The Notch signaling pathway plays an important role in cellular proliferation, differentiation, and apoptosis. Unregulated activation of Notch signaling can result in excessive cellular proliferation and cancer. Human T-cell leukemia virus type 1 (HTLV-I) is the etiological agent of adult T-cell leukemia (ATL). The disease has a dismal prognosis and is invariably fatal. In this study, we report a high frequency of constitutively activated Notch in ATL patients. We found activating mutations in Notch in more than 30% of ATL patients. These activating mutations are phenotypically different from those previously reported in T-ALL leukemias and may represent polymorphisms for activated Notch in human cancers. Compared with the exclusive activating frameshift mutations in the proline, glutamic acid, serine, and threonine (PEST) domain in T-ALLs, those in ATLs have, in addition, single-substitution mutations in this domain leading to reduced CDC4/Fbw7-mediated degradation and stabilization of the intracellular cleaved form of Notch1 (ICN1). Finally, we demonstrated that inhibition of Notch signaling by γ-secretase inhibitors reduced tumor cell proliferation and tumor formation in ATL-engrafted mice. These data suggest that activated Notch may be important to ATL pathogenesis and reveal Notch1 as a target for therapeutic intervention in ATL patients.


The Green Revolution boosted crop yields in developing nations by introducing dwarf genotypes of wheat and rice capable of responding to fertilisation without lodging. We now need a second Green Revolution, to improve the yield of crops grown in infertile soils by farmers with little access to fertiliser, who represent the majority of third-world farmers. Just as the Green Revolution was based on crops responsive to high soil fertility, the second Green Revolution will be based on crops tolerant of low soil fertility. Substantial genetic variation in the productivity of crops in infertile soil has been known for over a century. In recent years we have developed a better understanding of the traits responsible for this variation. Root architecture is critically important by determining soil exploration and therefore nutrient acquisition. Architectural traits under genetic control include basal-root gravitropism, adventitious-root formation and lateral branching. Architectural traits that enhance topsoil foraging are important for acquisition of phosphorus from infertile soils. Genetic variation in the length and density of root hairs is important for the acquisition of immobile nutrients such as phosphorus and potassium. Genetic variation in root cortical aerenchyma formation and secondary development ('root etiolation') are important in reducing the metabolic costs of root growth and soil exploration. Genetic variation in rhizosphere modification through the efflux of protons, organic acids and enzymes is important for the mobilisation of nutrients such as phosphorus and transition metals, and the avoidance of aluminum toxicity. Manipulation of ion transporters may be useful for improving the acquisition of nitrate and for enhancing salt tolerance. With the noteworthy exceptions of rhizosphere modification and ion transporters, most of these traits are under complex genetic control. Genetic variation in these traits is associated with substantial yield gains in low-fertility soils, as illustrated by the case of phosphorus efficiency in bean and soybean. In breeding crops for low-fertility soils, selection for specific root traits through direct phenotypic evaluation or molecular markers is likely to be more productive than conventional field screening. Crop genotypes with greater yield in infertile soils will substantially improve the productivity and sustainability of low-input agroecosystems, and in high-input agroecosystems will reduce the environmental impacts of intensive fertilisation. Although the development of crops with reduced fertiliser requirements has been successful in the few cases it has been attempted, the global scientific effort devoted to this enterprise is small, especially considering the magnitude of the humanitarian, environmental and economic benefits being forgone. Population growth, ongoing soil degradation and increasing costs of chemical fertiliser will make the second Green Revolution a priority for plant biology in the 21st century.


AbstractNarration in psychotherapy has become a key area of theoretical and empiri-cal concern. Rationales for this new concern are provided in the context of introducing a three-dimensional model of narrative structure. Numerous measures corresponding to each dimension are operationally defined and used in an illustrative study of 16 pairs of temporally contiguous child-thera-pist stories sampled from Gardner's (1971) Therapeutic Communication with Children. As predicted, the therapist's narratives were more structurally con-nected, more often concerned with protagonists' internal psychological pro-cesses, and more elaborate/complex than the children's narratives. The therapist's narrative measures, however, did not seem adapted to the chil-dren's varying narrative competence, indicated by the absence of significant covariation with the children's narrative measures or with their age. These and additional analyses illustrate how to assess narrative processes in psycho-therapy and suggest future research on and training in the use of narratives in psychotherapy. (Psychology)


Description: Safe to Learn is a five-year initiative dedicated to ending violence in schools so children are free to learn and pursue their dreams. The initiative's shared vision is to work with governments, civil society organisations, communities, teachers and children themselves to end the violence that undermines education and make sure every child especially the most marginalized is Safe to Learn within 5 years. Partners come from both the education and child rights communities; they include governments, UN agencies, Civil Society and leading voices for progress on both SDG 4 and SDG 16, underscoring that there are multiple wins if violence in and through schools comes to an end. Besides a five-point Call to Action which sets out in high-level terms what needs to happen to end violence in schools, this brief also includes the #ENDviolence Youth Manifesto, which calls on world leaders to end violence in and around schools.


This paper defines a new business cloud model to create an efficient high-frequency trading platform while validating the portability and also cost-efficiency of cloud execution environments for financial operations. Highfrequency trading systems, built to analyze trends in tick-bytick financial data and thus to inform buying and selling decisions, imply speed and computing power. They also require high availability and scalability of back-end systems which, require high cost investments. The defined model uses cloud computing architecture to fulfill these requirements, boosting availability and scalability while reducing costs and raising profitability. It incorporates data collection, analytics, trading, and risk management modules in the same cloud, all of which, are the main components of a high-frequency trading platform.


Last 50 yrs the conventional Nuclear Power (NP) witnessed several periods of optimistic expectation for NP growth. Nevertheless, no one scenario was completely realized, and periods of high expectation followed by NP stagnation. Apparently, this proves that not only economic but also social and geopolitical environment is at least not fully favorable to the conventional NP. Being nuclear, an Emerging Nuclear System (ENS) inherits this unfavorable environment. The ENS should therefore cope with the sigma of nuclear past and a potential dark side of nuclear future. The paper reviews several international studies of the global nuclear legacy performed last decade and the implication of the legacy on generic perspective of NP. Further, the paper identifies and discusses unresolved problems of nuclear fuel cycle, which can feed threat of proliferation and emerging face of nuclear terrorism. Finally, the paper formulates some recommendations that would help proponents of emerging nuclear energy systems to govern identified problems and thus helps to embed NP in sustainable development.


The incidence of life-threatening infections caused by the filamentous fungus Aspergillus fumigatus is increasing along with an increase in the number of fungal strains resistant to contemporary antifungal therapies. The fungal cell wall and the associated carbohydrates required for its synthesis and maintenance are attractive drug targets given that many genes encoding proteins involved in cell wall biosynthesis and integrity are absent in humans. Importantly, genes and associated cell wall biosynthesis and homeostasis regulatory pathways remain to be fully defined in A. fumigatus. In this report, we identify SsdA as an important component of trehalose and fungal cell wall biosynthesis in A. fumigatus that consequently impacts the host immune response and fungal virulence in animal models of infection. ABSTRACT Regulation of fungal cell wall biosynthesis is critical to maintain cell wall integrity in dynamic fungal infection microenvironments. Genes involved in this response that impact fungal fitness and host immune responses remain to be fully defined. In this study, we observed that a yeast ssd1 homolog, ssdA, in the filamentous fungus Aspergillus fumigatus is involved in trehalose and cell wall homeostasis. An ssdA null mutant strain exhibited an increase in trehalose levels and a reduction in fungal colony growth rate. In contrast, overexpression of ssdA perturbed trehalose biosynthesis and reduced germination of conidia. The ssdA null mutant strain was more resistant to cell wall-perturbing agents, while overexpression of ssdA increased sensitivity. Overexpression of ssdA significantly increased chitin levels, and both loss and overexpression of ssdA altered subcellular localization of the class V chitin synthase CsmA. Strikingly, overexpression of ssdA abolished adherence to abiotic surfaces and severely attenuated the virulence of A. fumigatus in a murine model of invasive pulmonary aspergillosis. Despite the severe in vitro fitness defects observed upon loss of ssdA, neither surface adherence nor murine survival was impacted. In conclusion, A. fumigatus SsdA plays a critical role in cell wall homeostasis impacting A. fumigatus-host interactions. IMPORTANCE The incidence of life-threatening infections caused by the filamentous fungus Aspergillus fumigatus is increasing along with an increase in the number of fungal strains resistant to contemporary antifungal therapies. The fungal cell wall and the associated carbohydrates required for its synthesis and maintenance are attractive drug targets given that many genes encoding proteins involved in cell wall biosynthesis and integrity are absent in humans. Importantly, genes and associated cell wall biosynthesis and homeostasis regulatory pathways remain to be fully defined in A. fumigatus. In this report, we identify SsdA as an important component of trehalose and fungal cell wall biosynthesis in A. fumigatus that consequently impacts the host immune response and fungal virulence in animal models of infection.


A number of pesticide application technologies offer the potential to reduce spray drift from pesticide applications. However, limited information exists on the effectiveness of these technologies in reducing spray drift. Working with a stakeholder technical panel under EPA's Environmental Technology Council, the Office of Pesticide Programs in EPA has developed and is in the process of validating a testing protocol to verify the effectiveness of drift reduction technologies (DRTs). The DRT testing protocol was adapted from standard test methods and regulatory methods used in other countries and describes the testing approach that will be used to generate high-quality, peer-reviewed data for DRTs, including test design and quality assurance aspects. Both low-speed and high-speed wind tunnel tests were completed using a reference nozzle and two test nozzles to evaluate the performance of the generic DRT testing protocol. By Summer 2010, EPA anticipates to finalize this testing protocol based on the test results performed by EPA and other stakeholders. As a next step, EPA intends to encourage equipment manufacturers to voluntarily use the protocol for testing their equipment. Tested technologies that are proven to significantly reduce spray drift may be considered for addition to pesticide product labels by pesticide registrants and by EPA in its risk assessment and management decisions for the registration of new pesticide and uses and registration review (reevaluation) of currently registered pesticides. Pesticide product labels citing the use of DRTs could have reduced restrictions for applications, provide applicators with greater flexibility, and result in less off-target pesticide deposition. This paper will provide an update of EPA's efforts to validate the DRT testing protocol and discuss future plans for using a validated protocol in evaluating DRTs in an effort to reduce load from unintended spray drift of pesticides in the environment.


