Objective: To compare all-cause-mortality in screening-detected prostate cancer cases versus non-cases after a median 12.2-year follow-up. Methods: In this prospective, population-based study of 3089 Afro-Caribbean men aged 40–79 years in Tobago, Trinidad and Tobago, West Indies, all men were screened for prostate cancer (serum prostate specific antigen and/or digital rectal exam) one to three times between 1997
and 2007 and followed for mortality to 2012. Among 502 men diagnosed with prostate cancer, 81 younger men underwent radical retropubic prostatectomy. Minimal treatment was available for older men. Survival curves compared all-cause-mortality in cases versus non-cases within 10-year age groups at first screening. Results: There were 350 all-cause-deaths over 34 089 person-years of follow-up. All-cause-survival
curves in men aged 60 years or above at first screening did not diverge between cases
and non-cases until after 10–12 years of follow-up (p > 0.36). In contrast, among men first screened at age 50–59 years, survival was lower in cases, with survival curves diverging at seven years (p = 0.003). Survival in men aged 50–59 years who underwent prostatectomy was similar to survival in non-cases (p = 0.63). Conclusion: Among men aged 60 years or above, the absence of excess all-cause-mortality among screening-detected prostate cancer cases provides argument against the utility of routine prostate cancer screening in this older population of African descent. However, the significantly poorer survival in men aged 50–59 years with screening-detected prostate cancer, compared with screened men without prostate cancer, along with the potential for prostate cancer treatment to improve survival, supports the continuation of prostate cancer screening in this age group, pending further research to assess the risks and benefits.


The recent solution to the fermion sign problem allows, for the first time, the use of cluster algorithm techniques to compute certain fermionic path integrals. To illustrate the underlying ideas behind the progress, a cluster algorithm is constructed to study the chiral phase transition in a strongly interacting staggered fermion model with an arbitrary mass term in 3 + 1 dimensions. Unlike conventional methods there is no difficulty in the cluster method to approach the chiral (massless) limit. Results using the new algorithm confirm that the chiral transition falls under the expected universality class.


In this talk, we present a nonlinear stochastic model studied in [1,2] for the development of gastrointenstinal nematode infection in growing lambs under seasonal conditions, which are model by nonhomogeneous Poisson processes governing the acquisition of parasites, the parasiteinduced and no parasite-induced host mortality, and the death of parasites within the host. Our interest is in individual-based grazing strategies which imply the movement or the anthelmintic treatment of the host at certain instant t_0. Two stochastic control criteria are presented in order to select the optimal instant t_0, as well as to compare between the convenience of the different grazing strategies under consideration. Numerical results are obtained with empirical data from the literature. References: [1] Gomez-Corral A, Lopez Garcia M (2013) Control strategies for a stochastic model of hostparasite interaction in a seasonal environment. Journal of Theoretical Biology, in press. DOI: 10.1016/j.jtbi.2014.03.021 [2] Gomez-Corral A, Lopez Garcia M (2013) Grazing management strategies for the control of gastrointestinal nematodes in sheep: a study based on stochastic control criteria. Ecological Complexity, under review.


Abstract. This work is aimed at identifying the origin of fine-scale features on the sea surface in synthetic aperture radar (SAR) imagery with the help of in-situ measurements as well as numerical models (presented in a companion paper). We are interested in natural and artificial features starting from the horizontal scale of the upper ocean mixed layer, around 30–50 m. These features are often associated with three-dimensional upper ocean dynamics. We have conducted a number of studies involving in-situ observations in the Straits of Florida during SAR satellite overpass. The data include examples of sharp frontal interfaces, wakes of surface ships, internal wave signatures, as well as slicks of artificial and natural origin. Atmospheric processes, such as squall lines and rain cells, produced prominent signatures on the sea surface. This data has allowed us to test an approach for distinguishing between natural and artificial features and atmospheric influences in SAR images that is based on a co-polarized phase difference filter.


Multi criteria methods for supporting decision-making procedures are widely used in sustainability assessment. One of the most important steps in decision-making procedures is the evaluation of policy options or alternatives in order to find a hierarchy of option choices. Utility function value distributions are often constructed for the range of indicators for the options to be assessed. This distribution can be presented as an impact matrix stacked with indicator weights to reflect the relative importance of different indicators for the decision-maker. Solving rules are then introduced to integrate all individual indicator evaluations into a single integral utility estimation. These are often based on the averaging procedures, one of the simplest being arithmetic averaging. Whilst averaging rules are very attractive to decision makers due to their simplicity and logical transparency, using averaging as the first step of the decision-making procedures can significantly reduce the discrimination of the options, especially if there are counteractive individual indicator estimations. This paper proposes a method to evaluate and overcome this loss of discrimination. The paper explains the basis of a discriminatory analysis approach to sustainability assessment, demonstrating its application through the use of illustrative data and describing its application to an existing case study where researchers had applied a number of multi criteria analysis tools. It was concluded that the discriminatory analysis provided a useful addition to the decision-makers toolbox as it provided a means of assessment of the validity of the application of the simple arithmetic averaging technique.


Background/context Debriefing is a critical phase in embedding learning as part of simulation training. A well accepted method for this includes playing back audio-visual recordings of parts of the simulation to the participants, drawing on Kolb's learning cycle.1 There are however associated technical and financial challenges: sound quality is often poor, the cost and technical expertise required to set up and run a fixed medium fidelity simulator precludes its use in most hospitals and even in hospitals with established simulation facilities it can be difficult and time consuming to set up mobile systems for in situ simulation training. I assessed the feasibility of using a commercially available, low cost, high quality audio-visual recording system to record simulated scenarios. Methodology I obtained a Reveal RS2-X2 high quality body-worn camera (as used by police and security services) from Reveal Media2 and with appropriate permissions, used it during a simulation faculty training day to record scenarios in our medium fidelity simulation centre. The quality of audio and visual recordings were reviewed Results/outcomes (recorded to date) Audio and video was clear, and satisfactory for debriefing purposes. Recorded material is automatically time and date stamped allowing easy searching for specific events. Potential impact For modest set up costs this technology could facilitate in situ simulation and could replace or supplement hard wired AV systems in low/medium fidelity simulation suites. The benefits of simulation with debriefing from audio-visual recordings could be brought to hospitals without dedicated simulation suites. Body-worn cameras could be worn by more than one delegate in a simulation as the time signatures can be synchronised across cameras allowing more than one viewpoint of the same simulation. References Kolb D, Fry R. Towards an applied theory of experiential learning. In: Cooper CL, ed. Theories of group processes. Wiley series on individuals, groups, and organizations. London; New York: Wiley, 1975: 33–58 http://revealmedia.com/products (accessed 17th May 2015)


The performances and stabilities of three laboratory-scale semi-batch anaerobic digesters, operated at 35°C, treating organic fraction of municipal solid waste (OFMSW) and primary sewage sludge (PSS) mixed at various ratios were compared during the start-up period. The OFMSW:PSS ratios in the feeds to the three digesters were 100:0, 80:20, and 60:40 on a total solids (TS) basis and their organic loading rates (OLR) were 5.2 kg VS m−3 d−1, 3.9 kg VS m−3 d−1, and 3.2 kg VS m−3 d−1, respectively. There were no indications of failure in any of the digesters. However, addition of primary sewage sludge significantly decreased the imbalances observed during the start-up and improved the process performance. The best performance in terms of specific gas production rate (SGPR) was obtained with a feedstock having an OFMSW:PSS ratio of 80:20. The use of inoculum from an operating anaerobic digester enabled a quick start-up and the reactors were capable of handling high OLRs from the beginning of the experiment.


Analysis of reactivity indexes supports the polar character of the reaction between (E)-3,3,3-trichloro-1-nitropropene and cyclopentadiene. This is confirmed by the analysis of electronic properties of transition complexes involved in the reaction paths using the B3LYP/6-31G(d) algorithm. The transition state's asymmetry is large, but it is insufficient to provoke a zwitterionic reaction mechanism. Attempts to find a heterocyclic intermediate 7 in the reaction path ultimately leading to 5-endo-nitro-6-exo-trichloromethylnorbornene 3 have been unsuccessful.


Research investigating top-down attentional capture has demonstrated a tight coupling of working memory content with attention and eye movements. By capitalizing on this relationship, we have developed a novel methodology called the Memory Activation Capture (MAC) procedure for measuring the dynamics of working memory content supporting complex cognitive tasks (e.g., decision making, problem solving). By observing which items are preferentially fixated in task irrelevant arrays containing task relevant information, we gain a measure of working memory content as the task evolves through time. The efficacy of the MAC procedure is demonstrated in a hypothesis generation task. Results suggest a two-stage process following hypothesis retrieval whereby it undergoes a brief period of heightened activation before entering a lower activation state while being maintained for output. The present effects are of additional general interest as they represent the first demonstrations of top-down attentional capture driven by participant-established WM content retrieved from long-term memory.


The introduction of immunotherapy in the treatment of advanced non-small cell lung cancer (NSCLC) has resulted in a new era of treatment options that have substantially improved efficacy and tolerability when compared to chemotherapy. Since 2015, many immunotherapeutic agents have been approved for the in advanced NSCLC. Treatment of nivolumab, pembrolizumab, and atezolizumab are all approved in the second line setting. Pembrolizumab is also approved in the first line setting, both as monotherapy and in combination with chemotherapy. Durvalumab is now approved after concurrent chemoradiation for stage III lung cancer. A large number of ongoing clinical trials are investigating the use of checkpoint inhibitors in combination with other treatments in both NSCLC and small cell lung cancer.


