Clinical management involves values, the recognition of a patient's unique circumstances, and information. Given strong biases in the way we all process experience, clinical decision making must acknowledge the results of formal research. Evidence-based clinical management requires that we take account of the whole body of available evidence, not a potentially biased "biopsy" of it. Systematic literature review is therefore a central element. Such an approach is time consuming and requires skills in literature search and data evaluation, which physicians frequently have not been taught. Computing and library facilities are an important aid, as is the development of evidence-based resources such as the Cochrane Library Collection. Practice guidelines can prove useful and acceptable to clinicians if they are both evidence- and practice-based. The largest single obstacle to evidence-based clinical management is the bias against the reporting of studies with negative findings. This can be overcome by compulsory trial registration.


MicroBooNE is a liquid argon time projection chamber which has been running in the Booster Neutrino Beam at Fermilab since 2015. The primary goal of MicroBooNE is investigation of the excess of electromagnetic events observed by the MiniBooNE collaboration. Due to limitations of the Cherenkov-based particle identification of MiniBooNE, this excess could be interpreted as either photon-like or electron-like. A photon-like excess would indicate that there are processes which are not well understood which could act as a background in neutrino oscillation measurements, while an electron-like excess could indicate the presence of sterile neutrinos, the existence of which is one of the most hotly debated questions in the field. This work will outline the MicroBooNE strategy for investigation of this low-energy excess, with particular attention given to the role of the muon neutrino sideband which is used as an important constraint on systematic uncertainties. A procedure has been developed in order to apply this constraint to an electron neutrino dataset, and it has been shown that the constraint results in an improvement to the sensitivity. In order to perform this constraint, an exclusive-state νμ CC selection has been developed, which results in 804 selected events from on-beam data. The ratio of the data with respect to simulation is R=0.78 ± 0.04 (stat.) ± 0.12 (syst.). In addition, this thesis presents a first measurement of the longitudinal ionisation electron diffusion coefficient from the MicroBooNE data, which is determined to be 3.73 (+0.70, -0.68) cm2/s.


This discussion paper outlines the connection between the perceived urgency of environmental and resource challenges that humanity is facing during the twenty-first century and the individual researcher's response within the emerging "Computing within Limits" community. What is the relationship between our beliefs as individuals and as researchers and the specific issues we chose to study? Furthermore, is there a relationship between skills and topics we happen to be expert in and the subsequent future scenarios we plan for and deem to be more likely to happen?


Laboratory studies were carried out to assess the effects of feeding on different prey species either individually or in a sequential combination, on the development, survival and reproduction of Nephaspis bicolor Gordon (Coleoptera: Coccinellidae). Three species of Aleyrodidae were used as prey, two from the subfamily Aleurodicinae (Aleurodicus cocois Curtis and Aleurodicus pulvinatus Maskell on coconut and seagrape, respectively), and one from the subfamily Aleyrodinae (Aleurothrixus floccosus Maskell on guava). Based on development rate and the size of adults, A. floccosus was the most suitable prey for larvae. Prey species affected lifetime fecundity with beetles ovipositing significantly more eggs when fed A. floccosus. Rearing N. bicolor on A. floccosus and A. cocois produced the fittest adults in terms of population growth statistics. Prey substitution in larval stages did not affect survival or the duration of development. However, switching newly-emerged adults to a prey different from that fed on as larvae resulted in an increased preoviposition periods. Based on these data, it is concluded that the N. bicolor is adapted to utilize prey from both whitefly subfamilies and can readily switch between prey types in accordance with changes in their availability. Thus, any biological control programme that plans to introduce the coccinellid as a predator of Aleyrodidae needs to take this into consideration in the risk analysis / decision-making process.


AIM OF THE STUDY
In Switzerland, clinical practice guidelines (CPGs) are not generally registered by a single central institution. Therefore, the total number and overall quality of the existing guidelines are not known. Our aim was to identify and describe the characteristics of current CPGs developed or endorsed by Swiss medical societies, by conducting a comprehensive systematic search.

METHODS
A systematic search was done in two medical literature databases (PubMed and OVID), two major non-indexed Swiss medical journals, Swiss medical societies' websites and the FMH guidelines platform. Synonyms of "guidelines" in English, German, French and Italian were used as search terms, complemented by a hand search. Inclusion criteria for the retrieved documents were that they: (1) contained recommendations for patient care provided by physicians; (2) defined specific clinical circumstances; (3) were developed, adapted or endorsed by one of the Swiss national medical specialty societies. Documents with publication date before 1 January 2008 or containing only general and public health recommendations were excluded. Retrieved documents were screened by two reviewers in parallel. Data on the reported methods as well as transparency and quality indicators of the CPGs were extracted in a standardised way.

RESULTS
A total of 295 CPGs were included in the analysis, 199 of which were found only on the societies' websites, 44 only in the literature and 13 only on the FMH platform. Overall, 159 (54%) of guidelines had at least one predefined keyword in the title, most frequently "Empfehlung" or "guideline". Health areas with the highest number of CPGs were cardiovascular (55) and infectious (52) diseases. Most CPGs were developed in Switzerland (212); the rest were developed in cooperation with German societies (6) or with both German and Austrian societies (23), or by other international organisations (54). At least one author and the date of publication were reported in 83% and 94% of guidelines, respectively. Conflicts of interest were stated in 44% and financial support documented in 29% of the guidelines. Any method of guideline development was mentioned in 56%.

CONCLUSIONS
Numerous CPGs provide recommendations for clinical practice in Switzerland. The majority are published on medical societies' websites only. The quality of reporting is extremely heterogeneous, ranging from documents without reported authors, methods of development and publication date, to graded, continuously updated guidelines based on a systematic review of evidence. CPGs could potentially be improved by using a standardised development and reporting framework.


This paper provides a comparative study based on experiments performed on four similar fault-tolerant architectures intended to reduce errors caused due to faults in combinational logic parts of microelectronic circuits and systems. The compared merits include area, power, performance and fault tolerance capability. The experimental results show that the improved Hybrid Fault-Tolerant Architecture can handle transient faults as effectively as Partial-TMR and exhibits permanent fault tolerance capability similar to that of Full-TMR. It offers 11.8% and 20.5% power saving compared to Partial and Full-TMR respectively. Furthermore, it can handle the fault accumulation effect better than TMR, hence an ideal candidate for low-power long duration mission-critical applications. Keywords-fault tolerant architecture; fault tolerance capability assessment.


Background Both stentriever and direct-aspiration thrombectomy effectively treat large-vessel occlusions. However, data are limited comparing clinical outcomes after aspiration-first versus stentriever-assisted aspiration for thrombectomy. Methods A retrospective cohort study compared procedure times and radiographic outcomes after two mechanical thrombectomy techniques (aspiration first or stentriever). To minimize bias and variability inherent to multi-operator series, we assessed consecutive patients with cerebrovascular occlusions treated by a single surgeon during a 1 year period at two stroke centers. Expanded Thrombolysis in Cerebral Infarction (eTICI) grades were assessed by an investigator blinded to treatment. Results Data from 93 patients (median age 70 years) were analyzed: 73 patients (78.5%) were treated with a strentriever-first strategy and 20 (21.5%) were treated with aspiration first, with stentriever rescue therapy required in only three of these cases following unsuccessful aspiration. There were no significant differences in patient demographics, sites of occlusion, or rates of tandem occlusions between aspiration-first and stentriever-assisted groups (p≥0.36). The rate of first-pass eTICI ≥2b was 75.0% (15/20) for aspiration-first and 52.1% (38/73) for strentriever-first groups (p=0.07), while the rate of final eTICI ≥2b was 100% (20/20) and 82.2% (60/72), respectively (p=0.04). The aspiration-first technique was associated with procedural times ≤25 min in a multivariable analysis (adjusted OR 4.77, 95% CI 1.15 to 18.39; p=0.03). Conclusions In this single-surgeon series, an aspiration-first technique was associated with a statistically significant improvement in eTICI outcomes and faster procedure times compared with stentriever-assisted aspiration. Further prospective studies are necessary to minimize selection bias inherent in this study design.


We propose to describe the dynamics of phase transitions in terms of a nonstationary generalized Langevin equation for the order parameter. By construction, this equation is nonlocal in time, i.e., it involves memory effects whose intensity is governed by a memory kernel. In general, it is a hard task to determine the physical origin and the extent of the memory effects based on the underlying microscopic equations of motion. Therefore we propose to relate the extent of the memory kernel to quantities that are experimentally observed such as the induction time and the duration of the phase transformation process. Using a simple kinematic model, we show that the extent of the memory kernel is positively correlated with the duration of the transition, and that it is of the same order of magnitude, while the distribution of induction times does not have an effect on the memory kernel. This observation is tested at the example of several model systems, for which we have run computer simulations: a modified Potts model, a dipole gas, an anharmonic spring in a bath, and a nucleation problem. All these cases are shown to be consistent with the simple theoretical model.


Traditional smart antennas are complicated, bulky, power hungry and expensive, as they require a large number of radio frequency (RF)/microwave phase shifters, and trans-mit/receive (T/R) modules. For wide applications in civilian wireless communications, it is important to investigate novel designs of electronically beam-steerable smart antennas which feature compact size, low power, and low cost.
This dissertation presents novel designs and implementation of low-cost smart anten-nas for wireless communications. Four different designs of low-cost smart antennas have been presented, and these smart antennas can be categorized into two different types: The first type is electronically beam-switching antenna based on the concept of electrically steerable parasitic array radiator (ESPAR). The design utilizes the strong mutual coupling between the driven element and reconfigurable parasitic elements to electronically steer the beams. A polarization-reconfigurable square patch is employed as the driven element which is surrounded by reconfigurable parasitic dipoles. The antenna does not require any micro-wave phase shifters and is shown to be able to achieve electronic beam switching and polarization reconfigurability by electronically controlling the PIN diodes. The second type is an electronically beam-switching antenna using active frequency selective surfaces (FSS). Omnidirectional feeders are employed to illuminate reconfigurable FSS cylinders which consist of a number of unit cells loaded by PIN diode or varactors. By controlling the DC bias of individual columns of the FSS cylinder, directive beams can be swept across the entire azimuth plane. Based on different active FSS unit cells, three different low-cost smart antennas have been designed, including a dual-band electronically beam-switching antenna, a 3-D beam scanning antenna, and an electronically beam-switching antenna with continuous frequency tuning.
In this thesis, in order to evaluate the antenna performance, comprehensive full-wave electromagnetic (EM) simulations are carried out using commercial software. Furthermore, prototypes are fabricated and tested to validate the design concepts. Good agreement between the simulation and measurement results is achieved, and demonstrates that the smart antennas designed in this thesis have advantages of low cost and low power, thus rendering them promising for applications in wireless communications.


