Scholars have long argued there is systemic injustice within higher education, particularly with regards to ethnic and gender disparity in Science, Technology, Engineering and Mathematics (STEM) education (Race, 2005; Rollock and Gillborn, 2011; Singh, 2011; Gillborn et al., 2016; Arday and Mirza, 2018; Bhopal and Henderson, 2019a; Advance HE, 2021a). In the UK, 35% of STEM students are female, but STEM disciplines are not innocent of bias and a females' ethnic background poses another hindrance to their academic and career trajectories (Bosworth and Kersley, 2015). Existing studies have highlighted institutional bias towards White male students and applicants, and it is undeniable that there is a myriad of gendered and racial biases, especially in the physical sciences. Using data collected over a two-year period, 69 qualitative interviews were coded and analysed from an England-based University to gain further insights and add to existing literature concerning racism and sexism in STEM degrees. This article argues that the UK is currently experiencing the 'height of capitalism', where the value of labour is considerably disproportionate. This can act as a demoralizing force against inclusivity within STEM disciplines. The race and gender gaps, particularly in terms of attainment, are two of the most significant avenues where we see the value of labour diminished, and capitalism pronounced. In addition to racial and gender biases, institutionalised racism and systemic injustices embedded within the higher education system has doubled, if not more, the burdens and barriers women and ethnic minorities in STEM face (Jones, 2019). This paper is not a crusade against corporations, but an investigation into the intersectionality of gender and race in relation to opportunity discrepancy and attainment, to better understand why large discrepancies in inclusivity is more pronounced in STEM disciplines and professions. The research explores the themes of microaggression as a possible explanation for attainment gaps, attitudes towards affirmative action and positive discrimination and the policy's attempt in mediating systemic injustices through representation, and introspectively unpacks its effects on students' potential career opportunities in the capitalist labour market.


Results of numerical simulation of heat and mass transfer in a wet fibroporous material in conditions of evaporation and steam diffusion were obtained. Values of heat and mass fluxes were established. The contribution of evaporation effect to total heat flux and need to consider volume fractions of water and steam into the structure of fibroporous material in calculation of effective thermal conductivity were shown. Nonstationarity of heat and mass transfer in conditions of considered problem can be ignored.


The influence of natural particulate organic matter (POM) input on sedimentary oxygen consumption (SOC) in permeable carbonate and silicate sediments close to a coral reef was investi- gated in front of the Marine Science Station in Aqaba, Jordan (northern Red Sea). We conducted 7 in situ experiments in stirred benthic chambers. Without additional POM input, SOC rates were similar and not significantly different (p > 0.5) in carbonate and silicate sands, with average rates of 20 ± 4 (n = 10) and 16 ± 2 (n = 3) mmol O2 m -2 d -1 , respectively. Gross photosynthesis in the carbon- ate and silicate sands accounted for 15 to 23 mmol produced O2 m -2 d -1 , characterising both sands as largely independent of allochthonous carbon input. SOC of unamended carbonate sands showed no significant variation in 5 in situ experiments conducted within a period of 19 d. Addition of 2 energy- rich sources of naturally occurring POM (coral mucus and clam eggs) resulted in significantly (p < 0.0001) increased SOC rates in the carbonate sands, but not in the silicate sands. Addition of a suspension containing high concentrations of zooxanthellae did not result in higher SOC in the carbonate sands, indicating that zooxanthellae cannot easily be degraded in reef sediments. Our results highlight the short cut between coral mucus production and degradation in the adjacent reef sands. Suspended particles are initially trapped by the cohesive mucus on the coral surface, and ensuing mucus strings sink to the seafloor at a short distance from the mucus-producing coral. Carbonate sands as porous filter systems obviously harbour more active heterotrophic microbial communities than silicate sands, and thus may constitute a major site of organic matter degradation in the reef ecosystem.


Objective: Evidence of a relation between use of lipid lowering drugs and cognitive outcomes is mixed. This study aimed to test the association between use of statins and incidence of dementia and cognitive impairment without dementia (CIND) over 5 years of follow-up. Methods: Data were from a population-based cohort study comprising 1,789 older Mexican Americans. All participants had cognitive and clinical evaluations performed every 12 to 15 months. Participants who fell below specified cutpoints on cognitive tests were then evaluated clinically. Dementia diagnoses were finalized by an adjudication team. A total of 1,674 participants free of dementia/CIND at baseline were included in these analyses. Statin use was verified at each participant's home by medicine cabinet inspection. Cox proportional hazards models were used to evaluate the association between statin use and incidence of dementia/CIND. Results: Overall, 452 of 1,674 participants (27%) took statins at any time during the study. Over the 5-year follow-up period, 130 participants developed dementia/CIND. In Cox proportional hazards models adjusted for education, smoking status, presence of at least one APOE ε4 allele, and history of stroke or diabetes at baseline, persons who had used statins were about half as likely as those who did not use statins to develop dementia/CIND (HR = 0.52; 95% CI 0.34, 0.80). Conclusion: Statin users were less likely to have incident dementia/cognitive impairment without dementia during a 5-year follow-up. These results add to the emerging evidence suggesting a protective effect of statin use on cognitive outcomes.


The aim of this work is to examine the upper-semicontinuity properties of the family of global attractors admitted by a non-isothermal viscous relaxation of some nonlocal Cahn-Hilliard equations. We prove that the family of global attractors is upper-semicontinuous as the perturbation parameters vanish. Additionally, under suitable assumptions, we prove that the family of global attractors satisfies a further upper-semicontinuity type estimate whereby the difference between trajectories of the relaxation problem and the limit isothermal non-viscous problem is explicitly controlled, in the topology of the relaxation problem, in terms of the relaxation parameters.


Experimental study was conducted at Debrezeite Agricultural Research Center with proper experimental set up. Indigenous and koekeok chickens were used in four treatments and a control groups with three replications each. The replications were 12 local and 19 koekoek chickens. The four treatments use I2 vaccine through eye drop, water, parboiled barley and litter spray. Pre vaccination serum was collected at day 1, 14 and 20 while post vaccination was taken at day 36, 46 and at pre-challenge. Sample was also taken 8 days after the challenge with wild ND strain. Pathogenic Index HI and survival rate were used. The result shows, the antibody response and the pathogenic index was not significantly different between breeds but protection was higher in all treatments than the control. Chickens vaccinated with ocular and spraying has lower pathogenic index and higher survival rate than the rest. But for village system spray vaccination is recommended over ocular and others because it easy to administer, effective and can also be performed by trained farmers.


This work describes a process to extract Named Entity (NE) translations from the text available in web links (anchor texts). It translates a NE by retrieving a list of web documents in the target language, extracting the anchor texts from the links to those documents and finding the best translation from the anchor texts, using a combination of features, some of which, are specific to anchor texts. Experiments performed on a manually built corpora, suggest that over 70% of the NEs, ranging from unpopular to popular entities, can be translated correctly using sorely anchor texts. Tests on a Machine Translation task indicate that the system can be used to improve the quality of the translations of state-of-the-art statistical machine translation systems.


This study explores the effects of month of birth (a proxy for early-life environmental influences) on the chances of survival to age 100. Months of birth for 1,574 validated centenarians born in the United States in 1880-1895 were compared to the same information obtained for centenarians' 10,885 shorter-lived siblings and 1,083 spouses. Comparison was conducted using a within-family analysis by the method of conditional logistic regression, which allows researchers to control for unobserved shared childhood or adulthood environment and common genetic background. It was found that month of birth has a significant long-lasting effect on survival to age 100: siblings born in SeptemberNovember have higher odds to become centenarians compared to siblings born in March. A similar month-of-birth pattern was found for centenarian spouses. These results support the idea of early-life programming of human aging and longevity. N.S.Gavrilova, L.A.Gavrilov. Month of birth and exceptional longevity.


There is considerable research on the impact of maternal mental health issues on infants' development. These studies emphasise the importance of early interventions to prevent the development of psychopathology later in life. In many studies infants who are involved in video-recorded studies show an observable distressed reaction. Whilst these studies have made major contributions to the field of child development, a key question that arises is: is it ethically acceptable in research with pre-verbal children for them to experience emotional distress during the research process? This article explores the ethical issues of harm and benefit from the perspective of the child. It aims further to refine discussion and understanding of children's vulnerability and examines pre-verbal children's ethical rights in video-recorded observation studies.


As one of the major directions in applied and computational harmonic analysis, the classical theory of wavelets and framelets has been extensively investigated in the function setting, in particular, in the function space L2(R). A discrete wavelet transform is often regarded as a byproduct in wavelet analysis by decomposing and reconstructing functions in L2(R) via nested subspaces of L2(R) in a multiresolution analysis. However, since the input/output data and all filters in a discrete wavelet transform are of discrete nature, to understand better the performance of wavelets and framelets in applications, it is more natural and fundamental to directly study a discrete framelet/wavelet transform and its key properties. The main topic of this paper is to study various properties of a discrete framelet transform purely in the discrete/digital setting without involving the function space L2(R). We shall develop a comprehensive theory of discrete framelets and wavelets using an algorithmic approach by directly studying a discrete framelet transform. The connections between our algorithmic approach and the classical theory of wavelets and framelets in the function setting will be addressed. Using tensor product of univariate complex-valued tight framelets, we shall also present an example of directional tight framelets in this paper.


