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In machine learning (ML), association patterns in the data, paths in decision trees, and weights between layers of the neural network are often entangled due to multiple underlying causes, thus masking the pattern-to-source relation, weakening prediction, and defying explanation. This paper presents a revolutionary ML paradigm: pattern discovery and disentanglement (PDD) that disentangles associations and provides an all-in-one knowledge system capable of (a) disentangling patterns to associate with distinct primary sources; (b) discovering rare/imbalanced groups, detecting anomalies and rectifying discrepancies to improve class association, pattern and entity clustering; and (c) organizing knowledge for statistically supported interpretability for causal exploration. Results from case studies have validated such capabilities. The explainable knowledge reveals pattern-source relations on entities, and underlying factors for causal inference, and clinical study and practice; thus, addressing the major concern of interpretability, trust, and reliability when applying ML to healthcare, which is a step towards closing the AI chasm.

A diagnostic has been developed to study the focusing dynamics of a high-power electron beam on a target. The diagnostic uses a pinhole camera to observe bremsstrahlung from the converter target. A data acquisition system yields images of the beam focal spot with a frame duration of 20 ns and an almost unlimited recording duration. The focal spot dynamics of a linear induction accelerator with an energy of 1.5 MeV, a current of 1.2 kA and a pulse duration of 350 ns were studied. The focal spot was found to be disrupted within the first 100 ns of the pulse. Defocusing has a complex 3-D character. The feasibility of additional cleaning of the target using an accelerator pre-pulse was shown. Stable beam focusing for up to 200 ns was demonstrated.

A simple internal charging current monitor has been developed to monitor the penetration of energetic particles within spacecraft in geostationary orbits. The instrument, known as a charging monitor (CM), is a component of a suite of space weather instruments aboard the geostationary satellite GEO-KOMPSAT-2A (GK2A), that was successfully launched on December 4, 2018, with a final longitude of 128.2° E. The instrument measures the integral fluxes of charged particles through a 1-mm-thick aluminum wall, along with another 1-mm-thick aluminum plate, effectively collecting electron and proton currents with energies approximately above 0.6 and 13.1 MeV, respectively. Great care has been exercised in the design of the instrument to extend the lifetime of the analog electronics of the detector, which may easily become vulnerable to the harsh radiation environment of the outer electron belt in geostationary orbits. Comparisons of measurements from the CM have been made with those from particle detectors with a more sophisticated design from the same suite. Initial results of the CM operation for the first four months are presented, including a period of moderate geomagnetic storms. The comparisons clearly show that the CM is sufficiently capable of monitoring the enhanced levels of electrical currents from the penetration of high-energy charged particles in the context of space weather research with a minimal spacecraft resources cost and design efforts.

Using the effective medium model, the complex permittivity of the ocular surface system in the THz frequency range is considered. The penetration depth of THz radiation and the sensitivity of the reflected component to the dynamics of evaporation of the tear film are discussed. The results of in vivo experiments aimed to determine the reflection coefficient of the ocular surface using continuous THz reflectometers are well described using the developed model.

AMoRE is an international project to search for the neutrinoless double beta decay of $^{100}$Mo using a detection technology consisting of magnetic microcalorimeters (MMCs) and molybdenum-based scintillating crystals. Data collection has begun for the current AMORE-I phase of the project, an upgrade from the previous pilot phase. AMoRE-I employs thirteen $^\mathrm{48depl.}$Ca$^{100}$MoO$_4$ crystals and five Li$_2$$^{100}$MoO$_4$ crystals for a total crystal mass of 6.2 kg. Each detector module contains a scintillating crystal with two MMC channels for heat and light detection. We report the present status of the experiment and the performance of the detector modules., Comment: 8 pages, 4 figures, published in Journal of Low Temperature Physics (2022)

Introduction/Objective The Kidd blood group antigens are urea transporters found on the surface of red blood cells, renal tubular epithelial cells, and endothelial cells in the renal medulla and vasa recta. While controversial, some reports have described an association between Kidd antigen donor/recipient mismatches and kidney transplant rejection when recipients possess or form anti-Kidd alloantibodies. To date, none of these reports have described development of a thrombotic microangiopathy (TMA) in the renal graft associated with these antibodies. We describe a case of fulminant renal transplant rejection associated with TMA in a patient with anti-Jk(a) alloantibodies who received a deceased-donor kidney transplant (DDKT). Methods/Case Report A 64-year-old woman with end-stage renal disease secondary to AL amyloidosis caused by plasma cell neoplasm received a DDKT associated with delayed graft function. No pre- or post-transplant donor specific antibodies (DSA) were detected, the flow crossmatch testing was negative, and a pre-operative type and screen identified anti-Jk(a) alloantibodies. On post-transplant day 5, her creatinine remained elevated at 6 mg/dL (ref range: 0.4–1.3 mg/dL) with an acute drop in platelets and undetectable haptoglobin. Allograft biopsy showed a combination of TMA with some additional evidence of acute cellular rejection. Tacrolimus was stopped to rule out drug-induced TMA, and the workup showed negative Shiga toxin, normal ADAMTS13 activity, negative atypical HUS genetic testing, and negative antiphospholipid syndrome testing. Genotyping of the donor kidney was positive for the Jk(a) antigen. Eculizumab, IVIG, and a trial of 8 sessions of therapeutic plasma exchange (TPE) were administered. Her creatinine improved (1.93–2.05 mg/dL), indicating a significant antibody-mediated etiology to her delayed graft function. About one month later, her creatinine worsened, and she received another trial of TPE with IVIG and eculizumab. Despite a mild decrease in her creatinine, repeat biopsies showed acute cellular rejection, persistent TMA, and chronic allograft injury. No DSAs were ever detected. Her creatinine never recovered, and she is now dialysis-dependent. Results (if a Case Study enter NA) NA Conclusion We speculate that anti-Jk(a) antibodies interacting with a Jk(a)-positive donor kidney account for graft TMA. This case underscores the potential importance of matching Kidd antigens in kidney transplantation.

