The energetic and comfort optimization of these buildings, however,is not yet generally accepted and therefore a more delicate discussion. (Too) often these buildings are (too easily) exempted from adaptations because: the reconciliation of energy savings / comfort optimization and heritage values seems too difficult or even impossible, the(unqualified)application of new techniques could (possibly) do more harm more than good,the behavior and ageing of new techniques are often not yet fully understood, investigated or well-known,it is generally accepted that the original state should be restored as much as possible by traditional materials and construction methods.However, one needs to be aware that adapting buildings and heritage to meet the actual needs of its users with evolving materials and techniques has always happened. Conservation of heritage in one certain original (?) historic state, makes that,in some cases, these buildings no longer meet present-day needs and comfort aspects. Whereas it should be acceptable for historic buildings only to meet the present-day standards partially, the users' comfort must be taken into account in order to assure the future use of these buildings. After all, it is common knowledge that unused buildings decay rapidly, and uncomfortable and energy consuming buildings are not likely to be used. Such an approach only would condemn them to be lost...Our generation should make the decision to preserve our built heritage in a way it reflects and is adapted to the economic,societal, environmental, comfort and energy context of today, while ensuring the absolute preservation of the heritage's intrinsic values. After all, an optimized preservation and use of heritage buildings offers several opportunities such as:a more attractive use and better occupation of these buildings by assuring a reduced energy bill,the improvement of the indoor climate (and reduction of fluctuations in temperature and air humidity) would enhance the conservation of the building, its structure, finishing materials, interior decoration and collections, a more constant maintenance of the occupied buildings minimizing the risks of decay due to condensation, corrosion, biological attack, deformations, frost and salt damage ..., this way reducing the need for large restoration campaigns,and last but not least, a contribution to the reduction of greenhouse gas emissions by this collection of buildings.All of these aspects would lead to an improved use and preservation of our heritage buildings, as used buildings remain preserved considerably better than unused.Yet, it is essential that this thermal and comfort optimization of heritage buildings must be approached in a holistic way. Certainly for heritage buildings the main focus may not be the maximisation of the energy consumption / greenhouse gas emission reduction, but should always be the search for an optimal intervention respecting the constraints of the heritage values, as these values make the historic buildings that form the core of our European cities and countryside so special. Luckily, in the last years the above mentioned approach and considerations are more and more accepted throughout an increasing group of (heritage, comfort and energy) experts and governments. One can notice for example the roadmap of EeB PPP (Energy Efficient Buildings Public Private Partnership)and several "Horizon 2020" calls in which energy intervention strategies and solutions for energy renovation of historic buildings are identified as a priority, several finished and ongoing nationals and European projects that focus on the interplay of energy efficiency and heritage preservation, or even the workgroup 8 "Energy efficiency of historic buildings" of the CEN/TC 346 on the "Conservation of cultural heritage" that is drafting a European standard(EN 16883:2015) entitled "Guidelines for Improving the energy performance of historic buildings". All of the above mentioned considerations, evolutions, needs, thoughts and the implication, expertise and concerns of the BBRI Laboratory of Retrofitting on this matter formed the basis for the Belgian Building Research Institute to organize and host the second edition of the International Conference on Energy Efficiency and Comfort of Historic Buildings in close collaboration with the concerned public institutes from Brussels(DMS–the Brussels Monument and Sites Directorate), Flanders (Onroerend Erfgoed–the Flanders Heritage Agency) and Wallonia(DG04-Patrimoine–the Walloon Monument and Sites Directorate)from October 19thto 21st2016at the Royal Library in Brussels.After a first edition organized by Casas Historicas y Singulares and Ars Civilis in Madrid (2014), this second edition will gather research groups, governments, building practitioners, product developers ... working on topics related to the generation,transfer and application of knowledge, methodologies, materials and techniques to optimize the interplay between improving energy efficiency and comfort on the one hand, and preserving the heritage values of our historic buildings and cities on the other.The EECHB2016 conference therefore brings together international experts and stakeholders, sharing state-of-the-art developments and their latest experiences, results, experiments, etc. around the following six themes related to the optimization of historic buildings: 1.Boundaries and obstacles, 2.Using and improving energy models, 3.Training and education, 4.Interventions related to (a) systems and indoor climate, and (b) materials, 5.Monitoring and feedback, 6.Governance issues.


Abstract INTRODUCTION: Atherosclerosis and cardiovascular diseases are the most common causes of death in western countries. The beneficial effect of ascorbic acid on various organs has been reported. The present study was conducted to determine the effect of ascorbic acid on the right and left coronary arteries of male rabbits fed with high-cholesterol diet. methods: Twenty white male rabbits (mean weight: 950 g) were weighed and randomly divided into two groups. For 40 days, group 1 (n=10) was given a high-cholesterol (1%) diet, group 2 (n=10) was fed with a high-cholesterol diet and ascorbic acid (100 mg/kg). Then both of the groups were weighed and the animals were sacrificed. The right and left coronary arteries were dissected and then fixation, tissue processing, histological sectioning and H & E staining were carried out and sections were studied by light microscopy. The results were analyzed by using the Mann Whitney test. results: Group 2 which received ascorbic acid had no fatty streaks in their coronary arteries. Significant difference in mean weight was observed before and after the diet in both groups (P<0.05). CONCLUSIONS: Histopathological study of the coronary arteries showed that the rabbits which received ascorbic acid diet did not develop fatty streaks. Thus ascorbic acid exerts an apparently inhibitory effect on fatty streak formation and may slow down or prevent atherosclerosis by countering the side effects of a high-fat meal. Keywords: Ascorbic acid, cholesterol, coronary arteries.


In high-density data storage systems, noise becomes highly correlated and data dependent as a result of media noise, channel nonlinearities, and front-end filters. In such environments, conventional timing recovery schemes will exhibit large residual timing jitter and, especially, data-dependent timing jitter. This paper presents a new data-aided timing recovery algorithm for data storage systems with data-dependent noise. We derive a maximum-likelihood timing recovery scheme based on a data-dependent Gauss-Markov model of the noise. The timing recovery algorithm incorporates data-dependent noise prediction parameters in the form of linear prediction filters and prediction error variances. Moreover, because noise can be nonstationary in practice, we propose an adaptive algorithm to estimate and track the noise prediction parameters. Simulation results, for an idealized optical storage channel incorporating a simple model of media noise, illustrate the merits of our algorithm


This research aims to establish Internet web marketing challenges of South African SMEs. The research design chosen for this research is descriptive research in conjunction with a quantitative approach. The population includes SMEs in South Africa. The sample for the study encompasses 500 SME owners who currently manage the SMEs in South Africa. The conducted research indicated that SME owners utilize the internet web for marketing their businesses. The research results showed that the wed is promising marketing advertising tool for the future. The results also revealed that older respondents are more successful in stimulating better sales and customer support through their internet marketing communication efforts than younger respondents while younger respondents are more successful in increasing product awareness and overall productivity of their SME than older respondents. Past research has proven that the web will not render traditional media obsolete. This is because traditional media has advantages that advertisers cannot ignore and the web cannot take away. This results show that the web is comparable to other marketing media. It is therefore important that SME owners include the web as part of their communication mix since an integrated approach is needed.


ISSUES
Treatment seeking for methamphetamine withdrawal is low in Australia. Insufficient knowledge regarding the withdrawal syndrome of methamphetamine and the appropriate management of these symptoms may be a contributing factor to the low treatment attendance.

APPROACH
A systematic review was performed using a range of electronic databases.

KEY FINDINGS
Common methamphetamine withdrawal symptoms include symptoms relating to depression, agitation, cognitive impairment and fatigue. These symptoms may last anywhere from a few days to a few months. Methamphetamine withdrawal is most commonly undertaken in an outpatient setting, and psychosocial interventions remain the primary treatment approach in Australia. Two withdrawal scales (Amphetamine Withdrawal Questionnaire and Amphetamine Cessation Symptom Assessment) have been validated for the assessment of methamphetamine withdrawal. Only a small number of medications for methamphetamine withdrawal have been investigated, and to date no medications stand out over the others.

IMPLICATIONS
Current recommendations for methamphetamine withdrawal tend to be based on clinical opinion and subsequently vary between settings. More research in the area is essential to ensure the development of more targeted, timely and effective withdrawal treatment interventions.

CONCLUSION
The review exposed a lack of well-conducted research targeted towards the management of methamphetamine withdrawal. Further research is essential, and should focus on understanding the nature of methamphetamine withdrawal, its duration, course and effective treatment.


In the cognitive form in which they develop their learning, human beings are submitted to a series of interfering factors for the process to happen. One of these factors is the way they absorb, learn and store knowledge. Constant questions on the teaching and learning process are discussed not only in pedagogy. The debate to improve education practices is present in any knowledge area and the issue is no different in the business area. This research aims to describe active learning methods as alternatives to improve the teaching and learning process in accounting. The study reveals the importance and use of active learning methods in accounting teaching and demonstrates what is being done in Brazil in this regard. The study presents some experiences to apply these methods in Brazilian literature, including problem based learning (PBL). A descriptive and exploratory research method is used. Based on the study, it is concluded that a knowledge process on active teaching methods applied to the business area is just beginning and that these can be used to improve the learning process of today's and future accounting professionals. Although few studies have been published in Brazil, the use of active learning methods has demonstrated efficiency and students' adherence, as it contributes to their learning process. In most cases, these methods are superior to traditional teaching methods.


