CONTEXT
States have been reluctant to enroll children with special health care needs (SHCN) into capitated managed care, because the financial incentives inherent in such plans may elicit undertreatment, restrict access to specific services and providers, and have adverse effects on quality. Little research has examined how children with SHCN who qualify for Supplemental Security Income (SSI) fare under managed care versus the fee-for-service (FFS) system.

OBJECTIVE
To examine how enrollment of children with SHCN with SSI into a Medicaid capitated managed care plan differs from regular FFS with respect to unmet needs and access to care in the District of Columbia.

DESIGN, SETTING, AND PARTICIPANTS
We conducted telephone interviews with a random sample of 1088 caregivers of children with SHCN who resided in the District of Columbia during the summer and fall of 2002.

MAIN OUTCOME MEASURES
1) Usual source of care; 2) unmet need for the following services during the 6-month period prior to the interview: physician/hospital, mental health, therapy services, dental care, durable medical equipment and supplies, prescription drugs, and home health services; and 3) caregivers' ratings of dimensions of access to services.

RESULTS
The percentage of FFS children who did not receive needed dental care, durable medical equipment/supplies, or prescription drugs was significantly larger than the percentage of children enrolled in the capitated managed care plan. We found no significant differences by plan type in unmet need for physician/hospital care, mental health services, home health service, or therapy services. The most problematic areas of access seem to be "wait time between making an appointment and the actual visit," "waiting time in the doctor's office," "office hours for appointments," "getting medical advice by phone," and "getting specialist's care if needed." For each of these dimensions of access, children in the FFS system experienced significantly more of such access problems, compared with children in Health Services for Children With Special Needs (HSCSN). These 4 dimensions of access cause problems for 18% to 29% of FFS parents but only 13.6% to 22.3% of caregivers with a child in HSCSN. Three other dimensions of access, "convenience of doctor's office," "getting emergency care if needed," and "getting hospital care if needed," also seemed to pose significantly more problems for caregivers with children in FFS plans, compared with those in HSCSN. These dimensions of access were only problematic for 9% to 14% of FFS caregivers and 5.9% to 7.7% of caregivers with children enrolled in HSCSN.

CONCLUSIONS
Children in the managed care option have lower levels of unmet need than children in FFS plans. Caregivers of children in FFS plans encountered more difficulties in navigating the health care system, compared with those with children in managed care. We conclude that a combination of factors that characterize the capitated managed care plan are responsible for improving access to care and mitigating the level of unmet need among children with SHCN. These include the comprehensive care plan assessment, ongoing case management, primary care providers' gatekeeping role, and higher physician reimbursement.


This paper describes the population characteristics in the drayage trucking population of the Port of Seattle as determined by the 2013 Truck Driver Survey. The 2013 Truck Driver Survey was created to give the Port of Seattle more information on the trip destinations, working conditions, equipment, and economics of truck drivers serving the Port of Seattle, so that policy makers creating regulations affecting trucking at the port could be better informed about the trucking population. The survey was a 44 question mail-back survey that was distributed at the Port of Seattle. The survey was distributed for eight days at all container terminals at the Port of Seattle, and got a 29% response rate. The majority of the trips to and from the Port of Seattle are for the local Seattle area (33%) and the Kent Valley (20%). Other trips are distributed to service areas throughout the State of Washington. Owner-operators were found to make more of the short trips, with employee drivers making more of the long trips. 62% of trucks at the Port of Seattle are more than 12 years old. These trucks will have to be replaced before 2015 to comply with the Port of Seattle Clean Trucks Program. The Port of Seattle has a diverse population, with 53% of drivers indicating that they did not speak English as a first language. Drivers who indicated that they didn't speak English were about 50% from Africa, with South/Central America and Asia/Pacific Islands also having significant populations.


High-resolution inputs of rainfall are important in hydrological sciences, especially for urban hydrology. This is mainly because heavy rainfall-induced events such as flash floods can have a tremendous impact on society given their destructive nature and the short time scales in which they develop. With the development of technologies such as radars, satellites and (commercial) microwave links (CMLs), the spatiotemporal resolutions at which rainfall can be retrieved are becoming higher and higher. For the land surface of The Netherlands, we evaluate here four rainfall products, i.e., link-derived rainfall maps, Integrated Multisatellite Retrievals for Global Precipitation Measurement (IMERG) Final Run (IMERG—Global Precipitation Measurement mission), Meteosat Second Generation Cloud Physical Properties (CPP), and Nighttime Infrared Precipitation Estimation (NIPE). All rainfall products are compared against gauge-adjusted radar data, considered as the ground truth given its high quality, resolution, and availability. The evaluation is done for seven months at 30 min and 24h. Overall, we found that link-derived rainfall maps outperform the satellite products and that IMERG outperforms CPP and NIPE. We also explore the potential of a CML network to validate satellite rainfall products. Usually, satellite derived products are validated against radar or rain gauge networks. If data from CMLs would be available, this would be highly relevant for ground validation in areas with scarce rainfall observations, since link-derived rainfall is truly independent of satellite-derived rainfall. The large worldwide coverage of CMLs potentially offers a more extensive platform for the ground validation of satellite estimates over the land surface of the Earth.


New BODIPY derivatives (dyes 1 and 2) with either catechol or resorcinol functionality, respectively, for anchoring to nanostructured (NS) TiO2 surfaces were synthesized. Extended conjugation at one of the two pyrrole rings at the C3 position helped us to achieve the desired control in tuning the optical and redox properties of the BODIPY based dye molecules. Relative emission quantum yields (Φem1 = ∼52 ± 2% and Φem2 = 54 ± 2%) were found to be much higher in a polar aprotic solvent (acetonitrile) and substantially lower for dye 1 in a polar protic solvent. Steady state optical absorption studies revealed the formation of a strong charge transfer complex between dye 1 and NS-TiO2, while this interaction was much weaker for dye 2. Transient absorption studies were carried out for 1/NS-TiO2 and 2/NS-TiO2 systems following excitation with a laser source of 400 nm to understand the charge transfer dynamics. The results of the transient absorption spectral studies helped us to elucidate the role of anchoring functionality in influencing the dynamics of interfacial electron transfer and charge recombination processes on an ultrafast timescale.


Our recent study demonstrated that higher expression of N-myc downregulated gene 1 (NDRG1) is closely correlated with poor prognosis in gastric cancer patients. In this study, we asked whether NDRG1 has pivotal roles in malignant progression including metastasis of gastric cancer cells. By gene expression microarray analysis expression of NDRG1 showed the higher increase among a total of 3691 up-regulated genes in a highly metastatic gastric cancer cell line (58As1) than their parental low metastatic counterpart (HSC-58). The highly metastatic cell lines showed decreased expression of E-cadherin, together with enhanced expression of vimentin and Snail. This decreased expression of E-cadherin was restored by Snail knockdown in highly metastatic cell lines. We next established stable NDRG1 knockdown cell lines (As1/Sic50 and As1/Sic54) from the highly metastatic cell line, and both of these cell lines showed enhanced expression of E-cadherin and decreased expression of vimentin and Snail. And also, E-cadherin promoter-driven luciferase activity was found to be increased by NDRG1 knockdown in the highly metastatic cell line. NDRG1 knockdown in gastric cancer cell showed suppressed invasion of cancer cells into surround tissues, suppressed metastasis to the peritoneum and decreased ascites accumulation in mice with significantly improved survival rates. This is the first study to demonstrate that NDRG1 plays its pivotal role in the malignant progression of gastric cancer through epithelial mesenchymal transition.


High doses of methylprednisolone (MPSS) came into use as part of a therapeutic protocol for acute spinal cord injuries following the published results from the NASCIS II study in 1992; they soon became a standard of care around the world. However, the results of this study have been critically reviewed and questioned by many authors since the beginning. The major argument is based on the fact that its effectiveness in reducing post-injury neurological damage has not been conclusively proved; in addition, there has been increasing evidence of serious side effects of steroids administered at high doses. In the Czech Republic, as part of pre-hospital care, MPSS according to the NASCIS II (or NASCIS III) protocol is used in all regional centres of emergency medical service. In the Czech spinal surgery centres involved in treating acute spinal cord injuries, there are 19 of them, attitudes towards the use of MPSS vary. In 16% of the centres a certainty of its beneficial effect is still maintained, faith in its effect together with fear of a "non-lege artis" procedure is the reason for MSPP use in 21%, and the fear of sanctions only leads to its use in 63% of the centres. There is no standard practice in application of the NASCIS II and NASCIS III protocols and no standard exclusion criteria exist. The two protocols are used equally, and one institution has its own modification. The recommended MPSS dose is administered with no exception in 63% of the centres; dose adjustment is employed according to the form of spinal cord lesion in 11%, the level of spinal cord injury in 5%, associated diseases in 16% and patient age in 11% of the spinal surgery centres. After the results of studies on MPSS administration in acute spinal cord injury have been analysed, many medical societies have changed their recommendations. In view of later relevant publications it is no longer possible to regard MPSS administration as a standard of cure for acute spinal cord injury. Current evidence suggests that MPSS administration in a 24-hour regimen after an initial dose given within 8 hours of injury is the therapeutic procedure that needs individual consideration in each patient according to their state of health and potential complications. MPSS administration at an interval longer than 8 hours after injury and for more than 24 hours is not justified, nor is it justified to use a high MPSS dose at the place of injury by an emergency ambulance crew. Key words: corticosteroids, methylprednisolone, spinal cord trauma, neurological damage.


In this paper a new zero voltage switching PWM flyback converter with simple auxiliary circuit is introduced. The auxiliary circuit is only composed of a resonant capacitor and an auxiliary switch connected to a tertiary winding on the converter main transformer. The proposed auxiliary circuit provides soft switching for the main switch while zero current switching condition is attained for the auxiliary switch. The proposed converter is analyzed and its various operating modes are discussed. The proposed converter is simulated with PSPICE software and is compared with hard switching counterpart. The simulation results confirm the theoretical analysis.


