Risk factors often develop at young age and are maintained over time, but it is not fully understood how risk factors develop over time preceding cardiovascular disease (CVD). Our objective was to examine how levels and trajectories of metabolic risk factors and biochemical markers prior to diagnosis differ between people with and without CVD over a period of up to 15–20 years. A total of 449 incident non-fatal and fatal CVD cases and 1,347 age- and sex-matched controls were identified in a prospective cohort between 1993 and 2011. Metabolic risk factors and biochemical markers were measured at five-year intervals prior to diagnosis. Trajectories of metabolic risk factors and biochemical markers were analysed using random coefficient analyses. Although not always statistically significant, participants with CVD had slightly more unfavourable levels for most metabolic risk factors and biochemical markers 15–20 years before diagnosis than controls. Subsequent trajectories until diagnosis were similar in participants with incident CVD and controls for body mass index, diastolic blood pressure, total cholesterol, HDL cholesterol, random glucose, triglycerides, gamma glutamyltransferase, C-reactive protein and uric acid. Trajectories were more unfavourable in participants with CVD than controls for systolic blood pressure, waist circumference and estimated glomerular filtration rate (p≤0.05). For example, among participants with CVD, systolic blood pressure increased on average by 9 mmHg over the 18-year period preceding diagnosis, whereas the increase among controls was 4 mmHg. In conclusion, unfavourable levels of metabolic risk factors and biochemical markers are present long before CVD, which indicates that the risk of CVD is already partly determined in young adulthood. This underscores the need for early prevention to reduce the burden of CVD.


The authors provide an exhaustive discussion of the differential diagnosis of congenital heart disease from the standpoints of conventional radiography, electrocardiography, and phonocardiography. They also present, in small print, additional detailed data of the anatomy and clinical course. Schematized differential diagnostic considerations are given at the end of each chapter, and a final chapter of schemas of the differential diagnosis of all congenital heart disease has been devised. Brief case summaries with illustrations of radiograms, electrocardiograms, and phonocardiograms of excellent quality finish each chapter. Many excellent reproductions of angiograms are presented. The bibliography is extensive. Pertinent hemodynamic data are interspersed but are not discussed as general topics or as subheadings. The indications for angiocardiography and cardiac catheterization are scarcely noted, and the indications and problems of surgery are superficially covered. This is not a clinical book. Rather is it a discussion of the diagnosis of congenital heart disease as


This paper reports the synthesis of a series of new half-squaraine dyes (Hf-SQ) based around a common chromophoric unit consisting of linked indoline and squaric acid moieties. Carboxylate groups have been incorporated onto this core structure at four different points to study the influence of the anchoring group position on dye-sensitized solar cell (DSC) device performance. Dyes have been linked to TiO2 directly through the squaric acid moiety, through a modified squaric acid unit where a vinyl dicyano group has replaced one carbonyl, via an alkyl carboxylate attached to the indole N or through a carboxylate attached to the 4 position of a benzyl indole. Contact angle measurements have been studied to investigate the hydrophobic/hydrophilic properties of the dyes and the results have been compared to N719 and Z907. Full characterization data of all the dyes and synthetic intermediates are reported including single-crystal X-ray structural analysis for dye precursors; the indole (2a) and the half-squarylium esters (3a) and (6b), as well as the dyes (4c), (8) and (12). Dye colours range from yellow to red/brown in solution (λmax range from 430 to 476 nm) with e ranging from 38000 to 133100 M−1 cm−1. The performance of the dyes in DSCs shows the highest efficiency yet reported for a Hf-SQ dye (η = 5.0%) for 1 cm2 devices with a spectral response ranging from 400 to 700 nm depending on the dye substituents. Co-sensitization of half-squarylium dye (7b) with squaraine dye (SQ2) resulted in a broader spectral response and an improved device efficiency (η = 6.1%). Density functional theory (DFT) calculations and cyclic voltammetry have been used to study the influence of linker position on dye HOMO–LUMO levels and the data has been correlated with I–V and EQE data.


The antibiotic antinonin first obtained from the culture filtrates of a Streptomyces species classified as Streptomyces sp. CUTTER c/2 NCIB 8845 (Gordon, Kelly & Miller, 1962) has been shown to have the constitutional formula of the pseudo-peptide shown in Fig. I (Ollis, East, Gordon & Sutherland, 1964). As a natural product this structure is of interest since it is the first known naturally occurring derivative of L-prolinol and is also the first known naturally occurring hydroxamic acid of the type R-CO-NHOH. Actinonin shows some structural relationship to other polypeptide antibiotics but it


The influence of cell length of a static diode-pumped Cs laser on laser power, gain medium temperature, and laser beam quality is studied theoretically using a 3D time-dependent computational fluid dynamics model where Gaussian spatial shapes of the pump and laser intensities in any cross section of the beams are assumed. Reasonable agreement with power measurements in a static diode-pumped alkali laser (DPAL) with 20 mm cell length [Electron. Lett.44, 582 (2008)ELLEAK0013-519410.1049/el:20080728] is obtained. It is shown that the gain medium temperature rise caused by the pump beam absorption can be decreased by increasing the length of the alkali cell and that, for given conditions, there is an optimal cell length corresponding to maximum laser power. At ∼100  W pump power the optimum cell length of ∼50−60  mm is larger than the 20 mm length usually used in DPAL experiments. The increase of the cell length from 20 to 60 mm results in decrease of the gain medium temperature rise by 100–150°K, making it possible to avoid degradation of the laser power due to chemical reactions in the gain medium. Laser beam quality in terms of Strehl ratio was calculated as a function of pump power and length of the DPAL cell and found to decrease as the DPAL cell length is increased. It is shown that the wavefront corrections result in substantial increase of the Strehl ratio and hence in improvement of the laser beam quality.


A recently developed simple device, the intervertebral body fixation dual-blade plate, was used in 88 cases of different spinal disorders. This patients in the first series were operated on from 1984 to 1986. The device is biomechanically simple and its application safe and easy. Using a proper bone grafting technique, it is a reliable device to establish spinal stability in spine surgery through an anterior approach. Its application in cases of fractures and fracture—dislocations of the thoracolumbar spine with paraplegia, tuberculous spondylitis, and primary tumors of vertebral bodies is presented. The midterm results, covering a follow-up period of 24–49 months (mean, 32 months) were satisfactory; there were no serious complications directly related to the device. There were four cases of pseudarthrosis due to insufficient bone graft technique. Of these, there were three cases of failure of the dual-blade plate.


OBJECTIVE
To estimate prevalence of lifetime and current eating disorders (ED) in a sample of pregnant women in South-East London and to describe their sociodemographic and clinical characteristics.

METHOD
Secondary analysis of data from a cross-sectional survey. Using a stratified sampling design, 545 pregnant women were recruited. Diagnostic interviews were administered to assess lifetime and current ED, depression, anxiety, and borderline personality disorder. Data were extracted from maternity records to assess identification of ED in antenatal care. Estimates of population prevalence of ED were obtained using sampling weights to account for the stratified sampling design.

RESULTS
Weighted prevalence of lifetime ED was 15.35% (95% confidence interval [CI] [11.80, 19.71]), and current ED was 1.47% (95% CI [0.64, 3.35]). Depression, anxiety, and history of deliberate self-harm or attempted suicide were common in pregnant women with ED. Identification of ED in antenatal care was low.

CONCLUSIONS
Findings indicate that by early pregnancy, a significant proportion of pregnant women will have had ED, although less typically during pregnancy, and psychiatric comorbidity is common. Yet ED were poorly recognised in antenatal care. The findings highlight the importance of increasing awareness about maternal ED to improve identification and response to the healthcare needs of pregnant women with ED. Highlights Weighted prevalence of lifetime eating disorders was 15.35% (95% CI [11.80, 19.71]), and current eating disorders was 1.47% (95% CI [0.64, 3.35]) in a UK inner-city antenatal sample; however, eating disorders were poorly recognised in antenatal care. Depression, anxiety, and a history of deliberate self-harm or attempted suicide are common amongst pregnant women with eating disorders. Findings highlight the clinical importance of increasing awareness about maternal eating disorders in maternity professionals to improve identification and response to the healthcare needs of pregnant women with eating disorders.


Abstract A wide spectrum of tomographic techniques now exists for studying palaeontological specimens, but the suitability of these methods for assessing Earth's oldest prokaryotic life has not been comprehensively investigated. We evaluated the ability of X-ray computed tomography – specifically X-ray microtomography – to reveal the morphology and petrological context of Precambrian microfossils, pseudofossils and biosedimentary structures, all of which are important in the origin and early evolution of life of Earth. The materials tested came from the Pilbara Craton of Western Australia (the 3.49 Ga Dresser Formation, the 3.46 Ga Apex chert and the 3.43 Ga Strelley Pool Formation) and the 1.88 Ga Gunflint Formation of Ontario, Canada. These units chart key developments in palaeobiology. The oldest formations contain profoundly controversial microfossil-like objects and microbially-induced sedimentary structures, whereas definitive prokaryotes are found in the youngest formations. We demonstrate that the imaging of individual microfossils and pseudofossils currently lies at the limits of the capabilities of laboratory-based X-ray microtomography and requires beneficial taphonomy. However, microtomography does provide a good overview of their petrological context at flexible spatial scales, although the quality of the data obtained from mesoscopic microbially-induced sedimentary structures and stromatolites depends largely on their style of preservation. Supplementary material: A zipped Drishti volume for all CT scans, a 0.7z split zip file of one Drishti volume and a HDMI supplementary movie showing digital visualizations for all of the scans are available at https://doi.org/10.5281/zenodo.58161


Aim: The purpose of this study was to develop biodegradable microspheres controlling drug delivery for treatment of prostate and breast cancer. The effects of formulation parameters on the characteristics of microspheres were studied. Material and Methods: Emulsification/extraction method was used to prepare goserelin acetate controlled-release poly(D, L-lactide-co-glycolide) (PLGA)-based biodegradable microspheres. Microspheres were formulated and characterized in terms of encapsulation efficiency, particle size distribution, surface morphology, and drug release profile. Results and Discussion: Preparative variables such as concentrations of stabilizer, drug–polymer ratio, stirring rate, and the ratio of internal to external phases were found to be important factors for the preparation of goserelin acetate-loaded PLGA microspheres. These changes were also reflected in drug release profile. Conclusion: The in vitro goserelin acetate release study from PLGA microspheres proved that the present microspheres had the properties of an ideal controlled release formulation for anticancer therapy.


