It is known that human influential factors (HIFs, e.g., sense of presence/immersion; attention, stress, and engagement levels; fun factors) play a crucial role in the gamer's perceived immersive media experience [1]. To this end, recent research has explored the use of affective brain-/body-computer interfaces to monitor such factors [2, 3]. Typically, studies have been conducted in laboratory settings and have relied on research-grade neurophysiological sensors. Transferring the obtained knowledge to everyday settings, however, is not straightforward, especially since it requires cumbersome and long preparation times (e.g., placing electroencephalography caps, gel, test impedances) which could be overwhelming for gamers. To overcome this limitation, we have recently developed an instrumented "plug-and-play" virtual reality head-mounted display (termed iHMD) [4] which directly embeds a number of dry ExG sensors (electroencephalography, EEG; electrocardiography, ECG; electromyography, EMG; and electrooculography, EoG) into the HMD. A portable bioamplifier is used to collect, stream, and/or store the biosignals in real-time. Moreover, a software suite has been developed to automatically measure signal quality [5], enhance the biosignals [6, 7, 8], infer breathing rate from the ECG [9], and extract relevant HIFs from the post-processed signals [3, 10, 11]. More recently, we have also developed companion software to allow for use and monitoring of the device at the gamer's home with minimal experimental supervision, hence exploring its potential use truly "in the wild". The iHMD, VR controllers, and a laptop, along with a copy of the Half-Life: Alyx videogame, were dropped off at the homes of 10 gamers who consented to participate in the study. All public health COVID-19 protocols were followed, including sanitizing the iHMD in a UV-C light chamber and with sanitizing wipes 48h prior to dropping the equipment off. Instructions on how to set up the equipment and the game, as well as a google form with a multi-part questionnaire [12] to be answered after the game were provided via videoconference. The researcher remained available remotely in case any participant questions arose, but otherwise, interventions were minimal. Participants were asked to play the game for around one hour and none of the participants reported cybersickness. This paper details the obtained results from this study and shows the potential of measuring HIFs from ExG signals collected "in the wild," as well as their use in remote gaming experience monitoring. In particular, we will show the potential of measuring gamer engagement and sense of presence from the collected signals and their influence on overall experience. The next steps will be to use these signals and inferred HIFs to adjust the game in real-time, thus maximizing the experience for each individual gamer.References[1] Perkis, A., et al, 2020. QUALINET white paper on definitions of immersive media experience (IMEx). arXiv preprint arXiv:2007.07032.[2] Gupta, R., et al, 2016. Using affective BCIs to characterize human influential factors for speech QoE perception modelling. Human-centric Computing and Information Sciences, 6(1):1-19.[3] Clerico, A., et al, 2016, Biometrics and classifier fusion to predict the fun-factor in video gaming. In IEEE Conf Comp Intell and Games (pp. 1-8).[4] Cassani, R., et al 2020. Neural interface instrumented virtual reality headsets: Toward next-generation immersive applications. IEEE SMC Mag, 6(3):20-28.[5] Tobon, D. et al, 2014. MS-QI: A modulation spectrum-based ECG quality index for telehealth applications. IEEE TBE, 63(8):1613-1622.[6] Tobón, D. and Falk, T.H., 2016. Adaptive spectro-temporal filtering for electrocardiogram signal enhancement. IEEE JBHI, 22(2):421-428.[7] dos Santos, E., et al, 2020. Improved motor imagery BCI performance via adaptive modulation filtering and two-stage classification. Biomed Signal Proc Control, Vol. 57.[8] Rosanne, O., et al, 2021. Adaptive filtering for improved EEG-based mental workload assessment of ambulant users. Front. Neurosci, Vol.15.[9] Cassani, R., et al, 2018. Respiration rate estimation from noisy electrocardiograms based on modulation spectral analysis. CMBES Proc., Vol. 41.[10] Tiwari, A. and Falk, T.H., 2021. New Measures of Heart Rate Variability based on Subband Tachogram Complexity and Spectral Characteristics for Improved Stress and Anxiety Monitoring in Highly Ecological Settings. Front Signal Proc, Vol.7.[11] Moinnereau, M.A., 2020, Saccadic Eye Movement Classification Using ExG Sensors Embedded into a Virtual Reality Headset. In IEEE Conf SMC, pp. 3494-3498.[12] Tcha-Tokey, K., et al, 2016. Proposition and Validation of a Questionnaire to Measure the User Experience in Immersive Virtual Environments. Intl J Virtual Reality, 16:33-48.


Aims. We analyze a sample of tens of thousands of spectra of halo turnoff stars, obtained with the optical spectrographs of the Sloan Digital Sky Survey (SDSS), to characterize the stellar halo population "in situ" out to a distance of a few tens of kpc from the Sun. In this paper we describe the derivation of atmospheric parameters. We also derive the overall stellar metallicity distribution based on F-type stars observed as flux calibrators for the Baryonic Oscillations Spectroscopic Survey (ROSS). Methods. Our analysis is based on an automated method that determines the set of parameters of a model atmosphere that reproduces each obserxrci spectrum best. We used an optimization algorithm and evaluate model fluxes by means of inter-polation in a precomputed grid, In our analysis, we account for the spectrograph's varying resolution as a function of fiber and wavelength. Our results for early SDSS (pre-BOSS upgrade) data compare well with those from the SEGUE Stellar Parameter Pipeline (SSPP). except for stars with log g (cgs units) lower than 2.5. Results. An analysis of stars in the globular cluster M 13 reveals a dependence of the inferred metallicity on surface gravity for stars with log g < 2.5, confirming the systematics identified in the comparison with the SSPP. We find that our rnetallicity estimates are, significantly more precise than the SSPP results. We also find excellent agreement with several independent analyses. We show that the SDSS color criteria for selecting F-type halo turnoff stars as flux calibrators efficiently excludes stars with high metallieities, but does not significantly distort the shape of the metallicity distribution at low rnetallicity. We obtain a halo metathcity distribution that is narrower and more asymmetric than in previous studies. The lowest gravity stars in our sample at tens of kpc from the Sun, indicate a shift of the metallicity distribution to lower abundances, consistent with what is expected from a dual halo system in the Milky Way. (Less)


There is a peculiar problem in the US that is proving to challenge core values that undergird our laws, interpersonal interactions, and challenge the civil rights of many. American society believes in harsh sentences for committing crimes without a system for rehabilitation from crime and absent from resources from a community level to prevent crimes. As crime has declined since the 1990s, policing behavior has grown to a level that reflects a disregard for humanity resulting in police-involved shootings, also known as "justifiable homicides" or deaths by legal intervention. This peculiar problem reifies old notions of racial inferiority and racial profiling that stem from a long history of lynchings in America, and highlights a broken legal system that shows bias toward poor communities and communities not of the racial and ethnic majority. When laws support one racial or ethnic group and those with resources, other communities become invisible and subjected to state-sanctioned violence that allows some police agencies and police officers to engage in behaviors that do not reflect their training foster an overwhelming sense of fear in these communities. We have observed that when communities fear the police and the larger society disbelieves the negative interactions with police, residents have begun to capture police encounters with community members on social media. Despite the video footage that has been collected documenting abuse of power, some police have been granted impunity for their actions, which further fuels fear in these communities. What we propose are ways to frame and solve negative police encounters with communities through an understanding of: (1) racial biases; (2) racial and gender consciousness; (3) ways to provide more equitable policing practices; (4) the enforcement of legal remedies for those who abuse power; and (5) the prevention of acts of discrimination by holding individuals culpable who informally police Black males. We believe these strategies aid in addressing the historical legacy of these behaviors and moves multiple systems and disciplines toward integrated solutions to eliminate "justifiable homicides."


Ever since the failed 1999 Royal Commission, England has been attempting to reform its long-term care funding system. More than a decade later, significant changes to the means tested arrangements are yet to be introduced, whilst the pressure to achieve long-term reform mounts linked to increases in public expenditure and ever growing demand for better services. This paper examines the pros and cons of alternative options for reforming the English long-term care funding arrangements by examining the rationale for and consequences of the recent long-term care developments in Germany, Japan and France. In particular, the paper examines the implications of the reform options adopted in the different countries examined for equity and efficiency in the use of long-term care resources and for the sustainability of the long-term care system as a whole.


Purpose: From a skills perspective, the academic field of entrepreneurship has grown to become a key element in university studies. Determining whether these skills exist among university students and how to foster them is a key in higher education. To this effect, the aim of this study is to determine the entrepreneurial skills' level among the students on the different bachelor's degrees taught at the Faculty of Business and Economics Sciences of University of Girona. Design/methodology/approach: Information about the skill level was collected using a skills model called Tricuspoid, which was specifically designed for the self-assessment of entrepreneurial skills. Information about students' sociodemographic, professional and educational profile was collected using a self-administered complementary questionnaire. Bivariate analysis and statistical contrast were applied. Findings: Being a man, doing sport, balancing studying with paid work and accessing university studies via the vocational training pathway are indicators of a greater entrepreneurial capacity. On the other hand, being a woman, accessing university studies via baccalaureate or having no knowledge of English, however, are factors associated with a deficit in entrepreneurial talent. Originality/value: Considering the fact that attitude to entrepreneurship can be modified through educational interventions, identifying these factors enables us to formulate guidelines for teaching activities that increase students' entrepreneurial and intrapreneurial capacity for a better integration for our students into the job market.


Most image completion methods produce only one result for each masked input, although there may be many reasonable possibilities. In this paper, we present an approach for pluralistic image completion – the task of generating multiple and diverse plausible solutions for image completion. A major challenge faced by learning-based approaches is that usually only one ground truth training instance per label. As such, sampling from conditional VAEs still leads to minimal diversity. To overcome this, we propose a novel and probabilistically principled framework with two parallel paths. One is a reconstructive path that utilizes the only one given ground truth to get prior distribution of missing parts and rebuild the original image from this distribution. The other is a generative path for which the conditional prior is coupled to the distribution obtained in the reconstructive path. Both are supported by GANs. We also introduce a new short+long term attention layer that exploits distant relations among decoder and encoder features, improving appearance consistency. When tested on datasets with buildings (Paris), faces (CelebA-HQ), and natural images (ImageNet), our method not only generated higherquality completion results, but also with multiple and diverse plausible outputs.


