Abstract Background: Art therapy is based mainly on clinical experience and is rarely described and evaluated scientifically. There is a need for further exploration of its use in patients with depression. Aim: The aim of this study was to explore what experts consider to be the main aspects of art therapy in clinical practice for patients with depression. Method: Eighteen occupational therapists experienced and educated in art therapy participated. The experts answered three rounds of Delphi questionnaires and ranked their agreement with 74 assertions. Consensus was defined as 70% or higher. Results: The experts agreed more on assertions about theoretical frames of reference than about clinical practice. The main aspects of art therapy were agreed to be the patients' opportunity to express themselves verbally and through making art. It was equally important that art tasks provided an opportunity to address depressive thoughts, feelings, life experiences, and physical symptoms. Conclusions: Experts in the field of art therapy considered that the main aspect of clinical practice in art therapy for patients with depression is that art themes should promote expression related to both to depression and personal history.


Privacy becomes one of the important issues in data-driven applications. The advent of non-PC devices such as Internet-of-Things (IoT) devices for data-driven applications leads to needs for light-weight data anonymization. In this paper, we develop an anonymization framework that expedites model learning in parallel and generates deployable models for devices with low computing capability. We evaluate our framework with various settings such as different data schema and characteristics. Our results exhibit that our framework learns anonymization models up to 16 times faster than a sequential anonymization approach and that it preserves enough information in anonymized data for data-driven applications.


In this study, we present a method to automatically detect the position of the optic disc (OD) in digital retinal fundus images. After some pre-processing steps in this method, to obtain the candidate regions of OD have been studied. The obtained OD candidate regions are distinguish by analyzes performed based on feature. The proposed method was evaluated using DRIVE dataset which is containing a total of 40 images from both normal and diseased retinal images. Consequently, the OD-center was detected correctly in all of the 40 images (100%).


A wave of public protests rocked Azerbaijan at the beginning of 2013. The first protest event of the year was inspired by the disputed death of a young conscript in the Azerbaijani army. While the official cause of death was heart attack, the family insisted he was beaten to death. The result was a fierce debate about the difficulties facing newly recruited soldiers and the conditions under which they serve. Some activists initiated a Facebook group and called for a demonstration in Baku on January 12. Twenty thousand people joined the group, an impressive number by Azerbaijani standards, given that support for anti-establishment manifestations can be dangerous. Later as many as 1,000 protesters, also a large number for Azerbaijan, joined the actual event in support of the dead soldiers' family, demanding the defense minister's resignation. Just a week later shopkeepers at Baku's largest shopping mall, Bina, protested against increased rents. The demonstrators blocked a major highway and 5,000 shopkeepers kept their businesses closed in support of the protest. This was shortly followed by another spontaneous outbreak of dissent in Ismayili, 150 km northwest of Baku, where community members set fire to cars and buildings and called for the governor's resignation after a controversial car accident. Riot police finally managed to disperse the protesters, many of whom were injured and/or imprisoned. The harsh treatment brought about another rally in the capital in support of the Ismayili protesters. The outbreak of civic unrest in Ismayili can be seen as particularly important since it indicates discontent with the government, not only in Baku, but outside the capital as well. (1) The January events were followed by others, very diverse in character; both in Baku and outside; some within the framework of "democracy activism" and others mainly addressing economic issues, such as low wages. Their common denominator appears to have been frustration with a leadership that, despite paying lip service to reforms, let corruption, nepotism and autocracy rule. Hence, some analysts and activists described these events as the beginning of an "Azerbaijani Spring." However, while the authorities appear to initially have been taken by surprise, they learned their lesson and all subsequent unsanctioned demonstrations were stifled with force, with the law enforcement agencies often taking advantage of new methods and equipment. Nevertheless, the protests are intriguing as they illustrate the increased will, of at least certain groups, to actively participate in shaping the societal and political arena in a country most often described in terms of political apathy. The articles in this issue focus on the new dynamics of political opposition in Azerbaijan by analyzing the actors (Sultanova), the role of social media (Pearce) and the innovative use of humor (Hadjizade and Pearce) to carry out dissent. This introduction will serve as a background to these texts by elaborating on the circumstances that have molded this new wave of activism. (2) Political Apathy and the Opposition's Endemic Problems To a large extent the recent mobilization in Azerbaijan can be accredited to a generational shift in the democratic opposition movement. In 1992 Abulfaz Elchibey, leader of the Azerbaijan People's Front Party was elected president of independent Azerbaijan, in what has been called the only free and fair election in the country's history. (3) His government lasted less than a year and ever since Azerbaijan has been under the presidency of the Aliyev family. The Popular Front Party instead became the backbone of the political opposition and most current opposition parties stem from the Popular Front, as do a majority of the current opposition leaders (see Sultanova, this issue). During these 20 years, since the fall of the Elchibey government, the efforts of the opposition have faced continuous official constraints and growing national and international discredit. …


India's attempts to control measles have failed, public health experts told a national round table consultation last week, with the estimated number of annual deaths from the infection stubbornly high at about 130 000.

The report from the three day consultation, to be submitted to the Indian health ministry, has attributed the failure to inadequate immunisation, poor surveillance, and lack of basic health services in several states.

The health ministry's own figures indicate that the number of cases of suspected measles each year over the past decade has ranged from 35 000 to 60 000, down from 40 000 to 90 000 in 1990-8. However, it is generally conceded that the ministry's numbers do not reflect the true picture.

"India's disease surveillance system is able to pick up …


SuperCollider IDE is a new cross-platform integrated development environment for SuperCollider. It unifies user experience across platforms and brings improvements and new features in comparison with previous coding environments, making SuperCollider easier to begin with for new users, easier to teach for teachers, and more efficient to work with for experienced users. We present an overview and evaluation of its features, and explain motivations from the point of view of user experience.


For a small open economy of Pakistan, exchange rate is determined through the two alternative theories; the nominal theory of exchange rate named by Purchasing Power Parity (PPP) and the real theory known as Harrod Balassa Sameulson (HBS). According to the requirements of theories, two kinds of real exchange rate have been employed for the yearly data of 1972-2008. As, both of the theories are disputed at the ground of their long run relationship with real exchange rate, therefore, the VAR based Johenson Co-integration approach has been utilised to see the long run relationships. PPP has shown less satisfactory results either in its form of absolute version or relative version. Because, real exchange rate in Pakistan is a non-stationary process by Augmented Dickey Fuller unit-root test, predicting some pushing force behind the non-tradable sector. While favouring the PPP in tradable sector, the ADF and KPSS are indicating the presence of the HBS in Pakistan. On the other hand, the analysis of the HBS through co-integration is showing that relative productivity difference has an opposite relationship with relative non-tradable sector prices and with RER. However, the relationship between relative non-tradable sector prices and RER is much stronger and according to the theory. So, there have been incorporated some demand side and external factors to reduce the mis-specification of the simple HBS model. Therefore, in the extended HBS model, productivity difference, government consumption expenditure, terms of trade and world oil prices are appreciating the RER and money supply (a control variable) is pursuing depreciation in RER. So, these results yield some policy implications for Pakistan which can be useful for developing countries as well.


This study measured the longevity and clinical success of preventive resin restorations (PRRs) placed in permanent teeth by multiple operators in the Pediatric Dentistry Clinic at the University of Minnesota. A retrospective chart audit identified patients who had one or more PRRs placed. Only restorations of the occlusal surfaces of the first or second permanent molars were included. Each patient was given a dental examination. On completion, the patient's chronological record of treatment was reviewed for the following information: experience of the operator, type of isolation used, bonding material, liner type, composite resin, and sealant type. Teeth were examined with a front surface dental mirror and a sharp No. 23 dental explorer. Evaluations were made according to criteria developed by Cvar and Ryge, but modified to include a sealant evaluation. Independent measurements were made by each of the two examiners and a consensus was obtained. One hundred restorations were examined in 64 patients. The mean duration of service was 27 +/- 13 months. Sealant was evaluated as alfa (complete) 26 per cent, bravo (incomplete/adequate) 48 per cent, charlie (incomplete/inadequate) 21 per cent and delta (lost) five per cent. Cavosurface discoloration was evaluated as alfa (none) 87 per cent, bravo (margin only) 12 per cent, and charlie (margin/proceeding toward pulp) one per cent. Anatomical form was evaluated as alfa (well contoured) 89 per cent, bravo (under contoured/dentin not exposed) 11 per cent. Marginal adaptation was evaluated as alfa (no visible crevice) 85 per cent, bravo (visible crevice/no dentin exposed) 12 per cent, charlie (visible crevice/dentin exposed) two per cent and delta (restoration missing) one per cent.(ABSTRACT TRUNCATED AT 250 WORDS)


Title Diffraction by volume gratings : approximate solution in terms of boundary diffraction coefficients Authors(s) Sheridan, John T.; Solymar, L. (Laszlo) Publication date 1992-09-01 Publication information Journal of the Optical Society of America A, 9 (9): 1586-1591 Publisher Optical Society of America Link to online version http://www.opticsinfobase.org/abstract.cfm?URI=josaa-9-9-1586 Item record/more information http://hdl.handle.net/10197/3290 Publisher's statement This paper was published in Journal of the Optical Society of America. A, Optics and image science and is made available as an electronic reprint with the permission of OSA. The paper can be found at the following URL on the OSA website: http://www.opticsinfobase.org/josaa/abstract.cfm?uri=josaa-9-9-1586. Systematic or multiple reproduction or distribution to multiple locations via electronic or other means is prohibited and is subject to penalties under law. Publisher's version (DOI) 10.1364/JOSAA.9.001586


