Background Chronic constipation is one of the most common paediatric problems seen within primary, secondary and tertiary care. It is hypothesised that the use of probiotics might alter the growth of bacteria in the bowel, promote normal gut physiology and reduce constipation symptoms. Given the recent growth in published studies in this area it is necessary to produce a new and focussed synthesis of this evidence by deploying a robust methodology to ensure that there can be a contemporaneous impact on clinical practice. Methods The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL and the Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Group Specialised Trial Register were searched (Inception – July 2015). Manufacturers of probiotics were contacted to identify unpublished trials. References of trials were also searched. Abstracts were considered for inclusion if full details to judge inclusion were offered or available from the authors. Randomised controlled trials (RCTs) were eligible for inclusion. Data extraction and assessment of methodological quality of included studies were independently performed by two authors. Analysis was completed in accordance with the intention to treat approach. Results The search yielded 1529 results. Seven placebo controlled studies (n = 496) met the inclusion criteria and were included in the review. All studies compared probiotics with placebo, but two gave all participants lactulose as concomitant therapy. The studies ranged in length from 3 to 12 weeks. Meta-analysis of four studies (n = 312, patients not on concomitant lactulose) found a statistical significant increase in the frequency of defecation using probiotics compared to placebo (MD 1.09; 95% CI 0.17 to 2.01, Figure 1). This result did not change on sensitivity analysis using a fixed effects model. Meta-analysis of these four studies found no statistical significant difference in adverse events between probiotics and placebo (OR 0.33; 95% CI 0.03 to 3.23). Conclusions The evidence from the published suggests superior efficacy of probiotics for chronic constipation in children when compared with placebo. There is no difference in adverse events, suggesting safety. The evidence base is of moderate quality and relatively small. Further research to investigate the long term impact of probiotic therapy on chronic constipation is suggested.


Probabilistic conformant planning problems can be solved by probabilistic inference algorithms after translating their PPDDL specifications into graphical models. We present two translation schemes that convert probabilistic conformant planning problems as graphical models. The first encoding is based on the probabilistic extension of the serial encoding of PDDL in SatPlan, and the second encoding compiles a graphical model from the finite-domain representation of the SAS+ formalism. We show that a probabilistic conformant plan can be found by answering a marginal MAP inference, and the plan is optimal with respect to the length of the plan as well as the probability of achieving the goal. Since a common task of the conformant planning is to find a plan achieving the goal with a probability that exceeds a threshold, we can consider relaxing of the marginal MAP query to the pure MAP which is far easier to compute. The success probability of the suboptimal plan derived by a pure MAP solver can be re-evaluated by solving a summation problem, also a hard task. The probabilistic inference algorithms for marginal MAP that we evaluated are based on anytime AND/OR branch and bound search guided by weighted mini-bucket heuristics. Our preliminary evaluation highlights the potential and the challenges in this methodology of applying search based probabilistic inference algorithms to probabilistic conformant planning.


Meta-learning learns across historical tasks with the goal to discover a representation from which it is easy to adapt to unseen tasks. Episodic meta-learning attempts to simulate a realistic setting by generating a set of small artificial tasks from a larger set of training tasks for meta-training and proceeds in a similar fashion for meta-testing. However, this (meta-)learning paradigm has recently been shown to be brittle, suggesting that the inductive bias encoded in the learned representations is inadequate. In this work we propose to compose episodes to robustify meta-learning in the few-shot setting in order to learn more efficiently and to generalize better to new tasks. We make use of active learning scoring rules to select the data to be included in the episodes. We assume that the meta-learner is given new tasks at random, but the data associated to the tasks can be selected from a larger pool of unlabeled data, and investigate where active learning can boost the performance of episodic meta-learning. We show that instead of selecting samples at random, it is better to select samples in an active manner especially in settings with out-of-distribution and class-imbalanced tasks. We evaluate our method with Prototypical Networks, foMAML and protoMAML, reporting significant improvements on public benchmarks.


Smallholders often have to certify according to international standards and produce under contract for large agro-businesses to access the export market. While mostly positive effects for the farmers have been found for contracts and certifications, little is known about the role of individual firm behavior and certifications in shaping farmer-agro-business relationships and contract success. This is what this article does. Data of 386 smallholders in the pineapple export sector in Ghana is analyzed quantitatively and enriched by a detailed case study of a large-scale agro-business in Ghana called Blues Skies. The results show that certification is an agent of change in farmer-agro-business relations. Building trust and aligning expectations of farmers and firms is important for success. Additionally, individual firm behavior matters more than taken into account in previous research. Our case study shows that three 'R', reliability, reputation and respect, constitute the basis for contract relationships that benefit all.


Epinephrine and norepinephrine produce distinct conformational changes in their receptor and distinct signaling output. The idea that a receptor works like an on-off switch that is flipped by ligand binding has given way to a realization that a receptor-ligand interaction is something more like a handshake that can send many signals, ranging from clammy, weak, and indecisive to firm, extroverted, and confident. This is particularly true of the β2-adrenergic receptor (β2AR), a heterotrimeric guanine nucleotide–binding protein (G protein)–coupled receptor that has two primary modes of signaling—activation of adenylyl cyclase either through the G protein Gs or through an internalization-dependent process that requires β-arrestins and leads to activation of mitogen-activated protein kinases. These signaling pathways can be differentially triggered by various pharmacological agonists, which appear to cause the receptor to adopt distinct conformations that can modify the signals emanating from the receptor. The two physiological ligands of the β2AR are epinephrine and norepinephrine, and in keeping with their distinct physiological functions, these agonists produce different signaling outputs from the receptor. Reiner et al. explored whether binding of these natural ligands also produces distinct conformations of the receptor. They used a combination of methods to monitor receptor structure, internalization, and biochemical activity. Receptor conformation was followed through fluorescence resonance energy transfer (FRET) between probes linked to the third intracellular loop and the C terminus of the receptor, the former being a region critical for activation of G proteins by the receptor. Their results showed that the receptor indeed has a sophisticated sense of "touch" that interprets the nature of its interacting ligand. Norepinephrine produced a smaller and slower FRET signal than did epinephrine, but G protein activation by the two ligands was similar, indicating that there may be an amplification step between the receptor and activation of adenylyl cyclase. This could reflect catalytic activation of multiple G proteins by the receptors, for example. On the other hand, the synthetic partial agonist terbutaline gave both weaker FRET signals and weaker activation of adenylyl cyclase. The authors also monitored association of β-arrestin with the receptor and found that norepinephrine was weaker at promoting this receptor signaling event. There were further subtle differences as well. Although all the agonists tested enhanced association of β-arrestin with the receptor with similar kinetics after a pulse of the ligand, a slower and smaller response was induced by norepinephrine. Norepinephrine thus appears to be more tightly coupled to activation of Gs rather than the other receptor-initiated events. The authors also conclude that the movements of the receptor cannot be fully resolved by the FRET sensor linked to the G protein activation site. Perhaps future studies may allow definition of the particular movements that result in β-arrestin association, internalization, and activation of G-protein–coupled receptor kinases. S. Reiner, M. Ambrosio, C. Hoffmann, M. J. Lohse, Differential signaling of the endogenous agonists at the β2-adrenergic receptor. J. Biol. Chem. 285, 36188–36198 (2010). [Abstract] [Full Text]


A method using simulated flows and measured pollutant concentrations was successfully applied to estimate pollutant loadings resulting from runoff during storm events from an urban area. The method was applied to a storm sewer outfall draining an area with a predominantly commercial land use into a natural water course. The method involves collection of runoff samples during the event, observation of rainfall amount and the use of a rainfall-runoff computer model. Runoff samples were analyzed for conventional as well as priority toxic pollutants. Delivered load and mean concentrations of pollutants were estimated for several rain events. The study indicated that the mean concentrations for oxygen-consuming and nutrient type of pollutants were higher than that of comparable sites studied in the National Urban Runoff Program (NURP). The quality of the runoff from the selected basin routinely exceeded point source discharge and surface water quality standards. Also discussed are some issues pertaining to comprehensive assessment of the pollution potential of storm water discharging from several outfalls into receiving waters.


We examined state-wide data of persons evaluated for Sexually Violent Predator (SVP) commitment and compared risk-relevant data of three groups: those committed as SVPs ( n = 374), those not recommended for commitment ( n = 2,707), and those nearly committed (recommended for commitment but ultimately not committed; n = 117). Consistent with legal language for SVP commitment, binary and multinomial regression analyses revealed risk scores predicted SVP commitment recommendations in addition to some historical factors (e.g., psychiatric history, never being married, prior sex offenses). For those recommended for commitment, prior sexual offenses predicted ultimate commitment. Those nearly committed had significantly higher sexual recidivism rates than others who were not committed; however, these recidivism rates were still low (11.5%). Findings suggest evaluators' SVP decisions incorporate risk data and follow empirically supported trends; however, the observed recidivism rates of a subset of those SVP commitment appears to target suggests SVP commitment's potential for reducing sexual recidivism effectively and efficiently appears to have a low ceiling.


Ostracism—being ignored and excluded—threatens the basic human needs for belonging, self-esteem, control, and meaningful existence. This work introduces belonging to a majority as a buffer against the immediate negative impact of ostracism on basic needs for individuals with a high need to belong, for whom social groups are especially relevant. Three studies show that for individuals high in the need to belong, need threat was attenuated by membership in a majority group, but not by membership in a minority group (Studies 1 and 3) or a group of unknown size (Study 2). By contrast, individuals low in the need to belong—who place less importance on group membership in general—did not benefit from belonging to a majority group. The general pattern replicated across different manipulations of group membership and social exclusion, with two measures of need threat, and with participants from two different countries.