Spatial skills, including mental rotation, are necessary to understand, comprehend, explore and learn mathematics, but research in mathematics education points out insufficient spatial skills of pre-service mathematics teachers. In this study, the effectiveness of the instruction, designed by taking Cognitive Load Theory (CLT) as the reference frame and executed in the Dynamic Geometry Learning Environment (DGLE), was investigated. The study sample was four pre-service mathematics teachers determined by the purposeful sampling technique. Individual teaching experiment, executed in three steps (pre-evaluation— teaching sessions/instruction— post-evaluation), was used as the method. The collected quantitative and qualitative data were analyzed through content analysis. Findings showed that participants' mental rotation skills were basic or below, before the instruction. They had low mental imagery skills, inadequacies in mathematics language use, and misconceptions about rotation and its components. After the instruction, their mental rotation skills, compassing the mental rotation performance, mental imagery skills, mathematical language use, and concept schemes about rotation and its components, developed. It is recommended that cognitive loads be considered while designing instruction executed in a DGLE.


BACKGROUND
Abusive water addition to octopus has evidenced the need for quick non-destructive methods for product qualification in the industry and control of fresh commercial products in markets. Electric conductivity (EC)/pH and dielectric property measurements were selected to detect water uptake in octopus.

RESULTS
A significant EC decrease was determined after soaking octopus in freshwater for 4 h. EC reflected the water uptake of octopus and the correspondent concentration decrease of available ions in the interstitial fluid. Significant correlations were determined between octopus water uptake, EC (R = -0.940) and moisture/protein (M/P) ratio (R = 0.923) changes. Seasonal and spatial variation in proximate composition did not introduce any uncertainty in EC discrimination of freshwater tampering. Immersion in 5 g L-1 sodium tripolyphosphate (STPP) increased EC to a value similar to control octopus. EC false negatives resulting from the use of additives (STPP and citric acid) were eliminated with the additional determination of pH. Octopus soaked in freshwater, STPP and citric acid can also be clearly discriminated from untreated samples (control) and also from frozen (thawed) ones using the dielectric properties. No significant differences in the dielectric property scores were found between octopus sizes or geographical locations.

CONCLUSION
Simultaneous EC/pH or dielectric property measurements can be used in a handheld device for non-destructive water addition detection in octopus. M/P ratio can be used as a reference destructive method. © 2017 Society of Chemical Industry.


Background The use of labor epidural analgesia has been associated with intrapartum fever, known as labor epidural associated fever (LEAF). LEAF is most commonly non-infectious in origin and associated with elevated inflammatory cytokines. Methods The LIFECODES pregnancy cohort was designed to prospectively collect data to evaluate the association of maternal inflammatory biomarkers with preterm birth in women who delivered between 2007 and 2008 at Brigham and Women's Hospital. Our secondary analysis of the data from the cohort identified 182 women for whom inflammatory biomarkers (i.e. interleukin-10, interleukin-1β, interleukin-6, tumor necrosis factor-α and C-reactive protein) collected longitudinally over four prenatal visits was available. Maternal temperature and other clinical variables were abstracted from medical records. The primary outcome, the presence of LEAF, was defined as oral temperature ≥ 38°C (≥100.4°F) after epidural analgesia initiation. Multivariable logistic regression estimated the association between inflammatory biomarker concentrations and the odds of developing an intrapartum fever after adjusting for a number of potential confounders. Results Women who developed LEAF were more likely to have a longer duration of epidural analgesia, whereas women who did not develop LEAF were more likely to have induced labor and positive or unknown Group B Streptococcus colonization status. However, no differences were seen by nulliparity, mode of delivery, white blood cell count at admission, baseline temperature, length of rupture of membranes and number of cervical exams performed during labor. Unadjusted and multivariable logistic regression models did not provide evidence for or exclude an association between individual maternal inflammatory biomarkers and the odds of developing LEAF, regardless of visit time-period. Conclusion The predictive value of maternal inflammatory biomarkers measured during early- and mid-pregnancy for the risk of developing LEAF cannot be excluded.


OBJECTIVE
To compare the results of femoral head replacement (FHR) and total hip replacement (THR) in treatment of subcapital femoral neck fractures (SFNF).

METHODS
Between May 1987 and July 1998, 56 elderly patients (6 5-90 years; average 73.5 years) with SFNF were treated with prosthetic replacement. Six cases were treated with unipolar FHR, 18 cases with Bateman bipolar FHR, and 32 cases with Bateman bipolar THR. All domestic prostheses were installed with cement.

RESULTS
There was no significant difference between the 2 groups in operating time and blood transfusion. Forty-nine patients were followed-up for an average of 5 years and 10 months. No wound infection or death was related to surgery. Complications in Group FHR were significantly higher than that i n Group THR.

CONCLUSIONS
Since FHR is difficult to fit the bony acetabulum, it is only indicated for senile cases with poor conditions. However, the bi polar THR installed with cement is indicated for most elderly patients. Since th e femoral head and acetabulum can fit each other completely, it is more stable for taking weight-bearing earlier with less complications.


A framework for energy-efficient resource allocation in a single-user, amplify-and-forward (AF), relay-assisted, multiple-input-multiple-output (MIMO) system is devised in this paper. Previous results in this area have focused on rate maximization or sum power minimization problems, whereas fewer results are available when bits/Joule energy efficiency (EE) optimization is the goal. Here, the performance metric to optimize is the ratio between the system's achievable rate and the total consumed power. The optimization is carried out with respect to the source and relay precoding matrices, subject to quality-of-service (QoS) and power constraints. Such a challenging non-convex optimization problem is tackled by means of fractional programming and alternating maximization algorithms, for various channel state information (CSI) assumptions at the source and relay. In particular the scenarios of perfect CSI and those of statistical CSI for either the source-relay or the relay-destination channel are addressed. Moreover, sufficient conditions for beamforming optimality are derived, which is useful in simplifying the system design. Numerical results are provided to corroborate the validity of the theoretical findings.


Glycoproteins, such as the glycoprotein hormone lutropin (LH), bear oligosaccharides terminating with the sequence SO4-4GalNAcbeta1, 4GlcNAcbeta1,2Manalpha (S4GGnM) and are rapidly removed from the circulation by a receptor present in hepatic endothelial cells and Kupffer cells. Rapid removal from the circulation is essential for attaining maximal hormone activity in vivo. We have isolated a protein from rat liver which has the properties expected for the S4GGnM-specific receptor (S4GGnM-R). The S4GGnM-R is closely related to the macrophage mannose receptor (Man-R) both antigenically and structurally. At least 12 peptides prepared from the S4GGnM-R have amino acid sequences that are identical to those of the Man-R. Nonetheless, the ligand binding properties of the S4GGnM-R and the Man-R differ in a number of respects. The S4GGnM-R binds to immobilized LH but not to immobilized mannose, whereas the Man-R binds to immobilized mannose but not to immobilized LH. When analyzed using a binding assay that precipitates receptor ligand complexes with polyethylene glycol, the S4GGnM-R is able to bind S4GGnM-bovine serum albumin (S4GGnM-BSA) conjugates whereas the Man-R is not. In contrast both the S4GGnM-R and the Man-R are able to bind Man-BSA. Monosaccharides that inhibit binding of Man-BSA by the Man-R enhance binding by the S4GGnM-R. Oligosaccharides terminating with S4GGnM and those terminating with Man are bound at independent sites on the S4GGnM-R. The S4GGnM-R present in hepatic endothelial cells may account for clearance of glycoproteins bearing oligosaccharides terminating with S4GGnM and glycoproteins bearing oligosaccharides terminating with either mannose, fucose, or N-acetylglucosamine.


validity because of differences of definition. Internal comparison between the "exposed" and control infants in Dr Tomlin's survey shows no overall significant difference in malformation rates (26 of 277 v 4 of 92, X(2)= 1-72, P-0-2). In summary, Dr Tomlin's survey, while provocative, adds little that is concrete to the existing literature on the possible relationship between exposure to anaesthetic agents and outcome of pregnancy. M P VESSEY


The empirical focus of our paper is an Enterprise Resource Planning (ERP) system implemented in a major University, itself formed by the merger of two independent establishments in October 2004. We found that the new ERP system replaced existing legacy systems for political as well as functional reasons. Within the University setting, we identified three distinct networks containing powerful actors who influenced and dictated the outcome of the ISD project. We show how an effective coalition between top management and the software supplier was able to transform the administrative structures of the University and inscribe the organizational new arrangement with the software. However, this was achieved by marginalizing the end users who were left to cope alone with many of the inadequacies of the new system through improvisation.


This study investigated the effect of a 12-week exercise programme consisting of jogging, calistnenics, and recreational activities on the cardiorespiratory function and body composition of 15 young and 15 middle-aged nonobese women 21-32 and 34-57 years, respectively. The exercise programme was 3 days per week for an average of 45 minutes each session. Pre- and post-programme data were obtained on: age, height, total body weight, resting heart rate, systolic and diastolic blood pressure, vital capacity, submaximal heart rate, supra-iliac skinfold, thigh skinfold, waist girth, cup size, body density, and percent fat. The t-test was used to test the difference between the young and middle-aged groups before and after the exercise programme and to test the pre- and post-programme mean values of each group. No differences between the groups or changes due to the exercise programme were observed on total body weight. No significant cardiorespiratory differences were found between the two groups at either test period, however, the young group decreased significantly (p < .01) in submaximal HR and the middle-aged group decreased significantly in resting (p < .01) and submaximal (p < .001) HR illustrating the positive effect of the programme. No significant body composition differences were found between the two groups at the pre-test. At the post-test the middle-aged group had a significantly (p < .10) larger thigh skinfold thickness than the young group. The young group did not change significantly on body composition measures from pre- to post-test. In contrast, the middle-aged group increased significantly in body density (p < .01) and decreased in percent body fat (p < .01) due to a significant (p < .01) reduction in supra-iliac skinfold thickness from 21.67 ± 2.35 to 18.13 ± 2.08 mm. The data were compared with data from other studies using similar age groups. The pre-test percent fat of the young group (25.07 ± .74) was similar to values reported in other studies. The middle-aged group had a relatively lower fat percentage (27.46 ± 1.58) compared with other middle-aged groups.


