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The British colonies, which contributed the lion’s share of Britain’s geographical expansion during the nineteenth century, also provided the largest material contribution to Britain’s industrialization, and much-needed ecological relief (in the form of land), through trade. Nevertheless, not all types of colonialism mattered equally. The biggest land relief came from the settler colonies in British North America and Australasia. The slave-based colonies were not as instrumental in alleviating Britain’s land constraints as the nineteenth century progressed.

The present article provides a comparative review of historical economic inequality in the two most unequal regions of the world, namely Latin America and Africa. This contribution examines novel studies that provide quantitative estimates of income and/or wealth inequality in the two continents in terms of sources, methods, results and interpretations, focusing on the period 1650 to 1950. The article shows that although scholars in the two regions have often employed similar methodologies, their results are far from conforming to a uniform pattern. The present review highlights how scholars of Latin America and Africa tend to remain geographically isolated, failing to capture the learning opportunities stemming from the work of their continental counterparts in terms of both sources and methods.

Anti-SARS-CoV-2 spike RBD (receptor-binding domain) IgG antibody levels were monitored in 1643 volunteer healthcare workers of Eginition, Evangelismos, and Konstantopoulio General Hospitals (Athens, Greece), who underwent vaccination with two doses of COVID-19 BNT162b2 mRNA vaccine (Pfizer) and had no history of SARS-CoV-2 infection. Venous blood was collected 20–30 days after the second vaccine dose and anti-RBD IgG levels were determined using CMIA SARS-CoV-2 IgG II Quant (Abbott) on ARCHITECT i System or ADVIA Centaur SARS-CoV-2 IgG (Siemens) on Centaur XP platform. From the total population of 1643 vaccinees (533 M/1110 F; median age = 49; interquartile range-IQR = 40–56), 1636 (99.6%) had anti-SARS-CoV-2 IgG titers above the positivity threshold of the assay used. One-Way ANOVA Kruskal-Wallis H test showed a statistically significant difference in the median of antibody titers between the different age groups (p < 0.0001). Consistently, Spearman’s correlation coefficient (r) for IgGs and age as continuous variables was −0.2380 (p = 1.98 × 10−17). Moreover, antibody titers were slightly higher by 1.2-mean fold (p = 3 × 10−6) in the total female population of the three hospitals (median = 1594; IQR = 875–2584) as compared to males (median = 1292; IQR = 671.9–2188). The present study supports that BNT162b2 vaccine is particularly effective in producing high anti-SARS-CoV-2 IgG levels in healthy individuals, and this humoral response is age- and gender-dependent.

Baltic trade is one of the key examples of flourishing economic activity in early modern European history. This study empirically outlines the role of comparative resource advantages between 1750 and 1856, using trade data from the Sound Toll Registers Online. On the one hand, the results show the significance of relative land abundance for trade patterns between the Baltic Sea region and North-Western Europe: the land abundant Baltic Sea region was overall exporting more land-intensive commodities. On the other hand, however, the results also show a seeming paradox: increasing trade openness during the nineteenth century was not associated with a higher degree of specialization along these comparative advantages.

Land was an unambiguous constraint for growth in the pre-industrial period. In Britain it was overcome partly through the transition from traditional land-based goods to coal (vertical expansion) and partly through accessing overseas land, primarily from colonies (horizontal expansion). Kenneth Pomeranz suggested that horizontal expansion may have outweighed vertical expansion in the first decades of the nineteenth century. Taking a more complete approach to trade, we find that Britain was a net exporter of land embodied in traded commodities, apart from in the early nineteenth century, when potash (rather than cotton or timber) constituted the major land-demanding import from North America. The vertical expansion was generally larger than the horizontal expansion. In other words, Britain was not simply appropriating flows of land and resources from abroad but simultaneously providing its trading partners with even more land-expanding resources.