Introduction Small bowel MRI (SBMRI) is the current standard for assessing ileal inflammation in Crohn's disease. Faecal calprotectin (FC) is closely correlated with colonic inflammation, but is thought to be of less utility in ileal disease. Interpretation of existing data linking FC with SBMRI findings have been confounded by the presence of colonic inflammation. We therefore aimed to ascertain how FC best reflects MRI findings exclusively in the small bowel. Methods 150 SBMRI studies with matched FC results (±30 days) were identified from the Edinburgh FC Register (2008–12; n = 18,138). Scans were entered into an anonymous 'teaching' list on PACS and each re-read independently by 2 expert GI radiologists blind to all clinical and lab data. Technical, quality and disease parameters were recorded onto standard proformas. Scans rated by one or other radiologist as being of poor quality were excluded (n = 31/150). 7/13 disease parameters were excluded due to poor interobserver variability (Cohen's kappa <0.5). A 6 item simple MRI score (range 0–10) was derived from assessment of the worst segment (bowel wall thickness, oedema, and relative enhancement, mesenteric oedema and pre-stenotic dilatation) plus total disease extent (overall kappa = 0.85). For comparisons with FC, studies where the radiologists reported upper GI or colonic inflammation were excluded (27/119). Results 150 SBMRI scans were re-evaluated from 123 patients with purely ileal Crohn's (Montreal L1, n = 109; L3 + previous panproctocolectomy, n = 14; 65% female; median age at MRI 45 years (IQR 32–56); median follow-up 34 months (IQR 25–44). The median (IQR) FC was 80 μg/g (20–142) where SBMRI demonstrated no active ileal disease (simple MRI score = 0, n = 38), 198 μg/g (120–444) for mild to moderate (1–6, n = 30) and 398 μ/g (168–771) for severe disease (>6, n = 24) (p < 0.001). ROC analysis showed an AUC of 0.81 (0.72–0.90) for FC which was significantly higher than for CRP (0.65 [0.53–0.77], p = 0.020) (Figure 1). Abstract PTU-081 Figure 1 Conclusion FC correlates closely with SBMRI findings in ileal Crohn's disease and outperforms other laboratory tests. In future, following validation, we will derive clinical useful MRI and FC cut-offs that predicate on important patient outcomes. Disclosure of Interest None Declared.


Textured surface analysis is essential for many applications. In this paper, we present a three-dimensional (3D) recovery approach for real textured surfaces based on photometric stereo. The aim is to be able to reconstruct the textured surfaces in 3D with a high degree of accuracy. For this, the proposed method uses a sequence of six images and a Lambertian bidirectional reflectance distribution function (BRDF) to recover the surface height map. A hierarchical selection of these images is employed to eliminate the effects of shadows and highlights for all surface facets. To evaluate the performances of our method, we compare it to other traditional photometric stereo methods on real textured surfaces using six or more images.


The development of language and communication skills in young children is directly related to future academic success. Young children who are at risk for language impairment should, therefore, be identified as early as possible. Multilingualism, which has become a universal phenomenon, may mask the presence of language impairment. In South African urban multilingual pre-school contexts, the teacher or speech-language therapist is not always proficient in the young multilingual learner's primary language. Assessment of learners' language behaviour is usually conducted in English, which is generally the language of mutual understanding. The aim of this study was to determine the feasibility of constructing a profile of typical English language behaviours for pre-school (English Additional Language) EAL learners in a circumscribed urban area. The profile is intended to provide speech-language therapists and pre-school teachers in collaborative practice with a dual-purpose tool: (i) an instrument for identifying those learners who are at risk for language impairment/language learning disabilities, and (ii) a means of obtaining guidelines for the development of an appropriate programme for facilitating language development. The results show that it was possible to construct a profile of typical English language behaviours for nine aspects of language form, one aspect of language content, and six aspects of language use.


Approximately 5-10% of patients with metastatic cancer will develop a fungating wound. The disfiguring or unpleasant nature of these wounds can lead to complex psychosocial problems in patients, which mean that many will seek medical assistance only when the wound is advanced. Curative treatment is often not an option, although a range of palliative treatments may be tried. When the tumour does not respond to these treatments the patient will be left with a chronic complex wound with local wound management as the only option. It is at this time that the community nurse usually becomes involved with the patient. This article discusses the assessment of patients with fungating wounds in the community, taking into consideration the immense psychological distress that they can cause. It highlights factors that need to be taken into consideration when assessing these complex wounds. Many of them are heavily exuding, malodorous and bleed easily. Strategies that focus on managing these symptoms are explored and recommendations for clinical practice are made.


Islands are noted for the occurrence of aberrant, endemic, and dwarfed taxa (the "island effect"). Late Cretaceous vertebrate assemblages of Romania and elsewhere in Europe are classic examples of island faunas in the fossil record, and are characterized by dwarfed herbivorous dinosaurs and other endemic taxa that are noticeably primitive relative to their mainland contemporaries. Fossils of the predators inhabiting the European paleoislands, however, are exceptionally rare and fragmentary. We describe a new dromaeosaurid theropod, based on an articulated skeleton from the Maastrichtian of Romania, which represents the most complete predatory dinosaur from the middle to Late Cretaceous of Europe. This taxon is characterized by a peculiar body plan, most notably extensive fusion in the hand and distal hindlimb, a highly retroverted pelvis with enlarged femoral muscle attachments, and a pair of hyperextensive pedal claws. However, unlike the island-dwelling herbivorous dinosaurs, its closest relatives are contemporary similar-sized Laurasian taxa, indicating faunal connections between Asia and the European islands late into the Cretaceous. This theropod provides support for the aberrant nature of the Late Cretaceous European island-dwelling dinosaurs, but indicates that predators on these islands were not necessarily small, geographically endemic, or primitive.


A new S- to L-band erbium-doped fiber amplifier (EDFA) module, which reaches 120-nm gain bandwidth of 1480 to 1600 nm, has been experimentally investigated and demonstrated by using coupled structure. A 32.8-, 34.7-, and 38.1-dB peak gain is obtained at 1504, 1532, and 1568 nm, respectively, when the input signal power is -30 dBm. In addition, this proposed amplifier also provides a broad-band amplified spontaneous emission (ASE) light source of 1480-1606 nm with the output level above -40 dBm.


For Italy, the First World War represented a very important step in the process of ationalisation that had started in 1861. It was the first Italian collective experience: encompassing men, women and children, civilians and military, both at the front and in the regions furthest from the north-eastern border. However, above all, the war strengthened ties between the Centre (the State) and the Periphery (the local area).
Even for Sicily, the war was a revolution that became engraved in peoples' mentality and habits. The "nationalisation of the Sicilian masses" involved the development of a collective consciousness never known before. At the front Sicilian peasants, they found themselves side by side with farmers from other regions and learned to understand other dialects and the customs of other regions.
For many Sicilian soldiers war represented a chance to go and discover, for the first time, the places and landscapes of their country, which they had, until then, "seen" only in the pages of textbooks. War for Sicily was principally a factor of nationalisation, especially for the more than 500,000 mobilised Sicilians. Between 1915 and 1922 (when the war has already been over for four years in major battlefields), more than 55.000 Sicilian soldiers died. Their death, if not to be seen in its rhetorical terms of "sacrifice" and "toll", deserves to be duly remembered as a huge period of mourning that hundreds of local communities sought to establish by publishing books of condolence and the building of monuments to the fallen.
Almost every family was heavily affected by the conflict through death, mutilation, injuries (physical or psychological) of a father, a husband, a son, a brother, a boyfriend, a fellow student or colleague or a near or distant relative. By reconstructing the magnitude of the human sacrifice and the story of the monuments, this essay analyses Sicilian mourning and its evolution in local communities who had lost in the war the most vital component of their younger population.


Currently over 50 million people worldwide wear contact lenses, of which over 75% wear hydrogel lenses. Significant deposition occurs in approximately 80% of hydrogel lenses and many contact lens wearers cease wearing lenses due to problems associated with deposition. The contact lens field is not alone in encountering complications associated with interactions between the body and artificial devices. The widespread use of man-made materials to replace structures in the body has emphasised the importance of studies that examine the interactions between implantation materials and body tissues.This project used carefully controlled, randomized clinical studies to study the interactive effects of contact lens materials, care systems, replacement periods and patient differences. Of principal interest was the influence of these factors on material deposition and their subsequent impact on subjective performance. A range of novel and established analytical techniques were used to examine hydrogel lenses following carefully controlled clinical studies in which clinical performance was meticulously monitored. These studies established the inter-relationship between clinical performance and deposition to be evaluated. This project showed that significant differences exist between individuals in their ability to deposit hydrogel lenses, with approximately 20% of subjects displaying significant deposition irrespective of the lens material. Additionally, materials traditionally categorised together show markedly different spoilation characteristics, which are wholly attributable to their detailed chemical structure. For the first time the in vivo deposition kinetics of both protein and lipid in charged and uncharged polymers was demonstrated. In addition the importance of care systems in the deposition process was shown, clearly demonstrating the significance of the quality rather than the quantity of deposition in influencing subjective performance.


The objective of this essay is to offer theoretical data to the understanding of care, oriented by an ethic in which interaction among the constitutive dimensions of the social subjects is put into effect. A review of the historical construction of care and its medication appraising and its influence in the training and in professional practices is done. It emphazises current meaning of care and the need for building a healthcare political project that should not only respond to the available services increasing and to technical actions solution but also, sensitively listen to the needs by taking into account singularities and the formation of critical-reflexive subjects able to promote changes and modify the reality in which they live in.