During catalytic ozonation, Al2O3-supported catalysts usually have stable structures but relatively low surface activity, while carbon-supported catalysts are opposite. To encourage their synergisms, we designed a Ni-induced C-Al2O3-framework (NiCAF) and reinforced it with a Cu-Co bimetal to create an efficient catalyst (CuCo/NiCAF) with a core-multishell structure. The partial graphitization of carbon adjacent to Ni crystals formed a strong out-shell on the catalyst surface. The rate constant for total organic carbon removal of CuCo/NiCAF (0.172 ± 0.018 min-1) was 67% and 310% higher than that of Al2O3-supported catalysts and Al2O3 alone, respectively. The metals on CuCo/NiCAF contributed to surface-mediated reactions during catalytic ozonation, while the embedded carbon enhanced reactions within the solid-liquid boundary layer and in the bulk solution. Moreover, carbon embedment provided a 76% increase in ·OH-production efficiency and an 86% increase in organic-adsorption capacity compared to Al2O3-supported catalysts. During the long-term treatment of coal-gasification wastewater (∼5 m3 day-1), the pilot-scale demonstration of CuCo/NiCAF-catalyzed ozonation revealed a 120% increase in ozone-utilization efficiency (ΔCOD/ΔO3 = 2.12) compared to that of pure ozonation (0.96). These findings highlight catalysts supported on NiCAF as a facile and efficient approach to achieve both high catalytic activity and excellent structural stability, demonstrating that they are highly viable for practical applications.


INTRODUCTION
The role of antibiotics in the treatment in COVID-19 cases has not yet been adequately defined, and no criteria have been established for antibiotic treatment, type and duration.

METHODOLOGY
This paper reports the results of an observational study on the extent of antibiotic use in 52 randomly selected patients in the intensive care unit (ICU) at the University Hospital in Pristina, Kosovo with severe forms of COVID-19.

RESULTS
Antibiotics were prescribed in all the cases (52; 100%). Of the 52 patients, 1) 13 (25%) were given antibiotics before hospitalisation, 2) 49 (94.2%) during treatment in the ward and 3) 52 (100%) during treatment in the ICU. Most often, empirical antibiotics were administered in 32 cases (61.5%) to treat methicillin resistant Staphylococcus aureus (MRSA) infections, and in 23 patients (44.2%) to treat atypical pathogens. The most prescribed antibiotics were ceftriaxone/cefotaxime plus macrolide in (17 cases; 32.7%), ceftriaxone/cefotaxime in (15 cases; 28.8%), ampicillin/amoxicillin plus clavulanic acid or sulbactam (five cases; 9.6%), and quinolones (five cases; 9.6%). Imipenem was the most frequently used antibiotic in the ICU (30 cases; 57.7%), followed by ceftriaxone (28 cases; 53.8%), and piperacillin/tazobactam and fluoroquinolone (17 cases; 32.7%). In 18 cases (34.6%), three antibiotics were given simultaneously; two antibiotics in 29 cases (55.8%) and in five cases (9.6%) only one antibiotic was given. The mean duration of antibiotic treatment was 12.71 days (3-22 days; SD 4.026).

CONCLUSIONS
The study showed unrestricted use of broad-spectrum antibiotics in the treatment of severe cases with COVID-19.


Objectives Research is a core competency of a modern-day doctor and evidence-based practice underpins a career in medicine. Early exposure encourages graduates to embed research in their medical career and improves graduate attributes and student experience. However, there is wide variability of research and scholarly experiences offered in medicals schools, many developed with a significant degree of pragmatism based on resources and financial and time constraints. We examined undergraduate medical students' awareness and experience of research throughout their degree to provide recommendations for implementation and improvement of research and scholarly experiences. Method Focus groups were conducted with medical students at all five stages of the medical degree programme. Data was coded to facilitate qualitative analysis for identification of important themes from each stage. Results Students reported positive impacts of research on undergraduate experience, future career and society in general. Two important themes emerged from the data, the opportunity for research and timing of research experiences. Early-stage students were concerned by their lack of experience and opportunity, whereas later-stage students identified the importance of research to employability, personal development and good medical practice, but ironically suggested it should be integrated in early stages of the course due to limitations of time. Conclusions Students provided feedback for improving research and scholarly experiences, ideally involving early exposure, a clear programme overview, with equality of access and a longitudinal approach. An emerging framework is proposed summarising the important issues identified by students and the positive impacts research experiences provide for them. These recommendations can be applied to both existing and new research programmes to provide a student-centred approach designed to augment the students' critical analysis, inspire life-long learning, enhance the student experience and inevitably train better physicians.


Let (X,Y) be a pair of random variables distributed over a finite product set V/spl times/W according to a probability distribution P(x,y). The following source coding problem is considered: the encoder knows X, while the decoder knows Y and wants to learn X without error. The minimum zero-error asymptotic rate of transmission is shown to be the complementary graph entropy of an associated graph. Thus, previous results in the literature provide upper and lower bounds for this minimum rate (further, these bounds are tight for the important class of perfect graphs). The algorithmic aspects of instantaneous code design are considered next. It is shown that optimal code design is NP-hard. An optimal code design algorithm is derived. Polynomial-time suboptimal algorithms are also presented, and their average and worst case performance guarantees are established.


BACKGROUND
Technological progress, as well as increasing success, of reproductive medicine may lower the threshold for childless couples to initiate infertility therapy. However this development may aggravate unsolved problems (e. g. multiple births) and may not increase the pregnancy rate, due to the present unsatisfactory legal situation in Germany (e. g. ban on selective blastocyst culture).

METHODS
Based on a systematic review of the literature, we studied actual problems of German reproductive medicine under three public health-related topics: (1) the decline in population in Germany, (2) criteria for success in reproductive medicine and (3) new treatment options in the light of legal and ethical aspects.

RESULTS
In Germany (and other industrial nations), reproductive medicine has emerged parallel to an ever-increasing rate of childlessness. Today, 2 % of all births result from treatments using the techniques of reproductive medicine. Nevertheless, the actual extent of involuntary childlessness is lower (below 8 %) than commonly suggested (between 10 and 15 %). Frequently, the success of treatment depends upon a series of treatment cycles and is, especially in Germany, accompanied by a high rate of multiple births (more than 30 %). Hence, a more adequate success rate may be the healthy, i. e., term, singleton baby. The use of selective blastocyst culture, currently not permitted in Germany, could further improve therapy or, at least, reduce patient stress and discomfort.

CONCLUSION
Reproductive medicine, as seen from a public health perspective, needs to pursue patient-oriented requirements more in-depth. An open discussion of new technologies which could improve reproductive health but are at present not permitted, would be imperative.


Soft red winter (SRW) wheat (Triticum aestivum L.) '5205' (Reg. No. CV-1038, PI 656755) developed and tested as VA01W-205 by the Virginia Agricultural Experiment Station was released in March 2008. 5205 was derived from the three-way cross Pioneer Brand '2684' /VA93-54-185//'Pocahontas'. Cultivar 5205 is broadly adapted, high-yielding, midseason maturity, short in stature, and semidwarf (Rht2), and it has very good milling and pastry baking quality. It also is notably resistant to powdery mildew (Blumeria graminis (DC.) E.O. Speer), leaf rust (Puccinia triticina Eriks.), and stripe rust (P. striiformis Westend.) and moderately resistant to Fusarium head blight (caused by Fusarium graminearum (Schwabe)). In Virginia average grain yield (2006-2008) of cultivar 5205 (6114 kg ha -1 ) has been equal to that of the highest-yielding cultivars. In USDA-ARS uniform southern SRW wheat nursery trials conducted at 26 locations in 2006 and at 19 locations in 2007, 5205 produced average grain yields of 5362 and 4488 kg ha -1 , respectively, in comparison to nursery mean yields of 5180 and 4146 kg ha -1 . In these nursery trials, 5205 was most similar in milling quality to the check 'AGS 2000', which ranks 25th among 830 soft wheat cultivars evaluated by the USDA-ARS Soft Wheat Quality Laboratory for Allis milling quality. 5205 has softer fl our texture (softness equivalent of 61.1 vs. 57.5 g 100 g -1 ), has stronger gluten strength (lactic acid solvent retention capacity of 118 vs. 107 g 100 g -1 ), and produces cookies that are larger in diameter (18.58 vs. 17.75 cm) than AGS 2000.


Crowdfunding is a way of raising money through small contributions from a large number of investors, i.e. "crowd". Crowdfunding constitutes a common denominator for number of financing methods, from donations through lending up to venture capital, while all taking place online. Thus, there is a considerable number of legal challenges, namely use of copyright, distribution of loans and credits or possible sale of securities. In many cases the "crowd" is constituted by large number of consumers, acting outside their trade, business, craft or profession. Yet there are also exceptions. Sometimes, on the other side of the Internet connection sits a professional looking for an investment opportunity instead of an inexperienced consumer. However, which one shall we protect and to what extent? Is there an economic and legal necessity or only an "EU urge" to protect the consumers even if the protection might not be necessary? Hence, this article analyzes and assesses the current regulatory framework through the lens of CJEU's jurisprudence on the consumer protection with the constant focus on balance of needs and protection of the parties involved.


Child removals are increasing in England and Wales. Family court involvement is particularly common among women with multiple disadvantages, and the rates are higher in economically marginalised areas. This article aims to explore women's narratives of child removal within life stories of homelessness and examines how stigma, power and State surveillance manifest in their experiences. Data drawn from qualitative interviews with 14 mothers in the north-east of England who had experienced the removal of their children through the family courts are explored within the wider context of a neoliberal political agenda of "troubled families", and in particular, "deviant mothers". The participants describe how stigma structured their interactions with social services. Despite the known poor outcomes associated with child removal for both mothers and children, professional involvement often tapers off afterwards, with little support for mothers. Drawing on women's accounts, we seek to illuminate their experiences of child removal and enhance our understanding of how stigma plays out in statutory settings, further entrenching social exclusion and ultimately increasing health inequalities.


She was a beautiful blond child, a quintessential Canadian teenager: she loved Saturday film matinees, giggled at pyjama parties, ran for student president, led the cheerleading squad, went steady with the right boy and married him, her proud father at her side. But from the age of seven Sylvia Fraser shared her body with a 'twin' who lived a separate life from her. This other self was created to do the things Sylvia was too frightened, too ashamed, too repelled to do - the things her father made her do. As an adult, she had no recollection of a sexual relationship with her father, yet some connection always remained - pain, terror and guilt were never far from the surface. With tremendous power, candour and eloquence, Sylvia Fraser breaks through her amnesia to discover and embrace the self she left behind. MY FATHER'S HOUSE is at once a terrible account of a woman's coming of age and a lyric story of love and forgiveness.