International cinema of every era has told of the relationship between men, women and food. In many cases it is presented as a common thread capable of binding every life impulse: sex, spirituality, greed, even death. In the cases of Italy and Japan, there are two directors in particular for whom the theme recurs with greater incisiveness: Marco Ferreri and Itami Jūzo, and especially in their works La Grande Abbuffata and Tanpopo. Both movies also represent a critique of the consumer society and the general decay of civil entourage. The characters thus contribute to representing a sort of mythology of the human being, each distinct in a grotesque, surreal and in many cases parodic way while they use food to translate their impulses. This essay aims to highlight the similarities between the main narrative strategies used by the two directors.


We have developed a fast 3D regularized magnetic inversion algorithm for depth-to-basement estimation based on an efficient way to compute the total-field anomaly produced by an arbitrary interface separating nonmagnetic sediments from a magnetic basement. We approximate the basement layer by a grid of 3D vertical prisms juxtaposed in the horizontal directions, in which the prisms' tops represent the depths to the magnetic basement. To compute the total-field anomaly produced by the basement relief, the 3D integral of the total-field anomaly of a prism is simplified by a 1D integral along the prism thickness, which in turn is multiplied by the horizontal area of the prism. The 1D integral is calculated numerically using the Gauss-Legendre quadrature produced by dipoles located along the vertical axis passing through the prism center. This new magnetic forward modeling overcomes one of the main drawbacks of the nonlinear inverse problem for estimating the basement depths from magnetic data: the intense computational cost to calculate the total-field anomaly of prisms. The new sensitivity matrix is simpler and computationally faster than the one using classic magnetic forward modeling based on the 3D integrals of a set of prisms that parameterize the earth's subsurface. To speed up the inversion at each iteration, we used the Gauss-Newton approximation for the Hessian matrix keeping the main diagonal only and adding the first-order Tikhonov regularization function. The large sparseness of the Hessian matrix allows us to construct and solve a linear system iteratively that is faster and demands less memory than the classic nonlinear inversion with prism-based modeling using 3D integrals. We successfully inverted the total-field anomaly of a simulated smoothing basement relief with a constant magnetization vector. Tests on field data from a portion of the Pará-Maranhão Basin, Brazil, retrieved a first depth-to-basement estimate that was geologically plausible.


In Johannesburg they talked about the scarcity of water, land, food, medicines, and education, the disappearance of forests, and the depletion in fish stocks. They talked about trade and sustainable development, and they identified, yet again, poverty, ignorance, disease, and the cussedness of the rich as the factors that keep the poor world poor, make it gradually poorer, destroy the environment and, by diminishing hope, increase hate. What they did not talk about was population growth, the demographic entrapment of many countries, and the consequences. Even if one disagrees with Maurice King, who claims that the US State Department prevents all sensible discussion about demography ( BMJ 1999;319:998-1001), one must concede his point that there is an international taboo: it is not desirable to speak about population problems.

> The covenant with Noah has been fulfilled. Man has multiplied, invaded every niche on earth

It appears that many of the politically correct, some of those who are religious, …


This article examines the perceived discrimination of immigrants – a group for whom experiences of discrimination can be damaging for their long-term commitment and identification with the national core group. Taking its point of departure in the literature on national identity, the article argues that perceived discrimination should be strongest among immigrants in host national societies with an exclusive self-image. This hypothesis is examined by use of multilevel regressions on cross-national survey data from 18 Western European countries. It is found that where exclusive attitudes are widespread in the host population, the percentage of immigrants who perceive themselves to be part of a group discriminated against is significantly greater, all else being equal. In addition, there is a cross-level interaction effect of host national inclusivity and ethnic minority identity which suggests that individual-level determinants of perceived discrimination do not 'work' in the same way in normatively different contexts. In terms of the implications of these findings, the article points to the importance of contextualising individual-level accounts of perceived discrimination, with particular focus on the power of a society's attitudinal milieu to affect individual feelings of inclusion and exclusion.


Our data may explain ST-segment elevation on the basis of
massive transmural voltage gradients during early
repolarization. Reentry-based tachycardia could be evoked
during conditions that further exaggerate conduction block in
this Brugada phenotype.


For a photoanode, a large overpotential for water oxidation, which limits the solar-to-hydrogen efficiency, may be caused by slow water oxidation kinetics and the recombination of photo-induced electrons and holes. Herein, taking flat and thin BiVO4 photoanodes as an example, the composite AgOx/NiOx electrocatalyst was found to promote not only the water oxidation kinetics, but also the bulk charge separation. As a result, the surface charge injection efficiency (ηinj) and the bulk charge separation efficiency (ηsep) of BiVO4 photoanodes were improved by the composite AgOx/NiOx electrocatalyst. Photo-assisted electrochemical impedance spectroscopy (EIS) was employed to illustrate the significantly reduced surface charge transfer resistance of the BiVO4/AgOx/NiOx sample at the interface between the photoanode surface and the electrolyte. Analysis of the surface potential changes obtained from photo-assisted Kelvin probe force microscopy (KPFM) revealed that the surface photovoltage (SPV) of the BiVO4/AgOx/NiOx photoanode is higher than those of BiVO4/AgOx and BiVO4/NiOx, representing its large band bending region for bulk charge separation. The open circuit photovoltage (OCP) measurements also demonstrated the superior charge separation ability of the BiVO4/AgOx/NiOx photoanode. The possible working mechanism is that one component of the composite AgOx/NiOx electrocatalyst may stabilize the high valence states of the other metal ions, which is beneficial for the formation of water oxidation active sites and the extension of the band bending region.


We provide a novel accelerated first-order method that achieves the asymptotically optimal convergence rate for smooth functions in the first-order oracle model. To this day, Nesterov's Accelerated Gradient Descent (AGD) and variations thereof were the only methods achieving acceleration in this standard blackbox model. In contrast, our algorithm is significantly different from AGD, as it relies on a predictor-corrector approach similar to that used by Mirror-Prox [Nemirovski, 2004] and Extra-Gradient Descent [Korpelevich, 1977] in the solution of convex-concave saddle point problems. For this reason, we dub our algorithm Accelerated Extra-Gradient Descent (AXGD). Its construction is motivated by the discretization of an accelerated continuous-time dynamics [Krichene et al., 2015] using the classical method of implicit Euler discretization. Our analysis explicitly shows the effects of discretization through a conceptually novel primal-dual viewpoint. Moreover, we show that the method is quite general: it attains optimal convergence rates for other classes of objectives (e.g., those with generalized smoothness properties or that are non-smooth and Lipschitz-continuous) using the appropriate choices of step lengths. Finally, we present experiments showing that our algorithm matches the performance of Nesterov's method, while appearing more robust to noise in some cases.


Lanthanum oxide was introduced to molybdenum powder by liquid-liquid doping and liquid-solid doping respectively. Mo alloys were prepared by powder metallurgy technology. The size distribution and feature of dopant particles and the fractographs of Mo alloys were investigated by TEM and SEM respectively. The results indicated that liquid-liquid doping method is favorable for refining and dispersing La2O3 particles uniformly in matrix. Fracture toughness of Mo alloys prepared by liquid-liquid doping showed better results than that of liquid-solid doping. Furthermore, the influences of the size distribution of La2O3 on properties of Mo alloys was discussed by dislocation pile-up theory.


This paper provides an introduction to the classic paper "Transoceanic Communication by Means of Satellites," which was written by J.R. Pierce and R. Kompfner and appeared in the March 1959 issue of the Proceedings of the IRE. This paper also provides a periscopic view of satellite communications development since then. Surprisingly, in some aspect, the fundamental ideas have not changed much after 40 years. Conceptually, most technical development falls within these ideas. Practically, however, technological advances and significant progress has been made in all areas of space segment, ground segment, and launch vehicles. Today, due to its impact and usefulness, satellite communications is no longer the domain of the technologists alone. Instead, it has created industries, established relevant institutions, coordinated regulations and standards, provided employment, and financially benefitted many persons. This paper addresses these issues, which have been indirectly created by the scientists and engineers who developed satellite communications.


This paper finds strong support for a Phillips curve that becomes nonlinear when inflation is "low"—which our baseline model defines as less than 3 percent. The nonlinear curve is steep when output is above potential (slack is negative) but flat when output is below potential (slack is positive) so that further increases in economic slack have little effect on inflation. This finding is consistent with evidence of downward nominal wage and price rigidity. When inflation is high, the Phillips curve is linear and relatively steep. These results are robust to placing the threshold between the high and low inflation regimes at 2, 3, or 4 percent inflation or for a threshold based on country-specific medians of inflation. In this nonlinear model, international factors play a large role in explaining headline inflation (albeit less so for core inflation), a role that has been increasing since the global financial crisis. These results provide evidence of channels which could boost inflation in the future, even if they were dormant before the Covid pandemic.


Automation of greenhouse environment using simple timer-based actuators or by means of conventional control algorithms that require feedbacks from offline sensors for switching devices are not efficient solutions in large-scale modern greenhouses. Wireless instruments that are integrated with artificial intelligence (AI) algorithms and knowledge-based decision support systems have attracted growers' attention due to their implementation flexibility, contribution to energy reduction, and yield predictability. Sustainable production of fruits and vegetables under greenhouse environments with reduced energy inputs entails proper integration of the existing climate control systems with IoT automation in order to incorporate real-time data transfer from multiple sensors into AI algorithms and crop growth models using cloud-based streaming systems. This chapter provides an overview of such an automation workflow in greenhouse environments by means of distributed wireless nodes that are custom-designed based on the powerful dual-core 32-bit microcontroller with LoRa modulation at 868 MHz. Sample results from commercial and research greenhouse experiments with the IoT hardware and software have been provided to show connection stability, robustness, and reliability. The presented setup allows deployment of AI on embedded hardware units such as CPUs and GPUs, or on cloud-based streaming systems that collect precise measurements from multiple sensors in different locations inside greenhouse environments.


