Background: -- Across Canada, waiting times for cardiac procedures, such as coronary artery bypass grafting (CABO), are higher than the ideal waiting time. From 1994 to 2002, there was a rapid increase in the number of patients receiving cardiac catheterizations and CABOs across Canada. The rates in Newfoundland and Labrador (NL) were higher than the Canadian average. This resulted in an extremely long waitlist with patients waiting longer than the acceptable benchmark time to have their surgery. In 2004, the number of people in Canada on cardiac surgery waitlists decreased significantly more than would be expected from simple waitlist management. The main reason is that the number of referral rates for CABO dropped dramatically. One major reason for this drop in referral rates may have been due to the introduction of drug-eluting stents in Canada in 2003. -- Objectives: -- The objective of this study is to identify changes in referral patterns for coronary revascularization and assess the impact on CABO waiting times in NL. This retrospective study will identify the changes that occurred during this time period and determine the reason(s) for these changes. -- Method: -- All 1341 patients who underwent a diagnostic cardiac catheterization in NL from ApriI 1, 2005 to September 30, 2005 were included in this study. Records from the Cardiac Program of Eastern Health were reviewed to determine referral rates, utilization rates, and wait times for percutaneous coronary intervention (PCI) and CABO procedures from 1998/1999 to 2007. The data obtained was compared to data from 1998/1999. -- Results: -- From 1998/1999 to 2005/2006 the number of coronary catheterizations increased by 21.6%. This was attributable to increased numbers of patients with stable angina, myocardial infarction or chest pain of uncertain etiology, treated not by revascularization procedures but by medical management. The proportion of patients diagnosed with critical coronary artery disease (CAD) decreased by 5%. Patients with critical CAD were referred for medical management, PCI, CABO or other. Referral rates increased 8.3% for medical management, decreased 4.8% for PCI, decreased 5.1 % for CABO and increased 1.6% for other. -- Between 2003 and 2007 the number of CABOs decreased by 12.7% and angioplasty increased by 8%. In 2002, the year prior to introduction of drug-eluting stents (DES), 50% of those referred for revascularization were treated with PCI compared to 59% in 2007. Within one year of the introduction half of all stents comprised DES. Total stent use has increased with an increase in DES and a decrease in bare metal stents (BMS). In 2005, 63% of stent cases received DES compared to 13.3% in 2003. Increased use of PCI for unstable angina was observed in 2005 compared to 1998/1999 (73% v 61 %), but its use in those with multi-vessel disease was similar in both years. -- From 2002 to 2007, the number of CABGs performed had an overall decrease from 568 to 492, and the waiting list went from 222 to 78. The recommended maximum waiting time (RMWT) for CABGs are being reached for most patients in the semi-urgent <2 weeks), short wait <6 weeks), delayed wait <6 weeks) and marked delay <6 months) priority groups. More than 80% of the patients in these groups are getting CABGs on time. For very urgent <24 hours) and urgent <72 hours) patients, the percent reaching
the target for the RMWT is less than 50% but has increased since 1998/1999. -- Conclusion: -- The number of coronary catheterizations performed each year continues to grow, however, the proportion diagnosed with critical CAD (69%) has decreased. CABG numbers decreased at the time when DES utilization increased. Management of CAD in the twenty-first century has changed rapidly. The rapid incorporation of DES in practice has helped alleviate the problem of large CABG waitlists.


In this study we conduct a field experiment to examine how qualifying an income-decreasing accounting change in years of strong financial performance affects user assessments of strategic reporting, current financial performance, and financial performance over the next three years (future performance). We find that without the qualification, users viewed the income-decreasing accounting change as relatively non-strategic, and user assessments of current and future performance were not different. In the presence of the qualification, users believed that the accounting change was relatively strategic, they discounted the income effect of the accounting change, and their assessments of future performance were below their assessments of current performance but no different from the assessments of future performance in the absence of the qualification. While our findings suggest audit qualifications encourage users to be skeptical of income-decreasing accounting changes, we find no evidence that they impose negative consequences on management in terms of lower assessments of financial performance.


Previous analyses of the history of the innovation and commodification of menstrual hygiene products largely subscribe to the misconception that the establishment of the industry was begun in the early years of the 20th century. This research firmly relocates the decisive development of this industry to the inception of Southall's Antiseptic and Absorbant Pad in Britain in 1880. Following analysis of the imperatives of menstrual management in the mid-19th century, consideration is given to the origins of the commodification of menstruation, its vital early promotional culture and the rapid development of an established competitive commercial context within an effective industrial infrastructure. Product development and diversification are considered through to the maturation of the industry prior to the First World War. These events are considered within a historically based interdisciplinary approach employing a historical and cultural analysis to develop a fuller understanding of the issues that are explored. The industrial and cultural encoding of menstrual objects within promotional discourse is seen to reconstruct Victorian menstrual etiquette; positioning objects of menstrual management in the establishment of new hygienic protocols and brand loyalty through an emphasis on issues of social transformation, technical innovation, medical certification and discretion. The presentation and interpretation of contemporary source material facilitate a reconstruction of accepted histories and contribute to a new understanding of early menstrual communication strategies.


Adapting model parameters to incoming streams of data is a crucial factor to deep learning scalability. Interestingly, prior continual learning strategies in online settings inadvertently anchor their updated parameters to a local parameter subspace to remember old tasks, else drift away from the subspace and forget. From this observation, we formulate a trade-off between constructing multiple parameter modes and allocating tasks per mode. Mode-Optimized Task Allocation (MOTA), our contributed adaptation strategy, trains multiple modes in parallel, then optimizes task allocation per mode. We empirically demonstrate improvements over baseline continual learning strategies and across varying distribution shifts, namely sub-population, domain, and task shift.


Field studies conducted along the railway lines in Australia have revealed the ability to implement the green corridor concept as a soil stabilization method. Native trees grown along rail corridors are capable of increasing the matric suction of the subgrade soil underneath the track substructure via root water uptake, in conjunction with the tree canopy evapo-transpiration. Moreover, these trees are capable of providing significant mechanical reinforcement through the anchoring effect provided by the root network plus the additional cohesive increment due to hair roots generating osmotic suction. Much of the previous research carried out to quantify the mechanical strength generated by tree roots has been mainly based on empiricism. In many cases, empirical relations have been developed for a given tree species grown under known soil conditions. The extrapolation of such empirical relations from one tree-soil system to another can be misleading. Furthermore, the effect of transpiration by tree canopy and its influence on the sustained suction equilibrium generated at the root zone for stabilising soft subgrade has not been considered rationally. To accommodate the above natural phenomena, a novel computational model has been developed to quantify the overall suction effect provided by the tree roots and its continual link with the rate and magnitude of canopy evapo-transpiration. Root based suction of a tree improves the shear strength; accelerates the pore water pressure dissipation and it may alter the potential failure conditions of the soil-root system from a saturated to an unsaturated domain. Therefore, it is necessary for the root based suction and the mechanical properties of the root network to be analysed within a coupled multiphase framework. Accordingly, this paper will present the requirement of an advanced shear strength model that captures and combines the root reinforcement effect with both osmotic and matric suction components generated in the soil through naturally coupled osmotic evapo-transpiration phenomenon.


The transition curves in the modern road and railway construction are route elements equally crucial as alignment and curve (circular). In order to prevent a sudden change of the centrifugal force, the transition curve must be applied due to the impact of the motion in a sharp curve. Over the years the application of the clothoid has become widespread in many countries in the world. However, in this study, in order to eliminate the problems concerning the road dynamics, created by clothoid for vehicles at high speed, the fourth degree parabola (Bi-quadratic parabola) is examined. The possibility of using bi-quadratic parabola in defining transition curves during design of transportation facilities is analyzed in the paper. Basic properties of bi-quadratic parabolas, their fundamental mathematical expression, calculation of point coordinates, driving-dynamic characteristics of bi-quadratic parabolas are described, and the function of change in curvature and lateral impact along the bi-quadratic parabola is presented.


Optical Poetry is the first critical biography of the painter and experimental filmmaker Oskar Fischinger. Active in avant-garde art circles in Germany between the two world wars, Fischinger and his family would emigrate to Los Angeles just ahead of the Nazis' denunciation of degenerate art. Fischinger's pioneering experiments in Visual Music and the melding of graphic arts, abstract design, and sound were instrumental in shaping animation into an art and cinematic form and inspiring animators to pursue its aesthetic potential. An accomplished representational animator who eventually worked uneasily under contract for Paramount, MGM, and Disney, Fischinger produced numerous abstract animated films over his lifetime, invented machines such as the "Wax Machine" and the "Lumigraph" for creating images, and became an accomplished and influential abstract painter. A labor of love for author William Moritz and the product of decades of research, Optical Poetry also includes an extensive filmography and testimonials from those who knew or were influenced by Fischinger.


The pathway of plasminogen transformation was studied in plasma, particularly in relation to fibrin formation and the subsequent stimulation of plasminogen activation. Plasminogen was activated by urokinase (low fibrin-affinity) or tissue-type plasminogen activator (high fibrin-affinity). Formation of 125I-labelled free and inhibitor-bound plasminogen derivatives was quantified after their separation by acetic acid/urea/polyacrylamide-gel electrophoresis. In plasma activator converted Glu-plasminogen (residues 1-790) into Glu-plasmin, which was complexed to alpha 2-plasmin inhibitor. When this inhibitor was saturated, Glu-plasmin was autocatalytically converted into Lys-plasmin (residues 77-790). No plasmin-catalysed Lys-plasminogen formation was observed. Upon fibrin formation, activation initially followed the same Glu-plasminogen-into-Glu-plasmin conversion pathway, and stimulation of plasminogen activation was only observed with tissue-type plasminogen activator. In agreement with the emergence of novel effector function, on early plasmin cleavage of fibrin [Suenson, Lützen & Thorsen (1984) Eur. J. Biochem. 140, 513-522] the fibrin-binding of Glu-plasminogen increased when solid-phase fibrin showed evident signs of degradation. This was associated with the formation of considerable amounts of the more easily activatable Lys-plasminogen, most of which was fibrin-bound. At the same time the rate of plasmin formation with urokinase increased over that in unclotted plasma and the rate of plasmin formation with tissue-type plasminogen activator accelerated. Altogether these processes favoured enhanced fibrin degradation. The rates of Lys-plasminogen and plasmin formation abruptly decreased after lysis of fibrin, probably owing to a compromised effector function on further fibrin degradation.


