Introduction: Since its clinical
introduction, extracorporeal shock wave lithotripsy (ESWL) has maintained an important role in the management of urinary
calculi. The success of ESWL depends on the effective disintegration and evacuation of stone debris. The stone clearance
rate differs for renal calculi at different sites, being the lowest for lower pole calyceal calculi. The low clearance rate for lower
calyceal stones is more a problem of debris retention rather than stone fragmentation. The aim of this study is to find out
the prevalence of stone clearance after ESWL for lower calyceal stones and relationship between the radiologic anatomy of the
lower pole calyx (as seen on pre-operative IVU) and stone clearance. Study design: A retrospective analysis of patients with
lower calyceal stones of 2cm or less in diameter which were treated with ESWL in HTAA from 2008 to 2011. The stone location
and size were determined on plain abdominal radiograph. Radiographic anatomical factors were determined on pre-ESWL
IVU, which were infundibulopelvic angle (IPA), infundibular length (IL) and width (IW). Patients were treated with ESWL
using LT02X lithotripter machine, under intravenous or intramuscular analgesia. A stone-free status was defined as no evidence
of fragments on plain radiograph 3 months after ESWL. All statistical analyses were performed with SPSS version 18.0.1 for
Windows. Result Total of 14 patients that fulfill the criteria were included in the study; 10 (71.4%) patients were male and
2 (28.6%) patients were female. Majority of patients were Malays (85.7%). Age ranges from 20-70 years, but most of the
patients were more than 40 years of age. Most of the patients have stone size of 1-2cm in sizes (85.7%), but the stone laterality
was equal. For anatomical factors of the lower pole calyx, most of the patients showed wide infundibular pelvic angle (IPA),
in which 64.3% had more than 40 degrees of angle. Majority had short infundibular length (IL), which was less than 30mm
(85.7%). The infundibular width (IW) was also wide in most of the patients, as 92.9% had IW of more than 4mm. Stone
clearance after ESWL was 71.4%. When measuring the predictors of outcome of stone clearance using Fishers exact test, there
was no statistically significant in
uence for all the anatomical factors tested. Conclusion It is important to assess the possible
factors that can predict the probability of stone clearance after ESWL, as the most appropriate treatment modality for lower
calyceal stones can accordingly be planned. However, statistically significant sample size cannot be achieved in this study due to
multiple unavoidable circumstances. Longer duration of study with larger sample size should be carried out for more complete
data review and accurate results.


General Electric, in conjunction with the US Department of Energy, has undertaken the design, manufacture and testing of a 100 MVA class high temperature superconducting (HTS) generator. The HTS rotor will be suitable for use in new generators as well as a retrofit product for existing generators. This paper discusses key areas of design and testing of the generator as first steps in the development of HTS synchronous generators


Abstract This study analyses organized crime from an economic perspective and highlights the crucial role of extortion in mafia activities. From an economic viewpoint, we debate the conditions that lead companies to resist mafia extortion. To study the reactions of firms to extortion, we adopt an institutional perspective and consider the contribution of different theories in the socially responsible behaviour and organized crime literature, in an attempt to understand this complex entrepreneurial behaviour better. A sample of 116 southern Italian SMEs, whose entrepreneurs have publicly opposed mafia extortion, was selected. By adopting a matched-pair design, anti-mafia firms were subsequently matched against a control sample. Determinants of anti-mafia behaviour were investigated by using both unconditional and conditional logistic regression models, in order to regress the anti-mafia choice on a set of economic, demographic, governance, and control variables. The results show that both financial and governance variables are significant determinants of anti-mafia entrepreneurial behaviour (AEB), whereas demographic variables are not relevant.


The low-frequency instabilities in the interaction between an ion beam and a magnetoactive plasma are investigated taking into account the effects of the dissipation and thermal motion of the charged particles. Furthermore, the effects of magnetic field strength, ion beam velocity, and propagation angle on the resonance frequency and the growth rate of the instabilities are studied. It is shown that, according to the strength of the magnetic field and the ion beam velocity, the increase of the thermal velocity of the charged particles can increase or decrease the resonance frequency in the ion acoustic frequency range.


The following case report describes a patient who suffered an anterior maxillary alveolar ridge fracture resulting from difficult laryngoscopy and intubation. An unfortunate sequelae of this injury was the loss of two maxillary central incisors due to persistent mobility despite long term dental stabilization. To the authors' knowledge, fractures involving the premaxilla have not been reported as a complication of laryngoscopy and intubation.


There is a large body of literature that studies the impact of transportation investment on the economy, mainly in the mid to long term. However, there is a potential to track the performance of the economy, to increase understanding of the short-term relationships among different sectors of the economy, and to forecast the performance of the economy--particularly its business cycles--through the effective use of monthly transportation-related indicators in addition to other traditionally used economic indicators. Some traffic data, such as vehicle volumes and vehicle miles traveled, can now be measured quite accurately and almost in real time using emerging technologies such as Automatic Vehicle Identification (AVI) and Geographic Positioning Systems (GPS). Until now freight movements were not included among these economic indicators. Preliminary work suggests that a freight indicator when used with other economic indicators could produce a better understanding of the current and future course of the economy. The movement of a freight index over time can be compared with other economic measures to understand the relationship of transportation to changes in the regional economy. To the extent that an indicator is a leading indicator it foreshadows changes in GDP—that is, when it goes up, GDP tends to go up some time later; when it goes down, GDP tends to eventually drop. Leading indicators are especially useful in forecasting turning points in the economy, and are therefore of particular interest for short-term economic decision-making. The main purpose of this project is to investigate the relationship between truck movements and the economic performance of New Jersey, thereby, to test whether truck movements on the I-95 Corridor (NJ Turnpike) are a leading indicator of changes in the performance of the New Jersey economy. The models produced in this study are promising in terms of developing a useful prediction methodology for the economic activity in New Jersey. This study showed that truck data collected by NJTA can be used for various important objectives such as the one studied in this project. The results of this study may also be used to inform the NJ state forecasting model (R/ECON) maintained at Rutger's Center for Urban Policy Research. However, more research and development are needed to further operationalize the models proposed in this study.


Museums in China have undergone tremendous transformations since they first appeared in the country in the late nineteenth century. Futuristic, state-of-the-art museums have today become symbols of China's global cultural, economic and technological prominence, and over the last two decades, the number of Chinese museums has increased at an unprecedented rate, with China set to become the country with the highest number of museums in the world. But why have museums become so important? This book, based on extensive research in a number of the museums themselves, examines recent changes in their display methods, narratives, actors and architectural style. It also considers their representations of Chinese national identity, millenarian history and extraordinary cultural diversity. Through an analysis of the changes affecting not only what we observe through museums, but also the very medium of observation (i.e. museums themselves), this book provides a unique, original and timely exploration of the ongoing changes affecting Chinese society, and an evaluation of their consequences. Dr Marzia Varutti is a post-doctoral fellow at the Centre for Museum Studies, Department of Culture Studies and Oriental Languages, University of Oslo.


Twenty-two patients undergoing penetrating keratoplasty received either topical fortified gentamicin (13.6 mg/mL) or a loading dose of intramuscular gentamicin before surgery. Cornea and aqueous humor samples were obtained and assayed by radioimmunoassay for gentamicin. In the topical group, the average gentamicin levels in the cornea and aqueous were 16.2 micrograms/g and 0.3 microgram/mL, respectively. Parenteral drug levels were less variable and averaged 6.1 micrograms/g in the cornea and 0.4 microgram/mL in the aqueous. Although this study demonstrates that parenteral therapy can be used to deliver adequate drug levels to the cornea, it requires far more antibiotic and subjects the patient to potentially toxic systemic side effects. Therefore, topical administration is the preferred route of delivery of antibiotic to the cornea.


In this article we examine the relationship between soccer culture and the vernacular region of Cascadia. Specifically, we consider how supporters of the Portland Timbers, Seattle Sounders and Vancouver Whitecaps mobilize the bioregional narrative of Cascadia. This Cascadian narrative helps to solidify supporter culture and identity by fostering a connection between supporters and place. As a result, soccer has also become one conduit through which ideas about Cascadia are constructed, experienced and communicated. In this way, ideas about Cascadia help to construct regional and local soccer cultures in Portland, Seattle and Vancouver and in turn, those soccer cultures help to construct and promote Cascadia. We examine three aspects of this situation: the formation of the Cascadia Football Federation, the Cascadia Cup Controversy and the use of Cascadian iconography by supporters of the aforementioned clubs.


"Reason" and "Rationality" have been the most controversial subjects in human thinking. Question of reason is faced not only with questions about the capacity of reason to discover truth, the possibility of choice, and the decisive role of reason in epistemology, but also it deals with questions about thought, freedom, and the nature of thought. Reason is a common point among all human beings; therefore, there is no difference between people in the amount of intellect, but the differences are due to the dominant epistemological paradigm in each period and the impact of historical, social and cultural conditions on the interpreting of that paradigm of intellect. In the last few centuries, the concept of reason and rationality has encountered major challenges. Western epistemological approaches such as post structuralism and methodological approaches such as genealogy, seek to find gaps of this concept in the historical process. On the other hand, the concept of reason in Islamic thought and its relationship with religion has always been controversial. Some contemporary Muslim thinkers, by giving originality to reason and respecting Western modernity, have a critical approach to traditional society and the way to achieve an ideal society with new outlook such as pluralism, critical religious rationality and democracy in a religious society based on rationality. Some other Muslim thinkers, by proposing views such as the theory of rationality and spirituality, go beyond the modernist approach to religion, seeking a way to avoid religious intellectual contradictions. This article tries to examine both Western and Islamic perspectives on reason and rationality.