The role of agriculture has been central in Africa’s long-term economic development. Previous research has argued that low productivity of African economies has posed significant challenges in African efforts to produce an agricultural surplus or develop commercial agriculture. Low agricultural productivity has also served as a key explanation for the transatlantic slave trade, on the basis that it was more profitable to export humans overseas than to grow and export produce. The field has however suffered from a lack of comparable empirical evidence. This paper contributes to this field by presenting quantitative data on historical land- and labour productivity in Africa, from a case study of the agricultural productivity in Senegambia in the early nineteenth century. Focusing on five key crops, our results suggest that both land- and labour productivity was lower in Senegambia than it was in all other parts of the world for which we have found comparable data. We thus lend support to claims that stress ecological factors as one of the main determinants of Africa’s historical development.

The investigation of Health-Related Quality of Life (HRQOL) of Orthodox Christian monks who live at the Holy Mount Athos in Greece, and its correlation with demographic characteristics and Sense of Coherence (SOC-13). A cross-sectional study was designed. The seven monasteries and five scetes with the largest number of monk population were invited to participate. Two monasteries and 1 scete gave their permission for the study. The final monks sample was formed by 166 monks from 215 who participated to the study. HRQOL was assessed using the SF-12 and Sense of Coherence the SOC-13 scales that were completed by monks from May to August 2012. Μultiple linear regression analyses were conducted to explore the association of the HRQOL subscales with the demographics and SOC-13. The mean age was 45.5 ± 13.0 years; 83.7% lived in communal monasteries, and the mean number of years in monasticism was 18.4 ± 12.1. The mean value of their Physical Component Summary (PCS) score was 47.3 ± 5.3, which is lower than in the general Greek men population, while their Mental Component Summary (MCS) score was 56.4 ± 5.8, which is higher than in the general Greek men population. The mean value of SOC-13 was 65.7 ± 6.5. Positive association for PCS appeared for place of living (β = 5.43, SE = 1.27, p

Although out-of-hospital cardiac arrests (OHCA) are a major cause of mortality internationally, data regarding survival in Greece remains scarce and inconclusive. The aim of this study is to assess the immediate and 24-hour survival of OHCA sufferers during a 5-year period in a public hospital in Athens. A retrospective study was conducted on all cardiac arrests that were transferred to our hospital during a five-year period (2011-2015). Our primary objective was to calculate return of spontaneous circulation (ROSC) and 24-hour survival ratios. Our secondary objective was to estimate 30-day survival. Demographic data was also collected. 283 OHCA were included in the study. The mean age was 67.2 years and the male: female ratio was 2. Medical history was available for 33.6% of patients. 72.1% of cases were transferred to the emergency department by ambulance and 2.8% by private means of transport. Cardiopulmonary resuscitation was attempted on 57.6% of cardiac arrests, 8.6% regained ROSC and 6.1% survived for 24 hours. The 30-day survival was expected to be less than 3.5%. In our institution, ROSC, 24-hour and expected 30-day survival were lower than the European average and in accordance with the recent prospective Eureca One study. However, data from our institution cannot be generalised and multicenter studies are required in order to clarify OHCA outcomes in Greece.

Listeria monocytogenes (L. monocytogenes) is a Gram-positive bacillus that infects immunocompromised persons, neonates, pregnant women and, occasionally, previously healthy individuals. L. monocytogenes brain abscesses are particularly rare.We present a 62-year-old female on corticosteroid treatment due to a recent diagnosis of autoimmune hepatitis, who suddenly developed right hemiparesis mimicking a stroke. A brain computerized tomography (CT) scan revealed a brain abscess and the blood cultures drawn yielded L. monocytogenes. A conservative treatment without surgical intervention was selected. The patient was commenced on intravenous ampicillin and gentamicin and showed remarkable improvement. She was successfully discharged on oral amoxicillin with probenecid. Since the subsequent magnetic resonance imaging (MRI) study and CT scans exhibited reduction in the size of the abscess, the antimicrobial treatment was discontinued after a three-month period. The patient underwent regular follow-up visits with no signs of relapse.

