We provide an evidence-based approach to managing patients with acute lung injury and acute respiratory distress syndrome (ARDS). We searched MEDLINE and the Cumulative Index to Nursing and Allied Health for randomized trials evaluating lung-protective ventilation strategies, inhaled nitric oxide, prone positioning, and late-phase corticosteroids for managing these patients, and for additional literature related to long-term follow-up of ARDS survivors. The results of our review suggest that pressure- and volume-limited ventilation, according to the ARDS Network protocol, can reduce mortality for patients with acute lung injury, and so may an "open lung" approach to mechanical ventilation. Those 2 strategies are currently being compared in 2 multicenter randomized trials. Although both inhaled nitric oxide therapy and prone positioning can produce dramatic acute improvements in oxygenation for some patients, there is no evidence that these interventions can benefit patients with respect to patient-important outcomes. Therefore it is unreasonable to be dogmatic about the role of inhaled nitric oxide and prone positioning in ARDS. The role of corticosteroids in the late phase of ARDS is unclear and remains a very important unanswered question. With respect to long-term follow-up, we found that pulmonary dysfunction is probably not a major source of morbidity for ARDS survivors, whereas neuropsychological dysfunction is prominent. Ongoing research may suggest interventions to improve the outcome of ARDS and of critical illness in general.


The strong claim of a criminal law guided by the principle of offensiveness is the intangible outcome of a modern rule of law. Of course, with this, referring to today's conception of criminal law as a means of protection against offensive behavior in practice for goods deemed worthy of legal protection and promotion appraisal, expunge every reference to the criminalization of mere violation of duties. In our system, the age-old debate on the Criminal Law of the offense can not disregard a constitutional perspective: in particular, the broad doctrine maintains that the Republican Constitution states, though not expressly, the general principle of the seriousness of the offense. The need for a criminal law of injury, where the use of criminal sanction is actually last resort, intended to punish only conduct offensive practice of well-defined legal property, conflicts with the proliferation of legislative initiatives, particularly in ' scope of criminal law and criminal law of the company, directed to the repression of private behavior of a concrete orientation offensive, they see the penalty call to punish breaches simple formal. The consequences of the choices of penalty should be obvious: the penalty should not take only in the presence of a complete attack on an individual situation, because the intrinsically dangerous nature of the business would be too large an area removed from the regulates criminal, with almost certain impact on the protection of the good of the individual. It outlines the need for an anticipation of the response penalties.


A 22-year-old man presented to the hospital after a motor vehicle collision in which his head struck the windshield of a bus. Initial observations and the physical and neurologic examinations were normal, but the injury warranted computed tomographic (CT) scanning. A CT scan of the brain (Panel A) showed an incidental finding of grossly dilated occipital and temporal horns of the right lateral ventricle. Magnetic resonance imaging (Panel B) confirmed the presence of a large cystic lesion extending from the temporal and posterior horns of the right lateral ventricle (axial size, 11 cm by 7 cm), with a mild midline shift of the third ventricle, and compression of the midbrain and brain stem with thinning of the temporal and occipital cortexes. A large, asymptomatic, intraventricular arachnoid cyst was diagnosed. Arachnoid cysts — collections of cerebrospinal fluid within the layers of the arachnoid membrane — occur infrequently. Most are congenital, but they can also be acquired after trauma or infection through the entrapment of cerebrospinal fluid within arachnoid adhesions. Neurosurgery was recommended in this case, but the patient discharged himself from the hospital and there was no further follow-up.


INTRODUCTION
Cassia singueana Del. (Fabaceae) is a rare medicinal plant used in the traditional medicine preparations to treat various ailments. The root of C. singueana is a rich source of anthraquinones that possess anticancer, antibacterial and antifungal properties.

OBJECTIVE
The objective of this study was to develop an ultrasound-assisted extraction (UAE) method for achieving a high extraction yield of anthraquinones using the response surface methodology (RSM), Box-Behnken design (BBD), and a recycling preparative high-performance liquid chromatography (HPLC) protocol for isolation of anthraquinones from C. singueana.

METHODOLOGY
Optimisation of UAE was performed using the Box-Behnken experimental design. Recycling preparative HPLC was employed to isolate anthraquinones from the root extract of C. singueana.

RESULTS
The BBD was well-described by a quadratic polynomial model (R2  = 0.9751). The predicted optimal UAE conditions for a high extraction yield were obtained at: extraction time 25.00 min, temperature 50°C and solvent-sample ratio of 10 mL/g. Under the predicted conditions, the experimental value (1.65 ± 0.07%) closely agreed to the predicted yield (1.64%). The obtained crude extract of C. singueana root was subsequently purified to afford eight anthraquinones.

CONCLUSION
The extraction protocol described here is suitable for large-scale extraction of anthraquinones from plant extracts.


BACKGROUND
In most West African countries, the distribution and risk factors for co-infection with Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) is unknown despite the current HIV epidemic and evidence of increasing prevalence of HCV in the region.

OBJECTIVE
This study aimed to evaluate the distribution and the risk factors for the transmission of co-infection between HIV and HCV in The Gambia.

METHODS
A total of 1500 persons referred for HIV serology at the Royal Victoria teaching Hospital were interviewed following informed consent to obtain information on their demographic variables, knowledge of sexually transmitted diseases and their prevention, and patterns of risk behavior. Blood was collected and tested for anti-HIV and anti-HCV antibodies by Enzyme Linked Immunosorbent Assay (ELISA).

RESULTS
In the general population, the prevalence of HIV was 6.7%, while that of HCV was 2.1%. Both infections occurred more frequently in males than in females. HIV and HCV coinfection rate was 0.6%. Co-infection was significantly more common in males than females. All types of infection--HIV, HCV and HIV/HCV co-infections occurred much more in polygamous settings than in monogamy.

CONCLUSION
This study has demonstrated the extent of coinfection with HIV and HCV in The Gambia. The prevalence of female circumcision may be a contributory occurrence factor in the transmission of HIV but not in that of HCV.


Parents and preschoolers show respiratory sinus arrhythmia (RSA) synchrony, but it is unclear how child self-regulation and the dyadic affective climate shape RSA synchrony and how synchrony differs for mothers and fathers. We examined child average RSA, externalizing problems, and dyadic positive affect as moderators of the synchrony of dynamic, within-epoch child and parent RSA reactivity during a challenging task. Mothers (N = 82) and fathers (N = 60) oversampled for familial risk participated with their 3-year-olds. For mothers, when children showed either higher externalizing or lower average RSA, negative RSA synchrony was observed as dynamic coupling of maternal RSA augmentation and child RSA withdrawal, suggesting inadequate support of the child during challenge. However, when children showed both higher externalizing and lower average RSA, indicating greater regulatory difficulties overall, positive synchrony was observed as joint RSA withdrawal. The same patterns were found for father-child RSA synchrony but instead with respect to the moderators of higher externalizing and lower dyadic positive affect. Findings suggest moderators of RSA synchrony differ by parent and shared positive affect plays a robust role in fathers' RSA reactivity and synchrony. Mothers may be more attuned to children's regulatory capacities, whereas fathers may be more influenced by the immediate behavioral context.


Concise and general strategies for radical-based dimerization of cyclotryptamine and cyclotryptophan derivatives in addition to radical-based oxidation of structurally complex diketopiperazines are discussed. The impact of these radical-based chemistries on the rapid generation of molecular complexity is highlighted using representative examples from recent complex homodimeric alkaloid total syntheses. Additionally, a new and general strategy for radical-based directed heterodimerization of cyclotryptamine substructures via solvent-caged unsymmetrical diazene fragmentation is discussed.


Although anaerobic digestion is a well‐established technology, the treatment and disposal of the digestate still presents a challenge due to lack of viable methods for processing. The residual organic matter in digestates also creates a significant residual biogas potential. This fact indicates that the digestates need further processing not only to reduce their organic content for disposal, but also to capture the biogas associated with this residual organic content. This study investigated anaerobic treatment and residual biogas potential of digestates obtained from five full‐scale farm‐based digesters. The results indicated that it was possible to reduce the total chemical oxygen demand (CODt) of the digestates with an efficiency of 21%–84%. The corresponding biogas yields of digestates ranged between 0.078 and 0.326 Lbiogas/g VSadded. This level of biogas production is comparable to the biogas production potential of several commonly used raw substrates.


The aim of this work is to study the solidification conditions necessary to produce good quality/low defect metal alloy strip when thixorolling directly from the semi-solid state. To facilitate the study lead/tin alloys were chosen for their relatively low operating temperature. The objective is to extrapolate these findings to the higher temperature aluminium alloys. Three alloys (70%Pb- 30%Sn, 60%Pb-40%Sn, 50%Pb-50%wtSn) were used particularly to study the influence of the solidification interval. The equipment consists of a two roll mill arranged as an upper and lower roller, where both rollers are driven at a controlled speed. The lower roller is fed with semi solid alloy through a ceramic nozzle attached to the lower end of a cooling slope. Several types of nozzle and their position at the roller were tested. This produced different solidifications and consequently different finished strip. The alloys were first cast and then poured onto the cooling slope through a tundish in order to create a continuous laminar flow of slurry and uniformity of metal strip quality. The pouring was tested at different positions along the slope. The cooling slope was coated with colloidal graphite to promote a smooth slurry flow and avoid the problem of adherence and premature solidification. The metallic slurry not only cools along the slope but is also initially super-cooled to a mush by the lower roller whilst at room temperatures, thus enabling thixorolling. It was also found that the nozzle position could be adjusted to enable the upper roller to also contribute to the solidification of the metallic slurry. However the rollers and the cooling slope naturally heat up. Temperature distribution in these zones was analysed by means of three thermocouples positioned along the cooling slope and a fourth in the base of the semi solid pool within the nozzle. The objective being to design an optimum pouring and cooling system. The formed strip was cooled down to room temperature with a shower of water. Microstructures of the thixorolling process were analysed. The differences in solidification conditions resulted in differing qualities of finished strip and corresponding defect types, all of which are a serious quality issue for the rolled product.


