We explore the low-frequency radio properties of the sources in the Fanaroff-Riley class 0 catalog (FR0CAT) as seen by the LOw Frequency ARray (LOFAR) observations at 150 MHz. This sample includes 104 compact radio active galactic nuclei (AGN) associated with nearby (z 0.5), an indication of the presence of substantial extended emission confined within the spatial resolution limit. The fraction of FR0s showing evidence for the presence of jets, by including both spectral and morphological information, is at least ~40%. This study confirms that FR0s and FRIs can be interpreted as two extremes of a continuous population of jetted sources, with the FR0s representing the low end in size and radio power.


Social media has quickly become an essential marketing and communication tool for private, public and non-governmental entities across the world to promote their organizational mission, daily events and publications. Many citizens use social media to post or share real time photos on a variety of environmental issues such as pollution or littering, forest fires, reported chemical spills in waterways, illegal dumping, and injured or deceased endangered animals. This simple, yet effective action can result in prompt awareness of an environmental incident and timely response from various agencies responsible for the environment. This paper presents a framework for evaluating the mechanisms that involve the public in environmental protection. It also investigates the role of social media in forming the environmental concepts. In this study, a systemic approach was adopted to investigate the environmental and social status of a target area and by preparing a suitable questionnaire and finally introducing theme and subtheme. According to the results, all the seven final themes showed the substantial impact of social media on attitude of the public and trend of participation in improving the status of Zayandeh-rood environment.


ABSTRACT Pulse Shape 22 is an improvisational audiovisual performance featuring shortwave radio transmissions as the sole source material for real-time audio processing alongside video of the sun projected through cast-glass lenses designed specifically for this piece. The structure of the piece is derived from metrics on energy accumulation over a period of 2.2 nanoseconds resulting from the targeting of 60 laser beams on a single tetrahedral hohlraum in weapons testing experiments as carried out by the Los Alamos Inertial Confinement Fusion unit, at the Omega Laser Facility at the University of Rochester. Pulse Shape 22 is an exploration of architectural space through the use of site- and time-specific information found in regions of the electromagnetic spectrum outside the reaches of the human sensory apparatus. It is an attempt to alter the audience's perceptions of their surroundings and create a moment of rupture from hidden worlds found in our local environment.


Treatment with cyclosporin for immunosuppression in renal allograft recipients was started in this hospital at the beginning of the year. Cyclosporin is nephrotoxic, but the exact mechanism by which the nephrotoxic effect is excited is unknown. In this preliminary study three cases were examined in an attempt to recognise the effect of cyclosporin on a cytological basis. Fresh preparations of urinary sediment were stained in the usual way by Giesma, methylgreen pyronin, and Papanicolaou. One preparation was also subjected to study under blue light fluorescence. During the first two to three days after the allograft when the patients were receiving a high dose of cyclosporin most of the cells in the urinary deposits showed faint yellow fluorescence. By the third day cells had appeared that displayed a variable degree of blue-green fluorescence extending from just the nucleus or periphery of the cell to the entire cell. The number of cells exhibiting blue-green fluorescence and the intensity of fluorescence continued to increase as the dosage of cyclosporin was maintained. The types of cells that displayed the blue-green fluorescence were initially tubular cells, renal tissue fragments, lymphocytes, and red cells, if these were present. The cells were identified by phase contrast microscopy. The blue-green fluorescence appeared only when high doses of cyclosporin were given, and on three occasions whole blood monitoring of cyclosporin by radioimmunoassay showed cyclosporin concentrations above 1000 ng/ml. When the dosage of cyclosporin was reduced fewer cells exhibited blue-green fluorescence, and the intensity of the fluorescence was reduced. The urinary deposits from recipients of renal allografts on low maintenance doses of cyclosporin were also examined and no blue-green fluorescence was observed. The urinary sediments from patients other than recipients of renal allografts, and who were not receiving cyclosporin treatment but were receiving various other drugs were also examined, and no blue-green fluorescence was seen. Cell deposits from other body sites such as pleural effusions and breast cyst fluids, were also examined and blue-green fluorescence was not observed. In all of these samples many cells did show varying degrees of yellow fluorescence that were considered to be non-specific. Letters


Traditional automata theory is an extremely useful abstraction for reasoning about sequential computing devices. For distributed systems, however, there is no clear consensus on how best to incorporate various features such as spatial independence, concurrency and communication into a formal computational model. One appealing and elegant approach is to have a network of automata operating on a distributed alphabet of local actions. Components are assumed to synchronize on overlapping actions and move independently on disjoint actions. We describe two formulations of automata on distributed alphabets, synchronous products and asynchronous automata, that differ in the degree to which distributed choices can be coordinated. We compare the expressiveness of the two models and provide a proof of Zielonka's fundamental theorem connecting regular trace languages to asynchronous automata. Along the way, we describe a distributed time-stamping algorithm that is basic to many interesting constructions involving these automata.


Critical infrastructure protection has become a topic of increasing interest in military and civilian socio-professional communities and, in particular, NATO and the EU, taking in consideration that the threats addressing to security are increasingly complex. In this context, research and education are important actors in the design of advanced integrated solutions for solving the subsumed problems. Besides, in the Horizon Framework Programme 2020' content are set as areas of interest the "smart grid" critical infrastructure protection type and resilience to the "smart meters" threats type. This is the general framework related to the proposed article, with the intention that its approach to become subject for a research project in future competitions, necessity supported by the fact that Land Forces Academy is the only higher education institution organizing a postgraduate course in the field, designed in accordance with existing national occupational standards. Specifically, the paper presents a possible way ahead to be implemented for increasing the functionality of a simulation laboratory for managerial decision on critical infrastructure protection field which helps to assess key points and risks of different infrastructure systems. Primary, we appreciate the need for modeling of interactions that occur between different critical infrastructures. There are highlighted existing software in the field and it is explained the utility of the best of them to be used in relation to the objectives of taken approach. Simulated enterprise represents the same idea that produces beneficial effects in polytechnic education. Similarly, it will be replicated the structures and decision-making areas corresponding to ten types of infrastructure sectors regulated at national level and a crisis management center, aiming to ensure technical, systemic and operational interoperability for scenarios that create cascading effects. Such as, it could be provided modern opportunities for practice of the procedures, for analysis and for designing the appropriate solutions based on tools and techniques of advanced knowledge.


OBJECT
Intracranial arteriovenous malformations (AVMs) are most commonly classified based on their Spetzler-Martin grades. Due to the composition of the Spetzler-Martin grading scale, Grade III AVMs are the most heterogeneous, comprising 4 distinct lesion subtypes. The management of this class of AVMs and the optimal treatment approach when intervention is indicated remain controversial. The authors report their experience with radiosurgery for the treatment of Grade III AVMs in a large cohort of patients.

METHODS
All patients with Spetzler-Martin Grade III AVMs treated with radiosurgery at the University of Virginia over the 20-year span from 1989 to 2009 were identified. Patients who had less than 2 years of radiological follow-up and did not have evidence of complete obliteration during that period were excluded from the study, leaving 398 cases for analysis. The median patient age at treatment was 31 years. The most common presenting symptoms were hemorrhage (59%), seizure (20%), and headache (10%). The median AVM volume was 2.8 cm(3), and the median prescription dose was 20 Gy. The median radiological and clinical follow-up intervals were 54 and 68 months, respectively. Univariate and multivariate Cox proportional hazards and logistic regression analysis were used to identify factors associated with obliteration, postradiosurgery radiation-induced changes (RIC), and favorable outcome.

RESULTS
Complete AVM obliteration was observed in 69% of Grade III AVM cases at a median time of 46 months after radiosurgery. The actuarial obliteration rates at 3 and 5 years were 38% and 60%, respectively. The obliteration rate was higher in ruptured AVMs than in unruptured ones (p < 0.001). Additionally, the obliteration rate for Grade III AVMs with small size (< 3 cm diameter), deep venous drainage, and location in eloquent cortex was higher than for the other subtypes (p < 0.001). Preradiosurgery AVM rupture (p = 0.016), no preradiosurgery embolization (p = 0.003), increased prescription dose (p < 0.001), fewer isocenters (p = 0.006), and a single draining vein (p = 0.018) were independent predictors of obliteration. The annual risk of postradiosurgery hemorrhage during the latency period was 1.7%. Two patients (0.5%) died of hemorrhage during the radiosurgical latency period. The rates of symptomatic and permanent RIC were 12% and 4%, respectively. Absence of preradiosurgery AVM rupture (p < 0.001) and presence of a single draining vein (p < 0.001) were independent predictors of RIC. Favorable outcome was observed in 63% of patients. Independent predictors of favorable outcome were no preradiosurgery hemorrhage (p = 0.014), increased prescription dose (p < 0.001), fewer isocenters (p = 0.014), deep location (p = 0.014), single draining vein (p = 0.001), and lower Virginia radiosurgery AVM scale score (p = 0.016).

CONCLUSIONS
Radiosurgery for Spetzler-Martin Grade III AVMs yields relatively high rates of obliteration with a low rate of adverse procedural events. Small and ruptured lesions are more likely to become obliterated after radiosurgery than large and unruptured ones.


Sing point incremental forming (SPIF) limit is much higher than the traditional processes. Currently, there are still no systematic theories and criterions to predict the limit. In this paper, the Oyane ductile fracture criterion is introduced to predict the forming limit of SPIF based on the stress-strain data by the finite element simulations. The predicted fracture initiation sites and the forming limit curve are consistent with the experiment results; further, the forming characteristic, stress state, local temperature are the main reasons of the higher forming limit in SPIF.


