Background Published estimates of mortality and progression to AIDS as children with HIV approach adulthood are limited. We describe rates and risk factors for death and AIDS-defining events in children and adolescents after initiation of combination antiretroviral therapy (cART) in 17 middle- and high-income countries, including some in Western and Central Europe (W&CE), Eastern Europe (Russia and Ukraine), and Thailand. Methods and findings Children with perinatal HIV aged <18 years initiating cART were followed until their 21st birthday, transfer to adult care, death, loss to follow-up, or last visit up until 31 December 2013. Rates of death and first AIDS-defining events were calculated. Baseline and time-updated risk factors for early/late (≤/>6 months of cART) death and progression to AIDS were assessed. Of 3,526 children included, 32% were from the United Kingdom or Ireland, 30% from elsewhere in W&CE, 18% from Russia or Ukraine, and 20% from Thailand. At cART initiation, median age was 5.2 (IQR 1.4–9.3) years; 35% of children aged <5 years had a CD4 lymphocyte percentage <15% in 1997–2003, which fell to 15% of children in 2011 onwards (p < 0.001). Similarly, 53% and 18% of children ≥5 years had a CD4 count <200 cells/mm3 in 1997–2003 and in 2011 onwards, respectively (p < 0.001). Median follow-up was 5.6 (2.9–8.7) years. Of 94 deaths and 237 first AIDS-defining events, 43 (46%) and 100 (42%) were within 6 months of initiating cART, respectively. Multivariable predictors of early death were: being in the first year of life; residence in Russia, Ukraine, or Thailand; AIDS at cART start; initiating cART on a nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimen; severe immune suppression; and low BMI-for-age z-score. Current severe immune suppression, low current BMI-for-age z-score, and current viral load >400 c/mL predicted late death. Predictors of early and late progression to AIDS were similar. Study limitations include incomplete recording of US Centers for Disease Control (CDC) disease stage B events and serious adverse events in some countries; events that were distributed over a long time period, and that we lacked power to analyse trends in patterns and causes of death over time. Conclusions In our study, 3,526 children and adolescents with perinatal HIV infection initiated antiretroviral therapy (ART) in countries in Europe and Thailand. We observed that over 40% of deaths occurred ≤6 months after cART initiation. Greater early mortality risk in infants, as compared to older children, and in Russia, Ukraine, or Thailand as compared to W&CE, raises concern. Current severe immune suppression, being underweight, and unsuppressed viral load were associated with a higher risk of death at >6 months after initiation of cART.


A series of cyclic triphosphenium ions containing three adjacent phosphorus atoms linked by a hydrocarbon backbone has been synthesised. They vary in ring size (four- to seven- membered rings), substituents on the four-coordinate phosphorus atoms, and organic backbone, and have been characterised by (^31)P NMR spectroscopy. Variable temperature studies probing the mechanism of formation of cyclic triphosphenium ions from a reaction of PX(_3) with a diphosphane have shown a three-step mechanism: (i) the addition of PX(_3) to the diphosphane to form an acyclic intermediate, (ii) cyclisation to afford a heterocycle with a halogen still bonded to the central P atom, and (iii) removal of the halogen to afford the cyclic triphosphenium ion. The syntheses of P(_c)-alkyl and aryl derivatives of cyclic triphosphenium ions using two different methods are described. Direct ethylation of a cyclic triphosphenium ion using ethyl triflate is only possible when the substituents on the four-coordinate phosphorus atoms are small e.g. Et. Synthesis of Pc-alkyl and aryl derivatives with larger substituents on the four-coordinate P atoms, and/or Pc, have been achieved via reaction of a diphosphane with a dichlorophosphane in the presence of AICI(_3_ or SnCI(_2). A series of tetraphosphonium ions containing four adjacent P atoms linked by an organic backbone has also been synthesised. These derivatives have been characterised using (^31)P NMR spectroscopy and where possible X-ray diffractions studies and elemental analyses. The P-P bonds in these derivatives are typical values for single bonds. The synthesis of Pt(II) complexes containing cyclic triphosphenium ions has been achieved to afford cis and/or trans isomers via reaction of a cyclic triphosphenium ion with trans-[Pt(PR(_3))CI(µCl)](_2). However, if the cyclic triphosphenium ion contains phenyl groups on both of the four-coordinate phosphorus atoms, ring scission followed by complexation of the diphosphane to Pt is observed. In the Pt(II) complexes containing cyclic triphosphenium ions, an unusually small 'J(_pt-p) value to the phosphenium central P (981-1267 Hz) suggests that the bond between the phosphenium central P atom and the Pt centre is long. Hydrolysis reactions of several Pt(II) complexes containing chlorophosphane ligands have been monitored by (^31)P NMR spectroscopy.


BACKGROUND
The gold standard for diagnosis of enteric fever caused by Salmonella Typhi or Salmonella Paratyphi A or B is bone marrow culture. However, because bone marrow aspiration is highly invasive, many hospitals and large health centers perform blood culture instead. As blood culture has several limitations, there is a need for novel typhoid diagnostics with improved sensitivity and more rapid time to detection.

METHODS
We developed a clyA-based real-time polymerase chain reaction (qPCR) method to detect Salmonella Typhi and Salmonella Paratyphi A simultaneously in blood. The sensitivity and specificity of this probeset was first evaluated in vitro in the laboratory and then in a typhoid-endemic population, in Karachi, Pakistan, and in healthy US volunteers.

RESULTS
We optimized a DNA extraction and real-time PCR-based method that could reliably detect 1 colony-forming unit/mL of Salmonella Typhi. The probe set was able to detect clinical Salmonella Typhi and Salmonella Paratyphi A strains and also diarrheagenic Escherichia coli, but not invasive E. coli or other invasive bacteria. In the field, the clyA qPCR diagnostic was 40% as sensitive as blood culture. However, when qPCR-positive specimens were considered to be true positives, blood culture only exhibited 28.57% sensitivity. Specificity was ≥90% for all comparisons and in the healthy US volunteers. qPCR was significantly faster than blood culture in terms of detection of typhoid and paratyphoid.

CONCLUSIONS
Based on lessons learned, we recommend that future field trials of this and other novel diagnostics that detect typhoidal and nontyphoidal Salmonella employ multiple methodologies to define a "positive" sample.


Temperature is projected to increase in Norway over the next 50 yr. Even though it is supposed to increase most during winter, the expected temperature increase in the summer as well as in spring and autumn will lead to a longer thermal growing season all over the country. The growing degree-day sum within the growing season is projected to increase all over the country. The largest increase is projected to occur along the western coast of Norway, while the smallest change is projected to occur in the high mountainous part of the country. The study is based on empirically downscaled temperature data from ECHAM4/OPYC3 with the GSDIO integration. The results are obtained with a spatially distributed model for which downscaled temperature data are used as input.


Many of us "know" things that are not true, and we sometimes act, or urge our representatives to act, on our mistaken beliefs. This article examines three common myths, or misconceptions, about the international economy. The author points out that, as with most myths, these embody grains of truth, but if accepted without qualification they could lead to grievous policy errors.> The author analyzes three common false assumptions: that global competition prevents inflation; that fair trade requires equal labor standards; and that small firms cannot profitably export. Global competition is a weak reed on which to rely for control of the overall price level, he finds. Far more important are U.S. monetary and exchange-rate policies, whose potency has been demonstrated many times over. He also argues that the failure to enforce certain core labor standards, such as a standard prohibiting forced labor, probably lowers a country's productivity rather than affording it an unfair competitive advantage. And the data on exporting show that relatively small as well as large firms can thrive while exporting.


One of the major challenges in high-speed fan stages used in compact, embedded propulsion systems is inlet distortion noise. A body-force-based approach for the prediction of multiple-pure-tone (MPT) noise was previously introduced and validated. In this paper, it is employed with the objective of quantifying the effects of nonuniform flow on the generation and propagation of MPT noise. First-of-their-kind back-to-back coupled aero-acoustic computations were carried out using the new approach for conventional and serpentine inlets. Both inlets delivered flow to the same NASA/GE R4 fan rotor at equal corrected mass flow rates. Although the source strength at the fan is increased by 38 dB in sound power level due to the nonuniform inflow, far-field noise for the serpentine inlet duct is increased on average by only 3.1 dBA overall sound pressure level in the forward arc. This is due to the redistribution of acoustic energy to frequencies below 11 times the shaft frequency and the apparent cut-off of tones at higher frequencies including blade-passing tones. The circumferential extent of the inlet swirl distortion at the fan was found to be two blade pitches, or 1/11th of the circumference, suggesting a relationship between the circumferential extent of the inlet distortion and the apparent cut-off frequency perceived in the far field. A first-principles-based model of the generation of shock waves from a transonic rotor in nonuniform flow showed that the effects of nonuniform flow on acoustic wave propagation, which cannot be captured by the simplified model, are more dominant than those of inlet flow distortion on source noise. It demonstrated that nonlinear, coupled aerodynamic and aero-acoustic computations, such as those presented in this paper, are necessary to assess the propagation through nonuniform mean flow. A parametric study of serpentine inlet designs is underway to quantify these propagation effects. © 2013 American Society of Mechanical Engineers.


HPCC systems, an open source cluster computing platform for big data analytics consists of generalized neural network bundle with a wide variety of features which can be used for various neural network applications. To enhance the functionality of the bundle, this paper proposes the design and development of generative adversarial networks (GANs) on HPCC systems platform using ECL, a declarative language on which HPCC systems works. GANs have been developed on the HPCC platform by defining the generator and discriminator models separately, and training them by batches in the same epoch. In order to make sure that they train as adversaries, a certain weights transfer methodology was implemented. MNIST dataset which has been used to test the proposed approach has provided satisfactory results. The results obtained were unique images very similar to the MNIST dataset, as it were expected.


