Drunkard's Progress: Narratives of Addiction, Despair and Recovery, by John Crowley (Baltimore, MD, and London, England: The Johns Hopkins University Press, 1999), 202 pp., $15.95 (paper). Listening to Lazarus: the voices of America's first "reformed drunkards" There are historically obscure points where the fields of temperance history, alcohol studies, and addiction studies dramatically intersect. John Crowley has illuminated one of the earliest and most interesting of such intersections in his latest book, Drunkard's Progress: Narratives of Addiction, Despair and Recovery. This article reviews Crowley's latest contribution, analyzes the reform narratives presented in this work for their portrayal of the processes of addiction and recovery, and reflects on what these narratives tell us about the rise and fall of America's most celebrated 19th-century alcoholic mutual aid society. I. Context: the Washingtonian Movement Rising alcohol consumption and alcohol-related problems during the late 18th and early 19th centuries triggered abstinence-based cultural revitalization movements among Native American tribes and the emergence of the American temperance movement. Published stories of addiction and recovery that began to appear in the 1820s and 1830s challenged the belief that `"There was hope for our friend, if the yellow fever or even the plague was upon him; but none if he became a drunkard."1,2 Reform narratives emerged as something of a cultural phenomenon after six "hard cases" organized their own abstinence-based mutual aid society in Baltimore, Maryland, in 1840. This society was founded on the assumption that the reformed drunkard could reach his still-drinking brethren in ways that no one else could. For the reformed inebriate knows each avenue to his brother's heart; he highly (sic] touches the strings on which hang all his sorrow; no rebuke mingles with his invitation of welcome . . . The Washington Temperance Society that was launched in Baltimore spread rapidly through the United States and at its peak claimed a membership of same 600,000-of whom 150,000 were confirmed drunkards.3, 4 The Washingtonian Movement reached its zenith in 1843 and then entered a period of rapid decline. This decline has been attributed to many factors: conflict with existing religious and temperance groups, damaged credibility resulting from the relapse of prominent members, ineffective organization, failure to maintain the original closed (drunkards only) meeting structure, internal strife (particularly debates over the role of religion in personal reformation and the advisability of the legal prohibition of alcohol), and the lack of a clearly defined long-term program of recovery.5 The Washingtonian Temperance Society placed the reformed drunkard at the head of the temperance table and used the vivid portrayal of his own fall and rebirth as an invitation for others (drunkards and moderate tipplers) to pledge themselves to lifelong abstinence from all alcoholic drink. The Washingtonians placed "experience sharing" at the center of the process of personal reform. During the early 1840s, Washingtonian temperance missionaries carried a message of hope to the drunkard by reaching out to those still suffering (active recruitment), by serving as traveling temperance orators, and by telling their stories of personal decline and resurrection in newspaper articles, pamphlets and books.b The most fully developed of the temperance narratives that emerged within the Washingtonian Movement are the focus of John Crowley's Drunkard's Progress. II. A brief review John Crowley is not a newcomer to the study of the portrayal of alcoholism within American literature. His book The White Logic: Alcoholism and Gender in American Modernist Fiction was a significant contribution.' A more recent essay, comparing the narratives of John Gough and Frederick Douglass, is a remarkable piece of research that raised for the first time the question of whether Douglass should be classified as one who reformed himself from the excesses of drink and, as such, should be positioned historically as the first African American who framed abstinence within the context of cultural as well as personal survival. …


In the present study, the cytotoxicity of 30 diterpenoids with an abietane or a halimane skeleton was determined against five human tumor cell lines (HL-60, U937, Molt-3, SK-MEL-1, and MCF-7). Diterpenoids containing an abietane skeleton including taxodone (1) and taxodione (2), as well as the semisynthetic derivatives 12, 14, 15, 17, and 22, were the most cytotoxic compounds for human leukemia cells. Overexpression of the protective mitochondrial proteins Bcl-2 and Bcl-x(L) did not confer resistance to abietane diterpene-induced cytotoxicity. Studies performed on HL-60 cells indicated that growth inhibition triggered by compounds 1, 12, 14, and 15 was caused by induction of apoptosis. This was prevented by the nonspecific caspase inhibitor Z-VAD-FMK and, in the case of compounds 14 and 15, reduced by the selective caspase-8 inhibitor Z-IETD-FMK. Cell death induced by these abietane diterpenes was found to be associated with the release of mitochondrial proteins, including cytochrome c, Smac/DIABLO, and AIF (apoptosis-inducing factor), accompanied by dissipation of the mitochondrial membrane potential (ΔΨ), and modulated by inhibition of extracellular signal-regulated kinases signaling and the p38 mitogen-activated protein kinase pathway.


This thesis investigates the use of problem-specific knowledge to enhance a genetic algorithm approach to multiple-choice optimisation problems. It shows that such information can significantly enhance performance, but that the choice of information and the way it is included are important factors for success. Two multiple-choice problems are considered. The first is constructing a feasible nurse roster that considers as many requests as possible. In the second problem, shops are allocated to locations in a mall subject to constraints and maximising the overall income. Genetic algorithms are chosen for their well-known robustness and ability to solve large and complex discrete optimisation problems. However, a survey of the literature reveals room for further research into generic ways to include constraints into a genetic algorithm framework.Hence, the main theme of this work is to balance feasibility and cost of solutions. In particular, co-operative co-evolution with hierarchical sub-populations, problem structure exploiting repair schemes and indirect genetic algorithms with self-adjusting decoder functions are identified as promising approaches. The research starts by applying standard genetic algorithms to the problems and explaining the failure of such approaches due to epistasis. To overcome this, problem-specific information is added in a variety of ways, some of which are designed to increase the number of feasible solutions found whilst others are intended to improve the quality of such solutions. As well as a theoretical discussion as to the underlying reasons for using each operator, extensive computational experiments are carried out on a variety of data. These show that the indirect approach relies less on problem structure and hence is easier to implement and superior in solution quality. The most successful variant of our algorithm has a more than 99% chance of finding a feasible solution which is either optimal or within a few percent of optimality.


This article contextualizes the films of Michael Moore in the tradition of American populism. Extending in particular from historian Thomas Frank's argument in People without Power that populism can usefully be understood as a particular American tradition of leftism, the article traces how three of Moore's films—Roger & Me (1989), Sicko (2007), and Capitalism: A Love Story (2009)—articulate political concerns that overlap with the political beliefs of American populism. The article also explores some of the populist elements in Moore's style and argues that there is good reason to see Michael Moore as a twenty-first-century American populist but that any attempt to do so must remain clear about the definitions of populism used to make this contextualist argument.


How does music embody cultural meaning? What is the cultural significance of musical structure? How is music linked with other domains of human behaviour, meaning and experience in oral cultures?

An approach to these questions might be based on the concept of schema as used in cognitive psychology (Bartlett 1932, Neisser 1976, Mandler 1984 etc.), cognitive anthropology (D'Andrade 1995, Shore 1996, Bloch 1998, 2012) and music cognition (Rosner and Meyer 1982, Gjerdingen 1988, 2007, Byros 2012). The term refers to an array of cognitive categories in a flexible relationship, which is acquired in memory through repeated experience and deployed in everyday life. Music employs highly specialised schemas that generate expectations (Huron 2006); they may be especially significant in orally transmitted music where the role of memory is paramount (cf Rubin 1995). Schemas can also carry meanings, explicit or implicit, and may re-appear in different, apparently unrelated cultural domains: such "foundational schemas" (Shore 1996) can link music, psychological experience, and other domains of culture – social, religious, architectural etc. (Widdess 2012, Lewis 2013).

To illustrate this approach I here analyse one example of a dāphā song, showing how its schematic structure can be related to schemas in other cultural domains. Dāphā is a tradition of sacred singing performed in the city of Bhaktapur, in the Kathmandu Valley, Nepal (Widdess 2013). It is performed by neighbourhood groups of male singers of the farmer castes (Ill. 1, p. 11), who belong to the Newar ethnic group. Their music is transmitted orally, and its performance is deeply embedded in local social and religious culture.


This study has examined whether estrogen regulates GABA transporter synthesis and activity in the female rat brain. In the first experiment in situ hybridization studies examined the effects of ovariectomy on cellular GABA transporter-1 (GAT-1) mRNA content. A 25% decrease in GAT- 1 mRNA expression was detected within the medial preoptic area (MPOA) but not the parietal cortex, magnocellular preoptic nucleus (Mg-POA) or caudate-putamen (C-P). Estrogen replacement for 7 d returned GAT-1 mRNA content of MPOA cells to levels observed in intact rats. In the second experiment, the effect of increased brain GABA concentrations on GAT-1 mRNA expression was investigated by treating rats with gamma-vinyl GABA, a GABA-transaminase inhibitor. Although resulting in a twofold increase in tissue GABA content, in situ hybridization experiments revealed no changes in GAT-1 transcript expression. A third series of experiments examined GABA transporter activity in vitro using a 3H GABA uptake assay in MPOA, cortex, and C-P punches. Nipecotic acid (10 microM) reduced specific 3H GABA uptake in all three brain regions while 100 microM beta-alanine only reduced uptake in the MPOA. Estrogen treatment for 7 d resulted in a significant increase in 3H GABA uptake in the MPOA but not the cortex or C-P. The presence of a putative estrogen response element in the GAT-1 gene and the effects demonstrated here on GAT-1 mRNA content and GABA transporter activity indicate that estrogen may influence GAT-1 gene transcription to alter GABA transporter function within the MPOA but not the C-P or cortex.


