Aberrant activation of with-no-lysine kinase (WNK)-STE20/SPS1-related proline-alanine-rich protein kinase (SPAK) kinase signaling in the distal convoluted tubule (DCT) causes unbridled activation of the thiazide-sensitive sodium chloride cotransporter (NCC), leading to familial hyperkalemic hypertension (FHHt) in humans. Studies in FHHt mice engineered to constitutively activate SPAK specifically in the DCT (CA-SPAK mice) revealed maladaptive remodeling of the aldosterone sensitive distal nephron (ASDN), characterized by decrease in the potassium excretory channel, renal outer medullary potassium (ROMK), and epithelial sodium channel (ENaC), that contributes to the hyperkalemia. The mechanisms by which NCC activation in DCT promotes remodeling of connecting tubule (CNT) are unknown, but paracrine communication and reduced salt delivery to the ASDN have been suspected. Here, we explore the involvement of prostaglandin E2 (PGE2). We found that PGE2 and the terminal PGE2 synthase, mPGES1, are increased in kidney cortex of CA-SPAK mice, compared to control or SPAK KO mice. Hydrochlorothiazide (HCTZ) reduced PGE2 to control levels, indicating increased PGE2 synthesis is dependent on increased NCC activity. Immunolocalization studies revealed mPGES1 is selectively increased in the CNT of CA-SPAK mice, implicating low salt-delivery to ASDN as the trigger. Salt titration studies in an in vitro ASDN cell model, mouse CCD cell (mCCD-CL1), confirmed PGE2 synthesis is activated by low salt, and revealed that response is paralleled by induction of mPGES1 gene expression. Finally, inhibition of the PGE2 receptor, EP1, in CA-SPAK mice partially restored potassium homeostasis as it partially rescued ROMK protein abundance, but not ENaC. Together, these data indicate low sodium delivery to the ASDN activates PGE2 synthesis and this inhibits ROMK through autocrine activation of the EP1 receptor. These findings provide new insights into the mechanism by which activation of sodium transport in the DCT causes remodeling of the ASDN.


The objective of this paper is to show the importance of measuring electricity end-uses in order to promote energy efficiency in low-income houses in Southern Brazil. Sixty low-income houses were surveyed, and data of socioeconomic variables, electricity use, and usage pattern were measured and obtained. Confidence intervals were assigned to obtain representative electricity end-uses and usage patterns. The results showed that the electric shower has the greatest electricity end-use, i.e., 33.5 to 40.3%, followed by the refrigerators, with end-use of 27.4 to 33.1% with 90% non-parametric confidence interval. Usage patterns were obtained for appliances and lighting for each room and also for the electric shower. The results of this study will provide basis for determination of guidelines for low-income houses and government programmes for energy efficiency, rational use of energy and renewable energy.


TO THE EDITOR: We agree with Selvey and Carey1 that minimising the environmental impact of the food supply chain is vital. However, we disagree with recommendations that target some food categories. Variation in environmental footprint within a food category can be more important than the variation between categories.2 Research on environmental modelling systems needs to address complex trade-offs between factors such as carbon emissions, water, land use and biodiversity. Without this, we risk unintended adverse outcomes in other areas of environmental protection.3 Therefore, we recommend the following strategies, where there is greater certainty of benefit. Reducing overconsumption of nutrient-poor foods: In Australian adults, 36% of kilojoules consumed are from energy-dense, nutrientpoor foods,4 which are predominantly of plant origin. Total food and kilojoule consumption correlates most strongly with environmental impact.5 Reducing consumption of these foods should be central to recommendations to benefit both health and the environment. Consuming adequate nutrient-rich foods: The nutritional value of foods needs attention in the environmental debate. Blanket recommendations to limit animal-based food products and increase plant-based foods are inconsistent with dietary changes required to achieve adequate nutrition. Reducing food waste: Australia wastes more than $5.2 billion of food each year.6 The World Resources Institute suggests that a 50% reduction in losses and wastage in the production and consumption chain is a necessary and achievable goal.7 The draft appendix to the Australian dietary guidelines makes an important attempt to focus on these actions. Manny Noakes Research Program Leader Bradley G Ridoutt Principal Research Scientist Gilly Hendrie Research Projects Officer Brian A Keating Director


Objectives: The aim of this study was to evaluate pre-operative real-time dynamic transvaginal ultrasound (TVS) in the prediction of pouch of Douglas (POD) obliteration in women undergoing laparoscopy for suspected endometriosis. Methods: Multi-centre prospective observational study undertaken from January 2009 to November 2011. All women with symptoms suggestive of endometriosis scheduled for laparoscopy underwent a detailed pre-operative TVS, in particular, to ascertain whether the POD was obliterated. POD obliteration was assessed using a realtime TVS technique called the 'sliding sign'. These pre-operative TVS 'sliding sign' findings were then compared to gold standard laparoscopic POD findings. Results: 100 consecutive women with pre-operative TVS and laparoscopic outcomes were included in the final analysis. Mean age was 32.8 years and mean age for diagnosis of endometriosis was 27.4 years. 84/100 (84%) were found to have some form of endometriosis at laparoscopy (73% peritoneal endometriosis, 35% ovarian endometrioma/s, 34% deep infiltrating endometriosis). At laparoscopy, 30/100 (30%) had an obliterated POD and 20/30 (66.7%) of these women also had evidence of bowel endometriosis. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio for using the real-time 'sliding sign' ultrasound technique to predict POD obliteration were 92.0%, 80.0%, 97.1%, 92.3%, 91.9%, 28.0 and 0.21, respectively. Conclusions: Pre-operative real-time dynamic TVS evaluation of the posterior compartment using the 'sliding sign' seems to establish whether the POD is obliterated with a high degree of certainty.


SUMMARY Given the increase in rates of intermarriages, it is vital that we understand the issues and benefits of interracial relationships and the ways in which therapists might assist interracial couples. Our focus in this article is on interracial relationships in Hawaii. Because of its history of promoting interracial ties and its plural character, Hawaii is, in many ways, a unique setting for interracial relationships. At the same time, there are relational issues, benefits, and needs faced by both mainstream U.S. interracial couples and interracial couples in Hawaii. There are a variety of therapeutic interventions that could be used to help interracial couples. This chapter examines the factors in Hawaii's past and present that contribute to its particular history of interracial relationships, the common challenges that face interracial couples, personal and relational benefits of interracial relationships, and the therapeutic interventions from which interracial couples may benefit.


"There exists a secret art of the performer. There exists recurring principles which determine the life of actors and dancers in various cultures and epochs. These are not recipes but points of departure which make it possible for an individual's qualities to become Scenic Presence and to be manifest as personalised and efficient expression in the context of the individual's own history" (Barba 1991: 268).

This quote professes to contain the secret to the performer's art, a fundamental hidden technique, and yet it invokes more questions than it answers; such as what is 'Scenic Presence' and how can the principles used in training help to develop it? This thesis interrogates those questions to find both an intellectual understanding of what Scenic Presence is and a practical grasp of how the principles used in training can help its development.

I have based my research on the theories of Eugenio Barba, Phillip Zarrilli and John Britton and compared their findings with my own explorations in the studio during and after the training I embarked on in the summer of 2011.

The principles I have worked with are the attitudinal principles drawn from the work of John Britton: "pursue your pleasure", "pay attention to the things you can do something about" and "have no opinion." These will be explored in relation to some of the technical, recurring features of the extradaily body, identified but not invented by Eugenio Barba as "balance", "dynamic oppositions" and "posture".

While this report began as an investigation of Scenic Presence I have since discovered that Scenic Presence is a direct consequence of attention and therefore, towards the end, the focus of my report shifted to embrace this discovery.