Asp-70 is the defining amino acid in the peripheral anionic site of human butyrylcholinesterase (BuChE), whereas acetylcholinesterase has several additional amino acids, the most important one being Trp-277 (Trp-279 in Torpedo AChE). We studied mutants D70G, D70K and A277W to evaluate the role of Asp-70 and Trp-277 in reactions with organophosphates. We found that Asp-70 was important for binding positively charged echothiophate, but not neutral paraoxon and iso-OMPA. Asp-70 was also important for binding of positively charged pralidoxime (2-PAM) and for activation of re-activation by excess 2-PAM. Excess 2-PAM had an effect similar to substrate activation, suggesting the binding of 2 mol of 2-PAM to wild-type but not to the D70G mutant. A surprising result was that Asp-70 was important for irreversible aging, the D70G mutant having a 3- and 8-fold lower rate of aging for paraoxon-inhibited and di-isopropyl fluorophosphate-inhibited BuChE. Mutants of Asp-70 had the same rate constants for phosphorylation and re-activation by 2-PAM as wild-type. The A277W mutant behaved like wild-type in all assays. Our results predict that people with the atypical (D70G) variant of BuChE will be more sensitive to the toxic effects of echothiophate, but will be equally sensitive to paraoxon and di-isopropyl fluorophosphate. People with the D70G mutation will be resistant to re-activation of their inhibited BuChE by 2-PAM, but this will be offset by the lower rate of irreversible aging of inhibited BuChE, allowing some regeneration by spontaneous hydrolysis.


This essay reports on the temporary and unpaid forms of labour around which the 2015 World's Fair (Expo 2015) in Milan is organized and upon which it depends. The collective agreement supporting Expo 2015 is especially significant, the paper contends, in that it has been seized upon by the government of Matteo Renzi as a blueprint for the future of labour relations in Italy. Expo 2015 ushers in the institutionalization of unpaid work in the crisis-stricken Italian economy—a transformation approved by the major Italian trade unions that signed off on the collective agreement, but forcefully opposed by social movements who have decried the expansion of unpaid work permitted by the contract.


Written in solitary confinement, Kody Scott s memoir of sixteen years as a gangbanger in Los Angeles was a searing best-seller and became a classic, published in ten languages, with more than 300,000 copies in print in the United States alone. After pumping eight blasts from a sawed-off shotgun at a group of rival gang members, twelve-year-old Kody Scott was initiated into the L.A. gang the Crips. He quickly matured into one of the most formidable Crip combat soldiers, earning the name Monster for committing acts of brutality and violence that repulsed even his fellow gang members. When the inevitable jail term confined him to a maximum-security cell, a complete political and personal transformation followed: from Monster to Sanyika Shakur, black nationalist, member of the New Afrikan Independence Movement, and crusader against the causes of gangsterism. In a document that has been compared to The Autobiography of Malcolm X and Eldridge Cleaver s Soul on Ice, Shakur makes palpable the despair and decay of America s inner cities and gives eloquent voice to one aspect of the black ghetto experience today."


Civil-Military Relations in Israel Defense and Diplomacy in Israel's National security Experience: Tactics, Partnership and Motives, by David Rodman. Brighton, UK and Portland, OR: Sussex Academic Press, 2005. ix + 122 pages. Notes to p. 144. Bibl. to p. 151. Index to p. 160. $52.50. The Israeli Military and the Origins of the 1967 War: Government, Armed Forces and Defense Policy 1963-1967, by Ami Gluska. London, UK and New York: Routledge, 2007. xvii + 261 pages, Appendix top. 268. Bio. notes to p. 271. Notes to p. 312. Bibl. to p. 316. Index to p. 324. $125. 1967: Israel, The War, and the Year that Transformed The Middle East, by Tom Segev. New York: Metropolitan Books, 2007. 585 pages. Notes to p. 642. Acknowledgments to p. 645. Index to p. 673. $35. Generals in the Cabinet Room: How the Military Shapes Israeli Policy, by Yoram Peri. Washington, DC: United States Institute of Peace, 2006. xiii + 264 pages. Appends, to p. 272. Notes to p. 296. Works cited to p. 305. Index to p. 327. $50. The emotional, ideological, and practical issues concerning the various roles of the Israeli Defense Force (IDF) and other powerful security organizations, such as Mossad and Shabak, their tense relations with the Israeli social and political systems, and their contributions to the formulation of policies and their implementation in various spheres, have always been on the agendas of Israeli politicians, generals, and journalists. To a lesser degree, until recently, these relations have been on the Israeli general public agenda. However, especially after the devastating 2006 "second war in Lebanon," more and more Israelis have become interested in and have shown growing concern about these matters. For similar reasons, Israeli civil-military relations have always been a popular topic for research and multiple publications mainly by Israeli academic analysts and writers, but also by foreign observers and analysts. There are several interrelated reasons for the longstanding interest in civil-military relations in Israel. First, the fact that during the pre-state period, and especially after independence in 1948, Israel has always been involved in full-scale wars as well as in lowintensity conflict and warfare in which the IDF was involved. second, because Israel has always suffered from real and imagined existential threats and, therefore, the IDF and the other security services were regarded as essential for the protection, indeed for the very survival, of Israel these organizations have enjoyed a special position. Third, what degree of autonomy the IDF and the other security organizations had in making strategic and tactical policies and decisions prior to, during, and between wars and low-intensity conflicts remains an open question. Fourth is the widespread belief that Israeli society has been a "mobilized" entity. Fifth is the blurred and confusing relationship between the social and political systems, on the one hand, and the IDF and the other security services, on the other hand. Apparently, all these factors also motivated the four authors to study and publish the books reviewed here. In order to put the discussion of these four books in proper analytical and theoretical perspectives, let me begin by presenting a categorization of the Israeli academic literature in this field of study.1 Accordingly, one can distinguish between three established approaches to the study of Israeli civil-military relations: the "traditional," the "critical," and the "new critical." The "traditional" approach, which dates back to the late 1950s and was influenced by the then-popular functional-structural approach, focuses on the formal structural and functional features of the purportedly very clearly distinctive civilian and military subsystems of the Israeli state. Their overall thesis has been that traditionally the civilian political system was dominant, thus ensuring the democratic nature of the Israeli state. …


This paper investigates the phonetic bases of aspects of the phonological behavior of the palatal segments (/ɲ ʎ ʝ/) of Spanish. A moraic geminate structure is assumed for these segments to account for rather exceptional distributional and prosodic effects, particularly the narrowing of the stress window apparently triggered by palatal onsets in ultimae. I conduct a series of acoustic analyses on field data to identify acoustic features that might underpin this proposed geminate structure. I focus on prepalatal vowels and, in line with recent research, examine their duration, F2 profiles, and perceptual loudness. Results show that vowels before palatals are significantly longer than those before other types of consonants (occlusives and sonorants). This is explained in coarticulatory terms: anticipatory tongue-raising in the vowels – manifest in pronounced F2 excursions – is posited to exert a lengthening effect on the vowels as speakers negotiate target values with those of the rising F2, providing a perceptual basis for the posited moraic structure of the palatals in question.


This paper solves for optimal policy rules in a stylized small open economy model under a spectrum of targeting regimes. These policy reaction functions are presented as feedback rules highlighting the dominant state variables in each rule. Optimal simple rules - rules that exploit a reduced information set - are explored to assess how much is lost when information is excluded from the optimal state-contingent rule. For the model analyzed we find that some optimal simple rules can approximate reasonably well the optimal state-contingent rule, these simple rules contain the real exchange rate. Knowing which variables underpin the performance of the optimal state-contingent rule is important for developing simple, robust, rules with good stabilizing properties.


This article presents four episodes from the political period 1969 to 1976 in India, focusing on the views and actions of P. N. Haksar, Principal Secretary and Advisor to Prime Minister Indira Gandhi (1967–1973). Unlike the 'national/international politics' hitherto under focus from then, that is, the Congress split (1969), birth of Bangladesh (1971) and the JP Movement/Emergency (1974–1975), the aspects under consideration in this article are of subterranean existence. First of these aspects is the provincial reverberations of the Congress split, the case considered here being that of the Bombay Pradesh Congress Committee. Second is the attitude of the Congress Party towards left opposition, the Communist Party of India Marxist (CPI [M]) in West Bengal, as revealed through the anxieties of Governor Shanti Dhavan. The third aspect under consideration is a glimpse of centre–states relations, as shown through New Delhi's interactions with the EMS Namboodiripad-led and CPI (M)-dominated United Front Government of Kerala. Finally, the article looks at Haksar's attempts at planning and development for the state of Bihar. Each of these four themes was among the 'wider range of functions' that Mrs Gandhi wished to be performed by her Secretariat and to allow us to test how successful each of it was. Each of these provides a context for contemporary issues.


