This paper explores how the control over the Near Field Communication (NFC) secure element could provide platform leadership in the mobile payment ecosystem. During a decade of trials, firms from different industries struggled to launch proximity mobile payment platforms to pay at physical point-of-sales. Mobile payments platforms are complex socio-technical systems that need to combine an array of resources and capabilities from different firms. The implementation of NFC platforms requires to store financial credentials of consumers in a secure element (SE). The industry designed several competing platform architectures for the secure element: SIM-centric, device-centric, SD-centric, and Host Card Emulation (HCE). Each of these alternatives gave more or less control to the different firms involved in the mobile payment ecosystem. For years, firms promoted the architecture which would give them more control. Over the time, this struggle just hindered the emergence of successful mobile payment platforms. The recent emergence of new actors (e.g., Google, Apple, Samsung) raised optimistic prospects for future developments. This paper provides a strategic analysis of the mobile payment ecosystem by studying the relationship between SE architectures and the establishment of platform leadership by incumbents and emerging actors.


The paper presents equations of theory of plates resting on elastic subsoil. Theories of thin and medium thickness plates applied to subsoils with one and two parameters, including Vlasov's and Winkler's subsoils, were analysed. The case of placing a "self-balancing" load on the edge of a half-band resting on the Vlasov's and Winkler's elastic subsoils was considered. It was proved that the so-called boundary effect occurs only in medium thickness plates and plates resting on Winkler's one-parameter and Vlasov's two-parameter elastic subsoils. The influence of the Poisson's ratio of the plate material on the deflection and cross-section forces in the plate half-band resting on subsoil was analysed. The solutions obtained using Hencky–Bolle's theory applied to plate half-band on Winkler's and Vlasov's subsoils were compared.


Objective: The
present study aimed to investigate and to compare the electrophysiological
changes in bipolar patients and healthy subjects during the execution of a
saccade task. Materials and Methods: The subjects had to respond to a fixed visual stimulus presented by a LEDs bar.
We executed an ANOVA (one-way) and post hoc Scheffe test to examine the
difference of absolute alpha power and reaction time among four groups:
control, depression, manic and euthymic. We observed the frontal, parietal and
occipital regions. The paired t test was realized on each electrode and group
to compare the pre and post moment in the task. Results: We observed a statistical difference among the groups for the behavioral variable—saccade reaction time. For the electrophysiological
variable—absolute
alpha power, we did not find significant difference between the moments (pre
and post stimulus presentation) for none of the electrodes of each bipolar
group. However, the results pointed out to a difference between the moments for
F3, P3, O1 and O2 electrodes for control group. Conclusion: We cannot affirm that the task influences the cortical
activity of the patients. It is possible that the method used to analyze the
data is not the adequate. The time-frequency analysis could be better to
analyze the present data. We also observed that the absolute alpha power could
be considered a marker of bipolar disorder, but not of the different states (i.e., mania, depression, euthymia).


We investigated the variations in the magnetic field distribution and power transmission efficiency, resulting from changes in the relative positions of the transmitting and receiving coils, for electromagnetic induction-type wireless power transmission using an elliptical receive coil. Results of simulations using a high-frequency structure simulator were compared to actual measurement results. The simulations showed that the transmission efficiency could be maintained relatively stable even if the alignment between the transmitting and receiving coils was changed to some extent. When the centre of the receiving coil was perfectly aligned with the centre of the transmitting coil, the transmission efficiency was in the maximum; however, the degree of decrease in the transmission efficiency was small even if the centre of the receiving coil moved by ±10 mm from the centre of the transmitting coil. Therefore, it is expected that the performance of the wireless power transmission system will not be degraded significantly even if perfect alignment is not maintained. Animal experiments confirmed good ECG signals for the simulation conditions. The results suggested a standardized application method of wireless transmission in the utilization of wireless power for implantable sensors.


Mono Basin, on the eastern flank of the central Sierra Nevada, is the highest of the large hydrographically closed basins in the Basin and Range province. We use geomorphic features, shoreline deposits, and basalt-filled paleochannels to reconstruct an early to middle Pleistocene record of shorelines and changing spillways of Lake Russell in Mono Basin. During this period of time, Lake Russell repeatedly attained altitudes between 2205 and 2280 m—levels far above the present surface of Mono Lake (∼1950 m) and above its last overflow level (2188 m). The spill point of Lake Russell shifted through time owing to late Tertiary and Quaternary faulting and volcanism. During the early Pleistocene, the lake periodically discharged through the Mount Hicks spillway on the northeastern rim of Mono Basin and flowed northward into the Walker Lake drainage basin via the East Walker River. Paleochannels recording such discharge were incised prior to 1.6 Ma, possibly between 1.6 and 1.3 Ma, and again after 1.3 Ma (ages of basaltic flows that plugged the paleochannels). Faulting in the Adobe Hills on the southeastern margin of the basin eventually lowered the rim in this area to below the altitude of the Mount Hicks spillway. Twice after 0.76 Ma, and possibly as late as after 0.1 Ma, Lake Russell discharged southward through the Adobe Hills spillway into the Owens–Death Valley system of lakes. This study supports a pre- Pleistocene aquatic connection through Mono Basin between the hydrologically distinct Lahontan and Owens–Death Valley systems, as long postulated by biologists, and also confirms a probable link during the Pleistocene for species adapted to travel upstream in fast-flowing water.


The neuregulin (NRG) family of trophic factors is present in the central and peripheral nervous systems and participates in the survival, proliferation, and differentiation of many different cell types, including motoneurons. NRG1 was first characterized by its role in the formation of the neuromuscular junction, and recently it was shown to play a crucial role in modulating glutamatergic and cholinergic transmission in the central nervous system of adult rats. However, little is known about NRG1's role in adult motor systems. Motoneurons receive dense glutamatergic and cholinergic input. We hypothesized that NRG1 is present at synapses on phrenic motoneurons. Confocal microscopy and 3D reconstruction techniques were used to determine the distribution of NRG1 and its colocalization with these different neurotransmitter systems. We found that NRG1 puncta are present around retrogradely labeled motoneurons and are distributed predominantly at motoneuron somata and primary dendrites. NRG1 is present exclusively at synaptic sites (identified using the presynaptic marker synaptophysin), making up ∼30% of all synapses at phrenic motoneurons. Overall, NRG1 immunoreactivity is found predominantly at cholinergic synapses (75% ± 14% colocalize with the vesicular acetylcholine transporter; VAChT). Nearly all (99% ± 1%) VAChT‐immunoreactive synapses expressed NRG1. NRG1 also is present at a subset of glutamatergic synapses expressing the vesicular glutamate transporter (VGLUT) type 2 (∼6%) but not those expressing VGLUT type 1. Overall, 26% ± 6% of NRG1 synapses are VGLUT2 immunoreactive. These findings provide the first evidence suggesting that NRG1 may modulate synaptic activity in adult motor systems. J. Comp. Neurol. 518:4213–4225, 2010. © 2010 Wiley‐Liss, Inc.


Objectives: MicroRNAs (miRs) have been identified as chief post-transcriptional regulators of cardiac disease progression. In addition, a critical role of the adenosine monophosphate-activated kinase (AMPK) pathway in the development of myocardial hypertrophy has been revealed. Yet, regulation of the AMPK pathway by miRs in the heart has not been addressed. We hypothesized that components of the AMPK pathway are targeted by miRs and alter AMPK signaling in a mouse model of hypertrophic cardiomyopathy (HCM). Methods and results: Using real-time PCR, a candidate miR screen that included 22 miRs implicated in pathological cardiac disease and/or metabolic dysregulation was performed on hearts from 60-, 120-, and 240-day-old transgenic HCM male mice harboring an R403Q mutation in the myosin heavy gene. Among early (60 day) elevated miRs were miR-195 and -451. Both miR-195 and -451 have conserved target sites in the 3′ UTR of CAB39 (MO25), a central component of the MO25/STRAD/LKB1 complex that acts as an upstream kinase for AMPK and its subsequent activation. We further confirmed the elevation of miR-195 and -451 by Northern blotting. Next, we demonstrated specific expression and a similar distribution pattern of miR-195 and -451 in cardiomyocytes of R403Q HCM hearts by in situ hybridization. To determine whether the conserved sites in MO25 3′ UTR acted as functional targets, either the miR-195 or miR-451 target sequence was cloned into a luciferase expression vector. MiR-195 but not miR-451 suppressed luciferase activity compared to the missense sequence control vector in C2C12 cells. In addition, over-expression of miR195 in C2C12 cells knocked down MO25 expression levels and downstream AMPK signaling (phosphorylation of Acetyl CoA carboxylase). Finally, parallel changes were measured in 60 day R403Q HCM male hearts that included reduced MO25 expression and lowered phosphorlation of AMPK and Acetyl CoA carboxylase. Conclusion: Our findings indicate that miR-195 targets the LKB1/AMPK signaling axis and suggest a functional role for miR-195 elevation in R403Q HCM disease progression.


: The implementation of a quality system in health care organizations offers huge potentials for improvement and development. But the realization of such systems necessitates high investments, which small companies and family businesses often are unable to raise. The German Association of Spa Accommodation Resorts (VdKB) commissioned two consultants to develop a reasonably priced implementation concept of a DIN EN ISO 9001 quality system specially adjusted to small companies and family businesses in medical spa and rehabilitation services, which was successfully accredited in May 2003. This paper describes fundamental requirements in combine management systems, considers the pros and cons of management combines and demonstrates the practical realization of combine requirements on the example of the VdKB-combine system.


