BACKGROUND
The sedation needs of critically ill patients have been recognized as a core component of critical care and meeting these is vital to assist recovery and ensure humane treatment. There is growing evidence to suggest that sedation requirements are not always optimally managed. Sub-optimal sedation incorporates both under- and over-sedation and has been linked to both short-term (e.g. length of stay) and long-term (e.g. psychological recovery) outcomes. Various strategies have been proposed to improve sedation management and address aspects of assessment as well as delivery of sedation.

OBJECTIVES
To assess the effects of protocol-directed sedation management on the duration of mechanical ventilation and other relevant patient outcomes in mechanically ventilated intensive care unit (ICU) patients. We looked at various outcomes and examined the role of bias in order to examine the level of evidence for this intervention.

SEARCH METHODS
We searched the Cochrane Central Register of Controlled trials (CENTRAL) (2013; Issue 11), MEDLINE (OvidSP) (1990 to November 2013), EMBASE (OvidSP) (1990 to November 2013), CINAHL (BIREME host) (1990 to November 2013), Database of Abstracts of Reviews of Effects (DARE) (1990 to November 2013), LILACS (1990 to November 2013), Current Controlled Trials and US National Institutes of Health Clinical Research Studies (1990 to November 2013), and reference lists of articles. We re-ran the search in October 2014. We will deal with any studies of interest when we update the review.

SELECTION CRITERIA
We included randomized controlled trials (RCTs) conducted in adult ICUs comparing management with and without protocol-directed sedation.

DATA COLLECTION AND ANALYSIS
Two authors screened the titles and abstracts and then the full-text reports identified from our electronic search. We assessed seven domains of potential risk of bias for the included studies. We examined the clinical, methodological and statistical heterogeneity and used the random-effects model for meta-analysis where we considered it appropriate. We calculated the mean difference (MD) for duration of mechanical ventilation and risk ratio (RR) for mortality across studies, with 95% confidence intervals (CI).

MAIN RESULTS
We identified two eligible studies with 633 participants. Both included studies compared the use of protocol-directed sedation, specifically protocols delivered by nurses, with usual care. We rated the risk of selection bias due to random sequence generation low for one study and unclear for one study. The risk of selection bias related to allocation concealment was low for both studies. We also assessed detection and attrition bias as low for both studies while we considered performance bias high due to the inability to blind participants and clinicians in both studies. Risk due to other sources of bias, such as potential for contamination between groups and reporting bias, was considered unclear. There was no clear evidence of differences in duration of mechanical ventilation (MD -5.74 hours, 95% CI -62.01 to 50.53, low quality evidence), ICU length of stay (MD -0.62 days, 95% CI -2.97 to 1.73) and hospital length of stay (MD -3.78 days, 95% CI -8.54 to 0.97) between people being managed with protocol-directed sedation versus usual care. Similarly, there was no clear evidence of difference in hospital mortality between the two groups (RR 0.96, 95% CI 0.71 to 1.31, low quality evidence). ICU mortality was only reported in one study preventing pooling of data. There was no clear evidence of difference in the incidence of tracheostomy (RR 0.77, 95% CI 0.31 to 1.89). The studies reported few adverse event outcomes; one study reported self extubation while the other study reported re-intubation; given this difference in outcomes, pooling of data was not possible. There was significant heterogeneity between studies for duration of mechanical ventilation (I(2) = 86%, P value = 0.008), ICU length of stay (I(2) = 82%, P value = 0.02) and incidence of tracheostomy (I(2) = 76%, P value = 0.04), with one study finding a reduction in duration of mechanical ventilation and incidence of tracheostomy and the other study finding no difference.

AUTHORS' CONCLUSIONS
There is currently insufficient evidence to evaluate the effectiveness of protocol-directed sedation. Results from the two RCTs were conflicting, resulting in the quality of the body of evidence as a whole being assessed as low. Further studies, taking into account contextual and clinician characteristics in different ICU environments, are necessary to inform future practice. Methodological strategies to reduce the risk of bias need to be considered in future studies.


Taffs Well is the only thermal spring in Wales, with an average temperature of 21.6°C ± 0.5°C. The River Taff is adjacent to the spring and removal of a weir and work on flood defences has reduced mixing with flood water from the river. This has enabled data to be gathered that more closely represent the thermal water end-member than previously possible. Limited interaction with modern waters is confirmed by tritium, nitrate, CFC and SF6 concentrations below or close to lower detection limits, showing at most 6% mixing with modern waters. 14C dating suggests a conservative age estimate of at least 5000 years.
Values for dissolved noble gases suggest that the waters originate as rainfall at an altitude several hundred metres higher than the spring. The northern Carboniferous Limestone outcrop is proposed, which would then require recharged waters to flow to a depth of 400m and distance of 25km, following the synclinal structure of the South Wales Coalfield, to discharge at the spring. Sr isotope data suggest interaction with the Marros Group (formerly known as the Millstone Grit), the waters flowing within or close to the contact between the Carboniferous Limestone and Marros Group before rising via the Tongwynlais Fault.


The aim of this paper is to shift attention to forms of public engagement and collective action which can be understood as "digital vigilantism". These involve various instances of "taking the law into your own hands" online, building on the specificities of the digital environment in order to exert forms of direct punishment. Drawing on both digital ethnography and political theory, I will first provide a more precise definition of what is meant by digital vigilantism, and how it relates to other (non-digital) contexts and specifically to the United States political history and political culture. I will then provide several case studies of online vigilantism both in the US and in France, which will serve to illustrate the phenomenon, its many different forms and the "action repertoires" which can be identified. Finally, a series of further questions will be outlined and addressed in order to understand if, indeed, such phenomena qualify as forms of political engagement; and how they question existing institutions – the judicial system, the press, the police – whose role is normally to deal with conflict resolution.


2018 University Libraries Undergraduate Research Award Winner---On October 9, 2016, armed residents of Rakhine, Myanmar ambushed three Border Guard posts, triggering a massive military backlash against the local Rohingya population. United Nations human rights chief Zeid Ra'ad al-Hussein has described the military's actions as a "textbook example of ethnic cleansing," and nearly 1.04 million Rohingya have sought refuge in neighboring Bangladesh since the crisis erupted. This scope of violence and displacement begs the following questions: are there underlying social causes to the 2016-2018 Rohingya ethnic cleansing crisis beyond the October 9, 2016 ambush, and if so, how can these underlying social causes inform appropriate solutions moving forward? Further, what political barriers stand in the way of resolution? Utilizing a qualitative research analysis this project identified which social causes have contributed to the current crisis's emergence: 1) periods of political turnover from 1784 to 1826, 2) the historical tension between Buddhist and Muslim communities in Rakhine, and 3) the military's functional defense of the Burmese-Buddhist identity. Using these findings, this project then evaluates the 2017 bilateral repatriation agreement between Myanmar and Bangladesh, concluding that the agreement is insufficient to address underlying social causes to the crisis, and argues that future relief efforts rather should prioritize local, aid-based solutions and humanitarian concerns in Bangladesh.


Earthmoving operations have significant importance, particularly for civil infrastructure projects. The performance of these operations should be monitored regularly to support timely recognition of undesirable productivity variances. Although productivity assessment occupies high importance in earthmoving operations, it does not provide sufficient information to assist project managers in taking the necessary actions in a timely manner. Assessment only is not capable of identifying problems encountered in these operations and their causes. Many studies recognized conditions and related factors that influence productivity of earthmoving operations. These conditions are mainly project-specific and vary from one project to another. Most of reported work in the literature focused on assessment rather than analysis of productivity.
This study presents three integrated models that automate productivity measurement and analysis processes with capabilities to detect different adverse conditions that influence the productivity of earthmoving operations. The models exploit innovations in wireless and remote sensing technologies to provide project managers, contractors, and decision makers with a near-real-time automated productivity measurement and analysis. The developed models account for various uncertainties associated with earthmoving projects.
The first model introduces a fuzzy-based standardization for customizing the configuration of onsite data acquisition systems for earthmoving operations. While the second model consists of two interrelated modules. The first is a customized automated data acquisition module, where a variety of sensors, smart boards, and microcontrollers are used to automate the data acquisition process. This module encompasses onsite fixed unit and a set of portable units attached to each truck used in the earthmoving fleet. The fixed unit is a communication gateway (Meshlium®), which has integrated MySQL database with data processing capabilities. Each mobile unit consists of a microcontroller equipped with a smart board that hosts a GPS module as well as a number of sensors such as accelerometer, temperature and humidity sensors, load cell and automated weather station. The second is a productivity measurement and analysis module, which processes and analyzes the data collected automatically in the first module. It automates the analysis process using data mining and machine learning techniques; providing a near-real-time web-based visualized representation of measurement and analysis outcomes. Artificial Neural Network (ANN) was used to model productivity losses due to the existence of different influencing conditions.
Laboratory and field work was conducted in the development and validation processes of the developed models. The work encompassed field and scaled laboratory experiments. The laboratory experiments were conducted in an open to sky terrace to allow for a reliable access to GPS satellites. Also, to make a direct connection between the data communication gateway (Meshlium®), initially installed on a PC computer to observe the received data latency. The laboratory experiments unitized 1:24 scaled loader and dumping truck to simulate loading, hauling and dumping operations. The truck was instrumented with the microcontroller equipped with an accelerometer, GPS module, load cell, and soil water content sensor. Thirty simulated earthmoving cycles were conducted using the scaled equipment. The collected data was recorded in a micro secure digital (SD) card in a comma separated value (CSV) format. The field work was carried out in the city of Saint-Laurent, Montreal, Quebec, Canada using a passenger vehicle to mimic the hauling truck operational modes. Fifteen Field simulated earthmoving cycles were performed. In this work two roads with different surface conditions, but of equal length (1150 m) represented the haul and return roads. These two roads were selected to validate the developed road condition analysis algorithm and to study the model's capability in determining the consequences of adverse road conditions on the haul and return durations and thus on the tuck and fleet productivity. The data collected from the lab experiments and field work was used as input for the developed model. The developed model has shown perfect recognition of the state of truck throughout the fifteen field simulated earthmoving cycles. The developed road condition analysis algorithm has demonstrated an accuracy of 83.3% and 82.6% in recognizing road bumps and potholes, respectively. Also, the results indicated tiny variances in measuring the durations compared with actual durations using time laps displayed on a smart cell telephone; with an average invalidity percentage AIP% of 1.89 % and 1.33% for the joint hauling and return duration and total cycle duration, respectively.


