Purpose: To present a patient with radiation chiasma neuropathy, secondary to radiotherapy of paranasal sinus lymphoma who was referred for evaluation of gradual decrease of vision in both eyes Case report: The patient was a 38-year-old male, with history of right maxillary sinus lymphoma, who underwent surgery, chemotherapy and radiation therapy. One year after radiotherapy, he noticed gradual decrease in his right eye vision. He referred to our center 6 months after onset of visual symptoms (1.5 years after radiotherapy). On his first examination, visual acuity (VA) of right eye was no light perception (NLP), and right optic disc was severely atrophic. Other examinations of right eye were unremarkable. The VA of left eye was 10 /10 with correction, color vision was normal, slit lamp exam and tonometry was normal as well, but bow tie atrophy of left optic disc was detected. Visual field of left eye revealed temporal hemianopia. MRI showed thickening and enhancement of optic chiasm, especially in right side. In follow-up the enhanced lesion enlarged posteriorly and involved both optic tracts and optic radiations. In spite of treatment with high dose corticosteroid and hyperbaric oxygen, within two years following radiotherapy, vision of left eye gradually decreased to NLP too. Conclusion: Radiation-induced optic neuropathy is an important differential diagnosis of decreased vision in a case with history of head and neck radiotherapy. Since this complication is very important with ominous consequence, ophthalmologists and radiotherapists should be aware of that; and decrease the chance of its occurrence by lowering the dosage, daily fractionation, stereotactic methods, and precise aiming of radiation beam.


The Myc genes (c-myc, n-myc, l-myc, s-myc) encode a family of protein that share structural an biological features and are conserved across all Metazoans. c-Myc, the most extensively studied of his family, has been found deregulated, at different level, in almost every kind of tumor. Originally described as a weak transcriptional activator, further studies disclosed uncommon features for an oncogene or a classic transcription factor. c-Myc exerts his influence on the cell growth, cell cycle progression, apoptosis, but the mechanisms that underlie these functions are still not well understood. In order to shed light on its role as master regulator of cell fate, we isolated the protein complex containing c-Myc. Among the molecular partners associated with c-Myc that were not described before, we have found Mcm7 and Mcm5. Mcm7 and Mcm5 are members of the MCM complex, a ring-shape structure composed by six proteins (Mcm2-7). They play a key role in DNA replication and are recently substituting the traditional tumor marker in clinical diagnosis. We have characterized the interaction between c-Myc and the entire MCM complex. Our studies seem to discard the possibility of a functional meaning of this interaction in c-Myc-mediated transcriptional activation, supporting the hypothesis of a direct effect of c-Myc in replication, already suggested by other authors.


A method is proposed for computing with unreliable nanoscale devices that have a high rate of transient errors. Errors are corrected using a probabilistic circuit in which device noise is leveraged as a computational asset. Example designs that achieve a low output bit error probability are presented. The effect of permanent defects is also evaluated, and transient device noise is found to be beneficial for correcting hard defects for defect rates of as high as 0.1% and transient fault rates above 1%. When compared with existing fault-tolerant methods, the sample design requires considerably fewer redundant gates to achieve reliable operation. These results predict that some degree of engineered randomness may prove to be a useful signal-processing feature in future nanoelectronic systems.


The number of female breadwinners has increased in recent times,  especially in developing countries, due to economic changes and social pressures, as many researchers have turned their attention to studying the problems that burden the group, as these single-faced women face many problems that lead to their inability to satisfy their family needs. So it was necessary for the home economics to have a role in solving this problem by participating in the development of their manual skills as an entry point for economic empowerment through small finite projects as the research tended to prepare a training program for this category in the design and implementation of curtains Plague through which to integrate into the labor market Where the study aimed to integrate the breadwinner women in the labor market through micro-projects and to train the breadwinner women in practical skills (design and implementation of curtains) to suit the labor market and achieve compatibility between the requirements of the breadwinner women and the labor market and the importance of the study lies in strengthening the economic, psychological and social aspect of the women's class Maintaining because it represents a productive and development force in society and the development of skills. As an introduction to micro projects to integrate them in the labor market, besides the content of the training program may provide a suggested solution to the problems of the breadwinner women. The most important results were that the training program achieved efficacy in developing the knowledge side (acquired knowledge) and the skill side (acquired skills) among the trainees of the female family category and the products implemented from the curtains were accepted in light of the averages of the specialist's evaluation of the evaluation axes.


The current study evaluated the diversity of yeast species in Cabernet Sauvignon grape must derived from three neighbouring vineyards from a similar terroir but on which significantly different management practices are employed. The fermentation kinetics and yeast population dynamics were monitored from the beginning to the end of spontaneous fermentation. The grape musts were characterised by distinct yeast populations comprising oxidative, weakly fermentative and strongly fermentative yeasts. Different combinations of dominant non-Saccharomyces yeasts were observed in each must, with significantly different assortments of dominant species, including Starmerella bacillaris (synonym Candida zemplinina), Lachancea thermotolerans, Hanseniaspora uvarum, Candida parapsilosis and Wickerhamomyces anomalus. None of these yeast consortia appeared to affect the growth of Saccharomyces cerevisiae or inhibit the overall progress of fermentation. However, the percentage of fermentative yeasts was positively correlated with the fermentation rate. Glucose and fructose consumption rates suggested active participation of both glucophilic and fructophilic yeasts from the onset of fermentation. The data highlight two parameters, viz. initial cell concentration and yeast community composition, as important fermentation drivers and open the possibility to predict fermentation behaviour based on the initial composition of the yeast community.


Learn, prepare, and practice for exam success Master every topic on both new 2009 A+ exams. Assess your knowledge and focus your learning. Get the practical workplace knowledge you need! DVD Features 2 Complete Sample Exams Start-to-finish A+ preparation from the worlds #1 PC hardware expert, Scott Mueller! Master every A+ topic! Essential concepts and troubleshooting principles BIOS and CMOS Memory types and characteristics I/O ports and multimedia devices Video cards and displays Motherboards, CPUs, and adapter cards Laptop components Networking Security Windows Vista, XP, and 2000 Power supplies and system cooling Printers Safety and environmental concerns Test your knowledge, build your confidence, and succeed! Packed with visuals to help you learn fast Dozens of troubleshooting scenarios Real-world A+ prep advice from experts Easy-to-use exam preparation task lists Do I Know This Already? quizzes help you gauge your knowledge, focus your study, and review the material DVD Features 2 Complete Sample Exams Detailed explanations of correct and incorrect answers Multiple test modes Random questions and order of answers Sample videos from CompTIA A+ Cert Kit www.pearsoncertification.com


Objectives: Unhealthy diet and physical inactivity are main causes of many diseases and hence, the development of effective interventions is warranted. However, targeting both health behaviors simultaneously might overburden participants. Thus, the aim of the study was to (a) investigate the relationship between these two health behaviors, (b) assess the perceived intergoal conflict and coherence, and (c) test the effects of stage-matched and mismatched interventions on perceived intergoal conflict and coherence.
Methods: Based on the Health Action Process Approach (HAPA; Schwarzer, 2008), which describes behavior change as a process with qualitatively different stages, an internet-based health prevention program was tested. The quasi-experimental study with two different interventions included N = 1260 and a longitudinal subsample with n = 300 participants.
Results: Results showed that both health behaviors are correlated, and that participants perceived more intergoal facilitation than conflicts. Perceived conflict varied between participants in the different HAPA stages. Stagematched interventions successfully reduced intergoal conflict.
Conclusion: Health promotion programs that simultaneously target physical activity and dietary behavior seem not to overburden participants. On the contrary, participants report high levels of intergoal coherence between the two goals. Nonetheless, intergoal conflicts do play a role in the early stages of behavior change and intention formation. Health promotion programs should take these results into consideration when more than one health behavior is to be targeted.


Objectives: This study aimed to examine the contribution of shift work, work time control (WTC) and informal caregiving, separately and in combination, to sleep disturbances in ageing employees. Methods: Survey data were obtained from two prospective cohort studies with repeated measurements of working conditions, informal caregiving, and sleep disturbances. We used fixed-effect conditional logistic regression analysis to examine whether within-individual changes in shift work, WTC and informal caregiving were associated with changes in sleep. Secondary analyses included between-individuals comparison using standard logistic regression models. Results from the two cohorts were pooled using meta-analysis. Results: Low WTC and informal caregiving were associated with sleep disturbances in within-individual analyses [odds ratios (OR) ranging between 1.13 (95% confidence interval 1.01–1.27) and 1.48 (95% CI 1.29–1.68)] and in between-individuals analyses [OR 1.14 (95% CI 1.03–1.26) to 1.33 (1.19–1.49)]. Shift work alone was not associated with sleep disturbances, but accumulated exposure to shift work, low WTC and informal caregiving was associated with higher risk of sleep disturbances (OR range 1.21–1.76). For some of the sleep outcomes, informal caregiving was related to a higher risk of sleep disturbances when WTC was low and a lower risk when WTC was high. Conclusions: Informal caregiving and low WTC are associated with risk of sleep disturbances among ageing employees. The findings also suggest that low WTC in combination with informal caregiving may increase the risk of sleep disturbances whereas high WTC may alleviate the adverse impact of informal caregiving on sleep.


There has been significant investment in shares market in Nigeria in recent years. This paper investigates the factors that have influenced the share investment decisions of a sample of 2000 Nigerian investors. Anchored on the behavioural finance theory, it explored and analysed the influence of various social, economic, psychological, and cultural factors and sub-groups as indicated by available literature. Our findings showed the degree of influence of each factor as well as the sub-groups. However, there were no significant differences among the subgroups. The study therefore concluded that investment decisions in shares by Nigerians investors are influenced jointly by several groups of factors.