The pT to IT phase transition in end-member anorthite, CaA12Si20g, has been reversed in-situ at high pressures and temperatures in an internally heated diamond-anvil pressure cell using single-crystal X-ray diffraction. The unit-cell parameters of anorthite were determined at 48 temperature-pressure points up to 255 OCand 2.6 GPa. At high pressures and temperatures, from room temperature up to -225°C, the transition is marked by a first-order step in the unit-cell volume and the complete disappearance of c and d reflections from the diffraction pattern. From room temperature to -195 °C and 2.1 GPa, the transition boundary is linear and nearly isobaric, with a slope, dP/ dT, of -0.003 GPa/°C. From 195 to 240°C and 1.5 GPa the boundary is curved, with increasingly negative dP/dT, and the magnitudes of 11V and the scalar strain associated with the transition decrease to about 75% of their high-pressure values of -0.2 and -0.011 %. From 1.5 GPa to room pressure, the boundary is isothermal at 240°C and is marked by the disappearance of the c and d reflections, although there are no detectable discontinuities in the unit-cell parameters. The phase transition remains unquenchable over the entire boundary. The distinct changes in character of the phase transition and the trajectory of the equilibrium boundary in P-T space are associated with a crossover in the IT phase field that is marked by a sudden change in cell parameters of this phase over the pressure interval of -1.5-2.0 GPa.


Abstract Aminoglycosides are commonly used antibiotics with excellent renal parenchymal penetration. Their clinical effectiveness is counter balanced with the risk of renal toxicity, which develops in a dose-dependent fashion. Aminoglycoside-induced renal tubular dysfunction could result in diffuse damage or manifest as a Fanconi-like syndrome, Bartter-like syndrome (BLS), or distal renal tubular acidosis.1–4 Although tubulopathy associated with amikacin and gentamicin was reported in adults and rarely children, to the best of our knowledge, netilmicin-associated BLS neither in adults nor in children has been reported in the literature. We here report a 30-week, 770 g male preterm infant who developed BLS just after netilmicin treatment for neonatal sepsis and recovered 6 weeks after the drug cessation.


Quantum information processing using photons has recently been stimulated by the suggestion to use linear optics, single photon sources and detectors. The recent work by Knill has also shown that errors in photon detectors leads to a high error rate threshold (around 29%). An important missing element are good single photon sources. In this paper we show how to make a single photon source using squeezed states, linear optics and conditional measurement. We use degenerate squeezed vacuum states, in contrast to the normal non-degenerate squeezed vacuum states used for single photon production. We show that we can get a photon with certainty when detectors click appropriately, the last event happening up to around 25% of the time. We also show the robustness of this method with respect to a variety of potential imperfections.


Content Based image retrieval (CBIR) is next big thing on search market. Performing content based image retrieval on internet databases connected using P2P network is the scope of our work. In case of unstructured P2P network CBIR has many challenges in terms of routing, match making etc. Authors in [1] have proposed a P2P-CBIR search engine to provide scalable image retrieval which can adaptively control the query scope and progressively define the accuracy of query results. But the problem in this solution is that query search time is high. We take this problem and propose optimizations to work in [1], so that the image search time can be reduced.


[Extract:] Celebrities are a ubiquitous aspect of contemporary Western culture. Although the phenomenon of celebrity itself predates the twentieth century, the rise of the modern mass media – popular newspapers, cinema, radio, and television, and more recently the Internet and other digital communication technologies – has done much to promote and circulate public knowledge of celebrities during the last 100 years. The presence of multi-channel digital television, radio, and the World Wide Web in Western households at the turn of the twenty-first century has not only increased the number of places in which celebrities can be seen and heard, but has also required media producers to compete with each other and with alternative leisure activities for the attention of fragmented audiences, an increasingly precious commodity.
The rise of celebrity culture is inextricably linked to developments in media systems that operate within capitalist systems of commodity exchange. Most obviously, celebrities provide a well-proven route to attracting and retaining audiences, helping to offset the risks inherent in cultural production. They also play out a fantasy of the individual simultaneously performing within public and the private spheres. As P. David Marshall neatly puts it, celebrities might be seen as a "production locale for an elaborate discourse on the individual and individuality" (1997: 4). However the ubiquity of celebrity culture does not mean that its considerable diversity can be ignored. A cursory glance through the prime-time television schedules, for instance, reveals how one might choose between shows featuring celebrity hosts and guests, contest-based reality television shows that participate in the construction of celebrity, personality driven lifestyle programming, sports shows featuring star athletes and commentators, and even political shows with celebrity journalists. All of this is indicative not just of the pervasiveness of modern celebrity culture but also its diversity and breadth.


BRCA1-BARD1 constitutes a heterodimeric RING finger complex associated through its N-terminal regions. Here we demonstrate that the BRCA1-BARD1 heterodimeric RING finger complex contains significant ubiquitin ligase activity that can be disrupted by a breast cancer-derived RING finger mutation in BRCA1. Whereas individually BRCA1 and BARD1 have very low ubiquitin ligase activities in vitro, BRCA1 combined with BARD1 exhibits dramatically higher activity. Bacterially purified RING finger domains comprising residues 1–304 of BRCA1 and residues 25–189 of BARD1 are capable of polymerizing ubiquitin. The steady-state level of transfected BRCA1 in vivo was increased by co-transfection of BARD1, and reciprocally that of transfected BARD1 was increased by BRCA1 in a dose-dependent manner. The breast cancer-derived BARD1-interaction-deficient mutant, BRCA1C61G, does not exhibit ubiquitin ligase activity in vitro. These results suggest that the BRCA1-BARD1 complex contains a ubiquitin ligase activity that is important in prevention of breast and ovarian cancer development.


This article provides a legal perspective on the new European External Action Service (EEAS), and positions this new body in the reshuffled institutional balance of EU external relations. To that end, the paper examines the EEAS's legal nature as compared to that of Council, Commission, their support services and EU agencies, and seeks to define the EEAS's sui generis status in the EU institutional set-up. Some relevant questions are: What are the implications of its absence of legal personality, what does its "functional autonomy" from the Council and Commission imply, what are its formal powers - if any, and could the EEAS be drawn into proceedings before the Court of Justice? In answering those questions, this article then examines to what extent the legal-institutional choices on the structure of the EU External Action Service reflects the age-old tension entrenched in EU external relations law: the EU's nature as an internally diverse entity, which seeks to present a coherent Union voice to the world.


The Electronic Medical Record (EMR) is the essential tool of the clinical consultation, effectively replacing the paper medical record. Since its gradual adoption in the early 2000s there has been a failure to achieve even moderate levels of EMR usability in clinical settings, resulting in a negative impact on clinical care, time efficiency and patient safety. This research explores how deeper collaboration with clinical users through participatory design, drawing on the disciplines of visual design, user experience (UX) design and visual analytics, might offer a more effective approach to this important problem.

The lead researcher for this project is both a practising doctor and design researcher. Usability of two commercial EMR interfaces in the field of sexual health is explored through a mixed method survey, with responses used to inform the design of an interface provotype. This in turn is evaluated through repeat survey and 'test-drive' talk-aloud workshops. Results from the survey on two commercial EMR interfaces (n=49) revealed deep dissatisfaction particularly around issues of navigation, flow of consultation, frustration, safety, time-dependent and time-independent data, data complexity and data salience. Comparative provotype evaluation (n=63) showed that clinically-relevant visualisation offers marked gains in clinical usability and performance.

This research argues for a re-imagining of the way we look at medical data during the clinical consultation so that the affordances and benefits of the digital format can be exploited more fully. It highlights the value of combining participatory design with visualisation to embed explicit, experiential and even tacit clinical knowledge into the EMR interface.


Objective: This article aims to review and provide more understanding of current knowledge of amniotic fluid embolism regarding pathophysiology, diagnostic criteria, risk factors, indicating biomarkers, treatment strategies and outcomes of some case reports. Study design: A systematic literature review was performed using the PubMed database, restricted to articles published in English from 1992 to 2018. Original research, case reports, guideline recommendations, and review articles were reviewed in this study. Summary: Amniotic fluid embolism (AFE) is a rare catastrophic obstetric condition defined by clinical manifestations of pregnancy with sudden onset of cardiopulmonary arrest, consumptive coagulopathy or neurological deficits without other explainable illnesses. The incidence varies from 1.7-14.8 cases per 100,000 worldwide. The current understanding of AFE pathophysiology includes fetal components obstructing maternal microvessels with subsequent anaphylactoid reaction. Maternal pulmonary vasospasm and hematologic activation occur later, followed by heart failure and sudden cardiovascular collapse. Some of the possible risk factors for AFE include; 1) Maternal risk: age over 35 years, hypertensive disorder and diabetes mellitus; 2) Fetal risk: polyhydramnios, multiparity, non-vertex at delivery, fetal distress and fetal macrosomia; 3) Obstetric risks: amniocentesis, artificial amniotic fluid injection, oxytocin infusion, and placental abruption. Some of the useful biomarkers have been proposed including zinc coproporphyrin-1, squamous cell carcinoma antigen, carcinoembryonic antigen, cancer antigen 125, Siatyl Tn, monoclonal antibody TKH-2, C3, C4, tryptase, insulin-like growth factor binding protein-1, C1 esterase inhibitor. Management of AFE requires immediate basic life support and advanced cardiac life support. Adequate oxygenation, ventilation, coagulopathy correction, and appropriate vasopressors are recommended. However, the outcome prediction of AFE remains challenging.


Aiming at that superheated steam temperature system exists the large inertia and large time delay of the dynamic characteristics,and the converge speed of the conventional CMAC neural network is not fast enough to the real-time system, a credit assignment CMAC (CA-CMAC) neural network control is adopted in superheated steam temperature control system, which is proposed to speed up the learning process in CMAC. The simulation of the superheated steam temperature control system shows that CA-CMAC converges faster than the conventional CMAC. This result illustrates the effectiveness of this method.