Motivation and Objectives The rapid expansion of the biomedical knowledge encoded in the scientific literature is proving to be a major bottleneck for the progress of biomedical sciences. It is increasing difficult even for the best experts to keep track of all relevant information pertinent to their domain of interest. It is becoming therefore imperative to explore solutions based on advanced text mining technologies in order to identify and extract the most relevant nuggets of information from the vastness of the literature. Methods The OntoGene system (http://www.ontogene.org/) is an advanced NLP-based pipeline capable of efficiently processing large quantity of textual documentation and extracting from it specific items of information, and in particular the biomedical entities of interest to the user, and their relationships. Biomedical terminological resources can be leveraged for construction of large-scale knowledge bases. One example is KaBOB (Knowledge Base of Biology), a large RDF store based upon 17 prominent biomedical databases (Bada et al, 2011). Similar kinds of integrated data networks can be used for knowledge discovery purposes through usage of semantic web technologies (Chen et al, 2009). In our own work we have used such databases as knowledge sources for the process of semi-automated information extraction. In the rest of this section we describe the OntoGene Text Mining pipeline which is used to (a) provide all basic preprocessing (e.g. tokenization) of the target documents, (b) identify all mentions of domain entities and normalize them to database identifiers, and (c) extract candidate interactions. We use in particular the following resources as terminology sources: UniProt Knowledge base (proteins), NCBI Taxonomy (species), Proteomics Standards Initiative Molecular Interactions Ontology (experimental methods), Cell Line Knowledge Base (cell lines), UMLS (diseases), etc. Terms, i.e. preferred names and synonyms, are automatically extracted from the original database and stored in a common internal format, together with their unique identifiers (as obtained from the original resource). An efficient lookup procedure is used to annotate any mention of a term in the documents with the ID(s) to which it corresponds. A term normalization step is used to take into account a number of possible surface variations of the terms. The same normalization is applied to the list of known terms at the beginning of the annotation process, when it is read into memory, and to the candidate terms in the input text, so that a matching between variants of the same term becomes possible despite the differences in the surface strings (Rinaldi et al, 2008). The system combines mentions of relevant domain entities (and their corresponding unique identifiers) from the same syntactic context in order to create candidate interactions. An initial ranking of the candidate relations can be generated on the basis of frequency of occurrence of the respective entities only. This ranking is further refined using a syntax-based approach, which is based upon an accurate parsing of all the sentences of the target document, and a machine learning approach which makes use of a maximum entropy classifier to boost candidate entities and interactions on the basis of the global distribution of information in the original database (Rinaldi, Schneider, et al, 2012). Results and Discussion The results of the text mining system are presented to the user through an intuitive and user-friendly interface, called ODIN (OntoGene Document Inspector). The ODIN interface allows the user to inspect entities and relationships identified by the text mining system, and see them in the context where they were originally found. For example, the figure below shows an implementation of ODIN customized for curation of the Comparative Toxicogenomics Database (CTD, Mattingly et al, 2006). The left panel shows the original document, with entities underlined and color-coded (green: chemicals, yellow: diseases, blue: genes). The right panel shows the candidate relationships identified by the system. Selecting one of the interactions will highlight in the document the information that was used by the system to propose that interaction. The results (interactions in this case) are presented according to a ranking which is based upon a score reflecting the confidence of the system in a given proposed interaction, thus allowing the user to stop inspecting them at an optional confidence threshold. The user can with a simple click then confirm or reject a candidate interaction. Additionally, all entities are easily editable, allowing correction of annotation errors. The OntoGene pipeline has been applied to several Information Extraction tasks. In the context of the BioCreative challenges (Krallinger et al 2008), the system was capable of achieving the best results in extracting mentions of protein-protein interactions (2009) and mentions of experimental methods for protein interaction detection (2006). Recently the system has been adapted for an experiment in assisted curation for the PharmGKB database (Klein et al 2001). This experiment, conducted in collaboration with PharmGKB curators, has lead to interesting results showing the reliability and usability of the system (Rinaldi, Clematide, et al, 2012). In the "triage" task of BioCreative 2012 (ranking of documents according to relevance for the curation process of the CTD database), once again the OntoGene system obtained the best overall results among the participants (Rinaldi et al, 2013). Acknowledgements This research is partially funded by the Swiss National Science Foundation (grant 100014-118396/1) and Novartis AG, NIBR-IT, TextMining Services, CH-4002, Basel, Switzerland. References Michael Bada, Kevin Livingston, and Lawrence Hunter. An ontological representation of biomedical data sources and records. Bio-Ontologies, 2011. Huajun Chen, Li Ding, Zhaohui Wu, Tong Yu, Lavanya Dhanapalan, and Jake Y. Chen. Semantic web for integrated network analysis in biomedicine. Briefings in Bioinformatics, 10(2):177–192, 2009 T.E. Klein, J.T. Chang, M.K. Cho, K.L. Easton, R. Fergerson, M. Hewett, Z. Lin, Y. Liu, S. Liu, D.E. Oliver, D.L. Rubin, F. Shafa, J.M. Stuart, and R.B. Altman. Integrating genotype and phenotype information: An overview of the PharmGKB project. The Pharmacogenomics Journal, 1:167–170, 2001. M. Krallinger, Alexander Morgan, Larry Smith, Florian Leitner, Lorraine Tanabe, John Wilbur, Lynette Hirschman, Alfonso Valencia. Evaluation of text-mining systems for biology: overview of the second BioCreative community challenge. Genome Biology, 2008, 9(Suppl 2):S1. C.J. Mattingly, M.C. Rosenstein, G.T. Colby, J.N. Forrest Jr, and J.L. Boyer. The Comparative Toxicogenomics Database (CTD): a resource for comparative toxicological studies. Journal of Experimental Zoology Part A: Comparative Experimental Biology, 305A(9):689–692, 2006. Fabio Rinaldi, Thomas Kappeler, Kaarel Kaljurand, Gerold Schneider, Manfred Klenner, Simon Clematide, Michael Hess, Jean-Marc von Allmen, Pierre Parisot, Martin Romacker, and Therese Vachon. OntoGene in BioCreative II. Genome Biology, 9(Suppl 2):S13, 2008. Fabio Rinaldi, Simon Clematide, Yael Garten, Michelle Whirl-Carrillo, Li Gong, Joan M. Hebert, Katrin Sangkuhl, Caroline F. Thorn, Teri E. Klein, and Russ B. Altman. Using ODIN for a PharmGKB revalidation experiment. The Journal of Biological Databases and Curation, Oxford Journals, 2012 Fabio Rinaldi, Gerold Schneider, Simon Clematide. Relation Mining Experiments in the Pharmacogenomics Domain. Journal of Biomedical Informatics, 2012. Fabio Rinaldi, Simon Clematide, Simon Hafner, Gerold Schneider, Gintare Grigonyte, Martin Romacker, Therese Vachon. Ranking of CTD articles and interactions using the OntoGene pipeline. The Journal of Biological Databases and Curation, Oxford Journals, 2013 (accepted for publication). Thomas C. Wiegers, Allan Peter Davis, and Carolyn J. Mattingly. Collaborative Biocuration-Text Mining Development Task for Document Prioritization for Curation. The Journal of Biological Databases and Curation, Oxford Journals, 2013 (accepted for publication). Note: Figures and tables are available in PDF version only.


In the upcoming Term, the Supreme Court will consider a case raising the question whether the Federal Insecticide, Fungicide, and Rodenticide Act preempts state tort law, or only state positive law. FIFRA, under which the Environmental Protection Agency regulates pesticide labels, has an express preemption clause and clearly preempts state positive law on labeling. The question presented is whether and to what extent it also preempts state tort law, particularly claims for failure to warn. The Court's precedent on preemption of state tort law is erratic, but for some reason, the pro-preemption view has been much more popular with lower courts. The view that FIFRA broadly preempted state tort law was unanimous for several years, until the EPA filed an amicus brief in a California case arguing against preemption. That brief was rejected in most courts but accepted in Montana and Oregon. Under President Bush, however, the EPA reversed its preemption and now argues in favor of preemption - which in practice means near-complete immunity for pesticide manufacturers against claims by consumers or bystanders. This paper argues that the Supreme Court should hold that even though FIFRA preempts states from passing laws about what should be on a pesticide label, FIFRA does not preempt tort claims for failure to warn about the dangers of the pesticide. In doing so, the Court should clarify the operation of various presumptions it is adopted for when to find state law preempted by a federal statute.


In summary, nerve sheath neoplasms have a wide spectrum of histological and ultrastructural appearances. The diagnosis of classical schwannomas can usually be made with confidence by light microscopy alone, but cellular schwannomas, malignant schwannoma, special types of schwann cell neoplasma (pigmented, epithelioid, granular cell), desmoplastic amelanotic melanomas, and neurofibromas should all be studied by electron microscopy if the cell type is to be established with certainty. It is our experience and impression that a high level of diagnostic accuracy can be accomplished by this technique in all but a few of the cellular and pleomorphic (probable) schwann cell tumors, and in many of the neurofibromatous tumors.


Three experimental paradigms used to study human-to-human and human-to-intelligent-machine relationships within a distributed decision-making environment are briefly described. Each approach focuses on different aspects of fusing multiple sources of knowledge into a coherent decision-making system. The first approach uses a computer-based team resource allocation problem to study dynamic team decision-making. The second approach uses the communication, command, and control (C3) interactive task for identifying emerging situations to study the effect of electronic media on group cohesion situation awareness and task performance. The third approach, cooperative systems methodology, proposes a methodology for integrating human decision-making with cooperative expert systems.<<ETX>>


Soils and recent marine sediments contain a complex polycyclic aromatic hydrocarbon assemblage. There is a high degree of similarity in the molecular weight distribution of the many series of alkyl homologs of these aromatic hydrocarbons, and this distribution varies little over a wide range of depositional environments. The evidence suggests that these hydrocarbons are formed in natural fires, are dispersed and mixed by air transport, and are eventually deposited into surface sediments. The analytical, geochemical, and environmental implications of these findings are discussed.


The ATIC balloon-borne experiment measures the energy spectra of elements from H to Fe in primary cosmic rays from about 100 GeV to 100 TeV. ATIC is comprised of a fully active bismuth germanate calorimeter, a carbon target with embedded scintillator hodoscopes, and a silicon matrix that is used as a main charge detector. The silicon matrix produces good charge resolution for the protons and helium but only a partial resolution for heavier nuclei. In the present paper a charge resolution of ATIC device was essentially improved and backgrounds were reduced in the region from Be to Si by means of the upper layer of the scintillator hodoscope that was used as an additional charge detector together with the silicon matrix. The flux ratios of nuclei B/C, C/O, N/O in the energy region from about 10 GeV/nucleon to 300 GeV/nucleon that were obtained from new high-resolution and high-quality charge spectra of nuclei are presented. The results are compared with existing theoretical predictions.


The aim of the present research was to evaluate the use of the sugary Kefir grains as a starter culture for new rice cereal-based Kefir beverage. Fermentation was performed by inoculating Kefir grains in rice extract. Flasks containing Kefir grains and substrates were statically incubated at 28°C for 24 h. The microbiota of sugary Kefir grains and rice cereal-based Kefir beverage were genera Lactobacillus, Lactococcus and Acetobacter as well as yeasts, such as Saccharomyces, Kluyveromyces, Lachancea and Kazachstania. The sugary Kefir grains were able to ferment the rice extract and produced Kefir beverage that are functional and healthy that satisfy nutrition-related conditions such as allergies and malabsorption, food intolerances, and lifestyle choices, for example vegetarianism and low salt. The use of starter cultures as Kefir grains offers a promising tool for innovation and diversification of cereal-based beverages. This study was the first to report the rice cereal-based Kefir beverage production. This result opens up perspectives for this innovative application of sugary Kefir grains for developing cereal-based beverages.

 Key words: Probiotic, fermentation, food intolerances, vegetarianism.