OBJECTIVE To evaluate the efficacy and safety of lixisenatide versus placebo on glycemic control in older patients with type 2 diabetes uncontrolled on their current antidiabetic treatment. RESEARCH DESIGN AND METHODS In this phase III, double-blind, randomized, placebo-controlled, two-arm, parallel-group, multicenter trial, patients aged ≥70 years were randomized to receive once-daily lixisenatide 20 μg or placebo before breakfast concomitantly with their existing antidiabetic therapy (including insulin) for 24 weeks. Patients at risk for malnutrition or with moderate to severe cognitive impairment were excluded. The primary end point was absolute change in HbA1c from baseline to week 24. Secondary end points included change from baseline to week 24 in 2-h postprandial plasma glucose (PPG) and body weight. RESULTS A total of 350 patients were randomized. HbA1c decreased substantially with lixisenatide (−0.57% [6.2 mmol/mol]) compared with placebo (+0.06% [0.7 mmol/mol]) from baseline to week 24 (P < 0.0001). Mean reduction in 2-h PPG was significantly greater with lixisenatide (−5.12 mmol/L) than with placebo (−0.07 mmol/L; P < 0.0001). A greater decrease in body weight was observed with lixisenatide (−1.47 kg) versus placebo (−0.16 kg; P < 0.0001). The safety profile of lixisenatide in this older population, including rates of nausea and vomiting, was consistent with that observed in other lixisenatide studies. Hypoglycemia was reported in 17.6% of patients with lixisenatide versus 10.3% with placebo. CONCLUSIONS In nonfrail older patients uncontrolled on their current antidiabetic treatment, lixisenatide was superior to placebo in HbA1c reduction and in targeting postprandial hyperglycemia, with no unexpected safety findings.


Objective: To determine the molecular diversification and frequency of mecA Gene in MRSA infections of hospitalised patients at Islamabad, Pakistan.
Study design: Cross-sectional study.
Place and Duration: Pakistan Institute of Medical Science, Islamabad, Pakistan, from Sep 2017 to Sep 2018.
Methodology: To explore the occurrence of pathogenic S. aureus in the hospitalised patients of Islamabad, 500 samples were collected. All the isolates were further characterised by gram staining, catalase test and DNAse media analysis validating the presence of S.aureus. The overall frequency of S.aureus was 19.5% in all the isolates. Six highly distinguished colonies were further evaluated through colony PCR by 16S r RNA analysis, and results revealed 99.9% homology of isolates with S.aureus. The degree of resistance was further evaluated for 12 isolates based on the previous MRSA resistance pattern. The extraction and concentration of DNA were done by the CTAB and Nanodrop methods. Then primers were designed for the presence of the mecA gene of S. aureus.
Results: Results showed 51 (52.7%) MSSA and 45 (47.4%) MRSA among all the isolates. Colony PCR by 16S r RNA analysis results revealed 97 (99.9%) homology of isolates with S.aureus. PCR of all the twelve extracted DNAs of isolates showed the frequency of the mecA gene in all the isolates.
Conclusion: The study is the first report the presence of resistance mecA gene in the hospitalised patients of Islamabad. It has depicted a resistant gene's presence and showed the rising trend of resistance in pathogenic S. aureus.


Introduction: To reduce treatment duration, we are treating our carcinoma breast patients with simultaneous integrated boost radiotherapy after breast conservation surgery. Here we are presenting our experience at median follow up of three years. Material and methods: Patients having at least 6 months of follow up after completion of radiotherapy were evaluated .All patients were treated with intensity modulated image guided radiotherapy technique. Dose prescribed to clinical target volume breast was 50 Gy in 25 fractions and CTV boost was 60 Gy in 25 fractions. Results: Median age of our patients was 49 years. Five patients (10.2%) had acute grade 2 skin toxicity and all other (89.7%) grade 1.Grade 2 toxicity was noted in patients with pendulous and bulky breast. Average treatment duration was 34 days (range 32-56 days). Median follow up is three years after completion of radiotherapy. Twenty six (53.06 %) patients had late grade zero and twenty three (46.9% ) grade 1 skin reactions. Conclusion: With simultaneous integrated boost in carcinoma breast patients, overall treatment time can be reduced without increasing early and late toxicities. Implementation is easy with decreased replanning workload. Henceforth SIB can be a feasible option for early breast cancer patients. Int J Appl Sci Biotechnol, Vol 3(3): 561-565


Background: Heart failure (HF) is a chronic condition where the heart cannot pump enough blood to adequately oxygenate cells. The CardioMEMS HF device is implanted into the pulmonary artery (PA) allowing practitioners to monitor pressures remotely and prescribe interventions. Objectives: The primary purpose of this project was to determine if CardioMEMS is an effective intervention in the reduction of hospital admissions, emergency department (ED), and clinic visits for HF patients. The secondary purpose was to determine if the quality of life (QOL) and exercise tolerance was improved post-implant. Methods: The author conducted a retrospective chart review by accessing previously compiled data for patients with the CardioMEMS device to evaluate the number of hospital admissions, emergency, and clinic visits pre and post-implant. Patients completed the Minnesota Living with Heart Failure Questionnaire to determine if their QOL improved. Pre and post 6-minute walk test (6MWT) data was reviewed to evaluate exercise tolerance. Results: The CardioMEMS HF device shows potential to decrease acute inpatient care needs and improve QOL for HF patients. Hospital admissions for HF were significantly reduced post implant (p= 0.020). Self-reported QOL scores significantly improved post-CardioMEMS implant (p<0.0001). There was a non-significant trend towards decreased ED (p= 0.292) and clinic visits (p=0.438) post-CardioMEMS implant. Comparison of changes in 6MWT was inconclusive. Conclusion: The CardioMEMS HF device appears to be a valid option to help minimize acute care needs of HF patients while improving QOL for most. More research is needed to determine effectiveness of CardioMEMS device for exercise tolerance. EVALUATION OF CARDIOMEMS 3 Evaluation of CardioMEMS Heart Failure Device


Background: The angiosome is a three-dimensional block of tissue supplied by a source vessel with its boundary outlined either by an anastomotic perimeter of reduced-caliber choke vessels or by true anastomoses with no reduction of vessel caliber. This article focuses on the role of these anastomotic vessels in defining flap survival or the necrotic pattern seen in fulminating meningococcal septicemia. Methods: Experiments in pigs, dogs, guinea pigs, and rabbits over the past 46 years were reviewed, focusing on the necrosis line of flaps, the effects of various toxins in vivo, and correlating these results in the clinical setting. Results: Experimentally, choke anastomoses are functional and control flow between perforator angiosomes. They (1) permit capture of an adjacent angiosome when the flap is raised on a cutaneous perforator in 100 percent of cases, with the necrosis line occurring usually in the next interperforator connection; (2) confine flow to the territory of the involved artery when a toxin is introduced by spasm around its perimeter; and (3) lose this property of spasm when choke vessels are converted to true anastomoses following surgical delay, or where true anastomoses occur naturally, thereby allowing unimpeded blood flow and capture of additional angiosome territories. Clinical experience supports these observations. Conclusions: The functional angiosome is the volume of tissue that clinically can be isolated on a source vessel. The area extends beyond its anatomical territory to capture an adjacent territory if connections are by choke anastomoses, or more if they are by true anastomoses.


Efficient photoluminescence up-conversion is observed in 4H SiC samples containing both the UD-3 defect with its characteristic photoluminescence (PL) no-phonon (NP) line in the near infrared at 1.356 eV and the titanium impurity with its emission in the visible spectral region. When both defects are present, the titanium emission can be excited efficiently by tuning the laser to UD-3. In 4H samples containing either only UD-3 or only titanium, a different photoluminescence up-conversion process can be observed. This second process occurs at photon energies higher than approximately 1.5 eV without exhibiting a clear threshold. In 6H and 15R SiC only this second process was found, even when both the UD-3 defect and the titanium impurity are abundant.


Coated glass products, and especially the low-emissivity coatings, have become a common building material used in modern architectural projects. More recently, these material systems became common in specialized glazing systems featuring solar energy harvesting. Apart from achieving the stability of optical parameters in multilayer coatings, it is also important to have improved control over the design of visual color properties of the coated glass. We prepare metal-dielectric composite (MDC)-based multilayer thin-film structures using the radio frequency (RF)-magnetron sputtering deposition and report on their optical and chromaticity properties in comparison with these obtained using pure metal-based Dielectric/Metal/Dielectric (DMD) trilayer structures of similar compositions. Experimentally achieved Hunter L, a, b values of MDC-based multilayer building blocks of coatings provide a new outlook on the engineering of future-generation optical coatings with better color consistency and developing approaches to broaden the range of achievable color coordinates and better environmental stability.


In Content-Based Image Retrieval (CBIR) sys- tems, the visual content of the images is mapped into a new space named the feature space. The features that are chosen must be discriminative and sufficient for the description of the objects. The key to attaining a successful retrieval sys- tem is to choose the right features that represent the images as unique as possible. A feature is a set of characteristics of the image, such as color, texture, and shape. In addition, a feature can be enriched with information about the spa- tial distribution of the characteristic that it describes. Eval- uation of the performance of low-level features is usually done on homogenous benchmarking databases with a lim- ited number of images. In real-world image retrieval sys- tems, databases have a much larger scale and may be hetero- geneous. This paper investigates the behavior of Compact Composite Descriptors (CCDs) on heterogeneous databases of a larger scale. Early and late fusion techniques are tested and their performance in distributed image retrieval is cal- culated. This study demonstrates that, even if it is not possi- ble to overcome the semantic gap in image retrieval by fea- ture similarity, it is still possible to increase the retrieval ef- fectiveness.


This essay presents the idea of James Baldwin as a freedom writer, the organizing idea of my biography in progress. As a freedom writer, Baldwin was a revolutionary intellectual, an essayist and novelist committed unfailingly to the realization of racial justice, interracial political equality, and economic democracy. While the book is still in process, this short essay narrates autobiographically how I came to meet and know Baldwin's work, explains in critical fashion my work in relation to existing biographies, and reflects interpretively my thoughts-in- progress on this fascinating and captivating figure of immense historical and social consequence.


