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Cancer incidence in Germany attributable to human papillomavirus in 2013

It is estimated that a total of 120,000 new cancer cases in men and in women in more developed countries could be avoided if exposure to HPV was prevented. We used the nationwide pool of German population-base...

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The association between high birth weight and the risks of childhood CNS tumors and leukemia: an analysis of a US case-control study in an epidemiological database

High birth weight (BW), 4000 g or larger, is an established risk factor for childhood leukemia. However, its association with central nervous system (CNS) tumor risk is yet unclear. The present study examined ...

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Methodological study to evaluate the psychometric properties of FACIT-CD in a sample of Brazilian women with cervical intraepithelial neoplasia

The occurrence of cervical intraepithelial neoplasia (CIN) is associated with changes in health-related quality of life, including psychological factors, such as fear and shame, and changes in sexuality and se...

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A systematic investigation of the maximum tolerated dose of cytotoxic chemotherapy with and without supportive care in mice

Cytotoxic chemotherapeutics form the cornerstone of systemic treatment of many cancers. Patients are dosed at maximum tolerated dose (MTD), which is carefully determined in phase I studies. In contrast, in mur...

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Characteristics and Outcomes of Vertebrobasilar Artery Dissection with Accompanied Atherosclerosis

Background: With the popularity of MRI use, vertebrobasilar artery dissection (VBD) has been found more frequently in patients with posterior circulation ischemic stroke (PCS). The relationship between VBD and atherosclerosis is unknown. The present study aimed to prove the hypothesis that PCS with pure VBD (p-VBD) and with VBD and accompanied cervical or cerebral artery atherosclerosis (a-VBD) have distinct manifestations. Methods: Patients with VBD-related PCS who were prospectively enrolled in the Taipei Veterans General Hospital Stroke Registry between January 1, 2010 and August 31, 2014 were recruited for the present study. Patients who had (1) atherosclerotic plaques with or without stenotic flow in cervical arteries on Duplex ultrasonography or (2) focal #x3e;30% stenosis in cerebral arteries other than the dissecting region (usually in arterial bifurcations which are prone to atheroma formation) on brain MRA were defined as a-VBD. Results: There were 91 patients (67 [73.6%] ma…

Improvement and Aggravation of Spontaneous Unruptured Vertebral Artery Dissection

Background: Intracranial vertebral artery dissection (VAD) is a well-recognized cause of stroke in young and middle-aged individuals, especially in Asian populations. However, a long-term natural course remains unclear. We investigated the long-term time course of VAD using imaging findings to examine the rate and predisposing factors for improvement. Methods: We registered 56 consecutive patients (40 males; mean age, 51.8 ± 10.7 years) with acute spontaneous VAD and retrospectively investigated neuroimaging and clinical course within 1 month and at 3 months ± 2 weeks, 6 months ± 2 weeks, and 12 months ± 2 weeks after onset to ascertain predisposing factors and time course for improvement. Results: The most common presenting symptoms were headache and/or posterior neck pain, seen in 41 patients (73%). Magnetic resonance imaging showed brainstem and/or cerebellum infarction in only 32 patients (57%). Of the 56 VADs, 16 (28%) presented with pearl and string sign, 5 (9%) with pearl sign,…

The Association of Quantitative Facial Color Features with Cold Pattern in Traditional East Asian Medicine

Introduction. Facial diagnosis is a major component of the diagnostic method in traditional East Asian medicine. We investigated the association of quantitative facial color features with cold pattern using a fully automated facial color parameterization system. Methods. The facial color parameters of 64 participants were obtained from digital photographs using an automatic color correction and color parameter calculation system. Cold pattern severity was evaluated using a questionnaire. Results. The values of the whole face, lower cheek, and chin were negatively associated with cold pattern score (CPS) (whole face: , ; lower cheek: , ; chin: , ), while value of the lower cheek was positively associated with CPS (, ). The values of the whole face were significantly correlated with specific cold pattern symptoms including cold abdomen (partial , ) and cold sensation in the body (partial , ). Conclusions. values of the whole face were negatively associated with CPS, indicating that indi…

Epidemiology of C2 Fractures in the 21st Century: A National Registry Cohort Study of 6,370 Patients from 1997 to 2014