Trypanosoma congolense and T. vivax are the main causative agents of animal African trypanosomosis (AAT), a disease which hinders livestock production throughout sub-Saharan Africa and in some parts of South America. Although two trypanocidal drugs are currently available, the level of treatment is low due to the difficulty in diagnosing the disease in the field. The major clinical signs of AAT such as anaemia, weight loss, and infertility, are common to several other endemic livestock diseases. Current diagnostic methods, based on the visualization of the parasite in the blood, or on the detection of its DNA or the antibodies it triggers in the host, are not suitable for direct use in the field as they require specialized equipment and personnel. Thus, we developed a quick-format diagnostic test (15 min) based on the recombinant TcoCB and TvGM6 antigens for detection of T. congolense and T. vivax , respectively, aimed at providing farmers and veterinarians in the field with the means to conduct a quick diagnosis. The specificity and sensitivity of the test were evaluated using sera from experimentally infected cattle, and fresh blood when possible. The prototype, which includes both antigens, shows a specificity of 95.9 (95% C.I., 90.4%–100%) and a sensitivity of 92.0% (95% C.I., 85.9%–98.1%) for T. congolense and 98.2% (95% C.I., 94.7%–100%) for T. vivax . The high levels of sensitivity and specificity of this rapid test, the possibility of using directly whole blood, and the ease of interpreting the result, all contribute to make of this test a valuable candidate to contribute to the control of AAT in the field. However, further tests with more representative, numerous and fresh reference samples are necessary in order to compare this test with the ELISA, the current gold standard serological test for trypanosomosis.

Background We aimed to consolidate our clinical observations regarding the development of pulmonary hypertension following pneumonectomy for lung cancer. Methods Sixty-nine of 82 initially selected patients without pulmonary or cardiac comorbidities, who underwent pneumonectomy for lung cancer between October 2009 and October 2011, accomplished our protocol. Mean patient age was 60.6 years (range 44–78 years) and 10.1% were women. Results Postoperative complications occurred in 16 (23.2%) patients. Mortality at 1, 12, and 18 months postoperatively was 4.3%, 15.9%, and 29%, respectively. One year postoperatively, 37.9% of patients developed mild to moderate pulmonary hypertension and 3.4% had severe pulmonary hypertension. The calculated mean pulmonary artery systolic pressure at 1, 6, and 12 months postoperatively was 21.9 ± 6.6, 27.3 ± 9.3, and 34.1 ± 14 mm Hg, respectively ( p Conclusions Pulmonary hypertension may occur after pneumonectomy with its known adverse effects. Patients with late postoperative pulmonary artery systolic pressure > 35.5 mm Hg are at higher risk of a suboptimal clinical outcome.

Although it has been proven that decreasing the arterial blood pressure decreases cardiovascular morbidity and mortality,25% of hypertensive patients receiving antihypertensive treatment achieve target values, which are mainly attributed to failure of the patients to comply to treatment. Ensuring patient compliance to antihypertensive treatment, to prevent the development of hypertension-associated complications, has proven to be challenging in several countries. The aim of the present study was to investigate the knowledge, perceptions and practices applied by doctors treating hypertensive patients regarding patient compliance to the prescribed treatment. We also aimed to assess the possible barriers physicians face to using reinforcement methods and currently available guidelines. A total of 202 doctors from the Serres and Drama prefectures of Greece participated in this study. The data collection comprised a quantitative method questionnaire and the data were processed using Stata 8.0 statistical software. The results demonstrated that 84.7% of the participating doctors do not use the current guidelines for compliance, whereas only 10.1% have consultations lasting15 min when discussing the medication with their patients. In addition, the majority (84.7%) of the doctors do not practice peer mentoring and consider the most effective interventions to be providing information and discussing the medication with their patients. In conclusion, the level of patient compliance to antihypertensive medication is unsatisfactory and the main reason is considered to be the non-use of guidelines by the treating physicians. Patients may benefit from further education of health professionals in this field.

This paper aims to investigate the stress management skills of Christian Orthodox monks and nuns, as measured by Antonovsky's scale sense of coherence (SOC). A case-control study was designed to test the hypotheses whether monks and nuns have higher SOC than secular people. The study population consisted of 193 individuals, 96 monks and nuns (study group) and 97 secular men and women (control group). SOC score was higher in monks and nuns as compared to the secular population (p = 0.002), men as compared to women (p = 0.012) and persons of older age (p = 0.004) as compared to younger individuals.