T his paper examines the multiple elements of Korean Quaker Ham Sok-Heon's religious, political, and theological identity from the perspective of hybridity, with a special focus on the impact of that hybridity on Quaker reconciliation theology. In this article, I outline the basic elements of his ideas and context, emphasising the ways in which they interact in the intricate web of his thought. I also outline ways in which both reconciliation and Liberal Quaker theology are present in his ideas, and how exploring these overlaps would strengthen theological and ethical thought in both of these areas. His ideas are relatively unknown outside of Korea, due in part to the fact that very few of his writings have been translated: both literally translated from Korean, but also figuratively translated into non-Korean contexts. As I argue, however, his ideas are actually highly 'translatable' to both reconciliation theology and Liberal Quaker theology. As a result, I argue that any subsequent construction of Quaker reconciliation theology which fails to take Ham's work into consideration is incomplete, especially due to the potential implications of his work to respond to the complex hybrid nature of both reconciliation and Liberal Quaker theology.


We present here an experimental demonstration of the wavelength dependence of the polarization singularities due to linear combination of the vector modes excited directly in a two-mode optical fiber. The coherent superposition of the vector modes excited by linearly polarized Gaussian beam as offset skew rays propagated in a helical path inside the fiber results in the generation of phase singular beams with edge dislocation in the fiber output. The polarization character of these beams is found to change dramatically with wavelength—from left-handed elliptically polarized edge dislocation to right-handed elliptically polarized edge-dislocation through disclinations. The measured behaviour is understood as being due to intermodal dispersion of the polarization corrections to the propagating vector modes, as the wavelength of the input beam is scanned.


This paper presents the hardware and software approach to replacing the current analogue linear feedback system on the TCV Tokamak with a DSP based system to allow for non-linear control. After preliminary combination, over 120 control signals are reduced to 32 parameters which enter an array of 32 DSP processors each of which is passed the complete parameter set. Apart from data transfer and storage, each DSP will run its separate control algorithm with a repetition rate up to 20 kHz. A separate DSP board is dedicated to the plasma vertical control which requires a 200 kHz feedback rate. This paper presents the hardware and the software that is being designed to put this control block in the hands of non DSP-expert physics users


This article operates on two main levels: it utilizes the theoretical framework of memory studies in order to examine the place of Greek Jews in the context of contemporary social and cultural memory in Greece on the one level, and it studies the case of Greek Jews from the point of view of history education on the other. The study points out that the viewpoints and the reactions of contemporary Greeks to the past and the present of their Jewish compatriots are very contradictory. Besides this, the dominant ideology and the conservative perception of national identity seem to be exclusive of "otherness". So, Greek Jews do not constitute a strong part of historical memory; their past and present, in contrast to the "official memory", is very marginal. In consequence of this, contemporary Greeks, even student teachers, do not have sufficient knowledge about the roots of Jews in Greece, about their culture or about the Holocaust. History education is, from this point of view, an example of "deafening silence", an example of how so-called "catastrophe didactics" can operate.


The authors present the concept of a 'segmental neural net' (SNN) for phonetic modeling in continuous speech recognition (CSR) and demonstrate how than can be used with a multiple hypothesis (or N-Best) paradigm to combine different CSR systems. In particular, they have developed a system that combines the SNN with a hidden Markov model (HMM) system. They believe that this is the first system incorporating a neural network for which the performance has exceeded the state of the art in large-vocabulary, continuous speech recognition. To take advantage of the training and decoding speed of HMMs, the authors have developed a novel hybrid SNN/HMM system that combines the advantages of both types of approaches. In this hybrid system, use is made of the N-best paradigm to generate likely phonetic segmentations, which are then scored by the SNN. The HMM and SNN scores are then combined to optimize performance.<<ETX>>


The currency crises of the 1990s all exhibit a divergence of the nominal and the real exchange rate together with an increase in the negative current account. The nominal rate does not reflect inflation differences fully and the ensuing real appreciation leads to a negative current account. This pattern holds for the Czech, the Mexican, Brazilian, Argentinian as well as the South Korean currency crises. It seems to be an iron law of currency crises.


Economic analyses of pests typically assume damage is either additively separable from pest free yield or proportional to it. This paper describes the ecological assumptions required for additive and proportional damage functions to demonstrate that both specifications are reasonable. Ecological research supports a proportional damage function for competitive pests such as weeds, while for insect pests the appropriate damage function depends on the level of pest free yield. Theoretical analysis identifies differences between additive and proportional damage functions in terms of the impact of pest control on output variance and the concavity of output in the pest control input.


In the past decade, phase-contrast imaging (PCI) has become a hot research with an increased improvement of the image contrast with respect to conventional absorption radiography. In this paper, effects of tube voltage (kVp) on propagation-based phase-contrast imaging have been investigated with two types of microfocus x-ray tubes, a conventional sealed x-ray tube with the focal spot size of 13-20 μm and an open x-ray tube with minimum focal spot size less than 2 μm. A cooled x-ray CCD detector with the pixel size of 24 μm was used to acquire digital images. Two thin plastic sheets with different thickness were used as radiography phantoms. Two different phenomena were observed for the two x-ray tubes, for the open tube, phase-contrast effect has a slight drop with the increasing of tube voltage, however, it is opposite for the sealed tube. A further investigation indicates that the variation of focal spot size causes the abnormal result for the sealed tube. It also shows that phase-contrast effect is more sensitive to focal spot size than tube voltage.


Peripheral neuromas are a prevalent problem following nerve injury or certain surgical interventions like limb amputation. It is important to consider a peripheral neuroma when a patient experiences pain in the innervation area of a peripheral sensory or mixed nerve (branch), especially following trauma or amputation. Adequate recognition of a painful neuroma is crucial to treat patients satisfactorily for their invalidating and chronic symptoms. We want to emphasize that surgical intervention can be an effective and permanent treatment for symptomatic neuromas. The standard surgical treatment is neuroma excision and burying of the nerve stump in adjacent muscle. However, there is a shift towards new and active techniques like Targeted Muscle Reinnervation, of which future comparative research will have to demonstrate whether it is more effective in treating peripheral neuroma pain than conventional surgery.


To generalize the notion of recurrent manifold, there are various recurrent like conditions in the literature. In this paper we present a recurrent like structure, namely, super generalized recurrent manifold, which generalizes both the hyper generalized recurrent manifold and weakly generalized recurrent manifold. The main object of the present paper is to study the geometric properties of super generalized recurrent manifold. Finally to ensure the existence of such structure we present a proper example by a suitable metric.


Despite major advances in treatment of coronary heart disease, apparently healthy patients die suddenly. Rupture of vulnerable fibroatheroma plaques in coronary arteries cause more than 250,000 deaths a year, yet the mechanisms as to why some caps rupture and some others do not, remain unknown. The current criterion to consider a fibroatheroma as "vulnerable" or prone to rupture is the thickness of its fibrous cap. However, available screening techniques and the cap thickness criterion have been shown to be insufficient to identify the victims before the event occurs.Copyright © 2011 by ASME


The difference in the proportion of students from families with different income levels attending college is due to two factors: the liquidity constraint and the difference deriving from the low returns to education among the poor. We find that grades in the school-leaving matriculation examinations (Bagrut) constitute an unbiased estimate of the returns to higher education for men, and can be used to estimate the extent of the liquidity constraint affecting students from an underprivileged socio-economic background. Among women, on the other hand, we find that the returns to higher education for school-leavers with matriculation from underprivileged families are higher than they are for school leavers with matriculation from better-off families, i.e., the liquidity constraint for women is underestimated. We find that 3.3 percent of male school-leavers and 4.5 percent of female school-leavers, both having matriculated from high school, refrained from going on to higher education because of a liquidity constraint. The existence of a liquidity constraint as regards higher education for both men and women is borne out by the longer time it takes for youngsters from low-income families to graduate from college. Despite the existence of a liquidity constraint we did not find that a reduction in university tuition fees had an effect on the composition of those graduating. In our opinion, this expresses the relatively small reduction in tuition fees (relative to the total cost of studying) as well as the relatively short period of time that has elapsed since tuition fees were reduced and our sample, which prevents us from identifying slight changes in the composition of those graduating from university.


Introduction Primary healthcare nurse practitioners (PHCNPs) practice in a wide range of clinical settings and with diverse patient populations. Several systematic reviews have examined outcomes of PHCNP roles. However, there is a lack of consistency in the definitions used for the PHCNP role across the reviews. The identification of indicators sensitive to PHCNP practice from the perspective of patients, providers and the healthcare system will allow researchers, clinicians and decision-makers to understand how these providers contribute to outcomes of care. Methods and analysis A review of systematic reviews is proposed to describe the current state of knowledge about indicators sensitive to PHCNP practice using recognised role definitions. Outcomes of interest include any outcome indicator measuring the effectiveness of PHCNPs. We will limit our search to 2010 onwards to capture the most up-to-date trends. The following electronic databases will be searched: Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library Database of Systematic Reviews and Controlled Trials Register, Database of Abstracts of Reviews of Effects, EMBASE, Global Health, Health Economics Evaluation Database, Health Evidence, HealthStar, Health Systems Evidence, Joanna Briggs Institute, Medline, PDQ-Evidence, PubMed and Web of Science. The search strategies will be reviewed by an academic librarian. Reference lists of all relevant publications will be reviewed. Grey literature will be searched from 2010 onwards, and will include: CADTH Information Services, CADTH's Grey Matters tool, OpenGrey, Organisation for Economic Co-operation and Development, ProQuest Dissertation and Theses and WHO. The PROSPERO International Prospective Register of Systematic Reviews will be searched to identify registered review protocols. The review protocol was developed using Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols recommendations. A narrative synthesis will be used to summarise study findings. Ethics and dissemination No ethical approval is required for the study. The data used in the study will be abstracted from published systematic reviews. Dissemination strategies will include peer-reviewed publication, conference presentations and presentations to key stakeholders. PROSPERO registration number CRD42020198182.


