The proliferation of small congenital malformations is studied among 570 female students 19-20 years old, permanently residing in the territory of the Tula region. Evaluation of the stigma disembriogeneza in different environmental conditions in the region. The differences of mass and length of newborn girls are shown from different ecozones. The most frequent high level stigmatsii having girls who are permanent residents in an environmentally disadvantaged area of south-east. The average value of stigmatsii in ecozones «South» was also significantly higher. There was significant difference in the growth and weight of newborn girls in the south-east of the region compared to other ecozones.


The relative contribution of the classical and alternative pathways in complement activation was quantified in 20 patients with systemic meningococcal disease. The activation products C4bc, C4bd, and Bb, indicating classical and alternative pathway activation, were measured with neoepitope-specific EIAs. Ten patients with persistent septic shock had significantly higher levels of Bb (P<.001), but not of C4bc (P=.43), than did 10 patients without septic shock. The Bb levels were significantly correlated with C3 activation products (C3bc; r= .72, P=.002), terminal SC5b-9 complement complex (TCC; r=.89, P<.001), and plasma lipopolysaccharides (LPS; r=.69, P= .01). There was no such association for C4bc versus C3bc, TCC, or LPS. Serially collected samples demonstrated activation of both pathways in patients with or without shock. Intervention strategies to stop the massive complement activation in fulminant meningococcal septicemia should include therapeutic principles that inhibit the alternative pathway.


Background: Porcine digestive peptides (PDP) have proven to be a valid substitute for other high-quality dietary protein sources for piglets, like spray-dried plasma (SDP), but knowledge about their influence on intestinal function is still scarce. This study was conducted to investigate the effects of PDP, SDP or a combination of both on growth performance and intestinal function of weaned pigs. Results: A total of 180 piglets (Trial 1) and 198 piglets (Trial 2) were used to evaluate the partial substitution of soybean ingredients with 2% SDP or 2% PDP (Trial 1), and with 3% SDP or the combination of 1% SDP and 2% PDP (SDP-PDP; Trial 2) during the pre-starter period (d0-14). A common commercial diet was offered up to day 35 in Trial 2. The effects on intestinal function were evaluated by quantifyingthe gene expression (56 genes in an Open Array Real-Time PCRPlatform) in jejunum and ileum samples obtained from piglets on d 14 after weaning (Trial 2).Piglets fed SDP, PDP and SDP-PDP had a higher body weight (BW), average daily gain (ADG) and feed efficiency (G:F) than the soybean controlon day 14 (P< 0.05), but no differences were observed among groups at the end of starter phase (Trial 2). Ten genes in jejunum and five in ileum samples were differentially expressed among treatments (P< 0.05). The highest expression was found in the SDP-PDP group. These genes are involved in the barrier function of intestinal cells,the immune response, mucosal nutrient transport, digestion and metabolization of oxidation products. Conclusion: The combination of SDP and PDP upregulated genes related to the intestinal functionwithout affecting growth performance. The underlying mechanisms that produced these effects are still unknown; however, protein hydrolysates might contain bioactive peptides that could be the cause.


Activation of granzyme B, a key cytolytic effector molecule of natural killer (NK) cells, requires removal of an N-terminal pro-domain. In mice, cathepsin C is required for granzyme processing and normal NK cell cytolytic function, whereas in patients with Papillon-Lefèvre syndrome (PLS), loss-of-function mutations in cathepsin C do not affect lymphokine activated killer (LAK) cell function. Here we demonstrate that resting PLS NK cells do have a cytolytic defect and fail to induce the caspase cascade in target cells. NK cells from these patients contain inactive granzyme B, indicating that cathepsin C is required for granzyme B activation in unstimulated human NK cells. However, in vitro activation of PLS NK cells with interleukin-2 restores cytolytic function and granzyme B activity by a cathepsin C-independent mechanism. This is the first documented example of a human mutation affecting granzyme B activity and highlights the importance of cathepsin C in human NK cell function.


It was aimed to verify the effect of different methodologies of osmopriming on physiological quality of gherkin seeds. Prior, it has been characterized the initial profile of the gherkin seeds. Then, the seeds were osmoprimed in gerboxes containing two blotter papers wetted with osmotic solutions in a volume equal to three times the paper dry weight and kept in BOD at 15 °C. After the priming, the seeds were dried at room temperature for 48 hours. Then, the following variables were evaluated: seeds moisture content, percentage of germination, percentage of emergence, emergence speed index and electrical conductivity. The analyses of variances were realized according to a randomized design in a factorial scheme 3 x 2 x 4: three solutes (polyetilene glycol 6000 - PEG, potassium nitrate - KNO3 and PEG + KNO3), two osmotic potentials (-0.55 and -1.10 MPa) and four times of priming (24, 48, 72 and 96 hours), followed by analyses of regression. It is concluded that the priming has no effect on germination and affects positively the vigor of the gherkin seeds lots; osmopriming with potassium nitrate is effective in improving the physiological quality of gherkin seeds lot.


In the Amazon, hydrological modelling is of great importance to the safety and operation of inland waterway transport. In this paper, a stochastic model named ARIMA (Autoregressive Integrated Moving Average) was used to forecast water levels and seaworthiness 24 months in advance in the Tapajós River. Additionally, a time series analysis aimed to model and predicting water levels in the Tapajós river basin was completed. During validation, the model had an average coefficient of Nash and Sutcliffe R² of 0.95 and an average RMSE of 0.06. Drought forecast for the model predicted depth gains of 30 cm and a load capacity gain of 2,800 tons per trip. In the analysis of the two seasonal periods, the model predicted annual savings in freight cost of U.S. $350,000.00. The performance of the model allows us to conclude that ARIMA models should be used to forecast water levels and navigation conditions in the Amazon.


This paper is devoted to the Polish leniency programme, including the conditions of obtaining lenient treatment and the applicable procedure. The type, scope and form of information that must be submitted are commented on as well as the marker system and summary applications. The intersection of the leniency scheme with private enforcement of antitrust rules is discussed in detail. Special attention is devoted to the possible ways in which private antitrust plaintiffs might access information submitted to the UOKiK by leniency applicants. Thoroughly analysed are the rules regulating the possibility of obtaining relevant documents from the UOKiK and from the defendant in the course of civil proceedings as well as the status of the administrative decision in subsequent civil litigation. The paper covers also the scope of the leniency recipient's civil liability and touches upon the possible ways in which it could be limited to enhance the effectiveness of the leniency scheme. Some suggestions de lege ferenda are also provided concerning the means of increasing this effectiveness without prejudice to the private parties' right to compensation.


This paper presents a proposal for the use of the Hybrid Fuzzy Inference System algorithm (HyFIS) as solar intensity forecast mechanism. Fuzzy Inference Systems (FIS) are used to solve regression problems in various contexts. The HyFIS is a method based on FIS with the particular advantage of combining fuzzy concepts with Artificial Neural Networks (ANN), thus optimizing the learning process. This algorithm is part of several other FIS algorithms implemented in the Fuzzy Rule-Based Systems (FRBS) package of R. The ANN algorithms and Support Vector Machine (SVM), both widely used for solving regression problems, are also used in this study to allow the comparison of results. Results show that HyFIS presents higher performance when compared to the ANN and SVM, when applied to real data of Florianopolis, Brazil, which helps to reinforce the potential of this algorithm in solving the solar intensity forecasting problems.


The current study was done to evaluate the effect of adding Jerusalem artichoke powder on growth of lactic acid bacteria (Lactobacillus. acidophlic and Lactobacillus. plant arum) as probiotic in single-strength carrot juice during fermentation at 37°cfor 48 hour. The obtained results showed that there increasing in titrable acidity (as lactic acid) and there is also increasing in number of probiotic bacteria and decreasing in pH value and content of total soluble sugars (non-reducing and reducing sugars) of packaged carrot juice. Treated with probiotic bacteria or sample treated with probiotic bacteria and probiotic as Jerusalem artichoke powder effect fermentation at 37°C for 48 hours. The number of probiotic and prebiotic is higher than their number in sample treated with only probiotic bacteria after incubation at 37°C for 48 hours. From the results, the study ends with the results that the normal carrot juice is suitable media and Jerusalem artichoke is suitable as probiotic for L. acidophilus and L. plant arum growth


We present an experimental study of azimuthally symmetric surface wave (SW) sustained discharges in argon at reduced pressure in an annular tube with a conducting inner. The presence of this conducting cylinder makes it possible to calibrate the field measuring antennas and perform absolute measurements of the SW field. The experimental data from these absolute measurements, and from Langmuir probe and spectroscopic diagnostics, are compared with the theoretical predictions of an accompanying paper.


This paper examines the hitherto undeveloped research area which examines the relationship between tourism and migration. Despite the emergence of a number of new studies in this area that have evolved from the interest in 'ethnic tourism', visiting friends and relatives and the relationship of tourism to migration, particularly immigration and emigration, many of these relationships remain tenuous and vague within existing conceptualisations of the area. As a result this paper explores the literature on tourism and migration, seeking to provide a cohesive synthesis of the field from publications within the realms of tourism studies, migration studies, sociology and the effect of globalisation of working lives and patterns of migration and tourism. The paper examines one specific ethnic group within New Zealand, Chinese immigrants, and establishes the travel patterns of the group, the principal motivating factors for travel, significant relationships with their recent immigration experiences and the effect of family and relatives on their travel patterns. The paper uses a hitherto neglected technique to assess the strength of these relationships - correspondence analysis.