Indications for endovascular aneurysm repair cannot be considered absolute. Patient selection depends on the availability of product, the skills and experience of the implant team, and the anatomy and overall condition of the patient. It is unclear if these procedures should be offered to all those with large aneurysms, restricted to high-risk or low-risk patients, or offered to patients with smaller aneurysms not currently considered for operation. More patients will be suitable as more devices become available, skills improve, sheath sizes decrease, and long-term data showing efficacy become available. Significant anatomic factors affecting patient selection include the length, shape, and angulation of the infrarenal neck, any involvement of the common iliac arteries with either aneurysmal or occlusive disease, occlusive disease or marked tortuosity of the ileofemoral access vessels, or intrinsically small iliac arteries. Early results indicate that the procedure is at least as safe as conventional repair, and patients can return to normal activities sooner. What we do not know is whether the natural history of aneurysms (i.e., death from rupture) is altered by an endovascular device. We are just learning the failures modes, and some were not anticipated in the design phase. We do not know if progressive dilatation of the attachments sites and aneurysm remodeling will result in device migration but the US IDE experience and reports from Europe suggest that these phenomena will occur. Our early experience suggests that we should avoid endografting in young, otherwise healthy patients with long life expectancies.


SAFI, M. I., A. BULAD and A. BLAWENAH, 2007. Flower yield and quality of Lilium aziatische irrigated with different types of water. Bulg. J. Agric. Sci., 13: 51-54 The effect of three water types with different salinity levels; the effluent from Al-Baq'a treatment plant 'EF' (2.02 dS/m), and extra treated wastewater after Ultra Filtration membrane 'UF' (1.91 dS/m), and Mixed water (50 % after Reverse Osmosis membrane 'RO' with 50 % of UF; 1.15 dS/m) on the performance , flower production and quality of three cultivars of Lilium aziatische cv. "Elite, Prato, and Pollyanna" planted in soil under the plastic house conditions was investigated during the year 2005. Water type had a significant effect on lily flower yield and quality produced. In general, the three lily cultivars produced the highest flower yields kg/m 2 when irrigated with the UF water type compared to the EF and Mix water treatments. The significantly highest flower yield was recorded for the Elite followed by Prato cultivar irrigated with the UF water type. While the lowest flower yields were recorded for the three cultivars irrigated with the Mix water treatment. We can notice that this increase in flower yield weight is a reflection of longer and thicker stalks and more buds per stalk produced by Elite and Prato irrigated with UF compared to the other water types. The results strongly indicate that the lower the percentage of buds droped per stalk the higher the number of flower buds remained on stalk in relation to water type used for irrigation


Laura Doyle, "At World9s Edge: Post/Coloniality, Charles Maturin, and the Gothic Wanderer" (pp. 513–547) The Gothic text has been shown to represent colonialism9s crimes through its literary tropes of imprisonment, terror, rape, and tyranny. This essay takes a further step to propose that Gothic texts also register the historical resistance to colonialism9s crimes. That is, they refer to anti-colonial insurgency—in Ireland, India, the Caribbean, and elsewhere—in the process evincing ambivalent anxieties about global, imperial instability. After reviewing the Gothic's entanglement with discourses of both liberation and barbarism, reflective of its contradictory political investments, the essay focuses on Charles Maturin9s Melmoth the Wanderer (1820) to demonstrate the ways in which Gothic texts are structured against insurgency even as, in their "wandering," haunted figures, they unveil a world in turmoil.


This second edition of the authors' influential LAWYERS, CLIENTS, AND MORAL RESPONSIBILITY explores the place of moral and social values in the law office with the use of engaging stories, dialogues and discussion. The book presents a practical way for lawyers to raise and discuss moral issues with clients. It will serve as an engaging supplement to professional responsibility, client-counseling, and legal clinic courses. This second edition adds substantial discussion of the place of moral discourse within law firms and corporations, ways to engage the powerless client in moral discourse, and the place of social justice in client counseling.


This paper examines how wealth and income inequality dynamics are related to fluctuations in the functional income distribution over the business cycle. In a panel estimation for OECD countries between 1970 and 2016, although inequality is, on average countercyclical and significantly associated with the capital share, one-third of the countries display a pro- or noncyclical relationship. To analyze the observed pattern, we incorporate distributive shocks into an RBC model, where agents are ex ante heterogeneous with respect to wealth and ability. We find that whether wealth and income inequality behave countercyclically or not depends on the elasticity of intertemporal substitution and the persistence of shocks. We match the model to quarterly US data using Bayesian techniques. The parameter estimates point toward a non-monotonic relationship between productivity and inequality fluctuations. On impact, inequality increases in response to TFP shocks but subsequently declines. Furthermore, TFP shocks explain 17% of inequality fluctuations.


In "The Quest" Mircea Eliade stresses the cultural function that a study of the history of religions can play in a secularized society. He writes for the intelligent general reader in the hope that what he calls a new humanism "will be engendered by a confrontation of modern Western man with unknown or less familiar worlds of meaning." "Each of these essays contains insights which will be fruitful and challenging for professional students of religion, but at the same time they all retain the kind of cultural relevance and clarity of style which makes them accessible to anyone seriously concerned with man and his religious possibilities." Joseph M. Kitagawa, "Religious Education""


This paper shows how the performance budget of a local government organization, in this case a province in the Netherlands, can be attuned to the specific task characteristics of the programmes in these budgets. Three ways of alignment are suggested: differentiating between standardized and complex programmes; focussing on the politically most relevant programmes in order to avoid information overload; and distinguishing between the types of performance information in terms of the role of the province in the programme (facilitator versus executor) and the stage in the policy making cycle (policy development, policy elaboration or policy execution). These suggestions challenge the generally straightforward NPM rationale of performance budgeting, in which standardized outputs are directly related to resources. Our empirical research shows on the one hand that the redesigned programme budget based on the above principles received substantial approval of its users, i.e., the provincial councillors. On the other hand, as regards the use of this programme budget the picture is rather diffuse, i.e., the majority of the councillors indicate that they use the information rather intensively, but its formal use in official Council and Council committee meetings remains limited.


Black holes are a powerful setting for studying general relativity and theories beyond GR. However, analytical solutions for rotating black holes in beyond-GR theories are difficult to find because of the complexity of such theories. In this paper, we solve for the deformation to the near-horizon extremal Kerr metric due to two example string-inspired beyond-GR theories: Einstein-dilaton-Gauss-Bonnet and dynamical Chern-Simons theory. We accomplish this by making use of the enhanced symmetry group of NHEK and the weak-coupling limit of EdGB and dCS. We find that the EdGB metric deformation has a curvature singularity, while the dCS metric is regular. From these solutions, we compute orbital frequencies, horizon areas, and entropies. This sets the stage for analytically understanding the microscopic origin of black hole entropy in beyond-GR theories.


A matrix stimulation candidate screening workflow was developed with the objective to reduce the time and effort in identifying under-performing wells. The workflow was initially tested manually for few fields followed by inclusion in Integrated Operation for an automated screening of wells with suspected formation damage. Analysis done in three fields for stimulation candidate selection will be displayed with actual statistics.
 The main aim of the work was to digitalize the selection of non-performing candidates rather than manually looking into performance of each well. A concept of Formation Damage Indicator (FDI) was combined with Heterogeneity Index (HI) of the formations to screen out the candidates. Separate database sets of Reservoir engineering, Petrophysicist and Production was integrated with suitable programming algorithms to come up with first set of screened wells evaluating well production performances, FDI and HI trends up to over the last 30 years. The shortlisted candidates were further screened on the basis of practical approach such as gas lift optimization, production trending, OWC-GOC contacts, well integrity and well history to come up with second round of screened candidates. The final candidates were analyzed further using nodal analysis models for skin evaluation and expected gain to come up with type of formation damage and expected remedial solution.
 For fields A and D with a total of 210 strings each, the initial FDI and HI screening resulted in 70 and 120 strings being shortlisted, respectively. This was followed by a second round of screening with 25 and 35 strings being further shortlisted as stimulation candidates, respectively. Nodal analysis models indicated presence of high skin in 90% of the selected wells indicating a very good efficiency and function-test of the workflow. In addition to selection of the candidates, the identification of formation damage type was compiled on an asset-wise basis rather than field basis which helped in more efficient planning of remedial treatments using a multiple well campaign approach to optimize huge amount of cost. The entire screening process was done in one month which was earlier a herculean task of almost one year and much more man-hours. With effective manual testing of the workflow in two major fields, workflow was included in Integrated Operations for future automation to conduct the same task in minutes rather than months.
 With this digitalized unique workflow, the selection of under-performing wells due to formation damage is now a one click exercise and a dynamic data. This workflow can be easily operated by any engineer to increase their operational efficiency for flow assurance issues saving tons of cost and time.


