A concurrent case-control study of 12 UK racecourses was made between March 1, 2000, and August 31, 2001, to identify and quantify the factors associated with the risk of horses falling in steeplechase races. Cases were defined as a jumping effort at a steeplechase fence that resulted in a fall and controls were defined as a successful jumping effort over any steeplechase fence at any of the 12 racecourses within 14 days before or after the case fall. Information on the horse, the jockey and the race were collected and all the fences on all the courses were surveyed. Conditional logistic regression was used to examine the relationships between the predictor variables and the risk of falling. There was one fall per 254 jumping efforts. The risk of a horse falling decreased the more times it had raced on a particular racecourse. The number of fences, the distance from the previous fence and the nature of the previous fence also affected the risk of falling. If the previous fence was a water jump the risk of falling increased; fences that were sited on flat or slight uphill gradients (up to approximately 1 in 25) were associated with a lower risk of horses falling than downhill fences, and higher takeoff boards were associated with a higher risk of falling.


This study investigated if there was any change in the HIV/AIDS knowledge, attitudes, and behaviour of the South African Police Service's (SAPS) employees of Limpopo province after attending the HIV/AIDS intervention programme. From a population of (N=108) employees, those who attended the HIV/AIDS awareness workshop participated as experimental group (n=51) while those who attended the suicide prevention and disability workshop as control group (n=57). Random sampling method was used to select the above sample. Both workshops were conducted at various places in Limpopo Province. Pre-tests were administered before the workshops while the post-tests were administered after the workshops. The results were analysed using 2 (Group: Experimental versus Control Group) x 2 (Time: Pre-test versus Post-test, a repeated measure) Analyses of Variances (ANOVA). The findings showed that there was a significant change in HIV/AIDS knowledge after employees have attended the HIV/AIDS awareness workshop. There was however no significant change in attitude and behaviour after the HIV/AIDS awareness programme. The study recommends that a one day workshop is not enough to change attitude and behaviour. It also recommends that a follow up in the form of delayed post-test is required to investigate if the behaviour of the members who promised to change positively had actually changed as behaviour changes cannot manifest in a one day workshop. This can also serve as a suggestion for further research.


This paper presents the "migratory project" and strategies triggered by a Venezuelan family in their trajectory in Brazil. The journey is marked by collective concerns, from the initial intention to migrate, going through the difficulties to bring loved ones together in Manaus, up to the decision to settle down. The data allow us to problematize a classic social science theme, the commitments between individuals and the group, emphasizing the enduring solidarity and a shared imaginary of mutual belonging implied in kinship relations. The theoretical discussion is guided by the framing of a "family project" articulating the local, the national and the transnational levels. At last, we reflect on the individual and collective transformations involved in the migration process.


Terror management research indicates that people reminded of mortality strongly affirm values and standards consistent with their cultural worldview and distance themselves from values and standards inconsistent with it. However, limited research has addressed how individuals holding beliefs inconsistent with the dominant worldview cope with death-related anxiety. The present article aims to determine which worldview subcultural groups rely on when reminded of mortality: mainstream or subcultural? Juvenile delinquents living in residential reformatories in Poland were invited to participate in a terror management study examining the anxiety-buffering strategies of individuals belonging to a group largely outside mainstream culture. Following reminders of mortality, juvenile delinquents increased support for values consistent with the mainstream cultural worldview and decreased support for values consistent with the subcultural worldview, as compared to control conditions. The present results suggest that when faced with existential threat, the subcultural worldview does not provide an adequate anxiety buffer, leading members of this subcultural group to display increased identification with mainstream cultural values. Additionally, participants' state anxiety following death reminders was mediated by mainstream cultural worldview defense.


SiCf/SiC composite has a high potential for applications such as thermal protection systems due to its high oxidation resistance, high heat emissivity and low through-the-thickness (transverse) thermal conductivity, mainly if hollow fibers are used as reinforcement phase of the composite. PAN polymer is a precursor widely used and studied for developing high performance carbon fibers. Most commercial carbon fibers are basically derived from PAN polymer. In this work, the influence of the fiber specific mass on the morphology of SiC fiber obtained by conversion reactions from PAN oxidized fiber precursor was investigated. These oxidized fibers were obtained by controlling the time and temperature during the process of stabilization/oxidation.


Background: The use of complementary and alternative medicine (CAM) among cancer patients is estimated to be approximately 40%. In self-help groups there is a need for information about CAM. This pilot study aimed to develop and evaluate a CAM educational program for cancer self-help groups. Methods: The educational program was developed in cooperation with health professionals and representatives of cancer self-help organizations. Participants were trained to increase their knowledge about CAM, to reflect their user behavior, and to use evidence-based information. Self-help group leaders were educated along the curriculum and motivated to carry out the course in their groups. Using questionnaires it was evaluated in terms of acceptance, feasibility, and satisfaction by participants. Results: A total of 171 self-help group leaders were educated. In a pilot run 7 implemented the course in their groups, with a total of 70 participants. Most of them (n = 60, 85.7%) appreciated its contents and material and would recommend it. Overall acceptance and satisfaction were high. Conclusions: The educational program was implemented successfully in a small sample and showed positive results for acceptance and feasibility. In addition to consultation by experts, it can be a good option to inform cancer survivors about CAM.


The severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection is associated with increased levels of autoantibodies targeting immunological proteins such as cytokines and chemokines. Reports further indicate that COVID‐19 patients may develop a broad spectrum of autoimmune diseases due to reasons not fully understood. Even so, the landscape of autoantibodies induced by SARS‐CoV‐2 infection remains uncharted territory. To gain more insight, we carried out a comprehensive assessment of autoantibodies known to be linked to diverse autoimmune diseases observed in COVID‐19 patients in a cohort of 231 individuals, of which 161 were COVID‐19 patients (72 with mild, 61 moderate, and 28 with severe disease) and 70 were healthy controls. Dysregulated IgG and IgA autoantibody signatures, characterized mainly by elevated concentrations, occurred predominantly in patients with moderate or severe COVID‐19 infection. Autoantibody levels often accompanied anti‐SARS‐CoV‐2 antibody concentrations while stratifying COVID‐19 severity as indicated by random forest and principal component analyses. Furthermore, while young versus elderly COVID‐19 patients showed only slight differences in autoantibody levels, elderly patients with severe disease presented higher IgG autoantibody concentrations than young individuals with severe COVID‐19. This work maps the intersection of COVID‐19 and autoimmunity by demonstrating the dysregulation of multiple autoantibodies triggered during SARS‐CoV‐2 infection. Thus, this cross‐sectional study suggests that SARS‐CoV‐2 infection induces autoantibody signatures associated with COVID‐19 severity and several autoantibodies that can be used as biomarkers of COVID‐19 severity, indicating autoantibodies as potential therapeutical targets for these patients.


In an approach proposed by V.P. Kumar et al. (see Proc. IEEE Int. Conf. on Computer-Aided Design, p.226-9, Nov. 1989) for the yield enhancement of programmable gate arrays (PGAs), an initial placement of a circuit is first obtained using a standard technique such as simulated annealing on a defect-free PGA. In the next step this placement is reconfigured so that the circuit is mapped onto the defect-free portion of a defective PGA chip with the same architecture. In the present work, the authors consider the problem of yield enhancement along the same lines as above not only for PGAs but also for wafer-scale-integrated arrays. A heuristic algorithm for reconfiguration based on a graph-theoretic formulation of the problem and a polynomial-time exact algorithm for a special case of the problem are presented. The reconfiguration algorithms are evaluated by comparing the routability and wire length of the reconfigured and initial placements of the circuit.<<ETX>>


Introduction. D-dimer levels increase throughout pregnancy, hampering the usefulness of the conventional threshold for dismissing thromboembolism. This study investigates the biological fluctuation of D-dimer in normal pregnancy. Methods. A total of 801 healthy women with expected normal pregnancies were recruited. D-dimer was repeatedly measured during pregnancy, at active labor, and on the first and second postpartum days. Percentiles for each gestational week were calculated. Each individual D-dimer was normalized by transformation into percentiles for the relevant gestational age or delivery group. The range in percentage points during the pregnancy and the delivery was calculated, and reference intervals were calculated for each pregnancy trimester, during vaginal delivery and scheduled and emergency cesarean section, and for the first and second day postpartum. Results. D-dimer increased during pregnancy; the maximal fluctuation was approximately 20 percentile points in approximately half of the women. In one out of ten women, the D-dimer values fluctuated by more than 50 percentile points. Conclusions. Due to the biological variation in D-dimer within each individual woman during normal pregnancy, repeated D-dimer measurements are of no clinical use in the evaluation of thromboembolic events during pregnancy.


This study was performed to investigate the occurrence of acute angiographic and clinical complications following PTCA using a low osmolar nonionic contrast medium. Five hundred consecutive PTCA procedures were analyzed retrospectively. The incidence of acute in-laboratory complications during PTCA as well as complications occurring during the hospital stay 24 to 48 hours after the procedure were recorded. Occlusion of the dilated artery or a side branch was observed in 19 (3.8%) of the procedures, major dissection in 34 (6.8%), and thrombus in 14 (2.8%). One patient died, 6 (1.2%) required emergency coronary artery bypass grafting (CABG), 4 (0.8%) required an emergency PTCA, and 7 (1.4%) suffered myocardial infarction (MI). Our results show that angiographic findings of thrombus, major dissection and occlusion were serious conditions that related to the clinical complications MI, emergency CABG and re-PTCA. Patients with unstable angina were risk patients for both angiographic and clinical complications. Low rates of intraarterial thrombus formation and coronary artery occlusion indicate good angiographic technique and anticoagulant and antiplatelet medication.


