Search

PurposeThis study aims to examine the determinants of corporate green investments (GI) by using a series of both firm- and country-level factors.Design/methodology/approachThe authors collect information on environmental expenditures of 763 firms from 40 countries and use random effects regressions to identify the determinants of GI.FindingsThe authors find that larger firms tend to invest more in green projects, whereas firms that are highly valued or more profitable are less likely to go green. In terms of country-level determinants, we find that the gross domestic product (GDP) per capita and population are positively related with GI, while GDP growth and surface area are negatively associated with GI. Additionally, firms in common-law countries and English-speaking countries make fewer GI than firms in other countries.Social implicationsThe findings of this research not only contribute to the academic literature in these areas, but also have important implications for both regulators and policymakers in countries that exhibit sub-par GI or who otherwise aim to increase GI by firms operating in their country.Originality/valueThe authors identify and explore the key determinants of GI from both a firm- and country-level perspective.

The paper provides robust evidence that compliance with Basel Core Principles (BCPs) has a strong positive effect on the Z-score of conventional banks, albeit less pronounced on the Zscore of Islamic banks. Using a sample of banks operating in 19 developing countries, the results appear to be driven by capital ratios, a component of Z-score for the two types of banks. Even though smaller on Islamic banks, individual chapters of BCPs also suggest a positive effect on the stability of conventional banks. The findings support the effective role of BCP standards in improving bank stability, whose important implications led to the Islamic Financial Services Board (IFSB) publication of new recommendations in 2015 to bring BCP standards in line with the Core Principles for Islamic Finance Regulation (CPIFRs) standards. Our findings suggest that because Islamic banks are benchmarked closely to BCPs, the implementation of CPFIRs should also positively affect their stability.

Ningli Wang,1 Da-Wen Lu,2 Yingzi Pan,3 Yury Astakhov,4 Tatyana Iureva,5 Adeniyi Adewale,6 Thomas M Walker6 1Beijing Tongren Eye Center, Beijing, People’s Republic of China; 2Tri-Service General Hospital, Taipei, Taiwan; 3Peking University First Hospital, Beijing, People’s Republic of China; 4Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia; 5Irkutsk Branch of the Academician S.N. Fyodorov Eye Microsurgery Federal State Institution, Irkutsk, Russia; 6Novartis Pharmaceuticals Corporation, Fort Worth, TX, USACorrespondence: Ningli WangBeijing Tongren Eye Center, No. 1 Dongjiaomin Str., Dongcheng District, Beijing 100041, People’s Republic of ChinaTel +861058265922Email wningli@vip.163.comObjective: To demonstrate that the intraocular pressure (IOP)-lowering efficacy of a twice-daily brinzolamide 10 mg/mL (BRINZ)/brimonidine 2 mg/mL (BRIM) fixed-dose combination (BBFC) was non-inferior to its individual components (BRINZ+BRIM) dosed concomitantly in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT). Safety was also evaluated.Methods and Analysis: This was a Phase III, multicenter, observer-masked study in patients from China, Russia and Taiwan. Patients aged ≥ 18 years with a mean IOP ≥ 21 mmHg and ≤ 36 mmHg in the same eye after washout of other IOP-lowering medications were included. Eligible patients were randomized (1:1) to receive BBFC or BRIZ+BRIM eye drops twice daily for 3 months. The primary endpoint was the mean change in diurnal IOP (averaged over 09:00, +2 h, and +7 h) from baseline to Month 3. Adverse events (AEs) were recorded throughout the study.Results: The per-protocol set included 349 patients (BBFC, n=172; BRINZ+BRIM, n=177). The mean±standard deviation diurnal IOP at baseline was 24.6± 2.66 mmHg in both groups. At Month 3, the least square mean±standard error change in diurnal IOP from baseline was − 7.2± 0.34 mmHg and − 7.3± 0.34 mmHg with BBFC and BRINZ+BRIM, respectively (between-group difference: 0.1 mmHg [95% CI − 0.5, 0.7]). In the BBFC and BRINZ+BRIM groups, 53.3% and 55.0% of patients achieved a diurnal IOP < 18 mmHg, and 43.2% and 37.4% of patients, respectively, achieved a mean diurnal IOP reduction > 30% from baseline at Month 3. Ocular AEs were reported in 28.7% (BBFC) and 22.5% (BRINZ+BRIM) of patients; conjunctival hyperemia was the most frequent ocular AE (BBFC, 6.4%; BRINZ+BRIM, 6.8%). Non-ocular AEs were reported in 32.4% (BBFC) and 30.4% (BRINZ+BRIM) of patients.Conclusion: The study findings demonstrate that the efficacy of twice-daily BBFC was non-inferior to BRINZ+BRIM in patients with OAG/OHT. The safety profile of BBFC was similar to that of BRINZ+BRIM.Keywords: brinzolamide/brimonidine fixed-dose combination, intraocular pressure reduction, ocular hypertension, open-angle glaucoma

