This paper reports on the results of a randomized controlled trial in which researchers collaborated with a department of health in a mid-size city to evaluate the effectiveness of targeted communications highlighting descriptive social norms to increase immunization compliance across 700 schools. Schools were randomly selected to receive a twice-annual immunization compliance report card reporting in detail their compliance rates compared to other schools of the same school type; the comparison rates reported included the school-type average, average compliance among the top 10% of performers, and the city target of 98% compliance. Shifts in immunization compliance are tracked in a city-wide administrative vaccine registry. The results suggest that there was no significant difference in compliance rates between treatment and control schools six months post-treatment. To our knowledge, it is the first randomized controlled trial evaluating the use of descriptive social norms in increasing immunization compliance rates in a school-based setting. In addition, it serves as an example of embedding a behaviorally-informed experiment in a government program utilizing high-quality administrative data.


a Universidad Industrial de Santander, carrera 27 calle 9, C.P 680002, Bucaramanga, Colombia b SPS-oil Ltda, Bucaramanga, Santander, Colombia c EcopetrolInstituto Colombiano del Petróleo, km 7 vía a Piedecuesta Bucaramanga, C.P 681011, Piedecuesta, Colombia. *email: email@example.com ABSTRACT The office U.S. Energy Information Administration (EIA) has suggested significant volumes of hydrocarbon resources in unconventional Shale type reservoirs, which happens to be very interesting nowadays. The complexity of these reservoirs, along with the high level of risk during the exploration stage, and the lack of laboratory data, are challenging for an adequate estimation of hydrocarbon volumes in shale reservoirs. An innovative methodology to estimate prospective resources on a Shale reservoir is proposed in this paper, based on petrophysical and geochemical data from well logs, such as porosity, hydrocarbon saturation, TOC (total organic content), gas content, thermal rock maturity, clay fraction, thickness, rock density, etc, all of them using Monte Carlo simulation. Further, this paper proposes a new way of interpreting petrophysical data to obtain a clearer view of reservoir characterization, especially Brittleness, which is of great relevance to define the potential of fracturing and hydrocarbon production. The methodology was applied to the Tablazo Formation in the Middle Magdalena Valley Basin (MMVB) in Colombia. The results show a total best estimate of oil in place (OOIP) of 51 637 Bls/acre, gas adsorbed in place 39.72 Mcf/acre, and free gas in place of 177.18 Mcf/acre. Comparing these results with those obtained by applying other methodologies, the best estimates of oil in place is 146 933 Bls/ acre, gas adsorbed in situ 40.57 Mcf/acre, and free gas in place of 504.07 Mcf/acre. Data reported in the literature, on the same area, corroborate these results. To conclude, with this methodology a new approach is achieved for estimating prospective resources in Shale reservoirs with better results using the Monte Carlo simulation.


Why did British industrial cities build art museums? By exploring the histories of the municipal art museums in Birmingham, Liverpool, and Manchester, Transformative Beauty examines the underlying logic of the Victorian art museum movement. These museums attempted to create a space free from the moral and physical ugliness of industrial capitalism. Deeply engaged with the social criticism of John Ruskin, reformers created a new, prominent urban institution, a domesticated public space that not only aimed to provide refuge from the corrosive effects of industrial society but also provided a remarkably unified secular alternative to traditional religion. Woodson-Boulton raises provocative questions about the meaning and use of art in relation to artistic practice, urban development, social justice, education, and class. In today's context of global austerity and shrinking government support of public cultural institutions, this book is a timely consideration of arts policy and purposes in modern society.


When children in Aotearoa New Zealand begin school at 5 years of age they take with them a wealth of learning. For the majority of children transitioning from early childhood education to school this learning has been documented in portfolios. In many cases, and for many reasons, these portfolios are not shared with the school. However, teachers in a number of early childhood centres and schools have explored ways in which this sharing can contribute to continuity for the child and their family across education settings, while strengthening the children's learning. The strong connections between the early childhood education curriculum Te Whāriki and the revised New Zealand Curriculum in 2007 provided one early childhood centre with the impetus to develop a meaningful way of sharing some of the critical learning of children transitioning from early childhood education to school.


Each volume in the "American Presidents Reference Series" is organized around an individual presidency and gathers a host of biographical, analytical, and primary source historical material that will analyze the presidency and bring the president, his dministration, and his times to life. The series focuses on key moments in U.S. political history as seen through the eyes of the most influential presidents to take the oath of office. Unique headnotes provide the context to data, tables and excerpted primary source documents. Lyndon Baines Johnson was born in 1908. He was first elected to Congress in 1937 and reelected twice. When he set his sights on the U.S. Senate in 1940 he was defeated. Following the Japanese attack on Pearl Harbor, Johnson was the first member of the House to volunteer for active military duty. In 1949 he became a U.S. Senator and was elected its majority leader in 1955. Johnson sought the Democratic presidential nomination in 1960, but lost to John F. Kennedy, who would offer him the vice president spot. In a close election, the Kennedy/Johnson ticket prevailed over Nixon/Lodge. In 1963 Vice President Johnson was part of the motorcade traveling through Dallas, Texas when Lee Harvey Oswald assassinated Kennedy. Johnson, while aboard Air Force One, was sworn in as 36th president of the United States. His administration crafted and oversaw several great moments in American history, including civil rights efforts, the Great Society, and technological advances. These events were, to some degree, overshadowed by the poor economy, civil unrest, and the U.S involvement in the Vietnam War. Troubled by his rapidly declining public approval, he did not seek re-election. This new volume on the presidency of Lyndon Baines Johnson will cover: His political skills; Replacing JFK; The Vietnam War; The Economy; The Great Society; Civil Rights; and, Technology and Space.


This study investigates the relationship between English listening comprehension and English and Chinese phonological awareness (PA), and the crosslinguistic transfer of PA in 48 Grade 2 and 47 Grade 4 Chinese English-immersion students. The results of the study indicate a correlation between English PA and English listening comprehension. English listening comprehension had a signifi cant effect on English PA in both grades; this effect is evident after considering Chinese PA, but only in Grade 4. A similar pattern is found for the effect of English PA on English listening comprehension. Only weak evidence exists pertaining to a connection between cross-linguistic transfer from Chinese PA (L1) to English listening comprehension (L2).


Background Concern over rising healthcare expenditures has led to increased scrutiny of medical practices. As medical liability and malpractice risk rise to crisis levels, the medical-legal environment has contributed to the practice of defensive medicine as practitioners attempt to mitigate liability risk. High-risk specialties, such as neurosurgery, are particularly affected and neurosurgeons have altered their practices to lessen medical-legal risk. We present the first national survey of American neurosurgeons' perceptions of malpractice liability and defensive medicine practices. Methods A validated, 51-question online-survey was sent to 3344 practicing U.S. neurosurgeon members of the American Association of Neurological Surgeons, which represents 76% of neurosurgeons in academic and private practices. Results A total of 1028 surveys were completed (31% response rate) by neurosurgeons representing diverse sub-specialty practices. Respondents engaged in defensive medicine practices by ordering additional imaging studies (72%), laboratory tests (67%), referring patients to consultants (66%), or prescribing medications (40%). Malpractice premiums were considered a "major or extreme" burden by 64% of respondents which resulted in 45% of respondents eliminating high-risk procedures from their practice due to liability concerns. Conclusions Concerns and perceptions about medical liability lead practitioners to practice defensive medicine. As a result, diagnostic testing, consultations and imaging studies are ordered to satisfy a perceived legal risk, resulting in higher healthcare expenditures. To minimize malpractice risk, some neurosurgeons have eliminated high-risk procedures. Left unchecked, concerns over medical liability will further defensive medicine practices, limit patient access to care, and increase the cost of healthcare delivery in the United States.


Obtaining high resolution Digital Elevation Models (DEMs) is a critical task for analysis and visualization in several remote sensing applications. LIDAR technology provides an effective way for obtaining highresolution topographic information. This paper presents a textured-based novel automatic algorithm for DEM generation from LIDAR data. The proposed technique uses multifractal-based textural features for object identification combined with a maximum slope filter. Although this work is concentrated on DEM generation, certain aspects of the algorithm make it suitable for classification of LIDAR data into other types of data. Some experimental results are presented to illustrate the effectiveness of the proposed algorithm.


The volume of investment capital flows between foreign nationals and developing nations has necessitated that a study be conducted to assess the impact of this foreign capital flows on the economic growth of these developing nations. This paper therefore aims at empirically determining the extent to which foreign capital flows have impacted on the growth performance of the Nigeria economy from 1982–2012. Data were drawn from the publications of the Nigerian Bureau of Statistics (NBS), the Central Bank of Nigeria (CBN) and the World Bank report. The multiple regression analysis method was adopted for the test of the hypotheses. The SPSS statistical software (version 17.0) was used for the data analysis. From the results of the analysis, it was discovered that Foreign Capital Inflows had a positive and significant effect on economic growth as proxied by the GDP, which is an indication that foreign capital inflows exerted considerable influence as a key fiscal policy instrument of economic growth over the stated period. Also the Foreign Capital Outflow in the same vein had a positive and significant effect on the GDP, which is another indication that it exerted considerable influence as a key fiscal policy instrument of economic growth over the stated period. Furthermore, the Openness of the economy, which was another explanatory variables used to ascertain the growth performance of the economy, had a positive and significant effect on the GDP. On the other hand, the Human Capital Development had a negative and insignificant effect on the GDP. The implication is that it did not exert much influence on economic growth over the stated period. Finally, the inflation rate had a positive sign with GDP. It was however; statistically insignificant which points to the severity of the inflationary pressure brought to bear on the economy over the stated period. The paper concludes that policy on foreign capital flows should be vigorously pursued and enhanced to provide a buffer to the nations dwindling internally generated revenue (IGR) amidst astronomically growing population.


