A Child\u27s Curiosity

A curious 5-year-old girl placed a stethoscope against her chest in St. James, Jamaica on the December 2018 medical outreach trip. Even though this was my second time returning to Jamaica, I remained amazed at the fearless children not cringing and even smiling during the physical exam. I recalled a brave 10-year-old girl seeing the medical and optometry teams by herself as her father volunteered on-site. Such positive attitudes were reflected among numerous community members through their great respect and continuous gratitude towards healthcare professionals. They touched my life as I touched theirs

EGFR Regulation of Epidermal Barrier Function

Keratinocyte terminal differentiation is the process that ultimately forms the epidermal barrier that is essential for mammals to survive in the ex utero environment. This process is tightly controlled by the expression of many well-characterized genes. Although a few of these genes are known to be regulated by the epidermal growth factor receptor (EGFR), an important regulator of multiple epidermal functions, neither the genome-wide scale of EGFR-mediated regulation nor the mechanisms by which EGFR signaling controls keratinocyte differentiation are well understood. Using microarray analysis we identified 2,676 genes that are regulated by EGF, a ligand of the EGFR. We further discovered, and separately confirmed by functional assays, that EGFR activation abrogates all essential metabolic processes of keratinocyte differentiation by (1) decreasing the expression of lipid matrix biosynthetic enzymes, (2) regulating numerous genes forming the cornified envelope, and (3) suppressing the expression of tight junction proteins. In organotypic cultures of skin, the collective effect of EGF impaired epidermal barrier integrity, evidenced by increased transepidermal water loss. As defective epidermal differentiation and disruption of the epidermal barrier are primary features of many human skin diseases, we used bioinformatics analysis to identify genes that are known to be associated with human skin diseases. In comparison to non-EGF-regulated genes, the EGF-regulated gene list was significantly enriched for disease genes. Further validation of the expression profiles of many of the 114 identified skin disease genes included the transcription factors GATA binding protein 3 (GATA3) and Kruppel-like factor 4 (KLF4), both required for establishing the barrier function of the skin in developing mice. These results provide a new systems level understanding of the actions of EGFR signaling to inhibit keratinocyte differentiation. As the overall effect of this inhibition is to impair epidermal barrier integrity, this study clarifies how dysregulation of the EGFR and its ligands may contribute to diseases of the skin

THE SITUATION OF FOOD PRODUCTS IN THANH HOA THROUGH THE ASSESSMENT OF TOURISM MINING

Thanh Hoa has rich and diverse natural conditions. The terrain is divided into three distinct regions: mountainous and midland areas, plains and coastal areas. Each region has its product that today is often called a "specialty". When it comes to "specialties", people often think of certain characteristics belonging to the cuisine of certain land. It can be the food or drink that is known to many tourists. It is like an object representing that land, when mentioning Thanh Hoa, people immediately think of foods and drinks such as spring rolls, Lam Phu Quang tea, Tu Tru gai cake, Tho Xuan grilled spring rolls... However, to exploit culinary specialties into tourism development, considering it as a resource to attract tourists, Thanh Hoa is still open. The article evaluates the current situation of Thanh Hoa cuisine so that all levels and the province's tourism industry have the right direction for Thanh Hoa tourism shortly

Saprochaete Capitata Infection in an 80–Year Old Chronic Obstructive Pulmonary Disease (COPD) Patient: A Case Report

BACKGROUND: The fungal disease caused by invasive fungus Saprochaete capitata is becoming an increasingly popular infection. Fungal pathogens mainly occur in patients with immunocompromised disorders such as hematologic malignancies, acute myeloid leukemia, transplant patients. CASE REPORT: In this study, we presented a COPD patient infected with S. capitata. At the first check, the patient showed cough, dyspnea, chest pain on both sides. The clinical laboratory test result was characterized with high White blood cell (12.8 G/L), HIV negative. The X ray showed bronchitis and emphysema. Bronchoscopy illustrated bronchial mucositis. CT scanner demonstrated pneumonia with fuzzy nodular lesions and thick interstitial organization in both lungs. The patient was treated with ciprofloxacin 800 mg/day; cefuroxime 2250 mmg/day. However, the fever appeared 2 weeks thereafter. The S. capitata was discovered in the bronchial fluid. The patient was then treated with fluconazole 400 mg/day for 14 days. At the end of treatment, all signs and symptoms of S. capitata infection disappeared and the patient recovered. CONCLUSION: This case study showed that S. capitata infection can occur in the COPD patients and fluconazole is a pertinent drug for treatment of the infection

FACTORS AFFECTING THE WORK MOTIVATION OF LAWYERS AT LAW OFFICES IN QUANG NGAI PROVINCE, VIETNAM

This study is conducted to investigate which factors affect the work motivation of lawyers at law offices in Quang Ngai province. The results of data analysis from a survey of 298 lawyers show that the work motivation of lawyers is most affected by Income and Benefit policy, followed by Working conditions, Relationship with colleagues, Feeling the personal role in work, Work-life balance and finally Recognition of Achievement. Article visualizations

Liberté de choix des élèves et concurrence des établissements: un survey de l’analyse du pilotage des systèmes éducatifs par les quasi- marchés

