br To show how an event

To show how an event can be measured using fuzzy measures, a triangular fuzzy variable, , is shown in Figure 2. From the definitions of possibility, necessity and credibility, it is easy to obtain:

Model formulation
In the context of this research, there is a network, , where represents the vertices and is the set of arcs. There are nodes in and there is a potential hub set, , which contains nodes. is the fixed cost to establish a hub link between nodes and ,and is the fixed cost of opening a hub facility at cytotoxicity assay . In addition, the travel time from node to node is shown by . Clearly, in a hub network, the travel time between any two hubs is less than, or equal to, the direct cost between them. Therefore, is defined as the travel time between hubs, and , without being discounted. is the time discount factor with a value between 0 and 1, and is usually a value greater than the cost discount factor. is the coverage radius, which is defined as the distance which defines the coverage status of a demand node. The budget available to invest in locating hub nodes is shown as . A feasible solution is the one in which hubs are located among potential hubs, hub links are established and spokes are allocated to hubs, so that the budget constraint is not violated and the credibility of “each flow in the network can be satisfied in a time less than ” is maximized. Furthermore, direct flows between non-hub nodes are not permitted. It should be considered that the formulation of this paper is a modified version of the one proposed by Alumur et al.  [31].
Additionally, there are some variables to be defined as follows: is defined as the radius of hub , the maximum travel time between the hub at node and those nodes which have been allocated to it. is a binary variable which equals one if node is allocated to a hub at node and zero otherwise. In addition, is another binary variable which shows if there is a hub link between hub nodes and . is another binary variable taking a value of one if the spanning tree which is originated from hub traverses from to . Now, the fuzzy single allocation incomplete hub-covering network design problem is defined as follows:

The objective function (10) deals with maximization of the credibility “each flow in the network could be satisfied in a time less than ”. Eq. (11) shows that the problem is a single-allocation hub location problem and each node must be assigned to one, and only one, hub facility. Eq. (12) states that a spoke could be assigned to a hub node. Using Eqs. (13) and (14) there is a guarantee that a link could be established only between hub nodes. In other words, there is not any inter-hub link between two non-hub nodes. Constraint (15) ensures that each hub is the end node for at least one of the inter-hub links. Constraint (16) guarantees that the arcs of the spanning tree of a non-hub node take a zero value. Constraint (17) ensures that only hub arcs are selected as spanning tree arcs. Eq. (18) is a linear constraint to calculate the time needed to travel between hubs using the established spanning tree arcs. Constraint (19) shows that the time matrix is symmetric. Since the distance of a node to itself equals zero, Constraint (20) has been added to the model. Constraint (21) calculates the radius of hubs. Constraint (22) guarantees that the total time to travel between any two hub nodes is less than a time bound. Constraint (23) is the valid inequality added to the model to reduce the time needed to solve the model to optimality. The budget constraint is stated as Constraint (24). Constraint (25) states that values are not negative. Constraints (26)–(28) govern that , , and variables take binary values. Since Eq. (10) is a non-linear equation, we have linearized the model as follows: Constraints (11)–(28)

Solution procedure

Computational experiments

Conclusion and future research areas
This study deals with the problem of designing single-allocation hub networks in incomplete networks with fuzzy travel times. It has been shown that this problem has remained essentially untouched in the literature. The hub-covering version of the problem has been considered and solved in this paper. To find the results, a simulation-embedded VNS has been designed. The results of solving the problems with various parameters showed that outputs of the fuzzy version may be quite different from the case with known parameters. Moreover, it has been seen that VNS is superb in finding near-optimal solutions of the problem. As some avenues for future research, these extensions may be followed:

purchase CM-272 br Pathophysiology The pathophysiology of IgG related

Pathophysiology
The pathophysiology of IgG4-related disease is poorly understood. IgG4-related disease seems to sit at an intersection between different inflammatory markers. Many patients have substantial allergic or atopic histories suggesting a modified Th2 response is critical to this condition. IgG4-related disease is most likely driven by an underlying autoimmune mechanism. There is higher risk for IgG4-related disease in certain genotypes and there is immune complex deposition and increase in regulatory CD25 T cells. No precise triggers have yet been identified for the initiation of IgG4-related disease. However, molecular mimicry by causing autoimmune reaction to a foreign antigen may be important. Escherichia coli and Helicobacter pylori have been implicated as possible candidates and source of molecular mimicry in IgG4-related pancreatitis. Mast purchase CM-272 have been shown to produce T helper 2 and regulatory T-cell cytokines in tissues affected by this condition suggesting a role in disease pathogenesis. There are four subclasses of IgG, of which IgG4 is the least common (<6%). IgG1-3 can activate all complement, whereas IgG4 cannot. IgG 1,3 and 4 are effective at opsonization of bacteria. Although IgG4 is increased in tissues and serum in IgG4-related disease, it is unclear if and how it would play a role in the pathophysiology of this condition or if it is a mere epiphenomenon.
Diagnosis
The diagnosis of IgG4-related disease is based on a typical clinical scenario, supportive laboratory data, expected radiological characteristics and distinct histopathological and immunohistochemical features. As mentioned previously, IgG4-related ophthalmic disease may involve the orbit including lacrimal glands, extraocular muscles or other orbital structures; affect the meninges causing ocular motor cranial nerve palsies or optic neuropathy; and/or extend to adjacent structures such as air sinuses or trigeminal nerve causing additional symptoms (case report).
The serum levels of total IgG and IgG4 are usually elevated in patients with IgG4-related disease and should be checked when the disease is suspected. However, it is increasingly clear that serum concentrations of IgG4 are unreliable as diagnostic marker in this condition. Approximately 20–40% of patients with biopsy-proven IgG4-related disease have normal IgG4 concentrations at the time of diagnosis, even before the institution of therapy. In addition, a proportion of both healthy and disease controls has elevated serum IgG4 levels, although it is uncommon for levels in controls to be more than twice the upper limit of normal. Furthermore, the serum concentration of IgG4 does not correlate with disease activity or response to treatment. Recently, Carruthers et al. estimated that elevation of serum IgG4 concentration had a sensitivity of 90% and specificity of 60% with high negative predictive value of 96% but low positive predictive value of 34% in the diagnosis of IgG4-related disease. Cerebrospinal fluid (CSF) analysis in patients with IgG4-related disease of the central nervous system may reveal mild to moderate lymphocytic pleocytosis, a non-specific finding. Therefore, the main value of CSF testing in those cases is the exclusion of infection and cancer. Further, it is unclear how sensitive or specific IgG4 measurement in CSF really is.
Katsura et al. reviewed the radiological features in the head, neck and brain of 17 histopathological confirmed cases of IgG4-related disease, including CT and MRI techniques. The general radiological features found included well-defined soft tissues masses showing homogeneous attenuation/signal intensity, which enhanced homogeneously. Lesions were iso- to hypointense relative to gray matter on T2-weighted imaging. Bones adjacent to the lesions showed remodeling with erosion or sclerosis, but without destruction. Diffuse thickening of the dura mater was also seen. Lacrimal, salivary and pituitary glands were preferentially affected. Perineural spread of cranial nerves, notably the trigeminal nerve, is characteristic, although not pathognomonic. Hardy et al. found enlargement of the infraorbital nerve and canal in patients with both, IgG4-related disease and benign reactive lymphoid hyperplasia, with orbital involvement.

According to Liebovitch ocular and periocular amyloidosis

According to Liebovitch, ocular and periocular amyloidosis can be presented as a subconjunctival or subcutaneous mass (95.8%), eyelid ptosis (54.2%), pain (25%), exophthalmos (21%), alteration in muscular activity (16.6%) and recurrent hemorrhage (12.5%).
The time between onset and diagnosis of the disease has been reported up to 11years. Although the 31year-old female patient described herein was younger than patients reported previously, and nine years had passed before diagnosis was made. Pseudoptosis was reported for the first time by Uchida in 1962 and classified as a subgroup of ptosis by Beard in 1969; it is a condition caused by a group of disorders that simulate ptosis with the lowering of the eyelid but without the malfunction of the levator muscle. In the present case drooping of superior eyelid was due to the accumulation of amyloid substance in all eyelid layers: subcutaneous, subconjunctival, Z-YVAD-FMK Supplier space of muscle, and Whitnall’s ligament, thus, increasing the weight of the eyelid and creating a greater effort for the aponeurotic muscle complex. Moreover, accumulation of amyloid substance weakened the muscle and created adherence within Whitnall’s ligament and the levator muscle aponeurosis exercising mechanical check. Therefore, this case could be classified as “true ptosis” as apposed to “pseudoptosis” since it was caused by both mechanical accumulation of amyloid in the lid lamella Z-YVAD-FMK Supplier and malfunction of the levator muscle.
Management of ptosis can be a challenge. Myasthenia must be ruled out. The paucity of local specific symptoms in rare cases can lead to incorrect diagnosis. Magnetic resonance imaging and computed tomography can be important to localize orbital structures that are involved and to evaluate the presence of amyloid material in muscular tissue. Furthermore, surgical treatment is very complex and requires precise indications. Appropriate management depends on the etiopathogenesis, accurate diagnosis, and clinical findings. Frontalis suspension is indicated in cases of absent levator muscle functionality, and although it was not indicated in this case of ptosis it had been performed as the diagnosis of amyloidosis had not been made. Indeed, management of ptosis in these cases is based on removal of localized amyloid, levator muscle advancement, levator resection, the Fasanella technique and, more rarely, tarsal and conjunctival resection, combined with reconstruction of the tarsus with conchal cartilage and levator muscle complex reinsertion.