While the idea of public service independence and its relationship to the rule of law has received significant recognition in the Canadian context, it raises the question of whether an analogous set of ethical norms operate at the international level, in settings such as the United Nations and its agencies, the European Commission and other settings of multilateral governance. Is an independent, global or multilateral public service a necessary precondition for an international rule of law? By what mechanisms does the operation of bureaucracy in multilateral governance strengthen (or erode) the international rule of law?In this brief paper, we examine the ethics and professionalism of the international public service – the individuals who collectively comprise the international organizations ("IO"s) that exercise authority through the auspices of entities recognized by international law – and reflect on the potential of the operation of such ethics and professionalism to define and enhance the concept of the international rule of law.


Abstract Objective. To determine the predictors of diabetic retinopathy (DR) in a Federally Qualified Health Center population of patients. Research design and methods. We retrospectively evaluated 526 patients who were screened for DR in the first year of a newly implemented telemedicine program (July 2009 to June 2010). Through this program, a total of 139 patients were diagnosed with DR, whereas 387 patients were not and then served as the comparator group. Multivariate logistic regression was used to determine the predictors of DR in this cohort of patients. Results. After multivariate analysis, four positive predictors of DR were found: insulin use (adjusted odds ratio [AOR] 1.94 [1.17–3.22]), years with diabetes (AOR 1.22 [1.16–1.28]), A1C (AOR 1.15 [1.02–1.29]), and kidney disease (AOR 5.11 [2.33–11.20]). No variables were found to decrease the odds of DR. Conclusion. Among patients with diabetes, use of insulin therapy, longer duration of diabetes, presence of kidney disease, and higher A1C values increase the odds of DR. These preliminary data may suggest patients who are at higher risk of DR to further prioritize screening for DR with a newly implemented telemedicine program.


CD44-dependent proliferation of gastric cancer cells is mediated by acetylated, but unphosphorylated, STAT3. The type I transmembrane glycoprotein CD44 regulates such processes as cell growth and survival. CD44 also serves as a marker of cancer stem cells, and both CD44 and its ligand osteopontin are associated with gastric cancers. Although a previous study showed that a CD44 fragment could associate with transcriptional machinery in the nucleus, how CD44 gets to the nucleus and what role it plays there are unclear. Through immunohistochemical and Western blot analyses, Lee et al. found whole CD44 in the nuclei of primary gastric cancers and gastric cancer cells treated with osteopontin, but not in the nuclei of normal gastric cells. Internalized CD44 passed through early endosomes, and a variant of CD44 missing its C terminus failed to internalize. Ectopic expression of CD44 in CD44-deficient cells promoted their proliferation, which was associated with the increased abundance of cyclin D1 mRNA and protein. Chromatin immunoprecipitation assays showed that CD44 associated with the cyclin D1 promoter, and immunofluorescence and immunoprecipitation (IP) assays demonstrated that nuclear CD44 associated with signal transducer and activator of transcription 3 (STAT3) and the p300 acetyltransferase. Activated CD44 bound to STAT3 in the cytosol and then translocated to the nucleus. Activation of CD44 by an antibody to CD44 resulted in the acetylation, but not the phosphorylation, of STAT3, and the abundance of acetylated STAT3 correlated with the abundance of p300. The expression of other STAT3-responsive genes was also increased in response to activation of CD44. Together, these data suggest that activation of CD44 triggers the acetylation and activation of STAT3, which leads to the expression of proliferation-associated genes in a phospho-independent manner. J.-L. Lee, M.-J. Wang, J.-Y. Chen, Acetylation and activation of STAT3 mediated by nuclear translocation of CD44. J. Cell Biol. 185, 949–957 (2009). [Abstract] [Full Text]


Goal: Simulators that incorporate haptic feedback for clinical skills training are increasingly used in medical education. This study addresses the neglected aspect of rendering simulated feedback for vascular palpation skills training by systematically examining the effect of haptic factors on performance. Methods: A simulator-based approach to examine palpation skill is presented. Novice participants with and without minimal previous palpation training performed a palpation task on a simulator that rendered controlled vibratory feedback under various conditions. Results: Five objective metrics were employed to analyze participants' performance that yielded key findings in quantifying palpation performance. Participants' palpation accuracy was influenced by all three haptic factors, ranging from moderate to statistically significant. Duration, Total Path Length and Ratio of Correct Movement also demonstrated utility for quantifying performance. Conclusions: We demonstrate that our affordable simulator is capable of rendering controlled haptic feedback suitable for skills training. Further, metrics presented in this study can be used for structured palpation skills assessment and training, potentially improving healthcare delivery.


Multiview video refers to videos of the same dynamic 3-D scene captured simultaneously by multiple closely spaced cameras from different viewpoints. We study interactive streaming of pre-encoded multiview videos, where, at any time, a client can request any one of many captured views for playback. Moreover, the client can periodically freeze the video in time and switch to neighboring views for a compelling look-around visual effect. We consider distributed content servers to support large-scale interactive multiview video service. These servers collaboratively replicate and access video contents. We study two challenges in this setting: what is an efficient coding structure that supports interactive view switching and, given that, what to replicate in each server in order to minimize the cost incurred by interactive temporal and view switches? We first propose a redundant coding structure that facilitates interactive view-switching, trading off storage with transmission rate. Using the coding structure, we next propose a content replication strategy that takes advantage of indirect hit to lower view-switching cost: in the event that the exact requested view is not available locally, the local server can fetch a different but correlated view from the other servers, so that the remote repository only needs to supply the pre-encoded view differential. We formulate the video content replication problem to minimize the switching cost as an integer linear programming (ILP) problem and show that it is NP-hard. We first propose an LP relaxation and rounding algorithm (termed Minimum Eviction) with bounded approximation error. We then study a more scalable solution based on dynamic programming and Lagrangian optimization (DPLO) with little sacrifice in performance. Simulation results show that our replication algorithms achieve substantially lower switching cost compared to other content replication schemes.


Consumers were interviewed about how they purchase, transport, store, and otherwise handle food. Emphasis was placed on handling of cold foods and home refrigeration. More than 70% of consumers took steps to protect cold foods during purchase and transport and more than 90% claimed to put away cold foods first. Only 7% of consumers used coolers to protect cold foods during transport. How consumers stored a variety of foods was determined and evaluated. Few consumers knew their own or correct refrigerator temperature and few had refrigerator thermometers. A second interview and refrigerator checklist were completed in 200 of the consumers'Â' homes at least a year later. Researchers judged that circumstances that might allow for cross-contamination existed in 41% of the refrigerators examined. A large percentage of refrigerators were above recommended temperatures. There is a need to disseminate current food-safety and home-refrigeration information as consumer lifestyles adapt to the changing global economy. Consumers need to assume responsibility for temperature control of foods within their homes.


Introduction: Flow cytometry is an integral part of routine diagnostics for hematologic malignancies and is most relevant in mature B-cell neoplasms (BCN). While quality management systems are widely applied for flow cytometric procedures of sample preparation and measurement, data analysis and interpretation still are completely relying on expert knowledge individually applied to each patient sample. To reduce the dependency on expert knowledge and to potentially increase consistency of data interpretation by lowering inter-observer variability the implementation of automated processes is desirable.
 Aim: To prospectively assess an artificial neural network applied to unselected samples analyzed by flow cytometry for suspected BCN.
 Patients and methods: Between April and July 2019 a total of 3272 unselected samples (peripheral blood n=2304, bone marrow aspirate n=968) of adult patients with suspected BCN were flow cytometrically analyzed applying two 9-color tubes of antibody cocktails targeting a total of 16 antigens (tube 1: FMC7, CD10, IgM, CD79b, CD20, CD23, CD19, CD5, CD45; tube 2: Kappa, Lambda, CD38, CD25, CD11c, CD103, CD19, CD22, CD45). An artificial neural network was used to predict previously learned classes of BCN based on unprocessed raw data as obtained from the cytometer. Same data was analyzed in parallel during routine workflow applying expert knowledge that also served as ground truth.
 Results: Routine diagnostic procedures resulted in the following diagnoses; CLL n=481 (14.7%), CLL/PL n=19 (0.6%), follicular lymphoma (FL) n=16 (0.5%), hairy cell leukemia (HCL) n=61 (1.9%), variant hairy cell leukemia (vHCL) n=3 (0.1%), lymphoplasmacytic lymphoma (LPL) n=46 (1.4%), mantle cell lymphoma (MCL) n=29 (0.9%), marginal zone lymphoma (MZL) n=11 (0.3%), monoclonal B-cell lymphocytosis, CLL type (MBL) n=229 (7.0%), no evidence of BCN n=2377 (72.6%). 117 cases had low level infiltration by BCN (<1%) and were not subject to evaluation by the algorithm. 778 cases had infiltration of at least 1% (median 39%, maximum 98%) and, together with negative cases, were subject to evaluation by the algorithm, i.e. 3155 cases in total. The artificial neural network returns probabilities of the classes listed above where the maximum probability refers to the most likely diagnosis. Maximum probabilities were high, i.e. at least 95%, in 2445/3155 cases (77.5%). Results of these 2445 cases with a high confidence level of the classifier were compared to results obtained by expert evaluation of the identical flow cytometric data.
 First, we focused on correct predictions of presence or absence of BCN. Prediction was correct in 2437/2445 cases (99.7%). 8 cases misclassified (3 BM, 5 PB) included 6 BCN (1 MCL, 1% infiltration; 1 HCL, 1%; 2 CLL, 1%/4%; 2 LPL, 2%/2%) classified as no evidence of lymphoma and 2 cases without BCN classified as MZL, respectively.
 Next, we analyzed the correct predictions of CD5 positive BCN vs. CD5 negative BCN vs. no BCN. Prediction was correct in 2435/2445 cases (99.6%). In addition to the wrongly predicted cases mentioned above, 2 cases (both PB) were correctly classified BCN but CD5 positivity was incorrectly predicted. Thus, 1 CLL and 1 CLL/PL (both >10% infiltration) were misclassified as LPL.
 Finally, we analyzed correct predictions of each class. Prediction was correct in 2429/2445 cases (99.3%). Besides the above mentioned wrongly predicted cases another 6 cases (2 BM, 4 PB) were correctly classified BCN with correct prediction of CD5 positivity but incorrect class prediction: 3 MCL (2%/61%/64%) and 1 MBL (8%) were classified as CLL/PL. 1 HCL (24%) and 1 vHCL (17%) were classified as MZL.
 Conclusions: The prospective application of an artificial neural network to a large set of flow cytometric raw data results in correct predictions of both presence of BNC and class of BCN at high accuracy (>99%) without any overconfidence effects of the classifier. Misclassified cases were assigned to classes with phenotypes most similar to the correct classes. Further development will focus on identification of small BCN populations, increase of the portion of cases correctly predicted with high probability and generalization of the approach to different antibody cocktails and additional hematologic neoplasms in order to exploit the diagnostic potential of the algorithm.