Aim/Purpose: This study designed and evaluated the impact of using a blended course and Web 2.0 tools into the "Design Fundamentals and Elements" course of a fine arts bachelor's program at a Saudi Arabian university. The study also examined how students used Web 2.0 tools to improve their learning in the design of a blended (hybrid) course following the Quality Matters TM Higher Education Rubric (QMHER).

Background: Web 2.0 tools such as Voki, YouTube, Pinterest, and Instagram feature educational technology that offers resources, helps instructors submit their lesson plans, create presentations, and conduct online student meetings.

Methodology: The research adopted a mixed-method approach: a qualitative and quantitative pilot study. Data were collected through a pre-survey, pre-test, and post-test for one focus group, and in-depth individual interviews.

Contribution: Blended courses should be integrated with the QMHER and Web 2.0 tools into art and design curricula. Art and design teaching and learning should be transformed through Web 2.0 tools, allowing students to explore their design capabilities in the fine arts, art education, interior design, fashion design, and graphic design fields.

Findings: The findings revealed three themes in the data: 1) how to design blended learning best with the QMHER in an art education course, 2) Voki's impact on learning 21st-century skills in a blended course, and 3) Voki's impact on personal interactions from students' perspectives.

Recommendations for Practitioners: The study suggests that blended courses featuring Voki animation activities play an important role in art education during the Covid-19 pandemic; students' favorite Web 2.0 tools can improve their learning, and Voki can offer a new method and animation tool that can be integrated into activities for art students.

Recommendation for Researchers: Blended courses using Voki should be implemented as they can lead to improvements in students' 21st-century skills (including technology literacy, creativity, decision-making, problem-solving, and collaboration and communication).

Impact on Society: The QMHER was valuable for students' understanding of the course requirements and to improve their grades. Moreover, many Web 2.0 tools were helpful in teaching and learning art and design concepts. The findings highlight how students' 21st-century skills increased using Voki in a blended course.

Future Research: The QMHER should be applied internationally to online and blended higher education courses.


Setting Kibong'oto National Tuberculosis Hospital (KNTH), Kilimanjaro, Tanzania. Objective Characterize the diagnostic process and interim treatment outcomes from patients treated for multidrug-resistant tuberculosis (MDR-TB) in Tanzania. Design A retrospective cohort study was performed among all patients treated at KNTH for pulmonary MDR-TB between November 2009 and September 2011. Results Sixty-one culture-positive MDR-TB patients initiated therapy, 60 (98%) with a prior history of TB treatment. Forty-one (67%) were male and 9 (14%) were HIV infected with a mean CD4 count of 424 (±106) cells/µl. The median time from specimen collection to MDR-TB diagnosis and from diagnosis to initiation of MDR-TB treatment was 138 days (IQR 101–159) and 131 days (IQR 32–233), respectively. Following treatment initiation four (7%) patients died (all HIV negative), 3 (5%) defaulted, and the remaining 54 (89%) completed the intensive phase. Most adverse drug reactions were mild to moderate and did not require discontinuation of treatment. Median time to culture conversion was 2 months (IQR 1–3) and did not vary by HIV status. In 28 isolates available for additional second-line drug susceptibility testing, fluoroquinolone, aminoglycoside and para-aminosalicylic acid resistance was rare yet ethionamide resistance was present in 9 (32%). Conclusion The majority of MDR-TB patients from this cohort had survived a prolonged referral process, had multiple episodes of prior TB treatment, but did not have advanced AIDS and converted to culture negative early while completing an intensive inpatient regimen without serious adverse event. Further study is required to determine the clinical impact of second-line drug susceptibility testing and the feasibility of alternatives to prolonged hospitalization.


Must the state handle the adjudication of disputes? Researchers of different perspectives, from heterodox scholars of law who advocate legal pluralism to libertarian economists who advocate the privatization of law, have increasingly questioned the idea that the state is, or should be, the only source of law. Both groups point out that government law has problems and that non-state alternatives exist. This Article discusses some problems with the public judicial system and several for-profit alternatives. Public courts lack both incentives to embrace customer orientation and pricing mechanisms, plus they face problems associated with the bureaucratic provision of services. When parties are able to choose their tribunals, in contrast, those tribunals must provide service to customers and be mindful about conserving resources. Competition between arbitrators also can allow for experimentation and the provision of customized services rather than a centrally planned, one-size-fits-all system. Contracts with arbitration clauses can easily stipulate the choice of tribunal, and we argue that if government courts simply refused to overrule binding arbitration agreements, de facto privatization could easily take place. This Article discusses how the private adjudication of disputes could enable the market to internalize externalities and provide services that customers desire.


Following pressure from some sectors of civil society, the Province of Ontario passed a law in 2016 allowing municipalities to use ranked ballots to elect mayors and councillors. This change in provincial regulation, and the dialogue and debate that led to the policy change, raise important questions about the nature of municipal electoral systems in Canada. Changing an electoral system can improve voter turnout and alter electoral outcomes for the better. However, no change to an existing electoral system will address all the perceived flaws within an existing system. Change may, in fact, introduce new and unintended complications to elections and voting. Understanding the nature of different electoral systems is a necessary step when contemplating change or the status quo, as is being able to articulate clearly the objectives one hopes to achieve through electoral reform. Ultimately, proponents of change must understand that the objectives they hope to achieve through electoral reform may not be universal, and that different objectives may actually conflict with one another. This paper is intended to introduce and discuss the variety of components that constitute a municipal electoral system so that proponents for change, supporters of the status quo, and individuals simply wishing to expand their knowledge of democratic institutions may be better informed about the potential and consequences of electoral reform at the municipal level.


Moscow has a rich tradition of successful math circles, to the extent that many other circles are modeled on them. This book presents materials used during the course of one year in a math circle organized by mathematics faculty at Moscow State University, and also used at the mathematics magnet school known as Moscow School Number 57. Each problem set has a similar structure: it combines review material with a new topic, offering problems in a range of difficulty levels. This time-tested pattern has proved its effectiveness in engaging all students and helping them master new material while building on earlier knowledge. The introduction describes in detail how the math circles at Moscow State University are run. Dorichenko describes how the early sessions differ from later sessions, how to choose problems, and what sorts of difficulties may arise when running a circle. The book also includes a selection of problems used in the competition known as the Mathematical Maze, a mathematical story based on actual lessons with students, and an addendum on the San Jose Mathematical Circle, which is run in the Russian style. In the interest of fostering a greater awareness and appreciation of mathematics and its connections to other disciplines and everyday life, MSRI and the AMS are publishing books in the Mathematical Circles Library series as a service to young people, their parents and teachers, and the mathematics profession.


The shallow subsurface hydrography in the southern Norwegian Sea during the past 135,000 years was investigated using parallel measurements of Mg/Ca and δ18O in shells of the planktic foraminiferal species Neogloboquadrina pachyderma. Two cleaning methods were applied prior to Mg/Ca analysis, "Mg cleaning" and "full cleaning" methods. Different results were obtained, which are most likely due to a more efficient removal of Mn‐contaminant coatings of the shells, when the "full cleaning" procedure was applied. We further combined Mg/Ca and B/Ca from the "full cleaning" method with δ18O values to constrain the calcification temperature and seawater‐δ18O (δ18Osw) in the past. During Heinrich Stadial (HS)1 (∼18.5–15 ka) N. pachyderma constituted >80% of the planktic foraminiferal population, δ18Osw decreased by ∼1.5‰, and shallow subsurface temperature increased by ∼1.5–3°C, suggesting strong stratification in the upper water column and a possible subsurface inflow of Atlantic water below a well‐developed halocline during the calcification seasons of N. pachyderma. Similar decreases in δ18Osw are also recorded for other Heinrich stadials (HS2, 3, 4, 6, and 11). Our temperature estimates confirm previous observations of the delay of the last interglacial "Eemian" warm peak in the eastern Nordic Seas compared to the North Atlantic, and a late warming coinciding with the summer insolation minimum at 60°N. In addition, relatively high values of δ18Osw during the early Eemian suggest a shallow subsurface inflow of Atlantic water below a thin layer of Arctic surface water.


This paper quantifies gaseous N losses due to ammonia volatilisation and denitrification under controlled conditions at 30 degrees C and 75% to 150% of Field Capacity (FC). Biosolids were mixed with two contrasting soils from subtropical Australia at a rate designed to meet crop N requirements for irrigated cotton or maize (i.e., equivalent to 180 kg N ha(-1)). In the first experiment, aerobically (AE) and anaerobically (AN) digested biosolids were mixed into a heavy Vertosol soil and then incubated for 105 days. Ammonia volatilization over 72 days accounted for less than 4% of the applied NH4-N but 24% (AN) to 29% (AE) of the total applied biosolids' N was lost through denitrification in 105 days. In the second experiment AN biosolids with and without added polyacrimide polymer were mixed with either a heavy Vertosol or a lighter Red Ferrosol and then incubated for 98 days. The N loss was higher from the Vertosol with 16-29% of total N applied versus the Red Ferrosol with 7-10% of total N applied, while addition of polymer to the biosolids increased N loss from 7 to 10% and from 16 to 29% in the Red Ferrosol and Vertosol, respectively. A major product from the denitrification process was N-2 gas, accounting for >90% of the emitted N gases from both experiments. Our findings demonstrate that denitrification could be a major pathway of gaseous N losses under warm and moist conditions.