Climate change frames in the media affect the political and public debate. However, focusing on the frames in texts, most framing research overlooks the factors which influence frame-building by reporters. However, this is crucial for a fuller understanding of the potential implications and meanings of frames. Besides, the existing frame-building research is exclusively engaged with mainstream media. Also, visual frame-building is under-researched. Therefore, we have conducted interviews with 26 climate journalists, photo editors, chiefs and opinion-makers, working for three mainstream and two progressive alternative outlets in northern Belgium. The findings were combined with the outcome of a deductive framing analysis of 114 climate articles. The results show a strong overlap among journalist frames and news frames. Anthropocentric Subframes prevail in the mainstream news articles and among the reporters. A mixture of Biocentric and Anthropocentric Subframes was found in the context of the alternative outlets. We explain this by presenting the studied mainstream newsrooms as machines and the (progressive) alternative newsrooms as organisms. We conclude that the mainstream journalists are guided towards Anthropocentric Subframes by various (internalised) pressures. The practices in the alternative media liberate reporters to introduce a broader variety of frames.


Objective: Past research has linked posttraumatic stress disorder (PTSD) symptoms to increased risk for intimate partner violence (IPV) perpetration. However, little is known about the impact that PTSD may have on treatment engagement or violence recidivism following treatment for IPV. The current study examined whether PTSD predicts treatment engagement and criminal recidivism in a 20-session, community-based, cognitive–behavioral abuse intervention program. Method: Participants (N = 293) completed assessments of PTSD symptoms, depression, drug use, and alcohol problems during agency intake. These variables were examined as predictors of group treatment engagement (session attendance, working alliance, cognitive–behavioral therapy homework compliance, group cohesion, and task orientation) and criminal recidivism during the 2 years after scheduled completion of treatment. Results: Individuals with higher levels of PTSD symptoms at pretreatment had lower homework compliance during treatment. Further, individuals with probable PTSD reported lower task orientation and group cohesion later in treatment. Individuals with a probable PTSD diagnosis at pretreatment had 4 times higher odds of general violence recidivism than those without a probable PTSD diagnosis, and this association remained significant when controlling for substance use and depression. In addition, participants with probable PTSD were more likely to have intimate partner abuse recidivism compared with those without (adjusted odds ratio = 2.5), although this effect was not statistically significant. Conclusions: Trauma symptoms affect violence cessation in IPV treatment, further highlighting the need to address unique clinical issues and underlying mechanisms associated with traumatic stress symptoms in treatments for this population.


A questionnaire was sent to 209 optometrists teaching at each of the thirteen U.S. optometry schools. It contained questions pertaining to optometric educators attitudes toward their educational background in developmentel vision and visual training. Questions were designed to solicit opinions on what role developmental vision and visual training play in optometric education today. The professors attitudes and opinions were compared to their year of graduation. Lastly, profile information and data concerning the field of expertise was gathered from each survey recipient.


To protect site integrity and conserve populations the Habitats Directive has placed a requirement for all water intakes on SAC rivers and estuaries to provide adequate screening for all Annex II fish species including shad. Annex II species are also indicator species for the fish biological element of the Water Framework Directive. The protection of these species could require very fine mesh intake frontage physical screens which could present a variety of engineering, operational, and environmental difficulties at abstraction sites. Behavioural fish screens which evoke an avoidance response to stimuli are a potential retro-fit alternative. Acoustic screens are the most common and well understood behavioural screening technology. The hearing capability of fish is dependent upon the physiology of the individual species and consequently, the effectiveness of acoustic deterrents is also species dependent. Research suggests that clupeid fish, including the Alosids, can hear over a far greater range than other fish species and appear to be unique among fish in that they can detect ultrasound. There is therefore evidence to suggest that shad could be stimulated to elicit an avoidance response using ultrasonic acoustic stimuli. On this basis behavioural trials were undertaken with juvenile twaite shad to determine whether an avoidance response could be elicited and if so, which frequencies and sound pressure levels were most effective. Startle reactions of wild-caught shad to ultrasound were observed, particularly at a frequency of 45 kHz. Experimental avoidance trials suggested that there was potential for ultrasonic acoustic stimuli to be used as a deterrent to juvenile shad entrainment and that deployment of such a deterrent at potable water intakes could assist in the conservation of this species. Following initial experimental trials a deterrent was developed and deployed at intakes within the river to determine its potential efficacy in the riverine environment.


The perspective of the embodiment is declined meaning in the primary function of touch the fundamental process of knowledge of the world. The touch, as a communication tool that allows the recognition of one's own and other people's corporeality. The nature and function of the contacts (self-contacts and hetero-contacts) and the educational value that aptic communication are analyzed in some different relational contexts (in rituals, in the symmetrical and asymmetrical relationships, depending on the gender differences, etc.). In today's postmodern society, characterized by a dominant touch culture, is needed an educational responsibility that takes the body and the "touch" as pedagogical objects, according to a methodological and epistemological approach of a critical-reflective and hermeneutic type.


To the Editor. —In their study of the influence of patient ethnicity on emergency department administration of analgesia, Todd et al 1 examined the potential influence of 17 other predictor variables (Table 2). Included among these were patient insurance status, occupation, and arrival time, as well as the ethnicity and gender of the treating physician. Conspicuous by its absence from the variables examined, however, is perhaps the single most important determinant of whether an individual patient in the emergency department ought to receive analgesia: his or her level of pain and distress as gauged by health providers. This would have been described in physicians' and nurses' notes and could have been reported and used to shed light on those questions of "cultural influences on the expression of pain" appropriately raised by the authors in the concluding paragraphs of the article. Is it the case that those study patients who received


Aerodynamic force tests were made in the N.A.C.A. 7 by 10 foot wind tunnel on a model Clark Y wing with a 20 percent chord split flap deflected 60 degrees downward. The tests were made to determine the effect of partial-span split flaps, located at various positions along the wing span on the aerodynamic characteristics of the wing-and-flap combination. The different lengths and locations of the flaps were obtained by cutting off portions of a full-span flap, first from the tips and then from the center. The results are given in the form of curves of lift, drag, and center of pressure. They show that with partial-span split flaps both the lift and drag are less than with full-span flaps; that the lift for a given length of flap is somewhat greater when the partial span is located at the center of the wing than when it is located at the tip portion, and that the drag for a given length of flap is the same regardless of the location over the flap with respect to the wing span.


The problem of adaptation cannot be reasonable well studied without due regard of the principle of reflection. The relationship between adaptation and reflection is realized in, for instance, the adequacy of body reactions to environmental impacts. The paper approaches this problem in the light of thermodynamics. A simple method for accounting the process of adaptation to continuous exposure in specially designed sealed chamber on the pattern of shift work of operators is proposed. The investigation embraced 29 divers aged 20-25 who stayed in shifts for long periods in a chamber with artificially and synthetically sustained air parameters. The investigation demonstrated the effectiveness of the description of adaptation process through probabilistic models with a high level of generalization, and the possibility to predict operator's functioning at various phases of his work cycle.


Abstract : In international relations literature, there seems to be some confusion caused by the many contradictory theories on alliance formation patterns. For this reason, this thesis surveys why there is not just one theory that explains most of the alliance formations throughout history. Using logistic regression models and statistical analysis for different historical periods from 1816 to 2012, the thesis explores the effects of four state-level variables-regime type, national material capabilities, geographical proximity, and trade exchange-on alliance formation behaviors.The results show that the four state-level variables have different levels of significance in the different periods. The thesis concludes that alliance formation behaviors differ depending on the prevailing system-level conditions in the different historical periods, especially under conditions of war and peace and based on the polarity of the international system. The approach presented in the thesis provides a new perspective to analyze alliance formation patterns for a better understanding of future alliances.


Sera from patients with paracoccidioidomycosis (PCM), histoplasmosis (HP), or Jorge Lobo's disease (JL) were titrated against purified gp43 from Paracoccidioides brasiliensis by using both enzyme-linked immunosorbent assay (ELISA) and immunoprecipitation (IPP) reactions with 125I-labeled antigens. In IPP, PCM sera and other sera could be distinguished on the basis of serum titers, whereas in ELISA, 53% of the HP sera and 29% of the JL sera reacted similarly to the PCM sera. To investigate the possible role of the carbohydrate epitopes in these reactions, we compared the reactivities of sera from several patients with native and deglycosylated gp43. Competition experiments were carried out with monosaccharides as inhibitors. The results suggest that greater than 85% of the reactions of the PCM sera with gp43 involved peptide epitopes. Cross-reactions with HP and JL sera in ELISA were predominantly attributed to periodate-sensitive carbohydrate epitopes containing galactosyl residues. HP and JL sera which reacted strongly with gp43 in ELISA were only weakly reactive or did not react in IPP with labeled antigens in solution. Moreover, ELISA reactions could be significantly inhibited either by monosaccharides or by periodate treatment. Apparently, carbohydrate epitopes in gp43 are more accessible to the antibodies when the molecule is bound to a plastic substrate than when it is in solution. Structural changes in the gp43 antigen arising by N deglycosylation abolish reactivity with PCM sera and support the existence of conformational peptide epitopes.


