debate and to engage with the criteria for excluding certain ("antagonistic") positions from political legitimacy. Supporting this argument, findings from mixed-methods research conducted in secondary schools suggest that training delivered under the Duty can offer significant gains in self-confidence and political engagement, and hence in effective citizenship and resilience to extremist messaging.


Purpose: This paper details a brief history and rationale for the use of virtual reality (VR) technology for clinical research and intervention, and then focuses on game-based VR applications in the area of rehabilitation. An analysis of the match between rehabilitation task requirements and the assets available with VR technology is presented. Key messages and implications: Low-cost camera-based systems capable of tracking user behavior at sufficient levels for game-based virtual rehabilitation activities are currently available for in-home use. Authoring software is now being developed that aims to provide clinicians with a usable toolkit for leveraging this technology. This will facilitate informed professional input on software design, development and application to ensure safe and effective use in the rehabilitation context. Conclusion: The field of rehabilitation generally stands to benefit from the continual advances in VR technology, concomitant system cost reductions and an expanding clinical research literature and knowledge base. Home-based activity within VR systems that are low-cost, easy to deploy and maintain, and meet the requirements for "good" interactive rehabilitation tasks could radically improve users' access to care, adherence to prescribed training and subsequently enhance functional activity in everyday life in clinical populations. Implications for Rehabilitation Virtual reality (VR) technology has an established track record of success in addressing the therapeutic needs of persons across a range of clinical health conditions. In-home systems for VR rehabilitation are now technologically and pragmatically feasible, but it will require informed professional input on software design, development and application to ensure safe and effective use. New tools are being created that will allow clinicians without programming expertise to build game-based VR tasks and this will serve to drive advances in rehabilitation interventions.


These two key texts of German Communism appear in English for the first time. Paul Levi's Our Path and What Is the Crime? were the response of the KPD leader to the disastrous 'March Action' of 1921. Over two years, Levi had succeeded in building a mass revolutionary party that drew on the traditions of both Luxemburg and Lenin; this was now over-ridden by a stereotyped Bolshevism enforced by the Comintern's emissaries. In the first text, subtitled 'Against Putschism' and written within days of the attempted coup, Levi criticised the attempt to seize power without the majority-backing of the working class, which had decimated the Party's membership. Its publication led to Levi's exclusion from the Party for breach of discipline, even though his critique of the March Action was shared by Lenin. The second text was delivered verbally to the Central Committee, as an unsuccessful appeal against his expulsion, and the transcript gives a unique flavour of the atmosphere in the KPD leadership at this crucial moment.


NFPA 85, Chapter 9.5.4 states "A pulverizer that is tripped under load shall be inerted and maintained under an inert atmosphere until confirmation that no burning or smoldering fuel exists in the pulverizer or the fuel is removed". Pulverizer systems with the potential for a resident inventory of combustible material upon trip must be designed and equipped with an inerting system that is capable of maintaining an inert atmosphere to meet this requirement. Proper design of the inerting system and operating procedure, integrated with the mill operation during start-up, shut down and emergency trip is critical for safe mill operation.This paper presents a mill steam inerting system review and performance validation. The technology has been applied to ball tube mill systems at Hoosier Energy's Merom Generating Station. A testing technique, used to validate performance of the steam inerting system at this generating plant, is described. It quantifies the compliance of the steam inerting system to meet NFPA requirements during start-up and shut down of the pulverizer. This type of operation is considered to be the most difficult for inerting as the primary air is flowing through the system. The developed testing approach can be applied to evaluate the performance of either existing or newly installed steam inerting systems. The validation technology, developed based on a ball tube mill system, can be readily applied on other types of mill systems, since the steam inerting principle is the same and inerting system requirements are similar, regardless of different mill types.Copyright © 2014 by ASME


We study a few Fermi atoms interacting through attractive contact forces in a one-dimensional trap by means of numerical exact diagonalization. From the combined analysis of energies and wave functions of correlated ground and excited states we find evidence of BCS-like pairing even for very few atoms. For moderate interaction strength, we reproduce the even-odd oscillation of the separation energy observed in Z\"urn, Wenz, Murmann, Bergschneider, Lompe, and Jochim, Phys. Rev. Lett. 111, 175302 (2013). For strong interatomic attraction the arrangement of dimers in the trap differs from the homogeneous case as a consequence of Pauli blockade in real space.


An overview of how series connected and combined series/shunt connected FACTS controllers are studied in an AC system is presented. Specifically, the TCSC, SSSC, and GUPFC (or CSC) is presented. The basic performance attributes of several FACTS controllers are presented. The impacts of the FACTS controller and its control setting on power system performance are also presented in the form of case studies.


Numerous studies have been conducted to explore students' employment of motivational and self-regulated learning strategies (SRL). Research highlights the importance of having motivated students equipped with strategies that help them self-regulate their learning, this being highly important when learning is acquired through online learning programs. Nonetheless, such research has been scarce with Vocational Education and Training (VET) students; this is the gap in the literature this paper aims to address. The article analyzes the degree to which VET students employ motivational and SRL strategies by comparing them according to the learning mode chosen. To achieve this, a quantitative approach was adopted to carry out a cross-sectional study. A total of 577 first-year VET students responded to an online questionnaire based on some of the motivational and SRL strategies scale included in Pintrich's model. Statistical analyses were applied to test two hypotheses. Pintrich's model was validated through a confirmatory factor analysis considering its application to Catalan VET students for the first time. The results reveal significant differences between classroom and online students in terms of levels of metacognitive self-regulation and effort regulation when starting a VET program. However, this difference might not be entirely explained by the learning mode chosen. The findings of this study will provide VET researchers and practitioners with a greater understanding of their students' characteristics when starting the program and the means to develop strategies that ensure their engagement throughout the course.


