Aim: To report the outcomes of robot-assisted radical cystectomy (RARC) with bilateral extended pelvic lymph node dissection (BEPLND) and intracorporeal Studer pouch formation for bladder cancer. Materials and Methods: Overall 98 patients (92 males, 6 females) were included. Patient demographics, operative and postoperative variables, pathological parameters, complications, and functional outcomes were evaluated. Results: Mean age and American Society of Anesthesiologists score and body mass index were 60.9 years, 1.7 and 26 kg/m2, respectively. Neoadjuvant chemotherapy was given to 18 patients. Mean operation time, intraoperative estimated blood loss, and mean lymph node (LN) yield were 8.22 hours, 314.6 mL, and 28.3, respectively. Mean hospitalization time was 13.6 days. There were one perioperative and one postoperative deaths, both due to cardiac arrest on postoperative 21st and 60th days. Drains were removed at a mean of 10 days. Surgical margins were positive in two patients. Postoperative pathological stages were reported as pT0 (n = 21), pTis (n = 7), pT1 (n = 7), pT2a (n = 14), pT2b (n = 14), pT3a (n = 15), pT3b (n = 11), and pT4a (n = 9). Positive LNs were found in 21 patients. Prostate cancer was incidentally detected in 23 patients. Twenty-five patients received adjuvant chemotherapy. At a mean follow-up period of 25.1 months, 13 patients died from metastatic disease and 7 from cardiac disease. According to the modified Clavien-Dindo system, 30 minor and 20 major complications were identified in the perioperative (0-30 days) period, and 6 minor and 7 major complications were detected in the postoperative (31-90 days) period. According to the available data of the 60 patients, 37 were fully continent, 14 had mild, 6 had moderate, and 4 had severe daytime incontinence. Conclusions: Due to our experience, RARC with BEPLND and intracorporeal Studer pouch reconstruction procedures are complex procedures with acceptable morbidity, excellent surgical and pathological outcomes, and satisfactory oncologic and functional results.


It is shown that within the language of Set Theory, if membership is assumed to be non-well-founded a la Aczel, then one can state the existence of infinite sets by means of an ∃∃∀∀ prenex sentence. Somewhat surprisingly, this statement of infinity is essentially the one which was proposed in 1988 for well-founded sets, and it is satisfied exclusively by well-founded sets. Stating infinity inside the BSR (Bernays–Schonfinkel–Ramsey) class of the ∃*∀*-sentences becomes more challenging if no commitment is taken as whether membership is well-founded or not: for this case, we produce an ∃∃∀∀∀ -sentence, thus lowering the complexity of the quantificational prefix with respect to earlier prenex formulations of infinity. We also show that no prenex specification of infinity can have a prefix simpler than ∃∃∀∀.

The problem of determining whether a BSR-sentence involving an uninterpreted predicate symbol and = can be satisfied over a large domain is then reduced to the satisfiability problem for the set theoretic class BSR subject to the ill-foundedness assumption. Envisaged enhancements of this reduction, cleverly exploiting the expressive power of the set theoretic BSR-class, add to the motivation for tackling the satisfaction problem for this class, which appears to be anything but unchallenging.


Several experiments were conducted to evaluate the utility of an in vivo acetolactate synthase (ALS) assay for comparing sensitivity to imazamox among imidazolinone-resistant wheat cultivars/lines. Ten single-gene imidazolinone-resistant winter wheat cultivars/lines, one two-gene and four single-gene imidazolinone-resistant spring wheat cultivars/lines, and three pairs of heterozygous and homozygous imidazolinone-resistant winter wheat lines were evaluated in the assay experiments. Additionally, a dose-response assay was conducted to evaluate the tolerance of several imidazolinone-resistant wheat cultivars to imazamox on a whole plant level. The I50 value (i.e., the imazamox dose that inhibited ALS activity by 50%) of the winter wheat cultivar 'Above' was 54 to 84% higher than the I50 values of 99-420, 99-433, and CV-9804. However, based on the results of this study, it is unclear whether genetic background or market class (hard red winter vs. soft white winter) influences the level of ALS inhibition by imazamox. Teal 15A, the two-gene imidazolinone-resistant spring wheat cultivar, had an I50 value that was two to three times greater than the I50 value of the single-gene imidazolinone-resistant spring wheat cultivars/lines. The heterozygous imidazolinone-resistant wheat lines had I50 values that were 69 to 81% less than the I50 values of the homozygous lines. In the whole plant dose response, the R50 values (i.e., the imazamox dose that reduced biomass by 50%) of the susceptible cultivars Brundage 96 and Conan were 15 to 17 times less than the homozygous single-gene imidazolinone-resistant winter and spring cultivars/lines, whose R50 values were about 1.7 times less than the R50 value of the two-gene imidazolinone-resistant spring wheat line, Teal 15A. The results of the in vivo ALS imazamox assays and the whole plant imazamox dose-response assay were similar, indicating that the in vivo assay can be used to accurately and quickly compare resistance between imidazolinone-resistant wheat cultivars/lines. Nomenclature: Imazamox, wheat, Triticum aestivum L. Additional index words: Crop safety, herbicide tolerance, herbicide-resistant wheat, in vivo ALS assay. Abbreviations: ALS, acetolactate synthase; CPCA, 1,1-cyclopropanedicarboxylic acid; I50, imazamox dose that inhibited ALS activity by 50%; KARI, keto-acid reductoisomerase; R50, imazamox dose that reduced biomass 50%.


This paper proposes a deep learning classification method for frame-wise recognition of human activities, using raw color (RGB) information. In particular, we present a Convolutional Neural Network (CNN) classification approach for recognising three basic motion activity classes, that cover the vast majority of human activities in the context of a home monitoring environment, namely: sitting, walking and standing up. A real-world fully annotated dataset has been compiled, in the context of an assisted living home environment. Through extensive experimentation we have highlighted the benefits of deep learning architectures against traditional shallow classifiers functioning on hand-crafted features, on the task of activity recognition. Our approach proves the robustness and the quality of CNN classifiers that lies on learning highly invariant features. Our ultimate goal is to tackle the challenging task of activity recognition in environments that are characterized with high levels of inherent noise.


The prophet Muḥammad's marriage to Zaynab bint Jaḥsh has been viewed as one of the more controversial events in the life of Muḥammad. In the West, Christian authors have long used the events surrounding the marriage to attack Muḥammad's character, suggesting a lack of morals and unquenchable sexual appetite. This thesis explores whether these negative portrayals of the marriage has been carried over into modern depictions of Muḥammad's life. A close examination of the historical sources and a discussion of the concept of "Orientalism" precede an analysis of three prominent 20th century English biographies of Muḥammad's life. The thesis concludes that there is little in way of "Orientalism" to be found in these works. Instead, the authors examined go to great length to exonerate Muḥammad from any immoral acts, motives or intentions, with regard to his marriage to Zaynab bint Jaḥsh.


BACKGROUND:
There is a dominant discourse within the literature that collaboration is the ideal way of working when formulating in CBT and particularly with clients experiencing psychosis. Despite formulation and collaboration being considered key principles for this widely evidence-based approach, the literature deconstructing these concepts or explicating the way these add value to CBT for psychosis is insufficient. The literature does not acknowledge complexities, challenges or inconsistencies regarding this dominant discourse. This may be due to methodological challenges of investigating such variable and abstract constructs. However discourse analysis is a productive way of investigating inconsistent and complex constructs. Foucauldian Discourse Analysis was utilised within this study to investigate how clinical psychologists talk about and construct collaboration within this context, discourses drawn upon, tensions apparent, and ways of managing these.
DESIGN:
Semi-structured interviews were conducted with 12 clinical psychologists working across 3 NHS trusts in England. All participants self-reported working with clients experiencing psychosis and developing cognitive-behavioural formulations with these clients. A local collaborator within each trust provided names and contact details of clinical psychologists working with this client group, all of whom were sent participant invitation letters. Interviews were transcribed verbatim using a light version of Jeffersonian transcription, according to the level of analysis.
ANALYSIS:
Foucauldian Discourse Analysis was used to analyse the data and the guidelines of Willig (2008) were heavily drawn upon. This involved investigating how collaboration was constructed in accounts and inconsistencies or variations in this; discourses drawn upon; close examination of the discursive context and the action orientation of talk within the interview; subject positions adopted; and the relationship between discourse, practice and subjectivity.
RESULTS:
Collaboration in the context of formulation in CBT for psychosis was constructed in diverse and inconsistent ways by participants. Collaboration was often initially presented as a straightforward process whilst accounts quickly moved on to construct this as complex and ambiguous. Clinical psychologists adopted multiple and seemingly conflicting positions within their talk such as 'collaborator' but also 'expert' and 'protector'. Tensions were apparent between conflicting discourses drawn upon such as 'collaboration as the ideal' but also 'openness and transparency as dangerous' and the 'importance of a shared understanding' alongside 'accepting multiple perspectives'.
CONCLUSION:
Current understandings of collaboration presented in the literature are inadequate and a more nuanced understanding of the complexities, tensions and variations of collaboration in CBT for psychosis, as presented by participants is called for. The research highlights that collaboration may be more usefully constructed as being made up of a range of approaches rather than as a singular way of working. It may be useful to consider an approach similar to the 'matching hypothesis' seen in health and social psychology literature when determining type of collaboration and therapeutic alliance suitable for the individual.


