Autonomous navigation in agricultural environments is often challenged by varying field conditions that may arise in arable fields. The state-of-the-art solutions for autonomous navigation in these agricultural environments will require expensive hardware such as RTK-GPS. This paper presents a robust crop row detection algorithm that can withstand those variations while detecting crop rows for visual servoing. A dataset of sugar beet images was created with 43 combinations of 11 field variations found in arable fields. The novel crop row detection algorithm is tested both for the crop row detection performance and also the capability of visual servoing along a crop row. The algorithm only uses RGB images as input and a convolutional neural network was used to predict crop row masks. Our algorithm out-performed the baseline method which uses colour-based segmentation for all the combinations of field variations. We use a combined performance indicator that accounts for the angular and displacement errors of the crop row detection. Our algorithm exhibited the worst performance during the early growth stages of the crop.


1. We have previously shown that [125I]‐endothelin (ET) receptor binding is localized almost exclusively to the fenestrated endothelial cells of glomerular capillaries and peritubular capillaries in the rat kidney following systemic administration of the radioligand in vivo. Because of the lack of specific ET receptor binding in other glomerular and tubular structures following in vivo labelling, we undertook further studies, using electron microscopic autoradiography and ET receptor subtype selective ligands, to investigate whether other renal components also contain ET receptor binding and, if so, to determine the cellular localization of the ET receptor subtypes, ETA and ETB, following in vitro labelling.


Medicines are generally developed to be effective and safe in adult populations, and only a small subset of drugs has been formally studied for efficacy and safety in paediatric or geriatric populations. As a consequence, 45% of prescribed drugs in paediatric hospitals are given off-label, and approximately 20% of drugs given to the geriatric population fall into the same category. However, it is not easy to extrapolate doses, therapeutic indications, safety and efficacy, from one age group to another. Physical size, weight, lipid fraction, metabolic state, drug target and metabolic machinery expression, etc., are all factors that play a role in drug absorption, distribution, elimination, and ultimately efficacy, and these change across the typical human life-span. However, the lack of understanding on how some of these factors change, especially at a molecular level, has been a hurdle in the safe translation of medicines from one population to another, giving rise to a few documented cases of differential drug responses: increased number of side effects, or lack of efficacy. The aim of my project was, therefore, to identify which pharmacologically relevant genes change their expression with age in human populations, in five primary organs (liver, brain, kidney, lungs and heart), which could increase the understanding of some of the age-related differential drug responses reported in the literature. In parallel, I also investigated on how these changes translated to animal models (macaque, rat and mouse) commonly used in drug development. Overall, a small fraction of pharmacologically relevant genes changed their expression with age in the five primary human organs analysed. However, it was generally observed, that for drug targets associated with reported age-related differential drug responses, when given to either paediatric or geriatric populations, there was an overall tendency for those targets to decrease their expression with age. This pattern was particular striking, among ion-channels, such as GABA A receptor, and interestingly this pattern was not seen in rodents, where the opposite trend was detected. This observation seemed to suggest that one of the reasons why a drug may lack efficacy in children, for instance, may be because the dose ix given was not high enough to occupy all the expressed receptors, and thus fully activate the necessary downstream signals for an effective therapy. Likewise, this trend also seemed to suggest, that for geriatric populations, a smaller dose may be required to prevent over inhibition or over activation of these drug targets. In conclusion, this systematic analysis on the ontogeny of pharmacologically relevant genes brings a new perspective on age-related differential drug responses, and challenges some of the approaches used when extrapolating knowledge from adult studies to other aged populations.


This case‐control study was aimed at identifying environmental risk factors for multiple sclerosis (MS). Ninety‐three Israeli‐born MS patients identified in country‐wide studies and 94 age‐ and sex‐matched controls were interviewed. The questionnaire covered a large span of factors at ages 0,10 and onset of the disease, with particular emphasis on socioeconomic status (SES) and sanitary conditions (SAN). A significantly larger percentage of patients reported frequent respiratory diseases. Patients and their parents had significantly (p < 0.01) higher educational levels than controls. The SES and SAN at age 10 were also systematically higher among patients, but significance was reached only when the frequencies of conditions indicating extremely low values of SES or SAN were compared. It is possible that the protective effect of low SES and SAN on risk of MS can be detected only when living conditions are well below average, as is frequent in developing countries.


THIS IS THE FINAL CHAPTER OF LAW AS AN AUTOPOIETIC SYSTEM BY GUNTHER TEUBNER, TRANSLATED BY JOSE ENGRACIA ANTUNES. IN IT, TEUBNER DEMONSTRATES THE ENLIGHTENING POWER OF HIS THEORY OF LAW EXAMINING THE PROBLEM OF THE REGULATION OF ENTERPRISE GROUPS. TEUBNER'S WORK IS AN IMPORTANT REFERENCE FOR VIVIANE MULLER PRADO'S AND JOSE ENGRACIA ANTUNES' ARTICLES, BOTH PUBLISHED IN THIS ISSUE OF REVISTA DIREITO GV (FGV-SP LAW REVIEW).


The technique of K x-ray fluorescence induced by 20-50 MeV protons appears to be well suited for use in trace element analysis of medium and heavy elements as the K x-ray yield is high at these proton energies. The separation in energy between K x-rays from adjacent heavy elements in the periodic table is such that spectra taken with a suitable Ge(Li) detector are readily analysed, and individual elements identified. Because of the high energy of the K x-rays, self absorption in the sample is greatly reduced over L x-rays from the same element - in some cases by several orders of magnitude. With thin samples, the effects of self-absorption are usually negligible, and beam energy loss in the sample is small. Some problems of targetry are discussed.


In this paper, we propose a novel disposable compliant forceps for general open surgical applications, developed using topology optimization techniques. Compliant mechanisms are much easier to sterilize than rigid-joint-based mechanisms, hence they are often used in the design of disposable medical forceps for preventing the spread of diseases from reusable medical devices. However, it is time consuming and inefficient to use empirical methods for designing compliant forceps. To simplify the design process, topology optimization techniques are employed in this paper to automatically synthesize the shape of compliant forceps. The entire design process was performed in Matlab. The designed forceps was quickly fabricated with selective laser sintering (SLS) and can be disposed of after single-use. The clamping capability of the proposed forceps was evaluated by a series of simulations and experiments. Results showed that the forceps is reliable and robust under different loads in open surgical tasks. With the work presented in this paper, we can achieve automatic synthesis of disposable compliant forceps with high performance.


empirical a of different locations suggests rural households do indeed engage in multiple activities rely on diversified income portfolios. Sub-Saharan a range of 30–50 percent reliance on non-farm income sources is common; but it may attain 80–90 percent in southern Africa. In Abstract: A growing body of empirical evidence shows that rainfall is highly variable throughout Ethiopia. This situation coupled with poor irrigation development, small agricultural land holding, and population pressure forced rural households to diversify their income sources into off-farm and non-farm activities. However, the contribution of these activities to total income of households and their role on reducing vulnerability of farmers to rainfall variability has not been studied. This study, using cross sectional data from Ijere woreda, Oromia regions and employing both descriptive and econometric analysis, attempted to explain the various off-farm & nonfarm activities, measured their contribution to total household income, and analyzed the role of such incomes on households' vulnerability to rainfall variability. As such, the study found that rural households who participated in off-farm and non-farm activities were able to earn 9.7% and 7% of their total income, respectively. Results also indicated that off-farm and nonfarm activities helped participant households to smooth their income over years enabling them to be less exposed to income fluctuation and rainfall variability than nonparticipants. Thus, income diversification is found a significant livelihood strategy to hedge against weather risks – rainfall variability. Yet, Off-farm activities are found to be more of labor intensive and used for day-to-day consumption. In addition, although there is a potential for developing the rural nonfarm economy, the current share of nonfarm income was very limited which was due to the limited/low profit margins and multiplier effects of the nonfarm activities. households under vulnerable context, the income diversification into nonfarm and off-farm activities has helped rural households in smoothing consumption over years. Results indicated that, over years, the seasonal rainfall variations have positive net effect on the total income of nonfarm and off-farm participant, unlike the nonparticipants. Here, the positive increase of the participants' income is mainly attributed to the dry (bega) season. This is could be due to the fact that dry (bega) season is an off-season where farmers search for income sources other than the agricultural activities, despite the driving forces behind.


Key Points Question Is social, cultural, and community engagement (SCCE) associated with subsequent health care utilization among older adults in the US? Findings In this cohort study of 12 412 US older adults, more frequent SCCE was associated with lower inpatient and community health care utilization but more interaction with outpatient and dental care in 2 years of follow-up. Longitudinally, compared with consistent engagement, individuals with decreased SCCE were more likely to use inpatient care but had fewer outpatient and dental care visits at 6 years of follow-up. Meaning These findings suggest that SCCE may have a protective association in shaping beneficial early and preventive health care–seeking behavior and potentially facilitate the decentralization of the health care system, reducing demand for inpatient and community health care.


Soil temperature has been the primary criterion for evaluating risks associated with losses of fall-applied nitrogen (N). The basic idea is that ammonium is not converted to nitrate in cold soils, so withholding applications until soils are cold reduces the risk of N losses by leaching and denitrification when soils have excess water in the spring. Recent studies indicate that soil pH also deserves attention.


The SUP Proposal for a reformed European single member company is at draft stage at the time of writing and is therefore evolving. This paper provides a critique from different national standpoints which can contribute to public debate on the issues raised. This particular contribution to this volume of essays on the SUP provides a common law perspective, with a particular focus on the company law ideology of Ireland and its nearest neighbour, the United Kingdom. It will review the SUP Proposal within the context of EU company law developments generally and will also give an academic and commercial Irish perspective on the issues raised.