Currently, the top-down spatial data update mechanism has made a big progress and it is wildly applied in many SDI (spatial data infrastructure). However, this mechanism still has some issues. For example, the update schedule is limited by the professional department's project, usually which is too long for the end-user; the data form collection to public cost too much time and energy for professional department; the details of geospatial information does not provide sufficient attribute, etc. Thus, how to deal with the problems has become the effective shortcut. Emerging Internet technology, 3S technique and geographic information knowledge which is popular in the public promote the booming development of geoscience in volunteered geospatial information. Volunteered geospatial information is the current "hotspot", which attracts many researchers to study its data quality and credibility, accuracy, sustainability, social benefit, application and so on. In addition to this, a few scholars also pay attention to the value of VGI to support the SDI updating. And on that basis, this paper presents a bottom-up update mechanism form VGI to SDI, which includes the processes of match homonymous elements between VGI and SDI vector data , change data detection, SDI spatial database update and new data product publication to end-users. Then, the proposed updating cycle is deeply discussed about the feasibility of which can detect the changed elements in time and shorten the update period, provide more accurate geometry and attribute data for spatial data infrastructure and support update propagation.


Using strict clinical and pathologic criteria for the inclusion of cases, the authors have reviewed the clinicopathologic features of 43 malignant peripheral nerve sheath tumors of the buttock and extremity seen over a 35‐year period. Twentythree (53%) of the patients had neurofibromatosis (VRN), whereas 20 (47%) did not. Fifty‐one percent of the patients were women. The mean age at presentation was 36 years for patients with VRN and 44 years for patients without VRN. A nerve of origin was identified for 72% of the cases and an associated neurofibroma for 44% (65% with VRN and 20% without VRN). The mean greatest dimension of the tumors was 12.3 cm, and this did not differ significantly between the two groups. The predominant histologic pattern in 86% of the tumors was that of tightly packed spindle cells in an interlacing and woven pattern; heterologous sarcomatous elements were noticed in 12% of the cases. Surgical resection was the main modality of treatment for all patients; 65% also received adjuvant therapy. Followup evaluation was done in every case. An unexpected finding was the absence of a significant difference in survival rates between patients with and without VRN. Overall, 63% of the patients died of tumor: 65% of the patients with VRN and 60% of the patients without VRN. Large tumor size and high mitotic rate (>20 per 10 high‐power fields) portended a poor prognosis, as did the need for resection by amputation. Adjuvant radiation therapy and chemotherapy did not affect survival rates.


—The Bayan-Kol gabbro–granite association has been recognized within the West Sangilen fragment of collision zone in the northwestern framing of the Tuva–Mongolian massif, and its composition, age, and tectonic and geodynamic settings have been studied. The association includes the Bayan-Kol pluton and composite (mingling) dikes, which formed in the late collision period (495 ± 5 Ma), during the transition from transpression to extension mode with left-lateral strike-slip kinematics. The Bayan-Kol gabbro–granite association is spatially confined to the penetrating tectonic zones of the West Sangilen shear system. The position of gabbroid and granite bodies is controlled by local zones of tectonic extension. Basic magmas have a similar petrogeochemical composition, which indicates their intrusion from a single chamber of basic composition and differentiation of ascending magma. The melting, transfer, and formation of crustal granitoids of the Bayan-Kol association are genetically related to the thermal effect of basic melt and a syntectonic drop in lithostatic pressure. The intrusion and formation of basic and acid melts of the Bayan-Kol association took place at the lower and middle crustal levels in the settings of the reactivation and subsequent fragmentation of the tectonic zone.


AIM
To investigate outcomes and predictors of in-hospital morbidity and mortality after total pancreatectomy (TP) and islet autotransplantation.

METHODS
The nationwide inpatient sample (NIS) database was used to identify patients who underwent TP and islet autotransplantation (IAT) between 2002-2012 in the United States. Variables of interest were inherent variables of NIS database which included demographic data (age, sex, and race), comorbidities (such as diabetes mellitus, hypertension, and deficiency anemia), and admission type (elective vs non-elective). The primary endpoints were mortality and postoperative complications according to the ICD-9 diagnosis codes which were reported as the second to 25(th) diagnosis of patients in the database. Risk adjusted analysis was performed to investigate morbidity predictors. Multivariate regression analysis was used to identify predictors of in-hospital morbidity.

