Abstract Background PSMA is overexpressed in PC with limited expression in other organs. PC is radiosensitive with dose-response. Dose-fractionation allows delivery of higher total dose per cycle, may result in less radioresistance due to repopulation compared with doses 6-12 wks apart. Initial Ph I safety results of the dose-escalation portion of this study [ESMO 2018] were without DLT at all dose levels. Methods Entry criteria: progressive mCRPC following at least 1 potent AR-targeted agent (e.g. abi/enza) and taxane (or unfit/refuse chemo) without limit of # prior therapies, adequate organ function, ECOG performance status 0-2. No preselection for PSMA expression. Treatment was a single cycle of fractionated dose 177Lu-PSMA-617 on D1 and D15. In the Ph I dose-escalation cohort, men received 7.4 to 22 GBq. In Ph II, a Simon 2 stage design enrolled pts at the 22.2 GBq dose level. Pre- and post-treatment 68Ga-PSMA11 PET/CT and post-treatment 177Lu-PSMA-617 imaging was performed in addition to standard serial CT and bone scans. Cellsearch CTC count at baseline and 12 wks. Results 44 men (29 in Ph I, 15 in Ph II; total 21 at 22.2 GBq) with median age 69 (range 55-91), median PSA 182.97 (range 0.89-5541) were treated. 93% with bone, 45% nodal, 18% lung, 9% liver, 9% other visceral metastases. 55% with at least 1 prior chemo regimen, 52% >1 prior potent AR therapy, 27% with Ra223, 30% sip-T, 5% 177Lu-J591; 66% Halabi poor risk, 30% intermed risk. With follow up ongoing, 61% with >50% PSA decline (71.4% at 22.2 GBq), median overall survival 16 months (95% CI 11-NR). Of 26 with paired CTC counts, 57.7% decreased, 7.7% stable, 34.6% increased; 34.6% converted from detectable to undetectable at 12 weeks). 61.4% with all grade xerostomia, 29.5% fatigue, 25% thrombocytopenia, 25% anemia, 25% pain, 15.5% nausea. While not required for eligibility, all pts had some PSMA uptake in at least 1 site on PSMA PET, with 2.2% highest lesion SUV 5x liver. Conclusions A single fractionated cycle of up to 22.2 GBq of 177Lu-PSMA-617 is safe, with encouraging early efficacy signals, even without selection for PSMA expression by imaging. A trend for dose-response was observed. Clinical trial identification NCT03042468. Legal entity responsible for the study Well Cornell Medicine. Funding Weill Cornell Medicine, Prostate Cancer Foundation, US Department of Defense, US National Institutes of Health, Endocyte. Disclosure S.T. Tagawa: Advisory / Consultancy, Research grant / Funding (institution): Endocyte. H. Beltran: Advisory / Consultancy: Endocyte. S. Vallabhajosula: Research grant / Funding (institution): Endocyte; Full / Part-time employment: NCM USA. O. Sartor: Research grant / Funding (institution): Endocyte. All other authors have declared no conflicts of interest.


OBJECTIVE
Many Special Olympics athletes experience hypokinetic diseases and comorbid conditions that may predispose them to serious injuries during physical activity. A clear understanding of these conditions and diseases may assist health care professionals in preventing further distress and managing the injuries sustained by these athletes. Such diseases and conditions include overweight and obesity, diabetes, vision problems, seizure disorders, and Down syndrome, which is often associated with atlantoaxial instability.

DATA SOURCES
MEDLINE, SPORT Discus, and Special Olympics information sources for the years 1990-2000 using the key terms Special Olympics, mental retardation, comorbidity, Down syndrome, hypokinetic diseases, and physical activity were searched.

DATA SYNTHESIS
A basic review of hypokinetic diseases and comorbid conditions prepares health care professionals for working with people with mental retardation.

CONCLUSIONS AND RECOMMENDATIONS
Health care volunteers at Special Olympics events treat athletes with mental retardation who may also have some of the comorbid conditions and hypokinetic diseases observed commonly in this population. Moreover, many of these conditions and diseases are typical in athletes without mental retardation. Athletic trainers should be familiar with these conditions and diseases but should review the unique conditions and prescription medications commonly found in the Special Olympics population before providing medical services for these athletes.


As digital comic book consumption continues to rise in popularity, the comic book community appears conflicted over the effects that digital scans have on the meaning of collecting and reading comic books. Historically, comic ownership served as the locus of comic fan social capital; will digital scans hold the same cultural capital as printed books? And does postpurchased digital scan dissemination primarily hurt copyright holders through lost sales, or does it help through social promotion? Building on an analysis of fan attitudes toward digital comic book texts, we seek to account for the limitations of locality by surveying the attitudes of comic book store patrons concerning their attitudes toward physical and digital comic book texts.


In this paper, we propose a new learning technique named message-dropout to improve the performance for multi-agent deep reinforcement learning under two application scenarios: 1) classical multi-agent reinforcement learning with direct message communication among agents and 2) centralized training with decentralized execution. In the first application scenario of multi-agent systems in which direct message communication among agents is allowed, the messagedropout technique drops out the received messages from other agents in a block-wise manner with a certain probability in the training phase and compensates for this effect by multiplying the weights of the dropped-out block units with a correction probability. The applied message-dropout technique effectively handles the increased input dimension in multi-agent reinforcement learning with communication and makes learning robust against communication errors in the execution phase. In the second application scenario of centralized training with decentralized execution, we particularly consider the application of the proposed messagedropout to Multi-Agent Deep Deterministic Policy Gradient (MADDPG), which uses a centralized critic to train a decentralized actor for each agent. We evaluate the proposed message-dropout technique for several games, and numerical results show that the proposed message-dropout technique with proper dropout rate improves the reinforcement learning performance significantly in terms of the training speed and the steady-state performance in the execution phase.


The energy slab is a novel type of horizontal Ground Heat Exchanger (GHEX), where heat exchange pipes are encased in building slab structures. The thermal performance of energy slabs is usually inferior to the conventional closed-loop vertical GHEX because its installation depth is relatively shallow and therefore affected by ambient air temperature. In this paper, heat exchange pipes were made of not only conventional high-density polyethylene (HDPE), but also stainless steel (STS), which is expected to enhance the thermal performance of the energy slabs. In addition to a floor slab, a side wall slab was also used as a component of energy slabs to maximize the use of geothermal energy that can be generated from the underground space. Moreover, a thermal insulation layer in the energy slabs was considered in order to reduce thermal interference induced by ambient air temperature. Consequently, two different field-scale energy slabs (i.e., floor-type and wall-type energy slabs) were constructed in a test bed, and two types of heat exchange pipes (i.e., STS pipe and HDPE pipes) were installed in each energy slab. A series of thermal response tests (TRTs) and thermal performance tests (TPTs) were conducted to evaluate the heat exchange performance of the constructed energy slabs. Use of the STS heat exchange pipe enhanced the thermal performance of energy slabs. Additionally, the wall-type energy slab had a similar thermal performance to the floor-type energy slab, which infers the applicability of the additional use of the wall-type energy slab. Note that if an energy slab is not thermally cut off from the building's interior space with the aid of thermal insulation layers, heat exchange within the energy slabs should be significantly influenced by fluctuations in ambient temperature.


The aim of this paper is to present the findings of a PhD research (Heinzl, 2007) conducted on the Universities of Applied Sciences in Austria. The research is to establish an idiosyncrasy model for Universities of Applied Sciences in Austria showing the effects of their idiosyncrasies on the ability to successfully conduct technology transfer. Research applied in the study is centred on qualitative methods as major emphasis is placed on theory building. The study pursues a stepwise approach for the establishment of the idiosyncrasy model. In the first step, an initial technology transfer model and list of idiosyncrasies are established based on a synthesis of findings from secondary research. In the second step, these findings are enhanced by the means of empirical research including problem-centred expert interviews, a focus group and participant observation. In the third step, the idiosyncrasies are matched with the factors conducive for technology transfer and focused interviews have been conducted for this purpose. The findings show that idiosyncrasies of Universities of Applied Sciences have remarkable effects on their technology transfer abilities. This paper presents four of the models that emerge from the PhD research: Generic Technology Transfer Model (Section 5.1); Idiosyncrasies Model for the Austrian Universities of Applied Sciences (Section 5.2); Idiosyncrasies-Technology Transfer Effects Model (Section 5.3); Idiosyncrasies-Technology Transfer Cumulated Effects Model (Section 5.3). The primary and secondary research methods employed for this study are: literature survey, focus groups, participant observation, and interviews. The findings of the research contribute to a conceptual design of a technology transfer system which aims to enhance the higher education institutions' technology transfer performance.


Three verbal item types employed in standardized aptitude tests were administered in four formats–conventional multiple-choice along with three formats requiring the examinee to produce rather than simply to recognize correct answers. For two item types, Sentence Completion and Antonyms, the response format made no difference in the pattern of correlations among the tests. Only for a multiple-answer open-ended Analogies test were any systematic differences found; even the interpretation of these is uncertain, since they may result from the speededness of the test rather than from its response requirements. In contrast to several kinds of problem-solving tasks that have been studied, discrete verbal item types appear to measure essentially the same abilities regardless of the format in which the test is administered.


Medical image segmentation is a critical task that plays a vital role in diagnosis, treatment planning, and disease monitoring. Accurate segmentation of anatomical structures and abnormalities from medical images can aid in the early detection and treatment of various diseases. In this paper, we address the local feature deficiency of the Transformer model by carefully re-designing the self-attention map to produce accurate dense prediction in medical images. To this end, we first apply the wavelet transformation to decompose the input feature map into low-frequency (LF) and high-frequency (HF) subbands. The LF segment is associated with coarse-grained features while the HF components preserve fine-grained features such as texture and edge information. Next, we reformulate the self-attention operation using the efficient Transformer to perform both spatial and context attention on top of the frequency representation. Furthermore, to intensify the importance of the boundary information, we impose an additional attention map by creating a Gaussian pyramid on top of the HF components. Moreover, we propose a multi-scale context enhancement block within skip connections to adaptively model inter-scale dependencies to overcome the semantic gap among stages of the encoder and decoder modules. Throughout comprehensive experiments, we demonstrate the effectiveness of our strategy on multi-organ and skin lesion segmentation benchmarks. The implementation code will be available upon acceptance. \href{https://github.com/mindflow-institue/WaveFormer}{GitHub}.


