The current study analyzes a subset of patients in whom

The current study analyzes a subset of patients in whom considerable effort would be required to avoid re-detachment or even achieve primary attachment with a single surgery using scleral buckling alone. Large series have already been published on minimal scleral buckling. This study gives a focused analysis of patients who received two or more radial buckle segments, without circumferential silicone bands, encircling procedures and external drainage in the era of modern vitrectomy. Over a third of the patients were pseudophakes, but subset analysis did not seem to suggest failure in this group. Long term follow up of these patients shows that nearly all patients (24/25, 96%) did well both in terms of visual recovery and anatomic success. One patient who developed a buckle infection required vitrectomy and endo-tamponade after explantation of the sponge; this however, happened five years after the primary buckling procedure. Most series that look at complications of buckling analyze patients who underwent hydrogel implants. Finally, radial buckles would probably cause lesser alterations in the morphology and biomechanical properties of the cornea as opposed to encerclage. Encircling surgery can alter corneal hysteresis and corneal resistance factor measurements, although it is not associated with a significant change in corneal morphology. This can lead to altered intraocular pressure measurements and can be avoided with radial buckling surgery.
Finally, one patient developed a buckle infection and had to undergo buckle removal. The R-115777 redetached one month after the buckle removal and required endo-tamponade. Re-detachments following buckle explantation is not unknown; while in some cases it occurs due to inadvertent perforation, in some cases the cause may not be identified. In our series, this probably occurred due to persistent traction at the site of the break and because of the loss of external indentation secondary to buckle removal.

Conflict of interest

Glaucoma is a leading cause of blindness and vision loss. It is the most frequent cause of irreversible blindness worldwide and the second most frequent cause of irreversible blindness worldwide after cataract and therefore improved methods of screening and therapy for glaucoma are urgently needed. Persistent high intraocular pressure which characterizes this condition, can lead to worsening of the disease. Currently, there are many drugs available for lowering IOP acting through various mechanisms; however, for adequate control of the IOP along with the minimal side effects, new drugs are the need of the hour.
Coleus forskohlii is an aromatic herb growing all over India from the Himalayas to Southern India. From the roots of this plant is extracted forskolin and it has been studied over the last three decades as a very interesting biological tool.
Current treatment for glaucoma includes beta-blockers and prostaglandin analogues. Beta blockers show systemic side effects that affect the heart and lungs while the increased iris pigmentation with prostaglandin analogues is a disadvantage. A need exists for new ocular hypotensive agents that are more efficacious and have fewer side effects than those used currently. Results from previous pilot exploratory studies indicate that forskolin eye drops may improve the overall symptoms of glaucoma. The current study on forskolin 1% eye drops, confirms the efficacy of the product over a large sample size, and could be an alternative in asthmatic patients having glaucoma, who are contradicted to use conventional beta blockers.

Materials and methods
The clinical study was approved by the Drug Controller General of India (DCGI), New Delhi and the trial was conducted in accordance with the Good Clinical Practice guidelines and by adhering to all the tenets of the Declaration of Helsinki. Forskolin 1% eye drops study material was supplied by the manufacturer Sami Labs Limited, India, This trial involved 90 adult patients screened and enrolled at three clinical centers across India. With respective Institutional Ethics Committee approvals, patients diagnosed with open angle glaucoma with an IOP of more than 24mm/Hg, who had not received miotic therapy for 24h and systemic therapy for at least 4days, were enrolled. The nature and purpose of the trial were explained in detail to all participants and their informed consent was obtained, in writing.

Histopathology Fig showed fibrous thickening

Histopathology (Fig. 3) showed fibrous thickening of the dura and arachnoid around the nerve with large collections of meningiothelial STA9090 manufacturer between the two layers with occasional psammoma bodies within the cellular collections. The meningiothelial cells show immunoperoxidase staining for progesterone receptors with a negligible proliferation rate with virtually no staining for Ki67. Taken altogether, this was consistent with an ONSM. No invasion of the optic nerve was noted. No subdural involvement of the meningioma was seen at either end of the nerve segment. Thus far, the patient has been followed up over a 12month period and is recovering well.

Our case demonstrated unusual radiological features of a histologically confirmed ONSM. The largest case series on record of ONSM describes five radiological patterns commonly encountered. The commonest pattern identified was tubular (62% of cases), with subgroups of diffuse (45%), apical expansion (15%) and anterior expansion (3%), which had minimal widening of the optic nerve and more frequent evidence of calcification. The second group was globular tumors (23%) where growth was outside the dural sheath causing significant proptosis. 11% displayed a fusiform pattern and 4% had a focal enlargement of the optic nerve. The radiological appearance of the ONSM in our case did not conform to any of the known patterns; rather, it appeared as a distinct band-like structure that displaced the optic nerve.
Previous ionizing radiation is a known cause of ONSM. Such secondary meningiomas tend to present at a younger age, present with multiple lesions commonly arising from the sphenoid ridge, tuberculum sellae or olfactory groove and demonstrate a higher recurrence rate. Histopathology also suggests that they tend to be more aggressive, with a higher tendency toward malignancy in patients who had high nose radiation therapy. This knowledge played a role in the decision made by our well-informed patient.
Canalicular ONSM can often pose a diagnostic challenge for clinicians as very small lesions can compress the optic nerve and cause significant and progressive visual symptoms because the bony canal walls limit expansion. Reports have shown diagnostic delays of greater than 1year due to this variability in radiological appearance. It is strongly recommended that all cases of progressive visual loss be investigated by high-spatial-resolution MR of the orbit before and after contrast enhancement in combination with fat suppression.
Recent literature reviews support the safety of fractionated radiotherapy in the treatment of ONSM.