Background and Purpose The current state of health care demands higher-value care. Due to many barriers, clinicians routinely do not implement evidence-based care even though it is known to improve quality and reduce cost of care. The purpose of this case report is to describe a theory-based, multitactic implementation of a quality improvement process aimed to deliver higher-value physical therapy for patients with low back pain. Case Description Patients were treated from January 2010 through December 2014 in 1 of 32 outpatient physical therapy clinics within an academic health care system. Data were examined from 47,755 patients (mean age=50.3 years) entering outpatient physical therapy for management of nonspecific low back pain, with or without radicular pain. Development and implementation tactics were constructed from adult learning and change management theory to enhance adherence to best practice care among 130 physical therapists. A quality improvement team implemented 4 tactics: establish care delivery expectations, facilitate peer-led clinical and operational teams, foster a learning environment focused on meeting a population's needs, and continuously collect and analyze outcomes data. Physical therapy utilization and change in functional disability were measured to assess relative cost and quality of care. Secondarily, charge data assessed change in physical therapists' application of evidence-based care. Outcomes Implementation of a quality improvement process was measured by year-over-year improved clinical outcomes, decreased utilization, and increased adherence to evidence-based physical therapy, which was associated with higher-value care. Discussion When adult learning and change management theory are combined in quality improvement efforts, common barriers to implementing evidence-based care can be overcome, creating an environment supportive of delivering higher-value physical therapy for patients with low back pain.


The Bhatnagar, Gross, and Krook modeled Boltzmann equation has been applied to simulate different fluid dynamics problems with varying degrees of success. However, its application to direct aeroacoustic computation is less successful. One possible reason could be its inability to recover the state equation correctly for a diatomic gas and hence an inaccurate determination of the speed of sound. The present study reports on the development of an improved modeled Boltzmann equation for aeroacoustics simulation. The approach is to modify the Maxwellian distribution normally assumed for the equilibrium particle distribution function. Constraints imposed are the exact recovery of the state equation for a diatomic gas and the Euler equations without invoking the small Mach number assumption. Thus formulated, a distribution function consisting of the Maxwellian distribution plus three other terms that attempt to account for particle-particle collisions is obtained. A velocity lattice method is used to solve the improved modeled Boltzmann equation using an equivalent lattice equilibrium distribution function. The simulations are validated against benchmark aeroacoustic problems whose solutions are deduced from a direct numerical simulation of the Euler equations. The results of the improved modeled Boltzmann equation obtained using a smaller computational domain are in excellent agreement with those deduced from direct numerical simulation using a larger computational domain, thus verifying the viability and correctness of the modified equilibrium distribution function.


How we know, is at least as important as what we know: Before educationalists can begin to teach sustainability, we need to explore our own views of the world and how these are formed. The paper explores the ontological assumptions that underpin, usually implicitly, the pedagogical relationship and opens up the question of how people know each other and the world they share. Using understandings based in a phenomenological approach and guided by social constructionism, it suggests that the most appropriate pedagogical method for teaching sustainability is one based on situated learning and reflexive practice. To support its ontological questioning, the paper highlights two alternative culture's ways of understanding and recording the world: Those of the Inca who inhabited pre-Columbian Peru, which was based on the quipu system of knotted strings, and the complex social and religious system of the songlines of the original people of Australia. As an indication of the sorts of teaching experiences that an emancipatory and relational pedagogy might give rise to, the paper offers examples of two community learning experiences in the exemplar sustainable community of Stroud, Gloucestershire in the United Kingdom where the authors live.


The purpose of this guide is to do provide users with instructions, suggestions, and tips on how to access Miami Dade College's electronic resources from various devices such as smartphones, tablets, and e-readers.


Background: Besides being a procedure with high level of patient satisfaction, one of the main causes for reoperation after breast augmentation is related to contour deformities and changes in breast volume. Few objective data are available on postoperative volumetric analysis following breast augmentation. The aim of this study was to evaluate volume changes in the breast parenchyma and pectoralis major muscle after breast augmentation with the placement of silicone implants in the subglandular and submuscular planes. Methods: Fifty-eight women were randomly allocated either to the subglandular group (n = 24) or submuscular group (n = 24) and underwent breast augmentation in the subglandular or submuscular plane, respectively, or to a control group (n = 10) and received no intervention. Volumetric magnetic resonance imaging was performed at inclusion in all participants and either after 6 and 12 months in the control group or at 6 and 12 months after surgery in the intervention groups. Results: Twelve months after breast augmentation, only the subglandular group had a significant reduction in glandular volume (mean, 22.8 percent), while patients in the submuscular group were the only ones showing significant reduction in muscle volume (mean, 49.80 percent). Conclusions: Atrophy of the breast parenchyma occurred after subglandular breast augmentation, but not following submuscular breast augmentation. In contrast, submuscular breast augmentation caused atrophy of the pectoralis major muscle. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.


The tourism industry circulates signs through its synergies with other cultural industries, such as film, music, museum, video gaming, and the sports industry, to name but a few. This paper aims at exploring the creation or preservation of tourist myths and ideologies through the cartoon industry following the travel experiences of one of the first and most widely known animation characters, Mickey Mouse, in animated films such as the Hawaiian Holiday (1937), Mickey's Trailer (1938), Mr. Mouse Takes a Trip (1940), On Vacation with Mickey Mouse and Friends (1956), Croissant de Triomphe (2013), Tokyo Go (2013), Yodelberg (2013), O Sole Minnie (2013), Panda- monium (2013), Mumbai Madness (2014), O FutebalClάssico (2014), ¡FelizCumpleaños! (2015), Al Rojo Vivo (2015), Turkish Delights (2016), Entombed (2016), Dancevidaniya (2016), Locked in Love (2017), or Shipped Out (2017). In terms of methodology, this study of animated films and images will be conducted with the help of Greimas' semiotic square combined with Roland Barthes' writings on myth. The main objective of such research is to trace the tourist myths and ideologies that the animation industry proposes and highlights. The focus will therefore be on outlining any simplifications, stereotypes, and boundaries regarding tourist image-brand production, as well as foregrounding the creative practices and invitations to co-productions of meaning offered to young gazes, that is, those of future travelers.


Abstract: We introduce the so far most efficient attack against the Kirchhoff-law-Johnson-noise (KLJN) secure key exchange system. This attack utilizes the lack of exact thermal equilibrium in practical applications and is based on cable resistance losses and the fact that the Second Law of Thermodynamics cannot provide full security when such losses are present. The new attack does not challenge the unconditional security of the KLJN scheme, but it puts more stringent demands on the security/privacy enhancing protocol than for any earlier attack. In this paper we present a simple defense protocol to fully eliminate this new attack by increasing the noise-temperature at the side of the smaller resistance value over the noise-temperature at the side with the greater resistance. It is shown that this simple protocol totally removes Eve's information not only for the new attack but also for the old Bergou-Scheuer-Yariv attack. The presently most efficient attacks against the KLJN scheme are thereby completely nullified.


The author deconstructs the prevailing conceptualization of public sector marketing and concludes it rests on three principles: voluntary exchange, an open system organization, and self-interest motivation. A review of the genesis of these principles revealed that alternative principles were ignored in the social science literature. Based on a qualitative analysis and critical hermeneutic approach a revised conceptualization of public sector marketing was suggested which incorporated the principles of redistribution, the features of a closed system model of formal organizations, and collectivistic interest motivation. A revised definition of public sector marketing is offered based on these principles.


Prostate cancer patients treated with androgen deprivation therapy (ADT) eventually develop castrate-resistant prostate cancer (CRPC). 1,25-dihydroxyvitamin D3 (1,25D3), is a potential adjuvant therapy that confers anti-proliferative and pro-differentiation effects in vitro, but has had mixed results in clinical trials. The impact of the tumor microenvironment on 1,25D3 therapy in CRPC patients has not been assessed. Transforming growth factor-β (TGF-β), which is associated with the development of tumorigenic "reactive stroma" in prostate cancer, induced VDR expression in the human WPMY-1 prostate stromal cell line. Similarly, TGF-β enhanced 1,25D3-induced upregulation of CYP24A1, which metabolizes of 1,25D3 and thereby limits VDR activity. Ablation of Hic-5, a TGF-β-inducible nuclear receptor co-regulator, inhibited basal VDR expression, 1,25D3-induced CYP24A1 expression and metabolism of 1,25D3 and TGF-β-enhanced CYP24A1 expression. Luciferase reporter mapping of the CYP24A1 promoter identified a Hic-5-responsive sequence 392-451 bp upstream of the transcription start site (TSS). Ectopic expression of Hic-5 sensitized LNCaP prostate tumor cells to growth-inhibitory effects of 1,25D3 at a lower concentration by a pathway independent of CYP24A1. The sensitivity of Hic-5-expressing LNCaP cells to 1,25D3-induced growth inhibition was accentuated in co-culture with Hic-5-ablated WPMY-1 cells. Therefore, my findings suggest that the search for mechanisms to sensitize prostate cancer cells to the anti-proliferative effects of VDR ligands needs to account for the impact of VDR activity in the tumor microenvironment. By acting as a co-regulator with distinct effects on VDR transactivation in prostate cancer and stromal cells, Hic-5 could exert diverse effects on adjuvant therapy designed to exploit VDR activity in prostate cancer.