Background & objectives: Prostate cancer (CaP) is the fifth most common cancer among Indian men. Tumour protein p53 (TP53) gene increases the fidelity of DNA replication and homologous recombination by transcriptional transactivation of mismatch repair (MMR) genes. DNA repair thus has a potential role in molecular carcinogenesis of CaP. The aim of the present study was to identify mutations, and polymorphisms in TP53 gene and MMR protein expression in CaP in Indian male population. Methods: TP53 codon 72 polymorphism was analysed in 105 CaP, 120 benign prostatic hyperplasia (BPH) cases and 106 normal controls. Mutational analysis of TP53 was done in DNA extracted from formalin fixed paraffin embedded tissue of 80 CaP and 24 BPH cases. Expression of MMR proteins viz. hMLH1, hMSH2, hPMS1 and hPMS2 was studied in 80 CaP, 15 prostatic intraepithelial neoplasia (PIN) and 15 BPH cases. Results: A somatic C/A variation at the intronic boundary of exon 7 in TP53 gene was observed in one each biopsy samples from CaP and BPH. A significant association of codon 72 TP53 Pro/Pro genotype was observed with the risk of CaP (OR, 2.59, P=0.02) and BPH (OR, 6.27, P<0.001). Immunohistochemical analysis of MMR proteins showed maximum loss of hPMS1 expression in cases of CaP and PIN while no loss in expression of MMR proteins was observed in BPH cases. The study also identified a significant loss of hPMS2 protein in poorly differentiated tumours (Gleason score >7) than in well differentiated tumours (Gleason score 3-6) (P<0.05). Interpretation & conclusions: The results of the present study demonstrate that TP53 codon 72 polymorphism plays significant role in the pathogenesis and susceptibility to CaP and BPH. Also, an aberrant MMR protein expression could be involved in progression of prostate cancer through PIN, early CaP to aggressive CaP. The loss of hPMS2 protein expression may serve as a marker for progression of CaP.


Purpose
Disease-specific research on the information needs of people with Parkinson's is non-existent but other diseases with a similar impact have been studied. This area of knowledge has a direct impact
upon self-management of diseases as well as on quality of life. While Parkinson's is not a life-threatening disease in the usual meaning of the words, it results in significant, increasing disability and
receiving the diagnosis is a life-altering moment. The person may experience conflicting sentiments of relief and turmoil, described by some as "life-shattering" (Pinder, 1992).

Methods
Google Scholar, Cochrane and PubMed were searched to identify randomised controlled trials, evidence-based review articles
and meta-analyses, as well as evidence-based guidelines. Only articles in English were studied.
The search included articles published between January 1990 and February 2012 using the keywords and subjects:
"Parkinson's", "information needs", "patients", "carers", and "diagnosis". Two review articles (Adams, Boulton and Watson,
2009; Kinnersley et al., 2008) and twenty studies (Wherry, 2012) were found and analysed

Findings
Two types of patients were noted within the literature. Type one (T1) was older, possibly had mild cognitive changes, had a lower level of educational attainment, and was likely to be retired or unemployed. Type two (T2), was younger, had a higher level of educational attainment and was likely to be still in employment (Kim et al., 2012). The typical T1 patient had a higher level of unmet information needs than T2 patients who were proactive in seeking information. Complex and rarely asked questions were more likely to be presented by T2 patients. Preferred sources of information for T1 patients included physicians and specialist nurses, whereas T2 patients supplemented the information from their care team by using external sources (Andreassen et al., 2005). Cultural behaviour in health had an impact, some patients exhibiting a higher reliance on medical teams for information and decision making than others (Wittman et al., 2011).
Information needs changed over time and there was an obvious challenge to identify these needs when the patient was seen in a clinic setting (Kim et al., 2012). The level of information provided influenced help-seeking behaviour and a balance between inappropriate reassurance and overemphasis on complications was necessary (Wittman et al., 2011).

Discussion
Chronic care health professionals have begun to see patients from the Baby Boomer generation and can anticipate a rise in "technologically-savvy" T2
patients who demand high levels of communication and consultation with their care teams. The challenge remains to identify the specific information requirements and so meet patients' needs in a personalised manner.

In the light of this literature review, local practice has evolved to institute a nurse-led clinic and to provide patients with an information pack, specifically focused on the needs of newly-diagnosed patients. Given the prevalence and impact of Parkinson's, the research base in this area is currently insufficient to inform policy and practice. Future research should explore the changes in information needs over the course of the disease, including the needs of the primary carers. A study identifying the best way to meet these needs is urgently required in order to ensure that best practice is informed by relevant and robust evidence


The contribution of professors of Hygiene to the progress and development of public health in Italy: one hundred years of history In 1917 Achille Sclavo, a distinguished researcher and founder of the Italian Society of Hygiene, ended up the first term as Rector of the University of Siena. Since then, the contribution of professors of hygiene in Italian universities has ranged over several relevant topics including vaccinations, environmental hygiene, hospital hygiene, healthcare organization and management, with an important contribution to the health reform of 1978 by Augusto Giovanardi and Alessandro Seppilli. Several Academic Schools (Roman, Neapolitan, Genoese, Sicilian, Venetian, Lombard, etc.) have produced excellent researchers, teachers and mentors who have also occupied important positions in the panorama of the Italian health system. This note analyzes the main research topics, the most famous institutes and departments of hygiene and public health and the contributions of the most famous professors for the development of the discipline, the management of the post- graduated Schools in hygiene and preventive medicine, the commitment in scientific associations and the role of some of them in important institutional positions. Even through its contribution and constant commitment to the institutions, Italian public health has achieved the reputation of being one of the best known and appreciated in the international scientific community.(www.actabiomedica.it)


In this paper, we propose a new method that can remove view-disturbing waterdrops from images by processing images taken with a pan-tilt camera system. In rainy days, it is often the case that images taken by the camera are hard to see because of adherent waterdrops on the surface of the protecting glass of the camera. In our method, an image of a distant prospect is taken at first and another image is taken after changing the direction of eyeshot. The new image is transformed with the projective transformation and compared with the first one to detect the region where waterdrops may exist. We can distinguish which image portion belongs to waterdrops by considering the distance between two waterdrop candidate regions. Finally, the region where waterdrops exist can be eliminated to merge two images. Experimental results show the effectiveness of the proposed method.


Serotonergic hallucinogens, such as (+)-lysergic acid diethylamide, psilocybin, and mescaline, are somewhat enigmatic substances. Although these drugs are derived from multiple chemical families, they all produce remarkably similar effects in animals and humans, and they show cross-tolerance. This article reviews the evidence demonstrating the serotonin 5-HT2A receptor is the primary site of hallucinogen action. The 5-HT2A receptor is responsible for mediating the effects of hallucinogens in human subjects, eywords: sychedelic -HT2A receptor ead twitch refrontal cortex isual effects as well as in animal behavioral paradigms such as drug discrimination, head twitch response, prepulse inhibition of startle, exploratory behavior, and interval timing. Many recent clinical trials have yielded important new findings regarding the psychopharmacology of these substances. Furthermore, the use of modern imaging and electrophysiological techniques is beginning to help unravel how hallucinogens work in the brain. Evidence is also emerging that hallucinogens may possess therapeutic efficacy. © 2014 Published by Elsevier B.V.


In large-scale online complex networks (Wikipedia, Facebook, Twitter, etc.) finding nodes related to a specific topic is a strategic research subject. This article focuses on two central notions in this context: communities (groups of highly connected nodes) and proximity measures (indicating whether nodes are topologically close). We propose a parameterized proximity measure which, given a set of nodes belonging to a community, learns the optimal parameters and identifies the other nodes of this community, called multi-ego-centered community as it is centered on a set of nodes. We validate our results on a large dataset of categorized Wikipedia pages and on benchmarks, we also show that our approach performs better than existing ones. Our main contributions are (i) a new ergonomic parametrized proximity measure, (ii) the automatic tuning of the proximity's parameters and (iii) the unsupervised detection of community boundaries.


Neumann et al. (Reports, 6 June 2008, p. 1326) recently reported the preparation of multiparticle entanglement among single spins in diamond. However, two of the system's nuclear eigenstates are incorrectly described as product states when they are inherently entangled. Consequently, three of the six states reported, namely the odd-parity Bell states and the W state, were not actually produced.


Based on the experiments on milling the 3Cr-1Mo-1/4Vsteel which is the main part of the large chemical equipment hydrogenation reactor with several types of different grooves milling inserts, we have experiment study on the impact disrepair. Using the Orthogonal experimental design method, we have cutting experiments on machining the high-strength steel with several types of different grooves milling inserts, and find out the difference of the impact disrepair invalidation types among them. Based on the plentiful and systemic impact disrepair experiments, we build the impact disrepair life cumulating distribution function mathematic model by the mathematics statistic method. We have contrast analysis of the impact disrepair average lives among these types of milling inserts, and the different grooves milling inserts are optimized. All these studies provide the theoretic and experimental bases for solving the cutter disrepair which is the key problem in the actual production and groove optimization.


The substantial increase of randomized controlled trials demand familiarity with the essential aspects of their design and performance by the cardiologist, particularly the adequate interpretation and applicability of the results. In this clinically-based review, we discuss some important aspects in the assessment of novel contemporary therapy such as the use and analysis of composite endpoints; implications from early termination of trials and extrapolation of results to the population.


Tear film stability and its interaction with the corneal surface play an important role in maintaining ocular surface integrity and quality of vision. We present a non-invasive technique to quantify the pre-corneal tear film thickness. A cMOS camera is used to record the interference pattern produced by the reflections from multiple layers of the tear film Principles of spatial autocorrelation are applied to extract the frequency of the periodic patterns in the images. A mathematical model is developed to obtain the thickness of the tear film from the spatial autocorrelation image. The technique is validated using micro-fabricated thin parylene films. We obtained repeatable and precise measurement on a live rabbit model (N = 6). We obtained an average value of 10.2µm and standard deviation of, SD = 0.3 (N = 4). We measured one rabbit infected with HSV-1 virus that had a baseline tear film thickness of 4.7µm.