This paper focuses on some tips for English teachers in Indonesian contexts to develop multicultural literacy using authentic English teaching materials engrossed with multicultural concern to be used at college level. Students are immersed not only in selected authentic language situations but also on multicultural issues that are to be discussed in the class progress. Students are encouraged to gain multicultural competence in terms of understanding multicultural knowledge, values, beliefs and patterns of behavior as stated by the excerpts being discussed. The excerpts and videos were selected from Barack Obama's electoral speeches that may provide both close reading and listening enrichment for upper intermediate students of English. The teaching material as offered is to focus on Barack Obama's persuasive texts and their delivery on some crucial multicultural issues in the U.S.A. The ultimate goal is to bring to the level of the students' consciousness construction the multicultural perspectives and practices derived from the selected English-speaking situations as they are designed to experience. This instructional activity may hopefully enhance the students' multiculturalism competence in the Indonesian context.


Composites consisting of MgB2 and Al, 11% by volume, undergo a transition-to-superconductivity onset at TC = 38 K, close to the value reported for pure MgB2. The transition appears to have broadened, as determined by both magnetic and transport measurements, possibly due to the proximity effect and disorder. Spatially resolved tunnelling spectroscopy at 4.2 K shows a distribution of gap structures, from Bardeen-Cooper-Schrieffer-like spectra with 2Δ/kBTC = 3.2 to spectra that are typical for proximity superconductors.


Adsorbent materials were prepared from Moroccan oil shale of Timahdit (layer Y). The objective is to optimize the procedure parameters of elaboration the adsorbents from two precursors; the raw rock Y and the decarbonated raw rock YH. The parameters examined in this study are: the activation temperature, the residence time in the furnace and the atmosphere gas. The textural and structural characteristics of the prepared adsorbents and their removal capacity of the methylene blue molecule revealed that the best adsorbents are obtained upon activation of the two precursors at 300 °C in air but with durations of different activation, 2h for Y and 2.30 for YH. Under these conditions the prepared adsorbents are characterized by significant textural and structural properties; a maximum adsorption capacity of methylene blue molecule that can reach 175 mg/g in the case (YH300 (2:30) in addition to the development of surface function.


This report describes a method that was used to determine total lung capacity from routine chest radiographs, using a programmable calculator to facilitate computation. The results correlated closely with those obtained by a computerized method. The technique was rapid, inexpensive (the necessary equipment cost less than $400), and could be used in any pulmonary laboratory or office. The program is listed, and an example provided.


Controversies and contestations of park and other protected area policies, new conservation rules and regulations (formal and informal), and new land classifications are redefining land and resource use, and thus livelihood options, for four ethnically distinct communities around Tarangire National Park, Tanzania. Research was conducted on how livelihoods have been shaped by perceptions of and in response to conservation policies and community-based conservation projects. Several factors were revealed that provide examples of perceived problems and issues, which would deter in-migration to these communities bordering a national park. Migration into these areas, located to the east, north-west, and western border of Tarangire National Park may be limited, at best, due to issues of fear and mistrust, lack of access to and alienation from land and resources, ethnicity, and litigious actions. This paper addresses these limiting factors, revealing how real world examples of conservation issues can be used to inform policy, rather than relying solely on statistical-based modelling.


The European economic integration has been an ongoing process for nearly a half century. This article discuss initially the concept of integration and then gives an overall assessment of the development of integration on various areas. Evidence points to a remarkable process towards monetary integration especially in the last decades. The significant increase of the intra-EU trade also points to a more integrated Europe especially since the establishing of the internal market. However, the integration seems to have less impact on other areas e.g. synchronisation of the business cycles between Member States and convergence of living standards. Prospects for the future development of integration is also discussed in the article.


This paper proposes two main techniques for reduce computational complexity on artificial neural networks, using piecewise linear activation function, and support vector machines built on a probability based binary tree. These methods are compared with well-known classifiers based on the computational complexity, correct rate and time taken to process the required information. The results show that probability based binary tree SVM has an equivalent recognition rate and is faster than ANNs.


The long-term vision of beyond 3G wireless communications describes a mobile service provision environment dramatically different from that of today. Users are expected to raise their demands to a significantly higher level, towards the situation-aware provision of ubiquitous personalized multimedia services. From this perspective, the need is emerging to apply, in a systematic way, adaptability and reconfigurability concepts for service delivery in largely diverse contexts. Generic dynamically extensible adaptation mechanisms that can be employed in a wide variety of situations and are independent of the subject and criteria of adaptation is a significant step in this direction. Moreover, effective profile representation and management becomes an increasingly important issue. In the present article we introduce an advanced adaptability and profile management framework aiming to fulfill these requirements. The proposed system has been designed, implemented, and incorporated in a distributed middleware platform for next-generation mobile service provision.


Currently, many countries try to satisfy their energy needs with an increasing usage of renewable resources. The general motivations, with varying weighting in the different countries, are ecological reasons, concerns about energy security, and economical considerations. A for now rather theoretical question, although interesting for opening a long-term perspective, is how an energy supply from exclusively renewable energy resources could look like. This question has to be answered individually for any specific energy supply system. The present paper has the objective to present and evaluate a scenario for an electricity supply only from renewable energy resources for the Java-Bali grid. After designing a load time series for the year 2050 for the Java-Bali grid, a scenario is developed how to cover the load with electricity from renewable energy resources alone. Assumptions about the usable energy sources are made as well as assumptions about the available power plant capacity or energy potential. A specific challenge is the fact that solar energy must be the main source in such a renewable-energy based system, which comes with the need for a large storage capacity to match the power supply at any time with the load. Several possibilities are presented how to bring down the storage capacity: the increment of the installed PV capacity, the usage of bioenergy for seasonal balancing, and the complementation of the proposed short-term storage with an additional long-term storage. The study shows some of the specific challenges that a gradual transformation of the current electricity supply system on Java and Bali into a renewable-energy-based one would face and gives some hints about how to cope with these challenges. Scenarios like the one designed in this study are an important tool for decision-makers who face the task to scrutinize the consequences of choosing between different development paths. Article History : Received: August 15 th 2017; Received: October 18 th 2017; Accepted: January 14 th 2018; Available online How to Cite This Article : Gunther, M., Ganal, I. and Bofinger, S. (2018) A 100% Renewable Electricity Scenario for the Java-Bali Grid. Int. Journal of Renewable Energy Development, 7(1), 13-22. https://doi.org/10.14710/ijred.7.1.13-22


Rational ways of treatment of fecal sludge (FS) from environmentally friendly toilet complexes of railway cars preserved with a biocidal agent (BA) based on quaternary ammonium compounds (QAC) and polyhexamethylene guanidine (PHMG) are considered. The bacteriostatic effect of BA on different groups (aerobic and anaerobic) of microorganisms in preserved FS was shown. An effective method for reducing the toxic effect of BA in FS by means of pretreatment with acid prior to microbiological processing has been proposed. The conditions for carrying out the process were selected, allowing to increase the efficiency of anaerobic fermentation of FS containing BA.


Abstract
As part of our effort to create an Integrated Academic Information Management System at Baylor College of Medicine, we are developing information technology to support the efforts of scientific work groups. Many of our ideas in this regard are embodied in a system called the Virtual Notebook which is intended to facilitate information sharing and management in such groups. Here we discuss the foundations of that system - a hypertext system that we have developed using a relational data base and the distributable interface the we have written in the X Window System.


The Article is dedicated to problem of the influence of the process globalizations on buddhism. It is noted that buddhism more gains from globalizations, than loses since he more easy, than the other religions East is adapted to all change the modern world.


The dikraneurine genus Igutettix Matsumura and its allies are revised. The definition of Igutettix is corrected and newly proposed on the basis of the true I. pulverosus Matsumura, resurrected from the synonymy with Dikraneura oculata Lindberg. Accordingly, the genus Vilbasteana Anufriev established for the latter species is resurrected as an independent valid genus. The genera Vikabara Dworakowska and Paraafrakra Chiang, Hsu et Knight, are newly synonymized under Igutettix and Vilbasteana, respectively. Igutettix is composed of three species, I. pulverosus Matsumura sp. rev., I. ater (Dworakowska) comb. nov. and I. glossatus (Dworakowska) comb. nov. Vilbasteana comprises two species, V. oculata (Lindberg) comb. rev. and V. fulva (Chiang, Hsu et Knight) comb. nov. Furthermore, a new genus, Cornicola gen. nov. related to Igutettix is described for a new species C. mizuki sp. nov. from Japan.


INTRODUCTION
Recently, different dressing styles and attitudes of psychiatrists have been proposed to enhance the interaction between patients and the physician. The aim of the present study was to investigate the preferences of dressing style and attitudes of a psychiatrist of the patients referred to an outpatient psychiatry clinic and the perception of psychiatrists regarding the preferences of the patients.

METHODS
One hundred and fifty-three patients referred to the outpatient psychiatry clinic of the Bülent Ecevit University School of Medicine, and 94 psychiatrists have been included in the present study.

RESULTS
When the images of psychiatrists were evaluated in terms of referral for treatment, trust in treatment, and willingness to share their confidential matters, both groups gave minimum scores to causal/sports dress style. While psychiatrists preferred to dress in a suit, casuals, and white coat, the preference order was white coat, casual dress, and suit in the patient group. There was a significant difference between the groups with respect to three dressing styles.

CONCLUSION
It can be suggested that psychiatrists assume that patients are traditional in terms of their preference of the dressing style of a doctor and doctor-patient relationship, and a white coat is important to enhance the treatment adherence of patients.


In this study, 4 cases of poisoning by wild mushrooms collected from Burdur province are reported. The specimens have been identified as Entoloma clypeatum (L.) P.Kumm. by examination of their morphology and spores. A description of the taxon and poisoning cases are presented.