Background: Thoracic endovascular aortic repair (TEVAR) is a common treatment for high-risk patients with thoracic aortic aneurysms. However, these aneurysms are relatively rare in patients with dilated cardiomyopathy. We successfully treated a thoracic aortic aneurysm in an older patient who presented with dilated cardiomyopathy and low ejection fraction using TEVAR under general anesthesia. Case Presentation: An 84-year-old man was admitted to our institution with a thoracic aortic aneurysm, as well as dilated cardiomyopathy and an extremely low ejection fraction (15.4%). We scheduled the patient for TEVAR. Before administering general anesthesia, an external defibrillator was prepared for possible arrhythmia. General anesthesia was induced with 3 mg of intravenous midazolam and 100 μg of fentanyl. After endotracheal intubation, anesthesia was maintained with sevoflurane (1.2-1.5%). Intra-operative transesophageal echocardiography revealed that an end-diastolic internal diameter was about 65-70 mm and ejection fraction was 15-20%. Successful hemodynamic management during surgery was achieved with dopamine (1.6–2.4 μg/kg/min), noradrenaline (0.02– 0.06 μg/kg/min), and milrinone (0.06 μg/kg/min). TEVAR was successfully performed without complication, and the patient's postoperative clinical course was uneventful. He was discharged 14 days after surgery. Conclusions: We describe the uncommon use of TEVAR in an older patient with dilated cardiomyopathy and an extremely low ejection fraction. This case demonstrates that this minimally invasive surgery may be a suitable technique (under vigilant monitoring) to repair thoracic aortic aneurysms in older patients with low cardiac function. Case Report Citation: Akiko Ando, Takeshi Umegaki, So Yamaki, et al. Thoracic Endovascular Aortic Repair in a Patient with Dilated Cardiomyopathy and Low Ejection Fraction: A Case Report. Anesth Pain Res. 2018; 2(1): 1-4.


Phosphotriesterase, isolated from the soil-dwelling bacterium Pseudomonas diminuta, catalyzes the detoxification of organophosphate-based insecticides and chemical warfare agents. The enzyme has attracted significant research attention in light of its possible employment as a bioremediation tool. As naturally isolated, the enzyme is dimeric. Each subunit contains a binuclear zinc center that is situated at the C-terminal portion of a "TIM" barrel motif. The two zincs are separated by approximately 3.4 A and coordinated to the protein via the side chains of His 55, His 57, His 201, His 230, Asp 301, and a carboxylated Lys 169. Both Lys 169 and a water molecule (or hydroxide ion) serve to bridge the two zinc ions together. Interestingly, these metals can be replaced with cadmium or manganese ions without loss of enzymatic activity. Here we describe the three-dimensional structures of the Zn(2+)/Zn(2+)-, Zn(2+)/Cd(2+)-, Cd(2+)/Cd(2+)-, and Mn(2+)/Mn(2+)-substituted forms of phosphotriesterase determined and refined to a nominal resolution of 1.3 A. In each case, the more buried metal ion, referred to as the alpha-metal, is surrounded by ligands in a trigonal bipyramidal ligation sphere. For the more solvent-exposed or beta-metal ion, however, the observed coordination spheres are either octahedral (in the Cd(2+)/Cd(2+)-, Mn(2+)/Mn(2+)-, and the mixed Zn(2+)/Cd(2+)-species) or trigonal bipyramidal (in the Zn(2+)/Zn(2+)-protein). By measuring the anomalous X-ray data from crystals of the Zn(2+)/Cd(2+)-species, it has been possible to determine that the alpha-metal ion is zinc and the beta-site is occupied by cadmium.


This paper presents a method based on geometric active contours to segment and track biological cells in fluorescence videomicroscopy. To achieve robust segmentation of fluorescent cells with fuzzy boundaries, we use the region-based model introduced by Chan and Vese. The level set approach allows fully automatic initialization, detection of dividing cells and of cells entering the field of view during the sequence. However, the standard approach using only one level set function leads to undesired merging of touching cells and failure of tracking. To prevent this, we represent each cell by its own level set function and introduce a coupling constraint that minimizes overlaps of active contours. This technique maintains the separation of contours and allows tracking to proceed even when the boundary between cells is weak or invisible.


SUMMARY: Sclerotia of the rice sheath blight fungus, Rhizoctonia solani Kohn, were examined for their capacity to synthesize RNA, DNA, polyadenylic acid, and for their ribonuclease and protease activities during development on a liquid medium. During maturation, sclerotia appeared to pass through three phases. The first, a period of rapid RNA synthesis, was accompanied by a decline in the content of polyA(+)-RNA and a decrease in the permeability of the sclerotia. These changes suggested that the first 2 h were a time of reorientation of cellular metabolism. This was followed by a period of general synthesis lasting for 30 h which was accompanied by a further decrease in permeability, increased protease and ribonuclease activities and a rapid build-up of ribosomes. The second period terminated when protease activity declined, the other activities stabilized and the sclerotia began to turn brown. The third period, maturation, lasted for 15 days at which time the sclerotia began to float.


This paper examines processes involved in designing experimental spaces for institutional innovation. Through a qualitative, process-oriented analysis of an experimental space related to the institutional innovation of carbon markets in Europe, we show how key actors in the European electricity sector deliberately designed an experimental space and engaged a range of stakeholders in experimenting incognito with a carbon market model. A mirror image of their prototype later appeared as European policy. Our findings show that the key actors engaged in two forms of institutional work, distancing work and anchoring work, to design the experimental space. Distancing work consists in designing rules and procedures that alleviate institutional pressure on participants, encouraging them to engage creatively in developing alternative prototypes. Anchoring work consists in designing rules and procedures that connect the prototype to the organizational field, hence increasing the likelihood of institutional innovation. We develop a process model of institutional institutionalization that, through temporal interactions between distancing work and anchoring work, enables the generation and legitimacy of alternative prototypes.


Few cases of bacterial meningitis during pregnancy have been reported in the literature, and the causative microorganisms and prognosis of bacterial meningitis during pregnancy are unclear. In a 6-year period we identified six cases of bacterial meningitis in pregnant women. All were multigravida and gestational age at presentation ranged from 5 to 39 weeks. Predisposing factors were present in five patients and consisted of otitis in four patients. The causative organism was Streptococcus pneumoniae in all patients. Two patients died, both due to florid septic shock and brain herniation. Foetal outcome was good in five cases; one woman had a miscarriage 3 weeks after the episode of bacterial meningitis. We reviewed the literature on bacterial meningitis during pregnancy and identified 42 cases of bacterial meningitis. Twenty-five of these patients had pneumococcal meningitis and seven had meningitis caused by L. monocytogenes. We found that pneumococcal meningitis during pregnancy can be rapidly fatal and is associated with foetal death, especially in the first trimester. L. monocytogenes meningitis was associated with a high rate of neonatal deaths.


A technique using a tunable dispersive filter is presented to obtain the relative phase and amplitude of a periodic optical waveform. A proof-of-concept demonstration is presented using a dual-drive modulator to create modulated test signals. The experimental results of their characterization are presented and compared to theory.


textabstractContrary to conventional thinking, research has shown that
consumer choice is a motivational and dynamic process based
on goals and 'circumstances'.


Abstract: Mild cognitive impairment (MCI) is a syndromic label for people with informant-corroborated memory problems and evidence of memory impairment on formal testing in the absence of more pervasive deficits in cognition and functional abilities. It is often described as a "risk factor" for dementia though this is misleading; patients with the first signs of Alzheimer's disease (AD) will meet the criteria for MCI and as their illness progresses they will move to more traditional criteria for dementia (eg, DSM). Importantly though, they have not changed or "converted" from one disease to another. The problem with MCI clinically, and hence the reason why all such patients are not simply diagnosed with very mild AD is that as one moves closer to normal performance (ie, not clearly demented), the risk of patients who do not have AD (eg, so-called "worried well"; depression; alternate degenerative or non-degenerative pathology) being captured by the MCI syndrome increases. Furthermore, although the concept of MCI seems straightforward, "absence of dementia" or "intact cognition in domains other than memory" or even "objective evidence of memory impairment" varies according to the methods used to define each criterion. Nevertheless, with longitudinal follow-up to confirm that initial MCI status was due to incipient AD, this syndrome offers a important window to examine the earliest symptomatic stages of the disease. Emerging evidence from such studies have highlighted that incipient (MCI-stage) AD is underpinned by degeneration of an interconnected neural circuit including mesial temporal lobe, diencephalon and posterior cingulate regions—all of which, interestingly, have been implicated in memory processing from focal lesion studies in humans.


The outline which follows must be considered as the summary of eight years of empirical and theoretical research on the relationships between economic base and state super-structure in the urban field. These have been personal projects exemplified notably by three theoretical studies (Lojkine, 1969; 1972; 1975) and three regional monographs (Lojkine, 1973; 1974; 1976). But it is also for us a reflection upon the whole of marxist research as it has developed in France since the early 1970s in the realm of urban planning and policies. We hope that it may contribute to a better use of dialectical materialism in our concrete research as well.


In the present study we have used an in vitro culture system that induces differentiation of human CD34+ cells down the erythroid lineage along with 2‐D DIGE to determine the differential proteome of erythroblasts at specific developmental stages during erythropoiesis. We initially distinguished 154 proteins differentially expressed between pro‐normoblasts and polychromatic/orthochromatic erythroblasts, of which 24 protein spots, representing 21 different proteins, were identified following MS/MS and verification in replicate experiments with cells from different individuals. These data were confirmed by analysis of the differential proteome of erythroblasts at more discrete stages of erythropoiesis using 2‐D DIGE and by mapping the expression of three identified proteins (Annexin I, Annexin II, Carbonic Anhydrase I) throughout erythropoiesis by Western blot with specific antisera. In addition, the differential expression of proteins due to biological variation, such as polymorphism, was determined by comparing erythroblasts at the same developmental stage from different individuals; none of the proteins thus identified were represented in the above data set. Finally, we discuss the problems associated with 2‐D DIGE gel‐based proteomic approaches such as ours and suggest a modified approach for decreased inter‐gel variation, improved protein resolution and increased protein concentration, which should significantly facilitate protein identification.


A particle-in-cell computer simulation code has been used to study the transverse dynamics of nonrelativistic misaligned space-charge-dominated coasting beams in an alternating gradient focusing channel. In the presence of nonlinear forces due to dodecapole or octupole imperfections of the focusing fields or to image forces, the transverse rms emittance grows in a beat pattern. Analysis . indicates that this emittance dilution is due to the driving of coherent modes of the beam near their resonant frequencies by the nonlinear force. The effects of the dodecapole and images forces can be made to effectively cancel for some boundary conditions, but the mechanism is not understood at this time.