Eutrophication of coastal areas as a consequence of the agricultural use of fertilizers is a widespread problem. The development of artificial lakes and constructed wetlands in nutrient rich rivers is a widely used management tool in the fight to decrease eutrophication. Juvenile salmonids that have to negotiate these lakes during their downstream migration to the sea are commonly subjected to high mortality due to increased predation pressure and delayed passage. In this study, we double-tagged 39 brown trout smolts with PIT and radio tags to gain further insight into predation rates and migration patterns during their passage of an artificial lake in a Danish lowland stream in the spring of 2016. Thirty-four of the tagged smolts, caught and released upstream, entered the lake, of which 22 (65 %) successfully exited the lake. Four smolts (12 %) returned upstream to the river. Three smolts were predated in the lake by two northern pike (Esox lucius). Three tags were recovered from the lake bottom and two disappeared out of the study area after a last detection in the lake. Tracking the smolts manually and by automatic listening stations showed highly erratic movement patterns during lake passage. Further, we observed long delays of up to 27 days after the smolts reached the river mouth and before they entered the sea, potentially due to low sea water temperature or due to the stocking of a large amount of hatchery-reared brown trout smolts. The results are discussed in the context of abiotic and biotic factors, that differed considerably in the year 2016 compared with previous years.


The article aims to analyze the connection between economic development, energy consumption, and prices of electricity and gas on one side and of the operation of the Energy Market Operator on the other. For this purpose we use a sample of eight EU countries with well-functioning energy markets but quite diverse characteristics. The results show that Market Operators in more developed countries in the sample have above average activity (according to revenue), and their primary goal is to achieve external economies. A higher level of Market Operator activity (greater revenue) is influenced by the decrease of transaction costs in energy markets and improves the prospect for greater use of energy. An active Market Operator is characteristically associated with international openness in the energy market as well as with the development of gas use in the given country. We find that a better equipped (greater assets used by the Market Operator) and more active (according to revenues) Market Operator is related with relatively higher levels of electricity and natural gas prices.


The technical aspects of dentistry need to be practised with insight into the spectrum of human diseases and illnesses and how these impact upon individuals and society. Application of this insight is critical to decision-making related to the planning and delivery of safe and appropriate patient-centred healthcare tailored to the needs of the individual. Provision for the necessary training is included in undergraduate programmes, but in the United Kingdom and Ireland there is considerable variation between centres without common outcomes. In 2009 representatives from 17 undergraduate dental schools in the United Kingdom and Ireland agreed to move towards a common, shared approach to meet their own immediate needs and that might also be of value to others in keeping with the Bologna Process. To provide a clear identity the term 'Clinical Medical Sciences in Dentistry' was agreed in preference to other names such as 'Human Disease' or 'Medicine and Surgery'. The group was challenged to define consensus outcomes. Contemporary dental education documents informed, but did not drive the process. The consensus curriculum for undergraduate Clinical Medical Sciences in Dentistry teaching agreed by the participating centres is reported. Many of the issues are generic and it includes elements that are likely to be applicable to others. This document will act as a focus for a more unified approach to the outcomes required by graduates of the participating centres and act as a catalyst for future developments that ultimately aim to enhance the quality of patient care.


A novel approach to represent learning in human decision behavior for evacuation scenarios is proposed under the context of an extended Belief-Desire-Intention framework. In particular, we focus on how a human adjusts his perception process (involving a Bayesian belief network) in Belief Module dynamically against his performance in predicting the environment as part of his decision planning function. To this end, a Q-learning algorithm (reinforcement learning algorithm) is employed and further developed. In this work, the human decision behavior model is implemented in AnyLogic agent-based simulation software, and the constructed simulation is used to test the impact of the proposed learning approach on emergency evacuation performance, and initial results look quite promising.


Standard statistical methods often provide no way to make accurate estimates about the characteristics of hidden populations such as injection drug users, the homeless, and artists. In this paper, we further develop a sampling and estimation technique called respondent-driven sampling, which allows researchers to make asymptotically unbiased estimates about these hidden populations. The sample is selected with a snowball-type design that can be done more cheaply, quickly, and easily than other methods currently in use. Further, we can show that under certain specified (and quite general) conditions, our estimates for the percentage of the population with a specific trait are asymptotically unbiased. We further show that these estimates are asymptotically unbiased no matter how the seeds are selected. We conclude with a comparison of respondent-driven samples of jazz musicians in New York and San Francisco, with corresponding institutional samples of jazz musicians from these cities. The results show that some standard methods for studying hidden populations can produce misleading results.


During most of the twentieth century, state and local regulatory bodies coordinated the siting or power plants and transmission lines. These bodies focused on two important issues: 1) the determination of need, so as to avoid unnecessary economic duplication of costly infrastructure; and 2) environmental protection, so as to provide local land use and other environmental concerns input on the placement of necessary generation and transmission facilities. With the rise of a deregulated wholesale power market, the issue of need is increasingly determined by the market, not regulators. Environmental concerns with siting, however, frequently remain contested - especially locally - but the regulatory apparatus for processing these concerns faces new challenges in deregulated markets. As this Essay suggests, environmental concerns in transmission line siting will increasingly be addressed at the federal level, with federal concerns predominating consideration of the issues. The dormant commerce clause does much of the work towards making this a predominantly federal concern, but eventually FERC's jurisdiction over such matters will need to be expanded by statute. Even if Congress does not expand FERC's jurisdiction, this Essay argues that courts can play a positive role to facilitate the resolution of state-federal siting conflicts. A recent siting dispute involving a power line in the Long Island Sound illustrates this fundamental shift in the environmental discourse of siting proceedings, as a well as a need for modifications to federal law regarding transmission siting. Ultimately, FERC may need authority to preempt state siting laws, but absent congressional action courts could enhance competition in electric power markers by empowering state and local siting boards to take into account federal goals in competitive markets in making siting decisions.


Transdermal drug delivery systems (TDDS), also known as "patches," are dosage forms designed to deliver a therapeutically effective amount of drug across a patient's skin. In order to deliver therapeutic agents through the human skin for systemic effects, the comprehensive morphological, biophysical and physicochemical properties of the skin are to be considered. Transdermal delivery provides a leading edge over injectables and oral routes by increasing patient compliance and avoiding first pass metabolism respectively. Transdermal delivery not only provides controlled, constant administration of the drug, but also allows continuous input of drugs with short biological half-lives and eliminates pulsed entry into systemic circulation, which often causes undesirable side effects.  This article deals with the innovations in the field of TDDS to improve the release rate and other parameters and most suitable to the patient. The number of medications and the ways in which they can be administered have expanded dramatically over the years. One such advance has been the development of transdermal delivery systems. The transdermal route of drug delivery has attracted researchers due to many biomedical advantages associated with it. However, excellent impervious nature of skin is the greatest challenge that has to be overcome for successfully delivery of the drug molecules to the systemic circulation via this route. Various types of transdermal approaches used to incorporate the active ingredients include use of prodrugs/lipophilic analogs, permeation enhancers, sub saturated systems and entrapment into vesicular systems. Innovations in technologies continue to occur at a positive rate, making the technology a fertile and vibrant. This article deals with the innovations in the field of TDDS to improve the release rate and other parameters and most suitable to the patient.


A fast and efficient method to calculate time schedules for internal and boundary PRVs and flow modulation curves has been developed and implemented. Both time and flow modulation can be applied to a single inlet DMA. The time modulation methodology is based on solving a nonlinear programming problem (NLP). In addition, Genetic Algorithms (GA) has been proposed and investigated to calculate the optimal coefficients of a second order relationship between the flow and the outlet pressure for a PRV to minimize the background leakage. The obtained curve can be subsequently implemented using a flow modulation controller in a feedback control scheme. The Aquai-Mod ® is a hydraulic device to control and modulate the outlet pressure of a PRV according to the valve flow. The controller was experimentally tested to assess its performance and functionality in different conditions and operating ranges. The mathematical model of the controller has been developed and solved, in both steady state and dynamic conditions. The results of the model have been compared with the experimental data and showed a good agreement in the magnitude and trends. A new method for combined energy and pressure management via integration and coordination of pump scheduling with pressure control aspects has been created. The method is based on formulating and solving an optimisation NLP problem and involves pressure dependent leakage. The cost function of the optimisation problem represents the total cost of water treatment and pumping energy. Developed network scheduling algorithm consists of two stages. The first stage involves solving a continuous problem, where operation of each pump is described by continuous variable. Subsequently, the second stage continuous pump schedules are discretised using heuristic algorithm. Another area of research has been developing optimal feedback rules using GA to control the operation of pump stations. Each pump station has a rule described by two water levels in a downstream reservoir and a value of pump speed for each tariff period. The lower and upper water switching levels of the downstream reservoir correspond to the pump being ―ON‖ or ―OFF‖. The achieved similar energy cost per 1 Ml of pumped water. In the considered case study, the optimal feedback rules had advantage of small number of ON/OFF switches, which increase the pump stations lifetime and reduce the maintenance cost as well.