This paper analyses the effects of a large reform in the minimum wages affecting youth workers in New Zealand since 2001. Prior to this reform, a youth minimum wage, applying to 16-19 year-olds, was set at 60% of the adult minimum. The reform had two components. First, it lowered the eligible age for the adult minimum wage from 20 to 18 years, and resulted in a 69 percent increase in the minimum wage for 18 and 19 year-olds. Second, the reform raised the youth minimum wage in two annual steps from 60% to 80% of the adult minimum, and resulted in a 41 percent increase in the minimum wage for 16 and 17 year-olds over a two-year period. We use data from the New Zealand Household Labour Force Survey (HLFS) to estimate the impact of these changes on a variety of labour market and related outcomes. We compare the average outcomes of these two groups of teenagers, before and after the policy reform, to those of 20-25 year-olds, who were unaffected by the reform. We find no robust evidence of adverse effects on youth employment or hours worked. In fact, we find stronger evidence of positive employment responses to the changes for both groups of teenagers, and that 16-17 year-olds increased their hours worked by 10-15 percent following the minimum wage changes. Given the absence of any adverse employment effects, we find significant increases in labour earnings and total income of teenagers relative to young adults. However, we do find some evidence of a decline in educational enrolment, and an increase in unemployment and inactivity, although these results depend on the specification adopted.


Tokyo during the 1960s was a city of immense uproar, protest-riots and insurrection.
 The work of Tatsumi Hijikata - the seminal figure in Japan's experimental arts culture of the 1960s, initiator of the 'Butoh' performance art and of unprecedented crossovers between dance and other media - took place within that urban uproar, and projects its unique intensity. Central to Hijikata's vital 1960s work are his many films, from experimental projects undertaken in collaboration with artists, to horror and sex films made for Japan's ailing studios, to his participation in the corporate, state-power spectacle of the Expo '70 World's Fair, where his film work was seen by around 8,000,000 people.
 Based on many original interviews with Hijikata's 1960s collaborators, and on new research, Hijikata's Films, Film's Ghosts illuminates Hijikata's world-renowned, spectral 'Dance of Utter Darkness', Butoh, and its many contradictions and mysteries. The book explores Hijikata's films directly against 1960s urban culture in Tokyo in its era of accelerated transmutation, with the rise of its screen-constellated mega-towers, its fierce protests and riot-police battles, its ascendant security-guard and surveillance industries, and its experimentations in art, sex and terrorism. For the first time, the book gives an in-depth account of film's pivotal status at Expo '70 and of Hijikata's involvement in that 'experimental metropolis' which marked the abrupt end of the great furore of 1960s Japan's art. Hijikata's films and 1960s Tokyo also form prescient, revealing entities for contemporary worldwide arts cultures in their current urgent dilemmas with ecological contamination and corporate media spectacles.
 This will be an essential book for readers engaged with film and performance, urban cultures and architecture, and Japan's experimental art and its histories.


This morning (despite the pressure that our panel comes right before lunch), I am going to provide a "101" on the role of prosecutorial discretion in immigration law, which is my primary area of research and fundamental to understanding how the immigration system operates. Prosecutorial discretion is a largely invisible tool that enables thousands, if not millions, of unauthorized noncitizens to reside in the United States without fear from deportation. It may be characterized as invisible because prosecutorial discretion decisions are largely connected to no action at all or as some call it, nonenforcement. A favorable exercise of "prosecutorial discretion" refers to a decision by a Department of Homeland Security, or DHS, employee to abstain from enforcing the immigration laws against a person or group. A grant of immigration prosecutorial discretion does not amount to a formal legal status but rather functions as a tenuous one. There are two or maybe three theories that lie beneath prosecutorial discretion in immigration law. One theory is economic. The agency has limited resources and deporting ten million people is not cost-effective (the agency has the resources to deport less than four percent or 400,000 of the total removable population). Therefore, the agency should target its resources toward its highest priorities such as those who present a risk to national security or a danger to the community. The second theory is humanitarian. There are scores of individuals — young people pursuing higher education, spouses of U.S. military members, single mothers acting as primary breadwinners and caregivers, and migrant workers who left their families to build a life for themselves — who are contributing to the U.S. in meaningful ways and therefore, should be protected from deportation. There is a possible third theory that I might characterize as more political in nature that occurs when the agency chooses to exercise executive power in the wake of congressional inaction or action.


Key Points President Vladimir Putin's support for the global war on terrorism demonstrates his strong commitment to Russia's integration with the West. His determination has survived several crucial early tests, notably the U.S. decision to withdraw from the Anti-Ballistic Missile Treaty, U.S. military deployments to Central Asia, and the prospect of Baltic states becoming members of the North Atlantic Treaty Organization (NATO). Putin's new course has not been well received by the Russian national security establishment. The United States cannot take Russia's newfound pragmatism for granted. Sustaining positive relations with Russia will not be cost-free, but it is a promising investment in a relationship and a region whose importance after September 11 has taken on a new meaning. A strong, friendly Russia can help bolster stability and security in Eurasia and combat terrorism and proliferation of weapons of mass destruction (WMD). Russia's Westward progress would be encouraged by several developments: a bilateral strategic framework that constrains American ability to reconstitute a vast nuclear arsenal and provides reassurances that future U.S. missile defenses will not negate Russian retaliatory capabilities; a new NATO-Russia relationship in the management of European security affairs; transparency measures concerning U.S. military operations in Central Asia; and multilateral relief from Soviet-era debt and other forms of financial assistance linked to restraints on WMD exports and more effective controls on weapons-grade material. ********** In 2001, President Vladimir Putin made a strategic choice for Russia's integration with the West. Indicators of this decision include Putin's quest for better relations with the United States and Europe, his stated commitment to Russian membership in the World Trade Organization (WTO), his pursuit of a new relationship with the North Atlantic Treaty Organization (NATO), and his almost casual dismissal of the potential major irritants in the relationship with the United States and its allies--U.S. withdrawal from the Anti-Ballistic Missile (ABM) Treaty, the likelihood of Baltic membership in NATO, sizeable U.S. military deployments to Central Asia, and a growing U.S. military presence in Georgia. Putin has unequivocally crossed these once-insurmountable red lines despite opposition from his closest advisers and the unease of the Russian public over the American presence in Russia's backyard. The May 2002 summit in Moscow and St. Petersburg will take place amid heightened Russian anxieties and expectations. Russian elites are eager to see the new strategic framework with the United States but are apprehensive about whether it will meet expectations for a new post-Cold War relationship with the Soviet Union's former enemy. President Putin's ability to forge a credible post-Cold War strategic framework with the United States, establish a new relationship with NATO (which will give Russia a more prominent voice in European security affairs), and protect Russian interests and influence in Central Asia will be an important test not only of the U.S.-Russian relationship but also of Putin's personal diplomacy. Putin is approaching these tasks in a difficult domestic environment. He is nearing the halfway mark in his first term in office and is enjoying high personal popularity. His job performance, however, does not get the same approval. The two major issues that propelled him to the Kremlin--Chechnya and law and order--remain the country's biggest problems. Hopes for a speedy resolution for the Chechen conflict have long faded. President Putin's declaration of war against crime in February 2002 only underscored that his campaign pledge of law and order remains unfulfilled. The Russian president's reform agenda faces strong domestic opposition. His military reform is getting poor marks and has been subjected to fierce criticism in the Duma and in the Russian media. …


A multi fuel biogas plant is under planning at Fiborgtangen, Norway. The plant will utilize biogas from several different sources, including fish silage, animal manures, sludge from the paper factory and straw. In order to make good decisions on how to design the plant, characterization of the substrates in regards to biogas potential and nutrient value was done, and laboratory scale models of a possible plant design was established. The characterization showed that a minimum of 42% of the DM should come from manure in order to meet the micro-nutrient demand, it also showed that some nitrogen rich substrates in addition to the manure needed to be present to avoid nitrogen limitation to balance out the high carbon substrates. A biochemical methane potential study was carried out for all substrates and showed promising results, with the exception of the fiber sludge from the paper factory that had a very poor methane potential. The mixed substrate fed to the reactor models gave a methane yield of 300 mL CH4/gVS in the biochemical methane potential study. A mix of all the substrates was fed to 4 semi continuous reactors with a HRT of 25 days and OLR of 3 gVS/L. The reactors performance was unstable, and operating with high propionic acid concentrations. The specific methane yield ranged from 170-230 mL CH4/gVS, but because the reactors did not reach steady state during the experimental period and the propionic acid concentrations were so high, it is not possible to conclude on what yield this design would give. It is recommended that the semi continuous experiments are continued until they reach steady state or collapse because of the high propionic acid concentrations. After this it would be recommended to start experiments with higher proportions of animal manure and to leave the fiber sludge out of the reactor feed as it is has very low methane and nutrient value.


Emotion is a psychophysiological process that is triggered by conscious or unconscious states. Emotional information in the human brain can be captured through a multi-channel Electroencephalogram (EEG). EEG signals are recorded from multiple channels, representing information points of electrical activity from different parts of the brain. While the EEG signal of each channel is a sequence, some studies use one dimension in recognizing patterns, and the signal from the next channel is a continuation of the sequence from the previous channel. It makes the channel sequence less maintained so that the EEG signal processing from multi-channel is seen as a matrix, i.e., the vertical direction is the signal from various channels. While the horizontal direction of the sequence of each channel. So that the signal processing of the multi-channel is rich in information in the appropriate order, this study used 2D Convolutional Neural Networks (CNN) for emotion recognition, with various architectures and configurations to get the best performance. In addition, the EEG signal needs to be extracted, which reflects the emotion variable first using a Wavelet. That is the 4-45 Hz frequency band of Theta, Alpha, Beta, and Gamma. The results show that two-dimensional CNN, which pays attention to signal order, produced the best accuracy of 83.44% compared to 75.97% with one-dimensional CNN. Experiments gave the best configuration used eight layers and Stochastic Gradient Descent (SGD) weight correction.


