ABSTRACT Although once placed solely in deaf schools, a growing number of deaf students in Sweden are now enrolling in mainstream schools. In order to maintain a functional educational environment for these students, municipalities are required to provide a variety of supporting resources, e.g. technological equipment and specialized personnel. However, the functions of these resources and how these relate to deaf students' learning is currently unknown. Thus, the present study examines public school resources, including the function of a profession called a hörselpedagog (HP, a kind of pedagogue that is responsible for hard-of-hearing students). In particular, the HPs' perspectives on the functioning and learning of deaf students in public schools were examined. Data were collected via (i) two questionnaires: one quantitative (n = 290) and one qualitative (n = 26), and (ii) in-depth interviews (n = 9). These show that the resources provided to deaf children and their efficacy are highly varied across the country, which holds implications for the language situations and learning of deaf students.


Long-term environmental sustainability and community acceptance of the shrimp farming industry in Australia requires on-going development of efficient cost-effective effluent treatment options. In this study, we aimed to evaluate the effectiveness of a shrimp farm treatment system containing finfish and vertical artificial substrates (VAS). This was achieved by (1) quantifying the individual and collective effects of grey mullet (Mugil cephalus L.) and VASs on water and sediment quality, and (2) comparing the retention of N in treatment systems with and without the presence of finfish (M. cephalus and the siganid Siganus nebulosus (Quoy & Gaimard)), where light was selectively removed. Artificial substrates were found to significantly improve the settlement of particulate material, regardless of the presence of finfish. Mullet actively resuspended settled solids and reduced the production of nitrate when artificial substrates were absent. However, appreciable nitrification was observed when mullet were present together with artificial substrates. The total quantity of N retained by the mullet was found to be 1.8– 2.4% of the incoming pond effluent N. It was estimated that only 21% of the pond effluent N was available for mullet consumption. When S. nebulosus was added, total finfish N retention increased from 1.8% to 3.9%, N retention by mullet also improved (78±16 to 132±21-mg N day−1 before and after siganid addition respectively). Presence of filamentous macroalgae (Enteromorpha spp.) was found to improve the removal of N from pond effluent relative to treatments where light was excluded. Denitrification was also a significant sink for N (up to 24% N removed). Despite the absence of algal productivity and greater availability of nitrate, denitrification was not higher in treatments where light was excluded. Mullet were found to have no effect on the rates of denitrification but significantly reduced macroalgal growth on the surface of the water. When mullet were absent, excessive macroalgal growth led to reduced dissolved oxygen concentrations and nitrification. This study concludes that the culture of mullet alone in shrimp farm effluent treatment systems does not result in significant retention of N but can contribute to the control of macroalgal biomass. To improve N retention and removal, further work should focus on polyculturing a range of species and also on improving denitrification.


We develop a rigorous theory to describe coupled multiple nonlinear processes in a single nonlinear multilayer structure using iteration technique and transfer-matrix method. Pump depletion is taken into account. The validity of the theory is confirmed by analyzing coupled third-harmonic generation (CTHG). The CTHG process consists of two processes: second-harmonic generation and sum-frequency generation. These two processes are coupled together when their phase-matching conditions are satisfied simultaneously. The conversion efficiencies of second-harmonic and third-harmonic under various phase-matching conditions are studied numerically. The results demonstrate that our theory can efficiently and accurately deal with the coupled nonlinearity problem. The model can deal with periodic or aperiodic nonlinear structures. Our approach may be helpful in designing nonlinear photonic crystals and quasi-phase-matching structures.


Abstract The development of electron cyclotron resonance heating (ECRH)-electron cyclotron current drive (ECCD) as a tool for suppression of plasma instabilities requires that the millimeter-wave beams used for testing magnetohydrodynamic (MHD) stabilization schemes for ITER be able to follow magnetic island position in real time. In the FTU tokamak, the design of a new ECRH fast-steerable launcher will enable a fast-controlled deposition at a precise poloidal location and the inclusion of the mirror motion in a feedback loop aimed at MHD stabilization. Two of the four existing transmission lines will be switched to the new launcher located in a different equatorial port. It will launch two independent beams with radius in the plasma changeable between 17 and 28 mm, in order to control the deposited power density. Real-time control of the poloidal steering requires high acceleration, speed, and positioning precision of the last mirror. Additionally, oblique toroidal injection at precise angles will allow current profile shaping through controlled ECCD and heating of overdense plasmas (ne > 2.4 × 1020 m-3) using electron Bernstein waves. For optimal O-X conversion, the required toroidal angle, estimated with dedicated beam-tracing calculations, is close to ±38.5 deg, near the upper limit in the toroidal steering angle. The launch requirements and their impact on the launcher design phase are presented in the paper.


Alternative Dispute Resolution, especially mediation, is at a critical point in its evolution. As a result of how ADR/mediation has adapted to the courthouse, it is a continuing challenge for mediation to develop in such a way that it is both "value-added" (and true to the original ideals of party self-determination and support of "procedural" justice) and cost-effective for our system of justice (achieving important "substantive" justice goals). This article analyzes empirical data from the author's 2003 survey of Minnesota's 287 trial court judges about their experiences with a statewide civil ADR Rule (Rule 114 of the Minnesota General Rules of Practice). Questions on the judicial survey include when and why ADR is ordered; the timing of mediation and discovery; client attendance at mediations; desired mediator qualifications; what happens with summary judgment motions; and what complaint and enforcement issues have surfaced. Based on the data analysis, suggestions for change in the court-connected ADR environment are made to better harmonize the implementation of mediation programs in the courts with the actual goals for such programs. Particular emphasis in the article is placed on the need for more rigorous monitoring and evaluation of court-connected ADR programs.


We consider a system of cubic complex Ginzburg–Landau equations governing copropagation of two waves with opposite signs of the dispersion in a nonlinear optical fiber in the presence of gain and losses. The waves are coupled by cross-phase modulation and stimulated Raman scattering. A special exact solution for a bound state of bright and dark solitons is found (unlike the well-known exact dark-soliton solution to the single complex Ginzburg–Landau equation, which is a sink, this compound soliton proves to be a source emitting traveling waves). Numerical simulations reveal that the compound soliton remains stable over ∼10 soliton periods. Next, we demonstrate that a very weak seed noise, added to an initial state in the form of a dark soliton in the normal-dispersion mode and nothing in the anomalous-dispersion one, gives rise to a process of the generation of a bright pulse in the latter mode, while the dark soliton gets grayer and eventually disappears. Thus this scheme can be used for an effective transformation of a dark soliton into a bright one, which is of interest by itself and may also find applications in photonics.


The COVID-19 pandemic—the worst pandemic since the Spanish flu—has dramatically changed the world, with a significant number of people still suffering and dying from the disease. Some scholars argue that the pandemic has severely damaged democratic countries, mainly because they cannot intervene in their citizens' lives, as opposed to their authoritarian counterparts. This paper reports that authoritarian countries tend to have lower COVID-19 deaths than their democratic counterparts, but stringent intervention is not necessarily a key determinant. A higher number of tests is a more critical determinant of authoritarian countries' advantage, using cross-national data for 163 countries. Testing seems to be a vital tool to reduce deaths (IRR=0.66, P < 0.001). This study uses statistical evidence to demonstrate that authoritarian countries are likely to conduct more tests leading to lower death rates. The result implies that authoritarian states can strengthen citizens' support for their government through the COVID-19 pandemic.


When people receive advice while making difficult decisions, they often make better decisions in the moment and also increase their knowledge in the process. However, such incidental learning can only occur when people cognitively engage with the information they receive and process this information thoughtfully. How do people process the information and advice they receive from AI, and do they engage with it deeply enough to enable learning? To answer these questions, we conducted three experiments in which individuals were asked to make nutritional decisions and received simulated AI recommendations and explanations. In the first experiment, we found that when people were presented with both a recommendation and an explanation before making their choice, they made better decisions than they did when they received no such help, but they did not learn. In the second experiment, participants first made their own choice, and only then saw a recommendation and an explanation from AI; this condition also resulted in improved decisions, but no learning. However, in our third experiment, participants were presented with just an AI explanation but no recommendation and had to arrive at their own decision. This condition led to both more accurate decisions and learning gains. We hypothesize that learning gains in this condition were due to deeper engagement with explanations needed to arrive at the decisions. This work provides some of the most direct evidence to date that it may not be sufficient to include explanations together with AI-generated recommendation to ensure that people engage carefully with the AI-provided information. This work also presents one technique that enables incidental learning and, by implication, can help people process AI recommendations and explanations more carefully.


The energetics and assembly pathways of small clusters may yield insights into processes occurring at the earliest stages of nucleation. We use a model system consisting of micrometer-sized, spherical colloidal particles to study the structure and dynamics of small clusters, where the number of particles is small (N ≤ 10). The particles interact through a short-range depletion attraction with a depth of a few kBT. We describe two methods to form colloidal clusters, one based on isolating the particles in microwells and another based on directly assembling clusters in the gas phase using optical tweezers. We use the first technique to obtain ensemble-averaged probabilities of cluster structures as a function of N. These experiments show that clusters with symmetries compatible with crystalline order are rarely formed under equilibrium conditions. We use the second technique to study the dynamics of the clusters, and in particular how they transition between free-energy minima. To monitor the clusters we use a fast three-dimensional imaging technique, digital holographic microscopy, that can resolve the positions of each particle in the cluster with 30–45 nm precision on millisecond timescales. The real-space measurements allow us to obtain estimates for the lifetimes of the energy minima and the transition states. It is not yet clear whether the observed dynamics are relevant for small nuclei, which may not have sufficient time to transition between states before other particles or clusters attach to them. However, the measurements do provide some glimpses into how systems containing a small number of particles traverse their free-energy landscape.