Non-orthogonal multiple access (NOMA) has been identified as a promising technology for future wireless systems due to its performance gains in spectral efficiency when compared to conventional orthogonal schemes (OMA). This gain can be easily translated to an increasing number of served users, but imposes a challenge in the system reliability which is of vital importance for new services and applications of coming cellular systems. To cope with these issues we propose a NOMA rate control strategy that makes use only of topological characteristics of the scenario and the reliability constraint. We attain the necessary conditions so that NOMA overcomes the OMA alternative, while we discuss the optimum allocation strategies for the 2-user NOMA setup when operating with equal rate or maximum sum-rate goals. In such scenario we show that the user with the largest target error probability times the ratio between the average receive signal power and the average interference power, should be scheduled to be decoded first for optimum performance. We compare numerically the performance of our allocation scheme with its ideal counterpart requiring full CSI at the BSs and infinitely long blocklength, and show how the gap increases as the reliability constraint becomes more stringent. Results also evidence the benefits of NOMA when the co-interference can be efficiently canceled, specially when the goal is to maximize the sum-rate.


Ontogenetic shifts in habitat use are widespread, especially in ectothermic taxa in which juveniles may be an order of magnitude smaller than large adult conspecifics. The factors that generate such habitat shifts are generally obscure, but we studied an unusual system that allowed us to compare consequences of habitat selection between adults and juveniles. Pit-vipers (Gloydius shedaoensis )o n a small island in north-eastern China feed almost entirely on seasonally migrating birds. During the spring bird-migration period, individual snakes consistently re-used either arboreal or terrestrial ambush sites. Snakes in trees were smaller (and more philopatric) than snakes on the ground. This ontogenetic shift in habitat use may reflect the difficulty of capturing birds on the ground, especially by small snakes. In laboratory trials, large (adult) pit-vipers struck faster, further and more accurately than did small (juvenile) snakes. In experiments with freeranging snakes, the proportion of strikes hitting the bird was lower for juveniles than for adults, and lower for terrestrial snakes than for arboreal snakes. Additionally, adult snakes generally seized the bird by the head whereas juveniles frequently struck the body or wings (and thus, obtained a less secure grip). Arboreal ambush sites may facilitate prey capture not only because they give access to smaller birds but also because they render the bird's location more predictable and, hence, enable the snake to position itself optimally prior to the prey's arrival. Because juvenile pit-vipers are less capable strikers, and are small relative to available prey items, they may benefit from the greater ease of prey capture from branches. Thus, the ontogenetic shift in habitat selection within this species may be because of ontogenetic shifts in the vipers' ability to capture and ingest large, mobile prey.


Pancreatic cancer has the worst prognosis and is the fourth leading cause of cancer-related deaths in the United States. The five-year survival for this disease is <6% and it is lethal to almost all of the patients diagnosed. As with many epithelial cancers, pre-invasive precursors in the pancreas progress slowly over many years to decades to development of invasive pancreatic cancers in humans. Lack of early detection and effective interventions are major factors contributing to the poor prognosis and dismal survival rates of pancreatic cancer patients for more than sixty years. Detection of pancreatic cancer at an early stage might permit life-saving interventions. Use of tumor xenografts and/or orthotopic models to predict valid targets and for design and development of drugs for pancreatic cancer patients has been disappointing. Animal models with etiological relevance that recapitulate the molecular pathology of human pancreatic intraepithelial neoplasia (PanINs) and their progression to pancreatic ductal adenocarcinoma (PDAC) are ideal models for establishing pancreatic cancer prevention and treatment strategies. Recent advent in genetically engineered mouse (GEM) models, such as development of transgenic KrasG12D-dependent mouse models of PDAC, that mimic human PDAC offer opportunities to identify putative targets of pancreatic lesion development and targeted drug strategies for PDAC prevention. We will present recent advances on i) selection of optimal Kras mouse models for prevention and early diagnosis, and ii) application of Whole Transcriptome (SOLiD) approaches to identify druggable targets for PanINs and PDAC. Then, iii) we will provide a few examples of development of molecularly targeted chemopreventive drugs using the krasG12D mouse model. Citation Format: Chinthalapally V. Rao. Animal models for human pancreatic cancer prevention. [abstract]. In: Proceedings of the Eleventh Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2012 Oct 16-19; Anaheim, CA. Philadelphia (PA): AACR; Cancer Prev Res 2012;5(11 Suppl):Abstract nr ED02-03.


The aim of the research was to study the significance of morbidity of Parkinson's disease (PD) and mortality in Russian Federation in international comparisons. Material and Methods: In accordance with the purpose of the study the morbidity and mortality were analyzed in the Russian Federation on the basis of volumes "Morbidity in Russia" of the Ministry of Health of the Russian Federation in 2009-2012, "Human resources for health care institutions" of the Ministry of Health of the Russian Federation in 2012, tables С 51 about the mortality of subjects of the Russian Federation in 2012, data of mortality from Parkinson's disease in different countries in 2011, published by WHO. Results. The analysis of data on the morbidity patterns showed that in the Russian Federation in 2009-2012 there was an increase in general morbidity of adult patients with PD from 75.1 to 87.7 per thousand of populations. The data of primary morbidity in the adult population of the Russian Federation from PD also tend to increase from 8.0 to 8.5 per thousand of populations. The sharp fluctuations of mortality's data were revealed in subject of Russian Federation that was related of unreliable data. Mortality from PD in Russian Federation in 2012 was 0.31 per thousand of populations. Conclusion. The values in the study of general and primary PD's morbidity in the Russian Federation were lower than performance in international comparisons. PD's mortality in Russia was also lower than in other developed countries. Abidance by rules of selecting the primary cause of death (PCOD), confirmed by an automated system, where one of the causes is PD will make mortality statistics of PD reliable and internationally comparable.


In this study, we have developed a rational design strategy to obtain highly selective supramolecular recognition systems of cyclodextrins (CyDs) on the basis of the lock and key principle. We designed and synthesized dipicolylamine (dpa)-modified γ-CyD-Cu2+ complexes possessing an azobenzene unit (Cu·1-γ-CyD) and examined how they recognized phosphoric acid derivatives in water. The results revealed that Cu·1-γ-CyD recognized ATP with high selectivity over other phosphoric acid derivatives. The significant blue shift in the UV-vis spectra and 1H NMR analysis suggested that the selective ATP recognition was based on the multipoint interactions between the adenine moiety of ATP and both the CyD cavity and the azobenzene unit in addition to the recognition of phosphoric moieties by the Cu-dpa complex site. Our unique receptor made it capable of distinguishing ATP from AMP and ADP, revealing the discrimination of even a length of one phosphoric group. This study demonstrates that, compared to conventional recognition systems of CyDs, this multipoint recognition system confers a higher degree of selectivity for certain organic molecules, such as ATP, over their similar derivatives.


Results showed that autonomic nervous system (ANS) and blood circulation system (BCS) dysfunction in 3 rd trimester pregnant women with gestosis are more pronounced, than in healthy pregnant women, despite the prescribed treatment. The most significant disturbances were vagotonia and hypokinetic haemodynamics type (often iatrogenic). Spinal arnesthesia (SA) during Cesarean section in pregnant women is accompanied by blood pressure decrease to the level demanding on vasopressors use. Considering normal indicators of SI, Cl, oxygen transportation and electrocardiogram vasopressor was not introduced. Apgar score assessment of newborns was within normal. However, vagotonia and hypokinetic haemodynamics type during anаesthesia that certifies autoregulation reserves insufficiency. Atropine introduction in pregnant women with vagotonia and hypokinetic haemodynamics type (often iatrogenic, owing to irrational therapy) before SA beginning of promoted neurovegetative inhibition optimization and haemodynamics stabilization in eukinetic range. Vagus blockade (elimination of ANS dysfunction) was accompanied by more physiologic sympathicotonia development with smaller decrease of blood pressure (without stroke index reduction!), absence of bradycardia and vomiting. Research showed that the blood pressure cannot be the only objective criterion of vasopressors use.


In this article, we propose a new probabilistic approach for product recommendations using deep learning framework, combining information from historical observations, similar users and prior knowledge. The deep learning approach is using autoregressive recurrent networks to model the recommendations probabilistically from a Bernoulli distribution. If prior information exists we implement a Pseudo-Bayesian approach, where we obtain posterior samples assuming Bernoulli likelihood on the sampled data from the deep learning model. The proposed approach allows for a very flexible modeling of product recommendations and quantifying uncertainty in predictions. Simulations and experiments were conducted to demonstrate the applicability and performance of the model. Comparisons made to related recommendation models revealed more accurate predictions among the proposed models.


BACKGROUND AND OBJECTIVE: The growing Anglicization of the German language especially affects medicine. This is true not only in medical research but also for congresses and publications. This leads to far-reaching consequences also for continuing medical education. This questionnaire study obtained the opinions by a selected group of doctors attending a general medical congress. METHODS: Questionnaires were distributed to 365 attendees of the 51. Doctors' Congress in Berlin in June 2002. In addition 345 questionnaires were sent to doctors working at 3 university clinics, 27 clinics at teaching hospitals and 9 at communal clinics throughout Germany. Answers were divided by work place (clinical or non-clinical) and age. RESULTS: There were 360 respondents (188 non-clinical, 172 clinical; 51.1%): 20% reported good self appraised knowledge of written and spoken English. 84.7% were against English as the only language at meetings of German medical societies, while 98.3% were against it for national congresses (except for foreign guests). 84.3% agreed that German and English should be the languages, both of talks and discussions, at international congresses held in Germany. English as the language of specialist journals was less strongly rejected by young respondents. There was no age-related difference regarding the other questions. CONCLUSIONS: The respondents considered it as self-evident that German be the only language at German national congresses and of journals by German publishers directed at German doctors, but certain exception were acceptable. At international congresses held in Germany, both German and English are equally acceptable in order to avoid a large part of the interested German medical community being disadvantaged in their acquisition of medical-scientific information were English to be the sole language.