Generalized holography is a technique for determining the properties of acoustical sources or scatterers [R. P. Porter, Progress in Optics 27, 1989]. In its most general form, the radiating or scattered field and its normal derivative are measured on a recording surface of arbitrary shape. The resulting measurements can be forward propagated into the far field to calculate the radiation pattern. The field can also be backpropagated toward the original source location to generate an image. For the special case of a closed recording surface surrounding the source, the image is independent of the shape of the hologram. Moreover, the image will be independent of evanescent (subsonic) components of the field even when the measurements are made in the near field. This is an important consideration for locating sources of radiation on an object. In this talk, generalized holography is applied to simple elastic structures to determine the modes of vibration. Numerical results will be presented for spherical shell...


The development of architectural materials and technology is transforming the colour palettes and identities of cities by juxtaposing or replacing vernacular colours with global and often contextually meaningless colours. As Built Environment designers have significant roles in determining city colourscapes, it might be expected that th ese professionals have considerable knowledge. However, there is largely an absence of colour training in the majority of built environment degree programs. While colour has been studied in a broad range of disciplines, very few studies have focussed on architecture and even less on colour in architectural education. This paper reports on the early findings of research into what informs architect's understanding and use of colour. Data was analysed from a survey of 33 practicing architects, academics and postgraduate students from Melbourne, Australia. The findings indicate that built environment designers see the need for increasing their colour knowledge. In line with previous studies, there was no evidence of correlations between gender and age, but findings suggest cultural differences in the level of colour education depending on country of architectural study. The wider research that this study is a part of ultimately aims to inform education around the use of colour in the built environment.


We examine the impact on relative success of bond fund managers under different market conditions defined by changes in bond yields and both longitudinal and cross-sectional volatility in the bond market. We analyze rising yield regimes and periods of increasing volatility to show that the active management opportunities in the bond market and the effectiveness of bond fund manager skills are time-varying. Even after accounting for style biases, both cross-sectional dispersion and time-series volatility measurably impact manager outperformance, thus providing fixed income managers with an opportunity for active management. Time-varying opportunity indicators can be utilized to employ timing between active and passive strategies, thereby producing economically significant information ratios and demonstrating the benefits of time-varying active risk budget.


Passive indoor localization for mobile Wi-Fi devices, e.g., smartphones, has attracted increasing attention from research communities recently. Existing passive localization techniques leverage received signal strength (RSS) of packets transmitted by target Wi-Fi devices and do not require a dedicated software installed on the devices. However, RSS-based passive localization techniques: 1) are device dependent, which results in poor localization accuracy for a wide variety of mobile devices and 2) cannot perform real-time passive localization. In this article, we present a novel passive localization technique, namely, packet delivery ratio (PDR) fingerprinting, to address these problems. In PDR fingerprinting, the lowest-power and highest-modulation scheme (LPHMS) is proposed to generate device-invariant PDR, which replaces RSS to construct fingerprints, to achieve device-invariant localization accuracy. Moreover, instead of passively monitoring packets rarely sent by mobile devices, in PDR fingerprinting, access points (APs) actively transmit request-to-send (RTS) frames to trigger target devices to reply clear-to-send (CTS) frames to calculate PDR. The RTS/CTS mechanism enables PDR fingerprinting to perform real-time localization. We have conducted extensive experiments in a real-world testbed. The experimental results demonstrate that PDR fingerprinting presents a competitive localization accuracy compared to RSS-based passive fingerprinting methods but is device invariant.


The Water4All project funded by the EU InterregIIIB programme aimed to demonstrate groundwater protection in the context of spatial planning and the implementation of the EU Water Framework Directive. Through a series of workshops, the four partner countries (Denmark, Germany, the Netherlands and the UK) developed a handbook containing an approach for risk-based land and water management to reduce diffuse pollution of groundwater from agricultural sources. Best practice guidelines were catalogued as a matrix of compensated and non-compensated 'soft' to 'hard' measures and were supported by illustrative case studies. The Water4All project also showed that spatially targeted measures can have wider benefits as part of a 'whole landscape' approach to planning and management. As an example, this paper explores a set of theoretical land-use scenarios, developed in consultation with stakeholders, which could potentially decrease nitrate concentrations in the regionally important Lincolnshire Limestone aquifer in eastern England. The results of a combined export coefficient and numerical groundwater modelling approach showed that a decrease in groundwater nitrate concentrations can be achieved over several decades with the implementation of a groundwater protection zone in which there is a significant element of land conversion from arable to woodland and grass. Hence, a long-term commitment to land management is required if the alternative and expensive end-of-pipe water treatment is to be avoided.


We explored ways of doing spatial search within a relational database: (1) hierarchical triangular mesh (a tessellation of the sphere), (2) a zoned bucketing system, and (3) representing areas as disjunctive-normal form constraints. Each of these approaches has merits. They all allow efficient point-in-region queries. A relational representation for regions allows Boolean operations among them and allows quick tests for point-in-region, regions-containing-point, and region-overlap. The speed of these algorithms is much improved by a zone and multi-scale zone-pyramid scheme. The approach has the virtue that the zone mechanism works well on B-Trees native to all SQL systems and integrates naturally with current query optimizers - rather than requiring a new spatial access method and concomitant query optimizer extensions. Over the last 5 years, we have used these techniques extensively in our work on SkyServer.sdss.org, and SkyQuery.net.


The author presents a report on Canaanite animal husbandry practices, diet, butchery methods, and animal sacrificial rituals. This information comes primarily from faunal remains that were retrieved from Middle Bronze IIB/C (1800/1750-1550 B.C.) strata at the site of Tel Haror, 20 km northwest of Beer Sheva in Israel. The work includes discussions on the origins of Canaanite civilization (and the continuing similarities between the cultures of Canaan, the Phoenician coast, and Syria), as well as a detailed analysis of the site itself (including faunal remains.


The spinel growth induces undulation of the thermal growth oxide layer and decreases the service life of plasma-sprayed thermal barrier coatings. An analytical model is introduced to investigate the effect of spinel growth on the delamination of thermal barrier coating. The analytical results show that the number per unit area and the growth rate of spinel have significant influence on the delamination of thermal barrier coating. The stiffer and thicker thermal barrier coating is more easily to delaminate from the bond coat due to the existence of spinels. The effect of spinel on the delamination cannot be neglected. How to reduce the growth rate and the number of spinel is a key problem to prolong the service life of thermal barrier coatings.


Background: The aim of this study was to evaluate the outcome and survival in patients with RCC treated with non-hilar clamping simple enucleation. Methods: In this case series study, all patients in Hashemi Nejad Hospital in Tehran undergone non-hilar clamping simple enucleation surgery in the years 1383 to 1393 by RCC T1 enrolled the study. Exclusion criteria included the presence of multi-focal RCC, synchronous mass in patients, the existence of positive lymph nodes before or during surgery and radical nephrectomy due to past RCC. 134 patients undergoing partial nephrectomy in tumors T1 (T1a, T1b) studied, 9 patients has not completed the follow up and 10 patients had oncocytoma and angiomyolipoma excluded the study. 115 patients with RCC pathology who undergone non-hilar clamping Simple Enucleation were examined. Results: In this case series study, 115 patients with pathologically confirmed RCC were evaluated on the basis that 70patients were male and 45 were female. Patients have ranged in age from 20 to 75 years old and 51.28 year. Average figure of 97% progression free survival at three-year and five-year study was 89%. Also three-year study of cancer specific survival at five years was 100% and 95% respectively. Patients who have relapsed 2 female and 2 were male. The recurrence was not significantly associated with gender (p= 0.511). Also 2 patients had recurrence of the left kidney and 2 were all right and there was no statistically significant difference (p= 0.643). Every 4 patients recurrent disease have T1b the difference was significant (p= 0.026). Also patients had recurrence of grade 2 to grade 1 patients have high grade recurrence was observed (p<0.001). No significant difference was found between GFR before and 3 months after surgery (p= 0.802) and a biopsy of the tumor bed margins were negative in all cases. Conclusion: Non-clamping SE in patients with T1 renal masses is similar to partial nephrectomy is onchologic results. In this study, recurrence was higher in patients with T1b tumors that appear in determining treatment and close follow-up T1 b should be more comprehensive criteria. Non clamping SE preserving kidney function is a good choice in the treatment of T1 tumors. Non clamping SE more complications following surgery and that could be more widely used.


ABSTRACT Neurotensin (NT) has multiple functions, ranging from acting as a neurotransmitter to regulating intestinal movement. However, its function in reproductive physiology is unknown. Here, we confirmed the expression and localization of NT receptors (NTR1) in mouse epididymal spermatozoa and investigated the effect of NT on sperm function. Sperm protein tyrosine phosphorylation, one of the indices of sperm capacitation, was facilitated dose-dependently by NT administration. In addition, the acrosome reaction was promoted in capacitated spermatozoa, and addition of a selective antagonist of NTR1 and NTR2 blocked the induction. Furthermore, intracellular calcium mobilization by NT addition was observed. This showed that NT was an accelerator of sperm function via its functional receptors. The presence of NT was confirmed by immunohistochemistry and its localization was observed in epithelia of the uterus and oviduct isthmus and ampulla, which correspond to the fertilization route of spermatozoa. The NT mRNA level in ovulated cumulus cell was remarkably increased by treatment with human chorionic gonadotropin (hCG). Using an in vitro maturation model, we analyzed the effects of FSH, epidermal growth factor (EGF), estradiol, and progesterone in NT production in cumulus cells. We found that FSH and EGF upregulated NT release and mRNA expression. Both FSH- and EGF-induced upregulation were inhibited by U0126, an MAPK kinase inhibitor, indicating that FSH and EGF regulate NT expression via a MAPK-dependent pathway. This evidence suggests that NT can act as a promoter of sperm capacitation and the acrosome reaction in the female reproductive tract.


