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Many adolescents and young adults (AYAs; 15-39 years) with cancer receive high intensity (HI) care at the end of life (EOL). Palliative care (PC) involvement in this population is associated with lower risk of HI-EOL care. Whether this association differs by specialized versus generalist PC (SPC, GPC) is unknown.(1) To evaluate whether SPC had an impact on the intensity of EOL care received by AYAs with cancer; (2) to determine which subpopulations are at highest risk for reduced access to SPC.A decedent cohort of AYAs with cancer who died between 2000-2017 in Ontario, Canada was identified using registry and population-based data. The primary composite measure of HI-EOL care included any of: intravenous chemotherapy14 days from death; more than one ED visit, more than one hospitalization or any ICU admission30 days from death. Physician's billing codes were used to define SPC and GPC involvement.Of 7,122 AYA decedents, 2,140 (30%) received SPC and 943 (13%) received GPC. AYAs who died in earlier years, those with hematologic malignancies, males and rural AYAs were least likely to receive SPC. No PC involvement was associated with higher odds of receiving HI-EOL care (odds ratio (OR) 1.5; p0.0001). However, SPC was associated with the lowest risk of HI-EOL care (OR SPC versus GPC 0.8; p=0.007) and decreased odds of ICU admission (OR 0.7; p=0.006).SPC involvement was associated with the lowest risk of HI-EOL care in AYAs with cancer. However, access to SPC remains a challenge.

Purpose The role of chemotherapy (CT) and radiotherapy (RT) for management of extraskeletal osteosarcoma (ESOS) remains controversial. We examined disease outcomes for ESOS patients and investigated the association between CT/RT with recurrence and survival. Patients and methods Retrospective review at 25 international sarcoma centers identified patients ≥18 years old treated for ESOS from 1971 to 2016. Patient/tumour characteristics, treatment, local/systemic recurrence, and survival data were collected. Kaplan–Meier survival and Cox proportional-hazards regression and cumulative incidence competing risks analysis were performed. Results 370 patients with localized ESOS treated definitively with surgery presented with mainly deep tumours (n = 294, 80%). 122 patients underwent surgical resection alone, 96 (26%) also received CT, 70 (19%) RT and 82 (22%) both adjuvants. Five-year survival for patients with localized ESOS was 56% (95% CI 51%–62%). Almost half of patients (n = 173, 47%) developed recurrence: local 9% (35/370), distant 28% (102/370) or both 10% (36/370). Considering death as a competing event, there was no significant difference in cumulative incidence of local or systemic recurrence between patients who received CT, RT, both or neither (local p = 0.50, systemic p = 0.69). Multiple regression Cox analysis showed a significant association between RT and decreased local recurrence (HR 0.46 [95% CI 0.26–0.80], p = 0.01). Conclusion Although the use of RT significantly decreased local recurrences, CT did not decrease the risk of systemic recurrence, and neither CT, nor RT nor both were associated with improved survival in patients with localized ESOS. Our results do not support the use of CT; however, adjuvant RT demonstrates benefit in patients with locally resectable ESOS.

Isogeometric analysis (IGA) is designed to combine computer-aided design (CAD) and finite element analysis (FEA) so that it significantly reduce the error in the representation of the computational domain. In the present work, a numerical procedure based on the framework of IGA for bending analysis of laminated and sandwich composite plates using the first-order shear deformation theory is described. In FEA, Lagrange or Hermit polynomial is used to approximate both the geometry and the solution field but IGA employs non-uniform rational B-splines (NURBS) from CAD technology to this objective. Hence considering geometry modelling, IGA have the advantage of no geometric error. Also, increasing the order of the elements in IGA gives higher con- tinuous basis functions than FEA while maintaining few degrees of freedom. Therefore, isogeometric approach utilizes NURBS to implement for the quadratic, cubic, and quartic elements. Bezier extraction operator is used to ease the integration of NURBS in an existing finite element data structures. Several numerical examples are presented to show the performance of the current approach, and the results obtained are compared with analytical and other numerical methods. NURBS elements display the same convergence rate as Lagrange elements of equal order, with higher accuracy.

Molecular chaperones have a role to stabilize proteins or assist them in reaching their native fold. Heat shock proteins (HSPs) are a family of molecular chaperons that protect proteins from cellular stress during the assembly of protein complexes and also prevent the proteins from aggregation and disassembly. The immediate increase of HSPs is crucial for cellular adaptation to environmental changes and protection of other proteins from denaturation, thereby maintaining the cellular homeostasis and increasing the longevity of an organism. HSP70 and HSP90 are the most studied HSPs in this very large HSP family. Notably, HSP90 also stabilizes the disease-related proteins in neurodegenerative disorders. Therefore, small molecules that inhibit the HSP90 but also increase the HSP70 has been tested as potential drugs for neurodegenerative disorders.

