The use of high-impedance surfaces (HISs) to increase the frequency-scanning sensitivity of hollow leaky-wave antennas (LWAs) is presented. The LWA consists of a hollow rectangular waveguide with one of its narrow walls replaced by a partially reflective surface, and it is loaded with a metallodielectric HIS to increase its beam-scanning response. Theoretical results based on a simple transverse equivalent network illustrate the physical mechanism responsible for the improvement, and they are verified by experiments on a prototype working in the 11-16 GHz band.


Abstract The activation marker CD3O is useful in the diagnosis of Hodgkin and non-Hodgkin lymphomas. It has also been described in nonhematopoietic tumors, including pancreatic carcinomas, salivary gland tumors, and embryonal carcinomas. We report a case of malignant mesothelioma with intense CD30 positivity. This finding has not previously been described and is important in broadening the differential diagnosis of a CD30+ cohesive large cell malignancy.


In Hong Kong's Legislature Under China's Sovereignty: 1998-2013 Dr Gu Yu thoroughly analyses how Hong Kong's legislature has impacted the law-making process as well as the financial control and supervision of the executive branch of the government. The political cleavage in Hong Kong seen in recent years has affected the level of Legco's autonomy in terms of leadership, rules, committee autonomy and control over the legislative agenda. Given the weakened autonomy of Legco and the decline of moderate forces in both the pro-Beijing and pro-democracy camps, the role of Legco as a collective actor of checks and balances against the executive branch has been weakened. This book will appeal to both academics and practitioners whose work involves the relationship between the legislature and the executive branch in the HKSAR.


Two iterative algorithms were introduced for reconstructing a band-limited function from its unevenly spaced sampled data. Each iterative method introduces its own varying coefficient which is adaptively determined at each iteration. A varying coefficient for the first algorithm is adaptively determined based on minimizing the error energy of the signal at each iteration. The second method (the method of steepest descent) determines a varying coefficient based on minimizing the error energy reduction of the unevenly spaced sampled data at each iteration. We show that the reconstructed signal from these algorithms converges to the desired signal when the sampling set {t/sub n/} is a sequence such that the nonharmonic Fourier functions {exp(jwt/sub n/)} form a complete set in the signal subspace of the original signal. >


Due to their direct conversion of electrochemical into electrical energy solid oxide fuel cells (SOFCs) have great potential for a future additional energy supply. Even in the last two years numerous developers of SOFCs, both industry and research institutions, have demonstrated long-term stable operation of stacks of various dimensions (ranging from 1 to 125 kWel, with durations of up to 25000 hours of operation). Besides technical proof, single component availability (cells, bipolar plates, sealing…), stable and low-aging operation, as well as cost efficient manufacturing of the components is becoming more and more evident in preparation for a market launch. Close cooperation between SOFC stack developers, SOFC users and manufacturers of powders, semifinished parts or stack components is a prerequisite for success. Within a collaboration project funded by the German Federal Ministry of Economics and Labor (BMWA) the development of an SOFC as an auxiliary power unit (APU) is being promoted. The industrial users are BMW for automotive applications and Liebherr for use in construction vehicles or aircraft. The content of this presentation will be the transfer of the manufacturing knowledge developed at Research Center Jülich to CeramTec; including on the one hand the problems and limitations and, on the other hand the successes and positive perceptions. In detail, the transfer of, for example tape casting and screen printing will be addressed, powder characteristics concerning paste or slip formulation and special tests with reference to SOFCs are presented, and single cell tests of various cells manufactured with different powders or fabrication processes are described. Additionally, some remarks will concern different priorities in either R&D or industry (e.g. R&D: high power density; industry: reproducibility), process windows for manufacturing and the search for alternative fabrication methods.


Abstract. The use of dynamic wind farm flow models is beneficial for power reference following wind farm control. However, currently investigated flow models are non-linear and computationally expensive, while common control approaches require fast, linear models. This work presents a novel wind farm operation modelling approach named the Dynamic Flow Predictor. The Dynamic Flow Predictor was developed with the objective to provide predictions of wind speed and turbine power using a computationally effective, linear, dynamic state space model. The model estimates wind turbine aerodynamic interaction using a linearized engineering wake model in combination with a delay process. Simulations of two turbines and eight turbines in SimWindFarm show that the Dynamic Flow Predictor can provide accurate estimates and predictions of wind turbine rotor effective wind speed and power. Additionally, the Dynamic Flow Predictor is computationally effective as it requires only 5 % of the states of a comparable, dynamic 2D CFD model. The presented modelling approach is thus well suited for the use in wind farm control, while it is envisioned that the model can also be useful for wind turbine control and as a virtual wind turbine sensor.


The relation of methamphetamine abuse and HIV infection to social cognition (Reading the Mind in the Eyes Task and Faux Pas Recognition Task) was examined in men who have sex with men (N = 56): Of the methamphetamine users (n = 29), 19 were identified as HIV positive, and of the nonusers (n = 27), 13 were identified as HIV positive. Both methamphetamine use and HIV were associated with impaired performance on the Eyes Task (p < .05). Methamphetamine use was also associated with impaired performance on the Faux Pas Task (p < .05). These results link impaired social cognition to methamphetamine abuse and HIV infection.


Previous in vitro studies demonstrated that bovine endometrium has the capacity to convert inactive cortisone to biologically active cortisol (Cr) and that Cr inhibits cytokine-stimulated prostaglandin F(2α) (PGF) production. This study was carried out to test the hypothesis that bovine reproductive tract has the capacity to convert cortisone to Cr in vivo and to evaluate the effects of intravaginal application of exogenous cortisone on uterine PGF secretion during the late luteal stage. The temporal relationships between PGF and Cr levels in uterine plasma were also determined. Catheters were inserted into jugular vein (JV), uterine vein (UV), vena cava caudalis (VCC) and aorta abdominalis (AA) of six cows on Day 15 of the oestrous cycle (ovulation = Day 0) for frequent blood collection. On Day 16, the cows were divided randomly into two groups and infused intravaginally with vaseline gel (10 ml; control; n = 3) or cortisone dissolved in vaseline gel (100 mg; n = 3). Blood samples were collected at -2, -1, -0.5, 0, 0.5, 1, 1.5, 2, 3, 4, 5 and 6 h after treatments (0 h). Intravaginal application of cortisone increased plasma concentrations of Cr between 0.5 and 1.5 h in UV, at 0.5 h in VCC, at 1 h in JV and at 1.5 h in AA. The plasma concentrations of PGF in UV and of PGF metabolite in JV were greater at 0.5 and 1 h in the cortisone-treated animals than in control animals. The levels of PGF in UV blood plasma decreased after Cr reached its highest levels. The overall findings suggest that the female reproductive tract has the capacity to convert cortisone to Cr in vivo. Based on the temporal changes of PGF and Cr levels in the uterine plasma, a biphasic response in PGF secretion was found to be associated to the Cr increase induced by the cortisone treatment at the late luteal stage in non-pregnant cows.


PURPOSE
To evaluate regional cone dysfunction in retinitis pigmentosa (RP) by recording focal electroretinograms (FERGs) from the central and paracentral retinal regions and to correlate the FERG with perimetric sensitivity losses.

METHODS
Twenty-three typical patients with RP (age, 18-65 years; visual acuity, 20/100 to 20/20; kinetic visual field by size II/4e, 20-40 degrees ) and eight age-matched control subjects were evaluated. FERGs were recorded in response to either a central (eccentricity, 0-2.25 degrees ) or a paracentral annular (2.25-9 degrees ) field, presented on a light-adapting background. Fields' luminances (mean: 80 cd/m(2)) were sinusoidally modulated at different temporal frequencies (TFs; 10.3, 14, 21, 32, 41, and 52 Hz). Amplitude and phase of the responses' fundamental harmonic (1F) were measured. Perimetric sensitivity was measured by a visual field perimeter. For each patient, mean sensitivity losses were calculated for both the central (0-2.25 degrees ) and paracentral (2.25-9 degrees ) regions.

RESULTS
On average, central and paracentral FERGs of patients with RP were reduced in amplitude (P </= 0.05) compared with control values. Amplitude losses tended to be smaller in the central than the paracentral region and were limited to low-medium TFs (10.3-14 Hz). Paracentral losses were rather invariant with TF. Paracentrally, but not centrally, the FERG phase in patients was delayed on average (P < 0.01), compared with control values. The central FERG phase was delayed only in patients with visual acuities less than 20/40. In individual patients, paracentral 41-Hz amplitude losses were positively correlated with corresponding perimetric losses (r = 0.7, P < 0.005). Both central and paracentral 41-Hz amplitudes displayed high specificity (87.5% and 100%, respectively) with relatively low sensitivity (46.6% and 63.6%, respectively) in predicting perimetric results in corresponding retinal regions.

CONCLUSIONS
In RP, central and paracentral FERGs are differently altered as a function of TF, indicating regional differences in the stage and/or pathophysiology of retinal cone dysfunction. FERG abnormalities may predict, to some extent, perimetric results at corresponding retinal regions. The data support the use of the present FERG method to evaluate regional cone dysfunction in different stages of RP.


This paper presents a new algorithm for synthesising image texture. Texture synthesis is an important process in image post-production. Previous approaches can be classified as either parametric or nonparametric. Of these nonparametric approaches have achieved the most impressive results. Unfortunately, these methods generally suffer from high computational cost and difficulty in handling scale in the synthesis process. By introducing the wavelet decomposition as a basis for nonparametric texture synthesis, the advantages of nonparametric methods are combined with the computational efficiency and scale information readily available from the transform. The results show an order of magnitude improvement in computational speed and a better approximation of the dominant scale in the synthesised texture. The paper also presents a fast block searching algorithm using commodity graphics hardware. The computationally demanding neighbourhood search required by the Efros texture synthesis algorithm is implemented on the GPU. This results in an Efros texture synthesis algorithm which is up to 8 times faster than a similar C++ implementation.