In 1989 the Spanish artist Pedro Cano [1] designed the stage set and costumes for a performance to be held in Hadrian's Villa in Tivoli. The play entitled Hadrian's Memoirs: portrait of a voice [2] was based on excerpts from the novel by Marguerite Yourcenar, interpreted by actors Giorgio Albertazzi, Eric Vu An and Maria Carta, and directed by Maurizio Scaparro [3]. Cano's very intense and meaningful painting of the Maritime Theatre in Hadrian's Villa is part of his 160 x 100 cm series of watercolours of Greek and Roman theatres and amphitheatres.  Although the artist executed this particular painting in 2016, he had already painted the site many years earlier when he created a notebook of paintings of Hadrian's Villa and a series of twelve aquatints in which he included not only the theatre, but also other architectures in the complex.


Due to deregulation of the broadcasting industry, television news has changed considerably during the last 10-15 years. This paper reports on a major study of changes in the Danish television news as regards news content, formats and editorial policies. In particular, the paper focuses on the development of proximity as a key news value that allows newsrooms to develop a closer relationship with their viewers. However, the editorial emphasis on proximity in selection of news stories, narrative and enunciative structure also entails a redefinition of the social character of news. Finally, the paper discusses these editorial changes in relation to broader changes in public discourse in Denmark, notably the increase in media generated populism and the rise of the "modern province".


The structures and stabilities of alkaline earth metal peroxides XO2 (X = Ca, Be, Mg) were studied using an adaptive genetic algorithm (GA) for global structure optimization in combination with first-principles calculations. From the adaptive GA search, we obtained an orthorhombic structure for CaO2 with 12 atoms in the unit cell, which is energetically more favorable than the previously proposed structures. Reaction energy of the decomposition CaO2 → CaO + 1/2O2 determined by density functional theory (DFT) calculation shows that this orthorhombic calcium peroxide structure is thermodynamically stable. The simulated X-ray diffraction (XRD) pattern using our predicted structure is in excellent agreement with experimental data. We also show that crystal phase BeO2 is unlikely to exist under normal conditions. MgO2 has a cubic pyrite structure, but it is not stable against decomposition: MgO2 → MgO + 1/2O2.


Dietary proteins from soybeans have been shown to offer health benefits in vivo and/or in vitro either as intact proteins or in partially digested forms also called bioactive peptides. Upon oral administration and absorption, soy-derived bioactive peptides may induce several physiological responses such as antioxidative, antimicrobial, antihypertensive, anticancer and immunomodulatory effects. There has therefore been a mounting research interest in the therapeutic potential of soy protein hydrolysates and their subsequent incorporation in functional foods and 'Food for Specified Health Uses' (FOSHU) related products where their biological activities may assist in the promotion of good health or in the control and prevention of diseases. This mini review discusses relevant patents and gives an overview on bioactive proteins and peptides obtainable from soybeans. Processes for the production and formulation of these peptides are given, together with specific examples of their therapeutic potential and possible areas of application.


Recent work on multifunctional materials has demonstrated that high-strength composites could be integrated with active Li-ion battery material to create high strength and high energy density storage structures that could meet the transportation requirements on mobility and energy storage density. However, the performance and the design of the multifunctional materials require fundamental understanding of the mechanical behavior of the integrated Multifunctional Energy Storage (MES) Composites systems under various loading conditions. Characterization of this new class of multifunctional materials would become very challenging without an adequate simulation model to guide the tests and validate the results. Therefore, this work presents the mechanical simulation and design of the MES Composites system that consists of multiple thin battery layers, polymer reinforcements, and carbon fiber composites, which results significant challenges in simulation and modeling. To tackle these issues, homogenization techniques were adopted to characterize the multi-layer properties of battery material with physics-based constitutive equations combined with non-linear deformation theories to handle the interface between the battery layers. Second, both mechanical and electrical damage and failure modes among battery materials, polymer reinforcements and carbon fiberpolymer interfaces were characterized through appropriate models and experiments. The model of MES Composite has been implemented in a commercial finite element code. A comparison of structural response and failure modes from numerical simulations and experimental tests will be presented in the paper. The simulated strain distribution and its application to Structural Health Monitoring (SHM) on MES Composites will also be discussed. The results of the study showed that the predictions of elastic and damage responses of MES Composites at various loading condition agreed with the test data. With appropriate material parameters determined from experiments, this multi-physics model can be used as a necessary tool to characterize a failure envelop that governs the design of MES Composites under specified electrical and mechanical loads.


Enrichment from local fishponds led to the isolation of a bacterium capable of lysing many species of unicellular and filamentous blue-green algae, as well as certain bacteria. The isolate is an aflagellate, motile rod which moves in a gliding, flexuous manner; the organism is capable of digesting starch and agar, but not cellulose and gelatin. Its deoxyribonucleic acid base pair composition (per cent guanine plus cytosine ∼70) shows a close resemblance to that of the fruiting myxobacteria. Algae in lawns on agar plates were lysed rapidly by the myxobacter, but only limited and slow lysis occurred in liquid media, and no lysis took place when liquid cultures were shaken. No diffusible lytic factors would be demonstrated. Continuous observation of the lytic process under a phase-contrast microscope suggested that a close contact between the polar tip of the myxobacter and the alga is necessary for lysis. The lytic action is limited to the vegetative cells of the algae, whereas heterocysts are not affected. The gas vacuoles of the algal host are the only remnant visible after completion of digestion by the myxobacter.


In many machine vision applications, objects or scenes are imaged in color (red, green and blue) but then transformed into grayscale images before processing. One can use equal weights for the contribution of the color components to gary scale image or can use the unequal weights provided by the luminance mapping of the National Television Standards Committee (NTSC) standard. NTSC weights, which basically enhance the visual properties of the images, may not perform well for classification purposes. In this study, we propose an adaptive color-to-grayscale conversion approach which increases the accuracy of the image classification problems. The method optimizes the contribution of the color components which increases the between-class distances of the images in opponent classes. It's observed from the experimental results that the proposed method increases the distances of the images in classes between 1% and 87% depending on the dataset which results increases in classification accuracies between 1% and 4% on benchmark classifiers.


Data augmentation by mixing samples, such as Mixup, has widely been used typically for classification tasks. However, this strategy is not always effective due to the gap between augmented samples for training and original samples for testing. This gap may prevent a classifier from learning the optimal decision boundary and increase the generalization error. To overcome this problem, we propose an alternative framework called Data Interpolating Prediction (DIP). Unlike common data augmentations, we encapsulate the sample-mixing process in the hypothesis class of a classifier so that train and test samples are treated equally. We derive the generalization bound and show that DIP helps to reduce the original Rademacher complexity. Also, we empirically demonstrate that DIP can outperform existing Mixup.


ABSTRACT Han, Z.; Li, H.; Xie, H.; Yang, H.; Ouyang, Q., and Gong, S., 2022. Dredging of the Shenzhen-Zhongshan Link in the Pearl River Estuary, China: Short-term siltation mechanism for a trial trench. Journal of Coastal Research, 38(5), 988–998. Coconut Creek (Florida), ISSN 0749-0208. Understanding the short-term, particularly daily, siltation mechanism of a dredged trench is critical for immersed tunnel construction, as well as for offshore engineering and coastal management. This study explored the short-term siltation mechanism of the trial trench dredged for the Shenzhen-Zhongshan Link in the Pearl River Estuary, China. Monthly silting characteristics over a period of ∼11 months indicate that the silting intensity during the flood season was much larger than during the dry season. Local suspended sediment concentrations (SSCs) also varied on a flood–dry seasonal cycle, which were impacted by the suspended load from the Pearl River. Daily silting characteristics indicate that the silting intensity during spring tides were higher than during neap and moderate tides and that the local SSCs and flow velocities also varied on a spring–neap tidal cycle, which was dominated by periodic variations in the astronomical tide. The flow velocity deceased substantially from the surface to the bottom of the trench, and flow circulation occurred at the bottom of the trench, which aided the silting process. Seasonal changes in the sediment load from the Pearl River were the dominant cause of the changes in suspended sediment around the trench, which produced seasonal siltation changes in the trench. Daily changes in trench siltation were directly caused by the amount of sediment that entered the trench, which was affected by changes in the flow velocity and bottom SSC around the trench during the neap–spring tidal cycle. Although the high-siltation intensity during the flood season was unhelpful, the low-siltation intensity during neap and moderate tides was helpful for the construction of immersed tunnel during the flood season.


OBJECTIVES
To identify malocclusion characteristics generated after using oral appliances (OAs) for at least 5 years for the management of snoring and obstructive sleep apnea (OSA) in adults.

MATERIALS AND METHODS
PubMed, MEDLINE (Ovid), Scopus, CINAHL, and Informit were searched without language restrictions through January 20, 2021. Unpublished literature was searched on ClinicalTrials.gov, the National Research Register, and the Pro-Quest Dissertation Abstracts and Thesis database. Authors were contacted when necessary, and reference lists of the included studies were screened. Risk of bias was assessed through the revised Cochrane Risk of Bias tool for randomized controlled trials (RoB2) and Non-Randomized Studies of Interventions for non-RCTs and uncontrolled before-after studies (ROBINS-I). A random-effects meta-analysis was conducted only on studies that used the same OAs to exclude biomechanical differences. Risk of bias across studies was assessed with the Grading of Recommendations, Assessment, Development and Evaluation tool.

RESULTS
A total of 12 studies were included in the final qualitative synthesis. Eight included studies had high, one had moderate, and three had low risks of bias. Significant progressive decreases of overjet (OJ; -1.43 mm; 95% confidence interval [CI], -1.66 to -1.20) and overbite (OB; -1.94 mm; 95% CI, -2.14 to -1.74) associated with maxillary incisor retroclination and mandibular incisor proclination were reported long term. Although most studies showed no sagittal skeletal changes, some degree of vertical skeletal changes were noted.