Introduction: Estrogen receptor is expressed in 75% of breast cancers and is related to a relatively indolent phenotype. Yet, up to 25% of these tumors develop resistance to endocrine therapy. Alternative splicing events are observed in almost every hallmarks of cancer, implying that dysregulation of splicing and cancer progression are closely related. The purpose of this study was to detect splice variants related to endocrine resistance in hormone receptor(HR)-positive breast cancer. Methods: RNA sequencing data of 455 HR-positive patients with documented endocrine treatment from The Cancer Genome Atlas (TCGA) database was used for analysis. Splice variants of 96 ESR1 pathway-related genes were detected using a data-mining algorithm recognizing spliceomic heterogeneity. A differential analysis of splice variants between 48 endocrine therapy-resistant and 407 endocrine therapy-responsive patients was performed to discover isoforms frequently detected in endocrine-resistant tumors. Isoforms related to endocrine resistance was further analyzed using whole transcriptome sequencing data from 59 HR-positive invasive breast cancer patients (24 endocrine therapy-resistant, 35 endocrine therapy-responsive who underwent operation at Seoul National University Hospital. Results: Of 96 ESR1 pathway-related genes, 17 genes showed statistically different splice variant isoforms frequencies (AKT1, ATF2, ATF4, CALM2, CALM3, CREB1, EGFR, ESR1, ESR2, GRM1, HRAS, HSP90AA1, OPRM1, PIK3R3, PRKACB, SHC1, and SHC4). A differential analysis of these isoforms using SNUH data confirmed a predominant isoform of HRAS (64.47% vs 57.14%, p-value 0.0037) and a minor isoform of SHC1 (25.53% vs 32.33%, p-value 0.0456) in endocrine therapy-resistant HR-positive patients. In the same analysis using HR-negative patients, the mean isoform percentage was similar between patients with distant recurrence and no recurrence. Potential Spliceomic Signatures Reproduced From Seoul National University Hospital Data Hormone Receptor Positive Hormone Receptor negative GeneMean Isoform % in Resistant SpecimensMean Isoform % in Responsive Specimensp-valueMean Isoform % in Resistant SpecimensMean Isoform % in Responsive Specimensp-valueHRAS64.4757.140.003757.9758.850.8413SHC125.5332.330.045628.3632.580.2551 Conclusions: Phenotype-specific splice variants can be detected using transcriptome sequencing data. Splice variants in HRAS and SHC1 are potential spliceomic signatures that may be used to predict endocrine therapy-resistant breast cancer. Further investigation is warranted to explore the biological role of these isoforms and identify the role of splice variants as a biomarker for endocrine resistance. Citation Format: Lee H-B, Kim M-S, Rhu J, Park JH, Kim KE, Ju YW, Lee E-S, Moon H-G, Noh D-Y, Kim S, Han W. Detection of splice variants related to endocrine resistant hormone receptor-positive breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-05-13.

Automated daylight redirecting slat technologies are designed to divert sunlight into the living space. They have a distinct advantage in that they can be retracted and extended, and slat angles can be adjusted according to the solar geometry and sky conditions. This study aimed to explore the geometric and photometric properties of a novel high-efficiency light redirection system (LRS). The LRS prototypes were installed in the clerestory window in the south-facing window testbed office and monitored under real sun and sky conditions. Workplane illuminance, daylight delivery efficiency (DDE) and visual comfort were evaluated. A number of simulation studies were conducted to evaluate the LRS and compare the results to the laboratory tests. The study shows that the specular properties of the slats provided significantly higher work plane illuminance and DDE. All systems showed an acceptable discomfort glare, or daylight glare probability (DGP) lower than 0.35. The comparison of the laboratory test and computer simulation was conducted using a Radiance tool. The results show that, for specular slats, the mkillum method with plastic material provided accurate work plane illuminance compared to the measurement. All simulated DGP shows accurate results compared to the laboratory test.

Background There are studies suggesting significant association between the patient's comorbidity and perioperative outcomes. In breast cancer, patient comorbidity can also influence the oncologic outcome by affecting the decisions regarding adjuvant treatments. In this study, we examined the long-term oncologic outcome in breast cancer patients who underwent curative surgery according to their pre-existing comorbid conditions. Methods The medical records of 2,501 patients who underwent surgery for primary breast cancer from June 2006 to June 2010 were reviewed retrospectively. The patients were classified into three groups (ASA 1, 2, 3) according to preoperative ASA status determined by the anesthesiologists. Clinico-pathologic characteristics and survival outcomes of the patients were compared among the different co-morbidity groups. Result There were 1,792 (71.6%), 665 (26.6%), and 44 (1.8%) patients in ASA 1, 2, and 3, respectively. Total 95 (3.8%) deaths and 269 (10.8%) recurrences (loco-regional and distant) occurred during the median follow-up period of 71 months. Patients with high comorbidity showed significantly higher rate of death (51 (2.8%), 38 (5.7%) and 6 (13.6%) deaths in ASA 1, 2 and 3 group, respectively, p Conclusion In this study, high comorbidity was related to increased risk of death and recurrence in breast cancer. The increased risk of recurrence in high co-morbidity group was mostly seen in patients who did not receive adjuvant therapies. In patients who underwent the adjuvant therapies, the incidence of serious adverse effects did not differ according to the co-morbidity status. Citation Format: Han J, Lee H-B, Lee E-S, Kang YJ, Kim Y, Choi J, Rhu J, Han W, Noh D-Y, Moon H-G. The association between patient comorbidity and breast cancer survival [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-07-12.

Background The identification of individuals at elevated risk for hereditary cancers has allowed the development of consensus recommendations for cancer screening and prevention. The introduction of multigene panels may identify more individuals with breast cancer gene mutations than does testing for BRCA1/2 alone. Therefore, the multigenerational panel increase the need for genetic counseling suggesting preventive approach or cancer-specific screening to patients and family members. The rapid clinical introduction of multigene panel testing, however, have several issues such as low- to moderate-risk gene mutations and clinical recommendations. We collect the mutation results and clinical recommendations after testing with multigene panel and giving genetic counseling. Methods We had developed multigene panel consisted of 64 genes related to hereditary cancer through previous study and prospectively enrolled 104 individuals who were appropriate candidates for hereditary breast cancer evaluation. The patients were tested with 64-gene panel(Celemics) and results were provided by us 4˜10 weeks later. We checked the family history of cancer and made a pedigree before testing. Result Among 104 participants, 26 patients harbored deleterious mutations, most commonly in high to moderate-risk breast/ovarian cancer genes (BRCA1/2, BRIP, RAD51 and RAD51D), Lynch syndrome gene(MSH6) and other genes(FH, SPINK1). We recommended the cancer-specific screening and/or preventive approach for mutation-positive patients and suggested additional genetic test for the family members. Among them, 6 (23%) patients received Risk reducing procedures (Prophylactic mastectomy or oophorectomy) and most of them(19 patients(73%)) received cancer specific screening. Conclusion We demonstrate the use of multigene panel testing for hereditary breast cancer and will suggest the process of the genetic counseling including indication and results analysis with multigene panel testing. Citation Format: Lee E-S, Han W, Kim Y, Rhu J, Park JH, Kim K-E, Ju YW, Kim R, Lee H-B, Moon H-G, Noh D-Y. Clinical application of multigene panel testing and genetic counseling for hereditary/familial breast cancer risk assessment: Prospective single center study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-06-18.