This thesis is written for the University of Twente, based on a research question given by the municipality of Hellendoorn. The reason for conducting this research is that municipalities are currently under a lot of pressure. Due to the increase of media attention given to the differences between the prices of services among municipalities and the publication of those differences, the citizens are increasingly questioning the way municipalities are pricing their services. Currently, the prices to provide services are determined by adjusting previous year's prices with the current national inflation rate. Since the pricing of services does not involve a particular costing method, the municipality lacks insight in the attached costs to the activities necessary to provide services.
The research question consists of two parts. The first part concerns selecting the right cost allocation model for the municipality of Hellendoorn, while the second part concerns the practical implementation of this model for the services provided by the municipality. The research question is formulated as follows: "What allocation model should the municipality of Hellendoorn use to allocate costs and which variables, and in which way, influence the cost price to provide services?"
There are several costing models discussed in the literature. Five commonly used costing models are included in this research to decide what costing model is best applicable for the municipality of Hellendoorn. The objectives and complexity of the municipality of Hellendoorn are compared with the pros and cons of the costing models found in the literature. Based on the four most important criteria set for Hellendoorn to allocate costs, the Time-driven activity-based costing model would be preferred in comparison with the other allocation models. TDABC covers all key criteria and the cost of activities largely depends on the amount of time spend in the process. This means that 'time' is the key variable that drives costs.
To implement the TDABC model, a proper estimation of the activity time and costs are needed. Two variables need to be determined; 1) the average department cost per minute and 2) the total activity time to render the services. Instead of surveying employees on how they spend their time, managers first directly estimate the practical capacity of the resources supplied as a percentage of the theoretical capacity (Kaplan & Anderson, 2004).
An important condition is that the price set to provide services should not exceed the costs made in the process, so a break-even point should be aimed for. The price charged for services should also be in proportion to the benefits received. Besides these two conditions, the municipality should also take into account several other conditions for pricing services.
When Hellendoorn implements the TDABC method according to the steps described in this research, Hellendoorn should be able to justify and explain the prices charged for their services. For activities that are difficult to estimate, Hellendoorn could be using a clocking system to determine the activity process time. The variables in the model should also be frequently updated to make sure that the activities and costs are still applicable. Any changes in costs or activities can influence the cost price of services.
The TDABC model helps the Municipality of Hellendoorn to understand and justify the activity time and the costs incurred for each service (direct and overhead costs), which increases transparency towards the community and reduces the risk for potential penalties.


This research paperentitled Hedges Realized in "Oprah Winfre"s Talk Show feat J.K Rowling".When people talk, sometimes they used hedges in their utterences. The objectives of the study are to describe the types of the hedges that aremostly used in ―Oprah Winfrey"s Talk Show feat J.K Rowling‖ and to find out the reason why the writer used hedges in ―Oprah Winfrey"s Talk Show feat J.K Rowling‖. As a descriptive research, the study was conducted by collecting any relevant data and information about the topic or problem of the study. The data collection used the following steps:watching Oprah Winfrey"s Talk Show Feat J.K Rowling, downloaded the transcript of the Oprah Winfrey"s Talk Show Feat J.K Rowling, and documenting the data collection. Observing words and phrase written in transcript on the "Oprah Winfrey"s Talk Show feat J.K Rowling". The researcher analyzed sentences that have hedging particles, words, and phrases used in"Oprah Winfrey"s Talk Show feat J.K Rowling".This study focuses on the hedges used in "Oprah Winfrey"s Talk Show feat J.K Rowling".In this reserach, there are 305 hedges found in the data. The first category is modal auxiliary verb; there are 78 hedges or 25,65%. The second category is modal lexical verb; there are 6 hedges or 1,96%. The third category is Adjective, adverbial and nominal phrases; there are 25 hedges or 8,19%. The fourth is approximators of degree, quantity, frequency and time; there are 35 hedges or 11,47%. The fifth category is introductory phrases; there are 122 hedges or 40%. The next category is If clause; there are 17 hedges or 5,57%. And the last category is compound hedges; there are 22 hedges or 7,21%. Accroding to the table above shows that the dominant types of hedges is Introductory phrases.The reason for minimizing the expression of doubt and confidence becomes the first domination in the data. That is 254 hedges or 83,27%. The hedges show tentativeness. The second domination is sensitivity to others' feelings with 48 hedges or 15,73%. The lastreason is avoiding playing the expert with 3 hedges or 0,98%. So, the conslusion is the expression of doubt and confidence is the dominant reason from the data.


Aromatization of androgens is a key step in estrogen production, and it regulates the delicate balance between estrogens and androgens in the gonads and sex steroid target tissues. In the present study, we generated transgenic mice (AROM(+)) bearing the human ubiquitin C promoter/human P450 aromatase fusion gene. AROM(+) male mice are characterized by an imbalance in sex hormone metabolism, resulting in elevated serum E(2) concentrations, combined with significantly reduced testosterone and FSH levels, and elevated levels of PRL and corticosterone. AROM(+) males present a multitude of severe structural and functional alterations in the reproductive organs, such as cryptorchidism associated with Leydig cell hyperplasia, dysmorphic seminiferous tubules, and disrupted spermatogenesis. The males also have small or rudimentary accessory sex glands with abnormal morphology; a prominent prostatic utricle with squamous epithelial metaplasia, and edema in the ejaculatory ducts and vas deferens. In addition, the abdominal muscle wall is thin, and the adrenal glands are enlarged, with cortical hyperplasia. Some of the abnormalities, such as undescended testes and undeveloped prostate, resemble those observed in animals exposed perinatally to high levels of exogenous estrogen, indicating that the elevated aromatase activity results in excessive estrogen exposure during early phases of development. Some of the disorders in the reproductive organs, furthermore, can be explained by the fact that AROM(+) males are hypoandrogenic, and have elevated levels of serum PRL and corticosterone. Thus, the AROM(+) mouse model provides a novel tool to investigate the consequences of a prolonged increase in conversion of androgens to estrogens which results in complex hormonal disturbances altering the structure and function of various male reproductive organs.


Understanding risks faced by firms and their reactions in response to those risks requires analysis of the ambiguities inherent in human behaviour. Yet, evidence from two case studies on investment and insurance professionals in the finance industry suggests that more focus on human capital may be prudent in reducing epistemic uncertainty particularly considering recent events in which the investing public has had a crisis of confidence in corporate leaders. It is particularly appropriate for regulators to provide a context in which market participants exercise due diligence by ensuring that human capital is enhanced by as much knowledge as possible where more human capital knowledge could reduce both risk in investments and insurance, ultimately challenging the sustainability of organisations during periods of epistemic uncertainty. This paper suggests that investment analysts, fund managers and insurance professionals lack the appropriate competencies, skills, knowledge and abilities required to meet the demands of the analysis of human capital in relation to understanding risk. Such competencies include disciplinary knowledge of sustainable human resource management (HRM) and organisational change systems and their links to corporate performance and risk mitigation. An alignment with HRM/HR that is equally focused on internal and external risk is of strategic importance for such professionals and their organisations in human capital risk mitigation.


Endometriosis is the ectopic presence of endometrial tissue outside the uterus. Though on its own endometriosis is not a rare lesion, the involvement of the urinary tract is rare but with the bladder being the most commonly affected organ. Endometriosis is usually seen in females between the ages of 30-40 years and may occur due to fluctuating levels of oestrogen and progesterone. Clinically the patient maybe asymptomatic or show symptoms of dysmenorrhea, irregular or heavy periods, pain in the pelvic area, lower abdomen or in the back. It has been suggested that ultrasonography should be done either before or during menstruation as the lesion becomes more evident and a biopsy taken during this period is a strong aid in reaching a final diagnosis. We report here an unusual case of bladder endometriosis where the patient came with severe pelvic pain and an endoluminal mass seen on the ultrasonographic report. Based on these findings a differential of transitional cell carcinoma was given which was ruled out based on the cystoscopic findings.


A century ago, an international team of scientists sailed under the Canadian flag to the western Canadian Arctic, via the Bering Strait, to achieve the goals of the Canadian Arctic Expedition of 1913–18. This major expedition was a milestone in the history of Canada. The scientists explored a vast, unknown sea and land area that extended from the Alaskan northern coast to Bathurst Inlet in Canada, and from Meighen Island to approximately 160 – 200 km inland from the continental coasts. This area had never been explored by an expedition before, and many parts of it had never been visited (except, presumably, by Inuit and their ancestors). The expedition resulted in a remarkable harvest of terrestrial and marine plants and animals, and associated data. The scientists furthered geographic and scientific knowledge of the Arctic and published 74 reports in various scientific fields, yet none of these addressed vertebrate zoology. The present report attempts to make up for this deficiency. Overall, the CAE collected and preserved 2084 vertebrate specimens and inventoried 139 species, which together fairly depicted the Arctic vertebrate community. Almost all specimens are preserved at the Canadian Museum of Nature. They significantly supplemented the rather meagre vertebrate collections of the Museum of those times and have since prompted the continuing development of these collections.