Technology enables those with access to ITC/Internet a range of opportunities to engage with the world through personal creative practice. However, many people found themselves excluded from the increasingly digitalizing modern society due to economic restraints and lack of new media literacy. This paper discusses whether Free and Open Source applications along with Creative Commons Licence are able to effect a social benefit by enabling non-professional creatives to participate in the culture of digital production.


beta-Lactamase K1 from Klebsiella aerogenes 1082E hydrolyses both penicillins and cephalosporins comparably and is inhibited by mercurials but not by cloxacillin. These properties distinguish it from those other beta-lactamases that have been allotted to classes on the basis of their amino sequences. beta-Lactamase K1 has been isolated by affinity chromatography; its composition shows resemblances to class A beta-lactamases. Moreover, the N-terminal sequence is similar to those of class A beta-lactamases: there is about 30% identity over the first 32 residues. Furthermore, a putative active-site octapeptide has been isolated and its sequence is similar to the region around the active-site serine residue in class A beta-lactamases. There is one thiol group in beta-lactamase K1; it is not essential for activity. The pH-dependence of kcat. and kcat./Km for the hydrolysis of benzylpenicillin by beta-lactamase K1 were closely similar, suggesting that the rate-determining step is cleavage of the beta-lactam ring.


Depending on the tissue, progesterone is classified as a proliferative or a differentiative hormone. To explain this paradox, and to simplify analysis of its effects, we used a breast cancer cell line (T47D-YB) that constitutively expresses the B isoform of progesterone receptors. These cells are resistant to the proliferative effects of epidermal growth factor (EGF). Progesterone treatment accelerates T47D-YB cells through the first mitotic cell cycle, but arrests them in late G1 of the second cycle. This arrest is accompanied by decreased levels of cyclins D1, D3, and E, disappearance of cyclins A and B, and sequential induction of the cyclin-dependent kinase (cdk) inhibitors p21 and p27(Kip1). The retinoblastoma protein is hypophosphorylated and extensively down-regulated. The activity of the cell cycle-dependent protein kinase, cdk2, is regulated biphasically by progesterone: it increases initially, then decreases. This is consistent with the biphasic proliferative increase followed by arrest produced by one pulse of progesterone. A second treatment with progesterone cannot restart proliferation despite adequate levels of transcriptionally competent PR. Instead, a second progesterone dose delays the fall of p21 and enhances the rise of p27(Kip1), thereby intensifying the progesterone resistance in an autoinhibitory loop. However, during the progesterone-induced arrest, the cell cycling machinery is poised to restart. The first dose of progesterone increases the levels of EGF receptors and transiently sensitizes the cells to the proliferative effects of EGF. We conclude that progesterone is neither inherently proliferative nor antiproliferative, but that it is capable of stimulating or inhibiting cell growth depending on whether treatment is transient or continuous. We also suggest that the G1 arrest after progesterone treatment is accompanied by cellular changes that permit other, possibly tissue-specific, factors to influence the final proliferative or differentiative state.


A methodology for imposing approximate plane strain conditions in magnetic resonance elastography through physical constraint is described. Under plane strain conditions, data acquisition and analysis may be conducted in two dimensions, which reduces imaging and reconstruction time significantly compared with three-dimensional analysis. Simulations and experiments are performed to illustrate the constraint concept. A signal/noise analysis of a two-dimensional linear inversion technique for relative elastic modulus is undertaken, and modifications to the numerical method are described which can reduce the SNR requirements by a factor of two to four. Experimentally measured data are reconstructed to illustrate the performance of the method.


Work has been performed to investigate the effect of pH on the performance of a tertiary amine possessing a single carboxylic acid group. The efficiency of this inhibitor and speed at which the efficiency increased were able to show a strong pH dependency, indicating that in such systems pH monitoring is important. Measurements have revealed that when the pH was lowered from 6.5 to 3.9 different changes in corrosion potential were observed after inhibitor addition and that the efficiency of the inhibitor decreased with increasing acidity. It is believed that cause (on clean and pre‐corroded specimens) is related to variations in the chemistry of the inhibitor such that at pH 6.5 inhibition is primarily due to O‐ adsorption at anodic sites, while at pH 3.9 decreased corrosion rates occur as a result of the inhibitor loosely lying flat at the metal solution interface. It is also proposed that between the pH range studied the steel surface consists mainly of anodic sites.


Mechanical loading modulates cartilage homeostasis through the control of matrix synthesis and catabolism. However, the mechanotransduction pathways through which chondrocytes detect different loading conditions remain unclear. The present study investigated the influence of cyclic compression on intracellular Ca2+ signalling using the well‐characterised chondrocyte‐agarose model. Cells labelled with Fluo4 were visualised using confocal microscopy following a period of 10 cycles of compression between 0% and 10% strain. In unstrained agarose constructs, not subjected to cyclic compression, a subpopulation of approximately 45% of chondrocytes exhibited spontaneous global Ca2+ transients with mean transient rise and fall times of 19.4 and 29.4 sec, respectively. Cyclic compression modulated global Ca2+ signalling by increasing the percentage of cells exhibiting Ca2+ transients (population modulation) and/or reducing the rise and fall times of these transients (transient shape modulation). The frequency and strain rate of compression differentially modulated these Ca2+ signalling characteristics providing a potential mechanism through which chondrocytes may distinguish between different loading conditions. Treatment with apyrase, gadolinium and the P2 receptor blockers, suramin and basilen blue, significantly reduced the percentage of cells exhibiting Ca2+ transients following cyclic compression, such that the mechanically induced upregulation of Ca2+ signalling was completely abolished. Thus cyclic compression appears to activate a purinergic pathway involving the release of ATP followed by the activation of P2 receptors causing a combination of extracellular Ca2+ influx and intracellular Ca2+ release. Knowledge of this fundamental cartilage mechanotransduction pathway may lead to improved therapeutic strategies for the treatment of cartilage damage and disease. J. Cell. Physiol. 209: 389–397, 2006. © 2006 Wiley‐Liss, Inc.


Universities use social media to attract prospective staff, students, and funding; to engage with current students; and to support teaching and learning. Images on social media are becoming particularly dominant, and whilst Twitter is not primarily an image-based social media service, nonetheless 36 percent of links shared on Twitter point to an image. This research paper compares the types of images that universities post on Twitter to the results of previous research that has investigated the types of images that universities post on Instagram, in order to better understand how universities are using the two services for image sharing.The most popular type of image tweeted by universities was showcasing (61 percent), followed by humanizing images (20.9 percent). The dominance of showcasing images on Twitter fits with the notion of Twitter as an information source rather than a networking source, with it predominantly being used as a means of one-way communication with current students to broadcast university-specific information, rather than for attracting prospective staff, students, and funding, or to support teaching and learning.


SUMMARY Bird vocalizations resonate as they propagate through a relatively long trachea and radiate out from the oral cavity. Several studies have described the dynamics with which birds actively vary beak gape while singing and it has been hypothesized that birds vary beak gape as a mechanism for varying vocal tract resonances. Nevertheless, few studies have attempted to quantify the effects of beak gape on vocal tract resonances. We replaced eastern towhee, Pipilo erythrophthalmus L., syringes with a small speaker and obtained recordings of frequency sweeps while rotating each subject in a horizontal plane aligned with either the maxilla or mandible. We describe vocal tract resonances as well as how sound radiates as a function of beak gape. Results are inconsistent with the hypothesis that songbirds vary beak gape as a mechanism for `tracking' fundamental frequencies in vocalizations. Instead, decreases in beak gape seem to attenuate resonances that occur between ∼4 and 7.5 kHz. We propose that songbirds vary beak gape as a mechanism for excluding and/or concentrating energy within at least two distinct sound frequency channels.


This case study is about preparing the urban communities for earthquake hazard through organizing the communities and activating the service providers (organizations responsible for responding to earthquake hazard). Being a pilot initiative, the project was intervened in 16 communities / wards of Dhaka City that were selected based on their receptivity and vulnerability through community participation. It features the various approaches of empowering the communities through linking with service providers (SPs), raising peoples' awareness, enhancing communities' capacity and activating the service providers. The success of this initiative was involving the Ward Commissioners who played the lead role for organizing community activities and ensuing peoples participation.


Three hundred cross-bred lambs with an average initial weight of 33.5 kg were used to compare the effects of three different hormone implants versus a control on lamb performance (ADG) and carcass characteristics.  Lambs were divided into four groups and assigned implant treatments as follows: no implant (CON), Synovex1 (SYN), Ralgro2 (RAL), or Component C3 (COM).  On d 0, lambs were weighed, ear tagged and implanted according to treatment.  Lambs were fed by a self-feeder.  Weights were recorded on subsequent d 28, 56, 84, 97, and 108 and as end-weights were reached, lambs were slaughtered.  Backfat thickness, cross-sectional ribeye area, USDA yield and quality grade measurements were recorded.  Analysis showed significantly higher ADG (P < 0.05) in COM and SYN lambs compared to CON d 28 through d 108.  On d 56, RAL lambs also exhibited higher (P < 0.05)  ADG than CON lambs.  Carcass evaluations yielded no conclusive evidence of improved quality of implanted vs. CON carcasses.  A majority (95%) of carcasses received "choice" quality grades and yield grades of 3 to 5 thereby implying improved ADG with hormone implant use, with no simultaneous improvements in carcass quality.