Individuals with poor knowledge of osteoporosis and lower socioeconomic status, including being single and having a lower level of annual income, are less likely to be assessed or treated for osteoporosis. Individuals with particular osteoporosis risk factors such as smokers and heavy drinkers are overlooked for diagnosis. Further study is needed to identify and address the existing barriers and to promote osteoporosis management for women with these risk factors. Despite the negative health consequences of osteoporosis and the availability of effective treatment, a pervasive and persistent prevention care gap for osteoporosis remains present throughout the world. We attempted to identify the factors affecting the willingness of patients to either undergo or avoid assessment and treatment for osteoporosis. A nationwide online survey was conducted in 926 Korean women over age 50. The survey included questions addressing three domains: (1) clinical and socio-demographic characteristics, (2) questions concerning the reasons for undergoing or avoiding osteoporosis assessment or treatment, and (3) knowledge of osteoporosis as measured using the modified Korean version of Facts on Osteoporosis Quiz. The assessed and non-assessed participants were compared in terms of their clinical and socioeconomic statuses, reasons for undergoing or avoiding osteoporosis management, and levels of knowledge of osteoporosis. The highest-ranked reason for undergoing osteoporosis assessment was fear of osteoporotic fracture, while the highest-ranked reason for avoiding osteoporosis assessment was not feeling a need to get tested for osteoporosis. Participants who sought assessment for osteoporosis were older and more likely to be married, and had greater knowledge of osteoporosis than those who did not seek assessment. The two groups were found to be similar in terms of tobacco use and daily alcohol use. Patients who had been diagnosed with osteoporosis but either did not initiate or discontinued osteoporosis treatment within 1 year were younger and had lower levels of annual income than those who began and continued treatment. Individuals with poor knowledge of osteoporosis and those of lower socioeconomic status, including those who were single and had a lower level of annual income, were less likely to be assessed and treated for osteoporosis. Individuals with particular osteoporosis risk factors such as smokers and heavy drinkers are overlooked for diagnosis. Further study is needed to identify and address the existing barriers and to promote osteoporosis management for women with these risk factors.

In this study, Invar alloy (Fe 63.5%, Ni 36.5%) was electrochemically polished by PECM (Pulse Electro Chemical Machining) in a mixture of NaCl, glycerin, and distilled water. A series of PECM experiments were carried out with different voltages and different electrode shapes, and then the surfaces of polished Invar alloy were investigated. The polished Invar alloy surfaces were investigated by optical microscope, scanning electron microscope (SEM), and non-contact 3D measurement (white light microscopes) and it was found that different applied voltages produced different surface characteristics on the Invar alloy surface because of the locally concentrated applied voltage on the Invar alloy surface. Moreover, we found that the shapes of electrode also have an effect on the surface characteristics on Invar alloy surface by influencing the applied voltage. These experimental findings provide fundamental knowledge for PECM of Invar alloy by surface analysis.

The deposition behavior of turbostratic boron nitride (t-BN) films was investigated with the focus on its microstructure variation in relation to deposition temperature substrate bias voltage. BN films were deposited using the unbalanced magnetron sputtering method. Thin (100 μm) Si strips (3 × 40 mm 2 ) coated with a nanocrystalline diamond thin layer were used as substrates. A BN target was used, which was connected to a radio frequency power supply set at 400 W. A pulsed direct current power supply connected to a substrate holder was used for negative biasing. The deposition pressure was 0.27 Pa with a flow of Ar (18 sccm)–N 2 (2 sccm) mixed gas. Only t-BN films were deposited with the substrate bias less than − 100 V irrespective of the deposition temperature. The orientation of (0002) t-BN laminate alignment changed from normal to parallel to the substrate surface with increased deposition temperature. High resolution transmission electron microscopy and Fourier transform infrared spectroscopy confirmed such behavior. However, the application of bias voltage made the (0002) laminates align normal to the substrate surface even at high deposition temperatures. The films tended to react with moisture in an ambient atmosphere as confirmed by the appearance of O H absorption peak in the FTIR spectrum. The measured O H absorption intensity was not influenced by the variation of deposition variables.

This study aimed to investigate excessive Internet use's (EIU's) association with oral health behaviors among Korean adolescents.This cross-sectional study was based on the 11th Korea Youth Risk Behavior Web-based Survey (2015).68,043 school students aged 13-18 years (35,204 boys and 32,839 girls). Data on, 45,271 (23,354 males and 21,917 females using the Internet on weekdays) and 49,324 (27,448 males and 21,876 females using the Internet on weekends) were analyzed after excluding questionnaires with missing values.The key variables were oral health behaviors (tooth-brushing frequency and tooth brushing after lunch at school, and preventive oral health behaviors), EIU (hours of Internet use on weekdays and weekends, excluding use for academic purposes).Compared to the general groups, the odds ratio (OR) for less tooth-brushing was 4.04 (95%CI=2.990-5.459) and 3.55-fold higher (95% CI=2.703-4.659) in the high-risk groups for weekday and weekend EIU, respectively. For post-lunch tooth-brushing, compared to the general groups, the OR for less tooth-brushing was 1.7-fold higher in the high-risk groups for EIU during weekdays and weekends. The OR for no preventive behavior was significantly higher in the high-risk groups than in the potential-risk and general groups.Policies moderating adolescents' EIU may enable appropriate oral health behaviors.