Supplemental Digital Content is available in the text. Objectives: About 5% of patients with coronavirus disease-2019 are admitted to the ICU for acute hypoxemic respiratory failure. Opinions differ on whether invasive mechanical ventilation should be used as first-line therapy over noninvasive oxygen support. The aim of the study was to assess the effect of early invasive mechanical ventilation in coronavirus disease-2019 with acute hypoxemic respiratory failure on day-60 mortality. Design: Multicenter prospective French observational study. Setting: Eleven ICUs of the French OutcomeRea network. Patients: Coronavirus disease-2019 patients with acute hypoxemic respiratory failure (Pao2/Fio2 ≤ 300 mm Hg), without shock or neurologic failure on ICU admission, and not referred from another ICU or intermediate care unit were included. Intervention: We compared day-60 mortality in patients who were on invasive mechanical ventilation within the first 2 calendar days of the ICU stay (early invasive mechanical ventilation group) and those who were not (nonearly invasive mechanical ventilation group). We used a Cox proportional-hazard model weighted by inverse probability of early invasive mechanical ventilation to determine the risk of death at day 60. Measurement and Main Results: The 245 patients included had a median (interquartile range) age of 61 years (52–69 yr), a Simplified Acute Physiology Score II score of 34 mm Hg (26–44 mm Hg), and a Pao2/Fio2 of 121 mm Hg (90–174 mm Hg). The rates of ICU-acquired pneumonia, bacteremia, and the ICU length of stay were significantly higher in the early (n = 117 [48%]) than in the nonearly invasive mechanical ventilation group (n = 128 [52%]), p < 0.01. Day-60 mortality was 42.7% and 21.9% in the early and nonearly invasive mechanical ventilation groups, respectively. The weighted model showed that early invasive mechanical ventilation increased the risk for day-60 mortality (weighted hazard ratio =1.74; 95% CI, 1.07–2.83, p=0.03). Conclusions: In ICU patients admitted with coronavirus disease-2019-induced acute hypoxemic respiratory failure, early invasive mechanical ventilation was associated with an increased risk of day-60 mortality. This result needs to be confirmed.


Objective To explore the technological process of preparing metformin hydrochloride/chitosan/sodium alginate sustained-release microcapsules,and investigate the properties of the microcapsules.Methods Metformin hydrochloride microcapsule was prepared by a coacervation process with natural polysaccharides chitosan and sodium alginate as the wall materials.The optimization criterion of the process was obtained by an orthogonal experimental design with drug encapsulation as reference standards.The drug dissolution rate was measured by the rotary basket method:the medicated microcapsules were put into a steel-wool basket and suspended in a volumetric flask filled with 1000ml PBS of pH 7.8-8.0,kept at 37℃with reciprocal shaking in speed of 100r/min.Results The optimal preparative condition for the microcapsules was as follows:the concentration of chitosan was 0.2% (w/v),pH 4.5,the optimal temperature was 45℃,with shaking speed of 200r/min.The morphology of chitosan-sodium alginate microcapsules containing metformin hydrochloride was nearly uniform with an average diameter of ca.24.2μm.The encapsulation efficiency of medicated microcapsules was 48.2%and drug-loading rate was 9.6%.The medicated microcapsule absorbed water molecules quite slowly in the solution and swelled gradually up to the balance by 15hours.Compared with commercial sustained-release tablets,the release speed of prepared medicated microcapsule decreased significantly:for the former,the time to complete release was 3hours,while for the latter the time to 75%release was 20hours.Conclusions The medicated microcapsules prepared with optimal technological process have the advantages of good reproducibility and hydrating swelling property,and the technological process of preparation is stable.It has been shown that the prepared microcapsules possess excellent sustained-release performance.


ABSTRACT In this exploratory study article, we examine Russian citizens, more specifically youth (college students), perceptions of private security guards who come in contact with private citizens. We examine public attitudes toward the nature of security guards' work as it relates to their professionalism, effectiveness, and the degree to which they are satisfied with their work. Data for this research was drawn from a sample of 364 college students attending various universities in St. Petersburg, Russia. Our findings suggest the Russian students are ambivalent in general about the nature of security work, security guards' professionalism, if they are effective, and that they are not satisfied with their services. However, positive contact with security guards appeared to be a strong predictor of their positive views on various dimensions of security guard work. Findings also suggest that there are group differences in terms of age, gender, and income in their views about the various dimensions of private security guards' work and occupation.


In the past couple of lectures, we saw how to use spectral signatures to build the filtering algorithm for robust mean estimation when you assume that your dataset has bounded second moment. In the next couple of lectures, we'll show how to get stronger guarantees when your dataset satisfies stronger regularity conditions. This happens for instance when your data is Gaussian. Before we do so, it will be helpful to understand exactly what these stronger regularity conditions should look like.


Purpose: Hybrid density override schemes have been shown to yield more accurate dose modeling for lung SBRT than plans calculated on free breathing (FB) or time average (AVG) CT scans. Before hybrid schemes are clinically implemented, comparisons are needed between dose delivered to a moving gross tumor volume (GTV) by plans calculated on hybrid scans (HP) and plans calculated on FB and AVG scans. Methods: Volumetric arc therapy plans were created on HP, FB, and AVG scans for 10 patients with FB and 4D-CT scans. Five of the cases had target volumes contained entirely in lung, 5 had target volumes that included chestwall. The HP were created by overriding the internal target volume (ITV) to GTV density, and the planning target volume minus ITV shell to a density between GTV and lung. If chestwall was in the target its density was not changed. Plans were copied to the 10 4D-CT phases and recalculated to evaluate the impact of tumor motion on each technique. The GTV doses from the initial plans were compared to mean doses over the 4D-CT phases. Doses were calculated with the anisotropic analytical algorithm. Results: The minimum GTV dose ratios from the 4D to initial plans were 0.95 +/−0.11, 0.97 +/−0.11, 0.94 +/−0.13 (2 SD), for the FB, AVG, and HP plans, respectively. The mean GTV dose ratios were 1.00 +/−0.07, 1.01 +/−0.03, 0.97 +/−0.09, for the FB, AVG, and HP plans, respectively. The individual minimum dose ratios for HP to FB or AVG were all < 10%, the mean ratios agreed < 10% for 90% of the comparisons. Conclusion: The FB, AVG, and HP plans showed consistent results when considering motion. The interpretation of the planning system dose and prescription definition with HP techniques should be similar to current practices.


With the development and popularity of information technology,internet is becoming an increasingly important resource for gaining information and knowledge.The biggest advantage of our internet lies in resource sharing.Utilizing internet for acquiring information about MICE science and industry can not only enrich classroom teaching content,but also cultivate the students' ability to innovate as well as make teaching more practical and interesting.According to the characters and problems of MICE education,this article demonstrates importance of using network resources in the MICE teaching,introduces network resources and their applications in MICE's main fields of teaching,at last,describes the possible problems and solutions to using network resources.


It is another important general plan for national running by morality that has been determined by the third generation leading collective of the party with the core of JIANG Ze-min. The logical starting point of implementing the general plan for national running by morality must be to establish and perfect the new type interpersonal relationships that meets the needs of the socialist market economy. The present conditions of the interpersonal relationships in our country should be regarded with dialectical point of view.


This work seeks to analyze Western thought as a system. As a case study representative of this system, I have chosen the United States of America, as it started as a strange experiment in purely Apollonian thought, which has largely remained a closed system and has become the primary engine of cultural change in the twentieth century. As the tools for my analysis, I have chosen the dialectic represented in the mythical opposites Dionysus and Apollo and the counter cultural reaction by a number of post World War II authors, most notably Thomas Pynchon, to the "American Dream." America began as an experiment in forming the perfect society according to "Gods blueprint'', or the therein projected values of some Anglo-Saxon, Protestant religious zealots. Puritan values are almost purely Apollonian in that they elevate structure, logic and hierarchy--all attributes of the left cerebral hemisphere. With at least equal zeal, the Puritans purged the Dionysian or right brain attributes of nonhierarchical, non-linear thinking, sensuality and


Wireless charging technology enables designers to miniaturize medical implants and eliminates the redundant surgical procedure to replace batteries. In this paper, we propose a precise and fast method of predicting mutual coupling inside a human body. A magnetic field at 6.78 MHz is generated with two different types of resonant coils - circumferential and Helmholtz coils. The circumferential coil generates a vertical magnetic field while the Helmholtz coil produces a horizontal field. They can operate individually or simultaneously. The combined field mitigates orientation mismatch and increases ability to charge the implant wirelessly within the volume of interest. To predict M precisely and rapidly, a theoretical derivation is presented and compared to a commercial full-wave solver. The results show that the theoretical value is well aligned with the simulated one. The time required to produce an estimation of the coupling within the entire constellation can be substantially reduced with this approach.


This study aimed to investigate the relationship between cardiomegaly and aortic arch calcification (AAC) and overall/cardiovascular mortality in hemodialysis patients.