 Kern: MLL Munich Leukemia Laboratory: Employment, Equity Ownership. Elsner:res mechanica: Employment, Equity Ownership. Schabath:MLL Munich Leukemia Laboratory: Employment. Haferlach:MLL Munich Leukemia Laboratory: Employment, Equity Ownership. Lueling:res mechanica: Employment, Equity Ownership. Haferlach:MLL Munich Leukemia Laboratory: Employment, Equity Ownership.


We study the atom-light interaction in the fully quantum regime, with focus on off-resonant light scattering into a cavity from ultracold atoms trapped in an optical lattice. The detection of photons allows the quantum nondemolition (QND) measurement of quantum correlations of the atomic ensemble, distinguishing between different quantum states. We analyse the entanglement between light and matter and show how it can be exploited for realising multimode macroscopic quantum superpositions such as Schr\"odinger cat states, for both bosons and fermions. We provide examples utilising different measurement schemes, and study their robustness to decoherence. Finally, we address the regime where the optical lattice potential is a quantum dynamical variable and is modified by the atomic state, leading to novel quantum phases, and significantly altering the phase diagram of the atomic system.


Integration of renewable energy into power grid systems by the use of microgrid are becoming attractive to supply electricity to remote areas in all aspects like reliability, sustainability, and environmental concerns; especially for communities living far in areas where grid extension is difficult so generation of renewable energy resources like solar energy to provide reliable power supply with improved system efficiency and significant cost reduction is best way. This paper reports the ETAP model of a conventional grid connected to Microgrid system of an educational Institute. The purpose of this work is to study the prototype model which is been designed according to some standard electrical conditions. This paper also provides the readers the understanding about the selection appropriate protective equipments, proper cable sizing and electrical parameters which results in a energy efficient design. In this paper we have considered an educational Institute which is connected to 33/0.4 kV conventional grid supply and to this system a 50 kW microgrid is connected.


The Bayesian online change point detection (BOCPD) algorithm provides an efficient way to do exact inference when the parameters of an underlying model may suddenly change over time. BOCPD requires computation of the underlying model's posterior predictives, which can only be computed online in O(1) time and memory for exponential family models. We develop variational approximations to the posterior on change point times (formulated as run lengths) for efficient inference when the underlying model is not in the exponential family, and does not have tractable posterior predictive distributions. In doing so, we develop improvements to online variational inference. We apply our methodology to a tracking problem using radar data with a signal-to-noise feature that is Rice distributed. We also develop a variational method for inferring the parameters of the (non-exponential family) Rice distribution.


TNF-alpha-induced protein 8 (TNFAIP8 or TIPE) is a newly described regulator of cancer and infection. However, its precise roles and mechanisms of actions are not well understood. Here I report the generation of TNFAIP8 knockout mice and describe their increased responsiveness to colonic inflammation and resistance to lethal Listeria monocytogenes infection. TNFAIP8 knockout mice were generated by germ line gene targeting and were born without noticeable developmental abnormalities. Their major organs including those of the immune and digestive systems were macroscopically and microscopically normal. However, compared to wild type mice, TNFAIP8 knockout mice exhibited significant differences in the development of listeriosis and experimentally induced colitis. I discovered that TNFAIP8 regulates L. monocytogenes infection by controlling pathogen invasion and host cell apoptosis potentially in a RAC1 GTPase-dependent manner. TNFAIP8 knockout mice had reduced bacterial load in the liver and spleen and TNFAIP8 knockdown in murine liver HEPA1-6 cells increased apoptosis, reduced bacterial invasion into cells, and resulted in dysregulated RAC1 activation. The combined effect of reduced bacterial invasion and increased sensitivity to TNF-alpha-induced clearance likely protected the TNFAIP8 knockout mice from lethal listeriosis. On the other hand, I also discovered that the increased apoptosis sensitized TNFAIP8 knockout mice to dextran sodium sulfate-induced colitis as demonstrated by decreased survival rates and increased body weight loss of TNFAIP8 knockout mice, and enhanced leukocyte infiltration, bacterial invasion, and inflammatory cytokine production in the TNFAIP8 knockout colon. Bone marrow chimeric experiments revealed that TNFAIP8 deficiency in non-hematopoietic cells was responsible for the exacerbated colitis and resistance to listeriosis in TNFAIP8 knockout mice. Taken together, these findings indicate that TNFAIP8 plays an important role in maintaining colon homeostasis, protecting against colitis, and regulating the pathogenesis of L. monocytogenes infection by controlling bacterial invasion and/or cell death of the non-immune cells. Degree Type Dissertation Degree Name Doctor of Philosophy (PhD) Graduate Group Cell & Molecular Biology First Advisor Youhai H. Chen


This study establishes connections between the themes and methodologies of writers within the South Asian diaspora in the New World, and serves both serious analysts as well as beginning readers of South Asian fiction. It is an impartial study that analyzes the stylistic excellence of South Asian fiction and the clearly emergent motifs of the writers, recognizing the value of the interplay of cultural differences and the need for resolution of those differences. The book begins with a discussion of the works of Indo-Caribbean novelists Samuel Selvon and V.S. Naipaul, author of A House for Mr. Biswas and The Enigma of Arrival, thereby establishing parallels between the immigration patterns of the South Asian diaspora who first emigrated to the Caribbean long before significant numbers of South Asians came to the United States. Next, the fiction of Ruth Prawer Jhabvala (Heat and Dust), the non-fictional narratives of Ved Mehta (Face to Face), and the satire and social criticism of Bharati Mukherjee (Wife) and Chitra Banerjee Divakaruni (Sister of My Heart) are discussed. New literary voices such as those of Bapsi Sidhwa (An American Brat), Pulitzer Prize winner Jhumpa Lahiri, whose characters, plots and themes deal with universal human experiences, Akhil Sharma, Manil Suri and Samrat Upadhyay are studied for the new directions and new methods they offer. A sub-genre of young adult fiction is discovered in the novels of Dhan Gopal Mukerji, such as in his Gay-Neck: The Story of a Pigeon, and more recently in the works of Mitali Perkins and Indi Rana. Recent expatriate novelists from South Asia such as Anita Desai, Amitav Chosh, Vikram Chandra and the American editions of Vikram Seth's novels are appraised together with contemporary Indo-Canadian novelists and Indo-Caribbean novelists resident in Canada.


Concurrency provides a thoroughly updatedapproach to the basic concepts and techniques behind concurrent programming. Concurrent programming is complex and demands a much more formal approach than sequential programming. In order to develop a thorough understanding of the topicMagee and Kramer present concepts, techniques and problems through a variety of forms: informal descriptions, illustrative examples, abstract models and concrete Java examples. These combineto provide problem patterns and associated solution techniqueswhich enablestudents torecognise problems and arrive at solutions. New features include: New chapters covering program verification and logical properties. More student exercises. Supporting website contains an updated version of the LTSA tool for modelling concurrency, model animation, and model checking. Website also includes the full set of state models, java examples, and demonstration programs and a comprehensive set of overhead slides for course presentation.


Complex oculomotor behavior in response to a simple step stimulus can include a variety of different types of saccadic patterns including combinations of normal saccades, simple/corrected/multi-corrected overshoots/undershoots, express, dynamic overshoots, and compound saccades depending on the state of the oculomotor plant and the neuronal control signal supplied by the brain. This paper presents an algorithmic framework that allows automated classification of such behavior. Automated classification results were compared to manually classified data used as a reference baseline. In addition, this work investigates the impact of various filtering methods and basic eye movement classification algorithms on the accuracy of classification of complex oculomotor behavior. The proposed framework can be used in clinical examination of normal and abnormal visual systems.


This review aimed to explore the psychometric properties of quality of life (QOL) scales to identify appropriate tools for research and clinical practice in Arabic-speaking adults. A systematic search of the Cumulative Index to Nursing and Allied Health Literature® (EBSCO Information Services, Ipswich, Massachusetts, USA), MEDLINE® (National Library of Medicine, Bethesda, Maryland, USA), EMBASE (Elsevier, Amsterdam, Netherlands) and PsycINFO (American Psychological Association, Washington, District of Columbia, USA) databases was conducted according to Preferred Reporting Items Systematic Reviews and MetaAnalysis guidelines. Quality assessment criteria were then utilised to evaluate the psychometric properties of identified QOL scales. A total of 27 studies relating to seven QOL scales were found. While these studies provided sufficient information regarding the scales' validity and reliability, not all reported translation and cross-cultural adaptation processes. Researchers and clinicians should consider whether the psychometric properties, subscales and characteristics of their chosen QOL scale are suitable for use in their population of interest.