A series of simple fluorescent chemosensors were synthesized and their binding constants for electron-deficient aromatic explosives were compared in semi-aqueous media. Among these molecules, the best fluorescent chemosensor 4 can detect

Introduction Graft rejection remains a major cause of morbidity and mortality following renal transplantation. One of the main determinants of success after renal transplantation is histocompatibility between donor and recipient. Most of the research on this topic has addressed human leukocyte antigen (HLA), but the roles played by minor histocompatibility antigens (mHAgs), such as mitochondrially transmitted antigens, are poorly understood. In this study, we evaluated immune responses induced by minor antigens originating from mitochondrial DNA (mtDNA) in a large animal model. Methods To characterize whole swine leukocyte antigen (SLA) allele in 8 cloned pigs, we performed SLA genotyping for SLA-1, SLA-2, SLA-3, SLA-DQB1, and SLA-DRB1 as well as the hypervariable region 1 (HV1) of mtDNA. Renal transplantation was performed using SLA-matched pigs with different mtDNA as well as SLA-mismatched cloned animals. Cytokine profiling was performed by incubating peripheral leukocytes with cellular components from SLA-matched different mtDNA and SLA-mismatched cells to evaluate mtDNA-mediated immune response. Results SLA types were confirmed to be identical, but mtDNA sequences of HV1 varied among cloned pigs. Rejection episodes in the SLA-matched group with different mtDNA were similar to those in the SLA-mismatched group; that is, plasma creatinine and BUN levels were increased and mononuclear cell infiltration was observed in perivascular regions in the matched and SLA-mismatched groups. Furthermore, in vitro studies showed interleukin (IL)-1β expression to be elevated in SLA-matched and SLA-mismatched groups. Conclusion Cloned pigs are a useful preclinical model to evaluate the immunogenicity of mtDNA encoding minor antigens. The mtDNA originating from nongenomic DNA induced cell-mediated immune rejection after kidney transplantation.

AIM Lamotrigine is a neuroprotective agent that is used clinically for the treatment of seizures and neuropathic pain. A significant volume of literature has reported that lamotrigine exerts analgesic effect by blocking Ca(2+) channels. However, little is known regarding the effect of lamotrigine on the intracellular Ca(2+) concentration ([Ca(2+)](i)). The aim of this study was to determine whether lamotrigine modulates [Ca(2+)](i) in sensory neurones. METHODS Lamotrigine-induced changes in [Ca(2+)](i) were measured in mouse dorsal root ganglion (DRG) neurones using the Ca(2+)-sensitive fluorescent indicator Fluo 3-AM and a confocal laser scanning microscope. Ca(2+)/calmodulin-dependent kinase II (CaMKII) activation was assessed by the fluorescence intensity using immunocytochemical procedures. RESULTS Treatment with 1, 10, 30 or 100 μM lamotrigine transiently increased [Ca(2+)](i) in DRG neurones in a dose-dependent manner. Treatment with 100 μM lamotrigine induced a significant (threefold) increase in the Ca(2+) peak in the presence or absence of extracellular Ca(2+). The lamotrigine-induced Ca(2+) increase was abolished or decreased by the treatment with a specific PLC inhibitor (U73122), IP3R antagonist (xestospongin C) or RyR antagonist (dantrolene). In some cells, treatment with 100 μM lamotrigine caused a transient Ca(2+) increase, and the Ca(2+) levels quickly fell to below the basal Ca(2+) level observed prior to lamotrigine application. The decrease in basal Ca(2+) levels was blocked by the treatment with a CaMKII inhibitor (KN93). Immunocytochemical analysis indicated that lamotrigine treatment increased the expression of phosphorylated CaMKII in DRG neurones. CONCLUSION Treatment with lamotrigine increased [Ca(2+)](i) apparently as a result of Ca(2+) release from intracellular stores and CaMKII activity.

Bulimia nervosa is one of the eating disorders. Psychological manifestations of this disease, such as guilt or denial, may interfere with patient communication. The patients with bulimia nervosa are most commonly between ages of 17 and 25 years old, and often maintain normal body weight. It is not easy to screen out and diagnose bulimia nervosa patients at the emergency department. We reported two bulimia nervosa patients who visited our emergency department with abdominal distension, and one of them died of abdominal compartment syndrome. We confirmed collapse of the abdominal aorta and key arteries in enhanced abdominal computed tomography. Promptly, we performed gastrostomy for reduction of abdominal pressure, but she finally succumbed due to multiple organ failure 12 hours after the surgery.

Purpose We aimed to identify whether hormonal receptors change throughout tumor progression, because this may influence management and influence prognosis in breast cancer patients. Patients and Methods From the institution's database, we collected data of 963 patients who developed relapse during their follow-ups. To determine estrogen receptor(ER) and progesterone receptor (PR), we retrospectively reviewed immunohistochemical(IHC) results in both primary and relapsed tumors. Results Among a total of 963 patients, 280 and 683 patients experienced locoregional relapse only and distant metastasis irrespective of locoreginal relapse, respectively. ER in 650 patients and PR in 590 patients from both primary tumor and relapse were identified, revealing a change in 157 (24.2%) and 154 (26.1%) patients, respectively. In patients with distant metastasis, assessment of ER and PR showed an alteration in 86 and 56 patients, respectively. The overall survival related to the change of ER and PR status in primary tumor and relapse was significantly different (log rank, P Conclusion The breast cancer showed alterations of hormone receptor status throughout tumor progression, hat were related to the strategy of treatment and significantly influences survival. Therefore, investigations of hormone receptor at relapse are essential and helpful in breast cancer patient management. Citation Format: Lee E-S, Kim J, Yoo T-K, Kim Y, Han J, Kang YJ, Choi J, Rhu J, Lee H-B, Han W, Noh D-Y, Moon H-G. An alteration of hormonal receptor status throughout tumor progression related to prognosis in breast cancer patients [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-07-19.

CdS nanoparticles embedded in a PVA (polyvinyl alcohol) matrix were prepared and characterized by using cadmium chloride (CdCl2) and sodium sulfide (Na2S). When CdCl2 of various molar concentrations was a mixed with a PVA aqueous solution, the -OH groups in PVA acted as coordinating sites for cadmium ion (Cd 2+ ) aggregations to form PVA-Cd 2+ composites. The CdS nanoparticles embedded in PVA were successfully grown at these sites by dipping PVA-Cd 2+ composites into a solution that contained 0.5 mM of S 2 ions from Na2S. The optical band gaps of the nanoparticles were increased from 2.51 eV to 2.74 eV by decreasing the molar concentration of CdCl2 from 5 mM to 0.5 mM, indicating that the size of the nanoparticles increased with increasing CdCl2 molar concentration. X-ray diraction results showed that the CdS nanoparticles were in a cubic phase while their sizes, estimated to be 4.7 nm, 4.8 nm and 5.9 nm for CdCl2 concentrations of 0.7 mM, 1.0 mM and 3.0 mM, respectively, were almost identical to the values calculated by using BrusOs formula. The PL emission spectra of the CdS nanoparticles formed by 0.7 mM of Cd 2+ showed two peaks, one at 471 nm and the other at 606 nm, which were attributed to the band edge and to surface defects, respectively.