The genes for the large and small subunits of ribulose bisphosphate carboxylase/oxygenase (Rubisco) from Anacystis nidulans have been expressed in Escherichia coli under the control of the lac promoter to produce active enzyme. The enzyme can be purified from the cells to yield up to 200 mg Rubisco/l cultured bacteria, and is indistinguishable from the enzyme extracted from A. nidulans. In order to investigate the role of the N-terminus of the large subunit in catalysis, chimaeric genes were constructed where the DNA coding for the 12 N-terminal amino acids in A. nidulans was replaced by DNA encoding the equivalent, but poorly conserved, region of either the wheat or maize large subunit. These genes, in constructs also containing the gene for the A. nidulans small subunit, were expressed in E. coli and produced enzymes with similar catalytic properties to the wild-type Rubisco of A. nidulans. In contrast, when the N-terminal region of the large subunit was replaced by unrelated amino acids encoded by the pUC8 polylinker, enzyme activity of the expressed protein was reduced by 90% under standard assay conditions, due to an approximately tenfold rise in the Km for ribulose 1,5-bisphosphate. This confirms that the N-terminus of the large subunit has a function in catalysis, either directly in substrate binding or in maintaining the integrity of the active site.


Abstract Introduction Limb lengthening is increasingly accomplished by internal lengthening nails. Previous versions of the magnetic lengthening nails made from titanium alloy allowed limited weight-bearing. In contrast, the newer nails made of stainless steel allow increased weight-bearing. An objective comparison of the rate of healing of the regenerate bone based on the weight-bearing capabilities of these two types of lengthening nails has not been evaluated. The hypothesis for the study is that earlier commencement of full weight-bearing in patients treated with the stainless steel STRYDE® nail will lead to faster healing of the regenerate bone during intramedullary limb lengthening compared with those treated with the titanium PRECICE® nail. Materials and methods Thirty patients, divided into two groups of 15 each, underwent antegrade intramedullary lengthening of the femur using a magnetic lengthening nail between May 2017 and November 2020. The pixel value ratio (PVR) obtained from serial digital radiographs was used to quantitatively determine the regenerate bone's mineralisation rate. We compared the rate of healing of the regenerate bone in both groups of patients using the PVR. Results Patients treated with the STRYDE® nail achieved unassisted full weight-bearing significantly earlier than patients treated with the PRECICE® nail (12 weeks vs 17 weeks for STRYDE® and PRECICE® nail-lengthened patients, respectively, p = 0.003). There was no difference in the PVR between both groups of patients at the time of full weight-bearing (p = 0.0857). However, patients treated with the STRYDE® nail attained a PVR of 1 significantly earlier than those treated with the PRECICE® nail (0.0317). Conclusion The STRYDE® nail provides an earlier return of function and full weight-bearing compared with the PRECICE® lengthening nail. Earlier commencement of weight-bearing ambulation leads to more rapid mineralisation of the regenerate bone in patients undergoing intramedullary limb lengthening. How to cite this article Bafor A, Duncan ME, Iobst CA, et al. Early Weight-bearing Accelerates Regenerate Bone Mineralisation: A Pilot Study Comparing Two Post-operative Weight-bearing Protocols Following Intramedullary Limb Lengthening Using the Pixel Value Ratio. Strategies Trauma Limb Reconstr 2022;17(3):148–152.


This paper presents findings from focus group interviews conducted in Swedish government group homes for young people with a history of psychosocial problems, substance misuse and criminal behaviour. Participants were asked to reflect on a newly developed sex education curriculum located within a harm-reduction paradigm prior to its implementation. In addition to appreciating the proposed 10 sessions, young people positively evaluated the proposed dialogical and norm critical teaching style as likely to facilitate productive discussion about sexuality. Findings will contribute to future implementation of the sex education curriculum across a range of institutional settings. Results also highlight the democratic aspects of involving vulnerable young people in matters that directly concern them, and underline the importance of properly contextualised forms of sex education.


A comparison of triiodothyronine and thyroxin binding to red blood cells sampled from children and adolescents with such thyroid pathologies as cancer, adenoma, nodular goiter and thyroiditis, on the one hand, and healthy children, on the other, has established significant changes in the hormone-binding activity of erythrocytes in thyroid cancer patients. The thyroiditis-related changes suggested that disturbed thyroid hormone-binding by blood cells might play a role in thyroiditis and thyroid cancer pathogenesis.


Abstract Scattered trees are declining rapidly on Australian farms, a process that threatens landscape sustainability. Addressing this decline requires, in part, understanding how landholders perceive and manage scattered trees. We explored this via a quantitative survey of landholders in the Lachlan catchment of New South Wales. Although landholders are typically aware that scattered trees are declining more rapidly than other trees on the land they manage, they are less likely to actively encourage their regeneration compared to other trees. Landholders believe scattered trees have many private and public benefits, although they often believe their public benefits are lower than those provided by long strips or large patches of trees. Landholders who undertake mixed grazing and cropping are less likely than those who focus solely on grazing to actively encourage regeneration of scattered trees, and more likely to view them as impacting negatively on their agricultural enterprise. Reversing scattered tree decline requires programs to both increase landholder awareness of their public benefits and to address the specific land management constraints faced by different types of landholders when considering protecting and regenerating scattered trees.


The problem of low-frequency lateral train-car vibration is an important issue surrounding the design of high-speed trains. Passive vibration control solutions such as stiffening the car chassis are impractical because of the weight increase, and modifying the structural dynamics of the carboy through nonrigid coupling of heavy underfloor equipment does not come with a weight penalty, but do not sufficiently reduce the vibrations. This paper addresses two simple active vibration control systems for reducing lateral vibrations: one feedforward system and one feedback. Computer simulations based on signals derived from a dynamic computer model of a train car indicates that the incorporation of an active control system, in addition to the passive approach, is likely to introduce an improved attenuation of the low-frequency lateral vibrations. Active control results illustrate an attenuation of the lateral train-car vibration by up to 14 dB.


Tractor traffic as a cause of soil compaction is widely recognized as one of the most important factors responsible for environmental degradation and plant yield losses. It is a serious problem for perennial crops, where the soil surface is wheeled without any opening operation. The aim of our study was to evaluate the effect of tractor traffic on meadow fescue (Festuca pratensis) yields and root development. The field experiment was located in Mydlniki near Krakow, Poland, on silty loam Mollic Fluvisol. Experimental plots were established in randomized block design with four replications. Four compaction treatments were applied using the following range of number of passes: (P0) untreated control, (P2) two passes, (P4) four passes and (P6) six passes completely covering plot surfaces after each harvest. The dry matter (DM) of the yield and roots (RMD) were determined. Morphometric parameters of roots were estimated using image analysis software. Root length density (RLD), specific root length (SRL), and mean diameter (MD) were calculated. Tractor traffic resulted in significant influence on meadow fescue annual yields. The highest annual yields were obtained at the P2 and P4 treatments. However, in the first cut it was noticed that an increase in the number of passes increased plant yields. During the second and the third cut it was found that intensive tractor traffic decreased plant yields, probably as an effect of damage caused to above-ground parts of plants. The meadow fescue roots were significantly affected by tractor traffic only in the 5-15 cm soil layer. Tractor traffic increased the RLD value in a root diameter range of 0.1-0.5 mm. However, any other morphometric parameters, like mean root diameter (MD), specific root length (SRL) or dry root diameter (RDM) were not affected by soil compaction.


The aim of this study is to contribute to the bottom-up perspective in the study of civil society participation in local government decisions regarding urban green space. The study investigates what role civic actors set out to take and traces their engagement in the municipal decision-making processes. A descriptive theoretical framework is created to categorize environmental Non-Governmental Organizations' (NGO) strategies to intervene in the municipally governed green space planning within Stockholm County. With a theoretical basis in sociological and political science studies of social movements and public participation, I assess: 1) the timing of an intervention in the municipal planning process 2) degree of NGO collaboration with municipal authorities, and 3) the consensus or conflict driven nature of their approach towards the municipal authorities. Data on the interventions was collected from newsletters, meeting protocols and comments on development plans from the website of two prominent NGO as well as interviews with six activists in the Stockholm region. The distribution of the interventions found in Stockholm shows that reactive, non-participatory and conflict-driven strategies are the most common combination, although one third of the interventions have a participatory approach towards the municipality and a few interventions work to make a change by initiating consensus among stakeholders. Interviews with civic actors suggest that a lack of resources and low expected impact on official planning decisions hinders proactive and consensus-driven engagement, but also broken promises and a lack of responsiveness by municipal authorities can catalyze civic actors towards more conflictual methods of engagement. Further research topics of an explanatory nature on distribution and dynamics of interventions in the new theoretical framework are suggested based on reflections from the interviews.


The topic to this study is determination of mass spectrometric diffusion parameters "DSD" of oligomeric associates of glycylhomopeptides and their AgI–complexes according to our "stochastic dynamic" approach and model equations under electrospray ionization condition. The problematic has recently gained attenion thanks to the latter formulas connecting among "DSD" data; the measurable outcome "intensity" of analyte ions; and the experimental parameter "temperature," respectively. The equations are empirically testable and verifiable. In advancing this innovative view upon which models we will carry out analysis of ions of oligomeric associates of peptides, we should point out that it is crucial to further test our formulas on a larger set of chemical classes and experimental conditions in order to verify their universal applicability to different mass spectrometric ionization methods. Because of, on the concept sketched above the DSD parameters correlate excellent linearly with kinetic parameters of fragment reactions and quantum chemical diffusions according to the Arrhenius's approximation which reflects the 3D molecular structures of analytes. The most important point regarding our concept is that it extends crucially the capability of the mass spectrometry of multidimentional structural analysis when is applied to high accuracy quantum chemical static and molecular dynamic approaches.