The team has become the basic organisational unit of development and innovation work and an understanding of creativity at the collective level is crucial for long-term sustainability. This article takes a process perspective and understands group creativity as emerging from the interaction among group members. It is about the possibility to enable the emergence of selforganisation, thereby increasing group creativity. This paper presents an experiment where four out of eight randomly formed groups of students were given a work order structured according to the group process model "GroPro". In groups using the GroPro ideas were significantly more often promoted, observed and used by other group members, and used in the final solution. Further, the two best solutions and the more creative solutions of the task were found among the GroPro groups. A work process structured according to the GroPro model seems to increase self-organisation as well as the creativity of the group. Further, the group process is shown to be more important for group creativity than the individual creativity of the group members. Our results encourage more focus on the group process by both academia and practitioners.


In the last few years, several studies have found an inverted-U relationship between per capita income and environmental degradation. This relationship, known as the environmental Kuznets curve (EKC), suggests that environmental degradation increases in the early stages of growth, but it eventually decreases as income exceeds a threshold level. The present paper reviews both early and recent contributions on this subject, discussing whether and to what extent such a curve can be empirically observed, and the policy implications that derive from the empirical evidence


Abstract. The European Space Agency's spacecraft ROSETTA has reached its final destination, comet 67P/Churyumov-Gerasimenko. Whilst orbiting in the close vicinity of the nucleus the ROSETTA magnetometers detected a new type of low-frequency wave possibly generated by a cross-field current instability due to freshly ionized cometary water group particles. During separation, descent and landing of the lander PHILAE on comet 67P/Churyumov-Gerasimenko, we used the unique opportunity to perform combined measurements with the magnetometers onboard ROSETTA (RPCMAG) and its lander PHILAE (ROMAP). New details about the spatial distribution of wave properties along the connection line of the ROSETTA orbiter and the lander PHILAE are revealed. An estimation of the observed amplitude, phase and wavelength distribution will be presented as well as the measured dispersion relation, characterizing the new type of low-frequency waves. The propagation direction and polarization features will be discussed using the results of a minimum variance analysis. Thoughts about the size of the wave source will complete our study.


This essay serves as a speculative design fiction that traces the history of fan creation platforms from the past to the present and finally to a possible future. Using the history and success of the Archive of Our Own (https://archiveofourown.org/) as a focal point, I consider the importance of owning the servers as a way for fan communities to create and preserve culture and reassert values. Examining one possible legal and technological future with an air of optimism allows us to consider what fannish communities can do now to maintain a path of our own.


Background: Primary focal axillary hyperhidrosis is a chronic distressing disorder affecting both the sexes. When the condition is refractory to conservative management, we should go for more promising therapies like intradermal botulinum toxin A (BtxA) injections in the axilla, and surgical therapies like subcutaneous curettage of sweat glands. Aims and Objectives: The aim of this study is to compare the efficacy, safety and duration of action of intradermal BtxA injections in one axilla and subcutaneous curettage of sweat glands in the other axilla of the same patient with axillary hyperhidrosis. Materials and Methods: Twenty patients (40 axillae) received intradermal BtxA injections on the right side (20 axillae) and underwent tumescent subcutaneous curettage of sweat glands on the left side (20 axillae). Sweat production rate was measured using gravimetry analyses at baseline and at 3 months after the procedure. Subjective analyses were done using hyperhidrosis disease severity scale (HDSS) score at baseline, at 3rd and 6th month after the procedure. Results: At 3 months post-treatment, the resting sweat rate in the toxin group improved by 80.32% versus 79.79% in the subcutaneous curettage method (P = 0.21). Exercise-induced sweat rate in the toxin group improved by 88.76% versus 88.8% in the subcutaneous curettage group (P = 0.9). There was a significant difference in the HDSS score after treatment with both the modalities. There were no adverse events with BtxA treatment compared to very minor adverse events with the surgical method. Conclusion: Both intradermal BtxA injections and tumescent subcutaneous curettage of sweat glands had a significant decrease in the sweat rates with no significant difference between the two modalities. Hence, in resource poor settings where affordability of BtxA injection is a constraint, subcutaneous curettage of sweat glands can be preferred which has been found equally effective with no or minimal adverse events.


This E-Special issue brings together a range of articles from the Theory, Culture, & Society archive that directly explore the relations between fiction and social theory. Each article develops a different perspective on these relations, yet they all share a common interest in probing at the different ways in which fiction might enrich and provoke our conceptual imaginations. These articles ask how theory might be used to understand or illuminate fiction, whilst also considering how theory might be extended, challenged or informed by fictional resources. In general terms, the articles take three types of overlapping approach. First, there are those that use fiction to extend the imagination of social theory. Second are the articles that use fiction as a documentary resource and platform for theorizing. And, finally, there are those articles that use theory to reanimate and re-examine fictional forms. In exploring these three intersecting branches the pieces illustrate the different ways in which fiction and social theory might interweave in our thinking. The articles gathered here provide frameworks, ideas and resources through which the reader might continue to think imaginatively and creatively about the social world.


Beyond their colorful appearances and versatile geometries, flowers can self‐shape‐morph by adapting to environmental changes. Such responses are often regulated by a delicate interplay between different stimuli such as temperature, light, and humidity, giving rise to the beauty and complexity of the plant kingdom. Nature inspires scientists to realize artificial systems that mimic their natural counterparts in function, flexibility, and adaptation. Yet, many of the artificial systems demonstrated to date fail to mimic the adaptive functions, due to the lack of multi‐responsivity and sophisticated control over deformation directionality. Herein, a new class of liquid‐crystal‐network (LCN) photoactuators whose response is controlled by delicate interplay between light and humidity is presented. Using a novel deformation mechanism in LCNs, humidity‐gated photoactuation, an artificial nocturnal flower is devised that is closed under daylight conditions when the humidity level is low and/or the light level is high, while it opens in the dark when the humidity level is high. The humidity‐gated photoactuators can be fueled with lower light intensities than conventional photothermal LCN actuators. This, combined with facile control over the speed, geometry, and directionality of movements, renders the "nocturnal actuator" promising for smart and adaptive bioinspired microrobotics.


The holographic stressmeter uses double-exposure holographic interferometry to record the displacements induced by the drilling of a sidehole into the borehole wall. The local stresses, which are the result of the far-field stresses, concentrated at the borehole, cause deformation of the surface of the borehole wall near the sidehole. To interpret the data, it is essential to understand this deformation. The initial model used a thin infinite elastic plate subjected to plane stress at infinity. Two-dimensional finite element analysis showed that the displacement depends on the depth of the
sidehole. We then developed a new model for the analysis of stress-relief displacements. For holes with a depth/diameter ratio greater than unity, the simple plane
stress elastic plate solution breaks down. The revised model, which gives a more exact solution of displacements near the hole, does a better job of fitting the observed
data. A three-dimensional smoothed particle hydrodynamics code was used to model normal and oblique impacts of silicate projectiles on planetary bodies. The energy of the system is partitioned after impact into internal and kinetic energy of the both bodies. These simulations show that, unlike the case of impacts onto a half-space, up to 70% of the initial energy remains in the kinetic energy of the impactor, as parts of it travel past the main planet and escape the system. More oblique impacts retain more kinetic energy in the impactor: 6 to 75% versus 4 to 30% for the normal impacts. Higher velocity collisions also show this trend, as the kinetic energy of the impactor is 2 to 50% of the total for 5 km/s impacts, and 13 to 75% for 20 km/s
impacts. Impacts at 20 km/s with an impactor 60% the size of the target completely melted both targets. Three to 4 times more vaporization of the target material occurred on the larger targets. The amount of target material ejected at velocities greater than the escape velocity is found to be higher than that predicted by studies of impact onto a half-space, and slightly less than the amount predicted by theories of catastrophic breakup of asteroids.


Over the last few decades, due to the need for clean energy production from renewable sources, wind generation has been gaining increasing importance. Efforts are being put, in particular, on the attempt to optimize the electric generation system between wind turbines and the grid. This paper reports on the development of a prototype slotless surface-permanent-magnet generator conceived for a 20 kW power station. The reasons which led to choose a slotless permanent-magnet generator topology are discussed along with the machine electromagnetic design optimization, carried out with stochastic algorithms. Finally, some preliminary test result on the prototype are reported.


"A Concise Hopi and English Lexicon" is a lexical research tool for persons interested in the Hopi language. An effort has been made to include the most frequent forms of basic roots. The work is designed to serve as wide-ranging an audience as possible: Hopi speakers as well as those not fluent in this language, the scholar as well as the general reader. The lexicon treats the Third Mesa dialect and the vocabulary items are limited to items of common usage. The work is presented in two sections: the first and main section is Hopi-English and the second is an English-Hopi index.