Abstract The indirect adaptive regulation of unknown nonlinear dynamical systems under the presence of dynamic and parameter uncertainties, is considered in this paper. The method is based on a new Neuro-Fuzzy Dynamical Systems definition named Fuzzy-Recurrent High Order Neural Network (F-RHONN), which however takes into account the fuzzy output partitions of the initial fuzzy dynamical system (FDS) operating in conjunction with appropriate HONNFs, that approximates the fuzzy rules. The proposed scheme does not require a-priori experts’ information on the number and type of input variable membership functions making it less vulnerable to initial design assumptions. Once the system is identified around an operation point, it is regulated to zero adaptively. Weight updating laws for the involved HONNFs are provided, which guarantee that under the presence of ‘small’ dynamic uncertainties both the identification error and the system states reach zero exponentially fast, while keeping all signals in the closed loop bounded. The existence of the control signal is always assured by introducing a method of parameter hopping, which is incorporated in the weight updating law. The applicability is tested on the Lorenz model, where it is shown that by following the proposed procedure one can obtain asymptotic regulation quite well in the presence of unmodeled dynamics.

Objective: The objective of this study is the assessment of the impact of a brief patient group education intervention (Conversation Maps TM ) in people with type 2 Diabetes Mellitus. Methods: A total of 138 people with type 2 Diabetes Mellitus who were regular patients at the diabetic clinic of a Primary Health Care setting in Attica participated in the study. The intervention group attended a structured group, brief educational programme (three sessions of two hours each). The main outcome measures were glycated hemoglobin (HbA1c), Body Mass Index (BMI), triglycerides, High-density lipoprotein (HDL), Low-density lipoprotein (LDL), measured at baseline and six months after the intervention. Results: After 6 months, significant reductions were observed between the baseline and follow-up data in HbA1c ( p < .001) in BMI (p < .007) in triglycerides ( p < .003), in LDL-cholesterol ( p < .001), while the mean HDL-cholesterol remained stable ( p = .397). Conclusions: Group-based patient education with Conversation Maps TM for people with type 2 diabetes is effective in the improvement of clinical outcomes.

This study aims to assess the impact of a brief patient group education intervention in people with type 2 diabetes mellitus. The sample, 193 people with type 2 diabetes mellitus who were patients at the diabetic clinic of a primary health care setting in Attica, was assigned to two groups, intervention (138 individuals) and control group (55 individuals). The intervention group, instead of receiving standard care, attended a structured group educational programme using Conversation Maps while the control group had standard care. The main outcome measures were HbA1c, body mass index (BMI), triglycerides, high density lipoprotein (HDL), low density lipoprotein (LDL), measured at baseline and 6 months after the intervention. After 6 months, significant differences in changes ofthestudiedparameterswereobservedbetween the groups in HbA1c, 1.4 (95% CI: 1.1, 1.7), (P

IntroductionMusic has been proposed as a safe, inexpensive, nonpharmacological antistress intervention. The purpose of this study was to determine whether patients undergoing cataract surgery while listening to meditation music experience lower levels of blood pressure and heart rate.MethodsTwo hundred individuals undergoing cataract surgery participated in the study. Hundred individuals listened to meditation music, through headphones, before and during the operation (intervention group) and 100 individuals received standard care (control group). Patients stress coping skills were measured by the Sense of Coherence Scale (SOC Scale). Systolic and diastolic blood pressure and heart rate were defined as outcome measures.ResultsAccording to the SOC Scale, both groups had similar stress coping skills (mean score: 127.6 for the intervention group and 127.3 for the control group). Before entering the operating room (OR) as well as during surgery the rise in systolic and diastolic pressures was significantly lower in the intervention group ( P < 0.001). Among patients receiving antihypertensive therapy, those in the intervention group presented a lower increase only in systolic pressure ( P < 0.001) at both time recordings. For those patients in the intervention group who did not receive antihypertensive treatment, lower systolic blood pressure at both time recordings was recorded ( P < 0.001) while lower diastolic pressure was observed only during entry to the OR ( P = 0.021). Heart rate was not altered between the two groups in any of the recordings.ConclusionsMeditation music influenced patients' preoperative stress with regard to systolic blood pressure. This kind of music can be used as an alternative or complementary method for blood pressure stabilizing in patients undergoing cataract surgery.