The Intelligent Transportation System (ITS) becomes an important component of the smart city toward safer roads, better traffic control, and on-demand service by utilizing and processing the information collected from sensors of vehicles and road side infrastructure. In ITS, Vehicular Cloud Computing (VCC) is a novel technology balancing the requirement of complex services and the limited capability of on-board computers. However, the behaviors of the vehicles in VCC are dynamic, random, and complex. Thus, one of the key safety issues is the frequent disconnections between the vehicle and the Vehicular Cloud (VC) when this vehicle is computing for a service. More important, the connection fault will disturb seriously the normal services of VCC and impact the safety works of the transportation. In this paper, a safety resource allocation mechanism is proposed against connection fault in VCC by using a modified workflow with prediction capability. We firstly propose the probability model for the vehicle movement which satisfies the high dynamics and real-time requirements of VCC. And then we propose a Prediction-based Reliability Maximization Algorithm (PRMA) to realize the safety resource allocation for VCC. The evaluation shows that our mechanism can improve the reliability and guarantee the real-time performance of the VCC.


The duration of mouse hepatitis virus (MHV) infection was examined in mice inoculated intranasally with selected strains of MHV. Following inoculation with virulent MHV-JHM, genetically susceptible BALB/c mice and resistant CD1 mice had detectable virus in the brain at 1 month, but not later intervals up to 12 months. BALB/c mice infected with avirulent MHV-S or MHV-1 had no detectable virus in brains at 1 month or thereafter. Immunosuppression of BALB/c mice with treatment regimens of hydrocortisone acetate or cyclophosphamide at 1 and 2 months after infection with MHV-JHM did not activate detectable virus in liver or increase the prevalence or degree of brain infection. Immunosuppression with these drugs during the acute phase of MHV-JHM infection influenced MHV infection, based on virus quantification in livers, but timing of drug treatment relative to MHV infection was critical. Mice infected with MHV developed IgG serum antibody titers that persisted without decline for up to 1 year after infection. Antibody titers varied with mouse genotype and infecting virus. These studies, using intranasal inoculation, support the conclusions of others, using other routes of inoculation, that MHV infection is not persistent in adult, immunocompetent mice.


Silver carp fillets were treated with liposomal encapsulated and unencapsulated pomegranate peel extract at 0.5 and 1% w/w to evaluate the effect of the extracts on the shelf life of the fillets during 15 days of refrigerated storage. Quality changes of the samples were investigated in terms of total volatile basic nitrogen (TVB-N), peroxide value (PV), thiobarbituric acid (TBA) and microbial counts (total viable counts (TVC) and total psychrotrophic count (TPC)). Results showed that the extract could reduce chemical deterioration and lipid oxidation in the fillets compared to the control, as reflected with lower TVBN and TBA values. Also, pomegranate peel extract reduced TVC and PTC of the fillets about 2 Log10CFU/g compared with control. Furthermore, silver carp fillets treated with the encapsulated pomegranate peel extract showed the lowest amount of lipid oxidation and microbial deterioration during the storage period compared with the control and pure extract treatments.


This thesis, a comparative study of Wesleyan and Primitive Methodism in the nineteenth century, is an exercise in religious and social history. Very little has been written on the religious and social history of the Illawarra region in the nineteenth century. Even Methodist historians have not explored the relationship between the Wesleyan and the Primitive Methodists in New South Wales. This thesis attempts to analyse Illawarra Methodism in the contexts of the history of Methodism and of Australian social history.
The thesis draws heavily on official church documents of Wesleyan and Primitive Methodism from the levels of the circuit (that is Wollongong), the District Meeting, the Conference or Assembly, and the General Conference as well as Connexional journals. There has been a higher survival rate for Wesleyan Methodist records than for Primitive Methodist ones, which has placed some limitations on the present study. Local newspapers have also proved valuable as a primary source. Diaries, an autobiography, preaching plans and written and oral recollections of past and present Methodists have given colour to the black and white of official church records and newspapers.
This thesis argues that colonial New South Wales inherited a divided Methodism, but not the reasons for the divisions, and, thus no further divisions occurred. The colonial environment diminished the differences between Wesleyan and Primitive Methodism particularly in the critical area of relations between clergy and laity, and thus opened up the possibility of re-union which occurred earlier and more easily than in Britain.
The structure of the thesis begins with a divided Methodism in nineteenth century Britain followed by its transposition into the New South Wales colonial environment, and the culmination of Methodist development in union in 1902 in Australia.
The history of, and the reasons for, the divisions within British Methodism are analysed in Chapter One. Chapter Two looks at Methodist (Wesleyan and Primitive) beginnings in New South Wales and then in Wollongong. The major part of this thesis is contained in Chapters Three and Four where an in-depth comparative study is made of several aspects of church and community life in the Wollongong Wesleyan and Primitive Methodist circuits. The final chapter examines a climax of Australian Methodist history: the movement towards union in 1902 together with some of its immediate results. Currie's model of ecumenical ism in an industrialised society is applied in a limited way to this example of church union.


Digital design tools are rapidly changing and blurring the boundaries between design disciplines. By extension, the relationship between humans and products is also changing, to the point where opportunities are emerging for products that can co-evolve with their human users over time. This chapter highlights how these '4D products' respond to the vision laid out three decades ago for ubiquitous computing, and have the potential to enhance human experiences by creating more seamless human-centered relationships with technology. These developments are examined in context with broader shifts in sociocultural and environmental concerns, as well as similar developments being researched in Responsive Architecture, 4D printing and systems designed to empower individuals during the design process through interactive, parametric model platforms. Technology is fundamentally changing the way designers create physical products, and new understandings are needed to positively guide these changes.


Multiple paternity, also termed polyandry, is a reproductive strategy that can increase the genetic variation within a brood to help preserve diversity within a population. A paternity analysis using multilocus microsatellites revealed that 8 of 25 (32%) quillback rockfish (Sebastes maliger) females mated with more than one male. Of the eight broods sired by multiple males, three were sired by two males and five were sired by three males. Polyandry is likely an important consideration when managing rockfish stocks for genetic diversity and productivity. The probability of polyandry increased with increasing weight and condition factor of the female, but not with increasing age or length. These results suggest polyandry is a common mating strategy in quillback rockfish in Alaska and may be related to female size.


We present a method for the automatic derivation of efficient protocol implementations from a formal specification. Optimized efficient protocol implementation has become an important issue in telecommunications systems engineering as recently network throughput has increased much faster than computer processing power. Efficiency will be attained by two measures. First, the inherent parallelism in protocol specifications will be exploited. Second, the order of execution of the operations involved in the processing of the protocol data will be allowed to differ from the order prescribed in the specification, thus allowing operations to be executed jointly and more efficiently. The method will be defined formally which is useful when implementing it as a tool.


The Azospirillum is one of the most common objects to study associative interactions between bacteria and plants. In the rhizosphere of cereals the Azospirillum cells form effective association and demonstrate a stimulating effect on plant growth and development, in particular in wheat. However, the details of these positive effects are still unknown. For example, there is no evidence of whether the Azospirillum cells are infected with bacteriophages, and little is known about the role that the bacteriohages of soil microorganisms can play in the development of associative relationship between microorganisms and plants. Nevertheless, the bacteriophages are well known to control the bacteria number in the population and be involved in genetic transduction. Note that the studied bacteriophages are mostly isolated from environment, in particular, from soil, while the bacteriphages of associative soil bacteria still remain poorly studied. To evaluated changes in the morphology of the wheat (Triticum aestivum L.) root system in Saratovskaya 29 variety after inoculation with Azospirillum brasilense Sp7 bacterial cells and bacteriophage FAb-Sp7, isolated from these cells, we first inoculated the 3-day old wheat seedlings with A. brasilense Sp7 at 108, 106, 104 cells per 1 ml. It resulted in a decrease in the length of the root, and the number of lateral roots grew considerably at 102 cells per 1 ml. After treatment wiht bacteriophage FAb-Sp7 an average number of roots remained unchanged. It was shown that wheat seedling inoculation with Azospirillum suspension resulted in a 3-fold decrease in root elongation zone, and the suction zone reduced 1.5 times. Treatment of wheat seedlings with a suspension containing Azospirillum and phages resulted in a 3.3-fold decrease in the tensile zone, but the root hair zone remained unchanged. Using confocal microscopy we demonstrated that incubation of wheat seedlings with Azospirillum at 102 cells per 1 ml significantly increased the number and length of root hairs (on average by 40 %) compared with the control. It was shown that a simultaneous inoculation with Azospirillum Sp7 cells and bacteriophage FAb-Sp7 also increased the number and length of root hairs (60 % on average) compared with control. It is suggested that bacteriophages of Azospirillum are involved into complex interaction of bacteria with wheat root system, and can influence on and, ultimately, determine the effectiveness of associative relationships between the plant and microorganisms.


We have investigated infinitely long, monostrand Pt nanowires theoretically, and found that they exhibit Hund's rule magnetism. We find a spin moment of 0.6 μB per atom, at the equilibrium bond length. Its magnetic moment increases with stretching. The origin of the wire magnetism is analyzed and its effect on the conductance through the wire is discussed.


In this paper, a new heuristic algorithm for the sparse adaptive equalization problem, termed as stochastic gradient pursuit, is proposed. A decision-feedback equalization structure is used in order to effectively mitigate the effect of long multipath channels. Diverging from the commonly used approach of sparse channel identification, we exploit the sparsity of the inverse problem under the compressive sensing perspective. Also, an extension to the case where the sparsity order parameter is unknown, is developed. Simulation results verify that the proposed schemes exhibit faster convergence and improved tracking capabilities compared to conventional and other sparse aware equalization schemes, offering at the same time a reduced computational complexity.