The large calanoid copepods Calanus glacialis and C.finmarchicus is a key link between primary producers and higher trophic levels in Arctic marine ecosystems being used as indicator species of respective Arctic and Atlantic water. In this study, the egg production success and population development of Calanus glacialis and C. finmarchicus were studied in Isfjorden, Svalbard, from February to August 2016. An experimental study, investigating potential effects of different oil spill clean-up methods on C. glacialis reproduction was also conducted to study the fate of Calanus spp., under different environmental stressors. The two Calanus species had similarly large populations in Isfjorden in winter and entered the surface water simultaneously in late winter-spring. Their reproductive strategy differed although. C. glacialis started to produce eggs earlier than C. finmarchicus and had a clear egg production maximum at the peak of the spring bloom that dropped to a minimum soon after the bloom. C. finmarchicus had a a modest, stable egg production over a relatively long time span from early May to July. The late spawned eggs, however, did not make it, resulting in lower recruitment of C. finmarchicus than C. glacialis in Isfjorden in 2016. Transformed Atlantic water prevailed in Isfjorden in 2016 and there were no strong evidence of major advective events from February to August. The increase in population numbers in June was thus mainly due to local recruitment, which also the timing of the egg production and the surface temperatures supported. C. glacialis timed its reproduction and population development more successfully than C. finmarchicus to the prevailing abiotic and biotic environment in Isfjorden. By the end of August, C. glacialis had reached its main overwintering stage and was already concentrated at depth. In comparison, C. finmarchicus had a biomodal vertical distribution end of August with still high numbers of young developmental stages in the surface. In the oil exposure experiment dispersant, residue from burnt oil and crude oil were added to the mesocosms placed in seasonal sea ice in Van Mijenfjorden, Svalbard,in February 2015. In May 2015, C. glacialis females were incubated in water from these mesocosms. Because of large variation in the data partly due to overall low egg production rates, no significant effect of the different treatments on the reproduction success and development was found. , However several of the nauplii from the dispersant treatment showed sign of deformation and reduced survival.In a changing Arctic with less ice, warmer temperatures and more activity, multitude of stressors will together impact the marine ecosystem. In future studies it is therefore important to not study single stressors effect on important biological functional units, but rather a multitude of stressors which not have any impact on its own, but when acting together may have a strong impact.


As the use of machine learning (ML) models in product development and data-driven decision-making processes became pervasive in many domains, people's focus on building a well-performing model has increasingly shifted to understanding how their model works. While scholarly interest in model interpretability has grown rapidly in research communities like HCI, ML, and beyond, little is known about how practitioners perceive and aim to provide interpretability in the context of their existing workflows. This lack of understanding of interpretability as practiced may prevent interpretability research from addressing important needs, or lead to unrealistic solutions. To bridge this gap, we conducted 22 semi-structured interviews with industry practitioners to understand how they conceive of and design for interpretability while they plan, build, and use their models. Based on a qualitative analysis of our results, we differentiate interpretability roles, processes, goals and strategies as they exist within organizations making heavy use of ML models. The characterization of interpretability work that emerges from our analysis suggests that model interpretability frequently involves cooperation and mental model comparison between people in different roles, often aimed at building trust not only between people and models but also between people within the organization. We present implications for design that discuss gaps between the interpretability challenges that practitioners face in their practice and approaches proposed in the literature, highlighting possible research directions that can better address real-world needs.


Natural selection may act in different directions during different life‐history stages, or in different directions on different classes of individuals. Antagonistic selection of this kind may be an important mechanism by which additive genetic variation for quantitative traits is maintained, and can prevent populations or species reaching local adaptive peaks. This paper reports the results of a study of viability selection on morphological traits of nestling collared flycatchers Ficedula albicollis. Analyses performed without knowledge of the sex of nestlings suggested that no selection was occurring on these traits. However, using molecular sex identification with the avian CHD gene, it is shown that selection acts in different directions on male and female body size from fledging to breeding, apparently favouring relatively small males and large females. The results suggest that differential selection on male and female nestlings may contribute to purely phenotypic sexual size dimorphism in this species. These findings highlight the potential of newly developed molecular sexing techniques to reveal the consequences of an individual's gender for many aspects of its life history in taxa where gender cannot be determined on the basis of external appearance.


Objectives Previous studies showed reductions in recurrence and mortality rate of several cancer types in patients receiving perioperative epidural analgesia. This study aimed to investigate the effects of thoracic epidural analgesia on oncological outcomes after resection for lung cancer. Design Retrospective study using propensity score matching methodology. Setting Single medical centre in Taiwan. Participants Patients with stages I–III non-small-cell lung cancer undergoing primary tumour resection between January 2005 and December 2015 and had either epidural analgesia, placed preoperatively and used intra- and postoperatively, or intravenous analgesia were evaluated through May 2017. Primary and secondary outcome measures Primary endpoint was postoperative recurrence-free survival and secondary endpoint was overall survival. Results The 3-year recurrence-free and overall survival rates were 69.8% (95% CI 67.4% to 72.2%) and 92.4% (95% CI 91% to 93.8%) in the epidural group and 67.4% (95% CI 62.3% to 72.5%) and 89.6% (95% CI 86.3% to 92.9%) in the non-epidural group, respectively. Multivariable Cox regression analysis before matching demonstrated no significant difference in recurrence or mortality between groups (adjusted HR: 0.93, 95% CI 0.76 to 1.14 for recurrence; 0.81, 95% CI 0.58 to 1.13 for mortality), similar to the results after matching (HR: 0.97, 95% CI 0.71 to 1.31; 0.94, 95% CI 0.57 to 1.54). Independent risk factors for both recurrence and mortality were male, higher pretreatment carcinoembryonic antigen level, advanced cancer stage, poor differentiation, lymphovascular invasion, microscopic necrosis and postoperative radiotherapy. Conclusions Thoracic epidural analgesia was not associated with better recurrence-free or overall survival in patients receiving surgical resection for stages I–III non-small-cell lung cancer.


When WikiLeaks first came to prominence in 2010, releasing millions of top secret State Department cables, the world saw for the first time what the US really thought about national leaders, friendly dictators, and supposed allies. It also discovered the dark truths of national policies, human rights violations, covert operations, and cover-ups done in your name. The WikiLeaks Files is the first volume that uses experts to collate and analyze the most important cables and show their historic importance. An essential book for anyone who is interested in America's role in the world and the history of the twenty-first century. Regional expert contributors include Tim Shorrock, Richard Heydarian, Russ Wellen, Conn Hallinan, Michael Busch, Robert Prince, Stephen Zunes, Peter Certo, Francis Nesbitt, Phyllis Bennis, and Gareth Porter.


Abstract This study analyses the possible influence of cultural activities such as visits to theatres, museums, exhibitions, zoos, circuses, excursions, trips and campaigns on educational progress. It uses longitudinal data taken from the Russia Longitudinal Monitoring Survey, which is a unique nationally representative survey; the sample consists of schoolchildren aged six to14. The methodology makes use of the panel data structure and logit regressions to effectively control for time-invariant determinants of educational achievements, and the method directly controls for socioeconomic status, students' health, public school, region, age and gender. Consequently, this study accurately measured the isolated effect of cultural activities. The findings suggest that these cultural activities correlated positively with educational progress, as the cultural capital theory predicts. However, participation in these activities without parents did not show significant effects. Therefore, parental participation seems necessary to observe a positive association between cultural activities and educational progress, in accordance with the social capital theory.


Statement of the problem: The variety of space-place experiences can be regarded as a feature that differentiates modern men from traditional men. Man's existence across natural and social realms, not only has a theoretical and epistemological history but also various distinctive perceptions of experiencing natural and social places. Throughout history, distinctive perceptions have had a unique spirit on one hand and a common spirit in human body on the other. Nevertheless, body and its corporeal and physical characteristics have not been given their due attention in dominant architectural discourses. Body has always been considered a passive object. Purpose: The present study aims to investigate bodily perception as a source of inspiration for redefining the concept of space in architectural experience. The secondary purposes of the study include examining the manifestations of reading space by incorporating bodily perceptions, as well as scrutinizing the integration of human senses in space perception. Methodology: The current study is qualitative and uses a hermeneutic phenomenologicalphilosophical approach. The study is "interpretive" in terms of research "purpose", and aims to produce new insights so as to use the findings to improve the existing knowledge about the topic of interest. Hence, the "results" are "pure". The "logic" of the study is "inductive." In the present study, a deep interview was conducted to infer and extract the "subconscious" from the responses of interviewees. The data analysis method includes qualitative content analysis via open and axial coding. Conclusion: The results suggest that phenomenal reading of spatial perception experience can be categorized into three levels of complete perception, dynamic perception of space through senses; space as a medium for perceiving collective nostalgia, and space as the possibility of intuition and perception of the other.


RhoGTPases control endothelial cell (EC) migration, adhesion, and barrier formation. Whereas the relevance of RhoA for endothelial barrier function is widely accepted, the role of the RhoA homologue RhoB is poorly defined. RhoB and RhoA are 85% identical, but RhoB's subcellular localization and half-life are uniquely different. Here, we studied the role of ubiquitination for the function and stability of RhoB in primary human ECs. We show that the K63 polyubiquitination at lysine 162 and 181 of RhoB targets the protein to lysosomes. Moreover, we identified the RING E3 ligase complex Cullin-3–Rbx1–KCTD10 as key modulator of endothelial barrier integrity via its regulation of the ubiquitination, localization, and activity of RhoB. In conclusion, our data show that ubiquitination controls the subcellular localization and lysosomal degradation of RhoB and thereby regulates the stability of the endothelial barrier through control of RhoB-mediated EC contraction.