This prospective study explored the relationship between expression of AKR1B10 mRNA and various clinical parameters in non-small-cell lung cancer (NSCLC) in terms of its validation as a marker for NSCLC. Tumour tissue samples were collected from 229 patients with NSCLC. Tissue samples from adjacent non-malignant lung tissue (> 5 cm from the tumour) of 89 of these patients and samples from 20 patients with benign lung disease were used as controls. Quantitative reverse transcription–polymerase chain reaction showed significantly higher levels of AKR1B10 mRNA expression in NSCLC tumour tissue than in adjacent non-malignant lung tissue and benign lung tissue. Statistically significant factors for AKR1B10 mRNA over-expression were found to be male gender, smoking, squamous cell carcinoma and moderate or poor cell differentiation. It is concluded that AKR1B10 seems to have potential as a prognostic marker for NSCLC and warrants further investigation.

This study investigated the effect of microclimate temperature during preslaughter transportation on chicken meat quality. Ninety broilers per load of 2,900 were monitored individually during 3 to 4 h of preslaughter transport in an actively ventilated trailer. Six transport test runs were conducted at average ambient temperatures of -27, -22, -17, -5, +4, and +11 degrees C. Birds were classified into 4 groups based upon the temperatures recorded in their immediate surroundings as follows: -16 to 0, 0 to 10, 10 to 20, and 20 to 30 degrees C. Internal body temperatures of the birds were recorded using Thermocron DS1922L iButtons. Birds were slaughtered in a commercial facility and meat quality of the chilled carcasses was evaluated by determination of pH, color, drip loss, thaw loss, cook loss, shear force, water-binding capacity, and pellet cook yield of the pectoralis major muscle. The breast meat from birds exposed to temperatures below 0 degrees C showed a significantly higher (P < 0.05) ultimate pH. Breast meat from birds exposed to temperatures below 0 degrees C showed significantly higher (P < 0.05) ultimate pH, a* value, water-binding capacity, and pellet cook yield and a significantly lower L* compared with breast meat of birds exposed to temperatures above 0 degrees C. The average core body temperatures were significantly lower (P < 0.05) during transport for birds exposed to temperatures below 0 degrees C compared with those exposed to temperatures between 0 and 10 degrees C. The latter birds had significantly lower (P < 0.05) core body temperatures compared with those exposed to temperatures above 10 degrees C. Thaw loss was significantly higher (P < 0.05) for breast meat of birds exposed to temperatures above 20 degrees C during transportation. There was no significant trend for b* value, drip loss, cook loss, or shear values based on environment temperature immediately surrounding the birds. Exposure to temperatures below 0 degrees C increased the incidence of dark, firm, and dry breast meat and decreased the incidence of pale, soft, and exudative breast meat. These results demonstrate that preslaughter transport may influence breast meat quality characteristics of broiler chicken.

The separation of X and Y chromosome-bearing sperm is of use in many aspects of livestock maintenance. In this study, we sought to determine the difference in DNA content between X- and Y-bearing sperm, separate sperm into X- and Y-enriched pools, and assess the efficacy of sorting. Sperm collected from Duroc and miniature pigs were stained with 20.8 μM Hoechst 33342 and analyzed using a high-speed cell sorter. Measurement of the fluorescence intensity of stained sperm nuclei revealed that the X-bearing sperm of Duroc and miniature pigs respectively contain 2.75% and 2.88% more DNA than Y-bearing sperm. In total, 50.18% of the sperm were assigned to the X-sorted sample and 49.82% was assigned to the Y-sorted sample for Duroc pigs. For miniature pigs, the X- sorted sample represented 50.19% of the population and the Y-sorted represented 49.81% of the population. Duplex PCR was used to evaluate accuracy of sorting. A fast and reliable method for porcine sexing was developed through amplification of the sex-determining region of the Y chromosome gene (SRY). Oligonucleotide primers were designed to amplify the conserved porcine SRY high motility group (HMG) box sequence motif. We found that the primer pair designed in this study was 1.46 times more specific than previously reported primers. Thus, this study shows that the present method can be applied in porcine breeding programs to facilitate manipulation of the sex ratio of offspring and to achieve precise sexing of porcine offspring by amplification of the HMG box of the SRY gene. (Key

Summary The Republic of Korea experienced a foot-and-mouth disease (FMD) outbreak during May–June 2002. The present study describes epidemiological characteristics of the 2002 FMD outbreak in Korea, including the pattern of the outbreak in both time and space, transmission routes among infected farms, and control measures. One of the notable features of the 2002 FMD epidemic in Korea was that the virus infected mostly pigs [15 of 16 infected premises (IPs)], despite the presence of other susceptible animals on infected and neighbouring farms. The epidemic showed temporal clustering at 8–9 day intervals, suggesting five generations of infection during the outbreak, and 13 of 16 (81.3%) IPs were located within a 10 km-radius of the index case. The clinical signs that prompted notification of infection included vesicles around hooves and snouts. The age of lesions was significantly less among cases reported by farmers compared with veterinarians. The high awareness of farmers from an earlier FMD outbreak greatly helped the animal hygiene authority in efforts associated with disease control and eradication. The outbreak was eradicated within < 2 months as a result of the intensive control efforts of the animal hygiene authorities and the cooperation of the Korean people. Although the outbreak was a costly lesson for the Korean people, the experience gained will contribute to future efforts in the prevention and control of animal infectious diseases.