ABSTRACT Vibrio tubiashii is a recently reemerging pathogen of larval bivalve mollusks, causing both toxigenic and invasive disease. Marine Vibrio spp. produce an array of extracellular products as potential pathogenicity factors. Culture supernatants of V. tubiashii have been shown to be toxic to oyster larvae and were reported to contain a metalloprotease and a cytolysin/hemolysin. However, the structural genes responsible for these proteins have yet to be identified, and it is uncertain which extracellular products play a role in pathogenicity. We investigated the effects of the metalloprotease and hemolysin secreted by V. tubiashii on its ability to kill Pacific oyster (Crassostrea gigas) larvae. While V. tubiashii supernatants treated with metalloprotease inhibitors severely reduced the toxicity to oyster larvae, inhibition of the hemolytic activity did not affect larval toxicity. We identified structural genes of V. tubiashii encoding a metalloprotease (vtpA) and a hemolysin (vthA). Sequence analyses revealed that VtpA shared high homology with metalloproteases from a variety of Vibrio species, while VthA showed high homology only to the cytolysin/hemolysin of Vibrio vulnificus. Compared to the wild-type strain, a VtpA mutant of V. tubiashii not only produced reduced amounts of protease but also showed decreased toxicity to C. gigas larvae. Vibrio cholerae strains carrying the vtpA or vthA gene successfully secreted the heterologous protein. Culture supernatants of V. cholerae carrying vtpA but not vthA were highly toxic to Pacific oyster larvae. Together, these results suggest that the V. tubiashii extracellular metalloprotease is important in its pathogenicity to C. gigas larvae.


: This prospective study examined the characteristics of children admitted to a pediatric emergency department and the factors that influenced the successful establishment of peripheral intravenous (IV) access. Descriptive and correlational analysis was completed using a convenience sample of 89 patients. Peripheral IV access was successful in 95.7% of the children, and the first attempt at insertion was successful in 53% of the procedures. Factors influencing the success of peripheral IV access were the patient's gender, skin color, presence of difficult-to-see veins, small veins, presence of fever, and a lack of palpable veins.


Rapid technological advances in molecular biology, including next-generation sequencing, have identified key genetic alterations in central nervous system (CNS) tumors. Accordingly, the fifth edition of the World Health Organization (WHO) CNS tumor classification was published in 2021. We analyzed 303 patients with diffuse glioma using an amplicon-based glioma-tailored gene panel for detecting 1p/19q codeletion and driver gene mutations such as IDH1/2, TERTp, EGFR, and CDKN2A/B on a single platform. Within glioblastomas (GBMs), the most commonly mutated genes were TERTp, TP53, PTEN, NF1, and PDGFRA, which was the most frequently mutated tyrosine kinase receptor in GBM, followed by EGFR. The genes that most commonly showed evidence of loss were PTEN, CDKN2A/B, and RB1, whereas the genes that most commonly showed evidence of gain/amplification were EGFR, PDGFRA, and CDK4. In 22 grade III oligodendroglial tumors, 3 (14%) patients had CDKN2A/B homozygous deletion, and 4 (18%) patients had ARID1A mutation. In grade III oligodendroglial tumors, an ARID1A mutation was associated with worse progression-free survival. Reclassification based on the WHO 2021 classification resulted in 62.5% of grade II/III isocitrate dehydrogenase (IDH)-wildtype astrocytomas being classified as IDH-wildtype GBM and 37.5% as not elsewhere classified. In summary, our glioma-tailored gene panel was applicable for molecular diagnosis in the WHO 2021 classification. In addition, we successfully reclassified the 303 diffuse glioma cases based on the WHO 2021 classification and clarified the genetic profile of diffuse gliomas in the Japanese population.


Soyfoods are consumed by many because of cultural factors, for potentialThere are strongly conflicting data regarding soy intake and breast cancer. As such, if women (with or without breast cancer) enjoyed partaking of soy products, then it seems quite reasonable for them to partake of them. As with most things, moderation in intake is probably wise. beneficial effects on overall health, and for the unproven hope that they will ease menopausal symptoms in women.[1]


Lithospheres of different thicknesses are often juxtaposed by movement on a continental-transform boundary. Such a boundary with a step change in densities may trigger a gravitational instability as lateral pressure gradients are created where normal mantle lithosphere terminates against less dense asthenospheric mantle. Here we show, for plausible values of the lithospheric viscosity, a mechanism by which the thicker mantle lithosphere will drip off into the lower density asthenosphere. As the mantle deforms it also progressively thickens and then thins the overlying crust, creating a topographic wave that migrates in concert with the removal of mantle lithosphere. Within western North Island, New Zealand, geophysical data define a sharp lithospheric step across the Taranaki-Ruapehu line, and geological observations provide a history of uplift and subsidence that has propagated southward in the past 12 m.y. The rate of observed north to south migration of the wave (∼30 mm/yr), its wavelength (∼250 km), and amplitude (∼±1 km) are compatible with it being caused by progressive removal of mantle lithosphere, if the viscosity of the uppermost lithospheric mantle is ∼5 × 10 20 Pa⋅s, providing one of the clearest examples yet of this fundamental geological process.


Currently multicore systems start to be used even in low-end devices such as embedded systems controllers requiring real-time guarantees. Hardware Transactional Memory (TM) is a new synchronization paradigm for this architecture, allowing problems of lock-based methods and making easer programming. We propose to use TM to synchronize the concurrent/parallel execution of the Garbage Collector (GC) and Java applications, within the context of an embedded real-time environment. GC gives robust programming, and performance advantages. Since in the context of real-time systems, a collector must guarantee a worst-case in it performance, the worst-case time for a committed transaction must be limited; we achieve this by limiting its size (i.e., the size of the explored object).


First published in 1991, "The Presidency of Theodore Roosevelt" has won acclaim as a lucid and thorough narrative of Roosevelt's two terms in the White House. Reviewers praised the depth of Lewis L. Gould's research, his comprehensive coverage of major aspects of Roosevelt's tenure, and the persuasiveness of his conclusions about his subject's personalized presidency. Writing in Reviews in American History, Willard Gatewood called the book "essential reading for all who wish to understand the complex, charismatic, and perennially fascinating political figure that was Theodore Roosevelt."" Long considered the standard work on its subject, Gould's book is a trusted source that newcomers to Roosevelt's years in the White House and experts in the field could consult with confidence in its research and historical judgments. It has also become an essential adoption for courses on the era, effectively engaging undergraduates and graduate students who have praised the author for his clarity and evenhandedness. Responding to frequent suggestions that the book be brought up-to-date to incorporate the excellent studies of Roosevelt's presidency that have appeared since 1991, Gould has provided a new edition that he believes "will reintroduce a new generation of readers to the fun and importance of an ebullient, lively chief executive." In this revised and expanded edition, Gould has built on the sterling qualities of the first edition and added new information and analysis based on continuing research and a command of the literature on Theodore Roosevelt's presidency published during the last two decades. He has tightened the prose and added numerous references to the latest scholarship on this most engaging of presidents. Interested readers will find new discussions of the origins of Roosevelt's creation of the Tongass Forest in Alaska, his treatment of a dissenting federal employee named Rebecca Taylor who took her grievance to the Supreme Court, the recent controversy over Roosevelt's relationship with Japan, the dispute over whether the president issued a warning to Germany about Venezuela in 1902-1903, and the important role of a little-known conservative senator named Winthrop Murray Crane. With these and other changes, the updated version of Gould's text provides an even more compelling narrative that broadens the already fascinating story of Roosevelt in power with new insights and perceptive conclusions.


Hydrothermal processing has received increased interest mostly in the area of waste conversion to higher density fuels. However in addition to energy generation from these materials, it has become a promising route for nutrient extraction and recovery from either the solid or aqueous products depending on the processing temperature. This research was carried out in phases with the aim to improve extraction of nitrogen and phosphorus from various nutrient-rich wet wastes and the potential to recover these nutrients by biological means or by adsorption unto biochar.

The initial study was on various hydrothermal processing routes – thermal hydrolysis (TH), hydrothermal carbonisation (HTC), hydrothermal liquefaction (HTL) and supercritical water gasification (SCWG) at 170°C, 250°C, 350°C and 500°C respectively using high moisture and high nutrient feedstocks namely microalgae, digestate, swine manure and chicken manure. Experiments were conducted with 10:1 water: solid ratio and 1 hour residence time except for SCWG which was 30 minutes with 15:1 water: solid ratio. The fate of N, P and other inorganics from each feedstock during these processes were investigated as well as the product yields, composition of the aqueous products and solid products. The results indicate that feedstocks behave differently during hydrothermal processing with the composition and yields of by products depending largely on feedstock composition and processing temperature. Highest solid yields were obtained at lowest temperatures while highest gas yields were obtained at the highest temperature. HTL favour formation of highest biocrude. Aqueous products from lower temperatures contain higher P levels (mainly organic-P and less phosphate) and lower N levels (mainly organic-N and less NH3-N). At higher temperature it is vice versa. Extracted P depends on Ca, Mg and Fe in unprocessed feedstock. P is immobilised in solid product at higher temperatures. TOC in aqueous product decrease with increasing processing temperature.

The effect of additives on nutrient extraction during low temperature processing –Thermal hydrolysis at 120°C and 170°C as well as HTC at 200°C and 250°C using different reagents - alkali (0.1M NaOH), mineral acid (0.1M H2SO4) and organic acids, (0.1M CH3COOH and 0.1M HCOOH) was investigated. All experiments were performed with 10:1 water: solid ratio in high pressure 600 mL Parr batch reactor for 1 hour. The nutrient mass flow balance during these processes, the composition of the aqueous product and solid products were investigated. The results indicate that TN is significantly affected by temperature rather than pH. NH3-N in aqueous product increases with increasing temperature while organic- N reduces. Phosphorus extraction is pH and temperature dependent and further enhanced with additives. Acidic conditions favour phosphorus extraction especially with H2SO4 at all temperatures; highest (94%) extracted using H2SO4 at 170°C and presents opportunity for nutrient recovery. Neutral or basic conditions immobilise P in hydrochar and offers potential route for manure management as P-loss is reduced in the environment. Mg, Na and K are mostly extracted into aqueous product, while Ca and P concentrate in solid product as temperature increases. Acidic conditions extracted higher levels of micronutrient compared to water or NaOH. Generally micronutrients were more in the solid for most additives except H2SO4 while Ni and Al were mostly in the solid products.

