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This study is addressing topics related to sustainable consumption and aims to identify and rank the decisional factors involved in the process of purchasing local eco-friendly agri-food products and to analyse to what extent the incidence of eco-friendly agri-food consumption is influenced by five factors: income, age, gender, education, living area. Thus, the paper presents the results of a market research regarding the consumer behaviour of agri-food and the willingness of adopting a more sustainable diet, in one of the developing regions of the European Union: the North-East Region of Romania, Ia.i County. Our substantive findings indicate that personal benefits (taste, perceived health benefits and freshness) are the main motivations driving sustainable consumption, while environmental conditions did not reach such a great significance. The results show that, in general, people are not well informed about the environmental implications of their diet. Their environmental attitudes are not aligned with their actual purchase practices: although the majority of people declare they are preoccupied with environmental protection, the driving motivations of agri-food purchase do not necessarily imply environmental concern factors, such as transportation, reusable/recyclable package or the wish to protect the environment. The study shows that women are more willing than men to change their consumption behaviour of agri-food products in order to contribute to a sustainable environment. Also, elderly people are more determined to purchase agrifood produced in an environmentally sustainable manner. Findings from this research lead to understanding the multiple factors that consumers consider in making purchase decisions of environmentally sustainable agri-food. Educational campaigns should be implemented in order to grow awareness about how our diet and food choices can address climate change.

This paper attempts to demonstrate the dissonance between the highlighted themes placing people at the epicenter and yet excluding the general public and their actual security needs, examines national security from a consumer’s perspective. To underscore a dissonance in the discourse on national security, the writer explores the paradigm of national security policy. Then, it illustrates the discord between the public security needs in their everyday life and the outlined threats in the national security documents. To validate the above argument, the paper offers a new avenue on the overlooked consumer identity of human beings and demonstrates the probability and impact of threats to national security by means of the qualitative data analysis.

Objective: To describe the proportion of women presenting with undiagnosed anaemia at confinement and to explore associations between anaemia and socio economic factors, dietary pattern and compare maternal and neonatal outcome among term mothers with anaemia compared to non-anaemic pregnant women at a tertiary care centre in Sri Lanka. Method: A comparative cross-sectional study was performed by recruiting anaemic and non-anaemic term mothers who delivered at the Teaching Hospital Peradeniya during the period March 2018-March 2019. Pregnant mothers whose haemoglobin level was less than 10.5 g/dl were considered as anaemic and compared with the mothers whose haemoglobin level was above this level. With written consent, demographic data, etiological factors, maternal and neonatal outcomes of term mothers were evaluated by an interview and blood samples were withdrawn to carry out anaemia related investigations. Results: Among 2854 pregnancies, a total of 234 (8.19%) term pregnant mothers were anaemic and they were and compared with 199 non-anaemic mothers. Out of the anaemic mothers (Hb < 105 g/l), 133 (56.76%) had moderate anaemia, 100 (42.79%) had mild anaemia and 1 mother (0.45%) had severe anaemia. Low monthly family income was significantly associated with the incidence of anaemia. Anaemia was also associated with low weekly consumption of red meat (OR 8.994; 95% CI, 5.74 - 14.09, p < 0.05) and high weekly tea intake (OR 0.217; 95% CI 0.144 - 0.327, p < 0.05). Among anaemic mothers, 215 (67.44%) had low serum ferritin (

Fecal incontinence is a health problem that leads to serious quality of life disturbances in the elderly, much greater than the ones generated by micturition disturbances. When physical therapy, habit changes and medication fail to control the disease, electrical stimulation of the sacral nerves at the level of the third sacral foramen represents a solution for eligible patients. Our research done on 29 patients, operated by the first author at Klinikum Bielefeld, Germany, revealed statistically significant improvements, slightly superior to the ones in the literature. As many as 82.75% of the patients experienced more than 70% reduction in the number of weekly incontinence episodes, correlated with a robust increase in the quality of life and level of daily physical activity. The aim of the present paper is to present our results after the intervention, and at 1-year follow-up, and to describe the surgical technique, hoping for an increased awareness and adoption in Romania.

Background. Patients with cervical spinal injury with quadriplegia are at an increased risk of developing serious gastrointestinal complications. We report an unusual case of spontaneous rectosigmoid perforation in a quadriplegic patient. Case Presentation. A 58-year-old man with diabetes mellitus and hypertension presented to the emergency department following a fall from 25 feet of height. He sustained a fifth cervical vertebral fracture with quadriplegia and neurogenic shock. One week later, he developed progressive abdominal distension with tachycardia, low blood pressure, and respiratory distress. His abdomen was soft but had impaired liver dullness. Imaging showed evidence of visceral perforation. He underwent an emergency laparotomy and was found to have a perforation of the antemesenteric border of the rectosigmoid junction with fecal contamination. The perforation was repaired primarily, and a temporary loop ileostomy was created. The patient received intensive care for 4 days, and thereafter, the recovery was uneventful. He was later transferred to the spinal unit for further management. The intraoperative findings, histology, and subsequent colonoscopy did not reveal any underlying cause for the perforation. Conclusions. Clinical signs and symptoms are generally absent in patients following spinal cord injury, and the diagnosis of serious gastrointestinal pathology can be difficult and challenging. We believe that ischemia at the rectosigmoid junction precipitated by multiple factors was the possible reason for the spontaneous perforation.

