This paper explores whether fundamental differences exist between urban and rural vulnerability to climate-induced changes in the fire regime of interior Alaska. We further examine how communities and fire managers have responded to these changes and what additional adaptations could be put in place. We engage a variety of social science methods, including demographic analysis, semi-structured interviews, surveys, workshops and observations of public meetings. This work is part of an interdisciplinary study of feedback and interactions between climate, vegetation, fire and human components of the Boreal forest social–ecological system of interior Alaska. We have learned that although urban and rural communities in interior Alaska face similar increased exposure to wildfire as a result of climate change, important differences exist in their sensitivity to these biophysical, climate-induced changes. In particular, reliance on wild foods, delayed suppression response, financial resources and institutional connections vary between urban and rural communities. These differences depend largely on social, economic and institutional factors, and are not necessarily related to biophysical climate impacts per se. Fire management and suppression action motivated by political, economic or other pressures can serve as unintentional or indirect adaptation to climate change. However, this indirect response alone may not sufficiently reduce vulnerability to a changing fire regime. More deliberate and strategic responses may be required, given the magnitude of the expected climate change and the likelihood of an intensification of the fire regime in interior Alaska.


Purpose The pathophysiological events that occur in advanced glaucoma are not well characterized. The principal purpose of this study is to characterize the gene expression changes that occur in advanced glaucoma. Methods Retinal RNA was obtained from canine eyes with advanced glaucoma as well as from healthy eyes. Global gene expression patterns were determined using oligonucleotide microarrays and confirmed by real-time PCR. The presence of tumor necrosis factor (TNF) and its receptors was evaluated by immunolabeling. Finally, we evaluated the presence of serum autoantibodies directed against retinal epitopes using western blot analyses. Results We identified over 500 genes with statistically significant changes in expression level in the glaucomatous retina. Decreased expression levels were detected for large number of functional groups, including synapse and synaptic transmission, cell adhesion, and calcium metabolism. Many of the molecules with decreased expression levels have been previously shown to be components of retinal ganglion cells. Genes with elevated expression in glaucoma are largely associated with inflammation, such as antigen presentation, protein degradation, and innate immunity. In contrast, expression of many other pro-inflammatory genes, such as interferons or interleukins, was not detected at abnormal levels. Conclusions This study characterizes the molecular events that occur in the canine retina with advanced glaucoma. Our data suggest that in the dog this stage of the disease is accompanied by pronounced retinal neuroinflammation.


Ion channels are protein molecules, embedded in the lipid bilayer of the cell
membranes. They act as powerful sensing elements switching chemicalphysical
stimuli into ion-fluxes. At a glance, ion channels are water-filled
pores, which can open and close in response to different stimuli (gating), and
one once open select the permeating ion species (selectivity). They play a
crucial role in several physiological functions, like nerve transmission,
muscular contraction, and secretion. Besides, ion channels can be used in
technological applications for different purpose (sensing of organic
molecules, DNA sequencing). As a result, there is remarkable interest in
understanding the molecular determinants of the channel functioning.
Nowadays, both the functional and the structural characteristics of ion
channels can be experimentally solved. The purpose of this thesis was to
investigate the structure-function relation in ion channels, by computational
techniques. Most of the analyses focused on the mechanisms of ion
conduction, and the numerical methodologies to compute the channel
conductance. The standard techniques for atomistic simulation of complex
molecular systems (Molecular Dynamics) cannot be routinely used to
calculate ion fluxes in membrane channels, because of the high
computational resources needed. The main step forward of the PhD research
activity was the development of a computational algorithm for the
calculation of ion fluxes in protein channels. The algorithm - based on the
electrodiffusion theory - is computational inexpensive, and was used for an
extensive analysis on the molecular determinants of the channel
conductance.
The first record of ion-fluxes through a single protein channel dates back to
1976, and since then measuring the single channel conductance has become
a standard experimental procedure. Chapter 1 introduces ion channels, and
the experimental techniques used to measure the channel currents. The
abundance of functional data (channel currents) does not match with an
equal abundance of structural data. The bacterial potassium channel KcsA
was the first selective ion channels to be experimentally solved (1998), and
after KcsA the structures of four different potassium channels were revealed.
These experimental data inspired a new era in ion channel modeling. Once
the atomic structures of channels are known, it is possible to define
mathematical models based on physical descriptions of the molecular
systems. These physically based models can provide an atomic description
of ion channel functioning, and predict the effect of structural changes.
Chapter 2 introduces the computation methods used throughout the thesis to
model ion channels functioning at the atomic level.
In Chapter 3 and Chapter 4 the ion conduction through potassium channels is
analyzed, by an approach based on the Poisson-Nernst-Planck
electrodiffusion theory. In the electrodiffusion theory ion conduction is
modeled by the drift-diffusion equations, thus describing the ion
distributions by continuum functions. The numerical solver of the Poisson-
Nernst-Planck equations was tested in the KcsA potassium channel (Chapter
3), and then used to analyze how the atomic structure of the intracellular
vestibule of potassium channels affects the conductance (Chapter 4). As a
major result, a correlation between the channel conductance and the
potassium concentration in the intracellular vestibule emerged. The atomic
structure of the channel modulates the potassium concentration in the
vestibule, thus its conductance. This mechanism explains the phenotype of
the BK potassium channels, a sub-family of potassium channels with high
single channel conductance.
The functional role of the intracellular vestibule is also the subject of
Chapter 5, where the affinity of the potassium channels hEag1 (involved in
tumour-cell proliferation) and hErg (important in the cardiac cycle) for
several pharmaceutical drugs was compared. Both experimental
measurements and molecular modeling were used in order to identify
differences in the blocking mechanism of the two channels, which could be
exploited in the synthesis of selective blockers. The experimental data
pointed out the different role of residue mutations in the blockage of hEag1
and hErg, and the molecular modeling provided a possible explanation based
on different binding sites in the intracellular vestibule.
Modeling ion channels at the molecular levels relates the functioning of a
channel to its atomic structure (Chapters 3-5), and can also be useful to
predict the structure of ion channels (Chapter 6-7). In Chapter 6 the structure
of the KcsA potassium channel depleted from potassium ions is analyzed by
molecular dynamics simulations. Recently, a surprisingly high osmotic
permeability of the KcsA channel was experimentally measured. All the
available crystallographic structure of KcsA refers to a channel occupied by
potassium ions. To conduct water molecules potassium ions must be
expelled from KcsA. The structure of the potassium-depleted KcsA channel
and the mechanism of water permeation are still unknown, and have been
investigated by numerical simulations. Molecular dynamics of KcsA
identified a possible atomic structure of the potassium-depleted KcsA
channel, and a mechanism for water permeation. The depletion from
potassium ions is an extreme situation for potassium channels, unlikely in
physiological conditions. However, the simulation of such an extreme
condition could help to identify the structural conformations, so the
functional states, accessible to potassium ion channels.
The last chapter of the thesis deals with the atomic structure of the !-
Hemolysin channel. !-Hemolysin is the major determinant of the
Staphylococcus Aureus toxicity, and is also the prototype channel for a
possible usage in technological applications. The atomic structure of !-
Hemolysin was revealed by X-Ray crystallography, but several experimental
evidences suggest the presence of an alternative atomic structure. This
alternative structure was predicted, combining experimental measurements
of single channel currents and numerical simulations.
This thesis is organized in two parts, in the first part an overview on ion
channels and on the numerical methods adopted throughout the thesis is
provided, while the second part describes the research projects tackled in the
course of the PhD programme. The aim of the research activity was to relate
the functional characteristics of ion channels to their atomic structure. In
presenting the different research projects, the role of numerical simulations
to analyze the structure-function relation in ion channels is highlighted.


The correspondence between the firing rates of atrial myocytes during atrial fibrillation and the dominant frequencies observed in the Fourier spectra of the corresponding surface ECG signals was studied. The observations were based on signals simulated using a biophysical model of the atria and of the volume conduction effects of the thorax. Different substrates for AF were generated, each resulting in a different type of AF dynamics. The results indicate that the full Fourier spectrum yields more information on the complexity of a particular variant of AF than the analysis of just its dominant frequency. The same applies to analyzing the spectra of multiple leads rather using just single lead signals.