— Legislative and regulatory reforms in the telecommunications sector of Pacific Small Island Developing States ("SIDS") stands out from the wider Asia Pacific region. Samoa was the first of the Pacific SIDS to undergo telecommunications reform. With the enactment of Samoa's first Competition and Consumer Act (2016) ("the Act"), this article presents our preliminary findings from initial evidence exploring the interface between competition law and telecommunications reform in Samoa, following commencement of the Act in 2017, effectively repealing the Fair Trading Act 1998 and the Consumer Information Act 1989. It also seeks to understand the effective approaches to help redress regulatory and legislative compliance issues in the telecommunications sector. Key lessons from this research will be pivotal for the Telecommunications and Competition law makers in both Samoa and the Pacific SIDS. Research in this area will further address this gap in the literature and present credible evidence to build up a knowledge base about the role of competition law in Samoa telecommunications reform whilst contributing to the discourse of competition law and telecommunications reform in the Pacific SIDS region.


OBJECTIVE
To analyse patient characteristics and the results of rehabilitation among patients admitted for rehabilitation to a nursing-home.

DESIGN
Retrospective study.

SETTING
St. Jozefsheil in Bakel, part of the Stichting Verpleeghuizen Gewest Helmond Nursing Homes Foundation, District Helmond, SVGH).

METHOD
On all 60 patients admitted to the SVGH homes in 1987, information was obtained from medical, paramedical and nursing records. The Barthel index was determined on admission and at discharge and the differences were tested statistically using a t-test.

RESULTS
37 female and 23 male patients were admitted, with a median age of 75.5 years. 62% had had a cerebrovascular accident and 90% were referred from the hospital, mainly by the neurologist. The median hospitalization time was 9 weeks and the waiting list for a nursing home 2.9 weeks. In 1990, 47% of the patients were discharged, after a median rehabilitation time of 15 weeks; 23% had died and 30% remained in the nursing home. Among the discharged patients the increase in mean Barthel index from admission to discharge was 17.9 points. The difference in mean Barthel index at admission compared with non-discharged patients was 35.4 points and that compared with the decreased patients 37.7 points. For the 23 patients discharged within one year compared with the 5 patients discharged after more then one year the difference was 13.6 points. The mean Barthel index at admission of the 14 discharged patients living alone was 21 points more then that of the 10 discharged patients living with a partner. At discharge this difference was 9.9 points.

CONCLUSION
The Barthel index appears useful for evaluation and comparison of results of (geriatric) rehabilitation.


Anthropogenic CO2 emissions from point sources (e.g., coal fired-power plants) account for the majority of the greenhouse gases in the atmosphere. Water-lean solvent systems such as CO2 -binding organic liquids (CO2 BOLs) are being developed to reduce the energy requirement for CO2 capture. Many water-lean solvents such as CO2 BOLs are currently limited by the high viscosities of concentrated electrolyte solvents, thus many of these solvents have yet to move toward commercialization. Conventional standard trial-and-error approaches for viscosity reduction, while effective, are time consuming and economically expensive. We rethink the metrics and design principles of low-viscosity CO2 -capture solvents using a combined synthesis and computational modeling approach. We critically study the effects of viscosity reducing factors such as orientation of hydrogen bonding, introduction of higher degrees of freedom, and cation or anion charge solvation, and assess whether or how each factor affects viscosity of CO2 BOL CO2 capture solvents. Ultimately, we found that hydrogen bond orientation and strength is the predominant factor influencing the viscosity in CO2 BOL solvents. With this knowledge, a new CO2 BOL variant, 1-MEIPADM-2-BOL, was synthesized and tested, resulting in a solvent that is approximately 60 % less viscous at 25 mol % CO2 loading than our base compound 1-IPADM-2-BOL. The insights gained from the current study redefine the fundamental concepts and understanding of what influences viscosity in concentrated organic CO2 -capture solvents.


A novel excitation system based on full controlled devices rectifier is proposed in this article, and the excitation system can provide double kinds of damping for power system by controlling the excitation voltage of DC side and exchanging reactive with generator. Through the Mat lab / Simu link simulation platform, a circuit model is established. This paper presents a current feed forward decoupling control method and the active and reactive current can be controlled independently by the method. The simulation results of two-area including four generators system shows the system damping ratio is improved significantly, and has better dynamic performance than conventional excitation system .


The tumor growth paradox refers to the observation that incomplete treatment of cancers can enhance their growth. As shown here and elsewhere, the existence of cancer stem cells (CSC) can explain this effect. CSC are less sensitive to treatments, hence any stress applied to the tumor selects for CSC, thereby increasing the fitness of the tumor. In this paper we use a mathematical model to understand the role of CSC in the progression of cancer. Our model is a rather general system of integro-differential equations for tumor growth and tumor spread. Such a model has never been analysed, and we prove results on local and global existence of solutions, their uniqueness and their boundedness. We show numerically that this model exhibits the tumor growth paradox for all parameters tested. This effect becomes more relevant for small renewal rate of the CSC.


We use information on monthly wage increases set by collective agreements in Italy and exploit their variation across sectors and over time in order to examine how household consumption responds to different types of positive income shocks (regular tranches versus lump-sum payments). Focusing on single-earner households, we find evidence of consumption smoothing in accordance with the Permanent-Income Hypothesis, since total and food consumption do not exhibit excess sensitivity to anticipated regular payments. Consumption does not respond at the date of the announcement of income increases either, as these are known to compensate workers for the overall loss in their wages' purchasing power. However, consumption responds, albeit a little, to transitory and less anticipated one-off payments, as the expenditures on clothing&shoes increase upon the receipt of the lump-sum payments. This behaviour is consistent with bounded rationality as consumers do not consider the lump-sum as part of the overall wage inflation adjustment.


OBJECTIVE
The main objective of this study is to compare the immediate results of manipulation to mobilization in neck pain patients.

DESIGN
The patients were compared in a randomized controlled trial without long-term follow-up.

SETTING
The study was conducted at an outpatient teaching clinic on primary and referred patients.

PATIENTS
One hundred consecutive outpatients suffering from unilateral neck pain with referral into the trapezius muscle were studied. Fifty-two subjects were manipulated and 48 subjects were mobilized. The mean (SD) age was 34.5 (13.0) yr for the manipulated group and 37.7 (12.5) yr for the mobilized group. Sixteen subjects had neck pain for less than 1 wk, 34 subjects had pain for between 1 wk and 6 mo and 50 subjects had pain for more than 6 mo. Seventy-eight subjects had a past history of neck pain. Thirty-one subjects had been involved in an injurious motor vehicle accident and 28 subjects had other types of minor trauma to the neck. There were no significant differences between the two treatment groups with respect to history of neck pain or level of disability as measured by the Pain Disability Index.

INTERVENTION
The patients received either a single rotational manipulation (high-velocity, low-amplitude thrust) or mobilization in the form of muscle energy technique.

MAIN OUTCOME MEASURES
Prior to and immediately after the treatments, cervical spine range of motion was recorded in three planes, and pain intensity was rated on the 101-point numerical rating scale (NRS-101). Both pre- and post-test measurements were conducted in a blinded fashion.

RESULTS
The results show that both treatments increase range of motion, but manipulation has a significantly greater effect on pain intensity. Eighty-five percent of the manipulated patients and 69% of the mobilized patients reported pain improvement immediately after treatment. However, the decrease in pain intensity was more than 1.5 times greater in the manipulated group (p = .05).

CONCLUSION
This study demonstrates that a single manipulation is more effective than mobilization in decreasing pain in patients with mechanical neck pain. Both treatments increase range of motion in the neck to a similar degree. Further studies are required to determine any long-term benefits of manipulation for mechanical neck pain.


Pronuclear microinjection of donor plasmid containing the tol 2 transposon that was flanked by a promoter β- actin and green fluorescent protein (GFP) reporter gene were injected into the perinuclear cytoplasm of Oreochromis niloticus fertilized eggs. The aim was to determine if the β-actin promoter will drive the expression of the GFP in specific tissues of the embryo. Few days after hatching, GFP was strongly expressed in the embryos when observed under UV-light microscope. Subsequently, β actin fused with a foreign growth hormone gene in a donor tols 2 transposon along with messenger RNA was co-injected into early stage of fertilized eggs using micro injector. Out of the 30 eggs injected, 15 representing 50% hatchlings were obtained. GH was successfully transposed to the genome of Fo as confirmed from PCR of DNA from fin clip of the founder population. Growth performance in transgenic after 2 months of rearing was 1.06gm (3.7cm) compared with 0.68gm(3.5cm) in nontransgenic individuals. The founder generation is being raised to maturity to determine the level of efficiency in transmission to next generation. Keywords : Transposon; growth enhancement; Oreochromis niloticus ; transgenesis; growth hormone gene


With a need for periodic inspection or access to many hot insulated surfaces, removable/reuseable insulation covers have been found to be a good solution. These covers reduce the heat loss on surfaces such as valves, flanges, pumps, compressors, and piping where otherwise a permanent, non-reuseable type of insulation might be added. The use of removable covers can reduce the long-term cost of gaining access to the hot surfaces that need periodic inspection. There are a number of different performance requirements encountered by removable insulation covers on hot surfaces. In general, the covers should insulate effectively, be capable of being easily removed and replaced, and last a certain period of time. An impediment to their durability is the conditions to which the blankets are exposed: high service temperature, leaking chemicals, sun and rain, physical abuse, and fire, among others. The selection of appropriate materials to meet the performance requirements of a particular job can be a difficult and complex task. Such a selection is generally addressed with specifications. As as first step in developing removable insulation specifications, ASTM Committee C-16 on Thermal Insulation formed a task group to develop a standard guide. This document, which was balloted before Committee C-16 in late 1987 and received Society approval as ASTM C 1094 in 1988, identifies the performance issues faced by removable covers and their constituent materials. Being a guide, it does not recommend particular materials or even performance values. Rather, it recommends appropriate test methods, as well as general design and construction issues, that should be addressed by a specification. The use of ASTM C 1094 in developing removable cover specifications should ultimately improve the performance and quality of those covers.