To the Editor: Morphea, atrophoderma, guttate lichen sclerosus et atrophicus (LS&A), anetoderma, and their subtypes are inflammatory processes ultimately leading to dermal remodeling. We report a case of a scaly, hypopigmented, macular rash that clinically appeared as an entity along the morphea-atrophoderma spectrum and demonstrated unique histopathologic changes in both collagen and elastin confined to the upper reticular and papillary dermis. This case is a potentially rare variant representing a combination of clinical and microscopic findings. A 29-year-old woman presented for an increasing number of white spots distributed on the trunk, arms, and legs. She denied local and systemic symptoms. The patient reported that she was stung by 100 wasps 23 years prior. Following the assault, her grandmother placed chewed tobacco leaves atop the painful erythematous wheals and flares. Upon resolution, hypopigmented macules and patches remained in their place. The patient denied associated symptoms or new lesions; she did not seek care at that time. In her early 20s, the patient noted new, similarly distributed hypopigmented macules and patches without associated arthropod assault. She was treated by an outside dermatologist without result for presumed tinea versicolor. A follow-up superficial shave biopsy cited subtle psoriasiform dermatitis. Topical steroids did not improve the lesions. Her medical history also was remarkable for a reportedly unprovoked complete rotator cuff tear. Physical examination revealed 0.5to 2.0-cm, illdefined, perifollicular and nonfollicular, slightly scaly macules and patches on the trunk, arms, and legs. There was no follicular plugging (Figure 1A). The hands, feet, face, and mucosal surfaces were spared. She had no family history of similar lesions. Although atrophic in appearance, a single lesion on the left thigh was palpably depressed (Figure 1B). Serology demonstrated a normal complete blood cell count and comprehensive metabolic panel, and negative Lyme titers. Light therapy and topical steroids failed to improve the lesions; calcipotriene cream 0.005% made the lesions erythematous and pruritic. A biopsy from a flank lesion demonstrated a normal epithelium without thinning, a normal basal melanocyte population, and minimally effaced rete ridges. Thin collagen bundles were noted in the upper reticular and papillary dermis with associated fibroplasia (Figure 2). Verhoeff-van Gieson stain revealed decreased and fragmented elastin filaments in the same dermal distribution as the changed collagen (Figure 3). There was no evidence of primary inflammatory disease. The dermis was thinned. Periodic acid–Schiff stain confirmed the absence of hyphae and spores. The relevant findings in our patient including the following: (1) onset of hypopigmented macules and patches following resolution of a toxic insult; (2) initially stable number of lesions that progressed in number but not size; (3) thinned collagen associated with fibroplasia in the upper reticular and papillary dermis; (4) decreased number and fragmentation of elastin filaments confined to the same region; (5) no congenital lesions or similar lesions in family members; and (6) a complete rotator cuff tear with Atrophodermalike Guttate Morphea


One hundred eighty-one antiretroviral-experienced, protease inhibitor-naive, clinically stable HIV-infected children between 4 months and 17 years of age were randomly assigned to receive one of four combination regimens to evaluate the change in plasma HIV RNA, safety, and tolerance when changing antiretroviral therapy to a protease inhibitor-containing combination regimen. All four regimens contained stavudine; in addition children received nevirapine plus ritonavir, lamivudine plus nelfinavir, nevirapine plus nelfinavir, or lamivudine plus nevirapine plus nelfinavir. Twelve additional children chose to receive stavudine plus lamivudine plus nelfinavir, with nelfinavir given bid, rather than tid as for the main regimens. Overall, 51% (89/176; 95% CI 43-58%) of the children on the randomized portion of the study had an HIV RNA response (< or =400 copies/ml) on at least two of the three HIV RNA determinations taken at Weeks 8, 12, and 16. At Week 24 the proportion of children with an HIV RNA response still on initial therapy was 47% (83/176; 95% CI 40-55%) and ranged from 41 to 61% for the four randomized treatment arms. Rash was frequently seen (27%) on the treatment arms containing nevirapine. At Week 24 64% (7/11, 95% CI 31-89%) of the children on the bid nelfinavir combination regimen were still on initial therapy with an HIV RNA response as compared with 46% (23/50; 95% CI 32-61%) on the corresponding tid nelfinavir combination regimen. A change in antiretroviral therapy to a protease inhibitor-containing regimen was associated with a virological response rate of approximately 50% for this patient population.


Many American artists throughout the 20th century designated Pablo Picasso as the central figure of the modern movement and defined their own artistic achievements through their absorption, critique, or rejection of his example. Picasso and American Art is a groundbreaking publication juxtaposing works by Picasso with the paintings, sculptures, and drawings created in response by an extremely diverse group of his contemporaries and successors, including Max Weber, Stuart Davis, Arshile Gorky, John Graham, Willem de Kooning, Jackson Pollock, David Smith, Roy Lichtenstein, and Jasper Johns. Based on extensive research, Michael FitzGerald's text provides valuable new information on the fundamental role that Picasso played in the development of modern American art--both through his friendships with individual artists and through the dissemination of his evolving work. This book also documents, for the first time, the accessibility of Picasso's work in the United States between 1911 and 1957 in exhibitions, collections, and publications through a comprehensive chronology. This unique book is essential for anyone interested in either Picasso or American art of the 20th century.


The effects of several commonly employed fixatives on the three-dimensional conformations of two soluble proteins and the protein of intact red blood cell membranes have been studied by means of circular dichroism measurements in the spectral region of the peptide absorption bands. The fixatives used produced significant and parallel conformational changes in all of the proteins, in the increasing order: glutaraldehyde; OsO4; glutaraldehyde followed by OsO4; and KMnO4. The last two treatments obliterated most of the helical character of the proteins. The significance of these observations to the preparation of specimens for electron microscopy is discussed.


Innovation and technology adoption is crucial to the effective enhancement and/or
improvement of an organisation's performance. Existing technology adoption models fail to
facilitate consideration of all aspects (i.e. individual, organisational, technology systems), and
fail to highlight where conflict between aspects occurs. By considering the interplay of
individual, organisational and technological aspects, the aim of this thesis is to investigate
innovation patterns within business environments and/or relationship structures that encourage
positive individual adoption activity in organisations. Data was captured in Thailand, a country
that has recently faced considerable technology and infrastructure adoption. Technology
turnover in Thailand is fast, and innovation adoption across Thai society is a key to economic
development. Using a mixed methods approach, with the use of both quantitative and qualitative data capture,
this thesis combines three interconnected activities:
Activity 1 relates to identification of a classification scheme to support innovation adoption
pattern analysis. The research justifies the need for, and describes the development of, a dual
aspect adoption model, which was developed on the theoretical foundation of Ronald Stamper.
The dual aspect model was strongly influenced by Stamper's semiotic onion, which divides
systems into informal, formal and technical norm layers. Stamper's semiotic onion, which in
turn was influenced by Edward T. Hall's 'Crucial Trio Concept'. Two overlapping semiotics
onions were used to represented, and highlight, the interaction between two systems; with each
system representing either an individual, an organisation, or a technology. Adoption matrices
were identified and nine points of potential conflicts were discovered. The adoption matrix was
validated using a survey questionnaire, conducted by 217 respondents, who had been or were
involved in technology adoption projects. Results showed that the order, definition of, and flow
between Stampers norm layers, i.e. as defined in Stamper's organisational semiotics onion, is
not evidenced empirically within modern day organisations. Results implied that norm
definitions, and norm layer interaction or empirical data aligned with Hall's original Major
Triad definition. Moreover, results highlighted a significant relationship between the
innovation matrix and individual cognitive dissonance and technology perception states,
suggesting the need to consider individual internal beliefs/concepts when considering innovation adoption. In terms of contributions, the section: provides a quantitative validation
of Stamper's semiotic onion; suggests a new onion that should be used when representing
individual, technology and/or organisational systems; proposes the reshaped dual aspect model,
based on Hall's Major Triad, as a tool to study the interplay between two systems; introduced
a reshaped alignment framework, based on Hall's Major Triad, which allows the decomposition
of systems conflict, and implies that full informal and formal alignment between the two
systems is not essential, as implied by Stamper, in order for a business to achieve technical
level innovation. The contributions allow combined consideration of individual, organisational
and technology aspects, and supports, decomposes, and guides management of the innovation
process. Activity 2 relates to the expansion of our understanding of the technology adoption conflicts
by development of a framework to identify, in context of business, potential aspect conflict
impacting technology adoption; i.e. to support problem identification, communicate and
support resolution of aspect conflict, and affiliate management of change. This research
investigated relevant norm structures from the literature, i.e. to capture the activities related to
individual, organisational and technology aspects. By facilitating common business methods,
i.e. BPMN / UML components and norm analysis, a framework was proposed to identify
relevant structures, using the classification scheme. The research subsequently, using case
example, qualitatively investigated how problem identification, communication, conflict
resolution, and management of change can be contextually handled in a range of business
contexts. The framework was validated via the use of relevant case studies. From the
framework, we were able to answer to the research question in terms of contributions,
practitioners can apply the developed framework to guide their gap analysis process, and apply
the bundled framework as a guidance towards detailed analysis, towards detecting possible
conflicts arising from technology adoption. Moreover, this framework can be considered as a
method for capturing and highlighting conflict in the innovation adoption process.
Activity 3 investigated the relationship between adoptions and individual factors, i.e. to support
enhancement of the conceptual innovation model. The research investigated the impact of
individuals by applying the CVScale, which captures Hofstede's five cultural dimensions
enhanced for measurement at the individual level. Moreover, by employing use of 3D-RAB
and Kano model, i.e. to investigate the relationship between innovation, technology and the individual dimension, we show the importance of the individual's concept layer on user behavioural activity.
The result from SEM analysis shows that long-term orientation (LTO) dimension, influences
the attitude towards targeted behaviour (ATTB) and the attitude towards changing non-target
and/or maintaining current target behaviour (ATCMB); sub factors of individual cognitive
dissonance. SEM confirmed that individual dimensions influence the individual's cognitive
dissonance state; i.e. the individual's attitude towards target behaviour and the individual's
attitude towards changing / maintaining behaviour. Moreover, it was shown that gender and
technology types have moderating effects on the relationship between LTO and ATTB. In terms
of contributions, this section provides insightful understanding of the relationship between
individual dimensions, individual attitude according to the innovation adoption process.
This thesis, as a whole, provides a significant contribution as combination of the activities
allows us to investigate adoption patterns and/or relationship structures that encourage positive
individual adoption activities in organisations. The practical contribution, from this thesis, is
that business users can fundamentally apply the dual aspect model, the dual innovation path
incorporating with the framework for analysis of interacting systems. These models help
identifying of, and support management of, potential conflicts and changes that must be
implemented to support innovation adoption in business.