In the smoothed particle hydrodynamics (SPH) discretisation method for the Navier-Stokes equations the most widespread method to solve for pressure and mass conservation is the weakly compressible assumption (WCSPH). This includes hydraulics applications and leads to some drawbacks such as severe artificial pressure fluctuations and a limitation to very small time steps related to the WCSPH Mach number and explicit method. This paper presents comparisons of a semi-implicit and truly incompressible SPH (ISPH) algorithm with the classical WCSPH method, showing how some of the problems encountered in WCSPH have been resolved by using ISPH to simulate incompressible flows. Mathematical models are presented before describing SPH formalism. Several standard boundary conditions are introduced and special attention is given to tracking the surface particles. The lid-driven cavity flow (Re=400 and 1000) is performed as a benchmarking test. A bluff body test case (a square cylinder in a closed channel, Re"d=20 and 100 based on the cylinder diameter) shows that pressure fields extracted from WCSPH are very unreliable whereas ISPH predict pressures and forces in closer agreement with classical finite volume CFD methods. Dam-breaking cases, with dry or wet beds downstream, are then presented to highlight free-surface flow and rapid dynamics effects. The WCSPH and ISPH results are generally verified with reference data from experiment and/or another numerical method. All the comparisons show improvement with ISPH and good agreement in general.

We investigated antibiogram and coagulase gene diversity in staphylococcal enterotoxin (StE)-producing Staphylococcus aureus isolated from raw milk samples of cows infected with mastitis from 140 dairy farms in Korea between 1997 and 2004. Of the 696 Staph. aureus isolates collected in this study, 164 isolates (23.6%) produced one or more staphylococcal enterotoxins (A to D), and 19 isolates (2.7%) were methicillin-resistant. The percentage of StE-producing Staph. aureus (SES) isolates resistant to methicillin, kanamycin, neomycin, amikacin, and tetracycline was greater than that of non-SES. Ten coagulase genotype patterns were observed, including 4 main types comprising I (25.4%), II (13.9%), VII (13.2%), and VIII (17.8%). More than 4 Staph. aureus types were isolated from each of 82 dairy farms in different geographic locations, and only 1 coagulase genotype pattern was observed in 39 of the herds (47.6%). There was no significant correlation between coagulase genotypes harbored by Staph. aureus and their specific StE type. The percentage of isolates producing major StE types (A, B, AC, and ABCD) and being resistant to cephalothin and methicillin was greater among the Staph. aureus isolates with the 4 predominant coagulase genotypes (I, II, VII, and VIII) than among the isolates harboring the 6 rare coagulase types (III, IV, V, VI, IX, and X). Based on coagulase gene polymorphisms, our data indicate that a broad distribution of identical or closely related enterotoxin-producing Staph. aureus strains seem to contribute to bovine mastitis in the Republic of Korea.

Background: Although most of the literature about health-related quality of life (HRQoL) focuses on breast cancer patients, few studies compared the HRQoL in disease-free breast cancer survivors with that of the general population. Materials and methods: We administered the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and Quality of Life Questionnaire Breast Cancer Module, McGill Quality of Life Questionnaire, Beck Depression Inventory, and Brief Fatigue Inventory to 1933 disease-free survivors for over 1 year after being diagnosed with stage 0 to III breast cancer. We performed multivariate-adjusted analyses in all HRQoL comparisons. Results: The scores for some HRQoL scales were comparable for both disease-free breast cancer survivors and the general female population; however, there was clinically significant difference in cognitive and social functioning, fatigue, insomnia, and financial difficulties between the two groups. Radiotherapy and systemic adjuvant therapy variables did not limit the HRQoL. Demographic characteristics such as age, time since surgery, and comorbidity were associated with some HRQoL scales and fatigue and depression were associated with almost all HRQoL scales. Conclusions: Disease-free survivors of breast cancer had good HRQoL, which was less affected by the type of treatment than it was by demographic characteristics, time since surgery, comorbidity, fatigue, and depression.

Cl(-) transporters that bear a terminal ethynyl group were synthesized; they consist of non-pyrrolic hydrogen bond motifs such as phenolic OH, amide NH, and triazole CH. The ethynyl group of these non-pyrrolic analogs plays an important role in chloride efflux and they exhibit no significant cytotoxic activity.

UNLABELLED Gamma irradiation (GI) was evaluated for its in vitro and in vivo antifungal activity against Penicillium expansum on pear fruits. GI showed a complete inhibition of spore germination, germ tube elongation and mycelial of P. expansum, especially 1·8 kGy. GI affected the membrane integrity and cellular leakage of conidia in a dose-dependent manner. Furthermore, the leakage of protein and sugar from mycelia increased along with the dose. GI was evaluated at lower doses in combination with a chlorine donor, sodium dichloro-s-triazinetrione (NaDCC), to examine the inhibition of P. expansum. Interestingly, only a combined treatment with 0·2 kGy of GI and 70 ppm of NaDCC exhibited significant synergistic antifungal activity. The mechanisms by which the combined treatment decreased the blue mould decay of pear fruits could directly associated with the disruption of the cell membrane of the fungal pathogen, resulting in a loss of cytoplasmic materials from the hyphae. SIGNIFICANCE AND IMPACT OF THE STUDY Gamma irradiation (GI) is used as an effective nonchemical approach to inactive pathogens. This study investigated the antifungal effect of gamma irradiation and its combined treatment with a chlorine donor on this fungal pathogen, both in vitro and in vivo. This study emphasized that the integration of low-dose GI and a chlorine donor, NaDCC, exhibited a significant antifungal effect, and that its mechanisms are directly associated with membrane integrity of fungal spores, promising that GI has the potential to be an antifungal approach.

Two fluorine-doped diamond-like carbon (F-DLC) stamps with sub-100 nm line patterns were fabricated using a direct etching method. These were applied successfully to ultraviolet (UV) nanoimprint lithography without requiring an anti-adhesion layer coating. Tests were performed to determine the optimum fluorine concentration for the F-DLC stamps. The ideal stamp material consisted of 25 at.% F-DLC with a contact angle of 85°, UV transmittance of 16.4-26.8%, and hardness of 4.5 GPa. The O(2) plasma etch rate of the DLC was increased considerably by the fluorine doping, making it comparable to the etch rate of polymethyl methacrylate (PMMA). Thus, only PMMA was used as the etch mask in the fabrication of the stamps.