Abstract 4530 BACKGROUND The treatment of acquired SAA is based on allogeneic stem cell transplantation (SCT) and immunosuppressive therapy. Up to 68% of patients in our country are treated without transplantation, and in our hospital a preliminary report (1999–2006) shows that 56% of these patients have achieved partial or complete response. Peruvian patients with aplastic anemia usually present poor prognosis factors, such as more than 6 months of diagnosed disease before transplantation (53%) and more than 15 RBC transfusions before the procedure (69%). The aim of this study was to assess the outcome of children and adults with SAA, treated with related allo-transplant and the evolution of patients with poor prognosis factors in Hospital Rebagliati (Lima, Peru - 1995 to 2010). DESIGN AND METHODS Retrospective and Descriptive analysis where was included variables related to the patients, disease and method of transplantation in 88 patients of the 95 who went to transplant. RESULTS The median age at diagnosis was 26 years (3–55 years), male/female ratio: 1.75, the interval between diagnosis – SCT was 12.7 months (1–151 months), in 47.7% of patients this interval was ≤ 6 months. GVHD prophylaxis consisted of CsA + MTX. The conditioning regimen was ALG equine or rabbit (based on availability), + cyclophosphamide in 95% of patients and cyclophosphamide + busulphan in 1%; 59 patients received equine anti-lymphocyte globulin and 27 patients received rabbit anti-lymphocyte globulin. The stem cell source was bone marrow in 35.2% (31), peripheral blood in 58% (51), bone marrow and peripheral blood in 5.7% (5) and umbilical cord blood 1.1% (1). Two of the 88 patients required a second transplant and continue alive. The stem cell source did not show a significant difference in the time to neutrophil engraftment (p=0.15), which took place around day 13 (10–28 days). The dose of MNC used was 3×10 8 /kg when BM was the graft source and CD34 > 2×10 6 if the source was peripheral blood. The engraftment was done all patients (n:88). The mortality rate was 19.4% after BMT, despite the number of RBC transfusions and mostly due to lost of engraftment, and 9.8% after using peripheral blood as the graft source. The overall survival was 80.5%, this patients were followed for a period up to 157 months. There was not a significant difference in survival with the use of bone marrow or peripheral blood as the stem cell source (p=0.2); nonetheless, we observed a trend toward better survival rates when performing PBSCT, according to the time interval between diagnosis to SCT and the number of transfusions. The kind of anti-lymphocyte globulin –horse or rabbit origin- used, did not show a major impact in survival (p=0.13). A major predictor of a significantly improved HSCT outcome in Peru, was the development of acute GVHD (p=0.03). CONCLUSIONS OS is 80%, superior compared with immunosuppressive therapy alone (56%). The presence of acute GVHD is a major predictor of survival in those receiving SCT. The use of peripheral blood as the stem cell source seems to improve survival in Peruvian patients with poor prognosis factors, in comparison with the use of bone marrow source. Disclosures: No relevant conflicts of interest to declare.


Purpose - The article discusses the issues involved in reconciling the development of natural resources with traditional uses of land, such as nomadic reindeer herding and fishing. Whilst it is in the national interest to exploit the oil-gas reserves the indigenous population cannot be protected by usual methods of compensation. It raises complex questions of whether the destruction of indigenous livelihoods and cultures can be avoided and whether and what ways the traditional users of the land can protect their interests through sharing in the benefits from natural resource development. Design/methodology/approach - The article uses a case study of Yamal-Nenets Autonomic Okrug undertaken by G Ledkov and examples from other Northern regions. Findings - There has been significant disruption of environment quality and indigenous livelihoods.Practical implications - The leading oil-gas companies developing the industry and infrastructure, are aware of the environmental and social impact of their operations and have sought to mitigate these through engineering solutions and by sponsoring cultural event in similar ways to those used by oil and mining companies elsewhere.Social implications - The Nenets' (and similar indigenous peoples') survival as a distinct culture is bound up with their traditional livelihoods and the natural environment. Originality/value - G Ledkov's perspective as the Duma member for the region gives this article a unique insight into the negotiation process in a situation of asymmetrical power. The results can be used for other Northern regions indigenous population.


Machine Learning (ML) research has focused on maximizing the accuracy of predictive tasks. ML models, however, are increasingly more complex, resource intensive, and costlier to deploy in resource-constrained environments. These issues are exacerbated for prediction tasks with sequential classification on progressively transitioned stages with ''happens-before'' relation between them.We argue that it is possible to ''unfold'' a monolithic single multi-class classifier, typically trained for all stages using all data, into a series of single-stage classifiers. Each single-stage classifier can be cascaded gradually from cheaper to more expensive binary classifiers that are trained using only the necessary data modalities or features required for that stage. UnfoldML is a cost-aware and uncertainty-based dynamic 2D prediction pipeline for multi-stage classification that enables (1) navigation of the accuracy/cost tradeoff space, (2) reducing the spatio-temporal cost of inference by orders of magnitude, and (3) early prediction on proceeding stages. UnfoldML achieves orders of magnitude better cost in clinical settings, while detecting multi-stage disease development in real time. It achieves within 0.1% accuracy from the highest-performing multi-class baseline, while saving close to 20X on spatio-temporal cost of inference and earlier (3.5hrs) disease onset prediction. We also show that UnfoldML generalizes to image classification, where it can predict different level of labels (from coarse to fine) given different level of abstractions of a image, saving close to 5X cost with as little as 0.4% accuracy reduction.


In many countries in Western Europe today, religion is an important factor in public debates. Contrary to most expectations, religion has not vanished or even become subordinate under the influence of secularism. While this phenomenon has put the general theory of secularization under pressure, an alternative model for explaining the place of religion in Western Europe is only slowly taking shape. The present article is a contribution to this discussion. Making use of discourse analysis as it has been developed in the sociology of knowledge and in historiography, the article problematizes and transcends the secular–religious divide. It is argued that the entanglement of religious and secular discourses has produced new meanings and new realities since the rise of secularism in the eighteenth century. Four perspectives on the reconfiguration of the religious fields of discourse are introduced that have shaped contemporary religious landscapes in Western Europe. These perspectives are discussed with special...


Purpose

The decisions marketing managers make on advertising expenditures are vital to maintaining the sales and profitability of a firm. However, these decisions have not been taken into account to a great enough extent when determining a firm's performance. The purpose of this paper is to better understand the marketing-finance interface and to reveal the effect marketers' discretionary advertising expenditures can have on firm performance. In particular, the real activities method of managed earnings (ME) will be used to study this phenomenon.

Design/methodology/approach

The initial sample consisted of all the companies that appear in the North American COMPUSTAT files over the period 1970-2014. Since the focus here is on the effect of discretionary advertising expenses on firm performance, the authors restricted the samples to only include observations with advertising expenses. Therefore, the sample included 14,732 firms.

Findings

OLS regressions revealed a negative relationship between marketers' discretionary advertising expenditures and firm performance using return on assets as a proxy for firm performance. Additional regressions displayed similar results for return on sale and return on cash adjusted asset proxies. Fixed effect and Tobit regressions also confirmed these findings. Finally, this effect was especially true for low performing firms. The economic significance of these findings on firm performance is also discussed.

Originality/value

The decisions made by marketing managers on advertising promotional efforts impact sales directly and brand equity indirectly, but they can also have an impact on firm performance. Therefore, it is important for investors to understand the level of ME in relation to marketing and advertising decisions that are taking place at their firm.


Parkinson's disease (PD) is a common neurodegenerative disease. Literature sources indicate the association of PD and mutations in the glucocerebrosidase A (GBA) gene. According to our study, the frequency of the two most common mutations in the GBA gene, N370S and L444P, is 1.85%. Mutation carriers have slower progression of motor symptoms, but are more likely to develop drug-induced motor fluctuations and dyskinesia. In carriers of GBA mutations, the severity of cognitive impairment corresponds to age-matched patients without mutations. Cognitive deficit in PD patients carrying GBA mutations primarily affects visual-spatial functions and often is associated with psychotic disorders and parasomnias syndrome. Other non-motor disorders in patients with GBA mutations do not differ from those in patients without mutations. In patients with PD and GBA mutations, a slower escalation of levodopa dose should be recommended because of the high risk of complications of therapy.


Originality and Idea-Expression Dichotomy as key concepts of copyrights that define protectable domain can be considered as mutually contradictory phenomena. Non-protection on ideas in Idea-Expression dichotomy is incongruent with the creativity orientation of originality, since the attainment of necessary level of creativity necessitates more of less idea-wise operation. Contradiction has mitigated by lower threshold of originality in line with overall non-monopolistic effect of the copyrights. Different dimensions of operation of these standards may be mitigating the conflict of these concepts, as idea-expression dichotomy focusing on non-monopolization of ideas, while in originality the attention to the minimum level of creativity. The added complexity of the problem reminds on unsuitability of the legal instrument in distinguishing the creativity as a process. While essential goal of originality is in distinguishing the creativity rather than labor or expression, and the product of creativity can be seen as more idea-wise, even if being an expression, as ideas are also expressed in the same form. The obvious contradiction is that ideas being results of creativity are excluded from the protection by idea-expression dichotomy. Some constructive but subtle primacy of originality over the idea-expression dichotomy is still perceptible, that can potentially mitigate the conflict of these concepts.


This paper aims to go beyond resilience into the study of security and local-repairability for distributed storage systems (DSSs). Security and local-repairability are both important as features of an efficient storage system, and this paper aims to understand the trade-offs between resilience, security, and local-repairability in these systems. In particular, this paper first investigates security in the presence of colluding eavesdroppers, where eavesdroppers are assumed to work together in decoding the stored information. Second, this paper focuses on coding schemes that enable optimal local repairs. It further brings these two concepts together to develop locally repairable coding schemes for DSS that are secure against eavesdroppers. The main results of this paper include: 1) an improved bound on the secrecy capacity for minimum storage regenerating codes; 2) secure coding schemes that achieve the bound for some special cases; 3) a new bound on minimum distance for locally repairable codes; 4) code construction for locally repairable codes that attain the minimum distance bound; and 5) repair-bandwidth-efficient locally repairable codes with and without security constraints.