The wireless channel is a hostile environment. The transmitted signal does not only suffers multi-path fading but also noise and interference from other users of the wireless channel. That causes unreliable communications. To achieve high-quality communications, error correcting coding is required to mitigate the noise and interference encountered during the signal transmission. However, the current design of error correcting codes does not take the power consumption in ADCs into account. ADCs consume about 50% of the total base-band power. The power-efficiency of ADCs does not increase in the same speed as the baseband signal processing. Digital signal processing follows Moore's law. Given the same specification, the power consumed in ADCs halves every 2.7 years but the power consumption in the baseband signal processing decreases a factor of 10 every 5 years. In the case of RF signal processing, the power efficiency is limited by the semi-conductor technology. Therefore, ADCs are the main bottleneck for an energy-efficient wireless receiver. Quantized channels arise in practical communication systems where ADCs are used to sample the analog transmitted signals. Conventional narrow-band systems usually do not take quantization into account, since a large number of quantization levels is used. In this case the difference between the quantized and unquantized channel can
be neglected. To lower the resolution of ADCs in the narrow-band wireless system, the design of the error correcting coding should consider the quantization effect. This
thesis describes the design of a coding scheme for the quantized channel. The approach
is based on multi-level coding and binary block codes to achieve the theoretical limits
in the narrow-band wireless channel.
Wide-band wireless systems often employ OFDM to ease the equalizer in the receiver.
OFDM has a high Peak-to-Average Power Ratio (PAPR) which is the main disadvantage
of OFDM. When signal peaks in the OFDM signal are clipped, all sub-carriers
are affected. Because the wide-band wireless channel is often modeled as a frequency
selective fading channel, some part of the channel may suffer from deep fading and
can not afford any distortion. Consequently, the communication is unreliable. That
urges the usage of high-resolution ADCs in OFDM systems. Current OFDM systems employ fixed high-resolution ADCs which are designed for the worst-case scenario.
However, the worst-case scenario does not happen often. This thesis proposes to apply
resolution adaptive ADCs in the OFDM system. In such a case, the ADC can
be designed for each channel condition instead of fixing for the worst-case scenario.
Correspondingly, the power consumption in ADCs reduces.
A further resolution reduction in ADCs can be achieved by designing an energy efficient
error correcting coding for the OFDM system. The error correction coding
in the current OFDM system is based on the joint coding scheme, which encodes
the source data over all the sub-carriers in parallel. The joint coding scheme works
better than separate coding, as it employs the fact that sub-carriers with high energy
can compensate for sub-carriers with low-energy. Its drawback is each sub-carrier
must be decoded, also the ones in deep fading. Hence, the maximum level of the
noise floor endured by the joint coding scheme is limited to the dynamic range of
the channel. Correspondingly, the minimum resolution of the ADC required by the
joint coding scheme in a certain channel condition is dependent on the dynamic range
of the channel. A way to reduce the dynamic range of the channel is to neglect
the deep-fading part of the channel and to exploit the high-energy part only. Obviously,
the joint-coding scheme can not apply this. Therefore, we propose in this
thesis an energy-efficient error correction scheme based on fountain codes for OFDM
systems. Fountain codes can reconstruct the original source file by only collecting
enough fountain-encoded packets. It does not matter which packet is received as we
only need to receive enough packets. In other words, fountain-encoded packets are
independent with respect to each other. Since fountain codes are designed for erasure
channels, error correction codes are required to transfer the noisy wireless channel into
an erasure channel. That inspires us to exchange the code rate of error correction
codes with the number of sub-carriers to be discarded. In this case, the resolution of
ADCs and thus the power consumption can be reduced even more.


Background: Cervical cancer is one of the most common cancers in women worldwide with 122,844 women are diagnosed every year in India. 67,477 die from the disease. High-quality screening with cytology (Pap smear) has markedly reduced mortality from squamous cell cervical cancer. Objective: Efficacy of Kasīsādi Kṣāra Karma followed by Dārvyādi Yonivarti (Vaginal suppository) in cervical cell pathology was evaluated. Materials and Methods: Total 44 patients with cervical erosion diagnosed by Pap smear test were selected from the outpatient department of Prasutitantra and Streeroga, out of which three patients discontinued. The treatment protocol comprised of Kṣāra Karma by Kasīsādi Kṣāra in one sitting followed by Dārvyādi Yoni Varti of 3 gm once at bed time from next day for 21 days. The assessment was done with subjective criteria and Pap-smear after 45 days. Results: The results were observed to be highly significant in clinical features of disease such as yonitaḥ -srāva (77.67%), yoni-kaṇḍu (84.09%), yoni-dāha (87.5%), kaṭi -śūla (73.41%), udara -śūla ( 79.48%), mūtra- dāha (84%), daurbalya ( 72.34%) and area of erosion (85.96%), appearance of erosion (69.32%). Conclusion:Kasīsādi Kṣāra followed by Dārvyādi Yoni Varti was effective in the management of primitive cervical cell pathology.


Feathers from carcasses of the Lesser Flamingo (Phoeniconaias minor), which had died after ingesting cyanobacterial toxins (cyanotoxins) contained between 0.02 and 30.0 µg microcystin-LR equivalents per gram of feather according to HPLC and ELISA analysis of feather extracts. Anatoxin-a was detected less frequently in the Lesser Flamingo feathers, up to 0.8 µg anatoxin-a per gram of feather being recorded. When feathers from different body regions were analysed and compared for microcystins and anatoxin-a, wing feathers were found to contain the highest concentrations of these cyanotoxins, the order of concentration and frequency of analytical detection being wing > breast > head. Consistent with the presence of the microcystins and anatoxin-a in gut contents and the livers of the dead birds and negligible in vitro adsorption to feathers, the cyanotoxins associated with the feathers of the dead wild flamingos are inferred to be primarily of dietary origin. †Dedicated to the memory of Ekkehard and Angelika Vareschi.


The fundamental properties of the Omani sarooj have been studied. Sarooj samples were collected from different sites to assess their pozzolanic activity. A laboratory testing program covering chemical and physical properties (consistency, setting times and compressive strength) were carried out. The effect of burning at different temperatures and durations on strength development was studied. The properties of sarooj were found to be dependent on the type of the clay, chemical composition, temperature and duration of burning. The controlling factors were viewed simultaneously in analyzing the test results. The optimum temperature that achieved the maximum compressive strength was found to be between 700°C and 800°C. At the optimum temperature, longer duration of burning produced shorter setting times.


A new analysis of the data set from the Pierre Auger Observatory provides evidence for anisotropy in the arrival directions of ultra-high-energy cosmic rays on an intermediate angular scale, which is indicative of excess arrivals from strong, nearby sources. The data consist of 5514 events above with zenith angles up to 80° recorded before 2017 April 30. Sky models have been created for two distinct populations of extragalactic gamma-ray emitters: active galactic nuclei from the second catalog of hard Fermi-LAT sources (2FHL) and starburst galaxies from a sample that was examined with Fermi-LAT. Flux-limited samples, which include all types of galaxies from the Swift-BAT and 2MASS surveys, have been investigated for comparison. The sky model of cosmic-ray density constructed using each catalog has two free parameters, the fraction of events correlating with astrophysical objects, and an angular scale characterizing the clustering of cosmic rays around extragalactic sources. A maximum-likelihood ratio test is used to evaluate the best values of these parameters and to quantify the strength of each model by contrast with isotropy. It is found that the starburst model fits the data better than the hypothesis of isotropy with a statistical significance of 4.0σ, the highest value of the test statistic being for energies above . The three alternative models are favored against isotropy with 2.7σ–3.2σ significance. The origin of the indicated deviation from isotropy is examined and prospects for more sensitive future studies are discussed.


Objective: Insurgents use terrorism as a tactic to push government to accede their demands Reports on the injuries inflicted by Boko Haram insurgency are not many. One from Maiduguri found out that over 90% of those affected are male. The objective of this study was to analyze the pattern of oral and maxillofacial injuries encountered during the BH insurgency in the Nigerian North Western states of Kano and Kaduna
Methods: A retrospective study covering patients brought from terrorist and other attacks by BH in the North Western Nigerian States of Kaduna and Kano seen at 3 tertiary care centres from 2010 to 2015 was conducted.
Results: A total of 56 cases were seen in study and the ratio of 17.7:1.  The mean age in years and standard deviation (SD) were 31.3 (9.70) years. The third decade was where most of the victims (37.5%) were found. Over 90% of the victims were brought to the accident and emergency center within 1-3 hours of sustaining injuries.
Conclusion:  The management of victims of insurgency in the Northwest Nigeria has been a challenge in the sense for lack of facilities and manpower.


In Norway, Sweden and Finland hunting Eurasian beaver Castor fiber Linnaeus, 1758 with firearms is presently the main harvest form and most are shot in late April and early May. As beaver cannot be sexed from external characteristics, and ageing by size is difficult, hunters usually shoot the first animal seen. This tends to select for pregnant females, which may conflict with management objectives. This study investigated whether pregnant females were more susceptible to being shot at a particular period of the season, time of day, or distance from the lodge to evaluate these criteria as a basis for selective shooting. Also, we examined the potential for using body size to selectively cull age groups. Beaver (n = 126) were shot between 13 March and 15 May, 1997-99, in southeast Norway. Neither period of the season nor time of day shot were adequate selective criteria. Pregnant females were shot significantly further away from the lodge than juveniles and averaged 2.6 times heavier. Thus hunting nearer the lodge and attempting to shoot smaller individuals may reduce the take-off of pregnant females. However, hunting in as few colonies as possible while leaving remaining colonies for recruitment should be more effective. .


The current study assessed the relative influence of both injunctive and descriptive norms in the context of different referent groups (i.e., family, street peers, home-based peers, and staff members) on past 30-day methamphetamine, heroin, and injection drug use behaviors of homeless youth. Cross-sectional data (N = 911) were collected from three drop-in centers in Los Angeles, California. The study consisted of two parts: a social network interview and a computerized self-administered survey. Multivariate logistic regression models examined the association of objection to drug use from referent groups (injunctive norms; that is, street-based peers, home-based peers, relatives, staff members) and drug use of referent groups (descriptive norms) with youths' substance use behaviors. Multivariate results indicated that the role of injunctive and descriptive norms varied across the three substance use behaviors and by referent group. Findings indicate the need to carefully consider the diversity of homeless youths' networks in designing substance use interventions.


People living with Complex Regional Pain Syndrome (CRPS) experience frustration with the lack of knowledge and understanding of CRPS as a pain condition. In this case study, we explain how we worked with a group of people living with CRPS with the intention of helping them create a Wikipedia page about CRPS written by them, for people like them. We share what happened when our participants did not engage. We show you how we found a solution and in so doing, show how you can be creative when facing research challenges, yet still meet the essence of the original goal of the research.


textabstractRitzer presents his 'The McDonalization of Society' as a social critique on the nationalization of modern society. In this article I will analyze the underlying assumptions of his critique. By means of a meta-theoretical analysis, I examine Ritzer's views on modernity and rationality. This analysis reveals that Ritzer holds a rather dualistic view of the relation between man and society. Ritzer does not give much thought to the ambivalence of modernity. I wil further argue that Ritzer uses a resticted idea of rationality. As a result, he can not escape the pessimism which also marked Weber's vision of the future. Ritzer can only offer his reader the hope that an awareness of McDonzalization will unleash a critical attitude towards the inevitable rationalization of the lifeworld. He does not present a well-founded theory of rational behavior, necessary for coping with a McDonzalized society. By introducing Habermas' theory of communicative action, and more specific his idea of rationality, I propose an alternative to Ritzer's hope.


