already demonstrated effects in man and rats of the close interrelations between carbohydrate metabolism of the host and tumour, but also because tumour growth can apparently, both in man and rats, be altered profoundly by the presence of diabetes in the host. Moreover, there is a considerable body of in vitro and in vivo (clinical) data suggesting the apparent marked dependence of malignant tumours on glucose being made freely available by their hosts. Of particular interest perhaps is the recent disclosure that insulin markedly influences the carbohydrate metabolism and especially the synthesis of ribosenucleic acid, phospholipid, and protein in cultured tumour cells."7 Experimental evidence, at any rate, has adequately disclosed the possible value of chemically or surgically induced diabetes in inhibiting the growth even of advanced cancers. While we are still far from convinced of the value of alloxan injections in the treatment of advanced cancer in man, we do, nevertheless, feel that there is more than enough experimental evidence and even sufficiently provocative clinical information to merit more work on this aspect of neoplasia by others, probably better qualified than we and certainly with better facilities for metabolic and follow-up studies on human material than presently available to us. There would also seem to be more data justifying attack on advanced cancers by altering the carbohydrate metabolism of both hosts and tumours than the rather slender evidence originally available when clinicians first attempted complicated operations such as adrenalectomies, hypophysectomies, and other endocrine ablations which seem, even to-day, to be rather unpredictable in their effects on the hormone metabolism of their hosts as well as on the growth and spread of malignant tumours.-We are, etc., THEODORE GILLMAN. M. HATHORN.


Th e cry3Aa11 gene of Bacillus thuringiensis strain Mm2 (B. thuringiensis Mm2) was PCR-amplifi ed and cloned into E. coli/B. thuringiensis shuttle vector pHT315. Th e recombinant plasmid carrying the cry3Aa11 gene was introduced into the parental B. thuringiensis Mm2. Th e toxin production capacities of parental and recombinant strains grown in DSM, containing either 50 mM or 200 mM inorganic phosphate (Pi), were compared by SDS-PAGE and western blot analyses. In comparison to the parental strain, recombinant B. thuringiensis Mm2 produced 4-fold more Cry3Aa11 toxin aft er 12 h of growth in the presence of 50 mM Pi. However, the 200 mM Pi concentration did not cause a drastic increase in toxin production by the recombinant strain. Th is study shows that higher toxin production could be obtained from the cultures during the early hours of growth by introducing the multicopy cry3Aa11 gene into the source organism.


Hot water extraction of hemicelluloses from aspen wood chips of different sizes and wood meal was performed, and the extracted hemicelluloses were characterized. With decreasing wood chip size, the total sugars and total poly- and oligosaccharides extracted with hot water increased. The dissolution of hemicelluloses was mainly limited by diffusion in the fiber wall and mass transfer from fiber to fiber during hot water extraction of the wood chips. The extraction yield of high molecular weight hemicelluloses was less than that of low molecular weight hemicelluloses, and the reduction of wood chip size benefited the extraction of high-molecular weight hemicelluloses. Compared to the wood chips, the high molecular weight hemicelluloses extracted from wood meal had a higher extraction yield and an increased average molecular weight.


Laparoscopic sleeve gastrectomy is a safe and accepted procedure for morbid obesity to reduce weight with an overall low rate of complications; the incidence of major blood vessel injury reported in the literature is 0.1%. In our patient, sudden bradycardia and a fall in blood pressure and oxygen saturation were immediately identified. A camera was inserted and revealed bleeding under the first trocar, necessitating conversion of the laparoscopic procedure to laparotomy. Management included repair of injuries to the aorta and the inferior vena cava by the vascular surgeon, initial supportive therapy with crystalloids, and initiation of inotropic agents and vasopressor drugs. A predefined massive transfusion protocol of red blood cells, fresh-frozen plasma/cryoprecipitate and platelet units (random donor platelets) in each pack in a 1 : 1 : 1 ratio was followed.


Vascular endothelial growth factor A (VEGFA) isoform treatment has been demonstrated to alter spermatogonial stem cell homeostasis. Therefore, we generated pDmrt1-Cre;Vegfa(-/-) (knockout, KO) mice by crossing pDmrt1-Cre mice to floxed Vegfa mice to test whether loss of all VEGFA isoforms in Sertoli and germ cells would impair spermatogenesis. When first mated, KO males took 14 days longer to get control females pregnant (P < .02) and tended to take longer for all subsequent parturition intervals (9 days; P < .07). Heterozygous males sired fewer pups per litter (P < .03) and after the first litter took 10 days longer (P < .05) to impregnate females, suggesting a more progressive loss of fertility. Reproductive organs were collected from 6-month-old male mice. There were fewer sperm per tubule in the corpus epididymides (P < .001) and fewer ZBTB16-stained undifferentiated spermatogonia (P < .003) in the testes of KO males. Testicular mRNA abundance for Bcl2 (P < .02), Bcl2:Bax (P < .02), Neurog3 (P < .007), and Ret was greater (P = .0005), tended to be greater for Sin3a and tended to be reduced for total Foxo1 (P < .07) in KO males. Immunofluorescence for CD31 and VE-Cadherin showed no differences in testis vasculature; however, CD31-positive staining was evident in undifferentiated spermatogonia only in KO testes. Therefore, loss of VEGFA isoforms in Sertoli and germ cells alters genes necessary for long-term maintenance of undifferentiated spermatogonia, ultimately reducing sperm numbers and resulting in subfertility.


Objective The aims of this study were to use a 3-dimensional (3D) system to compare molar relationship assessments performed from the buccal and lingual aspects, and to measure differences in occlusal contact areas between Class II and Class I molar relationships. Methods Study casts (232 pairs from 232 subjects, yielding a total of 380 sides) were evaluated from both the buccal and lingual aspects, so that molar relationships could be classified according to the scheme devised by Liu and Melsen. Occlusal contact areas were quantified using 3D digital models, which were generated through surface scanning of the study casts. Results A cusp-to-central fossa relationship was observed from the lingual aspect in the majority of cases classified from the buccal aspect as Class I (89.6%) or mild Class II (86.7%). However, severe Class II cases had lingual cusp-to-mesial triangular fossa or marginal ridge relationships. Mean occlusal contact areas were similar in the Class I and mild Class II groups, while the severe Class II group had significantly lower values than either of the other 2 groups (p < 0.05). Conclusions Buccal and lingual assessments of molar relationships were not always consistent. Occlusal contact areas were lowest for the Class II-severe group, which seems to have the worst molar relationships - especially as seen from the lingual aspect.


MLA divisions encompass the primary scholarly and professional concerns of the association, with each of the eighty-four divisions representing a major area of membership interest. Since membership in divisions is maintained as part of all members' records for the purpose of sending them special-interest materials, joining a division indicates an active involvement in the field and a desire to promote its scholarly and professional concerns. Membership in one division does not, of course, exclude a member from attending any or all meetings arranged by other divisions at the MLA Annual Convention. Members who wish to join a division or change membership from one division to another may do so by writing to the member and customer services office at the MLA office. It is, however, most convenient to make changes and additions when paying one's annual dues (the dues notice accommodates such changes). The following list of divisions includes code numbers to which members should refer when joining a particular division. [ P M L A


OBJECTIVE
Mesial temporal lobe epilepsy (MTLE) is one of the most common causes of intractable partial epilepsy. The conventional treatment of patients with MTLE is surgical excision. Currently, gamma knife (GK) radiosurgery is being explored as an alternative treatment. We report the first delayed major complication related to this treatment.

CLINICAL PRESENTATION
A 54-year-old woman with a medical history of a post-viral encephalitis in childhood was treated in April 2001 by GK radiosurgery for a medically refractory MTLE. Her right temporomesial area received a dose of 20 Gy at the 50% marginal isodose line. Unfortunately, the patient continued to experience seizures, although they were of shorter duration and occurred less frequently. She was seen in our department on November 8, 2007, for an intracranial hypertensive syndrome. The imaging work-up showed an expansive hemorrhagic lesion in the right mesiotemporal area. Despite corticosteroid treatment, the patient still complained about headaches on November 13, and surgery was scheduled for November 22. However, the patient returned to the emergency department on November 16 with a temporal herniation syndrome requiring an urgent surgical procedure.

INTERVENTION
The expansive lesion was completely removed. Histologic examination revealed lesions of the gray and white matter consisting of severe gliosis, hemorrhagic foci, hyalinized vessels, and neovascularization, giving the brain parenchyma an angiomatous aspect.

CONCLUSION
Although reports on GK radiosurgical treatment of MTLE are encouraging, this case stresses the risk of developing 6 years later an angiomatous degeneration of the targeted brain with life-threatening intracranial hypertension.


This research addresses the problem of coordinating multiple autonomous underwater vehicle (AUV) operations. An intelligent mission executive has been created that uses multiagent technology to control and coordinate multiple AUVs in communication-deficient environments. By incorporating real-time vehicle prediction, blackboard-based hierarchical mission plans, mission optimization, and a distributed multiagent–based paradigm in conjunction with a simple broadcast communication system, this research aims to handle the limitations inherent in underwater operations, namely poor communication, and intelligently control multiple vehicles. In this research, efficiency is evaluated and then compared to the current state of the art in multiple AUV control. The research is then validated in real AUV coordination trials. Results will show that compared to the state of the art, the control system developed and implemented in this research coordinates multiple vehicles more efficiently and is able to function in a range of poor communication environments. These findings are supported by in-water validation trials with heterogeneous AUVs. © 2010 Wiley Periodicals, Inc.


Over the last decade two reforms have affected the Italian hospital system, one introducing market mechanisms, the other concerning the tools of planning and expense control assigned to the regional governments. The paper summarizes these institutional changes and describes the evolution of the structure and the activity of the hospital system, with a focus on the differences between regions. It highlights the following: (1) the reduction in the number of hospitals and hospital beds and the gap between regions in terms of hospital beds per capita; (2) the growth in personnel compared with the number of hospital beds; (3) the stationarity of admissions since the end of the nineties and the growth in the share of those in day hospital; (4) the greater number of admissions in southern regions, especially for inappropriate or less complex treatment, and the high level of migration towards northern hospitals; (5) with reference to costs, increasing returns to scale up to a given hospital size, which is larger, the more complex the courses of treatment provided; (6) the differences between regions in costs which are affected by the size of facilities and their type of specialization.