The adoption rate of e-learning is found to be in a poor state which is evident from the e-learning implementations as well as the e-learning readiness scores of Sri Lanka. The objective of this research is to develop a research model to identify factors that affect the adoption of e-learning in Sri Lanka. UTAUT was used as the theoretical foundation; however other variable extensions were included to improve the variance which the model intends to explain. Cross sectional survey was conducted with 358 responses which were analyzed using correlation analysis and regression analysis. Correlation analysis found that all variables were significant. However, anxiety was found to have a negative correlation. The model was able to explain 36.7% (R2=0.367) of variance in students acceptance of elearning. The findings show that Performance Expectancy, Effort Expectancy, attitude towards elearning, Self Efficacy, Positive Facilitation Conditions, and Social Influence need to be improved to increase students' acceptance.


BACKGROUND
Cognitive impairment is recognised as a significant clinical issue in Multiple Sclerosis (MS). It can occur at any stage of the disease, affecting quality of life, occupational activity, and adherence to therapy. This makes the availability of a validated assessment tool for detecting and monitoring cognitive dysfunction in multiple sclerosis essential. The Brief International Cognitive Assessment for Multiple Sclerosis is a practical and simple means of administering a battery of three neuropsychological tests, and does not require any formal neuropsychological training.

OBJECTIVE
To establish the validity of BICAMS in the Polish MS population; to assess the correlations of cognitive status with demographic and clinical factors, including affective symptoms and fatigue.

METHODS
BICAMS was administered to 61 MS patients and 61 HC subjects. Examination of 20 participants with MS was repeated after one to three weeks to assess test-retest reliability. The patients with MS and HC subjects also completed the Hospital Anxiety and Depression Scale (HADS) and Modified Fatigue Impact Scale (MFIS).

RESULTS
The MS group performed worse than the HC group in all three BICAMS components, obtaining the following values respectively: 51.7 and 56.1 (p = 0.02) for CVLT, 25 and 28 (p = 0.03) for BVMT-R, and 48.8 and 57.2 (p < 0.001) for SDMT. All BICAMS tests had very significant correlations in test-retest reliability (r = 0.83, p < 0.001 for CVLT; r = 0.84, p < 0.001 for BVMTR; r = 0.9, p < 0.001 for SDMT). 34% of MS patients presented cognitive dysfunction based on the criterion of one or more test scores below the 5th percentile value of the HC group. Significant anxiety and depressive symptoms were reported by 31.1% and 18.0% of MS patients. 31.1% of PwMS reported significant fatigue. BICAMS test results were not associated with HADS or MFIS scores.

CONCLUSIONS
The Polish version of BICAMS is a valid and reliable tool for the assessment of cognitive impairment in patients with MS.


The apoptosis related proteins Bax, Bcl-2, and NF-kappaB were analyzed in sanguinarine induced apoptosis and blister cell death (BCD) of K562 erythroleukemia cells and in sanguinarine treated high Bcl-2 expressing JM1 pre-B lymphoblastic cells, utilizing immunofluorescence-flow cytometry. Sanguinarine induced apoptosis of K562 cells was found to have increased Bax expression and decreased NF-kappaB, whereas BCD showed a decrease in Bax expression and an increase in NF-kappaB. In contrast, high Bcl-2 expressing JM1 cells, when exposed to the same concentrations (and duration) of sanguinarine that induced PCD and BCD in K562 cells, failed to show the respective morphologies while showing a concomitant increase in Bcl-2. Results from studies with K562 cells suggest that Bax is pro-apoptotic and also that NF-kappaB activation may be associated with BCD. Results from studies with JM1 cells suggest that Bcl-2 is anti-apoptotic and anti-BCD. Results from JM1 cells strengthen the assumption in the literature of the central role Bcl-2 plays in chemoresistance by assuming an anti-PCD role. These results also suggest that, in JM1 cells, Bcl-2 may further complicate chemoresistance by being anti-BCD in nature, in addition to its anti-PCD role.


Because of wafer residency time constraints for cluster tools, it is very difficult to schedule them. This paper addresses their scheduling issues and conducts their schedulability and scheduling analysis. A Petri net (PN) model is developed to model them. With this model, to schedule a dual-arm cluster tool with wafer residency time constraints is to determine when and how long the robot should wait for. Based on the model, necessary and sufficient conditions under which the system is schedulable are presented. The conditions can be checked analytically. Meanwhile, an algorithm is developed for the optimal scheduling of dual-arm cluster tools. The algorithm finds an optimal periodic schedule with closed form expressions if it is schedulable. A method is also presented for the implementation of the obtained cyclic schedule by appropriately controlling the initial transient process. Examples are presented to show the application and power of the theory and algorithm.


In this article, the authors examine how the debate over women's executions during the nineteenth and early twentieth century funneled and in various ways processed the contrary demands of gender and capital justice. They show how encounters with capital punishment both reflected and reinforced dominant interpretations of womanhood and as such contributed to the intricate web of normative strictures that affected all women at the time. At the same time, however, the often heated debates that accompanied such cases pried open some of the contradictions inherent in the dominant interpretations and, as a result, came to challenge the boundaries that separated not only women from men but also women from each other. Rather than viewing gender as a unidirectional influence on capital punishment, the authors argue that gender is best approached as an evolving social category that gets reconstructed, modified, and transformed whenever it is implicated in social practices and public debates.


Monocular visual deprivation (MD) produces profound changes in the ocular dominance (OD) of neurons in the visual cortex. MD shifts visually evoked responses away from the deprived eye and toward domination by the open-eye. Over 30 years ago, two different theories were proposed to account for these changes: either through effects on excitatory visual drive, thereby shifting the balance of excitation in favor of the open-eye, or through effects on intracortical inhibition, thereby suppressing responses from the deprived eye. In the intervening years, a scientific consensus emerged that the major functional effects of MD result from plasticity at excitatory connections in the visual cortex. A recent study by Yazaki-Sugiyama et al. (2009) in mouse visual cortex appears to re-open the debate. Here we take a critical look at these intriguing new data in the context of other recent findings in rodent visual cortex.


Background: Forecasting is the process of predicting future behavior. In reviewing databases, no predicted value associated with international collaboration publications in Iran was found. Thus, the present study aimed at forecasting Iran's international collaborative articles in medical sciences. Methods: The number of Iran's articles and international collaborative articles in medical sciences written over 56 years was extracted from SCOPUS. Data were extracted from 1960 up to 2016. The time series method was used for forecasting using the Minitab software Version 17. Results: There was no increase in the number of medical articles from Iran from 1960 to 2001. However, the data showed incremental growth between 2001 and 2016. This was similar to Iran's medical sciences international collaboration articles. In 2016, the percentage of Iran's international collaboration articles was 15.2, which is expected to reach 19.9 in 2025. Conclusion: An investigation was performed on the number of international collaboration articles in the field of medical sciences in Iran. Future trends show an incremental growth. The number of Iran's articles can be increased with international cooperation. However, an increase or decrease in Iran's articles without international cooperation has to be investigated.


Phytophthora Clade 5 is a very poorly studied group of species of oomycete chromists, consisting of only two known species P. castaneae (≡ P. katsurae, nom. illegit .) and P. heveae with most isolates from East Asia and the Pacific Islands. However, isolates of two important disease-causing chromists in Clade 5, one of kauri ( Agathis australis ) in New Zealand, the other of coconut ( Cocos nucifera ) in Hawaii, poorly match the current species descriptions. To verify whether these isolates belong to separate species a detailed morphological study and phylogenetic analysis consisting of eight genetic loci was conducted. On the basis of genetic and morphological differences and host specificity, we present the formal description of two new species in Clade 5, Phytophthora agathidicida sp. nov . and Phytophthora cocois sp. nov . To clarify the typification of the other Clade 5 species, an authentic ex-holotype culture of Phytophthora castaneae is designated and P. heveae is lectotypified and epitypified.


Douglas Biber // Cambridge University Press, 1991 // Variation Across Speech and Writing // 0521425565, 9780521425568 // 299 pages // 1991 // Similarities and differences between speech and writing have been the subject of innumerable studies, but until now there has been no attempt to provide a unified linguistic analysis of the whole range of spoken and written registers in English. In this widely acclaimed empirical study, Douglas Biber uses computational techniques to analyze the linguistic characteristics of twenty-three spoken and written genres, enabling identification of the basic, underlying dimensions of variation in English. In Variation Across Speech and Writing, six dimensions of variation are identified through a factor analysis, on the basis of linguistic co-occurence patterns. The resulting model of variation provides for the description of the distinctive linguistic characteristic of any spoken or written text and demonstrates the ways in which the polarization of speech and writing has been misleading, and thus enables reconciliation of the contradictory conclusions reached in previous research. file download toda.pdf


This study proposes a method of robust regrasping an object using a dual-arm robot with general-purpose hands, which is robust against the error of grasping. In this paper, one arm is assigned to hand over the object to the other arm that is named a receiver arm. The grasping error must be considered to increase the success rate of the regrasping since a hand-over arm first picks up the object with the general-purpose hand. In an online phase, the proposed method performs object positioning at an optimal pose at the time of regrasping using an image-based visual servoing (IBVS) approach to reduce the effect of the grasping error. In the planning phase, the proposed method computes the optimal pose for regrasping by maximizing the minimum singular values of the image Jacobian of IBVS to achieve a high positioning accuracy using a 3D model of the target object. To achieve the regrasping objects with various shapes robustly against image noises and changes in light environments, the image Jacobian of IBVS is computed by numerical differential using an actual data set. A large number of data sets corresponding to each candidate grasp are usually required for computing the image Jacobian. To reduce the number of data sets, we propose a conversion method of the image Jacobian requiring only one data set corresponding to one representative grasp. The experimental results show that the proposed method achieves regrasping of target objects with the general-purpose hands with high success rates and performs target object positioning with less than 0.7[mm] positioning error.