Species that depend on ephemeral habitat often evolve distinct dispersal strategies in which the propensity to disperse is closely integrated with a suite of morphological, behavioural and physiological traits that influence colonizing ability. These strategies are maintained by natural selection resulting from spatial and temporal variation in resource abundance and are particularly evident during range expansion. Yet the mechanisms that maintain close alignment of such strategies with resource availability, integrate suites of dispersal traits and generate variability in dispersal propensity are rarely known. Breeding females can influence offspring phenotype in response to changes in current environmental conditions, making maternal effects uniquely suited to bridge fluctuations in resource abundance in the maternal generation and variation in offspring dispersal ability. Western bluebirds' (Sialia mexicana) dependence on nest cavities—an ephemeral resource—has led to the evolution of two distinct dispersal phenotypes: aggressive males that disperse and non-aggressive males that remain philopatric and cooperate with their relatives. Over the last 40 years, western bluebirds rapidly expanded their geographical range, providing us with an opportunity to test, in newly established populations, the importance of maternal effects for generating variability in dispersal propensity. Here, I show that, under variable resource conditions, breeding females group offspring of different competitive ability in different positions in the egg-laying order and, consequently, produce aggressive males that are more likely to disperse when resources are low and non-aggressive philopatric males when resources are abundant. I then show experimentally that the association between resource availability and sex-specific birth order is robust across populations. Thus, this maternal effect enables close tracking of resource availability and may explain how variation in dispersal is generated in newly colonized populations. More generally, these results suggest that, as a key source of variation in colonizing phenotypes, maternal effects are of crucial importance for understanding the dynamics of range expansion.


This study investigates the use of reflexive intensifiers by L1 German-speaking learners of L2 English against the background of previous research which has identified non-target-like distribution of such features which are sensitive to discourse constraints and/or register variation. Occurrences of intensified NPs are compared between the Louvain Corpus of Native English Essays and the German component of the International Corpus of Learner English. In line with previous research, it is found that learners overuse this lexico-grammatical means of information highlighting. However, there is only significant overuse of a specific sub-type of intensifier, the inclusive adverbial intensifier. These results are discussed in terms of (i) general learnability considerations which may account for learners' problems in mastering the use of register-sensitive information-structural patterns, and (ii) pedagogical issues which arise in connection with addressing residual non-target performance in written production beyond the stage at which target properties of lexico-grammar have generally been acquired.


In the last two years, a number of 5-HT1B/1D agonist triptans with enhanced lipophilicity (TELs) relative to the first drug of this class, sumatriptan, have been approved for marketing in most countries of the world (naratriptan, rizatriptan and zolmitriptan). In addition, at least three others are in advanced stage of clinical development (almotriptan, eletriptan, and frovatriptan). This paper sets out to review the recent data with the aim of identifying: 1) What are the critical differences between the TELs and sumatriptan? 2) How do the currently licensed TELs compare? 3) Is it possible to provide a rational approach to migraine therapy based on objective differences in the clinical profile of these new drugs? Recent randomised controlled and comparator data were reviewed, including the independent FDA assessment of rizatriptan. Critical differences for the new TELs (naratriptan, rizatriptan and zolmitriptan) which may lead to more rational migraine management: Both rizatriptan (10 mg) and zolmitriptan (2.5 mg and 5.0 mg) have demonstrated superior efficacy to sumatriptan 100 mg, and 25 and 50 mg respectively. Therefore, for first line use either rizatriptan or zolmitriptan would be appropriate for moderate and severe headache. Rizatriptan has a more rapid onset of action than sumatriptan 100 mg. Both rizatriptan and zolmitriptan have a more rapid onset of action than naratriptan. Therefore, for a rapid onset of action either rizatriptan or zolmitriptan would be appropriate. Naratriptan would appear to have a lower recurrent headache rate than sumatriptan, rizatriptan or zolmitriptan. However, 24-hour efficacy rates for zolmitriptan 2.5 mg were significantly greater than for sumatriptan 25 mg and 50 mg and were not significantly different from naratriptan. Therefore, for headaches of long duration and with a tendency to recur (e.g. menstrual headaches) either naratriptan or zolmitriptan would be appropriate. Naratriptan has lower reported adverse event rates comparable with placebo. This would support the use of naratriptan 2.5 mg in patients who have demonstrated poor tolerance to the "triptan type" adverse events.


Purpose : A pilot study has explored how to use telemedicine to improve handovers of patients with Parkinson's disease, from a neurologist at a specialist center to advanced treatment at Karolinska University Hospital (Karolinska), in order to provide the right treatment at the right time to the right patient. Context : When the basic medication starts to fail for a patient diagnosed with Parkinson ´ s disease , the neurologist consider s advanced treatment , and may refer the patient to a movement disorder specialist at Karolinska for a second opinion. In Sweden , the health care system prioritizes undiagnosed patients before second opinion. The waiting time for a second opinion is from six weeks up to six months. However, over 80% of the patients referred to Karolinska are not considered to be a candidate for advanced treatment . About 50% of these patients request medication adjust ment before going back to the previous care giver. T he patient has , thereby, been on a suboptimal medication for up to six months in vain, inflicting unnecessary discomfort and a lower quality of life. Methods : A movement disorder s pecialist at Karolinska and two of the most frequent referring neurologists have been interviewed. A standardized video conferencing solution, tested under controlled conditions and verified with the three participants, was installed at the three sites. Individual w eekly meeting s between the referring neurologist s and the movement disorder specialist were introduced. T he number of patients discussed at the meetings was documented along with if the patient need ed advanced treatment and thereby should be referred to Karolinska. Also , the perception of ease of use and technical difficulties were documented. An economical evaluation, based on a mathematical prediction model of the impact on the quality of life for the patient , based on published research, was made. Results and discussion: Traditionally the neurologist spent one hour per patient he/she assessed, including administrative work before and after visit. With the weekly meetings a patient is assessed in total 10-15 minutes. The waiting time for second opinion was reduced from six months to one week mainly because all referrals to the movement disorder specialist were correct . The patients could sometimes start their advanced treatment directly at Karolinska instead of first seeing the neurologist to get assessed . The movement disorder specialist could get a better picture of the patient ´ s situation since there was a previous dialogue with the referring neurologist who had known the patient for several years. The new method of working also enable d stored videos of the patient to be shown at the weekly meetings, something that otherwise usually is dependent on integration between different electronic patient records. The prediction model showed that it is likely that the method increases the quality of life by 1,2% over one year. The economical evaluation showed a return of investment of just 1,5 months. The initial interviews showed that the documentation of a referred patient could lack vital information or tests that had not been conducted, which made it difficult for the movement disorder specialist to make a decision without seeing the patient. The new way of working introduced a structure where the referring neurologists came prepared to the weekly meetings, where they used standardized information forms and had test results and vital information ready at hand. A we a kness in the method is that several changes were made to the process of refer r ing patients , i.e., the standardized information collection, possibility to show recorded videos and the bidirectional audio/video communication. These have n o t been isolated in order to determine if one alone can provide the results shown.


Upconversion (UC) of subbandgap photons has the potential to increase solar cell efficiencies. In this paper, we first review our recent investigations of silicon solar cell devices with an attached upconverter based on β-NaYF4 :20%Er3+. Such devices showed peak external quantum efficiencies of 0.64% under monochromatic excitation at 1523 nm and an irradiance of 2305 Wm -2. Under broad spectrum illumination, an average UC efficiency of 1.07 ± 0.13% in the spectral range from 1460 to 1600 nm was achieved. The measured quantum efficiency corresponds to a relative efficiency increase of 0.014% for the used bifacial silicon solar cell with 16.70% overall efficiency. This increase is too small to make UC relevant in photovoltaics. Therefore, additional means of increasing the UC efficiency are necessary. In this paper, we investigate plasmon resonance in metal nanoparticles in the proximity of the UC material, with the aim of increasing UC efficiency. The local field enhancement by the plasmon resonance positively influences UC efficiency because of the nonlinear nature of UC. Additionally, the metal nanoparticles also influence the transition probabilities in the upconverter. To investigate the effects, we combine different simulation models. We use a rate equation model to describe the UC dynamics in β-NaYF4 :20%Er3+. The model considers ground state and excited state absorption, spontaneous and stimulated emission, energy transfer, and multiphonon decay. The rate equation model is coupled with Mie theory calculations of the changed optical field in the proximity of a gold nanoparticle. The changes of the transition rates both for radiative and nonradiative processes are calculated with exact electrodynamic theory. Calculations are performed in high resolution for a 3-D simulation volume. The results suggest that metal nanoparticles can increase UC efficiency.


A 2015 French court decision flouting Muslim dietary restrictions in public schools serves as a sobering reminder that growing Islamophobia, or anti-Muslim prejudice and discrimination, threatens religious freedom in parts of contemporary Europe. Last year, a local French mayor announced that his district's school cafeterias would no longer provide students non-pork alternatives despite rules against bringing packed lunches and a sizable Muslim population. The Islamic faith prohibits consumption of pork and its by-products or derivatives. Additionally, many Muslims follow religious standards of slaughter known as halal in the preparation of meat and poultry. Notably, non-pork lunch alternatives have been available to Muslim students throughout France since 1984. In response to the decree, a Muslim group brought a court action requesting injunctive relief to stop the discriminatory changes from taking effect. The court decided, however, that such relief was unwarranted citing procedural deficiencies.While the French minister of education denounced the decision, unjust laws and policies are nothing new to Muslims in France or other parts of Europe. The minority faith group continues to grapple with increased bias, prejudice and discrimination perpetrated by individuals, groups and institutions in a variety of contexts including in schools, at work and on the street. Moreover, from banned burkinis, or modest swimwear, on French beaches to banning Muslim children from praying in German schools, anti-Muslim sentiment often victimizes the most vulnerable members of the minority faith community.This article engages in a descriptive, normative and comparative analysis of contemporary religious freedom challenges, measured by official restrictions and social hostilities, confronting Muslim minority communities in five European countries including, France, United Kingdom, Germany, Netherlands and Sweden. Interdisciplinary in nature, this inquiry will initially contextualize the subject matter in Part II by surveying relevant public opinion research toward Islam and Muslims as well as prevailing social, economic and political conditions. Part III explores from a historical and legal vantage point the role of religion and protections extended to freedom of religion, at least in theory. Part IV then examines the intersection of religion, law and society with a particular focus on Islamophobia. Finally, Part V engages in a comparative analysis highlighting relevant observations, patterns and trends.