CONCLUSIONS
Based on a very low evidence level, inevitable anterior teeth positional changes seem to be a common long-term adverse effect of OAs. The magnitude of those changes could be considered clinically irrelevant for most pretreatment occlusions, but in occlusions with limited OJ and OB, it may be worth clinical consideration.


Exposure of albino rats to incandescent radiant energy for a short period of time in an elevated environmental temperature (39 degrees C) causes degenerative changes in the extraocular muscles. The muscle fibres regenerate and the muscles reorganize if the animals are returned to room lighting and temperature. Extraocular muscles (EOMs) were damaged first near their insertion on the eyeball. All EOMs of both eyes were affected, but the degeneration did not extend the entire length of the muscle. The peripheral fibres of each muscle were damaged before the more central fibres. Mitochondria were swollen and often contained dense bodies. Numerous vesicular profiles, possibly from the sarcotubular system, were present. Myofibrils of the more severely damaged fibres lacked typical Z-disk structures, and I-bands had disappeared by 24 h after the exposure period, a degenerative pattern which seems to be unique for this method of EOM damage. EOM degeneration appeared to be dependent on the interaction between thermal and radiant energy on the orbital contents. However, EOMs were only rarely and very slightly affected when rats were exposed to elevated temperature in the absence of incandescent radiant energy. When an opaque, black, ocular occluder was placed over one eye and the contralateral eye was left unoccluded, EOMs and retinas of occluded eyes were undamaged, while those tissues were severely damaged in unoccluded eyes. Therefore, the most critical single variable in inducing EOM degeneration appears to be exposure to radiant energy.


Amide bond-containing (ABC) biomolecules are some of the most intriguing and functionally significant natural products with unmatched utility in medicine, agriculture and biotechnology. The enzymatic formation of an amide bond is therefore a particularly interesting platform for engineering the synthesis of structurally diverse natural and unnatural ABC molecules for applications in drug discovery and molecular design. As such, efforts to unravel the mechanisms involved in carboxylate activation and substrate selection has led to the characterization of a number of structurally and functionally distinct protein families involved in amide bond synthesis. Unlike ribosomal synthesis and thio-templated synthesis using nonribosomal peptide synthetases, which couple the hydrolysis of phosphoanhydride bond(s) of ATP and proceed via an acyl-adenylate intermediate, here we discuss two mechanistically alternative strategies: ATP-dependent enzymes that generate acylphosphate intermediates and ATP-independent transacylation strategies. Several examples highlighting the function and synthetic utility of these amide bond-forming strategies are provided.


A procedure for inverting the nonlinear relationship between the waveheight spectrum and the SAR image spectrum is presented, and this procedure is evaluated using simulated data as well as actual ERS SAR data collected near Duck, NC. Results of this nonlinear inversion are compared with those obtained from a quasi-linear estimation procedure using simulated data, in order to illustrate the effects of nonlinearities in the imaging process. These effects include the well-known azimuth falloff effect as well as the generation of harmonics which appear in the background region of the spectrum. The nonlinear inversion technique is able to reproduce the input image spectrum to high accuracy, although the wave spectrum obtained by this procedure is not necessarily the same as the input wave spectrum. In general, the estimated wave spectrum is quite similar to the portion of the input wave spectrum within the SAR passband region, but none of the energy outside the passband is recovered. The background signals due to nonlinear effects can cause large errors in the quasi-linear estimation procedure because these signals appear in regions of the spectrum where the SAR modulation transfer function (mtf) is small. Results using actual SAR data also indicate that energy within the passband is recovered fairly accurately, although energy outside the passband is clearly lost.


In this paper, a numerical modeling performed to study the effect of carbon fiber reinforced polymers (CFRP) as a shear strengthening of corbels. In this study a theoretical simulation is achieved with reinforced concrete corbels, several CFRP strengthening positions has been studied with different shear span – effective depth ratio (a/d) of (0.5,0.6&0.7). The numerical model, by using program (ANSYS 12.1) verified by compare its results with the experimental results. It was found that the position and the amount of (CFRP) as well as the vary of (a/d) ratio, have a great effects on the ultimate load capacity of corbels. Where, the ultimate load capacity increase as the amount of (CFRP) increased in certain positions of corbels, with regards the vary in (a/d) ratio.


Due to subjectivity in oral assessment, much concentration has been put on obtaining a satisfactory measure of consistency among raters. However, obtaining consistency might not result in valid decisions. One matter that is at the core of both reliability and validity in oral performance is rater training. Recently, the Multifaceted Rasch Measurement (MFRM) has been adopted to address the problem of rater bias and inconsistency; however, no research has incorporated the facets of test takers' ability, raters' severity, task difficulty, group expertise, scale criterion category, and test version together in a piece of research along with their two-sided impacts. Moreover, little research has investigated how long rater training effects endure. Consequently, this study explored the influence of the training program and feedback by having 20 raters score the oral production, as measured by the CEP (Community English Program) test, produced by 300 test takers in three phases, i.e., before, immediately after, and long after the training program. The results indicated that training can lead to higher degrees of interrater reliability and decrease in measures of severity/leniency and biasedness. However, it did not lead the raters into total unanimity, except for making them more self-consistent. Although rater training might result in higher internal consistency among raters, it cannot eradicate individual differences. That is, experienced raters, due to their idiosyncratic characteristics, did not benefit as much as the inexperienced ones. This study also showed that the outcome of training might not endure in long terms after training; thus, it requires ongoing training, letting raters regain consistency.


In electro discharge machining (EDM) the metal removal occurs from the erosive effects of high frequency sparks. Consequently the erosion rate depends on spark energy sparking frequency and the factors affecting them. However the experimental results are highly random and sometimes unexpected. Material erosion rate and surface roughness were analysed for the effect of important factors like pulse parameters (voltage current, ontime and offtime), polarity and work material. Taguchi method of experiment planning with orthogonal arrays was adopted to analyse the anomalies observed in the experimental results.


Discovery of temporal information is key for organising knowledge and therefore the task of extracting and representing temporal information from texts has received an increasing interest. In this paper we focus on the discovery of temporal footprints from encyclopaedic descriptions. Temporal footprints are time-line periods that are associated to the existence of specific concepts. Our approach relies on the extraction of date mentions and prediction of lower and upper boundaries that define temporal footprints. We report on several experiments on persons' pages from Wikipedia in order to illustrate the feasibility of the proposed methods.


During the Little Ice Age of the early modern centuries, close to a third of the globe's population perished. Because this period serves as the most recent example of the global impacts of climate change, historians and others interested in developing conceptual and methodological tools for understanding contemporary climate change regularly look to the historiography of the Little Ice Age for direction and inspiration. This article adds to this toolkit by arguing for the place of gender and sexuality in analyses of climate change, something environmental historians have seldom done. It does so through the discussion of a seemingly fantastical account of a young woman who gave birth to an elephant in the Ottoman Empire in the 1640s. Focusing on the experience of one woman, her rape by an elephant from India, the sad fate of her child, and her community's social and economic hardships shows how individuals both experienced and interpreted the environmental calamities of the Little Ice Age as a species crisis. Her story furthermore analogizes the political fortunes of the Ottoman Empire in a moment of weakness. By connecting the literatures of environmental and natural history, women's history and histories of sexuality, empire and science, this article centers the roles of women as prime agents of population, history, and culture.


We previously described an informatics tool (PROBE) to automate screening for behavioral risks for pain in children and adolescents. PROBE was deployed for a one year pilot study in our pediatric specialty care practice. Here we describe evaluation of this tool to assess self-report of pain, chronic disease activity and behavioral risks in 109 patients who sought routine care in the busy outpatient pediatric rheumatology practice of our large healthcare system. Results show that patients who self-report poorer self-efficacy and coping skills and night-time awakenings have significantly higher odds (8 and 5 times higher respectively) of reporting chronic pain even after accounting for their chronic disease activity. Our results show that automating screening in specialty care waiting rooms can not only inform the clinicians of patient's unknown risks but may even help drive the judicious use of precision healthcare resources such as cognitive behavioral therapy.


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EUCOR is a ceramic material resistant to extreme heat and wear. A block made of EUCOR with dimensions of 350 x 200 x 400 mm was used for the numerical calculation and the experiment. The numerical model of the casting block temperature field determines the temperature gradients, the solidification rate and the local solidification time (i.e., the time between the liquidus and solidus temperatures). The local solidification time significantly affects the forming of the pouring structure of the given material and it makes one of the input parameters for the second cooperating chemical heterogeneity model. This model and its application on EUCOR samples prove that the applied measuring method of the chemical heterogeneity provides detailed quantitative information on the material structure and makes possible the analysis of the solidification process. The analysis of this process entails statistical processing of results of the heterogeneity measurements of the EUCOR components and it performs correlation of individual components during the solidification. The model of the chemical heterogeneity enables estimation of the structure parameters at any critical point of castings. The combining of both models makes it possible to estimate the structure parameter, which expresses the size of the crystallites in the resultant material structure. It is a tool for the estimation of the tendency to surface cracking and fracturing tendency at the critical point of casting made of EUCOR.


Noise reduction of rail transport in Europe is an important step toward enhancing quality of life. According to the estimation of the European Environment Agency 14 million people are affected by rail noise in the European Union. Since the 1990s numerous measures have been taken by legislators but in practice noise levels did not lowered significantly. The changing regulations and upgraded standards have direct costs on rail freight transport and it is affecting its competitiveness. Some key countries in the European rail freight transport – Germany, Switzerland, Austria and the Netherlands – have already introduced Noise Differentiated Track Access Charges (NDTAC), which makes higher noise traffic more expensive, and encourages wagon owners to invest in low noise braking systems. Railway undertakings will face higher costs either due to higher network access charges or due to higher costs of low noise braking system. The higher costs will affect the competitiveness of rail freight transport compared to other modes of transport. Furthermore, the diverse regulation of European countries will restrict the interoperability and selective funding favors local corporations and can reduce competition. The aim of this paper is to show the possible effects of the current NDTAC regulation on the European rail freight market.