This paper investigates the effect of financial development on income inequality in 20 African countries. Theory and a growing number of empirical studies suggest that the former exerts a negative impact on the latter by enabling low-income holders to undertake income-enhancing education and business investments, thereby promoting a tighter income distribution. However, using the share of GDP constituted by domestic credit to the private sector and broad money respectively as proxies for financial development, the results of this study fail to give significant evidence of this income-equalising effect. Given the heterogeneous nature of the economies studied here and the fact that data quality and quantity improve over time, it is believed that country-specific studies and future research can offer more conclusive results on how financial development influences income distribution in the African context. This would also provide a stronger foundation for policy recommendations in the continent's plight to address the persistent high levels of income inequality.


This Research Note presents the outcome of an investigation into the processes of lone-actor terrorism which was part of the Countering Lone-Actor Terrorism (CLAT) Project. The research is based on a database of both plots and attacks across the twenty-eight EU member states, plus Norway and Switzerland, in the period 1 January 2000 to 31 December 2014. The database covers more than 70 variables and includes information relating to 120 individuals. This Research Note outlines some of the key findings of the CLAT project pertaining to 1) attack methodology and logistics; 2) political engagement and online activity and 3) leakage and interactions with authorities. The results relating to the personal characteristics of lone-actor terrorists are presented in a different Research Note in this issue of Perspectives on Terrorism.


A Gram-stain-negative, motile by gliding, non-spore-forming and oval-shaped bacterial strain designated T1-10T was isolated from pine forest soil, and its taxonomic position was investigated using a polyphasic approach. Growth occurred at 10-37 °C (optimum, 30 °C), at pH 6-7 and in the presence of 0-1 % (w/v) (optimum, 0 %) NaCl. Flexirubin-type pigments were produced. On the basis of 16S rRNA gene sequence similarity, strain T1-10T was assigned to the genus Taibaiella of the phylum Bacteroidetes, and the most closely related species was Taibaiella koreensis THG-DT86T with 97.11 % sequence similarity, but the strain formed an independent lineage in the phylogenetic tree. The genomic DNA G+C content of strain T1-10T was 42.5 mol%. The main cellular fatty acids were iso-C15 : 1 G, iso-C15 : 0 and iso-C17 : 0 3-OH. The only isoprenoid quinone detected in the strain was MK-7, and the major polyamine was homospermidine. The major polar lipids were phosphatidylethanolamine and unidentified aminophospholipids. Strain T1-10T could be distinguished from related species by physiological and biochemical properties. Phenotypic and phylogenetic data supported that strain T1-10T represents a novel species of the genus Taibaiella, for which the name Taibaiella soli sp. nov. is proposed (type strain T1-10T=KCTC 42277T=JCM 31014T).


This paper assessed the current and mid-century trends in rainfall and temperature over the Mono River watershed. It considered observation data for the period 1981–2010 and projection data from the regional climate model (RCM), REMO, for the period 2018–2050 under emission scenarios RCP4.5 and RCP8.5. Rainfall data were interpolated using ordinary kriging. Mann-Kendall, Pettitt and Standardized Normal Homogeneity (SNH) tests were used for trends and break-points detection. Rainfall interannual variability analysis was based on standardized precipitation index (SPI), whereas anomalies indices were considered for temperature. Results revealed that on an annual scale and all over the watershed, temperature and rainfall showed an increasing trend during the observation period. By 2050, both scenarios projected an increase in temperature compared to the baseline period 1981–2010, whereas annual rainfall will be characterized by high variabilities. Rainfall seasonal cycle is expected to change in the watershed: In the south, the second rainfall peak, which usually occurs in September, will be extended to October with a higher value. In the central and northern parts, rainfall regime is projected to be characterized by late onsets, a peak in September and lower precipitation until June and higher thereafter. The highest increase and decrease in monthly precipitation are expected in the northern part of the watershed. Therefore, identifying relevant adaptation strategies is recommended.


The risks and benefits of diets and supplements containing the estrogenic soy isoflavone genistein are not well established. We report that 10 nm genistein potently induces the granzyme B inhibitor, proteinase inhibitor 9 (PI-9) in MCF-7 human breast cancer cells. By inducing PI-9, genistein inhibits the ability of human natural killer (NK) cells to lyse the target breast cancer cells. In ERalphaHA cells, stably transfected MCF-7 cells, which contain elevated levels of estrogen receptor-alpha (ERalpha), 100 pm genistein or 17beta-estradiol potently induce PI-9 and prevent NK cells from killing the target breast cancer cells. The concentrations of genistein that fully induce PI-9 in MCF-7 cells, and in ERalphaHA cells, are far lower than those previously reported to elicit estrogenic responses through ERalpha. Because 4-hydroxytamoxifen, raloxifene, and ICI 182,780/Faslodex all block genistein induction of PI-9 and elevated levels of ERalpha enhance induction of PI-9, genistein acts via ERalpha to induce PI-9. Increasing levels of ERalpha in breast cancer cells results in a progressive increase in induction of PI-9 by genistein and in the cell's ability to evade killing by NK cells. Moderate levels of dietary genistein and soy flour effectively induce PI-9 in human breast cancers grown in ovariectomized athymic mice. A significant population consumes levels of genistein in soy products that may be high enough to induce PI-9, perhaps potentiating the survival of some preexisting breast cancers by enabling them to evade immunosurveillance.


This paper poses the question, "what are providers' obligations to patients who lie?" This question is explored through the lens of a specific case: a 26–year–old woman who requests prophylactic bilateral mastectomy with reconstruction reports a significant and dramatic family history, but does not want to undergo genetic testing. Using a conversational–style discussion, the case is explored by a breast surgeon, genetic counselor/medical geneticist, clinical psychologist, chair of a hospital ethics committee and director of a clinical ethics consultation service.


The Industrial Internet of Things (IIoT) network generates great economic benefits in processes, system installation, maintenance, reliability, scalability, and interoperability. Wireless sensor networks (WSNs) allow the IIoT network to collect, process, and share data of different parameters among Industrial IoT sense Node (IISN). ESP8266 are IISNs connected to the Internet by means of a hub to share their information. In this article, a light-diffusion algorithm in WSN to connect all the IISNs is designed, based on the Peano fractal and swarm intelligence, i.e., without using a hub, simply sharing parameters with two adjacent IINSs, assuming that any IISN knows the parameters of the rest of these devices, even if they are not adjacent. We simulated the performance of our algorithm and compared it with other state-of-the-art protocols, finding that our proposal generates a longer lifetime of the IIoT network when few IISNs were connected. Thus, there is a saving-energy of approximately 5% but with 64 nodes there is a saving of more than 20%, because the IIoT network can grow in a 3n way and the proposed topology does not impact in a linear way but log3, which balances energy consumption throughout the IIoT network.


In this work, the notion of biorthogonal two-directional shortly supported wavelets with poly-scale is developed. A new method for designing two-directional biorthogonal wavelet packets is proposed and their properties is investigated by means of time-frequency analysis methodand, operator theory. The existence of shortly supported biorthogonal vector-valued wavelets associated with a pair of biorthogonal compactly supported vector-valued scaling functions is investigated. A new method for designing a class of biorthogonal shortly supported vector-valued wavelet functions is presented by using multiresolution analysis and matrix theory.


Significant progress has been made both in experimentation and in theoretical modeling of scanning probe microscopy. The theoretical models used to analyze and interpret experimental scanning probe microscope (SPM) images and spectroscopic data now provide information not only about the surface, but also the probe tip and physical changes occurring during the scanning process. The aim of this review is to discuss and compare the present status of computational modeling of two of the most popular SPM methods-scanning tunneling microscopy and scanning force microscopy-in conjunction with their applications to studies of surface structure and properties with atomic resolution. In the context of these atomic-scale applications, for the scanning force microscope (SFM), this review focuses primarily on recent noncontact SFM (NC-SFM) results. After a brief introduction to the experimental techniques and the main factors determining image formation, the authors consider the theoretical models developed for the scanning tunneling microscope (STM) and the SFM. Both techniques are treated from the same general perspective of a sharp tip interacting with the surface-the only difference being that the control parameter in the STM is the tunneling current and in the SFM it is the force. The existing methods for calculating STM and SFM images are described and illustrated using numerous examples, primarily from the authors' own simulations, but also from the literature. Theoretical and practical aspects of the techniques applied in STM and SFM modeling are compared. Finally, the authors discuss modeling as it relates to SPM applications in studying surface properties, such as adsorption, point defects, spin manipulation, and phonon excitation.


Spartanamicins A and B, two antifungal antibiotics, were produced by a culture of Micromonospora spp. strain No. MSU-43097 (ATCC 53803), isolated from a potted soil containing asparagus (Asparagus officinalis L.) plants. The antibiotics were isolated from the mycelial cake using organic solvents. The structures of spartanamicins A and B were determined by spectral and chemical means. Spartanamicin B is more active as an antifungal compound than it's analogue, A. The minimum inhibitory concentration for spartanamicin B on Candida albicans and Aspergillus, Cladosporium, Cryptococcus, Rhodotorula and Staphylococcus spp. ranged from 0.2 to 1 microgram/ml. It was not active against Staphylococcus aureus, Escherichia coli and Citrobacter spp. but some strains of S. aureus were sensitive.


