Background: Mitral valve replacement in patients who previously had undergone aortic valve replacement is a technical challenge. The rigid aortic prosthesis limits visualization of the anterior mitral annulus and placement of sutures. Methods: Reoperative mitral valve replacement was performed in five patients after aortic valve replacement. Two patients underwent resternotomy to allow verification of normal aortic prosthetic valve function. Anterolateral right thoracotomy was used for reentry in the remaining three patients. Exposure of the anterior mitral annulus was accomplished by initial traction on the intact anterior leaflet, with resection of this leaflet only after placement of sutures. Results: All patients survived the surgical procedure and are well 2 to 30 months after operation. In one patient it was impossible to open one cusp of the mitral prosthesis, nor was it possible to rotate the valve. The valve was reimplanted, but sutures were tied only after testing for full free cusp motion. Conclusions: When appropriate, right thoracotomy incision offers excellent exposure of the mitral valve with minimal dissection. Placement of sutures along the anterior portion of the annulus is facilitated by traction downwards on the anterior leaflet. Full range of motion of the prosthetic cusps should be verified before tying the sutures.


There has been a rapid growth in the pace of environmental development in the past few years and thus there is an immediate need of a well-planned and urbanization plans. Now, using new and emerging technology and sustainable approach, the concept of smart cities is gaining momentum all around the globe. And so a smart city would be incomplete without an intelligent waste management system. Also, the scenario of cleanliness with respect to garbage management is degrading tremendously. Proper waste management techniques are very crucial to control the garbage menace which has spread everywhere. The paper elucidates the application of our project "Smart Bin" in managing the garbage collection system of our surroundings. The idea of Smart Dustbin is for Colleges, buildings, schools, bus stands, parks, hospitals and other community areas. Smart bin is an improvement of a regular dustbin by raising it to be an intelligent product using logic and sensors. The smart dustbin is a novel and innovative idea of implementation which makes a regular dustbin intelligent using sensors for garbage level detection and its other physical parameters. The network of sensors enabled bin helps to provide an automatic open and close facility and the analysis of the data regarding the height of the waste-filled in the dustbin at a particular time along with reporting the physical condition of the bin such as temperature and moisture to identify whether the type of garbage disposed of is solid or wet. Audio will be played every time the lid of the bin is opened which create awareness among people regarding the concept of blue and green bins. The real-time analytics of the bin with show the conscious response of the people when they spill the trash into the bin. The paper also aims at promoting further insightful research on the topic.


Copper(II) complexes. [Cu(salmet)B] (1-3), where H(2)salmet is the Schiff base derived from salicylaldehyde and L-methionine and B is heterocyclic bases like 1,10-phenanthroline (phen, 1), dipyridoquinoxaline (dpq, 2) and dipyridophenazine (dppz, 3), are prepared and their DNA cleavage properties studied. Complex [Cu((t)Bu(2)salmet)(phen)].CHCl3 (4.CHCl3) has been prepared for structural characterization using single crystal X-ray crystallography. Complex 4 has a ternary structure in which the copper displays a distorted square pyramidal (4 + 1) geometry showing tri- and bidentate mode of bonding for the Schiff base and phen, respectively, in CuN3O2 coordination. The phen ligand exhibits axial-equatorial mode of bonding, while the dianionic Schiff base binds at the equatorial sites of the basal plane. The one-electron paramagnetic complexes show a d-d band in the electronic spectra in DMF at ca. 670 nm and axial EPR spectral features indicating {d(x2-y2)}(1) ground state in. a DMF glass at 77 K. The complexes are redox active displaying quasi-reversible cyclic voltammetric response near 0.1 V (vs. SCE) in DMF-0.1 M TBAP assignable to the Cu(II)/Cu(I) couple. The complexes bind to the calf thymus DNA but to a lesser extent in comparison to bis(phen)copper(II) species that has been used as a standard. The complexes. cleave supercoiled (SC) pUC19 DNA in dark under aerobic conditions by oxidative process in presence of mercaptopropionic acid as a reducing agent. They also show photo-induced DNA cleavage on irradiation with UV light of 312 nm or visible green light of 532 nm. The cleavage activity follows the order: 3 similar to 2 > 1. The mechanistic pathways for the DNA cleavage reactions are discussed.


The atmospheric corrosion of Al and Mg-Al alloys was investigated using controlled air in the laboratory. The effects of CO 2 , temperature, NaCl, relative humidity, SO 2 , NO 2 and O 3 on corrosion rate and corrosion product composition were examined. Initial stages of corrosion were studied in situ using Scanning Kelvin Probe Force Microscopy (SKPFM), which monitors the Volta potential and the topography at sub-micrometer resolution. The corrosion products were analyzed by techniques including IC, GI-XRD, ESEM/EDX, SKP, FIB/SEM and AES. The main finding is that ambient concentrations of CO 2 (350ppm) inhibit the NaCl-induced atmospheric corrosion of Al and Mg-Al alloys. In the absence of CO 2 , high pH regions form in the surface electrolyte due to the cathodic reduction of oxygen. The high pH electrolyte dissolves the alumina-containing passive film, resulting in rapid corrosion. When CO 2 is present, it forms carbonic acid that neutralizes the hydroxide formed in the cathodic vicinity, which slows the corrosion. On aluminum-based alloys NaCl produces general corrosion in humid air without CO 2 , while pitting is observed at ambient CO 2 levels. The temperature-dependence of the NaCl induced atmospheric corrosion of aluminum alloys is strongly non-linear. With increasing temperature, the inhibitive effect of CO 2 declines due to the decreasing solubility of CO 2 in water. On Mg-Al alloys, corrosion attack is localized in the absence of CO 2 , while general corrosion prevails in its presence. The inhibitive effect of CO 2 is relevant to occluded areas, where the supply of CO 2 is limited, for example in crevice corrosion and corrosion beneath organic coatings. In humid air, SO 2 accelerates the atmospheric corrosion of Al and Mg-Al alloy. The surface electrolyte is acidified by sulfuric acid formation, destabilizing the passive film. However, for aluminum alloys, SO 2 inhibits the NaCl-induced pitting corrosion. The precipitation of aluminum hydroxy sulfates was believed to retard pit propagation. The deposition rate of SO 2 on Al is slow and almost independent of the SO 2 concentration. In contrast, SO 2 deposition on Mg-Al alloys is transport limited at high humidity. In the presence of SO 2 , Mg-Al alloys suffer pitting corrosion that preferentially attacks the a phase.


Abstract Objectives A recent discussion surrounding the extension of antenatal corticosteroid (ACS) use beyond 34 weeks of gestation did not include the subgroup of infants of diabetic mothers (IDM). We aimed to examine the association between ACS exposure and outcomes in neonates born at term and at near-term gestation in a large cohort of IDMs. Methods We selected 13976 eligible near-term and term infants who were included in the PEARL-Peristat Perinatal Registry Study (PPS). We assessed the association of ACS exposure with neonatal outcomes in a multivariate regression model that controlled for diabetes mellitus (DM) and other perinatal variables. Results The incidence of DM was 28% (3,895 of 13,976) in the cohort. Caesarean section was performed in one-third of the study population. The incidence of ACS exposure was low (1.8%) and typically occurred>2 weeks before delivery. The incidence rates of respiratory distress syndrome (RDS)/ transient tachypnoea of newborns (TTN), all-cause neonatal intensive care unit (NICU) admissions, NICU admissions for hypoglycaemia, and low 5-min Apgar scores were 3.5, 8.8, 1.3, and 0.1%, respectively. In a multivariate regression model, ACS was associated with a slight increase in NICU admissions (OR: 1.44; 95% CI: 1.04–2.03; p=0.028), but not with RDS/TTN. Conclusions Although the low exposure rate was a limitation, ACS administration did not reduce respiratory morbidity in near-term or term IDMs. It was independently associated with an increase in NICU admissions. Randomized controlled trials are required to assess the efficacy and safety of ACS administration in diabetic mothers at late gestation.


Abstract : Linear PCHD and polyisoprenes with different microstructures and molecular weights are synthesized and chemically modified to improve their thermal and chemical stability by forming a three-membered ring structure containing two C-F bonds. Pyrolysis of these fluorinated polydienes proceeds through a two-stage decomposition involving chain scission, crosslinking, dehydrogenation, and dehalogenation. The pyrolysis leads to graphite-like residues, whereas their polydiene precursors decompose completely under the same conditions. The fluorination of PCHD enhances its thermal stability. The stronger C-F bond along with high strain of the three-membered ring structure and formation of relatively stable free radicals play an important role in the thermal stability of fluorinated polydienes.


We present a probabilistic cellular automaton (CA) with two absorbing states which performs classification of binary strings in a non-deterministic sense. In a system evolving under this CA rule, empty sites become occupied with a probability proportional to the number of occupied sites in the neighborhood, while occupied sites become empty with a probability proportional to the number of empty sites in the neighborhood. The probability that all sites become eventually occupied is equal to the density of occupied sites in the initial string.


Enterprise systems (ES) implementations are difficult to govern successfully due to the degree of organizational change involved for a diverse set of stakeholders. These stakeholders typically have multiple and often conflicting interests and rarely agree on a set of common objectives. Prior studies have highlighted the need for stakeholder engagement, but have provided few details on the types of stakeholders and their roles in enterprise systems implementation projects. This paper describes an assessment of the various stakeholders involved in complex enterprise systems implementation projects with the purpose of surfacing the differences that exist in the perceptions, influence, and expectations. By gaining this insight into key stakeholders, project managers can more effectively anticipate, understand, and react to the evolving needs of the various stakeholder groups. The paper concludes with a discussion of contributions to the literature and a call for further research to extend and refine the knowledge provided.


"Hayden White...is the most prominent American scholar to unite historiography and literary criticism into a broader reflection on narrative and cultural understanding." --'The Johns Hopkins Guide to Literary Theory and Criticism' In his earlier books such as 'Tropics of Discourse' and 'The Content of the Form', Hayden White focused on the conventions of historical writing and on the ordering of historical consciousness. In 'Figural Realism', White collects eight interrelated essays primarily concerned with the treatment of history in recent literary critical discourse. "'History' is not only an object we can study," writes White, "it is also and even primarily a certain kind of relationship to 'the past' mediated by a distinctive kind of written discourse. It is because historical discourse is actualized in its culturally significant form as a specific kind of writing that we may consider the relevance of literary theory to both the theory and the practice of historiography."


