Background - Implantable cardioverter defibrillators (ICDs) are recommended for patients at high risk of sudden cardiac death or for survivors of cardiac arrest. All ICDs combine a shock function with a pacing function to treat fast and slow heart rhythms, respectively. The pacing function may be very sophisticated and can provide so-called cardiac resynchronisation therapy for the treatment of heart failure using a pacemaker (cardiac resynchronisation therapy with pacemaker) or combined with an ICD [cardiac resynchronisation therapy with defibrillator (CRT-D)]. Decision-making about these devices involves considering the benefit (averting sudden cardiac death), possible risks (inappropriate shocks and psychological problems) and the potential need for deactivation towards the end of life.

Objectives - To explore patients'/relatives' and clinicians' views/experiences of decision-making about ICD and CRT-D implantation and deactivation, to establish how and when ICD risks, benefits and consequences are communicated to patients, to identify individual and organisational facilitators and barriers to discussions about implantation and deactivation and to determine information and decision-support needs for shared decision-making (SDM).

Data sources - Observations of clinical encounters, in-depth interviews and interactive group workshops with clinicians, patients and their relatives.

Methods - Observations of consultations with patients being considered for ICD or CRT-D implantation were undertaken to become familiar with the clinical environment and to optimise the sampling strategy. In-depth interviews were conducted with patients, relatives and clinicians to gain detailed insights into their views and experiences. Data collection and analysis occurred concurrently. Interactive workshops with clinicians and patients/relatives were used to validate our findings and to explore how these could be used to support better SDM.

Results - We conducted 38 observations of clinical encounters, 80 interviews (44 patients/relatives, seven bereaved relatives and 29 clinicians) and two workshops with 11 clinicians and 11 patients/relatives. Patients had variable knowledge about their conditions, the risk of sudden cardiac death and the clinical rationale for ICDs, which sometimes resulted in confusion about the potential benefits. Clinicians used various metaphors, verbal descriptors and numerical risk methods, including variable disclosure of the potential negative impact of ICDs on body image and the risk of psychological problems, to convey information to patients/relatives. Patients/relatives wanted more information about, and more involvement in, deactivation decisions, and expressed a preference that these decisions be addressed at the time of implantation. There was no consensus among clinicians about the initiation or timing of such discussions, or who should take responsibility for them. Introducing deactivation discussions prior to implantation was thus contentious; however, trigger points for deactivation discussions embedded within the pathway were suggested to ensure timely discussions.

Limitations - Only two patients who were prospectively considering deactivation and seven bereaved relatives were recruited. The study also lacks the perspectives of primary care clinicians.

Conclusions - There is discordance between patients and clinicians on information requirements, in particular the potential consequences of implantation on psychological well-being and quality of life in the short and long term (deactivation). There were no agreed points across the care pathway at which to discuss deactivation. Codesigned information tools that present balanced information on the benefits, risks and consequences, and SDM skills training for patients/relative and clinicians, would support better SDM about ICDs.

Future work - Multifaceted SDM interventions that focus on skills development for SDM combined with decision-support tools are warranted, and there is a potential central role for heart failure nurses and physiologists in supporting and preparing patients/relatives for such discussions.


Abstract Introduction: The International Classification of Functioning, Disability and Health (ICF) Core Set for Vocational Rehabilitation is an application of the ICF of the World Health Organization with the purpose of identifying problems and resources relevant for people in a vocational rehabilitation given a health condition. Objective: The objective of the study was to validate the Comprehensive ICF Core Set for Vocational Rehabilitation from the perspective of patients with spinal cord injury (SCI). The specific aims were to explore the aspects of functioning and health important to patients with SCI regarding return to work and to examine to what extent these aspects are represented by the current version of the Comprehensive ICF Core Set for Vocational Rehabilitation. Methods: Focus group interviews were conducted. The sampling of patients followed the maximum variation strategy. Sample size satisfied saturation criterion. The focus groups were digitally recorded and transcribed verbatim. The meaning condensation procedure was used for the data analysis. After qualitative data analysis, the resulting concepts were linked to ICF categories according to established linking rules. Results: Twenty-four SCI patients participated in seven focus groups. Sixty-three ICF categories out of 90 ICF categories contained in the Comprehensive ICF Core Set for Vocational Rehabilitation were reported by the patients. Forty-two additional categories that are not covered in the Comprehensive ICF Core Set for Vocational Rehabilitation were found but adding the health condition-specific ICF Core Set for SCI in long-term context, only 11 categories were not covered. Conclusions: The existing version of the Comprehensive ICF Core Set for Vocational Rehabilitation was confirmed almost entirely by the focus groups to explore the vocational situation of patients with SCI. Implications for Rehabilitation Validation of the ICF Core Set for Vocational Rehabilitation as a useful tool to facilitate social reintegration and rehabilitation of patients with SCI. Return to work is a key outcome in vocational rehabilitation of patients with SCI including those who are young with long-term employment prospects. The results of this study could provide a foundation in utilizing the ICF Core Set for Vocational Rehabilitation to guide rehabilitation goals, service planning and evaluation, and fostering an engaging relationship with employers in the context of SCI rehabilitation. SCI patients have specific needs, not entirely covered by the both ICF Core Set for SCI long-term context and for Vocational Rehabilitation. Our results underline some of the second level categories, probably related to specific SCI impairment, which can be useful to plan specific rehabilitation programs to improve the return to work after SCI.


Three different issues are discussed in this thesis, which aim for a deeper understanding of Cu(In,Ga)Se2 material properties and solar cell functionality: (1) Near-surface ion implantation in Cu(In,Ga)Se2 absorber layers is studied as a method for the fabrication of buffer-free solar cells. Simulations show the beneficial effect of an n-type surface layer (buried junction). To obtain an inversion by means of ion implantation, an annealing procedure is developed that avoids annealing-induced degradation of the cell, minimizes the diffusion of the ions, and recovers the implantation damage. Buffer-free solar cells made from implanted absorbers show strongly improved diode characteristics comparable to the ones of cells with a CdS buffer and a maximum efficiency of 10.2% (11.2% active area). (2) A model is developed for the application of luminescence techniques on band-gap graded semiconductor thin-films. Several DA-emissions are detected in the cathodoluminescence (CL) and photoluminescence (PL) spectra of Ga-graded in Cu(In,Ga)Se2 and related to the local Ga-contents in the layer. The depth-distribution of the luminescence signal is correlated to the band-gap profile. Drift of excited charge carriers towards the band-gap minimum is caused by the grading-induced quasi-electric field, which must be considered when explaining the spectra obtained in plan-view measurements. Monochromatic CL imaging on cross-sections is capable to determine the minority carrier mobility. (3) An increase of the substrate temperature from the standard value of 530°C to 610°C, which was possible only using specially developed Na-containing high-temperature resistant glass, is shown to strongly influence the formation of the Cu(In,Ga)Se2 absorber layers. The higher temperature leads to an increased vertical and lateral homogeneity, an increase of the grain size, a decrease of the losses at the p-n-junction and, as a consequence, a considerable increase of the solar cell efficiency up to 19.4%.


Abstract Asking effective questions has been considered to be one of the most important indicators of good teaching since questioning is an important instructional tool and the ability to ask effective questions requires sophisticated pedagogical reasoning. Teachers can facilitate students' higher-level thinking through effective questions. However, teachers' utilization of effective and higher-level questions is usually limited in traditional settings. The goal of this study is to investigate how secondary mathematics teachers' knowledge and skills of questioning change when they are engaged in professional development activities based on the modeling perspective. The program included five cycles each of which lasted a month. Each cycle consisted of meetings before and after the implementation of a model-eliciting activity and its implementation. The results showed that the professional development program had a positive effect on teachers' ability to ask qualitatively different questions in order to move students' thinking forward.


BACKGROUND Liver transplantation (LT) presents a curative treatment option in patients with early stage hepatocellular carcinoma (HCC) who are not eligible for resection or ablation therapy. Due to a risk of up 30% for waitlist drop-out upon tumor progression, bridging therapies are used to halt tumor growth. Transarterial chemoembolization (TACE) and less commonly stereotactic body radiation therapy (SBRT) or a combination of TACE and SBRT, are used as bridging therapies in LT. However, it remains unclear if one of those treatment options is superior. The analysis of explant livers after transplantation provides the unique opportunity to investigate treatment response by histopathology. AIM To analyze histopathological response to a combination of TACE and SBRT in HCC in comparison to TACE or SBRT alone. METHODS In this multicenter retrospective study, 27 patients who received liver transplantation for HCC were analyzed. Patients received either TACE or SBRT alone, or a combination of TACE and SBRT as bridging therapy to liver transplantation. Liver explants of all patients who received at least one TACE and/or SBRT were analyzed for the presence of residual vital tumor tissue by histopathology to assess differences in treatment response to bridging therapies. Statistical analysis was performed using Fisher-Freeman-Halton exact test, Kruskal-Wallis and Mann-Whitney-U tests. RESULTS Fourteen patients received TACE only, four patients SBRT only, and nine patients a combination therapy of TACE and SBRT. There were no significant differences between groups regarding age, sex, etiology of underlying liver disease or number and size of tumor lesions. Strikingly, analysis of liver explants revealed that almost all patients in the TACE and SBRT combination group (8/9, 89%) showed no residual vital tumor tissue by histopathology, whereas TACE or SBRT alone resulted in significantly lower rates of complete histopathological response (0/14, 0% and 1/4, 25%, respectively, P value < 0.001). CONCLUSION Our data suggests that a combination of TACE and SBRT increases the rate of complete histopathological response compared to TACE or SBRT alone in bridging to liver transplantation.