The promise of randomized controlled trials is that evidence gathered through the evaluation of a specific program helps us—possibly after several rounds of fine-tuning and multiple replications in different contexts—to inform policy. However, critics have pointed out that a potential constraint in this agenda is that results from small "proof-of-concept" studies run by nongovernment organizations may not apply to policies that can be implemented by governments on a large scale. After discussing the potential issues, this paper describes the journey from the original concept to the design and evaluation of scalable policy. We do so by evaluating a series of strategies that aim to integrate the nongovernment organization Pratham's "Teaching at the Right Level" methodology into elementary schools in India. The methodology consists of re-organizing instruction based on children's actual learning levels, rather than on a prescribed syllabus, and has previously been shown to be very effective when properly implemented. We present evidence from randomized controlled trials on the designs that failed to produce impacts within the regular schooling system but helped shape subsequent versions of the program. As a result of this process, two versions of the programs were developed that successfully raised children's learning levels using scalable models in government schools. We use this example to draw general lessons about using randomized control trials to design scalable policies.


An analysis of the electron localization properties in doped graphene is performed by doing a numerical multifractal analysis. By obtaining the singularity spectrum of a tight-binding model, it is found that the electron wave functions present a multifractal behavior. Such multifractality is preserved even for second neighbor interaction, which needs to be taken into account if a comparison is desired with experimental results. States close to the Dirac point have a wider multifractal character than those far from this point as the impurity concentration is increased. The analysis of the results allows to conclude that in the split-band limit, where impurities act as vacancies, the system can be well described by a chiral orthogonal symmetry class, with a singularity spectrum transition approaching freezing as disorder increases. This also suggests that in doped graphene, localization is in contrast with the conventional picture of Anderson localization in two dimensions, showing also that the common belief of the absence of quantum percolation in two dimensional systems needs to be revised.


Species of the Rana kl. esculenta complex from twenty-one localities of the North-Western part of the Balkan Peninsula (Yugoslavia and Macedonia) were analyzed by electophoretic, morphometric and cytogenetic methods. The results of this research revealed that species that belong to the R. kl. esculenta complex from localities in Northern Yugoslavia form a ridibunda/esculenta/lessonae (R-E-L) population system of diploid forms of two parental species and predominantly female hybrids. Pure R. ridibunda populations exist south of the Sava and Danube Rivers. The unequal sex ratio observed in water frog population systems suggests, according to Haldane's rule, that the heterogametic sex suffers the effects of hybridization. Electrophoretic analysis shows that some introgression of ridibunda alleles into -R. lessonae, as well as lessonae into R. ridibunda has taken place. The occurrence of recombinations, and cytogenetic characteristics of the chromosome complements, does not support pure hybri-dogenesis as a general mode of reproduction in the hybrid form R. kl. esculenta from the examined localities.


Existing neuroimaging studies in decision making predominantly employ the fMRI method. Despite its superior spatial resolution, fMRI is an expensive and impractical neuroimaging technology for purchasing behavior studies in the field. This study aims to explore the role of prefrontal cortex during purchasing behavior by utilizing functional nearinfrared (fNIR) spectroscopy; a low-cost, non-invasive and portable optical brain imaging methodology. The findings suggest that fNIRS can be effectively used for developing a neuro-physiologically informed, predictive model of purchasing behavior based on multivariate effects of activations in frontopolar, dorso-medial and dorso-lateral prefrontal cortex.


At present there are two general points of view on the economy of early Canada. The dominant viewpoint is that the economic system was stagnant, due to the exaggerated concentration on the fur trade and insufficiencies of internal and external markets. This viewpoint is disputed with the counterargument put forward that the economy was becoming diversified and strong, and that it was on par with British America in the second quarter of the eighteenth century. However both these viewpoints are backed up by incoherent statistical and literary sources and the evidence is too fragmented to come to a firm conclusion. A more solid foundation for understanding this colony's economic structure and evolution could be produced by rough approximations of real gross domestic product for early Canada. Comprehensive and accurate censuses prepared for Canada by colonial authorities allow for a construction of a constant dollar GDP series. This RGDP series for 1695-1739 enables the computation of a per capita output series and growth rate, and permit for empirically grounded comparisons of early Canada with British America. The results, which are negatively biased, show an overall annual growth rate of 0.5 to 0.7 percent, which is on a par with some estimates of British America's annual growth. The majority of this growth is from the agricultural sector, though the non-agricultural sector also had a good growth rate. While at times the fur trade did have a positive impact on the growth rate, it was in decline. In conclusion, it appears that early Canada's economy was not stagnant nor relatively impoverished and instead was economically dynamic and prosperous.


Abstract : Planning is an essential part of intelligent behavior and a ubiquitous task for both humans and rational agents. One framework for planning in the presence of uncertainty is probabilistic planning in which actions are described by a probability distribution over their possible outcomes. Probabilistic planning has been applied to different real-world scenarios such as public health sustainability and robotics; however, the usage of probabilistic planning in practice is limited due to the poor performance of existing planners. In this thesis, we introduce a novel approach to effectively solve probabilistic planning problems by relaxing them into short-sighted problems. A short-sighted problem is a relaxed problem in which the state space of the original problem is pruned and artificial goals are added to heuristically estimate the cost of reaching an original goal from the pruned states. Differently from previously proposed relaxations, short-sighted problems maintain the original structure of actions and no restrictions are imposed in the maximum number of actions that can be executed. Therefore, the solutions for short-sighted problems take into consideration all the probabilistic outcomes of actions and their probabilities. In this thesis, we also study different criteria to generate short-sighted problems, i.e., how to prune the state space, and the relation between the obtained short-sighted models and previously proposed relaxation approaches. We present different planning algorithms that use short-sighted problems in order to solve probabilistic planning problems. These algorithms iteratively generate and execute optimal policies for short-sighted problems until the goal of the original problem is reached. We also formally analyze the introduced algorithms, focusing on their optimality guarantees with respect to the original probabilistic problem.


The stem cell-determining transcription factor Sox2 is required for the maintenance of normal neural stem cells. In this study, we investigated the requirement for Sox2 in neural cancer stem-like cells using a conditional genetic deletion mutant in a mouse model of platelet-derived growth factor-induced malignant oligodendroglioma. Transplanting wildtype pHGG cells into the brain generated lethal tumors, but mice transplanted with Sox2deleted cells remained free of tumors. Loss of the tumor-initiating ability of Sox2-deleted cells was reversed by lentiviral-mediated expression of Sox2. In cell culture, Sox2deleted tumor cells were highly sensitive to differentiation stimuli, displaying impaired proliferation, increased cell death, and aberrant differentiation. Gene expression analysis revealed an early transcriptional response to Sox2 loss. The observed requirement of oligodendroglioma stem cells for Sox2 suggested its relevance as a target for therapy. In support of this possibility, an immunotherapeutic approach based on immunization of mice with SOX2 peptides delayed tumor development and prolonged survival. Taken together, our results showed that Sox2 is essential for tumor initiation by mouse pHGG cells, and we illustrated a Sox2-directed strategy of immunotherapy to eradicate tumorinitiating cells.


AIMS
Anomalous origin of the coronary artery (AOCA) with an inter-arterial course (IAC) between the great vessels poses a risk for a life-threatening cardiovascular event. We assessed, in a registry-based study, the clinical features, treatment strategies, and prognoses of life-threatening cardiovascular events ensuant to AOCA.

METHODS AND RESULTS
Included were 65 AOCA patients (48 men/17 women, aged 41 ± 23 years) from 40 clinical centres who had experienced sudden cardiac arrest (SCA) (n = 30), acute myocardial infarction (AMI) (n = 5), angina (n = 23), or syncope (n = 7). The anomalous vessel was the right coronary artery in 72% of patients and left coronary artery in 28%; the ostium was slit-like in 42%. Coronary luminal narrowing ≥75% was absent in patients with SCA or syncope (86% and 57%, respectively), but occlusion or narrowing was seen in those with AMI (100%) or angina (52%). Age ≤40 years, male sex, sporting activity, absence of prodromal symptoms, acutely angled (≤30°) take-off from the aorta, and absence of luminal narrowing of the IAC segment were associated with SCA in this patient group. Coronary vasospasm was inducible in 12 of 17 patients without coronary narrowing. Management included surgical revascularization (n = 26) percutaneous coronary intervention (n = 9), and medical treatment (n = 26). Four SCA patients died while hospitalized; no others died during the median 5.0 (range, 1.8-7.0)-year follow-up period.

CONCLUSIONS
In patients with AOCA, age ≤40 years, male sex, sporting activity, and an acute take-off angle appear to be risk factors for SCA. Appropriate management can be beneficial. Confirmation in a large-scale study is warranted.


As in other countries, there is a growing public, policy and business interest in the UK in the roles and potential of community-led initiatives for sustainable energy consumption and production. Such initiatives include green lifestyle-based activities to reduce energy consumption (e.g. Transition Towns, and Carbon Reduction Action Groups), more traditional behaviour change initiatives such as neighbourhood insulation projects and energy-saving campaigns, as well as renewable energy generation projects such as community-owned windfarms and biofuel projects. Case studies of specific projects identify a variety of rationales amongst participants, whilst policy interest suggests a more instrumental concern for facilitating additional, larger-scale sustainable energy transitions. Amongst participant rationales are ideas that bottom-up, community-based projects deliver energy savings and behaviour changes that top-down policy instruments cannot achieve, due to the greater local knowledge and engagement they embody, the sense of common ownership and empowerment, and the social capital and trust that is generated among local actors. These resources provide organisational and values-based 'grassroots innovations' which experiment with new consumption practices based on alternative 'new economics' values. However, previous research shows 'grassroots innovations' face a series of critical challenges requiring support to overcome, in order to achieve their potential benefits more widely. This includes developing 'niche' networks for mobilising reforms both to highly centralised energy institutions and infrastructures, as well as deeply ingrained social practices of 'normal' energy consumption and everyday life. What makes this experience fascinating for the purposes of the SCORAI workshop is the way these community-based initiatives are trying to develop new energy-related consumption practices with a view to the socio-technical transition to local, renewable or lower carbon energy systems. Understandably, many projects remain practically focused on securing early successes and resourcing their long-term survival. However, the institutional and infrastructure reforms that will help in this endeavour require strategies for addressing the wider (national and international) political economy of consumption which adopts an ecological modernisation approach to sustainability. In surveying the community energy scene in the UK, our paper pays particular attention to this last issue.