In this article, we describe the development of poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate) (PEDOT:PSS)-based ink for the fabrication of indium tin oxide (ITO)-free polymer solar cells (PSCs). The ink consisted of PEDOT:PSS, suitably doped with dimethyl sulfoxide (DMSO) in solution. The printed PEDOT:PSS showed electrical conductivity of 1000 S/cm and transparency around 85% in the visible range. Then, they were employed as anodes in ITO-free polymer PSCs based on a bulk heterojunction of poly(3-hexylthiophene) and [6,6]-phenyl C61-butyric acid methyl ester. The effects of surface treatments (O2 plasma, UV ozone) of glass substrates on the quality and morphology of the printed layer were investigated in order to improve the anode quality. The performances of the devices with printed polymeric anode were compared to the one realized depositing DMSO-PEDOT:PSS by spin coating technique. The best cells performances were obtained by UV ozone treatment reaching a power conversion efficiency of 1.5%. POLYM. COMPOS., 34:1493–1499, 2013. © 2013 Society of Plastics Engineers


Primates have an intricate relationship with their environment. Previous studies have demonstrated that there is a positive correlation of primate body size and home range. Inasmuch biological characteristics such as body size and locomotion style  be characteristics which influence how primates use their surrounding environment to create home ranges. In this paper the author critically analysed research and bodies of data to locate body size and home range information for sixteen primate species. The primates that were selected were divided into four locomotor styles; arboreal quadrupedalism, terrestrial quadrupedalism, leaping and suspensory locomotion. Graphs and statistics were generated to determine if there were any patterns between body size and home range. Once graphs were created a comparison between locomotor types was feasible. The data demonstrated that only vertical clinging and leaping species demonstrated a strong positive body size vs. home range relationship. Although strong correlations did not exist between the other locomotor types it is likely that the sample size was too small and more data points are needed in future studies. Another possibility to explain the results is that non-leapers have their body size and home range affected by other biological, ecological or behavioural factors. The study reveals where more analysis is needed and what the next steps are in understanding body size and home range correlations.


Understanding how growth and development of grain sorghum [Sorghum bicolor (L.) Moench] genotypes respond to water limitation would provide a basis to assess the value of such responses in crop production and crop improvement. We conducted a greenhouse experiment to quantify responses of six genotypes to rive levels of water limitation between floral initiation and flowering achieved by daily watering to weight. At flowering, the thermal time, biomass, height, water transpired, and transpiration efficiency (biomass/water transpired) were recorded. Results for water-limited treatments were expressed relative to the well-watered treatment. Degree of water limitation was indexed by calculating the ratio of the amount of water transpired in water-limited treatments to that in the well-watered treatment. This transpiration ratio decreases from a value of one as degree of water limitation increases. Under well-watered conditions, genotypes differed significantly in thermal time and biomass, but not in height. Differences in biomass were related to differences in both water transpired and transpiration efficiency. The least efficient genotype had a value of transpiration efficiency 25% lower than that of the most efficient. Under water-limiting conditions, relative thermal time increased at transpiration ratios < 0.55; genotypes did not differ. Relative height decreased linearly with transpiration ratio, and genotypes did not differ. Relative biomass decreased with increasing water limitation, but genotypes differed. This was related to genotypic differences in relative transpiration efficiency for transpiration ratios < 1. Some genotypes increased transpiration efficiency 28% under water limitation. The value of expressing water limitation as transpiration ratio and possible mechanisms explaining these findings are discussed.


Families of patients receiving palliative care are profoundly affected by the challenges of the illness. They observe care that the patient receives, provide care for the patient, and receive support from health professionals in the form of information, counselling, or practical assistance. As they witness and participate in the patient's care, they judge the quality of care that the patient receives. They often see themselves as the patient's care advocates and may harbour regret and guilt if they believe that the patient did not have the best possible care. The illness experience profoundly affects family members' psychological and physical health; recognition of this has coined the term "hidden patients." This article briefly synthesizes empirical work that suggests how to best support families in a palliative care context. We discuss how to define the family, emphasizing a systems approach to family care. We describe the impact of the illness on the family in terms of family members' health, family communication issues, psychological issues, needs for information, physical care demands, and family costs of caring.


Gone are the days of homogeneous sets of disks. Even disks of a given batch, of the same make and model, will have significantly different bandwidths. This paper describes the disk technology trends responsible for the now-inherent heterogeneity of multi-disk systems and disk-based clusters, provides measurements quantifying it, and discusses its implications for system designers.


Most of the freshwater fauna originates from ancient or recent marine ancestors. In this study, we considered only completely aquatic non-parasitic animals, counting 25 phyla, 77 classes, 363 orders for a total that should include 236,070 species. We divided these taxa into three categories: exclusively marine, marine and freshwater, and exclusively freshwater. By doing so, we obtained three distribution curves which could reflect the marine species' mode of invasion into continental waters. The lack of planktonic stages in the benthic fauna of inland waters, in addition to what we know about the effects of the impoundment of epicontinental seas following marine regressions, lead us to think that the main invasion mode into inland waters is more linked to the sea level fluctuations of the past than to slow and "voluntary" ascents of rivers by marine elements.


Hygienic monitoring of lead, cadmium, and mercury as environmental pollutants should include the analysis of adverse human and environmental effects. The hygienic investigations of environmental pollution with gold-mining waste involved measurements of Hg in the water, soil, foodstuffs and human biological materials. Hg was found in the biological substrata of both industrial workers and the general population since they eat the products of animals and plants from the polluted area.


Impedance plethysmography (IPG) is an attractive diagnostic method for evaluating deep vein thrombosis in the pregnant patient because it is noninvasive and it avoids x-ray or radionuclide exposure. However, the accurate diagnosis of deep venous thrombosis by IPG in pregnant patients might be altered by the normal physiologic and anatomic changes that occur during pregnancy. We evaluated 50 healthy women by IPG throughout their pregnancies and during their nonpregnant state. We found that venous capacitance during pregnancy increases 50% over venous capacitance during the non pregnant state. Most of this change occurs during early pregnancy because of a decrease in venous tone caused by rising levels of progesterone and estradiol. During the third trimester of pregnancy venous outflow is diminished compared to outflow during early pregnancy. Venous obstruction by the gravid uterus and fetal head engaging in the pelvis are factors that contribute to this finding. The IPG results in four patients with ileofemoral thrombosis and in three with postpartum pulmonary emboli are also reported. IPG may be utilized as an accurate diagnostic technique in the pregnant woman if the physiologic and anatomic alterations of pregnancy, which are reflected as significant changes in venous capacitance and outflow on IPG testing, are considered.


The present article explores the possibility of queer heritage. In 2017, artists Kalle Hamm and Dzamil Kamanger organised a community art project called Queer- cache in Helsinki, and I use it as a case study on the heritagisation of queer pasts. Queercache borrowed its form from geocaching, presenting twelve caches with urban stories and memories. It asked whether phenomena which deviate from norms – the rejected past – can be recognised as heritage. As a means of analys- ing heritage discourse, i.e., the process of identifying and treating something
as heritage, I use the concept of the epistemology of the closet. It describes and questions heteronormatively conditioned ways of knowing. The epistemology, and heritage discourse have commonalities, since both are processes of signification characteristic of modernity, the core of which are identification, valuation and knowing. However, Queercache nurtured queer memories without the stories necessarily meeting criteria associated with heritage such as continuity, authen- ticity and expertise.


Fombonne's (2020) editorial is a thought-provoking appraisal of the literature on 'camouflaging', whereby some autistic people mask or compensate for their autistic characteristics as an attempt to fit in and to cope with disabilities under neurotypical social norms. Fombonne (2020) highlights three issues of contention: (a) construct validity and measurement of camouflaging; (b) camouflaging as a reason for late autism diagnosis in adolescence/adulthood; and (c) camouflaging as a feature of the 'female autism phenotype'. Here, we argue that (a) establishing construct validity and measurement of different aspects of camouflaging is warranted; (b) subjective experiences are important for the differential diagnosis of autism in adolescence/adulthood; and (c) camouflaging is not necessarily a feature of autism in female individuals - nevertheless, taking into account sex and gender influences in development is crucial to understand behavioural manifestations of autism. Future research and clinical directions should involve clarification of associated constructs and measurements, demography, mechanisms, impact (including harms and benefits) and tailored support.


Three monoclonal IgG of different subclasses (IgG1, IgG2, and IgG4) and one IgA1 were isolated from the serum of patient Per suffering from an immunocytic sarcoma. All four monoclonal Ig shared the same N-terminal sequence of their H chains (VH3). Furthermore, their kappa-chains exhibited identical isoelectric charges and N-terminal sequences (VK2) and expressed the same private idiotope. A strong antitubulin activity was found in IgA1Per and in two of the three monoclonal IgGPer. The specificity was restricted to tubulin for IgA1Per and IgG4Per, whereas IgG1Per also displayed significant polyreactive bindings and IgG2Per failed to react with any of the Ag tested. The monoreactive IgG4Per, as well as the polyreactive IgG1Per, bound a large peptide in the central part of both alpha and beta subunits of tubulin (amino acid position 100 to 300). In contrast, the monoreactive IgA1Per bound to a rarely detected epitope close to residue 310 of these subunits. The tubulin epitope recognized by polyreactive IgG1Per was similar to that of germ-line-encoded polyreactive antibodies. It is hypothesized that IgG4Per- and IgA1Per-producing cells derive from the IgG1Per polyreactive clone after somatic events leading to the production of monoreactive antibodies.