The vacuum membrane distillation (VMD) is a promising technology for lots of applications. To solve the membrane fouling and wetting problems, in this paper, a novel ZnO nanorods 1 H,1 H,2 H,2 H-perfluorodecyltriethoxysilane (PDTS) modified poly(vinylidene fluoride) (PVDF) membrane with a micro/nanoscale hierarchical structure and a superhydrophobic surface has been prepared and applied to the VMD process for distilling highly salty water, for the first time. Among these, a pyrolysis-adhesion method is created to obtain the ZnO seeds and fasten them on the PVDF substrate firmly. The novel modified membrane shows a stable superhydrophobic surface with a water contact angle of 152°, easy cleaning property, excellent thermal and mechanical stability, because of the Cassie's state caused by pocketing much air in the hydrophobized ZnO nanorods, the low surface energy of PDTS coating, and the strong adhesion between ZnO nanorods and PVDF membrane, which has built an ideal structure for VMD application. After 8 h VMD of 200 g L-1 NaCl solution, compared to the virgin PVDF membrane, the novel membrane shows a similar permeate flux but a much higher quality permeated liquid because of its unique antifouling and antiwetting caused by the several microns gap between the feed and the membrane. Due to its easy cleaning property, the novel membrane also exhibits an excellent reusability.


Members of the family Amphisteginidae have been nearly ubiquitous contributors to shelf carbonate facies through most of the Cenozoic. The most prolific carbonate producer of modern representatives is Amphistegina lobifera Larsen, which is the largest and shallowest dwelling of the Indo-Pacific taxa. This epiphytic, symbiont-bearing foraminifer is also a remarkably successful invasive species in coastal ecosystems of the eastern Mediterranean, where its shell production is altering the composition of shoreline sediment.

This paper reports a temporal study of an A. lobifera population collected monthly between June 2008–May 2009 in the Vravron/Attica coastal ecosystem of the south Evoikos Gulf (Aegean Sea), where winter temperatures can drop below previously reported minima for the species. Monthly variations in size, frequency distribution, and abundance indicate that this population reproduced primarily during the summer (July–September), when both asexual and sexual reproduction occurred simultaneously, suggesting a predominantly coeval, one-year life span for each generation. However, a modest increase in juveniles in January indicates some winter reproduction.

Comparison of these findings with previous studies shows that a) tolerance of low winter temperatures, b) adaptation of the life cycle to strong seasonality, and c) the mixotrophic feeding strategy have allowed A. lobifera to proliferate in the exceptionally clear, low nutrient, coastal waters of the Mediterranean Sea. These attributes elucidate how previous Cenozoic populations of Amphistegina were able to rapidly expand their latitudinal ranges and invade shallow epeiric seas during episodes of climatic warming.


We present a comparative study of the optical properties of zinc oxide (ZnO) thin film and nanorods prepared by wet-chemical methods. Crystalline thin film and nanorod samples were successfully fabricated on seeded substrates using spray pyrolysis technique and hydrothermal growth method, respectively. The thin film exhibits flake-like grains, while the nanorods exhibit well-defined hexagonal cross sections. Although both thin film and nanorods show similar optical band gaps of 3.26 eV, intense near-band-edge UV emissions at 380 nm, and broad and weak green emissions around 530 to 560 nm, the thin film exhibits higher visible transparency of 66 to 89% and faster ultraviolet (UV) emission lifetime of 30 ps. These results reveal important insights on selecting and designing ZnO-based optical sensors for future biological applications.


We report numerical results for the third virial coefficient of two center Lennard-Jones quadrupolar molecules. Calculations are performed for 35 models with different elongations and quadrupoles over a temperature range from half to twice the critical temperature. It is found that increasing the elongation at fixed quadrupole has the effect of increasing B3. On the other hand, at fixed elongation B3 first decreases with increasing quadrupole at low temperatures, then increases with increasing quadrupole at higher temperatures. We estimate the temperature at which the third virial coefficient vanishes. Although both this temperature and the critical temperature increase with the quadrupole moment, their ratio remains almost constant. We predict the critical properties using two different truncated virial series. The first one employs the exact second and third virial coefficients. The second one approximates the fourth order contribution by using estimates obtained for hard diatomics. It is found that both methods yield fairly good predictions, with a somewhat better performance of the approximate fourth order expansion. The two methods are complementary, however, because they consistently bracket the exact value as determined from computer simulations.


The geology, biostratigraphy and palaeoecology of exploration well Elf 55/30–1 in the Fastnet Basin are summarised. The biostratigraphical and ecological distribution of the foraminifera and Ostracoda from the late Triassic, the Lower Jurassic and the Lower Cretaceous are reviewed with reference to microfaunas elsewhere in Europe. Selected microfossil taxa are illustrated.


Developing chicken embryos have two ductus arteriosus (DA) that shunt blood away from the lungs and to the chorioallantoic membrane, the embryonic gas exchanger. In mammals, DA closure is stimulated by an increase in blood gas O2 that occurs as the animal begins to breathe with its lungs. The goal of this study was to determine the influence of O2 levels during incubation on the vascular reactivity and morphology of the O2-sensitive DA and to examine the effects of changing O2 levels during late incubation on the morphology of the DA from chicken embryos. In comparison to normoxia, hypoxia (15%) reduced venous O2 levels in day 16 and day 18 embryos and reduced aircell O2 values in day 16, day 18, and internally pipped (IP) embryos, whereas hyperoxia (30%) increased venous O2 levels and aircell O2 level in day 16, day 18, and IP embryos. In comparison to normoxia, hypoxia delayed closure of the DA, whereas hyperoxia accelerated DA closure. In comparison to the left DA from externally pipped (EP) normoxic embryos, the left DA from EP hypoxic embryos exhibited a significantly weaker contractile response to O2. The DA from day 18 hypoxic embryos exhibited a significantly weaker contractile response to norepinephrine and phenylephrine when compared with the DA from day 18 normoxic and hyperoxic embryos. The effect of incubation in hypoxia / hyperoxia during different developmental windows on the DA O2-induced contractile response was observed only in IP embryos that were incubated in normoxia for 16 days and were then moved to hyperoxia. Incubation in hypoxia / hyperoxia resulted in differences in embryo mass, yolk mass, and heart mass. There is an association between the decreased contractile response to O2 and delayed closure in the proximal portion of the DA from hypoxic embryos; as well as an increased contractile response to O2 and accelerated closure in the proximal portion of the DA from hyperoxic embryos.


We provide analytical solutions for mean firing rates and cross-correlations of coincidence detector neurons in recurrent networks with excitatory or inhibitory connectivity, with rate-modulated steady-state spiking inputs. We use discrete-time finite-state Markov chains to represent network state transition probabilities, which are subsequently used to derive exact analytical solutions for mean firing rates and cross-correlations. As illustrated in several examples, the method can be used for modeling cortical microcircuits and clarifying single-neuron and population coding mechanisms. We also demonstrate that increasing firing rates do not necessarily translate into increasing cross-correlations, though our results do support the contention that firing rates and cross-correlations are likely to be coupled. Our analytical solutions underscore the complexity of the relationship between firing rates and cross-correlations.


The Allahabad Bypass Project in India will improve highway transportation as part of the national policy to globalize its economy. The National Highways Authority of India (NHAI) is responsible for the development, maintenance and management of national highways in the country. However it is anticipated adverse environmental impacts will occur, thus mitigating measures stipulate the following. During construction operations - particularly if on temporarily acquired land - adequate traffic detours, storage and material handling should follow standard regulations, and topsoil from agricultural land will be preserved. Borrow pits shall not be dug continuously in a stretch, but rather re-developed at selected borrow location, while spoils shall be dumped with an overlay of stockpiled topsoil. To limit potential chemical hazards, the concrete foundation should contain a minimum cement content. Potential soil erosion at the high embankment portion on the north bank, should be contained by stone pitching. Vehicles/machinery, and equipment operation, maintenance and refueling activities shall be implemented so that spillage of fuel, and lubricants does not contaminate the Ganga river flows. Non-bituminous wastes will be dumped in borrow pits covered with a layer of excavated topsoil. The sewerage system for the construction workers' camp shall be designed, built and operated so that no pollution to ground, or adjacent watercourses occurs. On completion of the works, all temporary structures shall be cleared away.


This paper analyse the costs and benefits of being a capital or central municipality, where central costs are understood to be incurred specifically as a result of the problems large municipalities located at the centre of an urban agglomeration face and capital costs are understood to result from the presence of regional and/or central government institutions in the municipality. However, these two qualities might also be beneficial to municipalities, resulting in a direct increase in their fiscal capacity. Here, by estimating an equation of the expenditure needs and the fiscal capacity of Spanish municipalities with more than 75,000 inhabitants, we find that the central costs incurred by large municipalities are offset by their greater fiscal capacity, but that the same is not true for municipalities that serve as political/administrative capitals.