Objective To compare the safety and efficacy of manual and powered irrigation of the middle ear using saline or 1% baby shampoo to treat biofilm-forming bacterial middle ear infections. Background Biofilms play a major role in recalcitrant otitis media and are challenging to treat. Many therapeutic strategies have been attempted and the role of topical therapies is still being investigated. Topical irrigation using saline or 1% baby shampoo and the use of a hydrodebrider have been investigated in biofilms involved in chronic rhinosinusitis and their role within the middle ear is yet to be determined. Methods Twenty-two adult chinchillas underwent bilateral trans-bullar inoculation of non-typable biofilm forming Haemophilus influenza followed by unilateral middle ear irrigation 5 days later using saline administered via a powered hydrodebrider or manual irrigation of saline or 1% baby shampoo. Contralateral inoculated ears served as control and were not irrigated. Two days following irrigation, the bullae were harvested and processed for scanning electron microscopy to assess biofilm surface area. Auditory brainstem responses were performed before bacterial inoculation and prior to euthanasia. Results Manual and powered irrigation were effective in reducing the surface area of biofilm when compared to the control group. The hydrodebrider demonstrated to be more effective at eradicating biofilm than manual irrigation, especially in areas of difficult access, such as the ventral portion of the chinchillas' bullae. There was no difference in manual irrigation of saline when compared to 1% baby shampoo. Irrigations either manually or using the hydrodebrider did not affect hearing, the vestibular system or facial function. Conclusion Middle ear biofilms can be treated safely and effectively with rinses using either normal saline or 1% baby shampoo administered manually or with a powered hydrodebrider. Level of evidence NA.

Critical systems that produce big data streams can require human operators to monitor these event streams for changes of interest. Automated systems which oversee many tasks can still have a need for the ‘human-in-the-loop’ operator to evaluate whether an intervention is required due to a lack of suitable training data initially offered to the system which would allow a correct course of actions to be taken. In order for an operator to be capable of reacting to real-time events, the visual depiction of the event data must be in a form which captures essential associations and is readily understood by visual inspection. A similar requirement can be found during inspections on activity protocols in a large organization where a code of correct conduct is prescribed and there is a need to oversee whether the activity traces match the expectations, with minimal delay. The methodology presented here addresses these concerns by providing an adaptive window sizing measurement for subsetting the data, and subsequently produces a set of network diagrams based upon event label co-occurrence networks. With an intuitive method of network construction the amount of time required for operators to learn how to monitor complex event streams of big datasets can be reduced.

Alloplastic implants are widely used in facial plastic surgery, both in rhinoplasty and nonrhinoplasty procedures. Implant infection and extrusion are significant concerns of such implants after placement. Bacterial biofilms have been previously implicated in chronic wound infections, particularly in the presence of foreign bodies, such as alloplastic facial implants. Owing to their structural composition, biofilms are resistant to treatment with conventional antibiotics, and implant removal is frequently the only option.To evaluate explanted alloplastic facial implants for the presence or absence of bacterial biofilm using scanning electron microscopy.Facial implants explanted by a single surgeon were analyzed for biofilm formation between July 1, 2012, and June 30, 2013. Of 7 facial implants, 4 consisted of silicone, and 3 were porous polyethylene. Six of the 7 were nasal dorsal implants, and 1 silicone implant was removed from the midface. Nonexplanted fresh silicone and porous polyethylene implants were each used as a control.Scanning electron microscopy images were analyzed by an electron microscopist masked to the clinical history and implant type. The presence of biofilm formation was graded as none, mild, moderate, or severe.A total of 7 patients with previously placed alloplastic facial implants at an outside institution underwent revision rhinoplasty and removal of facial implants. All porous polyethylene implants showed biofilm formation to various degrees. Furthermore, all porous polyethylene implants had at least some areas of severe biofilm formation. One of the 3 porous polyethylene implants demonstrated severe biofilm formation on the entire implant, and the other 2 porous polyethylene implants showed areas of mild and severe biofilm formation. The only 2 implants without any evidence of biofilm were silicone implants. Of the other 2 silicone implants, 1 demonstrated no biofilm formation in 1 area and severe biofilm formation in another area, whereas the other had areas of moderate and severe biofilm formation.Five of 7 explanted facial implants showed at least some degree of biofilm formation. All implants with rougher surfaces, namely, porous polyethylene implants, demonstrated biofilm formation to a severe degree. Those with smoother surfaces, namely, silicone implants, were the only ones on which biofilm formation was either absent or less severe. Therefore, the suspicion that biofilms can form on facial implants is established through this investigation.NA.

Design of robust aircraft structure requires consideration of the load-carrying capability with large damage. Large notches, typically introduced as machined cracks (aka "notches") severing a single skin bay and a central stiffening member, are often used to conservatively address the wide range of possible large damage scenarios. The objective of the current effort was to develop more generalized and rapid analysis methods addressing large-notch residual strength of stiffened panels to support preliminary design activities..

Enhanced Recovery After Surgery (ERAS) is widely accepted in current surgical practice due to its positive impact on patient outcomes. The successful implementation of ERAS is challenging and compliance with protocols varies widely. Continual staff education is essential for successful ERAS programmes. Teaching modalities exist, but there remains no agreement regarding the optimal training curriculum or how its effectiveness is assessed. We aimed to draw consensus from an expert panel regarding the successful training and implementation of ERAS. A modified Delphi technique was used; three rounds of questionnaires were sent to 58 selected international experts from 11 countries across multiple ERAS specialities and multidisciplinary teams (MDT) between January 2016 and February 2017. We interrogated opinion regarding four topics: (1) the components of a training curriculum and the structure of training courses; (2) the optimal framework for successful implementation and audit of ERAS including a guide for data collection; (3) a framework to assess the effectiveness of training; (4) criteria to define ERAS training centres of excellence. An ERAS training course must cover the evidence-based principles of ERAS with team-oriented training. Successful implementation requires strong leadership, an ERAS facilitator and an effective MDT. Effectiveness of training can be measured by improved compliance. A training centre of excellence should show a willingness to teach and demonstrable team working. We propose an international expert consensus providing an ERAS training curriculum, a framework for successful implementation, methods for assessing effectiveness of training and a definition of ERAS training centres of excellence.