Recent results are reviewed describing the behavior of extraocular muscle motoneurons in the alert, behaving monkey during a variety of eye movements, namely, saccades, fixation, pursuit and vergence movements, and vestibular stabilizing movements. Combining this with recent results on the behavior of vestibular neurons, it is possible to present a fairly complete picture of the neuronal arrangement of the vestibulo-ocular reflex. It is proposed that this phylogenetically old motor apparatus used for stabilizing the visual axes is utilized by the visual system in stabilizing retinal image slip and making smooth pursuit and saccadic eye movements. Consideration is given to the types of neural networks needed to transform visual information into oculomotor commands.


This report contains proposals for a new framework for development cooperation. The Cold War is over and we have an opportunity to replace the ideological competition that dominated international relations for nearly half a century by a new ethos of solidarity and cooperation. The world is no longer divided between East and West and we must not let it become divided again along a new fault line separating North from South. Instead of viewing international relations in terms of conflicts between states we suggest that the problems of the globe should be seen in the round, as problems confronting all of us, and as problems we face as people and not as citizens of states. Indeed the actions of states frequently are the source of global problems and adequate solutions to those problems may require that the actions of states be constrained by rules delineating acceptable international behaviour.


A numerical study of the static behaviours of composite strip with bifurcated type shape memory alloy pins has been conducted. The case of bifurcated type shape memory alloy pins inserted inside the composite strip around the hole to reinforce the laminate, which was subjected to the axial stress was simulated. The models for stress analysis were established by using ANSYS finite element programme. Two types of shape memory alloy pins were proposed to insert along the through thickness direction of the carbon fibre woven fabric composite strip to induce the clamping force. The pre-tensioned load was applied to the shape memory alloy pins in order to reduce occurrence of delamination in the laminate. Three-dimensional elements and contact elements were used to simulate the contact between the composite laminate and shape memory alloy pin to investigate the stress distribution around the hole in the composite strip. The effect of pre-strain of shape memory alloy on the stresses inside composite was studied. The results show that the stress characteristics of the button-shaped and bifurcated shape memory alloy pin models are similar; however, the stresses for the button-shaped pin model are lower. The tensile and compressive stresses, both in button-shaped and bifurcated pin models, are strongly dependent on the percentage of pre-strain of the shape memory alloy. It is therefore concluded that the shape memory alloy pin method was significantly reduced the stress concentration of the composite strip laminate.


Clinical and laboratory observations of 133 children and adolescents with Crohn's disease were used to validate an index of severity of illness previously developed by a group of senior pediatric gastroenterologists at a research forum in April 1990. This pediatric Crohn's disease activity index (PCDAI) included (a) subjective reporting of the degree of abdominal pain, stool pattern, and general well-being; (b) presence of extraintestinal manifestations, such as fever, arthritis, rash, and uveitis; (c) physical examination findings; (d) weight and height; and (e) hematocrit, erythrocyte sedimentation rate, and serum albumin. Independent evaluation of each patient by two physician-observers was performed at the time of a visit, and each physician completed a PCDAI index and a modified Harvey-Bradshaw index and made a "global assessment" of disease activity as none, mild, moderate, or severe. Excellent interobserver agreement was noted for the PCDAI, modified Harvey-Bradshaw index, and global assessment. There was a strong correlation between global assessment and both the PCDAI or modified Harvey-Bradshaw. Increasing PCDAI scores were noted with increasing disease severity, and significant differences in scores were noted between the severity groups. We propose that the PCDAI could be used in multicenter projects to facilitate patient stratification by disease severity and that longitudinal PCDAI scores might provide a numerical measure of response to therapeutic regimens.


The ability to control the fluid velocity and flow rate in microfluidic paper-based analytical devices (μPADS) will help to enable more sensitive and flexible point-of-care (POC) diagnostics. We present an elastocapillary channel design, for fluid flow in porous membranes, which enables an increase in flow velocity by a factor of up to 4.45 compared with a porous membrane used in a standard, non-suspended, format. The increase in flow rate is controllable with varying channel width, and is enabled by using an elastocapillary action, where the flexible porous membrane is suspended over a rigid substrate and deformed during fluid imbibition. This enabling technology is particularly useful in POC diagnostics, where small samples need be rapidly transported and mixed with minimal loss of volume.


We propose a novel method for selective classification (SC), a problem which allows a classifier to abstain from predicting some instances, thus trading off accuracy against coverage (the fraction of instances predicted). In contrast to prior gating or confidence-set based work, our proposed method optimises a collection of class-wise decoupled one-sided empirical risks, and is in essence a method for explicitly finding the largest decision sets for each class that have few false positives. This one-sided prediction (OSP) based relaxation yields an SC scheme that attains near-optimal coverage in the practically relevant high target accuracy regime, and further admits efficient implementation, leading to a flexible and principled method for SC. We theoretically derive generalization bounds for SC and OSP, and empirically we show that our scheme strongly outperforms state of the art methods in coverage at small error levels.


Abstract : Respiratory measures of oxygen and carbon dioxide are routinely used to estimate the body s steady-state metabolic energy use. However, slow mitochondrial dynamics, long transit times, complex respiratory control mechanisms, and high breath-by-breath variability obscure the relationship between the body's instantaneous energy demands (instantaneous energetic cost) and that measured from respiratory gases (measured energetic cost). The purpose of this study was to expand on traditional methods of assessing metabolic cost by estimating instantaneous energetic cost during gait adaptation and other non-steady state conditions. To accomplish this goal, we first imposed known changes in energy use (input), while measuring the breath-by-breath response (output). We used these input/output relationships to model the body as a dynamic system that maps instantaneous to measured energetic cost. We found that a first-order linear differential equation well approximates transient energetic cost responses during gait. Across all subjects, model fits were parameterized by an average time constant (tau) of 42 +/- 12 s with an average R(2) of 0.94 +/- 0.05 (mean +/- SD). Armed with this input/output model, we next tested whether we could use it to reliably estimate instantaneous energetic cost from breath-by-breath measures under conditions that simulated dynamically changing gait. A comparison of the imposed energetic cost profiles and our estimated instantaneous cost demonstrated a close correspondence, supporting the use our methodology to study the role of energetics during locomotor adaptation and learning.


Purpose. We examined whether there was disparity in prescription medication cost-related non-adherence (CRN) by Hispanic ethnicity among Medicare enrollees. Methods. Multivariate logistic regression, adjusting for race, other socio-demographic variables, health status, health care utilization, and patient rating of their personal physician, was used to examine association of Hispanic ethnicity with CRN using cross-sectional data from Medicare's Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey (data collected in Spring 2007). Results. Hispanic respondents constituted 6.9% (unweighted n=22,304) of the analytic sample (unweighted n=272,701; response rate 5 48%). Overall, 13.4% of respondents reported CRN; among Hispanics and non-Hispanics, 20.3% and 12.9% reported CRN, respectively, p<.0001. Adjusted odds ratio (95% CI) of reporting CRN in the past six months was 1.18 (1.08, 1.29) for Hispanic compared with non-Hispanic respondents. Conclusions. Hispanic ethnicity was significantly associated with CRN. More research is needed to understand interventions to eliminate the disparity for this minority group.


OFFERING FROM THE CONSCIOUS BODY reveals both the theory and practice of a unique body-based process that is cathartic creative healing and mystical as presented by Janet Adler the presiding voice in the field. This Western awareness practice encourages the individual to experience the evolving relationship with oneself another the collective and the divine through the natural impulses of conscious movement compassionate witnessing and clear articulation of experience. Through the vivid examples taken from her own practice Adler demonstrates that physical movement can invite direct experience of spiritual truths. The reader is led through the multiple layers within the discipline - moving and witnessing in dyads and then groups in the presence of a witnessing teacher - to develop a comprehensive and experiential understanding of this innovative way of work. Designed for professionals and laypersons interested in psychology bodywork mystic traditions or personal transformation the discipline of Authentic Movement is at the cutting edge of emerging Western healing practices. * Uses sample sessions and descriptive theory to explain the discipline. * Based on the author's 35 years of movement work.


The paper provides an overview of institutional provisions and reforms regarding employment protection, active and passive labor market policies in Germany as well as of actors' responsibilities in these areas. It covers the period between the early 1990s and the most recent Hartz reforms. Empirical data on labor market outcomes with respect to the levels and structures of both employment and unemployment complements this study.


This case addresses CEO pay, a topic that annually stimulates the question of whether or not executive compensation is based on performance or something else and why it is so high in absolute terms. The societal impact of the new class of extremely high-paid executives in the United States inflames resentment among workers, widens an already unfathomable distance between those at the top and the rest of us, and endangers the social amity among citizens. Positive social change might result from the justification and recalibration of salaries to align more sensibly with actual differences in experience, knowledge, and talent among all workers. However, first, we must become aware of the impact of differences that now alienate much of the working class population from workplaces that enable such a wide salary gap between top executives and average workers. This case is designed to help learners think through the various elements constituting the excessive CEO pay issue.