Patient consent

Conflict of interests and source of funding

Morning glory syndrome (MGS) is an uncommon and unilateral congenital anomaly which was coined by Kindler in 1970. The appearance of the anomaly was so similar to the tropical morning glory flower; therefore, this name was chosen. It is a funnel-shaped excavation of the posterior pole involving the optic disk. The excavation is filled with a white tuft of glial tissue and surrounded by a pigment ring. The number of retinal vessels is increased, and amniocentesis appear to arise from the periphery of the disk, and tend to run to the peripheral retina. Choroidal neovascularization (CNV) secondary to congenital optic nerve abnormalities is a rare cause of visual loss in children. In this case report we aimed to present the clinical and therapeutic outcomes of a 7-year-old boy with unilateral CNV secondary to MGS.

Case report
A 7-year-old boy was admitted with the complaint of decreased visual acuity since 5days in the right eye. Systemic evaluation was not notable; therefore, cranial magnetic resonance imaging (MRI) was not obtained. He had a history of amblyopia in his right eye. His family history was not significant. On ocular examination, best corrected visual acuity (BCVA) was 20/100 in the right eye and 20/20 in the left eye. Slit lamp examination of the anterior segment did not show any abnormality and intraocular pressure was within normal limits in both eyes. Fundus examination revealed a morning glory disk and a yellowish subretinal lesion at the temporal margin of the optic disk in the right eye (Fig. 1a). The fundus examination was not notable in the left eye. Optical coherence tomography (OCT) revealed a peripapillary choroidal neovascularization (CNV) associated with intraretinal fluid at the temporal margin of the optic disk in the right eye (Fig. 1). Fluorescein angiography (FA) showed the staining of the peripapillary CNV and a mild leakage (Fig. 2). Based on ocular findings and the history, the patient was diagnosed as peripapillary CNV secondary to morning glory syndrome. Informed consent for intravitreal ranibizumab injection was obtained from the parents, and 0.5mg/0.05ml intravitreal ranibizumab injection was then performed under general anesthesia. There was no complication related to the injection. After 4weeks of treatment, BCVA improved to 20/50, and intraretinal fluid decreased significantly (b). The patient was then called for monthly follow-up visits, and the peripapillary CNV did not show any kind of activity (subretinal fluid, intraretinal fluid, visual loss, hemorrhage) for the next 12months.

Three quarters of the participants reported visiting the dentist Out

Three quarters of the participants reported visiting the dentist. Out of those who reported never visiting the dentist, 12% attributed this to dental fear while the rest attributed this to the fact that they never felt pain. Of those who reported visiting the dentist, 50% did so during the 6months prior to completing the questionnaire and 50% attributed the visits to dental pain. Out of total, 97% of participants reported being non-smokers. One third of participants had heard about dental caries and knew that sweet intake is linked to dental caries. More than half of the participants were unaware about role of fluoride in caries prevention. Fifty-six percent of participants were aware that dental bleeding is a primary sign of poor oral health and more than half considered that poor oral health can affect general health. Sixty six percent of participants considered that it is necessary to visit the dentist every 6months (Table 3). Chi square was run to estimate the significance of association between knowledge about oral health and gender. There was a statistically significant difference (in favor of females) related to the knowledge about bleeding gums, oral health effects general health and dental visit in 6months with the P value of <0.001, <0.05 and 0.017, respectively (Table 2). Our study also showed that 69% of participants were satisfied with their dentist. Out of 287 participants, 59% had heard about dentist and oral health from Cy5.5 NHS ester and more than half had never used the internet to search for information about oral health (Fig. 1).
Three third of the participants were worried about teeth color and halitosis. More than half considered healthy teeth means strong and caries-free teeth. When we compared genders with respect to attitudes regarding dental health we found that three fourth of the girls were worried about bad breath and tooth color (Table 3). Boys and girls reported similar levels of attitudes toward dental health. One exception was being worried about tooth color, which was reported more among females with chi-squared test showing a borderline significance for such difference (Table 3). Around half of the participants reported attending oral health education programs and 40% reported attending such events in their own schools (Fig. 2).