Elucidating the Origins of Heterosexual Sex Differences in Mating Psychology by Examining the Behaviour of Homosexual Men and Women Various competing theoretical frameworks have been invoked to explain heterosexual sex differences in mating psychology. Chapter One provides examples of such frameworks, details how considering both heterosexual and homosexual men and women can help identify the most tenable frameworks, and reviews previous research comparing the mating psychology of heterosexual and homosexual men and women. Chapter Two demonstrates the utility of this comparative method by examining the mate retention behaviour of heterosexual and homosexual men and women. Where heterosexual sex differences exist, the mate retention behaviour of homosexual men is largely sex-typical while that of homosexual women is sex-atypical. The significance of these results for explaining heterosexual sex differences in mate retention is discussed. Chapter Three discusses how the data presented and reviewed here might inform our understanding of the psychological mechanisms underlying mating psychology as well as the development of sexual orientation in men and women.


Abstract: When protests started spreading throughout the Arab world in January 2011, numerous observers argued that Saudi Arabia's turn would soon come. There was some truth to those expectations, as February and early March 2011 witnessed an unusual degree of protest activity by the Kingdom's standards. And yet, by mid-March, the regime had regained complete control of the situation. Who were the activists who challenged the regime and what did they want? And how did the regime manage to silence their protests? Does this episode mean that revolution is impossible in Saudi Arabia?


Background. With an increase in Japanese cedar and cypress (JC) pollinosis, the relationship between JC pollen and atopic dermatitis (AD) has been studied. Some reports suggest that JC pollen can be one exacerbating factor for AD, but there has been no report that discusses JC pollen counts relating to AD symptom flare although actual airborne JC pollen counts can widely fluctuate throughout the pollen season. Objective. The relationship between symptom flare of AD and airborne JC pollen counts was examined. Methods. We monitored JC pollen counts in real time and divided the counts into low and high level. We then analyzed self-scored "itch intensity" recorded by 14 AD patients through a self-scoring diary. Results. Among the 14 patients, 7 had significantly higher itch intensity while the pollen counts were high. Conclusion. Even during the pollen season, actual airborne pollen counts can widely fluctuate. Our study suggested that symptom flare of AD could be influenced by the actual pollen counts.


Herein, we present a demonstration of the usability of the chemical sensing properties of transition metal carbides (TMCs) as gas sensing channels. Two phases of nanostructured molybdenum carbide (α-MoC1−x and β-Mo2C) with high porosities were perfectly synthesized by a temperature-programmed reduction (TPR) method, and they showed distinct metallic characteristics due to different density of states (DOS) localization status. The molybdenum carbide sensors showed novel gas sensing characteristics which have not been shown by previous typical sensing materials: predominantly, an unprecedentedly high signal-to-noise ratio (SNR) with the ability to detect the ppb levels of NH3 and NO2 was achieved, which is attributed to a combination of high electrical conductivity and superior catalytic properties. In addition to high sensitivity, unlike previous channel materials, the molybdenum carbide sensors showed very high ambient stability. The electrical conductivity and sensing performance are well preserved for half-year ambient exposure without any oxidation or degradation of channel materials, due to the good corrosion resistance and low chemical reactivity of molybdenum carbides. In addition, a versatile gas sensing response is observed according to the crystal phase of molybdenum carbides due to the distinct DOS of α-MoC1−x and β-Mo2C. We believe that this observation of new chemical sensing materials can shed light on the superior potential of TMCs for highly sensitive and stable low-power operating internet-of-things (IoT) sensors. In addition, owing to their ultra-high chemical stability and high melting temperature, TMCs can be utilized as channel materials for sensors in harsh operating conditions.


Blood flow data from direct measurements (4D flow MRI) or numerical simulations opens new possibilities for the understanding of the development of cardiac diseases. However, before this new data can be used in clinical studies or for diagnosis, it is important to develop a notion of the characteristics of typical flow structures. To support this process we developed a novel blood flow clustering and exploration method. The method builds on the concept of coherent flow structures. Coherence maps for cross-sectional slices are defined to show the overall degree of coherence of the flow. In coherent regions the method summarizes the dominant blood flow using a small number of pathline representatives. In contrast to other clustering approaches the clustering is restricted to coherent regions and pathlines with low coherence values, which are not suitable for clustering and thus are not forced into clusters. The coherence map is based on the Finite-time Lyapunov Exponent (FTLE). It is created on selected planes in the inflow respective outflow area of a region of interest. The FTLE value measures the rate of separation of pathlines originating from this plane. Different to previous work using FTLE we do not focus on separating extremal lines but on local minima and regions of low FTLE intensities to extract coherent flow. The coherence map and the extracted clusters serve as basis for the flow exploration. The extracted clusters can be selected and inspected individually. Their flow rate and coherence provide a measure for their significance. Switching off clusters reduces the amount of occlusion and reveals the remaining part of the flow. The non-coherent regions can also be explored by interactive manual pathline seeding in the coherence map.


Education in the twenty-first century is about equipping students of all ages "to compete in the global economy on knowledge and innovation ... take advantage of opportunity and ... face challenges of this era with confidence" (Melbourne Declaration, 2008, p. 13). There is a strong commitment in Australia, as well as elsewhere, from Federal and State levels on developing reciprocal partnerships with low socio-economic and Indigenous communities. These commitments emerge in documents such as the Bradley Report and the MCEEDYA four year plan. The challenge is for education systems to respond comprehensively to government plans.


This study aims to apply fecal sterols as a chemical indicator to track feces contamination sources in the canals in Bangkok. The sewage and canal sediments were examined during the dry season. Fecal sterols in the canals were evaluated over a one-year period (2011–2012) for the selected sterol compounds. Several factors including season, canal water levels, rainfall data, and sewage were correlated to fecal contamination. The highest concentrations of cholesterol (CHR) (8.321 μg/L), coprostanol (CPN) (6.490 μg/L), and cholestanol (CHN) (1.205 μg/L) in discharged sewage were found from the community near Samata Amonmak bridge. Maximum yearly average fecal sterol contents observed in the canal sediments were: CHR (12.478 μg/g), CHN (10.782 μg/g), and CPN (16.903 μg/g). They indicate high fecal pollution both from human and warm-blooded animals such as dogs' and birds' feces. The water level in canals and rainfall intensity influenced changes in fecal sterol contents. Suspended solids in the canal water during summer were correlated with the sterol contents. Overall, it can be summarized that the studied canals were highly polluted with organic matter and enteric bacteria. Human feces from the discharged sewage were the major source of fecal contamination in Ong-Ang and Bang-Lumphu canals.


The authors present a model of regional catching-up and development without scale effects. Regional growth is driven by technological imitation which is determined by positive externalities from international trade, the regions geography, and regional institutions. For the two regions considered, factor endowments are immobile land and human capital which is perfectly mobile between the two regions. Endogenous formation of regions is analyzed by introducing a non-symmetric decrease in international transaction costs, reflecting the different geography and institutions in the two regions. Using panel data from 354 South African magisterial districts over the period 1996 to 2000, we find that geography is important in explaining trade patterns. As predicted, regions that are larger in terms of economic size, with good foreign market access and know-how of foreign markets, competitive transport costs and a good local institutional support framework will be more successful in exporting manufactured goods than other regions.


A simulated spinal fluid can be prepared by adding red and white blood cells and bovine serum albumin to a commercially available balanced salt solution. Using this preparation as a substitute for actual cerebrospinal fluid enables teachers to provide adequate quantities of microscopically positive fluid, and at the same time eliminates the danger of potential contamination. The appearance of the red and white cells, both in the hemocytometer and in a centrifuged and stained preparation, is realistic. This simulated spinal fluid is useful in teaching not only cell counting and identification techniques, but also total protein and glucose analyses. The method for preparing this solution is simple, inexpensive, and requires only equipment that is readily available to the teaching laboratory.


The cleantech industry has gained a lot of attention in recent years. This has made many
entrepreneurs discover opportunities and start new businesses. However, cleantech is
associated with high investments and a great deal of R&D costs. To overcome these obstacles
entrepreneurs, in particular ecopreneurs, have to select the best partners to work with. The
recent literature reveals weaknesses regarding how the partner selection process in startups is
structured and why some stakeholders come on board. Therefore this study aims to investigate
the impact of partnerships between stakeholders and entrepreneurs in their work towards
creating innovative cleantech products. The research paper gives an answer to the research
question: How do cleantech startups select stakeholders and how do they contribute to
the start ups? To accomplish this goal an introduction of the importance of partner selection
is given and a qualitative study with the CEOs of 6 start-ups across Europe has been
conducted. Data has been evaluated and several steps taken for the selection of answers,
which have been categorized into two groups, describing intrinsic and extrinsic motivational
reasons for finding the best match. Moreover, a guideline on how to succeed in collaborative
work with your partners will be presented at the end of the research. The outcome of the
partner selection is estimated by the contribution of the stakeholders to the venture. This
research provides insight over the most valuable resources which the startup can derive from
their stakeholders. Factors like risk and time to the market influencing the success of the
collaboration are also taken into account when evaluating the mutual fit. Implications for
further research and advice for entrepreneurs are discussed. To entrepreneurial practice, the
research presents that, startups need not only a good idea but a reliable partner to run a
successful business in cleantech environment. It should be noted that financial factors are not
the most important ones for a mutual fit.