Conclusions

Conflict of interest

Introduction
Leptomeningeal metastases are a late complication cancer that result from dissemination of malignant cells into cerebrospinal fluid (CSF), arachnoid mater, pia mater and subarachnoid space. It is estimated to occur in 5% of patients with malignancies but is likely to become more frequent as survival from systemic disease increases and many novel cancer drugs fail to achieve therapeutic concentrations in the central nervous system.

Case report
A 69-year-old male presented to his local optometrist complaining of headache and people’s speech being out of synchronicity with the movement of their lips for the past 1week. His medical history was unremarkable.
Ophthalmological assessment showed no abnormalities in the anterior segments of either eye. Dilated fundus examination revealed right macular subretinal fluid confirmed by OCT scan. As there were no obvious retinal pigment epithelial changes, no intraretinal fluid and no pigment epithelial detachment, a diagnosis of presumed central serous retinopathy (CSR) was made and explained to the patient. Further clinical review in 2weeks was planned.
One week later, the patient’s headache continued to worsen prompting emergency admission at a different medical centre. Neurological evaluation did not reveal any obvious focal deficits, inflammatory markers were within normal limits and a computed tomography (CT) of the head was reported as normal with no evidence of space-occupying lesions (Fig. 2a). The neurological team made a tentative diagnosis of severe migraine and sought an ophthalmic review prior to discharge.

Many factors may influence the decision of healthcare providers to

Many factors may influence the decision of healthcare providers to disclose medical errors. According to the conceptual model conceived by Fein et al. (2005), the most important influences on the decision to disclose a medical error fall into four categories: (a) provider factors, including perceived professional responsibility, (b) patient factors, including a desire for information, (c) error factors, including the level of harm to the patient, and (d) institutional culture, including the perceived tolerance for error by healthcare professionals.
Birks (2014) and Ghazal et al. (2014) proposed a set of guidelines for the disclosure of medical errors, citing conceptual reasons, such as the duty of candor, respect for autonomy, the imperative principle of truth-telling, the principles of beneficence and non-maleficence, and the deontology or Kantian obligation based theory. Healthcare providers, however, are not professional ethicists, and the disclosure of medical errors is not always a component of their ethical behavior.
In dentistry, medical errors include (a) incorrect medication prescription, (b) neglect of current scientific evidence regarding treatment, (c) improper maintenance of equipment, and failure to (d) properly maintain patient records, (e) acquire informed consent, (f) establish and maintain appropriate infection control measures, (g) accurately diagnose a dental condition, (h) prevent accidents or complications, (i) pursue appropriate follow-up care, and/or (j) follow statutory rules or regulations reflecting quality standards for dental care (Negalberg, 2015). Thusu et al. (2012) showed that the most frequently reported incidents in the practice of dentistry were clerical errors (36%) followed by patient injuries (10%), medical emergencies (6%), accidental ingestion or inhalation of clinical materials (4%), adverse reactions (4%), and erroneous tooth extractions (2%).
Although dentists have an ethical responsibility to fully disclose errors, in practice there is considerable inconsistency regarding opinions on the information that should be disclosed, and who should disclose this information (Blood, 2015). Thusu et al. (2012) reported a relatively low frequency of dental error disclosure, which they Vismodegib attributed to the voluntary nature of reporting and the reluctance of dentists to disclose incidents for fear of loss of earnings.
The disclosure of medical errors varies between clinical specialties (Blood, 2015; Chiodo et al., 1999; Ozar and Sokol, 2002; O’Connor et al., 2010; Yamalik and Perea, 2012). Accordingly, dentists may carry different attitudes than medical doctors toward ethical duty for disclosure. Possible reasons for freshwater biome discrepancy are hypothesized as follows. First, dental errors may be perceived as less serious. Second, medical care is most frequently provided at large institutions (e.g., hospitals), while dental care is generally more isolated at private practices. Third, medical care is generally provided by a team of doctors, while dentistry is often individually handled. Despite these differences, all medical practitioners, including dentists, have the same ethical obligation to tell the truth, respect patient autonomy, and disclose errors. The disclosure of dental errors is desired by patients and is also recommended by ethicists and professional organizations to ensure that the dental profession can be trusted (Chiodo et al., 1999; Blood, 2015). A critical examination of personal preferences and perceptions of the norm in current practice regarding the disclosure of dental errors is therefore necessary to the benefit of patients, dentists, and the practice of dentistry.