Developing Countries (DCs), particularly those in Sub-Saharan Africa (SSA), are suffering from scientific information famine. The expectation that the internet would facilitate scientific information flow does not seem to be realisable, owing to the restrictive subscription fees of the high quality sources and the beleaguering inequity in the access and use of the internet and other Information and Communication Technology (ICT) resources. This paper aims to assess and evaluate Open Access (OA) movement as a proposed solution to avoid the restrictions over accessing scientific knowledge, particularly in SSA. The paper also outlines the opportunities and challenges in implementing OA in SSA. However, there are often mismatches between what the 'donor' countries can reasonably offer and what the SSA countries can implement. Finally, the paper will discuss the slow uptake of the OA in Africa, the perception of the African scientists towards the movement, the non-expression of concern by policymakers and their implications on the scientific activities in Africa.


What do the laws governing municipal annexation, collective bargaining, and race-conscious employment decisions have in common? Each plays a significant and under-appreciated role in shaping local law enforcement practices even though each, on its face, has nothing to do with policing.This Article explores the incidental regulation of policing, illustrating the concept with examples from different areas of state and federal law. Many legal decisions happen to include police as constituents of a broader regulatory ambit, and thus are not intended to have any particular effect on the unique functions of policing. Nevertheless, these laws have profound ramifications for police practices. Policing-neutral laws can alter the dynamics of inter-agency cooperation, encourage the adoption of a particular policing style, and change the way that police interact with the members of the communities they patrol. Each of these effects can change how rank-and-file officers go about their jobs. Some, for example, encourage officers to engage in aggressive criminal enforcement while others expand the range of tactics that officers can use to respond to potential problems and to non-criminal disorder. This Article contends that recognizing the incidental effects of policing-neutral law is a necessary prerequisite to understanding and reforming police practices. The incidental regulation of policing is troubling when some broader legal decision affects unique policing functions. Here, the impact on officer behavior does not benefit from the deliberative process that protects the important societal interests that law enforcement implicates. This Article suggests mechanisms for identifying and addressing the potential problems of incidental regulation in the policing context. By taking a more comprehensive view of the legal environment in which police operate, we can more fully understand how the law shapes officer behavior. That understanding, in turn, can pave the way to a tighter regulatory regime and more effective police reform.


ABSTRACT Estimation of the macroeconomic effects of an earthquake critically depends on the identification of the affected area's boundaries, socioeconomic local heterogeneity and proper counterfactual analysis. By taking the 2012 Emilia-Romagna earthquake (Italy) as a case study, this paper answers these questions in a sub-regional framework. Cluster analysis tackles the heterogeneity issue, returning different types of affected municipalities. A difference-in-differences analysis then suggests that, since 2012, some clusters (and some municipalities within them) have performed better than others. This contrasts with the results observed by comparing the whole affected area with the non-affected one, with implications for both policy interventions and the recovery processes.


BACKGROUND AND OBJECTIVES
Studies examining dose of continuous renal replacement therapy (CRRT) and outcomes have yielded conflicting results. Most studies considered the prescribed dose as the effluent rate represented by ml/kg per hour and reported this volume as a surrogate of solute removal. Because filter fouling can reduce the efficacy of solute clearance, the actual delivered dose may be substantially lower than the observed effluent rate.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS
Data were examined from 52 critically ill patients with acute kidney injury (AKI) requiring dialysis. All patients were treated with predilution continuous venovenous hemodiafiltration (CVVHDF) and regional citrate anticoagulation. Filter performance was monitored during the entire course of therapy by measuring blood urea nitrogen (BUN) and dialysis fluid urea nitrogen (FUN) at initiation and every 12 hours. Filter efficacy was assessed by calculating FUN/BUN ratios every 12 hours of filter use. Prescribed urea clearance (K, ml/min) was determined from the effluent rate. Actual delivered urea clearance was determined using dialysis-side measurements.

RESULTS
Median daily treatment time was 1413 minutes (1260 to 1440) with a total effluent volume of 46.4 ± 17.4 L and urea mass removal of 13.0 ± 7.6 mg/min. Prescribed clearance overestimated the actual delivered clearance by 23.8%. This gap between prescribed and delivered clearance was related to the decrease in filter function assessed by the FUN/BUN ratio.

CONCLUSIONS
Effluent volume significantly overestimates delivered dose of small solutes in CRRT. To assess adequacy of CRRT, solute clearance should be measured rather than estimated by the effluent volume.


Objective:To compare the outcomes of mitral repair and replacement in revascularized patients with ischemic mitral regurgitation. Summary Background Data:Combined coronary bypass (CABG) and mitral procedures have been associated with the highest mortality (>10%) in cardiac surgery. Recent studies have suggested that mitral valve replacement (MVR) with sparing of the subvalvular apparatus had comparable results to mitral repair when associated with CABG. Methods:Over the past 7 years, 54 patients had CABG/mitral repair versus 56 who had CABG/MVR with preservation of the subvalvular apparatus. The groups were similar in age at 69.2 years in the replacement group versus 67.0 in the repair group. We compared these 2 groups based on hospital mortality, incidence of complications including nosocomial infection, neurologic decompensation (stroke), pulmonary complication (pneumonia, atelectasis, and prolonged ventilation), and renal complications (acute renal failure or insufficiency). Results:The mitral repair group had a hospital mortality of 1.9% versus 10.7% in the replacement group (P = 0.05). Infection occurred in 9% of repairs compared with 13% of replacements (P = 0.59). The incidence of stroke was no different between groups (2 of 54 repairs vs. 2 of 56 replacements, P = 1.00). Pulmonary complication rate was 39% in repairs versus 32% in replacements (P = 0.59). Worsening renal function occurred in 15% of repairs versus 18% of replacements (P = 0.67). Conclusions:Mitral repair is superior to mitral replacement when associated with coronary artery disease in terms of perioperative morbidity and hospital mortality. Although preservation of the subvalvular apparatus with MVR has a theoretical advantage in terms of ventricular function, mitral repair clearly adds a survival benefit in patients with concomitant ischemic cardiac disease.


Recent decades have seen a large increase in surface scums (blooms) of cyanophytes (blue‐green algae and blue‐green bacteria) in inland waters. These are potentially toxic to mammals, including humans, and have caused considerable public concern in Europe, Australasia, and North America. They are often associated with eutrophication, and much has been invested in their control. Not all blooms, however, are necessarily the results of human interference with lakes. Scattered paleolimnological evidence indicates that some blooms may be associated with pristine conditions, though this message has largely been ignored. Evidence is given here of a long history of blooms in Whitemere, U.K., from extraction and identification of specific carotenoids from dated sediment cores. Whitemere is representative of a large group of lakes in the West Midlands of the U.K. and is likely to be representative also of those similar postglacial kettle hole lakes in North America and Eurasia, which are groundwater fed with long retention times and thermally stratified. Blue‐green blooms may thus be a normal feature of such lakes and not necessarily a pathology to be controlled.


Fish growth is important for fisheries management and aquaculture. The growth pattern of fish is a complex process which is influenced by environmental factors, hormones and genetic composition. Thyroid hormones (THs) play an important role in regulating fish growth. The identification of TH-dependant genes in fish could provide valuable information for predicting growth. Brook charr is an important species in aquaculture and therefore represents a good model to study fish growth. The objectives of this study were: (1) to identify TH-regulated genes in brook charr, (2) to identify growth responsive genes in brook charr and assess whether or not the expression of TH dependent genes are altered in fast and slow growing fish using a genomics approach.
To identify TH-dependant genes, three experimental groups of immature charr were used: a euthyroid control group (n=lO), a hyperthyroid group (n=lO) in which brook charr were injected (i.p.) with 3, 5, 3'-triiodo-L-thyronine (T3; 10 ug/kg body weight), and a hypothyroid group (n=lO) in which fish were injected with sodium ipodate (50 mg/kg body weight) a TH inhibitor. Fish were injected on days 1 and 4 of the experiment and sampled on day 7. Serum T3 levels were measured by radioimmunoassay. Results indicate that serum T3 concentrations decreased from 2.20 ng/ml in controls to 0.85 ng/ml in the ipodate treated group. T3 levels in the hyperthyroid group were 263.4 ng/ml. THs induced hepatic gene expression as measured by differentiai display PCR. The results show that over 100 transcripts were differentially regulated by THs. The expression of 18 of these genes was further confrrmed by reverse dot blot. These were then cloned and sequenced. Sequence homology comparisons revealed seven known genes: trypomyosin (3 isoforms), leukocyte-derived chemotaxin, mitochondrial NADH dehydrogenase subunit 5, basic transcription factor 3 and crystalline. Eleven genes had no significant homology to known gene and were therefore considered novel. Tissue distribution of the transcripts, as determined by Northem blot analysis, varied for each gene. While ali genes were expressed in liver, clearly the functions of these genes were not restricted to hepatic function as most of these were expressed in multiple tissues.
Since THs are known to be important regulators of growth, we wanted to determine whether or not the expression of TH-dependent genes differed between animais exhibiting different growth rate. To characterize growth-dependent gene expression profiles, eDNA arrays (GRASP project, University of Victoria) containing
16,000 genes were used. Two families of immature brook charr that were known to exhibit different growth characteristics were compared. These fish bad been raised under similar rearing conditions from egg incubation to the time of sampling (April, 2003). One family bad fast growing fish (n=8; average weight 54.73 ± 12.14 g) while the second bad slow growing fish (n=8; average weight 8.43 ± 1.59 g). Total RNA isolated from livers of fast and slow growing fish were used to prepare eDNA probes. The eDNA probes were labeled and hybridized to the eDNA microarrays. Microarrays were scanned and analyzed using GeneSpring software according to MIAME standards. A total of 94 genes were found to be growth-dependent exhibiting at least a 2-fold change in expression. There were 69 genes that were up-regulated and 25 genes were down-regulated in fast growing fish. Out of the 94 differentially expressed genes, 39 of these are known genes that have been implicated in regulating carbohydrate, fatty acid and protein metabolism, as weil as mitochondrial function and signaling pathways. Twenty of these have been shawn in the literature to be TH-dependent. The remaining 55 genes have unknown functions. Only two of the genes (basic transcription factors and leukocyte-derived chemotaxin) identified in the first experiment were present on the microarrays. However, the microarray results did not indicate different expression for these two between our fast and slow growing fish. These results indicate that TH-dependent genes may be associated with growth.
In conclusion, we have identified 18 TH-dependent genes in brook charr. This bas allowed us to show that THs are implicated in a wide variety of physiological processes as indicated by their function and tissue expression pattern. The genomic analysis of hepatic gene expression in fast and slow growing fish revealed that 20 genes that are known to be TH-dependent and regulated by growth. This supports previous reports that THs may be involved in the regulation of growth.