Advances in Virus Research. Volume I. Edited by Kenneth M. Smith and Max A. Lauffer. (Pp. 362; illustrated. $8.) New York: Academic Press Inc. 1953. The problem of keeping abreast of the literature of any subject these days is one with which everyone engaged in medical research is only too familiar, but it is probably true to say that virus workers face this problem in its most acute form. Viruses are the cause of disease in animals and plants as well as in man; they are susceptible of investigation by a variety of scientific disciplines and their literature is widely scattered through a large number of journals. It is difficult, therefore, for the virus worker to keep himself widely informed of what is happening in all fields of virology, and it is with a view to remedying this that Advances in Virus Research is being produced. It is planned to publish in successive volumes authoritative review articles on all important aspects of virus research, and it can safely be predicted that if the standard set by Volume I is maintained in the rest of the series the editors will have amply achieved their object. This volume begins with an article on the properties of the bacteriophage by H. T. Epstein which is especially valuable, since these viruses and their bacterial hosts have been used extensively for the study of problems concerned with host-virus relationship and in particular the nature of virus multiplication ; in fact our views on this latter question have been largely coloured by the findings obtained with the bacteriophage. The interaction between viruses and virus strains, which include the interference phenomenon, is considered by C. W. Bennett ; there is much of interest here, even though the illustrative examples are drawn almost exclusively from plant pathology. Another section by a plant pathologist is on the role of leaf hoppers in the transmission of plant viruses by L. M. Black, and, following this, G. H. Bergold provides a most instructive and beautifully illustrated account of insect viruses. This is of particular value, since there is probably no aspect of virology of which those who work with animal viruses are more ignorant. It is interesting to note how these viruses resemble the influenza viruses in the possession of both spherical and rod forms ; it is also of interest that the author seems in no doubt as to the nature of these insect viruses-for him they are micro-organisms. Of the viruses peculiar to man those of influenza and poliomyelitis find a place in this volume. Henle writes of the multiplication of influenza virus, and a first-class article it is. It is, of course, well known that a great deal of the work on this subject has been done by Henle and his colleagues, so the excellence of this particular section is not surprising. What is particularly attractive about it is the detached and unbiased way in which the author examines the evidence and draws his conclusions, which is by no means invariably the case in writings on this highly controversial subject. A most valuable article on poliomyelitis comes from J. L. Melnick, who has been in the forefront of research on this disease and its causal viruses during the last ten years or so. The volume is completed by a section on the purification and properties of animal viruses contributed by Dr. Gordon Sharp, and a short but most interesting account of virus nucleic acids by Roy Markham. S. P. BEDSON.


Observations of the Martian planetary boundary layer lead to interpretations that are baffling and contradictory. In this paper, we specifically address the question of whether or not water vapor finds a substantial diurnal reservoir in the Martian regolith. To address this issue, we have measured H20 adsorption kinetics on SWy-1, a Na-rich montmorillonite from Wyoming. The highest-temperature (273 K) data equilibrates rapidly. Data gathered at realistic HzO partial pressures and temperatures appropriate to early morning show two phenomena that preclude a significant role for smectites in diurnally exchanging a large column abundance. First, the equilibration timescale is longer than a sol. Second, the equilibrium abundances are a small fi-action of that predicted by earlier adsorption isotherms. The explanation for this phenomenon is that smectite clay actually increases its surface area as a function of adsorptive coverage. At Mars-like conditions, we show that the interlayer sites of smectites are likely to be unavailable.


Most research in customer asset management has focused on specific aspects of the value of the customer to the company. The purpose of this article is to propose an integrated framework ? called CUSAMS -- that enables service organizations to comprehensively assess the value of their "customer assets" and to understand the influence of marketing instruments on them. The foundation of the CUSAMS framework is a careful specification of key customer behaviors that reflect the length, depth and breadth of the customer-service provider relationship: duration, usage, and cross-buying. This framework is the starting point for a set of theoretically based propositions regarding how marketing instruments influence customer behavior within the relationship, thereby influencing customer value. Then, building on prior research, we provide two empirical examples of how the CUSAMS framework can be used to conduct financial analyses of the return on investment from marketing expenditures designed to influence behavior and increase the value of the customer base. The framework and propositions provide the impetus for a research agenda that identifies critical issues in customer asset management


In this paper, we present a toolbox for structured model reduction developed for MATLAB. In addition to structured model reduction methods using balanced realizations of the subsystems, we introduce a numerical algorithm for structured model reduction using a subgradient optimization algorithm. We briefly present the syntax for the toolbox and its features. Finally, we demonstrate the applicability of various model reduction methods in the toolbox on a structured mass-spring mechanical system.


This paper describes an improved conformable composite array structure, for use in the NDE of irregular surfaces featuring efficient piezocomposite elements as the active array elements and soft polymer phase channels between elements. As each array element is in principle an individual piezocomposite, this device has been named a Composite Element Composite Array Transducer (CECAT). Finite Element (FE) virtual prototyping work identified two possible arrangements for the active phase incorporating either a periodic 1-3 composite or a random piezoceramic fibre structure with examples of both presented. Theoretical simulations and experimental measurements of impedance, surface displacement and mechanical cross talk demonstrate good correlation at an operational frequency of 2 MHz. The CECAT shows superior flexibility and acoustic characteristics over similar piezo-platelet arrangements and comparable sensitivity and bandwidth with a regular 1-3 composite. Enhancement of the piezoelectric performance of each array element is possible through implementation of a dual polymer passive phase configuration


: Purpose: In this paper Data Envelopment Analysis will be applied to investigate the technical efficiency of 196 Heath Centers in Greece. The analysis is referred at their efficiency in the year 2018. Design/Methodology/Approach: Data were collected by the Ministry of Health and were analyzed by performing quality tests to ensure validity and avoid bias. The method used is the non-parametric Data Envelopment Analysis and more specifically the input-oriented, one-stage VRS model. Tobit regression analysis was performed to analyze the effect of the Health Region in the efficiency of the Health Centers. Findings: The results of the paper indicate the efficient Health Centers in Greece, which construct the efficient frontier. The inefficient Health Centers in Greece lie beneath the efficient frontier. Moreover, the 196 Health Centers included in the research were classified depending on the Health Region they belong to, to investigate the effect of the Health Regions in the efficiency measured. Practical Implications: This study highlights the importance of measuring the efficiency of Primary Health Care. Taking into consideration the contribution of Health Centers to the National Health System, the results may be used as a guide for improvements for the efficiency of the Health Centers. Originality/Value: The research focus on the underestimated field of Primary Health Care and its importance. The application of Data Envelopment Analysis combined with the Tobit Regression Model reveals a new approach for measuring the efficiency.


Malaria is a major cause of morbidity and mortality in Mozambique. Approximately 6 million cases are reported each year. Malaria accounts for approximately 40 percent of all outpatient visits and 60 percent of pediatric hospital admissions. It is the leading cause of death among children admitted to pediatric services. Malaria transmission takes place year round with a seasonal peak extending from December to April. More than 18.5 million people in Mozambique are considered to be at-risk of malaria, including an estimated 3.6 million children less than 5 years old and almost 1 million pregnant women (13). The Presidential Malaria Initiative (PMI) -supported Malaria Indicator Survey, conducted in 2007, found the national prevalence of malaria parasitemia among children 6 to 59 months old to be 38.5 percent, with a range by province from 60.4 percent in Nampula to less than 10 percent in Maputo. Among pregnant women, the parasite prevalence was 16.3 percent, with 30.1 percent of women in their first pregnancy demonstrating parasites on blood slides (11).


Non-orthogonal multiple access (NOMA) and millimeter wave (mmWave) are two key enabling technologies for the fifth-generation (5G) mobile networks and beyond. In this paper, we consider uplink communications with a hybrid beamforming structure and focus on improving the spectral efficiency (SE) and energy efficiency (EE) of mmWave multiple-input multiple-output (MIMO)-NOMA systems with enhanced user grouping and power allocation. It is noted that the optimization of the SE/EE is a challenging task due to the non-linear programming nature of the corresponding problem involving user grouping, beam selection, and power allocation. Our idea is to decompose the overall optimization problem into a mixed integer problem comprised of user grouping and beam selection only, followed by a continuous problem involving power allocation and digital beamforming design. Exploiting the directionality property of mmWave channels, we first propose a novel initial agglomerative nesting (AGNES) based user grouping algorithm by taking advantage of the channel correlations. To avoid the prohibitively high complexity of the brute-force search approach and to address the overlapping beam problem, we propose two suboptimal low-complexity user grouping and beam selection schemes, the two-stage direct AGNES (D-AGNES) scheme and the joint successive AGNES (S-AGNES) scheme. We also introduce the quadratic transform (QT) to recast the non-convex power allocation optimization problem into a convex one subject to a minimum required data rate of each user. The continuous problem is solved by iteratively optimizing the power and the digital beamforming. Extensive simulation results have shown that our proposed mmWave-NOMA design outperforms the conventional orthogonal multiple access (OMA) scenario and the state-of-art NOMA schemes.


Abstract The transient cavity dynamics during water entry of a heavy, non-rotating sphere impacting a rotating pool of liquid is studied experimentally, numerically and theoretically. We show that the pool rotation advances the transition of the cavity type – from deep seal to surface seal – marked by a reduction in the transitional Froude number. The role of the dimensionless rotational number $\mathcal {S} \equiv \omega R_0/U_0$ on the transient cavity dynamics is unveiled, where $R_0$ is the sphere radius, $\omega$ the angular speed of the liquid and $U_0$ the impact velocity. The rotating background liquid has two discernible effects on the cavity evolution. Firstly, an increase in the underwater pressure field due to centripetal effects; and secondly, a reduction in the pressure of airflow in the cavity neck near the water surface. The non-dimensional pinch-off time of the deep seal shows a robust $1/2$ power-law dependence on the Froude number, but with a reducing prefactor for increasing $\omega$. Our findings reveal that the effects of a rotating background liquid on the water entry can be traced back to the subtle differences in the initial stage splash and the near-surface cavity dynamics.


ABSTRACT Cladosporium omanense has been recently described as a novel endophytic fungus from Zygophyllum coccineum in the desert habitat of Oman. The ability of this fungus to suppress Pythium aphanidermatum, the cause of cucumber and radish damping-off disease, was investigated. In vitro results showed effective suppression of P. aphanidermatum by C. omanense, producing an inhibition zone of 3.67 mm in dual culture assay. Light microscope and scanning electron microscope examination showed abnormalities in Pythium hyphae at the inhibition zone. The culture filtrate from C. omanense induced cellular leakage from Pythium mycelium and inhibited oospore production. A bioassay test was further conducted to examine the ability of C. omanense in suppressing P. aphanidermatum-induced damping-off disease of cucumber. It showed that C. omanense significantly increased the percent surviving cucumber seedlings up to 58.9%. Similarly, the addition of C. omanense significantly increased the percent surviving radish seedlings up to 80.4%. The in vivo and in vitro suppression effects of C. omanense were mainly due to the production of cellulase, β-1,3-glucanases and siderophores in the culture filtrate of C. omanense. This is the first report describing the biocontrol efficacy of C. omanense, especially in suppressing P. aphanidermatum-induced damping-off of cucumber and radish.