BACKGROUND Becker's nevus (BN) can be a distressing cosmetic handicap for patients and a treatment challenge for physicians. Various treatment modalities have been used, but repigmentation commonly occurs after treatment. OBJECTIVE To evaluate the efficacy of long‐pulse alexandrite laser in the treatment of BN. MATERIALS AND METHODS Eleven Korean patients with Fitzpatrick skin type III to V were included in this study. A long‐pulsed alexandrite laser with a wavelength of 755 nm and a pulse duration of 3 ms was used. Patients were treated with a fluence of 20 to 25 J/cm2 and a spot size of 15 to 18 mm. Cryogen spray cooling was not used. RESULTS Two patients had excellent responses, five had good responses, and four had fair responses. Hair density simultaneously decreased with treatment in all patients. Although mild hypopigmentation was observed in some patients, and partial hypertrophic scarring was observed in one patient, the outcomes were cosmetically acceptable. No repigmentation was noted during the follow‐up period. CONCLUSION A long‐pulsed alexandrite laser without cryogen spray cooling is an effective and safe alternative in the treatment of BN. The authors have indicated no significant interest with commercial supporters.


Energy efficient transmission is an important issue for mobile communication devices. In this paper, we study throughput and value-based packet scheduling over a wireless link under time and energy constraints. A mobile node is required to deliver multiple data streams to multiple receivers. These data streams may have different importance and incur different energy costs. In this research, point-to-point wireless data transmission is studied. The objective is to develop schemes that selectively transmit data streams at certain power levels so that the data throughput or the value of data delivery is maximized without violating the energy and time constraints. Exploiting the special properties of the throughput maximization problem, we propose an iterative algorithm that yields the optimal transmission schedule. The value maximization problem is formulated as a convex optimization problem and the optimal results can be obtained by solving the Kuhn-Tucker conditions. When time and transmission power are allocated at discrete slots and levels, respectively, a dynamic programming approach is proposed to find the optimal value.


A pragmatic method for assisting family practice residents in deciding whether or not to counsel patients with psychosocial problems is described. Called "the problem assessment framework," this seven-step method uses a process of sequential analysis to guide the resident through problem identification, goal setting, and determination of appropriate intervention. A checklist is employed to quickly evaluate the suitability of resident and patient for engaging in psychological counseling.


Background: DaxibotulinumtoxinA for Injection (DAXI) is a novel botulinum toxin type A formulation in clinical development. A phase 2 dose-ranging study identified an optimal dose and demonstrated efficacy with a median duration of 24 weeks. Methods: In two phase 3, multicenter, randomized, double-blind, placebo-controlled studies (SAKURA 1 and SAKURA 2), subjects with moderate or severe glabellar lines at maximum frown were assigned randomly to receive placebo or 40 U of DAXI. Glabellar lines were evaluated at least every 4 weeks for at least 24 weeks until severity returned to baseline (≤36 weeks). Results: Overall, 609 subjects were enrolled (DAXI, n = 405; placebo, n = 204). DAXI was significantly more effective than placebo in achieving the primary efficacy outcome (≥2-point improvement in glabellar line severity at maximum frown at week 4 according to both investigator and subject ratings): 73.6 percent versus 0.0 percent (SAKURA 1), and 74.0 percent versus 1.0 percent (SAKURA 2) (both p < 0.0001). Composite investigator and subject ratings of maximum frown after DAXI treatment showed that glabellar line severity of none or mild was maintained for a median of 24.0 weeks (SAKURA 1) and 23.9 weeks (SAKURA 2), and glabellar line severity did not return to baseline levels for a median of 27.7 and 26.0 weeks, respectively. DAXI was generally well tolerated, with the most common adverse events related to DAXI treatment being headache (SAKURA 1, 7.0 percent; SAKURA 2, 5.9 percent) and injection-site pain (5.0 percent and 2.4 percent, respectively). Conclusions: Results from both studies were highly consistent. DAXI may offer a prolonged duration of response (median, ≥24 weeks) and is generally well tolerated. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, I.


This paper surveys quantum learning theory: the theoretical aspects of machine learning using quantum computers. We describe the main results known for three models of learning: exact learning from membership queries, and Probably Approximately Correct (PAC) and agnostic learning from classical or quantum examples.


Across human history, by far the vast majority of learning for occupations has occurred within occupational practice in European, Central Asian, African and Asian countries. Indeed, the learning of occupations within family was the almost universal approach up until the various industry revolutions across the Western world (Greinhart 2002). The key exceptions were programs in universities that had specific and prestigious occupational focuses (i.e. medicine, architecture) (Clarke 1971). However, since the development of mass higher and vocational education systems, that arose as a result of industrialisation and modernity (Hanf 2002), little attention has been given to the traditions of learning through practice and within family and practice settings and that had generated the kinds of artefacts and services that societies and communities needed. It is only now when considerations of workplaces as learning environments, integrating experiences within practice settings in an increasing number of university programs and a broader emphasis on vocational education that has led to considerations of learning through practice (Billett 2010). This paper compares and contrasts the curriculum and pedagogic practices that were utilised long ago in Hellenic Greece (Lodge 1947) and Ancient China (Ebrey 1996; Portal 2007) and the ways in which the nature of work, working knowledge and practice pedagogies were enacted. These two cultural traditions generated quite distinctive views of what constitutes skilled artisans, the processes of working and learning through and for that work. It is proposed that the ordering of these experiences can assist inform how learning through practice might progress in contemporary times. The paper commences by proposing why there is a need for a science of learning through practice, and particularly in an era of schooling. Then, a consideration of how cultural, societal and situational factors shape the goals and opportunities for learning. Outlining developments in Ancient China and Hellenic Greece, and accounts of practices associated with learning occupations within those cultures and communities these range of factors are elaborated. Although far from complete, the evidence points to the structuring of learning experience as being of a particular kind. Following this, consideration of pedagogy is a practice that arise through these historical accounts are offered as a means of understanding that particular approaches to and purposes of learning through practice. From this analysis, concepts of curriculum can be broadened and ideas associated with pedagogy as part of practice can be reassessed.


During October to December 2008, over 50 water bodies from Kununurra to Esperance were surveyed for Phytophthora species by over 20 volunteers using "fishing" baits. Water bodies sampled included creeks, rivers, private dams, estuaries, and lakes. The main aim was to catalogue the diversity of Phytophthora species present in the water bodies. The outbreak of P. ramorum in California and Europe, where early detection of an infested area was important to the success of containment and eradication efforts, has popularised the stream surveys in native ecosystems worldwide. Additionally, our project aimed to develop methodologies for continual monitoring of water bodies in disease free areas for Phytophthora species that cause landscape problems and for monitoring of introduced species from interstate or overseas. No water body was free of Phytophthora. A total of eight Phytophthora species were found, four of which are yet to be officially described. The talk will outline the species caught, their significance in relation to other studies, and presents some future directions for the project.


We consider the convolution equation f * h + e = d, where f is sought, h is a known ``point spread function,'' e represents random errors, and d is the measured data. All these functions are defined on the integers mod(N). A mathematical-statistical fonnulation of the problem leads to minff * hdA, where the A-norm is derived from the statistical distribution of e. If f is known to be nonnegative, this is a quadratic progamming problem. Using the discrete Fourier transforms (DFT's) F, H, and D of f, h, and d, we arrive at a minimization in another norm: minF F · H-D ¿. A solution would be F = D/H, but H has zeros. We consider the theoretical and practical difficulties that arise from these zeros and describe two methods for calculating F numerically also when H has zeros. Numerical tests of the methods are presented, in particular tests with one of the methods, called ``the derivative method,'' where d is a blurred image.


Introduction: Cell blocking (CB) has gained wide acceptance as an integral diagnostic tool in cyto-diagnosis. It allows retrieval and concentration of exfoliated cells in fluid specimens to form paraffin blocks that are interpreted in a biopsy like fashion. The aim of this study was to compare the diagnostic utility of CB to conventional smears (CSs) in the evaluation of serous effusions and to evaluate whether the tested immunomarker panel increases the diagnostic yield of malignancy.
Materials and Methods: Serous effusion specimens were processed using both techniques; CSs and CB. An immunomarker panel (Ber-EP4, EMA E29, D2-40 and desmin) was then applied on CB sections.
Results: CB enhanced the cellularity; it increased the diagnostic yield by 27.4% over CSs. Both nuclear and cytoplasmic details were better demonstrated in CBs. CBs were superior in the preservation of architectural patterns as acini, papillae and sheets. The diagnosis of CBs concurred with that of CSs in 79% of cases, however the diagnostic yield of malignancy increased by 9.6% using CBs. Adding the immunomarker panel totally eliminated the suspicious category and further increased the diagnostic yield for malignancy by 9.7% over CBs and by 19.3% over CSs. Furthermore, categorization of malignant cases into primary malignant mesothelioma and metastatic carcinoma was feasible after thorough interpretation of the combined immunoprofile.
Conclusion: CB represents a cost-effective adjunct to CSs in the evaluation of serous effusions. It increases the cellular yield, provides superior cytomorphology, architectural preservation, and supplies material for ancillary studies.

Keywords: Serous effusions, Cell blocks, Immunohistochemistry, Marker panel.


Fixed-bed regenerators (FBRs) are air-to-air energy exchangers (AAEEs) used to reduce energy consumption in heating, ventilation, and air conditioning (HVAC) systems. Since energy savings are directly related to the effectiveness of FBRs, testing is essential to determine the effectiveness of FBRs for quality assurances and during product development. However, testing of full-scale FBRs has disadvantages such as requiring full-scale prototypes, a high volume of conditioned airflow, long tests, and large testing laboratories. The disadvantages are especially crucial during product development and can be overcome by small-scale testing provided the test data can be used to evaluate accurately full-scale FBRs. The major contribution of this paper is two new methodologies (one direct method and one predictive method) to determine the sensible effectiveness of full-scale FBRs from small-scale test data. In the direct method, the effectiveness of the full-scale FBR is determined directly from the small-scale test data, whereas in the predictive method the effectiveness is determined using the Wilson plot technique and a numerical model in addition to the small-scale test data. Both methods are shown to have uncertainties within the specified uncertainty limits required by testing standards and are applied to evaluate the influence of geometrical parameters (corrugation angle and corrugation depth) on the effectiveness of FBRs. The test methods and results will be useful in the design and development of FBRs for HVAC applications.


