Transformers trained with self-supervision using selfdistillation loss (DINO) have been shown to produce attention maps that highlight salient foreground objects. In this paper, we show a graph-based method that uses the selfsupervised transformer features to discover an object from an image. Visual tokens are viewed as nodes in a weighted graph with edges representing a connectivity score based on the similarity of tokens. Foreground objects can then be segmented using a normalized graph-cut to group self-similar regions. We solve the graph-cut problem using spectral clustering with generalized eigen-decomposition and show that the second smallest eigenvector provides a cutting solution since its absolute value indicates the likelihood that a token belongs to a foreground object. Despite its simplicity, this approach significantly boosts the performance of unsupervised object discovery: we improve over the recent state-of-the-art LOST by a margin of 6.9%, 8.1%, and 8.1% respectively on the VOC07, VOC12, and COCO20K. The performance can be further improved by adding a second stage class-agnostic detector (CAD). Our proposed method can be easily extended to unsupervised saliency detection and weakly supervised object detection. For unsupervised saliency detection, we improve IoU for 4.9%, 5.2%, 12.9% on ECSSD, DUTS, DUT-OMRON respectively compared to state-of-the-art. For weakly supervised object detection, we achieve competitive performance on CUB and ImageNet. Our code is available at: https://www.m-psi.fr/Papers/TokenCut2022/


The propagation and focusing properties of a class of Gaussian beams generated by optical resonators with Gaussian reflectivity mirrors are investigated. Attention is concentrated on the following two beams in this class: (a) the annular Gaussian beam (the Gaussian doughnut mode) and (b) the flat-topped Gaussian beam. A class of flat-topped Gaussian beams is introduced. All analysis is limited to a coherent superposition scheme of the lowest-order Gaussian modes (TEM00) that have different parameters.


Suspect Citizens offers the most comprehensive look to date at the most common form of police-citizen interactions, the routine traffic stop. Throughout the war on crime, police agencies have used traffic stops to search drivers suspected of carrying contraband. From the beginning, police agencies made it clear that very large numbers of police stops would have to occur before an officer might interdict a significant drug shipment. Unstated in that calculation was that many Americans would be subjected to police investigations so that a small number of high-level offenders might be found. The key element in this strategy, which kept it hidden from widespread public scrutiny, was that middle-class white Americans were largely exempt from its consequences. Tracking these police practices down to the officer level, Suspect Citizens documents the extreme rarity of drug busts and reveals sustained and troubling disparities in how racial groups are treated.


Many sources of renewable energy, including solar, wind, and ocean wave, offer significant advantages such as no fuel costs and no emissions from generation. However, in most cases these renewable power sources are variable and non-dispatchable. The utility grid is already able to accommodate the variability of the load and some additional variability introduced by sources such as wind. However, at high penetration levels, the variability of renewable power sources can severely impact the utility reserve requirements. This paper presents an analysis of the interaction between the variability characteristics of the utility load, wind power generation, solar power generation, and ocean wave power generation. The results show that a diversified variable renewable energy mix can reduce the utility reserve requirement and help reduce the effects of variability.


Over the past four years Emotion in Motion, a long running experiment, has amassed the world's largest database of human physiology associated with emotion in response to the presentation of various selections of musical works. What began as a doctoral research study of participants in Dublin, Ireland, and New York City has grown to include over ten thousand emotional responses to musical experiences from participants across the world, from new installations in Norway, Singapore, the Philippines, and Taiwan. The most recent iteration of Emotion in Motion is currently underway in Taipei City, Taiwan. Preparation for this installation gave the authors an opportunity to reimagine the architecture of Emotion in Motion, allowing for a wider range of potential applications than were originally possible with the initial development of the tools that drive the experiment. Now more than an experiment, Emotion in Motion is a framework for developing myriad emotional/musical/biomusical interactions with co-located or remote participants. This paper describes the development of this flexible, open-source framework and includes discussion of its various components: hardware agnostic sensor inputs, refined physiological signal processing tools, a public database of data collected during various instantiations of applications built on the framework, and the web application frontend and backend. We also discuss our ongoing work with this tool, and provide the reader with other potential applications that they might realize in using Emotion in Motion.


Syndesmotic injury, more commonly known as a "high ankle sprain", accounts for over 12% of all ankle sprain incidents in the US; of which, over 25% occur during a sporting activity. Typically, harm to the syndesmosis occurs in sports such as football, soccer, lacrosse, and hockey where it is common for an athlete to experience rapid and extreme dorsiflexion-external rotations of the foot. Severe syndesmotic sprains have been noted by clinicians as the most difficult ankle injury to accurately diagnose and treat, require the most recuperation time, and often results in life-long dysfunction. Even more problematic, 40% of patients suffering from a high ankle sprain also report joint instability 6 months after the initial injury. The distal tibiofibular syndesmosis joint consists of a fibrous interosseous membrane and four stabilizing ligaments, allowing for only slight movements of the fibula about the tibia. These distal bone surfaces closely articulate with the talus to form a stable mortise joint, giving the ankle joint complex its hinge-like range of motion (ROM). In the case of severe ankle sprains, excessive external rotation, dorsiflexion, and eversion of the foot can cause tearing of these stabilizing ligaments, distraction of the bones, or even fracture. A rigid screw fixation method is the standard practice for repair in these severe cases, although new dynamic fixation techniques using sutures and buttons instead of a screw are thought to allow for a more iii natural motion of the joint during healing and better post-operative results. However, most research of the ankle joint complex has primarily been dedicated to the talocrural joint formed between the talus and tibia, where the fibula is treated as single segment with the tibia. Very little research has been dedicated towards understanding the unique role the fibula plays in dynamic weight-bearing tasks to overall ankle joint strength, stability, and mobility. This gap in knowledge of fibular articulation and load bearing, lends to the difficulty and inaccuracy in properly reducing the bones during syndesmotic fixation. There also lacks a clear and consistent method for syndesmotic fixation with minimal validation that dynamic fixation heeds superior post-operative results. Gaining insight on healthy syndesmosis joint motion could provide baseline measures for more realistic loading conditions of cadaveric testing various fixation devices, serve as design parameters for new device design, set a gold standard for normal range of motion (ROM) in rehabilitation, and ultimately improve diagnostic and treatment modalities for syndesmotic injury. The goals of the project were to establish a standard for the six degree of freedom (DOF) kinematics in the syndesmosis and talocrural joints in healthy active adults, as well as define the normal ROM. This was done using a high speed stereo radiography (HSSR) system to capture dual plane in-vivo motion of the bones with sub-millimeter and sub-degree accuracy. Changes in bone positioning during static and dynamic weight bearing activities were compared to a non-weight bearing neutral pose of the foot. The second scope of this work defines average values of medial and lateral clear space


We empirically evaluate the job performance effects of a 6 month part-time training program in a large retail chain, in which participants received feedback on their training success based on a final exam. The data's quasi-experimental structure allows comparison of sales revenue of trained and untrained managers before, during and after the training. We find that the training significantly increases sales of very successful participants by approximately 8% during and by 7% after the training period. However, the training has a substantial negative impact on the post-training sales performance of unsuccessful participants. The results indicate that the indirect motivational effects of training programs may be much more important than the direct effects of skill acquisition.


We report the discovery of the millisecond pulsar PSR J2043+1711 in a search of a Fermi Large Area Telescope (LAT) source with no known associations, with the Nanc¸ay Radio Telescope. The new pulsar, confirmed with the Green Bank Telescope, has a spin period of 2.38 ms, is relatively nearby (d 2 kpc) and is in a 1.48-d orbit around a low-mass companion, probably an He-type white dwarf. Using an ephemeris based on Arecibo, Nanc¸ay and Westerbork timing measurements, pulsed gamma-ray emission was detected in the data recorded by the Fermi LAT. The gamma-ray light curve and spectral properties are typical of other gamma-ray millisecond pulsars seen with Fermi. X-ray observations of the pulsar with Suzaku and the Swift X-ray Telescope yielded no detection. At 1.4 GHz, we observe strong flux density variations because of interstellar diffractive scintillation; however, a sharp peak can be observed at this frequency during bright scintillation states. At 327 MHz, the pulsar is detected with a much higher signal-to-noise ratio and its flux density is far more steady. However, at that frequency the Arecibo instrumentation cannot yet fully resolve the pulse profile. Despite that, our pulse time-of-arrival measurements have a post-fit residual rms of 2 μs. This and the expected stability of this system have made PSR J2043+1711 one of the first new Fermi-selected millisecond pulsars to be added to pulsar gravitational wave timing arrays. It has also allowed a significant measurement of relativistic delays in the times of arrival of the pulses due to the curvature of space-time near the companion, but not yet with enough precision to derive useful masses for the pulsar and the companion. Nevertheless, a mass for the pulsar between 1.7 and 2.0M can be derived if a standard millisecond pulsar formation model is assumed. In this paper, we also present a comprehensive summary of pulsar searches in Fermi LAT sources with the Nanc¸ay Radio Telescope to date.