Fuzzy Cognitive Networks (FCN) stem from Fuzzy Cognitive Maps (FCM), initially introduced by Kosko to model complex behavioral systems in various scientific areas. This chapter presents basic definitions related to FCM and the traditional way of their operation. It starts with a brief bibliographical introduction, presenting various extensions of the initial model and areas of application. Since their convergence is a crucial point for the development of Fuzzy Cognitive Networks, particular emphasis is given to the subject of their convergence to equilibrium points and some noticeable peculiarities that may appear. Then, the scope of Part II of this book is analyzed and the organization of the relevant chapters is presented.

The indirect adaptive regulation of unknown nonlinear dynamical systems with multiple inputs and states (MIMS) using F-RHONNs under the presence of parameter and dynamic uncertainties, is considered in this chapter. The method is based on the new NF dynamical systems definition introduced in Chap. 2, which uses the concept of adaptive fuzzy systems (AFS) operating in conjunction with recurrent high order neural networks. Since the plant is considered unknown, we first propose the calculation of fuzzy output centers by systems data or linguistic information and in the sequel the fuzzy rules are approximated by appropriate HONNs. Thus, the identification scheme leads up to fuzzy subsystems approximated by recurrent high order neural networks, which however takes into account the centers of the fuzzy output partitions (F-RHONNs). Every high order neural network approximates a group of fuzzy rules associated with each center. The indirect regulation is achieved by first identifying the system around the current operation point, and then using its parameters to device the control law. Weight updating laws for the involved HONNs are provided, which guarantee that, under the presence of both parameter and dynamic uncertainties, both the identification error and the system states reach zero, or at least uniform ultimate boundedness of all signals in the closed-loop. The control signal is constructed to be valid for both square and nonsquare systems by using a pseudo-inversion. The existence of the control signal is always assured by employing the method of parameter hopping instead of the conventional projection method.

In this chapter, we present the framework of operation of FCN, which is based on the adaptive estimation algorithms developed in the previous chapter and on the proposal of a fuzzy rule-based mechanism for storing acquired knowledge during its operation and training. Moreover, selected applications are presented, which demonstrate the applicability of the FCN framework both in conventional benchmark control problems and in real life applications. Both parameter adaptation algorithms, the linear and the bilinear one, are tested, emphasizing their distinct characteristics and advantages. The applications include the control of an inverted pendulum, the control of a hydroelectric power plant, and the coordination of different renewable power sources in order to yield an overall optimal power production and consumption in a smart grid application.

In this chapter, we present a study for the existence of equilibrium points of FCNs equipped with continuous differentiable sigmoid functions that have contractive or at least nonexpansive properties. The study is done by using an appropriately defined contraction mapping theorem and the nonexpansive mapping theorem. It is proved that, when the weight interconnections fulfill certain conditions, related to the size of the FCN and the inclination of the sigmoid functions, the concept values will converge to a unique solution regardless of their initial states, or in some cases a solution exists that may not necessarily be unique. Otherwise the existence or the uniqueness of equilibria may or may not exist, it may depend on the initial states, but it cannot be assured. In case the FCN has also input nodes (that is nodes that influence but are not influenced by other nodes), the unique equilibrium does not depend solely on the weight set, as in the case of FCNs with no input nodes; it depends also on the values of the input nodes. Numerical examples explore the results and a thorough discussion interprets them.

In this chapter, we analyze the identification problem, which consists of choosing an appropriate identification model and adjusting its parameters according to some adaptive law, such that the response of the model to an input signal (or a class of input signals), approximates the response of the real system for the same input. As identification models, we use fuzzy-recurrent high-order neural networks (F-RHONNs). This model exploits the use of high-order networks (HONN), which are expansions of the first-order Hopfield and Cohen-Grossberg models that allow higher order interactions between neurons. It combines HONN with an underlying fuzzy model of Mamdani type assuming a standard defuzzification procedure such as centroid of area or weighted average. . Learning laws are proposed which ensure that the identification error converges to zero exponentially fast or to a residual set when a modeling error is applied. In the proposed method, there are two core ideas : (1) Several high-order neural networks are specialized to work around fuzzy centers, separating in this way the system in simpler (NF) subsystems with better approximation abilities and (2) the use of a novel method called switching parameter hopping to replace the commonly used \(\sigma \)-modification for the robustness of our system in order to restrict the weights and avoid drifting of their values to infinity.