Many companies are investing in coaching services for professional drivers with the goal of teaching them how to reduce fuel usage, as well as other eco-driving skills. To succeed, a clear perception of the variations in fuel consumption that can be attributed to driving behaviour is required. Currently, vehicles operated by CGI client Scania Group, a leading global transport provider, are equipped with monitoring devices that generate both driver and vehicle data. This allows us to relate fuel consumption with data gathered using a CAN Bus (controller area network) and from other sources like weather. To model the relation, we combined predictive analytics with Scania data on more than three million trips completed across seven European Union countries. In this paper, we explain the methods used and models built that allow for comparisons of the impact of eco-driving coaching for different fleets and countries. We also discuss unexpected statistical relations encountered during the analysis. In addition, we propose an estimated effect of coaching (EEOC), which provides a realistic estimate of the fuel savings to be gained from eco-driving coaching.


According to the psychological and social changes of adolescence, people in relationships with family, school and peers experience conflict. In shaping attitudes and views of adolescent, emotional aspects of relationships between parents and children are very important. Meanwhile, reviewing of the factors that influence the development of mental health, happiness and hope in the lives of young people involved, become important. This study aimed to evaluate the mental health, happiness and life expectancy in children of veterans and non-veterans in Qom's Shahed schools, 2015. This was a descriptive-comparative study. Questionnaires were completed by 286 high school female students in Qom through multi-stage sampling (cluster and stratified). Research tools: demographic questionnaires and 3 standard questionnaire (Oxford health, happiness and life expectancy, Schneider). The data collected were analyzed by SPSS software. Mental health, happiness and life expectancy in students with veteran and non-veteran parents were not significantly different. Among the studied variables, only the average had a significant relationship with all three of these variables. Kids are the future of the country, so their public health, happiness and life expectancy is of particular importance. Therefore, planning for them, makes the future of the country. To have a healthy and happy society, it is useful to have a special look at this generation.


The color temperature tunable warm-white/cool-white (WW/CW) LED cluster with extrahigh color rendering index (CRI) and high luminous efficacy of radiation (LER) has been obtained by simulation. The results show that the WW/CW LED cluster could realize correlated color temperature tunable white-lights with CRIs above 95, special CRIs of R9 above 81, and LERs above 310lm/W at CCTs of 2700K to 6500K.


In the March 2008 General Elections, the ruling Barisan Nasional (National Front) lost its two-third majority. It was the first time since independence that the Opposition was able to threaten the BN. This paper looks at the roles played by Anwar Ibrahim, the Opposition and civil society in this historical election, and argues that Malaysian politics will never be the same again. Although race and religion remain the core of the system, cross ethnic voting and the wide use of the internet to campaign may herald the start of a real competitive electoral system.


AbstractThe Cyclone Global Navigation Satellite System (CYGNSS) is a new NASA earth science mission scheduled to be launched in 2016 that focuses on tropical cyclones (TCs) and tropical convection. The mission's two primary objectives are the measurement of ocean surface wind speed with sufficient temporal resolution to resolve short-time-scale processes such as the rapid intensification phase of TC development and the ability of the surface measurements to penetrate through the extremely high precipitation rates typically encountered in the TC inner core. The mission's goal is to support significant improvements in our ability to forecast TC track, intensity, and storm surge through better observations and, ultimately, better understanding of inner-core processes. CYGNSS meets its temporal sampling objective by deploying a constellation of eight satellites. Its ability to see through heavy precipitation is enabled by its operation as a bistatic radar using low-frequency GPS signals. The mission will depl...


Television can be imagined in a number of ways: as a profuse flow of images, as a machine that produces new social relationships, as the last lingering gasp of Western metaphysical thinking, as a stuttering relay system of almost anonymous messages, as a fantastic construction of time. Richard Dienst engages each of these possibilities as he explores the challenge television has posed for contemporary theories of culture, technology, and media.

Five theoretical projects provide Still Life in Real Time with its framework: the cultural studies tradition of Raymond Williams; Marxist political economy; Heideggerian existentialism; Derridean deconstruction; and a Deleuzian anatomy of images. Drawing lessons from television programs like Twin Peaks and Crime Story , television events like the Gulf War, and television personalities like Madonna, Dienst produces a remarkable range of insights on the character of the medium and on the theories that have been affected by it.

From the earliest theorists who viewed television as a new metaphor for a global whole, a liberal technology empty of ideological or any other content, through those who saw it as a tool for consumption, making time a commodity, to those who sense television's threat to being and its intimate relation to power, Dienst exposes the rich pattern of television's influence on philosophy, and hence on the deepest levels of contemporary experience.

A book of theory, Still Life in Real Time will compel the attention of all those with an interest in the nature of the ever present, ever shifting medium and its role in the thinking that marks our time.


Veal is a promising raw material for use in the daily diet, as well as for production of functional and dietary foods. However the effect of cold treatment on the amino acid composition of veal has not been sufficiently studied. The aim of this study was the amino acid composition analysis of veal subjected to various variants of cold treatment. The selected material under research was muscle tissue of hip parts from calves, grown in the Leningrad Region, Russia and aged no more than 3 months. Cooling to 4 ± 1°C and rapid freezing to the temperature of minus 18 °C at the cooling air temperatures of minus 24 °C and minus 35 °C were used as variants of cold treatment. Amino acid composition analyses were carried out using precolumn derivatization with phenylisothiocyanate and reversed-phase gradient HPLC on the Shimadzu 20-AD chromatograph with spectrophotometric detection at 254 nm. The results show the effect of cold treatment on the content of free amino acids and total amino acid composition of veal. In many respects changes in amino acid composition are concerned with moisture losses during the refrigerating treatment. The dependence between the change in amino acid content and the structure of its side chain group type is shown. Amino acid score for essential amino acids was calculated and conclusions about changes in biological value of veal protein were made. The obtained data can be used in biological value calculation of the multi-component products and food rations with veal subjected to refrigerating treatment.


Objective: To determine the bacterial causative causes of diarrhea and related factors in children under 5 years in Kerbala Province, Iraq.Methods: The study was conducted on 648 children infected with diarrhea under the age of 5 years, visited hospitals and health centers in the province of Karbala for the period from January 2016 to October 2016 and collected information related to the patient by a special form for that.Results: The results showed that rate of bacterial infection of diarrhea is 244 (37.65%) of the total diseased samples of 648 cases. Rural characterized areas of Kerbala were the highest rate of diarrhea (33) compared with the center of Karbala urban landscape, the distributed highest infection was recorded in the Alhur (43.85%), and the lowest infected rate in the center of the of Karbala (39.75%). Diarrhea increase within May 33 (49.24%) and decrease during January 14 (24.56%) The isolates bacteria were distributed as follows: About 82 isolates (33.6%) from enteropathogenic Escherichia coli (EPEC), followed by 34 isolates (13.9%) Proteus mirabilis, 31 isolates (12.7%) Salmonella Typhimurium, 26 isolates (10.7%) Klebsiella pneumonia, 23 isolates (9.4%) Pseudomonas aeruginosa, 21 isolates (8.6%) Shigella spp, 16 isolates (8.6%) Aeromonas hydrophila, 6 isolates (2.5%) Staphylococcus aureus, four isolates (1.6%) Enterobacter areogenosa, and one isolates (0.4%) Vibrio cholera. There was no significant difference between gender in infected diarrhea patients. Bacterial isolates showed various reactions to the antibiotic used in the study.Conclusions: Enteropathogenic E. coli considered as a most common etiology of bacterial diarrhea in children under 5 years in Kerbala Province, Iraq, especially, aged 12–23 months. All isolates bacteria showed sensitivity to the Norfloxacin and resistant against Trimethoprim, Amoxicillin. Antibiotics should be used wisely after antibiotic susceptibility test.


Multisystemic Therapy (MST) is an intensive familyand community-based treatment that addresses the multiple determinants of serious antisocial behavior in juvenile offenders. The multisystemic approach views individuals as being nested within a complex network of interconnected systems that encompass individual, family, and extrafamilial (peer, school, neighborhood) factors. Intervention may be necessary in any one or a combination of these systems.


Aims: To investigate the seldom published views of children with type 1 diabetes about their condition and ways in which they share in managing their medical and health care with adults. Methods: Semi-structured, tape recorded interviews, during 2003, with a purposive sample of 24 children aged 3–12 years who have type I diabetes and who attend two inner London hospitals and one hospital in a commuter town. Results: The children reported high levels of understanding, knowledge, and skill gained from their experience of living with diabetes and constantly having to take account of the condition and their paediatrician's guidance. Their key goals were to be "normal" and "just get on with their lives". Discussion: The interviews showed that children's experiences of diabetes tended to enable them to make informed, "wise" decisions in their own best interests, even at a young age. They achieved a complicated balance between the sometimes competing goals of social health "being normal" and physiological health in controlling glycaemia. Their competence supports approaches in children's rights and in policy makers' aims that people with diabetes—including children—gain more knowledge, skills, and responsibility for their own care in partnership with healthcare professionals. Consent is usually considered in relation to surgery; however the children showed how they constantly dealt with decisions about consent or refusal, compliance with, or resistance to their prescribed treatment. Their health depends on their informed commitment to medical guidance; more research is needed about the daily realities of children's committed and responsible co-management of their chronic illness.