In the absence of a vital registration and health information systems, Indonesia does not have complete, accurate, and continuous data to summarize the mortality statistics of the population, nor determine the exact cause of death. Verbal autopsies performed in a community-based mortality surveillance have been used to provide information on the cause of deaths in such context. However, physician review of verbal autopsy can be expensive, time-consuming, and give inconsistent results, raising concern about its reliability. We used the Purworejo Health and Demographic Surveillance System's (HDSS) mortality data collected between 2000 and 2002 and assigned causes of death for all age groups using Interpreting Verbal Autopsy-4, analytic software that applies a probabilistic model. A total of 1,999 deaths were identified among 55,581 individuals surveyed in 14,409 households; 830 deaths were able to be recorded using the standardized World Health Organization (WHO) verbal autopsy questionnaire. We calculated the proportion of different causes of death and its incidence rate (IR) ratios with 95% confidence interval (CI) to compare the IR per person-years-observation (PYO). The IR of stroke was 126.7 per 100,000 PYO (95% CI: 109.7, 143.7); acute respiratory infection including pneumonia was 70.8 per 100,000 PYO (95% CI: 58.1, 83.5); and the IR of other and unspecified cardiac diseases was 57.7 per 100,000 PYO (95% CI: 46.2, 69.2). Stroke was indicated as the leading cause of death among elderly people aged 50 years and above. Meanwhile, pneumonia as a communicable disease was found to be the most common cause of death among both 0-14-year-old children and elderly people.


This paper presents the results of an experimental test that applies a low cost 3D sensor, i.e. a Kinect camera, for the perception of the terrain quality for the synthesis of a safe path. The 3D images are processed for generating a local 3D map, in front of the bicycle. The real time processing is based on a Piece Wise Multi-Linear (PWML) approximation of the 3D surfaces. The PWML patches are classified for inferring the traversability of the terrain. The acquired datasets are also made public for the educational and research community.


Previous studies of gallbladder pathology in primary sclerosing cholangitis (PSC) have suggested that a distinctive histologic triad ("diffuse lymphoplasmacytic acalculous cholecystitis," composed of diffuse, mucosal-based, dense lymphoplasmacytic infiltrates) is commonly present in gallbladders of patients with PSC and is relatively specific for that disease. However, prior control populations have included only patients with cholecystitis/cholelithiasis and hepatitis, and have not evaluated patients with non-PSC-associated extrahepatic biliary tract disease. We recently observed cases of diffuse lymphoplasmacytic chronic cholecystitis in a subset of patients with biliary tract disease associated with lymphoplasmacytic sclerosing pancreatitis and among patients undergoing Whipple resection for pancreatic head malignancy, suggesting that diffuse lymphoplasmacytic chronic cholecystitis is not specific for PSC. We studied 20 gallbladders from patients with obstructive jaundice due to malignancies of the pancreatic head, duodenum, or ampulla and 5 gallbladders from patients with choledocholithiasis, and compared them with 20 gallbladders from patients with PSC and 20 gallbladders with cholelithiasis. The following histologic features were evaluated: degree of mucosal and deep inflammation, lymphoid nodules, epithelial metaplasia, muscular hypertrophy, Rokitansky-Aschoff sinuses, fibrosis, and cholesterolosis. Gallbladders in malignancy-associated obstructive jaundice were nearly identical to gallbladders in PSC with respect to scores for mucosal inflammation, lymphoid nodules, and frequency of diffuse lymphoplasmacytic chronic cholecystitis (60% vs. 50%, respectively). PSC gallbladders, however, were significantly more likely to contain focal or extensive epithelial metaplasia (P = 0.01). The cholelithiasis control group was characterized by lack of significant mucosal inflammation in the majority of cases (95%) and frequent Rokitansky-Aschoff sinuses, fibrosis, and muscular hypertrophy. Gallbladders in the choledocholithiasis group showed overlapping histologic features with PSC/malignancy-associated obstructive jaundice and cholelithiasis. These results suggest that a pattern of diffuse lymphoplasmacytic chronic cholecystitis is highly specific for extrahepatic biliary tract disease but does not distinguish between primary and secondary cholangiopathies.


Henry James' The Bostonians is one of the most celebrated novels of Gilded Age America. As he wrote in his notebooks, it sprang from his desire to write an "American" tale, one dealing with what he took to be the most "characteristic" movement of the time, the "agitation" for woman's rights. Literary scholars have produced a vast literature dealing with the novel. Historians have largely ignored it. In this essay I seek to demonstrate two points. The first is that historians can, by grounding the novel in its historical context, provide insights into the work that have eluded literary scholars. The second is that The Bostonians proves a highly useful source for the historian into both the "agitation" for woman's rights and the largely unexplored role – the fascination with Victoria Woodhull and the Beecher-Tilton trial aside – Spiritualism played in that "agitation" and in the Gilded Age more generally.


The article analyze the main sectors of the publishing industry highlighting major features and factors that encourage or curb the shift from physical to intangible. To-day publishers are able to find a very wild on-line market for their products that offer the possibility to change in deep the organizational and costing structure, the time to market of the editorial contents and their life cycle. In the article is described also how on-line market give the possibility to broad or create the market of niche products. Introducing a selling mode no longer involving a physical good poses the problem of how to create or replace three little known, albeit decisive, factors in the purchase transaction. The first one is the pride of ownership, i.e. the pride and pleasure of possessing and collecting a physical object like a book or a record. The second is the reverberation effect which afford the customer an economy of scale when he visit a traditional bookshop and he can choose and taste in a very short time a large set of product. The third one is the simple pleasure of shopping or window-shopping that often will induce an impulse to buy.


Environmental context Atmospheric waters (clouds, fogs and wet aerosols) are media in which gases can be converted into particulate matter. This work explores aqueous transformations of glyoxal, a water-soluble gas with anthropogenic and biogenic sources. Results provide new evidence in support of previously proposed chemical mechanisms. These mechanisms are beginning to be incorporated into transport models that link emissions to air pollution concentrations and behaviour. Abstract Glyoxal (GLY) is ubiquitous in the atmosphere and an important aqueous secondary organic aerosol (SOA) precursor. At dilute (cloud-relevant) organic concentrations, OH• radical oxidation of GLY has been shown to produce oxalate. GLY has also been used as a surrogate species to gain insight into radical and non-radical reactions in wet aerosols, where organic and inorganic concentrations are very high (in the molar region). The work herein demonstrates, for the first time, that tartarate forms from GLY+OH•. Tartarate is a key product in a previously proposed organic radical–radical reaction mechanism for oligomer formation from GLY oxidation. Previously published model predictions that include this GLY oxidation pathway suggest that oligomers are major products of OH• radical oxidation at the high organic concentrations found in wet aerosols. The tartarate measurements herein provide support for this proposed oligomer formation mechanism. This paper also demonstrates, for the first time, that dilute (cloud or fog-relevant) concentrations of inorganic nitrogen (i.e. ammonium and nitrate) have little effect on the GLY+OH• chemistry leading to oxalate formation in clouds. This, and results from previous experiments conducted with acidic sulfate, increase confidence that the currently understood dilute GLY+OH• chemistry can be used to predict GLY SOA formation in clouds and fogs. It should be recognised that organic–inorganic interactions can play an important role in droplet evaporation chemistry and in wet aerosols. The chemistry leading to SOA formation in these environments is complex and remains poorly understood.


A review of 25 infants developing pneumediastinum and subcutaneous emphysema was done. These observations suggested that increasing airways presure creates excessive alveolar distention. Pulmonary interstitial emphysema results from movement of air out of alveoli into interstitial areas. From this point air could dissect along the perivascular or interstitial spaces to the mediastinum.


Liquid helium is the coldest fluid that exists in nature. By virtue of this fact, any unwanted substance present in liquid helium, that is, any impurity, will be "frozen" and will be in solid form. In practice, these solid impurities can be easily eliminated to obtain "optically clean" liquid. However, even "optically clean" filtered liquid helium may contain a non-negligible quantity of molecular hydrogen. These minute traces of molecular hydrogen are the causes of a known problem worldwide: the blockage of capillary tubes in helium evaporation cryostats. This problem seriously affects a wide range of cryogenic equipment used in low-temperature physics research at a considerable operational cost increase. In this chapter, we propose an underlying mechanism for this effect and provide a definitive solution by means of production of hydrogen-free liquid helium, that is, not only "optically clean" liquid helium but completely "clean" liquid helium. Moreover, basic superfluidity research studies could benefit from the availability of "clean" liquid helium.


The objective of the following paper is to clearly outline the types of Manufacturing Planning and Control systems (MPC) that have characterized the last hundred years, but which are affected, in terms of functionality, the characteristics of the contexts and the decades in which they were designed. This led to the need to devise a new planning and control approach called Demand Driven Material Requirements Planning (DDMRP) that does not create a clear detachment from previous methodologies but takes the characteristics of each that is more suited to the current volatile and complex context. In this paper, the fundamental characteristics of the approach will be reviewed and the methodology that will be followed in the future implementation will be presented.


: Successful extracapsular cataract surgery depends on adequate mydriasis, which will facilitate the anterior capsulotomy and provide a full field of view throughout the operation. The surgeon, especially the neophyte, must recognise which irises may present a difficulty in establishing, maintaining, and reversing mydriasis, with or without the introduction of an intraocular lens. The author describes the preliminary assessment of the iris for disease, previous iris surgery, ease of dilatation, and the place of primary iridectomy. Topical and subconjunctival preoperative mydriatics are assessed, and a practical account of the pharmacological, mechanical, and surgical means of maintaining intra-operative mydriasis is given. The indication for iridectomy in extracapsular lens extraction with or without an intraocular lens is reviewed, and the postoperative manipulation of the iris is described with reference to the problems caused by rebound mydriasis.


Distributed Constraint Optimization Problems (DCOP) has emerged as one of the most important multiagent coordination techniques, due to its ability to optimize the global function modeled as a set of constraints. This paper presents a study that proposes to use of distributed constraint optimization techniques to achieve energetic efficiency on railroad driving. The objectives are to present a real world problem with dynamic behavior as a DCOP, compare the main algorithms for this formalism and evaluate the quality of the solutions obtained.