Acacia nilotica exhibits morphogenetic diversity in the form of three North West Indian varieties, namely, var. typica, var. kauria and var. cupressiformis. These are distinguishable on the basis of bole, crown, spine and pod characters. The present communication covers the observations on the reproductive biology and germplasm evaluation in these varieties. In spite of having ca 1/3-1.2 of flowers pre head with sterile pistils, trees produce numerous pods, and seeds per pod. Trees of var. typica from dry zones provide the best wood both as timber and fuelwood. For bark tans, older trees over 40 years of var. typica should be harvested. Gum yield is the highest in var. cupressiformis but var. typica produces superior quality gum. On the basis of various fodder characteristics and in vitro dry matter digestibility (IVDMD), var. typica produces the best quality fodder both as leaf and pod. For the majority of the economic attributes, var. typica is far superior to var. kauria and var. cupressiformis. Muelleria 26(1): 86-94 (2008)


Field experimentation was conducted during rabi 2012-13 and 2013-14 to assess the performance of weed management practices and nitrogen (N) fertilization on weed dynamics, productivity and profitability of barley (Hordeum vulgare L.). Results indicated that hand–weeding at 25 and 50 days after sowing (DAS), and metsulfuron methyl @ 4 g/ha resulted in significant reduction in weed infestation and weed biomass production at different growth stages. The highest weed control efficiency (WCE) was recorded with 2 HWs' at 25 and 50 DAS followed by metsulfuron methyl @ 4 g/ha with lowest NPK depletion by weeds than other treatments. Two HWs' also remained superiormost w.r.t. grain (5.21 tonnes/ha) and straw (7.13 tonnes/ha) yields. Application of metsulfuron methyl also exhibited higher grain yield with minimum weed competition index (8.57%). Among N levels, application of 90 kg N/ha to barley resulted in highest weed count, weed intensity, weed infestation and their dry weight at all the stages as well as higher NPK concentrations in weeds and NPK depletion by weeds at harvest stage. Application of 90 kg N/ha also produced 20.8 and 20.6% more grain and straw yields over control (N0). Overall, metsulfuron methyl and N application at the rate of 90 kg/ha proved their superiority w.r.t. weed management, productivity and profitability in barley in hot semi-arid region of western India.


Nowadays, healthcare facilities constantly collect an immense amount of data as part of their daily-management systems, which include diverse type of information, such as patient admission details, drugs administered or clinical examinations' results. Even though medical research has been traditionally condition-oriented, researchers oftentimes use similar analysis methodologies, with very little context customization, making them computationally redundant. This project proposes an analysis pipeline capable of automatically mine big and diverse biomedical datasets, and identify potentially interesting patterns in the data, despite of the medical conditions the data might relate to. Such system is called an hypotheses engine, as its purpose is to output patterns that seem to be medically predictive, which we call hypotheses. HypE's novelty is two-fold: on one hand, a tailored data processing method was developed for analyzing inconsistent and chaotic temporal data (i.e. a patient has laboratory measurements, that usually are only partially repeated over time); and on the other hand, the hypotheses found are to be outputted in a physician-friendly way, to allow fast understanding of the patterns found, in case medical intervention is recommended. Given HypE's functionality, results cannot be straightforwardly classified as good or bad, as certain data subsets might actually not contain any patterns, at all. However, methodologically, it is to expect that some hypotheses found will be known medical patterns. Thus, HypE's outputs are presented and discussed on a high level, considering no manual check for their medical validity was performed by medical experts. The prototype implemented was ran on MIMIC-III data and the results exceeded the initial expectations as they did include common medical scenarios.


Elaborated the countryside informationization background,the significance and the necessity,have analyzed the domestic and foreign current new countryside informationization construction present situation and the existence question and have made the contrast,proposed in this foundation solves question some countermeasures,the suggestion and the implementation plan.


This study aimed to determine whether the reading skills of third-grade schoolchildren are associated with their preferences for semantic, phonological, and shape competitors (images or printed words) after being exposed to a spoken critical word. Two groups of children participated: skilled readers and less-skilled readers. Through a language-mediated visual search, children's fixations on the three competitors and a distractor were measured. When looking at images, both groups of readers preferred to look at the semantic competitor. When reading words, both groups showed a preference for the phonological competitor, but only skilled readers were sensitive to semantic information. These results suggest that early reading skills influence access to different types of representations in response to hearing a word, and they confirm the existence of a cascaded activation of information retrieval in childhood.


Abstract Purpose: To explore the changes in perceived barriers and facilitators associated with participation in secondary prevention activities of stroke survivors and their caregivers over the early stroke recovery period. Method: We conducted two individual interviews (at 2 weeks and 6 months post-discharge) with stroke survivors and their family members. Using purposive sampling, participants were recruited from the stroke units of two acute care hospitals. Results: About 11 male and 8 female stroke survivors and nine caregivers participated in the study. Thematic analysis identified three themes. (1) "A soul searching experience" indicating that the stroke was anxiety provoking leading to a soul searching experience into exploring its causes to adopt a healthy lifestyle; (2) "Old habits die hard" revealing that stroke survivors encountered barriers to adopt healthy lifestyle changes; (3) "Making a fresh start" recognizing that participants were motivated to make their lifestyle healthier and most sustained some lifestyle changes over the past 6 months. Conclusion: Despite experiencing some barriers, stroke survivors adopted lifestyle changes transitioning through different stages of change. Stroke prevention education and interventions from experts would be helpful later in the rehabilitation phase (once at home) and adopting a patient-family centered approach may assist stroke survivors and their caregivers in the uptake of secondary stroke prevention activities. Implications for rehabilitation Stroke is perceived as a soul searching experience by stroke survivors and their caregivers motivating them to enquire its causes and adopting lifestyle changes to prevent a future stroke. Despite experiencing some barriers, stroke survivors adopted lifestyle changes transitioning through different stages of change. Stroke prevention education and interventions from experts would be helpful later in the rehabilitation phase (once at home). Adopting a patient-family centered approach may assist stroke survivors and their caregivers in the uptake of secondary stroke prevention activities.


Background Video-assisted surgery helps surgeons learn surgical skills efficiently. The aim of this study was to evaluate the effect of mutual evaluation of trainees' surgical techniques using tabulated common evaluation criteria. Methods We created a check sheet in which a standard pulmonary lobectomy procedure was divided into six parts and the checkpoints to note listed. Both the trainees and trainers used tabulated common evaluation criteria to evaluate lobectomies performed by the trainees. Results From September 2019 to March 2020, 30 lobectomies were performed by three trainees. The trainee's evaluations of their own procedures were relatively high at first, then decreased, then gradually increased; however, the trainers' evaluations showed no such tendency. Conclusions Mutual evaluation of surgery using tabulated common evaluation criteria enables trainees to review their own surgery objectively and receive evaluations by trainers, thus helping them to avoid the Dunning–Kruger effect and efficiently acquire basic surgical skills.


Objective: This descriptive study was planned to assess the positive and negative ageist attitudes of individua ls over the age of 18 years through social media, to d e ermine the associated factors, and to develop sug ge tions. Materials and Methods: The study was conducted in June 2020 through socia l media with the participation of 328 individuals over the age of 18 years. Data wer e collected using the Positive and Negative Ageism Scale (PNAS) and an information form. Data were evaluated using means, percentages, standard deviation, and ANOVA and Tukey tests. Results: The mean total Positive and Negative Ageism Scale (PNAS) score was 90.29 ± 8.36. Conclusion: Educational status was found to have affected the mean PNAS total and subscores.


Diabetic Retinopathy (DR) is an eye disorder that progressively leads to vision loss due to high glucose causing impairment of retinal blood vessels (BVs). 'Retinal Bright Lesions' such as 'Hard Exudates' (HEs) are plasma leakages from rapture retinal capillaries. HEs appear as hard, waxy, yellowish deposits from tiny spots to fat patches and signify moderate-severe Non-Proliferative Diabetic Retinopathy (NPDR). This paper proposes a simple, compact and computationally inexpensive technique for detection and classification of HEs using Digital Image Processing Techniques on digital fundus images complements and Artificial Neural Networks (ANN). The proposed technique unfolds through five stages i.e. Pre-processing, coarse detection, optimization, features detection & extraction followed by classification. 'Speed Up Robust Features' (SURF) algorithm has been used for features detection & extraction while 'Feed-Forward Back-propagation' (FFBP) ANN has been used for classification. The proposed technique has yielded 98.7% 'Sensitivity' (SE), 97.5% 'Specificity' (SP) and 97.7% 'Accuracy' (AC) on 'DIARETDB1' fundus images.


The E34 phage is a member of the podoviridae family of phages, (short non-contractile tailed bacteriophages) that uses Salmonella newington as its host. This phage initiates the infection of its host via a specific interaction between its tailspike protein (TSP) and the lipopolysaccharides (LPS) of the bacterial. The E34 TSP is structurally similar and functionally equivalent to the P22 phage whose TSP has been well characterized and electron micrographs of both phages appear indistinguishable. The crystal structure of P22 phage TSP in complex with the O-antigen of S. typhimurium has been determined; and the active site of the TSP demonstrated to be the residues Asp392, Asp395 and Glu359 of the receptor binding domain. In another phage called E15, a phylogenetic relative of E34 phage, a short polysaccharide consisting of α repeating units is responsible for the interaction between the E15 phage and Salmonella anatum's LPS leading to the adsorption of the phage to the bacteria. Studies on E34 phage shows that it interacts with Salmonella newington's O antigen polysaccharide component of the LPS, this polysaccharide consists of mannosyl-rhamnosyl-galactose repeating units joined together by β-galactosyl linkages. However, no data exist regarding the specific residues of E34 TSP that are responsible for LPS binding and hydrolysis. In this study, the tailspike gene was cloned onto vector pET30a-LIC and expressed as a fusion protein termed the extended E34 TSP (EE34 TSP). We characterized the protein based on resistance to heat, SDS, and proteases; showing that the protein is heat resistant, shows aberrant electrophoretic mobility in the presence of SDS gradient, and actively binds to P22 phage heads to form hybrid phages that cannot infect P22 host. We also demonstrate via in silico study that the E34 TSP binds to and hydrolyses the O-antigen of its host via the ALA250, SER279 and ASP280 residues. Finally, testing E34 phage ability to protect Vero cells from Salmonella infection shows highly encouraging results, implying that E34 phage can be used in therapeutic/preventive medicine.