Book synopsis: Published by Peter Lang in 2007, The Impact of Hospitals 300-2000 (ed. Henderson, Horden and Pastore) comprised a selection of the papers delivered at two conferences (in 1999 and 2001) that were organised by the International Network for the History of Hospitals (INHH). The present volume, based on the Network's 2009 Barcelona conference, offers a new, wide-ranging collection of papers on the theme of 'Hospitals and Communities'. It discusses a select group of hospitals and communities, including those based in Europe and the Americas, from three main perspectives: isolation and disease, communities and the poor, and war and hospitals. The subject of community has been researched extensively by sociologists and anthropologists, less so by historians. The 2009 conference challenged participants to consider the idea of community in relationship to the hospital and, particularly, to reflect on how historians should approach the wide range of communities that continue to be shaped by the work of these institutions. Collectively, the case studies in this volume demonstrate that navigation of the history of hospitals requires an understanding of the societies in which these institutions operated. In other words, hospital histories are not just stories about medical institutions; they offer considerable insight into the communities in which they were situated and with which they intersected.


Scientists have developed the world's first drug that successfully halts the immune system's destruction of pancreatic b cells in humans. Called DiaPep277, the drug offers the possibility of preventing type I diabetes in healthy people with a genetic risk of the disease and halting its progression in people whose b cells have already begun to die.

The research team, led by Professor Irun Cohen of the Weizmann Institute of Science's department of immunology, proved that three injections of DiaPep277 given within six months of diagnosis of type I diabetes successfully arrested the progression of the disease in newly diagnosed patients. Participants did not show any harmful or major side effects, and none left the study.

"It remains to be seen if, and at what intervals, additional DiaPep277 treatments might be needed to maintain long term endogenous insulin production," Professor Cohen said.

A report on the …


Introduction: The Buriti (Mauritia flexuosa L. f.) is a Brazilian native palm tree. Its fruit has a hard shell and scaly covering a soft and oily pulp. Buriti oil is rich in oleic acid, also being considered natural source of beta-carotene, one of the most powerful antioxidants, becoming an excellent alternative for the cosmetic and pharmaceutical industry.
Methods: The fruits collected in the State Forest Antimary (Bujari city, Acre – Brazil) were processed, dried and then the oil was extracted by cold mechanical pressing. Chromatographic analyzes and the following physico-chemical analyses, according to the AOCS norms, were performed: Acid Index (AI), Peroxide Index (PI) and Saponification Index (SI). Samples of different batches were submitted to the gas chromatograph.
Results: After verified the excellent quality of the oil, a formulation of a three-phase oil for the skin hydration was prepared. From the physical and chemical analyzes, the average results for each parameter were compared with them limit by the RDC-270 ANVISA standard.
Conclusion: These results demonstrated that the analyzed oils have great composition for using in cosmetics; it is an excellent raw material for the production of three-phase oil, when accompanied with other elements, such as mineral oil and propylene glycol, which has the capacity of hydration and smoothness of the skin.


Adoption is a legal process in which a child is raised by someone other than his or her biological parents and can be accomplished with varying degrees of openness. Adopted children often experience a period of grief at some point in their lives related to their adoption and their loss of their biological origins. Bibliotherapy is one method of helping children cope with adoption related grief and though most of the adoption books in print are authored by adoptive parents and fail to address the issue of the child's birth parents in any detail. In response I authored a children's picture book intended to supplement the available literature—recreational, educational and therapeutic—written from the perspective of a birthmother that focuses on the love involved in adoption. The purpose of the book is to function as a bibliotherapy tool and aid in the healing process of adopted children as well as facilitate a better understanding of the often stigmatized practice of adoption.


Ageing population is increasing all across the globe, including Malaysia, due to better nutrition and healthy living, which ultimately result as an increase in life expectancy and rise of the elderly population. The most important concern is about health and care facilities along with living arrangements of the ageing population. Currently, in Malaysia, 365 ageing care centres are working in various states. However, these centres are not up to mark in place of services and technological equipment. This paper address the issues which elderly care centres management are facing, especially keeping in view the multicultural background of the people residing in Malaysia. This paper highlights the current scenario of elderly care centres in Malaysia and issues about the management of these centres. This study adopts the qualitative research strategy and focus group conducted with 15 Managers, 10 caregivers and 3 experts in the field of Ageing. The findings revealed that the services offered by these centres comprise of Islamic education, training programs, recreation activities and counselling session. Few of the centres just preferred Muslim to be admitted as their strategy based on Islamic values. The issues faced by care centre management include lack of trained staff, licensing issues, financial constraints, no administrative support, staff retention, lack of technological equipment and less funding.


Problem. The problem investigated in this study is the struggle of church planters and their key stakeholders to develop common understanding about the churches that are being planted in complex social contexts while relating to a denomination in the midst of an ecclesial paradigm shift in mission. Method. This qualitative research used a multiple case design with an emphasis on narrative inquiry. Data collection involved conducting semi-structured interviews with denominational and conference leaders, church planters, and key stakeholders. The four cases chosen included Anglo, Hispanic, Hmong, and multi-ethnic church plants. Findings. The study found that the attempt to establish a missional culture within Mennonite Church USA has been subverted by an underdeveloped change process. The study recommended a narratological approach to organizational culture development that involves generative learning and reflexive dialogue. This approach is consistent with the desired ecclesial paradigm and historic theological commitments. Common theological commitments among the cases of church planting in this study included the authority of Scripture, the normative teachings of Jesus, believers' baptism, community discernment in discipleship, justice, peacemaking, reconciliation of all things as a sign of God's reign, simplicity in lifestyle, and an understanding of the church as different from, yet engaged with, society. Significant aspects of a missional ecclesiology present in the cases included the classical view of missio Dei, contextual sensitivity, hospitality by welcoming the stranger, holistic and incarnational ministry, and a reaction to modern expressions of the church as the steward and purveyor of normative social values. Prior assumptions that threaten to derail the development of a missional ecclesiology include seeing the church as a vendor of therapeutic services rather than an alternative society, the inability of Mennonites to allow themselves to be hosted by others, and the tendency to replicate ministries rather than envision reproducing, contextualized ministries. Hospitality was identified as a significant multi-dimensional issue in developing a missional ecclesiology. Significant social and cultural pressures with which church planters contend included growing ambivalence toward organized religion, the marginalization of the church in society, inhospitable immigration policies, language barriers, overwhelming social complexity, financial constraints, and the uncritical acculturation of Mennonites into mainstream American individualism. Church planters understand their most significant contributions to be in the areas of congregation-based theological education and leadership development. An unexpected finding was the level to which church planters reflect on their practice. Creating opportunities for this level of reflection can provide important learning opportunities for increased competency.


OBJECTIVE
To investigate the independent risk factors of influencing short-term survival and prognosis of patients with HBV-related acute-on-chronic liver failure (HBV-ACLF).

METHODS
The clinical data of 338 HBV-ACLF patients hospitalized from January 2007 to December 2010 were collected and analyzed by a Cox regression model.

RESULTS
The Cox regression analysis showed that gastrointestinal hemorrhage, hepatorenal syndrome, electrolyte imbalance and hepatic encephalopathy could significantly increase their recent mortality risks. And the values of relative risk (RR) were 2.526, 2.356, 2.068 and 1.896 respectively. Prothrombin activity (Exp(β): 0.821) and opportunity of antiviral therapy (Exp(β) of early stage: 0.526; Exp(β) of medium stage: 0.601) were protective factors of reduced mortality.

CONCLUSION
Gastrointestinal hemorrhage, hepatorenal syndrome, electrolyte imbalance, hepatic encephalopathy, prothrombin activity and opportunity of antiviral therapy are independent risk factors of influencing short-term survival and prognosis of HBV-ACLF patients. The combination of MELD score and multivariate analysis is a more scientific method of determining the prognosis of HBV-related ACLF.


Background:Placebo-controlled and open-label studies have demonstrated the safety and efficacy of daily oral preexposure prophylaxis (PrEP) in preventing HIV infection, but data are limited on real-world PrEP use. Methods:We conducted a cohort study from July 2012 through June 2015 of Kaiser Permanente Northern California members initiating PrEP. We assessed pharmacy refill adherence and discontinuation, decreases in estimated glomerular filtration rate (eGFR), and sexually transmitted infection (STI)/HIV incidence. Results:Overall, 972 individuals initiated PrEP, accumulating 850 person-years of PrEP use. Mean adherence was 92% overall. Black race/ethnicity [adjusted risk ratio (aRR) 3.0; 95% confidence interval: 1.7 to 5.1, P < 0.001], higher copayments (aRR 2.0; 1.2 to 3.3, P = 0.005), and smoking (aRR 1.6; 1.1 to 2.3, P = 0.025) were associated with <80% adherence. PrEP was discontinued by 219 (22.5%); female sex (aRR 2.6; 1.5 to 4.6, P < 0.001) and drug/alcohol abuse (aRR 1.8; 1.3 to 2.6, P = 0.002) were associated with discontinuation. Among 909 with follow-up creatinine testing, 141 (15.5%) had an eGFR <70 mL·min−1·1.73 m−2 and 5 (0.6%) stopped PrEP because of low eGFR. Quarterly STI positivity was high and increased over time for rectal chlamydia (P < 0.001) and urethral gonorrhea (P = 0.012). No HIV seroconversions occurred during PrEP use; however, 2 occurred in individuals who discontinued PrEP after losing insurance coverage. Conclusions:PrEP adherence was high in clinical practice, consistent with the lack of HIV seroconversions during PrEP use. Discontinuation because of renal toxicity was rare. STI screening every 6 months, as recommended by current guidelines, may be inadequate. Strategies are needed to increase PrEP access during gaps in insurance coverage.