This article presents a survey of recent studies on the impact of digitalisation, and particularly blockchain technology, oncorporate governance and the principal-agent conflict in companies. The principal-agent conflict has been a centerpieceof the corporate governance research for more than 40 years. However, recent technological developments, andblockchain in particular, has created new avenues for exploration.We survey the implications of blockchain for the principal-agent conflict in three parts: 1) the organisationalenvironment, and the creation of the conflict; 2) common observable instances of conflict; 3) actions necessary tomaximise the value of blockchain implementation. We limit the studied conflict to the relationship between shareholdersand management. We also limit the blockchain use cases to those currently in testing. The applications for blockchain insecurities trading and for corporate functions automation via 'smart' contracts are both analysed. We also evaluate theimplications for investor activism.Our results indicate that passive investor behaviour is at the core of the environment that creates conflict. One of thekey drivers of low activity is a non-transparent voting process resulting in low participation rates. Studies indicate thatblockchain can solve this issue, thus mitigating the conflict, and is an attractive proposition for board members. Themost frequent instances of conflict are related to the composition of boards of directors and compensation schemesobserved at shareholder voting. Using blockchain for settlement would eliminate ambiguity in shareholder registersand prevent such strategies as "empty voting". Smart contracts promise automation of governance functions like audit,which also weakens conflict. Even skeptics agree that voting is a promising application for blockchain. However, thereis evidence that blockchain poses its own problems, and that smart contracts are associated with practical risks. Somecritics argue that blockchain is less efficient than conventional corporate procedures.Blockchain is among the top digital technologies that business leaders have to monitor closely. As such, this overview ofthe most up-to-date thinking on the subject is relevant for anyone interested in the future of corporate governance andthe digitalisation of business processes. This evaluation serves to highlight the current status of this innovative resource,outlining for both professionals and newcomers what exactly blockchain's potential uses and implications are, while alsooutlining where a lack of quantitative research creates opportunities for further contributions to the research field. Thisstudy will also be instructive for those investigating blockchain implementation and the optimal characteristics of thesolution.


The objectives of the present study were to evaluate the damage of DNA of the frozen-thawed (FT) boar spermatozoa and to investigate the effect of various concentrations of L-cysteine supplementation on the sperm DNA damage. A total of 104 cryopreserved semen samples from twenty-six ejaculates of 16 proven boars were analyzed. Of these samples, each semen sample contained a different concentration of L-cysteine i.e., 0 (n=41), 5 (n=41), 10 (n=11) and 15 (n=11) mM. All of the semen samples were cryopreserved by controlled-rate freezer. The semen was thawed at 50oC for 12 sec and the damage to the sperm DNA was determined using acridine orange (AO) staining. The results revealed that, on average, the DNA damage was observed in 0.5% of the FT boar spermatozoa. DNA damage varied among the boars from 0.0% to 4.0%. The levels of DNA damage were 0.6%, 0.4%, 0.5% and 0.9% in the extenders supplemented with 0, 5, 10 and 15 mM of L-cysteine, respectively (p>0.05). In conclusion, the DNA damage of the FT boar spermatozoa was relatively low. No adverse effect of L-cysteine supplementation up to 10 mM on the damage of the sperm DNA was found. Boar characteristic is the most important factor affecting the damage of the sperm DNA.


We previously reported lower ventromedial hypothalamic nucleus (VMN) serotonergic activity in 11-wk genetically obese vs. lean Zucker rats. To determine whether the activity was secondary to metabolic alterations associated with this established obesity (e.g., significant hyperphagia and hyperinsulinemia), we examined monoaminergic activity in various brain nuclei of 12-day lean (Fa/Fa and Fa/fa) and obese (fa/fa) rats early in the development of obesity. Obese pups had greater percent carcass fat than heterozygotes, both of which were fatter than homozygous lean rats. Obese, but not heterozygous lean, pups were hyperinsulinemic vs. Fa/Fa pups. VMN 5-hydroxy-3-indoleacetic acid levels, an index of serotonin release, were lower in obese and heterozygous than in homozygous lean pups and were not correlated with plasma insulin levels. Although monoamine differences also occurred in several other nuclei, for the most part they appeared to be unrelated to the obese genotype. We conclude that blunted VMN serotonergic activity is not secondary to the obese rat's hyperinsulinemia and may play a significant role in the development of obesity.


This paper is intended to be a follow-up to our previous paper with the title " Reinterpreting Tlon, Uqbar, Orbis Tertius: On the antirealism tendency in modern physics ." We will give more background for our propositions in the previous paper. Our message here is quite simple: Fellow physicists and cosmologists should become more aware of the Berkeley idealism tendency, which can lead one to so many distractions instead of bringing us closer to the truth. We observe that much of the progress of modern physics in the last few decades only makes us as confused as before, but at a much higher level. In the last section, we will give some examples of how we can do better than did practices of physics in the past.


The Covid-19 pandemic has generated shocks that have caused economic fluctuations globally, calling for an understanding of the behaviour of macroeconomic variables. This study presents an early review of the macroeconomic impact of the Covid-19 pandemic in Nigeria. The aggregate supply and aggregate demand (AS-AD) model provides the theoretical motivation for the study. From the findings, while the number of infected cases reflects significant correlations with economic activity from the perspective of a trend analysis, the estimates from dynamic ordinary least squares (DOLS) show that nexuses between the number of confirmed cases and attendant macroeconomic outcomes are largely insignificant with the expected signs. The study has therefore shown that the Covid-19 pandemic has insignificant negative impacts on basic macroeconomic variables in Nigeria such as inflation, employment, exchange rate, GDP growth, among others. In other words, time is required before the established correlations withstand empirical scrutiny in terms of causality. As the government has engaged the Economic Sustainable Plan (ESP, 2020), which is a post-Covid-19 recovery plan, it is hoped that the attendant policies would be properly implemented so as to provide the critical mass to repositioning the country's economy on the path towards inclusive and sustained economic development.


Bycatch on pelagic tuna longlines has contributed to population declines in several far-ranging, oceanic species and presents a conservation challenge that area-based management tools are increasingly promoted to address. In January 2020 the Republic of Palau, concerned about the impacts of longline fishing in its waters, closed 80% of its exclusive economic zone to all extractive activities, reserving the remaining 20% for a domestic fishing zone (DFZ). One of a growing number of very large marine protected areas, the Palau National Marine Sanctuary (PNMS) spans ∼500,000 km2 and was established inter alia to allow for the recovery of fish stocks adversely impacted by tuna longline fleets. Given that the main tuna stocks targeted in the western Pacific are not overexploited, the benefits of protection potentially afforded by the sanctuary are likely greater for vulnerable bycatch species. Evaluations of the sanctuary's performance require, in part, a baseline of historical catch rates and effort distribution in the distant-water fleet (DWF) and locally based fleet (LBF) operating in Palau prior to sanctuary implementation. We describe the fishing effort, catch rates, catch estimates and fishing mortality in Palau's longline fishery based on logbook, observer and electronic monitoring data. We defined bycatch as any species, retained or discarded, other than targeted tunas. Between 2010 and 2020, 104.8 million hooks were deployed, catching over 2 million individuals from 117 taxa at an overall target:bycatch ratio of 1:1, with a retention rate of ∼62%. Pronounced differences in fishing strategies and spatial distribution of effort between fleets were associated with large variations in catch rates and composition. The LBF had a larger effect on populations of at-risk species relative to the DWF, with higher catch rates and magnitudes for several vulnerable species and higher observable fishing mortality rates (64% vs 50% in the DWF). The sanctuary reshaped Palau's longline fishery, contracting the fishery's area and capacity. The relocation of the DFZ eliminated the LBF and constrained the DWF to an area where the fleet's total catch rates and those of a number of vulnerable species were historically lower relative to former fishing grounds now closed by the sanctuary. Our results highlight the importance of consistent bycatch monitoring and emphasize the need for regional area-based approaches for managing longline fisheries.


In this paper, we describe the status of the exploration and use of the Ginkgo biloba leaves in China. We emphasize the need for careful studies of the intra-specific genetic diversity of Ginkgo biloba since genetic variation within this species may result in significant differences between the chemical and pharmacological properties of the different sub-species. It is therefore imperative that we catalog the intraspecific diversity of Ginkgo biloba L., and we stress that it is important to conserve this diversity since different subspecies may have different pharmacochemical properties resulting in differential medical usages.


Crit Care Med 2016 • Volume 44 • Number 12 (Suppl.) quality improvement (QI) intervention 1) TI planning with risk factor review, 2) bedside "time-out" immediately before TI to review team roles and behaviors, 3) "time-out" immediately after TI to debrief, and 4) quarterly benchmark data feedback on bundle compliance and outcomes to participating ICUs in the US. QI bundle compliance was defined as >80% of checklist use for TIs. Data from initiation of the bundle until compliance >80% was censored. Univariate analysis with chi2 and multivariable logistic regression, with generalized estimate equation to account for site level clustering. Results: From 1/2013-3/2016, 19 PICUs (18 hospitals) implemented the bundled QI intervention with a checklist. 15/19 sites (79%) met criteria for bundle compliance (≥80% for consecutive 3 mo): median duration from initial implementation to ≥80% compliance was 395 days (IQR:135–778 days). Among the 15 compliant sites, the occurrence of adverse TIAEs were pre-intervention phase (12 months before QI implementation): 243/1,246 (16.3%) and post-intervention phase (from bundle compliance >80% to 3/2016, median 396 days, IQR 274–729 days): 354/2,294 (15.4%). Adverse TIAE during post-intervention vs. pre-intervention phase after adjusting for patient characteristics and clustering by site was odds ratio 0.91 (0.83–1.00, p=0.046). History of difficult airway (OR=1.27, p=0.013) and shock as TI indication (OR 1.39, p=0.003) were associated with higher risk for TIAE, and Procedural indication for TI (OR 0.87, p=0.007) was associated with lower risk for TIAEs. Conclusions: Effective implementation of a QI bundle with a checklist, "time out", debrief and benchmarking was associated with a reduction in adverse TIAEs across 15 diverse PICUs.