Healthcare providers are under increasing pressure to reduce waste, eliminate unnecessary costs and redundant efforts, thereby improving the quality and consistency of healthcare delivery. Lack of automation and the lack of use of global identifiers for products and locations, also known as supply chain data standards, are two critical factors that can help streamline providers operations and improve process efficiency. Despite widespread consensus among various stakeholders, healthcare providers lack a well-defined approach towards adopting and implementing data standards. Supply chain data standards can be defined as a set of product and location identifiers which are used in supply chain related processes and transactions. Healthcare providers willing to successfully adopt data standards in some or all of their operations need to invest in several process changes and technology installations or upgrades; however, they often struggle to justify returns on those investments and hence, find uncertain Return on Investment (ROI) as a critical barrier. In this article, we present a hierarchical comprehensive spreadsheet based decision support tool that helps potential healthcare providers to evaluate their readiness requirements and quantify the potential impacts of their decisions in terms of non-monetary performance measures, such as increased productivity, enhanced patient safety and reduction in errors resulting in decreased volume of transactions. This tool has undergone extensive testing with healthcare providers of different size, scope, and needs. We present numerical results showcased through practical examples in this article. The software is publicly available free of cost for download at http://cihl.uark.edu.


In obesity, dysregulated metabolism and aberrant expansion of adipose tissue lead to the development of tissue hypoxia that plays an important role in contributing to obesity-associated metabolic disorders. Recent studies utilizing adipocyte-specific hypoxia-inducible factor-α (HIF-α) gain- or loss-of-function animal models highlight the pivotal involvement of hypoxic responses in the pathogenesis of obesity-associated inflammation and insulin resistance. HIF-1α, a master transcription factor of oxygen homeostasis, induces inflammation and insulin resistance in obesity, whereas its isoform, HIF-2α, exerts opposing functions in these obesity-associated metabolic phenotypes. In this review, recent evidence elucidating functional implications of adipocyte HIFs in obesity and, more importantly, how these regulate obesity-associated inflammation, fibrosis, and insulin resistance will be discussed. Further, we propose that modulation of HIF-1 could be a potential novel therapeutic strategy for antidiabetic treatment.


Objectives Vascular stiffness (VS) and vascular calcification (VC) are surrogate markers of vascular health associated with cardiovascular events. Vitamin K-dependent proteins (VKDP) are associated with VS and VC and require vitamin K for activity. We conducted a systematic review and meta-analysis of: (1) the effect of vitamin K supplementation on VS and VC and (2) association of inactive VKDP levels with incident cardiovascular disease and mortality. Methods Two authors searched MEDLINE and Embase databases and Cochrane and ISRCTN registries for studies of vitamin K clinical trials that measured effects on VC, VS or VKDP and longitudinal studies assessing effect of VKDP on incident CVD or mortality. Random effects meta-analyses were performed. Results Thirteen controlled clinical trials (n=2162) and 14 longitudinal studies (n=10 726) met prespecified inclusion criteria. Vitamin K supplementation was associated with significant reduction in VC (−9.1% (95% CI −17.7 to −0.5); p=0.04) and VKDP (desphospho-uncarboxylated matrix Gla protein; −44.7% (95% CI −65.1 to −24.3), p<0.0001) and uncarboxylated osteocalcin; −12.0% (95% CI −16.7 to −7.2), p<0.0001) compared with control, with a non-significant improvement in VS. In longitudinal studies with median follow-up of 7.8 (IQR 4.9–11.3) years, VKDP levels were associated with a combined endpoint of CVD or mortality (HR 0.45 (95% CI 0.07 to 0.83), p=0.02). Conclusions Supplementation with vitamin K significantly reduced VC, but not VS, compared with control. The conclusions drawn are limited by small numbers of studies with substantial heterogeneity. VKDP was associated with combined endpoint of CVD or mortality. Larger clinical trials of effect of vitamin K supplementation to improve VC, VS and long-term cardiovascular health are warranted. Trial registration number CRD42017060344.


Background & Aims of the Study : The effective clinical training is from essential and important parts of medical education. Survey theviewpoints of medical students in this area as the pivot of education can be an effective step in planning of clinical education program and effective and efficient evaluation of it. This study was conducted by the aim of determination of medical externs and interns viewpoints about the effective clinical education. Materials & Methods: In this cross-sectional study, all of the externs and interns of Qom Islamic Azad University (140 students) were participated in 2012. The data were collected by the valid and reliable researcher-made questionnaire in the six domains of individual characteristics of students, clinical instructor, clinical environment, educational planning, clinical evaluation and facilities that every domain in according to the Likert attitude-meter scale were determined to too low, low, moderate, high and very high. Results: According to the student's viewpoints, the most efficient domains of clinical education were clinical instructor, individual characteristics of students, educational planning, clinical evaluation, the clinical setting and facilities, respectively. In according to the opinion of under-studied students, the most efficient factors in medical education in the domains of individual characteristics of students, clinical teacher, clinical setting, educational planning, clinical evaluation and facilities are self-confidence, commitment and responsibility, positive attitude to the education of students, the quality of education, existence of a systematic clinical evaluation system and existence of examination room, respectively. Conclusion: Two domains of clinical instructor and individual characteristics of student were more important than other domains. Therefore, attention to the strengthening of clinical instructor about effective clinical training and also the strengthening of student's interest and confidence in the area of clinical training can be important.


We consider the problem of offline change point detection from noisy piecewise constant signals. We propose normalized fused LASSO (FL), an extension of the FL, obtained by normalizing the columns of the sensing matrix of the LASSO equivalent. We analyze the performance of the proposed method, and in particular, we show that it is consistent in detecting change points as the noise variance tends to zero. Numerical experiments support our theoretical findings.


The objective of the research was to observe the effects of soil microfungi application on soil fertility. The soil fertility was determined based
on nitrogen, phosphorus and potassium (NPK) content and plant (Lycopersicon esculentum Mill.) growth. Firstly, groups of microfungi were
determined based on their decomposition properties on Coffea robusta. L leaf litters. The research covered several decomposition properties
which were (1) substrate weight loss, (2) cellulase activity and (3) xylanase activity during the process of decomposition on the pure culture
decomposition test. Secondly, the microfungi were grouped based on averages of all properties value paired in all possible ways. The result
showed that there were 10 groups of fungi (P1 – P10) combined based on their decomposition ability. The groups of fungi (P1 – P10) were
applied on sterile soils to determine the NPK content and on pots to observe L. esculentum Mill growth (plant height, leaf sizes, fresh and dry
weight). The effects indicated majority groups of fungi were able to increase NPK content and growth parameters comparing to that of control.
It concludes that the application of soil saprophytic microfungi on soils are possible to perform this process and able to increase soil fertility.


Abstract: Synovial inflammation in rheumatoid arthritis is closely related to the formation of ectopic lymphoid microstructures. In synovial tissue from some patients, one finds seemingly diffuse infiltrates; in others, T cells and B cells cluster in aggregates with interdigitating dendritic cells (DCs) but no follicular DCs (FDCs). In a third group, T cell/B cell follicles with germinal center (GC) reactions are generated. Within a given patient, aggregates and GCs are mutually exclusive and stable over time. Because antigen storage capacity, lymphoid density, and three‐dimensional topography of GCs optimize immune responses, synovial GCs should play a crucial role in the breakdown of self‐tolerance. We have identified factors critical for ectopic GCs, thereby transforming the synovial inflammatory process. Tissues with GCs produced 10‐ to 20‐fold higher amounts of the chemokines CXCL13 and CCL21. CXCL13 derived from three sources, endothelial cells, synovial fibroblasts, and FDC networks. The level of CXCL13 transcripts strongly predicted GCs; however, some tissues had high levels of CXCL13 but lacked GCs. Tissue expression of LT‐β emerged as a second key factor. LT‐β protein was detected on follicular center and mantle zone B cells. Multivariate regression analysis identified CXCL13 and LT‐β as the only cytokines predicting GCs. Remarkably, LT‐α did not contribute independently. The contribution of B cells to ectopic lymphoid organogenesis was not limited to LT‐β production. Rather, synovial tissue B cells were critical in regulating T cell activation. In adoptive transfer experiments in human synovium‐SCID mouse chimeras, activation of synovium‐derived CD4 T cells was strictly dependent on T cell/B cell follicles. Depletion of synovial tissue B cells abrogated T cell function, and non‐B cell antigen‐presenting cells could not maintain T cell stimulation. Unexpectedly, GC function in the rheumatoid lesion was also dependent on CD8 T cells. The majority of T cell receptors derived from CD8 T cells were shared between distinct GCs. Depletion of CD8 T cells disrupted synovial GCs, FDC networks disappeared, and transcription of LT‐β, IgG, and Igκ declined. Follicle‐sustaining CD8 T cells were located at the edge of or within the mantle zone. Cell‐cell communication in the mantle zone, including CD8 T cells, appears to be critical for ectopic GC formation in rheumatoid synovitis.


This thesis reports on over 27 sills and 213 associated vents. The sills and
vents were investigated using 3D seismic data, in a ~1000 km2 area,
offshore Norway between the More and Voring Basins (the Edvarda
survey).
A wide range of sill geometries are observed which are interpreted to be the
result of five different processes acting on the sills. Three of these
processes relate to how the host deforms. If sill intrusion causes
deformation of the seafloor, creating folds, or the sills interact with folds
created by neighbouring sills, sills are found to cross bedding (transgress)
abruptly. Alternatively, if deformation is interpreted to be local, then
continuously increasing Young's Modulus with depth is interpreted to
result in sills which transgress continuously upwards, akin to smooth
'bowls'. At shallow depths the host is interpreted to fluidise, leading to
limited transgression or in some cases multiple bowls. The seismic
amplitude responses of shallow sills include flow related features such as
channels and lobes. The other two processes interpreted to affect sill
propagation stem from structures in the host: abrupt changes in lithology
and pre-existing faults. Multiple sills are found to terminate, and in some
cases form, at sand rich units in the otherwise mudstone dominated host.
Additionally, some sills are interpreted to have intruded into a host with
pre-existing polygonal faults, which led to angular sill geometries.
Vents are found to occur directly above sills, often along the margins of
sills, but in some cases over sill interiors, especially where the sills are
locally shallower. Additionally, a cluster of 98, relatively small vents occur
above the shallowest sill. Differential compaction and slumping are found
to affect some larger vent morphologies. Overall, vent size is found to
closely follow a power-law such that smaller vents are significantly more
numerous than larger vents.