This is a case study about the implementation of an institutional repository (IR) at Marshall University. Libraries have always collected information from a worldwide marketplace and have disseminated these resources locally. The IR has created a new function for the library by making it practical to acquire locally developed resources and to disseminate them freely worldwide. This has altered the traditional role of librarians and suggests a broader set of implications for the future usefulness and relevancy of the IR as doors open to new partnerships that will strengthen the university and the library’s place within it.

Rishi P Singh,1 Giovanni Staurenghi,2 Ayala Pollack,3 Adeniyi Adewale,4 Thomas M Walker,4 Dana Sager,4 Robert Lehmann5 1Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA; 2Department of Biomedical and Clinical Science Luigi Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy; 3Ophthalmology Department, Kaplan Medical Center, Rehovot, Israel; 4Alcon Research Ltd., Fort Worth, TX, 5Lehmann Eye Center, Nacogdoches, TX, USA Objective: To assess the efficacy of nepafenac 0.1% ophthalmic suspension in improving the clinical outcomes following cataract surgery (CS) in patients with nonproliferative diabetic retinopathy. Methods: In two similar multicenter, randomized studies, patients received either nepafenac 0.1% or vehicle, instilled three times daily starting a day prior to surgery and continuing for 90 days postoperatively. A post hoc analysis of these two studies was conducted to assess 1) the likelihood for development of postoperative macular edema (ME), based on the percentage of patients who developed ME (≥30% increase from preoperative baseline in central subfield macular thickness) within 90 days following CS and 2) best-corrected visual acuity (BCVA) endpoints, including the percentage of patients with a BCVA improvement of ≥15 letters from preoperative baseline to Day 14 and maintained through Day 90. Results for individual studies and their pooled estimates (only visual acuity endpoints) are reported. Primary inference was based on odds ratio (OR). Results: This post hoc analysis included 411 patients (nepafenac 0.1%: 205; vehicle: 206). The incidence of postoperative ME within 90 days of CS was notably lower in the nepafenac-treated patients than in vehicle-treated patients (study 1: 3.2% vs 16.7%; OR =0.2, 95% confidence interval [CI] =0.1, 0.5, P=0.001; study 2: 5.0% vs 17.5%; OR =0.2, 95% CI =0.1, 0.8, P=0.018). A higher percentage of nepafenac-treated patients than vehicle-treated patients gained ≥15 letters from preoperative baseline to Day 14, which was maintained through Day 90 (study 1: 38.4% vs 21.4%; OR =2.4, 95% CI =1.4, 4.2, P=0.003; study 2: 35.0% vs 25.0%; OR =1.6, 95% CI =0.8, 3.2, P=0.172; pooled: 37.1% vs 22.8%; OR =2.0, 95% CI =1.3, 3.1, P=0.001). The odds of >5-letter and >10-letter loss in BCVA from postoperative Day 7 were higher in vehicle-treated than in nepafenac-treated patients. Conclusion: These results support the clinical benefit of prophylactic use of nepafenac 0.1% for reducing the risk of postoperative ME and for improvement in BCVA outcomes following CS in patients with nonproliferative diabetic retinopathy. Keywords: cataract surgery, nonproliferative diabetic retinopathy, nepafenac 0.1%, postoperative macular edema, visual outcomes

The field of information science has been documented in several ways during its existence and in some ways has mirrored that of other scientific disciplines during the same period. This article examines variables related to author gender of information science articles in American Documentation (AD) during its entire run, 1950 through 1969. Published by the American Documentation Institute, AD was a primary information science journal of its time, changing its name in 1970 to the Journal of the American Society for Information Science (JASIS), corresponding with the change of the parent organization’s name to the American Society for Information Science (1968). AD was preceded by an earlier “information science” publication, the Journal of Documentary Reproduction (JDR), 1938-1942, issued by the American Library Association. Studies indicate that females contributed about 8% for the entire run of articles in JDR (1938-1942) and about 22% for the first twenty-seven years of JASIS (1970-1996). The present study explores the nature of female contributions to AD for the middle period (1950-1969). It has been determined that for the entire run of the journal under the name AD, female authors comprised about 17% of the contributors, which places their publishing percentage for this period between the earlier and later periods, thus expectedly filling the gap.

To describe a surgical technique of en bloc resection of lacrimal sac tumors by the shared expertise of 2 specialists to achieve optimal tumor margin clearance and the simultaneous reconstruction of the bony defect to preserve ocular functions and cosmesis.All patients who had resection of malignant nasolacrimal drainage system tumors using the combined technique and posttreatment protocol between 1997 and 2011 were studied in this retrospective, noncomparative, interventional case series. A combined medial maxillectomy and medial orbitotomy for en bloc resection of the lacrimal sac tumor was followed by reconstruction with a tailored contoured titanium mesh to support the globe and eyelid. Disease relapse, disease survival, ocular functions (vision loss, motility, globe dystopia, and diplopia), and cosmesis (medial canthal tendon dystopia and eyelid retraction) were documented.Fourteen patients with malignant lacrimal sac tumors underwent en bloc resection. Postoperative radiation was ultimately administered to 9 patients. All patients but one were alive at last follow up. Tumor recurred locally in 2 patients with a regional recurrence in a third patient. Complications from radiation therapy included skin breakdown over the mesh (9/14 patients) with nasocutaneous fistula, medial canthal tendon dystopia (2/14 patients), and corneal perforation in a patient with recurrent disease. Despite removal of the tear drainage system, only 7 of 14 patients reported epiphora. None of the patients developed diplopia after resection and radiation therapy.The combined sinus-orbit approach is an effective method of managing lacrimal sac tumors to achieve optimal tumor clearance from the orbit and nasal cavity. Simultaneous reconstruction of the bony defect with a contoured titanium mesh provides a fixation anchor for the medial canthal tendon and globe support and serves as a supporting platform for the lower eyelid and cheek to minimize midface collapse. Postoperative radiation is associated with skin flap breakdown and nasocutaneous fistula formation.