Originally published in Seoul in 1938, soon after the outbreak of the Pacific War, "Peace Under Heaven" is a satirical novel centering on the household of a Korean landlord during the Japanese colonial occupation. Master Yun, embodying the traditional ambitions of a standard Korean paterfamilias, by being projected fast forward into a modern urban environment, caricatures the increasing irrelevance of Confucian mores to 20th-century social reality. Depicting the anomic lives of the Yun household in colonial Seoul, Chase Man-Sik, one of modern Korea's best-known writers, uses black comedy to underscore the collapse of ritualistic traditional values in the face of capitalist modernisation. The decadence of the nouveau riche pseudo-aristocrat Master Yun is interwoven with insights into the customary bases of oppression of Korean women into the self-deceptions underlying collaboration by Koreans with the Japanese oppressor. The savage hilarity of Chae's style lends force and historical relevance to his insight into the attitudes of the milieu in which his narrative is set.


The city of Demetriada was constructed around 294-292 BC and became a stronghold of the Macedonian navy fleet, whereas in the Roman period it experienced significant growth and blossoming. The ancient theatre of the town was constructed at the same time with the foundation of the city, without being used for 2 centuries (1st ce. BC - 1st ce. A.D.) and being completely abandoned after the 4th ce. A.D., to be used only as a quarry for extraction of building material for Christian basilicas in the area. The theatre was found in 1809 and excavations took place in various years since 1907. Geophysical approaches were exploited recently in an effort to map the subsurface of the surrounding area of the theatre and help the reconstruction works of it. Magnetic gradiometry, Ground Penetrating Radar (GPR) and Electrical Resistivity Tomogrpahy (ERT) techniques were employed for mapping the area of the orchestra and the scene of the theatre, together with the area extending to the south of the theatre. A number of features were recognized by the magnetic techniques including older excavation trenches and the pilar of the stoa of the proscenium. The different occupation phases of the area have been manifested through the employment of tomographic and stratigraphic geophysical techniques like three-dimensional ERT and GPR. Architectural orthogonal structures aligned in a S-N direction have been correlated to the already excavated buildings of the ceramic workshop. The workshop seems to expand in a large section of the area which was probably constructed after the final abandonment of the theatre.


Many U.S. cities have recently increased their minimum wages, especially in California. We report results from carrying out analyses of the impacts of these city minimum wages, as specified in a pre-analysis plan (PAP) that was registered on Open Science Framework prior to the release of data covering two years of minimum wage increases. In this working paper, we report results updating the data through 2018; our final paper will add another year of evidence on minimum wages. For employment effects, in our analysis of California cities we find a hint of negative employment effects, but the estimates are neither robust nor statistically strong. The analysis of local minimum wages nationally also provides some evidence of disemployment effects, although it is not statistically significant. For distributional effects, our city-specific analyses do not provide clear evidence one way or the other, except for evidence of increases in the shares poor or low-income in Santa Clara. In our panel data analyses of all California or national local minimum wages, there is evidence pointing to declines in the shares poor or low-income, although at least for California the data indicate that the shares poor or low-income were declining before local minimum wages took effect (or were increased). More definitive results await our next update.


Introduction The role of melatonin in human insulin regulation is poorly understood. Aim To investigate the influence of melatonin supplementation on glucose and insulin levels and on lipid metabolism in blood serum and the liver. Methodology The acute melatonin effects on insulin secretion in male Wistar rats were investigated. In addition, carbohydrate and lipid metabolism was studied. In in vivo experiments, melatonin was administered subcutaneously in two different doses (0.5 and 1.0 mg/kg body weight, respectively), and animals were decapitated after 1 hour. Results The higher dose of the hormone increased insulin level in blood. The applied pancreas perfusion technique allowed us to confirm a direct mechanism of melatonin action on the pancreas. The ability of melatonin to stimulate insulin output was dose dependent. The highest effect was noticed for 100 nmol/L, whereas 1 nmol/L did not influence this process. Conclusion Melatonin treatment in vivo caused many biochemical consequences. The hormone augmented significantly the concentrations of total, free, and esterified cholesterol, as well as high-density lipoprotein cholesterol in blood. Together with the enhanced insulin secretion observed in the in vivo experiment, the level of free fatty acids in blood decreased and, surprisingly, glucose concentration was significantly elevated.


This series of three talks is the first part of an introductory course on the generalized Sato-Tate conjecture, made in collaboration with Andrew V. Sutherland at the Winter School "Frobenius distributions on curves", celebrated in Luminy in February 2014. In the first talk, some general background following Serre's works is introduced: equidistribution and its connexion to L-functions, the Sato-Tate group and the Sato-Tate conjecture. In the second talk, we present the Sato-Tate axiomatic, which leads us to some Lie group theoretic classification results. The last part of the talk is devoted to illustrate the methods involved in the proof of this kind of results by considering a concrete example. In the third and final talk, we present Banaszak and Kedlaya's algebraic version of the Sato-Tate conjecture, we describe the notion of Galois type of an abelian variety, and we establish the dictionary between Galois types and Sato-Tate groups of abelian surfaces defined over number fields. generalized Sato-Tate conjecture - Sato-Tate group - equidistribution - Sato-Tate axioms - Galois type - Abelian surfaces - endomorphism algebra - Frobenius distributions


There is interest in testing the hypothesis that the non-carrier sisters of women with a breast cancer 1 (BRCA1) mutation face a greater than expected risk of breast cancer. Genetic testing on 3568 women with breast cancer under the age of 50 years was performed. These cases were unselected for family history. Genetic testing was offered to 261 sisters of 188 mutation-positive cases. One of 72 mutation-negative sisters was diagnosed with breast cancer. Of the 17 sisters diagnosed with breast cancer, only one was a phenocopy. Thus, we are unable to confirm the hypothesis that the non-carrier sisters of mutation carriers face a risk of breast cancer beyond that of the general population.

In the process of counselling women from families with a known breast cancer 1 (BRCA1) mutation, we often encounter healthy women who are found to have a negative test. This is usually a source of great relief for the woman, and traditionally the genetic counsellor or physician offers the opinion that the residual risk is low—that is, approximately that of women in the general population. In Canada and the USA, the risk to the population is approximately 8% to age 75 years, and in Poland it is about 5%. In a recent paper from the UK, Smith and colleagues suggest that the residual risk is, in fact, much greater than this. They estimate that the risk of breast cancer …


This study applies contingent valuation to assess farmers9 willingness to trade irrigation water. We analyse farmers9 willingness to pay for water and their willingness to accept the selling of water through a seasonal market, under both normal rainfall and drought conditions. A survey of 241 farmers (irrigators and non-irrigators) in the Guadalquivir River Basin and in the Mediterranean (Almanzora) Basin in southern Spain is used as a basis to construct the irrigation water supply and demand curves for both basins. Assuming that each basin operates as a single country, an international commerce framework is applied to study inter-basin trading. Results show that there is scope for both intra-basin and inter-basin markets. The equilibrium market price increases from 0.17 EUR/m 3 in the baseline scenario to 0.21 EUR/m 3 under drought conditions. These results are in line with observed market prices during 2006–2007. We also find a threshold volume under which start-up costs for irrigation infrastructure make it unprofitable for non-irrigators to enter the market. Finally, we conclude that farmers9 ethical perspective of considering irrigation water as a non-tradable commodity constrains them from participating in such markets.


The overall aim of this dissertation was to study the housing environment with a focus on indoor climate factors which may maintain or worsen respiratory symptoms among persons with asthma.Quasi-experimental and cross-sectional designs and a case-control approach were used. In Study I data was collected from a consecutive series of patients with asthma (n=21) and in the three other studies from a randomly selected sample, representative of the general population (n=6732). This sample was classified into subgroups (Study II): persons with asthma (n=261), healthy persons (n=5266) and persons with symptoms (n=1205). In Study III persons with asthma (n=49) were compared to persons without asthma (n=48), and the same group, persons with asthma (n=49) was also included in Study IV. Data were gathered using subjective information from diaries and questionnaires as well as objective measurements of medical and environmental factors.Lung function was improved and there was a tendency for the indoor climate to improve after the removal of textile wall-to-wall carpets or the increase of air exchange rate. No statistically significant differences were found in the housing environment when persons with and without asthma were compared. However in some individual homes, environmental factors at levels that could increase symptoms were identified. In single-family houses higher levels of humidity, insufficient ventilation and the occurrence of house dust mites indicated a less favorable indoor climate compared to multi-family houses. Respiratory symptoms attributed to specific environmental exposures increased in both healthy and unhealthy persons when they reported occurrence of indoor climate risk indicators. No statistically significant associations were found between separate risk indicators, identified by a 'Housing Environmental-index', or the frequency of indicators and clinical tests. The lack of significant associations may show that the chosen cut-off levels in the index were too high in reference to persons with asthma and further research is needed to establish relevant cut-off levels.In some of the investigated houses there was a need for secondary preventive interventions to improve the indoor climate in order to decrease the exposure of allergens and airway irritants. In this dissertation one aspect of the complex relationship between the person and the environment, i.e. accessibility, has been studied. Further research is needed to address the aspect of usability, i.e. the person's own evaluation of the degree to which they can be in and use the environment.