Infectious aneurysm is a rare event, especially after the introduction of antibiotic therapy. However, its early detection is very important for timely treatment with antibiotics and surgical intervention. This pathology may generally be due to mycotic endocarditis or septic embolization, prevailing in the preantibiotic era, and to aortitis, whose incidence is actually increasing, mainly in subjects with preexisting large-vessel atherosclerosis and intimal defects. This clinical entity is usually defined as microbial arteritis and recognizes Salmonella spp as the microorganism most frequently isolated from blood or vascular tissue cultures. The authors present the case of a 56-year-old man with a history of hypertension that some weeks before admission manifested as hyperpyrexia and episodic lumbar pain, associated with hepatosplenomegaly and with a pulsing mass in the periumbilical region. Abdominal computed tomography (CT) scan documented a voluminous infrarenal aortic aneurysm with a markedly reduced and irregular vessel wall. The patient underwent surgical excision of the aneurysm, during which marked periaortic inflammation phenomena, complete absence of the posterior aortic wall for a length of 5-6 cm, and the exposure of the correspondent vertebral bodies were observed. Histopathologic examination of the aneurysmal tissue showed atheromatous and thrombotic aspects and confirmed strong signs of inflammation. This case may suggest that the occurrence of microbial aortitis, especially from Salmonella spp, should be taken into account in the presence of a septic status associated with back, abdominal, or thoracic pain.


SUMMARY: Mutational studies on the PAS (sodium p-aminosalicylate) resistance of Mycobacterium tuberculosis var. hominis, strain H37RV have been carried out. It has been assumed that one type of population structure of clones with relation to drug resistance corresponds to one genotype. Clones derived from single colonies obtained on different PAS concentrations produced three types of population structure; the first type is similar to the population structure of the parent strain which has not been previously exposed to the drug and its degree of resistance is up to 0·2 μg. PAS/ml. The second and the third types are different from the parent strain and their degrees of resistance are up to 3 and 1000 μg. PAS/ml., respectively. Neither intermediate population structures nor intermediate degrees of resistance were clearly observed. From these results, it may be concluded that there are only two genotypes responsible for PAS resistance, one determining a lower, and the other a higher degree of resistance.


We use natural language processing (NLP) to retrieve location data for cheilostome bryozoan species (text-mined occurrences [TMO]) in an automated procedure. We compare these results with data from the Ocean Biogeographic Information System (OBIS). Using OBIS and TMO data separately and in combination, we present latitudinal species richness curves using standard estimators (Chao2 and the Jackknife) and range-through approaches. Our combined OBIS and TMO species richness curves quantitatively document a bimodal global latitudinal diversity gradient for cheilostomes for the first time, with peaks in the temperate zones. 79% of the georeferenced species we retrieved from TMO (N = 1780) and OBIS (N = 2453) are non-overlapping and underestimate known species richness, even in combination. Despite clear indications that global location data compiled for cheilostomes should be improved with concerted effort, our study supports the view that latitudinal species richness patterns deviate from the canonical LDG. Moreover, combining online biodiversity databases with automated information retrieval from the published literature is a promising avenue for expanding taxon-location datasets.


Changes in the amplitude and phase of the diurnal cycle of rainfall due to changes in the background circulation and thermodynamics associated with the intraseasonal variability of Indian summer monsoon have important implications for weather prediction over the region. Hourly rainfall data available at 91 Indian stations for 30 years of observations are examined to determine the role of intraseasonal variations of Indian summer monsoon in modulating the diurnal cycle of rainfall over four homogenous regions. Harmonic analysis of the diurnal cycle of rainfall shows predominance of principal harmonic during the break phase of monsoon. During an active phase first two harmonics contribute substantially to the total variance in central parts of the country. It is observed that peak rainfall occurs in the morning hours during both the active and break phases along the West Coast with small diurnal variation in rainfall. Two peaks in the diurnal cycle are observed during active phases over central India. This region shows delay in the occurrence of afternoon peak and rise in rainfall intensity during the break phase of recent years, while, increase in rainfall intensity at all hours during break phases is observed along the West Coast of India in recent years. Further analysis of meteorological parameters indicates that lower‐level convergence during late afternoon hours, reduction in geopotential height and increase in specific humidity (850 hPa) in central parts of India during morning and evening hours are in phase with the two maxima observed in the diurnal cycle of rainfall in this region. Therefore, spatial variations in daily rainfall pattern during active/break phases can be attributed to orographic effect and heterogeneous convective development in different parts of the country. © 2013 Royal Meteorological Society


This paper argues for an understanding of the problem of gender-based violence, specifically, the problem of rape that is not only based on sociological and psychological factors but also based on morality. This is premised on the fact that research on the problem of rape in South Africa points to different causes other than morality. I contend that besides social and psychological factors; rape should also be analyzed as a problem of moral failings. Hence, I explain the importance of reawakening an individual moral consciousness through self-conversation. I tap into conversational thinking to show that another veritable way of addressing the problem of rape as a strand of gender-based violence would be a mechanism of 'self-conversation' which involves a strategy of helping the rapist rethink, and unlearn the consciousness that encourages rape in South Africa.Keywords: Rape, Gender-based Violence, South Africa, Conversational Thinking, Self-conversation


Much has been learned in recent years about the innate immune pathways that exist in invertebrates, in particular in the fruit fly, and these results have helped to unravel the emerging innate immune pathways in mammals. Aside from innate immunity, mammals possess an adaptive immune system that has evolved a high degree of polymorphism in some proteins and the ability to generate receptor diversity as a means of dealing with pathogens. Lazzaro et al. observe that specific genes encoding proteins of the innate immune system in wild populations of Drosophila melanogaster are also polymorphic. In turn, this finding correlates with the heterogeneous ability of flies to cope with certain types of bacterial infection. B. P. Lazzaro, B. K. Sceurman, A. G. Clark, Genetic basis of natural variation in D. melanogaster antibacterial immunity. Science 303, 1873-1876 (2004). [Abstract] [Full Text]


Determination of recommendations for potassium (K) based on soil tests for tomato in Andisol is rarely studied in Indonesia. This experiment was started by making of K soil status in IPB Research Station Pasirsarongge Ciputri Cianjur and followed by correlation test in PKHT IPB greenhouse Tajur Bogor West Java, from Desember 2015 to May 2016. The objective of the experiment was to select the best extraction method of K for tomato on Andisol soil. The experiment used single location approach with randomized block design. The treatmens is soil K status by application of K2SO4 solution with five rate of K : 0, ¼,X, ½X, ¾X, and X. X was K rate of 413.4 kg K ha-1were applied to achieve maximum K concentration in the soil and incubated for 4 months to obtain different K nutrient status. Analysis of soil K using five extraction methods: Bray 1, HCl 25%, Morgan Wolf, Mechlich and NH4OAc. The results showed the differences in response of plant height and biomass dry weight to nutrient status of Andisols K. Quadratic response was shown in plant height at 6 and 7 weeks after planting and biomass dry weight. The best K extraction method was NH4OAc with correlation coefficient (r) of 0.75.
Key words: biomass, extraction method, K status, K2SO4, NH4Oac


Contemporary Roman Catholic considerations of church reform are often impeded by the worry that any acknowledgment of systematic or properly ecclesial failure calls Jesus's promise of the church's indefectibility into question. This makes honesty about such failure, and therefore true reform, impossible. At best, in this way of thinking, blame can be shifted onto a few "bad apples." Karl Rahner's engagement with a quite different problem—how Roman Catholics can account for the fruits of the Spirit in Protestant Ministries—can provide tools for a renewed ecclesiology capable of honestly reckoning with sin in and by the church.


Albinism, which is commonly inherited as an autosomal recessive trait, is characterized by a reduction or absence of melanin in the eyes, skin, and hair. To date, more than 20 causal genes for albinism have been identified; thus, the accurate diagnosis of albinism requires next‐generation sequencing (NGS). In this study, we analyzed 46 patients who tested negative for oculocutaneous albinism (OCA)1–4 and Hermansky‐Pudlak syndrome (HPS)1 based on conventional analysis, in addition to 28 new Japanese patients, using NGS‐based targeted resequencing. We identified a genetic background for albinism in 18 of the 46 patients (39%), who were previously tested negative according to the conventional analysis. In addition, we unveiled a genetic predisposition toward albinism in 23 of the 28 new patients (82%). We identified six patients with rare subtypes of albinism, including HPS3, HPS4, and HPS6, and found 12 novel pathological mutations in albinism‐related genes. Furthermore, most patients who were not diagnosed with albinism by the NGS analysis showed mild manifestations of albinism without apparent eye symptoms and harbored only one heterozygous mutation, occasionally in combination with skin‐color associated gene variants.