In order for inclusive education teachers to create a high quality environment, to recognize which individuals require special education, and to implement the principles of inclusive education, these teachers need to be able to use methods and techniques related to the program's content. In addition, student-performance evaluations need to happen and IEPs must be prepared, implemented, and evaluated by IEP teams. After examining the literature, however, teachers are observed to have insufficient knowledge about how toon preparing IEPs. This study aims to reveal the effect that the IEP training program has on how inclusive education teachers perceive their IEP competencies for the development process. In line with this aim, answers to the two following questions have been sought: (a) What are inclusive classroom teachers' selfperceptions of their IEP competencies, and (b) Do inclusive classroom teachers' post-test scores from the IEP Competence Scale show a significant difference based on whether or not they had attended the In-Service IEP Development Training Program? This study, being a mixed-methods design, makes use of both qualitative and quantitative methods. During the qualitative phase of the study, interviews have been conducted with 24 classroom teachers, whereas during the quantitative phase, an experimental study has been conducted over one control and one experimental group, each containing 19 teachers. As a result of the semi-structured interviews conducted in the present study, teachers are found to have shortcomings in almost every stage of the IEP development process, whereas a significant difference in favor of the experimental group was found upon examining both groups' post-test scores following the in-service IEP training program.


A novel, monolithic harvesting–storage (HS) device composed of a dye-sensitized solar cell (DSSC)-based module and a high voltage supercapacitor with impressive discharge capacity after photocharging is herein proposed. Both the harvesting and the storage sections are fabricated onto conductive glass substrates, paving the way to a smart and easy integration in window facades for energy self-sustainable buildings. In addition, the HS device can also be integrated in portable electronics or drive remote, off-grid sensor networks requiring high power intermittent electrical energy. The harvesting photovoltaic section is constituted by a series of four DSSCs integrated in a single W-type module while the storage section consists of an activated carbon-based supercapacitor (SC) utilizing Pyr14TFSI ionic liquid as the electrolyte. The testing of the two separated sections as well as of the integrated system is reported here. In particular, the integration is evaluated through photo-charge and subsequent discharge protocols performed at different galvanostatic currents, showing that the SC handles photo-charges up to 2.45 V while delivering discharge capacities exceeding 1.8 mA h (0.1 mA h cm−2) upon 1 mA discharge current. To the best of our knowledge this is a never reported before, absolute record value, for stable and reliable integrated HS devices.


Aims The present study aimed to determine factors associated with the frequency of paralyzed upper extremity (UE) use in chronic stroke patients with severe UE functional deficiency. Methods We retrospectively reviewed the medical records of 138 consecutive patients, and 117 was analyzed (median age, 55 [range, 18–85] years; median stroke duration, 24.5 [range, 7–302] months) with chronic hemiparetic stroke who were admitted to our hospital for intensive upper extremity rehabilitation. The mean Fugl-Meyer Assessment (FMA) UE score was 28.6. All of them are independent in their activity of daily living (ADL) and without remarkable cognitive deficits. Amount-of-use score of Motor Activity Log-14 (MAL-AOU) was applied as the index of daily use of affected UE. The following parameters were examined as the explanatory variables: demographics, proximal and distal sub-scores of FMA UE, Modified Ashworth Scale (MAS), and sensory function scores in the Stroke Impairment Assessment Set (SIAS). Results The median MAL-AOU score was 0.57 [range, 0.28–0.80]. Ordinal regression analysis revealed that FMA proximal, FMA distal, and SIAS sensory function (touch) were associated with AOU score of MAL-14 (Pseudo R-square = 0.460). Conclusion Not only motor but also sensory function, especially tactile sensation, play a crucial role in the daily use of affected UE in chronic stroke patients with severe UE hemiparesis.


Author(s): Shaheen, Susan, PhD; Cohen, Adam | Abstract: In 2017, researchers from UC Berkeley's Transportation Sustainability Research Center and Institute of Transportation Studies produced eight policy briefs on shared mobility. Shared mobility – the shared use of a vehicle, bicycle, or other travel mode – services are experiencing rapid growth and expansion. This is, in part, due to the launch of innovative business models across California, and their use of the smartphone as a way to enable on-demand transportation options. There is a need to clarify emerging terms and best practices for policymakers amidst the fast-paced developments of the field. Fluency in data sharing opportunities and standards, funding options, and equity considerations will be needed to implement flexible, forward-thinking policies. These topics are covered in the briefs that follow. Each brief includes a presentation of research findings, description of the research approach, and recommendations for the California Legislature. Policymakers and legislatures can refer to these briefs for digestible explanations of research findings and suggestions of ways to apply research to improve California's transportation system


Despite the growing academic criticism of using mandatory information duties as one of the main consumer protection measures in consumer law, the recently adopted Consumer Rights Directive (hereafter, the "CRD") maintains this trend in Europe. The long and detailed list of information duties provided for traders in Articles 5 and 6 of the CRD applies to any sale and services consumer contracts that falls under the scope of application of the CRD. For traders, however, fulfilling this obligation may seem to be an exercise in futility due to little evidence that consumers read these disclosures and actually benefit from them. Instead of understanding the duty to disclose as a duty to inform consumers we could see it as a duty to reach consumers with the disclosure, so that consumers possessed the information contained in it when they needed it for reference. With this in mind it is important to inquire what efforts traders must undertake to ascertain that the disclosure reaches consumers and whether they could rely on an, at least partially, active behaviour of consumers in obtaining this information. This conundrum plays a special role in online transactions. The Consumer Rights Directive was adopted, among others, to update the so-far existing rules on consumer distance selling contracts to the modern technologies, especially the Internet. Recital 5 CRD specifically recognizes the importance of the future increase in online trade and for the first time in European consumer law the Internet is clearly mentioned as one of the means of concluding distance selling contracts in Recital 20 CRD.


Background and Objectives: The body mistakenly considers some parts of its own system as pathogen and attack them, are known as autoimmune diseases. The auto - immune diseases are Rheumatoid Arthritis(RA), SLE, etc. are growing day by day worldwide. Till date no aetiological agents ar e documented for this disease. This study is carried out to with objective to find out the screening accuracy of RF and AntiCCP. Method: The study is based on 290 clinically suspected subjects. Cross - sectional cohort study design was used. Clinically suspected cases were referred by different OPD's of Sir Sunderlal Hospital for screening. Along with results of these tests other socio - demogr aphic, economic information were also carried through structured pre - tested schedule method. Result: Rheumatoid factor (RF) test screened 21.8% as positive which was approximately equal to AntiCCP (21.7%). CRP was observed some better test than RF and Ant iCCP because it screened approximately one third cases. The sensitivity of RF, AntiCCP , CRP, CRP+AntiCCP, RF+AntiCCP, RF+CRP and RF+AntiCCP+CRP were 77.08, 75.0, 93.75, 97.92, 100, 93.75 and 100 percentages respectively. The overall accuracy was observed highest for RF. Conclusion : The finding of this study illustrates that there is no single screening test is suitable to diagnose the RA disease. The combination of two screening tests had about 90% sensitivity which is increased up to 100% if three tests combined. Thus, these tests should be performed in all clinically suspected cases to find out the diseased.


The ability of the anaerobic mixed bacterial culture from an upflow anaerobic sludge blanket (UASB) bioreactor to convert blends of olive mill wastewaters (OMWs) with synthetic glucose medium or molasses into ethanol simultaneously with organic acids (OAs) was studied in the present work. All fermentations were conducted by free cells under non-aerated conditions at 37 οC and the effect of OMWs concentration on ethanol and OAs production was investigated. The highest amount of bioethanol (14.7 g L-1) was produced during fermentation of 45 % v/v OMWs mixed with synthetic glucose medium (5 % w/v) in only 28 hours. In mixtures of 30 % v/v OMWs and molasses solution (3 oBe) 13.4 g L-1 of bioethanol were produced. Also, 16.2 g L-1 of succinic acid were produced, when 65 % v/v OMWs mixed with synthetic glucose medium. Moreover, totally 11.6 g L-1 of varied OAs (succinic, malic, butyric and acetic) observed in mixtures of 35 % OMWs with molasses. Finally, it has been shown that the 14C-labelled glucose uptake rate (GUR) by biomass was strongly correlated to fermentation rate.


Empirical risk minimization (ERM) is ubiquitous in machine learning and underlies most supervised learning methods. While there is a large body of work on algorithms for various ERM problems, the exact computational complexity of ERM is still not understood. We address this issue for multiple popular ERM problems including kernel SVMs, kernel ridge regression, and training the final layer of a neural network. In particular, we give conditional hardness results for these problems based on complexity-theoretic assumptions such as the Strong Exponential Time Hypothesis. Under these assumptions, we show that there are no algorithms that solve the aforementioned ERM problems to high accuracy in sub-quadratic time. We also give similar hardness results for computing the gradient of the empirical loss, which is the main computational burden in many non-convex learning tasks.


The increasing demand for energy and the related environmental concerns are the main drivers for the strong interest in Biomass Fermentation towards usage in Fuel Cells. The integration of Biomass Fermentation (BF) and Fuel Cells (FC) technology creates a new and interdisciplinary research area.

Due to their high efficiency Fuel Cells are therefore considered as a strategic technology for future energy supply systems. The fact that biomass is a renewable source of energy in combination with the most efficient energy conversion system (FC) makes this combination unique and advantageous.