Engineering education research in Australia is a burgeoning field. The literature and theory on transdisciplinary research presents some valuable ideas for justifying, designing and evaluating engineering education research. Engineering education research is a transdisciplinary endeavour in both a literal sense (in that it draws on knowledge from the disciplines of engineering and education), and in a formal theoretical sense, given that transdisciplinarity is defined as problem solving through 'the context specific negotiation of knowledge'. In this paper, we describe three outcomes that transdisciplinary research aspires to (problemsolving, peer approval, and mutual learning) and a case study of their application in shaping engineering education research. The case study details a research project titled 'Teaching and Assessing Meta-attributes in Engineering: Identifying, Developing and Disseminating Good Practice'. This project commenced late in 2006 and is funded by the Carrick Institute for Teaching and Learning in Higher Education. This work is part of a much broader discourse globally concerned with research and scholarship in engineering education and its impact on the practice of engineering schools. For example, the ASEE has launched the "Year of Dialogue on Scholarship in Engineering Education" and the National Science Foundation in the US is conducting a series of Colloquy to determine the main research questions and themes in engineering education. As engineering education emerges as a discipline in it own right, we need to consider carefully the nature of knowledge in this field and how we acquire and share it.


The aim of the current study is to determine the effects of different heat treatment and varnish combination applications on some of the physical properties of wood materials sampled from limba (Terminalia superba), iroko (Chlorophora excelsa), ash (Fraxinus excelsior L.) and Anatolian chestnut (Castenea sativa Mill.) species. The heat treatment was applied at two levels (150 and 180°C) for both 3 and 6 h period. Once heat treatment was conducted, four types of varnish layers (cellulose lacquer, synthetic varnish, polyurethane varnish and water based varnish) were applied to the materials. After the treatments application, color, brightness and surface roughness of varnish film layers of the treated woods were measured. The effects of heat treatment and varnish combination applications on the earlier mentioned variables were analyzed according to the study design (factorial design with 4 (species) x 2 (heat) x 2 (duration) x 4 (varnish) = 64 experimental units). For significant analysis of variance (ANOVA) , Duncan mean separation test was performed to separate the interaction combinations. Results of the study indicated that surface roughness increased on wood samples for all four wood species treated with cellulose lacquer and synthetic varnish and across all heating treatments. However, surface roughness decreased for all wood species depending on heating temperature and time. As such, the value of brightness also decreased for all four wood species across all the treatment combinations. The results obtained from the upper surface of the enforcement process are thought to contribute to the national economy.


Image color harmonization algorithm aims to automatically match the color distribution of foreground and background images captured in different conditions. Previous deep learning based models neglect two issues that are critical for practical applications, namely high resolution (HR) image processing and model comprehensibility. In this paper, we propose a novel Deep Comprehensible Color Filter (DCCF) learning framework for high-resolution image harmonization. Specifically, DCCF first downsamples the original input image to its low-resolution (LR) counter-part, then learns four human comprehensible neural filters (i.e. hue, saturation, value and attentive rendering filters) in an end-to-end manner, finally applies these filters to the original input image to get the harmonized result. Benefiting from the comprehensible neural filters, we could provide a simple yet efficient handler for users to cooperate with deep model to get the desired results with very little effort when necessary. Extensive experiments demonstrate the effectiveness of DCCF learning framework and it outperforms state-of-the-art post-processing method on iHarmony4 dataset on images' full-resolutions by achieving 7.63% and 1.69% relative improvements on MSE and PSNR respectively.


To the Editor: We would like to bring your attention to a possible contradictory remark in the article by Dr. Charles Fisch (Circulation 47: 408, 1973). We feel the paragraph During diastole (phase 4 of the AP) the membrane is largely permeable to K+ with a net loss of intracellular K +. Due to this selective permeability to K+, the magnitude of the transmembrane resting potential (TRP) is dependent largely on transmembrane concentration of K+. This relation of TRP to K+ is expressed in the Nernst equation which predicts that an increase in extracellular K+ decreases the TRP (becomes less negative) while a lowering of the extracellular K+ results in hyperpolarization, or an increase in TRP (becomes more negative.) appearing on page 408 is not in accordance with the following paragraphs: The inhibition of diastolic depolarization by hyperkalemia is thought to be due to an increase in membrane conductance to K+ and thus return of the TRP to a more negative level. The rapidity with which changes of K+ level take place, not only the absolute level, is important in predicting the effect of K+ on impulse formation and conduction. A rapid increase of K+ level to normal in a preparation perfused with low K+ or in a K +-depleted animal or human may result in bradyeardia, cardiac arrest, or depression of conduction. These changes are attributed to a sudden increase in negativity of the TRP due to increased K + conductance secondary to rise of extracellular K+. which appeared on page 410 of the same volume. Please inform us if we are misinterpreting the article or if there is an actual error that should be corrected. DR. BRIAN EHRLICH Medical Student University of Illinois HADI DIZADJI, M.D. Chief of Cardiology Mercy Hospital Chicago, Illinois


Introduction
 Although the median age at diagnosis of acute myeloid leukemia (AML) is 67 years, with approximately one third of patients aged 75 years or older, limited treatment options are available for the elderly. There is no standard of care for older patients with AML unfit for intensive chemotherapy. In this case, despite specific treatment such as low-dose cytarabine (LDA) and 5 azacytidine (5AZA), outcome remains extremely poor, without cure (Thomas X, Current Treat Options Oncol 2017, 18(1):2). The goal of our study is to establish a prognostic model of survival in order to identify whether the absence of specific treatment may not be harmful in a subset of patients.
 Patients and Methods
 The French Hauts-de-France AML observatory is a population-based database reporting AML cases diagnosed and supported in 9 Hospital Centers from the French region Haut-de-France. From January 2008 to December 2016, 572 patients older than 75 years were included in the observatory. Among them 324 patients received best supportive care (BSC) alone, 142 hypomethylating agents, 82 low doses aracytine, and 24 other treatments. As a general consensus accepted in all participating centers, BSC was proposed in unfit patients, after performance status and comprehensive geriatric assessment according to results of a preliminary fast geriatric assessment oncodage G8 (Bellera CA, Ann Oncol 2012, 23(8):2166-72). Clinical data were collected in each center. The study was conducted according to the Declaration of Helsinki and was approved by the Human Research Committee of Lille and the internal review board of the Lille University Hospital Tumor Bank (certification NF 96900-2014/65453-1).
 Results
 In the BSC group, median age at diagnosis was 82 years (interquartile range [IQR] 78-86). Median WBC count was 7.3 x10^3/mL (IQR 2.18-42.5) with a median peripheral blood blasts percentage of 21% (IQR 6-59.5). Median bone marrow blasts was 51% (IQR 30-75). Karyotype was available for 181 patients. Two patients were in the favorable, 111 patients (61%) were in the intermediate, 68 patients (38%) were in the unfavorable cytogenetics group and 58 patients (32%) had a complex karyotype.
 For the BSC group, median survival was 3.2 months (IC 2.3- 4) with a 18% 12-months survival estimate.
 In univariate Cox models, WBC count (p<0.0001), circulating blasts percentage (P=0.0001), bone marrow blasts percentage (P=0.0001) and complex karyotype (p= 0.05) were predictive of a shorter survival. Neither age nor unfavorable karyotype retained prognostic value.
 Multivariate analysis selected two independent covariates namely circulating blasts percentage without identifiable cutoff (p=0.0002), and complex karyotype (p=0.05). Prediction of risk according to this proportional hazard model showed that patients at lowest risk could be defined by the absence of both complex karyotype and circulating blasts. The survival of this subgroup of unfit patients who received BSC (7% of patients, median 16 months) was not significantly different from the survival of fit patients with the same characteristics (absence of both complex karyotype and circulating blast) who received 5AZA or LDA (median survival of 26.6 months, p=0.07) (Figure 1.).
 Remaining patients (with complex karyotype or circulating blast), of the BSC cohort had a shorter survival than patients treated with 5AZA or LDA (3.7 months vs 13 months, p<0.0001).
 Conclusion
 In a population of elderly AML patients (> 75 years), 18% are alive at 12 months without any chemotherapy. Our results indicate that the absence of chemotherapy may not be detrimental in a small subset of unfit patients identified by the absence of both complex karyotype and circulating blasts. However further studies are mandatory for characterizing most of patients alive at 12 months with BSC.
 Figure 1. Survival of patients with both complex karyotype and circulating blasts

 No relevant conflicts of interest to declare.


The recent influx of international students into the tertiary institutions of Australia and New Zealand has altered the education system of both countries. While from the beginning university and other teachers noted the need to make provision for international students, many institutions have been slow to recognise the complexity of their needs. This report presents an emerging typology to support the learning needs of international students in Australasia. The authors, an academic and a learning needs specialist, have drawn on observation and experience, their own and others, to illuminate the situation. Current literature has supplemented the analysis of their professional experience. In order for appropriate provision to be made for international students, the complexity of the situation in which they are educated must be recognised. This includes acknowledging the varying perceptions held by the institutions, both management and the administrators, the students, both international and domestic, and teaching and support staff, including those with special expertise. The typology, which will be introduced for discussion, presents the four general concerns in providing for international students' learning: language needs, exposure to different educational systems, questions of prior knowledge, and cultural issues and acculturation problems. Six academic issues related to the students' academic progress are examined in terms of actual and possible provision. The work in progress presents an analytic framework which, on completion, will enable the complexity of providing for international students to be calibrated for implementation within different institutions.