Introduction: Hidradenitis is a chronic infl ammatory disease that has a negative impact on the patient's quality of life but which has few effective therapeutic options. Currently, the use of laser technology has been standing out as a treatment. Objective: To evaluate the use of 1,340nm ND:YAP laser (Neodimiun:Ytrium Aluminum Perovskite) to treat hidradenitis. Methods: Performing 4 1,340nm ND:YAP laser sessions in 3 patients bearing hidradenitis. Results: All patients had a clinically and histologically evidenced reduction of infl ammatory lesions. Conclusions: In the present study, the 1,340nm ND:YAP laser was effective in the treatment of hidradenitis, and can potentially become a new therapeutic option.


Porous lead titanate (PT) and lead zirconate titanate (PZT) coatings were prepared by spin coating alkoxide solutions modified with benzoic acid. Carrying out the spin coating in a humid atmosphere (>30% RH) promoted the formation of porous microstructures. The variations in the chemical structure of the alkoxide and the coating microstructure indicate that the porous microstructures developed due to phase separation induced by reaction with water and evaporation. The porosity is interconnected with a size on the order of 0.1 - 2 μm, depending on the solution composition and spinning rate. While PT and PZT formed into similar porous microstructures, only PT could be processed so that it was entirely perovskite. Residual pyrochlore on the surfaces of the porous structure persisted in PZT coatings. The porous coatings were infiltrated with a polymer to make 3-3 composite coatings.


Abstract Since the implementation of "two-child policy" in China, the prevalence and influencing factors of postpartum depression (PPD) between women at first childbirth and second childbirth remains unclear. We aimed to compare the prevalence and the influencing factors of PPD between the two groups. Postpartum women were recruited at their 6-week postpartum checkups and invited to complete questionnaires. The prevalence rate of PPD was 42.1%. There was no statistical difference found regarding the prevalence of PPD and the total score on the Edinburgh Postnatal Depression Scale between the two groups. The median of the item "self-injury" was significantly higher among women at first childbirth. Women with gestational diabetes in pregnancy, antenatal anxiety and depression, abortion, having babies getting sick occasionally, and deteriorated relationships with partner in pregnancy had much higher risks for PPD. Both primiparous and secundiparous had a high prevalence of PPD. It provides scientific evidence for clinical preventive and nursing care for PPD.


The existing approaches to the classification of diseases, based on the determination of their nosological forms, are mainly oriented on the clinical requirements. Within the only approach to the classification of diseases, it is difficult to combine the requirements of diagnostics and those of the epidemiological generalization of the data on morbidity for the development of the prophylactic system for the prevention of the mass spread of diseases, which is of particular importance for infectious diseases. It is necessary to form the specialized classification of epidemiological situations, based on the International Classification of Diseases and capable of ensuring the assessment of the epidemic spread of infectious diseases and the development of adequate measures for decreasing mass morbidity among the population.


The increase in the use of metal additive manufacturing (AM) processes in major industries like aerospace, defense, and electronics indicates the need for maintaining a tight quality control. A quick, low-cost, and reliable online surface texture measurement and verification system are required to improve its industrial adoption. In this paper, a comprehensive investigation of the surface characteristics of Ti-6Al-4V selective laser melted (SLM) parts using image texture parameters is discussed. The image texture parameters extracted from the surface images using first-order and second-order statistical methods, and measured 3D surface roughness parameters are used for characterizing the SLM surfaces. A comparative study of roughness prediction models developed using various machine learning approaches is also presented. Among the models, the Gaussian process regression (GPR) model gives an accurate prediction of roughness values with an R2 value of more than 0.9. The test data results of all models are presented.


Traditionally, social network analyses are applied to data from a particular social domain. With the advent of online social networks such as Facebook, we observe an aggregate of various social domains resulting in a layered mix of professional contacts, family ties, and different circles. These aggregates dilute the community structure. We provide a method for de-layering social networks according to shared interests. Instead of relying on changes in the edge density, our shared taste model uses content of users to disambiguate the underlying shared interest of each friendship. We successfully de-layer real world networks from LibraryThing and Boards.ie, obtaining topics that significantly outperform LDA on unsupervised prediction of group membership.


BACKGROUND
Sulfonylurea agents exert their physiological effects in many cell types via binding to specific sulfonylurea receptors (SUR). SUR couple to inwardly-rectifying K+ channel (Kir6.x) to form tetradimeric ATP-sensitive K+ channels (KATP). The SUR subunits confer ATP-sensitivity on KATP and also provide the binding sites for sulfonylureas and other pharmacological agents. Our previous work demonstrated that the exposure of mesangial cells (MC) to sulfonylureas generated profound effects on MC glucose uptake and matrix metabolism and induced heightened cell contractility in association with Ca2+ transients. Because these responses likely resulted from the binding of sulfonylurea to a mesangial SUR2, we subsequently documented [3H]-glibenclamide binding to MC and the gene expression of several mesangial SUR2 transcripts. From these data, we inferred that MC expressed the components of a mesangial KATP and sought to establish their presence in primary MC.

METHODS
To obtain mesangial SUR2 cDNA sequences, rapid amplification of cDNA ends (RACE) was utilized. DNA sequences were established by the fluorescent dye termination method. Gene expression of mesangial SUR2 and Kir6.1/2 was examined by reverse transcription polymerase chain reaction (RT-PCR) and Northern analysis. SUR2 proteins were identified by immunoblotting of mesangial proteins from membrane-enriched fractions with polyclonal antiserum directed against SUR2.

RESULTS
RACE cloning yielded two mesangial SUR2 cDNAs of 4.8 and 6.7 kbp whose open reading frames translated proteins of 964 and 1535 aa, respectively. Using probes specific to each cDNA, the presence of a unique, 5.5 kbp serum-regulated mesangial SUR2 splice variant was established. The sequence of this mesangial SUR2 (mcSUR2B) shares identity with the recently cloned rat SUR2B (rSUR2B), but, in comparison to rSUR2B, is truncated by 12 exons at the N-terminus where it contains a unique insert of 16 aa. Immunoblotting studies with anti-SUR2 antiserum demonstrated SUR2 proteins of 108 and 170 kD in membrane-enriched fractions of MC protein extracts. Complementary studies showed abundant gene expression of Kir6.1, thereby establishing gene expression of both components of KATP.

CONCLUSIONS
Based upon analogy to vascular smooth muscle cells (VSMC), there are at least two putative mesangial KATP that most likely represent hetero-octamers, comprised of either rSUR2B or mcSUR2 in complex with Kir6.1. Our results define the mesangial SUR2B as the possible first link in a chain of cellular events that culminates in MC contraction and altered extracellular matrix metabolism following exposure to sulfonylureas. In addition, our results serve as the basis for the future elucidation of the electrophysiologic characteristics of the mesangial KATP and the study of endogenous regulators of mesangial cell contractility.


Cutaneous anthrax is responsible for 95% of anthrax cases around the world. Transmission of Bacillus anthracis facilitated by direct contact with animal or animal product with abraded skin. The toxins produced after infection could trigger the production of inflammatory cytokines and leads to the cutaneous manifestation of anthrax and its complications. Antibiotics are the current and common therapy for anthrax. The adverse effects and bacterial resistance increase the need for alternative regimens. Propolis has been widely used as traditional medicine containing anti-inflammatory, antiproliferative, antioxidant, antiviral, and antibacterial effects. This experimental post-test only control group study was conducted in cutaneous anthrax animal models receiving ethanolic extract of propolis (EEP). Skin manifestation was assessed clinically by score, while skin tissue necrosis was evaluated and scored histologically through a skin biopsy. In this study, all anthrax animal models had skin manifestations include papules, nodules, and eschar, while most animal models given EEP did not have skin manifestations. Histologically, skin tissue necrosis was found in all control group animals and mostly not found in other groups receiving EEP before or after induction. This proves that administering EEP either before or shortly after exposure can prevent skin manifestations and at the same time reduce inflammatory reactions when clinical manifestations appear.


Optical chiral imaging, as an important tool in chemical and biological analysis, has recently undergone a revolution with the development of chiral metamaterials and metasurfaces. However, the existing chiral imaging approaches based on metamaterials or metasurfaces can only display binary images with 1 bit pixel depth having either black or white pixels. Here, the unique chiral grayscale imaging based on plasmonic metasurfaces of stepped V‐shaped nanoapertures is reported with both high circular dichroism and large polarization linearity in transmission. By interlacing two subarrays of chiral nanoaperture enantiomers into one metasurface, two specific linear polarization profiles are independently generated in transmission under different incident handedness, which can then be converted into two distinct intensity profiles for demonstrating spin‐controlled grayscale images with 8 bit pixel depth. The proposed chiral grayscale imaging approach with subwavelength spatial resolution and high data density provides a versatile platform for many future applications in image encryption and decryption, dynamic display, advanced chiroptical sensing, and optical information processing.


What We Already Know about This TopicTo date, there are not clinically practical, accurate, and precise noninvasive methods for measuring cardiac output in small children What This Article Tells Us That Is NewThis study describes a noninvasive method by which ultrasound can be used in small children to determine cardiac output with good precisionAfter surgery in 43 small children for repair of atrial or ventricular septal defects, cardiac output measurements performed using saline bolus injections and ultrasound detection of the expected blood dilution showed similar precision for measuring cardiac output as a cardiac outputs measured using periaortic flow probe Background: Technology for cardiac output (CO) and blood volume measurements has been developed based on blood dilution with a small bolus of physiologic body temperature saline, which, after transcardiopulmonary mixing, is detected with ultrasound sensors attached to an extracorporeal arteriovenous loop using existing central venous and peripheral arterial catheters. This study aims to compare the precision and agreement of this technology to measure cardiac output with a reference method, a perivascular flow probe placed around the aorta, in young children. The null hypothesis is that the methods are equivalent in precision, and there is no bias in the cardiac output measurements. Methods: Forty-three children scheduled for cardiac surgery were included in this prospective single-center comparison study. After corrective cardiac surgery, five consecutive repeated cardiac output measurements were performed simultaneously by both methods. Results: A total of 215 cardiac output measurements were compared in 43 children. The mean age of the children was 354 days (range, 30 to 1,303 days), and the mean weight was 7.1 kg (range, 2.7 to 13.6 kg). The precision assessed as two times the coefficient of error was 3.6% for the ultrasound method and 5.0% for the flow probe. Bias (mean COultrasound 1.28 l/min − mean COflow probe 1.20 l/min) was 0.08 l/min, limits of agreement was ±0.32 l/min, and the percentage error was 26.6%. Conclusions: The technology to measure cardiac output with ultrasound detection of blood dilution after a bolus injection of saline yields comparable precision as cardiac output measurements by a periaortic flow probe. The difference in accuracy in the measured cardiac output between the methods can be explained by the coronary blood flow, which is excluded in the cardiac output measurements by the periaortic flow probe.