Background and Aim: Psoriasis is an immunologically mediated chronic inflammatory skin disease. Altered platelets in psoriasis patients may have a role in predisposition to cardiovascular complications. The aim of this study is to study the platelet count (PLT) and indices in patients with psoriasis and to correlate platelet indices with Disease Area Severity Index score. Materials and Methods: The study was done in a tertiary care hospital. It was performed on 42 psoriasis patients (study group) and twenty healthy controls. Lifestyle factors, PLTs, and platelet indices were compared between psoriasis cases and controls. Correlation between these parameters and Psoriasis Area Severity Index (PASI) score was also studied in psoriasis patients. Chi-square test was applied to compare the categorical data from patients and controls. Spearman's rank correlation was used to correlate lifestyle factors with the severity of disease. Pearson's correlation coefficient was used to find the correlation between PASI and platelet parameters. Results: We found that PASI correlated with smoking (P = 0.042) and levels of psychological stress (P = 0.002). PLT (P = 0.043) and plateletcrit (P = 0.043) were significantly higher in the study group, whereas platelet distribution width (PDW) (P = 0.05) was lower in the study group. We found a significant correlation of PASI with PDW (P = 0.031), mean platelet volume (P = 0.050). and PLCR (0.028). Conclusion: Lifestyle factors such as smoking and levels of psychological stress play a significant role in psoriasis disease severity. There is a correlation of PLT and platelet indices with the pathogenesis and manifestation of disease.


With increasing frequency journal articles are retrieved digitally rather than by obtaining physical printed volumes. This shift to low-cost distribution of research literature has opened up new possibilities for increasing the accessibility and potential readership of published literature. Open Access is a term used to refer to publication of scholarly material without access restrictions, which can be realized either by the publisher directly or indirectly by the author. This paper studies the extent to which information systems research is available Open Access. The results are also contrasted to figures from other areas of science. By sampling journals within the field, systematically looking for free copies through a web search engine, the extent of peer-reviewed IS research was studied. The results indicate that none of the IS journals included in a large citation indexing service covering 18000 journals are fully Open Access, but this is something which is compensated for by authors being quite active in uploading copies of their manuscripts to web sites. There was no significant difference in Open Access patterns between the top journals in the discipline and the rest of the sample. The overall share of Open Access within the field is 21 %.


This article studies environmental and distributional effects from a differentiated tax system on a set of disaggregated transportation goods. Empirical examination on Norwegian data indicates that higher tax rates on high-pollution luxury modes of transportation such as air flights and taxis reduce inequality and increase the environmental quality. Lower tax rates on low-pollution necessary modes such as buses, bicycles, and mopeds reduce inequality and increase environmental quality. However, higher taxes on high-pollution necessities such as gasoline have favorable environmental effects, but increase inequality somewhat. Railway passenger transportation appears to be distributionally neutral. In order to interpret the estimates with respect to distributional and environmental concerns, we use a theory of distribution effects based on Engel, child, and adult elasticities and a wide range of empirical estimates of environmental hazards from transportation consumption. For different modes of transportation, we study emissions per passenger-kilometer and per monetary unit.


The menstrual cycle with fluctuation in female sex hormones has been suggested to influence neuromuscular function. However, variation in ligament laxity, soft tissue stiffness, and skeletal muscle strength across the menstrual cycle has led to conflicting results. Furthermore, premenstrual symptoms (PMS) have been suggested to have a negative impact on neuromuscular performance and contribute to the risk of musculoskeletal injury in physically active women. On the other hand, the use of oral contraceptives (OCs) might protect from injury. The mechanisms of the influence of sex hormones on neuromuscular function and PMS are not fully understood. The overall aim of this thesis was to explore the effect of endogenous sex hormones and OCs on muscle strength, postural control, and PMS in healthy women with moderate physical activity. A further aim was to explore the expression of sex hormone receptors in skeletal muscle during three well-defined phases of the menstrual cycle. Postural control was measured during the active and hormone-free phase of OC treatment in physically active women with or without PMS as evaluated by prospective symptom rating. In the same cohort of women, muscle strength and hop performance were measured during one OC cycle and one normal menstrual cycle at three specific phases, using a cross-over design. Furthermore, changes in PMS in the same women starting to use or discontinuing the use of OCs were evaluated. In another cohort of healthy women, muscle biopsies were collected from the musculus vastus lateralis in the follicular phase, the ovulatory phase, and the luteal phase of the menstrual cycle for determination of mRNA and protein levels of sex steroid hormone receptors. Women with PMS displayed a significant change in postural control (greater displacement area) during the active OC phase compared to the withdrawal phase of OC treatment, whereas women without such symptoms showed no variation in postural control during OC treatment. Muscle strength and hop performance did not vary during the different phases of the normal menstrual cycle, or during OC treatment. In women with PMS, OC treatment decreased ratings of premenstrual somatic symptoms, but not of negative mood symptoms. Gene and protein levels of estrogen receptor alpha and the progesterone receptor varied significantly during the three hormonally confirmed phases of the normal menstrual cycle. The results of this thesis indicate that PMS influences postural control and OC treatment decreases PMS of somatic type. Furthermore, muscle strength and hop performance are not influenced by endogenous and exogenous sex hormones. The variation in expression of sex hormone receptors in skeletal muscle may have an impact on the effects of muscular training and sports injuries in women.


Abstract. Defective pelvic organ support due to injuries of the levator ani is a common problem in women and its intervention requires a thorough understanding of the structure. Three-dimensional surfaces of the levator ani have proved to be a promising method of studying this. In this paper, we propose to build a statistical shape model (SSM) of the levator ani and describe a segmentation technique based on a limited number of control points with the SSM. The SSM was achieved by the use of harmonic shape embedding with the MDL objective function to optimise parameterisation while segmentation was performed by fitting the model to a user defined set of control points. The value of the technique was demonstrated with data acquired from a group of 11 asymptomatic subjects.


SUMMARY Tri-County Health Department investigated an outbreak of cryptosporidiosis linked to a community swimming pool. A cohort study was conducted in 37 persons who were invited to the pool party; 12 (57%) of 21 attendees had primary cryptosporidiosis infection. Risk factors for illness included swimming, getting water in mouth, and swallowing water. The pool met chlorination guidelines and used UV light irradiation, a supplemental disinfection technology that inactivates Cryptosporidium. A follow-up survey of the cohort was completed 7–8 weeks after the pool party; four (25%) of 16 non-attendees had secondary cryptosporidiosis infection. The median duration of illness, including patients with recurring symptoms, was 26 days. Clinical response rate to nitazoxanide, a therapeutic agent, was 67%. This study is unique because it describes a cryptosporidiosis outbreak from a well-maintained community swimming pool using supplemental disinfection. It also reports information on disease burden and treatment response.


We present an approach to recover absolute 3D human poses from multi-view images by incorporating multi-view geometric priors in our model. It consists of two separate steps: (1) estimating the 2D poses in multi-view images and (2) recovering the 3D poses from the multi-view 2D poses. First, we introduce a cross-view fusion scheme into CNN to jointly estimate 2D poses for multiple views. Consequently, the 2D pose estimation for each view already benefits from other views. Second, we present a recursive Pictorial Structure Model to recover the 3D pose from the multi-view 2D poses. It gradually improves the accuracy of 3D pose with affordable computational cost. We test our method on two public datasets H36M and Total Capture. The Mean Per Joint Position Errors on the two datasets are 26mm and 29mm, which outperforms the state-of-the-arts remarkably (26mm vs 52mm, 29mm vs 35mm).


Cancer treatments are now more effective than ever and, as a consequence, cancer is becoming a chronic disease. Chemotherapy is a frequently used treatment in people with cancer and it can cause a number of side-effects which if not properly managed could have a negative impact on the patients' quality of life. In this study, a sample of 56 patients receiving chemotherapy treatment for breast, colorectal and lung cancer is considered; each experienced side-effect is recorded during four consecutive treatment cycles (each lasting 14 days). Five of the most frequent side-effects (fatigue, nausea, mucositis, hand and foot sore, diarrhoea) are selected to build a comprehensive model which predicts the probability of experiencing a certain symptom on a specified day of each cycle of therapy. The computed accuracy of results shows that the newly proposed model has an enhanced predictive power compared to a state-of-the-art approach. The information gained from this study will help medical and nursing staff caring for such patients to more accurately predict the side-effects that patients will experience and therefore select appropriate help to minimise, whenever possible, the influence of those symptoms.


These units responded vigorously to stimuli moving entirely across their receptive field centers in one direction (preferred) and not at all when the direction of motion was reversed (null). The directional selectivity was the result of an inhibitory mechanism which prevented responses to null movements. Surrounding each field center was a concentric antagonistic region produced by a second inhibitory mechanism.


The human science or the human generated "knowledge" especially the physical science, through its methods of observation, experimentation and inferencing, in its study of the physical matter may be exact and accurate but not error-free, No doubt it is the natural science that has carried man to the moon, but it has not succeeded so far even in mastering thoroughly the mysteries of the human existence. Granted that the physical world/matter needs to be studied using the methodology of physical/natural science for want of any other sure method of studying the nature, matter and the material world. As regards the ultimate problems which comprehend within themselves the entire universe it would be extremely unscientific to expect their sure and accurate solutions from physical science. To know transcendental Reality and the ultimate truth, likewise the speculative human knowledge or philosophy, based on mere and share reason, is not capable of giving accurate answers to our ultimate questions . The philosophical answers have been best approximations in the nature of partial truths or in most instances "conjectures". The sure and infallible source (and method of gaining) of knowledge (especially the metaphysical, transcendental and the ultimate) and guidance is the wahyu (revelation). The (divine) revealed knowledge gives direction and orientation to the physical and rational sciences as well and makes every thing meaningful and purposeful which otherwise could and would be misdirected and meaningless. The nabawi wahyu is revelation of the ultimate truth, and source of guidance and infallible knowledge. It leads us on the way and path of the Truth. It affirms the existence and implications of God ,the only All-Powerful (Omnipotent), All- knowing (Omniscient) and Omnipresent. And He not only possesses that knowledge but has also revealed to humanity the correct guidance on the ultimate and intricate problems which defy correct and sure solution by means of (mere human) senses, ordinary experience and reason. The divine Revelation has been communicated to us from time to time through the nabis /rasuls. Those Spiritual Luminaries, the chosen Messengers of our Creator included men like Adam, Ibrahim, Musa, Isa etc. the last among them being Muhammad (Divine Peace and Blessing be with him and all other Messengers of Allah swt). Man with limitations of his natural and philosophical sciences is eternally in need of the divine guidance and connection which is available in revealed guidance & knowledge of risalah . The rasul, an infallible divinely protected bashar, himself an epitome of virtues stands as model for human conduct at different levels.