Conventional dietary guidelines put forth by health care institutions and providers for the past 40 years have stressed the importance of reducing the amount of dietary fat consumed. Such a diet is purported to mitigate metabolic risk factors and optimize the ability to achieve or maintain a healthy body weight. However, over the past 35 years obesity rates in the United States have risen dramatically though the level of dietary fat consumed by U.S. adults has fallen. This review examines the potential reasons for this paradox. Various meta-analyses, controlled trials, and cohort studies have demonstrated that reducing dietary fat intake provides for very little weight loss unless accompanied by equal or greater reductions in total energy intake. Due to both psychological (e.g., the tendency for people to eat more of what they consider low fat) and physiological (e.g., the low satiety that accompanies carbohydrate intake) factors, reducing total caloric intake while simultaneously reducing fat intake is a difficult challenge. Further, reductions in total carbohydrate intake, increases in protein intake, and adoption of a Mediterranean diet seem to be more effective in inducing weight loss than reductions in fat intake. Traditional claims that simply reducing dietary fat will improve metabolic risk factors are also not borne out by research. There is some evidence that replacing dietary saturated fat with unsaturated fat may improve metabolic risk factors, but that research is not conclusive.• Over the past 40 years, Americans have decreased the percentage of calories they get from dietary fat while rates of overweight and obesity have risen dramatically. • It appears that a decrease in total dietary fat in ad libitum diets may induce a very small decrease in body weight. • Evidence suggests that reductions in total dietary fat intake often occur in conjunction with an increase in total caloric intake. • It seems reasonable to conclude that guiding the public to simply reduce dietary fat intake is an ineffective method to mitigate the rise in obesity and improve public health.

Agility training (AT) has recently been instituted in several military communities in hopes of improving combat performance and general fitness. The purpose of this study was to determine how substituting AT for traditional military physical training (PT) influences physical and cognitive performance. Forty-one subjects undergoing military technical training were divided randomly into 2 groups for 6 weeks of training. One group participated in standard military PT consisting of calisthenics and running. A second group duplicated the amount of exercise of the first group but used AT as their primary mode of training. Before and after training, subjects completed a physical and cognitive battery of tests including V[Combining Dot Above]O2max, reaction time, Illinois Agility Test, body composition, visual vigilance, dichotic listening, and working memory tests. There were significant improvements within the AT group in V[Combining Dot Above]O2max, Illinois Agility Test, visual vigilance, and continuous memory. There was a significant increase in time-to-exhaustion for the traditional group. We conclude that AT is as effective or more effective as PT in enhancing physical fitness. Further, it is potentially more effective than PT in enhancing specific measures of physical and cognitive performance, such as physical agility, memory, and vigilance. Consequently, we suggest that AT be incorporated into existing military PT programs as a way to improve war-fighter performance. Further, it seems likely that the benefits of AT observed here occur in various other populations.

This paper examines the economic and social implications of the current system of residential electricity subsidies in Pakistan, and assesses the potential to improve the system's outcomes through alternative targeting and program design. The analysis is multi-disciplinary in nature, drawing on national household survey data, electric company data on household electricity consumption, a welfare database, and a specially commissioned qualitative assessment of household and service provider attitudes and experiences. Affordability is only one of many concerns among electricity users, with reliability of supply and customer service being arguably more important. The analysis finds that targeting could be improved considerably by allocating subsidies according to proxy-means test scores using an existing national proxy-means test database. Providing a flat credit rather than a price subsidy could also alleviate certain governance concerns. The paper concludes with some guidance on how to carry out these reforms based on international experience.

This study examined the ability of a commercial energy drink to enhance acceleration tolerance, strength under G-load, and cognitive performance immediately prior to and following acceleration exposure. Eight experienced centrifuge subjects completed three separate experimental acceleration exposures following ingestion of 11.5 ml/kg body weight of a)a commercial energy drink, providing 5.0 mg caffeine/kg body weight, b) a commercial energy drink without caffeine or c) placebo. The acceleration exposures consisted of a relaxed gradual onset run to peripheral light loss, a rapid onset run to 6.0 G for 15 s, and a simulated air combat maneuver (SACM) run of repeated alternations between 4.5 G for 15 seconds and 7G for 15 seconds until volitional exhaustion. Cognitive tests were performed prior to and after the acceleration profiles. Relaxed G-tolerance was significantly higher under the caffeine session, whereas SACM duration did not differ among the drink conditions. Hip adductor muscle strength was lower during the placebo session than during the other two sessions. Cognitive reaction time was faster post-acceleration than pre-acceleration, and faster under the caffeine condition than the placebo condition. We conclude that consumption of a caffeine-based energy drink enhances relaxed G-tolerance and may increase strength, but does not impact acceleration duration. We further conclude that cognitive reaction time is improved by the caffeinated drink, as well as by the physical exertion during the acceleration exposure.