Objective This study is part of the Global Maternal Sepsis Study (GLOSS). It aimed to estimate neonatal near-miss (NNM) and perinatal death frequency and maternal risk factors among births to women with infection during pregnancy in low-income and middle-income countries (LMIC). Design We conducted a 1-week inception hospital-based cohort study. Setting The study was carried out in 408 hospitals in 43 LMIC of all the WHO regions in 2017. Patients We included women with suspected or confirmed infection during pregnancy with at least 28 weeks of gestational age up to day-7 after birth. All babies born to those women were followed from birth until the seventh day after childbirth. Perinatal outcomes were considered at the end of the follow-up. Main outcome measures Perinatal outcomes were (i) babies alive without severe complication, (ii) NNM and (iii) perinatal death (stillbirth and early neonatal death). Results 1219 births were analysed. Among them, 25.9% (n=316) and 10.1% (n=123) were NNM and perinatal deaths, respectively. After adjustment, maternal pre-existing medical condition (adjusted odds ratios (aOR)=1.5; 95% CI 1.1 to 2.0) and maternal infection suspected or diagnosed during labour (aOR=1.9; 95% CI 1.2 to 3.2) were the independent risk factors of NNM. Maternal pre-existing medical condition (aOR=1.7; 95% CI 1.0 to 2.8), infection-related severe maternal outcome (aOR=3.8; 95% CI 2.0 to 7.1), mother's infection suspected or diagnosed within 24 hours after childbirth (aOR=2.2; 95% CI 1.0 to 4.7) and vaginal birth (aOR=1.8; 95% CI 1.1 to 2.9) were independently associated with increased odds of perinatal death. Conclusions Overall, one-third of births were adverse perinatal outcomes. Pre-existing maternal medical conditions and severe infection-related maternal outcomes were the main risk factors of adverse perinatal outcomes.


Abstract: The delay in delivering packets and packets loss in computer networks is due to the problem of congestion in TCP/AQM routers, and to solve this crisis the TCP and AQM worked together. Where TCP provides secure data transfer and designed to handle congestion after its occurrence. While AQM predicts congestion and tries to resolve the problem before it occurs. In this work, the Fuzzy-PID (FPID) controller presented to manage the avoidance of congestion problems associated with TCP networks. The approach is based on hybridization between the Fuzzy Logic Controller (FLC) and the Proportional-Integral-Derivative(PID) controller, with the structure of Fuzzy-Set-Point-Wight(FSW) for PID controller that optimized by Antlion Optimizer(ALO) Using a linearized TCP congestion model. our target is to control the queue length of the router for the queue level in demand. The FPID controller shows good robustness for a Different scenario of the TCP network and the queue length response showed fast tracking capability with good robustness to network parameters changing in comparison to PID controller, all simulations are carried out using MATLAB 2017b.


An algorithm for synthesizing a better relational database scheme in elementary key normal form (EKNF) is developed. This algorithm eliminates not only extraneous attributes and other redundancies, but also superfluities from a given set of functional dependences (FDs), based primarily on subset closures, Hamiltonian cycles of FDs, and equivalent subsets of attributes. Following this algorithm, a better LR-minimum FD covering is obtained. A more practical and efficient method for designing a relational database scheme in EKNF is then provided. The time complexity of the algorithm is polynomial. >


The Web contains a huge amount of text that is currently beyond the reach of structured access tools. This unstructured data often contains a substantial amount of implicit structure, much of which can be captured using information extraction (IE) algorithms. By combining an IE system with an appropriate data model and query language, we could enable structured access to all of the Web's unstructured data. We propose a general-purpose query system called the extraction database, or ExDB, which supports SQL-like structured queries over Web text. We also describe the technical challenges involved, motivated in part by our experiences with an early 90M-page prototype.


PURPOSE
In the context of the transcrestal maxillary sinus lift a wide variety of biomaterials have been used to fill the subantral space over the years. In this study, two types of biomaterials were used in order to fill the maxillary sinus: a nano-crystallized hydroxyapatite in an aqueous solution and a micronized heterologous bone in a collagen matrix.

MATERIALS AND METHODS
The surgical procedures were designed and carried out using computer-guided surgery. The filling volume obtained was measured with a comparative software program.

RESULTS
A ≥ 6 millimeter augmentation of osseous volume was obtained. This result is comparable to those obtained in lifts where conventional techniques were applied. The technique used was very precise and the difference between the projected and clinical outcome of the implant position had an average of less than 0.3 millimeters.

CONCLUSIONS
This technique allows for the surgery to be performed in a way which is both minimally traumatic and invasive, and represents a viable alternative to those surgical techniques for crestal sinus lift currently in use.


The elasticity promised by cloud computing does not come for free. Providers need to reserve resources to allow users to scale on demand, and cope with workload variations, which results in low utilization. The current response to this low utilization is to re-sell unused resources with no Service Level Objectives (SLOs) for availability. In this paper, we show how to make some of these reclaimable resources more valuable by providing strong, long-term availability SLOs for them. These SLOs are based on forecasts of how many resources will remain unused during multi-month periods, so users can do capacity planning for their long-running services. By using confidence levels for the predictions, we give service providers control over the risk of violating the availability SLOs, and allow them trade increased risk for more resources to make available. We evaluated our approach using 45 months of workload data from 6 production clusters at Google, and show that 6--17% of the resources can be re-offered with a long-term availability of 98.9% or better. A conservative analysis shows that doing so may increase the profitability of selling reclaimed resources by 22--60%.


CD27, a member of the tumor necrosis factor (TNF) receptor family, has been implicated in T cell activation, T cell development and T-dependent antibody production by B cells. Its ligand CD70 has been identified only in humans, and, thus, physiological and pathological roles of the CD70-CD27 interaction remain to be determined in an experimental animal system. In the present study, we identified murine (m) CD70 by molecular cloning, and characterized its expression and function by generating an anti-mCD70 mAb. The mCD70 cDNA encoded a type II transmembrane glycoprotein of the TNF family, having 56.5% identity to the human CD70 amino acid sequence. The mCd70 gene was assigned in the central region of chromosome 17. To explore the expression and function of mCD70, we generated cDNA transfectants and anti-mCD70 mAb (FR70), which inhibited binding of a murine CD27-Fc fusion protein (mCD27-Ig) to mCD70 transfectants. FR70, as well as mCD27-Ig, immunoprecipitated a 30-33 kDa surface protein from A20 and mCD70-P815 cells but not from P815 cells. The mCD70 transfectants exhibited a potent co-stimulatory activity for anti-CD3-stimulated T cell proliferation, which was blocked by FR70 far more efficiently than mCD27-Ig. FR70 also abrogated the CD28-independent co-stimulatory activity of A20 cells. The expression of mCD70 was detected on splenic T cells after stimulation with anti-CD3 and anti-CD28 mAb, and on splenic B cells after stimulation with anti-CD40 mAb. Cross-linking of surface Ig by anti-IgM mAb did not induce the mCD70 expression but enhanced the anti-CD40-induced mCD70 expression on splenic B cells. These results suggest a contribution of CD70 to murine T-B cognate interaction as proposed in the human system. FR70 will be useful for further investigating the physiological and pathological roles of the CD70-CD27 interaction in T cell development, T-dependent antibody production and various disease models in the murine system.


Adhesive bonding is a viable alternative to traditional joining systems (e.g., riveting or welding) for a wide class of components belonging to electronic, automotive, and aerospace industries. However, adhesive joints often contain flaws; therefore, the development of such technology requires reliable knowledge of the corresponding fracture properties. In the present paper, the candidate mode I fracture toughness of aluminum/epoxy joints is determined using a double cantilever beam fracture specimen. A proper data reduction scheme for fracture energy calculation has been selected based on the results of a sensitivity analysis. Furthermore, a scanning electron microscope is used in order to explore the locus of failure. Finally, the experimental findings are assessed by means of numerical simulations of crack growth carried out using a cohesive zone model.


: Emphysematous lung cysts in rare instances are associated with bronchial asthma, as evidenced by our patient and possibly another. Particularly in young patients, a trial period of steroid therapy should be instituted to confirm this possible association, to avoid unwarranted surgery and its attendant morbidity.


In order to achieve simultaneous, worldwide high quality assurance and other global production developments, Advanced TPS was proposed as a global production technology and management model, especially designed to realize high productivity and cost performance in global production. On this model, the inventory management is the key method at any manufacturing facility operating with Just-in-Time (JIT). On the other hand, the current inventory systems at manufacturing facilities do not provide real inventory data. So out-of-stock conditions sometimes have caused major productivity losses by causing the production line to stop. Therefore, the authors have proposed to create component inventory tool, which RFID tag can be replaced onto the containers with the trial parts and thus both the supplier and main manufacturing facility. This tool could provide constant feedback to ordering, logistics, and assembly conveyance groups in order to maintain and improve current JIT system. Concretely, this can also provide current information on components being shipped by the supplier and list what items are available in the production area by part number and supplier. The effectiveness of this proposal has been verified into Toyota Motor Manufacturing, Texas (TMMTX), which is unique for onsite supplier locations. This has been proven that RFID can prove to be an efficient tool with which to track inventory and generate cost savings.