This study investigates how the Theory of Motivated Information Management influences adolescents' sexual information-seeking behaviour and their satisfaction with the information they find. A cross-sectional investigation that purposively selected and surveyed 128 adolescents in the Matara District of Sri Lanka using a semi-structured questionnaire was designed. The variables such as high-risk sexual behaviour, having a partner or not, sexual curiosity, computer self-rated proficiency, sex of the adolescents, self-rated English proficiency, Uncertainty Discrepancy anxiety and self-efficacy were used to inquire about the contributing effects on adolescents' sexual health information seeking behaviour. The findings reveal that the most important sexual health information for adolescents is the information related to “high-risk sexual behaviour” and “sexual curiosity”. Boys are more likely to engage with sexual health information in a positive way than girls. The results further validate the TMIM framework. The orientation of associations between model variables has been consistent with past studies, particularly the negative relationship between anxiety and efficacy. Adolescents expressed difficulties in obtaining health information, including difficulty determining the quality of information and the lack of appropriate health information, highlighting the need for effective measures in this area. To overcome these barriers, the Ministries of Health and Education, the National Library, the Academic Library System and particularly medical/health libraries in universities, and the National Youth Services Council should plan easily accessible, outcome measurable, and appropriate opportunities and training through their official centres and institutions.

The paper investigates the main changes that have taken place in the Romanian fruits and vegetables supply chain over the past twenty years. Its sustainability is assessed using time-series data from different official and private data-bases applying statistic research methods. Results showed that the Romanian supply chain is dominated in terms of both inputs used and offer, by imports originating from different EU countries. The local subsistence and semi-subsistence farms cannot provide enough qualitative and quantitative products such as to penetrate the supermarkets, the main players from the market. Agritourism, a potential niche market, was investigated using sampling techniques. The guesthouses from one of the most important ecotourism destinations where assessed by face-to-face interviews. Results showed that even such short-marketing chains are unsustainable tools for the fresh fruits and vegetables products sectors. The lack of governance for the local producers does not allow them to enter on such niche market. All this findings can provide important incentives for better future targeted sectorial agricultural policies.

Objective To develop a real-time monitoring system that has the potential to guide the titration of anesthetic agents in the treatment of pediatric status epilepticus (SE). Methods We analyzed stored multichannel electroencephalographic (EEG) data collected from 12 pediatric patients with generalized SE. EEG recordings were initially segmented in 500 ms time-windows. Features characterizing the power, frequency, and entropy of the signal were extracted from each segment. The segments were annotated as bursts (B), suppressions (S), or artifacts (A) by two electroencephalographers. The EEG features together with the annotations were inputted in a three-layer feed forward neural network (NN). The sensitivity and specificity of NNs with different architectures and training algorithms to classify segments into B, S, or A were estimated. Results The maximum sensitivity (95.96% for B, 89.25% for S, and 75% for A) and specificity (89.36 for B, 96.26% for S, and 99.8% for A) was observed for the NN with 10 nodes in the hidden layer. By using this NN, we designed a real-time system that estimates the burst-suppression index (BSI). Conclusions Our system provides a reliable real-time estimate of multichannel BSI requiring minimal memory and computation time. Significance The system has the potential to assist intensive care unit attendants in the continuous EEG monitoring.

GOALS The goal of this study was to evaluate the impact of inpatient outcomes of gastrointestinal bleeding (GIB) related to percutaneous coronary intervention (PCI). BACKGROUND With all-cause mortality increasing in patients undergoing PCIs, outcomes for GIB associated with PCI may be adversely impacted. STUDY Using the National Inpatient Sample (2007 to 2012), we performed a nested case-control study assessing inpatient outcomes including incidence and mortality for PCI-related GIB hospitalizations. Multivariate logistic regression analyses were performed to determine significant predictors for GIB incidence and mortality. RESULTS A total of 9332 (1.2%) of PCI hospitalizations were complicated by GIB with the age-adjusted incidence rate increasing 13% from 2007 (11.3 GIB per 1000 PCI) to 2012 (12.8). Patients ≥75 years of age experienced the steepest incline in GIB incidence, which increased 31% during the study period. Compared with non-GIB patients, mean length of stay (9.4 d vs. 3.3 d) and median cost of care ($29,236 vs. $17,913) was significantly higher. Significant demographic risk factors for GIB included older age and comorbid risk factors included gastritis or duodenitis, and Helicobacter pylori infection.In total, 1044 (11%) of GIB patients died during hospitalization with the GIB mortality rate increasing 30% from 2007 (95 deaths per 1000 GIB) to 2012 (123). Older age had the strongest association with inpatient mortality. CONCLUSIONS Inpatient incidence and mortality for PCI-related GIB has been increasing particularly with a large increase in incidence among older patients. A multidisciplinary approach focused on risk-stratifying patients may improve preventable causes of GIB.