This book has a clear orientation towards making products of our waste. Biofuels for Fuel Cells comes at a time when this field is rapidly developing and there is a need for a synthetising book. The holistic and multidisciplinary description of this topic, including discussion of technological, socio-economic, system analysis and policy and regulatory aspects, make this book the definitive work for this market.

Biofuels for Fuel Cells will cross-link scientists of all fields concerned with Biomass Fermentation, Fuel Upgrading and Fuel Cells at European and World level.

This title belongs to Integrated Environmental Technology Series

ISBN: 9781843390923 (Print)

ISBN: 9781780403021 (eBook)


The effect of spray application of xyloglucan on strength and recyclability of bleached chemical pulp was studied. Xyloglucan alone and with a cross-linking chemical was applied on sheets made of unbeaten never-dried and once-dried virgin pulps. Recyclability of these pulps was evaluated based on the tensile strength of wet and dry handsheets. Dry strength measurements showed that the spray application reduces the loss of strength and bonding ability in recycling. The use of cross-linking chemical was found to be essential in enhancing both the wet and dry strength of the virgin and recycled pulps. The chemical application was efficient with both never-dried and once-dried pulps. Wet web strength results indicate that the amount of web breaks could be decreased in paper and board machines using recovered fibers by having cross-linked xyloglucan layer on fiber surface. Spray application was found to be an effective way to introduce non-charged chemicals into fiber network. As a consequence of improved fiber bonding the need of refining decreases which further improves the recyclability of fibers. In addition to xyloglucan also other polysaccharides, for example those provided by chemical or mechanical pulp mills, could be used for improving the recyclability and extending the lifetime of fiber material.


Volatile components in regular and decaffeinated green teas were isolated by simultaneous steam distillation and solvent extraction (SDE), and then analyzed by GC-MS. A total of 41 compounds, including 8 alcohols, 15 terpene-type compounds, 10 carbonyls, 4 N-containing compounds, and 4 miscellaneous compounds, were found in regular and decaffeinated green teas. Among them, linalool and phenylacetaldehyde were quantitatively dominant in both regular and decaffeinated green teas. By a decaffeination process using supercritical carbon dioxide, most volatile components decreased. The more caffeine was removed, the more volatile components were reduced in green teas. In particular, relatively nonpolar components such as terpene-type compounds gradually decreased according to the decaffeination process. Aroma-active compounds in regular and decaffeinated green teas were also determined and compared by aroma extract dilution analysis (AEDA). Most greenish and floral flavor compounds such as hexanal, (E)-2-hexenal, and some unknown compounds disappeared or decreased after the decaffeination process.


In the late 1950s the aerodynamicists at what is now the Hatfield site of British Aerospace accepted the challenge and met British European Airways' demand for a 600 m. p. h. (ca. 966 km h-1) short-haul jet airliner (the Trident). The experience and organization resulting from that project was the cornerstone on which the subsequent success story of civil wing design has been built. The substantial advances in efficiency achieved by the Hatfield team in the following designs for the 125 Business Jet, the 146 Feederliner and for the Airbus Industrie family of Wide-Body Mainline aircraft, has been supported by research programmes in the government establishments and universities as well as industry itself. Each project had its individual demands for fuel economy, high lift capability and structural efficiency, with commercial competition continually driving technological progress. The major highlights and achievements of the aerodynamic development programmes for these projects are reviewed. Turning to the present, the Hatfield team are currently working on the aerodynamic design for the combined Airbus A330/340 project. Technological progress continues apace with major investment in computational fluid mechanics, but the still essential role of experimental test techniques and facilities is emphasized.


In his precis, James Stacey Taylor sets out his full-blooded Epicureanism, which concludes that "death is not a harm to the person who dies and that persons can neither be harmed nor wronged by events that occur after their deaths."1 He then considers various topics in bioethics in the light of his Epicureanism, one of which I consider here: presumed consent in the procurement of organs for transplantation. Although I do not accept Taylor's Epicureanism and although his examination of presumed consent is flawed in various ways, I think we can learn something important from him.

Taylor couches the problem in terms of what we are supposed to presume about people's consent or dissent and he thinks that the USA and UK have a system of 'presumed refusal' "whereby it is presumed that a person would refuse to have her transplantable organs removed from her postmortem unless she had explicitly indicated otherwise" (ref. 2, p. 111—page references in text refer to this book). Taylor makes a common mistake. The USA and UK have never had such a presumption. In these countries, people who explicitly refuse may not have their organs taken, whereas people who do not explicitly consent may have their organs taken if, roughly speaking, their families consent. Thus non-consenters are not presumed to be refusers.

Leaving aside the mistake about the status quo, …


This paper sheds light on the similarities and differences with respect to the presence of anomalies in the China A-share market and other markets. To this end, we examine the existence of 32 anomalies in the China A-share market over the period 2000-2019. We find that value, risk, and trading anomalies carry over to China A-shares. Evidence for anomalies in the size, quality, and past return categories is substantially weaker, with the exception of a strong residual momentum and reversal effect. We document that most anomalies cannot be explained by industry composition, and are present among large, mid, and small capitalization stocks. We are the first to examine the existence of residual reversal, return seasonalities, and connected firm momentum for the China A-share market. We find strong out-of-sample evidence for the former two, but not the latter. Specific characteristics of the China A-share market, such as short-sale restrictions, the prevalence of state-owned enterprises, and the effect of stock market reforms, are examined in more detail. These features do not seem to be important drivers of our empirical findings.


PARA-SITE-SEEING: DEPARTURE LOUNGE is an art-science collaboration between Rod Dillon and Jen Southern, inviting you to imagine life from the perspective of the Leishmania parasite. This deadly parasite has been travelling for millions of years, catching flights between humans, dogs and other animals using sand flies as their mode of transport. Throughout human history, the parasites have exploited conflict and competition to move between continents. Now, humans at University of Dundee's Wellcome Centre for Anti-Infectives Research (WCAIR) are fighting back! Rod Dillon and Jen Southern have been collaborating since 2011. Rod is a Senior Lecturer and Director of Studies in Biomedicine at Lancaster University. During the past ten years Rod has worked on creative interspecies projects with artists, makers and scientists. Jen Southern is an artist and lecturer in Fine Art and New Media. She is Artistic Director at the Centre for Mobilities Research at Lancaster University. The exhibiton is an expansion of Rod Dillon and Jen Southern's travel blog website PARA-SITE-SEEING.org, co-commissioned by NEoN2018 Festival and Wellcome Centre for Anti-Infectives Research (WCAIR). PARA-SITE-SEEING: DEPARTURE LOUNGE is a partnership exhibition commissioned by LifeSpace Science Art Research Gallery and WCAIR. WCAIR is setting its sights on infectious disease, creating a world-leading hub for drug discovery.


This report provides additional information to the baseline and optimized scenarios that have been developed for the review and revision of the Thematic Strategy on Air Pollution in TSAP Reports #6 and #7.

The report examines the implications of different assumptions on the implementation of the Euro-6 emission standards for light duty diesel vehicles on compliance with NO2 air quality limit values in Europe. For the baseline assumptions of the TSAP-2012 baseline scenario, i.e., a decline of real-driving emission in two stages down to 1.5 times the value of test cycle value in 2018, it is estimated that almost all AIRBASE stations that have been modelled in this exercise would achieve the NO2 limit values by 2030 at the latest.

However, in the least optimistic sensitivity case, i.e., under the assumption of a failure of Euro-6 (no change in real-driving emissions compared to Euro-4), about 100 out of the 1173 AIRBASE monitoring stations would still remain in non-compliance with the limit value in 2030.

A second analysis examines the optimization results presented in TSAP Report #7 in more detail and provides, for each of the optimized scenarios, the sectors in which emission reductions would occur in the cost-optimal cases. These emission reductions will lead to lower background pollution concentrations in Europe, which will affect PM10 levels within cities. It is estimated, e.g., for the high ambition case, that in 2030 the number of stations for which non-compliance is robustly estimated will decline by about 20%. The number of stations for which compliance seems possible but not certain would fall by 30% compared to the baseline. In contrast, the optimized scenarios do not yield significant improvements in the compliance with NO2 limit values, as the series of scenarios did not consider further measures for road vehicle emissions.

Finally, an initial assessment of current and future emissions of mercury in Europe suggests for the TSAP-2012 baseline a decline of Hg emissions of 22% in 2020 and about 30% in 2030 (relative to 2005), mainly as a consequence of lower coal use in the power sector. Full implementation of the available technical emission controls, especially of certain measures to reduce PM emissions, could eliminate Hg emissions in the EU by another third, so that in 2030 the total release of Hg in the EU could be more than 50% lower than in 2005.