Background—Despite declining lengths of stay, postdischarge healthcare resource utilization may be increasing because of shifts to nonacute care settings. Although changes in hospital stay after coronary artery bypass graft (CABG) surgery have been described, patterns of discharge remain unclear. Our objective was to determine patterns of discharge disposition after CABG surgery in the United States. Methods and Results—We examined discharge disposition after CABG procedures from 1988 to 2005 using the Nationwide Inpatient Sample. Discharges with a "nonroutine" disposition defined patients discharged with continued healthcare needs. Multivariable regression models were constructed to assess trends and factors associated with nonroutine discharge. Median length of stay among 8 398 554 discharges decreased from 11 to 8 days between 1988 and 2005 (P 0.0001). There was a simultaneous increase in nonroutine discharges from 12% in 1988 to 45% in 2005 (P 0.0001), primarily comprising home healthcare and long-term facility use. Multivariable regression models showed age, female gender, comorbidities, concurrent valve surgery, and lower-volume hospitals more likely to be associated with nonroutine discharge. Conclusions—We found a significant increase in nonroutine discharges after CABG surgery across the United States from 1988 to 2005. The significant shortening of length of stay during CABG may be counterbalanced by the increased requirement for additional postoperative healthcare services. Nonacute care institutions are playing an increasingly significant role in providing CABG patients with postdischarge healthcare and should be considered in investigations of postoperative healthcare resource utilization. The impact of these changes on long-term outcomes and net resource utilization remain unknown. (Circ Cardiovasc Qual Outcomes. 2009;2:305-312.)


Background: Sumac (Rhus coriaria L., Anacardiaceae) is a medicinal plant traditionally used for the treatment of cardiovascular disorders. This study was designed to evaluate the effects of Sumac fruits in hypertensive patients. Material and Methods: a randomized, double-blind, placebo-controlled clinical trial was conducted on 80 hypertensive patients who were receiving captopril (25 mg day−1). The patients were randomly divided into 2 groups: the first group received R. coriaria fruit capsules (500 mg twice a day) and captopril (25 mg once a day), and the second one received placebo capsules (500 mg starch twice a day) and captopril (25 mg once a day), for 8 weeks. Blood pressure (BP) and body weight index (BMI) in all patients were determined every week. Phytochemical analysis of R. coriaria fruits was performed by using HPLC-DAD/QTOF-MS for analysing its phenolic compounds. Results: data indicated that hypertension was decreased significantly in R. coriaria group compared to baseline and placebo groups after 8 weeks, but BMI did not demonstrate a marked change in comparison with baseline and placebo groups. Moreover, the most abundant phenolic compounds identified in R. coriaria fruits were luteolin, apigenin, and quercetin flavonoids. Discussion: this finding suggests that R. coriaria fruits could be used as an effective natural remedy for management of hypertension. Since flavonoids were the main chemical constituents of this plant, its antihypertensive activity could be attributed to such compounds.


Acute infusion of hypertonic fluid increases mean arterial pressure (MAP) in part by elevating nonrenal sympathetic activity. However, it is not known whether chronic, physiological increases in osmolality also increase sympathetic activity. To test this hypothesis, MAP, heart rate (HR), and lumbar sympathetic nerve activity (LSNA) were measured in conscious, 48-h water-deprived rats (WD) during a progressive reduction in osmolality produced by a 2-h systemic infusion (0.12 ml/min) of 5% dextrose in water (5DW). Water deprivation significantly increased osmolality (308 +/- 2 vs. 290 +/- 2 mosmol/kgH2O, P < 0.001), HR (453 +/- 7 vs. 421 +/- 10 beats/min, P < 0.05), and LSNA (63.5 +/- 1.8 vs. 51.9 +/- 3.8% baroreflex maximum, P < 0.01). Two hours of 5DW infusion reduced osmolality (-15 +/- 5 mosmol/kgH2O), LSNA (-23 +/- 3% baseline), and MAP (-10 +/- 1 mmHg). To evaluate the role of vasopressin in these changes, rats were pretreated with a V1-vasopressin receptor antagonist. The antagonist lowered MAP (-5 +/- 1 mmHg) and elevated HR (32 +/- 7 beats/min) and LSNA (11 +/- 3% baseline) in WD (P < 0. 05), but not in water-replete, rats. 5DW infusion had a similar cumulative effect on all variables in V1-blocked WD rats, but had no effect in water-replete rats. Infusion of the same volume of normal saline in WD rats did not change osmolality, LSNA or MAP. Together these data indicate that, in dehydrated rats, vasopressin supports MAP and suppresses LSNA and HR and that physiological changes in osmolality directly influence sympathetic activity and blood pressure independently of changes in vasopressin and blood volume.


We have previously reported significant linkage between markers on 11q13.5 and Usher syndrome type 1 (USH1B) in a large Samaritan kindred. USH1B is an autosomal recessive disease characterized by profound congenital sensorineural deafness, vestibular dysfunction and progressive visual loss. A unique haplotype found only in all USH1B carriers and affected individuals implied that the disease-causing mutation probably entered the community from a single founder. Screening for mutations in a gene called GARP, which was mapped to the same genetic interval as USH1B, revealed a base substitution in the coding region of the gene, in a homozygous state in all affected individuals. This base substitution, which results in an arginine to tryptophane change, is not found in control individuals and occurs at an amino acid residue that is conserved across species, including mouse, gorilla, chimpanzee and macaque. This study emphasizes the strength of using an isolated inbred population for efficient identification of the primary linkage and for narrowing the disease interval, but also demonstrates its limitations in distinguishing between mutations causing the disease and those representing unique and private polymorphisms.


Nitroreductase (NR) was modified on glass carbon electrode and used in nitrobenzene analysis. Both cyclic voltammetry (CV) and triple potential step chronocoulometry (TPSC) with a narrow potential step interval were used. The modification of nitroreductase improved the sensitivity and selectivity of nitrobenzene detection. Both the peak area and peak current were examined for quantitative analysis, showing a linear relation between nitrobenzene concentration and peak area, and a logarithmic relation for peak current, with correlation coefficients of 0.9981 and 0.9993, respectively. Statistical tests to evaluate the reliability of TPSC showed that there was no evidence of systematic error, and it was not significantly different from CV or high performance liquid chromatography (HPLC). The new method could avoid most interferents, showing good selectivity.


In an examination of the relationships among plasma aminoglycoside concentrations, the minimal inhibitory concentration (MIC) for the infecting organism, and therapeutic outcome, data were analyzed from 236 patients with gram-negative bacterial infections who were participants in four clinical trials of gentamicin, tobramycin, and amikacin. Clinical response to therapy occurred in 188 (80%) patients. Elevated maximal and mean peak aminoglycoside concentration/MIC ratios were strongly associated with clinical response (P less than .00001 and P less than .0001, respectively). A graded dose-response effect was found between an increasing maximal peak concentration/MIC ratio and clinical response. By logistic regression the peak concentration/MIC ratios were associated significantly with clinical response after adjustment for underlying severity of illness and other factors correlated with response. These results demonstrate that a high peak concentration relative to the MIC for the infecting organism is a major determinant of the clinical response to aminoglycoside therapy.


This thesis describes the production of antibodies for the detection of cephalexin and their application in ELISA and Biacore 'real-time' surface plasmon resonance (SPR)-based biosensor assays. The use of antibiotics in food-producing animals has many beneficial effects (e.g. treatment of mastitis in dairy cattle). However, their use and misuse has also been implicated in the increased incidence of resistant microbial strains with the associated public health risks and economic losses for food processors. Antibiotic residues can adversely affect bacterial starter cultures used in the production of milk-based products such as cheese and yoghurts. The P-lactam antibiotic cephalexin was chosen as the target for the production of antibodies due to its generic cephem-based structure, solubility, and, in particular its use of this antibiotic in treatment of udder infections (e.g. mastitis).

Cephalexin-protein conjugates were produced and used for the generation of polyclonal and monoclonal antibodies that were then purified and characterised by SDS-PAGE, Western blotting and ELISA. The specificity of these antibodies was determined and they were used in displacement immunoassays for the detection of the relevant antibiotic in 'spiked' samples of PBS and whole milk.

Recombinant single chain Fv (scFv) antibody fragments were produced using phage-display technology. Naive and immune phage-display libraries were panned using cephalexin conjugates. In addition, a monoclonal antibody-secreting hybridoma cell line was used in the production of a phage-displayed recombinant scFv. The recombinant scFv (wild type) derived from the parental hybridoma cell was purified and characterised by SDS-PAGE, Western blotting and ELISA. Wild type scFv was subsequently used as a template for the production of a mutant scFv phage-displayed library using random mutagenesis and error-prone PCR.Mutant scFv antibodies were isolated, expressed and then purified using immobilised metal affinity chromatography (IMAC). Two mutant clones expressing scFv antibodies selected showed improved functional expression and assay performance when compared to wild type scFv. Comparative gene and amino-acid sequence analysis and protein modelling was carried out on wild type and selected mutant recombinant scFv antibodies and confirmed the presence of mutations in the framework and variable heavy chain complemetarity determining region amino acid sequences.

All antibodies were evaluated in ELISA and Biacore assay formats for the detection of cephalexin in milk samples. The polyclonal, monoclonal and recombinant scFv antibodybased assays demonstrated varying sensitivity and reproducibility but achieved cephalexin detection below the legislated European Union maximum residue limit (EUMRL) in milk ( 10 0 Mgflig).