We discuss a strategy to study non-perturbatively QCD up to very high temperatures by Monte Carlo simulations on the lattice. It allows not only the thermodynamic properties of the theory but also other interesting thermal features to be investigated. As a first concrete application, we compute the flavour non-singlet mesonic screening masses and we present the results of Monte Carlo simulations at 12 temperatures covering the range from T $\sim$ 1 GeV up to $\sim$ 160 GeV in the theory with three massless quarks. On the one side, chiral symmetry restoration manifests itself in our results through the degeneracy of the vector and the axial vector channels and of the scalar and the pseudoscalar ones, and, on the other side, we observe a clear splitting between the vector and the pseudoscalar screening masses up to the highest investigated temperature. A comparison with the high-temperature effective theory shows that the known one-loop order in the perturbative expansion does not provide a satisfactory description of the non-perturbative data up to the highest temperature considered.


Sand dams can be an effective community-scale solution to increasing water supplies in some arid and semi-arid regions, but there are few studies that have investigated water quality at sand dams. This study investigated the levels of coliform bacteria and salt content as parameters of potential concern. Most water taken from sand dam sources had fecal coliforms present. Median fecal coliforms were in the range of 150-800 cfu/100 ml for unprotected sources (scoop holes, surface water or hand dug wells), levels which are considered high or very high health risk. Pump wells had less contamination, with fecal coliforms detected in one-third of samples in the dry season. Despite this contamination, user surveys indicated that 74% of communities generally view water as clean for drinking, and 72% reported that no or few people in their community treat their water. Salt content in the dry season was in the poor or unacceptable range (above 900 ppm as total dissolved solids) in 33% of water samples. Results suggest that fecal coliforms and salt content represent two types of challenges to water quality at sand dams: fecal coliforms are a health hazard, whereas high salt content potentially reduces the amount of usable water that is available.


There is a lack of research concerning the connection between HIV-related sexual risk behaviors (SRBs) and the psychological characteristics of middle-aged male migrants in China. This study was aimed at describing how psychological characteristics affected the SRBs of migrant men in two Chinese cities. A cross-sectional survey in Hangzhou and Guangzhou was used to collect sociodemographic and psychological data from male migrants over 3 age groups: 20-29 (Group I), 30-39 (Group II), and 40-59 years (Group III). The mean incidence of the participants' extramarital sex was higher in Group I than Group III, while the mean Hedonism Seeking Scale (Yang et al., 2006) score was higher in Group III than Group I. Results suggest that poor health status, higher stress levels and higher hedonism seeking increase sexual risk taking in middle-aged male migrants, while the longer the duration of living in an urban area and living with a partner reduce such behaviors in all groups.


This paper draws attention to the specific post-civil-war situation in agriculture and the food sector in Bosnia and Herzegovina (B&H). These developments are presented in an association with the overall situation in the country. Due to economic and non-economic reasons, B&H faces a general problem of a lack of international competitiveness. In a current situation, there are rare products to be internationally competitive and the country relies on imports of food and other products. During the post-civil-war emergency and reconstruction stage, the bulk of food and agricultural inputs, were donated or granted by different governments, humanitarian organizations, and donors to mitigate the effects of widespread poverty caused by the war destructions and economic declines. During a development stage, recovery in the agricultural sector is burdened by the considerable lack of international competitiveness in food processing and marketing as well as by several sectors, institutional, and general economic problems. The rate of unemployment in B&H is high, and agricultural households are the important units providing food security for rural populations and relatives living in towns. Nevertheless, around half of agricultural land resources are unutilised, and even more striking is the "illegally occupied" agricultural land, which is one of the most significant in the structure of land leasing arrangements.


This paper attempts to reconcile the need for flexibility in fiscal policy, with the need for credibility and consistency in monetary policies. The idea is to generate fewer conflicts between policies but greater discipline within them. We assume an independent central bank and restraints on the use of national fiscal policies. Using a theoretical model, we examine the consequences of assigning leadership to fiscal or monetary policies to exploit the implicit (rule based) coordination available under standard transmission mechanisms, but where priorities and targets differ between policy makers. This works best with fiscal leadership: we introduce a debt rule (with hard or soft targets) to precommit fiscal policies over the longer term, but use monetary independence to guarantee credibility and discipline in the short run stabilization policies. Compared to the uncoordinated solution now operating in Europe, inflation biases are lower and debt repayments higher for no loss in output volatility. That corresponds to the experience of the UK, our benchmark case, whose empirical reaction functions show fiscal leadership. Across ten OECD countries, these gains are estimated to be worth 2%-4% of GDP.


A Thesis Submitted to the Department of Electrical Engineering, Ahmadu Bello University, Zaria, in Partial fulfillment of the requirements for the Award of Master of Science (M.Sc.) Degree in Electrical Engineering


Nef is a 27 kDa myristylated phosphoprotein expressed early in infection by HIV. The N terminus of Nef is thought to play a vital role in the functions of this protein through its interactions with membrane structures. The solution structure of a 25-residue polypeptide corresponding to the N terminus of Nef (Nef1-25) has been investigated by 1H NMR spectroscopy. In aqueous solution at pH 4.8 and 281 K, this peptide underwent conformational averaging, with Pro13 existing in cis and trans conformations in nearly equal proportions. In methanol solution, however, the peptide adopted a well-defined alpha-helical structure from residues 6 to 22, with the N- and C-terminal regions having a less ordered structure. On the basis of a comparison of chemical shifts and NOEs, it appeared that this helical structure was maintained in aqueous trifluoroethanol (50% v/v) and to a lesser extent in a solution of SDS micelles. When the N-acetyl group was replaced by either an N-myristyl or a free ammonium group, there was little effect on the three-dimensional structure of the peptide in methanol; deamidation of the C terminus also had no effect on the structure in methanol. In water, the myristylated peptide aggregated. The similarity between the sequences of Nef1-25 and melittin is reflected in the similar structures of the two molecules, although the N-terminal helix of melittin is more defined. This similarity in structure raises the possibility that Nef1-25 not only interacts with membranes but also may be capable of disrupting them and causing cell lysis. This type of interaction could contribute at least in part to the killing of bystander cells in lymphoid tissues during HIV infection.


Accurate and reliable prediction of relative humidity is of great importance in all fields concerning global climate change. The current study has employed Multivariate Adaptive Regression Spline (MARS) and M5 Tree (M5T) models to predict the relative humidity in the Hunza River basin, Pakistan. Both the models provided the best prediction for the input scenario S6 (RHt-1, RHt-2, RHt-3, Tt-1, Tt-2, Tt-3). The statistical analysis displayed that the MARS model provided a better prediction of relative humidity as compared to M5T at all meteorological stations, especially, at Ziarat followed by Khunjerab and Naltar. The values of root mean square error (RMSE), mean absolute error (MAE), and coefficient of determination (R2) were (5.98%, 5.43%, and 0.808) for Khunjerab; (6.58%, 5.08%, and 0.806) for Naltar; and (5.86%, 4.97%, 0.815) for Ziarat during the testing of MARS model whereas, the values were (6.14%, 5.56%, and 0.772) for Khunjerab; (6.19%, 5.58% and 0.762) for Naltar and (6.08%, 5.46%, 0.783) for Ziarat during the testing of M5T model. Both the models performed slightly better in training as compared to the testing stage. The current study encourages future research to be conducted at high altitude basins for the prediction of other meteorological variables using machine learning tools.


Prerigor lean and adipose beef carcass tissues were artificially inoculated individually with stationary-phase cultures of five nonpathogenic Escherichia coli cultures that had been previously identified as surrogates for E. coli O157:H7 or a mixture of five Salmonella strains in a fecal inoculum. Each tissue sample was processed with microbial interventions comparable with those used in the meat industry. The log reductions of the E. coli isolates were generally not statistically different from the salmonellae inoculum within a specific treatment. Inoculation experiments were also conducted with ground beef stored at either 4 or -20 degrees C. When compared with the Salmonella inoculum, at least three of the five E. coli strains survived in a manner that was not statistically different from the salmonellae. The E. coli strains and the Salmonella mixed culture were also inoculated into summer sausage batter, and the population enumerated both before and after fermentation. Four of the E. coli strains showed a lower population reduction (higher survival) than the Salmonella mixed culture. The five nonpathogenic E. coli strains may be used as individually or collectively for specific process validation indicators for Salmonella.


A method of localizing unknown acoustic sources using data derived replicas from ships of opportunity has been reported previously by Verlinden, Sarkar, Hodgkiss, Kuperman, and Sabra [J. Acoust. Soc. Am, 138(1), EL54-EL59 (2015)]. The method is similar to traditional matched field processing, but differs in that data-derived measured replicas are used in place of modeled replicas and, in order to account for differing source spectra between library and target vessels, cross-correlation functions are compared instead of comparing acoustic signals directly. The method is capable of localizing sources in positions where data derived replicas are available, such as locations previously transited by ships tracked using the Automatic Identification System, but is limited by the sparsity of ships of opportunity. This paper presents an extension of this localization method to regions where data derived replicas are not available by extrapolating the measured cross-correlation function replicas onto a larger search grid using waveguide invariant theory. This new augmentation provides a method for continuous tracking.


Importance
Cryptogenic strokes constitute approximately 40% of ischemic strokes in young adults, and most meet criteria for the embolic stroke of undetermined source (ESUS). Two randomized clinical trials, NAVIGATE ESUS and RESPECT ESUS, showed a high rate of stroke recurrence in older adults with ESUS but the prognosis and prognostic factors among younger individuals with ESUS is uncertain.

Objective
To determine rates of and factors associated with recurrent ischemic stroke and death and new-onset atrial fibrillation (AF) among young adults.

Design, Setting, and Participants
This multicenter longitudinal cohort study with enrollment from October 2017 to October 2019 and a mean follow-up period of 12 months ending in October 2020 included 41 stroke research centers in 13 countries. Consecutive patients 50 years and younger with a diagnosis of ESUS were included. Of 576 screened, 535 participants were enrolled after 1 withdrew consent, 41 were found to be ineligible, and 2 were excluded for other reasons. The final follow-up visit was completed by 520 patients.