State-of-charge (SOC) is a crucial battery quantity that needs constant monitoring to ensure cell longevity and safe operation. However, SOC is not an observable quantity and cannot be practically measured outside of laboratory environments. Hence, machine learning (ML) has been employed to map correlated observable signals such as voltage, current and temperature to SOC values. In recent studies, deep learning (DL) has been a prominent ML approach outperforming many existing methods for SOC estimation. However, yielding optimal performance from DL models relies heavily on appropriate selection of hyperparameters. At present, researchers relied on established heuristics to select hyperparameters through manual tuning or exhaustive search methods such as grid search (GS) and random search (RS). This results in lengthy development time in addition to less accurate and inefficient models. This study proposes a systematic and automated approach to hyperparameter selection with a Bayesian optimization strategy known as Tree Parzen Estimator (TPE). The TPE optimization is run on various DL models such as BGRU, GRU, LSTM, CNN, FCN and DNN to optimize for the best hyperparameter combination for each architecture. The proposed model BGRUTPE achieves the lowest RMSE and MAE error at 0.8% and 0.56% respectively on various electric vehicle drive cycles at varying ambient temperatures and maintains a low computational cost at 15,600 FLOPS with model size of 193.3 kilobytes.


The year 2020 has seen some unprecedented adjustments to life and work. Natural disasters are common, but the world-wide pandemic has gripped the world economy, schooling, and mobility to a suffocating level. But the collective human spirit is not easily smothered. Life goes on as we have found new ways to cope with life and work within the limited boundaries of home or living space. This second issue for 2020 is dedicated to the writers who kept going through these challenging times with their research and have contributed to the knowledge base of their respective disciplines. The 11 articles in this issue provide fascinating insights to readers in the areas of business, education, and health.Compliance with the financial policy of Adventist schools in Thailand is the focus of the primary quantitative study of Hamra and Namkote. Interestingly, some areas of flaws in policy compliance were identified that seem to match with the typical problems within many schools the world over. The problems presented also come with solutions as related to the findings. Next comes Regalado's study using photovoice, providing insightful views on quality public school education in the Philippines as portrayed by teachers. The expressions of "obfuscate" and "faceless" seem to dominate the realities of life even as these teachers look to a hopeful future for education.The primary study of Ngussa and Mpwani takes one to the area of curriculum within the theological field. Through this quantitative study, stakeholders' voice was sought regarding the curriculum components that are seen as relevant. The qualitative study of Gwizo and Gaikwad focuses on the lifestyle practices of university students in Zimbabwe through a holistic approach. Valuable findings to improve lifestyle practices are presented that can impact the academic performance of university students.Two qualitative case studies come from the Kingstons (husband and wife). The first deals with international students' relationships in a residential context. The multicultural set up provides both pros and cons in human interactions that are captured carefully to encourage a collegial and enriching relationship. The second study focuses on balancing the personal life and social responsibility of faculty members in higher education. Though faculty members seem to experience a great deal of tension in juggling personal and social responsibilities, they have found various means to manage these tensions.Tejero, Mancia, and Padagas' multi-design study portrays the healing impact of creative arts on children affected by Marawi siege in the Southern Philippines. The study found the role of community in creating resilience. Wa-Mbaleka discusses in his academic essay, Changing Lives through Qualitative Research: Some Practical Principles and Practices—useful guidelines for promoting qualitative research as advocacy in uplifting the voiceless individuals. He presents challenges as well as ways to promote such advocacy.Petre's action research in Romania resulted in a processes model for implementing cooperative learning in higher education. Using this model resulted in positive outcomes in the areas of students' leadership skills. The next article by Saban and Saban presented a quantitative study on the national service training program (NSTP) of Filipino students in a university setting. A heightened level of civic responsibility was evidenced among the participants who experienced the NSTP. The final article of Irembere and Lubani's presents a timely study on transitioning to remote learning due to Covid-19. This qualitative case study provides interesting insights on such transition experiences of students in higher education.The concerns discussed in the articles are both timely and relevant in higher education. As you read through the articles, consider ways you can adjust and enhance the life situation you are in at this moment. Consider ways that this issue of InFo can help you generate related studies and enrich the lives of others.


Objectives The prognosis of head and neck cancer (HNC) depends substantially on disease stage at the time of diagnosis. Unfortunately, the majority of HNC patients present at relatively late stages. In Oman, a national screening campaign was conducted to increase public awareness of HNC and encourage early detection. This study aimed to report the outcomes of that campaign. Methods The campaign took the form of biannual events conducted at a tertiary care centre and in public malls in Muscat, Oman from April 2015 to July 2019. Data were collected from participants using the Head and Neck Cancer Alliance screening form. Otolaryngologists and oral maxillofacial surgeons performed a thorough physical evaluation of the head and neck region. Results Of the 1,500 individuals visiting the hospital and malls during the campaign events, a total of 509 agreed to undergo screening (response rate: 33.9%). Of these, 12.8% had positive screening results and 5.9% required further evaluation. However, none of the cases with suspicious findings were found to be malignant after a thorough evaluation. Overall, 16.9% of the participants were aware of the early signs of HNC; in addition, 5.5% knew how to perform an oral self-examination. Conclusion Screening is a simple and safe method for the prevention and early detection of HNC. Mass screening and public awareness programmes may help to reduce the burden of this disease in Oman.


The action of hepatic chalone on cell proliferation in inoculated hepatoma 22a of mice was studied in the presence of a changed level of glucocorticoid hormones in experimental animals. Chalone was obtained from the liver of intact rats by ethanol precipitation. The intensity of cell proliferation in hepatoma was evaluated by the colcemide and autoradiography methods. Six hours after chalone injection c-mitosis in the tumor decreased 2.7-fold, and the DNA index 6.8-fold. It may be concluded that the preparation used contains both G1- and G2-chalones. Single or repeated injections of hydrocortisone to mice inhibits cell proliferation to a less degree than administration of chalone alone. Combination of hydrocortisone and chalone produces the same effect as injection of chalone alone. Adrenalectomy diminishes susceptibility of hepatoma cells to exogenous chalone. The degree of tumor proliferative activity in the adrenalectomized animals was half as much after chalone injection, as compared to that in intact animals. Thus, a certain level of glucocorticoid hormones in hepatoma tissue is necessary to reveal the action of chalones.


The present study assessed the impact of one of the dimension of parenting practices, that is, parent- adolescent communication and its influence on the development of delinquent behavior. The data was collected from 200 adolescents (100 delinquents and 100 non- delinquents) aged 11- 18 years. Results indicated that there exists a significant difference between delinquent and non- delinquent adolescents, in their perception of satisfactory parental communication. Further analyses revealed that both mother's and father's separate communication as well as their interaction effect was linked to the development of delinquent behavior. It was further noted that a satisfactory mother- adolescent communication was much more important compared to the father- adolescent communication in the present context. Furthermore, age of the adolescent was also related to delinquency and it was observed that early adolescence was a richer breeding ground of delinquency, although a satisfactory parental communication was crucial all throughout the adolescent period to serve as a protective factor against delinquency. The theoretical and practical implications of the findings are discussed.


Extensible Markup Language (XML) has been widely used as a middleware because of its flexibility. Fixed domain is one of the bottlenecks of Information Extraction (IE) technologies. In this paper we present a XML-based domain-adaptable bootstrapping method of pattern acquisition, which focuses on minimizing the cost of domain migration. The approach starts from a seed corpus with some seed patterns; extends the corpus based on the seed corpus through the Internet and acquires the new patterns from extended corpus. Positive and negative examples classified from training corpus are used to evaluate the patterns acquired. The result shows our method is a practical way in pattern acquisitions.


Black, Brian. Petrolia: The Landscape of America's First Oil Boom. Baltimore: Johns Hopkins University Press, 2000. In his book, Brian Black has revisited the oil fields of western Pennsylvania, the site of the first US industrial boom towns in the 1860s and 1870s, with the sensibility of a modern historian of cultural landscapes. The author offers us a multilayered portrait of this area, which seeks to capture the energy and danger of early oil exploration and to understand the myths of progress and opportunity that Americans wove in response to this new phenomenon. Besides providing a description of technological and administrative innovations and a basic account of the events and personalities that stand out in the story of Petrolia's rise and fall, Black seeks to understand how Americans turned the utter destruction of a peaceful rural valley and its communities into a cause for national celebration. Why did we get "oil on the brain", as a popular song called it, and how did it fuel support for what Black calls a "culture of massive disturbance" that created this "sacrificial landscape?" (Text adapted from an H-Net review by Robert Rakoff .) Brian Black is professor of history and environmental studies at Penn State University's Altoona College.


Community-based safety action projects, replications of the model developed in Surfers Paradise designed to reduce violence and disorder in licensed environments in city entertainment areas, were implemented in three diverse North Queensland cities (Cairns, Townsville and Mackay). The change model is based on prior experience with community interventions, the theory of situational crime prevention, and the theory of responsive regulation. The interventions took place in each city during 1995 and early 1996. The results are based on unobtrusive direct observations by patron-observers of aggression, drinking, and management practices in licensed venues in September 1994 and October 1996. There was a decline of 56% in all aggressive and violent incidents, and a decline of at least 75% in physical assaults, but conclusions concerning direct causality cannot be drawn. These declines, which did not differ significantly between cities, coincided with marked improvements in host responsibility practices and a decline in male drunkenness.