Abstract This chapter examines the history and distribution of seismicity across the Andaman–Nicobar island arc and Andaman Sea. Fundamental differences between the Andaman section of the subduction zone and the Sumatra–Java section to the south help to explain the nature of the deformation. Magnitudes of displacements varied along-strike from uniform dip-slip on the southern (Sumatran) segment to dip-slip and strike-slip components on the Andaman and Nicobar segment. The Andaman section has a more steeply dipping slab and a thicker sediment cover compared to the Sumatra region where coupling with the overlying plate is stronger. Temporal and spatial patterns of seismicity in the Andaman Sea spreading centre are consistent with normal faulting and c. 25 year cycles of dyke injection are considered responsible for the bulk of the spreading.


In the past, energy facilities on the Island of Puerto Rico have not been located in the best practicable sites. This is attributable to the absence of mandatory site selection procedures. This thesis has developed and tested procedures for siting goo MWe coal fired thermoelectric generation plants. The procedures developed here permit the placement of these facilities within the existing legal regime, with a minimum of adverse ecological and socioeconomic impact. The process has been designed to consider the entire Island of Puerto Rico for the suitability of siting a goo MWe coal fired facility. This is accomplished through the design and use of a five-phase process. The primary goal of the process was to quickly reduce the total geographic area under siting consideration. This allowed for the" identification of a number of "preferred areas" for a 900 MWe project. This provision allowed a majority of the effort and resources, involved in site selection, to be concentrated on those areas most suitable for facility development. This is particularly important in the case of Puerto Rico because the Island does not possess the physical or monetary resources to conduct financial and manpower intensive studies, compared to the continental United States. Is is equally important that siting procedures are responsive to the Island's environment. The environmental problems of Puerto Rico are particularly important due to spatial constraints. Due to its small size, the Island's residents perceive environmental change quickly. The lines of cause and effect are small and can be drawn with greater clarity than those for mainland areas. The thesis has successfully designed and tested procedures that in practice will attain these goals. Ideally, the process culminates in the selection of the optimum site(s) for a 900 MWe facility. The procedures have also been designed with a high degree of general applicability. With minor alterations, the process may also benefit other Caribbean Islands in their energy development programs. CHAPTER TABLE OF CONTENTS PAGE


MOTIVATION
Microarrays rapidly generate large quantities of gene expression information, but interpreting such data within a biological context is still relatively complex and laborious. New methods that can identify functionally related genes via shared literature concepts will be useful in addressing these needs.

RESULTS
We have developed a novel method that uses implicit literature relationships (concepts related via shared, intermediate concepts) to cluster related genes. Genes are evaluated for implicit connections within a network of biomedical objects (other genes, ontological concepts and diseases) that are connected via their co-occurrences in Medline titles and/or abstracts. On the basis of these implicit relationships, individual gene pairs are scored using a probability-based algorithm. Scores are generated for all pairwise combinations of genes, which are then clustered based on the scores. We applied this method to a test set composed of nine functional groups with known relationships. The method scored highly for all nine groups and significantly better than a benchmark co-occurrence-based method for six groups. We then applied this method to gene sets specific to two previously defined breast tumor subtypes. Analysis of the results recapitulated known biological relationships and identified novel pathway relationships unique to each tumor subtype. We demonstrate that this method provides a valuable new means of identifying and visualizing significantly related genes within gene lists via their implicit relationships in the literature.


Typical nonlinear model order reduction approachesneed to address two issues: reducing the order ofthe model, and approximating the vector field. In this paperwe focus exclusively on the second issue, and present resultscharacterizing the repercussions at the system level of vector fieldapproximations. The error assessment problem is formulatedas the L2 gain upper bounding problem of a scaled feedbackinterconnection. Applying the small gain theorem in the proposedsetup, we prove that the L2 gain of the error system is upperbounded by the L2 gain of the vector field approximationerror, provided it is small. In addition, the paper also presentsa numerical procedure, based on the IQC/LMI approach, toperform the error estimation task with less conservatism. Anumerical example is given in this paper to demonstrate thepractical implications of the presented results.


Promising to inject empirical rigor into the enterprise of statutory interpretation, corpus linguistics has, over the past couple years, taken the legal academy by storm. However, little attention has been paid to an important premise implicit in the operationalization of ordinary meaning through corpus linguistics: Where an ambiguous term retains two plausible meanings, the ordinary meaning of the term is the more frequently used meaning of the term. Call this the Frequency Hypothesis. This Essay identifies and explores an important reason to doubt the Frequency Hypothesis: A word might be used more frequently in one sense than another for reasons that have little to do with the ordinary meaning of that word. Specifically, a word's frequency will not necessarily reflect the sense of a word or phrase that is most likely implicated in a given linguistic context, but will instead, at least partly, reflect the prevalence or newsworthiness of the underlying phenomenon that the term denotes. Accordingly, the Essay advocates for a more thorough reckoning of the Frequency Hypothesis before judges and scholars embrace corpus linguistics as a tool for statutory interpretation.


An enzyme-linked immunospecific assay "sandwich" technique was developed for detecting soluble antigen from the Legionnaires disease bacterium (Legionella pneumophila). With this technique, antigen was detected in urine specimens from guinea pigs inoculated intraperitoneally with heat-killed Legionnaires disease bacteria and in urine specimens from three of four patients who attended the American Legion Convention in Philadelphia in 1976. Urine from a fifth pneumonia patient who attended the Eucharistic Congress (but who was a dubious seroconverter) was negative. Presumably, the test could also be used for detecting antigen in sputum or respiratory aspirates, but this has not been tried to date.


Most presentation software uses the slide deck metaphor to create visual presentation support. Recently, canvas presentation tools such as Fly or Prezi have begun to use a zoomable free-form canvas to arrange information instead. While their effect on authoring presentations has been evaluated previously, we studied how they impact the audience. In a quantitative study, we compared audience retention and macrostructure understanding of slide deck vs. canvas presentations. We found both approaches to be equally capable of communicating information to the audience. Canvas presentations, however, were rated by participants to better aid them in staying oriented during a talk. This makes canvas presentation tools a promising slideware alternative.


ISSN: 2319-7706 Volume 8 Number 11 (2019) Journal homepage: http://www.ijcmas.com Zinc inadequacy, both in human and plants, have now become a serious issue among the nutritionists, medicinal researchers and agronomists for quite a long time. It is evaluated that 33% of the total populace is zinc inadequate, bringing about various wellbeing complexities incorporating disabilities in insusceptible framework and mental capacities. Zinc is essential for the proper functioning of a large number of proteins and over 100 specific enzymes in the human body. Zinc deficiency in early life can impair physical and neural growth and development, brain function, memory and learning ability. Severe zinc deficiency is characterized by stunting, lack of normal sexual development, poor immune response, skin disorders, and anorexia. The recommended daily allowance of zinc is 12 mg for adult women and 15 mg for adult men. More than 66% of the rice become worldwide is delivered on overwhelmed paddy soils, which for the most part contain low sums of plantavailable zinc. The soil factors viz., pH, organic matter content, clay content, calcium carbonate content affecting the availability of zinc to plants. Total zinc content, redox conditions, microbial activity in the rhizosphere, soil moisture status, concentrations of other trace elements, concentrations of macro-nutrients, especially phosphorus and climate are also influenced its availability. Zinc can be additionally applied into soils after stronghold of ordinarily applied NPK composts. One-percent zinc-containing NPK and urea manures are accessible in numerous nations. Sufficient and adjusted supplement data sources are basic to delivering and keeping up ideal returns that outcome in most extreme benefit. Zinc fertilizers are broadcast and sprayed onto topsoil, banded in the seedbed, applied as seedlings are dipped into Zn before transplanting. Zinc sulphate is the commonly used fertilizer compound (ZnSO4. 7H2O containing 26% Zn, or ZnSO4-H2O containing 37% Zn). The historical backdrop of zinc in agribusiness is an exceptional showing of the interpretation of research to viable application. In any case, zinc lack in agronomically significant plants creatures still stays an issue around the world, particularly in zones with less created farming practices. K e y w o r d s


The relationship between the distribution of hydrogen and the electrical properties of (Ba, Sr)TiO3 (BST) thin film capacitors was investigated using secondary ion mass spectroscopy (SIMS) analyses. It has been clearly shown that there is a close relationship between the hydrogen distribution in BST thin film and the frequency dependence of the complex impedance of the BST thin film capacitors. It was confirmed that protons, the interstitial hydrogen impurity dissolved in BST thin films annealed at 400oC, were produced by a thermal equilibrium reaction between the hydrogen in the annealing atmosphere and the BST thin films.


In the electroplating and water treatment fields, as the demand and expectation on an electrode with high productivity and high efficiency are getting increased, various electrodes(DSE) with higher reactivity and durability are being developed. This study is intended to analyze the characteristics of the produced electrodes and to establish the optimum manufacturing conditions for electrode being used that we mentioned. For improving the durability, the changes of reactivity and corrosion resistance are observed as adding Tantalum and/or another components (hereafter stated as "α") and surface treatment of substrate(Ti). As a result, increasing the amount of Iridium, the reactivity of electrode increased, and increasing amount of Tantalum, the durability of electrode increased. And thus, it is found out that Iridium and Tantalum have the opposite role each on the electrode's reactivity and durability. And adding α and surface treatment substrate, an electrode with excellent reactivity and durability and low oxygen evolution can be manufactured. In the water treatment field like sterilizing in a swimming pool and power-plant cooling water, the high efficiency of sodium-hypochlorite generation is surely guaranteed.