This paper presents an FPGA-based real-time simulation system of a nonlinear permanent magnet synchronous machine and its qualification for power hardware-in-the-loop emulation systems. The machine model considers the magnetic anisotropy of the rotor, the saturation of the iron as well as dynamic cross-coupling effects between the direct- and quadrature axis of the machine. A specifically designed high performance signal processing system is developed to calculate the machine behavior with a frequency of 1.5 MHz. The developed model calculates the state variables of the machine as well as the counter voltage for an emulation converter in a way that the coupling network of the power hardware-in-the-loop emulation test bench could be equipped with any inductance. Measurements validate the proper function of the machine model and demonstrate the accurate solution of the nonlinear differential equation system of an anisotropie synchronous machine with nonlinear magnetics in real-time.


Hepatitis B virus (HBV) persistent infection remains a major public health issue. Long-lasting persistence/occult carriage is associated with a strong inhibition of HBV replication and viral protein synthesis involving the complex interplay of viral and/or cellular control mechanisms. The characterization of viral RNA metabolism of pregenomic and subgenomic HBV RNAs should provide insights into some of these molecular mechanisms. Singly and multiply spliced HBV transcripts from pgRNA and preS2/S mRNA have been identified. Constitutive and cryptic splicing signals vary in number and location according to genotypes and individual strain sequences. Sixteen and four splice variants of the pgRNA and the preS2/S mRNA have been characterized so far, respectively. It is critical that the majority of viral RNAs escapes the cellular splicing machinery and is exported by a splicing-independent mechanism. This suggests that HBV splicing is not a constitutive process but it is precisely regulated by cis -acting genetic elements and cellular and/or viral trans -acting factors controlling both activation of cryptic splicing sites and silencing of constitutive splicing sites. Modulation of alternate splicing events seems to be involved in the severity and progression of liver disease in HBV chronic carriers. Spliced pgRNA variants generate viral defective particles and encode for additional HBV proteins whose still unclear functions were associated with viral replication control and innate and/or adaptive immunity escape. Additional studies are required to characterize host factors, additional cis -acting elements, RNA-RNA, RNA-protein and protein-protein interactions involved in the complex regulatory mechanisms underlying HBV RNA splicing. Understanding the regulation of HBV splicing might provide valuable indications on its potential implication in the long-term persistence of HBV in occult carriers. Nevertheless, the conservation of splicing sites, the complex modulation of splicing during infection, and unique proteins encoded by spliced viral RNAs strongly suggest a functional role of splicing in the HBV life cycle. The present review aims to supplement HBV RNA splicing knowledge previously published (Allain JP, Fu Y, Li C, Raimondo G. editors, Occult hepatitis B infection, 1st ed. Science Press, Beijing, China) with the recent data from the literature.


The aim of this thesis is to reappraise the European Community's progress towards Economic and Monetary Union (EMU) and to set out the lessons which can be derived from this experience and from economic and political theory with regard to the kind of strategy which must be followed to achieve EMU in Europe. It compares the three monetary systems, Bretton Woods, the Snake and the EMS, which account for the development of European monetary relations in the post-war period and tries to explore the parallels and their respective strengths and weaknesses, to draw conclusions as to the conditions which are necessary for the successful operation of an adjustable-peg type of exchange rate system and to assess the chances of such a system to achieve full and permanent EMU in the Community. It looks into the economic and the political factors which account for the successes and failures so far, their relevance today, as well as some of the interconnections that exist between EMU and integration in other fields. The thesis concludes that the EEC has as yet failed to make the decisive break towards monetary union because the full implications of EMU and the commitment necessary to achieve it have not been understood or accepted by Europe's national governments. The co-ordination approach to EMU, which has underpinned the Community's efforts in this direction from the early 1960s to the recent Delors proposals has been an inappropriate one for the task. The best way to achieve EMU in the Community, especially given the dramatic developments in Eastern Europe, is through the creation of a European parallel currency which would depoliticise monetary policy and would allow EMU to be implemented at a pace dictated by Europe's need for it, rather than by the twists and turns of national politics. Finally, the firm belief is stated that true EMU can only be realised within the framework of a federal Europe.


Groundwater recharge estimates are required for water resource management and the investigation of water related hazards and environmental problems. The hydrological processes of recharge are controlled by spatially and temporally distributed characteristics that are both internal (e.g. topography, soil, and land-cover) and external (climate variables). BGS' field experiments showed that the thickness of low permeability superficial deposit affects the amount of water and soluble pollutants (such as nitrate) entering the groundwater system. Traditionally, the thickness of superficial drifts on recharge, however, is rarely considered in the recharge estimation. A method was developed in this study to objectively estimate recharge considering the spatial distribution and thickness of low permeability drifts.
Based on SLiM method (Wang et al., 2012), recharge in Great Britain was estimated using the information on rainfall intensity, potential evapotranspiration, topography, soil type, crop type, and baseflow index. The drifts were divided into five thickness classes, i.e., 0 – 2m, 2m – 5m, 5m – 10m, 10m – 30m, and >30m. The reduction of recharge for each class was identified based on Monte Carlo simulations. The model was calibrated using the surface water component of observed river flow in 103 river gauging stations in Great Britain. The national daily distributed recharge estimates from 1962 to 2011 were produced. The modelled results have been successfully applied in estimating the nitrate concentration trend in groundwater bodies at the national scale. This national recharge model could be a basis for investigating the impacts of climate changes on groundwater resources. In addition, this method that requires readily available datasets can be easily transferred to other areas.
Wang, Lei; Barkwith, Andrew; Jackson, Christopher; Ellis, Michael. 2012 SLiM : an improved soil moisture balance method to simulate runoff and potential groundwater recharge processes using spatio-temporal weather and catchment characteristics. [Lecture] In: 12th UK CARE Annual General Meeting, UK Chinese Association of Resources and Environment, Bristol, UK, 8 Sept 2012.


Finnish artist Tove Jansson's Moomin stories have been continually in print for more than half a century, in 35 languages. They are among Europe's best loved and enduring children's classics, and through the TV animation (BBC2), the warm-hearted, whimsical creatures of Moomin valley have been brought to a new younger British audience. Introducing the first Sort Of Children's Classic in a new English version by Sophie Hannah. Sort of Books proudly presents the original full colour Moomin picture book with its irresistible cut-out page designs and playful rhyming text in a new version by one of Britain's star poets.


The lived experience of disability is increasingly prominent in autobiographical writing. Numerous collections of creative work attest to an expanding market for stories that challenge prevalent stereotypes associated with disability. At the same time, scholars have begun to call for the incorporation into disability studies of poststructuralist critical theory, attempting to extend our understanding of disability beyond both medical and social models. Recent work presents disability as a diverse and ever-changing set of bodies and experiences that eludes any sort of universalizing metanarrative. A further question concerns the convergence in life writing of theory and faith: how do disabled writers interrogate stable identity while also representing religious belief? With close attention to memoirs by Nancy Mairs and Stephen Kuusisto, this paper explores the articulation of "disability theology" by writers committed to challenging the forms of stigma that attach to bodies marked by the difference of disability, as well as bodies generally as they are denigrated by Christianity. Do disability/faith narratives push inevitably toward the resolution of holy reward? Does faith somehow require self-representation as triumphant consciousness, transcending physical failure? How are narratives of spiritual compensation, which tend to suggest that disability can only be endured with the promise of heavenly reparation, inherently problematic from the perspective of disability activism? Conversely, how might narratives that resist cultural pressure to subordinate anomalous bodies to the radiance of the soul or the proficiency of the mind broaden our awareness of the locations and meanings of disability?


Research on the effects of the rate and method of fertilizer application or row spacing on dry matter yield and digestibility of perennial forage crops either is scarce or has produced contradictory results. The objective of this study was to determine the effects of various rates of N fertilization, method of fertilizer application and row spacing on dry matter yields and in vitro dry matter digestibility (IVDMD) in the cultivated, perennial forage grass Digitaria eriantha Steud. subsp. eriantha cv. Irene. Field studies were conducted on a petrocalcic Ustipsament, sandy loam soil. The total annual N fertilizer (0, 50 or 100 kg ha-1) was applied once (in early spring) or split (half in early spring, half in early summer) on rows 0.3 or 0.5 m apart. Plants were clipped, leaving 50 mm of stubble, whenever they reached 260-280 mm height during the 1998-1999 and 1999-2000 growing seasons. All fertilized treatments produced higher (P < 0.05) dry matter yields than unfertilized controls. Averaged across both seasons, annual dry matter yields were 3.5, 5.2, and 6.0 Mg ha-1 for 0, 50, and 100 kg ha-1 N treatments, respectively. Dry matter yields during summer were greater (P < 0.05) under split than single application. Row spacing did not affect dry matter yield. Although small, increases in IVDMD due to fertilization were significant (P < 0.05). Mean IVDMD was 602, 633, and 656 g kg-1 for N fertilization rates of 0, 50, and 100 kg ha-1. It is suggested that N application should be between 50 and 100 kg ha-1 for D. eriantha, and that this application should be split rather than applied at one time in early spring. DOI:10.2458/azu_jrm_v56i5_gargano


This article, previously published in Volume 49 of the Emory Law Journal, examines the federal doctrine of forum non conveniens in cases in which the plaintiff asserts a right to relief under federal law. The arguments we advance - particularly our claim that the federal doctrine of forum non conveniens can be better understood not as turning on matters of convenience, as the formal doctrine suggests, but on an assessment of the relative sovereign interests in adjudicating the dispute - remain relevant to an understanding of the federal doctrine. The paper, thus, may be of interest to practitioners, academics and judges who confront problems involving the court's discretionary dismissal authority.