Main Outcomes and Measures
Recurrent ischemic stroke and/or death, recurrent ischemic stroke, and prevalence of patent foramen ovale (PFO).

Results
The mean (SD) age of participants was 40.4 (7.3) years, and 297 (56%) participants were male. The most frequent vascular risk factors were tobacco use (240 patients [45%]), hypertension (118 patients [22%]), and dyslipidemia (109 patients [20%]). PFO was detected in 177 participants (50%) who had transthoracic echocardiograms with bubble studies. Following initial ESUS, 468 participants (88%) were receiving antiplatelet therapy, and 52 (10%) received anticoagulation. The recurrent ischemic stroke and death rate was 2.19 per 100 patient-years, and the ischemic stroke recurrence rate was 1.9 per 100 patient-years. Of the recurrent strokes, 9 (64%) were ESUS, 2 (14%) were cardioembolic, and 3 (21%) were of other determined cause. AF was detected in 15 participants (2.8%; 95% CI, 1.6-4.6). In multivariate analysis, the following were associated with recurrent ischemic stroke: history of stroke or transient ischemic attack (hazard ratio, 5.3; 95% CI, 1.8-15), presence of diabetes (hazard ratio, 4.4; 95% CI, 1.5-13), and history of coronary artery disease (hazard ratio, 10; 95% CI, 4.8-22).

Conclusions and Relevance
In this large cohort of young adult patients with ESUS, there was a relatively low rate of subsequent ischemic stroke and a low frequency of new-onset AF. Most recurrent strokes also met the criteria for ESUS, suggesting the need for future studies to improve our understanding of the underlying stroke mechanism in this population.


Relaxin is a small heterodimeric peptide hormone of the insulin/relaxin superfamily produced mainly in female and male reproductive organs. It has potent antifibrotic, vasodilatory and angiogenic effects and regulates the normal function of various physiological systems. Preclinical studies and recent clinical trials have shown the promise of recombinant relaxin as a therapeutic agent in the treatment of cardiovascular and fibrotic diseases. However, there are the universal drawbacks of peptide‐based pharmacology that apply to relaxin: a short half‐life in vivo requires its continuous delivery, and there are high costs of production, storage and treatment, as well as the possibility of immune responses. All these issues can be resolved by the development of low non‐peptide MW agonists of the relaxin receptors which are stable, bioavailable, easily synthesized and specific. In this review, we describe the discovery and characterization of the first series of such compounds. The lead compound, ML290, binds to an allosteric site of the relaxin GPCR, RXFP1. ML290 shows high activity and efficacy, measured by cAMP response, in cells expressing endogenous or transfected RXFP1. Relaxin‐like effects of ML290 were shown in various functional cellular assays in vitro. ML290 has excellent absorption, distribution, metabolism and excretion properties and in vivo stability. The identified series of low MW agonists does not activate rodent RXFP1 receptors and thus, the production of a RXFP1 humanized mouse model is needed for preclinical studies. The future analysis and clinical perspectives of relaxin receptor agonists are discussed.


Bayesian experimental design (BED) is to answer the question that how to choose designs that maximize the information gathering. For implicit models, where the likelihood is intractable but sampling is possible, conventional BED methods have difficulties in efficiently estimating the posterior distribution and maximizing the mutual information (MI) between data and parameters. Recent work proposed the use of gradient ascent to maximize a lower bound on MI to deal with these issues. However, the approach requires a sampling path to compute the pathwise gradient of the MI lower bound with respect to the design variables, and such a pathwise gradient is usually inaccessible for implicit models. In this paper, we propose a novel approach that leverages recent advances in stochastic approximate gradient ascent incorporated with a smoothed variational MI estimator for efficient and robust BED. Without the necessity of pathwise gradients, our approach allows the design process to be achieved through a unified procedure with an approximate gradient for implicit models. Several experiments show that our approach outperforms baseline methods, and significantly improves the scalability of BED in high-dimensional problems.


The article deals with the issue of dialogical communication in Oroonoko, or The History of the Royal Slave (1688) by Aphra Behn. The theoretical basis for the article is M. Bakhtin's concept of the dialogue and R. Sell's idea of dialogicality in literature. The topical questions of race, nationality and religion are discussed in relation to seventeenth-century England. After a brief overview of the representation of the nations other than English in Aphra Behn's plays, including her contribution to the prejudices against the Dutch, the main attention is paid to her novel Oroonoko, where a set of binary oppositions of Black and White, Christian and Heathen can be found. The prejudices towards Blacks in English culture are revealed, above all, the association of the black skin with vice, monstrosity and sexuality. Behn's subversion of traditional oppositions of civility and barbarity in relation to England and English colonies and Africa is made explicit using the example of Oroonoko, the hero of the novel, who conforms to all the standards of beauty and good education. The problem of family honour traditionally associated with the East is raised in the analysis of the first part of the novel. Oroonoko's attempt to have a dialogue with White people is traced throughout the novel: first he tries to communicate with the treacherous English captain, then with local authorities in Surinam. The failure of this dialogue is attributed to the absence of common moral values and the refusal on the side of the Whites to treat a Black as a human being equal to them. The end of the dialogue means the end for the hero, who becomes concentrated only on revenge and death. An optimistic possibility of a dialogue between people of different races, nations and religion can be found in the episode of a meeting of three nations – Whites, Blacks and South American Indians. Despite their differences, all the participants of this meeting share common moral values. Behn's attitude to woman's position in Oriental and Christian societies is also discussed in brief, as well as Oroonoko's anti-Christian opinions stimulated by the hypocrisy of the Christian people. The conclusion is drawn that the dialogicality we see in Oroonoko is very important nowadays.


We have developed URDME, a general software for simulation of stochastic reaction-diffusion processes on unstructured meshes. This allows for a more flexible handling of complicated geometries and curved boundaries compared to simulations on structured, Cartesian meshes. The underlying algorithm is the next subvolume method (NSM), extended to unstructured meshes by obtaining diffusion jump coefficients from the finite element formulation of the corresponding macroscopic equation. In this manual, we describe how to use the software together with Comsol Multiphysics 3.4 and Matlab to set up simulations. We provide a detailed account of the code structure and of the available interfaces. This makes modifications and extensions of the code possible. We also give two detailed examples, in which we describe the process of simulating and visualizing two models from the systems biology literature in a step-by-step manner.


Thermal Generation and Reactions of (Benzylthio)-and (Arylthio)-Substituted Nitrile Ylides

Thermolysis of 4-(benzylthio)- and 4-(arylthio)-1,3-oxazol-5(2H)-ones 6, at 110–155° in the presence of dipolarophiles with activated C≡C, CC, CO, CS, and NN bonds, led to 5-membered cyclo-adducts and CO2 (cf. Schemes 3, 5-7). Heating 6a and 6c in the presence of ethyl propiolate yielded ethyl quinoline-3-carboxylate (19) and ethyl pyridine-3-carboxylate(22), respectively (cf. Scheme 8). These results are rationalized on the basis of the intermediate formation of thio-substituted nitrile ylides of type 7 (cf. Scheme 2), which undergo regioselective 1,3-dipolar cycloadditions with reactive dipolarophiles. In the absence of such a dipolarophile, the nitrile ylides isomerize via a [1,4]-H shift to give 2-aza-1,3-butadienes of type 20. The latter are trapped in a Diels-Alder reaction with ethyl propiolate (cf. Scheme 8).


: A total of 83 patients with psoriasis were examined; of these, 53 individuals had disseminated forms of psoriasis (group 1), 30--generalized or global psoriatic erythroderma (group II). Studied in the peripheral blood were activity of interleukins--1 and 2 (IL-1 and 2), concentration of plasmic fibronektin and relative count of lymphocytes expressing receptors to urokinase. There have been revealed in group I patients moderate increase in IL-1 activity, apparent lowering of IL-2, reduction in concentration of plasmic fibronektin, decrease in relative count of lymphocytes expressing receptors to urokinase in both clinical groups. Negative correlation was established between the latter two parameters, which was the greatest in patients with psoriatic erythrodermia.


Regression testing is a form of software quality assurance (QA) that involves comparing the behavior of a newer version of a software artifact to its earlier correct behavior, and signaling the QA engineer when deviations are detected. Given the large potential in automated generation and execution of regression test cases for business process models in the context of running systems, powerful tools are required to make this practically feasible, more specifically to limit the potential impact on production systems, and to reduce the manual effort required from QA engineers. In this paper, we present a regression testing automation framework that implements the capture & replay paradigm in the context of BPMN 2.0, a domain-specific language for modeling and executing business processes. The framework employs parallelization techniques and efficient communication patterns to reduce the performance overhead of capturing. Based on inputs from the QA engineer, it manipulates the BPMN2 model before executing tests for isolating the latter from external dependencies (e.g. human actors or expensive web services) and for avoiding undesired side-effects. Finally, it performs a regression detection algorithm and reports the results to the QA engineer. We have implemented our framework on top of a BPMN2-compliant execution engine, namely jBPM, and performed functional validations and evaluations of its performance and fault-tolerance. The results, indicating 3.9% average capturing performance overhead, demonstrate that the implemented framework can be the foundation of a practical regression testing tool for BPMN 2.0, and a key enabler for continuous delivery of business process-driven applications and services.