Objective To investigate the effects of benazepril and candesartan on hemodynamics parameters and transforming growth factor β1(TGF-β1) expression during myocardial hypertrophy in spontaneous hypertensive rats(SHR).Methods 12-week-old SHRs were treated with benazepril at 10 mg/(kg·d),candesartan at 4 mg/(kg·d) and a combination of 2 drugs at half dose,respectively,for 12 weeks.After 12 weeks treatment,ejection fraction(EF) was acquired with the echocardiographic system.Left ventricular catheter was placed via right common carotid artery and hemodynamic parameters were determined.Left ventricular mass index(LVMI) and thickness of left ventricular posterior wall(LVPW) were also examined.Meanwhile,myocardium pathological structures were accessed with HE-staining.Expressions of TGF-β1 were detected using immunohistochemistry and Western blot analysis respectively.Results LVMI,thickness of LVPW,ratio of media area to lumen area in myocardial arteriole,ex-pressions of TGF-β1 were decreased after the treatment of benazepril or candesartan(P0.01).Hemodynamicparameters were also improved.After the combined treatment,the synergistic effect could be observed and EF was increased.Conclusion Synergistic attenuation of myocardial hypertrophy and improving of hemodynamic parameters in SHRs are produced by combined use of benazepril and candesartan possibly through negative modulation of TGF-β1 expression.


Mr Huang Chunyao,who is now in old age and enjoying high reputation for being sainted and literary talent,is an educationist of fine arts,a knowledgeable painting historian,and a master landscape painter.Mr Huang Chunyao learned the art of painting under the tutelage of Master Xu Beihong and Master Fubaoshi.In addition,there are a lot of creations and developments in his paintings.His moral quality and painting quality are so high that he fully deserves to be listed as a master landscape painter.More important,he is also a scholar-type master landscape painter.


Macrophages promote skeletal muscle homeostasis by participating in crosstalk with satellite cells, fibroadipogenic precursors, and myofibers that drives regeneration after injury. Dysregulation of this crosstalk contributes to conditions like myopathy, inefficient wound healing, and sarcopenia. Despite their central role in muscle homeostasis and regeneration, the tissue-intrinsic mechanisms that coordinate the recruitment and activity of these macrophages are poorly understood. In this study, we investigated how skeletal muscle homeostasis is regulated by the ESCRT protein CHMP5. CHMP5 was initially characterized as a member of the ESCRT family of proteins that coordinate membrane scission events in eukaryotic cells. However, recent studies by us and others have revealed non-canonical roles for CHMP5 wherein CHMP5 promotes the stability of client proteins required for cellular differentiation and cell fate decisions in hematopoietic and non-hematopoietic tissues. Using an in vitro model of myogenesis, we found that CHMP5 knockdown impaired the differentiation of C2C12 myoblasts into myotubes. Furthermore, when wild-type BMDMs were cocultured with CHMP5-knockdown C2C12 myoblasts, they failed to polarize into M2-like macrophages. In vivo, mice with muscle-specific CHMP5 heterozygous deletion (CHMP5 hetmice) displayed diminished myeloid cell presence in muscle following cardiotoxin-induced injury. 12 days post-injury, histologic and flow cytometric analyses of muscles from CHMP5 hetmice revealed less regenerative progress than littermate controls. These data suggest a critical function for CHMP5 in promoting muscle homeostasis both in the steady state and in the context of injury and inflammation.
 Supported in part by intramural funding from the National Cancer Institute, T32 GM007250, T32 NS077888-08, and NIH R01AI143992-03.


This study involves new notions of continuity of mapping between quasi-cone metrics spaces (QCMSs), cone metric spaces (CMSs), and vice versa. The relation between all notions of continuity were thoroughly studied and supported with the help of examples. In addition, these new continuities were compared with various types of continuities of mapping between two QCMSs. The continuity types are 𝒇𝒇-continuous, 𝒃𝒃-continuous, 𝒇𝒃-continuous, and 𝒃𝒇-continuous. The results demonstrated that the new notions of continuity could be generalized to the continuity of mapping between two QCMSs. It also showed a fixed point for this continuity map between a complete Hausdorff CMS and QCMS. Overall, this study supports recent research results.


Duchenne muscular dystrophy (DMD) is a lethal progressive skeletal muscle wasting disease caused by mutations of the dystrophin (DMD) gene. DMD has also been reported to function as a tumor suppressor gene. We report a case of recurrent glioma in a 25-year-old male with a nonsense mutation (c.8460G>A) in exon 57 of the DMD gene. The glioma was diagnosed as pilocytic astrocytoma (PA) through histological analysis. Evaluation of cDNA samples prepared from the tumor tissuederived RNA showed the presence of DMD transcripts which might produce dystrophin isoforms. However, anti-dystrophin antibodies could not detect any dystrophin isoform by immunostaining of the tumor tissue. This is the first case of PA in a DMD patient to the best of our knowledge. Although the occurrence of PA in this patient could be by chance, the discordant expression of transcript and protein might provide clues to support the new role of dystrophin as a tumor suppressor. Nevertheless, this is a single case and further analysis with many more patients is required to provide a definitive conclusion.


Response facilitation is an alternative learning process that could account for some imitative phenomena. It occurs when the presence of a conspecific performing an act temporarily increases the probability that an observing animal will perform the same act. This process could have important implications for sociallearning research, because it provides a plausible means by which social learning could occur in animals, yet it superficially resembles imitation and consequently affects the interpretation of current popular 'twoaction' tests of imitation. However, there is little good evidence on response facilitation effects, because cases of behavioural synchrony can usually be explained by other factors, so some researchers remain sceptical as to the importance of the process. We conducted an experimental study of social-learning processes in domestic fowl to evaluate whether response facilitation is a plausible explanatory term. Strong behavioural synchrony was observed in hens in preening, sitting and dustbathing behaviour. In the case of preening, we found strong evidence that this synchrony was unlikely to be accounted for by alternative social-learning processes or by external factors influencing birds in the same way. We conclude that there is compelling evidence for response facilitation in the domestic fowl.


When we face the historiography of the neighborhood policy, marked by the relationship between the United States and the rest of the Americas during the Seco...


masterly The English Reformation is justly acclaimed, will lend a sympathetic ear, both perhaps without giving full assent. The question will inevitably be raised : What has Tjernagel to say that Doernberg didn't say? Doernberg dealt with the personal relations around Henry VIII in his Henry VIII and Luther, a book less than half the size of Tjernagel's. That personal encounter he covered more fully than did Tjernagel. However, Tjernagel's topic required a broader treatment than did Doernberg's. The English diplomatic negotiations with Lubeck and Denmark, the dealings with the Schmalcaldic League, the activities of Robert Barnes, especially the Wittenberg Articles of 1536, are topics Tjernagel treats in much greater breadth than did Doernberg. The Wittenberg Articles of 1536 are translated for the first time into English in an excellent rendering by Ralph D. Gehrke (pp. 255 to 286). He also supplied a translation of the Thirteen Articles of 1538 (pp. 287306). The Ten Articles of 1536 might have been included in the appendices. Both of the English formularies are known from the researches of Jenkyns and Hardwicke. Mentz made the Wittenberg Articles available in a critical Latin and German edition. Tjernagel has shown their direct bearing on the English formularies and through them, he points out, on the Thirty-Nine Articles.


In this letter, we propose a novel signal detection method, reduced complexity QRM-MLD, which achieves almost identical error performance to that of the conventional QRM-MLD while significantly reducing the computational complexity.


Abstract In this investigation, the fracture energy of joints consisting of soda lime glass sandwiched around either an acrylate or poly(vinyl butyral) (PVB) was studied. This was accomplished for various adhesive thicknesses with the use of a tapered double cantilever beam specimen loaded in mode I. For adhesive thicknesses varying between 0.03 mm and 0.80 mm, the fracture energies ranged from 15 to 95 Pam for the glassy acrylate joints and from 375 to 1060 Pam for the more rubbery PVB joints. While the fracture energy was relatively independent of thickness for the acrylate joints, there was an increasing trend in toughness for the PVB joints. The fracture energy of the acrylate joints was modeled with a process zone model with reasonable results while the fracture energy of the PVB joints was modeled with constraints on the plastic zone. Scanning electron microscopy and measured bulk adhesive properties provided necessary input into the models.


DESPITE considerable literature on the pathology of acute and chronic thyroiditis, comparatively little is known about the functional status of the thyroid in these conditions. Recently radioiodine tracer technic has provided a means of observing some aspects of thyroid function in thyroiditis. It is the purpose of this paper to present the results of radioiodine tracer studies performed on 40 patients, of whom 21 had acute diffuse thyroiditis, 13 had struma lymphomatosa and 6 had struma fibrosa. Tracers consisting of 100 or 300 microcuries of I131 with 100 micrograms of sodium iodide added as carrier were administered by mouth to the subjects in the fasting state. After the ingestion of the I131, in vivo counts were taken over the thyroid at twenty-four or forty-eight hours as described by Luellen and associates (1), and urinary excretion of I131 was evaluated as described by Keating and associates (2). From the curve of urinary excretion, two rates were estimated: 1) the renal excretion rate, defined as...