In literature, knowledge and awareness about oral health is reported to be very low and marked differences in oral hygiene habits, depending on age and educational levels were observed. Studies conducted in Spain and Kuwait showed an association between increased knowledge and better oral health. Good oral health practice can be accomplished mainly through self-induced habits like maintenance of dental hygiene, restriction of diet especially reduced sugar intake, use of fluoridated products and also with the help of available dental services, which includes, regular dental checkup, utilization of primary and preventive care and dental health education. It is important to prevent dental problems before they start. The easiest way is to practice daily brushing and flossing that in turn will reduce the dental diseases. In our study the prevalence of daily brushing is reported as 66.5%. A figure which is similar to that reported in a Saudi study conducted in 2003 and found that 65% of students were doing brushing at least once. The same study reported that private school students had a better dental hygiene practice and that age was inversely related to oral health practices. While in our study, we found that both age and type of schooling were not significantly related to the habit of tooth brushing. Our results are consistent with a Chinese study that assessed oral health behavior in schoolchildren and reported that, around 22% of the 12-year-old group brushed at least twice a day, 62% reported brushing frequency to be once a day and it was observed that 16% never brushed or brushed less frequently.
Our study reported that three fourth of students were using tooth brush as a tool for brushing and use of miswak was not very commonly used by the study participants while a study conducted in 2008 among 1115 male students in Al Hasa Saudi Arab reported that 45% of students were using miswak as a brushing tool. This might be attributed to either difference in either venues or the timings in both studies. Our study reported that the study participants did not frequently use oral rinses and floss. The results are consistent with the findings of a study conducted in 2003 in Riyadh, which reported that only 5.1% of students were using dental floss, indicating that importance of the use of floss and mouth rinses is still underestimated among Saudi young population. Our results showed that more than half of the students consider that dental visits should be conducted every 6months and three fourth of the student had visited the dentist. Our results showed growth in the knowledge and practices related to oral health when comparing with the findings of studies conducted in past year, although this might be attributed to differences in demographics (mainly geographic regions) of population studies. A study conducted in 2011 in Madina among 240-student children reported less than half of the participant (45%) visits dentist annually.

br Numerical examples Time histories of the displacement

Numerical examples
Time histories of the displacement of the rotating shaft midpoint are presented in Figures 4–7, where only the first mode is excited and . In Figures 4 and 5, only plane has been excited by the initial displacement, i.e. . But, there is vibration in plane (Figure 5). The reason is due to the presence of the gyroscopic effect in Eq. (14). When one plane is excited, the other plane, due to the gyroscopic effect, oscillates too. The data in Figures 6 and 7 is the same as Figure 4, except that ginsenoside rg3 the rotary inertia and, consequently, the gyroscopic term, are neglected . Figure 6 is similar to Figure 4. But, Figure 7 shows that plane does not oscillate. To validate the results of the perturbation solution, the numerical method has been used in Figures 4–7. Both methods agree very well.
In Figure 8, forward and backward amplitudes ( and ) are plotted versus time with earlier data. Because of the damping, amplitudes decay. In addition, both forward and backward amplitudes have close values and curves are coincident, approximately.
Eq. (31) shows that the natural frequencies have two parts: the first, constant parts and , which are linear natural frequencies, the second, the parts that depend on the amplitudes, and consequently on time. Here, nonlinear natural frequencies are defined as:
The nonlinear natural frequencies are functions of and , as well as time. So, to investigate the effects of parameters, and , on the nonlinear natural frequencies, one may set the time on a specified value (e.g. ) and then examine the effects of these parameters. Here, forward and backward nonlinear natural frequencies are defined as: where and are determined from the initial conditions: . FNNF and BNNF, as a function of rotating speed , are shown in Figures 9 and 10 for the first two modes . In both modes, FNNF curves increase and BNNF curves decrease as the rotating speed increases, for all values of . For the same data, the values of FNNF are larger than BNNF. Also, the values of FNNF and BNNF, for the first mode, are smaller than those for the second mode. It is seen from the figures that due to the gyroscopic effects, if rotating speed changes, the change rates of FNNF and BNNF are higher for the larger values of .
In Figures 11 and 12, FNNF and BNNF are plotted versus external damping, “”, for different values of . Only the first two modes are considered. It is observed from the figures that the general characteristics of the curves are similar, and the rate changes of FNNF and BNNF, with respect to external damping, are small. For small ginsenoside rg3 “”, FNNF and BNNF have small values and have sharp changes as “” changes. For large values of “”, FNNF and BNNF change slowly.

Comparison between nonlinear natural frequency of a rotating shaft with stretching nonlinearity and a rotating shaft with nonlinearities in curvature and inertia
In this section, we compare the effects of stretching and in-extensionality on the free vibration of a rotating shaft. Hosseini and Khadem [15] investigated the free vibration of a rotating shaft with nonlinear curvature and inertia. To derive the equations of motion, community succession used the in-extensionality assumption. Since one of the shaft supports was free in an axial direction, this assumption was applicable. In this paper, both supports are fixed in an axial direction and a stretching assumption has been used. We compare the effects of these two types of nonlinearity on the free vibration of a rotating shaft.
From Eq. (42) of Hosseini and Khadem [15], the analytical solution for the free vibration of an in-extensional rotating shaft is: where: All parameters and variables used in the above equations were defined in Hosseini and Khadem [15]. Here, the analysis is carried out for a forward nonlinear natural frequency; the backward case is similar. To find a simple approximation for the nonlinear natural frequency, the quantity, , is expanded in a Taylor series about up to the first order, as: So, an approximation for the nonlinear natural frequency becomes: where (Hosseini and Khadem [15]): In addition, we have: which is due to the nonlinear inertia effect and: which is due to the nonlinear curvature effect.