Surface ozone is an air pollutant that contributes to hundreds of thousands of premature deaths annually. Accurate short-term ozone forecasts may allow improved policy to reduce the risk to health, such as air quality warnings. However, forecasting ozone is a difficult problem, as surface ozone concentrations are controlled by a number of physical and chemical processes which act on varying timescales. Accounting for these temporal dependencies appropriately is likely to provide more accurate ozone forecasts. We therefore deploy a state-of-the-art transformer-based model, the Temporal Fusion Transformer, trained on observational station data from three European countries. In four-day test forecasts of daily maximum 8-hour ozone, the novel approach is highly skilful (MAE = 4.6 ppb, R = 0.82), and generalises well to two European countries unseen during training (MAE = 4.9 ppb, R = 0.79). The model outperforms standard machine learning models on our data, and compares favourably to the published performance of other deep learning architectures tested on different data. We illustrate that the model pays attention to physical variables known to control ozone concentrations, and that the attention mechanism allows the model to use relevant days of past ozone concentrations to make accurate forecasts.


We consider online learning in episodic loop-free Markov decision processes (MDPs), where the loss function can change arbitrarily between episodes. The transition function is fixed but unknown to the learner, and the learner only observes bandit feedback (not the entire loss function). For this problem we develop no-regret algorithms that perform asymptotically as well as the best stationary policy in hindsight. Assuming that all states are reachable with probability $\beta > 0$ under any policy, we give a regret bound of $\tilde{O} ( L|X|\sqrt{|A|T} / \beta )$, where $T$ is the number of episodes, $X$ is the state space, $A$ is the action space, and $L$ is the length of each episode. When this assumption is removed we give a regret bound of $\tilde{O} ( L^{3/2} |X| |A|^{1/4} T^{3/4})$, that holds for an arbitrary transition function. To our knowledge these are the first algorithms that in our setting handle both bandit feedback and an unknown transition function.


Universities everywhere are rushing to upgrade their digital learning capabilities — and, more so now, in response to COVID-19. Long term, large-scale development of online courses requires investment in digital infrastructures and collaborative curriculum design involving educational, technical, and subjectmatter experts. However, compared to the resources invested in course development, there is relatively little investment in researching such development processes. Drawing on findings from a study of a strategic initiative to rapidly develop 12 fully online undergraduate degree programs in one Australian university, this paper reports on a study that aimed to capture the experiences of academic course writers. Findings show broad satisfaction with the production processes, courses created, and knowledge acquired - although also demonstrating key differences between senior, junior and casualised staff. This empirical case study contributes to knowledge about capacity building arising from large-scale, in-house development of fully online degree programs.


Recently, photonic crystal band-edge structures have been analyzed in the literature. However, most devices that have been presented so far emit light in different directions. We present a modal analysis (no gain included) of a few schemes to improve the directionality of these devices, i.e., in such a way that light that exits from them will travel mainly in a certain direction, eventually coupling its energy to a wide waveguide.


This document updates the colorectal cancer (CRC) screening recommendations of the U.S. Multi-Society Task Force of Colorectal Cancer (MSTF), which represents the American College of Gastroenterology, the American Gastroenterological Association, and The American Society for Gastrointestinal Endoscopy. CRC screening tests are ranked in 3 tiers based on performance features, costs, and practical considerations. The first-tier tests are colonoscopy every 10 years and annual fecal immunochemical test (FIT). Colonoscopy and FIT are recommended as the cornerstones of screening regardless of how screening is offered. Thus, in a sequential approach based on colonoscopy offered first, FIT should be offered to patients who decline colonoscopy. Colonoscopy and FIT are recommended as tests of choice when multiple options are presented as alternatives. A risk-stratified approach is also appropriate, with FIT screening in populations with an estimated low prevalence of advanced neoplasia and colonoscopy screening in high prevalence populations. The second-tier tests include CT colonography every 5 years, the FIT-fecal DNA test every 3 years, and flexible sigmoidoscopy every 5 to 10 years. These tests are appropriate screening tests, but each has disadvantages relative to the tier 1 tests. Because of limited evidence and current obstacles to use, capsule colonoscopy every 5 years is a third-tier test. We suggest that the Septin9 serum assay (Epigenomics, Seattle, Wash) not be used for screening. Screening should begin at age 50 years in average-risk persons, except in African Americans in whom limited evidence supports screening at 45 years. CRC incidence is rising in persons under age 50, and thorough diagnostic evaluation of young persons with suspected colorectal bleeding is recommended. Discontinuation of screening should be considered when persons up to date with screening, who have prior negative screening (particularly colonoscopy), reach age 75 or have <10 years of life expectancy. Persons without prior screening should be considered for screening up to age 85, depending on age and comorbidities. Persons with a family history of CRC or a documented advanced adenoma in a first-degree relative age <60 years or 2 first-degree relatives with these findings at any age are recommended to undergo screening by colonoscopy every 5 years, beginning 10 years before the age at diagnosis of the youngest affected relative or age 40, whichever is earlier. Persons with a single first-degree relative diagnosed at ≥60 years with CRC or an advanced adenoma can be offered average-risk screening options beginning at age 40 years.


The field of swarm robotics studies bio-inspired cooperative control strategies for large groups of relatively simple robots. The robots are limited in their individual capabilities, however, by inducing cooperation amongst them, the limitations can be overcome. Local sensing and interactions within the robotic swarm promote scalable, robust, and flexible behaviours. This thesis focuses on synthesising and analysing minimalist control strategies for swarm robotic systems. Using a computation-free swarming framework, multiple decentralised control strategies are synthesised and analysed. The control strategies enable the robots—equipped with only discrete-valued sensors—to reactively respond to their environment. We present the simplest control solutions to date to four multi-agent problems: finding consensus, gathering on a grid, shepherding, and spatial coverage. The control solutions—obtained by employing an offline evolutionary robotics approach—are tested, either in computer simulation or by physical experiment. They are shown to be—up to a certain extent—scalable, robust against sensor noise, and flexible to the changes in their environment. The investigated gathering problem is proven to be unsolvable using the deterministic framework. The extended framework, using stochastic reactive controllers, is applied to obtain provably correct solutions. Using no run-time memory and only limited sensing make it possible to realise implementations that are arguably free of arithmetic computation. Due to the low computational demands, the control solutions may enable or inspire novel applications, for example, in nanomedicine.


Abstract A remarkable encounter between two Cretaceous mosasaurs of the same species and a sick or recently dead nautiloid (Argonautilus catarinae Sundberg) is recorded. It is possible that the mosasaur was training its young to attack shelled cephalopods. This is the first recorded attack by two mosasaurs on a nautiloid in the eastern Pacific Ocean, although ammonites preyed upon by mosasaurs are known from the west coast of North America.


The South African educational system is in a crisis. This situation places huge demands on school principals and school management teams, and raises many theoretical and empirical questions. Transformational leadership is needed to deal with these challenges and complexities. Not all school leaders show the same level of transformational leadership. Some leaders conform more to other leadership styles. The aim of this article is to explore the relation between spiritual character traits and leadership styles from a theoretical and empirical perspective. The theoretical part focuses on the conceptualisation of leadership (styles) and spirituality. The empirical research consists of a web-based survey conducted in some private and religiously affiliated schools in South Africa in 2011–2012. The Multifactor Leadership Questionnaire (MLQ) and Cloninger's shortened Temperament and Character Inventory (TCI-140) were used to measure leadership styles and spiritual traits respectively. Statistical procedures included confirmatory factor analysis, correlation (Pearson rho ) and regression analysis. Key findings are that leaders of private schools in South Africa mostly conform to a transformative leadership style, disagree with corrective leadership and strongly disagree with passive-avoidant leadership. Regarding the spiritual character traits they agree with self-transcendence and strongly agree with self-directedness. Spiritual character traits are strong predictors for transformational and passive-avoidant leadership. Higher levels of self-transcendence and self-directedness are strong predictors for transformational leadership. Our research suggests that traditional religious variables are less important as predictors of leadership style than spiritual character traits.


How do different societies respond politically to environmental problems around the globe? Answering this question requires systematic, cross-national comparisons of political institutions, regulatory styles, and state-society relations. The field of comparative environmental politics approaches this task by bringing the theoretical tools of comparative politics to bear on the substantive concerns of environmental policy. This book outlines a comparative environmental politics framework and applies it to concrete, real-world problems of politics and environmental management. After a comprehensive review of the literature exploring domestic environmental politics around the world, the book provides a sample of major currents within the field, showing how environmental politics intersects with such topics as the greening of the state, the rise of social movements and green parties, European Union expansion, corporate social responsibility, federalism, political instability, management of local commons, and policymaking under democratic and authoritarian regimes. It offers fresh insights into environmental problems ranging from climate change to water scarcity and the disappearance of tropical forests, and it examines actions by state and nonstate actors at levels from the local to the continental. The book will help scholars and policymakers make sense of how environmental issues and politics are connected around the globe, and is ideal for use in upper-level undergraduateand graduate courses.