This study examined empirically-based studies regarding incarcerating individuals with mental health illness in the United States (U.S.) as a form of treatment intervention. Initially, the search for studies on the topic produced 2,715 results, closer examination of those studies reduced that number to 137 journals, abstracts, and sources. Further examination concluded that only 37 of those studies met the criteria for this examination. Many of the studies that were reviewed involved interventions which occurred after release from psychiatric hospitals. Based on the findings, the most referenced estimates of mental illness in correctional facilities is attributed to Paula M. Ditton's 1999 Bureau of Justice Statistics report, which indicated, "in 1998, of the 283,800 mentally ill offenders who were incarcerated in the United States, 16% of state inmates, 7% federal inmates, and 16% of those in local jails who identified as being mentally ill,16%, or an estimated 547,800 reported that they had been hospitalized for mental illness in their lifetime (Ditton, 1999, p. 1). Although social workers in the United States "play a key role in educating the public about mental illness, in order to foster prevention" (Reichert, 2011, p. 162), they have not yet made the connection between how human rights, social justice, and social work values and ethics are all related to the population who are incarcerated. This investigation illustrates that, social workers in the United States have not fully incorporated human rights into social work practice (Reichert, 2011, p. 8). Social work professionals need to produce better research data and policy recommendations to reduce the number of incarcerated mentally ill individuals and provide them with quality medical and social service treatment options.


This work applies snack, a flow-based algorithm for detecting connections between clients and supernodes to the Skype network, to the study of two separate outages on the Skype network in August 2007 and December 2010. We examine both outages in detail, comparing them to each other, and to previous work on the first outage. We find that a simple metric derived from connection events per unique client as measured by snack acts as a proxy for the Skype network, and would have provided forewarning of the 2007 outage, and may have applicability as an indicator of general Skype network health. We also examine the faster onset of and recovery from the 2010 outage, discovering that the distribution of clients per supernode is a proxy measurement for network centralization, and detects the apparent present recovery strategy from such outages. These two metrics may be applied by any network operator to monitor the health of the Skype network.


An investigation was carried out to studies on sulphur fractions in soils of Lohara tahsil of Osmanabad district during 2011-12. For study, 180 representative soil samples were collected from 30 different villages of Lohara tahsil. The collected soil samples were grouped into three orders viz, Vertisols, Inceptisols and Entisols. Out of the total surveyed soil samples, 37 per cent soil samples were grouped under Vertisols while, 40 and 23 per cent soil samples were grouped under Inceptisols and Entisols, respectively. These soil samples were analysed for chemical properties and sulphur fractions. The soils of Lohara tahsil were alkaline in reaction and found safe limit of electrical conductivity for growing crops. Organic carbon content in study area was low to medium while, these soils were calcareous in nature, Available S were categoried as low while, total and other remaining forms of S were noted as low to medium in soils. The pH, EC and CaCO3 were negatively but significantly correlated with sulphur forms whereas, organic carbon was positively and significantly correlated with all forms of sulphur under Vertisols, Inceptisols and Entisols of Lohara tahsil of Osmanabad district.


The tropical Indo-Pacific is a very large biogeographic region stretching from the Red Sea to the central Pacific, yet in spite of its size nearly 500 species of shallow water teleost fishes are mostly cosmopolitan throughout this vast region. To date only a small number of these species have been phylogeographically studied across their entire species ranges and most show some genetic population structure, usually between ocean basins. However, some Indo-Pacific coral reef fishes have genetically homogenous populations across the Indo-Pacific suggesting high levels of gene flow. Among those fishes that lack spatial population partitions some possess nongeographic or temporal population structures in the mtDNA. This means that their populations are composed of genetically differentiated lineages that are sympatrically distributed. The biological significance of this pattern is unclear and only a small number of reef fish taxa have been reported to have non-geographic clades. The first species in which this pattern was detected was the big nose unicornfish, Naso vlamingii, which is a widespread Indo-Pacific Acanthurid with a long pelagic larval duration (Klanten et al. 2007). The explanation given by Klanten et al. for the nongeographic clades of this species was temporary periods of isolation, mediated by low-sea-level barriers and followed by secondary contact and admixture of lineages. Yet, while the conclusions of Klanten et al. (2007) seem plausible, further investigation into non-geographic genetic patterns was warranted.

In this thesis four additional Naso species were phylogeographically surveyed at a broad scale across the Indo-Pacific: Naso brevirostris, Naso unicornis, Naso hexacanthus and Naso caesius. Like N. vlamingii, all species showed little in the way of spatial population structuring using conventional phylogeographic fixation indexes (F(st)). Model-based phylogenetic analysis, maximum parsimony and Bayesian inference revealed non-geographic population patterns in the mitochondrial control region with N. brevirostris being the most similar to N. vlamingii. Curiously, the sister species N. hexacanthus and N. caesius were not reciprocally monophyletic suggesting that some horizontal gene transfer has occurred between them. Expansion time based on mismatch distributions was also calculated for each species and each clade. Mismatch coalescence suggests mid-late Miocene expansion times for all taxa (considering N. hexacanthus and N. caesisus as a single taxon) and pre-Pleistocene expansion for non-geographic clades.

Coalescence age of species and clades was also assessed in the program BEAST using a fossil calibrated molecular dating and a relaxed molecular clock. For this analysis all Naso species previously mentioned, including N. vlamingii, were arranged into an interspecific phylogeny of cytochrome oxidase subunit one DNA sequences, with many representatives of each species and clade. Mean ages from this anaylsis suggest mid-miocene coalescence ages for each taxa and pre-Pleistocene coalescence for all non-geographic clades, indicating that Pleistocene processes probably do not account for non-geographic patterns in the genus Naso. Otherwise, little congruence could be found between the ages of clades, seemingly refuting the notion that a barrier was involved in the formation of these genetic features. Fossil calibrated coalescence ages were used to reconstruct demographic history of each species using Bayesian skyline plots. In all taxa, skyline plots suggest accelerated demographic expansion during the Pleistocene, rather than the bottlenecks or demographic decline expected based on the pretext that reef fishes suffered bottlenecks during the upheavals on coral reefs during the Pleistocene glacial cycles.

Complimentary to evolutionary genetic patterns, this thesis also includes a genetic survey of recently settled N. unicornis juveniles in the Marianas archipelago, using 12 polymorphic microsatellite loci and sequences from the mitochondrial control region. This particular study reveals that post-settlement larval pools of N. unicornis have an elevated genetic diversity in both the nuDNA and mtDNA relative to the preexisting adult population. Recruitment events are genetically unstructured in space and time in this species within the Marianas and recruits seemed likely to have sibling relationships among sampling locations and between year classes. The genetic diversity of larval pools, as well as the likelihood of sibling pairs to be separated in space and time suggests demographically open populations. In light of the phylogeography of this species, N. unicornis and its congeners most likely experience high levels of gene flow on ecological as well as evolutionary time frames.

Non-geographic clades appear to be a genetic phenomenon observed in some widespread and highly dispersive coral reef fishes of the lndo-Pacific. There was little evidence to suggest that a low-sea-level barrier to gene flow was associated with these clades. Most likely non-geographic clades arise as a consequence of rapid range expansion across patchily distributed coral reef habitat in a large biogeographic region. The sheer size of the Indo-Pacific appears to be an important factor shaping the population patterns of widespread cosmopolitan coral reef fishes.


This article unravels opportunities that arise from regarding corporate capital as media. First, it reviews relevant overlaps between media theory and legal theory. Second, it considers cases in which capital ownership can be best understood as mediated, affective claims. Third, it explores how recognizing capital as media can open doors to constructive, creative entrepreneurship and activism – to the point of reinventing or undermining received practices of capital ownership altogether. When we think of capital ownership as mediation, we discover our institutional surroundings to be more vulnerable to critical research and more pliable to tactical intervention.


In this paper, we propose a framework to reduce the aggregate power
consumption of an Autonomous System (AS) using a collaborative
approach between areas within an AS. We identify the low-power paths
within non-backbone areas and then use Traffic Engineering (TE)
techniques to route the packets along the stitched paths from non-
backbone areas / backbone area to other non-backbone areas. Such low-
power paths can be identified by using the power-to-available-
bandwidth (PWR) ratio as an additional constraint in the Constrained
Shortest Path First (CSPF) algorithm. For routing the data traffic
through these low-power paths, the Inter-Area Traffic Engineered Label
Switched Path (TE-LSP) that spans multiple areas can be used.
Extensions to the Interior Gateway Protocols like OSPF and IS-IS that
support TE extensions can be used to disseminate information about
low-power paths in the respective areas (backbone or non-backbone)
that minimize the PWR ratio metric on the links within the areas and
between the areas thereby creating a collaborative approach to reduce
the power consumption. The feasibility of our approaches is
illustrated by applying our algorithm to an AS with a backbone area
and several non-backbone areas. The techniques proposed in this paper
for the Inter-Area power reduced paths require a few modifications to
the existing features of the IGPs supporting TE extensions. The
proposed techniques can be extended to other levels of Internet
hierarchy, such as Inter-AS paths, through suitable modifications as
in [11]. When link state routing protocols like OSPF or ISIS are used
to discover TE topology, there is the limitation that traffic
engineered paths can be set up only when the head and tail end of the
label switched path are in the same area. There are solutions to
overcome this limitation either using offline Path Computation Engine
(PCE) that attach to multiple areas and know the topology of all
areas. This document proposes an alternative approach that does not
req ...