Microwave pre-treatment of various feedstocks such as sewage sludge, microalgae, digestate and manures was performed with 15:1 water: solid ratio at 120°C for 15 minutes. Also the influence of additives on nutrient extraction from swine manure was also investigated. Results show that aqueous products contain significant levels of N and P; nitrogen mainly as organic-N rather than NH3-N for all feedstock while it was mainly as organic-P for sewage sludge and digestate and more as phosphate with microalgae and manures. High TP was extracted with acidic reagents rather than with water or NaOH. With most additives, N in aqueous product was mainly as organic-N than NH3-N while P in the aqueous product was mainly as phosphate rather than organic-P. Aqueous products contain most K and Na while the residues contain most Ca, Mg, P and micronutrients for most feedstocks. Acidic conditions most especially with H2SO4 extracted more Ca, Mg, P, Co, Mn, and Zn unlike neutral or alkaline conditions. In comparison with conventional heating, microwave heating generally extracted more nitrogen and phosphorus into the aqueous products.

Biological recovery of nutrients using various SCWG aqueous waste streams showed significant autotrophic growth of Chlorella in the diluted aqueous products except for the aqueous product from SCWG of Chlorella diluted at 1:50. Chlorella was able to utilise ammonium as a source of nitrogen. Higher dilutions of 1:400 had insufficient nutrients to promote growth. Biomass obtained from 1:50 dilution of catalysed SCWG of S. latissimi, L.digitata, sewage sludge and 1:200 dilution of SCWG Chlorella were comparable with biomass obtained using the standard Bold's Basal Media. The recovered biomass could be used as feedstock for biodiesel or lipid extraction. Physical recovery of phosphate from H2SO4 extracted aqueous products by adsorption using Mg modified biochar shows that phosphate adsorption is affected by concentration and pH. Highest adsorption was achieved with 250 mg/L while higher adsorption efficiency was achieved at pH 8 and 9 compared to pH 7, precipitating more calcium phosphate on the biochar. Phosphate adsorption did not occur at lower/acidic pH conditions. There was no likelihood of struvite precipitation as EDX analysis showed no additional nitrogen and Mg in the adsorbed chars.


By Ronald B. Strode This study seeks to examine how American institutions and value orientations affect the spirituality of yoga. Secondary data is used to argue how social institutions exercise their power to influence the behaviors of individuals. The works of thinkers such as Robert Bellah, Wapola Rahula, and Michel Foucault are discussed to support theories on how norm conformance is used to maintain social order. Individuals in America are influenced by a variety of social institutions with each having its own agenda-serving purpose. Institutions use individuals' "self-interests" to promote specific agendas, and individuals are unconsciously serving as "tools" to legitimize these institutions. The results of this study show that individuality is an illusion in that it is surrendered to powerful interests. Power exercised by institutions causes the individual to conform to standards based on the goods and services that they promote. Through this social process, American institutions have even transformed yoga's spirituality into a commodity designed to increase the usefulness of the "individual body." DOES AMERICAN INDIVIDUALISM CHANGE YOGA'S ORIGINAL PURPOSE?


BACKGROUND
The most common surgical intervention to treat velopharyngeal dysfunction in the US is the posterior pharyngeal flap (PPF). In this retrospective study, the authors compare surgical and speech outcomes across 2 PPF surgical approaches: the palatal split (PS) and fish mouth (FM) techniques.

METHODS
An Institutional Review Board approved retrospective chart review was performed for PPF cases performed by a single surgeon between 2008 and 2016. Overall, 40 patients received the PS technique and 47 received the FM technique. Age at surgery, operative length, length of stay (LOS), revisional surgery, and pain medication administration were measured. Speech outcomes were measured based on the Universal Parameters for Reporting Speech Outcomes and included Speech Language Pathologist ratings of hypo- and hypernasality, speech acceptability, and audible nasal emission. Two sample t-tests and multivariable-mixed effects logistic regression were used to analyze the data.

RESULTS
Comparing the 2 groups (PS versus FM), there were statistically significant differences among the operative approaches across multiple measures: LOS (32.86 hours versus 26.20 hours, P = 0.01), acetaminophen use (1523.54 mg versus 805.74 mg, P = 0.01), revisional surgery rate (17.5% versus 2.10%, P = 0.02), and degree of postoperative hypernasality (0.61 versus 0.29, P = 0.03). Syndromic patients were more likely to receive the FM technique (PS: 15% versus FM: 29.8%; P = 0.05). The odds ratio for revision surgery with the FM technique was -2.32 (CI: -4.32 to -0.35, P = .04).

CONCLUSIONS
In this study, the FM technique offered a shorter LOS, lower revision rate, less acetaminophen administration, and more favorable speech outcomes when compared to the PS technique.


How morphogenesis depends on cell properties is an active direction of research. Here, we focus on mechanical models of growing plant tissues, where microscopic (sub)cellular structure is taken into account. In order to establish links between microscopic and macroscopic tissue properties, we perform a multiscale analysis of a model of growing plant tissue with subcellular resolution. We use homogenization to rigorously derive the corresponding macroscopic tissue scale model. Tissue scale mechanical properties are computed from all microscopic structural and material properties, taking into account deformation by the growth field. We then consider case studies and numerically compare the detailed microscopic model and the tissue-scale model, both implemented using finite element method. We find that the macroscopic model can be used to efficiently make predictions about several configurations of interest. Our work will help making links between microscopic measurements and macroscopic observations in growing tissues.


We propose a fault tolerant, peer-to-peer replication network for synchronizing files across multiple hosts. The proposed topology is constructed by applying existing technologies and tools to ensure that files are kept synchronized even after subsequent modifications. One of its main advantages lies in the fact that there is no central authority to coordinate the process, hosts are connected in a peer-to-peer fashion, thus avoiding a single point of failure. Our proposal is intended for use in networks of personal computers where a small number of hosts have to be synchronized.


POLYMER SCIENCE
When block copolymers (in which "blocks" of dissimilar polymers are connected in a single chain) are placed in solution, they can behave like surfactants if the two blocks of the polymer have differing affinities for the solvent and thus form micelles, spheres, cylinders, and vesicles.

Luo and Eisenberg studied a system of polystyrene- b -poly(acrylic acid) (PS- b -PAA) in a mixed solvent, where vesicles form with a hydrophobic PS corona sandwiched between hydrophilic PAA inner and outer shells. The size of the vesicles is thermodynamically (and reversibly) controlled by solvent composition. Increasing the water content raises the interfacial energy and increases the vesicle size. For small vesicles, segregation is observed between the long PAA segments that migrate to the outside of the vesicle and the short blocks that remain inside. Small changes in solvent composition lead to rapid and dramatic changes in the equilibrium vesicle size, which indicates that there is a constant flux in the vesicle sizes, possibly through fusion and fission mechanisms.— MSL

Langmuir , 10.1021/la0104370.


Background Diabetic ketoacidosis (DKA) is the leading cause of mortality in childhood diabetes, and at diagnosis might represent delayed presentation. The extent and reasons for delays are unclear, but identifying and targeting factors associated with DKA could reduce this incidence. Objective To compare the patient pathway before diagnosis of type 1 diabetes mellitus (T1DM) in children presenting with DKA and non-acidotic hyperglycaemia. Design, setting and patients Over a 3-month period, children newly diagnosed with T1DM were identified on admission to UK hospitals. Parents and medical teams completed a questionnaire about events before diagnosis. Results Data were available for 261 children (54% male), median age 10.3y (range 0.8–16.6 y). 25% presented with DKA, but more commonly in children <2y (80% vs 23%, p<0.001). Fewer children with DKA reported polyuria (76% vs 86%) or polydipsia (86% vs 94%) (both p<0.05), but more reported fatigue (74% vs 52%) and weight loss (75% vs 54%) (both p<0.01). 24% of children had multiple healthcare professional (HCP) contacts, and these children had lower pH on admission. 46% of children with a delayed presentation to secondary care had non-urgent investigations. 64% of parents had considered a diagnosis of diabetes, and these children were less likely to present with DKA (13% vs 47%, p<0.001). Conclusions Multiple HCP contacts increased risk of presentation in DKA, whereas, parental awareness of diabetes was protective. Improved public and health professional education targeting non-classical symptoms, awareness of diabetes in under 2 y, and point-of-care testing could reduce DKA at diagnosis of diabetes.


Learning goal-directed behaviours requires integration of separate information streams representing context, relevant stimuli and reward. Dendrites of pyramidal neurons are suitable sites for such integration, but it remains elusive how their responses adapt when an animal learns a new task. Here, we identify two distinct classes of dendritic responses that represent either contextual/sensory information or reward information and that differ in their task- and learning-related dynamics. Using longitudinal calcium imaging of apical dendritic tufts of L5 pyramidal neurons in mouse barrel cortex, we tracked dendritic activity across learning and analyzed both local dendritic branch signals and global apical tuft activity. During texture discrimination learning, sensory representations (including contextual and touch information) strengthened and converged on the reward-predicting tactile stimulus when mice became experts. In contrast, reward-associated responses were particularly strong in the naïve condition and became less pronounced upon learning. When we blocked the representation of unexpected reward in naïve animals with optogenetic inhibition, animals failed to learn until we released the block and learning proceeded normally. Our results suggest that reward signals in dendrites are essential for adjusting neuronal integration of converging inputs to facilitate adaptive behaviour.