In this chapter, adaptive estimation algorithms are proposed, which estimate the FCN parameters based on sampled data that correspond to FCN equilibrium points. First, we assume that the only parameters that have to be estimated are the FCN weights. This requires the development of estimation algorithms that are based on a linear parametric model of the FCN equilibrium equation. Discrete time repetitive weight estimation laws are derived based on Lyapunov stability analysis and appropriate projection methods are employed to guarantee that the weight updating procedure does not compromise the conditions of existence and uniqueness of solutions, derived in the previous chapter. Next, we assume that apart from the FCN weights, the sigmoid inclination parameter of each node has to be appropriately estimated. This leads to bilinear parametric modeling of the FCN equilibrium equation and the derivation of respective adaptation algorithm. Similar to the linear case, appropriate projection methods are derived and it is proved that they do not compromise the stability results of the estimation error dynamics. Simulations and comparisons between the two approaches are given, which highlight the benefit of each of them.

In this chapter we present the direct adaptive regulation and tracking of affine in control nonlinear MIMO dynamical systems possessing unknown nonlinearities. The method is based on the neurofuzzy modeling presented in Chaps. 3 and 4, which combines the definition of fuzzy dynamical systems with the recurrent high-order neural networks. When the neurofuzzy model matches the unknown plant, we provide a comprehensive and rigorous analysis based on Lyapunov stability of the closed-loop system. Convergence of the states to zero or to a residual set or to a reference signal, plus boundedness of all other signals in the closed-loop is guaranteed without the need of parameter (weights) convergence, which is ensured only if a sufficiency-of-excitation condition is satisfied. The existence of the control signal and the boundedness of the weight convergence is always ensured by introducing the method of parameter modified hopping which is incorporated in the weight updating laws. Furthermore, we present direct adaptive regulation results of unknown nonlinear dynamical systems, paying special attention to the analysis of modeling errors and the model order problem. In these results, the model error is expressed by adding in the NF model a new disturbance term. The disturbance depends both on input and system states and on a nonzero term that is not necessarily known. A robustifying analysis of the developed method is also presented for the several disturbance cases. Moreover, the proposed approximation method is analyzed for its robustness when a smaller number of states is assumed. The omission of states, referred to as model order problem, is modeled by introducing in the approximation equations a disturbance term, which depends on the unknown (omitted) states. The applicability of the method is also tested on a well-known simulated nonlinear system where it is shown that by following the proposed procedure one can obtain asymptotic regulation or trajectory tracking. Comparison is also made with simple RHONN controllers, showing that the NF approach works better in any case.

In this paper, an adaptive control method for trajectory tracking of robot manipulators, based on new neuro-fuzzy modelling is presented. The proposed control scheme uses a three-layer neural fuzzy network (NFN) to estimate system uncertainties. The function of robot system dynamics is first modelled by a fuzzy system, which in the sequel is approximated by a combination of high order neural networks (HONNs). The overall representation is linear in respect to the unknown NN weights leading to weight adaptation laws that ensure stability and convergence to unique global minimum of the error functional. Due to the adaptive neurofuzzy modelling, the proposed controller is independent of robot dynamics, since the free parameters of the neuro-fuzzy controller are adaptively updated to cope with changes in the system and the environment. Adaptation laws for the network parameters are derived, which ensure network convergence and stable control. A weight hopping technique is also introduced to ensure that the estimated weights stay within pre-specified bounds. The simulation results show very good approximation performance of the proposed representation as compared with a simple NN approximator and very good tracking abilities under disturbance torque compared to conventional computed torque PD control.