Materials and methods

Results

Discussion
Empirical data were obtained from 586 participants at over 10 dental institutions in Riyadh, Saudi Arabia, regarding issues related to the disclosure of dental errors. The research focused on the associations between the professional responsibility for disclosure (categorized by personal belief, perception of norm, and perception of current practice) and the error factors (specifically the nature of the dental error to be disclosed) and the institutional culture (specifically who should disclose the error). Statistical evidence based on the analysis of cross-tabulated data was consistent with the conceptual model of Fein et al. (2005) positing that three of the most important influences controlling whether to disclose medical errors involved provider factors, error factors, and institutional culture.

The growth and diversity of meiofauna

The growth and diversity of meiofauna may be stimulated by feeding on bacteria, which could increase the recycling of nutrients into the ecosystem and thereby be expected to have a greater productivity (De Wit et al., 2001; De Troch et al., 2006). Moreover, the meiofauna can provide food for higher trophic levels, such as fish and marine invertebrates (Leduc and Probert, 2009). The spatial patterns of the structure of the meiofaunal propyl in sandy beaches of marine ecosystems may be associated with different environmental variables. Related to this, the sediment granulometry (Gómez Noguera and Hendrickx, 1997; Barnes et al., 2008), the organic matter source in coastal sediments (Danovaro et al., 2002; Flach et al., 2002; Moreno et al., 2008; Ingels et al., 2009; Pusceddu et al., 2009), and oxic and anoxic conditions in the interstitial pore space (Mirto et al., 2000; Sutherland et al., 2007) have a fundamental role in the richness and abundance of the benthic meiofauna.
The criteria in the study of benthic meiofauna were established by Giere (1993) and these concepts have been recently applied for the Egyptian fauna of the Red Sea (Hanafy et al., 2011; Ahmed et al., 2011). However, none of the two studies took place on the vertical distribution of the meiofauna. This somewhat meager data suggest that there is a need for more information on meiofaunal community of the Egyptian coasts along the Red Sea and their temporal changes, weather stochastic, seasonal or long term to understand their trophic relation in the benthic ecosystem. This pioneer study was undertaken to provide answers to the basic question on what are different types of meiofaunal metazoans and their spatio-temporal variation in the Egyptian coasts of the Red Sea.

Materials and methods
Sediment samples for environmental parameters and meiofauna were collected from three stations of Gabal El-Zeit (site I), Safaga (site II) and Al-Qulaan (site III) (Fig. 1); with the help of a hand core of 4.5cm inner diameter and 10cm length situated approximately 350m apart in the sea. The three stations were selected based on their proximity to mangrove. Safaga (lat 26° 36′ 56″N, long 34° 00′ 43″E) and Al-Qulaan (lat 24° 21′ 28″N, long 35° 18′ 23″E) were closer to mangrove vegetation than Gabal El-Zeit (27° 48′ 10″N, long 33° 33′ 59″E). Samples for horizontal and vertical distribution were collected seasonally during 2012. Sampling was carried out where three replicate cores were collected at low tide by inserting the 10cm length core into the sediment from each station. The core sediments were sub-sectioned at 2cm interval for the study of vertical distribution of meiofauna, grain size analysis, and total organic matters. The percentage of silt/clay in the sediment was obtained by wet sieving using a 62μm sieve to separate the fine and sand fractions, which were then dried at 80°C and weighed (Harguinteguy et al., 2012).
Sediment samples containing meiofauna were preserved in 4% formalin and stained with Rose Bengal (Ansari et al., 2001). In the laboratory, these samples were elutriated of larger sand particles using a shake and decant procedure (Cross and Curran, 2000) and meiofauna were sorted by sieving through 0.50 and 0.062mm mesh sizes sieves. The content of the 0.062mm sieve was recovered and preserved in the fixative (Ditlevsen, 1911). Then, the fauna were identified to higher taxa and counted under a stereomicroscope (Higgins and Thiel, 1988), and dry weight biomass was obtained by multiplying a factor of 0.00045 with total number of taxa recorded on each sampling date and station (Ansari, 1989). The meiofaunal density was standardized to individuals per 10cm2. Identification of meiobenthic organisms were performed using the keys of Riedl (1969), Tarjan (1980), Norenburg (1988), Platt and Warwick (1988) and Huys et al. (1996).
Temperature was recorded with the help of a centigrade thermometer. Interstitial water was collected for the estimation of salinity and dissolved oxygen. For the estimation of salinity, method of Strickland and Parsons (1972) was followed. Oxygen concentration was estimated using an oxygen meter. The percentage of interstitial water of the sediment was measured regularly. Wet sediment from the fraction of core was weighed on a watch glass, dried at 100°C to constant weight and re-weighed. Wet weight minus dry wet was interpreted as a rough estimate of the weight of the interstitial water from which the percent interstitial water was calculated (Tietjen, 1969). Total organic matters of each sediment sample were determined according to Holme and McIntyre (1984). Sedimentary pigment determination was made according to Tietjen (1968) to obtain estimates of chlorophyll a in the sediment.