University library administrators in Sri Lanka, realising the necessity of complying with customer perception of high quality service, have begun to search for alternative ways to satisfy their clientele on the basis of service quality. This study therefore aims to meet this need by identifying business domains in the university library setting to assess the extent to which service quality domains may be used to predict customer satisfaction, from a service quality perspective. Domain identification of service quality was carried out with a sample of 262 subjects. Accordingly, seven domains–affect of service personnel, building environment, collection and access, furniture and facilities, technology, service delivery and web services–were statistically tested to be confirmed as potential business domains of service quality. Whilst not detracting from preceding research studies conducted in the field, this study has demonstrated significant implications for researchers and library administrators in understanding the importance of individual business domains within the specific service spectrum of university libraries, in order to provide ultimate satisfaction for customers with a quality library service.

Online promotion of wine products is a new but indispensable approach in all promotional activities initiated by companies and producers of wine, whereas there is a need for a greater focus on this specific market, not separated from the real one, but a new component, increasingly prevalent. The new market, where demand is getting bigger in our country and where consumers are becoming more and more faithful to this type of promotion, is the online environment, which generated, as a response from manufacturers and distributors in almost all food industry areas, online marketing. Promoting in the virtual environment follows the same stages of development as any promoting strategy from other environments of intersection with customers: initial research, market segmentation, setting goals, market positio-ning, marketing mix, implementation of the promotional campaign itself and the implementation and post implementation control. The key features of wine products online promoting is interactivity and socialization. Internet communication occurs in two directions, unlike traditional marketing, which is unidirectional. The other characteristic of virtual promotional methods - socialization characterizes the future of cyberspace. The research purpose is not to separate the new form of promotion of other forms of nonvirtual marketing activities, but to emphasize that online marketing is the component that should not be missing from any promotional cam-paign launched by a company. The research was based on information provided by the S.C. Cotnari S.A. Department of Marketing. In order to determine the characteristics of online communication and modern promoting trends, we analyzed the website and social media accounts of this wine producer, as well as news portals and blogs. Questionnaires were applied on a sample of 133 consumers, to analyze the impact on their use of online marketing. The studied sample consisted of consumers of wine and, most of them, Internet users, from urban or rural areas. Each questionnaire contained 16 questions, with a total of 63 variables, and aimed to compare the behavior of respondents towards online promotion activity of S.C. Cotnari S.A., Iaşi county.

Globalization has made a remarkable impact on the university education system, and the Internet has become the core resource for universities to make their facilities and opportunities available globally. University Web sites are increasingly used for a wide variety of purposes. The evaluation of universities based on their Web performance was introduced by Cybermetrics Lab as the "Webometric Ranking of World Universities" (WRWU), and this ranking system has become a popular way of measuring university excellence.

Non-alcoholic fatty liver disease (NAFLD), the most common cause of liver disease, affects approximately 75 to 100 million Americans. Patients with concurrent NAFLD and type 2 diabetes mellitus have a higher risk of progressing to advanced fibrosis and non-alcoholic steatohepatitis compared to non-diabetics. Lifestyle modifications, including weight loss, remain the mainstay of treatment for NAFLD, as there are no medications currently indicated for this disease state. Anti-diabetic pharmacologic therapies aimed at improving insulin sensitivity and decreasing insulin production have been studied to determine their potential role in slowing the progression of NAFLD. In this review, we focus on the evidence surrounding anti-diabetic medications and their ability to improve disease progression in patients with NAFLD.

We developed a 375-channel, whole-head magnetoencephalography (MEG) system (“BabyMEG”) for studying the electrophysiological development of human brain during the first years of life. The helmet accommodates heads up to 95% of 36-month old boys in the USA. The unique two-layer sensor array consists of: (1) 270 magnetometers (10 mm diameter, ∼15 mm coil-to-coil spacing) in the inner layer, (2) thirty-five three-axis magnetometers (20 mm × 20 mm) in the outer layer 4 cm away from the inner layer. Additionally, there are three three-axis reference magnetometers. With the help of a remotely operated position adjustment mechanism, the sensor array can be positioned to provide a uniform short spacing (mean 8.5 mm) between the sensor array and room temperature surface of the dewar. The sensors are connected to superconducting quantum interference devices (SQUIDs) operating at 4.2 K with median sensitivity levels of 7.5 fT/√Hz for the inner and 4 fT/√Hz for the outer layer sensors. SQUID outputs are digitized by a 24-bit acquisition system. A closed-cycle helium recycler provides maintenance-free continuous operation, eliminating the need for helium, with no interruption needed during MEG measurements. BabyMEG with the recycler has been fully operational from March, 2015. Ongoing spontaneous brain activity can be monitored in real time without interference from external magnetic noise sources including the recycler, using a combination of a lightly shielded two-layer magnetically shielded room, an external active shielding, a signal-space projection method, and a synthetic gradiometer approach. Evoked responses in the cortex can be clearly detected without averaging. These new design features and capabilities represent several advances in MEG, increasing the utility of this technique in basic neuroscience as well as in clinical research and patient studies.