Background: Diabetes can be successfully controlled by metabolic, psychological, social, and interpersonal factors. The present study aimed to determine the effectiveness of family empowerment therapy based on self-compassion on self-care and glycosylated hemoglobin in female patients with type 2 diabetes mellitus. Methods: In a randomized controlled clinical trial with control group, pre-test, and post-test, 60 women with type 2 diabetes referred to the endocrinology department of Imam Hossein Hospital in Tehran province from December 2018 to April 2019 were randomly selected from the 73 patients narrowed down according to the inclusion criteria. Afterwards, they were randomly assigned to experimental and control groups. The experimental group (n=30) was treated with family empowerment therapy based on self-compassion for eight weekly 90-minute sessions while the control group (n=30) received usual hospital treatments. Data collection instrument was Summary of Diabetes Self-Care Activities; glycosylated hemoglobin measurements were performed in three phases of baseline, after intervention, and three-month follow-up and analyzed by multivariate repeated measures analysis of variance and Bonfroni post-hoc test using the SPSS-21 software. Results: The results of repeated measures analysis of variance showed significant differences after the intervention between the experimental and control groups regarding self-care (P0.001=, F=561.086) and glycosylated hemoglobin (P=0.001, F=304.953); furthermore, comparison of the means indicated the effectiveness of the treatment in improving self-care and reducing glycosylated hemoglobin levels in the experimental group compared to the control group. Moreover, the Bonferroni test results showed that in the pretest stage, there was no significant difference between the two groups in terms of self-care (P=0.447) and glycosylated hemoglobin (P=0.887); however, in the post-test and follow-up stages, the two groups showed were significantly different concerning self-care (P=0.001) and glycosylated hemoglobin (P=0.001), implying the effectiveness of the intervention and the sustainability of its effects. Conclusions: The results of the present study revealed that family empowerment therapy based on self-compassion can be effective in improving self-care and reducing glycosylated hemoglobin in women with type 2 diabetes.


In her novels and stories Jhumpa Lahiri explores various issues regarding Indian American people, living both home and abroad, who lost their struggle with confusion about their identity and a sense of displacement. Her works are centered on several characters in three different locations: India, America and England. Her works problematize both the protagonists' self-perception, as well as the points of view of Americans who see immigrants as the Other, shunning them because of their origins. The perspectives as well as the images of India and the West are always in juxtaposition and this conflict between the two worlds is one of the main themes in Lahiri's oeuvre. In this respect, the paper will focus on the experiences of characters who are seen as the Other and are often discriminated against, which causes identity crises. The themes of split identity and the sense of loss of the protagonists, which prevail in Lahiri's works, will be seen through the lens of migration and the quest for the Self in the postmodern and post-colonial period. By addressing several viewpoints, primarily the one in Orientalism by Edward Said, this paper will particularly explore the attitudes and representations of India by the West, as well as the effects that they have on the characters of the novel.


Summary
Rice is the most important food crop in Asia. However, rice production in Asia is facing tremendous challenges in the 21st century. Fast-growing populations are demanding larger rice supplies under the increasingly difficult production conditions of declining water availability and quality. Furthermore, rice cultivation produces large amount of rice residues. With currently increasing trends in cropping intensity, the amounts of residues that are burned on the field are expected to increase dramatically, unless crop residues are managed more sustainably. Comparative research on the effects of different water and rice residue management practices on nutrient balances and greenhouse gas emissions are needed. They will provide information on the environmental and agronomic consequences of choices in rice residue management practices, including direct incorporation of rice residues into the soil, application of rice-residue compost, burning of rice residues on the field, and use of rice residues as fodder for livestock. The outcome of such studies can then be used to find the best option for rice residue management.
In a survey of rice residue management in northern Vietnam, we examined the present cropping systems and the patterns of crop residue management prevalent in three different ecological zones of northern Vietnam. We compared the farmers' practices of either burning or incorporating the residues of their rice crops, and furthermore, calculated involved costs and benefits. Our data demonstrate that the burning of crop residues might be an erroneous trend from an ecological perspective, but is rational from an economic point of view. Based on this finding, we argue that a change of the prevalent burning practice cannot be achieved without the farmers getting their extra expenses refunded.
A field study was therefore conducted to quantified soil nutrient balances of paddy rice fields under different crop-residue management practices in northern Vietnam. All plots received mineral N, P, and K fertilizer in addition. We found that soils with (1) direct incorporation of rice residues into the soil, (2) application of rice-residue compost, and (3) burning of rice residues on the field showed a positive nutrient balance, which indicates that soil fertility can be maintained under these practices and that amounts of chemical fertilizers can be considerably reduced. Without fertilizers reduction, there is a risk of eutrophication in surrounding surface waterbodies. In contrast, use of rice residues as fodder for livestock, resulted in a negative nutrient balance in paddy soils, which indicates the need for returning nutrients to the soils. From these findings, we conclude that knowledge about the effects of rice-residue management practices on nutrient cycles may help to optimize the use of fertilizers, resulting in a more sustainable form of agriculture in northern Vietnam.
Silicon (Si) is known to have beneficial effects for plants, in particular for rice, which is a strong Si accumulator. It helps mitigate environmental stresses and soil nutrient depletion. In some regions plant available Si in soil might be limited and have detrimental effect on rice agriculture. Here we study the impact of three rice residue management practices (burying, burning and manure production for use on the field) in Si-depleted rice fields from northern Vietnam. The different Si reservoirs in soils and the plants Si content were measured under these different practices. Our results show a strong correlation between the different soil Si reservoirs and plants Si content. Our results show no significant difference between the different management practices in terms of Si bio-availability and Si uptake by plants. These new data also suggest also raise the question whether Si-depleted environment may proportionally lose Si faster through grain harvest than other less Si-depleted environment.
In order to compare the fluxes of methane (CH4) and Nitrous oxide (N2O) from rice paddy fields managed by differently treated crop residue inputs (direct incorporation of rice residues into the soil (I), application of rice-residue compost (CR), burning of rice residues on-site burning of rice residues (B)) under two water management systems, a field experiment was performed in Bac Giang Province in northern Vietnam. The field experiment was carried out on spring rice and summer rice seasons. The results indicate that water management is a major factor in reducing CH4 emissions. The alternate wetting and drying (AWD) management led to a reduction of CH4 emissions by 15-42% for the CR treatment, by 27-47% for the B treatment, and by 36-45% for the I treatment. Similarly, AWD management resulted in a reduction of global warming potential (GWP) by 16-36% (CT), 15-39% (CR), 27-40% (B), and 35-40% (I), respectively. The treatment I led to the highest CH4 emissions, while the control (CT) showed the lowest CH4 emissions under both water management systems. Rice yields were slightly higher for treatments including with mineral and organic fertilizers compared to only mineral fertilizer (CT). In conclusion, we recommend a combination of treatment I with AWD water management, as this combination resulted in reduced greenhouse gas emissions while ensuring high rice yields.


In graph analytics, a truss is a cohesive subgraph based on the number of triangles supporting each edge. It is widely used for community detection applications such as social networks and security analysis, and the performance of truss analytics highly depends on its triangle counting method. This paper proposes a novel triangle counting kernel named Minimum Search (MS). Minimum Search can select two smaller adjacency lists out of three and uses fine-grained parallelism to improve the performance of triangle counting. Then, two basic algorithms, MS-based triangle counting, and MS-based support updating are developed. Based on the novel triangle counting kernel and the two basic algorithms above, three fundamental parallel truss analytics algorithms are designed and implemented to enable different kinds of graph truss analysis. These truss algorithms include an optimized K-Truss algorithm, a Max-Truss algorithm, and a Truss Decomposition algorithm. Moreover, all proposed algorithms have been implemented in the parallel language Chapel and integrated into an open-source framework, Arkouda. Through Arkouda, data scientists can efficiently con-duct graph analysis through an easy-to-use Python interface and handle large-scale graph data in powerful back-end computing resources. Experimental results show that the proposed methods can significantly improve the performance of truss analysis on real-world graphs compared with the existing and widely adopted list intersection-based method. The implemented code is publicly available from GitHub (https://github.com/Bears-R-Us/arkouda-njit).


The goal of in situ modification of DNA via phosphodiester alkylation has led to our design of quinone methide derivatives capable of alkylating dialkyl phosphates. A series of catechol derivatives were investigated to trap the phosphodiester-quinone methide alkylation adduct through in situ lactonization. The catechol derivatives were uniquely capable of characterizable p-quinone methide formation for mechanistic clarity. These investigations revealed that with a highly reactive lactonization group (phenyl ester), lactonization competed with quinone methide formation. Lactone-forming groups of lower reactivity (methyl ester, n-propyl ester, and dimethyl amide) allowed quinone methide formation followed by phosphodiester alkylation; however, they were ineffective at in situ lactonization to drain the phosphodiester alkylation equilibrium to the desired phosphotriester product. The derivatives tethered with lactone-forming functionality of intermediate reactivity (chloro-, trichloro-, and trifluoroethyl esters), allowed quinone methide formation, phosphodiester alkylation, and in situ lactonization to efficiently afford the trapped phosphotriester adduct.