Inclusive entrepreneurship policies aim to offer all people an equal opportunity to create a sustainable business, whatever their social group. Among the key targets of inclusive entrepreneurship policies and programmes are women, youth, older people, the unemployed, migrants and people with disabilities, who all continue to face challenges in the labour market and are under-represented or disadvantaged in entrepreneurship activities. This report is the third country assessment note prepared by the OECD in collaboration with the Directorate-General for Employment, Social Affairs and Inclusion of the European Commission on the state of inclusive entrepreneurship policies and programmes in each European Union Member State. This report provides an overview and assessment of UK policies and programmes that support people from under-represented and disadvantaged groups in business creation and self-employment and suggests policy actions to address gaps in the support system and to improve the quality of available support offers. The notes cover national-level policies and programmes and, where relevant, sub-national initiatives and actions by the non-governmental sector. The 2018 notes include an additional section on female entrepreneurship support, which provides an overview of the entrepreneurship activity levels, obstacles faced and policy responses. The notes are part of a wider programme of work by the OECD and the European Commission that includes 'The Missing Entrepreneurs' publications, the Better Entrepreneurship Policy Tool, a series of Policy Briefs on specific target groups, policies and issues, and country reviews of youth entrepreneurship and women entrepreneurship.


Background

Exercise have shown being effective for managing chronic pain and preventing frailty status in older adults but the effect of an exercise program in the quality of life of pre-frail older adults with chronic pain remains unclear. Our objective was to evaluate the effectiveness of multicomponent structured physical exercise program for pre-frail adults aged 65 years or more with chronic pain to improve their perceived health related quality of life, compared with usual care.
Methods

Open label randomized controlled trial. Participants were community-dwelling pre-frail older adults aged 65 years or older with chronic pain and non-dependent for basic activities of daily living attending a Primary Healthcare Centre. Forty-four participants were randomly allocated to a control group (n = 20) that received usual care or an intervention group (n = 24) that received an 8-week physical activity and education program. Frailty status (SHARE Frailty Index), quality of life (EuroQol-5D-5L), pain intensity (Visual Analogue Scale), physical performance (Short Physical Performance Battery) and depression (Yessavage) were assessed at baseline, after the intervention and after 3 months follow-up. The effect of the intervention was analysed by mean differences between the intervention and control groups.
Results

The follow-up period (3 months) was completed by 32 patients (73%), 17 in the control group and 15 in the intervention group. Most participants were women (78.1%) with a mean age (standard deviation) of 77.2 (5.9) years and a mean pain intensity of 48.1 (24.4) mm. No relevant differences were found between groups at baseline. After the intervention, mean differences in the EuroQol Index Value between control and intervention groups were significant (-0.19 95%CI(-0.33- -0.04)) and remained after three months follow-up (-0.21 95%CI(-0.37- -0.05)). Participants in the exercise group showed better results in pain intensity and frailty after the intervention, and an improvement in physical performance after the intervention and after three months.
Conclusions

An eight-week physical activity and education program for pre-frail older adults with chronic pain, compared with usual care, could be effective to improve quality of life after the intervention and after three-months follow-up.
Study registration details:

This study was retrospectively registered in ClinicalTrials.gov with the identifier NCT04045535.


We present Sunyaev-Zeldovich effect (SZE) imaging observations of three distant (z > 0.8) and highly X-ray luminous clusters of galaxies, Cl J1226.9+3332, Cl J0152.7-1357, and MS 1054.4-0321. Two of the clusters, Cl J1226.9+3332 and Cl J0152.7-1357, were recently discovered in deep ROSAT X-ray images. Their high X-ray luminosity suggests that they are massive systems, which, if confirmed, would provide strong constraints on the cosmological parameters of structure formation models. Our SZE data provide confirmation that they are massive clusters similar to the well-studied cluster MS 1054.4-0321. Assuming the clusters have the same gas mass fraction as that derived from SZE measurements of 18 known massive clusters, we are able to infer their mass and electron temperature from the SZE data. The derived electron temperatures are 9.8, 8.7, and 10.4 keV, respectively, and we infer total masses of ~2 × 1014 h M☉ within a radius of 65'' (340 h kpc) for all three clusters. For Cl J0152.7-1357 and MS 1054.4-0321, we find good agreement between our SZE-derived temperatures and those inferred from X-ray spectroscopy. No X-ray-derived temperatures are available for Cl J1226.9+3332, and thus the SZE data provide the first confirmation that it is indeed a massive system. The demonstrated ability to determine cluster temperatures and masses from SZE observations without access to X-ray data illustrates the power of using deep SZE surveys to probe the distant universe.


The continuing rise of population and globalisation have a large impact on the transport system. Railway transport, particularly High-Speed Railways (HSR) offers many advantages compared with other modes of transportation. HSR can reduce the amount of pollution from transport and ease congestion on roads and at airports. High speed railways may mean more noise and vibration which reduce the quality of life, disturb sleep and negatively affect health in addition to other impacts on the wild life and nature in general. Therefore, it is very important for the development of HSR systems to consider effective measures to reduce the level of noise and vibration among its most important goals.
This paper reports on a research that takes the form of an investigation and critical evaluation of the key existing factors that contribute to noise emissions from HSR and discusses possible ways to reduce them. A comparison of different influential factors and mitigation measures concerning a selected HSR systems will be reported. From the evidence that has been gathered from different sources and related critical evaluations, conclusions can be made to show that in some cases the increases in speed would not only be a threat to the environmental sustainability but also affect the economical sustainability of HSR systems. Most of the findings are based on research by the authors and data gathered from relevant sources including in depth research concerning HSR systems in selected countries, available railway statistics and relevant European and Institutional Publications.
The expected outcomes of this research will contribute to the development and advances of more sustainable HSR systems that can meet the growing demand for travel due to the continuing growth in world population and globalization.


The sense of cold develops due to the increase in heat loss from a human body. Excessive cold can be a health hazard, since excessive heat loss from the body may result in hypothermia/frostbite. Decreased body temperature due to heat loss also affects the physical, manual and perceptive performance of individuals. Therefore, protective measures are taken through clothing that controls and regulates heat loss. Clothing is a protective means for thermal insulation. Clothing and garments used in cold climates should have sufficient insulation to maintain the thermal balance of the body. The required clothing insulation (IREQ) is calculated on the basis of the hypothesis concerning the heat flow by conduction, convection, radiation and evaporation. This term is well defined in standards such as BS-EN 342 and ISO 11079:2007 (E). This paper presents an experimental study of the use of state-of-the-art Infrared (IR) thermography to estimate IREQ values. However, real IREQ values are difficult to estimate, considering that parameters, such as individual metabolism, are unknown and subject to change. Therefore, relative IREQ (IREQ*) values are computed and compared. Experiments were also conducted to measure the relative IREQ of winter jackets, summer jackets, and sweaters. The infrared images were obtained using a FLIR® T1030sc camera and analyzed using FLIR® Researcher Max software. The experiments were performed under conditions of -20°C to -35°C in the cold room at UiT- The Arctic University of Norway.


The Mott polarimeter has been used to detect the spin-polarization of electron beams. A disadvantage of the Mott polarimeter is a low sensitivity. In order to determine the optimum geometical conditions for the Mott Polarimeter, which give the highest signal contrast and maximize the electron detection efficiency, electron scattering phenomena in the target are quantitatively discussed. Three-dimensional electron trajectories in the target are calculated by Monte Carlo simulation of electron scattering based on the single scattering model. The Mott scattering cross section for spin polarized electrons is used in the simulation. The angular deflection and the spin polarization transfer of electrons for single scattering events are calculated sequentially. In the present study, the simulation is applied to the determination of the optimum incident angle of the spin polarized electron beams.


[1] Global air-sea flux of carbon dioxide (CO2) is calculated from wind data acquired by the satellite scatterometer QuikSCAT, the passive microwave radiometer AMSR-E, and the model reanalysis ERA-40 using four of the most commonly used wind speed dependent parameterizations of gas transfer velocity. Assuming QuikSCAT as reference, the results are compared to obtain an estimate of that relative uncertainty in the flux calculations which results solely from the origin of the input wind data. We illustrate the discrepancies between these data sets and quantify the uncertainty in the computed air-sea CO2 flux that arises from data processing such as temporal and spatial averaging using AMSR-E as an example data set. The impact of temporal variability of wind speed is shown to be significantly greater than that of spatial variability. However, simple parameterizations of temporal variability are found to be sensor-specific and cannot be applied in a straightforward way to data sets with lower temporal resolutions from other sensors. We show a simple methodology to correct monthly mean data in such a way that seasonally and zonally varying parameterizations of temporal variability derived from QuikSCAT data can be applied to data from AMSR-E and ERA-40. This allows us to produce a global 44-year time series of gas transfer velocity and to present a more coherent estimate of air-sea transfer of carbon dioxide from the three most commonly available types of wind data.


The principle of prohibition of reformatio in peius is established in Article 134 § 2 of the Law on Proceedings Before Administrative Courts. According to this provision the administrative court is not allowed to issue a decision to the detriment of the complainant. A judgment adverse to the complainant can be exceptionally issued but only if the court fi nds a violation of the law resulting in the annulment of the challenged act or action. This principle is a procedural institution which ensures that the complainant's situation will not deteriorate due to the decision of the administrative court. There are many interpretative doubts concerning the prohibition of reformatio in peius in the doctrine and the jurisdiction of the administrative courts. This is because administrative courts very rarely issue a decision on the merits. Decisions of administrative courts are basically of cassation nature. When the administrative court allows a complaint, the contested act is generally eliminated from the system of law and the case is returned for re-examination by the public administrative authority. It is therefore very diffi cult to determine the content of the prohibition of reformatio in peius in administrative court proceedings and in practice the prohibition of a change for the worse is not a real guarantee of the protection of the interests of the complainant. In the author's opinion, the way of approaching the mechanism of application of the prohibition of reformatio in peius by the administrative courts needs to be changed. And yet, a signifi cant improvement in the eff ectiveness of the protection against the worsening of the complainant's legal situation will only be possible through the introduction of a new legal regulation restricting the jurisdiction of public administrative authority, which will reconsider the case after the cassation judgment issued by the administrative court.