In projects, a strategic component is to identify all risks that might influence their success, prevent and manage them effectively. Risk management is essential to add value to an investment and improve results. With the economic and financial crisis in recent years, increasingly, more companies have realized the importance of using a system of risk management, given the multitude of variables that can influence the success of a project. These include: legislative changes, global political and economic instability, natural disasters, climate change, human resources, liquidity risk, environmental impact, risk of erroneous calculation of total project costs, risk of failure into initial project schedule, prolongation risk, the risk of failure of internal rate of return (IRR) and net present value (NPV) etc. The study proposes a new method of risk assessment and management in the investments projects with environmental impact and its application in a case study. The method will take into consideration besides the economic and financial indicators, hard to be understood by smaller investors, a set of simple and important questions that they have to analyze before deciding to start an investment project. The new methodology will have a comprehensive approach from identifying the investment opportunity, writing investment project until its implementation. This will take into account macroeconomic variables and the microeconomic environment that can influence the success of project implementation. The main advantage of applying the new methodology are: knowing all the variables that influence the success of a project realization; awareness of the importance of applying an effective risks management related to investment projects with environmental impact, increasing the quality and success of projects.

Continuous improvement of customer (user) service is essential to successful development of business in today’s highly competitive, dynamic and complex business environment. There is no exception from it for philanthropic areas including libraries. Thus, this paper reviews the existing literature related to customer satisfaction in relation to service quality to identify the research issues and implications to establish further research avenues in the field. The study revealed that there is a consensus among service marketing researchers on the causal sequence/order of the concepts of customer satisfaction and service quality. Through conceptual improvement and empirical findings of past studies, most researchers have concurred on the fact that quality judgments cause satisfaction, leading to the finding on service quality being the antecedent of customer satisfaction. The formation of satisfaction in relation to service quality is generally based upon some significant theories identified in the literature and it recognised two dominant theoretical paradigms, disconfirmation and performance-only, which can be duly used for modelling customer satisfaction through the service quality perspective in organisations, enabling them to perform possible customer-led service quality evaluations. Secondly, the review more closely examined the potentiality of the prevalent service quality and customer satisfaction models which have been applied in the field of library and information services, such as SERVQUAL, SERVPREF and LibQUAL, understand the customer satisfaction process in the context of service quality. These models were, however, not adequately qualified to confirm their strong applicability for the modelling of the satisfaction process in libraries. Finally, the review concluded with fourteen research issues and their implications relating to library services in demonstrating the void of the prevailing body of knowledge, for new research avenues. Keywords: Customer satisfaction; User satisfaction; Service quality; User services; Library marketing; User modelling DOI: http://dx.doi.org/10.4038/jula.v15i1.3188 Journal of the University Librarians’ Association of Sri Lanka, Vol.15, Issue 1, June 2011; 23-82

Access to fresh international research is a prerequisite for meaningful research endeavor. With the objective of providing online scholarly information, the e-Information service was established in 2003 and it was quickly became the hart of the library services and a catalyst for change and collaboration. The e-Information service of the University of Colombo's leading edge resource based teaching and learning facility, provides a collaborative interdisciplinary environment where campus wide access is granted. Identification of CSFs and degree of user satisfaction towards the e-Information service were the objectives of this study. The method of collecting data was informal discussions with 10 postgraduate students, 05 undergraduate students and 8 lecturers who were familiar with using e-resources and where comfortable using IT in FGS, Education, Arts and Science faculties. Physical observations in e-Resource centers were also made. The data collection was preliminary focused on four key areas namely Infrastructure, Support, Resources and Patrons. Conducting e-Information Literacy Development Programmes, enhancing resource sharing activities, strengthening e-information acquisition and delivery procedures were important suggestions.DOI: http://dx.doi.org/10.4038/sllim.v2i2.441 Sri Lankan Journal of Librarianship and Information Management Volume 2, No.2 pp. 1-12 The full text of this article is available on the NILIS website.

It is well known that the conventional fuels are responsible for environmental pollution. On the other hand, the unconventional sources for energy and biofuels are more environmentally friendly with a lower pollution degree than the conventional ones. Following the European Union Directive 2003/30/EC regarding the use of biodiesel in mixture with conventional diesel and its gradual replacement, Romania has either to produce its own percentage of biodiesel for the mixture or to import it. In this paper, the authors intend to present the history of biodiesel production, and the future potential of biodiesel production in Romania, especially in the Northeast Region. The analysis covers economic, social, and pedo-climatic conditions for raw material crops for biodiesel production. Also in this paper are presented the main vegetable sources for biodiesel production and the most representative factories of biodiesel in Romania. The study is made from 2004 until present, the results have been presented by relevant graphics and tables.