Undoubtedly social influence in IS research is an issue that needs to be much more clearly examined. In order to assuage the wants for more research in this field we conducted a scientometric analysis of subjective norm in the IS top-journals of the JAIS ranking for the last two decades. In total 113 empirical and conceptual research models predominately in adoption research contained the factor subjective norm. The results revealed that subjective norm is just in seven of ten models a significant antecedent. To gain more knowledge about this problem we followed the ideas of social psychology and marketing researchers and correlated the strength of the impact of subjective norm with its measurement as well as the impact of intention with the impact on other endogenous variables. The results show a significant negative correlation between the significant antecedent subjective norm and its original measurement, the perceived opinion of important others. Furthermore it revealed a significant negative correlation between the significant impact of subjective norm on intention and the significant impact on other endogenous variables.


We assess the reliability and validity of cognitive and socioemotional skills measures and investigate the correlation between schooling, skills acquisition, and labor earnings. Our primary data from Pakistan incorporates two innovations related to measurement and sampling. With regard to measurement, we developed and implemented a battery of instruments intended to capture cognitive and socioemotional skills among young adults. With regard to sampling, we use a panel that follows respondents from their original rural locations in 2003 to their residences in 2018, a period over which 38% of respondents left their native villages. We first show that in terms of their validity and reliability, our skills measures compare favorably to previous measurement attempts in low- and middle-income countries. We then document that in our data (a) more years of schooling are correlated with higher cognitive and socioemotional skills; (b) labor earnings are correlated with cognitive and socioemotional skills as well as years of schooling and; (c) the earnings-skills correlations depend on respondents' migration status. The magnitude of the correlations between schooling and skills on the one hand and earnings and skills on the other is consistent with a widespread concern that such skills are underproduced in the schooling system.


There are various studies investigating the speech community of people of German descent from Russia ( Russlanddeutsche ) and their language use. In my data, I find various language contact phenomena, most remarkably code-switching. I examine how the Russlanddeutsche alter their speech according to its possible functions in discourse. Thus, my qualitative study focuses on the morpho-syntactic and interactional linguistic analyses of spoken data in natural contexts and situations. In order to thoroughly answer the complex question 'How do speakers use the languages available to them?' I have taken the following socio-cultural factors into account: the sociolinguistic aspects of the interlocutors taken from their biographies, especially information about the preferred language of the speakers etc.


The goal of clustering is to determine the intrinsic grouping in a set of unlabeled data depending on some similarity measure (e.g. Euclidean distance).In this paper a steady state genetic algorithm (SSGA) approach is used to cluster true color images. After splitting the original images into red, green and blue components and displaying the image of each part, Steady State Genetic Algorithm (SSGA) is used to cluster the image to determine the number of clusters for the image by generating an initial population randomly and then applying the different operations of GA such as fitness function computation, selection, crossover, mutation and stopping condition. In the Crossover stage 1X, PMX and UX methods used for crossover between two parents to produce a new child. In addition to that another clustering method which combines kmean algorithms and k-harmonic mean algorithms are used. The last clustering algorithm uses two functions to find the cluster centers for each image. Finally root mean square error is used to find the difference between the clustering and original image.


Rainfall variability greatly influences corn production. Thus, an accurate forecast is potentially of value to the farmers because it could help them decide whether to grow their corn now or to delay it for the next cropping opportunity. A decision tree analysis was applied in estimating the value of seasonal climate forecast (SCF) information for corn farmers in Isabela. The study aims to estimate the value of SCF to agricultural decision makers under climate uncertainty. Historical climatic data of Isabela from 1951 to 2006 from PAGASA and crop management practices of farmers were used in the Decision Support System for Agrotechnology Transfer (DSSAT) to test the potential impact of climate change on corn. The approach is developed for a more accurate SCF and to be able to simulate corn yields for wet and dry seasons under different climatic conditions -- El Nio (poor year), La Nia (good year) and Neutral (neutral year) conditions. In order for the forecast to have value, the with forecast scenario should lead to better decision making for farmers to eventually get increase production over the without forecast scenario. While SCF may potentially affect a number of decisions including crop management practices, fertilizer inputs, and variety selection, the focus of the study was on the effect of climate on corn production. Improving SCF will enhance rainfed corn farmers decisionmaking capacity to minimize losses brought about by variable climate conditions.


Because fire rescue personnel often enter unfamiliar buildings to perform critical tasks like rescues, the importance of finding new and improved ways to train route navigation is becoming paramount. This research was designed to compare three methods for training firefighters to navigate a rescue route in an unfamiliar building. Thirty firefighters from the Madison County, Alabama, area were trained to navigate through the Administrative Science Building at The University of Alabama in Huntsville. The firefighters, who had not had any experience with the Administrative Science Building prior to the experiment, were randomly assigned to one of three experimental training groups: Blueprint, Virtual Reality, or No Training (Control). After training, we measured the total navigation time and number of wrong turns exhibited by firefighters in the actual building. Participants were required to rescue a mock baby (a life-sized doll) following the specific trained route. Measures of test performance were compared among groups by using analyses of variance (ANOVAs). The results indicated that firefighters trained with virtual reality or blueprints performed a quicker and more accurate rescue than those without training. Furthermore, the speed and accuracy of rescue performance did not differ significantly between virtual reality and blueprint training groups. These results indicate that virtual reality training, if constructed and implemented properly, may provide an effective alternative to current navigation training methods. The results are discussed with regard to theories of transfer of training and human performance in virtual environments.


The permeabilities of montmorillonite and kaolinite clays were reduced by precipitating aluminum hydroxide in the pores of the clay. The precipitate was formed by permeating the clays first with aluminum sulfate or polyaluminum-chloride followed by a dilute caustic solution. This caused the permeability to be decreased by at least a factor of 4 or 5. The integrity of the decreased permeability caused by the precipitate was only slightly affected when challenged by acidic and caustic solutions.


Synthetic polymers exhibiting reversible lower critical solution temperature (LCST), such as poly(N-isopropylacrylamide) (PNIPAM), are intriguing materials with various potential applications. We recently developed a new class of biodegradable thermoresponsive polyesters (TR-PEs) based on N-substituted diol monomers. TR-PEs exhibited reversible cloud point temperatures (Tcp) between 0–50 °C and were shown to be non-cytotoxic. The synthesis of N-substituted diols and TR-PEs is highly modular, allowing for a wide variety of possible homo- and copolyesters. In this work, we report the synthesis and characterization of 20 homopolyesters in order to better understand the structure–property relationship of TR-PEs. UV-vis spectroscopy showed that the Tcp of TR-PEs was highly dependent on pendant group structure, such as secondary or tertiary amides, cyclic and linear groups, and substitution of oxygen atoms. Structure-Tcp analysis provides a correlation between Tcp and the number of heteroatoms relative to the number of carbon atoms in the pendant group thereby providing a rationale for the design of thermoresponsive polyesters with desired Tcp values. To demonstrate the expanded tunability of the TR-PE system, copolyesters bearing covalently attached ibuprofen were synthesized and shown to exhibit LCST behavior dependent on comonomer hydrophilicity.


This work presents investigations and detailed analysis of ringing in a non-resonant pulsed nuclear magnetic resonance (NMR) circuit. Ringing is a commonly observed phenomenon in high power switching circuits. The oscillations described as ringing impede measurements in pulsed NMR systems. It is therefore desirable that those oscillations decay fast. It is often assumed that one of the causes behind ringing is the role of the magnetic core used in the antenna (acting as an inductive load). We will demonstrate that an LRC subcircuit is also set-up due to the inductive load and needs to be considered due to its parasitic effects. It is observed that the parasitics associated with the inductive load become important at certain frequencies. The output response can be related to the response of an under-damped circuit and to the magnetic core material. This research work demonstrates and discusses ways of controlling ringing by considering interrelationships between different contributing factors.


This book is dedicated to the application of the different theoretical models described in Volume 1 to identify the near-, mid- and far-infrared spectra of linear and nonlinear triatomic molecules in gaseous phase or subjected to environmental constraints, useful for the study of environmental sciences, planetology and astrophysics.

The Van Vleck contact transformation method, described in Volume 1, is applied in the calculation and analysis of IR transitions between vibration–rotation energy levels. The extended Lakhlifi–Dahoo substitution model is used in the framework of Liouville's formalism and the line profiles of triatomic molecules and their isotopologues subjected to environmental constraints are calculated by applying the cumulant expansion.

The applications presented in this book show how interactions at the molecular level modify the infrared spectra of triatomics trapped in a nano-cage (substitution site of a rare gas matrix, clathrate, fullerene, zeolite) or adsorbed on a surface, and how these interactions may be used to identify the characteristics of the perturbing environment.


The challenges of land degradation, climate change and food insecurity have led to the introduction of conservation agriculture (CA) aimed at enhancing yield and soil quality. Despite positive biophysical results, low adoption rates have been the focus of studies identifying constraints to wider uptake. While the adoption framework is popular for measuring agricultural innovation, objective adoption measurements remain problematic and do not recognize the contextual and dynamic decision‐making process. This study uses a technographic and participatory approach to move beyond the adoption framework and understand: (a) how agricultural decision‐making takes place including the knowledge construction, (b) how agriculture is performed in a context of project intervention and (c) how practice adaptation plays out in the context of interacting knowledge. Findings confirm that farmer decision‐making is dynamic, multidimensional and contextual. The common innovation diffusion model uses a theory of change, showcasing benefits through training lead farmers as community advocates and demonstration trials. Our study shows that the assumed model of technology transfer with reference to climate‐smart agriculture interventions is not as linear and effective as assumed previously. We introduce four lenses that contribute to better understanding complex innovation dynamics: (a) social dynamics and information transfer, (b) contextual costs and benefits, (c) experience and risk aversion, and (d) practice adaptation. Investments should build on existing knowledge and farming systems including a focus on the dynamic decision process to support the 'scaling up, scaling out and scaling deep' agenda for sustainable agricultural innovations.