Although the exact figures are not available, the incidence of burning accidents in the United States is extremely high. Only deaths due to burns are reported, and for this reason morbidity statistics are not available. Woodhall, in data derived from the North Carolina newspapers over a 12 month period from July 1, 1949, through June 30, 1950, found that burns ranked second with drownings in the list of causes of death in children.1It has been estimated that about 40,000 to 70,000 burns occur per year. Due to the vast improvements in the treatment of initial burn shock, about 50 to 60% of these burned children are surviving. Thus, those persons who formerly would have died as the result of a severe burn now present an ever-increasing problem of care, handicap, and disability as the result of their survival. The literature has been replete with papers on the treatment


Fieldwork is a lavish catalogue publication accompanying the inaugural exhibition of the same title at the National Gallery of Victoria's Australian wing at Federation Square. Drawn predominantly from the collection, the exhibition and catalogue present thematic rather than strictly chronological groupings such as "the politics of home," "postmodernism and popism," "postcolonial art" and "globalisation." Curated by Jason Smith and Charles Green, the combination of contemporary curator and academic who has published widely and practices as an artist, lends a particular intellectual rigor and cachet to the project. By linking up historically with the watershed exhibition The Field of 1968, Fieldwork takes its cue from the first temporary exhibition at the National Gallery of Victoria's Roy Grounds building on St. Kilda Road. While The Field focussed on hard-edged abstraction by young Australian artists, Fieldwork is an elaborate account of Australian art from 1968 to the present. Here the NGV takes up the mantle that collecting institutions have a responsibility to contribute to the discourse on Australian art through publishing while showcasing collection works that have been in storage for so long. Director Gerard Vaughan emphasises that "The NGV can only flourish as an active and relevant force in contemporary Australian visual culture by extending the collaborative interaction between artists, curators and writers through publications like Fieldwork"(S). I couldn't resist revisiting my precious, original copy of The Field. With its elegant, almost quaint white cover, the exhibition title is cut out in


Abstract : The purpose of this program is to investigate the nature and the principal causes of failures in microwave tubes. In this context, the following studies will be made: (a) An investigation of the factors influencing electrical breakdown in a vacuum and across the surface of a dielectric. (b) An investigation of the various electrical and surface properties of materials commonly used in microwave tubes, i.e., OFHC copper, alumina ceramic, tungsten thoria cermets, tungsten matrix, and others; in addition, less frequently used materials will be investigated, such as boron nitride and dispersion-strengthened copper. (c) Surface diffusion and other surface physics phenomena. (Author)


Abstract. Conventional incontinence surgery was performed in 41 consecutive female patients despite the finding of motor urge incontinence. The patients were reinvestigated 6 months to more than 2 years after operation. Twenty‐eight of the patients also had the symptom stress incontinence. Seventeen patients had coexisting symptomatic genital prolapse and were operated on without prior pharmacological treatment. The remaining 24 patients were all resistant to parasympatholytic treatment. The choice of operative procedure was based on vaginal examination as well as bladder suspension defect as demonstrated on voiding‐colpo‐cysto‐urethrography. Subjective cure and improvement rate was 73%. At follow‐up, 30% of the patients had normal de‐trusor reflex control, and a significant improvement in urge incontinence as well as frequency of micturition and noc‐turia was observed.


Abstract : For nearly two decades, the idea of creating fusion plasmas by the implosion of cylindrical shells or liners has appealed to workers interested in high energy density systems. A variety of schemes have been offered over the years to accomplish the adiabatic compression of plasmas at megagauss magnetic field levels by imploding liner magnetic flux compression techniques. The two main elements of such schemes have been the implosion of an electrically conducting cylindrical liner and the creation of an initial plasma suitable for compression by the surrounding liner. Some progress has been made both experimentally and conceptually in regard to plasmas that could be compressed by liner implosion, but no experimental test has yet been accomplished successfully in which the energy and temperature of the magnetically-confined plasma has been increased into a significant regime by liner implosion. Considerable progress has been made, however, in developing liner implosion techniques suitable for both experimental development and eventual imploding liner fusion reactors. The principal development has been the achievement of controlled, reversible liner implosions with excellent symmetry and surface quality. This paper reviews some of the highlights of the development of liner implosion systems at the Naval Research Laboratory and indicates directions of future work.


This study aimed to systematize the apparel vendor work processes and provide useful information to future employees of clothing export units by analyzing the processes of vendors` manufacturing tasks. A survey of 20 apparel vendors servicing mainly U.S. buyers was conducted on employees of overseas business departments working for more than five years. buyers. Based on the results, vendors mainly manufactured cut-and-sew knit products. Regarding the production method, OEM was used more frequently than ODM. Fourteen (70%) companies used the ODM method. This suggests that vendors are expanding their production method from OEM to ODM. In order to summarize the work of each business based on the clothing production process research results, buyers were in charge of planning products and the vendors were in charge of sampling. Production of materials and the approval of material tests were out sourced. Overseas factories of vendors were in charge of bulk (mass) production and garment finishing, as well as packaging and shipping the completed products. Even though the vendors` head offices do not directly produce clothes, they play a pivotal role in ensuring planning and management progress in clothing production. As buyers prefer direct contracts for cost reduction, the vendor additionally performs the role of an agent. Also, with the increase in ODM production ratio, the work area of the vendor is expanding. If Korean clothing exporters improve their global competitiveness by investing in the R&D of materials and design to enhance the ODM method, the development of Korea`s clothing and export industry will benefit significantly.


This paper reviews several membrane separation technologies and their applications in the separation and purification of polysaccharides in the past few years.


Abstract Recently, Paterson and Schuldt proposed an Identity-based (ID-based) signature scheme which is provably secure in the absence of random oracles. In this paper, we propose an ID-based threshold signature scheme based on their signature scheme. The proposed construction is proved secure in the standard model and its security rests on the hardness of discrete log assumption along with the computational Diffe-Hellman problem. To the best of our knowledge, previous-related schemes could only be proved secure in the random oracle model.


We describe a case of patient with alcoholic cirrhosis and severe functional hepatic impairment (Child C), developing in the last months renal impairment too and ingravescent, refractory ascites, despite high-dose diuretics. The patient was treated with intravenous albumin and, at last, weekly paracentesis. In this report we evaluate alternative therapeutic options (Transjugular Inrtahepatic Protosystemic Shunt, Orthotopic Liver Transplantation) when frequent paracentesis are needed.


In order to develop melanoma-targeted in situ peptide vaccine immunotherapy, magnetite nanoparticles were conjugated with a melanogenesis substrate, N-propionyl cysteaminylphenol (NPrCAP). Magnetite nanoparticles introduced thermotherapy which caused non-apoptotic cell death and generation of heat shock protein (HSP) upon exposure to alternating magnetic field (AMF). NPrCAP was expected to develop a melanoma-targeted therapeutic drug because of its selective incorporation into melanoma cells and production of highly reactive free radicals, that result in not only oxidative stress but also apoptotic cell death by reacting with tyrosinase.


ABSTRACT SIX methods of estimating stormwater runoff peak discharge are evaluated as to their performance on watersheds of Florida's flatwoods resource area. Characteristics of flatwoods watersheds include extremely flat relief, sandy soils, dynamic shallow water tables, and scattered wetlands. Data collected by the U.S. Geological Survey and South Florida Water Management District from five small (8 to 1450 ha) agricultural watersheds (improved and unimproved pasture) served as the basis of evaluation. Runoff peak rate estimation techniques ranged in approach from empirical formulas to an overland flow simulation model. Among the established methods examined, best results were achieved using the overland flow technique. Three of the six peak rate estimation methods (the SCS graphical method, the CREAMS hydrologic model equation, and the SCS triangular hydrograph method) were modified to improve their performance on flatwoods watersheds..


Morphology was manipulated by means of inoculum level and initial pH value.The physiological state of mycelial pellets was estimated according to the growth kintics,pH value,and 11α hydroxy-canrenone conversion ratio.It was found that more efficient biotransformation was performed with small and fluffy pellets.The highest 11α hydroxy-canrenone conversion ratio of 92% was achieved in 7L fermentor under the optimum conditions and the fermentation time was saved.


Background: Undernutrition among children has become a major public health issue due to the high risk of morbidity and mortality involving this vulnerable age group. This study focused on the rural population, especially among the Dayak children in Sarawak, Malaysia. Methodology: This community-based cross-sectional study was conducted in Sarawak's rural areas using a multistage stratified cluster sampling technique. Data were collected through face-to-face interviews using an interviewer-guided questionnaire. The nutritional status of the under-five children was measured according to the World Health Organization guidelines. The nutritional indicators were calculated as z-scores. Multivariate logistic regression analyses were performed using SPSS to identify the factors associated with nutritional status. Results: The prevalence of undernutrition among the under-five Dayak children in the rural areas of Sarawak was 39.6%. The analysis suggested that wasting was predominantly associated with parental education levels of primary and below, poor wealth index, environmental and sanitation issues, children with history of low birth weight, shorter duration of exclusive breastfeeding, and poor appetite. Stunting was high within the age group of <3 years old and was associated with parents' occupation and household wealth index. Low parental education, poor wealth index, environmental and sanitation issues, poor appetite, and the children's recent illness predicted underweight. Conclusion: These findings imply that a multi-sectoral and multi-dimensional approach is essential to address undernutrition in rural settings. Improvement on households' socioeconomy, environment and sanitation should be emphasised to reduce undernutrition among the children.


This article analyses the international trend towards the adoption of short-form disclosure documents for retail financial products through a comparison of six jurisdictions: the European Union, Australia, Hong Kong, Singapore, Canada and New Zealand. For the purposes of the analysis, 'short-form disclosure documents' are defined to mean disclosure documents in respect of which the maximum page length is prescribed, either on a mandatory or recommended basis. The comparative analysis suggests some important findings. These include the strong interrelationship between factors such as purpose, length, liability and language and the extent to which each of these factors, particularly purpose, influences the other factors. Each choice or setting involves certain tradeoffs and achieving a comfortable balance is not an easy task for legislators and regulators. In addition, the findings reveal the challenges that all jurisdictions have encountered in terms of incorporating the key features and risks of complex products into a short-form disclosure document. Finally, there is widespread recognition of the need to treat disclosure as part of a broader range of measures, including measures to improve the quality of financial advice and to increase investor literacy.