Amyloid Beta-Peptide (1-40) Figure shows the free surface flow over the stepped

Figure 7 shows the free surface flow over the stepped spillway in experiments, VOF and mixture numerical models. It is apparent that the mixture model flow field shows a better agreement with experiments than the VOF model. The reason is that in the explicit VOF model, the air cannot diffuse to the water, and the boundaries of the water and air are separate. In the mixture model, no obvious boundary is apparent between the water and air phase, and the flow field shows the aeration. In this figure, the contour of the volume fraction is shown and the value of 0.5 can be assumed for the boundary between water and air.
Figure 8 shows the vortex generated in the steps with the mixture model and this vortex causes more dissipation of Amyloid Beta-Peptide (1-40) in each step. Figure 9 depicts the depth at which the air volume concentration is 0.9. The negative pressure positions on the steps in the mixture model are depicted in Figure 10. These positions are the critical positions where cavitating flow may be occurred, and should be analyzed for this phenomenon.
After deducing that the mixture model can predict results better than the VOF model, the above example, again, has been solved with various types of two-equation Eddy-Viscosity, such as Standard , Realizable , RNG (RENORMALIZED GROUP) , Standard –, SST (Shear Stress Transport) – models and also the RSM model, in order to achieve the best turbulence model.
The simplest and most complete scheme in turbulence models are two-equation models, in which two separate transport partial differential equations for the kinetic energy of turbulence and the length scale or turbulence dissipation rate are solved. In the RSM model, each term of Reynolds stress is calculated using a transport partial differential equation and one additional partial differential equation is used for solving the dissipation rate. The RSM model usually has more ability in modeling turbulent flow; however, it increases the computational time  [18].
In Table 3, the total velocity and head loss in all turbulence models are compared with the experiments and it is obvious that the minimum error belongs to the RSM (Low-Re Stress-Omega) model and that it is superior to other models. In Table 3, is the difference between the numerical and experimental results of each model.
In this part of the study, a new design for a step-pool spillway is numerically analyzed. Mardashti  [10] designed six types of new step-pool spillway and experimentally analyzed them. He has reported that among his models, types 4 and 5 are the optimal types. The basic difference between these two types is in the coefficient, , of the ogee spillway curve relation, which is as follows:
General principles of step-pool spillway architecture, which are depicted in Figure 11, are as follows:
In this research, in addition to analyzing types 4 and 5 with slopes of 18.8 and 28, which are reported experimentally  [10], some new step-pool spillways of type 4 with slopes of 35°, 40°, 45°and 50° have been designed and numerically analyzed. Table 4 shows the characteristics of different models of step-pool spillways that have been analyzed here.
Table 5 is the comparison of the presented results with Mardashti and Talebbeydokhti  [11]  experiments for the models of types 4 and 5 with 18.8°and 28° slopes. Amyloid Beta-Peptide (1-40) It should be mentioned that the meshing strategy and boundary conditions are the same as stepped-spillways in the previous sections.
Figure 12 shows the comparison of Table 5 graphically. As clear in this figure, in both cases, the relative error increases by increasing the discharge flow. These errors may be related to the formation of the calculated vortices in the pools (Figure 13), which are not exactly the same size and shape as the experimental vortices.
Figure 14 shows the formed vortices in the steps, which is the main reason for energy dissipation.
Figure 15 shows the free surface contour and there is no obvious boundary apparent between the water and air phase, and the flow field shows the aeration. Figure 16 depicts the location of the negative pressure on the steps for one kind of step-pool spillway. This position is the critical position where cavitating flow may be occurred and should be analyzed for this phenomenon.

br Disubstituted quinolines have been synthesized according to

2,4-Disubstituted quinolines [19] have been synthesized according to Meyer-Schuster rearrangement (Sarma and Prajapati, 2008). In this method 2-aminoaryl ketones and phenylacetylenes rearrange in the presence of a catalytic amount of zinc trifluoromethanesulfonate in the ionic liquid 1-hexyl-3-methylilmidazolium hexafluorophosphate [hmim][PF6] resulting in 2,4-disubstituted quinolines. The same product has also been obtained in the presence of indium(III)trifluoromethanesulfonate (In(CF3SO3)3) under microwave irradiation without any solvent (Lekhok et al., 2008).

Palladium-catalysed Wacker-type oxidative cyclization has been proposed for the synthesis of 2-methylquinolines [20] with good yields under mild conditions (Wang et al., 2011).

Poly-substituted quinolines [21] have been developed by the reaction of 2-aminobenzylic alcohol derivatives with ketones or alcohols in the presence of base and benzophenone as hydride scavenger (Martinez et al., 2008).