Background: Aspirin is recommended as a first-line antiplatelet drug for all types of acute diseases that cause thrombosis in the blood vessel,
especially in cardiovascular disease. Orally administered aspirin has side effects such as the risk of gastrointestinal bleeding and has presystemic
metabolism in the gastrointestinal tract and liver. Transdermal delivery offers an alternative for administering aspirin that by passes the gut and this
may be more convenient and safe for long-term use. This study used a form of microemulsion to prevent hydrolysis of aspirin because it contains a
high concentration of the surfactant. A microemulsion is a dosage form that can penetrate into the skin for transdermal delivery.
Objectives: The aim of this research was to evaluate the effect of Tween 80 and propylene glycol as the surfactant and cosurfactant on the physical
stability of the microemulsion.
Materials and Methods: Various concentrations of Tween 80 and propylene glycol (2:1) were used 54%, 57%, 60%, and 63%, and the physical
stability of the different microemulsions was tested for 6 weeks.
Result: The results showed that the formula F3 was the most stable formula. The formula F3 showed the following properties such as pH of 3.74±0.30,
viscosity of 1198.76±56.02 cps, BJ of 1.0669±0.005 g/mL, surface tension of 38.77±0.43 dyne/cm, and particle size of 49.46±6.91 nm.
Conclusions: Based on the results concluded that the optimum concentration of Tween 80 as the surfactant and propylene glycol as the cosurfactant
with a ratio of 2:1 was 60%.


J2EE-based Web applications are becoming increasingly ubiquitous and with their increasing adoption, the performance is the attention focus and the most important factor of evaluating the system by users. In this paper, we present a systematic solution for performance testing and optimization of J2EE-based Web applications. The solution helps to identify and eliminate bottlenecks in the application design and ensures that systems are designed to meet their quality of service requirements. This paper firstly analyses the architecture of J2EE-based Web applications and performance testing principle, and then improves the JMeter testing framework for meeting the more concurrent users. Lastly, performance testing for J2EEbased Web applications is done; it finds performance bottlenecks and puts forward optimum measures, and compares the performance with the former one.


OBJECTIVE: To assess the accuracy of patients' perceptions of the risks associated with localised prostate cancer treatments (radical prostatectomy [RP], radiotherapy [RT], and active surveillance [AS]), and to identify correlates of misperceptions. PATIENTS AND METHODS: We used baseline data (questionnaires completed after treatment information was provided but before treatment) of 426 patients with newly diagnosed localised prostate cancer who participated (87% response rate) in a prospective, longitudinal, multicentre study. Patients' pretreatment perceptions of differences in adverse outcomes of treatments were compared to those based on the literature. We used univariate and multivariate linear regression to identify correlates of misperceptions. RESULTS: About two-thirds (68%, n = 211) of the patients did not understand that the risk of disease recurrence is comparable between RP and RT. More than half of the patients did not comprehend that RP patients are at greater risk of urinary incontinence (65%, n = 202) and erectile dysfunction (61%, n = 190), and less at risk of bowel problems (53%, n = 211) compared to RT patients. Many patients overestimated the risk of requiring definitive treatment following AS (45%, n = 157) and did not understand that mortality rates following AS, RP, and RT are comparable (80%, n = 333). Consulting a radiotherapist or a clinical nurse specialist was positively associated with, and emotional distress was negatively associated with, better understanding of the risks (P < 0.05), although effect sizes were small. CONCLUSION: Prior to choosing treatment, most patients with prostate cancer poorly understood the differences in treatment risks. Greater efforts should be made to better understand why these misperceptions occur and, most importantly, how they can be corrected.


We obtain recursion formulas for the Bethe vectors of models with periodic boundary conditions solvable by the nested algebraic Bethe ansatz and based on the quantum affine algebra $U_q(\widehat{\mathfrak{gl}}_{n})$. We also present a sum formula for their scalar products. This formula describes the scalar product in terms of a sum over partitions of the Bethe parameters, whose factors are characterized by two highest coefficients. We provide different recursions for these highest coefficients. In addition, we show that when the Bethe vectors are on-shell, their norm takes the form of a Gaudin determinant.


Purpose The Caregiver's Congenital Glaucoma QoL (CarCGQoL) questionnaire was proposed as a measure of QoL of caregivers with children with primary congenital glaucoma (PCG). Support for its psychometric properties among other diagnostic groups is required for scores to be interpreted in the same manner across groups. Therefore we investigated the measurement properties and cross-diagnostic validity of the CarCGQoL questionnaire among caregivers of children with congenital cataract, retinopathy of prematurity (ROP), and blinding corneal disorders. Methods Eight hundred ninety-one caregivers (mean age, 28.3 years; 76% mothers) of children with congenital cataract (n = 407), ROP (n = 272), and blinding corneal disorders (n = 212) completed the CarCGQoL questionnaire. Rasch analysis was used to investigate the psychometric properties. Unidimensionality (by principal components analysis of residuals, PCA) was examined for each group and for pooled sample. Differential item functioning (DIF) was investigated to explore whether bias in responses to the questionnaire existed for certain subgroups as compared to the reference group (PCG). Results Across groups, six items necessitated removal because of misfit (two common and four uncommon), after which three different versions of the questionnaire emerged. Measurement precision was adequate for each group and for the pooled sample (0.80). Unidimensionality was observed, albeit with some DIF. Regardless of the level of QoL, caregivers in the pooled sample were more likely to endorse two items reflecting ability to face child's disease, and interest to pursue leisure activity, as compared with caregivers of children with PCG. Conclusions Care must be taken when data from the CarCGQoL questionnaire from different pediatric ocular conditions are pooled, given the presence of DIF between the reference group (PCG) and the pooled sample. Translational Relevance When evaluating the impact of interventions on the caregiver's QoL using the CarCGQoL questionnaire in a pooled sample of pediatric ocular conditions, cross-diagnostic DIF must be taken into account.


In all forms of discrimination against women, the phenomena of gender stereotyping has played a significant role; gender stereotypes are often cited as one of the most crucial barriers states need to eliminate in order to achieve substantive equality between the sexes. Gender stereotyping and its impact on the realisation of women's human rights is arguably the most pervasive in the area of reproductive health. Whilst the existence of gender stereotyping can be damaging for both men and women, such stereotyping holds the sexual freedom and physical autonomy of women to unrivalled and relentless scrutiny. Despite the existence of human rights that regulate states' conduct when it comes to gender stereotyping and reproductive health, as has been consistently outlined in the breadth of international case law, gender stereotypes and patriarchal concepts that aim to determine a woman's role in society mean that rights such as access to abortion and contraception are endangered by religious and other ideological forces.  It is concluded that states and international human rights bodies must focus their attention on the importance of combatting the harmful gender stereotypes that exist within their jurisdictions to achieve any form of substantive equality for women.


This study presents an application of using a Convolutional Neural Network (CNN) based detector to detect chili and its leaves in the chili plant image. Detecting chili on its plant is essential for the development of robotic vision and monitoring. Thus, helps us supervise the plant growth, furthermore, analyses their productivity and quality. This paper aims to develop a system that can monitor and identify bird's eye chili plants by implementing machine learning. First, the development of methodology for efficient detection of bird's eye chili and its leaf was made. A dataset of a total of 1866 images after augmentation of bird's eye chili and its leaf was used in this experiment. YOLO Darknet was implemented to train the dataset. After a series of experiments were conducted, the model is compared with other transfer learning models like YOLO Tiny, Faster R-CNN, and EfficientDet. The classification performance of these transfer learning models has been calculated and compared with each other. The experimental result shows that the Yolov4 Darknet model achieves mAP of 75.69%, followed by EfficientDet at 71.85% for augmented dataset.


Introduction: This study aims to evaluate the balance and vestibular system of patients with pseudoexfoliation syndrome. Materials and Method: A prospective case–control study was performed in a university hospital. The study population consisted of 37 patients (16 patient group, 21 control group). The Modified Clinical Test of Sensory Interaction Balance was performed in four conditions: 1) eyes open, firm surface; 2) eyes closed, firm surface; 3) eyes closed, foam surface; and 4) eyes open, foam surface. The Equilibrium Score, Anteroposterior Stability Index, Mediolateral Stability Index were employed for all conditions in both groups. Scores were compared between and within groups. Additionally, the physical activity of the patients with pseudoexfoliation syndrome was assessed using questionnaires based on the Turkish versions of the Modified Falls Efficacy Scale and the Physical Activity Scale for the Elderly. Results: There were no significant differences in terms of stability index and equilibrium scores with eyes open or closed conditions between the two groups; the only difference was in the mean mediolateral stability index score in the eyes open, firm surface condition with low scores in the pseudoexfoliation group (p=0.01). In the group analysis, patients with pseudoexfoliation had a significant increase in the equilibrium scores when their eyes were closed in the firm and foam surface conditions (p=0.001 for both). Conclusion: The central nervous system redistributes its dependence on sensory information when vision is compromised in patients with pseudoexfoliation syndrome. Their somatosensory input might deteriorate in some way but not the vestibular system. Keywords: Dizziness; Glaucoma; Aged.


: In the present study, we examined die role of c-erbB-2 for chemoresistance in ovarian cancer. Overexpression of c-erbB-2 mRNA in tumor tissue was associated with a shorter survival of patients with primary ovarian cancer (P = 0.0001, N = 77) and was an independent prognostic factor in the proportional-hazard model (P = 0.035). A significant association between expression of c-erbB-2 mRNA und survival was obtained for the subgroup of patients who received a standard chemotherapy with carboplatin or cisplatin and cyclophosphamide (P = 0.0003). In addition, the application of a standard chemotherapy improved the survival of patients with relatively low c-erbB-2 expression (P = 0.013), but not of patients with overexpression of c-erbB-2 (P = 0.359). Expression of c-erbB-2 mRNA correlated with expression of topoisomerase IIalpha mRNA determined by a reverse semiquantitative PCR technique (P = 0.009), whereas expression of c-erbB-2 und topoisomerase IIbeta mRNA dit not correlate (P = 0.221). The data suggest that topoisomerase IIalpha, which correlates with c-erbB-2 expression, contributes to the resistance of c-erbB-2-overexpressing carcinomas.


A new architecture is developed for an integrated 20 Gbps fiber optic local area network (LAN) that supports data rates up to 9.6 Gbps. The architecture does not follow the standard, vertically-oriented open system interconnection (OSI) layering approach of other LANs. Instead, a horizontally-oriented model is introduced for the communication process to open up the three fundamental bottlenecks, i.e., opto-electronic, service and processing bottlenecks, that occur in a multi-Gbps integrated communication over multiwavelength optical networks. Furthermore, the design follows also a new concept called wavelength-dedicated-to-application (WDA) concept in opening up the opto-electronic and service bottlenecks. Separate, simplified and application-oriented protocols supporting both circuit- and packet-switching are used to open up the processing bottleneck.