The larvae of winter spawning fishes immigrating through Beaufort Inlet into the Pamlico Sound estuarine system (North Carolina, United States) were passively sampled during 14 flood tides and nine of the following ebb tides. Five taxa were abundant in the catches. Pelagic species were represented by Atlantic menhaden, Brevoortia tyrannus. Nonpelagic taxa were represented by Atlantic croaker, Micropogonias undulatus, spot, Leiostomus xanthurus, pinfish, Lagodon rhomboides, and flatfishes of the genus Paralichthys. The sampling was continuous and the sample duration varied between 4 min and 32 min. The longest samples furnished the most accurate and precise estimates of the mean tidal abundance. Sampling 10 min each hour of the tide was the most efficient protocol for determining the mean tidal abundance. The abundance patterns was shown to differ according to the pelagic or nonpelagic behavior of the larvae. Analyses suggested the nonpelagic taxa rely on astronomical tides and vertical migrations synchronous with the direction of the tide flow to be transported upstream in the estuary. These larvae were not dependent upon the strength of the tide to penetrate the inlet. In contrast, menhaden larvae seemed to rely primarily on strong food tides to enter the estuarine area, probably because the vertical positioning of the species within the water column is not dependent upon the direction of the tide. However, if larvae were present outside of the inlet, strong flood tides indiscriminately brought pelagic and nonpelagic species into the estuary.


Methodological issues concerning the estimation of the marital status of a population are examined. Consideration is given to the relationship between demographic and socioeconomic factors and their impact on population distribution by age sex and marital status. The geographical focus is on the USSR. (summary in ENG) (ANNOTATION)


highly sensitive diketopyrrolopyrrole-based ambipolar transistor for selective detection and discrimination of xylene isomers. in multiple discriminate similar xylene isomers from one (PDPPHD-T3)-based field effect transistor (FET) sensitively detects xylene isomers at low to 40 ppm levels in multiple sensing features. Combined with pattern recognition algorithms, a sole ambipolar FET sensor rather than arrays of sensors can discriminate highly similar xylene structural isomers from one another.


COVID-19 has led to increased remote working for occupational therapists and other health and social care professionals. Despite the rapid move to video consultations during COVID, the impact and implications of remote working still need consideration. Prior to COVID, digitisation was already recognised as essential, given the demands on health and social care (NHS, 2019). The National Health Service (NHS) long-term plan pledged to make digitally enabled care mainstream within the next decade (NHS, 2019). Technological innovation has the potential to improve care quality and cost savings across health and social care (Maguire et al., 2018). Allied health professionals (AHPs) have been urged to lead digital health innovations and use new technologies for patient benefit (NHS England, 2019). Video consultations had already emerged as a service model, with potential for improved efficiency and patient experiences (Greenhalgh et al., 2018a). In 2016 we embarked on a series of projects to explore the use of a remote-working software that could be used to undertake home assessments and consultations. This software allowed staff and service users to interact via a texted or emailed hyperlink. The link allowed staff to communicate via video, control the service user's camera (for example by using the flash or taking videos/photos) and make real-time notes. It did not require any software or apps to be downloaded. Our experiences of adapting a software to support remote home assessments (Read et al., 2020), and then consulting patient and public representatives and local health and social care professionals about its potential uses, highlighted the importance of influencing the development of such software to meet the needs of staff and service users. In March 2020 we embarked on our third project: evaluating and further developing the same software and exploring the data security and information governance implications of its use. Occupational therapy, AHP and medical staff had been ready to use the software with patients in different clinical settings in one NHS acute hospital trust and provide feedback. We then intended to use this feedback to inform the software's design. This most recent project launched in early March 2020. However, the restrictions, demands and rapid pace of change associated with the NHS response to the pandemic meant we were unable to evaluate and further develop the software as planned. Not surprisingly, given the context of COVID-19, front-line staff were under immense strain when providing and managing services. However, most of the staff involved in the project were keen and able to continue given the pressing need to work remotely. However, obstacles arose when staff began trialling the software. It became clear that the software could not be launched within the NHS trust firewall, although it worked on devices outside the firewall. Resolving this required input from senior NHS information technology (IT) personnel. Understandably, given COVID-related pressures, the IT resource was being carefully managed. The project team – which included clinical academic occupational therapists, computer scientists and academics – tried to establish a strong case to support the need to allocate IT time to the project. This included letters of support from the trust's own clinical and research innovation office and two clinical services. However, convincing IT services of the unique selling points of the software, whilst it was still in development, compared to the mainstream remote video consultation platforms the trust had already approved for use during the pandemic remained necessary. These obstacles


*† A structured, disciplined methodology is required to control major cost-influencing metrics of space transportation systems during design and continuing through the test and operations phases. This paper proposes controlling key space system design metrics that specifically influence life cycle costs. These are inclusive of flight and ground operations, test, and manufacturing and infrastructure. The proposed technique builds on today's configuration and mass properties control techniques and takes on all the characteristics of a classical control system. While the paper does not lay out a complete math model, key elements of the proposed methodology are explored and explained with both historical and contemporary examples. Finally, the paper encourages modular design approaches and technology investments compatible with the proposed method.


The Table of Contents (ToC) graphic and Figure 2 are incorrect in this article as it first appeared online on June 21, 2018 and in Volume 13, Issue 17, pages 1664–1672. The error pertains to an incorrect depiction of the carbohydrate 3′‐sialyllactose, specifically the glucose moiety of the lactose portion of 3′‐sialyllactose. The correct Table of Contents graphic / Figure 2 is shown here (same graphic used for both). The correction has no bearing on the conclusions presented in the article.


A rigid body moving with fluid in a narrow tube is expected to be developed for future engineering applications such as a capsule endoscopy, and it is also applied to some parts of industry. This paper deals with the flow characteristics around a single rigid body with a hole in its center and transient motion of the body when the body is influenced by pressure force from upstream. The model considered the width of the gap between the body and the wall is smaller than a diameter of a tube so that the force on the body can be numerically and analytically estimated as a viscous friction force. It was assumed that the flow is axisymmetric, laminar and taken to be Newtonian and incompressible. It was obtained that, with the hole in its center, the terminal velocity of the body becomes smaller than the average velocity at the inlet. Moreover, because there is a stagnation on the body, the pressure increases behind the body.Copyright © 2009 by ASME


It introduces the whole grade method and measurement of database server's software and hardware, makes the test on database as well as server before and after upgrade from hardware expansibility and treatment ability, system stability, and database performance, etc., finds out the reason that causes performance change, and concludes the change law and precaution of upgrade.


To the Editor: We read with interest the recent discussion about the 2015 American Society of Regional Anesthesia and Pain Medicine guidelines concerning interventional spine and pain procedures in patients on direct oral anticoagulants (DOACs). We agree that the interruption of DOACs should not be based only on their respective half-life but also on the residual drug concentration. Indeed, a recent multicenter study showed a high interindividual variability of DOACs' plasma concentration. Furthermore, a poor correlation between renal function and plasma concentration of rivaroxaban, apixaban, and dabigatran was found, except for dabigatran measurements at trough. Douketis et al stated recently that stopping dabigatran 48 hours before the procedure in patients with creatinine clearance greater than 50 mL/min may not be long enough to achieve normal coagulation tests in greater than 95% of patients. Indeed, in the prospective study of Douketis et al, the mass spectrometry (LC-MS/MS) measured a dabigatran level greater than 20 ng/mL in approximately 16% of patients undergoing high bleeding risk procedures. However, some issues need to be addressed regarding the laboratory assays. Contrary to the statement of Benzon et al, it should be mentioned that specific tests to measure DOACs are more widely available than in the past years, and some of them are already CE marked and easily available in the European Union (ie, The Hemoclot Thrombin Inhibitor [HTI] and the STA-Ecarin Chromogenic Assay II [ECA-II]). The US Food and Drug Administration is now considering an expansion of the availability of these tests in laboratories in the United States. Regarding the interpretation of the laboratory tests made by Douketis et al in their study, we have the following comments. First, the activated partial thromboplastin time can be normal in the presence