The increasing rate of road crashes in this newly era had opened space of research to be conducted virtually. Hence, this study primarily designed to define the concept of virtual and visual experience. The understanding of this knowledge then enables the comparison of its application to be analyzed, especially in the field of engineering, medical and psychological. Numerous studies were reviewed involving the virtual and visual experience, which was related to the subject's state of consciousness and awareness, ability to control the task given as well as the visual condition. These related studies were compared and interpreted accordingly, while those studies that were not associated with this review were eliminated. The results of the study indicated that the usage of virtual and visual experience in research had contributed to many fields that benefits humanity and reduce the risk of injuries and crashes more, including cost saving. Yet, the studies often linked to the effects where the subjects might feel motion sickness as the inability of the instrument to produce enough motion exposure during the research process. Moreover, most studies showed the driving impairment and road accidents in subjects that has a visual impairment. Thus, this study proposed that, the good visual requirements were important and crucial in each driver as even the task performed in virtual by visually impaired drivers proven to be unsafe. In future, the studies on proper visual needs for driving compatibility are needed to address certain benchmark for safe driving practice.


Introduction: Timely identification of those with complex discharge needs (CDN) in hospital is important for good discharge practice. Our region developed a number of pathways to support those with CDN including rehabilitation of frail older patients; support for patients with dementia; enhanced short-term support at home by community intervention team; and a new 18-bedded transitional care unit. However, hospital audit documented delays identifying patients with CDN and poor recording of the predicted date of discharge (PDD). As a consequence there were opportunities for improved patient flow & discharge support missed. Practice change implemented: We instigated a "discharge support meeting" daily between Monday & Friday in our hospital. The bed manager, discharge coordinators, clinical nurse specialist in gerontology and consultant in geriatric medicine are available to other teams at this meeting. A member of each medical and surgical team attends and shares the discharge plan for each of their patients. PDD are amended at the meeting. Aim: Our aim is for more timely identification of patients with CDN throughout the hospital, thereby allowing those patients be matched to appropriate discharge support services and improve overall patient flow. Targeted population and stakeholders: Those with CDN represent about 20% of discharges but account for over 50% of bed days. They have on-going health & social care needs, require multidisciplinary assessment, frequently require in-patient rehabilitation and regularly need support on discharge. The "discharge support meeting" helps make improving patient flow a hospital-wide endeavour. Impact: The meeting commenced September 2016. Discharge bottlenecks are identified and acted upon at the meeting. Potential discharge supports are highlighted for individual patients early. Over 80% of doctors responding to our feedback survey find the meeting helpful. The accuracy of the PDD has increased significantly. There has been a 25% increase in consultations by geriatric medicine with a corresponding appropriate increase of both rehabilitation and transitional care bed use. Our hospital weekend discharges have increased to our highest levels. There is cultural change in relation to discharge planning needing active management.  Sustainability and transferability: The meeting is scheduled during patients' mealtime as clinical teams would be leaving the wards. Individual team member presents their patients and then can leave. Intermittent text messages remind teams about the meeting. On average ~45% of all teams attend daily. There were no additional resources required and this structure could be replicated in other hospitals. Conclusions & discussion: Discharge planning is not always to the forefront of healthcare professionals looking after ill patients in hospital. This daily meeting has increased knowledge of discharge supports among doctors. Smooth patient flow depends on linking a defined population to appropriate capacity by means of an efficient process. Our daily "discharge support meeting" acts as the link in our hospital helping to identify those with CDN in a timely manner and drives efficiency in our discharge processes. Lessons learned: Managing patient flow is a complex task A daily discharge support meeting involves knowledge and discharge processes There were unexpected additional benefits of highlighting discharge bottlenecks


The paper presents a design procedure for anti-vortex end-plates that are fitted to tip limited blades of the subsonic axial fans utilised in compact cooling units. The authors study the impact of tip leakage vortex bursting on the performance of the studied class of fans. The vortex breakdown occurs in the swirling flows at a blade's tip, and is found to be a flow feature associated with the production of fan acoustic emissions. The link between aerodynamic flow features in the blade tip region and fan acoustic emissions is exploited through a design process that aims to control the blade tip flow with the specific objective of reducing fan acoustic emissions. This noise-by-flow flow control design process is implemented by reconfiguring the end-plate at the blade tip using a multiple-vortex-breakdown criterion for the design of the end-plates. The aerodynamic and acoustic performance of the newly conceived end-plate design has been assessed and is compared with the performance of a fan with blades fitted with base-line end-plate geometry. The assessment of aerodynamic and acoustic performance utilises both numerical simulations of the flow-field in the blade tip region plus an experimental assessment of fan aerodynamic and acoustic performance. The reported research verified the technical merit of the developed passive noise control strategy, demonstrating that the control of blade tip leakage flow can result in a reduction in blade tip flow generated noise.


This paper describes an initial exploration into large learning systems, i.e., systems that learn a large number of rules. Given the well-known utility problem in learning systems, efficiency questions are a major concern. But the questions are much broader than just efficiency, e.g., will the effectiveness of the learned rules change with scale? This investigation uses a single problem-solving and learning system, Dispatcher-Soar, to begin to get answers to these questions. Dispatcher-Soar has currently learned 10, 112 new productions, on top of an initial system of 1, 819 productions, so its total size is 11, 931 productions. This represents one of the largest production systems in existence, and by far the largest number of rules ever learned by an AI system. This paper presents a variety of data from our experiments with Dispatcher-Soar and raises important questions for large learning systems.


Nowadays, product designers, manufacturers, and consumers consider the environmental impacts of products, processes, and services in their decision-making process. Life Cycle Assessment (LCA) is a tool that assesses the environmental impacts over a product's life cycle. Conducting a life cycle assessment (LCA) requires meticulous data sourcing and collection and is often time-consuming for both practitioner and verifier. However, predicting the environmental impacts of products and services can help stakeholders and decision-makers identify the hotspots. Our work proposes using Artificial Intelligence (AI) techniques to predict the environmental performance of a product or service to assist LCA practitioners and verifiers. This approach uses data from environmental product declarations of construction products. The data is processed utilizing natural language processing (NLP) which is then trained to random forest algorithm, an ensemble tree-based machine learning method. Finally, we trained the model with information on the product and their environmental impacts using seven impact category values and verified the results using a testing dataset (20% of EPD data). Our results demonstrate that the model was able to predict the values of impact categories: global warming potential, abiotic depletion potential for fossil resources, acidification potential, and photochemical ozone creation potential with an accuracy (measured using R2 metrics, a measure to score the correlation of predicted values to real value) of 81%, 77%, 68%, and 70%, respectively. Our method demonstrates the capability to predict environmental performance with a defined variability by learning from the results of the previous LCA studies. The model's performance also depends on the amount of data available for training. However, this approach does not replace a detailed LCA but is rather a quick prediction and assistance to LCA practitioners and verifiers in realizing an LCA.


Pedagogy has a crucial role in constructions of the self and the "good" or the "ideal" citizen. Civic education in schools seeks to build up notions of the good citizen, by outlining "ideal" norms of behaviour, for instance, towards parents, elders, the government, as also the nation. But the human subject is not always a passive recipient of pedagogic formulations. Rather as this article that bases itself oi student responses in a test school in Delhi, establishes, students negotiate established pedagogy and received wisdom in a variety of ways. Their understanding of issues of citizenship is arrived at not merely through textbook instruction, but their reception to the very manner of this instruction that is exam-oriented, in their interactions with friends, peers and family as well as information received and interpreted through a variety of other sources. The article argues that to move beyond mere subjecthood and towards ensuring an individual's "agency" in the creation of "good" citizenship, pedagogy has to engage and debate widely with these varied sites of interaction.


In this study, a convenient synthesis of a series of La(III) complexes (in nanoscales) with different organic ligands was prepared by green chemical method. The physicochemical properties of the nanocomplexes were obtained. The SEM and TEM techniques were used to confirm the nanosize and morphology. The cytotoxicity of the newly synthesized compounds was demonstrated and tested for their anticancer activity against common pathogenic organisms and against human epithelial colorectal adenocarcinoma cells (Caco2), Vero, and MCF-7 cells. By examining its pharmacological activity, we were able to identify new potent and selective anticancer agents. Also, the structures succeeded to affect and stop the growth of Klebsiella pneumonia strain, and the results revealed promising activity. In addition, an electrospinning technique was used for the fabrication of novel bio-medicated nanofibers which are applied for wound dressing as local chemotherapy for skin injuries.


The best understood special form of P. carinii, P. carinii formae specialis (f.sp.) carinii, appears to be haploid and contains about 8 million base pairs of DNA (8.5 fg) per nucleus. The genome of P. carinii f.sp. carinii is divided into 13–15 linear chromosomes that range from 300 to 700 kb in size. Eight different P. carinii f.sp. carinii karyotypes have been observed. The karyotypes of P. carinii f.sp. carinii differ due to slight variations in the lengths of chromosomes, but the 8 karyotype-forms of P. carinii f.sp. carinii exhibit very little variation in DNA sequence. By contrast, the genome of P. carinii f.sp. carinii differs markedly in sequence from the genomes of P. carinii from other hosts, such as mouse, ferret and human. In addition, chromosomes and DNA sequences from P. carinii from mouse, ferret, and human also differ greatly from each other. The genome of a ferret P. carinii appears to be up to 1.7 times larger than those of P. carinii from other hosts. Nearly two dozen P. carinii genes have been cloned and sequenced. The typical P. carinii gene sequence is 60–65% A+T. P. carinii genes usually contain introns, which are typically less than 50 bp in length, but can be as numerous as 9 per gene. A system for naming P. carinii genes is proposed in which each gene would be designated by an italic three-letter lower case symbol. The first allele (i.e. sequence) that is found would have a superscript 1, such as xyz11. Any subsequent alleles would be designated as xyz12, etc. A protein would have the same symbol as the gene that produced it, but written in roman print with the first letter an uppercase, such as Msg1. Some of the P. carinii genome is comprised of DNA sequences that are present dozens of times. Three families of such repeated DNA sequences have been described. Two of these families (MSG and PRT) encode proteins. The third family is the telomere repeat, which is found at the ends of each chromosome, and sometimes at internal chromosomal sites, in which case it has been called the alpha repeat. Determination of the complete sequence of the P. carinii genome is both practicable and of primary importance to the understanding of this organism. The small size of the P. carinii genome and its packaging into chromosomes that are resolvable by PFGE will facilitate sequence analysis.