The performances of current texture analysis algorithms are still poor, especially when applied to a large, diffuse texture domain. Most of these purely computationally driven techniques are created to function within a highly restricted domain. When applied as computer vision techniques, frequently results are judged as not intuitive by the system's users. In the current line of research, after two smaller studies, a large study has been conducted with 450 participants with the aim to unravel human texture classification. The bare bones of texture analysis, as embedded in the human visual system, were taken as starting point. Consequently, three aspects were identified: 1) colorful texture analysis, 2) gray scale texture analysis, and 3) global color distribution. For artificial color analysis, an unique, human inspired color space segmentation was utilized. Artificial texture analysis was based on the co-occurrence matrix. In addition to color and texture, the influence of shape was taken into account. To gather information on the human texture classification process, an online card sorting experimentation platform was used: http://eidetic.ai.ru.nl/M-HinTS/. In separate experiments, the participants clustered color and gray scale versions of 54 textures, drawn from the OuTex and VisTex texture databases, into six clusters. Three versions of the experiments were conducted with textures printed in: squares (the 'shapeless condition'), three distinct shapes, (the 'three-shape condition'), and six predefined shapes (the 'six-shape condition'). Both color and shape did have a significant influence on the mutual agreement among the subjects, ranged from 78% (color - 'shapeless') to 60% (gray – 'six-shape condition'). Using artificial clustering techniques we mimicked human's average texture classification in 80% (color - 'shapeless') to 58% (gray – 'six-shape condition') of the cases. Hence, the artificial clustering did have a similar mutual agreement with the participants as the participants had among each others. The success of mimicking human texture classification could not mask the enormous variety among the participants in their classification task. The latter emphasized the impossibility to develop a generic texture classification system, which would resemble human texture classification. However, the results enable the design of a generic model. Subsequently, the model's parameters could be adapted to specific users, if preferred. Then, not only average human texture perception could be mimicked but also specific user characteristics could be replicated, which would be a first step in new cognitive computer vision techniques.


Purpose: The theory that glaucoma patients have a lower intracranial pressure (ICP) than healthy subjects is a controversial one. The aim of this study was to assess ICP noninvasively by determining the relationship between distortion product otoacoustic emission (DPOAE) phase and body position and to compare this relationship between patients with primary open angle glaucoma (POAG), patients with normal tension glaucoma (NTG), and controls. The relationship was also calibrated using published data (Lind en et al 2017) regarding invasive measurements of ICP versus body position. Methods: DPOAEs were measured in 30 controls and 32 glaucoma patients (17 POAG, 15 NTG) at the following body positions (assuming 90° as upright): 45, 30, 20, 10, 0 (supine), 10, and 20°. Results: DPOAE phase had a clear, nonlinear relationship with body position. The mean DPOAE phase shifts between the two most extreme body positions (45 to 20°) were 73.6, 80.7, and 66.3° for healthy, POAG, and NTG, respectively (p = 0.73), and the groups showed the same, nonlinear behaviour. Conclusions: Based on a noninvasive measurement, there is no evidence that glaucoma patients have a reduced ICP. When calibrated with invasive data, ICP and DPOAE phase were linearly related over an ICP of 3 mmHg. This suggests that, more broadly, DPOAEs could be used in the future to monitor changes in ICP in a clinical setting and to measure dynamic changes in ICP such as diurnal fluctuations or changes induced by certain medications. Lind en C, Qvarlander S, J ohannesson G, Johansson E, € Ostlund F, Malm J, et al. Normal-Tension Glaucoma Has Normal Intracranial Pressure: A Prospective Study of Intracranial Pressure and Intraocular Pressure in Different Body Positions. Ophthalmology [Internet]. 2017 Oct 30; Available from: https://doi.org/10.1016/j.ophtha.2017.09.022


Phenolic compounds are a wide family of thousands of natural bioactives well-known for their overwhelming demonstrated health benefits. Particularly in wines, polyphenols and quality are closely interconnected. Indeed, these compounds possess a critical role due to their contribution to organoleptic wine quality as color, astringency, and bitterness. The profile or the composition of certain polyphenols has been even proposed as an analytical tool for authenticity certification. In this sense, although important progress has been achieved, the understanding of the relationship between the quality of a particular wine and its phenolic composition remains one of the major challenges in enology research. But why? If there is an adjective to define wine, it is "complex." This final complexity of a wine begins with the enormous polyphenolic variability that may be present in grapes influenced by ripening, genetic, or environmental factors, among others. Winemaking process (alcoholic and malolactic fermentation) and wine aging with or without wood contact produce endless reactions giving rise to complex transformations (copigmentation, cycloaddition, polymerization, and oxidation) of polyphenols. This chapter gathers the most relevant information about the composition, variations, and transformations of phenolic compounds from grape to wine including their influence on sensory properties.


In this paper, we propose a minimum generation error (MGE) training method to refine the audio-visual HMM to improve visual speech trajectory synthesis. Compared with the traditional maximum likelihood (ML) estimation, the proposed MGE training explicitly optimizes the quality of generated visual speech trajectory, where the audio-visual HMM modeling is jointly refined by using a heuristic method to find the optimal state alignment and a probabilistic descent algorithm to optimize the model parameters under the MGE criterion. In objective evaluation, compared with the ML-based method, the proposed MGE-based method achieves consistent improvement in the mean square error reduction, correlation increase, and recovery of global variance. It also improves the naturalness and audio-visual consistency perceptually in the subjective test.


The demand for equal rights and a liberal space to women is under the strenuous attack of Moral and cultural Policing. Democratic law fails to protect the women from the onslaught of culture and tradition. Self-proclaimed defenders of culture and tradition in many parts of the country have sought to outline a woman's 'place' in the society. These so called 'custodians of Indian culture' have no understanding of the constitution and the law. Their concept of morality is prone to extremist religious beliefs. This paper explores the connection between women's body and morality seen through the lenses of culture specifically in Indian context. This paper focuses on the use of culture for violation of women's rights, issues of sexuality and women's equality in a gendered power relation.


Eighty-two percent of public firms have golden parachutes (or "chutes") under which CEOs and senior officers may be paid tens of millions of dollars upon their employer's change in control. What justifies such extraordinary payouts?Much of the conventional analysis views chutes as excessive compensation granted by captured boards, focusing on the payouts that occur following a takeover. Those explanations, if they ever were complete, miss the mark today. This Article demonstrates, theoretically and empirically, that chutes are less relevant to a firm during a takeover than they are before a takeover, particularly in relation to firms that invest in innovation. Chutes assure managers of realizing the long-term value of their work, even if the firm is later acquired. As a result, managers are more likely to make specific investments in innovation whose value may not be realized for some time — but that which are essential to sustaining long-term performance. Moreover, when granted, a chute's expected cost is a small fraction of what may be paid, reflecting the real likelihood a payment will never be made. That cost is more than offset by the value of the specific investments in innovation that managers are now more likely to make. Consequently, granting chutes tends to increase the value of innovative firms — promoting, rather than jeopardizing, shareholder interests in such firms.Nevertheless, an analysis of chutes as a valuable tool in promoting innovation is largely missing from the corporate law scholarship, with important consequences. Two, in particular, are the negative view of proxy advisors on chutes, and recent federal Say-on-Golden-Parachute legislation that mandates certain types of disclosure regarding chutes. We recommend changes that properly reflect the low expected cost of chutes and their positive effect on innovation.


Abstract. The mineralogy and chemistry of the less than 20μm fraction of marine sediments at Morphou Bay, north-west Cyprus, are presented to characterise fine-grained sediment supplies from basic and ultrabasic rocks of the Troodos Massif within a typological setting. The sediments comprise a mixture of smectite, illite, kaolinite and iron rich chlorite. They also contain amorphous iron oxides/hydroxides, calcite (with some magnesium substitution for calcium) and an amphibole. Spatial patterns in mineralogy occur: the near-shore sediments are rich in smectite, chlorite, amphibole and amorphous iron oxides/hydroxides, while the offshore sediments are rich in illite and calcite. The sediments are calcium, magnesium, iron, aluminium and potassium bearing, due to the presence of significant amounts of calcite (for Ca), clay minerals and aluminium and iron oxides/hydroxides. Potassium is present within the micaceous mineral illite, but it is also contained within other phases that are difficult to pinpoint. Statistical analysis reveals that the chemical composition of the sediments broadly follows the mineralogy with the dominant feature being related to spatial changes in the mineralogy. The patterns of change reflect a three component mix of clay-sized sediment types: (1) localised lithogenous sources rich in smectite with subsidiary amounts of amorphous iron oxides/hydroxides and amphibole, from Cyprus, the Troodos in particular, (2) illite rich and smectite chlorite and chlorite bearing material of lithogenous origin from other parts of the eastern Mediterranean and (3) calcite, mainly of marine origin. Keywords: smectite, illite, chlorite, kaolinite, calcite, sediments, Morphou Bay, Troodos, Cyprus, Mediterranean, calcium, potassium, magnesium, iron, silicon, phosphorus.


There is an increasing interest in understanding the crucial factors of sustainable development in terms of security of supply, conservation, and environmental impacts. Based on the current energy perspectives, there are serious challenges in achieving energy security and sustainability. Sustainable energy security (SES) must not only consider the security of energy supply-demand in the long-term and short-term, but also emphasise the balance between energy, economy, social, and environmental factors. Based on the five dimensions of energy security (availability, accessibility, affordability, acceptability, and develop-ability), this study aims to develop and evaluate SES index for Malaysia. The weight of energy security indexes was determined using the entropy weight method. Also, the security and rank performance of the five dimensions of energy security and sustainability were calculated using the Technique for Order of Preference by Similarity to Ideal Solution method. Then, the five dimensions' scores between 2005 and 2016 were measured. The results reveal that the weight of develop-ability and affordability were the most important weights in Malaysia's SES index system. This implied that the energy supply security greatly influenced the SES of Malaysia. In addition, the highest score in develop-ability reflected the sustainable development capacity of the energy system in low carbon, clean, and optimised mode, which plays a crucial role in Malaysia's energy sustainability. The results also reflected the affordability and ability to resist the negative impact of rising energy prices in Malaysia.