This paper reviews the prevailing literature on Knowledge Management in banking industries. The purpose of KM is to value to information resides in organizations resulting value addition to their tasks and ultimately to approach competitive advantage. Most common KM applications identified in the banking industries are risk management. Customer Relationship Management/Marketing (CRM), performance evaluation etc, Decision Support Systems (DSS), data where houses and data mining are rapidly growing techniques in this particular sector. However, most banks around the world do not use comprehensive knowledge management systems while other financial organizations in the same disciplines do. Keywords: Knowledge Management, Ban king Industries, Information Management doi: 10.4038/jula.v12i0.329 Journal of the University Librarians Association of Sri Lanka (Vol. 12) 2008 p.68-84

Tuberous sclerosis complex (TSC) is a rare disorder of tissue growth and differentiation, characterized by benign hamartomas in the brain and other organs. Up to 90% of TSC patients develop epilepsy and 50% become medically intractable requiring resective surgery. The surgical outcome of TSC patients depends on the accurate identification of the epileptogenic zone consisting of tubers and the surrounding epileptogenic tissue. There is conflicting evidence whether the epileptogenic zone is in the tuber itself or in abnormally developed surrounding cortex. Here, we report the localization of the epileptiform activity among the many cortical tubers in a 4-year-old patient with TSC-related refractory epilepsy undergoing magnetoencephalography (MEG), electroencephalography (EEG), and diffusion tensor imaging (DTI). For MEG, we used a prototype system that offers higher spatial resolution and sensitivity compared to the conventional adult systems. The generators of interictal activity were localized using both EEG and MEG with equivalent current dipole (ECD) and minimum norm estimation (MNE) methods according to the current clinical standards. For DTI, we calculated four diffusion scalar parameters for the fibers passing through four ROIs defined: (i) at a large cortical tuber identified at the right quadrant, (ii) at the normal appearing tissue contralateral to the tuber, (iii) at the cluster formed by ECDs fitted at the peak of interictal spikes, and (iv) at the normal appearing tissue contralateral to the cluster. ECDs were consistently clustered at the vicinity of the large calcified cortical tuber. MNE and ECDs indicated epileptiform activity in the same areas. DTI analysis showed differences between the scalar values of the tracks passing through the tuber and the ECD cluster. In this illustrative case, we provide evidence from different neuroimaging modalities, which support the view that epileptiform activity may derive from abnormally developed tissue surrounding the tuber rather than the tuber itself.

This study presents effects of intravenous laser blood irradiation (ILBI) in a transient immunodeficiency patient with juvenile idiopathic arthritis (JIA) treated with an interleukin-6 receptor inhibitor (Tocilizumab). Biological agents induce JIA remission, but some patients do not respond favorably to this final therapeutic line of defense. ILBI was performed in a 16-year-old male patient, with JIA and transient immunodeficiency. When ILBI was introduced, the patient was receiving disease-modifying drugs, steroids, tocilizumab, and physical therapy. Because the disease was not well controlled, ILBI was applied in addition to other ongoing therapies. The patient underwent 1 session daily, and 10 successive sessions per month, repeated every 3 months, for 7 months. Patient evaluation was performed before ILBI was started and at 3, 6, 9, and 12 months after ILBI initiation, using the ACR Pediatric response. The outcome was evaluated using Pediatric 50, 70, and 90 responses and compared to initial status, after 3, 6, 9, and 12 months. At the end of study, the titre of IgA and IgG levels returned to normal. Synergistic anti-inflammatory effect of ILBI was evident, if applied additionally in combination with tocilizumab, in a patient with a therapy-resistant severe form of JIA and related subacute transient immunodeficiency.

Sublingual laser blood irradiation (SLBI) was applied into a randomized, single-blind, placebo-controlled study in juvenile idiopathic arthritis (JIA), aimed at inducing disease remission. 105 children with JIA, without an adequate response to classical treatment, were administrated a disease modifying drug (Methotrexate) and were randomly assigned to three groups. Group I (36 patients) received SLBI with the Weberneedle Lasershower Mouth Applicator with three wavelengths (635 nm, 536 nm, and 405 nm), 5 mW maximum output power each, in continuous mode, simultaneously, for 20 minutes daily, 7 successive sessions per month, repeated every 7 weeks, for three times. Group II (36 patients) received placebo SLBI. Group III (33 patients) received only treatment with Methotrexate. Evaluation was performed using American College of Rheumatology Pediatric criteria (ACR Pedi) at study enrollment and at 8, 16, 24, and 48 weeks. At the end of study, there was an improvement of the ACR Pedi 30 by 86.11% in SLBI group compared to only 61.11% in Group II, respectively, and 60.6% in Group III (P=0.001), with significant statistical differences. SLBI has reduced the pain, lowered the number of articulations with movement limitation, increased the quality of life, and made it possible to avoid the administration of biological agents.