RESULTS
We evaluated a total of 923 patients who underwent IAT after pancreatectomy during 2002-2012. Among them, there were 754 patients who had TP + IAT. The most common indication of surgery was chronic pancreatitis (86%) followed by acute pancreatitis (12%). The number of patients undergoing TP + IAT annually significantly increased during the 11 years of study from 53 cases in 2002 to 155 cases in 2012. Overall mortality and morbidity of patients were 0% and 57.8 %, respectively. Post-surgical hypoinsulinemia was reported in 42.3% of patients, indicating that 57.7% of patients were insulin independent during hospitalization. Predictors of in-hospital morbidity were obesity [adjusted odds ratio (AOR): 3.02, P = 0.01], fluid and electrolyte disorders (AOR: 2.71, P < 0.01), alcohol abuse (AOR: 2.63, P < 0.01), and weight loss (AOR: 2.43, P < 0.01).

CONCLUSION
TP + IAT is a safe procedure with no mortality, acceptable morbidity, and achieved high rate of early insulin independence. Obesity is the most significant predictor of in-hospital morbidity.


The Korean High Speed Train (KHST) has been tested on the Kyongbu high speed line and the Honam conventional line since 2002. A data acquisition system was developed to test and prove the dynamic performance of the KHST, and the system has been found to be very efficient in acquiring multi-channel data from accelerometers located all over the train. Also presented in this paper is an analysis procedure which is simple and efficient in analyzing the acceleration data acquired during the on-line test of the KHST. The understanding of system vibration mode for a railway vehicle is essential to evaluate the characteristics of a dynamic system and to diagnose the dynamic problems of the vehicle system during tests and operations. Methods based on homogeneous linear systems are not realistic because real systems have nonlinear characteristics and are strongly dependent on environmental conditions. In this paper an efficient method of vibration analysis has been proposed and applied for the KHST to evaluate its vibration mode characteristics. The results show that this method is suitable to estimate the system vibration modes of the KHST.


Abstract. One of the potential dangers that might arise as a result of bringing excessive amounts of groundwater to the surface of the Earth is land subsidence. Such surface deformations – these velocities may vary from a few millimetres to a few metres per year – do the greatest damage to infrastructure facilities and buildings in residential units. Agricultural lands, in which excessive irrigation is performed, and densely populated cities are more likely to suffer from land subsidence. Konya Closed Basin (KCB), where a rapid groundwater withdrawal has been observed during the last 30–40 years, is faced with such a threat. In this study, the possibility of the occurrence of land subsidence, related to groundwater withdrawal for the KCB, is assessed and the geodetic studies conducted up to now, with the intention of identifying land subsidence, are introduced. The vertical displacements of between -12 and -52 mm/year have been detected through GNSS observations collected on the 6-point test network. The land subsidence phenomenon has been developing in the areas where the groundwater is extensively used for irrigation and daily life. The results support the findings derived from the historical leveling records and point out the need of an extended study based on both GNSS and InSAR techniques for spatial and temporal mapping of land subsidence in the KCB.


To enhance the efficiency of the search and rescue process of a Mass Casualty Incident, we introduce a low cost autonomous mobile platform. The mobile platform motion is controlled by an Android Smartphone mounted on a robot. The pictures and video captured by the Smartphone camera can significantly enhance the situational awareness of the incident commander leading to a more efficient search and rescue process. Moreover, the active RFID readers mounted on the mobile platform can improve the localization accuracy of victims in the disaster site in areas where the paramedics are not present, reducing the triage and evacuation time.


BACKGROUND
Evidence suggests that metastatic colorectal carcinoma (mCRC) has a high level of intratumor heterogeneity. We carried out a quantitative assessment of tumor heterogeneity for KRAS, NRAS, BRAF and PIK3CA mutations, in order to assess potential clinical implications.

PATIENTS AND METHODS
Tumor samples (n = 182) from the CAPRI-GOIM trial of first-line cetuximab + FOLFIRI in KRAS exon-2 wild-type mCRC patients were assessed by next-generation sequencing that allows quantitative assessment of mutant genes. Mutant allelic frequency was normalized for the neoplastic cell content and, assuming that somatic mutations usually affect one allele, the Heterogeneity Score (HS) was calculated by multiplying by 2 the frequency of mutant alleles in neoplastic cells. Therefore, HS virtually corresponds to the fraction of neoplastic cells carrying a specific mutation.

RESULTS
The KRAS HS ranged between 12 and 260 with mean value of 87.1 and median value of 84.4, suggesting that in most CRC, the majority of neoplastic cells carry mutant KRAS. Similar findings were observed for NRAS (HS range 35.5-146.7; mean 102.8; median 117.1). In contrast, in BRAF (HS range 17.1-120; mean 54.8; median 54.3) and PIK3CA (HS range 14.3-120; mean 59.5; median 47.3) mutant cases, only a fraction of neoplastic cells seem to carry the mutant allele. The response rate was 70% in KRAS mutant patients with an HS <33 (low KRAS; n = 10) and 45.7% in KRAS HS >33 patients (high KRAS; n = 35); median progression-free survival were 7.97 and 8.37 months, respectively. Low-KRAS tumors had a higher frequency of additional mutations in PIK3CA when compared with high-KRAS (6/10 versus 8/35).

CONCLUSIONS
KRAS and NRAS mutations are usually present in the majority of neoplastic cells, whereas BRAF and PIK3CA mutations often affect a limited fraction of transformed cells. Resistance to cetuximab in low-KRAS patients might be driven by the complex mutational profile rather than KRAS mutation load.