Background Psychotropic drugs may cause cutaneous eruptions with various degrees of severity ranging from urticaria to 'angioedema' (AE). Respiratory tract obstruction needs emergency care. Purpose To report on a patient who developed facial AE following treatment with risperidone. Materials and Methods An 85-year-old woman was admitted to the emergency department (ED) for acute respiratory failure 24 hours after risperidone was introduced. Results She presented macroglossia, dyspnoea and oedema of the soft palate, unresolved with antihistamines and steroids. In the ED, risperidone was reintroduced for agitation. It was immediately followed by severe dyspnoea, oedema of the tongue and uvula requiring admission to the intensive care unit. Risperidone imputability was suspected after a review of the literature. The Regional Reference Centre for Bradykinin AE (BAE) was consulted. Allergic oedema caused by risperidone but not BAE was concluded (delay of occurrence, absence of real BAE case with risperidone). Risperidone was stopped, the patient was monitored and treated with the optimal dose of steroids and antihistamines. Oedema resolved in 48 hours and patient went back home without sequelae. Naranjo evaluation scored 9, so it was highly probable that oedema was linked to the drug. Conclusions AE can result in laryngeal oedema and fatal airway obstruction. When differential diagnoses are eliminated, AE is classified into allergic/pseudo-allergic or bradykinin-related (hereditary or acquired with angiotensin-converting enzyme inhibitors and sartans). The mechanism of drug-induced BAE seems to be mediated by increased plasma bradykinin levels, because these drugs reduce its breakdown. AE has been reported to occur with antipsychotics like risperidone, but these drugs probably produce histaminergic AE, not BAE. In our case, this hypothesis must be ruled out with cutaneous allergology prick tests with risperidone. Diagnosis of BAE can be difficult. Clinical signs and oedema resistant to conventional treatments have led to suspicion of BAE. French Reference Centres can improve and optimise detection and treatment of these orphan diseases and limit use of expensive drugs (e.g. icatibant: 6,300 US dollars per patient). No conflict of interest.


: During the past 25 years psychiatry has increased its understanding of the social context of schizophrenia in four major areas. Reasonable reliability can now be achieved in describing and recognizing many of the acute and chronic syndromes, so that comparability can be achieved between different research teams. Much is now known about the proximate social causes of symptoms and disabilities. The relationship between social and pharmacological treatments is now better understood. A more rational approach to the planning and prescription of services and to the counseling of patients and relatives can be made. Each of these lines of advance promises to lead to further progress in the future.


This study aimed to examine the dynamics and factors that influence flourishing in female flood survivors. flourishing is defined as a condition in which life a person experiences happiness and meaningfulness. The research used a qualitative method by in-depth interviews. The subjects were seven female flood survivors who had moderate to high levels of flourishing. The data were analyzed using the thematic analysis by coding the obtained descriptive data. The credibility of the data was confirmed by a significant other as a reliable source that has a thorough understanding of the subject's life. The results showed that survivors perceived that they flourished because they had a strong motivation to achieve their desired goals. A positive relationship with friends, family, and lecturers lead survivors to perceive that there are no obstacles to attain their goals. Student survivors also play their role as students, family members, and community members seriously (engagement), due to a sense of responsibility towards their own quality of life and success which they perceive is self-determined. A fighting spirit (motivation), a sense of care or concern, gratitude, and a resilient and robust personality are important factors that influence subjects flourishing.


Chronic obstructive pulmonary disease (COPD) is a widespread condition markedly deteriorating quality of life; it is the fourth most frequent cause of death after cardiovascular diseases, diabetes mellitus and injuries. There is significant association between the severity of androgen deficiency occurrence, duration and pharmacotherapy of COPD. Androgen deficiency in men should be regarded as a new systemic pathogenetic mechanism of COPD complicating its clinical course, prognosis of the disease and concomitant pathologies. Therefore, pharmacotherapy of COPD should be prescribed taking into account the androgenic status of the patients.


Streptokinase (1 million international units) was given intravenously over 30 or 60 minutes to 50 patients four hours or less after the onset of acute myocardial infarction. All were aged less than or equal to 70 years and had 4 mm or greater ST segment elevation in anterior or inferior leads. Rapid (mean 95 min) ST segment resolution, which was taken to indicate reperfusion of the myocardium, occurred in 36 (72%) patients. In these 36 the average time from onset of symptoms to peak creatine kinase, creatine kinase MB, and myoglobin was 9.45 hours, whereas it was 17 hours in the 14 patients in whom indirect criteria did not indicate reperfusion. Reperfusion arrhythmias were invariably present and ventricular tachycardia developed in five patients and ventricular fibrillation in two. The infarct related artery was seen to be open in 28 (70%) of the 40 patients who had delayed coronary arteriography. The frequency of patency in the infarct related artery was no different in patients given streptokinase less than 2 hours or between 2-4 hours from onset of symptoms nor did it differ when streptokinase was infused over 30 or 60 minutes. Mean left ventricular ejection fraction was 57% in those with a patient infarct related artery and 48% in those with an occluded vessel. Eight patients subsequently underwent elective percutaneous transluminal coronary angioplasty after successful thrombolysis and six had coronary artery bypass grafting. There were nine in-hospital reocclusions of the infarct related coronary arteries. Two bleeding episodes occurred; one required transfusion. Five of the 50 patients died in hospital. All of them had had an anterior myocardial infarction; four had bifascicular block and one had right bundle branch block. During follow up, four patients died, two suddenly and two from reinfarction. During follow up (mean 15 months) the frequency of reinfarction, dyspnoea, and angina was low and there was no difference in the proportions of patients returning to work between those with an open infarct related artery and those with a closed infarct related artery. Intravenous administration of high dose streptokinase to selected patients during the acute phase of myocardial infarction is a safe, effective, and practical method of thrombolysis. It must, however, be followed by coronary arteriography to select those patients in whom percutaneous transluminal coronary angioplasty or coronary artery bypass grafting will be helpful.


In this thesis I examine the event modifier lexemes slow, fast and quick and the events they modify. A number of observations made of the use of these modifiers cannot be explained by existing event typologies. Instead I propose a model for event structure and construal, in which I define events according to their temporal configuration in terms of DURATIVITY, BOUNDEDNESS and CHANGE. By applying this model to examples of contemporary British English, I show that there are distinct usage patterns for each modifier with regard to the temporal configuration of the events they modify. I further demonstrate that the readings of SPEED and TIME which result from the combination of event and modifier depend on a number of factors, and in doing so provide an insight into the complex conceptual nature of SPEED and its relation to TIME. In the course of the analysis, several other factors, such as the position of the modifier, the function of the -ly suffix, and the adverbal/adjectival status of the modifier are brought to light. Keywords: SPEED, TIME, BOUNDEDNESS, CHANGE, events, event modifiers, dual-form adverbs, configurational structure, temporal configuration, construal.


textabstractA cross-sector partnership is a collaborative effort in which parties from different societal sectors pool resources to provide solutions to (perceived) common problems.
These partnerships are often rather complex because of a number of reasons: (1) they address complex issues, (2) they are implemented under (often) uncertain circumstances, and (3) they bring together parties that each have a different language, a different culture, and different interests and strategies. This knowledge is not new, but has been poorly understood so far. Complexity is further increased by the factors that influence the actual formation of a partnership when they are not well understood or managed as well.


Sleep loss is an important factor in the global burden of disease with collateral effects on cardiovascular and mental health as well as injury and violent death through human error. This disease burden is poorly recognized due to a range of factors. The paper argues that improving world-wide sleep health needs to match efforts currently being made in combating obesity and other non-communicable diseases.


Introduction The risk of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA) is 1.5–2 times higher than the general population. The fundamental risk factor for CVD is age, related to alterations at the arterial level. The aim of the study was to compare vascular age (VA) in RA patients under a strict treat-to-target (T2T) strategy with Osteoarthritis (OA) patients without strict follow up and to assess the influence of inflammaging (chronic, sterile, low-grade inflammation related to aging) and metabolic markers on VA. Materials and Methods This was an analytical cross-sectional study. Patients with RA (under a strict a T2T strategy) and OA patients without strict clinical follow-up were included. Patients with a history of uncontrolled hypertension, CVD, and/or current smoking were excluded. Sociodemographic, physical activity, and toxic exposure data were obtained. Waist-hip ratio and body mass index (BMI) were measured. DAS-28 (RA) and inflammatory markers, lipid profile, and glycaemia were analyzed. Pulse wave velocity (PWV) was measured (oscillometric method, Arteriograph-TensioMed®). VA was calculated based on PWV. Eleven components of inflammaging [six interleukins, three metalloproteinases (MMP), and two tissue inhibitors of metalloproteinases (TIMP)] were evaluated (Luminex® system). Univariate and bivariate analyzes (Mann Whitney U and chi-square) and correlations (Spearmans Rho) were done to compare the two groups. Results A total of 106 patients (74% women) were included, 52/RA and 54/OA. The mean age was 57 (Interquartile range - IQR 9 years). The BMI, waist circumference, and weight were higher in patients with OA (p < 0.001). RA patients had low disease activity (DAS-28-CRP). There were no differences in VA, inflammaging nor in PWV between the two groups. VA had a positive, but weak correlation, with age and LDL. In group of RA, VA was higher in those who did not receive methotrexate (p = 0.013). LDL levels correlated with MMP1, TIMP1, and TIMP2. Conclusions When comparing RA patients with low levels of disease activity with OA patients with poor metabolic control, there are no differences in VA. Furthermore, methotrexate also influences VA in RA patients. This shows that implemented therapies may have an impact on not only the inflammatory state of the joint but also CVD risk.


Digital gangrene is not usually associated with primary Raynaud's phenomenon (RP). Its presence should therefore alert the healthcare provider to look for an alternative explanation. A 19-year-old female patient with primary RP developed digital gangrene following surgical management of acute paronychia. The possible mechanism in this patient appears to be the augmentation of the vasoconstrictive response due to the local infiltration of epinephrine mixed with lignocaine prior to the incision and drainage of her infected finger.