Background National clinical guideline developers, such as the UK's National Institute for Health and Clinical Excellence (NICE), produce high quality guidelines, yet primary care practitioners (PCPs) may question the relevance of the evidence and recommendations to a primary care (PC) population. Objectives To evaluate PCPs' views about the relevance of NICE clinical guidelines to PC. Methods An online Delphi panel of 28 PCPs, recruited regionally and nationally, reviewed 14 guideline recommendations: 8 supported by PC relevant evidence and 6 by evidence from elsewhere. Panellists scored recommendations twice, on a scale of 1–9 (9 = highly relevant for PC), before and then again after reading a summary of the evidence, including study setting and population. They also commented on factors influencing guideline validity and PC implementability. Results 25 PCPs (89%) completed the Delphi. Overall mean scores were 7.4 (range 6.2–8.2) before reading the evidence summary, and 6.6 (4.6–8.3) after. Mean scores for the 8 recommendations supported by PC evidence were 7.4 before and 7.2 after (change -0.2). Mean scores for the 6 with evidence from elsewhere were 7.4 before and 5.8 after (change -1.6). Factors perceived to influence implementation included clarity, brevity, and relevance to PC. Discussion PCPs' ratings of PC guideline validity dropped when they became aware that substantial supporting evidence for the guidelines had come from non PC settings. The relevance of the evidence to PC patients was important. Implications for Guideline Developers/Users Developers should explicitly describe the relevance of available evidence for PCPs and their patients.


Introduction: A high percentage of musculoskeletal disorders in workplaces occur due to awkward posture and non-ergonomic design of the work stations for lifting and carrying of materials. To avoid these injuries, jobs should be designed in a way that ergonomics risk factors are controlled properly. The aim of this study was to utilize ergonomics interventions to minimize ergonomics risk factors in bag packing unit in a mineral processing plant. Material and Method: This cross sectional study was carried out among 20 workers of bag packing unit. Camera recording of working postures, evaluation of medical records, interview, and REBA technique were used to identify the ergonomic risk factors. Interventions included changing the conveyor belt height and the use of spring pallets (spring table). Data were analyzed using Paired T-Test by SPSS software version 18. Result: Before implementing ergonomics intervention, a total of 75% of evaluated postures by REBA technique obtained score of 8-10 (very high risk level) and 25% had score of 11-15 (very high risk level) that correspond to the action level 3 and 4, respectively. Following the implementation of ergonomics interventions, a total of 90% of the analyzed postures showed action level 2 (moderate risk level) and the remainder 10 percent of evaluated postures showed high risk level. Comparison of REBA technique scores before and after implementing interventions showed a significant difference (P-value < 0.05). Conclusion: Based on the findings of this study, the implementation of ergonomics interventions has remarkably decreased the required action level and it may be able to improve work-related postures.


The purpose of this study was to examine the scope and impact of emotional labor in early intervention. Focus groups and individual interviews were analyzed to determine the presence of emotional labor in the work, and the impact of emotional labor on participants' personal and professional activities. Findings from this study show emotional labor to be present in the work of Early Head Start home visitors. Participants experienced physical and emotional effects from managing their emotions in order to maintain an appropriate presence with families. Primary factors contributing to emotional labor include a relationship-based approach, the intimacy of the work, and the scope of work with families in poverty. Study participants identified strategies to balance the effects of emotional labor. Implications of this study suggest the need for additional investigation into emotional labor in early intervention, and the implementation of policies that will ameliorate this aspect of early intervention work.


Current Virtual Reality (VR) systems are bereft of stylization and embellishment of the user's motion - concepts that have been well explored in animations for games and movies. We present CoolMoves , a system for expressive and accentuated full-body motion synthesis of a user's virtual avatar in real-time, from the limited input cues afforded by current consumer-grade VR systems, specifically headset and hand positions. We make use of existing motion capture databases as a template motion repository to draw from. We match similar spatio-temporal motions present in the database and then interpolate between them using a weighted distance metric. Joint prediction probability is then used to temporally smooth the synthesized motion, using human motion dynamics as a prior . This allows our system to work well even with very sparse motion databases (e.g., with only 3-5 motions per action). We validate our system with four experiments: a technical evaluation of our quantitative pose reconstruction and three additional user studies to evaluate the motion quality, embodiment and agency.


Illinois Deaf Services2000 (IDS2000), a public/private partnership, promotes the creation and implementation of strategies to develop and increase access to mental health services for deaf, hard of hearing, late-deafened, and deaf-blind consumers. IDS2000 has resulted in the establishment of service accessibility standards, a technical support and adherence monitoring system,and the beginnings of a statewide telepsychiatry service.These system modifications have resulted in increase by 60% from baseline survey data in the number of deaf, hard of hearing, late-deafened, and deaf-blind consumers identified in community mental-health agencies in Illinois. Depending on the situation of deaf services staff and infrastructure, much of IDS2000 could be replicated in other states in a mostly budget-neutral manner.


Objectives Transmucosal fentanyl is used to treat transient exacerbations of cancer pain. Several immediate release products are available, presented as intranasal sprays, sublingual and buccal tablets, or lozenges. These are not interchangeable, creating potential for medication errors. We compared the incidence of medication errors in a simulated scenario using handwritten drug charts and charts labelled with preprinted self-adhesive stickers with full pictorial fentanyl prescriptions. Methods 54 nurses were shown 5 handwritten drug charts and 5 with self-adhesive pictorial labels. Nurses indicated which preparation and dose they would administer from boxes of Instanyl, Abstral, Effentora and Actiq (Nycomed, ProStrakan, Cephalon and Teva, respectively). We measured the frequency of drug administration errors and asked them to rate the prescriptions for clarity on four-point Likert items. Results The use of pictorial self-adhesive prescriptions significantly reduced errors in choice of preparation, from 20 with traditional handwritten charts to 6 with self-adhesive labels (OR 3.52, 95% CI 1.39 to 8.90, p=0.006), but the incidence of dose error was not significantly different (OR 1.47, 95% CI 0.80 to 2.70, p=0.281). Analysis of Likert items showed using pictorial printed labels significantly improved nurses' understanding of choice of preparation, dose and maximum four hourly dose (p<0.0001, p=0.006 and p=0.028, respectively). Conclusions The use of pictorial prescribing appears to be a promising strategy that could reduce medication errors in choice of fentanyl preparations. There may be a wider use for pictorial prescribing where non-interchangeable preparations of the same drug exist.


Review covering up to mid-2021The structure of polyketide and non-ribosomal peptide natural products is strongly influenced by how they are released from their biosynthetic enzymes. As such, Nature has evolved a diverse range of release mechanisms, leading to the formation of bioactive chemical scaffolds such as lactones, lactams, diketopiperazines, and tetronates. Here, we review the enzymes and mechanisms used for chain release in polyketide and non-ribosomal peptide biosynthesis, how these mechanisms affect natural product structure, and how they could be utilised to introduce structural diversity into the products of engineered biosynthetic pathways.


The problem of adolescents should get serious attention and focus on directing adolescents to a more positive direction, which focuses on creating a system to deal with delinquency among adolescents. The type of research used in this research is the evaluation research (evaluation study). The adolescent reproductive health counseling program carried out is one of a series of Field Learning Practice Programs (PBL) conducted by the Department of Public Health, Universitas Negeri Malang. To evaluate the success of this activity, an evaluation was carried out containing the pretest,posttest, and rating questionnaire. The resultsof the evaluation showed that students who studiedhealth increased from an average value of 41.47 to 90 after counseling. Based on the evaluation of the Adolescent Reproductive Health or called "Kesehatan Reproduksi Remaja"(KRR) counseling program through a questionnaire, an average score of 86.79 was obtained, which indicated that the Adolescent Reproductive Health Renewal Programwas given according to a top category. Thus, it can be concluded that supporting good health will increase knowledge about adolescent health.


This study was conducted to elucidate relationship between testicular protamine mRNA expression and spermatogenic activity in the quail as the following experiments. (+) Quail were raised under continuous light condition after hatching and body weights, testis weights, spermatogenic activity and protamine mRNA levels were determined weekly between and 2 weeks. (,) The other group of quail raised under continuous light condition up to 0 weeks after hatching were kept in either continuous light or reduced light-length (2-hour light, +0-hour darkness) conditions for weeks. At 0 and 3 weeks old, the same parameters were measured as in the foregoing experiment. Spermatogenic activity was evaluated by Bartholomew's classification after histological examination of the testis and mRNA expression of testis protamine was analyzed by Northern blot. Between and / weeks old, body weights, testis weights, and cloacal gland protrusion areas significantly increased and thereafter they stayed at plateau levels. Spermatogenic activity markedly increased from stage II to VI between and / weeks old and stayed at stage VI up to 2 weeks old. Spermatids and immature sperm were firstly observed at . weeks old. Protamine mRNA levels were also first detected at . weeks old and increased at / weeks old. A marked expression were maintained after 0 weeks old. In contrast, short daylengths treatment after 0 weeks old significantly reduced testis weights, cloacal gland protrusion areas, spermatogenic activity, and protamine mRNA levels at 3 weeks old (P *.*/) when compared to those raised under continuous light condition. Spermatogenic activity dropped from the full activity of stage VI to elongated spermatid (IV) or spermatocyte (II-III) stage after the treatment. Protamine mRNA levels also significantly decreased in response to short daylengths. These results suggest that protamine mRNA expression is highly related to spermatogenic activity in the quail.


BACKGROUND AND OBJECTIVES
Management of incidental renal artery and kidney abnormalities in patients undergoing computed tomography scans is a clinical challenge because their frequency in healthy subjects has not been precisely estimated. Therefore, the prevalence and management of these abnormalities were determined among a large cohort of potential kidney donors undergoing protocol evaluations.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS
All patients at the Mayo Clinic who underwent computed tomographic angiography and urography as part of their kidney donor evaluation between 2000 and 2008 were identified. Radiographic reports were abstracted for abnormalities of the renal arteries and kidneys. The prevalence of radiographic abnormalities was stratified by age and gender, and the effect on approval for kidney donation was determined.