In this study, we fabricate a metal- and vacuum-free electrode composed of aligned multiwall carbon nanotubes (MWCNTs) as top electrode in inverted type polymer solar cells. Simply drawn MWCNT sheets from vertically grown arrays were directly transferred over the top layer (PEDOT:PSS) of the device as an anode material. Without any post treatment, devices exhibited a short-circuit current density (Jsc) of 7.53 mA cm–2, which is 78% of that of devices employing a thermally deposited silver-based anode (Jsc = 9.69 mA cm–2). Scanning electron microscopy images of the device (top and cross-sectional views) show the successful incorporation of MWCNT sheets over the surface of the device without any damage. The thickness of the MWCNT sheets as top electrode is also investigated, and it has been demonstrated that when the sheets' thickness increased, the conductance of the electrode increased, which showed improvement for the device performance. The attributes of being flexible, vacuum-free, and stable with rega...


Teen mothers often have a lower socioeconomic position as adults than other women due to selection, opportunity costs of childbearing, or both. Few studies examine whether that is the case after an induced abortion as well. Also, few studies explore whether the strength of the association between teen pregnancy and adulthood socioeconomic position differs by family background. This study uses Finnish register data of 53,252 women born between 1975 and 1979 to examine with logistic regression whether the likelihood of having tertiary education depends differently on teen birth and abortion experiences by parental socioeconomic position. I also control for and report whether having a partner providing childcare helps mitigate the negative association between teen motherhood and education. The results show teen mothers had lower odds than those who aborted to have tertiary education, and both groups were behind those with no teen pregnancy. These groups' education did not vary statistically significantly by family background, although the gap in the probability of having tertiary education between teen mothers and those with no teen pregnancy among the lowest socioeconomic backgrounds was 43%-points, and only 27%-points among the highest. Teen mothers with and without a partner had similar probabilities of having tertiary education (8– 11%). Those who had an abortion and subsequently separated from their partner, however, had similar probability of having tertiary education as teen mothers (13%), although others who had an abortion had a much higher probability (20%). Selection shapes these relationships. Survey and register data should be combined to study these associations using methods of causal inference.


Secukinumab, a selective interleukin (IL)-17A inhibitor, is approved for use in adult and paediatric psoriasis, psoriatic arthritis, ankylosing spondylitis and non-radiographic axial spondyloarthritis. The aim of this study was to report the long-term safety of secukinumab in pooled data from 28 clinical trials and a post-marketing safety surveillance in psoriasis, psoriatic arthritis and ankylosing spondylitis patients. Analyses included 12,637 secukinumab-treated patients, corresponding to 15,063, 5,985 and 3,527 patient-years of exposure in psoriasis, psoriatic arthritis and ankylosing spondylitis patients, respectively. Incidences of serious adverse events were low, with no identifiable patterns across indications. Active tuberculosis or latent tuberculosis infections were rare. The incidence of opportunistic infections was < 0.2/100 patient-years, the incidence of malignancy was ≤ 1/100 patient-years, and the incidence of major adverse cardiovascular events was < 0.7/100 patient-years, with no apparent increases over time. Secukinumab demonstrated a favourable safety profile for up to 5 years of treatment across the 3 indications, and no new safety signals were identified.


Innovative Technology Summary Reports are designed to provide potential users with the information they need to quickly determine if a technology would apply to a particular environmental management problem. They are also designed for readers who may recommend that a technology be considered by prospective users. Each report describes a technology, system, or process that has been developed and tested with funding from DOE's Office of Science and Technology (OST). A report presents the full range of problems that a technology, system, or process will address and its advantages to the DOE cleanup in terms of system performance, cost, and cleanup effectiveness. Most reports include comparisons to baseline technologies as well as other competing technologies. Information about commercial availability and technology readiness for implementation is also included. Innovative Technology Summary Reports are intended to provide summary information. References for more detailed information are provided in an appendix. Efforts have been made to provide key data describing the performance, cost, and regulatory acceptance of the technology. If this information was not available at the time of publication, the omission is noted.


Independence is something that is important in order to deliver a child into adulthood so that he can declare himself as a social man in the relationship with the group interaction. The family is the first social group in her life as a man, old dimanaorang a dominant role in forming child's independence. In an intact family problems of forming self-reliance becomes not how, because they still consist of 2 parents (father and mother). In families that are no longer intact, independent demands are enormous. Living with one parent is a very heavy burden, because of the limitations of parents in supervising and guiding indirectly make children more independent. But in fact today the role of parents in providing opportunities for self-study is not fully there, especially the mothers. In contrast to the attitude of fathers who tend to provide independent learning at an early age. The study aims to determine whether there are differences in child's independence from single-parent families and children from the family's father who is a single-parent mothers. Research hypothesis is that there are differences in the independence of children from families with the status of single-parent family who is a father and mother's parents, where children from families with the status of single parent fathers tend to have higher self-reliance than children from families with the status of single parent mothers. The variables in this study consisted of 2 variables. The independent variable: the family single-parent status, and dependent variable: self-reliance. The population in this study is the status of children from single-father families, and children from single-mother family status, which overall amounted to 30 people. 15 children from single-father family status and family status of 15 of single mothers aged 9-13 years, with a total sampling technique sampling. Data obtained by distributing a scale that is independent of scale by analyzing the validity of the instrument by using the formula of Pearson product moment. While the reliability test using alpha formula. As used in data analysis techniques T.tes test. From the analysis of T-test showed that there are differences in the independence of children from families with the status of single-parent fathers and children from single-parent family status of the mother, with a value of t = 3144 and p = 0.004, where the status of children from single-father families have independence of the higher (: 103.40) than children from families with the status of single-parent mother. (: 90.00).


Title of Document: Tissue and Metabolic Engineering of Biohybrid Artificial Organs Chong Wing Yung, Doctor of Philosophy, 2005 Directed By: Professor, Timothy A. Barbari, Department of Chemical and Biomolecular Engineering In an effort to develop a biohybrid artificial organ, mammalian cells were engineered with several properties to make them adept in secreting therapeutic proteins and surviving low oxygen levels in an encapsulated environment. Three cell lines, C2C12, Jurkat, and HEK293, were investigated for their ability to secrete human interleukin 2 (hIL2), which can serve as an anti-cancer agent. An intracellular fluorescent protein marker was independently expressed using an internal ribosome entry site sequence so that hIL2 remained active and free for secretion. DsRed fluorescent protein markers were used since red light is known to be transmissible through mammalian tissue. Transient transfection of all three cell lines proved that internal red fluorescence measurements were indeed linearly correlated with the concentration of hIL2 secreted. To increase the survivability of encapsulated cultures, cells were engineered with an anti-apoptotic gene, bcl-2∆, placed under the control of a hypoxia sensitive promoter. This protective system was found to lessen both hypoxia induced necrosis and apoptosis. To complete the biohybrid system, a novel hydrogel (mTG-Gel), utilizing microbial transglutaminase (mTG) to enyzmatically crosslink gelatin, was developed as a biocompatible cellular scaffold for encapsulating the engineered cells. These gels were stable at physiological temperature (37 C) and could be tailored for enzymatic stability. Specifically, HEK293 cells that were metabolically engineered with all the previous characteristics were encapsulated in 4% mTG-Gels. In situ analysis of DsRed fluorescence showed that cells overlayed with mTG-Gel exhibited reductions in fluorescence with increasing height of gel. Human IL2 diffusion through the hydrogel into overlaying media was found to exhibit the expected dependence on the square of the gel thickness. Diffusion cells were used to determine an effective diffusion coefficient for hIL2, which compared well to that obtained from the gel-overlay cell culture experiments. TISSUE AND METABOLIC ENGINEERING OF BIOHYBRID ARTIFICIAL ORGANS


This study aims to look at the extent to which the parents perception of the importance of early childhood education (ECD) in Pasar Rebo. Subjects were 105 parents of children aged 3-6 years, both of which have got in early childhood education services or who have not received services in early childhood education or early childhood education service of others. This study uses a quantitative approach and the data collection methods used are questionnaires through the distribution of scores perception of parents using standard deviation formula. The results showed that parents' perceptions of the importance of early childhood education is very important category, 24%, 28% important, 48% fairly important, not important 0%, and 0% very important. The results of these studies indicate that parents do not fully understand that early childhood education is important as an important foundation of individual life in the future. Perception can direct the attitudes and behavior of parents so that when the perception of parents on the importance of positive early childhood education, parenting can be carried out in accordance with the stages of its development.


Echocardiographic imaging is ideally suited for the evaluation of cardiac mechanics because of its intrinsically dynamic nature. Because for decades, echocardiography has been the only imaging modality that allows dynamic imaging of the heart, it is only natural that new, increasingly automated techniques for sophisticated analysis of cardiac mechanics have been driven by researchers and manufacturers of ultrasound imaging equipment. Several such techniques have emerged over the past decades to address the issue of reader's experience and inter-measurement variability in interpretation. Some were widely embraced by echocardiographers around the world and became part of the clinical routine, whereas others remained limited to research and exploration of new clinical applications. Two such techniques have dominated the research arena of echocardiography: (1) Doppler-based tissue velocity measurements, frequently referred to as tissue Doppler or myocardial Doppler, and (2) speckle tracking on the basis of displacement measurements. Both types of measurements lend themselves to the derivation of multiple parameters of myocardial function. The goal of this document is to focus on the currently available techniques that allow quantitative assessment of myocardial function via image-based analysis of local myocardial dynamics, including Doppler tissue imaging and speckle-tracking echocardiography, as well as integrated back- scatter analysis. This document describes the current and potential clinical applications of these techniques and their strengths and weaknesses, briefly surveys a selection of the relevant published literature while highlighting normal and abnormal findings in the context of different cardiovascular pathologies, and summarizes the unresolved issues, future research priorities, and recommended indications for clinical use.