Background & Objective: Suicide is the act of injuring oneself in order to destruct one's life. One of the worst ways to attempt suicide, especially in eastern countries, is self- burning. This study aimed to show the frequency of self- burning and its relationship with social and demographic status. Materials & Methods: In this cross-sectional study, all medical records of patients who admitted to Ghotbeddin E Shirazi hospital for burns during the years 2006 and 2011 were collected. The data were analyzed by SPSS-16 software, descriptive statistical methods and chi-square tests. Results: The results showed that from 2071 cases of burn patients admitted to Ghotbeddin E Shirazi Hospital, 439 cases (21.1%) have been caused by self-immolation. The proportion of self-immolation among women was 70.7%, in married was 58.4%, and in rural population was 56.6%. It was most prevalent in the age group of 25-44 years old (47.4%). In most cases, self-immolation was occurred with flammable liquids especially oil and gasoline (71.8% and 17.3%, respectively) and at home (90/8%). 67.8% of cases lead to death. (Case-fatality rate was 67.8%). The most cause of self-immolation attempting was family disputes. Conclusion: in terms of health.


Objective To raise awareness of pulmonary vein stenosis (PVS) to neonatologists. Background PVS is rare, affecting approximately 2 per 100 000 children under the age of 2 years. Recent evidence suggests many children with PVS were premature and/or have cardiac lesions, particularly patent ductus arteriosus (PDA), atrial septal defects (ASD) and ventricular septal defects (VSD). PVS is difficult to diagnosis and can be mislabelled as chronic lung disease (CLD). Doppler echocardiography can diagnose this condition. Untreated PVS is frequently progressive with less than 50% survival at 5 years. Prognosis may be improved if diagnosed early and when treated with newer surgical techniques. Method Two cases are used to illustrate these issues. An 18-month old infant born at 27 weeks gestation that had a VSD closed in infancy presented with breathlessness and failure to thrive. She was treated for gastro-oesophageal reflux and respiratory infection before being found to have three obstructed pulmonary veins. She improved following sutureless repair of her veins but long-term prognosis is guarded due to restenosis. A 5 month old infant born at 28 weeks gestation with history of a PDA who has since been diagnosed with oxygen-dependant CLD was coincidentally found to have stenosis of one pulmonary vein during echocardiography. A month later two pulmonary veins were stenosed. His is stable but progression is likely and he may require surgery. Conclusion Review of literature raises the question: Should we be more vigorous in looking for PVS in babies whose clinical findings are suggestive of CLD?


Background Diversity and inclusion remain a concern in the field of cardiology. Female cardiologists have less opportunity to chair sessions in scientific meetings than men. However, cardiologists' awareness and perspectives on feasibility of chairing sessions is poorly understood. Methods and Results A web-based survey on awareness regarding the commitment of chairing sessions was sent to 14,798 certificated cardiologists registered with the Japanese Circulation Society (JCS). A total of 3,412 valid responses were obtained, such as 523 women and 2,889 men. Female cardiologists exhibited less interest in serving as chairpersons in Japanese and English sessions (71% women vs. 82% men, p < 0.001, 30% women vs. 40% men, p < 0.001). Influencing factors of chair acceptance in Japanese sessions for female cardiologists were being a cardiologist for over 10 years [odds ratio (OR) 1.84, 95% confidence interval (CI) 1.02–3.33], experience studying abroad (OR 3.35, 95% CI 1.93–5.81) and chairing sessions (OR 8.39, 95% CI 5.48–12.9), having a Doctor of Philosophy (OR 2.82, 95% CI 1.09–7.31), presence of 4 or more female cardiovascular specialists in the hospital (OR 1.70, 95% CI 1.10–2.61) and of role models (OR 2.86, 95% CI 1.93–4.24), and awareness of the JCS chairperson's manual (OR 10.7, 95% CI 6.67–17.1). The receiver operating characteristic (ROC) curve revealed that the number of female cardiovascular specialists in a hospital was a more sensitive predictor of chair acceptance among male than female cardiologists. Conclusions Female cardiologists were less likely to accept chairing sessions compared with male cardiologists and the presence of female cardiovascular specialists positively influenced chair acceptance.


We report a case of a 52 year old man, operated under spinal anesthesia for prostate adenoma. He presented two days after this surgery signs of intracranial hypertension. Magnetic resonance imaging of the brain revealed a pituitary abscess. The patient underwent sellar decompression via nasal transsphenoidal route with complete evacuation and irrigation of the pituitary abscess. The patient received appropriate antibiotics for 6 weeks. The histopathology confirmed the presence an abscess cavity featuring multiple fragments of fibrous. Staphylococcus aureus was identified on culture.


Abstract Short texts (STs) present in a variety of scenarios, including query, dialog, and entity names. Most of the exciting studies in neural machine translation (NMT) are focused on tackling open problems concerning long sentences rather than short ones. The intuition behind is that, with respect to human learning and processing, short sequences are generally regarded as easy examples. In this article, we first dispel this speculation via conducting preliminary experiments, showing that the conventional state-of-the-art NMT approach, namely, Transformer (Vaswani et al. 2017), still suffers from over-translation and mistranslation errors over STs. After empirically investigating the rationale behind this, we summarize two challenges in NMT for STs associated with translation error types above, respectively: (1) the imbalanced length distribution in training set intensifies model inference calibration over STs, leading to more over-translation cases on STs; and (2) the lack of contextual information forces NMT to have higher data uncertainty on short sentences, and thus NMT model is troubled by considerable mistranslation errors. Some existing approaches, like balancing data distribution for training (e.g., data upsampling) and complementing contextual information (e.g., introducing translation memory) can alleviate the translation issues in NMT for STs. We encourage researchers to investigate other challenges in NMT for STs, thus reducing ST translation errors and enhancing translation quality.


We study endogenous leverage in a general equilibrium model with incomplete markets. We prove that in any binary tree leverage emerges in equilibrium at the maximum level such that VaR = 0, so there is no default in equilibrium, provided that agents get no utility from holding the collateral. When the collateral does affect utility (as with housing) or when agents have sufficiently heterogenous beliefs over three or more states, VaR = 0 fails to hold in equilibrium. We study commonly used examples: an economy in which investors have heterogenous beliefs and a CAPM economy consisting of investors with different risk aversion. We find two main departures from VaR = 0. First, both examples show that with enough heterogeneity among the investors, equilibrium default is normal. Second, we find that more than one contract is actively traded in equilibrium on the same collateral, that is, the same asset is bought at different margin requirements by different agents. Finally, we study the relationship between leverage and asset prices. We provide an example that shows that as the regulatory authority gradually relaxes leverage restrictions from low levels and permits leverage to rise, asset prices start to rise, but eventually increased leverage paradoxically tends to reduce asset prices because the risky bonds become substitutes for the asset used as collateral.


The distance learning sector has despite of fast evolution still some vague areas. This paper addresses the problem area of distance education service quality assessment. Numerous factors, describing education service quality, are divided into two main categories: educational service quality factors and electronic service quality factor that causes the existence of two independent quality assessment approaches. Based on the analysis of these approaches the Kansei concept is offered as the compromise theory taking into account technical, emotional, pedagogical and other aspects of distance learning phenomenon.


This paper aims to make a discussion on acceptability of elderly drivers for Intelligent Speed Adaptation (ISA) in Japan. In Japan, the issue focusing on the traffic safety of elderly people has become one of most important issues because Japan has been the most representative country to be the rapidly ageing society. As a measure of traffic safety, the ISA is considered as an effective measure to reduce the number of traffic accidents in the field of ITS (Intelligent Transportation Systems) because the adaptable driving speeds let the traffic flow smoothly and stably. Generally, there are three modes regarding the ISA: 1. advisory mode, in which the driving speed information is provided to the driver as the system detects that the vehicle is moving beyond the enforced speed limit; 2. mandatory mode, by which the driving speed is regulated by the ISA so as not to exceed the allowable speed; 3. voluntary mode, which extricate the mandatory mode and grant the driver full control of the vehicle's acceleration. Normally, the mandatory type is the most effective one but is difficult to introduce because of too many obstacles such as the freedom of personal choice, the limitation for the automobile technology and so on. Comparatively the advisory type seems to be the easiest one to introduce. The analysis is based on an experiment by using a driving simulator. The targeted issues focus on the acceptances of both advisory mode and mandatory mode for the elderly driver because grasping of the acceptances for the ISA is absolutely essential to implement the novel system for the ageing society of Japan. As the conclusion of the paper, the acceptances of the elderly drivers for both mandatory ISA and advisory ISA on the community roads are generally high.


Determining serum CA 19‐9 using regular Centocor kit frequently requires numerous repeats when specimens contain highly elevated levels of CA 19‐9. We found that the number of repeats could be reduced if the Centocor kit with an extended concentration range was used. Using an extended Centocor kit could also eliminate falsely low CA 19‐9 results. However, when a Biomira RIA kit, based on a competitive binding principle, was used, falsely low CA 19‐9 values could be completely avoided and, in most cases, only a single repeat was usually required to arrive at the true result. This is because the level of CA 19‐9 in the specimen can be approximated from the radioactivity count. Therefore, when designing an immunoassay for tumor markers, one needs to take into consideration the concentration range of the tumor marker in the specimens if one would like to avoid repeats and falsely low values.


Chlamydia trachomatis was encountered in four cases during the evaluation of 29 premenarchal girls with gynecologic complaints during 1983. Only one of the patients had antecedent infection with Neisseria gonorrhoeae. The importance of using specific tests to actively establish a definite diagnosis of chlamydia is stressed. The susceptibility of the thin premenarchal vaginal mucosa to chlamydial infection is discussed as is the role of chlamydia as a marker for sexual abuse. Once a diagnosis of chlamydial rectogenital infection is established in a child, it is mandatory to investigate for child abuse and sexual molestation as the source of the infection. (Obstet Gynecol 65:384, 1985)


Fish is good for both mental and physical health. Fish contains high quality protein, good lipids consisting of essential fatty acids, important minerals, vitamins etc. The grey matter of the brain consists of about 60% lipids consisting of essential fatty acids DHA, ARA, EPA etc. DHA is the building blocks of brain tissues. Essential fatty acids are important in prevention and amelioration of many civilization and age related diseases such as heart diseases, dementia, mental decline etc. Fish protein as complete protein contains functional amino acids that are rich in brain, hearts, and eyes that are associated with their functions. Fish also contains important minerals, vitamins that are also good for brain. Factors of mental health are many but how to use the faculty is very important. The important functional components of fish are essential and help in overall well-being and quality of human life boosting performance ability. So the objective of the paper is to discuss the important roles of functional components of fish leading to overall well-being, better mental health and mood.