This paper examines the relationship between placement of publications in top five (T5) journals and receipt of tenure in academic economics departments. Analyzing the job histories of tenure–track economists hired by the top 35 US economics departments, we find that T5 publications have a powerful influence on tenure decisions and rates of transition to tenure. A survey of the perceptions of young economists supports the formal statistical analysis. Pursuit of T5 publications has become the obsession of the next generation of economists. However, the T5 screen is far from reliable. A substantial share of influential publications appear in non-T5 outlets. Reliance on the T5 to screen talent incentivizes careerism over creativity.( JEL A14, I23, J44, J62)


Decomposing images of document pages into high-level semantic regions (e.g., figures, tables, paragraphs), document object detection (DOD) is fundamental for downstream tasks like intelligent document editing and understanding. DOD remains a challenging problem as document objects vary significantly in layout, size, aspect ratio, texture, etc. An additional challenge arises in practice because large labeled training datasets are only available for domains that differ from the target domain. We investigate cross-domain DOD, where the goal is to learn a detector for the target domain using labeled data from the source domain and only unlabeled data from the target domain. Documents from the two domains may vary significantly in layout, language, and genre. We establish a benchmark suite consisting of different types of PDF document datasets that can be utilized for cross-domain DOD model training and evaluation. For each dataset, we provide the page images, bounding box annotations, PDF files, and the rendering layers extracted from the PDF files. Moreover, we propose a novel cross-domain DOD model which builds upon the standard detection model and addresses domain shifts by incorporating three novel alignment modules: Feature Pyramid Alignment (FPA) module, Region Alignment (RA) module and Rendering Layer alignment (RLA) module. Extensive experiments on the benchmark suite substantiate the efficacy of the three proposed modules and the proposed method significantly outperforms the baseline methods. The project page is at \url{https://github.com/kailigo/cddod}.


Extreme poverty exhausts institutions, depletes resources, weakens leadership, and ultimately contributes to rising insecurity and conflict. Just as poverty begets insecurity, however, the reverse is also true. As the destabilizing effects of conflict settle in, civil institutions are undermined and poverty proliferates. Breaking this nexus between poverty and conflict is one of the biggest challenges of the twenty-first century. The authors of this compelling book --some of the most experienced practitioners from around the world --investigate the complex and dynamic relationship between poverty and insecurity, exploring possible agents for change. They bring the latest lessons and intellectual framework to bear in an examination of African leadership, the private sector, and American foreign aid as vehicles for improving economic conditions and security. Contributors include Colin Kahl (University of Minnesota),Vinca LaFleur (Vinca LaFleur Communications), Edward Miguel (University of California, Berkeley), Jane Nelson (Harvard University and Brookings), Anthony Nyong (University of Jos and the International Development Research Centre, Nairobi), Susan Rice (Brookings), Robert Rotberg (Harvard University and the World Peace Foundation), Marc Sommers (Tufts University), Hendrik Urdal (International Peace Research Institute), and Jennifer Windsor (Freedom House).


From Mao to Market: Rent Seeking, Local Protectionism, and Marketization in China, by Andrew H. Wedeman. Cambridge: Cambridge University Press, 2003. xiv + 277 pp. US$60.00/£45.00 (hardcover). China can be distinguished from other post-Communist countries not only by its adoption of the so-called gradual approach to economic transformation but also by its success in achieving rapid growth and a sustained, phased marketization drive. The dual-track price system of the 1980s which epitomized the incrementalist spirit of China's reform program was seen by many market theorists as a recipe for disaster. They argued that the coexistence of a deregulated sector and the price rigidities of a Soviet-type economy in selected sectors was creating a complex system of rents, inducing corruption and, worst of all, raising the stakes for bureaucrats to preserve the hybrid system, all of which hindered progress toward full marketization. According to this argument, shock therapy, with its defining features of swift extensive reform, was a preferred alternative. The China success story defies this logic. Wedeman's book provides a nuanced explanation for why Chinese bureaucrats failed to stall the reform process. In particular, he critically evaluates the dynamics of local protectionism. He shares the market theorists' concern that partial reform can nurture a system of rents, and he argues that, even though by the mid-1980s the number of commodities under the state's purchase scheme had been significantly reduced, there remained a large number of resources subject to mandatory state purchase. The cautious spirit of the early post-Mao years resulted in a dual-track system for selected materials: an administrative price for a state-set purchase quota, and a market price for an above-quota portion. An ability to divert the in-plan portion onto the market held the key to capturing rents. The most revealing part of the account arises from Wedeman's first-rate analysis of the different possible options available to local governments in capturing these rents. In a highly accessible style, he elucidates the intricacies of the mechanisms of rent-seeking and identifies two different forms: export protectionism and import protectionism. Export protectionism involved the use of barriers to obstruct the outflow of commodities. It was a strategy used by localities which produced raw materials that were under partial price deregulation. A partial price control implies cheaper raw materials and higher profitability for commodities produced from these materials. Local governments in the raw-materials-producing regions could thus enrich themselves either by diverting supplies onto the black market or by processing the underpriced materials locally under their own sponsorship. The dominant strategy was to ensure that these raw materials were not simply shipped through the formal channels to places outside their jurisdiction. However, export protectionism was only part of the story. For these local governments, commodities produced using the diverted in-plan materials must have a market in order to maximize gains. Administrative barriers were therefore imposed in order to restrict the inflow of competing goods so as to preserve the local market for indigenous goods. Thus a two-front resource war inevitably arose between raw-material-producing regions and manufacturing regions. Wedeman's account also provides a sophisticated analysis of the impact of the economic reforms on the role of the central state. While there may be little theoretical novelty in arguing that the regulatory capacity of the central state has been weakened by the advent of decentralization and the market reforms, the book illuminates the complexities inherent in the central-local interfaces in the market transition process. …


Background Indoor residual spraying (IRS) is an effective method to control malaria-transmitting Anopheles mosquitoes and often complements insecticide-treated mosquito nets, the predominant malaria vector control intervention. With insufficient funds to cover every household, malaria control programs must balance the malaria risk to a particular human community against the financial cost of spraying that community. This study creates a framework for modeling the distance to households for targeting IRS implementation, and applies it to potential risk prioritization strategies in four provinces (Luapula, Muchinga, Eastern, and Northern) in Zambia. Methods We used optimal network models to assess the travel distance of routes between operations bases and human communities identified through remote sensing. We compared network travel distances to Euclidean distances, to demonstrate the importance of accounting for road route costs. We then compared the distance to reaching communities for different risk prioritization strategies assuming sufficient funds to spray 50% of households, using four underlying malarial risk maps: a) predicted Plasmodium falciparum parasite rate in 2-10 year olds (PfPR), or b) predicted probability of the presence of each of three main malaria transmitting anopheline vectors (An. arabiensis, An. funestus, An. gambiae) Results The estimated one-way network route distance to reach communities to deliver IRS ranged from 0.05 – 115.69 Km. Euclidean distance over and under-estimated these routes by −101.21 – 41.79 Km per trip, as compared to the network route method. There was little overlap between risk map prioritization strategies, both at a district-by-district scale, and across all four provinces. At both scales, agreement for inclusion or exclusion from IRS across all four prioritization strategies occurred in less than 10% of houses. The distances to reaching prioritized communities were either lower, or not statistically different from non-prioritized communities, at both scales of strategy. Conclusion Variation in distance to targeted communities differed depending on risk prioritization strategy used, and higher risk prioritization did not necessarily translate into greater distances in reaching a human community. These findings from Zambia suggest that areas with higher malaria burden may not necessarily be more remote than areas with lower malaria burden.


Intravenous thrombolysis and intra-arterial thrombectomy are proven emergency treatments for acute ischaemic stroke, but they require rapid delivery to selected patients within specialist services. National audit data have shown that treatment provision is suboptimal.

 The aims were to (1) determine the content, clinical effectiveness and day 90 cost-effectiveness of an enhanced paramedic assessment designed to facilitate thrombolysis delivery in hospital and (2) model thrombectomy service configuration options with optimal activity and cost-effectiveness informed by expert and public views.

 A mixed-methods approach was employed between 2014 and 2019. Systematic reviews examined enhanced paramedic roles and thrombectomy effectiveness. Professional and service user groups developed a thrombolysis-focused Paramedic Acute Stroke Treatment Assessment, which was evaluated in a pragmatic multicentre cluster randomised controlled trial and parallel process evaluation. Clinicians, patients, carers and the public were surveyed regarding thrombectomy service configuration. A decision tree was constructed from published data to estimate thrombectomy eligibility of the UK stroke population. A matching discrete-event simulation predicted patient benefits and financial consequences from increasing the number of centres.

 The paramedic assessment trial was hosted by three regional ambulance services (in north-east England, north-west England and Wales) serving 15 hospitals.

 A total of 103 health-care representatives and 20 public representatives assisted in the development of the paramedic assessment. The trial enrolled 1214 stroke patients within 4 hours of symptom onset. Thrombectomy service provision was informed by a Delphi exercise with 64 stroke specialists and neuroradiologists, and surveys of 147 patients and 105 public respondents.

 The paramedic assessment comprised additional pre-hospital information collection, structured hospital handover, practical assistance up to 15 minutes post handover, a pre-departure care checklist and clinician feedback.

 The primary outcome was the proportion of patients receiving thrombolysis. Secondary outcomes included day 90 health (poor status was a modified Rankin Scale score of > 2). Economic outputs reported the number of cases treated and cost-effectiveness using quality-adjusted life-years and Great British pounds.

 National registry data from the Sentinel Stroke National Audit Programme and the Scottish Stroke Care Audit were used.