Professionals in the television industry are working towards a certain future—rather than end—for the medium based on multi-platform storytelling, as well as multiple screens, distribution channels and streaming platforms. They do so rooted in institutional frameworks where traditional conceptualizations of television still persist. In this context, we reflect on the role of the national television archive as an agent of historical knowledge in the convergence era. Contextualisation and infrastructure function as important preconditions for users of archives to find their way through the enormous amounts of audio-visual material. Specifically, we consider the case of the Netherlands Institute for Sound and Vision, taking a critical stance towards the archive's practices of contextualisation and preservation of audio-visual footage in the convergence era. To do so, this article considers the impact of online circulation, contextualisation and preservation of audio-visual materials in relation to, first, how media policy complicates the re-use of material, and second, the archive's use by television professionals and media researchers. This article reflects on the possibilities for and benefits of systematic archiving, developments in web archiving, and accessibility of production and contextual documentation of public broadcasters in the Netherlands. We do so based on an analysis of internal documentation, best practices of archive-based history programmes and their related cross-media practices, as well as media policy documentation. We consider how audio-visual archives should deal with the shift towards multi-platform productions, and argue for both a more systematic archiving of production and contextual documentation in the Netherlands, and for media researchers who draw upon archival resources to show a greater awareness of an archive's history. In the digital age, even more people are part of the archive's processes of selection and aggregation, affecting how the past is preserved through audio-visual images.


Two new types of workers are rapidly emerging in the global economy. The first is the data-processing programmer or clerk who prefers "telecommuting" to reporting in a structured way to a traditional office. The benefits and pitfalls for these workers and their employers are many, and several million people may be formally engaged in this fashion already. The second type of off-site worker is the off-shore data entry clerk based in low-wage countries, employed by Fortune 1000 companies. Such off-shore telecommuting is generating enormous savings to major U.S. firms, but it also may be depriving an entire generation of entry-level clerical and low-tech jobs to American youth at a time when they are desperately needed in the economy. This article explores many of the implications of both forms of telecommuting and poses a number of political, economic, and social issues for further research.


Fine particle deposition within riverbeds plays a major role in riverine ecology and biogeochemistry by altering hyporheic exchange flux. Moreover, it is ubiquitous within streams and rivers across all flow stages. However, the dynamics of fine particle deposition are still not completely understood in rivers, and continuum models like the advection dispersion equation require modifications to represent the processes accurately. To enhance understanding of fine particle dynamics, we developed a novel numerical particle tracking model that simulates fine particle deposition as a stochastic process under losing, neutral, and gaining streamflow conditions. These flow conditions generate three different velocity profiles by combining the free surface and groundwater flows. In addition, a novel aspect of our model is the storage of filtered particles to estimate concentration fields within the bed. Our simulated results are qualitatively compared with previous laboratory flume experimental results of kaolinite deposition under similar conditions. The model indicates that fine particle deposition patterns and residence time functions depend heavily on the exchange flux between stream and groundwater, as well as bed filtration properties as the deposition of particles occurs at greater depths in the losing stream condition than in the neutral and gaining cases. Therefore, the spatial pattern of particle deposition is a direct result of pore water velocity profiles, while the concentration depends on filtration dynamics within the bed.


Islamic banking is an experiment in finding innovative ways to regulate a financial system under Islamic law. In Kuwait the Kuwait Finance House has been operating for ten years as an Islamic financial institution surrounded by other institutions based on the western model. Kuwait is a particularly interesting centre for Islamic finance, as the Kuwait Finance House (Kuwait's only Islamic bank) has been one of the more profitable Islamic banks in recent years. Kuwait has benefitted greatly from the high oil revenues of the past twenty years, and its tiny size and population mean that most indigenous Kuwaitis now lead affluent lives. The Kuwait Finance House desires to help form a healthy economic climate, by using the acquired wealth wisely according to Islamic law. This study takes the reader through the principles of Islamic finance and compares its ideals to those of the western venture capitalists, who seek to improve the economic climate in the same way that an Islamic bank does. Chapters 3 and 4 deal with the Kuwaiti economy and financial system, introducing the reader to the country within which the Kuwait Finance House operates. The activities of the House are reviewed in chapters 5,6 and 7, while chapter 8 evaluates how successful the House has been since its inception in 1979. Finally the concluding chapter looks to what lies ahead for the future of Islamic banking in general and the Kuwait Finance House in particular, with special emphasis on the development of a fully-fledged venture capital industry operating within Islamic law.


Most serious failure of power equipment is due to the insulation breakdown. Partial Discharge (PD) phenomenon that damages insulation by gradual erosion is major source of insulation failure. In high voltage engineering studies, partial discharge (PD) is an electrical discharge that is localized in nature and partially joins the insulation present in between the conductors and that may or may not happen next to a conductor. So, partial discharge (PD) phenomenon is an important tool for improving the reliability of HV insulation systems. Accurate simulating of PD is more important for insulation study. In this project, partial discharges mechanism in solid dielectric material will be modeled using Simulink in MATLAB® software. In this work, for the analysis of actual PD activity inside the insulator with respect to the application of high voltage using MATLAB Simulink software an electrical circuit model of a Teflon as an insulator with a cubical void as an impurity is taken.


This project is about the privatization of civil justice and its potential ramifications for democracy. Privatization is rapidly and increasingly occurring at all levels of the public justice system, including courts, tribunals and state sanctioned private dispute resolution regimes. This reform movement is driven by a wide-spread ethos of efficiency-based civil justice reform. There are many sound reasons for these privatization trends, including reduced costs, increased speed and efficiency, privacy, enhanced participation and autonomy through increased party choice within and control over dispute resolution processes, and improved access to the tools of justice. However, these trends also have a number of costs in the form of negative impacts on the development of the common law, potential procedural unfairness, power imbalances between disputants and a potential negative impact on systems of democratic governance. Civil society is publicly regulated largely through legislation and adjudication. To the extent that we are actively privatizing how we do adjudication, we are in effect actively privatizing a large part of the way we govern ourselves in modern democracies.By raising these issues, this project has three main goals. First, it seeks to bear witness to the modern and wide-ranging privatization initiatives that are currently defining the way we think about and resolve almost all non-criminal disputes. Given its importance, we need to publicize, politicize and ultimately temper – although not eliminate – this move to the private. Second, this project seeks to articulate the benefits and costs of these privatizing initiatives, particularly including their potential negative impacts on the way we publicly regulate ourselves in modern democracies. Third, this project makes recommendations for future thinking about, and approaches to, civil justice practice and reform. In so doing, it calls on academics, jurists, civil justice reformers, elected representatives, practitioners and citizens to engage in a robust debate about all aspects of the privatization of civil justice, the future of which will have a fundamental impact on our public processes of democracy.


The self-boring pressuremeter test has potential advantages over the conventional in situ method in the geotechnical investigation. It not only provides fundamental soil properties for the designer, but also plays more important role in the geotechnical analysis. With help of Cambridge self-boring model pressuremeter tests, some new application are studied in this paper as following: (1) Analysis of stress paths in clays adjacent to the cavity wall during self-boring pressuremeter test; (2) Experimental investigation on stiffness of soils at small strain under non-linear analysis; and (3) Study on magnitude of the changes in pore-water pressure of clays, which will help to enlarge the application of self-boring pressuremeter test in geotechnical engineering.


The paper presents an optimal design of steel curved roof frames with its roof being part of a circular arc. The elements of frames are tapered I-section members. In the objective function for optimization, two factors affecting the weight of frames are considered simultaneously. First, the roof slope angle as an effective variable on the values of the structural loading and second, the cross-section of members that are considered as continuous and discrete variables, respectively. In the range of 3 to 70 degrees, the optimum range of roof slope angles for steel curved roof frames, as well as precise value of the best roof slope angle, will be reported. Enhanced Vibrating Particles System (EVPS) algorithm is utilized for the optimal design of steel curved roof frames with tapered members. The performance and efficiency of the EVPS algorithm is compared with six other recently developed optimization algorithms including VPS, GWO, HS, SSA, ECBO and GOA algorithms. The effectiveness and performance of EVPS algorithm is proven. Frames design are performed using ANSI/AISC 360-05 specifications which strength, displacement and stability constraints are imposed on the frames.


Pretrained language models (LMs) do not capture factual knowledge very well. This has led to the development of a number of knowledge integration (KI) methods which aim to incorporate external knowledge into pretrained LMs. Even though KI methods show some performance gains over vanilla LMs, the inner-workings of these methods are not well-understood. For instance, it is unclear how and what kind of knowledge is effectively integrated into these models and if such integration may lead to catastrophic forgetting of already learned knowledge. This paper revisits the KI process in these models with an information-theoretic view and shows that KI can be interpreted using a graph convolution operation. We propose a probe model called \textit{Graph Convolution Simulator} (GCS) for interpreting knowledge-enhanced LMs and exposing what kind of knowledge is integrated into these models. We conduct experiments to verify that our GCS can indeed be used to correctly interpret the KI process, and we use it to analyze two well-known knowledge-enhanced LMs: ERNIE and K-Adapter, and find that only a small amount of factual knowledge is integrated in them. We stratify knowledge in terms of various relation types and find that ERNIE and K-Adapter integrate different kinds of knowledge to different extent. Our analysis also shows that simply increasing the size of the KI corpus may not lead to better KI; fundamental advances may be needed.


This article attempts to outline the concept of power of Michel Foucault based on the major works that he wrote during his lifetime. Foucault asserts that power exists everywhere, especially concerning the relationship between power and discourse of knowledge. Here, for him, the will to truth is the expression of the will to power. It is impossible for the knowledge to be neutral and pure. Therefore, there will be always a correlation between the two matters, i.e. the knowledge contains power, just like the power contains knowledge. This means that power is one dimension of the relation. Where there is a relationship, there is a power.