Objective. C2 fractures are a common injury in the elderly population. Treatment is often complicated due to osteoporosis and patient comorbidity. This study aims to investigate the incidence and treatment trend of C2 fractures in Sweden. Methods. Patients with the principal and secondary diagnosis of fracture of the second vertebrae (ICD-10: S12.1) between 1997 and 2014 were identified in the Swedish National Patient Registry (NPR). Results. Between 1997 and 2014, 6,370 patients with a C2 fracture (51% male; age: ) were identified in the NPR. The incidence of C2 fractures increased from 3 to 6 per 100,000 (; ), mainly due to an increase of incidence in the geriatric subgroup (≥70 years). The percentage of surgically treated patients decreased from 1997 to 2014 (; ). Younger age, male gender, spinal cord injury, and earlier year of admission were associated with surgical treatment assignment. Discussion. This study documents a rising incidence of C2 fractures in the elderly during the…

Numerical Bounds on the Price of Anarchy

Theoretical upper bounds for price of anarchy have been calculated in previous studies. We present an empirical analysis for the price of anarchy for congested transportation networks; different network sizes and demand levels are considered for each network. We obtain a maximum price of anarchy for the cases studied, which is notably lower than the theoretical bounds reported in the literature. This result should be carefully considered in the design and implementation of road pricing mechanisms for cities.

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Towards Merging Binary Integer Programming Techniques with Genetic Algorithms

This paper presents a framework based on merging a binary integer programming technique with a genetic algorithm. The framework uses both lower and upper bounds to make the employed mathematical formulation of a problem as tight as possible. For problems whose optimal solutions cannot be obtained, precision is traded with speed through substituting the integrality constrains in a binary integer program with a penalty. In this way, instead of constraining a variable with binary restriction, is considered as real number between 0 and 1, with the penalty of , in which is a large number. Values not near to the boundary extremes of 0 and 1 make the component of large and are expected to be avoided implicitly. The nonbinary values are then converted to priorities, and a genetic algorithm can use these priorities to fill its initial pool for producing feasible solutions. The presented framework can be applied to many combinatorial optimization problems. Here, a procedure based on this framew…

Health leaders blame addiction for US opioid crisis

Alternative pain treatment options, reducing overprescribing, and destigmatizing misuse were among the potential solutions to the US opioid epidemic cited by healthcare leaders in a panel discussion...

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Locating helicopter emergency medical service bases to optimise population coverage versus average response time

New South Wales (NSW), Australia has a network of multirole retrieval physician staffed helicopter emergency medical services (HEMS) with seven bases servicing a jurisdiction with population concentrated along...

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Patient-reported quality-of-life outcomes after de-escalated chemoradiation for human papillomavirus-positive oropharyngeal carcinoma: Findings from a phase 2 trial

BACKGROUNDThe current study represents a subset analysis of quality-of-life (QOL) outcomes among patients treated on a phase 2 trial of de-escalated chemoradiation for human papillomavirus (HPV)-associated oropharyngeal cancer. METHODSEligibility included newly diagnosed, (American Joint Committee on Cancer, 7th edition) stage III or IV oropharyngeal squamous cell carcinoma, p16 positivity, age ≥ 18 years, and a Zubrod performance status of 0 to 1. Treatment was induction paclitaxel at a dose of 175 mg/m2 and carboplatin at an area under the curve of 6 for 2 cycles followed by response-adapted, dose-reduced radiation of 54 Gy or 60 Gy with weekly concurrent paclitaxel at a dose of 30 mg/m2. The University of Washington Quality of Life (UW-QOL) and the Functional Assessment of Cancer Therapy-Head and Neck questionnaires were used to assess patient-reported QOL as a secondary endpoint. RESULTSA total of 45 patients were registered, 40 of whom completed QOL surveys and were evaluable. Nadi…

Testing feasibility of an accurate microscopic assessment of macrovesicular steatosis in liver allograft biopsies by smartphone add-on lenses

AbstractLight microscopy is an essential tool in histological examination of tissue samples. However, the required equipment for a correct and rapid diagnosis is sometimes unavailable. Smartphones and mobile phone networks are widespread, and could be used for diagnostic imaging and telemedicine. Macrovesicular steatosis (MS) is a major risk factor for liver graft failure, and is only assessable by microscopic examination of a frozen tissue section. The aim of this study was to compare the microscopic assessment of MS in liver allograft biopsies by a smartphone with eyepiece adaptor (BLIPS device) to standard light microscopy. Forty liver graft biopsies were evaluated in transmitted light, using an Iphone 5s and 4 different mini-objective, add-on lenses. A significant correlation was reported between the two different approaches for graft MS assessment (Spearman's correlation coefficient: rs = 0.946; p < .001). Smartphone with eyepiece adaptor had similar discriminatory power t…