Multi-task learning (MTL) aims to improve generalization performance by learning multiple related tasks simultaneously. While sometimes the underlying task relationship structure is known, often the structure needs to be estimated from data at hand. In this paper, we present a novel family of models for MTL, applicable to regression and classification problems, capable of learning the structure of tasks relationship. In particular, we consider a joint estimation problem of the tasks relationship structure and the individual task parameters, which is solved using alternating minimization. The task relationship revealed by structure learning is founded on recent advances in Gaussian graphical models endowed with sparse estimators of the precision (inverse covariance) matrix. An extension to include exible Gaussian copula models that relaxes the Gaussian marginal assumption is also proposed. We illustrate the effectiveness of the proposed model on a variety of synthetic and benchmark data sets for regression and classification. We also consider the problem of combining Earth System Model (ESM) outputs for better projections of future climate, with focus on projections of temperature by combining ESMs in South and North America, and show that the proposed model outperforms several existing methods for the problem.


The efficacy of systemic interferon-alpha (IFN-alpha n1; Wellferon) treatment on genital human papillomavirus (HPV) infections was studied in a double-blind, placebo-controlled trial. A total of 120 women were randomly allocated to receive either interferon (IFN, n = 60) or placebo (n = 60). In both treatment groups, 15 patients with lesions induced by each of the four HPV types (HPV 6, 11, 16, and 18) were included. The dose of IFN was 1.5 x 10(6) IU subcutaneously three times for the first week followed by 3 x 10(6) IU three times weekly for a further 6 weeks. The control patients received matching placebo injections. Ten patients (three IFN-treated and seven placebo-treated) were lost to follow-up. As determined by colposcopy, cytological and histological examinations, and HPV typing (in situ hybridization, ISH), 8 IFN-treated patients (14%) and 11 placebo-treated patients (18%) showed complete response (CR) at the 8th week. The corresponding figures were 22 (37%) and 25 (43%) at the 24th week and 28 (49%) and 25 (49%) at the 52nd week, respectively. The total number of HPV DNA negative patients at Week 8 was 29 (49%) in the IFN group and 24 (40%) in the placebo group (statistically nonsignificant). At Week 24, 37 (63%) of the IFN-treated patients and 39 (67%) of the placebo-treated patients were HPV DNA negative. In 2 placebo-treated cases, cervical lesions progressed to CIN III and were treated by conization after the 24th week. There were 4 recurrences (7%) in the IFN group and no recurrences in the placebo group at the 24th week, corresponding figures at the 52nd week being 6 (11%) and 4 (7%), respectively. When the clinical efficacy was evaluated in relation to the histological grade of lesion and four different HPV types, there were no differences in CR or in the number of HPV DNA negative patients between the two study groups. In conclusion, systemic IFN-alpha therapy did not show any significant therapeutic effect on genital HPV infections (by HPV types 6, 11, 16, and 18) compared to placebo.


On July 2, the inaugural assembly of the Council of Asian Science Editors (CASE) was held in Seoul. Over 140 science editors from 10 Asian countries attended the meeting and expressed their enthusiastic support for the establishment of the CASE. I believe this is an important first step toward an organized effort in developing scientific editing and publishing in Asia rapidly. Modern science has been created and developed by the efforts made mainly by scientists in Europe and North America during the last few centuries. Science journals were also invented by the Westerners, and even nowadays Europe and the US dominate the scientific publishing industry in the world. Since the latter part of the last century, many countries in Asia have undergone rapid economic development, which in turn lead to developments in many disciplines of science. Currently, the level of science in Asia is close to the global level both quantitatively and qualitatively. Asian scientists contribute well over 45% of the entire contents of all scientific publications in the world. Nevertheless the level of science journals published in Asia remains disproportionately and regrettably low. There are many reasons why the level of scientific publishing in Asia is so low. I think the lack of tradition and experience in journal publishing, the insufficient education and training of publishing professionals, and the society's inability to recognize the importance of the scientific publishing industry are the main reasons for this situation. The main motivation for establishing the CASE is that science editors in Asia need to share a common recognition of the problem and collaborate intimately to raise the level of scientific publishing in the region to the level comparable to that of scientific research in Asia. I believe the rapid expansions of the use of the internet in the publishing industry and online and open access journals provide a rich opportunity for late starters to catch up with more advanced publishers. Asian countries have long histories and unique cultures and have long traditions in academic research including science. By melding old traditions with new ideas, it will be possible for Asians to create new trends in scientific publishing, and thereby contributing to the development of human culture and well-being. I hope the CASE will grow to be an organization that can pioneer such a movement.


Abstract We present results from a high resolution cosmological galaxy formation simulation called Mare Nostrum and a ultra-high resimulation of the first 500 million years of a single, Milky Way (MW) sized galaxy. Using the cosmological run, we measure UV luminosity functions and assess their sensitivity to both cosmological parameters and dust extinction. We find remarkably good agreement with the existing data over the redshift range 4 < z < 7 provided we adopt the favoured cosmology (WMAP 5 year parameters) and a self-consistent treatment of the dust. Cranking up the resolution, we then study in detail a z = 9 protogalaxy sitting at the intersection of cold gas filaments. This high-z MW progenitor grows a dense, rapidly spinning, thin disk which undergoes gravitational fragmention. Star formation in the resulting gas clumps rapidly turns them into globular clusters. A far reaching galactic wind develops, co-powered by the protogalaxy and its cohort of smaller companions populating the filaments. Despite such an impressive blow out, the smooth filamentary material is hardly affected at these redshifts.


It is well known that large-scale organized motions, usually called coherent structures, exist in many transitional and turbulent flows (if not all). The topology and range of scales of those large-scale structures change widely from flow to flow such as counter-rotating vortices in wake flows, streaks and hairpin vortices in turbulent boundary layers. However, it is not well established what kind of large-scale structures exists in separated/reattached transitional flows. Large-eddy simulation with a dynamic subgrid-scale model is employed in the current study to investigate the physics of transitional separating/reattaching flows over a blunt plate held normal to a uniform stream. The Reynolds number based on the uniform inlet velocity and the plate thickness is 6500. Statistics of the LES are found to be in acceptable agreement with the available experimental data in the laminar, transitional, and turbulent flow regions. The entire transition process leading to breakdown to turbulence has been shown by flow visualization and large-scale structures have been identified at different stages of the transition process of the separating/reattaching flow. The well-known hairpin vortices commonly associated with boundary-layer transition on a flat plate have been clearly shown at about the mean reattachment point and more large-scale structures are presented as well. The large-scale structures are noticed to persist a considerable distance downstream of reattachment before they eventually break into smaller-scale turbulent structures. In addition, it may shed light on the transition mechanisms and the nature of instabilities involved to understand the formation of these large-scale structures, their spatial and temporal evolution and eventual break-up into smaller structures


Theories of violence have traditionally predicted that bystanders are less likely to intervene when in the presence of others than when alone. We re-examine this prediction using data from 42 episodes of public violence in "night-time economy" spaces in the United Kingdom, as captured on CCTV cameras. The behaviors of protagonists and bystanders were coded as either escalating or de-escalating acts, and the resulting interaction sequences were examined using state-transition diagrams. Analyses revealed that bystanders play a key role in shaping the trajectory of violence. They contributed more de-escalating than escalating behaviors; and their de-escalating behavior became more rather than less prevalent with more bystanders. This appeared to result from two dynamics: i) bystander interventions usually begin with a de-escalating act towards the target rather than the instigator; and ii) the third bystander act in the sequence was most likely to determine the trajectory of the violence. We conclude with some speculations about the intra-group regulation of violence, and highlight bystanders as an important resource for developing violence reduction initiatives.


A good, understandable informed consent form (ICF) is key to ethical medical research, and the ICF is necessary according to United States federal regulation. Since they may be written in complex technical language, ICFs are often difficult for subjects to understand. The purpose of this research was to evaluate students' understanding of terminology commonly used in the ICF. An online research survey was sent to active students of Eastern Michigan University (EMU) during the winter 2015 semester. Questions were asked to evaluate the students' understanding of the correct meaning of the terms used in medical research. The majority of students understood common terminology used in informed consents, but they were confused about the meaning of the term "Clinical Research/Trial" and the location where the clinical studies were conducted. Therefore, investigators and Institutional Review Boards (IRBs) need to be aware of these potentially confusing items when writing an ICF.


The motivation for this paper is the practical problem of interpreting bi-exponential rate-of-rise curves that are observed during many field piezometric tests. In the authors9 previous study, a laboratory W-tube system of water flow through two samples of sand was introduced with an adequate mathematical model. The desired bi-exponential character of water flow was obtained by placing two different samples of sand in separate but connected columns. In the present paper, a so-called inverse problem is solved. The optimization procedure is applied in order to jointly estimate a pair of hydraulic conductivity values based on experimentally recorded bi-exponential rate-of-rise curves. The obtained values of hydraulic conductivities are presented and compared to the values determined from independent constant-head permeability tests conducted for the analyzed sands. The results of this identification procedure varied in accuracy. The mean percent errors between the hydraulic conductivity values measured jointly and independently for the analyzed experimental series were in the range of 8.8 to 37.2%. The discussion presents the restrictions of this interpretational method and suggests further modeling plans.