Aims Current neuroanatomical models explain major depressive disorder (MDD) by abnormalities in neural circuits underlying negative emotions. The unresolved conundrum, however, is to explain why excessive negative feelings occur when MDD patients blame themselves (manifesting as guilt or self-worthlessness), but not when blaming others. Methods We used fMRI in fully remitted MDD (N=25) and a matched control group (N=22) with low MD vulnerability while controlling for antidepressant medication status. We employed psychophysiological interaction analysis (SPM8) and an anterior temporal lobe (aTL) seed region, previously shown to underpin blame differentiation, to identify brain regions showing coupling (at p=.05 family-wise-error corrected over a priori ROIs) with the aTL during two conditions: (1) guilt, (2) indignation, evoked by written statements presented in the scanner. We controlled the intensity of negative feelings and task performance. Results We corroborated our hypothesis that MDD patients can be distinguished from controls by functional decoupling between aTL and subgenual cingulate cortex while they experience self-blaming feelings (guilt). This effect was selective for self-blame but did not occur when blaming others (feeling indignation) and therefore explains vulnerability to self-blaming bias. Conclusions These results shed new light on the pathophysiology of MDD by unravelling the neuroanatomical basis of self-blaming bias.


Recently, statistical models of natural images have shown the emergence of several properties of the visual cortex. Most models have considered the nongaussian properties of static image patches, leading to sparse coding or independent component analysis. Here we consider the basic time dependencies of image sequences instead of their nongaussianity. We show that simple-cell-type receptive fields emerge when temporal response strength correlation is maximized for natural image sequences. Thus, temporal response strength correlation, which is a nonlinear measure of temporal coherence, provides an alternative to sparseness in modeling simple-cell receptive field properties. Our results also suggest an interpretation of simple cells in terms of invariant coding principles, which have previously been used to explain complex-cell receptive fields.


OBJECTIVE
Causes, clinical presentation, management, and outcomes of chronic subdural hematoma (CSDH) in low- and middle-income countries are not well characterized in the literature. Knowledge regarding these factors would be beneficial in the development and implementation of effective preventive and management measures for affected patients. The authors conducted a study to gain a better understanding of these factors in a low-income setting.

METHODS
This prospective study was performed at Mbarara Regional Referral Hospital (MRRH) in Uganda between January 2014 and June 2017. Patients of any age who presented and were diagnosed with CSDH during the aforementioned time period were included in the study. Variables were collected from patients' files at discharge and follow-up clinic visits. The primary outcome of interest was death. Secondary outcomes of interest included discharge Glasgow Coma Scale (GCS) score, ICU admission, wound infection, and CSDH recurrence.

RESULTS
Two hundred five patients, the majority of whom were male (147 [72.8%]), were enrolled in the study. The mean patient age was 60.2 years (SD 17.7). Most CSDHs occurred as a result of motor vehicle collisions (MVCs) and falls, 35.6% (73/205) and 24.9% (51/205), respectively. The sex ratio and mean age varied depending on the mechanism of injury. Headache was the most common presenting symptom (89.6%, 173/193), whereas seizures were uncommon (11.5%, 23/200). Presenting symptoms differed by age. A total of 202 patients underwent surgical intervention with burr holes and drainage, and 22.8% (46) were admitted to the ICU. Two patients suffered a recurrence, 5 developed a postoperative wound infection, and 18 died. Admission GCS score was a significant predictor of the discharge GCS score (p = 0.004), ICU admission (p < 0.001), and death (p < 0.001).

CONCLUSIONS
Trauma from an MVC is the commonest cause of CSDH among the young. For the elderly, falling is common, but the majority have CSDH with no known cause. Although the clinical presentation is broad, there are several pronounced differences based on age. Burr hole surgery plus drainage is a safe and reliable intervention. A low preoperative GCS score is a risk factor for ICU admission and death.


We study the impact of macroeconomic factors on apartment house prices. A simple version of the so-called new IS/LM model is used to analyze the interaction of macroeconomic variables and prices. It is assumed that prices follow the rational valuation formula (RVF), which states that prices correspond to the sum of discounted expected future cash flows. The model allows for time-varying discount factors, tax effects and systematic interdependence between macroeconomic factors. We construct a price-rent ratio for apartment houses in Berlin from transaction data between 1980 and 2000. It turns out that the rational valuation formula can explain the dynamics of price-rent ratios for apartment houses quite well. We then compare the stylised facts generated by the structural model with the observed empirical time series behavior.


BCR-ABL negative myeloproliferative neoplasms (MPNs), such as polycythemia vera (PV), essential thrombocythemia (ET) and myelofibrosis (MF) are chronic myeloid malignancies characterized by overproduction of hematopoietic cells. JAK2 mutations are found in most patients with PV, and in only 50-60% of patients with ET and MF. JAK2 mutation testing has greatly simplified MPN diagnosis, but distinguishing JAK2 -wildtype ET from reactive thrombocytosis remains a diagnostic challenge. Mutations in signalling pathways (MPL, LNK) and epigenetic regulators ( TET2, DNMT3A, IDH1/2, EXH2, ASXL1 ) have been found in a minority of MPNs. However genome-wide data are lacking and the pathogenesis of MPNs that do not harbor JAK2 or MPL mutations remains obscure.

Methods Exome sequencing was performed in 151 MPN patients on matched tumor and constitutional samples. CALR status was assessed in 3412 samples using Sanger sequencing and analysis of exome/genome sequencing data. Presence of CALR mutations in hematopoietic stem and progenitor cells was assessed by flow sorting and sequencing. Phylogenetic trees were established using hematopoietic colonies. Calreticulin cellular localisation was assessed in patient samples and cell lines expressing CALR variants by flow cytometry and immunofluorescence.

Results Exome sequencing identified 1498 somatic mutations with a median of 6.5 mutations in PV and ET, and 13 in MF (MF vs ET, P =0.0002; MF vs PV, P =0.008). JAK2 V617F was found in all cases of PV (n=48), 56% of ET (35/62), and 69% of MF (27/39), and MPL mutations in 7 ET and MF cases.  Mutations in epigenetic regulators TET2 , DNMT3A , ASXL1 , EZH2 , and IDH1/2 were identified in 22, 12, 12, 4, 3 patients respectively, and components of the splicing machinery (U2AF1, SF3B1 or SRSF2) were mutated in 9 patients.  Mutations in rare genes reported to be mutated in MPNs were found in four patients (1 CBL ; 2 NFE2 ; 1 SH2B3 / LNK ). We found novel somatic mutations in CHEK2 (1 PV, 1 ET and 1 MF) which have not been previously reported in MPNs.  The mutation spectrum showed a predominance of C>T transitions. Pairwise associations between MPN genes demonstrated that ASXL1 and SRSF2 mutations were positively correlated with mutations in epigenetic modifiers.

Novel somatic mutations in calreticulin ( CALR ) were identified by exome sequencing in the majority (26/31) of JAK2 or MPL unmutated patients. CALR and JAK2/MPL mutations were mutually exclusive, and 97% of patients harbored a mutation in 1 of these 3 genes. In an extended follow up screen of 1345 hematological malignancies, 1517 other cancers and 550 controls we found CALR mutations in 71% of ET (80/112), 56% of idiopathic MF (18/32), 86% of post ET-MF (12/14) and 8% of myelodysplasia (10/115), but not in other myeloid, lymphoid or solid cancers. Compared to JAK2 -mutated MPNs, those with CALR mutations presented with higher platelet counts (Wilcoxon rank-sum, P =0.0003), lower hemoglobin levels (Student's t test, P =0.02) and showed a higher incidence of transformation to MF (Fishers exact, P =0.03).

All CALR mutations were insertions or deletions affecting exon 9, with 2 common variants L367fs*46 (52 bp deletion) and K385fs*47 (5 bp insertion). Loss of heterozygosity over CALR was seen in a minority of patients. Of 148 CALR mutations identified, there were 19 distinct variants. Remarkably, all generated a +1 basepair frameshift, which results in loss of most of the C-terminal acidic domain of the protein as well as the KDEL Golgi-to-endoplasmic reticulum (ER) retrieval signal, raising the possibility of compromised ER retention. Mutant proteins were readily detected in transfected cell lines and localised to the ER in the same manner as wildtype CALR, without Golgi or cell surface accumulation. These results are consistent with studies reporting KDEL-independent mechanisms of ER retention.

Mutation of CALR was detected in highly purified hematopoietic stem/progenitor cells. Clonal analyses demonstrated CALR mutations in the earliest phylogenetic node in 5/5 patients, consistent with it being an initiating mutation in these individuals.

Conclusions We describe the mutational landscape of BCR-ABL negative MPNs and demonstrate that somatic mutations in the endoplasmic reticulum chaperone CALR are found in the majority of patients with JAK2 -unmutated MPNs. These results reveal a novel biological pathway as a target for tumorigenic mutations and will simplify diagnosis of MPN patients.

Disclosures: Bowen: Celgene: Honoraria. Harrison: S Bio: Honoraria, Membership on an entity's Board of Directors or advisory committees; Shire: Speakers Bureau; Celgene: Honoraria; YM Bioscience: Honoraria, Membership on an entity's Board of Directors or advisory committees; Sanofi: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Gilead: Honoraria, Membership on an entity's Board of Directors or advisory committees. Vannucchi: Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees.


Purpose: The article analyzes those processes having initiated the development of the European and political integration. The article is focused on the genesis and the development of the Council for Mutual Economic Assistance, the European Union, NATO and the Warsaw Pact. Design/Methodology/Approach: By applying the system analysis method as well as dialectical and historical methods, the authors have attempted to reveal the significance of those events resulted in modern international organizations establishment. Findings: Authors have analyzed the XX century trends in integration and highlighted Western Europe as the most productive in the process. Authors have provided the USSR and post-USSR integration overview to reveal the European development patterns. Practical Implications: The research results may be implemented into political and educational courses as well as to be used by official authorities. Originality/Value: The main contribution of this study is the deep integration trends' analysis and the emphasis on the unipolar-bipolar-multipolar world's concept.