Kainic acid has been described as a highly specific neurotoxin that when injected locally into the nervous system destroys neuronal perikarya but spares axons of passage and terminals in the vicinity of the injection site. The effects of injection of this agent into the rat dorsal lateral geniculate nucleus on geniculocortical and corticofugal pathways have been examined. Neuronal perikarya were absent from injected geniculates, and products of neuronal degeneration were observed in the external stratum of the optic radiation and in layer IV of striate cortex. Furthermore, no visually driven units could bu found in physiological recordings from ipsilateral visual cortex, and no orthograde axonal transport of radioactivity to cortex was de tectable by autoradiography. These observations are consistent with the complete destruction of the geniculocortical pathway. On the other hand orthograde axonal transport appeared normal in corticogeniculate and cor‐ticotectal neurons on the injected side. In addition to silver grains appearing over the geniculate and superior colliculus label was observed over corti cofugal axons in the internal stratum of the optic radiation. It is noteworthy that axons of the corticofugal pathways are clearly segregated from geniculocortical axons over a part of their course through white matter. Corticogeniculate neurons on the injected side were able to transport D‐aspartate but not nuclear yellow retrogradely to cell bodies in layer VI. These results are consistent with the notion that cortical neurons terminating in and passing through the kainate lesion site survive but suggests, however, that corticogeniculate neurons may be functionally altered by these lesions.


I study the effects of product concept demonstrations on firm value and on firms' profit using two different methods: empirical and analytical approaches. Utilizing an event study, in Essay 1, I assess the effects of product concept demonstrations in trade shows on abnormal stock returns and risks. My investigation has two interconnected parts: (1) analysis of the firm's decision on how many concepts to demonstrate and what would be the concept mix; and (2) analysis of investor reactions to the demonstration that influence the firm value and risk. I find that the number of concept demonstrations are influenced by the innovativeness of the concept mix, the demonstrating firm's past conversion history of concepts to commercialization, and the total number of concepts demonstrations, reflecting the size of the trade show. As a result, the concepts demonstrations for the first-time positively influence cumulative abnormal return, but the effects of demonstrating previously demonstrated concepts are negative. In Essay 2, I develop a two-period game-theoretic model to analyze the inter-temporal strategic interactions in a firm's pricing strategy for the old and new models with a product concept demonstration. My analysis provides new insights into the interplay of product positioning and a product concept demonstration that induces varying degrees of purchase delay while shaping the firm's dynamic pricing strategy. As a result, I find that a product concept demonstration can lower the new model price even below what it would be without a demonstration; further, I find that the volume of delayed purchases induced by a product concept demonstration is the greatest at very low or very high levels of product substitutability, exhibiting a U-shaped pattern. My findings suggest that differentiating the new model either horizontally or vertically is a critical factor for profitable pre-launch product concept demonstration. However, the mechanisms that lead to concept demonstration profitability are quite different between the two types of differentiation. Allowing various scenarios of product line and pricing policies, I find that the simpler pricing policy can dominate more complex pricing strategies. Overall, the influences of the product concept demonstrations are researched through both empirical and analytical methods. The results of this dissertation suggest that innovative product concept demonstration generates positive firm value in the short run. Product concept demonstration also creates greater profit when the new product concept is either horizontally or vertically differentiated.


This paper adopts a Marxist political economy approach to locate the place of an occupational health and safety (OHS) legal regime within capitalist economic, political and social relations. A theoretically rigorous account of OHS regulation requires a systemic integration of class and the state as analytic categories. It is argued that OHS regulation is a product of the historical epoch of capitalism in which it is inserted and the nature of the state as a 'strategic-relational,' form-determined social relationship. This hypothesis is tested through an analysis of the legislation in New South Wales (NSW) emanating from the findings of the 1972 UK Robens Committee and 1981 NSW Williams Report. It is demonstrated that the case study period represents a transitional era in which the impulses to regulate OHS stem from both a labour movement strengthened by the post-War Fordist boom and an 'institutional search' to find ways out of the developing economic crisis.


An automated Raman microscope mapping system is described which uses single point analysis combined with a stepper-motor-driven microscope stage. Methods for one-dimensional full spectra line-scans and repetitive frequency selective line-scans providing a two-dimensional species map are reported. The technique is applied to a surface feature appearing on a sample of Fe-Cr steel oxidized at 800°C for 143 h. The results suggest that Fe3O4, FeCr2O4 and Cr2O3 develop fairly uniformly across much of the surface and that the formation of raised areas of more extensive corrosion is due to the absence of Cr2O3 in these regions. In addition, a sample oxidized at 675°C for two hours was ball-cratered to provide a Raman depth profile. The corrosion scale was complex—the outermost layer comprising Fe2O3 and some Fe3O4, while the inner layer consisted mainly of FeCr2O4, with some evidence of Cr2O3.


A membrane-associated complex composed of the Vps15 protein kinase and the Vps34 phosphatidylinositol 3-kinase (PtdIns 3-kinase) is essential for the delivery of proteins to the yeast vacuole. An active Vps15p is required for the recruitment of Vps34p to the membrane and subsequent stimulation of Vps34p PtdIns 3-kinase activity. Consistent with this, mutations altering highly conserved residues in the lipid kinase domain of Vps34p lead to a dominant-negative phenotype resulting from titration of activating Vps15 proteins. In contrast, catalytically inactive Vps15p mutants do not produce a dominant mutant phenotype because they are unable to associate with Vps34p in a wild-type manner. These data indicate that an intact Vps15p protein kinase domain is necessary for the association with and activation of Vps34p, and they demonstrate that a functional Vps15p-Vps34p complex is absolutely required for the efficient delivery of proteins to the vacuole. Analysis of a temperature-conditional allele of VPS15, in which a shift to the nonpermissive temperature leads to a decrease in cellular PtdIns(3)P levels, indicates that the loss of Vps15p function leads to a defect in activation of Vps34p. In addition, characterization of a temperature-sensitive allele of VPS34 demonstrates that inactivation of Vps34p leads to the immediate missorting of soluble vacuolar proteins (e.g., carboxypeptidase Y) without an apparent defect in the sorting of the vacuolar membrane protein alkaline phosphatase. This rapid block in vacuolar protein sorting appears to be the result of loss of PtdIns 3- kinase activity since cellular PtdIns(3)P levels decrease dramatically in vps34 temperature-sensitive mutant cells that have been incubated at the nonpermissive temperature. Finally, analysis of the defects in cellular PtdIns(3)P levels in various vps15 and vsp34 mutant strains has led to additional insights into the importance of PtdIns(3)P intracellular localization, as well as the roles of Vps15p and Vps34p in vacuolar protein sorting.


BACKGROUND Catheter-associated urinary tract infections (CAUTIs) have been deemed "reasonably preventable" by the Centers for Medicare and Medicaid, thereby eliminating reimbursement. Elderly trauma patients, however, are at high risk for developing urinary tract infections (UTIs) given their extensive comorbidities, immobilization, and environmental changes in the urine, which provide the ideal environment for bacterial overgrowth. Whether these patients develop CAUTI as a complication of their hospitalization or have asymptomatic bacteriuria (ASB) or UTI at admission must be determined to justify the "reasonably preventable" classification. We hypothesize that a significant proportion of elderly patients will present with ASB or UTI at admission. METHODS Institutional review board permission was obtained to perform a prospective, observational clinical trial of all elderly (≥65 years) patients admitted to our Level I trauma center as a result of injury. Urinalysis (UA) and culture (UCx) were obtained at admission, 72 hours, and, if diagnosed with UTI, at 2 weeks after injury. Mean cost of UTI was calculated based on Centers for Disease Control and Prevention estimates of $862 to $1,007 per UTI. RESULTS Of 201 eligible patients, 129 agreed to participate (64%). Mean (SD) age was 81 (8.6) years. All patients had a blunt mechanism of injury (76% falls), with a mean Injury Severity Score (ISS) of 13.8 (7.6). Of the 18 patients (14%) diagnosed with CAUTI, 14 (78%) were present at admission. In addition, there were 18 patients (14%) with ASB at admission. The most common bacterial species present at admission urine culture were Escherichia coli (24%) and Enterococcus (16%). Clinical features associated with bacteriuria at admission included a history of UTI, positive Gram stain result, abnormal microscopy, and pyuria. The estimated loss of reimbursement for 18 UTIs at admission was $15,516 to $18,126; however, given an estimated cost of $1,981 to screen all patients with UA and UCx at admission, up to $16,144 savings was realized. CONCLUSION Many elderly trauma patients present with UTI. Screening UA and UCx at admission for elderly trauma patients identifies these UTIs and is cost-effective. LEVEL OF EVIDENCE Epidemiologic study, level II.


This dissertation focuses mainly on the airgap-less electric machine. An extensive literature review has been presented along with a systematic study that included analytical modeling, simulation with both steady-state and trasient analysis, prototype building, and experimental validation. In this type of device, the rotor is allowed to touch the stator at a contact point, which maximizes the internal flux and therefore the electromagnetic torque. A higher torque density motor is proposed in this dissertation due to a reduced reluctance caused by zero airgap situation. A comparison with other high torque density electric ma-chines demonstrates the advantages of the proposed machine. Switched reluctance motor for hybrid vehicle, integrated magnetic gear, induction machines, are some examples of the machines with lower torque density than the airgap-less electric machine. This machine will maximize the generated torque allowing these type of machines to be competitive in applications where hydraulic motors are prevalent, i.e., low-speed and high-torque requirements. Hydraulic motor systems face two major problems with their braking system and with low efficiency due to a large number of energy conversion stages (i.e., motor-pump, hydraulic connections and the hydraulic motor itself). The proposed electric motor, unlike hydraulic motors, converts electrical energy directly to mechanical energy with no extra braking system necessary and with higher efficiency. The evolution of the airgap-less electric machine from three poles to 9 bi-poles is discussed in this dissertation. The modeling of this machine with a minimum number of poles is discussed before a generalization is presented. The simulation and analysis of the airgap-less electric motor has been done using Euler integration method as well as Runge Kutta 4th order integration method due to its higher precision. A proof-of-concept electric machine with nine magnetic bipoles is built to validate the theoretical assumptions.