Leisure shopping expanded enormously over the course of the twentieth and into the twenty-first century, and shopping now monopolises most Western cities and structures the everyday lives of the people that live in them. This development has entrenched consumer capitalism (along with its ethos of exponential growth) as the only viable socio-economic model, even as its chronic problems of environmental, social, and economic unsustainability continue to grow. This thesis approaches this thorny problem from a fresh perspective, that of leisure shopping as a fundamentally embodied practice, and the phenomenological relation between shopper and city that this embodied practice generates. The thesis argues that, while the practice of leisure shopping can certainly arouse a raft of experiential and aesthetic pleasures, insofar as shopping is responsible for environmental degradation and social injustice, its aesthetic pleasures are also ethically compromised. It proposes that this gap between the ethics and aesthetics of shopping can, nevertheless, be bridged, and the aesthetics of shopping redirected to ethical effect. It investigates ways of building this bridge by drawing on the two correspondingly contradictory methodologies of phenomenology and Situationism, and applying them to the practice of leisure shopping. Through these means, it shows how the model of shopping imposed by consumer capitalism can be redirected to generate a sustainable model of shopping. One that both resists and transcends the consumption imperative and, as such, meets key criteria for the three-fold model of environmental, social, and economic sustainability, otherwise known as the 'three pillars' model. As arch anti-consumerists with a neo-Marxist agenda, the Situationists were ideologically biased and committed to socio-political change through revolution. Phenomenology, on the other hand, strives to set aside all bias and intention, and concentrate instead on an ideologically impartial study of first person experience. While these two methods approach their respective fields of operation with very different attitudes, they are both self-reflective practices that prioritise first person experience. By drawing them together and weaving them into a hybrid method, this thesis also constructs a self-reflective methodology. In this instance, however, the impartiality of phenomenology constrains the political bias of Situationism to generate a method of 'checks and balances'. Through this thesis, I detail this method and explain how I applied it to conduct four shopping experiments in Melbourne city's retail heartland. In the process, I unpack how these experiments enabled me to access leisure shopping in unusual ways and work fruitfully with both its problems and its pleasures. This approach to the research has proceeded on the basis that the two main discourses that have informed the consumption debate to date – the pro-consumption aesthetic pleasures analysis and the anti-consumption neo-Marxist ethical critique – are theoretical extremes that have been locked in a stalemate of mutual oversight and denial for too long. As a result, they have hindered rather than helped the contemporary sustainability discourse in its drive to find practical solutions to the overconsumption that leisure shopping epitomises. By analysing the outcomes of the four experiments through both discourses, and bringing the insights of each to bear critically on the oversights of the other, the thesis overcomes this stalemate and describes, instead, an alternate practice of leisure shopping that is both aesthetically pleasurable and ethically sound. In view of the anti-consumption critique's cornerstone claim that leisure shopping is, at best, a complete ethical void and, at worst, a deadly aesthetic siren call, this redirection of the aesthetics of shopping to ethical effect is a significant and original outcome of the research.


Feed and malting barley are major crops in Montana. Harrington, a two-rowed spring malting barley variety, is the most cultivated variety in the state. Barley was the last of the world's major cereals for which transformation methods were developed because in vitro-cultured barley rapidly loses regeneration ability or gives rise to albino plants during selection for transformed tissue. Previous research used the variety Golden Promise because it regenerates well under research conditions, though it is not commercially used. Transformation could be an important method to improve varieties in North American barley cultivars. The puroindoline proteins (PINA and PINB) can be isolated from wheat endosperm and are basic cysteine and tryptophan-rich proteins that might play a role in defense against pathogens. The puroindolines show antifungal activity both in vitro and in vivo. Milk stage seeds were harvested to obtain embryos. Embryos were placed on induction media [2.5 mg/L 2,4-Dichlorophenoxyacetic acid (2,4-D) and 0.01 mg/L 6-benzylaminopurine (BAP)] for 12 to 51days until calli formed. The biolistic method was chosen for transmitting the gene of interest into the calli, using a Biolistic PDS-1000/He Particle Delivery System (BioRad, Hercules, CA) with 900 psi rupture disks. Approximately 4,500 calli were bombarded with two plasmids; pinA driven by the maize ubiquitin promoter (Ubi1) which is expressed constitutively, and the hygromycin phosphotransferase (hph), which confers hygromycin B resistance and is driven by the CaMV 35S promoter for selection. The bombarded calli were selected on medium containing 30 mg/L Hygromycin B for 9 to 21 days, and subcultured to intermediate medium (1.0mg/L 2,4-D and 0.5 mg/L BAP), followed by regeneration media (1.0-3.0 mg/L BAP). Thirty hygromycin B resistant calli regenerated and 5 died in magenta box. Thirty five putative transgenic plants derived from 25 calli grew in soil and were harvested. Some plants tested by polymerase chain reaction (PCR) tested positive with primers for pinA and hph. Southern blots were performed to detect the presence of hph in T1 barley genomic DNA but were negative. Northern blots performed to detect the presence of pinA and hph transcribed RNA in the T1leaf tissue were also negative, showing that no stably transformed plants were obtained.


Introduction: We have developed a new tool, named Holistic Approach Risk Assessment (HOARA), to support occupational safety and health professionals (OSH) in risk assessment and management when evaluating the biomechanical load of healthcare workers. Objectives: The primary aim of the HOARA is to support OSH in risk assessment and management of biomechanical hazards in healthcare facilities. This tool ensures a superior level of analysis by targeting independently various body compartments during all activities completed throughout the work shift. These include: head, neck, back and upper and lower limbs. Methods: For each body segment, ergonomic determinants were defined on the basis of previous literature, according to which task and job analyses were performed. Upon direct observation, ergonomic factors were given a score based on their temporal extent. Subsequently, action-body segment raw indices and weighted indices were calculated. Results: Results of the application of the method are shown. Of note, a relational database was set up to improve its usability. Conclusions: From an occupational health perspective, the HOARA, integrated with other methods, is expected to allow a more effective management of human resources, especially when assigning workers to specific jobs or tasks. Overall, the HOARA will be instrumental in assessing the impact of fitness for work judgments on work organization and its resources, in compliance with the guidelines from the Società Italiana di Medicina del Lavoro (SIML).


Social evaluation occurs at personal, interpersonal, group, and intergroup levels, with competing theories and evidence. Five models engage in adversarial collaboration, to identify common conceptual ground, ongoing controversies, and continuing agendas: Dual Perspective Model (Abele & Wojciszke, 2007); Behavioral Regulation Model (Leach, Ellemers, & Barreto, 2007); Dimensional Compensation Model (Yzerbyt et al., 2005); Stereotype Content Model (Fiske, Cuddy, Glick, & Xu, 2002); and Agency-Beliefs-Communion Model (Koch, Imhoff, Dotsch, Unkelbach, & Alves, 2016). Each has distinctive focus, theoretical roots, premises, and evidence. Controversies dispute dimensions: number, organization, definition, and labeling; their relative priority; and their relationship. Our first integration suggests 2 fundamental dimensions: Vertical (agency, competence, "getting ahead") and Horizontal (communion, warmth, "getting along"), with respective facets of ability and assertiveness (Vertical) and friendliness and morality (Horizontal). Depending on context, a third dimension is conservative versus progressive Beliefs. Second, different criteria for priority favor different dimensions: processing speed and subjective weight (Horizontal); pragmatic diagnosticity (Vertical); moderators include number and type of target, target-perceiver relationship, context. Finally, the relation between dimensions has similar operational moderators. As an integrative framework, the dimensions' dynamics also depend on perceiver goals (comprehension, efficiency, harmony, compatibility), each balancing top-down and bottom-up processes, for epistemic or hedonic functions. One emerging insight is that the nature and number of targets each of these models typically examines alters perceivers' evaluative goal and how bottom-up information or top-down inferences interact. This framework benefits theoretical parsimony and new research. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Abstract Commercial homes, which provide hospitality where the private home dimension is significant, blur traditional boundaries between home and work and social constructions of hospitableness versus hospitality. Drawing on interviews with owner‐managers of these micro businesses and a guest‐researcher's experiences and observations, this paper explores the home space as a dual‐purpose site of both commercial work and domestic retreat. First, use and meanings of domestic symbols in performances on the home as stage are examined. Second, there is an exploration of social control and spatial management strategies employed by hosts and guests. The findings reveal that domestic symbols add to the construction and interpretation of negotiated normative practices within these home‐based enterprises. They may adopt the role of identity markers and communication tools. Hosts employ an array of mechanisms to achieve physical or emotional distance between the domains of home and work. Social constructs may be subtle as well as explicit, including spatial as well as temporal mechanisms of social control and boundary setting, framed by unspoken protocols.


Suicide rates, life evaluation, and measures of affect are all plausible measures of the mental health and wellbeing of populations. Yet in the settings we examine, correlations between suicide and measured wellbeing are at best inconsistent. Differences in suicides between men and women, between Hispanics, blacks, and whites, between age groups for men, between countries or US states, between calendar years, and between days of the week, do not match differences in life evaluation. By contrast, reports of physical pain are strongly predictive of suicide in many contexts. The prevalence of pain is increasing among middle-aged Americans, and is accompanied by a substantial increase in suicides and deaths from drug and alcohol poisoning. Our measure of pain is now highest in middle age—when life evaluation and positive affect are at a minimum. In the absence of the pain epidemic, suicide and life evaluation are likely unrelated, leaving unresolved whether either one is a useful overall measure of population wellbeing.