Background. Treatment of transplant recipients with either 15-deoxyspergualin (DSG) or monoclonal antibodies (mAbs) to T-cell proteins CD45RB and CD154 (a two-signal blockade) has been shown to prolong islet graft survival. Therefore, we investigated the combined effect of DSG, anti-CD45RB, and anti-CD 154 in murine islet model. Methods. Chemically induced diabetic C57BL/6 mice underwent allografting with islets from BALB/c mice or xenografting with rat islets. After transplantation, they were treated with either DSG, the two-signal blockade, or both (the triple treatment). The tolerogenic effects of the posttransplant treatments were measured with an intraperitoneal glucose tolerance test (IPGTT), immunohistology, enzyme-linked immunosorbent assays, and flow cytometry. Results. Blood glucose profiles measured after glucose challenges were improved in all islet recipients. Enhancement of xenograft survival in triple-treated groups was not statistically significant (P=0.08), compared to graft survival in group received only the two-signal blockade. However, 15 days after transplantation, xenografts in the triple-treated group showed a significant decrease in the proportion of CD4 + , CD8 + , and CD4 + CD45RB high T-cells, and in the expression of interleukin-10 and interferon-γ, relative to grafts in the other treatment groups. In addition, reduced infiltration of the xenografts by CD3 + T-cells was observed in groups that had received either the two-signal blockade or the triple treatment. With long-term (>248 days) xenografts, only those in the triple-treated group were free of inflammatory infiltrates. These grafts also exhibited larger islet clusters and contained more insulin- and glucagon-positive cells, relative to grafts in the other treatment groups. Conclusion. Triple treatment has a beneficial effect in murine islet xenotransplantation.

The manufacturing of silicon wafers forms the most important step in the construction of integrated circuit (IC) chips. One of the difficulties in this manufacture process is the removal of the waviness from the resulting wafers. In this paper, mathematical modelling and analysis of this removal process is carried out by the use of the support vector regression (SVR) algorithm. The results show that SVR is ideally suited for the modelling of this complicated process. Furthermore, by the use of the learning ability of SVR, the model can be continuously improved as more data become available. Based on the resulting model, the influences of the various factors on the rate of removal and the ease of control of the removal process are also discussed.

Background Induction of mixed chimerism is currently the most promising concept for clinical tolerance induction; however, the toxicity of the required host conditioning for allogeneic bone marrow transplantation (BMT) should be overcome. Therefore, we explored tolerogenic effectiveness of megadose BMT with anti-CD45RB and anti-CD154 mAb (two-signal blockade) in murine recipients without conditioning. Materials and methods Recipient B6 mice of BALB/c skin allograft received conditioning and an optimal dose (2 × 107 cells) of BMT. For a megadose BMT model, the conditioning was not performed; instead, megadose (2 × 108 cells) of BM was transplanted. The recipients were then treated with anti-CD45RB mAb and anti-CD154 mAb alone or their combination. Flow cytometry was performed to analyze the degree and distribution of donor-derived cells, peripheral deletion of Vβ5 or Vβ11 T cells and intrathymic presence of donor MHC class II+ cells. Induction of chimerism-based tolerance to skin allograft was further determined. Results High levels (∼23.7%) of mixed and multi-lineage chimerism-based tolerance to skin allograft were induced in the recipients (91%) treated with the optimal-dose BMT and the two-signal blockade. The megadose BMT could replace the recipient conditioning and establish low (∼10%) and stable multilineage chimerism. Donor-specific tolerance to skin allograft was induced in these chimeras through clonal deletion of donor-reactive cells. Conclusions The megadose BMT with the two-signal blockade could effectively establish mixed and multi-lineage chimerism and induce donor-specific tolerance, suggesting its potential for clinical application.

Due to the complexity of machine tool structure and the cutting process, the dynamics of machining processes are still not completely understood. This is especially true for high-speed machining processes. To model and control these complex processes, new approaches, which can represent complex phenomenon combined with learning ability, are needed. The combined neural-fuzzy approach appears ideally suited for this purpose. To illustrate the approach, the recently developed fuzzy adaptive networks are used to model dimensional error in turning operations. The fuzzy adaptive network has both the learning ability of a neural network and the linguistic representation of a complex, not well understood or vague phenomenon. An approximate model representing the influences of machining parameters on dimensional error is first established. This model is then improved by learning with the given training data. The improved models are verified by the use of test data, which are obtained by the use of actual experiments.

Behcet's disease (BD) is a multisystemic, recurrent inflammatory disease caused by the combinations of multiple genetic and environmental factors. Moreover, the MBL2 gene single-nucleotide polymorphisms and haplotypes are known to increase the susceptibility to inflammatory disease and to alter the serum levels of mannose-binding lectin (MBL. We postulated that the haplotypes of the MBL2 gene influence therapeutic response in BD, thus affecting the clinical symptoms in 282 BD patients. The promoter region, MBL2-550*C/*C (L/L) homozygote was found to have a lower frequency in BD patients than that in controls. No difference was observed in the allele frequencies of G-221C (Y/X), C+4T (P/Q) or Gly54Asp (A/B) of the MBL2 gene in BD patients and in controls. The HYPA haplotype contributed to BD occurrence, whereas the LYPA haplotype was negatively associated with BD. BD patients with several symptoms and with an earlier disease-onset age had a higher HYPA haplotype frequency. BD patients showing poor response (S) to therapy had a higher HYPA frequency than those showing good response (M). It seems that possessing HYPA increases the risk of BD and that the MBL2 HYPA haplotype plays a role in MBL levels and increases the susceptibility to BD.

The gridless Lagrangian method smoothed particle hydrodynamics (SPH) is preferentially used in CFD to simulate complex flows with one or several convoluted free surfaces. Indeed, this type of flow would require distorted meshes with Lagrangian finite difference methods or very fine meshes with VOF. As the literature is quite scarce concerning SPH validations for academic problems, we present in this paper some results relative to laminar recirculating flows. The ability of SPH to reproduce recirculation zone is revealed through a 2D hill and a backward-facing step geometry: axial velocity profiles obtained with SPH are quite satisfactory and separation and reattachment points are well predicted in both cases. Moreover, some practical and robust wall modelling conditions are also introduced and the limitation of the nearly incompressible assumption, used in most standard SPH codes, is illustrated. Indeed, we reveal that it is necessary to consider a relatively high speed of sound in order to avoid numerical voids. Copyright © 2005 John Wiley & Sons, Ltd.