The funerary shrine of Umm Haram, a holy woman of Islam, at the mosque of Hala Sultan Tekke near Larnaca, Cyprus, is the most important pilgrimage site for Muslims on the mostly Christian island of Cyprus. Its location at the interstices of the Muslim and Christian worlds, and amidst an unusually charged landscape of holiness for both religions, has also determined its role as an outpost within a liminal cultural space. The aspect of sacredness at the shrine itself can be seen as a poetics of "resistance" to Western attempts at viewing, description, analysis, and "possession" through comprehension. Moreover, Western travelers adopted different strategies of presentation and representation for reporting on Hala Sultan Tekke and their accounts regarding the female saint at the shrine are impressively inconsistent. One associated the monument with the grave of Mina, mother of Mohammed, another with a Turkish princess, and others with the grandmother of Mohammed. Surprisingly, only one traveler mentioned the "exotic," yet elusive megalithic configuration of the actual grave, whereas none referred to the foundation story and the rich local lore about the miraculous properties of the shrine. The idiosyncratic nature of travelers' encounters with this site reflects both their implicit rhetorical aims and the limitations imposed on their attempts at understanding by pragmatic circumstances such as language, inability or unwillingness to visit, and control of information. Travelers' accounts and other sources reveal the embeddedness of Hala Sultan Tekke within a complicated landscape of sacredness. This landscape also accommodated practices of cultic confluence and cross-cultural sharing, such as the veneration of the saints and holy sites common to Christians and Muslims of the Larnaca region.


textabstractGlobalisation, liberalization and rapid technological developments have been changing business environments drastically in
the recent decades. These trends are increasingly exposing businesses to market competition and thus intensifying competition.
In such an environment, the role of marketing management support systems (MMSS) becomes exceedingly important for the
long-term growth of an organisation's marketing expertise and success. In this paper, we discuss the evolution of a globally
distributed R&D project spanning three continents in developing an MMSS for the motion picture industry. We first provide the
conceptual background of the MMSS and knowledge management systems relevant for our work. We then provide a detailed
case study of our MMSS implementation. We specifically focus on the following elements of our work: globally distributed
R&D efforts, knowledge elements, and fit between demand and supply sides of MMSS. We conclude with a discussion of
implications for future research in this area.


Glass ceiling symbolizes a variety of barriers and obstacles that arise from gender inequality at business life. With this mind, culture influences gender dynamics. The purpose of this research was to examine the relationship between the glass ceiling and the power distance as a cultural variable within organizations. Gender variable is taken as a moderator variable in relationship between the concepts. In addition to conventional correlation analysis, we employed a new method to investigate this relationship in detail. The survey data were obtained from 109 people working at a research center which operated as a part of the nonprofit private university in Ankara, Turkey. The relationship between the variables was revealed by a new method which was developed as an addition to the correlation in survey. The analysis revealed that the female staff perceived the glass ceiling and the power distance more intensely than the male staff. In addition, the medium level relation was determined between the power distance and the glass ceiling perception among female staff.


New, coordinated measurements from the International Solar-Terrestrial Physics (ISTP) constellation of spacecraft are presented to show the causes and effects of recurrent geomagnetic activity during recent solar minimum conditions. It is found using WIND and POLAR data that even for modest geomagnetic storms, relativistic electron fluxes are strongly and rapidly enhanced within the outer radiation zone of the Earth's magnetosphere. Solar wind data are utilized to identify the drivers of magnetospheric acceleration processes. Yohkoh solar soft X-ray data are also used to identify the solar coronal holes that produce the high-speed solar wind streams which, in turn, cause the recurrent geomagnetic activity. It is concluded that even during extremely quiet solar conditions (sunspot minimum) there are discernible coronal holes and resultant solar wind streams which can produce intense magnetospheric particle acceleration. As a practical consequence of this Sun-Earth connection, it is noted that a long-lasting E>1MeV electron event in late March 1996 appears to have contributed significantly to a major spacecraft (Anik E1) operational failure.


Dear friends,
We hoped COVID-19 would leave us without any serious consequences; however, ScholarOne, the manager of the editorial program we used for many years, has increased their prices so much that we can no longer afford them. In an effort to find a more cost-effective solution, we moved to a new open-source editorial software that is managed by the Ljubljana University. This move required a huge amount of work and means a NEW ADDRESS as well as some delays on the way. We apologise for any inconvenience and hope to get everything running smoothly again by the end of the year.
Our journal can now be found at this new address:

https://journals.uni-lj.si/sgj

The first article - a case study from Brazil - is about an Olympic champion on rings and his preparation strategy to achieve his goals. Very interesting reading! Even though it provides no   scientific evidence to explain why he won at the OG, we decided to publish the article. In our view, such outstanding results are closely related to athlete's personal characteristics and abilities which are difficult to quantify. What we also want to emphasise with this article is planning. Many coaches work without proper planning, whereas here we have an example of good planing. Once we have more knowledge about how gymnasts won their titles, meta analyses will probably help us determine the data that define success. Let us just say this is the first step on this path.
Other contributing authors in this issue come from Germany, Serbia, Poland, Slovakia, China, USA, South Korea, Spain and Greece. Again, many different aspects of gymnastics are presented.
There are also new challenges for  researchers. In the middle of October, Flavio Bessi organised  International Freiburg Gymnastics Congress online. You can find it at https://www.sport.uni-freiburg.de/en/events/international-gymnastics-congress.
Anton Gajdoš drafted the 24rd short historical note introducing Aljaž Pegan from Slovenia.
Just to remind you, if you cite the journal, its abbreviation in the Web of Knowledge is
SCI GYMN J.
I wish you enjoyable reading and many new ideas for research projects and articles.
Editor-in-Chief


Background The relevance of the cause of kidney disease to prognosis among patients with chronic kidney disease is uncertain. Study Design Observational study. Settings & Participants 6,245 nondialysis participants in the Study of Heart and Renal Protection (SHARP). Predictor Baseline cause of kidney disease was categorized into 4 groups: cystic kidney disease, diabetic nephropathy, glomerulonephritis, and other recorded diagnoses. Outcomes End-stage renal disease (ESRD; dialysis or transplantation) and death. Results During an average 4.7 years' follow-up, 2,080 participants progressed to ESRD, including 454 with cystic kidney disease (23% per year), 378 with glomerulonephritis (10% per year), 309 with diabetic nephropathy (12% per year), and 939 with other recorded diagnoses (8% per year). By comparison with patients with cystic kidney disease, other disease groups had substantially lower adjusted risks of ESRD (relative risks of 0.28 [95% CI, 0.24-0.32], 0.40 [95% CI, 0.34-0.47], and 0.29 [95% CI, 0.25-0.32] for glomerulonephritis, diabetic nephropathy, and other recorded diagnoses, respectively). Albuminuria and baseline estimated glomerular filtration rate were associated more weakly with risk of ESRD in patients with cystic kidney disease than the 3 other diagnostic categories (P for interaction, <0.001 and 0.01, respectively). Death before ESRD was uncommon in patients with cystic kidney disease, but was a major competing risk for participants with diabetic nephropathy, whose adjusted risk of death was 2-fold higher than that of the cystic kidney disease group (relative risk, 2.35 [95% CI, 1.73-3.18]). Limitations Exclusion of patients with prior myocardial infarction or coronary revascularization. Conclusions The cause of kidney disease has substantial prognostic implications. Other things being equal, patients with cystic kidney disease are at much higher risk of ESRD (and much lower risk of death before ESRD) than other patients. Patients with diabetic nephropathy are at particularly high risk of death prior to reaching ESRD.


The aim of this research was to develop the first basic wind speed map for Oman. Hourly mean wind speed records from 40 metrological stations were used in the calculation. The period of continuous records ranged from 4–37 years. The maximum monthly hourly mean and the maxima annual hourly mean wind speed data were analysed using the Gumbel and Gringorten methods. Both methods gave close results in determining basic wind speeds, with the Gumbel method giving slightly higher values. Due to a lack of long-term records in some regions of Oman, basic wind speeds were extrapolated for some stations with only short-term records, which were defined as those with only 4– 8 years of continuous records; in these cases, monthly maxima were used to predict the long-term basic wind speeds. Accordingly, a basic wind speed map was developed for a 50-year return period. This map was based on basic wind speeds calculated from actual annual maxima records of 29 stations with at least 9 continuous years of records as well as predicted annual maxima wind speeds for 11 short-term record stations. The basic wind speed values ranged from 16 meters/second (m/s) to 31 m/s. The basic wind speed map developed in this research is recommended for use as a guide for structural design in Oman.


