The selection of sustainable supplier has a strategic significance and represents critical phase for whole sustainable supply chain.From this activity depend on the process of functioning of the supply chain. The aim of this paper is defining the most important criteria for assessment and selection of sustainable supplier in the company for the production of lime. For decision-making of this process expert’s team for comparison and assessment of the criteria grouped in two levels has formed. In the first level are economic, social and environmental criteria which consist of seven sub-criteria for each main group. For determining significance of criteria Full Consistency method (FUCOM) has applied. Obtained results show the significance of criteria on both levels of decision-making for sustainable supplier selection. Adequate supplier selection using sustainable criteria ensuring the possibility for timely and quality production. This provides a growing of competition in the market for companies.

Dear Editor, We highly appreciate Dr Altundag's feedback regarding our recently published manuscript in The Breast Journal.1 We are also thankful to the editor in chief (Dr S. Masood) for giving us the opportunity to address Dr Altundag's comments. Neo‐adjuvant chemotherapy has been widely used for breast cancer treatment due to the effective pathologic responses seen with newer therapeutic agents.2 Recently, it has also been introduced for the treatment of early breast cancer.3 Despite this, there is ongoing debate and controversies related to the use of neo‐adjuvant chemotherapy in breast cancer (critically appraised in a recent review by Vaidya et al2). We find Dr Altundag's point regarding our neo‐adjuvant cohort quite valid. In our study, ~43% of patients with invasive apocrine carcinoma (IAC) presented at the advanced stage (III or IV) with only 19% of the patients having the tumor size ≤2 cm at presentation. This is mainly due to the lack of organized screening program at the national level. In this regard, our small IAC cohort treated in neo‐adjuvant setting is somehow biased but it essentially reflected the previous and current overall breast cancer presentation in Bosnia and Herzegovina. Consequently, the response rates to neo‐adjuvant therapy in our study may be different from the previously published data. Noteworthy, IAC is a rare breast cancer subtype (~1%‐2% of all breast cancers)4,5 and future larger and multi‐institutional studies are required to validate the effectiveness of (neo)adjuvant chemotherapy in patients with IAC.

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3–6. Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017—and more than 80% in some low- and middle-income regions—was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing—and in some countries reversal—of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories. Contrary to the view that urbanization is a major driver of the global rise in obesity, the global increase in body-mass index is shown to be mostly due to increases in the body-mass indexes of rural populations.

In 2018, massive street protests against its corruption forced the long-dominant political party in Armenia to relinquish power to its nemesis, who himself had been imprisoned for leading protests ten years earlier. The peaceful transition earned the name the “Velvet Revolution.” The new Armenian government hosted the principal author of this essay at a week-long conference on anticorruption policy in Yerevan, its capital, with judges, prosecutors, and investigators selected for their integrity and competence. Based on the attitudes and concerns they expressed, publicly available documents reflecting years of research on the Armenian government and corruption and the circumstances of the Velvet Revolution, the authors sought to determine whether particular background conditions and/or characteristics of the peaceful rebellion were especially conducive to the successful implementation of a more fully democratic leadership, opposed to corruption and committed to the rule of law. In the literature addressing such questions in other national contexts, the authors found a similar pattern of background conditions and characteristics, leading to their conclusion that such elements can indeed foster successful transitions. Further research should assess future developments in Armenia, and determine how widely the lessons of its experience can be applied.