In this study the main goal is to investigate the impact of knowledge management processes (KMPs) on operational performance (OP) as mediated by IT agility (ITA). The data were collected using a questionnaire, as the instrument for the primary data collection, with total collected back responses of 314 from university lecturers and employees have actually participated. Partial least squares regression modeling technique was used to fully analyze the data in order to determine what level of the relationship between KMPs and OP as mediated by IT agility existed. The main findings were related to confirming the four main hypotheses of the research that were related to testing if there were relationships between the KMPs (represented by four surrogate measures, namely, knowledge creation, knowledge storage, knowledge sharing and knowledge application) and OP, as well as if the KMPs was related to the OP as mediated by IT agility.


This paper proposes a distributed incremental quantization and estimation scheme by which each sensor can make a maximum likelihood estimation (MLE) of the unknown parameter based on its local observations and the quantized messages transmitted by the previous sensor. We derive the upper bound of the estimation mean squared error (MSE) of the proposed scheme, and propose the bit allocation algorithms, which minimize the total required bandwidth while ensuring a given MSE performance. Simulation results demonstrate that the proposed scheme requires much less bandwidth, but achieves around 40% MSE reduction compared with the distributed adaptive quantization and estimation scheme.


An environmentally friendly direct foaming method was investigated to produce porous alumina ceramics. Egg white protein was used as a binder and foaming agent. The microstructures show that pores are interconnected with pore size of a few hundreds μm and pore window size of ca. 50 μm. The compressive strength of alumina foam is up to 100 MPa depending on porosity. Bioactivation of alumina was carried out using an alkaline solution treatment. Hydroxylation of alumina was achieved using 5M NaOH at 80°C for 4 days. In vitro assessments of the alumina in a human osteoblast cell-like cell (MG63) culture showed that the bioactivated alumina foams exhibited better cellularity and alkaline phosphatase (ALP) activity compared to untreated alumina foams. The results indicate that it is possible to improve the osseointgration of alumina ceramics by structural and surface modifications and to extend the applications of biocompatible alumina ceramics in biomedical implants and tissue engineering scaffolds.


DOUGLAS, B.C., 2008. Concerning evidence for fingerprints of glacial melting. Journal of Coastal Research, 24(2B), 218–227. West Palm Beach (Florida), ISSN 0749-0208. Recent investigations of tide gauge and hydrographic data point to the conclusion that twentieth-century global sealevel rise was about 1.8 mm/y, with significant decadal and longer variability. Ocean thermal expansion can account for about 0.5 mm/y of the trend, leaving an additional 1.3 mm/y water equivalent that must have come from other sources. Greenland, Antarctica, and small glaciers are obvious candidates, and ''fingerprints'' of their contributions must occur because additions of glacial ice or meltwater to the oceans will not cause a globally uniform rate of sealevel rise. As ice melts or is discharged, Earth will respond elastically, and the geoid will also adjust. The result is that large changes in relative sea level will occur near the area of melting or discharge, and significant ( 20%) deviations from a uniform global rise will occur antipodal to the source. Thus, several authors have used trends of relative sea-level rise obtained from tide gauge data to investigate possible contributions from Greenland, Antarctica, and other sources of global sea-level rise. In this paper, we consider the fingerprint question morphologically by examining the regional variations of relative sea-level change for evidence of these fingerprints. Unambiguous evidence for fingerprints of glacial melting was not found, most likely due to the presence of other signals present in sea-level records that cannot easily be distinguished. ADDITIONAL INDEX WORDS: Sea-level rise, sea-level variability, sea-level pressure, glacial melting.


Esthesioneuroblastoma is an uncommon nasal tumor originating from cells of neural crest origin. An increased awareness of this neoplasm by clinicians and pathologists has led to an increase in its diagnosis. In the Department of Otolaryngology--Head and Neck Surgery at the University of Virginia Medical Center, 22 cases have been treated. A review of the biologic course of these cases has allowed us to make certain recommendations for therapy. Patients with stage A and B disease are best treated with preoperative radiation therapy followed by craniofacial resection. Patients with stage C disease are treated with cyclophosphamide and vincristine before irradiation and craniofacial resection. If a significant response occurs these patients receive postoperative chemotherapy. We believe this treatment should result in five-year survivals in excess of 50%.


CYP4A11
 polymorphisms have been associated with hypertension (rs1126742) and CAD (rs3890011) in humans. In mice, deficiency of the
 Cyp4a
 gene causes ENaC dysfunction and salt-sensitive hypertension that is abolished by the ENaC inhibitor amiloride. We examined the relationship between genotypes in
 CYP4A11
 and the BP response to amiloride, spironolactone, both drugs, and placebo in 83 hypertensive African American participants in a previously published randomized clinical trial. Genotype frequencies for rs3890011 were CC:GC:GG=28:35:20. The frequency of the loss-of-function variant at rs1126742 was similar to that previously reported (CC:TC:TT=7:31:45), but too small to permit further analysis. There was no difference in baseline SBP (overall mean±SE 142±1) or number of medications (2.3±0.1) among genotype groups. RS3890011 C allele was associated with an attenuated SBP responses to spironolactone (7.3±4.5 in CC versus -9.3±2.6 in GC or GG in the spironolactone only group, p=0.002; -2.7±3.3 in CC versus -12.8±2.3 in GC or GG in subjects receiving spironolactone alone or in combination, p= 0.014, Figure) and similar for DBP (5.0±2.9 in CC versus -6.0±1.7 in GC or GG with spironolactone only, p=0.002; -1.2±2.0 in CC versus -6.3±1.4 in GC or CC in those receiving any spironolactone, p=0.043). Spironolactone reduced BP only in carriers of the rs3890011 G allele. In contrast, there was no difference among genotype groups in the BP response to ENaC inhibitor amiloride. Variation in
 CYP4A11
 influences the response to spironolactone but not amiloride; these data are consistent with studies in genetically modified mice suggesting that a product of CYP4A11 modifies ENaC function.


The energetically favorable structures and mechanical response to tensile and pure bending forces of single-wall and multi-wall cylindrical silica nanotubes of varying lengths and radii are predicted via classical molecular dynamics and checked, in part, by quantum mechanical studies. Two distinct parameterizations of a popular pair potential are used. One is adapted to bulk properties, the other to small nanoclusters. Predicted stable structures for single-walled tubes as a function of length at specified radii are dependent on potential parameterization. For the bulk-adapted parameterization, single-walled tubes with large radii (12-membered rings) have an energetic preference to rearrangement into twinned parallel-column structures. Conversely, the nanobased parameterization puts such twinned structures slightly higher in energy than the corresponding single tubes. Both the mechanical properties and failure mechanisms in tension and pure bending of the single-walled tubes depend upon the nanorod dimensions. Predicted structures for the double-walled nanotubes exhibit qualitatively opposite trends for the two parameterizations. Though the potentials give different values for the tensile and bending elastic moduli for the various structures, the qualitative pictures of nanotube failure are quite similar. For comparison and insight, we also studied a small single-walled nanotube using both pure quantum forces and quantum–classical multi-scale simulations. Some distinctly different behaviors emerged.


Lee Construction Limited is a leading indigenous construction company in Kenya. However, Lee Construction is also aware of the challenges which are there in construction industry. It has put in place measures to curb accidents and health related problems. However, it is still not yet known how the systems have done in terms of effectiveness of health and safety. The specific objectives were; to assess effectiveness of health and safety systems in Lee Construction Ltd; to assess the perception of workers about the status of health and safety systems at Lee construction Ltd and lastly, to assess the factors which affects the effectiveness of health and safety system at Lee Construction Ltd. The study utilized qualitative, descriptive and quantitative research methodology to assess how employees of Lee construction Ltd experience the effectiveness of health and safety systems in their organization. The population of the study was 150 permanent and 200 casual employees of Lee Construction Ltd. The final sample size was 100 employees. In which case 40 were permanent and 60 were casual employees. This study used primary data which was collected through use of a questionnaire. SPSS was used to produce frequencies, descriptive and inferential statistics which was used to derive conclusions and generalizations regarding the study. The study found out that knowledge has a positive influence on health outcome though not significant while management prioritization, attitude and practice have a positive and significant influence on health outcome. The study recommend that attention to the detail of regulatory frameworks may be necessary to ensure they meet the requirements of ILO Convention and properly support the activities of health and safety representatives.


In many problems of decision making under uncertainty the system has to acquire knowledge of its environment and learn the optimal decision through its experience. Such problems may also involve the system having to arrive at the globally optimal decision, when at each instant only a subset of the entire set of possible alternatives is available. These problems can be successfully modelled and analysed by learning automata. In this paper an estimator learning algorithm, which maintains estimates of the reward characteristics of the random environment, is presented for an automaton with changing number of actions. A learning automaton using the new scheme is shown to be e-optimal. The simulation results demonstrate the fast convergence properties of the new algorithm. The results of this study can be extended to the design of other types of estimator algorithms with good convergence properties.


James Thomas Scott ("Tom ") enjoyed a fine reputation as a consultant physician at Charing Cross Hospital. He was a gifted teacher, clinical scientific researcher, and mentor. He left a legacy of clinical excellence and diagnostic acumen to the future leaders of academic and clinical rheumatology.