The faithful and sophisticated control of motor neurons (MNs) allows for our ability to walk, chew, breathe, and speak. This dissertation is focused on the characterization of MNs and the intricate circuitry that are involved in the control of these MNs that surround the airways. The relevance of this study goes beyond satisfying our curiosity of the physiology of breathing. This knowledge is critical in their application in respiratory medicine and speech rehabilitation – as the same set of MNs generate rudimentary vocal sounds in rodents and may provide us with a greater understanding about speech motor pathways in humans. The dissertation begins with a literature review of principles of circuit assembly predominantly centered in the spinal cord. In Chapter 2, I define the molecular organization of the cranial MNs in the brainstem. Unique transcription factors and guidance cues including Foxp1, Pou3f1, Etv4, and Npn2 label specific cranial motor pools that match previously described motor populations identified by classic retrograde labeling. This molecular definition of cranial motor pools opens up new doors for us to understand their origins to harness the potential for rehabilitation when these MNs are diseased or injured.In Chapter 3, I demonstrate that the respiratory drive can extend to brachial limb-innervating MNs, a feature normally suppressed by Foxp1. In the absence of Foxp1, the limb-innervating MNs exhibit molecular and anatomical characteristics that resemble that of the thoracic respiratory MNs. The findings of this study provide another compelling evidence that the respiratory motor circuit can integrate MNs out of their usual field of innervation to harbor ectopic respiratory MNs – similar to the respiratory drive crossing the midline in the crossed phrenic phenomenon. In Chapter 4, through genetic manipulation I show that Pou3f1, a marker for phrenic and other respiratory MN populations, is essential for proper the phrenic nerve branch projection and intercostal cell fate specification. Finally in Chapter 5, I summarize the key findings of my dissertation and discuss the limitations as well as remaining questions. Together, the results presented in my dissertation have a significant impact on our understanding of the respiratory motor pathways, which could be applied for the regeneration of diseased cells or rehabilitation efforts to accelerate the recovery of motor circuitry involved in breathing, speech, and language.


Jalilah Nurfajri 14111310034. An analysis of "Listening Extra textbook" for
teaching EFL listening
The books used by the teachers are variety while they do not recognize
briefly the quality, suitability or sufficiency of the books they use. Especially to
someone or the teacher who teach listening in the first time. From these problems,
the researcher tries to answer this research, the researcher determine the
instrument to evaluating of the textbook, and the next examine a foreign course
book published by a great well-know publisher, Cambridge University. That used
in largely by many listening lecturer for teaching EFL listening to know how the
criteria of the books, its contents, specific purposed learning targets and its
sufficiency as a listening course for the students learning. This research aims at
finding out the level of micro and macro skill purposed in each tasks of the each
unit in Listening Extra and need to know the sufficiency of "Listening Extra
(Craven, M. 2004 Listening Extra Cambridge University)"as published material
for teaching EFL' listening.
Study of document becomes the technique of this research. This research
also takes a qualitative method in analyzing data where the data is taken from
book and the evaluators as a secondary data source to be analyzed in this research.
There are some steps to analyze the data. The researcher is determining the
instrument of evaluating of the course book, requesting the experts' opinion about
the result of analysis in evaluating the contents course book, then analyze the data,
recalling them to the theories.
The research has found some aspects for the sufficiency in teaching
listening comprehension to EFL learners, the importance of diverging tasks in
listening activities, guidance for designing learning objectives, and the importance
of knowing the purposes of a listening task. Diverging tasks in listening activities
is important in teaching listening. The purpose of the listening, together with the
micro- and macroskills of listening comprehension help teachers to determine
what tasks should be given to the students in listening classes. Different tasks
should be given to aim at different purposes
The sufficiency of the content of Listening Extra for teaching EFL
listening according to the experts' opinion showed that the contents contained in
listening extra have a great sufficiency for EFL Listening, if looked from the
assessing aspects, General Appearance, Objectives, Topic Content, Language
Content, Social and Cultural Context, Language Skills, Teachable, and Flexibility
are Sufficient, but Design and Illustration, Multimedia Content,Testing or Practice
are somewhat sufficient for teaching EFL listening.
Key words: the targeted of Macro and micro skills, Teaching EFL listening, Listening
Extra


This study examined the presence of emotional references in psychopathic communication. The analysis in this study is on secondary data, consisting of 54 interviews conducted with psychopathic and non-psychopathic offenders. It was hypothesized that emotional differences in psychopathic and non-psychopathic communication will be evident in terms of frequency, emotional locus, and emotional valence. The results supported these predictions. Overall, psychopaths produced fewer emotional references in their language use. Compared to non-psychopathic controls, psychopaths produced significantly fewer emotional references indicating empathy for others. Of all emotional terms produced by psychopaths, a significantly higher proportion of the emotional terms were negative. The results of this study indicate that emotional variations are evident in psychopathic language production. Detecting Emotion in Psychopathic Language 4


The heads of marketing and promotion for major professional and university sport organizations were asked to rate the relative importance of 19 marketing objectives on a 5-point Likert scale; 164 responded. Factor analysis resulted in the creation of six factors: player quality, community image of team, entertainment value of sport, team marketing, team as a contender, and attractiveness of game location. ANOVA, Tukey, and student t tests used on the data resulted in significant differences between leagues for the two factors of community image of team and entertainment value of sport. Professional teams favored 5 of 6 objectives over university teams: value of ticket price, entertainment value of the sport, image of the team, community-oriented nature of the team, and availability of athletes for community events.


This chapter intends to review the state of the art of a new nanomaterial generation based on electrospun composite nanofibers for dye removal from wastewater. Natural polymer-based nanofibers, nanofibers with unique morphology, and carbon nanofibers were comprehensively reviewed as capable carriers for a broad spectrum of functional materials such as metal oxides, zeolite, graphene and graphene oxide (GO), and metal-organic frameworks (MOFs) in the application of dye removal. The various nanostructures, adsorption capacity, advantages, and drawbacks were discussed along with mechanistic actions in the adsorption process and photocatalytic performance that emphasize current research development, opportunities, and challenges. The chapter covers multiple intriguing topics with in-depth discussion and is a valuable reference for researchers who are working on nanomaterials and the treatment of colored waters.


Three main Upper Jurassic–Cretaceous tectono-stratigraphic units recognized in Palmer Land and Alexander Island are comparable with assemblages formed (1) in an ensialic volcanic arc (Upper Jurassic Volcanic Group), (2) in a forearc or intra-arc marine basin (Fossil Bluff Formation), and (3) in a back-arc marine basin (Crabeater Point sediments and Latady Formation), possibly representing a proto–Weddell Sea. A sequence of intensely sheared, polyphasally deformed turbidites and pillow lava rocks of possible late Paleozoic or Triassic age, exposed along western Alexander Island, is tentatively interpreted as a trench assemblage accreted during an early stage of subduction. There is a close correlation between these units and the approximately coeval island-arc-marginal basin system of the southern Andes and South Georgia.


Skin and cartilage tissue specimens from 32 male and 13 female corpses aged between 17 and 50 years were collected within 24 h after the death. Each specimen was analyzed for the composition of dextro (D) and levo (L) forms of aspartate, glutamate, and alanine. Linear regression models were constructed using ln [(1 + D/L)/(1 − D/L] equation to define the relationship between the extent of racemization and the chronological age. Aspartate D/L rates from cartilage showed high correlation (r = 0.779, p < 0.001, n = 45). Aspartate D/L rates from skin showed very low correlation (r = 0.356, p < 0.002, n = 44). The multilinear regression model of both aspartate D/L rates of cartilage and skin tissues in 44 cases yielded a coefficient of r = 0.828 (p < 0.001). In conclusion, only racemization rate of Aspartate both in the skin and the cartilage tissues correlated with the chronological age. Our results may imply that the age can be estimated more precisely if two different tissue specimens are obtained from one corpse.


We tested the adhesive response of polymer surfaces structured with arrays of cylindrical fibrils having diameters of 10–20 µm and aspect ratios 1–2.4. Fibrils had two different tip shapes of end-flaps and round edges. A preload-induced mechanical buckling instability of the fibrils was used to switch between the states of adhesion and non-adhesion. Non-adhesion in fibrils with round edges was reached at preloads that caused fibril buckling, whereas fibrils with end-flaps showed adhesion loss only at very high preloads. The round edge acted as a circumferential flaw prohibiting smooth tip contact recovery leading to an adhesion loss. In situ observations showed that, after reversal of buckling, the end-flaps unfold and re-form contact under prevailing compressive stress, retaining adhesion in spite of buckling. At very high preloads, however, end-flaps are unable to re-form contact resulting in adhesion loss. Additionally, the end-flaps showed varying contact adaptability as a function of the fibril–probe alignment, which further affects the preload for adhesion loss. The combined influence of preload, tip shape and alignment on adhesion can be used to switch adhesion in bioinspired fibrillar arrays.


A capability of high-frequency ultrasound detection to monitor the process of energy deposition into a molecular system via Raman excitation is experimentally demonstrated. It is shown that the generated ultrasound signal is directly proportional to the optical signal generated in stimulated Raman scattering. Ultrasound detection provides a simple way to discriminate against laser-induced breakdown and allows for the quantification of the stimulated Raman scattering process where direct optical detection is not available. Additionally, it can be used for stimulated Raman imaging in deep tissue, provided that the generated photoacoustic signal is sufficiently strong.


This paper proposes a simple model to study the relationship between domestic institutions - financial system, corporate governance, and property rights protection - and patterns of international capital flows. It studies conditions under which financial globalization can be a substitute for reforms of domestic financial system. Inefficient financial system and poor corporate governance in a country may be completely bypassed by two-way capital flows in which domestic savings leave the country in the form of financial capital outflows but domestic investment takes place via inward foreign direct investment. While financial globalization always improves the welfare of a developed country with a good financial system, its effect is ambiguous for a developing country with an inefficient financial sector/poor corporate governance. However, the net effect for a developing country is more likely to be positive, the stronger its property rights protection. This is consistent with the observation that developed countries are often more enthusiastic about capital account liberalization around the world than many developing countries. A noteworthy feature of this theory is that financial and property rights institutions can have different effects on capital flows.