The purpose of this study was to investigate the ability of whey-protein and leucine supplementation to enhance physical and cognitive performance and body composition. Thirty moderately fit participants completed a modified Air Force fitness test, a computer-based cognition test, and a dual-energy X-ray-absorptiometry scan for body composition before and after supplementing their daily diet for 8 wk with either 19.7 g of whey protein and 6.2 g leucine (WPL) or a calorie-equivalent placebo (P). Bench-press performance increased significantly from Week 1 to Week 8 in the WPL group, whereas the increase in the P group was not significant. Push-up performance increased significantly for WPL, and P showed a nonsignificant increase. Total mass, fat-free mass, and lean body mass all increased significantly in the WPL group but showed no change in the P group. No differences were observed within or between groups for crunches, chin-ups, 3-mile-run time, or cognition. The authors conclude that supplementing with whey protein and leucine may provide an advantage to people whose performance benefits from increased upper body strength and/or lean body mass.

We report on chemical etching of ordered Au nanostructure arrays to continuously tune their localized surface plasmon resonances (LSPR). Real-time extinction spectra were recorded from both Au nanodisks and nanospheres immobilized on glass substrates when immersed in Au etchant. The time-dependent LSPR frequencies, intensities, and bandwidths were studied theoretically with discrete dipole approximations and the Mie solution, and they were correlated with the evolution of the etched Au nanostructures' morphology (as examined by atomic force microscopy). Since this chemical etching method can conveniently and accurately tune LSPR, it offers precise control of plasmonic properties and can be useful in applications such as surface-enhanced Raman spectroscopy and molecular resonance spectroscopy.

To evaluate the safety and efficacy of preservative-free triamcinolone (TRIESENCE(R) suspension) for visualization during pars plana vitrectomy.This phase III, observer-masked study was conducted in 6 centers by 10 surgeons and enrolled 60 patients undergoing pars plana vitrectomy. Preservative-free triamcinolone (up to 4 mg) was administered to all patients to enhance visualization of vitreous and membranes. During each surgery, video recordings captured visualization pre- and postinstillation of preservative-free triamcinolone. An independent, masked reader evaluated the videos for the degree of visualization using a five-point scale ranging from 0 (not visible) to 4 (clearly delineated). Surgeons used a five-point scale ranging from "strongly disagree" to "strongly agree" to assess whether preservative-free triamcinolone improved visualization.In 59 of 60 cases, the masked reader's scores for visualization of posterior segment structures were higher (i.e., structures were more clearly visible) after instillation of preservative-free triamcinolone. The preinstillation mean visualization score was 0.5 compared to 3.7 postinstillation (P0.0001). Greater than 90% of surgeon evaluations agreed or strongly agreed that preservative-free triamcinolone enhanced visualization of posterior segment structures. No safety issues were identified.Preservative-free triamcinolone (TRIESENCE(R) suspension) was well tolerated and effectively enhanced visualization of posterior segment structures during pars plana vitrectomy.

Reduction of posterior capsule opacification (PCO) after cataract surgery has been achieved since the general acceptance of posterior chamber intraocular lens implantation 30 years ago. Attention to surgical technique on the one hand and changes in lens design and materials on the other have synergistically reduced the incidence of PCO to less than 5% at 5 years. But lens epithelial cells still proliferate and pharmacological prevention has been largely unsuccessful so far. Any agent must be toxic to these lens epithelial cells without being toxic to the corneal endothelium. This review looks at many substances that have been tried and a few that have been partly successful without yet entering clinical practice. Possibilities for future clinical research are canvassed.

The properties of both insulators and metals can be characterized capacitively with scanning probe microscopy, though the techniques employed are different. Intermittent contact scanning capacitance microscopy (IC-SCM) is a useful technique for characterizing the dielectric constant of insulators. Scanning Kelvin force microscopy (SKFM) can image potential distributions and work functions within conductors. Both techniques depend on the capacitance between the tip and sample, which has an inverse square dependence on tip-sample separation, limiting spatial resolution. A differential data acquisition technique to improve spatial resolution is described.

In this work, an optical humidity sensor based on a nanoporous polymeric photonic crystal (PC) is demonstrated. The PC sensing structure is created by combining a holographic interference patterning technique with a modified holographic polymer-dispersed liquid crystal system. Changes in relative humidity (RH) induce the modification of the refractive index contrast between the nanoporous and nonporous regions, and thus the transmittance and bandgap position, of the PC structure. For a PC structure with 30% porosity and a grating spacing of 220 nm, a change in the RH from 40% to 95% at 34 °C results in a redshift of 43 nm in the central wavelength at the PC bandgap and an increase from 12% to 87% in the relative transmittance at λ = 600 nm. Other performance analyses have shown that the nanoporous polymeric PC-based humidity sensor is highly stable and reproducible, exhibits minimal hysteresis, and responds relatively fast.

BACKGROUND AND AIMS Fecal lactoferrin (FLA) is a neutrophil-derived surrogate marker of intestinal inflammation that is elevated in patients with inflammatory bowel disease. However, the correlation between FLA levels and serological markers of disease activity has not been previously reported, to our knowledge. In the present study we evaluated the ability of FLA levels to reflect disease activity in pediatric patients with inflammatory bowel disease. We further assessed the relationship between FLA levels and customary laboratory and clinical measures of inflammation. PATIENTS AND METHODS Fecal specimens were collected from 148 consecutive pediatric patients (79 with Crohn disease, 62 with ulcerative colitis, and 7 with irritable bowel syndrome) and 22 healthy control individuals. Lactoferrin was measured by enzyme-linked immunosorbent assay (IBD-SCAN, TECHLAB, Inc). Disease activity was assessed at the time of sample provision by laboratory measures (including erythrocyte sedimentation rate [ESR] and albumin) and previously validated disease activity indices (Pediatric Crohn Disease Activity Index, Kozarek, Harvey Bradshaw Activity Index). RESULTS Lactoferrin levels were significantly higher in patients with ulcerative colitis (1880 +/- 565 microg/mL) (mean +/- SE) or Crohn disease (1701 +/- 382 microg/mL) than in healthy control individuals under 21 years of age (1.17 +/- 0.47 microg/mL, P < 0.001). Lactoferrin levels correlated significantly with ESR, hematocrit, albumin, and platelet count (P < 0.001). Receiver operating characteristic curve analysis revealed that FLA levels were comparable to ESR in detecting patients with clinically active disease (P < 0.001). Patients who experienced a clinical flare within 2 months of specimen collection displayed higher lactoferrin levels (845 +/- 452 microg/mL) than did those who remained in clinical remission (190 +/- 90 microg/mL, P = 0.003). CONCLUSIONS Data presented here demonstrate that FLA is a sensitive and specific biochemical marker of inflammation for use in the diagnosis and interval assessment of pediatric patients with IBD, and its level correlates well with both clinical disease activity indices and ESR. Elevated levels of FLA may also identify patients at greater risk for the development of subsequent clinical flares.