Bronchial asthma is a chronic inflammatory disorder of the airways associated with reversible airway obstruction and increased airway responsiveness to a variety of stimuli. An intuitive inference from this definition is that a causal relationship may exist between airway inflammation and airway hyperresponsiveness. It can be say that "airway inflammation equal to airway hyperresponsiveness". Attachment of antigen antibody complex to the mast cell causes its disruption and release of inflammatory mediators such as histamine.To evaluate the efficacy of anti-asthmatic property of a drug, evaluation of anti-histaminic, mast cell stabilizing and bronchodilator property can be use as pharmacodynamic parameter. Bharangyadi is a polyherbal compound having Bharangi (Clerodendrum serratum), Sati (Hedychium spicatum) and Pushkarmoola (Inula racemosa) as ingredient herbs The present study aimed to evaluate the anti-asthmatic activity of an indigenous polyherbal compound Bharangyadi through various in-vitro & in-vivo experimental models. The results demonstrate that drug has potent histamine antagonism property with significant mast cell stabilizing and spasmolytic activity in the experimental animals. Compound 48/80, a potent mast cell degranulator, provoked 76% degranulation of mast cells in the control group. Ethanolic extract of Bharangyadi at the doses 500 and 1000 μg/ml protected from compound 48/80-evoked degranulation (P < 0.01) in dose dependent manner. Pre-treatment with Bharangyadi extract showed 80% & 86% protection from histamine induced bronchoconstriction in guinea pigs with 27.8% and 36.1% increase in preconvoulsion time (equal to standard drug). Screening of Histamine antagonism activity on guinea pig ileum showed that drug reduces the smooth muscle contraction in dose dependent manner. Increasing concentration of Bharangyadi extract with maximum dose of histamine (1.6μg) showed maximum inhibition at the dose of 50mg (99.78%). Inhibition of smooth muscle contraction by addition of drug in organ bath before adding histamine showed that drug has preventive type antagonism.


Co-contamination of diesel fuel and heavy metals can be challenging for microbial remediation due to the complex composition of the fuel and the inhibitory effect of heavy metals. There is an urgent need to study this interaction to improve the pollutant removal efficiency in the Polar Regions. The growth of an Antarctic bacterium, Rhodococcus sp. was studied by comparing the growth at the logarithmic phase under the effect of selected heavy metals (Pb, Cr, As, Cd, Cu, Zn, Ni, Hg and Co). The selected heavy metals inhibited the growth of the Rhodococcus sp. on diesel fuel in an order from highest to lowest of: Hg > Zn > Cd > Cu > Co > Ni > As > Pb > Cr. Growth on diesel fuel co-contaminated with Hg and Zn were 2.95% and 5.71%, respectively compared to the no-metal control. A further experiment with various Zn concentrations was conducted. The specific growth rate of Rhodococcus sp. co-contaminated with different concentrations of Zn showed a correlation coefficient (r) of 0.916, and was modelled with an exponential decay model. Additional investigation is needed to determine the effect of low concentration of Zn on hydrocarbon degradation. It is important to understand the relationships between microbes, hydrocarbons and heavy metals, especially in the Polar Regions because this interaction might be promising in treating hydrocarbon-polluted sites containing heavy metals. The data and results also provide baseline tools of bioremediation processes at low temperatures and the knowledge of the ecological roles of Rhodococcus sp. in Antarctica. Citation: Kai E X, Wan Johari W L, Habib S, et al. The growth of the Rhodococcus sp. on diesel fuel under the effect of heavy metals and different concentrations of zinc. Adv Polar Sci, 2020, 31(2): 132-136, doi: 10.13679/j.advps.2019.0043


The trend in parallel computing toward large-scale cluster computers running thousands of cooperating processes per application has led to an I/O bottleneck that has only gotten more severe as the the number of processing cores per CPU has increased. Current parallel file systems are able to provide high bandwidth file access for large contiguous file region accesses; however, applications repeatedly accessing small file regions on unaligned file region boundaries continue to experience poor I/O throughput due to the high overhead associated with accessing parallel file system data.
In this dissertation we demonstrate how client-side file data caching can improve parallel file system throughput for applications performing frequent small and unaligned file I/O. We explore the impacts of cache page size and cache capacity using the popular FLASH I/O benchmark and explore a novel cache sharing approach that leverages the trend toward multi-core processors. We also explore a technique we call progressive page caching that represents cache data using dynamic data structures rather than fixed-size pages of file data. Finally, we explore a cache aggregation scheme that leverages the high-level file I/O interfaces provided by the PVFS file system to provide further performance enhancements.
In summary, our results indicate that a correctly configured middleware-based file data cache can dramatically improve the performance of I/O workloads dominated by small unaligned file accesses. Further, we demonstrate that a well designed cache can offer stable performance even when the selected cache page granularity is not well matched to the provided workload. Finally, we have shown that high-level file system interfaces can significantly accelerate application performance, and interfaces beyond those currently envisioned by the MPI-IO standard could provide further performance benefits.


With proper treatment to remove organics and inorganics, the produced water (PW) generated during oil and gas extraction can be reused as process water. Biotreatment is generally regarded as the most cost-effective method for organics removal and although widely used in industrial wastewater treatment, PW biotreatment installations are limited. The research described in this paper focused on the aerobic biotreatment of PW from the Qatari "North Shore" gas field supplemented with either 1.5% kinetic hydrate inhibitor (KHI) or 1.5% thermodynamic hydrate inhibitor (monoethylene glycol, MEG). KHI and MEG are "field chemicals" added off-shore during the winter months. This research was part of a larger project assessing the biotreatability of produced water from both summer and winter seasons. Although the feed pH was 4.5 and the biomass used as seed was cultured at pH 5.5, the bioreactor pH stabilized at 2.6 when KHI or MEG were added. Active biological oxidation was demonstrated in our tests for a period of 7 months through COD tests and in-situ dissolved oxygen (DO) and oxygen uptake rate (OUR) measurements. When 1.5% KHI in PW was added to the bioreactor, the DO decreased sharply and the OUR increased quickly from 0.2 to 1.9 mg O2/L.min. The COD results indicated that 43% and 81% of the organics present were removed through biotreatment of PW dosed with 1.5% KHI or MEG respectively. The concentration of 2-butoxyethanol (one of the two main components in KHI) was reduced from >5,000 mg/l to <10 mg/L indicating effective biodegradation of these chemicals even under the acidic conditions of our reactor. Removal of KHI and MEG by simple stripping was also investigated and results indicated that stripping was not responsible for significant COD removal. Literature references on aerobic biological activity at pH 2.6 are scarce. We postulate that the biological activity in our reactor is producing acids that resulted in the pH depression. One possible mechanism by which the acid production could have occurred through the bio-oxidation of either KHI and MEG has been developed and will be included in this presentation. A discussion of the specific fungus believed to be responsible for this unexpected biological activity is also included. The results are aligned with the Qatar National Vision (QNV) 2030 and fall directly within "Energy and Environment" Research Theme of the QNRS in two areas: i) water security, and ii) energy security. With the recent announcement that Qatargas is building a water reuse system incorporating membrane bioreactor and reverse osmosis technologies, the research results are particularly relevant.


Conventional approaches to trans inclusion in the women's, gender, and sexuality studies classroom often involve what Diana Courvant has called the "special guest" approach of bringing in trans, intersex, and gender-nonconforming folk to represent and authenticate trans experiences, perspectives, and political engagements. This essay argues for the inadequacy of this pedagogical strategy, focusing on its complicity with a neoliberal politics of inclusion that fails to move students to deal with their own deep complicities in upholding understandings of sex and gender that are fundamentally transphobic, as well as its failure prompt pragmatic understanding and address of the maldistribution of life chances for trans, intersex, andgender-nonconforming subjects. I offer several alternative strategies aimed at producing more deeply transformative types of trans inclusion in WGSS classrooms. These strategies focus on mapping connections between cis and trans experiences of gendered transformation in order to produce an alternative understanding of gender as process, craft, and becoming.


The volume of international transfers of major arms in 2015–19 was 5.5 per cent higher than in 2010–14 and 20 per cent higher than in 2005–2009. The five largest exporters in 2015–19 were the United States, Russia, France, Germany and China. The five largest importers were Saudi Arabia, India, Egypt, Australia and China. Between 2010–14 and 2015–19, there were increases in arms transfers to the Middle East and to Europe, while there were decreases in the transfers to Africa, the Americas and Asia and Oceania. From 9 March 2020 the freely accessible SIPRI Arms Transfers Database includes updated data on arms transfers for 1950–2019. Based on the new data, this Fact Sheet presents global trends in arms exports and arms imports and highlights selected issues related to arms transfers.


Extracted from text ... This study and its publication is funded by the European Union, Ford
Foundation, USAID and the United States Embassy in South Africa. Their generous
assistance is gratefully acknowledged.
ACKNOWLEDGEMENTS
FIGURE 1 20
Number of votes received by the white right, 1970-1999
FIGURE 2 21
Proportion of vote going to white right in 1989 election, by province
FIGURE 3 22
Proportion of 'no vote' in 1992 referendum, selected regions
FIGURE 4 33
Votes for white right as a proportion of all votes cast, 1981-1999
FIGURE 5 76
Possible Boeremag command structure
FIGURE 6 84
Farm attacks, injuries and murders, 1998-2001 ..


The use of fixed-dose combinations (FDCs) in the daily practice of pharmacotherapy is increasing after years in the shadows. The main reasons for this renewed popularity are the increasing number of drugs prescribed per patient and the complexity of current pharmacotherapy. A lack of efficacy of current monotherapies in many diseases together with advances in knowledge on pathophysiological disease mechanisms have also created a push towards development of new FDCs. For the regulatory authorities in Europe, however, it is unclear whether FDCs in general have a positive benefit–risk balance. Hence, more research is needed to show that use of FDCs improves treatment effectiveness through better compliance, adherence and quality of life for patients, which may lead to a positive pharmacoeconomical benefit for society. Evidence-based data are thus needed, especially for those patient groups requiring multiple drugs—for example, the elderly. In this context, hospital practice regarding FDCs is crucial, as the recommended pharmacotherapy at discharge of the patient serves as a role model for outpatient care, and therefore needs greater recognition. The benefit–risk balance and pharmacoeconomical consequences of FDCs should also be a subject for attention in the hospital pharmacy setting.