Without relevant human priors, neural networks may learn uninterpretable features. We propose Dynamics of Attention for Focus Transition (DAFT) as a human prior for machine reasoning. DAFT is a novel method that regularizes attention-based reasoning by modelling it as a continuous dynamical system using neural ordinary differential equations. As a proof of concept, we augment a state-of-the-art visual reasoning model with DAFT. Our experiments reveal that applying DAFT yields similar performance to the original model while using fewer reasoning steps, showing that it implicitly learns to skip unnecessary steps. We also propose a new metric, Total Length of Transition (TLT), which represents the effective reasoning step size by quantifying how much a given model's focus drifts while reasoning about a question. We show that adding DAFT results in lower TLT, demonstrating that our method indeed obeys the human prior towards shorter reasoning paths in addition to producing more interpretable attention maps. Our code is available at this https URL.


Swinburne took comfort in the knowledge that "no life lives for ever / that dead men rise up never." Obviously, the man lived in the age before Facebook. Just when you thought the past was happily entombed, the curse of social networking is conjuring it up. more often than not, that knock on your inbox door is the risen dead from your high school yearbook, classmates you thought you'd safely buried in the boneyard of forgotten things with a gentle shovel-tap on the face. On rare occasion, a table-rap from the great beyond—a Facebook "friend request"—reminds you, out of the blue, of someone you were inordinately fond of but had lost touch with. more typically, though, that spectral hand tugging on your lapel is someone you didn't know at all. Yes, he went to your high school. But your paths never crossed—for good reason, likely. Nonetheless, he feels inclined to "friend" you, perhaps to pad his Coalition of the unwilling. A Facebook moment: someone's rattling my mailbox. What brings him knocking, I'm curious to know. Pleading early onset Alzheimer's, I ask if we've met before. We've never met, he replies. maybe he's read one of my books? Naw, he writes, he doesn't really have a clue who I am or what I do; he just mails "everybody," at random. Another one for the specimen jar: a stranger comes calling. "You'll forgive me," I write, "but I can't recall where—if?—we've met. how do we know each other?" he's an alumnus from my college, it turns out, though not in my class. even so, he remembers a poetry reading I gave, "a very impressive performance as I recall." Weeks go by. One morning, my Inbox is pelted by messages he's broadcasting to his friends. "Why am I being cc'd on this?," I ask. he's quick with his reply: "Why are you such a grouchy prick? that's how I remembered you..." Am I a grouchy prick? maybe. Or maybe my definition of "friend" is anachronistic, founded on the superannuated assumption that we reach out to people with whom we feel (or felt) some affinity; that our social networks grow organically, rooted in a mutual desire to connect (or re-connect) and twined around common interests or consonant sensibilities, if not a shared history. It's out of joint with Facebook's Phantom Zone, a being-in-nothingness where disembodied strangers pluck at other strangers' sleeves for no reason whatsoever. Or because they're curious about people they never knew. Or only knew from afar and now want to know up close, even if they always were grouchy pricks. to be sure, our inescapably connected age has its virtues. Recently, on Facebook, I ran into someone I hadn't seen since his last day at college—an afternoon curling and bleaching in my memory like an old Polaroid, tinged by one of those apocalyptic LA sunsets and the supersaturated, maxfield Parrish colors switched on by the magic mushrooms we'd eaten. A lifetime later, the rapport was instant, as if we'd never left that lost world, him telling me about his life as an ER doctor, mesmerizing me with tales of his MASH unit. But most of my Facebook traffic consists of friend requests from the restless dead of 1978—the shaghaired, bong-loaded Banquos of my high school class who are knocking, even now, at my virtual door. my Inbox pings. too perfectly, it's someone from hilltop high, from the class a year behind me, someone I never knew, someone who has Added me as a Friend on Facebook, and Needs me to Confirm that I Knew her in Order for us to be Friends on Facebook. I find myself thinking of Raymond Chandler, an almost pathologically private man who would have found abhorrent the transparency of our fishbowl selves, and the awful, grabby neediness of our compulsively social age. Chandler was a conundrum: a confirmed misanthrope and inveterate recluse haunted, late at night, by his self-imposed loneliness, which he warded off with a bottle of gin and a Dictaphone, composing letters to exorcise "that horrid blank feeling of not having anybody to talk or listen to." A difficult man ("my character is an unbecoming mixture of outer diffidence and inward arrogance"), he found epistolary friendship more congenial than face-to-face interaction. "I don't quite know why you are so close to my heart, but you are," he wrote to a female friend. "In some mysterious way you have put me inside of you, so that I have to lie awake at night and worry about you—you a girl I have never seen. Why? the older you get, the less you know..." even in his despairing last years, after his wife died, he shrank from human contact. "All my best friends I have never seen," he wrote to one correspondent. "to know me in the flesh is to pass on to better things." maybe Facebook would have helped.


Knowledge discovery from temporal data (e.g., time series) is among the most challenging problems in data mining. Compared to static representations like rules or decision trees, the temporal component greatly increases the pattern diversity. It is important to keep the human perception of time flow in mind when representing temporal patterns, otherwise we open the floodgates to misinterpretation and misconception. This article gives an overview of temporal interval patterns, which are considered as being a well‐suited mechanism of knowledge representation, and focusses on the various pattern representation languages. Four typical phenomena in temporal data, and how the pattern languages can cope with them, are discussed. Given the domain knowledge, this provides the reader some guidance on which pattern language may be best‐suited for a given application. WIREs Data Mining Knowl Discov 2014, 4:196–212. doi: 10.1002/widm.1122


Data from 9 healthy subjects collected during BCI experiments with a visual ERP paradigm for a photo browser application has been analyzed offline. A comparison of four stimulus presentation modes revealed that complex highlighting effects composed of brightness enhancement, rotation, enlargement and a trichromatic grid overlay in combination with row-column spatial arrangements of simultaneously highlighted objects boosted single subtrial classification performance best.


The marine benthic cartography of the Cap de Creus and surrounding areas (NW Mediterranean Sea) was obtained by combining classical grabbing methods with more recent imaging methods based on a remotely operated vehicle. The goals of this particular survey can be summarized as follows: 1) to chart the benthic communities (and the area of each one); 2) to evaluate the benthic diversity of the areas; 3) to produce visual documentation of the distributions of the benthic organisms; 4) to identify human-induced pressures on the benthic environment; 5) to make recommendations for future management based on the visual assessment; and 6) to set up a new methodology for making large biocenosis maps that would help to manage marine protected and non-protected areas. The marine environment off the Alt Emporda County was shown to have a very rich diversity of benthic habitats. Twenty community categories were identified from videos and grabs. Though benthic habitats mostly located inside a marine protected area were assessed, man-made objects were seen in 10% of the analyzed minutes filmed. The study led to a comprehensive review of the main biotope systems of this coastal area, as well as their environmental condition, and this will be an essential element for their future management.


The objective of this paper is to help inform future tax reforms related to tax expenditure provisions in Zambia. It sets out how tax expenditures can be categorised, measured and evaluated, and provides guidance on establishing a robust framework for monitoring and evaluating tax expenditures in Zambia.


Climate variability and change are affecting millions of poor people in Kenya, particularly in arid and semi-arid lands. Significant investments are being made in developing Climate Information Services (CIS) which are tailored to the needs of pastoralists and agro-pastoralists and aim to help them adapt to the impact of climate change in these regions. Recent research has found that a new category of ultra-poor are falling out of dominant pastoralist and agro-pastoralist livelihoods and they are unable to benefit from CIS. To improve the impact of CIS, Kenya's county governments should put more focus on: (a) adopting an equity lens for the integration of CIS in county planning processes, so as to better reach those outside dominant livelihoods types, and (b) improving the understanding of constraints and enabling conditions for the poor in accessing and using CIS within both mainstream and alternative livelihoods systems. Improving the Impact of Climate Information Services in Kenya's Arid and Semi-Arid Lands


ABSTRACT Aim: SGI-110 SC is a novel HMA that delivers prolonged decitabine exposure and potent DNA demethylation. Preliminary results of two different schedules (5 and 10-days every 28-days) in the treatment of r/r AML have been previously reported. Here we provide a comparative analysis of final results from the two schedules. Methods: Heavily pretreated r/r AML patients were treated in a single protocol by the same centers. Enrolment to the 5-day schedule was completed first (at 60 and 90 mg/m2/d) followed by enrolment to the 10-day schedule at 60 mg/m2/d. In the 10-day schedule, patients were allowed up to 4 cycles followed by consolidation with the 5-day schedule at 60 mg/m2/d. The primary endpoint was Overall Complete Response (OCR = CR + CRp + CRi) using revised IWG 2003 criteria. Results: Fifty and 53 patients were treated with the 5-day and 10-day schedules respectively. Baseline patients' characteristics were similar between the 2 schedules including median number of prior regimens (2); median age 62 vs 57 y; ECOG PS 2 in 10 vs 17%; median WBC count 1.7 vs 2.1x109/L; median bone marrow blasts 35 vs 32% for the 5 and 10-day schedules respectively. OCR was reported in 8 (16%) and 16 patients (30%) [P = 0.106] and CR was reported in 3 (6%) vs 10 patients (19%) [P =0.074] for the 5 and 10-day schedules respectively. The most common Grade ≥3 adverse events (AEs) regardless of relationship to treatment were febrile neutropenia: 60% vs 58%; thrombocytopenia: 20% vs 38% (P =0.054); anemia: 18 %vs 36% (P =0.049); and pneumonia: 24% vs 28% (P =0.660) for the 5 and 10-day schedules respectively. All-cause early mortality was similar at 30 days: 6% vs 2%, and at 60 days: 12% vs 11% for the 5 and 10-day schedules respectively. Conclusions: SGI-110 given SC for 10 days resulted in a trend towards higher OCR and CR rates than the 5-day schedule, albeit with a higher incidence of Grade ≥3 thrombocytopenia and anemia but no significant differences in other common Grade ≥3 AEs or all-cause early mortality. These results warrant further investigation of the 10-day schedule for the treatment of r/r AML and newly diagnosed elderly AML. Disclosure: G.J. Roboz: consultant for Astex; K. Yee: Astex Grant/Research support; E. Griffiths: Astex: Grants/Research Support Recipient; Advisor/Board Member Celegene: Consultant/Independent Contractor Honorarium Recipient; J. Issa: consultant and research support from Astex; S. Naim: Astex employee; Y. Hao and M. Azab: Astex employee. All other authors have declared no conflicts of interest.