A robust fault detection method is proposed for nonlinear dynamical systems with unknown but bounded noises. The Takagi-Sugeno (T-S) fuzzy neural network is used to build a model of the nonlinear dynamical system when the system is fault-free, taking into account that it is a universal approximator. The input space is partitioned by means of a fuzzy clustering algorithm based on the input and output data of the system. Supposing that the system noise and approximation error are unknown but bounded, the consequence parameters of the T-S fuzzy neural network are determined using a linear-in-parameter set membership estimation algorithm. An interval guaranteed to contain the actual output of the fault-free system is obtained by propagating the effect of model uncertainty to the model output. An occurrence of the fault is signaled when the measured output crosses the computed interval. Simulation results show the effectiveness of the proposed method.


Based on the test data in dynamic water and static water, the main factors, whichinfluence the fine sediment flocculation, are analyzed with a gray model method of correlation theory. It is shown that the main influencing factors are water temperature, settling time, salinity, grain size, sediment concentration and current velocity according to the correlation coefficients. Among them, the salinity and the sediment grain size are critical type influencing factors (CrTIF); the settling time, the sediment concentration and the velocity are continuous type influencing factors (CoTIF); and the water temperature has the characteristics of both. When the critical values of CrTIF are reached or exceeded, the fine sediments will be flocculated, but values of CrTIF will not influence the settlement strength of floes. The influence of CoTIF is continuous. The values of the CoTIF will not only influence the occurrence of flocculation but also the settlement strength of the floes.


ABSTRACT This article examines income received by National Health Service (NHS) providers from non-NHS sources. In 2015–2016, it amounted to 9.1% of their revenue. In the English NHS, there is an increasing reliance on non-NHS income to provide revenue for NHS organizations, due in part to government's austere financial plans. This article is the first comprehensive analysis of these financial data for all English organizations. It provides new evidence in the ongoing debate about the nature and values of public service organisations and the role of commercial imperatives. IMPACT The commercialization strategies of public organizations affects the nature and content of the public services they deliver. It also has ethical implications for staff who enact these strategies. This article examines the commercial income of health organizations in England following a relaxation of rules allowing them to increase their commercial income, for example from car parking, land sales, renting out retail space on hospital grounds, partnerships with pharmaceutical businesses, clinical trials and providing clinical services to private patients and international medical tourists. The authors raise important questions about the extent of commercial imperatives in the English NHS.


Abstract Aim of the present paper is to establish fractional integral formulas by using fractional calculus operators involving the generalized (p, q)-Mathieu type series. Then, their composition formulas by using the integral transforms are introduced. Further, a new generalized form of the fractional kinetic equation involving the series is also developed. The solutions of fractional kinetic equations are presented in terms of the Mittag-Leffler function. The results established here are quite general in nature and capable of yielding both known and new results.


The aim of this research is to perform Multi-Objective Optimisation (MOO) study for multistage flashing with brine recirculation and hybrid MSF?RO desalination systems using Genetic Algorithm (GA) technique. The hybrid MSF?RO desalination system has been simulated rigorously using first and second laws of thermodynamics in addition to the plant economical aspects. Four objectives have been considered in this analysis: distillate production, product cost, Gain Ratio and exergy destruction. The desalination systems have been optimised for single, double and triple simultaneous objectives. Results showed that MOO of MSF-BR and hybrid MSF?RO systems were successful and tend to enhance the performance of both systems.


Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a severe but treatment-responsive disorder, initially identified in young women with an ovarian teratoma. Symptoms include mood, behavior and personality irregularities that resemble acute psychosis. The present study reports the rare case of a patient with anti-NMDAR encephalitis and severe neurological symptoms, that exhibited a rapid recovery following a laparoscopic salpingo-oophorectomy. The 39-year-old woman was admitted to the Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine (Osaka, Japan) with a 5-day history of fever and stomach ache. One week later, the patient developed hallucinations and emotional lability. Initially, a diagnosis of limbic or herpes encephalitis was considered; thus, the patient was administered acyclovir and received steroid pulse therapy. However, the patient subsequently developed apnea, and in response, a tracheal intubation, mechanical ventilation and plasmapheresis were performed. Anti-NMDAR encephalitis was subsequently considered as a diagnosis and mediastinal and pelvic computed tomography (CT) examinations were conducted to detect for the presence of a teratoma. A 24×24-mm cystic lesion was identified in the pelvis from an abdominal CT scan and the lesion appeared to be an ovarian teratoma. In addition, serum and cerebrospinal fluid samples were collected, and were found to test positive for anti-NMDAR antibodies. A laparoscopic salpingo-oophorectomy was performed, which resulted in rapid improvement of the patients mental symptoms, followed by a complete recovery.


Chronic heart failure (CHF) is one of the most common comorbidities in elderly patients with community-acquired pneumonia (CAP).The aim of this study was to investigate etiology of CAP in patients with concomitant CHF.Methods. This prospective observational study involved adult hospitalized patients with CAP and concomitant CHF. CAP was confirmed by chest X-ray. Sputum samples or oropharyngeal swabs, blood and urine samples were collected in all eligible patients before starting the therapy with systemic antibiotics. Sputum was cultured for «typical» bacterial pathogens, such as Streptococcus pneumoniae, Staphylococcus aureus, Enterobacterales, etc., in accordance with standard methods and procedures. Mycoplasma pneumoniae, Chlamydophila pneumoniae and respiratory viruses in sputum or oropharyngeal swabs were identified using the real-time polymerase chain reaction (PCR). Urine samples were used to determine serogroup 1 Legionella pneumophila and S. pneumoniae soluble antigens using bedside immunochromatography.Results. Fifty patients were enrolled in the study. The mean age was 72.2 ± 9.5 years, 27 (54%) were females. The etiology of CAP was identified in 23 cases (46%). S. pneumoniae was the most common pathogen (16/23; 69.7%) followed by respiratory viruses (3/23; 13.1%), such as type 3 parainfluenza virus, coronavirus, human metapneumovirus; Haemophilus influenzae (1/23; 4.3%), S. aureus (1/23; 4.3%), and Klebsiella pneumoniae (1/23; 4.3%). S. pneumoniae and parainfluenza virus co-infection was diagnosed in one of 23 patients (4.3%).Conclusion. S. pneumoniae and respiratory viruses were predominant causative pathogens of CAP in hospitalized adults with concomitant CHF. Therefore, bedside tests for urine pneumococcal antigens should be used more widely considering difficult sputum expectoration in elderly. Atypical bacterial pathogens (M. pneumoniae, C. pneumoniae, L. pneumophila) were not identified in this study, so the routine PCR-test and urine tests for L. pneumophila antigens are thought to be not useful.


Background Molecular detection of low-density Plasmodium falciparum infections is essential for surveillance studies conducted to inform malaria control strategies in close-to-elimination settings. Molecular monitoring of residual malaria infections usually requires a large study size, therefore sampling and diagnostic processes need to be economical and optimized for high-throughput. In a method comparison, we aimed at identifying the most efficient diagnostic procedure for processing large collections of community samples with optimal test sensitivity, simplicity, and minimal costs.Methods In a reactive case detection study conducted on Zanzibar, parasitemia of 4590 individuals of all ages was investigated by a highly sensitive quantitative (q) PCR that targets multiple var gene copies per parasite genome. To reduce cost, a first round of positivity screening was performed on pools of dried blood spots from five individuals. Ten cycles of a pre-PCR were performed directly on the filter paper punches, followed by qPCR. In a second round, samples of positive pools were individually analyzed by pre-PCR and qPCR.Results Prevalence in household members and neighbors of index cases was 1.7% (78/4590) with a geometric mean parasite density of 58 parasites/µl blood. Using qPCR as gold standard, diagnostic sensitivity of rapid diagnostic tests (RDTs) was 37% (29/78). Infections positive by qPCR but negative by RDT had mean densities of 15 parasites/µl blood. Conclusion The approach of pre-screening reactive case detection samples in pools of five was ideal for a low prevalence setting such as in Zanzibar. Performing direct PCR on filter paper punches saves substantial time and justifies the higher cost for a polymerase suitable for amplifying DNA directly from whole blood. Molecular monitoring in community samples provided a more accurate picture of infection prevalence compared to RDT results alone, by identifying a reservoir of infection which is largely missed by RDT. qPCR as a research and surveillance tool can great benefits the evaluation of strategies or programs to eliminate malaria.


This chapter investigates the potential effects of unequal power relations on participation in a group of student teachers and invited professionals in two collaborative workshops in Second Life. The basic research enquiry addresses whether the relative anonymity afforded by virtual world environments has an effect on established power structures, thereby empowering relatively powerless language learners to more active participation than would be the case in more traditional learning set-ups. The data includes recordings, group reflections, and individual questionnaires. Participation was examined from the aspects of floor space, turn length, and utterance functions, and complemented with student reflections. The results show that the differences of floor space and turn length between the invited professionals and the students were small. The invited professionals did more conversational management than the students, while the students performed more supportive speech acts. No major gender differences in participation were found. There was, however, considerable individual variation.


Background information

The premise of this study was that hearing deterioration, associated with treatment for head and neck cancer, has a negative impact on patients' quality of life. However, there have been no studies to assess this phenomenon in people receiving current UK treatment, and there is little information on the impact of subsequent hearing deterioration.

Objective

This study, conducted in one UK hospital, aimed to investigate the incidence and severity of hearing deterioration, and patient experience of it, following treatment for head and neck cancer.

Design

A sequential mixed methods explanatory design was chosen as it was the most appropriate for addressing the research aims. A critical realist framework underpinned the study. A prospective observational repeated measures design was employed to obtain quantitative data in Phase 1 of the study to assess changes in hearing at the end of treatment, and at 3-month follow-up post-treatment, using pre-treatment test level comparison. The Common Terminology Criteria for Adverse Events (version 4.03) were used to determine the incidence and severity of hearing deterioration. Results from Phase 1 were used to inform selection of participants for Phase 2 of the study. An approach informed by phenomenology using interview methodology, was used to explore patient experience of hearing deterioration.