Appropriate chewing function is an important indicator of oral health, and masticatory efficiency assessment is one of the most objective methods of prosthetic treatment quality control.
In the globe dental practice, static and dynamic chewing tests are still considered to be the main methods of masticatory function assessment. Thus, there is an extension of functionally-oriented clinical investigations base, which actualizes the importance of this work.
The aim of the work was to evaluate the masticatory function of patients that use mandibular overdentures by studying the results of physiological masticatory test and self-assessment indicators of dental health associated with the use of dentures.
Materials and methods. The clinical trials were carried out in two stages. At the first stage upon informed consent an examination of 20 student volunteers aged 18-22 years (control group -I) and 36 patients -17 women, 19 men (aged 57-76 years) with complete mandibular removable dentures (comparison group -II) was proceeded. Patients of the group I underwent physiological masticatory test with agar-agar samples formed according to UMSA method, patients of group II- masticatory test procedure and interview survey. The second stage was performed by the group III–42 persons –23 women, 19 men (aged 56-89 years) at 1, 6 and 12 months after mandibular dental arch restoration with complete removable overdentures, fixed by spherical attachments. Chewing efficiency was determined using masticatory physiological test and problem-oriented questionnaires. Video registration by Nikon Digital Camera D3200 was used to determine chewing time, number of movements and peculiarities of the mastication process.
All patients of groups II and III in personal interview survey answered 6 questions about indicators of oral health connected with the use of dentures. Questions were formed according to European Oral Health Indicators (2005). Statistical data analysis was performed by standard statistics variation methods with Statistica 6.0 Program use.
Results and discussion. All the parameters of physiological masticatory test: duration of chewing, group I 25,3±2,8 sec. group II 67,3±3,7 sec., group III 60.5±3.5 sec, number of chewing movements in group I was 58.3±4,8, in group II − 82.3±6.3, in group III − 68.8±3,4, samples mass loss: group I − ≤0,13(4,3%), group II − ≤0,21(7,0%), group III − ≤0,18(5,9%). Diminution Index obtained: group I − 1.85±0.5, group II – 3.33±0.7, group III – 2.48±0.5). Masticatory efficiency level in patients of the group III prevailed over group II by the respective parameters. Masticatory test video registration data analysis showed that the patients of group I diminished test samples with bilateral chewing pattern, as the majority of group II patients, while patients in group II employed combined— uni- and bilateral chewing pattern.
According to the average values of the expression of all oral health-related questionnaire indicators: chewing difficulties - 2.67 ± 1.35 vs 0.50 ± 0.20*; excessive bite closure efforts - 1.19 ± 0.65 vs 0.57 ± 0.30*; limited food consumption 2.83 ± 1.35 vs 0.59 ± 0.30*; oral lesions 2.39 ± 1.20 vs 0.56 ± 0.30*; difficulty non-chewing movements 2.14 ± 1.05 vs 0.51 ± 0.30*; uncertainty about reaching treatment goals 2.06 ± 1.10 vs 0.66 ± 0.30*. A statistically significant (p <0.05) difference in favor of group III was clearly demonstrated.
Conclusions

The results of physiological masticatory test and patients interview survey indicated favorable adaptation process to mandibular overdentures with reestablished masticatory function restoration during 12 months of use.
Masticatory efficiency and oral health indicators, connected with dental prostheses usage proved the appropriate quality level of prosthetic treatment in mandibular single remaining teeth-attended patients, using dentures fixed by spherical attachments.


Exchange of notes between the Argentine Republic and Japan concerning Specific Programmes on technical cooperation with the Secretariat of communication (with schedule and annexes). Buenos Aires, 5 January 2010 and 4 February 2010


The growing forest products business in China has attracted foreign companies to the Chinese market. This study examines the unique characteristics of intercultural communication in the forest products business in China, using an exploratory case study approach. In-depth interviews were conducted with executives of a multinational forest industry company. The qualitative data analysis identified ten topics concerning business communication in China: bureaucracy, negotiation, business protocols, personal connections, distribution channel, employee recruitment, employee retention, language, publicity, and donations. The results illustrate the characteristics of business communication and how Western expatriates deal with communication issues in relation to the Chinese. Finally, this study generates keys to success in intercultural business communication in China.


Dedicated microprocessor-based data acquisition systems are beginning to be used to monitor the energy savings from building energy conservation retrofits. These systems capture data from important monitoring points and store the values for periodic transfer to a central location. While there are many data loggers available that appear suited to this task, choosing between them is complicated by a large number of manufactur ers, a lack of standard communications protocols, and most significantly, no standardized tests for reporting their capabilities. This paper addresses the last point with a battery of tests that were developed and applied to data loggers from nine manufacturers. INTRODUCTION The Texas LoanSTAR (Loan to Save Taxes And Resources) program was established in 1988 by the State of Texas' Governor's Energy Office. This $98.6 million program uses a revolving loan financing mechanism to fund energy conserving retrofits in state, public school and local government buildings. One important facet of the program is the Monitoring and Analysis Program (MAP), which was established to measure and report energy savings from the retrofits. Before retrofits are installed in a building, a data logging device is connected to monitor information, such as electricity consumption or steam condensate use, that allows the effectiveness of the retrofit to be measured. To ensure the highest level of confidence in the results of the MAP, data loggers from each manufacturer participating in the program were put through a series of bench tests. Since few standards for testing data logging equipment have been developed, it was decided to design the tests to reveal the logger's accuracy and limits on the behavior of attached sensors. DESCRIPTION OF TEST BENCH To test the data acquisition systems, a test bench consisting of 3 PCs (ffiM compatible personal computers), special signal generating hardware, a digital storage oscilloscope and a controlled temperature chamber was assembled as shown in Figure 1. The first PC controls the signal generating hardware and can simulate the outputs of sensors typically used to monitor buildings. Up to 4 analog signals and 20 digital signals can be generated simultaneously. The oscilloscope is used to inspect these signals and investigate how each data logger affects them. The second PC is connected to the data logger via modem or a direct serial line to initialize it, monitor each test's progress, and obtain the results at the end of the test. The third PC uses special software to monitor the communications between the second PC and the data logger. These tests took place with the data logger placed in a controlled temperature chamber fabricated from a used household refrigerator and a digitally controlled heating element. Dry ice was used to obtain temperatures below the refrigerator's normal ability. DESCRIPTION OF DATA LOGGERS The dat<'l loggers used in this program are special purpose microcomputers dedicated to monitoring signals provided by one or more sensors, periodically storing the time stamped value (integrated or instantaneously sampled) of each signal, and transmilling the stored values to a polling computer on command. A wide range of sensor types may be connected to loggers from various manufacturers. The sensors fall into 3 groups, digital, analog and power. Each of the loggers listed in Table I are capable of recording values from one or more of those sensor groups. RATIONAL OF TESTS A digital sensor is typically a dry contact that closes at a rate proportional to the quantity being sensed. An example is the KYZ pulse initiator on many watt-hour meters. There is a limit to the rate at which a logger can sense these pulses. Furthermore, each logger reacts differently to bouncing contacts, semiconductors used in place of contacts, and the resistance across the contact (which is increased by long wire runs between a data logger and the sensor). An analog sensor puts out a continuous (as opposed to discrete) signal that is proportional to the quantity being sensed. This signal may be resistance (RTDs), current (typically 4-20mA), or voltage. The data logger must convert that analog signal into digital values for storage. This A-D conversion can be sensitive to the ambient temperature in the logger's location. Since the A-D operation is a quantization, there is a minimum amount the analog signal must change before the logger can


In this study, low-quality rapeseed was used as a raw material for biodiesel fuel production. The application of such seeds with an enzyme catalyst is a green approach to producing renewable biodiesel fuel. During the in situ transesterification process, mineral diesel was selected as an extraction solvent for the simultaneous extraction and transesterification of rapeseed oil (RO). This allowed, at the end of the process, for the production of a mixture of mineral diesel and biodiesel fuel. Energy is saved using this process, as the need to extract the oil separately is eliminated and extraction and transesterification take place together in the in situ process. In this study, 11 different lipases were analyzed from which to select the most effective biocatalyst according to the chosen experimental conditions. The most suitable lipase for in situ transesterification was Lipozyme TL IM (Thermomyces lanuginosus). The impact of the temperature and duration of the reaction was investigated along with the concentration of the lipase. A ethanol-to-oil molar ratio of 5:1 was chosen. The optimal reaction conditions were as follows: a reaction duration of 7 h, a reaction temperature of 30 °C and a lipase concentration of 5% (based on oil weight). Under these conditions, 99.92% of oil was extracted from the rapeseed. The degree of oil transesterification acquired was 99.89%. A mineral diesel and rapeseed oil ethyl ester blend of 9:1 (w/w) was produced.


One of the biggest problems of Korean economy is polarization of firms for export and domestic demand and that of conglomerates and SME`s achievement. One of the culprits lies weakness of intermediate industry such as machine tool. Since intermediate industry is important path where export performance affects domestic demand and whose actor usually is SMEs with high spill over effect in labor market. Especially, intermediate industry is vulnerable because of industrial policy biased to backward linkage effect. However if a country fails to develop intermediate industry above some critical point, that country would fall in low-tech equilibrium without growth. In case of benign circle where final goods industry growth leads growth of intermediate industry and again it leads that of final goods industry, it can reach high-tech equilibrium. By contrast, in opposite case where in industrialization latecomer fails to link industries likewise above some critical point that country would fall in low-tech equilibrium without growth. Moreover, for several reasons, machine tool firms of Korea have difficulty in catching up technology above critical point. Firstly. Conglomerate demander neglects their product. Secondly, even after success of development overcoming difficulties they fail to get market share for response of dumping of foreign competitors. And the last one is patent litigation of foreign competitors that incapacitate the technology development. For these, Korean machine tool firms fell in `middle-income country trap` itself, since they stuck in some extent when they technologically catch up. Consequently, for latecomer country in machine tool industry to leapfrog meaningfully policy support is necessary. Weak intermediate industry does not induce domestic firms and remained fragile. Therefore, localization policy should reflect condition of technological catch up more than before, in order to be effective and fruitful. There should be turning point over relationship between conglomerates, major demander of machine tool and SME`s, for only with active purchasing of conglomerate Korean machine industry can grow.


A new optimized structure for micro electromagnetic actuator is introduced based on the research done before. Three-dimensional structure and new fabricate process is adopted accordingly in this improved design. The new structure can diminish the leak of magnetic circuit and increase the magnetic force. An electromagnetic micro actuator is fabricated based on the MEMS technology. The size of the micro electromagnetic actuator is about 5mm times 5mm times 0.4mm. The micro actuator consist a lower magnetic circuit, a planar exciting coil and a permalloy cantilever. Anisotropic etching, electroplating, polyimide film patterning is adopted in the fabricated process. The exciting coil has 20 turns and the resistance of the coil is about 20Omega. The initial experiments show that the permalloy cantilever displacement can reach 2mum at a current and voltage of 250mA and 5V. This electromagnetic actuator is expected to be useful in making a micro relay


This work explores rock fragmentation through drilling and explosives. Sections cover various characteristics, methods and types of equipment, including rotary percussive drilling, compressors, industrial explosives, blasting accessories, rock breakage, blasting for tunnels and drifts, underwater blasting, secondary fragmentation and special blasting, and structure and building demolition.