Purpose Available surgical procedures in the first stage of the palliation of hypoplastic left heart syndrome (HLHS) are currently the Norwood procedure with Blalock‐Taussing (BT) shunt, Norwood with a Sano shunt (5.0 mm right ventricular‐pulmonary artery conduit), or a hybrid procedure combining surgical pulmonary artery band placement and catheter‐based closure of the ductus arteriosus. Following any of the three procedures, it is necessary for patients to be mechanically ventilated for a period of time; however, little is known about the differences in pulmonary function and outcome among the three groups. Methods We conducted a retrospective chart review of 14 neonates who underwent stage 1 palliation for HLHS, by hybrid procedure or Norwood procedure with BT or Sano shunts, at Phoenix Children's Hospital from September 2013‐December 2014. Demographic, hemodynamic, and outcome information was collected. Heart rate, respiratory rate, mean arterial pressure, end tidal carbon dioxide (ETCO2), cerebral and renal somatic oximetry, mean airway pressure, ratio of partial pressure of arterial oxygen to inspired oxygen (PaO2/FiO2), partial pressure of arterial carbon dioxide (PaCO2), dead space fraction (Vd/Vt), and dynamic compliance were measured preoperatively, postoperatively, and at multiple time points from 6 to 120 hours postoperatively. Respiratory data was collected using the NM3 monitor (Philips Respironics, Pittsburgh, PA). Outcome measures collected included maximum postoperative lactate, time to extubation, hospital length of stay, and mortality. Results Of the 14 patients, 7 received the Norwood with BT shunt, 5 received the Sano shunt, and 2 received the hybrid procedure. Through linear regression analysis of groups stratified by shunt size, we found that the Vd/Vt ratios of the Sano and 3.0 mm BT shunt groups were higher at earlier times points, but became indistinguishable by 48 hours postoperatively (p=0.02). Linear regression of the 3 surgical groups comparing Vd/Vt across all times points did not show any significant differences (p = 0.79). Linear regression of dynamic compliance among the three groups across all time points also was not significant (p = 0.72). No significant difference was observed in dynamic compliance across all time points when groups were stratified by shunt size (p = 0.33). Examining differences between BT and Sano groups at each time point from 0‐ 120 hours postoperatively using Mann Whitney U analysis did not reveal significance. Analysis of outcomes of length of mechanical ventilation (p=0.61), hospital length of stay (p =0.99), and mortality (p>0.99) also did not differ significantly among the 3 surgical groups. Conclusion Our study identified that the 3.0 mm BT and Sano shunt group had higher Vd/Vt ratios throughout the first 48 postoperative hours. No other differences were found in Vd/Vt or dynamic compliance when surgical groups or shunt sizes were compared. Despite the early differences noted, lack of differences in outcome measures suggests that these early differences have little influence on prognosis. Table of


A protocol is described that permits the self-selection of hydrazides from a small library by a phosphonate-target immobilized on resin. Hydrazides are captured by a neighbouring aldehyde group through reversible hydrazone bond formation. Stabilizing intramolecular interactions between the phosphonate-target and functional groups of the hydrazides drive the selection process. The phosphonate-target is introduced onto commercially available Tentagel resin through straightforward synthetic steps. The functionalized resin could be conveniently characterized by HR-MAS NMR spectroscopy using a recently developed transverse relaxation filter that eliminates the strong phase defects commonly observed with CPMG sequences. In addition, a protocol was developed to quantitatively remove the captured hydrazides from resin in order to analyse their composition by LC/MS. Kinetic experiments were used to study hydrazone formation and exchange on resin yielding similar results to those obtained previously in solution. Competition experiments showed that the system reaches thermodynamic equilibrium if multiple hydrazides are added to the resin. Finally, competition experiments showed that the immobilized phosphonate-target indeed amplifies the capture of those hydrazides able to develop stabilizing interactions with the target. Importantly, the obtained amplification profile was nearly identical to the ones obtained previously in solution studies. Notably, the observed amplification factors for the self-selected hydrazides were higher, which was attributed to steric effects imposed by the resin.


Power supply is an inevitable component for all electronic instruments as a constant DC source. Almost all power supplies use feedback loop to achieve constant DC output voltage. In a feedback loop, the galvanic isolation is required between input and output. It can be achieved either by implementation of opto-coupler feedback on the secondary side or magnetic feedback. In this paper both opto-coupler and auxiliary feed-back techniques are implemented and analyzed in a high frequency half bridge converter using coreless Printed Circuit Board (PCB) power transformer. The implementation of opto-coupler feedback is temperature sensitive and has relatively high cost. The auxiliary winding of transformer can also be used to provide feedback signals as alternate to opto-coupler. Auxiliary feedback implementation is cheaper, temperature stable and insensitive to temperature variations. In this paper, the feasibility of feedback using auxiliary winding of coreless PCB power transformer is investigated. It is observed that this technique can be used as an alternative to opto-coupler feedback.


We report the mechanical action of infrared light on atoms and molecules based on the rectification of the electric force. This mechanism is qualitatively different from the conventional ways of controlling photochemistry. The rectification of the electric force originates from the synchronous charge transfer induced by the laser field. This brings about an opportunity to produce a site selective light-induced action, controlled by the tailored intense laser field, on atoms in molecules and clusters. The concept is illustrated by ab initio molecular dynamics simulations of the water hexamer.


Monofluorophosphate (MFP) is unique in that its calcium salt is relatively soluble. Because of this property MFP can be combined with a dicalcium dihydrate (dical) abrasive in a dentifrice formulation without loss of efficacy. It has been reported that fluoride uptake by artificial lesions in enamel and dentine is significantly greater from an MFP formulation containing dical than from an equivalent calcium-free formulation. Additionally, it has been shown in an in situ remineralisation study that brushing with MFP dical significantly increases the levels of fluoride and calcium in plaque, and produces a concomitant increase in remineralisation of artificial caries lesions, as compared to brushing with MFP silica. All of the foregoing suggests that dical may enhance the benefit of MFP in a dentifrice formulation. MFP dentifrices have been tested more exhaustively in human clinical trials than any other form of fluoride dentifrice. In some trials the test formulation contained dical while in others a non-calcium abrasive system was employed. Collectively, studies of F/dical formulations have not produced more impressive results than studies of calcium-free MFP agents. However, there has never been a direct comparison of the conventional 0.76 per cent sodium monofluorophosphate dentifrice in a dicalcium phosphate abrasive system with a dentifrice containing a similar level of MFP combined with a non-calcium containing abrasive. In the closest approximation to such a study, an MFP/NaF dentifrice with a dical abrasive was compared to an MFP/NaF dentifrice with a silica abrasive system.(ABSTRACT TRUNCATED AT 250 WORDS)


Background Ultrasound-guided supraclavicular block (US-SCB) can be achieved by needle maneuvering through the plexus ensuring local anesthetic deposition. Local anesthetic deposition at the corner pocket through a single path provides competent anesthesia mainly for the lower brachial plexus trunks. Our study hypothesized that dual path provides better block quality than single-path technique. Patients and methods This was a prospective randomized blinded study performed on patients undergoing upper limb surgery under US-SCB; patients were randomly allocated into two groups: in group S 30 ml of levobupivacaine 0.5% was injected in the corner pocket and in group D 15 ml was injected in the corner pocket and 15 ml was deposited in the center of the plexus. Sensory and motor blockades were recorded every 5 min until 30 min. The primary outcome was the percentage of patients achieving sensory and motor block over time interval, and the secondary outcome was total procedure time, incidence of paresthesia, time to sensory and motor recovery, and patient satisfaction. Results A total of 100 patients were equally allocated into two groups; early initial sensory block was achieved in 60% of patients (P = 0.028) and motor block in 86% of patients (P = 0.013) in the dual-injection group at 5 and 10 min, respectively. No significant difference was found in the percentage of patients progressed to sensory and motor blocks over time (P > 0.05). Paresthesia incidence in the dual group was 52% (P = 0.042), with no neurological adverse events. Significantly shorter total procedure time was observed in the single-injection group (P = 0.043). Conclusion Single US-SCB provides effective sensory and motor surgical block with less incidence of paresthesia and shorter performance time.


This article is a short reply to Richard Epstein's comments on my article, The Questionable Use of Custom in Intellectual Property, 93 Virginia Law Review 1899 (2007). In the underlying article, I critique the general preference of courts to incorporate customary practices into intellectual property law. In this reply, I disagree with Professor Epstein's claim that custom should be dispositive in some instances to determine the scope of copyright's fair use defense. Although I observe that for some individual parties various customary practices may be cost-effective, their incorporation into the law expands the scope of copyright in ways that unreasonably limit and undervalue fair uses. Epstein's preference for private ordering is flawed, at least in the IP context, because suboptimal customs will develop due to market inequalities, the complexity of the IP industries and the dearth of ongoing relationships and repeat players.


Optimal surgical management of spine trauma will restore blood flow to the ischemic spinal cord. However, spine stabilization may also further exacerbate injury by inducing ischemia. Current electrophysiological technology is not capable of detecting acute changes in spinal cord blood flow or localizing ischemia. Furthermore, alerts are delayed and unreliable. We developed an epidural optical device capable of directly measuring and immediately detecting changes in spinal cord blood flow using diffuse correlation spectroscopy (DCS). Herein we test the hypothesis that our device can continuously monitor blood flow during spine distraction. Additionally, we demonstrate the ability of our device to monitor multiple sites along the spinal cord and axially resolve changes in spinal cord blood flow. DCS-measured blood flow in the spinal cord was monitored at up to three spatial locations (cranial to, at, and caudal to the distraction site) during surgical distraction in a sheep model. Distraction was halted at 50% of baseline blood flow at the distraction site. We were able to monitor blood flow with DCS in multiple regions of the spinal cord simultaneously at ~1 Hz. The distraction site had a greater decrement in flow than sites caudal to the injury (median -40 vs. -9%,). This pilot study demonstrated high temporal resolution and the capacity to axially resolve changes in spinal cord blood flow at and remote from the site of distraction. These early results suggest that this technology may assist in the surgical management of spine trauma and in corrective surgery of the spine.