Na uzorku od 25 vaterpolista različitog kvalitativnog nivoa izvršena je procjena značaja kvaliteta „škara“ na jačinu bacanja vaterpolo lopte u uslovima optimalnog stanja aktuelne muskulature, kao i nakon pojave lokalnog zamora te procjena maksimalne sile ispitanika ostvarene prilikom simulacije suta primjenom klasicne dinamometrije. Tehniku ispitanika vrednovala je grupa eksperata dodjelom ocjena u rasponu od 5 do 10. Na osnovu ekspertskih ocjena uzorak je podjeljen u tri kvalitativne grupe: uslovno majstori (4 ispitanika), prosječni vaterpolisti (16 ispitanika) i uslovno početnici (5 ispitanika). Uvidom u dobijene rezultate statističke analize u potpunosti je potvrđena pretpostavka da zamor manje posledice ostavlja kod najkvalitetnijih takmičara. Realizovani nivoi značajnosti, naime, bili su niži od teorijskog limita (Sig.<,05) samo u subuzorcima tehnički prosječnih i najslabijih vaterpolista, dok su u grupi najkvalitetnijih ispitanika razlike izostale. Iako je i kod najjače grupe preciznost u prosjeku opala gotovo za jednu petinu (za oko 19%), ta promjena nije bila dovoljna da bi se proglasila i statistički signifikantnom. U grupi prosječnih i grupi početnika, relativni pad dužine bacanja je bio čak i niži nego u najjačoj grupi (15,99% u srednjoj grupi i 18,4% u najslabijoj), ali je ta promjena, zbog značajno nižih početnih vrijednosti (dobijenih u pretestu) bila ocjenjena kao statistički značajna.

BACKGROUND AND AIMS While non-alcoholic fatty liver disease (NAFLD) is rapidly becoming the most common liver disease worldwide, its treatment remains elusive. Since metabolic impairment plays a major role in NAFLD pathogenesis, any pharmaceuticals, such as molecular hydrogen (H2), that advance lipid and glucose metabolism could be appropriate to tackle this complex condition. The aim of this study was to analyze the effects of 28-day hydrogen-rich water intake on liver fat deposition, body composition and lab chemistry profiles in overweight patients suffering from mild-to-moderate NAFLD. METHODS Twelve overweight outpatients with NAFLD (age 56.2 ± 10.0 years; body mass index 37.7 ± 5.3 kg/m2; 7 women and 5 men) voluntarily participated in this double-blind, placebo-controlled, crossover trial. All patients were allocated to receive either 1 L per day of hydrogen-rich water (HRW) or placebo water for 28 days. The study was registered at ClinicalTrials.gov (ID NCT03625362). RESULTS Dual-echo MRI revealed that HRW significantly reduced liver fat accumulation in individual liver regions-of-interest at 28-day follow-up, as compared to placebo administration (P < 0.05). Baseline liver fat content was reduced from 284.0 ± 118.1 mM to 256.5 ± 108.3 mM after hydrogen treatment at 28-day follow-up (percent change 2.9%; 95% CI from 0.5 to 5.5). Serum aspartate transaminase levels dropped by 10.0% (95% CI; from -23.2 to 3.4) after hydrogen treatment at 28-day follow-up. No significant differences were observed between treatment groups in either weight or body composition among participants. CONCLUSIONS Although preliminary, the results of this trial perhaps nominate HRW as an adjuvant treatment for mild-to-moderate NAFLD. These observations provide a rationale for further clinical trials to establish safety and efficacy of molecular hydrogen in NAFLD.

A fully integrated single-photon avalanche diode (SPAD) using a high-voltage quenching circuit fabricated in a 0.35-μm CMOS process is proposed. The quenching circuit features a quenching voltage of 9.9 V, which is three times the nominal supply voltage to increase the photon detection probability (PDP). To prove the quenching performance, the circuit has been integrated together with a large-area SPAD having an active diameter of 90  μm. Experimental verification shows a maximum PDP of 67.8% at 9.9 V excess bias at a wavelength of 642 nm.

Fully halogenated chlorofluorocarbons (CFCs) are, despite their good thermodynamic properties, stability and non-toxicity, eliminated from use. Due to the content of one chlorine atom in the molecule, the use of hydrochlorofluorocarbons (HCFCs) has been reduced in many European countries. The use of partially halogenated hydrofluorocarbons (HFCs) in which the molecules have no chlorine atoms, due to increased inflammability, is also to a large extent limited. This paper presents a methodology for selecting working fluids or mixtures for use in cogeneration ORCs on biomass, which will, in addition to thermodynamics, also take into account the safety and environmental requirements of working fluid acceptability. The effects of thermodynamic properties of preselected working fluids on the performance of the cogeneration ORC plant have been analyzed and the thermodynamic properties of the working fluid are optimized by the exergy efficiency of the ORC as a function of the target, using a genetic algorithm. Optimal values of the exergy efficiency, component size and exergy losses of the cogeneration ORC for the use of biomass energy are compared and analyzed under the same heat source conditions and pre-defined boundary conditions. The experimental analysis of the cogeneration ORC shows that the most preferred working fluid is p-xylene because in comparison to undekan, MDM (OMTS) and D4 (OMCTS) it has the highest value of exergy efficiency but also requires the least dimension of ORC components (turbines and capacitors).