Ovarian-type epithelial tumors are extremely rare in testis and paratestis, and in literature no cases of this tumor are reported in a patient with history of bilateral cryptorchidism. We describe a case of an 81-year-old man with a scrotal ulcerative lesion associated with signs of infection. After a skin biopsy showing tumor cells and mucin, we performed a surgical resection of this scrotal lesion and the final pathologic examination revealed a mucinous adenocarcinoma with medium grade of differentiation. The pathologist suggested performing additional tests of this tumor to differentiate it from mucinous "ovarian-type" paratesticular tumor and from a metastatic tumor. We did not find any tumor of different type. We discuss clinical presentation, differential diagnosis and treatment of this rare tumor. World J Nephrol Urol. 2015;4(4):260-263 doi: http://dx.doi.org/10.14740/wjnu235w


In a few decades, requests for assistance to the elderly will increase the already high health care costs. Within this context, a possible solution is represented by smart environments where services help dwellers' life. The development of smart technologies requires large datasets for training, validation or testing. Since the data collection from real smart homes has high costs the authors developed SHARON - a Simulator of Human Activity, ROutines and Needs. This software aims to support such projects, virtually reproducing environments and behaviors of the dwellers. This work proposes and validates a behavioral model able reproduce decisions and human habits, starting from an available data set or an interview. Physiological parameters and habits are merged with a probabilistic approach, choosing the most likely activity. With respect to other behavioral simulators available in the literature, SHARON is focused on routines and activities generation, based on user defined high level parameters. Within the evaluation phase it was applied a cross-validation approach, by simulating 300 days starting from a training set of 23 days and testing with the remaining 7 days validation set. As expected, results prove the simulated data correctly reproduce the activities routine distributions, in particular the more regular ones.


A radio transmitter that is accelerating with a non-zero radial component with respect to a receiver will produce a signal that appears to change its frequency over time. This effect, commonly produced in astrophysical situations where orbital and rotational motions are ubiquitous, is called a drift rate. In radio SETI (Search for Extraterrestrial Intelligence) research, it is unknown a priori which frequency a signal is being sent at, or even if there will be any drift rate at all besides motions within the solar system. Therefore drift rates across the potential range need to be individually searched and a maximum drift rate needs to be chosen. The middle of this range is zero, indicating no acceleration, but the absolute value for the limits remains unconstrained. A balance must be struck between computational time and the possibility of excluding a signal from an ETI. In this work, we examine physical considerations that constrain a maximum drift rate and highlight the importance of this problem in any narrowband SETI search. We determine that a normalized drift rate of 200 nHz (e.g., 200 Hz s−1 at 1 GHz) is a generous, physically motivated guideline for the maximum drift rate that should be applied to future narrowband SETI projects if computational capabilities permit.


In recent years, the utilization of rotating parts, e.g., bearings and gears, has been continuously supporting the manufacturing line to produce a consistent output quality. Due to their critical role, the breakdown of these components might significantly impact the production rate. Prognosis, which is an approach that predicts the machine failure, has attracted significant interest in the last few decades. In this paper, the prognostic approaches are described briefly and advanced predictive analytics, namely a parsimonious network based on a fuzzy inference system (PANFIS), is proposed and tested for low speed slew bearing data. PANFIS differs itself from conventional prognostic approaches, supporting online lifelong prognostics without the requirement of a retraining or reconfiguration phase. The PANFIS method is applied to normal-to-failure bearing vibration data collected for 139 days to predict the time-domain features of vibration slew bearing signals. The performance of the proposed method is compared to some established methods, such as ANFIS, eTS, and Simp_eTS. From the results, it is suggested that PANFIS offers an outstanding performance compared to those methods.


OBJECTIVES
Periodontal disease is an infectious disorder caused by a small subset of periodontal pathogens including Porphyromonas gingivalis. Accumulated evidences show that the expression of P. gingivalis heterogenic virulence properties is dependent on its clonal diversity. P. gingivalis expresses two distinct fimbria molecules, major and minor fimbriae, on its cell surfaces, both of which seem to be involved in the development of periodontitis. In this short review, variations of fimbriae in relation to microbial pathogenesis are discussed.

MATERIALS AND METHODS
Our recent findings are summarized to elucidate the relationship between clonal variation of fimbriae and bacterial pathogenicity of various strains.

RESULTS
Major fimbriae were classified into six types (I to V and Ib) based on the diversity of fimA genes encoding FimA (a subunit of major fimbriae). A majority of periodontitis patients were found to carry type II fimA organisms, followed by type IV, and type II fimA organisms were significantly occurred with more severe forms of periodontitis. Studies of clones with type II fimA have revealed significantly greater adhesive and invasive capabilities to epithelial cells than other fimA type clones. Minor fimbriae induced interleukin-1alpha (IL-1alpha), IL-1beta, IL-6, and tumor necrosis factor-alpha (TNF-alpha) cytokine expression in macrophages and were suggested to be a causative factor of alveolar bone resorption in animal models. The clonal diversity of minor fimbriae is unclear, however, distinct minor fimbria molecules were found in different strains.

CONCLUSION
The fimbria variations may have an influence on the development of periodontal disease.


Introduction The COVID-19 pandemic was a tremendous challenge to the practice of modern medicine. In this study, we use neo-institutional theory to gain an in-depth understanding of how physicians in Sweden narrate how they position themselves as physicians when practicing modern medicine during the first wave of the pandemic. At focus is medical logic, which integrates rules and routines based on medical evidence, practical experience, and patient perspectives in clinical decision-making. Methods To understand how physicians construct their versions of the pandemic and how it impacted the medical logic in which they practice, we analyzed the interviews from 28 physicians in Sweden by discursive psychology. Results The interpretative repertoires showed how COVID-19 created an experience of knowledge vacuum in medical logic and how physicians dealt with clinical patient dilemmas. They had to find unorthodox ways to rebuild a sense of medical evidence while still being responsible for clinical decision-making for patients with critical care needs. Discussion In the knowledge vacuum occurring during the first wave of COVID-19, physicians could not use their common medical knowledge nor rely on published evidence or their clinical judgment. They were thus challenged in their norm of being the "good doctor". One practical implication of this research is that it provides a rich empirical account where physicians are allowed to mirror, make sense, and normalize their own individual and sometimes painful struggle to uphold the professional role and related medical responsibility in the early phases of the COVID-19 pandemic. It will be important to follow how the tremendous challenge of COVID-19 to medical logic plays out over time in the community of physicians. There are many dimensions to study, with sick leave, burnout, and attrition being some interesting areas.


Objective To determine the prevalence of iodine deficiency in crossbred cows (taurus x indicus) of Punjab and to assess the diagnostic value of the plasma concentrations of thyroid hormones, total cholesterol and free fatty acids in iodine deficiency. The efficacy of ethiodised oil, as a long-term supplement of iodine, was also evaluated.

Procedures Base-line survey of iodine status was conducted by measuring plasma inorganic iodine (PII) concentration in 48 crossbred cows from 31 dairy units. Concentrations of plasma triiodothyronine (T3), thyroxine (T4), total cholesterol and free fatty acids were compared between iodine deficient and normal cows. Circulating T4 and T3 concentrations were also determined before and after injection of ethiodised oil in cows with low PII levels.

Results The mean prevalence of iodine deficiency was 35.9% and showed considerable geographical variation from 0 to 86% within Punjab. Cardinal clinical signs of iodine deficiency were absent and basal plasma T3 and T4 concentrations and their ratio did not differ between deficient and control cows. Activity of circulating T4 and T4:T3 ratio increased in response to ethiodised oil injection and persisted beyond 70 days after injection.

Conclusion Asymptomatic iodine deficiency is prevalent in crossbred cows of Punjab and response to iodine supplementation is the most reliable index of thyroid dysfunction associated with iodine deprivation. The results of this study also support the view that injection of 1 mL of 78% ethiodised oil can prevent iodine deficiency for more than 70 days.


PURPOSE
Recurrent glioblastoma multiforme (GBM) is incurable with current therapies. Biallelic mismatch repair deficiency (bMMRD) is a highly penetrant childhood cancer syndrome often resulting in GBM characterized by a high mutational burden. Evidence suggests that high mutation and neoantigen loads are associated with response to immune checkpoint inhibition.

PATIENTS AND METHODS
We performed exome sequencing and neoantigen prediction on 37 bMMRD cancers and compared them with childhood and adult brain neoplasms. Neoantigen prediction bMMRD GBM was compared with responsive adult cancers from multiple tissues. Two siblings with recurrent multifocal bMMRD GBM were treated with the immune checkpoint inhibitor nivolumab.

RESULTS
All malignant tumors (n = 32) were hypermutant. Although bMMRD brain tumors had the highest mutational load because of secondary polymerase mutations (mean, 17,740 ± standard deviation, 7,703), all other high-grade tumors were hypermutant (mean, 1,589 ± standard deviation, 1,043), similar to other cancers that responded favorably to immune checkpoint inhibitors. bMMRD GBM had a significantly higher mutational load than sporadic pediatric and adult gliomas and all other brain tumors (P < .001). bMMRD GBM harbored mean neoantigen loads seven to 16 times higher than those in immunoresponsive melanomas, lung cancers, or microsatellite-unstable GI cancers (P < .001). On the basis of these preclinical data, we treated two bMMRD siblings with recurrent multifocal GBM with the anti-programmed death-1 inhibitor nivolumab, which resulted in clinically significant responses and a profound radiologic response.

CONCLUSION
This report of initial and durable responses of recurrent GBM to immune checkpoint inhibition may have implications for GBM in general and other hypermutant cancers arising from primary (genetic predisposition) or secondary MMRD.


This research is located within the current debate surrounding a 'crisis in care' within the nursing profession. Caring has been considered at the foundation of nursing practice since the days of Florence Nightingale. However the contemporary healthcare environment with increasing nursing workloads and a focus on productivity measures is creating real barriers for nurses who wish to be caring. Nurse education is at the centre of this debate regarding its location within Higher Education and the move to an all graduate profession across all fields of nursing.