Multi-wavelength laser sources with constant wavelength spacing are of great interest in dense wavelength division multiplexing (DWDM) communication and sensors systems.As the transmission capacity of optical communication systems is approaching a few Tb/s through WDM method in recent years, multiwavelength generation technology becomes more important, considering that the complexity and the cost of the source will increase as the number of WDM channel increases.In this thesis, the design and development of a novel architecture of multi-wavelength Brillouin/Erbium fiber laser (BEFL) utilizing a linear cavity fiber loop technique is presented. Simultaneous and stable multiple wavelength lasing in a linear cavity have been achieved. The results are based completely on the experimental work. The requirement of internal feedback that is commonly used for multiple wavelengths Brillouin/Erbium fiber laser using a ring configuration is achieved by the proposed linear cavity design. This design used only a single 980 nm pump laser for its multiple wavelengths operation. Based on the design parameters namely; 980 nm pump power, Brillouin pump power, Brillouin pump wavelength and single mode fiber (SMF) the performance of a novel BEFL is presented in terms of threshold power, Stokes signal peak power, number of Stokes generated, stability of the Stokes and tuning range.
Throughout this work, three lengths of SMF-fiber are used, 1.9 km, 8.8 km and 25 km.The optimization of Brillouin pump wavelength, power and Erbium gain led to a maximum possible number of Stokes. Twenty-two stable output laser lines with 10.88 GHz (0.088 nm) line spacing were obtained at 1558 nm that was the peak of Erbiumdoped fiber (EDF) gain. The injected Brillouin pump power into the 8.8 km SMF-fiber was set at 0.9 dBm and the EDF was pumped by 100 mW of 980 nm pump laser.The most efficient cascaded Brillouin Stokes operation occurred at the peak of Erbium gain centered on 1558 nm. The number of Stokes decreased as the Brillouin pump increased in the highest region of Erbium gain. On the contrary, the number of Stokes was proportional to the intensity of the Brillouin pump power outside this wavelength range. The best performance and conversion efficiency of Brillouin pump to the BEFL signal occurs at the lower levels of injected Brillouin pump power.A low threshold of 4 mW pump power with 2.3 mW launched Brillouin pump into the 8.8 km of SMF-fiber at 1558 nm was obtained. The tuning range of the Stokes signal must be taken into account both the Brillouin and EDF pump powers, at a fixed EDF pump power the Stokes signal can be tuned wider at a higher Brillouin pump power while higher EDF pump power produces smaller tuning range.


Summary Thyroid lipomatosis is a rare disease, as a total of 20 cases have been described in the literature. It is characterized by diffuse infiltration of the stroma by mature adipose tissue and by progressive growth that produces different degrees of compressive symptoms. Our aim is to present the case of a 36-year-old woman who consulted because of dyspnea caused by a multinodular goiter. She underwent surgery with the presumptive diagnosis of a malignant neoplasia, but the pathological examination of the surgical specimen established the diagnosis of thyroid lipomatosis. Learning points Thyroid lipomatosis is a rare, benign disease characterized by diffuse infiltration of the stroma by mature adipose tissue. The pathophysiology of diffuse proliferation of adipose tissue in the thyroid gland is unclear. Thyroid lipomatosis is clinically manifested by a progressive enlargement of the thyroid that can involve the airway and/or upper gastrointestinal tract, producing dyspnea, dysphagia, and changes in the voice. Given the rapid growth of the lesion, the two main differential diagnoses are anaplastic carcinoma and thyroid lymphoma. Imaging studies may suggest a differential diagnosis, but a definitive diagnosis generally requires histopathological confirmation after a thyroidectomy.


This study aims at exploring the issue of convergence in the tourist market of Greece based on tourist arrivals from different destinations. The period of the analysis covers the years 1995-2015. The sample includes 18 countries, namely Albania, Australia, Austria, Belgium, France, Germany, Denmark, Switzerland, United Kingdom, USA, Spain, Italy, Canada, Cyprus, Netherlands, Romania, Russia, and Czech Republic. Initially, conventional panel unit root tests were applied, which showed no signs of convergence. Subsequently, panel unit root test was used, based on which a break point is calculated endogenously. It was found that (except in the case of Russia), countries show signs of convergence, with time points of disruption that correspond to the years of the recent crisis as well as the Olympic Games. The analysis revealed these countries for which tourism policies are effective and therefore should be in the center of interest for Greece. Regarding the case of Russia, tourism policy seems to be ineffective and should be redefined.


Abstract. Very short-lived substances (VSLS) still represent a major factor of uncertainty in the quantification of stratospheric bromine loading. One of the major obstacles for short-lived source gases in contributing to the stratosphere is generally thought to be loss of inorganic bromine (Bry) in the tropical tropopause layer (TTL) due to dehydration. We use sensitivity calculations with a three-dimensional chemistry transport model comprising a consistent parametrization of convective transport and a comprehensive chemistry scheme to investigate the associated processes. The model considers the two most important bromine VSLS, bromoform (CHBr3) and dibromomethane (CH2Br2). The organic bromine source gases as well as the resulting profile of inorganic bromine in the model are consistent with available observations. In contrast to its organic precursors, Bry is assumed to have a significant sorption capacity regarding sedimenting liquid or frozen particles thus the fraction of intact source gases during their ascent through the TTL is a critical factor. We find that source gas injection is the dominant pathway into the stratosphere, about 50% of CHBr3 and 94% of CH2Br2 is able to overcome the cold point tropopause at approximately 17 km altitude, modulated by the interannual variability of the vertical transport efficiency. In fact, our sensitivity calculations indicate that the extent of source gas injection of CHBr3 is highly sensitive to the strength of convection and large-scale ascent; in contrast, modifying the photolysis or the destruction via OH yields a significantly smaller response. In principle, the same applies as well to CH2Br2, though it is considerably less responsive due to its longer lifetime. The next important aspect we identified is that the partitioning of available Bry from short-lived sources is clearly shifted away from HBr, according to our current state of knowledge the only member of the Bry family which is efficiently adsorbed on ice particles. This effect is caused by very efficient heterogeneous reactions on ice surfaces which reduce the HBr/Bry fraction below 15% at the tropical tropopause. Under these circumstances there is no significant loss of Bry due to dehydration in the model, VSLS contribute fully to stratospheric bromine. In addition, we conduct several sensitivity calculations to test the robustness of this result. If heterogeneous chemistry is ignored, the HBr/Bry fraction exceeds 50% and about 10% of bromine from VSLS is scavenged. Dehydration plays a minor role for Bry removal under the assumption that HOBr is efficiently adsorbed on ice as well since the heterogeneous reactions alter the partitioning equilibrium of Bry in favor of HOBr. In this case, up to 12% of bromine from VSLS is removed. Even in the extreme and unrealistic case that adsorbed species on ice particles are instantaneously removed the maximum loss of bromine does not exceed 25%. Assuming 6 parts per trillion by volume (pptv) of bromine short-lived source gases in convective updrafts, a value that is supported by observational data, we find a most likely contribution of VSLS to stratospheric bromine in the range of 4.5–6 pptv.


Purpose Myostatin negatively regulates skeletal muscle growth. Myostatin-knockout mice exhibit muscle hypertrophy and decreased interstitial fibrosis. We investigated whether a plasmid expressing a short hairpin interfering RNA (shRNA) against myostatin and transduced using electroporation would increase local skeletal muscle mass and reduce interstitial connective tissue. Methods Short interfering RNAs (siRNAs) targeting myostatin were transfected into HEK293 cells and identified for myostatin silencing by Western blot. Corresponding shRNAs were cloned into plasmid shRNA expression vectors. Myostatin or a randomer negative control shRNA plasmid were injected and electroporated into the tibialis anterior or its contralateral muscle, respectively, of 10 rats that were sacrificed after 2 weeks. Six other rats received a beta-galactosidase reporter plasmid and were sacrificed at 1, 2, and 4 weeks. Uptake of plasmid was examined by beta-galactosidase expression, whereas myostatin expression was determined by real-time PCR and Western blotting. Muscle fiber size and collagen expression were determined by histochemistry. Satellite cell proliferation was determined by PAX7 immunohistochemistry. Myosin heavy chain type II expression was determined by Western blot. Results Beta-galactosidase reporter plasmid was expressed at 1 and 2 weeks but diminished by 4 weeks. Myostatin shRNA reduced myostatin mRNA and protein expression by 27 and 48%, respectively. Tibialis weight, fiber size, and myosin heavy chain II increased by 10, 34, and 38%, respectively. Satellite cell number was increased by 64%. Interstitial collagen decreased by 40%. Conclusions This is the first demonstration that myostatin shRNA gene transfer is a potential strategy to increase muscle mass while reducing interstitial connective tissue.