RESULTS
Among 1957 potential kidney donors, the mean +/- SD age was 43 +/- 12 years, and 58% were women. The most common abnormalities were kidney stones (11%), focal scarring (3.6%), fibromuscular dysplasia (2.8%), and other renal artery narrowing or atherosclerosis (5.3%). Fibromuscular dysplasia, focal scarring, parenchymal atrophy, and upper tract dilation were more common in women. Renal artery narrowing, focal scarring, and indeterminate masses increased with age. Overall, 25% of potential donors had at least one abnormality. However, these incidental radiographic abnormalities contributed to exclusion from donation in only 6.7% of potential donors.

CONCLUSIONS
Incidental radiographic abnormalities of the renal arteries and kidneys are common. The majority of imaging findings are not perceived to be harmful enough to prevent kidney donation, but future studies are needed to determine their clinical relevance.


Conclusions. Labeling experiments using NeuroVue® Red dye allowed us to demonstrate individual afferent fiber tracks in the cochlea from the synaptic region of the inner hair cell in the organ of Corti (OC) to the spiral ganglion in Rosenthal's canal. Further optimization is necessary to obtain 3-dimensional (3D) neural distribution in the apical region for frequency mapping. Objectives. We intend to develop a method by which the radial fibers of the spiral ganglion (SG) can be individually visualized and tracked in 3D from the base to the apex of the cochlea. The combined trajectories of fibers from each cochlea could then be calculated for modeling of the 3D relationship of OC and SG in cochlear implant studies to assist in the optimization of cochlear implants for music and speech perception in noise. Materials and methods. We tested three different methods to visualize cochlear nerve fibers from OC to SG. Adult rat and mouse ears were stained with DiI dye, modified Golgi-Cox method or NeuroVue dye, sectioned or whole-mounted, and viewed with confocal or standard light microscope. Results. In DiI staining, spacial resolution and the number of neurons to be stained are too low to utilize this method to create a characteristic frequency map of the cochlea. The Golgi method mainly stained efferent nerve fibers, resulting in less information on cochlear nerve distribution. NeuroVue Red dye allowed clear tracking of individual fibers when combined with DAPI counterstaining.


We have developed an ellipsoidal mirror fluorescence detected circular dichroism (FDCD) device with enhanced detection sensitivity that eliminates the polarization artifact; this is applicable to samples with strongly polarized fluorescence. The device, JASCO FDCD465, has an ellipsoidal mirror structure with a framework consisting of three mirrors (one elliptical and two plane mirrors) that maximally collects light in the FDCD. All assemblies on the device including the ellipsoidal mirror, cylindrical cell, and photomultiplier tube (PMT) are aligned on the chamber-fitting sample mount as an attachment compatible with a standard CD spectropolarimeter. The new FDCD465 device eliminates the polarization artifact caused by anisotropic distribution of the emitted light. It represents a convenient, reliable, and sensitive FDCD attachment to the JASCO J-800 CD spectrometer series that can be used under both isotropic and photoselected conditions.


This study describes the results of a low-cost approach used to measure reported load reductions from a residential electric water heater (EWH) load control program operated as part of PJM Interconnection's Demand Response small customer pilot program. Lawrence Berkeley National Laboratory (LBNL) conducted this independent review of the engineering estimates for EWH load control reported by a Curtailment Service Provider (CSP) at PJM's request. LBNL employed low-cost measurement and verification (M&V) approaches that utilized existing interval metering equipment to monitor results for a series of load control tests. The CSP collected hourly load data for two substations and several hundred households over a six-week period in October and November 2003. During this time period, the CSP operated its electric water heater load control program during pre-specified test periods in the morning, afternoon and early evening. LBNL then analyzed substation and premise-level data from these tests in order to verify the diversified demand reductions claimed by the CSP for customers participating in the EWH load control program. We found that the observed load reductions for the premise-level data aggregated over all households in the two participating electric cooperatives were, respectively, 40 percent-60 percent less and 3 percent less-10 percent higher than the estimated diversified demand reduction values assumed by the CSP, depending on whether observed or normalized results are considered. We also analyzed sub-station level data and found that the observed load reductions during the test periods were significantly lower than expected, although confounding influences and operational problems signifiogram during pre-specified test periods in the morning, afternoon and early evening. LBNL then analyzed substation and premise-level data from these tests in order to verify the diversified demand reductions claimed by the CSP for customers participating in the EWH load control program. We found that the observed load reductions for the premise-level data aggregated over all households in the two participating electric cooperatives were, respectively, 40 percent-60 percent less and 3 percent less-10 percent higher than the estimated diversified demand reduction values assumed by the CSP, depending on whether observed or normalized results are considered. We also analyzed sub-station level data and found that the observed load reductions during the test periods were significantly lower than expected, although confounding influences and operational problems significantly limit our ability to differentiate between control-related and non-control related differences in substation-level load shape data. The usefulness and accuracy of the results were hampered by operational problems encountered during the measurement period as well as in sufficient number of load research grade interval meters at one cooperative. Given the larger sample size at one electric cooperative and more statistically-robust results, there is some basis to suggest that the Adjusted Diversified Demand Factor (ADDF) values used by the CSP somewhat over-state the actual load reductions. Given the results and limitations of the M&V approach as implemented, we suggest several options for PJM to consider: (1) require load aggregators participating in ISODR programs to utilize formal PURPA-compliant load research samples in their M&V plans, and (2) continue developing lower cost M&V approaches for mass market load control programs that incorporate suggested improvements described in this study.


'Cautious optimism' characterises many recent developments in Myanmar. In forestry, economic returns have, until recently, accrued to the government. Yet the 1995 Community Forestry Instructions, and ongoing revision of the 1992 forest law, are opening new commercial space for locally controlled forest and farm products. Community Forest User Groups are emerging to manage these resources, albeit at a pace below the government's Forest Master Plan target of 918,000 hectares by 2030. They are mobilising to sell timber, agroforestry crops, non-timber forest products (notably bamboo and rattan), eco-tourism and biomass energy. The Forest and Farm Facility is strengthening, through small grants, their business organisation and capacity. It is also initiating high-level multi-sectoral dialogue to showcase and discuss how stronger locally controlled forest and farm economies can deepen democracy.


Cardiovascular disease (CAD) is among the most prevalent diseases around the world; nevertheless, its diagnosis requires highly qualified medical staff (e.g., cardiologists) because of the many variables involved in the process. Due to diagnostic complexity and the limited number of available qualified staff, the development of smart systems that could automate the diagnostic process is paramount. This paper investigates two systems in order to achieve this goal. The first system proposes the application of a data fusion with Kalman filtering in diagnosing CAD as well as in the prediction of the need to conduct a Coronary Artery Bypass Graft (CABG) in patients identified as having CAD.The second system, which is based on a combination of Particle Swarm Optimization (PSO) and a Gravitational Search Algorithm (GSA), is also proposed. Patient data was gathered from King Abdullah Medical City in Saudi Arabia, and a statistical analysis was conducted to explore the relationship between an array of variables and CAD. After identifying pertinent variables for diagnosis, some learning algorithms (e.g., Kalman Filtering, Particle Swarm Optimization and Gravitational Search Algorithm) were applied to the collected data sets to train the system for predicting the diseased condition. The main aim of this paper is to identify the underlying functional relationship between the medical patient records and the medical diagnosis in the datasets in order to predict the presence or absence of the disease for new patients. This work takes a novel approach by using different neural networks training algorithms, e.g., Quasi Newton and Scaled Conjugate Gradient (SCG) with several activation functions on an extended Kalman filter.


As the diversity in end-user devices and networks grows, it becomes important to be able to efficiently and adaptively serve media content to different types of users. A key question surrounding adaptive media is how to do Rate-Distortion optimized scheduling. Typically, distortion is measured with a single distortion measure, such as the Mean-Squared Error compared to the original high resolution image or video sequence. Due to the growing diversity of users with varying capabilities such as different display sizes and resolutions, we introduce Multiple Distortion Measures (MDM) to account for a diverse range of users and target devices. MDM gives a clear framework with which to evaluate the performance of media systems which serve a variety of users. Scalable coders, such as JPEG2000 and H.264/MPEG-4 SVC, allow for adaptation to be performed with relatively low computational cost. We show that accounting for MDM can significantly improve system performance; furthermore, by combining this with scalable coding, this can be done efficiently. Given these MDM, we propose an algorithm to generate embedded schedules, which enables low-complexity, adaptive streaming of scalable media packets to minimize distortion across multiple users. We show that using MDM achieves up to 4 dB gains for spatial scalability applied to images and 12 dB gains for temporal scalability applied to video.


Individual transferable quota (ITQ) is a management measure that is widely discussed, not least in the reform of the European Common Fisheries Policy. While the system is expected to reduce overcapacity and improve economic performance, questions are raised concerning the future of small-scale fisheries. This paper uses a model for Swedish fisheries (the Swedish Resource Rent Model for the Commercial Fisheries, SRRMCF) where the economics and fleet structure in a potential Swedish ITQ-system are analysed. The model is an optimization model based on linear programming and data from the European Union's data collection framework. The modelling approach can readily be used by other member states. Three main conclusions can be drawn on how ITQs will affect fisheries: 1. The fishing fleet measured in number of vessels will decrease by approximately 30-50%. 2. Profitability will increase so that the fishing industry will be able to provide competitive wages and make a financial contribution to fisheries management. 3. The system can be designed so that small-scale fisheries are not disadvantaged. (Less)


In teaching a technical communication course, I introduced document design principles before discussing traditional verbal rhetoric. A comparison of the writing of two students—a competent writer and a weak one—before and after the design discussion indicates that a basic understanding of design principles helped them improve document macrostructure. They saw the need to involve the audience, to provide an introduction and a forecast, and to organize and highlight information using headings. The design discussion, however, appears to have had little effect on document microstructure. Although more research needs to be conducted to better understand the relationship between verbal and visual rhetoric in technical communication, integrating document design principles early appears to be a promising pedagogical technique.