 Systematic searches of electronic bibliographies were used to identify relevant literature. Study inclusion and data extraction processes were described using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

 The paramedic assessment trial found a clinically important but statistically non-significant reduction in thrombolysis among intervention patients, compared with standard care patients [197/500 (39.4%) vs. 319/714 (44.7%), respectively] (adjusted odds ratio 0.81, 95% confidence interval 0.61 to 1.08; p = 0.15). The rate of poor health outcomes was not significantly different, but was lower in the intervention group than in the standard care group [313/489 (64.0%) vs. 461/690 (66.8%), respectively] (adjusted odds ratio 0.86, 95% confidence interval 0.60 to 1.2; p = 0.39). There was no difference in the quality-adjusted life-years gained between the groups (0.005, 95% confidence interval –0.004 to 0.015), but total costs were significantly lower for patients in the intervention group than for those in the standard care group (–£1086, 95% confidence interval –£2236 to –£13). It has been estimated that, in the UK, 10,140–11,530 patients per year (i.e. 12% of stroke admissions) are eligible for thrombectomy. Meta-analysis of published data confirmed that thrombectomy-treated patients were significantly more likely to be functionally independent than patients receiving standard care (odds ratio 2.39, 95% confidence interval 1.88 to 3.04; n = 1841). Expert consensus and most public survey respondents favoured selective secondary transfer for accessing thrombectomy at regional neuroscience centres. The discrete-event simulation model suggested that six new English centres might generate 190 quality-adjusted life-years (95% confidence interval –6 to 399 quality-adjusted life-years) and a saving of £1,864,000 per year (95% confidence interval –£1,204,000 to £5,017,000 saving per year). The total mean thrombectomy cost up to 72 hours was £12,440, mostly attributable to the consumables. There was no significant cost difference between direct admission and secondary transfer (mean difference –£368, 95% confidence interval –£1016 to £279; p = 0.26).

 Evidence for paramedic assessment fidelity was limited and group allocation could not be masked. Thrombectomy surveys represented respondent views only. Simulation models assumed that populations were consistent with published meta-analyses, included limited parameters reflecting underlying data sets and did not consider the capital costs of setting up new services.

 Paramedic assessment did not increase the proportion of patients receiving thrombolysis, but outcomes were consistent with improved cost-effectiveness at day 90, possibly reflecting better informed treatment decisions and/or adherence to clinical guidelines. However, the health difference was non-significant, small and short term. Approximately 12% of stroke patients are suitable for thrombectomy and widespread provision is likely to generate health and resource gains. Clinician and public views support secondary transfer to access treatment.

 Further evaluation of emergency care pathways will determine whether or not enhanced paramedic assessment improves hospital guideline compliance. Validation of the simulation model post reconfiguration will improve precision and describe wider resource implications.

 This trial is registered as ISRCTN12418919 and the systematic review protocols are registered as PROSPERO CRD42014010785 and PROSPERO CRD42015016649.

 The project was funded by the National Institute for Health and Care Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 10, No. 4. See the NIHR Journals Library website for further project information.


This report presents the experimental results from a series of wind tunnel tests. The tests investigated the influence of various upstream bodies on the performance of a representative ship rudder-propeller combination for different angle of drift. All the tests were carried in the 3.5m x 2.5m low-speed wind tunnel at the University of Southampton and are an extension to basic rudder-propeller tests which have already been carried out and are reported elsewhere. The model rudders tested were all-movable and the model propeller used was based on a Wageningen B4.40. Rudder forces and moments and propeller thrust, torque and revolutions were measured for all conditions tested. A standard series of flow conditions were used. These were free-stream flow (no propeller present) and tests at propeller open-water advance ratio of J of 0.94, 0.51 and 0.36. For these conditions, forces were measured at rudder angles between -40 degrees and +40 degree. In addition, a select sample of tests were carried out for both larger rudder incidence and for tests in the second quadrant and at a low advance ratio J of 0.17. Three types of test were carried out: 1) the rudder-propeller combination alone was tested at drift angles of -15 degrees, -7.5 degrees, +7.5 degrees, and +15 degrees; 2) at two angles of drift of -15 degrees and +7.5 degrees, three different lengths of centre-board were place upstream of the rudder-propeller combination to simulate the effect of a thin upstream hull on performance; 3) at two angles of drift of -15 degrees and -7.5 degrees a representative ship hull form based on the stern of the Mariner class of vessels was mounted upstream of the rudder-propeller combination to assess the influence of hull thickness. Pressures were measured at 200 locations distributed over the rudder surface for the rudder-propeller combination alone and the results are given as both chordwise pressure distribution for eight spanwise locations and as distributions of spanwise sectional load distributions. The results give an essential insight into the behaviour of flow around the stern of a vessel providing rudder force data for use in more realistic manoeuvring simulations and detailed data for the validation of numerical models of the ship rudder-propeller-hull interaction problem.


To provide the best available evidence-based care to their patients, advanced practitioners (APs) must become proficient in genomic competencies and remain informed regarding the availability of pharmacogenomic tests. Databases, such as the Centers for Disease Control and Prevention's "Genomic Testing," provide guidance about pharmacogenomic testing, but many APs are not aware of these resources. This study employed a quasi-experimental pretest/posttest design using a convenience sample of APs in a large clinical outpatient breast cancer clinic to assess the knowledge base, beliefs, attitudes, and barriers regarding pharmacogenomic testing among front-line APs and increase knowledge through a targeted educational intervention. The objectives of the educational intervention were to (1) increase knowledge of the clinical indication for testing; (2) increase collaboration among the interprofessional team; and (3) identify correctly when the plan of care should be modified based on pharmacogenomic test results to optimize patient outcomes. Responses showed that these oncology APs possess a strong foundation in genetics and support the addition of new pharmacogenomic tests to their practice.


Objective: We sought to scope the practices in managing thyroid nodules in the Middle East and Africa (MEA). Materials and Methods: Survey of a convenience sample of physicians concerned with the management of thyroid disease. Results: Two hundred and twelve responses are included. Fine needle aspiration (FNA) is performed chiefly using ultrasound guidance (74.9%), generally by radiologists (47.1%). Respondents have a lower threshold for FNA than recommended. Management depends on the FNA cytology, with the follicular lesion of undetermined significance/atypia of undetermined significance resulting in repeat FNA for cytology (40.7%), immediate referral for thyroid surgery (32.9%), or molecular testing (13.2%). Follicular neoplasms are referred for lobectomy or total thyroidectomy by 81.6% of respondents. Nodules suspicious for malignancy are referred for thyroid surgery by 76.6% and for molecular testing by 20.1%. Respondents are less likely to perform FNA in an octogenarian than a younger patient with a comparable nodule. For a multinodular goiter, 29.9%, 25.9%, or 17.8% of respondents would, respectively, sample the largest 2–3 nodules, single largest nodule, or all nodules >1 cm in size. During pregnancy, respondents would perform FNA with nodular growth (27.1%) in the absence of nodular growth (25.6%), but more respondents (35.2%) would defer FNA until after pregnancy. Conclusions: The physicians' survey revealed a practice pattern in managing thyroid nodules in the MEA region, including both agreements and deviations from current guidelines. Focused quality assurance exercises, education, and research are needed.


The spatial evolution of Antarctic katabatic winds in the area of Terra Nova Bay is examined using the three-dimensional version of the Universite Catholique de Louvain-Modele Atmospherique Regional (UCL-MAR) mesoscale primitive equation models. The ability of the model to replicate classical linear mountain wave simulations is verified. Then, three-dimensional experiments are performed for the terrain configuration of Terra Nova (Ross Sea coastal zone) using different horizontal resolutions (5, 10, and 20 km). The model converges for resolutions lower than 10 km. Results are in qualitative agreement with available observations and previous modeling work. Strong katabatic winds are simulated with a jet over Terra Nova Bay. The model seems able to initiate the mesocyclonic activity in the Ross Sea due to the katabatic circulation.


Covalent organic frameworks (COFs) represent a type of promising porous crystalline material because of their enormous application potential in many fields, such as adsorption, catalysis, organic electronics, chemo-sensing and energy storage. Recent research achievements in the field of COFs, especially the results related to their application for industrialization, have led to great progress since the ground-breaking work of Yaghi and co-workers in 2005. However, although there are many reviews about COFs, no one has concentrated on the industrialization of COFs. Therefore in this critical review, we summarize the state-of-the-art development of COFs from an industrial point of view in five aspects, including their types, growth mechanisms, synthetic methods, processability and applications. Also we really hope that this review will arouse more scholars' attention to the industrialization of COFs.


Optic disc detection and segmentation is one of the key elements for automatic retinal disease screening systems. The aim of this survey paper is to review, categorize and compare the optic disc detection algorithms and methodologies, giving a description of each of them, highlighting their key points and performance measures. Accordingly, this survey firstly overviews the anatomy of the eye fundus showing its main structural components along with their properties and functions. Consequently, the survey reviews the image enhancement techniques and also categorizes the image segmentation methodologies for the optic disc which include property-based methods, methods based on convergence of blood vessels, and model-based methods. The performance of segmentation algorithms is evaluated using a number of publicly available databases of retinal images via evaluation metrics which include accuracy and true positive rate (i.e. sensitivity). The survey, at the end, describes the different abnormalities occurring within the optic disc region.