studies. Novel statistical approaches, such as the ones developed in the context of exposome research, may help disentangling the mutual effect of the numerous chemicals contained in DCP, as well as their mixture. The mechanisms underlying the association between DCP and respiratory health outcomes need to be clarified


Hemoglobin is an essential protein to the human body as it transports oxygen to organs and tissues through the bloodstream (Looker et al., 1992). In recent years, there has been an increasing concern regarding the global supply of this vital protein, as blood availability cannot currently meet the high demands in many developing countries. There are, in addition, several risks associated with conventional blood transfusions such as the presence of blood-borne viruses like HIV and Hepatitis. These risks along with some limitations are presented in Figure 1 (Kim and Greenburg, 2013; Martínez et al., 2015). As an alternative, producing hemoglobin recombinantly will eliminate the obstacles, since hemoglobin-based oxygen carriers are pathogen-free, have a longer shelf-life, are universally compatible and the supply can be adjusted to meet the demands (Chakane, 2017). A stable, safe, and most importantly affordable production, will lead to high availability of blood to the world population, and hence reduce global inequality, which is a focus point of the World Health Organization for the millennium (WHO, 2018). Synthetic biology and metabolic engineering have created a unique opportunity to construct promising candidates for hemoglobin production (Liu et al., 2014; Martínez et al., 2016). This review sets out to describe the recent advances in recombinant hemoglobin production, the societal and the economic impact along with the challenges that researchers will face in the coming years, such as low productivity, degradation, and difficulties in scale-up. The challenges are diverse and complex but with the powerful tools provided by synthetic biology and metabolic engineering, they are no longer insurmountable. An efficient production of cell-free recombinant hemoglobin poses tremendous challenges while having even greater potential, therefore some possible future directions are suggested in this review.


Summary In this study, the relationship between milk production and the factors used in milk production have been analyzed and the cost of milk production has been calculated. The data used for this study has been acquired from 94 dairy cattle breeder enterprises by the face to face survey method. It has been determined that the forage and concentrated feed costs compose 57% of the total production costs and 71% of the variable costs. It has been also determined that the dairy cattle breeding production division of the costs belong to 20.99% of productive stock value (PSA), 76.31% of milk production and 2.7% of manure production and 1 kg milk cost has been calculated as 0.29$. Additionally, according to the path analysis, it has been found out that the 61.49% variation resulting from the milk production can be explained with the changes resulting in the use of forage and concentrated feed. Through the path analysis, the direct and indirect effects of the feed materials used on the milk production have been analyzed. As a result, it has been found that silage maize (20%) and barley(14%) have the biggest effect on the milk yield. Anahtar sozcukler: Dairy cattle breeding, Cost analysis, Path analysis, Maize silage


In this paper, we propose a new approach for recognizing group events and abnormality detection in a crowded scene. A manifold learning algorithm with temporal-constraints is proposed to embed a video of a crowded scene in a low-dimensional space. Our low dimensional representation of a video preserves the spatial temporal property of a video as well as the characteristic of the video. Recognizing video events and abnormality detection in a crowded scene is achieved by studying the video trajectory in the manifold space. We evaluate our proposed method on the state-of-the-art public data-sets containing different crowd events. Qualitative and quantitative results show the promising performance of the proposed method.


The presence of drug residue in animal product may threat human health such as increasing  resistance to Camplyobacter infection treatment due to the use of enrofloxacin. The objectives of this research was to study the concentration of enrofloxacin (EFX) and ciprofloxacin (CFX) residues distributed in breast, thigh and liver and to determine the elimination rate of such residues in chicken which recieved enrofloxacin orally at 50 mg/kg bw daily for 9 days consecutively started at 23 rd day to 31 st day of age. Samples of breast muscle, thigh and liver were collected from chicken at ½ to 288 h after the drug administration. The concentration of EFX and CFX in samples were analyzed by high pressure liquid chromatography (HPLC). The results showed that the highest residues concentration of EFX and CFX at ½ hr post administration of EFX was: in liver (117.47 ng/g), breast (95.16 ng/gr) and thigh (71.40 ng/g), whereas the order of elimination rate was: thigh (120 hr), liver (168 hr) and breast (240 hr). The results also showed that concentration of CFX was higher than that of EFX. Key Words: Enrofloxacin, Ciprofloxacin, Residues, Broiler Chicken


Introduction: Early intervention in children with Autism Spectrum Disorder (ASD) improve prognosis. Although instruments can be translated, adapted and validated their performance is suboptimal compared to the original studies. The need to design culturally and context appropriate instruments for earlier assessment of Hispanic children with autism is urgent.
Methods: A validity study with a case control design with 70 ASD children and 16 children with Typical Development (TD) was performed. Autism diagnosis was confirmed with the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (Kiddie SADS-PL/ASD- supplement) and the ADI-R.
Results: Internal consistency examined by Cronbach's alpha for the 26 items of the total sample was α=0.81, p<0.01. The one-week test-retest reliability was 0.92, (95% CI 0.83 - 0.97), p<0.001. Using the criterion of ASD diagnosis vs. TD group a ROC curve (receiver operating characteristic) was constructed. With a cutoff of the Total ASA-HiCh score of 17, yielded an area under the curve of 0.84 (95% CI 0.74-0.94), sensitivity of 75.6 %, specificity of 87.5% and a positive predictive value of 93.9% and negative predictive value of 58.3%. For the K-SADS/ ASD classification diagnosis and the ASA-HiCh score 17 the kappa value was k= 0.60, p<0.01. For children <9 years-old Kappa coefficient was k=0.72, p<0.01, and for children <5 years-old k=0.87, p<0.01. In study 2 the kappa value for DSM-IV criteria was k=0.39, p<0.001, and for DSM-5 criteria was k=0.88, p<0.001. The medians for the total score of ASA-HiCh between ASD and TD groups, were analyzed by the Mann-Whitney U test, and were 34.51 and 14.88 respectively (U=102.0 Z -4.02, p=0.001).
Conclusion: The ASA-HiCh demonstrated good psychometric properties, future studies are necessary to determine the discriminant validity between ASD and other psychiatric disorders.


Information dissemination is a fundamental and frequently occurring problem in large, dynamic, distributed systems. We propose a novel approach to this problem, interest-aware information dissemination, that takes advantage of small-world usage patterns in data-sharing communities. These small-world characteristics suggest that users naturally form groups of common interest. We propose algorithms for identifying these groups dynamically, without a need for explicit classification of topics or declaration of user interests. These algorithms use information about the data consumed by users to identify, via online computation, groups with similar interests. As a proof of concept, we apply this methodology to the problem of locating files in large user communities. Using real-world traces from a scientific community and from a peer-to-peer system, we show that proactive information dissemination within groups of common interest can reduce the search load by up to 70%. In addition, this approach naturally supports the efficient discovery of collections of files, a requirement specific to scientific data analysis tasks. We hypothesize that our algorithms can find numerous other uses in distributed systems, such as reputation management.


: Analyzed in the paper are stages of networking of game biofeedback. Three main stages are defined on the basis of practical experience, they are: unification of local databases, use of game biofeedback in local network and training in game biofeedback via Internet. Possible solutions are suggested; technical and organizational issues are discussed on working out and using a set of therapeutic and health-improving training equipment based on the principles of LAN game biofeedback.


Public key cryptosystems in both classical and post-quantum settings usually involve a lot of computations. The amount as well as the type of computations involved vary among these cryptosystems. As a result, when the computations are performed on processors or devices, they can lead to a wide range of energy consumption. Since a lot of devices implementing these cryptosystems might have a limited source of power or energy, energy consumption by such schemes is an important aspect to be considered. The Diffie-Hellman key exchange is one of the most commonly used technique in the classical setting of public key cryptographic shceme, and elliptic curve based DiffieHellman (ECDH) has been in existence for more than three decades. An elliptic curve based post-quantum version of Diffie-Hellman, called supersingular isogeny based DiffieHellman (SIDH) was developed in 2011. For computations involved in ECDH and SIDH, elliptic curve points can be represented in various coordinate systems. In this thesis, a comparative analysis of energy consumption is carried out for the affine and projective coordinate based elliptic curve point addition and doubling used in ECDH and SIDH. We also compare the energy consumption of the entire ECDH and SIDH schemes. SIDH is one of the more than sixty algorithms currently being considered by NIST to develop and standardize quantum-resistant public key cryptographic algorithms. In this thesis, we use a holistic approach to provide a comprehensive report on the energy consumption and power usage of the candidate algorithms executed on a 64-bit processor.


Biclustering is one of the important techniques for gene expression data analysis. A bicluster is a set of genes coherently expressed for a set of biological conditions. Various biclustering algorithms have been proposed to find biclusters of different types. However, most of them are not efficient. We propose a novel algorithm MRCluster to mine constant row biclusters from real-valued dataset. MRCluster uses Apriori property and several novel pruning techniques to mine biclusters efficiently. We compare our algorithm with a recent approach RAP, and experimental results show that MRCluster is much more efficient than RAP in mining biclusters with constant rows from real-valued gene expression data.


ABSTRACT In this article, we evaluate the ground‐motion prediction equations (GMPEs) described by Atkinson (2015) and Shahjouei and Pezeshk (2016) with ground‐motion data collected from the central and eastern United States (CEUS). The former GMPE was developed for small‐to‐moderate events at short hypocentral distances with application to induced earthquakes in eastern North America, using the ground‐motion database developed by the Next Generation Attenuation‐West2 (NGA‐West2) project (Bozorgnia et al. , 2014). The latter GMPE was developed for the central and eastern North America for the NGA‐East project (Frankel, 2015). We compare spectral amplitudes from 46,178 ground‐motion recordings at 1069 stations from 2873 earthquakes in the CEUS to the GMPEs. The ground‐motion catalog is divided into potentially‐induced and tectonic earthquakes using the classification scheme of Petersen et al. (2015), and their differences in geometric spreading are observed. We observe that the Atkinson (2015) GMPE is a good fit for ground motions at hypocentral distances of less than 60 km, and that the Shahjouei and Pezeshk (2016) GMPE captures the geometric spreading of ground motions at larger distances, for both induced and tectonic earthquakes.