: Thermal performance has become one of the main issues in electronic industries in line with prevailing development. Conventional working fluid such as distilled water (DI) often used by electronic devices has some shortcomings on the efficiency of transferring heat for cooling purposes. Hence, nanofluid is a promising alternative as it will be able to help improvising and more competent than subsist working fluid. In this experiment, water-based nanofluid with gum Arabic (GA) as surfactant is used. The main purpose of this study is to investigate the effect of GA and different volume concentrations of silica nanoparticles in DI on thermal performance and stability of nanofluids. Various volume percentage (vol%) of nanoparticles (0.1 vol%, 0.3 vol% and 0.5 vol%) were used and nanofluid was dispersed using sonication process for 20 min. Temperature distribution on heat sink water block with range of flow rates (0.05 m 3 h –1 to 0.1 m 3 h –1 ) and heating power of 20 W was used to determine the efficiency of nanofluid as heat transfer fluids. The result shows that fluid contact surface temperature reduced with addition of silica at various flow rates as compared to that of distilled water. The thermal resistance of nanofluids reduced at all flow rates, reduction of 20% in thermal resistance is observed at all flow rate compared to DI. Higher heat transfer coefficient (HTC) is observed for nanofluids compared with DI because of their higher thermal conductivity. Comparison on experimental data with theoretical data calculated based on Maxwell theory indicated that thermal conductivity increased with increasing silica content with more significant data shown by experimental result. Thermal conductivity enhancements increased with increasing silica concentration in nanofluids. Finally, according to the results, it can be claimed that silica nano fluid can be introduced as an alternative fluid in heat transfer system .


BACKGROUND: Health care–associated infections (HAIs) are harmful and costly and can result in substantial morbidity for hospitalized children; however, little is known about national trends in HAIs in neonatal and pediatric populations. Our objective was to determine the incidence of HAIs among a large sample of hospitals in the United States caring for critically ill children from 2007 to 2012. METHODS: In this cohort study, we included NICUs and PICUs located in hospitals reporting data to the Centers for Disease Control and Prevention's National Healthcare Safety Network for central line–associated bloodstream infections (CLABSIs), ventilator-associated pneumonias, and catheter-associated urinary tract infections. We used a time-series design to evaluate changes in HAI rates. RESULTS: A total of 173 US hospitals provided data from NICUs, and 64 provided data from PICUs. From 2007 to 2012, rates of CLABSIs decreased in NICUs from 4.9 to 1.5 per 1000 central-line days (incidence rate ratio (IRR) per quarter = 0.96, 95% confidence interval 0.94–0.97) and in PICUs from 4.7 to 1.0 per 1000 central-line days (IRR per quarter = 0.96 [0.94–0.98]). Rates of ventilator-associated pneumonias decreased in NICUs from 1.6 to 0.6 per 1000 ventilator days (IRR per quarter = 0.97 [0.93–0.99]) and PICUs from 1.9 to 0.7 per 1000 ventilator-days (IRR per quarter = 0.95 [0.92–0.98]). Rates of catheter-associated urinary tract infections did not change significantly in PICUs. CONCLUSIONS: Between 2007 and 2012 there were substantial reductions in HAIs among hospitalized neonates and children.


Spatiotemporal sequence prediction is an important problem in deep learning. We study next-frame video prediction using a deep-learning-based predictive coding framework that uses convolutional, long short-term memory (convLSTM) modules. We introduce a novel reduced-gate convolutional LSTM architecture. Our reduced-gate model achieves better next-frame prediction accuracy than the original convolutional LSTM while using a smaller parameter budget, thereby reducing training time. We tested our reduced gate modules within a predictive coding architecture on the moving MNIST and KITTI datasets. We found that our reducedgate model has a significant reduction of approximately 40 percent of the total number of training parameters and training time in comparison with the standard LSTM model which makes it attractive for hardware implementation especially on small devices.


This research is motivated by the importance of the procurement of Human Resources at Universitas Brawijaya. The principles of Good University Governance (GUG) become a value and the best choice for universities as a basis for intense competition to become a leading tertiary institution in Indonesia and oriented to world-class universities. This research is designed to examine the implementation of the principles of good university governance (GUG) consisting of transparency, accountability, responsibility, fairness, and independence at every stage of human resource procurement (from recruitment to reward and punishment) in Universitas Brawijaya. This research is qualitative research with a grounded theory research approach. In this approach, researchers are responsible for developing other theories that arise from observing a group. This research uses data collection techniques with interviews, observation and documentation study, interviews conducted require three informants from the Civil Service Section. The results of this study indicate the procurement of Human Resources in UB has used the principles of GUG, transparency, accountability, responsibility, fairness, and independence in the recruitment process of educators and education staff, selection of educators and education staff, placement in assignments and positions that are accordingly, training and development, preparation of career paths, up to discipline enforcement and awarding.


Abstract The orotatotriethanolaminecopper(II) monohydrate, [Cu(C5H2N2O4)(C6H15NO3)] · H2O, has been synthesized and characterized with physico-chemical methods (IR and UV-Vis spectroscopy, magnetic susceptibility, conductivity and thermoanalytical measurements) and X-ray diffraction. The structure derived from physico-chemical methods is consistent with that of the X-ray diffraction. The compound crystallizes in the monoclinic system, space group P21/n, with a = 8.6282(12), b = 16.9919(18), c = 10.6985(15) Å, β = 110.08(3)°, V = 1473.1(3) Å3, Z = 4. The copper atom is chelated by the deprotonated nitrogen pyrimidine atom and by the carboxylate oxygen atom of the orotate dianion ligand, and by the nitrogen and oxygen atoms of the triethanolamine ligand. The title compound has a distorted octahedral coordination geometry.


We present first-principles approaches based on density functional theory for calculating positron states and annihilation characteristics in condensed matter. The treatment of the electron-positron correlation effects (the enhancement of the electron density at the positron with respect to mean-field density) is shown to play a crucial role when calculating the annihilation rates. A generalized gradient approximation (GGA) takes the strong inhomogeneities of the electron density in the ion core region into account and reproduces well the experimental total annihilation rates (inverses of the positron lifetimes) by suppressing the rates given by a local density approximation (LDA). The GGA combined with an electron-state-dependent enhancement scheme gives a good description for the momentum distributions of the annihilating positron-electron pairs reproducing accurately the trends observed in the angular correlation (ACAR) or Doppler broadening measurements of the annihilation radiation. The combination of the present positron lifetime and momentum density calculations with the corresponding measurements yields a unique tool for defect identification. Especially, the investigation of various vacancy-type defects in semiconductors able to trap positrons will be an important field for these methods. We will show that the identification of vacancy-impurity complexes in highly n-Type Si and the study of the SiO 2 /Si interface are particularly interesting applications.


Vapors of several common vinegars containing 4.2% to 6.0% (= 2.5 to 3.6 mol.L -1 ) acetic acid effectively prevented conidia of brown rot [Monilinia fructicola (G. Wint.) Honey], gray mold (Botrytis cinerea Pers.:Fr.), and blue mold (Penicillium expansum Link) from germinating and causing decay of stone fruit (Prunus sp.), strawberries (Fragaria xananassa Duchesne), and apples (Malus xdomestica Borkh.), respectively. Fruit were fumigated in 12.7-L sealed containers in which vinegar was dripped on to filter paper wicks or vaporized by heating from an aluminum receptacle. Vapor from 1.0 mL of red wine vinegar (6.0% acetic acid) reduced decay by M. fructicola on 'Sundrop' apricots (Prunus armeniaca L.) from 100% to 0%. Similarly, vapor from 1.0 mL of white vinegar (5.0% acetic acid) reduced decay in strawberries by B. cinerea from 50% to 1.4%. Eight different vinegars, ranging from 4.2% to 6.0% acetic acid, of which 0.5 mL of each vinegar was heat-vaporized, reduced decay by P. expansum to 1% or less in 'Jonagold' apples. The volume of heat-vaporized white vinegar (5.0% acetic acid) necessary to reduce decay by P. expansum on Jonagold' apples to zero was 36.6 μL-L -1 of air. Increasing the number of conidia on the apple surface reduced the effectiveness of vinegar vapor. The number of lesions caused by P. expansum on McIntosh' apple decreased exponentially with increasing time of fumigation, approaching zero after about 6 hours. These results suggest that vinegar vapor could be an effective alternative to liquid biocides such as sodium hypochlorite for sterilization of surfaces contaminated by conidia of fungal pathogens.


As 3D interfaces, and in particular virtual environments, become increasingly realistic there is a need to investigate the location and configuration of information resources, as distributed in the humancomputer system, to support any required activities. It is important for the designer of 3D interfaces to be aware of information resource availability and distribution when considering issues such as cognitive load on the user. This paper explores how a model of distributed resources can support the design of alternative aids to virtual environment wayfinding with varying levels of cognitive load. The wayfinding aids have been implemented and evaluated in a desktop virtual environment.


The incidence of schizophrenia in black Caribbeans living in the UK is substantially higher than in the white British population. When first reported, these findings were assumed to be a first-generation migrant effect or merely the result of methodological artefacts associated with inconsistencies in the diagnosis of schizophrenia in black Caribbeans and doubts about population denominators. More recently, it has become clear that the incidence of schizophrenia, based on standardised diagnosis and sophisticated census methods, is higher still in second-generation black Caribbeans. The largest study to date has demonstrated a ninefold higher risk of schizophrenia in UK-resident black Caribbeans: findings that are of concern to black Caribbean communities, to their GPs, and to health service managers responsible for resource allocation. A literature search was carried in order to explore possible reasons for the reported excess incidence of schizophrenia in UK-resident black Caribbeans. Competing hypotheses are reviewed and the paper concludes with a summary of specific social and psychological risk factors of significance within the black Caribbean community. Awareness of the factors associated with the onset and presentation of schizophrenia in black Caribbeans may help early diagnosis and rapid access to appropriate treatment which, in turn, appear to be related to improved long-term outcomes.