The aim of this study was to acquire a deeper understanding of how their development of caring was experienced within the pre-registration nursing mental health programme. A total of 9 second year student mental health (MH) nurses volunteered to participate in the study from a Higher Education Institution in the United Kingdom.

The interviews were analysed using an Interpretive Phenomenological Approach and this uncovered 3 super-ordinate themes. Participant's identified with caring as an innate characteristic that is central to their 'being', and this acted as a key motivator towards becoming a Mental Health Nurse. Several effective pedagogies were identified in the study that enhance and enrich the participant's innate caring qualities during their educational programme. The value of mental health practice placements and the role of reflection in their learning whilst acknowledged is also a source of dissonance as they encounter the reality of caring within mental health services.

The findings would indicate that caring within new student (MH) nurses' is an innate human quality that requires awakening and validating rather than instilling by the appropriate nursing pedagogies grounded in the ethics of caring. The role of nurse educators is clearly to produce competent (MH) nurses who can remain 'caring human beings', whilst responding effectively to the social, economic and cultural transformations and contemporary nursing demands. Introducing and embedding approaches that develop resilience and increase emotional intelligence are essential to protect their professional ideals.


Study Design. Cross-sectional analysis of analgesic use by patients with low back pain (LBP). Objectives. To describe patterns of analgesic use and their cost implications for the use of other care services among individuals with LBP enrolled in a health insurance plan during 2001. It was hypothesized that the use of analgesics would be most frequent among patients with LBP with neurologic findings. Summary of Background Data. National guidelines have recommended analgesics as the primary pharmacologic treatment of LBP. The choice of specific analgesics has major cost and service use implications. Methods. The University of Pittsburgh Health System includes 18 affiliated hospitals, more than 5000 physicians, and a commercial health plan with 255,958 members in 2001. This study uses the System Health Plan's insurance claims database to identify members who had services provided for one of 66 International Classification of Diseases, Version 9, Clinical Modification codes that identify mechanical LBP (n = 17,148). Results. In 2001, 7631 (43.5%) members with claims for LBP services had no analgesic pharmacy claims. The other 9517 (55.5%) had analgesics claims costing a total of $1.4 million; 68% of claimants were prescribed an opioid and 58% nonselective nonsteroidal antiinflammatory drugs (NSAID). The costs of opioids, NSAID, and cyclooxygenase-2 selective NSAID for patients with LBP represented 48%, 24%, and 28%, respectively, of total health plan expenditures for all uses of these drugs, including cancer. Opioid use was associated with the high volume usage of LBP care services. Patients with LBP with and without neurologic involvement and those with acquired lumbar spine structural disorders had similar patterns of analgesic use: those with congenital structural disorders were less likely to use analgesics; and those with psychogenic pain and LBP related to orthopedic devices were more likely to use opioids. Conclusions. With this health plan, a high proportion of patients with LBP had claims for opioids during 2001. The use of opioids by patients with LBP represents a major cost for the health plan, and is associated with specific patient characteristics and their use of other LBP services.


Background and Objective: As cognitive impairments represent the greatest impediment to participation following moderate–severe traumatic brain injury (TBI), cognitive rehabilitation is vital. Several sets of guidelines for cognitive rehabilitation have been published, including INCOG in 2014. However, little is known about current practice by therapists working with individuals with TBI. This study aimed to characterise current cognitive rehabilitation practices via an online survey of therapists engaged in rehabilitation in individuals with TBI. Method: The survey documented demographic information, current cognitive rehabilitation practice, resources used to inform cognitive rehabilitation, and reflections on cognitive rehabilitation provided. Results: The 221 Australian respondents were predominantly occupational therapists, neuropsychologists, and speech pathologists with an average 9 years of clinical experience in cognitive rehabilitation and TBI. Cognitive retraining and compensatory strategies were the most commonly identified approaches used in cognitive rehabilitation. Executive functioning was mostly targeted for retraining, whereas memory was targeted with compensatory strategies. Attentional problems were less frequently addressed. Client self-awareness, family involvement, team collaboration, and goal-setting were seen as important ingredients for success. Conclusion: Clinical practice of cognitive rehabilitation in Australia is broadly consistent with guidelines. However, addressing the impediments to its delivery is important to enhance the quality of life for individuals with TBI.


Although numerous studies have demonstrated the benefits of incorporating filler particles into maxillofacial silicone elastomer (MFPSE), a review of the types, concentrations and effectiveness of the particles themselves was lacking. The purpose of this systematic review and meta-analysis was to review the effect of different types of filler particles on the mechanical properties of MFPSE. The properties in question were (1) tensile strength, (2) tear strength, (3) hardness, and (4) elongation at break. The findings of this study can assist operators, technicians and clinicians in making relevant decisions regarding which type of fillers to incorporate based on their needs. The systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 26 original articles from 1970 to 2019 were selected from the databases, based on predefined eligibility criteria by two reviewers. The meta-analyses of nine papers were carried out by extracting data from the systematic review based on scoring criteria and processed using Cochrane Review Manager 5.3. Overall, there were significant differences favoring filler particles when incorporated into MFPSE. Nano fillers (69.23% of all studies) demonstrated superior comparative outcomes for tensile strength (P < 0.0001), tear strength (P < 0.00001), hardness (P < 0.00001) and elongation at break (P < 0.00001) when compared to micro fillers (30.76% of all studies). Micro fillers demonstrated inconsistent outcomes in mechanical properties, and meta-analysis of elongation at break argued against (P < 0.01) their use. Current findings suggest that 1.5% ZrSiO4, 3% SiO2, 1.5% Y2O3, 2–6% TiO2, 2–2.5% ZnO, 2–2.5% CeO2, 0.5% TiSiO4 and 1% Ag-Zn Zeolite can be used to reinforce MFPSE, and help the materials better withstand mechanical degradation.


In january 2013, I travelled with my studio to Israel. This project is a collection of what I experienced on our journey through the country, and the thoughts it evoked. It is also a collection of symbols and metaphors found in the areas we visited. Tel Aviv is widely known as the "White City". According to the myth, it rose out of the dunes of sand as a new Hebrew city. However, deeper investigation reveals that a part of the municipality is established on the post-Nakba ruins of the former village Manshiya. This village was almost totally erased, partly for political reasons. The project is an exploration into the story of erasure, and an attempt to evoke the traces of what once was there. I have proposed an underground structure hidden in sand.The objective is not to present a final answer, but to contribute to an ongoing discussion of who is the winner or loser in the writing of history, and what role architecture has in this battle.


Performance of microelectronic devices has been greatly enhanced owing to the development of the very large-skill technology. However, with the increase of circuit density and operating speed, more heat was generated by the microelectronics devices. So, the objective of this project is to do a comparative study between two different types of fractal microchannel at the same size and boundary condition by using Computational Fluid Dynamics (CFD) Besides that, this study also will investigate the hydrodynamic and thermal characteristics of T-shaped and Tree-shaped fractal microchannel network heat sinks by solving three-dimensional Navier– Stokes equations and energy equation, taking into consideration the conjugate heat transfers in microchannel walls. For the simulation, ANSYS software was used with the inlet temperature set to be 300 K, inlet velocity will be in the range of 0.1 m/s to 0.5 m/s and uniform heat flux be set at 325 W/cm 2 . From this study, it was found that due to the structural limitation of right-angled fractal-shaped microchannel network, hotspots may appear on the bottom wall of the heat sink where the microchannel are sparsely distributed. With slight modifications in both fractal-shaped structure of microchannel network, great improvements on the hydrodynamic and thermal performance of heat sink can be achieved. A comparison of the performance of modified fractal-shaped microchannel network heat sink with parallel microchannel heat sink is also conducted numerically based on the same heat sink dimensions. It is found that the modified fractal-shaped microchannel network is much better in terms of thermal resistance and temperature uniformity under the conditions of the same pressure drop or pumping power. Therefore, the modified fractal-shaped microchannel network heat sink appears promising to be used for microelectronic cooling in the future.


Maternal high-fat (HF) diet feeding is associated with increased risk of developing metabolism-related diseases in adult offspring, including chronic liver disease. The present study tested the hypothesis that maternal HF diet leads to a decreased antioxidant defense capacity and causes cellular senescence in liver of adult offspring rats, which might increase risk of developing chronic liver disease. Timed-pregnant Sprague Dawley rats were fed a HF diet (45% of energy from fat) or a control (C) diet (16% of energy from fat) during gestation and lactation. The resulting offspring were fed a C diet after weaning to generate 2 offspring groups: C diet-fed offspring of dams fed C diet (C/C) and C diet-fed offspring of dams fed a HF diet (HF/C). At 12 wk of age, male rats were killed and samples were collected for analysis. Maternal HF diet significantly increased plasma TG and hepatic TBARS concentrations and the size of hepatic lipid droplets in offspring rats. The expression of antioxidant defense genes, such as glutathione peroxidase-1, Cu/Zn superoxide dismutase (Sod1), paraoxonase enzymes (Pon1, Pon2, and Pon3), were significantly lower in the liver of HF/C pups than in C/C pups. The expression of Inhibitor of cyclin dependent Kinase 4a (p16INK4a), a marker of cellular senescence, and cyclooxygenase-2 (Cox2), a proinflammatory marker, was significantly higher in the HF/C offspring group than in the C/C offspring group. Western-blot analysis shows that cyclin D1 and phosphorylated retinoblastoma protein were significantly lower in HF/C offspring than in C/C offspring. The results provide the first evidence to our knowledge that maternal HF diet might alter antioxidant defense capacity and program the p16INK4a-dependent cellular senescence in the liver of adult offspring.