PURPOSE
To understand how rural residents with advanced cancer experience and manage their symptoms.

PARTICIPANTS & SETTING
16 adult patients with a diagnosis of advanced cancer, who were receiving antineoplastic treatment and living in rural areas of southeastern Iowa, participated in the study.

METHODOLOGIC APPROACH
Data were collected through semistructured, audio-recorded interviews using open-ended questions. Data were analyzed using content and dimensional analyses.

FINDINGS
Four themes were developed from the completed interviews, including (a) barriers and challenges associated with rural cancer care, (b) physical symptoms experienced from the time of diagnosis through the cancer trajectory, (c) symptom management strategies used to control physical symptoms, and (d) perceptions of having cancer and the use of technology in managing symptoms.

IMPLICATIONS FOR NURSING
Rural residents with advanced cancer experience a wide range of physical symptoms that may affect their quality of life. Although residents may develop self-management strategies to cope with symptoms, additional guidance on and interventions for how best to manage physical symptoms are needed.


The misuse of soft power terminology for domestic political ends diminishes the
complexity of the original concept and results in a simplistic "cool Japan"
version of soft power. Despite numerous works acknowledging and discussing
anime's soft power, there is a lack of audience study in this existing discussion.
Policy is being informed by these interpretations of soft power, the international
effectiveness of which relies on audiences behaving as anticipated. The absence
of research into a variable as central as audience limits our understanding of
how soft power functions in practice. Whether anime's soft power is articulated
as cool Japan or as agitprop, assumptions are involved about audiences
decoding anime according to the dominant-hegemonic reading. When audiences
decode anime, they draw on their knowledge and experiences in ways which
can result in negotiated or resistant readings. To test these ideas I have explored
Hall's encoding/decoding model. Using textual analysis and interviews with
Gundam's creator/encoder to identify a dominant, anti-war reading of Gundam
Seed, I then conducted a focus group interview to observe the decoding
practices of non-fan viewers. The focus group research presented in this thesis,
although limited in scope, suggests that the assumptions inherent to the
treatment of audience by popular soft power discourses are problematic,
particularly when issues of warfare and memory are involved. I propose
combining a cultural studies approach with existing research to achieve a more
nuanced understanding of anime and soft power.


Children who witness domestic violence may have impaired educational attainment as well as facing other challenges such as struggles with self-esteem and forming relationships. This qualitative study set in Northern Ireland explored the perceptions of Education Welfare Officers, child protection social workers and teachers in post-primary schools regarding the impact of domestic violence on schooling and educational attainment, and of service responses to this. The survey used semi-structured interviews with four professionals in each of the above categories. Findings confirmed the major effect that domestic violence can have on children's schooling and relationships. Two typical types of responses by children were identified: those who became quiet and withdrawn, and those who became loud and aggressive. There seemed to have been progress in terms of professional understanding and service responses regarding domestic violence, but there seemed to be limited structured cooperation between the professional groups in addressing the effects of domestic violence on children. Sharing of information is hindered by confidentiality issues, some of which might be addressed by integrated teams of appropriate professionals. Greater investment in inter-agency training and development of the preventive role of the Education Welfare Service are recommended.


The Department of Transport and Main Roads (DTMR) manages the state controlled road system in Queensland comprising the major traffic carrying and strategic roads in the state. A vast majority of these state controlled roads are located in areas where the insitu material is dominated by reactive soil. Mixing lime with the reactive subgrade is
a stabilisation technology to not only improve construction workability in these soils but to also reduce maintenance frequency on the road system.

Lime stabilisation is used to modify sub grade soils to improve constructability by improving plastic properties, flocculating particles and drying the material. Studies
indicate that lime stabilisation will improve load bearing capacity and will also achieve long term strength retention.

DTMR Specifications and AUSTROADS Pavement design guidelines for lime modified sub grade recommends the Unconfined Compressive Strength achieve a minimum of 1.5MPa at 28 days (unsoaked). This research will assess current test results against the original test results at completion of construction.

DTMR standards specify that lime stabilisation of subgrade material shall be carried out as 2 passes by applying half the dose in the first pass, waiting 24 hours then applying
the remaining dosage in the last pass. This time period between passes is called the Amelioration Period.

The major issue with having a 24 hour period for amelioration is it takes a longer time to finish construction. This delay has potential impacts on the contractor and exposes the open subgrade to potential weather such as rain for a longer period.

Amelioration is necessary in heavy clays as adequate mixing is difficult to achieve in one pass as heavy clays tend to clump together. Allowing 24 hours between passes permits the lime to flocculate clay particles and improve workability. Amelioration results in better mixing in the second run and construction also becomes easier. This
research will test a range of reduced time period to determine what length of time will achieve the Unconfined Compressive Strength of 1.5MPa.

This research project will confirm that stabilising the road pavement sub grade with lime is an effective and economic solution when applied in the appropriate environment and quantity. It is also expected that improvements will continue to be made to lime
stabilisation specifications.


This paper presents sedimentation aspects of a recent disastrous flood that occurred during September 10-12 1990 in the Han River basin, a central part of the Korean peninsula. The flood caused massive sediment deposits on the flood plains and great damages to the public facilities and infrastructures that had been constructed only recently. The flood also taught some valuable lessons to the concerned government authorities and engineers. They include: 1) A sound management of urban floodplain developed should encompass plans for alleviation of sediment deposition and for effective measure of sediment removal after flood; 2) Planning and design of floodplain modifications and developments must be based on careful studies on behavior of movable boundary rivers such as the Han River during extreme flood events; and 3) Sediment data as well as hydrologic data related to the flood of September 10-12 should be collected and documented for improvement in the future floodplain management.


Beginning with the first insurgencies in the ancient world-when Alexander the Great discovered that fleet nomads were harder to defeat than massive conventional armies-Max Boot, best-selling author and military advisor in Iraq and Afghanistan, masterfully guides us from the Jewish rebellion against the Roman Empire up through the horrors of the French-Indochina War and the shadowy, post-9/11 battlefields of today. Relying on a diverse cast of unforgettable characters-not only Mao and Che but also the legendary Italian nationalist Giuseppe Garibaldi, the archaeologist-turned-military commander T. E. Lawrence, and the "Quiet American" Edward Lansdale, among others-Boot explodes everything we thought we knew about unconventional combat. The result is both an enthralling read and our most important work on nontraditional warfare.


Abstract The aim of the research was to gain increased knowledge regarding the sexual risk behaviour of school-going young people in South Africa after two decades of HIV-education in schools, to contribute to the development of improved HIV prevention strategies. In collaboration with the Department of Education, a sample of 5305 learners (between 10 and 18 years in Grades 5–12) from high-risk communities were identified. They completed a survey that assessed self-reported sexual risk behaviour and variables that potentially underlie sexual risk, such as attitudes towards preventive behaviour, perceived social norms and self-efficacy (based on the theory of planned behaviour [TPB]) and social factors like caregiver relationships and gender norms (based on the social ecological theory). Lifetime sex was reported by 49.4% of boys and 30.5% of girls in Grades 8–12, while 56% of the sexually active young people reported consistent condom use. Accurate knowledge about HIV transmission was low (37.8%). Regression analysis showed that risk behaviour was more prominent among older male youths, who perceived social norms as encouraging sexual activity, who use alcohol excessively, and who have negative attitudes towards abstinence. Perceived traditional community gender norms and negative relationships with caregivers were also associated with sexual risk behaviour. This research showed that the TPB can be used in planning HIV prevention interventions for young people. It also revealed that HIV-prevention strategies should focus beyond educating the individual, to address community factors such as improving caregiver relationships, the culture of substance abuse, peer group norms and inequality in community gender norms. These community processes influence young people's behaviour and need to be addressed to allow the youth to make healthy behavioural choices.


The article describes the influence of colonialism on the Southern African Development Community (SADC) and reflects on the political legacy left to the region by the European empires. The historical perspective provides an overview on the so-called "scramble for Africa" and provides some of the reasons for colonialisation. The specific situations in the SADC states are discussed, their unique histories, the struggle for independence as well as current situations with regard to political structures and situations.


We generalise the Gaussian process (GP) framework for regression by learning a nonlinear transformation of the GP outputs. This allows for non-Gaussian processes and non-Gaussian noise. The learning algorithm chooses a nonlinear transformation such that transformed data is well-modelled by a GP. This can be seen as including a preprocessing transformation as an integral part of the probabilistic modelling problem, rather than as an ad-hoc step. We demonstrate on several real regression problems that learning the transformation can lead to significantly better performance than using a regular GP, or a GP with a fixed transformation.


1. Movements of hedgehogs, Erinaceus europaeus L., were analysed in relation to roads by recording their nocturnal foraging trajectories in urban areas adjacent to major road systems. Four male and four female hedgehogs at each of two sites were each tracked over five replicate trajectories of more than 3 h, using radio-telemetry and
direct observation. 2. Frequency of road crossings and use of habitat were compared to simulated random trajectories. For each observed trajectory, 100 trajectories were simulated with the same distribution of speeds as observed, but with random direction. 3. Observed trajectories had lower rates of crossing large but not small roads than simulated, indicating that hedgehogs treat large roads as barriers during nightly foraging activities. Most hedgehogs were never observed to cross roads, whereas almost all simulated trajectories did cross both large and small roads. 4. Crossing behaviour differed by site, but not by sex. 5. Roads and road verges had the lowest rank in a habitat preference analysis at both sites, while playing fields, gardens and urban areas were preferred habitats. These results are discussed in relation to the regional scale preference for urban areas, and the attraction to road verges while dispersing, shown by hedgehogs.