Settle back and let me tell you a brief version of the story I tell in my new book, Democracy Reborn - the story of the Fourteenth Amendment and its vital role in making our Constitution truly democratic.The National Constitution Center in Philadelphia, which opened in 2003, is a magnificent shrine to our Constitution - part museum, part library, part meeting hall. After leaving the theater, if a visitor looks carefully, he or she may find a small placard that indicates that the Constitution wasever-so-slightly changed during and after the Civil War. All three of the so-called Civil War Amendments are summarized on this one placard, and here is the entire discussion of the Fourteenth Amendment:"The 14th defines U.S. citizenship, and includes all black Americans."This summary represents the meaning of only twenty-eight of the Amendment's four hundred-plus words. And, at that, it does not summarize them correctly, as the Citizenship Clause, the first sentence of Section 1, contains no racial language. It includes not only black Americans, but any person born on American soil and subject to American jurisdiction. The Fourteenth Amendment goes on to specify a number of rights belonging to citizens and noncitizens, and the placard simply ignores this. The Fourteenth Amendment is the longest amendment ever placed in the Constitution, and, I will argue, the most important. But it is, alas, unsurprising that even those entrusted with celebrating our Constitution should be unclear about its text and its importance. Fourteenth Amendment amnesia is a national disease.Americans know that they have constitutional rights. The Bill of Rights, the first ten amendments to the Constitution, is a source of national pride. Written by James Madison and enacted by Congress when George Washington was president, these amendments are our national legacy and an example to the world.But relatively few Americans understand that, without the Fourteenth Amendment, the Bill of Rights would be no help to them in most of their dealings with government. That is because, as written by Congress and interpreted by the federal courts, the Bill of Rights originally applied only to the federal government. The first ten amendments barred "Congress" from abridging free speech, setting up a national religion, abridging "the right to bear arms," or requiring self-incrimination, but they left state governments perfectly free to do all those things, which many of them enthusiastically did. For most of us today, just as in the years before the Civil War, our dealings with government power are mostly with state police, prosecutors, regulators, and courts. "For most of us," an old legal saying points out, "the Constitution is the cop on the corner"-and that cop usually draws a state paycheck.


We describe version 2.0 of the chemistry-climate model (CCM) SOCOL. The new version includes fundamental changes of the transport scheme such as transporting all chemical species of the model individually and applying a family-based correction scheme for mass conservation for species of the nitrogen, chlorine and bromine 5 groups, a revised transport scheme for ozone, furthermore more detailed halogen reaction and deposition schemes, and a new cirrus parameterisation in the tropical tropopause region. By means of these changes the model manages to overcome or considerably reduce deficiencies recently identified in SOCOL version 1.1 within the CCM Validation activity of SPARC (CCMVal). In particular, as a consequence of these 10 changes, regional mass loss or accumulation artificially caused by the semi-Lagrangian transport scheme can be significantly reduced, leading to much more realistic distributions of the modelled chemical species, most notably of the halogens and ozone.


The bibliographic utilities discussed in Part 1 of this issue provide timeshared access to large databases of cataloging records. Typically, the databases reside on computers that are located at the utilities' headquarters. Libraries equipped with appropriately configured workstations access the bibliographic utilities through telephone lines, the Internet, or other telecommunication arrangements. CD-ROM cataloging products, in contrast, provide databases of bibliographic records on compact discs. The CD-ROMs are distributed to customer sites for local processing by cataloging support software that operates on microcomputer-based workstations. The earliest CD-ROM cataloging products were introduced in the mid-1980s. Their characteristics and capabilities have been described and discussed in many journal articles, conference papers, and other publications. Examples include Bazillion (1987, 1987a), Beaumont (1986), Beiser (1986, 1988), Bills and Helgerson (1988), Brennan (1989), Burr (1988), Campbell (1987), Desmarais (1985, 1986, 1987), Farris (1987), Farris and Yoshikawa (1987), Fink (1988), Gartshore (1987), Herther (1987), Hoffman (1987), Irwin (1991), Jacso (1989), Johnson (1988a), Joy and Keane (1989), Martin (1987), Miller (1986), and Strickland (1988). While they differ in detail, CD-ROM cataloging products offer similar capabilities and operating procedures. Designed to support both current cataloging activities and retrospective conversion projects, they typically include all or part of the LC MARC database on one or more compact discs. In some cases, LC cataloging data are supplemented by bibliographic records obtained from other sources, such as the National Library of Medicine, the National Library of Canada, and the British Library. Emulating the bibliographic utilities, some CD-ROM products include original cataloging records prepared by academic, public, or school libraries. Regardless of source, the records are stored on CD-ROM in the USMARC formats associated with specific types of library materials. With some products, as described below, CD-ROM databases are subdivided into English- and foreign-language components. In addition to databases, CD-ROM cataloging products include prewritten software that permits the retrieval of bibliographic records by various parameters, modification of cataloging copy for conformity with local practices, retention of the modified records in machine-readable form, and printing of catalog card sets and labels. The software also supports input of original cataloging records, using specially designed data-entry templates appropriate to the various USMARC format. CD-ROM cataloging products offer a potentially cost-effective alternative to those bibliographic utilities, such as OCLC and RLIN, which charge libraries for specific cataloging transactions as they are incurred. RLIN users, for example, pay 25 to 99 cents per database search, depending on the retrieval parameter employed, the number of searches purchased in advance, and the customer's RLG membership status. By contrast, CD-ROM customers pay a fixed annual subscription fee of several hundred to one thousand dollars or more, depending on the product and the subscription option selected. The annual subscription fee provides unlimited database access without additional transaction charges. Thus, CD-ROM cataloging products are particularly attractive for high-volume current cataloging operations or retrospective conversion projects, where a low unit cost for cataloging transaction can be achieved. Saffady (1989) provides detailed cost calculations and comparisons between CD-ROM cataloging products and bibliographic utilities. …


Problem statement: The Amino glycoside antibiotics cause drug induced nephrotoxicity at therapeutic doses and thus limits the use clinicall y. Oxidative stress is one of the main reasons for the development of nephrotoxicity. Approach: In light of this the aim of the present study was to investigate the role of mitochondrial as well as po st-mitochondrial oxidative stress in the developmen t of Gentamicin (GM) induced nephrotoxicity and to elucidate the role of Enicostemma Littoral blame (EL) extract, as a promising antioxidant therapy. R ats were divided into four groups, 1) (Control 2) GM (i.p., 80 mg kg -1 day -1 for 8 days) (treated 3) GM+EL treated (i.g, 2.5 gm kg -1 day -1 ) and (4) GM+ Vitamin C (VC) treated (i.g, 600 mg kg -1 day -1 ). GM treated animals showed high oxidative stress in mitochondrial as well as post-mitochondri al fractions of renal tissues as evidenced by increased lipid per oxidation levels, decrease in G SH content and activities of antioxidant enzymes, SOD and GPx. Results: Oxidative stress was more pronounced in mitochondrial fraction as compared to post-mitochondrial fraction. GM-induced nephrotoxicity was further corroborated by an increase in serum cretonne and Blood Urea Nitrogen (BUN) levels and altered kidney histopathological observations. Treatment with EL ameliorates antioxi dant defense system of mitochondrial as well as post-mitochondrial fraction, with better improvemen t seen in mitochondrial fraction. Conclusion: The present study explored beneficial effect of EL extr act as an antioxidant therapy to counteract mitochondrial and post-mitochondrial oxidative stre ss generated in kidney upon GM-treatment, thus prevented nephrotoxicity.


The deep structure of the Vale of Glamorgan is investigated using recently acquired seismic data. Reflection sections from a commercial seismic survey in the Vale enable the Carboniferous Limestone, Old Red Sandstone and Silurian sequences to be mapped in the subsurface. The Old Red Sandstone sequence thins westwards under the southern part of the Vale, and in the southwest corner of the Vale the base of the Old Red Sandstone is interpreted to overstep across the underlying Silurian sequence in an analogous manner to its regional overstep in west Wales. The Precambrian basement surface is not clearly represented on the sections but may coincide with the base of a reflective sequence observed in places along one of the reflection lines. Basement depth estimates from the reflection sections are compared with estimates derived from a new time term analysis of data from long seismic refraction lines. Basement depths remain uncertain to 1–2 km but appear to be greater under the central part of the Vale than under the western part and along the south coastal zone. A linked system of Variscan forethrusts is traced to outcrop in the core of the Cowbridge anticline but none involves major displacement. The Ty'n-y-Nant-Moel Gilau fault system of the South Wales coalfield is shown to be a component of the linked fault system and its current net extension is attributed to Mesozoic reactivation of a Variscan thrust involving only limited displacement. The individual thrusts appear to connect to a basal thrust that may extend northwards into or under the South Wales coalfield. The amount of displacement along the basal thrust cannot be determined reliably but it may exceed 10 km and involve large scale repetition of Palaeozoic sequences under the Vale.


In resolving "who did what to whom" in an active transitive clause, language users rely on intrasentential cues like word order, animacy and case marking. Most frequently, these cues will all point towards the same interpretation. For instance, in He kicked the ball, the agent he is both cued by word order (preverbal), animacy and case (the nominative). However, in Danish where word order may be subject to pragmatically motivated variations and thus allow for both subject-before-object and object-before-subject structures, conflicts often occur between the word order cue and other formal cues. Previous experiments in a variety of languages have shown that sentences with conflicting formal cues are habitually miscomprehended by pre-school children. For adults, they continue to be more difficult to read and comprehend, often being shallowly processed on the basis of heuristics. However, most previous experiments have presented sentences in isolation, that is, in situations that render a context-demanding structure with conflicting formal cues decidedly inappropriate. In this study we therefore cross the sentence boundary to investigate the interplay between intra- and extrasentential cues in Danish sentence comprehension. Comparing corpus data with recent act-out and reading experiments involving Danish sentences with conflicting formal cues, we argue that context plays an important role in the resolution of semantic role distribution. Children and adults weigh morphosyntactic cues differently, but we find a striking continuity in attention to context across development: when interpreting conflict clauses with object-before-subject structure, both children and adults systematically integrate intra- and extrasentential cues to assign semantic roles.