This thesis considers the impacts of legislation introduced by the British government in 1984 to restructure the administration of non-advanced further education (NAFE) in England and Wales. The White Paper Training for Jobs proposed to transfer a substantial proportion of responsibility for the delivery of NAFE away from local education authorities (LEAs) to the Manpower Services Commission (MSC), involving the transfer of a proportion of LEAs' block grant to the MSC's annual budget for the purposes of NAFE delivery. The thesis examines the impacts of the White Paper by recourse to three themes. First, the revision of the policy innovation as a consequence of resistance by local authorities and their national associations to the policy as framed, and the subsequent renegotiation of its terms. Second, the bureaucratic impacts of the policy change, principally the restructuring of local working relationships which it necessitated. Third, a consideration of its impacts upon local NAFE planning procedures, the target of the policy shift. Central to the thesis are the relative bureaucratic characteristic of, and the operational relationship between, the MSC and LEAs, and the effect of these upon the development and delivery of NAFE policy. These themes are set in the context of an historical overview of vocational education and training in England and Wales, and a theoretical perspective which considers Training for Jobs as an illustrative example of decision-making and policy implementation in practice. It presents evidence for the argument that these processes should be perceived as a continuum in which actors at all levels play a part in the policy process, rejecting more simplistic 'top-down' approaches to the issue.


Vacuum-packaged ground ostrich meat patties containing 2% sodium lactate (SL), 0.2% rosemary extract as oleoresin (RE), or their mixture (MIX) were evaluated and compared with control for their storage stability at 3 ± 1 °C in the dark by measuring pH, 2-thiobarbituric acid-reactive substance (TBARS) values, sample color (CIE L*, a*, b*, Hue and Chroma), and microbiological content. The pH values of ostrich patties, ranging from 6.03 to 6.13, were not affected by treatment (P < 0.05). At 9 d of storage, TBARS concentration for control samples containing no additives was 1.64 mg malonaldehyde/kg meat. Addition of RE to the ground ostrich meat inhibited lipid oxidation during storage at 3 ± 1 °C (P < 0.05). TBARS values of SL-added samples were lower than control samples (P < 0.05); addition of SL also delayed the oxidation. It was found that RE had a protective effect on color, whereas addition of SL decreased CIE a* values (P < 0.05). SL, either alone or with RE, was effective in inhibiting total aerobic bacteria (TAB), coliforms, lactic acid bacteria (LAB), and Brochothrix thermosphacta in ostrich patties (P < 0.05) and provided a 2-log reduction in microbial population during storage. In addition, RE did not have a significant effect on microbial growth at the concentration used in this study.


The study proposes a new method for estimating variation in reservoir sediment by gravimetry technique. The study area is located in Tseng-wen reservoir, which is the largest reservoir in Taiwan. Several field gravity surveys with FG-5 gravimeter have been carried out at three gravity stations surrounding the reservoir (shown in figure) during 2014~2016. The observed gravity values caused by the effects of ocean tide, polar motion, atmospheric pressure, and underground water will be well predicted and removed. The variation of Tseng-wen reservoir sedimentation derived from gravimetry technique will be compared to those derived from bathymetric Lidar. The purpose of the research is to develop a more efficient and economic method to measure the sediment variations in reservoirs, and subsequently bring contributions to soil and water conservation.


Notwithstanding the proliferation of studies linking e-commerce with the macro-environment, theoretical frameworks on the institution-e-commerce linkage are not well developed. Our primary purpose in this paper is to extend theory on the institution-e-commerce linkage by explicating the influences of normative and cognitive institutions on individuals' and firms' e-commerce adoption behaviors. Broadly speaking, the approach employed in this paper can be described as a positivistic epistemology. The paper takes a conceptual or a theory-building approach. We first develop a conceptual framework that represents how a technology's interaction with normative and cognitive institutions affects a firm's relationships with the profession, other businesses and customers. We then apply the framework to develop a set of propositions on normative and cognitive influences on a firm's e-commerce adoption behaviour. Our analysis indicates that normative and cognitive institutions, in spite of being less visible than regulatory institutions, are no less important in shaping the diffusion pattern of e-commerce.


Xenopus laevis tadpoles were produced from wild-caught, laboratory-reared toads. Separate sets were fed on diets of (1) liver powder; (2) nettle powder; (3) aminosol and Intralipid. The tadpoles were reared for 3 weeks at 22 degrees C and then three groups of experiments performed. Group I experiments showed a significant difference in the response to thiopentone between tadpoles fed on liver powder and those fed on nettle powder. Group II experiments showed a difference in response to thiopentone which did not result from kinetic factors between sets 1, 2 and 3. The dose-response curves of the nettle-fed tadpoles when compared with the liver-fed tadpoles were shifted to the right. The Intralipid-fed tadpoles showed a flat dose-response curve, which tended to fall off. Group III experiments showed a very large difference in response to 1-iodo-4-azido benzene between tadpoles fed on liver powder and those fed on aminosol and Intralipid.


This paper looks at restrictions of passage, accidents and oil transportation norms as causes of interruption in oil supplies. The key 'chokepoints' are discussed in detail: the Straits of Hormuz, Malacca, Bab el-Mandeb, the Canals of Suez and Panama, the Turkish Straits and the entrance to the Baltic Sea. It is concluded that in most cases the danger of closure can only be temporary; nevertheless, investment in bypasses and alternatives is highly desirable, and in the case of the Turkish Straits, has not been forthcoming. The discussion then turns to threats to navigation outside the chokepoints, such as piracy and oil spills in enclosed seas, particularly the Mediterranean. The final section looks at changing international norms, especially the entry into force of the requirement of double hulls for oil tankers. The paper's main conclusion is that there is no scenario of interruption of maritime oil and gas transportation that may cause a severe physical shortage of oil, in general or specifically for Europe. In almost all cases potential tensions could be easily allayed if responsible governments took the necessary steps to create alternatives (notably pipeline bypasses) or to curb illegal activities. The main factor preventing the required investment in transportation alternatives is the lack of a well-functioning market mechanism for burden sharing. Where passage must be paid for, the resulting income stream supports investment to increase capacity and accommodate growing demand.


Background: Software Code Cloning is widely used by developers to produce code in which they have confidence and which reduces development costs and improves the software quality. However, Fowler and Beck suggest that the maintenance of clones may lead to defects and therefore clones should be re-factored out. Objective: We investigate the purpose of code cloning, the detection techniques developed and the datasets used in software code cloning studies between the years of 2007 and 2011. This is to analyse the current research trends in code cloning to try and find techniques which have been successful in identifying clones used for defect prediction. Method: We used a mapping study to identify 220 software code cloning studies published from January 2007 to December 2011. We use these papers to answer six research questions by analysing their abstracts, titles and reading the papers themselves. Results: The main focus of studies is the technique of software code clone detection. In the past four years the number of studies being accepted at conferences and in journals has risen by 71%. Most datasets are only used once, therefore the performance reported by one paper is not comparable with the performance reported by another study. Conclusion: The techniques used to detect clones seem to be the main focus of studies. However it is difficult to compare the performance of the detection tools reported in different studies because the same dataset is rarely used in more than one paper. There are few benchmark datasets where the clones have been correctly identified. Few studies apply code cloning detection to defect prediction.


Aim: We sought to determine whether there were differences between men and women with acute stroke in their baseline characteristics and outcome in a large cohort of patients randomized in the International Stroke Trial (IST). Methods: Of the 19,435 patients randomized in the IST, 17,370 had an ischemic stroke confirmed by CT scan or autopsy (8,003 female and 9,367 male). In males and females, we compared baseline characteristics (age, frequency of atrial fibrillation, pre-stroke administration of aspirin and systolic blood pressure, conscious level, stroke syndrome) and outcome at 14 days and 6 months (death, complications, dependency, recovery, place of residence). We developed a specific logistic regression model to adjust for case-mix in order to evaluate the separate influence of gender on outcome. Results: Female patients were older, suffered more frequently from atrial fibrillation, had higher systolic blood pressure at randomization and generally had more severe strokes (a higher proportion were unconscious or drowsy or had a total anterior circulation syndrome). Females had higher 14-day and 6-month case fatality and were more likely to be dead or dependent at six months (and consequently more likely to require institutional or residential care). Gender was an independent predictor of death or dependency at 6 months. Conclusions: The adverse effect of female gender on outcome indicates that further research to explore the underlying biological mechanism is justified, and that more intensive acute and long-term treatment may be needed to improve outcome among female patients with stroke.


The influence of the amount of Pr6O11 additions on the microstructure and electrical properties of varistors ceramics in the ZnO-Bi2O3 system was investigated. Samples with a low level of Pr6O11 (0.1wt %) have high microstructural homogeneity, which enhances the nonlinear coefficient greatly, and decreases the leakage current without change of voltage ratio. When the Pr6O11 content reached 7wt%, the ZnO grain growth was restricted and the threshold voltage was improved from 275v/mm to 440v/mm. The additive of Pr6O11 changed the process of creating spinel phase, which came from the decomposition of pyrochlore phase. This type of small size phase has more dragging force on the ZnO crystal, which make the whole materials more uniform and compact.


Aims This study explored the association of active acute anterior uveitis (AAU) with depressive feelings and patients' general health. Methods This case-control study comprised 80 participants: 35 patients with an active case of AAU and 45 healthy peers were analysed to compare their depressive moods (Beck depression inventory (BDI), Zerssen Mood Scale (ZMS)) and general health (Short form-8 health survey (SF8)). Furthermore, patients were questioned regarding the presence of distress, occupational satisfaction and impairment in performing daily life tasks. Results During an acute attack, AAU patients were shown to suffer from depressive moods more often than their healthy peers (BDI 54% vs 9%, respectively; ZMS 2.7-fold shift in mood levels towards depression) and experienced a reduction in mental and physical scores (SF8). Patients felt impaired reading (94%), driving (69%) and working (69%). In all, 74% of the patients believed that distress was a probable trigger. Lack of occupational satisfaction was associated with a persistence of depressive feelings and a reduction in physical health. Conclusions AAU patients exhibited a significant psychopathology towards depression, a reduction of general health and impairment of performing daily life tasks. Patients who were unsatisfied at work seemed to suffer even more. The results underline the importance of offering psychological support to the patients and providing information to patients and close social contacts.