Introduction: Although the skin prick test (SPT) is a reliable diagnostic tool in perennial allergic rhinitis (PER) for patients allergic to cats, the minimum necessary SPT wheal size required to distinguish cat sensitization from true allergy remains controversial. The cat nasal challenge test (cNCT) could be considered the gold standard for detecting true cat allergy. Aims: To assess the difference in the frequency of cNCT positivity between cat owners and non-owners and to determine an appropriate cut-off level for SPT wheal size in detecting positive cNCT in PER patients who are candidates for allergen immunotherapy (AIT) with cat allergen extracts. Subjects and Methods: cNCT in the form of a nasal spray was administered to 60 adult patients with PER, i.e., cat owners (n = 19) and cat non-owners (n = 41) with positive SPT to cat fur allergen (Diater, Spain). Subjective (total nasal symptom score [TNSS]) and objective measurements (peak nasal inspiratory flow [PNIF]) for assessment of nasal patency and nasal eosinophil count [NEo]) were used to assess the nasal response. Peak expiratory flow (PEF) was used as a safety parameter during cNCT. Results: No differences were obtained in SPT wheal size and cNCT positivity between cat owners and non-owners. Positive cNCT detecting true cat allergy could be predicted by a cat SPT wheal size > 6.5 mm with 71.11% sensitivity and 100% specificity. Conclusions: In adult patients with PER, the frequency of cat allergy was similar among cat owners and non-owners. A cat SPT wheal size ≥6.5 mm could be helpful in detecting true cat allergy by avoiding the demanding, time-consuming, and often unavailable cNCT when cat AIT is needed.

Objetivo: Descrever os cuidados de enfermagem para manutenção da temperatura corporal durante o intraoperatório. Método: Estudo descritivo,transversal, realizado em junho de 2015 no centro cirúrgico de um hospital no interior de São Paulo. Os dados foram coletados por meio de instrumentodesenvolvido para este estudo, o qual continha dados de caracterização sociodemográfica, clínica, cirúrgica e cuidados de enfermagem. Para todas as variáveis,foram realizadas análises descritivas. Resultados® Foram analisados os cuidados de enfermagem em 19 cirurgias, sendo a de maior incidência a colecistectomiavideolaparoscópica (26,3%), sob anestesia geral (52,6%). O tempo médio de duração da anestesia foi de 113 minutos. A hipotermia foi identificada em 84,2%dos pacientes no período pós-operatório. O método de aquecimento utilizado em todos os pacientes no intraoperatório foi do tipo cutâneo ativo, com infusãode solução aquecida por via endovenosa. Conclusão® A hipotermia não intencional é uma condição real no centro cirúrgico, causando prejuízos à recuperaçãodos pacientes. Sua prevenção está relacionada à realização de cuidados de enfermagem mais seguros e à redução de complicações pós-operatórias.

Synthesis, characterization and interaction with BSA and apo-transferrin of novel water-soluble ruthenium complexes having differently coordinated alliin (S-allyl-l-cysteine sulfoxide).

Analysis of vertex-varying spectral content of signals on graphs challenges the assumption of vertex invariance and requires the introduction of vertex-frequency representations as a new tool for graph signal analysis. Local smoothness, an important parameter of vertex-varying graph signals, is introduced and defined in this paper. Basic properties of this parameter are given. By using the local smoothness, an ideal vertex-frequency distribution is introduced. The local smoothness estimation is performed based on several forms of the vertex-frequency distributions, including the graph spectrogram, the graph Rihaczek distribution, and a vertex-frequency distribution with reduced interferences. The presented theory is illustrated through numerical examples.