It's very common that there are cavities after the lining and seriously affects the health of the tunnels. According to the status that the health standard is not uniform at present, the health levels can be divided into four parts: health, sub-health, disease and sick into death. For studying the single index criterion of lining cavities, and introducing lab large-scale model test combining the engineering example, analyzing the variety of structure bearing capacity, disease producing shapes and varying rule and so on where are different dimension cavities after lining. The results show that the carrying capacity curve expresses reverse S characteristic, it can be divided into slow, fast and complete degradation basis on the variety of velocity, and it is uniform to the sub-health, disease and sick into death, finding out the single health criterion of cavity: it is health where no cavities after the lining, it's sub-health when the dimension is less than 100mm, disease when the dimension is between 100mm and 550mm, it's sick to death if the dimension were more than 550mm.


INTRODUCTION
To compare visual analog scale (VAS) pain scores between patients with a 2-minute versus 10-minute delay of peri-prostatic lidocaine injection prior to transrectal ultrasound-guided prostate biopsies (TRUS-bx).

MATERIALS AND METHODS
Eighty patients who underwent standard 12-core TRUS-bx by a single surgeon were prospectively randomized into four different treatment arms: bibasilar injection with a 2-minute delay, bibasilar injection plus a single apical injection with a 2-minute delay, bibasilar injection with a 10-minute delay, and bibasilar injection plus a single apical injection with a 10-minute delay. Patients were asked to report their level of pain on the VAS (0-10, with 10 indicating unbearable pain) at the following intervals: probe insertion (baseline), after each core, and post-procedure. The primary outcome measure was mean VAS score across all 12 cores minus baseline VAS score, which we refer to baseline-adjusted mean VAS score.

RESULTS
Baseline-adjusted mean VAS score was significantly higher for the 2-minute delay group compared to the 10-minute delay group (mean: -0.7 versus -1.6, p = 0.025). Subset analysis of biopsies 1-3, 4-6, 7-9 and 10-12 also demonstrated higher baseline-adjusted mean VAS scores in the 2-minute delay group (all p ≤ 0.043).

CONCLUSIONS
Lower TRUS-bx VAS scores can be achieved by extending the time from lidocaine injection to onset of prostate biopsy from 2 to 10 minutes.


What is it like to be a professional in today's Nordic Public sector organisations? In Tension between Organization and Profession describes everyday problems experienced by individuals in offical positions.The authors' analyses are set against a background of rising rates of sick leave, more cases of mental burnout, decreasing resources and constant demand for professional improvement. Rapid changes in organizations, such as new forms of leadership, new technology and management by documents and the call for client-oriented practices are part of the professional working life.The individual professional is the prime focus of this book. Tensions that arise between the individual and the organization/profession are illustrated by a range of examples of problems that public officals, such as teachers, policemen and nurses, are confronted with on a daily basis.The authors discuss subjects such as increased individualization, complexity in relationships, intensified pace and fragmentation of work.The title In Tension between Organization and Profession intends to signal an invitation to further the research about a dynamic field where today's professionals meet the requirements of their professions and organizations.


SUMMARY The rockpool mosquito, Georgecraigius atropalpus, is a facultatively autogenous species that produces its first egg clutch without a blood meal shortly after emergence. Several days after depositing this clutch, females must take a blood meal to produce a second egg clutch. Decapitation of females shortly after emergence or blood ingestion prevents egg maturation. Here, we report that a single injected dose of the neuropeptide ovary ecdysteroidogenic hormone (OEH) fully restored egg maturation in decapitated females in both circumstances. This neuropeptide and two insulin-like peptides (ILPs) are potent gonadotropins in the related yellow fever mosquito, Aedes aegypti. ILP3 was marginally restorative in decapitated G. atropalpus, and ILP4 had no effect. Egg maturation in non- and blood-fed G. atropalpus was dependent on the enzymatic mobilization of amino acids from stored protein or the blood meal for yolk protein (vitellogenin, VG) synthesis and uptake by oocytes. We further show that OEH stimulates serine protease activity in the fat body of newly eclosed females or in the midgut of blood-fed ones, and ecdysteroid hormone production by the ovaries of both females. In contrast, only 20-hydroxyecdysone stimulated VG synthesis in the fat body of non- and blood-fed females. Using RNA interference to knock down expression of the insulin receptor, we found that OEH still fully restored autogenous egg maturation. In summary, our results identify OEH as a primary regulator of egg maturation in both autogenous and blood-fed G. atropalpus females and suggest the shift from blood meal-dependent to blood meal-independent release of OEH is a key factor in the evolution of autogeny in this species.


A room temperature vulcanizable silicone rubber composition with high elongation and low modulus comprising 10-90 percent by weight polydiorganosiloxane having terminal hydroxyl groups, 1-10 percent by weight phenyl tris-functional ketoximino-containing silane crosslinker, 0-14 percent by weight of a reinforcing or 0-60 percent by weight of a nonreinforcing filler or semi-reinforcing filler or a mixture thereof for a total of all fillers in the range of from about 6-60 percent by weight, from 0-2.5 percent by weight of an organofunctional silane adhesion promoter and an optional plasticizer and catalyst. These compositions cure to elastic materials useful as caulking materials, adhesives, coatings and encapsulating materials for the construction and other industries.


Molecular dynamics (MD) simulations based on a plastic crystal model (PCM) were performed for a Pd0.4Ni0.4P0.2 alloy in Metal-Metalloid (M-MLD) type of bulk metallic glass (BMG). Two kinds of clusters of cubeoctahedron capped with four half-octahedra and trigonal prism were used as initial atomic arrangements of the Pd0.4Ni0.4P0.2 alloy. Random rotations of clusters around their centers of gravity and subsequent structural relaxation vitrified the alloy. The high glass-forming ability of the Pd0.4Ni0.4P0.2 alloy is due to the critically-percolated, cluster-packed structure that is a universal feature for both M-MLD and M-M types of BMGs.


The paper focuses on the Kalman filtering problem for linear continuous-time systems with multiple delayed measurements. An explicit and simpler solution to the Kalman filtering problem is presented for such systems. The approach applied is the reorganised innovation analysis. The obtained Kalman filter is given in terms of Riccati differential equations. A numerical example is given to demonstrate the proposed approach.


This correspondence presents performance analysis of symbol-level soft-decision decoding of q-ary maximum-distance-separable (MDS) codes based on the ordered statistics algorithm. The method we present is inspired by the one recently proposed by Agrawal and Vardy (2000), who approximately evaluate the performance of generalized minimum-distance decoding. The correspondence shows that in our context, the method allows us to compute the exact value of the probability that the transmitted codeword is not one of the candidate codewords. This leads to a close upper bound on the performance of the decoding algorithm. Application of the ordered statistics algorithm to MDS codes is not new. Nevertheless, its advantages seem not to be fully explored. We show an example where the decoding algorithm is applied to singly extended 16-ary Reed-Solomon (RS) codes in a 128-dimensional multilevel coded-modulation scheme that approaches the sphere lower bound within 0.5 dB at the word error probability of 10/sup -4/ with manageable decoding complexity.


There is increasing awareness that platelets play a significant role in creating a hypercoagulable environment that mediates tumor progression, beyond their classical hemostatic function. Platelets have heterogenic responses to agonists, and differential release and uptake of bioactive molecules may be manipulated via reciprocal cross-talk with cells of the tumor microenvironment. Platelets thus promote tumor progression by enhancing tumor growth, promoting the development of tumor-associated vasculature and encouraging invasion. In the metastatic process, platelets form the shield that protects tumor cells from high-velocity forces and immunosurveillance, while ensuring the establishment of the pre-metastatic niche. This review presents the complexity of these concepts, considering platelets as biomarkers for diagnosis, prognosis and potentially as therapeutic targets in cancer.


Introduction: The measurement precision of jaw is important for surgery or installing implants. Preimplant radiographs are important part of clinical evaluations before implant surgery. For choosing location, we should consider the important anatomical structures like mental foramen, inferior alveolar canal, nasal cavity and maxillary sinus.It is important to know the measurement accuracy of radiographic techniques. The purpose of this study was to compare mandibular vertical linear measurement in panoramic and tomography images. Methods: Three forms of mandible from dry adult human skulls were used in this study (triangle, square and ellipse). For each mandible, surgical stent was made using transparent with gold standard.acryl. A thin tube was placed in the stents in three regions (incisors, premolars and molars) to set gutta-percha. Then, the panoramic view and conventional tomography were obtained. Four oral and maxillofacial radiologists measured the vertical dimension in panoramic and conventional tomography. Finally, each mandible was sectioned in the marked sections and was measured by a digital caliper (gold standard) and compared with conventional tomography and panoramic view .The obtained data was analyzed using SPSS18 software and student t-test, Pearson correlation coefficient and non parametric Mann-Whitney Test. Results: The mean difference between the panoramic and gold standard linear vertical dimension values in premolar and molar regions was above 1mm and above 2mm in incisor region. The mean difference between conventional tomography and gold standard measurements in all three regions was 1mm. Conclusions: The linear measurement of vertical dimension in conventional tomography was more precise than panoramic. The use of a 2.0 mm safety margin in the evaluation of implant sites was recommended.In incisor area, the other radiography methods like CBCT was suggested.


Distortion product otoacoustic emissions (DPOAEs) measured in the ear canal represent the vector sum of components produced at two regions of the basilar membrane by distinct cochlear mechanisms. In this study, the effect of stimulus level on the 2f(1) - f(2) DPOAE phase was evaluated in 22 adult subjects across a three-octave range. Level effects were examined for the mixed DPOAE signal measured in the ear canal and after unmixing components to assess level effects individually on the distortion (generated at the f(1), f(2) overlap) and reflection (at f(dp)) sources. Results show that ear canal DPOAE phase slope becomes steeper with decreasing level; however, component analysis further explicates this result, indicating that interference between DPOAE components (rather than a shift in mechanics related to distortion generation) drives the level dependence of DPOAE phase measured in the ear canal. The relative contribution from the reflection source increased with decreasing level, producing more component interference and, at times, a reflection-dominated response at the lowest stimulus levels. These results have implications for the use of DPOAE phase to study cochlear mechanics and for the potential application of DPOAE phase for clinical purposes.