An effective numerical approach based on the isogeometric analysis (IGA) employing nonpolynomial shear deformation theory (NPSDT) has been proposed and implemented in the present work for the static and dynamic analysis of laminated and sandwich composite plates. The theory assumes the nonlinear distribution of transverse shear stresses, and also satisfy the zero transverse shear deformation at the top and bottom surfaces of the laminates. Using Hamilton’s principle, the governing equation of motion is derived and then discretized based on the IGA technique, which facilitates the use of non-uniform rational B-splines (NURBS) basis functions to easily satisfy the stringent continuity requirement of the NPSDT model ( C 1 -continuity) without any additional variables. The set of governing equations are solved to obtain transient response using Newmark’s time integration scheme. Fourier transformation is carried out on the transient response to obtain the natural frequency. Various numerical examples covering different features of present modeling for laminated and sandwich plates are investigated. The performance of the model has been observed by comparing the evaluated results with different published results available in the open literature which ascertain its precision and range of applicability at a reduced computational cost.

High performance surface plasmon resonance (SPR) sensor is proposed for relative humidity (RH) monitoring. The structure is based on widely used 2S2G chalcogenide glass and gold as SPR active metal applied with silica-based porous film. The angular interrogation method has been used to study the performance of the sensor in terms of intrinsic sensitivity (SI) that includes the width and shifts of SPR curve for the entire RH-range between 0% and 100%. The effect of temperature is also studied on the proposed sensor's performance. Any possibility of oxidation problem to the proposed SPR sensor due to constantly being in contact with humid environment may be addressed by using a stable buffer layer. Intrinsic sensitivity of the proposed sensor is significantly high for almost entire range of RH values. The proposed sensor has a good resolution of the order of 10−2% RH.

This paper presents the measurements of gaseous SO 2 , NO 2 , HNO 3 and NH 3 and particulate NH 4 + , NO 3 − and SO 4 2− at Rampur, a rural site of semi-arid region of India and annual mean concentrations are 3.7±2.2, 7.3±3.7, 0.7±0.6 and 6.7±4.2 and 1.0±0.4, 1.1±1.3 and 2.6±1.6 μg m −3 , respectively. Seasonal variation with higher concentration in winter is observed for gaseous SO 2 , NO 2 , and NH 3 and particulate NH 4 + . The concentration of HNO 3 and particulate NO 3 − and SO 4 2− are higher in summer. Summer to winter ratio of HNO 3 and particulate NO 3 − are 3.8 and 1.8, respectively, showing seasonal variation is more pronounced in case of HNO 3 than particulate NO 3 − . The ratio of gaseous NH 3 to particulate NH 4 + (NH 3 /NH 4 + ) is more than 1 probably due to basic nature of aerosol. Examination of equilibrium between gaseous NH 3 and HNO 3 and particulate NH 4 NO 3 shows observed equilibrium constant is lower than theoretical equilibrium constant in summer and vice versa in winter.