Data collection in preclinical small-animal PET studies has been hindered by the small number of recordings typically obtained for a single radiosynthesis. Therefore, we tested procedures for obtaining 8 simultaneous small-animal PET recordings from the brains of 8 mice using an acrylic anesthesia distributor (the Octamouse), with the dopamine D2/3 ligand 18F-fallypride serving as a test substance for brain receptor imaging. Methods: The effect of scatter correction on the small-animal PET recordings was first evaluated in phantom studies in which sources of different radioactivity concentration were placed within the chambers of the Octamouse. Next, potential effects of mass on the 18F-fallypride binding potential (BPND) in the striatum were tested in groups of mice receiving 18F-fallypride at 2 different specific activities (140 and 50 GBq/μmol), with and without scatter correction. Finally, the relationship between BPND and injected dose of 18F-fallypride (3.5–17 MBq/mouse) was tested. Results: Scatter correction improved the contrast between sources and air space within the Octamouse phantom. The magnitude of 18F-fallypride BPND in mouse striatum was invariant across the tested range of specific activities, and scatter correction increased BPND by a mean of 6%; covariances of the inter- and intraoperator variability of BPND were 10%. There was a positive correlation between radiochemical dose and BPND with (R2 = 0.53) and without (R2 = 0.63) scatter correction, which was driven by increasing area under the percentage injected dose curve in the striatum. Conclusion: The quantitation of emission sources placed within the Octamouse is linear over a wide range of source activities. In the striatum of living mice, the magnitude of 18F-fallypride BPND was highly reproducible between operators and was constant over a 3-fold range of specific activities, indicating a lack of significant occupancy. Scatter correction improved quantitation but did not entirely correct for the dependence of BPND on injected dose, which was deemed to arise because of effects propagating from detector dead time when the total radiochemical dose in the field of view exceeded 50 MBq. Given this consideration, we were still able to quantify 18F-fallypride BPND in 16 mice from a single radiosynthesis, an economy that should be generalizable to brain studies of diverse radioligands.


OBJECTIVE
Glucocorticoids (GCs) alter bone strength such that patients receiving these medications have a high rate of fragility-related fractures. The purpose of this study was to assess whether concurrent treatment with GCs (prednisolone) and risedronate (an aminobisphosphonate) would prevent the reduction in bone strength induced by GCs, in a mouse model of GC-induced bone loss and in patients enrolled in a clinical study.

METHODS
We evaluated mice treated with prednisolone pellets alone, GCs plus risedronate, or placebo alone and iliac crest biopsy specimens obtained from patients who were treated with GCs plus placebo or GCs plus risedronate for 1 year. We measured the mass, architecture, and physical and material properties of bone (subject to therapeutic treatments) at nanoscale to macroscopic dimensions, using synchrotron x-ray tomography, elastic modulus mapping, transmission electron microscopy, and small-angle x-ray scattering techniques.

RESULTS
GC treatment reduced trabecular bone mass, microarchitecture, and the degree of bone mineralization and elastic modulus within the trabeculae. Concurrent treatment with GCs and risedronate prevented the deterioration of trabecular bone architecture, reduced the degree of mineralization, and preserved elastic modulus within the trabeculae, in both mouse and human bone. In addition, treatment with risedronate plus GCs in mice appeared to preserve bone crystal orientation, compared with treatment with GCs alone.

CONCLUSION
Risedronate prevented the localized changes in mineral and material properties of bone induced by GCs, which may ultimately improve bone strength.


Our aim is to develop the service robot based on a systematic software engineering method, particularly for real-time, embedded and distributed systems with UML. To do so, we applied the COMET method, which is a UML-based method for the development of concurrent applications, specifically distributed and real-time applications. We describe our experience of applying the COMET/UML method to developing the service robot for the elderly, T-Rot, which is under development at CIR. Here, our emphasis was on an autonomous navigation system for the service robot, which is one of the most challenging issues and is essential in developing service robots, especially mobile service robots to help elderly people. It includes hardware integration for various sensors and actuators as well as software development and integration of modules like a path planner and a localizer.


Abstract Background Neurocognitive impairments are common among brain tumor patients, and may impact patients' awareness of performance in instrumental activities in daily life (IADL). We examined differences between patient- and proxy-reported assessments of the patient's IADL, and whether the level of (dis)agreement is associated with neurocognitive impairments. Methods Brain tumor patients and their proxies completed the phase 3 version of the EORTC IADL-BN32 questionnaire measuring IADL, and patients completed six neurocognitive measures. Patient-proxy difference scores in IADL were compared between patients who were defined as neurocognitively impaired (≥2 neurocognitive measures ≥2.0 standard deviations below healthy controls) and non-neurocognitively impaired. With multinomial logistic regression analyses we examined if neurocognitive variables were independently associated with patient-proxy disagreement in IADL ratings. Results Patients (n = 81) did not systematically (P < .01) rate IADL outcomes different than their proxies. Proxies did report more problems on 19/32 individual items and all five scales. This effect was more apparent in dyads with a neurocognitively impaired patient (n = 37), compared to dyads with non-neurocognitively impaired patients (n = 44). Multinomial logistic regression analyses showed that several neurocognitive variables (e.g., cognitive flexibility and verbal fluency) were independently associated with disagreement between patients and proxies on different scales. Conclusion Neurocognitive deficits seem to play a role in the discrepancies between brain tumor patients and their proxies assessment of patient's level of IADL. Although replication of our results is needed, our findings suggests that caution is warranted in interpreting self-reported IADL by patients with neurocognitive impairment, and that such self-reports should be supplemented with proxy ratings.


BACKGROUND
Functional status is the ability to perform daily activities. Little is known about quality of life and health status of gynaecological cancer patients. The present study therefore aimed to evaluate the functional status of women receiving treatment for gynecological oncological disease while not hospitalised.

MATERIALS AND METHODS
This descriptive study covered 42 patients monitored by the Gynecological Oncology Unit in 2011. Data were collected using the Functional Living Index-Cancer and analysed with the chi square test, independent samples t-test, Mann-Whitney U test, one-way ANOVA test and the Kruskal-Wallis H test.

RESULTS
Of the 42 cases, 66.7% had been diagnosed within the previous year and 90.5% were undergoing chemotherapy. The most severe symptoms experienced were pain (35.7%), fatigue-weakness (40.5%) and nausea and vomiting (56.5%). Daily activities where the most difficulty was experienced were housework (28.6%), average pace walking (31.0%), carrying more than 5 kg (28.6%). The mean Functional Living Index score was quite high (103.5 ± 24.1). FLIC-C scale scores did not vary with the educational status, diagnosis duration, and family history of cancer (p>0.05).

CONCLUSIONS
Evaluation of the functional status of gynecological cancer patients and how they cope with problems should indicate to healthcare professionals what help can be given to maintain quality of life.


Deep neural networks for video action recognition frequently require 3D convolutional filters and often encounter overfitting due to a larger number of parameters. In this paper, we propose Random Mean Scaling (RMS), a simple and effective regularization method, to relieve the overfitting problem in 3D residual networks. The key idea of RMS is to randomly vary the magnitude of low-frequency components of the feature to regularize the model. The low-frequency component can be derived by a spatio-temporal mean on the local patch of a feature. We present that selective regularization on this locally smoothed feature makes a model handle the low-frequency and high-frequency component distinctively, resulting in performance improvement. RMS can enhance a model with little additional computation only during training, similar to other regularization methods. RMS also can be incorporated into typical training process without any bells and whistles. Experimental results show the improvement in generalization performance on a popular action recognition datasets demonstrating the effectiveness of RMS as a regularization technique, compared to other state-of-the-art regularization methods.


We present a case of recurrent metastatic synovial sarcoma of the left ventricle. The first resection of the tumor was performed through a left ventriculotomy. This time, the tumor was resected through the aortic valve with a video‐assisted technique. The ultrasonic surgical aspirator was useful to remove the tumor near the papillary muscle and the chordae.


We report on microscopic structural characterizations of multicrystalline SiGe (mc-SiGe) bulk crystal, which contains microscopic compositional distribution, and discuss possible influence on solar cell applications. By combining microscopic Raman spectroscopy and energy-dispersive X-ray analysis, the existence of built-in strain and its spatial distribution were experimentally obtained. By a simple calculation assuming ellipsoidal SiGe inclusion coherently embedded in Si-matrix, effect of the built-in strain on the band gap is quantitatively estimated. For example, an ellipsoidal Si/sub 0.5/Ge/sub 0.5/ inclusion with an aspect ratio less than 0.10 is predicted to have the similar band gap with unstrained Ge. Therefore, to utilize strain is concluded to be important to realize spectroscopic response in the near infrared regime with minimizing incorporation of Ge.


Caribbean migrations have been widely documented, specially from demographic and economic views that emphasize the negative aspects of these processes on individuals and societies. However, new perspectives about migrations have spread, specially the migratory cultures concept. The main idea is that, more than an economical phenomena, linked to overpopulation and unemployment, Caribbean mobility can be understood as a cultural tradition that has become a way of life, legitimized through several migrants generations, allowing the survival of islands' societies. This way, the concept assumes the permanent mobility of people through return migrations, used as basic economic strategies, as well as mechanisms that facilitate and perpetuate this practice, such as informal and extended social networks and flexible social and domestic structures. This would be the case of Old Providence and Santa Catalina islanders in the English - speaking territory on the Colombian Caribbean, who have a long history of migrations that persist until today and that constitute a way of life. This document is the result of researches developed on the islands and with migrants in the city of Bogota between 2004 and 2011. On these studies, different subjects were aborded, including the role of migrations on islanders' life, their MEMORies and their perception about them


Understanding the mechanisms that allow biological species to co-occur is of great interest to ecologists. Here we investigate the factors that influence co-occurrence of members of the genus Protea in the Cape Floristic Region of southwestern Africa, a global hot spot of biodiversity. Due to the binomial nature of our response, a critical issue is to choose appropriate link functions for the regression model. In this paper we propose a new family of flexible link functions for modeling binomial response data. By introducing a power parameter into the cumulative distribution function (c.d.f.) corresponding to a symmetric link function and its mirror reflection, greater flexibility in skewness can be achieved in both positive and negative directions. Through simulated data sets and analysis of the Protea co-occurrence data, we show that the proposed link function is quite flexible and performs better against link misspecification than standard link functions.


The aim of this work is to analyse the causes which lead to the stress in educational institutions and see what is their connection to the motivation of the employees. The stress is the scheme of emotional and physiological reactions arising as a response to the demands set within or outside the organisation. Using the poll technique, it deals with the causes of stress among the employees in the educational institutions, as well as the level of their motivation. Specific relations between the features of stress and motivation should show the relation between the stress generated by different causes and the motivation of the employees.