The purpose of this paper is to evaluate the technical efficiency (productivity) of Mediterranean container ports by employing the data envelopment analysis (DEA) approach. In recent years, maritime transportation volume has been increasing with the trend of trade globalization. This tendency has positive effects on container cargo flows. Accordingly, container terminals have incessant expansions to meet this growing demand. However, before making an investment in the terminal area or handling equipment, efficiency evaluation is required to reveal optimal throughput with the present resources. As the Mediterranean Basin is an important region for container transportation, there should be studies on the efficiency of container terminals in this region. In this study, relative efficiency analysis is conducted for Mediterranean container ports which are on the list of world busiest container ports based on the year 2016 data. The findings show that subjected container terminals can increase their output by 1,47 times without expanding their inputs. Efficiency is slightly increasing from eastern through the western part of this region.


OBJECTIVE
The highly osteolytic interface tissue between the bone and loosening total hip prosthesis is characterized by low pH, formation of foreign body giant cells, osteoclasts, and production of receptor activator of nuclear factor-kappaB (RANKL) and cathepsin K. We hypothesized that fibroblasts in the interface tissue may form a source for RANKL production.

METHODS
Primary interface tissue fibroblasts, fibrous joint capsule fibroblasts, and trabecular bone osteoblasts were stimulated with tumor necrosis factor-alpha (TNF-alpha), interleukin 1beta (IL-1beta), IL-6, IL-11, or 1alpha,25-(OH)2 vitamin D3. Cellular RANKL and released cathepsin K were detected by Western blotting. RANKL in cell lysates and osteoprotegerin (OPG) in cell culture medium were measured by ELISA. RANKL, OPG, and cathepsin K mRNA were measured with quantitative reverse transcriptase polymerase chain reaction.

RESULTS
Interface tissue fibroblasts were found to produce RANKL. 1alpha,25-(OH)2 vitamin D3 stimulation increased RANKL mRNA expression. TNF-alpha was found to be the most potent OPG inducer in interface tissue fibroblasts. Cathepsin K mRNA production in fibroblasts was upregulated roughly 3-fold (p < 0.01) after 1alpha,25-(OH)2D3 stimulation, and both pro- and active cathepsin K protein was released to fibroblast culture media.

CONCLUSION
Interface tissue fibroblasts are able to produce RANKL, OPG, and cathepsin K and may contribute indirectly and directly to pathologic periprosthetic collagenolysis and bone destruction.


From the study has shown that as perpetrator of small business activity, woman personate as perpetrator of the business or as owner, as manager or even labour. In activity of small business, woman can personate as a member, official member, supervisor, manager, builder or even partner of the business. The role of woman in so many sector; however as according to excesses that she had, therefore most women are success in finance-related, crafting industry, and processing industry. In consequence, most small business that managed by woman is saving and loan in essence business activity, whether as a small entrepreneur, woman has developing in store business, food and beverage industry, convection/garment, salon/wedding service, also on crafting industry. The business volume or turnover of sampling small business which has reached Rp 2,6 billion until more than Rp 35 billion per year has given multiplier effect and also has a big role in developing small business in the region. Performance of sampling small business activity has quite good, whether from its value and development of self-supporting capital, turnover, and reached margin which average more than 25 %.


This paper studies compress-forward (CF) coding with BPSK modulation for the half-duplex Gaussian relay channel. In CF relaying, Wyner-Ziv coding is applied at the relay to exploit the joint statistics between signals at the relay and the destination. We propose Slepian-Wolf coded nested scalar quantization (SWCNSQ) for practical Wyner-Ziv coding at the relay. We first provide the achievable rate of SWCNSQ based CF relaying as a performance benchmark, and then present a practical code design using low-density parity-check (LDPC) codes for error protection at the source, and nested scalar quantization plus irregular-repeat accumulation (IRA) codes for CF coding at the relay. The degree distributions of the LDPC and IRA codes are optimized using extrinsic information transfer charts and Gaussian approximation. Under discretized density evolution for asymptotically large block lengths, our optimized code design operates 0.11-0.21 dB away from the SWCNSQ limit for CF relaying. Simulations with LDPC/IRA codes of length 2 times 105 bits show a performance gap of 0.27-0.38 dB from the achievable rate.


1. Salinity tolerance, osmoregulatory mechanisms and some effects of salinity on embryonic development and metamorphosis have been studied in the tadpoles of the euryhaline crab-eating frog (Rana cancrivora). 2. Tadpoles in developmental stages III-XIX survive well in all salinities from fresh water to 32% sea water. They are good osmoregulators over this entire range, plasma osmotic concentration changing by only 250 m-osmoles/l. in the face of environmental concentration changes of 900 m-osmoles/l. Na, Cl, and K account for over 90% of plasma osmotic concentration in all external concentrations. 3. The osmoregulatory mechanisms used by the tadpoles appear to be similar to those used by euryhaline teleost fishes. In hyperosmotic media they probably drink, then excrete salts by an extrarenal pathway. 4. A metamorphosis in osmoregulatory mechanisms occurs simultaneously with morphological metamorphosis. The osmoconforming behaviour of adult frogs is fully developed in the tadpoles by developmental stage XXV. As in other anuran species there probably is no significant urea production before metamorphosis. 5. Both early embryonic development and the completion of metamorphosis beyond stage XIX apparently require low salinities. 6. The pattern of osmoregulation shown by tadpoles of the freshwater R. limnocharis is identical with osmoregulatory patterns found in adult freshwater anurans. 7. Evolutionary and ecological implications of the data are discussed.