2,4-Disubstituted quinolines [22] have been synthesized by cyclization of 2-iodoanilines with alkynyl aryl ketones in the presence of nickel catalyst (Chen et al., 2006).

Horn et al. (2008) reported synthesis of quinolines [23] from α,β-unsaturated ketones and o-aminophenylboronic fluoxetine hydrochloride derivatives which is a modification of the traditional Skraup-Doebner-von Miller synthesis. The method has an advantage that it can proceed under basic conditions rather than strongly acidic conditions.

The reaction of benzimidoyl chlorides with 1-(1-(allyloxy)prop-2-ynyl)benzene (1,6-enynes) forms quinoline derivatives [24] via palladium-catalysed Sonogashira coupling and subsequent cyclization (Gao et al., 2010).

Intramolecular cyclization of 1-azido-2-(2-propynyl)benzene in the presence of electrophilic reagents in nitromethane (CH3NO2) at room temperature or in the presence of catalytic amounts of AuCl3/AgNTf2 in THF at 100°C gives corresponding quinolines [25] in good yields (Huo et al., 2010).

Biological activity

Malpractice is a type of negligence that may arise from a professional’s misconduct or failure to use adequate levels of care, skill or diligence in his performance, and further failing to follow generally accepted professional standards, and that breach of duty is the proximate cause of injury to a plaintiff who suffers harm. And when that takes place in the health care system, only then would it be health threatening, and thus worthy of investigating.
In 1978, a law regulating the profession of pharmacy in Saudi Arabia was passed. The law demanded professionalization of pharmacy performance and precluded the practice of pharmacy by persons other than licensed pharmacists. Furthermore a pharmacist is required to dispense drugs on prescription only, except those defined as OTC (Bawazir, 1992). This is of main concern; as an earlier study conducted by Al-Freihi et al. (1987), found that 85.4% of pharmacies dispensed antibiotics (a class known to be a prescription-only drug) promptly. Unfortunately, a study directed by S.Bawazeir in Riyadh in 1992 stated that more than 35% of drugs dispensed over-the-counter were prescription drugs (Bawazir, 1992). These findings draw high attention to the possible misuse of non-OTC drugs by the community, especially when no serious actions have been taken within the 5 years that separated these two studies.
On top of that, a more recent study conducted by Al Ghamdi, in 2001 surmised that despite the lack of pharmacist’s adherence to the pharmaceutical law, which represented (98.9%), it did not indicate that they had abused their patients (Al-Ghamdi, 2001). Sadly this can only lead to further negligence of the law.

Betwen December 2010- January 2011 retail pharmacies in Jeddah-KSA were visited randomly by a number of voluntary collaborators who played the role of asking for one or more of the following medications mainly by name ; without providing a prescription:or alternatively by mentioning the chief complaint of either sore throat or depression. For the purpose of the study, Jeddah was divided into three main regions according to the abundance of pharmacies within each region (North 40%, center 30% and south 30%) covering a total of 60 pharmacies, and further sub-divided into chain, single and hospital pharmacies. During the training of the collaborators on how to perform the study’s scenario, they were advised not to insist in case the medication was not dispensed or if the pharmacist asked for a prescription, in order not to influence the pharmacist’s decision.

Cerebral ischemic injury causes a series of

Cerebral ischemic injury causes a series of cascade reactions, and the inflammatory response is one of the important mechanisms of ischemia reperfusion injury (Ahmad et al., 2014). At the early stage of ischemia, a large number of inflammatory cells are activated, releasing of cytokines, chemotactic factor and matrix metalloproteinase inflammatory mediators, thereby promoting neutrophil cells migrate to the GSK126 cost ischemic area, ultimately increasing the death of neurons and the whole brain injury (Tao et al., 2016; Amantea et al., 2015). Cerebral ischemia reperfusion by triggering TNF-a, IL-1, two key cytokine releases, triggering a series of leukocyte infiltration and inflammatory cytokine expression of inflammatory reaction activation is caused by an important pathological mechanism of brain injury (Chen et al., 2016; Liu et al., 2016; Khaliq et al., 2016; Zwagerman et al., 2010). NO has the function of neurotransmitter or neuromodulator. The excessive production of NO after cerebral ischemia reperfusion can activate guanine nucleotide cyclase, which further result in DNA damage and mediated neurotoxicity.
ICAM-1 in cerebral ischemia reperfusion injury through the white blood cells and endothelial cell adhesion leads to vascular blockage, and no reflow phenomenon occurred, aggravated ischemic brain damage (Zhao and Ashraf, 2016; Xie et al., 2016; Sun et al., 2012). S100-beta protein is considered to be a marker of glial cells, which can promote neuronal differentiation, axon growth, glial proliferation and the stability of intracellular calcium (Feng et al., 2016; Kaca-Orynska et al., 2010). When ischemia and hypoxia and other factors cause the blood brain barrier damage, S100-beta can damage the blood brain barrier to enter the blood circulation. Therefore, the serum levels of S100-protein can be a reference to determine the degree of brain damage and prognosis.