Calcium magnesium ATPase Ca Mg ATPase which is universally considered

Calcium-magnesium ATPase (Ca2+-Mg2+-ATPase), which is universally considered an indicator of cell health (Haya and Waiwood, 1983; Atli and Canli, 2013; Eroglu and Canli, 2013), acts as a membrane-bound enzyme and is responsible for the maintenance of calcium homoeostasis in buy Puromycin (Carafoli, 1991; Nadukuru and Yallapragada, 2015). Changes in ATPase activity, caused by a disruption in transmembrane cation transport, are identified as key factors in cellular dysfunction (Stephenson, 1985). While a temporary increase in intracellular calcium ion concentrations is necessary to activate physiological functions of tissues, a sustained increase will lead to cell death (Orrenius et al., 1989). Therefore, it is critical to protect calcium homoeostasis against interference from any extraneous toxins. The bioactivities of Ca2+-Mg2+-ATPase were significantly elevated at both clove oil dosages, suggesting that clove oil may influence the cell function of V. destructor by inducing an excessive intracellular calcium ion concentration.
The glutathione-S-transferase enzymes are a major family of enzymes that detoxify cytosol (Ranson et al., 1997) by protecting against endogenous and exogenous toxic chemicals (Sheehan et al., 2001). GSTs protect other endogenous substances, such as proteins and nucleic acids, by catalysing the conjugation of activated xenobiotics and endogenous glutathione (GSH) to a water-soluble substrate. Elevated levels of GST activity are associated with insecticide resistance, such as DDT resistance in Anopheles gambiae (Ranson et al., 1997). In this study, the bioactivity of GSTs increased significantly after treatment with 0.1μl of clove oil, indicating that the self-protection mechanism of V. destructor mites was triggered by exposure to a low dosage of essential oil. In contrast, it was interesting to see that GST bioactivity decreased significantly when the mites were treated with a relatively high dosage. This indicates that the self-protection mechanism of V. destructor mites may not work when the mites are exposed to a high dosage of clove oil. Moreover, these inverse trends of GST activity indicate that the amount of clove oil used could affect its acaricidal effects.

Conclusion
In this study, we determined the effects of clove oils on the water-soluble protein content and enzyme bioactivities of V. destructor mites. Our results show that water-soluble protein content and the activities of enzymes related with detoxification/protection were influenced. The significant change of these parameters after the treatment of 0.1μl clove oil suggested that the related physiological process were affected/activated even no acute toxicity occurred to mites. The decease of GST activity after treatment with 1.0μl clove oil indicated dysfunction of this detoxification enzyme may be related to the acute toxicity caused by clove oil.

Acknowledgements

Introduction
The honeybee (Apis mellifera), is an important pollinator of various crops and plant species worldwide. The total annual global economic worth of pollination amounts to an estimated 153 billion euro, representing 10% of the value of the global agricultural production (Gallai et al., 2009). A mysterious decline in honeybee colonies has gained attention worldwide as they are threatened by various pathogens globally (van_Engelsdorp and Meixner, 2010). The most contagious and destructive diseases that affects honeybee honey brood is Chalkbrood, which is caused by the fungus Ascosphaera apis (Maassen ex Claussen) (Spiltoir, 1955). A. apis causes significant losses in terms of both bee numbers and colony productivity (Zaghloul et al., 2005). This disease is now found throughout the world, and there are indications that Chalkbrood incidence may be on the rise (Aronstein and Murray, 2010).
A. apis only produces sexual spores and is heterothallic, thus spores are only produced when mycelia of the two opposite mating types come together and fruiting bodies are formed (Aronstein et al., 2007). Honeybee larvae primarily get infected by ingesting sexual spores of A. apis with their food. Spores germinate in the lumen of the gut (Bailey and Ball, 1991). Germination of spores requires very specific conditions that are found in the larval gut environment (Bignell and Heath, 1985). Infected larvae rapidly reduce food consumption, and then stop eating altogether. Theantana and Chantawannakul (2008) recently identified several enzymes produced by A. apis, some of them implicated in assisting the pathogen in penetration of the peritrophic membrane of the bee larval midgut. Fungal spores present on all surfaces within the beehive (Puerta et al., 1995), and remain viable for many years, providing a continual source of infection. In addition to environmental conditions, interaction between biotic factors such as differences in fungal strains and the genetic background of the bees may affect the incidence and severity of the disease (Flores et al., 2005).