Purpose

The purpose of this paper is to examine the voluntary disclosure of risk-related issues, with a focus on credit risk, in graphical reporting for listed banks in the major European economies. It aims to understand if banks portray credit risk-related information in graphs accurately and whether these graphs provide incremental, rather than replicative, information. It also investigates whether credit risk-related graphs provide a fair representation of risk performance or a more favourable impression than is warranted.

Design/methodology/approach

A graphical accuracy index was constructed. Incremental information was measured. A multi-level linear model investigated whether credit risk affects the quantity and quality of graphical credit risk disclosure.

Findings

Banks used credit risk graphs to provide incremental information. They were also selective, with riskier banks less likely to use risk graphs. Banks were accurate in their graphical reporting, particularly those with high levels of credit risk. These findings can be explained within an impression management perspective taking human cognitive biases into account. Preparers of risk graphs seem to prefer selective omission over obfuscation via inaccuracy. This probably reflects the fact that individuals, and by implication annual report's users, generally judge the provision of inaccurate information more harshly than the omission of unfavourable information.

Research limitations/implications

This study provides theoretical insights by pointing out the limitations of a purely economics-based agency theory approach to impression management.

Practical implications

The study suggests annual reports' readers need to be careful about subtle forms of impression management, such as those exploiting their cognitive bias. Regulatory and professional bodies should develop guidelines to ensure neutral and comparable graphical disclosure.

Originality/value

This study provides a substantive alternative to the predominant economic perspective on impression management in corporate reporting, by incorporating a psychological perspective taking human cognitive biases into account.


The start of collisions at the LHC brings a new era of particle physics and much improved potential to observe signatures of new physics. Some of these may be evident already from the very beginning of collisions. It's essential at this point in the experiment to be prepared to quickly and efficiently determine the quality of the incoming data. Easy visualization of data for the shift crew and experts is one of the key factors in the data quality assessment process. This paper describes the design and implementation of the Data Quality Monitoring Display and discusses experience from its usage and performance during ATLAS commissioning with cosmic ray and single beam data.


Individual peculiarities of the receptor apparatus of cardiomyocytes may determine pathological features of heart activity and susceptibility to pharmaceuticals. The possible role of beta-adrenoreceptor polymorphism in the development of cardiac rhythm disturbances is assessed by PCR. Special attention is given to A145G polymorphism of the ADRB1 gene in 127 patients with primary cardiac rhythm disorders. It was shown that AJ45G polymorphism (Ser49Gly) at DNA sites encoding for the amino acid sequence of beta-1 adrenoreceptors can influence the development of sex-specific cardiac rhythm disorders.


To elucidate the role cAMP-dependent protein kinase (PKA) phosphorylations on tau play in Alzheimer's disease, we have generated highly specific monoclonal antibodies, CP-3 and PG-5, which recognize the PKA-dependent phosphorylations of ser214 and ser409 in tau respectively. The present study demonstrates by immunohistochemical analysis, CP-3 and PG-5 immunoreactivity with neurofibrillary pathology in both early and advanced Alzheimer's disease, but not in normal brain tissue and demonstrates that cAMP-dependent protein kinase phosphorylations on tau precede or are coincident with the initial appearance of filamentous aggregates of tau. Studies using heat-stable preparations demonstrate that neither site appears to be phosphorylated to any appreciable extent in normal rodent or human brain. Further analysis demonstrates that the β catalytic subunit of PKA (Cβ), the β II regulatory subunit of PKA (RIIβ), and the 79 kDa A-kinase-anchoring-protein (AKAP79), are tightly associated with the neurofibrillary pathology, positioning cAMP-dependent protein kinase to participate directly in the pathological hyperphosphorylation of tau seen in Alzheimer's disease.


BACKGROUND
Patients with insulin-dependent diabetes mellitus (IDDM) are often affected by chronic infections; antibiotic absorption, however, may be influenced by the disease. H. pylori eradication appears to be reduced in IDDM patients. The aim of the study was to evaluate the efficacy of the most common H. pylori eradication regimens in a population of IDDM-infected patients.

METHODS
One hundred and seventy-two IDDM patients were evaluated. H. pylori infection was assessed through the 13C-urea breath test. Infected patients were randomly assigned to three different standard 7-day eradication regimens: 1) amoxicillin, clarithromycin, pantoprazole; 2) tinidazole, clarithromycin, ranitidine bismuth citrate; or 3) tinidazole, clarithromycin, pantoprazole. Patients in whom eradication was not successful in the first cycle were subsequently submitted to a 7-day therapy with tinidazole, tetracycline, bismuth, and pantoprazole.

RESULTS
Thirty-seven per cent of IDDM patients were infected. None of the triple therapies used provided an eradication higher than 62%. Conversely, the quadruple regimen was successful in 88% of the patients. Ten per cent of the subjects undergoing the triple therapies showed minor side effects, without significant differences among groups, whereas side effects occurred in 25% of the patients treated with the quadruple therapy (P < 0.05).

CONCLUSIONS
IDDM patients show a low H. pylori eradication rate with a standard triple therapy regardless of the regimen utilized, the dosage and/or the duration of the therapy used appearing not to be sufficient to eradicate the infection efficiently. The use of a quadruple regimen leads to the cure of a large percentage of the infected patients in whom the eradication was unsuccessful in the first therapy, although it is accompanied by a greater incidence of minor side effects.


Dairy farming in West Java is still dominated by small scale. The research focussed on production factors of dairy fanning which are influencing the farmers income from selling milk . The research was carried out in 1993 via survey to 30 respondents in Garut and Bogor. The results showed that the profit earned per month from dairy farming was Rp 130,331 and Rp 118,449 in Garut and Bogor, respectively . Return to labor from dairy farming was Rp. 4.56 in Bogor and Rp. 4.38 in Garut. The production factors positively affecting the income of the farmers from selling milk were cost for barn, concentrate feed, animal health care and artificial insemination, labor, and number of lactating cows . In addition, several production factors such as cost for forages, retribution cost, and number of male calf were proven negatively affecting the income of the Canners from selling milk . Therefore, thrive related production factors should be considered in developing small scale dairy farming, not only from availability of inputs but also from institutional aspect .


Amylase and lysozyme are components of the salivary pellicle, exposing considerable enzymatic activity in the immobilized state. The purpose of the present study was to elucidate the influence of different solid substrata on the amount and distribution of amylase and lysozyme exposed on the surface of the salivary pellicle formed in situ. Slabs of titanium, feldspar ceramic, and bovine enamel were fixed on the buccal sites of individual splints worn by three subjects for 3 or 30 min, respectively, to allow pellicle formation. Subsequently, slabs were removed from the splints and rinsed with running water. Detection of amylase and lysozyme was performed by FEI-SEM after gold-immunolabeling of the enzymes. Both enzymes were found to be distributed randomly at the pellicle surface. Irrespective of formation time and substratum, significantly more labeled lysozyme molecules (5.23 +/- 4.5 microm(-2)) were detected compared with amylase (3.4 +/- 2.9 microm(-2)). Neither the substratum nor the pellicle formation time had significant impact on the amount of the respective enzyme that could be detected. This study for the first time provides evidence, that amylase and lysozyme are exposed at the surface of the salivary pellicle formed in situ on titanium and ceramics. Both enzymes are distributed randomly on the surface of the pellicle, irrespective of the underlying substratum.


The need to continuously design better aircraft is challenging on multiple fronts: the existing tube-and-wing aircraft are difficult to improve further, while more creative configurations prove more cumbersome to design due to the lack of empirical knowledge and the (usually) more highly integrated components. Multidisciplinary Design Analysis and Optimization (MDAO) can offer major benefits to tackle these issues. However, MDAO is not yet widely applied in the industrial context due to two major hurdles: configuration hurdle the set-up of the first executable MDAO workflow takes too long —namely 60-80%of the available project time—in collaborative projects in which a large team of heterogeneous experts needs to operate a large, complex MDAO system; reconfiguration hurdle once the executable system has been established, it lacks agility and cannot be reconfigured easily to address 'what if scenarios' or answer new questions arising from the insights obtained from previously configured systems. Typical reconfigurations include the removal, addition, or modification of disciplinary tools, adjustment of the MDAO problem to be solved (e.g. new design variables, different objective, additional constraints), or the alternation of the underlying strategy (i.e. design convergence, design of experiments, optimization) that needs to be implemented as an executable workflow.


This paper is proposed to eliminate the negative influence of the Rotational Phase Component (RPC) on the performance of the Doppler Centroid Tracking (DCT) phase compensation method. Firstly, the coherent property between adjacent echo pulses sampled directly in Intermediate Frequency (IF) is analyzed in the paper. Then a coherent phase compensation method is developed to improve the Translational Phase Component (TPC) estimation accuracy of DCT. Compared to the Modified DCT (MDCT) algorithm, the proposed method achieves better phase compensation performance. Experimental results prove the effectiveness and efficiency of the proposed strategy.


Differential signaling has become a popular choice for high-speed digital interconnection schemes on printed circuit boards (PCBs), offering superior immunity to crosstalk and external noise. However, conventional differential lines on PCBs still have unsolved problems, such as crosstalk and radiated emission. When more than two differential pairs run in parallel, a line is coupled to the line adjacent to it because all the lines are parallel in a fixed order. Accordingly, the two lines that constitute a differential pair are subject to the differential-mode crosstalk that cannot be canceled out by virtue of the differential signaling. To overcome this, we propose a twisted differential line (TDL) structure on a high-speed multilayer PCB by using a concept similar to a twisted pair in a cable interconnection. It has been successfully demonstrated by measurement and simulation that the TDL is subject to much lower crosstalk and achieves a 13-dB suppression of radiated emission, even when supporting a 3-Gb/s data rate.