Clinical trials have firmly established that 3-hydroxy-3-methylglutaryl-coenzyme-A reductase inhibitors (statins) can induce regression of vascular atherosclerosis as well as reduction of cardiovascular-related morbidity and death in patients with and without coronary artery disease. These beneficial effects of statins are usually assumed to result from their ability to reduce cholesterol synthesis. However, because mevalonic acid is the precursor not only of cholesterol but also of many nonsteroidal isoprenoid compounds, inhibition of 3-hydroxy-3-methylglutaryl-coenzyme-A reductase may result in pleiotropic effects. Indeed, statins can interfere with major events involved in the formation and the evolution of atherosclerotic lesions, such as arterial myocyte migration and proliferation and cholesterol accumulation, independent of their hypolipidemic properties. The aim of this article is to focus on clinical and experimental data that show that statins possess effects beyond cholesterol lowering, particularly on arterial smooth muscle cell proliferation. The contribution of these direct vascular effects to the reduction of cardiovascular events observed in clinical trials with statins represents one of the major challenges for future studies to understand the antiatherosclerotic benefits of these agents.


Surgical site infection (SSI) contributes significantly to surgical morbidity. Patient factors and operative factors contribute to the risk of development of SSI. This review focuses on understanding operative characteristics that are associated with an increased risk of SSI. Much attention has been given to protocol care to reduce SSI, such as hair removal, skin preparation, and pre-operative antibiotic agents. Even with this, the appropriate antibiotic and re-dosing regimens often remain a challenge. Other operative factors such as blood loss/transfusion, emergency/urgent cases, duration of the operation, type of anesthesia, and resident involvement are also potentially modifiable to reduce the risk of SSI. Data are reviewed to highlight the increased risk associated with such factors. Strategies to reduce risk, such as operative care bundles, have significant promise to reduce the incidence of SSI for any given procedure.


OBJECTIVE
To explore the use of a shared communication and coordination platform-the CareVirtue journal feature-for care networks of people living with Alzheimer's disease and related dementias to inform the design of care network support technologies.

MATERIALS AND METHODS
In the primary study, care networks comprised the primary caregiver and other caregivers they invited to participate (eg, family members, in-home aides) used CareVirtue, for 60 days followed by a semistructured interview to explore primary caregivers' perceptions of usefulness. This secondary analysis focused on use of the shared journal feature of CareVirtue, which allowed care networks to communicate through posts that were shared with the network and to which network members could respond. Journal posts were analyzed using a deductive/inductive content analysis to categorize information behavior. We also conducted a thematic analysis of the interviews to identify primary caregivers' perceptions of the journal's usefulness.

RESULTS
Care networks used the journal for: (1) information acquisition, (2) information sharing, (3) strategy development, and (4) information feedback. Thematic analysis revealed that caregivers felt the journal was useful at the individual, care network, and relational levels and that journal integration was influenced by care network structure and relationships.

DISCUSSION
Care networks used the journal to document, share, and acquire information; co-create strategies; and provide support. The usefulness of this shared communication and coordination platform included individual and care network level benefits.

CONCLUSION
These findings point to the importance of caregiver-centered technologies that support both the individual primary caregiver and the care network.


The ageing of the European population brings new financial risks that call for state, market and societal responses. In 2011, the first baby-boom generation is turning 65, and forecasts predict that the size of the old-age population in need of long-term care will double in the next 50 years in Europe. However, how different countries are responding to the challenge of financing long-term care is still a question open to further examination, including the role of market development, changing intergenerational contracts and especially the constraints of state intervention. Growing long-term care needs in several European countries as well as the reshaping of traditional modes of care-giving further increase the pressure for sustainable funding of more comprehensive long-term care systems. This book examines different forms of partnership and the potential cooperation of state, market and societal stakeholders. It not only offers a full understanding of the institutional responses and mechanisms in place for financing old age but also provides a deep analysis of both the demand and supply factors underpinning the development of financial instruments to cover long-term care needs in Europe.


Three recently developed control methods for voltage regulator modules, namely, V/sup 2/ control, enhanced V/sup 2/ control, and enhanced V/sup 2/ control without output voltage dynamic feedback, are analyzed and compared in this paper. All three methods utilize the output voltage switching ripple for pulse-width modulation (PWM), hence, are collectively referred to as ripple-based control. A general modeling method based on the Krylov-Bogoliubov-Mitropolsky ripple estimation technique is applied to develop averaged models for single-channel as well as multichannel buck converters employing each of the control methods. Unlike existing models that are limited to small-signal operation, the proposed models are valid for large-signal operation and are capable of predicting subharmonic instability without including any sample-and-hold block as used in previous models. The paper also shows that adding parallel, high-quality ceramic capacitors at the output, which are ignored in previous models, can lead to pulse skipping and ripple instability, and a solution based on proper selection of the ceramic capacitors and/or ramp compensation at the PWM is presented. The models are further applied to analyze and compare the performance of the three control methods in terms of ripple stability, effective load current feedforward gain, and output impedance.


Background: Law enforcement is often used in an effort to reduce the social, community and health-related harms of illicit drug use by injection drug users (IDUs). There are, however, few data on the benefits of such enforcement or on the potential harms. A large-scale police "crackdown" to control illicit drug use in Vancouver's Downtown Eastside provided us with an opportunity to evaluate the effect. Methods: As part of our ongoing prospective cohort study of IDUs in Vancouver, we examined data collected from 244 IDUs in the 3 months before the police crackdown and from 142 IDUs in the 3 months after the start of the crackdown, on Apr. 7, 2003. All study subjects were active drug users. We also examined external data on needle exchanges and syringe disposal. Results: The 2 groups of IDUs were statistically similar: they were mainly young (mean age 39 years) and male (63%), and they had injected illicit drugs for 13 years on average. Ethnic background and the proportion homeless were also similar. There were no statistically significant reported differences (all p > 0.1) in the street price of heroin, cocaine or "crack" in the 2 periods. In the 3-month periods before and after the crackdown, respectively, the rates of daily heroin injection were 27.9% and 26.8%, daily cocaine injection 28.7% and 27.5%, and daily crack use 59.4% and 60.6% (all p > 0.1). The proportions of study subjects receiving methadone treatment, 41.0% and 44.4% (p = 0.516), did not differ. However, the proportions reporting a change in where drugs were used, 22.5% and 33.8% (p < 0.05), and the proportions reporting a change in the neighbourhood of use because of police presence, 18.1% and 26.8% (p < 0.05), increased significantly. Needle-exchange data confirmed that the community levels of drug use were unchanged. Disposal statistics demonstrated that the monthly average number of used syringes found on the streets outside the traditional area of drug use increased from 784 in the 3 months before Apr. 1 to 1253 in the subsequent 3 months (p = 0.002) and the monthly average number of used syringes found in public boxes for the safe disposal of syringes decreased from 865 to 502 (p = 0.018). Interpretation: The effort to control illicit drug use did not alter the price of drugs or the frequency of use, nor did it encourage enrolment in methadone treatment programs. Several measures indicated displacement of injection drug use from the area of the crackdown into adjacent areas of the city, which has implications for both recruitment of new initiates into injection drug use and HIV prevention efforts.


A new short-circuit equivalent and reduction program is described that uses the adaptive reduction technique in which extra path nodes are retained to produce a sparser equivalent network. Nodes that may be reduced are chosen by flexible set formation facilities, with path nodes automatically retained as required to preserve sparsity. Tests on typical systems show that the sparsity-enhanced reduction produces an equivalent with fewer branches and a much lower branch-to-node ratio than conventional reduction for a wide range of numbers of nodes eliminated. At some point, as the number of retained nodes becomes small, conventional reduction produces an equivalent with fewer branches. >


We consider the classical ruin problem due to Cramer and Lundberg and we generalize it. Ruin times of the considered models are studied and sufficient conditions to usual stochastic dominance between ruin times are established. In addition an algorithm to simulate processes verifying the conditions under consideration is proposed.


Many people think of cooperatives as small, locally owned businesses, such as groceries, cafes, or bicycle shops, where people can work in an equal and participatory non-capitalist organization. In reality, the U.S. co-op movement is tied to federal agencies whose agenda is promoting neoliberalism, both domestically and abroad, and the co-op movement itself has neoliberal leaders. Many co-ops in name are profit-driven capitalist corporations in practice. And even in the abstract, the co-op principles of smaller co-ops enable neoliberal cooperative politics. All of this, however, raises the question of what a co-op based on socialist values would be, and China's Nanjie village provides a living example of that. This article can also be found at the Monthly Review website , where most recent articles are published in full. Click here to purchase a PDF version of this article at the Monthly Review website.


Synthesis and structural characterization of monooxo-and cis -dioxovanadium(v) complexes based on tridentate N-salicylidene carbonic acid hydrazide ligands are reported. By functionalization of the aliphatic side-chain of the chelate system, vanadium(v) compounds were obtained, which structurally mimic some of the hydrogen bonding interaction of the prosthetic group with the protein environment in vanadium-haloperoxidase enzymes. The vanadium model-complexes catalyze the bromination of an activated aromatic system (such as 1,3,5-trimethoxybenzene) in the presence of tetrabutylammonium bromide and hydrogen peroxide, thus mimicking the oxidative halogenation function of the native enzyme. In addition to bromide oxidation, the vanadium(v) complexes, particularly the cis -dioxovanadium(v) species have also shown to oxidize phenyl methyl sulfide to the corresponding sulfoxide. The relevance of these reactions to the mechanism of vanadium haloperoxidases, and moreover the capacity of the peroxovanadium complexes to intermediate the two catalytic reactions will be discussed. In addition binuclear cis -dioxovanadium(v) and cis -dioxomolybdenum(vi) complexes as high effcient catalysts for oxidation of organic sulfides by hydrogen peroxide will be also described.