Background and Objective: Glucosamine is a safe and common treatment for osteoarthritis. Even so, literature data on the cardiovascular safety of glucosamine are limited. The objective of this paper is to investigate the long-term effects of crystalline glucosamine sulfate (CGS) on key measures of cardiovascular risk in patients with osteoarthritis. Methods: We analyzed safety data from two long-term (6-month and 3-year, respectively) randomized controlled trials of CGS. Mean changes in blood pressure, lipids, and glucose were calculated for all patients randomized to CGS or placebo in either study and for subgroups with abnormally elevated baseline values. Shift tables were used to analyze transitions from normal to abnormal levels, or vice versa. Results: This analysis on 428 osteoarthritis patients includes data from subjects who had, on average, high normal blood pressure or high cholesterol at baseline. There were no significant changes in mean blood pressure after 6 months on CGS (systolic: -5±15 mmHg; diastolic: -5±10 mmHg) or placebo (systolic: -7±14 mmHg; diastolic: -4±10 mmHg). Subgroup analysis did not show significant effects in subjects with hypertension. Likewise, blood lipids (total/LDL cholesterol) and blood glucose did not change over 3 years and 6 months of treatment, respectively, even in hypercholesterolemic or hyperglycemic subjects. The proportions of patients whose blood pressure or cholesterol levels shifted from normal to abnormal, or vice versa, were comparable in the CGS and placebo groups. Conclusions: Long-term use of CGS did not affect blood pressure, lipids, or glucose in patients with osteoarthritis. These findings further support the cardiovascular safety of CGS.


This study aims to determine the temporal distribution and composition of suspended particulate matter in different sizes PM2.5–10 (Coarse Particle, CP) and PM2.5 (Fine Particle, FP) for source apportionment analysis. CP and FP samples were collected using the Gent PM10 stacked filter unit (SFU) sampler at an urban coastal city of Kuala Terengganu, in Malaysia, from August 2006 to December 2007. Samples were analyzed for elemental concentrations using Inductive Coupled PlasmaMass Spectrometry (ICP-MS) and Inductive Coupled Plasma-Optical Emission Spectrometry (ICP-OES). Water-soluble ionic species were determined using Ion Chromatography. The results show that the concentration range of the CP and FP fractions varied from 1.17 to 28.45 μg/m 3 and from 3.82 to 35.58 µg/m 3 with mean concentrations (n = 80) of 10.41 ± 5.40 µg/m 3 and 14.31 ± 6.53 µg/m 3 , respectively. On average, the measured chemical species accounted ca. 54% of the coarse particles and 32% of the fine ones. Na + , SO4 2– , Cl – , NO3 – , Al, Ca, Fe, K and Na were mainly in the coarse particle size range and accounted for ca. 52% of the coarse particle mass, while SO4 2– , NH4 + , K + , Al, Ca, K and Na were mainly in fine particle size range and accounted for ca. 28% of the fine particle mass. The data sets were then analyzed using Principle Component Analysis (PCA) to identify the possible sources of these fine and coarse particles based on their chemical species. For both fractions, the sources were soil dust, marine aerosol, vehicle exhaust, secondary aerosol, road dust and biomass burning. In addition, crustal enrichment factors (cEF) were calculated, and the results were consistent with those of the PCA analysis.


This guidance note provides advice on the principles, risks,
materials and methods for insulating pitched roofs at ceiling level. When insulation is placed at this position the roof is often referred to as a 'cold roof'.
Insulating the top floor ceiling is one of the easiest and
cheapest means of improving the energy efficiency of
buildings. Such work can be carried out successfully in older buildings if approached with care. Even very thick layers of insulation will not cause problems if installed carefully with materials that are compatible with the existing construction. However, the installation can be made much more difficult if part of the ceiling is sloping, for instance if the room is partly within a roof space.


In this paper, we demonstrate highly sensitive refractive index (RI) sensing based on multicore coupled structures. Specifically, we use a seven-core fiber (SCF) as the sensing element. The interaction of the SCF and its surroundings is induced by controllably etching material from the cladding in order to expose its external cores. Thus, the sensor sensitivity can be tuned by simply controlling the etching depth. In our case, the cladding of a 10-mm-long piece of SCF, spliced between two single-mode fibers, was slowly removed until the remaining cladding around the external cores is only 2.5 μm. Sensitivity on the order of 1 × 104 nm/RIU is experimentally demonstrated. These sensing architectures are compact, all-fiber, simple to fabricate, and highly sensitive. Based on our results RI changes of 10–4–10–5 can be resolved with standard laboratory-graded equipment, which opens the possibility of using this type of sensing architectures in biological applications.


BACKGROUND
Benign Epilepsy with Centro Temporal Spikes (BECTS) is a common epilepsy syndrome with onset in childhood which almost always remits by adolescence. It is characterised by focal seizures associated with motor signs and somatosensory symptoms, at times progressing to become generalised. The characteristic interictal EEG shows normal background activity with centrotemporal spikes which are more prominent in sleep. The prognosis is good though subtle cognitive impairment has been implicated. Antiepileptic drug (AED) treatment is used if seizures are frequent or occurring in the daytime.

OBJECTIVES
To evaluate whether or not treatment with AEDs changes the short- or long-term outcome of children with BECTS or both.

SEARCH METHODS
We searched the following databases: the Cochrane Epilepsy Group Specialized Register (30 April 2013), the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2013, Issue 4: (April 2013)), MEDLINE (Ovid, 1946 to 30 April 2013), SCOPUS (30 April 2013), ClinicalTrials.gov (30 April 2013) and the WHO International Clinical Trials Registry Platform ICTRP (30 April 2013). We also handsearched the reference lists of articles that were considered for inclusion in the review.

SELECTION CRITERIA
All randomised controlled trials (RCTs) that compared the use of different AEDs, or compared the use of AEDs with no treatment, or placebo in children with BECTS.

DATA COLLECTION AND ANALYSIS
Data were independently extracted by all four of the review authors and discrepancies were resolved by discussion. Analysis included assessment of risk of bias, quality of evidence of individual studies, heterogeneity, and statistical analysis of the effects on seizure remission and cognition.

MAIN RESULTS
There were six eligible studies but only four had sufficient data at the time of this review. The four RCTs included in this review reported on a total of 262 participants. One study, a placebo-controlled trial with a low risk of bias, found that individuals on sulthiame were significantly more likely to remain in seizure remission during the three and six months from commencement of treatment than those on placebo (3 months: RR 2.26, 95% CI 1.48 to 3.44; 6 months: RR 2.63, 95% CI 1.43 to 4.86, 66 participants, moderate quality evidence). The other three trials, all open-labelled studies, had a high risk of bias and did not show any significant differences in terms of seizure remission between AEDs. One compared levetiracetam with oxcarbazepine (3 months: RR 1.13, 95% CI of 0.93 - 1.36; 12 months: RR of 1.29 with 95% CI of 0.89 - 1.86, 39 participants, low to very low quality evidence), one clobazam with carbamazepine (4-40 weeks: RR of 1.04, 95% CI of 0.67 - 1.62; last 9 months: RR of 1.06 with 95% CI of 0.84, 1.34, 45 participants, low quality evidence), and one carbamazepine with topiramate (28 weeks: RR 1.02 with 95% CI of 0.8 - 1.3, 112 participants, low quality evidence).Other outcome measures assessed included time to first seizure after randomisation which was only obtained in the sulthiame versus placebo study as a hazard ratio of 7.8 (95% CI 2.66 - 22.87). There were no significant differences between the proportion of participants who had adverse events, apart from a higher incidence of rash in the carbamazepine group (14.8%) when compared with topiramate (1.7%), or the proportion who withdrew from treatment due to adverse events, when this was reported. Two trials (carbamazepine versus topiramate, and clobazam versus carbamazepine) evaluated the effects on cognition. The studies were of low to very low quality evidence showing no clear difference in cognition at the end of the study periods between the AEDs compared. A meta-analysis was not performed as the RCTs evaluated different therapies.

AUTHORS' CONCLUSIONS
There is evidence from one trial reviewed that sulthiame is effective for seizure remission in the short term in children with BECTS although the precision of the effect estimate is uncertain due to its small sample size. There were no significant differences in the proportion of adverse events between treatment groups studied, including those resulting in withdrawal of treatment. There is insufficient evidence about the medium to longer term effects on seizure control, the optimum antiepileptic drug treatment and the effects of AED treatment on cognition. There is a need for more good quality randomised controlled trials to address these questions to aid the management of children with BECTS.


BACKGROUND
Antioxidants such as α-tocopherol (vitamin E) and β-carotene (vitamin A) play an important role in protective effect of repeated brief periods of ischemia, namely ischemic preconditioning (IPC). Values of these antioxidants were investigated and compared after induction of ischemia reperfusion (IR) and kidney IPC in both male and female rats.

METHODS
Forty eight Wistar rats were divided randomly into six groups of 8: groups A and B (male and female controls, respectively), group C (male IR or IR cases), group D (female IR cases) and groups E and F (male and female IPC cases, respectively). In groups C and D, ischemia was induced by clamping of left renal arteries for 45 min. In groups E and F, rats underwent four cycles of 4 min of arterial clamping and 11 min of de-clamping before final 45 min ischemia induction. Afterward, serum was collected to assess the blood urea nitrogen, creatinine and vitamins E and A values. Renal tissues were obtained for histological assessments.

RESULTS
α-tocopherol levels in male and female rats showed a significant increase in IPC compared with IR group (P<0.01) and also in female IPC compared with male IPC group. β-carotene levels had no significant variations. Histological evaluation showed that IR-induced renal injuries were less in female rats. Also, protective effects of IPC were more in female rats (P<0.01).

CONCLUSIONS
Renal IPC reduced damages in both male and female rats, but tissue injuries in females were decreased much more along with the increase of endogenous vitamin E.


In wireless communications (with particular regard to digital mobile radio), spatial (via antenna arrays) and temporal (excess bandwidth) diversity may be exploited to simultaneously equalize a user of interest while canceling or reducing (cochannel) interfering users. This can be done using the interference canceling matched filter (ICMF) which we introduced previously. The ICMF depends on the channel for the user of interest, to be estimated with a training sequence, and a blind interference cancellation part. The critical part is the channel estimation. The usual least-squares method may lead to poor estimates in high interference environments. Significant improvements may result from the maximum-likelihood (ML) and suboptimal techniques investigated here.