A patient who had a small bowel mesentery perforation following insertion of a suprapubic catheter (SPC) is described. He had no bowel complaints immediately following the procedure, but presented 10 weeks later with insidious onset bowel obstruction due to the kink caused by the catheter. This complication occurred despite cystoscopy control and adequate bladder distension prior to the procedure. This isolated case illustrates the fact that regardless of the ease and frequency of SPC insertion, complications do occur.

This single-blind, placebo-controlled study assesses the efficacy of synergic administration of intravenous laser blood irradiation (ILBI) and etanercept in selected subtypes of juvenile idiopathic arthritis (JIA). Etanercept is a tumor necrosis factor alpha blocking agent with recognized importance in JIA. Laser radiation has immunomodulatory effects in animal and human studies. Fourteen patients (Group I) received ILBI and 9 patients (Group II) received placebo laser. ILBI was performed in addition to ongoing JIA medication, including etanercept. ILBI was administrated in 3 sets of 5 consecutive daily sessions, with a 7-week interval between every set of sessions. Evaluation was performed using ACR (American College of Rheumatology) Pediatric Criteria (ACR Pedi) at study enrollment and at 10 and 20 weeks, respectively. After 10 weeks, 85.7% of the patients in Group I fulfilled Pedi 30 criteria, compared to only 55.6% of the patients in Group II. After 20 weeks, all patients in both groups had a Pedi 30 response. In Group I, 92.8% of the subjects met the Pedi 50 response, compared to only 55.6% in the placebo group. One patient in Group I responded best, fulfilling Pedi 70 criteria. If applied synergistically, ILBI and etanercept would have an increased efficacy in promoting JIA remission.

Polytetrafluoroethylene or Gore-Tex sutures are used for chordal replacement, and are durable but extremely slippery, a property which causes knot slippage and ineffective neochordal length. We report a modification that is simple and reproducible in preventing knot slippage and maintaining optimal neochordal length, without the use of devices or additional sutures.

The concept of surgically restoring the ventricle to a near-normal physiologic geometry has been the goal of successful treatment of advanced heart failure due to left ventricular aneurysms following transmural myocardial infarctions [1]. The resulting geometry after surgical restoration has concerned a number of surgeons since the first successful repair in 1958, but little attention was placed on the altered geometry until attempts were made to effect a more physiologic aneurysmorrhaphy in 1973. Substantial attention was focused on a concept of geometric reconstruction from within the left ventricle in 1985 [2]. A prosthetic patch was employed with the concept to redirect normal muscle bundles to their original orientation and position. Further refinements include use of improved materials for the repair, preservation, and bypass of the left anterior descending coronary artery, ablation of ventricular arrhythmias when indicated, and the absence of prosthetic material used in contact with the pericardial surface. The previous chapters have dealt with the innovations in surgical technique which has led to an evolution toward greater normalcy in the restored ventricular geometry.