With a view to evaluating the putative involvement of cytokine gene variants in human essential hypertension, we carried out an association (case-control) study on 174 unrelated nationals (81 hypertensives and 93 normotensives) from the Abu Dhabi Emirate (UAE), a genetically homogeneous population also characterised by the absence of traditional confounding factors such as alcohol consumption and smoking. To that end, we targeted our investigation to five candidate gene loci-transforming growth factor beta1 (TGF-beta1), interferon gamma (IFN-gamma), epidermal growth factor (EGF), interleukin-1 beta (IL-1beta) and tumour-necrosis factor (TNF-alpha) genes. We investigated the distribution of genotypes and alleles of the six following dimorphic variants: TGF-beta1(*)10(T>C) and TGF-beta1(*)25(G>C), located at codons 10 and 25, respectively, of TGF-beta1; T874A in intron 1 of IFN-gamma; G61A in exon 1 of EGF; TaqI dimorphism at +3962 (exon 5) of IL-1beta; and -308A>G in the promoter of TNF-alpha. These six bi-allelic markers were visualised by methods based on the techniques of amplification refractory mutation system-polymerase chain reaction (for TGF-beta1, IFN-gamma, EGF and TNF-alpha) and by polymerase chain reaction-TaqI restriction endonuclease analysis in the case of IL-1beta. In each of the two groups (normotensives and hypertensives), genotype frequencies of all six markers occurred in Hardy-Weinberg proportions. There were, however, no statistical differences in the allele and genotype frequencies of any of the six markers between the two groups of subjects: TGF-beta1(*)10C frequencies were 0.46 and 0.49 (chi(2)=0.61; 2 d.f.; P=0.74) and TGF-beta1(*)25C were 0.07 and 0.08 (chi(2)=0.61; 2 d.f.; P=0.74) amongst normotensives and hypertensives, respectively; p(IFN-gamma(*)A874) were 0.41 in normotensives versus 0.46 in hypertensives (chi(2)=3.07; 2 d.f.; P=0.22); p(EGF (*)G61) were 0.51 versus 0.58 (chi(2)=1.76; 2 d.f.; P=0.41); p[IL-1beta (*)TaqI(+)] were 0.43 versus 0.36 (chi(2)=2.08; 2 d.f.; P=0.35); and p(TNF-alpha(*)-308G) were 0.80 versus 0.85 (chi(2)=1.29; 2 d.f.; P=0.53). There was also no difference in distribution and frequencies of haplotypes constructed with combinations of TGF-beta1(*)10(T>C) and TGF-beta1(*)25(G>C) sites. However, although they do not reach statistical significance (which may be due to the relatively restricted number of subjects included in this study), the distribution differences (in normotensives and hypertensives) observed in the cases of EGF and TNF-alpha reflect trends that could be expected from a mechanistic explanation of the pathways that underlie the patho-physiology of hypertension.

A specific standardized test of language proficiency called “Grammatical Analysis of Elicited Language (GAEL) for hearing-impaired children was used to examine language usage between the tester and the child. In order to capture language discourse, communication—verbal/nonverbal, and the language context, the entire test-taking sessions were videotaped for three out of the ten children selected for the study. These children primarily used oral language. The test consisted of two partsimitated and prompted. On the imitated component of the test, the study showed that “imitation” does not seem to facilitate grammatical development. “Functional readiness” (Bates & MacWhinney, 1987) was found to be an important factor in the production of a specific linguistic form. It was found that imitated speech was not grammatically more advanced than non-imitated spontaneous speech. On the prompted component of the test, the responses of the children were pragmatically appropriate in many instances yet not conforming to the expected responses on the test. It was shown that the communicative competence needs to be incorporated into the test as part of language proficiency assessment.

Fiji has two main islands and the total land area is about 2800 square miles. Fiji’s population is just over 800000 people with indigenous Fijians (50%), Indians (47%) and others (3%). Fiji is divided into three divisions: Central/East, Western and Northern with each having a major hospital. Labasa Divisional Hospital, where I serve, is the main hospital in the Northern division and also the least developed of the three. Until 2005, there was no pathologist in this division and pathologists from other divisions were called upon. It’s my privilege to be the first and the only pathologist of the Northern division. I have to go to various places, including remote/segregated islands and interiors of mainland, to do post-mortems. This is in itself an exciting and adventurous part of pathology, here in Fiji, which not many pathologists elsewhere would have experienced. The number of specimens is increasing annually and despite the limited resources and the relatively poor economic status of the country, we are doing our level best.

SCF- X α MO calculations for TiCl 4 , TiI 4 , VCl 4 , RuO 4 and NiCl 2 indicate that ligand p → metal d orbital excitations will generate metal core photoemission satellites having small intensities (∼5–10% that of the main peak) and low energies ( 4 and TiI 4 , the only molecules whose satellite spectra have been studied. The high intensity of the higher-energy (>7 eV) satellites observed for the Ti compounds is not reproduced by the present calculations, in which bound empty orbitals of Rydberg character are employed. It is suggested that the final-state orbital in the high-energy satellite case is actually a continuum orbital of “shape-resonance” type which is localized in the interior of the molecule.

Properties of hydrogen bonds formed by 1:1 interaction of H 2 O with oxygen, nitrogen, sulphur and other electron donors have been evaluated by extended Huckel and CNDO methods and the results are discussed in relation to the experimental data. A detailed analysis of the variation of the dissociation energies and charge densities with bond distances is presented for the amine-water system. 1:2 complexes of water with donors are found to contain weaker hydrogen bonds than 1:1 complexes. Results of molecular orbital calculations on the hydrogen bonding of H 2 S and CH 3 SH with some donors are presented. The theoretical value of hydrogen bond dissociation energy varies linearly with the overlap population, and stretching force constant of the hydrogen bond as well as with the experimental O—H frequency shift.