The precise causes and drivers of inflammatory bowel disease (IBD) are still incompletely understood. In recent years, intensive research has shown that not only chronic activation of the immune compartment, but also the integrity of the epithelial barrier plays a central role in disease progression. Inhibitors of histone deacetylases (HDACs) are known for their anti-inflammatory effects and increasing evidence suggests them as promising therapeutics for chronic inflammatory conditions such as IBD. However, the roles of single HDACs in the intestinal epithelium, especially class II HDACs, are still scarcely investigated. In genome wide association studies, HDAC7 has been identified as a risk locus for the development of IBD. Here, we investigated the role of HDAC7 in the intestinal epithelium to evaluate its potential as a therapeutic target.

 Intestinal epithelial organoids were derived from the ileum and colon of tamoxifen-inducible HDAC7 knockout mice. Hdac7 deletion of organoids was achieved in vitro by tamoxifen treatment over five consecutive days of culture. Morphological changes were monitored via microscopy and gene expression was analysed using qPCR. To examine barrier function, colon organoids were seeded as monolayers into filter inserts and transepithelial electrical resistance (TEER) was measured. Monolayer structure was verified using immunofluorescence.

 Hdac7 silencing in organoids of the small intestine caused a significant morphological shift to a spheroidal shape typical for an undifferentiated phenotype. Gene expression analysis revealed a dramatic downregulation of differentiation markers for all epithelial subtypes and an upregulation of stem cell markers. In colon organoids, undifferentiated HDAC7 knockout spheroids showed a significantly increased expression of goblet cell markers but displayed reduced enterocyte marker expression when subjected to differentiation medium. TEER build-up was consistently slower in colon organoid-derived monolayers after Hdac7 deletion but was higher after differentiation compared to wild type monolayers.

 In the ileal epithelium, HDAC7 seems to play an important role in the differentiation process of all specialized epithelial subtypes while it appears to suppress mainly secretory lineages and promote differentiation into absorptive cells in the colon epithelium. These results suggest HDAC7 as an important regulator of intestinal differentiation and regeneration making it an interesting therapeutic target to treat inflammation-induced injuries in the gut.


The paper describes a system level design approach to the power and performance of a dedicated application wearable computer, the Speech Translator Smart Module. While processor speed and type affect power consumption and performance, memory size, and type of secondary storage have an even greater influence. In particular, the time to swap information in/out of main memory can reduce the performance of a wearable computer by more than half.


Greater collaboration between medical and veterinary researchers would improve our understanding of human disease and speed up the development of potential treatments, scientists have said.

Learning from animals as patients, a discipline known as "comparative medicine" or "one medicine," involves combining and translating the scientific and clinical knowledge gained from human and veterinary medicine to advance the wellbeing of people as well as animals. In comparative medicine, data from animal research, rather than being derived from experiments on laboratory animals, come from research and treatment involving companion animals and livestock undertaken primarily for the benefit of the animals.

Comparative medicine is already being used at universities to improve understanding in areas such as ageing, cancer, and heart disease and is thought to have potential for accelerating research in these areas further.

Success stories include a sponge impregnated with a chemotherapeutic agent inserted locally …


XALT collects accurate, detailed, and continuous job-level and link-time data and stores that data in a database; all the data collection is transparent to the users. The data stored can be mined to generate a picture of the compilers, libraries, and other software that users need to run their jobs successfully, highlighting the products that researchers use. We showcase how data collected by XALT can be easily mined into a digestible format by presenting data from four separate HPC centers. XALT is already used by many HPC centers around the world due to its usefulness and complementariness to existing logs and databases. Centers with XALT have a much better understanding of library and executable usage and patterns. We also present new functionality in XALT - namely the ability to anonymize data and early work in providing seamless access to provenance data.


Researchers long have assumed that negotiators give priority to economic outcomes over relational outcomes such as satisfaction with negotiation process and desire for future interactions with the counterpart. However the relational structure of a negotiation may be more or less attended to depending on the importance of relationships within a culture. In this paper, we argue that in negotiations conducted in Middle Eastern culture – which can be considered a culture of honor – relational concerns, processes, and outcomes are more important than in Western cultures. We used a role-playing negotiation exercise with both economic and relational issues at stake to examine the impact of culture and relational context on Middle Eastern and American negotiators' plans, tactics, insight and economic and subjective outcomes. Results indicate of several relational challenges that Middle Easterners face in negotiations, as compared to Americans, including too much emphasis on face-saving and conflict avoidance when negotiating with familiar others, and too much concern about protection of honor and status leading to misunderstandings, and escalation of emotional conflict when negotiating with unfamiliar others. These relational challenges (concerning face and honor) also had economic consequences by leading Middle Eastern participants to set higher aspirations, be more competitive, exchange information less effectively, and obtain lower joint gains than American dyads. Furthermore we found the economic and social outcomes were not as strongly related for the Middle Eastern negotiators as for the Americans. Unlike the American negotiators, the Middle Eastern negotiators seemed to evaluate their satisfaction with a negotiation only in the light of their subjective experiences such as self-image and quality of relationship built, and their satisfaction was very weakly related to the economic gains of the negotiators.


This paper examines the concept of staff-student partnerships from the perspective of academic staff. Staff-student partnerships are located within a broader policy context concerned with the enhancement of the student experience, and specifically the theme of student engagement. The principles of staff-student partnerships are examined, and the literature in the field is reviewed with a focus on the benefits of partnerships for students and institutions. The research findings are based on ten interviews conducted across a single, post-1992 university in an English city. The data from the interviews were thematically analysed within a social practice theory framework to examine the attitudes of academic staff to partnerships. The findings suggest a lack of consistency in the interpretation of partnerships amongst staff. Staff attitudes are influenced by the social practices of individuals and work groups, and these are highly context-dependent. The implication of this is that any initiative to promote staff-student partnerships on a wider scale should not adopt a uniform, 'one-size-fits-all' approach but must take account of social context by recognising the social practices and traditions of different groups.


In this paper, the strength of the singular stress field near the ends of the CNTs in composites was analyzed to clarify the effects of the CNT length on stress filed in the CNT reinforced composites when studying the fracture toughness. The singular stress field was separated into two types of singularities, symmetric and skew-symmetric, near the ends of CNTs according to the deformation and loading types. The stress intensity factors of the singular stress field were calculated for these two types of singularities. The effects of the CNT length in CNT reinforced composites on these stress intensity factors were investigated.


Current treatments for advanced solid tumors tend to be only palliative. Although radiotherapy is administered with a curative intent, radioresistance and dose-limiting toxicities pose limitations to treatment. Abexinostat, an oral pan-histone deacetylase inhibitor, demonstrated enhanced sensitivity to radiation in various solid tumor cell lines. We conducted an exploratory, phase 1, dose-escalation study of abexinostat in combination with standard hypofractionated radiotherapy in patients with advanced solid tumors treated in a palliative setting. Among 58 treated patients, the median age was 61.5 years (range, 20-82); 47% of the patients had M1 stage disease, and 95% had received previous chemotherapy alone or chemotherapy in combination with surgery and/or radiotherapy. The recommended phase 2 dose was determined to be 90 mg/m2 (140 mg). Of the 51 patients evaluable for response, best overall response was 8% (1 complete response [CR], 3 partial responses [PRs]), and best loco-regional response was 12% (1 CR and 5 PRs) at a median follow-up of 16 weeks. Of note, patients with target or non-target brain lesions showed encouraging responses, with 1 patient achieving a best loco-regional response of CR. Treatment-emergent grade ≥3 adverse events (AEs) were few, with most common being thrombocytopenia (17%), lymphopenia (12%), and hypokalemia (7%). Six patients (10%) discontinued treatment due to AEs. No grade ≥3 prolongation of the QTc interval was observed, with no treatment discontinuations due to this AE. Oral abexinostat combined with radiotherapy was well tolerated in patients with advanced solid tumors. The combination may have potential for treatment of patients with brain lesions.


This book discusses the common ground between the protection of freedom of expression in English law and under the ECHR against a background of the incoporation of the ECHR into English law in the Human Rights Act 1998. The protection of freedom of expression in English law, under influence of the Human Rights Act, will have to be based on such a common ground. Three aspects that determine the protection of freedom of expression can be distinguished: the approach to the notion of the right to freedom of expression, the methods of protection applied by the courts and the consideration and appreciation of facts and circumstance. These aspects are examined and analyzed through the case law of the European Court of Human Rights and the case law of the English courts, in order to determine the extent of common ground with regard to them. The conclusion in that scope of common ground is considerable. Nevertheless, the English system of protection will need to undergo further changes in order to realize the aim of the Human Rights Act, which is to prevent citizens from having to take their cases to Strasbourg to see their rights protected.


Vast areas of the globe's coastal zone have experienced significant declines in ecosystem health. Deteriorating water quality, loss and alteration of vital habitats, and reduced populations of fish and shellfish are some of the major changes recorded. Establishing and running an effective assessment program is a complex process that necessitates strategic collaboration and partnerships between many individuals and agencies. This book was written to make the process of running a coastal assessment program easier and the outcomes more effective. It provides a step-by-step approach from data collection and information management to synthesis and application and draws on the knowledge of a variety of coastal scientists and managers.


Report presents the results of an investigation conducted in the Langley 19-foot pressure tunnel to determine the maximum lift and stalling characteristics of two thin wings equipped with several types of flaps. Split, single slotted, and double slotted flaps were tested on one wing which had NACA 65-210 airfoil sections and split and double slotted flaps were tested on the other, which had NACA 64-210 airfoil sections. Both wings were zero sweep, an aspect ratio of 9, and a taper ratio of 0.4.