Ectomycorrhizal (ECM) fungi are important root symbionts of trees, as they can have significant effects on the nutrient status of plants. In polluted environments, particular ECM fungi can protect their host tree from Zn toxicity by restricting the transfer of Zn while securing supply of essential nutrients. However, mechanisms and regulation of cellular Zn homeostasis in ECM fungi are largely unknown, and it remains unclear how ECM fungi affect the Zn status of their host plants. This study focuses on the characterization of a ZIP (Zrt/IrtT-like protein) transporter, SlZRT2, in the ECM fungus Suillus luteus, a common root symbiont of young pine trees. SlZRT2 is predicted to encode a plasma membrane-located Zn importer. Heterologous expression of SlZRT2 in yeast mutants with impaired Zn uptake resulted in a minor impact on cellular Zn accumulation and growth. The SlZRT2 gene product showed a dual localization and was detected at the plasma membrane and perinuclear region. S. luteus ZIP-family Zn uptake transporters did not show the potential to induce trehalase activity in yeast and to function as Zn sensors. In response to excess environmental Zn, gene expression analysis demonstrated a rapid but minor and transient decrease in SlZRT2 transcript level. In ECM root tips, the gene is upregulated. Whether this regulation is due to limited Zn availability at the fungal–plant interface or to developmental processes is unclear. Altogether, our results suggest a function for SlZRT2 in cellular Zn redistribution from the ER next to a putative role in Zn uptake in S. luteus.


Density and refractive index have been determined for binary liquid mixture of oleic acid with alcohols like methanol, ethanol, n-propanol, n-butanol and iso-butanol at 303.15K, 308.15K and 313.15K. For comparative nine relations Lorentz -Lorenz (L-L),Weiner (W), Heller (H), Gladstone- Dale (G-D),Arago-Biot (A-B), Eykman (Eyk),Newton (Nw), Eyring-John (EJ), Oster (Os) has been used for determining the refractive index of different liquidmixtures. Fromthe experimentallymeasured values, refractive index deviation at different temperatures have been computed and fitted to the Redlich- Kister polynominal equation to derive the binary coefficient and standard deviation. Comparison of various mixing rules has been expressed in term of average percentage deviation. All nine theoreticalmixing rules performedwellwithin the experimental error.Weiner equation has proved to be better then other relation. nE values are positive overwhale concentration range in case of all binarymixture indicative for weak interaction between unlike molecule leading to increase inmolar polarization.


Social and economic conditions, as well as the dynamism of the Chilean labour market, place new demands on middle-aged workers who have to explore both internal and external opportunities to develop successful careers. We assumed that possible self and identity in future states are core organizing aspects in this process. Identities, being core components of the self-concept, comprise self-representations that are contextually based and rooted in a social structure. Given the fact that there is a serious lack of empirical research in this domain, this study was aimed to help close an important gap in the literature. More specifically, it was intended to better understand the role played by possible selves and identity – that is, knowledge about what the self might eventually achieve or become – in career development. Based on an in-depth qualitative study among 25 male middle-aged Chilean managers, we found that the possible selves reported: (1) are evolving processes that vary in terms of content, stability and elaboration; (2) are related to career variety; (3) help in both career transitions and the adjustment process in novel situations; and (4) act as an incentive in career development. It is important to stress that in cases of challenging work contexts, employees are urged to create and recreate new selves and identities at work in order to increase their adaptability to ever-increasing working life demands and enhance their employability.


Several market gardeners have settled in the city and supply urban markets with fresh vegetables throughout the year. Despite their nutritional importance, market gardening products may carry health risks. The objective of this study is to identify and analyse the potential risk factors that could lead to the appearance of microbiological and physicochemical hazards in the production chain of fresh vegetables from these market gardening operations. The work was carried out in 5 permanent market gardening sites in the city of N'Djamena (Chad, Africa) and involved 96 market gardeners surveyed. Data related to production methods were collected. Standard methods were used to carry out microbiological analysis tests on 15 samples of vegetables and fruits taken from 3 sites.The results of the survey show that urban market gardening in N'Djamena is dominated by two plant species: lettuce (Lactuca sativa) and rocket (Eruca sativa). It is geared towards the production of leafy vegetables. The health risks associated with the conditions of production are numerous and real: the proximity of roads, the use of dirty water for irrigation, the overdose of chemical fertilizers (urea) and pesticides, and finally the unhygienic harvesting and transport. The high-water content of fresh vegetables and the lack of processes for the elimination of pathogenic microorganisms also do not guarantee the sanitary quality of the vegetables produced and can thus increase the risk of foodborne infections. The results of the microbiological evaluation showed the presence of germs pathogens including Escherichia coli, Staphylococcus aureus, Aeromonas spp. and Salmonella sp. in vegetable and fruit. Therefore, the best strategy to obtain a healthy product is to educate producers on good agricultural practices including reasoned fertilization, clean water, treated wastewater, approved pesticides.


Previous studies have proved that the piezoelectric L-shaped beam-mass structure is a good candidate to harvest energy from ambient mechanical vibration. However, most researches merely focused on bending mode of the structure, which only can capture energy from in-plane base excitation. To fully exert the advantages of L-shaped harvesters, this paper will explore their energy harvesting performance on torsional mode with out-of-plane base excitation. The electromechanical coupling governing equation of the L-shaped harvester in torsional mode is derived by applying Gauss's law and the Euler–Bernoulli beam theory with linear assumption, and the analytical results are also validated with experimental results. In addition, the influences of key geometric parameters on the resonance frequency and output voltage of the harvester are also presented. This work demonstrates the feasibility of utilizing torsional mode of the L-shaped unimorph structure to harvest energy from out-of-plane mechanical vibration, which shows the potential of designing multi-directional and multi-frequency L-shaped harvesters.


he sequence of strings played on a bowed string instrument is essential to understanding of the fingering. Thus, its estimation is required for machine understanding of violin playing. Audio-based identification is the only viable way to realize this goal for existing music recordings. A naive implementation using audio classification alone, however, is inaccurate and is not robust against variations in string or instruments. We develop a bowed string sequence estimation method by combining audio-based bowed string classification and context-dependent error correction. The robustness against different setups of instruments improves by normalizing the F0-dependent features using the average feature of a recording. The performance of error correction is evaluated using an electric violin with two different brands of strings and an acoustic violin. By incorporating mean normalization, the recognition error of recognition accuracy due to changing the string alleviates by 8 points, and that due to change of instrument by 12 points. Error correction decreases the error due to change of string by 8 points and that due to different instrument by 9 points.


This paper presents the use of the finite element technique for determining the parameters of a three-phase squirrel-cage induction motor. The common parameters, in addition to the core losses and ratio of number of tums, are obtained from the finite element field solutions. The magnetizing characteristic and core losses curve are used to determine the flux distribution within the motor structure. The linear time harmonic vector potential field solution is utilized for the inductances computation. The accuracy of the finite element application is verified using the available precise results.


Background: Diabetic nephropathy (DN) is one of the most
important microvascular complications associated with type 2 diabetic
patients. It is known that tubulointerstitial damage plays an important
role in diabetic nephropathy .Therefore; it would potentially be beneficial
if albuminuria, as a marker of glomerular damage, could be
supplemented by a marker of tubular damage to provide a more
complete status of the kidney injury. Liver-type fatty acid-binding protein
(LFABP) is an intracellular carrier protein that is expressed in the
proximal tubules in the human kidney and participates in fatty acid
metabolism.
The present study aimed to evaluate the relation between the u-LFABP
and some biochemical parameters to find their association with the
occurrence of diabetic nephropathy. The study included 60 patients were
divided into 3 groups diagnosed with type 2 diabetes (n=20/group) :
group I: normoal-buminuria (ACR <30) ,group II: microalbuminuria (
ACR 300) and control
subjects comprised 20 non-diabetic healthy, age-matched subjects as the
control group. All of the patients underwent a standardized laboratory
evaluation including fasting and postprandial serum levels of glucose,
glycated hemoglobin (HbA1c), kidney function, lipid profile, nonesterified fatty acids(NEFA)and serum and urinary levels of Liver-type
Fatty Acid Binding Protein (L-FABP).
Our results revealed that UL-FABP levels were significantly higher in
group I versus the control group and significantly increased according to
the severity of diabetic nephropathy. Urinary L-FABP levels showed
positive significant correlation with triglycerides and HDL-C, N-EFA and
ACR and a negative significant correlation with age, duration of diabetes,
HbA1c, serum creatinine, LDL-C., serum total cholesterol and systolic and
diastolic blood. Urinary L-FABP provides a suitable biomarker for the
early detection and monitoring of progression of diabetic nephropathy in
clinical practice.


We propose a method to learn a distribution of shape trajectories from longitudinal data, i.e. the collection of individual objects repeatedly observed at multiple time-points. The method allows to compute an average spatiotemporal trajectory of shape changes at the group level, and the individual variations of this trajectory both in terms of geometry and time dynamics. First, we formulate a non-linear mixed-effects statistical model as the combination of a generic statistical model for manifold-valued longitudinal data, a deformation model defining shape trajectories via the action of a finite-dimensional set of diffeomorphisms with a manifold structure, and an efficient numerical scheme to compute parallel transport on this manifold. Second, we introduce a MCMC-SAEM algorithm with a specific approach to shape sampling, an adaptive scheme for proposal variances, and a log-likelihood tempering strategy to estimate our model. Third, we validate our algorithm on 2D simulated data, and then estimate a scenario of alteration of the shape of the hippocampus 3D brain structure during the course of Alzheimer's disease. The method shows for instance that hippocampal atrophy progresses more quickly in female subjects, and occurs earlier in APOE4 mutation carriers. We finally illustrate the potential of our method for classifying pathological trajectories versus normal ageing.


Small rural hospitals, categorized as critical access hospitals (CAHs), are essential to the provision of health care in rural areas of the United States. Critical access hospitals, however, are faced with numerous challenges to their survival that are unique to their role as a rural health care provider. One of the most significant of these challenges involves the retention of well-qualified chief executive officers (CEOs). Following an assessment of the negative implications associated with CEO turnover, the study utilizes survey data obtained from CAHs experiencing CEO turnover to suggest strategies that can be implement by CAH governing board to retain CEO leadership and mitigate the negative impact of CEO turnover. A key issue identified by the authors involves the critical role played by CEO-board relationships and the need for board leadership to create a culture and environment that promotes a strong working relationship and clear expectations between the CAH board and CEO.