Abstract Before European settlement, vast areas of deciduous forest in what is now the eastern United States were dominated by oak species. Among these species, white oak (Quercus alba) reigned supreme. White oak tended to grow at lower elevations but was distributed across a broad range of sites, from wet mesic to subxeric, and grew on all but the wettest and most xeric, rocky, or nutrient-poor soils. A comparison of witness tree data from early land surveys and data on modern-day forest composition revealed a drastic decline in white oak throughout the eastern forest. By contrast, other dominant oaks, such as red oak (Quercus rubra) and chestnut oak (Quercus prinus), often exhibited higher frequency in recent studies than in surveys of the original forest. The frequency of red oak witness trees before European settlement was quite low, generally under 5% in most forests. Red oak's distribution was apparently limited by a lower tolerance to fire and drought and a greater dependence on catastrophic disturbances than that of white oak. During the late 19th and early 20th centuries, much of the eastern forest was decimated by land clearing, extensive clear-cutting, catastrophic fires, chestnut blight, and then fire suppression and intensive deer browsing. These activities had the greatest negative impact on the highly valued white oak, while promoting the expansion of red oak and chestnut oak. More recently, however, recruitment of all the dominant upland oaks has been limited on all but the most xeric sites. Thus, the dynamic equilibrium in the ecology of upland oaks that existed for thousands of years has been destroyed in the few centuries following European settlement.


Author(s): Mukhtar, Farhana | Advisor(s): Greenfield, Sheldon | Abstract: OBJECTIVE: The aim of my study was: to assess the maternal and neonatal outcomes of pre-viable PPROM pregnancies and to describe the predictors for better outcomes of these pregnancies.METHODS: I performed a systematic review of the literature published on the pregnancy outcomes of pre-viable PPROM following expectant management. I collected 17 high-quality studies through PubMed database search and reviewed them to obtain data on neonatal survival; maternal and neonatal morbidity; predictors for better neonatal survival and proportion of women opting for termination of pregnancies. RESULTS: The overall survival to hospital discharge was 41.1%. Of these, 49.2% neonates survived without a major morbidity. Respiratory morbidity was the most common morbidity among surviving neonates. 37% neonates suffered from respiratory distress syndrome, 28% from bronchopulmonary dysplasia, and 9.8% from pulmonary hypoplasia. Sepsis occurred in 22.7% neonates. 49.3% pre-viable PPROM women developed chorioamnionitis. Other common maternal morbidities included cesarean delivery (33%) and placental abruption (30%). The predictors of better neonatal survival to discharge included later gestational age at PPROM, an absence of oligohydramnios, iatrogenic etiology of PPROM, and the C-reactive protein (CRP) level l1mg/dl on the first day of the presentation. Later gestational age at birth was associated with less neonatal morbidity. Overall, 21.1% of pre-viable PPROM women opted for the termination of pregnancy instead of expectant management.CONCLUSION: The survival rate of pre-viable PPROM is poor, but it is not zero. 4 of every 10 affected neonates do survive and half of them are without any major morbidity. Maternal morbidity is still high, but serious maternal morbidities are rare.


Communication between two molecules, one confined and excited (triplet or singlet) and one free and paramagnetic, has been explored through quenching of fluorescence and/or phosphorescence by nitroxides as paramagnetic radical species. Quenching of excited states by nitroxides has been investigated in solution, and the mechanism is speculated to involve charge transfer and/or exchange processes, both of which require close orbital interaction between excited molecule and quencher. We show in this report that such a quenching, which involves electron-electron spin communication, can occur even when there is a molecular wall between the two. The excited state molecule is confined within an organic capsule made up of two molecules of a deep cavity cavitand, octa acid, that exists in the anionic form in basic aqueous solution. The nitroxide is kept free in aqueous solution. (1)H NMR and EPR experiments were carried out to ascertain the location of the two molecules. The distance between the excited molecule and the paramagnetic quencher was manipulated by the use of cationic, anionic, and neutral nitroxide and also by selectively including the cationic nitroxide within the cavity of cucurbituril. Results presented here highlight the role of the lifetime of the encounter complex in electron-electron spin communication when the direct orbital overlap between the two molecules is prevented by the intermediary wall.


Microorganisms (mainly bacteria and yeast) are frequently used as hosts for genetic constructs in synthetic biology applications. Molecular noise might have a significant effect on the dynamics of gene regulation in microbial cells, mainly attributed to the low copy numbers of mRNA species involved. However, the inclusion of molecular noise in the automated design of biocircuits is not a common practice due to the computational burden linked to the chemical master equation describing the dynamics of stochastic gene regulatory circuits. Here, we address the automated design of synthetic gene circuits under the effect of molecular noise combining a mixed integer nonlinear global optimization method with a partial integro-differential equation model describing the evolution of stochastic gene regulatory systems that approximates very efficiently the chemical master equation. We demonstrate the performance of the proposed methodology through a number of examples of relevance in synthetic biology, including different bimodal stochastic gene switches, robust stochastic oscillators, and circuits capable of achieving biochemical adaptation under noise.


There is hardly an issue in the entire history of the 20th century that has caught so much the interest of the historians and has seen the production of such a huge number of books and articles as the one regarding the origins of the First World War. It is no surprise that the explosion of interest in the First World War on the occasion of the centenary year was marked, among else, by new discussions and many publications on this subject. The book that has caught mostly the attention of public and academic debate is no other than Sleepwalkers by Christopher Clark, Professor of Modern History at the University of Cambridge. Through an exhaustive study of the main actors and the motives behind their decisions, characterized by thorough knowledge of the subject and a thrilling narrative style, the author tries to answer the crucial question of how Europe went to war in 1914.


To assess the safety profile of iso‐osmolar contrast medium (CM) versus low osmolar CM in cancer patients with an estimated glomerular filtration rate (eGFR) >60 ml/min. In this multicenter, blind trial of patients seeking a chest‐abdomen‐pelvis contrast enhanced computed tomography (CT) with iodated CM, participants were centrally randomized to iodixanol or iopromide. Contrast induced nephropathy (CIN) at 24 and/or 72 hr were our primary outcomes. We further considered irreversible CIN, average eGFR percentage variation (%Δ), and adverse events (AEs). Overall, 607 patients were enrolled. Among them, 497 eligible patients were randomized to iodixanol (N: 247) or iopromide (N: 250). No differences emerged by descriptive characteristics. Seven and 3 CIN at 24 hr (p = 0.34) and 8 and 2 CIN at 72 hr (p = 0.11) occurred in the iopromide and iodixanol group, respectively. Within the subgroup of individual patients who developed CIN (N: 17), the event rate was higher in the iopromide arm (p = 0.045). No cases of permanent CIN or significant differences in terms of AEs or GFR %Δ were observed. Our results suggest a more favorable safety profile of iodixanol versus iopromide. Adequately sized trials with similar design are warranted to confirm our findings and clarify the underlying biological mechanisms.


This thesis aims to identify patient characteristics and ovarian reserve markers that forecast pregnancy in women with advanced ovarian ageing and to investigate whether unfavourable cardiovascular health is associated with advanced ovarian ageing. Female reproductive ageing comprises the gradual decline in both oocyte quantity and quality will lead to four reproductive milestones, i.e. subfertility, sterility, menopausal transition and menopause. Female age has been identified as an important modulator of the reproductive ageing process, although the large inter-individual variation in normal ovarian ageing varies considerably, suggesting other factors may play a role. Women with a poor response in IVF or with elevated basal FSH levels, expressions of limited oocyte quantity, are suggested to have poor pregnancy prospects (an expression of poor oocyte quality), although reasonable pregnancy prospects have been published. The possible inconsistency between the quantity and quality of the primordial follicle pool as observed in women with advanced ovarian ageing evokes the question whether Anti-Mullerian Hormone (AMH) or patient characteristics can identify those women who still have acceptable pregnancy prospects. The large variation in normal ovarian ageing is also expressed by a considerable variation in age at normal menopause, covering a range from 40 to 60 years of age. Early menopause is associated with an increased risk of cardiovascular disease. However, recently it has been suggested that vascular health may act as cause instead of a consequence of menopause.

This thesis investigates whether markers of vascular ageing are associated with advanced ovarian ageing. Elucidation of these associations will create more understanding about the variation of the reproduction ageing process. The studies presented in this thesis focus on pregnancy forecasting based on information regarding quantitative ovarian reserve status, as well as the role of vascular health and unfavourable conditions during intra-uterine life in female reproductive ageing patterns. We studied these issues in several clinical cohorts, that serve as an extreme phenotype for compromised ovarian reserve, vascular health status or foetal environment.

In this thesis it was confirmed that there is a complex interplay between ovarian reserve quantity and quality. Female age plays an important role in the modulation of this interaction. Women with advanced ovarian ageing, as expressed by a poor response in IVF or elevated basal FSH levels, appear to be a heterogeneous group in which ovarian reserve tests, next to female age, may identify those women with reasonable pregnancy prospects. Future research will help us unravel the mechanisms behind the individual variation of ovarian ageing.

Furthermore, no conclusive evidence was found for an association between vascular health and the ovarian ageing process, using women with a history of preeclampsia, women with type 1 diabetes and women with exposure to prenatal famine as a model of compromised vascular health. To elucidate whether vascular compromise accelerates ovarian ageing, future studies would benefit from animal studies with an interventional design.