Tom was born and brought up in Mill Hill in north west London. He was an only child and his father, a civil servant in the postal services, died when he was 11. Tom was awarded a scholarship from the junior to the senior branch at University College School in Hampstead. During the war years he had to cycle to and from the school, where he excelled in all his academic activities. He was particularly gifted at Classics, studying Greek and Latin, but he was guided into a career of medicine because at the time he was advised that it had better career prospects. He trained at St Mary's Hospital Medical School in Paddington. He was active in undergraduate activities: he rowed for the medical school and also took part in theatrical, dramatic, and operatic activities. He completed a house post in medicine at St Mary's Hospital and a surgical house post in Lincoln. He moved on to Harefield Hospital as a junior registrar in medicine and deferred his national service until he acquired his membership of the Royal …


Teaching law in a different jurisdiction it originates from highlights cultural differences and expectations about the learning environment. The experience of the LLB English and French laws, a double degree running between Essex and Paris X- Nanterre, demonstrates the original clashes that exist when presenting French law in England. Maybe because the two year module with both French private and public law is not merely an introduction to French law, but aims at providing an understanding and knowledge of the law as approved by the French law society, multiple difficulties arise. Different conceptions of the relationships between learners and lecturers, with a French model relying on a passive student role; different legal methodologies that appear de facie opposite in their concepts; different learning resources (electronic and paper-based resources), different expectations about the workload and the module, and of course a distinct French legal culture which is not as uniform as it may seem, thus adding to the complexities (J. Bell, French Legal Cultures, London: Butterworths 2001, p. 256). In addition, the use of another language (French) seems only to amplify the cultural gaps in legal education, as translations are not made, like if two separate cultures could not intermingle. And yet, clashes can be overcome, at least sufficiently to demonstrate that multiple cultures can co-exist, feeding each other. At first a barrier, culture in legal education can become a bridge (L. Jin & M. Cortazzi, "The Culture the Learner Brings: a bridge or a barrier?", in M. Byram & M. Fleming (eds), Language Learning in Intercultural Perspective, approaches through drama and ethnography, Cambridge: Cambridge University Press 1998, p. 98-118). How? An understanding of legal cultures both in their differences and similarities, the use of emotional intelligence to unblock situations (A. Mortiboys, Teaching with Emotional Intelligence, London: Routledge 2005), a reflection on what teaching and learning mean (the CHEP programme as part of the staff development), and a willingness to innovate, are key features to a successful learning experience which embraces differences without promoting isolation. Ultimately, teaching law in another jurisdiction leads to the use of comparative law. Not a surprise for the comparatist is familiar with the above dynamics (see for example, R. Cotterrell, "Comparative Law and Legal Culture", in Mathias Reimann & Reinhard Zimmermann (eds), THE OXFORD HANDBOOK OF COMPARATIVE LAW, Oxford: Oxford University Press 2006, pp. 709-737; and also W. Twinning, "Globalisation and Comparative Law", in E. & D. Nelken, Comparative Law - A Handbook, Oxford: Hart Publishing 2007, p. 69)


Electromagnetism, quantum mechanics, statistical mechanics, molecular spectroscopy, optics and radiation form the foundations of the field. On top of these rest the techniques applying the fundamentals (e.g. Emission Spectroscopy, Laser Induced Fluorescence, Raman Spectroscopy). This book contains the basic topics associated with optical spectroscopic techniques. About 40 major sources are distilled into one book, so researchers can read and fully comprehend specific optical spectroscopy techniques without visiting many sources. Optical diagnostics are widely used in combustion research. Ideas first proposed here are now applied in other fields, including reacting flows for materials production (CVD reactors, oxidation reactors and some plasma work), atmospheric sensing, measuring constituents of exhaled human breath (to indicate stress in airway passages and the lungs and hence,e.g., provide a very early indicator of lung cancer). Researchers not formally trained who apply spectroscopy in their research need the detail in this book to ensure accuracy of their technique or to develop more sophisticated measurements. Time is valuable and future research will benefit. Learning 'on the fly' can involve direct information on a specific diagnostic technique rather than gaining the background necessary to go into further depth.


AIM: Analysis of standard and new risk factors (RF) to develop cardiovascular diseases (CVD) in patients with ankylosing spondylitis (AS). MATERIAL AND METHODS: Examination of 96 patients with a documented diagnosis of AS has detected symptoms of CVD (arterial hypertension--AH, ischemic heart disease -IHD) and conventional CVD RF (smoking, hyper- and dyslipidemia, overweight, hereditary predisposition, diabetes mellitus). The SCORE scale assessed the risk of CVD complications within 10 years of ischemic heart disease. The following RF were also studied: the levels of C-reactive protein, fibrinogen, platelets, von Willebrand factor activity, total fibrinolytic plasma activity, left ventricular hypertrophy (LVH) according to echocardiography, intima-media complex thickness of the common carotid artery by USI. RESULTS: Prevalence of AH in the examinees (34.4%), IHD (4.2%) was within population values. Total risk for IHD calculated with consideration of conventional RF in AS patients (6.3 +/- 5.0%) did not differ much from mean populational (6.8 +/- 4.4%) while in the absence of hypertension it was lower (4.1 +/- 2.5 and 5.4 +/- 3.5%, respectively, p < 0.05). The risk for lethal CVD complications proved not high (1.46 +/- 1.34%). However, AS patients have high risk for thrombosis due to elevated levels of prothrombogenic factors (fibrinogen, von Willebrand factor, platelets) and subnormal fibrinolytic blood activity. AS patients also demonstrate frequent LVH (overall 51% and 42.9% in normotensive AS patients). CONCLUSION: Higher risk of CVD death in AS patients than in general population may be caused by additional RF missed at conventional stratification.


This paper presents an overview of the cross-linguistically available strategies used in the formation of questions with coordinated wh-expressions. It offers a systematic characterization of the existing surface patterns of wh-coordination and the syntactic strategies underlying these, and presents typological generalizations on the distribution of these strategies, based on a cross-linguistic survey involving 12 languages. It will be pointed out that languages can be classified into four types according to the availability of coordinated wh-questions in them and that these four types can make use of at least six distinct syntactic strategies for the derivation of wh-coordination. The availability of these strategies will be shown to be limited by the syntactic typology of wh-questions. Keywords: wh-questions; coordination; ellipsis; sharing; (multiple) wh-movement


Multi-user applications can be complex to develop due to their large or intricate nature. Many of the issues encountered are related to performance and security. These issues are exacerbated when the scale of the application increases. This paper introduces a novel distributed architecture called OpenGL|D (OpenGL Distributed). This technology enables an application to pass through the graphical calls between a Virtual Machine (VM) and the graphics processing unit (GPU) on the native host across a network. This ability allows applications to run inside a virtual machine (VM), whilst still benefiting from hardware accelerated performance from the GPU for the computationally intensive graphical processing. This allows for the development of 3D software requiring no dependencies on specific hardware or technology other than ANSI C and a network stack, demonstrating our approach to platform agnostic development and digital preservation.


Glycocholic acid (GCA) is an important metabolite of bile acids, whose urine levels are expected to be a specific diagnostic biomarker for hepatocellular carcinoma (HCC). A high-throughput immunoassay for determination of GCA would be of significant advantage and useful for primary diagnosis, surveillance, and early detection of HCC. Single-chain variable fragment (scFv) antibodies have several desirable characteristics and are an attractive alternative to traditional antibodies for the immunoassay. Because chicken antibodies possess single heavy and light variable functional domains, they are an ideal framework for simplified generation of recombinant antibodies for GCA detection. However, chicken scFvs have rarely been used to detect GCA. In this study, a scFv library was generated from chickens immunized with a GCA hapten coupled to bovine serum albumin (BSA), and anti-GCA scFvs were isolated by a phage-displayed method. Compared to the homologous coating antigen, use of a heterologous coating antigen resulted in about an 85-fold improvement in sensitivity of the immunoassay. This assay, under optimized conditions, had a linear range of 0.02-0.18 μg/mL, with an IC50 of 0.06 μg/mL. The assay showed negligible cross-reactivity with various related bile acids, except for taurocholic acid. The detection of GCA from spiked human urine samples ranged from 86.7% to 123.3%. These results, combined with the advantages of scFv antibodies, indicated that a chicken scFv-based enzyme-linked immunosorbent assay is a suitable method for high-throughput screening of GCA in human urine.


The concepts of digital signal processing are playing an increasingly important role in the area of multirate signal processing, i.e. signal processing algorithms that involve more than one sampling rate. In this paper we present a tutorial overview of multirate digital signal processing as applied to systems for decimation and interpolation. We first discuss a theoretical model for such systems (based on the sampling theorem) and then show how various structures can be derived to provide efficient implementations of these systems. Design techniques for the linear-time-invariant components of these systems (the digital filter) are discussed, and finally the ideas behind multistage implementations for increased efficiency are presented.


Chromosomal rearrangements between sympatric species often contain multiple loci contributing to assortative mating, local adaptation and hybrid sterility. When and how these associations arise during the process of speciation remains a subject of debate. Here, we address the relative roles of local adaptation and assortative mating on the dynamics of rearrangement evolution by studying how a rearrangement covaries with sexual and ecological trait divergence within a species. Previously, a chromosomal rearrangement that suppresses recombination on the Z (sex) chromosome was identified in European corn borer moths (Ostrinia nubilalis). We further characterize this recombination suppressor and explore its association with variation in sex pheromone communication and seasonal ecological adaptation in pairs of populations that are divergent in one or both of these characteristics. Direct estimates of recombination suppression in pedigree mapping families indicated that more than 39% of the Z chromosome (encompassing up to ~10 megabases and ~300 genes) resides within a nonrecombining unit, including pheromone olfactory receptor genes and a major quantitative trait locus that contributes to ecotype differences (Pdd). Combining direct and indirect estimates of recombination suppression, we found that the rearrangement was occasionally present between sexually isolated strains (E vs. Z) and between divergent ecotypes (univoltine vs. bivoltine). However, it was only consistently present when populations differed in both sexual and ecological traits. Our results suggest that independent of the forces that drove the initial establishment of the rearrangement, a combination of sexual and ecological divergence is required for rearrangement spread during speciation.