Les systèmes éducatifs publics confrontés à des chocs internes et externes sont entrés dans l’ère turbulente des réformes. L’objet de l’article est de faire un « survey » sur les dispositifs constitués par les quasi-marchés dans le domaine de l’éducation. Le dispositif est présenté dans ses grands principes, ses diverses modalités en rappelant le contexte qui a présidé à son émergence puis son développement. Une évaluation est ensuite établie en prenant appui sur les argumentaires d’un débat nourri qui s’est décliné au plan théorique et au plan empirique. Les interrogations sur l’efficience via une concurrence stimulée, et la ségrégation via le « sorting » en constituent des temps forts, de même que celles sur le rôle du système éducatif privé et sur la mobilisation des ressources humaines. SUMMARY : The public educational systems confronted with internal and external, shocks entered the turbulent era of the reforms. The objective of the article is to draw up a survey about the mechanisms set up by the quasi markets in the field of education. The structure is presented in its major principles, its diver modalities in recalling the context that preside its emergence then its development. An evaluation is then established by taking supports on the arguments of a rich debate which declined to the theoretical and to the empirical field. The questions on the efficiency through a stimulated competition, and the segregation via the « sorting » constitute the strong periods, as well as the questions on the role of the private educational system and on the mobilization of the human resource

反応焼結法による希土類単硫化物 RESx (RE = Gd, Ho)の合成

\n 希土類単硫化物はNaCl型の結晶構造をもち，光学デバイス，太陽電池，フォトダイオード，磁気記録デバイスなどのエレクトロニクス分野における応用に不可欠な材料である。しかし，希土類金属と硫黄の蒸気圧が大きく異なる点，単体の希土類金属が極めて酸化しやすい点，これまでの試料作製方法が非常に多くの反応プロセスを伴う複雑なものであることなどから，純良な希土類単硫化物試料の合成は困難であった。本研究では，これまで研究例のほとんどない，Gd, Ho を含む希土類単硫化物に着目し，CS2ガス硫化法により作製した希土類三二硫化物（α-Gd2S3, δ-Ho2S3）と希土類単体（Ho）もしくは希土類水素化物（GdH2）を出発物質とし，放電プラズマ焼結（SPS）装置を用いた反応焼結法により，物性測定が可能である大きなサイズの希土類単硫化物GdS, HoSの純良な単一相焼結体の合成に成功した。また，出発原料の希土類と硫黄の比率を変えることにより，非化学量論比組成のGdSx，HoSxの単一相焼結体を広い組成範囲で合成することにも成功した。さらに，得られた試料について，結晶構造解析，元素組成分析，微量に含まれる不純物の同定を行い，熱物性，電子物性を詳細に調べた。その結果，格子定数，融点，電気伝導率の変化が，希土類と硫黄の組成比（x）と密接に関係していることを確認した。本研究では，従来の方法よりも単純なプロセスで不純物の少ない純良な希土類単硫化物の大型焼結体の合成が可能であることを示した。さらに，出発原料の比率を変えることで，非化学量論比組成の希土類単硫化物における希土類と硫黄の組成比（x）を制御することが可能であることを示した。さらに，希土類と硫黄の組成比（x）を変えることで電気伝導率などの物性を大きく変化させることが可能であることから，今回得られた結果は，物性値の最適化を行う上でも重要な知見であると考えられる。これらの結果は，Gd, Ho以外の希土類単硫化物にも応用が可能であると考えられ，今後の希土類単硫化物の設計の幅を広げることにつながり，次世代の高性能デバイスに不可欠な材料開発の発展に寄与するものであると考えられる。Rare-earth monosulfides RES (RE=rare earth element) with NaCl structure have various practical and potential applications in the electronics field, such as optical devices, photovoltaics, photodiodes, and magnetic recording devices. However, the synthesis of high-quality RES samples remains a challenge because RE is easily oxidized, large difference between the vapor pressures of RE and S, and the complexity of the previous synthesis methods. In this study, we focused on rare-earth monosulfides containing Gd and Ho, on which few studies have been done so far. Using rare-earth sesquisulfides (-Gd2S3, -Ho2S3) prepared by the CS2 gas sulfurization process and Ho metal or GdH2 as a starting material, we have succeeded in synthesizing single-phase GdS and HoS compacts of large size that we can measure their physical properties, by reaction sintering method using a spark plasma sintering (SPS) device. We have also succeeded in synthesizing single-phase GdSx and HoSx compacts with non-stoichiometric ratio composition in a wide composition range by changing the ratio of Gd (or Ho) and S as starting materials. Furthermore, for the obtained samples, crystal structure, elemental composition, identification of impurity phases, thermal properties and electronic properties were investigated in detail. As a result, it was confirmed that changes in lattice constant, melting point, and electrical conductivity are closely related to the composition ratio (x) of RE and S. In this study, we showed that it is possible to synthesize large compacts of pure rare-earth monosulfides with less impurities by a simpler process than the conventional method. Furthermore, it was shown that the composition ratio (x) of RE and S in rare-earth monosulfides with non-stoichiometric ratio composition can be controlled by changing the ratio of starting materials and we can significantly change physical properties such as electrical conductivity by changing the composition ratio (x) of RE and S. Therefore, the results are important for optimizing physical properties. These results are also considered to be applicable to rare-earth monosulfides other than Gd and Ho, which will lead to a wider range of designs for rare-earth monosulfides. It is considered to contribute to develop materials for next-generation high-performance devices.室蘭工業大学 (Muroran Institute of Technology)博士（工学