Study of the reproductive strategy of crayfish species is of great importance in the current astacological world. Crayfish are among the largest freshwater invertebrates, and as keystone species, they are able to regulate the structure of the benthic fauna in the freshwaters, demonstrating different ecological strategies and life spans ranging up to 20+ years. In order to bring together the various pieces of information related to this issue, this overview of published scientific reports was conducted. The majority of crayfish species studied show sexual dimorphism, with approximately equal numbers of males and females. However, over some decades numerous observations have been made for a few species that may have different modes of reproduction, such as hermaphroditism or intersex (e.g. Cherax quadricarinatus , Samastacus spinifrons, Parastacus virilastacus and Pacifastacus leniusculus ) and parthenogenesis (only Procambarus fallax f. virginalis ). A recent study showed a new case of parthenogenesis as apomictic parthenogenesis (only Orconectes limosus ). In addition, there are many investigations into the reproduction biology of crayfish, including using eyestalk ablation or androgenic gland ablation under various lab conditions and hybridization under natural conditions (e.g. Astacus astacus X Astacus leptodactylus , Orconectes rusticus X Orconectes propinquus ). There are also some chemical factors which could possibly affect the reproduction system of crayfish in the wild.


The Internet Protocol Version 6 (IPv6) transition opens a wide scope for potential attack vectors. Tunnel-based IPv6 transition mechanisms could allow the set-up of egress communication channels over an IPv4-only or dual-stack network while evading detection by a network intrusion detection system (NIDS). Increased usage of IPv6 in attacks results in long-term persistence, sensitive information exfiltration, or system remote control. Effective tools are required for the execution of security operations for assessment of possible attack vectors related to IPv6 security. In this paper, we review relevant transition technologies, describe two newly-developed IPv6 transition mechanism-based proof-of-concept tools for the establishment of covert information exfiltration channels, and compare their performance against common tunneling mechanisms. We evaluated commonly used exfiltration tools in an automated and virtualized environment, and assessed covert channel detection methods in the context of insider threat. An analysis of the generated test cases confirms that IPv6 and various evasion techniques pose a difficult task for network security monitoring. While detection of various transition mechanisms is relatively straightforward, other evasion methods prove more challenging. Additionally, some solutions do not yet fully support IPv6.


Business views on the most important barriers to trade facilitation are taken from two region-wide surveys in 2006 covering the ASEAN priority integration sectors, namely: agro-based, fisheries, automotive, electronics, e-ASEAN, healthcare, rubber, textile and apparel, wood-based, air travel, tourism, and logistics. The data were reassembled into (1) border procedures, (2) individual barriers, (3) broad categories of barriers, and the results ranked in terms of incidence and significance. Border procedures such as unofficial facilitation fees, tedious goods declaration, poor information on procedures, difficult release of goods, and complex refund and appeals process were the most widespread and serious. Logistics businesses were similarly affected by lengthy documentation, burdensome inspection, varying goods nomenclature, facilitation fees, poor regional coordination, and inefficient clearance. Across all types of barriers, for the goods sector, Customs procedures and their manner of implementation were prevalent, while quantity control measures, official and unofficial fees, and technical standards were significant. For the services sector, the operator's licensing requirement was the most common and severe, while high excise taxes, user fees, lengthy visa procedures, and market limits were further impediments. Logistics operators confirmed the singular importance of Customs procedures particularly time consuming documentation, followed by foreign ownership and transport-specific limitations. Time and monetary costs of complying were substantial.


The quasi-thermal noise spectroscopy is an accurate method of determination of density and temperature in space plasmas. When an electric antenna is immersed into a plasma, it is able to measure electrostatic uctuations caused by the thermal motion of plasma particles. These uctuations are detected as the power spectral density at the antenna terminals, observing a spectrum at frequencies comparable to the electron plasma frequency for both electrons and protons, since the proton signal is strongly Doppler-shifted towards higher frequencies due to the solar wind drift velocity. Beside inducing the uctuating electric eld, some of the electrons are impacting the antenna surface, causing disturbances of the antenna electric potential. The signal caused by this population is directly proportional to the ux of plasma electrons impacting the antenna and is dominant if the antenna has a large surface area. In this work, we use the orbit limited theory to calculate the incoming particle ux for a non-thermal plasma described by κ velocity distribution function, commonly measured in the solar wind. The increase in the particle collection by cylindrical and spherical objects is quanti ed and presented as a function of the surface electrostatic potential and the fraction of supra-thermal particles. Including these results into the theory has turned out to be absolutely necessary for accurate measurements of the plasma parameters whenever the shot noise is the dominant component in the power spectrum. This is the case for STEREO because the impact noise is overwhelming on this probe, due to the presence of short and thick antennas. The comprehensive study of data on this mission is motivated by the fact that the electron analyzers are malfunctioning since launch and no information on thermal electrons is available. Results obtained are veri ed by comparing with the results from Wind, showing a good match between the values measured by the two spacecraft. Uncertainties of the measurements are determined by the uncertainties of the instruments used and are estimated to be around 40%. The nal outcome of this work will be establishing a database of the electron moments in both STEREO A and B that will be covering the entire duration of the mission. In the second part of the thesis, we use the kinetic approach to expand the theory of the quasi-thermal noise to plasmas where electron-neutral collisions play a dominant role. This technique is able to measure the electron density, temperature and the collision frequency as independent parameters using the wide frequency range both below and above the plasma frequency, if the ratio of the collisional to plasma frequency is not smaller than 0.1. The results presented here have can be potentially applied in laboratory plasmas and unmagnetized ionospheres, while at the ionosphere of Earth their use is limited to low frequencies due to the presence of the magnetic eld.


Changes in soil moisture between two radar acquisitions can impact the observed coherence in differential interferometry: both coherence magnitude |Υ| and phase Φ are affected. The influence on the latter potentially biases the estimation of deformations. These effects have been found to be variable in magnitude and sign, as well as dependent on polarization, as opposed to predictions by existing models. Such diversity can be explained when the soil is modelled as a half-space with spatially varying dielectric properties and a rough interface. The first-order perturbative solution achieves–upon calibration with airborne L band data–median correlations ρ at HH polarization of 0.77 for the phase Φ, of 0.50 for |Υ|, and for the phase triplets ≡ of 0.56. The predictions are sensitive to the choice of dielectric mixing model, in particular the absorptive properties; the differences between the mixing models are found to be partially compensatable by varying the relative importance of surface and volume scattering. However, for half of the agricultural fields the Hallikainen mixing model cannot reproduce the observed sensitivities of the phase to soil moisture. In addition, the first-order expansion does not predict any impact on the HV coherence, which is however empirically found to display similar sensitivities to soil moisture as the co-pol channels HH and VV. These results indicate that the first-order solution, while not able to reproduce all observed phenomena, can capture some of the more salient patterns of the effect of soil moisture changes on the HH and VV DInSAR signals. Hence it may prove useful in separating the deformations from the moisture signals, thus yielding improved displacement estimates or new ways for inferring soil moisture.


OBJECTIVE
The ventral jugular foramen and the infrapetrous region are difficult to access through conventional lateral and posterolateral approaches. Endoscopic endonasal approaches to this region are obstructed by the eustachian tube (ET). This study presents a novel strategy for mobilizing the ET while preserving its integrity. Qualitative and quantitative comparisons with previous ET management paradigms are also presented.

METHODS
Ten dry skulls were analyzed. Four ET management strategies were sequentially performed on a total of 6 sides of cadaveric head specimens. Four measurement groups were generated: in group A, the ET was intact and not mobilized; in group B, the ET was mobilized inferolaterally; in group C, the ET underwent anterolateral mobilization; and in group D, the ET was resected. ET range of mobilization, surgical exposure area, and surgical freedom were measured and compared among the groups.

RESULTS
Wide exposure of the infrapetrous region and jugular foramen was achieved by removing the pterygoid process, unroofing the cartilaginous ET up to the level of the posterior aspect of the foramen ovale, and detaching the ET from the skull base and soft palate. Anterolateral mobilization of the ET facilitated significantly more retraction (a 126% increase) of the ET than inferolateral mobilization (mean ± SD: 20.8 ± 11.2 mm vs 9.2 ± 3.6 mm [p = 0.02]). Compared with group A, groups C and D had enhanced surgical exposure (142.5% [1176.9 ± 935.7 mm2] and 155.9% [1242.0 ± 1096.2 mm2], respectively, vs 485.4 ± 377.6 mm2 for group A [both p = 0.02]). Furthermore, group C had a significantly larger surgical exposure area than group B (p = 0.02). No statistically significant difference was found between the area of exposure obtained by ET removal and anterolateral mobilization. Anterolateral mobilization of the ET resulted in a 39.5% increase in surgical freedom toward the exocranial jugular foramen compared with that obtained through inferolateral mobilization of the ET (67.2° ± 20.5° vs 48.1° ± 6.7° [p = 0.047]) and a 65.4% increase compared with that afforded by an intact ET position (67.2° ± 20.5° vs 40.6° ± 14.3° [p = 0.03]).

CONCLUSIONS
Anterolateral mobilization of the ET provides excellent access to the ventral jugular foramen and infrapetrous region. The surgical exposure obtained is superior to that achieved with other ET management strategies and is comparable to that obtained by ET resection.


Best practice clinical guidelines for myopia control involve an understanding of the epidemiology of myopia, risk factors, visual environment interventions, and optical and pharmacologic treatments, as well as skills to translate the risks and benefits of a given myopia control treatment into lay language for both the patient and their parent or caregiver. This report details evidence-based best practice management of the pre-, stable, and the progressing myope, including risk factor identification, examination, selection of treatment strategies, and guidelines for ongoing management. Practitioner considerations such as informed consent, prescribing off-label treatment, and guides for patient and parent communication are detailed. The future research directions of myopia interventions and treatments are discussed, along with the provision of clinical references, resources, and recommendations for continuing professional education in this growing area of clinical practice.