: Overall eighty-seven patients with facial neuritis [correction of paralysis] received multimodality treatment involving infrared laser acupuncture procedures. The unit "Biomed-001" operating at wavelength 890 nm with intensity 20 mW served as a source of laser light. The acupuncture points (with 10 to 15 points in each treatment session, duration of exposure being 1 to 3 min) were selected according to principles of traditional Chinese medicine. One course of the infrared laser therapy acupuncture treatments is 12 to 16 sessions. The described treatment option applied in the above patients population was associated with a good clinical effect confirmed by results of studies made with the aid of electrophysiological modalities.


An immune response to urate oxidase--an enzyme from pig liver was studied. Peculiarities of antibody formation were investigated in three animal species. It was shown that the scheme for repeated injections of the enzyme preparation had a marked effect on the intensity of humoral immune response. In studying the process of the enzyme allergic properties it was found that urate oxidase had anaphylactogenic and skin sensitizing properties. The strength of anaphylactic reaction depened on the sensitizing dose of the antigen and correlated with the results of active skin anaphylaxis. However, there was no correlation between the strength of the immune response determined by means of the indirect hemagglutination test and the intensity of anaphylactic reaction.


The effect of smoking kilns on water activity, microbial load and sensory attributes was evaluated to adopt suitable technology that maintains the quality of fish in South Sudan. A total of 300 fresh Mormyrus caschive and Oreochromis niloticus were purchased, 36 fresh samples were iced and the remaining 264 fish samples were divided into two batches for pit and chorkor smoking. The experiment was done twice in a completely randomized design. Fish samples were analyzed for water activity using Lab-Swift Meter, microbial load using standard microbiological methods and sensory characteristics using 9-point hedonic grading scale. Result revealed that, water activity in pit smoked fish increased at a rate of 1.7 times faster than in chorkor smoked samples during storage. Corresponding to water activity, plate count equally increased at a rate of 1.7 times faster for pit smoked M. caschive and 1.1 times for O. niloticus than samples smoked using chorkor. Similarly, mould load increased at a rate of 1.5 times faster for pit smoked M. caschive and 2.2 times for O. niloticus than samples smoked using chorkor oven. Overall, chorkor smoked fish had significantly better sensory parameters than pit smoked samples after one month's storage. Therefore, chorkor kiln produced quality smoked fish in terms of microbial load and organoleptic parameters, and the study recommends its adoption for artisan fisheries in South Sudan. However, microbial characteristics of smoked fish need to be further examined for a period exceeding a month to determine microbiological quality and establish fish self-life in order to maintain the quality and safety of fish and fisheries products.

 Key words: Water activity, microbial load, sensory attributes, smoking technologies, shelf life.


We read with interest the excellent article on "Cholesterol and Violent Behavior" by Santiago and Dalen 1 that critically reviews the existing literature on this important issue. The authors start their conclusion with the statement: "There is certainly enough evidence to warrant further investigation and to formulate several hypotheses rather than a single, unitary explanation of the relationship between cholesterol level, serotonin, and violent behavior." 1 Later on, they comment that "The current literature does not support a relationship between low or lowered cholesterol levels and violent behavior." 1 In our opinion, there is evidence only for the second conclusion. From the data reviewed by the authors, it remains questionable whether a change in the total mortality may be expected at all in small short-term trials intended only to demonstrate that lowering cholesterol will reduce the incidence of coronary heart disease and of coronary death. Furthermore, it should be kept


Use your smartphone to scan this QR code and download this article ABSTRACT For the first time, an environmentally friendly and effective procedure to produce high-value engineering aerogels from fly ash (FA) has been developed by dispersing FA particles into a mixture of biodegradable polyvinyl alcohol (PVA) and carboxymethyl cellulose (CMC), followed by freezedrying. The effect of FA content on the physical properties, morphology, mechanical strength, and thermal conductivity of FA aerogels is also studied comprehensively. The lightweight FA aerogels show a low density of 0.072 – 0.093 g/cm3 with high porosity of 94.94 – 95.78%. The morphology of aerogels shows the uniform distribution of FA particles in PVA-CMC matrixes that creates a porous structure with a pore size of 2-5 μm. Therefore, the FA aerogels exhibit good heat insulation with extremely low thermal conductivity of 0.040 – 0.047 W/m.K at ambient temperature and pressure that is comparable to some commercial insulation materials such as mineral wool, fiberglass, expanded polystyrene, and other silica-based aerogels from waste. Moreover, the compressive modulus of FA aerogels is about 67.73 – 254.75 kPa indicating their excellent mechanical properties under 1 kN vertical compression. The experimental results indicate the significant better durability of FA aerogels than that of previous aerogels from other wastes such as sugarcane bagasse (88 kPa), pineapple leaf fibers (1.64 – 5.34 kPa), recycled polyethylene terephthalate (1.16 – 2.87 kPa), spent coffee grounds (5.41 – 15.62 kPa), and silica – cellulose (86 – 169 kPa). It is concluded that FA aerogels are a promising candidate as a lightweight thermal insulating material.


Most practical recommender systems focus on estimating immediate user engagement without considering the long-term effects of recommendations on user behavior. Reinforcement learning (RL) methods offer the potential to optimize recommendations for long-term user engagement. However, since users are often presented with slates of multiple items - which may have interacting effects on user choice - methods are required to deal with the combinatorics of the RL action space. In this work, we address the challenge of making slate-based recommendations to optimize long-term value using RL. Our contributions are three-fold. (i) We develop SLATEQ, a decomposition of value-based temporal-difference and Q-learning that renders RL tractable with slates. Under mild assumptions on user choice behavior, we show that the long-term value (LTV) of a slate can be decomposed into a tractable function of its component item-wise LTVs. (ii) We outline a methodology that leverages existing myopic learning-based recommenders to quickly develop a recommender that handles LTV. (iii) We demonstrate our methods in simulation, and validate the scalability of decomposed TD-learning using SLATEQ in live experiments on YouTube.


WNK3, a member of the With No Lysine (K) family of protein serine/threonine kinases, was shown to regulate members of the SLC12A family of cation-chloride cotransporters and the renal outer medullary K+ channel ROMK and Cl(-) channel SLC26A9. To evaluate the effect of WNK3 on TRPV5, a renal epithelial Ca2+ channel that serves as a gatekeeper for active Ca2+ reabsorption, WNK3 and TRPV5 were coexpressed in Xenopus laevis oocytes and the function and expression of TRPV5 were subsequently examined. An 82.7 +/- 7.1% increase in TRPV5-mediated Ca2+ uptake was observed when WNK3 was coexpressed. A similar increase in TRPV5-mediated Na+ current was observed with the voltage-clamp technique. WNK3 also enhanced Ca2+ influx and Na+ current mediated by TRPV6, which is the closest homolog of TRPV5 that mediates active intestinal Ca2+ absorption. The kinase domain of WNK3 alone was sufficient to increase TRPV5-mediated Ca2+ transport, and the positive regulatory effect was abolished by the kinase-inactive D294A mutation in WNK3, indicating a kinase-dependent mechanism. The complexly glycosylated TRPV5 that appears at the plasma membrane was increased by WNK3. The exocytosis of TRPV5 was increased by WNK3, and the effect of WNK3 on TRPV5 was abolished by the microtubule inhibitor colchicine. The increased plasma membrane expression of TRPV5 was likely due to the enhanced delivery of mature TRPV5 to the plasma membrane from its intracellular pool via the secretory pathway. These results indicate that WNK3 is a positive regulator of the transcellular Ca2+ transport pathway.


This study examines the factors that influenced poor Indonesian farmers to invest in floating net aquaculture after being relocated due to a reservoir construction project. To compare three primary decision factors, credit accessibility, risk attitudes, and social learning, (i.e., learning effects from others' experience), we analyze 16 years of socio-economic retrospective data collected in the field interviews exclusively for this study. Our analysis reveals that credit accessibility and risk attitudes are the most important factors that influence the rate of aquaculture investment. Social learning as well as household education also influences the investment decision significantly. Our results suggest that developmen t projects that involve voluntary investments by a poor populace will be more successful if complementary services to promote credit and insurance accessibility and/or local information sharing are made available, either by the government or the private sector. Also, such support should not cease at the launch of the project but rather continue and in fact evolve to address the changing factors at the different stages of the project.


Our studies implied the golden compounds may be more effective against COVID 19 as they synergy inhibit SARS COV 2 replication and down regulation inflammation cytokine level. Our crystal structure studies firstly revealed Au (I) ions, derived from auranofin (AF) or gold cluster (GA), covalently bind sulfur atom of Cys145 and Cys156 of Mpro of SARS COV 2. The auranofin or gold cluster well inhibit Mpro activity in vitro. Auranofin or gold cluster could well suppress inflammation cytokine level of IL 6, IL 1β, TNF α via down regulation NF κB activation in macrophage. The cell viability and rat toxicity studies show gold cluster is more safety when compared FDA approved auranofin. The rat pharmacokinetic studies of gold cluster revealed its good bioavailability.


For more than half a century, inventory investment has attracted wide attention as a major cause of short-term macroeconomic fluctuations, and the mechanisms involved have been the focus of many major studies. Yet microeconomists and business people familiar with corporate behavior have frequently expressed misgivings about the enterprise. Using Japanese quarterly GDP inventory investment statistics both by commodity and by category, 1994~2010, I investigate the nature of quarterly inventory statistics and the inventory investment behavior, and draw two conclusions. First, statisticians estimate the quarterly statistics under severe time constraints, and their resulting figures incorporate seasonal variations which dominate the quarterly fluctuations. This fluctuation mostly disappears in annual data. Secondly, when I examine the inventory variation after the Lehman Shock in the autumn of 2008, I find neither a notable increase in inventory stock nor a long-run stock adjustment process. Given the size of this unforeseen exogenous shock, most observers expected a large inventory stock accumulation to follow. That the accumulation did not follow suggests that the focus on inventory variation may be misplaced. For inventory investment data estimation, Japan is an ideal OECD country, with generous statistics availability. The conclusions of this research, drawn from the quarterly GDP inventory statistics, will stimulate the interest both in the study of inventory data in other countries focusing on its estimation process and source statistics, and in the great variety of inventory investment. At the same time, the conclusions pose a grave implication not only for re-evaluation of the literature in inventory investment variations but also for other research topics in macroeconomics like monetary transmission mechanisms including "financial accelerator" theory.