Jordan is a developing country with limited natural resources. It imports
most of its energy for heating, electric power generation, and other uses. The
limited energy sources consider renewable energy options such as solar, wind, and
hydropower as alternatives. For successful energy research and applications,
weather parameters (wind speed, sunshine duration, humidity_ temperature, and
global solar radiation) should be modeled.
For solar energy applications, information on global solar radiation are
required for the country over a long period of time. Some sites have no records of
solar radiation data. So, developing methods to predict solar radiation from any
available weather data are necessary. Models based on Angstrom formula using
data such as Sunshine, Temperature and Humidity of four stations are described. Wind is an important energy resource and man has long sought to harness
it. The calculation of the output of a wind machine requires knowledge of the
distribution of the wind speed. Weibull distribution was applied to fit the
probability distribution nature of wind speed. For all locations the wind speed data
can be modeled easily by the Weibull distribution.
Time series analyses of the weather parameters such as wind speed,
relative sunshine duration, relative humidity, range in temperature extrenies, and
relative solar radiation all as daily average were carried out. To apply
AutoRegressive process, transformation technique (Differencing) was applied to
generate stationary time series. Seasonal and non-seasonal AutoRegressive
models of order p AR(P) were used to describe the weather parameters data for all
stations.


FOXQ1 is an oncogene for a variety of tumors and encodes the forkhead boxrelated transcription factor FoxQ1. However, little is known about the role of FoxQ1 in pancreatic cancer (PC). In this study, we examined FoxQ1 expression in PC cell lines and human PC tissues by quantitative PCR and tissue microarray based immunohistochemical staining (IHC), and investigated the clinical correlation between FoxQ1 tissue levels and the clinicopathological characteristics of PC patients. We found that FoxQ1 mRNA expression was up-regulated both in PC cell lines and tumor tissues. IHC results revealed that FoxQ1 was mainly expressed in the cytoplasm, and to a lesser extent in the nucleus of PC cells. FoxQ1 protein levels were significantly higher in PC tissues when compared with matched non-cancerous tissues, and associated positively with the degree of tumor differentiation. Univariate and multivariate survival analysis revealed that patients with high FoxQ1 expression and advanced TNM stage had poor prognosis (HR=1.856, 95%CI 1.065- 3.234, P=0.029; HR=2.091, 95%CI 1.181-3.705, P=0.01). These data indicate that FoxQ1 expression is negatively associated with the overall survival of PC patients, and that this protein may therefore represent a novel molecular target and new prognostic biomarker for PC.


Following the financial crisis of 2008–2009, a large body of literature has emerged that attempts to quantify and measure systemic risk. In this article, the author focuses on some of the more popular systemic risk indicators from this literature and asks how well they work in the following sense: At the aggregate level, what information do we learn from these systemic risk indicators that is above that which is readily observable in the market? Several popular measures provide very little incremental information beyond that contained in implied volatilities and credit spreads—information that is commonly known to market participants. For some indicators, where neither the cross-sectional mean nor standard deviation contains meaningful incremental information, the author finds that the tail proportion (the cross-sectional proportion of indicators experiencing a tail realization) does contain information that is not already observable in the market.


The idea that ordinary people might contribute to verification of arms control treaties is not new; abstract discussions of the concept date back decades. But powerful and portable electronic devices have spread so widely in recent years that societal verification now seems an imminent reality. Motivated individuals might, for instance, collect treaty-relevant data through onboard sensors that smartphones can carry and then transmit the information to multilateral verification bodies or, as is already happening, share it online with global communities that subject it to crowdsourced analysis. But will societal verification generate enthusiasm in the developed and developing worlds alike? What legal protections must be established for participants? And will information gathered through societal verification ultimately prove useful and trustworthy? Three authors explore these emerging questions: from Burkina Faso and representing the Preparatory Commission for the Comprehensive Nuclear Test Ban Treaty Organization, Lassina Zerbo (2013); from the United States, research fellow Nima Gerami; and from Malaysia, nuclear engineer Jamal Khaer Ibrahim (2013).


ABSTRACT The key to efficacious intervention for youths with problematic sexual behavior (PSB) is direct caregiver involvement. Engaging families in treatment for youths PSB has unique complexities beyond known challenges with behavioral health treatment overall. Qualitative research with youths and caregivers in treatment for PSB complements clinical outcome research by examining consumer perception of impact, supports, and barriers. The authors sought to understand consumer impressions of treatment for PSB to identify factors that impact family participation. Following the completion of PSB–cognitive behavior therapy, 149 caregivers and 144 youths completed a program exit survey. Qualitative interviews were also conducted with 30 caregivers to gain further insight into their experiences. Results revealed that caregivers and youths communicated targets of improvements in their knowledge and skills, family communication, youth behavior, and social support. Recommendations from participants were to expand service availability and address logistical issues, approaches, and content of the program. Findings have implications for strategies to enhance engaging families in treatment programs for youths with PSB.