Background In patients with degenerative cervical myelopathy (DCM) that have spinal cord compression and sensorimotor deficits, surgical decompression is often performed. However, there is heterogeneity in clinical presentation and post-surgical functional recovery. Objectives Primary: a) to assess differences in muscle fat infiltration (MFI) in patients with DCM versus controls, b) to assess association between MFI and clinical disability. Secondary: to assess association between MFI pre-surgery and post-surgical functional recovery. Study design Cross-sectional case control study. Methods Eighteen patients with DCM (58.6 ± 14.2 years, 10 M/8F) and 25 controls (52.6 ± 11.8 years, 13M/12 F) underwent 3D Dixon fat-water imaging. A convolutional neural network (CNN) was used to segment cervical muscles (MFSS- multifidus and semispinalis cervicis, LC- longus capitis/colli) and quantify MFI. Modified Japanese Orthopedic Association (mJOA) and Nurick were collected. Results Patients with DCM had significantly higher MFI in MFSS (20.63 ± 5.43 vs 17.04 ± 5.24, p = 0.043) and LC (18.74 ± 6.7 vs 13.66 ± 4.91, p = 0.021) than controls. Patients with increased MFI in LC and MFSS had higher disability (LC: Nurick (Spearman's ρ = 0.436, p = 0.003) and mJOA (ρ = -0.399, p = 0.008)). Increased MFI in LC pre-surgery was associated with post-surgical improvement in Nurick (ρ = -0.664, p = 0.026) and mJOA (ρ = -0.603, p = 0.049). Conclusion In DCM, increased muscle adiposity is significantly associated with sensorimotor deficits, clinical disability, and functional recovery after surgery. Accurate and time efficient evaluation of fat infiltration in cervical muscles may be conducted through implementation of CNN models.


The dam-break induced loads and their effects on buildings are of vital importance for assessing the vulnerability of buildings in flood-prone areas. A comprehensive methodology, for risk assessment of buildings subject to flooding, is nevertheless still missing. This research aims to take a step forward by following previous research. To this aim, (1) five statistical procedures including: simple correlation analysis, multiple linear regression model, stepwise multiple linear regression model, principal component analysis and cluster analysis are used to study relationship between mean normalized force on structure and other related variables; (2) a new and efficient variable that can take into account both the shape of the structure and flow conditions is proposed; (3) a new and practical formula for predicting the mean normalized force is suggested for different types of obstacles, which is missing in the previous research.


The impact of immigration on the public finances is an important influence on public opinion. This study aims to provide a thorough conceptual survey, pointing out the complexities of a full understanding and the relevance of indirect effects and covering both static perspectives and longer run dynamic issues. It considers simple accounting approaches which are relatively neglectful of behavioural responses but also tries to bring out the complexities in the nature of the relationship between immigration and the public exchequer that come with more sophisticated modelling of its economic effects.


The Electroencephalogram (EEG) is one of the useful biosignals to detect the sleep disorders. This paper discusses on the changes in the electrical activity of the human brain related to distinct sleep disorders. The EEG data has been collected from PhysioNet database. The purpose of the research is to detect the different human sleep disorders through Electroencephalogram (EEG) signal with time-frequency analysis by receiving information from the internal changes of brain state. The paper presents the detection of sleep disorders based on some salient features of EEG signal. For this purpose seven different disorders have been specified such as sleep breathing disorder, rapid eye movement behavior disorder, periodic leg movement disorder, insomnia disorder, narcolepsy disorder, nocturnal frontal lobe epilepsy disorder, bruxism disorder and with them one healthy subject. Several EEG records have been collected for these sleep disorders and analyzed using discrete wavelet transform. The discrete wavelet transform (DWT) is used to extract different significant features from the analyzed signal by computing the subband coefficients and evaluating statistical measures like energy, variance, waveform length and standard deviation which are used to detect different sleep disorders.


Stream processors are emerging in industry as an apparatus that drives analytical but also mission critical services handling the core of persistent application logic. Thus, apart from scalability and low-latency, a rising system need is first-class support for application state together with strong consistency guarantees, and adaptivity to cluster reconfigurations, software patches and partial failures. Although prior systems research has addressed some of these specific problems, the practical challenge lies on how such guarantees can be materialized in a transparent, non-intrusive manner that relieves the user from unnecessary constraints. Such needs served as the main design principles of state management in Apache Flink, an open source, scalable stream processor.

We present Flink's core pipelined, in-flight mechanism which guarantees the creation of lightweight, consistent, distributed snapshots of application state, progressively, without impacting continuous execution. Consistent snapshots cover all needs for system reconfiguration, fault tolerance and version management through coarse grained rollback recovery. Application state is declared explicitly to the system, allowing efficient partitioning and transparent commits to persistent storage. We further present Flink's backend implementations and mechanisms for high availability, external state queries and output commit. Finally, we demonstrate how these mechanisms behave in practice with metrics and large-deployment insights exhibiting the low performance trade-offs of our approach and the general benefits of exploiting asynchrony in continuous, yet sustainable system deployments.


PURPOSE
The aims of this study were to present our experience with children who underwent laparoscopic adrenalectomy for adrenal tumors over a 4-year period, discuss the technical aspects of the procedure, and review the current literature.

METHODS
We performed a retrospective review of all laparoscopic adrenalectomies performed at our institution between August 2003 and August 2007.

RESULTS
Eight patients underwent laparoscopic adrenalectomy. There were 6 girls and 2 boys. The median age was 14.5 years (range, 2-18). The median weight was 53.5 kg (range, 13-73). We performed 6 left and 2 right adrenalectomies. A lateral transperitoneal approach was used in all cases. All left adrenalectomies required three ports, while the right adrenalectomies were completed with four ports. All cases were done with two or three 5-mm ports and one 10-mm port. Tumor size ranged from 3 to 7 cm maximum diameter. The mean operative time was 99 minutes (range, 58-140). There were no complications. Blood loss was minimal in all cases and none required a conversion to open. All patients resumed oral feeds immediately after surgery. The mean hospital stay was 1.5 days (range, 1-2). The need for narcotic analgesia was minimal. Final diagnoses included: adrenal cortical adenoma (n = 4), ganglioneuroma (n = 2), pheochromocytoma (n = 1), and neuroblastoma (n = 1).

CONCLUSIONS
Laparoscopic adrenalectomy appears to be a safe, effective technique in children with small, well-circumscribed adrenal masses. The lateral transperitoneal approach offers optimal visualization and excellent outcomes in terms of minimal discomfort, rapid recovery, and excellent cosmesis.


This paper deals with the gridshells built by the Navier laboratory in the last ten years. The numerical conception is developed, from the draft made by architects up to the final structure. Several numerical tasks are performed to design a gridshell. The geometry of the gridshell is first considered. Then, an important iterative step mixing geometry and mechanical considerations is carried out. In particular, it is explained how the naturally straight beams are bent together during a very quick step leading to the final shape. Thanks to this active bending, double-curvature shapes are made and offer many interests like high stiffness for a light weight structure. Lastly, the geometry of the membrane is drawn based on the numerical final geometry of the gridshell. The improvements of gridshells, including safety considerations as well as practical considerations are also developed, through the four gridshells recently built. Finally the model is improved to take into account the torsion which can have an important effect, especially when the beams have a rectangular cross section.


We study asymptotically constrained systems for numerical integration of the Einstein equations, which are intended to be robust against perturbative errors for the free evolution of the initial data. First, we examine the previously proposed `λ system', which introduces artificial flows to constraint surfaces based on the symmetric hyperbolic formulation. We show that this system works as expected for the wave propagation problem in the Maxwell system and in general relativity using Ashtekar's connection formulation. Second, we propose a new mechanism to control the stability, which we call the `adjusted system'. This is simply obtained by adding constraint terms in the dynamical equations and adjusting their multipliers. We explain why a particular choice of multiplier reduces the numerical errors from non-positive or pure-imaginary eigenvalues of the adjusted constraint propagation equations. This `adjusted system' is also tested in the Maxwell system and in the Ashtekar system. This mechanism affects more than the system's symmetric hyperbolicity.


The response of housing prices to financing conditions is determined by the effect on the marginal buyer, not the average household. I use heterogeneous willingness to pay (WTP) data from a stated preference experiment in Fuster and Zafar (2021) to estimate the effects of changes in mortgage rates and collateral constraints on housing prices by analysing the structure of housing demand curves. This work builds on their research, which focused on average changes in WTP. Relaxing down payment constraints has a large average effect on WTP, but the effect on price is less than half as large. Financially constrained households tend to respond more to relaxed constraints, but those households often have WTPs that are too low to affect market prices. Changing the mortgage rate has the same average effect on WTPs and on market prices, because there is no systematic relationship between a household's response to mortgage rates and their location on the demand curve. I use a heterogeneous user cost model of individual WTPs to understand how household heterogeneity determines the structure of overall housing demand. An empirical model using observable household characteristics allows the experimental findings to be applied to other household survey data to simulate the effects of credit conditions. The simulated effects of easing collateral constraints in Australia are fairly stable over the past 20 years, and show a similar pattern to the US results.


Introduction Nonessential central venous catheters (CVCs) should be removed promptly to prevent adverse events. Little is known about effective strategies to achieve this goal. The present study evaluates the effectiveness of a quality improvement (QI) initiative to remove nonessential CVCs in the intensive care unit (ICU). Methods A prospective observational study was performed in two ICUs following a QI intervention that included a daily checklist, education, and reminders. During 28 consecutive days, all CVCs were identified and the presence of ongoing indications for CVC placement was recorded. The proportions of nonessential CVCs and CVC days were compared with pre-intervention proportions and between the participating units. Rates of central line-associated bloodstream infections (CLABSI) were measured separately through Ontario's Critical Care Information System. Results One hundred and ten patients and 159 CVCs were reviewed. Eighty-eight (11%) of 820 catheter days showed no apparent indication for CVC placement, and compared with the pre-intervention period, the proportion of patients with any number of nonessential CVC days decreased from 51% to 26% (relative risk 0.51; 95% confidence interval 0.34 to 0.74; P \ 0.001). There was no significant difference in the proportion of nonessential catheter days between participating units. Reported rates of CLABSI decreased substantially during the intervention. Discussion A checklist tool supported by a multifaceted QI intervention effectively ensured prompt removal of nonessential CVCs in two ICUs.