Background: With support from the United States government, Uganda introduced the District Health Information Software 2 (DHIS2) in 2012 to improve surveillance for better prevention and treatment of HIV/ AIDS. However, districts have yet to fully adopt this system given a 70.2% reporting completeness attained nationally between April-June 2013. To get a deeper understanding of how Uganda has been progressing in the implementation of its DHIS2, this study applied the Boundary Objects and Social Order theories. Methods: The study has one dependent variable: Districts' reporting completeness and four independent variables. 1) Number of client visits; 2) Number of district health units; 3) Number of NGOs delivering HIV and AIDS services; and 4) Regional location. These data were collected from inpatient, outpatient, and maternal newborn health programs. Findings: Districts reporting the lowest number of client visits (under 2500) attained the highest mean reporting completeness (81.6%), whereas a range of 2501-5000, or over 5001client visits recorded 72.4% and 51.7% respectively. The higher the number of client visits the lower the reporting completeness (p<0.0005). Districts that were receiving support from only one NGO recorded a mere 56.7% whereas those from two recorded 67.2%. Districts supported by over three NGOs had the highest (80.6%) mean reporting completeness score. The number of NGOs was statistically associated with reporting completeness (p<0.0005). The number of health units operated by a district was also significantly associated with reporting completeness (p<0.0005). The regional location of a district was not associated with reporting completeness (p=0.674). Conclusion: Results of this study suggest that districts with higher patient volume for HIV and AIDS services should be identified and targeted with additional NGO support. Newly funded NGOs should be established in districts operating over 40 health units. Incomplete reporting undermines identification of HIV- affected


Aim: Bibliographic work in the Turkish emergency medicine community is very scarce. We aim to improve upon the shortcomings in this area. Materials and Methods: Original research published in the Eurasian Journal of Emergency Medicine (EAJEM) (formerly known as the Academic Journal of Emergency Medicine) within the 5-year period between 2010 and 2014 was retrospectively reviewed. Results: While retrospective publications stood out the most (n=81, 54.7%), they were followed by prospective (n=38, 25.7%) and sectional (n=29, 93.9%) works. A vast majority of the work was concentric (n=139, 93.9%). Here 6.1% publications were sourced overseas. The most commonly studied subjects in the articles published in the EAJEM were medical emergencies (26.35%), trauma (20.27%), and emergency service (19.59%). Further, 52.7% (n=78) texts were written in English and 47.3% (n=70) were written in Turkish. In 15.5% (n=23) articles, an emergency medicine resident and/or emergency medicine specialist was not among the authors. The original research most commonly had 3 keywords (n=73, 49.3%). There were 12 (8.1%) articles in which no tables were used and 70 (47.3%) articles in which there were no figures. According to our findings, a total of 2981 references were used in the 148 articles that were reviewed, and the median reference value per article was 17 (min: 6; max: 50). In our study, 38 references were self-references (12.85) and 727 (24.4%) references were references to texts published in journals in the Turkish index. Within all the references, there were 43 (14.4%) references to the Turkish Journal of Emergency Medicine (TJEM), 41 (13.8%) references to the EAJEM, and only 3 (1.1%) references to Journal of Emergency Medicine Case Reports (JEMCR). The median value of references made to texts in the journals in the Turkish index per article was 2 (min: 0; max: 32). The number of references to the TJEM per article was 43/148 (29.1%), that to the EAJEM was 41/148 (27.7%), and that to JEMCR was 3/148 (2%). While the acceptance period ranged between 1 and 350 days, the average period was 49 days. Conclusion: We believe that preference should be given to the printing of prospective and multi-centric publications and those with more keywords.


This paper reviews some developmental psycholinguistic literature on quantifier scope. I demonstrate how scope has been used as a valuable probe into children's grammatical representations, the nature of children's on-line understanding mechanisms, and the role that experience plays in language acquisition. First, children's interpretations of certain scopally ambiguous sentences reveals that their syntactic representations are hierarchical, with the c-command relation playing a fundamental role in explaining interpretive biases. Second, children's scope errors are explained by incremental parsing and interpretation mechanisms, paired with difficulty revising initial interpretations. Third, a priming manipulation reveals that children's clauses, like those of adults, are represented with predicate-internal subjects. Finally, data on scope variation in Korean reveals that in the absence of disambiguating evidence, parameter setting is an essentially random process. Together, these discoveries reveal how the developmental psycholinguistics of scope has proved a valuable tool for probing issues of grammar, parsing and learning.


In south-eastern Romania, a prominent place was given to pigs in the Gumelniţa culture (Late Chalcolithic, second half of 5th millennium BC); as was the highly prized wild boar, one of a variety of species targeted for hunting. The wild boars' ecological niche and the scale of pig husbandry were investigated during a stable isotope study of the Gumelniţa A2 occupations at Borduşani-Popină, Hârşova-tell and Vităneşti-Măgurice. Results from the bone collagen δ15N and δ13C analysis suggested that the wild boars did not inhabit dense forests, in any of these locations. The emerging picture is of small-scale pig husbandry involving household management: pigs being fed leftovers and/or byproducts of human activities. At Vităneşti, previous work involving geometric morphometrics on suid molars evidenced, besides the two expected groups of small domestic pigs and large specimens with wild molar shape (i.e. wild boar), the presence of specimens with large size and domestic shape molars, whose relationship with the human community was unclear. Results from the combined geometric morphometric and stable isotope analyses, suggested that the large specimens with domestic molar shape lived in close proximity to the wild ecosystem. They were probably not part of the domestic stock, but belonged to a feral population and were acquired through hunting. Paris, 18 December 2015


This correspondence outlines a method for designing two-stage Nyquist filters. The Nyquist filter is split into two equal and linear-phase finite-length impulse response spectral factors. The per-time-unit multiplicative complexity, of the overall structure, is included as the objective function. Examples are then provided where Nyquist filters are designed so as to minimize the multiplicative complexity subject to the constraints on the overall Nyquist filter. In comparison to the single-stage case, the two-stage realization reduces the multiplicative complexity by an average of 48%. For two-stage sampling rate conversion (SRC), the correspondence shows that it is better to have a larger SRC ratio in the first stage.


Abstract. In many countries with seasonally snow-covered mountain
ranges warnings are issued to alert the public about imminent avalanche
danger, mostly employing an ordinal, five-level danger scale. However, as
avalanche danger cannot be measured, the characterization of avalanche
danger remains qualitative. The probability of avalanche occurrence in
combination with the expected avalanche type and size decide on the degree
of danger in a given forecast region (≳100 km2). To describe
avalanche occurrence probability, the snowpack stability and its spatial
distribution need to be assessed. To quantify the relation between avalanche
occurrence and avalanche danger level, we analyzed a large data set of
visually observed avalanches (13 918 in total) from the region of Davos
(eastern Swiss Alps, ∼300 km2), all with mapped
outlines, and we compared the avalanche activity to the forecast danger level
on the day of occurrence (3533 danger ratings). The number of avalanches per
day strongly increased with increasing danger level, confirming that not only
the release probability but also the frequency of locations with a weakness
in the snowpack where avalanches may initiate from increase within a
region. Avalanche size did not generally increase with increasing avalanche
danger level, suggesting that avalanche size may be of secondary importance
compared to snowpack stability and its distribution when assessing the
danger level. Moreover, the frequency of wet-snow avalanches was found to be
higher than the frequency of dry-snow avalanches for a given day and danger
level; also, wet-snow avalanches tended to be larger. This finding may
indicate that the danger scale is not used consistently with regard to
avalanche type. Even though observed avalanche occurrence and avalanche danger
level are subject to uncertainties, our findings on the characteristics of
avalanche activity suggest reworking the definitions of the European
avalanche danger scale. The description of the danger levels can be
improved, in particular by quantifying some of the many proportional
quantifiers. For instance, based on our analyses, "many avalanches", expected
at danger level 4-High, means on the order of at least 10 avalanches per
100 km2. Whereas our data set is one of the most comprehensive,
visually observed avalanche records are known to be inherently incomplete so
that our results often refer to a lower limit and should be confirmed using
other similarly comprehensive data sets.


The constructions of the building professional body has been a main research subject in recent two decades. In Iran, the construction industry is mostly based on an overwhelming pattern of mutual design practices where the majority of expert personals are design and construction technicians. But these human forces have always been marginalized within research discourse as well as the educational context of architecture. The study aims at clarifying the occupational position of draftspersons and construction technicians and their impact on architectural designs. The first part of the article, proposes a conceptual framework for studying status of architectural technicians from antiquity to present comparing Iran and the west. For the second part, a logical analysis of official documents is used to produce a general model of the subject. The ethnographical strategy is chosen for the third part of the research where middle-range forces of the small design practices of Qom are studied (using deep observation, deep interview, and objective questionnaire technics) to be compared with findings of previous studies and make conclusions. The results of this study show that draftsman place in its historical evolution has experienced a vast change from an expertise-based hierarchy towards societal hierarchy. The all models of the varieties of occupation patterns of building technicians around the world are summed up in four conceptual models. The difference of the models falls into directness or indirectness of the mediatory role of the technician between architectural designer and other human figures in design decision making (clients, law agents, other engineers of building and operational forces). For Iranian small design practices, official duties, integration with clients and designing of some small projects are three common roles of the technician that are not within their official defined education as well as professional place. This fact invites to a review of their education an occupational pattern.


In "Minds, Machines, and Gödel", J. R. Lucas claims that Goedel's incompleteness theorem constitutes a proof "that Mechanism is false, that is, that minds cannot be explained as machines". He claims further that "if the proof of the falsity of mechanism is valid, it is of the greatest consequence for the whole of philosophy". It seems to me that both of these claims are exaggerated. It is true that no minds can be explained as machines. But it is not true that Goedel's theorem proves this. At most, Goedel's theorem proves that not all minds can be explained as machines. Since this is so, Goedel's theorem cannot be expected to throw much light on why minds are different from machines. Lucas overestimates the importance of Goedel's theorem for the topic of mechanism, I believe, because he presumes falsely that being unable to follow any but mechanical procedures in mathematics makes something a machine.