In the context of building software systems, Service-oriented Systems (SOS) have become one of the major research topics in the past few years. In SOS, services are basic functional units that can be created, invoked, composed, and if needed deleted on-the-fly. Since these software systems are composed of different services there is no easy way to assure the Quality of Service (QoS), therefore, formal specification of both functional and extra-functional system behaviour, compatibility, and interoperability between different services have become important issues. As a way to address this issues, resource-aware timing behavioural language REMES was chosen to be extended towards service-oriented paradigm with service specific information, such as type, capacity, time-to-serve, etc., as well as Boolean predicate constraints on control flow guarantees. In this thesis we present a design framework that provides a graphical user interface for behaviour modelling of services based on REMES language. NetBeans Visual Library API is used to display editable service diagrams with support for graph-oriented models. A textual dynamic service composition language was implemented, together with means to automatically verify service composition correctness. We ensure also an automated traceability between service specification interfaces, where both modelling levels are combined in an efficient tool for designing SOS.


Summary Almokalant (ALM, CAS 123955-10-2), a class III antiarrhythmic drug, has been shown to be embryotoxic in rats. In the absence of human pregnancy outcome data, the human relevance of these findings in rats is unknown, and results from other species would indicate if these findings are of more universal interest. Therefore, this study was initiated to evaluate the potential effects in mice. ALM was given to three groups of pregnant mice (~20 mice/group) during gestation days 6-15 at dose levels of 50, 125 and 300 µmol/kg. A fourth group served as a control. In addition, whole embryo culture was performed on gestation day 10 with doses of ALM ranging from 325-5200 nmol/1 (~17 embryos/group) in order to study if ALM had the potential to induce dysrhythmia in the embryonic mouse heart. ALM induced total embryonic death in the high dose group, and in the intermediate group the level of embryonic death was elevated and the mean foetal weights decreased. A slight increase in minor skeletal defects was observed, mainly consisting of reduced calcification of elements in the vertebral column and among the phalanges. ALM caused bradycardia in a concentration dependent manner (13-42% at 650-5200 nmol/1). Irregular heart rhythm and/ or episodes of cardiac arrest were observed in one embryo at 2600 and in seven embryos at 5200 nmol/1. In conclusion, ALM caused embryotoxicity in the mouse, most likely secondary to adverse effects on the embryonic heart. The results may suggest that class III antiarrhythmics are embryotoxic also in humans.


The vast majority of coastal areas of the United States as well as other coastal regions around the world are under increasing stress from both natural processes (e.g., erosion, catastrophic storms, sediment deficits, subsidence, rising sea level) and the effects of population growth and increasing development. Coastal regions, including the Great Lakes, are now home to more than 138 million people (53 percent of the U.S. population) who use the areas increasingly for recreation, transportation, energy extraction and transmission, and waste disposal. Equally important, barrier islands, estuaries, and coastal wetlands provide valuable habitats for wildlife and commercial fisheries.


This Essay explains why the Supreme Court's economic reasoning in its recent Ohio v. American Express Co. ("Amex") decision is wrong. The Amex case involved the use of what are called "antisteering" restraints in which a retailer is not allowed to use a variety of tactics to steer a consumer away from using an American Express ("Amex") card and toward using another payment mechanism. The reason why a merchant might want to do this is because the cost that the merchant incurs when a customer uses an Amex card can be higher than the cost that the merchant incurs when the customer uses either another credit card, debit card, or cash. Although not challenged in the Amex case, the Amex contractual rules also prevent a retailer from imposing a surcharge on customers who use an Amex card to reflect the higher merchant cost. It is interesting to note that some countries—such as Australia—have regulated certain credit card fees, others have forbidden credit card companies from telling merchants that they cannot surcharge, and some states in the United States—such as New York—have forbidden merchants from surcharging. Restraints on surcharging or steering are examples of restraints that Ralph Winter and I call "vertical most-favored-nation restraints," ("vMFN") in which one supplier tells a retailer that the retailer cannot set the retail price of its product higher than that of a rival, even if its wholesale price is higher than that of its rival. Such restraints have been the subject of some litigation already, but I expect that with the increasing use of web based platforms where such restraints are often used, litigation regarding such restraints will increase.
This Article illustrates the underlying economic logic behind the anticompetitive effect of vMFNs. I then apply the reasoning to credit cards and finally, using the economic framework developed, explain the economic errors in the Court's Amex decision. For a more detailed discussion, please see the Carlton and Winter paper referenced herein.


In order to succeed and advance as professionals in the modern workplace, women must exhibit agentic behavior (i.e., displaying confidence, dominance), due to the traditionally valued characteristics. However, because agentic behavior is a violation of female gender stereotypes, these women may be evaluated more negatively on a variety of social- and performance-related outcomes than women who conform to gender stereotypes. This process has been termed backlash (Rudman, 1998). The present study explored the ways in which race impacts how agentic women experience backlash in the workplace. Using a between-subjects design, participants were randomly assigned to conditions (i.e., Black, Latina, White, or Asian woman) and asked to evaluate an agentic female potential job candidate on various backlash-related measures. Based on past research (Sanchez-Hucles & Davis, 2010), it was expected that a hierarchical pattern would emerge with Latina women receiving the highest levels of general backlash, White women receiving the lowest levels of general backlash, and Black and Asian women in between. The specific type of backlash (agentic deficiency backlash, agentic penalty backlash) each candidate received was also explored. Results indicated no significant differences among the groups of women for both general backlash, as well as the specific types of backlash. Limitations and implications of these findings are discussed, as well as future directions.


This unit forms the first part of the 1997 Clinical Practice and Management Awards (see back page). Anyone who has attended a conference, listened to a talk or heard evidence being presented will know just how important good presentation is. If speakers cannot hold the audience's attention, the message theyare trying to convey will fail to be heard, however important it is. Good presentation skills can be developed by everybody using some simple techniques and plenty of practice.


Side-events are the most visible venue for civil society involvement in international climate negotiations. The many varied functions that side-events fulfil for participants and organizers are identified and analysed for their contributions generally as well as for their contribution to the negotiation process. The analysis is based on two surveys of over 2,000 side-event participants and organizers at COP-13 and COP-14. The surveyed side-events were found to fulfil the broader official objective of benefiting COP participants through providing a shared conceptual basis as well as building institutional capacity and legitimacy. All participant groups, particularly from Africa, G77, and less-developed countries, found these events useful for their work. As a venue for information dissemination, side-events provide an important opportunity for capacity building. Historically, new items were introduced at COP side-events before being discussed in the formal negotiations. Side-events also provide a process for creating a shared vision. By providing a forum that includes more organizations and actors in conjunction with the negotiations, side-events have the potential to increase the input legitimacy of the international policy process. A significant challenge will be the inclusion of a wider range of stakeholder groups and geographical, socioeconomic and epistemic communities, in order to avoid favouring the hegemony of NGOs and other organisations based in industrialized countries, as well as Annex 1 Parties.


Osteochondral lesions of the talar dome are common problems encountered in orthopaedics. Procedures for the treatment of osteochondral lesions of the talus, including debridement of the joint, shaving of fibrillated cartilage, and resection or perforation of subchondral bone in the last decade, have been performed arthroscopically with very low morbidity. These seem to be inadequate in lesions larger than 1.5 cm2 and have not been histologically effective in restoring the hyaline cartilage sheath. Osteochondral allografts or autogenous grafts and autologous chondrocyte transplantation have proven to be capable of restoring the articular hyaline cartilage surface, including defects larger than 2 cm2, although with higher costs and morbidity. In this review, the aforementioned methods of operative treatment are examined and issues that are related to these methods are discussed.


Formamidinium lead bromide perovskite nanocrystals (FAPbBr3 PNCs) are extremely promising for applications in green light emitting diodes (LEDs) since their photoluminescence maxima locate in the range of 530-535 nm with a narrow full width at half-maximum (<25 nm). However, the low exciton binding energy (EB) of FAPbBr3 (∼25 meV) hinders its development in LEDs. In this study, we have developed a 2-methyl-1-pentanol assisted hot injection method for the synthesis of 2D FAPbBr3 nanoplates with high stability. Due to strong quantum confinement in two dimensions of the nanoplates, the obtained FAPbBr3 nanoplates exhibited a high EB of 168.4 meV. The high EB dramatically enhances the photoluminescence (PL) properties with a high fluorescence quantum yield of 92%, which realizes a long photoluminescence lifetime of 2 ns with negligible trapping processes. Benefiting from the high EB and outstanding PL properties, the FAPbBr3 nanoplate LED device showed a current efficiency of 17.32 cd A-1 at a low voltage of 4 V, and a corresponding external quantum efficiency (EQE) up to 4.5% with the Commission Internationale de L'Eclairage (CIE) 1931 color coordinates of (0.24, 0.73), providing a new pathway for the fabrication of efficient perovskite based LED devices.