This article is the final document of the late Reinhold Grimm's intense and fruitful engagement within the field of literary translation. Grimm takes on the particularly difficult task of translating expressionist poems by August Stramm. Since simplistic attempts such as 'literal' or paraphrastic translations necessarily fail, Grimm transfers the structural principle of the source texts to the target texts. In analogy with the arts he names this principle cubist, thus trying to master a double task, i.e., to translate a German verbal rendering of cubism into English. The results of this endeavor are twofold: in addition to challenging translations of four challenging poems by August Stramm, Grimm offers critical reflections on every single decision that was made during the process of translation, thus providing the reader with transparent translations of opaque texts. (HA; in German)


Abstract Objectives To analytically evaluate Ortho Clinical Diagnostics VITROS high-sensitivity cardiac troponin I (hs-cTnI) assay in specific matrices with comparison to other hs-cTn assays. Methods The limit of detection (LoD), imprecision, interference and stability testing for both serum and lithium heparin (Li-Hep) plasma for the VITROS hs-cTnI assay was determined. We performed Passing-Bablok regression analyses between sample types for the VITROS hs-cTnI assay and compared them to the Abbott ARCHITECT, Beckman Access and the Siemens ADVIA Centaur hs-cTnI assays. We also performed Receiver-operating characteristic curve analyses with the area under the curve (AUC) determined in an emergency department (ED)-study population (n=131) for myocardial infarction (MI). Results The VITROS hs-cTnI LoD was 0.73 ng/L (serum) and 1.4 ng/L (Li-Hep). Stability up to five freeze-thaws was observed for the Ortho hs-cTnI assay, with the analyte stability at room temperature in serum superior to Li-Hep with gross hemolysis also affecting Li-Hep plasma hs-cTnI results. Comparison of Li-Hep to serum concentrations (n=202), yielded proportionally lower concentrations in plasma with the VITROS hs-cTnI assay (slope=0.85; 95% confidence interval [CI]:0.83–0.88). In serum, the VITROS hs-cTnI concentrations were proportionally lower compared to other hs-cTnI assays, with similar slopes observed between assays in samples frozen <−70 °C for 17 years (ED-study) or in 2020. In the ED-study, the VITROS hs-cTnI assay had an AUC of 0.974 (95%CI:0.929–0.994) for MI, similar to the AUCs of other hs-cTn assays. Conclusions Lack of standardization of hs-cTnI assays across manufacturers is evident. The VITROS hs-cTnI assay yields lower concentrations compared to other hs-cTnI assays. Important differences exist between Li-Hep plasma and serum, with evidence of stability and excellent clinical performance comparable to other hs-cTn assays.


BACKGROUND
 Patients with obstructive sleep apnea (OSA) are at a higher risk for atrial fibrillation (AF). Consumer wearable heart rate (HR) sensors may be a means for passive HR monitoring in patients with AF.

 OBJECTIVE
 The aim of this study was to assess the Apple Watch's agreement with telemetry in measuring HR in patients with OSA in AF.

 METHODS
 Patients with OSA in AF were prospectively recruited prior to cardioversion/ablation procedures. HR was sampled every 10 seconds for 60 seconds using telemetry and an Apple Watch concomitantly. Agreement of Apple Watch with telemetry, which is the current gold-standard device for measuring HR, was assessed using mixed effects limits agreement and Lin's concordance correlation coefficient.

 RESULTS
 A total of 20 patients (mean 66 [SD 6.5] years, 85% [n=17] male) participated in this study, yielding 134 HR observations per device. Modified Bland–Altman plot revealed that the variability of the paired difference of the Apple Watch compared with telemetry increased as the magnitude of HR measurements increased. The Apple Watch produced regression-based 95% limits of agreement of 27.8 – 0.3 × average HR – 15.0 to 27.8 – 0.3 × average HR + 15.0 beats per minute (bpm) with a mean bias of 27.8 – 0.33 × average HR bpm. Lin's concordance correlation coefficient was 0.88 (95% CI 0.85-0.91), suggesting acceptable agreement between the Apple Watch and telemetry.

 CONCLUSIONS
 In patients with OSA in AF, the Apple Watch provided acceptable agreement with HR measurements by telemetry. Further studies with larger sample populations and wider range of HR are needed to confirm these findings.


A bracket assembly for supporting rollers to be received in tracks on a drawer includes a vertical wing and a horizontal wing integral with and projecting laterally from the lower edge of the vertical wing. At least two rollers are journaled on the vertical wing with one roller disposed adjacent each end of the vertical wing. A slot is formed transversely in the horizontal wing and a screw coacts with two flanges on the vertical wing, one on each side of the slot, whereby the screw may selectively move the flanges toward and away from each other thereby to change the width of the slot and adjust the relative positions of the rollers.


The emerging conceptualization of the teaching-learning process brings with it a modification in the teaching role of a university professor. To think of the function of a tutor-professor from a complex perspective will help professors to develop underneath this paradigm, facilitating the construction of thinking in integrated networks having different types of knowledge which substitute fragmented and lineal knowledge characteristic to positivist thinking. From a complex paradigm, learning acquires a new sense. The complex viewpoint is rich in matrixes, complacent with diversity capable to integrate difficulties. The final objective of teaching is to accompany a student as he/she discovers and interprets reality. The most important function of a tutor is to permit a student to construct himself/herself by means of reflexive dialogue with the student's own learning experience. The tutor's role should enable a student to make use of his/her own speech, offering secure places where a student can find his/her appropriate spot, and where the pressure of an exam becomes more a stimulus to learn than a difficulty for his/her development.


Complex partial status epilepticus is a non-convulsive state of persistent behavioural change from baseline functioning, with continuous or intermittent ictal epileptic EEG discharges.1–3 Although relatively common, it is often difficult to diagnose. Treatment with widely available antiepileptic drugs is of limited success and can have relevant side effects.1 4 Here we report the use of a newly released intravenous formula of levetiracetam in a patient who, despite intravenous loading with phenytoin and oral administration of lorazepam, developed complex partial status epilepticus following a series of generalised tonic–clonic seizures. Video EEG monitoring showed resolution of mental clouding and a reduction in ictal EEG patterns within 35 min of administration of levetiracetam.

### Patient history

This 29-year-old female patient suffered from cryptogenic focal epilepsy since the age of 11 years. No typical risk factors for the development of epilepsy were present. In particular, there was no evidence of birth related injury, or neonatal or febrile convulsions. Her psychosocial, motor and cognitive development was normal until the onset of epilepsy and concomitant mental retardation. Seizures had been refractory to treatment with primidone, phenytoin, phenytouride, sultiam, topiramate, carbamazepine, oxcarbazepine, lamotrigine, zonisamide, pregabalin and valproate. Seizure types were complex partial seizures as well as tonic and generalised tonic–clonic seizures. Earlier oral treatment with valproic acid resulted …


The problem of origination of capacity for goal self-setting is discussed. It was shown that the definition "goal" in living systems differs from the definition "target function" in physical problems concerned with nonliving systems. It was also shown that the main goal of the elements of a system is the storage of information. In biology, this goal is the extension of the principle of struggle for existence. Conditions were determined that the dynamic system describing the goal self-setting process must satisfy. It was shown that living systems meet these conditions. In inorganic nature, such systems may also arise but only as a result of long-term evolution, after which they become living.


The literature suggests that personal information management is a serious challenge for many computer users. Online faculty are especially challenged because of the large number of electronic files necessitated by teaching online. Those who have experience in this environment may offer valuable insights regarding information management challenges and practices. Faculty who teach online courses as part of the WISE (Web-based Information Science Education) Consortium responded to a survey that questioned the ways they manage email, computer desktop, Web-based information and learning management systems. The authors concluded that "filter failure" rather than information overload is the key issue in information management. The study concludes with a list of recommendations for faculty to manage their personal information.


Overlay networks are networks operating on the inter-domain level, where the edge hosts learn of each other and, based on knowledge of underlying network performance, they form loosely coupled neighboring relationships. These relationships can be used to induce a specific graph, where nodes are representing hosts and edges are representing neighboring relationships. Graph abstraction and the associated graph theory can be further used to formulate routing algorithms on overlay networks. The main advantage of overlay networks is that they offer the possibility to augment the IP routing as well as the QoS functionality offered by the Internet.


Although oil price shocks have long been viewed as one of the leading candidates for explaining U.S. recessions, surprisingly little is known about the extent to which oil price shocks explain recessions. We provide the first formal analysis of this question with special attention to the possible role of net oil price increases in amplifying the transmission of oil price shocks. We quantify the conditional recessionary effect of oil price shocks in the net oil price increase model for all episodes of net oil price increases since the mid-1970s. Compared to the linear model, the cumulative effect of oil price shocks over course of the next two years is much larger in the net oil price increase model. For example, oil price shocks explain a 3% cumulative reduction in U.S. real GDP in the late 1970s and early 1980s and a 5% cumulative reduction during the financial crisis. An obvious concern is that some of these estimates are an artifact of net oil price increases being correlated with other variables that explain recessions. We show that the explanatory power of oil price shocks largely persists even after augmenting the nonlinear model with a measure of credit supply conditions, of the monetary policy stance and of consumer confidence. There is evidence, however, that the conditional fit of the net oil price increase model is worse on average than the fit of the corresponding linear model, suggesting much smaller cumulative effects of oil price shocks for these episodes of at most 1%.


Objectives: In this study we aimed to present our treatment results of
intramedullary nailing of femoral shaft fractures with compressive nailing
using proximal static hole and only distal dynamic hole with one screw. Methods: Forty-three patients who had
a fracture of the femoral shaft were managed between 2005 and 2008 with
intramedullary nailing and the use of only one screw for distal interlocking.
Prospectively we evaluated the union time, possible reoperation, fixation and
fracture alignment, range of knee motion and complications. Results: Union occurred within a mean
duration of 18.7 weeks. No failures of the fixation and fracture alignment and
no more than 1 cm
shortness were detected. The knee range of motion was all more than 90 degree.
Only one deep venous thrombosis was detected as complication. Conclusions: Compressive nailing using proximal hole and only
distal dynamic hole with one screw is a convenient technique for femur
fractures.