Study sample

Fifty adults who had been diagnosed with head and neck cancer were recruited to Phase 1 of the study using a consecutive sampling approach. These participants were due to receive standard UK curative radiotherapy (intensity modulated radiotherapy) or chemoradiotherapy (including the use of cisplatin or carboplatin). From the 50 participants recruited, 13 who had hearing deterioration were selected using purposive sampling for one-to-one interviews to obtain in-depth information on their experience of hearing loss.

Results

The incidence of hearing deterioration was 57% in the 42 participants who completed testing at the end of treatment, and 50% percent in those who completed 3-month follow-up testing. At 3-month follow-up, 26% of participants had major (Grade 3) hearing deterioration in at least one ear. Patients who had chemoradiotherapy were more likely to experience hearing deterioration compared with those who had had radiotherapy only (p=0.01). Older patients were more at risk of hearing deterioration than younger participants (p=0.03), but if hearing deterioration occurred it appeared that younger patients suffered more severe deterioration than older patients (p=0.02).

Aural change (including hyperacusis) experienced by some participants during treatment required a change in treatment regimen for them. Participants reporting either minor (Grade 1) or major hearing deterioration were adversely affected by their aural symptoms that manifested with treatment, and the impact of tinnitus (the incidence of which is not covered by existing studies), was extensive in head and neck cancer survivors. Another emerging finding in this study was that middle ear dysfunction, in the early post treatment phase, had a negative impact on patient experience. A further novel finding was that participants with bilateral mild-moderate or moderate severity, mid-high frequency sudden-onset hearing loss required lip-reading to assist their communication.

There was evidence that some participants played down their aural symptoms, yet hearing deterioration had a negative impact on their overall quality of life, including generating a sense of loss (principally in older patients) and isolation (associated with younger patients). Finally, there was varied experience among participants receiving information on their hearing test results and on the process of receiving support for their hearing and tinnitus concerns.

Conclusions and recommendations

This current study provides evidence that could be used to increase awareness of the potential scale and impact of hearing deterioration following head and neck cancer treatment, in the early post treatment period. A larger multi-centre UK study would test the issues identified in the study to inform national policy, clinical practice and education.

The study suggests a number of changes for consideration in improving current clinical practice when designing care provision of patients preparing for and recovering from radiotherapy or chemoradiotherapy for head and neck cancer. One key recommendation is for the adoption of a multidisciplinary approach in developing appropriate protocols to inform and support patients about hearing and tinnitus concerns that may occur with their treatment.


In the article I present an overview of transformations in approaches to textualizing and typologizing folklore texts over the past 150 years using the example of incantations from anthologies to digital databases with a view to highlighting the new horizons digital databases can open up for research. In the first part of the article, I show how the textological characteristics of the incantation genre and the often implicit questions of researchers influenced the textological strategies of classic incantation editions. These primarily typological considerations largely determined subsequent potential interpretations. Using the dimensions of comparability established by Lauri Honko (phenomenology of tradition, the historicity of tradition, and ecology of tradition) I summarize recent attempts at classification by international folklore studies of charms pointing out the pitfalls and shortcomings of typologies as well as the fundamental incompatibility of the different typological conceptualizations. In the second part of the article, after briefly describing the responses of computational folkloristics to the textological, typological and comparatist problems of folklore texts I come to the conclusion that the elaboration of an international guide to textology, standardizing the textualization techniques of digital editions of incantations, would be more important for comparative studies than the creation of further national and international incantation catalogues. To this end and to generate discussion and debate I conclude with the outline of a set of possible multidimensional textological features to be taken into consideration in the creation of future digital databases of verbal charms.


Comprised of more than 250 selections from Henry James's stories about writers, his critical and speculative essays, his Notebooks, Prefaces, and letters, this collection brings together for the first time, in a single, systematic volume, all the important passages in James's work which have implications for or ideas about his theory of fiction. The result is the most comprehensive, exhaustive, and innovative volume of fictional theory ever published; in many ways it is the consummation of James's contribution to letters. In a masterful introductory essay, James E. Miller Jr., presents James's theory of fiction in outline; he also contributes brief introductions to each of the seventeen chapters, summarizing the major points. Abundant guides direct the reader to subjects and sources.


This paper presents a model-based approach to diagnosis of hybrid systems. We have developed a combined qualitativequantitative diagnosis scheme that uses hybrid models of the system and a model of the supervisory controller. By applying the supervisory controller model to diagnostic analysis we significantly cut down on the complexity in tracking behaviors, and in generating and refining hypotheses across discrete mode changes in the system behavior. We present the algorithms for hybrid diagnosis: hypotheses generation by back propagation, and hypotheses refinement by forward propagation and parameter estimation. Example scenarios demonstrate the effectiveness of this approach.


Progressive control pathways provide a stepwise, measurable approach to disease control. Documenting program progress, assessing intervention efforts, and the achievement of interim outcomes depend on the capability of a surveillance system to provide useful information. We demonstrate a practical surveillance approach that progresses from measuring broad disease epidemiology and risk factors to specifically evaluating intervention options and documenting low disease prevalence. The process focusses on aligning components with disease program outcomes using foot-and-mouth disease as an example.


High-affinity antibodies produced by memory B cells differ from antibodies produced in naive B cells in two respects. First, many of these antibodies show somatic hypermutation, and second, the repertoire of antibodies expressed in memory responses is highly selected. To determine whether somatic hypermutation is responsible for the shift in the antibody repertoire during affinity maturation, we analyzed the immunoglobulin lambda light chain (Igλ) repertoire expressed by naive and antigen-selected memory B cells in humans. We found that the Igλ repertoire differs between naive and memory B cells and that this shift in the repertoire does not occur in the absence of somatic hypermutation in patients lacking activation-induced cytidine deaminase (AID). Our work suggests that somatic hypermutation makes a significant contribution to shaping the antigen-selected antibody repertoire in humans.


[EMBARGOED UNTIL 6/1/2023] This dissertation presents a study of environmental impact of woody biomass production and consumption on the eastern US forests. The first part is concerned with the impact of the exponential growth in trading of US pelletized wood fibers triggered by implementation of the European Union Renewable Energy Directive. We develop a panel data model with spatially dependent sample to assess variability in fundamental attributes for timberland structure and carbon stocks within procurement landscapes of wood pellet mills in the eastern US. In addition to the booming export market for US wood pellet, there has been a growing woody biomass domestic market for electricity generation in recent decades. The second part is a systematic assessment of associations between biopower generation, and selected timberland structure indicators and carbon stocks across areas surrounding wood-using and coal-burning power plants in the eastern US. Woody biomass is considered as a carbon neutral and sustainable source of energy that can be used in many coal-burning facilities to reduce the carbon footprint in the electricity sector. The last section provides a multi-objective optimization model to find the minimum cost of generating biopower that satisfies sustainability constraints as well as projected biopower demands under multiple policy scenarios in the eastern US. We studied potential federal policy interventions in 2035 that could be considered for decarbonization of the US power sector, including policies aimed at supporting an expanded role for biomass co-firing at existing coal-fired electric generating units.


The Mekong Delta was studied to quantify the impact of sea level rise on the salinity intrusion in the period 2015-2100. Sea level rise (RCP 4.5 and RCP 8.5) scenarios suggested that the sea level increases by 0.07 to 0.48 m in the future (2030s, 2050s, and 2080s). The MIKE 11 model (Hydrodynamic module and Advection-Dispersion module) was used to investigate the impact of saltwater intrusion under sea level rise scenarios. The model was calibrated and validated using observed data. The calibration and validation results indicated that the MIKE 11 model was able to simulate the streamflow and salinity concentration, with NSE values exceeding 0.53 for both calibration and validation periods. Their differences in simulating the salinity concentration under sea level rise scenarios were also analyzed. The results indicate salinity concentration increases by 1.2% to 10% in the future. This means that the saltwater will move deeply inland in the future and have significant impacts on agricultural activities and livelihoods of farmers in the Mekong Delta.


Objectives : Psoriasis is known to be associated with metabolic syndrome and studies have found discordant results of lipid profile in psoriasis. Hence, this study aims to study lipid profile in patients with psoriasis. Methods : A case control study was carried out at NKP Salve Institute of Medical Sciences, Nagpur. Lipid profile was estimated in 25 patients of psoriasis. They were age and sex matched with 25 normal healthy controls. Results : An increase in the levels of cholesterol, triglycerides, LDL and VLDL (p<0.001) with a decrease in the HDL cholesterol (p<0.001) was found in patients of psoriasis when compared with control. Conclusions: Altered lipid profile may be responsible for the higher prevalence of cardiovascular disease in psoriasis patients.


Dilute polymer solutions, besides being widely used in the chemical industry, are used to understand the physical processes that govern the dynamics of isolated macromolecules in solution. Several recent studies used Brownian dynamics simulations of mesoscale bead-spring chain models to demonstrate that the finite extensibility of polymer chains and the existence of fluctuating hydrodynamic interactions between different parts of the chains play a key role in determining the behaviour of polymer solutions in strong flows. Three closure approximations which incorporate these phenomena are presented which offer considerable gains in computational efficiency. The predictions of these approximate models are in good agreement with the results of simulations in strong extensional flows.