This study aims to investigate the antecedents of collaborative networked learning (hereafter CNL), to develop an integrative CNL framework and to bridge the gap between theory and praxis in manufacturing. Although collaborative learning has been at the forefront of educational and pedagogical studies, there is a lack of research in the mainstream of operations management and information systems. This study explores the antecedents of CNL and the sharing of information among diverse employees within the context of manufacturing industries in Malaysia. The study further extends the boundary of networked learning beyond internal enterprises to include suppliers, customers and external stakeholders. To provide a holistic perspective of CNL within the complexity of the manufacturing environment required a mixed-method research approach, including empirical investigation using survey questionnaires and semi-structured interviews. The qualitative findings from the interviews were corroborated with a 246 quantitative survey of multinational companies (MNCs) and small-medium enterprises (SMEs) in Malaysia. SPSS software was used for statistical analysis and NVivo for content analysis. The findings and discussions draw upon socio-technical systems (STS) theory, and present the theoretical context and interpretations through the lens of manufacturing employees. Results of the study show the existence of significant positive influences of organizational support, promotive interactions, positive interdependence, internalexternal learning, perceived effectiveness and perceived usefulness of CNL among manufacturing employees. The study further provides insights into information sharing and collaboration within MNCs and SMEs. Although employees in MNCs are more engaged in CNL compared to SMEs, a general consensus is found on the importance of collaborative technologies, the usage of online meetings and shared databases. The study offers a basis for empirical validity for measuring CNL in organizational learning, knowledge and information sharing in manufacturing.


This paper presents the findings of an Undergraduate Research Experience Program (UREP) research project funded by Qatar National Research Fund (QNRF). This interdisciplinary research project brings together architecture and sociolinguistics students and faculty members to develop a socio-cultural understanding and interpretation of the structures, designs, and physical dimensions of traditional elements employed by the members of the traditional society of Qatar from two complementary perspectives. The focus of this study is on identifying the multiple meanings and physical representations associated with elements of architecture, exemplified in the case of Qatari traditional architecture. These multiple meanings are dealt with from both architectural and multimodal discursive perspectives. The rationale behind this interdisciplinary approach is the fact that these two approaches are complementary to each other. This is because architecture spaces and elements act as a field and context where peoples' practices and activities take place, Hence, these practices are intricately interwoven with the architectural, i.e. structural and design, peculiarities of the individual spaces. One hundred Qatari traditional elements were selected for the purpose of this investigation within a framework of multimodal analysis. This approach takes into consideration the multiple modes through which meanings are constructed, i.e. building materials, structures and shapes of buildings, types of people who are entitled to use a particular building, activities that are organized around a space, to mention just a few. The project offers the opportunity to undergraduate students and faculty members from diverse disciplines to collaborate in an interdisciplinary research project, and thus to benefit from each other's background knowledge, ideas, and skills. The study recommends that this multidisciplinary approach be applied in undergraduate, postgraduate and other scholarly research pertaining to the study of traditional architecture and urban heritage. It proved to provide a better understanding and to serve as a strong motivation for students to engage themselves in research than an unidisciplinary approach.


5G is designed to leverage on network softwarization technologies, like NFV and MEC, to expose customized network instances and resources at the edge of the infrastructure to vertical stakeholders. Most of the 5G success will depend on the ability to attract vertical stakeholders acting in the cloud, enabling them to smoothly port cloud applications to 5G, and to add performance and cognitive capabilities not supported in cloud environments. To this end, this article provides an insight into the possible architectural approaches to fully integrate vApps into the 5G infrastructure. The article follows a top-down approach. First, it provides an outlook on the state of the art in cloud application design, and on the new MEC and NFV capabilities. Then, on this basis, the analysis is devoted to identifying integration issues not yet fully addressed in standards specifications. Two alternative architectural approaches are discussed.


The tension between federalism and national competition policy has come to a head. The state action doctrine finds its basis in principles of federalism, permitting states to replace free competition with alternative regulatory regimes they believe better serve the public interest. Public restraints have a unique ability to undermine the regime of free competition that provides the basis of U.S.- and state-commerce policies. Nevertheless, preservation of federalism remains an important rationale for protecting such restraints. The doctrine has elusive contours, however, which have given rise to circuit splits and overbroad application that threatens to subvert the state action doctrine's dual goals of federalism and competition. The recent Eleventh Circuit decision in FTC v. Phoebe Putney Health System, Inc. epitomizes the concerns associated with misapplication of state action immunity. The U.S. Supreme Court recently granted the FTC's petition for certiorari and now has the opportunity to more clearly define the contours of the doctrine. In Phoebe Putney, the FTC has challenged a merger it claims is the product of a sham transaction, an allegation certain to test the boundaries of the state action doctrine and implicate the interpretation of a two-pronged test designed to determine whether consumer welfare-reducing conduct taken pursuant to purported state authorization is immune from antitrust challenge. The FTC's petition for writ of certiorari raises two issues for review. First, it presents the question concerning the appropriate interpretation of foreseeability of anticompetitive conduct. Second, the FTC presents the question whether a passive supervisory role on the state's part can be construed as state action or whether its approval of the merger was a sham. In this paper, I seek to explicate the areas in which the state action doctrine needs clarification and to predict how the Court will decide the case in light of precedent and the principles underlying the doctrine.


The self-destruction of cells infected with viruses undergoes the process of apoptosis generally to restrict infection and the spread of viral progeny. To avoid infection host has evolved interconnected complex defence network that comprises innate and acquired immune response. Mitochondria being considered as powerhouse of a cell is not limited to only energy production, but mitochondria perform various other functions in (disease, apoptosis and host innate immune system) which make them absolutely indispensable to the cell. This makes them a target of almost all the invading pathogens including viruses. Therefore being a multifunctional organelle, the viruses choose mitochondria as a favourite organelle as they can easily take control of the whole cell and make it to promote or block apoptosis as per their need.


The aim of this research paper is to explore critical success factors required to implement green supply chain management. A descriptive analytical method was used by which a questionnaire was developed based on literature review and suggestions of academics as well as experts. It was distributed to a sample of 360 managers selected from food processing companies in Saudi Arabia. Out of 360 questionnaires, 278 were returned valid with a response rate of 77%. Using the principal component analysis to reduce the available data along with the confirmatory factor analysis to confirm the structure of extracted factors as observed variables and latent variables, the results revealed 16 critical success factors loaded on the major dimensions, which were management-led drivers (awareness of GSCM effects, management commitment, organizational involvement, investment recovery practices, green purchasing, environment-oriented TQM, and green information systems), external drivers (government drivers, cost drivers, customer drivers, supplier drivers and energy consumption reduction) in addition to product processing and recycling factors (society drivers, product end-of-life processing, eco-designed product-sand ISO 14001 certification). Considering these results, it was concluded that green supply chain management implementation is an integrated process consisted of activities directed to produce ecofriendly products oriented by internal and external drivers. This paper contributes to the literature through conceptualizing green supply chain management as a construct which embodies three major elements, management, environment and product. Managers in food processing companies who seek to achieve a successful implementation of green supply management initiative should take these three dimensions into their account.

 Key words: Green supply chain management implementation, critical success factors, food processing companies, Saudi Arabia.


Since the late 1990s, adult adoptees who were sent for adoption from South Korea to Western nations as infants and young children have been returning by the thousands to visit South Korea, search for relatives, and explore Korean culture. A smaller number choose to live and work for extended periods of time in their country of birth. This article contextualizes this phenomenon in relation to the South Korean government's proactive globalization policies and the rise of "English fever," and analyzes the shifting receptions of adoptees by the state and everyday South Koreans as a window onto post-IMF neoliberal transformations in South Korea. I show how a shift in the signification of adoptees between the 1990s and the 2000s is suggestive of the increasing association of adoption with human capital, whether in the state's attempts to enroll adoptees as successful global citizens and cultural ambassadors or vernacular views of adoptees as lucky cosmopolitans. Drawing on ethnographic research with resident adoptee returnees who lived and worked in South Korea for extended periods of time at the turn of the millennium, I show how their social marginalization and discrepant cosmopolitanism reveal the ascendance of neoliberal values in contemporary South Korea. In conclusion, I assert that resident adoptee returnees offer important critiques of dominant discourses that celebrate transnational adoption as the fast track to cosmopolitan privilege or as a postnational model for transcending racial and national hierarchies.


Neural attention has become central to many state-of-the-art models in natural language processing and related domains. Attention networks are an easy-to-train and effective method for softly simulating alignment; however, the approach does not marginalize over latent alignments in a probabilistic sense. This property makes it difficult to compare attention to other alignment approaches, to compose it with probabilistic models, and to perform posterior inference conditioned on observed data. A related latent approach, hard attention, fixes these issues, but is generally harder to train and less accurate. This work considers variational attention networks, alternatives to soft and hard attention for learning latent variable alignment models, with tighter approximation bounds based on amortized variational inference. We further propose methods for reducing the variance of gradients to make these approaches computationally feasible. Experiments show that for machine translation and visual question answering, inefficient exact latent variable models outperform standard neural attention, but these gains go away when using hard attention based training. On the other hand, variational attention retains most of the performance gain but with training speed comparable to neural attention.


The purpose of this study is to identify and quantify the effect of endogenous and exogenous economic factors on electricity demand in Ghana. The Structural Time Series Model is employed due to its ability to capture exogenous non-economic variables. The findings reveal that education has significant effect on electricity consumption in both the short and the long run. Education has inverse relationship with electricity consumption implying that the more consumers are educated, the less electricity they consume. The study also reveals that price changes have less impact on electricity consumption in the short run and that efficiency in electricity consumption has improved since 1971 and will continue for the next twenty years. The study recommends that more public education should be carried out to enhance energy conservation and also, realistic prices should be charge for electricity consumption to allow private investment into the sector.