In the scope of corporations, information and knowledge management are essential prac- tices that are carried out through information systems. In this chapter, we discuss the foundations of an ontological-based architecture for organizing information and knowl- edge within corporations. Our research focus on three main efforts: (i) to shed some light on the ontological status of corporations, (ii) to understand the relations between cor - porate units, and (iii) to approach the duties that corporations have to manage. After presenting background theories, we analyze the corporation through two dimensions, namely, a descriptive and a normative. While the former approaches the structure of the corporation from the point of view of its units, the latter approaches it from the point of view of duties and obligations. The descriptive side of our investigation is con ducted through principles of top-level formal ontologies; the normative side is addressed through the so-called social ontology. The relevance of developing such analysis rests on the need of a better understanding of corporations, its structures, and its activities. Such insight can provide a formal framework suitable to be applied in information systems, working in the context of modern technologies like the Semantic Web.


Macrophages become activated by bacterial endotoxin (lipopolysaccharide) and other stimuli to release proinflammatory cytokines and NO. To prevent release of toxic or potentially lethal quantities of these factors, the state of macrophage activation is counter-regulated by anti-inflammatory mediators (e.g., glucocorticoid hormones, interleukin 10, and transforming growth factor type beta). Fetuin, a negative acute-phase protein, recently was implicated as an anti-inflammatory mediator, because it is required for macrophage deactivation by spermine. In the present studies, we found that fetuin is necessary for macrophages to respond to CNI-1493, a tetravalent guanylhydrazone inhibitor of p38 mitogen-activated protein kinase phosphorylation. Fetuin dose-dependently increases macrophage uptake of CNI-1493, which can be specifically inhibited by anti-human fetuin antibodies. Anti-human fetuin antibodies render primary human peripheral blood mononuclear cells insensitive to deactivation by CNI-1493. Thus, macrophages use fetuin as an opsonin for cationic-deactivating molecules, both endogenous (e.g., spermine) and pharmacologic (e.g., CNI-1493). This role of fetuin as an opsonic participant in macrophage-deactivating mechanisms has implications for understanding and manipulating the innate immune response.


Density-functional theory simulations of CZTS, CZTSe, and CZTS0.25Se0.75 photovoltaic compounds have been performed to investigate the stability of the CZTS0.25Se0.75 alloy vs. decomposition into CZTS, CZTSe, and other secondary compounds. The Gibbs energy for vibrational contributions was estimated by calculating phonon spectra and thermodynamic properties at finite temperatures. It was demonstrated that the CZTS0.25Se0.75 alloy is stabilized not by enthalpy of formation but primarily by the mixing contributions to the Gibbs energy. The Gibbs energy gains/losses for several decomposition reactions were calculated as a function of temperature with/without intermixing and vibration contributions to the Gibbs energy. A set of phase diagrams was built in the multidimensional space of chemical potentials at 300 K and 900 K temperatures to demonstrate alloy stability and boundary compounds at various chemical conditions. It demonstrated for CZTS0.25Se0.75 that the chemical potentials for stability differ betwe...


Purpose It aimed at testing the validity and reliability of a validated team-based learning student assessment instrument (TBL-SAI) to assess United Kingdom pharmacy students' attitude toward TBL. Methods TBL-SAI, consisting of 33 items, was administered to undergraduate pharmacy students from two schools of pharmacy each at University of Wolverhampton and University of Bradford were conducted on the data, along with comparison between the two schools. Results Students' response rate was 80.0% (138/173) in completion of the instrument. Overall, the instrument demonstrated validity and reliability when used with pharmacy students. Sub-analysis between schools of pharmacy did, however, show that four items from Wolverhampton data, had factor loadings of less than 0.40. No item in the Bradford data had factor loadings less than 0.40. Cronbach's alpha score was reliable at 0.897 for the total instrument: Wolverhampton, 0.793 and Bradford, 0.902. Students showed preference to TBL, with Bradford's scores being statistically higher (P<0.005). Conclusion This validated instrument has demonstrated reliability and validity when used with pharmacy students. Furthermore students at both schools preferred TBL compared to traditional teaching.


Vagino-uterine prolapse is a form of hernia through the vaginal outlet which may involve respectively the bladder and anterior vaginal wall, the anterior vaginal wall or the bladder and the cervix uteri; or the eversion may comprise cervix, or uterus, and the entire vaginal structure. The protrusion of the anterior pelvic segment is frequently a sliding of the bladder, pushing it before the anterior vaginal wall and dragging on the cervix where the uterus is firmly fixed as by firm ligaments and resistant peritoneum. The traction on the cervix causes a hypertrophic elongation of the supravaginal portion of the cervix. The anterior and posterior vaginal walls are attached to the cervix at different levels so that such an elongation may occur in the vesical portion of the cervix with complete eversion of the anterior vaginal wall and the cervix, while the posterior vaginal, remains intact and presents its normal length.


We have investigated whether VEGF (vascular endothelial growth factor) regulates the proliferative capacity and eNOS (endothelial nitric oxide synthase)/NO (nitric oxide) pathway of EPCs (endothelial progenitor cells) by activating CaN (calcineurin)/NFAT (nuclear factor of activated T‐cells) signalling. EPCs were obtained from cultured mononuclear cells isolated from the peripheral blood of healthy adults. Treatment with VEGF (50 ng/ml) potently promoted CaN enzymatic activity, activation of NFAT2, cell proliferation, eNOS protein expression and NO production. Pretreatment with cyclosporin A (10 μg/ml), a pharmacological inhibitor of CaN or 11R‐VIVIT, a special inhibitor of NFAT, completely abrogated the aforementioned effects of VEGF treatment and increased apoptosis. The results indicate that VEGF treatment promotes the proliferative capacity of human EPCs by activating CaN/NFAT signalling leading to increased eNOS protein expression and NO production.


The paper highlights the importance of intercultural competence (IC) in business environment, and presents outcomes of a research into the level of IC among employees of Slovak enterprises. In the contemporary business world, intercultural competence and its individual components: affective, behavioral, and cognitive competences, become an inevitable asset for enterprises, due to high globalization of virtually all corporate processes and activities. Even though the available literature on research into this cultural phenomenon reports a rather high perception of one's own IC, namely its affective component, as proved by our research, the main objective of which was to measure IC of Slovak employees, the actual level of overall IC, and especially its affective component, in Slovak enterprises is rather low. The research, the detailed description of which is the primary focus of this paper, was conducted in spring 2018 on a representative sample of Slovak employees in enterprises of all types, sizes, and fields of industry, and has proved that by increasing one of the three components of IC, the overall IC of an individual will increase. Therefore, it may be stated that training of intercultural competence has a high potential in corporate environment, and may produce great benefits for enterprises who deal with interculturality in their operations, and encounter people of other than their home culture, may it be their external or internal stakeholders. The outcomes of the research also suggest a need, and provide a platform for, both the assessment of IC of employees, and a targeted intercultural training in Slovak enterprises, which would be tailored according to the individual needs of each enterprise.


The fragmentation and reduction of deciduous forests in Sweden is threatening many species. Particularity worrying is the loss of broad-leaf trees, since a diversity of species is often associated to them. Today many deciduous trees are situated along the border between forested and open areas, and these small fragments can be important for biodiversity.The aim of this study is to analyze if wildlife management can affect the variation of deciduous trees and bushes in the landscape. In brochures and literature Svenska Jagareforbundet (the Swedish Association for Hunting and Wildlife Management) recommend hunters and landowners to promote deciduous trees – often broad-leaf trees – as wildlife management measures, while the Swedish forestry laws can be sensed as unclear regarding the treatment of these trees.Five properties in Sodermanland, Sweden, were chosen as study areas and inventoried in respect of trees and bushes in September 2013. The landowners or game wardens were interviewed about how they manage the landscape to promote, or not promote, hunting. The landscapes' tree and bush composition and richness in ten randomly selected plots on each property were compared and analyzed in relation to the landowners' attitudes toward wildlife management and biodiversity.The interviewed landowners and game wardens who implemented wildlife management on their properties considered that they were promoting biodiversity in general, while the landowner who did not approve of wildlife management believed that game animals were threatening the biodiversity of the forest. The species inventories showed significant differences in species richness between the landscapes, where the property without wildlife management had the least amount of bush and tree species. No significant differences were found in respect of broad-leaf trees between the landscapes. The property with the least species also was the property with the lowest beta diversity, considered the variation between plots, and its species composition differed the most from that in the landscape where most species were found.The result of this study suggests that active wildlife management could increase deciduous trees and bushes in the landscape of Sodermanland. Wildlife management could also create habitat corridors and possible stepping stones in the landscape, but to restore whole deciduous forests major actions are probably needed, including clearer regulations from Skogsstyrelsen (the Swedish Forest Agency) and development of alternative land use methods compared with today.