With the increasingly growing technological advances and their consequences for societies, the public has the right to be engaged in the outcomes of science. On the one hand, the public are interested in acquiring information about the results of scientists' experiments. On the other hand, the scientists are willing to share their feelings about their discoveries with the public in order to achieve wider audience. These all have prompted popularizing of science within the last few decades. The current study aimed to explore the frequency of evaluative resources of Appraisal in English popular science articles (PSAs hereafter) in the field of Nutrition. A total of 40 English popularized articles published in four popular sources, WebMD, Better Nutrition, Science Daily, and New York Times, were analyzed in terms of three main categories and subcategories of Appraisal Theory. The results of the analysis revealed that authors used more Attitude resources followed by Graduation and Engagement resources. With regard to subcategories of three main categories, the authors of English PSAs included more cases of appreciation, force, and heterogloss resources. The findings indicated that the authors of PSAs tend to insert their feelings about their discoveries through employing Appraisal resources. The results might be used to embed Appraisal resources in EAP materials in order to equip the would-be scientists with a helpful tool to meet the expectations of another group of their intended audience, i.e. general public, in addition to fulfilling the requirements of their academic discourse community.


This metaphysical endeavor primarily attempts to expose human consciousness and its metaphysical inclination in the framework of transformative transcendence, and the recognition of inevitable death. Indeed, metaphysics is understood as a rethinking activity and the appreciation of our ordinary experiences that activates our consciousness. It motivates man to be truly cognizant and to be more aware to embrace the reality of life. For this reason, metaphysics is an effort to elucidate further our capacity to understand human experience and deeply appreciate our metaphysical being. Consciously, metaphysics is deeply rooted in our restless search for the meaning of life that is to appreciate what is true, what is morally good and meaningful to human experience. The goodness of life radiates in the horizon of the unification of human experiences. Thus, from the standpoint of metaphysics, everyday life is an encounter of a transformative challenges that man's experience physically, emotionally, psychologically, morally and spiritually.


BACKGROUND
Inflammatory cytokines play an important role in the development of experimental obliterative airway disease (OAD) after transplantation. To further determine the immunologic mechanisms associated with OAD development, we used a murine tracheal transplant model in which a single mismatched HLA-A2-transgenic molecule is indirectly recognized by the recipient CD4+ T cells and then determined whether neutralization of several inflammatory cytokines affected the development of OAD.

METHODS
Tracheas from HLA-A2+ C57BL/6 mice were heterotopically transplanted into C57BL/6 mice. Recipients were treated with neutralizing antibodies against tumor necrosis factor (TNF), interferon-gamma (IFN-gamma), or interleukin-1 (IL-1). Allograft histology as well as anti-HLA-A2 antibody development and T cell proliferative responses were determined at days +5, +15, +28, and +60.

RESULTS
Allografts in untreated and anti-IFN-gamma-treated recipients demonstrated full development of OAD by day +28. Allografts in anti-TNF-treated recipients showed no evidence of OAD, even at day +60. Allografts in anti-IL-1-treated recipients showed airway epithelium changes by day +28 but minimal evidence of OAD by day +60. Spleen cells from untreated and anti-IFN-gamma-treated recipients showed significantly higher proliferative responses to HLA-A2+ cells, compared with syngeneic recipients (negative controls). In contrast, anti-TNF and anti-IL-1-treated recipients showed significantly lower proliferative responses to HLA-A2+ cells, compared with untreated recipients. Development of anti-HLA-A2 antibodies was detected in all recipients by day +15, with the exception of those treated with anti-TNF.

CONCLUSION
Among the inflammatory cytokines, TNF seems to play a crucial role in the immunopathology of OAD developed after transplantation.


Last week Bill Gates, the chair of Microsoft Corp., gave $100 million to create the Bill and Melinda Gates Children9s Vaccine Program. The program will enlist existing international health organizations in a battle to protect children in the developing world against four diseases through its support of vaccine trials, public education, and new funding mechanisms. The donation will fund efforts to improve delivery of existing vaccines rather than to develop new ones.


Ontology mapping as a semantic data integration approach has evolved from traditional data integration solutions. The core problems and open issues related to early data integration approaches are also applicable to ontology mapping on the Semantic Web community. Therefore, in this review the authors present the related literature, starting from the traditional data integration approaches, in order to highlight the evolution of data integration from the early approaches. Once the roots of semantic data integration have been presented, the authors proceed to introduce the state-of-the-art of the ontology mappings systems including the early approaches and the systems that can be compared through the Ontology Alignment Initiative OAEI.


This dissertation reports on the research into Surinamese constitutional law during the military administration between 1980 and 1987. During this period of martial law there was neither an elected parliament nor any other form of authority with parliamentary legitimacy in Suriname. The research into the military administration is predominantly normative research into the formal constitutional arrangement of the Surinamese state during the 1980-1987 era. During the military period, historically developed principles and requirements of the rule of law and democracy were discarded either completely or in part, with some being completely absent and others remaining intact. This turnaround also brought about a fundamental change in the administrative structure and laws of Suriname. In addition, new legal institutions were added to the judicial system.During this period, the then ruling political powers argued that Suriname remained a constitutional democracy and that martial law was only a necessity under the circumstances. To assess to what extent there was democratic rule as well as the justification of the use of martial law, a study was conducted into the theoretics of constitutional democracy and martial law. States often are described as constitutional democracies; however, around the world there are differences as regards to what extent. To measure the degree of democracy, it is tested against internationally recognized frameworks enshrined in international conventions, treaties and doctrines. Theories on the subject of the constitutional democracy and martial law have been developed and fine-tuned over the years. In this research, such theories were applied in order to answer the main question as well as the key questions:How was the setup of the Trias Politica during the 1980 – 1987 military administration?Based on the main question key questions were formulated, namely: 1.How were the three powers arranged?2.What authorities were bestowed upon them?3.How did the three powers relate to each other?4.To what extent did the three powers and the governance as a whole comply with the requirements of a constitutional democracy and those of objective martial law? This study exposes the complexities of the executive, legislative and judiciary powers during the military era. Both the executive and legislative powers, but also areas of judiciary powers either directly or indirectly came under the Military Authority. Both the arrangement and population of governance and state structures, as well as the balances of power and control, were continuously changed during the military regime of seven years. These changes are clearly noticeable in the ratification and countersigning of the decrees adopting binding regulations.During the military era, state powers were predominantly arranged by decree. These binding decrees would be signed by or on behalf of the president and the Military Authority and countersigned by the Military Authority and ministers. During this seven-year period, enormous pressure was exerted on the Military Authority from across society, such as through the unions and the business community. Union members and members of the business community were given administrative and regulatory functions in 1985. An Appointed Assembly with legislative powers was formed, composed of members of the unions and the business community as well as members appointed by the military. This was a collaboration between the military, the unions and businesses aimed at kick starting a democracy. During this period, the old political parties were engaged with and together they contributed to the formulation of a new Constitution.This Constitution was approved by referendum on 30 September 1987. Subsequently, Parliamentary elections were held on 25 November 1987 and, after seven years of military administration, Suriname had a civilian government.


BACKGROUND
Disease recurrence and progression remain major challenges in the treatment of non-muscle invasive bladder cancer (NMIBC). Blue light-enhanced transurethral resection of bladder cancer (TURBT) is an approach to improve staging and achieve a complete resection of NMIBC.

OBJECTIVES
To assess the effects of blue light-enhanced TURBT compared to white light-based TURBT in the treatment of NMIBC.

SEARCH METHODS
We searched several medical literature databases, including the Cochrane Library, MEDLINE, and Embase, as well as trial registers, including ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform. We performed a comprehensive search with no restrictions on language of publication or publication status until March 2021.

SELECTION CRITERIA
We included randomized controlled trials using blue light versus white light TURBT. Included participants had a high level of suspicion based on imaging or 'visible diagnosis' for primary urothelial carcinoma of the bladder or recurrent urothelial carcinoma of the bladder upon cytoscopy. We excluded studies in which blue light was used in a surveillance setting.  DATA COLLECTION AND ANALYSIS: Two review authors independently performed data extraction and risk of bias assessment. Our primary outcomes were time to disease recurrence, time to disease progression, and serious surgical complications. Secondary outcomes were time to death from bladder cancer, any adverse events, and non-serious complications. We rated the certainty of evidence using the GRADE approach.

MAIN RESULTS
We included 16 randomized controlled trials involving a total of 4325 participants in the review. The studies compared blue light versus white light TURBT for treatment of NMIBC.  Primary outcomes Blue light TURBT may reduce the risk of disease recurrence over time (hazard ratio (HR) 0.66, 95% confidence interval (CI) 0.54 to 0.81; low-certainty evidence) depending on baseline risk. For participants with low-, intermediate-, and high-risk NMIBC, this corresponded to 48 (66 fewer to 27 fewer), 109 (152 fewer to 59 fewer), and 147 (211 fewer to 76 fewer) fewer recurrences per 1000 participants when compared to white light TURBT, respectively.  Blue light TURBT may also reduce the risk of disease progression over time (HR 0.65, 95% CI 0.50 to 0.84; low-certainty evidence) depending on baseline risk. For participants with low-, intermediate-, and high-risk NMIBC, this corresponded to 1 (1 fewer to 0 fewer), 17 (25 fewer to 8 fewer), and 56 (81 fewer to 25 fewer) fewer progressions per 1000 participants when compared to white light TURBT, respectively. Blue light TURBT may have little or no effect on serious surgical complications (risk ratio (RR) 0.54, 95% CI 0.14 to 2.14; low-certainty evidence). This corresponded to 10 fewer (19 fewer to 25 more) surgical complications per 1000 participants with blue light TURBT.  Secondary outcomes Blue light TURBT may have little or no effect on the risk of death from bladder cancer over time (HR 0.55, 95% CI 0.19 to 1.61; low-certainty evidence). This corresponded to 22 deaths per 1000 participants with white light TURBT and 10 fewer (17 fewer to 13 more) deaths per 1000 participants with blue light TURBT.   We are very uncertain how blue light TURBT affects the outcome adverse events of any grade (RR 1.09, 95% CI 0.88 to 1.33; low-certainty evidence).  No analysis was possible for the outcome non-serious surgical complications, as it was not reported by any of the included studies.