Homotopy Quantum Field Theory (HQFT) is a branch of Topological Quantum Field Theory founded by E. Witten and M. Atiyah. It applies ideas from theoretical physics to study principal bundles over manifolds and, more generally, homotopy classes of maps from manifolds to a fixed target space. This book is the first systematic exposition of Homotopy Quantum Field Theory. It starts with a formal definition of an HQFT and provides examples of HQFTs in all dimensions. The main body of the text is focused on 2-dimensional and 3-dimensional HQFTs. A study of these HQFTs leads to new algebraic objects: crossed Frobenius group-algebras, crossed ribbon group-categories, and Hopf group-coalgebras. These notions and their connections with HQFTs are discussed in detail. The text ends with several appendices including an outline of recent developments and a list of open problems. Three appendices by M. Müger and A. Virelizier summarize their work in this area. The book is addressed to mathematicians, theoretical physicists, and graduate students interested in topological aspects of quantum field theory. The exposition is self-contained and well suited for a one-semester graduate course. Prerequisites include only basics of algebra and topology.


It has been reported that, on average, most adults recall first memories formed around age 3.5. In general, most first memories are positive. However, whether these first memories tend to be visual or verbal and whether the period for childhood amnesia (CA) is greater for visual or verbal or for positive versus negative memories has not been determined. Because negative, stressful experiences disrupt memory and can injure memory centers such as the hippocampus and amygdala, and since adults who were traumatized or abused during childhood (TA) reportedly suffer memory disturbances, it was hypothesized that those with a history of early trauma might suffer from a lengthier childhood amnesia and form their first recallable memories at a later age as compared to the general population (GP). Because the right hemisphere matures earlier than the language-dominant left hemisphere, and is dominant for visual and emotional memory, as well as the stress reponse, it was hypothesized that first recallable memories would be visual rather than verbal. Lastly, since stress can injure the brain and disrupt memory, it was hypothesized that the traumatized group would demonstrate memory and intellectual disturbances associated with right hemisphere injury as based on WAIS-R, Wechsler Memory Scale, and facial-memory testing. All hypotheses were supported. Positive and visual memories are formed before negative and verbal memories. TA CA offset, on average, is at age 6.1 versus 3.5 for GPs. TA PIQ (performance IQ), short-term visual memory, and facial memory were significantly reduced.


On January 1st, the maximum amount of annual earnings subject to the Social Security tax – a.k.a. the payroll tax cap – increased to $118,500. Every year, this cap is adjusted to keep up with inflation. However, many American workers are not aware that any wages above the cap are not taxed by Social Security. This issue brief analyzes Census Bureau data to determine how many workers would be affected if the Social Security payroll tax cap were raised or phased out. We find that the richest 6.1 percent of workers (less than 1 in 15) would pay more if the cap were scrapped. Only the top 1.5 percent (1 in 67) and 0.7 percent (1 in 140) would be affected if the tax were applied to earnings over $250,000 and $400,000, respectively. When we look at the wage earners according to gender, race or ethnicity, age, or state of residence, the share of workers who would be affected by increasing or phasing out the cap varies widely. Keywords: CPI, social security, social security cap, inequality, payroll tax cap,


OBJECTIVE: Use of electroconvulsive therapy (ECT) in the Medicare population was examined to document trends and variations in the rate of use, expenditures, and patterns of treatment. METHODS: Medicare part B enrollment and claims data were used for a 5 percent nationally representative sample of Medicare beneficiaries for calendar years 1987 through 1992. Descriptive and multivariate analyses were performed. RESULTS: Weighted results showed that nationally the number of Medicare beneficiaries treated with ECT increased from 12,000 in 1987 to 15,560 in 1992. The rate of ECT use per 10,000 Medicare beneficiaries also increased from 4.2 to 5.1. Increases in use occurred among women, whites, and the disabled population (under age 65). Males, nonwhites, and the elderly did not share in the increase. Utilization and expenditure data showed an increase in outpatient ECT and a decrease in inpatient use between 1987 and 1992. The share of Medicare part B ECT expenditures in the outpatient setting increased steadily, from 7 percent in 1987 to 16 percent in 1992. Patients averaged eight ECT treatments, ranging from 6.7 in the West to 8.3 in the Northeast. CONCLUSIONS: The findings document that after a long period of declining use in the United States, ECT use in the Medicare population increased between 1987 and 1992. The analysis also documents a shift toward increasing use of outpatient ECT.


Deep neural networks (DNNs) are notorious for making more mistakes for the classes that have substantially fewer samples than the others during training. Such class imbalance is ubiquitous in clinical applications and very crucial to handle because the classes with fewer samples most often correspond to critical cases (e.g., cancer) where misclassifications can have severe consequences. Not to miss such cases, binary classifiers need to be operated at high True Positive Rates (TPRs) by setting a higher threshold, but this comes at the cost of very high False Positive Rates (FPRs) for problems with class imbalance. Existing methods for learning under class imbalance most often do not take this into account. We argue that prediction accuracy should be improved by emphasizing reducing FPRs at high TPRs for problems where misclassification of the positive, i.e. critical, class samples are associated with higher cost. To this end, we pose the training of a DNN for binary classification as a constrained optimization problem and introduce a novel constraint that can be used with existing loss functions to enforce maximal area under the ROC curve (AUC) through prioritizing FPR reduction at high TPR. We solve the resulting constrained optimization problem using an Augmented Lagrangian method (ALM). Going beyond binary, we also propose two possible extensions of the proposed constraint for multi-class classification problems. We present experimental results for image-based binary and multi-class classification applications using an in-house medical imaging dataset, CIFAR10, and CIFAR100. Our results demonstrate that the proposed method improves the baselines in majority of the cases by attaining higher accuracy on critical classes while reducing the misclassification rate for the non-critical class samples.


Summary Interest in the subject of this article arose in connection with searching for the causes of this innovativeness of the Polish economy compared to other EU countries. It was also accompanied by the desire to find possible solutions to this situation, discovering various methods of increasing the level of innovativeness in Poland. We are assuming that the level of innovativeness is affected by social awareness in the field of innovativeness. The basic, root cause of this state of innovativeness of the country is the level of awareness of innovation. An innovative economy cannot be built in an uninnovative environment. An attempt has been made in this paper to answer the following three questions: • How can the concepts of innovativeness and innovativeness awareness be defined, and why should they be discussed? • What role can higher education institutions play in shaping innovativeness awareness in society • What marketing actions of a higher education establishment can contribute to this role being fulfilled?


Although Phaeodactylum tricornutum is gaining importance in plant molecular farming for the production of high-value molecules such as monoclonal antibodies, little is currently known about key cell metabolism occurring in this diatom such as protein glycosylation. For example, incorporation of fucose residues in the glycans N-linked to protein in P. tricornutum is questionable. Indeed, such epitope has previously been found on N-glycans of endogenous glycoproteins in P. tricornutum. Meanwhile, the potential immunogenicity of the α(1,3)-fucose epitope present on plant-derived biopharmaceuticals is still a matter of debate. In this paper, we have studied molecular actors potentially involved in the fucosylation of the glycoproteins in P. tricornutum. Based on sequence similarities, we have identified a putative P. tricornutum GDP-L-fucose transporter and three fucosyltransferase (FuT) candidates. The putative P. tricornutum GDP-L-fucose transporter coding sequence was expressed in the Chinese Hamster Ovary (CHO)-gmt5 mutant lacking its endogenous GDP-L-fucose transporter activity. We show that the P. tricornutum transporter is able to rescue the fucosylation of proteins in this CHO-gmt5 mutant cell line, thus demonstrating the functional activity of the diatom transporter and its appropriate Golgi localization. In addition, we overexpressed one of the three FuT candidates, namely the FuT54599, in P. tricornutum and investigated its localization within Golgi stacks of the diatom. Our findings show that overexpression of the FuT54599 leads to a significant increase of the α(1,3)-fucosylation of the diatom endogenous glycoproteins.


Physical experiments were conducted to investigate the transport of a dissolved volatile organic compound (trichloroethylene, TCE) from shallow groundwater to the unsaturated zone under a variety of conditions including changes in the soil moisture profile and water table position. Experimental data indicated that at moderate groundwater velocities (0.1 m/d), vertical mechanical dispersion was negligible and molecular diffusion was the dominant vertical transport mechanism. Under these conditions, TCE concentrations decreased nearly 3 orders of magnitude across the capillary fringe and soil gas concentrations remained low relative to those of underlying groundwater. Data collected during a water table drop showed a short-term increase in concentrations throughout most of the unsaturated zone, but these concentrations quickly declined and approached initial values after the water table was returned to its original level. In the deep part of the unsaturated zone, the water table drop resulted in a long-term decrease in concentrations, illustrating the effects of hysteresis in the soil moisture profile. A two-dimensional random walk advection-diffusion model was developed to simulate the experimental conditions, and numerical simulations agreed well with experimental data. A simpler, one-dimensional finite-difference diffusion-dispersion model was also developed. One-dimensional simulations based on molecular diffusion also agreed well with experimental data. Simulations which incorporated mechanical dispersion tended to overestimate flux across the capillary fringe. Good agreement between the one- and two-dimensional models suggested that a simple, one-dimensional approximation of vertical transport across the capillary fringe can be useful when conditions are appropriate.


Background: The Society of Critical Care Medicine (SCCM) advocates use of a national data collection tool to measure compliance with treatment guidelines for severe sepsis. Some facilities utilize a Sepsis Response Team (SRT) to manage sepsis; however, their effectiveness has not been published. Purpose: Provide information to aid in the design of an appropriate study methodology, develop a multidisciplinary research team, create a paper data collection tool, utilize the SCCM data collection tool, and develop resource expectations needed to perform larger-scale studies. Setting: 760-bed tertiary care teaching hospital. Methods: This feasibility study describes the process to form a multidisciplinary research team, select patients, create a paper data collection form, utilize the SCCM tool, and retrospectively collect data from 20 patient charts, 10 treated by a SRT and 10 treated by individual prescribers. Results: Mean hours required for chart abstraction dropped significantly as the team gained experience with the abstraction process. Several SCCM data points were subjective, requiring a team consensus of definitions to maintain consistency. A difference in mean age between groups was identified. Other confounding variables that may be encountered in a larger-scale study were identified and are discussed. Conclusion: Large-scale studies evaluating efficacy of a SRT using the SCCM tool, will likely require significant resources and a multi-disciplinary team of researchers. A case-matched study design may be needed to mitigate population differences.