This article introduces the elements that we replaced together in order to achieve a decisional technology that can offer trust. Thus, we refer to it as Decisional Trust. Enhancing a decisional knowledge system with trust means that the user relies on what the system knows and that the system possesses a qualified reliance on received knowledge. Our proposal works in two fronts:(i) the construction of Reflexive Ontologies; and (ii)the construction of Decisional DNA. Then, we add trust models in order to gain certainty based upon the past decisional experience, and just until then, we can refer to the system as a Decisional Trust System. Additionally, an augmented reality (AR)maintenance system is improved by adding the elements of decisional trust. This framework improves the quality of decision-making, and advances the notion of administering trustable knowledge in the current decision making environment.


In the two decades since the 1993 launch of the widely followed Chicago Board Options Exchange (CBOE) Volatility Index (VIX), dozens of new volatility indexes have been introduced. This article provides an overview of 30 volatility-related indexes; 25 of the indexes are indicators that gauge investor sentiment regarding expected volatility of traded instruments such as commodities, interest rates, currencies, or worldwide stock indexes, and 5 indexes are designed to serve as benchmarks for investable performance of strategies that use VIX futures or options. Volatility indexes are used as market signals in asset allocation programs. Over the past 14 years, many investors have struggled to cope with multiple bear markets for stocks, higher correlations among many investments, and lower risk-adjusted returns for their portfolios. Investors now use long-volatility strategies with the goal of diversifying their portfolios and short-volatility strategies with the goal of enhancing risk-adjusted returns. Increased interest in volatility indexes is reflected by the fact that average daily volume for VIX options rose from 23,491 contracts in 2006 to 442,959 in 2012.


Abstract Objective To develop and evaluate an adjusted score for the multi-biomarker disease activity (MBDA) test to account for the effects of age, sex and adiposity in patients with RA. Methods Two models were developed to adjust MBDA score for age, sex and adiposity, using either serum leptin concentration or BMI as proxies for adiposity. Two cohorts were studied. A cohort of 325 781 RA patients who had undergone commercial MBDA testing and had data for age, sex and serum leptin concentration was used for both models. A cohort of 1411 patients from five studies/registries with BMI data was used only for the BMI-adjusted MBDA score. Univariate and multivariate linear regression analyses evaluated the adjusted MBDA scores and conventional clinical measures as predictors of radiographic progression, assessed in terms of modified total Sharp score (ΔmTSS). Results Two models were developed, based on findings that MBDA score was higher in females than males and increased with age, leptin concentration and BMI. In pairwise regression analyses, the leptin-adjusted (P = 0.00066) and BMI-adjusted (P = 0.0027) MBDA scores were significant independent predictors of ΔmTSS after adjusting for DAS28-CRP, whereas DAS28-CRP was not, after adjusting for leptin-adjusted (P = 0.74) or BMI-adjusted (P = 0.87) MBDA score. Moreover, the leptin-adjusted MBDA score was a significant predictor of ΔmTSS after adjusting for the BMI-adjusted MBDA score (P = 0.025) or the original MBDA score (0.027), whereas the opposite was not true. Conclusion Leptin-adjusted MBDA score significantly adds information to DAS28-CRP and the original MBDA score in predicting radiographic progression. It may offer improved clinical utility for personalized management of RA.


Technology is revolutionizing both our personal and professional lives. Advances in technology have revolutionized the way in which people work, communicate, and the way they live-simplifying and streamlining every profession and activity. The tasks of many can now be done by a few or even a single person. Automation is pervasive in our daily lives. Technology has also made collaboration an integral part of our daily lives, enabling virtual communities to instantly share all types of information across the globe in very simple ways. However, this simplification masks another fact visible to those who work in the information technology (IT) field- technology is also becoming increasingly complex. Have you ever considered the complexity of the technology that sits behind your "hi" in an instant message, or the sharing of a smiley face, or a "simple" tweet? With this complexity comes increased risk of failure, of skyrocketing deployment and maintenance cost, and of user dissatisfaction. Managing the risks of ever-more complex implementations of new technology is essential to realizing the benefits of increased productivity, simplification of daily life activities, and improved communication and collaboration.


We present a detailed investigation into the sensitivity of long-period fiber gratings (LPFGs) as a function of temperature, strain, and surrounding refractive index, with particular attention to the higher order cladding modes and the possibilities for ultrasensitive sensors. From a general theoretical analysis, we identify a general sensitivity factor which offers new physical insight into LPFG behavior and represents a useful design aid in conjunction with a set of measurand-specific sensitivity factors. Our analysis reveals the existence of turning points in the mode dispersion characteristics at which ultrasensitive operation may be obtained. In an extensive set of coordinated experiments, we verify the theoretical predictions with close agreement and provide demonstrations of the device behavior close to the turning points. Alternative sensor schemes for temperature, strain, and refractive index based, respectively, on measurement of the dual resonance characteristic of the modes and on the transmission characteristics close to the turning points, utilizing higher order modes of the LPFG, are presented. For two variables at least, we record the highest LPFG sensitivities yet reported.


The lattice constants of the y and y' phases of nickel base superalloys have been modelled using a neural network within a Bayesian framework, The analysis is based on datasets compiled from new experiments and the published literature, the parameters being expressed as a non-linear function of some eighteen variables which include the chemical composition and temperature. The analysis permits the estimation of error bars whose magnitude depends on their position in the input space, Of the many models possible, a "committee of models" is found to give the most reliable estimate. The method is demonstrated to be consistent with known metallurgical trends and has been applied towards the study of some experimental alloys.


Guide running is an activity where a blind or partially sighted (BPS) runner is assisted by a sighted guide who helps them move through an environment safely and efficiently at speed. This complex act has very little published research or supporting information on it and yet people are developing tools to aid the BPS community to run independently. This thesis aims to develop the foundation knowledge of guide running and the specifications for independent running on a 400m running track. A series of studies were conducted to investigate the complexities of guide running and to evaluate whether any specific methods could be devised to support a BPS person to run independently. The first study involved interviews with various stakeholders in guide running and utilised thematic coding to understand the challenges that BPS runners face. The findings showed the additional roles the guides take on including coaching, motivation, and tactical choices. It also revealed barriers into the sport such as the need to find multiple guides and the importance of being able to navigate networks and develop contacts.The second study observed guide running pairs around a 400m running track to understand how physical and verbal feedback work together to create the guide running experience. Pairs were recorded running five unique laps altering factors such as hand preference, verbal cues, and tactile cues. Each run was analysed using the following tools: A modified NASA TLX to understand mental workload and safety perceptions; TRACEr lite RETRO to understand errors during guidance; and examining audio transcripts with motion capture data. The findings revealed the value of communication, how reassurance acts as a key tool within guide running and helped define the roles audio and tactile feedback have within it. Notably, guidance with only verbal cues was an enjoyable experience despite preconceptions of the difficulty of the task, especially for those who lost their sight later in life. It was uncertain if the verbal only guidance was successful because the runner could also hear the footsteps of their guide as they ran alongside them. The third and final study gradually removed the guide's input over a series of laps, replacing it with verbal guidance received from a researcher cycling behind them. It was found that verbal guidance was possible without the physical presence of the guide for the majority of people. Some encountered a learning curve that seemed to be linked to the runner's interpretation of the instructions given and their personal spatial imagery of the environment. This study also interviewed the runners and guides to get their opinions on independent running tools and the types of research that would benefit guide running. The findings of all three studies are drawn together as part of a discussion to build a holistic image of guide running, examining the psychology and mechanics. It also presents a model explaining how guide running can be done around a 400m running track and delivers the first specifications for technology to guide someone independently around a track.


Gold is a noble metal, and it is commonly used because of its resistance to oxidation and electrical, magnetic, and physical properties. Forming gold into nanoparticles allows researchers to use gold in areas that are too small for bulk gold to reach and brings with it new capabilities. Gold nanoparticles have been utilized for centuries by artists due to the vibrant colors produced by their interaction with visible light. Gold nanoparticles, exhibit good chemical stability, and they can be surface functionalized with almost every type of electron-donating molecule including biomolecules. Gold nanoparticles are undoubtedly very versatile. Gold nanoparticles have played an important and severe role in medicine since ancient times. Also, gold nanoparticle is the most suitable for drug delivery applications. Drug delivery using gold nanoparticles, in combination with their intrinsic capability for photothermal therapy, should be explored in the future.


BACKGROUND
Chronic kidney disease (CKD) is common, particularly in those of advanced age. Because patients with CKD frequently have cardiac comorbidities and acute or chronic symptoms that may represent heart failure or an acute myocardial infarction (AMI), testing for concentrations of cardiac troponins and natriuretic peptides is frequent. Interpretation of these biomarkers can be challenging when differentiating acute from chronic processes, potentially resulting in missed opportunities to direct appropriate treatment.

CONTENT
This review is designed to provide clinicians and laboratorians a platform to understand cardiac specific biomarker interpretation in patients with CKD by summarizing the extensive literature base that has developed specific to this population. First we review the epidemiology and unique contributions of CKD to cardiac pathophysiology. Next we consider the interpretation of cardiac troponin tests for the diagnosis AMI and the prognostic significance of chronic increases across the spectrum of CKD including those requiring renal replacement therapy. Last, we consider the caveats of interpreting natriuretic peptide results for the diagnosis of acute decompensated heart failure in addition to the short- and long-term prognostic implications of increased natriuretic peptide concentrations and CKD in a patient with heart failure.