I've been thinking about Rainer Maria Rilke lately and what it means to be a doctor. In "Archaic Torso of Apollo" Rilke advised that in order to become something, one must change one's life. This slogan should have been emblazoned on all of my medical school pencils and notebooks, every professor should have started with it on the first Powerpoint slide, and instead of the Hippocratic oath as the culmination of our life-changing at graduation, we could have collectively recited this totalizing maxim as we received our degrees.

To put it kindly, for many there is often a lag between the being and the becoming. One day, I was looking for a prescription pad in my pocket. I was taking care of an elderly poet, and I had to fish through wadded-up receipts, keys and change. My hands kept scrambling through the right pocket, then the left pocket, then back to the right. His response was devastating: he said, after a minute of this, "I fear for your poetry."

It was uppercut Rilke: how can one create anything out of such disorder? I announced myself as a mess. And this is not the place to itemize that mess: let me say that icebergs were in my pockets.

But what about the being and becoming a doctor? I arrive at the office in a hurry, after dressing my daughter and scurrying her off to school. I look at my list and dread certain personalities who are neither being nor becoming; they merely are disorder. There is no open end to my day: I must finish in time to pick my daughter up. Then the evenings — oh, that they were filled with poetry or textbooks, with emotions recollected in tranquility, with edification or even love. But I admit it here: I stuff myself with reality television.

And I think I have settled into the "be" of myself. Doctoring is, as William Carlos Williams has said, an essentially creative activity; and as I weave disparate strands into a narrative, as I suggest hope as a logical position, I wonder about the example part of doctoring: about the creativity of inspiration, not the other way around. If I were less overweight, would the lifestyle change I preach have more success? If I weren't sullen, would I lead my moodies out of their clouded vales? I recall the old Herman cartoon of the gross old physician counselling the obese patient that he needs to get more exercise.

Everyone thinks that they could do better, be better, but many settle, despite this thought. Read Rilke's statement a little differently and it might be a warning. Listen to my old poet's statement with insight, as opposed to shock, and realize that he was saying, "I fear for you."

The receipts pile up, indicating a wasted life; the tide of patients is strong, but threatens to swamp my little boat of care; and as I am distracted, and succumb to these distractions, I begin to develop a fear of change. I do hear it as a warning, the very voice of experience is throttling me, saying See, See!

Shane Neilson MD Family physician Guelph, Ont.

Figure

Image by: Fred Sebastian


Research in dance psychology and mental health is rapidly growing. Yet, evidence in the field can seem dispersed due to few existing meta overviews that outline research in dance related to mental health. Therefore, the aim of this scoping review is to strengthen future dance research by gathering and contextualizing existing findings on mental health in dance. Following the PRISMA guidelines and protocols, 115 studies were included in the review. Overall, the data analysis shows a predominant adoption of quantitative research but a lack of applied interventions of preventive and reactive procedures in mental health. Similarly, there is a tendency to study pre-professional dancers, whereas research into professional dancers, especially aged 30–60 is underrepresented. Dance genres have been unevenly investigated, with classical ballet being the most researched, whereas different dance styles and freelance employment are in dire need of in-depth investigation. Conceptualizing mental health as a dynamic state, the thematic analysis identified three main categories: stressors, mental processes, and outcomes. These factors appear to be in a complex interaction. Overall, the existing literature gives indications of components essential to understanding dancers' mental health but has several blind spots and shortcomings. Therefore, a lot of in-depth understanding and research is still needed to fully grasp the dynamic complexity of mental health in dance.


We evaluated the potential of a histone methylation reversal agent 3-deazaneplanocin A (DZNep) in improving the chemosensitivity of pancreatic cancer to nucleoside analogs (i.e., gemcitabine). DZNep brought delayed but selective cytotoxicity to pancreatic cancer cells without affecting normal human pancreatic ductal epithelial (HPDE) cells. Co-exposure of DZNep and gemcitabine induced cytotoxic additivity or synergism in both well- and poorly-differentiated pancreatic cell lines. In contrast, DZNep exerted antagonism with gemcitabine against HPDE cells with significant reduction in cytotoxicity compared with the gemcitabine-alone regimen. DZNep marginally depended on purine nucleoside transporters for its cytotoxicity, but the transport dependence was circumvented by acyl derivatization. Drug exposure studies revealed that a short priming with DZNep followed by gemcitabine treatment rather than co-treatment of both agents produced a maximal chemosensitization response in both gemcitabine-sensitive and gemcitabine-resistant pancreatic cancer cells. DZNep rapidly and reversibly decreased trimethylation of histone H3 lysine 27 but increased trimethylation of lysine 9 in an EZH2- and JMJD1A/2C-dependent manner, respectively. However, DZNep potentiation of nucleoside analog chemosensitization was found to be temporally coupled to trimethylation changes in lysine 27 and not lysine 9. Polymeric nanoparticles engineered to chronologically release DZNep followed by gemcitabine produced pronounced chemosensitization and dose-lowering effects. Together, our results identify that an optimized DZNep exposure can presensitize pancreatic cancer cells to anticancer nucleoside analogs and emphasize the promising clinical utilities of histone methylation reversal agents in future pancreatic cancer combination therapies. Citation Format: Sau Wai Hung, Hardik Mody, Sean Marrache, Yangzom D. Bhutia, Franklin Davis, Jong Hyun Cho, Shanta Dhar, Chung K. Chu, Rajgopal Govindarajan. Optimized DZNep exposure presensitizes pancreatic cancer cells to anticancer nucleoside analogues: potential clinical implications. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1025. doi:10.1158/1538-7445.AM2013-1025


Ecologists believe that biodiversity is under the sixth great extinction wave. Whereas climate has had an important role in previous extinction events, human activities are now assuming the front row. The interactions between climate change and habitat fragmentation are enhancing concerns on future species distribution and abundance. Habitat fragmentation is affecting negatively species already under pressure by precluding movements and dispersal. The human-induced climate change is expected to force species to shift their ranges or to modify their physiology and seasonal behavior. Attempts to address some of these issues have relied on ecological niche based models (ENN). With the assumption of niche conservatism (stability of species niches requirements), this approach combines species occurrences with a series of environmental variables to predict habitat suitability across landscapes. Uncertainties and errors related with modeling procedures, algorithms and assumptions have been raising questions about the impact on modeling results. The existence of long historical records and interactions with humans make the African elephant and giraffe ideal species to address methodological and ecological issues. The main goal of this thesis was to compare the effects of modeling partial niches in predictions of future species distributions. Current and historical distributions were used to test four modeling approaches regarding their sensitivity to climate change predictions, and to infer the effects of human activities. Results revealed great modeling performance with the exception for the Ecological Niche Factor Analysis and the Generalized Linear Models. The niche evolution of modeled species exposed a decreased in the climatic space that was more evident in giraffes. Regardless of the dataset used, predictions under climate change revealed an increase in suitable area for elephants. The giraffe's predicted suitable area evolves differently according to datasets. Projections from historical data suggest an augment in distribution while projections made based on current distribution suggest a decreased in suitable areas. This study enlightens biogeographic patterns and future suitable areas under climate change. It also emphasizes the effects of human activities in species distributions and the consequences, limitations and uncertainties when modeling partial niches.


In the classroom, ABC looks like a great way to manage a company's resources. But many executives who have tried to implement ABC on a large scale in their organizations have found the approach limiting and frustrating. Why? The employee surveys that companies used to estimate resources required for business activities proved too time-consuming, expensive, and irritating to employees. This book shows you how to implement time-driven activity-based costing (TDABC), an easier and more powerful way to implement ABC. You can now estimate directly the resource demands imposed by each business transaction, product, or customer. The payoff? You spend less time and money obtaining and maintaining TDABC data--and more time addressing problems that TDABC reveals, such as inefficient processes, unprofitable products and customers, and excess capacity. The authors also show how to use TDABC to link strategic planning to operational budgeting, to enhance the due diligence process for mergers and acquisitions, and to support continuous improvement activities such as lean management and benchmarking. In presenting their model, the authors define the two questions required to build TDABC: 1) How much does it cost per time unit to supply resource capacity for each business process? 2) How much resource capacity (time) is required to perform work for a company's many transactions, products, and customers? The book demonstrates how to develop simple, valid answers to these two questions. Kaplan and Anderson illustrate the TDABC approach with a wealth of case studies, in diverse settings, based on actual implementations.


Most natural language processing researchers highlight the benefits of interlingua-based systems in multilingual settings. In this scenario, Role and Reference Grammar can contribute to build a cross-language semantic representation of the input text in terms of its logical structure. Our goal is to describe the various stages in the development of one of the first computational systems which employs a lexico-conceptual knowledge base to generate the logical structure of sentences. Our approach actually involved some changes in the standard functional model in order to convert the logical structure into an ontology-grounded representation of sentential meaning. In fact, we demonstrate that constructional schemata should become the cornerstone of the syntax-semantics interface in this computerized model of Role and Reference Grammar.


The immigration debate has proven to be fertile ground for promoting exceptionalist practices, where certain groups of people are isolated from the rest of the population and regarded as a subclass. The federal electronic employment verification system, E-Verify, is a prime example of such a practice. Passed under the Procurement Act, the goal of E-Verify was to promote efficiency and economy in government procurement. Unfortunately, the system falls far short of these goals because of problems inherent in the electronic database and increased state involvement over immigration reform. E-Verify is often criticized as unreliable because it relies on inaccurate databases, imposes an undue financial burden on employers, and leaves immigrant workers vulnerable to subjective determinations about their legal status. While Congress works on resolving these issues, the legal landscape is nevertheless changing as states enact and enforce their own immigration laws, including those that mandate the use of E-Verify. State entry into the immigration arena not only expands the reach of the system's problems, but it also threatens to legitimize the exclusion of immigrants, documented or undocumented. This Comment describes how the implementation of E-Verify has frustrated the goals of efficiency and economy, and argues that Congress should establish definitive boundaries between state and federal immigration reform to restore the political imbalance.