How to clean up the dirty water Puerto Ricans are drinking

Nearly a month after Hurricane Maria, many people on Puerto Rico are still without clean drinking water and have resorted to wells on a contaminated site

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Revisional Bariatric Surgery in Gastric Outlet Obstruction: A Minimalist Approach

by Fady Kamel, Ekua Yorke, and Christopher de Gara, MB, MS, FRCSC Christopher de Gara and Ekua Yorke are with the University of Alberta, Edmonton, Alberta, Canada and the Centre for the Advancement of Minimally Invasive Surgery, Edmonton, Alberta, Canada. Fady Kamel is with the University of Alberta, Edmonton, Alberta, Canada. Funding: No funding was provided. Disclosures: […]

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NHS boss reveals loss of further 162 000 pieces of medical correspondence

The loss of more than 700 000 items of NHS clinical correspondence, reported earlier this year,1 has been compounded after officials admitted that a further 162 000 patient files went missing over...

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Polarized Emission from Conjugated Polymer Chains Aligned by Epitaxial Growth during Off-Center Spin-Coating

Due to their macromolecular nature, conjugated polymers can be relatively easily aligned by applying a variety of processes resulting in either elongation or ordering of their conjugated backbones. Processes that induce chain alignment include electrospinning, mechanical rubbing, epitaxial growth, and nanoconfinement and unidirectional deposition techniques such as off-center spin-coating. In this study, we compare these deposition techniques by applying them to a green-emitting conjugated polymer material that exhibits liquid crystalline phase behavior. Our study reveals that while methods such as electrospinning and mechanical rubbing can be useful to locally generate polymer chain alignment, the combination of epitaxial growth using 1,3,5-trichlorobenzene as crystallizing agent with off-center spin-coating results in the formation of anisotropic nanofiber-like structures with enhanced crystallinity degree and polarized light-emission properties. The unidirectional epitaxial growth …

Candida Chorioamnionitis Leads to Preterm Birth and Adverse Fetal-Neonatal Outcome

Candida chorioamnionitis is rare but can lead to neonatal infection, high mortality, and neurodevelopmental impairment. We aimed to investigate maternal clinical features and perinatal outcomes and discuss future management strategies. We reviewed the medical records of women with Candida chorioamnionitis at our hospital over a 10-year period () and previous published case reports and case series. The most prevalent Candida species was C. albicans (71.3% of the all cases). The most prevalent predisposing condition was preterm premature rupture of membranes (31/123, 25.2%), followed by pregnancy with a retained intrauterine contraceptive device (26/123, 21.1%) and pregnancy after in vitro fertilization (25/123, 20.3%). Preterm labor was the most common symptom (52/123, 42.3%), and only 13% of cases involved fever. Of the infants, 27% of the singletons and 23.8% of the twins were born before 22 gestational weeks, while 60% of the singletons and 76.2% of the twins were born at 22–36 week…

Forecasting the Acquisition of University Spin-Outs: An RBF Neural Network Approach

University spin-outs (USOs), creating businesses from university intellectual property, are a relatively common phenomena. As a knowledge transfer channel, the spin-out business model is attracting extensive attention. In this paper, the impacts of six equities on the acquisition of USOs, including founders, university, banks, business angels, venture capitals, and other equity, are comprehensively analyzed based on theoretical and empirical studies. Firstly, the average distribution of spin-out equity at formation is calculated based on the sample data of 350 UK USOs. According to this distribution, a radial basis function (RBF) neural network (NN) model is employed to forecast the effects of each equity on the acquisition. To improve the classification accuracy, the novel set-membership method is adopted in the training process of the RBF NN. Furthermore, a simulation test is carried out to measure the effects of six equities on the acquisition of USOs. The simulation results show t…

Optimization of Production-Distribution Problem in Supply Chain Management under Stochastic and Fuzzy Uncertainties