It is essential to understand how financial variables, such as stock prices, bond prices and exchange rates, react to various announcements available to the public. The aim is to understand the determination of asset prices (Neely and Dey, 2011) because financial market developments – including foreign exchange market dynamics – are highly relevant for short-term and medium-term economic developments in market economies. Thus, there is a broad interest to understand price dynamics in financial markets from a theoretical and empirical perspective; and possibly also to draw lessons for policymakers interested to avoid excessive volatility and liquidity problems. In this context the role of information and news, respectively, has drawn increasing attention over the past decades in the Economics research community and specific new policy events such as Quantitative Easing (QE) as well as political shocks – such as the British EU referendum of 2016 with its Brexit majority – lend themselves as interesting events that could be analysed with respect to financial market dynamics. The first study investigates the impact of Brexit-related events on the spot exchange rate of the British pound against the euro and the US dollar. We want to find out whether Brexit-related news, including the result of the Brexit referendum itself, has an impact on British pound exchange rates. By splitting our Brexit-related events into 'good' Brexit news and 'bad' Brexit news, we find that Brexit news has an impact on British pound exchange rates. Bad Brexit news is associated with a depreciation of the British pound against the euro and the US dollar whereas 'good' Brexit news appreciates the Pound against the euro. The second study elaborates on the impact of Brexit-related events on the corporate bond yield spreads in the United Kingdom and Eurozone (or Euro Area: EA), respectively. We want to find out whether Brexit-related news, including the result of the Brexit referendum itself, had an impact on the risk conditions in those two corporate bond markets. Our estimation results indicate that the announcement of the referendum result is associated with increasing credit spreads in the UK and EA. However, only the actual announcement of the UK referendum result itself had an influence on the credit spreads. Furthermore, we distinguish between financial and non-financial economic sectors in order to analyse more specific sector-related effects of the referendum event. Our estimation results suggest that UK credit spreads were more strongly influenced by the announcement of the results of the Brexit referendum than credit bond spreads in the Eurozone were. The third study investigates the impact of ECB's announcements of non-standard policy measures on a broad range of financial assets from Denmark, Norway and Sweden. I find evidence that unconventional monetary policy announcements by the ECB resulted in pronounced spillovers to Denmark, Norway and Sweden. In particular, the results suggest that medium- and long-term government bond yields, corporate bond yields and CDS spreads were affected by the ECB's announcements of non-standard policy measures. Moreover, the results suggest that benchmark stock market indices and exchange rates vis-a-vis the euro were mainly unaffected by the ECB's announcements of unconventional monetary policies. Furthermore, I find pronounced spillover effects from Forward Guidance statements, Securities Markets Programme announcements, and Corporate Sector Purchase Programme announcements on financial assets from Denmark, Norway and Sweden.


Executive Overview The foci of strategic entrepreneurship (SE) are broad and rich, building on research from multiple disciplines such as economics, psychology, and sociology, along with other subdisciplines in management including organizational behavior and organization theory. Herein, we examine the contributions of strategic management and entrepreneurship to SE. Building on a previous model of SE, we develop an input-process-output model to extend our understanding of the SE construct. We examine the resource inputs into SE, such as individual knowledge and skills. In addition, we explore the resource orchestration processes that are important for SE and the outcomes, including creating value for customers, building wealth for stockholders, and creating benefits for other stakeholders, especially for society at large. Individual entrepreneurs also benefit through financial wealth, but other outcomes such as personal satisfaction and fulfillment of personal needs (e.g., self-actualization) may be of e...


Rechargeable aqueous metal-ion (such as Li+, Na+, Mg2+, Al3+) batteries are of great importance to enrich safer, cheaper and sustainable electrochemical energy storage technologies. One of the major challenges in developing such batteries is that few electrode material systems are available to achieve prominent, reversible and stable redox reactions in aqueous electrolytes. Here we systematically report that a versatile Bi2O3 electrode material is able to electrochemically store charges in more than ten types of aqueous monovalent, divalent and trivalent metal ion electrolytes. A remarkably high specific capacity (∼357 mA h g−1 at 0.72C), outstanding rate capability (217C; 75 000 mA g−1) and good cycle life (>200 cycles) are demonstrated in a neutral mixed Li+ electrolyte. A unique "quasi-conversion reaction" charge storage mechanism that differs from a conventional intercalation-type mechanism is further unveiled (Bi2O3 ↔ Bi0). By pairing with a Li+ intercalation electrode, an aqueous LiMn2O4//Bi2O3 full cell is fabricated, which exhibits stable cycling with a low self-discharge rate and delivers a high energy density of ∼78 W h kg−1, far superior to typical aqueous lithium ion batteries (≤50 W h kg−1). Moreover, even with a relatively high mass loading of 5 mg cm−2 by slurry casting, the Bi2O3 electrode still manifests excellent performance. We anticipate that our work will stimulate the development of diverse electrode materials for aqueous rechargeable batteries.


In this paper, the authors tentatively develop a theoretical model that depicts how the dynamic capabilities of a firm may be driven by three macro-organizational foundations: visionary leadership, organizational culture, and empowered human resources. The authors propose that visionary leaders are the original driver of dynamic capabilities and that visionary leaders create a unique organizational culture and empowered human resources so that their organizations embrace the spirit of entrepreneurship, an orientation toward learning, and a commitment to mission-driven improvement.,The authors use a case of the early success of a highly performing Chinese telecommunication equipment producer, Huawei Technology, to explain the theoretical model that shows how dynamic capabilities are developed as visionary leaders influence firm routines for learning, innovation, and strategic human resource policies, which in turn collectively create and update operational capabilities to deliver directly manipulatable competitive advantages.,The paper concludes by arguing that the sources of dynamic capabilities need not be dynamic. Instead, visionary leadership, organizational culture, and human resource policies are relatively stable factors in comparison with other possible competence-building mechanisms such as innovation or ambidexterity.,The authors' model provides a direction for firms in high-tech industries to develop dynamic capabilities in order to maintain competitiveness and sustain high performance.,This paper is the first to present three macro-level drivers of dynamic capabilities, and it is also the first to understand the success of Huawei from a dynamic capabilities perspective.


Transparent conducting oxides have been previously investigated for both bulk and thin film thermoelectric applications, and have shown promising results due to their thermal stability and electrical conductivity. Alloys of two or more transparent conducting oxides have been deposited using pulsed laser deposition (PLD) and combinatorial sputtering, and the resulting films were optimized for optical applications. In this study, thermoelectric materials were prepared by co-sputtering techniques, whereby a chemical gradient was formed across an alumina substrate that was patterned using photolithography to form hundreds of microthermocouples. The systems indium tin oxide (ITO), indium zinc oxide (IZO), and zinc tin oxide (ZTO) were investigated for this purpose and the resulting combinatorial libraries were rapidly screened to establish room temperature resistivity, Seebeck coefficient, and power factor as functions of both composition and heat treatment, in nitrogen and air ambients. Due to their chemical stability, oxidation resistance, and large Seebeck coefficients relative to metal thermocouples, these materials are ideal for temperature measurement or energy harvesting in harsh environments such as gas turbine engines.


The generally textured techniques used in industry can make the roller surface fall off or damage by burning to form aculeate concave. The textured rollers produced by the method mentioned above have some disadvantage performances that include rapid roughness attenuation, limited use time and more concave. These disadvantages are not suitable for the formation of roughness on the cold roller surface. On account of high hardness and excellent wearable capability, the element chrome, which can be deposited on the cold roller surface, can increase the use life of textured cold roller enormously. In this paper, an experiment of DC superimposed pulse was performed to obtain certain roughness chrome textured and hemisphere-shaped chrome coatings. From the results, it was shown that the roughness and hardness of coating obtained by electroplating was 3.79μm at 850mA/cm2 and 1000 Hv respectively.


The food additive butylated hydroxyanisole (BHA) has been shown to induce gastrointestinal hyperplasia in rodents by an unknown mechanism. The relevance of this observation for human risk assessment is not clear. We therefore analysed the effect of BHA and its primary metabolites tert-butylhydroquinone (TBHQ) and tert-butylquinone (TBQ) on 8-oxo-deoxyguanosine formation and labelling induces in human lymphocytes in vitro. Analysis of culture medium and cell lysate fractions after administration of BHA or metabolites of BHA revealed that BHA and TBHQ undergo biotransformation in whole blood cultures. Moreover, TBQ can be reduced to TBHQ. While in cultures treated with BHA 50-60% of the dose administered was recovered, a much lower dose recovery was found in cultures treated with either TBHQ or TBQ. This indicates a considerable binding of these compounds to macromolecules. BHA and TBHQ, as well as TBQ, induced a dose-dependent increase in cell proliferation of phytohaemagglutinin-stimulated lymphocytes, 50 microM being the optimal dose. Since BHA is metabolized to TBHQ, it is not clear which compound is responsible for the proliferation enhancing effects observed in culture. Inhibition of IBHQ metabolism to its semiquinone radical by acetylsalicylic acid (ASA) reduced the increase in labelling indices induced by TBHQ. This indicates that this metabolic pathway is involved in the enhancement of cell proliferation induced by the hydroquinone. HPLC-ECD analysis of oxidative DNA damage in lymphocytes exposed to 10, 50 and 100 microM BHA, TBHQ or TBQ respectively showed that BHA was not capable of inducing oxidative DNA damage to a significant degree. TBQ and, in particular, TBHQ at a dose of 50 microM (the optimal dose for induction of cell proliferation), however, increased lymphocyte 7-hydroxy-8-oxo-2'-deoxyguanosine formation by 320 and 680% respectively. Inhibition of prostaglandin H synthase by ASA in cultures treated with TBHQ decreased the oxidation ratio significantly, confirming the significance of this enzyme system in the mechanism of toxicity of BHA.


Developments in nanotechnology have brought new challenges in heat transfer and temperature control in nanoscale devices. In this thesis, the electromagnetic and thermal behavior of plasmonicnanoantennas are investigated when they are illuminated with a focused beam of light and placed in the vicinity of thin film magnetic layer structures. To investigate this problem, optical, electromagnetic, and thermal models are developed and integrated. An optical modeling tool is developed to define a tightly focused beam of light by utilizing Richards-Wolf theory, which is primarily based on ray-tracing of optical beams. An electromagnetic modeling tool is used to analyze nano antennas and thin-film magnetic layers in terms of electric field and dissipated power distribution profiles. A thermal modeling tool is developed to control the temperature distribution on nanoantennas and thin film magnetic layer structures. Optical, electromagnetic and heat transfer modeling tools are integrated and simulations are conducted by generating script files using MATLAB codes. Electromagnetic and heat transfer analysis are conducted for dipole, bowtie and arrow shaped nanoantennas. The conditions to obtain single optical and hot spots on the thin film magnetic layer are presented. A novel nanoantenna type is proposed to improve thermal performance. It has been demonstrated that dipole, bowtie and a newly proposed arrow-shaped nano antennas show similar electromagnetic behaviors while the arrow-shaped nano antenna shows significant improvement in terms of temperature control which yields low antenna temperatures.