Potato production is expanding rapidly in developing countries, particularly in Asia. For many poor farmers potatoes represent a staple food and an important cash crop. Potato insect pests have a substantial negative impact on the livelihood of farmers. Bt potatoes have been effective on a commercial scale in controlling Colorado potato beetle in North America. Small-scale tests have demonstrated Bt's efficacy in controlling potato tuber moth. Reliance on chemical pesticides can be reduced and/or replaced by pest-protected potato, genetically engineered to express genes from the bacterium Bacillus thuringiensis (Bt). Reductions in insecticide use would provide significant economic, health and environmental benefits. Unintentional Bt gene escape into wild relatives of cultivated potato should be rare and unlikely to persist. However, a monitoring system should be in place in areas where sexually compatible relatives of potato occur. The potential of Bt varieties to displace land races or reduce cr...

INTRODUCTION The purpose of this study was to test whether pressure breathing during G (PBC) without a counterpressure vest negatively influences G endurance or increases breathing fatigue during extended duration high-G exposures. METHODS While using PBG, 10 subjects underwent 2 trials of +3 Gz exposures: once when wearing a counterpressure vest and once without. The exposures consisted of a relaxed, gradual G onset run until peripheral or central light loss, a straining rapid onset GC run to +6 Gz for 15 s, and a simulated aerial combat maneuver (SACM) G profile consisting of 10-s periods varying between +5 Gz and +9 Gz, during which subjects executed a hand-eye tracking task. The SACM endpoint was light loss or exhaustion. Subjects provided ratings of subjective effort and discomfort after the SACM. RESULTS Significant differences were found between the vest and no-vest conditions for only 3 of 19 measures: heart rate under G and two measures of tracking ability. The vast majority of data indicated no difference between the vest and no-vest conditions for performance under G. DISCUSSION This experiment supports previous studies and expands those previous results by increasing the duration of PBG exposure shown to not be influenced by wearing of the vest. We conclude that there is likely no practical advantage to wearing a counterpressure vest during PBG.

The increasing emphasis on poverty alleviation as a motivation for investing in public-sector international agricultural research is discussed from the perspective of practitioners engaged in ex-post impact evaluation. Context is largely provided from the experience of the International Potato Center (CIP) in impact assessment of improved potato and sweet potato technologies. The poverty content of 10 CIP-related success stories of technological change was qualitatively assessed with a checklist of key questions. With this admittedly crude method, the size of project Net Present Value (NPV) appears to be an informative guide to the magnitude of poverty effects. Hence, projects that generate widespread benefits to many people, particularly to net consumers of food crops, remain likely to be the most effective vehicles to contribute to poverty alleviation from public sector investments in the improvement of food crops in developing countries.

The prevalence, incidence, risk factors, clinical associations, and morbidity of gallstones were studied in 311 patients with homozygous sickle cell disease and 167 patients with sickle cell-hemoglobin C disease in a cohort study from birth. Gallstones developed in 96 patients with homozygous sickle cell disease and 18 patients with sickle cell-hemoglobin C disease; specific symptoms necessitating cholecystectomy occurred in only 7 patients with homozygous sickle cell disease.

The purpose of this study was to compare the cleaning efficacy of passive ultrasonic activation with that of passive sonic activation after hand instrumentation. Sixty curved molar canals were hand-instrumented to size 35 and divided into three groups. Group 1 received no further treatment. Group 2 received 3 min of passive sonic activation. Group 3 received 3 min of passive ultrasonic activation. The roots were split and photomicrographs (x20) were made of the apical 6 mm of canal. A transparent grid was placed over projected images, and the total number of squares covering the apical 6 mm of canal space and the number of squares containing debris were counted. A debris score was calculated for each specimen by dividing the number of squares with debris by the total number of squares. The mean debris scores were 31.6% for hand instrumentation only, 15.1% for the sonic group, and 16.7% for the ultrasonic group. The debris scores for the sonic and ultrasonic activation groups were significantly lower than that for the hand instrumentation only group (p0.01); however, there was no significant difference between the sonic and ultrasonic activation groups. Passive sonics after hand instrumentation produces a cleaner canal than hand instrumentation alone and is comparable with that of passive ultrasonics.