<br>All banknotes have security features which are intended to help to determine whether a banknote is false or genuine. Typically however, the general public has limited knowledge of where on a banknote these security features can be found. Here we tested whether counterfeit detection can be improved with the help of salient cues, designed to guide bottom-up visuospatial attention. We also tested the influence of the participant's a priori level of trust in the authenticity of the banknote. In an online study (N=422), a demographically diverse panel of Dutch participants distinguished genuine banknotes from banknotes with one (left- or right-sided) counterfeited security feature. Either normal banknotes (without novel design elements) or banknotes that contained a salient cue (a pink rectangular frame) were presented for 1s. To manipulate the participant's level of trust, trials were administered in three blocks, whereby at the start of each block, participants were instructed that either one third, one half, or two thirds of the upcoming banknotes were counterfeit (though the true ratio was always 1:1). We hypothesized (i) that in the presence of a salient cue, counterfeits would be better detected when the cue was valid (whereby the location of the salient element matched the location of the counterfeited security feature) than when it was invalid; and (ii) that this effect would be stronger with lower trust. Our hypotheses were partly confirmed: counterfeit detection improved with valid cues and decreasing trust, but the level of trust did not modulate the cueing effect. As the overall detection performance was rather poor, we replicated the study with a sample of university students (N=66), this time presenting stimuli until response. While indeed observing better overall performance, all other patterns were replicated. Two lessons can be learned here. Firstly, as lower trust yields better authentication accuracy, central bankers may see merit in raising awareness about the existence of counterfeit banknotes. Secondly, our findings provide a proof of concept for the idea that bottom-up saliency can be used to aid banknote authentication.


Bovine herpesvirus 1 (BHV-1) establishes a latent infection in sensory ganglionic neurons of infected animals. Expression of latency-related (LR) gene products is controlled by a 980-bp fragment (LR promoter). DNA sequence analysis revealed that two major open reading frames (ORFs) are in the LR gene. Antibodies directed against both ORFs were generated in rabbits by using synthetic peptides. Antibody P2, which is directed to sequences near the amino terminus of ORF 2, recognized a 41-kDa protein in lytically infected cells, suggesting that ORF 2 encodes a protein. When the LR gene was inserted into a mammalian expression vector and subsequently transfected into COS-7 cells, a 41-kDa protein was detected by use of silver-stained sodium dodecyl sulfate-polyacrylamide gels and by the P2 antibody. In contrast, this protein was not detected in mock-transfected cells. Deletion of DNA sequences containing ORF 2 blocked synthesis of the 41-kDa protein in COS-7 cells. Reverse transcriptase-mediated PCRs indicated that splicing occurs near the C terminus of ORF 2. Further studies indicated that LR RNA was alternatively spliced in latently infected cattle and that a fraction of LR RNA was poly(A)+. Taken together, these studies suggested that a spliced LR transcript has the potential to encode a 41-kDa protein.


Abstract In our work as dance artists we have for many years worked at guiding creative and artistic processes based on body and movement. We have developed didactic models that can be put to use in encounters with both children and young people, as well as students and professional dancers. Our work is based on guiding or coaching starting from the individual's viewpoint. In these processes it is the individual expression that is being cultivated, always in an artistic context. The work is founded in a phenomenological view of body and movement, with the lived, experienced body as a central concept. An important part of our work has been about developing models and tools where physical principles, understanding of shape, expression, space and composition, can be seen in relation to the individual's creative and artistic process. Through this a need has arisen to find new words and terms that can explain artistic processes in a more overall way and where the development of bodily knowledge is not separated from the artistic processes. In this context we have found a new word, "fraskyv", that could be understood as the opposite of gravitation, like a push-off, some kind of upward pull, a spring, momentum, or maybe as a shift of weight, transfer or a change in a wider sense. The point has been to find a word that can contain both technical and creative elements, and this word "fraskyv" is the starting point for this article.


Driving simulation is an efficient, safe, and data-collection-friendly method to examine driving behavior in a controlled environment. However, the validity of a driving simulator is inconsistent when the type of the driving simulator or the driving scenario is different. The purpose of this research is to verify driving simulator validity in driving behavior research in work zones. A field experiment and a corresponding simulation experiment were conducted to collect behavioral data. Indicators such as speed, car-following distance, and reaction delay time were chosen to examine the absolute and relative validity of the driving simulator. In particular, a survival analysis method was proposed in this research to examine the validity of reaction delay time. The result indicates the following: (1) most indicators are valid in driving behavior research in the work zone. For example, spot speed, car-following distance, headway, and reaction delay time show absolute validity. (2) Standard deviation of the car-following distance shows relative validity. Consistent with previous researches, some driving behaviors appear to be more aggressive in the simulation environment.


This study investigates whether non-state actors, particularly private oil companies, possess any international rights and obligations while operating in contested waters. The United Nations Convention on the Law of the Sea (UNCLOS) provides certain rules that regulate the behaviour of states amid maritime disputes. Yet, it is unclear whether these rules extend to private corporations present in disputed maritime areas. An analysis of UNCLOS and the relevant case law reveals that the rights and obligations of private actors in contested waters are not conferred on them directly by international law of the sea. Rather, these attributes are derivative as they emerge from the authorizing states' domestic laws. Hence, in contrast to states, which are direct subjects of international law of the sea, non-state actors are mere objects thereof. The fact that non-state actors are 'invisible' in the eyes of UNCLOS means that they cannot be held liable for breaching international law of the sea while operating in contested waters. But at the same time, the fact that they possess no international rights deprives non-state actors of the capacity to protect their interests under the judicial procedures of the law of the sea.


Cobalt nanoparticles (NPs) are important materials for applications in very different fields like magnetic storage technology, catalysis or medicine. These applications require different properties that are related with the surface state of the original particles. In this thesis we have functionalized the surface of isotropic and anisotropic Co NPs in order to fulfill this demand.
Pre-synthesized Co nanowires have been submitted to a thermal treatment that permits the formation of carbon coated anisotropic objects, overcoming therefore one of the main limitations of this kind of materials: their instability towards oxidation. In other order of things, we have synthesized small Co NPs with a fluorophore (Rhodamine B) as unique stabilizer. Such system presents a very interesting opportunity to study the effect of the magnetic core over the optical properties of the dye and, at the same time, to observe how an excited organic molecule directly attached to the Co surface can have an effect over the magnetic properties of the particle. The
same dye has been used under other synthetic conditions to promote the anisotropic growth of Co NPs, leading to the formation of monodisperse Co nanodisks. These particles are single domain and present blocked behavior at room temperature, being therefore interesting materials
for magnetic data storage devices or permanent magnets.


The ability to predict city-wide parking availability is crucial for the successful development of Parking Guidance and Information (PGI) systems. Indeed, the effective prediction of city-wide parking availability can improve parking efficiency, help urban planning, and ultimately alleviate city congestion. However, it is a non-trivial task for predicting city-wide parking availability because of three major challenges: 1) the non-Euclidean spatial autocorrelation among parking lots, 2) the dynamic temporal autocorrelation inside of and between parking lots, and 3) the scarcity of information about real-time parking availability obtained from real-time sensors (e.g., camera, ultrasonic sensor, and GPS). To this end, we propose Semi-supervised Hierarchical Recurrent Graph Neural Network (SHARE) for predicting city-wide parking availability. Specifically, we first propose a hierarchical graph convolution structure to model non-Euclidean spatial autocorrelation among parking lots. Along this line, a contextual graph convolution block and a soft clustering graph convolution block are respectively proposed to capture local and global spatial dependencies between parking lots. Additionally, we adopt a recurrent neural network to incorporate dynamic temporal dependencies of parking lots. Moreover, we propose a parking availability approximation module to estimate missing real-time parking availabilities from both spatial and temporal domain. Finally, experiments on two real-world datasets demonstrate the prediction performance of \hmgnn outperforms seven state-of-the-art baselines.


Abstract In Mediterranean fire-prone ecosystems, annual species specific to post-fire habitats should have a soil seed bank and should be able to germinate after a fire. Therefore, various fire-related cues can be expected to stimulate germination in post-fire annuals. Germination patterns of the rare annual Chaenorhinum rubrifolium (Plantaginaceae) were examined in response to mechanical scarification, heat shock, aqueous smoke, nitrogenous compounds, gibberellic acid, karrikinolide (KAR1), and mandelonitrile (a cyanohydrin analogue, MAN) under dark and photoperiod conditions in the laboratory. Combinations of these treatments were also included in the experiment. Strong physiological dormancy in the seeds of C. rubrifolium was partially broken by several fire-related germination cues, including smoke and nitrate, under light conditions. KAR1 and MAN also stimulated germination, and the highest improvement in germination was achieved in the KAR1 treatment in the presence of light. Heat shock + smoke and KAR1 + MAN combinations had positive synergetic and additive effects on germination under light conditions, respectively. The light played a crucial role in the promotion of germination. The results suggest that multiple fire-related cues operate to stimulate germination in C. rubrifolium, an annual species from the Mediterranean Basin. However, the species may have a broader germination niche than a fire-restricted one.