congo red The target groups of the survey study consisted

The target groups of the survey study consisted of OSH representatives of employers and employees as well as of occupational health care service providers from different parts of the country. The study was carried out using questionnaire surveys in September and October 2008. The employer respondent group (N = 6,710) was extracted from the Finnish Registers of Occupational Safety Personnel. The representatives of the employers passed on the separate, targeted questionnaires to the representatives of their employees (N = 5,306) and to the representatives of the health service providers of their work place (N = 1,016) [7].
To conclude, the results indicated that the risk assessment required active training, which should cover issues concerning the assessment of health and safety of working conditions and issues of safety management. The training should be targeted to the management, superiors and employees as well as at the actors in occupational health services. However, according to the questionnaire to occupational safety experts, 20% of responders did not use the results of risk assessment in work place survey and only 40% used it congo red in an effective way [8]. Hence more co-operation is still needed between OSH and OHS experts.
Most improvements suggested by OHS were carried through in safety management and work environment (Table 3). About half of the recommended actions by OHS have been accomplished. Recommendations for the management and work of the foremen were best accepted by private occupational health care units. However, their suggestions were most often left undone. The best parameter for the success of co-operation was the duration of co-operation (> 5 years), the number or personnel at the enterprise (> 250 persons), the proposer (doctor → work environment, nurse → training, guidance, extra guides for workers), and the occupational health care unit (own occupational health) [9].
Safety personnel thought that findings of outsiders open eyes at work places and help to deal with problems that belong to nobody or are commonly shared. All persons must maintain their activity to improve the working conditions. Risk assessment and work place survey have basically the same goal, and combining them must be encouraged. Emphasis should be in risk management activities more than only in the evaluation of the situation. Resources for this activity will probably be reduced in future (competition, outscoring, recession). Occupational health organisation is so great a tool to improve Finnish working conditions that Major histocompatibility should not be neglected. However, safety and health responsibility is on the employer in a negative and positive way. Occupational health personnel work as consultants and consultants have only the responsibility and power of a consultant [9].
In relating to the question, what should be evaluated, we got the answer in one of our projects among SMEs [10]. The aim of this study was to examine how management influences succeeding in risk control and what benefits or possible disadvantages risk evaluation causes to SMEs. OSH management levels of SMEs were measured with safety-ten – method, which is developed especially for SMEs to evaluate the quality of their safety management. Risk evaluations in SMEs were made by the own staff of the companies and researchers from the Finnish Institute of Occupational Health. Six companies took part in this study and number of employees in these companies was between 10 and 280. In those enterprises, where OSH management was at an acceptable level or above it, there were also more varied and more successfully accomplished actions to remove or reduce the risks than in enterprises, where OSH management was in lower level (Fig. 3).
Every company had made quite appropriate actions in hazard identification. The biggest differences between OSH managements of the enterprises were in planning of functions, co-operation with interest groups, documentation and controlling of flow of information. New quality management systems included also occupational safety and health issues. According to this study it was also possible to achieve excellent OSH management level by using methods of new quality management systems. The most common consequences and benefits due to risk evaluations were the discovery of new risks (71%), the implementation of new protective equipment (71%) and various improvements to working environment (71%) and ergonomics (67%) (Table 4). Succeeding in risk control is difficult without using some kind of OSH management system. OSH management systems are similar to quality management systems and they help companies to execute systematic, continuous and effective actions to remove or to reduce risks or to improve working environment and conditions [10].