Production-Distribution Problem (PDP) in Supply Chain Management (SCM) is an important tactical decision. One of the challenges in this decision is the size and complexity of supply chain system (SCS). On the other side, a tactical operation is a mid-term plan for 6–12 months; therefore, it includes different types of uncertainties, which is the second challenge. In the literature, the uncertain parameters were modeled as stochastic or fuzzy. However, there are a few studies in the literature that handle stochastic and fuzzy uncertainties simultaneously in PDP. In this paper, the modeling and solution approaches of PDP which contain stochastic and fuzzy uncertainties simultaneously are investigated for a SCS that includes multiple suppliers, multiple products, multiple plants, multiple warehouses, multiple retailers, multiple transport paths, and multiple time periods, which, to the best of the author's knowledge, is not handled in the literature. The PDP contains deterministic, f…

IJERPH, Vol. 14, Pages 1235: Physiological and Perceptual Responses to Nordic Walking in a Natural Mountain Environment

IJERPH, Vol. 14, Pages 1235: Physiological and Perceptual Responses to Nordic Walking in a Natural Mountain EnvironmentInternational Journal of Environmental Research and Public Health doi: 10.3390/ijerph14101235Authors: Alessandro Grainer Livio Zerbini Carlo Reggiani Giuseppe Marcolin James Steele Gaspare Pavei Antonio PaoliBackground: Interest around Nordic Walking (NW) has increased in recent years. However, direct comparisons of NW with normal walking (W), particularly in ecologically valid environments is lacking. The aim of our study was to compare NW and W, over long distances in a natural mountain environment. Methods: Twenty one subjects (13 male/8 female, aged 41 ± 12 years, body mass index BMI 24.1 ± 3.7), walked three distinct uphill paths (length 2.2/3.4/7 km) with (NW) or without (W) walking poles over two separate days. Heart rate (HR), energy expenditure (EE), step length (SL), walking speed (WS), total steps number (SN) and rating of perceived exertion (RPE) were moni…

IJERPH, Vol. 14, Pages 1238: China’s Insurance Regulatory Reform, Corporate Governance Behavior and Insurers’ Governance Effectiveness

IJERPH, Vol. 14, Pages 1238: China's Insurance Regulatory Reform, Corporate Governance Behavior and Insurers' Governance EffectivenessInternational Journal of Environmental Research and Public Health doi: 10.3390/ijerph14101238Authors: Huicong Li Hongliang Zhang Sang-Bing Tsai Aichao QiuExternal regulation is an important mechanism to improve corporate behavior in emerging markets. China's insurance governance regulation, which began to supervise and guide insurance corporate governance behavior in 2006, has experienced a complex process of reform. This study tested our hypotheses with a sample of 85 firms during 2010–2011, which was obtained by providing a questionnaire to all of China's shareholding insurance companies. The empirical study results generally show that China's insurance governance effectiveness has significantly improved through strict regulation. Insurance corporate governance can improve business acumen and risk-control ability, but no significan…

IJERPH, Vol. 14, Pages 1239: Trends and Weekly Cycles in a Large Swiss Emergency Centre: A 10 Year Period at the University Hospital of Bern

IJERPH, Vol. 14, Pages 1239: Trends and Weekly Cycles in a Large Swiss Emergency Centre: A 10 Year Period at the University Hospital of BernInternational Journal of Environmental Research and Public Health doi: 10.3390/ijerph14101239Authors: Christian Braun Cornelia Gnägi Jolanta Klukowska-Rötzler Sufian Ahmad Meret Ricklin Aristomenis ExadaktylosPopular demand for high quality care has increased in recent years. This is also the case for medical services and support at all times of the day and night is nowadays required. During the last ten years, there has been a marked increase in the demands on hospital emergency hospitals, particularly in the Western industrialized countries. The present retrospective study investigates how the demands on a large Swiss university centre have changed over a period of 10 years. Patient numbers are differentiated by age, gender, nationality, weekday and mode of referral. A retrospective analysis was performed of the data of the patients admitted to …

IJERPH, Vol. 14, Pages 1241: Dampness and Moisture Problems in Norwegian Homes

IJERPH, Vol. 14, Pages 1241: Dampness and Moisture Problems in Norwegian HomesInternational Journal of Environmental Research and Public Health doi: 10.3390/ijerph14101241Authors: Rune Becher Anja Hortemo Høie Jan Vilhelm Bakke Sverre Bjørn Holøs Johan ØvrevikThe occurrence of dampness and mold in the indoor environment is associated with respiratory-related disease outcomes. Thus, it is pertinent to know the magnitude of such indoor environment problems to be able to estimate the potential health impact in the population. In the present study, the moisture damage in 10,112 Norwegian dwellings was recorded based on building inspection reports. The levels of moisture damage were graded based on a condition class (CC), where CC0 is immaculate and CC1 acceptable (actions not required), while CC2 and CC3 indicate increased levels of damage that requires action. Of the 10,112 dwellings investigated, 3125 had verified moisture or mold damage. This amounts to 31% of the surveyed dwellings. O…