Abstract Context: Advancement in HIV treatment has evolved over the last two decades with the discovery of new drugs and approaches. Studies have demonstrated that HIV-infected individuals have elevated immune activation even during effective antiretroviral therapy. Persistently elevated immune activation has been one of the main obstacles against developing an effective approach for curing HIV. Objective: This review examines the mechanism of microbial translocation in HIV-infected individuals and currently investigated potential therapeutic approaches. Methods: We searched PubMed and Medline for peer-reviwed articles and recent HIV/AIDS conference abstracts and papers. Narrative review method was used since the objectives of the study were mechanism of microbial translocation and mechanism of action of multiple drugs against it. Results: Microbial translocation occurs as a result of the disruption of epithelial barrier and immunological dysfunction within the intestinal tract due to defective tight junctions, loss of TH17 type CD4+ T cells, impaired liver architecture, and depletion of intestinal myelomonocytic cells. Potent and effective way to intervene microbial translocation is to target the mechanism of actions involved in microbial translocation by restoration of beneficial microbiata with supplemental probiotics/prebiotics, increased clearance of microbial products from systemic circulation with targeted antibodies and restoration of intestinal integrity with antibiotics. Conclusions: Number of promising drug molecules against microbial translocation are currently under various stages of trials and the results of these trials will hopefully contribute significantly toward effective therapeutic intervention. However, studies also need to explore the effect of combination drugs to abrogate microbial translocation.


Objective: Impacted third molars are a major problem in modern dentistry and the decision of whether to remove an impacted third molar is probably one of the most frequent treatment decisions faced by dentists. Impacted mandibular third molars are often associated with pericoronitis, periodontitis, cystic lesions, neoplasm, and pathological root resorption and can cause detrimental effects on the adjacent tooth. Therefore, the objective of the present study was to determine the frequency of different types of mandibular third molar impactions. Materials and Methods: This cross-sectional study was carried out in the outdoor patient Department of Oral and Maxillofacial Surgery, Multan Medical and Dental College, Multan during a period of 6 months from 15 December 2017 to 14 June 2018. After written informed consent, a total of 200 patients were recruited, diagnosed clinically and radiographically as having impacted mandibular 3rd molar. Angulation of impacted third molar was classified according to the long axis of the adjacent second molar on periapical and OPG radiographs. Statistical analysis was done through SPSS version 20. Results: Out of 200 patients, the frequency of mesioangular, vertical, distoangular, and horizontal impactions were 84 (42%), 60 (30%), 40 (20%), and 16 (8%) respectively. The depths of the impactions were 67 (33.5%) depth A, 92 (46%) depth B, and 41 (20.5%) depth C. Conclusion: Mesioangular impaction was more common followed by vertical. Depth B was the most common.


This study is the first known formative analysis of simulation-based healthcare education virtual communities of practice (VCoPs). The goal of this study was to analyse the frequency of participation, factors that influence participation, and strategies used to assess the value and credibility of content in simulation-based healthcare education VCoPs. A sequential mixed-methods approach was used to assess participation and content assessment factors for a sample of 100 online survey respondents and five semi-structured interviews. Participation frequency was directly observed in 11 simulation-based education VCoPs for a one-year period between September 1, 2014 and August 31, 2015. Simulation-based healthcare education VCoPs that were hosted on LinkedIn had poor user engagement compared to VCoPs hosted as independent discussion forums. Qualitative analysis suggested that the perceived unmoderated and commercial nature of LinkedIn VCoPs may have driven low participation rates. Factors that were empirically associated with community participation rates included platform ease of use, trust in the community, direct and indirect personal benefits, self-efficacy and psychological safety. In this study, VCoPs participants rarely engaged in a systematic process of content credibility and value assessment. Rather, heuristic shortcuts were leveraged to assess content, including reputation, enforcement, self-confirmation, expectancy violation, and persuasive intent.


This chapter reviews the literature relating to environmental processes that affect mineral dissolution reactions and the generation of acid mine drainage (AMD), the fate and transport of metal contaminants within the environment, the toxic influences of metals and mine drainage on aquatic species, characterization of abandoned mines and their potential for contamination, and technologies for remediation of mining-impacted systems or removing metals from wastewater streams.


da Rocha E.M., Nunes A.A., Flausino W., da Rocha M.N.M., de Souza W.J.S. & Lopes C.W.G. Cats and dogs as risk factors for pregnant women on Toxoplasma gondii infection at the Region of Araguarina in the State of Tocantins, Brazil. [Fatores de risco associados a gatos e caes e a positividade de gestantes ao Toxoplasma gondii na regiao de Araguarina no estado do Tocantins, Brasil]. Revista Brasileira de Medicina Veterinaria, 34(2):79-82, 2012. Faculdade de Medicina, Instituto Tocantinense Presidente Antonio Carlos, Av. Filadelfia, 600, Setor Oeste, Araguaina, TO 77800-000, Brasil. E-mail: email@example.com Toxoplasma gondii, etiological agent of toxoplasmosis, has the cat as the definitive host and, human being and others vertebrate hosts as intermediated hosts, the range of this parasite can determined by its low specificity and different forms of transmission. This disease is associated severe systemic, neurological and congenital lesions, mainly acquired in the first trimester of pregnancy. At the Araguarina in the State of Goias, the risk factor is associated to the presence of cats (p<0.0001) and dogs (p<0.0001) in relationship with the frequency of seropositivity pregnant human (57.32%). There is an evidence of the hole of cats and dogs as the main source of infection for pregnant women that get in contact with sporulated oocysts shed by cats and/or acquired from dogs by xenosmophilia.