Abstract Very little is known about the comparative long-term effectiveness of novel antipsychotics in relapse prevention, especially in first-episode schizophrenia. Nationwide data from Finnish health care registers were gathered prospectively for all persons with periods of inpatient care due to schizophrenia in Finland during 1972–2014. Altogether 62250 persons were included in the prevalent cohort, and 8719 in the incident (first-episode schizophrenia) cohort. The follow-up for antipsychotic use started at 1996 for the prevalent cohort, and at the first discharge from inpatient care for the incident cases. Within-individual Cox regression models for risk of psychiatric and all-cause hospitalization were constructed to compare risk during antipsychotic use and no use using individual as his/her own control to eliminate selection bias. With follow-up time up to 20 years (median = 14.1, interquartile range = 6.9–20.0), 59% of the prevalent cohort were readmitted to psychiatric inpatient care. Olanzapine long-acting injection (LAI; adjusted hazard ratio = 0.46, 95% confidence interval = 0.36–0.61), clozapine (0.51, 0.49–0.53), and paliperidone LAI (0.51, 0.40–0.66) were associated with the lowest risk of psychiatric rehospitalization in the prevalent cohort. Among first-episode patients, the lowest risks were observed for flupentixol LAI (0.24, 0.12–0.49), olanzapine LAI (0.26, 0.16–0.44), and perphenazine LAI (0.39, 0.31–0.50). Clozapine and LAIs were associated with the lowest risk of all-cause hospitalization in both cohorts. Clozapine and LAIs are the most effective treatments in preventing psychiatric and all-cause hospitalization among chronic and first-episode patients with schizophrenia.


1,000 questions and answers prepare you for the USMLE Step 1! The only comprehensive Q&A review for the USMLE Step directly linked to high-yield facts from Dr. Le's First Aid for the USMLE Step 1, this essential study guide offers 1000 board-style questions and answers, easy-to-navigate, high yield explanations for correct and incorrect answers, and more than 350 accompanying images. Features: 1000 board-style questions and answers -- reviewed and approved -- by students who just aced the exam Detailed explanations for both right and wrong answers - with letter options in boldface for at-a-glance review Chapters keyed to Dr. Le's First Aid for the USMLE Step 1 so you can simultaneously review questions and high-yield facts 130+ high-yield images, diagrams, and tables One complete practice exam consisting of 7 blocks of 50 questions simulates the exam experience


In Pauline Language and the Pastoral Epistles, Jermo van Nes argues that the language of the so-called Pastoral Epistles is not significantly different from the other Pauline writings, and therefore should no longer be used as a criterion in discussions of their authorship.


Objectives To describe the consequences in terms of health outcomes, care and associated healthcare costs for three hypothetical cohorts of women planning their first pregnancy at a fixed, different age. Design Decision model based on data from perinatal registries and the literature. Setting The Netherlands. Population 3 hypothetical cohorts of 100 000 women aged 23, 29 and 36 years, planning a first pregnancy. Main outcome measures Live birth, pregnancy complications for mother and child and associated healthcare costs. Results For the three cohorts of 23-, 29- and 36-year-old women, 1.6%, 4.6% and 14% of women would not succeed in an ongoing pregnancy (spontaneous or after assisted reproductive technology). The cohort aged 36 gave 9% more miscarriages, 8% more fertility treatment and 1.4% more multiple births than the cohort aged 29. The proportion of caesarean sections among low risk women was 4.9% and 11% higher respectively for the cohorts aged 29 and 36, compared with the cohort aged 23 at start. Eventually, 98%, 95% and 85% of the women in each of the three cohorts gave live birth. The costs for the two older cohorts were €415 and €1662 higher per ongoing pregnancy than the cohort aged 23 years. Conclusions Spontaneous conception and mode of delivery are most susceptible to increasing maternal age leading to involuntary childlessness and non-spontaneous labour. The increase in assisted reproduction technology, twin pregnancies and delivery complications results in higher costs along with fewer ongoing pregnancies at higher age.


The success of information systems (IS) projects continues to be low despite many initiatives to address the issue. Given the importance of IS for organizations, it is a key imperative for software development firms to understand what is needed to deploy high-quality and successful systems. This is systems that are adopted and used, which by extension can contribute to goal satisfaction and business value. The notion of successful systems is even more important for developing regions, such as the English-speaking Caribbean (ESC), as such regions have far less capacity to absorb these failures (when compared to software development firms in developed countries). Understanding the factors that impact the quality outcomes of IS projects (i.e. antecedents of IS success), is considered key to the success of these projects. This study therefore aims to provide a research model that identifies key factors impacting IS project quality and success, while taking into account the unique characteristics of developing countries (in this case, the ESC region).


OBJECTIVE
Life stressors and family socioeconomic position have often been associated with mental health status. The aim of the present study is to contribute to the understanding of the pathways from low socioeconomic position and life stressors to mental problems.

METHOD
In a cross-sectional analysis using data from a longitudinal study of early adolescents (N = 2,149, 51% girls; mean age 13.6 years, SD 0.53, range 12-15), we assessed the extent of mediation of the association between family socioeconomic position and mental health problems by different types of life stressors in multiple regression models. Stressors were rated as environment related or person related. Information on socioeconomic position was obtained directly from parents, and internalizing and externalizing problem behaviors were assessed by reports from multiple informants (parents, self, and teachers).

RESULTS
Low socioeconomic position was associated with more mental health problems and more life stressors. Both environment-related and person-related stressors predicted mental health problems independently of socioeconomic position. The associations between socioeconomic position and all mental health outcomes were partly mediated by environment-related life stressors. Mediation by environment-related and person-related stressors as assessed by linear regression amounted to 56% (95% confidence interval [CI] 35%-78%) and 7% (95% CI -25% to 38%) for internalizing problems and 13% (95% CI 7%-19%) and 5% (95% CI -2% to 13%) for externalizing problems, respectively.

CONCLUSIONS
Environment-related, but not person-related, stressors partly mediated the association between socio economic position and adolescent mental problems. The extent of mediation was larger for internalizing than for externalizing problems. Because the effect sizes of the associations were relatively small, targeted interventions to prevent impaired mental health may have only modest benefits to adolescents from low socioeconomic background.


We propose a computational model for interpreting line drawings as threedimensional surfaces, based on constraints on local surface orientation along extremal and discontinuity boundaries. Specific techniques are described for two key processes: recovering the three-dimensional conformation of a space curve (e.g., a surface boundary) from its two-dimensional projection in an image, and interpolating smooth surfaces from orientation constraints along extremal boundaries.


CONTEXT
There are limited published data characterizing severe hypoglycemia complicating type 2 diabetes.

OBJECTIVE
The objective of the study was to determine the incidence and predictors of severe hypoglycemia in community-dwelling type 2 patients.

DESIGN
This was a longitudinal observational cohort study.

SETTING
This was a community-based study.

PATIENTS
There were 616 patients (mean age 67.0 yr, 52.3% males, median diabetes duration 7.7 yr) assessed in 1998 and followed up to the end of June 2006.

MAIN OUTCOME MEASURES
Severe hypoglycemia defined as that requiring ambulance attendance, emergency department services, and/or hospitalization. Cox proportional hazards modeling was used to determine predictors of first episode, and Poisson, negative binomial, zero-inflated Poisson, and zero-inflated negative binomial regression models identified predictors of frequency.

RESULTS
Fifty-two (8.4%) experienced 66 episodes during 3953 patient-years (incidence 1.7 per 100 patient-years). Those experiencing severe hypoglycemia had one to four episodes. Significant independent predictors of time to first episode were duration of insulin treatment, estimated glomerular filtration rate less than 60 ml/min per 1.73 m(2), peripheral neuropathy, education beyond primary level, and past severe hypoglycemia. The zero-inflated negative binomial provided the best model of severe hypoglycemia frequency. Lower fasting serum glucose and higher glycosylated hemoglobin were significantly associated with frequency, whereas patients at minimal risk of repeated severe hypoglycemia were unlikely to use insulin or to have short-duration insulin treatment, to have renal impairment or peripheral neuropathy, or to be educated beyond primary level.

CONCLUSIONS
Duration of insulin treatment was confirmed as an independent risk factor for severe hypoglycemia. The novel association with educational attainment suggests knowledge-driven intensive glycemic self-management. The positive relationship between frequency and glycosylated hemoglobin may identify patients with unstable glycemic control.


Standard penalized methods of variable selection and parameter estimation rely on the magnitude of coefficient estimates to decide which variables to include in the final model. However, coefficient estimates are unreliable when the design matrix is collinear. To overcome this challenge an entirely new perspective on variable selection is presented within a generalized fiducial inference framework. This new procedure is able to effectively account for linear dependencies among subsets of covariates in a high-dimensional setting where $p$ can grow almost exponentially in $n$, as well as in the classical setting where $p \le n$. It is shown that the procedure very naturally assigns small probabilities to subsets of covariates which include redundancies by way of explicit $L_{0}$ minimization. Furthermore, with a typical sparsity assumption, it is shown that the proposed method is consistent in the sense that the probability of the true sparse subset of covariates converges in probability to 1 as $n \to \infty$, or as $n \to \infty$ and $p \to \infty$. Very reasonable conditions are needed, and little restriction is placed on the class of possible subsets of covariates to achieve this consistency result.