Objective Flow diverters are increasingly used for treatment of intracranial aneurysms. In previous series, the Pipeline Embolization Device (PED) was used essentially for the treatment of unruptured aneurysms. Little is known about the use of the PED in ruptured aneurysms. We assess the safety and efficacy of the PED in the largest series of acutely ruptured aneurysms to date. Methods A total of 20 patients with freshly ruptured aneurysms were treated with the PED between May 2011 and September 2013. Patients were loaded with aspirin and clopidogrel 8 h before the procedure. Platelet function was closely monitored throughout hospitalization using P2Y12 assays. Data on procedural safety was prospectively collected. Results Mean aneurysm size was 6.6 mm. Fifteen aneurysms (75%) arose from the anterior circulation. The number of PEDs used was 1.0 per aneurysm. Treatment was staged (initial coiling followed by coiling 1–2 weeks later) in 4 patients (20%). Adjunctive coiling was used in 6 cases (30%). There was only 1 complication (5%) in the series; this was a fatal intraoperative aneurysm dome rupture that occurred during adjunctive coil deployment. At the latest follow-up (mean, 6.1 months), all but one aneurysm were completely occluded. No aneurysm required further treatment. All except one patient (95%) achieved a favorable outcome (mRS 0–2). Conclusion In this study, treatment of ruptured aneurysms with the PED was associated with low complication rates, high aneurysm occlusion rates, and excellent clinical outcomes. These findings suggest that the PED is a safe and effective alternative for ruptured aneurysms non amenable to conventional endovascular techniques or surgical clipping. A staged approach that entails initial aneurysm coiling followed by coiling 1–2 weeks later appears to be an adequate strategy in this setting. Disclosures N. Chalouhi: None. M. Zanaty: None. D. Hasan: None. S. Tjoumarkis: None. R. Rosenwasser: None. P. Jabbour: None.


The relationship between hepatic lipid homeostasis and gallstone formation is intriguing. The reduction of the activity of cholesterol 7 -hydroxylase (CYP7A1), the limiting enzyme of bile acid synthesis, has long been claimed as a possible cause of gallstone formation.1,2 More recent evidence from fibric acid derivatives has confirmed an association between decreased bile acid synthesis and increased biliary cholesterol secretion.3,4 Finally, anecdotal evidence from a family with a congenital defect in CYP7A1 has also shown increased prevalence of gallstone disease.5 An article by Castro et al.6 recently published in HEPATOLOGY, confirming previous evidence that they had reported,7 shows, on the other hand, an increase in circulating 7 -hydroxy-4-cholesten-3-one, a marker of bile acid synthesis, and in hepatic CYP7A1 messenger RNA in gallstone patients. This is also correlated with increased hepatic activity of the microsomal triglyceride transfer protein, which is critical for hepatic lipoprotein production. In our opinion, different scenarios can be envisioned in the reciprocal relationships between bile acid synthesis and gallstone formation. In a few specific conditions, reduced degradation of cholesterol to bile acid, either congenital or secondary to drug treatment, may result in an increased concentration of free cholesterol recruitable for biliary secretion; this can therefore be regarded as a cause of increased cholesterol saturation and gallstone formation.3-5 In other patient subsets, bile acid malabsorption may occur, and the increases in bile acid synthesis, 7 -hydroxy-4-cholesten-3-one levels, and CYP7A1 expression need to be considered instead as results of an underlying metabolic defect, an epiphenomenon of gallstone disease. Indeed, this peculiar condition has been described mainly in Chilean Hispanic subjects.6,7 It would be interesting to assess whether the relationships linking intestinal bile acid uptake and malabsorption, hepatic lipoprotein production (considered a cause of primary hypertriglyceridemia),8 and gallstone disease also hold true in different patient settings. In a vast majority of untreated subjects, on the other hand, no specific defects in any of the metabolic pathways controlling hepatic cholesterol homeostasis, that is, cholesterol synthesis, esterification, and bile acid synthesis, have been disclosed,9 and this is in agreement with our own data on hepatic CYP7A1 expression and 7 -hydroxy-4cholesten-3-one levels.10 This leads us to conclude that in many instances cholesterol gallstone disease is multifactorial and is likely to require the concomitant presence of genetic (probably polygenic) and environmental factors, unfortunately in the absence of reliable and measurable biomarkers. Hepatic nuclear receptors can control many metabolic steps of cholesterol and bile acid homeostasis and may certainly represent a molecular link between bile acid and lipoprotein production.6 Changes in nuclear receptor expression and changes in the expression and activity of related target genes, such as hepatobiliary transporters, may occur in gallstone disease, as suggested by preliminary data from our group.10,11 It would be interesting to know whether changes in the tissue expression of farnesoid X receptor or related genes are present in this particular subset of gallstone patients and whether they are associated with changes in microsomal triglyceride transfer protein expression and activity. It is hoped that further exploration of the metabolic relevance of nuclear receptors for hepatic cholesterol and bile acid metabolism and for biliary lipid secretion will provide new clues in terms of pathophysiology and novel molecular approaches. In the meantime, more than 30 years after the utilization of the first (then unrecognized) farnesoid X receptor agonist, chenodeoxycholic acid, for stone dissolution, the causal relationship between bile acid synthesis and gallstone disease in humans still has a high degree of uncertainty. MARCO BERTOLOTTI CHIARA GABBI CLAUDIA ANZIVINO LUCIA CARULLI NICOLA CARULLI Dipartimento di Medicina, Endocrinologia, Metabolismo e Geriatria Università degli Studi di Modena e Reggio Emilia Modena, Italy


Composition engineering is a particularly simple and effective approach especially using mixed cations and halide anions to optimize the morphology, crystallinity, and light absorption of perovskite films. However, there are very few reports on the use of anion substitutions to develop uniform and highly crystalline perovskite films with large grain size and reduced defects. Here, the first report of employing tetrafluoroborate (BF4−) anion substitutions to improve the properties of (FA = formamidinium, MA = methylammonium (FAPbI3)0.83(MAPbBr3)0.17) perovskite films is demonstrated. The BF4− can be successfully incorporated into a mixed‐ion perovskite crystal frame, leading to lattice relaxation and a longer photoluminescence lifetime, higher recombination resistance, and 1–2 orders magnitude lower trap density in prepared perovskite films and derived solar cells. These advantages benefit the performance of perovskite solar cells (PVSCs), resulting in an improved power conversion efficiency (PCE) of 20.16% from 17.55% due to enhanced open‐circuit voltage (VOC) and fill factor. This is the highest PCE for BF4− anion substituted lead halide PVSCs reported to date. This work provides insight for further exploration of anion substitutions in perovskites to enhance the performance of PVSCs and other optoelectronic devices.


Background Mechanical thrombectomy (MT) is a primary endovascular modality for acute intracranial large vessel occlusion. However, further treatment, such as rescue stenting, is occasionally necessary for refractory cases. We aimed to investigate the efficacy and safety of rescue stenting in first-line MT failure and to identify the clinical factors affecting its clinical outcome. Methods A multicenter prospective registry was designed for this study. We enrolled consecutive patients who underwent rescue stenting for first-line MT failure. Endovascular details and outcomes, follow-up patency of the stented artery, and clinical outcomes were summarized and compared between the favorable and unfavorable outcome groups. Results A total of 78 patients were included. Intracranial atherosclerotic stenosis was the most common etiology for rescue stenting (97.4%). Seventy-seven patients (98.7%) were successfully recanalized by rescue stenting. A favorable outcome was observed in 66.7% of patients. Symptomatic intracranial hemorrhage and mortality were observed in 5.1% and 4.0% of patients, respectively. The stented artery was patent in 82.1% of patients on follow-up angiography. In a multivariable analysis, a patent stent on follow-up angiography was an independent factor for a favorable outcome (OR 87.6; 95% CI 4.77 to 1608.9; p=0.003). Postprocedural intravenous maintenance of glycoprotein IIb/IIIa inhibitor was significantly associated with the follow-up patency of the stented artery (OR 5.72; 95% CI 1.45 to 22.6; p=0.013). Conclusions In this multicenter prospective registry, rescue stenting for first-line MT failure was effective and safe. For a favorable outcome, follow-up patency of the stented artery was important, which was significantly associated with postprocedural maintenance of glycoprotein IIb/IIIa inhibitors.


Coffee is a popular beverage, and it contains caffeine, a psychoactive substance. Consuming coffee may reduce the risk of developing Alzheimer's disease (AD). However, the association between the reduced risk of developing AD and the consumption of coffee is controversial. Therefore, we conducted a systematic literature review and quantitative synthesis meta-analysis that included dose-response analysis on the relationship between the consumption of coffee and the risk of developing AD. Based on PRISMA guidelines, we analysed standard databases of journals published between January 1999 and May 2020. We included the two population-based cohort studies and one case-control study. All studies included looked at the association between consuming many cups of coffee, the amount of coffee consumed in milligrams per day and the risk of developing AD. The systematic literature review and meta-analysis had 1670 participants with follow-up years that ranged from 5 to 21. The consumption of moderate or 3-5 cups per day reduces the risk of developing AD. The pooled relative risk and 95% confidence interval of the 3 included studies were 0.63 (0.3, 1.54). Dose-response curve analysis appears to be U-shaped. The results of the forest plot showed that there is low heterogeneity between the studies. Plotting the funnel plot and the Galbraith plot demonstrated publication bias of the three included studies. More prospective and long-term studies have to be conducted in other countries to determine the exact risk of developing AD.