Author(s): Maize, Kerry | Advisor(s): Shakouri, Ali | Abstract: Performance, efficiency, and reliability of modern high power, high speed microelectronics and nanoscale structures are strongly influenced by device self-heating on the micron and nanometer scale. Local temperature "hotspots" on a chip indicate areas of high power density and possible failure locations. This dissertation presents results of case studies using high resolution thermoreflectance imaging microscopy to characterize self-heating in high power silicon transistor arrays, gallium nitride high electron mobility power transistors (HEMTs), and nanoscale percolation network devices. Thermoreflectance imaging microscopy was performed with submicron spatial resolution, 800 ps time resolution, and 50 mK temperature resolution.Thermoreflectance imaging of silicon transistor arrays revealed self-heating nonuniformity greater than a factor of two due to electrical debiasing. At low bias (12 mA/mm), temperature distribution matched state of the art electrothermal simulation. At high bias (47 mA/mm), however, measured self-heating diverged significantly from simulation despite inclusion of temperature dependent material properties in the thermal model. Hotspots with temperature change of 70 K were observed. Results demonstrate nonlinear dependence of current distribution on bias for complex arrayed power devices.Thermoreflectance imaging of GaN HEMTs revealed for the first time temperature gradients as large at 60 K and 80 K between critical gate, channel, and contact features within the first few microseconds of pulsed excitation at 19 W/mm. Fast transient self-heating gradients in the HEMT were confirmed with 5 ns time resolved thermoreflectance images. Thermoreflectance imaging revealed nonuniform self-heating in nanoscale percolation network devices consisting of disordered 90 nm diameter silver nanowires. Microscopic hot-spots at selected nanowire-nanowire junctions in the network exhibited nonlinear thermal properties, with temperature dependence of current exceeding the prediction of Joule self-heating for bulk materials. Results encourage a fundamental reevaluation of the transport models and characterization results for network based percolating conductors.The optical, non-contact thermoreflectance imaging microscopy method quickly measures self-heating distribution on the surface of integrated structures with 50 mK temperature resolution. Transient capable implementations with 50 ns and 800 ps temporal resolution were used to image fast pulsed transient temperature rise and fall in high frequency power integrated circuits. The method is capable of submicron spatial resolution, enabling temperature measurement of smaller device features than can be achieved with similar thermal imaging techniques, such as infrared thermal microscopy. Self-heating in silver nanowire network devices was imaged with 300 nm spatial resolution.


Abstract Integrative gravity and structural modelling of Ordovician-Silurian granitoids in the Eastern Lachlan Fold Belt (southeastern Australia) revealed contrasts in emplacement mode and deformation style between coeval S- and I-type granites. The NNE-SSW directed contraction during the Benambran event of the Lachlan Orogen caused dextral movement along two major strike-slip faults (Carcoar Fault/Copperhannia Thrust) and simultaneous formation of both transtensional pull-apart and transpressional shear zones. The geometry and deformation style of the plutons and country rock, their spatial relationship at depth to adjacent faults and the structural history of both the granites and country rocks suggest a genetic linkage between magma emplacement and synmagmatic deformation. Synchronously, the Carcoar Granodiorite was emplaced into a transtensional pull-apart structure and the Barry Granodiorite and Sunset Hills Granite intruded transpressional shear zones. The I-type Carcoar and Barry granites are square to tabular, wedge-shaped bodies exhibiting a weak deformation; whereas the S-type Sunset Hills Granite is an elongated, tabular to sheet-like pluton showing a moderate deformation degree. The contrasts in 3D shape, emplacement mode and deformation style between the I- and S-type granites are due to differences in nearfield stress regime, geometry of the emplacement sites, intrusion level with respect to thermal and rheological conditions, and in their response to deformation. This response is in part controlled by the proportion of resistant/non-resistant minerals in the granite and host rock. This study demonstrates that distinctive emplacement modes can operate simultaneously in different parts of a fault system under contrasting deformation conditions.


Atmospheric circulations create regions of similar climate at the land surface across the Northern Hemisphere's mid‐latitudes, while climate controls on plant phenology phases (phenophases) can vary. Here, we quantify and classify the seasonal impacts of the Northern Hemisphere jet stream (NHJ) on vegetation phenophases using novel NHJ indices, designed to characterize latitudinal jet stream position, and satellite‐based vegetation phenology products of length, start, and end of season (LOS, SOS, EOS). We composited years of northern and southern NHJ anomalies in April–May and October–November from LOS, SOS, and EOS and classified ecosystem response based on: latitudinal location relative to the climatological mean (CM) latitude of the NHJ; climate; and land cover type. For nearly a third of the NH, LOS was modulated by NHJ position. The magnitude and direction of NHJ influence on LOS was dependent on the season of NHJ position anomaly. In spring, a northern NHJ, which typically corresponded with warmer temperatures, led to earlier SOS and longer LOS, especially in cold systems north of the NHJ's CM. Surprisingly, in fall, a northern NHJ led to shorter LOS and earlier EOS for most systems, which may be due to the interaction of temperature and water availability in this season when water is critical for sustained growth. Southern NHJ corresponded with similar but opposite effects on phenophases. Crop land cover was mixed in LOS response to NHJ, reflecting the added impact of land‐use and management. The NHJ can synchronize phenology across apparently disparate regions of the Northern Hemisphere. Rather than simply lengthening or shortening seasons as the NHJ moves northward or southward, the influence of the NHJ on phenology at a given location depends on whether the NHJ is limiting resources—which vary relative to the climatological mean. We find that complex patterns in phenology emerge from a relatively simple contingency.


Limits and contentions of eU migration governance: refLec- tions on the J U ncker c ommission and beyondThis article shows how the new European Commission (2014-2019) has prioritised issues of migration and mobility in the European Union. It explains the key measures promised by the Commission, and how these relate to existing migration and mobility governance (MMG) and its dynamic political context. An interpretive policy analysis is undertaken in order to expose the trajectories of the Union's MMG, and the ways in which these are contested. In particular, the article explains how the emphasis in the Commission and Council on enhancing the operational coherence in asylum and border control represents a strong centripetal force in migration governance. In contrast, mobility of EU citizens within the EU is subject to centrifugal, welfare protectionist, forces. In this latter domain, the Commission is set for an ongoing struggle in its assertion of a Union-wide approach. Finally it is argued that the result is a contingently Europeanised governance of mobility and migration. This establishes a highly unstable and contested political ordering of social, economic and political relations in the Union. These cut across conventional distinctions between the interests of member states and Commission. Together, these issues should lead us to explore more systematically how the «high politics» of Council and Commission are linked to the everyday practices of migrants, and their experience of EU policy. KEywo Rds European Union, migration governance, migration policy, mobility, Eu- ropean Commission.


We describe a female patient with lung adenocarcinoma whose tumor extract was highly positive for prostate specific antigen (PSA) immunoreactivity. PSA was present in its Mr 33,000 free form. Using reverse transcription-PCR, we were able to amplify a 754-bp fragment that specifically hybridized to a PSA RNA probe on Southern blots. The PCR fragment was sequenced and found to represent PSA cDNA and not human glandular kallikrein cDNA. PSA immunoreactivity in the lung tissue was localized by immunohistochemistry to normal epithelial cells adjacent to the tumor which was completely negative for PSA. Tissue culture experiments suggested that beclomethasone, a glucocorticoid used to treat the patient, was able to up-regulate PSA gene expression. This is the first report that unequivocally demonstrates PSA expression in lung tissue. We speculate that PSA expression was mediated by the exogenously administered steroid beclomethasone.


Expand grant programs to encourage innovative research Over the past several years, we and others in the biomedical research community have become increasingly concerned that younger scientists are not being adequately supported as independent academic investigators and that, of equal importance, these newly launched investigators are being strongly discouraged from tackling novel scientific problems (1–6). Both issues can prevent talented trainees from aspiring to careers in biomedical research, despite the extraordinary opportunities offered by new technologies and recent discoveries. We view this situation as an existential threat to our profession, demanding that we urgently confront the underlying problems. It is widely recognized that career pathways for young scientists have changed dramatically and that over 80% of those who receive biomedical Ph.D.'s today will be employed in positions other than academic faculty (1, 5). The U.S. National Academies of Sciences, Engineering, and Medicine recently released a report that addresses many important aspects of these cultural changes (7). Here we focus on the problems faced by those who will renew the ranks of academic research faculty, with proposals that complement the recommendations in that report. Drawing on lessons from Europe and the United States, we propose three steps that could be taken by funding agencies, specifically the U.S. National Institutes of Health (NIH) but also others across the world, to support young investigators in more constructive and effective ways.


Periodontitis is an in lammation of gums and bones that supporting the teeth which caused by Staphylococcus intermedius. The saliva from a patient of periodontitis or suspect to periodontitis will have higher levels of Staphylococcus intermedius. Hence, human saliva is clinically informative in diagnosing oral disease and the oral health of an individual. In this study, oral bacteria in human saliva were identi ied using 16S ribosomal RNA. 16S ribosomal RNA (rRNA) genes from the isolated colonies were ampli ied through the colony Polymerase Chain Reaction (PCR) method. 16S rRNA genes were used to determine species identity by sequencing and generating the phylogenetic tree. The results showed that Streptococcus sp. and Staphylococcus sp. were the most prevalent oral bacteria found from all the saliva samples, while Lactobacillus sp. was found from two samples. From the constructed phylogenetic trees, bacteria strains B1 and B2 clustered with the Staphylococcus sp. database. Bacteria strains B9 and B10 were categorized as Streptococcus sp. as the con idential level between Streptococcus sp. database is 100% in Neighbour-Joining tree. Sample B15 and B16 clustered with Lactobacillus sp. database. Oral bacteria species typically associatedwith periodontitis was detected in all saliva samples. Therefore, it is important to fully understand the nature of the oral bacteria before further research on drug design and administration of oral treatment is executed.