Organizations increasingly initiate Internet-based innovation-contest communities through which individuals can interact and contribute to the innovation process. To successfully manage these communities, organizations need to understand what roles members assume, how they communicate and vary in their contribution behavior. In this exploratory study, we investigate the heterogeneous roles of contest participants based on an international innovation-contest community. We identify six user types associated with various behavioral contribution patterns by using cluster and social network analysis. The six user types further differ in their communicative content and contribution quality. Our paper contributes to a better theoretical understanding of distinctive user types in innovation-contest communities, their role in the community, and their contribution to the success of innovation contests in the era of social software. From a managerial perspective, the study provides guidance for contest platform design and appropriate reward structures.


Often, pregnant women don't realise the effects of alcohol use on the fetus. If the future mother drinks alcohol in the nine months of pregnancy, consequences on the fetal development can be extremely bad, leading to alcoholic fetal syndrome. Nowadays, as there doesn't exist a method to determine the safe quantity of alcohol comsumption, doctors recommend that women should not drink any alcohol during pregnancy.


Background: Low birth weight neonates are confronted with some problems after birth, they should be followed up and evaluated at different ages of life. The aim of this study was to determine the impact of birth weight on the risk of sensorineural hearing impairment on children. Method: This cross sectional and retrospective study determined the prevalence of hearing problems in low birth weight and normal birth weight school age children. The sample was consisted of 2400 children who referred to special educational organization for hearing screening before entrance to school in Mashhad - Iran between June 2005 and June 2006. Hearing problems were checked in all groups. Case definition was based on the mean sensorineural hearing loss of more than 35 decibel (dB) hearing level (HL) and in the better-hearing ear averaged over the pure-tone hearing thresholds at 500, 1000, 2000 and 4000 Htz. The results were then compared the low birth weight and normal birth weight children. Result: This study showed that prevalence of hearing problems was 1.4%. The prevalence of hearing impairment in low birth weight (LBW) was 2.1% and 1.3% in normal birth weight (NBW). There wasn't significant difference in hearing impairment between two groups (p=0.255). Conclussion:In this study there was no significant difference between low birth weight and normal birth weight children in hearing impairment although other studies indicated that the risks of hearing impairment increase with the LBW and low gestational age neonates. More investigation is needed for detecting the subtle hearing problems in children.


We report on the electronic structure of
α
-Sn films in the very low thickness regime grown on InSb(111)A. High-resolution low photon energy angle-resolved photoemission spectroscopy allows for the direct observation of the linearly dispersing two-dimensional (2D) topological surface state (TSS) that exists between the second valence band and the conduction band. The Dirac point of this TSS was found to be 200 meV below the Fermi level in 10-nm-thick films, which enables the observation of the hybridization gap opening at the Dirac point of the TSS for thinner films. The crossover to a quasi-2D electronic structure is accompanied by a full gap opening at the Brillouin-zone center, in agreement with our density functional theory calculations. We further identify the thickness regime of
α
-Sn films where the hybridization gap in the TSS coexists with the topologically nontrivial electronic structure and one can expect the presence of a one-dimensional helical edge state.


Salt ridges and domes underlie much of the present Louisiana slope. The bathymetric expression of underlying salt could be either a mound or a flattening of the normal rate of descent down the slope. The "mounded" salt features form barriers to the gravity-driven sediments from the shelf break. Much industrial research has been done in the search for reservoir sands about such an obstruction. Clues to depositional patterns about salt features may be obtained from studies in the deep ocean about seamounts located in pathways of ocean-bottom-following currents. Parallel-bedded sediments form foredrifts on the upcurrent side of a seamount. These foredrift sediments were deposited where the prevailing ocean bottom currents were locally decelerated by the obstructing seamount. In waters overlying the obstruction, a Taylor column of dead water or a slow cyclonic eddy provides tranquil oceanographic conditions, permitting a greater fallout of sediments. Moats are found on the sides of the obstruction and are the result of erosion or non-deposition owing to acceleration of deflected waters. Leedrifts are found on the downcurrent side of the obstruction. Current gyres result from deceleration of accelerated currents along the obstruction's flanks, and a complex sedimentation pattern results. Flow over the obstruction's top is determined by size and shape of the obstruction relative to size and velocity of the bottom-following current. A turbulent wave will be set up which may have sufficient amplitude to influence sedimentation on the downcurrent side. There are a preciable differences between the sedimentation patterns about a dome and a ridge. If ocean bottoms currents equal gravity-driven terrigenous sediment movement and seamounts equal salt domes and ridges, then the result of deep ocean surveys are directly applicable to sedimentation on slopes with underlying salt basement. The salt-related sedimentation pattern of the present slope should be applicable to similar paleoenvironments. End_of_Article - Last_Page 1215------------


In the vast realm of 19th-century Italian music dealing with Cervantine themes, Saverio Mercadante's Don Chisciotte alle nozze di Gamaccio (1830), perused recently by Adela Presas, stands out. The sole purpose of my annotations pertaining to Ferrero's libretto is to stress even more its relationship to Cervantes' novel. From the point of view of reception aesthetics, similar works of arts help the reader verify the temporal vitality of a text and, possibly, new ways of reading. The results of this analysis present Don Quixote in a serious fashion, in contrast to 18th-century attitudes, wherein a ridiculous and extravagant tradition of this character prevailed. Likewise, this study stresses the changes that Sancho Panza undergoes as a dramatic character. In his libretto , Ferrero reveals a keen knowledge of the two parts of Cervantes' Don Quixote since he mentions the novel's most quoted passages and oftentimes remains faithful to the letter of the text.


We introduce a new computer code, Octo-tiger/HPX. Octo-tiger/HPX simulates classically self-gravitating hydrodynamic fluids on an adaptive mesh refinement (AMR) grid. It is particularly suited for modeling interacting binary star systems. To that end, Octo-tiger/HPX uses special techniques to ensure the conservation of linear momentum, angular momentum, and energy to machine precision. Octo-tiger/HPX makes use of the new distributed C++ runtime system, High Performance Para$\|$eX, to enable execution on massively parallel computers.


Quantifying the width of the tropics has important implications for understanding climate variability and the atmospheric response to anthropogenic forcing. Considerable effort has been placed on quantifying the width of the tropics at tropospheric levels, but substantially less effort has been placed on quantifying the width at stratospheric levels. Here we probe tropical width in the stratosphere using chemical tracers, which are accessible by direct measurement. Two new tracer‐based width metrics are developed, denoted here as the "1σ method" and the gradient weighted latitude (GWL) method. We evaluate widths from three tracers, CH4, N2O, and SF6. We demonstrate that unlike previously proposed stratospheric width methods using tracers, these metrics perform consistently throughout the depth of the stratosphere, at all times of year and on coarse temporal data. The GWL tracer‐based widths correlate well with the turnaround latitude and the critical level, where wave dissipation occurs, in the upper and midstratosphere during certain months of the year. In the lower stratosphere, the deseasonalized tracer‐based widths near the tropical tropopause correlate with the deseasonalized tropopause‐height based metrics. We also find that tracer‐tracer width correlations are strongest at pressure levels where their chemical lifetimes are similar. These metrics represent another useful way to estimate stratospheric tropical width and explore any changes under anthropogenic forcing.


A PCR assay that allows identification of clinically relevant viridans group streptococci (Streptococcus gordonii, S. mitis, S. mutans, S. oralis, S. salivarius, and S. sanguis) to the species level and identification of milleri group streptococci (S. anginosus, S. constellatus, and S. intermedius) to the group level was developed. This assay was based on specific amplification of internal fragments of genes encoding D-alanine:D-alanine ligases which are species specific and ubiquitous in prokaryotes possessing peptidoglycan. The specificity of this assay was tested on 9 reference strains and 91 characterized clinical isolates. This assay offers a specific and rapid alternative to phenotypic or DNA-DNA hybridization methods for identification of clinically relevant viridans group streptococci.


The objective of the research is aimed to find out the implementation of Collaborative strategic Reading (CSR) can improves students' reading comprehension. This study came from the problem at the first grade electricity students of SMK PGRI 1 Lamongan. CSR strategies are: (1) preview the text (before reading), (2) click and clunk (during reading), (3) get the gist (during reading), and (4) wrap up (after reading). Design of this study was Classroom Action Research (CAR). The research is carried out within two cycles, cycle 1 and cycle 2. The procedures of the study were begun by conducting Preliminary Action and Realizing the Action consists of: (a) planning, (b) implementing of action, (c) observing, and (d) reflecting. The data collection techniques applied in this study such as test, observation, field notes and interview guide. The result shows that, there were improvements in every cycle. In the first cycle, some students' score had not reached the criteria of success. So researcher needed to continue the next cycle and revise the lesson plan. The result of cycle two was increased. The students' participation was in "Very Good" criterion. Then, the students' score showed that almost all the students had reached the criteria of success. Based on the result of second cycle the researcher stopped the cycle because all of the criteria of success had achieved. So, it can be concluded that Collaborative Strategic Reading (CSR) can improve students' reading comprehension at the first grade electricity students of SMK PGRI 1 Lamongan.


BACKGROUND/AIMS
To evaluate the effectiveness of tenofovir in patients with chronic hepatitis B infection in a real life setting.

MATERIALS AND METHODS
We performed a retrospective analysis of data from 164 patients with chronic hepatitis B who were treated with Tenofovir. Eighty-six patients (52.4%) were naïve. Seventy-seven (46.9%) patients were previously treated with anti-viral drugs, including standard interferon (n=4), pegylated (PEG) interferon (n=14), standard interferon together with lamivudine (n=13), lamivudine alone (n=41), adefovir (n=2), lamivudine together with adefovir (n=1), and entecavir (n=2). Six patients (3.7%) had liver cirrhosis before treatment of tenofovir.

RESULTS
The patients who have hepatitis B viral DNA>104 copy/mL with chronic hepatitis B infection were included in the treatment of Tenofovir. Average follow up time was 30.31±14.33 months. HBV DNA negativity and alanine aminotransferase (ALT) normalization were 86.5% and 71.3%, respectively, at the last visit. Hepatitis B e-Antigen (HBeAg) seroconversion occurred in 11 (19.6%) out of 164 patients. During the follow-up period, 4 (2.4%) patients developed liver cirrhosis and in 5 (3%) patients hepatocellular carcinoma (HCC) occurred out of 164 patients. HBsAg seroconversion occurred in one patient (0.6%).