The objective of this paper is to examine the effect of socioeconomic and environmental factors on health status in Tunisia. Data used are annual and taken from the database of the World Bank for the period 1995-2012. We employ the Autoregressive Distributed Lag (ARDL) model. In the proposed model, health status is measured by life expectancy at birth and the factors that determine health status are: the unemployment rate, the population growth rate, the Gross Domestic Product per capita, Expenditure on health total as a percentage of GDP, Expenditure on education total as a percentage of GDP, and improved access to water. The results of the long-term relationship estimation between determinants and health status show that health expenditure, education expenditure, Gross Domestic Product and improved access to water are positively related to the state while the population growth rate and the unemployment rate have an adverse effect. Regarding the short-term relationship, the results show a positive effect of population growth rate, improved access to drinking water, education expenditure, health expenditures, gross domestic product and health status. On the other hand, the results indicate the existence of a negative effect of the unemployment rate on the health status.


In early December 2012, the APA Board of Trustees approved the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). With this vote, the board made history with respect to the classification of premenstrual disorders. By moving premenstrual dysphoric disorder (PMDD) from DSM-IV-TR Appendix B, "Criterion Sets and Axes Provided for Further Study," to a full diagnosis with a distinct diagnostic code under the category of mood disorders, the long-suspected biological and brain basis of this disorder has been emphasized. Since the time of Hippocrates (Figure 1), philosophers, physicians, and scientists have written about the links between menstruation, the brain, and behavior (1). However, recent decades have witnessed a backlash against the inclusion of PMDD and its previous diagnostic versions in the DSM. The argument is typically based on the concern that a formal diagnosis of premenstrual syndrome (PMS) or PMDD would pathologize the normal premenstrual physical and behavioral changes experienced by the majority of women or would suggest that all women are somehow compromised by the menstrual cycle.

FIGURE 1

A Brief Overview of Discourse Regarding Premenstrual Mood and Physical Disturbances From Antiquity to Modern Daya

The state that is required for the manifestation of PMDD symptoms, as well as certain disorder-specific brain differences, is the fluctuating hormonal milieu of the menstrual cycle.

Fortunately for the 2%–5% of women who suffer from this debilitating disorder, physicians who provide care for these women and scientists exploring the causes of PMDD have not been swayed by these arguments. Late luteal phase dysphoric disorder (LLPDD) was included in Appendix A of DSM-III-R in 1987 (2), and research continues to codify the type of symptoms experienced by the most affected women, to confirm their temporal association with menstrual cycle phases and related hormonal changes, and to study the efficacy or lack thereof of various pharmacological and hormonal treatment strategies (3, 4). With this said, the application of modern scientific techniques to the study of premenstrual disorders over the past 40 years has lagged behind the study of brain disorders in general. Peripheral markers of CNS dysfunction were examined in schizophrenia in the early 1970s, but not until 1987 did Rapkin et al. (5) report abnormalities in whole blood serotonin in PMS. Likewise, the first psychophysiological techniques were applied to the study of schizophrenia in the early 1970s and to anxiety disorders soon thereafter. No publications described the results from an acoustic startle study in women with PMDD until 2007, when menstrual cycle phase-by-diagnosis differences in baseline arousal were observed (6). Magnetic resonance (MR) techniques were first used in the study of psychiatric disorders, in this case schizophrenia, in the early 1980s, but the application of brain imaging techniques for PMS and PMDD would not occur for another two decades (7, 8). If one assumes that the advent of modern research in the pathophysiology of premenstrual disorders is temporally linked to the inclusion of LLPDD in the appendix of DSM-III-R in 1987, it may be safe to say that the inclusion of PMDD as a full diagnosis in DSM-5 will further galvanize the study of this important disorder.

Referable to this latter point is the article by Baller et al. (9) in this issue of the Journal. This elegant study uses the same scientific method—namely, hormone add-back after treatment with gonadotropin-releasing hormone agonist (GnRH)—that provided some of the first confirmation that normal levels of estradiol and progesterone trigger negative affect in women with premenstrual dysphoria but not in healthy women (10). That women with PMDD are "sensitive" to the normal hormonal perturbations of the menstrual cycle, particularly those occurring after ovulation, has been suspected but not established by previous research. In the Baller et al. study, the GnRH hormone add-back paradigm was combined with functional MRI (fMRI) and positron emission tomography (PET) to examine the impact of hypogonadism (GnRH condition) and physiological levels of estrogen and progesterone individually on cerebral blood flow and brain activation in the functionally relevant areas of the prefrontal cortex. To probe for functional activity in the brain regions responsible for executive functions, including working memory and affect processing and regulation, the authors used the n-back task, which robustly activates dorsolateral prefrontal cortex neural circuitry, a potent target for ovarian hormones.

The women in the study underwent rigorous screening to confirm the presence or absence of PMDD using prospective daily ratings of mood and physical symptoms as first recommended in DSM-III-R for the diagnosis of LLPDD. With accepted cutoffs for symptom severity and impact on function, the women enrolled in the PMDD patient group experienced some degree of functional impairment from their illness. A strength of the study design is the number of women who underwent both fMRI and PET imaging: 11 with PMDD and seven without. Findings from this multimodal imaging study converge to implicate dysregulation in the working memory neural circuitry, specifically in the dorsolateral prefrontal cortex and medial frontal gyrus, in women with PMDD. Brain activation was greater in these regions in women with PMDD relative to comparison subjects, regardless of hormonal condition. As detected in a study by Rapkin et al. (11), Baller and colleagues also observed heightened cerebellar activation in women with PMDD relative to comparison subjects, although in the former study the degree of activation was affected by menstrual cycle phase.

The relevance of the prefrontal cortex regions to the pathogenesis of PMDD is highlighted by the inverse correlation between Global Assessment of Functioning Scale scores and activation observed with both brain imaging modalities, indicating that more severely affected women display the greatest activation in brain regions where women with PMDD differ most from healthy comparison subjects. Age at illness onset was inversely correlated with activation in the dorsolateral prefrontal cortex, while the overall severity of baseline symptoms and the severity of irritability were both correlated with bilateral activation in the dorsolateral prefrontal cortex. Interestingly, irritability is the second most frequently reported symptom of PMDD (mood lability being the first), and it is the symptom most commonly associated with PMS and PMDD among the general population (3, 12). Again, these correlations between markers of severity and the degree and location of brain activation were observed in all three hormonal conditions, when negative affect was not present (GnRH agonist treatment alone) and when negative affect was present (estrogen and progesterone add-back phases). These enduring differences between women with PMDD and healthy comparison subjects regardless of hormonal status have been observed in several studies of naturally cycling women and suggest an overarching trait vulnerability to the disorder. In contrast, a number of research paradigms have revealed menstrual cycle-by-diagnosis interactions, with biological differences between women with PMDD and healthy comparison subjects observed only in the follicular or luteal phases of the menstrual cycle. These findings include diagnosis-by-menstrual cycle phase differences in neuro-transmitter level (8), motor cortex inhibition (13), brain activation (14, 15), and psychophysiology (6), to name a few.

Abnormalities in stress neurocircuitry and prefrontal, top-down control over subcortical structures are certainly not specific to women with PMDD, which is a factor that could be used to argue against the distinctive nature of the disorder. However, unlike major depression, bipolar disorder, or any anxiety disorder, the state that is required for the manifestation of PMDD symptoms, as well as certain disorder-specific brain differences, is the fluctuating hormonal milieu of the menstrual cycle.

In summary, the brain origin of premenstrual mood disturbances has been recognized in some fashion since antiquity, and the burden of the disease is well established (16). The Baller et al. study provides additional evidence, using the most modern scientific methodologies readily available, that brain structure and function are altered in women with PMDD. In the coming years, the challenge will be to further refine our understanding of trait vulnerabilities and aspects of the hormonal state that are necessary and sufficient to manifest the symptoms of PMDD in order to better inform treatment and improve the quality of life for this sizable minority of women.


This paper provides an overview of a web-based, database-driven cognitive support system for scaffolding ill-structured problem solving processes through fostering self-regulation. Self-regulation learning and ill-structured problem-solving theories guided the design framework of this cognitive tool. Of particular interest are the roles of question prompts, expert view, and peer review mechanisms in supporting self-monitoring, self-regulation, and self-reflection in the processes of ill-structured problem solving, which have been tested through empirical studies in various content domains and contexts. Based on findings, suggestions are made to improve the cognitive support system for future research, including mapping self-regulation learning processes more closely with ill-structured problem-solving processes, and focusing on the system's capability to automatically adapt scaffolding based on individual needs and prior knowledge.