This thesis provides insights into the mechanisms of technological change by capturing the complexity that characterises the current technological transition of the transport system into existing evolutionary models of technological change. The transition towards a more sustainable transport system requires technological change. Its realisation requires the production of new vehicle technologies by technology providers, the adoption of those technologies by consumers, and facilitating policy instruments. Technological change in the transport sector is not easy, as it is locked in into fossil-fuel-based internal combustion engine vehicles. Escaping this lock-in is difficult, because vehicle technologies are dependent on infrastructures, which are characterised by high switching costs and network externalities. Moreover, negative externalities inherent in environmental problems are insufficiently internalised in the costs of technologies, which is a disadvantage for the competitive position of more environmentally friendly technologies. In contrast with earlier studies this thesis explicitly addresses the infrastructure dependence of vehicle technologies. In addition the models cover the emergence of multiple new technologies; the compatibility between different old and/or new technological systems; the technologies that emerge at different moments in time; and the effects of significant incremental improvements in the existing technologies. The two main overall conclusions of this thesis have major implications for policymakers who intend to accelerate technological change towards a more sustainable transport system. First, it is concluded that the emergence of a large variety of radically new vehicle technologies that depend on a physical infrastructure may hamper the diffusion of any one of those radically new vehicle technologies. Second, incremental improvements in the environmental performance of the existing vehicle technology may hamper the diffusion of radically new technologies with a higher environmental performance potential. The first conclusion has two major implications for policymakers. First, policymakers need to support technology providers in the creation of a limited number of vehicle technologies, which preferably make use of similar infrastructures. Second, each of the created vehicle technologies needs sufficient support for infrastructure build-up to stimulate consumer adoption and generate the critical mass needed to replace the existing technology. Two critical implications for policymakers follow from the second conclusion as well. First, policymakers need to set ambitious long-term goals to keep the option of zero emission vehicle systems open. These long-term goals provide incentives for technology providers to invest in radical innovations as well as in incremental improvements in environmental performance of the existing technology. Second, in order to attract market demand policymakers need to provide an advantage for those radically new technologies with a large CO2 reduction potential in the long term, but are not yet able to compete with the existing technology without help.


Increased globalised competition and the need to meet continuously changing
customer requirements has forced the UK construction industry to consider its
practice. The industry has been repeatedly criticised for its inefficiency,
fragmentation, profitability, and lack of co-ordination and communication by
many governmental and institutional reports (Phillips, 1950; Emmerson, 1962;
Banwell, 1964; Gyles, 1992; Latham, 1994; Egan, 1998). Latham and Egan cited
that process improvement and learning from the manufacturing industry could aid
the prevailing situation. Following such recommendations, a number of
construction clients started developing their own design and construction process,
including BAA (British Airports Authority), BAe (British Aerospace) and London
Underground, as a way to improve the prevailing situation. An appraisal of these
industrial approaches highlighted a common structure that contributed to the
development of the Generic Design and Construction Process Protocol (GDCPP).
This research project, led by the University of Salford, proved to be the impetus
for a flurry of other construction companies to remodel their processes.
However, the success of a construction project is not always directly attributed to
the performance of the new project process, and vice versa. Framed in these
terms, how can the effectiveness of implementing a new design and construction
project process be measured in recompense to this growing trend of process
improvement?
Construction performance measurement today is myopic. For too long,
construction organisations have focused on short-termism. If they are to remain
competitive, they need to embrace broader issues other than the traditional time
cost and quality metrics of construction performance (Love & Holt, 2000). They
must also consider the performance of the project process itself (Neely et al, 2000)
as to determine the true barriers to success, be that the process itself or
implementation factors. However, there is at present a lack of understanding on
how the measurement of project processes should be approached. This is attributable in part to the absence of publicly available information, and in part to
the inherent difficulty of measuring a complex and creative process. This thesis
describes the development of the project process evaluation (PPE) framework that
aims to address this research gap.
Literature reviews and a scoping survey questionnaire were used in this research
investigation for the discovery and building of the PPE framework. The
framework consists of five steps, which guides the user from the identification of
performance indicators governing the selection of the new project process,
through into a knowledge-learning domain in order to improve upon future
projects. A case study research strategy was then used to test and validate the
model, which employed various research methods to collect both qualitative and
quantitative data for the study; the Process Protocol was deployed on the case
studies in order to certify the framework. The resulting PPE framework provides
an original, prototypical solution to assessing the effectiveness of implementing a
new design and construction project process.


We have investigated adsorption and dissociation of water and HfCl4 on Ge/Si(100)-(2x1) surface with density functional theory. The Si-Ge heterodimer and Ge-Ge homodimer are employed to represent the Si1-xGex surface. The activation energy for adsorption of water on Ge-Ge homodimer is much higher than that on Si-Ge heterodimer. No net activation barrier exists during the adsorption of HfCl4 on both SiGe surface dimers. The differences in the potential energy surface between reactions on Si-Ge and Ge-Ge dimers are due to different bond strengths. It should also be noticed that the activation energy for HfCl4 is quite flat, thus HfCl4 adsorbs and dissociates on Ge/Si(100)-(2x1) easily.


Acute rehabilitation services make use of interdisciplinary teams in order to treat neurologically impaired patients.
The interdisciplinary teams work closely with an extensive network of supporting services.
The primary goal of rehabilitation is to restore maximal function following a neurological insult or illness.
Patients are admitted to acute rehabilitation units a short time after the neurological insult, once medically stable and able to participate in a graded programme of therapy.
The patient and family form a pivotal part of the interdisciplinary model of rehabilitation.
Patients with neurological deficits are often at high risk of developing serious secondary complications.
The prevention of secondary complications is an important goal in the effective management of neurologically impaired patients.
Acute inpatient rehabilitation is usually followed up by ongoing outpatient therapy services after discharge.
The delivery of effective rehabilitation services after injury has important economic implications for the patient, family, funders and state medical systems.


Several scholars, most recently and extensively Kevin Stack of Vanderbilt, have argued that statutes authorizing action by the "Secretary" or "Administrator," without mention of the President, are properly read to deprive the President of directive authority over those executive officials' decisions. Some have argued that reading delegations to a "Secretary or "Administrator" to authorize direction by the President would detrimentally affect an agency official's willingness to resist presidential pressure, even though it would not affect the President's formal power to remove the official. This short symposium essay responds by presenting more detailed evidence on several aspects of the interpretive question. It argues, consistently with the 2001 position of then-professor, now Justice, Elena Kagan, that outside of independent agencies, the choice of terminology does not communicate any particular congressional intent regarding presidential directive authority, at least with respect to executive branch agencies. Instead, a statutory delegation to the President, rather than to a "Secretary" or "Administrator," seems best understood as Congress conveying the power to the President to choose which executive branch official will be primarily responsible for implementing that delegation, and delegations to the "Secretary" or "Administrator" as restricting that choice. The essay then comments that the interpretive question may not make that much difference to agency resistance to presidential supervision. It concludes with some observations on the normative debate over presidential control of executive agency decision making and calls for greater disclosure of the content of that control.


The extent and content of boundary barrier functions can be explained by decisionsmade by the neighbouring states and their implementation on the local level. Withthe sudden changes of government and governance in 1989–1991 in Eastern andCentral Europe, the relation between individual and state changed drastically,from top-down, 'socialist' state-territorially contained relations into a moremultidimensional relationship where democratic bottom-up influences plays a moreimportant role, but where also commercial interests, mediated information andsupra-state ('international') regulation intervene. In the juxtaposition of territorialstates, the difference in jurisdiction between hierarchical levels has led to misfits,asymmetries that negatively impact the possibilities for cross-border co-operation.Using a cultural trait, that of religion as a measure of internal and cross-borderinteraction, the following questions were asked: What is the relation between theterritorial ("nation") state, civil society and education in border towns? Will the localteaching of religion be influenced by the proximity of a different state with anotherset of cultural and jurisdictional norms? The questions were approached withexamples from the teaching of religion, ethics and civics in northeastern Europeanborder areas, involving border twin towns in Norway, Russia, Finland, Estonia,Latvia, Poland and Germany. The present study involved four different academicdisciplines; the study of religion, education, geography and political science.Information about the teaching of religion and ethics was made throughstructured interviews with teachers and principals of selected schools made byassistants fluent in the language(s) of the locality. Questions were also asked aboutthe use of religious and other symbols, the celebration of holidays and other eventsThe study resulted in a general rejection of the hypotheses. Education,especially related to religion, civics and ethics, is almost completely influenced by thehomogeneous territorial jurisdiction of each state. Local civil society plays a minorrole in the teaching. Local religious groups are usually not invited to the schools,and parents show little interest in the teaching contents of school life. The existenceof cross-border migrants is to some extent taken into consideration in languageteaching, but not in civics or religion. While cross-border relations are friendly, theyare rarely intense.


Hotel sector causes significant environmental stress in both natural and built up areas due to their consumption of water and energy. In addition, the production of large volumes of liquid and solid waste results in a significant environmental footprint. The use of water and energy by hotels is strongly linked (e.g. energy is consumed for hot water, operation of the pool, preparation of meals, etc.) and usually referred to as the water – energy nexus. Thus, for big consumers like hotels, water and energy consumption should be addressed collectively as water-saving measures can lead to a reduction in energy consumption. The aim of this study is to assess the environmental performance of mid-sized hotel units by analyzing and quantifying their use of water. An analysis using a two-step approach was made of 8 accommodation facilities located on Samos Island, Greece: (i) a mapping of water use by adopting an end-use approach, and then (ii) an assessment of saving practices using three main criteria: savings, cost of investment and payback time. The preliminary results indicate that for small sized lodging units, water consumed inside the guest rooms accounts for the majority of all the water used and low-cost water saving measures and actions can reduce the pressure on water resources without disturbing guests, while increasing the financial profitability of a hotel.


Homeless people, in particular rough sleepers, are a group who are frequently marginalised and subject to processes of social exclusion (Newburn and Rock, 2005). Although rough sleepers constitute a significant research area for criminologists in the context of post-industrial decline, urban regeneration, and authoritarian policing strategies, there is a surprising dearth of criminological research into fear of crime among the homeless. Indeed, rough sleepers and the homeless in general are more likely to be examined as a causeof fear of crime rather than as subjectto it. In response to this, I am preparing to conduct critical research which seeks to establish levels of fear of crime among rough sleepers in Liverpool city centre, and the impact that Capital of Culture Year (2008) has had, and continues to have, on existing levels of fear.

This paper will explore anxieties experienced by a postgraduate researcher in preparing for research with a marginalised, criminalised, and 'hard to reach' group. Issues of care of the self will be explored, in terms of both personal security and emotional well-being. Conceptualisations of fear of crime will be explored reflexively, in that the paper will consider the ways in which researchingfear of crime among a marginalised group may cause the researcherto experience fear of crime herself.