The study examined household sugar consumption pattern in Bauchi State, Nigeria. Cross – sectional data were collected from 412 households using multistage sampling technique. The data were analyzed using descriptive statistics, Linear regression model and budget share index. The socio-economic factors influencing sugar consumption in northern zone of Bauchi State were; age, household size (P<0.01), income (P<0.05), educational level and primary occupation (P<0.1), with R 2 value of 0.685. The significant variables that influenced household sugar consumption in central zone were monthly income (P<0.05), cost of sugar and household size (P<0.01) and average monthly total food expenditure (P<0.05); with R 2 value of 0.497. In the western zone sugar consumption was influenced by average monthly income and household size (P<0.01), cost of sugar (P<0.05), and primary occupation (P<0.1) with an R 2 value of 0.375 and the F-value of all the three zones were significant (P<0.01). The central zone had the highest sugar budget share of 8.70%, followed by western zone (6.59%), while Northern zone had 5.20%. The result showed that, in northern zone the respondents spent 60.91% of their household budget on food, while in central and western zones it was 59.27% and 55.06% respectively. Most of the respondents, 89.4% and 84.2% in central and western zones, respectively reported price as a major constraint to sugar consumption; likewise, 79.7% in northern zone. Income is the second constraint to sugar consumption in all the three zones with 73.4%, 84.6% and 77.6% in northern, central and western zones, respectively. Household size ranked third, the northern zone had 51.0%, central zone 47.1% and western zone 32.7%. A small percentage of the respondents reported health as a constraint to sugar consumption, northern zone 23.1%, central 25.0% and western zone 24.2%. The research concluded that socioeconomic factors have an influence on sugar consumption of the household. The study therefore, recommended Policies and programs toward sugar sector in Nigeria should be improve and implemented toward self-sufficiency in sugar production. Thus, filling the demand and supply gap of the product in the country.


We explore a novel research idea, that we call Musical Language Processing (MLP), which investigates the possibility of a musical input to speech interaction systems. We present the first attempts at finding a mapping between musical pieces and dialogues, based on the frequency of musical patterns. Our findings on one possible alignment between classical piano compositions and dialogues from popular TV series are encouraging, and open the way to further investigations along this line of research.


Farm-level data for the 1988/89 agricultural year from a sample survey of wheat farmers in Eastern Free State, are analysed in this paper. Stochastic frontier production functions are estimated, in which the technical inefficiency effects are modelled in terms of the size of the farming operation and other explanatory variables. The technical inefficiency effects for the farmers involved are significant and the null hypothesis that the explanatory variables in the model for the inefficiency effects have zero coefficients is rejected. The technical inefficiency effects are negatively and significantly related to the size of the farms. Elasticities of mean outputs with respect to the different inputs, together with the technical efficiencies of the wheat farmers, are estimated for both the translog and the Cobb-Douglas stochastic frontier production functions. However, the Cobb-Douglas function is not an adequate representation of the data, given the specifications of the translog stochastic frontier produc...


Abstract Background: Cryotherapy using Wartner compound that contains a mixture of dimethyl ether (75%) and propane (25%) has been recently reported as an effective treatment for warts. The present study aimed to evaluate the safety and efficacy of Wartner in male patients with genital warts. Methods: A Phase II parallel-randomized clinical trial was performed on 16 Iranian men affected by genital warts who were referred to a dermatology clinic at Tehran University of Medical Sciences. Two genital warts of each patient were selected and randomly assigned to receive either Wartner (intervention) or liquid nitrogen (control). Results: Two weeks after the treatment, the sizes of the lesions in control and intervention groups decreased by 17.87 ± 2.14 mm2 and 15.81 ± 1.80 mm2, respectively (p = .299). Fourteen days after a single session of treatment, 81% of lesions in the control group and 50% in the Wartner group were completely eradicated, however, the difference was not statistically significant (p = .063). Conclusions: The Wartner compound is as effective as the conventional cryotherapy method for treating genital warts. It is particularly valuable when there are contraindications or no access to common treatment options.


This paper examines the efficiency of different rayshooting acceleration schemes, including the uniform space subdivision, octree and kd-tree. We use simple computational models, which assume that the objects are uniformly distributed in space. The efficiency is characterized by two measures, including the expected number of ray-object intersections needed to identify the firstly intersected object, and the expected number of steps on the space partitioning data structure. We can come to the interesting conclusion that these numbers are constant and are independent of the number of objects in the scene. The number of intersections is determined by how well the cells of the partitioning data structure enclose the objects. Such analysis helps to understand why kd-tree is better than octree and uniform space subdivision and provides hints to improve their implementation.


Landscape simplification and habitat fragmentation may cause severe declines of less mobile and habitat specialist species and lead to biotic homogenization of species communities, but large-scale empirical evidence on biotic homogenization remains sparse. We sampled butterfly and day-active geometrid moth communities within 134 differently fragmented landscapes in Finland situated in five geographical regions. Overall species richness was partitioned into alpha and beta diversity and butterflies were assigned a species-specific mobility rank and habitat specificity score based on published ecological trait classifications. Alpha and beta diversity of butterflies and geometrid moths decreased with increasing agricultural intensity, independently of geographical position. The responses were either linear or nonlinear with accelerating decrease of diversity when arable field cover exceeded 60%. Mobility rank and percentage generalists of butterfly communities increased linearly with increasing field cover. In landscapes with high agricultural intensity (>60% field coverage), the decrease in beta diversity of butterflies was strongly associated with an increasing proportion of habitat generalists and increasing average mobility in the butterfly communities. However, there was no such relationship in landscapes with low or moderate agricultural intensity. Synthesis and applications. We demonstrate that biotic homogenization caused by land-use change arises as a consequence of the loss of habitat specialists and poor dispersers in intensively cultivated landscapes with simplified landscape structure. Agri-environment schemes will therefore be inefficient in protecting high beta diversity unless they explicitly increase habitat availability and connectivity for habitat specialists and poor dispersers. © 2010 The Authors. Journal compilation © 2010 British Ecological Society. (Less)


The role of Carica papaya L. leaf juice in immune dysregulation caused by dengue virus infection remains unclear. This study aimed to investigate the immunomodulatory activities of the freeze-dried C. papaya leaf juice (FCPLJ) on AG129 mice infected with a clinical DENV-2 (DMOF015) isolate. The infected AG129 mice were orally treated with 500 and 1000 mg/kg/day of FCPLJ, for three days. Platelet, leukocyte, lymphocyte and neutrophil counts were microscopically determined. The level of plasma proinflammatory cytokines was measured by multiplex immunoassay. The levels of intracellular cytokines and viral RNA were determined by RT-qPCR technique. The results showed that the FCPLJ treatment increased the total white blood cell and neutrophil counts in the infected mice. The FCPLJ treatment decreased the level of GM-CSF, GRO-alpha, IL-1 beta, IL-6, MCP-1 and MIP-1 beta in the plasma of the infected mice. The intracellular IL-6 and viral RNA levels in the liver of infected mice were decreased by the FCPLJ treatment. In conclusion, this study supports the potential immunomodulatory role of the FCPLJ in a non-lethal, symptomatic dengue mouse model. Further studies on the action mechanism of the C. papaya leaf juice and its possible use as adjunctive dengue immunotherapy are warranted.


Adult onset Still's disease (AOSD), the adult variant of the systemic form of the juvenile rheumatoid arthritis, is an uncommon disorder of unknown origin. Although the pathogenesis has not yet been clarified, an immunologically mediated inflammation occurs in active AOSD. High spiking fever, evanescent maculo-papular skin rash, arthralgias/arthritis, neutrophilic leukocytosis, negative rheumatoid factor and antinuclear antibodies, as well as a marked hyperferritinemia are the major features of AOSD. Sore throat, lymphadenopathies, hepatosplenomegaly, abdominal pain, polyserositis, respiratory distress syndrome, multiple organ dysfunction and disseminated intravascular coagulation may also occur. The clinical course of AOSD is extremely variable and unpredictable and can be divided into three main patterns: a self-limited or monocyclic pattern, a polycyclic or intermittent course, with one or more flares of the disease and complete remission among the episodes, and a chronic course, characterized by persistently active disease, usually due to a chronic, destructive arthritis. Since there are not pathognomonic laboratory parameters or histological findings, the diagnosis of AOSD requires the exclusion of infectious, malignant and autoimmune disorders. Some sets of criteria for classification have been proposed, but so far not validated. The prognosis of AOSD is usually considered relatively benign, although a destructive arthritis may cause severe disability and the multisystemic life-threatening complications of the disease may determine a fatal outcome. Treatment usually consists in non-steroidal anti-inflammatory drugs and corticosteroids, but a more aggressive approach with disease modifying antirheumatic or immunosuppressive drugs may be required.


A geometrical theory of diffraction model for on-body propagation is developed in this paper. The exact solution to the canonical problem of a plane wave incident on an infinitely long cylinder, with arbitrary constitutive parameters, is found. The same is done for a magnetic and an electric infinitesimal dipole source of any orientation, located on the surface of the cylinder. The exact solutions are transformed with the Watson transformation to yield asymptotic expressions that are valid in the deep shadow region. These asymptotic expressions are validated by comparison to the numerically evaluated exact solution. It is found that the expressions are valid as long as the object is opaque, with a geometry down to the size of <inline-formula> <tex-math notation="LaTeX">$({\kappa }/{\kappa ^{2}+\tau ^{2}}) > \lambda _{0}/2$ </tex-math></inline-formula>, and the rays not too torsional <inline-formula> <tex-math notation="LaTeX">$\tau /\kappa < 2$ </tex-math></inline-formula>, where <inline-formula> <tex-math notation="LaTeX">$\kappa $ </tex-math></inline-formula> and <inline-formula> <tex-math notation="LaTeX">$\tau $ </tex-math></inline-formula> are the curvature and torsion of the local geometry, respectively. The asymptotic expressions are found to approximate the exact solution significantly better than the asymptotic expression of an equivalent perfect electric conductor geometry. The same is the case for the impedance boundary condition asymptotic approximation for low dielectric constant materials. Finally, the asymptotic expressions are generalized so they can be applied to any convex geometry of the human body or an opaque lossy dielectric of electrically large size.