Much of the literature surrounding education in emergencies focuses on the impact of armed conflict on children. Surprisingly little focuses explicitly on teachers, and yet it is commonly acknowledged that the biggest influences on the education a child receives are the knowledge, skills and attitudes of their teacher.
Through field research from Kenya, South Africa and Uganda, the study examines the role and status of teachers in emergencies. It identifies the issues refugee teachers face and makes recommendations on how policy can better address their particular needs and protect their rights, and thus improve access to and quality of education to populations affected by an emergency. The research findings also include data on South Sudan and the status of teachers returning there from exile.


In this paper three contributions are made. First, empirical support is provided for the 'trade-off' model of corporate capital structure where companies borrow to take advantage of the tax benefits of debt, which they set against possible costs of overindebtedness. Second, it is shown empirically how companies adjust their balance sheets when borrowing is out of equilibrium, through adjustments to dividend payments, new equity issues and to a lesser extent capital investment. Third, these factors are incorporated within an aggregate model that quantifies the process and speed of balance sheet adjustment in the economy as a whole.


Postvalvular dilatation was detected in the main pulmonary artery. The brachiocephalic trunk was enlarged relative to the aortic arch and color Doppler imaging revealed reverse flow in the aortic arch. Therefore, coarctation of the aorta was suspected. No other structural anomalies were detected. Karyotype analysis was declined. Follow-up scans were unremarkable. A female infant weighing 2910 g was delivered by Cesarean section at 39 weeks. The right arm, forearm and hand of the baby were enlarged with purple-red discoloration. Postnatal echocardiography did not confirm coarctation of the aorta. Doppler sonography, MR and CT angiography revealed dilated and tortuous brachiocephalic trunk, right subclavian, axillary and brachial arteries with diffuse collateral vessels. Right cephalic vein was also dilated while right brachial, axillary and subclavian veins were normal. No accompanying mass lesions were detected. Klippel-Trenaunay-Weber syndrome was diagnosed due to the macular vascular nevus, arteriovenous malformation and related hypertrophy of the bony structures. Interventional treatment was not recommended for the arteriovenous malformation. The baby was discharged on the 35th day, with digoxin and furosemide treatment. At present, the baby is two years old and doing well on digoxin and captopril therapy. In conclusion, prenatal detection of high cardiac output state should prompt a detailed, targeted examination for angiomatous malformations with careful examination of the limbs.


The term "peaceocracy" refers to a situation in which an emphasis on peace is used to prioritize stability and order to the detriment of democracy. As such, the term can be used to refer to a short-lived or longer-term strategy whereby an emphasis on peace by an incumbent elite is used to close the political space through the delegitimization and suppression of activity that could arguably foster division or conflict. At the heart of peaceocracy lies an insistence that certain actions—including those that are generally regarded as constituting important political and civil rights, such as freedom of speech and association, freedom of the press, and freedom to engage in peaceful protest and strike action—can spill over into violence and foster division and must therefore be avoided to guard against disorder. Recent history suggests that incumbents can effectively establish a peaceocracy in contexts where many believe that widespread violence is an ever-present possibility; incumbents have, or are widely believed to have, helped to establish an existing peace; and the level of democracy is already low. In such contexts, a fragile peace helps to justify a prioritization of peace; the idea that incumbents have "brought peace" strengthens their self-portrait as the unrivaled guardians of the same; and semi-authoritarianism provides a context in which incumbents are motivated to use every means available to maintain power and are well placed—given, for example, their control over the media and civil society—to manipulate an emphasis on peace to suppress opposition activities. Key characteristics of peaceocracy include: an incumbent's effective portrait of an existing peace as fragile and themselves as the unrivaled guardians of order and stability; a normative notion of citizenship that requires "good citizens" to actively protect peace and avoid activities that might foster division and conflict; and the use of these narratives of guardianship and disciplined citizenship to justify a range of repressive laws and actions. Peaceocracy is thus a strategy, rather than a discreet regime type, which incumbents can use in hybrid regimes as part of their "menu of manipulation," and which can be said to be "successful" when counter-narratives are in fact marginalized and the political space is effectively squeezed.


MADS genes encode regulatory factors that are involved in various developmental steps of the plant life cycle. During flower development, they regulate the early step of specifying floral meristem identity as well as the later step of determining the fate of floral organ primordia. Here, we report the isolation of two cDNA clones, NsMADS2 and NsMADS3, from a long-day tobacco species, Nicotiana sylvestris, which encode MADS domain-containing proteins. The NsMADS2 amino acid sequence showed 66% identity to SQUA and 64% to AP1. NsMADS3 showed a high degree of amino acid identity with FBP2 (98%), DEFH 72 (89%), DEFH 200 (88%), and AGL9 (76%). RNA blot analyses of NsMADS2 and NsMADS3 revealed that both transcripts were present in floral organs, but not in vegetative organs such as the leaf, root, stem, and 10 d old seedlings. The NsMADS2 transcript was localized in all four whorls and the NsMADS3 transcript was restricted in the three inner whorls of floral organs. The ectopic expression of NsMADS2 using the CaMV 35S promoter caused early flowering and lengthened internode length in transgenic tobacco plants. The ectopic expression of NsMADS3 also caused early flowering phenotype in transgenic tobacco plants, but the plants exhibited reduced apical dominance. Possible implications of these results in relation to the functions of NsMADS2 and NsMADS3 are discussed.


In Neonatal Intensive Care Unit, fungal sepsis are the third leading cause of late onset sepsis among very low birth weight neonates. Many of biomarkers known are neither sensitive nor specific enough to provide an accurate diagnosis of invasive fungal infections. Indeed even today, the "gold standard" in the diagnosis of neonatal fungal sepsis is positive blood culture. Since neonatal sepsis is a multiorgan disorder that leads to metabolic changes in the organism, new technologies such as metabolomics are becoming a promising method in early diagnosis and are capable of predicting onsets, thus allowing personalized treatment and monitoring of neonatal sepsis. Proceedings of the 10 th International Workshop on Neonatology · Cagliari (Italy) · October 22 nd -25 th , 2014 ·  The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou


A well-established event of intraplate basin inversion and basement thrusting affected central Europe in Late Cretaceous time. It is widely accepted to have resulted from the collision of the Alpine orogen with Europe's margin. At that time an early Alpine orogen, located on the leading edge of the Adria microplate, still lay far southeast of its present-day position and had entered a phase of extension after a first orogenic event characterized by W- to NW-directed thrusting. This configuration is not likely to have induced SSW-NNE–directed thrusting and folding in the future European foreland that was still separated from the Alpine wedge by a strip of oceanic lithosphere. By contrast, the onset of intraplate contraction coincides with an important change in relative motion between the European and African plates. At ca. 90 Ma, Africa's SSE-directed sinistral transform motion relative to Europe changed to NE-directed convergence. This agrees well with the timing and kinematics of intraplate thrusting in central Europe. Structures of similar age and kinematics occurring in southern France, Spain, and North Africa suggest that the Late Cretaceous pulse of contraction was caused by pinching west-central Europe's thin lithosphere between Baltica and Africa. Only since the onset of N-directed thrusting in the Alps in Paleocene or Eocene time are the kinematics of the Alps and their European foreland compatible, indicating that mechanical coupling between Africa-Europe and the Adria microplate had been achieved.


BACKGROUND
Postoperative ileus remains an issue after colorectal surgery delaying recovery and increasing the length of hospital stay and costs.

OBJECTIVE
The purpose of this study was to analyze the impact of perioperative fluid management on ileus occurrence after colorectal surgery within a fully implemented enhanced recovery pathway.

DESIGN
This was a retrospective cohort study of a prospectively maintained institutional database.

SETTINGS
The study was conducted at a tertiary academic facility with fully implemented standardized enhanced recovery pathway over the entire study period.

PATIENTS
All of the consecutive elective major colorectal resections for benign or malign indications between 2011 and 2016 were included.

MAIN OUTCOME MEASURES
Postoperative ileus was defined as the need for nasogastric tube reinsertion. Perioperative fluid management and surgical outcome were compared between patients presenting with ileus and those without. Potential risk factors for ileus were identified through multinomial logistic regression.

RESULTS
Postoperative ileus occurred in 377 (9%) of 4205 included patients at day 4 (interquartile range, 2-5 d). Intraoperatively, ileus patients received 3.2 ± 2.6 L of fluids, whereas the remaining patients received 2.5 ± 1.7 L (p < 0.001). Weight gain was 3.8 ± 7.1 kg in ileus patients versus 3.0 ± 6.6 kg (p = 0.272) in the remaining patients at postoperative day 1, 4.4 ± 6.5 kg versus 3.1 ± 7.0 kg (p = 0.028) at postoperative day 2, and 1.8 ± 6.0 kg versus 0.0 ± 6.0 kg at discharge (p = 0.002). The multivariable model including all significant (p < 0.05) demographic, fluid management-related, and surgical parameters retained postoperative day 0 fluids of >3 L (OR = 1.65 (95% CI, 1.13-2.41); p = 0.009), postoperative day 2 weight gain of >2.5 kg (OR = 1.49 (95% CI, 1.01-2.21); p = 0.048), and occurrence of postoperative complications (OR = 2.00 (95% CI, 1.39-2.90); p < 0.001) as independent risk factors for ileus.

LIMITATIONS
This study was limited by its retrospective design. Fluid management depends on patient-, disease-, and surgery-related factors and cannot be generalized and extrapolated.

CONCLUSIONS
Fluid overload and occurrence of postoperative complications were independent risk factors for postoperative ileus. This calls for action to keep perioperative fluids below suggested thresholds. See Video Abstract at http://links.lww.com/DCR/B54.