City Limits contributes to a growing body of work under the umbrella of 'cultural criminology', which attempts to bring an appreciation of cultural change to an understanding of crime in late modernity (Hayward and Young 2004). Hayward presents an ambitious theoretical analysis that attempts to inspire a 'cultural approach' to understanding the 'crime-city nexus' and, in particular, to re-address 'strain' and the concept of 'relative deprivation' in the context of a culture of consumption. The book incorporates an impressive array of literature from beyond the boundaries of traditional criminology - including urban studies, social theory and, most strikingly, from art and architectural criticism - illustrating a multidisciplinary approach. This provides for a challenging and enlightening read, with a particularly important emphasis on the impact of consumer culture on the lived urban experience and spatial dynamics of the city and, in turn, for an understanding of transgression and criminality. Runner-up for the British Society of Criminology Book Prize (2004).


Applications in the emerging high-frequency markets for millimeter wave applications more and more use SiGe components for cost reasons. To support the technology effort, a reliable TCAD platform is required. The main issue in the simulation of scaled devices is related to the limitations of the physical models used to describe charge carrier transport. Inherent approximations in the HD formalism are discussed over different technology nodes, providing for the first time a complete survey of HD models capability and restrictions with scaling for simulation of SiGe HBTs. Moreover, a complete set of models for transport parameters of SiGe HBTs is reported, including low-field mobility, energy relaxation time, saturation velocity, high-field mobility and effective density of state. Implementation in a commercial device simulator is drawn and findings are compared with simulation results obtained using a standard set of models and with trustworthy results (i.e. MC and SHE simulation results and experimental data), validating proposed models and clarifying their reliability and accuracy over different technologies. Finally, electrical breakdown phenomena in SiGe HBTs are analyzed: a novel complete model for multiplication factor is reported and validated by experimental results; new M model provides an exhaustive accuracy over a wide range of collector voltages.


Abstract Objective: In response to the 2013–2016 Ebola virus disease outbreak, the US government designated certain healthcare institutions as Ebola treatment centers (ETCs) to better prepare for future emerging infectious disease outbreaks. This study investigated ETC experiences and critical care policies for patients with viral hemorrhagic fever (VHF). Design: A 58-item questionnaire elicited information on policies for 9 critical care interventions, factors that limited care provision, and innovations developed to deliver care. Setting and participants: The questionnaire was sent to 82 ETCs. Methods: We analyzed ordinal and categorical data pertaining to the ETC characteristics and descriptive data about their policies and perceived challenges. Statistical analyses assessed whether ETCs with experience caring for VHF patients were more likely to have critical care policies than those that did not. Results: Of the 27 ETCs who responded, 17 (63%) were included. Among them, 8 (47%) reported experience caring for persons under investigation or confirmed cases of VHF. Most felt ready to provide intubation, chest compressions, and renal replacement therapy to these patients. The factors most cited for limiting care were staff safety and clinical futility. Innovations developed to better provide care included increased simulation training and alternative technologies for procedures and communication. Conclusions: There were broad similarities in critical care policies and limitations among institutions. There were several interventions, namely ECMO and cricothyrotomy, which few institutions felt ready to provide. Future studies could identify obstacles to providing these interventions and explore policy changes after increased experience with novel infectious diseases, such as COVID-19.


Purpose: The purpose of the work is to analyze the use of solutions aimed at preventing incompatibilities and assess the effectiveness of these solutions to minimize the risk associated with the quality of manufactured products. The analysis presented in the work is based on the Poka-Yoke error prevention concept used in the selected enterprise. The paper presents the state of the company before and after the introduction of Poka-Yoke method. Approach/Methodology/Design: The research methods used in the paper were the analysis of company data, analysis of literature states, as well as methods using the Poka-Yoke concept. The company was surveyed in 2017/2018 during the system implementation. Findings: The results on the control card for nonconforming units of type "p" were also presented, where the analysis showed that the introduction of the Poka-Yoke system to the company reduced the number of nonconformities by 6.69%. Practical Implications: Implementation of the Poka-Yoke system will allow enterprises to create conditions in which an error cannot happen, or will be immediately visible. The result of such an action may be distracting operators from repetitive operations, reducing the number of deficiencies and induce immediate action when a problem occurs. Originality/Value: Showing how the use of the Poka-Yoke system affects the prevention of inadvertent error in enterprises, by determining the differences between the state of the enterprise before and after the introduction of the Poka-Yoke system, there is an opportunity to improve the economy and contribute to the social and economic sphere.


Brazil is very much rich in agriculture and forestry. The agro industry occupies an area of 28840726 ha. The more important crops are sugarcane (7080920 ha), rice (289030 ha), wheat (1853220 ha), coconut (283205 ha), cassava (1894460 ha), corn (13767400 ha) and grass (140000 ha). These crops generated 597 million tons of residues. Forest plantations in Brazil supplied 102.9 million m 3 of industrial roundwood, of which nearly half is for renewable fuelwood and charcoal. Part of this plantation output is destined for the pulp and paper industry: The renewable sources are fulfilling 46.4% of the total Brazilian energy demands. Energy forestation in Brazil includes mainly Eucalyptus and Bracatingas. In this study three biomasses abundant in the Brazil are studied: i.e. Eucalyptus, Garapeira/Peroba (wood dust) and Sewage Sludge. The wood samples (Eucalyptus and Peroba/Garapeira) have higher heating value than the sewage sludge because the wood samples have higher amounts of carbon and hydrogen than the sewage sludge. The sewage sludge has higher ash content and lower amount of volatiles and fixed carbon than the wood samples resulting in a lower heating value. The pyrolysis of eucalyptus, garapeira/peroba and sewage sludge has been studied in a thermobalance over a wide range of degradation temperatures. Between 225 °C ‐ 375 °C (for eucalyptus) and 225 °C ‐ 425 °C (for garapeira), the thermal decomposition of the biomass leads to significant weight loss. The weight loss for Eucalyptus between 265°C and 350°C is 0.48 % / °C and taking into account a heating rate of 10°C/min, the weight loss is 4.8 % /min. Garapeira has a similar behaviour than eucalyptus. The weight loss for garapeira between 265°C and 365°C is 0.4 % / °C and taking into account a heating rate of 10°C/min, the weight loss is 4 % /min. The behaviour of the sewage sludge to the increase of temperature from 25°C to 700 °C in an inert atmosphere do not show such different zones as the behaviour of the woody biomass. Between 150 °C and 235°C the weight loss of the sewage sludge was 0.07 %/°C (0.7 %/min). The highest weight loss takes place between 300 °C and 390 °C (0.15 %/°C or 1.5 %/min). In the third zone, between 500 °C and 600°C, the weight loss was 0.03 %/°C (0.3 %/min). The pyrolysis is assumed to be a first order decomposition. The activation energy (E) and the pre exponential factor …


In this paper I differentiate among empathy, sympathy and personal distress and discuss the central role of empathy-related responding in positive (including moral) development. Empathy-related responding, especially sympathy, is likely an important source of prosocial, other-oriented motivation. In fact, empathy-related responding, especially sympathy, has been associated with prosocial behaviour (voluntary behaviour intended to benefit another, e.g. helping, sharing); this relation has been obtained for both specific instances of empathy-related responding and for dispositional sympathy. In addition, sympathy (or sometimes empathy) has been linked to relatively high levels of moral reasoning and social competence, and to low levels of aggression and antisocial behaviour. In my talk, I will review research on the relation of empathy-related responding to prosocial behaviour, the consistency of costly prosocial behaviour over time and the possible role of sympathy in its consistency, and the relation of empathy-related responding to moral reasoning, antisocial behaviour and social competence. Examples of research, including longitudinal research in our laboratory, are provided to illustrate these relations. Because of its close relations to social and prosocial responding, an understanding of empathy-related responding contributes to efforts to promote children's moral development.


In the globally and knowledge based economy, the universities and other knowledge organisations are valued for their ability to contribute to the regional innovation processes. This is particularly relevant for the developing countries in South America since their R&D spending is highly concentrated on the public knowledge infrastructure. However, there are few studies examining the role of knowledge organizations at regional level in Latin America. The proposed study aims to analyse the role played by knowledge organisations in the formation of a high-tech Regional Innovation Systems in Argentina. This country has a number of attractive features relative to the positive evolution of its R&D spending and the recent implementation of a policy that promotes cooperation between firms and knowledge organisations among high-tech sectors. As evidenced in developed regions, the organisations under study play a key role in the promotion of a high-tech Regional Innovation Systems. However, this prominent role is not based on those local factors identified in the literature, such as organisational and institutional local assets, but on national science and technology policies and individual initiatives conducted by the faculties involved.