SUMMARY
CKD is common and associated with acceleration of cardiovascular disease. Cardiac biomarker concentrations are often increased even in an absence of symptoms; typically reflecting the extent of underlying cardiovascular disease rather than impairment of renal clearance. Thoughtful interpretation of cardiac biomarkers in those with CKD can continue to provide important diagnostic and prognostic information.


ifferentiated thyroid cancer (DTC), in which histologic examination often reveals evidence of lymphocytic infiltration at the edges of the tumour, is a good model for the interaction between human cancer and the immunocompetent host immune system. Materials and Methods: We tested sera from patients with DTC for cytotoxicity against cultured human thyroid, eye muscle and K562 cells in antibody-dependent cell mediated cytotoxicity (ADCC) and natural killer (NK) cell cytotoxicity assays. Results: When cultured thyroid cells were used as targets in ADCC assay, specific cytotoxicity was increased (% specific lysis > mean + 2SD for normals) in only 2 out of 30 patients with DTC but decreased (% specific lysis < mean + 2SD for normals) in 19 patients and mean for the group was significantly less than that for the normals. The same effect was observed using human eye muscle cells as targets in an ADCC assay. Serum from patients with DTC, but not those from normal subjects, inhibited the ADCC activity against normal thyroid cells in serum from patients with Graves' disease, in a dose dependent manner. Serum from patients with thyroid cancer inhibited natural cytotoxicity against human K562 cells while normal serum did not. Pretreatment of normal PBMC with pooled serum from patients with DTC abolished natural cytotoxicity against K562 cells whereas pooled normal serum had no significant effect. Conclusion: This phenomenon reflected inhibition of the natural cytotoxicity mediated by (NK) cells in the mixed peripheral blood mononuclear cells (PBMC) population by an unknown serum factor or factors. We confirmed this by performing experiments using sera from patients with DTC, human K562 cells as targets in NK cell assay and PBMC from normal subjects as source of NK cells. The inhibitory factor, which probably works at the level of the NK cells and is called natural cytotoxicity blocking factor (NKBF), may be a marker for invasive thyroid cancer, although this needs to be addressed in further studies.


Abstract. Managing uncertainty is fundamental to geoscience practice, yet geoscience education generally does not incorporate explicit instruction on uncertainty. To the extent that students are exposed to scientific uncertainty, it is through in-person field experiences. Virtual field experiences – which rely on pictures, maps, and previously collected measurements – should therefore explicitly address uncertainty or risk losing this critical aspect of students' experience. In this paper we present a framework for teaching students to assess and communicate their uncertainty, which is grounded in best expert practices for conveying uncertainty and familiar terms-of-art in geology. The starting point of our framework is the recognition of uncertainty in both geologic data and models, the latter of which we use as an encompassing term to refer to potential geological processes and structures inferred on the basis of incomplete information. We present a concrete application of the framework to geological mapping and discuss how it could enhance student learning in both traditional in-person and virtual experiences. Our framework is extensible in that it can be applied to a variety of geologic features beyond those where uncertainty is traditionally assessed, and can also be applied to geological subdisciplines.


Periurban forests are key to offsetting anthropogenic carbon emissions, but they are under constant threat from urbanization. In particular, secondary Neotropical forest types in Andean periurban areas have a high potential to store carbon, but are currently poorly characterized. To address this lack of information, we developed a method to estimate periurban aboveground biomass (AGB)—a proxy for multiple ecosystem services—of secondary Andean forests near Bogota, Colombia, based on very high resolution (VHR) GeoEye-1, Pleiades-1A imagery and field-measured plot data. Specifically, we tested a series of different pre-processing workflows to derive six vegetation indices that were regressed against in situ estimates of AGB. Overall, the coupling of linear models and the Ratio Vegetation Index produced the most satisfactory results. Atmospheric and topographic correction proved to be key in improving model fit, especially in high aerosol and rugged terrain such as the Andes. Methods and findings provide baseline AGB and carbon stock information for little studied periurban Andean secondary forests. The methodological approach can also be used for integrating limited forest monitoring plot AGB data with very high resolution imagery for cost-effective modelling of ecosystem service provision from forests, monitoring reforestation and forest cover change, and for carbon offset assessments.


Our societal needs for greener, economically viable products and processes have grown given the adverse environmental impact and unsustainable development caused by human activities, including chemical releases, exposure, and impacts. To make chemical processes safer and more sustainable, a novel sustainability-oriented control strategy is developed in this work. This strategy enables the incorporation of online sustainability assessment and process control with sustainability constraints into chemical process operations. Specifically, U.S. Environmental Protection Agency (EPA)'s GREENSCOPE (Gauging Reaction Effectiveness for the ENvironmental Sustainability of Chemistries with a multi-Objective Process Evaluator) tool is used for sustainability assessment and environmental release minimization of chemical processes. The multivariable GREENSCOPE indicators in real time can be represented using a novel visualization method with dynamic radar plots. The analysis of the process dynamic behavior in terms of sustainability performance provides means of defining sustainability constraints for the control strategy to improve process sustainability aspects with lower scores. For the control tasks, Biologically Inspired Optimal Control Strategy (BIO-CS) is implemented with sustainability constraints so that the control actions can be calculated considering the sustainability performance. This work leads to a significant step forward towards augmenting the capability of process control to meet future demands on multiple control objectives (e.g., economic, environmental, and safety related). The effectiveness of the proposed framework is illustrated via two case studies associated with a fermentation system. The results show that the proposed control strategy can effectively drive the system to the desired setpoints while meeting a preset sustainability constraint and improving the transient sustainability performance by up to 16.86% in terms of selected GREENSCOPE indicators.


Dusty plasmas are ubiquitous in low-temperature laboratory discharges as well as in the near-earth environment, planetary rings, and interstellar spaces. In this paper, updated knowledge of fundamentals of collective dust-plasma interactions and several novel phenomena are presented that have been observed in laboratories and in space dusty plasmas. Mechanisms that are responsible for the charging of dust grains are discussed, and the fact that the dust charge perturbation is a new dynamical variable in a dusty plasma. The underlying physics of different forces that act on a charged dust grain is reviewed. In dusty plasmas, there are new attractive forces (e.g., due to wakefield and ion focusing effects and dipole-dipole interactions between unevenly charged dust rods). Furthermore, in the presence of an ensemble of charged dust grains, there are collective dust-plasma interactions featuring new waves (e.g., the dust acoustic wave, the dust ion-acoustic wave, the dust lattice wave, etc.), new instabilities, and coherent nonlinear structures (dust acoustic and dust ion-acoustic shocks, dust voids, and dust vortices), which are also discussed. Theoretical models for numerous collective dust-plasma interactions are compared with existing observations from laboratories and space environments.


Nonprofits are increasingly engaged in efforts to develop collective self-regulation systems. These efforts stem in part from of growing pressure on nonprofits to demonstrate accountability and transparency. In spite of the growth in such initiatives, however, little research examines self-regulation in a systematic way across settings, resulting in minimal accumulation of knowledge on the factors underlying the emergence, structure and effectiveness of self-regulation. This minisymposium addresses this gap by taking a comparative perspective on self-regulation initiatives in three regions: sub-Saharan Africa, Asia, and Europe. The introduction sets the stage for the three papers by providing a common framework and typology for understanding self-regulatory initiatives and outlining the theoretical frameworks applied in the empirical papers. The three papers that follow examine the commonalities and differences in the forms that emerge across these three regions.


This is the first quantitative analysis of mechanical reliability of all-solid state batteries. Mechanical degradation of the solid electrolyte (SE) is caused by intercalation-induced expansion of the electrode particles, within the constrains of a dense microstructure. A coupled electro-chemo-mechanical model was implemented to quantify the material properties that cause an SE to fracture. The treatment of microstructural details is essential to the understanding of stress-localization phenomena and fracture. A cohesive zone model is employed to simulate the evolution of damage. In the numerical tests, fracture is prevented when electrode-particle's expansion is lower than 7.5% (typical for most Li-intercalating compounds) and the solid-electrolyte's fracture energy higher than Gc = 4 J m−2. Perhaps counter-intuitively, the analyses show that compliant solid electrolytes (with Young's modulus in the order of ESE = 15 GPa) are more prone to micro-cracking. This result, captured by our non-linear kinematics model, contradicts the speculation that sulfide SEs are more suitable for the design of bulk-type batteries than oxide SEs. Mechanical degradation is linked to the battery power-density. Fracture in solid Li-ion conductors represents a barrier for Li transport, and accelerates the decay of rate performance.


The cell adhesion molecule (CAM) L1 plays crucial roles in axon growth in vitro and in the formation of major axonal tracts in vivo. It is generally thought that CAMs link extracellular immobile ligands with retrogradely moving actin filaments to transmit force that pulls the growth cone forward. However, relatively little is known about the fate of CAMs that have been translocated into the central (C)-domain of the growth cone. We have shown previously that L1 is preferentially endocytosed at the C-domain. In the present study, we further analyze the subcellular distribution of endocytic organelles containing L1 at different time points and demonstrate that internalized L1 is transported into the peripheral (P)-domain of growth cones advancing via an L1-dependent mechanism. Internalized L1 is found in vesicles positioned along microtubules, and the centrifugal transport of these L1-containing vesicles is dependent on dynamic microtubules in the P-domain. Furthermore, we show that endocytosed L1 is reinserted into the plasma membrane at the leading edge of the P-domain. Monitoring recycled L1 reveals that it moves retrogradely on the cell surface into the C-domain. In contrast, the growth cone advancing independently of L1 internalizes and recycles L1 within the C-domain. For the growth cone to advance, the leading edge needs to establish strong adhesive interactions with the substrate while attachments at the rear are released. Recycling L1 from the C-domain to the leading edge provides an effective way to create asymmetric L1-mediated adhesion and therefore would be critical for L1-based growth cone motility.


Quantum wells, alternate thin layers of two different semiconductor materials, show an exceptional electric field dependence of the optical absorption, called the quantum-confined Stark effect (QCSE), for electric fields perpendicular to the layers. This enables electrically controlled optical modulators and optically controlled self-electro-optic-effect devices that can operate at high speed and low energy density. Recent developments in these QCSE devices are summarized, including new device materials and novel device structures. The variety of sophisticated devices now demonstrated is promising for applications to information processing.