Aspect-Oriented Programming AOP extends object-oriented programming OOP with aspects to modularize crosscutting behavior on classes by means of aspects to advise base code in the occurrence of join points according to pointcut rules definition. However, join points introduce dependencies between aspects and base code, a great issue to achieve an effective independent development of software modules. Join Point Interfaces JPI represent join points using interfaces between classes and aspect, thus these modules do not depend of each other. Nevertheless, since like AOP, JPI is a programming methodology; thus, for a complete aspect-oriented software development process, it is necessary to define JPI requirements and JPI modeling phases.
Towards previous goal, this article proposes JPI UML class and sequence diagrams for modeling JPI software solutions. A purpose of these diagrams is to facilitate understanding the structure and behavior of JPI programs. As an application example, this article applies the JPI UML diagrams proposal on a case study and analyzes the associated JPI code to prove their hegemony.


We report the use of near-field electrospinning (NFES) as a route to fabricate composite electrodes. Electrodes made of composite fibers of carbon nanotubes in polyethylene oxide (PEO) are formed via liquid deposition, with precise control over their configuration. The electromechanical properties of free-standing fibers and fibers deposited on elastic substrates are studied in detail. We then examine the elastic deformation limit of the resulting free-standing fibers and find, similarly to bulk PEO composites, that the plastic deformation onset is below 2% of tensile strain. In comparison, the apparent deformation limit is much improved when the fibers are integrated onto a stretchable, elastic substrate. It is hoped that the NFES fabrication protocol presented here can provide a platform to direct-write polymeric electrodes, and to integrate both stiff and soft electrodes onto a variety of polymeric substrates.


Several cities in the developing world are transforming decentralized bus transit services into integrated transit systems. These programs aspire to improve service quality and mitigate negative impacts, such as pollution and traffic injuries and deaths. However, implementation processes in Santiago, Chile and elsewhere have proven difficult. One contributing factor has been a lack of integration of community concerns in the planning process. In this paper, the authors provide a framework for direct identification of user needs and apply it to the ongoing process in Bogota, Colombia. Bogota is integrating its BRT system with reorganized bus services throughout the city. Using expert interviews and a semi-structured community survey, the authors identify awareness, expectations and aspiration gaps, as well as equity concerns. They also suggest specific actions to improve user information during system implementation. The methods developed for this research and understanding of Bogota's lessons are useful for improving planning and implementation of other large-scale transit integration processes.


Photosynthetic biohybrid systems exhibit promising performance in biosynthesis; however, these systems can only produce a single metabolite and cannot further transform carbon sources into highly valuable chemical production. Herein, a photosynthetic biohybrid system integrating biological and chemical cascade synthesis was developed for solar-driven conversion of glucose to value-added chemicals. A new ternary cooperative biohybrid system, namely bacterial factory, was constructed by self-assembling of enzyme-modified light-harvesting donor-acceptor conjugated polymer nanoparticles (D-A CPNs) and genetically engineered Escherichia coli (E. coli). The D-A CPNs coating on E. coli could effectively generate electrons under light irradiation, which were transferred into E. coli to promote the 37% increment of threonine production by increasing the ratio of nicotinamide adenine dinucleotide phosphate (NADPH). Subsequently, the metabolized threonine was catalyzed by threonine deaminase covalently linking with D-A CPNs to obtain 2-oxobutyrate, which is an important precursor of drugs and chemicals. The 2-oxobutyrate yield under light irradiation is increased by 58% in comparison to that in dark. This work provides a new organic semiconductor-microorganism photosynthetic biohybrid system for biological and chemical cascade synthesis of highly valuable chemicals by taking advantage of renewable carbon sources and solar energy.


This paper is intended as a sequel to the collection of essays for an ambitious project on the History of the Visayas. Series I explored the role of the bodies of water surrounding the Visayas Islands in the historical development of the region by examining the folklore and etymologies about these Islands. Series 2 delved into the conditions of the islands at the time of European contract. Series 3 examines the subsequent Spanish colonization of the Visayas Islands and looks into the reaction of the inhabitants. By way of synthesis, the paper collates the textual constructs of experts and local historians dealing with each island of the Visayas region to present the History of the Visayas as a whole in the context of developing an evolving historiography towards a national history of the Philippines.


Resources for students in the NEOMED Master of Science Degree Program in Health-System Pharmacy Administration. Includes pharmacy administration and business resources.


In chapter 2, it was demonstrated that in 2016 several second-generation ribavirin-free DAA regimens achieved viral eradication in ≥95% in different type of patients other than those with prior NS5A-inhibitor exposure or decompensated cirrhosis. In chapter 3, various patient-reported outcomes (PROs) were prospectively evaluated before, during and after DAA treatment. Ribavirin use was the only independent predictor of the transient decline in the mental health-related quality of life (HRQL) that occurred at the end of treatment (EOT). Twelve weeks after the end of treatment (FU12), the HRQL had not changed compared to the baseline-levels. Through the REACH-project, described in chapter 4, 42 lost to follow-up (LFU) chronic HCV patients were re-evaluated by means of screening positive HCV diagnostics from the past 15 years. Retrieval was most feasible regionally since 28.3% of the patients eligible for retrieval from the Utrecht province were traced compared to 7.7% of those patients living outside the region. In 24% of the reevaluated patients, the liver fibrosis had progressed to an advanced stage (Metavir F3-F4). At follow-up, 59% of the traced patients had scheduled or initiated DAA therapy. Chapter 5 covers retrieval of chronic hepatitis B virus (HBV) patients. General practitioners (GPs) in Utrecht were asked to trace LFU chronic HBV patients and 49% returned a response that included either reevaluation outcomes or updated information on the patient's follow-up status. Finally, 10% (N=62) of the eligible LFU chronic HBV patients was reevaluated of which 32% (N=20) was referred to a hospital. Reasons for previous loss to follow-up were explored in retrieved chronic HCV patients through in-depth interviews, characterized in chapter 6. A grounded theory based qualitative analysis uncovered 'maintaining the achieved balance' as the basic socio-psychological process in LFU HCV patients. The balance is steadfast state of mind in which patients marginalize having HCV. Patients arrived at this balance through a transformative process that followed the initial HCV diagnosis. Patients subsequently adopted evasive behavior in order to defend and preserve the achieved balance. In chapter 7, strategies for achieving viral hepatitis C micro-elimination in the Netherlands were reviewed. Although many elimination endeavors were documented, the overview of the progress towards micro-elimination illustrates that no conclusions can be drawn until higher quality epidemiological data on the retention of patients in the HCV cascade of care is collected, with exception of the closely monitored HIV/HCV-coinfected population. The HCV in Addiction Care (HAC) quality improvement project (chapter 8) based on the Breakthrough methodology (i.e. Breakthrough project) implemented "good" or "sufficient" quality HCV healthcare pathways in 83% (N=10/12) of the participating addiction care units. Of all the identified chronic HCV infected clients 92% (N=70/76) was referred to a hepatitis treatment center. Uptake of HCV-screening (40% of all clients) and treatment after referral (39% of those referred) were identified as the main gaps to be closed in the HCV cascade of care in addiction care. Several best practices were identified including motivational counselling training, oral swabs for anti-HCV testing, facilitating complementary HCV RNA testing and supervised hospital visits.


There is growing recognition that classifying terrestrial plant species on the basis of their function (into 'functional types') rather than their higher taxonomic identity, is a promising way forward for tackling important ecological questions at the scale of ecosystems, landscapes or biomes. These questions include those on vegetation responses to and vegetation effects on, environmental changes (e.g. changes in climate, atmospheric chemistry, land use or other disturbances). There is also growing consensus about a shortlist of plant traits that should underlie such functional plant classifications, because they have strong predictive power of important ecosystem responses to environmental change and/or they themselves have strong impacts on ecosystem processes. The most favoured traits are those that are also relatively easy and inexpensive to measure for large numbers of plant species. Large international research efforts, promoted by the IGBP–GCTE Programme, are underway to screen predominant plant species in various ecosystems and biomes worldwide for such traits. This paper provides an international methodological protocol aimed at standardising this research effort, based on consensus among a broad group of scientists in this field. It features a practical handbook with step-by-step recipes, with relatively brief information about the ecological context, for 28 functional traits recognised as critical for tackling large-scale ecological questions.


Real-time four-dimensional (4D) echocardiography is the examination of the fetal heart in the three spatial dimensions plus motion.The matrix probe's technology allows direct volume scanning by electronically interrogation of a region of interest and acquisition of a pyramidal volume of ultrasonographic data. This technology has the potential to minimize motion artifacts associated with 3D/4D ultrasonography with a satisfactory spatial resolution.The system allows beam steering and focusing in the 3D volume dataset, making it possible to simultaneously examine two different planes of section of the same structure, in real-time, without resolution loss (Live xPlane imaging). The system achieves a pyramidal volume of data, creating a new real-time 3D moving imaging mode called Live 3D Volume Imaging, without the use of software-reconstructed section planes. Combination with Doppler techniques creates a new imaging option: Full Volume 3D imaging. The technique of Thick Slice Live Volume Imaging allows high resolution and contrast-enhanced images The strength of this technology is the easiness in obtaining real-time images of the heart, the high volumetric frame rate and the opportunity to obtain scanning planes with the same axial and lateral resolution. These features improve the overall understanding of anatomical structure arrangement. Matrix technology could be very useful in congenital cardiac clinical applications: real-time 3D echocardiography shows instantaneous rendered images of the beating fetal heart with complex pathologies in one complete heart cycle, and application of this modality allows its spatial location in the heart and its temporal location in the cardiac cycle.