Soon after the MAVEN (Mars Atmosphere and Volatile EvolutioN) spacecraft started orbiting Mars, the SEP (Solar Energetic Particle), SWIA (Solar Wind Ion Analyzer), and STATIC (Supra‐Thermal and Thermal Ion Composition) instruments on board the spacecraft detected planetary pickup ions. SEP can measure energetic (>60 keV) oxygen pickup ions, the source of which is the extended hot oxygen exosphere of Mars. Model results show that these pickup ions originate from tens of Martian radii upstream of Mars and are energized by the solar wind motional electric field as they gyrate back toward Mars. SWIA and STATIC can detect both pickup oxygen and pickup hydrogen with energies below ~30 keV and created closer to Mars. In this study, data from the SEP, SWIA, and STATIC instruments containing pickup ion signatures are provided and model‐data comparisons are shown. During the times when MAVEN is outside the Martian bow shock and in the upstream undisturbed solar wind, the solar wind velocity measured by SWIA and the solar wind (or interplanetary) magnetic field measured by the MAG (magnetometer) instrument can be used to model pickup oxygen and hydrogen fluxes. By comparing measured pickup ion fluxes with model results, the Martian thermal hydrogen and hot oxygen neutral densities can be probed outside the bow shock, providing a helpful tool in constraining estimates of neutral oxygen and hydrogen escape rates. Our analysis reveals an order of magnitude density change with Mars season in the hydrogen exosphere, whereas the hot oxygen exosphere was found to remain steadier.


The traditional scientific paper falls short of effectively communicating computational research. To help improve this situation, we propose a system by which the computational workflows underlying research articles are checked. The CODECHECK system uses open infrastructure and tools and can be integrated into review and publication processes in multiple ways. We describe these integrations along multiple dimensions (importance, who, openness, when). In collaboration with academic publishers and conferences, we demonstrate CODECHECK with 25 reproductions of diverse scientific publications. These CODECHECKs show that asking for reproducible workflows during a collaborative review can effectively improve executability. While CODECHECK has clear limitations, it may represent a building block in Open Science and publishing ecosystems for improving the reproducibility, appreciation, and, potentially, the quality of non-textual research artefacts. The CODECHECK website can be accessed here: https://codecheck.org.uk/.


Gastric acid is believed to be an important etiological factor in the pathogenesis of Barrett's esophagus. Pulsatile acid exposure increases cell proliferation in ex vivo Barrrett's tissue and normalization of esophageal pH reverses this. Proton pump inhibitors (PPIs) are the mainstay of therapy in Barrett's esophagus, and have numerous beneficial effects including symptom control, reduction of inflammation, and promotion of the development of squamous islands. However, PPI therapy causes hypergastrinemia and has not prevented recent increase in the incidences of esophageal cancer. Additionally, evidence presented here by Feagins et al. suggests that acid exposure has a p53-mediated, antiproliferative effect on a nondysplastic Barrett's epithelial cell line, an effect that acid suppression might abrogate. These complex pH, inflammation, and growth factor biological interactions can be most reliably tested in large clinical trials with hard end points like cancer conversion or all causes of mortality. Combining the anti-inflammatory effects of acid suppression with aspirin, a nonsteroidal anti-inflammatory agent, is the subject of the AspECT clinical trial, and this may be the future of chemoprevention in Barrett's.


Working memory (WM) is fundamental to many aspects of human life, including learning, speech and text comprehension, prospection and future planning, and explicit "system 2" forms of reasoning, as well as overlapping heavily with fluid general intelligence. WM has been intensively studied for many decades, and there is a growing consensus about its nature, its components, and its signature limits. Remarkably, given its central importance in human life, there has been very little comparative investigation of WM abilities across species. Consequently, much remains unknown about the evolution of this important human capacity. Some questions can be tentatively answered from the existing comparative literature. Even studies that were not intended to do so can nonetheless shed light on the WM capacities of nonhuman animals. However, many questions remain.


The paper analyzed the situation of honey production in Romania and by micro-region of development using the empirical data provided by National Institute of Statistics for the period 2007-2015, it determine de trend lines and regression functions and set up the forecast for the period 2016-2020. In 2015, Romania had 1,392.8 thousand bee families, by 41.81 % more than in 2007. They produced 27,893 tons by 66.35 % more than in 2007 according to NIS, but according to the EU Commission Romania came on the top position with 35,000 tons honey. The contribution of the micro-regions of development to honey production is in the decreasing order the following one: South West Oltenia, Center, North East, South Muntenia, West, North West, South East and Bucharest-Ilfov. The general trend in honey production was an increasing one, as reflected by the linear regression functions, both at country level and almost all the micro-regions except Bucharest-Ilfov. In 2020, it is estimated as Romania will produce 34,400 tons based on the average growth rate of 9.06 %. To increase honey production, beekeepers should keep more than 100 bee families per apiary, apply new technologies, use modern hives, selected bee queens, assure a corresponding feeding, maintenance and health to the bee families. Honey market should be extended by a more intensive promotion of the bee products, a higher quality of honey and development of organic honey and Romanian brands. In this way, beekeepers' income and living standard will increase as well as of the rural communities where they belong to.


Two species of banksia, studied on the south coast of Western Australia, flowered simultaneously and had floral characteristics often associated with vertebrate pollination. The pollen of both was carried by honeyeater birds and small mammals (honey possums). Despite this, differential exclusion of vertebrates and invertebrates from inflorescences indicated that Banksia attenuata set substantial quantities of seed when visited only by invertebrates, although seed set increased with the addition of vertebrate visitors. Banksia baxteri set much seed in the absence of any animal visitors and seed set increased with invertebrate, but not vertebrate, visitation. We suggest that these differences in pollination strategies reflect regeneration by B. baxteri solely from canopy seeds released after fire, whereas B. attenuata also regenerates from seeds released between fires, as well as from lignotubers and epicormic buds.


: The investigation of electrophysiological parameters of the cardiac activity in cats showed that, a derivative of lidocaine with glutamic acid (anion), does not influence the cardiac pacemaker and the myocardial excitability of atrium and ventricles, but decreases the atrioventricular conduction and increases the refractory period of myocardium in the left ventricle of intact heart. Under the conditions of myocardial ischemia, LKhT-3-00 exhibits a negative chronotropic effect. Lidocaine glutamate increases the refractory period of atrium and decreases the excitability and refractory period of ventricles.


Understanding how alloying elements and amounts affect the shape and size of graphite in compacted graphite cast irons could be of great importance. Some important material properties that are affected by the graphite shape are tensile strength and thermal conductivity. Knowing the effect of alloying additions could be of assistance when trying to optimise material for a specific application. In order to determine how graphite changes depending on alloying additions the microstructure of nineteen CGI materials were investigated. All melts were based on one chemical composition and alloying elements were added to obtain melts with variation in magnesium, silicon, copper, tin, chromium and molybdenum. Some of the more important microstructure features that were analysed are the amount and size of different graphite particles. The result from this analysis should give an indication on what features each alloying element affect and how these features varies with alloying amount.


On May 1st, 2014 Slovenia, together with nine other Member States, completed their first decade in the EU – which also entails a decade of adjustments to the principles of the internal market. Based on EU Court of Justice case law, Slovenia is not among the most serious of offenders of internal market rules for it was found to be in breach of these on a single occasion. Even so, practice shows that companies as well as state authorities are often poorly informed about EU internal market rules, which creates barriers nobody is acting against. Examples are numerous in various fields of the internal market and prove that Slovenian businesses as well as authorities are often not truly aware of the internal market yet, but also authorities of other Member States frequently do not regard Slovenia as a participant of the internal market, thereby creating barriers that are not compatible with the internal market.


Cellular systems are becoming more heterogeneous with the introduction of low power nodes including femtocells, relays, and distributed antennas. Unfortunately, the resulting interference environment is also becoming more complex, making evaluation of different communication strategies for cellular systems more challenging in both analysis and simulation. This paper suggests a simplified interference model for heterogeneous network. Leveraging recent applications of stochastic geometry to analyze cellular systems, this paper propose to analyze performance in a fixed-size typical cell surrounded by an interference field consisted of superposition of marked Poisson point processes outside a guard region. The proposed model simplifies the simulation of cellular systems and may provide analytical insights for certain signaling strategies.