Introduction During last three decades, global incidence of oesophageal adenocarcinoma has increased more rapidly than any other cancer. A concurrent reduction in the incidence of gastric cancer has been reported from some populations. We aimed to examine the geographical pattern of oesophageal adenocarcinoma versus gastric non-cardia cancer across the world where reliable cancer registry data were available. Methods Data were abstracted from "Cancer Incidence in Five Continents" Volume 10. Oesophageal and gastric cancers were selected based on ICD-10 codes C15 and C16, respectively. Oesophageal adenocarcinomas were identified by ICD-O morphology codes. Datasets reporting >500 cases for total gastric cancer and >100 for total oesophageal cancer were selected. We examined correlation between age-standardised Incidence rates (ASR) of oesophageal adenocarcinoma and non-cardia gastric cancer using Spearman's non-parametric correlation coefficient (CC). We also allocated cardia cancers into oesophageal and non-cardia gastric adenocarcinoma categories based on gender ratio for oesophageal adenocarcinoma and non-cardia gastric cancer in each dataset. Results Out of 424 datasets from 290 cancer registries, 206 datasets covering 40 countries met the selection criteria. There was a strong inverse correlation between oesophageal adenocarcinoma and gastric non-cardia cancer in males (CC= –0.768, p < 0.001) and females (CC = –0.705, p < 0.001). After dividing cardia cancer into two subtypes with potentially oesophageal or gastric origin and adding them to original oesophageal adenocarcinoma or gastric non-cardia groups, the inverse correlation remained strong in males (CC= –0.660, p < 0.001) and females (CC= –0.536, p < 0.001). Oesophageal adenocarcinoma only showed a rise when incidence of non-cardia gastric cancer fell below 9/100,000 person-years for males and 4.5/100,000 person-years for females. Conclusion This cross-sectional study is consistent with a common underlying factor predisposing to non-cardia gastric cancer and protecting from oesophageal adenocarcinoma, such as H. pylori atrophic gastritis. If this is the case, then the incidence of non-cardia gastric cancer would need to fall to substantially lower levels than currently seen in Far Eastern populations before any rise in oesophageal adenocarcinoma would be apparent. Disclosure of Interest None Declared.


Cities and states across the U.S. are assessing fees or taxes on transportation network company (TNC) platforms, such as Uber and Lyft. The goals of these policies include traffic and emissions mitigation, as well as revenue generation, among other objectives. This research aims to assess the goals and effectiveness of these fees in achieving some of these policy objectives, primarily congestion and emissions mitigation. The analysis addresses a core difficulty in comparing TNC fees—some fees are assessed per mile and others per trip. The researchers compared 21 fees implemented by state and local governments across the United States and apply a methodology to compare these diverse fees and taxes based on a hypothetical ride informed by Uber's fare calculator, as well as other sources. The findings show that when adjusted for comparison, the highest fees, by a wide margin, are assessed in downtown New York City and Chicago (during peak hours). A key policy implication of this research is that most fees or taxes are not large enough to affect enough travelers' choices to hail a TNC, and most do not differentiate between solo and pooled/shared rides. Only San Francisco, Chicago, New York City, and New Jersey differentiate between solo and shared rides, which is likely to influence travelers in choosing to share a ride. This is problematic given that increasing passengers per vehicle mile traveled is an essential strategy in managing congestion and reducing emissions associated with all vehicle travel, including TNCs.View the NCST Project Webpage


Background/Aims Patients with high blood pressure (BP) visit a physician on average 4 times per year though fewer than half achieve BP control. Practical, effective, and sustainable models are needed to improve BP management. Hyperlink is a clinic-randomized trial testing an intervention that combines home BP telemonitoring with pharmacist case management in patients with uncontrolled hypertension. Methods We enrolled 450 patients with uncontrolled BP from 16 primary care clinics. Eight clinics (222 patients) were randomized to usual care and 8 clinics (228 patients) to intervention. Intervention patients received home telemonitors that transmit BP data to a secure database. Pharmacists consult with patients by phone and adjust antihypertensive therapy based on home BP data. The intervention lasts 12 months with follow-up to 18 months to observe durability. The primary outcome is BP control at 6 and 12 months, defined as BP ≤140/90 mm Hg (or ≤130/80 mm Hg in patients with chronic kidney disease or diabetes). Data on demographics, medication use and adherence, and satisfaction with care were also gathered. Here we report 6-month BP outcomes. General and generalized linear mixed models are used to accommodate the cluster-randomization. Results Enrollees were 45% female, 82% white, and 12% black, with mean age of 61 years. Mean BP at baseline was 148/85 mm Hg in both treatment groups. Of the 403 attending the 6-month visit (197 usual care, 206 intervention), 45.2% in usual care and 71.8% in intervention achieved BP control (P <0.0001). In usual care, mean systolic BP decreased by 10.8 mm Hg and diastolic decreased by 3.4 mm Hg. In intervention, mean systolic BP decreased by 21.5 mm Hg and diastolic decreased by 9.4 mm Hg. The difference in change between groups was 10.7 mm Hg systolic (P <0.0001) and 6.0 mm Hg diastolic (P = 0.002). Secondary outcomes, including changes in self-reported satisfaction with care, treatment intensification, and medication adherence, will also be reported. Conclusions Home telemonitoring with pharmacist case management was effective at reducing BP for hypertensive patients over 6 months. This intervention may be cost-effective for managing hypertensive patients with uncontrolled BP, especially if results are sustained during the maintenance and post-intervention phases of follow-up.


Effective governance and the development of strong boards are critical factors influencing the achievement of missions and visions in nonprofit organisations. The purpose of this study is to investigate the board structures of arts organisations in Taiwan, and to understand the attributes of those boards, including their abilities to determine organisational mission of organisations, to identify appropriate strategies, to define the relationships between boards and executive officers, and to effectively manage community relations. Findings indicate that the majority of the boards of Taiwanese arts organisations examined, demonstrated the experiences and skills needed to provide effective governance. However, a majority also lacked systematic programs to orient and assist new board members to become full contributors; nor did they have processes in place to prioritize the focus of time and attention board members were able to contribute. It is concluded therefore, that most boards examined would be helped by the establishment and implementation of such things as functional job descriptions, a system of board activity evaluation and definition of advocacy responsibilities.


This study concerns a qualitative research about therapy processes that play a part in the effectivity of the online self-help course with counseling via e-mail 'Op verhaal komen'. This course is designed for clients of 40 years en older who suffer from mild to moderate symptoms of depression and make use of life review. A research complied in 2014 has proven the course as effective with regard to the symptoms of depression and well-being. There are assumptions that different therapy processes work together to make a therapy effective. However it remained unclear which therapy processes were responsible for this and how they bring the results. Therefore is the goal of this study to find out which therapy processes play a part in online therapy by reducing symptoms of depression and by the improvement of well-being, what together in this study is called effectivity.
At the above mentioned course 58 people participated in total. The e-mails of two clients and their counselors were analyzed in this study. The analysis is a form of change process research (CPR) and makes use of a holistic content analysis and an identity analysis. The combination of these two analyses is unique and carries out a lot of information. Through this combined method of analysis it was possible to predict of the course was effective for the clients of not. At the end the analyses from the two clients were compared with each other to get a more clear idea about the processes which are influential on the effectivity of the course.
Through the use of the different analyses it is found that it is especially important for the counselor to be responsive to the client in accordance with the basic abilities from Rogers (1979). That the client is motivated, communicative, authentic and therapy-loyal, and that they have a positive attitude with regard to the course is found, among other, as factors for the effectivity. Furthermore is found that an interaction which is characterized through trust, openness, honesty, cooperation and an adequate personal climate is promotable for the effectivity.
This study gives support for the cooperation between the three therapy processes 'therapist', 'client' and 'interaction', and thereby for a collective influence on the effectivity of a therapy. Furthermore, it was possible to make a difference between processes that influence the effectivity in general and processes that influence depressive symptoms and well-being. Through this there is gain a more clear idea about the different therapy processes and how they influence the effectivity of a therapy.


Objectives : MRI has proven to be the best imaging modality in the evaluation of pituitary tumors. Dynamic Imaging is technically a new tool, which has emerged with lot of promise in the evaluation of pituitary adenomas, particularly in accurate delineation of those microadenomas with no contour abnormality and in differentiating residual/recurrent adenoma from surrounding post operative tissue. Dynamic MR imaging is not only useful in the evaluation of pituitary microadenomas but has an equally important role in the assessment of macroadenoma as well. This study analyses and reviews the value of dynamic MR Imaging in pituitary adenomas and postoperative pituitary tumors. Materials and Methods : A prospective MR Study was undertaken in twenty-five consecutive patients with suspected pituitary adenomatous lesions. These patients were subjected to dynamic MR imaging at our Department from Jan 1997 to Dec 1998. The study was performed on a 0.5T super conducting MR imaging system with Fast Spin echo technique. Gadodiamide (0.1 mmol/Kg) was administered over sixty seconds by hand injection. Dynamic coronal images were obtained simultaneously from three different portions of the gland. Fifteen images were obtained from each of the three portions at an interval of twenty to thirty seconds between the images. Result : Dynamic MRI was performed in nineteen patients with microadenoma and six cases of macroadenoma. Dynamic MRI study was of diagnostic value in comparison with routine contrast MRI in eleven of the nineteen patients. Dynamic study did not add to the diagnosis and was merely of confirmatory value in remaining eight patients. Dynamic MRI study was used to identify the optimal time for delineation of the adenomatous tumor, by virtue view of the simultaneous differential contrast enhancement patterns between normal pituitary gland and adenoma. Further the enhancement pattern of the normal pituitary gland, the adenomatous nodule and the optimal delineation were individually assessed. This evaluation revealed the average time in seconds for onset of enhancement and the peak enhancement of normal pituitary gland were 43.1 and 111.9 seconds respectively. In comparison the pituitary adenomatous nodules exhibited an average time of 105.8 seconds for onset of enhancement and 188.1 seconds for peak enhancement. The average time in seconds for optimal tumor delineation was 93.9 seconds. Conclusion : Dynamic MR Imaging has emerged as a technically refined tool in the evaluation of pituitary adenomas. The key questions in evaluation of pituitary adenomas include the presence or absence of a tumor, the number, the location of adenoma nodule, the invasive effects on adjacent structures and the post therapy status of adenoma. Clearly, dynamic MR Imaging is the foremost imaging modality answering these vital questions in patients with pituitary adenomas.