The Book of Job in Medieval Jewish Philosophy, by Robert Eisen. New York: Oxford University Press, 2004. 324 pp. $60.00. This is a good idea for a book, and it is well executed throughout. Eisen takes six thinkers, some very well known, others less so, and examines their views on the enigmatic Book of Job. The thinkers are Saadya Gaon, Maimonides (definitely the kingpin in terms of his influence on the whole exercise), Samuel ibn Tibbon, Zerahiah Hen, Gersonides, and Simon ben Zemah Duran. Readers will find things to disagree with on occasion in Eisen's analysis, but he is pretty close to these authors and has a shrewd grasp of where their main points are, and where their weaknesses are also. His main theme, and it is a valuable one, is that we should not strictly demarcate between philosophy and theology during this period. There has been a tendency to regard philosophers looking at a topic like suffering as though they were doing something entirely different from their theological peers, and yet they often have considerable light to throw on the Bible, despite (or perhaps due to) their philosophical approach. Eisen seeks to buttress this view with a brief examination of some modern thinkers on Job and how they relate to the medieval discussion. This chapter does not to my mind really come off; it is too short to establish its aim and does not have the space to convince the reader that the problematic today and in the past is the same. Eisen asks an interesting question in this book, but it seems to me that he offers the wrong reason for the right answer. The question is whether in understanding medieval theological issues it is helpful to examine at least some of the philosophical texts. The answer is surely that these texts often are very revealing of aspects of the Bible, even if they do not use traditional theological techniques to establish their conclusions. Eisen's conclusion is that philosophy and theology are nor so different after all, and both contain insights when used to examine the Bible. In the Middle Ages the idea that philosophy and theology are similar in approach would have been regarded with horror. Thinkers then spent a good deal of time sharply distinguishing between different forms of thought, and the boundaries between grammar, logic, philosophy, theology, law and so on were drawn so as to establish a wide chasm between all these different techniques. Indeed, it was taken to be the mark of an educated person to be able to distinguish between these different forms of thought. …


A flexible microdome-grooved Gd(2)O(2)S:Tb scintillator is simulated, fabricated, and characterized for digital radiography applications. According to Monte Carlo simulation results, the dome-grooved structure has a high spatial resolution, which is verified by X-ray image performance of the scintillator. The proposed scintillator has lower X-ray sensitivity than a nonstructured scintillator but almost two times higher spatial resolution at high spatial frequency. Through evaluation of the X-ray performance of the fabricated scintillators, we confirm that the microdome-grooved scintillator can be applied to next-generation flexible digital radiography systems requiring high spatial resolution.


Plasmodesmata (PD) are membranebound tunnels that connect the cytosols of neighboring plant cells. The rate of plasmodesmatal transport between cells changes during the course of plant development. Forward genetic screens to identify factors controlling transport through PD have repeatedly revealed that chloroplasts influence plasmodesmatal transport. This has led to a paradigm shift, focusing less on the role of structural changes directly at PD (e.g. callose deposition) and more on how cellular physiology influences the function of PD. Although many groups have now demonstrated that chloroplast function and plasmodesmatal transport are tightly connected, the biological significance of this relationship between chloroplasts and PD remains unresolved. Given the connection between plasmodesmatal transport and chloroplast physiology, Brunkard and Zambryski (pp. 1459–1467) have examined whether plasmodesmatal transport is sensitive to light. In the current study, they combine genetic and physiological approaches to show that PD transport is dynamically regulated by light and the circadian clock throughout the diurnal cycle. Light promotes plasmodesmatal transport during the day, but light is not sufficient to increase rates of plasmodesmatal transport at night, suggesting a circadian gating mechanism. Indeed, silencing the expression of the core circadian clock gene, LHY/CCA1, allows light to strongly promote plasmodesmatal transport during subjective night, confirming that the plant circadian clock controls the plasmodesmatal transport light response. The authors conclude that plasmodesmatal transport is dynamically regulated during the day/ night cycle. Due to the many roles of PD in plant biology, this discovery has strong implications for plant development, physiology, and pathogenesis. Ray Parenchymal Cells Contribute to Lignification


The objective of the current study was to evaluate the antioxidant activity of Citrus peel essence by using DPPH radical scavenging activity and βcarotene test Methods The essence of four varieties of Citrus: C. Sinensis, C. paradisi, C. reticulata and C. aurantium were been extracted by cold expression, then the extract was analyzed to determine the chemical composition by Gas Chromatography coupled to Mass spectrophotometry (GC/MS). The antioxidant activity of Citrus essences was assessed by DPPH and βcarotene test comparatively to BHT and Quercetin. The results obtained demonstrated that the IC 50 of Citrus essences range from : 1,9068 ± 0,0912 μg ml-1 for Citrus reticulata, 6,2086 ± 0,0308 μg ml-1 for Citrus aurantium, 12,7662 ± 0,0736 μg ml-1 for Citrus paradisii, and 19,1567 ± 0,00499 μg ml-1 for Citrus sinensis, which were all lower than the lC50 of the synthetic antioxidants : Quercetin (IC50 15,9938 ± 0,01284 μg ml-1) and Butylhydroxyanisole (BHA) (IC50 21,9938 ± 0,01284μg ml-1). In conclusion it has been suggested that Citrus essences constituent a real source for natural antioxidant that can be used in several domain such as : pharmaceutics , culinary and food engineering.


Nick Tingle investigates the psychoanalytic dimensions of composition instruction in "Self-Development and College Writing "to boldly illustrate that mastering academic prose requires students to develop psychologically as well as cognitively. Asserting that writing instruction should be an engaging, developmental process for both teachers and students, he urges reaching for new levels of consciousness in the classroom to aid students in realigning their subjective relationships with knowledge and truth.Drawing on psychoanalytic theory and twenty years of experience as a teacher, Tingle outlines the importance of moving beyond usual ways of thinking, abandoning the common sense of everyday reality, and coming to understand beliefs as beliefs and not absolutes. These developmental moves must be accompanied, Tingle says, by a new attitude towards languagenot as something that points to things, but as a series of concepts that arrange the very things one points to. And this development is necessary not just in order to perform well in the writing class, but also to fully participate in and reap the academic rewards of structured, university life."Self-Development and College Writing "calls attention to the psychological destabilization this method may produce for students. Tingle explains that, if writing instructors are to respond to this destabilization, they must conceive of the classroom as a transitional space, or a kind of holding environment. They must also become aware of their psychological allegiances to particular theories of writing if they are to construct such environments.But the goal of the transitional environment is worth pursuing, Tingle argues, contending that university education fails to address students developmental needs. With purposeful writing and deft analyses, Tingle shows that this goal also affords a means by which to place writing courses at the center of the educational curriculum. Conceived as a transitional space, the writing class may support and stabilize students in their developmental passage, thereby fostering an improved understanding of their academic work and, more importantly, an increased intellectual understanding of themselves and the complex world in which they live. "


The results of earlier studies attribute acute stress reactions to nocturnal aircraft noise, but do not contain detailed information on the adaptive and habituation processes during the exposure. This question was followed up with an experimental longitudinal study at Hamburg's Fiihlsbiittel airport. The test persons were exposed to nocturnal electroacoustically simulated aircraft noise in their apartments. Recorded among other things was the personal health condition, cortisol excretion collected through the night and daily collected subjective data. After the initial cortisol reaction (increasing in the first days) the course of cortisol excretion is not uniform. The results suggest that adaptation to nocturnal aircraft noise is specific to the sex. Beside these sexually specific differences there are considerable individual differences both for women and men. We found three fundamental adaptation types in agreement with results of animal experiments. From a preventive medical point of view two of the adaptation types, i.e. increasing cortisol excretion and decreasing cortisol excretion, are accompanied with health hazards. The increasing cortisol excretion exceeds the normal medical range in the process of adaptation. The decreasing cortisol level can be identified as protective inhibition. The majority of the men can be classified in the first mentioned adaptation type. From this knowledge it can be concluded that noise-induced health risk for men is to be estimated as essentially higher than for women.


This document describes a simple method of encapsulating Stream
Control Transmission Protocol (SCTP) packets into UDP packets and its
limitations. This allows the usage of SCTP in networks with legacy
NATs that do not support SCTP. It can also be used to implement SCTP
on hosts without directly accessing the IP layer, for example,
implementing it as part of the application without requiring special
privileges. Please note that this document only describes the
functionality required within an SCTP stack to add on UDP
encapsulation, providing only those mechanisms for two end-hosts to
communicate with each other over UDP ports. In particular, it does not
provide mechanisms to determine whether UDP encapsulation is being
used by the peer, nor the mechanisms for determining which remote UDP
port number can be used. These functions are out of scope for this
document. This document covers only end-hosts and not tunneling
(egress or ingress) endpoints.


Purpose: The purpose of the study was to report the use of ranibizumab in choroidal neovascularization secondary to punctate inner choroidopathy. Methods: This was a retrospective case series. Clinical notes of 10 patients with choroidal neovascularization secondary to punctate inner choroidopathy were reviewed (mean age, 40.7 years, age range, 25-58 years). Results: Previous therapies included photodynamic therapy, posterior sub-Tenon's triamcinolone, oral prednisolone, and intravitreal triamcinolone. Ten eyes in 10 patients underwent a mean of 1.9 ± 1.3 (± standard deviation) injections of antivascular endothelial growth factor (range, 1-5). All 10 patients had a follow-up review of at least 6 months (median, 12.5 ± 9.2 standard deviation; range, 6-34 months). Nine eyes either maintained or improved vision by at least 1 line on the logarithmic of the minimal angle of resolution calculated equivalent chart at least 6 months after the start of treatment with antivascular endothelial growth factor therapy. No ocular or systemic complications were observed. Conclusion: The role of ranibizumab in choroidal neovascularization in association with punctate inner choroidopathy has been shown to be beneficial in this small group in whom improvement or stabilization of vision was observed in 9 of 10 eyes. Recurrent choroidal neovascularization can occur in these patients, and additional injections of ranibizumab appear to be safe and efficacious.