Bringing corpses of members of Seventh-day Adventist Church to church before funeral service has been a long discussion among members of Seventh-day Adventist Church itself particularly in Indonesia. Some agree but others not. Each group has its own argument. But, the group that agrees, unfortunately, is divided into two groups which are based on criteria that have been set up by each congregation. The main aim of this research was to find out whether there is a theological view in the Bible and Spirit of Prophecy regarding bringing a corpse into church. The other one is to give some guidelines for Seventh-day Adventist churches regarding this issue. The research itself used two methodologies. First, the writer did observation in some churches during his experience as church pastor. The observation itself was related to the regulations that have been set up by each church. The other one is library research. Here, Old and New Testaments became the main sources as well as Spirit of Prophecy (The writings of Ellen G. White). The results of the study are: first, bringing corpses to church before funeral service does not have theological basis in the Bible and Spirit of Prophecy. Moreover, Bible and Spirit of Prophecy also do not provide provisions relating to it as well as its positive or negative impacts whether a corpse is brought or not into church. Second, the organization of Seventh-day Adventist Church should give clear guidance about the criteria that will be implemented by all churches under it to occur alignment in addressing this issue. Third, if it turns out that decision being handed out to each congregation, then, let these three important things need to be considered, namely: (1) The person who died must be a faithful member of Seventh-day Adventist Church; (2) The person died in a reasonable state (not suicide, drug addicts, etc.); (3) It is not just limited to an ordained pastor or young pastor, church elders, church pioneers, old people, but to the younger age group the church should give the same opportunity. 1. Church. It is a building that has been dedicated to God and is used only for worship and religious activities. 2. Unclean. A term for a state in which the body or soul or one's life is not holy anymore. 3. Corpse. A term for the body of a dead person.


Abstract This article addresses issues of queer identity, aesthetics, and history in jazz through a focus on two midcentury works composed and/or arranged by Billy Strayhorn: a set of four pieces written in 1953 for an Off-Broadway production of Federico Garcia-Lorca9s The Love of Don Perlimplin for Belisa in Their Garden ( Amor de Don Perlimplin con Belisa en su jardin ); and several movements from the Strayhorn-Ellington adaptation of Tchaikovsky9s Nutcracker Suite (1960). My study considers how the two works engage artistic figures, themes, topics, and aesthetic practices that have strong queer historical affiliations. These include failed or impossible love, masking, stylized exotica, and other liminal spheres of identificatory ambiguity and reversal. Taken together, these works enable a positioning of Strayhorn within modernist queer cultural history and, more specifically, within the history of African American gay cultural production. At the same time, through showing how queerness inhabits jazz9s past, my analyses of Strayhorn9s queer musical encounters provide a critical vantage point from which to examine historical and cultural understandings of jazz at midcentury and, more broadly, the complex relationships between social identities (race, sexuality, gender) and composition, arrangement, and collaboration in twentieth-century music.


Finite-difference time-domain (FDTD) analysis has been used to predict the time-resolved reflectance from multilayered slabs with a nonscattering layer. Light propagation across the nonscattering layer was calculated based on the light intensity characteristics along a ray in free space. Additional equivalent source functions due to light from scattering regions across the nonscattering region were introduced into the diffusion equation and an additional set of the diffusion equation was solved by FDTD analysis by employing new boundary conditions. The formulation was used to calculate time-resolved reflectances of three- and four-layered slabs containing a nonscattering layer. The received light intensity and the mean time of flight estimated from the time-resolved reflectance are in reasonable agreement with previously reported experimental data and Monte Carlo simulations.


Effect of potassium lactate (PL) and sodium diacetate (SD) combinations at varying levels were evaluated in low (5%) and high (20%) fat chicken and turkey hotdog model systems. All the samples were surface inoculated with Lis- teria monocytogenes (approximately 4.6 log cfu/g), vacuum packed and stored at 4 o C for 28 days to determine the effec- tive combination of PL and SD and the effect of fat content on the growth inhibition of L. monocytogenes. In chicken hot- dog samples, maximum growth inhibitions (3.4 log cfu/g) were observed in low fat samples formulated with 3.0% PL and 0.15% SD. In turkey hotdog samples, maximum growth inhibitions (3.3 log cfu/g) were observed in low fat samples for- mulated with 3.0% PL and 0.2% SD. Effective combination levels determined in low and high fat chicken were 3.0% PL and 0.15% SD, whereas in low and high fat turkey, the effective levels were 3.0% PL and 0.20% SD. Overall, fat content had significant effect (P < 0.05) on growth inhibition as indicated by higher inhibitions in low fat chicken and turkey hot- dogs than high fat samples. These results demonstrate that commercial usage levels of PL (2.0%) and SD (0.15%) alone are not sufficient to control L. monocytogenes in case of pathogen contamination.


A maximum likelihood (ML) method is developed for estimation of direction of arrival (DOA) and associated parameters of narrowband signals based on the Taylor's series expansion of the inverse of the data covariance matrix R for large M, M specifying number of sensors in the array. The stochastic ML criterion function can thus be simplified resulting in a computationally efficient algorithm for DOA estimation. The more important result is the derivation of asymptotic (large M) expressions for the Cramer-Rao lower bound (CRB) on the covariance matrix of all unknown DOA angles for the general D source case. The derived bound is expressed explicitly as a function of snapshots, signal-to-noise ratio (SNR), sensors, separation, and correlation between signal sources. Using the condition of positive definiteness of the Fisher information matrix a resolution criterion is proposed which gives a tight lower limit on the minimum resolvable angle.


This paper targets on the design and analysis of specific types of transfer functions obtained by the summing operation of integer-order and fractional-order two-port responses. Various operations provided by fractional-order, two-terminal devices have been studied recently. However, this topic needs to be further studied, and the topologies need to be analyzed in order to extend the state of the art. The studied topology utilizes the passive solution of a constant-phase element (with order equal to 0.5) implemented by parallel resistor–capacitor circuit (RC) sections operating as a fractional-order two-port. The integer-order part is implemented by operational amplifier-based lossless integrators and differentiators in branches with electronically adjustable gain, useful for time constant tuning. Four possible cases of the fractional-order and integer-order two-port interconnections are analyzed analytically, by PSpice simulations and also experimentally in the frequency range between 10 Hz and 1 MHz. Standard discrete active components are used in this design for laboratory verification. Practical recommendations for construction and also particular solutions overcoming possible issues with instability and DC offsets are also given. Experimental and simulated results are in good agreement with theory.


Excerpt] The performance of hotel markets during the 1980s was unique and in violation of the economic principles that govern these markets. The most direct evidence of this period-specific behavior comes from the fact that hotel occupancy rates noticeably and persistently declined during the decade while the supply of hotel rooms sky rocketed. Exhibit 1 contains information on hotel market indicators from the database of thousands of hotels that my firm manages. The average hotel occupancy rate in the U.S. began the decade in 1980 at 73.5 percent and ended at 65.2 percent. In direct contradiction with how supply should have behaved in response to falling occupancy, the number of available hotel rooms increased every year of the 1980s and ended up 48 percent higher in 1990 than in 1980. In addition, real average daily room rates by 1993 ($57.69) about equaled the 1983 ($59.99) level. And by 1994, astute investors were able to pay a mere 30 to 40 cents of replacement cost dollar for quality, full-service hotel assets.


The purpose of this project was to examine how Grade One teachers in Central Alberta are integrating computer technology into daily teaching. The literature review provides a brief history of various technologies that have been introduced to schools throughout the twentieth century. The review also examines articles that are about the use of computer technology in primary classrooms. The interviews with six Grade One teachers included questions about their computer technology background and training, how they used the technology, their frustrations and their suggestions for better use of computer technology in the classroom. Findings reveal that teacher expertise was gained through workshops and personal use of computer technology. The workshops concentrated on hardware and software operation rather than effective classroom use of computer technology. The project conclusion includes recommendations to improve use of computer technology in the Grade One classroom. A significant aspect of the interviews was that all the teachers prefaced the interview with an apology regarding their lack of expertise with computers and software. In order for teachers to approach computer technology in a confident, constractive and positive manner, there is a need for a long term financial commitment by Alberta Education. Another aspect of the conclusion is that computer technology, especially at the Grade One level, should remain only a small part of a young child's education.


This research identifies and investigates the Safety, Health and Environment Hazards in a Malaysian Performing Arts Theatre Production. It analyses and quantifies the likelihood and severity of hazards on the well-being of theatre practitioners and members of the public and ascertains measures to prevent the risks. This research is important due to the current lack of regulations on the Malaysian performing arts theatre industry while operating under limited resources. It also seeks to build Safety, Health and Environment data for the Malaysian performing arts theatre industry. Currently, there is no official risk assessment on the production work of small scale Malaysian theatre production companies. As the production process begins with pre-production and production work outside of the theatre, the gap in research on hazards of these work processes are closed using the Hazard Identification, Risk Assessment and Risk Control (HIRARC) method on a Malaysian theatre company. The Malaysian company studied is a theatre company that specialises in opera productions with cast members, orchestra, production workers, designers and children. The performance was held at a theatre located in Kuala Lumpur, Malaysia. Each phase of the production was separated according to job steps by location, and hazards were identified accordingly. Each hazard was assigned a risk level according to likelihood and severity and control measures were identified to prevent these risks. It was found that most of the risks faced at the rehearsal space and the theatre were moderate, followed by imminent risk and insignificant risk. At the theatre, the percentage of moderate, imminent and insignificant risks were 64%, 35% and 1% respectively. At the rehearsal space, the risks were 80%, 19% and 2% respectively. Steps to prevent and mitigate the risks were highlighted in the form of recommendations to be shared with theatre practitioners and implemented in the theatrical production process.


BACKGROUND
Recently developed active workstation could become a potential means for worksite physical activity and wellness promotion. The aim of this review was to quantitatively examine the effectiveness of active workstation in energy expenditure and job performance.