The epidermal growth factor receptor (EGFR/HER1) is a member of the erbB family of receptor tyrosine kinase proteins, which also includes HER2, HER3, and HER4. EGFR is almost universally expressed in squamous cell carcinoma of head and neck (SCCHN), and high levels of expression have been correlated with a poor clinical prognosis [1]. Cetuximab, an IgG1 monoclonal antibody against EGFR, has demonstrated improved survival and disease control when used in combination with radiation therapy for the treatment of locally advanced SCCHN, and in combination with platinum-based chemotherapy in recurrent or metastatic SCCHN [2-4]. Additionally, single-agent cetuximab is active and provides good disease control rate and duration in platinum-refractory SCCHN [5]. Comparison of cetuximab versus cisplatin concurrently with radiotherapy is under investigation in patients with human papillomavirus-associated oropharyngeal cancer, who have better prognosis and may benefit from less toxic treatment [6]. Overexpression of HER2 in gastric cancer results in aggressive clinical course and poor prognosis [7]. Trastuzumab, a monoclonal antibody against HER2, exhibits antitumor activity in HER2 overexpressed gastric cancer cells, and enhances effects of chemotherapy in gastric cancer xenograft overexpressing HER2 [8]. The ToGA study screened about 3,800 patients with advanced gastric cancer from 24 countries, and HER2 overexpression was detected in 22% [9]. Higher rates of HER2 overexpression occurred in intestinal and proximal or gastroesophageal junction cancers than in diffuse or distal gastric cancers. In TOGA study, 584 patients with HER2 overexpression were randomized to receive fluoropyrimidine and cisplatin treatment with or without trastuzumab. Patients who received trastuzumab plus chemotherapy achieved longer overall survival (13.8 months vs. 11.1 months, P= 0.0046), longer progression-free survival (6.7 months vs. 5.5 months, P=0.0002), and higher response rates (47% vs. 35%, P=0.0017) than those who received chemotherapy alone. Complete response was noted in 5.4% of patients receiving trastuzumab plus chemotherapy vs. 2.4% in chemotherapy alone. There were no significant differences in the toxicities between these two groups. This study has established a new paradigm using trastuzumab in combination with chemotherapy in patients with advanced gastric cancer overexpressing HER2. Neoadjuvant treatment is a standard of care for locally advanced esophageal and gastric cancer. We have previously reported a case of pathological complete response after neoadjuvant chemotherapy with trastuzumab-containing regimen in HER2-overexpressing gastric cancer [10]. Incorporating trastuzumab as a part of neoadjuvant therapy in esophageal and gastric adenocarcinoma overexpressing HER2 is currently under active investigation. Radiation Therapy Oncology Group is conducting a phase III neoadjuvant study in patients with HER2overexpressing esophageal adenocarcinoma to determine if trastuzumab increases disease-free survival when added to chemoradiotherapy [11]. Other studies conducted in Europe are adding trastuzumab to oxaliplatinbased regimen as perioperative chemotherapy for HER2-overexpressing esophagogastric or gastric adenocarcinoma, and looking for improvement of pathological complete response and disease-free survival [12,13]. Pertuzumab is a monoclonal antibody interfering with HER2 dimerization with other HER receptors such as EGFR, HER3 and HER4. Pertuzumab and trastuzumab bind to HER2 at different sites, and combination of both antibodies leads to stronger inhibition of erbB signaling and greater therapeutic efficacy when combined with docetaxel in breast cancer [14]. Combination of pertuzumab and trastuzumab with platinum-based chemotherapy is currently studied in HER2-overexpressing gastric cancer [15]. References 1. Ang KK, Berkey BA, Tu X, Zhang HZ, Katz R, Hammond EH, Fu KK, Milas L: Impact of epidermal growth factor receptor expression on survival and pattern of relapse in patients with advanced head and neck carcinoma. Cancer Res 2002, 62(24):7350-7356. 2. Bonner JA, Harari PM, Giralt J, Azarnia N, Shin DM, Cohen RB, Jones CU, Sur R, Raben D, Jassem J, et al: Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck. N Engl J Med 2006, 354(6):567-578. 3. Bonner JA, Harari PM, Giralt J, Cohen RB, Jones CU, Sur RK, Raben D, Baselga J, Spencer SA, Zhu J, et al: Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: 5-year survival data from a phase 3 randomised trial, and relation between cetuximabinduced rash and survival. Lancet Oncol 2010, 11(1):21-28. 4. Vermorken JB, Mesia R, Rivera F, Remenar E, Kawecki A, Rottey S, Erfan J, Zabolotnyy D, Kienzer HR, Cupissol D, et al: Platinum-based chemotherapy plus cetuximab in head and neck cancer. N Engl J Med 2008, 359(11):1116-1127. 5. Vermorken JB, Trigo J, Hitt R, Koralewski P, Diaz-Rubio E, Rolland F, Knecht R, Amellal N, Schueler A, Baselga J: Open-label, uncontrolled, multicenter phase II study to evaluate the efficacy and toxicity of cetuximab as a single agent in patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck who failed to respond to platinum-based therapy. J Clin Oncol 2007, 25(16):2171-2177. 6. Phase III trial of radiotherapy plus cetuximab versus chemoradiotherapy in HPV-associated oropharynx cancer (clinicaltrials.gov identifier: NCT01302834). [http://clinicaltrials.gov/ct2/show/NCT01302834]. 7. Park D, Yun J, Park J, Oh S, Kim H, Cho Y, Sohn C, Jeon W, Kim B, Yoo C, et al: HER-2/neu Amplification Is an Independent Prognostic Factor in Gastric Cancer. Digestive Diseases and Sciences 2006, 51(8):1371-1379. Journal of Hematology & Oncology 2012, Volume 5 Suppl 1 http://www.jhoonline.org/supplements/5/S1 JOURNAL OF HEMATOLOGY & ONCOLOGY


Nasal mucociliary clearance (NMCC) time was measured in four groups of patients: asthmatics with allergic rhinitis, asthmatics without rhinitis, bronchiectasis and normal subjects. The saccharin method was used for the study. The NMCC time was prolonged significantly in the asthmatic groups and group with bronchiectasis when compared with control subjects (P less than 0.001). It is likely that the impaired mucociliary clearance is due to a combination of mucus abnormality and ciliary malfunction.


Abstract A gas chromatographic method for the determination of carbon monoxide and carbon dioxide in cigarette smoke was developed. A column containing Porapak Q packing and a cryogenic temperature programmer which employed liquid nitrogen to cool the column to subambient temperatures was used. The separation of N2, O2, CO, and CO2 was accomplished at temperatures of -70°C to 40°C, and the organic vapour phase of smoke was analysed as the column temperature was programmed to 220°C. The inorganic gases were detected by thermal conductivity and the organic vapours by flame ionization. The method was used to determine the amounts of carbon monoxide and carbon dioxide in the smoke of nonfilter, filter, and vented-filter cigarettes, and to analyse the organic vapour phase of smoke


Abstract Background: Phenylketonuria (PKU) often requires a lifelong phenylalanine (Phe)-restricted diet. Introduction of 6R-tetrahydrobiopterin (BH4) has made a huge difference in the diets of patients with PKU. BH4 is the co-factor of the enzyme phenylalanine hydroxylase (PAH) and improves PAH activity and, thus, Phe tolerance in the diet. A limited number of published studies suggest a pharmacodynamic profile of BH4 more suitable to be administered in divided daily doses. Methods: After a 72-h BH4 loading test, sapropterin was initiated in 50 responsive patients. This case-control study was conducted by administering the same daily dose of sapropterin in group 1 (n=24) as a customary single dose or in two divided doses in group 2 (n=26) over 1 year. Results: Mean daily consumption of Phe increased significantly after the first year of BH4 treatment in group 2 compared to group 1 (p<0.05). At the end of the first year of treatment with BH4, another dramatic difference observed between the two groups was the ability to transition to a Phe-free diet. Eight patients from group 2 and two from group 1 could quit dietary restriction. Conclusions: When given in two divided daily doses, BH4 was more efficacious than a single daily dose in increasing daily Phe consumption, Phe tolerance and the ability to transition to a Phe-unrestricted diet at the end of the first year of treatment.


An error inspection method based on 3D laser scanning measurement is proposed for the purpose of achieving field rapid inspection of turbine vane surface. The 3D model of vane is reconstructed by using the data of form drawing in CATIA. By using handy laser scanner, the point cloud data is obtained from the wood pattern of vane, which is processed in Geomagic Qualify. After registration of vane solid model and point cloud data, the vane surface is rapidly inspected by analyzing 3D error and comparing cross-sectional data.


Academic freedom has been defined as having two components: the freedom to teach and the freedom to learn. However, whether there is truly a freedom to learn and how it intersects with general liberties is unresolved. Incorporating a <r;ritical pedagogical approach, this thesis explores whether Canadian post-secondary students have any such role-related rights. In aiming to map the conditions that might safeguard such a freedom to learn, certain civil liberties are examined namely associational and expressive freedoms. A critique of contemporary jurisprudence and relevant legislation is situated within an historical and comparative context of academic freedom and students in Canada and United States. It examines how reinforcing robust civil liberties is necessary for supporting role related academic freedom rights on campus. This thesis proposes that it is necessary for both faculty and students to recognize the precarious and sometimes competing rights and freedoms to support the broader goals of academic freedom to develop knowledge and inquiry for the common good and to foster critical independence of mind.


A survey of tourists and tour operators in the Egyptian Red Sea region shows that the industry often misperceives its clients' environmental sensitivity, putting its own business at risk. Climate change is a growing threat to the tourism industry by making destinations less attractive and jeopardizing major sources of income. The awareness of tourists towards climate change and other environmental issues is likely to be a major driver of their future holiday choices.


The role of Sun2 has been described by previous studies in various types of cancers, including breast cancer and lung cancer. However, its role and potential molecular mechanism in the progression of prostate cancer have not been fully elucidated. In the present study, we found that Sun2 expression was reduced in prostate cancer tissues compared with paired normal tissues, and that low expression of Sun2 was significantly correlated with Higher Gleason scores, postoperative T stage (pT), Lymph nodal invasion and Clinical pathological stages. In addition, reduced Sun2 Expression predicts poor survival of prostate cancer patients and could serve as an independent predictor of prostate cancer patients overall survival (OS).Furthermore, Sun2 overexpression inhibits the prostate cancer cells growth, and Sun2 knockdown promotes the prostate cancer cells growth both in vitro and vivo. Mechanical silencing of , Sun2 promoted fat acid oxidation (FAO) in prostate cancer, prostate cancer cells growth promoted by Sun2 silencing could be reversed by the FAO inhibitor Etomoxir. Additionally, we also showed that serum amyloid A1 (SAA1) play a vital role in FAO, ATP and cell growth promoted by Sun2 loss in prostate cancer. These results suggest that Loss of Sun2 promoted the prostate cancer progression by regulating FAO.