CONCLUSION
Tenofovir can be used safely and successfully in those patients that were naive, experienced with immune modulators and/or antivirals, HBeAg-positive, and HBeAg-negative patients.


This collection of essays is a compilation of the thought and work of W. Norris Clarke, S.J., a philosopher inspired by the Thomistic tradition, who in 45 years of teaching and writing has delved into many of the central problems of perennial philosophy and made a significant contribution to the ongoing history of American Thomism. The essays presented here reflect an internal unity each essay deliberately building on the positions put forth in the preceding ones as they progress systematically through the themes of metaphysics and philosophy of God. Clarke begins with an overall survey of what in Aquinas's metaphysics is most relevant for today, and then suggests the most fruitful starting point for a contemporary presentation of such a metaphysics. The next five essays discuss key positions in metaphysics and are followed by two essays on the philosophy of God. The final essay illuminates key themes in Clarke's most recent work on the human person. Clarke's examination of topics in all these areas is especially concerned with the notions of action and participation in existence as being central to the metaphysical study of reality. This then leads to a close study of the often misunderstood Thomistic doctrine of analogy and how it functions in the construction of a viable philosophy of God. The overall spirit that permeates the volume is Clarke's firm conviction that the philosophical thought of St. Thomas Aquinas is an inexhaustibly rich and profound resource, and his purpose is to share this conviction with contemporary philosophers. In so doing Clarke both reflects and triggers significant new directions in contemporary Thomistic thought. "


Industrial control systems are complex, software-intensive systems that manage mission-critical production processes. Commissioning such systems requires installing, configuring, and integrating thousands of sensors, actuators, and controllers and is still a largely manual and costly process. Therefore, practitioners and researchers have been working on "plug and produce" approaches that automate commissioning for more than 15 years, but have often focused on network discovery and proprietary technologies. We introduce the vendor-neutral OpenPnP reference architecture, which can largely automate the configuration and integration tasks for commissioning. Using an example implementation, we demonstrate that OpenPnP can reduce the configuration and integration effort up to 90 percent and scales up to tens of thousands of communicated signals per second for large Industrial Internet-of-Things (IIoT) systems. OpenPnP can serve as a template for practitioners implementing IIoT applications throughout the automation industry and streamline commissioning processes in many thousands of control system installations.


Mobile node localization is important to offer wireless services in vehicular communication applications. Some typical methods realize the mobile node tracking through data fusion from time of arrival (TOA) and received signal strength (RSS) measurements provided by sensor nodes or base stations (BSs). Although the TOA/RSS method is not expensive under a concern of cost, it is very sensitive to multipath signal propagation effects. As the technology of angle of arrival (AOA) antennas is showing a rapid progress, we turn to consider AOA estimation. In this paper, the nonlinear extended Kalman filter (EKF) and the particle filter (PF) along with a three-model interacting multiple model (IMM) algorithm are utilized and compared for maneuvering mobile station (MS) tracking with bearing-only measurements. A coordinated turn model is used to improve the tracking performance since the MS frequently turns in the streets. We also propose an efficient method for resampling particles to alleviate the degeneracy effect of particle propagation in the interacting multiple model particle filter (IMMPF) algorithm. Moreover, a BS sensor selection scheme is also exploited for the long-haul MS tracking case which often changes BSs in a wireless vehicular sensor network. Numerical simulations show that the three-model IMMPF algorithm outperforms the interacting multiple model extended Kalman filter algorithm and achieves a root-mean-square tracking performance which is quite close to the posterior Cramer-Rao lower bound.


Using an integrated archival and ethnographic approach, this study investigates how the growing Haredi Jewish minority and the UK government negotiate their positions in the context of healthcare services in Manchester as one of the few sites where they directly engage. Low-level uptake of certain maternal and infant health interventions has led to claims that Haredi Jews are 'hard to reach' or a 'non-compliant community.' This thesis critically engages the above outlook by exploring how responses to healthcare services should be framed.
Rather than evading the NHS altogether, as the 'hard to reach' label implies, Haredi Jews in Manchester selectively negotiate healthcare services in order to avoid a cosmological conflict with the halachic custodianship of Jewish bodies. Maternal and infant care is situated as a particularly sensitive area of minority-state relations in which competing constructions of bodily protection are at play. Whilst maternal and infant care has historically formed part of the state's strategy to govern the population, it is increasingly being seized as a point of intervention by Haredi rabbis, doulas, and parents when attempting to reproduce the Haredi social body.
Following Roberto Esposito's (2015 [2002]) theoretical elaboration of 'immunitas' the present work depicts the margins as giving rise to antonymic conceptions of 'immunity' as a means of protecting collective life. Interventions that the state regard as protecting the health of the nation can, in turn, be viewed as a threat to the life of the Jewish social body. Immunity at the margins can be characterised by an antonymic fault of both the Haredim and the state to understand each other's expectations of health and bodily care. The margins of the state illustrate how responses to healthcare interventions can be entangled within a struggle of integration, insulation, and assimilation for minority groups in ways that are contiguous over time.


Blast exposure is common in military personnel during training and combat operations, yet biological mechanisms related to cell survival and function that coordinate recovery remain poorly understood. This study explored how moderate blast exposure influences gene expression; specifically, gene-network changes following moderate blast exposure. On day 1 (baseline) of a 10-day military training program, blood samples were drawn, and health and demographic information collected. Helmets equipped with bilateral sensors worn throughout training measured overpressure in pounds per square inch (psi). On day 7, some participants experienced moderate blast exposure (peak pressure ≥5 psi). On day 10, 3 days post-exposure, blood was collected and compared to baseline with RNA-sequencing to establish gene expression changes. Based on dysregulation data from RNA-sequencing, followed by top gene networks identified with Ingenuity Pathway Analysis, a subset of genes was validated (NanoString). Five gene networks were dysregulated; specifically, two highly significant networks: (1) Cell Death and Survival (score: 42), including 70 genes, with 50 downregulated and (2) Cell Structure, Function, and Metabolism (score: 41), including 69 genes, with 41 downregulated. Genes related to ubiquitination, including neuronal development and repair: UPF1, RNA Helicase and ATPase (UPF1) was upregulated while UPF3 Regulator of Nonsense Transcripts Homolog B (UPF3B) was downregulated. Genes related to inflammation were upregulated, including AKT serine/threonine kinase 1 (AKT1), a gene coordinating cellular recovery following TBIs. Moderate blast exposure induced significant gene expression changes including gene networks involved in (1) cell death and survival and (2) cellular development and function. The present findings may have implications for understanding blast exposure pathology and subsequent recovery efforts.


Psoriasis, a common chronic immune-mediated skin disease, is histologically characterized by a rapid keratinocyte turnover and differentiation defects. Key insights favor the idea that T cells are not the only key actors involved in the inflammatory process. Innate immune cells, and more precisely neutrophils and macrophages, provide specific signals involved in the initiation and the maintenance of the pathogenesis. Current data from animal models and, to a lesser extent, three-dimensional in vitro models have confirmed the interest in leaning towards other immune cell types as a potential new cellular target for the treatment of the disease. Although these models do not mimic the complex phenotype, nor all human features of psoriasis, their development is necessary and essential to better understand reciprocal interactions between skin cells and innate immune cells and to emphasize the crucial importance of the local lesional microenvironment. In this review, through the use of in vivo and 3D organotypic models, we aim to shed light on the crosstalk between epithelial and immune components and to discuss the role of secreted inflammatory molecules in the development of this chronic skin disease.


Abstract Background: Perioperative management of a patient with factor V Leiden has been infrequently reported with most studies focused in the orthopedic literature. Case Presentation: We report a case of a 74-year-old woman who underwent a pylorus-preserving pancreaticoduodenectomy without immediate perioperative embolic or thrombotic phenomena and her management throughout her hospital course. Conclusion: To the best of our knowledge, this is the first known report regarding factor V Leiden and surgical management of pancreatic ductal adenocarcinoma.


The new species Agglutinella kaminskii n. sp. (Miliolida: Siphonapertinae) is described from nearshore marine localities in eastern Bahrain. The species is characterized by its simple tooth and tendency for selectively incorporating colorful siliciclastic mineral grains of eolian origin into its test wall. The new species appears to be endemic to the Arabian Gulf.


The processes leading to the natural attenuation of hexavalent chromium (Cr(VI)) in marine systems are not well understood. To determine the rate at which Cr(VI) could be reduced and the effect of Cr(VI) on bacterial communities in marine sediments, we performed mesocosm experiments with 37.85 L aquaria containing San Diego Bay sandy sediments and seawater. Constant levels of 0, 0.25 (low), and 1.5 mM (high) Cr(VI) were maintained in the water column for 2 months. Chemical analyses of sediment cores taken from the mesocosms indicated that Cr accumulated in the upper 5 mm of the sandy sediments. In general, the distribution of total Cr did not correlate with Fe, Mn, or total organic carbon. Enrichment cultures of metal (iron and chromium)- and sulfate-reducing bacteria from the upper horizon (0-5 mm) of sediments were performed to look for the potential contributors in the detoxification/removal process. PCR of 16S rRNA genes and denaturing gradient gel electrophoresis (DGGE) was used to examine the microbial community structure in sediment depth profiles. When Cr(VI) was present, the number of DGGE bands decreased only in the upper 5 mm of sediments indicating an inhibition of certain bacterial populations and/or a selection for Cr-resistant bacteria in this region. Analysis of the DGGE bands was not especially helpful as most sequences were related to unknown, unidentified, or uncharacterized bacterial cloned sequences.