METHODS
The literature search was conducted in 6 databases (PubMed, SPORTDiscuss, Web of Science, ProQuest, ScienceDirect, and Scopuse) for articles published up to February 2014, from which a systematic review and meta-analysis was conducted.

RESULTS
The cumulative analysis for EE showed there was significant increase in EE using active workstation [mean effect size (MES): 1.47; 95% confidence interval (CI): 1.22 to 1.72, P < .0001]. Results from job performance indicated 2 findings: (1) active workstation did not affect selective attention, processing speed, speech quality, reading comprehension, interpretation and accuracy of transcription; and (2) it could decrease the efficiency of typing speed (MES: -0.55; CI: -0.88 to -0.21, P < .001) and mouse clicking (MES: -1.10; CI: -1.29 to -0.92, P < .001).

CONCLUSION
Active workstation could significantly increase daily PA and be potentially useful in reducing workplace sedentariness. Although some parts of job performance were significantly lower, others were not. As a result there was little effect on real-life work productivity if we made a good arrangement of job tasks.


Light Detection and Ranging (Lidar) is a state of the art technology to assess forest aboveground biomass (AGB). To date, methods developed to relate Lidar metrics with forest parameters were built upon the vertical component of the data. In multi-layered tropical forests, signal penetration might be restricted, limiting the efficiency of these methods. A potential way for improving AGB models in such forests would be to combine traditional approaches by descriptors of the horizontal canopy structure. We assessed the capability and complementarity of three recently proposed methods for assessing AGB at the plot level using point distributional approach (DM), canopy volume profile approach (CVP), 2D canopy grain approach (FOTO), and further evaluated the potential of a topographical complexity index (TCI) to explain part of the variability of AGB with slope. This research has been conducted in a mountainous wet evergreen tropical forest of Western Ghats in India. AGB biomass models were developed using a best subset regression approach, and model performance was assessed through cross-validation. Results demonstrated that the variability in AGB could be efficiently captured when variables describing both the vertical (DM or CVP) and horizontal (FOTO) structure were combined. Integrating FOTO metrics with those of either DM or CVP decreased the root mean squared error of the models by 4.42% and 6.01%, respectively. These results are of high interest for AGB mapping in the tropics and could significantly contribute to the REDD+ program. Model quality could be further enhanced by improving the robustness of field-based biomass models and influence of topography on area-based Lidar descriptors of the forest structure.


RATIONALE & OBJECTIVE
Gabapentinoids are an opioid substitute whose elimination by the kidneys is reduced as kidney function declines. To inform their safe prescribing in older adults with chronic kidney disease (CKD), we examined the 30-day risk of serious adverse events according to the prescribed starting dose.

STUDY DESIGN
Population-based cohort study.

SETTING & PARTICIPANTS
74,084 older adults (64% women; median age 79 [interquartile range 73-85]) with CKD (defined as an estimated glomerular filtration rate [eGFR] <60 mL/min/1.73m2 while not receiving dialysis) and a newly prescribed a gabapentinoid between 2008-2020 in Ontario, Canada.

EXPOSURE
Higher-dose gabapentinoids (gabapentin >300 mg/day or pregabalin >75 mg/day) vs lower-dose gabapentinoids (gabapentin ≤300 mg/day or pregabalin ≤75 mg/day).

OUTCOMES
The primary composite outcome was the 30-day risk of a hospital visit with encephalopathy, a fall, a fracture, or a hospitalization with respiratory depression.

ANALYTICAL APPROACH
Comparison groups were balanced on indicators of baseline health using inverse probability of treatment weighting using propensity score analysis that generated a pseudo-sample for the reference group with a distribution of measured covariates similar to the exposed group. Weighted risk ratios (RR) were estimated using modified Poisson regression, and weighted risk differences (RD) estimated using binomial regression. Pre-specified subgroup analyses were conducted by eGFR category and type of gabapentinoid.

RESULTS
Among 74,084 patients were identified with CKD and a new prescription for gabapentin or pregabalin 41% started at >300 mg/day and >75 mg/day, respectively. From this set of patients a weighted study population with a size of 61,367 was generated. Patients who started at a higher dose had a 30-day risk of the primary outcome higher than the risk among with patients who started at lower dose. Within the weighted population, the numbers of events for higher vs. lower dose were 585/30,660 [1.9%] vs 462/30,707 [1.5%], respectively. The weighted RR was 1.27 [95% CI, 1.13 to 1.42] and the weighted RD was 0.40% [95% CI, 0.21% to 0.60%]). In subgroup analyses, neither multiplicative nor additive interactions were statistically significant.

LIMITATIONS
Residual confounding.

CONCLUSIONS
In this population-based study, starting a gabapentinoid at a higher vs lower dose was associated with a slightly higher risk of a hospital stay with encephalopathy, a fall, or a fracture, or hospitalization with respiratory depression. If verified, these risks should be balanced against the benefits of using a higher-dose gabapentinoid.


Intimate partner violence (IPV) in Bermuda has received minimal recognition as a social problem in Bermuda. Limited academic research has been conducted. With increasing rates of IPV occurring in Bermuda, this illuminated the need for further exploration. Familialism is a strongly subscribed cultural belief that reinforces the silence in Bermudian society. Therefore a single case study was conducted. This case study is about a black Bermudian woman who experienced IPV during her relationship with the father of her children. Her narrative provides insight into a social problem that is obscured by cultural beliefs. She illustrated various elements of Bermudian culture that are intertwined and contribute to the perpetuation of IPV. She was motivated by her commitment and dedication to her family to challenge cultural beliefs and access social support. A combination of both informal and formal social support enabled her to navigate through her IPV experience. It is the hope that this case study will serve as the foundation for future research on IPV in Bermuda in order to attain a better understanding of the social issue, to create awareness about IPV and to develop comprehensive social policies.


In this paper, we describe a planning and control approach in terms of sampling using Rapidlyexploring Random Trees (RRTs), which were introduced in [7, 9]. We review RRTs for motion planning and show how to use them to solve standard nonlinear control problems. We extend them to the case of hybrid systems and describe our modifications to LaValle's Motion Strategy Library to allow for hybrid motion planning. Finally, we extend them to purely discrete spaces (using heuristic evaluation as a distance metric) and provide computational experiments comparing them to conventional methods, such as A*.


We present in this paper an e-banking platform used as a collaboration tool between more than 15 industrial companies, a school of engineering and different research laboratories. The main objective of this collaboration is to prepare the new e-banking protocols that will take place into the SEPA program (Single Euro Payments Area). This program has for objective to harmonize bank payment systems in Europe. It began to take effect in January 2008 and will continue through 2010. Many engineers have to be trained, lots of tests have to be realized from end to end in the e-banking chain with new protocols and recent research developments have to be integrated. Some quantitative results show the interest of this platform for all the partners.


Expectations and riskiness of future earnings are crucial determinants of individuals' intertemporal choices. Yet, the empirical literature lacks reliable measures of the distribution of future income. Lacking direct observability, the latter is usually estimated inferring the mean, the variance and other moments of the distribution from income realizations on panel data. In this paper we rely instead on subjective expectations available in the 1995 Survey of Household Income and Wealth, a large random sample representative of Italian households. The survey elicits information on the distribution of future earnings and the probability of employment in a very simple and parsimonious way. Based on the responses, we estimate the individual distributions of expected earnings conditional on working as well as unconditional. We can then relate various moments of these distributions to demographic and economic variables observable in the cross-section.


A production process includes several sub-processes (working areas) that are responsible for performing the different tasks required to accomplish the mission of the process. Thus, it is important to avoid a shortage of resources, unplanned stoppages and idle times that may arise. The problem addressed in this paper is: How should maintenance be considered in conjunction with plant activities, such as production, quality and personnel competence for easily and effectively identifying and quantifying company losses in profitability and eliminating underlying causes? In this paper, the interactions between major working areas have been introduced and discussed. The major result achieved in this study is the development of a new model (Maintenance Function Deployment (MFD)), for an easy and effective identification and quantification of company losses in profitability. Four matrixes have been used for developing MFD model for effectively integrating maintenance with production, competence and quality. An application example is conducted to demonstrate the possibility of applying the model and its potential for enhancing production processes profitably. The main conclusion is: applying MFD gives an enormous opportunity to continuously maintain the quality of the working areas under consideration, which makes MFD one of the company's objective-driven tools for enhancing its profitability and competitiveness.


To the Editor.— Doctors Garg and Yusuf noted some discrepancies between Fig 1 and Table 2 in our article entitled "Trends in Hospitalization Rates for Heart Failure in the United States, 1973-1986: Evidence for Increasing Population Prevalence" that appeared in the April 1990 issue of theArchives. 1 On reviewing our original data, we realized that Table 2 represented the unadjusted and not, as indicated in the table title, the age-adjusted hospital discharge ratesfrom US hospitals for congestive heart failure, 1973-1986. The title in Table 2 in the article 1 should have read"Unadjusted Annual Hospital DischargeRates From US Hospitals, for Congestive Heart Failure, 1973-1986, by Sex-Race Group (per 100000)." Enclosed herein is the correct Table for age-adjusted hospital discharge rates. Also, in the first paragraph of the "Results" section, the numbers for the rates of increase for the age-adjusted rates should be changed to the following: 62% (not 66%)


COVID-19 has been declared as a global pandemic by the World Health Organization (WHO) on March 11, 2020. In this paper, we investigate various aspects of the clinical recovery of the first 1000 COVID-19 patients in Singapore, spanning from January 23 to April 01, 2020. This data consists of 245 clinically recovered patients. The first part of the paper studies the descriptive statistics and the influence of demographic parameters, namely age and gender, in the clinical recovery-period of COVID-19 patients. The second part of the paper is on identifying the distribution of the length of the recovery-period for the patients. We identify a piecewise analysis of three different periods, identified based on trends of both positive confirmation and clinical recovery of COVID-19. As expected, the overall recovery rate has reduced drastically during the exponential increase of incidences. However, our in-depth analysis shows that there is a shift in the age-group of incidences to the younger population, and the recovery-period of the younger population is considerably lower. Here, we have estimated the recovery rate to be 0.125. Overall, the prognosis of COVID-19 indicates an improvement in recovery rate owing to the government-mandated practices of restricted mobility of the older population and aggressive contact tracing.