As the experimental results suggest, compared with the model mice, Rabdosia rubescens total flavonoids can significantly relieve the injury of brain in hippocampus and cortex nerve cells; experimental rat focal cerebral ischemia was to improve again perfusion model of nerve function defect score mortality; significantly reduce brain homogenate NOS activity and no content, MDA, IL-1, TNF-a, ICAM-1 content; increase in brain homogenate SOD and ATPase activity (P<0.05, P<0.01); reduce the serum S-100β protein content. Total flavonoids of the herb can inhibit the inflammatory response after ischemia, and improve the inflammatory response of a series of cascade reaction media and cytokines, which play a protective role in cerebral ischemia reperfusion injury. This study gives a better basis of pharmacological effects of Rabdosia rubescens treatment Bureau focal cerebral ischemia resistant disease, and offers the guidance for the deep research of clinical heat clearing, detoxifying, promoting blood circulation and removing blood stasis drugs for treatment of cerebral ischemia reperfusion injury, meanwhile providing experimental basis for the development of future rabdosia herb and product.
The authors acknowledge Fund project: Excellent science and technology innovation team in Henan Province (Grant No. TCJ2014-391); Natural Science Foundation of Henan Province (Grant No. 132300410019); Zhengzhou science and technology innovation team (131PCXTD612).

Inefficient vascular supply and the resultant reduction in tissue oxygen tension often lead to neovascularization in order to satisfy the needs of the tissue. The reliance of many cells on aerobic respiration as a mandatory energy source requires a variety of responses to oxygen lack or “hypoxia” (Darby and Hewitson, 2016). Both hypoxia (lack of oxygen relative to metabolic needs) and reoxygenation (reintroduction of oxygen to hypoxic tissue) are important in human pathophysiology because they occur in a wide variety of important clinical conditions. Prominent examples of tissue hypoxia that predispose to injury during reoxygenation include circulatory shock, myocardial ischemia, stroke, and transplantation of organs (Martindale and Holbrook, 2002; Wenger, 2002; Brady et al., 2006). At the cellular level, hypoxia activates numerous major signaling pathways, resulting in changes in gene expression, which influence the cellular ability to survive or die. Severe hypoxia, occurring at partial pressure of oxygen below 20mmHg, impairs cellular energy production and ion homeostasis, leading to cell injury and cell death. A lower degree of hypoxia, defined as between 50 and 100mmHg, may activate mechanisms that could produce cellular phenotype GSK126 cost more resistant to acute severe oxidative stress (Zweier and Talukder, 2006). This phenomenon is one of the most important components of different forms of ischemic heart diseases which include myocardial infarction also. Cellular models of hypoxia-reoxygenation (HR) have provided useful tools for the study of reactive species mediated mechanisms of cellular dysfunction in ischemia-reperfusion injury (Watkins et al., 1995). H9c2 cells are derived from embryonic rat heart and are generally accepted to be a good model for cardiomyoblast cells. These cells have been successfully implemented to study mechanisms of cellular and cardiac protection (Ekhterae et al., 1999; Ranki et al., 2002).

br Introduction Uveal melanoma presents at an average

Uveal melanoma presents at an average age of 58years and is rare in children. Based on a large series of 8033 patients with uveal melanoma, only 1% occurred at the age of 20years or younger. According to the database of 2493 cases of uveal melanoma from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER), uveal melanoma at all ages was more common in males (4.9 per million) compared to females (3.7 per million). The mean age at presentation was 60years, ranging from 6years to 100years. The age-specific incidence of uveal melanoma per million population for 10–14year old persons was 0.2 for males and for females, compared to 20–24years at 0.4 for males and 0.6 for females, and this peaked at 70–74years at 24.5 for males and 17.8 for females.
In this report, we specifically focus on a large cohort of uveal melanoma in children and teenagers of age 20years or younger. We will review tumor clinical features, treatments and outcomes. A review of the literature will be provided.

Statistical analysis
The clinical features and outcomes (tumor-related metastasis) were then statistically analyzed. Kaplan–Meier analysis was performed to estimate the cumulative probability of tumor-related l-name at 3, 5, 10 and 20years.