Reassembling the Collection presents innovative approaches to the study of historical and contemporary engagements between museums and the various individuals and communities who were (and are) involved in their production and consumption. Reassembling the Collection is interdisciplinary in scope and international in coverage. It addresses fundamental questions about the nature, value, and efficacy of museum collections in a postcolonial world, and the entangled agencies of those who have made, traded, received, collected, curated, worked with, researched, viewed, and experienced them in the past and present. In moving beyond the concerns of the politics of representation that have dominated critical museum studies, Reassembling the Collection considers the material networks and affective qualities of "things" alongside their representational role within the museum and explores the ways in which concepts of agency and indigeneity need to be reconfigured in light of the study of these concepts within the museum context. The contributors explore key concepts including the idea of museums as "meshworks" of material and social assemblages; how an "archaeological sensibility" might inform approaches to understanding past and present relationships between people, "things," and institutions in relation to museums; and the "weight of things" and sense of "curatorial responsibility," which arises from a reconsideration of the nature of museum objects.


Since the 1970s the utility and efficacy of medical ethics curricula in undergraduate programs
have received heightened world-wide attention. During this time, an "ethics boom" occurred designed
to counter the disappearance of ethics education and the marginalization of moral education from
higher education. This "boom", witnessed in most professional programs, is also notable for its absence
from teacher education programs in Australia and the US. Whilst there is a clear gap in the ethics
literature for teachers, the large number of investigations in medical ethics has still not resolved uncertainty
in relation to ethics education outcomes, effectiveness of teaching methods, effects of background
student characteristics upon professional decisions and the ever changing social mores shaping
ethical behaviours. Reported here are findings from a case study in a regional Australian university
whose aims were to identify domains of mutual interest between the schools of medicine and education.
The ultimate goal is to facilitate dialogue to prepare undergraduates to meet their professional obligations
with a clearer understanding of the ethical contingencies of other professions. Focus interviews
with students and practitioners, a survey and an examination of the ethics curricula of the two schools
suggests all students would develop a greater understanding of the complex issues facing both professions
if they attended a generic ethics course in the early undergraduate years. The use of real life
scenarios and case study methodology applied across fields to illuminate stake holder's perspectives
has been called for. Such an approach, highlighting effects of contemporary cultural norms upon
ethical professional behaviours, is thought to promote reflection.


TO THE EDITOR: In the August 2007 issue of the Journal, Xingjia Cui, M.D., M.P.H., et al. reported on the prospective relation between depression and the decline of executive function in elderly patients (1). They found that depression predicted a decline of executive functioning as measured with the Trails B and ∆ Trails. Executive dysfunction, on the other hand, did not predict subsequent depression in 709 persons age 65 years and older. The authors concluded that depression can be a harbinger of subsequent cognitive impairment. In contradiction to their introduction, the reciprocal relation between depression and executive dysfunction has been examined earlier (2, 3). In the Leiden 85-Plus Study, we found that depressive symptoms at baseline were not related to an accelerated decline in various cognitive domains, including attention and processing speed. In contrast, impairment of attention and memory at baseline predicted an increase of depressive symptoms during follow-up. We concluded that cognitive impairment in old age precedes the onset of depressive symptoms and not the other way round. These findings were in line with another study examining the reciprocal relation between depression and cognitive impairment in old age, which concluded that depressive symptoms are an early manifestation rather than a predictor of cognitive impairment (3). What explains the remarkable difference between these conclusions and the conclusion of Dr. Cui et al.? It is well known that depression in old age may be a concomitant phenomenon of cognitive decline. Therefore, depressed subjects who already show cognitive decline at baseline should be excluded when examining the relation between depression and executive dysfunction. Although Dr. Cui et al. excluded 31 subjects suffering from dementia, subjects with executive dysfunction were included in their analyses. The finding that the relation between depression and executive dysfunction is stronger cross-sectionally than longitudinally (Table 3, beta= 18.10 vs. beta=13.39) indeed suggests that depression is a concomitant phenomenon of executive dysfunction rather than an independent risk factor.


Rab small GTPases are highly conserved master regulators of membrane traffic in all eukaryotes. The same as the activation and inactivation of other small GTPases, the activation and inactivation of Rabs are tightly controlled by specific GEFs (guanine nucleotide exchange factors) and GAPs (GTPase-activating proteins), respectively. Although almost all Rab-GAPs reported thus far have a TBC (Tre-2/Bub2/Cdc16)/Rab-GAP domain in common, recent accumulating evidence has indicated the existence of a number of structurally unrelated types of Rab-GEFs, including DENN proteins, VPS9 proteins, Sec2 proteins, TRAPP complexes, heterodimer GEFs (Mon1-Ccz1, HPS1-HPS4 (BLOC-3 complex), Ric1-Rgp1 and Rab3GAP1/2), and other GEFs (e.g., REI-1 and RPGR). In this review article we provide an up-to-date overview of the structures and functions of all putative Rab-GEFs in mammals, with a special focus on their substrate Rabs, interacting proteins, associations with genetic diseases, and intracellular localizations.


On October 4, 2017, in an effort to recover some of the VAT lost annually, the European Commission proposed "far-reaching reforms." The immediate target is a €50 billion slice of an estimated €150 billion overall annual loss. In its proposal the Commission is looking only at Missing Trader Intra-Community (MTIC) fraud in goods.

Goods (alone) are targeted.

If we have learned anything about MTIC fraud since January 1, 1993, it is that fraudsters engaged in this activity are exceptionally agile. MTIC frauds migrate and mutate on command. For example, MTIC fraud in cell phones quickly migrated to computer chips in 2006 when the UK launched Nemesis, a computer program which tracked cell phones by IMEI (International Mobile Equipment Identity) numbers. But, as tax authorities chased the fraudulent computer chip trade, cost-conscious fraudsters migrated out of the small, high value, easy to transport chips market into tradeable services. Transferring supplies with a mouse and a keyboard is easier than shipping computer chips across EU borders to complete a fraud. And besides, the tax authorities were not looking in this direction at the time.

MTIC has now moved strongly into digitally transferred services, notably emissions permits, VoIP, and phone cards. If we know anything about MTIC, it is that it refuses to be confined to a country, a type of supply, or a commercial sector. In the gas and electric markets MTIC fraud occurs in a "virtual economy," one that intersects with the real economy only at the very beginning and very end of a highly controlled fraud chain. In other words, gas and electric MTIC fraud effectively occurs in the "cloud." What could be easier, or harder to prevent?

The difficulty with the Commission's October 4 proposal and its impact analysis is that it ignores the fungibility of MTIC fraud. Stopping one MTIC manifestation, will not necessarily reduce the overall economic loss. A system-wide fix is needed.

This paper considers the Commission's "far-reaching reform" proposal of October 4, 2017 in three respects.
• First it considers an immediate antecedent reform, one proposed by the Commission in 1996 that relied on a clearing house mechanism. This proposal failed largely due to a lack of trust among the Member States that were required to share collected revenue. Trust remains a critical component of any solution, and needs to be part of this "far-reaching reform" proposal.
• Secondly, it demonstrates how the current proposal works, how it prevents some types of MTIC fraud outright, and limits others. This discussion accepts the Commission's proposal as it finds it, and ignores the fact that a simple migration of MTIC goods frauds into services frauds would likely swallow up all the gains in MTIC prevention that this proposal brings to the table.
• Thirdly, it presents a blockchain solution that employs VATCoins. The paper concludes that the Commission's current proposal, if placed on a blockchain would bring trust back into this discussion in a manner that allows the Commission's current proposal to flourish as a solid technological extension of its original 1996 proposal.

This paper concludes that if the Commission's current proposal places cross-border transactional data on a blockchain, and utilizes VATCoins instead of fiat currency for cross-border tax payments, then the Commission will resolve the problem of Member State trust that doomed its 1996 solution. This solution can be rolled out over all cross-border trade (goods and services), and it should be if we hope to immunize the VAT from MTIC.


The recent advances made in MEMS and particularly in RF MEMS technology are enabling new architectures for the integration of RF transceivers with improved performance and smaller size. Several fundamental building blocks benefit from the availability of high-Q resonators in the RF front-end, the analog baseband and the frequency synthesizer to lower power consumption, phase noise and die area. In addition, the compatibility of MEMS with CMOS opens the door to a higher integration level using for example an above-IC approach. This paper presents the recent work made at CSEM in the field of ultra low-power transceiver for wireless sensor network applications. It first presents the high-Q resonators, including the BAW resonators used in the RF front-end and in the RF oscillator together with MEMS used in the low frequency oscillators and IF section. These MEMS are activated thanks to an A1N piezo layer avoiding the need for high voltage generation which is incompatible with the low-power and low-voltage requirement. These MEMS are also temperature compensated by the combination of additional layers and electronics means. The paper then focuses on the main building blocks that can take advantage of high-Q resonators starting with the RF front-end. The fundamentals of oscillators built around high-Q devices is described, highlighting the basic trade-offs. Finally, new approaches for the analog baseband are described. This includes an example of a quadrature Sigma-Delta converter combining the different functions of anti-alias and image-reject filter together with analog-to-digital conversion. An alternative to traditional Sigma-Delta oversampled converters is the use of phase analog-to-digital converters to directly quantize the phase information without the need to convert the amplitude. This innovative approach can save power and complexity for all wireless applications using phase or frequency modulations.


We quantify the commute time savings associated with work from home, drawing on data for 27 countries. The average daily time savings when working from home are 72 minutes in our sample. We estimate that work from home saved about two hours per week per worker in 2021 and 2022, and that it will save about one hour per week per worker after the pandemic ends. Workers allocate 40 percent of their time savings to their jobs and about 11 percent to caregiving activities. People living with children allocate more of their time savings to caregiving.