Long-chain polyunsaturated fatty acids (PUFAs) are essential nutrients for all marine animals that have previously been studied. Most marine animals obtain long-chain PUFAs from their diets (i.e. as products of photosynthetic processes) and few are known to be able to produce these compounds de novo. Deep-sea vent organisms live in an environment that is relatively isolated from photosynthetic sources of PUFAs, yet some species are known to contain substantial amounts of these compounds. To further understand the origins of PUFAs in deep-sea vent animals, we studied 2 annelid species; a vestimentiferan tubeworm (class Pogonophora) with endosymbiotic bacteria, and a tubicolous serpulid polychaete that feeds heterotrophically. The vestimentiferan tubeworms Ridgeia piscesae from the Juan de Fuca Ridge are rich in the monounsaturated fatty acids 16:1n-7 and 18:1n-7, the polyunsaturated fatty acids (PUFAs) 20:5n-3 and 20:4n-6, and the non-methylene- interrupted PUFAs 20:2∆ 5, 13. They also contain small but significant amounts of the PUFAs 18:2n-6, 18:3n-3 and 22:6n-3. δ 13 C values of ca -14‰ for 16:1n-7 and 18:1n-7 suggest that these fatty acids are synthesised by chemosynthetic processes at the vent site. A δ 13 C value of -22‰ for 20:5n-3 in R. piscesae makes it impossible to conclusively attribute the origin of this fatty acid to either the photic zone or hydrothermal vents. The lipids of the serpulid polychaete Protis hydrothermica from the East Pacific Rise are also rich in 16:1n-7 and contain the unusual PUFAs 18:3n-7. They also contain signif- icant amounts of 20:1n-13 and the PUFAs 20:3n-9, 20:5n-3 and 22:6n-3. Other than 22:6n-3, which had a δ 13 C of -22‰, the fatty acids in P. hydrothermica had δ 13 C values ranging from -33‰ to -41‰. This is consistent with the fatty acids of P. hydrothermica, other than 22:6n-3 but including 20:5n-3, originating from a chemoautotrophic carbon source in the hydrothermal vent. It cannot be excluded that the 22:6n-3 in P. hydrothermica originates in the photic zone. Potential origins of the long-chain PUFAs in hydrothermal vent animals, whether produced by photo- or chemotrophic processes or by pro- or eukaryotic organisms, are considered.


Three ion-typed surfactants, including anionic sodium dihexyl sulfosuccinate (SDSS), cationic ammonium salt of poly(ethylene glycol) (ASPEG) and non-ionic poly(ethylene glycol) (PEG), were added to 10 wt% tetramethyl ammonium hydroxide water (TMAHW) solutions to evaluate the silicon anisotropic etching properties of the (1 0 0) silicon plane without agitation and no isopropyl alcohol (IPA) additive. The results indicate that the wetting capacity of the etchants cause the efficacies of the etchants on the roughness reduction to follow the order cationic ASPEG, non-ionic PEG, pure solution and anionic SDSS in TMAHW solutions, especially at high etching temperatures. Moreover, the chemical activities of the etchants cause the efficacies of the etchants on the etching rates to follow the order anionic SDSS, pure solution, cationic ASPEG and non-ionic PEG in TMAHW solutions at a given etching temperature. The cationic ASPEG has a reasonable etching rate of 0.7 µm min−1 and the lowest surface roughness of 4 nm in TMAHW solutions at an etching temperature of 100 °C. ASPEG and PEG in TMAHW solutions markedly affect aluminum passivation. The undercutting of the convex corners in PEG-added TMAHW solutions can be drastically reduced without using corner compensation; the undercutting ratio obtained using a PEG surfactant is about 45% lower than that obtained in pure TMAHW solution. This finding reveals that non-ionic PEG should be added to TMAHW solutions when accurate profiles are required without extremely deep etching. This study also demonstrated that non-ionic PEG is more appropriate than IPA for anisotropic silicon TMAHW etching.


This series provides teachers with the opportunity of assessing their knowledge and understanding of some important aspects relating to their work as teachers. Only after you have committed your own answers to paper should you read the comments which follow.


Patients with ESRD consume a vastly disproportionate amount of financial and human resources. Approximately 0.03% of the US population began renal replacement therapy in 2004, an adjusted incidence rate of 339 per million. Declining incidence rates were observed for most primary causes of ESRD and in most major demographic categories; the worry is that rates of diabetic ESRD continue to rise in younger black adults. Although diabetes and hypertension remain the most commonly reported cause of ESRD, rates of end-stage atherosclerotic renovascular disease seem to be on the rise in older patients. Although clinical care indicators, such as the proportion of hemodialysis patients using fistulas, continue to improve gradually, the proportion of patients overshooting target hemoglobin levels under epoetin therapy may be a source of concern. Survival probabilities have improved steadily in the US ESRD population since the late 1980s, which is remarkable when one considers the ever-expanding burden of comorbidity in incident patients. However, although first-year dialysis mortality rates have clearly improved since 1987, meaningful improvements do not seem to have accrued since 1993, in contrast to steady annual improvements in years 2 through 5. Although most of these findings are grounds for cautious optimism, the same cannot be said for issues of cost; reflecting the growth in the size of the ESRD population, associated costs grew by 57% between 1999 and 2004 and now account for 6.7% of total Medicare expenditures.


Abstract Though there is an expanding field of research on public prekindergarten, there is a relatively little comprehensive investigation into what public prekindergarten costs. We address some of the absences in the literature by analyzing public-sector expenditures for the city of Boston's public prekindergarten program, a particularly high-quality program. We identify the different components of the Boston program and explore how they translate into costs. We also examine how costs change over time, how costs are distributed across different levels of the education system, and how costs can be adjusted in order to calculate nationally representative estimates. Our findings are relevant for localities interested in learning from existing prekindergarten programs.


Local heat-transfer coefficients, temperature recovery factors, and pressure distributions were measured on the front side of a circular cylinder at a nominal Mach number of 3.9 over a range of free-stream Reynolds numbers from 2.1 x 10 to the 3rd power to 6.7 x 10 to the 3rd power and yaw angles from zero degrees to 44 degrees. Yawing the cylinder reduced the heat-transfer coefficients and the pressure drag coefficients. The amount of reduction may be predicted by a theory presented herein.


Abstract In order to investigate a low-cost and sustainable food source, the present study evaluated the use of poultry litter for rearing Tenebrio molitor Linnaeus, 1758 (Coleoptera:  Tenebrionidae). The experiment was performed with five diets containing increasing levels of poultry litter (0, 25, 50, 75, and 100%) replacing the control diet and five replicates with 50 larvae per sample unit. Larval growth and development were evaluated and the chemical compositions of diet and T. molitor larvae were determined. Larval development and reproduction efficiency of T. molitor were similar in all treatments. The sole use of poultry litter to feed T. molitor reduced the crude protein of flour by only 8%. Including 50% or more poultry litter in the standard diet is the best-suited formulation for larvae production and incorporation of minerals in the larvae. Mealworm can be grown successfully on diets composed by poultry litter, the diet did not affect survival, growth, and development; however, studies spanning several insect generations should be performed to determine the effects of diet composition on adult fecundity. The knowledge acquired using poultry litter to feed T. molitor will be useful to carry out new research, in addition to evidencing the possibility of low-cost mass rearing of these larvae.


This paper provides the proof of invalidity of the most fundamental constant known to mankind. Imagining a circle without " " is simply unthinkable but it's going to be a reality very soon. " " is not a true circle constant. This paper explores this idea and proposes a new constant in the process which gives the correct measure of a circle. It is given by " " . As a result, it redefines the area of the circle. The circle area currently accounted is wrong and therefore needs correction. This has serious implications for science. I have also discovered the fundamental geometrical ratio b/w a circle and a square in which it's inscribed and have also discovered a new circle formula. This paper makes this strong case with less ambiguity.


We explore the observational characteristics of jet-driven supernovae (SNe) by simulating bipolar-jet-driven explosions in a red supergiant (RSG) progenitor. We present results of four models in which we hold the injected kinetic energy at a constant 1051 erg across all jet models but vary the specific characteristics of the jets to explore the influence of the nature of jets on the structure of the SN ejecta. We evolve the explosions past shock-breakout and into quasi-homologous expansion of the SN envelope into a RSG wind. The simulations have sufficient numerical resolution to study the stability of the flow. Our simulations show the development of fluid instabilities that produce pristine helium clumps in the hydrogen envelope. The oppositely directed, nickel-rich jets give a large-scale asymmetry that may account for the nonspherical excitation and substructure of spectral lines such as Hα and He i 10830 Å. Jets with a large fraction of kinetic to thermal energy punch through the progenitor envelope and give rise to explosions that would be observed to be asymmetric from the earliest epochs, inconsistent with spectropolarimetric measurements of Type II SNe. Jets with higher thermal energy fractions result in explosions that are roughly spherical at large radii but are significantly elongated at smaller radii, deep inside the ejecta, in agreement with the polarimetric observations. We present shock-breakout light curves that indicate that strongly aspherical shock breakouts are incompatible with recent Galaxy Evolution Explorer observations of shock breakout from RSG stars. Comparison with observations indicates that jets must deposit their kinetic energy efficiently throughout the ejecta while in the hydrogen envelope. Thermal-energy-dominated jets satisfy this criterion and yield many of the observational characteristics of Type II SNe.


Objective: The aim of this study was to analyze the association between the variations of coenzyme Q2 4-hydroxybenzoate polyprenyltransferase gene (COQ2) and Japanese patients with multiple system atrophy (MSA). Methods: We investigated the genetic variations in exons 1, 2, 6, and 7 of the COQ2 gene in 133 Japanese patients with MSA and 200 controls and analyzed the association between the variations and MSA. Results: Six DNA variations (G21S, L25V, V66L, P157S, V393A, and X422K) were found in the 133 patients with MSA, and G21S and X422K were new variations that had never been reported. V66L was a common variation that was found in all 133 patients with MSA. G21S, P157S, V393A, and X422K did not show gene frequency differences between patients with MSA and controls. On the other hand, L25V was newly proven to be the only risk factor of sporadic MSA with predominant olivopontocerebellar ataxia. Conclusions: The present study suggests L25V variant of COQ2 gene as a genetic risk factor in Japanese patients with MSA with cerebellar ataxia.