The effect of adrenergic blocking agents and adrenomimetics on sensitivity to insulin was studied in rat experiments. The sensitivity was judged from the duration of hypoglycemic coma development after intravenous infusion of 40 U/kg insulin. Sensitivity to insulin increased with the beta-adrenergic blocking agent obsidan and the alpha-adrenomimetic mesaton (phenylephrine hydrochloride) but diminished after infusion of the beta-adrenomimetic partusisten and the alpha-adrenergic blocking agent butyroxane. The obtained data are discussed from the standpoint of insulin-resistance control.


The findings in an unsuspected case of Strongyloides stercoralis infestation coexisting with adenocarcinoma of the lung are presented. The diagnosis of adenocarcinoma was confirmed histologically by lung biopsies; the parasitic infection was initially diagnosed by sputum cytology and then by bronchial washings. A stool specimen submitted to the microbiology laboratory confirmed the diagnosis of S. stercoralis infection. This case again suggests the possibility that neoplastic disease may play a role similar to that of immunosuppression in creating an immune deficiency, thus increasing the susceptibility to infectious diseases.


AIMS AND OBJECTIVES
To characterise the main difficulties, coping strategies, sources of satisfaction and levels of burden disclosed by informal caregivers of older people who are dependent due to physical and mental causes, in the Portuguese context and to compare the impact between caregivers for older people with physical dependence and caregivers for older people with mental dependence.

BACKGROUND
Caring for a dependent older person is a complex process that puts two people in interaction, each with their own traits and their own histories of private life. When performing this role, the care provider needs to know how to deal with difficulties through a range of coping strategies. The outcome of this relationship may result in burden as a result of the volume of care, the complexity of care or the caregiver's inability to provide needed care. Caring for a family member can also be a source of satisfaction thanks to the pleasure of giving back and/or providing well-being.

DESIGN
This is a quantitative, analytical and correlational study.

METHODS
This study was conducted among two distinct groups-caregivers of older people without dementia (physical impairment) and caregivers of patients with dementia (impairment of a predominantly cognitive nature). Data were collected by administering a previously defined questionnaire that sought to gather various sorts of information (sociodemographic, clinical and environmental) and that included certain specific instruments, such as dependency ratio, cognitive assessment tests, an index of difficulties, a satisfaction index, an index of coping strategies and a burden scale.

RESULTS
The sample consisted in 184 caregivers over 40 years of age, of which, 101 cared for dependent people without cognitive impairment and 83 cared for people with dementia. Most caregivers were women (87%), most were married (78·8%), with a low level of education (33·7% did not complete primary school and only 7·1% had any postsecondary education). Most were spouses or daughters (75·5%). The caregivers of older patients with dementia had lower levels of satisfaction, with a mean difference of 12·95 percentage points, p < 0·001. It appears that caring for older people with dementia implies a greater burden, with a mean difference of 15·4 percentage points, p < 0·001. There is a strong correlation between difficulties and burden (r = 0·89, p < 0·001) and between the effectiveness of coping strategies and satisfaction (r = 0·92, p < 0·001).

CONCLUSIONS
This study suggests that caregivers of older people with dementia are more vulnerable due to their higher levels of burden, which are associated with higher levels of difficulties and reduced sources of satisfaction.

RELEVANCE TO CLINICAL PRACTICE
These data are essential for the management and implementation of health programmes that can reduce the vulnerability of caregivers. Programmes should address caregivers' difficulties and burden as a way to promote satisfaction with providing care.


The study concentrates mainly on the circumstances that surround Lincoln Cathedral, a major masonry structure that appears always to have possessed an in-house maintenance team. During the past century, several significant campaigns of repair have produced sufficient documentation to examine the evolution of changing attitudes in caring for the masonry structure. Examination of such records, combined with study of the relevant areas of the building itself, are influential in addressing the needs of the building by forming a critical awareness, not only of the actual work applied to the structure, but of the nature of the skills that are available to carry the work out. In carrying out effective maintenance it is necessary to gain an intelligence of the structure itself, in its historic context. This will help to identify the likely weaknesses in engineering design as environmental conditions change and the constructional materials weaken due to attrition and the passing of time. An intimate knowledge of limestone, the principal structural material, and the agencies of deterioration and decay, is essential in combating what may be perceived as inevitable failure. This is assisted by understanding the local systems of decision-making, as policy is formulated within national perceptions of cathedral care. The thesis is structured in six parts, the first five covering areas of necessary understanding, both in the technical and historical sense, prior to outlining methods of initiating maintenance action. Case studies present illustrations of relative success and failure in understanding and implementation. It can be seen that failure can impose serious consequences that reach far into the future. Practical examples are presented of areas of difficulty in the routes of communication and approval. The question of skills is addressed, and the main methodologies associated with care of historic buildings are described. Part six identifies and defines deficiencies in these skills, and recommendations are made for improvements.


ABSTRACT In this study, teachers explored their professional identities by reflecting on their teaching role(s) and contexts through elicitation of textual (written) metaphors and visual (drawn) metaphors of teaching. Participants created impromptu drawings emblematic of their conceptualized metaphor. Analysis of participants' written metaphors and impromptu drawings suggests participants' preference for action-based (e.g. sports) metaphors to depict their professional teaching roles and identities. Findings further suggest a complementary relationship between textual and visual data, although contrasting or oppositional relationships of image and text are also possible. The authors found that visual data adds potency to teacher's self-metaphors and ponder the affordances that emerging visual research methods bring to future investigations.


Abstract The 18.6-year nodal tide is a component of all tide gauge records. It can affect estimates of sea level acceleration, in particular for tide gauge records with lengths of less than 60 years. We provide an analytic solution that shows the effect of the nodal tide on estimates of sea level trend and acceleration. By adding a term to the least squares formulation used to estimate sea level trend and acceleration, we can account for the nodal tide and eliminate its effect on the estimate. Using representative world-wide tide gauge records, we demonstrate that accounting for the nodal tide can improve estimates, particularly of acceleration.


Thrombocytopenia is one of the complications in human immunodeficiency virus (HIV) patients. To improve the health outcomes of patients living with HIV, it is important to understand the prevalence and pattern of associated key clinical markers globally. This meta-analysis, therefore, aimed to estimate the pooled prevalence of and associated clinical marker of thrombocytopenia globally. Methodology: The meta-analysis was conducted as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All statistical analyses were conducted using Stata. Twelve full-text papers out of 454 were eligible for meta-analysis. Results: Among 6686 participants, overall pooled prevalence of thrombocytopenia was 10.90% (95% CI: 7.91, 13.88) I2 = 93.62%. In addition, thrombocytopenia was more prevalent by 25.11% (95% CI: 13.33, 36.88) in patients with CD + T < 200 cells/μL, and less prevalent in patients with CD + T < 200 cells/μL 10.10% (95% CI: 7.37, 12.83), respectively. Conclusions and recommendations: This meta-analysis established the prevalence of thrombocytopenia among patients living with HIV, and that it may be more prevalent in patients with CD + T < 200 cells/μL indicating the necessity of routine screening for various haematological markers and a careful treatment plan for HIV patients.


The HLA-DR beta region of at least two members of the DRw52 (MT2) supertypic group (DR3, DR5, DRw6, and DRw8) has recently been shown to contain three beta-chain genes--beta I, beta II, and beta III, ordered in the direction of transcription. beta III is apparently a duplication of beta I. Both beta I and beta III are expressed, whereas beta II is a pseudogene. We previously reported the sequence of the DR5 beta I cDNA from the homozygous DR5 cell line Swei. We report here the sequence of two different DR5 beta III cDNA from the same cell line. The assignment of the genes of this and other members of the DRw52 supertypic group to specific loci allow comparisons between products of known alleles and between products of distinct loci. beta I allelic products showed approximately 11% divergence in the first domain, whereas beta I and beta III products showed 17% difference. These differences were clustered and found predominantly in the previously described variable regions (amino acid residues 9 through 13, 26 through 38, and 67 through 74). These data, coupled with the finding of shared variable regions among different DR beta chains, suggest gene conversion as a means of generating polymorphism in the beta I alleles. In contrast, the beta III allelic products showed less than 1% amino acid and nucleotide divergence in the first domain. These differences were outside the variable regions, and attributable to single nucleotide changes. The polymorphism at the beta I locus and the conservation at the beta III locus suggest selective pressure conserving the beta III locus and/or generating polymorphism at the beta I locus, and further suggest that gene conversion may be acting unidirectionally from beta III to beta I.