The paper studies the macroeconomic effects of government spending shocks in an economy characterized by positive trend growth. It shows that the lower is the trend growth rate the less inflationary are government spending shocks and vice versa. Moreover, on impact output is higher but exhibits less persistence the lower is trend growth, an effect that also characterizes consumption and the government spending multiplier, given that consumption and labor are somewhat complementary.


We characterize optical wave propagation along line defects in two-dimensional arrays of air-holes in free-standing silicon slabs. The fabricated waveguides contain random variations in orientation of the photonic lattice elements which perturb the in-plane translational symmetry. The vertical slab symmetry is also broken by a tilt of the etched sidewalls. We discuss how these lattice imperfections affect out-of-plane scattering losses and introduce a mechanism for high-Q cavity excitation related to polarization mixing.


The paper reviews the concept of sustained yield, assesses its advantages and disadvantages, and attempts to put into perspective its application in managing the forest of Malaysia and Southeast Asia. The concept is traced from its beginning in early European Forestry, through its various developments in North America, to its introduction to forestry thinking in Malaysia. Its alleged advantages and disadvantages are synthesized from the on-going debate on the concept in the forestry literature, and suggestions for the improvement of the concept are discussed. The form of sustained yield which should be used as an objective in Malaysian forest management is suggested. Its main features should be applicable to forest management in the other nations of Southeast Asia and the Tropics.


We present a method with fusion of images of three modalities 18 F-FDG PET, CT, and 3-D ultrasound (US) applied to imaging of the anal canal and the rectum. To obtain comparable geometries in the three imaging modalities, a plexiglas rod, with the same dimensions as the US transducer, is placed in the anal canal prior to the PET-CT examination. The method is based on manual co-registration of PET-CT images and 3-D US images. The three-modality imaging of the rectum-anal canal may become useful as a supplement to conventional imaging in the external radiation therapy in the treatment of anal cancer, where the precise delineation of a tumor is crucial to avoid damage from radiation therapy to the healthy tissue surrounding it. The technique is still in a phase of development, and the demands for integration different company software systems are significant before commercial application. Three-modality imaging may also be used in certain other diagnostic or therapeutic fields.


This paper proposes a novel two-axis solar tracker with a redundant parallel mechanism and investigates the distribution method of driving torque. In view of the difference between the singular configuration of the redundant parallel mechanisms and that of the corresponding non-redundant ones, an index related to the minimum singular value of the Jacobian matrix is used to indicate the position of the singular configuration relative to the boundaries of the required workspace. The driving torque and energy consumption can be optimized with this index. Based on the fact that the direction of driving torque is opposite to that of rotor in most of the running processes, a distribution method of driving torque with the minimum energy consumption for the redundant parallel solar tracker is proposed. The distribution method is compared with the minimum norm solution which is adopted by the conventional redundant parallel mechanism. And energy consumption can be significantly reduced by adopting this method. In addition, the workspace and energy consumption of the redundant solar tracker and its non-redundant counterpart are compared. The results show that the redundant solar tracker has a larger workspace and lower energy consumption.


In order to personalize the behavior of hearing aid devices in different acoustic scenes, we need personalized acoustic scene classifiers. Since we cannot afford to burden an individual hearing aid user with the task to collect a large acoustic database, we will want to train an acoustic scene classifier on one in-situ recorded waveform (of a few seconds duration) per class. In this paper we develop a method that achieves high levels of classification accuracy from a single recording of an acoustic scene.


The art market is famous for auctions at Sotheby's and Christie's, where works by well-known artists sell for stratospheric prices. Researchers often have concluded that auction prices are not driven by economic fundamentals; that they reflect some degree of unpredictable or irrational behavior by consumers. In this paper, we ask whether the broader retail art market, which is composed mostly of small galleries, is more consistent with standard economic models. In particular, we examine whether the location patterns of Manhattan art galleries exhibit agglomeration economies typical of retail markets. We also look at the correlation between gallery clusters and neighborhood economic and demographic characteristics, and whether location affects gallery longevity.


Abstract Objective: The objective of this study was to evaluate the effects of the decision support tool (DST) on the assessment of the acutely ill or injured out-of-hospital patient. Methods: This study included systematic reviews of randomized controlled trials (RCT) where the DST was compared to usual care in and out of the hospital setting. The databases scanned include: (1) Cochrane Reviews (up to January 2010); (2) Cochrane Controlled Clinical Trials (1979 to January 2010); (3) Cinahl (1986 to January 2010); and (4) Pubmed/Medline (1926 to January 2010). In addition, information was gathered from related magazines, prehospital home pages, databases for theses, conferences, grey literature and ongoing trials. Results: Use of the DST in prehospital care may have the possibility to decrease "time to definitive care" and improve diagnostic accuracy among prehospital personnel, but more studies are needed. Conclusions: The amount of data in this review is too small to be able to draw any reliable conclusions about the impact of the use of the DST on prehospital care. The research in this review indicates that there are very few RCTs that evaluate the use of the DST in prehospital care.


The failure of the ubiquitous New Keynesian "Dynamic Stochastic General Equilibrium"(NK-DSGE) models to capture interactions of finance and the real economy is widely-recognized since the 2008-9 financial crisis. NK-DSGE models exclude money, debt and asset prices and, importantly, ignore changing credit markets. These problems stem from assuming unrealistic micro-foundations for household behaviour, and that aggregate behaviour mimics a fully-informed "representative agent" (both assumptions are embodied in the underlying "rational expectations permanent income" hypothesis (REPIH)). This survey critiques the NK-DSGE models and its integral REPIH model, and discusses alternative post-crisis general equilibrium models which do incorporate debt and allow crises to occur. But neither model type can be directly applied to policy-making. The survey reviews misspecifications in standard non-DSGE macro-models used by central banks (e.g. the Fed.'s FRB-US), and related co-integration literature linking consumption with household portfolios. These too omit most of the "financial accelerator", ignoring credit shifts and crucially, aggregating liquid, illiquid assets, debt and housing into a single "net worth" construct. The survey's second focus is to improve non-DSGE models for policy using the Latent Interactive Variable Equation System (LIVES) approach, in which aggregate consumption is jointly modelled with the main elements of household balance sheets, extracting credit conditions as a latent variable. Empirical work on aggregate data is surveyed revealing the important role of debt and financial assets and the time and context-dependent role of housing collateral. Rather than "one-size-fits-all" monetary and macro-prudential policy, institutional differences between countries then imply major differences for monetary policy transmission and policy.


PURPOSE
Phase cycled balanced steady state free precession (bSSFP) magnetic resonance (MR) images demonstrate high contrast in the temporal bone region, but are limited by motion artifacts stemming from globe motion, CSF and carotid artery pulsation, and by signal loss/modulation typical of bSSFP imaging of complex tissue environments. We sought to generate images delineating the fine morphology of temporal bone structures while minimizing signal loss and motion artifacts.

METHODS
Four axial 3D bSSFP MR images with Δθ = 0°, 90°, 180°, and 270° phase cycling respectively were acquired with a Philips Ingenia 3T MRI scanner in 2.3 minutes of total scan time. Other parameters included a 30° flip angle applied with a transmit/receive radiofrequency head coil, TE/TR = 4.2/2.1ms, receiver bandwidth = 890 Hz/pixel, and 180/180/120 matrix size and 1/1/1 mm voxel size along frequency/phase/slice directions. Complex image data were input into the Geometric Solution (GS) algorithm for calculation of artifact-free bSSFP signal on a pixel-by-pixel basis. SNR was improved by linearizing the solution in a second-pass regional optimization.

RESULTS
The GS eliminated the bSSFP signal intensity modulations while minimizing motion artifacts present in the original four images. The efficacy of the GS is validated through comparison with a complex average of the four original bSSFP images; unlike the GS, the complex average only moderates artifacts.

CONCLUSION
The GS represents a novel method of correcting bSSFP MRI signal modulation and motion artifacts while maintaining contrast near the temporal bone. The technique is fast, easy to implement, and requires minimal post-processing. This technique may inspire early clinical adoption, as it overcomes two major artifactual obstacles which have historically limited the widespread use of bSSFP MRI.


A framework presenting a broad perspective of technology innovations is developed from a study of past innovations in urban transportation. Observations are forwarded on the characteristic life-cycle of "new" technologies. Key determinants of past successful and unsuccessful innovation efforts are identified and relevant theories examined. The methodology is then used to evaluate the present innovation efforts towards automation of urban transportation, in particular Personal Rapid Transit.


Auschwitz. Hiroshima. Cambodia's killing fields. The World Trade Center. The mass graves of Rwanda. These places of violent death have become part of the landscape of tourism, an industry that is otherwise dedicated to pleasure and escape. In dark places like concentration camps, prisons, battlegrounds, and the sites of natural disasters, how are memory and trauma mediated by this thanatourism, or tourism of death? In "Death Tourism", Brigitte Sion brings together essays by some of the most trenchant voices in the field to look at the tensions created by the juxtaposition of human remains and food stands, political agendas and educational programs, economic development and architectural ambition. How does a state redefine its national identity after catastrophic trauma? And what is the role of this kind of tourism in defining their new identity? A timely volume on an irresistible subject, this inquiry exposes the intersection of leisure with the inhumane, giving insight into how people respectfully share a public space that is both free and sacred, compelling and tragic.