Adaptive radiation is characterized by rapid phenotypic diversification as a result of utilizing different environments. Red crossbills (Loxia curvirostra Linnaeus - complex) have diversified in bill size and shape, and overall size, in response to differences in the conifer cones that hold the seeds they almost exclusively feed upon. However, a recent study showed how a bill of suboptimal size for foraging has evolved due to antagonistic selection by scaly leg mites Knemidokoptes jamaicensis. This suggests that the current variation in morphology within the adaptive radiation of crossbills may not be exclusively the result of adaptation to alternative resources. Using an independent set of populations, we found that the surprising and little-understood relationship between crossbill morphology and infection with mites is repeatable. Assuming mites depress survival, this relationship would result in directional, not stabilizing selection on morphology. We also find that the rates of infection can differ dramatically between populations, potentially depending on their ecologies. These findings suggest that morphological evolution within the adaptive radiation of crossbills may partly occur for reasons unrelated to resource use.


Background Accuracy in the quantification of the SUV is a critical point in PET because proper quantification of tumor uptake is essential for therapy monitoring and prognosis evaluation. Recent advances such as time-of-flight (TOF) and point-spread-function (PSF) reconstructions have dramatically improved detectability. However, first experiences with these techniques have shown a consistent tendency to measure markedly high SUV values, bewildering nuclear medicine physicians and referring clinicians. Purpose We investigated different reconstruction and quantification procedures to determine the optimum protocol for an accurate SUV quantification in last generation PET scanners. Methods Both phantom and patient images were evaluated. A complete set of experiments was performed using a body phantom containing 6 spheres with different background levels and contrasts. Whole-body FDG PET/CT of 20 patients with breast and lung cancer was evaluated. One hundred five foci were identified by 2 experienced nuclear medicine physicians. Each acquisition was reconstructed both with classical and advanced (TOF, PSF) reconstruction techniques. Each sphere and each in vivo lesion was quantified with different parameters as follows: SUVmax, SUVmean, and SUV50 (mean within a 50% isocontour). Results This study has confirmed that quantification with SUVmax produces important overestimation of metabolism in new generation PET scanners. This is a relevant result because, currently, SUVmax is the standard parameter for quantification. SUV50 has been shown as the best alternative, especially when applied to images reconstructed with PSF + TOF. Conclusions SUV50 provides accurate quantification and should replace SUVmax in PET tomographs incorporating advanced reconstruction techniques. PSF + TOF reconstruction is the optimum for both detection and accurate quantification.


In this thesis we improve upon the traditional smart phone remote control system for smart homes by adding a predictive component to the user interface. Our goal is to minimize the time it takes for the user to interact with smart home devices through the remote control. To achieve this goal, we locate and compare two prediction algorithms with regards to keeping the system fast and batteryfriendly. Additionally, we explore the capabilities of the Android user interface to utilize prediction in a way that minimizes interaction time. We find that we can best utilize prediction in the user interface by keeping the most likely devices on the lock screen, through the use of Android's expanded notification functionality. A separate app screen is accessed when the device can not be found in the expanded notification. To validate our system, we build a model of our system and a separate commercial system, which we then compare with regard to the time metric. The results show that our system is faster in most cases. Our work proves that with little extra effort, it is possible to decrease the user interaction time by several seconds in a smart phone remote control system for smart homes.


To regulate its complex splicing pattern, HIV-1 uses the adaptor protein Rev to shuttle unspliced or partially spliced mRNA from the nucleus to the cytoplasm. In the absence of Rev, these RNAs are retained in the nucleus, but it is unclear why. ABSTRACT The HIV-1 Rev protein is a nuclear export factor for unspliced and incompletely spliced HIV-1 RNAs. Without Rev, these intron-retaining RNAs are trapped in the nucleus. A genome-wide screen identified nine proteins of the spliceosome, which all enhanced expression from the HIV-1 unspliced RNA after CRISPR/Cas knockdown. Depletion of DHX38, WDR70, and four proteins of the Prp19-associated complex (ISY1, BUD31, XAB2, and CRNKL1) resulted in a more than 20-fold enhancement of unspliced HIV-1 RNA levels in the cytoplasm. Targeting of CRNKL1, DHX38, and BUD31 affected nuclear export efficiencies of the HIV-1 unspliced RNA to a much larger extent than splicing. Transcriptomic analyses further revealed that CRNKL1 also suppresses cytoplasmic levels of a subset of cellular mRNAs, including some with selectively retained introns. Thus, CRNKL1-dependent nuclear retention is a novel cellular mechanism for the regulation of cytoplasmic levels of intron-retaining HIV-1 mRNAs, which HIV-1 may have harnessed to direct its complex splicing pattern. IMPORTANCE To regulate its complex splicing pattern, HIV-1 uses the adaptor protein Rev to shuttle unspliced or partially spliced mRNA from the nucleus to the cytoplasm. In the absence of Rev, these RNAs are retained in the nucleus, but it is unclear why. Here we identify cellular proteins whose depletion enhances cytoplasmic levels of the HIV-1 unspliced RNA. Depletion of one of them, CRNKL1, also increases cytoplasmic levels of a subset of intron-retaining cellular mRNA, suggesting that CRNKL1-dependent nuclear retention may be a basic cellular mechanism exploited by HIV-1.


Author(s): Goodman, Emily Elizabeth | Advisor(s): Kester, Grant; Bryson, William N | Abstract: In my dissertation, I examine the ways that women artists engage with two primary and interrelated themes in their art practice — food and femininity — in an attempt to challenge gender inequality in midcentury American society. As such, I illustrate how these women's art practices are related to the discourse and political actions of the American feminism during mid-1960s. Recognizing that — despite the unity implied by the commonly employed umbrella terms of "Second Wave Feminism" and the "Women's Liberation Movement" — feminism in this period existed in myriad forms and was very much a personal issue for many of the individuals involved, my dissertation focuses on the experience of nine women artists and collectives within the larger artistic and political climate of feminism. I thus highlight the ways in which these different women artists used their art practice for political purposes, examining particular aspects of women's lives in a public forum in order to raise awareness to the ways in which misogyny and oppression are woven into the fabric of American culture and to simultaneously advocate for a potential alternative.This dissertation is divided into two parts, spanning six total chapters. The first part, which consists of a single chapter, presents the history of women's art in the United States prior to and during the emergence of women's art activism in the 1960s and 1970s. The second part of the dissertation is comprised of the remaining five chapters, each of which follows a similar format, focusing specifically on how two different women artists engage with one particular aspect of American food culture as it relates to the cultural construction of femininity. These dynamic relations between food and femininity are: Cooking, Serving, Feeding, Eating and Being Eaten. In each chapter, I situate these artists within their contexts — both geographically and temporally — and I examine how these works relate to their individual experiences as women, as artists, and as feminists. In so doing, my dissertation combines both an in-depth analysis of individual feminist art works and a broader narrative of American feminism during this period.


Abstract The transport, transformation, sorption and volatilization of trichloroethylene (TCE) as a non-aqueous phase liquid (NAPL) and as a dissolved aqueous constituent, under both laboratory and field conditions, are reviewed. NAPL-TCE is expected to migrate quite rapidly in soils and other water-unsaturated conditions, leaving droplets of organic liquid in the pore spaces. At the water table level, TCE may stop its downward movement and diffuse laterally, together with a slow migration downwards. From there on NAPL-TCE will slowly dissolve in groundwater. However, some specific hydraulic characteristics may induce rapid transport downwards away from the water table. TCE may appear in soils and aquifers as a result of its wide industrial use and also, possibly, as a degradation by-product of other chlorinated hydrocarbon solvents. TCE can undergo abiotic and (mostly) biotic, aerobic and (mostly) anaerobic transformations leading to less chlorinated ethenes. A half-life of 300 days was observed under field conditions. Batch and column experiments show that TCE is weakly sorbed on soil and aquifer solids with linear partition coefficients. Retardation factors in the range of l to 9 are reported from laboratory and field investigations. The adsorption is almost fully reversible. Gaseous TCE is more adsorbed than aqueous TCE, the extent of uptake being greatly influenced by the moisture content of the solid. Soil gas surveys appear as a promising technique for the study of soil and groundwater contamination by TCE. NAPL-TCE contamination should be quite effectively removed by steam injection. Because of its low adsorption and weak degradation under aerobic conditions, the diffuse contamination of aquifers by dissolved TCE can be extensive. In the case of localized and more severe pollution, approaches for the restoration of aquifers based on pumping followed by treatment at the surface may be effective but they usually are not economical. In situ treatment by stimulating the biotrans-formation is considered as a favourable alternative.


Giving too much emphasis to extrinsic values and too little emphasis to intrinsic values is known to depress well-being. But is simply working in an extrinsic job also risky, even if that job delivers the money? We compared 1414 'Money' (extrinsic) lawyers, 1145 'Service' (intrinsic) lawyers, and 3415 'Other' lawyers as to their income, values, well-being, and drinking behavior. Although service lawyers had much lower incomes, they also experienced more well-being and less negative affect compared to money lawyers, and drank less and less often. ANCOVAs showed that the intrinsic vs. extrinsic job-type effects were independent of rated intrinsic vs. extrinsic values, current income, years of work experience, and class rank at graduation, suggesting that the job-contexts themselves were operative. We discuss the difficult choice that pre-professional students face, between two versions of the American dream: one emphasizing wealth and status, and the other, service and personal development.