Wearing a mask has proven to be one of the most effective ways to prevent the transmission of SARS-Co V-2 coronavirus. However, wearing a mask poses challenges for different face recognition tasks and raises concerns about the performance of masked face presentation detection (PAD). The main issues facing the mask face PAD are the wrongly classified bona fide masked faces and the wrongly classified partial attacks (covered by real masks). This work addresses these issues by proposing a method that considers partial attack labels to supervise the PAD model training, as well as regional weighted inference to further improve the PAD performance by varying the focus on different facial areas. Our proposed method is not directly linked to specific network architecture and thus can be directly incorporated into any common or custom-designed network. In our work, two neural networks (DeepPixBis [21] and MixFaceNet [4]) are selected as backbones. The experiments are demonstrated on the collaborative real mask attack (CRMA) database [17]. Our proposed method outperforms established PAD methods in the CRMA database by reducing the mentioned shortcomings when facing masked faces. Moreover, we present a detailed step-wise ablation study pointing out the individual and joint benefits of the proposed concepts on the overall PAD performance.


Abstract This study examines variation in evaluations of im/politeness of a recording of a naturally occurring intercultural apology, focusing in particular on potential cultural differences in these evaluations across speakers of (Australian) English and (Mandarin) Chinese. We first closely analyze the apology itself as a form of social action, and suggest in the course of this analysis that evaluations of im/politeness are closely tied to converging and diverging interpretations of actions and meanings that are interactionally achieved in situated discourse. The results of a survey of evaluations of the apology and follow-up interviews with Australian and Taiwanese informants are then discussed. A comparison of ratings of im/politeness of the intercultural apology between Taiwanese and Australians suggests that there are indeed significant differences in evaluations of im/politeness between members of these two cultural backgrounds. We trace this through our analysis of metadiscursive commentary to differences in the ways in which "sincerity" is conceptualized in (Australian) English and Taiwanese Mandarin. In doing so, we propose a firmer empirical basis for the analyst to make inferences about whether the interactional achievement of diverging interpretations of meanings and actions in intercultural discourse is culturally motivated or simply idiosyncratic to the situation or individual participants. We conclude, however, that while evaluations of im/ politeness are indeed influenced by the cultural background of respondents, developing a more fine-grained understanding of cultural influences on evaluations of im/politeness is necessary.


Large scale BaTiO3 nanorods were successfully synthesized by a template method based on a precipitation process. The templates used in our method are H2Ti8O17 nanorods, which can be synthesized from K2Ti4O9 fibers. The unique process of the synthesis is BaC2O4•0.5H2O shell was coated on the 1-dimensional H2Ti8O17 nanorods (the core). The as-prepared products were characterized by X-ray powder diffraction (XRD), scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The results show that the BaTiO3 nanorods are ~100-300 nm in diameter and ~2-10 m in length. The process described provides a general route to fabricate this kind of perovskite 1-dimensional nanostructures, such as SrTiO3 and PbTiO3.


The earthquake sequence of the Central Italy in 2016 are characterized mainly by the Mw6.0 24th August, Mw5.9
26th October and Mw6.4 30th October as well as two Mw5.4 earthquakes (24th August, 26th October) (catalogue
INGV). They all show normal faulting mechanisms corresponding to the Apennines's tectonics. They are aligned
briefly along NNW-SSE axis, and they may not be on a single continuous fault plane. Therefore, dynamic rupture
modeling of sequences should be carried out supposing co-planar normal multiple segments.We apply a Boundary
Domain Method (BDM, Goto and Bielak, GJI, 2008) coupling a boundary integral equation method and a domainbased
method, namely a finite difference method in this study. The Mw6.0 24th August earthquake is modeled.
We use the basic information of hypocenter position, focal mechanism and potential ruptured dimension from
the INGV catalogue and Tinti et al., GRL, 2016), and begin with a simple condition (homogeneous boundary
condition). From our preliminary simulations, it is shown that a uniformly extended rupture model does not fit the
near-field ground motions and localized heterogeneity would be required.


We discuss implicit and explicit knowledge representation mechanisms for evolutionary algorithms (EAs). We also describe offline and online metaheuristics as examples of explicit methods to leverage this knowledge. We illustrate the benefits of this approach with four real-world applications. The first application is automated insurance underwriting-a discrete classification problem, which requires a careful tradeoff between the percentage of insurance applications handled by the classifier and its classification accuracy. The second application is flexible design and manufacturing-a combinatorial assignment problem, where we optimize design and manufacturing assignments with respect to time and cost of design and manufacturing for a given product. Both problems use metaheuristics as a way to encode domain knowledge. In the first application, the EA is used at the metalevel, while in the second application, the EA is the object-level problem solver. In both cases, the EAs use a single-valued fitness function that represents the required tradeoffs. The third application is a lamp spectrum optimization that is formulated as a multiobjective optimization problem. Using domain customized mutation operators, we obtain a well-sampled Pareto front showing all the nondominated solutions. The fourth application describes a scheduling problem for the maintenance tasks of a constellation of 25 low earth orbit satellites. The domain knowledge in this application is embedded in the design of a structured chromosome, a collection of time-value transformations to reflect static constraints, and a time-dependent penalty function to prevent schedule collisions.


Background: The rate of childhood obesity is rising across the world. The relationship between the level of adiponectin, which is a known marker for metabolic syndrome, and Abdominal Obesity (AO) among children are reported in various reports worldwide; however, there has not been such a research in Vietnam. This study aims to investigate adiponectin levels and its association with abdominal obesity among Vietnamese schoolchildren. Methods: We included 821 grade six students from four randomly selected secondary schools in Hanoi for anthropometric measurements and collecting biochemical samples for blood adiponectin, HbA1C, HDL-C, and LDL-C concentration analysis. AO was identified by waist-to-height ratio (WHtR) of ≥ 0.5. Mann-Whitney's U test was performed to compare abdominal and non-abdominal obesity among boys and girls. Logistic regression analyses were performed to determine the association of AO and body mass index (BMI) with adiponectin levels. Results: Adiponectin levels were lower in boys (7.65 µg/mL) than in girls (8.79 µg/mL). The percentage of boys with adiponectin levels less than the median was 39.64% in the non-AO group and 66.45% in the AO group, while the percentage for girls were 47.01% in the non-AO group and 74.07% in the AO group. When adiponectin levels were below median, the adjusted odd ratios (aOR) of AO and BMI at 95% confidence intervals were 2.89 (1.74-4.89) in boys and 2.55 (1.27-5.12) in girls and 2.73 (1.66-4.49) in boys and 1.96 (1.16-3.31) in girls, respectively. Conclusions: Regardless of sex, among schoolchildren, adiponectin levels are significantly different between abdominal and non-abdominal obesity groups. Adiponectin generates a clearer effect on AO in boys, and the aOR of AO is higher than BMI aOR. These results suggest that preventing AO could improve the levels of adiponectin in schoolchildren, which will consequently prevent metabolic syndrome and non-communicable diseases in the future.


The 15N tracer method is the most suitable method for studying complex N transformation processes in microbiology and biochemistry. It entails the constant determination of the 15N abundance of the inorganic nitrogen (N) compounds nitrite and nitrate. However, 15N analytical methods are time-consuming, difficult to automate, and require at least 10 µg of N per determination. An additional obstacle in the case of nitrite is that it usually only occurs in very small amounts (ppb) dwarfed by much larger quantities of nitrate (ppm). More useful is an approach in which the N compound is selectively converted into a gaseous form suitable for direct measurement by mass spectrometry. By using this 'reaction continuous-flow mass spectrometry' (R/CFMS) we developed methods for the 15N determination of nitrite and nitrate from tracer experiment samples, i.e. artificially enriched in 15N. Because both methods are based on the same principle, one continuous flow setup connected directly to a quadrupole mass spectrometer for all determinations was used. Nitrite and nitrate are reduced to NO by iodide and titanium(III) chloride, respectively. The technique developed ensures a precision of relative standard deviation ≤3% if at least 0.5 and 2 µg N with an abundance of ≥1 at.% are to be measured for nitrite and nitrate, respectively. Copyright © 1999 John Wiley & Sons, Ltd.


The "basic level", according to experiments in cognitive psychology, is the level of abstraction in a hierarchy of concepts at which humans perform tasks quicker and with greater accuracy than at other levels. We argue that applications that use concept hierarchies - such as knowledge graphs, ontologies or taxonomies - could significantly improve their user interfaces if they `knew' which concepts are the basic level concepts. This paper examines to what extent the basic level can be learned from data. We test the utility of three types of concept features, that were inspired by the basic level theory: lexical features, structural features and frequency features. We evaluate our approach on WordNet, and create a training set of manually labelled examples that includes concepts from different domains. Our findings include that the basic level concepts can be accurately identified within one domain. Concepts that are difficult to label for humans are also harder to classify automatically. Our experiments provide insight into how classification performance across domains could be improved, which is necessary for identification of basic level concepts on a larger scale.


An excellent light-emitting diodes phosphor must possess effective absorption, high quantum efficiency, high quenching temperatures, and high color purity. Our synthesized LiGd(WO4)2:Eu3+ materials possess all of these properties. Excitation of these phosphors with ultraviolet radiation yields bright red emission at 617 nm due to the 5D0 → 7F2 transition of Eu3+ ions. Compared with different Eu3+ doping concentrations, LiGd(WO4)2:80%Eu3+ phosphor has optimal photoluminescence properties and shows internal quantum efficiency as high as 69%. More impressive is its good thermal stability; when heated up to 150 °C, the LiGd(WO4)2:80%Eu3+ phosphor still has 81% of its initial emission intensity at room temperature. Furthermore, the LiGd(WO4)2:80%Eu3+ phosphor shows high purity of red emission with coordinate values (x = 0.656, y = 0.334). The abovementioned results suggest that the LiGd(WO4)2:80%Eu3+ phosphor can be a suitable red-emitting candidate for ultraviolet-excited white light-emitting diodes.