Advanced-level rural female students perform very poorly in Physics and Mathematics at national examinations in Uganda. Consequently, they fail to get state sponsorship for engineering and technology training in Universities. Hybrid e-learning was introduced for two years in two typical rural girls' advanced-level secondary schools (Ediofe and Muni) in the rural district of Arua to support the learning and teaching of Physics and Mathematics and was expected to result in an improvement in the achievement scores.. The purpose of this study was to analyze the effects of such an intervention on the achievement scores of the female students in both subjects. Multistage sampling was done to identify 21 participants for Mathematics (11 from Ediofe and 10 from Muni) and another 19 for Physics (12 from Ediofe and 7 from Muni). Six students of Ediofe were offering both Mathematics and Physics while Muni had four such participants. In the hybrid e-learning project, the main course delivery platforms were the training CD-ROMs that were developed based on the requirements of the local curriculum. Senior teachers from Makerere College School, one of the elite advanced level secondary school in Uganda, took part in the development of the content. Additionally, the participating students were allowed access to resources from the Internet from the Faculty of Technology ICT Research Center in Arua town. The Center was set up using the Triple Helix Methodology. External examinations were given to the participating female students in May, June, July and August 2007. The results of these examinations were analyzed as incomplete longitudinal multivariate data. The results of the analysis of the sources of variabilities in performance scores of students show that student level factors were more dominant than school level factors. These results were discussed in light of the Ugandan national policies on rural education.


We have previously shown that chronic treatment of chick embryos [from embryonic day 5 (E5) to E9] with NMDA rescues spinal cord motoneurons (MNs) from programmed cell death. In this situation, MNs exhibit a reduced vulnerability to acute excitotoxic lesions and downregulate NMDA and AMPA–kainate receptors. Here, we report that this treatment results in long-lasting sublethal structural changes in MNs. In Nissl-stained sections from the spinal cord of NMDA-treated embryos, MNs display an area adjacent to an eccentrically positioned nucleus in which basophilia is excluded. Ultrastructurally, MNs accumulate tubulovesicular structures surrounded by Golgi stacks. Thiamine pyrophosphatase but not acid phosphatase was detected inside the tubulovesicular structures, which are resistant to disruption by brefeldin A or monensin. Immunocytochemistry reveals changes in the content and distribution of calcitonin gene-related peptide, the KDEL receptor, the early endosomal marker EEA1, and the recycling endosome marker Rab11, indicating that a dysfunction in membrane trafficking and protein sorting occurs in these MNs. FM1-43, a marker of the endocytic pathway, strongly accumulates in MNs from isolated spinal cords after chronic NMDA treatment. Changes in the distribution of cystatin C and presenilin-1 and an accumulation of amyloid precursor protein and β-amyloid product were also observed in NMDA-treated MNs. None of these alterations involve an interruption of MN-target (muscle) connections, as detected by the retrograde tracing of MNs with cholera toxin B subunit. These results demonstrate that chronic NMDA treatment induces severe changes in the motoneuronal endomembrane system that may be related to some neuropathological alterations described in human MN disease.


Facing the ends warping of refrigerators door, a refrigerator door is simulated using finite element theory and ANSYS software. The enclosed of finite element model and geometric model are established to conduct computing. The results show that simulated values of end warping are significantly greater than the given value of company technique standard. Several structural design schemes are proposed on the basis of production practice and theory analysis. The only one scheme of design improvement is chosen to compute using ANSYS, the results show the values of warping ends are significantly reduced and can meet the production requirements. The reasonable of finite element analysis is proven effectively through long time production.


In this article, the results of the authors' research, including analysis of the clinical and instrumental data concerning 203 patients with stroke, are presented. The factors significantly affecting the recovery of patients in the rehabilitation are determine, viz. the age, the presence of the chronic pain, the level of education, the nature of the pathological process in the brain (the stroke type), the localization of the lesion (hemispheric, stem), right/left-sided localization of the lesion, the width of the lesion, the volume of the lesion (the atrophic post-ischemic changes, the volume of hematoma), the presence of cerebral atrophy (the width of the third ventricle), the presence of leukoareosis, the presence and the severity of stenosis in the internal carotid artery, the operations on the main arteries in the medical history, the presence of focal lesions on the electroencephalogram, the presence of the perifocal brain edema, accompanied by a shift of midline structures in the acute phase of stroke, the incidence of the stroke. We distinguished the "rehabilitation subgroups" according to the representation of the basic and additional risk factors. The influence of leukoareosis on the recovery of patients after hemorrhagic stroke in shown for the first time. The values of each risk factor for the patients presenting with ischemic stroke of hemisphere and stem localization, as well as for the patients with intracerebral hematomas were calculated. The prognostically significant percentage of the clinical improvement of the patients' conditions in the course of rehabilitation for each of the subgroups is estimated.


In recent years, the sensors are cheaper and are widely available, and also many sensing technologies are rapidly emerging. Sensors are available in a compact size and hence can be installed at inaccessible situations with less effort. They are deployed on a large scale in various industries because of their low cost and discrete varieties. Due to their broad range, there is a rapid expansion in the condition monitoring of the rail systems, for instance, bridges, rail tracks, signaling, etc. Condition monitoring reduces the risks and time involved during human inspections by automated condition monitoring, and it also reduces the maintenance by identifying faults before they get worse and improves safety and reliability. With the rapid improvements in wireless communications, wireless sensor networks (WSNs) are used to monitor these infrastructures effectively using MEMS sensors. WSN condition monitoring reduces the risks, increases the reliability and provide secure communication using the IEEE 802.15.4 protocol. The paper summarizes a background and a literature survey on the WSNs in remote condition monitoring. This paper presents the application of remote condition monitoring by using the ADXL 335 MEMS accelerometer sensor. The sensor records the acceleration of the train and the signal is pre-processed before sending it to the WSN. The output is received at the base station wirelessly via WSN.


Financial market infrastructures ("FMIs"), which facilitate the execution of financial transactions, exhibit such strong economies of scale that they are natural monopolies. In each market, production is controlled by a few dominant players. Federal courts have traditionally checked the abuses of natural monopolies under the Sherman Act. Yet recent Supreme Court decisions have reined in the role of antitrust in regulated industries, where administrative bodies set and enforce standards. To this effect, financial regulations require certain FMIs to grant open, nondiscriminatory access to users.This Article argues that weak "openness" regulations must be buttressed by their antitrust counterpart — specifically, the essential facilities doctrine, which enables an excluded user to sue for wrongful denial of access to an FMI.This Article situates FMIs at the intersection of four seismic trends. First, the role of FMIs as a mitigant of systemic risk renders their growth inevitable. Second, open access has become fashionable in the regulation of other natural monopolies (e.g., net neutrality rules), but this approach requires precise standards. Third, essential facilities can supplement weak open access regulations, but the doctrine was nearly dismantled by the Supreme Court a decade ago. Finally, the balance between antitrust and regulation is due to be reset, and the next move will likely come from FMIs.


Interpersonal communication is communication between two people face to face, which allows any other person reaction catch participants directly, either in verbal or nonverbal. Interpersonal communication is only consisted of two people, such us the patient and nurse, the husband and wife, teacher and student and etc. So that communicator can see the reaction given by komunikan. But the real practice interpersonal communication is often overlooked because of time belonging to the health worker. Treatment Compliance is a complete regularly and complete treatment without interrupted for at least 6 months up to 8 months. With good interpersonal communication built up between the health worker and the patients are expected to improve patient medication adherence. This research is descriptive analytic study with the purpose of analyzing the relations interpersonal communication health worker on the compliance of patients lived treatment of Pulmonary Tuberkulosis. The population in this study were all patients with Pulmonary Tuberculosis in Sunggal the Health Center and the number of samples is entire populations that as many as 42 people. Data was obtained with the interview using questionnaire were analyzed using Chi-square test at = 0.05. The results showed the frequency of adherent patients as many as 28 people (66,7%) and non-adherentmany as 14 people (33.3%) . The results of statistical tests shows interpersonal communication variable aspects of openness, empathy, supportiveness and equality effect to compliance of patients lived treatment of pulmonary Tuberculosis in Medan Sunggal the Health Center. Pulmonary Tuberculosis. To the health worker advised that holds especially Pulmonary Tuberculosis program in order to always provide motivation to patients to regularly take medication at the health center. Normal 0 false false false IN X-NONE X-NONE


Objective Multiple attempts at labour epidural placement result in patient discomfort and high incidence of complications. Identifying the factors that lead to more than one attempt would help anaesthesiologists prepare in advance such as getting expert help and additional equipment, patient counselling or planning alternative management. Methods This prospective observational study was conducted on 500 patients from July 2017 to June 2018 after obtaining approval from the institutional Ethics Review Committee. The study patients consisted of full-term parturient women who were admitted in the labour room suite of Aga Khan Hospital requesting for labour epidural and consented to participate in the study. A predesigned form was used to collect the following data: number of attempts at epidural insertion and factors such as patients' demographics, cervical dilatation, anatomical grading of spine according to visibility and palpation of spinous process and vertebral interspace, experience level of the anaesthesiologist, patient satisfaction and pain score during labour. Results The average age of the patients was 28.11±4.02 years. The total number of epidural attempts varied between one and four; the median number of attempts was 1 [IQR=1–2]. Anatomical grade of the spine was the only factor that was significantly associated with more than one attempt at epidural insertion (p=0.0005). Patient satisfaction was negatively associated with the number of attempts (p=0.04), but mean pain difference at different time points during the course of labour was not statistically significant between patients with one attempt and those with more than one attempt. Conclusion Determining the anatomical grade of the spine is the most reliable method for predicting a technically difficult neuraxial block that requires more than one attempt at epidural insertion.