Maternal and social behavior in multiparous Pelibuey ewes was assessed under intensive production system. The social behavior was recorded several days before and during birth. Mother-young behavior during the first hour after birth was recorded. A selective maternal test was performed at 2 hours postpartum. Eight hours after birth, a double choice test was done in mothers to asses their ability to discriminate between the own or alien lamb. While a similar double choice test was performed in 12 hours-old lambs. The agitation index when the ewes were tested without companions was lower in parturient ewes than in145 days pregnant ewes and non pregnant ewes [parturient ewes: (–0.59 ± 0.9), 145 days pregnant ewes: (2.6 ± 0.7) and non pregnant ewes (4.2 ± 0.9) P < 0.05]. During the first hour after birth the latency to stand up, to begin to look for the udder and to suck was shorter in male than female lambs, also the male lambs sucked for longer time than females (P < 0.05). During this time mothers emitted more high-pitched bleats than low-pitched bleats (P < 0.05). Besides, the ewes got shorter latencies to lick the area of head and thorax of the lamb than its tail, but they licked more frequently the lamb's tail and thorax (P < 0.03). Two hours postpartum all mothers were selective, they showed clear preference to accept to the udder their own lamb and reject actively the alien ones (P < 0.05). At eight or 12 hours, mothers and lambs spent longer time watching and staying with their own familiar animal than with the alien ones (P < 0.05). It is concluded that Pelibuey ewes show an adequate maternal temperament, and the behavior of the newborn lamb could be affected because of its sex.


The relative contributions of germline gene variation and somatic mutation to immunoglobulin diversity were studied by comparing germline gene sequences with their rearranged counterparts for the mouse VH, V kappa, and V lambda genes. The mutation rate at the amino acid level was estimated to be 7.0% in the first and second complementarity-determining regions (CDRs) and 2.0% in the framework regions (FRs). The difference in the mutation rate at the nucleotide level between the CDRs and FRs was of the same order of magnitude as that for the amino acid level. Analysis of amino acid diversity or nucleotide diversity indicated that the contribution of somatic mutation to immunoglobulin diversity is approximately 5%. However, the contribution of somatic mutation to the number of different amino acid sequences of immunoglobulins is much larger than that estimated by the analysis of amino acid diversity, and more than 90% of the different immunoglobulins seem to be generated by somatic mutation. Examination of the pattern of nucleotide substitution has suggested that clonal selection after somatic mutation may not be as strong as generally believed.


AbstractThe effects of a progressively enhanced Asian summer monsoon on the mean zonal wind are examined in a series of experiments using the Community Atmosphere Model version 4 (CAM4). The response of the barotropic mean zonal wind varies in a linear fashion with the forcings of 5, 10, and 20 W m−2 in net radiation over South Asia. The authors increase the strength of the monsoon by making the South Asian land surface hotter (via lower soil albedo). This leads to an enhanced Rossby wave source region over the Balkan Peninsula at 45°N, northwest of the upper-level Tibetan high (TH). Equatorward propagation of Rossby waves causes stationary eddy momentum flux divergence (SEMFD) to the south of this source region. This local area of SEMFD produces easterly tendencies of the barotropic part of the mean zonal wind in the subtropics. As the easterly mean flow strengthens, so do low-level easterlies across the subtropical Atlantic, leading to a westward displacement of the North Atlantic subtropical high (NASH...


Purpose: To identify baseline impairments associated with physical function and to identify what changes in impairments are associated with functional outcome in patients with PFPS following a standardized physical therapy (PT) treatment at 2 and 6-month follow-ups. Subjects: 74 patients diagnosed with PFPS and referred to PT treatment. Methods: Correlational, predictive design. Baseline measurement session was performed to complete demographic questionnaires, self-reported measures, and undergo a physical exam. Impairments measured during physical exam included quadriceps strength, hip abduction strength, hip external rotation strength, hamstrings length, quadriceps length, plantar flexors length, ITB/TFL complex length, lateral retinacular length, foot pronation, Q-angle, tibial torsion, quality of movement, pain, and anxiety. Following the baseline, subjects participated in a standardized PT program. Then, measurement sessions were performed at 2 and 6-month follow-ups. Analyses: Association between baseline impairment and function used a stepwise multiple regression in which potential confounder variables (age, sex, activity level, height and weight) were forced into the model as a single block. Then, impairment measures were entered in a stepwise procedure. Function measured by the Activity of Daily Living Scale (ADLS) was the criterion variable. Association between changes in impairment and function outcome was investigated with two stepwise multiple regressions, one with the 2 and the other with the 6-month follow-up data. The criterion variable was the ADLS of the respective follow-up controlled by the baseline ADLS. First, potential confounders were forced into the model as a single block. Then, changes in impairments and baseline pain were entered in a stepwise procedure. Results and Clinical Relevance: At baseline our study indicates that after controlling the confounders, pain and tightness of lateral retinaculum predicted baseline function. Data suggested that pain may mediate the relationship between anxiety and function in patients with PFPS and the role of pain and anxiety in the prediction of function should be considered together with this population. At the 2 and 6-month follow-ups, after controlling the confounders, increased gastrocnemius length and increased quadriceps length predicted functional outcome, respectively. It seems that clinicians should specifically target impairments of soft tissue length in an attempt to improve functional outcome in patients with PFPS.


We introduce the triangle-densest-K-subgraph problem (TDKS) for undirected graphs: given a size parameter K, compute a subset of K vertices that maximizes the number of induced triangles. The problem corresponds to the simplest generalization of the edge based densest-K-subgraph problem (DKS) to the case of higher-order network motifs. We prove that TDKS is NP-hard and is not amenable to efficient approximation, in the worst-case. By judiciously exploiting the structure of the problem, we propose a relaxation algorithm for the purpose of obtaining high-quality, sub-optimal solutions. Our approach utilizes the fact that the cost function of TDKS is submodular to construct a convex relaxation for the problem based on the Lovász extension for submodular functions. We demonstrate that our approaches attain state-of-the-art performance on real-world graphs and can offer substantially improved exploration of the optimal density-size curve compared to sophisticated approximation baselines for DKS. We use document summarization to showcase why TDKS is a useful generalization of DKS.


In this study, we show that bacteriocin production in Lactobacillus plantarum C11 is an inducible process triggered by a secreted protein factor produced by the bacteriocin producer itself. The induction factor was identified to be plantaricin A, a bacteriocin-like peptide whose gene (plnA) is located in the same operon as a two-component regulatory system (plnBCD). When L. plantarum C11 cultures were depleted for plantaricin A, either by growing individual colonies on agar plates or by starting a new culture with a highly diluted inoculum, no bacteriocin was produced during the following growth. When chemically synthesized plantaricin A or purified bacterially produced plantaricin A was added to non-producing cultures, bacteriocin production was induced. Only 1 ng ml-1 plantaricin A is sufficient to induce the bacteriocin production in non-producing L. plantarum C11, and bacteriocin activity appears in the growth medium approximately 150 min after induction. Northern analyses, using a plnA-specific probe, demonstrated that plantaricin A is able to induce its own synthesis by transcription of the plnABCD operon, and this is observed approximately 15 min after adding plantaricin A. Furthermore, heterologous expression of the plnABCD operon in a Lactobacillus sake strain showed that the conditioned growth medium contained the active induction factor. Neither synthetic nor expressed plantaricin A from the heterologous system possesses any bacteriocin activity, suggesting that plantaricin A is primarily an induction factor and not a bacteriocin as claimed earlier.


A free-standing, flexible, and semi-transparent MoO3 nanopaper was fabricated using ultralong MoO3 nanobelts (length ∼ 200 μm; width 200–400 nm), and its gas-sensing characteristics were investigated. The sensor exhibited high responses (resistance ratio) of 49 to 5 parts per million (ppm) hydrogen sulfide (H2S) at 250 °C and 121 to 5 ppm trimethylamine (TMA) at 325 °C with excellent gas selectivity, demonstrating its dual function for gas detection. Moreover, the sensor showed promising potential for the all-in-one detection of three representative offensive odors (TMA, H2S, and NH3) simply by tuning of the sensing temperature. This particular performance is attributed to the high chemical affinity of MoO3 to H2S and the acid–base interaction between basic TMA/NH3 and acidic MoO3. The mechanism underlying the control of gas selectivity by modulating the sensor temperature was investigated by Diffuse Reflectance Infrared Fourier Transform (DRIFT) measurements.


This paper introduces an idea of imitating camera movements and shooting styles from an example video and reproducing the effects on another carelessly shot video. Our goal is to compute a series of transformations so that we can warp the input video and make the flow of the output video resemble the example flow. We formulate and solve an optimization problem to find the required transformation for each video frame. By enforcing the resemblance between flow fields, our method can recreate different shooting styles and camera movements, from simple effect of video stabilization, to more complicated ones like anti-blur panning, smooth zoom, tracking shot, and dolly zoom.


Introduction GVK EMRI (GVK Emergency Management and Research Institute) is World's Largest Integrated Emergency Response Services (ERS) Provider. It is not—for—profit professional organization operating in the Public Private Partnership (PPP) mode. This is a free service delivered through state- of -art emergency call response centers and has over 2000 ambulances providing necessary professional pre-hospital care while transporting the victim to the nearest hospital. In our state it was launched on 16 July 2009. Objectives To determine the type of emergencies reported by 108-ERS. To determine the proportion of emergencies brought to medical college hospital by 108-ERS. To determine the impact of 108-ERS on emergency medical services. Methods Type of study- Record based data evaluation. Study area: Four Districts of M.P. Research period- 1 August 2010 to 31 August 2010. Tools and techniques: Review of secondary data from 108-ERS, Jabalpur and MRD of NSCB Medical College, Jabalpur. Results 74 557 individuals get benefitted in M.P. till 31 July 2010 from the launch. Out of which 25 000 (33.53%) were pregnancy related emergencies, followed by 16 986 (22.78%) of road traffic accidents and 6494 (8.7%) were of acute abdomen. About one tenth of total emergency cases seen in emergency department of NSCB Medical College, Jabalpur were brought by 108-ERS. Above 6000 lives saved by this 108- Emergency response service in Madhya Pradesh. Conclusion Record based data are a great help to formulate policies and strategies to improve the health services in any state or country.