The physic nut is an important plant for biodiesel production. However, research is still lacking as to the best leaves to be sampled in determining ideal mineral content. It is important that all factors causing variations in the mineral nutrient concentrations in leaves are identified and evaluated to determine the most efficient sampling technique. The positions of the leaves on the branches and on the plant shoot are critical variables affecting leaf composition. Thus, this study aimed to determine the best leaf position for sampling to evaluate the health status of adult physic nut plants. The experiment was conducted in the field, using a 5 × 3 factorial design, with leaves sampled at five positions on the branch (1st, 2nd, 3rd, 4th, and 5th node, from the apex), and three sections of the plant crown (apical, middle, and basal), in a completely randomized design with four replications, and four plants per plot. The concentration of macronutrients (N, P, Ca, Mg, and S) and micronutrients (Cu, Fe, Mn, and Zn) were determined for all samples. The results indicated that the sampling of leaves at the 3rd and 4th node of the flower-bearing branches, located in the middle section of the plant canopy, was the most indicative of the mineral composition of adult jatropha plants.


This case (an abridged version of UVA-M-0663) describes the history of the Red Bull brand and how the company stimulated and harnessed word of mouth to build a new product category (functional energy drinks) and brand franchise. The case concludes by asking the reader to consider where Red Bull will take its brand, product line, and marketing next, in light of many competitive challenges in the United States. The case was written to foster discussion of nontraditional brand-building strategies and the growing globalization of brands and products targeted toward younger consumers.


One of the most severe obstacles to increasing the longevity of tungsten-based plasma facing components, such as divertor tiles, is the surface deterioration driven by sub-surface helium bubble formation and rupture. Supported by experimental observations at PISCES, this work uses molecular dynamics simulations to identify the microscopic mechanisms underlying suppression of helium bubble formation by the introduction of plasma-borne beryllium. Simulations of the initial surface material (crystalline W), early-time Be exposure (amorphous W-Be) and final WBe2 intermetallic surfaces were used to highlight the effect of Be. Significant differences in He retention, depth distribution and cluster size were observed in the cases with beryllium present. Helium resided much closer to the surface in the Be cases with nearly 80% of the total helium inventory located within the first 2 nm. Moreover, coarsening of the He depth profile due to bubble formation is suppressed due to a one-hundred fold decrease in He mobility in WBe2, relative to crystalline W. This is further evidenced by the drastic reduction in He cluster sizes even when it was observed that both the amorphous W-Be and WBe2 intermetallic phases retain nearly twice as much He during cumulative implantation studies.


The local government here how can overcome existing problem. To that's local government have to can develop;build harmonious and harmonic relation with corporate world and society to realize to arrange good governance. Essensi from delivering birth of Law No. 32/2004 and Law No. 33/2004, for example are: Variety in unity, Political paradigm, using democracy principle, justice and generalization. Economic paradigm which emphasize at area competitiveness in face of global emulation through enableness of society. Problem of arising out along with journey of Autonomy Area, the local government have conducted stages;steps of inovatif in exploiting of natural sumberdaya and also available human being sumberdaya. When powered existing excellence in an optimal fashion of course will be able to move forward area economics marked with prosperity of society. But, if such excellence just for simply fulfilling formal ground, hence society will not obtain;get something benefit. Pursuant to its source, hence writer divide to become innovation of adoptif, innovate self-supporting innovation and instruktif. Result of research conclude, that 1) Ability of Municipalities innovation in Kaltim still relative lower 2) paradigm of governmental as steward of society not yet fully run; and 3) Condition of politically in labile center storey level cause doubt of leadership in area.


In situ synchrotron small-angle X-ray scattering was used to investigate various surfactant/water systems with hexagonal and lamellar structures regarding their structural behaviour upon heating and cooling. Measurements of the non-ionic surfactant Triton X-45 (polyethylene glycol 4-tert-octylphenyl ether) at different surfactant concentrations show an alignment of the lamellar liquid-crystalline structure close to the wall of the glass capillaries and also a decrease in d-spacing following subsequent heating/cooling cycles. Additionally, samples were subjected to a weak magnetic field (0.3-0.7 T) during heating and cooling, but no influence of the magnetic field was observed.


Rama is a Chibchan language spoken on the Atlantic Coast of Nicaragua. Although the community of Ramas has steadily increased in the last decades, from 825 in 1909 to 649 in 1981 (CIDCA 1982, the number of speakers of the Rama language has been  steadily declining. The Rama community has been concentreated on the island of Rama Cay, south of Bluefields in the Bluefields lagoon. The main language of the Rama community today is Rama Creole, an English-based creole which is distintic from the English-based creole spoken by the Creole population of the Atlantic coast of Nicaragua (Holm 1984).


J.H. van 't Hoffs theory of diluted solutions (1886) In his Etudes de dynamique chimique (1884).J.H. van 't Hoff was confronted with the problem of the magnitude of the attraction of water by salts. He wondered whether it is possible to measure this force, i.e. the affinity, in the simple case of an aqueous solution. Hugo de Vries drew his attention to Wilhelm Pfeffer's experiments on osmotic pressure. This led to van 't Hoffs theory of osmotic pressure, which he formulated in 1884-1885 and which was published in 1885-1887. Van 't Hoff found an analogy between the osmotic pressure and the gas pressure. The general gas law PV=RT is also applicable to dilute solutions, although for electrolytes a factor i had to be introduced: PV=iRT. It was Svante Arrhenius who suggested that i is equal to the number of ions. In 1887 Arrhenius published his theory of electrolytic dissociation. Connected with van 't Hoffs theory of osmotic pressure, the definitive formulation of the theory of dilute solutions was obtained. Soon discussions were held about the theory of solutions. The British Association for the Advancement of Science organized a meeting in Leeds in 1893 where the new theories were fiercely attacked by a number of British scientists. In April 1893 the meeting of the Nederlandsch Natuur- en Geneeskundig Congres (Dutch Physical and Medical Congress) in Groningen reached favourably to the new ideas, On January 8, 1894, van 't Hoff lectured on the genesis of the theory of solutions before the Deutsche Chemische Gesellschaft in Berlin. It is remarkable that he asked himself whether the theory of electrolytic dissociation conforms to reality. Although his student Jacob Jan Alexander Wijs had determined the value of the dissociation constant of water (1893), van 't Hoff ended his lecture with the intriguing question: "Is the theory of electrolytic dissociation proved in this way? By no means. But it wholly unexpectedly has supplied much in the field of saponification." It is not clear whether Van 't Hoff had his doubts on the degree of reality of the theory of electrolytic dissociation or whether he did not want to take the risk of a confrontation with his opponents.


Information and Communication Technology (ICT) is playing an ever increasing role in the lives of people which include young children; The role of ICT in early childhood educational services in Aotearoa New Zealand is still being argued despite curriculum, assessment and policy expectations that endorse and support its integration into practice. This chapter draws upon a small, qualitative case study involving young children and their uses of ICT in one early childhood education setting in Aotearoa New Zealand. A socio-cultural perspective has been used to recognise and examine the notion of children's understanding and practices of ICT. In this chapter the focus is on Jessica, aged 4 years old, and the ways she uses ICT in her life as tool to document and share her learning and interests. These uses also reflect Jessica as a competent and confident learner using ICT as a cultural tool to mediate her learning in her home and early childhood education setting. The researchers examine the way ICT practices can contribute and fulfil curriculum and policy intentions that can support and endorse the competent, confident learner that reflects the curriculum principle of Empowerment. The chapter supports the view that ICT can be used to enhance the empowerment of the learner. We conclude that the early childhood curriculum and policy in Aotearoa New Zealand justifies the place of ICT in early childhood settings and should guide and inform teachers to use it as a valued learning and teaching tool. The researchers are of the opinion that the teachers have an active and collaborative role in responding to the needs of the 21 century learner to direct their own learning and that this can be guided by the curriculum aspirations in the principle of Empowerment.


Psoriasis is an immunologically mediated disease caused by activation of T lymphocytes that elaborate a Th1 type of immune response. Targeted manipulation of the various mechanisms involved in T cell activation and blockade or inactivation of the various proinflammatory cytokines released by the process of T cell activation are methods used in treatment of psoriasis by use of 'biologicals'.


The prosperous growth of the Internet-of-Things industry attracts numerous interests in employing edge clouds (a.k.a. cloudlets) to enhance the performance of mobile services and applications. Most existing research has been focused on offloading computational tasks from mobile devices to a single cloudlet or a central location, yet overlooked the issue of jointly coordinating the offloaded tasks in a system of multiple cloudlets. In this paper, we fill this gap by investigating the assignment and the scheduling of mobile computational tasks over multiple cloudlets, while optimizing the overall cost efficiency by leveraging the heterogeneity of cloudlets. We model both data transfer and computation in terms of monetary and time costs, with task deadlines guaranteed. We formulate the problem as a mixed integer program and prove its NP-hardness. By introducing admission control for the cloudlet provider to shape the system workload, we transform our problem into maximizing the task admission rate over the two coupled phases: data transfer and computation. We propose an efficient two-phase scheduling algorithm, and demonstrate that, compared with the conventional approach of always selecting the closest cloudlet, our approach achieves significantly higher admission rate with up to 20% reduction in the average cost of all offloaded tasks.