There are several potential uses for green nanoparticle amalgamated in the medicinal and environmental sciences. Green synthesis specifically tries to reduce the use of harmful chemicals. For instance, it is often acceptable to employ organic resources like plants. In a single green synthesis step, biomolecules found in plant extract may transform metal ions into nanoparticles. This naturally occurring conversion of a metal ion to a base metal may be carried out quickly, conveniently, and at ambient temperature and pressure. In the current study, the production of CuNPs utilizing different-sized Nelumbo nucifera leaf extract has been reported. In order to determine how CuNPs generated, several techniques including UV-Visible, XRD, SEM, EDAX, FTIR, and cyclic voltammetry studies were used. The UV-Visible spectra of the amalgamated CuNPs show a peak between 250 and 450 nm. The morphology of CuNPs are spike in shapes with sizes of 33nm for 10mM and 25nm for 50mM, and the nanoparticles are crystalline in nature, according to the XRD and SEM examinations. The amalgamated CuNPs contain 37.55% copper, according to EDAX, and FTIR shows the absorption peak of copper at 1640 and 576 cm -1 .The oxidation and reduction of amalgamated CuNPs are visible by cyclic voltammetry. CuNPs have been put to the test against Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa for their antibacterial properties. CuNPs show the greatest zone of inhibition when used against Pseudomonas aeruginosa . Aspergillus flavus and Candida albicans have been used as test subjects for the antifungal testing of CuNPs. The CuNPs against Candida albicans show the largest zone of inhibition. CuNPs demonstrate strong antibacterial and antifungal efficacy, which means they have a considerable potential for application in the development of medications used to treat bacterial and fungal infections. The electrical potential difference of amalgamated CuNPs has been measured using a voltmeter and it is found that as concentration rises, so does the electrical potential difference.


Objectives: Investigate the effects of ischemic compression [IC] technique and passive stretching [PS] in isolation and in combination on the reduction of spontaneous electrical activity [SEA] and perceived pain in trigger points [TrPs] located in the upper trapezius muscle. Methods: Ninety participants with TrPs in the upper trapezius muscle were randomly assigned to three treatment groups: IC, PS, and IC + PS. TrP compression was applied on the TrP for three applications of 60 seconds each, followed by a 30-second rest period. PS was applied for three 45-second applications, with 30-second rest intervals. All patients received the same amount of therapy. Results: Significant decreases were found in pain perception and on SEA for all study participants. The IC + PS group evidenced greater declines in pain perception and SEA when compared to the IC and PS groups. Conclusion: Because of ethical considerations, a control group design was not possible, thereby limiting the robustness of the findings. Although each technique significantly reduced pain perception and SEA, the combination of IC and PS was superior, apparently because of the complementary nature of the therapeutic interventions.


A cell line established from a Ewing's sarcoma removed from the fibula of a 19-year-old female was investigated for morphology and hormone sensitivity. Cells in culture expressed neurofilaments and showed positive immunostaining for neuron-specific enolase (NSE), Leu-7-antigen (HNK-1) and S-100 protein. The cells also contained PAS-positive, diastase-digestible cytoplasmic material, indicative of glycogen inclusions. Moreover, the cells responded to dopamine as well as to beta-adrenergic agonists and prostaglandins to stimulate cyclic AMP synthesis and 3H-glycogen hydrolysis. In conclusion, the morphological and biochemical data show evidence for a neural differentiation pattern of Ewing's sarcoma cells in vitro.


Maintaining desired data availability while minimizing costs is the primary challenge in designing P2P storages. Data placement schemes and data availability calculation methods are two key design choices. Prior work has used the random placement and steady-state availability analysis model widely. We find this approach has two drawbacks: (1) it ignores the time-related property and greatly underestimates data availability in the short term and (2) it ignores differences in peers' availability and uses a mean value, which also leads to the underestimation of data availability. Both of these drawbacks influence the efficiency of storage and bandwidth resource usage. Also, this approach can not ensure all the objects achieve their expected availability due to the second drawback. This paper develops a different data placement scheme called similar-MTTF-MTTR placement, which takes into consideration differences in pees' dynamic characteristics. Under this scheme, this paper also presents a fine-gained analysis model for short-term data availability calculation. As a result, our scheme improves the efficiency of data maintaining significantly. We validate this by comparing with random placement under three different dynamic environments: a wide-area system (PlanetLab), a corporative environment (desktop personal computers at Microsoft Corporation), and a file-sharing system (Maze). The results show that our scheme can save the storage resource usage significantly under all environments.


This paper discusses the role of deterministic components in the DGP and in the auxiliary regression model which underlies the implementation of the Fractional DickeyFuller (FDF) test for I(1) against F I(d) processes with d 2 [0; 1): Invariant tests to the presence of a drift under the null of I(1) are derived. In common with the standard DF approach in the I(1) vs: I(0) framework, we also examine the consequences of including a constant and /or a linear trend in the regression model when there is a drift under the null. A simple testing strategy entailing only asymptotically normally-distributed tests is proposed. Finally, an empirical application is provided where the FDF test allowing for deterministic components is used to test for long-memory in the per capita GDP of several OCDE countries.


Background : Opportunistic intestinal parasitic infections cause severe diarrhoea specially in infants and in immunocompromised people world wide. Objective : The objective of this study was to assess and determine the prevalence of opportunistic intestinal parasites in paediatric patients with and without diarrhoea in selected hospitals in Addis Ababa. Methods : A cross-sectional study was conducted on 222 children under five years of age who had diarrhoea and on 74 children who had no diarrhoea in selected Hospitals in Addis Ababa. Single stool specimens were collected and screened for intestinal parasitic infections by using direct and concentrated methods. The Modified Ziehl-Neelsen Staining and Modified Water-Ether Sendimentaion methods were used for detecting Coccidial parasites. Results : Of the 222 paediatric diarrhoeal patients, 61(27.5%) were found to be infected with a variety of intestinal parasites and out of 74 children without diarrhoea 11(14.9%) were found to be infected. Among the emerging opportunistic parasites detected in diarrhoeal children were Cryptosporidium parvum (8.1%), Isospora belli (2.3%) and Enterocytozoon bieneusi/ Encephalitozoon intestinalis (0.5%). Other common intestinal parasites detected were Ascaris lumbricoides (0.5%), Trichuris trichiura (0.9%), Giardia lamblia (6.3%), Entamoeba histolytica/ E. dispar (1.4%), Blastocystis hominis (5.9%) and Hymnolepis nana (0.5%). Opportunistic parasites were found to be significantly associated with diarrhoeal and non-breastfed children (p C. parvum and I. belli respectively were isolated from 83.3% and 80% of diarrhoeal children aged less than 12 months. C. paravum and I. belli infections were also higher in male children, with a prevalence of 72.2% for C. paravum and 80% for I. belli . Conclusion : This study re-affirms and confirms the previously held view that opportunistic parasites can cause diarrhoea in paediatric patients and that it is more prevalent in male, non-breastfed children. The cause of diarrhoea in paediatrics in the absence of identifiable parasitic infections suggests that other infectious agents might be responsible for the diarrhoea. The Ethiopian Journal of Health Development Vol. 20(1) 2006: 39-46


In the last 20 years, the Brazilian population has increased by 30%, while the amount of waste has risen by 90%. This demographic expansion associated with an increasing consumption of disposable products has switched the type (quality and quantity) of waste produced. Currently, many municipalities are facing difficulties in finding appropriate disposal sites. As a result, waste management has become a national priority. In 2010, after been on hold in the Nation's Congress for decades, the National Waste Management Policy (PNRS) was approved through formal legislation (Law 12.305/10). The PNRS represented a major political and judicial improvement, but, still, represents a major economical and operational challenge. The strategies for improving waste management in Brazil should include instruments provided in the PNRS. Extended product responsibility, which includes all supply chain stakeholders, and reverse logistics are two main instruments incorporated in PNRS. A postconsumption reverse logistics program is the most common strategy to make operational the extended producer responsibility concept. Usually, a reverse logistics program deals with a specific range of products requiring by legal enforcement to be: recycled; reused; remanufactured; finally disposed of; treated; or incinerated. An efficient reverse logistics program should stimulate producers to internalize all social and environmental costs, from cradle to grave, in their decision making process. Thus, it is necessary to analyze the costs and benefits of PNRS instruments in order to balance benefits (reducing social and environmental damages) and costs (keeping reverse logistics chain operational). Legislation is the most common instrument to change market behavior in order Sustainable Development and Planning VI 649 www.witpress.com, ISSN 1743-3541 (on-line) WIT Transactions on Ecology and The Environment, Vol 173, © 2013 WIT Press doi:10.2495/SDP130541 to improve efficiency in returning numerous products. Even tough, reverse logistics has been successfully introduced in several national public policies; the instrument is still pending a further boost in the Brazilian regulatory system. This study discusses the strategies included in the PNRS.


Silicon nanocrystals in a range from 2 nm to 5 nm were prepared from Zintl salt, soldium silicide (NaSi) by sonochemical method. This synthesis permits that the reaction be completed in only a few hours and the easy alkyl-modification of nanocrystals surface at room temperature and ambient pressure. The average size of nanocrystals measured by the dynamic light scattering analysis was 2.7 nm. The high-resolution transmission electron micrograph confirmed the material identity of nanocrystals as crystalline silicon. FT-IR spectra are consistent with the surface states of nanocrystals that are chlorine-or butyl-capped. The emission peak center moved to a longer wavelength (up to 430 nm) with the reaction time, under a 325 nm excitation.


Knowing the value of the unbound drug fraction in the brain ( fu,brain) is essential in estimating its effects and toxicity on the central nervous system (CNS); however, no model to predict fu,brain without experimental procedures is publicly available. In this study, we collected 253 measurements from the literature and an open database and built in silico models to predict fu,brain using only freely available software. By selecting appropriate descriptors, training, and evaluation; our model showed an acceptable performance on a test dataset (R2: 0.630, percentage of compounds predicted within a 3-fold error: 69.4%) using chemical structure alone. Our model is available at https://drumap.nibiohn.go.jp/fubrain/, and all our datasets can be obtained from the Supporting Information.