Ecosystems degradation represents one of the major global challenges at the present time, threating people's livelihoods and well-being worldwide. Ecosystem restoration therefore seems no longer an option, but an imperative. Restoration challenges are such that a dialogue has begun on the need to re-shape restoration as a science. A critical aspect of that reshaping process is the acceptance that restoration science and practice needs to be coupled with socio-economic research and public engagement. This inescapably means conveying complex ecosystem's information in a way that is accessible to the wider public. In this paper we take up this challenge with the ultimate aim of contributing to making a step change in science's contribution to ecosystems restoration practice. Using peatlands as a paradigmatically complex ecosystem, we put in place a transdisciplinary process to articulate a description of the processes and outcomes of restoration that can be understood widely by the public. We provide evidence of the usefulness of the process and tools in addressing four key challenges relevant to restoration of any complex ecosystem: (1) how to represent restoration outcomes; (2) how to establish a restoration reference; (3) how to cope with varying restoration time-lags and (4) how to define spatial units for restoration. This evidence includes the way the process resulted in the creation of materials that are now being used by restoration practitioners for communication with the public and in other research contexts. Our main contribution is of an epistemological nature: while ecosystem services-based approaches have enhanced the integration of academic disciplines and non-specialist knowledge, this has so far only followed one direction (from the biophysical underpinning to the description of ecosystem services and their appreciation by the public). We propose that it is the mix of approaches and epistemological directions (including from the public to the biophysical parameters) what will make a definitive contribution to restoration practice.


In this work the least squares method is used to reduce anisotropy in transformation optics technique. To apply the least squares method a power series is added on the coordinate transformation functions. The series coefficients were calculated to reduce the deviations in Cauchy-Riemann equations, which, when satisfied, result in both conformal transformations and isotropic media. We also present a mathematical treatment for the special case of transformation optics to design waveguides. To demonstrate the proposed technique a waveguide with a 30° of bend and with a 50% of increase in its output width was designed. The results show that our technique is simultaneously straightforward to be implement and effective in reducing the anisotropy of the transformation for an extremely low value close to zero.


Gender based differences in the prevalence rate of mental disorders are described since ancient times. In particular a strong association between female reproductive events such as sexual maturity, pregnancy, postpartum period or menopause and mental illness was described and mainly used to describe the female sex as the weak and emotionally instable one. In this review mental disorders associated with specific stages of female life history are analyzed and interpreted from the viewpoint of evolutionary medicine. In particular the association between female adolescence and eating disorders, reproductive phase and postpartum depression and depression during post menopause are focused on using an evolutionary approach. From that viewpoint mental disorders associated with female life history events seem to be adaptive to some degree, but mental disorders may also be interpreted as a result of the mismatch between recent life circumstances and the environment in which our ancestors evolved.


This research explores the effect of industrialization on the process of development. In contrast to conventional wisdom that views industrial development as a catalyst for economic growth, the study establishes that while the adoption of industrial technology was conducive to economic development in the short-run, it has detrimental effects on the standard of living in the long-run. Exploiting exogenous geographic and climatic sources of variation in the diffusion and adoption of steam engines across French departments during the early phases of industrialization, the research establishes that intensive industrialization in the middle of the 19th century increased income per capita in the subsequent decades but diminished it by the turn of the 21st century. The analysis further suggests that the adverse effect of earlier industrialization on long-run prosperity can be attributed to the negative impact of the adoption of unskilled-intensive technologies in the early stages of industrialization on the long-run level of human capital and thus on the incentive to adopt skill-intensive technologies in the contemporary era. Preferences and educational choices of second generation migrants within France indicate that industrialization has triggered a dual techno-cultural lock-in characterized by a reinforcing interaction between technological inertia, reflected by the persistence predominance of low-skilled-intensive industries, and cultural inertia, in the form of a lower predisposition towards investment in human capital. These findings suggest that the characteristics that permitted the onset of industrialization, rather than the adoption of industrial technology per se, have been the source of prosperity among the currently developed economies that experienced an early industrialization. Thus, developing economies may benefit from the allocation of resources towards human capital formation and skilled intensive sectors rather than toward the promotion of traditional unskilled-intensive industrial sectors.


This paper attempts to deal with a short passage found at the end of the third chapter of the Huai Nan tzu book, a compendium of learning assembled in about 120 B.c. under the patronage of the prince Liu An I first became interested in it after reading the tantalizing reference in Needham (SCC, III, 224). (It occurs to me that the preceding sentence or some variant of it is likely to occur in learned journals with a high frequency for the next 50 years at least.) My first efforts to understand the original text led me to the conclusion that it was unique in a number of ways and had points of interest that did not fully appear in the version of Maspero, 1929, 348 ff. Professors A. C. Graham and D. C. Lau both gave very generously of their time in discussions of my first draft. Professor Graham raised the question of possible Mohist influences and brought to my notice a commentary by the Ch'ing scholar Ch'ien T'ang , Huai Nan tzu t'ien wen hsün pu chu c. 1788. I did not feel able to follow Ch'ien in all he wrote, but was relieved to find that we reached the same general conclusions about what the text was saying, although Ch'ien seems to miss much that is important. While there are still some obscurities of language in what appears to be a rather corrupt text, I offer the version given here with a fair degree of conviction that it does not substantially misrepresent the intentions of the unknown author. Any errors that I have obstinately retained despite the helpful advice given to me throughout the time I was engaged on this work are, of course, my responsibility alone.


This article investigates the intertextual and thematic links of Wilde's Salome with French Romantic and Decadent literature. Its primary focus is on the possible connection between the play and two of Balzac's novellas, Seraphita and La Fille aux yeux d'or. There are explicit references to the latter text in Salome, but the main link between them is a shared concern with sexuality and gender. Themes like androgyny, incest, homo- and bisexuality recur in them, as does the symbol of the green flower, in order to question what is "natural". Gautier, Baudelaire and Huysmans also contribute to this intertext; but in the last analysis Wilde is selective and quite independent of his predecessors.


BY CHARLES CRAWFORD Former British Ambassador to Bosnia-Herzegovina It is now three years since the General Framework Agreement for Peace in Bosnia and Herzegovina--usually known as the Dayton Accords--was signed in Paris on December 14, 1995. We now may take stock. First, the good news. Following Dayton an unprecedented international military and civilian pro-Bosnia effort was mobilized. In record time it has restored normal daily life in most parts of the country. Under close NATO-led supervision the rival ethnic armies have returned to barracks. Electricity, gas, water and other services have been repaired. Bosnians can travel reasonably easily between Bosnia and Herzegovina's two constituent entities, Republika Srpska and the Federation of Bosnia and Herzegovina, thanks to new ethnically neutral car license plates and reforms in the entity police forces. The World Bank has been promoting modern public financing and transparency. European customs teams have done an outstanding job in reducing smuggling and attendant corruption. The politics of the situation are likewise very different. Former enemies now calmly discuss the country's future in a way unthinkable in 1996. High Representative Carlos Westendorp has pushed media reform across the country, giving a voice to the moderate opposition. I witnessed these changes during my time in Bosnia and Herzegovina from July 1996 to July 1998. When asked by visitors to asses the situation, I would respond that it remained bad but was a marked improvement over the catastrophic conditions a few months earlier. When the war ended, Sarajevo was seen as an appalling symbol of failure by the international community. Today, a first-time visitor to Sarajevo will find many buildings still devastated or damaged, but the city is alive and busy once again - not yet a success, but at least a symbol of rebirth and hope. The bad news is that the Dayton accords stopped the war in Bosnia and Herzegovina without ending it. Politicians on all sides have continued to pursue war by other means, trying to consolidate war-time gains and secure more territory for their ethnic community. Despite intense international efforts to return Bosnians to their pre-war homes, maneuvers by pro-Karadzic extremists aimed at preserving the results of earlier ethnic cleansing have prevented displaced Bosniacs and Croats from returning to Republika Srpska. Few Serbs have returned to the Federation. On paper every Bosnian citizen enjoys full civil rights across the country. In practice three separate ethnic administrations each favor "their" community and discriminate against the others. The Dayton process aimed to re-unite the country. Yet despite Dayton's successes, Bosnia and Herzegovina in many respects is still as divided as it was when the war ended. Why? First and foremost, Dayton built the peace process around the very political movements and leaders who conducted the war, thus entrenching a divisive ethnic approach to post-war Bosnian politics. Second, the Accords did not create a firm civilian implementation structure. Third, insufficient attention was given to the implications of non-cooperation by Bosnia and Herzegovina's neighbors in Belgrade and Zagreb. It is not surprising that on the Bosnian side the Dayton negotiations were led in effect by the three political movements (Bosniac, Serb and Croat) which depended most heavily on ethnic mobilization: these movements defined the Bosnian problem for the international community and they alone could deliver the three rival armies. It also is not surprising that the resulting vision of democracy enshrined in the new Bosnia and Herzegovina constitution agreed at Dayton is unsatisfactory. This constitution provides for elections to the Bosnia and Herzegovina three-person Presidency on an ethnic/territorial basis. Accordingly, the Presidency now consists of one Bosnian and one Croat, each directly elected from the territory of the Federation, and one Serb directly elected from the territory of Republika Srpska. …


Energy Storage Systems (ESSs) has an important role in Active Distribution Networks (ADNs). Within this context this paper focuses on the problem of ESSs optimal siting and sizing. Following similar approaches already proposed by the Authors, this paper uses a multi-objective procedure to account various ancillary services that can be provided by ESSs. The proposed procedure takes into account the voltage support and network losses minimization along with minimization of the cost of energy from external grid. For the case of large-scale problems, accounting networks with large number of nodes and scenarios, the selection of the solution methodology is a non-trivial problem. In this respect, the paper proposes and discusses the applicability of the Alternative Direction Method of Multipliers in order to provide an efficient algorithm for large-scale networks that also provide a solution to the optimality aspect. A real large-scale network with real profiles of load and distributed photovoltaic generation is used as the case study to analyze the effectiveness of the proposed methodology.