ABSTRACT A 300-km length of west Florida's coastline is dominated by an open-marine coastal marsh system. Located along the central part of this sediment-poor region, Waccasassa Bay is presently a broad, shallow embayment rimmed by an expansive Juncus roemerianus salt marsh. In this system, sediments were first deposited in a forested swamp from ~ 4400 to 1800 cal yr BP. Contemporaneously, large oyster reefs grew in the embayment near a paleo-river mouth. These deposits indicate a period of slow sea-level rise during the Late Holocene that correlates with the establishment or regression of other west Florida coastal systems. Circa 1800 cal yr BP, a rapid transgression of 2-4 km led to salt marsh growth over the former swamp, and a brackish marsh developed over a previously unflooded upland surface. Calculated rates of shoreline retreat are 10 to > 20 m/yr at this time and compare to < 3.0 m/yr during most of the Late Holocene. Timing of the event in Waccasassa Bay corresponds with transgressive sequences in other Atlantic and Gulf coast systems and supports a relative sea-level fluctuation ca. 1800 cal yr BP. Following this event, sediments overstepped during the transgression were reworked onto the low-lying tidal marsh. Rapid accretion along the shore edge outpaced sea-level rise and led to the local development of high intertidal and supratidal levees. Evidence indicates that storm-driven surge was the principal mechanism of sediment transport for these deposits. In Waccasassa Bay, storm-surge deposition has played a significant role in marsh surface accretion, distinguishing the system from more typically tide-dominated wetlands. Within the past ~ 150 years, most of the supratidal environment became tidally inundated and there was a widespread transition into the modern salt marsh. This change and evidence from adjacent portions of the Florida coast implicate a rise in sea level within the past several hundred years.


This qualitative research study, based on data obtained from a 12 month psychoanalytic infant observation, explores the emergence and manifestations of maternal ambivalence in the relationship between a mother and infant, during the infant's first year of life. The research is presented as a single case study. Whilst literature is considered from the fields of object-relations psychoanalysis and feminist perspectives of psychoanalysis, particular consideration is given to themes raised in Donald Winnicott's seminal work 'Hate in the Countertransference.' Winnicott's paper, specifically his list of reasons 'why a mother hates her baby' is used as a thematic framework for analysing the research findings. The study concludes that for mothers, ambivalence is a typical and ordinary experience in the relationship with the infant, though there can be considerable anxiety and tension associated with this experience which can challenge the mother's capacity to manage her ambivalence. However, the experience of maternal ambivalence may also contribute to a more empathic understanding of the infant, if the mother is able to reflect on her range of experiences in the relationship. Finally, this thesis concludes with recommendations for work in the perinatal and maternal mental health field. All names and identifying personal details used in the findings have been changed to ensure confidentiality.


Pseudocapacitors store energy on/near the surface of electrode materials through redox reactions, whose capacitive activity thus depends on the electronic states of the surface and interface, and electronic conductivity of the electrode materials. Here, we report a simple strategy to prepare the hybrid nanostructure of NiCo2O4@rGO with the controllable composition by depositing graphene oxide (GO) on the NiCo2O4 scaffold combined with chemical reduction. By combining NiCo2O4 mesoporous nanosheets with reduced graphene oxide (rGO), the hybrid electrode shows significant improvement in electrical conductivity, as well as more electrochemically active sites and short transport path lengths for both electrons and ions. Moreover, resulting from the Schottky electric field at the interface of NiCo2O4 and rGO, NiCo2O4 exhibits superior electron collection efficiency, thus contributing to the redox reactions on/near the surface of NiCo2O4. Benefiting from the rational structural features and excellent electrical conductivity, the designed NiCo2O4@rGO hybrid electrode demonstrates high specific capacitance (3.6 F cm−2 at a current density of 5 mA cm−2), good rate capability and superior cycling stability (90% of the initial capacitance can be retained after 2000 charge/discharge cycles). This work provides a new strategy for high-performance supercapacitor electrodes by combining capacitive (especially carbons) and faradaic (redox electroactive) materials.


This study was intended to determine the problems facing Sudanese mango fruit exports. It concentrated on mango exports competitiveness in international markets and on the main economic factors affecting this competitiveness. Primary data were collected by interviewing mango producers and exporters in Abu Halima village (East Nile Locality, Khartoum State) and the Khartoum central market, during 2005-2012 seasons. Secondary data were obtained from different relevant sources. The data were analyzed by descriptive statistics and policy analysis matrix. This provided access to estimate the private and economic profitability of mango exports in the Sudan and to determine the effects of taxation policies. The results revealed that mango is highly competitive in foreign markets, and the government policies highly taxed mango crop throughout the study period (2005-2012). The Domestic Resource Cost (DRC), Coefficient of International Competitiveness (CIC) and International Value Added indicators were used to determine the competitiveness of mango exports and found to be about 0.02, 0.04 and 8237 US$, respectively, in season 2012. For improvement of mango exports, the study recommended the removal of export constraints, e.g. reducing the government taxes and fees on mango export so as to increase its competitiveness and reduce cost of air transport and study the possibility of using sea ports.


This study attempts investigates the effect of Foreign Direct Investments (FDI) on economic growth in Kenya. International Monetary Fund (1977) defines FDI as investment that is made to acquire a lasting interest in an enterprise operating in an economy other than that of the investor, the investor's purpose being to have an effective voice in the management of the enterprise. The study used descriptive research design which is used when the problem has been specifically defined and where the researcher has certain issue to be described by the respondents about the problem. Secondary data was collected for the period between1981 and 2010. Secondary data of FDI was collected from central bank of Kenya Databases, the world periodical and economic survey reports and websites, the Treasury periodical financial reports and periodicals, National Bureau of Statistics-the periodical economic survey and outlook reports and International Monetary Fund (IMF) periodical and economic survey reports and websites while economic growth data was captured from the Central Bank of Kenya quarterly for the last 10 years, 20032013. Microsoft excels package was used to analyze the data to obtain the descriptive statistics (mean and standard deviation) and correlation and multiple linear regression model fitted to explain the relationship between variables. Findings were presented in tables and graphs. The Pearson correlation was computed for Gross Domestic Product (GDP), FDI, Inflation Rate and Foreign Debt resulting in a weak negative relationship. These findings have led to the conclusion that there is a small impact brought about by FDI to Kenyan economic growth. The Kenyan government should embrace policies that aim to attract more FDI while micromanaging the same to avoid the negative impact of FDI on local firms such as crowding out


In most real-world environments, scheduling is an ongoing reactive process where the presence of a variety of unexpected disruptions is usually inevitable, and continually forces reconsideration and revision of pre-established schedules. Many of the approaches developed to solve the problem of static scheduling are often impractical in real-world environments, and the near-optimal schedules with respect to the estimated data may become obsolete when they are released to the shop floor. This paper outlines the limitations of the static approaches to scheduling in the presence of real-time information and presents a number of issues that have come up in recent years on dynamic scheduling. The paper defines the problem of dynamic scheduling and provides a review of the state-of-the-art of currently developing research on dynamic scheduling. The principles of several dynamic scheduling techniques, namely, heuristics, meta-heuristics, multi-agent systems, and other artificial intelligence techniques are described in detail, followed by a discussion and comparison of their potential.


—Face Recognition is rapidly growing field due to ease of its application in many vital security systems. In this paper, two non linear dimension reduction techniques namely LLE and ISOMAP are combined for implementing face recognition. Since face image database is believed to be non linear in nature due to varying pose, facial expressions and illuminations , superiority of non linear combination over linear combination is shown. Experimental results based on ORL database demonstrate effectiveness of above statement.


Gold nanoparticles (GNPs) have been extensively used in cancer research due to their abilities as anti-cancer drug carriers for chemotherapy and as dose enhancers in radiotherapy. Although most GNP research in the past involved cytoplasm localized GNPs, it is predicted that therapy response can be enhanced if GNPs can be effectively targeted into the nucleus. A strategy for designing a GNP-peptide complex for targeting the nucleus will be presented. Three different sequences of peptides (CKKKKKKGGAGDMFG, CGGRKKRRGRRRAP, CALNN) were conjugated onto GNPs. The first peptide was used to stabilize the complex, the second peptide to enhance uptake into the cell, while the third peptide was used to induce nuclear delivery. With nuclear targeting, more damage can be caused to the DNP of cancer cells upon irradiation. This research will establish a more successful NP-based platform that combines treatment modalities and more effectively approach cancer treatment.


Benign paroxysmal positional vertigo (BPPV) is one of the most common disorders that causes dizziness. The incidence of horizontal semicircular canal (HSC) BPPV ranges from 5% to 40.5% of the total number of BPPV cases diagnosed. Several studies have focused on establishing methods to treat BPPV caused by the apogeotropic variant of the HSC, namely, the Appiani maneuver (App). In 2016, a new maneuver was proposed: the Zuma e Maia maneuver (ZeM), based on inertia and gravity. The aim of this study is to analyze the efficacy of App versus ZeM in the resolution of episodes of BPPV produced by an affectation of the horizontal semicircular canal with apogeotropic nystagmus (Apo-HSC). A retrospective, quasi-experimental study was conducted. Patients attended in office (November 2014–February 2019) at a third-level hospital and underwent a vestibular otoneurology assessment. Those who were diagnosed with Apo-HSC, treated with App or ZeM, were included. To consider the efficacy of the maneuvers, the presence of symptoms and/or nystagmus at the first follow up was studied. Patients classified as "A" were those with no symptoms, no nystagmus; "A/N+": no symptoms, nystagmus present during supine roll test; "S": symptoms present. Previous history of BPPV and/or otic pathology and calcium levels were also compiled. From the 54 patients included, 74% were women. The average age was 69. Mean follow-up: 52.51 days. In those patients without previous history of BPPV (n = 35), the probability of being group "A" was 63% and 56% (p = 0.687) when treated with App and ZeM, respectively, while being "A/N+" was 79% and 87% for App and ZeM (p = 0.508). Of the 19 patients who had previous history of BPPV, 13% and 64% were group "A" when treated with App and ZeM (p = 0.043), and 25% and 82% were "A/N+" after App and ZeM, respectively (p = 0.021). In conclusion, for HSC cupulolithiasis, ZeM is more effective than App in those cases in which there is a history of previous episodes of BPPV ("A": 64% (p = 0.043); "A/N+": 82% (p = 0.021)).