Access management has been widely defined as the planning, design, and implementation of land use and transportation strategies that control the flow of traffic between roads and surrounding land. Management and control of vehicular, pedestrian, bicycle, air, and sea traffic occurs through various forms of access, including traffic signals, turning lanes and restrictions, driveway spacing management, intelligent transportation systems, gating and hubbing schemes, and port terminal management. The engineering of transportation systems thus involves access management as a critical negotiations tool. Previous studies on access management have focused mainly on the positive benefits of access management relating to reductions in accident counts and severities, and improvement in traffic flow. However, the evolution of transportation systems design is also influenced greatly by the perceptions of system users, and to date, research on perceptions of access has been limited. User perceptions of access affect business vitality as well as residential quality of life. This study addressed the perceived economic impacts that access management has specifically on businesses. This study collected 280 surveys from businesses along six major commercial corridors in Western Washington, as well as business-related data from geographic information systems. The researchers then focused on statistical frameworks for analyzing perceived economic impacts. Perceived economic impact due to access management was first assumed and then later proven to correlate implicitly and explicitly to perception of accessibility for any given business. Model estimation was conducted by using joint density models to capture the perceptual inter-relationships between business accessibility and patronage. Factors found to be statistically significant included business type, business operational variables, corridor and street environment variables, and willingness-to-pay amounts. The identification of significant business factors offers insights into how businesses view access management. In the dialogue on design requirements between public development review units and private land developers, such information can provide a successful and efficient negotiations tool.


PURPOSE
Field emission electron sources today have shown great potentials in various medical imaging applications, such as computed tomography (CT), which demands extremely high emission current. High emission current can be achieved by raising the gate voltage at the expense of increased cathode instability and reduced cathode life. This paper presents the design of a new 3D field emission electron source that has the potential to overcome the limits of conventional field emission cathode in emission current and cathode life.

METHODS
The 3D cathode design is based on a semi-enclosed rectangular cavity structure, with one face open to the anode for electron beam emission. All the inner faces of the cavity including four sides and one bottom are set to be the emission surfaces. The 3D cathode has a depth (cavity height) of 5mm along the source axial direction, along with a 10mm×10mm electron beam aperture that is 10mm away from the anode.

RESULTS
The performance of both the 3D and conventional 2D cathode was evaluated using the commercial software package CST Studio Suite, under the same operating condition. We have demonstrated that the total emission current of the 3D cathode is 2.4 times the one of the 2D cathode, from a total 3 times emission surface area. The slightly reduced electron transmission rate in the 3D cathode is due to the electron collision inside the cavity structure.

CONCLUSION
We present a novel field emission electron source design based on a 3D semi-enclosed cavity structure, by utilizing the multiple inner surfaces of the cavity for electrons emission. The 3D cathode has transverse dimensions the same as a conventional single surface 2D cathode, but larger emission area due to its extended space. The 3D cathode design was demonstrated to have the capability of providing much higher cathode current density.


My artistic production in graduate school is primarily temporary public art with an increasing commitment to art that presents political and social issues. Most of my artwork takes the form of large banners with images and words. My year of thesis work included writing criticism and producing video works. The thesis exhibition is a culmination and logical extension of my thinking of art as a means of communicating about issues that have vital importance to the world, integrating living with art, and stretching the limits of art. I am protesting "mastery" and "fine arts". "Mastery", furthers patriarchal values as a male term of dominance and control. It is an unsuitable term or value for these changing times. "Fine Arts", denoting a discipline separated from the other arts and disciplines, is also restrictive. I am interested in art as a form of communication. The urgent world situation prompts me to direct my powers to political and social issues. We receive most of our information about political and social issues from the major electronic and print media which address a mass audience. They are bound to the prevailing culture, its traditions, and to the constraints of commercial success. I have chosen to communicate to a smaller audience in a poetic, non-traditional manner relatively free of constraints. My thesis Exhibition included an occupation of the art gallery, a 21 day liquid fast, and various changing installations. It was entitled, "An Act of Uncivil Obedience". ACT OF UNCIVIL OBEDIENCE: A MASTER OF FINE ARTS THESIS AGAINST MASTERY AND FINE ARTS — A HOLISTIC VIEW. by Carl Thurston Stewart A thesis submitted in partial fulfillment of the requirements for the degree of Master of Fine Arts MONTANA STATE UNIVERSITY Bozeman, Montana May 1988


Modelling technology integration in the teaching and learning environment is a complex, uncertain and dynamic practice. A large amount of student behaviour data has been gathered literately for different processing purposes. Yet, considerable questions are still remaining due to the huge data volume, diversification and uncertainty. In this work, we implement a big-data analytical framework for online behaviour modelling, particularly taking streaming data of students' online activity from their laptop usage as an illustrative example. The proposed framework covers details from accessing streaming records to storing heterogeneous data. Furthermore, the work also demonstrates the use of a TF-IDF based feature generation and fuzzy representation strategy to discover critical patterns via this behaviour data. The accuracy of the modelling work is evaluated using students' score on a national-wide test. Experimental results show that the employed TF-IDF feature is much stabler than other traditional features, thereby achieving a better modelling performance. In summary, the simulation result demonstrates the flexibility and applicability of the proposed framework for processing complex behaviour data, and revealing important patterns for decision making.


We explored symbolic canine-human communication for working dogs through the use of canine head gestures. We identified a set of seven criteria for selecting head gestures and identified the first four deserving further experimentation. We devised computationally inexpensive mechanisms to prototype the live system from a motion sensor on the dog's collar. Each detected gesture is paired with a predetermined message that is voiced to the humans by a smart phone. We examined the system and proposed gestures in two experiments, one indoors and one outdoors. Experiment A examined both gesture detection accuracy and a dog's ability to perform the gestures using a predetermined routine of cues. Experiment B examined the accuracy of this system on two outdoor working-dog scenarios. The detection mechanism we presented is sufficient to point to improvements into system design and provide valuable insights into which gestures fulfill the seven minimum criteria.


Many microfluidic devices use an applied electric field to control and manipulate particles immersed in a fluid through the electrostatic force caused by dielectrophoresis (DEP). Additionally, electrothermal flow in the fluid can be caused by the effects of nonuniform temperature and the temperature-dependent electrical permittivity and conductivity material properties. We examine the effects on a particle immersed in a fluid subjected simultaneously to an electric and a nonuniform temperature field and find that the particle experiences an electrostatic force given by not only classical dielectrophoresis, but also an additional force, which we term thermal DEP. Assuming the change in the background electric field across the particle is small, and the relative change of temperature-dependent electric properties across the particle is also small, we develop a linearized model to solve the electric field analytically and integrate the Maxwell stress tensor to find an expression for the thermal DEP force. This thermal DEP force is proportional to the temperature gradient, the square of the electric field strength, and the particle's volume. We solve two special cases, one where the electric field and temperature gradient are aligned, and a second case where they are perpendicular to each other. The general case for an arbitrary angle can be found simply by a superposition of these two cases. We compute the fully-coupled system in COMSOL to determine a range of validity for our linearized model and show a practical way to superimpose the classical DEP and thermal DEP forces to find the total electrostatic force on the particle relative to the fluid. Due to the high electrical conductivity of common biological buffers, the thermal DEP force can play an important role when an electric field is used to control and manipulate cells or bacteria. The thermal DEP force may also modify the heat transfer rates in nucleate boiling applications, where large temperature gradients are present. Degree Type Dissertation Degree Name Doctor of Philosophy (PhD) Graduate Group Mechanical Engineering & Applied Mechanics First Advisor Howard H. Hu


Following the removal of the NSW Sea Level Rise Policy Statement in September 2012, there has been great interest in NSW sea level records to provide often misguided "evidence based" estimates of local/regional sea level trends. One of the great difficulties in climate change and sea level rise planning is that the level of common knowledge on the subject is highly diverse, often biased by urban myths and interspersed by detailed knowledge in particular aspects with poor overall congruence of fact and meaning to a particular issue at hand. This paper will help develop a good understanding of undisputed baseline ocean water level drivers and responses across different timescales to avoid misinterpretation of sea level data. It also will demonstrate how despite over 25 years of highly valuable continuous quality controlled sea level data available for NSW, sea level rise trends based on these and other historical data are not necessarily representative of expected future long-term sea level change. The paper will describe where sea level data is collected in NSW and how it is measured both today and in the past, including NSW's longest records from Fort Denison which commenced in 1886 and provide quality controlled sea level data since 1914. The importance of maintaining recording station metadata will be demonstrated, including instrumentation details, datum changes and monitoring intention(s), as the future value of data will be highly dependent on traceability of these metadata. Through the NSW State Government's recognition of the value of sustaining continuous quality controlled coastal data, the importance of NSW sea level records continues to increase, both in day to day activities and far longer-term. The paper will discuss key factors necessary to ensure that continuous data collection activities can be sustained. This includes understanding both the physical process development and effective communication of the value of these data.


INTRODUCTION
Based on reports, infection with Mycobacterium tuberculosis is believed to induce the development of antibodies that are considered to be biological indicators for the diagnosis of some other diseases. However, conflicting results have been published regarding the presence of antineutrophil cytoplasmic antibodies (ANCAs) in patients with tuberculosis. We aim to study the seroprevalence of ANCA in a population of Chinese patients with tuberculosis, which may lead to the misdiagnosis of vasculitic disorders.

METHODS
The study was conducted from January 2016 to May 2017 to evaluate the presence of ANCA in 103 Chinese patients using indirect immunofluorescent assay. An enzyme-linked immunosorbent assay was performed for anti-myeloperoxidase (MPO) and anti-proteinase 3 (PR3) detection.

RESULTS
Perinuclear ANCA (p-ANCA) was detected in 4.8% (5/103) of patients, whereas cytoplasmic ANCA (c-ANCA) was not detected; 1.9% (2/103) of patients with tuberculosis was positive for anti-MPO antibodies, and none had anti-PR3 antibodies. Both anti-MPO-positive patients were diagnosed with ANCA-associated vasculitides.