Introduction: The frequency of detection of peripheral pulmonary lesion (PPL) in suspected early lung cancer has been increasing, and whether preoperative pathological diagnosis (PPD) for small PPLs should always be established before their surgical resection can become a worrisome problem for physicians. The aim of the study was to clarify the impact of obtaining PPD on surgical and postoperative outcomes of lung resection for early stage lung cancer. Material and methods: This was a retrospective review of cases that underwent surgical resection for known or suspected primary lung cancer presenting pathological stage 0 or I, enrolled from June 2006 to May 2016. The patients divided into two groups according to PPD group (n = 57) and non-PPD group (n = 157) were compared. The procedure, node dissection, operation time, amount of bleeding, postoperative complications, postoperative length of stay, and postoperative recurrences were analyzed. Results: Among the 214 patients, no significant differences in operation time (248.5 ± 88.6 versus 257.6 ± 89.0, min, mean ± SD, p = 0.328), amount of bleeding (195.3 ± 176.5 vs 188.1 ± 236.1, ml, p = 0.460), postoperative complication (5.2% vs 4.5%, p = 0.728), postoperative length of stay (10.6 ± 6.3 vs 10.4 ± 5.3, days, p = 0.827), or postoperative recurrences (21.0% vs 17.2%, p = 0.550) were seen between PPD and non-PPD groups. Conclusion: Therefore, PPD had less impact on surgical and postoperative outcomes of pathological stage 0 or I lung cancer; direct surgical resection without non-surgical biopsy would be acceptable with careful selection of cases.


A bioinformatics laboratory exercise based on inherited human morphological traits is presented. It teaches how morphological characters can be used to study the evolutionary history of humans using parsimony. The exercise can easily be used in a pen-and-paper laboratory, but if computers are available, a more versatile analysis can be carried out. The exercise introduces students to the basics of bioinformatics laboratory work, shows them possible problems associated in data acquisition, and most importantly, teaches them basic group working skills, such as the appropriate distribution of work. An open and student-oriented approach, in which group work is designed to support the learning of individual students, was adapted. The exercise is devised in two sessions that cover collection of data, analysis using parsimony, and a combined matrix analysis in a parsimony framework. The exercise, or parts of it, has successfully been applied in bioinformatics courses intended for second to third year biology majors and in adult education.


The world is witnessing ever fastest growing pandemic with high morbidity and mortality that excessive volume of airline travels spread influenza infection; so physicians with various specialties should know and consider the impact of current pandemic on their daily practice. Among influenza A viruses that infect humans, an influenza A virus emerged that had shifted to H1N1. Primarily, the results of pandemic of H1N1 were in younger humans without preexisting immunity. Attack rates of swine influenza are relatively high, but mortality is relatively low and mortality rate is highest in the very young, the very old, and the immunosuppressed. In this new pandemic, there is not more evidence of the interface of H1N1 with chronic diseases; however, we expect that the Swine flu such as the previous influenza pandemics can change the course of many chronic diseases. In this review, we want to show the impacts of swine flu on cardiovascular system and disease. We will also discuss the importance of vaccination in chronic cardiovascular disease.


We consider the information transmission problem in neurons and its possible implications for learning in neural networks. Our approach is based on recent developments in statistical physics and complexity science. We also develop a method to try and select significant neural responses from the background activity and consider its wider applications. This would support temporal coding theory as a model for neural coding.


Summary Evidence supports the view that double-strand breaks (dsb) in the DNA of X-irradiated mammalian cells are the lesions leading to chromosome aberrations and eventual cell death. The detailed kinetics of repair of dsb in Ehrlich ascites tumour cells over long repair intervals have therefore been studied and compared under conditions simulating procedures known to cause large changes in cell survival. These conditions are: holding cells in stationary phase for 7h after X-irradiation, transference of cells to fresh growth medium immediately after X-irradiation, and treatment with the DNA synthesis inhibitor 9-f,-D-arabinofuranosyladenine (ara A) for 30min before, during and for 7h after X-irradiation. These conditions have also been investigated for their effects on the frequencies of chromosome abnormalities (anaphase bridges and fragments). It is shown that conditions leading to both an inhibition of dsb repair (in the presence of ara A) as well as an acceleration of dsb repair (by fresh growth medium) lead to higher frequencies of chromosome abnormalities as compared to those for cells under stationary conditions for 7h after irradiation. Holding dsb open for long periods with ara A may maximize the probability of formation of aberrations, however the data for fresh medium treatment show that it is not merely the rate at which dsb repair which determines the aberration frequency, and indicate the presence of other biochemical mechanisms in the cell which determine the frequency of conversion of dsb into chromosome aberrations.


Introduction: Blunt trauma to the penis is a rare but potentially serious injury that can occur by various mechanisms (e.g., kicks, accidents, sexual activity, and falls). The most common clinical presentation is sudden pain, swelling, and discoloration. Depending on the type and severity of injury, management can include conservative treatment or surgery, with the ultimate goal being the prevention of delayed complications. Case presentation: A 30-year-old male presented with penile pain, swelling, and redness as a result of blunt trauma to his penis 1 week after penile enhancement surgery using a subcutaneous soft silicone implant. Once the patient's blood pressure was stabilized, surgical management consisted of exploration with evacuation of a large hematoma and removal of the subcutaneous penile implant to avoid further perioperative and postoperative bleeding. Discussion: Postoperative bleeding is a risk factor associated with almost all types of surgical procedures, and its prevention is best achieved by identification and elimination of potential causes pre- and postoperatively. Hypertension is another risk factor for excessive postsurgical bleeding, particularly bleeding associated with prosthetic implant surgeries, and should be considered for any potential surgical patient. Conclusion: With penile prosthesis and implant surgery, hypertension is an especially serious risk factor. Early surgical management is warranted in cases involving a major hematoma and swelling. Even cases with minimal bleeding should be evaluated in a timely manner, with surgical treatment indicated, rather than watchful waiting, to prevent further damage to the penis.


The plays in this volume are one-act dramas based on human situations as conceived and interpreted by Strindberg at a time when he was convinced human beings are essentially selfish, self-centered creatures. All of them have been presented successfully in Swedish and other Scandinavian theaters. The situations are surely typical: people's willingness to claim credit for a fellow human being's success, a mother's manipulation of her daughter's life, a wife's indifference to her mate except when others obviously wan him, denigration of a mate for one's own purposes, indifference to rationalization of one's sins, playing with one's own and others' emotions, and the unhesitant destruction of a fellow human being, at least partly in the name of religion. Written toward the end of his pre-Inferno period, Strindberg labelled these plays 'one-acters out of cynical life'. ['En aktare. Ur det chniska livet']. Translations of two other plays - "The Stronger" and "The Bond" - which belong to this group were included in Pre-Inferno Plays (University of Washington Press, 1970). In translating these plays, Walter Johnson has presented American versions, faithful to the original and expressed in languages as idiomatic and natural as the original Swedish.


Research was performed for the Illinois Department of Transportation (IDOT) to evaluate the feasibility of using terrestrial laser scans (TLS) on road construction projects as a cost-effective means of measuring earthwork quantities. A scanning workflow was developed that included detailed planning of pre-construction scan locations to capture point cloud data efficiently. Customized software was developed to allow users to view the large data sets in familiar station/offset coordinates in order to eliminate extraneous points and generate the ground surface. This surface was converted to a Triangulated Irregular Network (TIN) and earthwork quantities were calculated and compared to quantities computed using traditional cross-sections and average end area (AEA) method. The results indicated that TLS yields earthwork quantities consistent with AEA, provides additional data that may alleviate the need for return field work, and requires comparable field time for data collection.


Attachment of the cationic sugar 4-amino-4-deoxy-l-arabinose (l-Ara4N) to lipid A is required for the maintenance of polymyxin resistance inEscherichia coli and Salmonella typhimurium. The enzymes that synthesize l-Ara4N and transfer it to lipid A have not been identified. We now report an inner membrane enzyme, expressed in polymyxin-resistant mutants, that adds one or twol-Ara4N moieties to lipid A or its immediate precursors. No soluble factors are required. A gene located near minute 51 on theS. typhimurium and E. coli chromosomes (previously termed orf5, pmrK, oryfbI) encodes the l-Ara4N transferase. The enzyme, renamed ArnT, consists of 548 amino acid residues in S. typhimurium with 12 possible membrane-spanning regions. ArnT displays distant similarity to yeast protein mannosyltransferases. ArnT adds two l-Ara4N units to lipid A precursors containing a Kdo disaccharide. However, as shown by mass spectrometry and NMR spectroscopy, it transfers only a single l-Ara4N residue to the 1-phosphate moiety of lipid IVA, a precursor lacking Kdo. Proteins with full-length sequence similarity to ArnT are present in genomes of other bacteria thought to synthesizel-Ara4N-modified lipid A, including Pseudomonas aeruginosa and Yersinia pestis. As shown in the following article (Trent, M. S., Ribeiro, A. A., Doerrler, W. T., Lin, S., Cotter, R. J., and Raetz, C. R. H. (2001) J. Biol. Chem. 276, 43132–43144), ArnT utilizes the novel lipid undecaprenyl phosphate-α-l-Ara4N as its sugar donor, suggesting that l-Ara4N transfer to lipid A occurs on the periplasmic side of the inner membrane.


Examines the influence of cultural values, ecological affect and ecological knowledge on the green purchasing behavior of Chinese consumers. Using structural equation modeling to assess the significance that ecological affect and ecological knowledge have on green purchase intention and actual green purchase, the results demonstrate that a strong positive relationship exists. However, other important findings suggest that Chinese people's level of ecological knowledge is low and actual green purchase behavior minimal. Yet in contrast, Chinese consumers express a positive ecological affect and green purchase intention. In relation to the hypothesis that the Chinese strongly adhere to the cultural value of living in harmony with nature, the relevant descriptive statistic shows that today's Chinese only pay moderate allegiance to this "man‐nature" orientation. Moreover, this cultural value is only found to exert significant bearing on ecological affect but not ecological knowledge.