Business data analyses are the iterative and the statistical methodological that considered as a soul of business research and education and are the utmost targets for any academic institute that seek a high quality standards in these areas. This special issue, inspired by the Workshop "Business Data Analysis: A Crossroad Between Research and Education" (BDA2016), which was held at the college of business administration, Al Falah University (Dubai-UAE) in April 28, 2016, highlights several statistical tools that used in the business data analysis.


This paper introduces a single-photon detection technique for time-of-flight distance ranging based on the temporal and spatial correlation of photons. A proof-of-concept prototype achieving depth imaging up to 100 meters with a resolution of 340 × 96 pixels at 10 frames/s was implemented. At the core of the system, a sensor chip comprising 32 macro-pixels based on an array of single-photon avalanche diodes featuring an optical fill factor of 70% was fabricated in a 0.18-μm CMOS. The chip also comprises an array of 32 circuits capable of generating precise triggers upon correlation events as well as of sampling the number of photons involved in each correlation event, and an array of 32 12-b time-to-digital converters. Characterization of the TDC array led to -0.52 LSB and 0.73 LSB of differential and integral nonlinearities, respectively. Quantitative evaluation of the TOF sensor under strong solar background light, i.e., 80 klux, revealed a repeatability error better than 10 cm throughout the distance range of 100 m, thus leading to a relative precision of 0.1%. In the same condition, the relative nonlinearity error was 0.37%. In order to show the suitability of our approach in a real-world situation, experimental results in which the depth sensor was operated in a typical traffic scenario are also reported.


In this study, the writer used a quasi-experimental non-equivalent-groups pre-test-post-test design. The subjects of this study were the second grade students of Elementary School. The writer used two classes as the sample of this experiment. The experimental group was taught using mind mapping and another was taught using word list. Before that, the writer gave a pre-test, and after the experiment a post-test to both groups. From the calculation of the t-test, the writer found the t-observation of both groups. From the analysis of the pre-test, the writer found out that those two groups had equal ability in vocabulary mastery. From the post-test scores, the writer also found out that those two groups were not significantly different. The t-observation of the two groups was 1.26, while the t-table was 2.08. It means that the null hypothesis which says "there is no significant difference between the vocabulary mastery of the second grade students who were taught by using mind mapping technique and one of those taught by using word list technique" was accepted.


Adenoviruses have been extensively researched for use as vectors for both gene therapy and vaccination. Gene therapy is the delivery of transgenes in order to treat genetic disease, whereas vaccination with viral vectors is primarily to induce immune responses to transgenes and in some cases the vector itself. While immune reactions against the adenovirus backbone can be desirable in vaccination strategies, this has proved to be a particular problem in gene therapy settings. The most fully investigated human adenoviruses (HAds) are serotypes 2 and 5, which are endemic in the population with most people harbouring neutralising antibodies to them. Quantifying the levels of neutralising antibodies to adenoviral vectors in patients is important as these may impede vector efficiency upon administration. Recent research has shown that this can be overcome by the use of alternative vectors based on less prevalent HAds and adenoviruses from heterologous species. However, before such alternatives can be used it is first necessary to investigate whether these viruses can express genes in cells of the target species. For development as a live vaccine vector their ability to infect cells of the target species is of interest. Canine adenovirus type 1 (CAV-1) is a candidate vector for both gene therapy and vaccination, hi its canine host CAV-1 causes a number of diseases including hepatitis. It has tlie ability to infect a wide range of tissues in the dog and cells from several animal species (Koptopoulos & Cornwell, 1981). In addition, limited investigations have shown CAV-1 capable of infecting human cells (Gehle & Smith, 1969). One of the aims of the presented work was to investigate CAV-1 infection in cells of two candidate species: cats and humans, using sensitive modern techniques including real-time PCR and RT-PCR. This would determine the suitability of CAV-1 as a vector in these species, primarily for vaccination in cats and gene therapy in humans. In feline cells CAV-1 infection was productive with growth kinetics similar to CAV-1 infection of canine cells. In addition, transgene expression was demonstrated from a replication competent CAV-1 vector. DNA replication and transcription were demonstrated in human cells, as was transgene expression. Classical adenoviral cytopathic effect was not observed in human cells, however, in A549 cells CAV-1 infection resulted in the limited production of de novo infectious virus. These findings indicate that CAV-1 has potential for development as a vector for use in both species. One of the features that initially attracted researchers to the development of adenoviral vectors was their ability to infect a wide variety of tissues. However, the promiscuous tropism of these vectors can lead to limited transgene expression in target tissues. Untargeted vectors can cause a number of problems such as toxicity in non-target tissues and high dosage requirements, which can lead to harmful immune responses. The fibre mediates initial adenovirus attachment to host cells and research has shown that adenoviruses can be targeted through modification of this protein. A second aim of this work was proof-of-principle experiments to investigate whether CAV-1 could tolerate the fibre of another adenovirus serotype. CAV-1 vectors that were pseudotyped with CAV-2 and HAd5 were created that grew to high titres and displayed altered tropism in preliminary investigations. As such, a vector system was developed that will facilitate targeting through exploitation of existed targeted HAd5 fibres in their entirety or through knob exchange. In addition, fibre deleted vectors were developed. Infection of MDCK cells with these viruses did not result in cytotoxicity. However, fibre expressing cell lines allowed productive infection. Finally, it is important to determine the levels of pre-existing antibodies in target species and therefore the neutralisation of CAV-1 by human and feline serum samples was determined. None of the feline samples had neutralising activity against CAV-I. Only 22% of human serum samples were able to neutralise CAV-1 compared with the neutralisation of HAd5 by 46% of samples. The same human samples were investigated for the ability to neutralise CAV-1 vector pseudotyped with the HAd5 fibre. The results showed that neutialisation of tliis vector by human sera was related to that of CAV-1 and HAd5. In conclusion these results demonstrate that CAV-1 can express transgenes in feline and human cells, that there is potential to modify its existing tropism and that there are low (or no) neutralising antibodies to it in both species investigated.


This paper examines the relationship between the quality of local labor force and variation in regional poverty outcomes among Michigan areas. A regional poverty model is derived from the household production model for that purpose. The US Census 2000 data on small geographical areas of Michigan (Census Block Groups) is used for the analysis. It is found that the difference in regional poverty is explained primarily by differences in quality and quantity of labor available to a household. Second, heterogeneity of the model is detected with respect to a degree of urbanization. Also, the relation between average income and regional poverty is found to be nonlinear and distribution of income playing a major role in explanation poverty. Higher poverty rates in rural areas tend to persist over time.


Research has consistently shown that principal leadership matters for successful schools. Evaluating principals on the behaviors shown to improve student learning should be an important leverage point for raising leadership quality. Yet principals are often evaluated with the use of instruments with no theoretical background and little, if any, documented psychometric properties. To address this need, a team of researchers in principal leadership, assessment development, and psychometrics developed the Vanderbilt Assessment of Leadership in Education (VAL-ED). The purpose here is to report on iterative development work where the instrument was tested and revised across several cycles. Future work to investigate the instrument's psychometric properties is identified. After an extensive item writing and instrument development phase, the authors embarked on a series of studies designed to guide improvements to the instrument. These studies include a sorting study, two rounds of cognitive interviews, a bias review, and two rounds of small- scale pilot tests. Results and implications from each study are discussed. The iterative development process helped improve the clarity of instructions and items while building a growing collection of preliminary validity and reliability evidence. At the end of the development process, the VAL-ED represents a promising instrument for assessing principal instructional leadership.The VAL- ED also represents a tool for possible use by principal leadership researchers in measuring the effectiveness of school principals.


Due to inter-subunit communication, multisubunit enzymes usually hydrolyze ATP in a concerted fashion. However, so far the principle of this process remains poorly understood. In this study, from the viewpoint of statistical mechanics, a simple model is presented. In this model, we assume that the binding of ATP will change the potential of the corresponding enzyme subunit, and the degree of this change depends on the state of its adjacent subunits. The probability of enzyme in a given state satisfies the Boltzmann's distribution. Although it looks much simple, this model can fit the recent experimental data of chaperonin TRiC/CCT well. From this model, the dominant state of TRiC/CCT can be obtained. This study provide a new way to understand biophysical processe by statistical mechanics analysis.


We previously demonstrated that subretinal injection (SRI) of isogenic mesenchymal stem cells (MSCs) reduced the severity of retinal degeneration in Royal College of Surgeons rats in a focal manner. In contrast, intravenous MSC infusion (MSCIV) produced panoptic retinal rescue. By combining these treatments, we now show that MSCIV supplementation potentiates the MSCSRI‐mediated rescue of photoreceptors and visual function. Electrophysiological recording from superior colliculi revealed 3.9‐fold lower luminance threshold responses (LTRs) and 22% larger functional rescue area from combined treatment compared with MSCSRI alone. MSCIV supplementation of sham (saline) injection also improved LTRs 3.4‐fold and enlarged rescue areas by 27% compared with saline alone. We confirmed the involvement of MSC chemotaxis for vision rescue by modulating C‐X‐C chemokine receptor 4 activity before MSCIV but without increased retinal homing. Rather, circulating platelets and lymphocytes were reduced 3 and 7 days after MSCIV, respectively. We demonstrated MSCSRI‐mediated paracrine support of vision rescue by SRI of concentrated MSC‐conditioned medium and assessed function by electroretinography and optokinetic response. MSC‐secreted peptides increased retinal pigment epithelium (RPE) metabolic activity and clearance of photoreceptor outer segments ex vivo, which was partially abrogated by antibody blockade of trophic factors in concentrated MSC‐conditioned medium, or their cognate receptors on RPE. These data support multimodal mechanisms for MSC‐mediated retinal protection that differ by administration route and synergize when combined. Thus, using MSCIV as adjuvant therapy might improve cell therapies for retinal dystrophy and warrants further translational evaluation. Stem Cells Translational Medicine 2017;6:444–457


The separation of generalization error into two types, bias and variance (Geman, Bienenstock, Doursat, 1992), leads to the notion of error reduction by averaging over a "committee" of classifiers (Perrone, 1993). Committee performance decreases with both the average error of the constituent classifiers and increases with the degree to which the misclassifications are correlated across the committee. Here, a method for reducing correlations is introduced, that uses a winner-take-all procedure similar to competitive learning to drive the individual networks to different minima in weight space with respect to the training set, such that correlations in generalization performance will be reduced, thereby reducing committee error.