Orientation:  The demand for retaining top talent in the highly competitive and turbulent working environment has made retention research relevant and important. A central question in retention research revolves around the psychological factors that drive employees to remain at an organisation. Research purpose:  This research explores the mediating and conditional (moderating) processes underlying the link between employees' job embeddedness and satisfaction with organisational retention practices. Motivation for the study:  Several research studies are available with regard to the association between job embeddedness and retention practices. However, there seems to be a paucity of information available on the psychological process of workplace friendship underlying the job embeddedness–retention practices satisfaction link, as well as the boundary conditions of this process as set by employees' career concerns. Research design, approach and method:  The study followed a cross-sectional, quantitative research design. Data were collected from a convenience sample of ( N = 200) permanently employed staff members within a South African higher education institution. Moderated-mediation analysis was performed to achieve the research objective. Main findings:  The findings indicated career concerns as important boundary conditions for the psychological (mediating) process of workplace friendship in the job embeddedness–retention practices satisfaction link. Practical/managerial implications:  Enhancing work conditions and practices to support the evolving career development needs and concerns of valuable employees may be key to maintaining person–environment correspondence and retaining them. Contribution or value-add:  The findings extend retention theory by adding new insights into under what circumstances employees' job embeddedness positively influences their satisfaction with organisational retention practices. The study provides new evidence of the important role of employees' career development needs in retention theory and practice.


Differential cross sections for a W boson produced in association with jets are measured in a data sample
of proton-proton collisions at a center-of-mass energy of 8 TeV recorded with the CMS detector and
corresponding to an integrated luminosity of 19.6 fb−1. The W bosons are identified through their decay
mode W → μν. The cross sections are reported as functions of jet multiplicity, transverse momenta, and the
scalar sum of jet transverse momenta (HT) for different jet multiplicities. Distributions of the angular
correlations between the jets and the muon are examined, as well as the average number of jets as a function
of HT and as a function of angular variables. The measured differential cross sections are compared
with tree-level and higher-order recent event generators, as well as next-to-leading-order and next-to-nextto-leading-order
theoretical predictions. The agreement of the generators with the measurements builds
confidence in their use for the simulation of W þ jets background processes in searches for new physics at
the LHC.


Religious piety has rarely been animated as vigorously as in "Old English Poems of Christ and His Saints." Ranging from lyrical to dramatic to narrative, the individual poems show great inventiveness in reimagining perennial Christian topics. In different poems, for example, Christ expels Lucifer from heaven, resists the devil's temptation on earth, mounts the cross with zeal to face death, harrows hell at the urging of John the Baptist, appears in disguise to pilot a ship, and presides over the Last Judgment. Satan and the fallen angels lament their plight in a vividly imagined hell and plot against Christ and his saints.In "Andreas" the poet relates, in language reminiscent of "Beowulf," the tribulations of the apostles Andrew and Matthew in a city of cannibals. In "The Vision of the Cross" (also known as "The Dream of the Rood"), the cross speaks as a Germanic warrior intolerably torn between the imperative to protect his Lord and the duty to become his means of execution. In "Guthlac A," an Anglo-Saxon warrior abandons his life of violence to do battle as a hermit against demons in the fens of Lincolnshire. As a collection these ten anonymous poems vividly demonstrate the extraordinary hybrid that emerges when traditional Germanic verse adapts itself to Christian themes."Old English Poems of Christ and His Saints" complements the saints' lives found in "The Old English Poems of Cynewulf, "DOML 23.


The anesthesiology profession may one day serve as a cautionary tale of how power, politics and privilege can perturb science and progress. Previous anesthesia practitioners possessed a superior understanding of physiology and pharmacology, but overenthusiastic CO 2 supplementation with inadequate monitors and machines caused asphyxiation disasters that were improperly attributed to CO 2 toxicity. Dr. Ralph Waters founded the anesthesiology profession on the basis of a practical new anesthetic technique that introduced elective intubation and hyperventilation to eliminate CO 2 toxicity, but mechanical hyperventilation dangerously depletes CO 2 tissue reserves and exaggerates morbidity and mortality. The beneits of CO 2 supplementation were forgotten, and consequent CO 2 confusion has derailed research, discouraged opioid treatment, damaged patient safety, and disrupted professional progress. Anesthesiologists can no longer claim to provide superior service, and hospital administrators are replacing them with nurses. Professional membership is in decline, and professional survival is in question. Modern machines have eliminated asphyxiation, and modern monitoring enables safe and beneicial hypercarbia that complements opioid treatment and minimizes surgical morbidity and mortality. CO 2 reform promises revolutionary advance but faces formidable opposition. Corresponding author: Lewis S. Coleman, MD, DABA, Department of Anesthesia, Fellow, American Institute of Stress, Tel: 5598023375/ (661) 900-2390; E-mail: email@example.com


The question of how best to combine work and family life has led to lively debates in recent years. Both a lifestyle and a policy issue, it has been addressed psychologically, socially, and economically, and conclusions have been hotly contested. But as Neil Gilbert shows in this penetrating and provocative book, we haven't looked closely enough at how and why these questions are framed, or who benefits from the proposed answers. A Mother's Work takes a hard look at the unprecedented rise in childlessness, along with the outsourcing of family care and household production, which have helped to alter family life since the 1960s. It challenges the conventional view on how to balance motherhood and employment, and examines how the choices women make are influenced by the culture of capitalism, feminist expectations, and the social policies of the welfare state. Gilbert argues that while the market ignores the essential value of a mother's work, prevailing norms about the social benefits of work have been overvalued by elites whose opportunities and circumstances little resemble those of most working- and middle-class mothers. And the policies that have been crafted too often seem friendlier to the market than to the family. Gilbert ends his discussion by looking at the issue internationally, and he makes the case for reframing the debate to include a wider range of social values and public benefits that present more options for managing work and family responsibilities.


Unique Bindings exhibited at
Ashiga Museum of Art, Tochigi Province, Japan: 22April - 4 June 2006
Koriyama City Museum of Art, Fukishima Province, Japan: 10 June - 9 July 2006
Chiba City Museum of Art, Chiba Province, Japan: 22 July - 27 August 2006

Grey was one of twenty-four Fellows of the internationally recognised Designer Bookbinders Society invited to take part in the
Beautiful British Books touring exhibition to Japan. It examined the development of 'fine' books in Britain. 'Fine' in this context
encompasses rare and limited edition books and/or high-quality bindings. In the context of traditional bookbinding, there is an
enduring pre-conception of the use of particular structures and materials, and although there have historically been
acknowledged design styles, the concept of 'fine binding' has changed little over three hundred years. Grey's research
evidences her instrumental re-definition of the term through the development and invention of structures that use non-traditional
techniques and materials, such as wood veneers, and stitch-work with suede. Her use of materials is content led, resulting in
each binding being a unique response to the text. The Canterbury Tales was selected because the binding reflects the theme of
religious pilgrimage and the zebrano veneer used is an intentional counterpoint to Edna Whyte's black and white wood block
illustrations. The embroidery of Shakespeare's Sonnets and a Lover's Complaint binding complements the etchings within the
text whilst the sombre colour of the background and the lighter energetic marks of the stitches reflect themes of youth, romantic
love and ageing. The pieces are part of an ongoing investigation (see output 1), and she has also given invited lectures and
master classes at the Folger Library, Washington DC (March 2001), and the Designer Bookbinders and Society of Bookbinders,
London (November 2005). Her work has been purchased for public collections including the British Library, the Library of
Congress (Washington DC), Winchester Cathedral, and by private collectors such as Edward Bayntun (Bath), world-renowned
bindery and booksellers which took over the famous Riviere Bindery established in 1829.


Misfolded proteins (MP) are a key component in aging and associated neurodegenerative disorders. For example, misfolded Amyloid-ß (Aß) and tau proteins are two neuropathogenic hallmarks of Alzheimer's disease. Mechanisms underlying intra-brain MP propagation/deposition remain essentially uncharacterized. Here, is introduced an epidemic spreading model (ESM) for MP dynamics that considers propagation-like interactions between MP agents and the brain's clearance response across the structural connectome. The ESM reproduces advanced Aß deposition patterns in the human brain (explaining 46∼56% of the variance in regional Aß loads, in 733 subjects from the ADNI database). Furthermore, this model strongly supports a) the leading role of Aß clearance deficiency and early Aß onset age during Alzheimer's disease progression, b) that effective anatomical distance from Aß outbreak region explains regional Aß arrival time and Aß deposition likelihood, c) the multi-factorial impact of APOE e4 genotype, gender and educational level on lifetime intra-brain Aß propagation, and d) the modulatory impact of Aß propagation history on tau proteins concentrations, supporting the hypothesis of an interrelated pathway between Aß pathophysiology and tauopathy. To our knowledge, the ESM is the first computational model highlighting the direct link between structural brain networks, production/clearance of pathogenic proteins and associated intercellular transfer mechanisms, individual genetic/demographic properties and clinical states in health and disease. In sum, the proposed ESM constitutes a promising framework to clarify intra-brain region to region transference mechanisms associated with aging and neurodegenerative disorders.


'Excellent, a very powerful and moving piece of work' Roddy Doyle One powerful novella, with two thematically linked short stories on either side of it, forms the basis of EVERYTHING IN THIS COUNTRY MUST. Although these are stories about Ireland and the Troubles, they have an almost mythical rather than a political feel. In the title story, four young soldiers help a farmer and his daughter free their horse from a stream in flood, unable to understand that their help will never be anything but an insult. In the novella, Hunger Strike, a young boy and his mother flee to Galway as the boy's uncle succumbs to a hunger strike in a Derry gaol. In Wood, a ten-year-old boy is asked by his mother to make poles for the marching season.