Objective To investigate the accuracy of procalcitonin (PCT) as a diagnostic marker of nosocomial sepsis (NS) and define the most accurate cut-off to distinguish infected from uninfected neonates. Setting Six neonatal intensive care units (NICUs). Patients 762 neonates admitted to six NICUs during a 28-month observational study for whom at least one serum sample was taken on admission. Main outcome measures Positive and negative predictive values at different PCT cut-off levels. Results The overall probability of an NS was doubled or more if PCT was >0.5 ng/ml. In very-low-birth-weight (VLBW) infants, a cut-off of >2.4 ng/ml gave a positive predictive value of NS near to 50% with a probability of a false-positive diagnosis of NS in about 10% of the patients. Conclusions In VLBW neonates, a serum PCT value >2.4 ng/ml prompts early empirical antibiotic therapy, while in normal-birth-weight infants, a PCT value ≤2.4 ng/ml carries a low risk of missing an NS.


High food prices in 2008 and 2010 generated concern about food security in developing countries. The number of food insecure people was estimated to have jumped significantly and food assistance donors were faced with unexpectedly high procurement bills. This paper discusses how high food prices affect the delivery of food assistance, focusing on recipient effects and on procurement decisions. Recent changes in Canadian food assistance policies are discussed in the context of high commodity prices, and food assistance flows during recent periods of high prices are reviewed. Two empirical investigations relating to high food prices are undertaken. First, the degree of price transmission from world markets to local and regional markets, where a growing share of food assistance is being purchased, is shown to vary widely across countries and provides some insulation for food assistance against world price shocks. Second, the degree to which donors substitute between important food assistance commodities when relative commodity prices change is examined. There is significant substitution between protein sources in food assistance baskets, but not between cereals.


The human papillomavirus (HPV) is a very common sexually transmitted infection that affects an estimated 14 million people each year in the United States. There are two licensed prophylactic HPV vaccines currently available for use: a quadrivalent vaccine that protects against HPV types 6, 11, 16, and 18 and a bivalent vaccine that protects against HPV types 16 and 18. Less than half of American adolescents are getting vaccinated against HPV, which is responsible for close to 26,000 incidence cases of cancer in men and women every year in the United States. Cancer prevention through vaccination is a significant public health achievement, although the benefit is only realized with uptake of the vaccine. Challenges including cost and delivery of the vaccine are prevalent, but the social challenges, including the misconceptions regarding safety and efficacy, perception of risk, and consequences of vaccination, are among the most difficult to overcome. However, a strong collaborative effort among health care providers, public health professionals, and legislators has the potential to overcome these challenges, increase uptake of the HPV vaccine, and ultimately prevent future cancers. An analysis of several HPV vaccination mandate scenarios indicate that 4,190 estimated cases of cervical cancer could be prevented by increasing vaccine coverage to 80% among girls entering public school for 6th grade (11-12 years old) in 2015. In addition to the decrease in estimated HPV-associated disease outcomes, health care costs decrease with a greater proportion of the population vaccinated. Compared to the current vaccination rate, vaccinating 90% of the population has the potential to save 219 million 2015 U.S.$ in health care costs associated with oropharyngeal cancer and 212 million 2015 U.S.$ in health case costs associated with cervical cancer. Information regarding the health and economic burden of HPV-associated disease may be useful to policymakers and public health professionals for informed decisions about investments in future HPV prevention programs.


Sixteen male growing pigs of about 24kg BW were fitted with both a duodenal re-entrant and a post-valve T-shaped cannula inserted in the caecum. The animals were divided into four groups. Each group received one of the following diets: corn starch-soybean protein isolate-based diet without (diet C) and with carboxymethylcellulose (diet CMC) or a rye-wheat-based diet without (diet RW) and with xylanase addition (diet RWX). The diets provided similar levels of apparent precaecal digestible crude protein (CP), lysine, methionine+cystine, threonine and tryptophan. Additionally, [15N]-yeast was given with the diets during the first 10 days of the experiment. For estimation of digesta viscosity, N-flow of dietary and endogenous origin, apparent precaecal digestibilities of dry matter (DM), CP, amino acids and non starch polysaccharides (NSP) (only in pigs fed diets RW and RWX), ileal and duodenal digesta were quantitatively collected on day 16 and 17, respectively. The endogenous N-proportion was measured by the ratio of 15N enrichment in the digesta and urine. The duodenal and ileal digesta supernatant viscosity increased as carboxymethylcellulose was included into the diet. Xylanase addition to the rye-wheat based diet reduced the viscosity in the ileal digesta. There were no differences in precaecal digestibilities of DM, CP and amino acids between diet C and CMC. The precaecal digestibilities of DM and soluble and insoluble NSP increased from 69.5% to 73.9%, from 1.3% to 47.9% and from 17.0% to 35.4%, respectively, as xylanase was added to the rye-wheat-based diet. The apparent precaecal digestibility of most essential amino acids increased by 2 to 5 percent units. The amounts of endogenous N at the duodenal level were estimated to be 158, 233, 313 and 276mg per 12h per kg0.75 BW of pigs fed diets C, CMC, RW and RWX, respectively. The corresponding values at the ileal level were 95, 107, 164 and 150mg per 12h per kg0.75 BW. For endogenous N amounts, significant differences were observed between diets C and CMC (duodenum) and also between semi-purified and cereal-based diets (duodenum and ileum). Methodological aspects for the estimation of endogenous N using the isotope dilution technique are discussed. Obviously, the digesta viscosity per se does not affect the nutrient absorption and endogenous N flow within the small intestine of pigs. Other properties of complex dietary fibre, digesta passage rate or bacterial activity probably contribute to the observed changes.


Since the seventies we can observe an increasing propensity of many European older people to retire to southern Europe. Besides Tuscany, Malta, the Algarve, the Costa del Sol, the Canary and the Balearic Islands the Costa Blanca is one of the most demanded regions for the so-called international retirement migration. It is an undeniable fact that the number of older people will increase in the coming years. The municipalities on the Costa Blanca, with a big proportion of European jubilees, are in a special situation: not only they have to find solutions for their own citizens but also for a bigger part of the older immigrants from Europe. As not all of the expatriate retirees can or will return when they become seriously ill they need sooner or later a place in a nursing respectively old peopleis home. The objectives of this paper are on the one hand to present statistical data regarding to European residents on the Costa Blanca and on the other hand to know the actual supply of residential homes in this region. The aim is to dispose information that allows map out specific strategies and programs of intervention for these cohorts of older people.


Abstract This study was conducted to characterize the ground beetle (Coleoptera: Carabidae) community in Nebraska continuous cornfields and investigate the potential for predation of the western corn rootworm, Diabrotica virgifera virgifera LeConte, a key root-feeding insect pest that is an annual management challenge in this system. Seven collection dates were conducted at five commercial cornfields in west central Nebraska during the growing season of 2014. In each field, carabids were sampled using five 24-h pitfall traps. Carabid specimens were placed in 95% ethanol in the field and stored at –20°C to preserve DNA. After identification to the species level, DNA was extracted and polymerase chain reaction was conducted for gut-content analysis using D. v. virgifera-specific primers. Data from single-plant emergence cages and yellow sticky cards showed high abundance of D. v. virgifera prey in three of the five fields sampled. Sixteen genera and 36 carabid species were found in pitfall traps. Of the total 235 carabid specimens tested in this study, zero tested positive for D. v. virgifera DNA. The lack of positive results for the presence of D. v. virgifera DNA in the gut-contents of carabids, despite abundant pest populations, indicates that, in this system, ground beetles may not be a strong mortality agent of D. v. virgifera. However, results presented here contribute to our knowledge of carabid diversity in agroecosystems and indicate that future D. v. virgifera biological control efforts in this region should focus on other natural enemies and/or other life stages of carabids, such as larvae.


From the Catholic perspective, in vitro fertilization (IVF) is morally problematic because it artificially separates the procreative and unitive aspects of the conjugal act. Embryo selection (ES) in the context of IVF is an injustice against the resulting embryos because it treats them as commodities and works against their right to life by determining their implantation potential in light of their features. The Church opposes the eugenics mentality underlying ES. Meanwhile, the IVF industry increasingly uses artificial intelligence (AI) for ES. However, doing so could worsen the injustice by deepening the disrespect of human lives under the technocratic paradigm. As such, Catholic bioethicists are encouraged to advocate for the Church's teachings with renewed vigor. In this commentary, we will examine (1) ES in the context of IVF, (2) using AI for ES, (3) the moral implications of using AI for ES, and (4) points for further consideration. Summary: Using AI for Embryo selection in the context of IVF deepens the disrespect of human lives under the technocratic paradigm.


Background To address unmet needs for family planning and advance women's rights, US federal foreign aid recipients must ensure compliance with the family planning legislative and policy requirements. Because many health providers work in rural and remote settings, blended learning, which combines in-person and online experiences, is a promising approach for strengthening their compliance knowledge. Methods This cross-sectional study examined the effect of blended learning that included three components (online course, in-person training and conference call) on retention of family planning compliance knowledge. A total of 660 learners from 44 countries completed the online survey (8% response rate). Study participants were asked about their knowledge of family planning compliance and suggestions to improve their learning experiences. Findings Knowledge retention was higher in the group that utilised all three learning approaches compared with the online course plus conference call group (P<0.05). Participants who took the online course multiple times tended to retain knowledge better than respondents who took it only once, although this result was not statistically significant. Limitations The study relied on a convenience sample, which may contribute to bias. The response rate, while low at 8%, was representative of the user base, and included 660 respondents. Conclusion Participation in a blended learning training resulted in the highest gains in knowledge retention compared with online-only learning. These findings suggest that blended learning and repeat online trainings are critical to ensuring health professionals are aware of family planning compliance regulations.