Lymphocyte subpopulations in human small intestinal mucosa have been studied using an immunofluorescence technique on tissue sections. In the normal intestine, the majority of intraepithelial lymphocytes (IEL) were of suppressor-cytotoxic phenotype (HuTLA+ UCHTI+ OKT8+ OKT4-; 84%). Only one-third of these OKT8+IEL reacted with anti-Leu-1, and antibody directed towards a 67,000 dalton antigen found on peripheral blood T cells. IEL failed to express the activation antigen, Tac, and also lacked detectable C3b receptor (C3RTO5-). The remaining T IEL, as well as the predominant lamina propria T lymphocytes (LPL), were OKT4+ OKT8-, helper type T cells. Most of the lamina propria OKT8+ cells were also Leu-1-. In patients with adult coeliac disease, the proportions of OKT8+ and OKT4+ lymphocytes in the epithelium were not altered. However, the proportion of OKT8+ Leu-1+TIEL was significantly increased (56 vs 32%; P less than 0.02). IEL were also HLA-DR-, Tac- and C3RTO5-. The proportion of OKT8+ cells in the lamina propria was slightly, but significantly, increased (40 vs 32%; P less than 0.005). Mucosal findings in treated patients did not differ from normal. Lymphocytes with the phenotype of natural killer cells (HNK-1) were rarely found in normal or diseased mucosa. No alterations in the proportions of circulating T lymphocytes or their subsets were found in patients with coeliac disease. These findings illustrate the heterogeneity of lymphocyte subpopulations in normal and in diseased small intestinal mucosa. The changes found in adult coeliac disease may reflect the increased traffic of IEL into the epithelium.


OBJECTIVE
To assess the upper airway (UAW) total volume (TV), the nasopharyngeal narrowest area (NNA), and the oropharyngeal narrowest area (ONA) in patients with bronchial asthma.

MATERIALS AND METHODS
The sample consisted of 52 patients divided into two groups: the control group (n  =  26; mean age  =  14.85 years), which consisted of patients not suffering from bronchial asthma; and the asthmatic group (n  =  26; mean age  =  16.65 years), which consisted of patients with bronchial asthma. To assess UAW-related variables (TV, NNA, and ONA), cone-beam computed tomography scans of the patients were evaluated by means of the Dolphin Imaging software 11.5. All measurements were repeated after 30 days, and the results were submitted to reliability tests by means of the intraclass correlation coefficient and the Bland-Altman agreement test. The values obtained for TV, NNA, and ONA for each group were compared by using Student's t-test for independent samples (5% level of significance).

RESULTS
The results showed that the groups were matched concerning gender, cephalometric characteristics, and type of malocclusion. The asthmatic group had significantly lower TV (P  =  .01) and ONA (P  =  .007) than the control group. However, no significant difference was observed for NNA between the groups (P  =  .54).

CONCLUSIONS
Bronchial asthma may be a determining factor for the reduction of UAW dimensions, as patients with asthma showed significant reductions in TV and ONA dimensions.


Each entry in the New Grove Guides series of composers and their operas is based on articles in The New Grove Dictionary of Opera, that feature information on the lives of individual composers, their works, their librettists and interpreters, and the places where they performed. These unique books compile the meticulously researched articles into organized narratives, designed to make finding information as easy as possible without sacrificing readability. Each volume is completely up-to-date, and includes a suggested listening guide and an eight-page glossy insert containing relevant illustrations. Each volume is a must-own for lovers of opera and classical music. Giuseppe Verdi is the most famous Italian composer of opera. While he was sometimes criticized for writing music considered too "simple," his works have endured, and are still performed throughout the world today. This concise volume is a handy guide to Verdi's life and operas, revising the original New Grove articles and adding a new introduction, a new section on modern Verdi productions, and an updated bibliography.


A new linear algebraic approach for identification of a nonminimum phase FIR system of known order using only higher order (>2) cumulants of the output process is proposed. It is first shown that a matrix formed from a set of cumulants of arbitrary order can be expressed as a product of structured matrices. The subspaces of this matrix are then used to obtain the parameters of the FIR system using a set of linear equations. Theoretical analysis and numerical simulation studies are presented to characterize the performance of the proposed methods.


Farmers in Nigeria are credit constrained. Thus, access to credit is a sina qua non for achieving the sustainable development goal of sustainable food production and improving the welfare of the farming folks. This study assessed credit utilization among cassava farmers in Ogun state and its influence on farm profit. Emphasis was placed on the Ogun State Agricultural and Multi-purpose Credit Agency (OSAMCA). The multi-stage sampling technique was used to select 400 farmers for the study. Data collected with the use of questionnaire (388 found useful) were analyzed using descriptive statistics, gross margin and the Logit regression analyses. Inferences were drawn at 5% level of significance. Result showed that OSAMCA credit was the predominant source of credit available to respondents however, only 39% have benefited and up to 47% have not benefitted from any source of credit. Generally, most of the farmers confirmed their need of credit especially for recapitalization or expansion. The t-test result for difference in mean average gross margin per hectare (proxy for profitability) for credit and non-credit beneficiaries showed that access to credit positively and significantly impacted agribusiness enterprise. Lack of collateral (compulsory security savings/ down payment) was reported by 74% of the farmers as the limitation for sourcing for credit. Regression result showed that the coefficients of hired labour, membership of cooperatives, awareness of credit sources, past loan size and ability to meet down payment arrangement were positive and significant thus increase in these variables will increase probability of access to credit (OSAMCA). Furthermore, coefficient of distance to the credit source was negative and significant indicating that proximity of farmers to credit source will enhance access. It is recommended that efforts directed towards enhancing the factors that increases farmers' access to credit is pertinent.

JEL Classification: E51, N27, Q18


Accumulation of non-biodegradable plastics leads to increase in land and water pollution. Polyolefins includ- ing polyethylene and polypropylene are the major plastics to be dumped in the environment and due to their recalcitrant nature persist in the environment. The hydrophobicity, high molecular weight, chemical and structural composition of these polymers hinders their biodegradation. In this review current research that have been performed to understand the abiotic mechanism of the degradation process, and various physical, chemical and biochemical approaches that can be adopted to enhance their biodegradation are discussed. Genetic engineering approaches to enhance the performance of the microorganism or computational techniques to simulate the degradation pathways could be the future to speed up the deg- radation of these polymers.


Tirio has always believed that he was cast out of his Amazonian tribe at a young age because of his deformed foot. Since then he has lived contentedly with his adoptive American mother, but as his thirteenth birthday approaches, he feels himself increasingly called back to his tribe, knowing that were he home, he would be embarking on a coming-of-age quest. Awaiting a forthcoming trip to the Amazon, Tirio begins plotting to escape from his mother and fulfill the challenge alone, thus proving to those who shunned him that he is strong, worthy, and part of the tribe. Tirio's narration alternates with that of Luka, another member of Tirio's Takunami tribe, who is readying himself for the same birthday quest. Ultimately, neither Tirio nor Luka completes the journey in the expected way: Luka is required to marry instead after his father suddenly dies, and Tirio is unable to make his way alone through the jungle because he is guided by an insistent voice in his head. In a clever twist, Luka's story, which seems to be concurrent with Tirio's, actually takes place years before, and it is only gradually revealed that the voice in Tirio's head (who announces himself as Tirio's father) is Luka. Unfortunately, the complex reasoning behind Tirio's tribal rejection is muddy, making the entire premise rather unconvincing. In addition, the mixture of authentic Amazonian plants, cultures, and rituals into what is ultimately a fictional tribe of people set in a mostly created jungle-scape suggests generic exoticism and would be less confusing if notes explained the difference between fact and fiction. In spite of the issues, Nelson presents two compelling coming-of-age stories, both of which feature protagonists who are memorable for their flaws as well as the ways in which they compensate for them. AS


In this study, effects of cutting speed (V), feed rate (f), depth of cut (a) and tool tip radius (R) on  surface roughness (Ra, Rz, and Rt) and cutting forces (radial force (Fx), tangential force (Fy), and feed force (Fz)) in hard finish turning processes of hardened 42CrMo4 (52 HRC) material was investigated experimentally. Taguchi's mixed level parameter design (L18) is used for the experimental design (2x1,3x3). The signal-to-noise ratio (S/N) was used in the evaluation of test results.  By using Taguchi method, cutting parameters giving optimum surface roughness and cutting forces were determined. Regression analyses are applied to predict surface roughness and cutting forces. Analysis of variance (ANOVA) is used to determine the effects of the machining parameters on surface roughness and cutting forces. According to ANOVA analysis, the most important cutting parameters were found to be feed rate for surface roughness and depth of cut among cutting forces.  By conducting validation experiments, optimization was seen to be applied successfully.


A novel ATP synthase gene from soybean has been cloned and characterized. A subunit from the FA portion of the complex is encoded by two nuclear genes. The genomic clone(s) contain five exons encoding a protein of 179 amino acids. The amino terminal end contains many properties of a mitochondrial targeting sequence and preliminary in vitro import studies indicate that there is a cleavable precursor of approximately 30 amino acids. The predicted protein sequence shows high homology with the N-terminal sequence from an isolated subunit of ATP synthase complex from spinach (Hamsaur and Glaser (1992) Eur. J. Biochem. 205, 409-416). The subunit was tentatively identified as the equivalent of subunit d in bovine and P18 in yeast based on structural identity.


This paper discusses the common issues in vibration attenuation for large aerospace structures using PZT actuators. In addition, a case study is presented to illustrate the vibration attenuation for a rocket fairing system, where the traditional PPF controller is modified by employing multiple actuators instead of a single one for any particular vibration mode. Simulation results demonstrate the effectiveness of this improved PPF control design approach. Thus a more robust control system is obtained due to the actuator redundancy in the presence of actuator failures. Fault-tolerant control systems are being designed for aerospace applications.


Tuber blight may result from infection of wounded or unwounded potato tubers exposed to sporangia from foliar blight, soil, or blighted tubers. However, there are limited data on the prediction of tuber blight in field or storage environment based on in vitro assays. To assess this relationship, potato cultivars with foliar blight resistance (R-genes) and general resistance were evaluated for tuber blight incited by Phytophthora infestans (US-1) based on wound-induced and unwounded tuber inoculations. Surface lesion diameter, lesion depth, and frequency distribution of blighted tubers were assessed in in vitro assays and tuber blight incidence determined in field experiments. Significant differences (P < 0.05) in lesion diameter and depth were recorded among cultivars. Surface lesion diameter, depth, and index ranged from 5 to 40, 2 to 16.3, and 15 to 656 mm, respectively, in wound-inoculated tubers. In nonwounded tuber assays, the incidence of blighted tubers ranged from 0% to 8.7% in both years. Tuber blight infection of potato cultivars varied between years in field studies. Although tuber infection differed among cultivars, the frequency of blighted tubers had a normal statistical distribution irrespective of R-genes, implying that foliar resistance may have limited effect on tuber blight occurrence based on in vitro experiments. Prediction of tuber blight based on inoculation assays can be effectively used to estimate and manage blight development in storage environments.