Bovine tuberculosis (bTB) caused by Mycobacterium bovis or M. caprae has recently (re-) emerged in livestock and wildlife in all countries bordering Switzerland (CH) and the Principality of Liechtenstein (FL). Comprehensive data for Swiss and Liechtenstein wildlife are not available so far, although two native species, wild boar (Sus scrofa) and red deer (Cervus elaphus elaphus), act as bTB reservoirs elsewhere in continental Europe. Our aims were (1) to assess the occurrence of bTB in these wild ungulates in CH/FL and to reinforce scanning surveillance in all wild mammals; (2) to evaluate the risk of a future bTB reservoir formation in wild boar and red deer in CH/FL. Tissue samples collected from 2009 to 2011 from 434 hunted red deer and wild boar and from eight diseased ungulates with tuberculosis-like lesions were tested by direct real-time PCR and culture to detect mycobacteria of the Mycobacterium tuberculosis complex (MTBC). Identification of suspicious colonies was attempted by real-time PCR, genotyping and spoligotyping. Information on risk factors for bTB maintenance within wildlife populations was retrieved from the literature and the situation regarding identified factors was assessed for our study areas. Mycobacteria of the MTBC were detected in six out of 165 wild boar (3.6%; 95% CI: 1.4–7.8) but none of the 269 red deer (0%; 0–1.4). M. microti was identified in two MTBC-positive wild boar, while species identification remained unsuccessful in four cases. Main risk factors for bTB maintenance worldwide, including different causes of aggregation often resulting from intensive wildlife management, are largely absent in CH and FL. In conclusion, M. bovis and M. caprae were not detected but we report for the first time MTBC mycobacteria in Swiss wild boar. Present conditions seem unfavorable for a reservoir emergence, nevertheless increasing population numbers of wild ungulates and offal consumption may represent a risk.


Background: Community pharmacists could play more potential role when finding ways to allocate effectively limited healthcare resources in primary care in many developing countries, including India. Pharmacists could participate in national public health programs, and cooperate effectively with other members of health care team. This small-scale pilot study was designed to develop a method for characterizing physicians' perceptions on the role of pharmacists in public health and patient care in India. Methods: Six volunteers visited 800 physicians in Southern region in India and collected data in 2014. The survey tool consisted of 28 structured questions concerning: (i) physicians' experiences of cooperation with pharmacists; (ii) physicians' general opinion on pharmacists' involvement in National Public Health Programs (NPHPs) in India; and (iii) pharmacists' involvement in 11 major NPHPs. The data were collated and extracted and descriptive statistical analysis was conducted by SAS (version 9.3). Results: Of total 800 physicians contacted, 129 responded. Of the responding physicians 98% were comfortable with pharmacists' roles in general, 96% were comfortable or somewhat comfortable to collaborate with pharmacists, and 82% regarded pharmacists as part of health care team. The physicians with shorter professional practice were more positive on pharmacists' involvement in NPHPs than physicians having at least 11 years' experience. Overall response of accepting pharmacists' role and involvement in NPHPs was positive, Pulse Polio, HIV/AIDS, Tuberculosis and Tobacco control, and Leprosy eradication programs being the top NPHPs where physicians perceived pharmacists had a role to play. Conclusion: This small-scale pilot study indicates that Indian physicians are willing to collaborate with pharmacists and are comfortable to involve them in the health care team. The survey also revealed differences in opinions between junior and senior physicians: the longer physicians' practice experience was, the less favorable they were for pharmacists' involvement in NPHPs. Key words: National Public Health Programs, pharmacists India, healthcare, cooperative practice, physicians, pharmacist role in public health


Background
This thesis explores the disclosure of erectile dysfunction to healthcare professionals by asking men with erectile dysfunction, their partners and healthcare professionals to recall their experiences of such conversations. Erectile dysfunction can be a difficult subject to broach or disclose, and as a result, it is considered that the condition is under reported and therefore under diagnosed. In the light of erectile dysfunction being considered a possible marker of cardiovascular risk this thesis seeks to highlight the issues around disclosing the condition with a view to improving disclosure rates and therefore informing subsequent cardiovascular risk assessment.
Literature
There is a body of literature which demonstrates that erectile dysfunction is a common issue which is correlated with many physical and mental health conditions. Specifically within populations of men with known cardiovascular disease prevalence rates of erectile dysfunction can be as high as 70%. Literature which explores the experience of having erectile dysfunction and disclosing it to a healthcare professional demonstrates that this is a conversation which is complex and is often avoided by both men with erectile dysfunction and healthcare professionals alike. In light of literature which demonstrates that ED and cardiovascular disease are linked, and that which demonstrates that disclosing ED is difficult there is a gap in the literature which specifically explores the disclosing of ED when it is a known marker of cardiovascular disease risk.
Research Process
Following a cardiac event, men who identified themselves as having erectile dysfunction, their partners and healthcare professionals to whom a disclosure may be given, were approached and asked to describe their experiences. The study was designed using a phenomenological perspective so as to allow the thoughts and experiences of the participants' and researcher to be used to provide an illustration of the disclosure of erectile dysfunction, particularly when considered as a precursor and marker of cardiovascular risk. The initial analysis used a thematic approach but this was found to be problematic in relation to the depth of the data that was captured and therefore a second analysis was undertaken, the results of which are presented as the findings of this study. The second analysis of data used a staged approach favoured in interpretative phenomenological analysis (Smith et al. 2009), which facilitated an analysis of the interview transcripts descriptively, interpretatively and linguistically. This latter analysis provided a unique perspective in relation to the topic which is acknowledged as difficult to discuss, and resulted in the linguistic tools which were used by the participants being identified as evidence for the embarrassment; this was identified as one of the themes which emerged from the descriptive analysis.
Analysis and Findings
Analysis of the interview data with men and their partners identified the themes of: the impact that erectile dysfunction has had on their lives, disclosure (or not) of erectile dysfunction and erectile dysfunction in contemporary society. The interviews with healthcare professionals generated themes which resonated with those from the men as well as focusing on professional issues of ownership in relation to ED disclosure, anxieties in relation to such discussions and experience of receiving disclosures.
All of the themes have been extensively written about in relation to other health related issues but they have not been explored explicitly in relation to the disclosure of erectile dysfunction and therefore a unique position of the findings in relation to the existing literature is evidenced within Chapter Nine. The discussion located the findings specifically within existing literature related to embarrassment, stigma and medicalisation. The discussion of the analysed data within the context of the existing literature is then extrapolated to the current clinical environment and changes to clinical practice are suggested by linking the findings to practice. Suggested adaptations to clinical practice focus on improving the confidence of all involved in the disclosure of erectile dysfunction in having such conversations, by increasing the opportunities for them to occur and improving the confidence of all involved in managing such situations.


Microstructures of three types of YBa/sub 2/Cu/sub 3/O/sub 7- delta / single crystals having strong differences in their j/sub c/ levels have been studied by means of electron microscopy. In order to find any existing relation between the microstructures and their j/sub c/ values, histograms of the frequency of twin spacings were obtained from SEM as well as TEM measurements. These histograms show that the finest and most regular twin domain texture (twin spacing 130+or-80 nm) may be correlated with the highest j/sub c/ values. The single crystals with the highest j/sub c/ values have stacking faults (due to double Cu-O chain layers) homogeneously distributed in an otherwise rather perfect matrix of 123-phase. These stacking defects have a limited extension of approximately 80 nm, while in the other types of crystals, they have an extension approximately 1 mu m. These results suggest that relatively higher j/sub c/ values are associated with certain characteristic microstructural features related to twin domain boundaries as well as to stacking faults.


Many biophysical forest properties such as wood volume and leaf area index (LAI) require prior knowledge on either photosynthetic or non-photosynthetic components. Laser scanning appears to be a helpful technique in nondestructively quantifying forest structures, as it can acquire an accurate three-dimensional point cloud of objects. In this study, we propose an unsupervised geometry-based method named Dynamic Segment Merging (DSM) to identify non-photosynthetic components of trees by semantically segmenting tree point clouds, and examining the linear shape prior of each resulting segment. We tested our method using one single tree dataset and four plot-level datasets, and compared our results to a supervised machine learning method. We further demonstrated that by using an optimal neighborhood selection method that involves multi-scale analysis, the results were improved. Our results showed that the overall accuracy ranged from 81.8% to 92.0% with an average value of 87.7%. The supervised machine learning method had an average overall accuracy of 86.4% for all datasets, on account of a collection of manually delineated representative training data. Our study indicates that separating tree photosynthetic and non-photosynthetic components from laser scanning data can be achieved in a fully unsupervised manner without the need of training data and user intervention.


These centuries, as the author demonstrates, were the era in which the most deeply rooted of ancient institutions disappeared for all time. By 476 the Russian empire had vanished from western Europe; by 655 the Persian empire had vanished from the Near East. Mr. Brown, Professor of History at Princeton University, examines these changes and men's reactions to them, but his account shows that the period was also one of outstanding new beginnings and defines the far-reaching impact both of Christianity on Europe and of Islam on the Near East. The result is a lucid answer to a crucial question in world history; how the exceptionally homogeneous Mediterranean world of c. 200 A.D. became divided into the three mutually estranged societies of the Middle Ages: Catholic Western Europe, Byzantium, and Islam. We still live with the results of these contrasts.


ABSTRACT The microbial diversity of a deteriorated biological phosphorus removal reactor was investigated by methods not requiring direct cultivation. The reactor was fed with media containing acetate and high levels of phosphate (P/C weight ratio, 8:100) but failed to completely remove phosphate in the effluent and showed very limited biological phosphorus removal activity. Denaturing gradient gel electrophoresis (DGGE) of PCR-amplified 16S ribosomal DNA was used to investigate the bacterial diversity. Up to 11 DGGE bands representing at least 11 different sequence types were observed; DNA from the 6 most dominant of these bands was further isolated and sequenced. Comparative phylogenetic analysis of the partial 16S rRNA sequences suggested that one sequence type was affiliated with the alpha subclass of theProteobacteria, one was associated with theLegionella group of the gamma subclass of theProteobacteria, and the remaining four formed a novel group of the gamma subclass of the Proteobacteria with no close relationship to any previously described species. The novel group represented approximately 75% of the PCR-amplified DNA, based on the DGGE band intensities. Two oligonucleotide rRNA probes for this novel group were designed and used in a whole-cell hybridization analysis to investigate the abundance of this novel group in situ. The bacteria were coccoid and 3 to 4 μm in diameter and represented approximately 35% of the total population, suggesting a relatively close agreement with the results obtained by the PCR-based DGGE method. Further, based on electron microscopy and standard staining microscopic analysis, this novel group was able to accumulate granule inclusions, possibly consisting of polyhydroxyalkanoate, inside the cells.