In Virtual Reality Interactive Systems, texture is one of the most important factors which affects the scene fidelity and the entire system resources. In this article, we talk about the texture making methods in constructing virtual reality interactive scene. We discuss the bake mapping technique, and make the comparison and analysis among different mapping methods to find the method that can get the best effect with limited resources. According to our study method, users can choose the most appropriate methods based on their needs to construct the virtual reality scenes effectively, and make more realistic effects with limited hardware and software resources.


Dual-bus metropolitan area networks (MANs) are well suited to provide broad-band network access and network interconnection over a city area by functioning as distributed broadband multiplexers between existing corporate/public networks, multi-media terminals, and broadband integrated services' digital networks employing an asynchronous transfer mode. The authors address the important problem of integrating time-sensitive and non-time-sensitive traffic over MANs. In the proposed integration scheme, time-sensitive variable bit-rate isochronous (VBRI) traffic, such as voice and video, is statistically multiplexed over the MAN by a novel, reservation-arbitrated (RA) access protocol, while non-time-sensitive asynchronous traffic, such as data, is transported over the residual bandwidth by queue-arbitrated access. RA access allows a VBRI traffic source to capture and reserve some isochronous channels on a bandwidth-on-demand basis. Compared to previously proposed reservation protocols, RA access is fair, provides a better isochronous transport service, and is compatible to the slot format of the existing IEEE 802.6 MAN standard. The system performance is analysed by an approximate theoretical model and computer simulations. Results indicate that the proposed integration scheme can be engineered to meet the stringent quality of service requirements of the time-sensitive VBRI traffic, while providing a satisfactory service to the non-time-sensitive data traffic and ensuring efficient bandwidth utilisation.


Annual time series data for the period 1950-51 through 1975-76 are used to estimate the price elasticity of aggregate Australian agricultural supply using two methods. The short-run elasticity is estimated to be highly inelastic but it has been increasing through time. The preferred estimate of the long-run elasticity is in the relatively inelastic range and it has also been increasing through time. Some implications of these results for intersectoral resource flows and compensatory assistance, the cost-price squeeze, the effects of the mineral boom and monetary policy are discussed.


Context: A downward trend is being observed in the incidence of human immunodeficiency virus (HIV) infection in India due to strategic activities of National AIDS Control Organisation (NACO) in the last 24 years. Opt-out testing has consistently shown high seroprevalence in our tertiary care center. Aim: This study aims to audit opt-out testing and compare various commercial test kits used to detect HIV seroprevalence in patients in our tertiary care institute and suggest new algorithm for HIV testing in tertiary hospitals in India. Materials and Methods: Retrospective analysis of 30,021 samples tested in Department of Immunopathology using opt-out testing delinked from the NACO-sponsored testing for Integrated Counselling and Testing Centre (ICTC) was performed. Study population comprised of presurgery and emergency patients which at the time of our reporting were not included in ICTC testing. Results: Microlisa was the first test performed on 76% samples. 1.02% cases were reactive only with Microlisa and negative with other rapid kits hence were reported as negative, according to NACO scheme of reporting. Advanced testing algorithm followed by centre for disease control (CDC) showed that 80% of these 4th-generation positive and rapid test-negative patients turned out to be acute HIV infections on molecular testing. Conclusion: Patients in tertiary referral center constitute high-risk population and should be screened with 4th-generation enzyme-linked immunosorbent assay which incorporates p24 antigen. Those which are found indeterminate should have molecular testing by nucleic acid amplification test or real-time polymerase chain reaction, as our study has demonstrated that 1.02% of these cases may harbor acute HIV infection.


Exchange rates are important indicators of the economic power of countries, directly affected by the international trading patterns and relations. Since almost every pair of countries in the globalized world are economically and financially related, exchange rates can be evaluated as nodes of a global financial network to make meaningful inferences. In this study, a financial network approach is conducted by evaluating the movements of the most traded 35 currencies against gold between years 2005 and 2017. Using graph theory and statistical methods, the analysis of economic relations between currencies is carried out, supported with geographical and cultural inferences. A risk map of currencies is generated through the portfolio optimization. Another approach of applying various threshold levels for correlations to determine connections between currencies is also employed. Results indicate that there exists a saddle point for correlation threshold as 0.9 which results in a robust network topology that is highly modular and clustered, also dominantly displaying small-world and scale-free properties.


Female BALB/c mice were infested four times with pathogen-free Ixodes scapularis nymphs prior to infestation with nymphs infected with Borrelia burgdorferi B31. Each infestation was separated by a 14-day tick-free period. Mean weights of fed ticks and percentage reaching repletion did not indicate development of acquired resistance. Only 16.7% of mice repeatedly infested with pathogen-free ticks prior to infected I. scapularis nymph challenge became positive for B. burgdorferi. One hundred percent of control mice infested only with infected ticks were culture positive for B. burgdorferi.


REACH is a very demanding system for any business either large or small, yet right from the start one of the more serious concerns was whether and how SMEs could cope with the Regulation. After all, some 27,600 companies in EU chemistry are SMEs (95% of all firms). Seven years down the line, many of these fears are materialising. Assuming no significant changes are introduced to REACH, this paper suggests the following recommendations:

Above all, we strongly encourage SMEs to start early and develop a strategy for REACH compliance well before 2018.
Address the potential competition law implications of current SIEF arrangements, e.g. through a Guidance document from DG Competition by 2014 (in time for 2018)
Facilitate the exchange of information along the value chain by adopting pragmatic approach to the content and format of Safety Data Sheets. More can be done on the IT front as well, for instance by developing tools that generate compliant Safety Data Sheets.
Improve the communication of REACH and its intended goals, that is, the health and environmental benefits, to the wider public. SMEs regret the unawareness of the public in the light of the enormous efforts they have to undertake.
In the event of a later review of REACH, the logic should be risk-based rather than hazard-based.


Ecosystem services are by definition benefits that people receive from nature - such as naturally produced food, fresh water or climate but also cultural or leisure experiences of which people are aware or not. Due to the negative impacts to which biodiversity was exposed, ecosystem services have undergone significant changes, many of them being degraded. Currently, there are very few techniques for assessing and measuring ecosystem services as these processes are considered expensive and difficult to technically implement. This article details how information technology can be used to conceptualize and operationalize in practice a set of theoretical instruction that provide guidance on how to assess and monitor ecosystem services without the use of expensive resources for technical expertise or financial resources. The paper presents TESSA - an application for mobile learning that can be used intuitively by any person interested in ecosystem services, be they scientists or uninitiated people in this field but interested in assessing the benefits of biodiversity spread across human society. The main features of TESSA are geolocation and data evaluation. The results obtained through this evaluation can be saved for future research or can be shared via e-mail. This mobile application is designed to improve the limited techniques for assessing and measuring the available ecosystem services by providing practical guidance to scientists on how they can identify significant ecoservices at a site in order to analyze the data needed to measure them, the methods or sources that can be used to obtain the data and how to communicate results.


This article provides elements of a communitybased approach to youth development. The plan contains strong support for linkages between principle-centered leadership among staff and participants to create positive values transference and development through recreation programming. The goal of the plan is to enhance the mental and physical well-being of youth and communities. The paper explores and develops strategies to accomplish two related but quite different goals: (a) develop programs that can reduce youth risk factors such as drug abuse, teen pregnancy, violence, and illiteracy, while (b) simultaneously providing activities that build the character, values, self-esteem, and employability of youth. A number of studies of adolescents, public health, recreation, and education point to comprehensive approaches as a means of fostering youth participation and development (Carnegie, 1995 ). The focus of this work is to generate support and resources for the implementation of a comprehensive youth risk-reduction and development strategy that utilizes recreation facilities as centers for youth and for the community. The issues facing teens today are much greater than those facing youth in the past. By working to reduce harmful risks, meet physical, mental and emotional needs, and build competencies, we can truly reclaim, rebuild, and restore essential bonds between youth and community development. The paper presents programs, activities, and methods that have worked in Seattle with low- to high-risk youth. Major themes include: an introduction to a Re-creation Strategy, which redefines the role of recreation as a fulcrum for linking youth and community development; and an exploration of best practices and principles of youth work. Five basic principles underlying youth work are introduced: trust, respect, integrity, consistency, and self-esteem. Recurring themes and qualities that make up a successful youth worker are also described. This is the first of two papers that will be published by the author. The second paper will appear later this year and deal with development of the Seattle Teen Life Center.


Introduction: The main target of long lasting insecticidal nets (LLINs) distribution in Nigeria is to have at least 80% of households in rural communities own two or more LLINs and children under five and pregnant women sleep inside LLINs. Objectives: To determine access and usage of LLINs by women of reproductive age and under five children in rural communities of Benue State. Methods: This was a cross-sectional descriptive study in which a structured questionnaire was administered to 420 respondents (household head). Four Local Government Areas (LGA) - Konshisha, Kwande, Obi and Okpokwu and a total of seventeen settlements were sampled based on set criteria: hard to reach communities with cultural and seasonal barriers. We selected households were selected based on the presence of under - five children in such households using a systematic random sampling technique. Data analysis was carried out using SPSS version 23 and results were presented in frequencies and percentages. Results: Ninety three percent of the respondents used LLIN. Households had one (6%), two (26%), three (20%) and four (21%) bed-nets. The majority of the bed-nets were obtained from government hospitals (60%), mass campaign (30%) and open market (6%). Of those that used bed-nets regularly, 75% were male. The age distribution of net users was 0-59 months (67%), 6-14 years (8%) and 15-49 years (25%). Conclusion: Access to bed-net was high however; regular usage among the female population was low. We recommend that advocacy on bed-net usage should be targeted at women of child bearing age.