Abstract Our health care system is constantly adapting to change at an increasingly rapid pace. Unavoidably, this also applies to the field of medical education. As a result, clinical teaching teams face the challenging task of successfully implementing the proposed changes in daily practice. It goes without saying that implementing change takes time and that you need to be patient. However, a successful change process needs more than that. Change models or strategies could offer a helping hand. The questionnaire Specialty training's Organizational Readiness for curriculum Change (STORC) is a tool aiming to do just that. With a focus on readiness for change, this questionnaire tries to support implementation efforts in PGME. Additionally, since change is a team effort, it focusses on clinical teaching teams particularly. In this paper, we offer a practical guide for clinical teaching teams on how to deal with any concerns or hurdles detected in any of the core elements of readiness for change, in order to smoothen and support the educational change processes these teams are confronted with.


Al–Si alloy-based composites are widely used in automotive, aerospace and mineral processing industries with improved properties. In situ techniques have been developed to fabricate Al–Si alloy-based composites, which can lead to better adhesion at the interface and hence better mechanical properties. Al–Si alloy reinforced with in situ TiB2 particles was synthesized successfully by using salt reaction route. These in situ composites have shown significant improvement in mechanical properties compared with the base alloy. The wear resistance of the alloy is also significantly improved with the addition of TiB2 particles. The hardness, strength and wear resistance are strengthened with increasing TiB2 content of the composites. TiB2 can act not only as a grain refiner for primary Al but also as a modifier of Si in eutectic mixture. Analysis of the worn surface of Al–Si/TiB2 composites tested under loads of 30 and 110N suggests that ploughing is predominant at lower loads and delamination is predominant at higher loads.


The Kodály-concept is often associated with the relative solfa and choir singing. Both are important features, although the concept involves variable forms of activities. Being a member of the academic staff at the University in Győr, I have had the opportunity to teach methodology for primary school teachers as well as keyboard skills and solfeggio to professional instrumentalists at university level. In the course of my research conducted among my students at the Faculty of Arts of Széchenyi University, I experienced that the difference in the background of primary school music education might influence the development of future musical competences. Due to the limitations of this paper, I will focus on competences which may have an effect on being an accomplished chamber musician.


As part of a larger study titled "Integration Trajectories of Immigrant Families", this literature review looked at who provides support for newcomer settlement and integration, and how they are funded. The reviewed studies assessed why support was important, whether the existing supports were sufficient, and what else could be done. Beyond formal and informal support specific to newcomer integration, housing and health were identified as two areas of critical need and as important points of comparison with non-immigrant Canadians. Common across the paper's three sections on settlement supports, housing, and health were the grey areas pertaining to the service mandates of programs and departments; the coping mechanisms that newcomers and their allies develop to make integration happen; and the barriers to accessing services that include discrimination and differential incorporation. It is recommended that future studies should focus on how different migration pathways affect housing and healthcare needs. They should ask how communities can tailor support to the diverse needs of families, consider how informal community support is leveraged by the government, and examine the ways in which established immigrants facilitate the orientation and integration of more recent newcomer families.


The Carboniferous was the time of the assembly of Pangaea by the collision of the Gondwanan and Larussian supercontinents, and the principal interval of the late Paleozoic ice ages. These tectonic and climatic events caused dramatic sea-level fluctuations and climate changes and produced a Carboniferous world that was diverse topographically and climatologically, perhaps only rivalled in that diversity by the late Cenozoic world. Furthermore, the Carboniferous was a time of the accumulation of vast coal deposits of great economic and societal significance. The temporal ordering of geological and biotic events during Carboniferous time thus is critical to the interpretation of some unique and pivotal events in Earth history. This temporal ordering is based on the Carboniferous timescale, which has been developed and refined for nearly two centuries. This book reviews the history of the development of the Carboniferous chronostratigraphic scale and includes comprehensive analyses of Carboniferous radioisotopic ages, magnetostratigraphy, isotope-based correlations, cyclostratigraphy and timescale-relevant marine and non-marine biostratigraphy and biochronology.


Abstract. Recently, the Kessem–Tendaho project is completed to bring about socioeconomic development and growth in the Awash River Basin, Ethiopia. To support reservoir Koka, two new reservoirs where built together with extensive infrastructure for new irrigation projects. For best possible socioeconomic benefits under conflicting management goals, like energy production at three hydropower stations and basin wide water supply at various sites, an integrated reservoir system management is required. To satisfy the multi-purpose nature of the reservoir system, multi-objective parameterization-simulation-optimization model is applied. Different Pareto-optimal trade-off solutions between water supply and hydro-power generation are provided for two scenarios (i) recent conditions and (ii) future planned increases for Tendaho and Upper Awash Irrigation projects. Reservoir performance is further assessed under (i) rule curves with a high degree of freedom – this allows for best performance, but may result in rules curves to variable for real word operation and (ii) smooth rule curves, obtained by artificial neuronal networks. The results show no performance penalty for smooth rule curves under future conditions but a notable penalty under recent conditions.


BACKGROUND
Bioabsorbable interference screws are used frequently for graft fixation in ACL (anterior cruciate ligament) reconstruction. The resorption properties of many available screws that are marketed as bioabsorbable are not well defined. The CALAXO (Smith & Nephew Endoscopy) and MILAGRO (DePuy Synthes) bioabsorbable screws contain polymers of poly(lactic-co-glycolic acid) (PLGA) plus additives to encourage osseointegration over time. The purpose of this study was to evaluate radiographic and magnetic resonance imaging (MRI) properties and compare patient-reported outcomes at a minimum of two years of follow-up after ACL reconstruction using CALAXO or MILAGRO bioabsorbable interference screws.

METHODS
A cohort of patients who underwent ACL reconstruction in which the fixation used was either CALAXO or MILAGRO screws returned for repeat radiographs for evaluation of tunnel widening, repeat MRI for evaluation of graft integrity and screw breakdown, and completion of the pain and symptom items of the KOOS (Knee injury and Osteoarthritis Outcome Score) questionnaire.

RESULTS
At a mean of three years (range, 2.5 to 4.0 years) after surgery, thirty-one patients with sixty-two CALAXO screws and thirty-six patients with seventy-two MILAGRO screws returned for repeat evaluation. Two blinded, independent reviewers found no significant differences between the two screw types when comparing radiographs for tibial or femoral tunnel widening or MRIs for graft integrity, tibial and femoral foreign body reactions, or femoral screw degradation. Both reviewers found a significant difference between the two screw types when comparing tibial screw degradation properties (p < 0.01). All analyzed CALAXO screws were rated as partially intact or degraded; the MILAGRO screws were more likely to be rated as intact. No significant differences were noted between the two screw types when comparing the two KOOS subscales.

CONCLUSIONS
CALAXO screws in the tibial tunnel were more likely to be rated as degraded or partially degraded compared with MILAGRO screws at a mean of three years after implantation for ACL reconstruction. Although these newer-generation bioabsorbable screws were designed to promote osseointegration, no tunnel narrowing was noted, and in the majority of cases the remains of the screws were present at approximately three years.


Background BI-RADS Category 4 patients have a 2–95% risk for malignancy and are generally recommended for breast biopsy with little discrimination for risk level or distinction between risk of invasive or in situ disease. Our study sought to determine if higher thresholds for biopsy based on stratifying for risk and distinguishing between risk of invasive cancer and DCIS could reduce biopsy rates and increase cancer-to-biopsy yields without missing cancers urgent for resolution. Methods 108 BI-RADS 4 cases with final outcomes data were evaluated from a prospective cohort of 215 consecutive patients seen at a same-day multidisciplinary breast clinic for women with mammograms categorized as BI-RADS 0, 4, or 5 in 2006–07. Final outcomes were determined from pathologic diagnosis or two-year follow-up. Risk estimates (RE) for DCIS and invasive cancer were collected prospectively and re-assessed by a radiologist blinded to outcomes and prior reading assessments. Cases were stratified according to the risk ranges of the BI-RADS 4 subcategories and risk of invasive or in situ disease. Biopsy rates, cancer-to-biopsy yields, and number of malignancies missed were calculated for various thresholds for intervention. Results A ROC curve for invasive cancer risk for the radiologist demonstrated a 98.5% level of accuracy (95% confidence interval [CI]: 96.9%, 100%). 60 cases had some risk for invasive cancer and 48 had some risk for DCIS. There were 14 invasive cancer and 11 DCIS outcomes, 3 of which were high-grade. Pathologic assessment from biopsy or surgery was available for 100 patients. The outcomes of 8 cases were determined by benign two-year follow-up. There are several strategies for intervention that improve biopsy yield and reduce biopsies for benign disease as shown in Table 1. If cases with RE between 2–10% for DCIS or invasive cancer were not biopsied, 23% of biopsies would be avoided and the yield would increase to 30%. If cases with invasive cancer RE between 10–95% and DCIS RE between 50–95% were biopsied, 52% of biopsies would be avoided and the yield would increase to 39%. One invasive ductal carcinoma (3 mm, Grade 2) would be missed, although with six-month follow-up, this would not be a problem. Limitations Small sample size; one radiologist providing RE may not be representative of general mammographic assessment. Conclusion Setting higher biopsy thresholds for BI-RADS 4 lesions can safely reduce biopsy rates and increase biopsy yields. Given evidence suggesting that low/intermediate grade DCIS may be overdiagnosed, distinguishing between DCIS and invasive cancer risk at screening by offering active surveillance as an alternative to biopsy for BI-RADS 4 lesions suspicious for non-high-grade DCIS may be a promising approach for reducing biopsies. This will be prospectively tested in a reader study using several radiology readers in a series of 750 cases in the Athena Breast Health Network. New biopsy thresholds can be set if the results of our study can be validated. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-09-02.