In January 2013, civic leaders, community stakeholders, and residents came together to release Detroit Future City: 2012 Detroit Strategic Framework Plan, a guiding blueprint for transforming Detroit from its current state of population loss and excessive vacancy into a model for the reinvention of post-industrial American cities. Three years prior, the U.S. Census had reported that the city had lost 24% of its population over the last decade and had experienced a 20% increase in vacant and abandoned property, bringing total vacancy to roughly the size of Manhattan. In addition to physical and economic challenges, Detroiters had also acknowledged significant barriers to effective civic engagement. Foremost among these barriers were a profound sense of immobilization, planning fatigue, and a general perception of cynicism about planning and engagement efforts. These challenges were compounded by historic racial dynamics and tension. This case study elaborates on the comprehensive and innovative civic engagement executed in a citywide planning process called the Detroit Works Project, which took place from late 2010 through late 2012. For the citywide planning process to be successful and sustainable, civic leaders and project funders committed to a planning initiative that would be different from previous efforts, in large part because the "owners" of the process would be diverse and inclusive across all community sectors. The case study, written by three of the key consultants from the project, describes four key civic engagement strategies deployed in the creation of the strategic framework: (1) addressing profound challenges of culture, race, and politics by deliberately building trust; (2) elevating community expertise by fostering a sense of ownership of the process; (3) blending technical and community expertise; and (4) viewing civic engagement as an ongoing two-way conversation rather than a series of large-scale episodic events. This article elaborates on important lessons that other communities might learn from Detroit's planning initiative in relation to these strategies. It concludes with a brief summary of the results and implications of the civic engagement process.


Prefabricated surfaces containing α-cyano-4-hydroxycinnamic acid and trypsin have been developed to facilitate enzymatic digestion of endogenous tissue proteins prior to matrix-assisted laser desorption/ionization (MALDI) imaging mass spectrometry (IMS). Tissue sections are placed onto slides that were previously coated with α-cyano-4-hydroxycinnamic acid and trypsin. After incubation to promote enzymatic digestion, the tissue is analyzed by MALDI IMS to determine the spatial distribution of the tryptic fragments. The peptides detected in the MALDI IMS dataset were identified by Liquid chromatography-tandem mass spectrometry/mass spectrometry. Protein identification was further confirmed by correlating the localization of unique tryptic fragments originating from common parent proteins. Using this procedure, proteins with molecular weights as large as 300 kDa were identified and their distributions were imaged in sections of rat brain. In particular, large proteins such as myristoylated alanine-rich C-kinase substrate (29.8 kDa) and spectrin alpha chain, non-erythrocytic 1 (284 kDa) were detected that are not observed without trypsin. The pre-coated targets simplify workflow and increase sample throughput by decreasing the sample preparation time. Further, the approach allows imaging at higher spatial resolution compared with robotic spotters that apply one drop at a time. Copyright © 2016 John Wiley & Sons, Ltd.


We report on the feasibility of short-wavelength transmission window modification in anti-resonant hollow core fibers using post-processing by hydrofluoric (HF) acid etching. Direct drawing of stacked anti-resonant hollow core fibers with sub-micron thin cladding capillary membranes is technologically challenging, but so far this has been the only proven method of assuring over an octave-spanning transmission windows across the visible and UV wavelengths. In this study we revealed that low HF concentration allows us to reduce the thickness of the cladding capillary membranes from the initial 760 nm down to 180 nm in a controlled process. The glass etching rates have been established for different HF concentrations within a range non-destructive to the anti-resonant cladding structure. Etching resulted in spectral blue-shifting and broadening of anti-resonant transmission windows in all tested fiber samples with lengths between 15 cm and 75 cm. Spectrally continuous transmission, extending from around 200 nm to 650 nm was recorded in 75 cm long fibers with cladding membranes etched down to thickness of 180 nm. The experiment allowed us to verify the applicability and feasibility of controlling a silica fiber post-processing technique, aimed at broadening of anti-resonant transmission windows in hollow core fibers. A practical application of the processed fiber samples is demonstrated with their simple butt-coupling to light-emitting diodes centered at various ultraviolet wavelengths between 265 nm and 365 nm.


Tens of millions of Chinese peasants have been affected by the loss of their land in the past two decades. This has given rise to many disputes, which in many cases have culminated in physical resistance to land takings and evictions. Wrongful takings have been among the factors preventing the development of a sound law on land tenure and property rights. The principal cause of the phenomenon of land grabs is China's rapid urbanization, estimated to see the migration of hundreds of millions more Chinese people into urban areas within the next few decades. To handle the land disputes in rural China is an important challenge faced by Chinese society. If they are not handled well, the resulting protests may ultimately lead to major social and political upheaval. This paper provides a brief overview of China's land rights and land tenure system, and of the legal status of its peasants today. It describes how expropriations happen in rural China, and describes avenues of redress and forms of protest and resistance chosen by the peasants in such cases. Increasingly explicit defiance of the written law that provides a basis for land grabs underlines the urgent need for fundamental changes of the current property regime.


In the medical diagnosis and treatment planning, radiologists and surgeons rely heavily on the slices produced by medical imaging scanners. Unfortunately, most of these scanners can only produce two dimensional images because the machines that can produce three dimensional are very expensive. The two dimensional images from these devices are difficult to interpret because they only show cross-sectional views of the human structure. Consequently, such circumstances require highly qualified doctors to use their expertise in the interpretation of the possible location, size or shape of the abnormalities especially for large datasets of enormous amount of slices. Previously, the concept of reconstructing two dimensional images to three dimensional was introduced. However, such reconstruction model requires high performance computation, may either be time-consuming or costly. Furthermore, detecting the internal features of human anatomical structure, such as the imaging of the blood vessels, is still an open topic in the computer-aided diagnosis of disorders and pathologies. This study proposed, designed and implemented a visualization framework named SurLens with high performance computing using Compute Unified Device Architecture (CUDA), augmenting the widely proven ray casting technique in terms of superior qualities of images but with slow speed. Considering the rapid development of technology in the medical community, our framework is implemented on Microsoft .NET environment for easy interoperability with other emerging revolutionary tools. The Visualization System was evaluated with brain datasets from the department of Surgery, University of North Carolina, United States, containing 109 datasets of MRA, T1-FLASH, T2-Weighted, DTI and T1-MPRAGE. Significantly, at a reasonably cheaper cost, SurLens Visualization System achieves immediate reconstruction and obvious mappings of the internal features of the human brain, reliable enough for instantaneously locate possible blockages in the brain blood vessels without any prior segmentation of the datasets.


Looking at our face in a mirror is one of the strongest phenomenological experiences of the Self in which we need to identify the face as reflected in the mirror as belonging to us. Recent behavioral and neuroimaging studies reported that self-face identification not only relies upon visual-mnemonic representation of one's own face but also upon continuous updating and integration of visuo-tactile signals. Therefore, bodily self-consciousness plays a major role in self-face identification, with respect to interplay between unisensory and multisensory processing. However, if previous studies demonstrated that the integration of multisensory body-related signals contributes to the visual processing of one's own face, there is so far no data regarding how self-face identification, inversely, contributes to bodily self-consciousness. In the present study, we tested whether self–other face identification impacts either the egocentered or heterocentered visuo-spatial mechanisms that are core processes of bodily self-consciousness and sustain self–other distinction. For that, we developed a new paradigm, named "Double Mirror." This paradigm, consisting of a semi-transparent double mirror and computer-controlled Light Emitting Diodes, elicits self–other face merging illusory effect in ecologically more valid conditions, i.e., when participants are physically facing each other and interacting. Self-face identification was manipulated by exposing pairs of participants to an Interpersonal Visual Stimulation in which the reflection of their faces merged in the mirror. Participants simultaneously performed visuo-spatial and mental own-body transformation tasks centered on their own face (egocentered) or the face of their partner (heterocentered) in the pre- and post-stimulation phase. We show that self–other face identification altered the egocentered visuo-spatial mechanisms. Heterocentered coding was preserved. Our data suggest that changes in self-face identification induced a bottom-up conflict between the current visual representation and the stored mnemonic representation of one's own face which, in turn, top-down impacted bodily self-consciousness.


"The Vigorous Core of Our Nationality" explores conceptualizations of regional identity and a distinct population group known as nordestinos in northeastern Brazil during a crucial historical period. Beginning with the abolition of slavery and ending with the demise of the Estado Novo under Getulio Vargas, Stanley E. Blake offers original perspectives on the paradoxical concept of the "nordestino" and the importance of these debates to the process of state and nation building. Since colonial times, the Northeast has been an agricultural region based primarily on sugar production. The area s population was composed of former slaves and free men of African descent, indigenous Indians, European whites, and mulattos. The image of the "nordestino" was, for many years, linked with the predominant ethnic group in the region, the Afro-Brazilian. For political reasons, however, the conception of the "nordestino" later changed to more closely resemble white Europeans. Blake delves deeply into local archives and determines that politicians, intellectuals, and other urban professionals formulated identities based on theories of science, biomedicine, race, and social Darwinism. While these ideas served political, social, and economic agendas, they also inspired debates over social justice and led to reforms for both the region and the people. Additionally, Blake shows how debates over northeastern identity and the concept of the "nordestino" shaped similar arguments about Brazilian national identity and true Brazilian people."