Deep learning algorithms have tremendous potential utility in the classification of biomedical images. For example, images acquired with retinal optical coherence tomography (OCT) can be used to accurately classify patients with adult macular degeneration (AMD), and distinguish them from healthy control patients. However, previous research has suggested that large amounts of data are required in order to train deep learning algorithms, because of the large number of parameters that need to be fit. Here, we show that a moderate amount of data (data from approximately 1,800 patients) may be enough to reach close-to-maximal performance in the classification of AMD patients from OCT images. These results suggest that deep learning algorithms can be trained on moderate amounts of data, provided that images are relatively homogenous, and the effective number of parameters is sufficiently small. Furthermore, we demonstrate that in this application, cross-validation with a separate test set that is not used in any part of the training does not differ substantially from cross-validation with a validation data-set used to determine the optimal stopping point for training.


BACKGROUND
It was shown that nonoxidized PTH (n-oxPTH) is bioactive, whereas the oxidation of PTH results in a loss of biological activity.

METHODS
In this study we analyzed the association of n-oxPTH on mortality in hemodialysis patients using a recently developed assay system.

RESULTS
Hemodialysis patients (224 men, 116 women) had a median age of 66 years. One hundred seventy patients (50%) died during the follow-up period of 5 years. Median n-oxPTH levels were higher in survivors (7.2 ng/L) compared with deceased patients (5.0 ng/L; P = .002). Survival analysis showed an increased survival in the highest n-oxPTH tertile compared with the lowest n-oxPTH tertile (χ², 14.3; P = .0008). Median survival was 1702 days in the highest n-oxPTH tertile, whereas it was only 453 days in the lowest n-oxPTH tertile. Multivariable-adjusted Cox regression showed that higher age increased odds for death, whereas higher n-oxPTH reduced the odds for death. Another model analyzing a subgroup of patients with intact PTH (iPTH) concentrations at baseline above the upper normal range of the iPTH assay (70 ng/L) revealed that mortality in this subgroup was associated with oxidized PTH but not with n-oxPTH levels.

CONCLUSIONS
The predictive power of n-oxPTH and iPTH on the mortality of hemodialysis patients differs substantially. Measurements of n-oxPTH may reflect the hormone status more precisely. The iPTH-associated mortality is most likely describing oxidative stress-related mortality.


We examine dynamic search as a game in which two rivals explore (an island) for a hidden prize of known value. In every period until its discovery, the players decide how much of the unsearched area to comb. If a player finds the prize alone he wins it and the game ends. Players have a per-period discount factor and costs proportional to the area they search. First, as a benchmark for efficiency, we solve the one-player search problem. Second, in the two-player setting we show that typically there is inefficient over-search – a result akin to the tragedy of the commons. However, for players with intermediate levels of patience, there is the possibility of inefficient under-search as players incorporate the expected future payoffs in their current search decisions. Finally, with patient players, several counterintuitive results can arise: for example, players might be better off searching a larger island or looking for a less valuable prize.


Throughout history the continent of Africa has witnessed major conflicts and wars. Most of these conflicts have wreaked havoc in people's lives and their socio-economic well-being. The nature of conflict on the continent has both indigenous and exogenous origins. Past colonial wars of occupation and the subsequent occupations generated conflicts and wars of its own. These led to the creation of what the so-called modern states that exist in Africa. Most of these creations by colonial powers were designed to serve their own interest. However, the wars and movements of independence also generated conflicts of their own. The modern states created during the colonial days are also the root cause of some of the conflicts today in Africa. The world conflicts during the Cold War also generated Africa's own conflicts. The rise of extreme religious movements like Al-Qaeda, the Islamic State of Iraq and the Levant (ISIS), and their affiliates have taken advantage of the fragile states of Africa to cause destruction in the continent. All these conflicts have had an impact on the heritage of Africa and in some instances generated its own places of commemoration and remembrance.
 With the creation of United Nations Educational, Scientific and Cultural Organization (UNESCO)'s World Heritage Convention in 1972 and its efforts to protect heritage places, Africa has registered some of the places of remembrance and commemoration to the prestigious World Heritage list. Some of the sites registered are a result of conflict. But what concerns UNESCO is the management of the sites on its World Heritage list. Thirteen of these sites from the continent are on the danger list, largely due to the conflicts ravaging Africa. Through the 1954 Hague Convention, UNESCO has tried to ensure that African state parties adhere to the norms of protecting heritage in the event of a war or conflict between nations. Unfortunately most conflicts in Africa are not between conventional armies but largely internal through guerrilla warfare, thus limiting the application of the 1954 Convention.
 Some of the conflicts in Africa that have had an impact on heritage have attracted attention from major powers in the world. For example, the conflict in Libya has had countries such as Italy, the United States, and France interested in protecting the heritage places there. In the same vain France has been attracted to the conflict in Mali, which threatens the famous sites of Timbuktu among others. In all these UNESCO has played a part in highlighting the need to protect heritage and in the case of Mali even successfully enlisted the International Court of Justice to prosecute the perpetrators of these attacks on heritage. In some cases, like in Nigeria with the Boko Haram attacks on the world heritage site of Sukur Cultural Landscape, there has been a deafening silence from either UNESCO or any other international organization or country.


Human memory can be split into familiarity and recollection processes which contribute to different aspects of memory function. These separate processes result in different experiential states. In this review, we examine how this dominant theoretical framework can explain the subjective experience of people with Alzheimer's disease, the profile of their memory impairments and their inability to reflect on their performance metacognitively. We conclude with a brief overview of the brain regions supporting conscious experience of memory, and propose that the memory and awareness deficits seen in Alzheimer's disease could be conceived of as a deficit in autonoetic consciousness. A future priority for research is to take these robust constructs into research programmes examining rehabilitation and pharmacological intervention.


As a result of its geographical location and its proximity to the city of Villahermosa in Tabasco, the Ocuilzapotlan-Macultepec road corridor is an area of great potential for urban growth. This has originated intense changes in land use in its peri-urban area that have affected the functions of its natural resources. For this reason, the objective of this research was to analyze land use changes that occurred during the period 2000-2017 and the impact on some environmental functions of the peri-urban areas of said corridor. By means of image analysis we identif ied land uses, land use change rates, and regulation of water flows. Our results suggest that urban areas and grasslands grew by 2.27 and 2.26%, respectively, while forests and wetlands decreased by 11.48 and 1.09%, respectively. Soil carbon concentrations are estimated to be 92.4 ± 5.1, 73.2 ± 2.8 and 220.4 ± 4.6 Mg C ha-1 for meadow, forest and wetland uses, respectively. The shoot compartment of the forest stores 63.27 Mg C ha-1, which, when added to soil carbon, totals 136.47 Mg C ha-1, making this land use the second most important carbon store, only after wetlands. It is concluded that the greatest environmental impact caused by land use change of the peri-urban area of the polygon studied is the reduction of wetlands since they are the main areas of carbon stores and are regulators of water flows.


As a new optical pressure sensor technique, Pressure Sensitive Paint (PSP) is one of the important techn iques for model surface p ressure m easurement in wind tunnel test s . With the help of PSP , it is possible to do p ressure m easurement on compl icated or special model surface , which is usually difficult to be measured by pressure tap s . Since PSP technique being introduced into China from TsAGI (Russia) , AVIC ARI has investigated two-component PSP technique in high-speed wind tunnel in cooperati on with ICCAS China . T his report present s the principle of PSP technique, test control system development and the test result comparison s between PSP technique with two-component pressure sensitive paint FOP-2 and classic tap measurement on wing surface of an airplane model . T he results showed that the two-component pressure sensitive paint has better performance and can be used for model pressure measurement.


Population Meltdown Populations of wild animals, including deer and moose, are often actively managed by hunting. Following such harvesting, populations of some exploited animal species collapse, whereas others are able to withstand exploitation. To understand the reasons for these varied responses, Fryxell et al. (p. 903) developed a mathematical model which predicts that weak regulation causes damped population cycles with period lengths on the order of decades. The model was tested using time-series data for hunted populations of moose and deer in three ecosystems in Norway and Canada. The predictions of a model that describes humans hunting prey are confirmed using long-term ungulate data. Constant harvest policies for fish and wildlife populations can lead to population collapse in the face of stochastic variation in population growth rates. Here, we show that weak compensatory response by resource users or managers to changing levels of resource abundance can readily induce harvest cycles that accentuate the risk of catastrophic population collapse. Dynamic system models incorporating this mix of feedback predict that cycles or quasi-cycles with decadal periodicity should commonly occur in harvested wildlife populations, with effort and quotas lagging far behind resources, whereas harvests should exhibit lags of intermediate length. Empirical data gathered from three hunted populations of white-tailed deer and moose were consistent with these predictions of both underlying behavioral causes and dynamical consequences.


Introduction:
 The Centers for Medicare and Medicaid Services hospital-acquired conditions (HACs) and the Agency for Healthcare Research and Quality patient safety indicators (PSIs) are quality metrics linked to reimbursement. An assessment of these events in the pediatric stroke population has not previously been reported.

 Methods:
 The Nationwide Inpatient Sample (2002-2011) was queried using primary ICD-9-CM codes to identify hospitalizations for pediatric ischemic stroke (IS), subarachnoid hemorrhage (SAH), or intracerebral hemorrhage (ICH). We evaluated the effect of patient and hospital factors on occurrence of PSIs and HACs and the impact of these occurrences on length of stay (LOS), total costs, and in-hospital mortality.