A critical requirement of an efficient cancer immunotherapy is the generation of long-lasting, specific memory. In a clinical trial active at Istituto Besta, first diagnosis glioblastoma (GBM) patients, with post-surgery volume ≤10 cc, underwent leukapheresis before radiotherapy and chemotherapy with the alkylating agent temozolomide (TMZ). Three intradermal injections of mature dendritic cells (DCs) loaded by autologous tumor lysates were done before adjuvant chemotherapy. Subsequent 4 injections were performed in association with six cycles of adjuvant TMZ. Peripheral blood lymphocytes (PBLs) were analyzed by flow cytometry to characterize immune response before and after DC vaccines. The ratio of vaccination/baseline frequencies and counts (V/B ratio) of all of the immunological parameters for each patient was calculated, and the median of all of the observations used as the cut off value to separate patients. V/B ratio was correlated with the progression free survival (PFS) of each patient. Preliminary results from the interim analysis on 24 patients showed that an increased NK, but not CD8+ T cell response was significantly associated with prolonged survival (p In a group of responder patients (PFS>12), during the first three vaccines, CD8+ T cells underwent a rapid expansion and produced higher levels of IFN-γ compared to the baseline (p After the third vaccine and TMZ administration, primed CD8+ T cells failed to form an effector memory phenotype (CCR7negCD45RAnegCD62Llow/neg). Our results support a possible interference of adjuvant chemotherapy on effector memory formation. Further investigations are required to understand how memory T cells behave in response to repeated exposure to TMZ. Citation Format: Serena Pellegatta, Marica Eoli, Elena Anghileri, Sara Pessina, Carlo Antozzi, Simona Frigerio, Gabriele Cantini, Maria Grazia Bruzzone, Bianca Pollo, Eugenio A. Parati, Gaetano Finocchiaro. CD8+T cells fail to form an effector memory in glioblastoma patients treated with dendritic cell immunotherapy in combination with chemotherapy. [abstract]. In: Proceedings of the CRI-CIMT-EATI-AACR Inaugural International Cancer Immunotherapy Conference: Translating Science into Survival; September 16-19, 2015; New York, NY. Philadelphia (PA): AACR; Cancer Immunol Res 2016;4(1 Suppl):Abstract nr A031.


A U(2) algebraic model is introduced for the spectrum of a molecule XY4, where the interactions between the stretch and bend modes are described by Td symmetric Fermi resonance terms. The presented algebraic model in a limit corresponds to another model in recent literature. The vibrational spectrum of methane (CH4) measured recently with modern spectroscopy techniques is employed to test those models. The obtained standard deviation between the observed and the calculated vibrational energy levels in the algebraic model is smaller than that in the corresponding model.


PURPOSE
This study aimed to describe bladder dysfunction in elderly women such as frequency, nocturia, and residual urine.

METHODS
One hundred elderly women aged 60 and over. The Bristol Female Lower Urinary Symptoms (BFLUT) was used to evaluate the bladder function and to measure the residual urine amount by using a bladder scanner. Data was analyzed with the differences between voiding dysfunction by age group and life habits by t-test, ANOVA and correlation by Pearson correlation coefficient.

RESULTS
the mean daytime frequency was 6.8 times and night-time frequency 2.7 times. Sixty three percent of subjects had urgency and 41% had urgent incontinence. Over half of subjects had problem in voiding function. There were significant differences in frequency by age groups and constipation, but not in daytime frequency and residual urine. Lastly, there were significant positive relations between daytime frequency and night-time frequency. Also results indicate that more frequency in daytime equaled to a less residual urine amount.

CONCLUSION
We know many elderly women have lower urinary tract symptoms. Specially women over 75 years have more daytime frequency and night-time frequency. This suggests further research needed in order to understand the relation of voiding patterns and life habits and its influence on quality of life.


RT PCR on mRNA from enzymatically dissociated, isolated bipolar cells showed that these neurons express the Shaker-like K+ channels Kv1.1, Kv1.2, and Kv1.3. Immunohistochemical localization showed each channel to have a unique subcellular distribution: Kv1.1 immunoreactivity was detected in the dendrites and axons terminal, whereas Kv1.2 and Kv1.3 subunits were localized to the axon and the postsynaptic membrane of the rod ribbon synapse, respectively. Whole-cell patch-clamp recordings indicated that the activation voltage of the delayed rectifier current of the isolated bipolar cell and the inhibitory constants for current blockade by TEA, 4-AP, and Ba2+ were similar to these same properties measured for Kv1.1 expressed in oocytes. However, the TEA and 4-AP inhibitory constants for the bipolar cell current differed from the inhibitory constants for Kv1.2 or Kv1.3. These results suggest that the current of the isolated rod bipolar cell is most similar to Kv1.1 but that all three channels may function in the intact retina to allow complex modulation of retinal synaptic signals.


There is an abundance of perspectives and interpretations about the practices and actions of the Russian Federation on states and individuals, especially at the information level. However, in some respects, Western perspectives tend to simplify Russian actions and categorise them as zero-sum games. In this respect, the paper tries to interpret the actions of the Russian Federation, especially at the informational level, by defining key concepts, as well as to provide a perspective on how Russian military theorists use the notion of "hostile actions" in the context of designing peacetime operations. Moreover, the complexity of the Russian military theoretical background is highlighted, with brief comparisons between the theoretical forms of some concepts from the Soviet period and the present. The paper also reviews some conceptions of the hybrid form of Russian action, attempts to synthesise certain views of Russian military theorists and, based on Russian strategic culture, to show the levels of action in the context of a series of operations. Finally, the paper proposes an orientation model that addresses a holistic perspective on how the subversive and informational actions of the Russian Federation can influence the policy and security of a state targeting the individual, society and the political system.


Can the Singleton pattern [Gamma95] be turned into a reusable component? To help answer this question, we have reviewed existing implementations and tried to improve them. This article explains the difficulties of having a single-instance class in Eiffel and proposes language extensions, namely once creation procedures, which would be satisfactory in most cases, or frozen classes.


The purpose of this thesis is to establish a direct relationship between literature and fields of knowledge such as science and technology, by focusing on some concepts that were fundamental for both science and the humanities at the beginning of the 20th century. The concepts are those of simultaneity, multiple points of view, map, relativity and acausality.

In the spirit of several recent ideas, for example Katherine Hayles' isomorphism notion, the dissertation shows how writers such as James Joyce, Virginia Woolf, Thomas Mann and Robert Musil developed the mentioned concepts within their narratives. The working hypothesis is that those concepts were at a crossroad of human activities, and that those authors used them extensively within their narratives. It is further argued that those same concepts – as developed by Joyce in Ulysses, Woolf's shorts stories and novels from the end of the 1910's until the end of the1920's, Mann's Der Zauberberg (The Magic Mountain), and Musil's Der Mann ohne Eigenschaften (The Man Without Qualities) — are still fundamental for our conception of time and space today.

The thesis is divided into two parts. The first two chapters will analyse the concepts of simultaneity and multiple points of view and their relationship to cartography as developed within English literature and culture. The next two chapters will address the concepts of relativity and acausality, as developed within German literature and culture.


Information goods are characterized by high fixed (first-copy) costs, but very low costs for the production of additional copies. Marginal costs of electronically-delivered information goods have been further reduced by the remarkable recent decline in computing and digital communication costs. Most previous research focuses on how a monopolist would perform (and the proper regulation to impose) in such an environment. Achieving dynamic efficiency is difficult because pricing at marginal cost (which is statically efficient) eliminates the incentive to invest in the creation of new content. Recently, the strategy of bundling numerous goods together has been explored in greater detail. Bundling may achieve static efficiency since individuals will face a zero cost on the margin for each item consumed. Yet, dynamic efficiency can be maintained because the producer is able to recover investment costs through bundle sales. This paper analyzes the profitability and welfare properties of bundling in a multi-firm setting. This allows us to explore how incumbents and entrants interact when each firm is selling numerous competing products. Our fundamental conclusion is that even adding only a single firm to this industry with substantial fixed costs and negligible marginal costs will result in much lower prices for consumers, much higher social welfare, and only a moderate reduction in firms' profits regardless of the pricing schemes employed. This outcome is somewhat surprising given that in a standard static two-good Bertrand model, a duopoly would lead to a price war which eliminates the incentive to invest in new content (or to enter the industry in the first place). Although the firms are producing a priori identical items, consumers know that their valuations for the particular items will vary ex post. Thus, no price reduction by one firm can completely eliminate the demand faced by other firms. Although there remains an incentive to invest in new product creation, this incentive is lower than a monopolist would have. As a result, in a dynamic version of this model, the welfare superiority of the duopoly becomes dampened (but not eliminated). Finally, when firms are allowed to sell items both as a bundle and individually, we find that most revenue will be obtained from bundle sales. These results indicate that bundling will persist in a multi-firm setting and suggest that only firms of substantial size will be able to survive in such a market.


We report a glutathione (GSH) responsive drug carrier that is based on the Michael addition reaction between an olefinic bond and GSH. Amphiphilic copolymers with multi-linear-cyclized and branched structures that contain vinyl groups were successfully synthesized by deactivation enhanced atom transfer radical polymerization (DE-ATRP). The polymers self-assembled into GSH responsive micelles with sizes of 68 to 97 nm and spherical morphology. The core cross-linked micelles were confirmed to greatly decrease doxorubicin (DOX) leakage due to the concentration gradient. Drug release experiments indicated that the drug carrier containing no disulfide has the same responsive ability as a conventional GSH reduction responsive carrier with a similar polymer structure. MTT assays showed that the blank micelles are totally non-cytotoxic, while the DOX-loaded micelles exhibit GSH-dependent behaviour.


BACKGROUND
Invasive group A Streptococcus (GAS) infections are associated with significant morbidity and mortality rates. We report the epidemiology and trends of invasive GAS over 8 years of surveillance.