This work develops a theory of agent influence and applies it to a coached system of simple reactive agents. Our notion of influence is intended to describe agent ability which is contingent on the actions of other agents and we view such behaviours as being "nested". An agent may have the ability to make A hold only if another agent has carried out a particular action. Our analysis of this is based on a combination of the observation of the effects of an agent's actions in a bounded environment and observations on what may be changed in that environment and is intended to allow for a logical representation of nested behaviours. We build on this notion to develop a theory of influence which we offer as an extension of existing systems for representing agency and its effects. The notion of an agent being able to "see to it" that something is brought about has been a useful device for reasoning about agent ability. These so-called STIT semantics have been developed by a number of researchers. Standard STIT semantics allow statements of the form [α stit: A] which says that agent a has the ability to see to it that A holds. Although based on the concept of agent action STIT semantics also allow for the representation of concepts involving what may be thought of as inaction. An agent deciding, for example, not to execute a particular action may be characterised as seeing to it that it does not see to it that A, [α stit: [α stit: -A]]. STIT encourages nesting and although this nesting extends across actions within an agent it does not extend easily across agents. So called other agent statements of the form [β stit: [α stit: A]] do not make sense in standard stit semantics because β seeing to it that α sees to it that A holds implies that β has some dominion over a which, in turn, compromises α's agency. Although the statement makes no sense under standard STIT it does make sense in an intuitive way and Brian Chellas [31] notes that it would be:
 "...bizarre to deny that an agent should be able to see to it that another agent sees to something" This is also mentioned in Belnap et al. [8, page 275]. Chellas is correct and there are numerous settings in which other agent STIT does make sense. These settings, which are captured in various readings of STIT, may bring a great deal of system level overhead. In a normative system, for example, β may have the option of imposing a sanction on α if α fails to bring about A and in this sense may be thought of as seeing to it that α sees to it that A holds. Similarly a deontic reading may place β in a position where it is able to place an obligation on α to bring about A. These readings allow for sensible interpretation of other agent STIT but the examples above require that agents have sufficient awareness of personal utility be able to manage sanctions or that they are able to reason about obligations. These readings offer nothing for simple agents with limited resources and abilities. We offer another reading for the STIT element, one based on the concept of agent influence and one which carries minimal system level overhead. Because influence may be contingent on simultaneous or sequential behaviour by a number of agents it is extendible across agents and offers a means of addressing other agent statements. We extend the standard STIT semantics of Horty, Belnap and others with the introduction of "leads to" and "may lead to" operators which allow us to move our analysis into a setting where observation provides evidence of influence. We then explore the manifestation of influence in a number of scenarios. After exploring how influence manifests itself we then offer a partial logical characterisation of the influence operators and discuss its relationship with standard STIT. Building on these semantics and the partial logical characterisation we then explore the practical use of our theory of influence in an agent learning system. We describe experiments with a system specified by safety and liveness properties and having two broad classes of agents, actors and coaches. Actor agents will manipulate their environment and coaching agents will observe the actor's behaviour and its effects using aggregated observations to generate new behaviours which are then seeded in the environment to modify actor behaviour. We then offer a discussion and evaluation of our theory and its applications indicating where it may be further developed and applied.


Since the early 2000s, the Madre de Dios Region of southern Peru has experienced rapid expansion of both licit and illicit mining activities, in the form of artisanal and small-scale mining (ASM). ASM typically takes place in remote, inaccessible locations and is therefore difficult to monitor in situ. This paper explores the utility of Landsat-5 imagery via decision tree classification to determine ASM locations in Madre de Dios. Spectral mixture analysis was used to unmix Landsat imagery, using WorldView and QuickBird l imagery to aid spectral endmember selection and validate AMS maps. The ASM maps had an overall area-weighted accuracy of 96% and indicated a large proportion of illicit ASM activity (~65% of all ASM in the study area) occurring outside the permitted concessions. Holistic visual comparison of ASM output maps with reference imagery showed that these methods produce reasonable, realistic maps of mined area extent.


Social indicators are now indispensable in the list of variables of epidemiological studies, based on the fact that the determination of health complaints is complex and multidimensional. From this perspective, social inequality has gained prominence as an explanatory factor for the health conditions of populations. The scope of this article is to discuss the different concepts that underpin the selection of the indicators used in epidemiological studies and examine the psychosocial effects on human beings caused by social inequality. A literature review of epidemiological studies that used social inequality and social capital indicators was conducted for a better understanding of health problems, as well as an investigation in the fields of sociology and social psychology. The research revealed that there is some controversy surrounding the effect of social inequality on health, possibly because these indicators are predominantly based on income and individual consumption capacity. Likewise, social capital indicators at cognitive and structural levels are too limited to understand the dynamism of social relations. Accordingly, further studies are needed for the construction of social indicators capable of examining the complexity of modern societies.


This study was aimed at investigating the haematological and histological effects of ethanolic leaves extract of Jatropha curcas on Plasmodium berghei infected mice. Forty eight mice weighing between 22-24g were assigned into six study groups of eight mice each. Forty mice were parasitized by Plasmodium berghei and used for extract and orthodox treated groups while eight mice were unparasitized. Group 1 was designated as positive control, group 2 was parasitized and designated as negative control. Group 3 was parasitized and designated as orthodox treated group of 100mg/kg body weight of Lonart DS. Group 4 to 6 were parasitized groups and treated with 400mg/kg, 100mg/kg and 200mg/kg body weight of ethanolic extract of Jatropha curcas leaves. Haematological parameters analyzed were hemoglobin (Hb), packed cell volume (PCV) and white blood cell (WBC). The hematological and histological investigations in groups 3, 4, 5 and 6 in orthodox and extract treated mice with 400mg/kg, 100mg/kg and 200mg/kg body weight of ethanolic extract of Jatropha curcas leaves showed significant reduction in their parasitemia levels  compared to negative control group. The ameliorating effect of extract treated groups showed anti-plasmodia and anti-anemic activities which were confirmed in the histological tissues of Plasmodium berghei infected mice.


It seems unassailable that attorneys must refrain from deception or dishonesty of any kind as a condition of professional licensure. But this principle, one of the foundational norms of the legal profession, may well infringe upon First Amendment rights, at least in certain applications. In this Article, we confront the tension between an attorney's expressive and associational rights and her professional duty of absolute honesty. We explain that the latter must yield to the former in the unique circumstances presented by undercover investigations, where attorneys work side-by-side with journalists, civil rights testers, political activists, and others who seek to expose information of profound public concern. Deception about the investigator's identity or purpose is often necessary to obtain access to information that has been deliberately concealed from the public. That attorneys should be permitted to provide counsel, notwithstanding the deceptive element of the investigation, may seem like a surprising conclusion for a profession that pervasively regulates attorney speech and has long assumed that any kind of deception must be categorically off limits for lawyers. Nonetheless, a close examination of rapidly evolving First Amendment principles reveals that lawyers have a right to provide counsel, advice, and supervision to individuals and entities engaged in investigations – even the deceptive kind.


This evaluation examines IDB's management of credit risk of Non-Sovereign Guaranteed Operations. Although the IDB is not subject to the Principles for the Management of Credit Risk issued by the Basel Committee for Banking Supervision, these principles have been used as guidelines for this assessment. It can be concluded that the IDB largely complies with Basel's credit risk management principles. To further develop what is already a solid foundation for its credit risk management system, it is recommended that the IDB adopts a comprehensive Credit Risk Framework that clearly defines its risk appetite for NSG. Such framework should spell out the objectives and procedures supporting the desired NSG loan/guarantee portfolio. The strengthening of the Portfolio Management Function is also recommended to complement the current credit administration and risk management functions being carried out by the originating divisions within SCF and OMJ, PMU and RMG. The IDB should also address the risks posed by the current absence of an integrated information system to support the loan/guarantee granting, administration, risk and portfolio management.


Recurrent neural networks (RNNs) provide a powerful tool for online prediction in online partially observable problems. However, there are two primary issues one must overcome when training an RNN: the sensitivity of the learning algorithm's performance to truncation length and and long training times. There are variety of strategies to improve training in RNNs, particularly with Backprop Through Time (BPTT) and by Real-Time Recurrent Learning. These strategies, however, are typically computationally expensive and focus computation on computing gradients back in time. In this work, we reformulate the RNN training objective to explicitly learn state vectors; this breaks the dependence across time and so avoids the need to estimate gradients far back in time. We show that for a fixed buffer of data, our algorithm—called Fixed Point Propagation (FPP)—is sound: it converges to a stationary point of the new objective. We investigate the empirical performance of our online FPP algorithm, particularly in terms of computation compared to truncated BPTT with varying truncation levels.


Manuscript type: Research paper Research aims: This study aims to investigate the effects of safety climate and employee engagement on organisational citizenship behaviour (OCB). Design/Methodology/Approach: Drawing from the social exchange theory and flow theory, a theoretical framework was developed and tested using data collected from 610 freelance sewage workers. A questionnaire survey was used to collect the data, while structural equation modelling (SEM) analysis was used as the data analysis approach. Research findings: The results reveal that both safety climate and employee engagement have significantly positive impact on employees' organisational citizenship behaviour amongst sewage workers in Indonesia. This finding indicates that although the sewage cleaners are often employed based on contract and may not be in a position to demand more from the organisations, they do appreciate the organisational commitment in producing a safe workplace environment. They, in return will demonstrate a higher engagement towards their work. Theoretical contribution/Originality: This study contributes to the organisational citizenship behaviour literature by examining how workplace environmental factors such as safety climate affects organisational citizenship behaviour. In the context of sewage cleaning, safety climate is important, as sewage workers are frequently exposed to and threatened by serious health problems. Yet, there has been a paucity of research on the sewage cleaning sector to understand the relationships. Research limitation/Implications: The study implies that when organisations are willing to improve safety climate, their employees will perceive improved safety climate, and then will have more engagement and organisational citizenship behaviour.


Genetically modified crops – are they monsters of nature or could they provide answers to some of our most pressing environmental concerns? Will they create superweeds, run amock and change life as we know it, or are these fears greatly exaggerated?

Internationally respected microbiologist Jennifer Thomson takes us through the issues and concerns surrounding the development of genetically modified crops and their impacts on the environment. She explains how such crops are developed and assessed and discusses the likelihood of negative effects on biodiversity, pollen spread, and organic farming. GM crops may have tremendous potential for addressing some of the world's environmental problems and protecting the planet, particularly in developing countries – in fact we could face more harm if some of these technologies are not adopted.