AUTHORS' CONCLUSIONS
Blue light-enhanced TURBT for the treatment of non-muscle invasive bladder cancer compared to white light-based TURBT may reduce the risk of disease recurrence and disease progression over time depending on baseline risk. There may be little or no effect on serious surgical complications. The certainty of evidence for our findings was low, meaning that future studies are likely change to the reported estimates of effect. Frequent issues that led to downgrading of the certainty of the evidence were study limitations, inconsistency, and imprecision.


Abstract The histories of post-mortem intervention in 18th- and 19th-century Britain illustrate how the relationships within which the dead were located affected their post-mortem treatment and were reproduced through it. This paper explores how traditions of marking social distinctions among the dead have been incorporated into archaeological practice, tracing some of the ways in which relationships between the dead and the living define the nature and tone of post-mortem interventions. This history suggests that the conditions within which people are produced as dead bodies through archaeological practice are at present poorly understood, and, as such, I contribute some notes towards a relational understanding of this production.


We analyse computational modules of a frequency decoding signal transduction network. The gonadotropin releasing hormone (GnRH) signal transduction network mediates the biosynthesis and release of the gonadotropins, luteinizing hormone (LH) and follicle stimulating hormone (FSH). The pulsatile pattern of GnRH production by the hypothalamus has a critical influence on the release and synthesis of gonadotropins in the pituitary. In humans, slower pulses lead to the expression of the beta-subunit of the LH protein and cause anovulation and amenorrhea. Higher frequency pulses lead to expression of the alpha subunit and a hypogonadal state. The frequency sensitivity is a consequence of the structure of the GnRH signal transduction network. We analyse individual components of this network, organized into three network architectures, and describe the frequency-decoding capabilities of each of these modules. We find that these modules are comparable to simple circuit elements, some of which integrate and others which perform as frequency sensitive filters. We propose that the cell computes by exploiting variation in the time scales of protein activation (phosphorylation) and gene expression.


This study evaluated differences in efficacy and safety outcomes with bivalirudin compared with unfractionated heparin (UFH) in patients with cardiogenic shock requiring venoarterial extracorporeal membrane oxygenation (VA ECMO). We performed a retrospective study at an academic medical center that included patients greater than 18 years of age supported with VA ECMO due to cardiogenic shock from January 2009 to February 2021. The primary endpoint was ECMO-associated thrombotic events normalized to duration of ECMO support. Secondary safety endpoints included major bleeding (per ELSO criteria) and blood product administration. Overall, 143 patients were included in our analysis with 54 having received bivalirudin and 89 having received UFH. Median duration of ECMO support was 92 (interquartile range, 56–172) hours. ECMO-associated thrombotic events per ECMO day were significantly less among those that received bivalirudin (P < 0.001). In adjusted regression, bivalirudin was independently associated with an increased time to thrombosis when compared with UFH (Exp[B] –3.8; 95% confidence interval, 1.7–8.8; P = 0.002). Patients receiving bivalirudin experienced less major bleeding events (P = 0.02) with less total red blood cell and fresh frozen plasma administration (P = 0.04 and P = 0.03, respectively). Bivalirudin is a safe and efficacious alternative to UFH in patients requiring VA ECMO for cardiogenic shock.


The existing models for IEEE 802.11 DCF networks only consider unicast frames, ignoring the existence of broadcast traffic. In a real scenario, the stations are most of the times non-saturated and unicast and broadcast frames exist. These specific characteristics influence the service time which consequently affects the queue behaviour. In this paper, the authors model the total frame's delay for IEEE 802.11 DCF networks in presence of both unicast and broadcast traffic. Our theoretical analysis proposes a model able to compute the time between the instant when a new frame is inserted on the transmission queue and the instant when its transmission finishes. The time needed to serve a frame (service time) is formally deduced from the IEEE 802.11 transmission procedure, conceptually using the view of one network's node. The authors use an M/M/1/K queue model in order to model each frame's queueing delay. The authors validate the total frame's delay using several simulations and present some results. These are analysed for different scenarios of broadcast/unicast network loads and different number of nodes.


The year 2014 marked the 50th anniversary of Paul Baran's work on Packet Switched Networks, the 25th anniversary of Tim Berners-Lee's original paper outlining the concept of the World Wide Web and the 20th anniversary of the commercialization of the Internet. The positive socio-economic benefits derived from the Internet and the World Wide Web have been enormous and are well documented. The negative developments and Net-Threats (e.g. Malware, Cyber-fraud, Cyber-crime, loss of Trust and Confidence in the Internet as a platform for commercial transactions) need to be studied more carefully and understood better, so that practical and workable remedial measures can be proposed.Today we have near-universal availability of the Internet, with almost 3 billion users in some 200 countries worldwide. Also over the last decade the use of the increasingly intelligent mobile phone has exploded and it has become the most widely used communications device in the world.. The number of mobile-cellular subscriptions worldwide, estimated by the International Telecommunications Union at around 7 billion by the end of 2014, is approaching the number of people on earth. The mobile phone is the telecommunications access device of choice in the developing world, and often the only available device for accessing the Internet and its associated services. As high-speed mobile Internet access becomes more readily available and affordable, smart phones and other more intelligent mobile devices with greater functionalities (e.g. tablet computers, laptops) are being used widely for business applications as well as for personal and social purposes, potentially creating more billions of mobile Internet users. These new mobile Internet users are likely to become an additional major target for Net-Threats like malware, cyber-fraud and cyber-crime.In this paper the authors show that every economy requires a physical, institutional and legal infrastructure, as well as understandable and enforceable marketplace rules, in order to function smoothly. Although the Internet has transformed the economy, society and politics, it was never designed and built for global, ubiquitous and secure commercial use. While the technology is new, for commercial use the need for trust, confidence and security remains. One characteristic of the public Internet is that since it consists of many thousands of autonomous networks spanning a large number of jurisdictions, it has no well-defined oversight mechanism that can administer sanctions or enforce rules of behavior. In this it is historically unique, when compared to other transportation and communications networks (e.g. railways, airlines, postal systems, telegraph and telephone networks). The openness, anonymity and decentralized control which are the Internet's great strength for freedom of expression, creativity and information sharing also become its weakness for commercial use.The authors show that the building of an appropriate institutional and legal infrastructure for the global digital marketplace, as well as commonly accepted, understandable and enforceable marketplace rules which provide trust and confidence for all those who operate in or are affected by it, is a necessary condition for the efficient functioning of a global, digital economy. For the Internet to achieve its maximum economic, social and political potential there will have to be agreed upon and effective "rules of the road", both nationally and globally. Drawing upon the lessons of history and historical analogies, the paper explores some possible solutions.


PURPOSE
This study assessed whether liquid carbohydrate-protein (C+P) supplements, ingested early during recovery, enhance muscle glycogen resynthesis versus isoenergetic liquid carbohydrate (CHO) supplements, given early or an isoenergetic solid meal given later during recovery (PLB).

METHODS
Two hours after breakfast (7.0 kcal.kg; 0.3 g.kg P, 1.2 g.kg C, 0.1 g.kg F), six male cyclists performed a 60-min time trial (AMex). Pre- and postexercise, vastus lateralis glycogen concentrations were determined using nMRS. Immediately, 1 h, and 2 h postexercise, participants ingested C+P (4.8 kcal.kg; 0.8 g.kg C, 0.4 g.kg P), CHO (4.8 kcal.kg; 1.2 g.kg C), or PLB (no energy). Four hours postexercise, a solid meal was ingested. At that time, C+P and CHO received a meal identical to breakfast, whereas PLB received 21 kcal.kg (1 g.kg P, 3.6 g.kg C, 0.3 g.kg F); energy intake during 6 h of recovery was identical among treatments. After 6 h of recovery, measurement and cycling protocols (PMex) were repeated.

RESULTS
Absolute muscle glycogen utilization was 18% greater (P <or= 0.05) during AMex (C+P: -42.75+/-5.24 mmol.L; CHO: -37.08+/-7.59 mmol.L; PLB: -53.78+/-11.59 mmol.L; P=0.302) relative to PMex (C+P: -38.40+/-4.37 mmol.L; CHO: -31.16+/-3.78 mmol.L; PLB: -40.33+/-1.47 mmol.L; P=0.292), but there were no differences between groups. During 6 h of recovery, muscle glycogen resynthesis was greater in C+P (+ 28.62+/-2.10 mmol.L) versus CHO (+ 22.20+/-1.19 mmol.L, P <or= 0.05) or PLB (+18.50+/-7.67 mmol.L, P <or= 0.05). Cycling performance was similiar (P=0.282) among treatments during both AMex (C+P: 37.61+/-0.63 km; CHO: 37.03+/-0.60 km; PLB: 37.24+/-0.34 km) and PMex (C+P: 36.31+/-0.83 km; CHO: 36.38+/-0.80 km; PLB: 35.34+/-0.45 km).

CONCLUSIONS
C+P supplements, given early after exercise, enhance glycogen resynthesis relative to CHO and PLB. However, this does not influence performance in this type of exercise bout.


Modal concord is the phenomenon by which certain modal adverbs seem to become semantically vacuous in the presence of modal auxiliaries if the adverb and the auxiliary match in quantificational force (e.g., universal vs existential) and modal flavor (e.g., epistemic vs deontic). We propose that neither concord adverbs nor modal auxiliaries are vacuous: concord adverbs are modal-auxiliary modifiers and the compositional process ensures that both auxiliary and modifying adverb comment on the same proposition (contributed by the same radical), with respect to the same modal base. Agreement in flavor between the two distinct modal claims follows directly, while agreement in force is indirectly derived via the interaction between the assertion contributed by one of the modal claims and the implicatures triggered by the other. Finally, we outline a typology of interactions between modals and their modifiers and study the behavior of three adverbs – absolutely, legitimately and legally – from this perspective.