To investigate media effects in political campaigns, we administered a field experiment around the first general election presidential debate of 2016. In this three-wave study, subjects were randomly incentivized to watch the debate and post-debate television coverage on Fox News or MSNBC. We find that post-debate coverage has strong effects on performance evaluations, with subjects' perceptions moving in the direction of the partisan slant of the channel they were assigned to watch on. Though these effects evolve over time, with subjects coming to express beliefs more in line with the media consensus, they do not disappear altogether. Moderate partisans were still affected by the post-debate coverage a week later. The effects we observe are limited to debate evaluations; at no point do we observe partisan media affecting vote choice. Our results offer evidence that media effects can persist over time, but are confined to candidate evaluations.


• Abstract — The PC12 pheochromocytoma tumor cell line is derived from a rat adrenal medullary tumor and secretes dopamine. We have previously reported that grafted microencapsulated PC12 cells using agarose and poly(styrene sulfonic acid) survived in the xenogeneic brain without immunosuppression. To investigate whether unencapsulated PC12 cells form a tumor and how they provoke immunological reaction, PC12 cell suspension was im planted into the striatum of Sprague-Dawley rat (allogeneic graft) or guinea pig (xenogeneic graft) and histological analysis using Nissl stain and immunocytochemical analysis using antityrosine hydroxylase (TH) antibody were per formed 1, 2, and 4 wk after transplantation. Host animals were not immunosuppressed. PC12 cells formed a mass 1 and 2 wk after transplantation both in allogeneic and xenogeneic brain. These grafted PC12 cells were immuno reactive to anti-TH antibody. Four weeks after transplan tation, however, grafted PC12 cells in the allogeneic brain were only found within the restricted area near the site of implantation. In the xenogeneic brain, only the trace of grafted PC12 cells were found around the site of implanta tion 4 wk after transplantation. In both allogeneic and xenogeneic animals, a number of lymphocytes were found in and around the grafts at all period investigated. These findings indicate that PC12 cells could survive in the allogeneic or xenogeneic brain for 2 wk and were ultimately rejected by immunological reaction by 4 wk after trans plantation. Implantation of encapsulated PC12 cells in the allogeneic or xenogeneic brain is considered a safe and effective method for delivering dopamine into the brain because PC 12 cells will not form a tumor in the long-term even if capsules are damaged in some reason. © 1997 Elsevier Science Inc.


The purpose of this study is to cast light on how three teachers in third grade state that they work with reading comprehension, which methods and strategies they use in their teaching to develop pupils reading comprehension. As previous research shows that the teaching of reading comprehension is important, the study addresses various methods that can be used in teaching and which methods the informers state that they use. Qualitative interviews have been made with teachers from primary school. The results show that teachers largely make use of textbooks in their teaching, but they start modifying towards explicit teaching. Methods that have been emphasized to enhance reading comprehension are reading aloud, quiet reading, a reading class and Thinking aloud. Reading aloud is an important method in the informers teaching and reading aloud is combined with the method Thinking aloud. The teachers are aware of the need of spending time on reading comprehension but find it easy to forget when something else has to be done.


Current approaches to transactional support of distributed processes in service-oriented environments are limited to scenarios where the participant initiating the process maintains a controlling position throughout the lifetime of the process. This constraint impedes support of complex processes where participants may only possess limited local views on the overall process. Furthermore, there is little support of dynamic aspects: failure or exit of participants usually leads to cancelation of the whole process. In this paper, we address these limitations by introducing a framework that strengthens the role of the coordinator and allows for largely autonomous coordination of dynamic processes. We first discuss motivating examples and analyze existing approaches to transactional coordination. Subsequently, we present our framework TracG, which is based on WS-BusinessActivity. It contains at its core a set of rules for deciding on the ongoing confirmation or cancelation status of participants' work and protocol extensions for monitoring the progress of a process. Various types of participant vitality for a process are distinguished, facilitating the controlled exit of nonvital participants as well as continuation of a process in case of tolerable failures. The implementation of the framework is presented and discussed regarding interoperability issues.


Gartzke and Li (2003b) formulate a mathematical relationship between "trade share," "trade dependence," and "trade openness," and use this to argue that the disparity between the findings in studies by Barbieri and those of Oneal and Russett and others can partly be explained by features of variable construction. This article argues that although Gartzke and Li's formulation is very useful, the authors draw some conclusions from their analysis that only hold under very restrictive assumptions. "Trade share" does not in general measure a state's disconnectedness from the world trading system, and "trade share" is not associated with a high risk of interstate dispute if "trade dependence" is associated with a low risk. What Gartzke and Li attribute to "trade share" is rather an effect of trade substition from one partner to another. Finally, the trade openness variable may be a proxy for country size. The discussion also illustrates some problems involved in controlling for variables that are related by definition to a key explanatory variable.


interactions of cholecystokinin COOH-terminal octapeptide (CCK-8) and somatostatin-14 (SS-14) on food intake in dogs were examined by administration of graded doses of these peptides alone and in combination. In animals fasted 19 h, SS-14 (2,000 or 20,000 pmol.kg-1.h-1) had no effect on food intake. In animals fasted 4 h, food intake was not affected by 40 or 400 pmol.kg-1.h-1 SS-14 but was significantly (P less than 0.05) increased by 20% after 4,000 pmol.kg-1.h-1 SS-14. Feeding responses to simultaneous infusions of CCK-8 (50 or 400 pmol.kg-1.h-1) and SS-14 (40, 400, or 4,000 pmol.kg-1.h-1) were determined in animals fasted 4 h. Given alone, the high dose of CCK-8 (400 pmol.kg-1.h-1) significantly (P less than 0.01) depressed food intake by 55%. This effect was blocked by all doses of SS-14. In the absence of CCK-8, SS-14 had no effect except at the highest dose (4,000 pmol.kg-1.h-1), which significantly (P less than 0.01) stimulated food intake by 57%. This effect was blocked by both doses of CCK-8. Simultaneous infusion of lower doses of SS-14 (40 and 400 pmol.kg-1.h-1) and CCK-8 (50 pmol.kg-1.h-1) had no effect on food intake. These results suggest that plasma levels of CCK and SS-14 after a meal are not sufficient alone or in combination to produce satiety.


Over the recent years, the incidence of diabetes has significantly increased. Use of preventive services and treatment with oral antidiabetic drugs (OAD) has remained cornerstone in the management of type 2 diabetes (T2DM). Despite strong evidence that treating diabetes using these disease management strategies decreases morbidity, mortality and complications, glycemic control as well as other diabetes related outcomes remain unsatisfactory. The prevalence of diabetes in the United States has grown vastly in proportion over the last few years with the American Diabets Association estimating that 9.3% of the population suffered from diabetes in the year 2012. These estimates are expected to increase in the future with the World Health Organization (WHO) estimating that 366 billion people (4.4%) will have diabetes. Diabetes places a greater clinical as well as economic burden on the patients as well as the health care system. The presence of comorbid depression is frequent in people suffering from diabetes and can cause health outcomes in patients with diabetes. Poor adherence and persistence to diabetic medications resulting from the occurrence of adverse events is a cause of poor health as well as economic outcomes. There is a continuing need to evaluate the associations between comorbidities as well as common complications of medication treatment in persons with diabetes and examine how they influence health behavior. Evidence regarding differences in the utilization of preventive care services in diabetic patients with and without comorbid depression is scant. Similarly, the factors that predispose an individual to hypoglycemia as well as the association between hypoglycemic episodes and persistence to OAD therapy, specifically sulfonylureas, has rarely been quantified retrospectively. This dissertation utilizes the manuscript format and has four fold objectives: 1. To review the current literature regarding the role of hypoglycemia and comorbid depression in the diabetes and examine their impact on clinical and economic aspects of diabetes management; 2. To quantify the effect of comorbid depression on the rates of preventive care service use in a nationally representative population of US adults; 3. To identify significant predictors and estimate the costs associated with the occurrence of hypoglycemia in the inpatient and outpatient settings. 4. To evaluate the association between the development of hypoglycemia and persistence to oral sulfonylurea therapy in patients newly initiated on this class of OAD medications. In order to review the literature regarding the effect of hypoglycemia and comorbid depression and diabetes, we utilized various biomedical and psychological databases. We analyzed the effect of comorbid depression as a principal risk factor associated with use of ADA recommended preventive services in patients with diabetes using the Medical Expenditure Panels Survey Data. A logistic regression was performed to achieve this objective and all the relevant confounders were controlled for in order to achieve the results. Claims data provided by the Blue Cross and Blue Shield of Rhode Island was utilized to assess the relationship between hypoglycemia and persistence to sulfonylurea medication as well as outline the predictors and costs of hypoglycemia. A time-varying Cox proportional hazards regression model was utilized to compare the hazard rate of medication discontinuation in diabetic patients that were exposed to hypoglycemic events, compared to those that were unexposed. A predictive modelling approach was utilized to highlight the factors associated with hypoglycemia. While the impact of comorbid depression and diabetes was significant both clinically and economically, it was seen that the extent of preventive care service use was comparable for diabetic patients with and without comorbid depression but suboptimal in general thus indicating major gaps in the implementation of ADA recommended preventive care practices. While depression was not significantly associated with increased use of the recommended diabetes preventive care services, other sociodemographic factors were seen to contribute. Moreover, though no significant association between events of hypoglycemia and subsequent discontinuation sulfonylurea medication was illustrated, we demonstrated several clinical factors to have a profound impact on the risk of developing hypoglycemic episodes.