The prevalence of allergic disorders is increasing around the world. This study used the standardized written questionnaire from International Study of Asthma and Allergies in Childhood (ISAAC, phase III) to collect two cross-sectional appraisals of schoolchildren 5 years apart–one performed 2002 and another on 2007, to focus on the secular trends in prevalence of allergies in central Taiwan. This questionnaire was administered to schoolchildren from over 46 schools across Changhwa County in 2002, and again in 2007. The present study is a follow-up study and uses data collected from a previously reported study conducted in the year 2002 of the same location using the same methodology. Although the repeated cross-sectional survey after a 5-year lapse suggests a mere increase of diagnosed asthma cases from 7.1% to 7.4%, the prevalence of its related symptoms–nocturnal cough, rhinitis, and eczema–was found to increase significantly by 2.6% (p < 0.0001), 6.8% (p < 0.001), and 5.9% (p < 0.001), respectively. Additionally, comparing the secular trends in asthma prevalence, rhinitis, and eczema between several polluted areas in Changhwa County with its less polluted neighbors in 2002 and 2007 indicates that schoolchildren in TaiHao area, which is noted to be polluted by a petrochemical company, has a significantly increased prevalence of wheezing (3.7%, p < 0.05) and nocturnal cough (3.6%, p < 0.05). For schoolchildren living in the coastal areas, a 6% (p < 0.05) increase in the prevalence of rhinitis is noted. The prevalence of eczema uniformly increased for all areas of Changhwa County (p < 0.01). In the downtown areas, besides eczema, the prevalence of asthma and rhinitis also increased significantly (p < 0.05). Of note is the consistent finding in these two periods of the higher prevalence of childhood asthma, rhinitis, and eczema in the downtown areas compared with that from both the polluted and coastal areas. The secular trends in prevalence of asthma, rhinitis, and eczema in these two periods seem to correlate to environmental factors. While the symptoms of asthma, rhinitis, and eczema in schoolchildren affected boys more than girls, it is observed that affected girls have more marked manifestations, although it did not reach statistical significance.


Previous research has demonstrated that a laccase/xylanase system (LXS) from white-rot fungus (Lentinus lepideus) has the same ability to delignify as a laccase/mediator system (LMS). In order to enhance delignification ability of LXS treatment, the effect of refining on delignification with LXS treatment of Masson pine (Pinus massoniana) pulp was investigated by refining the pulp in a PFI mill to different revolutions (14,000/21,000/35,000/42,000/56,000) prior to LXS treatment (enzyme dosage 5/10/15IU/g o.d. pulp). The results indicated that both kappa number and yield of the LXS treated pulp decreased with increasing refining. A substantial delignification without severe yield loss could be achieved by moderate refining prior to LXS treatment. The SEM images suggested that refining increased the accessibility of the material to enzymes and thereby enhanced the delignification ability of LXS. The small cellulase activity detected in the LXS had little effect on the viscosity of the treated pulp even at high enzyme dosage.


To the Editor. —I would like to address two important issues raised by Gurewich and Mittleman 1 in their Editorial on lipoprotein(a) [Lp(a)] levels and coronary heart disease in men: first, the lack of similar prospective data in women and, second, testing the hypothesis of Rath and Pauling 2 that dietary supplementation with ascorbic acid might be efficacious in lowering elevated Lp(a) levels. My colleagues and I have reported that the presence of a sinking pre—β-lipoprotein band (a valid, specific marker for elevated Lp[a] levels 3 ) is a strong, independent predictor of incident myocardial infarction, cerebrovascular disease, and intermittent claudication in Framingham women free of baseline cardiovascular disease. 4 Also, in collaboration with investigators at Brown University, I recently completed a randomized, placebo-controlled intervention trial (A.G.B., unpublished data, 1994) testing one aspect of Rath and Pauling's hypothesis. In 44 subjects with documented coronary heart disease block, randomized (based on age,


Within the mm-Wave range of the B5G communication systems, there will appear many types of applications with different link types. In discussions on how to cover the various channel modeling requirements of such applications, some researchers have suggested map-based channel models that are based on a ray-tracing algorithm. This article thus begins with an overview of mapbased mm-Wave channel models. The overview includes available modeling requirements with map-based channel models and the categorization of map-based channel parameters. We then explain why map-based channel models are necessary for researchers trying to evaluate novel technologies in the mm-Wave range. They are particularly necessary when the technologies operate with a new link type or when channel behaviors of a user exhibit user-specific characteristics. Next, we share the measurement data and the map-based channel parameters, which can model new link types and have user-specific characteristics. Finally, as a use case of the proposed channel model, we evaluate a machine-learning-based beam-selection algorithm that exploits power delay profiles through the shared database and a geometry-based stochastic channel model (GSCM). The delay profiles of the shared database are user-specific so they are highly correlated with angular parameters. Numerical results show that the algorithm can be more accurately evaluated through the shared database than through a GSCM. We expect that our overview and sharing the database will enable researchers to readily design a map-based channel model and evaluate B5G and machine-learning technologies.


Editor's Introduction

When Oxford University Press sent us the three enormous volumes of Irwin's The Development of Ethics, we had two thoughts: First, the book is very important and demands a review; second, since human sacrifice is abolished in North America, it will be very difficult to find a reviewer. We handed the volumes to several interested persons, who in the end returned the books saying the task was beyond them. Then, my wife, a lifetime worker at that center of communal thought, the United Nations, suggested that we form a team to review the book. We put an announcement out on the Web, asking for reviewers to do a chapter each, at 250 words a review. We got several hundred volunteers, and chose 82 to review the 96 chapters of Irwin (reviewers got the chapters in Portable Document Format [PDFs], kindly supplied by Oxford). We got 81 of 82 reviews, 75 before the deadline, six slightly later. For purposes of completeness, I filled in the sole missing review. Would that the students in my seminars were so punctual! I would like to thank Elyse Turr at Oxford University Press for the PDFs, and my 82 reviewers for their expertise and diligence. I am grateful to all the volunteers who showed an interest in this strange and perhaps unprecedented project, and who patiently endured the vetting process. Special thanks is due to Laura di Summa, who coordinated all the pieces of this incredible puzzle. Did we accomplish something, something new, by mobilizing 82 minds to review one book? I hope so, but I can now only say what they say on television: "America, it's up to you."


3C-SiC MOSFET with 200 cm2/Vs channel mobility was fabricated. High performance device processes were adopted, including room temperature implantation with resist mask, polysilicon-metal gates, aluminium interconnects with titanium and titanium nitride and a specially developed activation anneal at 1600°C in Ar to get a smooth 3C-SiC surface and hence the expected high channel mobility. CVD deposited oxide with post oxidation annealing was investigated to reduce unwanted oxide charges and hence to get a better gate oxide integrity compared to thermally grown oxides. 3C-SiC MOSFETs with 600 V blocking voltage and 10 A drain current were fabricated using the improved processes described above. The MOSFETs assembled with TO-220 PKG indicated specific on-resistances of 5 to 7 mΩcm2.


A compendium of the papers read at the Geological Society on 18 September 1981 It is surprising that in the UK, where so much of the ground on which we build originated as muddy sediments, there is no collection of papers readily available for engineers and geologists alike that describes the geological distribution and general character of our mudrocks, their range of properties and the problems associated with defining and predicting their geotechnical behaviour. The one-day meeting was an attempt to fill this gap. It soon became clear, however, that the subject could not be adequately covered in one day, and the meeting was probably the first of what will become a series, over the years, to deal with the subject at large. The scope of this meeting was restricted to the non-calcareous mudrocks, which were taken to include our over-consolidated clays. Calcareous mudrocks, which include many limestones, were not considered. The papers reproduced here are largely a record of the data that were presented at the meeting. The authors of the papers were asked to provide a review of their particular subject, supported by a selected bibliography that would direct the reader to more detailed information. Many of the papers are, therefore, general in nature and are written for the reader in need of basic information founded upon our knowledge of the subject to date. Twelve papers were read at the meeting and their sequence in this publication reflects the grouping that was used for presentation. The first four papers describe the geographical position and geological nature of the major mudrock deposits in


The discovery of antibiotics is one of the most significant milestones in modern medicine. Upon the advent of the antibiotic era, invasive surgical procedures, which were previously deemed too risky because of the possibility of bacterial infection, became a reality. In the process, medicine as a whole made great strides that led to the rise of the average human life span by almost three decades. Unfortunately, over the course of time bacteria have started to evolve resistance to antibiotic agents being administered, thus rendering many of these drugs ineffective (or on the verge of being ineffective). Today, the number of antibiotic- resistant bacteria continues to escalate and yet the number of new antibiotics being approved for clinical use has drastically decreased. The combination of these two factors has brought about a primary public health crisis for the 21st century. In order to maintain the status quo of modern medicine, new antibiotics need to be discovered and developed. Two emerging new strategies that hold considerable promise is the use of immunomodulator antibiotics and infection tolerance agents. Rather than targeting the bacteria directly, as traditional antibiotics do, these agents function to clear or tolerate infections by interfering with the bacterial colonization process and by stimulating the immune system of infected host. This review focuses on the different types of immunomodulation antibiotics and infection tolerance strategies that have been discovered over the last two decades and the mechanisms by which they act upon the host system to effectively combat bacterial infections.


Thyroid cancers have long been considered to arise in middle age and, after their repeated proliferation, resulting in further damage to the genome, they progress to more aggressive and lethal cancers. However, in 2014, some studies were reported that might lead to a marked change in our understanding of the natural history of thyroid cancer. A high prevalence of papillary carcinoma in the young suggested that the first initiation of thyroid cancer is likely to occur in the infantile period. Such a conclusion was also supported by a very slow growth rate of papillary microcarcinomas (PMCs) in an observation trial. The proliferation rate of PMCs was negatively correlated with the age, and surgery to remove PMCs did not contribute to reduce mortality from thyroid cancer. These findings strongly suggested the existence of self-limiting cancers, which are truly malignant but do not progress to lethal cancers, for the first time in human history. The early detection of self-limiting cancers results in overdiagnosis. Ultrasonographic screening of the thyroid in the young should be avoided. Lethal thyroid cancers, whose origin is still unknown, appear suddenly after middle age. In the elderly, thyroid cancers are a mixture of self-limiting and lethal cancers; thus, when thyroid cancer is detected, careful follow-up with examination of its growth rate is required.