In 1962, Apt reported on uveal melanoma in children from the Registry of Ophthalmic Pathology of the Armed Forces Institute of Pathology (AFIP) and identified 46 cases. He commented that nearly all patients were Caucasian and most cases occurred during the mid to late teenage years. He speculated that this acceleration was related to [unproven] hormonal influence in the development of melanoma. One important observation was the relative number of tumors in the iris, representing 19 (41%) of the 46 cases. Unfortunately, the cohort was not purely melanoma in that 8 (42%) of the 19 l-name iris melanomas and 4 (15%) of the 27 posterior uveal melanomas proved to be benign spindle A nevus and not melanoma.
In 1981, Barr et al. revisited the files of the AFIP and found 78 cases of pediatric uveal melanoma. They identified 5, 10, and 15-year mortality for pediatric iris melanoma at 8%, 8%, and 13% and for pediatric choroid/ciliary body melanoma at 21%, 21%, and 25%. For iris melanoma, risks for death included glaucoma, posterior invasion into ciliary body/choroid, diffuse growth pattern, angle involvement, scleral invasion, necrosis, epithelioid cells, and high mitotic activity. For choroidal melanoma, factors related to death included painful red eye, extraocular extension, basal tumor diameter ⩾10mm, tumor thickness >2mm, tumor necrosis, high mitotic activity, Bruch’s membrane invasion, and iris/ciliary body invasion. There were 7 cases of erroneous clinical diagnosis with unsuspected melanoma before enucleation in that series. In fact, 4 patients had scleral buckle for retinal detachment and 2 had filtration surgery for glaucoma before the diagnosis of melanoma was established, with 3 of these 6 patients succumbing to metastatic disease. They concluded that uveal melanoma in children should be promptly recognized, avoiding misdirected therapy, and managed as aggressively as those in adults.
The previous reports emanated retrospectively from a tertiary pathology laboratory with little clinical detail. In 1965, Verdaguer et al. reported a clinical series of 17 children with uveal melanoma and noted no metastatic event over median 5-year follow up. In 1991, Shields et al. described a comprehensive clinical series of 40 children with uveal melanoma. They stated that this represented 1% of the 3706 consecutive patients managed with uveal melanoma in their tertiary clinical ocular oncology center. There was no previous misdiagnosis in this series and misdirected therapy was avoided. Overall cumulative survival was excellent with only 4% metastasis at 5years. They stated that this early survival was encouraging but longer follow up was necessary to understand the true impact of uveal melanoma in children. Part of the favorable survival was likely related to the detection of the melanoma when small, avoidance of misdirected therapy, and management at an experienced center for uveal melanoma. Later, in 2000, an updated clinical database from this department by Singh et al. added 23 more patients for a total of 63 pediatric patients with uveal melanoma. They observed that oculo(dermal) melanocytosis was 9 times more common in this cohort than expected in the general population. An additional observation was that the early favorable prognosis appeared to normalize at the 15-year point, more similar to adults.

Fig shows the reference actual and

Fig. 14 shows the reference, actual and estimated speeds during zero speed operation with a sudden load change from light load (20%) to the rated value. It is obvious that the estimated speed tracks correctly the actual one. This confirms the robustness of the speed observer to load disturbances. The rotor speed and stator resistance are estimated by stable observers, therefore the proposed observers confront no problem in the low speed region. Furthermore, the algorithms of parallel speed and stator resistance identification scheme are characterized by their simplicity and small computation time.


With the rapid development of Internet, mobile networks and high-performance networking technology, multicast routing has become a very important research issue in the areas of networks and distributed systems. Currently multicast-based applications have pervasive presence and influence in wide area networks. This increased the demand for multicasting algorithms that can efficiently mange network resources and satisfy QoS requirements [1–4]. The provision of quality-of-service (QoS) guarantees is of utmost importance as the internet expands many new real-time communication services such as multimedia teleconference, audio/video broadcasting, and remote education. These services usually require the transmission of information from one source buy Homoharringtonine to a large number of destination nodes according to a multicast distribution tree [1]. Their analysis is classified as multiple destinations routing (MDR). The main objective of the MDR problem is to construct the optimal multicast tree in the distributed network that determines the best routing for the delivery of a message from the source node to multiple destination nodes while optimizing a certain performance criteria and meeting all QoS requirements. Recently, with the high demand of fast and better quality of services, a number of rigid QoS criteria, such as bandwidth, delay, jitter, and packet loss rate, have been considered.
This QoS multicast routing (QMR) problem has drawn wide spread attention from researchers who have been using different methods to solve the problem using conventional algorithms, such as exhaustive search routing and greedy routing. Typical approaches include (1) applying Dijkstra algorithm to find the shortest path, (2) seeking the minimum network cost using Steiner tree routing algorithm, and (3) finding multicast trees that the paths between source node and the destination nodes are connected and their cost is minimized [4]. An extensive review of QMR problem can be found in [2,3].
The multicast routing problem is known to be NP-Complete [1] and for a large scale network with high real time response, it is expensive or even infeasible to find the optimal multicast trees. Thus, most previous researchers have focused on developing heuristic algorithms that take polynomial time and produce near optimal results for solving the multicasting routing problem [4–19]. The advent of evolutionary computation has inspired new resources for optimization problem solving. Many evolutionary algorithms, such as genetic algorithm (GA) [5–9], simulated annealing (SA) [10], and ant colony optimization (ACO) [4,11–13], have been proposed for solving the QMR problem. However GA, SA, and ACO have practical limitations in real-time multicast routing. The GA climbing capacity is weak and premature easily. Both the efficiency of the SA algorithm and the quality of the solution depends on procedures that are sensitive to the influence of random annealing sequence. The ACO algorithm has many parameters and cannot guarantee convergence to the global optimal.
Until now, limited papers have discussed the application of particle swarm optimization (PSO) algorithm to solve the QMR problem. Liu et al. [14] and Wang et al. [15] proposed a PSO based algorithm to solve the QMR problem in by means of serial path selection to realize the optimization of a multicast tree. The multicast tree can obtain a feasible solution by exchanging paths in the vector. Experimental results indicate that the proposed algorithm could converge to the optimal or a near-optimal solution with lower computational cost. Another algorithm was described by Sun et al. [16] based on the quantum-behaved PSO (QPSO). It was inspired by quantum mechanics and seemed to be a promising optimization problem solver. The proposed method converts the QoS multicast routing problem into an integer-programming problem and then solves the problem by QPSO. Additionally, combining PSO with other optimization techniques to deal with QoS routing was also proposed in the literature. Xi-Hong et al. [17] proposed an ACO-PSO algorithm to solve the QMR problem. The solution generated by ACO is regulated by position update strategy of PSO, which extends the search scope efficiently and avoids premature convergence to local optima. The simulation results demonstrate its superiority to other algorithms such as the GA and the ACO. Li et al. [18] described a new evolutionary scheme for the optimization of multicast QoS routing based on the hybrid of GA and PSO, called HGAPSO. In HGAPSO, the upper-half of the best-performing individuals in a population are regarded as elites. Instead of being reproduced exactly in the next generation, these elites are enhanced first. The group constituted by the elites is regarded as a swarm, and each elite corresponds to a particle within it. Wang et al. [19] proposed a new method for tree-based optimization. The algorithm optimizes the multicast tree directly, unlike the conventional solutions to finding paths and integrating them to generate a multicast tree. The algorithm combines PSO with tree based optimization to the solution to control the optimization orientation of the tree shape.