The aim of the present study was to investigate relationships between scales from the Karolinska Scales of Personality (KSP) and the factor structure of the KSP in a sample of male juvenile delinquents. The KSP was administered to a group of male juvenile delinquents (n=55, mean age 17 years; standard deviation = 1.2) from four Swedish national correctional institutions for serious offenders. As expected, the KSP showed appropriate correlations between the scales. Factor analysis (maximum likelihood) arrived at a four-factor solution in this sample, which is in line with previous research performed in a non-clinical sample of Swedish males. More research is needed in a somewhat larger sample of juvenile delinquents in order to confirm the present results regarding the factor solution.


In this paper, a genetic-based image segmentation method is proposed which optimizes a fuzzy-set-based evaluation function. A K-Means clustering method is used to generate the initial finely segmented image and to reduce the search space of the image segmentation. A genetic algorithm is then employed to control region splitting and merging to optimize the evaluation function. A critical factor affecting the performance of the segmentation is the choice of the evaluation function in the design of genetic algorithm. Here an evaluation function is defined that incorporates both edge and region information. Considering the edge ambiguity in the image, a novel fuzzy-set-based edge-boundary-coincidence measure is defined and combined with a region heterogeneity measure to guide the genetic algorithm to tune the segmentation. Experimental results on test images show that the genetic segmentation algorithm with the fuzzy-set-based evaluation function performs very well.


Abstract:The Commentary on the Psalms is the least studied of Cassiodorus's sixth-century works. Close knowledge of it significantly alters our understanding of the Introduction to Divine and Human Readings, with which it should be paired. The Commentary serves to establish the Bible as the source for all the liberal arts and a model for rhetorical imitation. This essay examines the eloquence Cassiodorus discovers in the Psalter, focussing in particular on those passages which he marked with the marginal notation for Rhetoric: RT. Cassiodorus finds examples of deliberative, demonstrative, and judicial oration in the Psalter. His elucidation of them does not simply preserve classical lore, but rather presents a sophisticated alternative to pagan theory and practice. A fuller understanding of Cassiodorus's view helps us to grasp his formative influence on medieval culture, rhetoric, and poetics.


DOS TODAY MS-DOS and its clones were all the PC world had to choose from back in the 80s and early 90s, but faded fast once Windows 95 and its successors were released. Still, tens of thousands of powerful applications and awesomely enjoyable games were released in those years. Some, such as SimCity and Tomb Raider, have been regularly updated and modernized, but what about all the rest? M.U.L.E., Wing Commander, Chessmaster, Kings Quest, Leisure Suit Larry, Pinball Construction Set, and literally thousands of other games have been ignored for decades. They were fun in the 80s, so why not now? And thats not to mention all the powerful non-gaming applications. WordStar, WordPerfect, dBase, Lotus, WildCat, TBBS, Telix, and many, many more run as well today as they did in their prime (or maybe better, since all the bugs were worked out decades ago). Although its possible to find and restore an old computer from thirty years ago, parts are getting scarce. This book explains the ins and outs of DOS emulation on modern Mac and PC computers. How to install and configure the emulators, how to install DOS or a clone, how to work with VIRTUALBOX or DOSBOX to make it all work. Everything you need to know is here!


The Palos Lagoon, the largest choked coastal lagoon in the world, is a typical centre of population, commerce, industry and recreation, and consequently it is also a site for disposal of industrial, agricultural and municipal wastes. Important questions concerning beneficial uses of and potential changes to the lagoon and its estuary are left unanswered without a good understanding of hydrodynamic processes. The current study involves the choice, calibration and application of a numerical model which can be used in future hydrodynamic. sediment transport and water quality studies in the area. The twoand three-dimensional modes of the TELEMAC System were chosen to study the hydrodynamics of the Patos Lagoon. In order to calibrate the TELEMAC-2D model for the lagoon, measurements of salinity, current speed and direction, water elevation and wind speed and direction were carried out simultaneously at three stations in the estuarine area during three days. The model validation was carried out against an independent data set from the 1998 El Nino event. Several two-dimensional simulations were carried out to investigate the main processes controlling the Patos Lagoon hydrodynamics. The model was forced with prescribed river inflow at the top of the lagoon, wind stress at the siuface and water elevation at the ocean boundary. The barotropic pressure gradients established between the lagoon and the coastal area as a result of local and remote wind combined with the freshwater discharge, proved to be the main forces controlling the lagoon subtidal circulation, as well as the exchanges between the lagoon and the coast. The local wind dominates the lagoon circulation through the set-up/set-down mechanism of oscillation, whereas the non-local wind drives the circulation in the lower estuary. The entrance channel acts as a filter and strongly reduces tidal and subtidal oscillations generated offshore. Three-dimensional simulations proved to be essential. Studies of the processes involved in the estuarine transverse circulation showed that the wind drives the lateral flow in the shallow areas, whereas in the channel it depends on lateral pressure gradients and channel curvature and geometry. Insights on the estuarine baroclinic circulation indicate the barotropic forces as the main mechanism controlling salt water penetration and salinity structure in the estuary. This study produced valuable information into the forces controlling the circulation of the Patos Lagoon and its estuary. Important issues regarding the capabilities of the TELEMAC System twoand three-dimensional modules were explored, producing a valuable tool for further hydrodynamic and sediment transport numerical modelling experiments.


This paper aims to analyze the determinants of state intervention upon the social and economic life, and to grasp their implications in terms of public policy. The study starts with an over time update of the main theoretical contributions. Some indicators that quantify the extent of state intervention throughout public revenues are analyzed on the EU member countries' sample. Empirical analysis is aimed to establish the relevance held by the main determinants of state intervention in budgetary revenues for the EU countries (1995-2007). Perspectives on state interference during the actual crisis are drawn from the significant determinants of the interference policy.


A cross-lineage therapeutic antibody potently targets the receptor binding site of influenza B virus via multiple mechanisms. An antibody to battle flu B Although it circulates globally and is prevalent enough to warrant inclusion in the seasonal influenza vaccine, influenza B is far less well studied than its cousin, influenza A, and therapeutics are lacking. Shen et al. have now generated a potent antibody that inhibits diverse strains of influenza B virus. The antibody recognizes the receptor binding site in hemagglutinin, a region critical to viral entry, and was shown to be therapeutically effective in mice and ferrets. This antibody could be widely deployed to treat or prevent influenza B infection around the world. Influenza B virus causes considerable disease burden worldwide annually, highlighting the limitations of current influenza vaccines and antiviral drugs. In recent years, broadly neutralizing antibodies (bnAbs) against hemagglutinin (HA) have emerged as a new approach for combating influenza. We describe the generation and characterization of a chimeric monoclonal antibody, C12G6, that cross-neutralizes representative viruses spanning the 76 years of influenza B antigenic evolution since 1940, including viruses belonging to the Yamagata, Victoria, and earlier lineages. Notably, C12G6 exhibits broad cross-lineage hemagglutination inhibition activity against influenza B viruses and has higher potency and breadth of neutralization when compared to four previously reported influenza B bnAbs. In vivo, C12G6 confers stronger cross-protection against Yamagata and Victoria lineages of influenza B viruses in mice and ferrets than other bnAbs or the anti-influenza drug oseltamivir and has an additive antiviral effect when administered in combination with oseltamivir. Epitope mapping indicated that C12G6 targets a conserved epitope that overlaps with the receptor binding site in the HA region of influenza B virus, indicating why it neutralizes virus so potently. Mechanistic analyses revealed that C12G6 inhibits influenza B viruses via multiple mechanisms, including preventing viral entry, egress, and HA-mediated membrane fusion and triggering antibody-dependent cell-mediated cytotoxicity and complement-dependent cytotoxicity responses. C12G6 is therefore a promising candidate for the development of prophylactics or therapeutics against influenza B infection and may inform the design of a truly universal influenza vaccine.


Eight opinion surveys were conducted among French GPs, from 1983 through 1996. They showed that GPs utilize a great deal of means for updating their skills and knowledge. However, some means are only used for information purpose whereas others are high-ranked as tools for continuing training. About 3 GPs out of 10 quote the sessions organized by a medical association aimed at continuing education as the most important tool for them. Medical journals are quoted by 3 others (out of 10). One tenth quote the sessions for continuing education organized by hospital departments. We have to note that attendance of the sessions organized by continuing education associations is now subsidized by the Sickness Insurance National Fund. Nearly 48 percent declare they have attended subsidized sessions for continuing education during 1995 and 1996, and 65% among them find these sessions "very interesting" and appropriate to their needs. About 22 French GPs out of 100 need additional training as concerns AIDS, drug abuse and the like. One tenth need additional training in the section of pains and cancer treatment. The third sector where training need is felt covers office management, administration, health economics and related topics. Continuing education is now compulsory to French medical doctors. In late 1996, about 43 percent GPs deemed it "a good thing" whereas 45 found it either useless or heavy.


The transmission of impact forces in a straight leg from the foot to the level of the greater trochanter was investigated by a two-degree of freedom linear damped-spring model. Foot ground forces measured during a vertical jump and accelerations measured at the level of the greater trochanter were used as model input. The model elastic constant and damping coefficient were determined by solving the dynamic equations of the system. The model was used to predict peak acceleration values for a given input force. Satisfactory prediction of the magnitudes of the first two peaks of the acceleration (maximum difference of 3 percent) was achieved in the two subjects studied.