Retrieval-Augmented Generation (RAG) is a promising approach for mitigating the hallucination of large language models (LLMs). However, existing research lacks rigorous evaluation of the impact of retrieval-augmented generation on different large language models, which make it challenging to identify the potential bottlenecks in the capabilities of RAG for different LLMs. In this paper, we systematically investigate the impact of Retrieval-Augmented Generation on large language models. We analyze the performance of different large language models in 4 fundamental abilities required for RAG, including noise robustness, negative rejection, information integration, and counterfactual robustness. To this end, we establish Retrieval-Augmented Generation Benchmark (RGB), a new corpus for RAG evaluation in both English and Chinese. RGB divides the instances within the benchmark into 4 separate testbeds based on the aforementioned fundamental abilities required to resolve the case. Then we evaluate 6 representative LLMs on RGB to diagnose the challenges of current LLMs when applying RAG. Evaluation reveals that while LLMs exhibit a certain degree of noise robustness, they still struggle significantly in terms of negative rejection, information integration, and dealing with false information. The aforementioned assessment outcomes indicate that there is still a considerable journey ahead to effectively apply RAG to LLMs.


This paper presents an approach for providing terminology Web services for controlled vocabulary terms. Services are implemented within a service oriented framework. Aset of experimental services for genre vocabularies are provided through the MS Office Research pane, a built-in feature of Internet Explorer (IE) when users have loaded MS Office 2003. Web browsers, such as Mozilla Firefox and Opera, also provide side-bars which could be used to deliver loosely-coupled Web services.


The purpose of the study was to examine the relationship between corporate social responsibility and brand loyalty of Dahabshiil Remittance Company in Mogadishu, Somalia. The study focused in determining the relationship between philanthropic responsibilities and brand loyalty, ethical responsibilities and brand loyalty, legal responsibilities and brand loyalty as well as the relationship between economic responsibilities and brand loyalty. Across-sectional research, which is a type of descriptive research design, was adopted using a sample of 377 out of a population of 20 thousand of Dahabshiil consumers in Mogadishu. Self-administered questionnaires were used to collect data from respondents while descriptive statistics such as frequencies and percentages were used. It was also used inferential statistics such as correlation and regressions to determine the relationship between corporate social responsibility and brand loyalty. The findings of the study revealed that the company engages in CSR actions as most of the respondents appreciated that fact. The CSR initiatives used include but not limited; funding and supporting educational institutions, initiatives aiming environmental protection, improving the needs of the society, and donating money for various charitable causes. The findings also revealed that philanthropic responsibilties have statistically siginifacnt positive relationship with brand loyalty (r=.755, N= 377, p-value< .01), ethical responsibilities have statistically significant positive relationship with brand loyalty effect (r=.694, N= 377, p-value< .01), legal responsibilities have statistically significant relationship with brand loyalty (r=.627, N= 377, p-value< .01), and also legal responsibilities have significant effect on brand loyalty (r=.531, N= 377, p-value< .01). From the regression analysis, it was found that CSR initiatives adopted by the company would contribute up to (44.1%, p-vale< 0.05). The key recommendations of the study were that the organization should devote whatever resources that are available philanthropic social responsible initiatives for achieving higher levels of brand loyalty. Secondly, to retain the customers and maintain their loyalty, the 2 researcher recommends that the company to behave ethically and honestly with its customers and that CSR initiatives is communicated with community ethically and sincerely. Third, the study recommends that the company needs to respect always the laws when carrying out its business activities and protect the natural environment in order to retain the customers and maintain their loyalty. The company must also meet the legal requirements related to goods and services as the consumers expressed that they will rely on the business of the company if its meets the minimal requirements related to goods and services. Finally, the study recommends that the company should strive to maximize its financial performance and engage marketing activities that are beneficial to its stockholders and also to general community. The maximization of the financial performance will help the company to be competitive and profitable so they can give percentage of its profits back to society.


The use of relational database management systems (RDBMSs) to store and query XML data has attracted considerable interest with a view to leveraging their powerful and reliable data management services. Due to the mismatch between the relational and XML data models, it is necessary to first shred and load the XML data into relational tables, and then btranslate XML queries over the original data into equivalent SQL queries over the mapped tables. Although there is a rich literature on XML-relational storage, none of the existing solutions addresses all the storage problems in a single framework. Works on mapping strategies often have little or no details about query translation, and proposals for query translation often target a specific mapping strategy. XML-storage solutions provided by RDBMS also have limitations. Notably, they are tied to a specific backend and use proprietary mapping languages, which not only may require a steep learning curve, but often are unable to express certain desirable mappings.
 In order to address these limitations, we developed ShreX, a XML-to-relational mapping framework and system that provides the first comprehensive and end-to-end solution to the relational storage of XML data. Mappings in ShreX are defined through annotations to an XML Schema. The use of XML Schema simplifies the mapping process, since it does not require users to master a new specialized mapping language. The use of annotations allows mapping choices to be combined in many different ways. As a result, ShreX not only supports all the mapping strategies proposed in the literature, but also new useful strategies that had not been considered previously. ShreX provides generic (and automatic) document shredding and query translation capabilities; and it is portable --- its mapping specifications are independent of the database backend.


Abstract The silicified brachiopod faunas collected by G. Arthur Cooper and Richard E. Grant over decades of field work in the Permian Basin of western Texas provide a remarkable resource for studying change in the structure of fossilized ecological communities. Ordination analyses using 511 faunal lists that include 967 species (190 genera) from the Kungurian through the Capitanian Stages of the Guadalupe and Glass Mountains (∼15 myr) reveal four distinct, major stratigraphic clusters, each divisible into two to three subclusters. For the most part, these clusters coincide with third-order depositional sequences bounded by unconformities. Except for the youngest (Capitanian Stage), all the stratigraphic clusters show internal ordination patterns consistent with biogeographic and environmental (i.e., biotic gradients) control on the distribution of taxa. Despite this evidence for environmental sorting of taxa, Mantel tests indicate that patterns of generic co-occurrence break down from cluster to cluster despite sharing many of the same species and genera. This pattern cannot easily be explained by preservational or stratigraphic biases, suggesting that the processes that govern ecological communities may not lead to unique, strictly determined associations despite the presence of broadly similar species under similar environmental conditions. In contrast to the rest of the study interval, Capitanian clusters are less well structured (i.e., they do not show strong biotic gradients) than assemblages from any of the other clusters and do not show significant recurrence of generic associations. This may reflect evolution of carbonate margins in the basin from ramps to shelves with steep slopes over the duration of the study interval, a shift that may have changed the spatial distribution of (and covariation among) the environmental parameters that controlled brachiopod distributions.


In Citizens United, the Supreme Court interpreted the government's interest in preventing corruption as being limited to preventing quid pro quo—cash-for-votes—corruption. This narrow interpretation drastically circumscribed legislatures' abilities to regulate the financing of elections, in turn prompting scholars to propose a number of reforms for broadening the government interest in campaign finance cases. These reforms include urging the Court to recognize a new government interest such as political equality, to adopt a broader understanding of corruption, and to be more deferential to legislatures in defining corruption. Building upon that body of scholarship, this Article begins with a descriptive account of campaign finance jurisprudence that identifies various conceptions of corruption found in the case law. The Article then explains how these conceptions of corruption are animated by underlying disagreements about democracy and deference. More particularly, one group of Justices believes that preserving a robust process of public opinion formation is paramount in campaign finance cases, and that individual rights and political process concerns warrant intervention in defining corruption. The other group of Justices believes that the deployment of concentrated wealth in elections impairs legislative responsiveness to public opinion and that the Court should defer to legislative expertise in defining corruption. Having presented this account, the Article proposes a reform to accommodate both groups of Justices' concerns in campaign finance cases. This reform, which I call the Compromise Methodology, instructs the Court to defer to the legislature's understanding of the anticorruption interest when the campaign finance law in question protects either: (a) legislative responsiveness to public opinion; or (b) the process of public opinion formation. If the law protects neither of these concerns, then the Court intervenes and finds that the anticorruption interest cannot justify the law. Aside from this reframing of the anticorruption interest, the Compromise Methodology leaves the Court's ordinary decision-making process intact. The Court can still determine whether a campaign finance law impacts individual rights and whether a law is sufficiently tailored to the anticorruption interest to withstand scrutiny. I argue that the Compromise Methodology locates valuable middle ground in campaign finance jurisprudence.


Microseismic monitoring and evaluation is one aspect of the National Institute for Occupational Safety and Health (NIOSH) research program. Roof falls are often preceded by a period of elevated microseismic activity, but not all periods of elevated activity result in a roof fall, nor do all roof falls occur after some amount of elevated activity. The objective of this study is to review periods of elevated microseismic activity and determine whether fracture activity rate can be used to anticipate the initiation of roof falls. The study was carried out at an underground limestone mine where major roof falls are associated with excessive horizontal stress. The progression of roof falls was detected by the microseismic signature produced by the rock falling from the mine roof onto the mine floor, which is termed a roof fall impact event. A total of nine elevated fracture activity periods that resulted in seven major roof falls were examined. It was observed that elevated fracture activity preceded the initial roof fall impact event in three out of four major roof falls. The initial impact event was not identified for the remaining three roof falls. Fracture event rates were analyzed and a roof fall alarm trigger of five fracture events in a ten minute time period was established for this test case. The fall alarm trigger was tested against six of the elevated activity periods. Four roof falls occurred in the six periods of elevated activity, and two would have triggered the alarm before the roof fall occurred, while two false alarms were generated. The results show that limited success would have been achieved by the microseismic system as a roof fall alarm trigger. However, the trigger would have been successful at warning of the onset of elevated activity, allowing mine employees to respond appropriately. The study highlighted some issues with implementing such a system in an operating mine, including the need for real time identification of fracture related microseismic signals among mining induced signals, and accurate location and identification of fracture clustering.