IJMS, Vol. 18, Pages 2158: Quantitative Phosphoproteomic Analysis Provides Insight into the Response to Short-Term Drought Stress in Ammopiptanthus mongolicus Roots

IJMS, Vol. 18, Pages 2158: Quantitative Phosphoproteomic Analysis Provides Insight into the Response to Short-Term Drought Stress in Ammopiptanthus mongolicus RootsInternational Journal of Molecular Sciences doi: 10.3390/ijms18102158Authors: Huigai Sun Bolin Xia Xue Wang Fei Gao Yijun ZhouDrought is one of the major abiotic stresses that negatively affects plant growth and development. Ammopiptanthus mongolicus is an ecologically important shrub in the mid-Asia desert region and used as a model for abiotic tolerance research in trees. Protein phosphorylation participates in the regulation of various biological processes, however, phosphorylation events associated with drought stress signaling and response in plants is still limited. Here, we conducted a quantitative phosphoproteomic analysis of the response of A. mongolicus roots to short-term drought stress. Data are available via the iProx database with project ID IPX0000971000. In total, 7841 phosphorylation sites were found from t…

IJMS, Vol. 18, Pages 2161: Cold Treatment Induces Transient Mitochondrial Fragmentation in Arabidopsis thaliana in a Way that Requires DRP3A but not ELM1 or an ELM1-Like Homologue, ELM2

IJMS, Vol. 18, Pages 2161: Cold Treatment Induces Transient Mitochondrial Fragmentation in Arabidopsis thaliana in a Way that Requires DRP3A but not ELM1 or an ELM1-Like Homologue, ELM2International Journal of Molecular Sciences doi: 10.3390/ijms18102161Authors: Shin-ichi Arimura Rina Kurisu Hajime Sugaya Naoki Kadoya Nobuhiro TsutsumiThe number, size and shape of polymorphic plant mitochondria are determined at least partially by mitochondrial fission. Arabidopsis mitochondria divide through the actions of a dynamin-related protein, DRP3A. Another plant-specific factor, ELM1, was previously shown to localize DRP3A to mitochondrial fission sites. Here, we report that mitochondrial fission is not completely blocked in the Arabidopsis elm1 mutant and that it is strongly manifested in response to cold treatment. Arabidopsis has an ELM1 paralogue (ELM2) that seems to have only a limited role in mitochondrial fission in the elm1 mutant. Interestingly, cold-induced mitochondrial fragmentati…

IJMS, Vol. 18, Pages 2168: Molecular Aspects of Circadian Pharmacology and Relevance for Cancer Chronotherapy

IJMS, Vol. 18, Pages 2168: Molecular Aspects of Circadian Pharmacology and Relevance for Cancer ChronotherapyInternational Journal of Molecular Sciences doi: 10.3390/ijms18102168Authors: Narin Ozturk Dilek Ozturk Ibrahim Halil Kavakli Alper OkyarThe circadian timing system (CTS) controls various biological functions in mammals including xenobiotic metabolism and detoxification, immune functions, cell cycle events, apoptosis and angiogenesis. Although the importance of the CTS is well known in the pharmacology of drugs, it is less appreciated at the clinical level. Genome-wide studies highlighted that the majority of drug target genes are controlled by CTS. This suggests that chronotherapeutic approaches should be taken for many drugs to enhance their effectiveness. Currently chronotherapeutic approaches are successfully applied in the treatment of different types of cancers. The chronotherapy approach has improved the tolerability and antitumor efficacy of anticancer drugs both in exp…

IJMS, Vol. 18, Pages 2157: TGF-β-Induced Endothelial-Mesenchymal Transition in Fibrotic Diseases

IJMS, Vol. 18, Pages 2157: TGF-β-Induced Endothelial-Mesenchymal Transition in Fibrotic DiseasesInternational Journal of Molecular Sciences doi: 10.3390/ijms18102157Authors: Evangelia Pardali Gonzalo Sanchez-Duffhues Maria Gomez-Puerto Peter ten DijkeFibrotic diseases are characterized by net accumulation of extracellular matrix proteins in affected organs leading to their dysfunction and ultimate failure. Myofibroblasts have been identified as the cells responsible for the progression of the fibrotic process, and they originate from several sources, including quiescent tissue fibroblasts, circulating CD34+ fibrocytes and the phenotypic conversion of various cell types into activated myofibroblasts. Several studies have demonstrated that endothelial cells can transdifferentiate into mesenchymal cells through a process termed endothelial- mesenchymal transition (EndMT) and that this can give rise to activated myofibroblasts involved in the development of fibrotic diseases. Transforming…