Microfinance Institutions (MFIs), created based on Law No 1 of the Year 2013 concerning Microfinance Institutions, aim to provide legal certainty and fulfill financial service needs for the poor and/or low-income people. Meeting the needs of financial services by increasing access to micro-scale funding, contributing to the increase in economic empowerment and community productivity, as well as increasing the income and welfare of the community. Thus, MFIs can be one of the effective solutions to support the development of Micro, Small and Medium Enterprises (MSMEs) due to their financial service procedures being more flexible and more affordable in rural areas. MSMEs are basically part of the poor who have the willingness and productive ability to improve people's lives in the regions. MSMEs must be provided the widest access to obtain funding from MFIs. Hence, it is important to know the role of MFIs in supporting the development of MSMEs. associated with improving regional economies.


An integrated study involving advanced seismic attribute and reservoir characterization tools in Macuspana Basin of Mexico provided an understanding of the structure, reservoir continuity, and quality of three mature reservoirs that optimized new drilling locations for exploration and development and generated a reservoir model for simulation purposes.

Conventional and advanced technologies were integrated after a feasibility analysis to generate several attribute cubes over a 3D seismic volume; these included acoustic impedance, amplitude variation with offset (AVO), porosity derived from artificial neural network (ANN) schemes, and spectral decomposition. These attributes, added to the structural and stratigraphic analysis and to a J-function capillary pressure analysis, yielded information on compartmentalization that provided a geologic model to support reservoir delineation and characterization.

Cobo, Bitzal, and Guiro fields are in Macuspana Basin, state of Tabasco, southeastern Mexico (Figure 1). The Cobo area, which includes the Cobo, Bitzal, and Guiro fields, is stratigraphically and structurally complex; its complexity is comparable to that of many other gas-producing fields in Macuspana Basin in which the dominant trap mechanisms vary from fault-assisted closures with a stratigraphic component to purely stratigraphic traps. The fields have produced gas for more than 20 years from a series of thin, principally Plio-Pleistocene sands thought to be fluvial-to-deltaic in origin. Cobo fields are cut by many NE-SW striking faults. Some northwest-dipping faults exhibit classic growth fault geometries; some show evidence for reactivation and inversion. This complexity, coupled with older well data, makes analysis using traditional exploration and reservoir characterization tools challenging. Figure 1.
Map of Cobo area.

Historically in Cobo fields, selection of well locations depended first on structural and stratigraphic analysis using limited 2D seismic; then, when 3D seismic became available, 3D seismic interpretation, detailed amplitude analysis, and AVO schemes were used as the basis for proposing new well sites. Amplitude, AVO, and resistivity measurements …


The evolution of body size is a dominant feature of animal evolution. However, little is known about how the underlying developmental mechanisms that determine size change as body size evolves. Here we report on a case of body size evolution in the tobacco hornworm Manduca sexta that occurred over a period of nearly 30 years. We take advantage of an extensive series of physiological studies performed in the early 1970s that established the parameters that regulate body size in this species and compare their values with those of modern individuals that are descendants of the same colony. We show that three of the five processes that determine adult body size changed during this period, while two remained constant. Changes in these three developmental processes completely account for the observed evolutionary change in body size.


The Professional Doctorate at Middlesex University has developed over the last fifteen years with over 180 current and past candidates. It is a generic, individually negotiated programme where the primary resource for the candidate is the one to one support of the academic adviser. In contrast the Professional Doctorate in Practical Theology at the University of Chester is a subject-specific programme based on cohorts who meet regularly within a residential format. One author on this paper is a lead faculty member of the Middlesex programme and consultant to the second author who is a candidate on the Chester programme. We both come from a professional background in coaching and the candidate's DProf research focus is the advisor-advisee relationship. This research explores the nature and practice of academic supervision of professional doctorates through the observation and interpretation of lived experience of supervisory relationships in the context of a generic and a practical theology programme. This positioning allows us to compare our experience of advising from multiple perspectives in two very different programme designs.
Specifically our previous work (Armsby and Fillery-Travis 2009) had confirmed the pivotal role of the academic advisor to the delivery of the programme. We had identified that in practice this role goes beyond that of tutor/assessor and is principally one of facilitator/coach. It is unlike the traditional research supervisory role as the leadership of the research is shifted from the professional researchers and scholars to the candidate. It places the research professionals and scholars at the service of the candidate's research agenda. The candidate approaches the research activity as the expert in the context and goal of the research – the work environment and the requirements of the research– and the advisor approaches as an expert in the process of research and inquiry.
Clearly the power distribution between advisor and candidate is a delicate balance of allowing the expertise of the practitioner not to be overshadowed by the advisor or vice versa; that the advisor be overawed by the seniority or eminence of the candidate within their particular professional sphere. The candidate through the development of their research question seeks to produce actionable knowledge (Antonacopoulou, E. 2009) and the advisor through their holding of a learning framework and relational interaction facilitates that creation. This places significant emphasis on the mode of interaction between advisor and candidate and preferences a coaching engagement. It identifies the need for cognitive and affective 'I-thou' relationships, integrating being and doing (Buber 1958).
Coaching is, however, not a one-size-fits-all intervention. It is a complex practice that draws from the range of disciplines which inform the facilitation of professional learning for the individual or team (Jarvis, Lane and Fillery-Travis, 2004). There are a multitude of coaching models available but they are generally developed to aid practice within a commercial environment and do not consider the requirements identified here. The complexity of the interaction between adviser and candidate highlights the need for an explicit model of coaching practice between them. Once developed such a model can be used to train and supervise advisors in the future providing a cornerstone for development of best practice in the field. As identified by Schon (1987) 'In a reflective practicum...the question is not how much you know, but rather how effectively you can help others to learn'.
In this contribution we consider a framework approach that can be used by advisors to explore the purpose of their work, the perspectives underpinning it and the process by which it occurs. It takes as a starting point the premise that the advisor is acting as a learning peer (or coach) to the candidate; using their expertise as a learning and development professional but recognising and honouring the expertise of the candidate in their own professional sphere. Using the framework the advisor can develop their own model of practice that embraces their own habitus whilst maintaining coherence to their programme outcomes and deliverables. We explore how the paper can address the evolution of the relationship within the timeframe of the programme and the shift in perspective required by the advisor as their candidate's self efficacy increases. We will hope to engage out audience in an interactive consideration of such a model and its application in the facilitation of learning of advanced practitioners.


African newsrooms are experiencing the disruptive impact of new digital technologies on the way they generate and disseminate news. Indeed, newsrooms are being forced to adapt in various ways and there are clear dimensions of localized creativity and adaptations by journalists to the digital revolution. In the same way, the influences of digitization, Internet, and social media are changing the informational needs of readers, including how they engage with news. These developments nonetheless remain on the margins of 'mainstream' journalism research – very few researchers have sought to qualitatively capture the implications of developments in digital technologies on the routine practices of African journalists, especially in their 'natural habitat', the newsroom.
 In this light, this edited book volume interrogates the changing ecology of newsmaking in Africa in the context of rapid technological changes in newsrooms as well as in the wider social context of news production. It brings together six contributions drawn from five countries: Egypt, Mozambique, South Africa, Nigeria and Zimbabwe, to explore practices, challenges and professional normative dilemmas emerging with the adoption and appropriation of new technologies. While the studies point to dimensions of localised new technology appropriations as defined by the complex socio-political structures in which African journalists operates, they are not rigidly confined to Africa. They are expressly in dialogue with theoretical observations largely emerging from Western scholarship. In this sense, the book goes beyond simply mainstreaming African perspectives, it engages directly with dominant theoretical observations and offers a point of departure for developing what could loosely be branded as an African digital journalism epistemology.


AbstractWe have evaluated continental shale oil enrichment via experiments. Rock pyrolysis, nuclear magnetic resonance, and pulse permeability tests were conducted to establish the pore saturation index (PSI), which comprehensively evaluates the enrichment of shale oil features using the characteristics of self-generation and self-preservation, the parameters of which include the pyrolysis-free hydrocarbon (S1) and total organic carbon of source rocks as well as the porosity and permeability of reservoir rocks. The correlation of the oil content (S1) and PSI values indicated that PSI values greater than 50 generally indicate good oil enrichment plays, whereas those smaller than 50 imply poor conditions for oil enrichment. This conclusion was successfully applied to the Zhanhua Sag with shale oil plays in the Jiyang Depression, Bohai Bay Basin, China. In addition, the shale oil plays of the Dongying Sag in the Jiyang Depression were investigated to verify the effectiveness and reliability of the new method.


This installation comprised a series of photographs of suburban scenes and a large, floor-based structure. The raised, wooden, floating platform, covering the entire gallery floor, presents as a stage upon which the exhibition is mounted and where the act of viewing is performed. Concepts of construction and performance carry through both the installation and photographic elements of this work. The 6 photographic images shown as part of this exhibition explore the notion of landscape as a cultural construct, a scene to be pictured, framed and defined by our relationship to it. The act of viewing is depicted in one photograph, 'The Wordless Exchange', by a solitary figure, a common motif in classical landscape painting. In the other images a process of entropy is at work in the neglected and abandoned spaces depicted. A domestic interior, a backyard, a public park; environments that were once ordered and animated through human presence, tend slowly towards disorder. The juncture between the man-made and natural worlds sets the scene for this installation. The banal spaces, which form the subject of the photographs, appear as staged compositions, which relate in both material form and metaphor to the wooden structure from which one views these photographic images. The diptych, 'Fallen Leaves & Shadows I & II', presents two views of a run down backyard on a dank autumn afternoon, where splintered wood juts out from a broken fence. The wooden structure that forms the basis of this installation reflects the broken down materials that once demarcated the domestic boundaries featured in these images. The acoustic qualities that resonate from this wooden structure as the viewer moves from one image to another, further highlights the act of 'looking'. The photographic works included as part of this installation were: 'A Complex Variety of Greens (from Emerald to Viridian)' (2011), 'Silent, Empty, Waiting for the Day' (2011), 'Stagnant Pool' (2010), 'The Wordless Exchange' (2010), 'Fallen Leaves & Shadows I & II' (2011) diptych, each measuring 122 cm x 152 cm, colour lightjet photographic prints. Edition of three.