Prenatal diagnosis of a pelvic cyst is a rare finding and could be of different etiologies, mainly ovarian in case of female gender. Male fetuses have different diagnostic possibilities. We present a case report aiming to depict changes in the evolution of the image and the possibilities arising from the images. A 31-year-old patient G2P1 had a normal obstetrical follow-up with a normal first-trimester ultrasound, NT=1.56 mm; morphology and biometry were normal along with an unusual nasal bone and IT. The biochemical screening was proposed to the couple but they chose not to do it. At 21 weeks, the morphology scan was normal, except an anechoic image measuring 9 mm located posterior to the bladder. No communication was noted between this cystic image and the bladder. Amniotic fluid was adequate. No particular pathology of the kidneys or ureter was noted. Gender is male without any ambiguity seen. Parents were informed about the findings and it was decided to undergo follow-up without any genetic investigation. Monthly periodic measurement showed a slow increase of the cyst to 10*9 mm (26 w) and 13*9 mm (31 w). Biometry is about the 50e percentile and the patient is currently at 36 weeks. The couple gave their consent for the scientific use of the images and they were also informed about the possible diagnostic possibilities including wolfian cyst, anal imperforation, and intestinal or neural cyst. MRI was postponed to the postnatal period if needed mainly because it would not change the obstetrical management. Postnatal investigation is needed to elucidate the different pathologies.


Coastal marine species with pelagic egg and larval stages, such as the Atlantic cod Gadus morhua, can be structured into genetically distinct local populations on a surprisingly small geographic scale considering their dispersal potential. Mechanisms responsible for such small-scale genetic structure may involve homing of adults to their natal spawning grounds, but also local reten- tion of pelagic eggs and larvae. For example, spawning within sheltered fjord habitats is expected to favour local retention of early life stages. Here, we studied the distribution of cod eggs along inshore- offshore transects in 20 Norwegian fjords. The general pattern exhibited across all fjords was a higher concentration of cod eggs inside the fjords than further offshore. In particular, fjords with shal- low sills (model threshold 37 m) show an abrupt reduction in egg density over the sill. This study pro- vides empirical support for an offspring retention hypothesis, which may help to explain the mainte- nance of local population structure in pelagic marine systems.


Previous studies have demonstrated that while blowdown pressure is reproduced well by both adiabatic and isothermal analytical models, the dynamics of temperature cannot be predicted well by either model. The reason for the last is heat transfer to cooling during expansion gas from the vessel wall. Moreover, when exposed to an external fire, the temperature inside the vessel increases, i.e. when a thermally activated pressure relief device (TPRD) is still closed, with subsequent pressure increase that may lead to a catastrophic rupture of the vessel. The choice of a TPRD exit orifice size and design strategy are challenges: to provide sufficient internal pressure drop in a fire when the orifice size is too small; to avoid flame blow off expected with the decrease of pressure during the blowdown; to decrease flame length of subsequent jet fire as much as possible by the decrease of the orifice size under condition of sufficient fire resistance provisions, to avoid pressure peaking phenomenon, etc. The adiabatic model of blowdown [1] was developed using the Abel-Nobel equation of state and the original theory of underexpanded jet [2]. According to experimental observations, e.g. [3], heat transfer plays a significant role during the blowdown. Thus, this study aims to modify the adiabatic blowdown model to include the heat transfer to non-ideal gas. The model accounts for a change of gas temperature inside the vessel due to two "competing" processes: the decrease of temperature due to gas expansion and the increase of temperature due to heat transfer from the surroundings, e.g. ambience or fire, through the vessel wall. This is taken into account in the system of equations of adiabatic blowdown model through the change of energy conservation equation that accounts for heat from outside. There is a need to know the convective heat transfer coefficient between the vessel wall and the surroundings and wall size and properties to define heat flux to the gas inside the vessel. The non-adiabatic model is validated against available experimental data. The model can be applied as a new engineering tool for the inherently safer design of hydrogen tank-TPRD system.


ABSTRACT Prion diseases are fatal neurodegenerative disorders. Identification of possible therapeutic tools is important in the search for a potential treatment for these diseases. Congo red is an azo dye that has been used for many years to detect abnormal prion protein in the brains of diseased patients or animals. Congo red has little therapeutic potential for the treatment of these diseases due to toxicity and poor permeation of the blood-brain barrier. We have prepared two Congo red derivatives, designed without these liabilities, with potent activity in cellular models of prion disease. One of these compounds cured cells of the transmissible agent. The mechanism of action of these compounds is possibly multifactorial. The high affinity of Congo red derivatives, including compounds that are ineffective and are effective at the cure of prion disease, for abnormally folded prion protein suggests that the amyloidophylic property of these derivatives is not as critical to the mechanism of action as other effects. Congo red derivatives that are effective at the cure of prion disease increased the degradation of abnormal PrP by the proteasome. Therefore, the principal mechanism of action of the Congo red analogues was to prevent inhibition of proteasomal activity by PrPSc.


This article examines intergovernmental relations, the concept of equalization (peculiar to a federalism of a cooperative matrix) and its relations with collaboration regulations, as well as the recent contours being shaped by the actions and propositions for collaborative partnerships regarding education in Brazil. The analytical path indicates that there is - besides the permanence of the strong inductor power of the federal government in defining the forms of collaboration for education and the relationship that this federal entity directly establishes with the municipalities, disregarding the states - significant growth in the role of the private sector, along with the federal government, in attempting to seek other forms of regulations for collaboration, being the arrangements for the development of education the most expressive one.


Planning permission (Ref: 02/03/00371) has been granted for the conversion of a barn at Hankinsons Farm, Stalmine, near Poulton-le-Fylde, Lancashire (NGR SD 391 451) to a dwelling. The barn is illustrated on the first edition Ordnance Survey map of 1844, resulting in Lancashire County Archaeology Service (LCAS) issuing a recording condition to carry out an archaeological investigation prior to any construction works. A verbal brief was issued by LCAS stipulating building recording to English Heritage level II/III standard (English Heritage 2006). The owner, Mr Jon Wolstenholme, commisioned Oxford Archaeology North (OA North) to carry out the building investigation following the approval of a project design (Appendix I) by LCAS. Hankinsons Farm is a small farmstead with buildings of varying dates clustered around a central yard. The complex consists of the barn under investigation, together with a contemporaneous farmhouse, pig sty and late nineteenth century multi-phase milking parlour which is located to the east of the barn. Some large sheds of late twentieth century date have also been erected. A rapid map regression was carried out which showed that the barn was not on the 1833 enclosure awards map it but does appear on the 1841 tithe map providing a date range for its construction. However, the enclosure awards map did illustrate that the land containing the farm, together with the surrounding land, was allotted to a Mary Hankinson, from whom the farm obviously acquired its name. The tithe map schedule of 1841 however, makes no reference to Mary Hankinson suggesting that the land may have been sold on. The results of the building investigation concur with the suggested date of construction; the general appearance and construction methods, together with the fabric of the barn, appears consistent with an early-mid nineteenth century date. The barn is a T-shaped threshing barn with a large porch doorway on the northern side, and a shippon and loft at the east (widest) end divided from the main part by a brick cross wall. The main fabric is hand-made brick which was probably produced locally (two clay pits are illustrated on Ordnance Survey maps of 1892, 1912 and 1932). It is probably of a single phase and stands little altered from its original plan, the exception being two later additions, probably from the mid and late twentieth century. In addition, some internal modification has taken place, most notably in the shippon where late twentieth century milking stalls and apparatus was installed. Some graffiti dating to 1934 was discovered on one of the remaining doors on the porch on the northern side of the barn, together with two additional undated inscribed letters. A second, smaller porch probably once existed on the south side but the date of this is impossible to deduce. The investigations found no evidence of an historic link or connecting block between the barn and the milking parlour to the east. It is recommended that as much of the original hand-made brick fabric of the barn as possible be retained. Allied to this, it is also recommended that the original layout of the barn be retained, where possible.


The Mexican American community has been involved in a struggle to improve the educational conditions of their children ever since the US invasion and continued occupation of Mexican territory (Gallegos, 2000). This struggle includes the successful litigation of court cases against segregation a decade prior to Brown v. Board of Education in 1954 (Moreno, 1999). But, perhaps the biggest event surrounding Education was during the early Chicana/o movimientos in the 1960s. An estimated 10,000 Chicana/o students walked out of classes on March 3, 1968 in East Los Angeles to protest the unequal conditions of their education (San Miguel, 1996; Solorzano and Delgado Bernal, 2001). Since then Chicana/o activism in Education has focused on the rights of Latina/o students, especially non-English speaking and migrant students and the right to bilingual education programs. Increased efforts to integrate Latina/o students, equal distribution of educational funding sources, and the constant struggle against alienating schooling practices such as tracking, standardized testing, the whitestream (Grande, 2000) curriculum, and access to higher education (Gandara, 1995) have also been important issues. This special issue of The High School Journal is dedicated to this struggle and legacy for social justice and change. Although arguments for a color-blind society claim that racial prejudice and discrimination are a part of the past, more realistic and critical examinations attest that race and discrimination are still big problems in US society (Baker, 1998). In fact, the conservative backlash unleashed by the Bush dynasty has reversed a lot of the gains of the civil rights movements creating a state of siege against minority communities and the poor at home and abroad. Corporate greed and neoliberal, market-oriented policies continuously push for educational changes that aggravate the racial and socio-economic inequities in society as do vouchers, charter schools, and high-stakes testing accountability that attempt to privatize and quantify education. More recently, to the amazement of many, proactive Chicana/o high school and college student organizations for community empowerment and advocacy such as Movimiento Estudiantil Chicano de Aztlan (MEChA-Chicano Student Movement of Aztlan), have been attacked as racist and to the extreme even as terrorists for working for social justice (Gonzales & Rodriguez, 2003). During the recent gubernatorial race in California Lieutenant General Cruz Bustamante was chastised by conservative opponents for his early activism in MEChA, who likened MEChA to the Ku Klux Klan (Sifuentes, 2003). Irresponsible accusations like these, although aggravating, do call for self-reflection as we re/consider our recent past as Chicanas/os and plan for our future. This introduction intends to accomplish several goals. First to re-call what Chicana/o activism has been in education and what the outcomes of that activism have accomplished. Second, it is important to re-call what the conservative backlashes against the larger Latina/o community have redressed and how those redresses influence how we re/think activism for social justice. Third, I focus on the contributions this special issue hopes to make in tracing some of the legacies and accomplishments of Chicana/o activism as well as illustrate how the locus of practice concerning activism has changed and what that might mean for informed future action. Chicana/o Activism and Education Chicana/o identity "officially" arose within the context of the social movements of the 1960s. In an effort to self-identify and in response to both the material and symbolic oppression and subjugation of people of Mexican descent, the Chicana/o movimientos emerged. The Chicana/o movimientos were by no means a unified social movement given the large geophysical area of the Southwest and the diverse leadership and points of contention and struggles of its early founders. …