P796 – Figure 1 LP31 EEG and MEG source localization of the epileptogenic foci in tuberous sclerosis complex: a pediatric case report A. Hunold1, J. Haueisen1, B. Ahtam2,3, C. Doshi2,4, C. Harini4, S. Camposano4, S.K. Warfield5,6, P.E. Grant2,3,6, Y. Okada2,4, C. Papadelis2,4 1Technische Universitaet Ilmenau, Institute of Biomedical Engineering and Informatics, Ilmenau, Germany; 2Boston Children’s Hospital, Harvard Medical School, Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston, MA, United States; 3Boston Children’s Hospital, Harvard Medical School, Department of Newborn Medicine, Boston, MA, United States; 4Boston Children’s Hospital, Harvard Medical School, Department of Neurology, Boston, MA, United States; 5Boston Children’s Hospital, Harvard Medical School, Department of Radiology, Boston, MA, United States; 6Boston Children’s Hospital, Harvard Medical School, Computational Radiology Laboratory, Boston, MA, United States Question: Tuberous sclerosis complex (TSC) is a disorder of tissue growth and differentiation, characterized by benign hamartomas in the brain triggering epilepsy in up to 90% of TSC patients. There is an ongoing debate on whether or not the epileptogenic zone is within the tuber itself or in abnormally developed surrounding tissue. Methods: We examined a four-year old patient with TSC-related refractory epilepsy undergoing magnetoencephalography (MEG) and electroencephalography (EEG) recordings. For MEG, we used a prototype system that offers higher spatial resolution and sensitivity compared to the conventional adult systems. EEG was simultaneously recorded from 32-leads according to the 10-20 international system. The source analysis of interictal activity was performed using both EEG and MEG data. Equivalent current dipoles (ECD) were fitted to the peak of individual interictal spikes. For averaged interictal spike signals, we performed ECD localizations to the spike upslope. Further, we estimated the minimum norm estimates (MNEs) to averaged interictal spike signals. Results: Multiple cortical tubers were identified in patient’s MRI including one prominent calcified tuber in the right parietal-occipital lobe. The simultaneously recorded spikes in EEG and MEG data provided a time shift of 20 ms between peak latencies. ECDs localized to individual and averaged interictal activity in EEG and MEG consistently clustered in the millimeter Abstracts of Poster Presentations / Clinical Neurophysiology 125, Supplement 1 (2014) S1–S339 S175s of Poster Presentations / Clinical Neurophysiology 125, Supplement 1 (2014) S1–S339 S175 vicinity of the large calcified cortical tuber. The ECD trace localized to the averaged EEG data located on the posterior side ∼5 mm superior to the tuber. The ECD trace localized to the averaged MEG spike located ∼4 mm anterior to the tuber. MNE and ECDs indicated epileptiform activity in the same areas. Conclusion: Our source analysis indicated generators of epileptiform activity in the millimeter vicinity of the tuber margin outside the tuber volume. Separate EEG and MEG source analysis provided distinct source characteristics. LP32 Scalp EEG in malformations of cortical development (MDC). Analysis by localization S. Cieza, A. Gomez, F. Escobar, N. Pereira, C. Viteri, J. Artieda, E. Urrestarazu Clinica Universidad de Navarra, Neurophysiology, Pamplona, Spain Objectives: The aim of our study was to describe the EEG findings of the MDC according to the localisation in the MRI. Patients and methods: We analyze the scalpEEGs of the patients diagnosed of MDC by RM in the Clinica Universidad de Navarra, and we considerate: the background activity, the presence and regional localisation of focal slow waves, interictal epileptiform discharges and focal fast frequencies. Results: We identified 51 patients with MDC (31 women and 20 men). In 21 patients the MDC was located in the temporal lobe, 12 showed focal slow waves and 13 showed epileptiform discharges. These EEG abnormalities had a high topographic correlation with MRI findings (>80% for slow waves and>90% for epileptiform discharges). In 19 patients the lesion was located in the frontal lobe, and the EEG showed focal slow waves in 12 of these patients, and epileptiform discharges in 9; however, these abnormalities coincide with the location in the MRI in less than 50% of the cases. In 8 patients the lesion was located in the parietal lobe, and just in only one case the EEG abnormalities correctly identified the location showed by MRI. Finally in 3 patients the lesion was located in the occipital lobe, and EEG showed slow waves in one case and epileptiform discharges in 2 cases. Only 2 patients had theta-alpha rhythm and were well correlated with the MRI findings (frontal and temporal MDC). One patient with temporal lobe MDC had a no localising continuos beta rhythm. Conclusions: Most of the MDC were located in the temporal and frontal lobes. The slow waves and the epileptiform discharges were highly well localising when the lesion was located in the temporal lobe, but failed in more than 50% of the cases when it was extra temporal. Focal rhythms were rare but have a good correlation with dysplasia. Therefore the presence and locator value of the EEG abnormalities are highly dependent on the location of the focus. Poster session 27. ICU monitoring P472 Epileptiform activity in patients treated with therapeutic hypothermia after cardiac arrest C. Santos-Sanchez1, M. Agundez Sarasola2, X. Mancisidor Solaberrie3, A. Martin Lopez3, P. Goiriena Seijo3, T. Perez Concha2, I. Yurrebaso Santamaria1 1Cruces University Hospital, Clinical Neurophysiology, Barakaldo, Spain; 2Cruces University Hospital, Neurology, Barakaldo, Spain; 3Cruces University Hospital, Cardiology, Barakaldo, Spain Question: Since the implementation of therapeutic hypothermia (TH) after cardiac arrest (CA), some researchers have been trying to redefine the value of the parameters traditionally used as predictors of neurologic outcome. In this context, the EEG represents an important tool to improve prognostication in postanoxic coma. Methods: We retrospectively reviewed the electronic medical records of all patients undergoing TH after CA from January 2011 until October 2013. We identified the patients with any type of epileptiform activity and reviewed their EEGs. Results: Forty patients were included. Sixteen died (40%). Epileptiform activity was found in 11 patients (27.5%), from whom only 2 (18.2%) had a favorable outcome (CPC 1 or 2). This epileptiform activity appeared in the following patterns; 2 patients had isolated interictal discharges, 2 had 2-2.5 Hz generalized periodic epileptiform discharges (GPEDs) over a continuous, diffusely slowed background, 2 had 2-2.5 Hz GPEDs over a suppressed background and 6 fulfilled non convulsive status epilepticus (NCSE) criteria. In one of the patients with NCSE, the EEG evolved into the pattern of GPEDs at 2-2.5 Hz over a suppressed background. When treating these 3 patients with benzodiazepine trials, even though they remained comatose, the epileptiform discharges stopped, and a continuous theta background appeared. Two of these patients died eventually, and the other one remains in a persistent vegetative state. Conclusions: Epileptiform activity is common in comatose patients treated with TH after CA. The presence of epileptiform discharges during the TH or shortly after was associated with a poor outcome. P473 Defining EEG reactivity in patients treated with therapeutic hypothermia after cardiac arrest C. Santos-Sanchez1, M. Agundez Sarasola2, X. Mancisidor Solaberrie3, P. Goiriena Seijo3, A. Martin Lopez3, T. Perez Concha2, I. Yurrebaso Santamaria1 1Cruces University Hospital, Clinical Neurophysiology, Barakaldo, Spain; 2Cruces University Hospital, Neurology, Barakaldo, Spain; 3Cruces University Hospital, Cardiology, Barakaldo, Spain Question: In patients treated with therapeutic hypothermia (TH) after cardiac arrest (CA), the EEG reactivity in the first 24 hours has an important prognostic value. However, it has not been reported yet whether or not there are differences between the type of stimuli required or the reactivity patterns obtained. Methods: We prospectively assessed EEG background continuity and reactivity in 16 consecutive patients undergoing TH after CA from August 2012 to October 2013. EEG background reactivity was tested to auditory, tactile and painful stimuli. We analyzed the relation between the continuity of the background, the EEG reactivity patterns, and the neurologic outcome. Results: All of our patients had the first EEG done within 24 hours after the CA. We established 4 backgrounds categories; continuous, discontinuous, burst-suppression and low voltage, and 2 reactivity patterns; increase of faster frequencies and background attenuation. All survivors (11/16) had different degrees of background reactivity in the first EEG (