This paper describes a new adaptive spectral matched filter that incorporates the idea of regularization (shrinkage) to penalize and shrink the filter coefficients to a range of values. The regularization has the effect of restricting the possible matched filters (models) to a subset which are more stable and have better performance than the non-regularized adaptive spectral matched filters. The effect of regularization depends on the form of the regularization term and the amount of regularization is controlled by so called regularization coefficient. In this paper the sum-of-squares of the filter coefficients is used as the regularization term and several different values for the regularization coefficient are tested. Experimental results for detecting targets in hyperspectral imagery are presented for regularized and non-regularized spectral matched filters.


Anatomy is considered one of the foundation studies for all of the health science students especially medical and nursing students. Anatomy of the hand is complicated. It composes of bones, nerves, blood veins, muscles, and tendon. Memorising all the details about all those parts is tedious work and need much imagination. With the advances in computer graphics and human-computer interaction techniques, understanding how those body parts move is easy to understand in a visual presentation. Augmented Reality (AR) is the technique that allowed the computer-generated objects to overlay on top of the real world. In this study, we concentrate on studying the bones only. We have selected the Leap Motion, which is the device that can detect the hands and fingers, like a tracking device, and marker-based AR technique for displaying the computer generated bones on top of the real hand. Since the Leap Motion detects the hands and shows the bone in real time, so when a user moves the hands such as waving, all the 3D virtual bones move to the new position just like the real hand. Besides using this tool as the educational tool to help the students have better learning about anatomy, it can also be used as an assessment tool for anatomy class as well. Results from testing this tool with volunteer students indicate that it helps them to understand the hand anatomy better and faster than traditional ways.


Abstract: Allometric models are commonly used to estimate biomass, nutrients and carbon stocks in trees, and contribute to an understanding of forest status and resource dynamics. The selection of appropriate and robust models, therefore, have considerable influence on the accuracy of estimates obtained. Allometric models can be developed for individual species or to represent a community or bioregion. In Bangladesh, the nation forest inventory classifies tree and forest resources into five zones (Sal, Hill, Coastal, Sundarbans and Village), based on their floristic composition and soil type. This study has developed allometric biomass models for multi-species of the Sal zone. The forest of Sal zone is dominated by Shorea robusta Roth. The study also investigates the concentrations of Nitrogen, Phosphorus, Potassium and Carbon in different tree components. A total of 161 individual trees from 20 different species were harvested across a range of tree size classes. Diameter at breast height (DBH), total height (H) and wood density (WD) were considered as predictor variables, while total above-ground biomass (TAGB), stem, bark, branch and leaf biomass were the output variables of the allometric models. The best fit allometric biomass model for TAGB, stem, bark, branch and leaf were: ln (TAGB) = -2.460 + 2.171 ln (DBH) + 0.367 ln (H) + 0.161 ln (WD); ln (Stem) = -3.373 + 1.934 ln (DBH) + 0.833 ln (H) + 0.452 ln (WD); ln (Bark) = -5.87 + 2.103 ln (DBH) + 0.926 ln (H) + 0.587 ln (WD); ln (Branch) = -3.154 + 2.798 ln (DBH) - 0.729 ln (H) - 0.355 ln (WD); and ln (Leaf) = -4.713 + 2.066 ln (DBH), respectively. Nutrients and carbon concentration in tree components varied according to tree species and component. A comparison to frequently used regional and pan-tropical biomass models showed a wide range of model prediction error (35.48 to 85.51%) when the observed TAGB of sampled trees were compared with the estimated TAGB of the models developed in this study. The improved accuracy of the best fit model obtained in this study can therefore be used for more accurate estimation of TAGB and carbon and nutrients in TAGB for the Sal zone of Bangladesh.


One Von Hippel-Lindau (VHL) tumor suppressor gene is lost in most renal cell carcinomas while the nondeleted allele exhibits hypermethylation-induced inactivation or inactivating somatic mutations. As a result of these genetic modifications, there is an increased production of VEGF-A and pro-angiogenic growth factors in this disorder. The important role of angiogenesis in the pathogenesis of renal cell carcinomas and other tumors has focused the attention of investigators on the biology of VEGFs and VEGFR1–3 and to the development of inhibitors of the intricate and multifaceted angiogenic pathways. VEGFR1–3 contain an extracellular segment with seven immunoglobulin-like domains, a transmembrane segment, a juxtamembrane segment, a protein kinase domain with an insert of about 70 amino acid residues, and a C-terminal tail. VEGF-A stimulates the activation of preformed VEGFR2 dimers by the auto-phosphorylation of activation segment tyrosines followed by the phosphorylation of additional protein-tyrosines that recruit phosphotyrosine binding proteins thereby leading to signalling by the ERK1/2, AKT, Src, and p38 MAP kinase pathways. VEGFR1 modulates the activity of VEGFR2, which is the chief pathway in vasculogenesis and angiogenesis. VEGFR3 and its ligands (VEGF-C and VEGF-D) are involved primarily in lymphangiogenesis. Small molecule VEGFR1/2/3 inhibitors including axitinib, cabozantinib, lenvatinib, sorafenib, sunitinib, and pazopanib are approved by the FDA for the treatment of renal cell carcinomas. Most of these agents are type II inhibitors of VEGFR2 and inhibit the so-called DFGAspout inactive enzyme conformation. These drugs are steady-state competitive inhibitors with respect to ATP and like ATP they form hydrogen bonds with the hinge residues that connect the small and large protein kinase lobes. Bevacizumab, a monoclonal antibody that binds to VEGF-A, is also approved for the treatment of renal cell carcinomas. Resistance to these agents invariably occurs within one year of treatment and clinical studies are underway to determine the optimal sequence of treatment with these anti-angiogenic agents. The nivolumab immune checkpoint inhibitor is also approved for the second-line treatment of renal cell carcinomas. Owing to the resistance of renal cell carcinomas to cytotoxic drugs and radiation therapy, the development of these agents has greatly improved the therapeutic options in the treatment of these malignancies. © 2017 Elsevier Ltd. All rights reserved.


The drag which the earth's surface exerts on the wind has been measured directly by observing the deflexion of a horizontal plate, floating in oil and under torsional control, and forming part of the earth's surface. Simultaneous measurements of the velocity profile above the surface have enabled von Karman's constant for the lower atmosphere to be deduced. The value obtained under moderately unstable atmospheric stratification is 0.46, which is considered to be in good agreement with Nikuradse's value of 0.40, obtained from the flow of water through pipes under isothermal conditions. Evidence is also adduced for a considerable variation of von Karman's constant with atmospheric stability. The observations of drag and velocity profile have also been used to determine the variation of mixing length with height. In unstable conditions the mixing length increases more rapidly than the height, while in stable conditions the increase is likely to be less rapid than the height.


Background : Vitex pinnata is a popular ethnomedicinal plant but scientific studies to validate its pharmacological properties are lacking for this plant. This study aims to determine the antioxidant, antimicrobial and wound healing properties of the methanolic extract of the leaves and the hexane, chloroform and ethyl acetate fractions. Methods: The leaves of Vitex pinnata underwent methanol extraction and the methanol extract was fractionated with hexane, chloroform and ethyl acetate solvents. The antioxidant activity was determined using the DPPH radical scavenging assay. The antimicrobial activity was assessed by disc diffusion assay against Staphylococcus aureus, Bacillus subtilis, Escherichia coli and Pseudomonas aeruginosa. For the wound healing studies, the methanolic extracts of V. pinnata were used to prepare ointments with compositions of 10% (w/w) and 50% (w/w), which were evaluated for wound healing activity in an excision wound model in Wistar rats. Results: All the extracts showed antioxidant activities, with the ethyl acetate extract having the highest DPPH radical scavenging activity, followed by the methanol, chloroform and hexane extracts. Similarly, their quercetin equivalent concentrations were 33.1, 31, 20.3 and 4.5 mg/mL, respectively. Except for the methanol extract, the disc diffusion assay showed that the extracts demonstrated species-specific antibacterial activities, with the ethyl acetate extract showing antibacterial activities against all four tested strains. The wound healing activity of the high dose treated group (50% [w/w]) shows significant increase of wound contraction when compared to the control group. Conclusion: In the current study, the ethyl acetate extract showed activity for all tested bacteria and also had the highest DPPH activity. The methanolic extracts of V. pinnata leaves show modest wound healing activity in an excision wound model.


As processes shrink, the on-chip variability grows and this variation causes clock skew to rapidly consume a larger-and-larger percentage of the clock period. New techniques to reduce skew are required, but post-silicon clock adjustments will still be necessary to compensate for intra-die PVT variations. A relatively new technique for skew reduction, called Single-Edge Clocking (SEC), focuses clock buffer design on the critical edge by using alternating strong pull-up and strong pull-down buffers. In this paper, a new digitally-tuned buffer for SEC clock networks is presented. It is based on a single-sided starved inverter configuration and is tuned using a 3-bit thermometer code. Sizing issues and skew reduction achievable in the presence of PVT variations are presented. The overhead in terms of layout area and current consumption for this new tunable buffer is only a small fraction of other tunable buffer designs.


Lymphocyte migration into the brain represents a critical event in the pathogenesis of multiple sclerosis and its animal model, experimental autoimmune encephalomyelitis (EAE). However, the mechanisms controlling the recruitment of lymphocytes to the CNS via inflamed brain venules are poorly understood, and therapeutic approaches to inhibit this process are consequently few. In this study, we demonstrate for the first time that human and murine Th1 lymphocytes preferentially adhere to murine inflamed brain venules in an experimental model that mimics early inflammation during EAE. A virtually complete inhibition of rolling and arrest of Th1 cells in inflamed brain venules was observed with a blocking anti-P-selectin glycoprotein ligand 1 Ab and anti-E- and P-selectin Abs. Th1 lymphocytes produced from fucosyltransferase (FucT)-IV−/− mice efficiently tethered and rolled, whereas in contrast, primary adhesion of Th1 lymphocytes obtained from FucT-VII−/− or Fuc-VII−/−FucT-IV−/− mice was drastically reduced, indicating that FucT-VII is critical for the recruitment of Th1 cells in inflamed brain microcirculation. Importantly, we show that Abs directed against cutaneous lymphocyte Ag (CLA), a FucT-VII-dependent carbohydrate modification of P-selectin glycoprotein ligand 1, blocked rolling of Th1 cells. By exploiting a system that allowed us to obtain Th1 and Th2 cells with skin- vs gut-homing (CLA+ vs integrin β7+) phenotypes, we observed that induced expression of CLA on Th cells determined a striking increase of rolling efficiency in inflamed brain venules. These observations allow us to conclude that efficient recruitment of activated lymphocytes to the brain in the contexts mimicking EAE is controlled by FucT-VII and its cognate cell surface Ag CLA.