The Romanian-Hungarian Relations and the Change of
Regime from 1989. After 1945, the Romanian-Hungarian relations have
been officially presented as normal, appropriate for two friendly
socialist states, without raising any special issue. But, beyond the official
relations between two good neighbours, in specific circumstances, some
issues and differences did emerge. These were generated by historic
legacies of the two states and nations. Two of the major factors that
influenced the bilateral relations were the issue of minorities and that of
the ethnic Hungarians from Romania. Once the nationalist socialism line
of the Ceausescu regime became proeminent, the relations between the
two states got tensioned. The overthrow of Ceausescu's dictatorship
released the tension at the level of the bilateral relations between the two
neighbours. Beginning with the change in the political regime, almost
instantaneously the first conveyance of aids from Hungary set off for
Romania. The Hungarian government was the first to diplomatically
recognise the leadership of the FSN (National Salvation Front) and
using its international connections lobbied for the Bucharest government
at the chancelaries of the Western states. Several Hungarian delegations
arrived to Bucharest in order to resume bilateral discussions. But this
euphoria of the renewed Romanian-Hungarian relations was soon
shadowed by the same old differences. The "interference" of Hungary,
its presence at different levels was regarded as disturbing for the
Romania, the latter considering that its neighbour exaggeratedly tried to
interfere with Romania's process of transition.


CUMT(China University of Mining and Technology),retaining its intrinsic disciplinary tradition in reform and development,has established a "Greater Coal-mining" discipline.The "Greater Coal-mining" has been proved to be a success in many respects: its formation and development has effectively improved the intersecting and overlapping of disciplines;innovative awareness in university management has been promoted in establishing the "Greater Coal-mining" structure as well as its supporting system;the teaching system,based on the "Greater Coal-mining" system,has put the educational stress on students' innovation and capability to carry on engineering practice.


Cerastium qingliangfengicum H.W. Zhang & X.F. Jin sp. nova (Caryophyllaceae) is described. The new species was found in moist places in the valleys of Mt. Qingliangfeng in western Zhejiang of China. It is morphologically similar to C. wilsonii, hut differs by having sparsely to densely pubescent stems, leaves densely pubescent on both surfaces, petal lobes obtuse at apex, and capsules more than twice as long as sepals.


With the economy being globalized,3 factors,i e customer,competition and change,urge the tourist agencies to make organizational transformations in order to ensure their long term and sustained development The idea of business process reengineering prevailed in the western counties in 1990s This article uses this idea to analyze the organizational transformations of the tourist agencies in China The simultaneous engineering and the significance of such transformations are also described


1. A method for determining characteristics of at least one microorganism from a sample, which comprises the identification of said at least one microorganism typing and the determination of characteristics, stability of potential of at least one antimicrobial agent and a virulence factor, wherein the determination of typing characteristics, stability at least one antimicrobial agent and a virulence factor for said at least one microorganism is carried out by the mass spectrum triey using proteins, peptides and / or metabolites as markers for typing of these characteristics, the stability of at least one antimicrobial agent and virulentnosti.2 factor. The method of claim 1, wherein the mass spectrometry used to determine characteristics of typing, stability potential of at least one antimicrobial agent and a virulence factor, is the spectrometry MS / MS.3 type. A method according to claim 2, characterized in that the MS / MS spectrometry is MRM.4. A method according to any one of claims 1-3, characterized in that the determination of typing characteristics, resistance to at least one antimicrobial agent and a virulence factor is performed in a single device for mass spektrometrii.5. A method according to claim 4, characterized in that the determination of typing characteristics, resistance to at least one antimicrobial agent and a virulence factor odnovremenno.6 performed. A method according to any one of claims 1-3, characterized in that the identification of said at least one microorganism also impl


BACKGROUND
Color classification and its subjective clearance evaluation in response to treatment are essential in the management of patients with port wine stains (PWS). But color perception by physicians is not an objective measurement so that it can change among observers. Agreement among physicians is essential for the reliability of the color classification and the clinical assessment of the response to laser treatment.

OBJECTIVE
The purpose of our study was to determine the reliability of the clinical color classification of port wine stains and of their color change or clearance in response to laser treatment. The study was not designed to evaluate the outcome of laser treatment in PWS or the factors that could predict the final response.

METHODS
We used the kappa index to evaluate the proportion of agreement in color and clearance perception among dermatologists. Six dermatologists classified the initial color of PWS in 80 patients. Three of them also assessed the amount of clearance achieved after treatment with the flashlamp-pumped dye laser. These three dermatologists were usually dedicated to treat patients with PWS, while the other three were not.

RESULTS
The kappa index showed a substantial agreement in both cases. No difference in the initial color perception was observed between the group of dermatologists specialized in PWS and the other three dermatologists.

CONCLUSION
These results favor the reliability of the clinical method in the assessment of PWS before and after laser treatment. So, although subjective, color perception by physicians can be used in the study of laser treatment outcome in PWS and its related factors, and the results of different authors can be compared.


BackgroundThe importance of exercise-induced exaggerated blood pressure (BP) response in endurance athletes is not known. ObjectiveTo assess the hemodynamic parameters and metabolic profile in athletes with an exaggerated BP response to exercise. MethodsForty-four endurance athletes underwent a maximal exercise test, a 24-h ambulatory blood pressure monitoring, a 24-h Holter assessment, and sampling of blood on two occasions: (a) during intense training and (b) following 3 weeks without training. ResultsDuring the training period, 11 athletes showed an exaggerated BP response to exercise, whereas seven of these 11 athletes also showed an exaggerated BP response during the resting period. Elevation in systolic BP was greater in athletes with an exaggerated BP response than athletes with a normal BP response to exercise (resting: 84±22 vs. 60±18 mmHg, P=0.02; training: 100±21 vs. 70±18 mmHg, P=0.004). During the training period, athletes with an exaggerated BP response to exercise showed higher systolic BP values on 24-h ambulatory blood pressure monitoring (136±15 vs. 118±8 mmHg, P=0.02). During the resting period, athletes with an exaggerated BP response to exercise had lower apolipoprotein-A1 (1.3±0.1 vs. 1.5±0.2 g/l, P=0.009), and higher SDNN (259±47 vs. 209±52 ms, P=0.03) and pNN50 (0.4±0.1 vs. 0.3±0.1%, P=0.05). ConclusionThese observations may represent the first sign of a slight metabolic disturbance associated with vascular wall abnormalities, although the parameters remain within normal values.


lar weight in a family of hyperbranched thermoplastics derived from soybean oil. Acrylated epoxidized triglycerides from soybean oils have been polymerized to hyperbranched thermoplastic elastomers using reversible addition-fragmentation chain transfer (RAFT) polymerization. With the proper choice of chain transfer agent, both homopolymer and block copolymer can be synthesized. By changing the number of acrylic groups per triglycerides, the chain architectures can range from nearly linear to highly branched. We show how the fundamental viscoelastic properties (e.g. entanglement molecular weight, plateau modulus, etc.) are inuenced


Abstract Thirty multiparous lactating cows were divided in three groups based on milk yield: high (H), average (A) and low (L). Within each group, cows were randomly allotted to two levels of iodine inclusions into the diet and respectively: level 1 (1): base diet containing 1.55 mg/kg dry matter, level 2 (2): base diet plus 47.2 mg/d. Potassium iodide was used. Feeds, orts, drinking water and individual milk samples were collected and analysed for the iodine content. The iodine concentration and total excretion in milk were affected by the level of iodine supplementation (P<0.05). No effect on milk iodine concentration could be addressed either to the level of milk yield or to the milk yield x treatment interaction. The total amount of iodine excretion and carry over were affected (P<.05) by the level of milk yield.


Matrix metalloproteinase‐2 (MMP2) has been shown to play an important role in cancer cell invasion and the expression of MMP2 is associated with the poor prognosis of prostate cancer; however, the mechanism of MMP2 expression is largely unknown. SIRT1 is a nicotinamide adenine dinucleotide‐dependent histone deacetylase (class III HDAC) that has recently been shown to have implications in regulating cancer cell growth and apoptosis. The purpose of this study is to determine the role of SIRT1 in regulating MMP2 expression and tumor invasion in prostate cancer cells.


The National Center on Addiction and Substance Abuse at Columbia University is conducting a study on the impact of substance abuse on the budgets of the governments of the 50 states in the United States of America, the District of Columbia and Puerto Rico. The goals of the study are to provide policy makers with a map of how substance abuse affects the costs of state governments; to document the total bill for substance abuse that states pay, itemizing expenditure on prevention, treatment, research and consequences; and to point the way to more cost-effective investments.

The present article documents the methodology used in the study by the National Center on Addiction and Substance Abuse to estimate state costs linked to substance abuse. The methodology relies on previously documented costs of illness research to estimate the costs imposed by substance abuse on the health-care system and on the state workforce. It also documents costs that are directly attributable, namely, prevention, treatment, research and regulation. Finally, the methodology establishes the pool of substance-involved individuals for whom prevention and treatment may be a necessary condition of reducing public spending. The study demonstrates that states devote tremendous resources to managing the effects of substance abuse, while only a small portion of state spending is aimed at reducing substance abuse through treatment and prevention programmes. By providing a map of state spending on substance abuse, the study has established a base against which policy makers can begin to compare the value of alternative policies concerning prevention, treatment, regulation and tax that might reduce the consequences of substance abuse and addiction. Understanding the enormous costs attached to current policy choices with regard to substance abuse should help policy makers think more strategically about how they might invest in interventions that would yield a better return.