Jane Austen completed only six novels, but enduring passion for the author and her works has driven fans to read these books repeatedly, in book clubs or solo, while also inspiring countless film adaptations, sequels, and even spoofs involving zombies and sea monsters. Austen's lasting appeal to both popular and elite audiences has lifted her to legendary status. In "Jane Austen's Cults and Cultures", Claudia L. Johnson shows how Jane Austen became "Jane Austen," a figure intensely - sometimes even wildly - venerated, and often for markedly different reasons. Johnson begins by exploring the most important monuments and portraits of Austen, considering how these artifacts point to an author who is invisible and yet whose image is inseparable from the characters and fictional worlds she created. She then passes through the four critical phases of Austen's reception-the Victorian era, the First and Second World Wars, and the establishment of the Austen House and Museum in 1949-and ponders what the adoration of Austen has meant to readers over the past two centuries. For her fans, the very concept of "Jane Austen" encapsulates powerful ideas and feelings about history, class, manners, intimacy, language, and the everyday. By respecting the intelligence of past commentary about Austen, Johnson shows, we are able to revisit her work and unearth fresh insights and new critical possibilities. An insightful look at how and why readers have cherished one of our most beloved authors, "Jane Austen's Cults and Cultures" will be a valuable addition to the library of any fan of the divine Jane.


There are several classes of ranked posets related to reflection groups which are known to have the Sperner property, including the Bruhat orders and the generalized noncrossing partition lattices (i.e., the maximal intervals in absolute orders).  In 2019, Harper–Kim proved that the absolute orders on the symmetric groups are (strongly) Sperner.  In this paper, we give an alternate proof that extends to the signed symmetric groups and the dihedral groups.  Our simple proof uses techniques inspired by Ford–Fulkerson's theory of networks and flows, and a product theorem.


The aspiration of Albania for European integration has added mandatory requirements for public sector to modernize the internal audit function in adherence with International Internal Auditing Standards. According to such Standards supported by Picket (2005) and CIPFA (2003) the internal audit is an assurance function that provides independent opinion on the effectiveness of internal controls that support the achievement of the organizations objectives. Internal auditors can provide consultancy service, in particular to aid management to improve the organization control environment. Meanwhile, Diamond (2002) explains that the internal audit role, remit, scope and activities are driven by the macroeconomic objectives and political stabilization. For those countries with governance problems the first objective is to ensure compliance with financial laws and regulations. Therefore, the most suitable approach for the internal audit is the compliance auditing to attain macroeconomic stabilization objectives. Therefore, the main question around which this paper is based is whether the public sector in Albania is ready to adopt the modern model of internal audit moving beyond the traditional compliance and financial remit to comply with recognized International Internal Audit Standards. This paper finds that although changes in Albanian normative framework since 2007, internal audit within government organizations are still adopting traditional approach of internal audit involving financial inspections rather than performance auditing activities aiming to provide opinion on risk management, control and governance. This paper analyzes that the embryonic risk culture of Albanian public sector, the lack of skilled internal audit resources and a little understanding of both managers and internal auditors with regard to the contribution of internal audit in risk management and corporate governance system aimed at achieving the government organizations objectives are the main reasons why the risk based model and consultancy role of internal auditors is not yet applied. Therefore, this paper recommends the internal auditors to perform additional consultancy tasks to enhance the internal control system and build the risk management methodologies and structures due to the management lack of knowledge. As soon as the organizations become risk mature the internal auditors can provide assurance appraisal service based on risks. The Practice Advisory Standard 1000 recommends principles which should be used as guidance for regulatory framework of internal audit function within Albania, public sector, guiding internal auditors in order for them to maintain their independence, objectivity and due professional care while conducting consulting service.


Theoretical basis
This case uses the concept of social entrepreneurship to analyze the entrepreneurial journey of Mr Suraj Prakash and his social enterprise, the Swasth Foundation. It further deepens our understanding of strategic decision-making by exploring the successful use of pivots.

Research methodology
The case was primarily developed through a series of interviews with the leadership team over a year. Secondary sources included literature about Swasth Foundation available on the internet and those shared by the founder.

Case overview/synopsis
In 2008, Suraj Prakash left McKinsey & Company after six and half years in the health and development sector as an engagement manager. Along with his friends, Aman Paul and Ankur Sharma, he established Swasth with the goal of building an ecosystem that delivered high-quality, affordable and accountable health services to low-income communities in India. Right from its inception, Swasth went through many fundamental shifts in terms of its business model, team composition and even the nature of its existence; however, this did not deter Suraj from pursuing his goal.
The case brings into focus the health-care system of India, especially in the context of the urban poor and the challenges they are facing, followed by the initiatives taken by Swasth Foundation and the impact it is trying to create. The remainder of the case delves into Suraj's entrepreneurial journey and the three pivotal decisions that changed the course of his organization over 11 years. It will also provide a transpicuous view of the entrepreneurial decision-making process through the lens of pivoting. As Suraj and his team are trying to bring about the required changes through the third pivot, there remain some challenges that need to be addressed for a successful implementation.

Complexity academic level
The case is written for business management students and can be used in general management, entrepreneurship and strategy classes. The case can be used for discussions on leadership, social entrepreneurship and strategic decision-making. It is suited for both undergraduate and postgraduate levels.


To be effective, wave energy converter devices (WECs) must be installed in unsheltered locations with high wave energy density. Such regimes are more likely to be at offshore locations and much current interest is focused on offshore floating devices. Since the wave energy industry has little practical long-term experience with deployed WEC systems there is no historical experience upon which to base the formulation of appropriate station-keeping arrangements. The development of generic station-keeping arrangements that will allow reliable, yet cost-effective, mooring systems presents a challenging task. This paper raises issues pertinent to the station-keeping of floating WECs and discusses a preliminary design procedure to identify suitable mooring arrangements.


Purpose: Cardiovascular disease is a common cause of death in prostate cancer patients. Low testosterone is associated with increased cardiovascular risk in the general male population. We investigated the relationship between serum testosterone, cardiovascular disease and risk factors in androgen-deprivation therapy-naïve prostate cancer patients. Materials and Methods: We performed a cross-sectional analysis of a subgroup of 1,326 androgen-deprivation therapy-naïve men from RADICAL-PC (Role of Androgen-Deprivation Therapy In CArdiovascular Disease—A Longitudinal Prostate Cancer study) in whom serum testosterone was measured at baseline. RADICAL-PC is a prospective multicenter cohort study of men (2,565) enrolled within 1 year of prostate cancer diagnosis, or within 6 months of commencing androgen-deprivation therapy for the first time. Cardiovascular risk factors, cancer characteristics and total serum testosterone were collected at baseline. Low testosterone was defined as total serum testosterone <11 nmol/L (<320 ng/dL). A Framingham cardiovascular risk score ≥15 was considered high risk for future cardiovascular events. We performed logistic regression to calculate odds ratios for the association between testosterone and cardiovascular risk. Results: Among 1,326 participants (median age 67 years, range 45–93), 553 (42%) had low testosterone. Low testosterone was associated with existing cardiovascular disease, diabetes, elevated hemoglobin A1c, obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol, hypertension and Framingham score >15. Among patients with low testosterone, the odds ratio for high cardiovascular risk was 1.33 (1.02–1.73) after adjusting for ethnicity, education, alcohol use, cancer characteristics, physical activity and body mass index. Conclusions: Among androgen-deprivation therapy-naïve prostate cancer patients, low testosterone is common and associated with increased cardiovascular risk factors.


Power amplifier (PA) designs at high frequency are not straightforward and they depend on designers' experience by dealing with a high number of parameters to be set. To address PA design problems, we propose an automated bottomup method based on an artificial neural network (ANN) to be employed in the optimization-oriented strategy. The proposed methodology starts with a PA based on lumped elements (LEs), then ANN is trained for characterizing the lumped element PA and finally a PA with distributed components, the natural environment at high frequency, is designed by using a bottomup method and the constructed ANN. In this way, the resulting distributed element PA inherits the advantages of the lumped element design, i.e., offering higher and flatter gain performance. To validate our method, we design 10 W PAs in band frequency of 1 GHz to 2 GHz (L band). The automated design of PA with transmission lines (TLs) results in gain between 10–13dB and power added efficiency larger than 50%. Our results demonstrate the robustness of the presented approach adopting ANN in designing PAs, automatically.


Ribonucleic acid (RNA) extracted from Neurospora crassa has been fractionated by oligodeoxythymidylic acid [oligo(dT)]-cellulose chromatography into polyadenylated messenger RNA [poly(A) mRNA] and unbound RNA. The poly(A) mRNA, which comprises approximately 1.7% of the total cellular RNA, was further characterized by Sepharose 4B chromatography and polyacrylamide gel electrophoresis. Both techniques showed that the poly(A) mRNA was heterodisperse in size, with an average molecular weight similar to that of 17S ribosomal RNA (rRNA). The poly(A) segments isolated from the poly(A) mRNA were relatively short, with three major size classes of 30, 55, and 70 nucleotides. Gel electrophoresis of the non-poly(A) RNA indicated that it contained primarily rRNA and 4S RNA. The optimal conditions were determined for the translation of Neurospora mRNA in a cell-free wheat germ protein-synthesizing system. Poly(A) mRNA stimulated the incorporation of [14C]leucine into polypeptides ranging in size from 10,000 to 100,000 daltons. The RNA that did not bind to oligo(dT)-cellulose also stimulated the incorporation of [14C]leucine, indicating that this fraction contains a significant concentration of mRNA which has either no poly(A) or very short poly(A) segments. In addition, the translation of both poly(A) mRNA and unbound mRNA was inhibited by 7-methylguanosine-5'-monophosphate (m7G5'p). This is preliminary evidence for the existence of a 5'-RNA "cap" on Neurospora mRNA.