Integrated study is considered to be important for preschool students. This study is aiming at understanding the implementation of learning music in integrated learning context in preschool education level especially kindergarten. Research methodology employed in this research was qualitative method. The subject of this study was the implementation of learning in preschool education level especially kindergartens in Semarang. This study focuses on how music or children song is used as integrated education tool by the teacher. Observation, interview and study of documentation were implemented here as the data collection technique. In addition, source triangulation technique was applied here as the validation technique, while interactive analysis was used as the data analysis technique. Results of the research show that the application of learning music process in preschool level of kindergarten school in Semarang is integrated with the other lessons. The development of its learning materials refers to the curriculum by considering the developments of the children in general. The main technique in the implementation of the learning process is by singing together. Messages of the music or song are used in order to deliver the education message according to the theme of learning.


181 Background: Patients with lung cancer who are treated with curative intent are rarely included in quality-of-life (QOL) intervention research in cancer, and the transition from treatment to surveillance is an understudied phase in lung cancer. Given the high risk of recurrence in this population, we aimed to 1) characterize the QOL challenges of patients with lung cancer who complete curative treatment and 2) develop and refine an intervention to support patients during their transition to surveillance. Methods: We first conducted semi-structured interviews to explore the QOL challenges of patients in transition from lung cancer treatment to surveillance (n = 12). Interviews were transcribed, coded, and analyzed using a thematic analysis approach. Results were used to develop the content, timing, and delivery of a cognitive behavioral intervention to enhance patient QOL during the transition to surveillance. We conducted an open pilot with patients within 3 weeks of completing lung cancer treatment (systemic therapy +/- radiation) to test and refine the intervention (n = 5). Mixed methods data were collected to evaluate intervention feasibility, acceptability, and areas for refinement. All study procedures were conducted at an academic medical center in the New England region. Results: Qualitative study results indicated that during the transition to surveillance, patients with lung cancer (6 female, 6 male; age range: 26-76) faced unexpected challenges in coping with residual symptoms (e.g., dyspnea, fatigue), uncertainty about future health, and changes in close relationships. Results were used to develop a 5-session intervention to address patient challenges with a coping skills framework that balanced acceptance-and change-oriented approaches. Study clinicians delivered intervention sessions remotely (video or telephone). Of 6 patients approached, 5 enrolled in the pilot (all female; age range: 62-73; 1 declined due to time commitment). Pilot patient feedback indicated that the intervention timing and content targeted patients' current needs and concerns. Patients valued the opportunity to normalize and address current challenges and to cope with difficult emotions. Results suggested further refinements to the timing for patient recruitment and the order of session content to enhance skills uptake. Conclusions: Patients who are treated for lung cancer with curative intent may face unexpected QOL challenges related to residual symptoms, health uncertainty, and changes in close relationships during the transition to surveillance. Results enhance our understanding of lung cancer survivorship and provide a framework for addressing QOL challenges in this population. Remote delivery of this manualized intervention supports scalability for survivors of cancers with high risk of recurrence. This model will be tested further in a larger scale efficacy trial. Clinical trial information: 04450043.


This project was funded, in part, with support from the Indiana Clinical and Translational Sciences Institute funded, in part by UL1TR002529 from the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Background: The diagnosis and outcomes of posterior reversible encephalopathy syndrome (PRES) in children with cancer are not well understood. We aim to determine the incidence of PRES in pediatric oncology patients, describe the associated morbidity and mortality, and to better understand risk factors in this patient population.

Project Methods: We screened 473 children with a hematologic malignancy or post-allogeneic hematopoietic cell transplantation (HCT) between June 2015 and June 2020 for PRES to determine incidence and if age or diagnosis is associated with PRES. To evaluate if comorbidities or chemotherapeutic agents are associated with PRES, we conducted a case-control study. Children with PRES were matched with two controls based on age and diagnosis to identify additional risk factors for PRES development.  Incidence was calculated over the 5-year period. Mann Whitney U and Chi-Squared or Fisher Exact Tests were performed using SPSS v26 to compare continuous and categorical variables respectively.

Results: Fourteen (3.0%) patients developed PRES, resulting in an incidence of 5.9/1000 people/year. Median age was not different between those that developed PRES [14 years (IQR: 11, 17.25)] and those that did not [9.6 years (IQR: 3.8, 15.4)], (p=0.421). Allogenic HCT was associated with the development of PRES (p=0.019). PRES symptoms were common: hypertension (100%), seizures (79%), nausea/vomiting (50%), altered mental status (50%), and headaches (43%). All received an MRI, and 79% had findings consistent with PRES. The majority (79%) of patients with PRES were admitted to the PICU and 4 (29%) later died. After 2:1 matching, we found that the use of Etoposide (p=0.008) was associated with PRES but comorbidities were not.

Conclusion and Implications: While PRES was infrequent in this population, it carries a high morbidity with most requiring PICU admission and a high associated hospital mortality of 29%. The use of etoposide and HCT were associated with PRES.


Green energy helps in reducing carbon emission from fossil fuel, harvesting energy from natural resources like wind to power consumer appliances. To date, many researches have been focusing on designing circuits that harvest energy from electromagnetic signals wirelessly. While it could be designed to be efficient, the generated power however is insufficient to drive large loads. Wind energy is highly available environ- mentally but development of small-scale energy harvesting apparatus aiming to extract significant power from miniature brushless fan has received limited attention. The aim of this chapter is to give audience an insight of different voltage multipliers used in energy harvester and knowledge on various circuit techniques to configure voltage multipliers for use in different high voltage applications. These include AC-DC converter, AC-AC converter and variable AC-DC converter.


3-Phenylpyruvate evoked a monophasic insulin release from perifused mouse islets. L-Phenylalanine was not an insulin secretagogue and was oxidized by islets at a very low rate, suggesting that 3-phenylpyruvate does not trigger insulin release by enhancing production of reducing equivalents. Moreover, allosteric activation of glutamate dehydrogenase does not play a role in 3-phenylpyruvate-induced insulin secretion.


Photodynamic therapy (PDT) does well in both curing early stage tumors and improving patients' quality of life. However, the limited selectivity of photosensitizers (PSs) to tumors has become an urgent issue during the application of PDT clinically, which would exhibit a poor therapeutic outcome and induce skin phototoxicity. To solve this problem, PS-loaded D-α-tocopheryl polyethylene glycol succinate (vitamin E TPGS, or simply TPGS) nanoparticles with tumor homing and penetrating peptide tLyp-1 decoration (t-NP) were constructed for PDT of tumors in this study. Verteporfin (VP), as an effective PS, was encapsulated in the core of t-NP, and tLyp-1 was functionalized on the surface as a functional ligand to increase vascular permeability and target the tumor cells. These nanoparticles were spherical in shape and exhibited a narrow size distribution of 23.3 ± 0.80 nm, and had a high encapsulation efficiency and loading capacity of hydrophobic VP. Compared with unmodified nanoparticles (NP), t-NP exhibited enhanced cellular uptake in both primary human umbilical vein endothelial cells (HUVECs) and drug-resistant human colon adenocarcinoma cells (HCT15); and t-NP showed higher selectivity to HCT15 tumors in vivo after intravenous administration of the same dose of VP. The anti-tumor experiment in vivo strongly indicated that nanoparticles with tLyp-1 peptide modification can enhance the selectivity of the PS, and improve the PDT effect.


Background: Proximal femoral insufficiency fractures are increasingly common in the elderly population. Urinary tract infection (UTI) is the most common associated complication in this group of patients with these injuries and may add to an already severe morbidity and mortality. The incidence of patients presenting with an established UTI from home is unknown as most research focuses on UTIs that occur after hospital admission. The aim of the study was to determine the prevalence of UTIs on admission and to compare urine culture results and patient profiles of these patients.
Methods: Forty patients presenting with a proximal femoral insufficiency fracture were identified on admission to casualty. A urine specimen was taken according to a standard protocol and sent for microscopy, culture and sensitivity (MCS). The organism and sensitivity profiles were determined from all positive MCS samples. Risk factors and patient demographics were identified using a questionnaire.
Results: Twenty of the 40 patients (50%) had a positive culture from the urine MCS. The most common organism was Escherichia coli (55%) [CI = 33.2; 76.8%] and the most common antibiotic sensitivity was to amoxicillin/clavulanic acid. Most of the organisms identified were resistant to ampicillin/amoxicillin and trimethoprim/sulfamethoxazole. Significant risk factors associated with an increased prevalence were female sex and the age of the patient.
Conclusion: The prevalence of UTI in elderly patients with proximal femoral fractures is underestimated. Higher risk patients for presenting with a UTI from home are the elderly female patients above 80 years of age. Screening for, diagnosing and treating UTIs earlier has clear benefits for this specific group of patients to potentially decrease overall morbidity and mortality.
Level of evidence: Level 4


Almost all real-world networks are distributed in space. In many of these networks, more short-than long-distance connections exist. Thus, there is a preference to minimize the length of connections. Such networks often exhibit properties of small-world, scale-free or multi-clustered networks. However, previous models for development, where only distance between nodes is considered when establishing a connection, were unable to yield spatial graphs with these properties. I present a new model for spatial graph development that can generate small-world networks. Notably, also scale-free networks (similar to the German highway system or the yeast protein-protein interaction network) can be generated without using preferential attachment. The final topology of the network depended on whether the growing network reached spatial limits during development or not. Furthermore, different models for network evolution (limited, unlimited and preferential attachment) could be distinguished by observing the change of density and clustering coefficient over time. Spatial growth was able to yield networks similar to real-world spatial networks. As a case study, I generated networks similar to cortical networks. I found that not only global network properties but also wiring properties were similar. In addition, multiple clusters could be generated by introducing time windows.