IJMS, Vol. 18, Pages 2160: Impact of Natural Compounds on DNA Methylation Levels of the Tumor Suppressor Gene RASSF1A in Cancer

IJMS, Vol. 18, Pages 2160: Impact of Natural Compounds on DNA Methylation Levels of the Tumor Suppressor Gene RASSF1A in CancerInternational Journal of Molecular Sciences doi: 10.3390/ijms18102160Authors: Reinhard Dammann Antje Richter Adriana Jiménez Michelle Woods Miriam Küster Chamindri WitharanaEpigenetic inactivation of tumor suppressor genes (TSG) is a fundamental event in the pathogenesis of human cancer. This silencing is accomplished by aberrant chromatin modifications including DNA hypermethylation of the gene promoter. One of the most frequently hypermethylated TSG in human cancer is the Ras Association Domain Family 1A (RASSF1A) gene. Aberrant methylation of RASSF1A has been reported in melanoma, sarcoma and carcinoma of different tissues. RASSF1A hypermethylation has been correlated with tumor progression and poor prognosis. Reactivation of epigenetically silenced TSG has been suggested as a therapy in cancer treatment. In particular, natural compounds isolated from herba…

IJMS, Vol. 18, Pages 2169: Replacing Nitrogen by Sulfur: From Structurally Disordered Eumelanins to Regioregular Thiomelanin Polymers

IJMS, Vol. 18, Pages 2169: Replacing Nitrogen by Sulfur: From Structurally Disordered Eumelanins to Regioregular Thiomelanin PolymersInternational Journal of Molecular Sciences doi: 10.3390/ijms18102169Authors: Mariagrazia Iacomino Juan Mancebo-Aracil Mireia Guardingo Raquel Martín Gerardino D'Errico Marco Perfetti Paola Manini Orlando Crescenzi Félix Busqué Alessandra Napolitano Marco d'Ischia Josep Sedó Daniel Ruiz-MolinaThe oxidative polymerization of 5,6-dihydroxybenzothiophene (DHBT), the sulfur analog of the key eumelanin building block 5,6-dihydroxyindole (DHI), was investigated to probe the role of nitrogen in eumelanin build-up and properties. Unlike DHI, which gives a typical black insoluble eumelanin polymer on oxidation, DHBT is converted to a grayish amorphous solid (referred to as thiomelanin) with visible absorption and electron paramagnetic resonance properties different from those of DHI melanin. Mass spectrometry experiments revealed gradational mixtures of o…

A Novel SHLNN Based Robust Control and Tracking Method for Hypersonic Vehicle under Parameter Uncertainty

Hypersonic vehicle is a typical parameter uncertain system with significant characteristics of strong coupling, nonlinearity, and external disturbance. In this paper, a combined system modeling approach is proposed to approximate the actual vehicle system. The state feedback control strategy is adopted based on the robust guaranteed cost control (RGCC) theory, where the Lyapunov function is applied to get control law for nonlinear system and the problem is transformed into a feasible solution by linear matrix inequalities (LMI) method. In addition, a nonfragile guaranteed cost controller solved by LMI optimization approach is employed to the linear error system, where a single hidden layer neural network (SHLNN) is employed as an additive gain compensator to reduce excessive performance caused by perturbations and uncertainties. Simulation results show the stability and well tracking performance for the proposed strategy in controlling the vehicle system.

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Injecting drug use continues in older drug users too

Rao and Roche note that the number of people aged over 50 who have substance misuse problems is rising globally across a range of settings.1 This rise also applies to people who inject drugs, at...

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James Paget Stanfield

bmj;359/oct17_7/j4771/FAF1faThere is something very end of empire about a British paediatrician lying on the floor in Idi Amin's Uganda, simultaneously listening to gunfire outside and an eminent...

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The future of the Quality and Outcomes Framework in England

To describe the Quality and Outcomes Framework (QOF)—one of the most ambitious pay-for-performance schemes introduced into any health system—as divisive would be an understatement. Launched in the UK...

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