Capecitabine (Xeloda(®)) is an oral fluoropyrimidine which is produced as a pro-drug of fluorouracil, and shows improved tolerability and intratumor drug concentrations following its tumor-specific conversion to the active drug. We have searched the Pubmed and Cochrane databases from 1980 to 2009 with the purpose of reviewing all available information on Capecitabine, focusing on its clinical effectiveness against colorectal cancer. Special attention has been paid to trials that compared Capecitabine with standard folinic acid (leucovorin, LV)-modulated intravenous 5-fluorouracil (5-FU) bolus regimens in patients with metastatic colorectal cancer. Moreover the efficacy of Capecitabine on metastatic colorectal cancer, either alone or in various combinations with other active drugs such as Irinotecan and Oxaliplatin was also assessed. Finally, neoadjuvant therapy consisting of Capecitabine plus radiation therapy, for locally advanced rectal cancer was analysed. This combination of chemotherapy and radiotherapy has a special role in tumor down staging and in sphincter preservation for lower rectal tumors. Comparative trials have shown that Capecitabine is at least equivalent to the standard LV-5-FU combination in relation to progression-free and overall survival whilst showing a better tolerability profile with a much lower incidence of stomatitis. It is now known that Capecitabine can be combined with other active drugs such as Irinotecan and Oxaliplatin. The combination of Oxaliplatin with Capecitabine represents a new standard of care for metastatic colorectal cancer. Combinating the Capecitabine-Oxaliplatin regimen with promising new biological drugs such as Bevacizumab seems to give a realistic prospect of further improvement in time to progression of metastatic disease. Moreover, preoperative chemo-radiation using oral capecitabine is better tolerated than bolus 5-FU and is more effective in the promotion of both down-staging and sphincter preservation in patients with locally advanced rectal cancer. Finally, the outcomes of recently published trials suggest that capecitabine seems to be more cost effective than other standard treatments for the management of patients with colorectal cancer.

The direct adaptive regulation of affine in the control nonlinear dynamical systems with modeling error effects, is considered in this paper. The method is based on a new Neuro-Fuzzy Dynamical System definition, which uses the concept of Fuzzy Dynamical Systems (FDS) operating in conjunction with High Order Neural Network Functions (F-HONNFs). Since the actual plant is considered unknown, we first propose its approximation by a special form of a fuzzy dynamical system (FDS) and in the sequel the fuzzy rules are approximated by appropriate HONNFs. This way the unknown plant is modeled by a fuzzy-recurrent high order neural network (F-RHONN), which is of known structure considering the neglected nonlinearities. The development is combined with a sensitivity analysis of the closed loop in the presence of modeling imperfections and provides a comprehensive and rigorous analysis of the stability properties of the closed loop system. The proposed scheme does not require a-priori information from the expert on the number and type of input variable membership functions making it less vulnerable to initial design assumptions. The control signal is constructed to be valid for both square and non square systems by using a pseudoinverse, in Moore-Penrose sense. The existence of the control signal is always assured by introducing a novel method of parameter hopping and incorporating it in weight updating law. Simulations illustrate the potency of the method where it is shown that the proposed approach is superior to the case of simple RHONN's.

A multi-serovar ELISA based on the outer membrane Lipoprotein L41 (LipL41) of pathogenic Leptospira was developed to increase sensitivity by using a single test antigen. A sensitivity of 99 % and a specifity of 92 % could be achieved. The established diagnostic polymerase chain reaction is also able to detect fast and reliably pathogenic Leptospira in different clinical samples.

In Germany, the application of antimicrobial agents represents the method of choice to control infections of food-producing animals by bacteria of the genus Leptospira. However, only few data are available on the susceptibility of Leptospira spp. against antimicrobial agents and the in vivo efficacy of antimicrobial agents. Based on a modified broth microdilution method, a standardised in-vitro susceptibility testing system for Leptospira spp. was established which also included quality control aspects. Considering the minimum inhibitory concentrations determined in this study in-vivo efficacy is expected for the following classes of antimicrobial agents: penicillins, cephalosporins, macrolides, lincosamides, fluoroquinolones, phenicols, and in part also for aminoglycosides and tetracyclines. Clinical aspects and bioavailability of the drugs in the target tissues have to be taken into account. Penicillins and aminoglycosides as commonly used inhibitory supplements in semen extender seem to be effective against leptospires.