This article presents the third in a series of three interviews that P&T conducted with several members of the American Society of Health-System Pharmacists (ASHP) Expert Panel on Formulary Management.In 2008, ASHP convened this panel of experts to develop revised guidelines for P&T committee and formulary management to replace the previous guidance issued in 1991.1 These revised guidelines include recommendations concerning the review and evaluation of drugs for formulary inclusion, pharmacoeconomic assessments, therapeutic interchange, medication-use evaluations (MUEs), management of drug shortages, and many other important topics.In this series, ASHP experts discuss P&T committee and formulary management guidelines in their respective institutions as well as other observations and insights. In Part 3, the author interviews Sabrina Cole, PharmD, Clinical Specialist, Drug Information, at the Grady Health System in Atlanta, Georgia.


Scalability is one of the main challenges of trapped ion based quantum computation, partly limited by the ability to manipulate the increasing number of quantum bits (qubits). For individual addressing of qubits, microelectromechanical systems (MEMS) technology allows one to design movable micromirrors to focus laser beams on individual ions and steer the focal point in two dimensions. This system is able to scale to multiple beams, has switching speeds comparable to typical single qubit gate times, and has negligible crosstalk on neighboring ions.


In Geometry Processing, and more specifically in surface approximation, one of the most important issues is the automatic generation of a quad-dominant control mesh from an arbitrary shape (e.g. a scanned mesh). One of the first fully automatic solutions was proposed by Eck and Hoppe in 1996. However, in the industry, designers still use manual tools (see e.g. cyslice). The main difference between a control mesh constructed by an automatic method and the one designed by a human user is that in the second case, the control mesh follows the features of the model. More precisely, it is well known from approximation theory that aligning the edges with the principal directions of curvature improves the smoothness of the reconstructed surface, and this is what designers intuitively do.
 In this paper, our goal is to automatically construct a control mesh driven by the anisotropy of the shape, mimicking the mesh that a designer would create manually. The control mesh generated by our method can be used by a wide variety of representations (splines, subdivision surfaces ...).
 We demonstrate our method applied to the automatic conversion from a mesh of arbitrary topology into a T-Spline surface. Our method first extracts an initial mesh from a PGP (Periodic Global Parameterization). To facilitate user-interaction, we extend the PGP method to take into account optional user-defined information. This makes it possible to locally tune the orientation and the density of the control mesh. The user can also interactively remove edges or sketch additional ones. Then, from this initial control mesh, our algorithm generates a valid T-Spline control mesh by enforcing some validity constraints. The valid T-Spline control mesh is finally fitted to the original surface, using a classic regularized optimization procedure. To reduce the L approximation error below a user-defined threshold, we iteratively use the T-Spline adaptive local refinement.


Clinical Criteria to Identify Patients With Sepsis To the Editor Dr Seymour and colleagues1 assessed the predictive validity of various clinical criteria to identify patients with sepsis. However, their conclusion that the Sequential [Sepsisrelated] Organ Failure Assessment (SOFA) and quick SOFA (qSOFA) scores are more clinically useful than the systemic inflammatory response syndrome (SIRS) criteria was primarily based on differences in the area under the receiver operating curve (AUROC), which has several limitations.2 First, differences in the AUROC may be of minimal clinical relevance. For example, although the American College of Cardiology/American Heart Association (ACC/AHA) and the Adult Treatment Panel III cardiovascular risk prediction models have similar AUROCs, the ACC/AHA model recommends statin therapy for more adults and better reclassifies patients according to their true risk (net reclassification index [NRI], 0.332).3,4 To better assess for clinically meaningful differences in the utility of different sepsis diagnostic criteria, the authors should report the overall categorical NRI (for ≥2 vs <2 points), event and nonevent NRIs, and risk reclassification tables. Second, Seymour and colleagues proposed implementing both the SOFA and qSOFA scores in practice by defining patients with scores of 2 points or greater as having "sepsis" and those with less than 2 points as not having sepsis. However, the reported AUROCs were calculated using continuous scores. Assessing the performance of each set of clinical criteria using the dichotomous categorization and reporting the positive and negative predictive values and corresponding likelihood ratios compared with the SIRS criteria would be more clinically relevant than reporting the differences in the AUROC or the relative difference in outcomes across deciles of baseline risk. Most important, it is unclear that the lower AUROC reflects inferior predictive validity of the SIRS criteria. Rather, the lower AUROC (and relative fold difference in outcomes) may reflect the influence of incorporation bias. The current standard of care for clinicians during the period of this study was to initiate early goal-directed therapy for patients with suspected sepsis based on SIRS criteria. Thus, the lower performance of SIRS for predicting mortality may simply be an artifact—patients diagnosed as having sepsis by 2 or more SIRS criteria were more likely to have received early goal-directed therapy and less likely to die as a consequence.5 Before the current diagnostic criteria for sepsis are replaced, we believe that more robust analyses are needed, including a prospective study of the utility of these various clinical criteria that would eliminate the influence of incorporation bias.


Vaccination against influenza is important in pregnancy for the health of both mother and unborn baby. Influenza introduces risks to pregnancy and to the baby who relies on maternal antibodies for protection. Because the data associated with pregnancy is fragmented across multiple providers of health care, it is challenging to conduct pregnancy-related public health surveillance using a single data source. We report the integration of a novel ontological approach to identifying pregnancies in routine data with a web-based dashboard that feeds back information to general practices in a sentinel network. As a result, practices receive information about how well they are performing influenza vaccination in pregnancy in near-real-time.


Cu-Au-Mo deposits represent major metal resources known to be spatially and temporally associated with intrusive arc magmatism, and in particular with adakites. Although the bulk of the ore metals seem to originate from the magmas, there is as yet no consensus on processes responsible for their concentration. The fact that primary ore minerals are predominantly sulfides has led to the suggestion that sulfur may play an important role in metal enrichment processes at the magmatic stage. Here, we conducted highpressure/ temperature experiments (0.4 GPa, 1000°C) on 3 natural dacitic magmas from the Philippines (two adakites and one typical calc-alkaline composition) over a wide range of fO2 (~NNO-1 to ~NNO+3), as measured by solid sensors. The experiments were carried out in pure Au capsules, the latter also serving as the source of gold, in the presence of variable amounts of H2O. Both S-free and S-bearing (~1 wt% S added) experiments were performed. Charges consist of dominant silicate melt quenched to glass plus minor silicate phases (mostly Cpx). All S-bearing charges are saturated with either sulfides or sulfates, depending on the fO2. Our data show that Au solubility in S-free charges is very low (30-240 ppb) but increases with fO2. In S-bearing charges Au contents reach much higher values, ranging from ~500 to 5200 ppb depending on the fO2, the most reduced charges being the gold-richest. Also, the behaviour of Au w.r.t. sulfur appears to be radically different according to the fO2. No significant difference of Au solubility is observed between adakitic and non-adakitic melts in both S-free and S-bearing charges. A major consequence of this study is that sulfide crystallization does not scavenge all Au present in the magma, but allows gold-enriched residual magmas to be emplaced in the upper crust. Additional experimental runs are currently being performed at higher pressures (> 1 GPa), that should lead to important supplementary data and results.


The original Swedish dictionary series LEXIN was launched in the 1980's, designed specifically for minority language immigrants living in Sweden. In 1996, The Norwegian Ministry for Education, Research and Church Affairs initiated a corresponding Norwegian project at The Norwegian Term Bank. The project has since continued in the same environment. At present it is a part of the university-owned company Uni Research, and it is owned and funded by The Norwegian Directorate for Education and Training (Utdanningsdirektoratet). The Norwegian series consists of dictionaries from Norwegian Bokmal and Nynorsk into 16 target languages, and more languages are forthcoming. Since the launch in 2002 the dictionary users have been able to contact the project group directly through the project's website. The user dialogue has proven to be of great value. Two user surveys have also contributed to improve our knowledge about the user needs and about how they benefit from using Norwegian LEXIN.


Management practices following forest harvesting that modify organic matter (OM) inputs and influence changes in the soil environment have the potential to alter soil C pools, but there is still much uncertainty regarding how these practices influence soil C flux. We examined the influence of varying amounts of logging-debris retention (0, 40, and 80% coverage) and vegetation control (initial or annual applications) on in situ bulk soil respiration, microbial respiration, and total soil C at two Douglas-fir [ (Mirb.) Franco] sites. Annual vegetation control decreased bulk respiration, which was attributed to reduced root respiration and OM inputs when competing vegetation was absent. There was no difference in potential microbial respiration or total soil C pools between vegetation-control treatments, indicating that OM inputs from competing vegetation were rapidly consumed in situ. Logging-debris retention reduced bulk respiration, microbial respiration, and soil temperature, but the significance and magnitude of the difference were variable. A soil temperature function explained between 44 and 76% of the variation in microbial and bulk respiration, but there was no effect of reduced temperature on microbial respiration with 40% coverage. Total soil C at the end of the experiment was higher with 80% coverage at the site with relatively low initial total soil C, but there was also a significant increase in total soil C at both sites when the logging debris was removed. The results suggest that root decomposition following harvesting causes an increase in total soil C, which is dependent on the magnitude of logging-debris retention, its influence on the soil environment, and ultimately the microbial response.


The Birnbaum-Sanders (BS) distribution was first introduced in 1969 by Birnbaum and Saunders as a combination of inverse Gaussian distributions with a length-biased inverse Gaussian distribution. Later, in 2008, Ahmed et al. introduced a new parametrization of the BS distribution based on Birnbaum-Sanders, and they also proposed a parameter estimation using the method of moments and regression-quantile estimation. In this paper, we emphasize the Birnbaum-Sanders distribution presented by Ahmed et al., and we develop an EM-algorithm to estimate two unknown parameters of this distribution. The EM-algorithm is a general method used to estimate the parameters when the probability density function is complicated and it is the best alternative for the estimation of a mixture distribution. We assumed that this problem has a missing value, and maximized complete data log-likelihood function instead log-likelihood function because it is analytically easier. Moreover, some simulation experiments were conducted in order to examine the performance of the proposed parameter estimation, and it was observed that the performances were quite satisfactory. Specifically, the MSE, variance and bias tend to decrease as n increases.