Most literature exploring the biological effects of ocean acidification (OA) has focused on macroscopic organisms and far less is known about how marine microbial communities will respond. Studies of OA and microbial community composition and diversity have examined communities from a limited number of ocean regions where the ambient pH is near or above the global average. At San Juan Island (Salish Sea), a region that experiences naturally low pH (average = 7.8), the picoplankton (cell diameter is 0.2–2μm) community was predicted to show no response to experimental acidification in a three-week mesocosm experiment. Filtered seawater mesocosms were maintained via semicontinuous culturing. Three control mesocosms were maintained at pH 8.05 and three acidified mesocosms were maintained at pH 7.60. Total bacteria was quantified daily with a flow cytometer. Microbial communities were sampled every two days via filtration followed by DNA extraction, 16S rRNA amplification, and MiSeq sequencing. There was no significant difference in total bacteria between pH treatments throughout the experiment. Acidification significantly reduced Shannon's diversity over time. During the final week of the experiment, acidification resulted in a significant decrease in Shannon's diversity, Faith's phylogenetic distance, and Pielous's Evenness. ANCOM results revealed four bacterial ASVs (amplicon sequence variants), in families Flavobaceriaceae and Hyphomonadaceae that significantly decreased in relative frequency under acidification and two bacterial ASVs, in families Flavobacteriaceae and Alteromonadaceae, that significantly increased under acidification. This is the first OA study on the microbial community of the Salish Sea, a nutrient rich, low pH region, and the first of its kind to report a decrease in both picoplankton richness and evenness with acidification. These findings demonstrate that marine microbial communities that naturally experience acidic conditions are still sensitive to acidification.


Synechocystis sp. pee 6803 is a unicellular, freshwater cyanobacterium. Its dependence upon light to support its photoautotrophic lifestyle increases the importance of environmental sensing mechanisms to be able to maximise lightharvesting whilst avoiding the harmful effects of light-mediated cell damage. The sequencing of the Synechocystis sp. pee 6803 genome in 1996 now allows the identification of genes that encode putative proteins with roles in sensing the environment.

Two such open reading frames, slr1212 and slrI213, were identified from the genome following computer analysis of the protein sequences. These two proteins encode a putative two-component signal transduction system with a role in sensing the environment. SIr1212 possesses homology to (i) the binding domain of ethylene receptors of higher plants, (ii) P AS/P AC domains, potentially involved in ligand binding and protein dimerisation, (iii) GAF domains, which contain the chromophore binding region of plant phytochromes, and (iv) histidine kinases of two-component signal transduction systems. SIr1213 possesses homology to characterised response regulators, and contains a helix-turn-helix DNA binding motif.

This study set out to characterise a physiological role for these enigmatic proteins by analysing interposon mutants. Single and double interposon mutants were generated in these open reading frames. Growth of these mutants was unaffected in different light qualities, but SIr1212 was shown to be involved in the acclimation of the Synechocystis sp. pee 6803 cells to high light irradiance as analysed by 77K fluorescence spectroscopy, which also indicated possible structural alterations in PSI reaction centres ofORF slr1212 mutants.

Using laser photo acoustic spectroscopy, it was shown that Synechocystis sp. pee 6803 could release ethylene following incubation with Ace suggesting a possible ethylene biosynthetic route, though genome analysis revealed no obvious homologues of ACC oxidase, an enzyme required for conversion of Ace to ethylene in vascular plants. It is hypothesised that an ethylene signalling mechanism may be present that regulates cell responses to non-specific stress.

Site-directed mutagenesis of SIr1213 that caused constitutive activation of the protein had a lethal effect in Synechocystis sp. pee 6803 cells. The mutation consisted of a substitution of the conserved aspartate residue with glutamate, thus mimicking the phosphorylated state of the protein.

In summary, SIr 1212 has a role in the acclimation of cells to high light irradiance and binds ethylene, and may act in conjunction with Slr1213 to modulate these responses.


OBJECTIVE
To determine the applicability of uterine biophysical profile (UBP) scoring with chances of pregnancy in a spontaneous cycle in a cohort of females with unexplained infertility.

DESIGN
Observational study.

PLACE AND DURATION OF STUDY
A secondary level private hospital, from June 2003 to June 2004.

PATIENTS AND METHODS
The study subjects included 26 infertile females in the third decade of life primarily referred for follicle maturation monitoring by ultrasound with patent tubes and normal utero-ovarian morphology. Male factor infertility was also excluded. The UBP was determined by applying the uterine scoring system for reproduction (USSR). A score of 17 or above, out of a perfect score of 20, was hypothesized to be favorable for pregnancy. Frequency of pregnancy was correlated with the cumulative score as well as individual variable. Significance of correlation was taken at p<0.05.

RESULTS
None of the patients showed a perfect score of 20. A score of 17 was noted in 06 patients out of whom 04 conceived (pregnancy rate=66.6%). A score of 15 or less was observed in 20 patients, none of whom conceived (p=0.001). No significant correlation was found with any of the individual variables including the endometrium and myometrium characteristics, as well as the uterine artery flow. Myometrium contraction was the most technically difficult parameter to be observed.

CONCLUSION
In this small cohort of patients, an ultrasonographically assessed uterine score of 17 or above was significantly associated with chances of pregnancy in the similar spontaneous cycle.


Training machine learning models that are robust against adversarial inputs poses seemingly insurmountable challenges. To better understand adversarial robustness, we consider the underlying problem of learning robust representations. We develop a notion of representation vulnerability that captures the maximum change of mutual information between the input and output distributions, under the worst-case input perturbation. Then, we prove a theorem that establishes a lower bound on the minimum adversarial risk that can be achieved for any downstream classifier based on its representation vulnerability. We propose an unsupervised learning method for obtaining intrinsically robust representations by maximizing the worst-case mutual information between the input and output distributions. Experiments on downstream classification tasks support the robustness of the representations found using unsupervised learning with our training principle.


The Safe Schools program in Australia has attracted great controversy. On one end of the spectrum it is defended as an anti-bullying program. On the other end of the spectrum it is regarded as social engineering.It is important to have programs in schools that offer support for same-sex attracted youth, or those experiencing confusion about their gender identity, particularly those who do not have support at home. However, this particular program has some serious flaws.This paper seeks to draw attention to various problems in the Safe Schools materials which ought to be rectified if a program like this is to continue to be offered in schools. First, the materials present statistics on same-sex attraction and transgender prevalence that have no valid scientific basis. Secondly, they present sexual orientation as fixed when for school-aged adolescents it is very volatile, and many same-sex attractions are transitory. Thirdly, they present gender as fluid when for about 99.5% of the population, there is complete congruence between sexual characteristics and gender identity. Fourthly, they promote gender transitioning without the need for any medical and psychological guidance and even without parental knowledge or consent. Finally, they offer potentially misleading legal advice to teachers.While a program of this kind may offer benefits for some young people, there is reason to be concerned that it may cause harm to other young people who experience same-sex attraction or gender confusion. There is certainly a place for an anti-bullying program that addresses the issues with which the Safe Schools program is concerned, but this program needs to be rescued from its progenitors.


Crime forecasting is a new area of research, following upon the success of crime mapping for support of tactical deployment of police resources. The major question investigated in this paper is whether it is possible to accurately forecast crime one month ahead at a "smallscale" aggregation, i.e., at the precinct level. In a case study of Pittsburgh, Pennsylvania, we contrast the forecast accuracy of standard, univariate time series models with non-modeling practices commonly used by police. Included is a comparison of seasonality estimates made by precinct versus the city as a whole. As suspected for the small-scale data of this problem, average crime count by precinct and crime type is the major determinant of forecast accuracy. A fixed effects regression model of absolute percent forecast errors shows that such counts need to be on the order of 30 or more to achieve accuracy of 20 percent error or less. A second major result is that practically any model-based forecasting approach is vastly more accurate than current police practices. Thirdly, this is the first empirical paper to investigate crime seasonality at the sub-city level. Our seasonality estimates provide evidence supporting the routine activities theory of crime, but not earlier theories.


In this work, we propose a novel end-to-end multi-class attention network to jointly perform peripheral zone (PZ) segmentation and PZ lesions detection with Gleason score (GS) group grading. After encoding the information on a latent space, the network is separated in two branches: 1) the first branch performs PZ segmentation 2) the second branch uses this zonal prior as an attention gate for the detection and grading of PZ lesions. The model was trained and validated with a 5-fold cross-validation on an heterogeneous series of 98 MRI exams acquired on two different scanners prior prostatectomy. In the free-response receiver operating characteristics (FROC) analysis for clinically significant lesions (defined as GS > 6) detection, our model achieves 75.8% ±3.4% sensitivity at 2.5 false positive per patient. Regarding the automatic GS group grading, Cohen's quadratic weighted kappa coefficient is 0.35 ±0.05, which is considered as a fair agreement and an improvement with regards to the baseline U-Net model. Our method achieves good performance without requiring any prior manual region delineation in clinical practice. We show that the addition of the attention mechanism improves the CAD performance in comparison to the baseline model.


Density (ρ), ultrasonic velocities (u) and dynamic viscosity (η) for three binary mixtures of Trichloroethylene with 1-pentanol, 1-hexanol and 1-heptanol are presented at ambient temperature 303.15 K at atmospheric pressure over the entire composition range. The density and viscosity are measured using Specific gravity bottle and Ostwald's glass capillary viscometer respectively. The velocity is measured using ultrasonic interferometer. Molar volume, adiabatic compressibility, Intermolecular free length, and Wada's Constant are calculated using the above measured values. The excess parameters viz., excess molar volume, Excess adiabatic compressibility, Excess Intermolecular free length, viscosity deviation are also deduced from experimental values. Intermolecular interactions, and structural interactions present in various mixture are discussed in detail.