BACKGROUND The aim of this prospective study was to evaluate the predictive value of [18F]fluorodeoxyglucose positron emission tomography (FDG PET) for the pathological response of breast cancer after completion of neo-adjuvant chemotherapy. METHODS Fifty patients with newly diagnosed, non-inflammatory, large or locally advanced breast cancer undergoing neo-adjuvant chemotherapy were eligible for this study. Clinical assessment was accomplished by comparing initial tumor size with preoperative tumor size. Pathological responses were classified into three groups: pathological non-response (pNR), pathological partial response (pPR) and pathological complete response (pCR). To determine the effect of reduction rate (RR) of peak standardized uptake values for tumor responses, logistic regression analyses were performed. To identify an optimal threshold value of RR for the prediction of pathological response, receiver operating characteristic analysis was performed. RESULTS Eight per cent (four of 50) of the patients had pCR and 46% had pPR. Ten per cent of patients had clinical CR and 52% had clinical PR. In clinical response, the RRs (+/- SD) of CR (-83.4 +/- 12), PR (-81.8 +/- 22.7) and NR (-79.7 +/- 31.9) showed no statistical differences (P > 0.05). However, for pathological responses, the RR of CR (-96.5 +/- 3.4) had a lower value than those of PR (-87.9 +/- 15.1) and NR (-56.2 +/- 29.6) (P = 0.0006; CR versus PR, P < 0.05; CR versus NR, P < 0.05; PR versus NR, P < 0.01). When -88% of RR was used as threshold value for differentiation between pCR and pPR, the area under the curve (AUC) was 0.788 [standard error (SE) 0.106; 95% confidence interval (CI) 0.589-0.920]. The sensitivity and specificity were 100% and 56.5%, respectively. When -79% of RR was used as threshold value for differentiation between pathological responders and non-responders, the AUC was 0.838 (SE 0.059; 95% CI 0.707-0.927). The sensitivity and specificity were 85.2% and 82.6%, respectively. CONCLUSIONS Despite some limitations, this study suggests a possible predictive value of FDG PET for the assessment of the pathological response of primary breast cancer after neo-adjuvant chemotherapy. However, these findings deserve further investigation on a larger number of patients, and more frequent and earlier PET scans in each patient need to be performed to allow a better validation of the differentiation between the responder and non-responder groups.

We measured critical current densities (Jcb) at 24°, 30°, 36.8°, and 45° grain boundaries of Y1Ba2Cu3O7 and Sm1Ba2Cu3O7 films, and we compared them with the previous measurements on Nd1Ba2Cu3O7 films. We observed salient hysteretic behaviours in the field-dependent Jcb at various temperatures. The main features of these measurements were consistent with the results of our calculations, where Jcb depends on the vortex density at the grain boundary as expressed by the modified Kim model. The vortex densities were estimated from field distributions around grain boundaries, while the field distributions were obtained from the Brandt formula. By these data analyses, we estimated the four characteristic parameters of grain boundaries and compared them for the three different types of material.

Background A small subgroup of atopic dermatitis (AD) patients with normal serum IgE levels and without specific IgE sensitization has been termed 'intrinsic type of AD' (ADi) as a counterpart to the term 'extrinsic type of AD' (ADe). However, there are neither molecular markers nor clinically diagnostic tools for distinguishing between ADi and ADe. Objective The present studies were undertaken to clarify the pathogenesis and in vivo cytokine micromilieu of ADi patients in comparison with ADe patients. Methods We used semiquantitative RT-PCR to investigate the expression of various cytokines and assessed the tissue eosinophil counts in skin biopsies from both types of AD patients. Results Although there was no significant difference of cellular infiltrates in the lesional skin between ADe and ADi patients, ADe had significantly increased tissue eosinophilia than ADi. Based on our RT-PCR, the expression patterns of cytokines could be categorized into four groups. The first group includes IL-5, IL-13, and IL-1beta, whose levels of mRNA expression were higher in both types of AD patients than non-atopic (NA) subjects, while ADe patients had even higher levels than ADi patients. The second group includes interferon-gamma (IFN-gamma), IL-12, granulocyte-macrophage colony-stimulating factor (GM-CSF), IL-4, and IL-10, whose levels of mRNA expression were elevated in both types of AD patients without differences between ADe and ADi patients. The third group includes tumour necrosis factor-alpha (TNF-alpha), whose mRNA expression was more decreased in both types of AD patients than NA, and the fourth group includes IL-6 and transforming growth factor-beta (TGF-beta), which did not show any differences among the three groups. Conclusion These current data demonstrate that the expressions of cytokines IL-5, IL-13, and IL-1beta mRNA and the number of dermal infiltrating eosinophils are increased in ADe patients compared with ADi patients.

The prevalence of asthma has been on the increase in the USA and worldwide. To understand the worsening epidemiological trends of asthma, this study analysed the data from the third National Health and Nutrition Examination Survey (NHANES III) to determine the prevalence and risk factors for asthma and wheezing among US adults. This analysis used data from 18,825 US adults aged > or = 20 yrs who had participated in the NHANES III project. After excluding subjects with physician-diagnosed emphysema, a total of 18,393 subjects were included in the final analysis. The prevalence of current asthma (asthma) was 4.5% and the prevalence of wheezing in the previous 12 months (wheezing) was 16.4%. Mexican-Americans exhibited the lowest prevalence of asthma when compared with other race/ethnic groups. Multiple logistic regression analysis showed that Mexican-Americans were less likely to report asthma when compared to non-Hispanic whites. Low education level, female sex, current and past smoking status, pet ownership, lifetime diagnosis of physician-diagnosed hay fever and obesity were all significantly associated with asthma and/or wheezing. No significant effect of indoor air pollutants, as derived from the use of household heating/cooking appliances, on asthma and wheezing was observed in this study. In conclusion, this study observed racial/ethnic differences in the prevalence of asthma and wheezing and identified several important risk factors that may contribute to development and/or exacerbation of asthma and wheezing. Contrary to earlier reports, the proxy measures of indoor air pollution used in this study were not found to be associated with increased risk of asthma and wheezing.

Multi-attribute decision making forms an important part of the decision process for both the small (an individual) and the large (an organization) problems. When available information is precise, many methods exist to solve this problem. But the uncertainty and fuzziness inherent in the structure of information make rigorous mathematical models inappropriate for solving this type of problems. This paper incorporates the fuzzy set theory and the basic nature of subjectivity due to the ambiguity to achieve a flexible decision approach suitable for uncertain and fuzzy environment. The proposed method can take both crisp and fuzzy inputs. An outranking intensity is introduced to determine the degree of overall outranking between competing alternatives, which are represented by fuzzy numbers. The comparison of these degrees is made through the concept of overall existence ranking index. A numerical example is given to illustrate the approach.