In our part of the world invasive fungal infections include invasive yeast infections with Candida as the absolutely dominating pathogen and invasive mould infections with Aspergillus as the main organism. Yeasts are part of our normal micro-flora and invasive infections arise only when barrier leakage or impaired immune function occurs. On the contrary, moulds are ubiquitous in the nature and environment and their conidia inhaled at a daily basis. Hence invasive mould infections typically arise from the airways whereas invasive yeast infections typically enter the bloodstream causing fungaemia. Candida is by far the most common fungal blood stream pathogen; hence this genus has been the main focus of this thesis. As neither the Danish epidemiology nor the susceptibility of fungal pathogens was well described when we initiated our studies we initially wanted to be able to include animal models in our work. Therefore, a comprehensive animal study was undertaken comparing the virulence in a haematogenous mouse model of eight different Candida species including the five most common ones in human infections (C. albicans, C. glabrata, C. krusei, C. parapsilosis and C. tropicalis and in addition three rarer species C. guilliermondii, C. lusitaniae and C. kefyr). We found remarkable differences in the virulence among these species and were able to group the species according to decreasing virulence in three groups I: C. albicans and C. tropicalis, II: C. glabrata, C. lusitaniae and C. kefyr, and III: C. krusei, C. parapsilosis and C. guilliermondii. Apart from being necessary for our subsequent animal experiments exploring in vivo antifungal susceptibility, these findings also helped us understand at least part of the reason for the differences in the epidemiology and the pitfalls associated with the establishment of genus rather than species specific breakpoints. In example, it was less surprising that C. albicans has been the dominant pathogen and associated with a significantly higher mortality than C. parapsilosis and that C. glabrata and C. krusei mainly emerged in the post fluconazole era and in settings with azole selection pressure. Moreover, it was less surprising that infections due to mutant C. albicans isolates with echinocandin MICs of 1-2 mg/l were not good targets for the echinocandins despite the fact that the outcome for infections involving wild type C. parapsilosis for which similar echinocandin MICs were similar was not inferior. This last observation highlights the importance of providing optimal, reproducible and sensitive reference susceptibility testing methods and notably accompanied by appropriate breakpoints that allow a separation and detection of susceptible and resistant isolates against which the commercial tests can be validated. Correct detection of resistant isolates is for obvious reasons crucial in order to avoid inappropriate treatment. And if the test method cannot correctly identify resistant isolates it makes little sense performing susceptibility testing at all. On the other hand misclassification of susceptible isolates as resistant is also an issue as the patient is thereby deprived an appropriate treatment option among the few available. These comments may seem very basic; nevertheless, it has taken a lot of effort and patience to optimise the susceptibility tests, understand the variability issue for caspofungin testing, to provide appropriate breakpoints that reduced misclassifications to a minimum and not the least to facilitate a harmonisation of breakpoints across the Atlantic sea. We initially realised that the CLSI method and echinocandin breakpoint misclassified resistant isolates. This was due to the endorsement of a single susceptibility breakpoint across all Candida species and the three echinocandins and therefore set as high as 2 mg/l in order to include and not bisect the C. parapsilosis population. Through our comprehensive comparisons of echinocandin susceptibility testing using EUCAST, CLSI, Etest, disk diffusion and agardilution with different media with and without the supplementation of bovine serum albumin we provided data that supported the current reference methodologies, provided that drug and species specific breakpoints were selected. Moreover, the issues of caspofungin variability and of overlap between micafungin MICs for wild type and mutant C. glabrata populations were handled and understood. Anidulafungin EUCAST breakpoints are now published and publically available at the www.eucast.org website and anidulafungin testing recommended as a marker for the echinocandin class. Our antifungal EUCAST breakpoint setting approach has been adopted by the CLSI leading to revision and harmonisation of breakpoints for the three echinocandins, fluconazole and voriconazole. Our epidemiological studies developed gradually over the years following our observation of a notably high incidence rate of fungaemia compared to our Nordic neighbours. Initially, we anticipated that our high incidence was at least in part related to the fact that the capture area for our initial studies was skewed with dominance of university hospitals and inclusion of all centres performing solid organ or bone marrow transplantation. However, when the surveillance was extended to the entire country, the high incidence remained a consistent finding and we even demonstrated that the incidence rate is still increasing. Additionally we demonstrated a changing epidemiology as a high and increasing proportion of the cases involved fluconazole resistant isolates and that this proportion also was significantly higher than in the other Nordic countries. This appears to be related to a significantly higher and increasing fluconazole use in Denmark than in the other Nordic countries. Exploring the incidence rate for the individual hospitals and age groups we demonstrated not unexpectedly that the incidence rate was highest at the university centres, but also that whereas the age specific incidence rate was comparable in children and the younger adults with that in the other Nordic countries it was notably higher in the elderly population. This in combination with the fact that it is increasing specifically in the elderly men and that the incidence rates in the Nordic countries were comparable two decades back suggest that host specific factors including antifungal consumption rather than genetic differences in susceptibility to fungaemia account for the differences, and hence that it is possibly modifiable by implementing relevant measures. Hence, it was important to investigate the underlying clinical conditions and diagnostic factors and the outcome in Danish patients with fungaemia. In this study we demonstrated that two thirds of the patients had received abdominal surgery or intensive care treatment prior to the development of the fungaemia, a proportion that is higher than in most other studies. We also demonstrated that unless surveillance cultures are handled with careful attention the detection of non-C. albicans may go unnoticed which imply a risk of inappropriate treatment in cases involving intrinsically resistant species. Finally, we demonstrated the necessity of using a fungal blood culture flask in addition to the conventional aerobic and anaerobic ones if all C. glabrata infections (BACTEC) and all polymicrobial infections (BacT/ALERT) are to be diagnosed. Hence close monitoring with the use of improved diagnostic options (such as frequent BC including a mycosis bottle, surveillance cultures and mannan antigen and antibody screening) of particularly ICU and abdominal surgery patients may help better identify patients with fungaemia and allow early treatment. With respect to treatment and outcome we found that the fluconazole resistant species C. glabrata, C. krusei and S. cerevisiae were significantly more common in patients exposed to at least 7 days of antifungal prophylaxis (mainly fluconazole). We also demonstrated that a significant proportion of the patients initially received inappropriate antifungal treatment and that the outcome was significantly improved when patients with C. glabrata received caspofungin as their first line agent. This has today been incorporated in the Danish and international treatment guidelines. The prevalence of acquired antifungal resistance remained very low throughout the study period, however, we may only have detected the tip of the resistance iceberg due to the study design, where for epidemiological purposes only the initial isolate was included with the lowest antifungal exposure, and as the susceptibility tests and breakpoints were not optimal for the detection of resistance at all centres. Most Danish laboratories either do not susceptibility test or use commercial tests such as the Etest and later the VITEK system. These are FDA approved with the CLSI breakpoints which, as we have shown, have been far too high to reliably detect resistance and which despite having now been revised and harmonised are not yet in formal CLSI print and hence not incorporated in the product inserts for the commercial tests on the market. Finally, even for laboratories aware of these issues challenges are still ahead as the official breakpoints not always lead to a correct classification for MIC endpoints obtained using the commercial systems or as the commercial tests do not include a relevant concentration range for all drug bug combinations. I thus believe, the studies included in this thesis have contributed significantly to the understanding of the interplay between the Candida virulence, epidemiology and susceptibility and the importance of appropriate diagnostics and treatment choice. It is my hope that we thereby have contributed to the improved options and outcome for patients with candidaemia.


OBJECTIVE
To investigate the relationship between the environmental tobacco smoke (ETS) and lung cancer by Meta-analysis.

METHODS
We used "lung cancer/lung neoplasm", "non-smoking/non-smoker", "China/Chinese", "case-control/case control", "risk factor", "environmental tobacco smoke/passive smoking" as key words, to search papers in databases including Chinese BioMedical Literature (CBM), China National Knowledge Internet (CNKI), Wanfang, Vip Citation Databases (VIP), PubMed and Web of Science databases, and collected the case-control studies on ETS and lung cancer among Chinese non-smokers from January 1999 to December 2013. A total of 129 research papers were collected. RevMan 5.2 software was used to calculate combined odds radio (OR) and 95% CI.

RESULTS
Qualified 18 literatures were included, total cases 6 145 and controls 8 132. Consolidated results showed that ETS exposure could increase the risk of lung cancer, combined OR (95% CI) = 1.52 (1.42-1.64). Stratified analysis showed that ETS exposure was found to be significantly associated with an increasing risk of the lung cancer on non-smoking women and men, and combined OR (95% CI) were 1.58 (1.42-1.75) and 1.34 (1.08-1.65), respectively; the ETS exposure from family or the working environment could increase the risk of lung cancer, and combined OR (95% CI) were 1.48 (1.20-1.82) and 1.38 (1.13-1.69) respectively; childhood exposure and adult exposure were no significant statistical significance, and combined OR (95% CI) were 1.37 (0.98-1.91), and 1.34 (0.97-1.85) respectively.

CONCLUSION
Environmental tobacco smoke exposure was a significant risk factor of lung cancer among non-smokers in China.