In many deltas worldwide subsidence still is an underestimated problem, while the threat posed by land subsidence low-lying urbanizing and urbanized deltas exceeds the threat of sea-level rise induced by climate change. Human-induced subsidence is driven by the extraction of hydrocarbons and groundwater, drainage of phreatic groundwater, and loading by buildings and infrastructure. The consequences of subsidence are increased flood risk and flood water depth, rising groundwater levels relative to the land surface, land loss, damage to buildings and infrastructure, and salinization of ground and surface water.. The Netherlands has a long history of subsidence. Large-scale drainage of the extensive peatlands in the western and northern parts of the Netherlands started approximately 1000 years ago as a result of rapid population growth. Subsidence is still ongoing due to (1) continuous drainage of the former peatland, which is now mainly in use as agricultural land and built-up area, (2) expansion of the built-up area and the infrastructural network, (3) salt mining and the extraction of gas in the northern Netherlands. Mitigating subsidence and its negative impacts requires understanding of the relative contribution of the drivers contributing to total subsidence, accurate predictions of land subsidence under different management scenarios, and its impacts. Such understanding enables the development of effective and sustainable management strategies. In the Netherlands, a lot of effort is put into water management aiming at amongst others the protection against floods and the ensuring agricultural activities, but a specific policy focusing on subsidence is lacking. The development of strategies to cope with subsidence is very challenging, because (1) the exact contribution of different drivers of subsidence to total subsidence is spatially different within the Netherlands, (2) there is no single problem owner, which makes it difficult to recognize this a common societal issue that should be tackled, and (3) it requires an integrated approach involving technical knowledge on contributors to subsidence, water management, governance arrangements, the legislative framework, socio-economic developments and spatial planning. To develop a sustainable solution to subsidence, we propose an approach including: (1) monitoring of surface elevation and drivers of subsidence, (2) scenario studies using coupled state-of-the-art 3D geological, hydrological and subsidence numerical models , and (3) a national database and model infrastructure. The next step is to carry out (4) a societal cost-benefit analysis and (5) to optimize governance arrangements and the legislative framework enabling the (6) implementation of measures. The realization of these requirements and the implementation of the resulting management strategies requires a joint effort of the national research institutes, including universities, and the involved local, and regional governmental organizations controlled by the national government. The research institutes should be responsible for developing monitoring strategies, generating the data and databases and developing the numerical models, governance arrangements and the legislative framework. The governmental organizations have the important responsibility for putting subsidence on their agendas, facilitating the research institutes and the implementation of governance arrangements and legislative framework enabling the implementation of effective measures.


Objective The aim of the present study was to identify the factors associated with non-attendance of immediate postpartum glucose test using a machine learning algorithm following gestational diabetes mellitus (GDM) pregnancy. Method A retrospective cohort study of all GDM women (n = 607) for postpartum glucose test due between January 2016 and December 2019 at the George Eliot Hospital NHS Trust, UK. Results Sixty-five percent of women attended postpartum glucose test. Type 2 diabetes was diagnosed in 2.8% and 21.6% had persistent dysglycaemia at 6–13 weeks post-delivery. Those who did not attend postpartum glucose test seem to be younger, multiparous, obese, and continued to smoke during pregnancy. They also had higher fasting glucose at antenatal oral glucose tolerance test. Our machine learning algorithm predicted postpartum glucose non-attendance with an area under the receiver operating characteristic curve of 0.72. The model could achieve a sensitivity of 70% with 66% specificity at a risk score threshold of 0.46. A total of 233 (38.4%) women attended subsequent glucose test at least once within the first two years of delivery and 24% had dysglycaemia. Compared to women who attended postpartum glucose test, those who did not attend had higher conversion rate to type 2 diabetes (2.5% vs 11.4%; p = 0.005). Conclusion Postpartum screening following GDM is still poor. Women who did not attend postpartum screening appear to have higher metabolic risk and higher conversion to type 2 diabetes by two years post-delivery. Machine learning model can predict women who are unlikely to attend postpartum glucose test using simple antenatal factors. Enhanced, personalised education of these women may improve postpartum glucose screening.


The Obama administration has elevated nuclear disarmament to the center of its nuclear agenda through the New Strategic Arms Reduction Treaty (New START) with Russia and the release of the U.S. Nuclear Posture Review (NPR). The administration also expects that its professed goal of "getting to zero" has symbolic value and will encourage reciprocity in terms of disarmament and nuclear arms control by other nuclear weapons states, as well as cooperation on measures to limit nuclear proliferation and the threat of nuclear terrorism. In the case of the two rising powers of Asia — China and India — it is highly questionable whether either of these expectations will be met.From China's perspective, New START is merely a first, tentative step toward global disarmament, while the NPR is disturbingly ambiguous on key issues and retains a worrisome emphasis on ballistic missile defense. In the case of India, any decision to reciprocate on disarmament and arms control will be more strongly influenced by concerns about China than by any ideological commitment to a nuclear-free world or developments in Washington's nuclear posture. Washington's emphasis on disarmament could provide both states, especially China, with a pretext for limiting their cooperation on U.S. nonproliferation goals that are more important and achievable. Because of that risk, the United States should be cautious about dissipating its advantages in the nuclear arena without getting significant concessions in return.


Since 1992, in Baden-Wurttemberg, ten-year old children have been surveyed in the project Sentinel Health Departments to study their exposure to environmental pollutants and possible health effects. In the four study areas 1200 children have been investigated every year initially, since 1996 every second year. The data for mercury in body fluids are reported here. The decrease in the body burden of mercury as a result of the declining usage of dental amalgam fillings, was been verified. In 1992/93, of all the children who had been surveyed, the 95 percentile for the body burden of mercury was 3.1 μg/l and in 2000/011.35 μg/l. Also to be discussed is the reason why mercury-based cosmetic ointments seriously exceed the HBM-11-intervention-value. Because of using these ointments, concentrations of mercury in urine up to 1400 μg/l were found. A study within the project Sentinel Health Departments compared the concentrations of mercury in the urine of adults with those in blood and salvia. The results support the opinion that mercury in urine is appropriate for estimating the mercury uptake from dental amalgam fillings. It can be assumed that these results reflect the situation in the entire Federal Republic of Germany. The ten years' experience confirms that the concept of the Sentinel Health Departments is excellently suited to obtain data relevant for environ-mental health of children. Environmental health protection and the essential gathering of data for future health observation in Baden-Wurttemberg.


The Federal Food, Drug, and Cosmetic Act (FDCA) does not expressly prohibit companies from marketing or promoting drugs for unapproved, "off-label" uses. The FDA itself acknowledges that off-label promotion is not a "prohibited act" under the statute, or an element of any such act. Instead, the FDA uses off-label promotion as evidence of other statutory violations. This Article engages in perhaps the most thorough statutory construction analysis of the FDCA on this question, finding that the statute does support the FDA's functional ban on off-label promotion. Using various tools of construction, I find that several sections of the FDCA assume or expressly contemplate a ban on off-label promotion, and that the FDCA's regulation of medical products, as a whole, depends on such a ban.


The influence on memory of 7.5 mg zopiclone, given in single and repeated doses was compared with that of 2 mg flunitrazepam, 5 mg nitrazepam and placebo. Compared with placebo, all three drugs induced some impairment of memory especially after the first day of administration. Effects were more pronounced for the two benzodiazepines and more marked for flunitrazepam. There was one report of an anterograde amnestic episode after flunitrazepam.


The ethnic ties on the Baltic and Slavic musical folklore are shown and examined on the base of Lithuanian wedding folk song "Sėskis, sesute, sėskis, jaunoji" and its parallels in Polish, Belarusian and Ukrainian folk songs heritage sources. Clear examples of analogue or relative variants of actual songs are presented here, and common features of their poetic texts and melodic lines peculiarities are explored as well. We see much closer analogues in poetic texts here to compare with parallels in melodic lines hereby. The hypothesis about possible great number of such Lithuanian (Baltic) and Polish, Belarusian, Ukrainian, etc. (Slavic) folk songs relative variants is declared, certifying their common historical sources and relative ethnic roots. Key words: Lithuanian folk songs, Polish folk songs, Belarusian folk songs, Ukrainian folk songs, comparative research studies, Baltic and Slavic musical folklore relations. DOI: http://dx.doi.org/10.15181/td.v11i0.1432


The role of human lactoferrin (hLf) in alimentary iron absorption across intestinal cells was explored using a human differentiated colon carcinoma cell line, HT-29cl.19A. The apical surface of HT-29cl.19A cell monolayers exhibited 1.5 x 10(6) specific binding sites for hLf per cell, with a dissociation constant of 8.3 x 10(-7) M. The apical-to-basolateral transport of 125I-labeled hLf (125I-hLf) or 125I-59Fe-labeled hLf (125I-[59Fe]hLf) was investigated using filter-grown HT-29cl.19A cell monolayers mounted in Ussing chambers. Transport of total (intact plus degraded) hLf, measured by the 125I flux, was not saturable up to an apical hLf concentration of 12.5 microM, whereas immunoreactive hLf transport measured by enzyme-linked immunoabsorbent assay was saturable at 3.75 microM. Lowering the temperature to 4 degrees C reduced the total and immunoreactive hLf fluxes by 77% and 90%, and colchicine (500 microM) reduced these fluxes by 30% and > 97%, respectively. These results indicate that both types of transport are transcellular. Electrophoretic analysis revealed that 125I-hLf transported to the basal compartment consisted of largely degraded fragments (< 2 and 10-20 kDa) and a small portion of intact hLf. At an apical concentration of 3.75 microM diferric 125I-[59Fe]hLf, the immunoreactive hLf flux (64.6 +/- 14.3 ng.h-1.cm-2) constituted approximately 12% of the total hLf flux (552.0 +/- 61.6 ng.h-1.cm-2) and was similar to the [59Fe]hLf-equivalent flux (77.0 +/- 12.3 ng.h-1.cm-2).(ABSTRACT TRUNCATED AT 250 WORDS)


The design of the autopilot is one of the most important algorithms of missiles. Performance of the autopilot and its robustness are significant matters to hit a target accurately. The autopilot should satisfy the desired performance under disturbances. In the scope of this study, three autopilots were offered for tracking pitch acceleration command using different control methods: three-loop classic control, pole-placement control and receding horizon predictive control. The aim of the autopilot designed by employing receding horizon predictive control is to minimize the flight control effort, and to make the close-loop system insensitive against modelling uncertainties and stochastic shattering factors. This study comes up with that the missile is able to move in desired performance under disturbances such as control surface misplacement, thrust misalignment, wind and aerodynamic uncertainties with more robustness, less control effort and minimum miss distance and terminal time using an alternative control method instead of classic and pole-placement control methods which are generally referred by the defence industry.