OBJECTIVE— We sought to identify type 2 diabetes susceptibility genes through a genome-wide association scan (GWAS) in the Amish. RESEARCH DESIGN AND METHODS— DNA from 124 type 2 diabetic case subjects and 295 control subjects with normal glucose tolerance were genotyped on the Affymetrix 100K single nucleotide polymorphism (SNP) array. A total of 82,485 SNPs were tested for association with type 2 diabetes. Type 2 diabetes–associated SNPs were further prioritized by the following: 1) associations with 5 oral glucose tolerance test (OGTT) traits in 427 nondiabetic Amish subjects, and 2) in silico replication from three independent 100L SNP GWASs (Framingham Heart Study Caucasians, Pima Indians, and Mexican Americans) and a 500K GWAS in Scandinavians. RESULTS— The strongest association (P = 1.07 × 10−5) was for rs2237457, which is located in growth factor receptor–bound protein 10 (Grb10), an adaptor protein that regulate insulin receptor signaling. rs2237457 was also strongly associated with OGTT glucose area under the curve in nondiabetic subjects (P = 0.001). Of the 1,093 SNPs associated with type 2 diabetes at P < 0.01, 67 SNPs demonstrated associations with at least one OGTT trait in nondiabetic individuals; 80 SNPs were nominally associated with type 2 diabetes in one of the three independent 100K GWASs, 3 SNPs (rs2540317 in MFSD9, rs10515353 on chromosome 5, and rs2242400 in BCAT1 were associated with type 2 diabetes in more than one population), and 11 SNPs were nominally associated with type 2 diabetes in Scandinavians. One type 2 diabetes–associated SNP (rs3845971, located in FHIT) showed replication with OGTT traits and also in another population. CONCLUSIONS— Our GWAS of type 2 diabetes identified several gene variants associated with type 2 diabetes, some of which are worthy of further study.


This paper describes the development of a common Nordic test method for the evaluation ofhydrophobic impregnations for concrete, for protection against chloride ingress. The first stage of theexperimental campaign served to evaluate the influence of the precondition environment before surfacetreatment, curing time and type of surface on the performance of the impregnation agent. In the secondstage, a round robin test involving 3 Nordic laboratories was conducted; the results showed very littlevariation and were compared to results obtained according to previous standards in order to defineperformance requirements. Finally, data from field exposed specimens for more than 5 years was used tovalidate the suitability for use.


One of the premier social issues in contemporary US politics is that of same-sex marriage. This research explores language use and identity construction by same-sex marriage supporters through narratives of discrimination. This paper analyzes data collected through the non-profit Marriage Equality USA, wherein narrators respond to a survey question about experiences of discrimination during California's Proposition 8 campaign, a statewide initiative that repealed the rights of same-sex couples to marry. In doing so, narrators use ideologies of religion and religious affiliation to: (1) construct a victim identity in relation to their experiences, (2) use this as a springboard to challenge their victimization, (3) establish opposition between individual and institutional positioning of religious identity, and (4) switch roles with their victimizers with respect to victim and empowered positions. In doing so, narrators use victimization as empowerment to convey a progressive position in an inevitably successful social movement.


Employment protection - the set of rules governing hiring and terminating employees - is a key feature of any country's labor market. What types of contracts will be permitted between employers and employees? Under what conditions can the relationship be terminated? What are the requirements for providing advance notice? What are the obligations of the employer regarding severance or termination payments? These are important questions for policy-makers in addressing the trade-offs between labor market flexibility and the economic security of employed workers. A mix of cultural norms, collective bargaining, and legislation determines employment protection practices in any country. This primer note focuses on the statutory regulations affecting employment protection. It provides a basic overview of the policy options and a summary of what is known about their impacts on workers and on the labor market. It also addresses the institutional and political aspects of employment protection.


Table grape stands out among the main fruit-bearing plants of irrigated agriculture in the Sao Francisco Valley region of Brazil. This study estimated repeatability and heritability coefficients and predicted genetic gains in order to select superior genotypes in grape progenies from controlled hybridizations using the Restricted Maximum Likelihood/Best Linear Unbiased Prediction (REML/BLUP) methodology. Individual plants were evaluated for the variables of production (kg per plant), number of bunches, bunch weight (g), berry diameter (mm), and soluble solids content (°Brix). We evaluated 194 hybrids from 30 crosses between Vitis vinifera and interspecific hybrids in Juazeiro, Bahia State, Brazil, over four growing seasons. Repeatability coefficients, ranging from 0.164 for soluble solids content to 0.72 for berry diameter, were estimated with accuracy values higher than 80 % for all variables, except for soluble solids content (66 %). The 30 best individuals classified for each variable exhibited genetic gains and their new estimated mean values were higher than the overall mean of the population in all variables. Regarding production and number of bunches per plant as the main variables, 15 genotypes were selected simultaneously for both variables. Among which, hybrids CPATSA 15.05, 15.06, 15.06T, and 23.103 stand out because they have trace seeds and should be selected for the following steps of genetic breeding to develop new table grape cultivars for the Brazilian semiarid region.


Background: Organizational restructuring is often accompanied by job insecurity. The fear of losing either the job (quantitative job insecurity) or important job features (qualitative job insecurity) is associated with mental (e.g., psychomental distress) and somatic health impairment (e.g., musculoskeletal disorders). Methods: Objectives of our longitudinal study were to examine the relation between job insecurity and psychomental health and to evaluate effects of a leadership intervention designed to reduce job insecurity during restructuring at the production site of a chemical company. Job insecurity and health indicators (e.g., anxiety, depression) were examined by well-established measures. A leadership training was developed and customized to the organization, subsuming health-oriented work design, change-oriented leadership, and stress management. Findings: N=46 supervisors participated in the program and N=140 employees in the questionnaire study at both measurement times (T1 before, T2 after intervention). Effects of the intervention were estimated by analysis of covariance (intervention vs. control group; T1 vs. T2). Conclusions: Results provide evidence for a causal relationship between job insecurity and health impairment. Moreover, the leadership intervention alleviated job insecurity and certain health problems. Limitations and recommendations for further interventions will be discussed.


Lattice distortion due to octahedral rotation and distortion are high focussed, and it produces profound effect on a material's properties, such as its bandgap, magnetism and optical properties etc. Rutile-type \b{eta}-MnO2 is a wide used non-Perovskite magnetic material with octahedrons. We systematically studied its stability, electronic structures, magnetic structures, and optical properties within 0-100 GPa with density-functional theory (DFT). We find that the competition between bondlength and bonding angle leads its bandgap enlarging or shrinking within in the Pnnm phase with increasing pressure, because of the interaction of Mn-d and O-p states. We also find same pressure indused bandgap evolutions in the Pnnm phases of SiO2, GeO2, SnO2 and PbO2. The different ways of octahedral connection in Pnnm phase and Pa-3 phase leads to an interesting pressure-induced bandgap enlarging. And in the Pa-3 phase, the band gap can be tuned to 1.34 eV by pressure to meet the Shockley-Queisser limit. Moreover the two high pressure phases can be quenched to ambient pressure. Together with its mechanical, optical and antiferromagnetic properties, it ensures MnO2's application as a photovoltaic material for all working condition with multi-purpose. This study extends MnO2's application and give some new mechanism of pressure induced bandgap enlargement.


Technology evolution in the field of Unmanned
Aircraft Systems (UAS) will affect the Air Traffic
Management (ATM) performance regarding
to new military and civil applications. UAS, as
new airspace users, will represent new challenges
and opportunities to design the ATM system of
the future. The goal of this future ATM network
is to keep intact (or improve) the network in terms
of security, safety, capacity and efficiency level.
On the other hand, most UAS are, at present, designed
for military purposes and very few civil
applications have been developed mainly because
the lack of a regulation basis concerning their certification,
airworthiness and operations. Therefore,
UAS operations have always been solutions
highly dependent on the mission to be accomplished
and on the scenario of flight. The generalized
development of UAS applications is still
limited by the absence of systems that support
the development of the actual operations. Moreover,
the systematic development of UAS missions
leads to many other operational risks that
need to be addressed. All this elements may delay,
increase the risk and cost in the implementation
of a new UAS application.


The structure of cooling stave was simplified with equivalent convective heat transfer coefficient, and the thermal stress axisymmetric calculation model of blast furnace hearth linings under erosion state was established. The thermal stresses of familiar erosion states were analyzed. The thermal stress concentration of erosion part is an importance cause of erosion development. 'Elephant-foot' erosion seldom develops to 'boiler-bottom' erosion. 'Boiler-bottom' erosion is a ideal long life erosion state. When the erosion stabilizes, smaller cooling intensity is favorable to linings stabilization.


There is rising evidence of an inverse association between chronic diseases and diets characterized by rich fruit and vegetable consumption. Dietary components may act directly or indirectly on the human genome and modulate multiple processes involved in disease risk and disease progression. However, there is currently no exhaustive resource on the health benefits associated to specific dietary interventions, or a resource covering the broad molecular content of food. Here we present the first release of NutriChem, available at http://cbs.dtu.dk/services/NutriChem-1.0, a database generated by text mining of 21 million MEDLINE abstracts for information that links plant-based foods with their small molecule components and human disease phenotypes. NutriChem contains text-mined data for 18478 pairs of 1772 plant-based foods and 7898 phytochemicals, and 6242 pairs of 1066 plant-based foods and 751 diseases. In addition, it includes predicted associations for 548 phytochemicals and 252 diseases. To the best of our knowledge this database is the only resource linking the chemical space of plant-based foods with human disease phenotypes and provides a foundation for understanding mechanistically the consequences of eating behaviors on health.