In this paper outage data analysis of kV power

In this paper, outage data analysis of 220kV power transformers is considered because power plants and wind farms are connected to the Egyptian unified grid through the 220kV power network. Outage-data are obtained from the Egyptian Electricity Transmission Company (EETC). Outage-data analysis over 8years from 2002 to 2009 of 252 (average number) transformers with MVA rating ranging from 40MVA to 150MVA is presented. Several indices are determined for evaluating the reliability of power transformers. In addition, knowledge of these indices is essential for proper system planning and operation. The determined indices are the average annual number of failures (AANF), average annual interrupted MW (AAIMW), average annual repair time (AART), and average annual customer interruption duration (AACID), failure rate, availability, and maintainability. Forced outages due to correct and false action of transformer’s protection systems are carefully considered.

Outage-data preparation
A summary of averaged data is given in Appendix A. The total number of transformers in service was 223 and 292 in 2002 and 2009 respectively. Table 1 shows the actual and average numbers of transformers in various geographical zones for years 2002–2009.
The 220kV network is considered one of the oldest transmission networks in many European countries [6]. The generation plants in Germany are linked to the unified Grid through 220kV level [7]. In Egypt, the 220kV network in the EETC system plays a key role in transferring the bulk power generated to other voltage levels. Therefore, reliable performance of the 220kV network guarantees delivery of osthole generated to the rest of the system.
There are numerous outage causes for transformers. This is mainly due to operating conditions, aging factor, maintenance strategy, and environmental conditions. According to their type and nature, outage causes are categorized into five outage categories as shown in Table 2. These outage categories are transformer related outages, power system related outages, environmental related outages, human factor (or human mistakes) related outages, and unclassified/other outages.

Outage-data analysis

Failure rate, availability, and maintainability evaluation
Based on reliability theory, the following definitions apply [1,4,8].The failure rate is a measure of the basic design of the transformer as well as the operating and maintenance practices employed. Maintainability is the measure of the ability of an item to be restored or retained in a specified condition. Maintenance should be performed by personnel having specified skill levels, using prescribed procedures and resources, at each prescribed level of maintenance and repair. Simply stated, maintainability is a measure of how effectively and economically failures can be prevented through preventive maintenance and how quickly system operation can be restored following a failure through corrective maintenance. A commonly used measure of maintainability in terms of corrective maintenance is the mean time to repair (MTTR). It is important to note that maintainability is not the same as maintenance. Maintainability is a design parameter, while maintenance consists of actions to correct or prevent a failure event. Maintainability is a function of design features, such as access, interchangeability, standardization, and modularity. Maintainability includes designing with the human element of the system in mind. The human element includes operators and maintenance personnel. Designing for improved maintainability involves consideration of ways to minimize the duration of outages [9]. Availability is the percentage of time the item is available to perform its required functions. Availability is a function of both MTBF and MTTR.

In the 220kV transformers, the largest AANF was caused by over current protection due to heavy loads. This indicates that the number of 220kV transformers is insufficient to supply the present loads. Meanwhile the largest values of AAIMW were associated with Human mistakes. Most of the mistakes occur during the maintenance of disconnected transformer or equipment. The longest AACID occurred due to outages that include human mistakes, breakdown and damage. Buchholz and pressure relief relays contributed in the large values of AART.