We present a diffusion-based model for 3D-aware generative novel view synthesis from as few as a single input image. Our model samples from the distribution of possible renderings consistent with the input and, even in the presence of ambiguity, is capable of rendering diverse and plausible novel views. To achieve this, our method makes use of existing 2D diffusion backbones but, crucially, incorporates geometry priors in the form of a 3D feature volume. This latent feature field captures the distribution over possible scene representations and improves our method's ability to generate view-consistent novel renderings. In addition to generating novel views, our method has the ability to autoregressively synthesize 3D-consistent sequences. We demonstrate state-of-the-art results on synthetic renderings and room-scale scenes; we also show compelling results for challenging, real-world objects.


This paper investigates electrostatically actuated resonator micro-sensor response near natural frequency. The Casimir effect is included. Both the electrostatic force and the Casimir force introduce nonlinearities in the system. Hamilton's principle is used to derive the partial-differential equation of motion for the general case of nonuniform sensors. The method of multiple scales is then used in a direct approach of the problem. Two approximation problems resulting from the direct approach are solved. The phase-amplitude relationship is obtained. Numerical results for uniform capacitive resonator micro-sensors are provided.Copyright © 2009 by ASME


Transmit beamforming is an energy-efficient wireless communication technique that allows a transmitter with two or more antennas to focus its bandpass signal in an intended direction. The idea of transmit beamforming has been extended to networks of single-antenna cooperative transmitters that pool their antenna resources and behave as a ldquodistributed beamformer.rdquo Unlike conventional transmit beamforming, however, the carriers of the single-antenna transmitters in a distributed beamformer are each synthesized from independent and imperfect local oscillators; carrier phase and frequency synchronization among the transmitters is necessary to ensure that a beam is aimed in the desired direction. In this paper, a new time-slotted round-trip carrier synchronization protocol is proposed to enable distributed beamforming in multiuser wireless communication systems. Numerical results for a distributed beamformer with two transmitters show that the parameters of the round-trip synchronization protocol can be selected such that a desired level of phase accuracy and reliability is achieved during beamforming and such that the synchronization overhead is small with respect to the amount of time that reliable beamforming is achieved. The impact of mobility on the performance of the round-trip carrier synchronization protocol is also shown to be small when the synchronization timeslots are short.


With persistent efforts on constructing personal and collective memories arising from the unprecedented transformations in post-socialist China, Jia Zhangke has produced an ensemble of realist films with an impressive personal and authentic appeal. This paper examines how his films are characterised by a variety of accents, images of authenticity, a quotidian ambience, and a new sense of materiality within the local-global nexus. Within a tripartite model of truth, identity, and performance, Jia's oeuvres demonstrate the powerful performativity of different modes of realism arising out of a state of conundrum when China undergoes a transition from planned economy into wholesale marketisation and globalisation.


Since the discovery that neuronal transmission can be chemically mediated, a large number of compounds have been found in the mammalian central nervous system which appear to function as neurotransmitter agents. Recently, electrophysiological and biochemical methods have been developed which have enabled neuroscientists to classify better the myriad of neurotransmitter receptor sites in brain and to study their properties in finer detail. As a result of these investigations, a significant number of new discoveries have been made about the mechanisms involved in neurotransmitter receptor interactions, the role neurotransmitters play in the actions of pharmacological agents and in the pathogenesis of various neuropsychiatric disorders. The present two volume text was compiled to summarize the information relating to the physiological, biochemical, pharmacological and functional characteristics of neurotransmitter receptor sites. While emphasis is placed on neurotransmitter receptors in the mammalian central nervous system, the characteristics of these receptors in other species, both vertebrate and invertebrate, are also discussed where appropriate. While these books cover the major classes of putative neurotransmitters - amino acids, peptides and biogenic amines - and are therefore broad in scope, each is discussed in a concise fashion to highlight the major points of historical and contemporary interest. In addition to outlining data, each chapter addresses current theories relating to the various aspects of receptor properties and function in an attempt to reveal the directions of future research and as a stimulus for other workers in the field.


The clo index, which indicates the amount of clothing required to maintain comfort, is used to evaluate the human thermal climates in China. Daily clo values for 200 stations were computed using daily air temperature, wind speed, and cloud-cover data from 1960 to 1998, and they were reduced and grouped into seasonal values. In winter, the roughly zonal pattern of thermal stress reflects the influence of latitude. In summer, the spatial pattern becomes more meridional. In eastern China, seasonal monsoon and maritime effects are crucial factors determining spatial variations of physioclimates. In western China, altitude and local topography play an important role in shaping the bioclimatic patterns. For the regional patterns of severe thermal stress, during the winter months, the northeast and northwest experience the highest percent of stressful time. In summer, the most oppressive heat stress is located in areas east of the Sichuan Basin and south of Huaihe River.


: Radionuclide scanning is a safe, simple, sensitive technique for demonstrating lesions of the skeletal system. It has proved to be valuable in the early detection and differential diagnoses of lesions involving the maxillofacial region. Abnormal uptake of a bone scanning agent relies on a disturbance of the mineral metabolism of bone. These changes in the pathophysiology of bone are detected earlier on radioisotope bone scans than on radiographs. Bone scanning is a superior technique for diagnosis when compared to radiographic examination. A positive scan is not pathognomonic of any specific disease, but with the clinical, laboratory, and radiographic findings, it can differentiate many lesions and contribute invaluable information concerning a particular lesion or condition so that treatment can be more effectively planned.


Severe anemia was found in a 4-month-old heifer, which was admitted with a 1-day history of anorexia, signs of depression, and recumbency. A diagnosis of immune-mediated hemolytic anemia (IHA) was made on the basis of a Coomb's titer of 1:128 and decreased resistance to osmotic stress, as determined by an RBC fragility test. Anaplasmosis and leptospirosis were ruled out as possible causes of the IHA. Other causes of hemolytic anemia, including intoxication by copper, water, Brassica spp, or drugs were ruled out. Therefore the IHA was considered idiopathic. Treatment consisted of supportive therapy, oxytetracycline, and dexamethasone. After 60 days of treatment, CBC, Coomb's test result, and RBC fragility were within normal limits.


Increased urban and suburban populations in the arid western United States have resulted in more water demand; however, water availability in the region has become limited because of inadequate precipitation. Recent droughts have led to restrictions on irrigating landscape plants. Garden rose (Rosa ×hybrida) is commonly used as flowering plants in residential landscapes, but its drought tolerance has not been widely studied. The objective of this study was to determine the impact of reduced irrigation frequency on visual quality, plant growth, and physiology of five garden rose cultivars, including ChewPatout (Oso Easy® Urban Legend®), Meibenbino (Petite Knock Out®), MEIRIFTDAY (Oso Easy® Double Pink), Overedclimb (Cherry Frost™), and Radbeauty (Sitting Pretty™). Twenty-four plants of each rose cultivar were established in a trial plot at Utah Agricultural Experiment Station Greenville Research Farm (North Logan, UT, USA) in Summer 2021. Plants were randomly assigned to one of three deficit irrigation treatments for which irrigation frequencies were calculated using 80% reference evapotranspiration (ETO) (high), 50% ETO (medium), and 20% ETO (low). The total volumes of irrigation water applied to each plant were 345.6, 172.8, and 43.2 L for the high, medium, and low irrigation frequencies, respectively, during the deficit irrigation trial from 12 May to 30 Sep 2022. Root zones were wetted more frequently as irrigation frequency increased from low to high irrigation frequencies. Decreased irrigation frequency increased the number of visibly wilted and damaged leaves on all rose cultivars. However, only 'Meibenbino' and 'MEIRIFTDAY' exhibited a reduction in overall appearance under decreased irrigation frequency. The relative growth indices of both 'Meibenbino' and 'MEIRIFTDAY' decreased by 6%, whereas the dry weights of their leaves decreased by 37% and 36%, respectively, as irrigation decreased from high to low frequencies. Roses in this study appeared to decrease stomatal conductance up to 51% when irrigation decreased from high to low frequencies, or when air temperature increased. 'Meibenbino' and 'MEIRIFTDAY' exhibited unacceptable overall appearance, growth reduction, and higher leaf–air temperature differences, and they were less tolerant to reduced irrigation. Although the 'Radbeauty' maintained plant growth under the reduced irrigation frequency, the large leaf size led to a more visibly wilted appearance and the potential for heat stress, thus impairing visual quality. 'ChewPatout' and 'Overedclimb' were most tolerant to deficit irrigation at 20% ETO and maintained plant growth with acceptable visual quality and lower leaf temperatures when they received one irrigation during the growing season.


In this paper the ideological relationships between the media and Australian sport are examined from a critical perspective. After outlining the contributions of political economy, structuralism, and cultural studies to the critical paradigm, we argue that the Australian media have two main ideological effects. First, they legitimate masculine hegemony, capitalist rationality, consensus, and militaristic nationalism. Second, they marginalize, trivialize, and fragment alternative ideologies of sport. We conclude by suggesting some worthwhile topics for future research and by affirming that politicizing media representations of sport is an important part of the counter-hegemonic struggle in patriarchal capitalist societies.


Transient or permanent focal brain injury following acute thromboembolic occlusion develops from a complex cascade of pathophysiological events. The processes of excitotoxicity, peri-infarct depolarisation, inflammation, and apoptosis within the ischemic penumbra are proposed. While the translation of therapeutic agents from the animal models to human clinical trials have been disappointing, there remains an atmosphere of optimism as a result of the development of new diagnostic and therapeutic approaches, which include physiological, as opposed to pharmacological, intervention. This article provides an insight into the understanding of cerebral ischemia, together with current and future treatment strategies.