METHODS
From January 2005 through December 2012, we collected data from the Centers for Disease Control and Prevention's Active Bacterial Core surveillance, a population-based network of 10 geographically diverse US sites (2012 population, 32.8 million). We defined invasive GAS as isolation of GAS from a normally sterile site or from a wound in a patient with necrotizing fasciitis (NF) or streptococcal toxic shock syndrome (STSS). Available isolates were emm typed. We calculated rates and made age- and race-adjusted national projections using census data.

RESULTS
We identified 9557 cases (3.8 cases per 100 000 persons per year) with 1116 deaths (case-fatality rate, 11.7%). The case-fatality rates for septic shock, STSS, and NF were 45%, 38%, and 29%, respectively. The annual incidence was highest among persons aged ≥65 years (9.4/100 000) or <1 year (5.3) and among blacks (4.7/100 000). National rates remained steady over 8 years of surveillance. Factors independently associated with death included increasing age, residence in a nursing home, recent surgery, septic shock, NF, meningitis, isolated bacteremia, pneumonia, emm type 1 or 3, and underlying chronic illness or immunosuppression. An estimated 10 649-13 434 cases of invasive GAS infections occur in the United States annually, resulting in 1136-1607 deaths. In a 30-valent M-protein vaccine, emm types accounted for 91% of isolates.

CONCLUSIONS
The burden of invasive GAS infection in the United States remains substantial. Vaccines under development could have a considerable public health impact.


Structural effects on intermediate species of methanol oxidation are studied on low-index planes of platinum using in-situ infrared (IR) spectroscopy. A flow cell is designed for rapid migration of reactant and product species on the electrode surface. IR spectra show adsorption of formate and the formation of carbonate species on the Pt(111) surface at potentials higher than that of CO oxidation. The band assignments for carbonate and formate are confirmed by vibrational isotope shifts. On Pt(100), the absorption band of adsorbed formate is much smaller than that on Pt(111). On the other hand, there is no adsorbed formate on Pt(110) in the potential region examined. The band intensity of formate follows the order: Pt(111)>Pt(100)>Pt(110). This order is opposite to that of the current density in the regions of higher potential. Adsorbed formate on Pt(111) behaves like a catalyst-poisoning intermediate, like adsorbed CO.


Abstract This study investigates the comprehensive organosulphur compounds and evaluation of antioxidant activities in Allium hookeri, called hooker chive. The non-volatile and volatile organosulphur compounds were determined by high-performance liquid chromatography-photodiode array detector (HPLC-PDA) and gas chromatography-mass spectrometry (GC-MS), respectively. Among 11 non-volatileorganosulphur compounds, methiin and cycloalliin were major compounds. A total of 42 volatile compounds were identified and allyl methyl sulphides and dimethyl sulphides were primarily volatiles. The total phenols ranged from 19.32 to 71.19 mg gallic acid equivalents (GAE)/g. The antioxidant capacities expressed IC50 values ranged from 9.59 to 38.54 mg/mL for DPPH radical scavenging activity and from 0.39 to 2.36 for ferric reducing antioxidant power assay. The results were proposed as useful tools for evaluating the nutraceutical of hooker chive.


Abstract In this research note, we present results from a review of research on local resilience in relation to radicalization in public health, social work, crisis management, and community policing using terrorism studies as a point of departure. In order to identify agreements between literatures, we focus on how local resilience is understood, how it is said to be promoted, and how this knowledge could be synthesized. We show that resilience by and large is understood as both a process and a capacity underpinned by cooperation, social networks, and community resources and that an initial mapping of existing strengths and resources is pivotal for local resilience-building.


Summary The breast of the human male can be induced to grow to a functionally mature state by the administration of estrogenic substances without additional exogenous steroid synergists. Spontaneous lactation was not observed in these men, but it was induced by luteotrophin. The formation of milk in any amount by the breast is a criterion of functional maturity of the mammary epithelium. Luteotrophin induced the secretion of small amounts of milk in a group of women with mammary cancer and in a number of healthy women as well, and, in addition, in two human males to whom estrogenic substances had been administered for therapeutic purposes. Lactation did not occur in two normal males. Many patients with carcinoma of the breast, even those in the 7th decade, secreted milk when the mammary gland was challenged with luteotrophin, despite the menopause and earlier removal of the ovaries; the primary mammary cancer in most of these women was adenocarcinoma. Other women with cancer of the breast failed to lactate when treated with luteotrophin; the primary neoplasm in most of these patients was undifferentiated. A potential secretory capacity can be retained by the breasts of the human female in senility. The prolonged administration of testosterone did not cause functional atrophy of mammary epithelium. When lactation was induced in human beings, the secretion often persisted for many months; it lasted for 7 years in one man. In certain women with mammary cancer lactation ceased abruptly following the removal of the ovaries and adrenal glands, while in others it persisted. In three women with this persistent lactation, the secretion of milk was not stopped by the administration of diethylstilbestrol, testosterone, or progesterone.


'Living fossils', a phrase first coined by Darwin, are defined as species with limited recent diversification and high morphological stasis over long periods of evolutionary time. Morphological stasis, however, can potentially lead to diversification rates being underestimated. Notostraca, or tadpole shrimps, is an ancient, globally distributed order of branchiopod crustaceans regarded as 'living fossils' because their rich fossil record dates back to the early Devonian and their morphology is highly conserved. Recent phylogenetic reconstructions have shown a strong biogeographic signal, suggesting diversification due to continental breakup, and widespread cryptic speciation. However, morphological conservatism makes it difficult to place fossil taxa in a phylogenetic context. Here we reveal for the first time the timing and tempo of tadpole shrimp diversification by inferring a robust multilocus phylogeny of Branchiopoda and applying Bayesian divergence dating techniques using reliable fossil calibrations external to Notostraca. Our results suggest at least two bouts of global radiation in Notostraca, one of them recent, so questioning the validity of the 'living fossils' concept in groups where cryptic speciation is widespread.


Sir.—The recent analysis of 46 patients with the VATER association by Weaver et al1prompts the following observations. 1. Selection for inclusion in the study by the presence of only two of the six major association defects (vertebral defects, imperforate anus, tracheoesophageal malformations, upper extremity defects, renal malformations, and cardiac anomalies) is insufficiently rigorous. When all common congenital malformations are examined, virtually all two-defect combinations occur more frequently than would be expected by chance alone.2Twenty-eight percent of infants with cardiac lesions have noncardiac anomalies as well; skeletal anomalies are most common, and urinary tract anomalies are second.3Do all of these infants show examples of the VATER association? 2. We are not told the number of infants with only two defects, which defects they were, or which associated "nonmajor" defects were present. As a result, it is difficult to evaluate one of the more interesting


The present study was undertaken to evaluate the effects of two structurally dissimilar calcium channel blockers, verapamil (a phenylalkylamine) in a single dose of 40 and 80 mg, and nifedipine (a dihydropyridine) in a single dose of 10 and 15 mg, on psychomotor performance and higher mental functions in human volunteers. Placebo and diazepam (5 mg) were used as negative and positive controls respectively. For evaluating these functions, tests employed were arithmetic ability, visual and auditory reaction time, letter (alphabet) cancellation, rapid fire arithmetic deviation and short term memory for playing cards. Careful record was kept of the heart rate, blood pressure and side effects of the therapy, each time the psychomotor tests were performed. Verapamil, both in 40 and 80 mg dose, was found to impair the performance of subjects to a significant extent in auditory reaction time, letter cancellation and short term memory. These effects were similar to those observed with administration of diazepam. With nifedipine, impairment in performance was observed only in rapid arithmetic deviation test. Thus, calcium channel antagonists, specially verapamil, impaired psychomotor performance of human subjects in our study.


The response to the Ebola outbreak in West Africa of the governments of Guinea, Sierra Leone and Liberia, local WHO representatives, international organisations with WHO at the helm, and the international community has been much too slow. The help that is now at last being given has come much too late, and, with a few notable exceptions, it is far too little. The European Union, including the Netherlands, is distinguishing itself by its absence. It does not appear to have got through to Europe that, even if it is only in its own interest, it must offer far more help to Guinea, Sierra Leone and Liberia - and quickly.


This brief, inexpensive guide introduces students and novices to the key elements of qualitative research methods. Written in a friendly, conversational style, replete with good examples from multiple disciplines, student exercises, and key points to remember, the volume works ideally with other qualitative textbooks to provide a comprehensive overview to qualitative methods for students. Chapters cover the essentials of theory building, research design, methods, data collection and analysis, writing, ethics, rigor and proposal writing.


This paper studies the linear positive discrete-time systems with the uncertainty in the system model. Some parameters of system's matrix are unknown and only some information about their lower and upper bounds are available. The goal of this paper is design of output feedback control law in the presence of parametric uncertainties. The control law is designed in a way that in addition to asymptotic stability of the closed-loop system; it guarantees the positivity of the closedloop system which adds some complexity in the process of problem solving. Another case has also been investigated in this paper is design of output feedback control law such that as well as the asymptotic stability and positivity of the closed-loop system; the control signal be also positive. The realization of this constraint is necessary in some positive systems. In this paper, two theorems are given and proved. Moreover, the conditions expressed in these theorems are converted to linear programming formats. Finally, computer simulations are presented to verify the theoretical results.


This paper presents and articulates the art and the science of Qualified Historiography, that is, History-writing in cases of uncertainty and unreliability of the narrative – where narratives are not absolute or certain, based on hypotheses, need to be refined and recast, and therefore also need to be qualified. This is a practical and immeasurably useful approach that allows readers to sift the grain from the chaff, and cull the essence without jettisoning the meat. It can be used in many different cases, for example, when research is still underway, when data is incomplete, when it is intended to be used by one or more researchers as a platform for other researchers to contribute to nascent and budding ideas, when it brings some value to the table and adds to knowledge in some way and when a hypothesis is proposed to be presented to elicit feedback from a broader audience. This approach forms an integral part of twenty-first century historiography and is meant to be understood along with the trilogy of papers encompassing core twenty-first century historiography, namely Historiography by objectives, the core principles of twenty-first century historiography, and Anthropological historiography, which have already been published by us in various peer-reviewed journals. This approach is therefore complementary and supplementary to the aforesaid papers, and takes the principles presented therein to their logical conclusion.