This study aimed at establishing service quality determinants which may affect customer satisfaction in university libraries in Sri Lanka. Using the literature, 113 service quality determinants were identified. These were then reviewed by eight focus groups in four different universities. Forty of the determinants were perceived to be applicable to their context. The participants also added 14 quality requirements which they thought were not provided for in the list. Finally, the content and face validity of the 54 determinants were evaluated by a panel of experts who ultimately reduced them to 50. This study recommends the use of the identified quality determinants by library administrators and policymakers in the higher education sector in Sri Lanka to gauge the levels of customer satisfaction and assure quality of service.

University library administrators in Sri Lanka have begun to search for alternative ways to satisfy their clientele on the basis of service quality. This article aims at providing a theoretical model to facilitate the identification of service quality attributes and domains that may be used to predict customer satisfaction from a service quality perspective. The effectiveness of existing service quality models such as LibQUAL, SERVQUAL and SERVPREF have been questioned. In that regard, this study developed a theoretical model for academic libraries in Sri Lanka based on the disconfirmation and performance-only paradigms. These perspectives were considered by researchers to be the core mechanism to develop service quality/customer satisfaction models. The attributes and domain identification of service quality was carried out with a stratified sample of 263 participants selected from postgraduate and undergraduate students and academic staff members from the faculties of Arts in four universities in Sri Lanka. The study established that responsiveness, supportiveness, building environment, collection and access, furniture and facilities, technology, Web services and service delivery were quality domains which can be used to predict customer satisfaction. The theoretical model is unique in its domain structure compared to the existing models. The model needs to be statistically tested to make it valid and parsimonious.

This paper introduces the general architecture of a prototype for monolingual Italian QA. The adopted strategies, the tools and resources for the linguistic processing are presented, together with the system results.

Letters not directly related to articles published in Clinical Medicine and presenting unpublished original data should be submitted for publication in this section. Clinical and scientific letters should not exceed 500 words and may include one table and up to five references. The central theme of

We present three applications which share some of their linguistic processor. The first application "FILES" - Fully Integrated Linguistic Environment for Syntactic and Functional Annotation - is a fully integrated linguistic environment for syntactic and functional annotation of corpora currently being used for the Italian Treebank. The second application is a shallow parser - the same used in FILES - which has been endowed with a feedback module in order to inform students about their grammatical mistakes, if any, in German. Finally an LFG-based multilingual parser simulating parsing strategies with ambiguous sentences. We shall present the three applications in that sequence.

A simplified method for measuring the director fluctuation intensity below the electrohydrodynamic instability in a thin layer of a nematic liquid crystal is presented.

Recently, pressure sensors that combine SOI structures with the properties of piezoelectric layers have been developed. With a SOI-MOSFET used as a transducer element, the sensor can detect pressures just over a threshold value, corresponding to the inversion onset. In this paper, a pseudo-MOS/SOI transistor is the transducer that enhances the work regime: accumulation or inversion for a SOI-MOSFET like regime and depletion for a J-FET like regime. A PZT layer is used for sensing the pressure. New analytical models for the sensor sensitivity in various regimes are presented. ATLAS simulations, based on the concept of "equivalent gate voltage", verify how does the sensor works and provide the current through the transducer. A strongly non-linear characteristic of the sensor results.