In this study an easy strategy for conducting polymer based nanocomposite formation is presented through the deposition of cobalt-ferrite (CoFe(2)O(4)) containing poly(3,4-ethylenedioxythiophene) (PEDOT) thin layers. The electrochemical polymerization has been performed galvanostatically in an aqueous micellar medium in the presence of the nanoparticles and the surface active Triton X-100. The nanoparticles have been characterized by Transmission electron microscopy (TEM), the thin layers has been studied by applying Scanning electron microscopy (SEM), and X-ray diffraction (XRD), and the basic electrochemical properties have been also determined. Moreover, electrocatalytic activity of the composite was demonstrated in the electrooxidation reaction of dopamine (DA). The enhanced sensitivity - related to the cobalt-ferrite content - and the experienced photocatalyitic activity are promising for future application.


The quality of temperature distributions that can be generated with the multi-electrode current source (MECS) interstitial hyperthermia system, which allows 3D control of the spatial SAR distribution, has been investigated. For the investigations, computer models of idealized anatomies were used. These anatomical models did not contain discrete vessels. Binary-media anatomies, containing media interfaces oriented parallel, perpendicular or oblique with respect to the long axis of the implant, represent simple anatomies which can be encountered in the clinic. The implant volume was about . A seven-catheter hexagonal implant geometry with a nearest-neighbour distance of 15 mm was used. In each interstitial probe between one and four electrodes with a diameter of 2.1 mm were placed along an `active section' with a length of 50 mm. The electrode segments had lengths of 50, 20, 12 and 9 mm. This study shows that even with high contrasts in electrical and thermal conductivity in the implant it remains possible to obtain satisfactory temperature distributions with the MECS system. Due to its 3D spatial control the temperature homogeneity in the implant can be made quite satisfactory, with of the order of 2 - 3 K. Treatment planning must ensure that the placement of the current source electrodes is compatible with the media configuration.


This paper proposes a set of performance factors for load characterization and revenue metering. They are based on the Conservative Power Theory, and each of them relates to a specific load non-ideality (unbalance, reactivity, distortion). The performance factors are capable to characterize the load under different operating conditions, considering also the effect of non-negligible line impedances and supply voltage deterioration.


Using charge modulated electroabsorption spectroscopy (CMEAS), for the first time, the energy level alignment of a polymer:fullerene bulk heterojunction photovoltaic cell is directly measured. The charge-transfer excitons generated by the sub-bandgap optical pumping are coupled with the modulating electric field and introduce subtle changes in optical absorption in the sub-bandgap region. This minimum required energy for sub-bandgap charge genreation is defined as the effective bandgap.


The IgG2 subclass of antibodies has emerged as an attractive therapeutic framework. However, a method for sufficiently separating the three IgG2 disulfide isoforms has not been developed. Here, we report a method for efficient separation of monoclonal IgG2 isoforms by means of high-performance liquid chromatography on a column packed with 2 μm nonporous ODS silica particles. Under optimized conditions, the isoforms were separated with high resolution because mass transfer resistance in the stationary phase was reduced by the use of the small, nonporous particles. The number of separated peaks was more than twice that reported previously. The run-to-run repeatability of the IgG2 separation pattern was satisfactory, and the day-to-day repeatability of the retention time of the main peak was good (relative standard deviation 0.9%). The separation pattern can be expected to be useful for monitoring quality consistency of therapeutic antibodies.


Objective: To determine the accuracy of first trimester sonography in identifying fetal gender. Materials and methods: This study was carried out prospectively in 250 singleton pregnancies who underwent sonography at 11–14 weeks of gestation (confirmed by CRL or BPD). Fetal genitalia was examined in a midsagittal plane and if the angle of genital tubercle to horizontal line through the lumbosacral skin surface was greater than 30′ the gender was assigned as male and when the genital tubercle was parallel or convergent less than 30′, female. The results were checked after birth. Results: In 22 (8.2%) patients fetal sex was not determined. Genital tubercle was identified in 228 (91.2%) patients. Sex determination was correct in 207 (90.8%) and wrong in 21 (9.2%) of cases. The accuracy of sex determination increase with gestational age from 82.7% at 11 weeks, to 90.9% at 12 weeks, 94.7% at 13 weeks and 94.1% at 14 weeks. Most common mistake was to assign male fetuses as female. Conclusion: Sex determination by sonography at first trimester has an important role in case of X-linked anomalies to avoid invasive procedures in female fetuses. The accuracy of correctly identifying fetal gender by sonography at first trimester was 90.8%.


Chylous pericardial effusion is a rarely reported complication of lung cancer surgery. Here, we report a case of an elderly man who suffered chylous pericardial effusion after radical right upper lung resection for cancer. The massive chylous effusion first occurred in the pericardium, drained to the right chest after the drainage of the hydropericardium and subsequently moved back to the pericardium again. Lymphoscintigraphy examination indicated that a chylous fistula was present in the plane of the tracheal carina. After failure to control the chylous effusion with conservative medical treatment, the patient underwent video-assisted thoracic surgery through the left chest for thoracic duct ligation and pericardial fenestration. The patient was ultimately discharged without recurrence of the effusion after surgical treatment. This case report discusses the possible mechanism of chylopericardium after lung cancer surgery and suggests some strategies to prevent postoperative chylous pericardial effusion.


The chemical and mineralogical analyses of manganese-rich and iron-rich oxide crusts, of probable hydrothermal origin, from several locations on active spreading centers and seamounts in the Pacific and Atlantic indicate that these crusts originate from a uniform depositional process. These crusts are characterized by extreme Fe/Mn ratios, Fe and Si contents which co-vary, generally very low concentrations of most trace metals and the rare-earth elements, and variable contents of Zn and the volatile elements Hg, As, and Sb. Co is markedly depleted relative to Cu and Ni, and Zn is enriched, resulting in characteristically low Co/Zn values. These compositions can be accounted for by the fractional precipitation of Fe, SiO 2 , and Mn and incorporation of Zn, As, Sb, and Hg from hydrothermal solutions, and adsorption of minor amounts of Co, Cu, Ni, Pb, Ba, and rare-earth elements from sea water. Mineralogical analyses by ultra-slow scan X-ray diffraction show the manganese-rich crusts to be composed of nearly pure, well-crystallized birnessite and/or todorokite. Iron-rich crusts consist of either amorphous hydrated iron oxide and silica or iron-rich, low-aluminum nontronite. Analyses of a suite of thin ferromanganese crusts formed on ocean-ridge out-croppings of basalt and of a number of Pacific manganese nodules indicate that ferromanganese crusts are enriched in Fe and Si and depleted in trace metals relative to nodules and are similar in chemical composition to East Pacific Rise metalliferous sediments. The similarity of the ferromanganese crusts to metalliferous sediment suggests that they have a common origin. It is believed that most of the Fe, SiO 2 and Mn entering sea water in hydrothermal solutions precipitates as colloidal SiO 2 and hydrated Fe and Mn oxides which are advected by bottom currents and deposited as crusts and sediments. Trace-element contents in these deposits result from adsorption from sea water onto the Fe and Mn colloids during advection.


The Percival Collaboration is developing a high-speed,low X-ray energy detector capable of detecting single pho-tons while maintaining a large dynamic range of sensitivity.The increased brilliance of state-of-the-art Synchrotronradiation sources and Free Electron Lasers require imagingdetectors capable of taking advantage of these light sourcefacilities. The PERCIVAL ("Pixelated Energy ResolvingCMOS Imager, Versatile and Large") detector is being de-veloped in collaboration between DESY, Elettra SincrotroneTrieste, Diamond Light Source and Pohang Accelerator Lab-oratory.It is a CMOS detector targeting soft X-rays < 1 KeV, witha high resolution of up to 13 M pixels reading out at 120 Hz,producing a challenging data rate of 6 GiB/s.The controls and data acquisition system will include aSoftware Development Kit to allow integration with thirdparty control systems like Tango and DOOCS; an EPICS [1]areaDetector [2] driver will be included by default. It willmake use of parallel readout to keep pace with the datarate, distributing the data over multiple nodes to create asingle virtual dataset using the HDF5 file format for its speedadvantages in high volumes of regular data.This development project will culminate in a control andDAQ system capable of dealing with very high data rateswhile providing easy integration with site-specific controlsystems.This report presents the design of the control system soft-ware for the Percival detector, an update of the current stateof the implementation carried out by Diamond Light Source.


Although Antarctic blue whales (Balaenoptera musculus intermedia) are known to occur throughout the Southern Ocean, undertaking seasonal migrations between their breeding and feeding grounds, knowledge on spatio-temporal patterns in their distribution is limited. Here, passive acoustic recordings collected over three years from four locations at different latitudes along the Greenwich meridian south of 59°S, provided data on patterns in occurrence of stereotyped 3-unit vocalizations of Antarctic blue whales in the Weddell Sea.