In this study, three different Ga-containing systems based on GaCl3, Ga2Cl6, or ionic [Ga(L)3][GaCl4]3 (L = methylidenemalonate) complex were screened to elucidate the mechanism, regioselectivity, chemoselectivity, and role of Ga mediator in the reaction between two types of acetylenes (phenylacetylene and but-1-yn-1-ylbenzene) and methylidenemalonates, i.e., the 1,2-zwitterionic precursors that are similar to intermediates derived from donor-acceptor cyclopropanes (DACs). Our DFT calculation results clearly show that the ionic gallium complex [Ga(L)3][GaCl4]3 represents the key mediator in the title reaction. After the formation of such a complex, the first reaction step is the nucleophilic addition of phenylacetylene or but-1-yn-1-ylbenzene to [Ga(L)3][GaCl4]3, generating an unstable vinyl cation intermediate. In the phenylacetylene system, this vinyl cation intermediate accepts a chlorine atom from [GaCl4]- to give E-configuration intermediate. Then, the above process occurs to other two ligands of the Ga(III) complex to furnish a final product. On the other hand, in the but-1-yn-1-ylbenzene system, the vinyl cation intermediate prefers to undergo Friedel-Crafts (F-C) alkylation to generate a five-membered ring intermediate. This process is repeated on the other two methylidenemalonate ligands, giving rise to a final cyclization product. The distortion/interaction analysis shows that in the nucleophilic addition step the distortion energy of the Ga complex part is the main factor that influences the activation energy. Furthermore, the global reactivity index (GRI) analysis indicates that the Ga-complex model has the highest electrophilicity index ω, thus leading to the lowest energy barrier among three Ga-based models. In addition, DFT results reveal that the regioselectivity (E-configuration preference) and chemoselectivity (chloration or F-C alkylation) are mainly controlled by the steric effect rather than the electronic effect. The main findings of the present work provide a new way to analyze and rationalize various Ga-mediated reactions, which might also be extrapolated to organic transformations undergoing in the presence of aluminum and indium complexes.


This paper deals with the important task of finding the optimal siting and sizing of Distributed Generation (DG) units for a given distribution network so that the cost of active and reactive power generation can be minimized. The optimization technique is based on Genetic Algorithm (GA) and Optimal Power Flow (OPF) calculations. Using the suggested technique of this paper, the search space of GA is limited and the optimum generation condition can be achieved. The proposed procedure has been applied to a distribution system and the results of simulations indicate that the application of the suggested technique can result in considerable savings.


Failure to rescue, or the unexpected death of a patient due to a preventable complication, is a nationally documented problem with numerous and multifaceted contributing factors. These factors include the frequency and method of collecting vital sign data, response to abnormal vital signs, and delays in the escalation of care for general ward patients who are showing signs of clinical deterioration. Patients' clinical deterioration can be complicated by concurrent secondary factors, including opioid abuse/dependence, being uninsured, or having sleep-disordered breathing. Using the Johns Hopkins Nursing Evidence-Based Practice Model, this integrative review synthesizes 43 research and nonresearch sources of evidence. Published between 2001 and 2017, these sources of evidence focus on failure to rescue, the multifaceted contributing factors to failure to rescue, and how continuous vital sign monitoring could ameliorate failure to rescue and its causes. Recommendations from the sources of evidence have been divided into system, structural, or technological categories.


Coach developers provide education and support to coaches. Therefore, these individuals play an important role in coaching systems. However, the formal training of coach developers is a relatively new concept. Both practitioners and academics seem eager to understand how to effectively train these individuals. We had the opportunity to collect feedback from participants of an international coach developer training programme (CDTP). The primary purpose of this insights paper is to share this feedback and make recommendations for future CDTPs based on connections between participant feedback and relevant literature. A secondary purpose of this paper is to stimulate dialogue from programme participants and coordinators, who can offer additional insight regarding their experiences in CDTPs.


Set five thousand years ago and ranging through what is now Montana, Wyoming, northern Colorado, and Utah, "People of the Earth" follows the migration of the Uto-Aztecan people south out of Canada. It is the unforgettable tale of a woman torn between two peoples and two dreams, of the two men who love her and the third who must have her, and of the vision given to the peoples long ago by the spirit of the wolf."New York Times "and "USA Today "bestselling authors and award-winning archaeologists W. Michael Gear and Kathleen O'Neal Gear bring the stories of these first North Americans to life in this and other volumes in the magnicent North America's Forgotten Past series.


The creping process and the conditions on the Yankee cylinder are the key factors in the production process. They need to be kept under good control in order to maintain a high and uniform quality. A natural coating always develops on the surface of the Yankee cylinder due to evaporation from dissolved and dispersed substances and to fiber fragments that remain on the surface after creping. Nevertheless, coating chemicals are sprayed onto the Yankee surface in order to modify the adhesion between the paper and the dryer cylinder. To be able to control the process, on-line measurements of coating thickness as well as of the crepe structure of the tissue paper produced would be very valuable. In the work described in this thesis, the coating layer was analyzed chemically and morphologically to provide information about the coating layer before starting any on-line measurements. The chemicals added and the constituents of the pulps are known to the paper producers, but what is left on the cylinder and whether there are different layers of coating still remain to be investigated. The chemical analysis indicated that the adhesive content was higher in an inner layer of the coating than in the outer layer. The relative amount of polyamide-amine resin calculated on the basis of the nominal nitrogen content in the resin was low indicating that the coating consisted of a significant amount of carbohydrates or other substances. The coating layer could not be considered transparent. It was observed that the coating was thick and appeared patch-wise and that it contained fiber fragments. Measurements on a laboratory scale, to further be applied on-line on the tissue machine, have been investigated and evaluated in this study. The thickness of the coating layer on a laboratory dryer has been measured. The method was based on fluorescence with an optical brightener added to the coating chemicals sprayed on the Yankee dryer. With a UV-LED (Ultra Violet - Light Emitting Diode) the coating layer was exposed to UV-light and the intensity of the light emitted by the optical brightener in the layer was measured. The intensity in the trials with different thickness of the coating and no coating was scattered and no trend could be seen between the different trial points. Attempts were made to measure the wavelength of the tissue paper produced with an optical fiber perpendicular to and at an angle to the paper surface. The paper was travelling in a slow speed while the measurements were made. The collected signal to noise ratio was low and it was not possible to detect any representative characteristic wavelength of the tissue.


The main purpose of this study is to analyze the thermomechanical behavior of the dry contact between the brake disk and pads during the braking phase. The simulation strategy is based on computer code ANSYS11. The modeling of transient temperature in the disk is actually used to identify the factor of geometric design of the disk to install the ventilation system in vehicles The thermal-structural analysis is then used with coupling to determine the deformation and the Von Mises stress established in the disk, the contact pressure distribution in pads. The results are satisfactory when compared to those of the specialized literature.


The industrialization process began in Latin America as a way to promote economic growth, and at the same time to save foreign exchange. Import substitution policies were adopted in almost every Latin American country. High tariffs and other import restrictions were adopted in order to protect the infant industries. Tax exemptions and other incentives were created in order to promote domestic and foreign investments. While the process of import substitution continued, there were increasing needs for the importation of intermediary and capital goods, Under these circumstances, the Latin American countries initiated programs of regional integration. In 1958 the Central American Isthmian countries, except Panama, created the Central American Common Market (CACM). In 1960 the Latin American Free Trade Association (LAFTA) was founded and involves all South American countries, plus Mexico. The purpose of this paper is to analysze the effects of LAFTA on the economic growth of Colombia, based on the main objectives of LAFTA.


In this study, sector-based relationships between confidence indices and stock exchange indices are investigated for January 2011-June 2019 period. Monthly data sets on financial service confidence index, service confidence index, construction confidence index, retail trade confidence, and stock market indices are firstly analyzed by Hacker and Hatemi-J (2006) test. Secondly, they are examined in terms of asymmetric causality relationship with Hatemi-J (2012) test. According to the findings obtained as a result of the tests; the existence of a symmetric causality relationship between the sectoral confidence indices and related Istanbul Stock Exchange (ISE) sector indices could not be identified in Turkey. However, an asymmetric causality relationship is found between these variables. In other words, while there is no direct causal relationship between sectoral confidence indices and stock market sector indices, there is a causality relationship through the components of these variables. Key Words: Confidence Index, Stock Exchange Sector Index, Symmetric Causality, Asymmetric Causality JEL Classification: G19, G23, G40


The high consumption activity done by the community is directly proportional to the increase of waste production. One of the problems of high waste production is the low public awareness of waste management. This is a problem encountered in big cities. Garbage has a negative impact on changes in existing natural conditions, namely the occurrence of air pollution, water and soil that causes the environment to become unhealthy. Waste management activities through the socialization of the 3R (Reduce, Reuse, Recycle) program on waste, but this program has not maximized the public awareness about the importance of a healthy environment. as population increases have an impact on increasing waste production. So that requires sufficient land disposal land in the long term. To overcome these problems, data analysis of long-term waste land disposal estimation using data mining techniques is used. from the data mining analysis using a simple linear regression algorithm with respect to population growth from 2018 until 2025 by 201484 people, it is known that the increase of waste from 2018 to 2025 is 36,052,326 tons. So from the land area of 30000 M2 only available land disposal until the year 2025 of 5,965.1 M2.


OBJECTIVE
To investigate the influence of micro-ribonucleic acid (miR)-9 on epithelial-mesenchymal transition (EMT) of ovarian cancer cells by targeted inhibition on E-cadherin (CDH1).

PATIENTS AND METHODS
The human ovarian cancer cells were cultured and miR-9 was repressed by inhibitors and overexpressed by miRNA mimics. The expression of EMT-related proteins was measured via Western blotting (WB). The action target of miR-9 was determined through the dual-luciferase reporter gene assay. The changes in protein levels were detected using WB.

RESULTS
The expression of miR-9 was markedly up-regulated in ovarian cancer tissues, that is, the expression level of serum miR-9 in ovarian cancer patients was higher than that in control group. After the inhibition of miR-9, the expression level of epithelial indicator CDH1 was increased, while that of interstitial indicator Vimentin was decreased. MiR-9 contained a complementary site in the 3'-untranslated region (UTR) of CDH1 messenger RNA (mRNA) and the mRNA and protein expressions of CDH1 in the cells were down-regulated obviously by miR-9 overexpression.