Thailand Remote Sensing Center (TRSC) has operated a ground receiving station since late 1981 with the capability of acquiring Landsat MSS data and the high resolution Landsat TM and SPOT HRV data since 1987. TRSC presently has a large archive which can serve users worldwide. Since the user community is steadily increasing, multi-level satellite data is therefore needed. TRSC has tried its best to fulfil this requirement. In mid-1992, TRSC completed a system to receive NOAA-AVHRR data, and in December 1992, in the cooperation with the European Community, Thailand ground station was able to acquire SAR ERS-1 data. Moreover, the Japanese JERS-1 data will also be available in the very near future. The multi-level satellite data from TRSC can be used in many multi-disciplinary applications especially global environment monitoring.<<ETX>>


The operating principle and design of a TDM (time-division multiplexer) wattmeter with 0.5-MHz carrier frequency are described. At power frequency the meter was compared with the National Research Council's current-comparator power bridge. The nonlinearity error of the meter was smaller than 100 ppm of full scale over the wide range of inputs and the whole range of power factor. Preliminary results have shown that the frequency dependent errors are below 100 ppm up to 2 kHz in the whole range of power factor. This accuracy is comparable with the accuracy of the standard thermal wattmeters. However, the meter itself is more compact, is relatively simple, and has a faster response time. The design described demonstrates that relatively simple corrections permit a considerable increase in the TDM wattmeter carrier frequency, thus decreasing its systematic frequency errors. >


The essays collected in this volume aim to provide the building-blocks of a learning-based understanding of the development of fundamental rights in the European Union. Instead of asking how much harmonization of fundamental rights is required at EU level or whether fundamental rights should rather be protected at domestic level, it acknowledges that even when it is desirable, harmonization may be in many cases politically unrealistic to achieve; that it may presume too much about our ability to identify how best to implement fundamental rights; and that the required legal bases may be missing. It also notes that we have currently no mechanism allowing us to identify, on a more or less systematic basis, the need for the Union to take action in this field. A learning-based understanding of the development of fundamental rights takes seriously these limitations which the fundamental rights policy of the EU is currently facing. This redefinition moves from substance to procedure: since there is uncertainty about how to improve the protection of fundamental rights (beyond the minimum requirement not to violate them), a fundamental rights policy should be about devising adequate mechanisms for the constant testing of the policies pursued in different settings, in order to arrive at a better understanding of how to best achieve their objectives. Reflexive governance, these essays argue, may represent one way of thinking about how to address this challenge. This hypothesis is tested in three policy areas: equality of treatment, data protection, and the establishment of an area of freedom, security and justice. The essays collected in this volume do not form a blueprint for the further improvement of the regime of fundamental rights protection in the EU. Rather, they identify a blindspot: the lack of a principled way of reconciling the protection of fundamental rights within each EU Member State, with the establishment between these States of an internal market and of an area of freedom, security and justice. And they explore the potential of non-judicial means of ensuring the protection and promotion of fundamental rights, particularly through techniques – mutual evaluation mechanisms, the use of indicators and benchmarks, and participatory processes – inspired by existing 'open' forms of coordination between the Member States. These techniques allow us to shift from the post hoc, reactive modes of protection of fundamental rights, to more ex ante, proactive methods of protection. Fundamental rights are a concern of the EU institutions since well over thirty years, and a number of tools, both legislative and judicial, have been deployed in order to ensure that the progress of European integration shall not lead to lower the level of protection of rights in the EU. It is time that fundamental rights become more than that, however – it is time that they become a policy. But such a fundamental rights policy for the EU must be respectful of the diversity of approaches within the EU, and it must acknowledge that, in many domains, we simply do not know how best to ensure the fulfilment of fundamental rights. It must therefore be conceived as a policy which encourages collective learning, and permanent re-evaluation of earlier choices in the light of new circumstances. It is in this direction that this volume seeks to move the debate.


A splendid presentation of Pope's poems, excluding only his translations of Homer, this is the only one-volume edition that can lay claim to completeness and accuracy of text. It presents the corpus of Pope's poetry as printed in the highly praised Twickenham Edition, except for the 1712 version of The Rape of the Lock and other early versions of phrases preserved in the critical apparatus of the six-volume work. Pope's own notes to his poems are included, as well as a generous selection of the copious annotation in the Twickenham text. This reduced version of the unsurpassed standard edition of Pope will be of great value to all students and teachers of English literature. John Butt, Regius Professor of Rhetoric and English Literature at Edinburgh University, is general editor of the Twickenham Edition. "The publishers are surely right in claiming that 'this should for long remain the standard one-volume edition of Pope's poems.' The Twichenham edition ...has been a splendid achievement, and Professor Butt's distillation of the long labours of his fellow-editors is most commendable."-Times Literary Supplement.


One of the commonest diseases of man is that in which, over the course of 10 or 20 years, a person is gradually pulled down by dozens or scores of thromboses of little arteries in the brain. Dr. James Kernohan,1pathologist of the Mayo Clinic, said, on examining tissues from brains, these are among the commonest of the lesions he finds. Today most physicians know the syndrome of "the little strokes," but, I am sorry to say, the diagnosis is still often delayed and usually for two reasons 1. The patient often fails to tell the physician of a bad dizzy spell at the start of his trouble. 2. The physician is not well enough acquainted with the more bizarre and puzzling of the symptoms that can result from little strokes. Obviously, the syndrome must vary greatly with each patient, depending largely on the position in the brain of


GENERAL CONSIDERATIONS..................................................................... 72 VIRAL INTERFERENCE ......................................................................... 74 NATURE OF INTERFERON ....................................................................... 75 ENDOGENOUS PRODUCTION OF INTERFERON BY LETHALLY INFECTED CELLS......................... 76 ENDOGENOUS INTERFERON IN NONLETHAL INFECTIONS........................................... 77 INTERFERON PRODUCTION BY PERSISTENTLY INFECTED CELLS ................................... 78 INTERFERON PRODUCTION IN ANIMALS ........................................................... 79 RELATION TO MEDICAL PROBLEMS .............................................................. 81 LITERATURE CITED ............................................................................ 83


Relevance. The use of certain single or mixed cultures of lactic acid microorganisms and the mandatory control of the fermentation process of white cabbage are of great importance to ensure that the product is of stable quality without the need for any chemical preservatives or harsh processing conditions. Carbohydrates contained in raw materials play an important role in this process, since carbohydrates are the main source of maintaining the viability of lactic acid microorganisms. By adjusting the carbohydrate component of raw materials at different stages of fermentation, it is possible to maintain a high titer of microorganisms, while obtaining not only a high-quality product, but also giving it, along with prebiotic (a source of fiber) and probiotic properties. Materials and methods. The purpose of this research work was to ensure the direction of the biotechnological process in the direction of stabilization of the concentration of functional microflora (starting systems of lactic acid microorganisms), under the influence of introduced carbohydrate nutrients. In this work, we studied two fermentation systems of microorganisms that are fundamental microorganisms in the fermentation of cabbage, namely, systems consisting of a pre-fermentation culture of Leuconostoc mesenteroides and one of the cultures of lactobacilli: Lactobacillus plantarum or Lactobacillus brevis. The study used the usual microbiological method for determining the number of microorganisms by seeding in an agarized culture medium, as well as processing experimental data. Results. As a result, we found that the introduction of a carbohydrate Supplement allows us to stabilize the dynamics of changes in the concentration of the studied starting systems at the same initial level throughout the main stage of fermentation.


Aim. Primary immunodeficiencies are disorders in which immune system is missing or does not function normally due to genetic disorders. X-linked agammaglobulinemia (XLA) is a rare genetic disorder in which don't generate of mature B cells, which manifests as a complete or near-complete lack of proteins called gamma globulins, including antibodies, in their bloodstream. The BTK protein is the key regulator of β-cell maturation, so mutations in the BTK gene lead to hereditary agammaglobulinemia. Detection of mutations of the BTK gene is important for confirmation of the diagnosis in patients with XLA. Methods. DNA and RNA extraction, RT-PCR, direct Sanger sequencing of PCR fragments. Results. An analysis of blood samples from patients with XLA using a proposed test system was performed. It has been shown that the proposed test system allows for the initial screening of mutations in the BTK gene. Conclusions. The test system for the detection of mutations in patients with X-linked agammaglobulinemia, based on using of reverse transcriptase PCR and direct sequencing, was developed and tested on clinical samples. This system is proposed for the initial screening of BTK gene mutations inUkraine.Keywords: X-linked agammaglobulinemia, XLA, BTK, mutation, RT-PCR, primary immunodeficiency.


ABSTRACT Jeanson, M., Anthony, E.J., Etienne, S., Dolique, F., 2014. Morphodynamic characterization of beaches on a Pacific atoll island: Tetiaroa, French Polynesia. In: Green, A.N. and Cooper, J.A.G. (eds.), Proceedings 13th International Coastal Symposium (Durban, South Africa), Journal of Coastal Research, Special Issue No. 70, pp. 176–181, ISSN 0749-0208. Beach profile types and wave characteristics were monitored in April 2013 on the small islet of Onetahi in the south Pacific coral reef atoll of Tetiaroa, French Polynesia, with the aim of characterizing atoll islet beach morphodynamics. Twelve beach profiles were each surveyed using a theodolite, and water levels and wave characteristics measured over four semi-diurnal tidal cycles using four miniature pressure sensors deployed in the subtidal zone. Water levels corresponded to a very narrow microtidal range (~0.2 m). Wave heights were extremely low throughout (<0.15 m), and spectral decomposition showed a mix between gravity and infragravity energy. The latter dominant at high water, whereas energy was virtually nil at low tide. The wave characteristics, which reflect significant filtering of large Pacific waves by the atoll reef, were not in phase with the intertidal beach morphology. These were interpreted as largely inherited from differential exposure to higher-energy events that occasionally impacted the atoll, notably Cyclone Oli in February 2010. Sand aprons in the lagoon, moving from the eastern to the southern and ultimately the western shores of the island in response to wave pumping, locally enhance build-up of the lower beach where shoreline orientation changes. Confrontation of these observations with long-term islet shoreline trends identified by Le Cozannet et al. (2013) suggests that high-energy event-scale changes and daily background beach cosmetic changes associated with subtidal sand apron mobility, and intertidal swash reworking during the narrow tidal excursion are embedded in long-term morphological stability likely hinged on sand circulation around the islet.