Highest vocalization rates occurred during austral summer at all recording locations, with calls detectable during 10 months in recordings from 59°S and 66°S, over 11 months in recordings from 69°S and year-round in recordings from coastal waters off the Antarctic continent at 70°S. Antarctic blue whale acoustic activity showed seasonal maxima that differed in timing between recorders, but were consistently present between years. Onset of increased acoustic presence occurred in November-December in the northernmost recorder at 59°S, in January in the recorders at 66°S and 69°S and in February in the southernmost recorder at 70°S. These results are consistent with a southbound migration of vocalizing Antarctic blue whales with at least some individuals migrating as far south as the Antarctic coastal waters during austral summer. A secondary increase in acoustic activity occurred during March and April in the recorders at 59°S and 66°S, respectively, supporting previous suggestions that migration of Antarctic blue whales is segregated in time. The absence of a corresponding secondary maximum at 69°S hints towards not all individuals migrating this far south, and that migratory destinations (or alternatively, vocal activity) may hence be spatially segregated. The year-round presence of Antarctic blue whale calls off the Antarctic continent suggests that Antarcticas' coastal polynyas, i.e. patches of open water where animals can surface to breathe, may provide important habitats for animals to overwinter in high latitude waters.


The influence of kappa/beta-carrageenan from red marine alga Tichocarpus crinitus on the development of tobacco mosaic virus (TMV) infection in Xanthi-nc tobacco leaves was studied. It was shown that the number of necrotic lesions on the leaves inoculated with the mixture of TMV (2 microg/ml) and carrageenan (1 mg/ml) was reduced by 87%, compared to the leaves inoculated with the virus only. The suppression of virus infection was also observed when leaves were treated with carrageenan 24 h before or 24 h after leaf inoculation with TMV; however, in these cases, suppression was less evident than after inoculation with the virus-polysaccharide mixture. It is supposed that the antiviral activity of carrageenan applied together with TMV may be explained by its action not only on the plant but also on the virus itself. The inhibitory effect of carrageenan pretreatment can be explained by its favorable effect on tissue resistance to infection. The suppression of this resistance by actinomycin D indicates that carrageenan functions via its action on the cell genome.


Copper‐plated interconnects were widely adopted for volume manufacture of integrated circuits after more than a decade of intensive research to demonstrate that use of Cu would not impact device reliability. However, although Cu‐plated metallisation promises significantly reduced costs for Si photovoltaics, its adoption in manufacturing has not gained the same traction. This review identifies some key challenges facing the introduction of Cu‐plated metallisation for Si photovoltaics. These include the following: (1) increased carrier recombination due to the use of Cu for metal contact formation; (2) reduced module reliability due to adhesion or contact integrity failures; and (3) limited availability of cost‐effective processes and equipment for metal plating. For integrated circuits, Cu's low electrical resistance and high resistance to electromigration provided an impetus for the large investment in process development that was required to realise Cu‐plated interconnects. However, the technical advantages of using Cu for Si solar cell contacts are not as compelling, as solar cells can tolerate larger feature sizes thus reducing the criticality of the contact metal's conductivity and electromigration properties. Additionally, for Si photovoltaics, low cost is paramount, and new challenges arise from the need for modules to absorb light and operate in the field for 25+ years in diverse outdoor climates. However, with the scale of Si photovoltaic manufacturing expected to increase dramatically in the next decade, the use of large quantities of silver for cell metallisation will provide an incentive to address reliability concerns regarding the use of Cu for Si photovoltaic metallisation.


In patients with bronchogenic carcinoma of various types and stages, serum beta 2-microglobulin (beta 2-M) and carcinoembryonic antigen (CEA) were assayed simultaneously. The concentrations of serum beta 2-M and CEA were found to be statistically related to complete remission of the tumor (P less than 0.01). But it was also found that there was no correlation between the levels of beta 2-M and CEA (r = 0.0621). In follow-up, the CEA was found to be increasing incessantly as the disease progressed. For the level of serum beta 2-M, as the patients' condition got worse, it first rose, then dropped and became markedly lower before the patient died. The serum beta 2-M was often elevated 3-5 months earlier than CEA, and frequently resumed the normal level later than CEA after the carcinoma had a complete remission. With the progression of the bronchogenic carcinoma, elevation of beta 2-M was not necessarily a sign of poor prognosis. In contrast, with the serum beta 2-M markedly lowered after an initial elevation, the serum CEA became elevated, the prognosis was usually poor. The authors believe that, in patients with lung cancer, CEA produced from the lung cancer cells would give a level fluctuating with the size of the primary focus and the extent of the metastasis. But its positive rate is rather low. The serum beta 2-M is produced indirectly by certain immunologic function against bronchogenic carcinoma or its metabolites and not by the cancer cells directly. The positive rate of beta 2-M is high, so slightly is its false positive rate.(ABSTRACT TRUNCATED AT 250 WORDS)


Cherokee--Anglo-American culture contact during the Federal Period in eastern Tennessee is examined. This study attempts to understand the historic outcome of this particular contact situation by looking at the motivating normative beliefs underlying the actions of each culture. Also of interest is the identification of those core qualities of Cherokee culture that enabled survival of contact and extreme acculturation. The Anglo-American culture was divided into two subcultures: the Federal Government and Frontier Settler. Both subcultures possessed distinctive beliefs and exhibited dissimilar patterns of behavior. The Cherokee studied embodied an eastern Tennessee regional subculture that was not necessarily reflective of the overall Cherokee ethnic and cultural group. Analysis was oriented toward defining and discussing normative beliefs, behavior patterns, and patterns of material culture. Such analysis required both ethnohistoric and archaeological data bases. A structured set of questions was used to analyze historic documents in the collection of the Records of the Cherokee Indian Agency in Tennessee, 1801-1835. Proceeding with this analytic format, inferences of normative beliefs were made and patterns of behavior defined. Analysis of archaeological remains representing the Cherokee, Federal Government, and Frontier Settler subcultures required the formulation of a quantitative classification scheme capable of vi vii incorporating both Native American and Euroamerican material elements. Quantitative artifact patterns were formulated for each subculture and then statistically tested to ascertain the degree to which they were related. This method also measured the degree of Cherokee material acculturation and gave insight into the frontier economic system. Once normative beliefs, behavior patterns, and patterns of material culture were defined, the relationship of these categories within each culture was examined. One research objective was to understand the effect of normative beliefs on material culture and determine how the beliefs may be revealed by the archaeological record. The dynamic interaction between the Cherokee and Anglo-Americans was analyzed from the perspective of the process of directed culture contact. Conditions characteristic of directed contact are defined and illustrated from the ethnohistoric and archaeological data. TABLE OF CONTENTS CHAPTER


Abstract. This paper presents an improvement of a one-dimensional lake hydrodynamic model (Simstrat) to characterize the vertical thermal structure of deep lakes. Using physically based arguments, we refine the transfer of wind energy to basin-scale internal waves (BSIWs). We consider the properties of the basin, the characteristics of the wind time series and the stability of the water column to filter and thereby optimize the magnitude of wind energy transferred to BSIWs. We show that this filtering procedure can significantly improve the accuracy of modelled temperatures, especially in the deep water of lakes such as Lake Geneva, for which the root mean square error between observed and simulated temperatures was reduced by up to 40 %. The modification, tested on four different lakes, increases model accuracy and contributes to a significantly better reproduction of seasonal deep convective mixing, a fundamental parameter for biogeochemical processes such as oxygen depletion. It also improves modelling over long time series for the purpose of climate change studies.


We explore the prospects for indirect detection of neutralino dark matter in supersymmetric models with an extended Higgs sector (next-to-minimal supersymmetric standard model, or NMSSM). We compute, for the first time, one-loop amplitudes for NMSSM neutralino pair annihilation into two photons and two gluons, and point out that extra diagrams (with respect to the minimal supersymmetric standard model, or MSSM), featuring a potentially light CP-odd Higgs boson exchange, can strongly enhance these radiative modes. Expected signals in neutrino telescopes due to the annihilation of relic neutralinos in the Sun and in the Earth are evaluated, as well as the prospects of detection of a neutralino annihilation signal in space-based gamma-ray, antiproton and positron search experiments, and at low-energy antideuteron searches. We find that in the low mass regime the signals from capture in the Earth are enhanced compared to the MSSM, and that NMSSM neutralinos have a remote possibility of affecting solar dynamics. Also, antimatter experiments are an excellent probe of galactic NMSSM dark matter. We also find enhanced two-photon decay modes that make the possibility of the detection of a monochromatic gamma-ray line within the NMSSM more promising than in the MSSM, although likely below the sensitivity of next generation gamma-ray telescopes.


Poverty in Romania is a significant problem, in search of adequate efficient solutions. Many scholars point to education as perhaps the most important means to achieve the objective of poverty alleviation. The available literature reflects on the multidimensional disadvantage that poor children face in their families and communities, both in terms of availability and quality of educational services offered to them and in terms of the cumulative factors that determine the manner in which they are able to pertain to existing opportunities. Research brings to the forefront the importance of attitudes and values, as behavioural determinants that should be studied in order to understand the strategies employed in tackling poverty. In this paper we focus on the manner in which poor Romanian families conceptualise education, its effects on their quality of life, on poverty reduction and personal development, assuming that the manner in which people perceive the role of education and the quality of the educational services available to them will determine their investment in terms of time, personal effort and financial resources. Beneficiaries of social assistance for poverty alleviation (guaranteed minimum income) were surveyed in October 2016, using a nationally representative sample (600 respondents). Results show that, while the respondents acknowledge education as an important means to achieve a better life, with improved employment and social opportunities, thus adhering to mainstream values, most of them face significant difficulties in offering their children the minimum necessary conditions for learning and a decent living.