BACKGROUND: Advancing the science of quality improvement (QI) requires dissemination of the results of QI. However, the results of few QI interventions reach publication. OBJECTIVE: To identify barriers to publishing results of pediatric QI research and provide practical strategies that QI researchers can use to enhance publishability of their work. METHODS: We reviewed and summarized a workshop conducted at the Pediatric Academic Societies 2007 meeting in Toronto, Ontario, Canada, on conducting and publishing QI research. We also interviewed 7 experts (QI researchers, administrators, journal editors, and health services researchers who have reviewed QI manuscripts) about common reasons that QI research fails to reach publication. We also reviewed recently published pediatric QI articles to find specific examples of tactics to enhance publishability, as identified in interviews and the workshop. RESULTS: We found barriers at all stages of the QI process, from identifying an appropriate quality issue to address to drafting the manuscript. Strategies for overcoming these barriers included collaborating with research methodologists, creating incentives to publish, choosing a study design to include a control group, increasing sample size through research networks, and choosing appropriate process and clinical quality measures. Several well-conducted, successfully published QI studies in pediatrics offer guidance to other researchers in implementing these strategies in their own work. CONCLUSION: Specific, feasible approaches can be used to improve opportunities for publication in pediatric, QI, and general medical journals.


Some second order semilinear elliptic boundary value problems of the Ambrosetti-Prodi-type are studied. Existence and multiplicity of solutions is proved in dependence on a parameter. Constructing a global strongly increasing fixed point operator in a suitable function space, observing - under appropriate conditions, which are in some sense optimal - that the fixed point operator has some properties similar to a strongly positive linear endomorphism, one unifies and improves the treatment of such problems, whether the nonlinearity is dependent on the gradient or not, and obtains some new results.


E-learning allows for efficient transfer of knowledge in the real-time process, while at the same time empowering learners with the information technology awareness and skills crucial to succeed in the present Knowledge Revolution Era. The world scenario of Library and Information Science (LIS) education is changing fast. The change is enforced by many forces such as technology, demographic features, economic characters, etc. The present paper discussed the concept of e-learning and its application in LIS education. It also emphasized on the potential benefits of implementing e-learning in LIS education in North-East India and equally discussed the challenges that can affect in the adoption of Elearning in LIS education in North East India.


Purpose
Social enterprise plays a pivotal role in helping people and communities. Since the global financial crisis of 2008, there has been an upsurge of social enterprise within a local, national and global context. The purpose of this paper is to explore the debates and issues presented by social enterprise in a very complex globalized world.

Design/methodology/approach
In this paper, the authors apply two geographical case studies: China and India. The purpose for selecting both China and India is their increasing economic super power on the global stage. It is argued that the concept of social enterprise within the geographical context of China and India is significant to their individual economies.

Findings
The concept of social enterprise within the geographical context of China and India is significant to their individual economies and as explored within the notion of "think global, act local" the conceptual debates of place, space and time enables people to take positive action and enable the development of healthy communities.

Originality/value
This paper contributes to the discussion around the definition of the nature of social enterprise and gives concrete examples of the contextually specific nature of the term.


Scene text detection has become an important field in the computer vision area due to the increasing number of applications. This is a very challenging problem as textual elements are commonly found in "noisy" and complex natural scenes. Another issue refers to the presence of texts encoded into different languages within the same image. State-of-the-art solutions rely on the use of deep neural network approaches or even ensembles of them. However, such solutions are associated with "heavy" models, which are computationally expensive in terms of memory and storage footprints, which hampers their use in real-time mobile applications. In this work, we introduce Pelee-Text++, a lightweight neural network architecture for multi-lingual multi-oriented scene text detection, especially tailored to running on devices with computational restrictions. Additionally, to the best of our knowledge, this is the first work to evaluate the performance of text detection methods in commercial smartphones. Over this scenario, Pelee-Text++ processes 2.94 frames per second and it is the only evaluated approach that did not cause memory issues on smartphones, even using an input image of $1024\times 1024$ pixels. Our proposal achieves a promising trade-off between efficiency and effectiveness, with a model size of 27 Megabytes and F-measure of 91.20%, 85.78%, 81.72%, 80.30%, 82.53% and 66.51% on ICDAR 2011, ICDAR 2013, ICDAR 2015, MSRA-TD500, ReCTS 2019 and Multi-lingual 2019 datasets, respectively.


Surveys of chairpersons and faculty members of engineering departments of U.S. universities were conducted in the fall of 1985 to examine the relation between the high proportion of foreign graduate students and the operation and quality of engineering education in the United States. Information was obtained on admissions criteria and policies, financial aid, and the performance of U.S. and foreign students as teaching and research assistants. Overall, the survey respondents believed that foreign students are an asset and that, without them, training and research would suffer. Language and communications were the problems most frequently mentioned as adversely affecting the performance of foreign students.


We investigated how deciduous trees can adjust their freezing resistance in response to temperature during the progress of the ecodormancy phase, from midwinter to budburst. We regularly sampled twigs of four different temperate deciduous tree species from January to the leaf-out date. Using computer-controlled freezers and climate chambers, the freezing resistance of buds was measured directly after sampling and also after the application of artificial hardening and dehardening treatments, simulating cold and warm spells. The thermal time to budburst in forcing conditions (c. 20°C) was also quantified at each sampling as a proxy for dormancy depth. Earlier flushing species showed higher freezing resistance than late flushing species at either similar bud development stage or similar dormancy depth. Overall, freezing resistance and its hardening and dehardening potential dramatically decreased during the progress of ecodormancy and became almost nil during budburst. Our results suggest that extreme cold events in winter are not critical for trees, as freezing resistance can be largely enhanced during this period. By contrast, the timing of budburst is a critical component of tree fitness. Our results provide quantitative values of the freezing resistance dynamics during ecodormancy, particularly valuable in process-based species distribution models.


Selection of a count interval to extract flow data on pedestrian facilities seems to be governed by the operational environment of the facility and context of the study. Based on the flow condition, which may be intermittent, uniform, or periodic, the count interval has been found varying between 1 minute and 5 minutes. For instantaneous peaks, it is reduced to even 10s. The selection of a count interval will impact the flow values and subsequently the design requirements and operational efficiency. Present study, in this light, focusses on escalators located at metro rail stations. The study region is Delhi, India. Based on the analysis, the count interval for data extraction is recommended as 24 seconds, which is expected to result in a flow that does not cause unnecessary increase in facility size and keep it usable for most of the time. The absolute design flow value may be considered between 140–148 ped/m/min, which is the 5th highest rank order peak flow. The results are expected to optimize the resources, both for data collection and size of a facility.


The domesticated insect Bombyx mori respond well to environmental fluctuations that govern the success of cocoon production due to its piokilothermic nature. Since, the interaction between heat shock proteins and proteases in the whole organism that complete larval life in natural environment remain obscure, we have employed zymography technique to examine different classes of proteases and its activity under imposed temperature stress (heat shock) condition. The total protein extracted from the whole larvae was analyzed in SDS-polyacrylamide gel copolymerized with gelatin, casein and BSA. Discrete proteolytic bands aptly visualized in the gel contained gelatin as substrate revealed strong activity of five proteases with molecular mass of 116 (P1), 83 (P2), 57 (P3), 35 (P4) and 24 kDa (P5) and the only protease that exhibits activity in all the substrates was P5. Various protease inhibitors like leupeptine, aprotonin, pepstatin, EDTA and PMSF were used for identification and most of the proteases activity eventually was inhibited by PMSF while other inhibitors had no effect. With this we could determine the presence of large group of serine proteases in the whole body of B. mori. Further, for the first time, we have employed zymographic technique to evaluate protease activity in the heat shock (40°C) induced larvae. Interestingly, the activity of three proteases (P3 to P5) found inhibited on gelatin substrate while high molecular weight proteases (P1 and P2) were not affected. The protease assay further confirmed decreased protease activity in the heat shock induced larvae compared to control. The differential and altered proteases activities in normal and heat-shocked larvae respectively envisaged its significance in stress physiology and adaptation of whole organism to elevated temperature.


Perspective on the papers by Howells et al and Archer et al (see pages 323 and 330)

The papers by Howells et al 1 and Archer et al ,2 are timely, and raise a range of important issues for paediatricians, educators and regulators to do with assessments where there is likely to be – or indeed where there is necessarily – a degree of subjectivity. They are the latest in a canon of work from Helena Davies' world class group on workplace-based assessment. The kind of issues they tackle are part of the contemporary desire to come to terms with the teaching and testing of such areas, both within communication skills, as the term is normally used, and within the broader area, which communication impinges on, of professionalism.3,–,5

In the UK, the issue has assumed additional importance with the publication of the government white paper on professional regulation6 and the Chief Medical Officer's subsequent report setting the approach to medical revalidation.7 Revalidation will involve two separate processes based on a range of assessments and other evidence of actual practice. Annual relicensure will confirm performance within the General Medical Council's generic standards. Recertification confirms that paediatricians practise within standards appropriate for our speciality. However, the Chief Medical Officer emphasises that revalidation should be supportive to all doctors, aimed at raising …


Ontology mapping is seen as a solution provider in today's landscape of ontology research. As the number of ontologies that are made publicly available and accessible on the Web increases steadily, so does the need for applications to use them. A single ontology is no longer enough to support the tasks envisaged by a distributed environment like the Semantic Web. Multiple ontologies need to be accessed from several applications. Mapping could provide a common layer from which several ontologies could be accessed and hence could exchange information in semantically sound manners. Developing such mappings has been the focus of a variety of works originating from diverse communities over a number of years. In this article we comprehensively review and present these works. We also provide insights on the pragmatics of ontology mapping and elaborate on a theoretical approach for defining ontology mapping.