Objective. To describe the epidemiology of vancomycin usage at a children's hospital. Methods. A cohort study of patients at Egleston Children's Hospital who were charged for the receipt of vancomycin from October, 1992, through October, 1995, was performed. Data were obtained from pharmacy charge records in the hospital's medical records information system. Results. During the study period there were 3589 patient hospitalizations in which vancomycin was used. Patients receiving vancomycin were predominantly male (56.6%) and white (62.4%), ranged in age from 0 to 31 (median, 3.8) years and had an average length of stay of 6.0 days. The total number of vancomycin doses was 105 704; the median number of vancomycin doses during each patient hospitalization was 11.0 (range, 1 to 1215). The total charge for vancomycin used was $2 009 746; the median charge for vancomycin per patient was $297.50 (range, $11 to 19 864). The majority (75.7%) of vancomycin doses were given on the hematology (27.6%), neurosurgery (17.9%), cardiothoracic surgery (13.4%), neonatology (9.7%) or general pediatrics (7.1%) services. Overall surgery service patients were significantly more likely to receive vancomycin than were medicine service patients (1267 doses/6221 admissions vs. 1954/19446; relative risk, 2.03; P < 0.001). During the study period the number of vancomycin doses decreased significantly (P < 0.001). Conclusions. This study shows the value of evaluating antimicrobial use through a pharmacy database. Although vancomycin use decreased during the study period, large amounts of vancomycin are still being prescribed primarily on subspecialty service patients. Interventions to reduce vancomycin use should focus on these groups.

This report presents a case of classic Kawasaki disease with progression to acute respiratory distress syndrome. The severity of the patient's pulmonary disease led clinicians to suspect toxic shock syndrome. Clinicians need to be aware that pulmonary manifestations of Kawasaki disease can include acute respiratory distress syndrome.

Huntington's disease (HD) is caused by the expansion of a CAG repeat in the huntingtin (HTT) gene. The R6 mouse models of HD express a mutant version of exon 1 HTT and typically develop motor and cognitive impairments, a widespread huntingtin (HTT) aggregate pathology and brain atrophy. Unlike the more commonly used R6/2 mouse line, R6/1 mice have fewer CAG repeats and, subsequently, a less rapid pathological decline. Compared to the R6/2 line, fewer descriptions of the progressive pathologies exhibited by R6/1 mice exist. The association between the molecular and cellular neuropathology with brain atrophy, and with the development of behavioral phenotypes remains poorly understood in many models of HD. In attempt to link these factors in the R6/1 mouse line, we have performed detailed assessments of behavior and of regional brain abnormalities determined through longitudinal, in vivo magnetic resonance imaging (MRI), as well as an end-stage, ex vivo MRI study and histological assessment. We found progressive decline in both motor and non-motor related behavioral tasks in R6/1 mice, first evident at 11 weeks of age. Regional brain volumes were generally unaffected at 9 weeks, but by 17 weeks there was significant grey matter atrophy. This age-related brain volume loss was validated using a more precise, semi-automated Tensor Based morphometry assessment. As well as these clear progressive phenotypes, mutant HTT (mHTT) protein, the hallmark of HD molecular pathology, was widely distributed throughout the R6/1 brain and was accompanied by neuronal loss. Despite these seemingly concomitant, robust pathological phenotypes, there appeared to be little correlation between the three main outcome measures: behavioral performance, MRI-detected brain atrophy and histopathology. In conclusion, R6/1 mice exhibit many features of HD, but the underlying mechanisms driving these clear behavioral disturbances and the brain volume loss, still remain unclear.

Background: Two cases of allergic (IgE-mediated) reaction to bovine collagen are described. Both patients developed conjunctival oedema in response to the topical application of highly purified bovine collagen to the eye during opthalmic surgery (corneal shields and catgut suture material). One patient developed periocular angioedema and angioedema of the throat after the ingestion of bovine collagen in the form of gelatin-containing foods. Methods: The presence of allergen-specific IgE was evaluated by skin prick testing with collagen-derived products, and by topical challenge with a highly purified bovine collagen-derived corneal shield. Results: In both patients, application of collagen to the eye reproduced the original subconjunctival oedema. In one patient, skin testing with purified and crude extracts of bovine collagen in the form of a corneal shield, catgut suture material and edible gelatin demonstrated evidence of collagen-specific IgE. Conclusions: Clinical reactions to collagen are rare. Neverthless, patients with a history of allergic reactions to bovine collagen-derived products should be investigated because of the widespread use of collagen-derived therapeutic devices, the potential for immunological cross-reactivity with dietary collagen (gelatin) and the potential for anaphylaxis.

Many public library administrators are being forced to look toward outsourcing as a way of securing critical support services. Begins with a description of the Charleston County Library’s use of cataloging outsourcing services, followed by an explanation of the various methods employed by vendors to transmit cataloging data to customers. There are practical suggestions for those considering an outsourcing arrangement, with solutions for offsetting the cataloging quality shortcomings inherent in some outsourcing practices. Concludes that with proper planning and vigilance, outsourcing can produce a quality product, one that will allow the technical‐services staff the time needed to construct a unified index for the library’s multifarious materials and information sources.

Ramon Llull (1232-1316) wrote many didactic and theoretical works that demonstrate an exhaustive and creative approach to the organization of knowledge. His encyclopedic Arbre de sciencia (1296) was a multi-volume summation of human knowledge, organized according to a plan that could be applied to other works. Set against a background of Llull's other tree-based works, including the Libre del gentile dels tres savis (1274-89), and the Arbre de filosofia desiderat (1294), the Arbre de sciencia is described and analyzed as a faceted classification system.