Images that are obtained in the real world in low contrast are inappropriate for human eyes to read the medical images. Enhancement and segmentation have an important role to play in digital image processing, pattern recognition, and the computer vision. Here, this paper presents an effective way of changing histograms and improving contrast in digital images. Segmentation is done on AGCWD enhanced images. Histogram equalization is an important technique for contrast enhancement. Nevertheless, modern Histogram Equalization commonly results in unnecessary contrast enhancement, which in turn offers an un-natural presence to the processed image and produces visual artifacts. We present an automated transformation technique that helps boost dimmed image brightness by gamma correction and weighted distribution, commonly known as Adaptive Gamma Correction Weighted Distribution (AGCWD). The contrast enhancement level can be modified using this technique; noise robustness, white or black stretching, and the protection of medium brightness can be easily integrated into the optimization process. Finally, a contrast enhancement algorithm with low complexity is introduced. All the process of enhancement will be done during the process of pre-processing the image. Later, in post-processing, we introduce a specific level set method known as ORACM for better segmentation of an enhanced AGCWD image, and it is compared with the traditional level set method.


Abstract:This article is about representations of poverty and governmental frameworks for addressing poverty in postapartheid South Africa. It is, therefore, also about "the poor," about their place in society and the ways they intervene in the making of the present. The article returns to a South African metaphor—Thabo Mbeki's "two economies" thesis—focused on the problem of poverty, its causes, and the governmental approach to combating it. This discussion shows how the work of Partha Chatterjee helps us understand the governmental problems Mbeki's representations reframe and their relationship to forms of contemporary capitalism and governmentality, as well as the emerging practices through which the poor "invade" the political and impact the frameworks targeting them. But the essay also suggests that, in following these threads, we need to push beyond Chatterjee's conceptual framework, with implications for how we think about the state, its relationship to capitalist development, and the political practices of subaltern classes.


Rising sea level poses significant challenges to infrastructure and populations, particularly for coastal [Heberger et al., 2009] and island communities [Webb and Kench, 2010] in the North Pacific where population density at or near coastal waters is high. A significant portion of the United States' security, commerce, and ecosystem assets are located at or near the coast, making them vulnerable to sea level rise. Although global mean sea level (MSL) rise is a fundamental consideration, regional mean sea level (RSL) height variability within ocean basins and along their boundaries can be more critical, particularly in the North Pacific where the amplitude of inter-annual variability is high.


The Internet's inter-domain routing infrastructure, provided today by BGP, is extremely rigid and does not facilitate the introduction of new inter-domain routing protocols. This rigidity has made it incredibly difficult to widely deploy critical fixes to BGP. It has also depressed ASes' ability to sell value-added services or replace BGP entirely with a more sophisticated protocol. Even if operators undertook the significant effort needed to fix or replace BGP, it is likely the next protocol will be just as difficult to change or evolve. To help, this paper identifies two features needed in the routing infrastructure (i.e., within any inter-domain routing protocol) to facilitate evolution to new protocols. To understand their utility, it presents D-BGP, a version of BGP that incorporates them.


To measure the degradation of carbohydrates during fermentation, the photometrical Anthron method has been adapted. The method has been verified in mesophilic batch tests with the model substrates glucose (water-soluble), corn-starch and cellulose (both insoluble in water). First, the content of soluble carbohydrates was measured. For determination of carbo-hydrates in soluble phase, the samples were filtered (syringe PTFE filter with mesh size 0.45 μm) to separate the solution from all types of particles, particulate carbohydrates included. The soluble phase reacted with the Anthron solution for 8 minutes at 100 °C. Afterwards, the coloration reaction was stopped by a quick (5 min) cooling step in ice water to ensure repeatability of the method considering a larger number of samples to be measured. Afterwards samples had been equilibrated at room temperature for at least 30 minutes. Before measurement, the sample had to be diluted to reduce on the one hand the intensity of the background and on the other hand to obtain the measuring range (λ = 625 nm) of soluble carbohydrates of 10 to 100 mg/l. The total carbohydrate content, which consists of the soluble and particulate fraction, was determined by an additional pre-hydrolysis step (50% sulfuric acid at 100 °C during 8 minutes) before the Anthron reaction was started. To measure insoluble carbohydrates, e.g. starch and cellulose, they had to pass an additional pre-hydrolysis step which is performed before filtration and the subsequent Anthron reaction. This additional step (in the following called "indirect method") is necessary to measure the part of insoluble respectively polymeric carbohydrates of a sample. The amount of particulate carbohydrates is further calculated by the difference between total and soluble carbohydrates.


Sea transportation is considered as an environmentally friendly transportation option compared to other freight transportation such as airway, rail and road transport. The majority of freight transportation is completed by the sea. Moreover, emissions from ships are increasing due to the increase in trade volume and sea transportation worldwide. Due to this increase, health of people living in coastal cities is affected adversely. In this study, real-time air quality measurements of PM2.5, PM10, SO2, CO, NO and NO2 emissions are performed for three months in the Port of Ambarli located in Marmara region that has intense sea trade. The daily average values of real-time emission data measurement are shown for June, July and August 2017. Real-time measurements are received from Air Quality Monitoring Station in Avcilar district of Istanbul for the same period and same air quality measurement device. These PM2.5, PM10, SO2, CO, NO and NO2 emission values are compared with the limit values of air quality in Europe and Turkey. As a result, PM2.5, PM10, SO2, CO, NO and NO2 measurements are under air quality limit value set by Europe and Turkey for the Port of Ambarli based on values obtained from Avcilar and Kadikoy.


The objective of this study was to provide a unique insight into the relationship between ketosis and fat cow syndrome using clinical-chemical parameters, serum lipoproteins and histopathological changes of the liver. The cholesterol and protein concentrations were significantly lower in the ketotic cows (p<0.05) than in the controls. The glucose and HDL-cholesterol levels were significantly lower in the ketotic cows (p<0.01) than controls.The total bilirubin, CPK levels (p<0.05), and direct bilirubin, albumin levels (p<0.01) were significantly higher in the than controls. The percentage of fatty in filtration of the liver parenchyma varied from 27 to 42 percent in seven ketotic caws and was 13 per cent in one ketotic cow. In light of this a relationship was established between postpartum clinical ketosis and fat cow syndrome.


The purpose of the present review was to provide an up-to-date summary of the bio ecological theory in sport literature. Systematic reviews can facilitate decision-making in areas where randomized control trials (RCTs) have not been performed or are in-appropriate. In order to appreciate the status of current knowledge and understanding and to identify potential future directions, the authors conducted a synthesis of published work in sports science using a systematic-review methodology. Published since 1977, Bronfenbrenner's model of human development provided an ecological lens for identifying and synthesizing barriers to sport participation. From a search of electronic databases, findings comprised 1120 identified records, from which only 896 entries were considered. From these a total of 183 published studies relating to the bioecological theory and sports science were assessed, and from this point only articles pertaining to sport related issues were taken into consideration (n = 89) exclud-ing other types of documents (n = 94). The Systematic Review (SR)develops upon these 89 articles and a total of 23 articles were selected for the fourth and final re-trieval. A semi quantitative review protocol and standard quality assessment criteria-have dominated the research. The authors conclude by summarizing the key findings in the literature and highlighting the gaps that could be filled by future research. Word count : 4,323


We propose a method to improve speaker recognition lexical model performance using acoustic-prosodic information. More specifically, the lexical model is trained using durationand pronunciation-conditioned word N-grams, simultaneously modeling lexical information along with their acoustic and prosodic characteristics. Support vector machines are used for modeling and scoring, with N-gram frequency vectors serving as features. Experimental results using NIST Speaker Recognition Evaluation data sets show that this method outperforms the regular word N-gram-based lexical models. Furthermore, our approach gives additional information when combined with a high-accuracy acoustic speaker model. We believe that this is a promising step toward integrated speaker recognition models that combine multiple types of high-level features.


BACKGROUND
Treatment of de novo metastatic breast cancer is usually centered around systemic therapy, with local therapy (surgery and radiation therapy) largely reserved for palliation in patients with significant symptoms from primary tumour. The efficacy of locoregional treatment like surgery and/or radiotherapy is still controversial and the debate about surgical resection of primary tumor (PT) in de novo metastatic breast cancer (MBC) patients persists.

METHODS
All patients with de novo MBC undergone surgical treatment between January 2015 and January 2020 at the Multidisciplinary Breast Center of the Fondazione Policlinico Universitario A. Gemelli IRCCS in Rome were included in this study. The primary endpoint was overall survival (OS) after PT resection, the secondary endpoint was progression free survival (PFS). The survival analyses were done using Kaplan-Meier method. Patients and tumour characteristics were analyzed in an exploratory modality in order to identify prognostic factor.

RESULTS
45 patients received resection of the primary breast cancer (26 mastectomy and 19 breast conserving surgery). Median age of diagnosis was 53 years old (range 25-75 years old). Median follow-up was 25.67 months. The median OS was not reached with 75% of patients alive over 2 years from PT resection. The median PFS was not reached with 64% of patients alive over 2 years from PT resection. For both PFS and OS only the triple negative (TN) immunophenotype appears to be a prognostically unfavorable factor in multivariate analysis.

CONCLUSIONS
In view of the low number of disease progression events and deaths, although our results are preliminary, surgical treatment of primary breast cancer in metastatic setting seems to be an option after systemic therapies in luminal and HER2 positive breast cancer. Randomized prospective trials in for each immunophenotype are necessary order to confirm this evidence.