Purpose: The objective of this study involves the determination of cyclical characteristics that occur on the European construction market. Design/Methodology/Approach: In the research implementation process, time-frequency analysis was used to identify and analyze cyclicalities in the construction market. Findings: The results clearly demonstrate the absence of a homogeneous construction market in the investigated countries. The diversity of the European construction market is revealed by the various responses to the periods corresponding to the ups and downs of the economy. Practical Implications: The present research provides grounds for the clear indication of specific countries and cyclical characteristics on the construction market in them to define guidelines suitable for the identification of adequate scenarios for the development of construction markets in them. Originality/value: The conclusion derived from the study is associated with the classification of construction markets and identification of various responses of individual markets to the occurrence of macroeconomic or microeconomic stimuli.


SUMMARY Catastrophic disturbances of forest ecosystems are natural and anthropogenic phenomena that promote the natural dynamics of biocenosis and biogeochemical processes, and are the main causes of landscape fragmentation. The aim of this study was to evaluate the effect of orientation and toposequential positions on some biological activities in a relict forest community of Lapagerio- Aextoxiconetum during two seasons. Soil samples were collected from an Andisol (0-15 cm), for each toposequential position (high, medium and low slope) of a forest with orientation northeast and southwest in summer and winter. The parameters evaluated were: fluorescein diacetate hydrolysis, carbon and nitrogen biomass and activity of six enzymes related to microbiological activity: carboximethylcellulase, β-glucosidase, manganese peroxidase, urease, acid phosphatase and arylsulfatase. The results indicate that the high slope with northeast orientation showed most favourable conditions on biological activities. In turn, orientation had direct effects on the evaluated biological activities, mostly significant, due to variation in soil moisture, temperature, pH, organic matter content and nutrient availability. Urease was the only enzyme with higher activity levels in summer, because of increase in soil temperature. Biological activities were affected by seasonality, being significantly higher in winter; the differences observed for different biological parameters are attributed to microclimates that were generated under the tree canopy and mulch.


Why do employers discriminate against job applicants who reside in poor, distant neighborhoods? Previous research indicates that employers call back applicants from these neighborhoods at lower rates, but the motivation for employer discrimination based on residential neighborhood remains unclear. Employers could be responding to long commuting distances, which could lead to higher employee absence/tardiness rates or fatigue on the job. On the other hand, employers may perceive workers from particular neighborhoods to be lower quality workers, on average, and thus discriminate based on neighborhood characteristics such as poverty or racial composition rather than distance to the job. The distinction between discrimination based on commuting distance versus neighborhood characteristics matters for public policy. Some policy responses, such as public transit improvements, may be appropriate if employers respond to distance itself but not if they respond to fixed neighborhood attributes. However, no experimental studies have measured the extent to which distance vs. neighborhood affluence motivate discrimination based on residential location. The present study addresses this gap using a job application audit experiment. I experimentally vary residential addresses of fictional applicants to real jobs in Washington, DC. Distance to job and neighborhood characteristics will be controlled experimentally via the address listed on the job application, allowing me to measure separately how employers respond to applicants from distant neighborhoods versus poor/black/less-educated neighborhoods. This study was piloted during summer 2013 and has been demonstrated to be feasible. In the present grant application, I aim to obtain support for expanding the sample to the size necessary for a complete, publishable academic study.


OBJECTIVE
To compare a visual analog pain scale (VAS) with the Medical Outcomes Study Short Form-36 Health Survey (SF-36) bodily pain; to define the minimal clinically important change (MCIC) for pain in observational studies; to define clinically useful cutpoints for pain; to quantify the predictors of pain; and to estimate the effect of anti-tumor necrosis factor (TNF) therapy on pain.

METHODS
Over 6 years we studied 12,090 patients with rheumatoid arthritis (RA). Pain was assessed by VAS and SF-36 pain scales.

RESULTS
Compared with the SF-36 scale, the 0-10 VAS pain scale was better correlated with all clinical variables. The mean VAS score was 3.4 (standard deviation 2.8), and the best cutpoint for an "acceptable" level of pain was <or=2.0. The MCIC for pain was approximately 0.5 units by one measure and 1.1 by another. Pain increased slightly with the duration of RA, 0.03 (95% confidence interval 0.02-0.03) and decreased with age, 0.01 (95% CI 0.01-1.02) units per year. Pain was greater in ethnic minorities [0.78 (95% CI 0.63-0.93)] and women [0.31 (95% CI 0.23-0.39)] and was lower in college graduates [-0.88 (95% CI -1.00 to -0.76)]. Self-reported joint and nonarticular pain at 16 bilateral sites explained 44% of VAS pain scores. Anti-TNF therapy reduced pain by 0.59 to 0.53 units and EuroQol utility by 0.02 (95% CI 0.02-0.02) units.

CONCLUSION
Anti-TNF therapy improved pain by 0.53 to 0.70 units. The MCIC for improvement and worsening of pain is about 0.5 to 1.1 units. Pain levels are almost constant over RA duration, and are increased in women, ethnic minorities, smokers, and those with less education.


A key promise of Virtual Reality (VR) is the possibility of remote social interaction that is more immersive than any prior telecommunication media. However, existing social VR experiences are mediated by inauthentic digital representations of the user (i.e., stylized avatars). These stylized representations have limited the adoption of social VR applications in precisely those cases where immersion is most necessary (e.g., professional interactions and intimate conversations). In this work, we present a bidirectional system that can animate avatar heads of both users' full likeness using consumer-friendly headset mounted cameras (HMC). There are two main challenges in doing this: unaccommodating camera views and the image-to-avatar domain gap. We address both challenges by leveraging constraints imposed by multiview geometry to establish precise image-to-avatar correspondence, which are then used to learn an end-to-end model for real-time tracking. We present designs for a training HMC, aimed at data-collection and model building, and a tracking HMC for use during interactions in VR. Correspondence between the avatar and the HMC-acquired images are automatically found through self-supervised multiview image translation, which does not require manual annotation or one-to-one correspondence between domains. We evaluate the system on a variety of users and demonstrate significant improvements over prior work.


Dr. George Gaylord Simpson, one of the most important evolutionary biologists of the Twentieth Century, was born on June 16, 1902 and died on October 6, 1984. His contributions to science include not only a modern synthesis of evolutionary thought, but original research on anthropology, mammalogy, paleontology, general biology, and statistics. His prolific writings were intended for scientific and non—scientific communities alike. He helped and encouraged many who now work in the fields of paleontology and evolutionary biology. Contributors to this book dedicate their efforts as tribute to his memory.

Included authors are colleagues, former students, and friends of Dr. Simpson's. They represent but a few of the people he would have included in these categories. The book is intended to suggest only a sampling of the diversity of George Gaylord Simpson's impact on present vertebrate paleontology, from its most senior to its very junior participants.

Ms. Flanagan's letter of invitation entreated the following from potential authors: "In the spirit of Dr. Simpson's own writings, we encourage imaginative contributions that would be just a little different from items expected in a regular scientific journal." The title of the volume (Vertebrates, Phylogeny, and Philosophy) reflects that request. Though individual articles deal almost exclusively with fossil mammals, emphases cross the spectrum of evolutionary biology, including systematic paleontology, considerations of adaptation, ontogeny, analyses of evolutionary tem— po and mode, biogeographic procedure, and paleogeography. Philip Gingerich's contribution stresses the crucial importance of solid empirical research to the foundations upon which theoretical/philosophical writings should be based. Mesozoic and Cenozoic taxa are considered, and two articles discuss the modern union of molecular biology, genetics, and paleontology. Most articles benefited directly from the pioneering writings of George Simpson, yet the breadth of concerns of this volume covers only a small fraction of the interests exhibited in his lifetime of evolutionary research.

> Kathryn Flanagan served as principal correspondent with authors and reviewers. Jason Lillegraven had principal responsibility for manuscript editing and considerations of production.

We take this opportunity to thank the thirty-two authors for their contributions. Similarly, more than fifty individuals served as unpaid reviewers, and we give our most sincere thanks for their generosity of time and effort. Also, we thank Linda E. Lillegraven for creating the cover design.


Research into maternal-fetal attachment is increasing yet has not yielded substantive scientific results due in part to the lack of a clear definition of the word "attachment." Furthermore, a controversy currently exists in the literature with debate focused on the use of the word "attachment" as referenced by John Bowlby when discussing the maternal-fetal relationship. Part of this debate involves the presence or lack thereof of true reciprocal interactions between mother and fetus with the onus on fetal consciousness—is the fetus a sentient being able to consciously interact with its mother? Further variables impacting the controversy involve the lack of a concise definition of consciousness and fetal sentience; there is no agreement on fetal consciousness. Current research demonstrates that fetuses perceive pain, react to touch, smells, and sounds, and display different facial expressions in response to external stimuli. Yet, these reactions may be preprogrammed with subcortical nonconscious origins—they are not universally considered true conscious cognitions. Studies investigating fetal brain development have demonstrated that fetuses do not acquire brain structures necessary for consciousness until 24 weeks gestation age; however, studies have not ruled out the existence of a subcortical consciousness. This paper will conduct a brief literature review of maternal-fetal attachment and fetal consciousness in order to consider fetal sentience as a viable variable impacting the potential for reciprocal interactions, thus supporting use of the word "attachment" in maternal-fetal attachment. Implications for Maternal-Fetal Attachment interventions are also discussed.