congo red The target groups of the survey study consisted

The target groups of the survey study consisted of OSH representatives of employers and employees as well as of occupational health care service providers from different parts of the country. The study was carried out using questionnaire surveys in September and October 2008. The employer respondent group (N = 6,710) was extracted from the Finnish Registers of Occupational Safety Personnel. The representatives of the employers passed on the separate, targeted questionnaires to the representatives of their employees (N = 5,306) and to the representatives of the health service providers of their work place (N = 1,016) [7].
To conclude, the results indicated that the risk assessment required active training, which should cover issues concerning the assessment of health and safety of working conditions and issues of safety management. The training should be targeted to the management, superiors and employees as well as at the actors in occupational health services. However, according to the questionnaire to occupational safety experts, 20% of responders did not use the results of risk assessment in work place survey and only 40% used it congo red in an effective way [8]. Hence more co-operation is still needed between OSH and OHS experts.
Most improvements suggested by OHS were carried through in safety management and work environment (Table 3). About half of the recommended actions by OHS have been accomplished. Recommendations for the management and work of the foremen were best accepted by private occupational health care units. However, their suggestions were most often left undone. The best parameter for the success of co-operation was the duration of co-operation (> 5 years), the number or personnel at the enterprise (> 250 persons), the proposer (doctor → work environment, nurse → training, guidance, extra guides for workers), and the occupational health care unit (own occupational health) [9].
Safety personnel thought that findings of outsiders open eyes at work places and help to deal with problems that belong to nobody or are commonly shared. All persons must maintain their activity to improve the working conditions. Risk assessment and work place survey have basically the same goal, and combining them must be encouraged. Emphasis should be in risk management activities more than only in the evaluation of the situation. Resources for this activity will probably be reduced in future (competition, outscoring, recession). Occupational health organisation is so great a tool to improve Finnish working conditions that Major histocompatibility should not be neglected. However, safety and health responsibility is on the employer in a negative and positive way. Occupational health personnel work as consultants and consultants have only the responsibility and power of a consultant [9].
In relating to the question, what should be evaluated, we got the answer in one of our projects among SMEs [10]. The aim of this study was to examine how management influences succeeding in risk control and what benefits or possible disadvantages risk evaluation causes to SMEs. OSH management levels of SMEs were measured with safety-ten – method, which is developed especially for SMEs to evaluate the quality of their safety management. Risk evaluations in SMEs were made by the own staff of the companies and researchers from the Finnish Institute of Occupational Health. Six companies took part in this study and number of employees in these companies was between 10 and 280. In those enterprises, where OSH management was at an acceptable level or above it, there were also more varied and more successfully accomplished actions to remove or reduce the risks than in enterprises, where OSH management was in lower level (Fig. 3).
Every company had made quite appropriate actions in hazard identification. The biggest differences between OSH managements of the enterprises were in planning of functions, co-operation with interest groups, documentation and controlling of flow of information. New quality management systems included also occupational safety and health issues. According to this study it was also possible to achieve excellent OSH management level by using methods of new quality management systems. The most common consequences and benefits due to risk evaluations were the discovery of new risks (71%), the implementation of new protective equipment (71%) and various improvements to working environment (71%) and ergonomics (67%) (Table 4). Succeeding in risk control is difficult without using some kind of OSH management system. OSH management systems are similar to quality management systems and they help companies to execute systematic, continuous and effective actions to remove or to reduce risks or to improve working environment and conditions [10].

Social perception was impaired in the CHR group confirming findings

Social perception was impaired in the CHR group, confirming findings from previous studies (Couture et al., 2008; Green et al., 2012a; Healey et al., 2013). It is worth noting that social perception assessments typically consider the awareness of cues that occur in social situations (Addington et al., 2006); however, studies to date assessing social perception in CHR individuals have typically considered only one aspect of social perception. In this GW788388 study, we have examined the understanding of social relationships, as assessed by the RAD, and our results are supported by two other studies that demonstrated poor performance on the RAD for both schizophrenia (Green et al., 2012a; Sergi et al., 2009) and CHR samples (Green et al., 2012a). Furthermore, after controlling for IQ, we observed group differences in RAD Authority. Interestingly, in the RAD, the Authority Ranking relationship model refers to relationships where there is a hierarchy between the members. Inappropriate use of this relationship model has been found to be associated with psychosis proneness (Allen et al., 2005) and schizotypal personality (Haslam et al., 2002), in support of our findings.
Finally, there were no relationships between symptoms and social cognition, which is similar to several prior reports (Couture et al., 2008; Stanford et al., 2011; Yong et al., 2014), although a link between symptom progression and social cognition has been reported (Allott et al., 2014; Healey et al., 2013; Kim et al., 2011). In the literature, the evidence for a relationship between social cognition and symptoms is mixed, and this could at least in part be due to the use of different measures to assess both symptoms and social cognition. It is interesting to note that no relationship was observed in previous studies that used the SOPS to assess symptoms (Couture et al., 2008; Stanford et al., 2011; Yong et al., 2014).

Contributors

Conflict of Interest

Acknowledgements

Introduction
In recent years, computerized cognitive batteries have been increasingly used in schizophrenia research, particularly in randomized-control trials which require retesting participants. This testing modality is attractive to researchers for many reasons, namely precise stimulus presentation and response recording, automated administration and scoring, reduced administration and scoring time, and the possibility of multiple equivalent alternate (Collie et al., 2001, 2003). It is important to better understand how the results from such batteries compare to previous reports using traditional pen and paper neuropsychological tests. So far, research focusing on computerized neurocognitive batteries involved mostly patients with chronic schizophrenia and investigated their construct validity (Forbes et al., 2012; Irani et al., 2012; Pietrzak et al., 2009a, 2009b; Ritsner et al., 2006; Silverstein et al., 2010; Snyder et al., 2008; Yoshida et al., 2011).
The use of computerized cognitive batteries in the early phases of schizophrenia or related psychotic disorders has not yet been sufficiently validated. The CogState Research Battery’s (CSRB) structure follows the recommended MATRICS cognitive domains of processing speed, attention, working memory, visual learning and memory, verbal learning and memory, executive functions, and social cognition for research in schizophrenia (Nuechterlein et al., 2004).This battery has been previously validated in a chronic schizophrenia sample against the pen and paper MATRICS Consensus Cognitive Battery (MCCB) in chronic schizophrenia (Pietrzak et al., 2009a). Strong correlations were found between the performance on each test of the CSRB and the MCCB in control and patient samples and sensitivity to deficits was comparable (Pietrzak et al., 2009a). To date, the CSRB has not been directly compared to a pen and paper battery in a sample of patients experiencing psychosis in first-episode psychosis (FEP). It is unclear whether resulting cognitive performance would be equivalent in this population since factors like age, familiarity with computers, and inclusion of all subtypes of psychosis in a sample of mostly out-patients as opposed to samples limited to schizophrenia or low-functioning patients may influence the outcome.