CONCLUSIONS
MiR-9 promotes the EMT of ovarian cancer cells through the targeted inhibition on CDH1.


Emerging from the shade into the light As a growing seedling emerges into the light, it needs to shift its developmental program to grow toward the light. Signaling components that flip the switch from growth in the shade to growth in the light include phytochromes, which are sensitive to red light, and transcription factors that drive the shade-adapted pattern of development. Ni et al. now show how phosphorylation sets these signaling partners up for destruction. The signaling established by red light invokes photomorphogenesis by promoting the destruction of the photoreceptor and its signaling partner. Science, this issue p. 1160 Phytochrome and its partner transcription factor go to their doom together in response to a change in light quality. After light-induced nuclear translocation, phytochrome photoreceptors interact with and induce rapid phosphorylation and degradation of basic helix-loop-helix transcription factors, such as PHYTOCHROME-INTERACTING FACTOR 3 (PIF3), to regulate gene expression. Concomitantly, this interaction triggers feedback reduction of phytochrome B (phyB) levels. Light-induced phosphorylation of PIF3 is necessary for the degradation of both proteins. We report that this PIF3 phosphorylation induces, and is necessary for, recruitment of LRB [Light-Response Bric-a-Brack/Tramtrack/Broad (BTB)] E3 ubiquitin ligases to the PIF3-phyB complex. The recruited LRBs promote concurrent polyubiqutination and degradation of both PIF3 and phyB in vivo. These data reveal a linked signal-transmission and attenuation mechanism involving mutually assured destruction of the receptor and its immediate signaling partner.


This thesis analyses poor law administration in Wigan Union from 1880-1900. The late-nineteenth century is fertile territory for poor law historians, and this study intends to further enhance our understanding of the period. Local studies are vital given that the weakness of central authority ensured a wide variety of practice amongst unions, and are essential to the development of a better informed national picture. With that purpose, the thesis focuses on the important Lancashire industrial town of Wigan. Analysis addresses selected themes that require greater attention from historians in order to facilitate a more developed understanding of the poor law. Chapter one analyses politics in relation to guardians' elections before and after the democratisation of the boards in 1894. Chapter two explores the role of boards of guardians, both individually and collaboratively, as active political agencies and defenders of the public interest in relation to removal of Irish paupers and in battles over rating with canal and railway companies. Chapters three and four focus on what was arguably the greatest poor law controversy of the period – the 'Crusade' against outdoor relief, initiated nationally in 1870. Wigan Union was an apparent supporter of this 'reform' movement, but appearances were deceptive. Chapter five addresses the problem of the 'casual poor', another major national concern of the period. Analysis illustrates the detail of local practice and the nature of central-local relations between the guardians and the LGB. Chapter six examines the themes of dismissal of union officers and superannuation for those deemed to have given good public service, further illustrating conceptions of professionalism and central-local relations. From this analysis, the Wigan board emerges as a politically engaged institution; financially cautious but with a paternalistic sense of obligation to the poor and pragmatic rather than ideologically driven in its policy and practice. Strong local conceptions of identity, professionalism and public service are evident within a nuanced context of central-local relations.


approved and Aims: This review critically assesses the evidence that support the use of conivaptan for the treatment of patients with euvolemic and hypervolemic hyponatremia. Evidence review conclusion: Conivaptan is effective in raising serum sodium levels in a predictable and safe fashion in euvolemic and hypervolemic hyponatremic patients. Conivaptan provides the first molecularly targeted approach for correcting hyponatremia in hospitalized patients.


Humans learn to speak before they can read or write, so why can't computers do the same? In this paper, we present a deep neural network model capable of rudimentary spoken language acquisition using untranscribed audio training data, whose only supervision comes in the form of contextually relevant visual images. We describe the collection of our data comprised of over 120,000 spoken audio captions for the Places image dataset and evaluate our model on an image search and annotation task. We also provide some visualizations which suggest that our model is learning to recognize meaningful words within the caption spectrograms.


There are a number of critical problems related to road safety in intelligent transportation systems (ITS) caused by increased vehicle usage, urbanisation, population growth and density, and faster rates of movements of goods and people. It is envisaged that vehicular ad hoc networks (VANETs) will bring about a substantial change to the way our road transport operates to improving road safety and traffic congestion. A major challenge in VANETs is to provide real-time transfer of information between vehicles within a highly mobile environment. The authors propose a new clustering scheme named robust mobility adaptive clustering (RMAC) to strategically enable and manage highly dynamic VANETs for future ITS. It employs a novel node precedence algorithm to adaptively identify the nearby 1-hop neighbours and select optimal clusterheads based on relative node mobility metrics of speed, locations and direction of travel. Furthermore, the zone of interest concept is introduced for optimised approach to the network structure such that each vehicular node maintains a neighbour table of nodes, beyond its communications range, that reflects the frequent changes on the network and provides prior knowledge of neighbours as they travel into new neighbourhoods. RMAC predominantly employs more reliable unicast control packets and supports geographic routing by providing accurate neighbour information crucial when making routing decisions in multi-hop geographic routing. It is shown by simulations that RMAC on IEEE802.11 ad hoc WLAN protocol is very effective in a highly dynamic VANETs environment, being robust on link failures, and having very high cluster residence times compared to the well known distributed mobility clustering scheme.


Will the Automotive era come to an end in the 21th century? Looking at today's environmental and economic challenges of the use of cars based on last century technology and listening to some trend watchers one could think so. Cars can be regarded, as an old school status product indeed, for which there is no use, no place, no money and no interest in our modern society. On de other hand, auto-mobility is still growing, both in developed as in developing countries. The current worldwide road travel by motorbikes, cars, trucks and busses will probably double to 80 trillion kilometers in 2050. Facing comparable mobility growth in the Dutch Port City areas of Rotterdam, this paper describes the research of the Rotterdam University of Applied Science, following developments in automotive and providing first living lab experiments. In our vision, the traditional automotive values 'individual freedom and flexibility' and using new disruptive technologies, the automobile will very likely consolidate its position as preferred choice for mobility of persons and goods during the 21th century. To achieve that the sustainable disruptions: Electrification, Automation and Connectivity (sharing) must be adopted. Meanwhile one should focus on tempting goals, the Six Zero's; Zero Emission, Zero Energy, Zero Congestion, Zero Accident, Zero Empty and Zero Cost. These goals will guide us towards a new economy, sustainable ecology and more efficient use of time.


The initial conditions of our Universe can be summarized on a single sheet of paper. Yet the Universe is full of complex structures today, such as stars, galaxies and groups of galaxies. In this review I describe the standard theoretical model for how complexity emerged from the simple initial state of the Universe at early cosmic times through the action of gravity. In order to test and inform the related theoretical calculations, large-aperture telescopes and arrays of radio antennae are currently being designed and constructed. The actual transition from simplicity to complexity has not been observed as of yet. The simple initial conditions were already traced in maps of the microwave background radiation, but the challenge of detecting the first generation of galaxies defines one of the exciting frontiers in the future of cosmology. Once at hand, the missing images of the infant Universe might potentially surprise us and revise our current ideas.


Primary hypothyroidism is a disease commonly encountered by GPs and internal medicine doctors. It is treated with levothyroxine, the synthetic T4 hormone. If a patient with primary hypothyroidism suddenly requires higher dosages the reason for this should be investigated. Common causes are drug-interactions, pregnancy or non-compliance. Nevertheless, if a patient has other symptoms such as oedema or unexpected weight gain, nephrotic syndrome should be considered. Urinalysis can be very helpful in this. Thyroxin binds to plasma albumin, high levels of which are excreted in patients with nephrotic syndrome. This paper presents two patients, a 45-year-old male and a 72-year-old male, with primary hypothyroidism who due to nephrotic syndrome required large amounts of levothyroxine.


Cloud computing and its related virtualization technologies have become one of dominant trends to deploy software, compute difficult problems, store different types of data, and stream real-time video and audio. Due to its benefits from cost-efficiency and scalability to maintain server solutions, many organizations are migrating their server applications running on physical servers to virtual servers in cloud computing infrastructures. Moreover, cloud computing has enabled mobile and battery-powered devices to operate without strong processing power and large storage capacity. However, it is not trivial to use this trendy technology for medical Cyber Physical Systems (CPSs) which require processing tasks' requests to send instructions to the local actuator within specified deadlines. Since a medical CPS device monitoring a patient's vital signs may not have a second chance to recover from an erroneous state, achieving cost-efficiency with higher resource utilization in cloud computing may not be the ultimate goal to configure the healthcare IT infrastructure with medical CPS devices. In this paper, we focus on private cloud infrastructures with the fair resource sharing mechanism in order to run medical CPS applications. First, we introduce our medical CPS device model used for designing our cloud infrastructure following the Integrated Clinical Environment (ICE) standard developed by the Medical Device Plug-and-Play (MDPnP) project. Second, we investigate limitations to deploy CPS applications using existing auto-scaling mechanisms. Finally, we propose our novel middleware with a virtual resource sharing mechanism inspired by autonomic computing, and present its performance evaluation results simulated in the OpenStack private cloud.


Under some circumstances, the marginal cost approach to infrastructure pricing leads to problems with cost recovery; a pricing policy which ensures that existing assets are efficiently used may not deliver revenue to pay for the costs for maintenance of existing, nor indeed for construction of new infrastructure. For different reasons governments may find this inappropriate and rather want to complement the marginal-cost-pricing principle with a requirement for a sector of the economy to break even. Efficiency would then be jeopardised. The idea behind work package 2 is to establish the micro-aspects of requirements to recover costs over and above marginal costs. This is done for all modes of transport. More precisely, the objective of this report is to establish some core features of how each mode of transport is organised, to describe the implications of cost recovery requirements for each mode and to analyse different mechanisms which would ascertain that each mode covers a larger share of its own costs.