We have previously identified the gene Metastasis-Associated in Colon Cancer 1 (MACC1). MACC1 acts a prognostic biomarker for tumor progression, metastasis and patient survival for a broad variety of solid cancer types. Here we assessed if the MACC1 gene could separate stage II colon cancer patients with proficient mismatch repair (pMMR) into high- and low-risk groups who might benefit from or be spared adjuvant chemotherapy based on their prognosis. In the Charite 1 discovery cohort (n=61), MACC1 expression and MSI status were assayed by qRT-PCR in cryo-preserved tumors from CRC patients. MSS/MSI-low/MACC1-low tumors showed better survival vs. MSS/MSI-low/MACC1-high (Pl0.0001). Patients with MSS/MSI-low/MACC1-low tumors had a similar prognosis as patients with MSI-H tumors. The Charite 2 comparison cohort (n=40) was used to translate MACC1 qRT-PCR analyses to FFPE samples. MACC1 expression was significantly higher in metachronously metastasizing tumors linked to shorter relapse-free survival (RFS), independent of the tissue type analyzed (cryo-preserved or FFPE). Next we translated MACC1 mRNA levels from qRT-PCR to MACC1 protein levels from immunohistochemistry (IHC) by comparing them in consecutive FFPE tumor sections in the BIOGRID 1 training cohort (n=189) enriched for disease recurrence. Chemotherapy-naive patients with unfavorable pMMR status separated into MACC1-high and -low groups. Better RFS was seen in the pMMR/MACC1-low vs. pMMR/MACC1-high group using MACC1 mRNA and protein expression. pMMR/MACC1-low expression was seen in 12% and 8% of patients by qRT-PCR and IHC; interestingly, they had the same favorable prognosis as the deficient MMR (dMMR) group. Prognostic and predictive findings from BIOGRID 1 were confirmed in the independent BIOGRID 2 validation cohort (n=306) unenriched for recurrence. Better RFS was again seen in chemotherapy-naive patients in the pMMR/MACC1-low (6%) vs. pMMR/MACC1-high group. No patients with pMMR/MACC1-low phenotype had disease recurrence. Remarkably, pooling BIOGRID 1 and 2, 5-year RFS was 100% and thus significantly longer in the pMMR/MACC1-low vs. pMMR/MACC1-high group (P=0.037). Taken together, MACC1 expression, measured by qRT-PCR or IHC, differentiates patients with unfavorable pMMR status. Patients with stage II colon cancer and pMMR/MACC1-low tumor status have a similar favorable prognosis as those patients with dMMR status who might not benefit from adjuvant therapy. Citation Format: Ulrich-Peter Rohr, Pia Herrmann, Katharina Ilm, Hai Zhang, Sabine Lohmann, Astrid Reiser, Andrea Muranyi, Janice Smith, Susen Burock, Marc Osterland, Katherine Leith, Shalini Singh, Patrick Brunhoeber, Rebecca Bowermaster, Jeanne Tie, Michael Christie, Hui-Li Wong, Paul Waring, Kandavel Shanmugam, Peter Gibbs, Ulrike S. Stein. Combination of DNA mismatch repair status and MACC1 expression in patients with stage II colon cancer: The BIOGRID studies [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 2778. doi:10.1158/1538-7445.AM2017-2778


In the visual and auditory systems specialized neural pathways use motion cues to track object motion and self-motion, and use differential motion cues for figure-ground segregation. To examine the neural circuits that encode motion in the somatosensory system, we have developed neuroimaging methods to study motion processing in human and nonhuman primates. We have implemented stimulus presentation paradigms to examine neural encoding of apparent motion percepts. These paradigms are designed to be compatible with fMRI, optical imaging, and electrophysiological methods, thereby permitting direct comparison of data derived across neurofunctional scales. An additional motivation for using a common tactile motion stimulation paradigm is to bridge two disparate bodies of work, that derived from neuroimaging studies in humans and another from neuroimaging, neurophysiological and neuroanatomical studies in monkeys. Here, we demonstrate that such an approach through the use of optical imaging and 9.4 Tesla fMRI experiments in monkeys, and 7 Tesla fMRI experiments in humans is effective in revealing neural regions activated by tactile motion stimuli. These methods span spatial scales capable of detecting 100 μm sized domains to those that would reveal global whole brain circuits. Armed with such capabilities, our long-term goals are to identify directionally selective areas and directionally se-lective functional domains and understand the global pathways within which they reside. Such knowledge would have great impact on our thinking regarding not only tactile motion processing, but also general strategies underlying somatosensory cortical processing.


Focusing on ten key figures whose careers illuminate the history of the European exploration of North America, this book presents compelling first-person narratives that bring to life the challenges of historical scholarship in the academic classroom.
 Explorers of the American East: Mapping the World through Primary Documents covers 280 years of North American exploration and colonization efforts, ranging geographically from Florida to the Arctic. Arranged thematically and mononationally, the work focuses on a selection of 10 explorers who represent the changing course of North American exploration during the early modern period. The use of biography to narrate this history draws in readers and makes the work accessible to both a specialized and general audience. The dozens of primary source documents in this guided source reader span travel accounts, autobiographies, letters, official reports, memoirs, patents, and articles of agreement. This wide variety of primary sources serves to bring to life the failures and triumphs of exploring a newly discovered continent in the early modern period.
 This work focuses on ten explorers, including those who are well known, including John Cabot, John Smith, Jacques Cartier, and Samuel de Champlain, as well as discoverers who have slipped from our modern historical consciousness, such as George Waymouth, John Lawson, and J.F.W. Des Barres. The documents that narrate the voyages of these adventurers are arranged chronologically, vividly telling the story of historical events and presenting different voices to the reader. This variety of viewpoints serves to heighten readers' critical engagement with historical source material. The vast variety of primary source materials present students with the opportunity to read and engage critically with different types of historical documents, thereby growing their analytical skillsets.


Schizophrenia (SZ) that is resistant to treatment with dopamine (DA) D2 antagonists may involve changes other than those in the dopaminergic system. Recently, histamine (HA), which regulates arousal and cognitive functions, has been suggested to act as a neurotransmitter in the central nervous system. Four HA receptors-H1, H2, H3, and H4-have been identified. Our recent basic and clinical studies revealed that brain HA improved the symptoms of SZ. The H3 receptor is primarily localized in the central nervous system, and it acts not only as a presynaptic autoreceptor that modulates the HA release but also as a presynaptic heteroreceptor that regulates the release of other neurotransmitters such as monoamines and amino acids. H3-receptor inverse agonists have been considered to improve cognitive functions. Many atypical antipsychotics are H3-receptor antagonists. Imidazole-containing H3-receptor inverse agonists inhibit not only cytochrome P450 but also hERG potassium channels (encoded by the human ether-a-go-go-related gene). Several imidazole H3-receptor inverse agonists also have high affinity for H4 receptors, which are expressed at high levels in mast cells and leukocytes. Clozapine is an H4-receptor agonist; this agonist activity may be related to the serious side effect of agranulocytosis caused by clozapine. Therefore, selective non-imidazole H3-receptor inverse agonists can be considered as novel antipsychotics that may improve refractory SZ.


Fine dust particles in the air travel into our body via the airway tract and cause severe respiratory diseases. Thus, the analysis of the effects of dust particles on the respiratory system has been receiving significant research interest. However, most studies on the toxicity of dust particles involve two‐dimensional (2D) cell cultures, animal models, and epidemiology. Here, we inkjet‐printed a three‐dimensional (3D) alveolar barrier model to study how dust particles cause respiratory diseases. The three‐layered in vitro model was exposed to A2 fine test dust with varying concentrations and exposure durations. The results highlighted the destruction of the tissue architecture along with apoptosis in the bioprinted alveolar barrier. The damage at the cellular level induced an increase in the amount of pro‐inflammatory cytokines secreted, followed by triggering of the signal transduction pathway and activation of transcription factors. As a consequence of the release of cytokines, the extracellular matrix was degraded, which led to the collapse of the cell structure, loss of cell polarity, and a decrease in barrier tightness. Further, the pulmonary surfactant protein‐related genes in the dust‐treated alveolar tissue were investigated to evaluate the possible role of dust particles in pulmonary surfactant dysfunction. This study demonstrated the use of 3D‐printed tissue model to evaluate the physiological impact of fine dust particles on cytotoxicity, alveolar barrier rigidity, and surfactant secretion of an alveolar barrier.


Highly stable supercooled fluorescent liquids and crystallization-induced reversible fluorescence switching have been achieved via varying the alkyl chain length of the alkoxy group in the triphenylamine aldehyde, 4-(diphenylamino)-2-methoxybenzaldehyde (DPAMB). DPAMB and different alkyl chain substituted compounds, namely, ethyl (DPAEB), propyl (DPAPrB), butyl (DPABB), pentyl (DPAPeB), hexyl (DPAHB) and cyanohexyl (DPAH-CNB), exhibited weak fluorescence (λmax between 429 and 490 nm) in the solid state except DPAEB which did not show any measurable fluorescence. Structural analysis was performed to obtain an insight into the alkyl chain length effect on molecular packing in the solid state. Hard crushing of all the solids led to a drastic enhancement of the fluorescence intensity without altering λmax. Interestingly, the melts of all the compounds showed strong fluorescence with a red shift of the fluorescence λmax (460–489 nm). Slight rubbing of the melts produced reversible fluorescence switching. Powder X-ray diffraction (PXRD) studies suggested that the conversion from crystalline into amorphous and vice versa while melting the solids and rubbing the melts was responsible for the fluorescence switching. Importantly, the melt showed an alkyl chain length dependent stable supercooled fluorescent liquid at room temperature. Differential scanning calorimetry (DSC) indicated crystallization of the melts while heating/cooling the DPAMB and DPAEB melts, whereas DPAPrB, DPABB, DPAPeB, DPAHB and DPAH-CNB did not show any crystallization in the subsequent cooling/heating cycles. Thus, the alkyl chain length and propeller molecular shape of triphenylamine have been utilized for developing strongly fluorescent supercooled fluorescent liquids at room temperature.


Is 2015 the year you decide to open an urgent care practice? If you are interested in urgent care medicine, you are not alone. Growth is expected to continue as patients seek immediate access to medical care and lower-cost alternatives to emergency department visits. Despite the rewards, urgent care medicine comes with risks—especially for physicians unprepared for the business demands of operating an urgent care center.