The role of position L8′, located in transmembrane domain 1 of the neuronal nicotinic α3 subunit, was characterized by using two‐electrode voltage clamp in Xenopus oocytes. Four amino acids (Ala, Ser, Phe, and Tyr) were inserted at this conserved position, and the mutant subunit was coexpressed with either wild‐type β2 or β4 subunits. These substitutions led to significant alterations in the pharmacodynamic parameters of cholinergic agents, resulting in loss of function. Ala and Ser substitutions resulted in losses in agonist (ACh, nicotine, and DMPP) potency and intrinsic activity at both α3β2 and α3β4 receptors. Similarly, significant changes in antagonist potency were produced by the Ala and Ser substitutions. Phe and Tyr mutations did not alter the receptor's EC50 for ACh or nicotine but reduced the EC50 for DMPP at both receptors. The Phe mutation also reduced the intrinsic activity of all agonists tested at both receptors. The Tyr mutation, though, led to a decrease in intrinsic activity for all agonists at the α3β2 receptor, yet resulted in no changes for DMPP, a decrease for nicotine, and an increase for ACh at the α3β4 receptor. The most dramatic changes in the receptor's functional properties were produced by substitutions that introduced the largest changes in amino acid volume. Additional replacements (Gly, Thr, and Val) suggested an inverse correlation between amino acid volume at position α3L8′ and EC50 for α3β4 nAChRs; however, α3β2 nAChRs displayed a nonlinear correlation. These data demonstrate that structural alterations at position α3L8′ could propagate to the agonist‐binding site. © 2008 Wiley‐Liss, Inc.


Abstract In 1996-97 the author interviewed 73 civic leaders in Hamilton, Ontario, Canada, on their attitudes toward gay rights. Twelve respondents opposed gay rights, 40 were moderately favorable to gay rights, and 21 were strongly favorable. Almost all favored basic equality rights (education, housing, employment), and only 10 said they had difficulty with gay sexuality. Twenty-seven volunteered a concern with gay "flaunting," but this did not mean that they necessarily opposed gay rights. Respondents had the most difficulty accepting the rights of gays to marry and to adopt children, although almost all of those who opposed gay marriages agreed with the idea of a legal domestic partnership. Most agreed that children should be taught about homosexuality in schools. These 73 civic leaders reflect the rapidly changing attitudes to gay rights in Canada as a whole. Their more favorable attitudes were often a consequence of learning that someone close to them was gay or lesbian. They also responded to changes in religious teaching. Most respondents, including recent immigrants, were influenced by the dominant Canadian values of equality, respect for privacy, and respect for diversity. In general, the process these civic leaders were undergoing was one of humanizing gays, no longer thinking of them as the Other. In their view, human rights for gays did not mean mere formal equality, but rather concern and respect for gays.


Measurements of galaxy cluster abundances, clustering properties, and mass-to-light ratios in current and future surveys can provide important cosmological constraints. Digital wide-field imaging surveys, the recently demonstrated fidelity of red-sequence cluster detection techniques, and a new generation of realistic mock galaxy surveys provide the means for construction of large, cosmologically interesting cluster samples, whose selection and properties can be understood in unprecedented depth. Here we present the details of the "maxBCG" algorithm, a cluster detection technique tailored to multiband CCD imaging data. MaxBCG primarily relies on an observational cornerstone of massive galaxy clusters: they are marked by an overdensity of bright, uniformly red galaxies. This detection scheme also exploits classical brightest cluster galaxies (BCGs), which are often found at the centers of these same massive clusters. We study the algorithm through its performance on large, realistic, mock galaxy catalogs, which reveal that it is over 90% pure for clusters at 0.1 < z < 0.3 with 10 or more red galaxies, and over 90% complete for halos at 0.1 < z < 0.3 with masses above 2 × 1014 h-1 M☉. MaxBCG is able to approximately recover the underlying halo abundance function and assign cluster richnesses strongly coupled to the underlying halo properties. The same tests indicate that maxBCG rarely fragments halos, occasionally overmerges line-of-sight neighboring (≃10 h-1 Mpc) halos, and overestimates the intrinsic halo red-sequence galaxy population by no more than 20%. The study concludes with a discussion of considerations for cosmological measurements with such catalogs, including modeling the selection function, the role of photometric errors, the possible cosmological dependence of richness measurements, and fair cluster selection across broad redshift ranges employing multiple bandpasses.


Manuscript Type. Empirical. Research Question/Issue. Past empirical efforts in corporate governance have examined the effects of large shareholders with excess control rights on tunneling activities. However, no study has systematically investigated the effects of multiple large shareholders on excess leverage policies and tunneling in an emerging country environment where minority rights protection is weak. In this study, we examine the role of multiple large shareholders and the effects of control contestability of multiple large shareholders on firm excess leverage decision and tunneling by controlling shareholders. Research Findings/Insights. Using a sample of 2,341 Chinese firms for the years 2001 to 2013, we document that the contestability of multiple non‐controlling large shareholders relative to controlling shareholders reduces the adoption of excess leverage policies, tunneling and enhances capital investment. Another intriguing finding is that the government, as a controlling shareholder, exerts significant influence and reduces the monitoring effectiveness of multiple larger shareholders. Theoretical/Academic Implications. By addressing the role of multiple large shareholders on excess leverage decisions, this study makes an important contribution to the corporate governance literature. We extend the recent developments in agency theory regarding the role of multiple large shareholders in constraining expropriation of controlling shareholders with excess control rights and their effect on firm leverage decisions. Our results support the theoretical models which indicate that the presence of multiple large shareholders is an important and efficient internal governance mechanism that mitigates a firm's agency costs, particularly, in an emerging market environment where corporate governance is weak and inadequate to curb the tunneling problem.


Lyme disease is a multisystemic disease, of subacute and chronic course, caused by the bacterium Borrelia burgdorferi. In addition to a thorough patient examination and laboratory analyses, it is first of all necessary to take good epidemiological survey to set the correct diagnosis. This paper presents a patient and the data used in the medical records (medical records, specialist reports). The patient A.M. aged 8 in July 2010 came to see the doctor of the Children's Clinic in Knjaževac with the clinical findings of erythema on the forehead of about 20 cm in diameter. A part of the circular erythematous change spread to 1.5 cm above the eyebrows and the second part of the change was over the hairy part of the head. The change was at the level of the skin, it did not cause itching or general infectious symptoms. The doctor in Knjaževac prescribed corticosteroid ointment. The erythema and erythematous changes migrated down to the level of eyebrows after two weeks. After being reviewed by specialist dermatovenerologists in Zajecar and Nis the patient underwent serological analysis Biomedica ELISA (Enzyme-linked immunosorbent assay). Antibodies class IgG and IgM were positive for Borrelia burgdorferi. Morbus Lyme was diagnosed in early August 2010. The epidemiologist in the Health Centre Knjaževac agreed with the diagnosis on the basis of epidemiological, clinical and serological findings. The patient was treated with antibiotics for 21 days: amoxicillin syrup with clavulonic acid. After the therapy, the patient was proposed to continue monitoring the movement of antibodies to Borrelia burgdorferi. It is important to promptly recognize the disease incubation period of 3-30 days when the symptoms appear (based on clinical and epidemiological surveys) and to begin timely treatment (immediately after epidemiological surveys and clinical findings of migrated erythema). The choice of antibiotics, method of administration and length of treatment depend on the form or the stage of the disease. But if there is evidence about a tick bite and after the tick bite there occurs erythema that fits the description of erythema migrans, with or without general infectious symptoms, the treatment should begin without waiting for serological results. Laboratory analysis, as a confirmation of the disease, can be done later, but the treatment with the appropriate dose and for a sufficiently long time should start immediately!.


India accounted for 30 percent or more of World GDP a little over a thousand years ago, a level no other country has attained anytime in history. Then came China's rise, and the pillages and plunders of invaders who literally raided India. The European colonizers came soon thereafter, continuing the loot of India more systematically. Today China has made up for lost growth and has emerged as the second largest economy in the world. India, under a democratic political framework with some devious and corrupt political actors, is struggling to make progress. The last five years has witnessed much nationalistic fervor and generated new hopes of capturing the ancient and historic economic aura and governance, and making more swift progress plausible despite COVID-19. This SWOT analysis, lists and discusses factors that encourage entertaining hopes of rapid growth. It also highlights constraints shackling even modest progress. Inspiring leadership can help realize the inner economic tiger that could enable a 10-12% annual growth for at least next ten years.


Large Ruminants in Tropical Environment, they are buffaloes and cattle. In Thailand, as an area of hot climate and high humidity, the animals were subjected to adapt themselves not only temperature but even more harder in adaptation to humidity. Environment interaction among the nutrition plants and biological responses on temperature and humidity contributed greatly to depress the genetic expression. Production of large ruminant is, therefore, in tropical environment mainly focused on reproduction and health care. Natural selection was resulted in well performance but low reproductive rate. According to author's career as a chemist and biochemist she has been much concentrating on biological regulation for enhancing fertility and growth with co-incidentally better health care. The three aspects of achievement of fertility, growth and health within one injection may be called "Three in One that is Mato-Matid technology" However, Mato-Matid technology did provide a great deal of prime biological responses positively to several reproductive technologies in which some of them may be regarded as artificial breeding like IVM/IVF/IVC/ET/ Cloning. an effect of MATO triggering on enchancing growth, reproduction and diseases resistance, by cytokine mediated through the whole systematic immune cells, endocrine and neuroresponses.