The behaviour of the chemical hybridising agent, WL84S11, was studied on diverse plant systems. Information about its effect on germinating seeds and on growth of the unicellular alga Chlorella was used to complement information obtained from direct studies on pollen. Although work with germinating seeds showed that WL8481J affects coleoptile and root growth somewhat differently, there were similarities between the responses of the seed and algal systems. In both cases, WL848i l has two separate effects: at lowWL84811 concentrations, much higher concentrations of proline (the amino acid implicated in determining pollen viability, of which WL84S11 is an analogue) cannot overcome its effect significantly; however, at high WL84S11 concentrations the same concentration of proline significantly reduces the effect of WL84811. WL84811 causes the production of giant algal cells which fail to divide normally until the cells are returned to medium without WL84811. Azetidine-2-carboxylic acid (A2C), the naturally-occurring isomer of WL84811 also inhibits growth in both systems but proline is unable to ameliorate its effect at any concentration. In vivo pollination experiments showed that the gametocidal effect of WL84811 is expressed solely through the pollen, which is prevented from germinating. The development of wheat pollen is severely affected by stem-injection with WL84811 and is unable to germinate in vitro. No such effect is apparent with rye pollen. Addition of WL8481J to the germination medium has little effect on pollen germination of either the bi- or trinucleate pollen tested. In some cases pollen tube length is reduced by WL84S11 and in other cases it is increased; some pollen may utilise the compound as a nitrogen source after germinating.WL848] 1 does not appear to act in the same way as its isomer A2C, at least at higher concentrations. It may be involved in some aspect of wall formation common to the division of algae, root and coleoptile extension and pollen tube growth.


Yellow passion fruit ( Passiflora edulis var. flavicarpa ) is emerging as an important high value horticultural crop in Kenya since its introduction five years ago. The fruit is gaining wide adoption in Mbeere Sub County due to its apparent adaptation to the hot arid conditions and tolerance to Fusarium wilt disease. However, the current production levels of the fruit are low due to poor water and nutrient management, erratic rainfall and poor agronomic practices. A study was conducted to assess the agronomic practices and main constraints among the farmers in Mbeere Sub County. A stratified random sampling procedure was used to collect data from 63 households from a total population of 170,950. Data was collected on household demographics, farm size, farming systems, planting materials, fertilizer use and irrigation types. This was carried out through personal interviews with members in each household responsible for management of passion fruit orchards using structured and semi-structured questionnaires. The results indicate that the majority of the farmers (65%) grow yellow passion as an intercrop with other food crops. Nevertheless, passion contributes to <10% of the proportion of the farm, though this proportion is expected to increase with expansion in production. Major findings indicate that the main source of planting materials were seedlings from KARLO (44%), use of Yaramillar (44%) as the preferred planting fertilizers and irrigation of crops three times per week (49%). In conclusion, yellow passion is a fruit with potential for increased adoption but more detailed studies are needed to clearly identify and understand water and nutrient management.


The gut microflora of the honey bee, Apis mellifera, is receiving increasing attention as a potential determinant of the bees' health and their efficacy as pollinators. Studies have focused primarily on the microbial taxa that appear numerically dominant in the bee gut, with the assumption that the dominant status suggests their potential importance to the bees' health. However, numerically minor taxa might also influence the bees' efficacy as pollinators, particularly if they are not only present in the gut, but also capable of growing in floral nectar and altering its chemical properties. Nonetheless, it is not well understood whether honey bees have any feeding preference for or against nectar colonized by specific microbial species. To test whether bees exhibit a preference, we conducted a series of field experiments at an apiary using synthetic nectar inoculated with specific species of bacteria or yeast that had been isolated from the bee gut, but are considered minor components of the gut microflora. These species had also been found in floral nectar. Our results indicated that honey bees avoided nectar colonized by the bacteria Asaia astilbes, Erwinia tasmaniensis, and Lactobacillus kunkeei, whereas the yeast Metschnikowia reukaufii did not affect the feeding preference of the insects. Our results also indicated that avoidance of bacteria-colonized nectar was caused not by the presence of the bacteria per se, but by the chemical changes to nectar made by the bacteria. These findings suggest that gut microbes may not only affect the bees' health as symbionts, but that some of the microbes may possibly affect the efficacy of A. mellifera as pollinators by altering nectar chemistry and influencing their foraging behavior.


Background: Tonsillitis is a common infectious disease contributing to significant social-economic impact worldwide. Like other infectious diseases, the determination of the pathogenic agents is important in antibiotic selection for the medical treatment of tonsillitis. Data on bacteriology of tonsillitis in Tanzania is scarce. The aim of this study was thus to determine the prevalence and bacteriology of tonsillitis in one of the largest tertiary hospital in Tanzania.
Methods: Descriptive cross-sectional study was conducted involving 485 patients at Muhimbili National Hospital, from June to December 2016. Data was collected using specially designed questionnaires. Laboratory isolation of bacterial pathogens implicated in tonsillitis followed by consequent antimicrobial susceptibility testing was doneat the Country's largest laboratory. Gathered data was then analyzed using the SPSS program version 20.
Results: A total of 485 patients were recruited in the study, where majority were females (55.7%) and the mean age was found to be 27.7 years. Out of 485 patients 100(20.6%) had tonsillitis. Male preponderance was found (51%). The most affected age group was 1-10years (42.6%). Nearly 25% of patients had family history of tonsillitis with siblings being commonly affected. The isolated bacteria were Coagulase negative staphylococcus 41.7%, S. pyogenes 40%, Bacillus species 8.3%,K.pneumoniae 5.8%, E.Coli 2.5% and P.aeruginosa 1.7%. S.pyogeneswassusceptible to Ceftriaxone 95.7%; Azithromycin 93.6%; Doxycline 91.5%; Clindamycin 87.2%; Ampicillin 80.9%; Erythromycin 74.5%; Amoxiclav 59.6% and resistant to penicillin G(38.3%).
Conclusion: Tonsillitis was found to be prevalent in our setting with young individuals being most commonly affected. Male preponderance was found in this study and family history of tonsillitis was depicted in nearly 25% of patients.  Majority had recurrent tonsillitis and S. pyogenes was found to be the commonest isolated pathogenic bacterium and was susceptible to most of the drugs available in our setting though it was found to be resistant to penicillin G.


The research programme described in this thesis examines the theoretical and practical aspects of visual degradation caused by vibration. Initially, the published literature was reviewed in two areas: the effects of vibration on visual performance and the influence of display parameters on legibility under normal and vibration-degraded viewing conditions. A series of eight experiments were then conducted to assess visual performance and display legibility with reading and threshold detection tasks presented on cathode ray tube displays. The first experiment compared the visual degradation caused by sinusoidal and narrow-band random vibration in the frequency range 2.5 to 31.5 Hz. Random vibration produced a significantly smaller reading performance decrement than sinusoidal vibration. This finding was attributed to the greater probability of low image velocity with the random vibration stimuli and, in a follow-up experiment, velocity-based predictions accounted for the visual performance decrements due to laboratory-simulated aircraft vibration. A comparison of the effects of whole-body, display and simultaneous whole-body and display vibration showed that at frequencies below 4 Hz, vibration of the display resulted in the largest performance decrement and simultaneous vibration of observer and display, the least. In a second series of experiments, display parameters (horizontal and vertical character separation, contrast, font and symbol definition) were manipulated during static and vibration-degraded viewing conditions. Vertical separation was found to be a more significant variable than horizontal separation and tentative guidelines for character separation were stated. The relationship between contrast and legibility was shown to be quadratic during static and vibration-degraded viewing conditions. Optimum legibility occurred in the contrast range 60 to 88% . The determination of font and symbol definition requirements showed that for characters of equal subtense, 7x9 dot-matrix characters were significantly more legible than 5x7 characters during whole-body vibration. Differences between two frequently recommended fonts, the Huddleston and Lincoln Mitre, were not apparent at 7x9 definition although at 5x7 definition the Huddleston font was responsible for significantly fewer reading errors. In the final experiment, the spatial filtering characteristics of vibration were examined. In addition to an alphanumeric reading task, contrast thresholds for sinusoidally modulated grating patterns were determined during whole-body vibration. It was shown that the effects of vibration could be conceived as low-pass spatial filtering and the implications of this finding for simulating the effects of vibration were discussed. The overall findings of the experimental programme have been summarised and areas for future research discussed.


Chris Okasaki showed how to implement red-black trees in a functional programming language. Ralf Hinze incorporated even the invariants of such data structures into their types, using higher-order nested datatypes. We show how one can achieve something very similar without the usual performance penalty of such types, by combining the features of nested datatypes, phantom types and existential type variables.


Water repellents and water-repellent preservatives increase the durability of wood by enabling the wood to repel liquid water. This report focuses on water-repellent finishes for wood exposed outdoors above ground. The report includes a discussion of the effects of outdoor exposure on wood, the characteristics of water repellent and water-repellent preservative formulations, and methods for applying these finishes.