London, Thousand Oaks, CA and New Delhi: Sage, 2004. £19.99. 199 pp. The claim of this book to distinctiveness is that it discusses social science approaches to qualitative research from a particular perspective, that of ethnomethodology. It aims to intervene in the stand-off between ethnomethodology and other qualitative schools, and so is not for the budding young tyro. It is directed rather at those with existing knowledge of qualitative research methodology and with ethnomenthodology. The latter is the approach which is privileged in the book in that it comes first and provides the frame for looking at a broader range of qualitative social research. Interview-based research, documentary evidence, ethnographic field methods and grounded theory are the main areas covered. The book has a coherent purpose and is clearly written, with various helpful examples.


The cross-border competition between financial institutions and internet firms become more and more intensely. Financial institutions have advantage about offline market capacity, professional ability, numerous capitals and the exiting customer. Internet companies have strength on innovation, collaboration and platform competition. Using internet factors to improve financial business is an irresistible trend. The strategy between financial enterprise and internet firm is Symbiosis and competition.


Efficient charge separation accelerated by a spatial electric field is a vital factor for semiconductor photocatalysts to achieve high photocatalytic activity. In this work, poly(vinylidene fluoride) (PVDF) with piezoelectric effects was first introduced into a photocatalyst system to highly improve the photocatalytic efficiency. The results indicate that, in the presence of organic piezoelectric PVDF, the photocatalytic efficiency of a PVDF–TiO2 film is improved by about 55%. The corresponding first-order reaction rate constant (k) value is increased 5.42 times. Moreover, photocatalytic activity enhancement is ascribed to the promotion effect of the spatial electric field on charge separation, which has been demonstrated by hydroxyl radical analysis. Furthermore, the results indicate that the spatial electric field of PVDF plays a generic enhancement role in the photocatalysis of both ultraviolet (UV)-light-responsive and visible-light-responsive photocatalysts. In a wider perspective, this work provides an efficient strategy, coupling solar energy and electric energy induced by organic flexible piezoelectric PVDF, to greatly enhance the photocatalytic performance.


Ovarian cancer (OC) is a heterogeneous disease characterized by defective DNA repair. Very few targets are universally expressed in the high grade serous (HGS) subtype. We previously identified that CHK1 was overexpressed in most of HGSOC. Here, we sought to understand the DNA damage response (DDR) to CHK1 inhibition and increase the anti-tumor activity of this pathway. We found BRD4 suppression either by siRNA or BRD4 inhibitor JQ1 enhanced the cytotoxicity of CHK1 inhibition. Interestingly, BRD4 was amplified and/or upregulated in a subset of HGSOC with statistical correlation to overall survival. BRD4 inhibition increased CBX5 (HP1α) level. CHK1 inhibitor induced DDR marker, γ-H2AX, but BRD4 suppression did not. Furthermore, nuclear localization of CBX5 and γ-H2AX was mutually exclusive in BRD4-and CHK1-inhibited cells, suggesting BRD4 facilitates DDR by repressing CBX5. Our results provide a strong rationale for clinical investigation of CHK1 and BRD4 co-inhibition, especially for HGSOC patients with BRD4 overexpression.


Maximal Grip Strength (MGS) is regarded as a good indicator of upper-limb strength or even of the whole neuromuscular system. Two popular dynamometers used for MGS evaluation are the Jamar and the Martin Vigorimeter. The Myogrip is a new digital dynamometer designed for testing very weak patients suffering from various neuromuscular disorders. It offers a sensitivity, precision and accuracy adapted to such a population. The main aim of this study was to compare grip strength assessment using these three dynamometers. Sixty nine healthy undergraduate students volunteered for the study. They were required to exert their MGS using the Jamar, the Vigorimeter and the Myogrip in a random order. After 14 days, 47 subjects participated in a second test.

Results show that grip-strength estimates obtained by different measurement devices are strongly correlated. The Myogrip had a significantly better correlation with the Jamar (r=0.93; 95% confidence interval 0.90--0.95) than with the Vigorimeter (0.77; 0.40--0.83). In addition, the Myogrip had high test-retest reliability (ICC: 0.97, 95% confidence interval 0.96--0.98). Test-retest values showed a consistent distribution according to Bland-Altman plots. The circumference of the hand was found to be the most important anthropometric factor in determining MGS, followed by the circumference of the forearm. Predictive regression-based functions with the circumference of the hand alone are given, for dominant and non-dominant sides.


Nano-hydroxyapatite/polyamide66/chitosan composite (n-HA/PA66/CS) was prepared by a co-precipitation method and porous scaffolds from n-HA/PA66/CS composite were prepared by means of porogen–leaching method and were characterized by SEM, IR, XRD and universal mechanical testing machine. IR and XRD analyses showed that some chemical bonds existed between n-HA and polymers. Furthermore, macroporous structure of the scaffolds and mechanical strength were tested with a changed ratio of porogens (PVP/NaCl). When the ratio of PVP and NaCl is1: 6, the scaffold processed highly porosity and the pores were interconnected. The compressive strength of the scaffold, can meet the requirement of tissue regeneration.


G8 Online is a university-level, internet-based program focussed on the G7/G8 and G20 systems of global governance and on the upcoming 2004 G8 Summit in Sea Island, Georgia


Elite female ballet dancers exhibit several risk factors for osteoporosis during their performing years. To study the long‐term effect of this lifestyle, we compared the bone mineral density (BMD) of 101 retired elite female ballet dancers (mean age 51 years, SD = 14 years) and 101 normal controls, derived from a twin study, matched hierarchically for age, height, weight, and menopausal status. The dancers, who had been retired for a mean of 25.6 years (range 1–53 years) reported a greater prevalence of previous menstrual disturbance, greater lifetime alcohol intake and smoking, and a lower dietary milk intake in adolescence than controls (all p < 0.05). However, current exercise in the dancers was twice that of the controls (p < 0.01). The BMD of retired dancers did not differ from that of the controls at weightbearing sites. The mean ± SE difference in BMD (dancers minus controls) was 0.009 ± 0.013 at the total body, –0.009 ± 0.018 at the total hip, 0.005 ± 0.017 at the femoral neck, 0.014 ± 0.018 at the femoral trochanter, 0.036 ± 0.022 at the femoral intertrochanter and –0.017 ± 0.021 at the lumbar spine. Retired dancers had lower mean (± SE) BMD at the nonweightbearing sites: ultradistal radius (–0.029 ± 0.008) (p < 0.01) and at the midthird radius (–0.019 ± 0.011) (p < 0.05). There was no difference in the proportion in each of the World Health Organization (WHO) categories of osteopenia (t score –1.0 to –2.5) and osteoporosis (t score <–2.5) at any of the measured sites. Regression analysis revealed that menstrual disturbance was negatively associated with BMD at the lumbar spine and the ultradistal radial sites, but not at the weightbearing femoral sites. This sample of retired elite ballet dancers who had multiple historical risk factors does not appear to have an increased risk for future hip or vertebral fracture based on WHO standards.


This study documents a link between sea-level fall and basin-scale dolomite cementation of shoreface sandstones in the Upper Cretaceous Desert Member, Book Cliffs, Utah, by integrating sedimentology, sequence stratigraphy, and sedimentary geochemistry. Within the Desert Member shoreface sandstones, a number of high-frequency sequence boundaries formed as a result of relative sea-level falls that led to localized incised valley formation, subaerial exposure, and meteoric leaching of upper shoreface sandstones. Shoreface sandstones up to 10 km downdip from these subaerial exposure surfaces contain ferroan dolomite concretion bodies as much as 8 m thick. Basinward of this smaller (as much as 1 m in size), less abundant dolomite, concretions can be traced at the same horizons. Some δ 1 8 O data suggest that cement precipitated from porewater with a significant meteoric component, although reequilibration and recyrstallization cannot be eliminated. Some δ 1 3 C data suggest carbonate derivation from detrital dolomite leached from beneath organic-rich coastal plain strata deposited during high-frequency sequence boundary development. We propose that during high-frequency sequence boundary formation, meteoric fluids migrated basinward into shoreface sandstones as a result of the relative fall in sea level. The precipitation of dolomite cement in the shoreface sandstones was promoted by the updip dissolution and remobilization of detrital dolomite by the meteroic fluids, mixing with marine pore fluids, and the presence of detrital dolomite in the shoreface sandstones, which acted as nucleation sites for dolomite precipitation. This study illustrates the impact of stratigraphic development upon basin-scale early diagenetic cementation of siliciclastic succcesions.


Objectives The objective was to determine recent cross-sectional trends in health-related fitness (HRF) in secondary school students by studying the 13–14 years old age group repeatedly over 6 years, considering parallel national trends in physical education (PE). Methods Height, weight, broad jump, grip strength, 20 m shuttle run and throwing and catching skills were measured by the same research team using standardised techniques from 2014 to 2019. Trends in these HRF measures were assessed by linear regression, adjusting for school, sex and height. Interactions with fitness and body mass index (BMI) were tested. The number of PE lessons reported in the UK Annual School Workforce Census between 2010 and 2019 for all state-funded secondary schools was analysed. Results Grip strength (B=−0.60, 95% CI −0.78 to –0.41), broad jump (B=−1.16, 95% CI −1.99 to –0.34), 20 m shuttle run (B=−1.85, 95% CI −2.58 to –1.12) and throwing and catching skills (B=−0.12, 95% CI −0.15 to –0.08) declined significantly over the study period. There was a greater reduction in broad jump and grip strength in adolescents with low fitness and a greater reduction in fitness and motor competence in adolescents with normal BMI. These declines coincided with a 16% reduction nationally in secondary school PE between 2010 (333 800 hours) and 2019 (280 725 hours). Conclusion Adolescent HRF has declined in recent years, in parallel with PE lessons. Declines were observed across all young people and particularly those of low fitness and normal BMI. To reach the majority of young people, policy makers could increase PE in schools to increase activity and prevent worsening fitness and health in future generations.