We consider an infinite vortex line in a viscous fluid interacting with a plane boundary surface at right angles to the line. If the boundary surface were absent, the vortex would impart to the fluid a circular motion about the vortex line with speed inversely proportional to the distance to the line. The presence of the boundary surface, however, leads to a secondary flow due to the forced adherence of the fluid at the surface. The purpose of the paper is to describe a family of exact solutions of the Navier-Stokes equations which applies to the above situation. Under quite general hypotheses, it is shown that there can exist only three types of motion compatible with the assumed structure. In the first kind, the radial velocity component (using spherical polar coordinates about the point where the vortex meets the plane surface) is directed inward along the plane surface and upward along the axis of the vortex. In the second type of motion the radial velocity component is directed inward along the plane surface and downward on the axis, with a compensating outflow at an intermediate angle. In the third kind the radial velocity is directed outward near the plane and downward on the central axis. The results can also be used as a basis for numerical calculations of the solutions in question, and several typical flow patterns have been explicitly computed in order to illustrate the theory. The paper concludes with a discussion of the relation between the theoretical solutions and observed phenomena near the point of contact of tornadoes with the ground; this requires that the flows under discussion be considered as mean motions in a turbulent flow with constant eddy viscosity. The present work adds theoretical weight to the argument that central downdrafts can occur in tornadoes. Moreover, the model provides an explanation, other than centrifugal action, for the frequent appearance of a cascade effect at the foot of both tornadoes and water-spouts; finally it offers a unified point of view from which to consider the diversity of flow patterns observed when vortex fields interact with a boundary surface.


Valid causal inference in observational studies often requires controlling for confounders. However, in practice measurements of confounders may be noisy, and can lead to biased estimates of causal effects. We show that we can reduce the bias caused by measurement noise using a large number of noisy measurements of the underlying confounders. We propose the use of matrix factorization to infer the confounders from noisy covariates, a flexible and principled framework that adapts to missing values, accommodates a wide variety of data types, and can augment many causal inference methods. We bound the error for the induced average treatment effect estimator and show it is consistent in a linear regression setting, using Exponential Family Matrix Completion preprocessing. We demonstrate the effectiveness of the proposed procedure in numerical experiments with both synthetic data and real clinical data.


Faced with global pressures and intensifying competition, `growth coalitions' in European cities respond with the construction of iconic consumption landscapes. In many cases, such efforts are questionable because they abide by unimaginative, mainstream planning concepts, resulting in an erosion of the idiosyncratic qualities of urban landscapes. The serial reproduction of cityscapes also extends to tourism development strategies, which fail to meet the increasing demand expressed by travellers for genuine and creative experiences. However, the `knowledge city' is populated with new actors producing alternative images and brands.Among these, academic and student communities are emerging as significant agents of urban regeneration. This article discusses the potential role students play as generators of landscapes of creativity, which develop as appealing spaces for cultural consumers, including `new cultural tourists'.The fluid,glocal geography of student activity may well be the epicentre of change for destinations now basing their product on an unreflexive relation between gazers and place,towards a more sustainable engagement of visitors in creative production and consumption. However, this process presents substantial challenges for policy and may be short-lived. Illustrations are provided from the case of Venice, Italy, a paradigmatic mass tourism destination where student-related activities are breathing new life into a clichéd tourism product.


ABSTRACT What is the relation between divine and human action in the world? To understand how a certain group of Christians reckon human capacity and divine authority, I explore articulations of two theological concepts – sin and sovereignty – as they played out in the concerns of a congregation of Baptists in Zimbabwe's capital city. This paper is situated within emerging conversations between anthropologists and theologians, and from my ethnographic case I argue that contemporary readings of Calvin and of Augustinian notions of original sin offer the anthropologist alternatives to the analytic category of 'agency'. Beliefs about the limits of human capacity and about God's control among urban Zimbabwean Baptists shape their engagement with the political realm, and their case contributes to ethnographic explorations of theological and political conceptions of sovereignty.


Work with sample surveys often makes extensive use of measures of size. Two prominent examples are the use of "probability proportional to size" sampling; and use of size measures in adjustment of survey weights through, e.g., ratio estimation, poststratification or calibration weighting. However, many survey applications use size variables that are imperfect approximations to the idealized size measures that would produce optimal efficiency results. This paper explores the effects that alternative size measures may have on the efficiency of some standard design-estimator pairs. Principal emphasis is placed on numerical results of a simulation study that uses size measures and economic variables available through the Quarterly Census of Employment and Wages of the Bureau of Labor Statistics.


The rati¯cation of ILO Labor Standards Conventions is a key explanatory variable in the empirical literature linking labor standards to economic performance. The assumption is that rati¯cation gives information on labor standards implemented in a country. This paper investigates the determinants of rati¯cation directly and, indirectly, the determinants of labor standards. We ¯nd considerable variation across di®erent Conventions, and across developing and developed countries. But there are some systematic and interesting patterns. While economic variables such as real per capita income do not explain rati¯cation, legal systems do. Most interestingly, for some Conventions, even after controlling for basic economic characteristics and domestic legal institutions, we ¯nd that peer e®ects are in play { the probability of adopting an international standard depends on how many other countries in a peer group have already adopted that standard.


Polymyxa spp. are obligate biotrophs belonging to the plasmodiophorid group, responsible for transmitting a large number of plant viruses to many crop species. Their obligate nature makes them difficult to study. Controlled environment experiments were used to investigate the potential of infection of Arabidopsis thaliana by Polymyxa spp. to provide a more tractable system. Two ecotypes of Arabidopsis, Columbia and Landsberg erecta, were grown in soils known to be infested with Polymyxa. At the end of a 2-month growth period, both ecotypes were found to harbour Polymyxa-like structures or spores. These findings were confirmed by Polymyxa-specific PCR tests and rDNA sequencing, which positively identified the presence of Polymyxa in the roots of both ecotypes of Arabidopsis. Both Polymyxa graminis and Polymyxa betae were identified. This is the first report of infection of Arabidopsis by Polymyxa spp. and shows the possibility of using this system for studies of infection biology and host-parasite interactions.


Consumers who have suffered as a result of a product defect can claim compensation from the producer. By placing a product recall notice, producers can reduce their liability. Ideally, such a notice should protect the image of the company as well as warn consumers. The problem is that a clear warning may damage the image of the company that placed the notice. This study reports on experiments carried out among 128 female shoppers to gain insight into how a recall notice should be worded in order to protect the company's image and, yet to be clear. Split-run tests were carried out to determine whether Minimisation (minimising the danger of the defect) and Bolstering (stressing the company's good traits) contributed positively to the image of the company and whether inclusion of pictures, a list format, a reader-oriented approach, Minimisation, and Bolstering contrib- uted positively to the clarity of the notice. Likert scales were used to determine which heading drew most attention and through which channels consumers prefered to be informed about a product recall. According to our respondents, a recall notice including Minimisation strategies protects the company's image more than one without such strategies. A recall notice is consid- ered clearer when it includes a picture, when it contains elements to highlight the structure of the information, and when it does not include Bolstering. According to our respondents, the most attention-grabbing heading is 'Waarschuwing' warning), and they prefer to be informed about product recalls through newspapers and television.


Ground level ozone is one of the six criteria primary pollutants that is monitored by the United States Environmental Protection Agency. Statistical methods are increasingly being used to model ground level ozone concentration data. This thesis is motivated by the need to perform practical data analysis, and to develop methods for modelling of ozone concentration data observed over a vast study region in the eastern United States (US. For the purposes of analysis, we use two space-time modelling strategies: the dynamic linear models (DLM) and the auto-regressive (AR) models and obtain predictions and forecasts for set aside validation data. These methods are developed under the Bayesian paradigm and MCMC sampling techniques are used to explore the posterior and predictive distributions. Particularly, for analysis, we use a subset data set from the state of New York to illustrate the methods. Both the DLM and AR modelling approaches are compared in detail using the predictive and forecast distributions induced by them. The comparisons are facilitated by a number of theoretical results. These show better properties for the AR models under some conditions, which have been shown to hold for the real life example that we considered. To address the challenge of modelling large dimensional spatio-temporal ozone concentration data, we adopt Gaussian predictive processes (GPP) technique and propose a rich hierarchical spatio-temporal AR model. The important utility of this method lies in the ability to predict the primary ozone standard at any given location for the modelled period from 1997-2006 in the eastern US. Different sensitivity analyses are performed, and, in addition, hold-out data sets are used for model validation. Specifically, this new modelling approach has been illustrated for evaluating meteorologically adjusted trends in the primary ozone standard in the eastern US over the 10 year period. This helps in understanding spatial patterns and trends in ozone levels, which in turn will help in evaluating emission reduction policies that directly affect many industries. Forecasting of ozone levels is also an important problem in air pollution monitoring. We compare different spatio-temporal models for their forecasting abilities. The GPP based models provide the best forecast for set aside validation data. In addition, in this thesis we use computer simulation model output as an explanatory variable for modelling the observed ozone data. Thus, the proposed methods can also be seen as a spatio-temporal downscaler model for incorporating output from numerical models, where the grid-level output from numerical models is used as a covariate in the point level model for observed data. This type of space and time varying covariate information enriches the regression settings like the methods used in this thesis. Currently there is no package available that can fit space-time environmental data using Bayesian hierarchical spatio-temporal models. In this thesis we, therefore, develop a software package named spTimer in R. The spTimer package with its ability to fit, predict and forecast using a number of Bayesian hierarchical space-time models can be used for modelling a wide variety of large space-time environmental data. This package is built in C language to be computationally efficient. However, this C-code is hidden from the user and the methods can be implemented by anyone familiar with the R language. This thesis can be extended in several ways for example, for multivariate data, for non-Gaussian first stage data, and for data observed in environmental monitoring of stream networks.


We propose a hierarchical graph neural network (GNN) model that learns how to cluster a set of images into an unknown number of identities using a training set of images annotated with labels belonging to a disjoint set of identities. Our hierarchical GNN uses a novel approach to merge connected components predicted at each level of the hierarchy to form a new graph at the next level. Unlike fully unsupervised hierarchical clustering, the choice of grouping and complexity criteria stems naturally from supervision in the training set. The resulting method, Hi-LANDER, achieves an average of 49% improvement in F-score and 7% increase in Normalized Mutual Information (NMI) relative to current GNN-based clustering algorithms. Additionally, state-of-the-art GNN-based methods rely on separate models to predict linkage probabilities and node densities as intermediate steps of the clustering process. In contrast, our unified framework achieves a three-fold decrease in computational cost. Our training and inference code are released 1.