Despite increasing incidences of human salmonellosis caused by consumption of contaminated vegetables, relatively little is known about how the plant immune system responds to and may inhibit Salmonella colonization. Here we show that Salmonella Typhimurium activates the plant immune system primarily due to its recognition of the flg22 region in Salmonella flagellin. Several previously identified plant genes that play a role in immunity were found to affect the host response to Salmonella. The Salmonella flg22 (Seflg22) peptide induced the immune response in leaves which effectively restricted the growth of Salmonella as well as the plant pathogenic bacterium, Pseudomonas syringae pv. tomato. Induction of immune responses by Seflg22 was dependent on the plant FLS2 receptor. Salmonella multiplied poorly on plant tissues similar to other bacteria which are non-pathogenic to plants. However, Salmonella populations increased significantly when co-inoculated with P. syringae pv. tomato but not when co-inoculated with a type III secretion system mutant of this pathogen. Our results suggest that Salmonella benefits from the immune-suppressing effects of plant pathogenic bacteria, and this growth enhancement may increase the risk of salmonellosis.


This work investigated the effect of substrates on de-emulsification capability and the growth of a bacillus sp. (screened by our laboratory).The biomass and de-emulsification ratios(DR) of cultures grown in substrate with the different nutrients (glucose, liquid paraffin, NH4NO3 and yeast) were determined. In the orthogonal tests, the significant of de-emulsification capability in turn is glucose>liquid paraffin>yeast>NH4NO3. The glucose is the highest effect of nutrients on de-emulsification capability and growth. The de-emulsification ratios(DR) and the glucose utilization ratios increase simultaneously at log and lag growth phase. Measurements of the liquid paraffin residue indicates that 30.1% liquid paraffin in substrate is consumed and used in inducing the demulsifying compounds production rather than the increase of the biomass. The culture grown in substrate with 2%~5% liquid paraffin exhibits highest de-emulsification ratio(DR). The contents of yeast at 0.8mg/L~1.0mg/L is beneficial to the growth and demulsifying compound production.


OBJECTIVE
Wide-bandwidth electronic stethoscopy is reliable and accurate for pediatric telecardiology. We tested a much less expensive and more convenient system for the same purpose, a narrow-bandwidth telephonic stethoscope (TS).

METHODS
Seventy-six consecutive patients (mean age: 10.0; standard deviation: 6.5 years) in a pediatric cardiology outpatient clinic were studied. One pediatric cardiologist examined the patients with his acoustic stethoscope (AS); a second examined them within a few minutes using a remote TS. A nurse placed the TS chest piece as directed by the remote examiner via intercom, but neither video examination nor conversation with the parent/patient were permitted. Examiners independently recorded the stethoscope findings for all heart sounds, all murmurs, and heart disease (present/absent). TS accuracy was indexed using the kappa statistic for TS/AS agreement and for TS agreement with auscultatory findings predicted from echocardiographic (echo) studies (N = 49).

RESULTS
TS/AS agreement was satisfactory for presence/absence of heart disease (kappa = 0.63) and for organic, functional, vibratory, diastolic aortic, and diastolic pulmonic murmurs (kappa range: 0.65-0.75). For other specific murmurs and all heart sounds, TS/AS agreement was either unsatisfactory (kappa < or = 0.60) or indeterminate because prevalence was 0. TS-AS agreement improved when the TS was used by the more-experienced TS examiner and with patients at least 5 years of age. When the older children were examined by the more TS-experienced examiner, the TS-echo comparison yielded kappa = 0.90, raw agreement = 0.96, sensitivity = 0.94, and specificity = 1.00.

CONCLUSIONS
In pediatric patients, a narrow-bandwidth telephonic stethoscope can accurately distinguish between functional and organic murmurs and thus can detect heart disease. Accuracy is greatest when the instrument is used by an experienced examiner with patients at least 5 years of age.


The exploitation and application of recycled concrete are more and more extensive in latest years. But the research on the mechanics characteristic of recycle concrete under cyclic loading is very little. Six types of recycled concrete specimens were made in laboratory. After they were cured for a certain age, we have made a series of cycling loading tests on them. In the tests the maximum and minimal stress ratio, the loading frequency and loading waveform were all considered. The mechanics characteristic of recycled concrete under static loading and cyclic dynamic loading were contrasted. After analyzing the test results, we could get that the maximum stress and minimal stress ratio, the loading frequency and loading waveform influenced the unloading and loading modulus of recycled concrete directly in the tests, and the fatigue life of recycled concrete changed with the loading method.


Myostatin (MSTN), a member of the transforming growth factor β (TGF-β) superfamily, is a negative regulator of skeletal muscle growth. Improving muscle growth is very important to increase the economic value of Indonesian indigenous chicken especially in sentul chicken. This study was aimed to identify the polymorphism of the Myostatin gene in sentul indonesian indigenous chicken with maternal immunization against Myostatin  on post hatch and to evaluate its effect on carcass traits. In this study, 48 Sentul hens for up to 6 months have been divided into three groups with 16 birds in each group: CON, KLH, and KLH-MSTN. The CON group has not received immunization, the KLH group has been immunized with 1 mg of KLH, and KLH-MSTN has been immunized with 1 mg of KLH-MSTN conjugate intramuscularly. The effects of each group have been observed on F1 carcass production.The gene polymorphism was identified using PCR-RFLP and the effect of genotype on carcass chacteristics were analyzed using SAS General Linear Model Procedure. The product of amplification was 247 bp. This  locus was polymorphic in sentul chicken with two alleles (G and T) and three genotypes (GG, GT, TT). Association analysis were not significant in carcass characteristics. The result of this study showed that interaction of each group with genotype not significant on carcass weight of F1 chicken sentul each age group. F1 sentul chicken 12 week-old significant association of genotype was observed only in thighs weight while 20 week-old was significant in live weight, carcass weight, breast weight, wings weight, thighs weight, drum sticks weight, breast muscle weight, thighs muscle weight and drum sticks muscle weight. These results suggest that no effect genotype on maternal immunization against myostatin to stimulate carcass characteristic in sentul chickens.


Extracted from text ... GP AFFAIRS
Medical aid fraud
GAR)/ TAYLOR, MD, Group Services Division,
Medscheme writes:
May I respond to the letter from Dr Mabasa published
in the January edition of CME (2003; 21: 43) . As the
director responsible for Medscheme's Special
Investigations Unit, I was particularly saddened to
observe the defamatory generalisations in the article,
given that:
Ethics was the theme of that edition of CME and in
no sentence was there any stance made against
medical aid fraud
Dr Mabasa accused our investigators of harassment
and worse, but himself approached them to assist a
GP whose child had been kidnapped. We did so at
no cost and successfully recovered the child in 48
hours
Dr Mabasa had ..


Data collected in the International Crown Fire modeling Experiment during 1999 are evaluated to characterize the magnitude and duration of convective energy heating in full scale crown fires. To accomplish this objective data on total and radiant incident heat flux, air temperature, and horizontal and vertical gas velocities were evaluated. Total and radiant energy fluxes were measured. Temperatures were measured using bare Type K 0.13 mm wire diameter thermocouples. Gas velocities were measured using pitot-static type sensors designed specifically for velocity measurements in fires. The experiments occurred in 14 m tall jack pine stands. Flames were 18-25 m tall, fire spread rates were between 0.5 and 1.0 m-s-1. The magnitudes of the temperatures presented are representative of those found in naturally occurring wildland fires. The measured peak gas temperatures varied from 1000 to 2000 K, and gas velocities of 10 to 20 m-s-1. Convective heating rates reached 150 kW-m-2 for short durations (5 to 10 seconds) with sustained flux rates of 40 to 80 kW-m-2 for durations of (~20 to 40 s). The data suggest that maximum convective heat transfer coefficients to the sensor face range from 30 to 50 W-m-2-K-1.


In order to investigate the analgesic effect of needling at "Sitian" points for the nerve root-involved cervical spondylopathy, 68 cases of the nerve root-involved cervical spondylopathy were randomly divided into a treatment group of 46 cases treated by needling at "Sitian" points, and a control group of 22 cases treated by needling at cervical Jiaji points. After 2 therapeutic courses, the therapeutic effects were evaluated by using the visual analogue scale (VAS) and the semeiographic format. The results showed that the markedly effective rate was 78.3% and 54.5%, respectively in the treatment group and the control group, and the difference between the two groups was of significance (P<0.05). It can be concluded that needling at "Sitian" points can bring about a better therapeutic effect on the improvement of clinical symptoms, physical signs and pain than that of the needling at the cervical Jiaji points.


Web-based aptitude tests, which are a special category of aptitude tests, can be used for rather standardized test methods and for a large amount of users. The characteristics of web-based aptitude tests can have an impact on the result of the test. The aim of our research is to develop a method for the evaluation of the user acceptance for web-based aptitude tests. Negative influences when using a Human Computer Interface should be identified and minimized. After an analysis of existing acceptance models, the DART-approach is chosen as a basis for the adoption to web-based aptitude tests. Due to literature research and expert discussion, we identified twelve aggregated acceptance indicators. The use of the DART-approach helps to define a balanced set of measurable acceptance indicators for the evaluation of the user acceptance.


This study was conducted to identify Eimeria species in lambs in Antakya province. For this purpose, 248 samples were collected from 34 randomly selected lamb herds in 6 different towns. In the laboratory examination of samples, 10 different Eimeria species were identified in Antakya province. These species were E. ahsata (11.29%), E. bakuensis (38.70%), E. crandallis (64.91%), E. faurei (11.29%), E. intricata ( 9.27%), E. marsica (16.93%), E. ovinoidalis (55.24%), E. pallida (3.62%), E. parva (13.30%), and E. weybridgensis (30.24%). Among these species, E. weybridgensis, E. marsica and the varieties of E. crandallis (small and blue varieties) are reported for the first time in Antakya province. E. gilruthi, E. gonzalezi, E. granulosa and E. punctata were not observed.