Categorical approach to define elderly by age may fall into ageism, for the boundaries of ageing have changed because of longevity. Medical doctors have a slanted view on ageing because of inevitable degenera- tive biological processes it connotes. However, old age should be understood in developmental perspectives; a proactive and maturing processes with creative poten- tials. Old age is an active developmental process for fuller and more matured conditions despite psychologi- cal losses and obstacles due to physical weakening. The life of an old age can be creative with significant self- transformation and meaning-making process. Everyday can be a challenge for them to change "self" upsetting old rules and beliefs, and to make meanings to new ideas and patterns. They could welcome new experiences in which hidden capabilities are found. This challenge against risks and for openness to new experiences lead life of an old age to be creative. Creativity sets off old people in advantage. Thus they could begin a new life, writing a new story and to become the author of the story.


We report resolved near-infrared spectroscopy and photometry of the recently identified brown dwarf binary WISE J104915.57−531906.1AB, located 2.02 ± 0.15 pc from the Sun. Low-resolution spectral data from Magellan/FIRE and IRTF/SpeX reveal strong H2O and CO absorption features in the spectra of both components, while the secondary also exhibits weak CH4 absorption at 1.6 μm and 2.2 μm. Spectral indices and comparison to low-resolution spectral standards indicate component types of L7.5 and T0.5 ± 1, the former consistent with the optical classification of the primary. Both sources also have unusually red spectral energy distributions for their spectral types, which we attribute to enhanced condensate opacity (thick clouds). Relative photometry reveals a flux reversal between the J and K bands, with the T dwarf component being brighter in the 0.95–1.3 μm region (ΔJ = −0.31 ± 0.05). As with other L/T transition binaries, this reversal likely reflects the depletion of condensate opacity in the T dwarf, with the contrast enhanced by the thick clouds present in the photosphere of the L dwarf primary. The 1 μm flux from the T dwarf most likely emerges from gaps in its cloud layer, as suggested by the significant optical variability detected from this source by Gillon et al. Component mass measurements of the WISE J1049−5319AB system through astrometric and component radial velocity monitoring may resolve the current debate as to whether the loss of photospheric condensate clouds at the L dwarf/T dwarf boundary is a slow or rapid process, a conceivable endeavor given its proximity, brightness, small separation (3.1 ± 0.3 AU), and reasonable orbital period (20–30 yr).


This paper discusses a unified approach to reliability, availability and performability analysis of complex engineering systems. Theoretical basis of this approach is continuous-time discrete state Markov processes with rewards. From reliability modeling point of view complex systems are the systems with static and dynamic redundancy, imperfect fault coverage, various recovery strategies, multilevel operation and varying severity of failure states. We propose a unified method of calculating the reliability, availability and performability indices based on the definition of special forms of reward matrix. This method proved to be effective in calculating both cumulative and instantaneous measures in steady-state and transient cases. We describe special analytical software which implements suggested method. We demonstrate the flexibility of the proposed method and software by analyzing multilevel process unit with protection and demand-based warm standby system.


In A Coincidence of Desires , Tom Boellstorff considers how interdisciplinary collaboration between anthropology and queer studies might enrich both fields. For more than a decade he has visited Indonesia, both as an anthropologist exploring gender and sexuality and as an activist involved in HIV prevention work. Drawing on these experiences, he provides several in-depth case studies, primarily concerning the lives of Indonesian men who term themselves gay (an Indonesian-language word that overlaps with, but does not correspond exactly to, the English word "gay"). These case studies put interdisciplinary research approaches into practice. They are preceded and followed by theoretical meditations on the most productive forms that collaborations between queer studies and anthropology might take. Boellstorff uses theories of time to ask how a model of "coincidence" might open up new possibilities for cooperation between the two disciplines. He also juxtaposes his own work with other scholars' studies of Indonesia, Thailand, the Philippines, Malaysia, and Singapore to compare queer sexualities across Southeast Asia. In doing so, he asks how comparison might be understood as a queer project and how queerness might be understood as comparative.

The case studies contained in A Coincidence of Desires speak to questions about the relation of sexualities to nationalism, religion, and globalization. They include an examination of zines published by gay Indonesians; an analysis of bahasa gay —a slang spoken by gay Indonesians that is increasingly appropriated in Indonesian popular culture; and an exploration of the place of warias (roughly, "male-to-female transvestites") within Indonesian society. Boellstorff also considers the tension between Islam and sexuality in gay Indonesians' lives and a series of incidents in which groups of men, identified with Islamic fundamentalism, violently attacked gatherings of gay men. Collectively, these studies insist on the primacy of empirical investigation to any queer studies project that wishes to speak to the specificities of lived experience.


Control systems for cone and gyratory crushers were first introduced during the early 60ths. The common opinion is that if these systems are able to compensate for the wear of the crushing liners the production yield can be increased with 20-25%. Over the years these types of systems have been widely used but the theory behind the principles have not been thoroughly scientifically scrutinized and presented. Of special interest is the capability to protect the crushers from long term overloading commonly defined as fatigue.


SUMMARY Large, second-order neurones of locust ocelli ('L-neurones') make both excitatory and inhibitory connections amongst each other. A single Lneurone can be presynaptic at both types of connection. At the excitatory connections, transmission can be maintained for long periods without decrement. In contrast, inhibitory postsynaptic potentials (IPSPs) never last for more than 15—35 ms. This paper examines mechanisms which could limit the duration of these IPSPs. 1. An IPSP begins 4-5 ms after a presynaptic neurone starts to depolarize from its resting potential, and the time-to-peak is 7 ms. 2. The amplitude of an IPSP depends both upon the amplitude of the peak presynaptic potential and upon the potential at which a presynaptic neurone is held before it is depolarized. 3. The rate at which a postsynaptic neurone hyperpolarizes to produce an IPSP is proportional to the rate at which the presynaptic neurone depolarizes, independent of the potential from which the presynaptic depolarization starts. A maximum rate of postsynaptic hyperpolarization is reached when the presynaptic neurone depolarizes at lOmVms" 1 . 4. Once an IPSP has occurred, both the amplitudes and the rates of hyperpolarization of subsequent IPSPs are depressed. The connection recovers its full ability to transmit over a period of 1-5 s. Larger IPSPs are followed by initially greater depression than smaller IPSPs. 5. A connection can begin to recover from depression while the presynaptic neurone is held depolarized from resting. 6. Transmission fails when a presynaptic neurone is depolarized by pulses shorter than 2 ms. 7. The most likely reason why the duration of the IPSPs is limited is that calcium channels in the presynaptic terminal inactivate within 7 ms of first opening.


To the Editor.— In the article by Cohen et al 1 on anogenital warts in children, the authors conclude that most of their children were at low risk for sexual abuse. Only eight of 73 children examined by them qualified for "suspected or documented abuse" after their evaluation. The first problem with the article is that the criteria for sexual abuse are not detailed. Instead, subjective criteria are employed. Another major problem with their study is that only half of the fathers were available for examination. Since adult men are the most common instigators of sexual abuse in children, examining only half of the fathers provides insufficient evidence to conclude that parental abuse is absent. The role of caretakers and babysitters in the family is also important in determining sexual abuse. However, we are not told the extent to which this avenue was explored, only that such caretakers were


Lung isolation can be accomplished in two ways: the first, a double-lumen endotracheal tube (DLT) and the second, a bronchial blocker (Univent® or Arndt® blocker). Previous studies have found that the DLT and the Univent® are comparable when providing lung isolation. A new bronchial blocker, the wire-guided endobronchial blocker (Arndt® blocker), has been introduced. However, there is no study to report its effectiveness with lung isolation during elective thoracic surgical cases. Therefore, we designed a prospective, randomized trial to compare the effectiveness of lung isolation among the 3 endotracheal tubes: the left-sided DLT Broncho-Cath® Group A (n = 16 patients), the torque control blocker Univent® Group B (n = 16 patients), and the wire-guided Arndt® blocker Group C (n = 32 patients). The following variables were recorded: 1) time to initially position the assigned tube, 2) frequency of malpositions, 3) frequency of use of fiberoptic bronchoscope, 4) overall surgical exposure, and 5) tube acquisition cost. The Arndt® blocker took longer to place (3:34 min/s) compared with the other 2 groups: the DLT group (2:08 min/s) or the Univent® group (2:38 min/s) (P < 0.0004). There was no statistical difference in tube malpositions among the three groups: two for the DLT group, four for the Univent® group, and nine in the Arndt® group. Excluding the time for tube placement, the Arndt® group also took longer for the lung to collapse (26:02 min/s), compared with the DLT group (17:54 min/s) or Univent® group (19:28 min/s) (P < 0.0060). Furthermore, unlike the other two groups, the majority of the Arndt® patients required suction to achieve lung collapse. Once lung isolation was achieved, overall surgical exposure was rated excellent for the three groups. Acquisition cost for the DLT group was $1663.20 (21 tubes opened), $2329.00 for the Univent® group (17 tubes opened), and $3567.00 for the Arndt® group (33 wire-guided blockers opened). This study demonstrates that the Arndt® blocker takes longer to position and longer to deflate the isolated lung. For elective thoracic surgical cases, once the lung was isolated, the management seemed to be similar for all three tube groups.


Concepts of Culture, Diversity and Cultural Care Among Undergraduate Nursing Students: A Nursing Education Perspective Culture, diversity and cultural care have become important concepts for nurses professionals. However, little is known about how nursing students come to understand these complex concepts. The purpose of this study was to explore what nursing students learn and understand about diversity, culture and cultural encounters from a nursing education perspective. A qualitative approach utilizing the focused ethnography method guided this research study. The study population was first and fourth year undergraduate nursing students enrolled in a Western Canadian university. Findings revealed that the majority of first and fourth year students supported expanded essentialist views of culture. Although students demonstrated increased knowledge of nursing practice, the overall understanding of culture care changed very little between first and fourth year students. This study may be an important step to help nurses improve their understanding of culture, diversity and cultural care. Recommendations are provided for students, educators, program leaders and researchers.