In this thesis, two different issues in econometrics are studied, the estimation of regression coefficients and the non-stationartiy analysis in a panel setting.Regarding the first topic, we study a set of measure of location-based estimators (MLBEs) for the slope parameter in a linear regression model with a single stochastic regressor. The median-unbiased MLBEs are interesting as they can be robust to heavy-tailed and, hence, preferable to the ordinary least squares estimator (LSE) in such situations. Two cases, symmetric stable regression and contaminated normal regression, are considered as we investigate the statistical properties of the MLBEs. In addition, we illustrate how our results can be extended to include certain heteroscedastic regressions.There are three papers concerning the second part. In the first paper, we propose a novel way to test the unit roots in the panel setting. The new tests are based on the observation that the trajectory of the cross sectional sample variance behaves differently for stationary than for non-stationary processes. Three different test statistics are proposed. The limiting distributions are derived and the small sample properties are studied by simulations. In the remaining papers, we focus on the studies of the block bootstrap panel unit root tests proposed by Palm, Smeekes and Urbain (2011) which aims at dealing with a rather general cross-sectional dependency structure. One paper studies the robustness of PSU tests by a comparison with two representative tests from the second generation panel unit root tests. In another paper, we generalized the block bootstrap panel unit root tests in the sense of considering the deterministic terms in the model. Two different methods to deal with the deterministic terms are proposed and the asymptotic validity of bootstrap tests under the main null hypothesis is theoretically checked. The small sample properties are studied by simulations.


Over the past two decades, induction heating technology has begun to replace conventional heating methods in manufacturing due to its ability to rapidly and uniformly heat conductive materials. This advancement has made induction heating very attractive to a wide range of industries, including applications in which thin sheet geometries are used (sheet thickness < 10 mm). According to preliminary testing, conventional coil geometries cannot efficiently heat thin sheet samples. Thus, the primary goal of this study is to investigate a suitable coil design for thin sheet materials and to evaluate the effects of varying coil design parameters. To this end, this project has developed a 3D Multiphysics model that includes a longitudinal induction coil and a thin sheet workpiece. Using the model, a series of parametric studies have been performed to identify the best induction coil geometry for heating of thin sheets along with suitable excitation parameters for the coil and workpiece. It was found that uniform heating is produced when the space between coils is tight. Additionally, insignificant variance in temperature uniformity was found when vertically displacing the workpiece within the coil. Parametric studies resulted in finding a cross-section geometry that reduced temperature deviation to within 1.1% across the workpiece width. The model can be used as a design tool for developing a (full-scale) prototype induction heating system.


The aim of this study was to investigate the effects of Parkinson's disease (PD) on upper body acceleration patterns during level walking. Twenty-three patients with PD and 29 controls of similar age participated in this study. Subjects walked along a 12 m linear walkway at self-selected comfortable speeds. Upper body accelerations were measured using three-axis accelerometers located at the pelvis, shoulder, and head. Acceleration magnitude, stride-to-stride irregularity, and degree of coupling among three body parts were derived from the acceleration signals. In the vertical (supero-inferior) direction, PD patients exhibited a smaller acceleration magnitude, a more irregular pattern, and less coupling of acceleration among body parts compared to the controls (p<0.05). In the anterio-posterior (AP) direction, acceleration magnitude at the pelvis in PD patients was smaller than that in the controls (p<0.05). In addition, the phase lag of AP head acceleration from shoulder and pelvis was smaller in PD patients than in the controls (p<0.05). These results suggest that PD patients walk with reduced ankle power generation and a more rigid upper body in the AP direction and with more irregular muscle force generation in the SI direction.


Vivek Maize Hybrid 9- a popular single-cross hybrid developed by crossing CM 212 and CM 145 was released for commercial cultivation in India. The parental lines, being deficient in lysine and tryptophan, were selected for introgression of opaque-2 allele using CML 180 and CML 170 as donor lines through marker-assisted backcross breeding. The opaque-2 homozygous recessive genotypes with >90% recovery of the recurrent parent genome were selected in BC2F2, and the seeds with <25% opaqueness in BC2F3 were forwarded for seed multiplication. Vivek Quality Protein Maize (QPM) 9, the improved QPM hybrid, showed 41% increase in tryptophan and 30% increase in lysine over the original hybrid. The grain yield of the improved hybrid was on par with the original hybrid. The newly improved QPM maize hybrid released in 2008 will help in reducing the protein malnutrition because its biological value is superior over the normal maize hybrids. This short duration QPM maize hybrid has been adopted in several hill states of North Western and North Eastern Himalayan regions.


College teachers are frequently told that knowing the details of the cognitive psychological processes of their students will improve their teaching effectiveness. However, investigations of college teachers' beliefs about teaching and learning have yielded conceptions of teaching at a very general level. Most studies have resulted in conceptions that focus more on the teacher and teaching methods than on the learning processes of students. This paper argues for a more differentiated study of teacher thinking about student thinking that explores what teachers tacitly believe about their students' attention, memory, learning strategies and motivation. Potential implications of differences in how teachers may think about their students' cognitions are explored.


: The structure and ultrastructure of the following regions of the hypothalamo-hypophysial neurosecretory system (HHNS) in the population cycle of lemming were studied: supraoptic (SON), paraventricular (PVN) and arcuate nuclei (AN), the median eminence (ME) and posterior pituitary (PP). Being compared to the state of endocrine glands and gonads, and the level of reproduction stress in the population cycle of the lemming described earlier, the obtained data revealed a certain regularity. First, at the stages of decrease, increase and in the first period of the stage of population peak the activity of the SON-PP complex and AN is gradually increased. This coincides with intensified reproduction, intensified functioning of the thyroid gland and adrenal cortex. Second, while the population is decreasing, all the above functions become depressed, except that of the thyroid gland which, on the contrary, becomes active. In the second period of the stage of population peak, when reproduction stops abruptly, this regularity, however, does not hold, the activity of SON-PP complex and AN is sharply lowered, whereas that of PVN becomes very high. The structure of the thyroid damaged as a result of previous hyperfunction, is restored, and the adrenal cortex shows signs of hypercorticism. The present work is devoted to specificity of the HHNS functioning at the stage of population peak, referred to as crucial, and the pathways and mechanisms by which neurohormones produced by this system can affect the endocrine glands. In addition, the causes likely to lead to the mass death of animals at this stage, and biological significance of this fact are also given attention to.


Background and significance Current Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines recommend the use of long-acting beta agonists (LABA) plus inhaled corticosteroids (ICS), or long-acting muscarinic antagonists (LAMA) for the treatment of patients with moderate to severe COPD. The combination of LABA+LAMA is recently indicated for COPD patients with severe symptoms; however, its role in reducing exacerbations is less clear. Methods We performed a meta-analysis of randomised controlled trials that compared efficacy and safety of LABA+LAMA versus LABA+ICS in moderate to severe COPD patients. The primary outcome is the rate of COPD exacerbations. Other outcome measures include improvement in trough FEV1, St. George Respiratory Questionnaire for COPD (SGRQ-C) scores, transition dyspnea index (TDI) scores, rescue medication use and pneumonia risk. Analysis was performed in accordance with the Quality of Reporting of Meta-Analyses (QUORUM) guidelines. Results A total of 6 RCTs with 3370 patients were included. Over-all exacerbation rates were 21% lower in those treated with LABA+LAMA versus LABA+ICS (RR 0.79, [95% CI: 0.66–0.94]). This effect is more pronounced in patients who had >1 exacerbation per year, showing 25% lower exacerbation rates (RR 0.75 [0.60–0.95]) compared to those with no history of prior exacerbations (RR 0.85 [0.61–1.14]). Patients given Indacaterol+Glycopyrronium also experienced lower rates exacerbation versus LABA+ICS (RR 0.71 [0.57–0.59]) compared to those given Umeclidinium+Vilanterol (RR 1.16 [0.68–2.00]). There were also statistically significant improvements in FEV1 (mean difference 70 mL [95% CI: 0.07–0.07 Liters]), improvement in SGRQ-C (mean difference −0.92 points [−0.95, −0.90]), improvement in TDI scores (mean difference 0.24 [0.23–0.25]) and decrease in use of rescue medications (mean difference −0.20 puffs/day[−0.21, −0.20]). Pneumonia risk was 41% lower in patients given LABA+LAMA compared LABA+ICS (RR 0.59 [0.43 – 0.80]). Conclusions The combination of LABA+LAMA is safer and more effective in reducing exacerbations and improving clinical outcomes compared with LABA+ICS in patients with moderate to severe COPD. Abstract P56 Figure 1