The novel Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) causing COVID-19 has rapidly turned into a pandemic, infecting millions and causing ~7 million deaths across the globe. In addition to studying the mode of transmission and evasion of host immune system, analysing the viral mutational landscape constitutes an area under active research. The latter is expected to impart knowledge on the emergence of different clades, subclades, viral protein functions and protein-protein and protein-RNA interactions during replication/transcription cycle of virus and response to host immune checkpoints. In this study we have attempted to bring forth the viral genomic variants defining the major clade(s) as identified from samples collected from the state of Telangana, India.


Background: Ventilator-Associated Pneumonia (VAP) is a recognized nosocomial infection and a leading cause of high morbidity and mortality. Intensive Care Unit (ICU) nurses are in the best position to put the known evidence-based strategies into practice to prevent VAP. The aim of the present study is to assess the knowledge and practices of ICU nurses related to prevention of VAP in selected ICUs of a tertiary care centre in India (2013–2014) and to find out the association between knowledge and practices. Materials and Methods: A descriptive survey was conducted in the different ICUs of a tertiary care hospital in India. Purposive sampling technique was used and 108 ICU staff nurses were enrolled during the period of data collection. The tool used for data collection was a self-developed valid and reliable knowledge-based questionnaire and an observational checklist. The descriptive (frequency and percentages) and inferential (Chi-square test) statistics was used. Results Out of the 108 nurses enrolled in the study, 82 (75.93%) had average, 24 (22.22%) had good and only 2 (1.85%) of the ICU nurses had poor knowledge. Assessment of the practices revealed that 68 (94.44%) nurses had average and only 4 (5.55%) nurses had good practice. There was no association between the knowledge and practices of ICU nurses related to prevention of VAP. (χ2 = 0.14, p = 0.710). Conclusions: Although the nurses were having good to average knowledge scores, their practices were not associated with knowledge scores. There is a need to find out the ways that would help the nurses to adhere to good practices.


The human hemofiltrate peptide HF6478, a putative serine proteinase inhibitor, which is part of the precursor protein LEKTI, was cloned, overexpressed, and purified. HF6478 contains two disulfide bridges with 1-4, 2-3 connectivity, sharing partial homology to Kazal-type domains and other serine proteinase inhibitors. It was expressed as thioredoxin (Trx) fusion protein, and disulfide formation occurred in the oxidative cytoplasm of Escherichia coli Origami (DE3) strain which carries a trxB(-)/gor522(-) double mutation. The soluble fusion protein was purified using metal-chelating affinity chromatography. Cleavage of the Trx fusion protein with factor Xa and subsequent purification yielded the final product in amounts sufficient for structural studies. Characterization of recombinant HF6478 was done by amino acid sequencing, mass spectrometry, capillary zone electrophoresis, and CD spectroscopy. Taking the blood filtrate peptide HF6478 as example, we present a strategy which should facilitate the expression of different extracellular proteins in the E. coli cytoplasm.


Clinico-statistical analysis of the treatment results of 624 injured persons for the period from 1990 till 1995 year was conducted. In 509 (81.6%) of them the combined closed thoracic trauma was revealed, in 15 (18.4%)--the isolated closed affection of the skull, thorax, abdomen and extremities have occurred. The anatomic-functional model of the injury severity and prognosis outcome estimation was elaborated, an optimal timing and surgical treatment methods of the thoracic cage bones injury was substantiated, what have promoted to lower lethality from 50%--in injured persons, operated on without taking into account the trauma severity and prognosis outcome, to 31.6%--in operated on in the postponed order.


As sessile organisms, plants have to endure a wide variety of biotic and abiotic stresses, and accordingly they have evolved intricate and rapidly inducible defense strategies associated with the activation of a battery of genes. Among other mechanisms, changes in chromatin structure are thought to provide a flexible, global, and stable means for the regulation of gene transcription. In support of this idea, we demonstrate here that the Arabidopsis (Arabidopsis thaliana) histone methyltransferase SET DOMAIN GROUP8 (SDG8) plays a crucial role in plant defense against fungal pathogens by regulating a subset of genes within the jasmonic acid (JA) and/or ethylene signaling pathway. We show that the loss-of-function mutant sdg8-1 displays reduced resistance to the necrotrophic fungal pathogens Alternaria brassicicola and Botrytis cinerea. While levels of JA, a primary phytohormone involved in plant defense, and camalexin, a major phytoalexin against fungal pathogens, remain unchanged or even above normal in sdg8-1, induction of several defense genes within the JA/ethylene signaling pathway is severely compromised in response to fungal infection or JA treatment in mutant plants. Both downstream genes and, remarkably, also upstream mitogen-activated protein kinase kinase genes MKK3 and MKK5 are misregulated in sdg8-1. Accordingly, chromatin immunoprecipitation analysis shows that sdg8-1 impairs dynamic changes of histone H3 lysine 36 methylation at defense marker genes as well as at MKK3 and MKK5, which normally occurs upon infection with fungal pathogens or methyl JA treatment in wild-type plants. Our data indicate that SDG8-mediated histone H3 lysine 36 methylation may serve as a memory of permissive transcription for a subset of defense genes, allowing rapid establishment of transcriptional induction.


Ethiopia has an estimated >10,000 MW of geothermal energy potential, more than double its current power generating capacity (4,400 MW). Electricity access stands at 44% of the total population, with 31% in rural areas, so effective development of this low‐carbon resource could make a significant impact to equitable delivery of electricity. However, geothermal energy exploitation must be done responsibly to protect valuable water resources under stress from climate‐change driven drought conditions and competing uses across agricultural, domestic, and industrial sectors. Our review provides progress updates on geothermal developments—which soon aim to deliver more than 1,000 MW of electricity—and performs a high‐level assessment of hydrochemical data for ground and surface waters across Ethiopia. A water quality database was built using publicly available information and three quality control criteria: well‐defined sample location, cation‐anion balance (CAB) of ±10%, and clear fluid type definition. Ethiopia hosts two major geothermal water types, sodium‐alkalinity dominated in the Main Ethiopian Rift and sodium‐chloride dominated in the Afar Depression, separated by sodium‐mixed waters between Dofan‐Fantale and Meteka. H and O stable isotopes suggest a largely meteoric source for geothermal waters, with δ18O enrichment adding to evidence of a high enthalpy resource at Tendaho. Hydrochemical investigations provide critical information for successful delivery of sustainable geothermal energy developments. However, the current lack of data available for Ethiopia poses a significant challenge for completion of predevelopment baselines and ongoing environmental impact assessment. We encourage the release of unpublished findings from private companies and government agencies to build upon our database and demonstrate social and environmental responsibility in the development of Ethiopian geothermal resources.


A derivation is presented of an approximate form of the dynamics governing a structurally flexible manipulator carrying a massive payload at its end-effector. An output called the /spl mu/-tip rate which incorporates end-effector and elastic motions is introduced. The input-output mapping relating a transformed version of the joint torques to the /spl mu/-tip rates is shown to be passive for large payloads. A feedforward torque strategy is developed which preserves the passivity property in the error dynamics and a suitable Lyapunov function is used to demonstrate global asymptotic stability of the tracking provided by a PD law. Implementation of the controllers without measurements of the elastic coordinates and rates is shown to be possible. Simulation studies of a six DOF manipulator with flexible links, modeled after the Shuttle Remote Manipulator System, demonstrate excellent tracking in all six Cartesian end-effector coordinates, even for payloads with modest mass properties. A major conclusion is that some of the problems normally associated with lack of collocation in flexible manipulators can be surmounted when large (massive) payloads are involved.


We aimed to assess the efficacy and safety of S-1 combined with cisplatin (SC) over cisplatin alone (C) for the treatment of advanced gastric cancer in China. Between July 2009 and June 2011, 72 eligible patients with advanced gastric cancer were selected and divided randomly into two groups. Thirty-six patients received SC, with S-1 on days 1 through 14 of a 21-day cycle and cisplatin (60 mg/m2 on day 1) every 4 weeks for two cycles. The other 36 patients were administered only cisplatin (in the same manner as SC). The primary outcome was overall survival. The secondary outcomes were progression-free survival and adverse events. The 2-year overall response rate was 51.5 and 42.3% for the SC and C groups, respectively, and the difference was statistically significant, whereas the median overall survival was 9.4 months (range, 1.9–24.4 months) and 7.6 months (range, 1.7–21.4 months), respectively (P=0.039). The median progression-free survival was 7.7 months for SC (range, 1.8–19.4 months), whereas it was 6.5 months (range, 1.5–16.4 months) for C (P=0.047). The toxicity profile was similar in both groups. In summary, we have shown that S-1 combined with cisplatin is more effective, with acceptable toxicity in comparison with cisplatin alone in Chinese patients with advanced gastric cancer. Chinese Clinical Trials Register: ChiCTR-TRC-13003993.