A novel equalization/detection algorithm for orthogonal frequency division multiplexing (OFDM) signals transmitted over frequency-selective channels is introduced and investigated. The algorithm stems from the recognition that the Fourier transform processing inherent in OFDM turns a single wideband frequency-selective channel into a set of correlated narrowband frequency-flat fading channels. This suggests that sequence detection techniques, such as those discussed by Vitetta et al. (see IEEE Trans. Commun., vol.43, p.2750-8, 1995, IEEE Trans. Commun., vol.43, pt.II, p.1256-9, 1995, and Proc. IEEE Commun. Theory Mini-Conf (Globecom '96), London, UK, p.153-7, 1996), for time-selective flat-fading channels, can be also profitably utilized for joint equalization and decoding of OFDM signals in the frequency domain. Simulation results show that the proposed detection strategy, implemented via a standard Viterbi algorithm, provides improved performance over differential detection, with a moderate increase in receiver complexity and without requiring the periodic transmission of training blocks.


A field experiment was conducted to remove the potential eutrophication effect of N and P from rural wastewater (RW) during the whole rice growing season of 2010. Commercial fertilizer and RW were applied to furnish 40 kg P ha-1except CK. Results showed TN concentration of the floodwater in the paddy wetland system decreased quickly after transplanting, rosed significantly (P ≤ 0.05) after two N topdressings, and then decreased gradually as the following sequences: SW > GW > DW > BW > CK. Total P (TP) concentration had significantly declined after P application, from October 15 there were no significant increases in TP concentration in the floodwater. Meanwhile, the yield for CK was significantly less (P ≤0.05) than SW, GW, DW, and BW, with the yield of BW significantly greater (P ≤ 0.05) than other treatments. It is feasible to remove N and P from RW by the paddy wetland system and can be widely used to improve the yield of rice.


Augmented Reality enhances the user perception by overlaying real world information with computer-generated information. In this paper, we study the user experience in Augmented Reality for the deployment of real-time adaptation. In the context of thin-client mobile Augmented Reality, the rate is often constrained due to limitations in the transmission link. End-to-end delay, frame rate, image size and head motion speed have been identified as important variables impacting the user experience. We propose a model to link the effect of these variables with the Quality of Experience metrics. Using this model, we present an adaptation scheme that adapts, in real time, the frame rate and the image size to maximize the Quality of Experience according to the context while satisfying the given rate constraint. Simulation shows the efficiency of the proposed scheme which achieves a better Quality of Experience than without adaptation. The adaptation still performs better than a solution with a fixed frame rate set to its maximum value.


Deep Neural Networks (DNNs) have achieved impressive accuracy in many application domains including im-age classification. Training of DNNs is an extremely compute-intensive process and is solved using variants of the stochastic gradient descent (SGD) algorithm. A lot of recent research has focused on improving the performance of DNN training. In this paper, we present optimization techniques to improve the performance of the data parallel synchronous SGD algorithm using the Torch framework: (i) we maintain data in-memory to avoid file I/O overheads, (ii) we propose optimizations to the Torch data parallel table framework that handles multi-threading, and (iii) we present MPI optimization to minimize communication overheads. We evaluate the performance of our optimizations on a Power 8 Minsky cluster with 64 nodes and 256 NVidia Pascal P100 GPUs. With our optimizations, we are able to train 90 epochs of the ResNet-50 model on the Imagenet-1k dataset using 256 GPUs in just 48 minutes. This significantly improves on the previously best known performance of training 90 epochs of the ResNet-50 model on the same dataset using the same number of GPUs in 65 minutes. To the best of our knowledge, this is the best known training performance demonstrated for the Imagenet-1k dataset using 256 GPUs.


In this paper we study the motion of a rigidly rotating Nambu - Goto test string in a stationary axisymmetric background spacetime. As special examples we consider rigid rotation of strings in a flat spacetime, where explicit analytic solutions can be obtained, and in the Kerr spacetime where we find an interesting new family of test string solutions. We present a detailed classification of these solutions in the Kerr background.


Oral anticoagulant therapy with vitamin K antagonists (VKAs) such as warfarin has proven benefits in the treatment and prevention of thromboembolic disorders but has important limitations that result in substantial underuse. In particular, the VKAs have variable and unpredictable pharmacokinetics and pharmacodynamics and a narrow separation between antithrombotic and hemorrhagic effects that necessitates careful dose adjustment based on frequent coagulation monitoring. In contrast, the oral direct thrombin inhibitor ximelagatran has a predictable and reproducible pharmacokinetic/pharmacodynamic profile that allows treatment using fixed-dose regimens without coagulation monitoring. The bioavailability of melagatran, the active form of ximelagatran, after oral administration of ximelagatran is approximately 20% with low inter- and intra-individual variability. Peak plasma melagatran concentrations are reached approximately 2 hours after oral dosing of ximelagatran to healthy volunteers, and melagatran is eliminated with a half-life of approximately 3 hours with clearance predominantly by renal excretion. Hence, a higher melagatran exposure is seen in patients with renal failure; ximelagatran is currently not recommended for patients with severe renal impairment (creatinine clearance of <30 mL/min) as these patients were not included in the clinical trial program. Exposure to melagatran increases linearly with the ximelagatran dose. The pharmacokinetic/pharmacodynamic profile is consistent across a broad range of different patient populations and is unaffected by gender, age, body weight, ethnic origin, obesity, and mild-to-moderate hepatic impairment. Any differences in melagatran pharmacokinetics associated with these factors are attributable to differences in renal function.


Omega‐3 polyunsaturated fatty acids (PUFAs) have unique properties purported to influence several aspects of metabolism, including energy expenditure and protein function. Supplementing with n‐3 PUFAs may increase whole‐body resting metabolic rate (RMR), by enhancing Na+/K+ ATPase (NKA) activity and reducing the efficiency of sarcoplasmic reticulum (SR) Ca2+ ATPase (SERCA) activity by inducing a Ca2+ leak‐pump cycle. The purpose of this study was to examine the effects of fish oil (FO) on RMR, substrate oxidation, and skeletal muscle SERCA and NKA pump function in healthy older individuals. Subjects (n = 16 females; n = 8 males; 65 ± 1 years) were randomly assigned into groups supplemented with either olive oil (OO) (5 g/day) or FO (5 g/day) containing 2 g/day eicosapentaenoic acid and 1 g/day docosahexaenoic acid for 12 weeks. Participants visited the laboratory for RMR and substrate oxidation measurements after an overnight fast at weeks 0 and 12. Skeletal muscle biopsies were taken during weeks 0 and 12 for analysis of NKA and SERCA function and protein content. There was a main effect of time with decrease in RMR (5%) and fat oxidation (18%) in both the supplementation groups. The kinetic parameters of SERCA and NKA maximal activity, as well as the expression of SR and NKA proteins, were not affected after OO and FO supplementation. In conclusion, these results suggest that FO supplementation is not effective in altering RMR, substrate oxidation, and skeletal muscle SERCA and NKA protein levels and activities, in healthy older men and women.


Introduction Sepsis is a common and deadly complication of infection. As part of the host response, sympathetic stimulation can result in septic myocardial depression, and metabolic, haematological and immunological dysfunction. Administration of β-blockers may attenuate this pathophysiological response to infection, but the effects on clinical outcomes are unknown. The objective of this systematic review is to determine the efficacy and safety of β-blockers in adults with sepsis using data from randomised control trials. Methods and analysis We will identify randomised control trials comparing treatment with β-blockers, versus placebo or standard care in adults with sepsis. Data sources will include MEDLINE, EMBASE, CENTRAL, clinical trial registries and conference proceedings. Two reviewers will independently determine trial eligibility. For each included trial, we will conduct duplicate independent data extraction, risk of bias assessment and evaluation of the quality of the evidence using the GRADE approach. Ethics and dissemination Our systematic review will evaluate the effects of β-blockers in adults with sepsis, comprehensively summarising and appraising the available evidence from randomised control trials. The results of this systematic review will help clinicians treating patients with sepsis to understand the potential role of β-blockade, and inform future research on this topic. Our findings will be disseminated through conference presentation and publication in a peer-reviewed journal. Trial registration number CRD42016036933.


Department of Radiotherapy and Chemotherapy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China Purpose: To evaluate the predictive value of blood lymphocyte, monocyte to lymphocyte ratio (MLR), and neutrophil to lymphocyte ratio (NLR) for radiation pneumonia (RP) in patients with thoracic tumors receiving radiotherapy. Patients and Methods: The clinical data of 65 patients with thoracic tumor (esophageal cancer, lung cancer) treated by radiotherapy in our hospital were retrospectively analyzed. Patients were divided into the RP group and the non-RP group according to the Common Terminology Criteria for Adverse Events (CTCAE 5.0). Data on blood cell counts, including lymphocytes, monocytes, and neutrophils, were collected before (0 weeks) and after 1, 2, and 4 weeks of radiotherapy. Results: Of the 65 patients enrolled, 27 developed radiation pneumonia and 38 did not. Patients' clinical factors, including age, TNM stage, tumor type, underlying lung disease, and history of smoking, had no correlation with RP. ANOVA of repeated measurement data showed that the changes of MLR in the group with RP during radiotherapy were significantly different from those in the non-RP group (P<0.05). The RP prediction model based on the identified risk factors was established using receiver operator characteristic curves. The results showed that the area under the curve for the monocyte to lymphocyte ratio was 0.755 (95% CI, 0.63–0.87, P=0.000), and the best cutoff point for MLR was 0.426. Conclusion: MLR could predict radiation pneumonia in patients with thoracic tumor radiotherapy and achieve early monitoring, early prevention, and treatment.


By using the general solutions of a new coupled Riccati equations, a direct algebraic method is described to construct doubly periodic solutions (Jacobi elliptic function solution) for the coupled nonlinear Klein-Gordon equations.It is shown that more doubly periodic solutions and the corresponding solitary wave solutions and trigonometric function solutions can be obtained in a unified way by this method.


Achieving adequate oral immunosuppression in a renal transplant patient who develops short bowel syndrome provides a significant challenge. We report a case where oral tacrolimus has been used to provide immunosuppression in an established renal transplant patient who developed short bowel syndrome secondary to mesenteric infarction. After reviewing the literature, we conclude that tacrolimus can be used as first-line immunosuppression in patients with short bowel syndrome.