This study determined if the cleaning efficiency of nickel-titanium rotary files in an endodontic electric handpiece using a no-torque control setting was superior to that obtained when using the torque-control feature. Fifty extracted human anterior teeth with straight canals were divided into two groups of 20 and two control groups of 5. Canals were instrumented with GT and .04 ProFile nickel-titanium files until a size 35 advanced to working length. Samples were sectioned and the apical 6 mm of the canal was photographed (x20) and projected onto a 3- x 4-foot grid with squares measuring 0.5 inches each. Total debris was the percentage of the number of squares containing debris versus the total number of squares. The teeth in the torque-controlled group showed an average of 24.99% debris versus 15.55% for the teeth in the no-torque group. The difference was not statistically significant; therefore, no difference can be said to exist between the two torque settings in terms of cleaning efficiency.

We report on chemical etching of ordered Au nanostructure arrays to continuously tune their localized surface plasmon resonances (LSPR). Real-time extinction spectra were recorded from both Au nanodisks and nanospheres immobilized on glass substrates when immersed in Au etchant. The time-dependent LSPR frequencies, intensities, and bandwidths were studied theoretically with discrete dipole approximations and the Mie solution, and they were correlated with the evolution of the etched Au nanostructures’ morphology (as examined by atomic force microscopy). Since this chemical etching method can conveniently and accurately tune LSPR, it offers precise control of plasmonic properties and can be useful in applications such as surface-enhanced Raman spectroscopy and molecular resonance spectroscopy.

Viral infections constitute more than 60% of acute lower respiratory illnesses. Respiratory syncytial virus (RSV) and parainfluenza viruses are the most frequent etiologic agents. After transmission by large droplet aerosol or direct contact, the viruses gain entry into host cells through specific viral surface proteins; subsequently, pathogenetic mechanisms cause tissue injury and result in clinical disease. In the intensive care unit the mainstay of treatment is primarily supportive. Nonspecific treatment may include nebulized beta-agonists, aminophylline, and steroids. Ribavarin is the only specific antiviral agent approved for respiratory syncytial virus infection but its efficacy remains controversial. New therapies and vaccines offer hope for improved outcome from viral respiratory infections such as RSV.

Objective: Bacteria in biofilms are extremely resistant to antibiotics. Recurrent acute otitis media appears to be a disease related to biofilm formation. The goal of this study is to determine if middle ear irrigations with saline or baby shampoo could eradicate mucosal biofilms in a chinchilla model of acute otitis media.Method: After a baseline ABR, middle ears of 10 chinchillas were inoculated with Haemophilus influenzae. On day 5, the ears were irrigated with saline or 1% baby shampoo using a syringe or hydrodebrider. A final ABR was obtained before the animals were euthanized and middle ear mucosa were harvested for SEM analysis.Results: Biofilm formation on middle ear mucosa in chinchillas was in nonuniform distribution. SEM analysis by a blinded microscopist showed a statistically significant decrease in biofilm densities of middle ear mucosa after normal saline or 1% baby shampoo irrigations when compared with nonirrigated ears using Wilcoxon/Kruskal-Wallis Tests (P < .01). No statistically signi...

Rapid deployments do not allow our airmen to slowly progress to high altitudes, so predeployment strategies for the optimal use of hypoxic tents need to be developed. The primary objective of this study was to determine if alternating days of intermittent normobaric hypoxic exposures (IHE) for previously unacclimatized, sea-level residents (SLR) would work as a training strategy to minimize physical and cognitive impairments, and possibly reduce acute mountain sickness (AMS) incidence in our battlefield airmen during deployment. A secondary objective was to compare the physical and cognitive performance results between normobaric hypoxic and hypobaric hypoxic conditions. We conducted a crossover style, randomized study to assess the efficacy of IHE on physical and cognitive performance decrements. Baseline physical tests were conducted at SL, normobaric hypoxic (NH), and hypobaric hypoxic (HH) environments. Subjects were randomly assigned to either five consecutive (C-IHE) or five alternating (A-IHE) days of IHE. All tests were repeated post-IHE exposure. Following a four-week washout interval, all subjects repeated the process again under the opposite IHE exposure schedule. Intra-subject differences between training regimens (C-IHE vs. A-IHE) and the three environments (SL vs. NH vs. HH) were analyzed. Seven well-conditioned (average VO2 max = 57 mL-1.Kg-1.min) male subjects (30.4 ? 8.7 yrs) completed the study. Significant physiological differences in VO2 max (p

PURPOSE: The aim of this study was to evaluate the role of preoperative angiography in patients undergoing colonic interposition. MATERIALS AND METHODS: We searched the electronic database of our radiology department for the term "mesenteric angiography" over a 10-year period from January 1, 2001 to December 31, 2010. RESULTS: We identified 54 patients who had undergone mesenteric angiography before esophageal reconstruction, 16 of whom proceeded to have colonic interposition surgery. One patient (6.3%) developed graft necrosis, two (12.5%) developed an anastomotic leak, and three (18.8%) developed an anastomotic stricture. These complication rates are similar to those reported in the surgical literature for patients who did or did not undergo routine preoperative angiography. CONCLUSION: There is no significant difference in the rates of complications secondary to ischemia (graft necrosis, anastomotic stricture, and anastomotic leak) in patients who undergo routine preoperative angiography as compared with those who do not.

This paper examines how compensation and corporate governance mechanisms affect the occurrence of securities fraud and related shareholder litigation for young IPO firms. While prior research has focused on seasoned firms, we examine how CEO incentives and corporate governance in IPO firms affect the incidence of IPO-related shareholder litigation. We find that the likelihood of securities fraud allegations increases with pre-IPO CEO equity incentives, suggesting a “dark side” to executive equity incentives. Additionally, we find that the risk of being sued is higher for firms whose boards are dominated by insiders, whose CEOs are older, have shorter tenure, or who founded the firm.