This series of volumes provides access to a compendium of the best and most significant scholarship published on European performance practice over the last half century or so. The featured articles and book chapters provide a comprehensive introduction to many of the major past and current developments in the field, emphasizing acting, performance spaces, staging and audiences, from the Middle Ages to the present day. Each of the four volumes covers a specific period: these, with inevitable overlaps dictated by geographical and other concerns, are 1400–1580, 1580–1750, 1750–1900 and 1900 to the present. The volume editors have selected those publications that most usefully represent performance practice within their own specialist period. The strong focus on British theatre is complemented by European material and references.
The timeframe spanned by the four volumes witnessed striking changes in definitions of the term 'performance'. The editors of the first and fourth volumes confront this challenge from different perspectives. Philip Butterworth and Katie Normington remind us that the term 'performance' was not used in conjunction with what we now define as 'theatrical performance' prior to 1580. For the purpose of considering medieval performance they insist that the term must encompass: "the conscious and deliberate organization, execution, perception and reception of theatre and its aftermath to people who choose to witness and participate in it. This involves indoor and outdoor performance – both formal and informal, theatre of the streets and the deliberate organization and construction of stage and spectator space."
By the twentieth century, as Nadine Holdsworth and Geoff Willcocks demonstrate, with reference to Richard Schechner, 'the very term "performance" has taken on multiple meanings and infiltrated numerous disciplines within the arts and humanities', whether through Goffman's work on performance in everyday life or Butler's on the performance of gendered identity. Thus their task is not so much to define performance as to limit definition to a focus on: "Performance … that is, in some sense, theatrical in that it has been created with an audience in mind, whether that audience is deliberately party to the transaction through the act of purchasing a ticket or turning up at an allotted time or inadvertent as with works such as happenings or street theatre that address both a knowing and unknowing audience in its broadest sense."
While performance practice, especially at the beginning and end of our period, is not necessarily confined within purpose built spaces, theatre buildings and the performances they engendered, through their impact on acting, design, technology and audiences, figure in many of the extracts anthologized in these four volumes.
Each volume has been compiled with an awareness of the historiographical background to the study of theatre practices in different periods. Butterworth and Normington provide a useful account of the development of scholarship on medieval theatre prior to the twentieth century and more recently through the work of Chambers, Wickham, Kolve, Meredith and Twycross, showing how the REED project has provided greatly enhanced resources for a new generation of medieval scholars, enabling them to examine medieval performance practices more closely. In response to these advances, the first volume provides a cross-section of performance documents as well as critical discussion. In Volume II, Robert Henke and M.A. Katritzky provide a rich insight into the influence of the Renaissance on European theatre practices and the convergences and development of different practices, organizing their materials under Gurr's 'four estates' of theatre: playing spaces, staging, actors and audiences. The impact of space on performance – on acting, setting, design and dramaturgy – is closely considered, while notions of acting 'character' and acting the 'passions' are also examined. Audiences become increasingly more diverse and complex during this period, a theme followed up by Jim Davis in Volume III, which covers a period of greatly expanding audience demand for professional theatre, in both its popular and its high cultural manifestations. Larger theatres, new technologies, advances in scene design and lighting, the cult of the celebrity actor, as well as debates about the nature of acting itself, are among the many factors that influenced European performance during the late eighteenth and nineteenth centuries. The rise of the director towards the end of the nineteenth century gathers momentum in the twentieth century, when many directors and practitioners demonstrate a pan-European range of new approaches to theatrical practice, covered in Volume IV. Holdsworth and Willcocks are also mindful of the strong focus on the social and political dimensions of performance during this period, the notion of spectator as witness and the extraordinary cross-fertilization of performance practices throughout Europe. The chosen chronological subdivision, just one of many ways in which these four volumes could have been organized, reflects a widespread approach in performance practice studies. The editors have worked from the premise that each volume has its own idiosyncratic voice, most appropriate to the period under consideration, while maintaining a focus on performance practices as they have developed and varied across time and space. This selection offers the reader a compact and reliable introduction to the vast range of publications generated by scholarship in this field and provides reference pointers for further study. We trust that this representative cross-section of articles, book chapters and records will serve as an invaluable resource for those wishing to study, teach or recreate aspects of the many and varied facets of performance practice in Europe from medieval times up until the present day.


The central thesis of the paper is that some criminal law solutions and responses by criminal justice systems to cybersecurity threats across Europe and the USA raise substantial public policy and human rights concerns. The thesis is explained by presenting the criminal justice systems' reactions to cybercrime as they are manifested in cybercrime prevention strategies (for instance in data retention regulation and in the changed nature of cybercrime policing), substantive criminal law solutions (for instance with incrimination of mere illegal access) and criminal procedure possibilities that are granting law enforcement impressive powers (for instance with on-line searches and seizures). These changes are heading towards an overregulated cyberspace.


For quantitative estimation of the intra-layer porous structure in the initial stage of landfill formation with municipal solid waste incineration (MSWI) bottom ash, the water absorption of individual MSWI bottom ash particles was measured under still-water, degassed, and agitated conditions. The ratio of the water absorption rate found for the still-water procedure to the effective absorption capacity which was the one under degassing was 35.2%. In the water flow experiment of a column filled with MSWI bottom ash, the true density of the bottom ash was higher after water flow than before, which indicated that dissolution of the soluble components of the bottom ash particle surfaces resulted in a loss of apparent particle volume that more than offset the accompanying weight loss. The volume-based water absorption rate found for the bottom ash particles following 50 mL/h water flow through the column, as a ratio to the effective absorption capacity was about 51.8% of the effective absorption capacity. In a landfill layer comprised of MSWI bottom ash, it was suggested that some regions of the ash particle interiors underwent almost no contact with water.


With billions of networked connected embedded systems, the security historically provided by the isolation of embedded systems is no longer sufficient. Both proactive security measures that prevent intrusions and reactive measures that detect intrusions are essential. Anomaly-based detection is a common reactive approach employed to detect malware that has evaded proactive defenses by observing anomalous deviations in the system execution. Timing-based anomaly detection detects malware by monitoring the system's internal timing, which offers unique protection against mimicry malware compared to sequence-based anomaly detection. However, previous timing-based anomaly detection methods focus on each operation independently at the granularity of tasks, function calls, system calls, or basic blocks. These approaches neither consider the entire software execution path nor provide a quantitative estimate of the presence of malware. This paper presents a novel model for specifying the normal timing for execution paths in software applications using cumulative distribution functions of timing data in sliding execution windows. We present a probabilistic formulation for estimating the presence of malware for individual operations and sequences of operations within the paths, and we define thresholds to minimize false positives based on training data. Experimental results with a smart connected pacemaker and three sophisticated mimicry malware demonstrate improved performance and accuracy compared to state-of-the-art timing-based malware detection.


In this paper we present the first ever measured experimental electron momentum density of Cu2Sb at an intermediate resolution (0.6 a.u.) using 59.54 keV 241 Am Compton spectrometer. The measurements are compared with the theoretical Compton profiles using density function theory (DFT) within a linear combination of an atomic orbitals (LCAO) method. In DFT calculation, Perdew-Burke-Ernzerhof (PBE) scheme is employed to treat correlation whereas exchange is included by following the Becke scheme. It is seen that various approximations within LCAODFT show relatively better agreement with the experimental Compton data. Ionic model calculations for a number of configurations (Cu +x/2 )2(Sb -x ) (0.0≤x≤2.0) are also performed utilizing free atom profiles, the ionic model suggests transfer of 2.0 electrons per Cu atom from 4s state to 5p state of Sb.


Brazil has become by far the largest higher education system in Latin America, with a large share of enrollments in the private sector. A recently established and fast growing for-profit sub-sector consolidates as one of the largest worldwide. It already surpasses the public sector in enrollment and its role is growing. Public policy has backed the for-profit growth, largely for tax revenue reasons but in recent years the federal government has taken social initiatives that include tax exemption policies for the sub-sector. As indicated by fields of study, the for-profit sub-sector shares some important characteristics with the nonprofit sub-sector, contrasting dramatically to the public sector.


Meta-analyses of randomized controlled trials are increasingly performed to obtain more precise results. On the other hand, meta-analyses of prevalence studies are relatively rarely performed. In this review, some important points for interpretation of meta-analyses are given along with the comments on the meta-analyses of prevalence studies that are published in this issue of The Archives of The Turkish Society of Cardiology. ABSTRACT


Introduction Cardiopulmonary Exercise testing (CPET) has become an important tool for perioperative assessment as it may identify patients at risk of postoperative cardiopulmonary complications. Older (1) recommended that an Anaerobic Threshold (AT)<11 or >11ml/min/kg can be used to stratify post-operative treatment in colorectal patients (ITU, HDU or ward). The BTS guidelines (2) recommend that a Peak VO2 (PVO2)<15 or >15ml/min/kg can be used as a risk assessment in thoracic surgical patients. However, CPET can be difficulty to carry out. This study was undertaken to determine whether selected lung function values correlated with CPET outcome, so that they could be used as an alternative to AT and PVO2. Method 500 pre-operative colorectal (388) and oesophageal (112) patients attending the Lung Function Department were analysed. Spirometry and Gas Transfer were performed to assess lung function. CPET was performed on a cycle ergometer to calculate PVO2 and AT. Results The area under the curve (AUC) of a Receiver Operating Curve (ROC) analysis was carried out on the 500 patients. This compared percent predicted FEV1, FVC, TLco and Kco values to PVO2 and AT. Abstract S21 Table 1 AUC FEV1 (% Predicted) FVC (% Predicted) TLco (% Predicted) Kco (% Predicted) PVO2 AT PVO2 0.560 0.557 0.721 0.625 1.00 0.894 AT 0.547 0.568 0.643 0.555 0.877 1.000 Discussion Our findings indicated that analysis of lung function variables cannot reliably predict PVO2 or AT outcome. However, of the variables recorded, TLco was the best marker for predicting a PVO2>15ml/min/kg (0.721). When the cut-off for TLco was set at 80% predicted it had a sensitivity and 1-specificity of 62% and 24% respectively. Interestingly, there was a significant correlation between AT and PVO2 (0.894), suggesting that AT can be used as a predictor of PVO2. If the cut-off for AT was set at 11ml/min/kg; the sensitivity was 91.7% and the 1-specificity 37.7%. However if the cut-off was adjusted to 12ml/min/kg; the sensitivity was 77.3% and the 1-specificity was 13.7%. Conclusion These results suggest that in pre-operative assessment of patients undergoing thoracic surgery, an AT>12ml/min/kg could be used as an alternative measure if the patient was unable to achieve a PVO2>15ml/min/kg. Reference Older (1999). Cardiopulmonary exercise testing as a screening test for perioperative management of major surgery in the elderly. Chest; 116; 355–62. BTS Guidelines on the selection of patients with lung cancer for surgery (2001). Thorax 56:89–108.