Evaluating the seismic performance of concrete dams requires nonlinear dynamic analysis of two- or three-dimensional dam–water–foundation rock systems that include all the factors known to be significant in the earthquake response of dams. Such analyses are greatly complicated by interaction between the structure, the impounded reservoir and the deformable foundation rock that supports it, and the fact that the fluid and foundation domains extend to large distances. Presented in this report is the development of a direct finite-element (FE) method for nonlinear earthquake analysis of two- and three-dimensional dam–water–foundation rock systems. The analysis procedure applies standard viscous-damper absorbing boundaries to model the semi-unbounded fluid and foundation domains, and specifies at these boundaries effective earthquake forces determined from a ground motion defined at a control point on the ground surface. This report is organized in three parts, with a common notation list, references, and appendices at the end of the report. Part I develops the direct FE method for 2D dam–water–foundation rock systems. The underlying analytical framework of treating dam–water–foundation rock interaction as a scattering problem, wherein the dam perturbs an assumed "free-field" state of the system, is presented, and by applying these concepts to a bounded FE model with viscous-damper boundaries to truncate the semi-unbounded domains, the analysis procedure is derived. Step-by-step procedures for computing effective earthquake forces from analysis of two 1D free-field systems are presented, and the procedure is validated by computing frequency response functions and transient response of an idealized dam–water–foundation rock system and comparing against independent benchmark results. This direct FE method is generalized to 3D systems in Part II of this report. While the fundamental concepts of treating interaction as a scattering problem are similar for 2D and 3D systems, the derivation and implementation of the method for 3D systems is much more involved. Effective earthquake forces must now be computed by analyzing a set of 1D and 2D systems derived from the boundaries of the free-field systems, which requires extensive book-keeping and data transfer for large 3D models. To reduce these requirements and facilitate implementation of the direct FE method for 3D systems, convenient simplifications of the procedure are proposed and their effectiveness demonstrated. Part III of the report proposes to use the direct FE method for conducting the large number of nonlinear response history analyses (RHAs) required for performance-based earthquake engineering (PBEE) of concrete dams, and discusses practical modeling considerations for two of the most influential aspects of these analyses: nonlinear mechanisms and energy dissipation (damping). The findings have broad implications for modeling of energy dissipation and calibration of damping values for concrete dam analyses. At the end of Part III, the direct FE method is implemented with a commercial FE program and used to compute the nonlinear response of an actual arch dam. These nonlinear results, although limited in their scope, demonstrate the capabilities and effectiveness of the direct FE method to compute the types of nonlinear engineering response quantities required for PBEE of concrete dams.


Chronic potassium deficiency results in progressive tubulointerstitial injury, associated with augmented renal ammoniagenesis. We investigated the role of elevated renal ammonia levels and the interaction of ammonia with the complement system in this injury. Potassium deficiency was induced in rats by feeding a low potassium diet. Experimental animals received 150 mM NaHCO3 or equimolar NaCl, as drinking water. After 3 wk, NaHCO3 supplemented rats demonstrated decreased ammonia production, less renal hypertrophy, less histologic evidence of injury, and less proteinuria. In in vitro studies on normal cortical tubular fragments, the addition of ammonia to serum in concentrations comparable to renal cortical levels in potassium-deficient animals significantly increased tubular deposition of C3 as quantitated by a radiolabeled antibody binding technique. Thus, alkali supplementation reduced chronic tubulointerstitial disease in a rat model of hypokalemic nephropathy. We propose that increased cortical ammonia levels contribute to hypokalemic nephropathy through ammonia-mediated activation of the alternative complement pathway.


We propose a class of left-right symmetric models (LRSMs) with spontaneous $D$-parity breaking, where $SU(2{)}_{R}$ breaks at the TeV scale while discrete left-right symmetry breaks around $1{0}^{9}\text{ }\text{ }\mathrm{GeV}$. By embedding this framework in a nonsupersymmetric $SO(10)$ grand unified theory (GUT) with Pati-Salam symmetry as the highest intermediate breaking step, we obtain ${g}_{R}/{g}_{L}\ensuremath{\approx}0.6$ between the right- and left-handed gauge couplings at the TeV scale. This leads to a suppression of beyond the Standard Model phenomena induced by the right-handed gauge coupling. Here we focus specifically on the consequences for neutrinoless double beta decay, low-energy lepton flavor violation, and LHC signatures due to the suppressed right handed currents. Interestingly, the reduced ${g}_{R}$ allows us to interpret an excess of events observed recently in the range of 1.9 to 2.4 TeV by the CMS group at the LHC as the signature of a right-handed gauge boson in LRSMs with spontaneous $D$-parity breaking. Moreover, the reduced right-handed gauge coupling also strongly suppresses the nonstandard contribution of heavy states to the neutrinoless double beta decay rate as well as the amplitude of low-energy lepton flavor violating processes. In a dominant type-II seesaw mechanism of neutrino mass generation, we find that both sets of observables provide stringent and complimentary bounds which make it challenging to observe the scenario at the LHC.


CD4+CD25+ T cells (Tregs) play a critical role in maintaining dominant peripheral tolerance, and pathogenic autoreactive T cells may be frequent in the CD25‐negative fraction of peripheral blood mononuclear cells (PBMCs) from patients with autoimmune disease. We therefore investigated whether T cell autoimmune responses to recombinant GAD65 can be detected by the use of ELISPOT assay in the CD25‐negative fraction of PMBCs from Japanese type 1 diabetes (T1D) patients. The frequency of CD4+CD25+ T cells was not different among patients with newly developed T1D, established T1D, and healthy controls. The CD25 positive cell–depleted fraction was obtained by negative selection with antihuman CD25 magnetic beads, reducing the number of CD4+CD25+ T cells from 4–5% to less than 1%. In whole PBMC fraction, there was a significant elevation of IFN‐γ spots in PBMCs from recently diagnosed patients with T1D (P < 0.05), whereas the number of IFN‐γ spots from patients with established T1D was not significant. In the CD25‐negative fraction, unlike whole PBMCs, we observed the significant IFN‐γ spots to GAD65 in the fraction from patients with established T1D (P < 0.05), but not in those with recently diagnosed disease. The phenomena were not observed for IL‐4 spots. Our data suggest a possible role of Tregs maintaining dominant peripheral tolerance in T1D and application of further improved T cell assay detecting autoimmunity even in established T1D.


Andrew Motion's new book opens with a sequence of war poems (first published as the pamphlet "Laurels and Donkeys", on Armistice Day 2010), drawing on soldiers' experiences of war from 1914 until today - beginning with a story about Siegfried Sassoon and moving via World War Two and Korea to the recent conflicts in Iraq and Afghanistan. Many of the poems are in the voices of combatants, others are based on memories of the poet's father, who landed at D-day and fought in France and Germany. The poems combine understatement with a clear-eyed and unswerving candor. "The Customs House" has other rooms: a group of topographies, mapping moments in a marriage against the contingencies of place and family history; and several 'found poems', in which the poet collaborates with his source, mixing what is there already with what is about to be there: whether a remarkable sonnet sequence on the last days of the Baroque genius Francesco Borromini, or in other poems a richly imagined extrapolation from the silent premises of a painting.


Electrical Impedance Tomography can provide images with well-defined characteristics using a fully non-linear reconstruction process when appropriate constraints are imposed on the solution to allow the ill-posed inverse problem to be solved. Using appropriate finite element discretizations for forward solution and inverse problem offers additional advantages in the image reconstruction process, such as (a) inclusion of prior knowledge, (b) generic model templating to adapt to, for example, individual head shapes, and (c) obtaining accurate results without unnecessary computational overhead. We have developed an efficient 3D non-linear reconstruction algorithm based on a regularized inverse conjugate gradient solver which incorporates (a) local image smoothness constraints, and (b) a number of optimisations which reduce the computing power required to obtain an accurate solution. We show results from applying this to various problems which arise in medical resistivity reconstruction given only surface potential measurements and demonstrate the importance of the FE discretization. Keywords: 3D non-linear electrical impedance tomography, FE template modelling, optimal finite element meshes, 3D visualization, FE discretization.


We present a general framework for analyzing tradeoffs when designing systems in which an agent with limited computational resources is required to respond in a timely manner to situations arising in a dynamic environment. These tradeoffs are characterized in terms of architectural constraints that limit the computational alternatives available to the agent. We apply the framework to a design problem in which the designer is given a set of controllers, each of which is capable of responding to a subset of situations, and a model of the run-time dynamics that can be used to predict the sets of situations that might arise over time. Exactly one controller is active at any moment, and a fixed time delay is required to activate a controller. Additional architectural constraints limit the number of controllers that are capable of being activated. The objective is to design (off-line) a strategy for activating and deactivating controllers that guarantees that there will be an active controller capable of responding no matter what situation arises. We provide an asymptotic analysis for this design problem, describe exact and approximate algorithms for the off-line design, and sketch how the framework can be applied to real-time avionics scheduling. We argue that the architectural constraints of this design problem model a rich class of planning and control systems.


In 1919, Ramanujan initiated the study of congruence properties of the integer partition function p(n) by showing that p(5n+ 4) ≡ 0 (mod 5) and p(7n+ 5) ≡ 0 (mod 7) hold for all integers n. These results attracted a lot of interest in the mathematical community and inspired other mathematicians to investigate the divisibility of various classes of integer partitions. The purpose of this thesis is to illustrate the use of generating series in the study of the residue classes of integer partition values. We begin by presenting the work of Mizuhara, Sellers and Swisher in 2015 on the residue classes of restricted plane partitions numbers. Next, we introduce Ramanujan's Conjecture regarding Ramanujan Congruences. Moreover, we use modular forms to present Ahlgren and Boylan's resolution of Ramanujan's Conjecture from 2003. Then, we discuss the open problems surrounding the distribution of the integer partitions values into residue classes and present Judge, Keith and Zanello's work from 2015 on the the distribution of the parity of the partition function. We continue by introducing m−ary partitions and provide an account of Andrews, Fraenkel and Sellers' work from 2015 and 2016 which yielded a complete characterization of the congruence classes of m−ary partitions with and without gaps. Finally, we present new results regarding the complete characterization of the residue classes of coloured m−ary partitions with and without gaps.