A highly specific Diels-Alder protein catalyst was made by manipulating the antibody repertoire of the immune system. The catalytic antibody 13G5 catalyzes a disfavored exo Diels-Alder transformation in a reaction for which there is no natural enzyme counterpart and that yields a single regioisomer in high enantiomeric excess. The crystal structure of the antibody Fab in complex with a ferrocenyl inhibitor containing the essential haptenic core that elicited 13G5 was determined at 1.95 angstrom resolution. Three key antibody residues appear to be responsible for the observed catalysis and product control. Tyrosine-L36 acts as a Lewis acid activating the dienophile for nucleophilic attack, and asparagine-L91 and aspartic acid-H50 form hydrogen bonds to the carboxylate side chain that substitutes for the carbamate diene substrate. This hydrogen-bonding scheme leads to rate acceleration and also pronounced stereoselectivity. Docking experiments with the four possible ortho transition states of the reaction explain the specific exo effect and suggest that the (3R,4R)-exo stereoisomer is the preferred product.


In late 17th-century New England, the eternal battle between God and Satan was brought into the courtroom. Between January 1692 and May 1693 in Salem, Massachusetts, neighbours turned against neighbours and children against parents with accusations of witchcraft, and 19 people were hanged for having made pacts with the devil. Peter Charles Hoffer, a historian long familiar with the Salem witchcraft trials, now reexamines this notorious episode in American history. He tells the real story of how religious beliefs, superstitions, clan disputes and Anglo-American law and custom created an epidemic of accusations that resulted in the investigation of nearly 200 colonists and, for many, the ordeal of trial and incarceration. He also examines life during this crisis period of New England history - a time beset by Indian wars, disease, severe weather, and challenges to Puritan hegemony - to show how an atmosphere of paranoia contributed to this outbreak of persecution. Hoffer examines many aspects of this history, from accusations to grand jury investigations to the conduct of the trials themselves. He shows how rights we take for granted today - such as rules of evidence and a defendant's right to legal counsel - did not exist in colonial times, and he demonstrates how these cases relate to current instances of children accusing adults of abuse. "The Salem Witchcraft Trials", a concise history written expressly for students and general readers, sheds important light on the period and shows that our horror of these infamous proceedings must be tempered with sympathy for a people who gave in to panic in the face of a harsh and desolate existence.


Members of the family Cimicidae (Heteroptera) are obligate haematophagous ectoparasites. The Cimex pipistrelli species group parasitizes on bats, the likely ancestral hosts of the whole family. Based on morphology, it was suggested that three species of the group were present in the West-Palaearctic region, although their validity remained a matter of discussion. Surprisingly, the status of these species has not been studied from the point of view of host specificity. We examined the diversification of the species group using morphological data, including the putative diagnostic characters, and sequences of one mitochondrial (cytochrome oxidase subunit I, COI) and four nuclear loci (internal transcribed spacer 2, 18S and 28s ribosomal genes and elongation factor 1 subunit α). This was carried out on a sample of 225 individuals from 69 bat roosts and 44 mist-netted bats, altogether representing 12 bat species from 13 European countries and Lebanon. We revealed 27 mitochondrial haplotypes representing two distinct haplogroups and one outlying haplotype. The extent of morphological variability of specimens representing both haplogroups covers the range of characters reported for all three recognized species; therefore, the haplogroups clearly do not correspond to any described species. Also, the very limited variability found in the nuclear sequences of the cimicid bugs examined suggests that separate species do not exist in the region. We found considerable morphological differentiation among samples from different bat species, although individuals representing particular mitochondrial haplogroups often live sympatrically and on the same host species. It seems that batbugs are morphologically adapted to a particular bat host despite the low genetic structuring among individuals parasitizing different species of bats.


: Data on the frequency of detection of serological markers of hepatitis C and B viruses using enzyme immunoassay for examinations of blood donors in different regions of the country, of patients with hepatitis of obscure etiology and patients with hemophilia regularly receiving hemostatic therapy are presented. The rate of detection of antibody to hepatitis C (anti-HCV) in reserve donors varied from 2% (Baltic states) to 9.2% (Moldavia), that of the carrier state of HBsAg from 0.3% to 10.3%, respectively. Among patients with hepatitis of obscure etiology, anti-HCV was found in 9-18%. A higher rate of anti-HCV was found in donors with high levels of aminotransferases (18.75%) and in patients with hemophilia (77.6%). Epidemiological serological surveys of group incidence of hepatitis revealed a high portion of incidence of virus hepatitis C (from 50 to 90%).


The discrete Fourier transform (DFT) is widely used in data compression, pattern recognition, and image reconstruction. The study of properties of the DFT shows that this transform can be generalized and used mere effectively for solving many problems in such areas as signal and image processing. The traditional N-point DFT is defined as the decomposition of the signal by N roots of the unit, which are on the unit circle. On different stages of the DFT, the data of the signal are multiplied by the exponential factors, or rotated around the circles. This paper presents a novel concept of the DFT by considering the block-wise representation of the transform in the real space, which can be generalized to obtain new methods in spectral analysis. For that, the new concept of the N-point elliptic discrete Fourier transform (EDFT) is introduced, whose basic 2×2 transformations that are not Given transformations, but rather rotations around ellipses. The elliptic transformation is therefore defined by different Nth roots of the identity matrix 2×2, matrix whose groups of motion move a point around the ellipses. The main properties of the EDFT are described and examples are provided. The EDFT preserves main properties of the DFT, such as shifting and energy preservation among others. The EDFT distinguishes the carrying frequencies of the signal in both real and imaginary parts better than the DFT. It also has a simple inverse matrix. It is parameterized and includes the DFT, as a partial case. The preliminary results show that by using different parameters, the EDFT can be used effectively for solving many problems in signal and image processing field, which includes image enhancement, filtration, encryption and others.


We consider a repeated electoral competition game between two parties, each representing a constituent with a given income level. Parties are unable to commit to any policy before the election; they choose a non-linear income tax schedule once elected. In each period, citizens cast a vote either for the incumbent or for the challenger. We first show that there exist (pure strategy) subgame perfect equilibria where both parties choose the most-preferred tax schedule of their constituent, subject to the constraint that they are reelected. We characterize a specific class of these BPR (Best Policy with Reelection) equilibria in which one of the parties plays its constituent's unconstrained optimal tax function. Equilibrium tax schedules are always piecewise linear. Depending on the income levels of the two parties' constituents, we obtain either classical left-vs-right equilibria (where poorer people vote for one party and richer people for the other one) or ends-against-the-middle equilibria (where both poor and rich people vote for one party while the middle class vote for the other party). In both types of equilibria both parties propose the same tax schedule to a subset of the population.


Introduction: Cervical cancer is the second most commonly diagnosed cancer and the third leading cause of death by cancer in women worldwide. Over 85% of annual cervical cancer deaths occur in developing parts of the world and other low-resource populations where it is the leading cause of death from cancer among women chronically infected by at least one oncogenic type of human papillomavirus. Background/Significance: Pap smear cytologic screening and current therapies for pre-cancerous low-grade lesions are costly, invasive and not feasible for use as therapy in low-resource settings. Inexpensive and validated alternative screening methods such as visual inspection with acetic acid (VIA) and a promising new HPV-DNA test (careHPV™, Qiagen), suggest the feasibility of implementing a single visit "screen-treat-prevent" public health care model in low-resource settings. However, there remains an unmet and urgent global need for an alternative therapy to serve as the "treatment arm" of a combined strategy that integrates screening with a safe, effective and affordable treatment for cervical dysplasia to prevent progression to cervical cancer. Purpose/Approach: Our aim is to create a non-invasive therapy specifically for use in a "screen-treat-prevent" public health care model that can be readily implemented even in a remote village in Sub-Saharan Africa, without benefit of electricity, running water, clinical work-space or formally trained medical personnel. Such a therapy should be inexpensive, easily self-administered and curative as a single dose therapy (assume no follow-up). We used an approach derived from a fundamental principle of synthetic biology—a "bottoms up" approach—employing highly sophisticated material science research instrumentation and technologies to engineer a "low tech" alternative therapy that represents an unconventional and innovative solution to an urgent global health challenge. Results: Our preliminary studies demonstrate the feasibility of controlled delivery of decoy peptide in situ to the cervical transformation zone in a transgenic mouse strain (K14E6) in which the high-risk type HPV16 E6 oncoprotein synergizes with 17 -estradiol to induce disease in situ that closely mimics the multi-stage development of human cervical cancer. Stable peptide-containing biopolymer formulations were created with properties that allow them to be solid phase at room temperature for ease of targeted application to the ectocervix, instantly melt at body temperature, adhere to mucosa and enhance peptide penetration across cervical mucosa. Penetration of decoy peptide across multiple layers of cervical squamous epithelium occurred in a dose- and time-dependent manner. Social Impact: The ability to offer women a health care solution that encompasses a "screen-treat-prevent" approach requiring minimal medical supervision is at once powerful and empowering. Advancement in modern western medicine should aim at producing more equity rather than disparity. Studies have shown that women are often caregivers of the communities to which they belong, so that when they achieve improvements in their own health, the quality of life of the community as a whole improves significantly. This study hopes to add to the effort of continuing to enable and empower women all over the world to take stewardship of their own health for the betterment of the community at large. Controlled topical delivery of biopolymer drug formulations represents an affordable and effective therapy for cervical dysplasia aimed at reducing cervical cancer incidence and mortality. Optimization of drug delivery using biopolymer formulations in a mouse model of human multi-stage cervical cancer will lay the groundwork for future human clinical trials. Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A48.