The diagenetic history of the Oolite Group from Pwll du to Blaen Onneu has been unravelled. Cement types, solution events, dolomitisation, concretions and other authigenic minerals are described.

The calcite cement crystals show chemical zonation through staining but cathodoluminescence (CL) has proved the most useful method for displaying internal features of calcite crystals. CL makes it possible to trace the growth of crystals and monitor changes in crystallographic form during growth. Seven cement zones are identified using stained specimens. Each zone has a characteristic luminescence. The age of these zones relative to the exposure of the top of the Oolite Group is established. Two distinct diagenetic areas are recognised on the basis of the distribution of the cement zones.
Area 1 : the Pwll-y-cwm and Blaen Onneu Oolites in the Clydach area, in which Zones 1, 2b and 6 are present,
Area 2 : the rest of the Oolite Group, in which Zones 2a, 3, 4, 5 and 6 are present.

It is possible to correlate the cement zones of Area 2 along the outcrop for a distance of 8 km and also with cements in the overlying Llanelly formation. Oolomitisation prevents correlation of cements in Area 1 over a distance of more than 1/2 km.

Using CL it is possible to identify solution surfaces, on a micron to millimetre scale, within the cements. four solution events are identified in Area 2. Solution affects that are previously unreported are described. The presence of solution surfaces is used to illustrate the constantly changing nature of the pore waters that have affected the Oolite Group.

Carbon and oxygen stable isotope analysis of allochems and cement zones highlights the distinction between Areas 1 and 2 and are used to try and identify the nature of the pore waters affecting the Oolite Group during its diagenesis. The carbon isotopic composition of the allochems and cements pre-dating the exposure of the top of the Oolite Group is related to their distance below the exposure surface at the top of the Oolite Group and thus seems to reflect meteoric alteration. The successive cement zones do not show a progressive trend in caroon and oxygen values; however, in different samples successive cement zones do show the same pattern of changes in carbon and oxygen values. The values typical of a specific cement zone are thought to relate to the pore fluids from which it was precipitated. The pattern of changes seen in successive cement zones is explained in terms of changing pore water chemistry and isotopic composition with time. These changes occurred over an area at least the size of the study area. Very light oxygen values in veins are attributed to increased temperatures associated with deep burial.

An attempt is made to reconstruct the paleohydrology of the study area in an attempt to explain the nature and distribution of the cements.


The contamination of pasteurised fruit juice products by thermophilic acidophilic bacteria (TAB) has become a concern for producers. The aim of this study was to identify the bacteria present in South African fruit juices before and after pasteurisation, using polymerase chain reaction (PCR)-based denaturing gradient gel electrophoresis (DGGE). Alicyclobacillus acidoterrestris was found to be present in apple, pear, white grape and aloe vera juice. White grape juice was found to contain Alicyclobacillus pomorum, while two uncultured bacteria in the orange, apple, mango and pear juices were presumptively identified as members of the genus Bacillus, and one uncultured bacteria was identified as being closely related to Alcaligenes faecalis. The results emphasise the need for rapid and accurate detection of TAB in food products.


The type three-secretion system (T3SS) is a large and complex protein nano-machine
that many gram-negative pathogens employ to infect host cells. A key structure of this
machine is a proteinaceous pore that inserts into the target membrane and forms a
channel for bacterial toxins to flow from bacteria into the host cell. The pore is mainly
formed from two large membrane proteins called "translocators". Importantly,
effective secretion and thus pore formation of the translocators depends on their
binding to and being transported by small specialized chaperones after synthesis in the
bacterial cytosol. Recent crystal structures have shown these chaperones are formed
from modular tetratricopeptide repeats (TPRs). However, each crystal structure
produced different homodimeric structures, suggesting flexibility in their topology that
may be of importance to function.

Given the crucial role of the translocator chaperones, we investigated the
conformational stability of the chaperone LcrH (Yersinia pestis). Mutational analysis
coupled with analytical ultra-centrifugation and equilibrium chemical denaturations
showed that LcrH is a weak and thermodynamically unstable dimer (KD ≈ 15 μM, ΔGH2O
= 7.4 kcalmol-1). The modular TPR structure of the dimer allows it to readily unfold in a
non-cooperative manner to a one-third unfolded dimeric intermediate (ΔGH2O = 1.7
kcalmol-1), before cooperatively unfolding to a monomeric denatured state (ΔGH2O =
5.7 kcalmol-1). Thus under physiological conditions the chaperone is able to populate
C-terminally unravelled partially folded states, whilst being held together by its dimeric
interface. Such ability suggests a "fly-casting" mechanism as a route to binding their far
larger translocator cargo.


Surveillance for possible breeding populations of the exotic Asian mosquito Aedes albopictus (Skuse) was undertaken in Durban near the premises of the two largest importers of used tyres from the Far East. Water-filled bamboo pots were exposed as ovitraps from December 1991 to May 1992. Aedes aegypti (Linnaeus) was most prevalent, occurring in 2S-S2 % of pots at 0.14-0.60 mosquitoes/pot/day. Culex quinquefasciatus Say was found in S-24 % of pots at 0.0s-D.36 mosquitoes/pot/day. Three other species occurred sporadically. No Ae. Albopictus were collected, suggesting that this species has not become established in Durban.


The current technological era has largely influenced the development of learning environments. As a result, there are new opportunities for teaching, learning and assessment. The emergence of Massive Open Online Courses (MOOCs) in particular, has attracted the attention of higher education institutions and course designers. MOOCs may provide the opportunity to thousands of students to learn from anywhere and at their convenience. Assessment is a component of the learning environment that drives student learning. However, only a small proportion of existing literature on assessment investigates its use for the enhancement of educational growth as most of the literature is concerned with how to use assessment for purposes of grading and ranking (Rowntree, 1987). Assessment has a double role in learning by both motivating students to study in order to undertake it, but also providing the necessary feedback on their performance so that students can track their learning progress (Rowntree, 1987).

Research in MOOCs is currently growing, focusing on different aspects such as the "questionable course quality, high dropout rate, unavailable course credits, complex copyright, limited hardware and ineffective assessments" (Chen, 2014). Assessment in MOOCs has been mostly investigated from a perspective that is looking at: how the grading load can be diminished by adopting automated techniques, the aims of each technique, and finally new potential approaches that will be able to assess high-level cognition. Summing up, researchers are currently testing tools that will be automatically scoring essays and giving feedback to learners in an effective way (see Balfour, 2013). However, the learners' voice and standpoint about the different assessment types in the MOOCs context is inconclusive in the current literature and there is need for more research.

This study explores learners' views on assessment types in Massive Open Online Courses, whether any of these has an impact on their enrolment and completion of a course and in what aspects each type of assessment is effective in supporting their learning experience. Auto-assessment, peer-assessment and self-assessment are the types under investigation as they are frequently used in MOOCs and therefore are the most commonly discussed in literature (see Balfour, 2013, Suen, 2013, Wilkowski et al, 2014). The study draws upon literature on assessment in general and on assessment in MOOCs in particular. The concept of online communities, i.e. the learners that appear in MOOCs will also be discussed in detail.

Online ethnographic approaches are employed to explore the issue in question by using online interviewing and observation methods. Thematic analysis is carried out using a sample of 12 MOOCs participants from online interviews and 13 posts of online observations. The outcome of this qualitative research study reveals that even though participants identify benefits in peer assessment, there is a preference for automated assessment since it is an already known, clear type of assessment for them. Moreover, self-assessment is not popular by participants. Learners' comments also reveal that a clear guidance for assessment helps them to carry out peer assessment more effectively. Some learners also consider that the combination of assessment types may also have a positive effect on students' learning as each of them serves a different purpose.


A controlled experiment was performed to explore the contribution of waterborne radon to home air quality and the effect of radon removal from a centralized water system on indoor radon levels in three communities with widely disparate waterborne radon contamination levels. In community A, the contribution of waterborne radon to indoor air radon is small relative to those coming from sort gas and other sources. Thus, the water treatment system for radon removal had little effect on indoor air radon. This may lead residents to have a false sense of safety due to the installation of a water treatment system. In community B, average pretreatment indoor air radon concentrations are low. The small difference in pre- and post-treatment concentrations indicates a small contribution of waterborne radon. In community C, a relatively large reduction of indoor air radon between pre-and post-treatment measurements indicates a large contribution of waterborne radon and the effectiveness of a water treatment system. The effect of reducing waterborne radon on indoor air radon concentrations has been found to be a reduction of 1.3×10 -4 pCi/L of indoor air radon for every reduction of 1 pCi/L of waterborne radon.


Collaborative Filtering (CF) algorithms, used to build web-based recommender systems, are often evaluated in terms of how accurately they predict user ratings. However, current evaluation techniques disregard the fact that users continue to rate items over time: the temporal characteristics of the system's top-N recommendations are not investigated. In particular, there is no means of measuring the extent that the same items are being recommended to users over and over again. In this work, we show that temporal diversity is an important facet of recommender systems, by showing how CF data changes over time and performing a user survey. We then evaluate three CF algorithms from the point of view of the diversity in the sequence of recommendation lists they produce over time. We examine how a number of characteristics of user rating patterns (including profile size and time between rating) affect diversity. We then propose and evaluate set methods that maximise temporal recommendation diversity without extensively penalising accuracy.