Although pure formamidinium iodide perovskite (FAPbI3) possesses an optimal gap for photovoltaics, their poor phase stability limits the long-term operational stability of the devices. A promising approach to enhance their phase stability is to incorporate cesium into FAPbI3. However, state-of-the-art formamidinium-cesium (FA-Cs) iodide perovskites demonstrate much worse efficiency compared with FAPbI3, limited by different crystallization dynamics of formamidinium and cesium, which result in poor composition homogeneity and high trap densities. We develop a novel strategy of crystallization decoupling processes of formamidinium and cesium via a sequential cesium incorporation approach. As such, we obtain highly reproducible and highly efficient solar cells based on FA1-xCsxPbI3 films, with uniform composition distribution and low defect densities. In addition, our cesium-incorporated perovskites demonstrate much enhanced stability compared with FAPbI3, as a result of suppressed ionic migration due to reduced electron-phonon coupling.


From a large combinatorial library of chemically constrained bicyclic peptides we isolated a selective and potent (K(i) = 53 nM) inhibitor of human urokinase-type plasminogen activator (uPA) and crystallized the complex. This revealed an extended structure of the peptide with both peptide loops engaging the target to form a large interaction surface of 701 Å(2) with multiple hydrogen bonds and complementary charge interactions, explaining the high affinity and specificity of the inhibitor. The interface resembles that between two proteins and suggests that these constrained peptides have the potential to act as small protein mimics.


The Lithuanian Consulate in Petrograd in the years 1921–1923 has been studied in Lithuanian historiography by focusing on the establishment of Lithuanian consulates in Soviet Russia in 1921 and the appointment and activities of Stasys Zaskevičius as Consul ad Interim from the second half of 1922 through 1923. The period when the consulate was led by Jonas Matukas, his appointment and activities, the origins of the consulate and its operation in 1922 have not been investigated at all. Therefore, based on the sources and historiography, the aim of the research is to reconstruct the process of the establishment and functioning of the Lithuanian Consulate in Petrograd from 1921 to 1923 with a special focus on the specificities of the living conditions and activities. The research is based on unpublished sources from the Political Archive of the German Federal Foreign Office, the Collection of the Ministry of Foreign Affairs kept at the Lithuanian Central State Archives, the Manuscripts Department of the Wroblewski Library of the Lithuanian Academy of Sciences and published sources, namely documents, periodicals and studies by Lithuanian (Tomas Balkelis, Milena Tamošiūnienė) and foreign (Aleksander Wasilewski, Winfried Baumgart) authors. Methods of qualitative analysis and synthesis (the new material of the sources was supplemented with the information circulating in historiography), the comparative method (the information published in the Lithuanian press was compared with the information found in the Lithuanian Central State Archives), and the descriptive method were applied in this research. To process the primary sources in Lithuanian, German, and Russian languages, the logical-analytical method was applied (the notional content and information analysis was conducted). The research led to the conclusion that due to the correspondence bureaus established in Petrograd during World War I, the city became the centre of communication between Lithuanians on both sides of the front. After the Treaty of Brest-Litovsk was signed and Germany recognised Lithuania's independence, Petrograd became the centre of repatriation of Lithuanian deportees and refugees. The Lithuanian consular institution established in Petrograd in 1921 employed over thirty members of staff who helped the deportees and refugees of Lithuanian nationality and citizenship to return to the restored state of Lithuania and provided assistance in the form of food and clothes through the Lithuanian Red Cross until 30 September 1923.


Purpose of the Study
Technology revolution have made the communication and information sharing quite easy and approachable around the world. Such technology platforms comes under the category of social media. However, social media bring the ease of the communication and information sharing along with negative effects on health in case of extreme usage. Especially, youngsters have encounter with negative effects of the social media platforms like bad academics performance and health (Murray et al., 2012). Therefore, increase in the number of the psychiatrist patients has occur especially of young age including college and university students. This negative effect of extreme use of  social media on society cannot be ignored. Thus, current study examines the association of social media usage with depression among the collge students.
Methodology
The correlational study design are used  and data was getheared through self administered questionnaire. Respondents were selected through simple random sampling and questionnaire were distributed to 155 students of Nisa girls college and Nursing College, Allama Iqbal Medical College through . SPSS version 21 apply the tests of frequency distribution, reliability and validiy, correlation and regression.
Findings
The results reveal that there exists positive and significant relationship between social media usage and depression (P<0.000) among the college students. It is the responsibility of  the parents and management of educational institutes to spread the awareness and focus on the measures to avoid its extensive usage among the young adults.
Significance
The increase of depression among the young adults have severe damages to the society and raise the concens of the parents. This study will enhance the knowledge of parents that extreme usage of social media can cause problems of health to their childeren. Likewise, educational institutes can take the benefits of these findings to avoid such technology at their campus. Meanwhile, the policy makers of governement can take the guide while designing the regulatory policies for institutes and awareness compaigns. Future directions and limitations are provided at the end of the this study.

Key Words:  Social Media Usage, Depreesion, Young adults.


ZnO thin films were grown on glass slides by thermal evaporation of zinc powder in vacuum followed by heat treatment in air. The films were characterized by x-ray diffraction (xrd), Raman scattering and scanning electron microscopy (SEM). Xrd pattern for as-deposited thin film sample consists of hexagonal Zn structure with slight wurtzite ZnO texture. It is observed that the heat-treatment at between 450 and 600 °C for 1 to 3 h turns the xrd pattern almost completely to wurtzite ZnO structure. SEM micrographs display flakes like hexagonal button shaped grains for as-deposited thin film which turns to needle like nanometer size structures with heat treatment. The red shift of some vibrational modes in Raman spectra for as-deposited thin film relative to the heat treated films and the introduction of a line at around 582 cm−1 indicate that ZnO thin films have defects such as oxygen vacancies or zinc interstitials. The most intense Raman mode due to high frequency oxygen vibration for as-deposited zinc film is red-shifted by about 7 cm−1 relative to the Raman mode for the ZnO thin film heat-treated.


Nowadays, Barton's Joint Roughness Coefficients (JRC) are widely used as the index for roughness and as a challenging fracture property. When JRC ranking is the goal, deriving JRC from different fractal/wavelet procedures can be conflicting. Complexity increases when various rankings outcome from different calculation methods. Therefore, using Barton's JRC, we cannot make a decision based on the proven mathematical theories because each method has a different rank. Ideally, these rankings must be equal but, in practice, they are different for each method. To solve this problem and to achieve a robust and valid ranking for JRC, Condorcetand Borda count methods have been used. These methods have been proposed as fusion approaches. Re-ranking of JRC using different methods integrated with Condorcet showed confusion in ranking of the JRC4, JRC5, and JRC6 profiles. This ambiguity is equal to equalizing decision conditions about all the three at the examination of the winners, losers, and draws in pairwise matrices. Therefore, Borda Count was applied and resulted in robust rankings. In fact, a new approach for a roughness measurement is presented. A new JRC ranking called JRCN is introduced. This new ranking shows a lower sum of squared errors (0.00390) in comparison with the original JRC ranking method (0.00410) and ranked JRCN1 to JRCN10. Thus it is proposed to consider JRCN as a new and improved version of JRC rankings.


Human musicality is a mystery. Theorists have proposed that it was evolutionarily adaptive through its ability to create a shared and positive emotional state, increase a sense of social cohesion, and encourage pro-social behaviours. This research found that group singing provides immediate socio-emotional wellbeing benefits but longer-term benefits are confined to emotional domains. These effects were not unique to group singing, but were similar across comparison groups. Wellbeing was facilitated by both group characteristics (music, movement, socialising) and individual mindset towards participation (motivation, flow), with greater benefits for exercise groups. Implications for social prescribing and similar interventions are discussed.


Recent studies in the literature examining impact of government seed price intervention on adoption of Bt cotton get different results depending on the specifics of the situation analyzed. According to one study, reduction in seed prices enables farmers to buy seeds at lower prices and this can result in surge of area sown under Bt cotton. The other view holds that seed price interventions have little impact on the adoption rates rather these interventions may adversely affect firms' incentives to innovate. Which of the two views characterize adoption of Bt cotton in India? Using three variations of dynamic logistic model, this paper analyzes the impact of certain economic factors like seed prices, technological development, and cotton prices on the diffusion of Bt cotton in India. It uses panel data set covering 9 major cotton growing states over the years 2002 to 2008 and finds that although seed prices were significant in impacting the diffusion rates, its impact was limited. The study also sheds light on the significance of technological development in impacting diffusion rates.


JOHN R. RICE AND EVANGELISM: AN ESSENTIAL MARK OF INDEPENDENT BAPTIST FUNDAMENTALISM Matthew Lee Lyon, Ph.D. The Southern Baptist Theological Seminary, 2019 Chair: Dr. Thomas J. Nettles This dissertation examines the theology of John R. Rice through the lens of his commitment to evangelism. Rice was a prominent twentieth-century independent Baptist fundamentalist whose ministry covered many areas, including pastor, newspaper editor, and evangelist. This dissertation argues that evangelism was Rice's focus and defined his other theological, ministerial, and historical perspectives. Rice's devotion to evangelism, especially as informed by nineteenth-century revivalism, created a unique form of fundamentalism, one that trumped other doctrines, such as separatism. Chapter 2 places Rice in the context of twentieth-century fundamentalism. Rice developed a unique model, focused on cooperation with all believers for evangelism. It was largely abandoned by his successors. Chapter 3 argues that Rice taught that the Christian life and church should be organized entirely around evangelism, following the heart of Jesus. This approach would naturally produce discipleship and church health. Chapter 4 examines Rice's bibliology. His conversionism led him away from evidentialist and Common Sense views and toward a Reformed, presuppositional perspective. Chapter 5 demonstrates that Rice was only a nominal dispensationalist. Rice held to the system as far as it facilitated evangelism, but no farther. This stance left Rice on the edges of the typical fundamentalist identification with dispensationalism. Chapter 6 analyzes Rice's opposition to Arminianism and Calvinism. Rice's held a superficial understanding of both systems, leading him to make errors in evaluating them, as well past Reformed evangelists. Chapter 7 focuses on Rice's pneumatology. Rice maintained that evangelism was dependent on a post-conversion enduement of power from the Holy Spirit. Rice's also strongly opposed the tongues theology of Pentecostalism. Chapter 8 examines Rice's preaching style in relation to current social issues. Rice advocated pointed preaching against modern social ills, primarily as a means to bring conviction. However, Rice drew most of his analysis from a white, conservative culture, centered around authority, demonstrated by his opposition to the Civil Rights Movement. Chapter 9 focuses on Rice's methodology of evangelism, which was determined by pragmatism. Rice taught that personal evangelism was the most effective means of evangelism, while mass evangelism was necessary mostly as a means to prepare for evangelism.