Faecal sludge requires treatment before it can be safely discharged. Novel treatment technologies, such
as vermifiltration need to be explored. This study aims to determine if a simple vermifilter containing
Eisenia fetida can process sludge and explores the effect of bedding materials (woodchip, granular
activated carbon (GAC) + woodchip, and clay pebbles + woodchip) on nitrogen reduction in the effluent.
All bedding materials performed well for general effluent quality, but nitrification was not found to
occur. This was thought to be due to sampling and analysis techniques. The GAC bedding was unsuitable
as worm density decreased. The optimum bedding material was woodchip which yielded the highest
worm and cocoon densities, vermicompost production and solids conversion. This study proves that E.
fetida have the ability to process sludge in a simple vermifilter and adds to the debate on nitrification in
these systems.


A 'natural' taxonomic system, inherent in organisms that themselves demonstrate their 'affinity', is to be recognized perhaps only in the biospecies. The concept of the biospecies as a comprehensive taxon is, however, only notional amongst the vast majority of living organisms, and it is not directly applicable to fossils. 'Natural' systems of Linnaean kind rest on assumptions made a priori and are imposed by the systematist. The graded time-sequence of the lineage and the clade introduces factors into a systematics that cannot well be accommodated under pre-Darwinian assumptions or be formulated by a Linnaean nomenclatural method. The fossil evidence of 'affinity' is best served by a system of classes defining intrinsic relationships that are phylogenetic. Multiple demic variants, clinal bioseries, variable rates of evolutionary change, pulses of biased selection pressure in expanded and restricted palaeodemes, and permutations of character-expression in the evolutionary plexus impose a need for a palaeontologically-orientated systematics under which (in evolutionary descent) could be subsumed the taxa of the neontological moment. Environmentally controlled morphs, biofacies variants, migrating variation fields, and typological segregants are sources of ambiguity in a distinction between phenetic and genetic fossil grades. Trends in variants are not to be confused with trends in transients; and sequential demes may (in time and space) show trend reversals as a sign of nongenetic (phenetic) selection. The morphospecies of the local palaeodeme is then to be distinguished from the holomorphospecies of the lineage segment, both in kind and in taxonym; and the association of variant morphotypes in a unitary deme is no justification for a splitting of the deme into several morphospecies. Criteria of cladal disjunction are multiple. They may rest in one or a few 'differential' characters, or (in a 'numerical' taxonomy) on an Adansonian equal-weighting of 'all' characters. A consequence is to impose on an inferred phylogeny taxonomic incompatibilities deriving from contrasted interpretations of homology and homoeomorphy. Clinal disjunction as an incipient sign of cladal branching presents other problems in nomenclature and in the definition of taxon-range. Accelerated and retarded rates of bioserial change in sub-parallel lineages further complicate systematics notably in mosaic evolution. A basic distinction between Linnaean (morphotypic) and evolutionary systematics rests in the relevance of the question that asks whether the class determines the characters or the characters the class.


Many challenges in systems biology have to do with analyzing data within the framework of molecular phenomena and cellular pathways. How does this relate to thermodynamics that we know govern the behavior of molecules? Making progress in relating data analysis to thermodynamics is essential in systems biology if we are to build predictive models that enable the field of synthetic biology. This report discusses work at the crossroads of thermodynamics and data analysis, and demonstrates that statistical mechanical free energy is a multinomial log likelihood. Applications to systems biology are presented.


The author shows that the relationship between rhetoric and ritual is quite obvious. Traditionally, it is associated with such social domains as: politics, law, religion, public performances and celebrations as well as formalized, everyday behaviours. The author invokes the theory of Roman Ingarden, pointing out that the emphasis on the phenomenological analysis of the artefact itself pushes aside the issue of meanings as founded on the formal layers of a literary work (a layer of linguistic-sound creations, a layer of deliberate appearance and a layer of objects). The formal part of a literary work is largely based on the principles of rhetoric. In conclusion, the author puts forward the hypothesis that a specific ritual and rhetoric constitute an additional layer of not just meanings, but rather ritual rhetorical tropes. They imply some meanings, but this is only suggestive. They are not elements of the layer of meanings, but they form a separate layer that has been overlooked in literary studies so far. In the philological tradition the terms used were: parallel places, or similia, and it was a domain not of "reading fun" but of scientific research. Meanwhile, it belongs to the structure of a literary work of art and is intentionally introduced by the writer.


Prosthetic knee designs have become extremely sophisticated compared to early constant friction single axis mechanisms. Today, prosthetists and physicians have a wide variety of components to choose from for their transfemoral amputee patients. Unfortunately, there are little quantitative data comparing the performance of different types of prosthetic components, and prosthetic prescription is often based on empirical knowledge and experience, rather than objective comparison of prosthetic designs. This study used gait analysis to objectively evaluate the stability characteristics of two types of prosthetic knee designs, the polycentric Total Knee 2000 (Ossur, Aliso Viejo, CA) and the single axis 3R80 stance control knee (Otto Bock Healthcare, Minneapolis, MN). Five healthy, active transfemoral amputees participated in this study by completing two gait analysis sessions, one with the Total Knee 2000 and one with the 3R80. At the end of each session, subjects were asked to complete a questionnaire for comparison of their subjective preferences with the objective biomechanical measures from the gait analysis. Kinematic and kinetic gait data were collected. Stride and temporal parameters (i.e., velocity, cadence, stride length, step length, stance and swing phase durations, and single and double support durations), joint angles and moments were computed from the Vicon data. A within subjects statistical analysis was then conducted, using repeated measures ANOVA, to determine if there were significant differences in performance between the two knee designs. The stride and temporal parameters computed in this study indicated that the Total Knee 2000 demonstrated a high degree of overall stability compared to the 3R80. The differences in inherent mechanical stability in the Total Knee 2000 and the 3R80 resulted in different calculated hip moments. The corresponding required hip moments indicated that the relative stability of the two knee designs changed throughout the gait cycle due to the polycentric nature of the Total Knee 2000. Specifically, the Total Knee 2000 was found to be less stable than the 3R80 in early stance and more stable than the 3R80 in mid- and late-stance. In addition to the biomechanical evidence of increased stability with the Total Knee 2000, the responses to the subjective questionnaires indicated that most subjects felt more stable and more confident bearing weight on the Total Knee 2000 than the 3R80.


The services provided by digital libraries can be much improved by correctly identifying variants of the same name. For example, this will allow for better retrieval of all the works by a certain author. We focus on variants caused by abbreviations of first names, and show that significant achievements are possible by simple lexical analysis and comparison of names. This is done in two steps: first a pairwise matching of names is performed, and then these are used to find cliques of equivalent names. However, these steps can each be performed in a variety of ways. We therefore conduct an experimental analysis using two real datasets to find which approaches actually work well in practice. Interestingly, this depends on the size of the repository, as larger repositories may have many more similar names.


Abstract Objective To review and critically appraise published and preprint reports of prediction models for diagnosing coronavirus disease 2019 (covid-19) in patients with suspected infection, for prognosis of patients with covid-19, and for detecting people in the general population at risk of being admitted to hospital for covid-19 pneumonia. Design Rapid systematic review and critical appraisal. Data sources PubMed and Embase through Ovid, Arxiv, medRxiv, and bioRxiv up to 24 March 2020. Study selection Studies that developed or validated a multivariable covid-19 related prediction model. Data extraction At least two authors independently extracted data using the CHARMS (critical appraisal and data extraction for systematic reviews of prediction modelling studies) checklist; risk of bias was assessed using PROBAST (prediction model risk of bias assessment tool). Results 2696 titles were screened, and 27 studies describing 31 prediction models were included. Three models were identified for predicting hospital admission from pneumonia and other events (as proxy outcomes for covid-19 pneumonia) in the general population; 18 diagnostic models for detecting covid-19 infection (13 were machine learning based on computed tomography scans); and 10 prognostic models for predicting mortality risk, progression to severe disease, or length of hospital stay. Only one study used patient data from outside of China. The most reported predictors of presence of covid-19 in patients with suspected disease included age, body temperature, and signs and symptoms. The most reported predictors of severe prognosis in patients with covid-19 included age, sex, features derived from computed tomography scans, C reactive protein, lactic dehydrogenase, and lymphocyte count. C index estimates ranged from 0.73 to 0.81 in prediction models for the general population (reported for all three models), from 0.81 to more than 0.99 in diagnostic models (reported for 13 of the 18 models), and from 0.85 to 0.98 in prognostic models (reported for six of the 10 models). All studies were rated at high risk of bias, mostly because of non-representative selection of control patients, exclusion of patients who had not experienced the event of interest by the end of the study, and high risk of model overfitting. Reporting quality varied substantially between studies. Most reports did not include a description of the study population or intended use of the models, and calibration of predictions was rarely assessed. Conclusion Prediction models for covid-19 are quickly entering the academic literature to support medical decision making at a time when they are urgently needed. This review indicates that proposed models are poorly reported, at high risk of bias, and their reported performance is probably optimistic. Immediate sharing of well documented individual participant data from covid-19 studies is needed for collaborative efforts to develop more rigorous prediction models and validate existing ones. The predictors identified in included studies could be considered as candidate predictors for new models. Methodological guidance should be followed because unreliable predictions could cause more harm than benefit in guiding clinical decisions. Finally, studies should adhere to the TRIPOD (transparent reporting of a multivariable prediction model for individual prognosis or diagnosis) reporting guideline. Systematic review registration Protocol https://osf.io/ehc47/, registration https://osf.io/wy245.