This new book presents a deep review of various power theories and shows how the instantaneous active and reactive power theory provides an important basic knowledge for understanding and designing active filters for power conditioning. The book consists of six chapters covering the following topics and more: instantaneous power theory; shunt active filters; hybrid and series active filters; and combined series and shunt power conditioners. The book is easy to read and each chapter ends with a summary and list of references. The book perfectly fills the gap on the power electronics book market. It is an extremely attractive reference book for research and development engineers who are interested in design of modern active power filters and conditioners as well as flexible ac transmission systems. It can also be recommended for advanced senior-level courses as well as for undergraduate courses.


Polyhydroxyalkanoates (PHA) are intracellular polymers that can be produced by
bacteria as energy reserve material. This biodegradable material has properties
similar to synthetic thermoplastics. However, the process recovery of PHA using
organic solvents such as chloroform is expensive and not environmental-friendly.
Although most of the organic solvent is recovered for reuse, it still causes serious
damage to health and environment. Thus, alternative methods that are
environmental-friendly are needed for the recovery of PHA. Fermentation was
carried out using a 50 L bioreactor at pH 7, 30°C, with agitation speed of 200 rpm
and 1 vvm aeration rate to maintain aerobic condition. Ralstonia eutropha ATCC
17699 was chosen as the PHA production bacteria. Twenty g/L mixture of acetic and
propionic acids were fed into the broth as carbon sources and PHA was produced in
nitrogen limited condition with C/N = 50. Cells were harvested by centrifugation and
the pellets were then dried in oven at 60°C, grinded and stored at 4OC for recovery of
PHA.
Biomass containing PHA with the concentration of 0.32 glg biomass was treated
with various chemicals such as alkaline solutions (NaOH, KOH), surfactants
(sodium dodecyl sulfate or SDS, sodium salt of a-sulfonate methyl esters derived
from palm stearin or a-SMEPS, Tween 20, Tween 80 and betaine anhydrous) and
enzyme (lysozyme) to digest non-PHA cellular material (NPCM) at dried cells
concentration of 5 g/L. Mechanical methods such as ultrasonic sonication and
homogenization were also used for further cell disruption. Combined treatment of
alkali and homogenization was also investigated. After treatment, PHA granules
were separated from cell debris by centrifugation at 3500 rpm for 10 min. PHA
granules recovered were rinsed twice with deionized water to avoid floatation,
centrifuged and air-dried. Pellet was analyzed by using HPLC and supernatant was
analyzed by the presence of protein.
Combined treatment of NaOH and homogenization were found to give the highest
PHA purity and yield of 97% and 94%, respectively, compared to other methods.
The purity of the final PHA increased with the released of cellular protein. PHA
could be recovered from biomass by combined NaOH pretreatment, (0.2 M, 60 min)
and homogenization (18 min) to achieve cell disruption. This method is simple,
economical, environmental friendly, non-toxic and suitable for larger scale
production. The product obtained was white in colour and ready to be accepted by
end user for commercialization. Thus, combined NaOH treatment and
homogenization can replace chloroform for the recovery of PHA.


This paper presents a method for the optimisation of both PAE and EVM of a millimeter wave power amplifier applied here to MQAM modulations. A first key point lies in that both input and output biasing voltages of the SSPA are dynamically controlled versus the RF power level associated with the symbol to be transmitted. The leading idea here is that the dynamic biasing control is designed and implemented to keep fixed AM/AM and AM/PM conversion values while RF input power level changes. By doing so, the power gain of the PAs can be dynamically tuned to a fixed power gain corresponding to the compression gain behaviour for which the PAE is optimum either at low, medium and high input RF power level. As a main consequence, PAE performances can be drastically improved (from 1% to 20% at Ka band) as compared to classical back-off solutions and optimised while keeping a very good EVM. A Ka band hybrid amplifier has been developed using an 8*75 /spl mu/m Power PHEMT. The proposed linearisation technique is validated by comparisons between measured PAE and EVM on the SSPA when a fixed bias and a controlled bias are used.