A plate forging process of tailored blanks having local thickening for the deep drawing of square cups was developed to improve the drawability. A sheet having uniform thickness was bent into a hat shape of two inclined portions, and then was compressed with a flat die under restraint of both edges to thicken the two inclined portions. The bending and compression were repeated after a right-angled rotation of the sheet for thickening in the perpendicular direction. The thickness of the rectangular ring portion equivalent to the bottom corner of the square cup was increased, particularly the thickening at the four eywords: late forging ailored blank ocal thickening ending ompression corners of the rectangular ring undergoing large decrease in wall thickness in the deep drawing of square cups became double. The degree of thickening can be adjusted by controlling the punch stroke in the bending. By using the tailor blanks having local thickening, not only the decrease in wall thickness at the bottom corner of the square cup was prevented, but also the limiting drawing height of the cup without fracture was increased to 28.3 mm, whereas that for the uniform blank was 21.3 mm. quare cup


Hybrid input/output automata provide a language for the description and analysis of hybrid systems. In this paper, we develop a notion of approximate simulation relation for metric hybrid input/output automata, which is an extension classic simulation relation in hybrid input/output automata, and investigate some interesting results. In addition, we discuss a particular kind of approximation simulation relation, i.e. approximate refinement. Moreover, we show how to adopt approximate synchronization methods to guarantee substitutive under the condition of approximate simulation.


Personalized diagnoses have not been possible due to a sear amount of data pathologists have to bear during the day-to-day routine, leading to the current generalized standards being continuously updated as new findings are reported. It is noticeable that these practical standards are developed based on multi-source heterogeneous data, including whole-slide images and pathology and clinical reports. In this study, we propose a framework that combines pathological images and medical reports to generate a personalized diagnosis result for an individual patient. We use nuclei-level image feature similarity and content-based deep learning method to search for a personalized group of populations with similar pathological characteristics, extract structured prognostic information from descriptive pathology reports of the similar patient population, and assign importance of different prognostic factors to generate a personalized pathological diagnosis result. We use multi-source heterogeneous data from TCGA (The Cancer Genome Atlas) database. The result demonstrates that our framework matches the performance of pathologists in the diagnosis of renal cell carcinoma. This framework is designed to be generic, and this could be applied to other types of cancer. The weights could provide insights into the known prognostic factors and further guide more precise clinical treatment protocols.


Color features of an image are the most widely used features in content-based image retrieval (CBIR) [1][6] systems. Specifically histogram-based algorithms are considered to be effective for color image indexing. Color histogram [2] describes the global distribution of pixels of an image which is insensitive to variations in scale and easy to calculate. However, the high dimensionality of feature vectors results in high computation cost and space cost. In this paper, we mainly focus on color features and propose a novel method named Color Frequency Sequence Difference (CFSD) to express color images, which only has one numerical value in one color channel. The CFSD is combined with information entropy to realize indexing. The novel approach is described in detail and compared with color histogram method presented in the literature. The experiment is finished and shows that the method proposed in this paper is effective and efficient.


1. The rate of loss of 24 Na from the terminal abdominal ganglion of Periplaneta americana L. has been studied by measuring the decline in radioactivity associated with an isolated preparation maintained in flowing physiological solution. 2. The rate of sodium efflux was substantially reduced in the presence Of 0.2 mM./l. dinitrophenol and in potassium-free solution. 3. The extrusion of 24 Na was not significantly affected by the removal of the fibrous and cellular sheath surrounding the ganglion. The rate-limiting process in the efflux of sodium measured in the experiments was not, therefore, the transfer of ions across the nerve sheath, but an extrusion from tissues lying at a deeper level in the central nervous system.


In this paper we present an approach to indoor classification that presupposes a certain amount of prior information in terms of statistical information about possible interdependencies among objects and locations. A preselective perception process (that here is only hinted), using a database of textures, and built using the energy value computed with a tree-structured wavelet transform, selects regions in the image and, according to the database, builds an observation state including also a saliency map of the features of the image. The process of delivering this information is interleaved with a process that using a database of interdependencies between objects and locations, mimicking a memory, forms an hypothesis about the current location. We show that the process of hypothesis formation converges under specific constraints.


If the process of diffusion in metals results simply in the interchange of pairs of atoms large strains must be set up when a new phase precipitates in an alloy. The strain energy involved is calculated for particles of precipitate of various shapes, and is found to be least if the precipitate forms thin plates. The shape of the particle actually formed is influenced by this energy, by the degree of supersaturation of the solid solution, and by surface effects; the calculated shape is shown to agree reasonably well with that observed experimentally.


We consider reliable multicast in overlay networks where nodes have finite-size buffers and are subject to failures. We address issues of end-to-end reliability and throughput scalability in this framework. We propose a simple architecture which consists of using distinct point-to-point TCP connections between adjacent pairs of end-systems, together with a back-pressure control mechanism regulating the transfers of adjacent TCP connections, as well as a back-up buffering system handling node failures. This architecture, that we call the one-to-many TCP overlay, is a natural extension of TCP to the one-to-many case, in that it adapts the rate of the group communication to local congestion in a decentralized way via the window back-pressure mechanism. Using theoretical investigations, experimentations in the Internet, and large network simulations, we show that this architecture provides end-to-end reliability and can tolerate multiple simultaneous node failures, provided the backup buffers are sized appropriately. We also show that under random perturbations caused by cross traffic described in the paper, the throughput of this reliable group communication is always larger than a positive constant, that does not depend on the group size. This scalability result contrasts with known results about the non-scalability of IP-supported multicast for reliable group communication.


The present paper reviews the scientific development of our understanding of S-Phase. It is now known that S-Phase formation is an example of para equilibrium phenomena. A necessary but not sufficient condition for S-Phase formation is the presence of an fcc structure at least in part with structure in the starting alloy. An essential requirement is for a nitride forming element to be present particularly Cr. After surface engineering with carbon, nitrogen or carbon and nitrogen to generate supersaturated solid solutions, the various tribological, corrosion, mechanical and microstructural studies are reviewed for the various alloy systems. The current industrial status of S-Phase technology on an international basis is examined and the potential for its acceptance in china is discussed.


PURPOSE/OBJECTIVES
To understand how hospital inpatients express their spirituality and to investigate the impact of hospice environment on this expression.

RESEARCH APPROACH
Qualitative.

SETTING
Two metropolitan hospice centers in southern Australia.

PARTICIPANTS
12 inpatients (7 males, 5 females) who were residents for at least four days.

METHODOLOGIC APPROACH
Influenced by Heidegger's Phenomenological Hermeneutics, semistructured interviews were conducted. Interview transcripts and field notes were analyzed to reduce data into codes and themes. Data were coded by extracting verbatim phrases used to describe spiritual expression and the impact of hospice environment on it.

MAIN RESEARCH VARIABLES
The nature of spiritual expression and the impact of the hospice environment on the spiritual expression of hospice inpatients.

FINDINGS
Participants were comfortable discussing their spiritual expression within the context of four main themes: Relationships, That Which Uplifts, Spiritual Practice, and Having Hope. Finding meaning was a common link among these themes. The impact of the hospice environment was variable. Most believed that it facilitated their spiritual expression to some degree.

CONCLUSIONS
Spiritual expression is important but is facilitated by individualized spiritual care. Nurses play an important role in the provision of spiritual care within a hospice setting.

INTERPRETATION
Nurses are significant in assisting in patients' spiritual expression. Nurses' needs for training in listening skills, confidence in discussing spiritual issues, and time to provide individualized spiritual care should be assessed to ensure optimal patient expression.


Background: The pneumonia caused by the 2019 novel coronavirus (SARS-CoV-2) is a highly infectious disease that causes lethal disease and multiorgan failure. The aim of this research is to investigate association between coronavirus disease 2019 (COVID-19) infection and kidney dysfunction.Methods and Materials: In this retrospective study, sixty-eight patients with kidney dysfunction and COVID-19 infection were investigated. Clinical features, laboratory data at initial presentation, management and outcomes were collected.The paper has written based on searching PubMed Central and Google Scholar to identify potentially relevant articles. Median, percentage, mean ± standard deviation (SD), two-tailed t and chi-square and Cohen᾽s-d tests were used for statistical analyses. Moreover, relative risk, odds ratio, pearson᾽s correlation for statistical analyses were used.Results: The average age of patients at time of diagnosis in COVID-19 nephropathy was 52.04 ± 14.42 years (ranging from 24 years to 88 years). There was not statistical significance correlation between lymphocytopenia and serum creatinine (SCr) in COVID-19 nephropathy (R2=0.063; p-value= 0.33). Effect size of elevated IL-6 on decreased estimated glomerular filtration rate (eGFR) in COVID-19 nephropathy was assessed 0.656 (medium effect size). Relative risk and odds ratio of acute kidney disease (AKD) in COVID-19 nephropathy were assessed 0.57 and 0.4, respectively (p-value: 0.422). Correlation between SCr changes and time of emergent acute kidney injury (AKI), AKD and chronic kidney disease (CKD) was assessed with R2 of 0.0003 and p-value of 0.94 (not significant). Conclusion: The present study revealed medium effect size of elevated IL-6 on decreased eGFR. Future clinical research is required for investigating novel unknown findings in COVID-19 nephropathy.