CONCLUSIONS
ANCA positivity may be more related to vasculitis and immunological disorders than to a M. tuberculosis infection. Therefore, to improve diagnostic accuracy, patients with M. tuberculosis who are ANCA positive should be investigated for concurrent diseases, including the effects of drugs. Therefore, even in tuberculosis epidemic area, ANCA seropositivity, detected by ELISA, is still more suggestive of ANCA-associated vasculitides.


Despite high hopes for quantum computation in the 1990s, progress in the past decade has been slow; we still cannot perform computation with more than about three qubits and are no closer to solving problems of real interest than a decade ago. Separately, recent experiments in fluid mechanics have demonstrated the emergence of a full range of quantum phenomena from completely classical motion. We present two specific hypotheses. First, Kuramoto theory may give a basis for geometrical thinking about entanglement. Second, we consider a recent soliton model of the electron, in which the quantum-mechanical wave function is a phase modulation of a carrier wave. Both models are consistent with one another and with observation. Both models suggest how entanglement and decoherence may be related to device geometry. Both models predict that it will be dicult to maintain phase coherence of more than three qubits in the plane, or four qubits in a three-dimensional structure. The soliton model also shows that the experimental work which appeared to demonstrate a violation of Bell's inequalities might not actually do so; regardless of whether it is a correct description of the world, it exposes a flaw in the logic of the Bell tests. Thus the case for the security of EPR-based quantum cryptography has just not been made. We propose experiments in quantum computation to test this. Finally, we examine two possible interpretations of such soliton models: one is consistent with the transactional interpretation of quantum mechanics, while the other is an entirely classical model in which we do not have to abandon the idea of a single world where action is local and causal.


This project explores stakeholders' perceptions of the role of the International English Language Testing System (IELTS) in the admissions processes of UK higher education (HE) institutions. It draws on two pieces of empirical study: a large-scale questionnaire survey of those responsible for admissions decisions in a range of HE institutions in the pre- and post-1992 sectors; and a smallerscale interview-based qualitative study of a subset of these participants. The empirical data gathered offered insights into the processes of standards-setting in various contexts, highlighted tensions between standards-setting and a growing economic imperative to recruit, and identified a niche for development opportunities in raising stakeholders' awareness of the content and process of IELTS to enhance the quality of decision-making in this area. The study offered a number of recommendations for the designers/producers of IELTS, and for HE institutions. It also highlighted a number of directions for further complementary research.


Background Concussions are a leading cause of sustained physical, cognitive and emotional impairment in both athletes and military personnel. A pathological feature is disinhibited brain frontal and temporal lobe function, with impaired attention, memory, judgment, emotional regulation and decision-making. Objective Conventional neuroimaging has limited ability to detect structural abnormalities in mTBI. Alternatively, a neuroimaging biomarker using MRI magneto-encephalograpy (MEG) is capable of mapping brain wave activity in mTBI. The objective was to use MEG technology to study brain function during a computerized "Go-No Go" vigilance and reaction test in military personnel. Design Prospective, case series clinical study. Setting Active duty infantrymen from the US Marine Corps explosive ordnance disposal program (high concussion risk). Participants 37 male subjects, tested (summer of 2013) during pre-deployment training at Camp Pendleton, CA. Assessment of risk factors The subjects completed neuroimaging, neurocognitive assessment and clinical interviews. Each provided data on mTBI, post-traumatic stress disorder (PTSD) symptoms, and had a MEG scan while performing the neurocognitive Go-NoGo test. Main outcome measurements 1) Motor cortex, frontal and temporal lobe activation, 2) commission errors (reacting when not supposed to), 3) PTSD and mTBI scoring. Results The Go stimulus activated the motor cortex exclusively, while the NoGo stimulus activated the dorsolateral prefrontal cortex (DLPFC) and left mediolateral temporal lobe (MLTL) exclusively. There were statistically significant negative correlations between: DLPFC and commission errors, and MLTL and Clinican-Administered PTSD scale. Conclusions MEG imaging showed regional brain activation patterns during functional tests requiring the individual to act, or to repress action. Lower activation of the frontal and temporal lobes was associated with more errors of inhibition, and greater fear symptoms. These structure-function relationships of the brain may be useful to predict concussion risk or monitor recovery. The subjects were deployed overseas (Fall 2013), and will be retested post-deployment (expected Spring 2015).


1. The timing of onset of attacks of acute intermittent porphyria (AIP) in relation to the menstrual cycle has been studied in three patients experiencing frequent attacks. Nineteen of their 27 admissions in attack for which no exogenous precipitating causes could be identified were during the 7 days before the onset of menstruation. 2. Haem biosynthesis has been monitored throughout a complete menstrual cycle in six normal females and compared with that in male control subjects. In the females, there was marked fluctuation in the activity of the rate-controlling enzyme of haem biosynthesis, δ-aminolaevulinate (ALA) synthase, which was monitored in peripheral leucocytes. The fluctuation did not show any clear association with menstruation and no association was found between the enzyme activity and ovarian or adrenal steroid production as monitored by measurement of plasma concentrations of androstenedione, dehydroepiandrosterone (DHA), dehydroepiandrosterone sulphate (DHAS), testosterone, oestradiol and progesterone. The activity of uroporphyrinogen I (URO) synthase, the enzyme which is deficient in AIP, was monitored in peripheral erythrocytes of four of the normal female subjects and was similar to that found in four male control subjects. The urinary excretion of ALA and porphobilinogen (PBG) was also similar in the male and female subjects and there was no association with the phase of the menstrual cycle or activity of the enzymes studied. 3. Studies of haem biosynthesis have been made throughout a complete menstrual cycle in a 26 year old female with latent AIP. The activity of leucocyte ALA synthase showed more marked fluctuation than in the normal female subjects and was highest at the time of menstruation. No association was apparent between the activity of ALA synthase and plasma concentrations of androstenedione, DHA and DHAS. The fluctuation in activity of erthrocyte URO synthase was similar to that of the normal subjects. The urinary excretion of ALA and PBG was normal throughout and showed no correlation with fluctuations in enzyme activity. 4. The human menstrual cycle modifies haem biosynthesis in normal subjects as well as in subjects with latent and manifested AIP. 5. The human female menstrual cycle modifies haem biosynthesis in peripheral blood cells as well as in the liver.


The delays in the release of macroeconomic variables such as GDP mean that policymakers do not know their current values. Thus, nowcasts, which are estimates of current values of macroeconomic variables, are becoming increasingly popular. This paper takes up the challenge of nowcasting Scottish GDP growth. Nowcasting in Scotland, currently a government office region within the United Kingdom, is complicated due to data limitations. For instance, key nowcast predictors such as industrial production are unavailable. Accordingly, we use data on some non-traditional variables and investigate whether UK aggregates can help nowcast Scottish GDP growth. Such data limitations are shared by many other sub-national regions, so we hope this paper can provide lessons for other regions interested in developing nowcasting models.


This study investigated two information-processing modes for political messages from favored politicians: "biased" systematic processing and heuristic processing. In an experiment, college students (N = 183) with different levels of political interest received messages about unfamiliar political issues from either a favored or a less favored candidate in the 2008 U.S. presidential election. For those with low levels of political interest, source favorability had a direct effect on attitudes, indicating heuristic processing. For those with high political interest, source favorability had an indirect effect on attitudes through message-relevant thoughts, indicating biased systematic processing. Theoretical and practical implications of the findings are discussed.


Reversible logic synthesis is important for the design of conventional logic systems such as adiabatic logic and also for quantum logic systems since all quantum logic gates are necessarily reversible in nature. A framework is presented that improves reversible logic synthesis by employing a dynamically determined variable order for quantum multiple-valued decision diagrams (QMDD). We demonstrate our approach through augmentation of the Miller-Maslov-Dueck (MMD) synthesis algorithm that processes the complete function specification in lexicographical order with our technique. We represent and minimize the complete specification with the QMDD and then synthesize the function specification based on the minimized variable order. The framework produces significantly smaller reversible circuits in many cases. Experimental results also show the effectiveness of using the QMDD size as a measure of the complexity of MVL and binary reversible circuits.


This week we have the pleasure of hearing from Dr. Carol Nadelson, who delivered her speech titled "Creating Your Legacy" at the University of Rochester School of Medicine and Dentistry 2017 commencement. In 1985, Dr. Nadelson became the first female president of the American Psychiatric Association. She was also the first female editor-in-chief of the APA Press, and the first director of Partners Office for Women's Careers at Brigham and Women's Hospital, where she continues as the director today. As a Harvard Medical School psychiatrist and Brigham and Women's Hospital expert on promoting academic medical careers for women, she has had a major influence on the lives of women in medicine by advocating for mental health resources and by leading the office for the professional development, career planning, and mentoring of female hospital staff. Dr. Nadelson was elected to the Alpha Omega Alpha medical honor society at the University of Rochester Medical School in 1961. From 1979 to 1993, she served as vice chair of the Department of Psychiatry at the New England Medical Center in Boston. She became a clinical professor of psychiatry at Harvard Medical School in 1995. In 1985, Dr. Nadelson received the Elizabeth Blackwell Award for "contributions to the cause of women in the field of medicine" and in 2002, she was honored with the Alexandra Symonds Award for sustained high-level contributions to the field of psychiatry and leadership in advancing women's health. She currently serves as president and CEO of the American Psychiatric Association Press, president of the Association for Academic Psychiatry, and president of the Group for Advancement of Psychiatry. The road to practicing medicine is arduous, and few will deny this fact.  For Dr. Carol Nadelson—a female in the 1950's—the dream of a career in medicine seemed unachievable.  Giving up on this dream, however, was not an option for Dr. Nadelson. "Most people, including my parents, thought that there were other, more reasonable careers for women. But I was determined……What did I learn from it? To accept challenges, find role models and support, and persist in pursuing my dream. While the threat of imminent failure was always on my mind, I had to learn to believe in myself. " Throughout medical school we are required to memorize an infinite amount of information. We are exposed to brilliant professors who are capable of helping us with this task, and simultaneously inspiring us. For Dr. Nadelson, however, the most informative and inspiring teachers were her patients. "Most important was what I learned from my patients. They taught me to listen and to care for them. It wasn't only a physical exam, a procedure or a new medication; they needed me to understand them, be honest with them, and help them come to terms with their pain, loneliness and fear. They needed to trust that I would commit myself to helping them; they needed caring and hope. Their needs could not be met in short, hurried and impersonal exchanges, nor if I were absorbed with filling out forms, more recently looking away from them to a computer screen." Dr. Nadelson closes with a reminder that we are entering the most noble of careers, a career without bounds, and with unlimited opportunities to apply the skills and knowledge base we have developed. "As I welcome you into this compassionate and honorable profession, always remember that it is a privilege to be accepted into the lives of your patients and to serve them. At every age in our history, being a physician has been demanding, but at this time you face unique obstacles and challenges. You have the opportunity, indeed the mandate, to create a legacy that builds from the past and leads to a better future for medicine, for yourselves and for your patients. Congratulations! "