Over the last 20 years the study of brain functions experienced a huge impulse due to the technical improvements in the imaging and neurosurgical cortico-subcortical direct electrical stimulation (DES) procedures. Particularly, functional MRI (fMRI), DES and diffusion tensor imaging (DTI) allowed the in vivo study of functional organization and white matter (WM) connections. The integration of data provided by these different techniques opened a new door in the study of the brain, leading neuroscientists and neurosurgeons in the connectomic era. This conceptual evolution renewed the interest also for the structural study of brain connections with blunt dissection, in order to improve and confirm data provided by DTI. Considering that DES is, since now, the only direct and specific method to explore the functional role of subcortical bundles, we aimed to a study integrating blunt dissection, according to the technique described by Klingler, DTI and DES during neurosurgical procedure for resection of lowgrade gliomas (LGGs). Aims of the study are: l) definition of course and terminations of the main WM fascicles; 2)            production of antomo-topographical data, including course and reciprocal relationships of different association, projection and connection bundles, in order to produce anatomofunctional details for the improvement of surgical approach to intra-axial lesions. 3)            computation of the first functional atlas of the human WM and of a probabilistic map of WM resectability, using data provided by DES during awake surgery with intra-operative neuropsychological monitoring.


Abstract. We discuss the evolution and state-of-the-art of the use of Building Information Modelling (BIM) in the field of culture heritage documentation. BIM is a hot theme involving different characteristics including principles, technology, even privacy rights for the cultural heritage objects. Modern documentation needs identified the potential of BIM in the recent years. Many architects, archaeologists, conservationists, engineers regard BIM as a disruptive force, changing the way professionals can document and manage a cultural heritage structure. The latest years, there are many developments in the BIM field while the developed technology and methods challenged the cultural heritage community in the documentation framework. In this review article, following a brief historic background for the BIM, we review the recent developments focusing in the cultural heritage documentation perspective.


Inferring the information structure of scientific documents is useful for many NLP applications. Existing approaches to this task require substantial human effort. We propose a framework for constraint learning that reduces human involvement considerably. Our model uses topic models to identify latent topics and their key linguistic features in input documents, induces constraints from this information and maps sentences to their dominant information structure categories through a constrained unsupervised model. When the induced constraints are combined with a fully unsupervised model, the resulting model challenges existing lightly supervised feature-based models as well as unsupervised models that use manually constructed declarative knowledge. Our results demonstrate that useful declarative knowledge can be learned from data with very limited human involvement.


Atomic force microscopes offer the possibility for imaging a sample topography with accuracy in the nanometer scale. This kind of performance is impossible without actuators enabling a certain accuracy. A frequently used actuator in such nanopositioning applications is the piezoelectric actuator which, although precise, exhibit the unwanted phenomenon of hysteresis. Hysteresis is recognized as the main nonlinearity in the piezoelectric actuator, and introduces severe control issues for accurate positioning. To compensate for hysteresis an accurate model of the nonlinearity has to be identified. A discrete and a piecewise-continuous model, based on the Preisach operator, is identified with a constraint least squares method. An algorithm for computing the output of the continuous model is proposed and outlined together with a solution for the discrete model. The general approach for control of hysteresis is to create a right inverse of the identified model. Since the Preisach operator does not have an analytical inverse, this is done numerically by a closest match algorithm. These algorithms are described based on previous literature. In order to achieve a well designed model for the Preisach operator, the input function has to be thoughtfully designed. It is pointed out that to achieve a persistently excited input signal, the number of reversals has to be sufficient compared to the discretization level of the implemented Preisach operator. Additionally, effects from systematic errors in the signal loop, such as negative phase due to low pass filtering, time delay, creep and actuator dynamics, has to be minimized. It was shown that negative phase in the signal loop can invalidate the identified models. Both the discrete and continuous model was shown to describe the hysteresis nonlinearity. To reduce the step-size of each discrete value, a higher discretization level can be applied to the discrete model. The inverse models were simulated to verify the inversion algorithms, followed by results from testing the inverse signal. The inverted signal based on the discrete method showed need for interpolation between the discrete levels, while the continuous inverse exhibit higher frequency components that causing vibrations due to resonance dynamics. An input signal consisting of the same amount of reversals as the discretization level was shown to give a valid identified model. Furthermore, increasing the number of reversals was shown to continue improving the accuracy. The effect of negative phase, from low pass filtering and time delay, was tested, and changes in the distribution of the Preisach weights were shown. Such effects can cause significant errors in identification of hysteresis models, especially if the reference frequency is subject to changes.


The prognostic role of c-erbB-2 in gastric cancer is controversial. We conducted a meta-analysis to evaluate the relationship between c-erbB-2 expression and the prognosis of gastric cancer. We evaluated 20 published studies assessing the relationship between c-erbB-2 and gastric cancer prognosis. The Revman 5.0 software was used to perform literature retrieval, article selection, data collection, and statistical analysis. We utilized a fixed-effect model to pool hazard ratios and 95% confidence intervals from the studies. A total of 20 eligible studies including 4468 gastric cancer patients were analyzed. We were unable to demonstrate the prognostic value of c-erbB-2 for gastric cancer (hazard ratio = 1.01, 95% confidence interval = 0.87-1.16, P = 0.93). The present study indicated that c-erbB-2 expression is not a prognostic factor for gastric cancer.


When mining large databases, the data extraction problem and the interface between the database and data mining algorithm become important issues. Rather than giving a mining algorithm full access to a database (by extracting to a flat file or other directly-accessible data structure), we propose the SQL Interface Protocol (SIP), which is a framework for interaction between a mining algorithm and a database. The data continues to reside entirely within the database management system (DBMS), but the query interface to the database gives the data mining algorithm sufficient information to discover the same patterns it would have found with direct access to the data. This model of interaction brings several advantages; for example, it allows a mining algorithm to be parallelized automatically just by using a parallelized DBMS to answer queries. We show how two families of mining algorithms may be implemented as "SIPpers," and we discuss related work in databases that should further enhance performance in the future.


To assess if there was any advantage in the prophylactic use of theophylline to prevent apnea in preterms, we treated 56 preterms (Group A) < 34 weeks gestation with theophylline infusion and compared these with 25 age and weight matched preterms (Group B) who received no therapy. Aminophylline (25 mg/ml) was infused from admission in all neonates (group A) at rates ranging 0.2 to 0.38 mg/kg/h and blood levels estimated on an Abbots TDX analyser by Fluorescence Polarization Immunoassay, after 5 days infusion. All neonates (Groups A + B) were monitored on a Corometric 505 neonatal monitor. In Group A, 1/48 developed primary apnea while in Group B, 4-21 had primary apnea (p < 0.05). Serum theophylline ranged from 2.3 to 39.5 micrograms/ml with a mean of 12.7 micrograms/ml. The mean serum level of theophylline in 4 cases who exhibited clinical evidences of toxicity was 30.1 micrograms/ml. A statistically significant difference (p < 0.05) was noted in birth weight and serum level inspite of similar infusion rates of theophylline. A linear correlation r = 0.65 was noted between serum level and infusion rate. Multivariate regression analysis, between birth weight and gestational age to serum level, showed a linear correlationship only between birth weight and serum level (r = 0.45).


The literate brain must contend with countless font variants for any given letter. How does the visual system handle such variability? One proposed solution posits stored structural descriptions of basic letter shapes that are abstract enough to deal with the many possible font variations of each letter. These font-invariant representations, referred to as allographs in this paper, while frequently posited, have seldom been empirically evaluated. The research reported here helps to address this gap with 2 experiments that examine the possible influence of allograph representations on visual letter processing. In these experiments, participants respond to pairs of letters presented in an atypical font in 2 tasks—visual similarity judgments (Experiment 1) and same/different decisions (Experiment 2). By using representational similarity analysis (RSA) in conjunction with linear mixed effect models (LMEM; RSA-LMEM) we show that the similarity structure of the responses to the atypical font is influenced by the predicted similarity structure of allograph representations even after accounting for font-specific visual shape similarity. Similarity due to symbolic (abstract) identity, name, and motor representations of letters are also taken into account providing compelling evidence for the unique influence of allograph representations in these tasks. These results provide support for the role of allograph representations in achieving font-invariant letter identification.


PURPOSE: To quantify the number of defense cells and immunoglobulin E (IgE) levels in peripheral blood sampled from women with recurrent vulvovaginal candidiasis. METHODS: A cross-sectional study was conducted on 60 women, 40 with vulvovaginal candidiasis and 20 controls. The defense cells were identified using an impedance system combined with flow cytometry and total and specific IgE was measured by chemiluminescence. The Mann-Whitney test was used for nominal variables and the Spearman test was used to determine the correlation of IgE concentration and eosinophils in peripheral blood. RESULTS: The number of eosinophils in peripheral blood from patients with recurrent vulvovaginal candidiasis, 302.60 (±253.07), was significantly higher compared to control, 175.75 (±109.24) (p=0.037). Serum levels of total and specific IgE were similar in the groups of women with and without recurrent vulvovaginal candidiasis (p=0.361). However, there was a moderate positive correlation between eosinophils and total serum IgE in the candidiasis group (r=0.25). CONCLUSION: Women with recurrent vulvovaginal candidiasis are more likely to have eosinophils in peripheral blood.