Background: Animal bites result in significant medical costs due to injury and infection. One per cent of emergency department visits in the United States are related to animal bites. Relatedly, 60-70 dogs, over 250 cats, and thousands of wild animals test positive for rabies in the U.S. each year. However, Pennsylvania has not had a human rabies case since 1984. Animal bite and rabies surveillance by local health departments, such as the Allegheny County Health Department (ACHD), is critical to rabies prevention efforts as staff recommend rabies post-exposure prophylaxis vaccination when necessary.

Methods: All animal bite report data and rabies test results from 2017 were obtained from the ACHD's Oracle database. Data were imported into Microsoft Excel and deduplicated, and values were reclassified if the information was inconsistently reported. Analysis was completed using SAS, and figures were created in Excel.

Results: There were 1,883 mammal bites reported to ACHD in 2017, with dogs (71%) and cats (24%) involved in the majority of bites. Victims ranged from <1 to 100 years of age. In most 5-year age groups, females had more reported bites than males. Only 4 bite incidents involved an animal that tested positive for rabies; 3 involved stray cats and 1 involved a bat. Antibiotics were prescribed for 63% of reported bites, and a tetanus shot was given for 31%. A total of 104 (6%) people completed the rabies vaccine series (HRIG/HDCV), including the 4 people who were exposed to rabies positive animals. There were 13 people who completed HRIG/HDCV unnecessarily, ultimately costing between $39,000-$91,000.

Conclusion: The bite reporting system and current medical practices have continued to prevent human rabies in Allegheny County. The frequency of rabies positive animals fluctuates over time, but is relatively consistent. Requiring vaccination as a part of pet licensing may be a way to improve pet vaccination rates. Analysis of bite treatments indicated physicians may need decision help regarding animal bite post-exposure prophylaxis protocols to avoid unnecessary prescription of antibiotics, administration of tetanus boosters, and vaccination with the expensive HRIG/HDCV series. The high rabies case fatality rate and medical costs associated with animal bites and prophylaxis make continued surveillance and outreach important to protecting public health.


During the last 20 years, we have witnessed the digital transformation of the economy with the rise of digital giants, companies like Google, Facebook, Amazon, Netflix and Apple, whose business takes place online. Existing corporate taxation rules, however, have proven to be ineffective for the taxation of such businesses, as they do not take into account their particularities, including, inter alia, the absence of physical presence in the countries where their products are marketed online. Indicatively, the European Commission announced that on average digital companies pay an effective tax rate of just 9,5%, whilst traditional enterprises pay an effective rate of 23,2%.1 Currently, policy makers worldwide are looking into effective measures to adapt the corporate taxation into the digital economy and to achieve a "fair" and "just" tax system for same. In this regard, on September 21st, 2017, the European Commission released a Communication on 'A Fair and Efficient Tax System in the European Union for the Digital Single Market', which led to the proposition of two directives on the subject. The first proposal introduces rules for the establishment of an additional type of Permanent Establishment (PE) on the basis of a 'significant digital presence'. The second proposal introduces an interim measure, to allow Member States to immediately tax revenues stemming from digital services that currently escape taxation. The present Article will explore the proposal introduced by the European Commission and critically analyse whether such proposals can in fact establish a fair tax system or whether they will lead to further discrimination and injustice. It is divided into three parts. In the first part I will explore the motives and underlying reasoning behind the European Commission's initiatives and other initiatives in the field of taxation of digital enterprises taken by the OECD and other States and explore if such initiatives afford a more fair result. In the second part, I will analyse and critically review the EU proposals and attempt to respond on the question of whether in fact a fair tax system is achieved. On the third part, I will briefly examine the steps that need to be taken in the future.


AIMS: To determine the effects of (a) post-milking teat disinfection compared with no disinfection and (b) pre- and post-milking teat disinfection compared with post-milking disinfection alone, on the incidence of new intramammary infection (IMI), somatic cell count (SCC) and teat skin abnormalities in dairy cows. METHODS: In Experiment 1, dairy cows in five dairy herds were randomly allocated to a post-milking teat disinfection group (n=230), that was sprayed with an iodine-based disinfectant (TeatguardPlus) for a complete lactation, or to a non-disinfected group (n=239). In Experiment 2, cows were randomly allocated to post-milking teat disinfection (n=239) or both pre- and post-milking teat disinfection (n=235), using a chloramine-T-based disinfectant (Teatsweet) for both treatments, from calving to 118–127 days in milk. The incidence of new IMI was determined by aseptic sampling of all quarters at calving, during lactation, and at trial end or at drying-off, with clinical mastitis cases sampled on detection. SCC and teat skin abnormalities were measured at 2-monthly intervals during lactation. In both experiments, disinfectant was applied by spray application. RESULTS: Cows that received post-milking teat disinfection had a lower incidence of new IMI caused by Staphylococcus aureus, Streptococcus uberis, Corynebacterium spp and coagulase negative staphylococci, had lower bulk milk SCC during lactation, and had fewer teat skin abnormalities compared with the non-disinfected cows (p < 0.05). Pre-milking teat disinfection, in addition to post-milking teat disinfection, did not reduce the incidence of new IMI for any pathogens and did not reduce SCC (p> 0.05). CONCLUSIONS: Post-milking teat disinfection applied as a spray is a key component in mastitis control in New Zealand. There was no benefit from the addition of pre-milking disinfection. CLINICAL RELEVANCE: This study confirms previous findings of the effectiveness of post-milking teat disinfection in reducing the incidence of IMI caused by the common mastitis-causing pathogens in New Zealand, and presents the first results of a controlled study examining pre-milking teat spraying undertaken in New Zealand commercial dairy herds.


Abstract COVID-19 pandemic has become a global health issue that is ravaging every aspect of human life. Various countries, thus, institute many measures to prevent the spread of the disease among the citizenry. This article investigates measures that are put in place at construction project sites to curb the spread of COVID-19 among construction site workers. An open-ended questionnaire was used as an instrument to collect qualitative data from construction companies. A purposive sampling method was used to distribute the interview questions. The collected data were analyzed with content analysis. The findings show that most construction companies have instituted prescribed and appropriate measures to curb the spread of COVID-19 on-site. Moreover, some construction companies had implemented extra measures and developed new protocols to help mitigate the spread of COVID-19 on-site. However, few construction companies were lacking in the provision of some of the recommended measures. The study identified three categories of measures (i.e. screening, site access and handling of material and equipment deliveries on-site) where improvement is required. Construction companies could use the recommendations provided to improve upon the approach adopted to curb the spread of COVID-19 on-site. The study could also inform policymakers on COVID-19 measures that are unsatisfactorily implemented on site for which more attention and oversight is required. Research on construction site health and safety measures during this COVID-19 season are still being developed. Thus, this article contributes to advancing the body of knowledge in this area of study. Data were collected from grades 6 to 9 construction firms; therefore, the research findings may not be applied to smaller construction firms. A study that focuses on lower grades is recommended.


Abstract Background Current near-infrared spectroscopy (NIRS)-based systems for continuous flap monitoring are limited to flaps which carry a cutaneous paddle. As such, this useful and reliable technology has not previously been applicable to muscle-only free flaps where other modalities with substantial limitations continue to be utilized. Methods We present the first NIRS probe which allows continuous monitoring of local tissue oxygen saturation (StO2) directly within the substance of muscle tissue. This probe is flexible, subcentimeter in scale, waterproof, biocompatible, and is fitted with resorbable barbs which facilitate temporary autostabilization followed by easy atraumatic removal. This novel device was compared with a ViOptix T.Ox monitor in a porcine rectus abdominus myocutaneous flap model of arterial and venous occlusions. During these experiments, the T.Ox device was affixed to the skin paddle, while the novel probe was within the muscle component of the same flap. Results The intramuscular NIRS device and skin-mounted ViOptix T.Ox devices produced very similar StO2 tracings throughout the vascular clamping events, with obvious and parallel changes occurring upon vascular clamping and release. The normalized cross-correlation at zero lag describing correspondence between the novel intramuscular NIRS and T.Ox devices was >0.99. Conclusion This novel intramuscular NIRS probe offers continuous monitoring of oxygen saturation within muscle flaps. This experiment demonstrates the potential suitability of this intramuscular NIRS probe for the task of muscle-only free flap monitoring, where NIRS has not previously been applicable. Testing in the clinical environment is necessary to assess durability and reliability.


This research aims to make learning model accounting with accounting application program so that learning becomes easier accounting, challenging and fun for students and teachers of accounting so difficult to study accounting assumption can be helped with accounting application program that the author designed. The problem often faced by students in learning accounting including; transaction that is pretty much it often wrong in the calculation of the transaction, despite being put on mechanical calculators (calculator), recording repeated in subsequent keform posting one transaction that requires a long processing time, the difficulty in preparing the financial statements (Income Statement, Balance Sheet, Capital statement, and Retained Earnings) because students have to memorize any accounts that must exist on the financial statement, it causes less mandirinya in learning more centralized accounting finally learning to teachers. With a program he designed accounting application with Delphi programming language, learning problems occurred in accounting can be helped, because the author designed programs available facilities such as teaching materials, a data input form (General Journal) where the program automatically adds the transaction is entered, with only one input data, then the data is directly accessible to the next form as the form of the accounting equation, the form of financial statements (Balance sheet, Income Statement, statement of Capital and Retained Earnings), as well as for the ledger and work sheets (annual report). So that the processing time to be effective and efficient as well as students become productive. Accounting application program design will be tested on students making an accounting class 1 semester of the 2014/2015 academic year at the Department of informatics management with accounting reasons as writers first in the majors in order to make it easier to analyze the reliability and ease of application programs accounting in analyzing the program on learning  process accounting. From the results of this study are expected to be useful for accounting faculty, students, high school, vocational school, so tertananm independent learning, challenge and fun, the general public who want to study accounting easily and for science as a reference model of the development of the application of ICT in learning. Keywords : Analysis, Information Systems, Accounting Education, ICT, Program Application.