: Acute embolic renal artery occlusion is usually clinically typical. In case of early diagnosis, an in situ thrombolysis may be effective. As thrombosis often progressively completes a severe renal artery stenosis, the classical clinical description of renal infarction (lumbar pain, hematuria) is frequently not present. The kidney parenchyma downstream from the renal arterial occlusion is not always irreparably lost: collateral circulation may preserve nephron viability, which requires a lower perfusion pressure than glomerular filtration. An iodine, isotopic, or MR gadolinium nephrogram may prove this viability. Over the last 10 years, we attempted 21 percutaneous recanalizations of renal artery occlusion. Mean patient age was 62 years (44-85). All were hypertensive. Serum creatinin level of 17 patients was above 130 micromoles/ml. Three patients were previously hemodialysed. We observed 8 failures, without any complication. Thirteen immediate technical successes occurred, but one rethrombosis occurred at Day 1. Immediate complications were seen in 2 patients: 1 acute pulmonary edema, 1 puncture site false aneurysm. The mean follow up of the 12 technical successes was 26 months (18-60). One rethrombosis occurred at 6 months. Hypertension was unchanged in 4 patients and improved in 8. In all patients with renal insufficiency, a significative improvement of serum creatinine level was observed. It was possible to discontinue hemodialysis in the 3 patients previously hemodialysed. One predictive factor of success was recognized: a short delay (shorter than 90 days) between occlusion and recanalization. Percutaneous recanalization must be proposed in case of renal artery occlusion, especially to avoid vascular azotemia and dialysis, even if the kidney fed by the occluded artery is small.


textabstractDuring the last decades, the EU has actively encouraged and pursued the digitalisation of European procedures at various levels (e.g. use of technology in court proceedings, dedicated online portals, digital handling of European procedures). In building an EU e-justice system to facilitate and support cross-border litigation, law and technology need to be properly assembled in a common system interconnecting national and European systems. This paper explores the complexity digitisation of cross-border procedures involves and the coevolution of the components on which such an e-justice system rely. In this process, the European uniform procedures – the European Order for Payment and the European Small Claims Procedure – have been used to test the possibilities of full digital handling of procedures as they can support the use of electronic communication means at various stages of the proceedings. Developing an EU e-justice system is not without problems as digitisation is a complex process that can facilitate as well as limit access to justice. The interaction between the requirements of law and technology has a major effect for the complexity the system needs to handle. The e-Justice Portal and the e-CODEX tests also reveal the difficulty of interaction between multiple legal and institutional frameworks as well as different national e-justice architectures. In this process of building an EU e-justice system, complexity and evolvability of law and technology have to be considered in order to allow the adaptation of the system over technical developments and legislative amendments. This analysis seeks to address the importance of these aspects in the architecture of a sustainable and reliable cross border e-justice system.


We investigate the possibility of leveraging side information for improving quality control over crowd-sourced data. We extend the GLAD model, which governs the probability of correct labeling through a logistic function in which worker expertise counteracts item difficulty, by systematically encod- ing different types of side information, including worker in- formation drawn from demographics and personality traits, item information drawn from item genres and content, and contextual information drawn from worker responses and la- beling sessions. Modeling side information allows for better estimation of worker expertise and item difficulty in sparse data situations and accounts for worker biases, leading to bet- ter prediction of posterior true label probabilities. We demon- strate the efficacy of the proposed framework with overall improvements in both the true label prediction and the un- seen worker response prediction based on different combina- tions of the various types of side information across three new crowd-sourcing datasets. In addition, we show the framework exhibits potential of identifying salient side information fea- tures for predicting the correctness of responses without the need of knowing any true label information.


A statistical thermodynamics approach to the temporal development of biological regulation provides a phenomenological description of the dynamical behavior of genome expression in terms of autonomous self-organization with a critical transition (Self-Organized Criticality: SOC). In early mouse embryo development, the dynamical change in the self-organization of overall expression determines how and when reprogramming of the genome-expression state occurs. Reprogramming occurs via a transition state (climbing over an epigenetic landscape), where the critical-regulation pattern of the zygote state disappears. A critical transition is well captured in terms of the bimodality of expression ensembles, which reflects distinct thermodynamic states (critical states). These critical states exhibit a genome avalanche pattern: competition between order (scaling) and disorder (divergence) around a critical point. The genome avalanche in mouse embryo development, which is committed to erase a previous ordered state, reveals that the direction of early embryo single-cell development traverses the same steps as in differentiation, but in the opposite order of self-organization.


Between 2014 and 2018, two million students and staff in higher education undertook a learning, training or teaching period abroad with the new Erasmus+ programme. The objective of the study was to assess the impact of Erasmus+ mobilities on staff, students and higher education institutions. It was based on almost 77,000 survey responses from these groups.


Results of a 1200V 4H-SiC vertical DMOSFET based on ion implanted n+ source and pwell regions are reported. The implanted regions are activated by way of a high temperature anneal (1675°C for 30 min) during which the SiC surface is protected by a layer of graphite. Atomic force microscopy shows the graphite to effectively prevent surface roughening that otherwise occurs when no capping layer is used. MOSFETs are demonstrated using the graphite capped anneal process with a gate oxide grown in N2O and show specific on-resistance of 64 mW×cm2, blocking voltage of up to 1600V and leakage current of 0.5–3 ´10-6 A/cm2 at 1200V. The effective nchannel mobility was found to be 1.5 cm2/V×s at room temperature and increases as temperature increases (2.8 cm2/V×s at 200°C).


This study presents a new concept for single-phase diode bridge rectifier circuits applied to automotive applications. The proposed circuit is able to enhance the output voltage to a much higher output level over a wide load range compared to the classical single-phase diode bridge rectifier without using complex control algorithms. This is achieved by embedding two capacitors and two switches to a new designed diode bridge converter topology. The embedded capacitors are charged and discharged simultaneously with the help of two switches. The embedment of the capacitors and switches will provide two functions: energy storage as known from traditional rectifier circuits and voltage oscillation with the supply inductance to reduce supply current distortion. The switches are on/off event triggered and do not require any complex control algorithms. The operation and the performance of the proposed rectifier are simulated using Matlab/Simulink software. Experimental results are obtained from a 1 kW prototype test circuit, which is used to evaluate the performance of the proposed circuit. Test results show a significant increase in the output voltage in addition to a reduced supply current distortion.


Massive Radio Frequency Identification (RFID) datasets are expected to become commonplace in supply-chain management systems. Warehousing and mining this data is an essential problem with great potential benefits for inventory management, object tracking, and product procurement processes. Since RFID tags can be used to identify each individual item, enormous amounts of location-tracking data are generated. Furthermore, RFID tags can record sensor information such as temperature or humidity. With such data, object movements can be modeled by movement graphs, where nodes correspond to locations, and edges record the history of item transitions between locations and sensor readings recorded during the transition. This chapter shows the benefits of the movement graph model in terms of compact representation, complete recording of spatio-temporal and item level information, and its role in facilitating multidimensional analysis. Compression power and efficiency in query processing are gained by organizing the model around the concept of gateway nodes, which serve as bridges connecting different regions of graph, and provide a natural partition of item trajectories. Multi-dimensional analysis is provided by a graph-based object movement data cube that is constructed by merging and collapsing nodes and edges according to an application-oriented topological structure. DOI: 10.4018/978-1-60566-328-9.ch003


Abstract Since 2004 it was allowed to inform all pregnant women on the possibility of having a screening test for DS, with the first-trimester combined test (maternal serum concentrations of pregnancy-associated plasma protein A (PAPP-A) and the free beta subunit of human chorion gonadotrophin (f?-hCG) between 8-14 weeks of the pregnancy, first-trimester ultrasound measurement of the fetal nuchal translucency and maternal age) as test of choice. Since January 2007, a nationwide screening program is running. Currently, 24% of all pregnant women are involved in the screening for Down syndrome. The detection rate for the first-trimester combined test during the period 2004 - 2006 was 75.9% at a cut-off level of 1 in 250 at term, with a screen-positive rate of 3.3%. The performance of the first-trimester test has improved over the years, but there is still room for further improvements. There is growing evidence that the first-trimester test can also be put to use for a broader screening for foetal and maternal health, including trisomy 13 and 18, preeclampsia (PE), preterm birth, growth restriction, fetal death. New markers emerge such as A Desintegrin And Metalloproteinase 12 (ADAM12), Placental Protein 13 (PP13) and Placental Growth Factor (PlGF), these have been associated with placental growth and development. Altered levels of these markers have been reported to be associated with chromosomal abnormalities, fetal growth restriction and maternal PE. For example, ADAM12 values were clearly reduced early in the first-trimester for all trisomies and PP13 and PlGF were reduced in early-onset PE. The search for new potential markers that are capable of detecting the presence of pathological conditions early in pregnancy with a high sensitivity and specificity is still a major challenge. Accurate prediction of these pathologies is crucial for prenatal diagnostic testing, for adequate monitoring of pregnancies at risk for hypertensive and other diseases and for the development of preventive treatment strategies to improve maternal and perinatal outcome. While screening for DS currently has a low uptake, it may be anticipated that a more generic approach to screening as "screening for fetal and maternal health", may be more preferred by the pregnant women. We will then facilitate 'a la carte' screening, with pregnant women opting in for e.g. screening for preeclampsia or maternal health, trisomy 13 and 18, and may be choosing not to be informed about the DS risk, as a child with DS might be welcome in their family. This research has delivered some of the elements (screening for other pregnancy complications like trisomie 13 and 18, PE, macrosomia in gestational diabetes pregnancies) of such a new screening program.


Objective: to evaluate the tendency and polarization of dental caries in children 4-5 years of age, between 2006 and 2014. Method: this is a comparison of two similar cross-sectional studies that included 226 children each year. Clinical data were collected according to the criteria proposed by the World Health Organization (WHO). A previously validated questionnaire was administered to parents or guardians of children, in order to obtain data related to family income. Results: 32.7% of children in 2006 and 35% in 2014 had at least one decayed tooth. The dmft index was 1.25 in 2006 and 1.40 in 2014, with no statistically significant difference (p> 0.05). It was verified that there is a higher concentration of dental caries in populations of lower economic status (p <0.05) for the years of analysis. Conclusion: the caries prevalence showed a tendency to remain constant after eight years of the baseline. Thus, the disease showed polarized, indicating a higher concentration of children whose families had worse socioeconomic conditions.