Results: During the study period, 53 cases of RAA and 18 cases of DAA were prenatally diagnosed and postnatally confirmed. Among the 53 cases of RAA, 50 cases (94.3%) showed left ductal arch (LDA), and three (5.7%) had right ductal arch (RDA). Twenty-nine patients (54.7%) had mirror-image branching and 24 (45.3%) had an aberrant left subclavian artery, among which of four cases (7.5%) were associated with the Kommerell's diverticulum. Of 12 patients who underwent chromosomal study, only one revealed abnormal karyotype, and there was no case with 22q11 microdeletion. All RAA patients did not show any symptoms related to tracheal or esophageal compression despite having a vascular ring and thus, did not require corrective surgery. Of the 18 DAA patients, four (22.2%) had symptoms and six (33.3%) underwent a corrective surgery at the median age of 22.5 months (range, 9–27 months). During surgery, five cases (27.7%) revealed right dominant arch, and one case (1.5%) had left dominant arch. chromosomal study was done for six patients (33.3%), and none of them had abnormal results. Conclusions: RAA and DAA can be prenatally detected by fetal echocardiography and may form a vascular ring that can possibly cause obstructive symptoms. However, even with vascular ring, RAA has an excellent prognosis without corrective surgery and DAA also has favorable outcomes after the surgical release of vascular ring.


In the last 2 decades, the Netherlands has experienced an increase in real-estate prices, accompanied by an increase in mortgages and a marked decline in household savings. As a consequence, banks are faced with a large retail funding gap: outstanding mortgage debt is insufficiently matched by retail deposits, whereas other funding possibilities of banks have increasingly been constrained – also due to their large foreign exposures. Traditional macroeconomic models cannot analyse this phenomenon appropriately as they lack a proper model of the financial sector and underestimate the potential for interactions between the monetary and the real sphere. We present a stock-flow consistent approach developed by Godley and Lavoie as a valuable alternative to traditional and New Keynesian macroeconomic models, enabling us to analyse the deposit financing gap for the Netherlands.


To compare the benefits of different therapeutic methods in patients suffering from tinnitus persisting for more than one year, the results of a study with 462 patients are presented. Transtympanal electrical stimulation at the promontory, iontophoresis of lidocaine, EMG biofeedback and masking by hearing aids or tinnitus maskers are compared with regard to their therapeutic efficiency directly after the test period and half a year later. The results indicate the importance of controlling for placebo effect in assessing the therapeutic value of the first three methods (electrical stimulation, iontophoresis and biofeedback). For these therapies an improvement by only less than 10% could be attained compared to success rates of 60% reported in the literature. About 30% of the patients could be successfully equipped with hearing aids or tinnitus maskers, 60% showing a stable benefit over a period of three years. To compare the benefits of the different methods the features of tinnitus (pitch, loudness, type and stability of masking, residual inhibition) and the subjective scaling of the therapeutic efficiency are examined. With regard to other even more recent therapies, the fitting of hearing aids in patients with tinnitus plus hearing loss seems to be of utmost importance in combatting tinnitus.


This paper presents a real-time optimization approach based on the Newton-type algorithm (NTA) and the least-squares (LS) method for power system frequency estimation. A nonlinear Newton algorithm is used to track the modulation effect of frequency variation on the online estimation of the phase angle. The LS curve fitting technique extracts the instantaneous power system frequency from the time-varying phase angle estimation by the NTA. A very low sampling rate is adopted to implement the introduced NTA-LS optimization technique. The presented slow sampling NTA-LS approach is a very efficient real-time algorithm which rectifies the need for wide-bandwidth sensors and promises to reduce the hardware complexity in the phasor and frequency measurement applications. The performance of the proposed method is validated by simulations in MATLAB-Simulink. Real-time implementation results are presented which prove robustness and accuracy of the NTA-LS method under time-varying conditions and in the simulated "real-life" field environment.


Hospitals have for centuries been considered safe havens for immigrants and people on the move. However, immigrants and migrants who seek health care have also been targeted for exclusion and deportation. This article discusses the history of how hospitals and health care facilities in the United States have acted both as sanctuaries and as sites of immigration enforcement. This debate came to a head in California in the 1970s, when conservatives began attacking local public health facilities' informal sanctuary practices. Following the California battles, which culminated in Proposition 187 in 1994, immigrant rights movements have increasingly connected calls for sanctuary with demands for a right to health care.


Action hiding and probabilistic choice have independently established their roles in process algebraic modeling and verification of concurrent systems. While action hiding allows abstraction from unimportant details and model reduction, and the induced nondeterminism enables modeling uncertainty in the system behaviour, probabilistic choice allows quantification of the nondeterminism. However, as not all of the nondeterministic behaviour has a random nature, we are faced with the challenge to combine the above two aspects of concurrent systems, such that one can take maximal advantage of both. This thesis addresses two problems regarding concurrent processes that exhibit both hidden and probabilistic behaviour, or probabilistic processes for short. Namely, a proper reduction of a model, by elimination of the hidden actions, requires a semantical equivalence that preserves the process properties of interest and is a congruence for the process operators. For non-probabilistic processes it has been shown that such an equivalence is branching bisimilarity. However, in the presence of probabilistic choice, more concretely in the alternating model of probabilistic processes, the intuitive notion of branching bisimulation is not a congruence for parallel composition. In this thesis a new branching bisimulation for this model is defined, and it is shown that this is the coarsest congruence for parallel composition that is included in the former. To achieve the congruence result, a hidden action preceding directly a non-trivial probabilistic choice cannot be eliminated. The new branching bisimulation preserves the properties expressible in the probabilistic computation tree logic, and is decidable in polynomial time. Similar to the non-probabilistic case, a single axiom characterizes branching bisimilarity for finite probabilistic processes. The previous results imply that branching bisimilarity, although potentially useful for model reduction, may be in fact too strong to serve as an equivalence relation for probabilistic processes. Another view, taken in the may/must testing theory (as well as in the process calculus CSP), is to distinguish two processes only if they can be distinguished when interacting with their environment, i.e. with another process. However, although processes that differ only in the moment an internal (nondeterministic) choice is made are not distinguished by this theory, for probabilistic processes this is no longer valid. The problem stems from an earlier observation that the schedulers that resolve the nondeterminism in concurrent probabilistic processes are too powerful and yield unrealistic overestimations of the probabilities with which a process can pass a test. The power of the schedulers comes from the fact that they allow the same choice to be resolved in different manners in different futures. In order to restrict the schedulers and thus to obtain the right probabilities, this thesis proposes integrating the information, based on which a nondeterministic choice is resolved, in labels on the nondeterministic transitions. In this way, choices using the same information are resolved in the same way, regardless of the considered future. As a result, the new testing preorder relation can be characterized by a probabilistic ready-trace preorder, a relation that is insensitive to the moment an internal choice is made, yet sensitive to deadlock and to action priorities. In other words, it combines useful features of both the bisimulation-style and the trace-style relations. The parallel composition is also generalized here to include both interleaving and action hiding after synchronization, and it is shown that probabilistic ready-trace preorder is a precongruence with respect to it. Finally, the CSP-style axiomatic characterization shows that all the distributivity laws for nondeterministic choice from CSP are preserved and no new laws are added.


The fifth Rejuvenate dialogue was held on 19th July 2022. Five panellists working across contexts and themes joined the Rejuvenate team on a discussion on gender in child and youth rights. We asked speakers and participants to consider the following four questions: How does gender intersect with child/youth rights and participation?; What kind of gender equality work is being done by/with children and young people?; What are the challenges and opportunities of working at the intersection of gender, child rights and children/youth's participation?; What work is not being done, and is needed?


In this paper we present ReCap, a tool for automated capture and creation of synchronized audio, PowerPoint and digital ink presentation in Real media format. Our tool creates the presentation based on the capture of a classroom lecture in real-time. Our tool is built using several technologies including .Net framework, Microsoft.Ink, ActiveX, SMIL and RealPix. While the tool can be used on any standard PC running Windows with .Net 1.1 framework, the use and capture of digital ink requires a Tablet PC. Recorded presentations are then made available through a podcast which students can subscribe using any podcast receiver. A slide level and pen stroke level indexed presentation is also supported on any browser supporting Active X, like Internet Explorer. By avoiding full-fledged video capture, file sizes are significantly reduced, typically requiring only about 10 Mb for a one-hour lecture. Another salient feature of our tool is that it requires no post-processing to create the synchronized media, thus saving significant post-production effort. ReCap requires minimal hardware support: a windows-based PC with sound recording capability for capturing the lecture dynamics, and a web server with PHP support. The system has been extensively used by the authors in the classroom and has received positive feedback from the students.


Introduction: Dry needling: e.t. Acupuncture: is one of the most accepted CAM therapies, most well: known branch of the Traditional Chinese Medicine, which flows intensive research a few decades in the US, Europe, even in China. Is backed by proving research results of Evidence Based Medicine for properly as well. Objective: To summarize the newer understanding of the mechanism of action and indications with regard to harmonization and closer to the TCM/TCM tenets of contemporary classical Chinese medical applying for. Method: An international literature review, which called CAMbrella, the Pan: European Union project work package based on its research, which took part in the work of the Department of Complementary Medicine in, Health Science Faculty of Pecs University, as well. Results: Acupuncture and TCM, are one of the most researched area of non–conventional, complementary therapies. We have already demonstrated convincingly established by the management of the majority of acupuncture point physiological responses. The mediator neurohormonal transmitters are already known about now. 40 have been identified which are involved in induced "dry needling" effect. Discussion: The "Bridge" between the Eastern and Western medicine is the appropriate knowledge transfer, research and application. The performance of in: service training is a university competence. Evidence Based Medicine has an efficient and effective use based on the quality of training in: service training, which is conducted in some Universities for more decades. Further development of this training, quality education can only be realistic to achieve the goals (which effectively give rise to a dedicated TCM Confucius Institute Pecs University).