Information-driven networks include a large category of networking systems, where network nodes are aware of information delivered and thus can not only forward data packets but may also perform information processing. In many situations, the quality of service (QoS) in information-driven networks is provisioned with the redundancy in information. Traditional performance models generally adopt evaluation measures suitable for packet-oriented service guarantee, such as packet delay, throughput, and packet loss rate. These performance measures, however, do not align well with the actual need of information-driven networks. New performance measures and models for information-driven networks, despite their importance, have been mainly blank, largely because information processing is clearly application dependent and cannot be easily captured within a generic framework. To fill the vacancy, we develop a new performance evaluation framework particularly tailored for information-driven networks, based on the recent development of stochastic network calculus. Particularly, our model captures the information processing and the QoS guarantee with respect to stochastic information delivery rates, which have never been formally modeled before. This analytical model is very useful in deriving theoretical performance bounds for a large body of systems where QoS is stochastically guaranteed with a certain level of information delivery.


Maize grains from twenty three cultivars developed by research and produced at farm level were evaluated for chemical composition and their ability to produce flour and grit after removal of panicle in wet and dry processes. Sixteen cultivars used for this evaluation were developed by the breeding program of the Institute of Agricultural Research for Development (IRAD) of Cameroon. The remaining seven originated from CIMMYT, West and Central Africa Maize Network (Wecaman), Ghana and Congo. Flour and grit were produced in wet and dry processes with samples of 10 kg of grains from each cultivars using available machinery at village level. Wet process of the grains included the removal of the panicle, soaking for 3 hours, drying on the mat for 2 hours, milling, drying of the flour and sieving through different mesh sizes (400 to 800 microns). For the dry milling, whole or pealed grains were simply processed in a hammer mill and the flour fractions separated as with wet milling. Results indicated some variation in the proximate composition with nine cultivars exhibiting protein contents above 8%. High protein cultivars were in order hybrids 88094X87036, 87036XExp124, Acid soil pool yellow, 88094XM131XExp124, 87084XM131XExp124, Drought pool yellow, Drought pool white, Kassaï SR, Tuxpeno sequia and BSR 81. PCA analyses revealed that protein and fat contents as factors accounted for over 80% of intra cultivar variability related to chemical composition. Four major similarity groups of cultivars emerged as striga tolerant with high starch contents, the soft endosperm cultivars, the high fat and high protein cultivars. Flour and grit yields were cultivar and treatment dependant. Wet milling produced higher flour yields while grit yields were higher when dry milling of pealed grains was done for all cultivars. Cultivars that demonstrated good ability for grit production were ATP SR-Y, Acid soil pool yellow, Drought pool yellow and the hybrids. All cultivars exhibited their ability and suitability for different end uses and this should be taken into account when embarking on large scale maize production.


The objectives of the study were: (1) To analyze the socio-economic and demographic characteristics of Baduy people; (2) To analyze the health status and nutritional status of Baduy people and its influential factors. This research is an explorative and descriptive study on the socio-cultural aspects of food system. The data were collected through a direct interview and discussion with respondents as well as a direct observation at the location of respondents. A sample size of 338 households was drawn from the population. To obtain the data on the cultural aspects, history and  socio aspect of food, in-depth interviews was conducted with 19 key persons. The study was last for 12 months. In Outer Baduy, the factors significantly related to nutritional status are age, number of household size, income, nutritional knowledge, and wife's ability to read. In Moslem Baduy, only age and income are related to the nutritional status of children. In Moslem Baduy and the Outer Baduy, the correlation between age and W/A or W/H is similar: namely, the higher the age, the lower would the Z-score for the W/A or W/H. The income is significantly correlated to the child nutritional status according to Z-score for W/A with a high correlation coefficient, that is, 0.61. This means that the higher the income, the higher would be the Z-score value for the W/A.  The distribution of adults according to BMI classification in Outer Baduy it shows that 12.7% husbands and 17.6% wives are thin (wasted), while the overweight prevalence of the husbands is 2.4% and the wives 8.6%.  This shows that Baduy women suffer from double nutrition problems (double burden). When the survey was carried out, 2.7% women were pregnant and still breastfeeding, the rest was neither pregnant nor breastfeeding.


The relationships between luminal hydrostatic pressure and fluid transport by dog jejunum in vivo studied as a sheet in the Wells clamp were compared with quantitative predictions from a model proposed for the mechanism of the secretion produced by elevated venous pressure. According to the model, the secretion produced by increasing venous pressure and the secretion produced by negative luminal pressure are both passive filtrates contingent on a transepithelial pressure of a few centimeters of H2O. We consider that the agreement between the observed and predicted responses to luminal pressure provides strong support for the model. In particular, a) the observations displayed a predicted gross asymmetry in rates of fluid transfer with isotonic fluids depending on whether the luminal pressure was positive or negative; b) the observed magnitude of the negative luminal pressure required for the onset of secretion agreed with predictions; and c) the secretion contained significant amounts of protein at about 25% of the plasma concentration.


Organizational Management is one of the exciting themes in modern economies nowadays. An organization is a collection of people working together towards a common target. The basic building block of any organization is its people; employees. Managing an organization is ultimately getting things done through employees. Hence, more humanistic and pragmatic ways of organizational management which excel in managerial competencies are needed to sustain in this modern turbulent environment. It could be seen that Buddhist 'Sanga Communities' were organizations which excelled in managerial skills. Buddhism offers a pragmatic and an interesting perspective on the proper application of modern organizational management practices. This conceptual paper is done with the objective of exploring the implications of Buddhist perspectives such as moderation, impermanency, the belief in no-self, five precepts, eightfold path, mindfulness and self-discipline, collectivistic view of team building, value of self-sacrifices for the common good, mutual respect, seven reconciliation rules and four bases of sympathy could manifest themselves in a number of different aspects of modern organizational management. This paper explores the application of those Buddhist concepts and practices in areas of organizational management including interpersonal relations, ethical behavior, emotional intelligence, team building, communication, leadership, conflict management, personal development, good governance, group harmony, goal setting, performance management, knowledge management, and in broader sense managing people at work. The paper suggests that Buddhist concepts and practices are effective to be applied in organizational management and that those concepts and practices have more universal application which could improve the organizational productivity as the end result. It is recommended for modern managers to be mindful, compassionate and flexible, open minded, and recognize that nothing is permanent. In conclusion the Buddhist perspective of organizational management is about accepting change, creating harmony among employees and treating all with dignity and respect to achieve the ultimate goals of the organization. The Kelaniya Journal of Management, Vol. 3(2); 2014: 93-112


The INCOSE definition of "systems engineering" is "an interdisciplinary approach and means to enable the realization of successful systems." The Value‐Based Theory of Systems Engineering presents necessary and sufficient conditions for realizing a successful system and elaborates them into an executable process. The theory and process are illustrated on a supply‐chain system example, and evaluated with respect to criteria for a good theory.


This study attempts to establish the relationship between knowledge management strategy and organizational change in commercial banks in Kenya. Knowledge management strategy can assist a firm to induce individuals to offer their knowledge voluntarily for a firm's use, achieve distinctive advantage through full exploitation of a firm's knowledge base, build institutional memory and protect it from prying competitors. It can influence amongst others a successful organizational change. The study employed a descriptive cross sectional survey. A total of 39 commercial banks in operation (not under statutory management) were surveyed. Primary data was collected from the respondents using a questionnaire. Analysis utilized largely the median and mode as measures of central tendency while the inter-quartile range was used as a measure of dispersion. Percentages and frequencies were also utilised to present part of the findings. Pseudo R square statistics were used as a measure of association between knowledge management strategy (independent variable) and organizational change (dependent variable). The study found that commercial banks in Kenya primarily employ proactive and moderate knowledge management strategies. Both strategies had a strong association with the organizational changes that the commercial banks have undergone. The most popular form of organizational change was found to be a mix of both revolutionary and evolutionary change. The findings of this study are consistent with theory in that knowledge management strategy was found to have given banks dynamic capabilities in pursuit of a firm's goals such as organizational change.


Gothic architecture is the most visible and striking product of medieval European civilization. Jean Bony, whose reputation as a medievalist is worldwide, presents its development as an adventure of the imagination allied with radical technical advances - the result of a continuing quest for new ways of handling space and light as well as experimenting with the mechanics of stone construction. He shows how the new architecture came unexpectedly to be invented in the Paris region around 1140 and follows its history - in the great cathedrals of northern France and dozens of other key buildings - to the end of the thirteenth century, when profound changes occurred in the whole fabric of medieval civilization. Rich illustrations, including comprehensive maps, enhance the text and themselves constitute an exceptionally valuable documentation. Despite its evident scholarly intention, this book is not meant for specialists alone, but is conceived as a progressive infiltration into the complexities of history at work, revealing its unpredictable vitality to the uninitiated curious mind.


The influence of insulin (100 mU ml-1) on the mitotic rate in a tissue culture of muscle fibroblasts L was studied. The metod of temporary inhibition of cell transformation from G1 to S period with the aid of maintaining cells in serum free medium was used. Moreover, the number of mitoses in a stage of metaphasis after the addition of colchicine was counted and autoradiography was used. Insulin showed two independent effects on mitotic cycle: first it initiated the synthesis of DNA and increased the rate of a transformation of cells from a period G1 into period S; second--it increased the rate of processes at the final stages of mitotic cycle and increased the number of cells entering this cycle.