The lithium enolate 16 derived in 5 steps from the Diels-Alder adduct of furan to 1-cyanovinyl (1S)-camphanate [(+)-12: a "naked sugar" of the first generation] was reacted with (+)(1R,4S,5S,6S)-6-endo-chroro-3-methylidene-5-exo-phenylseleno-7-oxabic yclo[2.2.1]. heptan-2-one [(+)-8] to give a unique product of Michael addition after acidic quenching. This adduct (-)-18 was transformed into branched long-chain carbohydrate derivatives such as benzyl 5-deoxy-5-[(5"-O-acetyl-3"-deoxy-2"-O-methoxymethyl-D-manno-furanurono-6 , 1-lactone-3''-yl)methyl]- (tert-butyl)dimethylsilyl-2,3-di-O-methoxymethyl-alpha and beta-L-gulo-furanosideuronate [(-)-27]. Hydrogenolysis, followed by a Curtius rearrangement permitted to construct the corresponding branched 5-amino-5,6-dideoxydodecose derivative (-)-30 which was converted into 5-O-acetyl-3- [ 5'-N-(benzyloxy)carbonyl-2',3'-di-O-methoxymethyl-alpha and beta-D-manno-furanose]-2-O-methoxymethyl-D-manno-furanurono-6, 1-lactone [(-)-31] and then into methyl 3-deoxy-3-(1',2',6'-trideoxy-2',6'-imino-D-galactitol-1'-yl)-alpha-D-man no-pyranoside [(-)-1]. Its H-1 NMR spectrum measured at variable temperature demonstrated that (-)-1 exist as a double equilibrium involving two pairs of rotamers about the sigma C(1')-C(2') and sigma C(1')-C(3) bond [CH2 bridge linking beta-C(I) of the I,5-dideoxy-1,5-imino-D-lyxitol unit at C(3) of methyl alpha-D-manno-pyranoside]. Rotamers B' in which C(3) is gauche with respect to C(3') is preferred to conformers C' in which C(3) is anti with respect to C(3'). An equilibrium constant K (B' = C') congruent to 0.35 (25 degrees C) was evaluated. Rotamers B [C(2) gauche with respect to C(2')] and C [C(2) anti with respect to C(2')] are equally populated. Disaccharide mimetic (-)-1 is a moderate inhibitor of alpha-L-fucosidases from bovine liver (K-i = 100 mu M) and human placenta.


The layering of HIV-related stigma with stigmas associated with gender, race, and class poses a methodological challenge to those seeking to understand and, thereby, to minimize its negative effects. In this meta-study of 32 reports of studies of stigma conducted with HIV-positive women, we found that gender was hardly addressed despite the all-female composition of samples. Neither sexual orientation nor social class received much notice. Race was the dominant category addressed, most notably in reports featuring women in only one race/ethnic group. The relative absence of attention to these categories as cultural performances suggests the recurring assumption that sample inclusiveness automatically implies the inclusion of gender, race, and class, which is itself a cultural performance.


Genomic-scale experimentation aims to view biological processes as a whole, yet with molecular precision. Using massively parallel DNA microarray technology, the mRNA expression of tens of thousands of genes can be measured simultaneously. Mathematical distillation of this flood of gene expression data reveals a deep molecular and biological logic underlying gene expression programs during cellular differentiation and activation. Genes that encode components of the same multi-subunit protein complex are often coordinately regulated. Coordinate regulation is also observed among genes whose products function in a common differentiation program or in the same physiological response pathway. Recent application of gene expression profiling to the immune system has shown that lymphocyte differentiation and activation are accompanied by changes of hundreds of genes in parallel. The databases of gene expression emerging from these studies of normal immune responses will be used to interpret the pathological changes in gene expression that accompany autoimmunity, immune deficiencies, and cancers of immune cells.


BACKGROUND
Entrapment of the median nerve at the pronator teres muscle can contribute to symptoms in the forearm and wrist. The pronator teres is also involved in patterns of spasticity observed in people who had suffered a stroke. Research on treatment efficacy with dry needling is scarce.

OBJECTIVE
To determine if a solid filiform needle safely penetrates the pronator teres muscle during the clinical application of dry needling.

DESIGN
A cadaveric descriptive study.

METHODS
Needle insertion of the pronator teres was conducted in ten cryopreserved forearms with a 30*0.32 mm filiform needle. With the forearm supinated, the needle was inserted 3 cm distal to the mid-point between the biceps tendon insertion and the medial epicondyle. The needle was advanced in a cranial and medial direction to a depth clinically judged to be in the pronator teres muscle. Safety was assessed by measuring the distance from the needle to the surrounding neurovascular bundles.

RESULTS
Accurate needle penetration of the pronator teres was observed in 100% of the specimens (mean needle penetration: 16.7 ± 4.3 mm, 95%CI 13.6 to 19.7 mm). No neurovascular bundles were pierced in any of the specimen's forearms. The distances from the tip of the needle to the surrounding neurovascular bundles were 16.4 ± 3.9 mm (95%CI 13.6 to 19.2 mm) to the ulnar nerve (A), 9.0 ± 2.2 mm (95%CI 7.3 to 19.5 mm) to the median nerve (B), and 12.8 ± 4.0 mm (95%CI 10.0 to 15.7 mm) to brachial artery (C).

CONCLUSION
The results from this cadaveric study support the assumption that needling of the pronator teres using described anatomical landmarks can be accurately and safely conducted by an experienced clinician.


Jewelry as an art form in Mughal India has probably never been surpassed by any other civilization in the history of the world. This full-colour presentation of its fabulously varied achievements, with over 300 specially-taken photographs (the great majority illustration objects never previously published), accompanies the major international exhibition of the same title. The pieces range from rings, necklaces and other body ornaments to astonishingly detailed jewelled work on objects as diverse as boxes, flasks, bowls and daggers. They are presented and analysed here in themes that include creative varieties in stone settings, precious-metal inlay in hardstones, relief decoration in hammered metals, engraved gold-backed jewels, stones set on a gold floral ground, enamelling, gold-embellished steel, three-dimensional expressions, relief carved ornament, carved set gems, the varieties of gemstone forms, and inscribed royal stones, concluding with a selection of particularly exuberant pieces that combine to create an explosion of jewelled magnificence of incomparable splendour. The result is a visual feast of almost unbelievable richness, gathered together in this book for the first time.