Erbium YAG laser which was used in this

Erbium:YAG laser which was used in this study, is an instrument that allows surface ablation of skin with minimum heat effect, only operative inside the skin without involving the melanocytes and blood vessels. It is characterized by a wave length 2.94μm that corresponds to maximum faah inhibitors of water. Since approximately 77% of skin consists of water, this absorption was the optimal condition for the ablation effect. When the energy administered reaches the ablation threshold, the water vaporizes at ultrasonic speed, removing the tissue with the sound phenomenon of a sharp bang.
Borelli and Kaudewitz treated 33 xanthelasma lesions with erbium:YAG laser with promising results as all lesions were removed without hyperpigmentation or scarring. Also, Mannino and colleagues reported good esthetic results in 30 female patients, 70 xanthelasmas treated with erbium:YAG laser without leaving scars and/or dyschromia.
Kaufman and Hibst treated 9 xanthelasmas in 4 patients with erbium:YAG laser using spots with a diameter 2mm and energy of 315mJ. Only in 2 particularly extensive patients, atrophic scars remained after 4months.
Drnovsek-Olup and Vedlin reported that in 32 faah inhibitors xanthelasmas of 8 patients treated with erbium:YAG laser and with average follow up of 3months, an optimum results was achieved in 100% of patients. For all the lesions, one single session of treatment was sufficient.
By using slit lamp mounted argon laser, Hintschich reported that in 32 xanthelasma lesions treated with green argon, good and very good cosmetic results was achieved in 80% of cases. There were no intra or postoperative complication or functional scars. Recurrence occurred in 14 out of 25 lids after 12–16month of follow up.
Ruban and colleagues treated 25 patients with 101 xanthelasma by slit lamp blue-green argon laser. Cosmetic results was good in 83% of cases without either scarring or dyschromia and in 13.3% of patients, there was minimal scarring/slight dyschromia while in 3.3% of patients there was visible scarring/marked dyschromia.
Basar and co-workers reported 85% good, 10% fair and 5% poor cosmetic results in 40 eyes with xanthelasma treated with argon laser.
In this study, 40 xanthelasma lesions, 35 eyes in 20 patients were treated with argon laser. 71.4% had excellent results, 20% very good, 5.7% good, 2.8% had satisfactory results. Small lesion <1cm2 had excellent results in all cases regardless of its firmness. Large lesions needed more than one session with 2weeks apart. Hintschich showed that effectiveness of argon laser in xanthelasma is due to its thermal effect when laser energy absorbed with skin chromospheres, it is converted into heat and by using sublesional probe to measure the temperature it was elevated to 50–60° which alter the foam cells in xanthelasma and coagulated blood vessel. Sampath et al. showed that histological changes of xanthelasma after argon laser are consistent with a superficial photocoagulation of the upper skin levels to a depth of 1mm dermis preserving dermal appendages and aiding in the rapid healing of the wound without scar.
Major disadvantage of argon laser photocoagulation as reported in literature was significant recurrence rate. One study has reported that 14 recurrences out of 32 treated lesions were within the first 12–16months after argon laser. Baser and coworkers were also reported that 6 out of 40 treated with argon laser were recurred after one year of treatment.
Most of recurrences were found to be developed from the margin of xanthelasma, so margin of xanthelasma should be treated well. In this study, there was no recurrence which may be due to relatively short follow up period (6months).

Conflict of interest

Introduction
The major development in ophthalmic imaging was the introduction of optical coherence tomography (OCT) in 1991 by Huang et al. Ophthalmoscopy, fundus photography and fluorescein angiography are the common tools to diagnose diabetic retinopathy (DR) and diabetic macular edema (DME). Due to the non-invasive nature of the OCT technique it might replace or add as a complementary to fluorescein angiography. Spectral Domain OCT (SDOCT) is an advanced modification of traditional time domain OCT. The main advantages of the SDOCT are speed and sensitivity, which have helped in conducting advanced clinical and research oriented studies. There is an increasing demand for high-resolution imaging of the ocular tissue to improve the diagnosis and management of various retinal diseases.