Abstract. Debris flows represent frequent hazards
in mountain regions. Though significant effort has been made to predict such
events, the trigger conditions as well as the hydrologic disposition of a
watershed at the time of debris flow occurrence are not well understood.
Traditional intensity-duration threshold techniques to establish trigger
conditions generally do not account for distinct influences of rainfall,
snowmelt, and antecedent moisture. To improve our knowledge on the connection
between debris flow initiation and the hydrologic system at a regional scale,
this study explores the use of a semi-distributed conceptual rainfall–runoff
model, linking different system variables such as soil moisture, snowmelt, or
runoff with documented debris flow events in the inner Pitztal watershed,
Austria. The model was run on a daily basis between 1953 and 2012. Analysing
a range of modelled system state and flux variables at days on which debris
flows occurred, three distinct dominant trigger mechanisms could be clearly
identified. While the results suggest that for 68 % (17 out of 25) of the
observed debris flow events during the study period high-intensity rainfall
was the dominant trigger, snowmelt was identified as the dominant trigger for
24 % (6 out of 25) of the observed debris flow events. In addition,
8 % (2 out of 25) of the debris flow events could be attributed to the
combined effects of low-intensity, long-lasting rainfall and transient
storage of this water, causing elevated antecedent soil moisture conditions.
The results also suggest a relatively clear temporal separation between the
distinct trigger mechanisms, with high-intensity rainfall as a trigger being
limited to mid- and late summer. The dominant trigger in late spring/early
summer is snowmelt. Based on the discrimination between different modelled
system states and fluxes and, more specifically, their temporally varying
importance relative to each other, this exploratory study demonstrates that
already the use of a relatively simple hydrological model can prove useful to
gain some more insight into the importance of distinct debris flow trigger
mechanisms. This highlights in particular the relevance of snowmelt
contributions and the switch between mechanisms during early to mid-summer in
snow-dominated systems.


Collisions in automobiles have become a major safety concern; cases of damage and death due to automobile collisions are frequently reported. The number of pedestrians knocked to death by automobiles is also on the rise in cities and highways. Further into the game reserves, wild animals are also frequently knocked to death by automobiles. The cost of a life cannot be estimated, the cost of damages to the automobiles also impacts negatively on investment. In most cases drivers fail to notice the presence of obstacles ahead and brakes need a driver's response to operate thus increasing the response time, hence reducing their reliability. Many approaches to automobile crash avoidance systems have been proposed in recent time, however, such approaches mainly concentrate on steering maneuvering control. In addition, these approaches do not take into consideration the safety distance to stoppage of the automobile, more so, many approaches only provide a warning signal to the driver for activating the automatic braking. This always provides a room for human error. This paper presents the development of an automatic microcontroller based crash avoidance system that employs obstacle detection and distance measurement using ultrasonic sensors to detect obstacles and their distances. Once the obstacle has been detected and safe separation distance is reached, the automobile performs safety distance induced braking at that distance to bring the automobile to a stoppage. From the results obtained after tests, the system has an average response time of 0.86s to the activation of the brakes and a 12.8 percentage error with respect to the obstacle real distance.


The potential of a 27 GHz microwave link for measuring both evaporation and
precipitation is investigated. For the estimation of evaporation a combination of
the microwave link (radio wave scintillometer) and an energy budget constraint is
proposed. This Radio Wave Scintillometry-Energy Budget Method (RWS-EBM) has been
tested using data from an experiment with a 27 GHz radio wave scintillometer over
2.2 km and four eddy covariance (EC) systems. Comparing one day of measurements (30-
minute intervals) of the evaporation estimated using the RWS-EBM to those measured
by eddy covariance systems leads to the conclusion that the method provides
consistent estimates under relatively wet conditions.

In the case of precipitation, analyses show that the specifc attenuation of an
electromagnetic signal at 27 GHz varies nearly linearly with the rainfall
intensity, which is ideal for line-integrating instruments. Data from an experiment
with a 4.89 km microwave link and a line configuration of seven tipping-bucket
raingauges are used to test whether this instrument is indeed suitable for the
estimation of path-average rainfall. Results from this experiment show that the
attenuation due to wet antennas can have a significant effect on
the retrieved rainfall intensity. However, when a two-parameter wet antenna
correction function is applied to the link data, comparisons with the raingauge
data show that the instrument is indeed well-suited for the measurement of path
average rainfall.


In this chapter, the activity and isoenzymes number of laccases of Pleurotus ostreatus grown in solid-state and liquid fermentations are reported. An atypical behavior of this fungus with relation on enzyme production was observed, since the major laccase activity levels were observed in liquid fermentation, whereas the solid-state fermentation has been recognized as better system for enzyme production.


Abstract The Beryl Field is one of the largest oil fields in the UK Continental Shelf. Mobil commenced production in 1976 via the Beryl Alpha platform. Production peaked at approximately 200 000 BOE/day in 1993 before declining to around 50 000 BOE/day in 2012. Apache assumed operatorship in 2012 and, along with partners Shell, has arrested and reversed production decline on platform production through investment in 3D seismic data, drilling, workovers and improvements to operational efficiency. Redevelopment to date by the Beryl area partnership has focused on strategic wells across multiple play types and fields. These wells have realized an 88% success rate and have led to the delineation of additional, lower risk, drill locations. Drilling flexibility, a deep target inventory and effective partner relationships help to expedite the most valuable opportunities and maintain the drilling campaign. In the future, production growth is anticipated through cost-effective developments of new and existing near-field opportunities, including the recently discovered Callater Field with first oil planned in 2017. Three case studies will illustrate: the importance of structural compartmentalization in under-developed fields; the opportunities remaining in mature fields as a result of historical field management practices; and the value of near and new field opportunities for extending field life.


Surface-tension-driven flows and, in particular, their tendency to decay spontaneously into drops have long fascinated naturalists, the earliest systematic experiments dating back to the beginning of the 19th century. Linear stability theory governs the onset of breakup and was developed by Rayleigh, Plateau, and Maxwell. However, only recently has attention turned to the nonlinear behavior in the vicinity of the singular point where a drop separates. The increased attention is due to a number of recent and increasingly refined experiments, as well as to a host of technological applications, ranging from printing to mixing and fiber spinning. The description of drop separation becomes possible because jet motion turns out to be effectively governed by one-dimensional equations, which still contain most of the richness of the original dynamics. In addition, an attraction for physicists lies in the fact that the separation singularity is governed by universal scaling laws, which constitute an asymptotic solution of the Navier-Stokes equation before and after breakup. The Navier-Stokes equation is thus continued uniquely through the singularity. At high viscosities, a series of noise-driven instabilities has been observed, which are a nested superposition of singularities of the same universal form. At low viscosities, there is rich scalingmore » behavior in addition to aesthetically pleasing breakup patterns driven by capillary waves. The author reviews the theoretical development of this field alongside recent experimental work, and outlines unsolved problems. {copyright} {ital 1997} {ital The American Physical Society}« less


Patient: Female, 14 Final Diagnosis: Pulmonary embolism Symptoms: Chest pain • dyspnea • syncope Medication: Combined oral contraceptives Clinical Procedure: — Specialty: Internal Medicine Objective: Adverse events of drug therapy Background: The prothrombotic effect of combined oral contraceptives (COCs) is well-established, with a 3–6-fold increased risk of VTE compared to non-users. When initiation of COCs is considered, it is therefore of paramount importance to carefully evaluate all other potential risk factors for VTE. Based on a case of life-threatening COC-associated pulmonary embolism in a girl heterozygous for the prothrombin G20210A mutation and with a family history of thrombotic disease, we discuss the importance of assessing not just the genotype but also the phenotype when considering initiation of COCs in patients with thrombophilia. Case Report: A 14-year-old girl presented with acute onset of chest pain and dyspnea followed by syncope. She was hypoxic and hemodynamically compromised at admission. Computed tomography pulmonary angiography revealed a large central "saddle" pulmonary embolism causing nearly total occlusion of the right pulmonary artery, and several minor peripheral embolisms bilaterally. She was successfully treated with thrombolysis (alteplase) followed by aPTT-adjusted heparin infusion until adequate anticoagulation with warfarin was achieved. Two years earlier, the patient had been found heterozygote for the prothrombin G20210A mutation, and 9 months before admission she had initiated use of second-generation COCs. Conclusions: Hereditary thrombophilia and a family history of early-onset venous thromboembolism (VTE) each pose an increased risk of VTE and should be considered as separate, irreversible risk factors. Other contraceptive methods should be used when treatment with COCs is expected to result in an unacceptable high risk of VTE.


BACKGROUND: Pulse dye-densitometry (PDD) is a newly developed technique for monitoring the arterial concentration of indocyanine green. Using this method, circulating blood volume (CBV) can be calculated without using radioisotopes. In this study, the CBV value obtained by PDD was validated by comparison using the human serum albumin ((131)I-HSA) dilution method. METHODS: Eleven healthy volunteers underwent placement of cannulae into the radial artery and antecubital vein for withdrawal of blood samples and injection of indicator. Probes for PDD were attached to the right nostril and the right index finger. Indocyanine green (20 mg), dissolved in 4 ml water, and 25 microCi (131)I-HSA in 1 ml distilled water were injected simultaneously into the left antecubital vein. Blood samples were withdrawn 3, 6, 10, 20, 30, and 45 min after injection, then processed for spectrophotometric measurement of indocyanine green and scintillation counting. RESULTS: The blood dye concentration correlated well with the values obtained by PDD (r=0.986, imprecision 0.04+/-0.11 mg/l, 10.0+/-31%. The imprecision of the CBV value obtained by PDD (nose probe) and by the (131)I-HSA dilution method was 3.99+/-10.54%, 0.259+/-0.593 l. The imprecision of the CBV obtained by in vitro spectrophotometry compared with PDD was 2.47+/-9.00%, 0.100+/-0.446 l. CONCLUSIONS: This newly developed, less invasive method can measure CBV with an imprecision of 3.99+/-10.54%, 0.259+/-0.593 l (nose probe), and thus is also as accurate as the conventional radioisotope method.