First of all, parameter model of bond strength after bolt corrosion is built consideration of the own characteristics of mortar bolt anchorage; second, the whole process of mortar cover cracking is simulated by numerical method using the thinking of interface assembly in mechanical industry for reference; and at last, the results of above two are used to analysis anchor characteristics in anchorage body after bolt corrosion. The analysis result shows that before mortar cover cracking, bond stress increases with the improvement of bolt corrosion ,and the max stress can be obtained when mortar cover begin to crack and after that the bond stress begin to decrease ,the min stress is got just at the time that the mortar cover crack completely. After mortar cover cracking, the peak value of bond strength in bolt-mortar interface and mortar-rock interface will move to deeper place and the distribution of bond stress in effectively anchored length tends to be uniform in high stress level.


Abstract The investigation of the electromagnetic field in a regular waveguide filled with a homogeneous substance reduces to the study of two independent boundary value problems for the Helmholtz equation. In the case of a waveguide filled with an inhomogeneous substance, a relationship arises between the modes of these two problems, which in numerical experiments can not always be fully taken into account. In this paper, we will show how to rewrite the Helmholtz equations in the "Hamiltonian form" to express this connection explicitly. In this case, the problem of finding monochromatic waves in a waveguide with arbitrary filling will be reduced to an infinite system of ordinary differential equations in a properly constructed Hilbert space. The results of numerical experiments on finding normal waves, realized in the computer algebra system Sage, are presented.


A promising route to highly efficient thermoelectric materials is to introduce the effect of strong electronic correlations into cage compounds which contain weakly bound ions in oversized cages of the framework structure. By this approach the low thermal conductivity of cage compounds shall be combined with giant thermopower values of strongly correlated systems, thus doubly optimizing the thermoelectric figure-of-merit. We present here results on a new candidate material, Ce4Pt12Sn25. There is a unique Ce site in the center of a polyhedron cage made up of 6 Pt and 12 Sn atoms. Synthesis, structure and various physical properties measured between room temperature and 2 K are presented.


The effective diagnosis of wind turbine gearbox fault is an important means to
ensure the normal and stable operation and avoid unexpected accidents.

To accurately identify the fault modes of the wind turbine gearbox, an intelligent diagnosis
technology based on BP neural network trained by the Improved Quantum Particle Swarm Optimization
Algorithm (IQPSOBP) is proposed. In IQPSO approach, the random adjustment scheme of contractionexpansion
coefficient and the restarting strategy are employed, and the performance evaluation is executed
on a set of benchmark test functions. Subsequently, the fault diagnosis model of the wind turbine
gearbox is built by using IQPSO algorithm and BP neural network.

According to the evaluation results, IQPSO is superior to PSO and QPSO algorithms. Also,
compared with BP network, BP network trained by Particle Swarm Optimization (PSOBP) and BP network
trained by Quantum Particle Swarm Optimization (QPSOBP), IQPSOBP has the highest diagnostic
accuracy.

The presented method provides a new reference for the fault diagnosis of wind turbine
gearbox.


Background: Descriptions of interprofessional education (IPE) programs and teacher competencies exist, but limited research has been undertaken about the process of IPE teaching team formation. This research project examined how pedagogically naive clinicians of different disciplines initially formed an IPE teaching team. Methods and Findings : A case study approach was undertaken with data collected over the first sixteen months of an IPE program. Data included: audio recordings, transcripts, and field notes from nine individual teacher interviews, two teaching team focus groups, five student focus groups, and eight summary reports. Data analysis using a grounded theory constant comparison approach revealed themes relating to the formation, development, and evolving sophistication of the teaching team from functioning, to co-ordinating, to co-operating, and finally to collaborating. These stages were influenced by four external factors: remote rural context, Hauora Māori principles, personal attributes, and teacher development. Conclusions: Formation of interprofessional clinical teaching teams requires educational preparation, time learning to work with each other, and trust development, with a number of local contextual factors influencing this process. Teaching team formation paralleled Wegner's Community of Practice model where shared vision supported the adoption of an increasingly complex IPE pedagogy.


ABSTRACT The concept of community identity has often been employed to explain ways in which communities respond to agents that impact community well-being. Using a case study of the Florida cattlemen community, we examine how cattlemen understand and perceive regulatory efforts to recover the Florida panther on private ranch lands. The data comes from participants in the Florida cattlemen community, and was collected through in-depth interviews (n = 13), group interviews (n = 32), and written comments associated with a survey about panther conservation (n = 78). Our findings indicate that some cattlemen in Florida have a strong sense of community identity. Perceptions of government actions and variation in economic risks are critical factors in understanding how this community responds to federal interventions. Our findings suggest that the concept of community identity can be used to explain the responses of agricultural landowners to governmental policies that are perceived as a threat to collective identity.


The paper describes methods for setpoints setting of digital protections (terminals) in traction DC networks. A technique for their improvement and protection settings in a complete scheme is proposed. Besides, the main technical characteristics of digital protection and automation devices are listed. Numerous network parameters, which include those affecting its service reliability, are also reviewed. The parameter factor evaluation of dc traction network servicing, including the random parameter affects, is given. The algorithm and the design procedure of the dc traction network are reported in the paper. Besides, a real operation circuit of traction network protection at the experimental site is considered.


A unified approach to unwarping of omni-images into panoramic or perspective-view images is proposed. The approach does not adopt the conventional technique of calibrating the related parameters of an omni-camera. Instead, it is based on a new concept of pano-mapping table, which is created once forever by a simple learning process for an omni-camera of any kind as a summary of the information conveyed by all the camera parameters. The learning process takes as input a set of landmark point pairs in the world space and in a given image. With the help of the pano-mapping table, any panoramic or perspective-view image can be created from an input omni-image taken by the omni-camera according to an analytic computation process proposed in this study. Experimental results show the feasibility of the proposed approach.


Brzeziny is a small village located in the zachodniopomorskie province. In 1825 P. J. Lenne-a well-known landscape architect prepared a design of decorating fields for the Brzeziny estate owner. The aim of this study is to identify characteristic design solutions and elements implemented by the planner in his landscape formation. The perfored analysis of the composition and spatial structure of the estate has revealed a mosaic distribution of individual crops and their irregular, rounded outline which create a picturesque effect. The analysis of the spatial structure leads to the conclusion that P. J. Lenne designated the biggest areas for meadows and lawns, whilst the smaller ones for the open fields. The fruit crops were not so important as the tree plantings of various types (coherent, openwork, in column habit of the tree…). Their irregular distribution is very characteristic


San Juan, a noted Philippine Marxist now living in the United States, gives a detailed account of the Philippine situation from many perspectives. The essays deal with new-imperialism, the Muslim community, literature, the New People's Army, women, and Filipinos in the United States. While Marcos is gone, many of the issues San Juan raises still need attention and the Marxist perspective he uses gives a very different insight than has been heard previously. Thus the work merits serious consideration for academic libraries. Library Journal Crisis in the Philippines is an unparalleled view of the making of a revolution. E. San Juan offers an insider's examination of the unrelenting avalanche of political events, culminated by the summary killing of opposition leader Benigno Aquino. He dramarically illuminates the Filipino people's struggle for self-determination, the actual activities and growth of the New People's Army, and an analysis of the global forces influencing the current crisis. Unprecedented focus is given to the ways in which certain groups within Phillippine society--particularly the feminist movement and the Church--are coalescing with the Left. Poignantly illustrated with photographs of village life, the New People's Army, protest rallies, press and media clippings, this is the first unrestricted story of the Philippine revolution.


Vertical transverse isotropy (VTI) will affect seismic inversion, but it is not possible to solve for the full set of anisotropic elastic parameters from amplitude variation with offset inversion because there exists an isotropic solution to every VTI problem. We can easily approximate the pseudoisotropic properties that result from the isotropic solution to the anisotropic problem for well-log data. We can then use these well-log properties to provide a low-frequency model for inversion and/or a framework for interpreting either absolute or relative inversion results. This, however, requires prior knowledge of the anisotropic properties, which are often unavailable or poorly constrained. If we ignore anisotropy and assume that the amplitude variations caused by VTI are going to be accounted for by effective wavelets, the inversion results would be in error: The impact of anisotropy is not merely a case of linear scaling of seismic amplitudes for any particular angle range. Ignoring VTI does not affect the prediction of acoustic impedance, but it does affect predictions of [Formula: see text] and density. For realistic values of anisotropy, these errors can be significant, such as predicting oil instead of brine. If the anisotropy of the rocks is known, then we can invert for the true vertical elastic properties using the known anisotropy coefficients through a facies-based inversion. This can produce a more accurate result than solving for pseudoelastic properties, and it can take advantage of the sometimes increased separation of isotropic and anisotropic rocks in the pseudoisotropic elastic domain. Because the effect of anisotropy will vary depending on the strength of the anisotropy and the distribution of the rocks, we strongly recommend forward modeling for each case prior to inversion to understand the potential impact on the study objectives.


Named Data Networking [1] has an intrinsic distributed nature, which eases decentralizing formerly centralized protocols as discussed in [12], [10]. Nevertheless, implementing fully distributed protocols for many-to-many communications remains challenging. The NDN architecture, built upon CCN [3], makes the following assumptions in order to place content as the narrow waist of the communication stack: (1) content, not machines, should be explicitly addressed and (2) data are not sent unless the receiver explicitly requested it. These assumptions require some specific considerations when multiple parties publish content under the same name, as in some many-to-many communication applications. This paper discusses the challenges arising from the implementation of many-to-many channels over NDN.We propose an algorithm, inspired by the frequency hopping algorithm used in wireless systems, named Prefix Hopping (PH) to implement high rate many-to-many channels. We show evidence that with the current state of the art, content updates can be lost when generic shared names are used, due to the fact that interest packets - i.e. data requests - can be generated at a fixed bounded rate. The results show how adopting PH is possible to arbitrarily reduce data losses at the cost of a negligible overhead. We have implemented PH and show that it results in a dramatic performance improvement.


Take a certain suspension system of forging manipulator as research object, mechanical system sub-model and hydraulic control system sub-model of suspension system were respectively built by using Pro/E, Mechanism/Pro, ADAMS and AMESim software, and the whole virtual prototype model of suspension system contains mechanical and hydraulic system sub-model was connected by interface module of software collaboration. Based on integrated features of virtual prototype technology, the dynamic and static characteristics of suspension system were researched by the method of multi-field co-simulation and software collaboration. The results can provide certain theoretical significance for designing suspension system of forging manipulator.