In recent years, stringent world-wide regulation of copper in drinking water, wastewater discharge and sludge has prompted utilities to carefully evaluate copper sources and sinks, benefits and detriments, and mitigation. This work compiled the individual efforts of researchers and utilities to provide a basis for holistic decision-making. Mass balances suggest that between 14-61% of copper in wastewater originates from home plumbing. Dosing of pure copper sulfate "root killer" by consumers, which is of unlikely value, accounted for up to 27% of copper inputs. Removal of copper in wastewater treatment ranged from 24-90%, suggesting a potential for optimization of these processes if desired. Finally, though utilities are pressured to reduce copper inputs at all stages of the urban water cycle, substantial benefits including human and wastewater bacteria micro-nutrition, water disinfection and algae control should not be overshadowed. To better understand copper inputs from corrosion in soft waters, a 12 month study was executed. Free chlorine (0.7 mg/L) was determined to have minimally adverse effects on copper release at pH 9.5 but no significant effect at pH 7.0, and higher temperatures usually increased copper release. Organic matter including soluble and particulate NOM, sodium alginate, and gum xanthan, tended to worsen copper release. Their direct effects included complexation and mobilization of pre-existing copper scale as particulates. Indirect effects were also discovered, including a propensity of gum xanthan and alginate to decrease pH, increasing copper release, and also to produce a microbiologically unstable water, decreasing the dissolved oxygen necessary for fueling corrosion reactions. The range of organic matter effects could be placed within a unified conceptual framework.


SOMMARIO: 1. Laicita necessaria - 2. Il Cristianesimo: una fede scandalosa - 3. La maggiore eta del mondo - 4. Ritrovare Dio da adulti - 5. Provvisorieta dell'etica cristiana - 6. Fuhrer e Verfuhrer: lo scambio delle vesti e la fragilita del male. Secularism as requirement of reason: the actuality of Dietrich Bonhoeffer ABSTRACT: Dietrich Bonhoeffer is a very significant figure of the Protestant theology. Having experienced the most dramatic period of the German history he is well remembered as "resistant" to the National Socialism, but he deserves also to be reconsidered because of his defense, as believer, of the value of "secularism", necessary to safeguard an authentic profession of faith.


The objective of this study was to find out the effect of volume and source of growth media and lettuce growth and yield in Deep Pool Growing System (DPGS). The study was conducted from September to December 2003 at Deep Pool Growing System facility, Danasworo Hydro - Garden Ciapus, Bogor. The Study was arranged in randomized completely block design with two factors. First factor was volume of growth media ( 20 cm³ and 110 cm³). The second factor was source of growth media (synthetic foam, cocodust, rice-husk + OSF and rice-husk + cocodust). Medium volume of  20 cm³ with rockwool was used as a check. Nutrient compotion of the solution was as follows (ppm): Ca 117, Mg 24, K 210, NH4 25, NO3 233, SO4 113, and PO4 60, Fe 2.14, B 1.2, Zn 0.26, Cu 0.048, Mn 0.18, and Mo 0.046. Medium volume of 20 cm³ with synthetic foam obtained the best yield for all parameters. Therefore, this treatment could replace rockwool as medium for lettuce production in DPGS. Key words : Deep Pool Growing System, hydroponics, growth medium


Examined type-of-stepfamily differences in child well-being and parenting behaviors and how child well-being in stepfamilies relates to parenting behaviors. Data were drawn from the National Survey of Families and Households (J. A. Sweet et al, 1988) and included fathers and mothers in 448 stepfather, 76 stepmother, and 41 complex stepfamilies. Biological parents in stepfamilies perceived themselves as having higher quality relationships with their children than stepparents reported having with their stepchildren. Although stepfathers reported behaving less positively toward their children than did other fathers, stepmothers reported responding as positively to their stepchildren as did biological mothers in stepfamilies. In general, child well-being was positively related to perceptions of parental warmth. The relations between parental control and child well-being varied for different dimensions of well-being and in different types of stepfamilies.


Internet Small Computer Systems Interface (iSCSI) is a Small Computer Systems Interface (SCSI) transport protocol designed to run on top of TCP. The iSCSI session abstraction is equivalent to the classic SCSI "I_T nexus", which represents the logical relationship between an Initiator and a Target (I and T) required in order to communicate via the SCSI family of protocols. The iSCSI session provides an ordered command delivery from the SCSI initiator to the SCSI target. This document goes into the design considerations that led to the iSCSI session model as it is defined today, relates the SCSI command ordering features defined in T10 specifications to the iSCSI concepts, and finally provides guidance to system designers on how true command ordering solutions can be built based on iSCSI.


We report the results of a detailed mineralogical investigation of platinum-group minerals (PGM) and copper-gold nuggets from the Uktus Ural-Alaskan type complex in the Central Urals (Russia). The studied nuggets were sampled in alluvial-eluvial deposits from three small valleys, with temporary water flows, cutting across the Uktus massif. The volume of the washed samples varies from 0.03 to 0.08 m 3 and a few tens of PGM nuggets, ranging in size from about 100 μm to about 2 mm, were collected. According to their chemical composition, the most abundant PGM are native Ir-Os and alloys in the Pt-Fe-Cu-Ni system. The following less abundant PGM were also recognised: sulfarsenides of the irarsite-hollingworthite-platariste series, sulfides such as laurite, cuproiridsite, kashinite and the sulfantimonide tolovkite. One alloy corresponding to the formula Cu 3 Au 2 was found, and proved to be Cu-rich tetraauricupride. The nuggets of Uktus have, in some cases, a polygonal shape. However, most of them have an irregular morphology and are characterised by a porous rim and zoning. The investigated nuggets occur as single-phase crystals or as polyphase grains, composed of different PGM. One nugget displays a very complex texture, being composed of a Pt-Fe alloy associated with osmium and Cu-rich tetraauricupride. These minerals are in contact with quartz that contains minute inclusions of hollingworthite and platarsite. The mineralogical similarity with the PGM inclusions in the Uktus chromitites indicates these rocks as a possible source for the PGM nuggets. The presence of faceted morphology in some nuggets suggests that they were mechanically liberated and transported for a relatively short distance from their lode deposits. The nuggets characterized by a rounded shape and occurring in association with quartz and Cu-rich tetraauricupride have probably been reworked in the placer environment. Therefore, in the Uktus placers deposits, two types of PGM nuggets can coexist: (i) primary with a magmatic origin, i.e ., only mechanically liberated from their source rock, and (ii) secondary, i.e ., reworked and grown in the placers. The mineralogical assemblage of the Uktus PGM nuggets, the fact that the Uktus PGM placers have never been mined and the recent exponential increase in demand for noble metals make the placer deposits associated with the Uktus complex potentially important for the economic recovery of these rare metals, at least on a small scale.


Soybean MON 87708 contains a single insert consisting of the dmo expression cassette. The DMO (dicamba mono-oxygenase) proteins confer tolerance to dicamba-based herbicides. Bioinformatic analyses of the inserted DNA and flanking regions do not raise safety issues. The levels of DMO proteins in soybean MON 87708 have been sufficiently analysed. The stability of the genetic modification has been demonstrated. No differences were identified in the compositional data of forage and seeds obtained from soybean MON 87708 or in its agronomic and phenotypic characteristics that would require further assessment with regard to safety by the GMO Panel. The safety assessment identified no concerns regarding the potential toxicity and allergenicity of the DMO proteins, or of soybean MON 87708. The compositional data indicating that soybean MON 87708 is as nutritious as non-GM soybean varieties were supported by the outcome of a chicken study. There are no indications of an increased likelihood of establishment and spread of feral GM soybean plants. Considering the scope of this application, potential interactions of soybean MON 87708 with the biotic and abiotic environment were not considered to be an issue. Environmental risks associated with an unlikely but theoretically possible horizontal gene transfer from soybean MON 87708 to bacteria have not been identified. The post-market environmental monitoring plan and reporting intervals are in line with the intended uses of soybean MON 87708. In conclusion, the GMO Panel considers that the information available for soybean MON 87708 addresses the scientific comments raised by the Member States, and that the soybean MON 87708, as described in this application, is as safe as its conventional counterpart and non-GM soybean reference varieties with respect to potential effects on human and animal health or the environment, in the context of its intended uses.