Previous work on transposable element distribution in colonizing populations of Drosophila buzzatii revealed a high frequency of occupancy in several chromosomal sites. Two explanatory hypotheses were advanced: the founder hypothesis, by which founder genetic drift was responsible, and the unstable hypothesis that assigns this unusual distribution to bursts of transposition toward some chromosomal sites. Here, we study the molecular structure of three euchromatic Osvaldo clones isolated from sites occupied at high (A4 and B9) and low frequency (B4) in colonizing populations, to test these hypotheses. Large insertions, duplications, and indels in the Osvaldo coding region and LTR were detected in the A4 clone and a truncated Osvaldo with many substitutions was found in the B9 clone. These altered sequences indicate that the two copies of this retroelement are precolonization insertions. Interestingly, the LTR of the A4 clone and the reverse transcriptase region of B9 show identical sequences in all colonizing populations indicating, most probably, that they are identical by descent. Moreover, Osvaldo is inserted at the same nucleotide site in all colonizing populations. On the other hand an almost identical LTR sequence, except by 1 base deletion, was found in the B4 clone compared to the canonical active Osvaldo element. These results suggest that Osvaldo copies in highly occupied sites are, most probably, identical by descent and strongly favor the founder hypothesis. On the other hand, low-insertion-frequency sites could represent recent transposition events. This work emphasizes the importance of molecular population studies to disentangle the effects of genetic drift and transposition in colonization.


This article records the findings of a qualitative study in which circle dialogue sessions and questionnaires were used to explore and evaluate the experiences of victims who participated in peacemaking mediations offered at Khulisa Social Solutions victim empowerment centres in Gauteng, South Africa. The findings highlight that the overall facilitation of the peacemaking mediation offered at Khulisa victim empowerment centres was conducted in a fair and respectful manner. The participants expressed their satisfaction with the facilitators, the facilitation, and the peacemaking agreements. Reconciliation was achieved in some cases, but the most significant result was that the victims were empowered, informed and strengthened through their experiences. Moreover, the participants expressed their appreciation for the restorative approach owing to its support and protection of the family unit. The findings showed that reconciliation was hindered in some cases by a lack of accountability, voluntary participation and needs-based interventions which could have been foreseen or resolved through adequate preparation and follow-ups. Moreover, the need for intervention and awareness in the community context was highlighted. However, the findings revealed that Khulisa is limited in providing preparation, follow-ups and interventions owing to a lack of staff, resources and time, because of limited funding. A call is made for funding to be provided to Khulisa and similar organisations by government and/or private enterprises, so that outreach, awareness and needs-based interventions may be provided. Furthermore, research should be conducted focusing on broader scale experiences of all stakeholders participating in services offered at Khulisa victim empowerment centres.


We propose a new multi-frame method for efficiently computing scene flow (dense depth and optical flow) and camera ego-motion for a dynamic scene observed from a moving stereo camera rig. Our technique also segments out moving objects from the rigid scene. In our method, we first estimate the disparity map and the 6-DOF camera motion using stereo matching and visual odometry. We then identify regions inconsistent with the estimated camera motion and compute per-pixel optical flow only at these regions. This flow proposal is fused with the camera motion-based flow proposal using fusion moves to obtain the final optical flow and motion segmentation. This unified framework benefits all four tasks – stereo, optical flow, visual odometry and motion segmentation leading to overall higher accuracy and efficiency. Our method is currently ranked third on the KITTI 2015 scene flow benchmark. Furthermore, our CPU implementation runs in 2-3 seconds per frame which is 1-3 orders of magnitude faster than the top six methods. We also report a thorough evaluation on challenging Sintel sequences with fast camera and object motion, where our method consistently outperforms OSF [30], which is currently ranked second on the KITTI benchmark.


We determined the total activity and isoenzyme distribution of lactate dehydrogenase and creatine kinase in serum and biopsy specimens from skeletal muscle of nine normal individuals and nine patients with Duchenne muscular dystrophy (I), five with collagen disease (II), and four with non-progressive unclassified myopathy (III). Mean total serum creatine kinase in patients with Duchenne muscular dystrophy (867 U/liter, SD = 197) was 31-fold that in the control group (28 U/liter, SD = 14). There was also a small (3.3-fold) increase in the mean total serum creatine kinase of patients with III, but none in the serum from patients with II. Changes in the creatine kinase isoenzyme distribution of skeletal muscle were primarily in the MB isoenzyme. The mean percentage of creatine kinase-MB activity in muscle from patients with I (2.81, SD = 1.15) and patients with III (1.69, SD = 1.07) significantly (P less than 0.005) exceeded that of the control group (0.43, SD = 0.18). Muscle from patients with II showed little change. The most striking changes in lactate dehydrogenase were also observed in patients with I, in whom the mean total serum activity (356 U/liter, SD = 115) was 3.4-fold that of serum from the control group (105 U/liter, SD = 19). Skeletal muscle from these patients also showed a significant decrease in mean percent isoenzyme 5 activity (from 50 to 23) and an increase in that of isoenzymes 1 and 2 (from 1 to 9 and 8 to 20, respectively). These changes in the distribution of these two sets of isoenzymes in muscle were reflected in the serum.


As an emerging technological and procedural shift within the building design industry, Building Information Modeling (BIM) is a set of interacting processes and technologies to manage essential building design and project data in digital format throughout the design procedure. It is also a central data repository to store and recall different kinds of project information through creating a 3D model as well as providing intelligent data for this model. Besides, project documentation can be brought forward as a byproduct of the 3D model. This kind of BIM approach allows designers to finish their design work and have the documentation of a building simultaneously. As a result, this design approach can accelerate the design procedure of building project through less time and effort. This paper begins with an outlook on the mechanism that BIM approach how to increase the productivity rates and reduce the waste of resources in architecture industry. Then, it provides a project example on theuse of Autodesk Revit software system. At the end, a discussion on how BIM approach is applied to into the building design industry and on the potential benefits of BIM approach is put forward.


Abstract Usage of online data collection methods is increasing in leisure research. Some potential benefits to using online methods over traditional paper/pencil techniques include financial savings and easier access to large populations. Disadvantages, however, include difficulty in sample selection and variations of the instruments' reliability. This study explores how subject responses potentially differ when collecting data online versus paper/pencil for six instruments commonly used within leisure research. A repeated measure design with paired sample t-tests and HLM was used with 207 college students to compare these methods of data collection. Responses differed between methods on three of the tested instruments. A general pattern was found suggesting participants perceived their anonymity was better protected when completing online questionnaires.


Production of cephamycin C and clavulanic acid by Streptomyces clavuligerus took place during the exponential phase of growth in a defined medium. Both antibiotic biosynthetic pathways were activated shortly after spore germination, but the timing and kinetics of activation were affected by inoculum density. Rapid activation was favoured by high inoculum density or by growth in medium conditioned by previous incubation of S. clavuligerus spores or mycelium. A heat-resistant conditioning factor able to accelerate the acquisition of antibiotic-biosynthetic capacity when added to low-density cultures was released in suspensions of spores in water. Conditioning factor was also obtained in suspensions of spores from different Streptomyces species or of Bacillus cells, indicating that the signal was not produced specifically by S. clavuligerus. Fractionation of conditioning factor showed that its effect was not due to a single molecule. The fractions contained amino acids (as free amino acids and oligopeptides) in amounts that roughly correlated with their respective conditioning power. Furthermore, the conditioning effect was reproduced by supplementing defined medium with amino acids and peptides in concentration that mimicked those found in conditioning factor. When individually tested at concentrations in the micromolar range, only some amino acids were able to stimulate antibiotic biosynthetic capacity. This stimulation ws also promoted by low concentrations (less than 1 microgram ml-1) of peptide mixtures obtained with different proteolytic enzymes. The results suggest that both amino acids and peptides are responsible for the effects of conditioning factor released by spores. Possible implications of intercellular signalling on activation of secondary metabolism are discussed.


OBJECTIVE
To compare cerebral near-infrared regional spectroscopy (NIRS) with the 12-lead electroencephalogram for the detection of ischemia during carotid artery clamping for carotid endarterectomy (CEA).

DESIGN
Prospective, observational.

SETTING
Single, tertiary care center.

PARTICIPANTS
Ninety patients older than 18 undergoing elective, unilateral CEA.

INTERVENTIONS
In addition to EEG monitoring, all patients underwent continuous blinded NIRS monitoring with sensors placed bilaterally above the supraorbital ridge.

MEASUREMENTS AND MAIN RESULTS
Seventeen patients were excluded, leaving 73 patients available for evaluation. Four patients (5.5%) required shunting based on EEG findings. Changes in cerebral oxygen saturation (rSO2) were assessed on the operative side using the average value for the 1 minute prior to cross-clamp and the lowest rSO2 value the first 5 minutes postclamp. Each 1% absolute decrease and each 1% relative decrease from baseline conferred a 50% increase in the need for shunt placement (OR 1.5; 95% CI (1.03-2.26); p = 0.03 and OR 1.4; 95% CI (1.02-1.81); p = 0.04 respectively). Sensitivity, specificity, and positive and negative predictive values were determined using significant cutoffs of≥5% absolute change or≥10% relative change. Positive predictive value was low (<25%) for both absolute and relative changes.

CONCLUSIONS
A decrease in rSO2 during carotid cross-clamping for CEA is associated with EEG-determined need for shunting, but the positive predictive value is low. Using the above cutoffs in the current series would have resulted in an increase in the shunt rate by approximately 20% when it was not indicated by EEG.


This paper examines the impact of capital market integration (CMI) on higher education and economic growth. We take into account that participation in higher education is non-compulsory and depends on individual choice. Integration increases (decreases) the incentives to participate in higher education in capital-importing (-exporting) economies, all other things equal. Increased participation in higher education enhances productivity progress and is accompanied by rising wage inequality. From a national policy point of view, education expenditure should increase after integration of similar economies. Using foreign direct investment (FDI) as a measure for capital flows, we present empirical evidence which largely confirms our main hypothesis: An increase in net capital inflows in response to CMI raises participation in higher education and thereby fosters economic growth. We apply a structural estimation approach to fully track the endogenous mechanisms of the model.