This amicus brief explains why the Education Department's recent decision to suspend new rules that would help defrauded students obtain debt relief was arbitrary and capricious. Following an extensive process that generated over 50,000 public comments, on November 1, 2016, the Department of Education released new rules for students seeking debt relief (the "2016 Regulations"). The 2016 Regulations included a "group process" under which Department officials could commence a single action to consistently adjudicate common facts and claims on behalf of a large group of student borrowers against the same school. The process was adopted in response to the collapse of the Corinthian Colleges, which prompted thousands of students to petition the Department for debt relief in 2016. At the time, the Department stated that a centralized hearing process offered many benefits: (1) students and schools gained access to a "consistent, clear, fair, and transparent" process; (2) administrators conserved resources by avoiding repetitive claims; and (3) taxpayers saved money when discharged federal loans were offset by money recovered from schools found to have engaged in misconduct. But two weeks before the rules were to take effect, the Department suspended this procedure, without explanation, just as its backlog of claims surged to historic levels (the "Delay Rule"). Four months later, the Department further delayed the effective date of the 2016 Regulations in an Interim Final Rule. We offer the Court a unique perspective, based on extensive research, about the impact of the Department's delay on the "group process," which was a critical part of the 2016 Regulations. The Department's failure to provide any explanation for suspending that part of the 2016 Regulations was itself "arbitrary and capricious" and "contrary to law." As we show, the Department carefully crafted this group process, repeatedly emphasizing that it was necessary to fairly resolve large numbers of student claims for debt relief. But just when the Department faced mounting backlogs of those same claims, the Department suspended that part of the rule without any justification. With a backlog of student applications approaching 100,000 claims, the Department has needlessly shelved a process carefully designed to provide students with swift relief.


Packaging is the ultimate symbol of the 20th century's consumer culture. It protects what we buy and raises our standard of living. In developing countries, 30 to 50 percent of food shipments are spoiled because of inadequate packaging and distribution systems. In developed countries with more sophisticated packaging, storage, and distribution, only 2 to 3 percent of food shipments are wasted. Packaging not only protects goods, but conveys information about their contents and preparation or administration, and – in some cases – foils would-be tamperers. It plays a vital and growing role in the global economy. And through the vision of Andy Warhol, the Campbell's Soup can and the Brillo box have been elevated to the level of art.


A chiral metasurface, which obtains chirality through a subwavelength artificial structure, is essential for realizing asymmetric transmission in the application of enantioselective sensing, spin-dependent light emission, and other polarization control systems. Here, we studied a split Archimedean spiral metasurface, which can control the propagating wave from asymmetric transmission to symmetric transmission for linear polarized light. As a proof of concept, a dual-band asymmetric transmission is demonstrated in the GHz region using the coupling of the split spiral structures. The maximum asymmetric transmission parameter reaches 53%. By manipulating the height of the split spiral structures using microfluidic technology, a broadband asymmetric transmission is obtained with the bandwidth of 25.9%. Meanwhile, the asymmetric transmission can be controlled from 50% to 0%, enabling the propagation wave from asymmetric transmission to symmetric transmission. Furthermore, the asymmetric transmission is maintained when the metasurface is bent into different curvatures, promising high potential applications for optical isolation, one-way glass, and optical interconnects.A chiral metasurface, which obtains chirality through a subwavelength artificial structure, is essential for realizing asymmetric transmission in the application of enantioselective sensing, spin-dependent light emission, and other polarization control systems. Here, we studied a split Archimedean spiral metasurface, which can control the propagating wave from asymmetric transmission to symmetric transmission for linear polarized light. As a proof of concept, a dual-band asymmetric transmission is demonstrated in the GHz region using the coupling of the split spiral structures. The maximum asymmetric transmission parameter reaches 53%. By manipulating the height of the split spiral structures using microfluidic technology, a broadband asymmetric transmission is obtained with the bandwidth of 25.9%. Meanwhile, the asymmetric transmission can be controlled from 50% to 0%, enabling the propagation wave from asymmetric transmission to symmetric transmission. Furthermore, the asymmetric transmission is maintai...


The integration of intermittent and volatile renewable energy resources requires increased flexibility in the operation of the electric grid. Storage, broadly speaking, provides the flexibility of shifting energy over time; network, on the other hand, provides the flexibility of shifting energy over geographical locations. The optimal control of general storage networks in uncertain environments is an important open problem. The key challenge is that, even in small networks, the corresponding constrained stochastic control problems with continuous spaces suffer from curses of dimensionality, and are intractable in general settings. For large networks, no efficient algorithmis known to give optimal or near-optimal performance. This paper provides an efficient and provably near-optimal algorithm to solve this problem in a very general setting. We study the optimal control of generalized storage networks, i.e., electric networks connected to distributed generalized storages. Here generalized storage is a unifying dynamic model for many components of the grid that provide the functionality of shifting energy over time, ranging from standard energy storage devices to deferrable or thermostatically controlled loads. An online algorithm is devised for the corresponding constrained stochastic control problem based on the theory of Lyapunov optimization. We prove that the algorithm is near-optimal, and construct a semidefinite program to minimize the sub-optimality bound. The resulting bound is a constant that depends only on the parameters of the storage network and cost functions, and is independent of uncertainty realizations. Numerical examples are given to demonstrate the effectiveness of the algorithm.


Abstract : This thesis is an organization assessment of the army G4 (the logistics department of the Rwandese Patriotic Army) using a systems framework. The purpose of the study was to describe the current state of the organization and to determine whether G4 is functioning efficiently and if not, then recommend measures to improve performance. Assessment results show a responsive organization struggling to cope with a dynamic and uncertain external environment. The organization is riddled with internal misfits and rigidities, all of which inhibit operational efficiency. The thesis suggests possible courses of action to help G4 leaders improve their service. Specific recommendations include: revision of the organization's mandate; specification of G4 mission and direction; redesign to achieve more congruence; treatment of personnel issues; and adoption of clear and inspiring goals with corresponding procedures for evaluation. Improvement efforts require active support and participation of all G4 stakeholders.


To test the hypothesis that plasma contains native constituents capable of impairing microcirculatory flow in zones of acute ischemic tissue damage, we performed 14C-antipyrine autoradiographic blood flow studies in splenectomized dogs subjected to 35 min of cerebrospinal fluid compression ischemia followed by 30 min of recirculation to the neuraxis. The animals were anticoagulated with heparin and were divided into 4 groups by exposure to various measures before induction of ischemia. Groups 1 and 2 served for comparison with the other groups and underwent, respectively, no glass-wool filtration and glass-wool filtration via an arteriovenous shunt. Post-ischemic brain blood flows in Group 1 were low and focal zones of greatly impaired reperfusion were present. In Group 2, post-ischemic brain blood flows were high and focal perfusion impairment did not occur. Group 3 received homologous purified factor VIII/von Willebrand factor protein (F VIII/vWF) after glass-wool filtration but before induction of ischemia; Group 4 received F VIII/vWF-poor cryoprecipitate at the same time point. The purpose of administering the plasma preparations was to check for the presence of activity that nullified the enhancement of post-ischemic reperfusion expected after exposure to glass-wool. The results indicate that activity deleterious to post-ischemic reperfusion primarily resides in the F VIII/vWF fraction of cryoprecipitate. The F VIII/vWF-poor cryoprecipitate infusate, containing 250 to 800-fold more protein than the F VIII/vWF fraction, produced an intermediate reduction of blood flow.


small foramen into left uterine cavity. Patient delivered a healthy baby by elective cesarean section at 34 wks. No constriction band was found in umbilical cord. A thick fibrous band was discovered in uterine cavity attaching from anterior wall to the posterior wall. Conclusions: Complete amniotic sheets may be associated with intrauterine death due to cord accident. Incomplete amniotic sheets with a small foramen can be benign, but close monitoring and appropriate obstetric management is important.


Objective: The aim of this study is to investigate the relationships between the nutritional characteristics of pregnant women and the risk of gestational diabetes mellitus (GDM) and Gestational Glucose Intolerance (GGIT). Materials and Method: Women were investigated for GDM during the 24th to 28th weeks of pregnancy. According to the two-step diagnostic approach, women with normal glucose tolerance (normal), those with only 1 high glucose (GGIT) and those with at least 2 high values (GDM) in OGTT were included in the study. There was 60 pregnant women in each group (mean age 31.6±5.4; range 19-46 years). Demographic and clinical characteristics of the participants were questioned and a 3-day food consumptions record were evaluated with BEBIS program. Results: The mean weight, BMI and daily fiber intake in GDM group were significantly higher than the normal group. In the GDM and GGIT groups, the mean age, weight, daily carbohydrate (CHO) and protein intakes, and family history of diabetes were higher than those with normal group. Moreover, in the GDM group, daily fat intake was also significantly higher than the normal and GGIT groups. According to the separate models of logistic regression analysis; the age; daily protein, CHO and fat consumptions; having the first pregnancy and higher pre-pregnancy BMI (>25 kg/m2) were associated with increased likelihood of GDM. Similarly, the age, daily protein consumption, history of giving birth to a macrosomic baby and current smoking were positively linked with the risk of GGIT. Conclusion: Women's nutritional habits (excessive CHO, fat and especially protein consumptions), phenotypic characteristics, family history of diabetes and poor obstetric history are similarly related to the risk of developing GDM and GGIT. Our results showed that in all women, particularly in those at high-risk for GDM who are planning pregnancy, a special attention should be given to general health and balanced diet, starting from pre-pregnancy. Disclosure M. Yabaci: None. I. Satman: None. C. Idiz: None. F. Turker: None. A. Yuksel: None. B. Omer: None. B. Demirel: None. E. Ozer: None. Funding Istanbul University