The research goal is to identify marketing channels, marketing margin and marketing efficiency. This research was conducted in the village of Kuok Kuok District of Kampar regency. The method used in the study using survey methods, sampling purposive sampling. The sample consisted of a sponge cake agroindustry entrepreneurs and 30 customers sponge cake. The data used in this study are primary data and secondary data. Agroindustry research results sponge cake has a marketing channel of entrepreneurs to consumer marketing channel efficiency Rated sponge cake made at home by 8.06% more efficient than the efficiency of marketing channels is done in the market Bangkinang by 15.56%, due to marketing channels in Bangkinang market while the cost of transportation for marketing in the home does not use transport. Value marketing channel efficiency sponge cake made in the market Air Tiris by 13.23% more efficiency than do marketing channels in the market Bangkinang by 15.56%, due to marketing in Bangkinang done every 5 days a week so that the transport is greater than transport to Air Tiris that marketing is done every once a week. The value of marketing efficiency in marketing channels carried in Rumbio market is 13.66% larger than marketing channels Air Tiris performed in the market, namely 13.23%, because many employers bring cakes to Air Tiris market. Keyword: Marketing, Channel, Cost, Margin, Efficiency


Considerable geographic variation occurs in the Tasmanian endemic butterfly, Oreixenica ptunarra, and
there is a high correlation between clusters of morphological characters and ecological factors, especially
climate and elevation. Evidence is presented for the existence of a longitudinal cline in phenotypic
characters of wing pattern and size, which is unrelated to the modest amount of variation in the male
genitalia (a possible surrogate for genetic variability). Butterflies from warmer, less cloudy eastern
Tasmania are larger and less dark in colour than those from the west, culminating in the small dark
populations of the north-west. This suggests selection for efficiency in thermoregulation as climatic
conditions become more marginal for adult activity from east to west. The prevailing subspecies
classification does not fully reflect the range of variation in this species. Conservation strategies that aim to
guarantee the survival of the collective phenotype of O. ptunarra based on this taxonomy are therefore
misinformed. The north-west populations are disjunct geographically and in features of phenotype, but are
not especially discrete in the morphology of the male genitalia. We propose that the subspecies angeli
Couchman and roonina Couchman be reduced to synonymy with nominotypical ptunarra Couchman, and a
new subspecies should be recognised to incorporate populations from the montane grasslands of northwestern
Tasmania.


A mathematical model for antiviral clinical trials improves dose selection and understanding of drug-virus interaction. Dosing HSV Choosing the correct drug dose can be the difference between the success or the failure of a clinical trial, yet this decision is frequently stochastic. Current models aim to improve this process by predicting the pharmacokinetics and pharmacodynamics of an antiviral agent. Schiffer et al. expand these models to include viral and immunological factors that influence the course of infection. They model herpes simplex virus shedding during dose trials of pritelivir, a DNA helicase-primase inhibitor. They find that not only does pritelivir decrease viral shedding by inhibiting replication in epithelial cells at appropriate doses but also it limits downstream viral spread to additional sites. Their model successfully predicts outcome in a subsequent trial and may serve as a tool to improve dosing decisions in the clinic. Pharmacokinetic and pharmacodynamic models estimate the potency of antiviral agents but do not capture viral and immunologic factors that drive the natural dynamics of infection. We designed a mathematical model that synthesizes pharmacokinetics, pharmacodynamics, and viral pathogenesis concepts to simulate the activity of pritelivir, a DNA helicase-primase inhibitor that targets herpes simplex virus. Our simulations recapitulate detailed viral kinetic shedding features in five dosage arms of a phase 2 clinical trial. We identify that in vitro estimates of median effective concentration (EC50) are lower than in vivo values for the drug. Nevertheless, pritelivir potently decreases shedding at appropriate doses based on its mode of action and long half-life. Although pritelivir directly inhibits replication in epithelial cells, our model indicates that pritelivir also indirectly limits downstream viral spread from neurons to genital keratinocytes, within genital ulcers, and from ulcer to new mucosal sites of infection. We validate our model based on its ability to predict outcomes in a subsequent trial with a higher dose. The model can therefore be used to optimize dose selection in clinical practice.


A major difficulty with logic programming is combinatorial explosion: since goals are solved with possibly indeterminate (i.e., branching) reductions, the resulting search trees may grow wildly. Constraint logic programming systems try to avoid combinatorial explosion by building in strong determinate (i.e., non-branching) reduction in the form of constraint simplification. In this paper we present two concepts, residuation and guarded rules, for further strengthening determinate reduction. Both concepts apply to constraint logic programming in general and yield an operational semantics that coincides with the declarative semantics. Residuation is a control strategy giving priority to determinate reductions. Guarded rules are logical consequences of programs adding otherwise unavailable determinate reductions.


Building and productionizing Machine Learning (ML) models is a process of interdependent steps of iterative code updates, including exploratory model design, hyperparameter tuning, ablation experiments, and model training. Industrial-strength ML involves doing this at scale, using many compute resources, and this requires rewriting the training code to account for distribution. The result is that moving from a single host program to a cluster hinders iterative development of the software, as iterative development would require multiple versions of the software to be maintained and kept consistent. In this paper, we introduce the distribution oblivious training function as an abstraction for ML development in Python, whereby developers can reuse the same training function when running a notebook on a laptop or performing scale-out hyperparameter search and distributed training on clusters. Programs written in our framework look like industry-standard ML programs as we factor out dependencies using best-practice programming idioms (such as functions to generate models and data batches). We believe that our approach takes a step towards unifying single-host and distributed ML development.


William Dalrymple is a popular, bestselling author, initially known for his travel writing and subsequently for his popular narrative histories. He is also a prolific journalist and reviewer. His major publications include: In Xanadu: A Quest (1990), City of Djinns: A Year in Delhi (1993), From the Holy Mountain: A Journey in the Shadow of Byzantium (1997), The Age of Kali: Indian Travels & Encounters (1998), White Mughals: Love & Betrayal in Eighteenth-Century India (2002), The Last Mughal: The Fall of a Dynasty, Delhi, 1857 (2006), and Nine Lives: In Search of the Sacred in Modern India (2009). In each of these works, Dalrymple focuses on his interactions with India and the Middle East.
This thesis examines Dalrymple's travel writing and histories from a postcolonial perspective in order to map the relationship between travel and history writing, especially in colonial and postcolonial contexts. Travel writing is a textual representation of cultural interactions, even (or especially) if what eventuates is more a reflection of the "home" country than the traveller's destination. In a similar way, the strategies by which we negotiate, choose and fashion historical narratives construct our place in the present. Dalrymple's texts repeatedly consider the British Raj and its legacies. The thesis analyses the ways in which Indians, Britons, and the relationships between them are represented. It argues that the British Empire is represented through a sentimental and nostalgic lens, resulting in an overwhelmingly positive portrayal. This thesis is also interested in the ways in which Dalrymple's texts construct their authority. This narrative authority is achieved principally through an emphasis on the first-person, autobiographical experiences of the narrator, blended in varying degrees with an invocation of the importance of history (which is expressed through the narrator's relationship with primary source material). Dalrymple then uses the cultural capital that this authority provides to argue for the value of his version of travel and history writing over other (particularly theoretical, postcolonial) approaches.
In addition to his myriad print publications, Dalrymple has also written and performed in radio and television documentaries, and recently complemented his public speaking appearances (to promote Nine Lives) with a travelling stage show featuring Indian song, dance and religious practices. Dalrymple's influence extends beyond that of simple author, to that of an expert, celebrity figure who operates across media platforms to reach his audiences. This thesis undertakes a close reading of each of Dalrymple's monographs, as well as the ways in which they are positioned in the public sphere, both by their author and by reviewers and critics. This reading enables an analysis of the arguments made about the past and present relationship between India and Britain within and outside the texts.


The ultimate goal in trauma resuscitation is to promptly identify and treat all injuries. Despite clinical and technological advances in diagnosis and treatment of trauma patients, missed injuries continue to significantly affect modern trauma services. Delayed diagnosis and missed injuries have the potential to exacerbate the severity of the initial insult, and may result in permanent disability or even mortality. Moreover, missed injuries add significantly to length of hospitalization and overall costs of trauma patient care. This article will discuss common themes associated with missed injuries, and will highlight steps that practitioners can take to minimize delays in diagnosis and to reduce the number of missed injuries. This article begins with basic definitions, followed by a discussion of literature pertaining to, and factors associated with, missed injuries. We will then focus on specific mechanisms and injury patterns, as well as the corresponding injury-specific diagnostic and treatment pitfalls that have to be considered in order to avoid


Objective To test the hypothesis that there is negative bias towards escalating levels of care in decompensated cirrhosis, compared with other patient groups. Design An electronic survey containing eight acute clinical scenarios with equivalent physiological derangement, in which respondents were asked to score the degree to which they would advocate for intensive care unit admission on a scale of 1–10. Scenarios included respiratory, haematology, vascular, renal, gastrointestinal, postoperative and hepatological conditions. Follow-up questions examined the reasons why the patient should or should not be transferred, and enquired about ceilings of care, end-of-life decisions, degree of organ support and healthcare financial rationing. 273 doctors responded. Setting Secondary care hospitals in south of England. Patients None involved. Interventions None. Main outcome measures Advocacy score (1–10) and subsidiary responses. Results The hepatology patient ranked 4th of 8 with a mean advocacy score of 7.2. There were no significant differences between intensivists and physicians or between grades of seniority. Of those less likely to escalate (score 1–5, n=42), the reasons given were based on unsurvivability or excessive burden of treatment rather than aetiology. One-fifth cited 'lifestyle decision'. 25 (62.5%) respondents not favouring escalation would make the patient DNACPR, 17 (42.5%) would stipulate ward-based care only and a small minority would instigate active palliation. Of those favouring escalation (advocacy score 6–10), 70% (n=122) would consider unlimited organ support. Fifty-four (29.5% of those who answered) said they 'sometimes' or 'frequently' consider resource allocation when making decisions about escalation of care. Conclusions When compared with a variety of acute medical scenarios, doctors did not overly appear to exhibit therapeutic nihilism for patients with decompensated liver disease; however, significant variation in interpretation of the data and management approaches was identified.