 Results:
 Of a total of 6,265 IS, 3,096 SAH, and 3,103 ICH admissions, the percentage of patients with 1 or more PSI or HAC, respectively, was 15.6% and 2.0% in IS, 44.7% and 2.7% in SAH, and 38.2% and 2.0% in ICH. The most frequently reported PSIs (incidence 56,000/100,000) were respiratory failure (50.7%), deep vein thrombosis (1.65%), and sepsis (1.32%), whereas falls/trauma (1.78%) and poor glycemic control (0.22%) were the most frequently reported HACs (incidence, 2,351/100,000). Multivariate adjusted risk factors for PSI included SAH (OR: 5.02), ICH (OR: 3.79), black and Hispanic race (OR: 1.35, 1.37), urban hospital (OR: 7.00), and 3+ comorbidities (OR: 7.06) (all p<0.0001). In adjusted analyses, Hispanic race (OR: 2.04), Medicaid insurance (OR: 1.51), 3+ comorbidities (OR: 2.18), weekend admission (OR: 1.78), rural hospitals (OR: 3.03), and nonteaching hospitals (OR: 1.64) increased odds of HAC occurrence (all p<0.01). PSI occurrence increased LOS by 11 days and total costs by $47,573 per admission, while HAC occurrence increased LOS by 12 days and total costs by $12,373 per admission (all p<0.0001). In adjusted analyses, children enduring a PSI were 5 times more likely to acquire disability and 21 times more likely to suffer mortality (all p<0.0001).

 Conclusion:
 We established benchmark rates for PSIs and HACs in pediatric stroke. Race, insurance status, hospital characteristics, and pre-existing comorbidity significantly impact PSI and HAC occurrence, which further impacts LOS, costs, disability, and mortality.


We introduce tax contracts and examine how they affect government formation and welfare of voters in a democracy with proportional elections. A tax contract specifies a range of tax rates a party is committed to if in government. We develop a new model of party competition in which parties choose tax rates, public-good provision, and perks, and we show that the introduction of tax contracts has two effects: a perks effect and a policy-shift effect. The former plays a central role in societies with a low degree of political polarization, where it tends to reduce politicians' perks. If a society is highly polarized, tax contracts can yield more moderate political outcomes. However, there are also circumstances in which tax contracts induce more extreme policies.


Past choices can influence subsequent choices in employee selection. Previous approaches rather described similar sequential effects with feedback learning or the misperception of randomness. However, in the selection of job candidates also the accumulation of the moral impact of previous choices might influence subsequent choices. We investigated that question by making two major contributions to the literature. First, we developed an experimental paradigm for measuring sequential choices in employee selection and second, we implemented a widely applicable computational model, the Dependent Sequential Sampling Model, for explaining sequential effects in choices. By using this methodological approach, we uncovered sequential effects in employee selection. Participants (N=600) were especially motivated to compensate for morally dubious choices, with some participants showing consistent choice behavior if their previous choices had been morally virtuous. These results support the assumption of asymmetric compensation of morally dubious choices, sometimes referred to as the moral cleansing hypothesis.


Accurately forecasting volatility at distant horizons is critical for managing long-term risk in agriculture. Given the poor performance of GARCH-type models at long-term volatility forecast, we develop a risk-adjusted implied volatility, which adjust the risk-neutral implied volatility by correctly accounting for the volatility risk premium. The paper evaluates the performance of the new implied volatility in the corn futures market relative to two alternative forecasts- a three-year moving average forecast and a naive forecast. The finding from the study is that the new implied volatilities have at least as well as or stronger predictive power than alternative predicting approaches.


The mechanism by which the aminoglycoside antibiotic streptomycin permeabilizes the cytoplasmic membrane of Escherichia coli cells was reinvestigated. For this purpose, the extent of streptomycin-induced K+ loss from cells growing at low external K+ concentrations was taken as a measure of membrane permeabilization. Experiments with different K(+)-uptake mutants showed that the antibiotic specifically increased the passive permeability of the cell membrane to K+ and other ions. These permeability changes were small and the membrane potential of the treated cells remained high. The membrane permeabilization was not due to a direct interaction of the antibiotic with the cell membrane, since cells that carry an rpsL mutation and synthesize proteins in a streptomycin-insensitive way did not lose K+ after the addition of the antibiotic. Due to misreading and premature termination of translation the cells synthesized aberrant proteins under the conditions where membrane permeabilization occurred. Two conditions are described under which the cells both degraded these mistranslated proteins rapidly and reaccumulated K+, lending support to the hypothesis that membrane permeabilization is due to the presence of the mistranslated proteins in the cell membrane. Evidence is presented that the irreversibility of (dihydro)streptomycin uptake by cells washed free from the antibiotic might also be due to rapid degradation of the mistranslated proteins, leading to 'caging' of the antibiotic inside the cells.


Abstract. Development of change detection methods that are functional and reliable enough for operational work is still a demanding task. This article discusses automated change detection from the viewpoint of one case study: the Finnish Land Parcel Identification System (FLPIS). The objective of the study is to develop a change detection method that could be used as an aid in the updating of the FLPIS. The method is based on object-based interpretation, and it uses existing parcel boundaries and new aerial ortho images as input data. Rules for classifying field and non-field objects are defined automatically by using the classification tree method and training data. Additional, manually created rules are used to improve the results. Classification tests carried out during the development work suggest that real changes can be detected relatively well. According to a recent visual evaluation, 96% of changes larger than 100 m2 were detected, at least partly. The overall accuracy of the change detection results was 93% when compared with reference data pixel-by-pixel. On the other hand, there are also missing changes and numerous false alarms. The main challenges encountered in the method development include the wide diversity of agricultural fields and other land cover objects locally, across the country, and at different times of the spring and summer, variability in the digital numbers (DNs) of the aerial images, the different nature of visual and automatic interpretation, and the small percentage of the total field area that has really changed. These challenges and possible solutions are discussed in the article.


Regulatory T cells have been clearly implicated in the control of disease in murine models of autoimmunity. The paucity of data regarding the role of these lymphocytes in human autoimmune disease has prompted us to examine their function in patients with rheumatoid arthritis (RA). Regulatory (CD4+CD25+) T cells isolated from patients with active RA displayed an anergic phenotype upon stimulation with anti-CD3 and anti-CD28 antibodies, and suppressed the proliferation of effector T cells in vitro. However, they were unable to suppress proinflammatory cytokine secretion from activated T cells and monocytes, or to convey a suppressive phenotype to effector CD4+CD25− T cells. Treatment with antitumor necrosis factor α (TNFα; Infliximab) restored the capacity of regulatory T cells to inhibit cytokine production and to convey a suppressive phenotype to "conventional" T cells. Furthermore, anti-TNFα treatment led to a significant rise in the number of peripheral blood regulatory T cells in RA patients responding to this treatment, which correlated with a reduction in C reactive protein. These data are the first to demonstrate that regulatory T cells are functionally compromised in RA, and indicate that modulation of regulatory T cells by anti-TNFα therapy may be a further mechanism by which this disease is ameliorated.


Clostridium difficile is a significant nosocomial and community-acquired pathogen, and is the leading cause of antibiotic-induced diarrhea associated with high morbidity and mortality. Given that the treatment outcome depends on the severity of C. difficile infection (CDI), we aimed to establish an efficient method of assessing severity, and focused on the stool biomarker fecal calprotectin (FC). FC directly reflects the intestinal inflammation status of a patient, and can aid in interpreting the current guidelines, which requires the integration of indirect laboratory parameters. The distinction of 80 patients with CDI versus 71 healthy controls and 30 severe infection cases versus 50 mild cases was possible using FC as a marker. The area under the receiver operating characteristic curves were 0.821 and 0.746 with a sensitivity of 75% and 70% and specificity of 79% and 80%, for severe versus mild cases, respectively. We suggest FC as a predictive marker for assessing CDI severity, which is expected to improve the clinical management of CDI.


Two-year toxicity studies were conducted on the widely used herbal products, goldenseal and milk thistle, in male and female F344/N rats and B6C3F1 mice. With goldenseal root powder, the primary finding was an increase in liver tumors in rats and mice, and with milk thistle extract, a decrease in spontaneous background tumors including mammary gland tumors in female rats and liver tumors in male mice. Increased tumorigenicity in rodents exposed to goldenseal root powder may be due in part to the topoisomerase inhibition properties of berberine, a major alkaloid constituent in goldenseal, or its metabolite, berberrubine. In the clinic, use of topoisomerase-inhibiting agents has been associated with secondary tumor formation and inhibition in DNA repair processes. In contrast, the radical-scavenging and antioxidant properties of silibinin and other flavonolignans in milk thistle extract may have contributed to the decrease in background tumors in rodents in the present studies. The fate of the active constituents of goldenseal and milk thistle is similar in humans and rodents; therefore, the modes of action may translate across species. Further studies are needed to extrapolate the findings to humans.


Sums of lognormal random variables occur in many problems in wireless communications because signal shadowing is well modelled by the lognormal distribution. The lognormal sum distribution is not known in closed-form and is difficult to compute numerically. Several approximations to the distribution have been proposed and employed in applications. Some widely used approximations are based on the assumption that a lognormal sum is well approximated by a lognormal random variable. Here, a new paradigm for approximating lognormal sum distributions is presented. A linearizing transform is used with a linear minimax approximation to determine an optimal lognormal approximation to a lognormal sum distribution. The accuracies of the new method are quantitatively compared to the accuracies of some well-known approximations. In some practical cases, the normal lognormal approximation is several orders of magnitude more accurate than previous approximations. Efficient numerical computation of the lognormal characteristic function is considered.


Wendy Brown on The U.S. Army/Marine Corps Counterinsurgency Field Manual. By the U.S. Army and Marine Corps. Forward by David H. Petraeus, James F. Amos, and John A. Nagl. Introduction by Sarah Sewall. Chicago: University of Chicago Press, 2007. 472p. $15.00.


Because digital libraries (DLs) are treated as determinant information centers, libraries especially their managers are thinking about how phenomenon "DLs" can be effectively managed. So, the present article aims to provide managers of DLs with an approach. To do this, two main pillars considered in definition offered by Digital Library Federation namely staff and users are debated. Accordingly, some skills, instructional programs and qualities needed both for users and staff of DLs with which they can interact more effectively with new technologies such as DLs are included in the text. In fact, this paper emphasizes on educational function of DLs and thus offers an approach for its implementation from a managerial standpoint.