Abstract: The dryland ecosystem is the dominant component of the global terrestrial ecosystem since arid regions occupy 45% of the earth's land area and feed 38% of the world's population. The stability and sustainable development of the dryland ecosystem are critical for achieving the millennium development goal (MDG) in the arid and semiarid areas. However, there is still no scientific guideline for measuring and conserving the health and productivity of dryland ecosystems. Therefore, the purpose of this study is to develop the scientific conceptual framework of defining, monitoring and evaluating the ecological quality of dryland ecosystems. The ecological quality of dryland ecosystems is represented by a system of comprehensive indicators that are each extracted from the ecological elements, and structural and functional indices of the ecosystem. These indicators can be monitored by integrating satellites and unmanned aerial vehicles with ground-based sensor networks at the scale of either observational sites or regional scales. Finally, the ecological quality can be evaluated by evaluation models based on the normalized index values and their thresholds. This paper presents a conceptual framework for monitoring and evaluating the ecological quality of drylands, which provides a way of advancing the monitoring, diagnosis, and evaluation of the ecological quality of the dryland ecosystems.


This study aimed to examine the correlation between empowerment perception and STEM attitudes in young girls from a Costa Rican high school. 327 young people aged 11 to 18 years from "Colegio de Señoritas". The sample included only girls, from different ethnic and socio-economic backgrounds, living in different parts of the urban area in San José. In-depth, the study was carried out an S-STEM attitude survey (α = 0.91) and Empowerment Scale (modified, α = 0.89). As a result, the correlation between STEM attitude and empowerment did not confirm a significant relation. However, girls showed a poor attitude in math and the selection of STEM majors, but they have a better attitude in XXI skills and science. At the same time, young girls present a good perception of their empowerment in almost all areas. However, they are not perceived as generating an impact in the class and they also do not consider receiving enough external support, especially in their academic environment.


Let G be a simple graph with n vertices and m edges. Let edges of G be given an arbitrary orientation, and let Q be the vertex-edge incidence matrix of such oriented graph. The oriented incidence energy of G is then the sum of singular values of Q. We show that for any n 2 N, there exists a set of n graphs with O(n) vertices having equal oriented incidence energy.


The chapter discusses the results of an empirical analysis we conducted on the management accounting courses taught at Ca' Foscari between 1871 and 1991. The aim is to explore the roots and the evolution of management accounting at Ca' Foscari. The evidence we collected shows that the early management accounting concepts can be traced back to the course Bookkeeping which was taught in 1871 by Biliotti and, some years later, by Besta. As time went by, management accounting concepts evolved and expanded until some specific courses devoted to this field of study were created. The chapter discusses the evolution not only of the contents but also of the teaching methods. In its early years, teaching at Ca' Foscari was very much based on practice (case study, simulations) while it became more theoretical as time went by. We also provide a brief description of the teaching of management accounting at the Harvard Business School, one of the pioneering institutions in management accounting, pointing out some similarities and differences in the Italian and in the United States contexts.


aureus strains isolated from the oral mucosa in a young Peruvian population. ABSTRACT: Staphylococcus aureus is an important pathogen responsible for a variety of infectious diseases. The increase of resistant strains is an issue of concern. There are very few studies reporting the resistant strains isolated from oral cavity. Aim: To determine the antimicrobial susceptibility of Staphylococcus aureus isolated from oral mucosa of Peruvian young healthy carriers. The study included 64 healthy individuals whose oral mucosa, nasal mucosa and hand swabs were collected and seeded in salt mannitol agar for primary isolation. Then, coagulase test was performed to confirm the presence of Staphylococcus aureus . After that, colonies of Staphylococcus aureus underwent antibiogram by using the Kirby Bauer method. The prevalence of Staphylococcus aureus positive strains isolated from oral mucosa, nasal mucosa, and hand, was 7.8 %, 15.6 %, 50.0 %, respectively. There was less than 40 % and 11 % of prevalence of susceptibility to erythromycin and penicillin, respectively, in the three studied samples. There was equal or more than 60% of prevalence of susceptibility to amoxicillin/clavulanic acid, co-trimoxazole, gentamicin, oxacillin, ciprofloxacin, vancomycin and ampicillin/sulbactam in all the studied samples. Vancomycin resistance was found in 10 - 20 % of all samples. A high prevalence in susceptibility to amoxicillin/ clavulanic acid, gentamicin, co-trimoxazole, oxacillin, ciprofloxacin, vancomycin and ampicillin /sulbactam in healthy carriers was found. Vancomycin resistance percentage is higher than previous reports.


Denitrification walls have significantly reduced nitrogen concentrations in groundwater for at least 15 yr. This has spurred interest in developing methods to efficiently increase capture volume to reduce N loads in larger watersheds. The objective of this study was to maximize treatment volume by locating a wall where a large groundwatershed was funneled toward seepage slope headwaters. Nitrogen concentration and load were measured before and after wall installation in paired treatment and control streams. Beginning 2 d after installation, nitrogen concentration in the treatment stream declined from 6.7 ± 1.2 to 3.9 ± 0.78 mg L and total N loading rate declined by 65% (391 kg yr) with no corresponding decline in the control watershed. This wall, which only comprised 10 to 11% of the edge of field area that contributed to the treatment watershed, treated approximately 60% of the stream discharge, which confirmed the targeted approach. The total load reduction measured in the stream 155 m downstream from the wall (340 kg yr) was higher than that found in another study that measured load reductions in groundwater wells immediately around the wall (228 kg yr). This indicated the possibility of an extended impact on denitrification from carbon exported beyond the wall. This extended impact was inauspiciously confirmed when oxygen levels at the stream headwaters temporarily declined for 50 d. This research indicates that targeting walls adjacent to streams can effectively reduce N loading in receiving waters, although with a potentially short-term impact on water quality.


The aim of this study was to compare two variants of a novel polycarbonate polyurethane prosthesis with polyethylene terephthalate (Dacron) prosthesis in an established sheep model of carotid patch angioplasty. Two variants of the polycarbonate polyurethane prosthesis were used: (1) Polycarbonate polyurethane equal (PCU-e) prosthesis consisted of a multilayered porous structure with equal internal and external layers; (2) Polycarbonate polyurethane with more porous inner layers (PCU-mp) prosthesis had more porous inner layers than external layers. Carotid patch angioplasty was performed in 12 sheep: in six sheep, the PCU-e variant and in the other six sheep, the PCU-mp variant was implanted. Dacron patches were implanted in the contralateral carotid artery of all sheep as a control. Half of the animals with each polycarbonate polyurethane variant were euthanized after two weeks and the other half after eight weeks. Cellular infiltration, endothelialization, and neointimal hyperplasia were examined. All grafts were patent, and no thrombus was seen in any of the harvested arteries. The pores of all the three patch materials allowed infiltration of inflammatory cells, capillaries, and connective tissue. After eight weeks, a nearly complete endothelialization was visible in all patch groups without an obvious difference between the three patch materials. The neointima was thinner in the PCU patches (PCU-e: 56 ± 13 µm, PCU-mp: 119 ± 60 µm) when compared to Dacron patches (156 ± 64 µm) after two weeks. After 8 weeks, a further neointimal growth was detectable, without any significant difference of neointimal thickness between the three patch materials (Dacron: 274 ± 82 µm, PCU-e: 324 ± 98 µm, PCU-mp: 235 ± 59 µm). With the novel polycarbonate polyurethane patch materials, we achieved promising functional and morphological results with 100% patency and nearly complete endothelialization. Our findings showed at least a non-inferiority of the novel polycarbonate polyurethane patch material compared to Dacron. There were no significant differences detected between the two polycarbonate polyurethane patch variants.


Post-traumatic haemorrhage is the leading cause of death in trauma patients. The development of coagulopathy substantially contributes to bleeding severity and to the ensuing unfavourable outcome. Trauma-induced coagulopathy (TIC) can be seen in 10-25% of patients with major trauma, and its early and appropriate therapeutic management leads to considerable reduction of mortality risk. Due to the extreme complexity of TIC pathophysiology, the limitations of conventional coagulation tests (CCTs) have become evident in recent years. Unlike these routine tests, point of care viscoelastic tests (VET) such as thromboelastogram (TEG) or rotational thromboelastography (ROTEM) provide valuable clinical information by real time assessment of changes in viscoelastic properties of blood throughout clot formation. This review was aimed to collect and discuss available evidence on goal-directed hemostatic resuscitation, based on TEG or ROTEM data. We included studies with patients aged 18 years or older, major trauma, and needing massive transfusions. Overall, 6 studies totalling 1533 patients were finally included. A total number of 288 patients died, 98 of whom in the TEG- or ROTEM-guided cohorts (i.e., intervention groups). A 36% reduction of death was observed in the intervention groups (relative risk, 0.641; 95% CI 0.517-0.795; P<0.001). Our results show that VET-guided management is effective to reduce mortality compared to conventional management with CCTs. Except for mortality, all others endpoints were heterogeneous across the studies. This emphasize the need of scheduling new and well-designed trials, aimed to better define the optimal strategy for TIC management.