The purpose of this study was to assess the electoral process and the visually impaired so as to determine their inclusion in the electoral process. The objectives were to, establish the electoral needs of people with visual impairment in Zambia, to determine how people with visual impairment have been embraced in the electoral process, to examine the barriers that have contributed to the nonparticipation of people with visual impairment in the electoral process and finally to ascertain how the electoral process can be made more inclusive for individuals with visual impairment. The study employed a phenomenological research design. Both qualitative and quantitative methods were used to collect and analyse data. A purposive sampling technique was employed. The key informants were officials from the ECZ, the Zambia Agency for persons with disabilities and selected individuals with visual impairments, Jesuit center for theological reflections official, selected students with visual impairments at Kwame Nkrumah University and selected lectures and individuals with visual impairments in kabwe District of Zambia. Data was collected through Questionnaires, interviews and focus group discussions and observation. The findings from this study revealed that despite the fact that the legal framework in Zambia provides for the conduct of elections by means of a secret ballot, the practice has been that the visually impaired voters are subjected to the assistance of a third party that is required to mark the ballot paper on their behalf, despite the braille jacket which was used in the 2016 elections by some visually impaired persons by slotting in a ballot paper and be able to identify a candidate of their choice, by no means was that used by the visually impaired who are illiterate because braille is as good as reading and writing of which the uneducated visually impaired will still need assistance to vote, hence the study further revealed that, the visually impaired ,both total and partially blind need braille jackets across the country, large font ballot paper and most of all efficient and effective sensitation at all levels of the electoral process in all local languages. The study recommends that a law that restricts fundamental human rights must be shown to be reasonably justified in a democratic society and must be cross-cutting also and not be discriminatory in its effect or application. In this regard, there is need to adopt alternative voting and participation mechanisms that will allow both partially and totally visually impaired voters to vote independently and exercise the right to a secret ballot and fully participate at all levels of the electoral process. These uncertainties, therefore, call for an extensive sensitisation on the part of the organisations directly dealing with the disabled persons and stakeholders regarding the purpose and importance of participation in the electoral process hence enhancing the visually impaired persons's inclusion in the entire electoral process in Zambia.


Though the issue of translation occasionally surfaces in Foucault Studies, it remains an area that deserves more attention. To that effect, I briefly introduce some basic concepts of Translation Studies and then compare a chapter from Surveiller et punir ('Les moyens du bon dressement') with its English, Spanish, and Norwegian translations. Moving beyond the blatant errors, I argue that these translations are not generally 'the same text in a different language'. Rather, concepts are carved up in translation; or the analysis shifts from the structural to the historical; or syntactic adjustments make Foucault sound like an instruction book writer. Although I have deep respect for the work of the translators, who have brought Foucault to multitudes of new readers, I also argue that Foucault interpretation could profit from a translational turn.


Supply chain collaboration is the key to success in business. A major challenge in such collaborations is the dilemma between locally optimized quick solutions and the more systemic, long-term but 'slow-acting' approaches. Such dilemma in business collaborations has been contemplated in supply chain management research, illustrating their respective benefits and disadvantages. In light of the findings from literature, this study investigates the dynamics of this dilemma using an integrated perspective, utilizing both theories and case studies in supply chain relationships and collaborations. The archetypical dynamics and behavior of relationships over time are modeled, proposing an ever-evolving framework of supply chain collaborations. Along with the model, a prototype of a supply chain collaboration simulation model is also presented, as a customizable environment for policy testing and demonstration of different supply chain collaboration approaches. This model may also be used for training purposes as Microworlds.


We designed highly active and practical bis(imidazole)/zinc complexes for transesterification reactions. X-ray crystallographic analysis was used to confirm the structures of the zinc complexes and an equivalent of bis(imidazole) ligand was crucial for high catalytic activity. The octahedral zinc complex 8c was prepared in up to a multigram scale by mixing Zn(OCOCF3)2·xH2O and meta-bis(imidazolylmethyl)benzene ligand 7j (two equivalents per zinc ion) and storable under air at room temperature for at least 9 months. The stable nature of the catalyst was amenable to recovery/reuse at least five times without a significant loss of reactivity. The transesterification reaction proceeded without strict reaction conditions, and expanded substrate generalities, including sterically demanding secondary and tertiary alcohols, were applicable. Remarkably, the present zinc catalyst proved highly effective for valuable monomer synthesis from readily available methyl acrylate derivatives. Chemoselective transesterification reactions of unprotected-amino alcohols were also achieved, using not only a simple methyl ester but also an unprecedented dimethyl carbonate.


The accumulation of senescent cells induced by intracellular and extracellular stress contributes to multi-organ dysfunction and aging. Persistent DNA damage chronically accumulates with aging initiating a cellular stress response termed DNA damage response (DDR). Ataxia-telangiectasia mutated (ATM) kinase, a core component of DDR signaling, is involved in p53-p21 and p16-Rb senescent effector pathways, and is essential for senescence-associated secretory phenotype (SASP). In addition, ATM activates NEMO-dependent NF-κB pathway in response to genotoxic stress. However, the underlying molecular mechanisms through which DNA damage drives senescence and aging remain poorly characterized. Here we used the Ercc1-/Δ mouse model of a human progeria that spontaneously develops osteoporosis, disc degeneration, glomerulonephropathy and neurodegeneration, to address the causal link between DDR-dependent NF-κB activation, cellular senescence and aging. In the first part, we demonstrated that DDR signaling, concomitant with NF-κB, was highly activated in Ercc1-/Δ mice. A causal role of ATM in DNA damage-induced aging was demonstrated by genetic depletion of ATM in Ercc1-/Δ mice, which extended health span as well as alleviated aging-related pathology. Moreover, ATM haploinsufficiency showed significantly reduced NF-κB activation and SASP. In vitro assays support an activation of ATM- and NEMO-dependent canonical NF-κB activation in response to oxidative stress. In the second part, we developed novel small molecule inhibitors to disrupt the interaction between IKKβ and NEMO/IKKγ. We demonstrated that novel NBD mimetics, in particular SR12343 and SR12460, efficiently inhibited both TNF-α and LPS-induced NF-κB activation in vitro. Additionally, the chronic treatment with SR12343 and SR12460 reduced LPS-induced acute inflammation in lung and liver, and improved muscle pathology in mdx mice, a murine model of Duchenne muscular dystrophy. In the third part, we demonstrated that chronic treatment of Ercc1-/Δ mice with SR12343 significantly improved aging symptoms and prolonged healthspan, as well as reduced the level of cellular senescence. Furthermore, suppression of IKK/NF-κB attenuated lipodystrophy and associated impaired glucose tolerance by reducing cellular senescence in fat. Taken together, these results suggest that NF-κB activation promotes cellular senescence and aging through an ATM-dependent pathway in Ercc1-/Δ mice and the ATM-IKK-NF-κB pathway represents a key target for the development of novel approaches for healthy aging.


We investigated the nutritional effects of both food quantity and quality on Brachionus plicatilis. Decomposition of particulate and dissolved organic matter by rotifer digestive enzymes play a crucial role in rotifer nutrition. Among other enzymes, rotifers produce phosphatases, non-specific enzymes that allow for the release of orthophosphate from a variety of organic phosphorus compounds. Phosphatase saturation was measured in B. plicatilis homogenates using the spectrofluorimetric method. We examined population growth rate, reproduction and phosphatase activity in the homogenate of rotifers (PARH) fed by nutrient-replete algal food supplied at different quantities. Population growth rate, number of eggs per individual and PARH were affected by food quantity. Growth rate and number of eggs per individual significantly increased in rotifers fed by food supplied at the highest quantity. The highest population growth rate was reached by rotifers fed by nutrient-replete food, while it did not significantly differ between rotifers fed on nitrogen (N)-depleted and phosphorus (P)-depleted food. The number of eggs per individual was more affected by N than P supply. PARH and rotifer RNA content were not influenced by different food quality. The results indicate that B. plicatilis is not able to regulate its digestive apparatus in terms of efficiently getting access to essential nutrients when scarce, but do this when nutrient-replete food is available in different quantity. (© 2009 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim)


We studied the incidence and duration of cumulative bisphosphonate use among older Finnish women and men with or without Alzheimer's disease (AD). The MEDALZ-2005 cohort is a nationwide sample of all persons with clinically diagnosed AD on 31 December 2005 and their age-, gender-, and region of residence-matched control persons without AD. Information on bisphosphonate use by persons with an AD diagnosis and their controls without AD during 2002–2009 was obtained from the prescription register database containing reimbursed medications. A total of 6,041 (11.8%) persons used bisphosphonates during the 8-year follow-up. Bisphosphonates were more commonly used among persons without AD (n = 3121, 12.3%) than among persons with AD (n = 2,920, 11.2%) (p = 0.001). The median duration of bisphosphonate use was 743 days (IQR). Among persons with AD, the median duration of use was 777 days (IQR) and among persons without AD, 701 days (IQR) (p = 0.011). People without AD more often used bisphosphonate combination preparations including vitamin D than did people with AD (p <  0.0001). Bisphosphonate use was more common among people without AD who had comorbidities, asthma/COPD, or rheumatoid arthritis compared with users with AD. Short-term users were more likely to be male, at least 80 years old, and not having AD. Although the incidence of bisphosphonate use was slightly higher among persons without AD, the cumulative duration of bisphosphonate use was longer in persons with AD. Short-term use was associated with male gender, older age, and not having AD.