Human cognitive processing and decision making are essential aspects in emergency management. Emergency situations imply additional demands to information processing. To meaningfully support decision makers in emergencies, a comprehensive understanding of the human perception and decision making processes and their underlying principles is required in the design of Emergency Management Information Systems (EMIS). This paper presents a psychological framework that models the stages and components of decision making in the context of emergency management. To this end, psychological research on human perception and information processing, knowledge and competence modelling, human judgement and decision making, individual and situational factors, stress, and self-regulation are identified as important compents of the framework. The psychological framework represents a comprehensive model of decision making of emergency managers, for a better understanding of the involved cognitive processes and influencing factors on the person level and on the context level. The paper posits the framework as a guide in the identification of requirements for emergency managers during systems analysis. This comprises systematically describing decision tasks in emergency situations and identifying needs for supporting them. The knowledge on human perception and decision making represented by the framework can also be used to inform the user interface design of the EMIS. It may also inform the evaluation of EMIS as it provides a theoretically founded representation of relevant aspects of human-computer interaction, which facilitates the identification of success indciators to be addressed in user-centred evaluation. The framework furthermore supports the design and implementation of training programmes through the differentiation and modelling of knowledge and competence relevant in emergency decision making. To demonstrate the application of the psychological framework in the design, development, and testing of EMIS a set of concrete design principles as well as exemplary paper prototypes applying these principles are presented.


The catalytic fast pyrolysis (CFP) of pine was investigated over 10 wt% MoO3/TiO2 and MoO3/ZrO2 at 500 °C and H2 pressures ≤0.75 bar. The product distributions were monitored in real time using a molecular beam mass spectrometer (MBMS). Both supported MoO3 catalysts show different levels of deoxygenation based on the cumulative biomass to MoO3 mass ratio exposed to the catalytic bed. For biomass to MoO3 mass ratios <1.5, predominantly olefinic and aromatic hydrocarbons are produced with no detectable oxygen-containing species. For ratios ≥1.5, partially deoxygenated species comprised of furans and phenols are observed, with a concomitant decrease of olefinic and aromatic hydrocarbons. For ratios ≥5, primary pyrolysis vapours break through the bed, indicating the onset of catalyst deactivation. Product quantification with a tandem micropyrolyzer–GCMS setup shows that fresh supported MoO3 catalysts convert ca. 27 mol% of the original carbon into hydrocarbons comprised predominantly of aromatics (7 C%), olefins (18 C%) and paraffins (2 C%), comparable to the total hydrocarbon yield obtained with HZSM-5 operated under similar reaction conditions. Post-reaction XPS analysis on supported MoO3/ZrO2 and MoO3/TiO2 catalysts reveal that ca. 50% of Mo surface species exist in their partially reduced forms (i.e., Mo5+ and Mo3+), and that catalyst deactivation is likely associated to coking.


Human inter-alpha-trypsin inhibitor (I alpha I) is a plasma proteinase inhibitor active against cathepsin G, leucocyte elastase, trypsin and chymotrypsin. It owes its broad inhibitory specificity to tandem Kunitz-type inhibitory domains within an N-terminal region. Sequence studies suggest that the reactive-centre residues critical for inhibition are methionine and arginine. Reaction of I alpha I with the arginine-modifying reagent butane-2,3-dione afforded partial loss of inhibitory activity against both cathepsin G and elastase but complete loss of activity against trypsin and chymotrypsin. Reaction of I alpha I with the methionine-modifying reagent cis-dichlorodiammineplatinum(II) resulted in partial loss of activity against cathepsin G and elastase but did not affect inhibition of either trypsin or chymotrypsin. Employment of both reagents eliminated inhibition of cathepsin G and elastase. These findings suggest that both cathepsin G and elastase are inhibited at either of the reactive centres of I alpha I. Trypsin and chymotrypsin, however, appear to be inhibited exclusively at the arginine reactive centre.


Objectives To examine how the frequency of information regarding a real disease threat influences hand washing with soap. Design and setting The authors installed wireless devices in highway service station lavatories in England to record the proportion of individuals washing hands with soap from May 2009 to January 2010. Participants Participants were users of men's and women's toilets. Combined there was an average of 6800 participant entrances into the lavatories daily. Primary outcome measure The primary outcome measure is the proportion of soap usage to the number of entries into the lavatories. Results Hand-washing rates were positively related to both H1NI coverage in blogs and the news; however, these relationships were stronger for men than for women. Conclusions Hand washing with soap increases proportionally to the frequency of media key words related to H1N1. Women's hand washing was more strongly associated with incidence of media keywords than men's.


Speculation as to the origins of music flourished around 1900, in the climate of the recently institutionalized academic discipline of Musikwissenschaft at German-speaking universities. Even across the methodological divides of the young discipline, virtually all branches of Musikwissenschaft participated in this search, which was fueled by the nineteenth-century "philosophy of origins," a powerful ideology that invested special metaphysical significance in the point of departure. Resonating with such concepts as authenticity, autochthony, stability, and purity, the philosophy of origins encouraged a search particularly for the Germanic origins of music. The article traces how various branches of Musikwissenschaft-psychological, ethnological, theoretical, and historical-contribute to this search by reconstructing these elusive origins of music, and at the same time (to varying degrees) establish a sense of identity. This search for origins was not merely of archaeological interest but became instrumental in defining the meaning of Musik as the object of the wissenschaftlich enterprise in the young discipline-not coincidentally at a time when this object, the tradition of tonal music, was increasingly perceived to be under threat from contemporary composition.


In this paper we study the problem of finding a conformal metric with the property that the k-th elementary symmetric polynomial of the eigenvalues of its Weyl-Schouten tensor is constant. A new conformal invariant involving maximal volumes is defined, and this invariant is then used in several cases to prove existence of a solution, and compactness of the space of solutions (provided the conformal class admits an admissible metric). In particular, the problem is completely solved in dimension four, and in dimension three if the manifold is not simply connected.


This study has examined the causality between disaggregated energy consumption (electricity and fossil consumption) and overall growth, agricultural and manufacturing growth in Ghana's economy over the period 1971-2007. By employing the Augmented Dickey Fuller test all variables were found to be integrated of the order one and the Johansen test showed the presence of cointegration between the variables. The granger causality test for the study indicated a unidirectional causality from overall growth to electricity and fossil consumption; a unidirectional causality from agriculture to electricity consumption both in the short and long run; and a feedback relationship between manufacturing and electricity consumption. Energy seem not be an essential factor of production in the agricultural sector but important in the manufacturing sector therefore, it is recommended that efforts be geared towards ensuring a high supply of energy to the manufacturing sector in order to keep up its contribution to the economy.


Biomaterials![Figure][1]

Engineered tissue resembling the stapes, a middle-ear bone.

PHOTO: ERIK VRIJ

Tissue engineering requires the use of degradable scaffolds that provide temporary support and an architectural guide that controls the initial growth and proliferation of seeded cells to form a desired tissue. Vrij et al. develop a more general approach in which cellular aggregates progressively fuse and assemble to form tissues. By controlling the general shape of the well into which the cells or clusters are seeded, they introduce anisotropy into both the shape of the growing objects and in deformation upon compaction. This encourages the formation of a primitive vasculature and self-scaffolding as the final tissue is assembled from the smaller building blocks.

Adv. Mater. 10.1002/adma.201505723 (2016).

 [1]: pending:yes


We engineer policies to stimulate technology development in a manufacturing industry using an agent-based model of value networks within a multi-region industry. Generally, industrial production is organized in value networks, where firms in upstream tiers supply components to firms in downstream tiers. We postulate that ties are increasingly intraregional with incremental innovation typical for the mature stage of the industry life-cycle, while ties are increasingly interregional to accommodate experimental recombination and discontinuous innovation in the decline and inception stages of the industry life-cycle. Policy instruments should create conditions favorable for regional performance in either of the two distinct industry life-cycle phases. We present an agent-based model based on Pyka, Gilbert & Ahrweiler (2007) in which agents decentrally form multi-tier production networks that produce products for the end-consumer market. Production knowledge is modeled as a capability taxonomy with an expandable set of abilities per capability class. These abilities are the production recipes to transform input products acquired at upstream tiers into output products sold at downstream tiers. Agents continuously experiment with their abilities to improve the product they produce, but the increase in performance of products gradually tapers off. In case agents repeatedly discover inferior products, they look for new combinations of capabilities, both within and outside the set of their current value network partners. This radical capability experimentation may yield new capabilities, thereby new possible abilities, hence possibly new (end-)products that can be produced. Firms either collaborate with other firms, collaborate with a research institute, or vertically integrate to access capabilities that may or may not 'unlock' new capabilities. We introduce a spatial limit to both the production network partnership (and thereby ability hill-climbing) and the innovation network partnership (and thereby capability discovery search). To understand which technology search heuristics are to be stimulated and what research infrastructure is to be put in place, we study technological progress under different distributions of capabilities (over regions, over public pools, and over firms in the value networks) and different (spatial characteristics of) search heuristics used by the agents. Finally, we initialize our agent-based model to reflect the particular cases of the biotechnology industry in Vienna and automotive industry in the Stuttgart region. Using the empirical distribution of capabilities over agents and regions, we study technological progress in both industries for the different scenarios for the (spatial characteristics of) search heuristics and for different research infrastructures for capability pooling.