Abstract Objective Numerous localities have mandated that chain restaurants post nutrition information at the point of purchase. However, some studies suggest that consumers are not highly responsive to menu labelling. The present qualitative study explored influences on full-service restaurant customers' noticing and using menu labelling. Design Five focus groups were conducted with thirty-six consumers. A semi-structured script elicited barriers and facilitators to using nutrition information by showing excerpts of real menus from full-service chain restaurants. Setting Participants were recruited from a full-service restaurant chain in Philadelphia, Pennsylvania, USA, in September 2011. Subjects Focus group participants were mostly female, African American, with incomes <$US 60 000, mean age 36 years and education 14·5 years. At recruitment, 33 % (n 12) reported changing their order after seeing nutrition information on the menu. Results Three themes characterized influences on label use in restaurants: nutrition knowledge, menu design and display, and normative attitudes and behaviours. Barriers to using labels were low prior knowledge of nutrition; displaying nutrition information using codes; low expectations of the nutritional quality of restaurant food; and restaurant discounts, promotions and social influences that overwhelmed interest in nutrition and reinforced disinterest in nutrition. Facilitators were higher prior knowledge of recommended daily intake; spending time reading the menu; having strong prior interest in nutrition/healthy eating; and being with people who reinforced dietary priorities. Conclusions Menu labelling use may increase if consumers learn a few key recommended dietary reference values, understand basic energy intake/expenditure scenarios and if chain restaurants present nutrition information in a user-friendly way and promote healthier items.


In the analysis of hand samples for barium and antimony levels indicative of gunshot residue, severe problems are encountered with swabs contaminated by blood, dirt, or grease. These problems originate from two main sources: decreased effectiveness of sample leaching and high instrumental backgrounds. When the flameless atomic absorption spectroscopy (FAAS) method developed in our laboratory [1] is used, the choice of sample collection materials is restricted to those that can be easily separated from the elements of interest. In our approach, a sample such as a cotton swab is leached with dilute nitric acid to extract any residues present. Surface contamination may make the swab impervious to solvent penetration and, therefore, inefficient leaching occurs. Contaminants such as blood, dirt, or grease on the sample can coat any primer residue particles present and prevent their dissolution in the acid, resulting in the amount of the elements of interest being lower in the solution than expected. The measured level of these elements will thus be lower than that actually present in the sample. Increasing the contact time between solvent and sample, or rigorous agitation to improve solvent attack, usually results in enhancement of the background response during the atomization phase of the AA analysis with no improvement in analytical results. This enhanced background, especially notable at the 217.6- and 217.9-nm (2176- and 2179-A) lines used for antimony detection, may be attributed to light scattering by organic materials not completely destroyed during the drying and ashing cycle of the AA determination. Destruction of the matrix by ashing of the samples prior to analysis significantly decreases the analytical background and eliminates leaching difficulties.


The present article looks at a section of Estonian translation history, through the criticism and practice of translation of an extremely prolific and well-known Estonian translator and reviewer of translations Marta Sillaots (1887–1969). Touching upon the issue of the aging of translational texts as well as the norms of translational behavior in the Estonia of the first half of the 20th century, the article makes use of Peeter Torop's concepts of the explicit poetics of translation (theoretical ideas about translation expressed in paratexts) and implicit poetics of translation (translational choices inside translations) in an attempt to map the translational thought of Marta Sillaots. Firstly, the explicit poetics of translation of Marta Sillaots is analyzed by focusing on the recurring topics and keywords in Sillaots' translation reviews, published in a monthly literary journal Eesti Kirjandus during the 1920s and 1930s. Secondly, the implicit poetics of Marta Sillaots' translations is analyzed based on a comparative corpus of two novels translated by Sillaots and their later editions: Romain Rolland's Jean-Christophe 1936 and 1958 (edited by Henno Rajandi) and Charles Dickens' David Copperfield 1937 and 1991 (edited by Lia Rajandi). Although the originals are held close at hand, the translations are approached as facts in Estonian cultural space, and thus the focus is on the translation rather than on the original. In comparison with the first edition, the changes made by the editors reveal a pattern of movement towards greater fluency by standardizing the word order, adding linking devices and making the constructions confirm to the rules of target language.The comparison of the explicit and implicit poetics of Sillaots reveals certain conformities as well as inconsistencies. In reviewing translations by other translators, Sillaots traditionally balances between the terms good and bad translation. Firstly, for her, a precondition for a good translation is the connection between the translator and the original that can be expressed by a theoretical interest of the translator in the original author or in a similarity of their literary styles. Secondly, Sillaots emphasizes the need to lead the reader to the translational text by a comprehensive foreword, something that she, as a translator, always tried to do. But most importantly, Sillaots finds it necessary for the translators to educate the Estonian readers, first by the choice of authors to translate and second by the language of translation, which has to be in accordance with the norms of grammar and style of the target language.However, the comparative analysis of her translations to their later editions shows that, although never adding any lexical items, Sillaots often used sentence structure, word order as well as minimal collocation in order to convey what, according to her, was the style of the original author. This practice distanced her translations somewhat from what is regarded as adherence to the rules of Estonian text formation. Sillaots remains an important part of Estonian translation history because of the number of her translations as well as for her poetics of translation.


Sulkunen, P. (2015). The images theory of addiction.  The International Journal Of Alcohol And Drug Research, 4 (1), 5-11. doi: http://dx.doi.org/10.7895/ijadr.v4i1.191 In everyday language, addiction usually refers to a strong desire that drives people to continue habitual behaviour despite acknowledged harm and their own will to quit. Many theorists and practitioners have long rejected the concept because of its tendency to individualize problem behavior, to focus on treatment rather than prevention, and to limit harmful consequences unduly to a selected group of users. There is no commonly accepted etiology of, or evidence-based treatment for, the condition, and diagnostic definitions are based on syndromes only. This article argues that the objections are not valid if we understand addiction as a generic concept, defined in terms of characteristics shared by several specific types, of which some are called prototypes. Addictions involve neurological adaptations but are not caused by them. They always emerge from culturally regulated behaviours, they are processes rather than on-off conditions, and involve types and pathways that depend on the social conditions in which they evolve. Addicted and normal uses are closely related and governed by images that define the functions, norms, meanings and use-values of the behavior. These will be transformed as addictions develop. The Images Theory of Addiction opens the way to understanding cultural variations in the addictive process, as well as to identify particularly risky images of potentially addictive behaviors. The theory is illustrated with examples from recent comparative studies.


Three explanations regarding the prediction that early career success will moderate the relationship between cognitive ability and career attainment are presented along with an empirical examination of this issue. Using longitudinal data provided for 156 managerial, professional, and technical employees, significant moderating effects for an age-graded index of early career success were observed. The relationships between two measures of cognitive ability and later career job level were stronger for individuals identified as below average with respect to early career success than for their above average counterparts. These results agree with the proposition that the acquisition of knowledge, skills, and information is particularly dependent upon cognitive ability for inhviduals competing without the advantages associated with early career signals of high potential.


In mirror reflections, visual stimuli in near peripersonal space (e.g., an object in the hand) can project the retinal image of far, extrapersonal stimuli "beyond" the mirror. We studied the interaction of such visual reflections with tactile stimuli in a cross-modal congruency task. We found that visual distractors produce stronger interference on tactile judgments when placed close to the stimulated hand, but observed indirectly as distant mirror reflections, than when directly observed in equivalently distant far space, even when in contact with a dummy hand or someone else's hand in the far location. The stronger visual-tactile interference for the mirror condition implies that near stimuli seen as distant reflections in a mirror view of one's own hands can activate neural networks coding peripersonal space, because these visual stimuli are coded as having a true source near to the body.


Abstract Background and Objectives: Chronic stress contributes to psychopathology and the practise of yoga is suggested to decrease stress and improve well-being. However, the literature often reports methodological problems (cross-sectional designs, sample sizes ≤ 20, and limited exploration of community populations). The aim of this study was to address these limitations and evaluate the potential psychological benefits of yoga to a non-clinical population. Methods: Women (N = 116) reporting chronic stress participated in this longitudinal study. Participants were allocated to a twice-weekly, hour-long yoga class for a period of two months, or a waitlist-control. Indicators of psychological well-being were measured at baseline, post-test and one-month follow-up. Results: Psychological distress decreased over time in both groups, however the control group experienced decreases in positive effect compared with the yoga group. Curvilinear trends were observed, indicating that trajectories of improvement seen at post-test were not robustly seen at follow-up. Conclusion: The study indicates that short-term yoga practise may yield some benefits to stressed individuals, but that evaluation over a longer term of practise may be required to determine the optimal dose for improvements and maintenance. Differential treatment effects may be difficult to detect in studies with populations that may already be motivated to improve their health.


This paper draws upon selected findings from a small scale qualitative study of the situated practice of health visitors. The study was carried out in a context of local organisational change, after the merger of two primary care trusts in the north of England, and emergence of national policy drivers positioning health visitors in a leadership role in the delivery of integrated services to children and families. The findings from four focus groups give grounded and context specific examples of the types of knowledge that health visitors value and ways in which they exchange knowledge and draw upon the distributed knowledge and expertise of others. The results are interpreted through the lenses of different discourses of knowledge and barriers to change are identified through an iteration between practice-based narrative and theoretical frameworks. These barriers include: dominance of linear and hierarchical transmission models of knowledge transfer rather than promotion of a knowledge sharing/creating culture; a devaluing of context specific and practice based knowledge in comparison to abstract knowledge; bureaucratisation of knowledge; defensive practices emerging from a perceived threat to professional identity; and limited tools and allocation of time for collaborative work within the profession and across professional boundaries. Recommendations and strategies to drive change and enable health visitors to take on leadership roles in multi skilled teams and a multi agency context are underpinned by the argument that what is needed in this context is a transformational model of knowledge exchange and co creation of knowledge that works with tensions between different discourses of knowledge and promotes collaborative dialogue and practice across professional and organisational boundaries.