A late Palaeoproterozoic unconformity surface developed on low-dipping sandstone in the Kimberley region, northwestern Australia, exhibits numerous linear, parallel grooves 10–50 mm deep, 40–80 mm wide and tens of metres long, and other erosional forms including sichelwannen. These features are interpreted as Nye channels and sculpted forms eroded by subglacial meltwaters. Sandstone-filled cracks exposed at the unconformity are viewed as periglacial frost fissures. An overlying conglomerate facies 1–15 m thick at the base of the c. 1800 Ma King Leopold Sandstone, Kimberley Basin succession, contains poorly sorted, pebble to boulder conglomerate and is interpreted as glaciofluvial in origin. The orientation of the Nye channels and sculpted forms and the palaeocurrent direction for the glaciofluvial deposits indicate westward ice flow. The conformably following, locally glauconitic quartzarenite of the King Leopold Sandstone probably accumulated in an epeiric sea, implying that glaciation reached close to sea level. Transgression in northwestern and central Australia at c. 1800 Ma may have been partly glacio-eustatic. Glaciation was initiated to the east of the Kimberley Basin, evidently in the Halls Creek Orogen, during a major phase of continental collision in Australia and worldwide supercontinental assembly. Recognition of the King Leopold glaciation, which occurred in low palaeolatitudes (<20°), shortens by 400 million years the claimed non-glacial interval between c. 2200 and 800 Ma.


Abstract Although the benefits of trust are well documented across a variety of settings, little empirical attention has been dedicated to trust in carceral settings, particularly among incarcerated women. Knowing how individuals in prison establish relationships of trust with one another is crucial for understanding how individuals adjust to conditions of confinement. Using data from 133 incarcerated women in a Pennsylvania prison unit, this study adopts a network approach to examine the role of individual and structural determinants of trust using exponential random graph models. Findings provide weak support for the claim that individual determinants (e.g. age, religious affiliation) shape whether women are more likely to trust someone to support them during an argument or a dispute. Instead, our findings show that structural determinants are the primary drivers of trust relationships. Trust is deeply entwined with friendship relations among women who get along with each other. Our approach paves a new path for the examination of trust in correctional settings and other criminological contexts.


Chlorinated Aliphatic Hydrocarbons (CAHs) are widespread wastewater and groundwater contaminants and represent a real danger for human health and environment. This research is related to the biodegradation technologies to treat chlorinated hydrocarbons. In particular the study of this thesis is focused on chloroform cometabolism by a butane-grown aerobic pure culture (Rhodococcus aetherovorans BCP1) in continuous-flow biofilm reactors, which are used for in-situ and on-site treatments. The work was divided in two parts: in the first one an experimental study has been conducted in two packed-bed reactors (PBRs) for a period of 370 days; in the second one a fluid dynamics and kinetic model has been developed in order to simulate the experimental data concerning a previous study made in a 2-m continuous-flow sand-filled reactor. The goals of the first study were to obtain preliminary information on the feasibility of chloroform biodegradation by BCP1 under attached-cell conditions and to evaluate the applicability of the pulsed injection of growth substrate and oxygen to biofilm reactors. The pulsed feeding represents a tool to control the clogging and to ensure a long bioreactive zone. The operational conditions implemented in the PBRs allowed the attainment of a 4-fold increase of the ratio of chloroform degraded to substrate consumed, in comparison with the phase of continuous substrate supply. The second study was aimed at identifying guidelines for optimizing the oxygen/substrate supply schedule, developing a reliable model of chloroform cometabolism in porous media. The tested model led to a suitable interpretation of the experimental data as long as the ratio of CF degraded to butane consumed was ≤ 0.27 mgchloroform /mgbutane. A long-term simulation of the best-performing schedule of pulsed oxygen/substrate supply indicated the attainment of a steady state condition characterized by unsatisfactory bioremediation performances, evidencing the need for a further optimization of the pulsed injection technique.


Abstract. We present and examine a multi-sensor global compilation of mid-Holocene (MH) sea surface temperatures (SST), based on Mg/Ca and alkenone palaeothermometry and reconstructions obtained using planktonic foraminifera and organic-walled dinoflagellate cyst census counts. We assess the uncertainties originating from using different methodologies and evaluate the potential of MH SST reconstructions as a benchmark for climate-model simulations. The comparison between different analytical approaches (time frame, baseline climate) shows the choice of time window for the MH has a negligible effect on the reconstructed SST pattern, but the choice of baseline climate affects both the magnitude and spatial pattern of the reconstructed SSTs. Comparison of the SST reconstructions made using different sensors shows significant discrepancies at a regional scale, with uncertainties often exceeding the reconstructed SST anomaly. Apparent patterns in SST may largely be a reflection of the use of different sensors in different regions. Overall, the uncertainties associated with the SST reconstructions are generally larger than the MH anomalies. Thus, the SST data currently available cannot serve as a target for benchmarking model simulations. Further evaluations of potential subsurface and/or seasonal artifacts that may contribute to obscure the MH SST reconstructions are urgently needed to provide reliable benchmarks for model evaluations.


The mixing of confined liquids is a central yet challenging operation in miniaturized devices. Microfluidic mixing is usually achieved with passive mixers that are robust but poorly flexible, or active mixers that offer dynamic control but mainly rely on electrical or mechanical transducers, which increase the fragility, cost, and complexity of the device. Here, we describe the first remote and reversible control of microfluidic mixing triggered by a light illumination simply provided by an external LED illumination device. The approach is based on the light-induced generation of water microdroplets acting as reversible stirrers of two continuous oil phase flows containing samples to be mixed. We demonstrate many cycles of reversible photoinduced transitions between a nonmixing behavior and full homogenization of the two oil phases. The method is cheap, portable, and adaptable to many device configurations, thus constituting an essential brick for the generation of future all-optofluidic chip.


NY-ESO-1, a member of the cancer-testis family of antigens, is expressed in a subset of a broad range of different human tumor types. Patients with advanced NY-ESO-1-expressing tumors frequently develop humoral immunity to NY-ESO-1, and three HLA A2-restricted peptides were defined previously as targets for cytotoxic CD8(+) T cells in a melanoma patient with NY-ESO-1 antibody. The objectives of the present study were (i) to develop enzyme-linked immunospot (ELISPOT) and tetramer assays to measure CD8(+) T cell responses to NY-ESO-1, (ii) to determine the frequency of CD8(+) T cell responses to NY-ESO-1 in a series of HLA-A2 patients with NY-ESO-1 expressing tumors, (iii) to determine the relation between CD8(+) T cell and humoral immune responses to NY-ESO-1, and (iv) to compare results of NY-ESO-1 ELISPOT assays performed independently in two laboratories with T cells from the same patients. NY-ESO-1 ELISPOT and tetramer assays with excellent sensitivity, specificity, and reproducibility have been developed and found to correlate with cytotoxicity assays. CD8(+) T cell responses to HLA-A2-restricted NY-ESO-1 peptides were detected in 10 of 11 patients with NY-ESO-1 antibody, but not in patients lacking antibody or in patients with NY-ESO-1-negative tumors. The results of ELISPOT assays were concordant in the two laboratories, providing the basis for standardized monitoring of T cell responses in patients receiving NY-ESO-1 vaccines.


Hybrid models are those containing continuous and discontinuous behaviour. In constructing dynamic systems models, it is frequently desirable to abstract rapidly changing, highly nonlinear behaviour to a discontinuity. Bond graphs lend themselves to systems modelling by being multi-disciplinary and reflecting the physics of the system. One advantage is that they can produce a mathematical model in a form that simulates quickly and efficiently. Hybrid bond graphs are a logical development which could further improve speed and efficiency. A range of hybrid bond graph forms have been proposed which are suitable for either simulation or further analysis, but not both. None have reached common usage.

A Hybrid bond graph method is proposed here which is suitable for simulation as well as providing engineering insight through analysis. This new method features a distinction between structural and parametric switching. The controlled junction is used for the former, and gives rise to dynamic causality. A controlled element is developed for the latter. Dynamic causality is unconstrained so as to aid insight, and a new notation is proposed.

The junction structure matrix for the hybrid bond graph features Boolean terms to reflect the controlled junctions in the graph structure. This hybrid JSM is used to generate a mixed-Boolean state equation. When storage elements are in dynamic causality, the resulting system equation is implicit.

The focus of this thesis is the exploitation of the model. The implicit form enables application of matrix-rank criteria from control theory, and control properties can be seen in the structure and causal assignment. An impulsive mode may occur when storage elements are in dynamic causality, but otherwise there are no energy losses associated with commutation because this method dictates the way discontinuities are abstracted.

The main contribution is therefore a Hybrid Bond Graph which reflects the physics of commutating systems and offers engineering insight through the choice of controlled elements and dynamic causality. It generates a unique, implicit, mixed-Boolean system equation, describing all modes of operation. This form is suitable for both simulation and analysis.


Evidence about cost-effectiveness is increasingly being used to inform decisions about the funding of new technologies that are usually implemented as guidelines from centralized decision-making bodies. However, there is also an increasing recognition for the role of patients in determining their preferred treatment option. This paper presents a method to estimate the value of implementing a choice-based decision process using the cost-effectiveness analysis toolbox. This value is estimated for 3 alternative scenarios. First, it compares centralized decisions, based on population average cost-effectiveness, against a decision process based on patient choice. Second, it compares centralized decision based on patients' subgroups versus an individual choice-based decision process. Third, it compares a centralized process based on average cost-effectiveness against a choice-based process where patients choose according to a different measure of outcome to that used by the centralized decision maker. The methods are applied to a case study for the management of acute coronary syndrome. It is concluded that implementing a choice-based process of treatment allocation may be an option in collectively funded health systems. However, its value will depend on the specific health problem and the social values considered relevant to the health system.