One way to appraise the historical importance of an individual is to consider the effect that his work has on the lives of the generations that follow him. By this measure Joseph Goldberger surely ranks among the great men of medicine in the 20th Century. Another way to judge a man's stature is to consider the manner in which he worked. Here, too, Goldberger was preeminent. His investigations are models for present and future generations of epidemiologists. Indeed, 60 years after his study of pellagra in 24 South Carolina mill towns this work is still used in schools of public health and the Center for Disease Control to teach students how to assemble, analyze, and interpret epidemiologic data. His investigations were characterized by the careful collection and critical examination of facts, by thoughtful analysis and hypothesis formation, and by searching experiments to test the validity of these hypotheses.


The article aims to establish how incisive the changes in social reality triggered by the COVID-19 pandemic are. The first part examines the distinctiveness of the current pandemic in comparison with other epidemics, and investigates responses to it from within the humanities. The second part focuses on defining the viable criteria of social change. Two such criteria are provided: change in the world-picture in terms of Ludwig Wittgenstein's philosophy and change in the concept of the reality of reality as proposed by Luc Boltanski. In the following part, these criteria are applied to analyze the debate on the pandemic unfolding in the humanities and social sciences. In the concluding part, the notion of the apparatus (dispositif) is introduced as a useful tool for exploring and depicting the social consequences of the pandemic. When this notion is juxtaposed with the adopted criteria, the epidemic can be seen to change the operative trajectory and the structure of apparatuses and, consequently, to alter the world-picture and the reality of reality as it progresses. While what durable changes (if any) the pandemic will cause cannot be established with any certainty, it can definitely be expected to enhance the social and political processes which had commenced before its outbreak. In this regard, the epidemic has produced one crucial change; specifically, communitarians are clearly getting the upper hand over liberals in the long-standing dispute between the two.


The correlation between anterior cruciate ligament (ACL) collagen fibril diameter and aging were studied in subjects aged 15 to 87 years. The samples processed for light and electron microscopy showed statistically significant differences in collagen fibril diameter among young (< 20 years), adult (20-60) and elderly subjects (> 60 years). In the young, the ACL was made up of collagen fibrils which were highly variable in size (range 20-180 nm); the diameter distribution curve was very asymmetrical (mean asymmetry +0.895). In adults and elderly subjects, the maximum diameter had decreased remarkably (120 and 110 nm, respectively) and the diameter distribution curve had become less asymmetrical (mean asymmetry +0.527 and +0.297 respectively). Fibril concentration increased considerably from young (68 fib/mu 2) and elderly subjects (140 fib/mu 2). This reduction in diameter and the relative change in collagen fibril concentration may be related to changes in elastic stiffness. The increase in small collagen fibrils and the marked rise in their concentration may make the ligament more pliable. These findings are similar to those we obtained in Achilles tendon. They demonstrate that both ACL and Achilles tendon, a tissue which responds to unidirectional mechanical forces more than ACL does, show a reduction in diameter value during ageing. These data further suggest that collagen fibril diameter is related to the aging process.


The "multilevel converter" has drawn tremendous interest in the power industry. The general structure of the multilevel converter is to synthesize a sinusoidal voltage from several levels of voltages, Multilevel voltage source converters are emerging as a new breed of power converter options for high power applications, These converter topologies can generate high- quality voltage waveforms with power semiconductor switches operating at a frequency near the fundamental. Among the available multilevel converter topologies, the cascaded multilevel converter constitutes a promising alternative, providing a modular design that can be extended to allow a transformer less connection. This paper presents a three-phase, five-level and seven level cascaded multilevel voltage source inverter based active filter for power line conditioning to improve power quality in the distribution network. The active filter compensates both reactive power and harmonic currents drawn by non-linear loads; additionally it facilitates power factor corrections. The compensation process is based on concept of p-q theory. This proposed cascaded five level and seven level active power filter system is validated through MATLAB/SIMULINK Platform.


The work aimed at studying atherosclerotic lesions in brachiocephalic arteries and lipid spectrum in coronary heart disease (CHD) and arterial hypertension (AH) in indigenous and alien population of Yamalo-Nenetsky Autonomous Okrug. It included 200 patients with CHD and AH (men and women aged 21—55 years, mean 48.2±07 yr). They were allocated to indigenous and alien groups (100 persons each). The patients matched for age and sex were examined by duplex scanning based at an outpatient facility (Salekhard). The indigenous population showed more pronounced thickening of the intima-media complex (IMC) of the common carotid artery (p = 0.001) and more frequent lesions of the main head arteries with stenosis of different severity (especially in internal carotid arteries). Total cholesterol, LDLP and atherogenicity index were similar in both groups and higher than normal. Indigenous subjects had less atherogenic structure of the lipid spectrum due to lower TG and VLDLP but higher HDLP levels.


The common autoimmune endocrinopathies result from an interaction between environmental factors and genetic predisposition. Several chromosomal gene regions have been shown to contribute to more than one disease, supporting the clinical observation that the autoimmune endocrine diseases cluster within individuals and families. Genetic studies have implicated the major histocompatability complex (MHC)‐human leucocyte antigen (HLA) genes on chromosome 6p21, although this chromosomal region does not explain all of the genetic contribution to the various disorders. Non‐MHC‐HLA genes, including disease‐specific loci, are beginning to be identified and the publication of the draft sequence of the human genome will undoubtedly expediate future discoveries. Combined with the establishment of large cohorts of subjects with disease and the development of technology capable of performing high‐throughput genotyping, genetic studies are likely to impact on the future treatment and prevention of the common autoimmune endocrine diseases.


Recent developments in online learning platforms and associated technologies have changed the dynamics of higher education by forcing practitioners to reconsider traditional assumptions of teaching and learning (Garrison & Kanuka, 2004). This has fundamentally changed the nature and parameters of pedagogy within higher education whilst also shifting the associated expectations of students (HEA, 2000). Today, face-to-face teaching alone is considered somewhat antiquated; instead an effective higher education practitioner is now someone who can draw upon a myriad of blended learning strategies (see HEFCE, 2009). Because of this, the author of this paper contends that it is a fundamental responsibility of higher education practitioners today to be responsive to such changes and to continually seek ways of innovatively 'blending' traditional face-to-face methods of teaching and learning with new technologies and online platforms. In this vein, this short paper provides an example of how micro-video-blogging has been used as a blended learning tool within a social science programme.


Three issues are explored in this article with regard to death by stoning as a punishment for adultery. First is its total absence in the Quran; the Quran makes no reference to stoning, providing a punishment of one hundred lashes of the whip for all adulterers, without any further qualification. Stoning as a punishment originates in the Sunnah of the Prophet, who applied it in the case of married adulterers, thus seemingly reserving the Quranic punishment for the unmarried adulterer. This perspective has dominated legal practice ever since. The second issue arising is as to how the conflicting rulings in the Quran and Sunnah relate to one another. Is it a case of specification (takhsis) or of abrogation (naskh)? If the latter, is it in order for the Sunnah to abrogate the Quran? The third issue is over the chronological sequence of the two rulings. If it is accepted that the Quranic ruling was revealed in Madinah after the few cases in which the Prophet applied stoning, then the Quran would have effectively overruled/abrogated the Prophetic practice. It is also said that the Prophet applied stoning by reference to the Torah, which was then set aside by the Quran. A minority opinion has also held that the Prophet applied stoning by way of tazir. A number of prominent twentieth-century shariah scholars have advised against the enforcement of stoning altogether.


We develop a pairwise classification framework for face recognition, in which a C class face recognition problem is divided into a set of C(C-1)/2 two class problems. Such a problem decomposition not only leads to a set of simpler classification problems to be solved, thereby increasing overall classification accuracy, but also provides a framework for independent feature selection for each pair of classes. A simple feature ranking strategy is used to select a small subset of the features for each pair of classes. Furthermore, we evaluate two classification methods under the pairwise comparison framework: the Bayes classifier and the AdaBoost. Experiments on a large face database with 1079 face images of 137 individuals indicate that 20 features are enough to achieve a relatively high recognition accuracy, which demonstrates the effectiveness of the pairwise recognition framework.


Abstract The influence of pre-dialysis blood pressure (BP) on the prognosis of hemodialysis (HD) patients is still inconclusive. A total of 3436 HD patients were prospectively followed up for 4 years. The patients were divided into quintiles of pre-dialysis systolic BP (SBP) and diastolic BP (DBP) levels [mm Hg]: Quintile 1 (Q1), SBP <134, DBP <66; Q2, SBP 134 to 147, DBP 66 to 72; Q3, SBP 148 to 158, DBP 73 to 79; Q4, SBP 159 to 171, DBP 80 to 85; Q5, SBP ≥172, DBP ≥86. The association between the pre-dialysis BP and outcomes were examined using a Cox proportional hazards model. During a 4-year follow-up period, 564 (16.4%) patients died of any cause and 590 (17.2%) developed cardiovascular (CV) events. The lowest level of pre-dialysis SBP group (Q1) showed a significantly increased risk of all-cause mortality (hazard ratio [HR] 1.83, 95% confidence interval [CI] 1.40–2.39) and the highest group (Q5) significantly increased risk of CV events (HR 1.31, 95% CI 1.02–1.68) compared with the reference group (Q3), respectively. The highest level of pre-dialysis DBP group was significantly associated with increased risk for both all-cause mortality and CV events. Restricted cubic spline analysis for BP and outcomes suggested the optimal pre-dialysis BP value associated with the lowest risk of outcomes was SBP 152 mm Hg for all-cause mortality, SBP 143 mm Hg for CV events, and DBP 68 mm Hg for all-cause mortality. Our results suggested that pre-dialysis BP was independently associated with all-cause mortality and CV events among Japanese HD patients.