Purpose: New teacher evaluation systems have expanded the role of principals as instructional leaders, but little is known about principals' ability to promote teacher development through the evaluation process. We conducted a case study of principals' perspectives on evaluation and their experiences implementing observation and feedback cycles to better understand whether principals feel as though they are able to promote teacher development as evaluators. Research Method: We conducted interviews with a stratified random sample of 24 principals in an urban district that recently implemented major reforms to its teacher evaluation system. We analyzed these interviews by drafting thematic summaries, coding interview transcripts, creating data-analytic matrices, and writing analytic memos. Findings: We found that the evaluation reforms provided a common framework and language that helped facilitate principals' feedback conversations with teachers. However, we also found that tasking principals with primary responsibility for conducting evaluations resulted in a variety of unintended consequences which undercut the quality of evaluation feedback they provided. We analyze five broad solutions to these challenges: strategically targeting evaluations, reducing operational responsibilities, providing principal training, hiring instructional coaches, and developing peer evaluation systems. Implications: The quality of feedback teachers receive through the evaluation process depends critically on the time and training evaluators have to provide individualized and actionable feedback. Districts that task principals with primary responsibility for conducting observation and feedback cycles must attend to the many implementation challenges associated with this approach in order for next-generation evaluation systems to successfully promote teacher development.


To perform my late promise to you, I shall without further ceremony acquaint you, that in the beginning of the year 1666 (at which time I applied myself to the grinding of optic glasses of other figures than spherical) I procured me a triangular glass prism, to try therewith the celebrated phenomena of colours. And in order thereto having darkened my chamber, and made a small hole in my window shuts, to let in a convenient quantity of the sun's light, I placed my prism at its entrance, that it might be thereby refracted to the opposite wall. It was at first a very pleasing divertisement, to view the vivid and intense colours produced thereby; but after a while applying myself to consider them more circumspectly, I became surprised to see them in an oblong form; which, according to the received laws of refraction, I expected should have been circular. They were terminated at the sides with straight lines, but at the ends, the decay of light was so gradual, that it was difficult to determine justly, what was their figure; yet they seemed semicircular. Comparing the length of this coloured spectrum with its breadth, I found it about five times greater; a disproportion so extravagant that it excited me to a more than ordinary curiosity of examining, from whence it might proceed. I could scarce think, that the various thickness of the glass, or the termination with shadow or darkness, could have any


Due to an increased focus on the development of high-power marine microgrids, new vessels are being installed with large power systems including highly fluctuating loads operating at high efficiency and with low emissions. The introduction of a battery energy storage system in a shipboard DC grid allows for operating the diesel gensets at variable speeds, not being locked to a fixed frequency or speed. The transient performance of the system can also be improved and an optimal load leveling of the different prime movers can be achieved by the proper implementation of a battery. Thus, the system can operate efficiently with highly fluctuating loads while keeping the fuel consumption low. In order to integrate the batteries into the shipboard DC grid, high-power bidirectional DC/DC converters are needed. Many converter configurations are available, yielding different advantages and disadvantages. Thus, each different system should be evaluated in order to see which converter topology is best suited for that specific system. The stress levels on the switching devices are also higher than before, which can be seen as a result of the utilization of higher voltages and currents in the shipboard grids. Isolated bidirectional DC/DC converters for high power applications can provide the proper connection, but along with the increased loads comes higher requirements to component ratings as well as a more complex control system. A high-power medium-voltage DC/DC converter suitable for implementing such a battery is analyzed in this thesis after explaining the shipboard electrical system. The converter has a rated power of 4MW with an equal input and output voltage of 1100V and with a high-frequency transformer providing galvanic isolation between the shipboard power grid and the battery. Its performance is evaluated by means of modeling it in Matlab/Simulink where the focus has been on the switch resonance components in order to achieve a high-performance, soft-switched converter. A PI controller is also implemented in order regulate the output voltage of the converter for different load levels. As some of the converter requirements are a robust design, high operating efficiency and a fast response, the PI controller is tuned in order achieve this and it is seen that the converter responds fast with small deviations in parameter values for load variations of several megawatts. A gate signal generator is also made, where the output of the PI controller is used as input, delaying the gate signals to switches in either the primary or secondary side, depending on the power flow direction. The model is used to analyze the current waveforms through the switches and the transformer, and by doing measurements and calculations based on the simulation results, the efficiency of the converter is calculated at different load steps ranging from 0 to 4MW . It is seen that the converter operates at an efficiency of 97.2% at an output power of 4MW with increasing efficiency for lower load levels due to the lower conduction losses. However, the high-frequency transformer is assumed ideal in this thesis and thus the efficiency will be somewhat lower with the transformer losses included.


This is Part I of a two paper set dealing with transmission and integrated resource planning. The primary objective of this paper is to report a framework to bring transmission and selected other resources into the sphere of integrated resource planning. Transmission lines and related equipment are indeed a resource, and may constitute either a substitute for other resources (e.g., a strengthened transmission network may reduce the need for remote generation) or a complement to other resources (e.g., additional transmission investment may be needed to facilitate power purchases from a neighboring system or an independent power producer). Moreover, growing competitive pressures make it necessary to plan transmission systems to facilitate competition among alternative generation and demand-side resources. A combined transmission and integrated resource planning model, called the Comprehensive Electrical Systems Planning Model (CESPLAN), is described in this paper. >


Nitric oxide is a recently discovered biomolecule with a broad range of actions. The present study investigated the regulation of nitric oxide synthase activity by dexamethasone and the cofactor tetrahydrobiopterin in murine macrophages. The influence of the tetrahydrobiopterin biosynthesis inhibitors 2,4-diamino-6-hydroxypyrimidine, an inhibitor of GTP cyclohydrolase I, and phenprocoumon, an inhibitor of sepiapterin reductase, on the synthesis of nitric oxide was investigated. Dexamethasone decreased the nitric oxide production due to direct inhibition of the induction of nitric oxide synthase and of GTP cyclohydrolase. Substitution of tetrahydrobiopterin via sepiapterin could not overcome the dexamethasone-mediated inhibition. 2,4-Diamino-6-hydroxypyrimidine abolished nitric oxide synthesis and synergized with dexamethasone, completely eliminating nitric oxide production. Phenprocoumon inhibited production of nitric oxide via interference with later steps of tetrahydrobiopterin biosynthesis. An exogenous supply of tetrahydrobiopterin through sepiapterin led to a further increase of nitric oxide production, even in fully activated macrophages. The amount of nitric oxide produced by murine macrophages is therefore limited by the amount of tetrahydrobiopterin present in the cells. Inhibitors of tetrahydrobiopterin biosynthesis could provide a novel approach for therapy of pathological conditions mediated by nitric oxide, such as septic shock.


Purpose: This study was conducted to show diverse clinical presentation of ocular surface squamous neoplasia with a rare presentation of caruncle squamous cell carcinoma (SCC).
Methods: All cases that had suspicious ocular lesion were included in the treatment study. A detailed history including demographic data was obtained. Clinical features regarding the type of lesion, location, and the involvement of cornea were evaluated. For all patients, excisional biopsy following "Shield's no-touch technique" with 3 to 4 mm margins of uninvolved tissue and cryotherapy at excisional margins was done. All specimens were sent for a histopathological evaluation. Topical chemotherapy (mitomycin C, 0.02%) was used as an adjunctive therapy following surgical excision for large and diffuse ocular surface tumors. All patients were subjected to long-term regular follow-ups.
Results: Twenty-six patients (18 men and 8 women) with a mean age of 54.2 years were enrolled in this study. The results showed that the most common localization was bulbar conjunctiva (92%). Nodular lesions (46.5%) and SCC (57.5%) were the most common clinical and histopathological features, respectively. We observed one rare case of primary SCC of the left caruncle in a 68-year-old man who had an asymptomatic medial canthal mass. Recurrence was found in two patients with SCC, one of them having an orbital extension.
Conclusion: The early suspicion of ocular surface neoplasia will be accomplished with a simple excision in most cases, leading to a favorable outcome except in severe progressive cases.


Professor Steer comments: I am grateful for the comments by Drs Seidman and Mashiach. However they seem to have misread my review because they claim that I stated that up to three digital vaginal examinations have no effect on provoking labour. In fact I suggested that 'careful cervical assessment should be made on all women' and that 'up to three (examinations) when they (the membranes) are ruptured'. Nowhere do I state that the examination should be digital, and I agree with Drs Seidman and Mashiach that 'virtually all the information necessary can be obtained from a sterile speculum examination'. I also agree that this need only be performed once if a decision is made for conservative management. However, if subsquently there are signs of active labour supervening, then usually the only way of establishing whether this is really the case is to repeat the examination. Usually a speculum examination is sufficient, but very occasionally if the mother is uncooperative a digital examination may be necessary as a last resort. In relation to the risk of digital examination, I am grateful for the references supplied; it should be noted however that of the four sources given, two appeared after I prepared my manuscript and a third remains unpublished.


A simple technique for fabrication of nonlinear gratings in polymer films, based on simultaneous embossing and poling, is proposed and demonstrated. A master grating consisting of a metal electrode with a dielectric die was fabricated and used for repeated embossing of the grating structures into nonlinear optical polymers at elevated temperatures. At the same time, we applied high voltage to the polymer films to induce second-order nonlinearity. The grating profile and the nonlinearity were estimated, as well as the mass productivity of nonlinear gratings.