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Crystallographic data about T-Cell Receptor – peptide – major histocompatibility complex class I (TCRpMHC) interaction have revealed extremely diverse TCR binding modes triggering antigen recognition. Understanding the molecular basis that governs TCR orientation over pMHC is still a considerable challenge. We present a simplified rigid approach applied on all non-redundant TCRpMHC crystal structures available. The CHARMM force field in combination with the FACTS implicit solvation model is used to study the role of long-distance interactions between the TCR and pMHC. We demonstrate that the sum of the coulomb interactions and the electrostatic solvation energies is sufficient to identify two orientations corresponding to energetic minima at 0° and 180° from the native orientation. Interestingly, these results are shown to be robust upon small structural variations of the TCR such as changes induced by Molecular Dynamics simulations, suggesting that shape complementarity is not required to obtain a reliable signal. Accurate energy minima are also identified by confronting unbound TCR crystal structures to pMHC. Furthermore, we decompose the electrostatic energy into residue contributions to estimate their role in the overall orientation. Results show that most of the driving force leading to the formation of the complex is defined by CDR1,2/MHC interactions. This long-distance contribution appears to be independent from the binding process itself, since it is reliably identified without considering neither short-range energy terms nor CDR induced fit upon binding. Ultimately, we present an attempt to predict the TCR/pMHC binding mode for a TCR structure obtained by homology modeling. The simplicity of the approach and the absence of any fitted parameters make it also easily applicable to other types of macromolecular protein complexes.


CONTEXT
Little is known about how state-level driver licensure laws, such as in-person renewal, vision tests, road tests, and the frequency of license renewal relate to the older driver traffic fatality rate.

OBJECTIVE
To determine whether state driver's license renewal policies are associated with the fatality rate among elderly drivers.

DESIGN, SETTING, AND POPULATION
Retrospective, longitudinal study conducted January 1990 through December 2000 of all fatal crashes in the contiguous United States identified in the Fatality Analysis Reporting System, which involved either an older (ages 65-74 years, 75-84 years, and > or =85 years) or middle-aged (ages 25-64 years) driver. Two regression approaches were used to study the effect of state laws mandating in-person renewal, vision tests, road tests, and frequency of license renewal on driver fatalities, controlling for state-level factors including the number of licensed elderly drivers, primary and secondary seatbelt laws, maximum speed limit laws, blood alcohol level of 0.08, and administrative license revocation drinking and driving laws, per capita income, and unemployment rate. The first regression approach examined only elderly driver fatalities and the second approach examined daytime elderly driver fatalities and used daytime fatalities among middle-aged drivers as a general control for unobserved variation across states and over time.

MAIN OUTCOME MEASURES
Older driver fatalities and older and middle-aged daytime driver fatalities.

RESULTS
Among individuals aged 85 years or older, there were a total of 4605 driver fatalities and 4179 daytime driver fatalities during the study period. For this age cohort, after controlling for middle-aged daytime driver deaths, states with in-person license renewal were associated with a lower driver fatality rate (incident rate ratio [RR], 0.83; 95% confidence interval [CI], 0.72-0.96). This was the only policy related to older drivers that was significantly associated with a lower fatality risk across both regression models. Thus, state-mandated vision tests, road tests, more frequent license renewal, and in-person renewal (for individuals aged 65-74 years and 75-84 years) were not found to be independently associated with the fatality rate among older drivers in the 2 models.

CONCLUSIONS
In-person license renewal was related to a significantly lower fatality rate among the oldest old drivers. More stringent state licensure policies such as vision tests, road tests, and more frequent license renewal cycles were not independently associated with additional benefits.


OBJECTIVE. The growing shift toward home care services assumes that "being home is good" and that this is the most desirable option. Although ethical issues in medical decision-making have been examined in numerous contexts, home care decisions for technology-dependent children and the moral dilemmas that this population confronts remain virtually unknown. This study explored the moral dimension of family experience through detailed accounts of life with a child who requires assisted ventilation at home. This study involved an examination of moral phenomena inherent in (1) the individual experiences of the ventilator-assisted child, siblings, and parents and (2) everyday family life as a whole. METHODS. A qualitative method based on Richard Zaner's interpretive framework was selected for this study. The population of interest for this study was the families of children who are supported by a ventilator or a positive-pressure device at home. Twelve families (38 family members) were recruited through the Quebec Program for Home Ventilatory Assistance. Children in the study population fell into 4 diagnostic groups: (1) abnormal ventilatory control (eg, central hypoventilation syndrome), (2) neuromuscular disorders, (3) spina bifida, and (4) craniofacial or airway abnormalities resulting in upper airway obstruction. All 4 of these diagnostic groups were included in this study. Among the 12 children recruited, 4 received ventilation via tracheostomies, and 8 received ventilation with face masks. All of the latter received ventilation only at night, except for 1 child, who received ventilation 24 hours a day. Family moral experiences were investigated using semistructured interviews and fieldwork observations conducted in the families' homes. RESULTS. Data analysis identified 6 principal themes. The themes raised by families whose children received ventilation invasively via a tracheostomy were not systematically different or more distressed than were families of children with face masks. The principal themes were (1) confronting parental responsibility: parental responsibility was described as stressful and sometimes overwhelming. Parents needed to devote extraordinary care and attention to their children's needs. They struggled with the significant emotional strain, physical and psychological dependence of the child, impact on family relationships, living with the daily threat of death, and feeling that there was "no free choice" in the matter: they could not have chosen to let their child die. (2) Seeking normality: all of the families devoted significant efforts toward normalizing their experiences. They created common routines so that their lives could resemble those of "normal" families. These efforts seemed motivated by a fundamental striving for a stable family and home life. This "striving for stability" was sometimes undermined by limitations in family finances, family cohesion, and unpredictability of the child's condition. (3) Conflicting social values: families were offended by the reactions that they faced in their everyday community. They believe that the child's life is devalued, frequently referred to as a life not worth maintaining. They felt like strangers in their own communities, sometimes needing to seclude themselves within their homes. (4) Living in isolation: families reported a deep sense of isolation. In light of the complex medical needs of these children, neither the extended families nor the medical system could support the families' respite needs. (5) What about the voice of the child? The children in this study (patients and siblings) were generally silent when asked to talk about their experience. Some children described their ventilators as good things. They helped them breathe and feel better. Some siblings expressed resentment toward the increased attention that their ventilated sibling was receiving. (6) Questioning the moral order: most families questioned the "moral order" of their lives. They contemplated how "good things" and "bad things" are determined in their world. Parents described their life as a very unfair situation, yet there was nothing that they could do about it. Finally, an overarching phenomenon that best characterizes these families' experiences was identified: daily living with distress and enrichment. Virtually every aspect of the lives of these families was highly complicated and frequently overwhelming. An immediate interpretation of these findings is that families should be fully informed of the demands and hardships that would await them, encouraging parents perhaps to decide otherwise. This would be but a partial reading of the findings, because despite the enormous difficulties described by these families, they also reported deep enrichments and rewarding experiences that they could not imagine living without. Life with a child who requires assisted ventilation at home involves living every day with a complex tension between the distresses and enrichments that arise out of this experience. The conundrum inherent in this situation is that there are no simple means for reconciling this tension. This irreconcilability is particularly stressful for these families. Having their child permanently institutionalized or "disconnected" from ventilation (and life) would eliminate both the distresses and the enrichments. These options are outside the realm of what these families could live with, aside from the 1 family whose child is now permanently hospitalized, at a tremendous cost of guilt to the family. CONCLUSIONS. These findings make important contributions by (1) advancing our understanding of the moral experiences of this group of families; (2) speaking to the larger context of other technology-dependent children who require home care; (3) relating home care experiences to neonatal, critical care, and other hospital services, suggesting that these settings examine their approaches to this population that may impose preventable burdens on the lives of these children and their families; and (4) examining a moral problem with an empirical method. Such problems are typically investigated through conceptual analyses, without directly examining lived experience. These findings advance our thinking about how we ought to care for these children, through a better understanding of what it is like to care for them and the corresponding major distresses and rewarding enrichments. These findings call for an increased sensitization to the needs of this population among staff in critical care, acute, and community settings. Integrated community support services are required to help counter the significant distress endured by these families. Additional research is required to examine the experience of other families who have decided either not to bring home their child who requires ventilation or withdraw ventilation and let the child die.