Abstract I evaluate whether the so-called long-run risk framework can jointly explain key features of both equity and bond markets as well as the interaction between asset prices and the macroeconomy. I find that shocks to expected consumption growth and time-varying macroeconomic volatility can account for the level of risk premia and its variation over time in both markets. The results suggest a common set of macroeconomic risk factors operating in equity and bond markets. I estimate the model using a simulation estimator that accounts for time aggregation of consumption growth and utilizes a rich set of moment conditions.


Background–Several non-pharmaceutical policies, which include stay-at-home orders, mobility restrictions, and quarantine, have been implemented to reduce the spread of novel coronavirus disease 2019 (COVID-19). The present study examines work style changes among company workers after COVID-19 and analyses their effects on workers' domain-specific sedentary and active behaviours. Methods - We analysed data from a nationwide prospective online survey in Japan. The data were obtained in February 2019 (n = 3200) and in July 2020 (n = 1709) from the registered individuals of a Japanese internet research service company. The participants reported work style patterns before and after the outbreak of COVID-19 in the follow-up survey. Domain-specific sedentary behaviours and physical activities were assessed by questionnaires. Paired t-tests were used to compare work styles before and after the outbreak of COVID-19. Multivariable linear regression models were used to assess the associations between changes in work style and changes in sedentary behaviours and physical activities. Results. Workers had more working from home days and fewer office-based working days after the outbreak of COVID-19 (p < 0.001 and p < 0.001, respectively). The increase in the number of working from home days per week was significantly associated with increases in work-related sitting time and total sitting time (b = 0.16, 95% CI 0.08, 0.24, p < 0.001 and b = 0.23, 95% CI 0.11, 0.36, p < 0.001, respectively). However, it was also associated with a decrease in car sitting time (b = −0.04, 95% CI −0.06, -0.01, p < 0.001). In addition, the increase in the number of working from home days was associated with a decrease in work-related moderate physical activity (b =−0.06, 95% CI −0.10, −0.02, p < 0.001). Conclusions. Our study provided preliminary evidence of an increase in working from home days in response to COVID-19 in Japan and of how this increase in the number of working from home days has affected workers' sedentary behaviours and physical activities. These findings shed light on the effects of COVID-19 on work styles and workers' sedentary behaviours and physical activity.


Electricity energy savings potential by eliminating air leakage from ducts in large commercial buildings is on the order of 10 kWh/m 2 per year (1 kWh/ft 2 ). We have tested, in two large commercial buildings, a new technology that simultaneously seals duct leaks and measures effective leakage area of ducts. The technology is based upon injecting a fog of aerosolized sealant particles into a pressurized duct system. In brief, this process involves blocking all of the intentional openings in a duct system (e.g., diffusers). Therefore, when the system is pressurized, the only place for the air carrying the aerosol particles to exit the system is through the leaks. The key to the technology is to keep the particles suspended within the airstream until they reach the leaks, and then to have them leave the airstream and deposit on the leak sites. The principal finding from this field study was that the aerosol technology is capable of sealing the leaks in a large commercial building duct system within a reasonable time frame. In the first building, 66% of the leakage area was sealed within 2.5 hours of injection, and in the second building 86% of the leakage area was sealed within 5 hours. We also found that the aerosol could be blown through the VAV boxes in the second building without impacting their calibrations or performance. Some remaining questions are (1) how to achieve sealing rates comparable to those experienced in smaller residential systems; and (2) what tightness level these ducts systems can be brought to by means of aerosol sealing.


South African motor manufacturers should find ways to improve their performance management systems to ensure survival in the face of strong competition in the market. The main objective of this study is to evaluate the industry's approach to performance management and to make recommendations about a framework for performance management that can be implemented to obtain a competitive advantage. A well‐known instrument that proves to be highly effective in performance management is the balanced scorecard. This instrument manages performance on four distinct levels, namely from the financial perspective, the customer perspective, internal business processes and learning and growth. It is apparent from the results of this study that performance management is still very much a one‐way process, and that a lack of communication is the primary reason for unsatisfactory workforce performance. Furthermore, the majority of motor manufacturers consider the customer perspective as the most important of the four above‐mentioned perspectives. Motor manufacturers also disagree about the number of performance measures that need to be included in the performance management system, and the majority feel that both controllable and non‐controllable fixed costs must be included in the measurement of management performance. Shareholder value measures are also largely neglected in practice.


This action research project examined the initial effects of an experiential learning intervention on students by instituting a long-term salt marsh research project at a New England private school. The field element of the research project included identification of salt marsh vegetation and measurement of soil salinity along three transects. Two first year high school biology classes were tested for student motivation towards learning biology, achievement in the relevant ecology unit and overall perception of the environment through preand post-intervention attitudinal surveys, summative evaluations, short answer essays, and teacher notes. The treatment group (N=9) studied the salt marsh ecology curriculum over a one month period and participated in two field days in the marsh while the non-treatment group (N=15) was exposed to the curriculum in the classroom only. It was discovered that treatment students had increased motivation toward learning biology. Achievement and perspective on environmental preservation remained fairly unchanged regardless of participation in the experiential research intervention. These factors together show that while experiential field work does not have significantly better results than standard ecology curriculum, it certainly was shown to be just as good as traditional classroom practices. When the geographic proximity and local significance of salt marsh preservation was considered, there was a strong argument that outdoor classroom activities in the marsh were worth pursuing. At the very least they were just as worthy as typical classroom based lessons and therefore should be considered as a worthwhile endeavor.


Background: Functional somatic symptoms (FSS), like chronic pain and overtiredness, are often assumed to be stress-related. Altered levels of the stress hormone cortisol could explain the association between stress and somatic complaints. We hypothesized that low cortisol levels after awakening and low cortisol levels during stress are differentially associated with specific FSS. Methods: This study is performed in a subsample of TRAILS (Tracking Adolescents' Individual Lives Survey) consisting of 715 adolescents (mean age: 16.1 years, SD = 0.6, 51.3% girls). Adolescents' cortisol levels after awakening and during a social stress task were assessed. The area under the curve with respect to the ground (AUCg) and the area under the curve above the baseline (AUCab) were calculated for these cortisol levels. FSS were measured using the Youth Self-Report (YSR) and pain questions. Based upon a factor analysis, FSS were divided into two clusters, one consisting of headache and gastrointestinal symptoms and the other consisting of overtiredness, dizziness and musculoskeletal pain. Results: Regression analyses revealed that the cluster of headache and gastrointestinal symptoms was associated with a low AUCg of cortisol levels during stress ( β = -.09, p =.03) and the cluster of overtiredness, dizziness and musculoskeletal pain with a low AUCg of cortisol levels after awakening ( β = -.15, p = .008). All these analyses were adjusted for the potential confounders smoking, physical activity level, depression, corticosteroid use, oral contraceptive use, gender, body mass index and, if applicable, awakening time. Conclusion: Two clusters of FSS are differentially associated with the stress hormone cortisol.


BACKGROUND
We sought to investigate the degree to which cognitive skills explain associations between health literacy and asthma-related medication use among older adults with asthma.

METHODS
Patients aged ≥ 60 years receiving care at eight outpatient clinics (primary care, geriatrics, pulmonology, allergy, and immunology) in New York, New York, and Chicago, Illinois, were recruited to participate in structured, in-person interviews as part of the Asthma Beliefs and Literacy in the Elderly (ABLE) study (n = 425). Behaviors related to medication use were investigated, including adherence to prescribed regimens, metered-dose inhaler (MDI) technique, and dry powder inhaler (DPI) technique. Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Cognitive function was assessed in terms of fluid (working memory, processing speed, executive function) and crystallized (verbal) ability.

RESULTS
The mean age of participants was 68 years; 40% were Hispanic and 30% non-Hispanic black. More than one-third (38%) were adherent to their controller medication, 53% demonstrated proper DPI technique, and 38% demonstrated correct MDI technique. In multivariable analyses, limited literacy was associated with poorer adherence to controller medication (OR, 2.3; 95% CI, 1.29-4.08) and incorrect DPI (OR, 3.51; 95% CI, 1.81-6.83) and MDI (OR, 1.64; 95% CI, 1.01-2.65) techniques. Fluid and crystallized abilities were independently associated with medication behaviors. However, when fluid abilities were added to the model, literacy associations were reduced.

CONCLUSIONS
Among older patients with asthma, interventions to promote proper medication use should simplify tasks and patient roles to overcome cognitive load and suboptimal performance in self-care.


Objective: Pyridoxine is 1 of 8 B vitamins that assist in a variety of essential functions including immune functions. The purpose of this study was to assess the risk factors associated with low pyridoxine levels in solid organ transplantation recipients. Design: The study cohort was divided into 2 groups: (a) patients with normal pyridoxine levels or (b) patients with low pyridoxine levels. Dietary evaluation and clinical characteristics of all patients, rejection episodes, and immunosuppression were collected. Simple descriptive statistics were used to analyze the overall cohort. Results: Of the 48 patients, 29 (60%) in the study cohort were identified to have low pyridoxine levels. The mean interval between transplantation and pyridoxine level check was 910 days (standard deviation [SD] 456). The mean weight at the time of dietary consultation was 80 kg (SD 20.7). More patients in the deficient group received thymoglobulin for rejection treatment (56% vs 0%; P = .01) and were thymoglobulin recipients (78% vs 10%; odds ratio [OR] = 31.5; 95% confidence interval [CI], 2.35-422.30; P < .01). A strong correlation was identified between thymoglobulin treatment for induction and a low level of pyridoxine (correlation coefficient R = 0.6, P = .004) and between thymoglobulin treatment for rejection and a low pyridoxine level (correlation coefficient R = 0.5, P = .05). Based on multivariate logistic regression analysis, only thymoglobulin treatment (induction or rejection treatment) was significantly associated with low pyridoxine levels (OR = 19.5, 95% CI, 1.01-375.24; P < .05). Conclusions: Low levels of pyridoxine appear to be relatively common, and thymoglobulin treatments are associated with low pyridoxine levels. Prospective studies are needed to confirm and valuate the significance of these findings.